Change in Coronary Blood Flow After Percutaneous Coronary Intervention in Relation to Baseline Lesion Physiology Results of the JUSTIFY-PCI Study

PubMed Central

Nijjer, Sukhjinder S.; Petraco, Ricardo; van de Hoef, Tim P.; Sen, Sayan; van Lavieren, Martijn A.; Foale, Rodney A.; Meuwissen, Martijn; Broyd, Christopher; Echavarria-Pinto, Mauro; Al-Lamee, Rasha; Foin, Nicolas; Sethi, Amarjit; Malik, Iqbal S.; Mikhail, Ghada W.; Hughes, Alun D.; Mayet, Jamil; Francis, Darrel P.; Di Mario, Carlo; Escaned, Javier; Piek, Jan J.; Davies, Justin E.

2016-01-01

Background Percutaneous coronary intervention (PCI) aims to increase coronary blood flow by relieving epicardial obstruction. However, no study has objectively confirmed this and assessed changes in flow over different phases of the cardiac cycle. We quantified the change in resting and hyperemic flow velocity after PCI in stenoses defined physiologically by fractional flow reserve and other parameters. Methods and Results Seventy-five stenoses (67 patients) underwent paired flow velocity assessment before and after PCI. Flow velocity was measured over the whole cardiac cycle and the wave-free period. Mean fractional flow reserve was 0.68±0.02. Pre-PCI, hyperemic flow velocity is diminished in stenoses classed as physiologically significant compared with those classed nonsignificant (P<0.001). In significant stenoses, flow velocity over the resting wave-free period and hyperemic flow velocity did not differ statistically. After PCI, resting flow velocity over the wave-free period increased little (5.6±1.6 cm/s) and significantly less than hyperemic flow velocity (21.2±3 cm/s; P<0.01). The greatest increase in hyperemic flow velocity was observed when treating stenoses below physiological cut points; treating stenoses with fractional flow reserve ≤0.80 gained Δ28.5±3.8 cm/s, whereas those fractional flow reserve >0.80 had a significantly smaller gain (Δ4.6±2.3 cm/s; P<0.001). The change in pressure-only physiological indices demonstrated a curvilinear relationship to the change in hyperemic flow velocity but was flat for resting flow velocity. Conclusions Pre-PCI physiology is strongly associated with post-PCI increase in hyperemic coronary flow velocity. Hyperemic flow velocity increases 6-fold more when stenoses classed as physiologically significant undergo PCI than when nonsignificant stenoses are treated. Resting flow velocity measured over the wave-free period changes at least 4-fold less than hyperemic flow velocity after PCI. PMID:26025217

Change in coronary blood flow after percutaneous coronary intervention in relation to baseline lesion physiology: results of the JUSTIFY-PCI study.

PubMed

Nijjer, Sukhjinder S; Petraco, Ricardo; van de Hoef, Tim P; Sen, Sayan; van Lavieren, Martijn A; Foale, Rodney A; Meuwissen, Martijn; Broyd, Christopher; Echavarria-Pinto, Mauro; Al-Lamee, Rasha; Foin, Nicolas; Sethi, Amarjit; Malik, Iqbal S; Mikhail, Ghada W; Hughes, Alun D; Mayet, Jamil; Francis, Darrel P; Di Mario, Carlo; Escaned, Javier; Piek, Jan J; Davies, Justin E

2015-06-01

Percutaneous coronary intervention (PCI) aims to increase coronary blood flow by relieving epicardial obstruction. However, no study has objectively confirmed this and assessed changes in flow over different phases of the cardiac cycle. We quantified the change in resting and hyperemic flow velocity after PCI in stenoses defined physiologically by fractional flow reserve and other parameters. Seventy-five stenoses (67 patients) underwent paired flow velocity assessment before and after PCI. Flow velocity was measured over the whole cardiac cycle and the wave-free period. Mean fractional flow reserve was 0.68±0.02. Pre-PCI, hyperemic flow velocity is diminished in stenoses classed as physiologically significant compared with those classed nonsignificant (P<0.001). In significant stenoses, flow velocity over the resting wave-free period and hyperemic flow velocity did not differ statistically. After PCI, resting flow velocity over the wave-free period increased little (5.6±1.6 cm/s) and significantly less than hyperemic flow velocity (21.2±3 cm/s; P<0.01). The greatest increase in hyperemic flow velocity was observed when treating stenoses below physiological cut points; treating stenoses with fractional flow reserve ≤0.80 gained Δ28.5±3.8 cm/s, whereas those fractional flow reserve >0.80 had a significantly smaller gain (Δ4.6±2.3 cm/s; P<0.001). The change in pressure-only physiological indices demonstrated a curvilinear relationship to the change in hyperemic flow velocity but was flat for resting flow velocity. Pre-PCI physiology is strongly associated with post-PCI increase in hyperemic coronary flow velocity. Hyperemic flow velocity increases 6-fold more when stenoses classed as physiologically significant undergo PCI than when nonsignificant stenoses are treated. Resting flow velocity measured over the wave-free period changes at least 4-fold less than hyperemic flow velocity after PCI. © 2015 American Heart Association, Inc.

Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts

PubMed Central

Wehrschuetz, M.; Wehrschuetz, E.; Schuchlenz, H.; Schaffler, G.

2010-01-01

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a k-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations. PMID:20567636

Right ventricular stress-induced perfusion defects and late gadolinium enhancement in coronary artery disease.

PubMed

Milks, Michael Wesley; Upadhya, Bharathi; Hall, Michael E; Vasu, Sujethra; Hundley, William Gregory; Stacey, Richard Brandon

2015-01-01

The assessment of right ventricular (RV) perfusion defects has remained challenging during vasodilator stress perfusion with cardiovascular magnetic resonance (CMR). The significance of RV signal abnormalities during vasodilator stress perfusion and late gadolinium-enhanced CMR is yet uncertain. Among 61 individuals who underwent adenosine CMR stress testing before cardiac catheterization, we assessed the severity of coronary artery stenoses, mortality, the presence of stress and rest perfusion defects, as well as the presence of late gadolinium enhancement (LGE). Right ventricular stress-induced perfusion defects were positively associated with left anterior descending artery and proximal right coronary artery stenoses but were negatively associated with left circumflex artery stenoses. The presence of RVLGE was associated with mortality, but 77% of those with RVLGE also had left ventricular LGE. Proximal right coronary artery and left anterior descending artery stenoses are positively associated, whereas left circumflex artery stenoses are negatively associated with RV stress-induced perfusion defects. Right ventricular LGE was associated with mortality, but further study is needed to determine whether this is independent of left ventricular LGE.

[Interventional catheter treatment of bypass graft stenosis: comparison of intracoronary stent implantation and balloon angioplasty].

PubMed

Heidland, U E; Heintzen, M P; Schoppmann, D; Michel, C J; Strauer, B E

2000-02-25

Balloon angioplasty of a stenosed bypass graft has a much higher risk of recurrent stenosis than dilatation of a stenosed native coronary artery. Intracoronary stent implantation has established itself as the better treatment of native coronary artery stenosis than conventional balloon angioplasty. However, there is still uncertainty whether intracoronary stent implantation in stenosed bypass vessels gives better long-term results than conventional balloon angioplasty. Results were retrospectively analyzed of unrandomized 224 primarily successful interventions--122 balloon dilatations and 102 stent implantations--performed between January 1996 and June 1998 on stenosed coronary bypass grafts, re-examined by coronary angiography an average of 6 months later. All but 11 patients were on combined aspirin and ticlopidine antiplatelet aggregation treatment. There was a significantly lower 6-month restenosis rate (30.4%) after stent implantation than after balloon dilatation (51.6%). The re-intervention rate was also significantly lower after stent implantation. These data suggest that stent implantation of stenosed coronary bypass grafts under cover of platelet-aggregation inhibition with aspirin and ticlopidine provides a lower restenosis and thus higher revascularization rate than conventional balloon dilatation.

Flow of Red Blood Cells in Stenosed Microvessels.

PubMed

Vahidkhah, Koohyar; Balogh, Peter; Bagchi, Prosenjit

2016-06-20

A computational study is presented on the flow of deformable red blood cells in stenosed microvessels. It is observed that the Fahraeus-Lindqvist effect is significantly enhanced due to the presence of a stenosis. The apparent viscosity of blood is observed to increase by several folds when compared to non-stenosed vessels. An asymmetric distribution of the red blood cells, caused by geometric focusing in stenosed vessels, is observed to play a major role in the enhancement. The asymmetry in cell distribution also results in an asymmetry in average velocity and wall shear stress along the length of the stenosis. The discrete motion of the cells causes large time-dependent fluctuations in flow properties. The root-mean-square of flow rate fluctuations could be an order of magnitude higher than that in non-stenosed vessels. Several folds increase in Eulerian velocity fluctuation is also observed in the vicinity of the stenosis. Surprisingly, a transient flow reversal is observed upstream a stenosis but not downstream. The asymmetry and fluctuations in flow quantities and the flow reversal would not occur in absence of the cells. It is concluded that the flow physics and its physiological consequences are significantly different in micro- versus macrovascular stenosis.

Flow of Red Blood Cells in Stenosed Microvessels

NASA Astrophysics Data System (ADS)

Vahidkhah, Koohyar; Balogh, Peter; Bagchi, Prosenjit

2016-06-01

A computational study is presented on the flow of deformable red blood cells in stenosed microvessels. It is observed that the Fahraeus-Lindqvist effect is significantly enhanced due to the presence of a stenosis. The apparent viscosity of blood is observed to increase by several folds when compared to non-stenosed vessels. An asymmetric distribution of the red blood cells, caused by geometric focusing in stenosed vessels, is observed to play a major role in the enhancement. The asymmetry in cell distribution also results in an asymmetry in average velocity and wall shear stress along the length of the stenosis. The discrete motion of the cells causes large time-dependent fluctuations in flow properties. The root-mean-square of flow rate fluctuations could be an order of magnitude higher than that in non-stenosed vessels. Several folds increase in Eulerian velocity fluctuation is also observed in the vicinity of the stenosis. Surprisingly, a transient flow reversal is observed upstream a stenosis but not downstream. The asymmetry and fluctuations in flow quantities and the flow reversal would not occur in absence of the cells. It is concluded that the flow physics and its physiological consequences are significantly different in micro- versus macrovascular stenosis.

DNS of flow in stenosed carotid artery

NASA Astrophysics Data System (ADS)

Grinberg, Leopold; Yakhot, Alexander; Karniadakis, George

2006-11-01

Direct numerical simulation (DNS) of a three-dimensional flow through a stenosed carotid artery has been performed. Onset of turbulence downstream of the occlusion has been observed. The developing turbulence is characterized by an alternating spatio-temporal transitional regime. The transition to turbulence occurs during the systolic phase approximately five throat-diameters downstream of the throat, while laminarization occurs during the diastolic phase. Transition in space is first enhanced and subsequently decays downstream. The wall shear stress increases in the stenosed internal carotid artery due to the vessel occlusion and as the result of turbulence.

Management of benign stenoses of the large airways in the university hospital in Prague, Czech Republic, in 1998-2003.

PubMed

Marel, Miloslav; Pekarek, Zdenek; Spasova, Irena; Pafko, Pavel; Schutzner, Jan; Betka, Jan; Pospisil, Ronald

2005-01-01

Clinically significant benign stenoses of the large airways develop in about 1% of patients after intubation. The management of benign stenoses is not unified around the world, nor are there any accepted methods for their screening. The purpose of this study is to describe and compare results of interventional bronchoscopy and surgical therapy of benign stenoses as well as to propose an algorithm for the management of this airways disorder. Prospective study on 80 consecutive patients with benign stenoses of the large airways admitted to the Pulmonary Department of the University Hospital of Prague-Motol. Sixty-two patients developed stenoses after endotracheal intubation or tracheostomy, in 18 patients the stenosis was caused by other diseases or pathological situations. Thirty-eight patients were sent for surgical resection of the stenotic part of the airways. 2 surgically treated patients developed recurrence of the stenosis and had to be reoperated on. Narrowing of the trachea at the site of end-to-end anastomosis developed in 6 other patients and was cured by interventional bronchoscopy. The remaining 42 patients were treated by interventional bronchoscopy (Nd-YAG laser, electrocautery, stent) which was curative in 35 patients. Sixty-five patients were alive at the time of evaluation, 15 patients died. Five of them died between 3 and 14 (median 4) months after surgery from a disease other than airway stenosis. Ten nonresected patients also died, with 1 exception, due to a disease other than airway stenosis; the median survival was 9 months. We recommend to assess the patient for surgery after the initial diagnosis and therapeutic bronchoscopy with dilatation of the stenosis. If the patient is not a suitable candidate for resection, interventional bronchoscopy is an appropriate alternative for the management of benign stenoses of the large airways. Copyright (c) 2005 S. Karger AG, Basel.

Ultrasound-Guided Angioplasty of Dysfunctional Vascular Access for Haemodialysis. The Pros and Cons

DOE Office of Scientific and Technical Information (OSTI.GOV)

García-Medina, J., E-mail: josegmedina57@gmail.com; García-Alfonso, J. J., E-mail: juanjozarandieta@gmail.com

PurposeTo describe the benefits and the disadvantages of angioplasty in dialysis fistulas using only ultrasound guidance.Materials and MethodsThis is a prospective study in 132 failing or non-maturing arteriovenous accesses that underwent 189 ultrasound-guided balloon angioplasties. The technical success was defined as non-use of X-ray fluoroscopy during the procedure.Results127 procedures (67%) were successfully completed without fluoroscopy. Most failures were due to difficulty to traverse aneurismal segments, as well as anastomotic stenoses. Including initial failures, the primary patency rates at 6, 12 months and 2 years were 75 ± 3, 41 ± 3 and 14 ± 2%, respectively.ConclusionEndovascular repair of the dysfunctional vascular access for haemodialysis under ultrasound guidance ismore » feasible and safe in roughly two-thirds of cases.« less

Endovascular interventions of juxtaanastomotic stenoses and thromboses of hemodialysis arteriovenous fistulas.

PubMed

Cohen, Aenov; Korzets, Asher; Neyman, Haim; Ori, Yaakov; Baytner, Shlomo; Belenky, Alexander; Knieznik, Michael; Bachar, Gil N; Atar, Eli

2009-01-01

To assess the primary and secondary patency rates for juxtaanastomotic stenoses, with or without superimposed thromboses, of arteriovenous hemodialysis fistulas treated with angioplasty and to compare it with National Kidney Foundation Dialysis Outcomes Quality Initiative treatment guidelines for stenosed and occluded arteriovenous fistulas (50% primary patency rate at 12 months). This study was a retrospective analysis, covering a period of 5(1/2) years. Forty-three hemodialysis patients were referred due to secondary fistula dysfunction, and angiography was diagnostic of a juxtaanastomotic lesion. Interventions consisted of standard angioplasty techniques along with thrombolysis and/or thrombectomy and intravascular stent placement as needed. Follow-up was performed at the attending dialysis center, and repeat angiography was performed as clinically required. Immediate postprocedural angiography demonstrated an angiographic success rate of 98%. Clinical success, with at least one session of normal dialysis, occurred in 95% of interventions. Primary patency rates at 12 months for the stenosed and stenosed/thrombosed fistulas were 56% and 64%, respectively. Secondary patency rates at 12 months were 64% and 63%, respectively. Half of the stenosed fistulas were patent at 1.5 years, 28% were patent at 4 years, and 13% remained patent at 6 years. No major complications were documented. Four minor complications, which did not require therapy, were noted. The results achieved are comparable to those reported for interventions at nonjuxtaanastomotic sites and exceed those quoted by the National Kidney Foundation Dialysis Outcomes Quality Initiative guidelines. Angioplastic interventions in a juxtaanastomatic area of arteriovenous fistulas are safe, promote prolonged patency, and postpone the need for surgical intervention or creation of a new fistula.

The diagnosis of aortoiliac disease. A noninvasive femoral cuff technique.

PubMed Central

Barringer, M; Poole, G V; Shircliffe, A C; Meredith, J W; Hightower, F; Plonk, G W

1983-01-01

An inexpensive femoral "cuff" developed in this noninvasive vascular laboratory allows pulse volume recordings and systolic pressure measurements of the femoral arteries. Using the parameters 1) femoral/brachial systolic pressure ratio, 2) wave amplitude, and 3) status of the dicrotic notch for assessment of results, it was found that the cuff correctly identified 59 of 62 limbs with at least 50% aortoiliac stenosis, with only two false-positive results, for an accuracy of 97%. The high, wide thigh cuff identified 57 of the 62 limbs, but had 45 false-positive results (77% accuracy). Use of the femoral "cuff" has refined the ability to identify the anatomic location of significant arterial stenoses in the lower extremities. Images Fig. 1. Fig. 2. PMID:6824373

Acute myocardial infarction during l-thyroxine therapy in a patient with intermittent changing axis deviation, permanent atrial fibrillation and without significant coronary stenoses.

PubMed

Patanè, Salvatore; Marte, Filippo

2010-01-07

It has been rarely reported intermittent changing axis deviation also occurs during atrial fibrillation. Intermittent changing axis deviation during acute myocardial infarction and changing axis deviation associated with atrial fibrillation and acute myocardial infarction too have been also rarely reported. It has also been reported acute myocardial infarction during l-thyroxine substitution therapy in a patient with elevated levels of free triiodothyronine and without significant coronary artery stenoses. An acute myocardial infarction due to coronary spasm associated with l-thyroxine therapy has also been reported too. We present a case of changing axis deviation during acute myocardial infarction in a 56-year-old Italian woman with permanent atrial fibrillation and l-thyroxine therapy and without significant coronary stenoses. Also this case focuses attention on changing axis deviation in the presence of atrial fibrillation during acute myocardial infarction and on the possible development of acute myocardial infarction without significant coronary stenoses associated with l-thyroxine therapy.

Efficacy of stent angioplasty for symptomatic stenoses of the proximal vertebral artery.

PubMed

Weber, W; Mayer, T E; Henkes, H; Kis, B; Hamann, G F; Holtmannspoetter, M; Brueckmann, H; Kuehne, D

2005-11-01

To evaluate the safety and efficacy of stent angioplasty in the treatment of symptomatic arteriosclerotic stenoses of the proximal vertebral artery (VA). Thirty-eight symptomatic stenoses of the vertebral origin were treated with flexible balloon-expandable coronary stents. Angiographic and clinical follow-up examinations were obtained in 26 patients at a mean of 11 months. The immediate post-procedural angiographic results showed no residual stenosis in 33 vessels and mild residual stenoses in five vessels. Periprocedurally, there were two asymptomatic technical complications and one TIA. During follow-up re-stenosis could be detected in 10 cases (36%), and vessel occlusions in two patients. Two stents were broken. One of the restenosis caused a TIA within the follow-up period. Flexible balloon-expandable coronary stents proved to be save and effective in preventing vertebrobasilar stroke but were incapable to preserve the proximal vertebral artery lumen. For the VA origine an adequate stent, self-expanding, bioresorbable, or drug-eluting has to be found.

Analyzing Transient Turbuelnce in a Stenosed Carotid Artery by Proper Orthogonal Decomposition

NASA Astrophysics Data System (ADS)

Grinberg, Leopold; Yakhot, Alexander; Karniadakis, George

2009-11-01

High resolution 3D simulation (involving 100M degrees of freedom) were employed to study transient turbulent flow in a carotid arterial bifurcation with a stenosed internal carotid artery (ICA). In the performed simulation an intermittent (in space and time) laminar-turbulent-laminar regime was observed. The simulation reveals the mechanism of the onset of turbulent flow in the stenosed ICA where the narrowing in the artery generates a strong jet flow. Time- and space-window Proper Orthogonal Decomposition (POD) was applied to quantify the different flow regimes in the occluded artery. A simplified version of the POD analysis that utilizes 2D slices only - more appropriate in the clinical setting - was also investigated.

[The value of mobilization of the prostatic region via perineal approach in the treatment of ruptures and stenoses of the posterior urethra].

PubMed

L'Hermite, J; Chopin, G; Hubert, J; Six, A; Guillemin, P

1990-01-01

11 cases of end to end anastomosis associated with the mobilization of the prostate is reported. The authors use only the perineal access. The operation is utilised in two circumstances: injuries or traumatic strictures to the membranous urethra. 4 ruptured prostato-membranous urethras with 4 good results. 7 stenosis with 5 good results. 2 recurrences which one of them had a good result with a simple urethrotomy. Complication: no incontinence. 2 cases of impotence are noted. One of them had recovered, the other is secondary of the pelvic fracture. Follow up: mean 3 years (6 months-5 years). our experience suggest that the mobilization of the prostate is an excellent aid to end to end anastomosis. This technique permits the only perineal access.

Extra-anatomic bypass for recurrent abdominal aortic and renal in-stent stenoses following radiotherapy for neuroblastoma.

PubMed

Luehr, Maximilian; Siepe, Matthias; Beyersdorf, Friedhelm; Schlensak, Christian

2009-04-01

We describe the case of an 11-year-old girl with an abdominal neuroblastoma which was operated and intraoperatively irradiated nine years ago. After six years, she developed stenoses of the infrarenal abdominal aorta and both renal arteries. Initial treatment of the stenosed vessels comprised endovascular balloon dilatations and repeated stent-graft implantations, including drug eluting stents. However, severe in-stent stenoses occurred during follow-up and the girl developed acute renal failure. Open surgery was performed with two extra-anatomic bypasses, a thoracic-to-abdominal aortic bypass and a left iliac-to-renal bypass, on an urgent basis. The postoperative course was uneventful and the patient was discharged home two weeks after the operation with full recovery of renal function. We conclude that endovascular stent-graft placement in children can only be a palliative treatment due to outgrowing of the stent-graft and the potential risk of re-stenosis, especially after a history of irradiation. Vascular surgery with placement of extra-anatomic bypasses will provide a definite treatment.

Gianturco-Rösch Z stents in tracheobronchial stenoses.

PubMed

Petersen, B D; Uchida, B T; Barton, R E; Keller, F S; Rösch, J

1995-01-01

To evaluate expandable metallic Gianturco-Rösch Z (GRZ) stents for treatment of benign and malignant tracheobronchial stenoses. Six patients, ages 45-73 years, were treated for severe dyspnea with placement of GRZ stents. Three patients had benign tracheal lesions (one tracheomalacia, two postoperative) and received uncovered GRZ stents. Three patients had malignant stenoses at the level of the carina; one received an uncovered stent and the other two received silicone-covered GRZ stents. Two patients with benign lesions responded well to stent placement. One was asymptomatic for a year and then was lost to follow-up; the other improved substantially but died of end-stage lung disease 5 months after stent placement. A third patient with a benign high tracheal lesion did poorly; symptoms recurred secondary to inferior migration of a stent, which was removed surgically at 4 months. All patients with malignant lesions improved symptomatically after stent placement and remained without significant dyspnea until death (from 1 to 6 months). Expandable GRZ stents are promising devices for treatment of benign lesions and offer effective palliation of malignant tracheobronchial stenoses.

Learning-based automatic detection of severe coronary stenoses in CT angiographies

NASA Astrophysics Data System (ADS)

Melki, Imen; Cardon, Cyril; Gogin, Nicolas; Talbot, Hugues; Najman, Laurent

2014-03-01

3D cardiac computed tomography angiography (CCTA) is becoming a standard routine for non-invasive heart diseases diagnosis. Thanks to its high negative predictive value, CCTA is increasingly used to decide whether or not the patient should be considered for invasive angiography. However, an accurate assessment of cardiac lesions using this modality is still a time consuming task and needs a high degree of clinical expertise. Thus, providing automatic tool to assist clinicians during the diagnosis task is highly desirable. In this work, we propose a fully automatic approach for accurate severe cardiac stenoses detection. Our algorithm uses the Random Forest classi cation to detect stenotic areas. First, the classi er is trained on 18 CT cardiac exams with CTA reference standard. Then, then classi cation result is used to detect severe stenoses (with a narrowing degree higher than 50%) in a 30 cardiac CT exam database. Features that best captures the di erent stenoses con guration are extracted along the vessel centerlines at di erent scales. To ensure the accuracy against the vessel direction and scale changes, we extract features inside cylindrical patterns with variable directions and radii. Thus, we make sure that the ROIs contains only the vessel walls. The algorithm is evaluated using the Rotterdam Coronary Artery Stenoses Detection and Quantication Evaluation Framework. The evaluation is performed using reference standard quanti cations obtained from quantitative coronary angiography (QCA) and consensus reading of CTA. The obtained results show that we can reliably detect severe stenosis with a sensitivity of 64%.

Multicenter Evaluation Of Coronary Dual-Source CT angiography in patients with intermediate Risk of Coronary Artery Stenoses (MEDIC): study design and rationale.

PubMed

Marwan, Mohamed; Hausleiter, Jörg; Abbara, Suhny; Hoffmann, Udo; Becker, Christoph; Ovrehus, Kristian; Ropers, Dieter; Bathina, Ravi; Berman, Dan; Anders, Katharina; Uder, Michael; Meave, Aloha; Alexánderson, Erick; Achenbach, Stephan

2014-01-01

The diagnostic performance of multidetector row CT to detect coronary artery stenosis has been evaluated in numerous single-center studies, with only limited data from large cohorts with low-to-intermediate likelihood of coronary disease and in multicenter trials. The Multicenter Evaluation of Coronary Dual-Source CT Angiography in Patients with Intermediate Risk of Coronary Artery Stenoses (MEDIC) trial determines the accuracy of dual-source CT (DSCT) to identify persons with at least 1 coronary artery stenosis among patients with low-to-intermediate pretest likelihood of disease. The MEDIC trial was designed as a prospective, multicenter, international trial to evaluate the diagnostic performance of DSCT for the detection of coronary artery stenosis compared with invasive coronary angiography. The study includes 8 sites in Germany, India, Mexico, the United States, and Denmark. The study population comprises patients referred for a diagnostic coronary angiogram because of suspected coronary artery disease with an intermediate pretest likelihood as determined by sex, age, and symptoms. All evaluations are performed by blinded core laboratory readers. The primary outcome of the MEDIC trial is the accuracy of DSCT to identify the presence of coronary artery stenoses with a luminal diameter narrowing of 50% or more on a per-vessel basis. Secondary outcome parameters include per-patient and per-segment diagnostic accuracy for 50% stenoses and accuracy to identify stenoses of 70% or more. Furthermore, secondary outcome parameters include the influence of heart rate, Agatston score, body weight, body mass index, image quality, and diagnostic confidence on the accuracy to detect coronary artery stenoses >50% on a per-vessel basis. The results of the MEDIC trial will assess the clinical utility of coronary CT angiography in the evaluation of patients with intermediate pretest likelihood of coronary artery disease. Copyright © 2014 Society of Cardiovascular Computed Tomography. All rights reserved.

Mathematical modeling of power law and Herschel - Buckley non-Newtonian fluid of blood flow through a stenosed artery with permeable wall: Effects of slip velocity

NASA Astrophysics Data System (ADS)

Chitra, M.; Karthikeyan, D.

2018-04-01

A mathematical model of non-Newtonian blood flow through a stenosed artery is considered. The steadynon-Newtonian model is chosen characterized by the generalized power-law model and Herschel-Bulkley model incorporating the effect of slip velocity due to steanosed artery with permeable wall. The effects of slip velocity for non-Newtonian nature of blood on velocity, flow rate and wall shear stress of the stenosed artery with permeable wall are solved analytically. The effects of various parameters such as slip parameter (λ), power index (m) and different thickness of the stenosis (δ) on velocity, volumetric flow rate and wall shear stress are discussed through graphs.

[Optimization of organizational approaches to management of patients with atherosclerosis].

PubMed

Barbarash, L S; Barbarash, O L; Artamonova, G V; Sumin, A N

2014-01-01

Despite undoubted achievements of modern cardiology in prevention and treatment of atherosclerosis, cardiologists, neurologists, and vascular surgeons are still facing severe stenotic atherosclerotic lesions in different vascular regions, both symptomatic and asymptomatic. As a rule hemodynamically significant stenoses of different locations are found after development of acute vascular events. In this regard, active detection of arterial stenoses localized in different areas just at primary contact of patients presenting with symptoms of ischemia of various locations with care providers appears to be crucial. Further monitoring of these stenoses is also important. The article is dedicated to innovative organizational approaches to provision of healthcare to patients suffering from circulatory system diseases that have contributed to improvement of demographic situation in Kuzbass.

Incidence, treatment and outcome of rectal stenosis following transanal endoscopic microsurgery.

PubMed

Barker, J A; Hill, J

2011-09-01

As an alternative to more radical abdominal surgery, transanal endoscopic microsurgery (TEM) offers a minimally invasive solution for the excision of certain rectal polyps and early-stage rectal tumours. The patient benefits of TEM as compared to radical abdominal surgery are clear; nevertheless, some drawback is possible. The aim of our study was to determine the risk factors, treatment and outcomes of rectal stenosis following TEM. We analysed a series of 354 consecutive patients who underwent TEM for benign or malignant rectal tumours between 1997 and 2009. We recorded the maximum histological diameter of the lesion, and whether the lesion was circumferential. Rectal stenosis was defined as a rectal narrowing not allowing passage of a 12 mm sigmoidoscope. Histological results with a measured specimen diameter were available in 304 of the 354 cases. There were 11 stenoses in total (3.6%), 7 stenoses due to 9 circumferential lesions (78%) and 4 due to lesions with a maximum diameter ≥ 5 cm (3.2%). Two patients presented as emergencies, and the other 9 patients reported symptoms of increased stool frequency at follow-up. Three of the stenoses were associated with recurrent disease. All stenoses were treated by a combination of endoscopic/radiological balloon dilatation or surgically with Hegar's dilators. A median of two procedures were required to treat stenoses until resolution of symptoms. Rectal stenosis following TEM excision is rare. It is predictable in patients with circumferential lesions but is rare in patients with non-circumferential lesions with a maximum diameter ≥ 5 cm. It is effectively treated with surgical or balloon dilatation. Most patients require repeated treatments.

Normal stress-only myocardial single photon emission computed tomography predicts good outcome in patients with coronary artery stenoses between 40 and 70.

PubMed

Jiang, Zhixin; Liu, Yangqing; Xin, Chaofan; Zhou, Yanli; Wang, Cheng; Zhao, Zhongqiang; Li, Chunxiang; Li, Dianfu

2016-09-01

Normal stress myocardial single photon emission computed tomography (SPECT) usually indicates good physiologic function of all coronary lesions, and also indicates a good outcome. We hypothesize that it can still predict good outcome in patients with coronary stenoses between 40 and 70%. A group of patients who underwent stress myocardial SPECT after coronary angiography were consecutively recruited in our center. Patients were eligible if they had one or more coronary stenoses between 40 and 70%. Patients with coronary stenoses greater than 50% diameter of left main or greater than 70% diameter of nonleft main epicardial vessels, and left ventricular ejection fraction less than 50% were excluded. The outcome was defined as major adverse events, including cardiac death, nonfatal myocardial infarction, and revascularization. Patients' survival curves were constructed accorded to the method of Kaplan and Meier and compared using the log-rank test. A study cohort of 77 patients was enrolled. According to the summed stress score, 43 patients were assigned to the perfusion defect group and 34 patients were assigned to the perfusion normal group. The follow-up duration was 6.4±0.3 years. In the perfusion normal group, only one of 34 (2.9%) patients developed major adverse events. In the perfusion defect group, six of 43 (14%) developed major adverse events, P-value of 0.041. It is safe to defer a percutaneous coronary intervention in patients with coronary stenoses between 40 and 70% and normal stress myocardial SPECT.

Assessment of coronary artery stenosis pressure gradient by quantitative coronary arteriography in patients with coronary artery disease.

PubMed

Atar, D; Ramanujam, P S; Saunamäki, K; Haunsø, S

1994-01-01

The aim of the study described here was to correlate coronary artery (CA) stenosis pressure gradients calculated by quantitative coronary arteriography (QCA) to invasively measured transstenotic pressure drops in patients with anginal symptoms and with known or suspected coronary artery disease. Furthermore, the known mathematical models are improved by introducing (1) pressure catheter-corrected minimal stenosis area, (2) modification of flow assumptions, and (3) stenosis exit angle. Included in the study were 45 patients with 61 stenoses. The visually estimated CA lesion severity in these non-complex stenoses was in the equivocal range of 40-70%. All measurements were performed after intracoronary administration of nifedipine and nitroglycerin. Stenosis dimensions were assessed from magnified cinefilms, using hand-held calipers. Highly significant overall correlation was found between measured and calculated pressure gradients with correction for the impact of the intracoronary catheter (P < 0.00001, r = 0.84). In particular, a substantial number of stenoses with haemodynamically-insignificant pressure gradients were identified by hydrodynamic calculations. In conclusion, the great majority of the coronary artery stenoses could be classified reliably by QCA as being haemodynamically insignificant or significant, respectively.

Anastomotic stenoses occurring after circular stapling in esophageal cancer surgery.

PubMed

Petrin, G; Ruol, A; Battaglia, G; Buin, F; Merigliano, S; Constantini, M; Pavei, P; Cagol, M; Scappin, S; Ancona, E

2000-07-01

Circular staplers have reduced the incidence of anastomotic leaks in esophagovisceral anastomosis. However, the prevalence of stenosis is greater with staplers than with manual suturing. The aim of this study was to analyze potential risk factors for the onset of anastomotic stenoses and to evaluate their treatment and final outcome. Between 1990 and 1995, 187 patients underwent esophagectomy and esophagogastrostomy with anastomosis performed inside the chest using a circular stapler. Twenty-three patients (12.3%) developed an anastomotic stenosis. The incidence of strictures was inversely related to the diameter of the stapler. Concomitant cardiovascular diseases; morphofunctional disorders of the tubulized stomach, such as those related to duodenogastric reflux; and neoadjuvant chemotherapy were also recognized as significant risk factors. Endoscopic dilatations proved safe and were effective in the treatment of most anastomotic stenoses. To reduce the risk of anastomotic stenosis after stapled intrathoracic esophagogastrostomy, adequate vascularization of the viscera being anastomized should be maintained, and it is mandatory to use the largest circular stapler suitable. Furthermore, it is essential to reduce the negative inflammation-inducing effects of duodenogastroesophageal reflux to a minimum. Endoscopic dilatations are safe and effective in curing the great majority of anastomotic stenoses.

Heart imaging: the accuracy of the 64-MSCT in the detection of coronary artery disease.

PubMed

Alessandri, N; Di Matteo, A; Rondoni, G; Petrassi, M; Tufani, F; Ferrari, R; Laghi, A

2009-01-01

At present, coronary angiography represents the gold standard technique for the diagnosis of coronary artery disease. Our aim is to compare the conventional coronary angiography to the coronary 64-multislice spiral computed tomography (64-MSCT), a new and non-invasive cardiac imaging technique. The last generation of MSCT scanners show a better imaging quality, due to a greater spatial and temporal resolution. Four expert observers (two cardiologists and two radiologists) have compared the angiographic data with the accuracy of the 64-MSCT in the detection and evaluation of coronary vessels stenoses. From the data obtained, the sensibility, the specificity and the accuracy of the coronary 64-MSCT have been defined. We have enrolled 75 patients (57 male, 18 female, mean age 61.83 +/- 10.38; range 30-80 years) with known or suspected coronary artery disease. The above population has been divided into 3 groups: Group A (Gr. A) with 40 patients (mean age 60.7 +/- 12.5) affected by both non-significant and significant coronary artery disease; Group B (Gr. B) with 25 patients (mean age 60.3 +/- 14.6) who underwent to percutaneous coronary intervention (PCI); Group C (Gr. C) with 10 patients (mean age 54.20 +/- 13.7) without any coronary angiographic stenoses. All the patients underwent non-invasive exams, conventional coronary angiography and coronary 64-MSCT. The comparison of the data obtained has been carried out according to a per group analysis, per patient analysis and per segment analysis. Moreover, the accuracy of the 64-MSCT has been defined for the detection of >75%, 50-75% and <50% coronary stenoses. Coronary angiography has identified significant coronary artery disease in 75% of the patients in the Gr. A and in 73% of the patients in the Gr. B. No coronary stenoses have been detected in Gr. C. According to a per segment analysis, in Gr. A, 36% of the segments analysed have shown a coronary stenosis (37% stenoses >75%, 32% stenoses 50-75% and 31% stenoses <50%). In Gr. B, 32% of the segments have shown a coronary stenosis (33% stenoses >75%, 29% stenoses 50-75% and 38% stenoses <50%). In-stent disease has been shown in only 4 of the 29 coronary stents identified. In Gr. A, coronary 64-MSCT has confirmed the angiographic results in the 93% of cases (sensibility 93%, specificity 100%, positive predictive value 100% and negative predictive value 83%) while, in Gr. B, this confirm has been obtained only in 64% of cases (sensibility 64%, specificity 100%, positive predictive value 100% and negative predictive value 50%). In Gr. C, we have observed a complete agreement between angiographic and CT data (sensibility, specificity, positive predictive value and negative predictive value 100%). According to a per segment analysis, the angiographic results have been confirmed in 98% of cases in Gr. A (sensibility 98%, specificity 94%, positive predictive value 90% and negative predictive value 94%) but only in 55% of cases in Gr. B (sensibility 55%, specificity 90%, positive predictive value 71% and negative predictive value 81%). Moreover, only 1 of the 4 in-stent restenoses has been detected (sensibility 25%, specificity 100%, positive predictive value 100% and negative predictive value 77%). Coronary angiography has detected a greater number of coronary stenoses than the 64-MSCT. 64-MSCT has demonstrated better accuracy in the study of coronary vessels wider than 2 mm, while its accuracy is lower for smaller vessels (diameter < 2.5 mm) and for the identification of in-stent restenosis, because there is a reduced image quality for these vessels and therefore a lower accuracy in the coronary stenosis detection. Nevertheless, 64-MSCT shows high accuracy and it can be considered a comparative but not a substitutive exam of the coronary angiography. Several technical limitations of the 64-MSCT are responsible of its lower accuracy versus the conventional coronary angiography, but solving these technical problems could give us a new non-invasive imaging technique for the study of coronary stents.

Extracellular Vesicles in Bile as Markers of Malignant Biliary Stenoses.

PubMed

Severino, Valeria; Dumonceau, Jean-Marc; Delhaye, Myriam; Moll, Solange; Annessi-Ramseyer, Isabelle; Robin, Xavier; Frossard, Jean-Louis; Farina, Annarita

2017-08-01

Algorithms for diagnosis of malignant common bile duct (CBD) stenoses are complex and lack accuracy. Malignant tumors secrete large numbers of extracellular vesicles (EVs) into surrounding fluids; EVs might therefore serve as biomarkers for diagnosis. We investigated whether concentrations of EVs in bile could discriminate malignant from nonmalignant CBD stenoses. We collected bile and blood samples from 50 patients undergoing therapeutic endoscopic retrograde cholangiopancreatography at university hospitals in Europe for CBD stenosis of malignant (pancreatic cancer, n = 20 or cholangiocarcinoma, n = 5) or nonmalignant (chronic pancreatitis [CP], n = 15) origin. Ten patients with CBD obstruction due to biliary stones were included as controls. EV concentrations in samples were determined by nanoparticle tracking analyses. The discovery cohort comprised the first 10 patients with a diagnosis of pancreatic cancer, based on tissue analysis, and 10 consecutive controls. Using samples from these subjects, we identified a threshold concentration of bile EVs that could best discriminate between patients with pancreatic cancer from controls. We verified the diagnostic performance of bile EV concentration by analyzing samples from the 30 consecutive patients with a diagnosis of malignant (pancreatic cancer or cholangiocarcinoma, n = 15) or nonmalignant (CP, n = 15) CBD stenosis. Samples were compared using the Mann-Whitney test and nonparametric Spearman correlation analysis. Receiver operating characteristic area under the curve was used to determine diagnostic accuracy. In both cohorts, the median concentration of EVs was significantly higher in bile samples from patients with malignant CBD stenoses than controls or nonmalignant CBD stenoses (2.41 × 10 15 vs 1.60 × 10 14 nanoparticles/L in the discovery cohort; P < .0001 and 4.00 × 10 15 vs 1.26 × 10 14 nanoparticles/L in the verification cohort; P < .0001). A threshold of 9.46 × 10 14 nanoparticles/L in bile best distinguished patients with malignant CBD from controls in the discovery cohort. In the verification cohort, this threshold discriminated malignant from nonmalignant CBD stenoses with 100% accuracy. Serum concentration of EVs distinguished patients with malignant vs patients with nonmalignant CBD stenoses with 63.3% diagnostic accuracy. Concentration of EVs in bile samples discriminates between patients with malignant vs nonmalignant CBD stenosis with 100% accuracy. Further studies are needed to confirm these findings. Clinical Trial registration no: ISRCTN66835592. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Combined Endovascular Treatment with Distal Radial Artery Coil Embolization and Angioplasty in Steal Syndrome Associated with Forearm Dialysis Fistula.

PubMed

Tercan, Fahri; Koçyiğit, Ali; Güney, Bünyamin

2016-09-01

The present study was performed to define the results of the endovascular treatment with angioplasty and distal radial artery embolization in ischemic steal syndrome associated with forearm arteriovenous accesses. The cases referred to our interventional radiology unit with symptoms and physical examination findings suggestive of ischemic steal syndrome were retrospectively evaluated first by Doppler ultrasonography, and then by angiography. Cases with proximal artery stenosis were applied angioplasty, and those with steal syndrome underwent coil embolization to distal radial artery. Of 589 patients who underwent endovascular intervention for dialysis arteriovenous fistulae (AVF)-associated problems, 6 (1.01 %) (5 female, 1 males; mean age 62 (range 41-78) with forearm fistula underwent combined endovascular treatment for steal syndrome. In addition to steal phenomenon, there were stenosis and/or occlusion in proximal radial and/or ulnar artery in 6 patients concurrently. Embolization of distal radial artery and angioplasty to proximal arterial stenoses were performed in all patients. Ischemic symptoms were eliminated in all patients and the AVF were in use at the time of study. In one patient, ischemic symptoms recurring 6 months later were alleviated by repeat angioplasty of ulnar artery. In palmar arch steal syndrome affecting forearm fistulae, combined distal radial embolization and angioplasty is also an effective treatment method in the presence of proximal radial and ulnar arterial stenoses and occlusions.

Pulse patterning effect in optical pulse division multiplexing for flexible single wavelength multiple access optical network

NASA Astrophysics Data System (ADS)

Jung, Sun-Young; Kim, Chang-Hun; Han, Sang-Kook

2018-05-01

A demand for high spectral efficiency requires multiple access within a single wavelength, but the uplink signals are significantly degraded because of optical beat interference (OBI) in intensity modulation/direct detection system. An optical pulse division multiplexing (OPDM) technique was proposed that could effectively reduce the OBI via a simple method as long as near-orthogonality is satisfied, but the condition was strict, and thus, the number of multiplexing units was very limited. We propose pulse pattern enhanced OPDM (e-OPDM) to reduce the OBI and improve the flexibility in multiple access within a single wavelength. The performance of the e-OPDM and patterning effect are experimentally verified after 23-km single mode fiber transmission. By employing pulse patterning in OPDM, the tight requirement was relaxed by extending the optical delay dynamic range. This could support more number of access with reduced OBI, which could eventually enhance a multiple access function.

Numerical simulation of unsteady generalized Newtonian blood flow through differently shaped distensible arterial stenoses.

PubMed

Sarifuddin; Chakravarty, S; Mandal, P K; Layek, G C

2008-01-01

An updated numerical simulation of unsteady generalized Newtonian blood flow through differently shaped distensible arterial stenoses is developed. A shear-thinning fluid modelling the deformation dependent viscosity of blood is considered for the characterization of generalized Newtonian behaviour of blood. The arterial model is treated as two-dimensional and axisymmetric with an outline of the stenosis obtained from a three-dimensional casting of a mildly stenosed artery. The full Navier-Stokes equations governing blood flow are written in the dimensionless form and the solution is accomplished by finite time-step advancement through their finite difference staggered grid representations. The marker and cell (MAC) method comprising the use of a set of marker particles moving with the fluid is used for the purpose. Results are obtained for three differently shaped stenoses - irregular, smooth and cosine curve representations. The present results do agree well with those of existing investigations in the steady state, but contrary to their conclusions the present findings demonstrate that the excess pressure drop across the cosine and the smooth stenoses is caused by neither their smoothness nor their higher degree of symmetry relative to the irregular stenosis, but is rather an effect of area cover with respect to the irregular stenosis. This effect clearly prevails throughout the entire physiological range of Reynolds numbers. Further the in-depth study in flow patterns reveals the development of flow separation zones in the diverging part of the stenosis towards the arterial wall, and they are influenced by non-Newtonian blood rheology, distensibility of the wall and flow unsteadiness in order to validate the applicability of the present model.

Detection of benign hilar bile duct stenoses - A retrospective analysis in 250 patients with suspicion of Klatskin tumour.

PubMed

Scheuermann, Uwe; Widyaningsih, Rizky; Hoppe-Lotichius, Maria; Heise, Michael; Otto, Gerd

2016-06-01

The aim of this study was to identify clinical, laboratory and radiological parameters to distinguish benign from malignant stenoses of the proximal bile duct. Between 1997 and 2011, 250 patients were referred to our clinic with hilar bile duct stenoses suspicious for Klatskin tumour. Medical histories, clinical data, pre-interventional laboratory tests, imaging findings, as well as therapeutic approach and patient outcome were compared to final histological results. All data were retrieved from our prospectively maintained database and analysed retrospectively. We found benign bile duct lesions in 34 patients (13.6%). Among the entire study population, uni- and multivariate analyses of 18 clinicopathological parameters revealed that patient age, serum alkaline phosphatase, tumour marker CA19-9 and presence of tumour mass in computed tomography were independent predictors for malignant biliary stenoses (p < 0.05). Receiver operator characteristic curve showed that a CA19-9 serum level of 61.2 U/ml or more has a sensitivity, specificity and diagnostic accuracy for predicting the malignant nature of the hilar biliary stenoses of 74.6%, 80.0% and 83.5%, respectively. Surgical resection could be avoided by preoperative work-up and surgical exploration in 10 out of 34 patients with benign lesions. Rates of major liver resections performed were 66.7% in the benign lesion group and 90.7% in the Klatskin tumour group. Despite improvements of preoperative diagnostics, it remains difficult to differentiate between benign and malignant hilar bile duct stenosis. Even explorative laparotomy was not able to safely exclude Klatskin tumour in all cases and therefore major liver resection was inevitable.

Benign tracheobronchial stenoses: changes in short-term and long-term pulmonary function testing after expandable metallic stent placement.

PubMed

Gotway, Michael B; Golden, Jeffrey A; LaBerge, Jeanne M; Webb, W Richard; Reddy, Gautham P; Wilson, Mark W; Kerlan, Robert K; Gordon, Roy L

2002-01-01

To determine the short- and long-term improvement in airflow dynamics in patients undergoing tracheobronchial stent placement for benign airway stenoses. Twenty-two patients underwent 34 tracheal and/or bronchial stent placement procedures for benign airway stenoses and had the results of pulmonary function tests available. Stent placement indications included bronchomalacia after lung transplantation (n = 11), postintubation stenoses (n = 6), relapsing polychondritis (n = 2), and 1 each of tracheomalacia, tracheal compression, and histoplasmosis. Six patients underwent more than one stent placement procedure (range: 2-7 procedures). The mean forced expiratory volume in one second (FEV(1) ), forced expiratory flow rate in the midportion of the forced vital capacity curve (FEF(25-75) ), forced vital capacity, and peak flow (PF) rate obtained before stent placement were compared with those immediately after stent placement and with those measurements most remote from stent placement using the paired two-tailed test. All patients reported improved respiratory function immediately after stent placement. The mean FEV(1), FEF(25-75), and PF rate improved significantly (p < 0.001, p = 0.002, and p = 0.009, respectively) after stent placement. On long-term follow-up averaging 15 months after stent placement, these parameters declined despite patients' subjective sense of improvement. Segregating the population into transplant and nontransplant airway stenosis etiologies, however, FEF(25-75) and PF rate remained significantly improved (p = 0.045, p = 0.027, respectively), over the long term for the latter. FEV increased after subsequent stent placements for patients receiving multiple stents. Stent placement for benign tracheobronchial stenoses provides significant immediate improvement in airflow dynamics. Long-term improvement in airflow obstruction may be expected, and additional stent placements may further improve pulmonary function.

Angina Relief by Ranolazine Identifies False-Negative SPECT Myocardial Perfusion Scans in Patients with Coronary Disease Demonstrated by Coronary Angiography.

PubMed

Murray, Gary L

2014-09-01

Normal myocardial perfusion imaging (MPI) reduces intermediate- or high-risk pretest probability patients to low- or intermediate-risk posttest probability, respectively, for coronary disease (CD). Since ranolazine (RAN) relieves only angina, anginal patients with normal MPI whose angina is relieved by RAN present a significant dilemma. The purpose of this retrospective chart review was to confirm the impression that coronary angiography (CA) is indicated in patients whose class 3 to 4 angina is relieved by RAN, but have normal myocardial single-photon emission computed tomography (SPECT) MPIs. Charts of patients with stable class 3 to 4 angina (typical and atypical) and normal MPIs (left ventricular ejection fraction [LVEF] ≥50% and segmental score = 0) were reviewed. CA was done on all the patients with complete angina relief taking RAN, as well as nonresponders whose anginal etiology could not be explained. Stenoses were considered flow-restrictive when more than 70% diameter stenosis is observed by quantitative CA, or, when 50 to 70%, fractional flow reserve (FFR) measured ≤0.80. RAN relieved angina in 36 of 54 (67%) patients. Of the known cases, 25 of these 36 (69%) had 43 stenoses ≥50% (mean = 66%): 15 (60%) had 1 vessel disease; 9 (36%) had multivessel disease; 18 (72%) had left anterior descending (LAD) disease; 1 (4%) had left main disease. Twenty one of 43 (49%) stenosis were > 70%; 22 (51%) stenoses were 50 to 70% and required FFR measurement. Twenty nine of 43 stenoses (67%) were considered flow-restrictive in 18 of these 25 (72%) patients. Eight RAN nonresponders with no explanation for angina had no CD at CA. RAN angina relief is invaluable in identifying falsely negative SPECT MPI, and 50% of these patients have flow-restrictive stenoses.

[Late stage stenoses of bile ducts after iatrogenic bile duct injuries following cholecystectomy].

PubMed

Bektas, H; Winny, M; Schrem, H; Becker, T; Klempnauer, J

2007-12-01

Iatrogenic bile duct injuries represent a severe complication after cholecystectomy. For the attending physician therapy and management of these injuries are a challenge. Inadequate and delayed treatment can lead to stenoses at a late stage, which can necessitate further surgical intervention. In a study data of 74 patients, who were treated in our clinic for bile duct injuries following cholecystectomy, were analysed retrospectively. A total of 8 patients with late stage bile duct strictures following iatrogenic bile duct injury including the subsequent therapy could be identified. The data of these patients were analysed in respect of cause and strategies to prevent late stage stenoses. In 62 patients the bile duct injury occurred following laparoscopic and in 12 patients following open cholecystectomy. In 16 patients the injury was combined with a vascular lesion. The interval between primary intervention and definitive therapy was 11 days in 53 patients and 1-15 years in 21 patients. In 8 patients the reason for the re-operation after a long interval (1-15 years) was a late stage stenosis. A hepatico-jejunostomy was performed subsequently and during follow-up 5 / 8 patients were symptom-free; 7 patients were re-operated due to a stenosed primary biliodigestive anastomosis and 3 patients each due to atrophy of the right liver lobe and recurrent cholangitis. One patient complained of recurrent cholangitis and a further patient of symptoms due to adhesions. If treated inadequately bile duct injuries occurring during cholecystectomy can in the long-term lead to considerable problems such as recurrent cholangitis, late stage stenoses and even to secondary biliary cirrhosis. Therefore, a complex inter-disciplinary therapeutic concept aiming at timely treatment is necessary.

Anatomic distribution of renal artery stenosis in children: implications for imaging.

PubMed

Vo, Nghia J; Hammelman, Ben D; Racadio, Judy M; Strife, C Frederic; Johnson, Neil D; Racadio, John M

2006-10-01

Renal artery stenosis (RAS) causes significant hypertension in children. Frequently, pediatric RAS occurs with systemic disorders. In these cases, stenoses are often complex and/or include long segments. We believed that hypertensive children without comorbid conditions had a different lesion distribution and that the difference might have implications for imaging and treatment. To identify locations of RAS lesions in these hypertensive children without comorbid conditions. Patients who had renal angiography for hypertension from 1993 to 2005 were identified. Patients with systemic disorders, renovascular surgery, or normal angiograms were excluded. The angiograms of the remaining patients were reviewed for number, type, and location of stenoses. Eighty-seven patients underwent renal angiography for hypertension; 30 were excluded for comorbid conditions. Twenty-one of the remaining 57 patients had abnormal angiograms; 24 stenoses were identified in those patients. All were focal and distributed as follows: 6 (25%) main renal artery, 12 (50%) 2nd order branch, 3 (12.5%) 3rd order branch, and 3 (12.5%) accessory renal artery. Hypertensive children without comorbid conditions who have RAS usually have single, focal branch artery stenoses. This distribution supports angiography in these patients because of its superior sensitivity in detecting branch vessel disease and its therapeutic role in percutaneous transluminal renal angioplasty.

[Can the degree of renal artery stenosis be automatically quantified?].

PubMed

Cherrak, I; Jaulent, M C; Azizi, M; Plouin, P F; Degoulet, P; Chatellier, G

2000-08-01

The objective of the reported study is to validate a computer system, QUASAR, dedicated to the quantification of renal artery stenoses. This system estimates automatically the reference diameter and calculates the minimum diameter to compute a degree of stenosis. A hundred and eighty images of atheromatous stenoses between 10% and 80% were collected from two French independent protocols. For the 49 images of the EMMA protocol, the results from QUASAR were compared with the visual estimation of an initial investigator and with the results from a reference method based on a panel of fixe experienced experts. For the 131 images of the ASTARTE protocol, the results from QUASAR were compared with those from a semi-automatic quantification system and with those from a system based on densitometric analysis. The present work validates QUASAR in a population of narrow atheromatous stenoses (> 50%). In the context of the EMMA protocol, QUASAR is not significantly different from the mean of the fixe experts. It is unbiased and more precise than the estimation of a single investigator. In the context of the ASTARTE protocol, there is no significant difference between the three methods for the stenoses higher than 50%, however, globally, QUASAR surestimates significantly (up to 10%) the degree of stenosis.

[Fine mesh metal endoprostheses for treatment of extensive cervical and intrathoracic tracheomalacia].

PubMed

Wilmes, E; Berger, H; Dienemann, H; Jolk, A

1994-01-01

The treatment of tracheal stenoses caused by tracheomalacia is mainly carried out by means of sleeve resection, tracheopexy with ring support or other tracheoplastic operative procedures. If patients cannot be treated by surgical operative strategies, conventional stents are usually used to dilate the trachea. The use of a self-expanding elastic metal prosthesis in 5 patients with tracheal airway obstruction caused by tracheomalacia proved to be a true alternative in the therapy of tracheobronchial stenoses. We report on the long term use of 5 patients with tracheal stenoses treated by implantation of elastic metal wallstents. The implantation of the stents resulted in immediate improvement in respiratory function in all 5 patients. None of the patients experienced complications secondary to the stent placement. The stents were well tolerated (long-time follow-up 26 months). The implantation of self-expanding metal stents type "wallstent" seems to offer alternative possibilities for the treatment of tracheomalacia.

[The efficacy of endoscopic endosonography in diagnosis of benign and malignant stenoses of common bile duct].

PubMed

Solodinina, E N; Starkov, Iu G; Shumkina, L V

2016-01-01

To define criteria and to estimate diagnostic significance of endosonography in differential diagnosis of benign and malignant stenoses of common bile duct. We presented the results of survey and treatment of 57 patients with benign and malignant stenoses of common bile duct. The technique of endosonography is described. We have formulated major criteria of differential diagnostics of tumoral and non-tumoral lesion of extrahepatic bile ducts. Comparative analysis of endosonography, ultrasound, computed tomography and magnetic resonance cholangiopancreatography was performed. Sensitivity, specificity and accuracy of endosonography in diagnosis of stenosis cause is 97.7%, 100% and 98.2% respectively. So it exceeds the efficacy of other diagnostic X-ray methods. In modern surgical clinic endosonography should be mandatory performed. It is necessary for final diagnostics of cause of common bile duct stenosis especially in case of its low location.

111-Indium platelet imaging, Doppler spectral analysis and angiography compared in patients with transient cerebral ischaemia.

PubMed

Goldman, M; Leung, J O; Aukland, A; Hawker, R J; Drolc, Z; McCollum, C N

1983-01-01

We have evaluated carotid gamma imaging using 111Indium-labelled platelets in the diagnosis of carotid artery disease and measured the accumulation of labelled platelets on endarterectomy specimens. Autologous 111In labelled platelets were injected in 25 patients with TIA. Gamma images were then taken daily and independently interpreted by two observers. Carotid endarterectomy was performed in 11 patients allowing measurement of the radioactivity on the operative specimen. These results were compared to the findings on angiography and Doppler spectral analysis. All endarterectomy specimens accumulated platelets with the most active equivalent to platelets from 1.8 ml blood. Atheromatous ulcers were more active than stenoses with mean (+/- SEM) activities of 1.12 +/- 0.37 and 0.38 +/- 0.10 respectively. These radioactivity levels were at the threshold of gamma camera resolution in a theoretical model. Both observers agreed that 22 of the 50 carotid bifurcations showed platelet accumulation on gamma imaging. Of the 12 atheromatous ulcers demonstrated by angiography 11 were visualized, but only five of ten stenoses greater than 80% were detected. As Doppler identified all stenoses only one angiographically diseased carotid was not detected by combining ultrasound with platelet scanning. Atherosclerotic arteries accumulate 111In platelets and the more thrombogenic ulcerated plaques are identified more frequently than stenoses. Long-term follow-up is required to establish the clinical relevance of platelet deposition.

Combined Endovascular Treatment with Distal Radial Artery Coil Embolization and Angioplasty in Steal Syndrome Associated with Forearm Dialysis Fistula

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tercan, Fahri, E-mail: ftercan@yahoo.com; Koçyiğit, Ali, E-mail: alkoc@yahoo.com; Güney, Bünyamin

PurposeThe present study was performed to define the results of the endovascular treatment with angioplasty and distal radial artery embolization in ischemic steal syndrome associated with forearm arteriovenous accesses.MethodThe cases referred to our interventional radiology unit with symptoms and physical examination findings suggestive of ischemic steal syndrome were retrospectively evaluated first by Doppler ultrasonography, and then by angiography. Cases with proximal artery stenosis were applied angioplasty, and those with steal syndrome underwent coil embolization to distal radial artery.ResultsOf 589 patients who underwent endovascular intervention for dialysis arteriovenous fistulae (AVF)-associated problems, 6 (1.01 %) (5 female, 1 males; mean age 62 (rangemore » 41–78) with forearm fistula underwent combined endovascular treatment for steal syndrome. In addition to steal phenomenon, there were stenosis and/or occlusion in proximal radial and/or ulnar artery in 6 patients concurrently. Embolization of distal radial artery and angioplasty to proximal arterial stenoses were performed in all patients. Ischemic symptoms were eliminated in all patients and the AVF were in use at the time of study. In one patient, ischemic symptoms recurring 6 months later were alleviated by repeat angioplasty of ulnar artery.ConclusionIn palmar arch steal syndrome affecting forearm fistulae, combined distal radial embolization and angioplasty is also an effective treatment method in the presence of proximal radial and ulnar arterial stenoses and occlusions.« less

Guidewire navigation in coronary artery stenoses using a novel magnetic navigation system: first clinical experience.

PubMed

Tsuchida, Keiichi; García-García, Héctor M; van der Giessen, Willem J; McFadden, Eugène P; van der Ent, Martin; Sianos, Georgios; Meulenbrug, Hans; Ong, Andrew T L; Serruys, Patrick W

2006-03-01

The objective of this study was to investigate the efficacy of guidewire navigation across coronary artery stenoses using magnetic navigation system (MNS) versus conventional navigation. The MNS is a novel option to facilitate access to target lesions, particularly in tortuous vessels. In an experimental study using a challenging vessel phantom, magnetic-navigated guidewire passage has been reported to reduce fluoroscopy and procedure time significantly. Both magnetic and manual guidewire navigation were attempted in 21 consecutive diseased coronary arteries. The study endpoint was defined as an intraluminal wire position distal to the stenosis. Procedural success was defined as successful guidewire passage without procedural events. Procedure time, amount of contrast, fluoroscopy time, and radiation dose/area product (DAP) were evaluated. There were no procedural events related to either guidewire. Although the lesions attempted had relatively simple and straightforward characteristics, significantly shorter procedure and fluoroscopy time were observed for manual guidewire navigation compared to MNS (median, 40 vs. 120 sec, P=0.001; 38 vs. 105 sec, P=0.001, respectively). Contrast amount and DAP were higher in MNS than in conventional method (median, 13 vs. 9 ml, P=0.018; 215 vs. 73 Gym2, P=0.002, respectively). The magnetic wire did not cross in two vessels. Guidewire navigation using MNS presented a novel, safe, and feasible approach to address coronary artery lesions. Clinical studies are needed to evaluate the potential benefit of the MNS in more complex coronary lesions and tortuous anatomy. Copyright (c) 2006 Wiley-Liss, Inc.

Painless motor radiculopathy of the cervical spine: clinical and radiological characteristics and long-term outcomes after operative decompression.

PubMed

Siller, Sebastian; Kasem, Rami; Witt, Thomas-Nikolaus; Tonn, Joerg-Christian; Zausinger, Stefan

2018-03-23

OBJECTIVE Various neurological diseases are known to cause progressive painless paresis of the upper limbs. In this study the authors describe the previously unspecified syndrome of compression-induced painless cervical radiculopathy with predominant motor deficit and muscular atrophy, and highlight the clinical and radiological characteristics and outcomes after surgery for this rare syndrome, along with its neurological differential diagnoses. METHODS Medical records of 788 patients undergoing surgical decompression due to degenerative cervical spine diseases between 2005 and 2014 were assessed. Among those patients, 31 (3.9%, male to female ratio 4.8 to 1, mean age 60 years) presented with painless compressive cervical motor radiculopathy due to neuroforaminal stenosis without signs of myelopathy; long-term evaluation was available in 23 patients with 49 symptomatic foraminal stenoses. Clinical, imaging, and operative findings as well as the long-term course of paresis and quality of life were analyzed. RESULTS Presenting symptoms (mean duration 13.3 months) included a defining progressive flaccid radicular paresis (median grade 3/5) without any history of radiating pain (100%) and a concomitant muscular atrophy (78%); 83% of the patients were smokers and 17% patients had diabetes. Imaging revealed a predominantly anterior nerve root compression at the neuroforaminal entrance in 98% of stenoses. Thirty stenoses (11 patients) were initially decompressed via an anterior surgical approach and 19 stenoses (12 patients) via a posterior surgical approach. Overall reoperation rate due to new or recurrent stenoses was 22%, with time to reoperation shorter in smokers (p = 0.033). Independently of the surgical procedure chosen, long-term follow-up (mean 3.9 years) revealed a stable or improved paresis in 87% of the patients (median grade 4/5) and an excellent general performance and quality of life. CONCLUSIONS Painless cervical motor radiculopathy predominantly occurs due to focal compression of the anterior nerve root at the neuroforaminal entrance. Surgical decompression is effective in stabilizing or improving motor function with a resulting favorable long-term outcome.

Visual and Quantitative Assessment of Coronary Stenoses at Angiography Versus Fractional Flow Reserve: The Impact of Risk Factors.

PubMed

Adjedj, Julien; Xaplanteris, Panagiotis; Toth, Gabor; Ferrara, Angela; Pellicano, Mariano; Ciccarelli, Giovanni; Floré, Vincent; Barbato, Emanuele; De Bruyne, Bernard

2017-07-01

The correlation between angiographic assessment of coronary stenoses and fractional flow reserve (FFR) is weak. Whether and how risk factors impact the diagnostic accuracy of angiography is unknown. We sought to evaluate the diagnostic accuracy of angiography by visual estimate and by quantitative coronary angiography when compared with FFR and evaluate the influence of risk factors (RF) on this accuracy. In 1382 coronary stenoses (1104 patients), percent diameter stenosis by visual estimation (DS VE ) and by quantitative coronary angiography (DS QCA ) was compared with FFR. Patients were divided into 4 subgroups, according to the presence of RFs, and the relationship between DS VE , DS QCA , and FFR was analyzed. Overall, DS VE was significantly higher than DS QCA ( P <0.0001); nonetheless, when examined by strata of DS, DS VE was significantly smaller than DS QCA in mild stenoses, although the reverse held true for severe stenoses. Compared with FFR, a large scatter was observed for both DS VE and DS QCA . When using a dichotomous FFR value of 0.80, C statistic was significantly higher for DS VE than for DS QCA (0.712 versus 0.640, respectively; P <0.001). C statistics for DS VE decreased progressively as RFs accumulated (0.776 for ≤1 RF, 0.750 for 2 RFs, 0.713 for 3 RFs and 0.627 for ≥4 RFs; P =0.0053). In addition, in diabetics, the relationship between FFR and angiographic indices was particularly weak (C statistics: 0.524 for DS VE and 0.511 for DS QCA ). Overall, DS VE has a better diagnostic accuracy than DS QCA to predict the functional significance of coronary stenosis. The predictive accuracy of angiography is moderate in patients with ≤1 RFs, but weakens as RFs accumulate, especially in diabetics. © 2017 American Heart Association, Inc.

Biodegradable stents for the treatment of benign stenoses of the small and large intestines.

PubMed

Rejchrt, S; Kopacova, M; Brozik, J; Bures, J

2011-10-01

Biodegradable stents, which are made of various synthetic polymers, such as polylactide or polyglycolide, or co-polymers, such as polydioxanone, can be used for the treatment of benign refractory stenoses of the gastrointestinal tract. Here we report 11 patients (median age 41) with stenosing Crohn's disease of the small and/or large intestine. Endoscopic insertion of a biodegradable stent was successful at the first attempt in all patients except one. Subsequent follow-up was for a mean of 16 months, median 17 months, range 12-29 months. Early stent migration (between 2 days and 8 weeks) was seen in three patients. Mucosal overgrowth (epithelial hyperplasia) was not observed in any of the patients during the follow-up period. The high rate of early stent migration might be solved by appropriate tailoring and further improvements in the design of the biodegradable stents. Proof of long-term efficacy and safety requires further studies. © Georg Thieme Verlag KG Stuttgart · New York.

Performing and Interpreting Fractional Flow Reserve Measurements in Clinical Practice: An Expert Consensus Document

PubMed Central

Rudolph, Tanja; Rieber, Johannes; Eggebrecht, Holger; Richardt, Gert; Schmitz, Thomas; Werner, Nikos; Boenner, Florian; Möllmann, Helge

2017-01-01

Fractional flow reserve (FFR) measurements can determine the haemodynamic relevance of coronary artery stenoses. Current guidelines recommend their use in lesions in the absence of non-invasive proof of ischaemia. The prognostic impact of FFR has been evaluated in randomised trials, and it has been shown that revascularisation can be safely deferred if FFR is >0.80, while revascularisation of stenoses with FFR values ≤0.80 results in significantly lower event rates compared to medical treatment. Left main stenoses, aorto-ostial lesions, as well as patients with left ventricular hypertrophy and severely-impaired ejection fraction, have been excluded from large, randomised trials. While FFR measurements are relatively straightforward to perform, uncertainty about procedural logistics, as well as data acquisition and interpretation in specific situations, could explain why they are not widely used in clinical practice. We summarise the clinical data in support of FFR measurements, and provide recommendations for performing and interpreting the procedure. PMID:29588737

Expandable metallic stents for tracheobronchial stenoses in esophageal cancer.

PubMed

Takamori, S; Fujita, H; Hayashi, A; Tayama, K; Mitsuoka, M; Ohtsuka, S; Shirouzu, K

1996-09-01

Tracheobronchial stenosis in patients with esophageal cancer can be life threatening. Few reports have discussed use of expandable metallic stents for central airway stenoses in patients with esophageal cancer. Twelve patients with esophageal cancer underwent placement of expandable metallic stents for respiratory distress caused by tracheobronchial stricture. Single or double metallic stents were placed in the stenotic airways under fluoroscopic guidance. Improvement in respiratory symptoms and clinical outcome were assessed. Most stenoses were located in the trachea or the left main bronchus. From one to four expandable metallic stents were placed in each stricture site, with immediate relief of respiratory symptoms in 8 patients. One patient with tracheomalacia in alive 3 years after stent placement and another is alive 6 months after stent insertion. The other 10 patients lived from 10 to 70 days (mean; survival, 35 days) after stent placement. Death was due to progression of disease. Although metallic stents are useful for relieving respiratory distress in patients with advanced esophageal cancer, additional therapies should be considered.

111-Indium platelet imaging, Doppler spectral analysis and angiography compared in patients with transient cerebral ischaemia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldman, M.; Leung, J.O.; Aukland, A.

An evaluation was made of carotid gamma imaging using /sup 111/Indium-labelled platelets in the diagnosis of carotid artery disease and measured the accumulation of labelled platelets was measured on endarterectomy specimens. Autologous /sup 111/In labelled platelets were injected in 25 patients with TIA. Gamma images were then taken daily and independently interpreted by two observers. Carotid endarterectomy was performed in 11 patients allowing measurement of the radioactivity on the operative specimen. These results were compared to the findings on angiography and Doppler spectral analysis. All endarterectomy specimens accumulated platelets with the most active equivalent to platelets from 1.8 ml blood.more » Atheromatous ulcers were more active than stenoses with mean (+/- SEM) activities of 1.12 +/- 0.37 and 0.38 +/- 0.10 respectively. These radioactivity levels were at the threshold of gamma camera resolution in a theoretical model. Both observers agreed that 22 of the 50 carotid bifurcations showed platelet accumulation on gamma imaging. Of the 12 atheromatous ulcers demonstrated by angiography 11 were visualized, but only five of ten stenoses greater than 80% were detected. As Doppler identified all stenoses only one angiographically diseased carotid was not detected by combining ultrasound with platelet scanning. Atherosclerotic arteries accumulate /sup 111/In platelets and the more thrombogenic ulcerated plaques are identified more frequently than stenoses. Long-term follow-up is required to establish the clinical relevance of platelet deposition.« less

Urethral Strictures and Stenoses Caused by Prostate Therapy

PubMed Central

Chen, Mang L.; Correa, Andres F.; Santucci, Richard A.

2016-01-01

The number of patients with prostate cancer and benign prostatic hyperplasia is on the rise. As a result, the volume of prostate treatment and treatment-related complications is also increasing. Urethral strictures and stenoses are relatively common complications that require individualized management based on the length and location of the obstruction, and the patient’s overall health, and goals of care. In general, less invasive options such as dilation and urethrotomy are preferred as first-line therapy, followed by more invasive substitution, flap, and anastomotic urethroplasty. PMID:27601967

Harmonic skeleton guided evaluation of stenoses in human coronary arteries.

PubMed

Yang, Yan; Zhu, Lei; Haker, Steven; Tannenbaum, Allen R; Giddens, Don P

2005-01-01

This paper presents a novel approach that three-dimensionally visualizes and evaluates stenoses in human coronary arteries by using harmonic skeletons. A harmonic skeleton is the center line of a multi-branched tubular surface extracted based on a harmonic function, which is the solution of the Laplace equation. This skeletonization method guarantees smoothness and connectivity and provides a fast and straightforward way to calculate local cross-sectional areas of the arteries, and thus provides the possibility to localize and evaluate coronary artery stenosis, which is a commonly seen pathology in coronary artery disease.

Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

PubMed

Somers, S; Stevenson, G W; Thompson, G

1986-06-01

Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

[Classification of cerebrovascular processes using ultrasound methods].

PubMed

Klein, K

1984-01-01

By means of ultrasound A-mode echography and Doppler-Kranzbühler sonography new fundamentals of non-invasive qualitative and quantitative classification of cerebrovascular processes could be developed: Apart from usual screening of stenoses and pulse curve analyses, measurements of diameters and wall movements in the extracranial and intracranial carotid artery and in the vertebral artery as well as determinations of the systolic and diastolic flow velocities in the extracranial arteries are outstanding features. By recording and evaluating these parameters and data patterns, coupled with clinical findings, differential conclusions on reactions of the cerebral hemodynamics in macrocirculatory and microcirculatory regions were realized in geriatric patients under the following pathophysiological and therapeutically induced conditions: Generally and regionally accentuated arteriosclerotic lesions of the brain (predominant vertebrobasilar insufficiency), decrease of flow velocities according to the diameter, aggravation by distress; principal possibility of pharmacological influence if myogenic autoregulation function is rehabilitable: It is demonstrated by the example of a long-term therapy with a combination of Raubasine, Dihydroergocristine and DHE (Defluina forte).

Information hiding and retrieval in Rydberg wave packets using half-cycle pulses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Murray, J. M.; Pisharody, S. N.; Wen, H.

We demonstrate an information hiding and retrieval scheme with the relative phases between states in a Rydberg wave packet acting as the bits of a data register. We use a terahertz half-cycle pulse (HCP) to transfer phase-encoded information from an optically accessible angular momentum manifold to another manifold which is not directly accessed by our laser pulses, effectively hiding the information from our optical interferometric measurement techniques. A subsequent HCP acting on these wave packets reintroduces the information back into the optically accessible data register manifold which can then be read out.

Atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis.

PubMed

Patanè, Salvatore; Marte, Filippo

2010-11-05

Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that sub-clinical hyperthyroidism is not associated with CHD or mortality from cardiovascular causes but is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Moreover increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. It has been also reported an acute myocardial infarction with normal coronary arteries associated with iatrogenic hyperthyroidism and with a myocardial bridge too. It has been also reported an acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism. Furthermore it has been reported that at highly increased hematocrit levels patients may experience hyperviscosity symptoms. We present a case of atrial fibrillation and acute myocardial infarction without significant coronary stenoses associated with subclinical hyperthyroidism and erythrocytosis. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism. Copyright © 2008 Elsevier Ireland Ltd. All rights reserved.

DIRECT NUMERICAL SIMULATION OF TRANSITIONAL FLOW IN A STENOSED CAROTID BIFURCATION

PubMed Central

Lee, Seung E.; Lee, Sang-Wook; Fischer, Paul F.; Bassiouny, Hisham S.; Loth, Francis

2008-01-01

The blood flow dynamics of a stenosed, subject-specific, carotid bifurcation were numerically simulated using the spectral element method. Pulsatile inlet conditions were based on in vivo color Doppler ultrasound measurements of blood velocity. The results demonstrated the transitional or weakly turbulent state of the blood flow, which featured rapid velocity and pressure fluctuations in the post-stenotic region of the internal carotid artery during systole and laminar flow during diastole. High-frequency vortex shedding was greatest downstream of the stenosis during the deceleration phase of systole. Velocity fluctuations had a frequency within the audible range of 100–300 Hz. Instantaneous wall shear stress within the stenosis was relatively high during systole (~25-45 Pa) compared to that in a healthy carotid. In addition, high spatial gradients of wall shear stress were present due to flow separation on the inner wall. Oscillatory flow reversal and low pressure were observed distal to the stenosis in the internal carotid artery. This study predicts the complex flow field, the turbulence levels and the distribution of the biomechanical stresses present in vivo within a stenosed carotid artery. PMID:18656199

Gastrojejunal Anastomosis Complications and Their Management after Laparoscopic Roux-en-Y Gastric Bypass.

PubMed

Fringeli, Yannick; Worreth, Marc; Langer, Igor

2015-01-01

Complications at the gastrojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass (LRYGB) are challenging in terms of diagnosis, therapy, and prevention. This study aims at identifying these complications and discussing their management. Data of 228 patients who underwent a LRYGB between October 2008 and December 2011 were reviewed retrospectively to evaluate the frequency and treatment of complications such as stenoses, marginal ulcers, perforated marginal ulcers, or anastomotic leaks related to the operation. Follow-up information was available for 209 patients (91.7%) with a median follow-up of 38 months (range 24-62 months). Of these patients 16 patients (7.7%) experienced complications at the gastrojejunostomy. Four patients (1.9%) had stenoses and 12 patients (5.7%) marginal ulcers, one of them with perforation (0.5%). No anastomotic leaks were reported. One case with perforated ulcer and one with recurrent ulcers required surgical revision. Gastrojejunal anastomotic complications are frequent and occur within the first few days or up to several years after surgery. Stenoses or marginal ulcers are usually successfully treated nonoperatively. Laparoscopic repair, meanwhile, is an appropriate therapeutic option for perforated ulcers.

FFR analysis of blood flow through a stenosed Left Anterior Descending Artery

NASA Astrophysics Data System (ADS)

Pasupathi, Jawahar; Arul Prakash, K.

2017-11-01

The numerical analyisis of blood flow through a stenosed tapering Left Anterior Descending (LAD) artery was done using Streamwise Upwind Petrov Galerkin (SUPG) method to obtain the clinical parameters such as Fractional Flow reserve (FFR) and Wall Shear Stress (WSS). The geometry was considered to be a straight tapering cylindrical duct with the severity of stenosis modeled using a curve equation based on the reduction in diameter at the stenosed region. Poiseuille velocity profile was given at the inlet such that at each time step the product of mean velocity and the inlet area gives the realistic flow rate through the LAD. The simulation was done for 30,50 and 70 percent reduction in cross-section of LAD. The average pressure values across the stenosis was used to quantify FFR. The FFR increased with higher pressure ratio across the stenosis, which is a result of increased severity of stenosis. The velocity gradients that are responsible for the shear stress at the walls were found to be dependent on the shape of the stenosis, i.e., the diameter and its length.

