Improving coronary artery bypass graft durability: use of the external saphenous vein graft support.

Coronary bypass grafting remains the best option for patients suffering from multivessel coronary artery disease, and the saphenous vein is used as an additional conduit for multiple complete revascularizations. However, the long-term vein graft durability is poor, with almost 75% of occluded grafts after 10 years. To improve the durability, the concept of an external supportive structure was successfully developed during the last years: the eSVS Mesh device (Kips Bay Medical) is an external support for vein graft made of weft-knitted nitinol wire into a tubular form with an approximate length of 24 cm and available in three diameters (3.5, 4.0 and 4.5 mm). The device is placed over the outer wall of the vein and carefully deployed to cover the full length of the graft. The mesh is flexible for full adaptability to the heart anatomy and is intended to prevent kinking and dilatation of the vein in addition to suppressing the intima hyperplasia induced by the systemic blood pressure. The device is designed to reduce the vein diameter of about 15-20% at most to prevent the vein radial expansion induced by the arterial blood pressure, and the intima hyperplasia leading to the graft failure. We describe the surgical technique for preparing the vein graft with the external saphenous vein graft support (eSVS Mesh) and we share our preliminary clinical results.

A comprehensive model for quantum noise characterization in digital mammography.

NlmCategory="UNASSIGNED">A version of cascaded systems analysis was developed specifically with the aim of studying quantum noise propagation in x-ray detectors. Signal and quantum noise propagation was then modelled in four types of x-ray detectors used for digital mammography: four flat panel systems, one computed radiography and one slot-scan silicon wafer based photon counting device. As required inputs to the model, the two dimensional (2D) modulation transfer function (MTF), noise power spectra (NPS) and detective quantum efficiency (DQE) were measured for six mammography systems that utilized these different detectors. A new method to reconstruct anisotropic 2D presampling MTF matrices from 1D radial MTFs measured along different angular directions across the detector is described; an image of a sharp, circular disc was used for this purpose. The effective pixel fill factor for the FP systems was determined from the axial 1D presampling MTFs measured with a square sharp edge along the two orthogonal directions of the pixel lattice. Expectation MTFs were then calculated by averaging the radial MTFs over all possible phases and the 2D EMTF formed with the same reconstruction technique used for the 2D presampling MTF. The quantum NPS was then established by noise decomposition from homogenous images acquired as a function of detector air kerma. This was further decomposed into the correlated and uncorrelated quantum components by fitting the radially averaged quantum NPS with the radially averaged EMTF(2). This whole procedure allowed a detailed analysis of the influence of aliasing, signal and noise decorrelation, x-ray capture efficiency and global secondary gain on NPS and detector DQE. The influence of noise statistics, pixel fill factor and additional electronic and fixed pattern noises on the DQE was also studied. The 2D cascaded model and decompositions performed on the acquired images also enlightened the observed quantum NPS and DQE anisotropy.

Connectivity and tissue microstructural alterations in right and left temporal lobe epilepsy revealed by diffusion spectrum imaging.

Focal epilepsy is increasingly recognized as the result of an altered brain network, both on the structural and functional levels and the characterization of these widespread brain alterations is crucial for our understanding of the clinical manifestation of seizure and cognitive deficits as well as for the management of candidates to epilepsy surgery. Tractography based on Diffusion Tensor Imaging allows non-invasive mapping of white matter tracts in vivo. Recently, diffusion spectrum imaging (DSI), based on an increased number of diffusion directions and intensities, has improved the sensitivity of tractography, notably with respect to the problem of fiber crossing and recent developments allow acquisition times compatible with clinical application. We used DSI and parcellation of the gray matter in regions of interest to build whole-brain connectivity matrices describing the mutual connections between cortical and subcortical regions in patients with focal epilepsy and healthy controls. In addition, the high angular and radial resolution of DSI allowed us to evaluate also some of the biophysical compartment models, to better understand the cause of the changes in diffusion anisotropy. Global connectivity, hub architecture and regional connectivity patterns were altered in TLE patients and showed different characteristics in RTLE vs LTLE with stronger abnormalities in RTLE. The microstructural analysis suggested that disturbed axonal density contributed more than fiber orientation to the connectivity changes affecting the temporal lobes whereas fiber orientation changes were more involved in extratemporal lobe changes. Our study provides further structural evidence that RTLE and LTLE are not symmetrical entities and DSI-based imaging could help investigate the microstructural correlate of these imaging abnormalities.

