Background-A method is needed to identify nonstenotic, lipid-rich coronary plaques that are likely to cause acute coronary events. Near-infrared (NIR) spectroscopy can provide information on the chemical composition of tissue. We tested the hypothesis that NIR spectroscopy can identify plaque composition and features associated with plaque vulnerability in human aortic atherosclerotic plaques obtained at the time of autopsy. Methods and Results-A total of 199 samples from 5 human aortic specimens were analyzed by NIR spectroscopy.Features of plaque vulnerability were defined by histology as presence of lipid pool, thin fibrous cap (Ͻ65 m by ocular micrometry), and inflammatory cell infiltration. An InfraAlyzer 500 spectrophotometer was used. Spectral absorbance values were obtained as log (1/R) data from 1100 to 2200 nm at 10-nm intervals. Principal component regression was used for analysis. An algorithm was constructed with 50% of the samples used as a reference set; blinded predictions of plaque composition were then performed on the remaining samples. NIR spectroscopy sensitivity and specificity for histological features of plaque vulnerability were 90% and 93% for lipid pool, 77% and 93% for thin cap, and 84% and 89% for inflammatory cells, respectively. Conclusions-NIR

Surgeons can rapidly perform PDT at the bedside with a lower risk of complications than open tracheostomy and at a significantly reduced patient charge.

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Hemodynamically stable patients with a grade IV or V BRI were safely managed nonoperatively. Nonoperative management failed for only 6.5% of patients owing to renal-related injuries, and three-fourths of the entire population retained their kidneys.

"The feasibility of using ultrasound and video laryngoscopy in a mobile telemedicine consult." Telemedicine and e-Health.14,3. 266-272. (2008 O R I G I N A L R E S E A R C H

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TM to a moving ambulance improved the care of simulated trauma patients. Furthermore, procedurally naïve EMTs were able to perform needle thoracostomy and pericardiocentesis with TM guidance.

Skinned, single-fiber preparations from the quadriceps or gastrocneumius muscles of four ambulatory male children with Duchenne dystrophy were tested for theri ability to generate tension and to regulate CA++. To determine the intrinsic strength (P0) of the contractile material, the maximum Ca++ -activated tensions were normalized to the fiber diameters. Sixty-four percent of the Duchenne fibers had P0 values below 1.0 kg per square centimeter--the lowest value observed in control muscle--and the average P0 values of fibers from each Duchenne biopsy were significantly (p less than 0.01) below the average P0 values for control muscle fibers and for muscle fibers obtained from one obligatory carrier of the Duchenne gene. The low tensions in the Duchenne muscle fibers could not be ascribed to altered Ca++ regulation or to substrate sensitivity of the contractile proteins in the fibers, since these were normal. However, ultrastructural abnormalities of the myofilaments, which might reduce the ability of the contractile system to develop tension, were observed. Furthermore, Ca++ regulation by the sarcoplasmic reticulum (SR) was impaired in most of those muscle fibers, from both carriers and Duchenne patients, that did develop normal tension. These results suggest that in Duchenne muscle a functional disorder in the SR may precede loss of the ability of the contractile proteins to generate tension. However, since muscle fibers from Duchenne-gene carriers developed significantly greater tensions than fibers from Duchenne-patients, while yet having similar defects in Ca++ regulation, the SR disorder may not be exclusively responsible for abnormal contractile protein function.