Simulations of blood flow through a stenosed carotid artery

NASA Astrophysics Data System (ADS)

Lundin, Staffan; Meder, Samuel; Metcalfe, Ralph

2000-11-01

The human carotid artery is often the site of the formation of atherosclerotic lesions that can lead to severe reduction of blood flow to the brain, frequently resulting in a stroke. There is strong evidence that hemodynamic variables such as the wall shear stress and its spatial and temporal derivatives play a role in fostering atherosclerosis. To investigate the potential of these effects, we have performed unsteady, three-dimensional numerical simulations of blood flow through the carotid bifurcation in the presence of stenoses of varying degrees and eccentricities. The simulations indicate that regions of low maximum and minimum shear stress correlate better with lesion prone sites than low average wall shear stress. As the degree of stenosis increases, it is found that the downstream flow changes drastically for stenoses greater than about 25Downstream eddies are generated during systole that create local shear stress peaks on the internal carotid artery wall, resulting in significant reduction in flow rates through the internal carotid artery. Large secondary flows develop, and there are also periods of flow reversal during the systolic/diastolic cycle.

Ferromagnetic effects for nanofluid venture through composite permeable stenosed arteries with different nanosize particles

NASA Astrophysics Data System (ADS)

Akbar, Noreen Sher; Mustafa, M. T.

2015-07-01

In the present article ferromagnetic field effects for copper nanoparticles for blood flow through composite permeable stenosed arteries is discussed. The copper nanoparticles for the blood flow with water as base fluid with different nanosize particles is not explored upto yet. The equations for the Cu-water nanofluid are developed first time in literature and simplified using long wavelength and low Reynolds number assumptions. Exact solutions have been evaluated for velocity, pressure gradient, the solid volume fraction of the nanoparticles and temperature profile. Effect of various flow parameters on the flow and heat transfer characteristics are utilized.

Harmonic Skeleton Guided Evaluation of Stenoses in Human Coronary Arteries

PubMed Central

Yang, Yan; Zhu, Lei; Haker, Steven; Tannenbaum, Allen R.; Giddens, Don P.

2013-01-01

This paper presents a novel approach that three-dimensionally visualizes and evaluates stenoses in human coronary arteries by using harmonic skeletons. A harmonic skeleton is the center line of a multi-branched tubular surface extracted based on a harmonic function, which is the solution of the Laplace equation. This skeletonization method guarantees smoothness and connectivity and provides a fast and straightforward way to calculate local cross-sectional areas of the arteries, and thus provides the possibility to localize and evaluate coronary artery stenosis, which is a commonly seen pathology in coronary artery disease. PMID:16685882

Endovascular Treatment of Supra-Aortic Extracranial Stenoses in Patients with Vertebrobasilar Insufficiency Symptoms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zaytsev, A.Y., E-mail: cir-auz@mail.ru; Stoyda, A.Y.; Smirnov, V.E.

2006-10-15

Purpose. Stenoses and thromboses of vessels feeding the vertebrobasilar territory can evoke serious disturbances including ischemic stroke. We present our experience of endovascular interventions for patients with signs of vertebrobasilar insufficiency (VBI) resulted from subclavian, vertebral and brachiocephalic arterial stenoses. Methods. Twenty-one patients (10 men) aged from 35 to 84 years (mean 64.3 years) with symptoms compatible with VBI underwent balloon angioplasty and stenting of subclavian (SA), innominate (IA) and vertebral (VA) arteries. Procedures were done by radiologists experienced in systematic stenting of the lesions. VBI was manifested by persistent signs in 15 patients, and by transitory ischemic attacks inmore » the posterior circulatory territory in 4 (19%). Two patients (10%) experienced ischemic strokes (in the vertebrobasilar circulation in both cases). In 3 patients (14%) VBI was accompanied by upper limb vascular insufficiency symptoms. All cases were resistant to medical treatment. A neurologist assessed complaints, initial VBI signs and their alteration after intervention in all patients. Outcomes were measured with the 5-point scale suggested by Malek et al.: (1) excellent result (asymptomatic, no neurologic deficits and no symptoms of vertebrobasilar ischemia); (2) good (no neurologic deficits, at most one transient episode of vertebrobasilar ischemia over a period of 3 months after treatment); (3) fair (minimal neurologic deficit and at most one transient episode per month of vertebrobasilar ischemia); (4) poor (no improvement compared with neurologic status before treatment and/or persistent symptoms of vertebrobasilar ischemia); (5) death (regardless of cause). Endovascular treatment was performed for SA stenosis in 15 patients, for SA occlusion in 2, for IA stenosis in 2, and for VA stenosis in 2. There were 15 cases of atherosclerosis, 2 of aortoarteritis, 4 of proximal SA kinking. SA and IA stenoses ranged from 60% to 100% (mean 74.5%), VA stenoses were 90% in both cases. Results. Initial technical success was achieved in 96% of cases. There were no postprocedural complications or deaths. During 6-36 months (mean 21.3 months) of follow-up all patients showed improvement in VBI symptoms or upper limb ischemia. Within 36 months after the procedure outcomes were estimated as excellent and good in 13 patients (76%) and poor in 2 (12%), the last being attributed to atherosclerosis progression in other vascular areas. Restenosis in the stented area has developed in 1 patient (6%). Conclusions. Balloon angioplasty and stenting of extracranial vertebrobasilar arterial stenoses appeared to be effective in endovascular treatment of medically resistant VBI. Further investigations are required to clarify the role of subclavian artery kinking in VBI development and indications for various methods of its correction.« less

Numerical analysis of the pressure drop across highly-eccentric coronary stenoses: application to the calculation of the fractional flow reserve.

PubMed

Agujetas, R; González-Fernández, M R; Nogales-Asensio, J M; Montanero, J M

2018-05-30

Fractional flow reverse (FFR) is the gold standard assessment of the hemodynamic significance of coronary stenoses. However, it requires the catheterization of the coronary artery to determine the pressure waveforms proximal and distal to the stenosis. On the contrary, computational fluid dynamics enables the calculation of the FFR value from relatively non-invasive computed tomography angiography (CTA). We analyze the flow across idealized highly-eccentric coronary stenoses by solving the Navier-Stokes equations. We examine the influence of several aspects (approximations) of the simulation method on the calculation of the FFR value. We study the effects on the FFR value of errors made in the segmentation of clinical images. For this purpose, we compare the FFR value for the nominal geometry with that calculated for other shapes that slightly deviate from that geometry. This analysis is conducted for a range of stenosis severities and different inlet velocity and pressure waveforms. The errors made in assuming a uniform velocity profile in front of the stenosis, as well as those due to the Newtonian and laminar approximations, are negligible for stenosis severities leading to FFR values around the threshold 0.8. The limited resolution of the stenosis geometry reconstruction is the major source of error when predicting the FFR value. Both systematic errors in the contour detection of just 1-pixel size in the CTA images and a low-quality representation of the stenosis surface (coarse faceted geometry) may yield wrong outcomes of the FFR assessment for an important set of eccentric stenoses. On the contrary, the spatial resolution of images acquired with optical coherence tomography may be sufficient to ensure accurate predictions for the FFR value.

Carotid artery ultrasonographic assessment in patients from the Fremantle Diabetes Study Phase II with carotid bruits detected by electronic auscultation.

PubMed

Knapp, Arthur; Cetrullo, Violetta; Sillars, Brett A; Lenzo, Nat; Davis, Wendy A; Davis, Timothy M E

2014-09-01

Electronic auscultation appears superior to acoustic auscultation for identifying hemodynamic abnormalities. The aim of this study was to determine whether carotid bruits detected by electronic stethoscope in patients with diabetes are associated with stenoses and increased carotid intima-medial thickness (CIMT). Fifty Fremantle Diabetes Study patients (mean±SD age, 73.7±10.0 years; 38.0% males) with a bruit found by electronic auscultation and 50 age- and sex-matched patients with normal carotid sounds were studied. The degree of stenosis and CIMT were assessed from duplex ultrasonography. Patients with a bruit were more likely to have stenosis of ≥50% and CIMT of >1.0 mm than those without (odds ratios [95% confidence intervals]=14.0 [1.8-106.5] and 5.3 [1.8-15.3], respectively; both P=0.001). For the six patients with stenosis of ≥70%, five had a bruit, and one (with a known total occlusion) did not (odds ratio=5.0 [0.6-42.8]; P=0.22). The sensitivity and specificity of carotid bruit for stenoses of ≥50% were 88% and 58%, respectively; respective values for stenoses of ≥70% were 83% and 52%. The equivalent negative predictive values were 96% and 98%, and positive predictive values were 30% and 10%, respectively. Electronic recording of carotid sounds for later interpretation is convenient and reliable. Most patients with stenoses had an overlying bruit. Most bruits were false positives, but ultrasonography is justified to document extent of disease; CIMT measurement will identify increased vascular risk in most of these patients. The absence of a bruit was rarely a false-negative finding, suggesting that these patients can usually be reassured that they do not have hemodynamically important stenosis.

[Comparison of 64 MDCT coronary CTA and coronary angiography in the detection of coronary artery stenosis in low risk patients with stable angina and acute coronary syndrome].

PubMed

Cazalas, G; Sarran, A; Amabile, N; Chaumoitre, K; Marciano-Chagnaud, S; Jacquier, A; Paganelli, F; Panuel, M

2009-09-01

To determine the accuracy of 64 MDCT coronary CTA (CCTA) compared to coronary angiography in low risk patients with stable angina and acute coronary syndrome and determine the number of significant coronary artery stenoses ( 50%) in these patients. Materials and methods. Fifty-five patients underwent CCTA using a 32 MDCT unit with z flying focus allowing the acquisition of 64 slices of 0.6 mm thickness as well as coronary angiography (gold standard). Nine patients were excluded due to prior coronary artery bypass surgery (n=4), insufficient breath hold (n=3), calcium scoring>1000 (n=1) and delay between both examinations over 4 months (n=1). Forty-six patients: 27 males and 19 females were included. CCTA results were compared to coronary angiography per segment and artery with threshold detection of stenoses 50%. The degree of correlation between both examinations was performed using a regression analysis with a Pearson correlation coefficient<0.05 considered significant. The overall accuracy of CCTA was 90%; limitations related to the presence of calcifications, motion artifacts or insufficient vessel opacification. The correlation for all analyzed segments was 96.4%. Thirty-eight of 50 significant stenoses seen on coronary angiography were correctly detected on CCTA. Sensitivity, specificity, PPVC and NPV for detection of stenoses 50% were 76%, 98.3%, 80.3% and 97.7% respectively. Evaluation per segment had a NPV of 96.8% (interventricular and diagonal segments) to 100% (main trunk). Our results for specificity and NPV are similar to reports from the literature. This suggests that CCTA in this clinical setting may replace coronary angiography.

“Protected” Wallstenting of Atheromatous Stenoses at the Carotid Bifurcation

PubMed Central

Théron, J.G.; Guimaraens, L.J.; Casasco, A.E.; Courtheoux, P.G.; Beaujeux, R.L.; Rufenacht, D.A.; Coskun, O.; Sola, M.T.; Constans, J.-M.; Martin, J.-B.

2003-01-01

Summary Atheromatous stenoses at the carotid bifurcation were treated by angioplasty and Wallstenting with cerebral protection obtained in most cases by temporary occlusion of the internal carotid artery. 287 carotid stenoses were treated in 233 patients. The stenosis was symptomatic in 79% of cases. All patients presented either a stenosis of >70% with significant impairment of the cerebral circulation (281 cases) or a symptomatic ulcerated plaque (six cases). A self-mounted protection system was used in 177 cases, the Percusurge Guardwire protection device in 98 cases an EPI filter in 12 cases. There was a contralateral internal carotid occlusion in 13% of cases. A combined stenting (vertebral, siphon, subclavian) was performed in 14% of cases. A Rolling membrane Wallstent was used in 84 patients, a first generation Easy Wallstent in 38 cases, a “Carotid” Easy Wallstent 35 in 55 cases and monorail 14 in 110 cases. Full opening of the stenosis was obtained in 98% of patients with correction of the arterial curve and improvement of the cerebral vascular supply. There were 0.7% cases with transient symptomatic neurological complications and 2% with permanent sequelae mainly related to avoidable inadequacy in flushing or to the insufficient radial force of the first generation Easy Wallstent. There were no per and one post-procedural cardiac complication (0.6%) in the s165 cases performed with the “Carotid” Easy Wallstent. Follow-up angiograms showed O.7% of restenoses. Still in evolution, endovascular treatment of atheromatous stenoses at the carotid bifurcation with cerebral protection and stenting is a promising alternative technique to surgery. The association of Carotid Easy Wallstent 14 monorail and Percusurge Guardwire appears to be currently satisfactory. PMID:20591262

[Endoscopic treatment of oesophageal sténosis using Celestin prosthesis (author's transl)].

PubMed

Célestin, L R; Etienne, J; Raimbert, P; Fallouh, H; Sultan, R

The Celestin pulsion tube introduced by endoscopy seems to constitute a satisfactory method of dealing with oesophageal strictures, both malignant and benign. The site and histology of the tumour, as well as the diameter of the remaining lumen are determined by an initial endoscopic examination. The Eder-Puestow guide wire, essential to safe dilatation and intubation, may be introduced in various ways depending upon the size, length and nature of the stenosis: it may be threaded through the lumen with a fiberoscope under radiological control, or after drilling with laser. Subsequent dilatation may be carried out with olive-shaped metal dialtors, stepped plastic dilators of laminaria, depending upon the degree of fibrosis and the risks of fissuration. A final diameter of 17 mm is advisable. The pulsion tube, with its soft anti-migration skirt, is positioned using an introducer mounted on a semi-rigid mandrin or sliding over a fiberoscope. Its position must be checked at three-monthly intervals. The authors have used this method in 115 patients, 24 of whom had benign lesions and 91 malignant lesions. Among the latter, 23 had been irradiated, 7 were post-anatomotic and 61 had never been treated. There were 5 cases of mediatinitis and one of haemorrhage. Eleven tight strictures, wich had resisted dilatation with metal olive yieled laminaria. The longest follow-ups are of 19 months for malignant stenose and 40 months for benign stenoses. The main indications are malignant stenoses, irrespective of whether they have been irradiated or not, and peptic stenoses in inopereable patients. The procedure restores normal oral feeding, thereby avoiding the need for gastrostomy or jejunostomy.

Management of postintubation tracheal stenosis: appropriate indications make outcome differences.

PubMed

Melkane, Antoine E; Matar, Nayla E; Haddad, Amine C; Nassar, Michel N; Almoutran, Homère G; Rohayem, Ziad; Daher, Mohammad; Chalouhy, Georges; Dabar, George

2010-01-01

Laryngotracheal stenosis is difficult to treat and its etiologies are multiple; nowadays, the most common ones are postintubation or posttracheostomy stenoses. To provide an algorithm for the management of postintubation laryngotracheal stenoses (PILTS) based on the experience of a tertiary care referral center. A retrospective study was conducted on all patients treated for PILTS over a 10-year period. Patients were divided into a surgically and an endoscopically treated group according to predefined criteria. The characteristics of the two groups were analyzed and the outcomes compared. Thirty-three consecutive patients were included in the study: 14 in the surgically treated group and 19 in the endoscopically treated group. Our candidates for airway surgery were healthy patients presenting with complex tracheal stenoses, subglottic involvement or associated tracheomalacia. The endoscopic candidates were chronically ill patients presenting with simple, strictly tracheal stenoses not exceeding 4 cm in length. Stents were placed if the stenosis was associated with tracheomalacia or exceeded 2 cm in total length. In the surgically treated group, 2/14 patients needed more than one procedure versus 8/19 patients in the endoscopically treated group. At the end of the intervention, 50% of the patients were decannulated in the surgically treated group versus 84.2% in the endoscopically treated group (p = 0.03). However, the decannulation rates at 6 months and the symptomatology at rest and on exertion on the last follow-up visit were comparable in the two groups. Our experience in the management of PILTS demonstrates that both surgery and endoscopy yield excellent functional outcomes if the treatment strategy is based on clear, predefined objective criteria. Copyright 2010 S. Karger AG, Basel.

Angiogenesis in symptomatic intracranial atherosclerosis: predominance of the inhibitor endostatin is related to a greater extent and risk of recurrence.

PubMed

Arenillas, Juan F; Alvarez-Sabín, José; Montaner, Joan; Rosell, Anna; Molina, Carlos A; Rovira, Alex; Ribó, Marc; Sánchez, Esther; Quintana, Manuel

2005-01-01

Angiogenesis may be beneficial in chronic myocardial and limb ischemia, but its role in intracranial atherosclerosis remains unknown. We aimed to investigate the relationship between the pro-angiogenic vascular endothelial growth factor (VEGF) and the anti-angiogenic endostatin, and the extent and risk of recurrence of symptomatic intracranial atherosclerosis. Of a total of 94 consecutive patients with symptomatic intracranial stenoses, 40 fulfilled all inclusion criteria. Intracranial stenoses were confirmed by magnetic resonance angiography. Magnetic resonance imaging (MRI) including diffusion-weighted sequences was conducted. Plasmatic VEGF and endostatin were determined from blood samples obtained 3 months after stroke onset, and patients were followed-up thereafter. A total of 144 intracranial stenoses were confirmed (median number per patient=3). Endostatin/VEGF ratio gradually augmented with the increasing number of intracranial stenoses (r=0.35, P=0.02). Diabetes mellitus (OR, 6.04; CI, 1.1 to 32.2; P=0.03) and a higher endostatin/VEGF ratio (OR, 15.7; CI, 2.2 to 112.3; P=0.006) were independently associated with a greater extent of intracranial atherosclerosis. During a median follow-up of 13 months, 8 patients (20%) experienced a new cerebral ischemic event. A higher baseline endostatin concentration was an independent predictor of new events (hazard ratio, 7.24; CI, 1.6 to 33.8; P=0.011) in a Cox regression model after adjustment for age, sex, number of stenotic vessels, and risk factors. Patients with a higher endostatin level had a lower survival free of new events (P=0.01, log-rank test). A predominance of the inhibitor endostatin within the endogenous angiogenic response is associated with a greater extent and risk of recurrence of symptomatic intracranial atherosclerosis, suggesting that angiogenesis may be beneficial in this condition.

Contrast material-enhanced, moving-table MR angiography versus digital subtraction angiography for surveillance of peripheral arterial bypass grafts.

PubMed

Loewe, Christian; Cejna, Manfred; Schoder, Maria; Loewe-Grgurin, Maria; Wolf, Florian; Lammer, Johannes; Thurnher, Siegfried A

2003-09-01

To assess the accuracy of moving-table MR angiography (MRA) in the evaluation of peripheral bypass grafts. There were 39 patients who had had peripheral bypass graft surgery and then subsequently underwent digital subtraction angiography (DSA) and contrast material-enhanced MRA, which was performed with moving-table software on a 1.0-T system before and during administration of 40 mL gadolinium. For evaluation, every bypass graft was divided into three parts and every leg into 14 segments. Disease severity was scored in four categories (0%-29%, 30%-69%, 70%-99%, 100%). Results were compared with those of the DSA. A total of 147 bypass graft segments and 938 vessel segments were classified. In 132 of the assessable 147 bypass segments, disease gradings with both methods were congruent; however, 13 stenoses were misinterpreted by MRA for one grade and two additional lesions by two grades, leading to an accuracy in precise stenoses detection of 89.9%. The sensitivity and specificity values in the detection of bypass graft stenoses >69% (grade 3 + 4 lesions) reached 90.0% and 98.3%, respectively. In 821 of 938 vessel segments the accuracy of MRA in stenoses detection reached 87.5%. The sensitivity and specificity values in the detection of grade 3 + 4 lesions were 95.6% and 94.0% for the native vessels, respectively. Moving-table MRA was as accurate in assessing bypass grafts as it was for the native arteries and showed a great accuracy in stenosis detection compared with DSA. Therefore, MRA is a promising modality for bypass graft surveillance and might be a noninvasive alternative to DSA in this regard.

Photonic ultra-wideband pulse generation, hybrid modulation and dispersion-compensation-free transmission in multi-access communication systems.

PubMed

Tan, Kang; Shao, Jing; Sun, Junqiang; Wang, Jian

2012-01-16

We propose and demonstrate a scheme for optical ultrawideband (UWB) pulse generation by exploiting a half-carrier-suppressed Mach-Zehnder modulator (MZM) and a delay-interferometer- and wavelength-division-multiplexer-based, reconfigurable and multi-channel differentiator (DWRMD). Multi-wavelength, polarity- and shape-switchable UWB pulses of monocycle, doublet, triplet, and quadruplet are experimentally generated simply by tuning two bias voltages to modify the carrier-suppression ratio of MZM and the differential order of DWRMD respectively. The pulse position modulation, pulse shape modulation, pulse amplitude modulation and binary phase-shift keying modulation of UWB pulses can also be conveniently realized with the same scheme structure, which indicates that the hybrid modulation of those four formats can be achieved. Consequently, the proposed approach has potential applications in multi-shape, multi-modulation and multi-access UWB-over-fiber communication systems.

Unsteady Blood Flow with Nanoparticles Through Stenosed Arteries in the Presence of Periodic Body Acceleration

NASA Astrophysics Data System (ADS)

Fatin Jamil, Dzuliana; Roslan, Rozaini; Abdulhameed, Mohammed; Che-Him, Norziha; Sufahani, Suliadi; Mohamad, Mahathir; Ghazali Kamardan, Muhamad

2018-04-01

The effects of nanoparticles such as Fe 3O4,TiO2, and Cu on blood flow inside a stenosed artery are studied. In this study, blood was modelled as non-Newtonian Bingham plastic fluid subjected to periodic body acceleration and slip velocity. The flow governing equations were solved analytically by using the perturbation method. By using the numerical approaches, the physiological parameters were analyzed, and the blood flow velocity distributions were generated graphically and discussed. From the flow results, the flow speed increases as slip velocity increases and decreases as the values of yield stress increases.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cavagna, Enrico; D'Andrea, Paolo; Schiavon, Francesco

Purpose: To evaluate failing hemodialysis arteriovenous fistulas with helical CT angiography (CTA), MR angiography (MRA), and digital subtraction angiography (DSA), and to compare the efficacy of the three techniques in detecting the number, location, grade, and extent of stenoses and in assessing the technical results of percutaneous transluminal angioplasty (PTA) and stenting.Methods: Thirteen patients with Brescia-Cimino arteriovenous fistula malfunction underwent MRA and CTA of the fistula and, within 1 week, DSA. A total of 11 PTAs were performed; in three cases an MR-compatible stent was placed. DSA served as the gold standard for comparison in all patients. The presence, site,more » and number of stenoses or occlusions and the technical results of percutaneous procedures were assessed with DSA, CTA, and MRA.Results: MRA underestimated a single stenosis in one patient; CTA and MRA did not overestimate any stenosis. Significant artifacts related to stent geometry and/or underlying metal were seen in MRA sequences in two cases.Conclusions: CT and MRI can provide information regarding the degree of vascular impairment, helping to stratify patients into those who can have PTA (single or multiple stenoses) versus those who require an operative procedure (occlusion). Conventional angiography can be reserved for candidates for percutaneous intervention.« less

In vivo measurement of hemodynamic information in stenosed rat blood vessels using X-ray PIV

NASA Astrophysics Data System (ADS)

Park, Hanwook; Park, Jun Hong; Lee, Sang Joon

2016-11-01

Measurements of the hemodynamic information of blood flows, especially wall shear stress (WSS), in animal models with circulatory vascular diseases (CVDs) are important to understand the pathological mechanism of CVDs. In this study, X-ray particle image velocimetry (PIV) with high spatial resolution was applied to obtain velocity field information in stenosed blood vessels with high WSS. 3D clips fabricated with a 3D printer were applied to the abdominal aorta of a rat cadaver to induce artificial stenosis in the real blood vessel of an animal model. The velocity and WSS information of blood flows in the stenosed vessel were obtained and compared at various stenosis severities. In vivo measurement was also conducted by fastening a stenotic clip on a live rat model through surgical intervention to reduce the flow rate to match the limited temporal resolution of the present X-ray PIV system. Further improvement of the temporal resolution of the system might be able to provide in vivo measurements of hemodynamic information from animal disease models under physiological conditions. The present results would be helpful for understanding the relation between hemodynamic characteristics and the pathological mechanism in animal CVD models.

[Peculiarities of the course of arterial hypertension in patients with atherosclerotic stenoses of brachiocephalic arteries before and after surgery on carotid arteries].

PubMed

Kosacheva, N B; Tuev, A V

2013-01-01

Study aim was to investigate relationship between atherosclerosis of carotid arteries (CA) and the presence of arterial hypertension (AH) and possibilities of correction of AH after surgery. We examined 70 patients with episodes of elevation of arterial pressure (AP) scheduled for surgical interventions on brachiocephalic arteries (BCA) because of CA stenoses (n=50, group 1) or anomalies of BCA development (n=20, group 2). Before operation patients of group 1 had higher mean AP than patients of group 2 (103.6+/-11.3 and 91.7+/-6.6 mm Hg, respectively, p=0.00007). This difference disappeared after surgery. In postoperative period in patients with CA stenoses levels of both systolic and diastolic AP decreased (from 145.1+/-14.7 to 135.6+/-12.3, p=0.02; and from 83.3+/-10.2 78.1+/-9.7 mm Hg, =0.02, respectively). In group 2 no significant AP reduction was observed. Thus AP elevation in patients with involvement of BCA to a considerable degree is caused by CA stenosis. Surgical treatment of these patients facilitates lowering of AP.

Technical and Clinical Results After Percutaneous Angioplasty in Nonmedial Fibromuscular Dysplasia: Outcome After Endovascular Management of Unifocal Renal Artery Stenoses in 30 Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barrier, Pierre, E-mail: p.barrier@gmail.com; Julien, Auriol; Guillaume, Canevet

2010-04-15

Although percutaneous transluminal renal angioplasty (PTRA) is associated with excellent results in medial fibromuscular dysplasia (FMD), the clinical and technical outcome in the less common nonmedial subtype of FMD is not clearly known. Angiographic PTRA results and clinical follow-up were documented, to report technical and clinical results in 30 patients with unifocal, nonmedial dysplastic stenoses. Balloon angioplasty was technically successful in only 65% of the lesions. Additional stenting, performed after PTRA failure in six patients, increased the initial technical success rate to 82%. Stenting was used in another lesion after restenosis, and long-term patency was achieved in only three ofmore » the seven stented lesions. Frequent restenoses and unusual complications were observed during follow-up. Stent fracture occurred in two cases. Overall, long-term clinical and technical successes were sustained in 70 and 76%, respectively. We conclude that nonmedial, unifocal renal artery dysplastic stenoses do not share the excellent prognosis of the medial type and that stenting should be avoided. Therefore, surgery should be considered in lesions remaining unresponsive to balloon dilatation, after a second PTRA attempt.« less

Color-coded depth information in volume-rendered magnetic resonance angiography

NASA Astrophysics Data System (ADS)

Smedby, Orjan; Edsborg, Karin; Henriksson, John

2004-05-01

Magnetic Resonance Angiography (MRA) and Computed Tomography Angiography (CTA) data are usually presented using Maximum Intensity Projection (MIP) or Volume Rendering Technique (VRT), but these often fail to demonstrate a stenosis if the projection angle is not suitably chosen. In order to make vascular stenoses visible in projection images independent of the choice of viewing angle, a method is proposed to supplement these images with colors representing the local caliber of the vessel. After preprocessing the volume image with a median filter, segmentation is performed by thresholding, and a Euclidean distance transform is applied. The distance to the background from each voxel in the vessel is mapped to a color. These colors can either be rendered directly using MIP or be presented together with opacity information based on the original image using VRT. The method was tested in a synthetic dataset containing a cylindrical vessel with stenoses in varying angles. The results suggest that the visibility of stenoses is enhanced by the color information. In clinical feasibility experiments, the technique was applied to clinical MRA data. The results are encouraging and indicate that the technique can be used with clinical images.

Is Repeat PTA of a Failing Hemodialysis Fistula Durable?

PubMed

Bountouris, Ioannis; Kristmundsson, Thorarinn; Dias, Nuno; Zdanowski, Zbigniew; Malina, Martin

2014-01-01

Purpose. Our objective was to evaluate the outcome of percutaneous transluminal angioplasty (PTA) and particularly rePTA in a failing arteriovenous fistula (AV-fistula). Are multiple redilations worthwhile? Patients and Methods. All 159 stenoses of AV fistulas that were treated with PTA, with or without stenting, during 2008 and 2009, were included. Occluded fistulas that were dilated after successful thrombolysis were also included. Median age was 68 (interquartile range 61.5-78.5) years and 75% were male. Results. Seventy-nine (50%) of the primary PTAs required no further reintervention. The primary patency was 61% at 6 months and 42% at 12 months. Eighty (50%) of the stenoses needed at least one reintervention. Primary assisted patency (defined as patency after subsequent reinterventions) was 89% at 6 months and 85% at 12 months. The durability of repeated PTAs was similar to the durability of the primary PTA. However, an early primary PTA carried a higher risk for subsequent reinterventions. Successful dialysis was achieved after 98% of treatments. Nine percent of the stenoses eventually required surgical revision and 13% of the fistulas failed permanently. Conclusion. The present study suggests that most failing AV-fistulas can be salvaged endovascularly. Repeated PTA seems similarly durable as the primary PTA.

Initiation Mechanisms of Low-loss Swept-ramp Obstacles for Deflagration to Detonation Transition in Pulse Detonation Combustors

DTIC Science & Technology

2009-12-01

minimal pressure losses. 15. NUMBER OF PAGES 113 14. SUBJECT TERMS Pulse Detonation Combustors, PDC, Pulse Detonation Engines, PDE , PDE ...Postgraduate School PDC Pulse Detonation Combustor PDE Pulse Detonation Engine RAM Random Access Memory RDT Research, Design and Test RPL...inhibiting the implementation of this advanced propulsion system. The primary advantage offered by pulse detonation engines ( PDEs ) is the high efficiency

Doppler velocity measurements from large and small arteries of mice

PubMed Central

Reddy, Anilkumar K.; Madala, Sridhar; Entman, Mark L.; Michael, Lloyd H.; Taffet, George E.

2011-01-01

With the growth of genetic engineering, mice have become increasingly common as models of human diseases, and this has stimulated the development of techniques to assess the murine cardiovascular system. Our group has developed nonimaging and dedicated Doppler techniques for measuring blood velocity in the large and small peripheral arteries of anesthetized mice. We translated technology originally designed for human vessels for use in smaller mouse vessels at higher heart rates by using higher ultrasonic frequencies, smaller transducers, and higher-speed signal processing. With these methods one can measure cardiac filling and ejection velocities, velocity pulse arrival times for determining pulse wave velocity, peripheral blood velocity and vessel wall motion waveforms, jet velocities for the calculation of the pressure drop across stenoses, and left main coronary velocity for the estimation of coronary flow reserve. These noninvasive methods are convenient and easy to apply, but care must be taken in interpreting measurements due to Doppler sample volume size and angle of incidence. Doppler methods have been used to characterize and evaluate numerous cardiovascular phenotypes in mice and have been particularly useful in evaluating the cardiac and vascular remodeling that occur following transverse aortic constriction. Although duplex ultrasonic echo-Doppler instruments are being applied to mice, dedicated Doppler systems are more suitable for some applications. The magnitudes and waveforms of blood velocities from both cardiac and peripheral sites are similar in mice and humans, such that much of what is learned using Doppler technology in mice may be translated back to humans. PMID:21572013

A balloon-expandable sheath facilitates transfemoral TAVR in patients with peripheral vascular disease and tortuosity.

PubMed

Goldsweig, Andrew M; Faheem, Osman; Cleman, Michael W; Forrest, John K

2015-06-01

We sought to perform transcatheter aortic valve replacement (TAVR) via the transfemoral approach in patients with peripheral arterial disease (PAD), small caliber ileofemoral vessels and vascular tortuosity. For patients with increased surgical risk, TAVR is associated with a higher 1-year survival rate than surgical aortic valve replacement (SAVR). Transfemoral vascular access for TAVR results in superior outcomes versus procedures performed via other routes in terms of mortality, morbidity and healthcare economics. In many patients, the ability to safely perform the procedure via the transfemoral approach is limited by narrow, diseased and tortuous ileofemoral vasculature. We employed the SoloPath Balloon Expandable TransFemoral Access System (Terumo Med. Corp., Tokyo, Japan) to perform transfemoral TAVR in five patients with PAD, small caliber ileofemoral vessels and vascular tortuosity. We report our experience using this balloon-expandable sheath during 5 cases of transfemoral TAVR in patients with inhospitable ileofemoral vasculature of mean diameter ⩽ 5.8 mm. The unexpanded sheath's malleable structure and hydrophilic coating permitted deployment despite severe stenoses and tortuosity. Subsequent inflation to 18 Fr facilitated successful TAVR. Postprocedural angiography demonstrated no significant vascular access complications. In one case, the entire procedure was performed percutaneously, without common femoral artery surgical cutdown. The SoloPath sheath system permits transfemoral TAVR in patients with PAD small caliber ileofemoral vessels and vascular tortuosity. The transfemoral balloon-expandable sheath allowed these patients to avoid the increased morbidity and mortality risks associated with direct aortic or transapical access. © The Author(s), 2015.

[The current views of the problem of the plastic correction of the laryngo-tracheal defects in the patients presenting with combined laryngeal stenoses].

PubMed

Selezneva, L V

2017-01-01

The present review of the literature is designed to analyze the currently available methods for the plastic correction of the laryngo-tracheal defects in the patients presenting with combined laryngeal stenoses at the concluding stage of their medical rehabilitation. We looked through 56 literature sources including 28 publications of the foreign authors. The different approaches to the plastic correction of the laryngo-tracheal defects have been critically considered with special reference to their advantages and disadvantages. The importance of the problem under consideration arises from the necessity of the search for the new methods of plastic correction of the laryngo-tracheal defects.

Surgical correction of bladder neck contracture following prostate cancer treatment.

PubMed

Bugeja, Simon; Andrich, Daniela E; Mundy, Anthony R

2014-01-01

The surgical and non-surgical treatment of localised prostate cancer may be complicated by bladder neck contractures, prostatic urethral stenoses and bulbomembranous urethral strictures. In general, such complications following radical prostatectomy are less extensive, easier to treat and associated with a better outcome and more rapid recovery than the same complications following radiotherapy, high-intensity focussed ultrasound and cryotherapy. Treatment options range from minimally invasive endoscopic procedures to more complex and specialised open surgical reconstruction.In this chapter the surgical management of bladder neck contractures following the treatment of prostate cancer is described together with the management of prostatic urethral stenoses and bulbomembranous urethral strictures, given the difficulty in distinguishing them from one another clinically.

Simultaneous Iliac Vein Bovine Pericardial Patch Venoplasty and Creation of PTFE Lower Limb Arteriovenous Fistula Graft for Rescue Vascular Access.

PubMed

Meecham, Lewis; Fisher, Owain; Kirby, George; Evans, Richard; Buxton, Pauline; Legge, Jocelyn; Rajagopalan, Sriram; Asquith, John; Pherwani, Arun

2016-10-01

We present a case of external iliac vein patch venoplasty to accommodate rescue vascular access via a polytetrafluoroethylene loop arteriovenous fistula graft (AVG) for a patient with multiple central venous stenoses. A 35-year-old female with anti-glomerular basement membrane antibody disease required rescue vascular access for hemodialysis. Repeated occlusion and/or thrombosis of long-term central venous access cannulae, to facilitate dialysis, had caused stenosis of brachiocephalic veins: right external iliac vein and occlusion of the left common iliac vein. A previous right brachiobasilic fistula had occluded within 1 year. No other upper limb options for arteriovenous fistula (AVF) were available. A right external iliac vein bovine patch angioplasty concurrently with a polytetrafluoroethylene AV graft between common femoral artery and common femoral vein was performed to restore venous patency and allow rescue dialysis access. At 3-year follow-up, the fistula remains widely patent with 2 L/min flow rates and no recurrent stenosis to the treated iliac vein. She has not required any further surgical or interventional radiological procedures to maintain fistula or central venous patency. Central venous stenosis or occlusion is common for patients requiring dialysis, especially those with multiple previous long-term central venous cannulations. If restriction of outflow is present, AVF may fail. Venous patch angioplasty in these cases is a successful technique, allowing AVF formation and long-term patency. Central venous stenosis can be treated successfully with patch venoplasty to accommodate AVF/AVG formation for rescue vascular access; this is a potentially lifesaving intervention for patients requiring dialysis. Copyright © 2016 Elsevier Inc. All rights reserved.

Intraoperative endovascular ultrasonography

NASA Astrophysics Data System (ADS)

Eton, Darwin; Ahn, Samuel S.; Baker, J. D.; Pensabene, Joseph; Yeatman, Lawrence S.; Moore, Wesley S.

1991-05-01

The early experience using intra-operative endovascular ultrasonography (EU) is reported in eight patients undergoing lower extremity revasularization. In four patients, intra-operative EU successfully characterized inflow stenoses that were inadequately imaged with pre- operative arteriography. Two patients were found to have hemodynamically significant inflow stenoses, and were treated with intra-operative balloon angioplasty followed by repeat EU. The other two patients were found to have non-hemodynamically significant inflow stenoses requiring no treatment. Additional outflow procedures were required in all four patients. In the remaining four patients, EU was used to evaluate the completeness of TEC rotary atherectomy, of Hall oscillatory endarterectomy, of thrombectomy of the superficial femoral and popliteal arteries, and of valve lysis during in situ saphenous vein grafting, respectively. In the latter case, the valve leaflets were not clearly seen. In the other cases, EU assisted the surgeon. Angioscopy and angiography were available for comparison. In one case, angioscopy failed because of inability to clear the field while inspecting retrograde the limb of an aorto-bi-femoral graft. EU however was possible. No complications of EU occurred. EU is a safe procedure indicated when characterization of a lesion is needed prior to an intervention or when evaluation of the intervention's success is desired. We did not find it useful in valve lysis for in-site grafting.

Coronary artery stenosis detection with holographic display of 3D angiograms

NASA Astrophysics Data System (ADS)

Ritman, Erik L.; Schwanke, Todd D.; Simari, Robert D.; Schwartz, Robert S.; Thomas, Paul J.

1995-05-01

The objective of this study was to establish the accuracy of an holographic display approach for detection of stenoses in coronary arteries. The rationale for using an holographic display approach is that multiple angles of view of the coronary arteriogram are provided by a single 'x-ray'-like film, backlit by a special light box. This should be more convenient in that the viewer does not have to page back and forth through a cine angiogram to obtain the multiple angles of view. The method used to test this technique involved viewing 100 3D coronary angiograms. These images were generated from the 3D angiographic images of nine normal coronary arterial trees generated with the Dynamic Spatial Reconstructor (DSR) fast CT scanner. Using our image processing programs, the image of the coronary artery lumen was locally 'narrowed' by an amount and length and at a location determined by a random look-up table. Two independent, blinded, experienced angiographers viewed the holographic displays of these angiograms and recorded their confidence about the presence, location, and severity of the stenoses. This procedure evaluates the sensitivity and specificity of the detection of coronary artery stenoses as a function of the severity, size, and location along the arteries.

The development of colon innervation in trisomy 16 mice and Hirschsprungs disease

PubMed Central

Li, Ji Cheng; Mi, Kai Hong; Zhou, Ji Lin; Busch, LC; Kuhnel, W

2001-01-01

AIM: To study the colon innervation of trisomy 16 mouse, an animal model for Down’s syndrome, and the expression of protein gene product 9.5 (PGP 9.5) in the stenosed segment of colon in Hirschsprungs disease (HD). METHODS: Trisomy 16 mouse breeding; cytogenetic analysis of trisomy 16 mice; and PGP 9.5 immunohistochemistry of colons of trisomy 16 mice and HD were carried out. RESULTS: Compared with their normal littermates, the nervous system of colon in trisomy 16 mice was abnormally developed. There existed developmental delay of muscular plexuses of colon, no submucosal plexus was found in the colon, and there was 5 mm aganglionic bowel aparting from the anus in trisomy 16 mice. The mesentery nerve fibers were as well developed as shown in their normal littermates. Abundant proliferation of PGP 9.5 positive nerve fibers was evealed in the stenosed segment of HD colon. CONCLUSION: Trisomy 16 mice could serve as an animal model for Hirschsprung’s disease for aganglionic bowel in the distal part of colon. Abundant proliferation of PGP 9.5 positive fibers resulted from extrinsic nerve compensation, since no ganglionic cells were observed in the stenosed segment of the colon in HD. HD has a genetic tendency. PMID:11819726

Is Repeat PTA of a Failing Hemodialysis Fistula Durable?

PubMed Central

Zdanowski, Zbigniew

2014-01-01

Purpose. Our objective was to evaluate the outcome of percutaneous transluminal angioplasty (PTA) and particularly rePTA in a failing arteriovenous fistula (AV-fistula). Are multiple redilations worthwhile? Patients and Methods. All 159 stenoses of AV fistulas that were treated with PTA, with or without stenting, during 2008 and 2009, were included. Occluded fistulas that were dilated after successful thrombolysis were also included. Median age was 68 (interquartile range 61.5–78.5) years and 75% were male. Results. Seventy-nine (50%) of the primary PTAs required no further reintervention. The primary patency was 61% at 6 months and 42% at 12 months. Eighty (50%) of the stenoses needed at least one reintervention. Primary assisted patency (defined as patency after subsequent reinterventions) was 89% at 6 months and 85% at 12 months. The durability of repeated PTAs was similar to the durability of the primary PTA. However, an early primary PTA carried a higher risk for subsequent reinterventions. Successful dialysis was achieved after 98% of treatments. Nine percent of the stenoses eventually required surgical revision and 13% of the fistulas failed permanently. Conclusion. The present study suggests that most failing AV-fistulas can be salvaged endovascularly. Repeated PTA seems similarly durable as the primary PTA. PMID:24587906

Taking care of your vascular access for hemodialysis

MedlinePlus

... blood through the access. This is called stenosis. Day-to-day Care of Your Vascular Access Following these guidelines ... pulse (also called thrill) in your access every day. Your health care provider will show you how. ...

Carotid Artery Ultrasonographic Assessment in Patients from the Fremantle Diabetes Study Phase II with Carotid Bruits Detected by Electronic Auscultation

PubMed Central

Knapp, Arthur; Cetrullo, Violetta; Sillars, Brett A.; Lenzo, Nat; Davis, Wendy A.

2014-01-01

Abstract Background: Electronic auscultation appears superior to acoustic auscultation for identifying hemodynamic abnormalities. The aim of this study was to determine whether carotid bruits detected by electronic stethoscope in patients with diabetes are associated with stenoses and increased carotid intima-medial thickness (CIMT). Subjects and Methods: Fifty Fremantle Diabetes Study patients (mean±SD age, 73.7±10.0 years; 38.0% males) with a bruit found by electronic auscultation and 50 age- and sex-matched patients with normal carotid sounds were studied. The degree of stenosis and CIMT were assessed from duplex ultrasonography. Results: Patients with a bruit were more likely to have stenosis of ≥50% and CIMT of >1.0 mm than those without (odds ratios [95% confidence intervals]=14.0 [1.8–106.5] and 5.3 [1.8–15.3], respectively; both P=0.001). For the six patients with stenosis of ≥70%, five had a bruit, and one (with a known total occlusion) did not (odds ratio=5.0 [0.6–42.8]; P=0.22). The sensitivity and specificity of carotid bruit for stenoses of ≥50% were 88% and 58%, respectively; respective values for stenoses of ≥70% were 83% and 52%. The equivalent negative predictive values were 96% and 98%, and positive predictive values were 30% and 10%, respectively. Conclusions: Electronic recording of carotid sounds for later interpretation is convenient and reliable. Most patients with stenoses had an overlying bruit. Most bruits were false positives, but ultrasonography is justified to document extent of disease; CIMT measurement will identify increased vascular risk in most of these patients. The absence of a bruit was rarely a false-negative finding, suggesting that these patients can usually be reassured that they do not have hemodynamically important stenosis. PMID:24988112

Access to long-term optical memories using photon echoes retrieved from electron spins in semiconductor quantum wells

NASA Astrophysics Data System (ADS)

Poltavtsev, S. V.; Langer, L.; Yugova, I. A.; Salewski, M.; Kapitonov, Y. V.; Yakovlev, D. R.; Karczewski, G.; Wojtowicz, T.; Akimov, I. A.; Bayer, M.

2016-10-01

We use spontaneous (two-pulse) and stimulated (three-pulse) photon echoes for studying the coherent evolution of optically excited ensemble of trions which are localized in semiconductor CdTe/CdMgTe quantum well. Application of transverse magnetic field leads to the Larmor precession of the resident electron spins, which shuffles optically induced polarization between optically accessible and inaccessible states. This results in several spectacular phenomena. First, magnetic field induces oscillations of spontaneous photon echo amplitude. Second, in three-pulse excitation scheme, the photon echo decay is extended by several orders of magnitude. In this study, short-lived optical excitation which is created by the first pulse is coherently transferred into a long-lived electron spin state using the second optical pulse. This coherent spin state of electron ensemble persists much longer than any optical excitation in the system, preserving information on initial optical field, which can be retrieved as a photon echo by means of third optical pulse.

Rerouting the external auditory canal. A method of correcting congenital stenosis.

PubMed

Baron, S H

1975-04-01

An hourglass or funnel-shaped, stenosed, external auditory meatus with a normal tympanic membrane, middle and inner ear is one of the congenital anomalies that occasionally occurs. Such abnormality was present in both ears of a woman and caused chromic otitis externa and deafness. A routine meatoplasty on the right ear failed because of an unusual cephalad position of the drumhead in relation to a "downhill" position of the stenosed outer meatus. Rerouting the ear canal to a horizontal position by removing bone of the canal superiorly, posteriorly, and inferiorly, and grafting the now horizontal canal with skin taken from the postauricular fold produced a good result. This is a satisfactory procedure for a woman, but would be cosmetically unacceptable for a man.

Multi-pulse frequency shifted (MPFS) multiple access modulation for ultra wideband

DOEpatents

Nekoogar, Faranak [San Ramon, CA; Dowla, Farid U [Castro Valley, CA

2012-01-24

The multi-pulse frequency shifted technique uses mutually orthogonal short duration pulses o transmit and receive information in a UWB multiuser communication system. The multiuser system uses the same pulse shape with different frequencies for the reference and data for each user. Different users have a different pulse shape (mutually orthogonal to each other) and different transmit and reference frequencies. At the receiver, the reference pulse is frequency shifted to match the data pulse and a correlation scheme followed by a hard decision block detects the data.

t-PA power-pulse spray with rheolytic mechanical thrombectomy using cross-sectional image-guided portal vein access for single setting treatment of subacute superior mesenteric vein thrombosis.

PubMed

Syed, Mubin I; Gallagher, Ryan M; Ahmed, Rukan S; Shaikh, Azim; Roberto, Edward; Patel, Sumeet

2018-01-01

Isolated superior mesenteric vein (SMV) thrombosis is a rare but potentially fatal condition if untreated. Current treatments include transjugular or transhepatic approaches for rheolytic mechanical thrombectomy and subsequent infusions of thrombolytics. Tissue plasminogen activator (t-PA) power-pulse spray can provide benefit in a single setting without thrombolytic infusions. Computed tomography (CT) guidance for portal vein access is underutilized in this setting. Case 1 discusses acute SMV thrombosis treated with rheolytic mechanical thrombectomy alone using ultrasound guidance for portal vein access. Case 2 discusses subacute SMV thrombosis treated with the addition of t-PA power-pulse spray to the rheolytic mechanical thrombectomy, using CT guidance for portal vein access. With rheolytic mechanical thrombectomy alone, the patient in Case 1 had significant improvement in abdominal pain. Follow-up CT demonstrated no residual SMV thrombosis and the patient continued to do well in long-term follow-up. With the addition of t-PA power-pulse spray to rheolytic mechanical thrombectomy, the patient in Case 2 with subacute SMV thrombosis dramatically improved postprocedure with resolution of abdominal pain. Follow-up imaging demonstrated patency to the SMV and partial resolution of thrombus. The patient continued to do well at 2-year follow-up. Adding t-PA power-pulse spray to rheolytic mechanical thrombectomy can provide benefit in a single setting versus mechanical thrombectomy alone and prevent the need for subsequent infusions of thrombolytic therapy. CT guidance is a useful alternative of localization for portal vein access via the transhepatic route that is nonoperator-dependent and helpful in the case of obese patients.

Minimally invasive therapy of pseudoaneurysms of the trunk: application of thrombin.

PubMed

Schellhammer, Frank; Steinhaus, Daniele; Cohnen, Mathias; Hoppe, Jonas; Mödder, Ulrich; Fürst, Günter

2008-01-01

Thrombin injection has been proven to be successful in postcatheterization pseudoaneurysms. However, there are only a few reports on the treatment of pseudoaneurysms of the trunk. We report our first experiences using a percutaneous as well as an endovascular access. Eight iatrogenic pseudoaneurysms of the trunk (aorta, n = 4; pulmonary artery, n = 1; gastroduodenal artery, n = 1; left gastric artery, n = 1, renal artery, n = 1) were treated either percutaneously using CT guidance (n = 3) or via an endovascular access (n = 5). Noninvasive control angiograms were performed at day 1 and weeks 1 and 3 by either CT or MR angiography. The total volume of the pseudoaneurysms was 31.2 +/- 23.1 ml on average, with a mean volume of the perfused aneurysmal lumen of 12.9 +/- 7.2 ml. The maximum diameter was 4.1 +/- 1.39 cm on average. In each case, the aneurysmal neck was not wider than 2 mm. One pseudoaneurysm occluded spontaneously following selective catheterization. The remaining pseudoaneurysms were successfully treated by injection of 765 +/- 438.1 IU thrombin. In one individual, a nontarget embolization occurred, as well as an intervention-associated rupture of a pseudoaneurysm. High-grade stenoses of the donor artery were found in a different case. Only once was the endoluminal access converted to a percutaneous one. Thrombin injection might be a future first-line treatment of vascular lesions such as pseudoaneurysms of the trunk. In our experience both percutanous and endoluminal access are technically feasible and safe. However, further experiences are mandatory, especially concerning the question of dosage and long-term results.

Pulse based sensor networking using mechanical waves through metal substrates

NASA Astrophysics Data System (ADS)

Lorenz, S.; Dong, B.; Huo, Q.; Tomlinson, W. J.; Biswas, S.

2013-05-01

This paper presents a novel wireless sensor networking technique using ultrasonic signal as the carrier wave for binary data exchange. Using the properties of lamb wave propagation through metal substrates, the proposed network structure can be used for runtime transport of structural fault information to ultrasound access points. Primary applications of the proposed sensor networking technique will include conveying fault information on an aircraft wing or on a bridge to an ultrasonic access point using ultrasonic wave through the structure itself (i.e. wing or bridge). Once a fault event has been detected, a mechanical pulse is forwarded to the access node using shortest path multi-hop ultrasonic pulse routing. The advantages of mechanical waves over traditional radio transmission using pulses are the following: First, unlike radio frequency, surface acoustic waves are not detectable outside the medium, which increases the inherent security for sensitive environments in respect to tapping. Second, event detection can be represented by the injection of a single mechanical pulse at a specific temporal position, whereas radio messages usually take several bits. The contributions of this paper are: 1) Development of a transceiver for transmitting/receiving ultrasound pulses with a pulse loss rate below 2·10-5 and false positive rate with an upper bound of 2·10-4. 2) A novel one-hop distance estimation based on the properties of lamb wave propagation with an accuracy of above 80%. 3) Implementation of a wireless sensor network using mechanical wave propagation for event detection on a 2024 aluminum alloy commonly used for aircraft skin construction.

Ferromagnetic CNT suspended H2O+Cu nanofluid analysis through composite stenosed arteries with permeable wall

NASA Astrophysics Data System (ADS)

Akbar, Noreen Sher

2015-08-01

In the present article magnetic field effects for CNT suspended copper nanoparticles for blood flow through composite stenosed arteries with permeable wall are discussed. The CNT suspended copper nanoparticles for the blood flow with water as base fluid is not explored yet. The equations for the CNT suspended Cu-water nanofluid are developed first time in the literature and simplified using long wavelength and low Reynolds number assumptions. Exact solutions have been evaluated for velocity, pressure gradient, the solid volume fraction of the nanoparticles and temperature profile. Effect of various flow parameters on the flow and heat transfer characteristics is utilized. It is also observed that with the increase in slip parameter blood flows slowly in arteries and trapped bolus increases.

Impulsion of nanoparticles as a drug carrier for the theoretical investigation of stenosed arteries with induced magnetic effects

NASA Astrophysics Data System (ADS)

Nadeem, S.; Ijaz, S.

2016-07-01

In this paper hemodynamics of stenosis are discussed to predict effect of atherosclerosis by means of mathematical models in the presence of uniform transverse magnetic field. The analysis is carried out using silver and copper nanoparticles as a drug carrier. Exact solution for the fluid temperature, velocity, axial induced magnetic field and current density distribution are obtained under mild stenosis approximation. The results indicate that with an increase in the concentration of nanoparticle hemodynamics effects of stenosis reduces throughout the inclined composite stenosed arteries. The considered analysis also summarizes that the drug silver nanoparticles is more efficient to reduce hemodynamics of stenosis when compare to the drug copper nanoparticle. In future this model could be helpful to predict important properties in some biomedical applications.

Successful percutaneous treatment of gluteal claudication secondary to isolated bilateral hypogastric stenoses.

PubMed

Chaer, Rabih A; Faries, Peter L; Lin, Stephanie; Dayal, Rajeev; McKinsey, James F; Kent, K Craig

2006-01-01

We report an unusual case of bilateral buttock claudication at ambulation of less than two blocks in a 57-year-old man with normal lower-extremity segmental pressure on noninvasive exercise testing. He was found to have bilateral high-grade internal iliac artery stenoses on arteriography. Both sides were successfully treated in a staged fashion via a contralateral approach with percutaneous transluminal angioplasty and a balloon-expandable stent, with complete symptom resolution. A clinical vascular examination with normal findings of the common iliac, external iliac, and common and superficial femoral arteries eliminates significant vascular obstruction as a cause of claudication. However, internal iliac occlusive disease may be suspected when symptoms are limited to the gluteal musculature and other causes are eliminated. Percutaneous interventions can be of diagnostic and therapeutic value.

Pancreatic duct stenosis: Differential diagnosis between malignant and benign conditions at secretin-enhanced MRCP.

PubMed

Boninsegna, Enrico; Manfredi, Riccardo; Negrelli, Riccardo; Avesani, Giacomo; Mehrabi, Sara; Pozzi Mucelli, Roberto

To define imaging criteria of benign and malignant nature in patients with main pancreatic duct (MPD) stenosis. S-MRCPs of 35 patients with pancreatitis and 14 with adenocarcinoma were evaluated. Adenocarcinoma caused higher prevalence of complete stenosis (14/14-100% vs 17/35-49%), dilated side-branches (14/14-100% vs 18/35-51%) and lower prevalence of duct-penetrating sign (0/14-0% vs 31/35-89%). The number of stenoses was higher in benign conditions (mean 1.4 Vs 1). Upstream MPD diameter was higher in cancer-induced stenoses (4.5 vs 2.9mm). Single complete stenosis with dilated side branches, increased MPD caliber and absent duct-penetrating sign are suggestive of malignancy. Copyright © 2016 Elsevier Inc. All rights reserved.

Acute myocardial infarction without significant coronary stenoses associated with endogenous subclinical hyperthyroidism.

PubMed

Patanè, Salvatore; Marte, Filippo; Sturiale, Mauro

2012-04-05

Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including atrial fibrillation and atrial flutter. Nowadays, there is growing interest regarding endogenous sublinical hyperthyroidism and the cardiovascular system. We present a case of acute myocardial infarction without significant coronary stenoses in a 75-year-old Italian woman with endogenous subclinical hyperthyroidism. Also this case focuses attention on the importance of a correct evaluation of endogenous subclinical hyperthyroidism. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Trigger Finger (Stenosing Tenosynovitis)

MedlinePlus

... Trigger Finger Find a hand surgeon near you. Videos Trigger Finger Animation Trigger Finger Close Popup Close ... or "in." Also, avoid using media types like "video," "article," and "picture." Tip 4: Your results can ...

Effect of blood viscosity on oxygen transport in residual stenosed artery following angioplasty.

PubMed

Kwon, Ohwon; Krishnamoorthy, Mahesh; Cho, Young I; Sankovic, John M; Banerjee, Rupak K

2008-02-01

The effect of blood viscosity on oxygen transport in a stenosed coronary artery during the postangioplasty scenario is studied. In addition to incorporating varying blood viscosity using different hematocrit (Hct) concentrations, oxygen consumption by the avascular wall and its supply from vasa vasorum, nonlinear oxygen binding capacity of the hemoglobin, and basal to hyperemic flow rate changes are included in the calculation of oxygen transport in both the lumen and the avascular wall. The results of this study show that oxygen transport in the postangioplasty residual stenosed artery is affected by non-Newtonian shear-thinning property of the blood viscosity having variable Hct concentration. As Hct increases from 25% to 65%, the diminished recirculation zone for the increased Hct causes the commencement of pO(2) decrease to shift radially outward by approximately 20% from the center of the artery for the basal flow, but by approximately 10% for the hyperemic flow at the end of the diverging section. Oxygen concentration increases from a minimum value at the core of the recirculation zone to over 90 mm Hg before the lumen-wall interface at the diverging section for the hyperemic flow, which is attributed to increased shear rate and thinner lumen boundary layer for the hyperemic flow, and below 90 mm Hg for the basal flow. As Hct increases from 25% to 65%, the average of pO(2,min) beyond the diverging section drops by approximately 25% for the basal flow, whereas it increases by approximately 15% for the hyperemic flow. Thus, current results with the moderate stenosed artery indicate that reducing Hct might be favorable in terms of increasing O(2) flux and pO(2,min), in the medial region of the wall for the basal flow, while higher Hct is advantageous for the hyperemic flow beyond the diverging section. The results of this study not only provide significant details of oxygen transport under varying pathophysiologic blood conditions such as unusually high blood viscosity and flow rate, but might also be extended to offer implications for drug therapy related to blood-thinning medication and for blood transfusion and hemorrhage.

Quantitative evaluation improves specificity of myocardial perfusion SPECT in the assessment of functionally significant intermediate coronary artery stenoses: a comparative study with fractional flow reserve measurements.

PubMed

Sahiner, Ilgin; Akdemir, Umit O; Kocaman, Sinan A; Sahinarslan, Asife; Timurkaynak, Timur; Unlu, Mustafa

2013-02-01

Myocardial perfusion SPECT (MPS) is a noninvasive method commonly used for assessment of the hemodynamic significance of intermediate coronary stenoses. Fractional flow reserve (FFR) measurement is a well-validated invasive method used for the evaluation of intermediate stenoses. We aimed to determine the association between MPS and FFR findings in intermediate degree stenoses and evaluate the added value of quantification in MPS. Fifty-eight patients who underwent intracoronary pressure measurement in the catheterization laboratory to assess the physiological significance of intermediate (40-70%) left anterior descending (LAD) artery lesions, and who also underwent stress myocardial perfusion SPECT either for the assessment of an intermediate stenosis or for suspected coronary artery disease were analyzed retrospectively in the study. Quantitative analysis was performed using the 4DMSPECT program, with visual assessment performed by two experienced nuclear medicine physicians blinded to the angiographic findings. Summed stress scores (SSS) and summed difference scores (SDS) in the LAD artery territory according to the 20 segment model were calculated. A summed stress score of ≥ 3 and an SDS of ≥ 2 were assumed as pathologic, indicating significance of the lesion; a cutoff value of 0.75 was used to define abnormal FFR. Both visual and quantitative assessment results were compared with FFR using Chi-square (χ²) test. The mean time interval between two studies was 13 ± 11 days. FFR was normal in 45 and abnormal in 13 patients. Considering the FFR results as the gold standard method for assessing the significance of the lesion, the sensitivity and specificity of quantitative analysis determining the abnormal flow reserve were 85 and 84%, respectively, while visual analysis had a sensitivity of 77% and a specificity of 51%. There was a good agreement between the observers (κ = 0.856). Summed stress and difference scores demonstrated moderate inverse correlations with FFR values (r = -0.542, p < 0.001 and r = -0.506, p < 0.001, respectively). Quantitative analysis of the myocardial perfusion SPECT increases the specificity in evaluating the significance of intermediate degree coronary lesions.

Diagnostic Delay in Romanian Patients with Inflammatory Bowel Disease: Risk Factors and Impact on the Disease Course and Need for Surgery

PubMed Central

Zaharie, Roxana; Zaharie, Florin; Tantau, Marcel; Gheorghe, Liana; Gheorghe, Cristian; Gologan, Serban; Cijevschi, Cristina; Trifan, Anca; Dobru, Daniela; Goldis, Adrian; Constantinescu, Gabriel; Iacob, Razvan; Diculescu, Mircea

2016-01-01

Background: The epidemiology of inflammatory bowel disease [IBD] in Eastern Europe is poorly understood, particularly with regard to diagnostic delay. Here we investigated the factors leading to delayed diagnosis and the effect of the delay on several disease progression and outcome measures. Methods: A total of 1196 IBD cases [682 ulcerative colitis [UC], 478 Crohn’s disease [CD], 36 indeterminate colitis] from the Romanian national registry IBDPROSPECT were reviewed. Standard clinical and demographic factors were evaluated as predictors of a long diagnostic delay in both CD and UC. Diagnostic delay was subsequently evaluated as a potential risk factor for bowel stenoses, bowel fistulas, perianal fistulas, perianal surgery, and intestinal surgery in CD patients. Results: The median diagnostic delay was significantly longer in CD [5 months] than in UC [1 month] patients [p < 0.001]. Compared with 5 months for UC patients, 75% of CD patients were diagnosed within 18 months of symptom onset. In CD patients, extra-ileal location was a protective factor (odds ratio [OR], 0.5; p = 0.03), whereas being an active smoker [OR, 2.09; p = 0.01] and symptom onset during summer [OR, 3.35; p < 0.001] were independent risk factors for a long diagnostic delay [> 18 months]. In UC patients, an age > 40 years was a protective factor [OR, 0.68; p = 0.04] for a long delay. Regarding outcomes, a long diagnostic delay in CD patients positively correlated with bowel stenoses [OR, 3.38; p < 0.01] and any IBD-related surgery [OR, 1.95; p = 0.03] and had a positive trend for intestinal fistulas [OR, 2.64; p = 0.08] and perianal fistulas [OR, 2.9; p = 0.07]. Disease duration since diagnosis positively correlated with bowel stenoses [OR, 1.04; p = 0.04], any IBD-related surgery [OR, 1.04; p = 0.02], and intestinal surgery [OR, 1.07; p < 0.01]. Conclusions: A long diagnostic delay in IBD correlates with an increased frequency of bowel stenoses and need for IBD-related surgery. PMID:26589956

Introduction

NASA Astrophysics Data System (ADS)

Takayama, Ken; Briggs*, Richard J.

The motivation for the initial development of linear induction accelerators starting in the early 1960s came mainly from applications requiring intense electron pulses with beam currents and a charge per pulse above the range accessible to RF accelerators, and with particle energies beyond the capabilities of single stage pulsed-power diodes. The linear induction accelerators developed to meet these needs utilize a series of induction cells containing magnetic cores (torroidal geometry) driven directly by pulse modulators (pulsed power sources). This multistage "one-to-one transformer" configuration with non-resonant, low impedance induction cells accelerates kilo-Ampere-scale electron beam current pulses in induction linacs.

Runge-Kutta method for wall shear stress of blood flow in stenosed artery

NASA Astrophysics Data System (ADS)

Awaludin, Izyan Syazana; Ahmad, Rokiah@Rozita

2014-06-01

A mathematical model of blood flow through stenotic artery is considered. A stenosis is defined as the partial occlusion of the blood vessels due to the accumulation of cholesterols, fats and the abnormal growth of tissue on the artery walls. The development of stenosis in the artery is one of the factors that cause problem in blood circulation system. This study was conducted to determine the wall shear stress of blood flow in stenosed artery. Modified mathematical model is used to analyze the relationship of the wall shear stress versus the length and height of stenosis. The existing models that have been created by previous researchers are solved using fourth order Runge-Kutta method. Numerical results show that the wall shear stress is proportionate to the length and height of stenosis.

Complications and Follow-up after Unprotected Carotid Artery Stenting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hauth, Elke A.M.; Drescher, Robert; Jansen, Christian

2006-08-15

Purpose. This prospective study was undertaken to determine the success rate, complications, and outcome of carotid artery stenting (CAS) without the use of cerebral protection devices. Methods. During 12 months, 94 high-grade stenoses of the carotid artery in 91 consecutive patients were treated. Sixty-six (70%) of the stenoses were symptomatic and 28 (30%) were asymptomatic. Results. In all 94 carotid stenoses CAS was successfully performed. During the procedure and within the 30 days afterwards, there were 2 deaths and 3 major strokes in the 66 symptomatic patients, resulting in a combined death and stroke rate of 5 of 66 (7%).more » Only one of these complications, a major stroke, occurred during the procedure. In the 6-month follow-up, one additional major stroke occurred in a originally symptomatic patient resulting in a combined death and stroke rate of 6 of 66 (10%) for symptomatic patients at 6 months. No major complications occurred in asymptomatic patients during the procedure or in the 6-month follow-up period. At 6 months angiographic follow-up the restenosis rate with a degree of >50% was 3 of 49 (6%) and the rate with a degree of {>=}70% was 1 of 49 (2%). Conclusions. Cerebral embolization during CAS is not the only cause of the stroke and death rate associated with the procedure. The use of cerebral protection devices during the procedure may therefore not prevent all major complications following CAS.« less

Invited Review Article: Pump-probe microscopy.

PubMed

Fischer, Martin C; Wilson, Jesse W; Robles, Francisco E; Warren, Warren S

2016-03-01

Multiphoton microscopy has rapidly gained popularity in biomedical imaging and materials science because of its ability to provide three-dimensional images at high spatial and temporal resolution even in optically scattering environments. Currently the majority of commercial and home-built devices are based on two-photon fluorescence and harmonic generation contrast. These two contrast mechanisms are relatively easy to measure but can access only a limited range of endogenous targets. Recent developments in fast laser pulse generation, pulse shaping, and detection technology have made accessible a wide range of optical contrasts that utilize multiple pulses of different colors. Molecular excitation with multiple pulses offers a large number of adjustable parameters. For example, in two-pulse pump-probe microscopy, one can vary the wavelength of each excitation pulse, the detection wavelength, the timing between the excitation pulses, and the detection gating window after excitation. Such a large parameter space can provide much greater molecular specificity than existing single-color techniques and allow for structural and functional imaging without the need for exogenous dyes and labels, which might interfere with the system under study. In this review, we provide a tutorial overview, covering principles of pump-probe microscopy and experimental setup, challenges associated with signal detection and data processing, and an overview of applications.

Invited Review Article: Pump-probe microscopy

PubMed Central

Wilson, Jesse W.; Robles, Francisco E.; Warren, Warren S.

2016-01-01

Multiphoton microscopy has rapidly gained popularity in biomedical imaging and materials science because of its ability to provide three-dimensional images at high spatial and temporal resolution even in optically scattering environments. Currently the majority of commercial and home-built devices are based on two-photon fluorescence and harmonic generation contrast. These two contrast mechanisms are relatively easy to measure but can access only a limited range of endogenous targets. Recent developments in fast laser pulse generation, pulse shaping, and detection technology have made accessible a wide range of optical contrasts that utilize multiple pulses of different colors. Molecular excitation with multiple pulses offers a large number of adjustable parameters. For example, in two-pulse pump-probe microscopy, one can vary the wavelength of each excitation pulse, the detection wavelength, the timing between the excitation pulses, and the detection gating window after excitation. Such a large parameter space can provide much greater molecular specificity than existing single-color techniques and allow for structural and functional imaging without the need for exogenous dyes and labels, which might interfere with the system under study. In this review, we provide a tutorial overview, covering principles of pump-probe microscopy and experimental setup, challenges associated with signal detection and data processing, and an overview of applications. PMID:27036751

Magnetic navigation in patients with coronary artery bypass grafting.

PubMed

Ramcharitar, Steve; van Geuns, Robert-Jan

2009-05-01

Magnetic navigation (MN) can precisely control a percutaneous coronary interventions (PCI) guidewire or a device in three-dimensional space within the body without requiring reshaping of the tip to access vessels or areas of the heart that are often challenging using conventional wires. In this article we review and report on the use of magnetic navigation system in secondary revascularisation of coronary arterial bypass grafts (CABG). MN was successfully used in the secondary revascularisation of failed conventional CABG cases. Retrograde PCI through a LIMA is not only feasible but the wires can manage complex stenoses involving a bifurcation by using 3D reconstruction software. Difficult anatomies such as a hairpin bend as highlighted in this paper found at a saphenous vein graft (SVG) anastomosis can be overcome by co-integrating a CTCA 3D dataset for navigation. Preliminary data supports potential advantages in reduction of contrast media usage, crossing and fluoroscopy times and suggest that larger randomised studies are warranted.

Warm Dense Matter: Another Application for Pulsed Power Hydrodynamics

DTIC Science & Technology

2009-06-01

Pulsed power hydrodynamic techniques, such as large convergence liner compression of a large volume, modest density, low temperature plasma to...controlled than are similar high explosively powered hydrodynamic experiments. While the precision and controllability of gas- gun experiments is...well established, pulsed power techniques using imploding liner offer access to convergent conditions, difficult to obtain with guns – and essential

Outcomes of Prosthetic Hemodialysis Grafts after Deployment of Bare Metal versus Covered Stents at the Venous Anastomosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Charles Y., E-mail: charles.kim@duke.edu; Tandberg, Daniel J.; Rosenberg, Michael D.

2012-08-15

Purpose: To compare postintervention patency rates after deployment of bare metal versus covered stents across the venous anastomosis of prosthetic arteriovenous (AV) grafts. Methods: Review of our procedural database over a 6 year period revealed 377 procedures involving stent deployment in an AV access circuit. After applying strict inclusion criteria, our study group consisted of 61 stent deployments in 58 patients (median age 58 years, 25 men, 33 women) across the venous anastomosis of an upper extremity AV graft circuit that had never been previously stented. Both patent and thrombosed AV access circuits were retrospectively analyzed. Within the bare metalmore » stent group, 20 of 32 AV grafts were thrombosed at initial presentation compared to 18 of 29 AV grafts in the covered stent group. Results: Thirty-two bare metal stents and 29 covered stents were deployed across the venous anastomosis. The 3, 6, and 12 months primary access patency rates for bare metal stents were not significantly different than for covered stents: 50, 41, and 22 % compared to 59, 52, and 29 %, respectively (p = 0.21). The secondary patency rates were also not significantly different: 78, 78, and 68 % for bare metal stents compared to 76, 69, and 61 % for covered stents, respectively (p = 0.85). However, covered stents demonstrated a higher primary stent patency rate than bare metal stents: 100, 85, and 70 % compared to 75, 67, and 49 % at 3, 6, and 12 months (p < 0.01). Conclusion: The primary and secondary access patency rates after deployment of bare metal versus covered stents at the venous anastomosis were not significantly different. However, bare metal stents developed in-stent stenoses significantly sooner.« less

Multiple channel programmable coincidence counter

DOEpatents

Arnone, Gaetano J.

1990-01-01

A programmable digital coincidence counter having multiple channels and featuring minimal dead time. Neutron detectors supply electrical pulses to a synchronizing circuit which in turn inputs derandomized pulses to an adding circuit. A random access memory circuit connected as a programmable length shift register receives and shifts the sum of the pulses, and outputs to a serializer. A counter is input by the adding circuit and downcounted by the seralizer, one pulse at a time. The decoded contents of the counter after each decrement is output to scalers.

Attosecond electronic recollision as field detector

NASA Astrophysics Data System (ADS)

Carpeggiani, P. A.; Reduzzi, M.; Comby, A.; Ahmadi, H.; Kühn, S.; Frassetto, F.; Poletto, L.; Hoff, D.; Ullrich, J.; Schröter, C. D.; Moshammer, R.; Paulus, G. G.; Sansone, G.

2018-05-01

We demonstrate the complete reconstruction of the electric field of visible–infrared pulses with energy as low as a few tens of nanojoules. The technique allows for the reconstruction of the instantaneous electric field vector direction and magnitude, thus giving access to the characterization of pulses with an arbitrary time-dependent polarization state. The technique combines extreme ultraviolet interferometry with the generation of isolated attosecond pulses.

Cryptogenia multifocal ulcerous stenosing enteritis: an entity on its own as a cause of abdominal pain, iron deficiency anemia and protein-losing enteropathy.

PubMed

Guisado Vasco, P; Fraile Rodríguez, G

2014-01-01

We studied a patient with edema secondary to protein losing enteropathy, and recurrent bouts of bloating and abdominal pain secondary to intestinal subocclusion episodes. After the clinical study, the patient was diagnosed of cryptogenic multifocal ulcerous stenosing enteritis (CMUSE), that is a rare disease, probably caused by mutations in the gene PLA2G4A, and characterized by multiple short stenosis of the small bowel with superficial ulcers, which do not exceed the submucosa layer. Inflammatory bowel disease (Chron's disease), intestinal tuberculosis and intestinal ulcers secondary to non-steroidal anti-inflammatory drugs are the main differential diagnosis. To sum up, physicians should included CMUSE in the differential diagnosis of recurrent abdominal pain, iron deficiency anaemia, occult intestinal bleeding, edema and protein losing enteropathy. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Comparison of CT angiography with conventional arterial angiography in aortoiliac occlusive disease.

PubMed

Tins, B; Oxtoby, J; Patel, S

2001-03-01

This study compared the results of conventional and CT angiography of the aortoiliac segment in 35 patients with occlusive disease. Disease severity was graded into five categories. Two assessors independently assessed the segment from the distal abdominal aorta to the proximal superficial femoral artery and a consensus was formed. There was interobserver agreement in 87% of segments for conventional angiography and in 78% for CT angiography. Comparison of the two modalities gave identical grading in 84% of segments. Dissimilar grading was found in 16%, with a roughly equal number of undergrading and overgrading. CT angiography has the advantages of being minimally invasive, requiring only an intravenous injection of contrast medium and imaging surrounding soft tissues. Multiplanar reconstruction aids the visualization of asymmetrical stenoses, and collateral blood supply is readily appreciated. However, CT angiography may fail to demonstrate short stenoses owing to limited z-axis resolution.

Influence of magnetic field on chemically reactive blood flow through stenosed bifurcated arteries

NASA Astrophysics Data System (ADS)

Hossain, Khan Enaet; Haque, Md. Mohidul

2017-06-01

Dynamic response of mass transfer in chemically reactive blood flow through bifurcated arteries under the stenotic condition is numerically studied in the present of a uniform magnetic field. The blood flowing through the artery is assumed an incompressible, fully developed and Newtonian. The nonlinear unsteady flow phenomena are governed by the Navier-Stokes and concentration equations. All these equations together with the appropriate boundary conditions describing the present biomechanical problem are transformed by using a radial transformation and the numerical results are obtained using a finite difference technique. Effects of stenosed bifurcation and externally applied magnetic field on the blood flow with chemical reaction are discussed with the help of graph. All the flow characteristics are found to be affected by the presence of chemical reaction and exposure of magnetic field of different intensities. Finally some important findings of the problem are concluded in this work.

Results of a Seven-Year, Single-Centre Experience of the Long-Term Outcomes of Bovine Ureter Grafts Used as Novel Conduits for Haemodialysis Fistulas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Das, Neelan, E-mail: neelan.das@gmail.com; Bratby, Mark J.; Shrivastava, Vivek

2011-10-15

Purpose: To report the long-term outcomes of bovine ureter grafts as novel conduits for haemodialysis fistulas. Materials and Methods: Thirty-five patients underwent placement of a total of 40 SynerGraft 100 (SG100; CryoLife Europa{sup Registered-Sign}, Guildford, UK) bovine ureter grafts between April 2002 and February 2009. Prospective data were collected on all patients, including active surveillance with blood flow studies and 6-monthly duplex ultrasound studies. Main outcome measures were primary and secondary patency rates. Results: Mean follow-up time was 97 weeks (range 4-270). Thirteen patients died from unrelated causes during the study period; 12 of these patients had a functioning graftmore » at the time of death. Five patients underwent transplantation, and all had a functioning graft at transplantation. Twelve patients had a functioning graft at the end of the study period. One hundred and ten stenoses were detected, and 97 venoplasty procedures were performed. Of the stenoses, 41.8% were located at the venous anastomosis, 12.7% within the graft, 17.3% in the outflow veins, and 28.1% in central veins. No arterial stenoses were detected. Primary patency rates were 53% at 6 months and 14% at 1 year. Secondary patency rates were 81% at 6 months, 75% at 1 year, and 56% at 2 years. Conclusions: Active surveillance and intervention was able to achieve satisfactory long-term secondary patency for these novel conduits compared with those made of PTFE seen in other studies.« less

Evaluation of the carotid artery stenosis based on minimization of mechanical energy loss of the blood flow.

PubMed

Sia, Sheau Fung; Zhao, Xihai; Li, Rui; Zhang, Yu; Chong, Winston; He, Le; Chen, Yu

2016-11-01

Internal carotid artery stenosis requires an accurate risk assessment for the prevention of stroke. Although the internal carotid artery area stenosis ratio at the common carotid artery bifurcation can be used as one of the diagnostic methods of internal carotid artery stenosis, the accuracy of results would still depend on the measurement techniques. The purpose of this study is to propose a novel method to estimate the effect of internal carotid artery stenosis on the blood flow based on the concept of minimization of energy loss. Eight internal carotid arteries from different medical centers were diagnosed as stenosed internal carotid arteries, as plaques were found at different locations on the vessel. A computational fluid dynamics solver was developed based on an open-source code (OpenFOAM) to test the flow ratio and energy loss of those stenosed internal carotid arteries. For comparison, a healthy internal carotid artery and an idealized internal carotid artery model have also been tested and compared with stenosed internal carotid artery in terms of flow ratio and energy loss. We found that at a given common carotid artery bifurcation, there must be a certain flow distribution in the internal carotid artery and external carotid artery, for which the total energy loss at the bifurcation is at a minimum; for a given common carotid artery flow rate, an irregular shaped plaque at the bifurcation constantly resulted in a large value of minimization of energy loss. Thus, minimization of energy loss can be used as an indicator for the estimation of internal carotid artery stenosis.