Ressonância magnética na síndrome da interseção do antebraço: ensaio iconográfico

A ressonância magnética tem papel importante na avaliação de pacientes com dor na face dorsal do antebraço distal e do punho. Entre as causas de dor destaca-se a síndrome da interseção, um processo inflamatório dos tendões do segundo compartimento extensor do antebraço (extensor radial curto do carpo e extensor radial longo do carpo), geralmente provocado por trauma local direto ou atividades repetitivas que exigem a flexão e extensão do punho. Nosso trabalho visa a ilustrar os achados típicos da síndrome da interseção do antebraço e discutir os principais diagnósticos diferenciais.

Ensiharvennuksen ja puun metsikköaseman vaikutus männyn sädekasvuun ja puuaineen tiheyteen

Seloste artikkelista: Peltola, H., Kilpeläinen, A., Sauvala, K., Räisänen, T. & Ikonen, V.-P. 2007. Effects of early thinning regime and tree status on the radial growth and wood density of Scots pine. Silva Fennica 4 (3): 489-505.

Adrenoleucodistrofia ligada ao X: correlação entre o escore de Loes e parâmetros do tensor de difusão

Objetivo: Avaliar a correlação dos parâmetros do tensor de difusão com o escore de Loes e se os parâmetros do tensor de difusão poderiam indicar alterações estruturais precoces. Materiais e Métodos: As medidas do tensor de difusão foram obtidas em 30 exames de 14 pacientes com adrenoleucodistrofia ligada ao X e foram correlacionadas com o escore de Loes. Um grupo controle de 28 pacientes masculinos foi avaliado para estabelecer medidas do tensor de difusão pareadas por idade. Análises estatísticas intra e interobservador foram feitas. Resultados: As medidas do tensor de difusão apresentam forte correlação com o escore de Loes segundo o coeficiente de Pearson (r), com valores de –0,86, 0,89, 0,89 e 0,84 para a fração de anisotropia e difusibilidades média, radial e axial (p < 0,01). A análise da mudança nas medidas do tensor de difusão no estágio inicial da doença indica que os valores de difusibilidades média e radial podem ajudar a predizer a progressão da doença. Conclusão: As medidas de parâmetros do tensor de difusão poderiam ser usadas como um adjunto ao escore de Loes, auxiliando no monitoramento da doença e alertando uma possível progressão do escore de Loes na faixa de interesse para decisões terapêuticas.

Angioplastie primaire par voie radiale ou fémorale dans les STEMI

Introduction La stratégie de reperfusion coronarienne par voie percutanée (PCI: percutaneous coronary intervention) est considérée comme étant la méthode de choix dans la prise en charge urgente des STEMI(H). Actuellement, les deux accès artériels principaux pour les PCI sont l'artère fémorale et l'artère radiale. La voie radiale est préconisée en première intention par les guidelines actuelles car elle serait associée à moins de complications hémorragiques. Objectif L'objectif de cette étude était de comparer la voie d'abord radiale à la voie fémorale, chez les patients admis pour un STEMI, en analysant le succès de la procédure de revascularisation, l'évolution clinique et les complications. Méthode Il s'agit d'une étude observationnelle, comprenant 268 patients admis au CHUV entre le 1er janvier et le 31 décembre 2013, avec le diagnostic de STEMI. Le choix de la voie d'accès artériel (fémorale ou radiale) était laissé au cardiologue interventionnel, sans randomisation. Les patients ont été séparés en 2 groupes, selon la voie d'abord vasculaire choisie au début de la procédure de revascularisation (intention to treat). Les endpoints primaires étaient les saignements majeurs (≥ 3 selon BARC)(A), et le door to balloon time(B). Les endpoints secondaires étaient les MACE(C), les saignements mineurs(A), le taux succès des procédures(D), le temps de fluoroscopie, la quantité de produit de contraste, et le taux de crossover(E) Résultats 268 patients en STEMI ont été inclus dans cette étude, pour un geste de revascularisation en urgence. La moyenne d'âge était de 64.3 ans, avec 73.1% d'hommes. 3 cas de saignements majeurs(A) ont lieu avec la voie radiale (3.4%), et 10 avec la voie fémorale (5.6%), p=0.44. Le door to balloon time ne diffère pas de manière significative selon la voie d'accès employée : 42 min (34-57) pour le groupe radial, et 48 min (31-61) pour le groupe fémoral, p=0.09. Les taux de MACE étaient de 8.0% avec la voie radiale, et de 6.7% avec la voie fémorale, p=0.7. Le taux de crossover était de 4.5% avec la voie radiale, et 0.6% avec la voie fémorale, p=0.02. Le temps de fluoroscopie était de 7min 28sec (5min 9 sec - 12min 25) pour la voie fémorale, contre 12min 22sec (9min 30 sec - 16min 19sec) pour la voie radiale, p < 0.05. La quantité de produit de contraste nécessaire était de 120 ml (100-160) pour le groupe fémoral, et de 170 ml (140-210) pour le groupe radial, p < 0.05. Le taux de succès était comparable entres les 2 groupes : 97.7% pour le groupe radial et 96.0% pour le groupe fémoral, p=0.47. 5.7% des patients du groupe radial sont décédés, contre 5.7% du groupe fémoral, p=0.97. Conclusion Notre étude démontre que la prise en charge d'un STEMI par voie radiale est possible, puisqu'elle n'allonge pas le « door to balloon time », qu'elle n'augmente pas le taux de MACE ni les saignements majeurs, que soit au point de ponction ou non. Par contre la voie radiale augmente la quantité de produit de contraste nécessaire, et allonge le temps de fluoroscopie de manière non négligeable. De futures études permettront peut-être de mieux définir les groupes de patients qui pourraient bénéficier le plus d'une approche radiale.

