Utilidade do Ultrassom intracardíaco no isolamento de veias pulmonares usando cateter-balão a laser

FUNDAMENTO: O isolamento das veias pulmonares (IVP) tem sido usado como endpoint para a ablação da fibrilação atrial (FA) com cateter balão. OBJETIVO: Determinar a utilidade do ultrassom intracardíaco (USIC) para guiar o IVP, usando cateter balão a laser. MÉTODOS: 59 VP foram ablacionadas em 27 cães. Imagens de Doppler foram usadas para identificar os vazamentos do fluxo sanguíneo entre a VP e o balão. Após cada liberação de energia, o cateter de mapeamento circular foi reposicionado para verificar se o isolamento tinha sido obtido. A posição de vazamento foi então correlacionada com a posição do gap no estudo patológico. A análise de regressão logística multivariada foi realizada. RESULTADOS: Cinquenta e nove VP foram submetidas à ablação. O tempo médio de energia liberada foi de 279±177 seg., o diâmetro médio do balão era de 23±3 mm, e o comprimento médio do balão era 25±4 mm. O isolamento completo foi obtido em 38/59 (64%), e foi significantemente mais comum sem vazamento: [30/38 (79%) versus 8/23 (35%), p<0,001]. Isso foi independente do tempo de aplicação (302±223 seg. vs. 266±148 sec., p=ns), potência (3,5 W/cm, 4,5 W/cm, e 5,5 W/cm), diâmetro do balão (24± 3 mm vs. 22± 3 mm, p= ns) e comprimento (27±4 mm vs. 24±4 mm, p=ns). O valor preditivo positivo para previsão de isolamento completo foi de 65% e o valor preditivo negativo foi 83%. CONCLUSÃO: Um vazamento identificável entre a VP e o dispositivo de ablação por cateter-balão observado no USIC é preditor de menor taxa de isolamento de VP mais baixas. O USIC pode ser útil para detectar vazamentos a fim de evitar o uso ineficaz de aplicação energia durante a ablação circunferencial da VP. Isto também pode ser útil quando outras energias são utilizadas.

Hemodynamic Effect of Laser Therapy in Spontaneously Hypertensive Rats

Systemic arterial hypertension (SAH) is considered to be the greatest risk factor for the development of neuro-cardiovascular pathologies, thus constituting a severe Public Health issue in the world. The Low-Level Laser Therapy (LLLT), or laser therapy, activates components of the cellular structure, therefore converting luminous energy into photochemical energy and leading to biophysical and biochemical reactions in the mitochondrial respiratory chain. The LLLT promotes cellular and tissue photobiomodulation by means of changes in metabolism, leading to molecular, cellular and systemic changes. The objective of this study was to analyze the action of low-level laser in the hemodynamic modulation of spontaneously hypertensive rats, in the long term. Animals (n = 16) were randomly divided into the Laser Group (n = 8), which received three weekly LLLT irradiations for seven weeks, and into the Sham Group (n = 8), which received three weekly simulations of laser for seven weeks, accounting for 21 applications in each group. After seven weeks, animals were cannulated by the implantation of a catheter in the left carotid artery. On the following day, the systemic arterial pressure was recorded. The Laser Group showed reduced levels of mean blood pressure, with statistically significant reduction (169 ± 4 mmHg* vs. 182 ± 4 mmHg from the Sham Group) and reduced levels of diastolic pressure (143 ± 4 mmHg* vs. 157 ± 3 mmHg from the Sham Group), revealing a 13 and 14 mmHg decrease, respectively. Besides, there was a concomitant important decline in heart rate (312 ± 14 bpm vs. 361 ± 13 bpm from the Sham Group). Therefore, laser therapy was able to produce hemodynamic changes, thus reducing pressure levels in spontaneously hypertensive rats.