Correlation of laser-Doppler-velocity measurements and endothelial cell shape in a stenosed dog aorta.

PubMed

Liepsch, D W; Levesque, M; Nerem, R M; Moravec, S T

1988-01-01

Laser-Doppler-velocity measurements were carried out in an elastic 1:1 true-to-scale silicone rubber model of a dog aorta with stenosis. The model was constructed from a cast of a severely stenosed dog aorta (71% of its area). The stenosis in the dog aorta was prepared by wrapping a cotton band around the aorta. This band was tightened until the presence of a thrill or a bruit was felt distal to the band. Twelve weeks later the animal was sacrificed and a cast was prepared from the aorta. From this vascular cast, the cross-sectional area was calculated. Endothelial cell geometry and orientation was studied using computerized analysis to determine the cell area and shape index. An elastic silicone rubber model was prepared from the cast to measure the velocity profiles and to estimate the local wall shear stress. Velocity measurements were done at steady and pulsatile flow using a Newtonian aqueous-glycerol solution and a non-Newtonian blood-like fluid. From those velocity measurements the velocity gradients near the wall were determined and the shear stress calculated. The flow distal to the stenosis separates from the wall at physiological conditions. The endothelial cells are smaller and more elongated in the throat; distal to the stenosis they are larger and rounder. The shape index distribution along the stenosed aorta is correlated with the level of wall shear stress. It is shown that even low changes in the wall shear stress have an influence on the orientation of the endothelial cells.

Compact Fast Ignition experiments using Joule-class tailored drive pulses under counterbeam configuration

NASA Astrophysics Data System (ADS)

Mori, Yoshitaka; Hanayama, Ryohei; Ishii, Katsuhiro; Kitagawa, Yoneyoshi; Sekine, Takashi; Takeuchi, Yasuki; Kurita, Takashi; Katoh, Yoshinori; Satoh, Nakahiro; Kurita, Norio; Kawashima, Toshiyuki; Komeda, Osamu; Hioki, Tatsumi; Motohiro, Tomoyoshi; Sunahara, Atsushi; Sentoku, Yasuhiko; Miura, Eisuke; Iwamoto, Akifumi; Sakagami, Hitoshi

2017-10-01

Fast ignition (FI) is a form of inertial confinement fusion in which the ignition step and the compression step are separate processes resulting in a reduction of the symmetry requirement for hot spot generation. One of the problems of FI so far are the accessibility of an ignition laser pulse into the assembled core in which the driver energy is converted into relativistic electrons produced in the laser-plasma interaction. We have experimentally demonstrated that a tailored-pulse-assembled core with a diameter of 70 μ m, originally a deuterated polystyrene spherical shell of 500 μ m diameter, is flashed by directly counter irradiating 0.8 J/110 fs laser pulses [Y. MORI et al., PRL 2016]. This result indicates that once the assembled core is squeezed into the target center, the heating lasers can access the core's; edges and deposit their energy into the core. In this talk, we will discuss the heating effects in relation to formation of the assembled core.

Multi-pulse multi-delay (MPMD) multiple access modulation for UWB

DOEpatents

Dowla, Farid U.; Nekoogar, Faranak

2007-03-20

A new modulation scheme in UWB communications is introduced. This modulation technique utilizes multiple orthogonal transmitted-reference pulses for UWB channelization. The proposed UWB receiver samples the second order statistical function at both zero and non-zero lags and matches the samples to stored second order statistical functions, thus sampling and matching the shape of second order statistical functions rather than just the shape of the received pulses.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fischer, Martin C., E-mail: Martin.Fischer@duke.edu; Wilson, Jesse W.; Robles, Francisco E.

Multiphoton microscopy has rapidly gained popularity in biomedical imaging and materials science because of its ability to provide three-dimensional images at high spatial and temporal resolution even in optically scattering environments. Currently the majority of commercial and home-built devices are based on two-photon fluorescence and harmonic generation contrast. These two contrast mechanisms are relatively easy to measure but can access only a limited range of endogenous targets. Recent developments in fast laser pulse generation, pulse shaping, and detection technology have made accessible a wide range of optical contrasts that utilize multiple pulses of different colors. Molecular excitation with multiple pulsesmore » offers a large number of adjustable parameters. For example, in two-pulse pump-probe microscopy, one can vary the wavelength of each excitation pulse, the detection wavelength, the timing between the excitation pulses, and the detection gating window after excitation. Such a large parameter space can provide much greater molecular specificity than existing single-color techniques and allow for structural and functional imaging without the need for exogenous dyes and labels, which might interfere with the system under study. In this review, we provide a tutorial overview, covering principles of pump-probe microscopy and experimental setup, challenges associated with signal detection and data processing, and an overview of applications.« less

Frequency comb-based multiple-access ultrastable frequency dissemination with 7 × 10(-17) instability.

PubMed

Zhang, Shuangyou; Zhao, Jianye

2015-01-01

In this letter, we demonstrate frequency-comb-based multiple-access ultrastable frequency dissemination over a 10-km single-mode fiber link. First, we synchronize optical pulse trains from an Er-fiber frequency comb to the remote site by using a simple and robust phase-conjugate stabilization method. The fractional frequency-transfer instability at the remote site is 2.6×10(-14) and 4.9×10(-17) for averaging times of 1 and 10,000 s, respectively. Then, we reproduce the harmonic of the repetition rate from the disseminated optical pulse trains at an arbitrary point along the fiber link to test comb-based multiple-access performance, and demonstrate frequency instability of 4×10(-14) and 7×10(-17) at 1 and 10,000 s averaging time, respectively. The proposed comb-based multiple-access frequency dissemination can easily achieve highly stable wideband microwave extraction along the whole link.

Cooperative photoinduced metastable phase control in strained manganite films

NASA Astrophysics Data System (ADS)

Zhang, Jingdi; Tan, Xuelian; Liu, Mengkun; Teitelbaum, S. W.; Post, K. W.; Jin, Feng; Nelson, K. A.; Basov, D. N.; Wu, Wenbin; Averitt, R. D.

2016-09-01

A major challenge in condensed-matter physics is active control of quantum phases. Dynamic control with pulsed electromagnetic fields can overcome energetic barriers, enabling access to transient or metastable states that are not thermally accessible. Here we demonstrate strain-engineered tuning of La2/3Ca1/3MnO3 into an emergent charge-ordered insulating phase with extreme photo-susceptibility, where even a single optical pulse can initiate a transition to a long-lived metastable hidden metallic phase. Comprehensive single-shot pulsed excitation measurements demonstrate that the transition is cooperative and ultrafast, requiring a critical absorbed photon density to activate local charge excitations that mediate magnetic-lattice coupling that, in turn, stabilize the metallic phase. These results reveal that strain engineering can tune emergent functionality towards proximal macroscopic states to enable dynamic ultrafast optical phase switching and control.

Electrical Characterization of Microprocessor Memories.

DTIC Science & Technology

1981-06-01

INPUT PULSE 0 TO 3.0 20 T--- MEAN VALUE T AA (30) 3,Y VALUE t:_______ -50 -50 0 25 50 70 75 100 125 CASE TEMPERATURE (O)VENDOR SPEC LIMIT 45 NSEC 40 ...PULSE 0 TO 3.0 T AA MEAN VALUE T AA (3a) = 3a VALUEm ’t -.55 - 40 -25 -10 0 20 35 50 65 80 75 110 125 -CASE TEMPERATURE IN 0 aC Figure 2-2. Address Access...times for 2147H-1 and 2147H-2 were increased 5 nanosec- onds each to 40 and 50 nanoseconds, respectively. For the 2148, the access times were increased

Accessing defect dynamics using intense, nanosecond pulsed ion beams

DOE Office of Scientific and Technical Information (OSTI.GOV)

Persaud, A.; Barnard, J. J.; Guo, H.

2015-06-18

Gaining in-situ access to relaxation dynamics of radiation induced defects will lead to a better understanding of materials and is important for the verification of theoretical models and simulations. We show preliminary results from experiments at the new Neutralized Drift Compression Experiment (NDCX-II) at Lawrence Berkeley National Laboratory that will enable in-situ access to defect dynamics through pump-probe experiments. Here, the unique capabilities of the NDCX-II accelerator to generate intense, nanosecond pulsed ion beams are utilized. Preliminary data of channeling experiments using lithium and potassium ions and silicon membranes are shown. We compare these data to simulation results using Crystalmore » Trim. Furthermore, we discuss the improvements to the accelerator to higher performance levels and the new diagnostics tools that are being incorporated.« less

[Coarctation of the descending aorta. A rare form of connatal aortic stenosis].

PubMed

Stammwitz, E; Schöttler, M; Brix, F; Poser, H L; Langkau, G; Yükseltan, I

1983-07-01

A clinical diagnosis of a coarctation of the aorta was made in a 17-year-old female hypertensive patient. Angiography revealed an atypical stenosis of the descending aorta which was surgically corrected. The causes of aortic stenoses are discussed.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sommer, Karsten, E-mail: sommerk@uni-mainz.de, E-mail: Schreiber-L@ukw.de; Bernat, Dominik; Schmidt, Regine

Purpose: The extent to which atherosclerotic plaques affect contrast agent (CA) transport in the coronary arteries and, hence, quantification of myocardial blood flow (MBF) using magnetic resonance imaging (MRI) is unclear. The purpose of this work was to evaluate the influence of plaque induced stenosis both on CA transport and on the accuracy of MBF quantification. Methods: Computational fluid dynamics simulations in a high-detailed realistic vascular model were employed to investigate CA bolus transport in the coronary arteries. The impact of atherosclerosis was analyzed by inserting various medium- to high-grade stenoses in the vascular model. The influence of stenosis morphologymore » was examined by varying the stenosis shapes but keeping the area reduction constant. Errors due to CA bolus transport were analyzed using the tracer-kinetic model MMID4. Results: Dispersion of the CA bolus was found in all models and for all outlets, but with a varying magnitude. The impact of stenosis was complex: while high-grade stenoses amplified dispersion, mild stenoses reduced the effect. Morphology was found to have a marked influence on dispersion for a small number of outlets in the post-stenotic region. Despite this marked influence on the concentration–time curves, MBF errors were less affected by stenosis. In total, MBF was underestimated by −7.9% to −44.9%. Conclusions: The presented results reveal that local hemodynamics in the coronary vasculature appears to have a direct impact on CA bolus dispersion. Inclusion of atherosclerotic plaques resulted in a complex alteration of this effect, with both degree of area reduction and stenosis morphology affecting the amount of dispersion. This strong influence of vascular transport effects impairs the accuracy of MRI-based MBF quantification techniques and, potentially, other bolus-based perfusion measurement techniques like computed tomography perfusion imaging.« less

Comparison of ferumoxytol-enhanced MRA with conventional angiography for assessment of severity of transplant renal artery stenosis.

PubMed

Fananapazir, Ghaneh; Bashir, Mustafa R; Corwin, Michael T; Lamba, Ramit; Vu, Catherine T; Troppmann, Christoph

2017-03-01

To determine the accuracy of ferumoxytol-enhanced magnetic resonance angiography (MRA) in assessing the severity of transplant renal artery stenosis (TRAS), using digital subtraction angiography (DSA) as the reference standard. Our Institutional Review Board approved this retrospective, Health Insurance Portability and Accountability Act-compliant study. Thirty-three patients with documented clinical suspicion for TRAS (elevated serum creatinine, refractory hypertension, edema, and/or audible bruit) and/or concerning sonographic findings (elevated renal artery velocity and/or intraparenchymal parvus tardus waveforms) underwent a 1.5T MRA with ferumoxytol prior to DSA. All DSAs were independently reviewed by an interventional radiologist and served as the reference standard. The MRAs were reviewed by three readers who were blinded to the ultrasound and DSA findings for the presence and severity of TRAS. Sensitivity, specificity, and accuracy for identifying substantial stenoses (>50%) were determined. Intraclass correlation coefficients (ICCs) were calculated among readers. Mean differences between the percent stenosis from each MRA reader and DSA were calculated. On DSA, a total of 42 stenoses were identified in the 33 patients. The sensitivity, specificity, and accuracy of MRA in detecting substantial stenoses were 100%, 75-87.5%, and 95.2-97.6%, respectively, among the readers. There was excellent agreement among readers as to the percent stenosis (ICC = 0.82). MRA overestimated the degree of stenosis by 3.9-9.6% compared to DSA. Ferumoxytol-enhanced MRA provides high sensitivity, specificity, and accuracy for determining the severity of TRAS. Our results suggest that it can potentially be used as a noninvasive examination following ultrasound to reduce the number of unnecessary conventional angiograms. 3 J. Magn. Reson. Imaging 2017;45:779-785. © 2016 International Society for Magnetic Resonance in Medicine.

Does grafting coronary arteries with only moderate stenosis affect long-term mortality?

PubMed Central

Sabik, Joseph F.; Olivares, Gabriel; Raza, Sajjad; Lytle, Bruce W.; Houghtaling, Penny L.; Blackstone, Eugene H.

2016-01-01

Objective Stenting coronary arteries with non–ischemia-producing moderate stenosis leads to worse outcomes than leaving them unstented. We sought to determine whether grafting coronary arteries with angiographically moderate stenosis is associated with worse long-term survival than leaving them ungrafted. Methods From 1972 to 2011, 55,567 patients underwent primary isolated coronary artery bypass grafting (CABG); 8531 had a single coronary artery with moderate (50%-69%) stenosis, bypassed in 6598 (77%) and not bypassed in 1933 (23%). These arteries were grafted with internal thoracic arteries (ITAs) in 1806 patients (27%) and with saphenous veins (SVs) in 4625 (70%). Mean follow-up for all-cause mortality was 13.0 ± 9.7 years. Results Survival was similar for patients with and without a graft to the moderately stenosed coronary artery (P = .3): 97%, 76%, 43%, and 18% at 1, 10, 20, and 30 years among patients receiving no graft; 97%, 74%, 41%, and 18% among those receiving an SV graft; and 98%, 82%, 51%, and 23% among those receiving an ITA graft. After adjusting for patient characteristics, SV grafting versus nongrafting of moderately stenosed coronary arteries was associated with similar long-term mortality (P = .2), whereas ITA grafting was associated with 22% lower long-term mortality (hazard ratio 0.78; 68% confidence interval 0.75–0.82; P<.0001). Conclusions Grafting coronary arteries with angiographically moderate stenosis is not harmful. Instead, ITA grafting of such coronary arteries is associated with lower long-term mortality. Thus, after placing the first ITA to the left anterior descending, the second ITA should be placed to the second most important coronary artery, even if it is moderately stenosed. PMID:26611750

ECG-triggered high-pitch CT for simultaneous assessment of the aorta and coronary arteries.

PubMed

Hachulla, Anne-Lise; Ronot, Maxime; Noble, Stéphane; Becker, Christoph D; Montet, Xavier; Vallée, Jean-Paul

2016-01-01

To study the image quality of ECG-gated-computed tomography (CT) acquisition with a high-pitch CT imaging for the exploration of both the aorta and coronary arteries. Eighty-four patients underwent high-pitch ECG-gated aortic CT without β-blockers with iterative reconstruction algorithms. Contrast-to-noise ratio (CNR) between vessels and adjacent perivascular fat tissue were calculated on the aorta and the coronary arteries. Dose-length-products (DLP) were recorded. Two blinded readers graded image quality of the aorta and the coronary arteries on a 3-point scale. Coronary artery stenoses were compared with coronary angiograms in 24 patients. Kappa values were calculated. High-pitch acquisition resulted in a mean DLP of 234 ± 93 mGy cm(4.2 mSv) for an acquisition of the entire aorta, (mean 73 ± 16 bpm). CNR for ascending aorta was 10.6 ± 4 and CNR for coronary arteries was 9.85 ± 4.1. Image quality was excellent in 79/84 patients (94%), and excellent or moderate but diagnostic in 1087/1127 coronary artery segments (96%). 74 significant stenoses were observed, and 38/40 significant stenoses were confirmed by coronary angiography (K = 0.91, Sensitivity = 0.97, Specificity = 0.98). High-pitch ECG-gated aortic CT with iterative reconstructions allows an accurate exploration of both aorta and coronary arteries during the same acquisition, with limited dose deposition, despite the lack of β-blockers and relatively high heart rate. Radiologists need to be aware of the necessity to analyze and report coronary artery disease in aortic examination. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Surgical treatment in stenosing rectal cancer.

PubMed

Deaconescu, V; Simion, L; Alecu, M; Ionescu, S; Mastalier, B; Straja, N D

2014-01-01

Rectal cancer represents an important health issue, which involves multidisciplinary treatment, posing a major surgical challenge, both in terms of diagnosis and treatment. Between 2009-2013, we analysed 83 patients with stenosing rectal cancer operated on at the Clinic of General Surgery II of Colentina Clinical Hospital and at the Clinic of General Surgery I of "Prof. Dr. Al. Trestioreanu"€ Oncology Institute, in Bucharest. Gender distribution was: 51 males and 32 females. Average age was 65 years old. The most frequently encountered symptoms were colicky abdominal pain and rectorrhagia. 25 patients presented intestinal occlusion phenomena at admission, the other 58 cases being in subocclusive stage. In occlusive stages: 17 patients presented with resectable tumour, while 8 patients had locally advanced neoplastic forms (€œfrozen pelvis€), left iliac colostomy with tumour biopsy being the chosen approach. In subocclusive stages: 5 cases had unresectable tumours for which left iliac anus with tumour biopsy was performed; 53 cases presented with resectable tumour, for which the Hartmann procedure (12 patients) and left iliac colostomy with tumour biopsy (41 patients) were performed. Depending on the histopathological result, patients were submitted to radio- and chemotherapy.Tumour resection was possible in 70 cases (84.33%), only 34 of these (40.96%) being with radical intent. Treatment for stenosing rectal cancer is multimodal,represented by surgical approach, radio- and chemotherapy. The rationality behind surgery as a first therapeutic gesture in the given study group was represented by the need to treat occlusive type complications, patients benefitting subsequently from radio- and chemotherapy. The opportunity of a second surgical intervention, with the objective to remove the tumour, was established based on the therapeutic response to radio- and chemotherapy. Celsius.

High Prevalence of Multiple Arterial Bed Lesions in Patients With Fibromuscular Dysplasia: The ARCADIA Registry (Assessment of Renal and Cervical Artery Dysplasia).

PubMed

Plouin, Pierre-François; Baguet, Jean-Philippe; Thony, Frédéric; Ormezzano, Olivier; Azarine, Arshid; Silhol, François; Oppenheim, Catherine; Bouhanick, Béatrice; Boyer, Louis; Persu, Alexandre; Hammer, Frank; Gosse, Philippe; Mounier-Vehier, Claire; Le Hello, Claire; Jeunemaitre, Xavier; Azizi, Michel; Amar, Laurence; Chatellier, Gilles; Mousseaux, Elie; Touzé, Emmanuel

2017-09-01

Fibromuscular dysplasia (FMD) commonly affects the renal and cervical arteries but has been described to affect other vascular beds as well. The prevalence of and clinical characteristics associated with multisite FMD (string-of-beds or focal stenoses affecting at least 2 vascular beds) are not known. In the prospective ARCADIA registry (Assessment of Renal and Cervical Artery Dysplasia), symptomatic patients with renal artery (RA) FMD underwent tomographic- or magnetic resonance-angiography from the aortic arch to the intracranial arteries and those with cervical FMD from the diaphragm to the pelvis. Of 469 patients (84.0% women), 225 (48.0%) had multisite FMD. In addition, 86 of 244 patients with single-site disease had dissections or aneurisms affecting other vascular beds, totaling 311 patients (66.3%) with lesions in >1 vascular bed. Among patients with a cerebrovascular presentation, the prevalence of RA lesions was higher in patients with than in those without hypertension (odds ratio, 3.4; 95% confidence interval, 1.99-6.15). Among patients with a renal presentation, the prevalence of cervical lesions was higher in patients with bilateral than in those with unilateral RA lesions (odds ratio, 1.9; 95% confidence interval, 0.99-3.57). In conclusion, FMD is a systemic arterial disease. At least 2 vascular beds were affected by dysplastic stenoses in 48.0% of cases and by dysplastic stenoses, aneurysms, and dissections in 66.1% of cases. RA imaging should be proposed to hypertensive patients with a cerebrovascular presentation. Cervical artery imaging should be considered in patients with a renal presentation and bilateral RA lesions. URL: www.Clinicaltrials.gov. Unique identifier: NCT02884141. © 2017 American Heart Association, Inc.

[Technical feasibility of the implantation of a monorail stent system into the renal arteries without pre-dilatation].

PubMed

Neumann, C; Gschwendtner, M; Karnel, F; Mair, J; Dorffner, G; Dorffner, R

2005-01-01

To evaluate the technical feasibility of the implantation of the monorail RX Herculink system into the renal arteries without pre-dilatation. Forty-two patients (mean age 71 years) from four centers with a total of 44 renal artery stenoses underwent implantation of the RX Herculink stent. The mean grade of the stenosis was 83.8 %, the mean length 7.5 mm. The stenoses were ostial in 38 cases and in immediate proximity to the ostium in 6 cases. The mean follow-up-period was 57 weeks (24 - 176 weeks). In 42 cases, the implantation was successful without pre-dilatation. In 2 cases, pre-dilatation was carried out. In none of the cases, detachment of the stent from the balloon was observed. In one stenosis with a length of 17 mm, implantation of two stents was performed. In 9 cases, post-dilatation with a larger balloon or higher balloon pressure was necessary. Residual stenoses exceeding 30 % were not observed. Two patients developed local bleeding at the puncture site. During the follow-up, restenoses were observed in 5 stents after 26 to 126 weeks, which necessitated a second intervention in 3 cases (PTA in 2 cases, re-stenting in 1 case). The primary patency rate after 6 and 12 months was 0.92 +/- 0.056 according to Kaplan-Meier, the secondary patency rate after 6 and 12 months was 1.0 +/- 0.0. Implantation of the RX Herculink stent system into the renal arteries without pre-dilatation is technically feasible and safe. Even without pre-dilatation, the stent-system can be advanced through the stenosis without detachment. The complication rate is low. Our clinical results are comparable to previous studies.

Coronary artery size and disease in UK South Asian and Caucasian men.

PubMed

Zindrou, Dlear; Taylor, Kenneth M; Bagger, Jens Peder

2006-04-01

South Asian patients in the UK have a higher mortality rate after coronary artery bypass grafting (CABG) than Caucasian patients. As coronary artery size has been shown to correlate to outcome from bypass grafting, it has been suggested that smaller coronary arteries in South Asians as compared to Caucasians could contribute to a poorer outcome in the Asian population. We aimed to measure coronary artery size and disease in matched South Asian and Caucasian men undergoing first time coronary artery bypass grafting. Coronary arteriograms from 53 matched first generation South Asian and Caucasian men were examined. The patients had no history of myocardial infarction, coronary revascularisation, familial dyslipidaemia, diabetes or renal disease. They were individually matched for age, height, weight, body mass index and body surface area. Thereafter, coronary artery diameters and significant (> or =50%) diameter stenoses were measured in a blinded fashion using quantitative coronary angiography (QCA). In South Asian men, diameters of the left main stem (LMS) and the proximal left anterior descending, the circumflex and the right coronary arteries were 4.6+/-0.9 mm, 3.5+/-0.8 mm, 3.4+/-0.8 mm and 3.5+/-0.8 mm, respectively. The corresponding arterial diameters among Caucasian men (4.5+/-0.9 mm, 3.5+/-0.7 mm, 3.5+/-0.8 mm and 3.8+/-0.8 mm) did not differ from those in South Asians. There was no difference in the number of significant coronary artery stenoses between the two groups and no difference in bypass and cross-clamp times or in adverse outcome (one from each group died after coronary artery bypass grafting). Proximal coronary artery size and number of significant coronary stenoses did not differ between matched pairs of South Asian and Caucasian men using strict inclusion/exclusion criteria.

Randomized clinical trial of cutting balloon angioplasty versus high-pressure balloon angioplasty in hemodialysis arteriovenous fistula stenoses resistant to conventional balloon angioplasty.

PubMed

Aftab, Syed Arafat; Tay, Kiang Hiong; Irani, Farah G; Gong Lo, Richard Hoau; Gogna, Apoorva; Haaland, Benjamin; Tan, Seck Guan; Chng, Siew Png; Pasupathy, Shanker; Choong, Hui Lin; Tan, Bien Soo

2014-02-01

To compare the efficacy and safety of cutting balloon angioplasty (CBA) versus high-pressure balloon angioplasty (HPBA) for the treatment of hemodialysis autogenous fistula stenoses resistant to conventional percutaneous transluminal angioplasty (PTA). In a prospective, randomized clinical trial involving patients with dysfunctional, stenotic hemodialysis arteriovenous fistulas (AVFs), patients were randomized to receive CBA or HPBA if conventional PTA had suboptimal results (ie, residual stenosis > 30%). A total of 516 patients consented to participate in the study from October 2008 to September 2011, 85% of whom (n = 439) had technically successful conventional PTA. The remaining 71 patients (mean age, 60 y; 49 men) with suboptimal PTA results were eventually randomized: 36 to the CBA arm and 35 to the HPBA arm. Primary and secondary target lesion patencies were determined by Kaplan-Meier analysis. Clinical success rates were 100% in both arms. Primary target lesion patency rates at 6 months were 66.4% and 39.9% for CBA and HPBA, respectively (P = .01). Secondary target lesion patency rates at 6 months were 96.5% for CBA and 80.0% for HPBA (P = .03). There was a single major complication of venous perforation following CBA. The 30-day mortality rate was 1.4%, with one non-procedure-related death in the HPBA group. Primary and secondary target lesion patency rates of CBA were statistically superior to those of HPBA following suboptimal conventional PTA. For AVF stenoses resistant to conventional PTA, CBA may be a better second-line treatment given its superior patency rates. © 2014 SIR Published by SIR All rights reserved.

Revascularization decisions in patients with stable angina and intermediate lesions: results of the international survey on interventional strategy.

PubMed

Toth, Gabor G; Toth, Balint; Johnson, Nils P; De Vroey, Frederic; Di Serafino, Luigi; Pyxaras, Stylianos; Rusinaru, Dan; Di Gioia, Giuseppe; Pellicano, Mariano; Barbato, Emanuele; Van Mieghem, Carlos; Heyndrickx, Guy R; De Bruyne, Bernard; Wijns, William

2014-12-01

Fractional flow reserve (FFR) measurement of intermediate coronary stenoses is recommended by guidelines when demonstration of ischemia by noninvasive testing is unavailable. The study aims to evaluate the penetration of this recommendation into current thinking about revascularization strategies for stable coronary artery disease. International Survey on Interventional Strategy was conducted via a web-based platform. First, participants' experiences in interventional cardiology were queried. Second, 5 complete angiograms were provided, presenting only focal intermediate stenoses. FFR and quantitative coronary angiography values were known; however, remained undisclosed. Determination of stenosis significance was asked for each lesion. In cases of uncertainty, the most appropriate adjunctive invasive diagnostic method among quantitative coronary angiography, intravascular ultrasound, optical coherence tomography, or FFR needed to be selected. International Survey on Interventional Strategy was taken by 495 participants who provided 4421 lesion evaluations. In 3158 (71%) decisions, participants relied solely on angiographic appearance that was discordant in 47% with the known FFR, using 0.80 as cutoff value. The use of FFR and imaging modalities was requested in 21% and 8%, respectively. Comparing 4 groups of participants according to the experience in FFR, angiogram-based decisions were less frequent with increasing experience (77% versus 72% versus 69% versus 67%, respectively; P<0.001). As a result, requests for FFR were more frequent (14% versus 19% versus 24% versus 28%, respectively; P<0.001) and rates of discordant decisions decreased (51% versus 49% versus 47% versus 43%, respectively; P<0.022). The findings confirm that, even when all potential external constraints are virtually eliminated, visual estimation continues to dominate the treatment decisions for intermediate stenoses, indicative of a worrisome disconnect between recommendations and current practice. © 2014 American Heart Association, Inc.

Does grafting coronary arteries with only moderate stenosis affect long-term mortality?

PubMed

Sabik, Joseph F; Olivares, Gabriel; Raza, Sajjad; Lytle, Bruce W; Houghtaling, Penny L; Blackstone, Eugene H

2016-03-01

Stenting coronary arteries with non-ischemia-producing moderate stenosis leads to worse outcomes than leaving them unstented. We sought to determine whether grafting coronary arteries with angiographically moderate stenosis is associated with worse long-term survival than leaving them ungrafted. From 1972 to 2011, 55,567 patients underwent primary isolated coronary artery bypass grafting (CABG); 8531 had a single coronary artery with moderate (50%-69%) stenosis, bypassed in 6598 (77%) and not bypassed in 1933 (23%). These arteries were grafted with internal thoracic arteries (ITAs) in 1806 patients (27%) and with saphenous veins (SVs) in 4625 (70%). Mean follow-up for all-cause mortality was 13.0 ± 9.7 years. Survival was similar for patients with and without a graft to the moderately stenosed coronary artery (P = .3): 97%, 76%, 43%, and 18% at 1, 10, 20, and 30 years among patients receiving no graft; 97%, 74%, 41%, and 18% among those receiving an SV graft; and 98%, 82%, 51%, and 23% among those receiving an ITA graft. After adjusting for patient characteristics, SV grafting versus nongrafting of moderately stenosed coronary arteries was associated with similar long-term mortality (P = .2), whereas ITA grafting was associated with 22% lower long-term mortality (hazard ratio 0.78; 68% confidence interval 0.75-0.82; P < .0001). Grafting coronary arteries with angiographically moderate stenosis is not harmful. Instead, ITA grafting of such coronary arteries is associated with lower long-term mortality. Thus, after placing the first ITA to the left anterior descending, the second ITA should be placed to the second most important coronary artery, even if it is moderately stenosed. Copyright © 2016. Published by Elsevier Inc.

Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

PubMed

Gheorghe, Andrada; Zahiu, Denise Carmen Mihaela; Voiosu, Theodor Alexandru; Mateescu, Bogdan Radu; Voiosu, Mihail Radu; Rimbaş, Mihai

2017-06-01

As already known, spondyloarthritis patients present a striking resemblance in intestinal inflammation with early Crohn's disease. Moreover, the frequent use of nonsteroidal anti-inflammatory drugs is an important part of their treatment. Both conditions could lead to intestinal stenoses. Therefore we proposed to investigate the usefulness of the patency capsule test in patients with spondyloarthritis. 64 consecutive patients (33 males; mean age 38 ± 11 years) that fulfilled the AMOR criteria for seronegative spondyloarthropathy (59.4% ankylosing spondylitis) lacking symptoms or signs of intestinal stenosis were enrolled and submitted to an AGILE™ capsule patency test followed by a video capsule endoscopy (PillCam SB2™), as part of a protocol investigating the presence of intestinal inflammatory lesions. After reviewing the VCE recordings, the Lewis score (of small bowel inflammatory involvement) was computed. In only 5 patients (7.8%) of the study group, the luminal patency test was negative. However, there was no retention of the videocapsule in any of the patients. From the 59 patients with a positive patency test, 3 patients presented single small bowel stenoses (two with ulcerated overlying inflamed mucosa, one cicatricial), all being traversed by the videocapsule along the length of the recording. None of the patients with a negative test had bowel stenoses. There was no correlation between the patency test and the Lewis score, the C reactive protein value, diagnosis of inflammatory bowel disease, or the family history of spondyloarthritis, psoriasis or inflammatory bowel disease. The AGILE patency capsule does not seem to be a useful tool for all patients with spondyloarthritis prior to small bowel videocapsule endoscopy (ClinicalTrial.gov ID NCT 00768950).

Silent myocardial ischemia in patients with symptomatic intracranial atherosclerosis: associated factors.

PubMed

Arenillas, Juan F; Candell-Riera, Jaume; Romero-Farina, Guillermo; Molina, Carlos A; Chacón, Pilar; Aguadé-Bruix, Santiago; Montaner, Joan; de León, Gustavo; Castell-Conesa, Joan; Alvarez-Sabín, José

2005-06-01

Optimization of coronary risk evaluation in stroke patients has been encouraged. The relationship between symptomatic intracranial atherosclerosis and occult coronary artery disease (CAD) has not been evaluated sufficiently. We aimed to investigate the prevalence of silent myocardial ischemia in patients with symptomatic intracranial atherosclerosis and to identify factors associated with its presence. From 186 first-ever transient ischemic attack or ischemic stroke patients with intracranial stenoses, 65 fulfilled selection criteria, including angiographic confirmation of a symptomatic atherosclerotic stenosis and absence of known CAD. All patients underwent a maximal-stress myocardial perfusion single-photon emission computed tomography (SPECT). Lipoprotein(a) [Lp(a)], C-reactive protein, and homocysteine (Hcy) levels were determined before SPECT. Stress-rest SPECT detected reversible myocardial perfusion defects in 34 (52%) patients. Vascular risk factors associated with a pathologic SPECT were hypercholesterolemia (P=0.045), presence of >2 risk factors (P=0.004) and high Lp(a) (P=0.023) and Hcy levels (P=0.018). Ninety percent of patients with high Lp(a) and Hcy levels had a positive SPECT. Existence of a stenosed intracranial internal carotid artery (ICA; odds ratio [OR], 7.22, 2.07 to 25.23; P=0.002) and location of the symptomatic stenosis in vertebrobasilar arteries (OR, 4.89, 1.19 to 20.12; P=0.027) were independently associated with silent myocardial ischemia after adjustment by age, sex, and risk factors. More than 50% of the patients with symptomatic intracranial atherosclerosis and not overt CAD show myocardial perfusion defects on stress-rest SPECT. Stenosed intracranial ICA, symptomatic vertebrobasilar stenosis and presence of high Lp(a) and Hcy levels may characterize the patients at a higher risk for occult CAD.

Generation of flat-top pulsed magnetic fields with feedback control approach.

PubMed

Kohama, Yoshimitsu; Kindo, Koichi

2015-10-01

We describe the construction of a simple, compact, and cost-effective feedback system that produces flat-top field profiles in pulsed magnetic fields. This system is designed for use in conjunction with a typical capacitor-bank driven pulsed magnet and was tested using a 60-T pulsed magnet. With the developed feedback controller, we have demonstrated flat-top magnetic fields as high as 60.64 T with an excellent field stability of ±0.005 T. The result indicates that the flat-top pulsed magnetic field produced features high field stability and an accessible field strength. These features make this system useful for improving the resolution of data with signal averaging.

Ultrashort pulse energy distribution for propulsion in space

NASA Astrophysics Data System (ADS)

Bergstue, Grant Jared

This thesis effort focuses on the development of a novel, space-based ultrashort pulse transmission system for spacecraft. The goals of this research include: (1) ultrashort pulse transmission strategies for maximizing safety and efficiency; (2) optical transmission system requirements; (3) general system requirements including control techniques for stabilization; (4) optical system requirements for achieving effective ablative propulsion at the receiving spacecraft; and (5) ultrashort pulse transmission capabilities required for future missions in space. A key element of the research is the multiplexing device required for aligning the ultrashort pulses from multiple laser sources along a common optical axis for transmission. This strategy enables access to the higher average and peak powers required for useful missions in space.

Implementation of radial arterial access for cardiac interventions: a strong case for quality assurance protocols by the nursing staff.

PubMed

Steffenino, Giuseppe; Fabrizi, Mauro De Benedetto; Baralis, Giorgio; Tomatis, Marilena; Mogna, Aldo; Dutto, Monica; Dutto, Maria Stefania; Conte, Laura; Lice, Giulietta; Cavallo, Simona; Porcedda, Brunella

2011-02-01

Radial arterial access is becoming increasingly popular for coronary angiography and angioplasty. The technique is, however, more demanding than femoral arterial access, and hemostasis is not care-free. A quality assurance program was run by our nursing staff, with patient follow-up, to monitor radial arterial access implementation in our laboratory. In 973 consecutive patients, both a hydrophilic sheath and an inflatable bandage for hemostasis were used. Bandage inflation volume and time were both reduced through subsequent data audit and protocol changes (A = 175 patients; B = 297; C = 501). An increase was achieved in the percentage of patients with neither loss of radial pulse nor hematoma of any size (A = 81.3%, B = 90.9%, C = 92.2%, P < 0.001), and no discomfort at all (A = 44.2%, B = 75.1%, C = 89.3%, P < 0.001). Follow-up was available for 965 patients (99%), and in 956, the access site could be re-inspected at least once. There were no vascular complications. Overall, the radial artery pulse was absent at latest follow-up in 0.6% of cases (95% confidence interval 0.21-1.05%). In 460 consecutive patients with complete assessment in protocol C, a palpable arterial pulse was absent in 5% of cases at about 20 h after hemostasis. Barbeau's test was positive in 26.5% of patients (95% confidence interval 22.5-30.6%). They had a significantly lower body weight, a lower systolic blood pressure at hemostasis, and a higher bandage inflation volume; a hematoma of any size and the report of any discomfort were also more frequent. Barbeau's test returned to normal in 30% of them 3-60 days later. Our nurse-led quality assurance program helped us in reducing minor vascular sequelae and improving patient comfort after radial access. Early occlusion of the radial artery as detected by pulse oxymeter is frequent, often reversible, and may be mostly related to trauma/occlusion of the artery during hemostasis. 2011 Italian Federation of Cardiology.

Endurance Enhancement and High Speed Set/Reset of 50 nm Generation HfO2 Based Resistive Random Access Memory Cell by Intelligent Set/Reset Pulse Shape Optimization and Verify Scheme

NASA Astrophysics Data System (ADS)

Higuchi, Kazuhide; Miyaji, Kousuke; Johguchi, Koh; Takeuchi, Ken

2012-02-01

This paper proposes a verify-programming method for the resistive random access memory (ReRAM) cell which achieves a 50-times higher endurance and a fast set and reset compared with the conventional method. The proposed verify-programming method uses the incremental pulse width with turnback (IPWWT) for the reset and the incremental voltage with turnback (IVWT) for the set. With the combination of IPWWT reset and IVWT set, the endurance-cycle increases from 48 ×103 to 2444 ×103 cycles. Furthermore, the measured data retention-time after 20 ×103 set/reset cycles is estimated to be 10 years. Additionally, the filamentary based physical model is proposed to explain the set/reset failure mechanism with various set/reset pulse shapes. The reset pulse width and set voltage correspond to the width and length of the conductive-filament, respectively. Consequently, since the proposed IPWWT and IVWT recover set and reset failures of ReRAM cells, the endurance-cycles are improved.

Variable-viscosity thermal hemodynamic slip flow conveying nanoparticles through a permeable-walled composite stenosed artery

NASA Astrophysics Data System (ADS)

Akbar, Noreen Sher; Tripathi, Dharmendra; Bég, O. Anwar

2017-07-01

This paper presents a mathematical model for simulating viscous, incompressible, steady-state blood flow containing copper nanoparticles and coupled heat transfer through a composite stenosed artery with permeable walls. Wall slip hydrodynamic and also thermal buoyancy effects are included. The artery is simulated as an isotropic elastic tube, following Joshi et al. (2009), and a variable viscosity formulation is employed for the flowing blood. The equations governing the transport phenomena are non-dimensionalized and the resulting boundary value problem is solved analytically in the steady state subject to physically appropriate boundary conditions. Numerical computations are conducted to quantify the effects of relevant hemodynamic, thermophysical and nanoscale parameters emerging in the model on velocity and temperature profiles, wall shear stress, impedance resistance and also streamline distributions. The model may be applicable to drug fate transport modeling with nanoparticle agents and also to the optimized design of nanoscale medical devices for diagnosing stenotic diseases in circulatory systems.

Numerical Investigation of Oxygenated and Deoxygenated Blood Flow through a Tapered Stenosed Arteries in Magnetic Field.

PubMed

Abdollahzadeh Jamalabadi, M Y; Akbari Bidokhti, Amin Ali; Khak Rah, Hamid; Vaezi, Siavash; Hooshmand, Payam

2016-01-01

Current paper is focused on transient modeling of blood flow through a tapered stenosed arteries surrounded a by solenoid under the presence of heat transfer. The oxygenated and deoxygenated blood are considered here by the Newtonian and Non-Newtonian fluid (power law and Carreau-Yasuda) models. The governing equations of bio magnetic fluid flow for an incompressible, laminar, homogeneous, non-Newtonian are solved by finite volume method with SIMPLE algorithm for structured grid. Both magnetization and electric current source terms are well thought-out in momentum and energy equations. The effects of fluid viscosity model, Hartmann number, and magnetic number on wall shear stress, shearing stress at the stenosis throat and maximum temperature of the system are investigated and are optimized. The current study results are in agreement with some of the existing findings in the literature and are useful in thermal and mechanical design of spatially varying magnets to control the drug delivery and biomagnetic fluid flows through tapered arteries.

[High resolution functional magnetic resonance tomography with Gd-DTPA eyedrops in diagnosis of lacrimal apparatus diseases].

PubMed

Hoffmann, K T; Anders, N; Hosten, N; Holschbach, A; Walkow, T; Sörensen, R; Hartmann, C; Felix, R

1998-08-01

Both dacryocystography and dacryoscintigraphy are well established in the evaluation of stenoses of the lacrimal drainage system. They provide limited information about the ductal anatomy itself and about periductal structures. MR imaging was evaluated for its capability to directly visualize the lacrimal drainage system in detail and simultaneously provide functional characterization of dacryostenosis. Twenty-seven lacrimal drainage systems of 23 patients suffering from epiphora were examined in an MR unit before and after conjunctival and intravenous application of Gd-DTPA using a surface coil. Dacryostenosis was found in 23 of 27 lacrimal systems. Stenoses were localized to the canalicular (n = 3), saccular (n = 8), and ductal (n = 12) level, and were classified as stenosis or occlusion. MR imaging with conjunctival contrast application allows within one examination both detailed morphological and functional assessment of the lacrimal drainage system with depiction of surrounding structures. Limitations arise mainly from demands on technical and patient-related preconditions.

SIU/ICUD Consultation on Urethral Strictures: Posterior urethral stenosis after treatment of prostate cancer.

PubMed

Herschorn, Sender; Elliott, Sean; Coburn, Michael; Wessells, Hunter; Zinman, Leonard

2014-03-01

Posterior urethral stenosis can result from radical prostatectomy in approximately 5%-10% of patients (range 1.4%-29%). Similarly, 4%-9% of men after brachytherapy and 1%-13% after external beam radiotherapy will develop stenosis. The rate will be greater after combination therapy and can exceed 40% after salvage radical prostatectomy. Although postradical prostatectomy stenoses mostly develop within 2 years, postradiotherapy stenoses take longer to appear. Many result in storage and voiding symptoms and can be associated with incontinence. The evaluation consists of a workup similar to that for lower urinary tract symptoms, with additional testing to rule out recurrent or persistent prostate cancer. Treatment is usually initiated with an endoscopic approach commonly involving dilation, visual urethrotomy with or without laser treatment, and, possibly, UroLume stent placement. Open surgical urethroplasty has been reported, as well as urinary diversion for recalcitrant stenosis. A proposed algorithm illustrating a graded approach has been provided. Copyright © 2014 Elsevier Inc. All rights reserved.

New presentation method for magnetic resonance angiography images based on skeletonization

NASA Astrophysics Data System (ADS)

Nystroem, Ingela; Smedby, Orjan

2000-04-01

Magnetic resonance angiography (MRA) images are usually presented as maximum intensity projections (MIP), and the choice of viewing direction is then critical for the detection of stenoses. We propose a presentation method that uses skeletonization and distance transformations, which visualizes variations in vessel width independent of viewing direction. In the skeletonization, the object is reduced to a surface skeleton and further to a curve skeleton. The skeletal voxels are labeled with their distance to the original background. For the curve skeleton, the distance values correspond to the minimum radius of the object at that point, i.e., half the minimum diameter of the blood vessel at that level. The following image processing steps are performed: resampling to cubic voxels, segmentation of the blood vessels, skeletonization ,and reverse distance transformation on the curve skeleton. The reconstructed vessels may be visualized with any projection method. Preliminary results are shown. They indicate that locations of possible stenoses may be identified by presenting the vessels as a structure with the minimum radius at each point.

Frequency-domain nonlinear optics in two-dimensionally patterned quasi-phase-matching media.

PubMed

Phillips, C R; Mayer, B W; Gallmann, L; Keller, U

2016-07-11

Advances in the amplification and manipulation of ultrashort laser pulses have led to revolutions in several areas. Examples include chirped pulse amplification for generating high peak-power lasers, power-scalable amplification techniques, pulse shaping via modulation of spatially-dispersed laser pulses, and efficient frequency-mixing in quasi-phase-matched nonlinear crystals to access new spectral regions. In this work, we introduce and demonstrate a new platform for nonlinear optics which has the potential to combine these separate functionalities (pulse amplification, frequency transfer, and pulse shaping) into a single monolithic device that is bandwidth- and power-scalable. The approach is based on two-dimensional (2D) patterning of quasi-phase-matching (QPM) gratings combined with optical parametric interactions involving spatially dispersed laser pulses. Our proof of principle experiment demonstrates this technique via mid-infrared optical parametric chirped pulse amplification of few-cycle pulses. Additionally, we present a detailed theoretical and numerical analysis of such 2D-QPM devices and how they can be designed.

Long Pulse Homopolar Generator

DTIC Science & Technology

1988-08-01

AD-A205 452 AFWAL-TR-88-2045 LONG PULSE HOMOPOLAR GENERATOR Edward A. Knoth David P. Bauer lAP Research, Inc. 2763 Culver Avenue Dayton OH 45429-3723...TASK WORK UNIT ELEMENT NO. NO. NO ACCESSION NO. 61101F ILIR P3 01 11. TITLE (include Security Classiflcation) Long Pulse Homopolar Generator 12. PERSONAL...FIELD GROUP SUB-GROUP C6 6; y .- o- , -, ’, - 20 07 homopolar , high current, high power, high speed, generator, 19. ABIT!CT (Contkwe on rer if =ray and

Thrust noise minimization in long-term laser ablation of propellant material in the nanosecond and picosecond regime

NASA Astrophysics Data System (ADS)

Lorbeer, Raoul-Amadeus; Scharring, Stefan; Karg, Stephanie; Pastow, Jan; Pastuschka, Lisa; Förster, Daniel Johannes; Eckel, Hans-Albert

2017-01-01

The avoidance of any moving parts in a microthruster exhibits a great potential for low-noise thrust generation in the micronewton range. This is required, e.g., for scientific missions that need attitude and orbit control systems with exquisite precision. Laser ablation propulsion offers the opportunity of permanent inertia-free, electro-optical delivery of laser energy to access the propellant entirely without moving it. New propellant is accessed by ablating the previous surface in layers, essentially damaging the surface with a laser over and over again. The resulting surface properties for different fluences and scanning patterns were investigated for multiple layers of aluminum, copper, and gold. The pulse-length-specific issues of various ablation mechanisms such as vaporization, spallation, and phase explosion are accounted for by the use of a 10-ps laser system and a 500-ps laser system. We show that the surface roughness produced with 500-ps laser pulses is approximately twice the surface roughness generated by using 10-ps laser pulses. Furthermore, with 500-ps pulses, the surface roughness shows low dependency on the fluence for carefully chosen scanning parameters. Therefore, we conclude that laser pulse duration differences in the picosecond and nanosecond regimes will not necessarily alter surface roughness properties.

Effect of canning on color, protein and phenolic profile of grains from kidney bean, field pea and chickpea.

PubMed

Parmar, Naincy; Singh, Narpinder; Kaur, Amritpal; Virdi, Amardeep Singh; Thakur, Sheetal

2016-11-01

The aim of the present study was to evaluate the effect of canning on color, protein and phenolic profile of grains of kidney bean, field pea and chickpea varieties/accession. Color of grains of different pulses was enhanced after canning. Grains L* (lightness) decreased while a* (redness to yellowness) and b* (greenness to blueness) increased after canning in all the pulses. Protein profiling of grains of different pulses after canning revealed that kidney bean and chickpea, respectively, had the least and the most thermally susceptible polypeptides. Kidney bean and chickpea showed higher Percentage washed drained weight (PWDW) than field pea. Pulse with more grain hardness and PWDW showed higher degree of grain splitting during canning. Grain splitting was also higher in dark colored accessions/varieties as compared to the light colored. Ferulic acid was the most predominant compound present in raw grains of different pulses. Raw kidney bean grains showed higher accumulation of catechin, chlorogenic, protocatechuic acid, p-coumaric acid and ferulic acid than those of chickpea and field pea. Canning caused reduction in all the phenolic compounds except gallic acid and most prominent effect of canning on protocatechuic acid, chlorogenic and ferulic acid was observed. Copyright © 2016. Published by Elsevier Ltd.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Amano, Yasuo; Gemma, Kazuhito; Kawamata, Hiroshi

Fat-suppressed, three-dimensional magnetic resonance angiography (3D MRA) was performed on nine patients with 11 iliac artery stenoses following atherectomy or stent placement. The MRA accurately depicted continued patency, restenosis, or aneurysm formation when compared with immediate posttreatment conventional arteriography. Therefore MRA is accurate and can be used independently for clinical decision making.

[A modern look at benign stenosing lesions. Etiology and pathogenesis of diagnostic capabilities. A systematic review].

PubMed

Pakhabova, E Iu; Belova, G V

2012-01-01

The problem of nonneoplastic stenosis of major duodenal papilla is on joint of gastroenterology and surgery and present a challenge for physicians. This article reviews what is known about the pathogenesis, epidemiology and diagnostics of papillostenosis and sphincter of Oddi dysfunction.

Novel and Advanced Techniques for Complex IVC Filter Retrieval.

PubMed

Daye, Dania; Walker, T Gregory

2017-04-01

Inferior vena cava (IVC) filter placement is indicated for the treatment of venous thromboembolism (VTE) in patients with a contraindication to or a failure of anticoagulation. With the advent of retrievable IVC filters and their ease of placement, an increasing number of such filters are being inserted for prophylaxis in patients at high risk for VTE. Available data show that only a small number of these filters are retrieved within the recommended period, if at all, prompting the FDA to issue a statement on the need for their timely removal. With prolonged dwell times, advanced techniques may be needed for filter retrieval in up to 60% of the cases. In this article, we review standard and advanced IVC filter retrieval techniques including single-access, dual-access, and dissection techniques. Complicated filter retrievals carry a non-negligible risk for complications such as filter fragmentation and resultant embolization of filter components, venous pseudoaneurysms or stenoses, and breach of the integrity of the caval wall. Careful pre-retrieval assessment of IVC filter position, any significant degree of filter tilting or of hook, and/or strut epithelialization and caval wall penetration by filter components should be considered using dedicated cross-sectional imaging for procedural planning. In complex cases, the risk for retrieval complications should be carefully weighed against the risks of leaving the filter permanently indwelling. The decision to remove an embedded IVC filter using advanced techniques should be individualized to each patient and made with caution, based on the patient's age and existing comorbidities.

Strong-field ionization with twisted laser pulses

NASA Astrophysics Data System (ADS)

Paufler, Willi; Böning, Birger; Fritzsche, Stephan

2018-04-01

We apply quantum trajectory Monte Carlo computations in order to model strong-field ionization of atoms by twisted Bessel pulses and calculate photoelectron momentum distributions (PEMD). Since Bessel beams can be considered as an infinite superposition of circularly polarized plane waves with the same helicity, whose wave vectors lie on a cone, we compared the PEMD of such Bessel pulses to those of a circularly polarized pulse. We focus on the momentum distributions in propagation direction of the pulse and show how these momentum distributions are affected by experimental accessible parameters, such as the opening angle of the beam or the impact parameter of the atom with regard to the beam axis. In particular, we show that we can find higher momenta of the photoelectrons, if the opening angle is increased.

Cost-effective WDM-PON Delivering Up/Down-stream Data on a Single Wavelength Using Soliton Pulse

NASA Astrophysics Data System (ADS)

Tawade, Laxman

2013-06-01

This paper presents wavelength division multiplexing passive optical network (WDM-PON) system delivering downstream 2.5 Gbit/s data and upstream 1 Gbit/s data on a single wavelength using pulse source is mode locked laser which generating a single pulse of "sech" shape with specified power and width i.e. soliton pulse. The optical source for downstream data and upstream data is sech pulse generator at central office and reflective semiconductor optical amplifier (RSOA) at each optical network unit. We also investigate analysis of backscattered optical signal for upstream data and downstream data simultaneously. Bit error rate, Q-Factor were measured to demonstrate the proposed scheme. In this paper Long reach aspects of an access network is investigated using single channel scenario.

Photonic ultrawideband impulse radio generation and modulation over a fiber link using a phase modulator and a delay interferometer.

PubMed

Shao, Jing; Sun, Junqiang

2012-08-15

We propose and experimentally demonstrate a simple and flexible photonic scheme for generation and modulation of ultrawideband (UWB) using a phase modulator and a fiber delay interferometer (DI)-based multichannel frequency discrimination. By introducing a Gaussian signal to the phase modulator, the UWB polarity-switchable doublet pulses can be achieved by combining the pair of UWB monocycle pulses with inverted polarities at the DI outputs under proper time delay. Furthermore, the pulse shape modulation, pulse position modulation, and on-off keying can be performed by coding the electrical data patterns and adjusting the time delay between the two monocycle pulses. Only a laser source introduced in the architecture guarantees the excellent dispersion tolerance over 75 km optical fiber link for UWB pulse sequence, which has potential application in future high-speed UWB impulse radio over optical fiber access networks.

The use of lasers for achieving extreme conditions of matter, and fusion

NASA Astrophysics Data System (ADS)

Roberts, P. D.

2012-05-01

Since the early'70s AWE has focussed on indirect drive as a means of accessing high energy density regimes. We give a brief historical perspective of this work and the rationale for the construction of the ORION laser. This laser is currently in commissioning and is scheduled to commence experiments in 2012. The ORION laser is configured to provide long pulses (~ 1ns) with a high degree of pulse shape flexibility, together with synchronised short pulse (~1ps) irradiation. The paper describes how this combination should enable pressures in excess of 1 Gb and temperatures of greater than 500 eV to be achieved. The ability to access and diagnose such conditions has applications in many fields; examples are given in planetary science, astrophysics and inertial fusion energy. For these applications we first describe the approach to measuring equation of state and opacity properties in the high energy density regime. Such properties are then incorporated into integrated computer simulation codes and validated against laser experiments, some of which have been conducted recently at the OMEGA laser at the University of Rochester. The paper concludes with a discussion of inertial fusion energy and the new high energy density regimes that this would access, if successful.

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gonsalves, Carin F., E-mail: Carin.Gonsalves@mail.tju.edu; Eschelman, David J.; Sullivan, Kevin L.

2003-04-15

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine cathetermore » dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices.Patients with longer catheter dwell time were more likely to develop central vein abnormalities. In order to preserve vascular access for dialysis fistulae and grafts and adhere to Dialysis Outcomes Quality Initiative guidelines, alternative venous access sites should be considered for patients with chronic renal insufficiency and end-stage renal disease.« less

Diffuse supravalvular aortic stenosis with multiple stenoses of the branches of arcus aorta in a child.

PubMed

Uçar, Tayfun; Tutar, Ercan; Atalay, Semra

2008-01-01

We give details of a sporadic case with congenital supravalvular aortic stenosis associated with critical stenosis of the left carotid artery, and severe stenosis of the innominate artery at their origins as well as excessive dilatations of both the right and the left coronary arteries.

Understanding the Impact of Arterial Stenosis on Blood Flow through a Tissue

ERIC Educational Resources Information Center

Prakash, Elapulli Sankaranarayanan

2015-01-01

This article arises from the author's experience helping medical students apply core biophysical principles toward understanding cardiovascular physiology. The purpose of the article is illustrate how the effect of an arterial stenosis on blood flow to tissue supplied exclusively by the stenosed artery should be assessed. This discussion was…

Theoretical study on the constricted flow phenomena in arteries

NASA Astrophysics Data System (ADS)

Sen, S.; Chakravarty, S.

2012-12-01

The present study is dealt with the constricted flow characteristics of blood in arteries by making use of an appropriate mathematical model. The constricted artery experiences the generated wall shear stress due to flow disturbances in the presence of constriction. The disturbed flow in the stenosed arterial segment causes malfunction of the cardiovascular system leading to serious health problems in the form of heart attack and stroke. The flowing blood contained in the stenosed artery is considered to be non-Newtonian while the flow is treated to be two-dimensional. The present pursuit also accounts for the motion of the arterial wall and its effect on local fluid mechanics. The flow analysis applies the time-dependent, two-dimensional incompressible nonlinear Navier-Stokes equations for non-Newtonian fluid representing blood. An extensive quantitative analysis presented at the end of the paper based on large scale numerical computations of the quantities of major physiological significance enables one to estimate the constricted flow characteristics in the arterial system under consideration which deviates significantly from that of normal physiological flow conditions.

Detection of ischemical dyssynchrony in patients with normal duration of QRS at rest and during exercise echocardiography (Dyssynchrony in coronary artery disease patients during exercise).

PubMed

Zagatina, A; Guseva, O; Bartosh-Zelenaya, S Y; Zhuravskaya, N

2014-04-01

Ischemic segments cannot develop a sufficient amount of strength during systole, so theoretically they begin to contract later in comparison with non-ischemic zones. There is a lack of information about methods that can detect dyssynchrony during exercise in patients with QRS not longer 100 ms. The aim of the study was to compare different methods of detection regarding left ventricular moving dyssynchrony in patients with significant coronary stenosis artery lesions: pulsed-wave of PW-TDI, strain (S) and strain rate (SR). The study included 133 subjects: 106 consecutive patients who were scheduled for coronary angiography with previous stress-echocardiography and 27 healthy persons. All the patients underwent a supine bicycle exercise test. Seventy-six patients had stenoses and 30 subjects had no significant lesions by coronary angiography. There was a detectable difference between time parameters of left ventricle contraction for the two groups and controls before and during exercise using all Doppler methods. Subgroups of patients without previous myocardial infarction and without hypertrophy of left ventricle had the same results. Maximal difference was observed using strain method. There was a moderate correlation between time parameters and the existence of significant lesions of coronary arteries. Patients without prolongations of QRS with significant lesions of coronary arteries have detectable left ventricular dyssynchrony before and during exercise.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nielsen, Yousef W., E-mail: yujwni01@heh.regionh.d; Eiberg, Jonas P.; Logager, Vibeke B.

The purpose of this investigation was to determine if addition of infragenicular steady-state (SS) magnetic resonance angiography (MRA) to first-pass imaging improves diagnostic performance compared with first-pass imaging alone in patients with peripheral arterial disease (PAD) undergoing whole-body (WB) MRA. Twenty consecutive patients with PAD referred to digital-subtraction angiography (DSA) underwent WB-MRA. Using a bolus-chase technique, first-pass WB-MRA was performed from the supra-aortic vessels to the ankles. The blood-pool contrast agent gadofosveset trisodium was used at a dose of 0.03 mmol/kg body weight. Ten minutes after injection of the contrast agent, high-resolution (0.7-mm isotropic voxels) SS-MRA of the infragenicular arteriesmore » was performed. Using DSA as the 'gold standard,' sensitivities and specificities for detecting significant arterial stenoses ({>=}50% luminal narrowing) with first-pass WB-MRA, SS-MRA, and combined first-pass and SS-MRA were calculated. Kappa statistics were used to determine intermodality agreement between MRA and DSA. Overall sensitivity and specificity for detecting significant arterial stenoses with first-pass WB-MRA was 0.70 (95% confidence interval 0.61 to 0.78) and 0.97 (0.94 to 0.99), respectively. In first-pass WB-MRA, the lowest sensitivity was in the infragenicular region, with a value of 0.42 (0.23 to 0.63). Combined analysis of first-pass WB-MRA and SS-MRA increased sensitivity to 0.81 (0.60 to 0.93) in the infragenicular region, with specificity of 0.94 (0.88 to 0.97). Sensitivity and specificity for detecting significant arterial stenoses with isolated infragenicular SS-MRA was 0.47 (0.27 to 0.69) and 0.86 (0.78 to 0.91), respectively. Intermodality agreement between MRA and DSA in the infragenicular region was moderate for first-pass WB-MRA ({kappa} = 0.49), fair for SS-MRA ({kappa} = 0.31), and good for combined first-pass/SS-MRA ({kappa} = 0.71). Addition of infragenicular SS-MRA to first-pass WB MRA improves diagnostic performance.« less

Real-time use of instantaneous wave-free ratio: results of the ADVISE in-practice: an international, multicenter evaluation of instantaneous wave-free ratio in clinical practice.

PubMed

Petraco, Ricardo; Al-Lamee, Rasha; Gotberg, Matthias; Sharp, Andrew; Hellig, Farrel; Nijjer, Sukhjinder S; Echavarria-Pinto, Mauro; van de Hoef, Tim P; Sen, Sayan; Tanaka, Nobuhiro; Van Belle, Eric; Bojara, Waldemar; Sakoda, Kunihiro; Mates, Martin; Indolfi, Ciro; De Rosa, Salvatore; Vrints, Christian J; Haine, Steven; Yokoi, Hiroyoshi; Ribichini, Flavio L; Meuwissen, Martjin; Matsuo, Hitoshi; Janssens, Luc; Katsumi, Ueno; Di Mario, Carlo; Escaned, Javier; Piek, Jan; Davies, Justin E

2014-11-01

To evaluate the first experience of real-time instantaneous wave-free ratio (iFR) measurement by clinicians. The iFR is a new vasodilator-free index of coronary stenosis severity, calculated as a trans-lesion pressure ratio during a specific period of baseline diastole, when distal resistance is lowest and stable. Because all previous studies have calculated iFR offline, the feasibility of real-time iFR measurement has never been assessed. Three hundred ninety-two stenoses with angiographically intermediate stenoses were included in this multicenter international analysis. Instantaneous wave-free ratio and fractional flow reserve (FFR) were performed in real time on commercially available consoles. The classification agreement of coronary stenoses between iFR and FFR was calculated. Instantaneous wave-free ratio and FFR maintain a close level of diagnostic agreement when both are measured by clinicians in real time (for a clinical 0.80 FFR cutoff: area under the receiver operating characteristic curve [ROC(AUC)] 0.87, classification match 80%, and optimal iFR cutoff 0.90; for a ischemic 0.75 FFR cutoff: iFR ROC(AUC) 0.90, classification match 88%, and optimal iFR cutoff 0.85; if the FFR 0.75-0.80 gray zone is accounted for: ROC(AUC) 0.93, classification match 92%). When iFR and FFR are evaluated together in a hybrid decision-making strategy, 61% of the population is spared from vasodilator while maintaining a 94% overall agreement with FFR lesion classification. When measured in real time, iFR maintains the close relationship to FFR reported in offline studies. These findings confirm the feasibility and reliability of real-time iFR calculation by clinicians. Copyright © 2014 The Author. Published by Elsevier Inc. All rights reserved.

Stent-protected carotid angioplasty using a membrane stent: a comparative cadaver study.

PubMed

Müller-Hülsbeck, Stefan; Gühne, Albrecht; Tsokos, Michael; Hüsler, Erhard J; Schaffner, Silvio R; Paulsen, Friedrich; Hedderich, Jürgen; Heller, Martin; Jahnke, Thomas

2006-01-01

To evaluate the performance of a prototype membrane stent, MembraX, in the prevention of acute and late embolization and to quantify particle embolization during carotid stent placement in human carotid explants in a proof of concept study. Thirty human carotid cadaveric explants (mild stenoses 0-29%, n = 23; moderate stenoses 30-69%, n = 3; severe stenoses 70-99%, n = 2) that included the common, internal and external carotid arteries were integrated into a pulsatile-flow model. Three groups were formed according to the age of the donors (mean 58.8 years; sample SD 15.99 years) and randomized to three test groups: (I) MembraX, n = 9; (II) Xpert bare stent, n = 10; (III) Xpert bare stent with Emboshield protection device, n = 9. Emboli liberated during stent deployment (step A), post-dilatation (step B), and late embolization (step C) were measured in 100 microm effluent filters. When the Emboshield was used, embolus penetration was measured during placement (step D) and retrieval (step E). Late embolization was simulated by compressing the area of the stented vessel five times. Absolute numbers of particles (median; >100 microm) caught in the effluent filter were: (I) MembraX: A = 7, B = 9, C = 3; (II) bare stent: A = 6.5, B = 6, C = 4.5; (III) bare stent and Emboshield: A = 7, B = 7, C.=.5, D = 8, E = 10. The data showed no statistical differences according to whether embolic load was analyzed by weight or mean particle size. When summing all procedural steps, the Emboshield caused the greatest load by weight (p = 0.011) and the largest number (p = 0.054) of particles. On the basis of these limited data neither a membrane stent nor a protection device showed significant advantages during ex vivo carotid angioplasty. However, the membrane stent seems to have the potential for reducing the emboli responsible for supposed late embolization, whereas more emboli were observed when using a protection device. Further studies are necessary and warranted.

Hybrid treatment of tandem, common carotid/innominate artery and ipsilateral carotid bifurcation stenoses by simultaneous, retrograde proximal stenting and eversion carotid endarterectomy: Preliminary results of a case series.

PubMed

Illuminati, Giulio; Pizzardi, Giulia; Pasqua, Rocco; Frezzotti, Francesca; Palumbo, Piergaspare; Macrina, Francesco; Calio', Francesco

2018-04-01

Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses. The proximal stenosis involved the left proximal CCA in 4 patients, the proximal innominate artery in 2 patients and the right CCA in one patient. The procedure was performed under general anesthesia in a conventional operating room equipped with a mobile C-arm. A covered, balloon expandable stent was deployed over the proximal stenosis via a 6-F sheath directly introduced into the proximal CCA through the obliquely transected carotid bulb. After removing the sheath, debris were flushed through the carotid bulb and eversion CEA completed the procedure. Study endpoints were: postoperative stroke/mortality rate, cardiac mortality and morbidity, peripheral nerve injury, cervical hematoma, overall late survival, freedom from ipsilateral stroke and patency of arterial reconstruction. No postoperative mortality or neurologic morbidity was observed in any patient. Cervical hematomas and peripheral nerve injuries were likewise absent. At a mean follow-up of 18 months, all the patients were alive, free from neurologic events of new onset and free from restenosis. Combined proximal stenting and eversion CEA for tandem lesions seems a valid treatment, with the advantages of eversion CEA over other techniques of carotid bifurcation revascularization. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Advanced 2-dimensional quantitative coronary angiographic analysis for prediction of fractional flow reserve in intermediate coronary stenoses.

PubMed

Opolski, Maksymilian P; Pregowski, Jerzy; Kruk, Mariusz; Kepka, Cezary; Staruch, Adam D; Witkowski, Adam

2014-07-01

The widespread clinical application of coronary computed tomography angiography (CCTA) has resulted in increased referral patterns of patients with intermediate coronary stenoses to invasive coronary angiography. We evaluated the application of advanced quantitative coronary angiography (A-QCA) for predicting fractional flow reserve (FFR) in intermediate coronary lesions detected on CCTA. Fifty-six patients with 66 single intermediate coronary lesions (≥ 50% to 80% stenosis) on CCTA prospectively underwent coronary angiography and FFR. A-QCA including calculation of the Poiseuille-based index defined as the ratio of lesion length to the fourth power of the minimal lumen diameter (MLD) was performed. Significant stenosis was defined as FFR ≤ 0.80. The mean FFR was 0.86 ± 0.09, and 18 lesions (27%) were functionally significant. FFR correlated with lesion length (R=-0.303, P=0.013), MLD (R=0.527, P<0.001), diameter stenosis (R=-0.404, P=0.001), minimum lumen area (MLA) (R=0.530, P<0.001), lumen stenosis (R=-0.400, P=0.001), and Poiseuille-based index (R=-0.602, P<0.001). The optimal cutoff values for MLD, MLA, diameter stenosis, and lumen stenosis were ≤ 1.3 mm, ≤ 1.5 mm, >44%, and >69%, respectively (maximum negative predictive value of 94% for MLA, maximum positive predictive value of 58% for diameter stenosis). The Poiseuille-based index was the most accurate (C statistic 0.86, sensitivity 100%, specificity 71%, positive predictive value 56%, and negative predictive value 100%) predictor of FFR ≤ 0.80, but showed the lowest interobserver agreement (intraclass correlation coefficient 0.37). A-QCA might be used to rule out significant ischemia in intermediate stenoses detected by CCTA. The diagnostic application of the Poiseuille-based angiographic index is precluded by its high interobserver variability.

Detection of myocardial ischemia by automated, motion-corrected, color-encoded perfusion maps compared with visual analysis of adenosine stress cardiovascular magnetic resonance imaging at 3 T: a pilot study.

PubMed

Doesch, Christina; Papavassiliu, Theano; Michaely, Henrik J; Attenberger, Ulrike I; Glielmi, Christopher; Süselbeck, Tim; Fink, Christian; Borggrefe, Martin; Schoenberg, Stefan O

2013-09-01

The purpose of this study was to compare automated, motion-corrected, color-encoded (AMC) perfusion maps with qualitative visual analysis of adenosine stress cardiovascular magnetic resonance imaging for detection of flow-limiting stenoses. Myocardial perfusion measurements applying the standard adenosine stress imaging protocol and a saturation-recovery temporal generalized autocalibrating partially parallel acquisition (t-GRAPPA) turbo fast low angle shot (Turbo FLASH) magnetic resonance imaging sequence were performed in 25 patients using a 3.0-T MAGNETOM Skyra (Siemens Healthcare Sector, Erlangen, Germany). Perfusion studies were analyzed using AMC perfusion maps and qualitative visual analysis. Angiographically detected coronary artery (CA) stenoses greater than 75% or 50% or more with a myocardial perfusion reserve index less than 1.5 were considered as hemodynamically relevant. Diagnostic performance and time requirement for both methods were compared. Interobserver and intraobserver reliability were also assessed. A total of 29 CA stenoses were included in the analysis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection of ischemia on a per-patient basis were comparable using the AMC perfusion maps compared to visual analysis. On a per-CA territory basis, the attribution of an ischemia to the respective vessel was facilitated using the AMC perfusion maps. Interobserver and intraobserver reliability were better for the AMC perfusion maps (concordance correlation coefficient, 0.94 and 0.93, respectively) compared to visual analysis (concordance correlation coefficient, 0.73 and 0.79, respectively). In addition, in comparison to visual analysis, the AMC perfusion maps were able to significantly reduce analysis time from 7.7 (3.1) to 3.2 (1.9) minutes (P < 0.0001). The AMC perfusion maps yielded a diagnostic performance on a per-patient and on a per-CA territory basis comparable with the visual analysis. Furthermore, this approach demonstrated higher interobserver and intraobserver reliability as well as a better time efficiency when compared to visual analysis.

Diagnostic TCD for intracranial stenosis in acute stroke patients: experience from a tertiary care stroke center in Karachi, Pakistan.

PubMed

Kamal, Ayeesha Kamran; Rehman, Hasan; Mustafa, Nasir; Ahmed, Bilal; Jan, Mohammad; Wadivalla, Faisal; Kamran, Syed

2015-08-11

Stroke is a common cause of morbidity and mortality around the world. Intracranial large artery atherosclerosis (ICAD) is a frequent etiology of stroke in the South Asian population. There is a need for widely available screening tools to identify patients that are at high risk of stroke due to ICAD for aggressive risk management. This study describes the experience of using the transcranial Doppler (TCD) as a screening tool for this purpose at a tertiary care hospital in a developing country. 86 Patients admitted with stroke due to ICAD underwent TCD for six arteries (Right and left middle cerebral arteries, right and left anterior cerebral arteries, right and left posterior cerebral arteries) in addition to the magnetic resonance angiography (MRA) that is done routinely at the stroke center. Arteries were labeled with either <50 or >50% stenosis by TCD using two separate criteria. These findings were compared with those from the MRA which was used as the gold standard. The proportion of patients that had complete exams (all six arteries insonated by TCD) was reported. The success rate of each TCD criteria in detecting arteries with >50% stenosis was also calculated. There was an attempt to visualize 516 arteries (86 patients with 6 arteries each) of which 375 (72.7%) were successfully insonated. 38 of the 86 (55.8%) patients had complete examinations. MRA reported 43 (8.3%) arteries as stenosed >50%. The TCD did not categorize any artery as stenosed using either criterion and hence failed to classify any stenosed artery correctly. The positive predictive and sensitivity was 0 for this study and the negative predictive value was 93.3%. This study indicates the poor sensitivity of TCD to be a reliable screening tool for the presence of ICAD in the South Asian population in a real life clinical setting.

Early rectal stenosis following stapled rectal mucosectomy for hemorrhoids

PubMed Central

Petersen, Sven; Hellmich, Gunter; Schumann, Dietrich; Schuster, Anja; Ludwig, Klaus

2004-01-01

Background Within the last years, stapled rectal mucosectomy (SRM) has become a widely accepted procedure for second and third degree hemorrhoids. One of the delayed complications is a stenosis of the lower rectum. In order to evaluate the specific problem of rectal stenosis following SRM we reviewed our data with special respect to potential predictive factors or stenotic events. Methods A retrospective analysis of 419 consecutive patients, which underwent SRM from December 1998 to August 2003 was performed. Only patients with at least one follow-up check were evaluated, thus the analysis includes 289 patients with a mean follow-up of 281 days (±18 days). For statistic analysis the groups with and without stenosis were evaluated using the Chi-Square Test, using the Kaplan-Meier statistic the actuarial incidence for rectal stenosis was plotted. Results Rectal stenosis was observed in 9 patients (3.1%), eight of these stenoses were detected within the first 100 days after surgery; the median time to stenosis was 95 days. Only one patient had a rectal stenosis after more than one year. 8 of the 9 patients had no obstructive symptoms, however the remaining patients complained of obstructive defecation and underwent surgery for transanal strictureplasty with electrocautery. A statistical analysis revealed that patients with stenosis had significantly more often prior treatment for hemorrhoids (p < 0.01). According to the SRM only severe postoperative pain was significantly associated with stenoses (p < 0.01). Other factors, such as gender (p = 0.11), surgical technique (p = 0.25), revision (p = 0.79) or histological evidence of squamous skin (p = 0.69) showed no significance. Conclusion Rectal stenosis is an uncommon event after SRM. Early stenosis will occur within the first three months after surgery. The majority of the stenoses are without clinical relevance. Only one of nine patients had to undergo surgery for a relevant stenosis. The predictive factor for stenosis in the patient-characteristics is previous interventions for hemorrhoids, severe postoperative pain might also predict rectal stenosis. PMID:15153248

Coherent-pulse implementations of quantum cryptography protocols resistant to photon-number-splitting attacks

NASA Astrophysics Data System (ADS)

Acín, Antonio; Gisin, Nicolas; Scarani, Valerio

2004-01-01

We propose a class of quantum cryptography protocols that are robust against photon-number-splitting attacks (PNS) in a weak coherent-pulse implementation. We give a quite exhaustive analysis of several eavesdropping attacks on these schemes. The honest parties (Alice and Bob) use present-day technology, in particular an attenuated laser as an approximation of a single-photon source. The idea of the protocols is to exploit the nonorthogonality of quantum states to decrease the information accessible to Eve due to the multiphoton pulses produced by the imperfect source. The distance at which the key distribution becomes insecure due to the PNS attack is significantly increased compared to the existing schemes. We also show that strong-pulse implementations, where a strong pulse is included as a reference, allow for key distribution robust against photon-number-splitting attacks.

Generation of narrowband, high-intensity, carrier-envelope phase-stable pulses tunable between 4 and 18  THz.

PubMed

Liu, B; Bromberger, H; Cartella, A; Gebert, T; Först, M; Cavalleri, A

2017-01-01

We report on the generation of high-energy (1.9 μJ) far-infrared pulses tunable between 4 and 18 THz frequency. Emphasis is placed on tunability and on minimizing the bandwidth of these pulses to less than 1 THz, as achieved by difference-frequency mixing of two linearly chirped near-infrared pulses in the organic nonlinear crystal DSTMS. As the two near-infrared pulses are derived from amplification of the same white light continuum, their carrier envelope phase fluctuations are mutually correlated, and hence the difference-frequency THz field exhibits absolute phase stability. This source opens up new possibilities for the control of condensed matter and chemical systems by selective excitation of low-energy modes in a frequency range that has, to date, been difficult to access.

A Simple Exact Error Rate Analysis for DS-CDMA with Arbitrary Pulse Shape in Flat Nakagami Fading

NASA Astrophysics Data System (ADS)

Rahman, Mohammad Azizur; Sasaki, Shigenobu; Kikuchi, Hisakazu; Harada, Hiroshi; Kato, Shuzo

A simple exact error rate analysis is presented for random binary direct sequence code division multiple access (DS-CDMA) considering a general pulse shape and flat Nakagami fading channel. First of all, a simple model is developed for the multiple access interference (MAI). Based on this, a simple exact expression of the characteristic function (CF) of MAI is developed in a straight forward manner. Finally, an exact expression of error rate is obtained following the CF method of error rate analysis. The exact error rate so obtained can be much easily evaluated as compared to the only reliable approximate error rate expression currently available, which is based on the Improved Gaussian Approximation (IGA).

Pulse shape optimization for electron-positron production in rotating fields

NASA Astrophysics Data System (ADS)

Fillion-Gourdeau, François; Hebenstreit, Florian; Gagnon, Denis; MacLean, Steve

2017-07-01

We optimize the pulse shape and polarization of time-dependent electric fields to maximize the production of electron-positron pairs via strong field quantum electrodynamics processes. The pulse is parametrized in Fourier space by a B -spline polynomial basis, which results in a relatively low-dimensional parameter space while still allowing for a large number of electric field modes. The optimization is performed by using a parallel implementation of the differential evolution, one of the most efficient metaheuristic algorithms. The computational performance of the numerical method and the results on pair production are compared with a local multistart optimization algorithm. These techniques allow us to determine the pulse shape and field polarization that maximize the number of produced pairs in computationally accessible regimes.

