Adiabatic pulses have been employed in spectroscopic imaging and relaxation rate measurements at 4.7 T to demonstrate the feasibility of obtaining spectroscopic data from the complete sensitive volume of a surface coil using the surface coil as a transmitter and receiver. With conventional B1 sensitive pulses, spectroscopic localization or imaging techniques, such as chemical-shift imaging, yield resonance intensities that are distorted severely as a function of space, and maximal signal is detected from a small region within the complete sensitive volume of the coil. With adiabatic pulses, however, this problem is eliminated completely. In addition, a new method of spatial localization is introduced. This method, referred to as FLAX-ISIS, is a derivative of longitudinally modulated Fourier series window and ISIS approaches and utilizes adiabatic inversion and excitation pulses. The method allows construction of localized spectra for multiple regions along the surface coil axis by postacquisition data manipulation of a single set of free induction decays. These techniques were applied to the study of the myocardium using an implanted surface coil in an instrumented closed-chest canine model and in an open-chest preparation. The results demonstrate that one-dimensional techniques are adequate for transmural detection of metabolites provided signal origin is restricted to a column perpendicular to the left ventricle wall.
Spatially localized phosphorus-3 I nuclear magnetic resonance ( 3'P NMR) spectroscopy has been applied to the study of the normal canine myocardium to measure the relative content of high energy phosphates across the left ventricular wall. Transmural NMR data were acquired in five voxels spanning the wall of the left ventricle using the FLAX-ISIS technique. The validity of the FLAX-ISIS approach in acquiring localized spectra for transmural studies and in providing quantitative information from the localized spectra was examined rigorously by studies involving phantoms, intact rats, and the canine myocardium in vivo. The results indicated that ( 1 ) this technique yields spatially resolved spectra with partial overlap between adjacent voxels and virtually no overlap between every other voxel; ( 2 ) in the canine heart, signals from subepicardium, midwall, and subendocardium can be detected separately without cross contamination; and (3 ) relative metabolite contents within a voxel and among voxels can be quantitated. Transmural 3'P NMR spectra were acquired with cardiac gating on 29 separate animals either at early systole or late diastole, and at three different workloads with the heart rate peak systolic pressure product (RPP) increasing from 6000 mmHg/min to 35,000 mmHg/min. The data revealed that in the normal canine myocardium, the creatine phosphate (CP) content and the CP/ATP ratio was significantly lower in the subendocardium than in the subepicardium. ATP levels were transmurally constant. Both the CP content and the CP/ATP ratio measured for each voxel remained unaltered in relation to either the phase of the cardiac cycle or -fourfold increase in workload. Free ADP levels calculated for each voxel showed that ADP was relatively higher in the subendocardium than the subepicardium, and in all transmural layers was higher than its apparent K,,, for oxidative phosphorylation. In this domain changes in ADP content with workload and MV02 are not expected and were not observed.
Phosphorus-31 nuclear magnetic resonance (31P NMR) has been applied to study the canine heart prior to and during regional myocardial ischemia induced by partial flow reduction in the left anterior descending coronary artery (LAD). NMR data were acquired in a transmural fashion by restricting the signal to a column perpendicular to the heart wall using B0 gradients and obtaining spectroscopic spatial resolution along the third dimension using the B1 gradient and adiabatic excitation. With this approach, transmural spectra were accumulated in five separate voxels spanning the wall of the left ventricle from the epicardium to the endocardium. In the normal canine myocardium the levels of high-energy phosphates CP and ATP were relatively constant throughout the left ventricular wall, with only minor evidence of free inorganic phosphate in any of the transmural voxels. However, during sustained partial occlusion of the LAD, significant regional differences between the epi- and the endocardium were noted. The data demonstrate the importance of studying cardiac bioenergetics with transmural differentiation.
Super-hydrophobic surfaces which have been fabricated by various methods such as photolithography, chemical treatment, self-assembly, and imprinting have gained enormous attention in recent years. Especially 2D arrays of nano-needles have been shown to have super-hydrophobicity due to their sharp surface roughness. These arrays can be easily generated by removing the top portion of the honeycomb films prepared by the breath figures method. The hydrophilic block of an amphiphilic polymer helps in the fabrication of the nano-needle arrays through the production of well-ordered honeycomb films and good adhesion of the film to a substrate. Anisotropic patterns with water wettability difference can be useful for patterning cells and other materials using their selective growth on the hydrophilic part of the pattern. However, there has not been a simple way to generate patterns with highly different wettability. Mechanical stamping of the nano-needle array with a polyurethane stamp might be the simplest way to fabricate patterns with wettability difference. In this study, super-hydrophobic nano-needle arrays were simply fabricated by removing the top portion of the honeycomb films. The maximum water contact angle obtained with the nano-needle array was 150°. By controlling the pore size and the density of the honeycomb films, the height, width, and density of nano-needle arrays were determined. Anisotropic patterns with different wettability were fabricated by simply pressing the nano-needle array at ambient temperature with polyurethane stamps which were flexible but tough. Mechanical stamping of nano-needle arrays with micron patterns produced hierarchical super-hydrophobic structures.PACS: 05.70.Np, 68.55.am, 68.55.jm
A transcatheter technique using a probing catheter and 0.014 wire to form a loop snare was used percutaneously to safely retrieve segments of retained guidewire fragments in mid- and distal coronary arteries in three patients.
Stroke is the leading cause of upper limb impairments resulting in disability. Modern rehabilitation includes training with robotic exoskeletons and functional electrical stimulation (FES). However, there is a gap in knowledge to define the detailed use of FES in stroke rehabilitation. In this paper, we explore applying closed-loop FES to the upper extremities of healthy volunteers and individuals with a hemiparetic arm resulting from stroke. We used a set of gyroscopes to monitor arm movements and used a non-linear controller, namely, the robust integral of the sign of the error (RISE), to assess the viability of controlling FES in closed loop. Further, we explored the application of closed-loop FES in improving functional tasks performed by individuals with stroke. Four healthy individuals of ages 27–32 years old and five individuals with stroke of ages 61–83 years old participated in this study. We used the Rehastim FES unit (Hasomed Ltd.) with real-time modulation of pulse width and amplitude. Both healthy and stroke individuals were tested in RISE-controlled single and multi-joint upper limb motions following first a sinusoidal trajectory. Individuals with stroke were also asked to perform the following functional tasks: picking up a basket, picking and placing an object on a table, cutting a pizza, pulling back a chair, eating with a spoon, as well as using a stapler and grasping a pen. Healthy individuals were instructed to keep their arm relaxed during the experiment. Most individuals with stroke were able to follow the sinusoid trajectories with their arm joints under the sole excitation of the closed-loop-controlled FES. One individual with stroke, who was unable to perform any of the functional tasks independently, succeeded in completing all the tasks when FES was used. Three other individuals with stroke, who were unable to complete a few tasks independently, completed some of them when FES was used. The remaining stroke participant was able to complete all tasks with and without FES. Our results suggest that individuals with a low Fugl–Meyer score or a higher level of disability may benefit the most with the use of closed-loop-controlled FES.
Right ventricular endomyocardial biopsy can be obtained successfully with a manually shaped flexible disposable bioptome introduced in the right jugular vein. Introduction of a curve at the tip provides better control of the bioptome so that a short introducer sheath can be used and the right ventricular sampling site can be varied.
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