Monte Carlo thermodynamic and structural properties of the TIP4P water model: dependence on the computational conditions

Classical Monte Carlo simulations were carried out on the NPT ensemble at 25°C and 1 atm, aiming to investigate the ability of the TIP4P water model [Jorgensen, Chandrasekhar, Madura, Impey and Klein; J. Chem. Phys., 79 (1983) 926] to reproduce the newest structural picture of liquid water. The results were compared with recent neutron diffraction data [Soper; Bruni and Ricci; J. Chem. Phys., 106 (1997) 247]. The influence of the computational conditions on the thermodynamic and structural results obtained with this model was also analyzed. The findings were compared with the original ones from Jorgensen et al [above-cited reference plus Mol. Phys., 56 (1985) 1381]. It is notice that the thermodynamic results are dependent on the boundary conditions used, whereas the usual radial distribution functions g(O/O(r)) and g(O/H(r)) do not depend on them.

Termodinâmica estatística de líquidos com o método de Monte Carlo. II. O líquido clorofórmio

Thermodynamic properties and radial distribution functions for liquid chloroform were calculated using the Monte Carlo method implemented with Metropolis algorithm in the NpT ensemble at 298 K and 1 atm. A five site model was developed to represent the chloroform molecules. A force field composed by Lennard-Jones and Coulomb potential functions was used to calculate the intermolecular energy. The partial charges needed to represent the Coulombic interactions were obtained from quantum chemical ab initio calculations. The Lennard-Jones parameters were adjusted to reproduce experimental values for density and enthalpy of vaporization for pure liquid. All thermodynamic results are in excelent agreement with experimental data. The correlation functions calculated are in good accordance with theoretical results avaliable in the literature. The free energy for solvating one chloroform molecule into its own liquid at 298 K and 1 atm was computed as an additional test of the potential model. The result obtained compares well with the experimental value. The medium effects on cis/trans convertion of a hypotetical solute in water TIP4P and chloroform solvents were also accomplished. The results obtained from this investigation are in agreement with estimates of the continuous theory of solvation.

Redes neurais e suas aplicações em calibração multivariada

Neural Networks are a set of mathematical methods and computer programs designed to simulate the information process and the knowledge acquisition of the human brain. In last years its application in chemistry is increasing significantly, due the special characteristics for model complex systems. The basic principles of two types of neural networks, the multi-layer perceptrons and radial basis functions, are introduced, as well as, a pruning approach to architecture optimization. Two analytical applications based on near infrared spectroscopy are presented, the first one for determination of nitrogen content in wheat leaves using multi-layer perceptrons networks and second one for determination of BRIX in sugar cane juices using radial basis functions networks.