A rapid-exchange monorail stent system for salvage of failing femoropopliteal bypass grafts.

PubMed

Jahnke, Thomas; Brossmann, Joachim; Walluscheck, Knut; Heller, Martin; Müller-Hülsbeck, Stefan

2003-08-01

To analyze the safety and effectiveness of a new monorail stent system for the treatment of failing femoropopliteal bypass grafts. Acute distal occlusions or stenoses of femoropopliteal bypass grafts were treated with balloon-expandable stents (13 or 18-mm diameter) pre-mounted on a monorail balloon catheter system. The delivery system was assessed subjectively for (1). compatibility with the sheath, (2). lesion crossing potential, (3). radiopacity, (4). flexibility of the catheter, (5). adequacy of stent expansion, and (5). balloon refolding. In 8 failing bypass grafts with distal lesions, the delivery system successfully deployed the stent at the desired location. Sheath compatibility, catheter flexibility, lesion crossing, and stent expansion were rated "excellent" by all examiners for the 18-mm device. Radiopacity of the mounted stent was graded "good" before and during positioning, but only "sufficient" following expansion. For this type of lesion, the investigators rated the overall performance of the device superior to conventional "over-the-wire" systems. The monorail balloon-expandable stent delivery system provides rapid introduction of the device over the guidewire, and its low profile facilitates the use of small sheaths to minimize access-site complications.

Endovascular Electrodes for Electrical Stimulation of Blood Vessels for Vasoconstriction - a Finite Element Simulation Study

NASA Astrophysics Data System (ADS)

Kezurer, Noa; Farah, Nairouz; Mandel, Yossi

2016-08-01

Hemorrhagic shock accounts for 30-40 percent of trauma mortality, as bleeding may sometimes be hard to control. Application of short electrical pulses on blood vessels was recently shown to elicit robust vasoconstriction and reduction of blood loss following vascular injury. In this study we present a novel approach for vasoconstriction based on endovascular application of electrical pulses for situations where access to the vessel is limited. In addition to ease of access, we hypothesize that this novel approach will result in a localized and efficient vasoconstriction. Using computer modeling (COMSOL Multiphysics, Electric Currents Module), we studied the effect of endovascular pulsed electrical treatment on abdominal aorta of pigs, and compared the efficiency of different electrodes configurations on the electric field amplitude, homogeneity and locality when applied on a blood vessel wall. Results reveal that the optimal configuration is the endovascular approach where four electrodes are used, spaced 13 mm apart. Furthermore, computer based temperature investigations (bio-heat model, COMSOL Multiphysics) show that the maximum expected temperature rise is of 1.2 degrees; highlighting the safety of the four endovascular electrodes configuration. These results can aid in planning the application of endovascular pulsed electrical treatment as an efficient and safe vasoconstriction approach.

Effect of Pulse and dc Formation on the Performance of One-Transistor and One-Resistor Resistance Random Access Memory Devices

NASA Astrophysics Data System (ADS)

Liu, Hong-Tao; Yang, Bao-He; Lv, Hang-Bing; Xu, Xiao-Xin; Luo, Qing; Wang, Guo-Ming; Zhang, Mei-Yun; Long, Shi-Bing; Liu, Qi; Liu, Ming

2015-02-01

We investigate the effect of the formation process under pulse and dc modes on the performance of one transistor and one resistor (1T1R) resistance random access memory (RRAM) device. All the devices are operated under the same test conditions, except for the initial formation process with different modes. Based on the statistical results, the high resistance state (HRS) under the dc forming mode shows a lower value with better distribution compared with that under the pulse mode. One of the possible reasons for such a phenomenon originates from different properties of conductive filament (CF) formed in the resistive switching layer under two different modes. For the dc forming mode, the formed filament is thought to be continuous, which is hard to be ruptured, resulting in a lower HRS. However, in the case of pulse forming, the filament is discontinuous where the transport mechanism is governed by hopping. The low resistance state (LRS) can be easily changed by removing a few trapping states from the conducting path. Hence, a higher HRS is thus observed. However, the HRS resistance is highly dependent on the length of the gap opened. A slight variation of the gap length will cause wide dispersion of resistance.

Endovascular Electrodes for Electrical Stimulation of Blood Vessels for Vasoconstriction – a Finite Element Simulation Study

PubMed Central

Kezurer, Noa; Farah, Nairouz; Mandel, Yossi

2016-01-01

Hemorrhagic shock accounts for 30–40 percent of trauma mortality, as bleeding may sometimes be hard to control. Application of short electrical pulses on blood vessels was recently shown to elicit robust vasoconstriction and reduction of blood loss following vascular injury. In this study we present a novel approach for vasoconstriction based on endovascular application of electrical pulses for situations where access to the vessel is limited. In addition to ease of access, we hypothesize that this novel approach will result in a localized and efficient vasoconstriction. Using computer modeling (COMSOL Multiphysics, Electric Currents Module), we studied the effect of endovascular pulsed electrical treatment on abdominal aorta of pigs, and compared the efficiency of different electrodes configurations on the electric field amplitude, homogeneity and locality when applied on a blood vessel wall. Results reveal that the optimal configuration is the endovascular approach where four electrodes are used, spaced 13 mm apart. Furthermore, computer based temperature investigations (bio-heat model, COMSOL Multiphysics) show that the maximum expected temperature rise is of 1.2 degrees; highlighting the safety of the four endovascular electrodes configuration. These results can aid in planning the application of endovascular pulsed electrical treatment as an efficient and safe vasoconstriction approach. PMID:27534438

A Simple Band for Gastric Banding.

PubMed

Broadbent

1993-08-01

The author has noted that flexible gastric bands have occasionally stenosed the gastric stoma or allowed it to dilate. A band was developed using a soft outer silicone rubber tube over a holding mechanism made out of a nylon cable tie passed within the silicone tube. This simple, easily applied band is rigid, resisting scar contracture and dilatation.

Effects of subcutaneously infiltrated nitroglycerin on diameter, palpability, ease-of-puncture and pre-cannulation spasm of radial artery during transradial coronary angiography.

PubMed

Ezhumalai, Babu; Satheesh, Santhosh; Jayaraman, Balachander

2014-01-01

The success of transradial catheterization depends on meticulous access of radial artery which in turn depends on palpating a good radial pulse. Our objectives were to analyze the effects of subcutaneously infiltrated nitroglycerin on diameter of radial artery, palpability of radial pulse, ease-of-puncture and pre-cannulation spasm of radial artery during transradial coronary angiography. Patients undergoing transradial coronary angiography were randomized to Group NL or Group SL. In Group NL, 3 ml of solution containing nitroglycerin and lignocaine was infiltrated subcutaneously at the site intended for puncture of radial artery. Similarly, saline and lignocaine were infiltrated in Group SL. Diameter of radial artery was objectively assessed by ultrasonography. Measurements were performed at baseline and repeated at 1 min after injecting the solutions. The ease-of-puncture was evaluated by the number of punctures and the time needed for successful access of radial artery. Both groups had 100 patients each. Baseline diameter of radial artery was similar between two groups. The post-injection diameter of radial artery increased by 26.3% in Group NL and 11.4% in Group SL. Nitroglycerin significantly improved the palpability of radial pulse, reduced the number of punctures and shortened the time needed for successful access of radial artery. Pre-cannulation spasm of radial artery occurred in 1% of Group NL and 8% of Group SL. Subcutaneously infiltrated nitroglycerin leads to significant vasodilation of radial artery. This avoids pre-cannulation spasm of radial artery, enhances palpability of the radial pulse and thus makes the puncture of radial artery easier. Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

Effects of subcutaneously infiltrated nitroglycerin on diameter, palpability, ease-of-puncture and pre-cannulation spasm of radial artery during transradial coronary angiography

PubMed Central

Ezhumalai, Babu; Satheesh, Santhosh; Jayaraman, Balachander

2014-01-01

Background The success of transradial catheterization depends on meticulous access of radial artery which in turn depends on palpating a good radial pulse. Objectives Our objectives were to analyze the effects of subcutaneously infiltrated nitroglycerin on diameter of radial artery, palpability of radial pulse, ease-of-puncture and pre-cannulation spasm of radial artery during transradial coronary angiography. Methods Patients undergoing transradial coronary angiography were randomized to Group NL or Group SL. In Group NL, 3 ml of solution containing nitroglycerin and lignocaine was infiltrated subcutaneously at the site intended for puncture of radial artery. Similarly, saline and lignocaine were infiltrated in Group SL. Diameter of radial artery was objectively assessed by ultrasonography. Measurements were performed at baseline and repeated at 1 min after injecting the solutions. The ease-of-puncture was evaluated by the number of punctures and the time needed for successful access of radial artery. Results Both groups had 100 patients each. Baseline diameter of radial artery was similar between two groups. The post-injection diameter of radial artery increased by 26.3% in Group NL and 11.4% in Group SL. Nitroglycerin significantly improved the palpability of radial pulse, reduced the number of punctures and shortened the time needed for successful access of radial artery. Pre-cannulation spasm of radial artery occurred in 1% of Group NL and 8% of Group SL. Conclusions Subcutaneously infiltrated nitroglycerin leads to significant vasodilation of radial artery. This avoids pre-cannulation spasm of radial artery, enhances palpability of the radial pulse and thus makes the puncture of radial artery easier. PMID:25634390

Access to edge scenarios for testing a scraper element in early operation phases of Wendelstein 7-X

DOE PAGES

Holbe, H.; Pedersen, T. Sunn; Geiger, J.; ...

2016-01-29

The edge topology of magnetic fusion devices is decisive for the control of the plasma exhaust. In Wendelstein 7-X, the island divertor concept will be used, for which the edge topology can change significantly as the internal currents in a plasma discharge evolve towards steady-state. Consequently, the device has been optimized to minimize such internal currents, in particular the bootstrap current [1]. Nonetheless, there are predicted pulse scenarios where effects of the remaining internal currents could potentially lead to overload of plasma-facing components. These internal currents are predicted to evolve on long time scales (tens of seconds) so their effectsmore » on the edge topology and the divertor heat loads may not be experimentally accessible in the first years of W7-X operation, where only relatively short pulses are possible. However, we show here that for at least one important long-pulse divertor operation issue, relevant physics experiments can be performed already in short-pulse operation, through judicious adjustment of the edge topology by the use of the existing coil sets. The specific issue studied here is a potential overload of the divertor element edges. This overload might be mitigated by the installation of an extra set of plasma-facing components, so-called scraper elements, as suggested in earlier publications. It is shown here that by a targeted control of edge topology, the effectiveness of such scraper elements can be tested already with uncooled test-scraper elements in short-pulse operation. Furthermore, this will allow an early and well-informed decision on whether long-pulse-capable (actively cooled) scraper elements should be built and installed.« less

Pulse width and height modulation for multi-level resistance in bi-layer TaOx based RRAM

NASA Astrophysics Data System (ADS)

Alamgir, Zahiruddin; Beckmann, Karsten; Holt, Joshua; Cady, Nathaniel C.

2017-08-01

Mutli-level switching in resistive memory devices enables a wide range of computational paradigms, including neuromorphic and cognitive computing. To this end, we have developed a bi-layer tantalum oxide based resistive random access memory device using Hf as the oxygen exchange layer. Multiple, discrete resistance levels were achieved by modulating the RESET pulse width and height, ranging from 2 kΩ to several MΩ. For a fixed pulse height, OFF state resistance was found to increase gradually with the increase in the pulse width, whereas for a fixed pulse width, the increase in the pulse height resulted in drastic changes in resistance. Resistive switching in these devices transitioned from Schottky emission in the OFF state to tunneling based conduction in the ON state, based on I-V curve fitting and temperature dependent current measurements. These devices also demonstrated endurance of more than 108 cycles with a satisfactory Roff/Ron ratio and retention greater than 104 s.

Chirped pulse Raman amplification in warm plasma: towards controlling saturation

PubMed Central

Yang, X.; Vieux, G.; Brunetti, E.; Ersfeld, B.; Farmer, J. P.; Hur, M. S.; Issac, R. C.; Raj, G.; Wiggins, S. M.; Welsh, G. H.; Yoffe, S. R.; Jaroszynski, D. A.

2015-01-01

Stimulated Raman backscattering in plasma is potentially an efficient method of amplifying laser pulses to reach exawatt powers because plasma is fully broken down and withstands extremely high electric fields. Plasma also has unique nonlinear optical properties that allow simultaneous compression of optical pulses to ultra-short durations. However, current measured efficiencies are limited to several percent. Here we investigate Raman amplification of short duration seed pulses with different chirp rates using a chirped pump pulse in a preformed plasma waveguide. We identify electron trapping and wavebreaking as the main saturation mechanisms, which lead to spectral broadening and gain saturation when the seed reaches several millijoules for durations of 10’s – 100’s fs for 250 ps, 800 nm chirped pump pulses. We show that this prevents access to the nonlinear regime and limits the efficiency, and interpret the experimental results using slowly-varying-amplitude, current-averaged particle-in-cell simulations. We also propose methods for achieving higher efficiencies. PMID:26290153

Time-diagnostics for improved dynamics experiments at XUV FELs

NASA Astrophysics Data System (ADS)

Drescher, Markus; Frühling, Ulrike; Krikunova, Maria; Maltezopoulos, Theophilos; Wieland, Marek

2010-10-01

Significantly structured and fluctuating temporal profiles of pulses from self-amplified spontaneous emission free electron lasers as well as their unstable timing require time diagnostics on a single-shot basis. The duration and structure of extreme-ultraviolet (XUV) pulses from the Free Electron Laser (FEL) in Hamburg (FLASH) are becoming accessible using a variation of the streak camera principle, where photoemitted electrons are energetically streaked in the electric field component of a terahertz electromagnetic wave. The timing with respect to an independently generated laser pulse can be measured in an XUV/laser cross-correlator, based on a non-collinear superposition of both pulses on a solid state surface and detection of XUV-induced modulations of its reflectivity for visible light. Sorting of data according to the measured timing dramatically improves the temporal resolution of an experiment sampling the relaxation of transient electronic states in xenon after linear- as well as nonlinear excitation with intense XUV pulses from FLASH.

Fast and efficient STT switching in MTJ using additional transient pulse current

NASA Astrophysics Data System (ADS)

Pathak, Sachin; Cha, Jongin; Jo, Kangwook; Yoon, Hongil; Hong, Jongill

2017-06-01

We propose a profile of write pulse current-density to switch magnetization in a perpendicular magnetic tunnel junction to reduce switching time and write energy as well. Our simulated results show that an overshoot transient pulse current-density (current spike) imposed to conventional rectangular-shaped pulse current-density (main pulse) significantly improves switching speed that yields the reduction in write energy accordingly. For example, we could dramatically reduce the switching time by 80% and thereby reduce the write energy over 9% in comparison to the switching without current spike. The current spike affects the spin dynamics of the free layer and reduces the switching time mainly due to spin torque induced. On the other hand, the large Oersted field induced causes changes in spin texture. We believe our proposed write scheme can make a breakthrough in magnetic random access memory technology seeking both high speed operation and low energy consumption.

Radiation-Induced Chemical Dynamics in Ar Clusters Exposed to Strong X-Ray Pulses.

PubMed

Kumagai, Yoshiaki; Jurek, Zoltan; Xu, Weiqing; Fukuzawa, Hironobu; Motomura, Koji; Iablonskyi, Denys; Nagaya, Kiyonobu; Wada, Shin-Ichi; Mondal, Subhendu; Tachibana, Tetsuya; Ito, Yuta; Sakai, Tsukasa; Matsunami, Kenji; Nishiyama, Toshiyuki; Umemoto, Takayuki; Nicolas, Christophe; Miron, Catalin; Togashi, Tadashi; Ogawa, Kanade; Owada, Shigeki; Tono, Kensuke; Yabashi, Makina; Son, Sang-Kil; Ziaja, Beata; Santra, Robin; Ueda, Kiyoshi

2018-06-01

We show that electron and ion spectroscopy reveals the details of the oligomer formation in Ar clusters exposed to an x-ray free electron laser (XFEL) pulse, i.e., chemical dynamics triggered by x rays. With guidance from a dedicated molecular dynamics simulation tool, we find that van der Waals bonding, the oligomer formation mechanism, and charge transfer among the cluster constituents significantly affect ionization dynamics induced by an XFEL pulse of moderate fluence. Our results clearly demonstrate that XFEL pulses can be used not only to "damage and destroy" molecular assemblies but also to modify and transform their molecular structure. The accuracy of the predictions obtained makes it possible to apply the cluster spectroscopy, in connection with the respective simulations, for estimation of the XFEL pulse fluence in the fluence regime below single-atom multiple-photon absorption, which is hardly accessible with other diagnostic tools.

Radiation-Induced Chemical Dynamics in Ar Clusters Exposed to Strong X-Ray Pulses

NASA Astrophysics Data System (ADS)

Kumagai, Yoshiaki; Jurek, Zoltan; Xu, Weiqing; Fukuzawa, Hironobu; Motomura, Koji; Iablonskyi, Denys; Nagaya, Kiyonobu; Wada, Shin-ichi; Mondal, Subhendu; Tachibana, Tetsuya; Ito, Yuta; Sakai, Tsukasa; Matsunami, Kenji; Nishiyama, Toshiyuki; Umemoto, Takayuki; Nicolas, Christophe; Miron, Catalin; Togashi, Tadashi; Ogawa, Kanade; Owada, Shigeki; Tono, Kensuke; Yabashi, Makina; Son, Sang-Kil; Ziaja, Beata; Santra, Robin; Ueda, Kiyoshi

2018-06-01

We show that electron and ion spectroscopy reveals the details of the oligomer formation in Ar clusters exposed to an x-ray free electron laser (XFEL) pulse, i.e., chemical dynamics triggered by x rays. With guidance from a dedicated molecular dynamics simulation tool, we find that van der Waals bonding, the oligomer formation mechanism, and charge transfer among the cluster constituents significantly affect ionization dynamics induced by an XFEL pulse of moderate fluence. Our results clearly demonstrate that XFEL pulses can be used not only to "damage and destroy" molecular assemblies but also to modify and transform their molecular structure. The accuracy of the predictions obtained makes it possible to apply the cluster spectroscopy, in connection with the respective simulations, for estimation of the XFEL pulse fluence in the fluence regime below single-atom multiple-photon absorption, which is hardly accessible with other diagnostic tools.

Full 3D modelling of pulse propagation enables efficient nonlinear frequency conversion with low energy laser pulses in a single-element tripler.

PubMed

Kardaś, Tomasz M; Nejbauer, Michał; Wnuk, Paweł; Resan, Bojan; Radzewicz, Czesław; Wasylczyk, Piotr

2017-02-22

Although new optical materials continue to open up access to more and more wavelength bands where femtosecond laser pulses can be generated, light frequency conversion techniques are still indispensable in filling the gaps on the ultrafast spectral scale. With high repetition rate, low pulse energy laser sources (oscillators) tight focusing is necessary for a robust wave mixing and the efficiency of broadband nonlinear conversion is limited by diffraction as well as spatial and temporal walk-off. Here we demonstrate a miniature third harmonic generator (tripler) with conversion efficiency exceeding 30%, producing 246 fs UV pulses via cascaded second order processes within a single laser beam focus. Designing this highly efficient and ultra compact frequency converter was made possible by full 3-dimentional modelling of propagation of tightly focused, broadband light fields in nonlinear and birefringent media.

THz field engineering in two-color femtosecond filaments using chirped and delayed laser pulses

NASA Astrophysics Data System (ADS)

Nguyen, A.; González de Alaiza Martínez, P.; Thiele, I.; Skupin, S.; Bergé, L.

2018-03-01

We numerically study the influence of chirping and delaying several ionizing two-color light pulses in order to engineer terahertz (THz) wave generation in air. By means of comprehensive 3D simulations, it is shown that two chirped pulses can increase the THz yield when they are separated by a suitable time delay for the same laser energy in focused propagation geometry. To interpret these results, the local current theory is revisited and we propose an easy, accessible all-optical criterion that predicts the laser-to-THz conversion efficiencies given any input laser spectrum. In the filamentation regime, numerical simulations display evidence that a chirped pulse is able to produce more THz radiation due to propagation effects, which maintain the two colors of the laser field more efficiently coupled over long distances. A large delay between two pulses promotes multi-peaked THz spectra as well as conversion efficiencies above 10‑4.

Full 3D modelling of pulse propagation enables efficient nonlinear frequency conversion with low energy laser pulses in a single-element tripler

NASA Astrophysics Data System (ADS)

Kardaś, Tomasz M.; Nejbauer, Michał; Wnuk, Paweł; Resan, Bojan; Radzewicz, Czesław; Wasylczyk, Piotr

2017-02-01

Although new optical materials continue to open up access to more and more wavelength bands where femtosecond laser pulses can be generated, light frequency conversion techniques are still indispensable in filling the gaps on the ultrafast spectral scale. With high repetition rate, low pulse energy laser sources (oscillators) tight focusing is necessary for a robust wave mixing and the efficiency of broadband nonlinear conversion is limited by diffraction as well as spatial and temporal walk-off. Here we demonstrate a miniature third harmonic generator (tripler) with conversion efficiency exceeding 30%, producing 246 fs UV pulses via cascaded second order processes within a single laser beam focus. Designing this highly efficient and ultra compact frequency converter was made possible by full 3-dimentional modelling of propagation of tightly focused, broadband light fields in nonlinear and birefringent media.

Phase control in coherent population distribution in molecules

NASA Astrophysics Data System (ADS)

Datta, Avijit

2018-06-01

A chirped laser pulse transfers population from one level to another level accessible by one photon dipole transition. We have used a pair of phase-locked chirped pulses of same frequency instead of a single chirped pulse to achieve phase control over the population transfer and thus creating coherent population distribution in hydrogen molecule. Simultaneous actions of the phase controlled interference and rapid adiabatic passages due to chirped pulses lead to the control in population transfer from the ground X(v = 0, j = 0) level to the C(v = 2, j = 1) level. We have extended this two-level system to a three-level 1 + 1 ladder system for population transfer from the X level to the J(v = 2, j = 2) level via the C intermediate level using two pairs of phase-locked laser chirped pulses and have achieved laudable control over the coherent population distribution.

Final project report for NEET pulsed ion beam project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kucheyev, S. O.

The major goal of this project was to develop and demonstrate a novel experimental approach to access the dynamic regime of radiation damage formation in nuclear materials. In particular, the project exploited a pulsed-ion-beam method in order to gain insight into defect interaction dynamics by measuring effective defect interaction time constants and defect diffusion lengths. This project had the following four major objectives: (i) the demonstration of the pulsed ion beam method for a prototypical nuclear ceramic material, SiC; (ii) the evaluation of the robustness of the pulsed beam method from studies of defect generation rate effects; (iii) the measurementmore » of the temperature dependence of defect dynamics and thermally activated defect-interaction processes by pulsed ion beam techniques; and (iv) the demonstration of alternative characterization techniques to study defect dynamics. As we describe below, all these objectives have been met.« less

Coherent-pulse implementations of quantum cryptography protocols resistant to photon-number-splitting attacks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Acin, Antonio; Gisin, Nicolas; Scarani, Valerio

2004-01-01

We propose a class of quantum cryptography protocols that are robust against photon-number-splitting attacks (PNS) in a weak coherent-pulse implementation. We give a quite exhaustive analysis of several eavesdropping attacks on these schemes. The honest parties (Alice and Bob) use present-day technology, in particular an attenuated laser as an approximation of a single-photon source. The idea of the protocols is to exploit the nonorthogonality of quantum states to decrease the information accessible to Eve due to the multiphoton pulses produced by the imperfect source. The distance at which the key distribution becomes insecure due to the PNS attack is significantlymore » increased compared to the existing schemes. We also show that strong-pulse implementations, where a strong pulse is included as a reference, allow for key distribution robust against photon-number-splitting attacks.« less

The Predictive Value of Pulse Oximeters for Pulse Improvement after Angiography in Infants and Children

PubMed Central

Alipour, Mohammad-Reza; Rastegar, Mazyar; Ghaderian, Mehdi; Namayandeh, Seyedeh-Mahdieh; Faraji, Reza; Pezeshkpour, Zohreh

2016-01-01

Background Information from pulse oximeter waves confirms the presence of a pulse and helps obtain waves from tissue when the supplying artery is not readily accessible. Objectives This study determined the predictive value of pulse oximeters for detecting improved arterial pulses after angiography. Patients and Methods This cross-sectional, multi-center study included 467 4-day-old to 12-year-old patients and was conducted from January 2012 to January 2016. Angiographies were performed on 12-year-old or younger children for various medical reasons using venous, arterial, or both types of paths. The posterior malleolar or dorsalis pedis were palpated in punctured lower extremities. In the absence of a pulse, pulse oximetry was performed to identify pulse curves at 1 hour, 6 hours, and 12 hours after each angiography. Results Pulse oximetry displayed the pulses of 319 patients immediately following each angiography. Of these, 262 patients had palpable pulses at 6 hours after angiography (P < 0.0001), while 57 patients had no palpable pulse. Of these 57 patients, 15 had no palpable pulse at 12 hours after angiography (P < 0.0001). The odds of pulse improvement in children 6 hours after catheter angiography were 76% for the arterial path, 90% for the venous path, and 83.2% for both paths. At 12 hours after catheter angiography, these values increased to 91.6% for the arterial path, 100% for the venous path, and 95.9% for both paths. Conclusions The pulse oximeter can display the pulse curve immediately (1 hour) after angiography and indicate pulse improvement at 12 hours maximally following an angiography. In this case, heparin alone may be used instead of thrombolytic agents. PMID:28203338

Efficient generation of ultra-intense few-cycle radially polarized laser pulses.

PubMed

Carbajo, Sergio; Granados, Eduardo; Schimpf, Damian; Sell, Alexander; Hong, Kyung-Han; Moses, Jeffrey; Kärtner, Franz X

2014-04-15

We report on efficient generation of millijoule-level, kilohertz-repetition-rate few-cycle laser pulses with radial polarization by combining a gas-filled hollow-waveguide compression technique with a suitable polarization mode converter. Peak power levels >85  GW are routinely achieved, capable of reaching relativistic intensities >10(19)  W/cm2 with carrier-envelope-phase control, by employing readily accessible ultrafast high-energy laser technology.

Optical multiple access techniques for on-board routing

NASA Technical Reports Server (NTRS)

Mendez, Antonio J.; Park, Eugene; Gagliardi, Robert M.

1992-01-01

The purpose of this research contract was to design and analyze an optical multiple access system, based on Code Division Multiple Access (CDMA) techniques, for on board routing applications on a future communication satellite. The optical multiple access system was to effect the functions of a circuit switch under the control of an autonomous network controller and to serve eight (8) concurrent users at a point to point (port to port) data rate of 180 Mb/s. (At the start of this program, the bit error rate requirement (BER) was undefined, so it was treated as a design variable during the contract effort.) CDMA was selected over other multiple access techniques because it lends itself to bursty, asynchronous, concurrent communication and potentially can be implemented with off the shelf, reliable optical transceivers compatible with long term unattended operations. Temporal, temporal/spatial hybrids and single pulse per row (SPR, sometimes termed 'sonar matrices') matrix types of CDMA designs were considered. The design, analysis, and trade offs required by the statement of work selected a temporal/spatial CDMA scheme which has SPR properties as the preferred solution. This selected design can be implemented for feasibility demonstration with off the shelf components (which are identified in the bill of materials of the contract Final Report). The photonic network architecture of the selected design is based on M(8,4,4) matrix codes. The network requires eight multimode laser transmitters with laser pulses of 0.93 ns operating at 180 Mb/s and 9-13 dBm peak power, and 8 PIN diode receivers with sensitivity of -27 dBm for the 0.93 ns pulses. The wavelength is not critical, but 830 nm technology readily meets the requirements. The passive optical components of the photonic network are all multimode and off the shelf. Bit error rate (BER) computations, based on both electronic noise and intercode crosstalk, predict a raw BER of (10 exp -3) when all eight users are communicating concurrently. If better BER performance is required, then error correction codes (ECC) using near term electronic technology can be used. For example, the M(8,4,4) optical code together with Reed-Solomon (54,38,8) encoding provides a BER of better than (10 exp -11). The optical transceiver must then operate at 256 Mb/s with pulses of 0.65 ns because the 'bits' are now channel symbols.

Use of a prototype pulse oximeter for time series analysis of heart rate variability

NASA Astrophysics Data System (ADS)

González, Erika; López, Jehú; Hautefeuille, Mathieu; Velázquez, Víctor; Del Moral, Jésica

2015-05-01

This work presents the development of a low cost pulse oximeter prototype consisting of pulsed red and infrared commercial LEDs and a broad spectral photodetector used to register time series of heart rate and oxygen saturation of blood. This platform, besides providing these values, like any other pulse oximeter, processes the signals to compute a power spectrum analysis of the patient heart rate variability in real time and, additionally, the device allows access to all raw and analyzed data if databases construction is required or another kind of further analysis is desired. Since the prototype is capable of acquiring data for long periods of time, it is suitable for collecting data in real life activities, enabling the development of future wearable applications.

The CARIBU EBIS control and synchronization system

NASA Astrophysics Data System (ADS)

Dickerson, Clayton; Peters, Christopher

2015-01-01

The Californium Rare Isotope Breeder Upgrade (CARIBU) Electron Beam Ion Source (EBIS) charge breeder has been built and tested. The bases of the CARIBU EBIS electrical system are four voltage platforms on which both DC and pulsed high voltage outputs are controlled. The high voltage output pulses are created with either a combination of a function generator and a high voltage amplifier, or two high voltage DC power supplies and a high voltage solid state switch. Proper synchronization of the pulsed voltages, fundamental to optimizing the charge breeding performance, is achieved with triggering from a digital delay pulse generator. The control system is based on National Instruments realtime controllers and LabVIEW software implementing Functional Global Variables (FGV) to store and access instrument parameters. Fiber optic converters enable network communication and triggering across the platforms.

Microcontroller-based binary integrator for millimeter-wave radar experiments.

PubMed

Eskelinen, Pekka; Ruoskanen, Jukka; Peltonen, Jouni

2010-05-01

An easily on-site reconfigurable multiple binary integrator for millimeter radar experiments has been constructed of static random access memories, an eight bit microcontroller, and high speed video operational amplifiers. The design uses a raw comparator path and two adjustable m-out-of-n chains in a wired-OR configuration. Standard high speed memories allow the use of pulse widths below 100 ns. For eight pulse repetition intervals it gives a maximum improvement of 6.6 dB for stationary low-level target echoes. The doubled configuration enhances the capability against fluctuating targets. Because of the raw comparator path, also single return pulses of relatively high amplitude are processed.

Surgical management of Crohn's disease.

PubMed

Lu, Kim C; Hunt, Steven R

2013-02-01

Although medical management can control symptoms in a recurring incurable disease, such as Crohn's disease, surgical management is reserved for disease complications or those problems refractory to medical management. In this article, we cover general principles for the surgical management of Crohn's disease, ranging from skin tags, abscesses, fistulae, and stenoses to small bowel and extraintestinal disease. Copyright © 2013 Elsevier Inc. All rights reserved.

Congenital solitary intestinal fibromatosis.

PubMed

Numanoglu, A; Davies, J; Millar, A J W; Rode, H

2002-10-01

Neonatal intestinal obstruction due to a tumour is rare. We report a six-day-old male neonate who presented with abdominal distension and vomiting. Laparotomy revealed colonic obstruction caused by a stenosing fibrotic lesion in the proximal transverse colon. Histopathological examination of the resected specimen confirmed fibromatosis. We believe this represents the third reported case of solitary colonic fibromatosis. The literature on neonatal intestinal fibromatosis is reviewed.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klein, W.M.; Schlejen, P.M.; Eikelboom, B.C.

Purpose: To assess the value of MR angiography (MRA) with automatic table movement in a consecutive series of patients with peripheral arterial disease. Methods: Seventy-two patients underwent both conventional angiography (CA) and MRA for peripheral arterial occlusive disease. Both techniques were scored in a masked way. Consensus scoring for CA was compared with MRA scoring per observer. If there was a discrepancy in scoring of asegment on MRA and CA, the images were reviewed and a consensus arrived at. Results: Observer A found 7.4% and observer B found 6.5% of the segments could not be analyzed on MRA. Observer Amore » scored 11.4% dissimilar on MRA and CA, observer B 15.2%. In the aortoiliacarteries, this was mainly caused by stents and overestimation of stenoses; in the crural arteries it resulted from underestimation of the stenoses on MRA. Overall sensitivity and specificity for the aortoiliac, femoropopliteal and crural vessels were respectively 90% and 91%, 90% and 96%, 59% and 96% for observer A, and 85% and 91%, 84% and 89%, 68% and 85% for observer B. Conclusion: Although MRA of the lower extremities is a promising technique, improvements still need to be made. In particular, MRA below the knee is suboptimal for clinical use.« less

Hemodynamic consequences of LPA stenosis in single ventricle stage 2 LPN circulation with automatic registration

NASA Astrophysics Data System (ADS)

Schiavazzi, Daniele E.; Kung, Ethan O.; Dorfman, Adam L.; Hsia, Tain-Yen; Baretta, Alessia; Arbia, Gregory; Marsden, Alison L.

2013-11-01

Congenital heart diseases such as hypoplastic left heart syndrome annually affect about 3% of births in the US alone. Surgical palliation of single ventricle patients is performed in stages. Consequently to the stage 2 surgical procedure or other previous conditions, a stenosis of the left pulmonary artery (LPA) is often observed, raising the clinical question of whether or not it should be treated. The severity of stenoses are commonly assessed through geometric inspection or catheter in-vivo pressure measurements with limited quantitative information about patient-specific physiology. The present study uses a multiscale CFD approach to provide an assessment of the severity of LPA stenoses. A lumped parameter 0D model is used to simulate stage 2 circulation, and parameters are automatically identified accounting for uncertainty in the clinical data available for a cohort of patients. The importance of the latter parameters, whether alone or in groups, is also ranked using forward uncertainty propagation methods. Various stenosis levels are applied to the three-dimensional SVC-PA junction model using a dual mesh-morphing approach. Traditional assessments methodologies are compared to the results of our findings and critically discussed.

[Sudden death due to acute coronary insufficiency].

PubMed

Mazur, N A; Zhukov, V N

1976-01-01

The study was conducted in the course of 2 years in accordance with the programme of myocardial infarction register of all mortality cases among the inhabitants of one of the Moscow districts. In conformity with the criteria recommended by the WHO Expert Committee, general figures of sudden death incidence at the age of 20 to 64 years comprised 80.3--76.2 and 32.7--34.5 per 100,000 males and females, respectively, during the 1st and 2nd year of observation. Autopsies performed in 89.5% of the mortality cases established that only in 39.8% of the cases death ensued in the presence of fresh foci of necrosis in the myocardium, while in the rest no myocardial infarction was found. In an overwhelming majority of the dying patients severe stenoses or occlusions of the coronary arteries were seen, and only 13% had no stenoses. However, the latter group showed fresh necroses or postinfarction cicatrices in the myocardium. The obtained data indicate that sudden death occupies an important place in the structure of mortality in ischaemic heart disease. It has been demonstrated that no reduction of general mortality due to myocardial infarction is possible without effective measures against this kind of death.

“Do-it-yourself in vitro vasculature that recapitulates in vivo geometries for investigating endothelial-blood cell interactions”

PubMed Central

Mannino, Robert G.; Myers, David R.; Ahn, Byungwook; Wang, Yichen; Margo Rollins; Gole, Hope; Lin, Angela S.; Guldberg, Robert E.; Giddens, Don P.; Timmins, Lucas H.; Lam, Wilbur A.

2015-01-01

Investigating biophysical cellular interactions in the circulation currently requires choosing between in vivo models, which are difficult to interpret due in part to the hemodynamic and geometric complexities of the vasculature; or in vitro systems, which suffer from non-physiologic assumptions and/or require specialized microfabrication facilities and expertise. To bridge that gap, we developed an in vitro “do-it-yourself” perfusable vasculature model that recapitulates in vivo geometries, such as aneurysms, stenoses, and bifurcations, and supports endothelial cell culture. These inexpensive, disposable devices can be created rapidly (<2 hours) with high precision and repeatability, using standard off-the-shelf laboratory supplies. Using these “endothelialized” systems, we demonstrate that spatial variation in vascular cell adhesion molecule (VCAM-1) expression correlates with the wall shear stress patterns of vascular geometries. We further observe that the presence of endothelial cells in stenoses reduces platelet adhesion but increases sickle cell disease (SCD) red blood cell (RBC) adhesion in bifurcations. Overall, our method enables researchers from all disciplines to study cellular interactions in physiologically relevant, yet simple-to-make, in vitro vasculature models. PMID:26202603

Radial extracorporeal shockwave therapy for the treatment of finger tenosynovitis (trigger digit)

PubMed Central

Malliaropoulos, Nikos; Jury, Rosanna; Pyne, Debasish; Padhiar, Nat; Turner, Jennifer; Korakakis, Vasileios; Meke, Maria; Lohrer, Heinz

2016-01-01

Introduction Stenosing tenosynovitis that is characterized by the inability to flex the digit smoothly, usually leads to prolonged rehabilitation or surgery. Study design This case series is a retrospective cohort study. Purpose The aim of this case series was to evaluate the effectiveness of radial extracorporeal shockwave therapy (rESWT) for the treatment of stenosing tenosynovitis of the digital flexor tendon (trigger digit). Methods A retrospective analysis of 44 patients (49 fingers) treated with an individually adapted rESWT protocol was conducted. Trigger digit pain and function were evaluated at baseline and 1-, 3-, and 12-months posttreatment. Recurrence and pretreatment symptom duration were analyzed. Results Significant reductions in pain scores and functional improvement were found between baseline and all follow-up assessments (P<0.001). Pretreatment symptom duration was significantly correlated with the number of rESWT sessions required (r=0.776, P<0.001) and 1-year posttreatment pain score (r=0.335, P=0.019). Conclusion This study provides initial evidence that rESWT is an effective treatment for trigger digit, but randomised controlled trials are required to provide further evidence of this effect. PMID:27843364

Estimation of pressure gradients at renal artery stenoses

NASA Astrophysics Data System (ADS)

Yim, Peter J.; Cebral, Juan R.; Weaver, Ashley; Lutz, Robert J.; Vasbinder, G. Boudewijn C.

2003-05-01

Atherosclerotic disease of the renal artery can reduce the blood flow leading to renovascular hypertension and ischemic nephopathy. The kidney responds to a decrease in blood flow by activation of the renin-angiotensin system that increases blood pressure and can result in severe hypertension. Percutaneous translumenal angioplasty (PTA) may be indicated for treatment of renovascular hypertension (RVH). However, direct measurement of renal artery caliber and degree of stenosis has only moderate specificity for detection of RVH. A confounding factor in assessment of the proximal renal artery is that diffuse atherosclerotic disease of the distal branches of the renal artery can produce the same effect on blood-flow as atherosclerotic disease of the proximal renal artery. A methodology is proposed for estimation of pressure gradients at renal artery stenoses from magnetic resonance imaging that could improve the evaluation of renal artery disease. In the proposed methodology, pressure gradients are estimated using computational fluid dynamics (CFD) modeling. Realistic CFD models are constructed from images of vessel shape and measurements of blood-flow rates which are available from magnetic resonance angiography (MRA) and phase-contrast magnetic resonance (MR) imaging respectively. CFD measurement of renal artery pressure gradients has been validated in a physical flow-through model.

Divergence-free smoothing for MRV data on stenosed carotid artery phantom flows

NASA Astrophysics Data System (ADS)

Im, Chaehyuk; Ko, Seungbin; Song, Simon

2017-11-01

Magnetic Resonance Velocimetry (MRV) is a versatile technique for measuring flow velocity using an MRI machine. It is frequently used for visualization and analysis of blood flows. However, it is difficult to accurately estimate hemodynamics parameters like wall shear stress (WSS) and oscillatory shear index (OSI) due to its low spatial resolution and low signal-to-noise ratio. We suggest a divergence-free smoothing (DFS) method to correct the erroneous velocity vectors obtained with MRV and improve the estimation accuracy of those parameters. Unlike previous studies on DFS for a wall-free flow, we developed a house code to apply a DFS method to a wall-bounded flow. A Hagen-Poiseuille flow and stenosed carotid artery phantom flows were measured with MRV. Each of them was analyzed for validation of the DFS code and confirmation on the accuracy improvement of hemodynamic parameters. We will discuss the effects of DFS on the improvement of the estimation accuracy of velocity vectors, WSS, OSI and etc in detail This work was supported by the National Research Foundation of Korea(NRF) Grant funded by the Korea government(MSIP) (No. 2016R1A2B3009541).

Prediction of blood pressure and blood flow in stenosed renal arteries using CFD

NASA Astrophysics Data System (ADS)

Jhunjhunwala, Pooja; Padole, P. M.; Thombre, S. B.; Sane, Atul

2018-04-01

In the present work an attempt is made to develop a diagnostive tool for renal artery stenosis (RAS) which is inexpensive and in-vitro. To analyse the effects of increase in the degree of severity of stenosis on hypertension and blood flow, haemodynamic parameters are studied by performing numerical simulations. A total of 16 stenosed models with varying degree of stenosis severity from 0-97.11% are assessed numerically. Blood is modelled as a shear-thinning, non-Newtonian fluid using the Carreau model. Computational Fluid Dynamics (CFD) analysis is carried out to compute the values of flow parameters like maximum velocity and maximum pressure attained by blood due to stenosis under pulsatile flow. These values are further used to compute the increase in blood pressure and decrease in available blood flow to kidney. The computed available blood flow and secondary hypertension for varying extent of stenosis are mapped by curve fitting technique using MATLAB and a mathematical model is developed. Based on these mathematical models, a quantification tool is developed for tentative prediction of probable availability of blood flow to the kidney and severity of stenosis if secondary hypertension is known.

LOCO with a Shipboard Lidar

DTIC Science & Technology

2008-01-01

components attached. The laser is located on the far left corner of the bench the pulse chopper assembly and beam expansion optics are at center. The IMU...access to the computer and receivers. Modifications were also made to lock the alignment of the beam through the chopper to increase the output...Receiver 2 CPU & Digitizer Laser Head Pulse Chopper 100 cm 56 cm GPS & INS Therm al M anagem ent 56 cm INS Laser PC & Digitize TE cooler Page 6 of

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lü, B.; Münger, E. P.; Sarakinos, K.

The morphology and physical properties of thin films deposited by vapor condensation on solid surfaces are predominantly set by the processes of island nucleation, growth, and coalescence. When deposition is performed using pulsed vapor fluxes, three distinct nucleation regimes are known to exist depending on the temporal profile of the flux. These regimes can be accessed by tuning deposition conditions; however, their effect on film microstructure becomes marginal when coalescence sets in and erases morphological features obtained during nucleation. By preventing coalescence from being completed, these nucleation regimes can be used to control microstructure evolution and thus access a largermore » palette of film morphological features. Recently, we derived the quantitative criterion to stop coalescence during continuous metal vapor flux deposition on insulating surfaces—which typically yields 3-dimensional growth—by describing analytically the competition between island growth by atomic incorporation and the coalescence rate of islands [Lü et al., Appl. Phys. Lett. 105, 163107 (2014)]. Here, we develop the analytical framework for entering a coalescence-free growth regime for metal vapor deposition on insulating substrates using pulsed vapor fluxes, showing that there exist three distinct criteria for suppressing coalescence that correspond to the three nucleation regimes of pulsed vapor flux deposition. The theoretical framework developed herein is substantiated by kinetic Monte Carlo growth simulations. Our findings highlight the possibility of using atomistic nucleation theory for pulsed vapor deposition to control morphology of thin films beyond the point of island density saturation.« less

A Dual-Colour Architecture for Pump-Probe Spectroscopy of Ultrafast Magnetization Dynamics in the Sub-10-femtosecond Range.

PubMed

Gonçalves, C S; Silva, A S; Navas, D; Miranda, M; Silva, F; Crespo, H; Schmool, D S

2016-03-15

Current time-resolution-limited dynamic measurements clearly show the need for improved techniques to access processes on the sub-10-femtosecond timescale. To access this regime, we have designed and constructed a state-of-the-art time-resolved magneto-optic Kerr effect apparatus, based on a new dual-color scheme, for the measurement of ultrafast demagnetization and precessional dynamics in magnetic materials. This system can operate well below the current temporal ranges reported in the literature, which typically lie in the region of around 50 fs and above. We have used a dual-colour scheme, based on ultra broadband hollow-core fibre and chirped mirror pulse compression techniques, to obtain unprecedented sub-8-fs pump and probe pulse durations at the sample plane. To demonstrate the capabilities of this system for ultrafast demagnetization and precessional dynamics studies, we have performed measurements in a ferrimagnetic GdFeCo thin film. Our study has shown that the magnetization shows a sudden drop within the first picosecond after the pump pulse, a fast recovery (remagnetization) within a few picoseconds, followed by a clear oscillation or precession during a slower magnetization recovery. Moreover, we have experimentally confirmed for the first time that a sub-10-fs pulse is able to efficiently excite a magnetic system such as GdFeCo.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turmel-Rodrigues, Luc A

Acute thrombosis of native fistulae for hemodialysis occurs more rarely than for prosthetic grafts. The vascular access should be reopened as soon as possible in order to resume regular dialysis and to avoid resorting to a temporary central line. Manual aspiration is one of the numerous methods described in this setting. Clinical examination is essential to rule out local infection, which is the only serious contraindication to percutaneous maneuvers. Two introducer-sheaths are placed in a criss-cross fashion in order to gain access to the venous outflow and to the anastomosis. Access to the venous outflow is performed first in ordermore » to check the proximal extent of the thrombosis. Heparin and antibiotics are injected systemically. A similar maneuver is then performed in the direction of the anastomosis. The aspiration phase is then initiated. A 7-9 Fr aspiration catheter is pushed through the 'venous' introducer. Manual aspiration is created through a 50 ml syringe while the catheter is progressively removed with back and forth movements. The catheter and the contents of the syringe are flushed through a gauze on the working table to evaluate the amount of thrombus which has been removed and the maneuver is repeated as often as necessary to remove all the thrombus. Once all the clots located downstream from the venous introducer have been removed, any unmasked underlying stenosis is NOT dilated at this stage since it provides protection against major embolism coming from the inflow. The aspiration catheter is then pushed through the 'arterial' introducer down to the anastomosis in order to aspirate the thrombus located between the tip of the introducer and the anastomosis. Dilatation of unmasked stenoses is finally performed using high-pressure balloons. The holes made by the two introducers are closed using a U-shaped suture with interposition of a short piece of plastic and the patient is sent back to the nephrologists for dialysis.« less

The CARIBU EBIS control and synchronization system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dickerson, Clayton, E-mail: cdickerson@anl.gov; Peters, Christopher, E-mail: cdickerson@anl.gov

2015-01-09

The Californium Rare Isotope Breeder Upgrade (CARIBU) Electron Beam Ion Source (EBIS) charge breeder has been built and tested. The bases of the CARIBU EBIS electrical system are four voltage platforms on which both DC and pulsed high voltage outputs are controlled. The high voltage output pulses are created with either a combination of a function generator and a high voltage amplifier, or two high voltage DC power supplies and a high voltage solid state switch. Proper synchronization of the pulsed voltages, fundamental to optimizing the charge breeding performance, is achieved with triggering from a digital delay pulse generator. Themore » control system is based on National Instruments realtime controllers and LabVIEW software implementing Functional Global Variables (FGV) to store and access instrument parameters. Fiber optic converters enable network communication and triggering across the platforms.« less

ORION laser target diagnostics.

PubMed

Bentley, C D; Edwards, R D; Andrew, J E; James, S F; Gardner, M D; Comley, A J; Vaughan, K; Horsfield, C J; Rubery, M S; Rothman, S D; Daykin, S; Masoero, S J; Palmer, J B; Meadowcroft, A L; Williams, B M; Gumbrell, E T; Fyrth, J D; Brown, C R D; Hill, M P; Oades, K; Wright, M J; Hood, B A; Kemshall, P

2012-10-01

The ORION laser facility is one of the UK's premier laser facilities which became operational at AWE in 2010. Its primary mission is one of stockpile stewardship, ORION will extend the UK's experimental plasma physics capability to the high temperature, high density regime relevant to Atomic Weapons Establishment's (AWE) program. The ORION laser combines ten laser beams operating in the ns regime with two sub ps short pulse chirped pulse amplification beams. This gives the UK a unique combined long pulse/short pulse laser capability which is not only available to AWE personnel but also gives access to our international partners and visiting UK academia. The ORION laser facility is equipped with a comprehensive suite of some 45 diagnostics covering optical, particle, and x-ray diagnostics all able to image the laser target interaction point. This paper focuses on a small selection of these diagnostics.

Ionization processes in combined high-voltage nanosecond - laser discharges in inert gas

NASA Astrophysics Data System (ADS)

Starikovskiy, Andrey; Shneider, Mikhail; PU Team

2016-09-01

Remote control of plasmas induced by laser radiation in the atmosphere is one of the challenging issues of free space communication, long-distance energy transmission, remote sensing of the atmosphere, and standoff detection of trace gases and bio-threat species. Sequences of laser pulses, as demonstrated by an extensive earlier work, offer an advantageous tool providing access to the control of air-plasma dynamics and optical interactions. The avalanche ionization induced in a pre-ionized region by infrared laser pulses where investigated. Pre-ionization was created by an ionization wave, initiated by high-voltage nanosecond pulse. Then, behind the front of ionization wave extra avalanche ionization was initiated by the focused infrared laser pulse. The experiment was carried out in argon. It is shown that the gas pre-ionization inhibits the laser spark generation under low pressure conditions.

Coronary pressure notch: an early non-hyperemic visual indicator of the physiologic significance of a coronary artery stenosis.

PubMed

Holmes, David; Velappan, Priya; Kern, Morton J

2004-11-01

The disappearance of a dichrotic notch on the peripheral arterial pulse wave has been associated with significant peripheral vascular disease. A similar observation has not been reported in the distal coronary pressure waveform. The purpose of this study was to investigate the significance of a coronary pressure notch distal to a coronary stenosis and its relationship to fractional flow reserve. Ninety-seven patients with 131 angiographically indeterminate lesions (40-80% diameter narrowing) underwent FFR measurements for physiological significance. Hemodynamic tracings were recorded prior to the administration of adenosine and visually analyzed for the presence or absence of a dicrotic notch in the distal coronary artery pressure tracing. The stenoses were then divided into two groups based on the presence or absence of a notch. Of the 54 lesions without a distal coronary pressure notch, 31 had a FFR greater than or equal to 0.75 and of the 77 lesions with a notch, 75 had a FFR greater than or equal to 0.76. The sensitivity and specificity of a pressure notch was 94% and 74%, respectively, with positive and negative predictive values of 57% and 97%, respectively. The presence of a distal coronary pressure notch was predictive of a FFR greater than or equal to 0.76. The distal dicrotic pressure notch may be used as an additional parameter without requiring hyperemia for FFR measurements of uncertain clinical significance.

Sphygmology of ibn sina, a message for future.

PubMed

Zarshenas, Mohammad M; Abolhassanzadeh, Zohreh; Faridi, Pouya; Mohagheghzadeh, Abdolali

2013-07-01

Sphygmology is a 2000-year-old method that is still used in some traditional medicine systems, mainly Iranian, Chinese and Ayurveda. Ibn Sina is one of the most popular physicians in the history of Sphygmology, who had made great contributions to this method, but few meticulous studies have been made on his concepts. In this article, his standpoints on Pulsology are studied. Ibn Sina has mentioned 10 parameters for pulse palpation, and 13 compound pulses, as well. Besides, some pulse patterns applicable for differentiating similar diseases have been introduced. Nowadays some concepts on pulse patterns, such as pulse change in sleep and pregnancy have been studied; but unfortunately many of the ideas on Pulsology have not yet been examined. Sphygmology, as an accessible and inexpensive means, having a substantial diagnosis yield, has been accepted by the people since its rise, and its development over centuries ago. Although some new instruments have been innovated, which can measure different parameters of pulse, yet sphygmology can be one of the most commonly usable diagnostic methods in future, not only applicable by cardiologists but also by all the physicians.

Control of ultrafast pulses in a hydrogen-filled hollow-core photonic-crystal fiber by Raman coherence

NASA Astrophysics Data System (ADS)

Belli, F.; Abdolvand, A.; Travers, J. C.; Russell, P. St. J.

2018-01-01

We present the results of an experimental and numerical investigation into temporally nonlocal coherent interactions between ultrashort pulses, mediated by Raman coherence, in a gas-filled kagome-style hollow-core photonic-crystal fiber. A pump pulse first sets up the Raman coherence, creating a refractive index spatiotemporal grating in the gas that travels at the group velocity of the pump pulse. Varying the arrival time of a second, probe, pulse allows a high degree of control over its evolution as it propagates along the fiber through the grating. Of particular interest are soliton-driven effects such as self-compression and dispersive wave (DW) emission. In the experiments reported, a DW is emitted at ˜300 nm and exhibits a wiggling effect, with its central frequency oscillating periodically with pump-probe delay. The results demonstrate that a strong Raman coherence, created in a broadband guiding gas-filled kagome photonic-crystal fiber, can be used to control the nonlinear dynamics of ultrashort probe pulses, even in difficult-to-access spectral regions such as the deep and vacuum ultraviolet.

Generation of bright attosecond x-ray pulse trains via Thomson scattering from laser-plasma accelerators.

PubMed

Luo, W; Yu, T P; Chen, M; Song, Y M; Zhu, Z C; Ma, Y Y; Zhuo, H B

2014-12-29

Generation of attosecond x-ray pulse attracts more and more attention within the advanced light source user community due to its potentially wide applications. Here we propose an all-optical scheme to generate bright, attosecond hard x-ray pulse trains by Thomson backscattering of similarly structured electron beams produced in a vacuum channel by a tightly focused laser pulse. Design parameters for a proof-of-concept experiment are presented and demonstrated by using a particle-in-cell code and a four-dimensional laser-Compton scattering simulation code to model both the laser-based electron acceleration and Thomson scattering processes. Trains of 200 attosecond duration hard x-ray pulses holding stable longitudinal spacing with photon energies approaching 50 keV and maximum achievable peak brightness up to 10²⁰ photons/s/mm²/mrad²/0.1%BW for each micro-bunch are observed. The suggested physical scheme for attosecond x-ray pulse trains generation may directly access the fastest time scales relevant to electron dynamics in atoms, molecules and materials.

Pulse width modulation inverter with battery charger

DOEpatents

Slicker, James M.

1985-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a microprocessor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .theta., where .theta. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands for electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a "flyback" DC-DC converter circuit for recharging the battery.

Pulse width modulation inverter with battery charger

NASA Technical Reports Server (NTRS)

Slicker, James M. (Inventor)

1985-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a microprocessor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .theta., where .theta. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands for electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a flyback DC-DC converter circuit for recharging the battery.

Real-Space Imaging of Carrier Dynamics of Materials Surfaces by Second-Generation Four-Dimensional Scanning Ultrafast Electron Microscopy.

PubMed

Sun, Jingya; Melnikov, Vasily A; Khan, Jafar I; Mohammed, Omar F

2015-10-01

In the fields of photocatalysis and photovoltaics, ultrafast dynamical processes, including carrier trapping and recombination on material surfaces, are among the key factors that determine the overall energy conversion efficiency. A precise knowledge of these dynamical events on the nanometer (nm) and femtosecond (fs) scales was not accessible until recently. The only way to access such fundamental processes fully is to map the surface dynamics selectively in real space and time. In this study, we establish a second generation of four-dimensional scanning ultrafast electron microscopy (4D S-UEM) and demonstrate the ability to record time-resolved images (snapshots) of material surfaces with 650 fs and ∼5 nm temporal and spatial resolutions, respectively. In this method, the surface of a specimen is excited by a clocking optical pulse and imaged using a pulsed primary electron beam as a probe pulse, generating secondary electrons (SEs), which are emitted from the surface of the specimen in a manner that is sensitive to the local electron/hole density. This method provides direct and controllable information regarding surface dynamics. We clearly demonstrate how the surface morphology, grains, defects, and nanostructured features can significantly impact the overall dynamical processes on the surface of photoactive-materials. In addition, the ability to access two regimes of dynamical probing in a single experiment and the energy loss of SEs in semiconductor-nanoscale materials will also be discussed.

The Accuracy of 6 Inexpensive Pulse Oximeters Not Cleared by the Food and Drug Administration: The Possible Global Public Health Implications.

PubMed

Lipnick, Michael S; Feiner, John R; Au, Paul; Bernstein, Michael; Bickler, Philip E

2016-08-01

Universal access to pulse oximetry worldwide is often limited by cost and has substantial public health consequences. Low-cost pulse oximeters have become increasingly available with limited regulatory agency oversight. The accuracy of these devices often has not been validated, raising questions about performance. The accuracy of 6 low-cost finger pulse oximeters during stable arterial oxygen saturations (SaO2) between 70% and 100% was evaluated in 22 healthy subjects. Oximeters tested were the Contec CMS50DL, Beijing Choice C20, Beijing Choice MD300C23, Starhealth SH-A3, Jumper FPD-500A, and Atlantean SB100 II. Inspired oxygen, nitrogen, and carbon dioxide partial pressures were monitored and adjusted via a partial rebreathing circuit to achieve 10 to 12 stable target SaO2 plateaus between 70% and 100% and PaCO2 values of 35 to 45 mm Hg. Comparisons of pulse oximeter readings (SpO2) with arterial SaO2 (by Radiometer ABL90 and OSM3) were used to calculate bias (SpO2 - SaO2) mean, precision (SD of the bias), and root mean square error (ARMS). Pulse oximeter readings corresponding to 536 blood samples were analyzed. Four of the 6 oximeters tested showed large errors (up to -6.30% mean bias, precision 4.30%, 7.53 ARMS) in estimating saturation when SaO2 was reduced <80%, and half of the oximeters demonstrated large errors when estimating saturations between 80% and 90%. Two of the pulse oximeters tested (Contec CMS50DL and Beijing Choice C20) demonstrated ARMS of <3% at SaO2 between 70% and 100%, thereby meeting International Organization for Standardization (ISO) criteria for accuracy. Many low-cost pulse oximeters sold to consumers demonstrate highly inaccurate readings. Unexpectedly, the accuracy of some low-cost pulse oximeters tested here performed similarly to more expensive, ISO-cleared units when measuring hypoxia in healthy subjects. None of those tested here met World Federation of Societies of Anaesthesiologists standards, and the ideal testing conditions do not necessarily translate these findings to the clinical setting. Nonetheless, further development of accurate, low-cost oximeters for use in clinical practice is feasible and, if pursued, could improve access to safe care, especially in low-income countries.

Full-band TDM-OPDMA for OBI-reduced simultaneous multiple access in a single-wavelength optical access network.

PubMed

Jung, Sun-Young; Kim, Chang-Hun; Han, Sang-Kook

2018-05-14

Simultaneous multiple access (MA) within a single wavelength can increase the data rate and split ratio in a passive optical network while optical beat interference (OBI) becomes serious in the uplink. Previous techniques to reduce OBI were limited by their complexity and lack of extendibility; as well, bandwidth allocation among MA signals is needed for single photo diode (PD) detection. We proposed and experimentally demonstrated full-band optical pulse division multiplexing-based MA (OPDMA) in an optical access network, which can effectively reduce OBI with extendibility and fully utilize frequency resources of optical modulator without bandwidth allocation in a single-wavelength MA.

Nutritional and anti-nutritional potential of three accessions of itching bean (Mucuna pruriens (L.) DC var. pruriens): an under-utilized tribal pulse.

PubMed

Kala, Balasubiramanian Kamatchi; Mohan, Veerabahu Ramasamy

2010-08-01

Three accessions of the under-utilized legume itching bean (Mucuna pruriens var. pruriens) were analysed for proximate composition, mineral profiles, vitamins (niacin and ascorbic acid), fatty acid profiles, amino acid profiles of total seed protein, in vitro protein digestibility and certain anti-nutritional factors. All three accessions of M. pruriens var. pruriens contained higher amounts of crude protein and crude lipid when compared with most of the commonly consumed pulses. The fatty acid profiles revealed that the seed lipids contained a higher concentration of palmitic acid and linoleic acids. Amino acid profiles of M. pruriens var. pruriens revealed that the seed protein contained relatively higher levels of certain essential amino acids compared with the FAO/WHO requirement pattern. The investigated seeds are rich in minerals such as potassium, calcium, magnesium, phosphorus, iron and manganese. Anti nutritional substances such as total free phenolics, tannins, 3,4-dihydroxyphenylalanine, phytic acid, hydrogen cyanide, trypsin inhibitor activity, oligosaccharides and phytohaemagglutinating activity were investigated. The anti-nutritional fatty acid, behenic acid, also was detected in the present study.

Measuring radiation damage dynamics by pulsed ion beam irradiation: 2016 project annual report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kucheyev, Sergei O.

2017-01-04

The major goal of this project is to develop and demonstrate a novel experimental approach to access the dynamic regime of radiation damage formation in nuclear materials. In particular, the project exploits a pulsed-ion-beam method in order to gain insight into defect interaction dynamics by measuring effective defect interaction time constants and defect diffusion lengths. For Year 3, this project had the following two major milestones: (i) the demonstration of the measurement of thermally activated defect-interaction processes by pulsed ion beam techniques and (ii) the demonstration of alternative characterization techniques to study defect dynamics. As we describe below, both ofmore » these milestones have been met.« less

Systemic Hypertension and Transient Ischemic Attack in a 6-Year-Old Girl with Fibromuscular Dysplasia Treated with Percutaneous Angioplasty

DOE Office of Scientific and Technical Information (OSTI.GOV)

Foa-Torres, Gustavo; Ganame, Javier, E-mail: javier.ganame@uzleuven.b; Juaneda, Ernesto

We describe a 6-year-old girl with arterial hypertension secondary to fibromuscular dysplasia with stenoses of both renal arteries and transient ischemic attack due to extracranial right internal carotid artery subtotal occlusion as well as left internal carotid artery stenosis. She was treated with percutaneous angioplasty of both renal and both carotid arteries.

Instantaneous wave-free ratio as an alternative to fractional flow reserve in assessment of moderate coronary stenoses: A meta-analysis of diagnostic accuracy studies.

PubMed

Maini, Rohit; Moscona, John; Katigbak, Paul; Fernandez, Camilo; Sidhu, Gursukhmandeep; Saleh, Qusai; Irimpen, Anand; Samson, Rohan; LeJemtel, Thierry

2017-12-27

Fractional flow reserve (FFR) remains underutilized due to practical concerns related to the need for hyperemic agents. These concerns have prompted the study of instantaneous wave-free ratio (iFR), a vasodilator-free index of coronary stenosis. Non-inferior cardiovascular outcomes have been demonstrated in two recent randomized clinic trials. We performed this meta-analysis to provide a necessary update of the diagnostic accuracy of iFR referenced to FFR based on the addition of eight more recent studies and 3727 more lesions. We searched the PubMed, EMBASE, Central, ProQuest, and Web of Science databases for full text articles published through May 31, 2017 to identify studies addressing the diagnostic accuracy of iFR referenced to FFR≤0.80. The following keywords were used: "instantaneous wave-free ratio" OR "iFR" AND "fractional flow reserve" OR "FFR." In total, 16 studies comprising 5756 lesions were identified. Pooled diagnostic accuracy estimates of iFR versus FFR≤0.80 were: sensitivity, 0.78 (95% CI, 0.76-0.79); specificity, 0.83 (0.81-0.84); positive likelihood ratio, 4.54 (3.85-5.35); negative likelihood ratio, 0.28 (0.24-0.32); diagnostic odds ratio, 17.38 (14.16-21.34); area under the summary receiver-operating characteristic curve, 0.87; and an overall diagnostic accuracy of 0.81 (0.78-0.84). In conclusion, iFR showed excellent agreement with FFR as a resting index of coronary stenosis severity without the undesired effects and cost of hyperemic agents. When considering along with its clinical outcome data and ease of application, the diagnostic accuracy of iFR supports its use as a suitable alternative to FFR for physiology-guided revascularization of moderate coronary stenoses. We performed a meta-analysis of the diagnostic accuracy of iFR referenced to FFR. iFR showed excellent agreement with FFR as a resting index of coronary stenosis severity without the undesired effects and cost of hyperemic agents. This supports its use as a suitable alternative to FFR for physiology-guided revascularization of moderate coronary stenoses. Copyright © 2017. Published by Elsevier Inc.

Sirolimus‐eluting stent treatment for unprotected versus protected left main coronary artery disease in widespread clinical routine: 6‐month and 3‐year clinical follow‐up results from the prospective multicentre German Cypher Registry

PubMed Central

Khattab, Ahmed A; Hamm, Christian W; Senges, Jochen; Toelg, Ralph; Geist, Volker; Bonzel, Tassilo; Kelm, Malte; Levenson, Benny; Neumann, Franz‐Josef; Nienaber, Christoph A; Pfannebecker, Thomas; Sabin, Georg; Schneider, Steffen; Tebbe, Ulrich; Richardt, Gert

2007-01-01

Background Percutaneous coronary intervention (PCI) of left main coronary artery (LMCA) disease in the bare stent era was limited by high restenosis rates which eventually resulted in sudden death in unprotected cases. Clinical and angiographic restenosis has been substantially reduced by drug‐eluting stents, reviving therefore this indication for PCI despite the absence of direct comparative studies with coronary artery bypass graft surgery. Objective To assess the acute, mid‐ and long‐term outcomes of patients treated with sirolimus‐eluting stents for unprotected LMCA stenoses and to compare them with those treated for protected LMCA disease in the same time period from the German Cypher Registry. Setting and patients The German Cypher Registry included 6755 patients. Eighty‐two patients treated for unprotected LMCA disease were compared with 118 patients treated for protected LMCA stenoses. All patients were treated by sirolimus‐eluting stents. The primary end point was death, myocardial infarction (MI) and target vessel revascularisation at 6 months' follow‐up. Survival free of MI at the long term was considered as the safety end point. Results One‐third of the patients in both groups were treated for the distal left main bifurcation. Angiographic success was 98.5% for both groups. The cumulative combined incidence of all‐cause death, non‐fatal MI and target vessel revascularisation at 6 months was 14.1% in the unprotected LMCA group and 13.1% in the protected group (hazard ratio = 0.81 (95% CI 0.37 to 1.74), p = 0.8). At long‐term, death/MI were reported among 20.2% (95% CI 13.5% to 29.6%) of the protected group versus 11.8% (95% CI 6.3% to 21.4%) of the unprotected group (p = 0.2). Conclusion Sirolimus‐eluting stent treatment of unprotected and protected LMCA stenoses is technically feasible in widespread routine clinical use. Acceptable long‐term clinical results can be achieved, with no particular safety concerns about treatment of unprotected LMCA disease. PMID:17890701

Magnetic particle capture for biomagnetic fluid flow in stenosed aortic bifurcation considering particle-fluid coupling

NASA Astrophysics Data System (ADS)

Bose, Sayan; Banerjee, Moloy

2015-07-01

Magnetic nanoparticles drug carriers continue to attract considerable interest for drug targeting in the treatment of cancer and other pathological conditions. Guiding magnetic iron oxide nanoparticles with the help of an external magnetic field to its target is the basic principle behind the Magnetic Drug Targeting (MDT). It is essential to couple the ferrohydrodynamic (FHD) and magnetohydrodynamic (MHD) principles when magnetic fields are applied to blood as a biomagnetic fluid. The present study is devoted to study on MDT technique by particle tracking in the presence of a non uniform magnetic field in a stenosed aortic bifurcation. The present numerical model of biomagnetic fluid dynamics (BFD) takes into accounts both magnetization and electrical conductivity of blood. The blood flow in the bifurcation is considered to be incompressible and Newtonian. An Eulerian-Lagrangian technique is adopted to resolve the hemodynamic flow and the motion of the magnetic particles in the flow using ANSYS FLUENT two way particle-fluid coupling. An implantable infinitely long cylindrical current carrying conductor is used to create the requisite magnetic field. Targeted transport of the magnetic particles in a partly occluded vessel differs distinctly from the same in a regular unblocked vessel. Results concerning the velocity and temperature field indicate that the presence of the magnetic field influences the flow field considerably and the disturbances increase as the magnetic field strength increases. The insert position is also varied to observe the variation in flow as well as temperature field. Parametric investigation is conducted and the influence of the particle size (dp), flow Reynolds number (Re) and external magnetic field strength (B0) on the "capture efficiency" (CE) is reported. The difference in CE is also studied for different particle loading condition. According to the results, the magnetic field increased the particle concentration in the target region. Analysis shows that there exists an optimum regime of operating parameters for which deposition of the drug carrying magnetic particles in a target zone on the partly occluded vessel wall can be maximized. The results provide useful design bases for in vitro set up for the investigation of MDT in stenosed blood vessels.

Cardiovascular magnetic resonance profiling of coronary atherosclerosis: vessel wall remodelling and related myocardial blood flow alterations.

PubMed

Jahnke, Cosima; Manka, Robert; Kozerke, Sebastian; Schnackenburg, Bernhard; Gebker, Rolf; Marx, Nikolaus; Paetsch, Ingo

2014-12-01

To determine the association between coronary vessel wall morphology and haemodynamic consequences to the myocardium using a combined cardiovascular magnetic resonance (CMR) imaging protocol. Non-invasive CMR profiling of coronary atherosclerotic wall changes and related myocardial blood flow impairment has not been established yet. Sixty-three patients (45 men, 61.5 ± 10.7 years) with suspected or known coronary artery disease underwent 3.0 Tesla CMR imaging. The combined CMR protocol consisted of the following imaging modules at rest: 3D vessel wall imaging and flow measurement of the proximal right coronary artery (RCA), myocardial T2*, and first-pass perfusion imaging. During adenosine stress coronary flow, T2* and first-pass perfusion imaging were repeated. Coronary X-ray angiography classified patient groups: (i) all-smooth (n = 19); (ii) luminal irregular (diameter reduction < 30%; n = 35); and (iii) stenosed RCA (diameter reduction ≥ 50%; n = 9). The ratio of CMR-derived vessel wall area-to-lumen area significantly increased stepwise for the comparison of all-smooth vs. luminal irregular vs. stenosed RCA (1.9 ± 0.6 vs. 2.6 ± 0.6 vs. 3.6 ± 0.9, P < 0.01). Epicardial coronary flow reserve exhibited a stepwise significant decrease (3.4 ± 0.5 vs. 2.9 ± 0.7 vs. 1.7 ± 0.3, P < 0.01). On the myocardial level, stress-induced percentage gain of T2* values (ΔT2*) was significantly decreased between groups (29.2 ± 10.6 vs. 9.0 ± 9.8 vs. 2.2 ± 11.8%, P < 0.01) while perfusion reserve index decreased in the presence of stenosed RCA only (2.2 ± 0.6 vs. 2.0 ± 0.4 vs. 1.3 ± 0.3, P = ns and P < 0.01, respectively). The proposed comprehensive CMR imaging protocol provided a non-invasive approach for direct assessment of coronary vessel wall remodelling and resultant pathophysiological consequences on the level of epicardial coronary and myocardial blood flow in patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

The renal blood flow reserve in healthy humans and patients with atherosclerotic renovascular disease measured by positron emission tomography using [15O]H2O.

PubMed

Päivärinta, Johanna; Koivuviita, Niina; Oikonen, Vesa; Iida, Hidehiro; Liukko, Kaisa; Manner, Ilkka; Löyttyniemi, Eliisa; Nuutila, Pirjo; Metsärinne, Kaj

2018-06-11

Microvascular function plays an important role in ARVD (atherosclerotic renovascular disease). RFR (renal flow reserve), the capacity of renal vasculature to dilate, is known to reflect renal microvascular function. In this pilot study, we assessed PET (positron emission tomography)-based RFR values of healthy persons and renal artery stenosis patients. Seventeen patients with ARVD and eight healthy subjects were included in the study. Intravenous enalapril 1 mg was used as a vasodilatant, and the maximum response (blood pressure and RFR) to it was measured at 40 min. Renal perfusion was measured by means of oxygen-15-labeled water PET. RFR was calculated as a difference of stress flow and basal flow and was expressed as percent [(stress blood flow - basal blood flow)/basal blood flow] × 100%. RFR of the healthy was 22%. RFR of the stenosed kidneys of bilateral stenosis patients (27%) was higher than that of the stenosed kidneys of unilateral stenosis patients (15%). RFR of the contralateral kidneys of unilateral stenosis patients was 21%. There was no difference of statistical significance between RFR values of ARVD subgroups or between ARVD subgroups and the healthy. In the stenosed kidneys of unilateral ARVD patients, stenosis grade of the renal artery correlated negatively with basal (p = 0.04) and stress flow (p = 0.02). Dispersion of RFR values was high. This study is the first to report [ 15 O]H 2 O PET-based RFR values of healthy subjects and ARVD patients in humans. The difference between RFR values of ARVD patients and the healthy did not reach statistical significance perhaps because of high dispersion of RFR values. [ 15 O]H 2 O PET is a valuable non-invasive and quantitative method to evaluate renal blood flow though high dispersion makes imaging challenging. Larger studies are needed to get more information about [ 15 O]H 2 O PET method in evaluation of renal blood flow.

Stent-Protected Carotid Angioplasty Using a Membrane Stent: A Comparative Cadaver Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mueller-Huelsbeck, Stefan, E-mail: muehue@rad.uni-kiel.de; Guehne, Albrecht; Tsokos, Michael

2006-08-15

Purpose. To evaluate the performance of a prototype membrane stent, MembraX, in the prevention of acute and late embolization and to quantify particle embolization during carotid stent placement in human carotid explants in a proof of concept study. Methods. Thirty human carotid cadaveric explants (mild stenoses 0-29%, n = 23; moderate stenoses 30-69%, n = 3; severe stenoses 70-99%, n = 2) that included the common, internal and external carotid arteries were integrated into a pulsatile-flow model. Three groups were formed according to the age of the donors (mean 58.8 years; sample SD 15.99 years) and randomized to three testmore » groups: (I) MembraX, n 9; (II) Xpert bare stent, n = 10; (III) Xpert bare stent with Emboshield protection device, n = 9. Emboli liberated during stent deployment (step A), post-dilatation (step B), and late embolization (step C) were measured in 100 {mu}m effluent filters. When the Emboshield was used, embolus penetration was measured during placement (step D) and retrieval (step E). Late embolization was simulated by compressing the area of the stented vessel five times. Results. Absolute numbers of particles (median; >100 {mu}m) caught in the effluent filter were: (I) MembraX: A = 7, B = 9, C = 3; (II) bare stent: A 6.5, B = 6, C = 4.5; (III) bare stent and Emboshield: A = 7, B = 7, C.=.5, D = 8, E = 10. The data showed no statistical differences according to whether embolic load was analyzed by weight or mean particle size. When summing all procedural steps, the Emboshield caused the greatest load by weight (p 0.011) and the largest number (p = 0.054) of particles. Conclusions. On the basis of these limited data neither a membrane stent nor a protection device showed significant advantages during ex vivo carotid angioplasty. However, the membrane stent seems to have the potential for reducing the emboli responsible for supposed late embolization, whereas more emboli were observed when using a protection device. Further studies are necessary and warranted.« less

Control Infrastructure for a Pulsed Ion Accelerator

NASA Astrophysics Data System (ADS)

Persaud, A.; Regis, M. J.; Stettler, M. W.; Vytla, V. K.

2016-10-01

We report on updates to the accelerator controls for the Neutralized Drift Compression Experiment II, a pulsed induction-type accelerator for heavy ions. The control infrastructure is built around a LabVIEW interface combined with an Apache Cassandra backend for data archiving. Recent upgrades added the storing and retrieving of device settings into the database, as well as ZeroMQ as a message broker that replaces LabVIEW's shared variables. Converting to ZeroMQ also allows easy access via other programming languages, such as Python.

Control Infrastructure for a Pulsed Ion Accelerator

DOE PAGES

Persaud, A.; Regis, M. J.; Stettler, M. W.; ...

2016-07-27

We report on updates to the accelerator controls for the Neutralized Drift Compression Experiment II, a pulsed induction-type accelerator for heavy ions. The control infrastructure is built around a LabVIEW interface combined with an Apache Cassandra backend for data archiving. Recent upgrades added the storing and retrieving of device settings into the database, as well as ZeroMQ as a message broker that replaces LabVIEW's shared variables. Converting to ZeroMQ also allows easy access via other programming languages, such as Python.

High Energy Density Capacitors for Pulsed Power Applications

DTIC Science & Technology

2009-07-01

As a result of this effort, the US Military has access to capacitors that are about a third the size and half the cost of the capacitors that were...resistor in terms of shock and vibration, mounting requirements, total volume, system reliability, and cost . All of these parameters were improved...it t tipo ymer m qua y an capac or cons ruc on. Energy Density of 10,000 Shot High Efficiency Pulse Power Capacitors The primary driver was 1 5

Fiber-Optic Terahertz Data-Communication Networks

NASA Technical Reports Server (NTRS)

Chua, Peter L.; Lambert, James L.; Morookian, John M.; Bergman, Larry A.

1994-01-01

Network protocols implemented in optical domain. Fiber-optic data-communication networks utilize fully available bandwidth of single-mode optical fibers. Two key features of method: use of subpicosecond laser pulses as carrier signals and spectral phase modulation of pulses for optical implementation of code-division multiple access as multiplexing network protocol. Local-area network designed according to concept offers full crossbar functionality, security of data in transit through network, and capacity about 100 times that of typical fiber-optic local-area network in current use.

Ejecta Experiments at the Pegasus Pulsed Power Facility

DTIC Science & Technology

1997-06-01

Laboratory (LANL ). The facility provides both radial and axial access for making measurements. There exist optical, laser , and X-Ray paths for performing...and axial access for making measurements. There exist optical, laser , and X-Ray paths for performing measurements on the target assembly located near...surface variations, microjets can be formed thus contributing to the amount of ejecta. In addition to material properties which contribute to ejecta

Important considerations for the newborn: access to postdischarge newborn care, pulse oximetry screening for congenital heart disease, and circumcision.

