Assessment of flow in perforating arteries during intracranial aneurysm surgery using intraoperative near-infrared indocyanine green videoangiography

OBJECTIVE: Perforating arteries are commonly involved during the surgical dissection and clipping of intracranial aneurysms. Occlusion of perforating arteries is responsible for ischemic infarction and poor outcome. The goal of this study is to describe the usefulness of near-infrared indocyanine green videoangiography (ICGA) for the intraoperative assessment of blood flow in perforating arteries that are visible in the surgical field during clipping of intracranial aneurysms. In addition, we analyzed the incidence of perforating vessels involved during the aneurysm surgery and the incidence of ischemic infarct caused by compromised small arteries. METHODS: Sixty patients with 64 aneurysms were surgically treated and prospectively included in this study. Intraoperative ICGA was performed using a surgical microscope (Carl Zeiss Co., Oberkochen, Germany) with integrated ICGA technology. The presence and involvement of perforating arteries were analyzed in the microsurgical field during surgical dissection and clip application. Assessment of vascular patency after clipping was also investigated. Only those small arteries that were not visible on preoperative digital subtraction angiography were considered for analysis. RESULTS: The ICGA was able to visualize flow in all patients in whom perforating vessels were found in the microscope field. Among 36 patients whose perforating vessels were visible on ICGA, 11 (30%) presented a close relation between the aneurysm and perforating arteries. In one (9%) of these 11 patients, ICGA showed occlusion of a P1 perforating artery after clip application, which led to immediate correction of the clip confirmed by immediate reestablishment of flow visible with ICGA without clinical consequences. Four patients (6.7%) presented with postoperative perforating artery infarct, three of whom had perforating arteries that were not visible or distant from the aneurysm. CONCLUSION: The involvement of perforating arteries during clip application for aneurysm occlusion is a usual finding. Intraoperative ICGA may provide visual information with regard to the patency of these small vessels.

Hierarchical clustering of flow cytometry data for the study of conventional central chondrosarcoma

We have investigated the use of hierarchical clustering of flow cytometry data to classify samples of conventional central chondrosarcoma, a malignant cartilage forming tumor of uncertain cellular origin, according to similarities with surface marker profiles of several known cell types. Human primary chondrosarcoma cells, articular chondrocytes, mesenchymal stem cells, fibroblasts, and a panel of tumor cell lines from chondrocytic or epithelial origin were clustered based on the expression profile of eleven surface markers. For clustering, eight hierarchical clustering algorithms, three distance metrics, as well as several approaches for data preprocessing, including multivariate outlier detection, logarithmic transformation, and z-score normalization, were systematically evaluated. By selecting clustering approaches shown to give reproducible results for cluster recovery of known cell types, primary conventional central chondrosacoma cells could be grouped in two main clusters with distinctive marker expression signatures: one group clustering together with mesenchymal stem cells (CD49b-high/CD10-low/CD221-high) and a second group clustering close to fibroblasts (CD49b-low/CD10-high/CD221-low). Hierarchical clustering also revealed substantial differences between primary conventional central chondrosarcoma cells and established chondrosarcoma cell lines, with the latter not only segregating apart from primary tumor cells and normal tissue cells, but clustering together with cell lines from epithelial lineage. Our study provides a foundation for the use of hierarchical clustering applied to flow cytometry data as a powerful tool to classify samples according to marker expression patterns, which could lead to uncover new cancer subtypes.

Endothelial function and sleep: associations of flow-mediated dilation with perceived sleep quality and rapid eye movement (REM) sleep.

Endothelial function typically precedes clinical manifestations of cardiovascular disease and provides a potential mechanism for the associations observed between cardiovascular disease and sleep quality. This study examined how subjective and objective indicators of sleep quality relate to endothelial function, as measured by brachial artery flow-mediated dilation (FMD). In a clinical research centre, 100 non-shift working adults (mean age: 36 years) completed FMD testing and the Pittsburgh Sleep Quality Index, along with a polysomnography assessment to obtain the following measures: slow wave sleep, percentage rapid eye movement (REM) sleep, REM sleep latency, total arousal index, total sleep time, wake after sleep onset, sleep efficiency and apnea-hypopnea index. Bivariate correlations and follow-up multiple regressions examined how FMD related to subjective (i.e., Pittsburgh Sleep Quality Index scores) and objective (i.e., polysomnography-derived) indicators of sleep quality. After FMD showed bivariate correlations with Pittsburgh Sleep Quality Index scores, percentage REM sleep and REM latency, further examination with separate regression models indicated that these associations remained significant after adjustments for sex, age, race, hypertension, body mass index, apnea-hypopnea index, smoking and income (Ps < 0.05). Specifically, as FMD decreased, scores on the Pittsburgh Sleep Quality Index increased (indicating decreased subjective sleep quality) and percentage REM sleep decreased, while REM sleep latency increased (Ps < 0.05). Poorer subjective sleep quality and adverse changes in REM sleep were associated with diminished vasodilation, which could link sleep disturbances to cardiovascular disease.