Modelling the influence of microstructure on elastic properties and tensile damage behaviour of Mo-base silicide alloys

Mo-Si-B alloys, Real microstructures, Voronoi structures, Microstructural characterization, Modelling and finite element simulations, Effective material properties, Damage and Crack growth, tensile strength, fracture toughness

Micro scale modeling grain boundary damage under creep conditions

Magdeburg, Univ., Fak. für Maschinenbau, Diss., 2014

Development of an in vitro model for studying aneurysms

The aims of this project was to develop an arterial aneurysm using either enzymatic or laser degradation of the arterial wall without affecting the viability of the tissue and to cultivate the arteries under pulsatile flow conditions in a vascular bioreactor with a view to investigate the progress of the disease. Characteristics of aneurysms are the degradation of smooth muscle cells, collagen and elastin. Detached smooth muscle cells and degradation of the collagen matrix and elastin fibres were observed in arteries degraded with enzymes elastase and collagenase. Only remnants of the arterial wall were detected after cultivation. This might be a suitable model for late stage aneurysms. Arteries treated with the laser system showed no charring or heat damage of the not dissected area. Collagen matrix, smooth muscle cells and elastin fibres were intact. A clear defined cut was made in a depth of 200 μm and tissue was removed. Following cultivation of these arteries a dilation of the laser-eroded area was observed. This model can mimic atherosclerotic aneurysms, when plaques weaken the tunica media of the blood vessel wall and rupture. Limitations of this study were contamination of the bioreactor system and a low number of cultivations. The aim to generate a living arterial aneurysm in vitro was not achieved. Tissue viability decreased to the level of negative controls after cultivation.

Determinació de la ubicació estructural dels ions Yb3+ i Nb3+ en Yb:RTP, Nb:RTP i (Nb,Yb):RTP

Estudi elaborat a partir d’una estada al Stony Brook University al juliol del 2006. El RbTiOPO4 (RTP) monocristal•lí és un material d' òptica no lineal molt rellevant i utilitzat en la tecnologia làser actual, químicament molt estable i amb unes propietats físiques molt destacades, entre elles destaquen els alts coeficients electro-òptics i l'alt llindar de dany òptic que presenta. En els últims anys s’està utilitzant tecnològicament en aplicacions d'òptica no lineal en general i electro-òptiques en particular. En alguns casos ja ha substituït, millorant prestacions, a materials tals com el KTP o el LNB(1). Dopant RTP amb ions lantànids (Ln3+) (2-4), el material es converteix en un material làser auto-doblador de freqüència, combinant les seves propietats no lineals amb les de matriu làser. El RTP genera radiació de segon harmònic (SHG) a partir d’un feix fonamental amb longituds d’ona inferiors a 990 nm, que és el límit que presenta el KTP.La determinació de la ubicació estructural i l’estudi de l'entorn local del ions actius làser és de fonamental importància per a la correcta interpretació de les propietats espectroscòpiques d’aquest material. Mesures de difracció de neutrons sobre mostra de pols cristal•lí mostren que els ions Nb5+ i Ln3+ només substitueixin posicions de Ti4+ (8-9). Estudis molt recents d'EPR (electron paramagnetic resonance) semblen indicar que quan la concentració d'ió Ln3+ es baixa, aquest ió presenta la tendència a substituir l'ió alcalí present a l'estructura (10).Després dels resultats obtinguts en el present treball a partir de la tècnica EXAFS a la instal•lació sincrotò del Brookhaven National Laboratory/State University of New York (Stony Brook) es pot concloure definitivament que els ions Nb s’ubiquen en la posició Ti (1) i que els ions Yb3+ es distribueixen paritariament en les dues posicions del Ti (1 i 2). Aquests resultats aporten una valuosa informació per a la correcta interpretació dels espectres, tant d’absorció com d’emissió, del material i per la avaluació dels paràmetres del seu comportament durant l'acció làser.