PubMed

Pattishall, Amy E; Spector, Nancy D; McPeak, Katie E

2014-12-01

This article addresses three areas in which new policies and research demonstrate the opportunity to impact the health of neonates: access to postdischarge newborn care, pulse oximetry screening for congenital heart disease, and circumcision. Recent research has identified that child healthcare providers are not typically adhering to the recommended first newborn visit within 48 h of hospital discharge. Despite its benefits, cost-effectiveness, and the recommendation that routine screening for cyanotic congenital heart disease be added to the panel of universal newborn screening, adoption of this practice is variable. Evidence suggests a significant reduction in the transmission of HIV linked to circumcision, leading professional organizations to generate new policy statements on neonatal male circumcision. Pediatric healthcare providers should pay careful attention to the timing of the first newborn outpatient follow-up visit. Pulse oximetry screening for cyanotic congenital heart disease is specific, sensitive and meets criteria for universal screening, and providers should utilize well designed screening protocols. In addition, healthcare providers for newborns, especially those who perform circumcisions, should provide nonbiased, up-to-date information on the medical, financial, and ethical aspects of the procedure.

Influence of cooling rate in planar thermally assisted magnetic random access memory: Improved writeability due to spin-transfer-torque influence

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chavent, A.; CNRS, INAC-SPINTEC, F-38000 Grenoble; CEA, INAC-SPINTEC, F-38000 Grenoble

This paper investigates the effect of a controlled cooling rate on magnetic field reversal assisted by spin transfer torque (STT) in thermally assisted magnetic random access memory. By using a gradual linear decrease of the voltage at the end of the write pulse, the STT decays more slowly or at least at the same rate as the temperature. This condition is necessary to make sure that the storage layer magnetization remains in the desired written direction during cooling of the cell. The influence of the write current pulse decay rate was investigated on two exchange biased synthetic ferrimagnet (SyF) electrodes.more » For a NiFe based electrode, a significant improvement in writing reproducibility was observed using a gradual linear voltage transition. The write error rate decreases by a factor of 10 when increasing the write pulse fall-time from ∼3 ns to 70 ns. For comparison, a second CoFe/NiFe based electrode was also reversed by magnetic field assisted by STT. In this case, no difference between sharp and linear write pulse fall shape was observed. We attribute this observation to the higher thermal stability of the CoFe/NiFe electrode during cooling. In real-time measurements of the magnetization reversal, it was found that Ruderman-Kittel-Kasuya-Yosida (RKKY) coupling in the SyF electrode vanishes for the highest pulse voltages that were used due to the high temperature reached during write. As a result, during the cooling phase, the final state is reached through a spin-flop transition of the SyF storage layer.« less

Entropy Production Within a Pulsed Bose-Einstein Condensate

NASA Astrophysics Data System (ADS)

Heinisch, Christoph; Holthaus, Martin

2016-10-01

We suggest to subject anharmonically trapped Bose-Einstein condensates to sinusoidal forcing with a smooth, slowly changing envelope, and to measure the coherence of the system after such pulses. In a series of measurements with successively increased maximum forcing strength, one then expects an adiabatic return of the condensate to its initial state as long as the pulses remain sufficiently weak. In contrast, once the maximum driving amplitude exceeds a certain critical value there should be a drastic loss of coherence, reflecting significant heating induced by the pulse. This predicted experimental signature is traced to the loss of an effective adiabatic invariant, and to the ensuing breakdown of adiabatic motion of the system's Floquet state when the many-body dynamics become chaotic. Our scenario is illustrated with the help of a two-site model of a forced bosonic Josephson junction, but should also hold for other, experimentally accessible configurations.

Polarization control of isolated high-harmonic pulses

NASA Astrophysics Data System (ADS)

Huang, Pei-Chi; Hernández-García, Carlos; Huang, Jen-Ting; Huang, Po-Yao; Lu, Chih-Hsuan; Rego, Laura; Hickstein, Daniel D.; Ellis, Jennifer L.; Jaron-Becker, Agnieszka; Becker, Andreas; Yang, Shang-Da; Durfee, Charles G.; Plaja, Luis; Kapteyn, Henry C.; Murnane, Margaret M.; Kung, A. H.; Chen, Ming-Chang

2018-06-01

High-harmonic generation driven by femtosecond lasers makes it possible to capture the fastest dynamics in molecules and materials. However, thus far, the shortest isolated attosecond pulses have only been produced with linear polarization, which limits the range of physics that can be explored. Here, we demonstrate robust polarization control of isolated extreme-ultraviolet pulses by exploiting non-collinear high-harmonic generation driven by two counter-rotating few-cycle laser beams. The circularly polarized supercontinuum is produced at a central photon energy of 33 eV with a transform limit of 190 as and a predicted linear chirp of 330 as. By adjusting the ellipticity of the two counter-rotating driving pulses simultaneously, we control the polarization state of isolated extreme-ultraviolet pulses—from circular through elliptical to linear polarization—without sacrificing conversion efficiency. Access to the purely circularly polarized supercontinuum, combined with full helicity and ellipticity control, paves the way towards attosecond metrology of circular dichroism.

Detection limits of organic compounds achievable with intense, short-pulse lasers.

PubMed

Miles, Jordan; De Camillis, Simone; Alexander, Grace; Hamilton, Kathryn; Kelly, Thomas J; Costello, John T; Zepf, Matthew; Williams, Ian D; Greenwood, Jason B

2015-06-21

Many organic molecules have strong absorption bands which can be accessed by ultraviolet short pulse lasers to produce efficient ionization. This resonant multiphoton ionization scheme has already been exploited as an ionization source in time-of-flight mass spectrometers used for environmental trace analysis. In the present work we quantify the ultimate potential of this technique by measuring absolute ion yields produced from the interaction of 267 nm femtosecond laser pulses with the organic molecules indole and toluene, and gases Xe, N2 and O2. Using multiphoton ionization cross sections extracted from these results, we show that the laser pulse parameters required for real-time detection of aromatic molecules at concentrations of one part per trillion in air and a limit of detection of a few attomoles are achievable with presently available commercial laser systems. The potential applications for the analysis of human breath, blood and tissue samples are discussed.

Self-regulated oscillation of transport and topology of magnetic islands in toroidal plasmas

DOE PAGES

Ida, K.; Kobayashi, T.; Evans, T. E.; ...

2015-11-04

The coupling between the transport and magnetic topology is an important issue because the structure of magnetic islands, embedded in a toroidal equilibrium field, depends on the nature of the transport at the edge of the islands. Measurements of modulated heat pulse propagation in the DIII-D tokamak have revealed the existence of self-regulated oscillations in the radial energy transport into magnetic islands that are indicative of bifurcations in the island structure and transport near the q = 2 surface. Large amplitude heat pulses are seen in one state followed by small amplitude pulses later in the discharge resulting in amore » repeating cycle of island states. These two states are interpreted as a bifurcation of magnetic island with high and low heat pulse accessibility. In conclusion, this report describes the discovery of a bifurcation in the coupled dynamics between the transport and topology of magnetic islands in tokamak plasmas.« less

Double optical gating

NASA Astrophysics Data System (ADS)

Gilbertson, Steve

The observation and control of dynamics in atomic and molecular targets requires the use of laser pulses with duration less than the characteristic timescale of the process which is to be manipulated. For electron dynamics, this time scale is on the order of attoseconds where 1 attosecond = 10 -18 seconds. In order to generate pulses on this time scale, different gating methods have been proposed. The idea is to extract or "gate" a single pulse from an attosecond pulse train and switch off all the other pulses. While previous methods have had some success, they are very difficult to implement and so far very few labs have access to these unique light sources. The purpose of this work is to introduce a new method, called double optical gating (DOG), and to demonstrate its effectiveness at generating high contrast single isolated attosecond pulses from multi-cycle lasers. First, the method is described in detail and is investigated in the spectral domain. The resulting attosecond pulses produced are then temporally characterized through attosecond streaking. A second method of gating, called generalized double optical gating (GDOG), is also introduced. This method allows attosecond pulse generation directly from a carrier-envelope phase un-stabilized laser system for the first time. Next the methods of DOG and GDOG are implemented in attosecond applications like high flux pulses and extreme broadband spectrum generation. Finally, the attosecond pulses themselves are used in experiments. First, an attosecond/femtosecond cross correlation is used for characterization of spatial and temporal properties of femtosecond pulses. Then, an attosecond pump, femtosecond probe experiment is conducted to observe and control electron dynamics in helium for the first time.

Realization of the Switching Mechanism in Resistance Random Access Memory™ Devices: Structural and Electronic Properties Affecting Electron Conductivity in a Hafnium Oxide-Electrode System Through First-Principles Calculations

NASA Astrophysics Data System (ADS)

Aspera, Susan Meñez; Kasai, Hideaki; Kishi, Hirofumi; Awaya, Nobuyoshi; Ohnishi, Shigeo; Tamai, Yukio

2013-01-01

The resistance random access memory (RRAM™) device, with its electrically induced nanoscale resistive switching capacity, has attracted considerable attention as a future nonvolatile memory device. Here, we propose a mechanism of switching based on an oxygen vacancy migration-driven change in the electronic properties of the transition-metal oxide film stimulated by set pulse voltages. We used density functional theory-based calculations to account for the effect of oxygen vacancies and their migration on the electronic properties of HfO2 and Ta/HfO2 systems, thereby providing a complete explanation of the RRAM™ switching mechanism. Furthermore, computational results on the activation energy barrier for oxygen vacancy migration were found to be consistent with the set and reset pulse voltage obtained from experiments. Understanding this mechanism will be beneficial to effectively realizing the materials design in these devices.

Evaluation of Angiographic and Technical Aspects of Carotid Stenting with Diffusion-Weighted Magnetic Resonance Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Blasel, Stella, E-mail: Stella.Blasel@kgu.de; Hattingen, Elke; Berkefeld, Joachim

2009-07-15

The detection of clinically silent ischemic lesions on postprocedural diffusion-weighted magnetic resonance images has become a preferred method for the description of embolic risks. The purpose of this single-center study was to evaluate whether diffusion-weighted imaging (DWI) could determine material related or technical risk factors of filter-protected carotid stenting. Eighty-four patients with symptomatic severe ({>=}60%) carotid artery stenoses received filter-protected carotid stenting. Standard DWI (b = 1000) was performed within 48 h before and after carotid stenting. The occurrence and load of new postinterventional DWI lesions were assessed. Multivariate analysis was performed to determine risk factors associated with DWI lesions,more » with emphasis on technical factors such as use of different access devices (guiding catheter method vs. long carotid sheath method), type of stent (open-cell nitinol stent vs. closed-cell Wallstent), and protective device (filters with 80-{mu}m vs. 110-120-{mu}m pore size). Markers for generalized atherosclerosis and for degree and site of stenosis were assessed to allow comparison of adequate risk profiles. Access, protective device, and stent type were not significantly associated with new embolic DWI lesions when we compared patients with equivalent risk profiles (long carotid sheath method 48% [11 of 23] vs. guiding catheter method 44% [27 of 61], Wallstent 47% [15 of 32] vs. nitinol stent 44% [23 of 52], and small pore size filter 61% [11 of 18] vs. large pore size filter 41% [27 of 66]). Single-center DWI studies with a moderate number of cases are inadequate for proper assessment of the embolic risk of technical- or material-related risk factors in carotid stenting. Larger multicenter studies with more cases are needed.« less

Effects of 532 nm pulsed-KTP laser parameters on vessel ablation in the avian chorioallantoic membrane: implications for vocal fold mucosa.

PubMed

Broadhurst, Matthew S; Akst, Lee M; Burns, James A; Kobler, James B; Heaton, James T; Anderson, R Rox; Zeitels, Steven M

2007-02-01

Selective vascular ablation (photoangiolysis) using pulsed lasers that target hemoglobin is an effective treatment strategy for many vocal fold lesions. However, vessel rupture with extravasation of blood reduces selectivity for vessels, which is frequently observed with the 0.45-ms, 585-nm pulsed dye laser. Previous studies have shown that vessel rupture is the result of vaporization of blood, an event that varies with laser pulse width and pulse fluence (energy per unit area). Clinical observations using a 532-nm wavelength pulsed potassium-titanyl-phosphate (KTP) laser revealed less laser-induced hemorrhage than the pulsed dye laser. This study investigated settings for the pulsed KTP laser to achieve selective vessel destruction without rupture using the avian chorioallantoic membrane under conditions similar to flexible laryngoscopic delivery of the laser in clinical practice. The chick chorioallantoic membrane offers convenient access to many small blood vessels similar in size to those targeted in human vocal fold. Using a 532-nm pulsed KTP laser, pulse width, pulse energy, and working distance from the optical delivery fiber were varied to assess influence on the ability to achieve vessel coagulation without vessel wall rupture. Third-order vessels (n = 135) were irradiated: Energy (471-550 mJ), pulse width (10, 15, 30 ms), and fiber-to-tissue distance (1 mm, 3 mm) were varied systematically. Selective vessel destruction without vessel wall rupture was more often achieved by increasing pulse width, increasing the fiber-to-tissue distance, and decreasing energy. Vessel destruction without rupture was consistently achieved using 15- or 30-ms pulses with a fiber-to-tissue distance of 3 mm (pulse fluence of 13-16 J/cm). This study substantiates our clinical observation that a 532-nm pulsed KTP laser was effective for ablating microcirculation while minimizing vessel wall rupture and hemorrhage.

Stent implantation influence wall shear stress evolution

NASA Astrophysics Data System (ADS)

Bernad, S. I.; Totorean, A. F.; Bosioc, A. I.; Petre, I.; Bernad, E. S.

2016-06-01

Local hemodynamic factors are known affect the natural history of the restenosis critically after coronary stenting of atherosclerosis. Stent-induced flows disturbance magnitude dependent directly on the strut design. The impact of flow alterations around struts vary as the strut geometrical parameters change. Our results provide data regarding the hemodynamic parameters for the blood flow in both stenosed and stented coronary artery under physiological conditions, namely wall shear stress and pressure drop.

A physiological model for interpretation of arterial spin labeling reactive hyperemia of calf muscles.

PubMed

Chen, Hou-Jen; Wright, Graham A

2017-01-01

To characterize and interpret arterial spin labeling (ASL) reactive hyperemia of calf muscles for a better understanding of the microcirculation in peripheral arterial disease (PAD), we present a physiological model incorporating oxygen transport, tissue metabolism, and vascular regulation mechanisms. The model demonstrated distinct effects between arterial stenoses and microvascular dysfunction on reactive hyperemia, and indicated a higher sensitivity of 2-minute thigh cuffing to microvascular dysfunction than 5-minute cuffing. The recorded perfusion responses in PAD patients (n = 9) were better differentiated from the normal subjects (n = 7) using the model-based analysis rather than characterization using the apparent peak and time-to-peak of the responses. The analysis results suggested different amounts of microvascular disease within the patient group. Overall, this work demonstrates a novel analysis method and facilitates understanding of the physiology involved in ASL reactive hyperemia. ASL reactive hyperemia with model-based analysis may be used as a noninvasive microvascular assessment in the presence of arterial stenoses, allowing us to look beyond the macrovascular disease in PAD. A subgroup who will have a poor prognosis after revascularization in the patients with critical limb ischemia may be associated with more severe microvascular diseases, which may potentially be identified using ASL reactive hyperemia.

Mathematical modeling of pulsatile flow of non-Newtonian fluid in stenosed arteries

NASA Astrophysics Data System (ADS)

Sankar, D. S.; Lee, Usik

2009-07-01

The pulsatile flow of blood through mild stenosed artery is studied. The effects of pulsatility, stenosis and non-Newtonian behavior of blood, treating the blood as Herschel-Bulkley fluid, are simultaneously considered. A perturbation method is used to analyze the flow. The expressions for the shear stress, velocity, flow rate, wall shear stress, longitudinal impedance and the plug core radius have been obtained. The variations of these flow quantities with different parameters of the fluid have been analyzed. It is found that, the plug core radius, pressure drop and wall shear stress increase with the increase of yield stress or the stenosis height. The velocity and the wall shear stress increase considerably with the increase in the amplitude of the pressure drop. It is clear that for a given value of stenosis height and for the increasing values of the stenosis shape parameter from 3 to 6, there is a sharp increase in the impedance of the flow and also the plots are skewed to the right-hand side. It is observed that the estimates of the increase in the longitudinal impedance increase with the increase of the axial distance or with the increase of the stenosis height. The present study also brings out the effects of asymmetric of the stenosis on the flow quantities.

[The value of spectral frequency analysis by Doppler examination (author's transl)].

PubMed

Boccalon, H; Reggi, M; Lozes, A; Canal, C; Jausseran, J M; Courbier, R; Puel, P; Enjalbert, A

1981-01-01

Arterial stenoses of moderate extent may involve modifications of the blood flow. Arterial shading is not always examined at the best incident angle to assess the extent of the stenosis. Spectral frequency analysis by Doppler examination is a good means of evaluating the effect of moderate arterial lesions. The present study was carried out with a Doppler effect having an acoustic spectrum, which is shown in a histogram having 16 frequency bands. The values were recorded on the two femoral arteries. A study was also made of 49 normal subjects so as to establish a normal envelope histogram, taking into account the following parameters: maximum peak (800 Hz), low cut-off frequency (420 Hz), high cut-off frequency (2,600 Hz); the first peak was found to be present in 81 % of the subjects (at 375 Hz) and the second peak in 75 % of the subjects (2,020 Hz). Thirteen patients with iliac lesions of different extent were included in the study; details of these lesions were established in all cases by aortography. None of the recorded frequency histograms were located within the normal envelope. Two cases of moderate iliac stenoses were noted ( Less Than 50 % of the diameter) which interfered with the histogram, even though the femoral velocity signal was normal.

Primary Cutting Balloon Angioplasty for Treatment of Venous Stenoses in Native Hemodialysis Fistulas: Long-Term Results from Three Centers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bhat, Rajesh; McBride, Kieran; Chakraverty, Sam

2007-11-15

Aim. To evaluate the technical success and patency rates following primary cutting balloon angioplasty for venous stenoses in native dialysis fistulas. Methods. Forty-one patients (26 men, 15 women; age range 26-82 years, average age 59 years) underwent 50 (repeat procedures in 9 patients) primary cutting balloon (PCB) angioplasty procedures in three institutions by three primary operators. The indication was primary stenosis in 21 patients, recurrent lesions in 15, and immature fistulas in 5. A PCB was used alone in 17 cases, but was followed by a larger standard balloon in 33 cases. Follow-up included ultrasound, flow analysis and urea reductionmore » ratio, and ranged from 2 to 30 months (mean 14 months). Results. The technical success rate was 98%. All procedures were relatively painless. Two PCBs burst and 4 leaked, but without causing any morbidity. Nineteen fistulas were still working at last follow-up. Primary patency rates at 6, 12, and 24 months using Kaplan-Meier analysis were 88%, 73%, and 34%, respectively, and the primary assisted patencies were 90%, 75%, and 50%, respectively. Conclusion. PCB angioplasty has high technical success and low complication rates. The long-term patency rates are favorable for PCB angioplasty and compare favorably with other series.« less

The Generation and Propagation of Arterial Murmurs from a Stenosed Artery: A Computational Study

NASA Astrophysics Data System (ADS)

Zhu, Chi; Seo, Jung-Hee; Bakhshaee, Hani; Mittal, Rajat

2015-11-01

Cardiac auscultation - the procedure of diagnosing cardiovascular conditions using the stethoscope - has been used effectively for over a hundred years but still, the flow mechanism(s) responsible for the generation of these murmurs, as well as the effect of intervening tissue on the propagation of these murmurs, is not well understood. In this study, a one-way coupled, hybrid approach is used to investigate the propagation of murmurs generated from the flow in a stenosed artery. Specifically, the flow in the modeled artery is solved by an incompressible Navier-Stokes solver with the immersed-boundary method. The structural wave propagation in the tissue is resolved by a high-order, linear viscoelastic wave solver, and a mathematical decomposition is applied to separate the compressional and shear component of the acoustic wave propagating through the tissue. The simulations suggest, somewhat counterintuitively, that the shear wave contributes a significant component to the signal picked up by a stethoscope, and that this component carries much of the information that characterizes the source of the murmur. The implications of this for cardiac auscultation and further modeling of hemoacoustics are discussed. The effect of the stenosis severity and the flow pulsatility will also be investigated. The authors would like to acknowledge the SCH for funding this project.

A novel method of forceps biopsy improves the diagnosis of proximal biliary malignancies.

PubMed

Kulaksiz, Hasan; Strnad, Pavel; Römpp, Achim; von Figura, Guido; Barth, Thomas; Esposito, Irene; Schirmacher, Peter; Henne-Bruns, Doris; Adler, Guido; Stiehl, Adolf

2011-02-01

Tissue specimen collection represents a cornerstone in diagnosis of proximal biliary tract malignancies offering great specificity, but only limited sensitivity. To improve the tumor detection rate, we developed a new method of forceps biopsy and compared it prospectively with endoscopic transpapillary brush cytology. 43 patients with proximal biliary stenoses, which were suspect for malignancy, undergoing endoscopic retrograde cholangiography were prospectively recruited and subjected to both biopsy [using a double-balloon enteroscopy (DBE) forceps under a guidance of a pusher and guiding catheter with guidewire] and transpapillary brush cytology. The cytological/histological findings were compared with the final clinical diagnosis. 35 out of 43 patients had a malignant disease (33 cholangiocarcinomas, 1 hepatocellular carcinoma, 1 gallbladder carcinoma). The sensitivity of cytology and biopsy in these patients was 49 and 69%, respectively. The method with DBE forceps allowed a pinpoint biopsy of the biliary stenoses. Both methods had 100% specificity, and, when combined, 80% of malignant processes were detected. All patients with non-malignant conditions were correctly assigned by both methods. No clinically relevant complications were observed. The combination of forceps biopsy and transpapillary brush cytology is safe and offers superior detection rates compared to both methods alone, and therefore represents a promising approach in evaluation of proximal biliary tract processes.

Management of Severe and Complex Hypopharyngeal and/or Laryngotracheal Stenoses by Various Open Surgical Procedures: A Retrospective Study of Seventeen Patients.

PubMed

Chen, Wenxian; Gao, Pengfei; Cui, Pengcheng; Ruan, Yanyan; Liu, Zhi; Sun, Yongzhu; Bian, Ka

2016-01-01

To systematically study various surgical approaches for treating complex hypopharyngeal and/or laryngotracheal stenoses at a variety of sites and levels. We retrospectively analyzed the treatment of 17 patients with severe and complex hypopharyngeal and/or laryngotracheal stenosis at various sites and levels of severity. All of the 17 patients initially had a tracheostomy. Thirteen had failed the previous laser lysis and/or dilation treatment. Given the high severity and complexity of stenosis, all of these patients were treated by open surgical reconstruction techniques using repairing grafts (flaps), followed by stenting. Thirteen of 17 patients had successful decannulation 1-8 months post-operation and had stable airway and adequate vocal and swallow function. Two patients with complex hypopharyngeal and esophageal stenosis had unsuccessful decannulation. Follow-up was lost in 1 patient with complex hypopharyngeal and esophageal stenosis and 1 patient with original hypopharyngeal stenosis and recurrent thoracotracheal stenosis. Despite the failure by the regular treatments using laser lysis and/or dilation therapy, severe and complex hypopharyngeal and/or laryngotracheal stenosis may be successfully treated by variable open surgical reconstruction techniques using different grafts (flaps) depending on the site and severity of the stenosis. © 2016 S. Karger AG, Basel.

Arthroscopic Release of Flexor Hallucis Longus Tendon Sheath in Female Ballet Dancers: Dynamic Pathology, Surgical Technique, and Return to Dancing Performance.

PubMed

Funasaki, Hiroki; Hayashi, Hiroteru; Sakamoto, Kanako; Tsuruga, Rei; Marumo, Keishi

2015-12-01

Stenosing tenosynovitis of the flexor hallucis longus (FHL) tendon is known as a major overuse lesion in female dancers. We describe arthroscopic surgical techniques in relation to the dynamic pathology of the disease. Crepitus and pain on moving the great toe with the ankle in plantar flexion on preoperative examination confirm the diagnosis of FHL stenosing tenosynovitis even if the os trigonum is not evident. The ankle is approached through standard posterolateral and posteromedial portals. A 4.0-mm-diameter 30° arthroscope is used. Soft tissues around the talus are cleared with a motorized shaver and a radiofrequency device. The posterior aspects of the talus, os trigonum, and FHL tendon surrounded by the tendon sheath are visualized. The dynamic pathology of the FHL tendon is well observed on passive motion of the great toe. The prominent bone fragment of the talus is removed and the tendon sheath is cut with a retrograde knife and a motorized shaver from the superior border down to the entrance of the fibro-osseous tunnel. Arthroscopic release of the FHL tendon sheath is a useful and easy method to directly approach the dynamic pathology of FHL tenosynovitis in female ballet dancers.

Adaptive Phase Delay Generator

NASA Technical Reports Server (NTRS)

Greer, Lawrence

2013-01-01

There are several experimental setups involving rotating machinery that require some form of synchronization. The adaptive phase delay generator (APDG) the Bencic-1000 is a flexible instrument that allows the user to generate pulses synchronized to the rising edge of a tachometer signal from any piece of rotating machinery. These synchronized pulses can vary by the delay angle, pulse width, number of pulses per period, number of skipped pulses, and total number of pulses. Due to the design of the pulse generator, any and all of these parameters can be changed independently, yielding an unparalleled level of versatility. There are two user interfaces to the APDG. The first is a LabVIEW program that has the advantage of displaying all of the pulse parameters and input signal data within one neatly organized window on the PC monitor. Furthermore, the LabVIEW interface plots the rpm of the two input signal channels in real time. The second user interface is a handheld portable device that goes anywhere a computer is not accessible. It consists of a liquid-crystal display and keypad, which enable the user to control the unit by scrolling through a host of command menus and parameter listings. The APDG combines all of the desired synchronization control into one unit. The experimenter can adjust the delay, pulse width, pulse count, number of skipped pulses, and produce a specified number of pulses per revolution. Each of these parameters can be changed independently, providing an unparalleled level of versatility when synchronizing hardware to a host of rotating machinery. The APDG allows experimenters to set up quickly and generate a host of synchronizing configurations using a simple user interface, which hopefully leads to faster results.

Method and apparatus for pulse width modulation control of an AC induction motor

DOEpatents

Geppert, Steven; Slicker, James M.

1984-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a micro-processor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .THETA., where .THETA. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands of electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a "flyback" DC-DC converter circuit for recharging the battery.

Coherent optical pulse sequencer for quantum applications.

PubMed

Hosseini, Mahdi; Sparkes, Ben M; Hétet, Gabriel; Longdell, Jevon J; Lam, Ping Koy; Buchler, Ben C

2009-09-10

The bandwidth and versatility of optical devices have revolutionized information technology systems and communication networks. Precise and arbitrary control of an optical field that preserves optical coherence is an important requisite for many proposed photonic technologies. For quantum information applications, a device that allows storage and on-demand retrieval of arbitrary quantum states of light would form an ideal quantum optical memory. Recently, significant progress has been made in implementing atomic quantum memories using electromagnetically induced transparency, photon echo spectroscopy, off-resonance Raman spectroscopy and other atom-light interaction processes. Single-photon and bright-optical-field storage with quantum states have both been successfully demonstrated. Here we present a coherent optical memory based on photon echoes induced through controlled reversible inhomogeneous broadening. Our scheme allows storage of multiple pulses of light within a chosen frequency bandwidth, and stored pulses can be recalled in arbitrary order with any chosen delay between each recalled pulse. Furthermore, pulses can be time-compressed, time-stretched or split into multiple smaller pulses and recalled in several pieces at chosen times. Although our experimental results are so far limited to classical light pulses, our technique should enable the construction of an optical random-access memory for time-bin quantum information, and have potential applications in quantum information processing.

Method and apparatus for pulse width modulation control of an AC induction motor

NASA Technical Reports Server (NTRS)

Geppert, Steven (Inventor); Slicker, James M. (Inventor)

1984-01-01

An inverter is connected between a source of DC power and a three-phase AC induction motor, and a micro-processor-based circuit controls the inverter using pulse width modulation techniques. In the disclosed method of pulse width modulation, both edges of each pulse of a carrier pulse train are equally modulated by a time proportional to sin .THETA., where .THETA. is the angular displacement of the pulse center at the motor stator frequency from a fixed reference point on the carrier waveform. The carrier waveform frequency is a multiple of the motor stator frequency. The modulated pulse train is then applied to each of the motor phase inputs with respective phase shifts of 120.degree. at the stator frequency. Switching control commands of electronic switches in the inverter are stored in a random access memory (RAM) and the locations of the RAM are successively read out in a cyclic manner, each bit of a given RAM location controlling a respective phase input of the motor. The DC power source preferably comprises rechargeable batteries and all but one of the electronic switches in the inverter can be disabled, the remaining electronic switch being part of a flyback DC-DC converter circuit for recharging the battery.

Optimal waveforms design for ultra-wideband impulse radio sensors.

PubMed

Li, Bin; Zhou, Zheng; Zou, Weixia; Li, Dejian; Zhao, Chong

2010-01-01

Ultra-wideband impulse radio (UWB-IR) sensors should comply entirely with the regulatory spectral limits for elegant coexistence. Under this premise, it is desirable for UWB pulses to improve frequency utilization to guarantee the transmission reliability. Meanwhile, orthogonal waveform division multiple-access (WDMA) is significant to mitigate mutual interferences in UWB sensor networks. Motivated by the considerations, we suggest in this paper a low complexity pulse forming technique, and its efficient implementation on DSP is investigated. The UWB pulse is derived preliminarily with the objective of minimizing the mean square error (MSE) between designed power spectrum density (PSD) and the emission mask. Subsequently, this pulse is iteratively modified until its PSD completely conforms to spectral constraints. The orthogonal restriction is then analyzed and different algorithms have been presented. Simulation demonstrates that our technique can produce UWB waveforms with frequency utilization far surpassing the other existing signals under arbitrary spectral mask conditions. Compared to other orthogonality design schemes, the designed pulses can maintain mutual orthogonality without any penalty on frequency utilization, and hence, are much superior in a WDMA network, especially with synchronization deviations.

Optimal Waveforms Design for Ultra-Wideband Impulse Radio Sensors

PubMed Central

Li, Bin; Zhou, Zheng; Zou, Weixia; Li, Dejian; Zhao, Chong

2010-01-01

Ultra-wideband impulse radio (UWB-IR) sensors should comply entirely with the regulatory spectral limits for elegant coexistence. Under this premise, it is desirable for UWB pulses to improve frequency utilization to guarantee the transmission reliability. Meanwhile, orthogonal waveform division multiple-access (WDMA) is significant to mitigate mutual interferences in UWB sensor networks. Motivated by the considerations, we suggest in this paper a low complexity pulse forming technique, and its efficient implementation on DSP is investigated. The UWB pulse is derived preliminarily with the objective of minimizing the mean square error (MSE) between designed power spectrum density (PSD) and the emission mask. Subsequently, this pulse is iteratively modified until its PSD completely conforms to spectral constraints. The orthogonal restriction is then analyzed and different algorithms have been presented. Simulation demonstrates that our technique can produce UWB waveforms with frequency utilization far surpassing the other existing signals under arbitrary spectral mask conditions. Compared to other orthogonality design schemes, the designed pulses can maintain mutual orthogonality without any penalty on frequency utilization, and hence, are much superior in a WDMA network, especially with synchronization deviations. PMID:22163511

Electrical Evaluation of RCA MWS5001D Random Access Memory, Volume 4, Appendix C

NASA Technical Reports Server (NTRS)

Klute, A.

1979-01-01

The electrical characterization and qualification test results are presented for the RCA MWS5001D random access memory. The tests included functional tests, AC and DC parametric tests, AC parametric worst-case pattern selection test, determination of worst-case transition for setup and hold times, and a series of schmoo plots. Statistical analysis data is supplied along with write pulse width, read cycle time, write cycle time, and chip enable time data.

Quadriphase DS-CDMA wireless communication systems employing the generalized detector

NASA Astrophysics Data System (ADS)

Tuzlukov, Vyacheslav

2012-05-01

Probability of bit-error Per performance of asynchronous direct-sequence code-division multiple-access (DS-CDMA) wireless communication systems employing the generalized detector (GD) constructed based on the generalized approach to signal processing in noise is analyzed. The effects of pulse shaping, quadriphase or direct sequence quadriphase shift keying (DS-QPSK) spreading, aperiodic spreading sequences are considered in DS-CDMA based on GD and compared with the coherent Neyman-Pearson receiver. An exact Per expression and several approximations: one using the characterristic function method, a simplified expression for the improved Gaussian approximation (IGA) and the simplified improved Gaussian approximation are derived. Under conditions typically satisfied in practice and even with a small number of interferers, the standard Gaussian approximation (SGA) for the multiple-access interference component of the GD statistic and Per performance is shown to be accurate. Moreover, the IGA is shown to reduce to the SGA for pulses with zero excess bandwidth. Second, the GD Per performance of quadriphase DS-CDMA is shown to be superior to that of bi-phase DS-CDMA. Numerical examples by Monte Carlo simulation are presented to illustrate the GD Per performance for square-root raised-cosine pulses and spreading factors of moderate to large values. Also, a superiority of GD employment in CDMA systems over the Neyman-Pearson receiver is demonstrated

Nonlinear pulse propagation in one-dimensional metal-dielectric multilayer stacks: ultrawide bandwidth optical limiting.

PubMed

Scalora, Michael; Mattiucci, Nadia; D'Aguanno, Giuseppe; Larciprete, MariaCristina; Bloemer, Mark J

2006-01-01

We numerically study the nonlinear optical properties of metal-dielectric photonic band gap structures in the pulsed regime. We exploit the high chi3 of copper metal to induce nonlinear effects such as broadband optical limiting, self-phase modulation, and unusual spectral narrowing of high intensity pulses. We show that in a single pass through a typical, chirped multilayer stack nonlinear transmittance and peak powers can be reduced by nearly two orders of magnitude compared to low light intensity levels across the entire visible range. Chirping dielectric layer thickness dramatically improves the linear transmittance through the stack and achieves large fields inside the copper to access the large nonlinearity. At the same time, the linear properties of the stack block most of the remaining electromagnetic spectrum.

FPGA-Based Reconfigurable Processor for Ultrafast Interlaced Ultrasound and Photoacoustic Imaging

PubMed Central

Alqasemi, Umar; Li, Hai; Aguirre, Andrés; Zhu, Quing

2016-01-01

In this paper, we report, to the best of our knowledge, a unique field-programmable gate array (FPGA)-based reconfigurable processor for real-time interlaced co-registered ultrasound and photoacoustic imaging and its application in imaging tumor dynamic response. The FPGA is used to control, acquire, store, delay-and-sum, and transfer the data for real-time co-registered imaging. The FPGA controls the ultrasound transmission and ultrasound and photoacoustic data acquisition process of a customized 16-channel module that contains all of the necessary analog and digital circuits. The 16-channel module is one of multiple modules plugged into a motherboard; their beamformed outputs are made available for a digital signal processor (DSP) to access using an external memory interface (EMIF). The FPGA performs a key role through ultrafast reconfiguration and adaptation of its structure to allow real-time switching between the two imaging modes, including transmission control, laser synchronization, internal memory structure, beamforming, and EMIF structure and memory size. It performs another role by parallel accessing of internal memories and multi-thread processing to reduce the transfer of data and the processing load on the DSP. Furthermore, because the laser will be pulsing even during ultrasound pulse-echo acquisition, the FPGA ensures that the laser pulses are far enough from the pulse-echo acquisitions by appropriate time-division multiplexing (TDM). A co-registered ultrasound and photoacoustic imaging system consisting of four FPGA modules (64-channels) is constructed, and its performance is demonstrated using phantom targets and in vivo mouse tumor models. PMID:22828830

FPGA-based reconfigurable processor for ultrafast interlaced ultrasound and photoacoustic imaging.

PubMed

Alqasemi, Umar; Li, Hai; Aguirre, Andrés; Zhu, Quing

2012-07-01

In this paper, we report, to the best of our knowledge, a unique field-programmable gate array (FPGA)-based reconfigurable processor for real-time interlaced co-registered ultrasound and photoacoustic imaging and its application in imaging tumor dynamic response. The FPGA is used to control, acquire, store, delay-and-sum, and transfer the data for real-time co-registered imaging. The FPGA controls the ultrasound transmission and ultrasound and photoacoustic data acquisition process of a customized 16-channel module that contains all of the necessary analog and digital circuits. The 16-channel module is one of multiple modules plugged into a motherboard; their beamformed outputs are made available for a digital signal processor (DSP) to access using an external memory interface (EMIF). The FPGA performs a key role through ultrafast reconfiguration and adaptation of its structure to allow real-time switching between the two imaging modes, including transmission control, laser synchronization, internal memory structure, beamforming, and EMIF structure and memory size. It performs another role by parallel accessing of internal memories and multi-thread processing to reduce the transfer of data and the processing load on the DSP. Furthermore, because the laser will be pulsing even during ultrasound pulse-echo acquisition, the FPGA ensures that the laser pulses are far enough from the pulse-echo acquisitions by appropriate time-division multiplexing (TDM). A co-registered ultrasound and photoacoustic imaging system consisting of four FPGA modules (64-channels) is constructed, and its performance is demonstrated using phantom targets and in vivo mouse tumor models.

Water accessibility in a membrane-inserting peptide comparing Overhauser DNP and pulse EPR methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Segawa, Takuya F., E-mail: takuya.segawa@alumni.ethz.ch; Doppelbauer, Maximilian; Garbuio, Luca

2016-05-21

Water accessibility is a key parameter for the understanding of the structure of biomolecules, especially membrane proteins. Several experimental techniques based on the combination of electron paramagnetic resonance (EPR) spectroscopy with site-directed spin labeling are currently available. Among those, we compare relaxation time measurements and electron spin echo envelope modulation (ESEEM) experiments using pulse EPR with Overhauser dynamic nuclear polarization (DNP) at X-band frequency and a magnetic field of 0.33 T. Overhauser DNP transfers the electron spin polarization to nuclear spins via cross-relaxation. The change in the intensity of the {sup 1}H NMR spectrum of H{sub 2}O at a Larmormore » frequency of 14 MHz under a continuous-wave microwave irradiation of the nitroxide spin label contains information on the water accessibility of the labeled site. As a model system for a membrane protein, we use the hydrophobic α-helical peptide WALP23 in unilamellar liposomes of DOPC. Water accessibility measurements with all techniques are conducted for eight peptides with different spin label positions and low radical concentrations (10–20 μM). Consistently in all experiments, the water accessibility appears to be very low, even for labels positioned near the end of the helix. The best profile is obtained by Overhauser DNP, which is the only technique that succeeds in discriminating neighboring positions in WALP23. Since the concentration of the spin-labeled peptides varied, we normalized the DNP parameter ϵ, being the relative change of the NMR intensity, by the electron spin concentration, which was determined from a continuous-wave EPR spectrum.« less

Water accessibility in a membrane-inserting peptide comparing Overhauser DNP and pulse EPR methods.

PubMed

Segawa, Takuya F; Doppelbauer, Maximilian; Garbuio, Luca; Doll, Andrin; Polyhach, Yevhen O; Jeschke, Gunnar

2016-05-21

Water accessibility is a key parameter for the understanding of the structure of biomolecules, especially membrane proteins. Several experimental techniques based on the combination of electron paramagnetic resonance (EPR) spectroscopy with site-directed spin labeling are currently available. Among those, we compare relaxation time measurements and electron spin echo envelope modulation (ESEEM) experiments using pulse EPR with Overhauser dynamic nuclear polarization (DNP) at X-band frequency and a magnetic field of 0.33 T. Overhauser DNP transfers the electron spin polarization to nuclear spins via cross-relaxation. The change in the intensity of the (1)H NMR spectrum of H2O at a Larmor frequency of 14 MHz under a continuous-wave microwave irradiation of the nitroxide spin label contains information on the water accessibility of the labeled site. As a model system for a membrane protein, we use the hydrophobic α-helical peptide WALP23 in unilamellar liposomes of DOPC. Water accessibility measurements with all techniques are conducted for eight peptides with different spin label positions and low radical concentrations (10-20 μM). Consistently in all experiments, the water accessibility appears to be very low, even for labels positioned near the end of the helix. The best profile is obtained by Overhauser DNP, which is the only technique that succeeds in discriminating neighboring positions in WALP23. Since the concentration of the spin-labeled peptides varied, we normalized the DNP parameter ϵ, being the relative change of the NMR intensity, by the electron spin concentration, which was determined from a continuous-wave EPR spectrum.

Electronically tunable femtosecond all-fiber optical parametric oscillator for multi-photon microscopy

NASA Astrophysics Data System (ADS)

Hellwig, Tim; Brinkmann, Maximilian; Fallnich, Carsten

2018-02-01

We present a femtosecond fiber-based optical parametric oscillator (FOPO) for multiphoton microscopy with wavelength tuning by electronic repetition rate tuning in combination with a dispersive filter in the FOPO cavity. The all-spliced, all-fiber FOPO cavity is based on polarization-maintaining fibers and a broadband output coupler, allowing to get access to the resonant signal pulses as well as the idler pulses simultaneously. The system was pumped by a gain-switched fiber-coupled laser diode emitting pulses at a central wavelength of 1030 nm and an electronically tunable repetition frequency of about 2 MHz. The pump pulses were amplified in an Ytterbium fiber amplifier system with a pulse duration after amplification of 13 ps. Tuning of the idler (1140 nm - 1300 nm) and signal wavelengths (850 nm - 940 nm) was achieved by changing the repetition frequency of the pump laser by about 4 kHz. The generated signal pulses reached a pulse energy of up to 9.2 nJ at 920 nm and were spectrally broadened to about 6 nm in the FOPO by a combination of self-phase and cross-phase modulation. We showed external compression of the idler pulses at 920 nm to about 430 fs and appleid them to two-photon excitation microscopy with green fluorescent dyes. The presented system constitutes an important step towards a fully fiber-integrated all-electronically tunable and, thereby, programmable light source and already embodies a versatile and flexible light source for applications, e.g., for smart microscopy.

The 30 GHz solid state amplifier for low cost low data rate ground terminals

NASA Technical Reports Server (NTRS)

Ngan, Y. C.; Quijije, M. A.

1984-01-01

This report details the development of a 20-W solid state amplifier operating near 30 GHz. The IMPATT amplifier not only met or exceeded all the program objectives, but also possesses the ability to operate in the pulse mode, which was not called for in the original contract requirements. The ability to operate in the pulse mode is essential for TDMA (Time Domain Multiple Access) operation. An output power of 20 W was achieved with a 1-dB instantaneous bandwidth of 260 MHz. The amplifier has also been tested in pulse mode with 50% duty for pulse lengths ranging from 200 ns to 2 micro s with 10 ns rise and fall times and no degradation in output power. This pulse mode operation was made possible by the development of a stable 12-diode power combiner/amplifier and a single-diode pulsed driver whose RF output power was switched on and off by having its bias current modulated via a fast-switching current pulse modulator. Essential to the overall amplifier development was the successful development of state-of-the-art silicon double-drift IMPATT diodes capable of reproducible 2.5 W CW output power with 12% dc-to-RF conversion efficiency. Output powers of as high as 2.75 W has been observed. Both the device and circuit design are amenable to low cost production.

A single-solenoid pulsed-magnet system for single-crystal scattering studies

NASA Astrophysics Data System (ADS)

Islam, Zahirul; Capatina, Dana; Ruff, Jacob P. C.; Das, Ritesh K.; Trakhtenberg, Emil; Nojiri, Hiroyuki; Narumi, Yasuo; Welp, Ulrich; Canfield, Paul C.

2012-03-01

We present a pulsed-magnet system that enables x-ray single-crystal diffraction in addition to powder and spectroscopic studies with the magnetic field applied on or close to the scattering plane. The apparatus consists of a single large-bore solenoid, cooled by liquid nitrogen. A second independent closed-cycle cryostat is used for cooling samples near liquid helium temperatures. Pulsed magnetic fields close to ˜30 T with a zero-to-peak-field rise time of ˜2.9 ms are generated by discharging a 40 kJ capacitor bank into the magnet coil. The unique characteristic of this instrument is the preservation of maximum scattering angle (˜23.6°) on the entrance and exit sides of the magnet bore by virtue of a novel double-funnel insert. This instrument will facilitate x-ray diffraction and spectroscopic studies that are impractical, if not impossible, to perform using split-pair and narrow-opening solenoid magnets. Furthermore, it offers a practical solution for preserving optical access in future higher-field pulsed magnets.

Filamentation and light bullet formation dynamics in solid-state dielectric media with weak, moderate and strong anomalous group velocity dispersion

NASA Astrophysics Data System (ADS)

Gražulevičiūtė, I.; Garejev, N.; Majus, D.; Jukna, V.; Tamošauskas, G.; Dubietis, A.

2016-02-01

We present a series of measurements, which characterize filamentation dynamics of intense ultrashort laser pulses in the space-time domain, as captured by means of three-dimensional imaging technique in sapphire and fused silica, in the wavelength range of 1.45-2.25 μm, accessing the regimes of weak, moderate and strong anomalous group velocity dispersion (GVD). In the regime of weak anomalous GVD (at 1.45 μm), pulse splitting into two sub-pulses producing a pair of light bullets with spectrally shifted carrier frequencies in both nonlinear media is observed. In contrast, in the regimes of moderate (at 1.8 μm) and strong (at 2.25 μm) anomalous GVD we observe notably different transient dynamics, which however lead to the formation of a single self-compressed quasistationary light bullet with an universal spatiotemporal shape comprised of an extended ring-shaped periphery and a localized intense core that carries the self-compressed pulse.

Electrical Characterization of Temperature Dependent Resistive Switching in Pr0.7C0.3MnO3

NASA Astrophysics Data System (ADS)

Lopez, Melinda; Salvo, Christopher; Tsui, Stephen

2012-02-01

Resistive switching offers a non-volatile and reversible means to possibly create a more physically compact yet larger access capacity in memory technology. While there has been a great deal of research conducted on this electrical property in oxide materials, there is still more to be learned about this at both high voltage pulsing and cryogenic temperatures. In this work, the electrical properties of a PCMO-metal interface switch were examined after application of voltage pulsing varying from 100 V to 1000 V and at temperatures starting at 293 K and lowered to 80 K. What was discovered was that below temperatures of 150 K, the resistive switching began to decrease across all voltage pulsing and that at all temperatures before this cessation, the change in resistive switching increased with higher voltage pulsing. We suggest that a variable density of charge traps at the interface is a likely mechanism, and work continues to extract more details.

Spectrum of the Nuclear Environment for GaAs Spin Qubits.

PubMed

Malinowski, Filip K; Martins, Frederico; Cywiński, Łukasz; Rudner, Mark S; Nissen, Peter D; Fallahi, Saeed; Gardner, Geoffrey C; Manfra, Michael J; Marcus, Charles M; Kuemmeth, Ferdinand

2017-04-28

Using a singlet-triplet spin qubit as a sensitive spectrometer of the GaAs nuclear spin bath, we demonstrate that the spectrum of Overhauser noise agrees with a classical spin diffusion model over 6 orders of magnitude in frequency, from 1 mHz to 1 kHz, is flat below 10 mHz, and falls as 1/f^{2} for frequency f≳1  Hz. Increasing the applied magnetic field from 0.1 to 0.75 T suppresses electron-mediated spin diffusion, which decreases the spectral content in the 1/f^{2} region and lowers the saturation frequency, each by an order of magnitude, consistent with a numerical model. Spectral content at megahertz frequencies is accessed using dynamical decoupling, which shows a crossover from the few-pulse regime (≲16π pulses), where transverse Overhauser fluctuations dominate dephasing, to the many-pulse regime (≳32 π pulses), where longitudinal Overhauser fluctuations with a 1/f spectrum dominate.

The NOD2 p.Leu1007fsX1008 mutation (rs2066847) is a stronger predictor of the clinical course of Crohn's disease than the FOXO3A intron variant rs12212067.

PubMed

Schnitzler, Fabian; Friedrich, Matthias; Wolf, Christiane; Angelberger, Marianne; Diegelmann, Julia; Olszak, Torsten; Beigel, Florian; Tillack, Cornelia; Stallhofer, Johannes; Göke, Burkhard; Glas, Jürgen; Lohse, Peter; Brand, Stephan

2014-01-01

Very recently, a sub-analysis of genome-wide association scans revealed that the non-coding single nucleotide polymorphism (SNP) rs12212067 in the FOXO3A gene is associated with a milder course of Crohn's disease (CD) (Cell 2013;155:57-69). The aim of our study was to evaluate the clinical value of the SNP rs12212067 in predicting the severity of CD by correlating CD patient genotype status with the most relevant complications of CD such as stenoses, fistulas, and CD-related surgery. We genotyped 550 CD patients for rs12212067 (FOXO3A) and the three common CD-associated NOD2 mutations rs2066844, rs2066847, and rs2066847 and performed genotype-phenotype analyses. No significant phenotypic differences were found between the wild-type genotype TT of the FOXO3A SNP rs12212067 and the minor genotypes TG and GG independently from NOD2 variants. The allele frequency of the minor G allele was 12.7%. Age at diagnosis, disease duration, body mass index, surgery rate, stenoses, fistula, need for immunosuppressive therapy, and disease course were not significantly different. In contrast, the NOD2 mutant p.Leu1007fsX1008 (rs2066847) was highly associated with penetrating CD (p = 0.01), the development of fistulas (p = 0.01) and stenoses (p = 0.01), and ileal disease localization (p = 0.03). Importantly, the NOD2 SNP rs2066847 was a strong separator between an aggressive and a mild course of CD (p = 2.99×10(-5)), while the FOXO3A SNP rs12212067 did not separate between mild and aggressive CD behavior in our cohort (p = 0.35). 96.2% of the homozygous NOD2 p.Leu1007fsX1008 carriers had an aggressive disease behavior compared to 69.3% of the patients with the NOD2 wild-type genotype (p = 0.007). In clinical practice, the NOD2 variant p.Leu1007fsX1008 (rs2066847), in particular in homozygous form, is a much stronger marker for a severe clinical phenotype than the FOXO3A rs12212067 SNP for a mild disease course on an individual patient level despite its important impact on the inflammatory response of monocytes.

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors.

PubMed

Luo, Mingyue; Duan, Chaijie; Qiu, Jianping; Li, Wenru; Zhu, Dongyun; Cai, Wenli

2015-01-01

To evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors. Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology. Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm-56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm-68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without obvious enhancement, n = 1). MDCT and its MPR, VR and VB images have respective advantages and disadvantages. Their combination could complement to each other to accurately detect locations, natures (benignancy, malignancy or low malignancy), and quantities (extramural invasions, longitudinal involvements, extents of luminal stenoses, distances between main bronchus tumors and trachea carinae) of primary trachea and main bronchus tumors with crucial information for surgical treatment, are highly useful diagnostic methods for primary trachea and main bronchus tumors.

Five-Year Outcomes with PCI Guided by Fractional Flow Reserve.

PubMed

Xaplanteris, Panagiotis; Fournier, Stephane; Pijls, Nico H J; Fearon, William F; Barbato, Emanuele; Tonino, Pim A L; Engstrøm, Thomas; Kääb, Stefan; Dambrink, Jan-Henk; Rioufol, Gilles; Toth, Gabor G; Piroth, Zsolt; Witt, Nils; Fröbert, Ole; Kala, Petr; Linke, Axel; Jagic, Nicola; Mates, Martin; Mavromatis, Kreton; Samady, Habib; Irimpen, Anand; Oldroyd, Keith; Campo, Gianluca; Rothenbühler, Martina; Jüni, Peter; De Bruyne, Bernard

2018-05-22

Background We hypothesized that fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) would be superior to medical therapy as initial treatment in patients with stable coronary artery disease. Methods Among 1220 patients with angiographically significant stenoses, those in whom at least one stenosis was hemodynamically significant (FFR, ≤0.80) were randomly assigned to FFR-guided PCI plus medical therapy or to medical therapy alone. Patients in whom all stenoses had an FFR of more than 0.80 received medical therapy and were entered into a registry. The primary end point was a composite of death, myocardial infarction, or urgent revascularization. Results A total of 888 patients underwent randomization (447 patients in the PCI group and 441 in the medical-therapy group). At 5 years, the rate of the primary end point was lower in the PCI group than in the medical-therapy group (13.9% vs. 27.0%; hazard ratio, 0.46; 95% confidence interval [CI], 0.34 to 0.63; P<0.001). The difference was driven by urgent revascularizations, which occurred in 6.3% of the patients in the PCI group as compared with 21.1% of those in the medical-therapy group (hazard ratio, 0.27; 95% CI, 0.18 to 0.41). There were no significant differences between the PCI group and the medical-therapy group in the rates of death (5.1% and 5.2%, respectively; hazard ratio, 0.98; 95% CI, 0.55 to 1.75) or myocardial infarction (8.1% and 12.0%; hazard ratio, 0.66; 95% CI, 0.43 to 1.00). There was no significant difference in the rate of the primary end point between the PCI group and the registry cohort (13.9% and 15.7%, respectively; hazard ratio, 0.88; 95% CI, 0.55 to 1.39). Relief from angina was more pronounced after PCI than after medical therapy. Conclusions In patients with stable coronary artery disease, an initial FFR-guided PCI strategy was associated with a significantly lower rate of the primary composite end point of death, myocardial infarction, or urgent revascularization at 5 years than medical therapy alone. Patients without hemodynamically significant stenoses had a favorable long-term outcome with medical therapy alone. (Funded by St. Jude Medical and others; FAME 2 ClinicalTrials.gov number, NCT01132495 .).

Results of a phase I-II study on intraductal confocal microscopy (IDCM) in patients with common bile duct (CBD) stenosis.

PubMed

Giovannini, M; Bories, E; Monges, G; Pesenti, C; Caillol, F; Delpero, J R

2011-07-01

Confocal endomicroscopy is an emergent technique and allows real optical biopsies in the gastrointestinal (GI) tract. The aim of this study was to evaluate a new intraductal confocal miniprobe in patients with a normal common bile duct (CBD) or with a suspicion of a malignant stenosis (cholangiocarcinoma). Thirty-seven patients (23 males) underwent endoscopic retrograde cholangiopancreatography (ERCP) for bile duct stone removal (7 cases) or bile duct stenosis (30 cases). Intraductal confocal microscopy (IDCM) was performed during the ERCP using a probe-based confocal laser endomicroscopy (pCLE) technique. IDCM was done with the CholangioFlex probe with Cellvizio (Mauna Kea Technologies, Paris, France). The depth of penetration of theCholangioFlex probe was 40-70 μm and magnification was 400×. Images were reviewed by an experienced pathologist in GI disease and compared to ERCP findings, CBD biopsies performed during ERCP or EUS, and in 15 patients to the resected specimen (Wipple resection). No complications related to the CholangioFlex insertion occurred after the ERCP. Good images were obtained in 33 patients. Final histology diagnosis was a normal CBD in 7 cases, 23 malignant stenoses (4 ampullary carcinomas, 13 cholangiocarcinomas, and 6 pancreatic cancer), and 7 inflammatory stenoses (4 chronic pancreatitis, 1 stenosis of hepaticojejunal anastomosis, 1 postcholecystectomy CBD stenosis, and 1 primary sclerosing cholangitis). IDCM of a normal CBD showed a thin black band (<20 μm), normal vessels (thin and regular), and no visible glands. IDCM of malignant strictures revealed irregular vessels with lack of contrast in the CBD wall, large black band (>20 μm), and an aggregate of irregular black cells (black clumps). These aspects were seen in all malignant stenoses and none were seen in benign or normal CBD. The presence of irregular vessels, large black bands, and black clumps seen with confocal laser microscopy enabled prediction of neoplasia with an accuracy rate of 86%, sensitivity of 83%, and specificity of 75%. The respective numbers for standard histopathology were 53, 65, and 53%. This phase I-II study on IDCM showed that IDCM is feasible. This new technique will open a new door for optical biopsy of the CBD.

SPH-DEM approach to numerically simulate the deformation of three-dimensional RBCs in non-uniform capillaries.

PubMed

Polwaththe-Gallage, Hasitha-Nayanajith; Saha, Suvash C; Sauret, Emilie; Flower, Robert; Senadeera, Wijitha; Gu, YuanTong

2016-12-28

Blood continuously flows through the blood vessels in the human body. When blood flows through the smallest blood vessels, red blood cells (RBCs) in the blood exhibit various types of motion and deformed shapes. Computational modelling techniques can be used to successfully predict the behaviour of the RBCs in capillaries. In this study, we report the application of a meshfree particle approach to model and predict the motion and deformation of three-dimensional RBCs in capillaries. An elastic spring network based on the discrete element method (DEM) is employed to model the three-dimensional RBC membrane. The haemoglobin in the RBC and the plasma in the blood are modelled as smoothed particle hydrodynamics (SPH) particles. For validation purposes, the behaviour of a single RBC in a simple shear flow is examined and compared against experimental results. Then simulations are carried out to predict the behaviour of RBCs in a capillary; (i) the motion of five identical RBCs in a uniform capillary, (ii) the motion of five identical RBCs with different bending stiffness (K b ) values in a stenosed capillary, (iii) the motion of three RBCs in a narrow capillary. Finally five identical RBCs are employed to determine the critical diameter of a stenosed capillary. Validation results showed a good agreement with less than 10% difference. From the above simulations, the following results are obtained; (i) RBCs exhibit different deformation behaviours due to the hydrodynamic interaction between them. (ii) Asymmetrical deformation behaviours of the RBCs are clearly observed when the bending stiffness (K b ) of the RBCs is changed. (iii) The model predicts the ability of the RBCs to squeeze through smaller blood vessels. Finally, from the simulations, the critical diameter of the stenosed section to stop the motion of blood flow is predicted. A three-dimensional spring network model based on DEM in combination with the SPH method is successfully used to model the motion and deformation of RBCs in capillaries. Simulation results reveal that the condition of blood flow stopping depends on the pressure gradient of the capillary and the severity of stenosis of the capillary. In addition, this model is capable of predicting the critical diameter which prevents motion of RBCs for different blood pressures.

OSTEOID OSTEOMA IN SCAPHOID: CASE REPORT.

PubMed

Severo, Antônio Lourenço; de Araújo Filho, Raimundo; Puentes, Rulby; Lemos, Marcelo Barreto; Piluski, Paulo Faiad; Lech, Osvandré

2012-01-01

Osteoid osteoma is a benign osteoblastic tumor that is unusual in the hand. A location in the carpal bones is infrequent, which leads to errors in diagnosing it because of polymorphism of the clinical symptoms. Reviewing the literature shows that nine cases of osteoid osteoma in the scaphoid have been reported. Here, one case of osteoid osteoma in the scaphoid that was initially treated as De Quervain's stenosing tenosynovitis is reported, with a definitive diagnosis that was delayed for five years.

Efficiency of the confocal method of laser endomicroscopy in complex diagnoses of diseases of common bile duct

NASA Astrophysics Data System (ADS)

Anaskin, S. G.; Panchenkov, D. N.; Chertyuk, V. B.; Sazonov, D. V.; Zabozlayev, F. G.; Danilevskaya, O. V.; Mokshina, N. V.; Korniletsky, I. D.

2017-01-01

One of the more frequent manifestations of diseases of the bile ducts are its’ strictures or stenoses that could be of either malignant or benign nature. Current methods of diagnosing this pathology include computer tomography (CT) scan, magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). However, these methods are not always informative, which makes this a current and topical problem. A fundamentally new method that broadens the capabilities of ERCP when diagnosing diseases of the bile duct accompanied by the development of strictures or stenoses is probe-based confocal laser endomicroscopy (pCLE). The method is based on the principle of confocal fluorescence microscopy. The most elaborate complications arise with the presence of the pre-existing pancreatobiliary pathology: pseudotumoral chronic pancreatitis, acute cholangitis, etc. Early stage cholangiocarcinoma diagnosis can be difficult (and not always possible) even with the help of modern research methods. For the timely diagnostic it is advantageous to conduct pCLE and targeted biopsy of the zone with most manifested changes. In all instances, the first use of the pCLE method for diagnostic purposes allowed us to clarify and correctly verify the diagnosis. When concerning the diseases of the bile duct, the modern stage of pCLE development can be of critical importance when other methods are not effective.

Elastic Deformation Properties of Implanted Endobronchial Wire Stents in Benign and Malignant Bronchial Disease: A Radiographic In Vivo Evaluation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hautmann, Hubert; Rieger, Johannes; Huber, Rudolf M.

1999-03-15

Purpose: To evaluate the long-term mechanical behavior in vivo of expandable endobronchial wire stents, we imaged three different prostheses in the treatment of tracheobronchial disease. Methods: Six patients with bronchial stenoses (three benign, three malignant) underwent insertion of metallic stents. Two self-expandable Wallstents, two balloon-expandable tantalum Strecker stents and two self-expandable nitinol Accuflex stents were used. Measurements of deformation properties were performed during voluntary cough by means of fluoroscopy, at 1 month and 7-10 months after implantation. The procedures were videotaped, their images digitized and the narrowing of stent diameters calculated at intervals of 20 msec. Results: After stent implantationmore » all patients improved with respect to ventilatory function. Radial stent narrowing during cough reached 53% (Wallstent), 59% (tantalum Strecker stent), and 52% (nitinol Accuflex stent) of the relaxed post-implantation diameter. Stent compression was more marked in benign compared with malignant stenoses. In the long term permanent deformation occurred with the tantalum Strecker stents; the other stents were unchanged. Conclusion: Endobronchial wire stents can be helpful in the treatment of major airway collapse and obstructing bronchial lesions. However, evidence of material fatigue as a possible effect of exposure to recurrent mechanical stress on the flexible mesh tube may limit their long-term use. This seems to be predominantly important in benign bronchial collapse.« less

Analysis of flow disturbance in a stenosed carotid artery bifurcation using two-equation transitional and turbulence models.

PubMed

Tan, F P P; Soloperto, G; Bashford, S; Wood, N B; Thom, S; Hughes, A; Xu, X Y

2008-12-01

In this study, newly developed two-equation turbulence models and transitional variants are employed for the prediction of blood flow patterns in a diseased carotid artery where the growth, progression, and structure of the plaque at rupture are closely linked to low and oscillating wall shear stresses. Moreover, the laminar-turbulent transition in the poststenotic zone can alter the separation zone length, wall shear stress, and pressure distribution over the plaque, with potential implications for stresses within the plaque. Following the validation with well established experimental measurements and numerical studies, a magnetic-resonance (MR) image-based model of the carotid bifurcation with 70% stenosis was reconstructed and simulated using realistic patient-specific conditions. Laminar flow, a correlation-based transitional version of Menter's hybrid k-epsilon/k-omega shear stress transport (SST) model and its "scale adaptive simulation" (SAS) variant were implemented in pulsatile simulations from which analyses of velocity profiles, wall shear stress, and turbulence intensity were conducted. In general, the transitional version of SST and its SAS variant are shown to give a better overall agreement than their standard counterparts with experimental data for pulsatile flow in an axisymmetric stenosed tube. For the patient-specific case reported, the wall shear stress analysis showed discernable differences between the laminar flow and SST transitional models but virtually no difference between the SST transitional model and its SAS variant.

Fluoroscopically Guided Epidural Injections of the Cervical and Lumbar Spine.

PubMed

Shim, Euddeum; Lee, Joon Woo; Lee, Eugene; Ahn, Joong Mo; Kang, Yusuhn; Kang, Heung Sik

2017-01-01

Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications. Although computed tomographic (CT) or combined CT-fluoroscopic guidance has been increasingly used in ESI, conventional fluoroscopic guidance is generally performed. In ESI, drugs are delivered into the epidural space by interlaminar or transforaminal routes in the cervical spine or by interlaminar, transforaminal, or caudal routes in the lumbar spine. Epidurography is usually performed before drug delivery to verify the proper position of the needle in the epidural space. A small amount of contrast agent is injected with fluoroscopic guidance. Familiarity with the findings on a typical "true" epidurogram (demonstrating correct needle placement in the epidural space) permits proper performance of ESI. Findings on "false" epidurograms (demonstrating incorrect needle placement) include muscular staining and evidence of intravascular injection, inadvertent facet joint injection, dural puncture, subdural injection, and intraneural or intradiscal injection. © RSNA, 2016 An earlier incorrect version of this article appeared online. This article was corrected on December 22, 2016.

The Effectiveness of Corticosteroid Injection for De Quervain's Stenosing Tenosynovitis (DQST): A Systematic Review and Meta-Analysis.

PubMed

Rowland, Patrick; Phelan, Nigel; Gardiner, Sean; Linton, Kenneth N; Galvin, Rose

2015-01-01

De Quervain's stenosing tenosynovitis (DQST) treatments include corticosteroid injection around the tendon sheath; however there is some ambiguity concerning the efficacy of this treatment. The aim of this systematic review and meta-analysis is to examine the totality of evidence relating to the use of corticosteroid injection in DQST when compared to placebo or other active treatments. A systematic literature search was conducted in July 2014. Only randomized control trials (RCTs) were included. Outcome measures included impairment, activity limitation and participation restriction. Five RCTs were identified with 165 patients, 88 in the treatment group and 77 in the control group.Patients who received corticosteroid injection (n=142) had a higher rate of resolution of symptoms [RR 2.59, 95% CI: 1.25 to 5.37, p=0.05, I2=62%]. This group reported greater pain relief as assessed by Visual Analogue Scale (VAS) at first assessment [mean difference -2.51, 95% CI: -3.11 to -1.90, p=0.0003, I2=65%] and demonstrated a statistically significant improvement in function (n=78) as measured by the DASH score and Dutch AIMS-HFF score [SMD -0.83, 95% CI: -1.54 to -0.12, p=0.02, I2=48]. This review confirms that corticosteroid injection results in a statistically significant increase in resolution of symptoms, pain relief and increased function in the treatment of DQST.

Stent placement with the monorail technique for treatment of mesenteric artery stenosis.

PubMed

Schaefer, Philipp J; Schaefer, Fritz K W; Hinrichsen, Holger; Jahnke, Thomas; Charalambous, Nikolas; Heller, Martin; Mueller-Huelsbeck, Stefan

2006-04-01

To analyze the immediate and midterm success of stenting of mesenteric arteries by a monorail technique in patients with chronic mesenteric ischemia. In this prospective case series, 19 patients (11 male, 8 female; mean age, 62.9 +/- 10.4 y; range, 36-82 y) with 23 symptomatic stenoses of mesenteric arteries were treated with stent placement by a monorail technique in a radiologic intervention center over a period of 4.5 years. Clinical examinations and duplex sonography were used to evaluate the stents' patency and clinical success. Kaplan-Meier graphs were calculated to analyze the patency and freedom-from-symptom rate. Initial technical success rate was 22/23 (96%). Mean follow-up was 17 months (range, 1-58 mo). Primary patency and primary clinical success rates were 82% and 78%, respectively. According to Kaplan-Meier tables, the patency rates were 96%, 87%, 76%, and 61% at 0, 1, 15, and 24 months, respectively, and the freedom-from-symptom rates were 95%, 90%, 72%, and 54% at 0, 1, 24, and 30 months, respectively. No peri-interventional complications occurred. Two patients died of cardiac failure in the hospital within 30 days after intervention; deaths were not related to the intervention. Stent placement by a monorail technique in mesenteric arteries is an effective and safe treatment for symptomatic stenoses in patients with chronic mesenteric ischemia after a mean follow-up of 17 months.

Complimentary use of epicardial echo imaging and Doppler in quantification of coronary artery stenoses

NASA Astrophysics Data System (ADS)

Richards, Kent L.; Cannon, Scott R.

1990-08-01

As more advanced therapeutic procedures are performed on coronary arteries during open chest surgery more advanced diagnostic procedures will be required to define the location and severity of coronary artery disease. This manuscript describes our preliminary experiences in identifying human coronary artery stenoses using epicardial two-dimensional color flow Doppler. Once the lesions were identified we used standard echo Doppler and imaging techniques to define their severity. The accuracy of stenotic cross sectional area calculated using the continuity equation and pressure gradient calculated using the Bernoulli equation were defined using a pulsatile flow model of the coronary circulation. Suggestions about further hardware development required to allow easy clinical application of this technique are described. 1 - CLINICAL NEED FOR INTRA-OPERATIVE EVAUJATION OFCORONARY ARTERIES The severity of coronary artery disease in adults who require coronary bypass surgery has changed significantly in the last ten years. More effective medications used to control angina pectoris and the wide use of percutaneous y artery angioplasty have delayed the timing of surgery until atherosclerotic involvement is more extensive. In addition patients who have had initial coronary bypass operations are now reaching ages at which atherosclerotic involvement of their bypass grafts and native vessels has progressed and reoperation is required. To meet the challenge of coronary arteries with multiple lesions or diffuse disease intraoperative angioplasty devices are being developed. Whether bypass surgery for advanced lesions or reoperation of

Standardized evaluation framework for evaluating coronary artery stenosis detection, stenosis quantification and lumen segmentation algorithms in computed tomography angiography.

PubMed

Kirişli, H A; Schaap, M; Metz, C T; Dharampal, A S; Meijboom, W B; Papadopoulou, S L; Dedic, A; Nieman, K; de Graaf, M A; Meijs, M F L; Cramer, M J; Broersen, A; Cetin, S; Eslami, A; Flórez-Valencia, L; Lor, K L; Matuszewski, B; Melki, I; Mohr, B; Oksüz, I; Shahzad, R; Wang, C; Kitslaar, P H; Unal, G; Katouzian, A; Örkisz, M; Chen, C M; Precioso, F; Najman, L; Masood, S; Ünay, D; van Vliet, L; Moreno, R; Goldenberg, R; Vuçini, E; Krestin, G P; Niessen, W J; van Walsum, T

2013-12-01

Though conventional coronary angiography (CCA) has been the standard of reference for diagnosing coronary artery disease in the past decades, computed tomography angiography (CTA) has rapidly emerged, and is nowadays widely used in clinical practice. Here, we introduce a standardized evaluation framework to reliably evaluate and compare the performance of the algorithms devised to detect and quantify the coronary artery stenoses, and to segment the coronary artery lumen in CTA data. The objective of this evaluation framework is to demonstrate the feasibility of dedicated algorithms to: (1) (semi-)automatically detect and quantify stenosis on CTA, in comparison with quantitative coronary angiography (QCA) and CTA consensus reading, and (2) (semi-)automatically segment the coronary lumen on CTA, in comparison with expert's manual annotation. A database consisting of 48 multicenter multivendor cardiac CTA datasets with corresponding reference standards are described and made available. The algorithms from 11 research groups were quantitatively evaluated and compared. The results show that (1) some of the current stenosis detection/quantification algorithms may be used for triage or as a second-reader in clinical practice, and that (2) automatic lumen segmentation is possible with a precision similar to that obtained by experts. The framework is open for new submissions through the website, at http://coronary.bigr.nl/stenoses/. Copyright © 2013 Elsevier B.V. All rights reserved.

Endoscopic balloon dilatation as an effective treatment for lower and upper benign gastrointestinal system anastomotic stenosis.

PubMed

Akarsu, Cevher; Unsal, Mustafa Gokhan; Dural, Ahmet Cem; Kones, Osman; Kocatas, Ali; Karabulut, Mehmet; Kankaya, Burak; Ates, Mustafa; Alis, Halil

2015-04-01

Endoscopic balloon dilatation (EBD) is currently accepted as an effective, safe, and first-line treatment of postoperative benign gastrointestinal anastomosis stenosis (BGAS); however, a limited number of publications on the subject exist in the literature. The aim of the study was to retrospectively evaluate the efficiency of endoscopic dilatation in patients with postoperative intestinal anastomotic stenoses at a single surgical center. Patients with postoperative BGAS treated by EBD at our institution from February 2008 to 2012 were included. The dilatations were all performed using through-the-scope balloons. The balloon was introduced into the stricture using a guidewire under radiologic guidance. Each dilatation session consisted of 2 to 3 two-minute multistep inflations of the balloon until adequate dilatation was achieved. Of the 48 patients included in the study, 44 patients (91.7%) fully recovered and 4 (8.3%) did not respond to treatment. The mean follow-up period was 24 months (range, 3 to 57 mo). Four patients who did not respond to the procedure were treated surgically. Two patients (4.1%) with intestinal perforation during EBD were treated conservatively with a stent. EBD has a low rate of complications and a high success rate, is well tolerated, and avoids further surgical procedures for BGAS. Therefore, EBD should be the first choice of treatment for postoperative anastomotic stenoses.

High-capacity and security molecular capsule transporters.

PubMed

Visessamit, Jakkapol; Kulsirirat, Kathawut; Yupapin, Preecha P

2015-01-01

Multiwavelength optical capsules can be generated and controlled by using soliton/Gaussian pulses within a nonlinear device system known as a "PANDA" ring circuit and system. The security of molecule/drug transportation can be formed by the strong coupling of soliton-like pulse, where the high-capacity optical capsules can be formed using the multiwavelength solitons, which can be a good advantage and combination of drug delivery to the required targets. Moreover, the multiple access of drug delivery can be formed using the optical networks, which allows the use of various drug molecules with variety of diagnosis and therapeutic applications.

Sequential single shot X-ray photon correlation spectroscopy at the SACLA free electron laser

DOE PAGES

Lehmkühler, Felix; Kwaśniewski, Paweł; Roseker, Wojciech; ...

2015-11-27

In this study, hard X-ray free electron lasers allow for the first time to access dynamics of condensed matter samples ranging from femtoseconds to several hundred seconds. In particular, the exceptional large transverse coherence of the X-ray pulses and the high time-averaged flux promises to reach time and length scales that have not been accessible up to now with storage ring based sources. However, due to the fluctuations originating from the stochastic nature of the self-amplified spontaneous emission (SASE) process the application of well established techniques such as X-ray photon correlation spectroscopy (XPCS) is challenging. Here we demonstrate a single-shotmore » based sequential XPCS study on a colloidal suspension with a relaxation time comparable to the SACLA free-electron laser pulse repetition rate. High quality correlation functions could be extracted without any indications for sample damage. This opens the way for systematic sequential XPCS experiments at FEL sources.« less

Sequential single shot X-ray photon correlation spectroscopy at the SACLA free electron laser

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lehmkühler, Felix; Kwaśniewski, Paweł; Roseker, Wojciech

In this study, hard X-ray free electron lasers allow for the first time to access dynamics of condensed matter samples ranging from femtoseconds to several hundred seconds. In particular, the exceptional large transverse coherence of the X-ray pulses and the high time-averaged flux promises to reach time and length scales that have not been accessible up to now with storage ring based sources. However, due to the fluctuations originating from the stochastic nature of the self-amplified spontaneous emission (SASE) process the application of well established techniques such as X-ray photon correlation spectroscopy (XPCS) is challenging. Here we demonstrate a single-shotmore » based sequential XPCS study on a colloidal suspension with a relaxation time comparable to the SACLA free-electron laser pulse repetition rate. High quality correlation functions could be extracted without any indications for sample damage. This opens the way for systematic sequential XPCS experiments at FEL sources.« less

Vortex-Core Reversal Dynamics: Towards Vortex Random Access Memory

NASA Astrophysics Data System (ADS)

Kim, Sang-Koog

2011-03-01

An energy-efficient, ultrahigh-density, ultrafast, and nonvolatile solid-state universal memory is a long-held dream in the field of information-storage technology. The magnetic random access memory (MRAM) along with a spin-transfer-torque switching mechanism is a strong candidate-means of realizing that dream, given its nonvolatility, infinite endurance, and fast random access. Magnetic vortices in patterned soft magnetic dots promise ground-breaking applications in information-storage devices, owing to the very stable twofold ground states of either their upward or downward core magnetization orientation and plausible core switching by in-plane alternating magnetic fields or spin-polarized currents. However, two technologically most important but very challenging issues --- low-power recording and reliable selection of each memory cell with already existing cross-point architectures --- have not yet been resolved for the basic operations in information storage, that is, writing (recording) and readout. Here, we experimentally demonstrate a magnetic vortex random access memory (VRAM) in the basic cross-point architecture. This unique VRAM offers reliable cell selection and low-power-consumption control of switching of out-of-plane core magnetizations using specially designed rotating magnetic fields generated by two orthogonal and unipolar Gaussian-pulse currents along with optimized pulse width and time delay. Our achievement of a new device based on a new material, that is, a medium composed of patterned vortex-state disks, together with the new physics on ultrafast vortex-core switching dynamics, can stimulate further fruitful research on MRAMs that are based on vortex-state dot arrays.

LIDAR pulse coding for high resolution range imaging at improved refresh rate.

PubMed

Kim, Gunzung; Park, Yongwan

2016-10-17

In this study, a light detection and ranging system (LIDAR) was designed that codes pixel location information in its laser pulses using the direct- sequence optical code division multiple access (DS-OCDMA) method in conjunction with a scanning-based microelectromechanical system (MEMS) mirror. This LIDAR can constantly measure the distance without idle listening time for the return of reflected waves because its laser pulses include pixel location information encoded by applying the DS-OCDMA. Therefore, this emits in each bearing direction without waiting for the reflected wave to return. The MEMS mirror is used to deflect and steer the coded laser pulses in the desired bearing direction. The receiver digitizes the received reflected pulses using a low-temperature-grown (LTG) indium gallium arsenide (InGaAs) based photoconductive antenna (PCA) and the time-to-digital converter (TDC) and demodulates them using the DS-OCDMA. When all of the reflected waves corresponding to the pixels forming a range image are received, the proposed LIDAR generates a point cloud based on the time-of-flight (ToF) of each reflected wave. The results of simulations performed on the proposed LIDAR are compared with simulations of existing LIDARs.