Classes of multichannel EEG microstates in light and deep hypnotic conditions

The study assessed the brain electric mechanisms of light and deep hypnotic conditions in the framework of EEG temporal microstates. Multichannel EEG of healthy volunteers during initial resting, light hypnosis, deep hypnosis, and eventual recovery was analyzed into temporal EEG microstates of four classes. Microstates are defined by the spatial configuration of their potential distribution maps ([Symbol: see text]potential landscapes') on the head surface. Because different potential landscapes must have been generated by different active neural assemblies, it is reasonable to assume that they also incorporate different brain functions. The observed four microstate classes were very similar to the four standard microstate classes A, B, C, D [Koenig, T. et al. Neuroimage, 2002;16: 41-8] and were labeled correspondingly. We expected a progression of microstate characteristics from initial resting to light to deep hypnosis. But, all three microstate parameters (duration, occurrence/second and %time coverage) yielded values for initial resting and final recovery that were between those of the two hypnotic conditions of light and deep hypnosis. Microstates of the classes B and D showed decreased duration, occurrence/second and %time coverage in deep hypnosis compared to light hypnosis; this was contrary to microstates of classes A and C which showed increased values of all three parameters. Reviewing the available information about microstates in other conditions, the changes from resting to light hypnosis in certain respects are reminiscent of changes to meditation states, and changes to deep hypnosis of those in schizophrenic states.

Measurement of flow harmonics with multi-particle cumulants in Pb+Pb collisions at √sNN=2.76 TeV with the ATLAS detector

ATLAS measurements of the azimuthal anisotropy in lead–lead collisions at √sNN = 2.76 TeV are shown using a dataset of approximately 7μb−1 collected at the LHC in 2010. The measurements are performed for charged particles with transversemomenta 0.5 < pT < 20 GeV and in the pseudorapidity range |η| < 2.5. The anisotropy is characterized by the Fourier coefficients, vn, of the charged-particle azimuthal angle distribution for n = 2–4. The Fourier coefficients are evaluated using multi-particle cumulants calculated with the generating function method. Results on the transverse momentum, pseudorapidity and centrality dependence of the vn coefficients are presented. The elliptic flow, v2, is obtained from the two-, four-, six- and eight-particle cumulants while higher-order coefficients, v3 and v4, are determined with two- and four-particle cumulants. Flow harmonics vn measured with four-particle cumulants are significantly reduced compared to the measurement involving two-particle cumulants. A comparison to vn measurements obtained using different analysis methods and previously reported by the LHC experiments is also shown. Results of measurements of flow fluctuations evaluated with multiparticle cumulants are shown as a function of transverse momentum and the collision centrality. Models of the initial spatial geometry and its fluctuations fail to describe the flow fluctuations measurements.

Development and in-vitro characterization of an implantable flow sensing transducer for hydrocephalus

An implantable transducer for monitoring the flow of Cerebrospinal fluid (CSF) for the treatment of hydrocephalus has been developed which is based on measuring the heat dissipation of a local thermal source. The transducer uses passive telemetry at 13.56 MHz for power supply and read out of the measured flow rate. The in vitro performance of the transducer has been characterized using artificial Cerebrospinal Fluid (CSF) with increased protein concentration and artificial CSF with 10\% fresh blood. After fresh blood was added to the artificial CSF a reduction of flow rate has been observed in case that the sensitive surface of the flow sensor is close to the sedimented erythrocytes. An increase of flow rate has been observed in case that the sensitive surface is in contact with the remaining plasma/artificial CSF mix above the sediment which can be explained by an asymmetric flow profile caused by the sedimentation of erythrocythes having increased viscosity compared to artificial CSF. After removal of blood from artificial CSF, no drift could be observed in the transducer measurement which could be associated to a deposition of proteins at the sensitive surface walls of the packaged flow transducer. The flow sensor specification requirement of +-10\% for a flow range between 2 ml/h and 40 ml/h. could be confirmed at test conditions of 37 degrees C.

Analysis Methodology for Flow-level Evaluation of a Hybrid Mobile-Sensor Network

Our society uses a large diversity of co-existing wired and wireless networks in order to satisfy its communication needs. A cooper- ation between these networks can benefit performance, service availabil- ity and deployment ease, and leads to the emergence of hybrid networks. This position paper focuses on a hybrid mobile-sensor network identify- ing potential advantages and challenges of its use and defining feasible applications. The main value of the paper, however, is in the proposed analysis approach to evaluate the performance at the mobile network side given the mixed mobile-sensor traffic. The approach combines packet- level analysis with modelling of flow-level behaviour and can be applied for the study of various application scenarios. In this paper we consider two applications with distinct traffic models namely multimedia traffic and best-effort traffic.