Empleo de óptica adaptativa y fluorescencia en un oftalmoscopio laser de barrido para el registro de células

Estudio elaborado a partir de una estancia en la Universidad de Rochester, Estados Unidos, de octubre del 2006 a enero del 2007. La estancia realizada en la Universidad de Rochester estuvo orientada al aprendizaje en profundidad del oftalmoscopio láser de barrido. El oftalmoscopio láser de barrido emplea una técnica confocal con la finalidad de visualizar diferentes estructuras retinianas en seres vivos. El instrumento diseñado y desarrollado en el Centro de Ciencias de la Visión incorpora un sistema de óptica adaptativa y fluorescencia. La óptica adaptativa aplicada en este oftalmoscopio tiene como objetivo corregir las aberraciones existentes en el ojo y así permitir observar detalles de la retina que de otra forma se verían emborronados. De esta forma se consigue alcanzar valores de resolución muy cercanos a los impuestos por difracción. Por otro lado el uso de fluorescencia tiene por objetivo el permitir la visualización de células y estructuras que, de no ser teñidas, son transparentes a la luz y visible. Esta técnica se ha estado utilizando principalmente en primates y ratas, aunque actualmente también se están llevando a cabo medidas de células de epitelio pigmentario en seres humanos ya que el pigmento contenido en estas células permite la aplicación de la fluorescencia sin necesidad de utilizar tinción.

Terrestrial laser scanning for landslides deformation monitoring

Within last few years a new type of instruments called Terrestrial Laser Scanners (TLS) entered to the commercial market. These devices brought a possibility to obtain completely new type of spatial, three dimensional data describing the object of interest. TLS instruments are generating a type of data that needs a special treatment. Appearance of this technique made possible to monitor deformations of very large objects, like investigated here landslides, with new quality level. This change is visible especially with relation to the size and number of the details that can be observed with this new method. Taking into account this context presented here work is oriented on recognition and characterization of raw data received from the TLS instruments as well as processing phases, tools and techniques to do them. Main objective are definition and recognition of the problems related with usage of the TLS data, characterization of the quality single point generated by TLS, description and investigation of the TLS processing approach for landslides deformation measurements allowing to obtain 3D deformation characteristic and finally validation of the obtained results. The above objectives are based on the bibliography studies and research work followed by several experiments that will prove the conclusions.

Does abdominoplasty with liposuction of the love handles yield a shorter scar? An analysis with abdominal 3D laser scanning.

The aim of this study was to evaluate the combination of abdominoplasty with liposuction of both flanks with regards to length of scar, complications, and patient's satisfaction. A retrospective analysis of 35 patients who underwent esthetic abdominoplasty at our institution between 2002 and 2004 was performed. Thirteen patients underwent abdominoplasty with liposuction of both flanks, 22 patients underwent conventional abdominoplasty. Liposuction of the flanks did not increase the rate of complications of the abdominoplasty procedures. We found a tendency toward shorter scars in patients who underwent abdominoplasty combined with liposuction of the flanks. Implementation of 3-dimensional laser surface scanning to objectify the postoperative outcomes, documented a comparable degree of flatness of the achieved body contouring in both procedures. 3-dimensional laser surface scanning can be a valuable tool to objectify assessment of postoperative results.

Performance of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of bacterial strains routinely isolated in a clinical microbiology laboratory.

Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been introduced in diagnostic microbiology laboratories for the identification of bacterial and yeast strains isolated from clinical samples. In the present study, we prospectively compared MALDI-TOF MS to the conventional phenotypic method for the identification of routine isolates. Colonies were analyzed by MALDI-TOF MS either by direct deposition on the target plate or after a formic acid-acetonitrile extraction step if no valid result was initially obtained. Among 1,371 isolates identified by conventional methods, 1,278 (93.2%) were putatively identified to the species level by MALDI-TOF MS and 73 (5.3%) were identified to the genus level, but no reliable identification was obtained for 20 (1.5%). Among the 1,278 isolates identified to the species level by MALDI-TOF MS, 63 (4.9%) discordant results were initially identified. Most discordant results (42/63) were due to systematic database-related taxonomical differences, 14 were explained by poor discrimination of the MALDI-TOF MS spectra obtained, and 7 were due to errors in the initial conventional identification. An extraction step was required to obtain a valid MALDI-TOF MS identification for 25.6% of the 1,278 valid isolates. In conclusion, our results show that MALDI-TOF MS is a fast and reliable technique which has the potential to replace conventional phenotypic identification for most bacterial strains routinely isolated in clinical microbiology laboratories.