Pump-probe studies of radiation induced defects and formation of warm dense matter with pulsed ion beams

NASA Astrophysics Data System (ADS)

Schenkel, T.; Persaud, A.; Gua, H.; Seidl, P. A.; Waldron, W. L.; Gilson, E. P.; Kaganovich, I. D.; Davidson, R. C.; Friedman, A.; Barnard, J. J.; Minior, A. M.

2014-10-01

We report results from the 2nd generation Neutralized Drift Compression Experiment at Berkeley Lab. NDCX-II is a pulsed, linear induction accelerator designed to drive thin foils to warm dense matter (WDM) states with peak temperatures of ~ 1 eV using intense, short pulses of 1.2 MeV lithium ions. Tunability of the ion beam enables pump-probe studies of radiation effects in solids as a function of excitation density, from isolated collision cascades to the onset of phase-transitions and WDM. Ion channeling is an in situ diagnostic of damage evolution during ion pulses with a sensitivity of <0.1% displacements per atom. We will report results from damage evolution studies in thin silicon crystals with Li + and K + beams. Detection of channeled ions tracks lattice disorder evolution with a resolution of ~ 1 ns using fast current measurements. We will discuss pump-probe experiments with pulsed ion beams and the development of diagnostics for WDM and multi-scale (ms to fs) access to the materials physics of collision cascades e.g. in fusion reactor materials. Work performed under auspices of the US DOE under Contract No. DE-AC02-05CH11231.

Electron volt spectroscopy on a pulsed neutron source

NASA Astrophysics Data System (ADS)

Newport, R. J.; Penfold, J.; Williams, W. G.

1984-07-01

The principal design aspects of a pulsed source neutron spectrometer in which the scattered neutron energy is determined by a resonance absorption filter difference method are discussed. Calculations of the accessible dynamic range, resolution and spectrum simulations are given for the spectrometer on a high intensity pulsed neutron source, such as the spallation neutron source (SNS) now being constructed at the Rutherford Appleton Laboratory. Special emphasis is made of the advantage gained by placing coarse and fixed energy-sensitive filters before and after the scatterer; these enhance the inelastic/elastic descrimination of the method. A brief description is given of a double difference filter method which gives a superior difference peak shape, as well as a better energy transfer resolution. Finally, some first results of scattering from zirconium hydride, obtained on a test spectrometer, are presented.

Ultrafast random-access scanning in two-photon microscopy using acousto-optic deflectors.

PubMed

Salomé, R; Kremer, Y; Dieudonné, S; Léger, J-F; Krichevsky, O; Wyart, C; Chatenay, D; Bourdieu, L

2006-06-30

Two-photon scanning microscopy (TPSM) is a powerful tool for imaging deep inside living tissues with sub-cellular resolution. The temporal resolution of TPSM is however strongly limited by the galvanometric mirrors used to steer the laser beam. Fast physiological events can therefore only be followed by scanning repeatedly a single line within the field of view. Because acousto-optic deflectors (AODs) are non-mechanical devices, they allow access at any point within the field of view on a microsecond time scale and are therefore excellent candidates to improve the temporal resolution of TPSM. However, the use of AOD-based scanners with femtosecond pulses raises several technical difficulties. In this paper, we describe an all-digital TPSM setup based on two crossed AODs. It includes in particular an acousto-optic modulator (AOM) placed at 45 degrees with respect to the AODs to pre-compensate for the large spatial distortions of femtosecond pulses occurring in the AODs, in order to optimize the spatial resolution and the fluorescence excitation. Our setup allows recording from freely selectable point-of-interest at high speed (1kHz). By maximizing the time spent on points of interest, random-access TPSM (RA-TPSM) constitutes a promising method for multiunit recordings with millisecond resolution in biological tissues.

Increased pulse wave transit time after percutaneous coronary intervention procedure in CAD patients.

PubMed

Ji, Lizhen; Liu, Chengyu; Li, Peng; Wang, Xinpei; Liu, Changchun; Hou, Yinglong

2018-01-08

Pulse wave transit time (PWTT) has been widely used as an index in assessing arterial stiffness. Percutaneous coronary intervention (PCI) is usually applied to the treatment of coronary artery disease (CAD). Research on the changes in PWTT caused by PCI is helpful for understanding the impact of the PCI procedure. In addition, effects of stent sites and access sites on the changes in PWTT have not been explored. Consequently, this study aimed to provide this information. The results showed that PWTT significantly increased after PCI (p < 0.01) while the standard deviation (SD) of PWTT time series had no statistically significant changes (p = 0.60) between before and after PCI. Significantly increased PWTT was found in the radial access group (p < 0.01), while there were no significant changes in the femoral access group (p > 0.4). Additionally, PWTT in the left anterior descending (LAD) group significantly increased after PCI (p < 0.01), but the increase that was found in the right coronary artery (RCA) group was not significant (p > 0.1). Our study indicates that arterial elasticity and left ventricular functions can benefit from a successful PCI procedure, and the increase of peripheral PWTT after PCI can help to better understand the effectiveness of the procedure.

Where do pulse oximeter probes break?

PubMed

Crede, S; Van der Merwe, G; Hutchinson, J; Woods, D; Karlen, W; Lawn, J

2014-06-01

Pulse oximetry, a non-invasive method for accurate assessment of blood oxygen saturation (SPO2), is an important monitoring tool in health care facilities. However, it is often not available in many low-resource settings, due to expense, overly sophisticated design, a lack of organised procurement systems and inadequate medical device management and maintenance structures. Furthermore medical devices are often fragile and not designed to withstand the conditions of low-resource settings. In order to design a probe, better suited to the needs of health care facilities in low-resource settings this study aimed to document the site and nature of pulse oximeter probe breakages in a range of different probe designs in a low to middle income country. A retrospective review of job cards relating to the assessment and repair of damaged or faulty pulse oximeter probes was conducted at a medical device repair company based in Cape Town, South Africa, specializing in pulse oximeter probe repairs. 1,840 job cards relating to the assessment and repair of pulse oximeter probes were reviewed. 60.2 % of probes sent for assessment were finger-clip probes. For all probes, excluding the neonatal wrap probes, the most common point of failure was the probe wiring (>50 %). The neonatal wrap most commonly failed at the strap (51.5 %). The total cost for quoting on the broken pulse oximeter probes and for the subsequent repair of devices, excluding replacement components, amounted to an estimated ZAR 738,810 (USD $98,508). Improving the probe wiring would increase the life span of pulse oximeter probes. Increasing the life span of probes will make pulse oximetry more affordable and accessible. This is of high priority in low-resource settings where frequent repair or replacement of probes is unaffordable or impossible.

AxBAxB… pulsed atomic layer deposition: Numerical growth model and experiments

NASA Astrophysics Data System (ADS)

Muneshwar, Triratna; Cadien, Ken

2016-02-01

Atomic layer deposition (ALD) is widely used for the fabrication of advanced semiconductor devices and related nanoscale structures. During ALD, large precursor doses (>1000 L per pulse) are often required to achieve surface saturation, of which only a small fraction is utilized in film growth while the rest is pumped from the system. Since the metal precursor constitutes a significant cost of ALD, strategies to enhance precursor utilization are essential for the scaling of ALD processes. In the precursor reaction step, precursor physisorption is restricted by steric hindrance (mA1) from ligands on the precursor molecules. On reaction, some of these ligands are removed as by-products resulting in chemisorbed species with reduced steric hindrance (mA1 → mA2, where mA2 < mA1) and some of the initially hindered surface reaction sites becoming accessible for further precursor physisorption. To utilize these additional reaction sites, we propose a generalized AxBAxB… pulsed deposition where the total precursor dose (ΦA) is introduced as multiple x (x > 1, x ∈ I) short-pulses rather than a single pulse. A numerical first-order surface reaction kinetics growth model is presented and applied to study the effect of AxBAxB… pulsed ALD on the growth per cycle (GPC). The model calculations predict higher GPC for AxBAxB… pulsing than with ABAB… deposition. In agreement with the model predictions, with AxBAxB… pulsed deposition, the GPC was found to increase by ˜46% for ZrN plasma enhanced ALD (PEALD), ˜49% for HfO2 PEALD, and ˜8% for thermal Al2O3 ALD with respect to conventional ABAB… pulsed growth.

Laser Ignition Technology for Bi-Propellant Rocket Engine Applications

NASA Technical Reports Server (NTRS)

Thomas, Matthew E.; Bossard, John A.; Early, Jim; Trinh, Huu; Dennis, Jay; Turner, James (Technical Monitor)

2001-01-01

The fiber optically coupled laser ignition approach summarized is under consideration for use in igniting bi-propellant rocket thrust chambers. This laser ignition approach is based on a novel dual pulse format capable of effectively increasing laser generated plasma life times up to 1000 % over conventional laser ignition methods. In the dual-pulse format tinder consideration here an initial laser pulse is used to generate a small plasma kernel. A second laser pulse that effectively irradiates the plasma kernel follows this pulse. Energy transfer into the kernel is much more efficient because of its absorption characteristics thereby allowing the kernel to develop into a much more effective ignition source for subsequent combustion processes. In this research effort both single and dual-pulse formats were evaluated in a small testbed rocket thrust chamber. The rocket chamber was designed to evaluate several bipropellant combinations. Optical access to the chamber was provided through small sapphire windows. Test results from gaseous oxygen (GOx) and RP-1 propellants are presented here. Several variables were evaluated during the test program, including spark location, pulse timing, and relative pulse energy. These variables were evaluated in an effort to identify the conditions in which laser ignition of bi-propellants is feasible. Preliminary results and analysis indicate that this laser ignition approach may provide superior ignition performance relative to squib and torch igniters, while simultaneously eliminating some of the logistical issues associated with these systems. Further research focused on enhancing the system robustness, multiplexing, and window durability/cleaning and fiber optic enhancements is in progress.

Time-domain Brillouin scattering assisted by diffraction gratings

NASA Astrophysics Data System (ADS)

Matsuda, Osamu; Pezeril, Thomas; Chaban, Ievgeniia; Fujita, Kentaro; Gusev, Vitalyi

2018-02-01

Absorption of ultrashort laser pulses in a metallic grating deposited on a transparent sample launches coherent compression/dilatation acoustic pulses in directions of different orders of acoustic diffraction. Their propagation is detected by delayed laser pulses, which are also diffracted by the metallic grating, through the measurement of the transient intensity change of the first-order diffracted light. The obtained data contain multiple frequency components, which are interpreted by considering all possible angles for the Brillouin scattering of light achieved through multiplexing of the propagation directions of light and coherent sound by the metallic grating. The emitted acoustic field can be equivalently presented as a superposition of plane inhomogeneous acoustic waves, which constitute an acoustic diffraction grating for the probe light. Thus the obtained results can also be interpreted as a consequence of probe light diffraction by both metallic and acoustic gratings. The realized scheme of time-domain Brillouin scattering with metallic gratings operating in reflection mode provides access to wide range of acoustic frequencies from minimal to maximal possible values in a single experimental optical configuration for the directions of probe light incidence and scattered light detection. This is achieved by monitoring the backward and forward Brillouin scattering processes in parallel. Potential applications include measurements of the acoustic dispersion, simultaneous determination of sound velocity and optical refractive index, and evaluation of samples with a single direction of possible optical access.

A graphite based STT-RAM cell with reduction in switching current

NASA Astrophysics Data System (ADS)

Varghani, Ali; Peiravi, Ali

2015-10-01

Spin Transfer Torque Random Access Memory (STT-RAM) is a serious candidate for "universal memory" because of its non-volatility, fast access time, high density, good scalability, high endurance and relatively low power dissipation. However, problems with low write speed and large write current are important existing challenges in STT-RAM design and there is a tradeoff between them and data retention time. In this study, a novel STT-RAM cell structure which uses perfect graphite based Magnetic Tunnel Junction (MTJ) is proposed. First, the cross-section of the structure is selected to be an ellipse of 45 nm and 180 nm dimensions and a six-layer graphite is used as tunnel barrier. By passing a lateral current with a short pulse width (before applying STT current and independent of it) through four middle graphene layers of the tunnel barrier, a 27% reduction in the amplitude of the switching current (for fast switching time of 2 ns) or a 58% reduction in its pulse width is achieved without any reduction in data retention time. Finally, the effect of downscaling of technology on the proposed structure is evaluated. A reduction of 31.6% and 9% in switching current is achieved for 90 and 22 nm cell width respectively by passing sufficient current (100 μA with 0.1 ns pulse width) through the tunnel barrier. Simulations are done using Object Oriented Micro Magnetic Framework (OOMMF).

Practical system for the generation of pulsed quantum frequency combs.

PubMed

Roztocki, Piotr; Kues, Michael; Reimer, Christian; Wetzel, Benjamin; Sciara, Stefania; Zhang, Yanbing; Cino, Alfonso; Little, Brent E; Chu, Sai T; Moss, David J; Morandotti, Roberto

2017-08-07

The on-chip generation of large and complex optical quantum states will enable low-cost and accessible advances for quantum technologies, such as secure communications and quantum computation. Integrated frequency combs are on-chip light sources with a broad spectrum of evenly-spaced frequency modes, commonly generated by four-wave mixing in optically-excited nonlinear micro-cavities, whose recent use for quantum state generation has provided a solution for scalable and multi-mode quantum light sources. Pulsed quantum frequency combs are of particular interest, since they allow the generation of single-frequency-mode photons, required for scaling state complexity towards, e.g., multi-photon states, and for quantum information applications. However, generation schemes for such pulsed combs have, to date, relied on micro-cavity excitation via lasers external to the sources, being neither versatile nor power-efficient, and impractical for scalable realizations of quantum technologies. Here, we introduce an actively-modulated, nested-cavity configuration that exploits the resonance pass-band characteristic of the micro-cavity to enable a mode-locked and energy-efficient excitation. We demonstrate that the scheme allows the generation of high-purity photons at large coincidence-to-accidental ratios (CAR). Furthermore, by increasing the repetition rate of the excitation field via harmonic mode-locking (i.e. driving the cavity modulation at harmonics of the fundamental repetition rate), we managed to increase the pair production rates (i.e. source efficiency), while maintaining a high CAR and photon purity. Our approach represents a significant step towards the realization of fully on-chip, stable, and versatile sources of pulsed quantum frequency combs, crucial for the development of accessible quantum technologies.

Performance evaluation of modulation and multiple access schemes in ultraviolet optical wireless connections for two atmosphere thickness cases.

PubMed

Raptis, Nikos; Pikasis, Evangelos; Syvridis, Dimitris

2016-08-01

The exploitation of optical wireless communication channels in a non-line-of-sight regime is studied for point-to-point and networking configurations considering the use of light-emitting diodes. Two environments with different scattering center densities are considered, assuming operation at 265 nm. The bit error rate performance of both pulsed and multicarrier modulation schemes is examined, using numerical approaches. In the networking scenario, a central node only receives data, one node transmits useful data, and the rest of them act as interferers. The performance of the desirable node's transmissions is evaluated. The access to the medium is controlled by a code division multiple access scheme.

Assessing five evolving microbial enzyme models against field measurements from a semiarid savannah—What are the mechanisms of soil respiration pulses?

NASA Astrophysics Data System (ADS)

Zhang, Xia; Niu, Guo-Yue; Elshall, Ahmed S.; Ye, Ming; Barron-Gafford, Greg A.; Pavao-Zuckerman, Mitch

2014-09-01

Soil microbial respiration pulses in response to episodic rainfall pulses (the "Birch effect") are poorly understood. We developed and assessed five evolving microbial enzyme models against field measurements from a semiarid savannah characterized by pulsed precipitation to understand the mechanisms to generate the Birch pulses. The five models evolve from an existing four-carbon (C) pool model to models with additional C pools and explicit representations of soil moisture controls on C degradation and microbial uptake rates. Assessing the models using techniques of model selection and model averaging suggests that models with additional C pools for accumulation of degraded C in the dry zone of the soil pore space result in a higher probability of reproducing the observed Birch pulses. Degraded C accumulated in dry soil pores during dry periods becomes immediately accessible to microbes in response to rainstorms, providing a major mechanism to generate respiration pulses. Explicitly representing the transition of degraded C and enzymes between dry and wet soil pores in response to soil moisture changes and soil moisture controls on C degradation and microbial uptake rates improve the models' efficiency and robustness in simulating the Birch effect. Assuming that enzymes in the dry soil pores facilitate degradation of complex C during dry periods (though at a lower rate) results in a greater accumulation of degraded C and thus further improves the models' performance. However, the actual mechanism inducing the greater accumulation of labile C needs further experimental studies.

OSTEOID OSTEOMA IN SCAPHOID: CASE REPORT

PubMed Central

Severo, Antônio Lourenço; de Araújo Filho, Raimundo; Puentes, Rulby; Lemos, Marcelo Barreto; Piluski, Paulo Faiad; Lech, Osvandré

2015-01-01

Osteoid osteoma is a benign osteoblastic tumor that is unusual in the hand. A location in the carpal bones is infrequent, which leads to errors in diagnosing it because of polymorphism of the clinical symptoms. Reviewing the literature shows that nine cases of osteoid osteoma in the scaphoid have been reported. Here, one case of osteoid osteoma in the scaphoid that was initially treated as De Quervain's stenosing tenosynovitis is reported, with a definitive diagnosis that was delayed for five years. PMID:27047881

Clinical experience with iodine-123-iodophenylpentadecanoic acid.

PubMed

Corbett, J

1994-04-01

Initial research in dogs and later research in normal volunteers and patients with coronary artery disease indicated that 123I-iodophenylpentadecanoic acid (IPPA) can provide valuable diagnostic information. This agent compared favorably to 201Tl in detecting stenosed coronary arteries and identified reversible lesions with greater frequency. Testing with both 201Tl and IPPA before and after percutaneous transluminal coronary angioplasty produced similar results, supporting the notion that IPPA deserves inclusion among the diagnostic tools used to evaluate coronary heart disease.

Strong-field ionization of clusters using two-cycle pulses at 1.8 μm

PubMed Central

Schütte, Bernd; Ye, Peng; Patchkovskii, Serguei; Austin, Dane R.; Brahms, Christian; Strüber, Christian; Witting, Tobias; Ivanov, Misha Yu.; Tisch, John W. G.; Marangos, Jon P.

2016-01-01

The interaction of intense laser pulses with nanoscale particles leads to the production of high-energy electrons, ions, neutral atoms, neutrons and photons. Up to now, investigations have focused on near-infrared to X-ray laser pulses consisting of many optical cycles. Here we study strong-field ionization of rare-gas clusters (103 to 105 atoms) using two-cycle 1.8 μm laser pulses to access a new interaction regime in the limit where the electron dynamics are dominated by the laser field and the cluster atoms do not have time to move significantly. The emission of fast electrons with kinetic energies exceeding 3 keV is observed using laser pulses with a wavelength of 1.8 μm and an intensity of 1 × 1015 W/cm2, whereas only electrons below 500 eV are observed at 800 nm using a similar intensity and pulse duration. Fast electrons are preferentially emitted along the laser polarization direction, showing that they are driven out from the cluster by the laser field. In addition to direct electron emission, an electron rescattering plateau is observed. Scaling to even longer wavelengths is expected to result in a highly directional current of energetic electrons on a few-femtosecond timescale. PMID:28009012

Automatic Realistic Real Time Stimulation/Recording in Weakly Electric Fish: Long Time Behavior Characterization in Freely Swimming Fish and Stimuli Discrimination

PubMed Central

Forlim, Caroline G.; Pinto, Reynaldo D.

2014-01-01

Weakly electric fish are unique model systems in neuroethology, that allow experimentalists to non-invasively, access, central nervous system generated spatio-temporal electric patterns of pulses with roles in at least 2 complex and incompletely understood abilities: electrocommunication and electrolocation. Pulse-type electric fish alter their inter pulse intervals (IPIs) according to different behavioral contexts as aggression, hiding and mating. Nevertheless, only a few behavioral studies comparing the influence of different stimuli IPIs in the fish electric response have been conducted. We developed an apparatus that allows real time automatic realistic stimulation and simultaneous recording of electric pulses in freely moving Gymnotus carapo for several days. We detected and recorded pulse timestamps independently of the fish’s position for days. A stimulus fish was mimicked by a dipole electrode that reproduced the voltage time series of real conspecific according to previously recorded timestamp sequences. We characterized fish behavior and the eletrocommunication in 2 conditions: stimulated by IPIs pre-recorded from other fish and random IPI ones. All stimuli pulses had the exact Gymontus carapo waveform. All fish presented a surprisingly long transient exploratory behavior (more than 8 h) when exposed to a new environment in the absence of electrical stimuli. Further, we also show that fish are able to discriminate between real and random stimuli distributions by changing several characteristics of their IPI distribution. PMID:24400122

Design, fabrication, and performance testing of a vacuum chamber for pulse compressor of a 150 TW Ti:sapphire laser

NASA Astrophysics Data System (ADS)

Tripathi, P. K.; Singh, Rajvir; Bhatnagar, V. K.; Sharma, S. D.; Sharma, Sanjay; Sisodia, B.; Yedle, K.; Kushwaha, R. P.; Sebastin, S.; Mundra, G.

2012-11-01

A vacuum chamber, to house the optical pulse compressor of a 150 TW Ti:sapphire laser system, has been designed, fabricated, and tested. As the intensity of the laser pulse becomes very high after pulse compression, there is phase distortion of the laser beam in air. Hence, the beam (after pulse compression) has to be transported in vacuum to avoid this distortion, which affects the laser beam focusability. A breadboard with optical gratings and reflective optics for compression of the optical pulse has to be kept inside the chamber. The chamber is made of SS 316L material in cuboidal shape with inside dimensions 1370×1030×650 mm3, with rectangular and circular demountable ports for entry and exit of the laser beam, evacuation, system cables, and ports to access optics mounted inside the chamber. The front and back sides of the chamber are kept demountable in order to insert the breadboard with optical components mounted on it. Leak tightness of 9×10-9 mbar-lit/sec in all the joints and ultimate vacuum of 6.5×10-6 mbar was achieved in the chamber using a turbo molecular pumping system. The paper describe details of the design/ features of the chamber, important procedure involved in machining, fabrication, processing and final testing.

Multiple core-hole formation by free-electron laser radiation in molecular nitrogen

NASA Astrophysics Data System (ADS)

Banks, H. I. B.; Little, D. A.; Emmanouilidou, A.

2018-05-01

We investigate the formation of multiple-core-hole states of molecular nitrogen interacting with a free-electron laser pulse. In previous work, we obtained bound and continuum molecular orbitals in the single-center expansion scheme and used these orbitals to calculate photo-ionization and auger decay rates. We extend our formulation to track the proportion of the population that accesses single-site versus two-site double-core-hole (TSDCH) states, before the formation of the final atomic ions. We investigate the pulse parameters that favor the formation of the single-site and TSDCH as well as triple-core-hole states for 525 and 1100 eV photons.

Disturbance characteristics of half-selected cells in a cross-point resistive switching memory array

NASA Astrophysics Data System (ADS)

Chen, Zhe; Li, Haitong; Chen, Hong-Yu; Chen, Bing; Liu, Rui; Huang, Peng; Zhang, Feifei; Jiang, Zizhen; Ye, Hongfei; Gao, Bin; Liu, Lifeng; Liu, Xiaoyan; Kang, Jinfeng; Wong, H.-S. Philip; Yu, Shimeng

2016-05-01

Disturbance characteristics of cross-point resistive random access memory (RRAM) arrays are comprehensively studied in this paper. An analytical model is developed to quantify the number of pulses (#Pulse) the cell can bear before disturbance occurs under various sub-switching voltage stresses based on physical understanding. An evaluation methodology is proposed to assess the disturb behavior of half-selected (HS) cells in cross-point RRAM arrays by combining the analytical model and SPICE simulation. The characteristics of cross-point RRAM arrays such as energy consumption, reliable operating cycles and total error bits are evaluated by the methodology. A possible solution to mitigate disturbance is proposed.

Processing and properties of Pb(Mg(1/3)Nb(2/3))O3--PbTiO3 thin films by pulsed laser deposition

NASA Astrophysics Data System (ADS)

Tantigate, C.; Lee, J.; Safari, A.

1995-03-01

The objectives of this study were to prepare in situ Pb(Mg(1/3)Nb(2/3))O3 (PMN) and PMN-PT thin films by pulsed laser deposition and to investigate the electrical features of thin films for possible dynamic random access memory (DRAM) and microactuator applications. The impact of processing parameters such compositions, substrate temperature, and oxygen pressure on perovskite phase formation and dielectric characteristics were reported. It was found that the highest dielectric constant, measured at room temperature and 10 kHz, was attained from the PMN with 99% perovskite.

Real-Time Observation of Internal Motion within Ultrafast Dissipative Optical Soliton Molecules

NASA Astrophysics Data System (ADS)

Krupa, Katarzyna; Nithyanandan, K.; Andral, Ugo; Tchofo-Dinda, Patrice; Grelu, Philippe

2017-06-01

Real-time access to the internal ultrafast dynamics of complex dissipative optical systems opens new explorations of pulse-pulse interactions and dynamic patterns. We present the first direct experimental evidence of the internal motion of a dissipative optical soliton molecule generated in a passively mode-locked erbium-doped fiber laser. We map the internal motion of a soliton pair molecule by using a dispersive Fourier-transform imaging technique, revealing different categories of internal pulsations, including vibrationlike and phase drifting dynamics. Our experiments agree well with numerical predictions and bring insights to the analogy between self-organized states of lights and states of the matter.

Accessible solitons of fractional dimension

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhong, Wei-Ping, E-mail: zhongwp6@126.com; Texas A&M University at Qatar, P.O. Box 23874, Doha; Belić, Milivoj

We demonstrate that accessible solitons described by an extended Schrödinger equation with the Laplacian of fractional dimension can exist in strongly nonlocal nonlinear media. The soliton solutions of the model are constructed by two special functions, the associated Legendre polynomials and the Laguerre polynomials in the fraction-dimensional space. Our results show that these fractional accessible solitons form a soliton family which includes crescent solitons, and asymmetric single-layer and multi-layer necklace solitons. -- Highlights: •Analytic solutions of a fractional Schrödinger equation are obtained. •The solutions are produced by means of self-similar method applied to the fractional Schrödinger equation with parabolic potential.more » •The fractional accessible solitons form crescent, asymmetric single-layer and multilayer necklace profiles. •The model applies to the propagation of optical pulses in strongly nonlocal nonlinear media.« less

2D IR Spectroscopy using Four-Wave Mixing, Pulse Shaping, and IR Upconversion: A Quantitative Comparison

PubMed Central

Rock, William; Li, Yun-Liang; Pagano, Philip; Cheatum, Christopher M.

2013-01-01

Recent technological advances have led to major changes in the apparatuses used to collect 2D IR spectra. Pulse shaping offers several advantages including rapid data collection, inherent phase stability, and phase cycling capabilities. Visible array detection via upconversion allows the use of visible detectors that are cheaper, faster, more sensitive, and less noisy than IR detectors. However, despite these advantages, many researchers are reluctant to implement these technologies. Here we present a quantitative study of the S/N of 2D IR spectra collected with a traditional four-wave mixing (FWM) apparatus, with a pulse shaping apparatus, and with visible detection via upconversion to address the question of whether or not weak chromophores at low concentrations are still accessible with such an apparatus. We find that the enhanced averaging capability of the pulse shaping apparatus enables the detection of small signals that would be challenging to measure even with the traditional FWM apparatus, and we demonstrate this ability on a sample of cyanylated dihydrofolate reductase (DHFR). PMID:23687988

Electro-optic sampling of near-infrared waveforms

NASA Astrophysics Data System (ADS)

Keiber, Sabine; Sederberg, Shawn; Schwarz, Alexander; Trubetskov, Michael; Pervak, Volodymyr; Krausz, Ferenc; Karpowicz, Nicholas

2016-03-01

Access to the complete electric field evolution of a laser pulse is essential for attosecond science in general, and for the scrutiny and control of electron phenomena in solid-state physics specifically. Time-resolved field measurements are routine in the terahertz spectral range, using electro-optic sampling (EOS), photoconductive switches and field-induced second harmonic generation. EOS in particular features outstanding sensitivity and ease of use, making it the basis of time-resolved spectroscopic measurements for studying charge carrier dynamics and active optical devices. In this Letter, we show that careful optical filtering allows the bandwidth of this technique to be extended to wavelengths as short as 1.2 μm (230 THz) with half-cycle durations 2.3 times shorter than the sampling pulse. In a proof-of-principle application, we measure the influence of optical parametric amplification (OPA) on the electric field dynamics of a few-cycle near-infrared (NIR) pulse.

Front-surface fabrication of moderate aspect ratio micro-channels in fused silica by single picosecond Gaussian-Bessel laser pulse

NASA Astrophysics Data System (ADS)

Liu, Xin; Sanner, Nicolas; Sentis, Marc; Stoian, Razvan; Zhao, Wei; Cheng, Guanghua; Utéza, Olivier

2018-02-01

Single-shot Gaussian-Bessel laser beams of 1 ps pulse duration and of 0.9 μm core size and 60 μm depth of focus are used for drilling micro-channels on front side of fused silica in ambient condition. Channels ablated at different pulse energies are fully characterized by AFM and post-processing polishing procedures. We identify experimental energy conditions (typically 1.5 µJ) suitable to fabricate non-tapered channels with mean diameter of 1.2 µm and length of 40 μm while maintaining an utmost quality of the front opening of the channels. In addition, by further applying accurate post-polishing procedure, channels with high surface quality and moderate aspect ratio down to a few units are accessible, which would find interest in the surface micro-structuring of materials, with perspective of further scalability to meta-material specifications.

Developments in fiber optics for distribution automation

NASA Technical Reports Server (NTRS)

Kirkham, H.; Friend, H.; Jackson, S.; Johnston, A.

1991-01-01

An optical fiber based communications system of unusual design is described. The system consists of a network of optical fibers overlaid on the distribution system. It is configured as a large number of interconnected rings, with some spurs. Protocols for access to and control of the network are described. Because of the way they function, the protocols are collectively called AbNET, in commemoration of the microbiologists' abbreviation Ab for antibody. Optical data links that could be optically powered are described. There are two versions, each of which has a good frequency response and minimal filtering requirements. In one, a conventional FM pulse train is used at the transmitter, and a novel form of phase-locked loop is used as demodulator. In the other, the FM transmitter is replaced with a pulse generator arranged so that the period between pulses represents the modulating signal. Transmitter and receiver designs, including temperature compensation methods, are presented. Experimental results are given.

Attosecond Streaking in the Water Window: A New Regime of Attosecond Pulse Characterization

NASA Astrophysics Data System (ADS)

Cousin, Seth L.; Di Palo, Nicola; Buades, Bárbara; Teichmann, Stephan M.; Reduzzi, M.; Devetta, M.; Kheifets, A.; Sansone, G.; Biegert, Jens

2017-10-01

We report on the first streaking measurement of water-window attosecond pulses generated via high-harmonic generation, driven by sub-2-cycle, carrier-to-envelope-phase-stable, 1850-nm laser pulses. Both the central photon energy and the energy bandwidth far exceed what has been demonstrated thus far, warranting the investigation of the attosecond streaking technique for the soft-x-ray regime and the limits of the frogcrab retrieval algorithm under such conditions. We also discuss the problem of attochirp compensation and issues regarding much lower photoionization cross sections compared with the extreme ultraviolet in addition to the fact that several shells of target gases are accessed simultaneously. Based on our investigation, we caution that the vastly different conditions in the soft-x-ray regime warrant a diligent examination of the fidelity of the measurement and the retrieval procedure.

Method and apparatus for active tamper indicating device using optical time-domain reflectometry

DOEpatents

Smith, D. Barton; Muhs, Jeffrey D.; Pickett, Chris A.; Earl, D. Duncan

1999-01-01

An optical time-domain reflectometer (OTDR) launches pulses of light into a link or a system of multiplexed links and records the waveform of pulses reflected by the seals in the link(s). If a seal is opened, the link of cables will become a discontinuous transmitter of the light pulses and the OTDR can immediately detect that a seal has been opened. By analyzing the waveform, the OTDR can also quickly determine which seal(s) were opened. In this way the invention functions as a system of active seals. The invention is intended for applications that require long-term surveillance of a large number of closures. It provides immediate tamper detection, allows for periodic access to secured closures, and can be configured for many different distributions of closures. It can monitor closures in indoor and outdoor locations and it can monitor containers or groups of containers located many kilometers apart.

Unsplit bipolar pulse forming line

DOEpatents

Rhodes, Mark A [Pleasanton, CA

2011-05-24

A bipolar pulse forming transmission line module and system for linear induction accelerators having first, second, third, and fourth planar conductors which form a sequentially arranged interleaved stack having opposing first and second ends, with dielectric layers between the conductors. The first and second planar conductors are connected to each other at the first end, and the first and fourth planar conductors are connected to each other at the second end via a shorting plate. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short at the first end a high voltage from the third planar conductor to the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

Predictive value of auscultation of femoropopliteal arteries.

PubMed

Kaufmann, Carla; Jacomella, Vincenzo; Kovacicova, Ludmila; Husmann, Marc; Clemens, Robert K; Thalhammer, Christopf; Amann-Vesti, Beatrice R

2013-03-05

Femoropopliteal bruits indicate flow turbulences and increased blood flow velocity, usually caused by an atherosclerotic plaque or stenosis. No data exist on the quality of bruits as a means for quantifying the degree of stenosis. We therefore conducted a prospective observational study to investigate the sensitivity and specificity of femoropopliteal auscultation, differentiated on the basis of bruit quality, to detect and quantify clinically relevant stenoses in patients with symptomatic and asymptomatic peripheral arterial disease (PAD). Patients with known chronic and stable PAD were recruited in the outpatient clinic. We included patients with known PAD and an ankle-brachial index (ABI) <0.90 and/or an ABI ≥0.90 with a history of lower limb revascularisation. Auscultation was performed independently by three investigators with varied clinical experience after a 10-minute period of rest. Femoropopliteal lesions were classified as follows: normal vessel wall or slight wall thickening (<20%), atherosclerotic plaque with below 50% reduction of the vessel lumen, prestenotic/intrastenotic ratio over 2.5 (<70%), over 3.5 (<99%) and complete occlusion (100%). Weighted Cohen's κ coefficients for differentiated auscultation were low in all vascular regions and did not differ between investigators. Sensitivity was low in most areas with an increase after exercise. The highest sensitivity in detecting relevant (>50%) stenosis was found in the common femoral artery (86%). Vascular auscultation is known to be of great use in routine clinical practice in recognising arterial abnormalities. Diagnosis of PAD is based on various diagnostic tools (pulse palpation, ABI measurement) and auscultation can localise relevant stenosis. However, auscultation alone is of limited sensitivity and specificity in grading stenosis in femoropopliteal arteries. Where PAD is clinically suspected further diagnostic tools, especially colour-coded duplex ultrasound, should be employed to quantify the underlying lesion.

A physical map, including a BAC/PAC clone contig, of the Williams-Beuren syndrome--deletion region at 7q11.23.

PubMed

Peoples, R; Franke, Y; Wang, Y K; Pérez-Jurado, L; Paperna, T; Cisco, M; Francke, U

2000-01-01

Williams-Beuren syndrome (WBS) is a developmental disorder caused by haploinsufficiency for genes in a 2-cM region of chromosome band 7q11.23. With the exception of vascular stenoses due to deletion of the elastin gene, the various features of WBS have not yet been attributed to specific genes. Although >/=16 genes have been identified within the WBS deletion, completion of a physical map of the region has been difficult because of the large duplicated regions flanking the deletion. We present a physical map of the WBS deletion and flanking regions, based on assembly of a bacterial artificial chromosome/P1-derived artificial chromosome contig, analysis of high-throughput genome-sequence data, and long-range restriction mapping of genomic and cloned DNA by pulsed-field gel electrophoresis. Our map encompasses 3 Mb, including 1.6 Mb within the deletion. Two large duplicons, flanking the deletion, of >/=320 kb contain unique sequence elements from the internal border regions of the deletion, such as sequences from GTF2I (telomeric) and FKBP6 (centromeric). A third copy of this duplicon exists in inverted orientation distal to the telomeric flanking one. These duplicons show stronger sequence conservation with regard to each other than to the presumptive ancestral loci within the common deletion region. Sequence elements originating from beyond 7q11.23 are also present in these duplicons. Although the duplicons are not present in mice, the order of the single-copy genes in the conserved syntenic region of mouse chromosome 5 is inverted relative to the human map. A model is presented for a mechanism of WBS-deletion formation, based on the orientation of duplicons' components relative to each other and to the ancestral elements within the deletion region.

Time-resolved MR angiography of renal artery stenosis in a swine model at 3 Tesla using gadobutrol with digital subtraction angiography correlation.

PubMed

Morelli, John N; Ai, Fei; Runge, Val M; Zhang, Wei; Li, Xiaoming; Schmitt, Peter; McNeal, Gary; Michaely, Henrick J; Schoenberg, Stefan O; Miller, Matthew; Gerdes, Clint M; Sincleair, Spencer T; Spratt, Heidi; Attenberger, Ulrike I

2012-09-01

To establish the minimum dose required for detection of renal artery stenosis using high temporal resolution, contrast enhanced MR angiography (MRA) in a porcine model. Surgically created renal artery stenoses were imaged with 3 Tesla MR and digital subtraction angiography (DSA) in 12 swine in this IACUC approved protocol. Gadobutrol was injected intravenously at doses of 0.5, 1, 2, and 4 mL for time-resolved MRA (1.5 × 1.5 mm(2) spatial resolution). Region of interest analysis was performed together with stenosis assessment and qualitative evaluation by two blinded readers. Mean signal to noise ratio (SNR) and contrast to noise ratio (CNR) values were statistically significantly less with the 0.5-mL protocol (P < 0.001). There were no statistically significant differences among the other evaluated doses. Both readers found 10/12 cases with the 0.5-mL protocol to be of inadequate diagnostic quality (κ = 1.0). All other scans were found to be adequate for diagnosis. Accuracies in distinguishing between mild/insignificant (<50%) and higher grade stenoses (>50%) were comparable among the higher-dose protocols (sensitivities 73-93%, specificities 62-100%). Renal artery stenosis can be assessed with very low doses (~0.025 mmol/kg bodyweight) of a high concentration, high relaxivity gadolinium chelate formulation in a swine model, results which are promising with respect to limiting exposure to gadolinium based contrast agents. Copyright © 2012 Wiley Periodicals, Inc.

Metallic stents for tracheobronchial pathology treatment.

PubMed

Serrano, Carolina; Laborda, Alicia; Lozano, Juan M; Caballero, Hugo; Sebastián, Antonio; Lopera, Jorge; de Gregorio, Miguel Ángel

2013-12-01

To present the 7-year experience of the treatment of benign and malignant tracheobronchial stenoses using metallic stents. One hundred twenty-three stents were inserted in 86 patients (74 benign and 12 malignant stenoses). Ninety-seven stents were placed in the trachea and 26 in the bronchi. The procedures were performed under fluoroscopic and flexible bronchoscopic guidance with the patient under light sedation. In cases of severe stenotic lesions or obstructions, laser resection was performed before stent placement. Clinical and functional pulmonary data were recorded before and 3 months after the procedure. Follow-up involved clinical data and radiographic techniques at 48 h and at 1-, 3-, 6-, and 12-month intervals. The technical success was 100 %. Dyspnea disappearance, forced expiratory volume in the first second, and pulmonary functional data improvement was observed in all patients (p < 0.001). Complications were detected in 23 patients (26.7 %). Mean follow-up time was 6.3 ± 1.2 months in patients with malignant lesions and 76.2 ± 2.3 months patients with in benign lesions. By the end of the study, 100 % of patients with malignant pathology and 6.7 % of patients with benign lesions had died. Endoluminal treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients who are poor candidates for surgery. In unresectable malignant lesions, the benefit of metallic stenting is unquestionable. In benign lesions, the results are satisfactory, but sometimes other interventions are required to treat complications. New stent technology may improve these results.

Automated quantification of myocardial perfusion SPECT using simplified normal limits.

PubMed

Slomka, Piotr J; Nishina, Hidetaka; Berman, Daniel S; Akincioglu, Cigdem; Abidov, Aiden; Friedman, John D; Hayes, Sean W; Germano, Guido

2005-01-01

To simplify development of normal limits for myocardial perfusion SPECT (MPS), we implemented a quantification scheme in which normal limits are derived without visual scoring of abnormal scans or optimization of regional thresholds. Normal limits were derived from same-day TI-201 rest/Tc-99m-sestamibi stress scans of male (n = 40) and female (n = 40) low-likelihood patients. Defect extent, total perfusion deficit (TPD), and regional perfusion extents were derived by comparison to normal limits in polar-map coordinates. MPS scans from 256 consecutive patients without known coronary artery disease, who underwent coronary angiography, were analyzed. The new method of quantification (TPD) was compared with our previously developed quantification system and visual scoring. The receiver operator characteristic area under the curve for detection of 50% or greater stenoses by TPD (0.88 +/- 0.02) was higher than by visual scoring (0.83 +/- 0.03) ( P = .039) or standard quantification (0.82 +/- 0.03) ( P = .004). For detection of 70% or greater stenoses, it was higher for TPD (0.89 +/- 0.02) than for standard quantification (0.85 +/- 0.02) ( P = .014). Sensitivity and specificity were 93% and 79%, respectively, for TPD; 81% and 85%, respectively, for visual scoring; and 80% and 73%, respectively, for standard quantification. The use of stress mode-specific normal limits did not improve performance. Simplified quantification achieves performance better than or equivalent to visual scoring or quantification based on per-segment visual optimization of abnormality thresholds.

Prevalence and severity of coronary artery disease in diabetic patients with aortic valve calcification.

PubMed

Chen, Zhang-wei; Qian, Ju-ying; Jian, Ying; Ge, Lei; Liu, Xue-bo; Shu, Xian-hong; Ge, Junbo

2011-02-01

Aortic valve calcification (AVC) is common in the elderly and associated with increased cardiovascular mortality, while diabetes is one of the confirmed risk factors for coronary artery disease (CAD). In this study, we aimed to evaluate the prevalence and severity of CAD in type-2 diabetic patients with AVC. From June to December in 2007, a total of 325 consecutive patients with chest pain or chest distress were admitted for coronary angiography. The severity of CAD was evaluated by the Gensini score and the number of stenosed vessels. All patients underwent transthoracic echocardiography for detecting AVC. Compared with the patients without diabetes (n = 221), the type-2 diabetic patients (n = 104) had a similar prevalence of CAD (66.5% vs. 72.1%, P = 0.312). Further classified by the presence of AVC, patients with AVC had a higher prevalence of CAD, average Gensini score and the number of stenosed vessels, both in the group with and without diabetes. It was also demonstrated that the odds ratio (OR) of AVC for CAD in the diabetic patients was higher than in the non-diabetic ones (3.405 vs 2.515) after chi-square analysis (single-variable). However, at multivariable logistic regression analysis for CAD, the OR of AVC was 3.757 (P = 0.03) in diabetic group, while it did not achieve statistical significance in the non-diabetic group (OR = 2.130, P= 0.074). Type-2 diabetic patients with AVC had a higher prevalence of and more severe CAD.

A novel patient-specific model to compute coronary fractional flow reserve.

PubMed

Kwon, Soon-Sung; Chung, Eui-Chul; Park, Jin-Seo; Kim, Gook-Tae; Kim, Jun-Woo; Kim, Keun-Hong; Shin, Eun-Seok; Shim, Eun Bo

2014-09-01

The fractional flow reserve (FFR) is a widely used clinical index to evaluate the functional severity of coronary stenosis. A computer simulation method based on patients' computed tomography (CT) data is a plausible non-invasive approach for computing the FFR. This method can provide a detailed solution for the stenosed coronary hemodynamics by coupling computational fluid dynamics (CFD) with the lumped parameter model (LPM) of the cardiovascular system. In this work, we have implemented a simple computational method to compute the FFR. As this method uses only coronary arteries for the CFD model and includes only the LPM of the coronary vascular system, it provides simpler boundary conditions for the coronary geometry and is computationally more efficient than existing approaches. To test the efficacy of this method, we simulated a three-dimensional straight vessel using CFD coupled with the LPM. The computed results were compared with those of the LPM. To validate this method in terms of clinically realistic geometry, a patient-specific model of stenosed coronary arteries was constructed from CT images, and the computed FFR was compared with clinically measured results. We evaluated the effect of a model aorta on the computed FFR and compared this with a model without the aorta. Computationally, the model without the aorta was more efficient than that with the aorta, reducing the CPU time required for computing a cardiac cycle to 43.4%. Copyright © 2014. Published by Elsevier Ltd.

Do we need invasive confirmation of cardiac magnetic resonance results?

PubMed

Siastała, Paweł; Kądziela, Jacek; Małek, Łukasz A; Śpiewak, Mateusz; Lech, Katarzyna; Witkowski, Adam

2017-01-01

Coronary artery revascularization is indicated in patients with documented significant obstruction of coronary blood flow associated with a large area of myocardial ischemia and/or untreatable symptoms. There are a few invasive or noninvasive methods that can provide information about the functional results of coronary artery narrowing. The application of more than one method of ischemia detection in one patient to reevaluate the indications for revascularization is used in case of atypical or no symptoms and/or borderline stenosis. To evaluate whether the results of cardiac magnetic resonance need to be reconfirmed by the invasive functional method. The hospital database revealed 25 consecutive patients with 29 stenoses who underwent cardiac magnetic resonance (CMR) and fractional flow reserve (FFR) between the end of 2010 and the end of 2014. The maximal time interval between CMR and FFR was 6 months. None of the patients experienced any clinical events or underwent procedures on coronary arteries between the studies. According to the analysis, the agreement of CMR perfusion with the FFR method was at the level of 89.7%. Assuming that FFR is the gold standard in assessing the severity of stenoses, the sensitivity of CMR perfusion was 90.9%. The percentage of non-severe lesions which were correctly identified in CMR was 88.9%. The study shows that CMR perfusion is a highly sensitive method to detect hemodynamically significant CAD and exclude nonsevere lesions. With FFR as the reference standard, the diagnostic accuracy of MR perfusion to detect ischemic CAD is high.

[Actual review of diagnostics and endovascular therapy of intracranial arterial stenoses].

PubMed

Gizewski, E R; Weber, R; Forsting, M

2011-02-01

Approximately 6 - 50% of all ischemic strokes are caused by intracranial arterial stenosis (IAS). Despite medical prevention, patients with symptomatic IAS have a high annual risk for recurrent ischemic stroke of about 12%, and up to 19% in the case of high-grade IAS (≥ 70%). Digital subtraction angiography remains the gold standard for the diagnosis and grading of IAS. However, noninvasive imaging techniques including CT angiography, MR angiography, or transcranial Doppler and duplex ultrasound examinations are used in the clinical routine to provide additional information about the brain structure and hemodynamic. However, for technical reasons, the grading of stenoses is sometimes difficult and inaccurate. To date, aspirin is recommended as the treatment of choice in the prevention of recurrent ischemic stroke in patients with IAS. IAS patients who suffer a recurrent ischemic stroke or transient ischemic attack while taking aspirin can be treated with endovascular stenting or angioplasty in specialized centers. The periprocedural complication rate of these endovascular techniques is about 2 - 7% at experienced neuro-interventional centers. The rate of re-stenosis is reported between 10 and 40% depending on patient age and stenosis location. Further randomized studies comparing medical secondary prevention and endovascular therapy are currently being performed. With regard to the improvement of endovascular methods and lower complication rates, the indication for endovascular therapy in IAS could be broadened especially for stenosis in the posterior circulation. © Georg Thieme Verlag KG Stuttgart · New York.

Aneurysm flow characteristics in realistic carotid artery aneurysm models induced by proximal virtual stenotic plaques: a computational hemodynamics study

NASA Astrophysics Data System (ADS)

Castro, Marcelo A.; Peloc, Nora L.; Chien, Aichi; Goldberg, Ezequiel; Putman, Christopher M.; Cebral, Juan R.

2015-03-01

Cerebral aneurysms may rarely coexist with a proximal artery stenosis. In that small percent of patients, such coexistence poses a challenge for interventional neuroradiologists and neurosurgeons to make the best treatment decision. According to previous studies, the incidence of cerebral aneurysms in patients with internal carotid artery stenosis is no greater than five percent, where the aneurysm is usually incidentally detected, being about two percent for aneurysms and stenoses in the same cerebral circulation. Those cases pose a difficult management decision for the physician. Case reports showed patients who died due to aneurysm rupture months after endarterectomy but before aneurysm clipping, while others did not show any change in the aneurysm after plaque removal, having optimum outcome after aneurysm coiling. The aim of this study is to investigate the intra-aneurysmal hemodynamic changes before and after treatment of stenotic plaque. Virtually created moderate stenoses in vascular models of internal carotid artery aneurysm patients were considered in a number of cases reconstructed from three dimensional rotational angiography images. The strategy to create those plaques was based on parameters analyzed in a previous work where idealized models were considered, including relative distance and stenosis grade. Ipsilateral and contralateral plaques were modeled. Wall shear stress and velocity pattern were computed from finite element pulsatile blood flow simulations. The results may suggest that wall shear stress changes depend on relative angular position between the aneurysm and the plaque.

The Effectiveness of Corticosteroid Injection for De Quervain’s Stenosing Tenosynovitis (DQST): A Systematic Review and Meta-Analysis

PubMed Central

Rowland, Patrick; Phelan, Nigel; Gardiner, Sean; Linton, Kenneth N; Galvin, Rose

2015-01-01

De Quervain’s stenosing tenosynovitis (DQST) treatments include corticosteroid injection around the tendon sheath; however there is some ambiguity concerning the efficacy of this treatment. The aim of this systematic review and meta-analysis is to examine the totality of evidence relating to the use of corticosteroid injection in DQST when compared to placebo or other active treatments. A systematic literature search was conducted in July 2014. Only randomized control trials (RCTs) were included. Outcome measures included impairment, activity limitation and participation restriction. Five RCTs were identified with 165 patients, 88 in the treatment group and 77 in the control group. Patients who received corticosteroid injection (n=142) had a higher rate of resolution of symptoms [RR 2.59, 95% CI: 1.25 to 5.37, p=0.05, I2=62%]. This group reported greater pain relief as assessed by Visual Analogue Scale (VAS) at first assessment [mean difference -2.51, 95% CI: -3.11 to -1.90, p=0.0003, I2=65%] and demonstrated a statistically significant improvement in function (n=78) as measured by the DASH score and Dutch AIMS-HFF score [SMD -0.83, 95% CI: -1.54 to -0.12, p=0.02, I2=48]. This review confirms that corticosteroid injection results in a statistically significant increase in resolution of symptoms, pain relief and increased function in the treatment of DQST. PMID:26587059

Type-I frequency-doubling characteristics of high-power, ultrafast fiber laser in thick BIBO crystal.

PubMed

Chaitanya N, Apurv; Aadhi, A; Singh, R P; Samanta, G K

2014-09-15

We report on experimental realization of optimum focusing condition for type-I second-harmonic generation (SHG) of high-power, ultrafast laser in "thick" nonlinear crystal. Using single-pass, frequency doubling of a 5 W Yb-fiber laser of pulse width ~260 fs at repetition rate of 78 MHz in a 5-mm-long bismuth triborate (BIBO) crystal we observed that the optimum focusing condition is more dependent on the birefringence of the crystal than its group-velocity mismatch (GVM). A theoretical fit to our experimental results reveals that even in the presence of GVM, the optimum focusing condition matches the theoretical model of Boyd and Kleinman, predicted for continuous-wave and long-pulse SHG. Using a focusing factor of ξ=1.16 close to the estimated optimum value of ξ=1.72 for our experimental conditions, we generated 2.25 W of green radiation of pulse width 176 fs with single-pass conversion efficiency as high as 46.5%. Our study also verifies the effect of pulse narrowing and broadening of angular phase-matching bandwidth of SHG at tighter focusing. This study signifies the advantage of SHG in "thick" crystal in controlling SH-pulse width by changing the focusing lens while accessing high conversion efficiency and broad angular phase-matching bandwidth.

Noncollinear wave mixing of attosecond XUV and few-cycle optical laser pulses in gas-phase atoms: Toward multidimensional spectroscopy involving XUV excitations

NASA Astrophysics Data System (ADS)

Cao, Wei; Warrick, Erika R.; Fidler, Ashley; Neumark, Daniel M.; Leone, Stephen R.

2016-11-01

Ultrafast nonlinear spectroscopy, which records transient wave-mixing signals in a medium, is a powerful tool to access microscopic information using light sources in the radio-frequency and optical regimes. The extension of this technique towards the extreme ultraviolet (XUV) or even x-ray regimes holds the promise to uncover rich structural or dynamical information with even higher spatial or temporal resolution. Here, we demonstrate noncollinear wave mixing between weak XUV attosecond pulses and a strong near-infrared (NIR) few-cycle laser pulse in gas phase atoms (one photon of XUV and two photons of NIR). In the noncollinear geometry the attosecond and either one or two NIR pulses interact with argon atoms. Nonlinear XUV signals are generated in a spatially resolved fashion as required by phase matching. Different transition pathways can be identified from these background-free nonlinear signals according to the specific phase-matching conditions. Time-resolved measurements of the spatially gated XUV signals reveal electronic coherences of Rydberg wave packets prepared by a single XUV photon or XUV-NIR two-photon excitation, depending on the applied pulse sequences. These measurements open possible applications of tabletop multidimensional spectroscopy to the study of dynamics associated with valence or core excitation with XUV photons.

Ultrafast photo-induced hidden phases in strained manganite thin films

NASA Astrophysics Data System (ADS)

Zhang, Jingdi; McLeod, A. S.; Zhang, Gu-Feng; Stoica, Vladimir; Jin, Feng; Gu, Mingqiang; Gopalan, Venkatraman; Freeland, John W.; Wu, Wenbin; Rondinelli, James; Wen, Haidan; Basov, D. N.; Averitt, R. D.

Correlated transition metal oxides (TMOs) are particularly sensitive to external control because of energy degeneracy in a complex energy landscape that promote a plethora of metastable states. However, it remains a grand challenge to actively control and fully explore the rich landscape of TMOs. Dynamic control with pulsed photons can overcome energetic barriers, enabling access to transient or metastable states that are not thermally accessible. In the past, we have demonstrated that mode-selective single-laser-pulse excitation of a strained manganite thin film La2/3Ca1/3MnO3 initiates a persistent phase transition from an emergent antiferromagnetic insulating ground state to a ferromagnetic metallic metastable state. Beyond the photo-induced insulator to metal transition, we recently discovered a new peculiar photo-induced hidden phase, identified by an experimental approach that combines ultrafast pump-probe spectroscopy, THz spectroscopy, X-ray diffraction, cryogenic near-field spectroscopy and SHG probe. This work is funded by the DOE, Office of Science, Office of Basic Energy Science under Award Numbers DE-SC0012375 and DE-SC0012592.

Simultaneous 10 Gbps data and polarization-based pulse-per-second clock transmission using a single VCSEL for high-speed optical fibre access networks

NASA Astrophysics Data System (ADS)

Isoe, G. M.; Wassin, S.; Gamatham, R. R. G.; Leitch, A. W. R.; Gibbon, T. B.

2017-01-01

Access networks based on vertical cavity surface emitting laser (VCSEL) transmitters offer alternative solution in delivering different high bandwidth, cost effective services to the customer premises. Clock and reference frequency distribution is critical for applications such as Coordinated Universal Time (UTC), GPS, banking and big data science projects. Simultaneous distribution of both data and timing signals over shared infrastructure is thus desirable. In this paper, we propose and experimentally demonstrate a novel, cost-effective technique for multi-signal modulation on a single VCSEL transmitter. Two signal types, an intensity modulated 10 Gbps data signal and a polarization-based pulse per second (PPS) clock signal are directly modulated onto a single VCSEL carrier at 1310 nm. Spectral efficiency is maximized by exploiting inherent orthogonal polarization switching of the VCSEL with changing bias in transmission of the PPS signal. A 10 Gbps VCSEL transmission with PPS over 11 km of G.652 fibre introduced a transmission penalty of 0.52 dB. The contribution of PPS to this penalty was found to be 0.08 dB.

The NOD2 p.Leu1007fsX1008 Mutation (rs2066847) Is a Stronger Predictor of the Clinical Course of Crohn's Disease than the FOXO3A Intron Variant rs12212067

PubMed Central

Wolf, Christiane; Angelberger, Marianne; Diegelmann, Julia; Olszak, Torsten; Beigel, Florian; Tillack, Cornelia; Stallhofer, Johannes; Göke, Burkhard; Glas, Jürgen; Lohse, Peter; Brand, Stephan

2014-01-01

Background Very recently, a sub-analysis of genome-wide association scans revealed that the non-coding single nucleotide polymorphism (SNP) rs12212067 in the FOXO3A gene is associated with a milder course of Crohn's disease (CD) (Cell 2013;155:57–69). The aim of our study was to evaluate the clinical value of the SNP rs12212067 in predicting the severity of CD by correlating CD patient genotype status with the most relevant complications of CD such as stenoses, fistulas, and CD-related surgery. Methodology/Principal Findings We genotyped 550 CD patients for rs12212067 (FOXO3A) and the three common CD-associated NOD2 mutations rs2066844, rs2066847, and rs2066847 and performed genotype-phenotype analyses. Results No significant phenotypic differences were found between the wild-type genotype TT of the FOXO3A SNP rs12212067 and the minor genotypes TG and GG independently from NOD2 variants. The allele frequency of the minor G allele was 12.7%. Age at diagnosis, disease duration, body mass index, surgery rate, stenoses, fistula, need for immunosuppressive therapy, and disease course were not significantly different. In contrast, the NOD2 mutant p.Leu1007fsX1008 (rs2066847) was highly associated with penetrating CD (p = 0.01), the development of fistulas (p = 0.01) and stenoses (p = 0.01), and ileal disease localization (p = 0.03). Importantly, the NOD2 SNP rs2066847 was a strong separator between an aggressive and a mild course of CD (p = 2.99×10−5), while the FOXO3A SNP rs12212067 did not separate between mild and aggressive CD behavior in our cohort (p = 0.35). 96.2% of the homozygous NOD2 p.Leu1007fsX1008 carriers had an aggressive disease behavior compared to 69.3% of the patients with the NOD2 wild-type genotype (p = 0.007). Conclusion/Significance In clinical practice, the NOD2 variant p.Leu1007fsX1008 (rs2066847), in particular in homozygous form, is a much stronger marker for a severe clinical phenotype than the FOXO3A rs12212067 SNP for a mild disease course on an individual patient level despite its important impact on the inflammatory response of monocytes. PMID:25365249

Cost-minimization analysis of three decision strategies for cardiac revascularization: results of the "suspected CAD" cohort of the european cardiovascular magnetic resonance registry.

PubMed

Moschetti, Karine; Petersen, Steffen E; Pilz, Guenter; Kwong, Raymond Y; Wasserfallen, Jean-Blaise; Lombardi, Massimo; Korosoglou, Grigorios; Van Rossum, Albert C; Bruder, Oliver; Mahrholdt, Heiko; Schwitter, Juerg

2016-01-11

Coronary artery disease (CAD) continues to be one of the top public health burden. Perfusion cardiovascular magnetic resonance (CMR) is generally accepted to detect CAD, while data on its cost effectiveness are scarce. Therefore, the goal of the study was to compare the costs of a CMR-guided strategy vs two invasive strategies in a large CMR registry. In 3'647 patients with suspected CAD of the EuroCMR-registry (59 centers/18 countries) costs were calculated for diagnostic examinations (CMR, X-ray coronary angiography (CXA) with/without FFR), revascularizations, and complications during a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive CXA and revascularization at the discretion of the treating physician (=CMR + CXA-strategy). In the hypothetical invasive arm, costs were calculated for an initial CXA and a FFR in vessels with ≥50% stenoses (=CXA + FFR-strategy) and the same proportion of revascularizations and complications were applied as in the CMR + CXA-strategy. In the CXA-only strategy, costs included those for CXA and for revascularizations of all ≥50% stenoses. To calculate the proportion of patients with ≥50% stenoses, the stenosis-FFR relationship from the literature was used. Costs of the three strategies were determined based on a third payer perspective in 4 healthcare systems. Revascularizations were performed in 6.2%, 4.5%, and 12.9% of all patients, patients with atypical chest pain (n = 1'786), and typical angina (n = 582), respectively; whereas complications (=all-cause death and non-fatal infarction) occurred in 1.3%, 1.1%, and 1.5%, respectively. The CMR + CXA-strategy reduced costs by 14%, 34%, 27%, and 24% in the German, UK, Swiss, and US context, respectively, when compared to the CXA + FFR-strategy; and by 59%, 52%, 61% and 71%, respectively, versus the CXA-only strategy. In patients with typical angina, cost savings by CMR + CXA vs CXA + FFR were minimal in the German (2.3%), intermediate in the US and Swiss (11.6% and 12.8%, respectively), and remained substantial in the UK (18.9%) systems. Sensitivity analyses proved the robustness of results. A CMR + CXA-strategy for patients with suspected CAD provides substantial cost reduction compared to a hypothetical CXA + FFR-strategy in patients with low to intermediate disease prevalence. However, in the subgroup of patients with typical angina, cost savings were only minimal to moderate.

Diagnostic Value of Multidetector CT and Its Multiplanar Reformation, Volume Rendering and Virtual Bronchoscopy Postprocessing Techniques for Primary Trachea and Main Bronchus Tumors

PubMed Central

Luo, Mingyue; Duan, Chaijie; Qiu, Jianping; Li, Wenru; Zhu, Dongyun; Cai, Wenli

2015-01-01

Purpose To evaluate the diagnostic value of multidetector CT (MDCT) and its multiplanar reformation (MPR), volume rendering (VR) and virtual bronchoscopy (VB) postprocessing techniques for primary trachea and main bronchus tumors. Methods Detection results of 31 primary trachea and main bronchus tumors with MDCT and its MPR, VR and VB postprocessing techniques, were analyzed retrospectively with regard to tumor locations, tumor morphologies, extramural invasions of tumors, longitudinal involvements of tumors, morphologies and extents of luminal stenoses, distances between main bronchus tumors and trachea carinae, and internal features of tumors. The detection results were compared with that of surgery and pathology. Results Detection results with MDCT and its MPR, VR and VB were consistent with that of surgery and pathology, included tumor locations (tracheae, n = 19; right main bronchi, n = 6; left main bronchi, n = 6), tumor morphologies (endoluminal nodes with narrow bases, n = 2; endoluminal nodes with wide bases, n = 13; both intraluminal and extraluminal masses, n = 16), extramural invasions of tumors (brokethrough only serous membrane, n = 1; 4.0 mm—56.0 mm, n = 14; no clear border with right atelectasis, n = 1), longitudinal involvements of tumors (3.0 mm, n = 1; 5.0 mm—68.0 mm, n = 29; whole right main bronchus wall and trachea carina, n = 1), morphologies of luminal stenoses (irregular, n = 26; circular, n = 3; eccentric, n = 1; conical, n = 1) and extents (mild, n = 5; moderate, n = 7; severe, n = 19), distances between main bronchus tumors and trachea carinae (16.0 mm, n = 1; invaded trachea carina, n = 1; >20.0 mm, n = 10), and internal features of tumors (fairly homogeneous densities with rather obvious enhancements, n = 26; homogeneous density with obvious enhancement, n = 1; homogeneous density without obvious enhancement, n = 1; not enough homogeneous density with obvious enhancement, n = 1; punctate calcification with obvious enhancement, n = 1; low density without obvious enhancement, n = 1). Conclusion MDCT and its MPR, VR and VB images have respective advantages and disadvantages. Their combination could complement to each other to accurately detect locations, natures (benignancy, malignancy or low malignancy), and quantities (extramural invasions, longitudinal involvements, extents of luminal stenoses, distances between main bronchus tumors and trachea carinae) of primary trachea and main bronchus tumors with crucial information for surgical treatment, are highly useful diagnostic methods for primary trachea and main bronchus tumors. PMID:26332466

Design and preliminary validation of a mobile application-based expert system to facilitate repair of medical equipment in resource-limited health settings.

PubMed

Wong, Alison L; Lacob, Kelly M; Wilson, Madeline G; Zwolski, Stacie M; Acharya, Soumyadipta

2018-01-01

One of the greatest barriers to safe surgery is the availability of functional biomedical equipment. Biomedical technicians play a major role in ensuring that equipment is functional. Following in-field observations and an online survey, a mobile application was developed to aid technicians in troubleshooting biomedical equipment. It was hypothesized that this application could be used to aid technicians in equipment repair, as modeled by repair of a pulse oximeter. To identify specific barriers to equipment repair and maintenance for biomedical technicians, an online survey was conducted to determine current practices and challenges. These findings were used to guide the development of a mobile application system that guides technicians through maintenance and repair tasks. A convenience sample of technicians in Ethiopia tested the application using a broken pulse oximeter task and following this completed usability and content validity surveys. Fifty-three technicians from 13 countries responded to the initial survey. The results of the survey showed that technicians find equipment manuals most useful, but these are not easily accessible. Many do not know how to or are uncomfortable reaching out to human resources. Thirty-three technicians completed the broken pulse oximeter task using the application. All were able to appropriately identify and repair the equipment, and post-task surveys of usability and content validity demonstrated highly positive scores (Agree to Strongly Agree) on both scales. This research demonstrates the need for improved access to resources for technicians and shows that a mobile application can be used to address a gap in the access to knowledge and resources in low- and middle-income countries. Further research will include prospective studies to determine the impact of an application on the availability of functional equipment in a hospital and the effect on the provision and safety of surgical care.

Design of pulse waveform for waveform division multiple access UWB wireless communication system.

PubMed

Yin, Zhendong; Wang, Zhirui; Liu, Xiaohui; Wu, Zhilu

2014-01-01

A new multiple access scheme, Waveform Division Multiple Access (WDMA) based on the orthogonal wavelet function, is presented. After studying the correlation properties of different categories of single wavelet functions, the one with the best correlation property will be chosen as the foundation for combined waveform. In the communication system, each user is assigned to different combined orthogonal waveform. Demonstrated by simulation, combined waveform is more suitable than single wavelet function to be a communication medium in WDMA system. Due to the excellent orthogonality, the bit error rate (BER) of multiuser with combined waveforms is so close to that of single user in a synchronous system. That is to say, the multiple access interference (MAI) is almost eliminated. Furthermore, even in an asynchronous system without multiuser detection after matched filters, the result is still pretty ideal and satisfactory by using the third combination mode that will be mentioned in the study.

Utilizing Fission Technology to Enable Rapid and Affordable Access to any Point in the Solar System

NASA Technical Reports Server (NTRS)

Houts, Mike; Bonometti, Joe; Morton, Jeff; Hrbud, Ivana; Bitteker, Leo; VanDyke, Melissa; Godfroy, T.; Pedersen, K.; Dobson, C.; Patton, B.;

Modeling Photo-multiplier Gain and Regenerating Pulse Height Data for Application Development

NASA Astrophysics Data System (ADS)

Aspinall, Michael D.; Jones, Ashley R.

2018-01-01

Systems that adopt organic scintillation detector arrays often require a calibration process prior to the intended measurement campaign to correct for significant performance variances between detectors within the array. These differences exist because of low tolerances associated with photo-multiplier tube technology and environmental influences. Differences in detector response can be corrected for by adjusting the supplied photo-multiplier tube voltage to control its gain and the effect that this has on the pulse height spectra from a gamma-only calibration source with a defined photo-peak. Automated methods that analyze these spectra and adjust the photo-multiplier tube bias accordingly are emerging for hardware that integrate acquisition electronics and high voltage control. However, development of such algorithms require access to the hardware, multiple detectors and calibration source for prolonged periods, all with associated constraints and risks. In this work, we report on a software function and related models developed to rescale and regenerate pulse height data acquired from a single scintillation detector. Such a function could be used to generate significant and varied pulse height data that can be used to integration-test algorithms that are capable of automatically response matching multiple detectors using pulse height spectra analysis. Furthermore, a function of this sort removes the dependence on multiple detectors, digital analyzers and calibration source. Results show a good match between the real and regenerated pulse height data. The function has also been used successfully to develop auto-calibration algorithms.

Single coronary artery with bicuspid aortic valve stenosis and aneurysm of the ascending aorta: report of a case.

PubMed

Ishida, Narihiro; Shimabukuro, Katsuya; Matsuno, Yukihiro; Ogura, Hiroki; Takemura, Hirofumi

2014-03-01

A 73-year-old man with a severely stenosed bicuspid valve and an aneurysm of the ascending aorta underwent valve and aortic surgery. Preoperative imaging revealed a single coronary artery arising from the right side of the sinus of Valsalva and a branch that perfused into the left side of the heart to pass through the front of the pulmonary artery. We replaced the aortic valve and ascending aorta, painstakingly avoiding damage to the coronary artery and obstruction of the sole coronary ostium.

[Revascularisation of the aorta, of the renal and of the lower limb arterial systems].

PubMed

Nagy, Csaba; Király, István; Bánsághi, Zoltán; Doros, Attila

2015-04-26

Revascularisation aims to create a patent lumen in an acutely or chronically occluded or stenosed vessel. Interventional radiology has developed and used minimally invasive methods for decades concurring surgical methods and medical therapy. Innovative fields in healthcare may be handicapped since revolutionary solutions usually gain wide acceptance slowly and the results of randomized controlled trials are reported late. At present endovascular recanalization, dilatation and stent placement have achieved a well-established role in the treatment of stenosis or occlusion of the aorta, and renal and peripheral arteries.

Sporadic Kindler syndrome with a novel mutation.

PubMed

Almeida, Hiram Larangeira de; Heckler, Gláucia Thomas; Fong, Kenneth; Lai-Cheong, Joey; McGrath, John

2013-01-01

We report the case of a 28-year-old woman with Kindler syndrome, a rare form of epidermolysis bullosa. Clinically, since childhood, she had widespread pigmentary changes in her skin as well as photosensitivity and fragility of the skin and mucous membranes. The mucosal involvement led to an erosive stomatitis as well as esophageal, anal and vaginal stenoses, requiring surgical intervention. The diagnosis of Kindler syndrome was confirmed by DNA sequencing with compound heterozygosity for a nonsense/frameshift combination of mutations (p.Arg110X; p.Ala289GlyfsX7) in the FERMT1 gene.

Transcatheter intervention for the treatment of congenital cardiac defects.

PubMed Central

Grifka, R G

1997-01-01

Cardiac catheterization has an illustrious history, originating in 1929 when Werner Forsmann, a surgical resident, performed a heart catheterization on himself. Transcatheter interventional procedures have been performed since the 1960s. The 1st intracardiac procedure to become standard therapy was a balloon atrial septostomy. Skeptics attacked this innovative procedure. However, the balloon septostomy procedure soon became the standard emergency procedure for certain congenital heart defects, and was the impetus for other investigators in the field of transcatheter intervention. We will discuss transcatheter treatment for congenital vascular stenoses and vascular occlusion. Images PMID:9456482

Correlation of heart rate/ST slope and coronary angiographic findings.

PubMed Central

Balcon, R; Brooks, N; Layton, C

1984-01-01

The heart rate/ST slope was evaluated in 49 patients undergoing routine investigation for possible coronary artery disease. The slope correctly predicted the absence of any 75% stenoses in the seven patients to whom this applied; it was, however, correct for only four of 30 with one stenosis, one of 10 with two, and neither of the patients with three. Distinct slope ranges were not found, and the previously published ranges said to be specific for no significant stenosis and one, two, and three vessel disease were not. PMID:6466516

Application of pulsed multi-ion irradiations in radiation damage research: A stochastic cluster dynamics simulation study

NASA Astrophysics Data System (ADS)

Hoang, Tuan L.; Nazarov, Roman; Kang, Changwoo; Fan, Jiangyuan

2018-07-01

Under the multi-ion irradiation conditions present in accelerated material-testing facilities or fission/fusion nuclear reactors, the combined effects of atomic displacements with radiation products may induce complex synergies in the structural materials. However, limited access to multi-ion irradiation facilities and the lack of computational models capable of simulating the evolution of complex defects and their synergies make it difficult to understand the actual physical processes taking place in the materials under these extreme conditions. In this paper, we propose the application of pulsed single/dual-beam irradiation as replacements for the expensive steady triple-beam irradiation to study radiation damages in materials under multi-ion irradiation.

Complete Coherent Control of a Quantum Dot Strongly Coupled to a Nanocavity.

PubMed

Dory, Constantin; Fischer, Kevin A; Müller, Kai; Lagoudakis, Konstantinos G; Sarmiento, Tomas; Rundquist, Armand; Zhang, Jingyuan L; Kelaita, Yousif; Vučković, Jelena

2016-04-26

Strongly coupled quantum dot-cavity systems provide a non-linear configuration of hybridized light-matter states with promising quantum-optical applications. Here, we investigate the coherent interaction between strong laser pulses and quantum dot-cavity polaritons. Resonant excitation of polaritonic states and their interaction with phonons allow us to observe coherent Rabi oscillations and Ramsey fringes. Furthermore, we demonstrate complete coherent control of a quantum dot-photonic crystal cavity based quantum-bit. By controlling the excitation power and phase in a two-pulse excitation scheme we achieve access to the full Bloch sphere. Quantum-optical simulations are in good agreement with our experiments and provide insight into the decoherence mechanisms.

PULSED EDDY CURRENT THICKNESS MEASUREMENT OF SELECTIVE PHASE CORROSION ON NICKEL ALUMINUM BRONZE VALVES

DOE Office of Scientific and Technical Information (OSTI.GOV)

Krause, T. W.; Harlley, D.; Babbar, V. K.

Nickel Aluminum Bronze (NAB) is a material with marine environment applications that under certain conditions can undergo selective phase corrosion (SPC). SPC involves the removal of minority elements while leaving behind a copper matrix. Pulsed eddy current (PEC) was evaluated for determination of SPC thickness on a NAB valve section with access from the surface corroded side. A primarily linear response of PEC amplitude, up to the maximum available SPC thickness of 4 mm was observed. The combination of reduced conductivity and permeability in the SPC phase relative to the base NAB was used to explain the observed sensitivity ofmore » PEC to SPC thickness variations.« less

Complete Coherent Control of a Quantum Dot Strongly Coupled to a Nanocavity

NASA Astrophysics Data System (ADS)

Dory, Constantin; Fischer, Kevin A.; Müller, Kai; Lagoudakis, Konstantinos G.; Sarmiento, Tomas; Rundquist, Armand; Zhang, Jingyuan L.; Kelaita, Yousif; Vučković, Jelena

2016-04-01

Strongly coupled quantum dot-cavity systems provide a non-linear configuration of hybridized light-matter states with promising quantum-optical applications. Here, we investigate the coherent interaction between strong laser pulses and quantum dot-cavity polaritons. Resonant excitation of polaritonic states and their interaction with phonons allow us to observe coherent Rabi oscillations and Ramsey fringes. Furthermore, we demonstrate complete coherent control of a quantum dot-photonic crystal cavity based quantum-bit. By controlling the excitation power and phase in a two-pulse excitation scheme we achieve access to the full Bloch sphere. Quantum-optical simulations are in good agreement with our experiments and provide insight into the decoherence mechanisms.

Calculating with light using a chip-scale all-optical abacus.

PubMed

Feldmann, J; Stegmaier, M; Gruhler, N; Ríos, C; Bhaskaran, H; Wright, C D; Pernice, W H P

2017-11-02

Machines that simultaneously process and store multistate data at one and the same location can provide a new class of fast, powerful and efficient general-purpose computers. We demonstrate the central element of an all-optical calculator, a photonic abacus, which provides multistate compute-and-store operation by integrating functional phase-change materials with nanophotonic chips. With picosecond optical pulses we perform the fundamental arithmetic operations of addition, subtraction, multiplication, and division, including a carryover into multiple cells. This basic processing unit is embedded into a scalable phase-change photonic network and addressed optically through a two-pulse random access scheme. Our framework provides first steps towards light-based non-von Neumann arithmetic.

Trends in Science Education Research, 1998: Taking the Annual Pulse of the Science Education Research Community.

ERIC Educational Resources Information Center

McCann, Wendy Sherman, Ed.; Haury, David L., Ed.

This document contains summaries of research in science education for the year 1998 and provides easy access to research findings and a critique of research efforts. Contents include: (1) "Science Education Research Published in Professional Journals" (Judith Sulkes Ridgway and Hyonyong Lee); (2) "Science Education Research Papers,…

Long-term results of 81 prevertebral subclavian artery angioplasties: a 26-year experience.

PubMed

Berger, Ludovic; Bouziane, Zacharie; Felisaz, Aurélien; Coffin, Olivier; Dugue, Audrey; Maiza, Dominique

2011-11-01

Long-term results of transluminal angioplasty (TLA) of the prevertebral subclavian artery (PVSA) are not well known. The aim of this work was to present a retrospective analysis of a consecutive series of 81 TLAs of the PVSA, with a mean follow-up of approximately 7 years (82 months). From January 1984 to May 2007, 81 TLAs of PVSA were consecutively performed in 72 patients (64% men; median age = 56.7 years) to treat 71 tight stenoses and 10 occlusions. In 58 cases, TLA was carried out under local anesthesia (71.6%), 65 times by femoral approach, and 16 times by humeral approach. A percutaneous approach was used 72 times (89%). A stent was placed in 18 cases (22.2%). Immediate technical success rate was 93%. One transient monoplegia was noticed after TLA and four puncture complications were observed, which occurred significantly more frequently with percutaneous humeral approach (p = 0.024). A recurrent stenosis occurred 28 times (34.6%) and was symptomatic in three cases. With a mean 82-month follow-up (3-299 months), primary patency at 10 years was 85.2% and primary assisted patency was 92.6%. No restenosis occurred after the 25th month of the follow-up. No restenosis factor was statistically predictive. TLA of the PVSA is a mildly invasive and efficient treatment. Early restenoses are frequent but remain accessible to a new TLA with stable long-term results. Copyright © 2011 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

A satellite mobile communication system based on Band-Limited Quasi-Synchronous Code Division Multiple Access (BLQS-CDMA)

NASA Technical Reports Server (NTRS)

Degaudenzi, R.; Elia, C.; Viola, R.