Fragmentation of massive dense cores down to <~ 1000 AU: relation between fragmentation and density structure

In order to shed light on the main physical processes controlling fragmentation of massive dense cores, we present a uniform study of the density structure of 19 massive dense cores, selected to be at similar evolutionary stages, for which their relative fragmentation level was assessed in a previous work. We inferred the density structure of the 19 cores through a simultaneous fit of the radial intensity profiles at 450 and 850 μm (or 1.2 mm in two cases) and the spectral energy distribution, assuming spherical symmetry and that the density and temperature of the cores decrease with radius following power-laws. Even though the estimated fragmentation level is strictly speaking a lower limit, its relative value is significant and several trends could be explored with our data. We find a weak (inverse) trend of fragmentation level and density power-law index, with steeper density profiles tending to show lower fragmentation, and vice versa. In addition, we find a trend of fragmentation increasing with density within a given radius, which arises from a combination of flat density profile and high central density and is consistent with Jeans fragmentation. We considered the effects of rotational-to-gravitational energy ratio, non-thermal velocity dispersion, and turbulence mode on the density structure of the cores, and found that compressive turbulence seems to yield higher central densities. Finally, a possible explanation for the origin of cores with concentrated density profiles, which are the cores showing no fragmentation, could be related with a strong magnetic field, consistent with the outcome of radiation magnetohydrodynamic simulations.

3D kinematics of the near-IR HH 223 outflow in L723

In this work, we derive the full 3D kinematics of the near-infrared outflow HH 223, located in the dark cloud Lynds 723 (L723), where a well-defined quadrupolar CO outflow is found. HH 223 appears projected on to the two lobes of the eastwest CO outflow. The radio continuum source VLA 2, towards the centre of the CO outflow, harbours a multiple system of low-mass young stellar objects. One of the components has been proposed to be the exciting source of the eastwest CO outflow. From the analysis of the kinematics, we get further evidence on the relationship between the near-infrared and CO outflows and on the location of their exciting source. The proper motions were derived using multi-epoch, narrow-band H2 (2.122 μm line) images. Radial velocities were derived from the 2.122 μm line of the spectra. Because of the extended (∼5 arcmin), S-shaped morphology of the target, the spectra were obtained with the multi-object-spectroscopy (MOS) observing mode using the instrument Long-Slit Intermediate Resolution Infrared Spectrograph (LIRIS) at the 4.2 m William Herschel Telescope. To our knowledge, this work is the first time that MOS observing mode has been successfully used in the near-infrared range for an extended target.

Aplicação de alguns modelos quimiométricos à espectroscopia de fluorescência de raios-X de energia dispersiva

The objective of this work was to accomplish the simultaneous determination of some chemical elements by Energy Dispersive X-ray Fluorescence (EDXRF) Spectroscopy through multivariate calibration in several sample types. The multivariate calibration models were: Back Propagation neural network, Levemberg-Marquardt neural network and Radial Basis Function neural network, fuzzy modeling and Partial Least Squares Regression. The samples were soil standards, plant standards, and mixtures of lead and sulfur salts diluted in silica. The smallest Root Mean Square errors (RMS) were obtained with Back Propagation neural networks, which solved main EDXRF problems in a better way.

SSPBE: um programa para solução numérica da equação de Poisson-Boltzmann em simetria esférica com modelo de adsorção

A Fortran77 program, SSPBE, designed to solve the spherically symmetric Poisson-Boltzmann equation using cell model for ionic macromolecular aggregates or macroions is presented. The program includes an adsorption model for ions at the aggregate surface. The working algorithm solves the Poisson-Boltzmann equation in the integral representation using the Picard iteration method. Input parameters are introduced via an ASCII file, sspbe.txt. Output files yield the radial distances versus mean field potentials and average molar ion concentrations, the molar concentration of ions at the cell boundary, the self-consistent degree of ion adsorption from the surface and other related data. Ion binding to ionic, zwitterionic and reverse micelles are presented as representative examples of the applications of the SSPBE program.

Radiaalikompressorin juoksupyörän virtauskanavan suunnittelu

Diplomityössä on tutkittu radiaalikompressorin juoksupyörän virtauskanavan suunnittelua ja esitelty yleisesti käytetyt suunnittelumenetelmät. Virtauskanavan muodon vaikutukset virtauskenttään on esitetty. Työssä on kehitetty uusi tietokoneohjelma juoksupyörän kolmiulotteisen geometrian luomiseen, yksiulotteisesta suunnittelusta saatujen päämittojen pohjalta. Ohjelmalla luotua juoksupyörän geometriaa voidaan käyttää virtaus- ja lujuusanalyyseissä. Ohjelmaan on myös liitetty kaksiulotteinen kokoonpuristuvan viskoosittoman virtauksen ratkaisija.