Predicting trabecular bone microdamage initiation and accumulation using a non-linear perfect damage model

Studies evaluating the mechanical behavior of the trabecular microstructure play an important role in our understanding of pathologies such as osteoporosis, and in increasing our understanding of bone fracture and bone adaptation. Understanding of such behavior in bone is important for predicting and providing early treatment of fractures. The objective of this study is to present a numerical model for studying the initiation and accumulation of trabecular bone microdamage in both the pre- and post-yield regions. A sub-region of human vertebral trabecular bone was analyzed using a uniformly loaded anatomically accurate microstructural three-dimensional finite element model. The evolution of trabecular bone microdamage was governed using a non-linear, modulus reduction, perfect damage approach derived from a generalized plasticity stress-strain law. The model introduced in this paper establishes a history of microdamage evolution in both the pre- and post-yield regions

Schistosoma mansoni: structural damage after treatment with oxamniquine

The effects of a single dose (100 mg/kg-body weight of mouse) of oxamniquine on the worm's tegument and paranchyma in relation to the process of immunological granulomatous reaction of the host's liver are described under light and electron microscopy (EM). The lesions caused by the drug are sequentially and simultaneously described in form of swelling, surface bulble and disruption with erosions. Ulceration in the tubercules with loss of spines is often more extensive and severe in male worms and concentration of host's mononuclear cells is observed. The possible role of host's immune response is discussed.

Femtosecond-laser assisted cataract surgery: a review.

Introduced in 2008, the femtosecond laser is a promising new technological advance which plays an ever increasing role in cataract surgery where it automates the three main surgical steps: corneal incision, capsulotomy and lens fragmentation. The proven advantages over manual surgery are: a better quality of incision with reduced induced astigmatism; increased reliability and reproducibility of the capsulotomy with increased stability of the implanted lens; a reduction in the use of ultrasound. Regarding refractive results or safety, however, no prospective randomized study to date has shown significant superiority compared with standard manual technique. The significant extra cost generated by this laser, undertaken by the patient, is a limiting factor for both its use and study. This review outlines the potential benefits of femtosecond-laser-assisted cataract surgery due to the automation of key steps and the safety of this new technology.

A peptide inhibitor of C-jun N-terminal kinase modulates hepatic damage and the inflammatory response after hemorrhagic shock and resuscitation

Hemorrhage and resuscitation (H/R) leads to phosphorylation of mitogen-activated stress kinases, an event that is associated with organ damage. Recently, a specific, cell-penetrating, protease-resistant inhibitory peptide of the mitogen-activated protein kinase c-JUN N-terminal kinase (JNK) was developed (D-JNKI-1). Here, using this peptide, we tested if inhibition of JNK protects against organ damage after H/R. Male Sprague-Dawley rats were treated with D-JNKI-1 (11 mg/kg, i.p.) or vehicle. Thirty minutes later, rats were hemorrhaged for 1 h to a MAP of 30 to 35 mmHg and then resuscitated with 60% of the shed blood and twice the shed blood volume as Ringer lactate. Tissues were harvested 2 h later. ANOVA with Tukey post hoc analysis or Kruskal-Wallis ANOVA on ranks, P < 0.05, was considered significant. c-JUN N-terminal kinase inhibition decreased serum alanine aminotransferase activity as a marker of liver injury by 70%, serum creatine kinase activity by 67%, and serum lactate dehydrogenase activity by 60% as compared with vehicle treatment. The histological tissue damage observed was blunted after D-JNKI-1 pretreatment both for necrotic and apoptotic cell death. Hepatic leukocyte infiltration and serum IL-6 levels were largely diminished after D-JNKI-1 pretreatment. The extent of oxidative stress as evaluated by immunohistochemical detection of 4-hydroxynonenal was largely abrogated after JNK inhibition. After JNK inhibition, activation of cJUN after H/R was also reduced. Hemorrhage and resuscitation induces a systemic inflammatory response and leads to end-organ damage. These changes are mediated, at least in part, by JNK. Therefore, JNK inhibition deserves further evaluation as a potential treatment option in patients after resuscitated blood loss.