1990-01-01

Discussed here is a new approach to code division multiple access applied to a mobile system for voice (and data) services based on Band Limited Quasi Synchronous Code Division Multiple Access (BLQS-CDMA). The system requires users to be chip synchronized to reduce the contribution of self-interference and to make use of voice activation in order to increase the satellite power efficiency. In order to achieve spectral efficiency, Nyquist chip pulse shaping is used with no detection performance impairment. The synchronization problems are solved in the forward link by distributing a master code, whereas carrier forced activation and closed loop control techniques have been adopted in the return link. System performance sensitivity to nonlinear amplification and timing/frequency synchronization errors are analyzed.

Intense, carrier frequency and bandwidth tunable quasi single-cycle pulses from an organic emitter covering the Terahertz frequency gap

PubMed Central

Vicario, C.; Monoszlai, B.; Jazbinsek, M.; Lee, S. -H.; Kwon, O. -P.; Hauri, C. P.

2015-01-01

In Terahertz (THz) science, one of the long-standing challenges has been the formation of spectrally dense, single-cycle pulses with tunable duration and spectrum across the frequency range of 0.1–15 THz (THz gap). This frequency band, lying between the electronically and optically accessible spectra hosts important molecular fingerprints and collective modes which cannot be fully controlled by present strong-field THz sources. We present a method that provides powerful single-cycle THz pulses in the THz gap with a stable absolute phase whose duration can be continuously selected between 68 fs and 1100 fs. The loss-free and chirp-free technique is based on optical rectification of a wavelength-tunable pump pulse in the organic emitter HMQ-TMS that allows for tuning of the spectral bandwidth from 1 to more than 7 octaves over the entire THz gap. The presented source tunability of the temporal carrier frequency and spectrum expands the scope of spectrally dense THz sources to time-resolved nonlinear THz spectroscopy in the entire THz gap. This opens new opportunities towards ultrafast coherent control over matter and light. PMID:26400005

Modeling Pilot Pulse Control

NASA Technical Reports Server (NTRS)

Bachelder, Edward; Hess, Ronald; Godfroy-Cooper, Martine; Aponso, Bimal

2017-01-01

In this study, behavioral models are developed that closely reproduced pulsive control response of two pilots from the experimental pool using markedly different control techniques (styles) while conducting a tracking task. An intriguing find was that the pilots appeared to: 1) produce a continuous, internally-generated stick signal that they integrated in time; 2) integrate the actual stick position; and 3) compare the two integrations to issue and cease pulse commands. This suggests that the pilots utilized kinesthetic feedback in order to perceive and integrate stick position, supporting the hypothesis that pilots can access and employ the proprioceptive inner feedback loop proposed by Hess' pilot Structural Model. The Pulse Models used in conjunction with the pilot Structural Model closely recreated the pilot data both in the frequency and time domains during closed-loop simulation. This indicates that for the range of tasks and control styles encountered, the models captured the fundamental mechanisms governing pulsive and control processes. The pilot Pulse Models give important insight for the amount of remnant (stick output uncorrelated with the forcing function) that arises from nonlinear pilot technique, and for the remaining remnant arising from different sources unrelated to tracking control (i.e. neuromuscular tremor, reallocation of cognitive resources, etc.).

Dominance of hole-boring radiation pressure acceleration regime with thin ribbon of ionized solid hydrogen

NASA Astrophysics Data System (ADS)

Psikal, J.; Matys, M.

2018-04-01

Laser-driven proton acceleration from novel cryogenic hydrogen target of the thickness of tens of microns irradiated by multiPW laser pulse is investigated here for relevant laser parameters accessible in near future. It is demonstrated that the efficiency of proton acceleration from relatively thick hydrogen solid ribbon largely exceeds the acceleration efficiency for a thinner ionized plastic foil, which can be explained by enhanced hole boring (HB) driven by laser ponderomotive force in the case of light ions and lower target density. Three-dimensional particle-in-cell (PIC) simulations of laser pulse interaction with relatively thick hydrogen target show larger energies of protons accelerated in the target interior during the HB phase and reduced energies of protons accelerated from the rear side of the target by quasistatic electric field compared with the results obtained from two-dimensional PIC calculations. Linearly and circularly polarized multiPW laser pulses of duration exceeding 100 fs show similar performance in terms of proton acceleration from both the target interior as well as from the rear side of the target. When ultrashort pulse (∼30 fs) is assumed, the number of accelerated protons from the target interior is substantially reduced.

Radiation damage in a-SiO 2 exposed to intense positron pulses

NASA Astrophysics Data System (ADS)

Cassidy, D. B.; Mills, A. P.

2007-08-01

In addition to its numerous technological applications amorphous silica (a-SiO 2) is also well suited to the creation and study of exotic atoms such as positronium (Ps) and muonium. In particular, a dense Ps gas may be created by implanting an intense positron pulse into a porous a-SiO 2 sample. However, such positron pulses can constitute a significant dose of radiation, which may damage the sample. We have observed a reduction in the amount of Ps formed in a thin film of porous a-SiO 2 following irradiation by intense positron pulses, indicating the creation of paramagnetic centers. The data show that the primary effect of the irradiation is the inhibition of Ps formation, with no significant change in the subsequent Ps lifetime, from which we deduce that damage centers are created primarily in the bulk material and not on the internal surfaces of the pores, where they would be accessible to the long-lived Ps. We find that the damage is reversible, and that the system may be returned to its original state by heating to 700 K. The implications of these results for experiments with dense Ps in porous materials are discussed.

Electrical Switching of Perovskite Thin-Film Resistors

NASA Technical Reports Server (NTRS)

Liu, Shangqing; Wu, Juan; Ignatiev, Alex

2010-01-01

Electronic devices that exploit electrical switching of physical properties of thin films of perovskite materials (especially colossal magnetoresistive materials) have been invented. Unlike some related prior devices, these devices function at room temperature and do not depend on externally applied magnetic fields. Devices of this type can be designed to function as sensors (exhibiting varying electrical resistance in response to varying temperature, magnetic field, electric field, and/or mechanical pressure) and as elements of electronic memories. The underlying principle is that the application of one or more short electrical pulse(s) can induce a reversible, irreversible, or partly reversible change in the electrical, thermal, mechanical, and magnetic properties of a thin perovskite film. The energy in the pulse must be large enough to induce the desired change but not so large as to destroy the film. Depending on the requirements of a specific application, the pulse(s) can have any of a large variety of waveforms (e.g., square, triangular, or sine) and be of positive, negative, or alternating polarity. In some applications, it could be necessary to use multiple pulses to induce successive incremental physical changes. In one class of applications, electrical pulses of suitable shapes, sizes, and polarities are applied to vary the detection sensitivities of sensors. Another class of applications arises in electronic circuits in which certain resistance values are required to be variable: Incorporating the affected resistors into devices of the present type makes it possible to control their resistances electrically over wide ranges, and the lifetimes of electrically variable resistors exceed those of conventional mechanically variable resistors. Another and potentially the most important class of applications is that of resistance-based nonvolatile-memory devices, such as a resistance random access memory (RRAM) described in the immediately following article, Electrically Variable Resistive Memory Devices (MFS-32511-1).

5-Azacytidine combined with 2,4-D improves somatic embryogenesis of Acca sellowiana (O. Berg) Burret by means of changes in global DNA methylation levels.

PubMed

Fraga, Hugo P F; Vieira, Leila N; Caprestano, Clarissa A; Steinmacher, Douglas A; Micke, Gustavo A; Spudeit, Daniel A; Pescador, Rosete; Guerra, Miguel P

2012-12-01

DNA methylation is an epigenetic regulatory mechanism of gene expression which can be associated with developmental phases and in vitro morphogenetic competence in plants. The present work evaluated the effects of 5-azacytidine (AzaC) and 2,4-dichlorophenoxyacetic acid (2,4-D) on Acca sellowiana somatic embryogenesis (SE) and global DNA methylation levels by high-performance liquid chromatography mass spectrometry (HPLC/MS/MS). 2,4-D-free treatments revealed no somatic embryo formation in both accessions tested. Treatments supplemented with 2,4-D pulse plus AzaC in the culture medium resulted in increased embryo formation. In AzaC-free treatment, HPLC/MS/MS analysis showed a gradual increase in methylation levels in cultures of both accessions tested during SE induction. Treatment with AzaC and 2,4-D-free resulted in a marked decrease in methylation for both accessions, ranging from 37.6 to 20.8 %. In treatment with 2,4-D and AzaC combined, the 85 accession showed increasing global methylation levels. Otherwise, the 101X458 accession, in the same treatment, showed a decrease between 10 and 20 days, followed by an increase after 30 days (39.5, 36.2 and 41.6 %). These results indicate that 2,4-D pulse combined with AzaC improves SE induction. However, the conversion phase showed that although positively influencing SE induction, AzaC had a dysregulatory effect on the stage of autotrophic plant formation, resulting in significantly lower conversion rates. The results suggest that DNA methylation dramatically influences SE in Acca sellowiana, and global DNA methylation dynamics are related to morphogenetic response. 5-Azacytidine combined with 2,4-D increases the number of Acca sellowiana somatic embryos. Global DNA methylation is directly affected by these compounds.

Generation and Coherent Control of Pulsed Quantum Frequency Combs.

PubMed

MacLellan, Benjamin; Roztocki, Piotr; Kues, Michael; Reimer, Christian; Romero Cortés, Luis; Zhang, Yanbing; Sciara, Stefania; Wetzel, Benjamin; Cino, Alfonso; Chu, Sai T; Little, Brent E; Moss, David J; Caspani, Lucia; Azaña, José; Morandotti, Roberto

2018-06-08

We present a method for the generation and coherent manipulation of pulsed quantum frequency combs. Until now, methods of preparing high-dimensional states on-chip in a practical way have remained elusive due to the increasing complexity of the quantum circuitry needed to prepare and process such states. Here, we outline how high-dimensional, frequency-bin entangled, two-photon states can be generated at a stable, high generation rate by using a nested-cavity, actively mode-locked excitation of a nonlinear micro-cavity. This technique is used to produce pulsed quantum frequency combs. Moreover, we present how the quantum states can be coherently manipulated using standard telecommunications components such as programmable filters and electro-optic modulators. In particular, we show in detail how to accomplish state characterization measurements such as density matrix reconstruction, coincidence detection, and single photon spectrum determination. The presented methods form an accessible, reconfigurable, and scalable foundation for complex high-dimensional state preparation and manipulation protocols in the frequency domain.

An experimental platform for pulsed-power driven magnetic reconnection

NASA Astrophysics Data System (ADS)

Hare, J. D.; Suttle, L. G.; Lebedev, S. V.; Loureiro, N. F.; Ciardi, A.; Chittenden, J. P.; Clayson, T.; Eardley, S. J.; Garcia, C.; Halliday, J. W. D.; Robinson, T.; Smith, R. A.; Stuart, N.; Suzuki-Vidal, F.; Tubman, E. R.

2018-05-01

We describe a versatile pulsed-power driven platform for magnetic reconnection experiments, based on the exploding wire arrays driven in parallel [Suttle et al., Phys. Rev. Lett. 116, 225001 (2016)]. This platform produces inherently magnetised plasma flows for the duration of the generator current pulse (250 ns), resulting in a long-lasting reconnection layer. The layer exists for long enough to allow the evolution of complex processes such as plasmoid formation and movement to be diagnosed by a suite of high spatial and temporal resolution laser-based diagnostics. We can access a wide range of magnetic reconnection regimes by changing the wire material or moving the electrodes inside the wire arrays. We present results with aluminium and carbon wires, in which the parameters of the inflows and the layer that forms are significantly different. By moving the electrodes inside the wire arrays, we change how strongly the inflows are driven. This enables us to study both symmetric reconnection in a range of different regimes and asymmetric reconnection.

Imaging shock waves in diamond with both high temporal and spatial resolution at an XFEL

DOE PAGES

Schropp, Andreas; Hoppe, Robert; Meier, Vivienne; ...

2015-06-18

The advent of hard x-ray free-electron lasers (XFELs) has opened up a variety of scientific opportunities in areas as diverse as atomic physics, plasma physics, nonlinear optics in the x-ray range, and protein crystallography. In this article, we access a new field of science by measuring quantitatively the local bulk properties and dynamics of matter under extreme conditions, in this case by using the short XFEL pulse to image an elastic compression wave in diamond. The elastic wave was initiated by an intense optical laser pulse and was imaged at different delay times after the optical pump pulse using magnifiedmore » x-ray phase-contrast imaging. The temporal evolution of the shock wave can be monitored, yielding detailed information on shock dynamics, such as the shock velocity, the shock front width, and the local compression of the material. The method provides a quantitative perspective on the state of matter in extreme conditions.« less

Imaging Shock Waves in Diamond with Both High Temporal and Spatial Resolution at an XFEL.

PubMed

Schropp, Andreas; Hoppe, Robert; Meier, Vivienne; Patommel, Jens; Seiboth, Frank; Ping, Yuan; Hicks, Damien G; Beckwith, Martha A; Collins, Gilbert W; Higginbotham, Andrew; Wark, Justin S; Lee, Hae Ja; Nagler, Bob; Galtier, Eric C; Arnold, Brice; Zastrau, Ulf; Hastings, Jerome B; Schroer, Christian G

2015-06-18

The advent of hard x-ray free-electron lasers (XFELs) has opened up a variety of scientific opportunities in areas as diverse as atomic physics, plasma physics, nonlinear optics in the x-ray range, and protein crystallography. In this article, we access a new field of science by measuring quantitatively the local bulk properties and dynamics of matter under extreme conditions, in this case by using the short XFEL pulse to image an elastic compression wave in diamond. The elastic wave was initiated by an intense optical laser pulse and was imaged at different delay times after the optical pump pulse using magnified x-ray phase-contrast imaging. The temporal evolution of the shock wave can be monitored, yielding detailed information on shock dynamics, such as the shock velocity, the shock front width, and the local compression of the material. The method provides a quantitative perspective on the state of matter in extreme conditions.

A fatigue monitoring system based on time-domain and frequency-domain analysis of pulse data

NASA Astrophysics Data System (ADS)

Shen, Jiaai

2018-04-01

Fatigue is almost a problem that everyone would face, and a psychosis that everyone hates. If we can test people's fatigue condition and remind them of the tiredness, dangers in life, for instance, traffic accidents and sudden death will be effectively reduced, people's fatigued operations will be avoided. And people can be assisted to have access to their own and others' physical condition in time to alternate work with rest. The article develops a wearable bracelet based on FFT Pulse Frequency Spectrum Analysis and IBI's standard deviation and range calculation, according to people's heart rate (BPM) and inter-beat interval (IBI) while being tired and conscious. The hardware part is based on Arduino, pulse rate sensor, and Bluetooth module, and the software part is relied on network micro database and APP. By doing sample experiment to get more accurate standard value to judge tiredness, we prove that we can judge people's fatigue condition based on heart rate (BPM) and inter-beat interval (IBI).

Field transients of coherent terahertz synchrotron radiation accessed via time-resolving and correlation techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pohl, A.; Hübers, H.-W.; Institute of Optical Sensor Systems, German Aerospace Center

2016-03-21

Decaying oscillations of the electric field in repetitive pulses of coherent synchrotron radiation in the terahertz frequency range was evaluated by means of time-resolving and correlation techniques. Comparative analysis of real-time voltage transients of the electrical response and interferograms, which were obtained with an ultrafast zero-bias Schottky diode detector and a Martin-Puplett interferometer, delivers close values of the pulse duration. Consistent results were obtained via the correlation technique with a pair of Golay Cell detectors and a pair of resonant polarisation-sensitive superconducting detectors integrated on one chip. The duration of terahertz synchrotron pulses does not closely correlate with the durationmore » of single-cycle electric field expected for the varying size of electron bunches. We largely attribute the difference to the charge density oscillations in electron bunches and to the low-frequency spectral cut-off imposed by both the synchrotron beamline and the coupling optics of our detectors.« less

Bipolar pulse forming line

DOEpatents

Rhodes, Mark A.

2008-10-21

A bipolar pulse forming transmission line module for linear induction accelerators having first, second, third, fourth, and fifth planar conductors which form an interleaved stack with dielectric layers between the conductors. Each conductor has a first end, and a second end adjacent an acceleration axis. The first and second planar conductors are connected to each other at the second ends, the fourth and fifth planar conductors are connected to each other at the second ends, and the first and fifth planar conductors are connected to each other at the first ends via a shorting plate adjacent the first ends. The third planar conductor is electrically connectable to a high voltage source, and an internal switch functions to short a high voltage from the first end of the third planar conductor to the first end of the fourth planar conductor to produce a bipolar pulse at the acceleration axis with a zero net time integral. Improved access to the switch is enabled by an aperture through the shorting plate and the proximity of the aperture to the switch.

Ultra high-speed x-ray imaging of laser-driven shock compression using synchrotron light

NASA Astrophysics Data System (ADS)

Olbinado, Margie P.; Cantelli, Valentina; Mathon, Olivier; Pascarelli, Sakura; Grenzer, Joerg; Pelka, Alexander; Roedel, Melanie; Prencipe, Irene; Laso Garcia, Alejandro; Helbig, Uwe; Kraus, Dominik; Schramm, Ulrich; Cowan, Tom; Scheel, Mario; Pradel, Pierre; De Resseguier, Thibaut; Rack, Alexander

2018-02-01

A high-power, nanosecond pulsed laser impacting the surface of a material can generate an ablation plasma that drives a shock wave into it; while in situ x-ray imaging can provide a time-resolved probe of the shock-induced material behaviour on macroscopic length scales. Here, we report on an investigation into laser-driven shock compression of a polyurethane foam and a graphite rod by means of single-pulse synchrotron x-ray phase-contrast imaging with MHz frame rate. A 6 J, 10 ns pulsed laser was used to generate shock compression. Physical processes governing the laser-induced dynamic response such as elastic compression, compaction, pore collapse, fracture, and fragmentation have been imaged; and the advantage of exploiting the partial spatial coherence of a synchrotron source for studying low-density, carbon-based materials is emphasized. The successful combination of a high-energy laser and ultra high-speed x-ray imaging using synchrotron light demonstrates the potentiality of accessing complementary information from scientific studies of laser-driven shock compression.

Photon-photon scattering at the high-intensity frontier

NASA Astrophysics Data System (ADS)

Gies, Holger; Karbstein, Felix; Kohlfürst, Christian; Seegert, Nico

2018-04-01

The tremendous progress in high-intensity laser technology and the establishment of dedicated high-field laboratories in recent years have paved the way towards a first observation of quantum vacuum nonlinearities at the high-intensity frontier. We advocate a particularly prospective scenario, where three synchronized high-intensity laser pulses are brought into collision, giving rise to signal photons, whose frequency and propagation direction differ from the driving laser pulses, thus providing various means to achieve an excellent signal to background separation. Based on the theoretical concept of vacuum emission, we employ an efficient numerical algorithm which allows us to model the collision of focused high-intensity laser pulses in unprecedented detail. We provide accurate predictions for the numbers of signal photons accessible in experiment. Our study is the first to predict the precise angular spread of the signal photons, and paves the way for a first verification of quantum vacuum nonlinearity in a well-controlled laboratory experiment at one of the many high-intensity laser facilities currently coming online.

Multiple scattering of broadband terahertz pulses

NASA Astrophysics Data System (ADS)

Pearce, Jeremiah Glen

Propagation of single-cycle terahertz (THz) pulses through a random medium leads to dramatic amplitude and phase variations of the electric field because of multiple scattering. We present the first set of experiments that investigate the propagation of THz pulses through scattering media. The scattering of short pulses is a relevant subject to many communities in science and engineering, because the properties of multiply scattered or diffuse waves provide insights into the characteristics of the random medium. For example, the depolarization of diffuse waves has been used to form images of objects embedded in inhomogeneous media. Most of the previous scattering experiments have used narrowband optical radiation where measurements are limited to time averaged intensities or autocorrelation quantities, which contain no phase information of the pulses. In the experiments presented here, a terahertz time-domain spectrometer (THz-TDS) is used. A THz-TDS propagates single-cycle sub-picosecond pulses with bandwidths of over 1 THz into free space. The THz-TDS is a unique tool to study such phenomena, because it provides access to both the intensity and phase of those pulses through direct measurement of the temporal electric field. Because of the broad bandwidth and linear phase of the pulses, it is possible to simultaneously study Rayleigh scattering and the short wavelength limit in a single measurement. We study the diffusion of broadband single-cycle THz pulses by propagating the pulses through a highly scattering medium. Using the THz-TDS, time-domain measurements provide information on the statistics of both the amplitude and phase of the diffusive waves. We develop a theoretical description, suitable for broadband radiation, which accurately describes the experimental results. We measure the time evolution of the degree of polarization, and directly correlate it with the single-scattering regime in the time domain. Measurements of the evolution of the temporal phase of the radiation demonstrate that the average spectral content depends on the state of polarization. In the case of broadband radiation, this effect distinguishes photons that have been scattered only a few times from those that are propagating diffusively.

Non-Newtonian effects of blood flow on hemodynamics in distal vascular graft anastomoses.

PubMed

Chen, Jie; Lu, Xi-Yun; Wang, Wen

2006-01-01

Non-Newtonian fluid flow in a stenosed coronary bypass is investigated numerically using the Carreau-Yasuda model for the shear thinning behavior of the blood. End-to-side coronary bypass anastomosis is considered in a simplified model geometry where the host coronary artery has a 75% severity stenosis. Different locations of the bypass graft to the stenosis and different flow rates in the graft and in the host artery are studied. Particular attention is given to the non-Newtonian effect of the blood on the primary and secondary flow patterns in the host coronary artery and the wall shear stress (WSS) distribution there. Interaction between the jet flow from the stenosed artery and the flow from the graft is simulated by solving the three-dimensional Navier-Stokes equation coupled with the non-Newtonian constitutive model. Results for the non-Newtonian flow, the Newtonian flow and the rescaled Newtonian flow are presented. Significant differences in axial velocity profiles, secondary flow streamlines and WSS between the non-Newtonian and Newtonian fluid flows are revealed. However, reasonable agreement between the non-Newtonian and the rescaled Newtonian flows is found. Results from this study support the view that the residual flow in a partially occluded coronary artery interacts with flow in the bypass graft and may have significant hemodynamic effects in the host vessel downstream of the graft. Non-Newtonian property of the blood alters the flow pattern and WSS distribution and is an important factor to be considered in simulating hemodynamic effects of blood flow in arterial bypass grafts.

Application of Y-shaped, coated self-expandable metallic stents for anastomotic stenosis after gastrojejunostomy (Billroth II).

PubMed

Li, Teng-Fei; Wu, Gang; Han, Xin-Wei; Shui, Shao-Feng; Ren, Jian-Zhuang; Li, Zhen; Ren, Ke-Wei

2017-01-01

Anastomotic stenosis is an infrequent but life-threatening complication after gastrojejunostomy (Billroth II). Tubular or single tubular stents have limited efficacy due to the particular anatomy. To assess the feasibility of a Y-shaped, fully-coated, self-expandable, metallic stent (SEMS) for anastomotic stenosis after gastrojejunostomy (Billroth II). Between January 2008 and August 2014, 14 patients (10 with gastric carcinoma and four with duodenal ulcers) had anastomotic stenoses following Billroth II reconstructions. Eight patients with gastric cancer had tumor recurrence near the anastomosis; two had benign strictures. The four duodenal ulcer patients had benign stenoses. An integrated Y-shaped, fully coated SEMS was designed to accord with the anatomy of residual gastrojejunal anastomotic strictures. Fourteen stents were inserted under fluoroscopic control. Follow-up was at 1, 3, 9, and 12 months, and then annually. All 14 stents were inserted successfully at the first attempt with a technical success rate of 100%. After stenting, abdominal symptoms resolved in all patients. All patients were followed up for 4-27 months (mean, 13.9 months). One of the eight recurrent cases died of multiple tumor metastases and liver failure after 7 months, without obstruction symptoms. In all six patients with benign anastomotic stenosis, the stents were removed successfully without complication and with no evidence of restenosis based on clinical evaluation and imaging. A Y-shaped, fully-coated SEMS proved to be a feasible and minimally invasive procedure for treating anastomotic stenosis after gastrojejunostomy (Billroth II). © The Foundation Acta Radiologica 2016.

[Consensus diagnosis and treatment of arterial intermittent claudication. Central Guidance Organization for Peer Review].

PubMed

Kitslaar, P J

1997-12-06

Intermittent claudication is an indicator of increased risk of cardiac and cerebrovascular morbidity and mortality and as such a reason to look for modifiable risk factors for atherosclerosis. A vascular anamnesis and physical examination can reliably exclude presence of peripheral arterial occlusive disease in the lower extremities, but cannot reliably demonstrate its presence. Certainty about presence or absence of peripheral arterial occlusive disease can be obtained by determination of an ankle-brachial blood pressure index. The main method for the diagnosis of severity and localisation of stenoses and occlusions in the arteries to the legs is the echo-Doppler (duplex) examination. With this method the feasibility of percutaneous transluminal angioplasty (PTA) can also be determined. Consequently, angiography has lost importance as a diagnostic method and is only still indicated as part of an interventional treatment (operation or PTA). Treatment should be aimed at both amelioration of symptoms and reduction of risk factors for atherosclerosis. A key-stone of the treatment is cessation of smoking. The role of pharmacotherapy in reducing symptomatology is only limited. Walking exercise can have a positive effect on walking distance and should always be tried. PTA is the treatment modality of first choice for stenoses in the aortoiliac and femoropopliteal arteries. For segmental occlusions in the iliac pathway, also recanalisation by means of PTA (in combination with stent placement) is a justifiable treatment option. In all other cases operative revascularisations give good functional results. Invasive treatments for patients with intermittent claudication should be performed within a multidisciplinary team.

Connection method of separated luminal regions of intestine from CT volumes

NASA Astrophysics Data System (ADS)

Oda, Masahiro; Kitasaka, Takayuki; Furukawa, Kazuhiro; Watanabe, Osamu; Ando, Takafumi; Hirooka, Yoshiki; Goto, Hidemi; Mori, Kensaku

2015-03-01

This paper proposes a connection method of separated luminal regions of the intestine for Crohn's disease diagnosis. Crohn's disease is an inflammatory disease of the digestive tract. Capsule or conventional endoscopic diagnosis is performed for Crohn's disease diagnosis. However, parts of the intestines may not be observed in the endoscopic diagnosis if intestinal stenosis occurs. Endoscopes cannot pass through the stenosed parts. CT image-based diagnosis is developed as an alternative choice of the Crohn's disease. CT image-based diagnosis enables physicians to observe the entire intestines even if stenosed parts exist. CAD systems for Crohn's disease using CT volumes are recently developed. Such CAD systems need to reconstruct separated luminal regions of the intestines to analyze intestines. We propose a connection method of separated luminal regions of the intestines segmented from CT volumes. The luminal regions of the intestines are segmented from a CT volume. The centerlines of the luminal regions are calculated by using a thinning process. We enumerate all the possible sequences of the centerline segments. In this work, we newly introduce a condition using distance between connected ends points of the centerline segments. This condition eliminates unnatural connections of the centerline segments. Also, this condition reduces processing time. After generating a sequence list of the centerline segments, the correct sequence is obtained by using an evaluation function. We connect the luminal regions based on the correct sequence. Our experiments using four CT volumes showed that our method connected 6.5 out of 8.0 centerline segments per case. Processing times of the proposed method were reduced from the previous method.

Wingspan Stent for High-Grade Symptomatic Vertebrobasilar Artery Atherosclerotic Stenosis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li Jian, E-mail: ns981212@yahoo.com.cn; Zhao Zhenwei, E-mail: zzwzc@sina.com; Gao Guodong, E-mail: gaoguo_dong@163.com

2012-04-15

Purpose: This study was designed to present the treatment outcomes with Wingspan stent angioplasty of high-grade intracranial vertebrobasilar artery (VBA) stenosis in symptomatic patients. Methods: Between 2007 and 2010, the records of 30 patients with 31 intracranial high-grade VBA stenoses (all{>=}70%) who underwent elective stenting due to the failure of medical therapy were retrospectively reviewed. Clinical evaluation was performed based on the modified Rankin scale and the National Institutes of Health Stroke Scale. Results: In all cases, the stent deployment was technically successful. The mean stenosis decreased significantly from 82.28 {+-} 8.02% (range, 72-99%) to 11.18 {+-} 7.28% (range, 0-25%)more » after stent-assisted angioplasty (P < 0.05). Periprocedure complications occurred in 3 (10%) of 30 patients; there were 2 cases of perforator strokes and 1 case of transient flow insufficiency with stent overlap. Clinical follow-up (mean, 17.81 {+-} 11.49 months; range, 5-40 months) was available for 27 patients, and angiographic follow-up (mean, 9.95 {+-} 5.74 months, range, 5-20 months) was available for 19 patients. Only one case demonstrated recurrent symptoms with restenosis ({>=}50%). There were no recurrent ischemic events and no cases of restenosis in the other patients. Conclusions: According to our data, the Wingspan stent for symptomatic intracranial VBA stenoses is a safe and efficacious treatment alternative in cases with recurrent symptoms despite medical therapy. However, the improvement of outcome requires the reduction in the rate of procedure-related complications and long-term outcomes still have to be demonstrated.« less

Relationship between aortic valve calcification and the severity of coronary atherosclerotic disease.

PubMed

Qian, Juying; Chen, Zhangwei; Ge, Junbo; Ma, Jianying; Chang, Shufu; Fan, Bing; Liu, Xuebo; Ge, Lei

2010-07-01

Aortic valve calcification (AVC), which has been confirmed to be associated with various risk factors of cardiac disease, is common in the elderly and associated with increased cardiovascular mortality. It has been hypothesized that AVC is associated with coronary atherosclerotic disease, and its severity. Between July 2007 and November 2007, a total of 235 patients with chest pain or chest distress were admitted to the authors' institution for coronary angiography. The severity of coronary atherosclerotic disease (CAD) was evaluated by the Gensini score, the number of stenosed vessels, and the prevalence of total occlusion. All patients underwent transthoracic echocardiography to detect AVC. Patients with CAD had a higher prevalence of AVC than those without CAD (44% versus 26%, p = 0.005). Likewise, the prevalence of AVC was significantly higher in patients with a higher Gensini score than in those with a lower score. Patients with AVC had a higher prevalence of CAD, and higher Gensini scores and numbers of stenosed coronary arteries, even after stratification by age (65 years). On multivariable logistic regression analysis for CAD, the odds ratio (OR) of AVC was 2.315 (95% confidence interval (CI): 1.158-4.629, p = 0.018); this value was higher than that for total cholesterol (OR = 1.637, p = 0.008), lipoprotein-a (OR = 1.003, p = 0.015) and fibrinogen (OR = 1.009, p = 0.006), and marginally less than that for male gender (OR = 2.665, p = 0.005). Patients with AVC had a higher prevalence and greater severity of CAD.

Computational modeling of venous sinus stenosis in idiopathic intracranial hypertension

PubMed Central

Levitt, Michael R; McGah, Patrick M; Moon, Karam; Albuquerque, Felipe C; McDougall, Cameron G; Kalani, M Yashar S; Kim, Louis J; Aliseda, Alberto

2016-01-01

Background and Purpose Idiopathic intracranial hypertension has been associated with dural venous sinus stenosis in some patients, but the hemodynamic environment of the dural venous sinuses has not been quantitatively described. Here, we present the first such computational fluid dynamics model using patient-specific blood pressure measurements. Materials and Methods Six patients with idiopathic intracranial hypertension and at least one stenosis or atresia at the transverse-sigmoid sinus junction underwent MRV followed by cerebral venography and manometry throughout the dural venous sinuses. Patient-specific computational fluid dynamics models were created using MRV anatomy, with venous pressure measurements as boundary conditions. Blood flow and wall shear stress were calculated for each patient. Results Computational models of dural venous sinuses were successfully reconstructed in all six patients with patient-specific boundary conditions. Three patients demonstrated a pathologic pressure gradient (≥ 8 mm Hg) across four dural venous sinus stenoses. Small sample size precludes statistical comparisons, but average overall flow throughout the dural venous sinuses of patients with pathologic pressure gradients was higher than in those without (1041.00 ± 506.52 vs. 358.00 ± 190.95 mL/min). Wall shear stress was also higher across stenoses in patients with pathologic pressure gradients (37.66 ± 48.39 vs 7.02 ± 13.60 Pa). Conclusion The hemodynamic environment of the dural venous sinuses can be computationally modeled using patient-specific anatomy and physiological measurements in patients with idiopathic intracranial hypertension. There was substantially higher blood flow and wall shear stress in patients with pathological pressure gradients. PMID:27197986

Efficacy of treatment of edge stenosis of endografts inserted for superficial femoral artery stenotic disease.

PubMed

Golchehr, Bahar; Holewijn, Suzanne; Kruse, Rombout R; van Walraven, Laurens A; Zeebregts, Clark J; Reijnen, Michel M P J

2015-09-01

The role of endografts in the treatment of extensive superficial femoral artery (SFA) occlusive disease is enlarging. Results are limited by the occurrence of edge stenosis. The aim of the study was to retrospectively evaluate the efficacy of treatment of edge stenosis of endografts inserted for SFA occlusive disease. All patients, treated between November 2001 and December 2011, with a self-expandable polytetrafluoroethylene-endograft were gathered in a prospective database in three hospitals. The incidence of primary edge stenosis and the incidence of re-edge stenosis after treatment were retrospectively noted and a comparison was made between the results of percutaneous transluminal angioplasty (PTA) and extension of the endograft. A total of 88 patients presented with 115 edge stenoses, of which the majority presented within 1 year after insertion of the endograft (mean time to edge stenosis 10.7 ± 8.2 months). Seventy-three stenoses (63%) manifested at the proximal and 42 at the distal edge (37%). The 1-year incidence of restenosis and/or occlusion was 45% after PTA and 43% after endograft extension, with 1-year patency rates of 81% and 92%, respectively. The incidence of restenosis/occlusion after treatment with PTA was 12% higher at two years compared to extension of the endograft (55% vs. 43%, respectively). Edge stenosis may well be treated with either PTA or extension of the endograft. The incidence of restenosis and/or occlusion after both PTA and extension is high, but patency rates are acceptable. Aggressive surveillance is needed during the first year after insertion. © 2015 Wiley Periodicals, Inc.

Angiographic Features, Collaterals, and Infarct Topography of Symptomatic Occlusive Radiation Vasculopathy

PubMed Central

Zou, Winnie X.Y.; Leung, Thomas W.; Yu, Simon C.H.; Wong, Edward H.C.; Leung, S.F.; Soo, Yannie O.Y.; Ip, Vincent H.L.; Chan, Anne Y.Y.; Lam, Wynnie W.M.; Siu, Deyond Y.W.; Abrigo, Jill; Lee, Kwok Tung; Liebeskind, David S.; Wong, Ka Sing

2014-01-01

Background and Purpose Occlusive radiation vasculopathy (ORV) predisposes head-and-neck cancer survivors to ischemic strokes. Methods We analyzed the digital subtraction angiography acquired in 96 patients who had first-ever transient ischemic attack or ischemic strokes attributed to ORV. Another age-matched 115 patients who had no radiotherapy but symptomatic high-grade (>70%) carotid stenoses were enrolled as referent subjects. Digital subtraction angiography was performed within 2 months from stroke onset and delineated carotid and vertebrobasilar circulations from aortic arch up to intracranial branches. Two reviewers blinded to group assignment recorded all vascular lesions, collateral status, and infarct pattern. Results ORV patients had less atherosclerotic risk factors at presentation. In referent patients, high-grade stenoses were mostly focal at the proximal internal carotid artery. In contrast, high-grade ORV lesions diffusely involved the common carotid artery and internal carotid artery and were more frequently bilateral (54% versus 22%), tandem (23% versus 10%), associated with complete occlusion in one or both carotid arteries (30% versus 9%), vertebral artery (VA) steno-occlusions (28% versus 16%), and external carotid artery stenosis (19% versus 5%) (all P<0.05). With comparable rates of vascular anomaly, ORV patients showed more established collateral circulations through leptomeningeal arteries, anterior communicating artery, posterior communicating artery, suboccipital/costocervical artery, and retrograde flow in ophthalmic artery. In terms of infarct topography, the frequencies of cortical or subcortical watershed infarcts were similar in both groups. Conclusions ORV angiographic features and corresponding collaterals are distinct from atherosclerotic patterns at initial stroke presentation. Clinical decompensation, despite more extensive collateralization, may precipitate stroke in ORV. PMID:23306321

Duplex ultrasonography for the detection of vertebral artery stenosis: A comparison with CT angiography.

PubMed

Rozeman, Anouk D; Hund, Hajo; Westein, Michel; Wermer, Marieke J H; Lycklama À Nijeholt, Geert J; Boiten, Jelis; Schimsheimer, Robert-Jan; Algra, Ale

2017-08-01

Vertebrobasilar stenosis is frequent in patients with posterior circulation stroke and it increases risk of recurrence. We investigated feasibility of duplex ultrasonography (DUS) for screening for extracranial vertebral artery stenosis and compared it with CT angiography (CTA). We gathered data on 337 consecutive patients who had DUS because of posterior circulation stroke or TIA. Matching CTA studies were retrieved and used as reference. Stenosis on CTA was considered "significant" if >50%, at DUS if Peak Systolic Velocity (PSV) > 140 cm/s for the V1 segment and PSV > 125 cm/s for the V2 segment. We determined the area under the ROC curve (AUROC). In addition, we calculated which PSV cut-off value resulted in highest sensitivity with acceptable specificity. DUS was able to make an adequate measurement in 378 of 674 V1 segments and 673 of 674 V2 segments. DUS detected a significant stenosis in 52 of 378 V1 segments; 12 were confirmed by CTA (AUROC 0.73, 95% Confidence Interval 0.63-0.83). The optimal DUS PSV cut-off value for this segment was 90 cm/s. For the V2 segment there were too few stenoses to allow reliable assessment of diagnostic characteristics of DUS. Although DUS has a fair AUROC for detecting significant stenosis, adequate assessment of the V1 segment is often not possible due to anatomic difficulties. Assessment of the V2 segment is feasible but yielded few stenoses. Hence, we consider usefulness of DUS for screening of extracranial vertebral artery stenosis limited.

Do we need invasive confirmation of cardiac magnetic resonance results?

PubMed Central

Kądziela, Jacek; Małek, Łukasz A.; Śpiewak, Mateusz; Lech, Katarzyna; Witkowski, Adam

2017-01-01

Introduction Coronary artery revascularization is indicated in patients with documented significant obstruction of coronary blood flow associated with a large area of myocardial ischemia and/or untreatable symptoms. There are a few invasive or noninvasive methods that can provide information about the functional results of coronary artery narrowing. The application of more than one method of ischemia detection in one patient to reevaluate the indications for revascularization is used in case of atypical or no symptoms and/or borderline stenosis. Aim To evaluate whether the results of cardiac magnetic resonance need to be reconfirmed by the invasive functional method. Material and methods The hospital database revealed 25 consecutive patients with 29 stenoses who underwent cardiac magnetic resonance (CMR) and fractional flow reserve (FFR) between the end of 2010 and the end of 2014. The maximal time interval between CMR and FFR was 6 months. None of the patients experienced any clinical events or underwent procedures on coronary arteries between the studies. Results According to the analysis, the agreement of CMR perfusion with the FFR method was at the level of 89.7%. Assuming that FFR is the gold standard in assessing the severity of stenoses, the sensitivity of CMR perfusion was 90.9%. The percentage of non-severe lesions which were correctly identified in CMR was 88.9%. Conclusions The study shows that CMR perfusion is a highly sensitive method to detect hemodynamically significant CAD and exclude nonsevere lesions. With FFR as the reference standard, the diagnostic accuracy of MR perfusion to detect ischemic CAD is high. PMID:28344614

Metallic Stents for Tracheobronchial Pathology Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Serrano, Carolina, E-mail: carolina.serrano@unizar.es; Laborda, Alicia, E-mail: alaborda@unizar.es; Lozano, Juan M., E-mail: juamauloz@gmail.com

2013-12-15

Purpose: To present the 7-year experience of the treatment of benign and malignant tracheobronchial stenoses using metallic stents. Patients and Methods: One hundred twenty-three stents were inserted in 86 patients (74 benign and 12 malignant stenoses). Ninety-seven stents were placed in the trachea and 26 in the bronchi. The procedures were performed under fluoroscopic and flexible bronchoscopic guidance with the patient under light sedation. In cases of severe stenotic lesions or obstructions, laser resection was performed before stent placement. Clinical and functional pulmonary data were recorded before and 3 months after the procedure. Follow-up involved clinical data and radiographic techniquesmore » at 48 h and at 1-, 3-, 6-, and 12-month intervals. Results: The technical success was 100 %. Dyspnea disappearance, forced expiratory volume in the first second, and pulmonary functional data improvement was observed in all patients (p < 0.001). Complications were detected in 23 patients (26.7 %). Mean follow-up time was 6.3 {+-} 1.2 months in patients with malignant lesions and 76.2 {+-} 2.3 months patients with in benign lesions. By the end of the study, 100 % of patients with malignant pathology and 6.7 % of patients with benign lesions had died. Conclusion: Endoluminal treatment of tracheobronchial stenosis with metallic stents is a therapeutic alternative in patients who are poor candidates for surgery. In unresectable malignant lesions, the benefit of metallic stenting is unquestionable. In benign lesions, the results are satisfactory, but sometimes other interventions are required to treat complications. New stent technology may improve these results.« less

Multimodal flow visualization and optimization of pneumatic blood pump for sorbent hemodialysis system.

PubMed

Shu, Fangjun; Parks, Robert; Maholtz, John; Ash, Steven; Antaki, James F

2009-04-01

Renal Solutions Allient Sorbent Hemodialysis System utilizes a two-chambered pneumatic pump (Pulsar Blood Pump, Renal Solutions, Inc., Warrendale, PA, USA) to avoid limitations associated with peristaltic pumping systems. Single-needle access is enabled by counter-pulsing the two pump chambers, thereby obviating compliance chambers or blood reservoirs. Each chamber propels 20 cc per pulse of 3 s (dual access) or 6 s (single access) duration, corresponding to a peak Reynolds number of approximately 8000 (based on inlet velocity and chamber diameter). A multimodal series of flow visualization studies (tracer particle, dye washout, and dye erosion) was conducted on a sequence of pump designs with varying port locations and diaphragms to improve the geometry with respect to risk of thrombogenesis. Experiments were conducted in a simplified flow loop using occluders to simulate flow resistance induced by tubing and dialyzer. Tracer visualization revealed flow patterns and qualitatively indicated turbulence intensity. Dye washout identified dwell volume and areas of flow stagnation for each design. Dye erosion results indicated the effectiveness and homogeneity of surface washing. Compared to a centered inlet which resulted in a fluid jet that produced two counter-rotating vortices, a tangential inlet introduced a single vortex, and kept the flow laminar. It also provided better surface washing on the pump inner surface. However, a tangential outlet did not present as much benefit as expected. On the contrary, it created a sharp defection to the flow when transiting from filling to ejection.

Pulse oximeter based mobile biotelemetry application.

PubMed

Işik, Ali Hakan; Güler, Inan

2012-01-01

Quality and features of tele-homecare are improved by information and communication technologies. In this context, a pulse oximeter-based mobile biotelemetry application is developed. With this application, patients can measure own oxygen saturation and heart rate through Bluetooth pulse oximeter at home. Bluetooth virtual serial port protocol is used to send the test results from pulse oximeter to the smart phone. These data are converted into XML type and transmitted to remote web server database via smart phone. In transmission of data, GPRS, WLAN or 3G can be used. The rule based algorithm is used in the decision making process. By default, the threshold value of oxygen saturation is 80; the heart rate threshold values are 40 and 150 respectively. If the patient's heart rate is out of the threshold values or the oxygen saturation is below the threshold value, an emergency SMS is sent to the doctor. By this way, the directing of an ambulance to the patient can be performed by doctor. The doctor for different patients can change these threshold values. The conversion of the result of the evaluated data to SMS XML template is done on the web server. Another important component of the application is web-based monitoring of pulse oximeter data. The web page provides access to of all patient data, so the doctors can follow their patients and send e-mail related to the evaluation of the disease. In addition, patients can follow own data on this page. Eight patients have become part of the procedure. It is believed that developed application will facilitate pulse oximeter-based measurement from anywhere and at anytime.

Electronic and structural response of nanomaterials to ultrafast and ultraintense laser pulses.

PubMed

Jiang, Chen-Wei; Zhou, Xiang; Lin, Zhibin; Xie, Rui-Hua; Li, Fu-Li; Allen, Roland E

2014-02-01

The interaction of materials with ultrafast and ultraintense laser pulses is a current frontier of science both experimentally and theoretically. In this review, we briefly discuss some recent theoretical studies by the present authors with our method of semiclassical electron-radiation-ion dynamics (SERID). In particular, Zhou et al. and Jiang et al. respectively, determined the optimal duration and optimal timing for a series of femtosecond scale laser pulses to excite a specific vibrational mode in a general chemical system. A set of such modes can be used as a "fingerprint" for characterizing a particular molecule or a complex in a solid. One can therefore envision many applications, ranging from fundamental studies to detection of chemical or biological agents. Allen et al. proved that dimers are preferentially emitted during photofragmentation of C60 under an ultrafast and ultraintense laser pulse. For interactions between laser pulses and semiconductors, e.g., GaAs, Si and InSb, besides experimentally accessible optical properties--epsilon(omega) and chi(2)-Allen et al. offered many other indicators to confirm the nonthermal nature of structural changes driven by electronic excitations and occurring during the first few hundred femtoseconds. Lin et al. found that, after the application of a femtosecond laser pulse, excited electrons in materials automatically equilibrate to a Fermi-Dirac distribution within roughly 100 fs, solely because of their coupling to the nuclear motion, even though the resulting electronic temperature is one to two orders of magnitude higher than the kinetic temperature defined by the nuclear motion.

GPs' views of health policy changes: a qualitative 'netnography' study of UK general practice online magazine commentary.

PubMed

Elvey, Rebecca; Voorhees, Jennifer; Bailey, Simon; Burns, Taylor; Hodgson, Damian

2018-06-01

Shifts in health policy since 2010 have brought major structural changes to the English NHS, with government stating intentions to increase GPs' autonomy and improve access to care. Meanwhile, GPs' levels of job satisfaction are low, while stress levels are high. PulseToday is a popular UK general practice online magazine that provides a key discussion forum on news relevant to general practice. To analyse readers' reactions to news stories about health policy changes published in an online general practice magazine. A qualitative 'netnography' was undertaken of readers' comments to PulseToday. METHOD: A sample of readers' comments on articles published in PulseToday was collated and subjected to thematic analysis. Around 300 comments on articles published between January 2012 and March 2016 were included in the analysis, using 'access to care' as a tracer theme. Concern about the demand and strain on general practice was perhaps to be expected. However, analysis revealed various dimensions to this concern: GPs' underlying feelings about their work and place in the NHS; constraints to GPs' control of their own working practices; a perceived loss of respect for the role of GP; and disappointment with representative bodies and GP leadership. This study shows a complex mix of resistance and resignation in general practice about the changing character of GPs' roles. This ambivalence deserves further attention because it could potentially shape responses to further change in primary care in ways that are as yet unknown. © British Journal of General Practice 2018.

USMC ISR: Preparing for the A2AD Threat

DTIC Science & Technology

2014-06-13

millimeter waves, high - power microwaves, lasers or electromagnetic pulses (Brimley 2013, 15). Replacing modern day munitions, directed- energy ...space and cyber capabilities” (JCS, 26). The precept further states the need to protect access to the electromagnetic spectrum. Given the high cost...is the “division of electronic warfare involving the use of electromagnetic , directed energy , or antiradiation weapons to attack personnel, facilities

Shortening the Feedback Loop for Sleep Apnea Patients Via a Wireless Blood Pulse-Oximetry System

PubMed Central

Stepnowsky, Carl; Blair, Paul; DiNicola, Gia; Lenert, Leslie A

2006-01-01

Much of the clinical care of sleep apnea patients is focused on case identification, diagnosis, and treatment prescription, while follow-up care tends to be intermittent and patient-initiated. There is a clear need for an alternative, cost-effective way to examine sleep apnea treatment efficacy. As part of our research program to improve the clinical care of sleep apnea patients using Internet enabled systems, we have developed a prototype Wireless Blood Pulse-Oximeter System that patients can use in their homes. The oximeter system can be applied by the patient and is based on a data-push mechanism to a secure server that is designed for both patient and provider access. PMID:17238730

[Treatment of a postoperative rectal stenosis with a self-expanding biodegradable polydioxanone stent].

PubMed

Dederichs, F; Knüdeler, S; Nolte, W; Iesalnieks, I

2013-05-01

Rectal stricture is a serious although infrequent complication of transanal endoscopic microsurgery (TEM). In some cases, these strictures may be refractory to treatment by endoscopic balloon dilatation. Biodegradable stents might improve the outcome by providing an extended period of dilatation. Moreover, these stents can remain in place without the need to remove them. In the presented case, a biodegradable polidioxanone stent originally developed to treat benign oesophageal stenoses was used to treat a patient suffering from rectal stricture following a TEM. © Georg Thieme Verlag KG Stuttgart · New York.

[The endoscopic therapy of benign stenoses of the esophagus and cardioesophageal junction using Eder-Puestow instrumentation].

PubMed

Donev, Sht; Bosekert, N; Belchev, B

1995-01-01

The results of palliative endoscopic treatment by bougienage using Eder-Puestow instrumentation, performed in a limited contingent of patients presenting benign esophageal strictures, are analyzed. It is underscored that the method is readily carried out and effective, and seldom leads to noteworthy complications, such as esophageal perforations--one patient alone presenting cicatricial stricture out of the total of 42 cases given treatment with bougienage over a 10-year period. The commonest cause of benign strictures of the esophagus in the series being examined is reflux (peptic) esophagitis against the background of hiatus hernia.

Electrical neuromodulation for disabling angina pectoris related to isolated stenoses of small epicardial coronary arteries.

PubMed

Jessurun, G A; Hautvast, R W; DeJongste, M J; Meyler, W J; van Boven AJ; Crijns, H J

1999-07-01

Patients with symptomatic small vessel coronary artery disease may be inadequate candidates for revascularization procedures. They may suffer from refractory angina, which does not respond to maximal anti-anginal drug therapy. In addition to patients with end stage coronary artery disease and syndrome X, this newly defined group of subjects with an isolated stenosis of a small coronary artery may benefit from electrical neurostimulation. We describe two patients with intractable angina caused by a significant narrowing of a diagonal branch. This treatment modality should be considered as an alternative method for unsatisfactory revascularization procedures.

Fibromuscular Dysplasia Presenting with Bilateral Renal Infarction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doody, O., E-mail: orla_doody@hotmail.co; Adam, W. R.; Foley, P. T.

2009-03-15

Fibromuscular dysplasia (FMD) describes a group of conditions which cause nonatheromatous arterial stenoses, most commonly of the renal and carotid arteries, typically in young women. We report a rare case of bilateral segmental renal infarction secondary to FMD in a young male patient. His initial presentation with loin pain and pyrexia resulted in a delay in the definitive diagnosis of FMD. He was successfully treated with bilateral balloon angioplasty. The delayed diagnosis in this patient until the condition had progressed to bilateral renal infarcts highlights the need for prompt investigation and diagnosis of suspected cases of FMD.

Excimer laser coronary angioplasty: relative risk analysis of clinical results

NASA Astrophysics Data System (ADS)

Bittl, John A.

1992-08-01

Reports of successful use of excimer laser coronary angioplasty for complex coronary artery disease abound, yet firm indications for its use have not been defined. We attempted to treat 858 coronary stenoses in 764 consecutive patients (mean age 61 years; range 32 - 91 years; 75% men; 76% with Class III or IV angina) with excimer laser angioplasty at 308 nm. Successful treatment was achieved in 86% of patients, as indicated by 20 mm), total occlusions and calcified lesions were treated as successfully as all other lesion types. Successful treatment with excimer laser coronary angioplasty was also achieved in almost all patients (15/16) who had a prior unsuccessful attempt at balloon angioplasty in the lesion was crossed with a guidewire yet resists either balloon catheter passage or full dilatation. Follow-up angiography was obtained in 70% of eligible patients. Angiographic restenosis, defined by > 50% stenosis, was seen in 60% of patients. Relative risk analysis showed an increased risk of restenosis when adjunctive balloon angioplasty was not used (OR equals 1.68; 95% CI equals 1.02, 2.28; P equals 0.039). Other variables known to affect the outcome of balloon angioplasty, such as lesion length or stenosis in degenerated saphenous vein bypass graft, did not influence the restenosis rates. This analysis defines the profile of risk for excimer laser angioplasty and now provides a sound basis for future, rigorous comparison of excimer laser and balloon angioplasty to balloon angioplasty for a group of lesions that appear to have acceptable success rates with excimer laser coronary angioplasty, which we have denoted the `alpha class' -- saphenous vein lesions, long lesions, ostial stenoses, lesions in calcified vessels, total occlusions, and balloon dilatation failures. Although adjunctive balloon angioplasty may be beneficial, restenosis remains a significant limitation of the procedure and will restrict the usefulness of excimer laser coronary angioplasty for may other types of lesions.

Hormone-dependent control of developmental timing through regulation of chromatin accessibility

PubMed Central

Uyehara, Christopher M.; Nystrom, Spencer L.; Niederhuber, Matthew J.; Leatham-Jensen, Mary; Ma, Yiqin; Buttitta, Laura A.

2017-01-01

Specification of tissue identity during development requires precise coordination of gene expression in both space and time. Spatially, master regulatory transcription factors are required to control tissue-specific gene expression programs. However, the mechanisms controlling how tissue-specific gene expression changes over time are less well understood. Here, we show that hormone-induced transcription factors control temporal gene expression by regulating the accessibility of DNA regulatory elements. Using the Drosophila wing, we demonstrate that temporal changes in gene expression are accompanied by genome-wide changes in chromatin accessibility at temporal-specific enhancers. We also uncover a temporal cascade of transcription factors following a pulse of the steroid hormone ecdysone such that different times in wing development can be defined by distinct combinations of hormone-induced transcription factors. Finally, we show that the ecdysone-induced transcription factor E93 controls temporal identity by directly regulating chromatin accessibility across the genome. Notably, we found that E93 controls enhancer activity through three different modalities, including promoting accessibility of late-acting enhancers and decreasing accessibility of early-acting enhancers. Together, this work supports a model in which an extrinsic signal triggers an intrinsic transcription factor cascade that drives development forward in time through regulation of chromatin accessibility. PMID:28536147

Removal of slow-pulsing artifacts in in-phase 15N relaxation dispersion experiments using broadband 1H decoupling.

PubMed

Chatterjee, Soumya Deep; Ubbink, Marcellus; van Ingen, Hugo

2018-06-02

Understanding of the molecular mechanisms of protein function requires detailed insight into the conformational landscape accessible to the protein. Conformational changes can be crucial for biological processes, such as ligand binding, protein folding, and catalysis. NMR spectroscopy is exquisitely sensitive to such dynamic changes in protein conformations. In particular, Carr-Purcell-Meiboom-Gill (CPMG) relaxation dispersion experiments are a powerful tool to investigate protein dynamics on a millisecond time scale. CPMG experiments that probe the chemical shift modulation of 15 N in-phase magnetization are particularly attractive, due to their high sensitivity. These experiments require high power 1 H decoupling during the CPMG period to keep the 15 N magnetization in-phase. Recently, an improved version of the in-phase 15 N-CPMG experiment was introduced, offering greater ease of use by employing a single 1 H decoupling power for all CPMG pulsing rates. In these experiments however, incomplete decoupling of off-resonance amide 1 H spins introduces an artefactual dispersion of relaxation rates, the so-called slow-pulsing artifact. Here, we analyze the slow-pulsing artifact in detail and demonstrate that it can be suppressed through the use of composite pulse decoupling (CPD). We report the performances of various CPD schemes and show that CPD decoupling based on the 90 x -240 y -90 x element results in high-quality dispersion curves free of artifacts, even for amides with high 1 H offset.

A new imaging technique for detecting interstellar communications

NASA Astrophysics Data System (ADS)

Vallerga, John; Welsh, Barry; Kotze, Marissa; Siegmund, Oswald

2017-01-01

We report on a unique detection methodology using the Berkeley Visible Image Tube (BVIT) mounted on the 10m Southern African Large Telescope (SALT) to search for laser pulses originating in communications from advanced extraterrestrial (ET) civilizations residing on nearby Earth-like planets located within their habitability zones. The detection technique assumes that ET communicates through high powered pulsed lasers with pulse durations on the order of 5 nanoseconds, the signals thereby being brighter than that of the host star within this very short period of time. Our technique turns down the gain of the optically sensitive photon counting microchannel plate detector such that ~30 photons are required in a 5ns window to generate an imaged event. Picking a priori targets with planets in the habitable zone substantially reduces the false alarm rate. Interplanetary communication by optical masers was first postulated by Schwartz and Townes in 1961. Under the assumption that ET has access to a 10 m class telescope operated as a transmitter then we could detect lasers with a similar power to that of the Livermore Laboratory laser (~1.8Mj per pulse), to a distance of ~ 1000 pc. In this talk we present the results of 2400 seconds of BVIT observations on the SALT of the star Wolf 1061, which is known to harbor an Earth-sized exoplanet located in the habitability zone. At this distance (4.3 pc), BVIT on SALT could detect a 48 joule per pulse laser, now commercially available as tabletop devices.

Carcinogenic damage to deoxyribonucleic acid is induced by near-infrared laser pulses in multiphoton microscopy via combination of two- and three-photon absorption

NASA Astrophysics Data System (ADS)

Nadiarnykh, Oleg; Thomas, Giju; Van Voskuilen, Johan; Sterenborg, Henricus J. C. M.; Gerritsen, Hans C.

2012-11-01

Nonlinear optical imaging modalities (multiphoton excited fluorescence, second and third harmonic generation) applied in vivo are increasingly promising for clinical diagnostics and the monitoring of cancer and other disorders, as they can probe tissue with high diffraction-limited resolution at near-infrared (IR) wavelengths. However, high peak intensity of femtosecond laser pulses required for two-photon processes causes formation of cyclobutane-pyrimidine-dimers (CPDs) in cellular deoxyribonucleic acid (DNA) similar to damage from exposure to solar ultraviolet (UV) light. Inaccurate repair of subsequent mutations increases the risk of carcinogenesis. In this study, we investigate CPD damage that results in Chinese hamster ovary cells in vitro from imaging them with two-photon excited autofluorescence. The CPD levels are quantified by immunofluorescent staining. We further evaluate the extent of CPD damage with respect to varied wavelength, pulse width at focal plane, and pixel dwell time as compared with more pronounced damage from UV sources. While CPD damage has been expected to result from three-photon absorption, our results reveal that CPDs are induced by competing two- and three-photon absorption processes, where the former accesses UVA absorption band. This finding is independently confirmed by nonlinear dependencies of damage on laser power, wavelength, and pulse width.

Pulsed Dye Laser Therapy in the Treatment of Warts: A Review of the Literature.

PubMed

Veitch, David; Kravvas, Georgios; Al-Niaimi, Firas

2017-04-01

Warts or verrucae vulgaris are common cutaneous infections with currently no definitive curative treatments available. To determine the efficacy of pulsed dye laser (PDL) in the treatment of warts. A literature search was performed using the PubMed and MEDLINE databases. A search using {(Wart[s], verruca or condylomata)} AND [(Pulsed dye laser)] was used. Forty-four articles were identified as relevant to this review. Simple warts were very responsive to PDL, being treated successfully in over 95% of patients. Facial and anogenital warts also demonstrated excellent outcomes. Recalcitrant warts, displayed significant variability in their response, ranging between 50% and 100% across all articles. The response rates seen in peripheral warts (involving the hands and feet) were also very variable, ranging between 48% and 95%. Recurrence rates at 4 months of follow-up were documented as 0% to 15%. Complications have been described as very few and rare, the main ones being topical discomfort and erythema. Pulsed dye laser is a safe and effective modality in the treatment of warts that can be applied to most body parts. Cost and availability remain a limitation to the use of PDL; however, this modality can be used when other more traditional and accessible treatments have failed.

Wright Research and Development Center Test Facilities Handbook

DTIC Science & Technology

1990-01-01

Variable Temperature (2-400K) and Field (0-5 Tesla) Squid Susceptometer Variable Temperature (10-80K) and Field (0-10 Tesla) Transport Current...determine products of combustion using extraction type probes INSTRUMENTATION: Mini computer/data acquisiton system Networking provides access to larger...data recorder, Masscomp MC-500 computer with acquisition digitizer, laser and ink -jet printers,lo-pass filters, pulse code modulation AVAILABILITY

Treatment of High Flow Arteriovenous Fistulas after Successful Renal Transplant Using a Simple Precision Banding Technique.

PubMed

Gkotsis, Georgios; Jennings, William C; Malik, Jan; Mallios, Alexandros; Taubman, Kevin

2016-02-01

Observation versus ligation of a functional arteriovenous fistula (AVF) after successful renal transplantation (SRT) has been a controversial topic of debate. Congestive heart failure and pulmonary hypertension are common in dialysis patients, and more frequent when vascular access flow is excessive. Renal transplant failure may occur in up to 34% of patients after 5 years, therefore maintaining a moderate flow AVF appears warranted. We review SRT patients with high flow-AVFs (HF-AVF) and clinical signs of heart failure where a modified precision banding procedure was used for access flow reduction. Patients referred for HF-AVF evaluation after SRT were identified and records reviewed retrospectively. In addition to recording clinical signs of heart failure, each patient had ultrasound AVF flow measurement before and after temporary AVF occlusion of the access by digital compression. Pulse rate and the presence or absence of a cardiac murmur was noted before and after AVF compression. Adequacy of access flow restriction was evaluated intraoperatively using ultrasound flow measurements, adjusting the banding diameter in 0.5 mm increments to achieve the targeted AVF flow. Twelve patients were evaluated over a 19-month period. Eight (66%) were male and one (8%) obese. Ages were 15-73 years (mean = 42). The AVFs were established 24-86 months previously. The mean pulse rate declined after AVF compression from 90/min to 72/min (range 110-78). Six patients had a precompression cardiac flow murmur that disappeared with temporary AVF compression. One patient with poor cardiac function underwent immediate AVF ligation with dramatic improvement in cardiac status. All other patients underwent a precision banding procedure with real-time flow monitoring. Mean access flow was 2,280 mL/min (1,148-3,320 mL/min) before access banding and was 598 mL/min (481-876) after flow reduction. The clinical signs of heart failure disappeared in all patients. All AVFs remained patent although one individual later requested ligation for cosmesis. Two patients had renal transplant failure and later successfully used the AVF. Follow-up postbanding was 1-18 months (mean = 12). Patients with successful renal transplants and HF-AVFs had resolution of heart failure findings and maintenance of access patency using a modified precision banding procedure. Flow reduction in symptomatic renal transplant patients with elevated access flow is recommended. Further study is warranted to substantiate these recommendations and clarify the appropriate thresholds for such interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Calibrating and training of neutron based NSA techniques with less SNM standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geist, William H; Swinhoe, Martyn T; Bracken, David S

2010-01-01

Accessing special nuclear material (SNM) standards for the calibration of and training on nondestructive assay (NDA) instruments has become increasingly difficult in light of enhanced safeguards and security regulations. Limited or nonexistent access to SNM has affected neutron based NDA techniques more than gamma ray techniques because the effects of multiplication require a range of masses to accurately measure the detector response. Neutron based NDA techniques can also be greatly affected by the matrix and impurity characteristics of the item. The safeguards community has been developing techniques for calibrating instrumentation and training personnel with dwindling numbers of SNM standards. Montemore » Carlo methods have become increasingly important for design and calibration of instrumentation. Monte Carlo techniques have the ability to accurately predict the detector response for passive techniques. The Monte Carlo results are usually benchmarked to neutron source measurements such as californium. For active techniques, the modeling becomes more difficult because of the interaction of the interrogation source with the detector and nuclear material; and the results cannot be simply benchmarked with neutron sources. A Monte Carlo calculated calibration curve for a training course in Indonesia of material test reactor (MTR) fuel elements assayed with an active well coincidence counter (AWCC) will be presented as an example. Performing training activities with reduced amounts of nuclear material makes it difficult to demonstrate how the multiplication and matrix properties of the item affects the detector response and limits the knowledge that can be obtained with hands-on training. A neutron pulse simulator (NPS) has been developed that can produce a pulse stream representative of a real pulse stream output from a detector measuring SNM. The NPS has been used by the International Atomic Energy Agency (IAEA) for detector testing and training applications at the Agency due to the lack of appropriate SNM standards. This paper will address the effect of reduced access to SNM for calibration and training of neutron NDA applications along with the advantages and disadvantages of some solutions that do not use standards, such as the Monte Carlo techniques and the NPS.« less

Global operating theatre distribution and pulse oximetry supply: an estimation from reported data.

PubMed

Funk, Luke M; Weiser, Thomas G; Berry, William R; Lipsitz, Stuart R; Merry, Alan F; Enright, Angela C; Wilson, Iain H; Dziekan, Gerald; Gawande, Atul A

2010-09-25

Surgery is an essential part of health care, but resources to ensure the availability of surgical services are often inadequate. We estimated the global distribution of operating theatres and quantified the availability of pulse oximetry, which is an essential monitoring device during surgery and a potential measure of operating theatre resources. We calculated ratios of the number of operating theatres to hospital beds in seven geographical regions worldwide on the basis of profiles from 769 hospitals in 92 countries that participated in WHO's safe surgery saves lives initiative. We used hospital bed figures from 190 WHO member states to estimate the number of operating theatres per 100,000 people in 21 subregions throughout the world. To estimate availability of pulse oximetry, we sent surveys to anaesthesia providers in 72 countries selected to ensure a geographically and demographically diverse sample. A predictive regression model was used to estimate the pulse oximetry need for countries that did not provide data. The estimated number of operating theatres ranged from 1·0 (95% CI 0·9-1·2) per 100,000 people in west sub-Saharan Africa to 25·1 (20·9-30·1) per 100,000 in eastern Europe. High-income subregions all averaged more than 14 per 100,000 people, whereas all low-income subregions, representing 2·2 billion people, had fewer than two theatres per 100,000. Pulse oximetry data from 54 countries suggested that around 77,700 (63,195-95,533) theatres worldwide (19·2% [15·2-23·9]) were not equipped with pulse oximeters. Improvements in public-health strategies and monitoring are needed to reduce disparities for more than 2 billion people without adequate access to surgical care. WHO. Copyright © 2010 Elsevier Ltd. All rights reserved.

Automatic Between-Pulse Analysis of DIII-D Experimental Data Performed Remotely on a Supercomputer at Argonne Leadership Computing Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kostuk, M.; Uram, T. D.; Evans, T.

For the first time, an automatically triggered, between-pulse fusion science analysis code was run on-demand at a remotely located supercomputer at Argonne Leadership Computing Facility (ALCF, Lemont, IL) in support of in-process experiments being performed at DIII-D (San Diego, CA). This represents a new paradigm for combining geographically distant experimental and high performance computing (HPC) facilities to provide enhanced data analysis that is quickly available to researchers. Enhanced analysis improves the understanding of the current pulse, translating into a more efficient use of experimental resources, and to the quality of the resultant science. The analysis code used here, called SURFMN,more » calculates the magnetic structure of the plasma using Fourier transform. Increasing the number of Fourier components provides a more accurate determination of the stochastic boundary layer near the plasma edge by better resolving magnetic islands, but requires 26 minutes to complete using local DIII-D resources, putting it well outside the useful time range for between pulse analysis. These islands relate to confinement and edge localized mode (ELM) suppression, and may be controlled by adjusting coil currents for the next pulse. Argonne has ensured on-demand execution of SURFMN by providing a reserved queue, a specialized service that launches the code after receiving an automatic trigger, and with network access from the worker nodes for data transfer. Runs are executed on 252 cores of ALCF’s Cooley cluster and the data is available locally at DIII-D within three minutes of triggering. The original SURFMN design limits additional improvements with more cores, however our work shows a path forward where codes that benefit from thousands of processors can run between pulses.« less

Automatic Between-Pulse Analysis of DIII-D Experimental Data Performed Remotely on a Supercomputer at Argonne Leadership Computing Facility

DOE PAGES

Kostuk, M.; Uram, T. D.; Evans, T.; ...

2018-02-01

For the first time, an automatically triggered, between-pulse fusion science analysis code was run on-demand at a remotely located supercomputer at Argonne Leadership Computing Facility (ALCF, Lemont, IL) in support of in-process experiments being performed at DIII-D (San Diego, CA). This represents a new paradigm for combining geographically distant experimental and high performance computing (HPC) facilities to provide enhanced data analysis that is quickly available to researchers. Enhanced analysis improves the understanding of the current pulse, translating into a more efficient use of experimental resources, and to the quality of the resultant science. The analysis code used here, called SURFMN,more » calculates the magnetic structure of the plasma using Fourier transform. Increasing the number of Fourier components provides a more accurate determination of the stochastic boundary layer near the plasma edge by better resolving magnetic islands, but requires 26 minutes to complete using local DIII-D resources, putting it well outside the useful time range for between pulse analysis. These islands relate to confinement and edge localized mode (ELM) suppression, and may be controlled by adjusting coil currents for the next pulse. Argonne has ensured on-demand execution of SURFMN by providing a reserved queue, a specialized service that launches the code after receiving an automatic trigger, and with network access from the worker nodes for data transfer. Runs are executed on 252 cores of ALCF’s Cooley cluster and the data is available locally at DIII-D within three minutes of triggering. The original SURFMN design limits additional improvements with more cores, however our work shows a path forward where codes that benefit from thousands of processors can run between pulses.« less

All-optical signatures of strong-field QED in the vacuum emission picture

NASA Astrophysics Data System (ADS)

Gies, Holger; Karbstein, Felix; Kohlfürst, Christian

2018-02-01

We study all-optical signatures of the effective nonlinear couplings among electromagnetic fields in the quantum vacuum, using the collision of two focused high-intensity laser pulses as an example. The experimental signatures of quantum vacuum nonlinearities are encoded in signal photons, whose kinematic and polarization properties differ from the photons constituting the macroscopic laser fields. We implement an efficient numerical algorithm allowing for the theoretical investigation of such signatures in realistic field configurations accessible in experiment. This algorithm is based on a vacuum emission scheme and can readily be adapted to the collision of more laser beams or further involved field configurations. We solve the case of two colliding pulses in full 3 +1 -dimensional spacetime and identify experimental geometries and parameter regimes with improved signal-to-noise ratios.

Personalized design and virtual evaluation of physician-modified stent grafts for juxta-renal abdominal aortic aneurysms

NASA Astrophysics Data System (ADS)

Sanathkhani, Soroosh; Shroff, Sanjeev G.; Menon, Prahlad G.

2017-02-01

Endovascular aneurysm repair (EVAR) of juxtarenal aortic aneurysms (JAA) is particularly challenging owing to the requirement of suprarenal EVAR graft fixation, which has been associated with significant declines in long term renal function. Therefore, the ability to design fenestrated EVAR grafts on a personalized basis in order to ensure visceral and renal perfusion, is highly desirable. The objectives of this study are: a) To demonstrate novel 3D geometric methods to virtually design and deploy EVAR grafts into a virtually designed JAA, by applying a custom surface mesh deformation tool to a patient-specific descending aortic model reconstructed from computed tomographic (CT) images; and b) To virtually evaluate patient-specific renal flow and wall stresses in these patient-specific virtually EVAR geometries, using computational fluid dynamics (CFD). The presented framework may provide the modern cardiovascular surgeon the ability to leverage non-invasive, pre-operative imaging equipment to personalize and guide EVAR therapeutic strategy. Our CFD studies revealed that virtual EVAR grafting of a patient-specific JAA, with optimal fenestration sites and renal stenting, led to a 179.67±15.95% and 1051.43±18.34% improvement in right and left renal flow rates, respectively, when compared with the baseline patient-specific aortic geometry with renal stenoses, whereas a right and left renal flow improved by 36.44±2.24% and 885.93±12.41%, respectively, relative to the equivalently modeled JAA with renal stenoses, considering averages across the three simulated inflow rate cases. The proposed framework have utility to iteratively optimize suprarenal EVAR fixation length and achieve normal renal wall shear stresses and streamlined juxtarenal hemodynamics.

Combined optical coherence tomography morphologic and fractional flow reserve hemodynamic assessment of non- culprit lesions to better predict adverse event outcomes in diabetes mellitus patients: COMBINE (OCT-FFR) prospective study. Rationale and design.

PubMed

Kennedy, Mark W; Fabris, Enrico; Ijsselmuiden, Alexander J; Nef, Holger; Reith, Sebastian; Escaned, Javier; Alfonso, Fernando; van Royen, Niels; Wojakowski, Wojtek; Witkowski, Adam; Indolfi, Ciro; Ottervanger, Jan Paul; Suryapranata, Harry; Kedhi, Elvin

2016-10-10

Fractional flow reserve (FFR) is a widely used tool for the identification of ischaemia-generating stenoses and to guide decisions on coronary revascularisation. However, the safety of FFR-based decisions in high-risk subsets, such as patients with Diabetes Mellitus (DM) or vulnerable stenoses presenting thin-cap fibro-atheroma (TCFA), is unknown. This study will examine the impact of optical coherence tomography (OCT) plaque morphological assessment and the identification of TCFA, in combination with FFR to better predict clinical outcomes in DM patients. COMBINE (OCT-FFR) is a prospective, multi-centre study investigating the natural history of DM patients with ≥1 angiographically intermediate target lesion in three subgroups of patients; patients with FFR negative lesions without TCFA (group A) and patients with FFR negative lesions with TCFA (group B) as detected by OCT and to compare these two groups with each other, as well as to a third group with FFR-positive, PCI-treated intermediate lesions (group C). The study hypothesis is that DM patients with TCFA (group B) have a worse outcome than those without TCFA (group A) and also when compared to those patients with lesions FFR ≤0.80 who underwent complete revascularisation. The primary endpoint is the incidence of target lesion major adverse cardiac events (MACE); a composite of cardiac death, myocardial infarction or rehospitalisation for unstable/progressive angina in group B vs. group A. COMBINE (OCT-FFR) is the first prospective study to examine whether the addition of OCT plaque morphological evaluation to FFR haemodynamic assessment of intermediate lesions in DM patients will better predict MACE and possibly lead to new revascularisation strategies. Trial Registration Netherlands Trial Register: NTR5376.

Contrast-enhanced ultrasound imaging of intraplaque neovascularization and its correlation to plaque echogenicity in human carotid arteries atherosclerosis.

PubMed

Cattaneo, Mattia; Staub, Daniel; Porretta, Alessandra P; Gallino, Jeanne Marie; Santini, Paolo; Limoni, Costanzo; Wyttenbach, Rolf; Gallino, Augusto

2016-11-15

Currently the most widely accepted predictor of stroke risk in patients with carotid atherosclerosis is the degree of stenoses. Plaque echogenicity on ultrasound imaging (US) and intraplaque neovascularization (IPNV) are becoming recognized as factors of plaque vulnerability. Aim of the study was to investigate the correlation between the echogenicity of the carotid atherosclerosis by standard US and the degree of IPNV by contrast enhanced US (CEUS). We recruited 45 consecutive subjects with an asymptomatic ≥50% carotid artery stenoses. Carotid plaque echogenicity at standard US was visually graded according to Gray-Weale classification (GW) and measured by the grayscale median (GSM), a semi-automated measurement performed by Adobe Photoshop©. On CEUS imaging IPNV was graded by different point scales according to the visual appearance of contrast within the plaque as follows: CEUS_A (1=absent; 2=present); CEUS_B (increasing IPNV from 1 to 3); and CEUS_C (increasing IPNV from 0 to 3). The correlation between echogenicity by GW and IPNV grading was as follows: CEUS_B (-0.130 p .423), CEUS_C (-0.108, p .509), CEUS_A (0.021, p .897). The correlation between echogenicity by GSM measurement and IPNV was as follows: using a CEUS_A (-0.125, p .444), CEUS_C (-0.021, p .897) (0.005, p .977). No correlation was found statistically significant. Our results display that there is no significant correlation between plaque echogenicity and IPNV. The small sample number and the multifaceted pathophysiology of the atherosclerotic plaque may explain the absence of statistically significantly correlation. Curtailing vulnerability explanation to either IPNV or echolucency may be misleading. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Endovascular treatment of intracranial aneurysms with the p64 flow diverter stent: mid-term results in 35 patients with 41 intracranial aneurysms.

PubMed

Morais, Ricardo; Mine, Benjamin; Bruyère, Pierre Julien; Naeije, Gilles; Lubicz, Boris

2017-03-01

The p64 flow diverter (FD) device is a fully resheathable and detachable stent dedicated for endovascular treatment (EVT) of intracranial aneurysms (IAs). We report our mid-term experience with this device. Between January 2015 and February 2016, we retrospectively identified, in our prospectively maintained database, all patients treated with p64 FDs in two institutions. Independent clinical follow-up was performed by a vascular neurologist. Imaging follow-up included a digitalized subtraction angiography (DSA) at 3, 6, and 12 months and a magnetic resonance angiography (MRA) at 12 months. Thirty-nine patients (22 women/17 men; median age 54 years) with 48 IAs (median aneurysm size 6.2 mm; mean neck size 3.4 mm) were identified. All IAs were saccular and unruptured. Failure of safe stent delivery occurred in 15% of cases (7/48 IAs) which were excluded. Transient neurological morbidity occurred in 2/35 patients (5.7%) including one delayed thromboembolic complication. No permanent morbidity or mortality was encountered. Complete aneurysmal occlusion at 3, 6, and 12 months was 20/30 (66.6%), 18/27 (66.6%), and 24/28 (85.7%), respectively. Intra-stent stenosis was observed in 9/29 patients (31%) and classified as moderate in 4/29 (13.7%) and mild in 5/29 patients (17.2%). These stenoses gradually improved over time, with only mild stenoses being identified at 6 months and at 12 months. In our small case series, the p64 FD stent appears safe and effective for EVT of IAs. A high occlusion rate and a low morbidity rate were observed.