Modeling of Heat Transfer in Microchannel Gas Flow

Due to the existence of a velocity slip and temperature jump on the solid walls, the heat transfer in microchannels significantly differs from the one in the macroscale. In our research, we have focused on the pressure driven gas flows in a simple finite microchannel geometry, with an entrance and an outlet, for low Reynolds (Re<200) and low Knudsen (Kn<0.01) numbers. For such a regime, the slip induced phenomena are strongly connected with the viscous effects. As a result, heat transfer is also significantly altered. For the optimization of flow conditions, we have investigated various temperature gradient configurations, additionally changing Reynolds and Knudsen numbers. The entrance effects, slip flow, and temperature jump lead to complex relations between flow behavior and heat transfer. We have shown that slip effects are generally insignificant for flow behavior. However, two configuration setups (hot wall cold gas and cold wall hot gas) are affected by slip in distinguishably different ways. For the first one, which concerns turbomachinery, the mass flow rate can increase by about 1% in relation to the no-slip case, depending on the wall-gas temperature difference. Heat transfer is more significantly altered. The Nusselt number between slip and no-slip cases at the outlet of the microchannel is increased by about 10%.

The simultaneous role of an alveolus as flow mixer and flow feeder for the deposition of inhaled submicron particles

In an effort to understand the fate of inhaled submicron particles in the small sacs, or alveoli, comprising the gas-exchange region of the lung, we calculated the flow in three-dimensional (3D) rhythmically expanding models of alveolated ducts. Since convection toward the alveolar walls is a precursor to particle deposition, it was the goal of this paper to investigate the streamline maps' dependence upon alveoli location along the acinar tree. On the alveolar midplane, the recirculating flow pattern exhibited closed streamlines with a stagnation saddle point. Off the midplane we found no closed streamlines but nested, funnel-like, spiral, structures (reminiscent of Russian nesting dolls) that were directed towards the expanding walls in inspiration, and away from the contracting walls in expiration. These nested, funnel-like, structures were surrounded by air that flowed into the cavity from the central channel over inspiration and flowed from the cavity to the central channel over expiration. We also found that fluid particle tracks exhibited similar nested funnel-like spiral structures. We conclude that these unique alveolar flow structures may be of importance in enhancing deposition. In addition, due to inertia, the nested, funnel-like, structures change shape and position slightly during a breathing cycle, resulting in flow mixing. Also, each inspiration feeds a fresh supply of particle-laden air from the central channel to the region surrounding the mixing region. Thus, this combination of flow mixer and flow feeder makes each individual alveolus an effective mixing unit, which is likely to play an important role in determining the overall efficiency of convective mixing in the acinus.

European Working Group on Clinical Cell Analysis: Consensus protocol for the flow cytometric characterisation of platelet function

An increased or disturbed activation and aggregation of platelets plays a major role in the pathophysiology of thrombosis and haemostasis and is related to cardiovascular disease processes. In addition to qualitative disturbances of platelet function, changes in thrombopoiesis or an increased elimination of platelets, (e. g., in autoimmune thrombocytopenia), are also of major clinical relevance. Flow cytometry is increasingly used for the specific characterisation of phenotypic alterations of platelets which are related to cellular activation, haemostatic function and to maturation of precursor cells. These new techniques also allow the study of the in vitro response of platelets to stimuli and the modification thereof under platelet-targeted therapy as well as the characterisation of platelet-specific antibodies. In this protocol, specific flow cytometric techniques for platelet analysis are recommended based on a description of the current state of flow cytometric methodology. These recommendations are an attempt to promote the use of these new techniques which are at present broadly evaluated for diagnostic purposes. Furthermore, the definition of the still open questions primarily related to the technical details of the method should help to promote the multi-center evaluation of procedures with the goal to finally develop standardized operation procedures as the basis of interlaboratory reproducibility when applied to diagnostic testing.

Flow impairment during protected carotid artery stenting: impact of filter device design

PURPOSE: To investigate the impact of filter design on blood flow impairment in the internal carotid artery (ICA) among patients undergoing carotid artery stenting (CAS) using filter-type emboli protection devices (EPD). METHODS: Between July 2003 and March 2007, 115 filter-protected CAS procedures were performed at an academic institution in 107 consecutive patients (78 men; mean age 68 years, range 38-87). The Angioguard, FilterWire EZ, and Spider filters were used in 68 (59%), 32 (28%), and 15 (13%) of cases, respectively. Patient characteristics, procedural and angiographic data, and outcomes were prospectively entered into an electronic database and reviewed retrospectively along with all angiograms. RESULTS: Flow impairment while the filter was in place was observed in 25 (22%) cases. The presumptive reason of flow impairment was filter obstruction in 21 (18%) instances and flow-limiting spasm at the level of the filter in 4 (4%). In all cases, flow was restored after retrieval of the filter. Flow obstruction in the ICA occurred more frequently with Angioguard (22/68; 32.3%) than with FilterWire EZ (2/32; 6.2%) or Spider (1/15; 6.7%; p = 0.004). No flow occurred in 13 (19%) procedures, all of them protected with Angioguard; no patient treated with other devices experienced this event (p = 0.007). Two (8.0%) strokes occurred in procedures associated with flow impairment, while 1 (1.1%) event was observed in the presence of preserved flow throughout the intervention (p = 0.11). CONCLUSION: Flow impairment in the ICA during filter-based CAS is common and related to the type of filter used.