[Treatment of acute and chronic laryngeal and tracheal stenoses in the 19th and beginning of the 20th century by tracheotomy, coniotomy, intubation and dilatation. Pictures from the history of otorhinolaryngology illustrated by instruments from the collection of the Ingolstadt Medical History Museum].

PubMed

Feldmann, H

1995-04-01

Although tracheotomy had been described in the Middle Ages and especially in the 17th century in writings (Fabricius d'Aquapendente 1620) and illustrations (Scultetus 1645), there was hardly any possibility of actually performing this operation as a life-saving intervention until the middle of the 19th century. It was only after suitable cannulae had been introduced by Trousseau in 1851 (double cannula with removeable insert) that tracheotomy became a routine procedure, and it was immediately carried out in a great many cases of diphtheria, croup, typhus, and lues, which often caused critical dispnea. Within the following 25 years, all technical modifications of cannulae were devised that are in use up to this day: the flap valve for the artificial larynx (1861), inflatable cuff (1871), and extra long flexible cannula. Beginning in 1885, O'Dwyer's method of intubation became established as an alternative to tracheotomy. Both procedures, like the underlying disease itself, frequently resulted in a permanent stenosis of the larynx or the trachea rendering decannulation impossible. Since about 1870 the treatment of these stenoses, primarily by bougienage, became an important issue in laryngology, which had just been established as a discipline in its own right. The history of this evolution and the therapeutic approaches by Schrötter in Vienna and Thost in Hamburg are described in detail, including their specially devised equipment. Apart from that, other medical aspects of historical interest around the turn of the century are mentioned, such as artificial nutrition by subcutaneous injections and tracheotomy in horses.(ABSTRACT TRUNCATED AT 250 WORDS)

The Contegra bovine valved jugular vein conduit for pediatric RVOT reconstruction: 4 years experience with 108 patients.

PubMed

Breymann, Thomas; Boethig, Dietmar; Goerg, Reiner; Thies, Wolf-Rüdiger

2004-01-01

Porcine xenografts for pediatric right ventricular outflow tractus (RVOT) reconstruction lack durability, homografts lack availability. The Contegra is a valve bearing bovine jugular vein. It is tear resistant, well pliable, and permits RVOT reconstruction without further foreign material. The 108 Contegras implanted in Bad Oeynhausen from May 1999 until January 2003 represent the largest single-center Contegra experience. The study gives the preliminary results from a controlled prospective multicenter trial aiming at FDA admission. The patients' diagnoses were truncus arteriosus (27%), double outlet right ventricle (14%), tetralogy of Fallot (48%), transposition of great arteries (6%), rare complex malformation (2%), and Ross procedure (1%). Fifty-eight were female. Age: 2 days to 20.1 years, mean: 4.3 +/- 5.2, median: 1.8 years. Thirty-three had primary implantations, 38 previous repairs, 37 conduit exchange. Total follow-up time: 227.7 years, mean: 2.1. About 848 echos were evaluated. Early mortality: 7.4% (8 patients); 1 late death. None was Contegra-related. Echocardiographic controls showed no relevant average valvular gradient development. Trace and mild-grade insufficiency is frequent, without tendency to increase. Average insufficiency is between trace and mild unless RV pressure remains under 100 mmHg. Average individual right/left ventricle length ratios did not increase over time. We saw no relevant conduit dilatation and no leaflet calcification. Pulmonary artery stenoses had mainly extrinsic reasons. At 4 years, freedom- from- event rates were: reoperation for Conduit inflow or valvular degeneration: 100%; reoperation for pulmonary artery branch stenoses (n = 10) 86%, explantation (n = 4): 92%. Survival: 91.7%. Contegra is worth being considered as an alternative to homografts.

Polyethylene glycol and contrast-enhanced MRI of Crohn's disease in children: preliminary experience.

PubMed

Magnano, Gianmichele; Granata, Claudio; Barabino, Arrigo; Magnaguagno, Francesca; Rossi, Umberto; Calevo, Maria Grazia; Toma, Paolo

2003-06-01

To assess the ability of MRI to detect bowel abnormalities in children affected by Crohn's disease (CD). We studied 22 children (age range 8-18 years) referred to us with a known history of CD. MRI was carried out using a 1.5-T unit with a maximum gradient field strength of 16 mT and a phased-array body coil. The sequences performed were breath-hold coronal and axial T2-weighted, express fat saturation, followed by T1-weighted, spoiled gradient, fast fat saturation after IV injection of gadolinium chelate (0.3 mmol/kg) for contrast enhancement of the bowel wall. Bowel distension was achieved using oral administration of isosmotic polyethylene glycol solution. Ileo-colonoscopy was considered the gold standard for evaluation of superficial abnormalities and stenoses of the colon and terminal ileum. MRI findings of bowel-wall thickening, increased vascularisation and extramural involvement were compared with the findings using B-mode and Doppler US. Concordance between MRI and endoscopy, B-mode US and Doppler US findings was determined by the Kappa statistical method. Superficial lesions were not shown by MRI. MR enteroclysis easily detected stenoses, thickening and hyperaemia of bowel wall. Concordance of findings between MRI and endoscopy was 90% (K=0.79, substantial concordance). Concordance of findings between MRI and US concerning bowel-wall thickening and increased vascularisation was 95% (K=0.875, excellent concordance) and 80% (K=0.6, fairly good concordance), respectively. Our initial results show that MRI can detect intra- and extra-mural lesions of CD. The high concordance observed between MRI, endoscopy, US and Doppler US findings suggests that MRI is at least comparable for diagnostic capability with these techniques offering, thanks to multiplanar projections, an improved visualisation of the bowel without ionising radiation.

Redirection of arachidonic acid metabolism by ICI D1542: effects on thrombus formation in the coronary artery of the anaesthetized dog.

PubMed Central

McAuliffe, S. J.; Moors, J. A.; Snow, H. M.; Wayne, M.; Jessup, R.

1993-01-01

1. The effects of simultaneous redirection of arachidonic acid metabolism, by inhibition of thromboxane A2 (TXA2) synthase and blockade of the platelet thromboxane A2 receptor (TP-receptor), was examined on the rate of thrombus formation in a stenosed coronary artery with damaged endothelium in an anaesthetized dog. 2. Redirection of arachidonic acid metabolism was achieved by intravenous doses of ICI D1542, a selective and potent inhibitor of TXA2 synthase and the TP-receptor. 3. Redirection of arachidonic acid metabolism was demonstrated in whole blood, stimulated ex vivo by collagen. The ED50 for inhibition of TXB2 production was 7.1 micrograms kg-1, i.v.; there were corresponding increases in the production of the eicosanoids prostaglandin D2 (PGD2), PGE2 and PGF2 alpha. 4. Thrombus formation was inhibited by D1542 (ED50 0.55 micrograms kg-1, i.v.), but could be restarted by an intravenous infusion of adrenaline (0.2-38 micrograms kg-1 min-1, i.v.). In the presence of the maximum effective dose of D1542 (1 mg kg-1, i.v.) a 190 fold increase in the infusion rate of adrenaline was required to restore thrombus formation. 5. In the presence of D1542, removal of endoperoxide metabolites by inhibition of cyclo-oxygenase with aspirin (5 mg kg-1, i.v.) caused thrombus formation to restart, indicating the ability of the endoperoxide metabolites to inhibit thrombus formation in vivo. 6. These results indicate that, in the stenosed and damaged coronary artery of the dog, redirection of arachidonic acid metabolism by D1542 is more effective at preventing thrombus formation than inhibition of cyclo-oxygenase by aspirin. PMID:8485629

Correlation between carotid bifurcation calcium burden on non-enhanced CT and percentage stenosis, as confirmed by digital subtraction angiography

PubMed Central

Sarikaya, B; Lohman, B; Mckinney, A M; Gadani, S; Irfan, M; Lucato, L

2012-01-01

Objectives Previous evidence supports a direct relationship between the calcium burden (volume) on post-contrast CT with the percent internal carotid artery (ICA) stenosis at the carotid bifurcation. We sought to further investigate this relationship by comparing non-enhanced CT (NECT) and digital subtraction angiography (DSA). Methods 50 patients (aged 41–82 years) were retrospectively identified who had undergone cervical NECT and DSA. A 64-multidetector array CT (MDCT) scanner was utilised and the images reviewed using preset window widths/levels (30/300) optimised to calcium, with the volumes measured via three-dimensional reconstructive software. Stenosis measurements were performed on DSA and luminal diameter stenoses >40% were considered “significant”. Volume thresholds of 0.01, 0.03, 0.06, 0.09 and 0.12 cm3 were utilised and Pearson'S correlation coefficient (r) was calculated to correlate the calcium volume with percent stenosis. Results Of 100 carotid bifurcations, 88 were available and of these 7 were significantly stenotic. The NECT calcium volume moderately correlated with percent stenosis on DSA r=0.53 (p<0.01). A moderate–strong correlation was found between the square root of calcium volume on NECT with percent stenosis on DSA (r=0.60, p<0.01). Via a receiver operating characteristic curve, 0.06 cm3 was determined to be the best threshold (sensitivity 100%, specificity 90.1%, negative predictive value 100% and positive predictive value 46.7%) for detecting significant stenoses. Conclusion This preliminary investigation confirms a correlation between carotid bifurcation calcium volume and percent ICA stenosis and is promising for the optimal threshold for stenosis detection. Future studies could utilise calcium volumes to create a “score” that could predict high grade stenosis. PMID:21896662

Risk of colorectal cancer and small bowel adenocarcinoma in Crohn's disease: a population-based study from western Hungary 1977-2008.

PubMed

Lakatos, Peter Laszlo; David, Gyula; Pandur, Tunde; Erdelyi, Zsuzsanna; Mester, Gabor; Balogh, Mihaly; Szipocs, Istvan; Molnar, Csaba; Komaromi, Erzsebet; Kiss, Lajos S; Lakatos, Laszlo

2011-04-01

Limited data are available on the incidence and predictors of colorectal (CRC) and small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) from population-based cohorts. Since data are completely missing from Eastern Europe, our aim was to analyze the incidence and risk factors of CD associated CRC and SBA in the population-based, Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008. The data of 506 incident CD patients were analyzed (age-at-diagnosis: 31.5, SD: 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. CRC was diagnosed in five patients (5/5758 person-year-duration) during follow-up, while no patients developed SBA in this cohort. Standardized incidence ratio (SIR) of CRC was not increased overall with five cases observed vs. 5.02 expected (SIR: 0.99, 95% CI: 0.41-2.39); however, there was a tendency for increased incidence in males (five cases observed vs. 2.56 expected; SIR: 1.95, 95% CI: 0.81-4.70). Age at onset of CD (p<0.001), male gender (p=0.022) and stenosing disease behavior at diagnosis (p<0.001) but not disease location were identified as risk factors for developing CRC in univariate analysis and Kaplan-Meier analysis. The cumulative risk for developing CRC after a disease duration of 20 years was 1.1% (95% CI: 0.6-1.7%). The incidence of CRC and SBA was not increased in this population-based CD cohort. Age at onset of CD, male gender and stenosing disease behavior at diagnosis were identified as risk factors of CRC. Copyright © 2010 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

[Transperineal ultrasound imaging of the internal pudendal artery in arteriogenic erectile dysfunction].

PubMed

Povelitsa, E; Dosta, N I; Parhomenko, O V; Nitkin, D M; Shesternja, A M; Anichkin, V V

2017-09-01

To determine the practical and diagnostic value of transperineal ultrasound imaging of the internal pudendal artery (IPA) in patients with arteriogenic erectile dysfunction (ED). Transperineal IPA and penile Doppler ultrasonography was performed in 50 healthy young male volunteers aged 23.6+/-3.4 years without ED (IIEF-5 score of 21-22) and 60 patients with ED (IIEF-5 score of 6-18, mean age 49+/-4.6 years), including 30 men with prostate cancer (PCa) after comprehensive treatment and 30 patients with type 1 and type 2 diabetes mellitus. To determine the diagnostic value of the transperineal IPA imaging, the results were compared with the findings of magnetic resonance or contrast-enhanced dynamic CT angiography of the iliac arteries. In all healthy men no abnormalities were found in the perineal primary arterial blood flow, in 100% of cases perineal branch of IPA was rectilinear, while patients with arteriogenic ED had low IPA and penile peak systolic blood flow velocity (<0.05), pathologically altered type of blood flow and non-rectilinear course of IPA, stenosis and occlusion in the pelvic and extrapelvic branches of IPA. When comparing the findings of IPA Doppler ultrasound and angiography studies of the small pelvis in healthy men, they completely matched, showing satisfactory arterial IPA perfusion, absence of stenoses or occlusions. Sensitivity and specificity of the transperineal IPA ultrasound imaging were 95% and 90%, respectively. Transperineal IPA ultrasound imaging allows to assess the important morphometric features of the perineal branches of IPA - the arterial diameter, the response to stimulation, the course of the artery, the type of arterial blood flow, the presence or absence of arterial stenoses and occlusions, and to measure peak systolic blood flow velocity.

Prospective Coronary Heart Disease Screening in Asymptomatic Hodgkin Lymphoma Patients Using Coronary Computed Tomography Angiography: Results and Risk Factor Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Girinsky, Theodore, E-mail: girinsky.theodore@orange.fr; M’Kacher, Radhia; Lessard, Nathalie

Purpose: To prospectively investigate the coronary artery status using coronary CT angiography (CCTA) in patients with Hodgkin lymphoma treated with combined modalities and mediastinal irradiation. Methods and Materials: All consecutive asymptomatic patients with Hodgkin lymphoma entered the study during follow-up, from August 2007 to May 2012. Coronary CT angiography was performed, and risk factors were recorded along with leukocyte telomere length (LTL) measurements. Results: One hundred seventy-nine patients entered the 5-year study. The median follow-up was 11.6 years (range, 2.1-40.2 years), and the median interval between treatment and the CCTA was 9.5 years (range, 0.5-40 years). Coronary artery abnormalities were demonstrated in 46 patientsmore » (26%). Coronary CT angiography abnormalities were detected in nearly 15% of the patients within the first 5 years after treatment. A significant increase (34%) occurred 10 years after treatment (P=.05). Stenoses were mostly nonostial. Severe stenoses were observed in 12 (6.7%) of the patients, entailing surgery with either angioplasty with stent placement or bypass grafting in 10 of them (5.5%). A multivariate analysis demonstrated that age at treatment, hypertension, and hypercholesterolemia, as well as radiation dose to the coronary artery origins, were prognostic factors. In the group of patients with LTL measurements, hypertension and LTL were the only independent risk factors. Conclusions: The findings suggest that CCTA can identify asymptomatic individuals at risk of acute coronary artery disease who might require either preventive or curative measures. Conventional risk factors and the radiation dose to coronary artery origins were independent prognostic factors. The prognostic value of LTL needs further investigation.« less

Comparison of Quantitative Wall Motion Analysis and Strain For Detection Of Coronary Stenosis With Three-Dimensional Dobutamine Stress Echocardiography

PubMed Central

Parker, Katherine M.; Clark, Alexander P.; Goodman, Norman C.; Glover, David K.; Holmes, Jeffrey W.

2015-01-01

Background Quantitative analysis of wall motion from three-dimensional (3D) dobutamine stress echocardiography (DSE) could provide additional diagnostic information not available from qualitative analysis. In this study we compare the effectiveness of 3D fractional shortening (3DFS), a measure of wall motion computed from 3D echocardiography (3DE), to strain and strain rate measured with sonomicrometry for detecting critical stenoses during DSE. Methods Eleven open-chest dogs underwent DSE both with and without a critical stenosis. 3DFS was measured from 3DE images acquired at peak stress. 3DFS was normalized by subtracting average 3DFS during control peak stress (Δ3DFS). Strains in the perfusion defect (PD) were measured from sonomicrometry, and PD size and location were measured with microspheres. Results A Δ3DFS abnormality indicated the presence of a critical stenosis with high sensitivity and specificity (88% and 100%, respectively), and Δ3DFS abnormality size correlated with PD size (R2=0.54). The sensitivity and specificity for Δ3DFS was similar to that for area strain (88%, 100%) and circumferential strain and strain rate (88%, 92% and 88%, 86%, respectively), while longitudinal strain and strain rate were less specific. Δ3DFS correlated significantly with both coronary flow reserve (R2=0.71) and PD size (R2=0.97), while area strain correlated with PD size only (R2=0.67), and other measures were not significantly correlated with flow reserve or PD size. Conclusion Quantitative wall motion analysis using Δ3DFS is effective for detecting critical stenoses during DSE, performing similarly to 3D strain, and provides potentially useful information on the size and location of a perfusion defect. PMID:24815588

Microembolic Signals Detected with Transcranial Doppler Sonography Differ between Symptomatic and Asymptomatic Middle Cerebral Artery Stenoses in Northeast China

PubMed Central

Wu, Xiujuan; Zhang, Hongliang; Liu, Haiyu; Xing, Yingqi; Liu, Kangding

2014-01-01

Although microembolus monitoring has been widely used for ischemic cerebrovascular disease, the clinical significance of microembolic signal (MES) in asymptomatic middle cerebral artery (MCA) stenosis remains unclear. We aim to investigate the frequency of MES and the value of MES in predicting ischemic stroke secondary to asymptomatic MCA stenosis. From June 2011 to December 2012, microembolus monitoring was performed in 83 asymptomatic and 126 symptomatic subjects. By comparing the demographics and risk factors between the symptomatic and asymptomatic subjects, we found that the ratio of male sexuality and smoking history differed (101/126 vs 43/83, and 88/126 vs 38/83, respectively, p<0.01). The frequency of MES was significantly higher in the symptomatic group than in the asymptomatic group (49/126 vs 2/108, p<0.01). Specifically, the frequency of MES in the symptomatic and asymptomatic groups with mild stenosis, moderate stenosis, severe stenosis and occlusion groups was 4/18 (22.22%) vs 0/30 (0), 13/31 (41.94%) vs 1/28 (3.57%), 30/62 (48.39%) vs 1/39 (2.56%), 2/15 (13.33%) vs 0/11 (0), respectively. Except for the occlusive group, the frequency of MES is correlated with stenosis degree and symptom. Two patients in the asymptomatic group were found positive for MES, and the MES number was 1 for both. During the one-year follow-up, neither of them developed ischemic stroke. In conclusion, MES detected with TCD differs between symptomatic and asymptomatic MCA stenoses. Due to the low frequency, the value of MES as a predictor of subsequent ischemic stroke in patients with asymptomatic MCA stenosis might be limited. PMID:24551204

3D digital subtraction angiography of intracranial aneurysms: comparison of flat panel detector with conventional image intensifier TV system using a vascular phantom.

PubMed

Kakeda, S; Korogi, Y; Ohnari, N; Hatakeyama, Y; Moriya, J; Oda, N; Nishino, K; Miyamoto, W

2007-05-01

Compared with the image intensifier (I.I.)-TV system, the flat panel detector (FPD) system of direct conversion type has several theoretic advantages, such as higher spatial resolution, wide dynamic range, and no image distortion. The purpose of this study was to compare the image quality of 3D digital subtraction angiography (DSA) in the FPD and conventional I.I.-TV systems using a vascular phantom. An anthropomorphic vascular phantom was designed to simulate the various intracranial aneurysms with aneurysmal bleb. The tubes of this vascular phantom were filled with 2 concentrations of contrast material (300 and 150 mg I/mL), and we obtained 3D DSA using the FPD and I.I.-TV systems. First, 2 blinded radiologists compared the volume-rendering images for 3D DSA on the FPD and I.I.-TV systems, looking for pseudostenosis artifacts. Then, 2 other radiologists independently evaluated both systems for the depiction of the simulated aneurysm and aneurysmal bleb using a 5-point scale. For the degree of the pseudostenosis artifacts at the M1 segment of the middle cerebral artery at 300 mg I/mL, 3D DSA with FPD system showed mild stenoses, whereas severe stenoses were observed at 3D DSA with I.I.-TV system. At both concentrations, the FPD system was significantly superior to I.I.-TV system regarding the depiction of aneurysm and aneurysmal bleb. Compared with the I.I.-TV system, the FPD system could create high-resolution 3D DSA combined with a reduction of the pseudostenosis artifacts.

Turbulence intensity in a region of interest 2cm distal to the carotid bifurcation in a family of seven anthropomorphic flow phantoms

NASA Astrophysics Data System (ADS)

Powell, Janet L.; Poepping, Tamie L.

2011-03-01

An in vitro flow system has been used to assess the flow disturbances downstream of the stenosis in a family of seven carotid bifurcation phantoms modelling varying plaque build-up both axially symmetrically (concentrically) and asymmetrically (eccentrically). Radio frequency data were collected for 10 s at each of over 1000 sites within each model, and a sliding 1024-point FFT is applied to the data to extract the Doppler spectrum every 12 ms. From this, the ensemble average over 10 cardiac cycles of the spectral mean velocity, and the root mean square over these same 10 cardiac cycles - the turbulence intensity (TI), can be obtained as a function of an ensemble averaged cardiac cycle at each spatial point in all phantoms. TI was investigated by looking at the average over a 25 mm2 square region of interest in the ICA centered 2 cm distal to the apex of the bifurcation. TI in the region of interest increased with stenosis severity; at 23ms following peak systole, the time point when TI was maximal for the majority of models, this ranged from 2.4+/-0.1 cm/s in the non-diseased model to 6.6+/-0.3, 16.0+/-1.4 and 26.1+/-1.3 cm/s in the 30, 50 and 70% concentrically stenosed (by NASCET criteria) models, respectively. Similarly, TI was 8.3+/-0.7, 19.9+/-1.1, and 26.2+/-1.2 cm/s in the 30, 50 and 70% eccentrically stenosed models, respectively. Differences in TI between models, both in increasing stenosis severity and between eccentricities, were statistically different except between the 70% concentric and eccentric models.

The value of pre-discharge Duplex scanning in infrainguinal graft surveillance.

PubMed

Wilson, Y G; Davies, A H; Currie, I C; McGrath, C; Morgan, M; Baird, R N; Lamont, P M

1995-08-01

Protocols and criteria for Duplex-based graft surveillance programmes (GS) vary widely as to the optimum regimens for maximising detection of "at risk" grafts. Few centres recommend starting GS before discharge. The aim of this study was to audit our experience with respect to early scanning. Vascular Studies Unit, Bristol Royal Infirmary. The records of 123 patients entering GS from January 1992 were reviewed. Patients were scanned at 1 week, 6 weeks and 3, 6, 9 and 12 months post-bypass. Haemodynamic criteria used were a peak mean velocity (PMV) less than 45 cm/s and a focal velocity disturbance with a V2/V1 ratio of 1.5 or more. Forty-six abnormalities (37% detection rate) were identified on scans within one week. In all cases, on-table completion studies with either arteriography and/or flow measurements had failed to identify the anomalies subsequently detected by Duplex. At 1 week, six grafts had occluded, 27 had a focal PMV increase (mean V2/V1 ratio: 2.6; range 1.5-4.3), four had low flow velocities, four had arteriovenous fistulae, one contained mobile thrombus, two had retained cusps and two had hamstring entrapment. Of 40 patent, but compromised grafts, 18 warranted immediate investigation. Of the 27 patients with velocity disturbances on Duplex, 25 were simply observed but, eight have since required intervention for definitive stenoses at these sites which, in retrospect, were evident within the first postoperative week. Pre-discharge scanning is a useful modality for detecting technical problems. Intrinsic graft abnormalities, possibly the sites of future definitive stenoses, have been visualised even at 1 week and once identified, can be more closely scrutinised thereafter. Pre-discharge colour Duplex is recommended as standard practice for quality control after infrainguinal bypass.

Influence of renal artery variants, number, location, and degree of renal artery stenoses on the atherosclerotic burden of the aorta.

PubMed

Petersen, Johannes; Plaikner, Michaela; Nasseri, Parinaz; Rehder, Peter; Koppelstätter, Christian; Pauli, Guido F; Glodny, Bernhard

2012-10-01

To determine the assumed influence of the number of renal arteries, the distribution and extent of renal artery stenosis (RAS), and the kidney length on calcified aortic atherosclerotic plaque burden. The computed tomographic angiographies of 1381 patients were analyzed retrospectively using a volumetric aortic calcium scoring method. The Spearman method was used to calculate the correlation between kidney length, number and diameter of renal arteries, as well as number, degree, and location of RASs on main or additional renal arteries with the extent of aortic atherosclerosis. Logistic regression analyses were conducted with the target variable "calcification present or absent." Patients with multiple renal arteries (38.3%) had lower plaque volumes than patients without such variants (0.55 ± 0.97 vs 0.64 ± 1.06 mL; P < 0.05). Renal artery stenoses affected all renal vessels with equal frequency. The aortic calcium score correlated with the number of RASs (P < 0.0001) and the maximum degree of RAS up to a threshold of 60%. Location of an RAS in the various renal arteries was irrelevant. In regression analyses, the presence of RAS (Wald = 5.523), the degree of RAS (Wald = 6.251), and age (Wald = 223.1) were positive predictors of the aortic calcium score, whereas kidney length (Wald = 9.564) proved to be a negative predictor. The aortic calcium score correlates with both the number of RASs and the maximum degree of RAS up to a threshold of 60% but correlates inversely with the number of renal arteries. Renal artery stenosis affects all renal vessels with equal frequency, and this finding should be considered in screening procedures.

Quasi-elastic light scattering: Signal storage, correlation, and spectrum analysis under control of an 8-bit microprocessor

NASA Astrophysics Data System (ADS)

Glatter, Otto; Fuchs, Heribert; Jorde, Christian; Eigner, Wolf-Dieter

1987-03-01

The microprocessor of an 8-bit PC system is used as a central control unit for the acquisition and evaluation of data from quasi-elastic light scattering experiments. Data are sampled with a width of 8 bits under control of the CPU. This limits the minimum sample time to 20 μs. Shorter sample times would need a direct memory access channel. The 8-bit CPU can address a 64-kbyte RAM without additional paging. Up to 49 000 sample points can be measured without interruption. After storage, a correlation function or a power spectrum can be calculated from such a primary data set. Furthermore access is provided to the primary data for stability control, statistical tests, and for comparison of different evaluation methods for the same experiment. A detailed analysis of the signal (histogram) and of the effect of overflows is possible and shows that the number of pulses but not the number of overflows determines the error in the result. The correlation function can be computed with reasonable accuracy from data with a mean pulse rate greater than one, the power spectrum needs a three times higher pulse rate for convergence. The statistical accuracy of the results from 49 000 sample points is of the order of a few percent. Additional averages are necessary to improve their quality. The hardware extensions for the PC system are inexpensive. The main disadvantage of the present system is the high minimum sampling time of 20 μs and the fact that the correlogram or the power spectrum cannot be computed on-line as it can be done with hardware correlators or spectrum analyzers. These shortcomings and the storage size restrictions can be removed with a faster 16/32-bit CPU.

Using Medical-Device Wearable to Improve Hemodialysis Patient’s Live and Access the Holistic Health

NASA Astrophysics Data System (ADS)

Chen, W. L.; Wu, C.-C.; Kan, C. D.

2017-06-01

The increasing incidence of end-stage renal disease (ESRD) is the major burden to health budgets and a threat to public health worldwide. For many years, Taiwan has been ranked the first in the world for the number of hemodialysis patients. For solving the above-mentioned circumstance, we demonstrate the project, here, which goal is to construct the holistic health for hemodialysis patient. The project is to design a wearable medicine-device which can simultaneously measure and monitor the vital sign, including heart rate (HR), pulse oximetry (SPO2), continuous non-invasive blood pressure (c-NIBP), and total body water (TBW), of hemodialysis patient. By aid of the device we design, hemodialysis patients will get better health care than before. This device comprises three techniques. The first is named “Using phonoangiography technique to early detect the dysfunction of arteriovenous access by arteriovenous access (AVA) stenosis detector”. The stenosis detector based on autoregressive model was employed to simultaneously estimate the status of AVA life cycle and to tract changes in frequency spectra. It helps hemodialysis patients to early detect the dysfunction of AVA and alarms them to make a return visit. The second technique is named “Physiological detecting device for wearable medical device and encoding algorithm development”. The feature of the second technique is to optimize the prognosis by analyzing physiological signals, including water content index, pulse oximetry, and blood pressure in the meanwhile. The third technique is named “Intelligent and smart tourniquet”. This technique aims to preclude AVA dysfunction caused by inappropriate hemostasis.

Scalable Super-Resolution Synthesis of Core-Vest Composites Assisted by Surface Plasmons.

PubMed

Montazeri, A O; Kim, Y; Fang, Y S; Soheilinia, N; Zaghi, G; Clark, J K; Maboudian, R; Kherani, N P; Carraro, C

2018-02-15

The behavior of composite nanostructures depends on both size and elemental composition. Accordingly, concurrent control of size, shape, and composition of nanoparticles is key to tuning their functionality. In typical core-shell nanoparticles, the high degree of symmetry during shell formation results in fully encapsulated cores with severed access to the surroundings. We commingle light parameters (wavelength, intensity, and pulse duration) with the physical properties of nanoparticles (size, shape, and composition) to form hitherto unrealized core-vest composite nanostructures (CVNs). Unlike typical core-shells, the plasmonic core of the resulting CVNs selectively maintains physical access to its surrounding. Tunable variations in local temperature profiles ≳50 °C are plasmonically induced over starburst-shaped nanoparticles as small as 50-100 nm. These temperature variations result in CVNs where the shell coverage mirrors the temperature variations. The precision thus offered individually tailors access pathways of the core and the shell.

Photoplethysmography: beyond the calculation of arterial oxygen saturation and heart rate.

PubMed

Shelley, Kirk H

2007-12-01

In this article, I examine the source of the photoplethysmograph (PPG), as well as methods of investigation, with an emphasize on amplitude, rhythm, and pulse analysis. The PPG waveform was first described in the 1930s. Although considered an interesting ancillary monitor, the "pulse waveform" never underwent intensive investigation. Its importance in clinical medicine was greatly increased with the introduction of the pulse oximeter into routine clinical care in the 1980s. Its waveform is now commonly displayed in the clinical setting. Active research efforts are beginning to demonstrate a utility beyond oxygen saturation and heart rate determination. Future trends are being heavily influenced by modern digital signal processing, which is allowing a re-examination of this ubiquitous waveform. Key to unlocking the potential of this waveform is an unfettered access to the raw signal, combined with standardization of its presentation, and methods of analysis. In the long run, we need to learn how to consistently quantify the characteristics of the PPG in such a way as to allow the results from research efforts be translated into clinically useful devices.

Charting the functional relevance of Broca's area for visual word recognition and picture naming in Dutch using fMRI-guided TMS.

PubMed

Wheat, Katherine L; Cornelissen, Piers L; Sack, Alexander T; Schuhmann, Teresa; Goebel, Rainer; Blomert, Leo

2013-05-01

Magnetoencephalography (MEG) has shown pseudohomophone priming effects at Broca's area (specifically pars opercularis of left inferior frontal gyrus and precentral gyrus; LIFGpo/PCG) within ∼100ms of viewing a word. This is consistent with Broca's area involvement in fast phonological access during visual word recognition. Here we used online transcranial magnetic stimulation (TMS) to investigate whether LIFGpo/PCG is necessary for (not just correlated with) visual word recognition by ∼100ms. Pulses were delivered to individually fMRI-defined LIFGpo/PCG in Dutch speakers 75-500ms after stimulus onset during reading and picture naming. Reading and picture naming reactions times were significantly slower following pulses at 225-300ms. Contrary to predictions, there was no disruption to reading for pulses before 225ms. This does not provide evidence in favour of a functional role for LIFGpo/PCG in reading before 225ms in this case, but does extend previous findings in picture stimuli to written Dutch words. Copyright © 2012 Elsevier Inc. All rights reserved.

In-line monitoring technique with visible light from 1.3 microm-band SHG module for optical access systems.

PubMed

Kubo, Takahiro; Taniguchi, Tomohiro; Tadanaga, Osamu; Sakurai, Naoya; Kimura, Hideaki; Hadama, Hisaya; Asobe, Masaki

2010-02-01

We propose an in-line monitoring technique that uses 650 nm visible light for performing maintenance work on Fiber-to-the-home (FTTH) network quickly without the need for measuring skills or external devices. This technique is characterized by visible light (650 nm) generated by an SHG module from the 1.3 microm-band line signal. We fabricate a 1.3 microm-band quasi phase matched LiNbO(3) (QPM-LN) module, and the measure the 650 nm second harmonic (SH) power to test the proposed short-pulse modulation method. The results confirm the feasibility of the short-pulse modulation method with different peak factors (PFs) (1.0-7.3). We also examine the effect of short-pulse modulation on system performance at the optical receiver by measuring the bit error rate (BER) of received data (1.25 Gb/s). The BER is basically unaffected by the PF (1.0-5.5). This means that the proposed technique has little influence on data reception as regards PF (1.0-5.5).

Deep-tissue two-photon imaging in brain and peripheral nerve with a compact high-pulse energy ytterbium fiber laser

NASA Astrophysics Data System (ADS)

Fontaine, Arjun K.; Kirchner, Matthew S.; Caldwell, John H.; Weir, Richard F.; Gibson, Emily A.

2018-02-01

Two-photon microscopy is a powerful tool of current scientific research, allowing optical visualization of structures below the surface of tissues. This is of particular value in neuroscience, where optically accessing regions within the brain is critical for the continued advancement in understanding of neural circuits. However, two-photon imaging at significant depths have typically used Ti:Sapphire based amplifiers that are prohibitively expensive and bulky. In this study, we demonstrate deep tissue two-photon imaging using a compact, inexpensive, turnkey operated Ytterbium fiber laser (Y-Fi, KM Labs). The laser is based on all-normal dispersion (ANDi) that provides short pulse durations and high pulse energies. Depth measurements obtained in ex vivo mouse cortex exceed those obtainable with standard two-photon microscopes using Ti:Sapphire lasers. In addition to demonstrating the capability of deep-tissue imaging in the brain, we investigated imaging depth in highly-scattering white matter with measurements in sciatic nerve showing limited optical penetration of heavily myelinated nerve tissue relative to grey matter.

SPIDYAN, a MATLAB library for simulating pulse EPR experiments with arbitrary waveform excitation.

PubMed

Pribitzer, Stephan; Doll, Andrin; Jeschke, Gunnar

2016-02-01

Frequency-swept chirp pulses, created with arbitrary waveform generators (AWGs), can achieve inversion over a range of several hundreds of MHz. Such passage pulses provide defined flip angles and increase sensitivity. The fact that spectra are not excited at once, but single transitions are passed one after another, can cause new effects in established pulse EPR sequences. We developed a MATLAB library for simulation of pulse EPR, which is especially suited for modeling spin dynamics in ultra-wideband (UWB) EPR experiments, but can also be used for other experiments and NMR. At present the command line controlled SPin DYnamics ANalysis (SPIDYAN) package supports one-spin and two-spin systems with arbitrary spin quantum numbers. By providing the program with appropriate spin operators and Hamiltonian matrices any spin system is accessible, with limits set only by available memory and computation time. Any pulse sequence using rectangular and linearly or variable-rate frequency-swept chirp pulses, including phase cycling can be quickly created. To keep track of spin evolution the user can choose from a vast variety of detection operators, including transition selective operators. If relaxation effects can be neglected, the program solves the Liouville-von Neumann equation and propagates spin density matrices. In the other cases SPIDYAN uses the quantum mechanical master equation and Liouvillians for propagation. In order to consider the resonator response function, which on the scale of UWB excitation limits bandwidth, the program includes a simple RLC circuit model. Another subroutine can compute waveforms that, for a given resonator, maintain a constant critical adiabaticity factor over the excitation band. Computational efficiency is enhanced by precomputing propagator lookup tables for the whole set of AWG output levels. The features of the software library are discussed and demonstrated with spin-echo and population transfer simulations. Copyright © 2016 Elsevier Inc. All rights reserved.

Identifying individual sleep apnea/hypoapnea epochs using smartphone-based pulse oximetry.

PubMed

Garde, Ainara; Dekhordi, Parastoo; Ansermino, J Mark; Dumont, Guy A

2016-08-01

Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis. We propose to extract features characterizing pulse oximetry (SpO2 and pulse rate variability [PRV], a surrogate measure of heart rate variability) to create a multivariate logistic regression model that identifies epochs containing apnea/hypoapnea events. Overnight pulse oximetry was collected using a smartphone-based pulse oximeter, simultaneously with standard PSG from 160 children at the British Columbia Children's hospital. The sleep technician manually scored all apnea/hypoapnea events during the PSG study. Based on these scores we labeled each epoch as containing or not containing apnea/hypoapnea. We randomly divided the subjects into training data (40%), used to develop the model applying the LASSO method, and testing data (60%), used to validate the model. The developed model was assessed epoch-by-epoch for each subject. The test dataset had a median area under the receiver operating characteristic (ROC) curve of 81%; the model provided a median accuracy of 74% sensitivity of 75%, and specificity of 73% when using a risk threshold similar to the percentage of apnea/hypopnea epochs. Thus, providing a detailed epoch-by-epoch analysis with at-home pulse oximetry alone is feasible with accuracy, sensitivity and specificity values above 73% However, the performance might decrease when analyzing subjects with a low number of apnea/hypoapnea events.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vajda, Zsolt, E-mail: Z.Vajda@klinikum-stuttgart.de; Guethe, Thomas, E-mail: T.Guethe@klinikum-stuttgart.de; Perez, Marta Aguilar, E-mail: M.Aguilar@klinikum-stuttgart.de

Stenting in intracranial atherosclerotic disease (ICAD) is increasingly debated, due to issues of procedural safety, technical efficacy, and in-stent recurrent stenoses (ISR). In the present study, feasibility, safety, and efficacy of angioplasty using a drug-eluting balloon (DEB) followed by the implantation of a self-expanding stent (Enterprise) were evaluated for the treatment of ICAD lesions. Fifty-two patients (median age: 71 years; range: 54-86 years; male/female ratio 37:15) underwent stenting of high-grade ICAD lesions between February 2010 and November 2011 in a single center. Angioplasty using a paclitaxel coated SeQuent Please (B. Braun, Germany) or DIOR (Eurocor, Germany) coronary PTCA balloon, followedmore » by the implantation of a self-expanding stent (Enterprise, Codman, USA) was performed in 54 lesions. Angiographic and clinical follow-up was performed at 6 and 12 weeks, 6 and 12 months, and yearly thereafter. Technical success rate, periprocedural complications, occurrence of recurrent ischemic symptoms, and the development of an ISR were analyzed. Angioplasty using a DEB followed by stent implantation was successfully performed in 44 (81 %) cases. DEB insertion failed in 19 % of the cases and angioplasty was finally performed using a conventional PTCA balloon. The combined procedure related permanent neurologic morbidity and mortality rate (stroke, ICH, and subarachnoid hemorrhage) at 30 days and beyond was 5 %. Angiographic and clinical follow-up were obtained in 33 (61 %) lesions in 32 patients. Recurrent stenosis was seen in one (3 %) lesion. Angioplasty and stenting using a DEB is safe and yields encouragingly low ISR rates. Further technical developments to improve lesion accessibility are, nevertheless, mandatory.« less

Processing of on-board recorded data for quick analysis of aircraft performance. [rotor systems research aircraft

NASA Technical Reports Server (NTRS)

Michaud, N. H.

1979-01-01

A system of independent computer programs for the processing of digitized pulse code modulated (PCM) and frequency modulated (FM) data is described. Information is stored in a set of random files and accessed to produce both statistical and graphical output. The software system is designed primarily to present these reports within a twenty-four hour period for quick analysis of the helicopter's performance.

Fault-Tolerant Sequencer Using FPGA-Based Logic Designs for Space Applications

DTIC Science & Technology

2013-12-01

Prototype Board SBU single bit upset SDK software development kit SDRAM synchronous dynamic random-access memory SEB single-event burnout ...current VHDL VHSIC hardware description language VHSIC very-high-speed integrated circuits VLSI very-large- scale integration VQFP very...transient pulse, called a single-event transient (SET), or even cause permanent damage to the device in the form of a burnout or gate rupture. The SEE

Interspecific variation of calls in clownfishes: degree of similarity in closely related species.

PubMed

Colleye, Orphal; Vandewalle, Pierre; Lanterbecq, Déborah; Lecchini, David; Parmentier, Eric

2011-12-19

Clownfishes are colorful coral reef fishes living in groups in association with sea anemones throughout the Indo-Pacific Ocean. Within their small societies, size hierarchy determines which fish have access to reproduction. These fishes are also prolific callers whose aggressive sounds seem to play an important role in the social hierarchy. Agonistic interactions being involved in daily behaviour suggest how acoustic communication might play an important role in clownfish group. Sounds were recorded and compared in fourteen clownfish species (some of which have never been recorded before) to evaluate the potential role of acoustic communication as an evolutionary driving force. Surprisingly, the relationship between fish size and both dominant frequency and pulse duration is not only species-specific; all the specimens of the 14 species are situated on exactly the same slope, which means the size of any Amphiprion can be predicted by both acoustic features. The number of pulses broadly overlaps among species, whereas the pulse period displays the most variation even if it shows overlap among sympatric species. Sound comparisons between three species (A. akallopisos, A. ocellaris and A. frenatus) having different types of teeth and body shape do not show differences neither in the acoustic waveform nor in the power spectrum. Significant overlap in acoustic features demonstrates that the sound-producing mechanism is highly conservative among species. Differences in the calls of some species are due to size dimorphism and the sound variation might be in this case a by-product. This morphological constraint does not permit a consideration of acoustic communication as the main driving force in the diversification of clownfishes. Moreover, calls are not produced to find mate and consequently are less subject to variations due to partner preference, which restricts the constraints of diversification. Calls are produced to reach and defend the competition to mate access. However, differences in the pulse period between cohabiting species show that, in some case, sounds can help to differentiate the species, to prevent competition between cohabiting species and to promote the diversification of taxa.

Interspecific variation of calls in clownfishes: degree of similarity in closely related species

PubMed Central

2011-01-01

Background Clownfishes are colorful coral reef fishes living in groups in association with sea anemones throughout the Indo-Pacific Ocean. Within their small societies, size hierarchy determines which fish have access to reproduction. These fishes are also prolific callers whose aggressive sounds seem to play an important role in the social hierarchy. Agonistic interactions being involved in daily behaviour suggest how acoustic communication might play an important role in clownfish group. Sounds were recorded and compared in fourteen clownfish species (some of which have never been recorded before) to evaluate the potential role of acoustic communication as an evolutionary driving force. Results Surprisingly, the relationship between fish size and both dominant frequency and pulse duration is not only species-specific; all the specimens of the 14 species are situated on exactly the same slope, which means the size of any Amphiprion can be predicted by both acoustic features. The number of pulses broadly overlaps among species, whereas the pulse period displays the most variation even if it shows overlap among sympatric species. Sound comparisons between three species (A. akallopisos, A. ocellaris and A. frenatus) having different types of teeth and body shape do not show differences neither in the acoustic waveform nor in the power spectrum. Conclusion Significant overlap in acoustic features demonstrates that the sound-producing mechanism is highly conservative among species. Differences in the calls of some species are due to size dimorphism and the sound variation might be in this case a by-product. This morphological constraint does not permit a consideration of acoustic communication as the main driving force in the diversification of clownfishes. Moreover, calls are not produced to find mate and consequently are less subject to variations due to partner preference, which restricts the constraints of diversification. Calls are produced to reach and defend the competition to mate access. However, differences in the pulse period between cohabiting species show that, in some case, sounds can help to differentiate the species, to prevent competition between cohabiting species and to promote the diversification of taxa. PMID:22182416

Endodontic applications of a short pulsed FR Nd:YAG dental laser: photovaporization of extruded pulpal tissue following traumatic fractures of two maxillary central incisors--a clinical trial repor

NASA Astrophysics Data System (ADS)

Gregg, Robert H., II

1992-06-01

Historically, many techniques have been attempted in the search for a satisfactory and consistent treatment of inflamed, painful, hyperemic pulpal tissue. Present techniques attempting to achieve profound local anesthesia in such tissue, have not been satisfactory. Local anesthesia techniques acceptable to the patient with painful hyperemic pulpal tissue, has eluded previous technology. The subsequent treatment of hyperemic tissue without sufficient anesthesia primarily involves undesirable invasive mechanical/surgical procedures. Described in this clinical trial is a technique using free running (FR) pulsed, Nd:YAG laser energy to ablate soft tooth pulpal tissue--a technique employed after conventional endodontic methods failed. A free running pulsed, FR Nd:YAG dental laser was successfully used at 20 pulses per second and 1.25 watts to photovaporize endodontic pulpal tissue (pulpectomy) to allow a conventional endodontic file to extirpate the remaining soft tissue remnants and access the root apex. Also described in this paper is the 'hot-tip' effect of contact fiber laser surgery. This clinical trial achieved the immediate, short term objective of endodontic soft tissue removal via photovaporization, without pain reported by the patient. The pulsed FR Nd:YAG dental laser used as described in this clinical report appears to be a very safe and very effective technique; offers a treatment alternative to traditional therapy that suggests high patient acceptance; and is significantly less stressful for the doctor and staff than traditional treatment options. Long-term, controlled scientific and clinical studies are necessary to establish the safety and efficacy of both the helium-neon energy for visualization and the low-watt pulsed FR Nd:YAG energy for photovaporization of soft endodontic pulpal tissue within the root canal. Research is especially needed to understand the effects of a low-watt, pulsed FR, Nd:YAG laser on the activity of osteoclasts and odontoclasts and identify risks for developing external and/or internal resorption after intracanal application of pulsed FR Nd:YAG laser energy.

Numerical simulation of heat transfer in power law fluid flow through a stenosed artery

NASA Astrophysics Data System (ADS)

Talib, Amira Husni; Abdullah, Ilyani

2017-11-01

A numerical study of heat transfer in a power law fluid is investigated in this paper. The blood flow is treated as power law fluid with a presence of cosine shaped stenosis. This study reveals the effect of stenosis on the heat transfer and velocity of blood flowing in the constricted artery. The governing and energy equations are formulated in a cylindrical coordinate system. Hence, the set of equations and boundary conditions are solved numerically by Marker and Cell (MAC) method. The graphical result shows the profile of blood temperature is increased while the blood velocity is decreased at the critical height of stenosis.

Entropy Generation Analysis in Convective Ferromagnetic Nano Blood Flow Through a Composite Stenosed Arteries with Permeable Wall

NASA Astrophysics Data System (ADS)

Sher Akbar, Noreen; Wahid Butt, Adil

2017-05-01

The study of heat transfer is of significant importance in many biological and biomedical industry problems. This investigation comprises of the study of entropy generation analysis of the blood flow in the arteries with permeable walls. The convection through the flow is studied with compliments to the entropy generation. Governing problem is formulized and solved for low Reynold’s number and long wavelength approximations. Exact analytical solutions have been obtained and are analyzed graphically. It is seen that temperature for pure water is lower as compared to the copper water. It gains magnitude with an increase in the slip parameter.

Tako-tsubo-like syndrome, a case report.

PubMed

Patanè, Salvatore; Marte, Filippo

2008-02-29

Tako-tsubo-like (Japanese word for octopus-catcher) left ventricular dysfunction is an enigmatic cardiomyopathy. Typically, the patients have a history of recent stressful incidents immediately preceding onset of mild to moderate chest pain, have ST-segment elevation in leads V3 through V6, ECG changes that typically demonstrate diffuse T-wave inversions and abnormal QS-wave development, discrete wall motion abnormalities involving the lower anterior wall and apex on echocardiography or left ventriculography, and limited myocardial enzyme release without evidence for hemodynamically significant coronary arterial stenoses by angiography. We describe a case of a Tako-tsubo-like left ventricular dysfunction in a 72-year-old female Italian woman.

Hemodynamic effects of innominate artery occlusive disease on anterior cerebral artery.

PubMed

Tan, Teng-Yeow; Lien, Li-Ming; Schminke, Ulf; Tesh, Paul; Reynolds, Patrick S; Tegeler, Charles H

2002-01-01

Stenoses of the innominate artery (IA) may affect flow conditions in the carotid arteries. However, alternating flow in ipsilateral anterior cerebral artery (ACA) due to IA stenosis is extremely rare. A 49-year-old woman who was evaluated for symptomatic cerebrovascular disease presented with right latent subclavian and right carotid system steal. Transcranial Doppler examination displayed systolic deceleration wave-forms in the right terminal internal carotid artery and alternating flow in the right ACA. Magnetic resonance angiography demonstrated tight stenosis of the right IA. For a thorough study of the hemodynamic effects of IA stenosis, a combination of duplex and transcranial Doppler examination is required.

Magnetic field effects for copper suspended nanofluid venture through a composite stenosed arteries with permeable wall

NASA Astrophysics Data System (ADS)

Akbar, Noreen Sher; Butt, Adil Wahid

2015-05-01

In the present paper magnetic field effects for copper nanoparticles for blood flow through composite stenosis in arteries with permeable wall are discussed. The copper nanoparticles for the blood flow with water as base fluid is not explored yet. The equations for the Cu-water nanofluid are developed first time in the literature and simplified using long wavelength and low Reynolds number assumptions. Exact solutions have been evaluated for velocity, pressure gradient, the solid volume fraction of the nanoparticles and temperature profile. The effect of various flow parameters on the flow and heat transfer characteristics is utilized.

Aneurysm of the right ventricular outflow following bovine valved venous conduit insertion.

PubMed

Boudjemline, Younes; Bonnet, Damien; Agnoletti, Gabriella; Vouhé, Pascal

2003-01-01

A case of aneurysm of the right ventricular outflow tract is described after repair of tetralogy of Fallot using a Contegra supported conduit. Angiograms revealed that the aneurysm was located between the ventricular anastomosis and the proximal ring of the conduit confirming echocardiographic data. Because the conduit between the rings was not dilated, the valve was perfectly functioning. Pulmonary anastomosis was severely stenosed explaining the dilatation seen below. Conduit replacement with resection of the aneurysmal part of the failing conduit was performed. Supported conduits do not eliminate the risk of secondary dilatation below the artificial ring but preserve valvular function.

Potentially stress-induced acute splanchnic segmental arterial mediolysis with a favorable spontaneous outcome.

PubMed

Belbezier, Aude; Sarrot-Reynauld, Françoise; Thony, Frédéric; Tahon, Florence; Heck, Olivier; Bouillet, Laurence

2017-03-01

A 62-year-old woman presented with hemithoracic anesthesia and acute abdominal pain following a violent psychological stress. Magnetic resonance imaging showed a thoracic hematoma with arachnoiditis of the spinal cord. Tomography revealed a typical aspect of segmental arterial mediolysis with multiple aneurysms and stenoses of the splanchnic arteries, confirmed by abdominal arteriography. There was no argument for hereditary, traumatic, atherosclerotic, infectious, or inflammatory arterial disease. Segmental arterial mediolysis was diagnosed on the basis of the radiologic data and probably involved both medullary and splanchnic arteries. The patient spontaneously recovered and was in good health 18 months later.

One-dimensional photonic crystals for code-division multiple access

NASA Astrophysics Data System (ADS)

Wang, Shamino Yuanliang

One-dimensional photonic crystals exhibit reduced group velocity and huge dispersion at their rejection band edge frequencies. Therefore they are natural candidates as optical delay lines, dispersion compensators, and pulse reshapers. Using wavelength tunable pulses spectrally sliced from a mode-locked fiber laser, the transmission mode measurement was performed in the time domain with single picosecond resolution. Group delays and dispersion were measured with an autocorrelator as an ultrafast optical detector and cross-correlator. Our experimental results agree qualitatively with the theoretical and simulation predictions. A maximum group delay of 10 ps for a commercial 3 mm long uniform fiber Bragg grating and that of 22.6 ps for a research laboratory fabricated 1 cm grating were measured, corresponding to a group velocity 66% of the speed of light in bare fiber. We have also demonstrated in the overlap transmission region of a grating pair both gratings contribute to the group delay while the group velocity dispersion was canceled, resulting in additive delay in transmission with minimal pulse reshaping. This compound grating configuration was further expanded as specially designed grating sequence encoders and decoders in matched filter CDMA. The transmitter grating sequence temporally stretched the input pulse into a long time scale low peak intensity pseudorandom noise, while the conjugate grating sequence in the receiver performed pulse reconstruction and data recovery. A temporal FWHM contrast ratio of 2.5 and a peak intensity contrast ratio of 10 between the correctly and incorrectly decoded signals were achieved. Armed with more sophisticated grating designs we believe this would be a powerful solution to CDMA orthogonal code requirements.

The interaction of intense subpicosecond laser pulses with underdense plasmas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coverdale, Christine Ann

1995-05-11

Laser-plasma interactions have been of interest for many years not only from a basic physics standpoint, but also for their relevance to numerous applications. Advances in laser technology in recent years have resulted in compact laser systems capable of generating (psec), 10 16 W/cm 2 laser pulses. These lasers have provided a new regime in which to study laser-plasma interactions, a regime characterized by L plasma ≥ 2L Rayleigh > cτ. The goal of this dissertation is to experimentally characterize the interaction of a short pulse, high intensity laser with an underdense plasma (n o ≤ 0.05n cr). Specifically, themore » parametric instability known as stimulated Raman scatter (SRS) is investigated to determine its behavior when driven by a short, intense laser pulse. Both the forward Raman scatter instability and backscattered Raman instability are studied. The coupled partial differential equations which describe the growth of SRS are reviewed and solved for typical experimental laser and plasma parameters. This solution shows the growth of the waves (electron plasma and scattered light) generated via stimulated Raman scatter. The dispersion relation is also derived and solved for experimentally accessible parameters. The solution of the dispersion relation is used to predict where (in k-space) and at what frequency (in ω-space) the instability will grow. Both the nonrelativistic and relativistic regimes of the instability are considered.« less

Real-time 2D spatially selective MRI experiments: Comparative analysis of optimal control design methods

NASA Astrophysics Data System (ADS)

Maximov, Ivan I.; Vinding, Mads S.; Tse, Desmond H. Y.; Nielsen, Niels Chr.; Shah, N. Jon

2015-05-01

There is an increasing need for development of advanced radio-frequency (RF) pulse techniques in modern magnetic resonance imaging (MRI) systems driven by recent advancements in ultra-high magnetic field systems, new parallel transmit/receive coil designs, and accessible powerful computational facilities. 2D spatially selective RF pulses are an example of advanced pulses that have many applications of clinical relevance, e.g., reduced field of view imaging, and MR spectroscopy. The 2D spatially selective RF pulses are mostly generated and optimised with numerical methods that can handle vast controls and multiple constraints. With this study we aim at demonstrating that numerical, optimal control (OC) algorithms are efficient for the design of 2D spatially selective MRI experiments, when robustness towards e.g. field inhomogeneity is in focus. We have chosen three popular OC algorithms; two which are gradient-based, concurrent methods using first- and second-order derivatives, respectively; and a third that belongs to the sequential, monotonically convergent family. We used two experimental models: a water phantom, and an in vivo human head. Taking into consideration the challenging experimental setup, our analysis suggests the use of the sequential, monotonic approach and the second-order gradient-based approach as computational speed, experimental robustness, and image quality is key. All algorithms used in this work were implemented in the MATLAB environment and are freely available to the MRI community.

A Physical Map, Including a BAC/PAC Clone Contig, of the Williams-Beuren Syndrome–Deletion Region at 7q11.23

PubMed Central

Peoples, Risa; Franke, Yvonne; Wang, Yu-Ker; Pérez-Jurado, Luis; Paperna, Tamar; Cisco, Michael; Francke, Uta

2000-01-01

Summary Williams-Beuren syndrome (WBS) is a developmental disorder caused by haploinsufficiency for genes in a 2-cM region of chromosome band 7q11.23. With the exception of vascular stenoses due to deletion of the elastin gene, the various features of WBS have not yet been attributed to specific genes. Although ⩾16 genes have been identified within the WBS deletion, completion of a physical map of the region has been difficult because of the large duplicated regions flanking the deletion. We present a physical map of the WBS deletion and flanking regions, based on assembly of a bacterial artificial chromosome/P1-derived artificial chromosome contig, analysis of high-throughput genome-sequence data, and long-range restriction mapping of genomic and cloned DNA by pulsed-field gel electrophoresis. Our map encompasses 3 Mb, including 1.6 Mb within the deletion. Two large duplicons, flanking the deletion, of ⩾320 kb contain unique sequence elements from the internal border regions of the deletion, such as sequences from GTF2I (telomeric) and FKBP6 (centromeric). A third copy of this duplicon exists in inverted orientation distal to the telomeric flanking one. These duplicons show stronger sequence conservation with regard to each other than to the presumptive ancestral loci within the common deletion region. Sequence elements originating from beyond 7q11.23 are also present in these duplicons. Although the duplicons are not present in mice, the order of the single-copy genes in the conserved syntenic region of mouse chromosome 5 is inverted relative to the human map. A model is presented for a mechanism of WBS-deletion formation, based on the orientation of duplicons' components relative to each other and to the ancestral elements within the deletion region. PMID:10631136

Femtosecond nonlinear ultrasonics in gold probed with ultrashort surface plasmons.

PubMed

Temnov, Vasily V; Klieber, Christoph; Nelson, Keith A; Thomay, Tim; Knittel, Vanessa; Leitenstorfer, Alfred; Makarov, Denys; Albrecht, Manfred; Bratschitsch, Rudolf

2013-01-01

Fundamental interactions induced by lattice vibrations on ultrafast time scales have become increasingly important for modern nanoscience and technology. Experimental access to the physical properties of acoustic phonons in the terahertz-frequency range and over the entire Brillouin zone is crucial for understanding electric and thermal transport in solids and their compounds. Here we report on the generation and nonlinear propagation of giant (1 per cent) acoustic strain pulses in hybrid gold/cobalt bilayer structures probed with ultrafast surface plasmon interferometry. This new technique allows for unambiguous characterization of arbitrary ultrafast acoustic transients. The giant acoustic pulses experience substantial nonlinear reshaping after a propagation distance of only 100 nm in a crystalline gold layer. Excellent agreement with the Korteveg-de Vries model points to future quantitative nonlinear femtosecond terahertz-ultrasonics at the nano-scale in metals at room temperature.

Mid-IR laser system for advanced neurosurgery

NASA Astrophysics Data System (ADS)

Klosner, M.; Wu, C.; Heller, D. F.

2014-03-01

We present work on a laser system operating in the near- and mid-IR spectral regions, having output characteristics designed to be optimal for cutting various tissue types. We provide a brief overview of laser-tissue interactions and the importance of controlling certain properties of the light beam. We describe the principle of operation of the laser system, which is generally based on a wavelength-tunable alexandrite laser oscillator/amplifier, and multiple Raman conversion stages. This configuration provides robust access to the mid-IR spectral region at wavelengths, pulse energies, pulse durations, and repetition rates that are attractive for neurosurgical applications. We summarize results for ultra-precise selective cutting of nerve sheaths and retinas with little collateral damage; this has applications in procedures such as optic-nerve-sheath fenestration and possible spinal repair. We also report results for cutting cornea, and dermal tissues.

Radial current high power dummy load for characterizing the high power laser triggered transformer-type accelerator.

PubMed

Yin, Yi; Zhong, Hui-Huang; Liu, Jin-Liang; Ren, He-Ming; Yang, Jian-Hua; Zhang, Xiao-Ping; Hong, Zhi-qiang

2010-09-01

A radial-current aqueous resistive solution load was applied to characterize a laser triggered transformer-type accelerator. The current direction in the dummy load is radial and is different from the traditional load in the axial. Therefore, this type of dummy load has smaller inductance and fast response characteristic. The load was designed to accommodate both the resistance requirement of accelerator and to allow optical access for the laser. Theoretical and numerical calculations of the load's inductance and capacitance are given. The equivalent circuit of the dummy load is calculated in theory and analyzed with a PSPICE code. The simulation results agree well with the theoretical analysis. At last, experiments of the dummy load applied to the high power spiral pulse forming line were performed; a quasisquare pulse voltage is obtained at the dummy load.

NMR-based diffusion lattice imaging

NASA Astrophysics Data System (ADS)

Laun, Frederik Bernd; Müller, Lars; Kuder, Tristan Anselm

2016-03-01

Nuclear magnetic resonance (NMR) diffusion experiments are widely employed as they yield information about structures hindering the diffusion process, e.g., about cell membranes. While it has been shown in recent articles that these experiments can be used to determine the shape of closed pores averaged over a volume of interest, it is still an open question how much information can be gained in open well-connected systems. In this theoretical work, it is shown that the full structure information of connected periodic systems is accessible. To this end, the so-called "SEquential Rephasing by Pulsed field-gradient Encoding N Time intervals" (SERPENT) sequence is used, which employs several diffusion encoding gradient pulses with different amplitudes. Two two-dimensional solid matrices that are surrounded by an NMR-visible medium are considered: a hexagonal lattice of cylinders and a rectangular lattice of isosceles triangles.

Study of vesicle size distribution dependence on pH value based on nanopore resistive pulse method

NASA Astrophysics Data System (ADS)

Lin, Yuqing; Rudzevich, Yauheni; Wearne, Adam; Lumpkin, Daniel; Morales, Joselyn; Nemec, Kathleen; Tatulian, Suren; Lupan, Oleg; Chow, Lee

2013-03-01

Vesicles are low-micron to sub-micron spheres formed by a lipid bilayer shell and serve as potential vehicles for drug delivery. The size of vesicle is proposed to be one of the instrumental variables affecting delivery efficiency since the size is correlated to factors like circulation and residence time in blood, the rate for cell endocytosis, and efficiency in cell targeting. In this work, we demonstrate accessible and reliable detection and size distribution measurement employing a glass nanopore device based on the resistive pulse method. This novel method enables us to investigate the size distribution dependence of pH difference across the membrane of vesicles with very small sample volume and rapid speed. This provides useful information for optimizing the efficiency of drug delivery in a pH sensitive environment.

Radial current high power dummy load for characterizing the high power laser triggered transformer-type accelerator

NASA Astrophysics Data System (ADS)

Yin, Yi; Zhong, Hui-Huang; Liu, Jin-Liang; Ren, He-Ming; Yang, Jian-Hua; Zhang, Xiao-Ping; Hong, Zhi-qiang

2010-09-01

A radial-current aqueous resistive solution load was applied to characterize a laser triggered transformer-type accelerator. The current direction in the dummy load is radial and is different from the traditional load in the axial. Therefore, this type of dummy load has smaller inductance and fast response characteristic. The load was designed to accommodate both the resistance requirement of accelerator and to allow optical access for the laser. Theoretical and numerical calculations of the load's inductance and capacitance are given. The equivalent circuit of the dummy load is calculated in theory and analyzed with a PSPICE code. The simulation results agree well with the theoretical analysis. At last, experiments of the dummy load applied to the high power spiral pulse forming line were performed; a quasisquare pulse voltage is obtained at the dummy load.

A review of electric propulsion systems and mission applications

NASA Technical Reports Server (NTRS)

Vondra, R.; Nock, K.; Jones, R.

1984-01-01

The satisfaction of growing demands for access to space resources will require new developments related to advanced propulsion and power technologies. A key technology in this context is concerned with the utilization of electric propulsion. A brief review of the current state of development of electric propulsion systems on an international basis is provided, taking into account advances in the USSR, the U.S., Japan, West Germany, China and Brazil. The present investigation, however, is mainly concerned with the U.S. program. The three basic types of electric thrusters are considered along with the intrinsic differences between chemical and electric propulsion, the resistojet, the augmented hydrazine thruster, the arcjet, the ion auxiliary propulsion system flight test, the pulsed plasma thruster, magnetoplasmadynamic propulsion, a pulsed inductive thruster, and rail accelerators. Attention is also given to the applications of electric propulsion.

Theoretical and experimental investigation of the nonlinear dynamical trends of passively mode-locked quantum dot lasers

NASA Astrophysics Data System (ADS)

Raghunathan, Ravi

In recent years, passively mode-locked quantum dot lasers have shown great promise as compact, efficient and reliable pulsed sources of light for a range of precision and high performance applications, such as high bit-rate optical communications, diverse waveform generation, metrology, and clock distribution in high-performance computing (HPC) processors. For such applications, stable optical pulses with short picosecond pulse durations and multi-gigahertz repetition rates are required. In addition, a low pulse-to-pulse timing jitter is also necessary to prevent errors arising from the ambiguity between neighboring pulses. In order to optimize pulse quality in terms of optical characteristics such as pulse shape and pulse train behavior, as well as RF characteristics such as phase noise and timing jitter, understanding the nonlinear output dynamics of such devices is of critical importance, not only to get a sense of the regimes of operation where device output might be stable or unstable, but also to gain insight into the parameters that influence the output characteristics the most, and how they can be accessed and exploited to optimize design and performance for next generation applications. In this dissertation, theoretical and experimental studies have been combined to investigate the dynamical trends of two-section passively mode-locked quantum dot lasers. On the theoretical side, a novel numerical modeling scheme is presented as a powerful and versatile framework to study the nonlinear dynamics specific to a device, with device-specific parameters extracted over a range of operating conditions. The practical utility of this scheme is then demonstrated, first, in an analytical capability to interpret and explain dynamical trends observed in experiment, and subsequently, as a predictive tool to guide experiment to operate in a desired dynamical regime. Modeling results are compared to experimental findings where possible. Finally, optical feedback from an external reflector is experimentally studied as an additional control mechanism over the output dynamics of the device, and shown to enable invaluable insight into the behavior of the RF and optical spectra of the output. Together, the theoretical and experimental findings of this dissertation are shown to offer a systematic approach to understand, control and exploit the dynamical trends of passively mode-locked two-section quantum dot lasers.

Redox-Active Star Molecules Incorporating the 4-Benzolypyridinium Cation: Implications for the Charge Transfer Efficiency Along Branches versus Across the Perimeter in Dendrimers

NASA Technical Reports Server (NTRS)

Yang, Jin-Hua; Rawashdeh, Abdel Monem M.; Oh, Woon Su; Sotiriou-Leventis, Chariklia; Leventis, Nicholas

2003-01-01

We report the redox properties of four star systems incorporating the 4-benzoyl-N-alkylpyridinium cation; the redox potential varies along the branches, but remains constant at fixed radii. Voltammetric analysis (cyclic voltammetry and differential pulse voltammetry) shows that only two of the three redox-active centers in the perimeter are electrochemically accessible during potential sweeps as slow as 20 mV/s and as fast as 10 V/s. On the contrary, both redox centers of a branch are accessible electrochemically within the same time frame. These results are discussed in terms of slow through-space charge transfer and the globular 3-D folding of the molecules.

Discovery and Testing of Ricin Therapeutics

DTIC Science & Technology

2011-06-01

reticulum (ER) lumen. While in the ER, the ricin A chain co-opts ER quality control to gain access to the cytosol by a process referred to as...containing N-linked oligosaccharides characteristic of ER-resident molecules (21). RTAE177D and RTA! polypeptides with the predicted molecular weight...U373RTA! cells by pulse - chase analysis (Figure 2B and C). The cells were metabolically labeled with 35S-methionine for 15 min and Lane 1

Development of Inspection and Repair Technology for Heat Exchanger Tubes in Fast Breeder Reactors

DTIC Science & Technology

2009-06-01

Technology for Heat Exchanger Tubes in Fast Breeder Reactors Akihiko NISHIMURA *1 , Takahisa SHOBU, Kiyoshi OKA, Toshihiko YAMAGUCHI, Yukihiro SHIMADA...fast breeder reactors (FBRs). It comprises a laser processing head combined with an eddy current testing unit. Ultrashort laser pulse ablation is used...be applied in the main- tenance of large structures such as nuclear reactors and chemical factories [1]. Internal access to a blanket cooling pipe

Composite and shaped pulses for efficient and robust pumping of disconnected eigenstates in magnetic resonance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Theis, T.; Feng, Y.; Wu, T.

2014-01-07

Hyperpolarization methods, which can enhance nuclear spin signals by orders of magnitude, open up important new opportunities in magnetic resonance. However, many of these applications are limited by spin lattice relaxation, which typically destroys the hyperpolarization in seconds. Significant lifetime enhancements have been found with “disconnected eigenstates” such as the singlet state between a pair of nearly equivalent spins, or the “singlet-singlet” state involving two pairs of chemically equivalent spins; the challenge is to populate these states (for example, from thermal equilibrium magnetization or hyperpolarization) and to later recall the population into observable signal. Existing methods for populating these statesmore » are limited by either excess energy dissipation or high sensitivity to inhomogeneities. Here we overcome the limitations by extending recent work using continuous-wave irradiation to include composite and adiabatic pulse excitations. Traditional composite and adiabatic pulses fail completely in this problem because the interactions driving the transitions are fundamentally different, but the new shapes we introduce can move population between accessible and disconnected eigenstates over a wide range of radio-frequency (RF) amplitudes and offsets while depositing insignificant amounts of power.« less

Development of the Miniature Pulse Tube Cryocooler

NASA Astrophysics Data System (ADS)

Matsumoto, N.; Yasukawa, Y.; Ohshima, K.; Toyama, K.; Tsukahara, Y.; Kamoshita, T.; Takeuchi, T.

2004-06-01

Fuji Electric has developed a pulse tube cryocooler (PTC) with in-line configuration with a cooling capacity of 3 W at 70 K and requiring 100 W of electrical input power. The emphasis has been on compactness, lightweight, high performance and low cost. In particular, the dimensions of the PTC have been reduced to a width of 190 mm and a height of 300 mm. Presently, we are developing a U-shaped PTC based on the technology of the in-line PTC. The advantage of the U-shaped PTC is that the cold head is located at the end for easy accessing. The key issue for developing the U-shaped PTC is the design of the flow straightener at the cold head. As a first step in the development we visualized the inside of the pulse tube by using particle image velocimetry (PIV). The design of the flow straightener is based on the visualization results. Preliminary tests indicated that the cooling performance of the U-shaped PTC is 2 W at 70 K while requiring 51 W PV power. We will present the test results on the U-shaped PTC as well as the in-line PTC.

Experimental Study of Magnetic Field Production and Dielectric Breakdown of Auto-Magnetizing Liners

NASA Astrophysics Data System (ADS)

Shipley, Gabriel; Awe, Thomas; Hutchinson, Trevor; Hutsel, Brian; Slutz, Stephen; Lamppa, Derek

2017-10-01

AutoMag liners premagnetize the fuel in MagLIF targets and provide enhanced x-ray diagnostic access and increased current delivery without requiring external field coils. AutoMag liners are composite liners made with discrete metallic helical conduction paths separated by insulating material. First, a low dI/dt ``foot'' current pulse (1 MA in 100 ns) premagnetizes the fuel. Next, a higher dI/dt pulse with larger induced electric field initiates breakdown on the composite liner's; surface, switching the current from helical to axial to implode the liner. Experiments on MYKONOS have tested the premagnetization and breakdown phases of AutoMag and demonstrate axial magnetic fields above 90 Tesla for a 550 kA peak current pulse. Electric fields of 17 MV/m have been generated before breakdown. AutoMag may enhance MagLIF performance by increasing the premagnetization strength significantly above 30 T, thus reducing thermal-conduction losses and mitigating anomalous diffusion of magnetic field out of hotter fuel regions, by, for example, the Nernst thermoelectric effect. This project was funded in part by Sandia's Laboratory Directed Research and Development Program (Projects No. 200169 and 195306).

Highly accurate pulse-per-second timing distribution over optical fibre network using VCSEL side-mode injection

NASA Astrophysics Data System (ADS)

Wassin, Shukree; Isoe, George M.; Gamatham, Romeo R. G.; Leitch, Andrew W. R.; Gibbon, Tim B.

2017-01-01

Precise and accurate timing signals distributed between a centralized location and several end-users are widely used in both metro-access and speciality networks for Coordinated Universal Time (UTC), GPS satellite systems, banking, very long baseline interferometry and science projects such as SKA radio telescope. Such systems utilize time and frequency technology to ensure phase coherence among data signals distributed across an optical fibre network. For accurate timing requirements, precise time intervals should be measured between successive pulses. In this paper we describe a novel, all optical method for quantifying one-way propagation times and phase perturbations in the fibre length, using pulse-persecond (PPS) signals. The approach utilizes side mode injection of a 1550nm 10Gbps vertical cavity surface emitting laser (VCSEL) at the remote end. A 125 μs one-way time of flight was accurately measured for 25 km G655 fibre. Since the approach is all-optical, it avoids measurement inaccuracies introduced by electro-optical conversion phase delays. Furthermore, the implementation uses cost effective VCSEL technology and suited to a flexible range of network architectures, supporting a number of end-users conducting measurements at the remote end.

Hydrodynamic and material properties experiments using pulsed power techniques

NASA Astrophysics Data System (ADS)

Reinovsky, R. E.; Trainor, R. J.

2000-04-01

Within the last five years, a new approach to the exploration of dynamic material properties and advanced hydrodynamics at extreme conditions has joined the traditional techniques of high velocity guns and explosives. This new application uses electromagnetic energy to accelerate solid density material to produce shocks in a cylindrical target. The principal tool for producing high energy density environments is the high precision, magnetically imploded, near-solid density cylindrical liner. The most attractive pulsed power system for driving such experiments is an ultrahigh current, low impedance, microsecond time scale source that is economical both to build and to operate. Two families of pulsed power systems can be applied to drive such experiments. The 25-MJ Atlas capacitor bank system currently under construction at Los Alamos is the first system of its scale specifically designed to drive high precision solid liners. Delivering 30 MA, Atlas will provide liner velocities 12-15 km/sec and kinetic energies of 1-2 MJ/cm with extensive diagnostics and excellent reproducibility. Explosive flux compressor technology provides access to currents exceeding 100 MA producing liner velocities above 25 km/sec and kinetic energies of 5-20 MJ/cm in single shot operations

Symmetry-controlled time structure of high-harmonic carrier fields from a solid

PubMed Central

Langer, F.; Hohenleutner, M.; Huttner, U.; Koch, S. W.; Kira, M.; Huber, R.

2017-01-01

High-harmonic (HH) generation in crystalline solids1–6 marks an exciting development, with potential applications in high-efficiency attosecond sources7, all-optical bandstructure reconstruction8,9, and quasiparticle collisions10,11. Although the spectral1–4 and temporal shape5 of the HH intensity has been described microscopically1–6,12, the properties of the underlying HH carrier wave have remained elusive. Here we analyse the train of HH waveforms generated in a crystalline solid by consecutive half cycles of the same driving pulse. Extending the concept of frequency combs13–15 to optical clock rates, we show how the polarization and carrier-envelope phase (CEP) of HH pulses can be controlled by crystal symmetry. For some crystal directions, we can separate two orthogonally polarized HH combs mutually offset by the driving frequency to form a comb of even and odd harmonic orders. The corresponding CEP of successive pulses is constant or offset by π, depending on the polarization. In the context of a quantum description of solids, we identify novel capabilities for polarization- and phase-shaping of HH waveforms that cannot be accessed with gaseous sources. PMID:28572835

Measurements and FLUKA simulations of bismuth and aluminium activation at the CERN Shielding Benchmark Facility (CSBF)

NASA Astrophysics Data System (ADS)

Iliopoulou, E.; Bamidis, P.; Brugger, M.; Froeschl, R.; Infantino, A.; Kajimoto, T.; Nakao, N.; Roesler, S.; Sanami, T.; Siountas, A.

2018-03-01

The CERN High Energy AcceleRator Mixed field facility (CHARM) is located in the CERN Proton Synchrotron (PS) East Experimental Area. The facility receives a pulsed proton beam from the CERN PS with a beam momentum of 24 GeV/c with 5 ṡ1011 protons per pulse with a pulse length of 350 ms and with a maximum average beam intensity of 6.7 ṡ1010 p/s that then impacts on the CHARM target. The shielding of the CHARM facility also includes the CERN Shielding Benchmark Facility (CSBF) situated laterally above the target. This facility consists of 80 cm of cast iron and 360 cm of concrete with barite concrete in some places. Activation samples of bismuth and aluminium were placed in the CSBF and in the CHARM access corridor in July 2015. Monte Carlo simulations with the FLUKA code have been performed to estimate the specific production yields for these samples. The results estimated by FLUKA Monte Carlo simulations are compared to activation measurements of these samples. The comparison between FLUKA simulations and the measured values from γ-spectrometry gives an agreement better than a factor of 2.

Cardiac transient outward potassium current: a pulse chemistry model of frequency-dependent properties.

PubMed

Liu, L; Krinsky, V I; Grant, A O; Starmer, C F

1996-01-01

Recent voltage-clamp studies of isolated myocytes have demonstrated widespread occurrence of a transient outward current (I(to)) carried by potassium ions. In the canine ventricle, this current is well developed in epicardial cells but not in endocardial cells. The resultant spatial dispersion of refractoriness is potentially proarrhythmic and may be amplified by channel blockade. The inactivation and recovery time constants of this channel are in excess of several hundred milliseconds, and consequently channel availability is frequency dependent at physiological stimulation rates. When the time constants associated with transitions between different channel conformations are rapid relative to drug binding kinetics, the interactions between drugs and an ion channel can be approximated by a sequence of first-order reactions, in which binding occurs in pulses in response to pulse train stimulation (pulse chemistry). When channel conformation transition time constants do not meet this constraint, analytical characterizations of the drug-channel interaction must then be modified to reflect the channel time-dependent properties. Here we report that the rate and steady-state amount of frequency-dependent inactivation of I(to) are consistent with a generalization of the channel blockade model: channel availability is reduced in a pulsatile exponential pattern as the stimulation frequency is increased, and the rate of reduction is a linear function of the pulse train depolarizing and recovery intervals. I(to) was reduced in the presence of quinidine. After accounting for the use-dependent availability of I(to) channels, we found little evidence of an additional use-dependent component of block after exposure to quinidine, suggesting that quinidine reacts with both open and closed I(to) channels as though the binding site is continuously accessible. The model provides a useful tool for assessing drug-channel interactions when the reaction cannot be continuously monitored.