RESUMEN
The development and successful implementation of cutting-edge imaging technologies to visualise cardiac anatomy and function is a key component of effective diagnostic efforts in cardiology. Here, we describe a number of recent exciting advances in the field of cardiology spanning from macro- to micro- to nano-scales of observation, including magnetic resonance imaging, computed tomography, optical mapping, photoacoustic imaging, and electron tomography. The methodologies discussed are currently making the transition from scientific research to routine clinical use, albeit at different paces. We discuss the most likely trajectory of this transition into clinical research and standard diagnostics, and highlight the key challenges and opportunities associated with each of the methodologies.
Asunto(s)
Técnicas de Imagen Cardíaca/métodos , Corazón/diagnóstico por imagen , Tomografía con Microscopio Electrónico/métodos , Tomografía con Microscopio Electrónico/tendencias , Predicción , Humanos , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/tendencias , Nanotecnología/métodos , Nanotecnología/tendencias , Técnicas Fotoacústicas/métodos , Técnicas Fotoacústicas/tendencias , Investigación/tendencias , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X/métodos , Tomografía Computarizada por Rayos X/tendencias , Imagen de Colorante Sensible al Voltaje/métodos , Imagen de Colorante Sensible al Voltaje/tendenciasAsunto(s)
Enfermedades de la Médula Ósea/diagnóstico por imagen , Edema/diagnóstico por imagen , Imagen Radiográfica por Emisión de Doble Fotón/métodos , Fracturas de la Tibia/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Interfaz Usuario-Computador , Diagnóstico Diferencial , Femenino , Fractura-Luxación/diagnóstico por imagen , Humanos , Persona de Mediana Edad , Intensificación de Imagen Radiográfica/métodosRESUMEN
Quantification of CINE phase contrast (PC)-MRI data is a challenging task because of the limited spatiotemporal resolution and signal-to-noise ratio (SNR). The method presented in this work combines B-spline interpolation and Green's theorem to provide optimized quantification of blood flow and vessel wall parameters. The B-spline model provided optimal derivatives of the measured three-directional blood velocities onto the vessel contour, as required for vectorial wall shear stress (WSS) computation. Eight planes distributed along the entire thoracic aorta were evaluated in a 19-volunteer study using both high-spatiotemporal-resolution planar two-dimensional (2D)-CINE-PC ( approximately 1.4 x 1.4 mm(2)/24.4 ms) and lower-resolution 3D-CINE-PC ( approximately 2.8 x 1.6 x 3 mm(3)/48.6 ms) with three-directional velocity encoding. Synthetic data, error propagation, and interindividual, intermodality, and interobserver variability were used to evaluate the reliability and reproducibility of the method. While the impact of MR measurement noise was only minor, the limited resolution of PC-MRI introduced systematic WSS underestimations. In vivo data demonstrated close agreement for flow and WSS between 2D- and 3D-CINE-PC as well as observers, and confirmed the reliability of the method. WSS analysis along the aorta revealed the presence of a circumferential WSS component accounting for 10-20%. Initial results in a patient with atherosclerosis suggest the potential of the method for understanding the formation and progression of cardiovascular diseases.
Asunto(s)
Aorta Torácica/fisiología , Velocidad del Flujo Sanguíneo/fisiología , Diagnóstico por Imagen de Elasticidad/métodos , Aumento de la Imagen/métodos , Interpretación de Imagen Asistida por Computador/métodos , Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Adulto , Algoritmos , Aorta Torácica/anatomía & histología , Módulo de Elasticidad , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Resistencia al Corte , Estrés MecánicoRESUMEN
Modern phase contrast MR imaging at 3 Tesla allows the depiction of 3D morphology as well as the acquisition of time-resolved blood flow velocities in 3 directions. In combination with state-of-the-art visualization and data processing software, the qualitative and quantitative analysis of hemodynamic changes associated with vascular pathologies is possible. The 4D nature of the acquired data permits free orientation within the vascular system of interest and offers the opportunity to quantify blood flow and derived vessel wall parameters at any desired location within the data volume without being dependent on predefined 2D slices. The technique has the potential of overcoming the limitations of current diagnostic strategies and of implementing new diagnostic parameters. In light of the recent discussions regarding the influence of the wall shear stress and the oscillatory shear index on the genesis of arteriosclerosis and dilatative vascular processes, flow-sensitive 4D MRI may provide the missing diagnostic link. Instead of relying on experience-based parameters such as aneurysm size, new hemodynamic considerations can deepen our understanding of vascular pathologies. This overview reviews the underlying methodology at 3T, the literature on time-resolved 3D MR velocity mapping, and presents case examples. By presenting the pre- and postoperative assessment of hemodynamics in a thoracic aortic aneurysm and the detailed analysis of blood flow in a patient with coarctation we underline the potential of time-resolved 3D phase contrast MR at 3T for hemodynamic assessment of vascular pathologies, especially in the thoracic aorta.
Asunto(s)
Enfermedades de la Aorta/fisiopatología , Velocidad del Flujo Sanguíneo/fisiología , Aumento de la Imagen/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Angiografía por Resonancia Magnética/métodos , Músculo Liso Vascular/fisiopatología , Adolescente , Adulto , Aneurisma de la Aorta Torácica/diagnóstico , Aneurisma de la Aorta Torácica/fisiopatología , Aneurisma de la Aorta Torácica/cirugía , Coartación Aórtica/diagnóstico , Coartación Aórtica/fisiopatología , Coartación Aórtica/cirugía , Enfermedades de la Aorta/diagnóstico , Enfermedades de la Aorta/cirugía , Arteriosclerosis/diagnóstico , Arteriosclerosis/fisiopatología , Arteriosclerosis/cirugía , Diagnóstico Diferencial , Humanos , Masculino , Oscilometría , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/fisiopatología , Sensibilidad y Especificidad , Programas InformáticosRESUMEN
The effect of 3,4-DHBA was tested in vitro on strips of cattle myometrium. It was discovered that adding DHBA to non-contracting strips of myometrium, clear contractions can be induced. With spontaneously weakly contracting strips addition of DHBA further strengthens the contractions. With irregular contraction forms a coordination of the contractions can be achieved. The optimal effective doses is 5.1.10(-6) mmol DHBA/ml of the nutrient solution.
Asunto(s)
Bovinos/fisiología , Dopamina/análogos & derivados , Miometrio/efectos de los fármacos , Contracción Uterina/efectos de los fármacos , Animales , Técnicas de Cultivo , Dopamina/farmacología , FemeninoRESUMEN
The neonatal depression of puppies, developed by C-section, can be treated effectively by the application of 0.1-0.2 ml Narcanti respectively Narcanti Neonatal (Naloxon) right after development. The technique of the intravenous injection in newborn puppies is simple and easy to learn.
Asunto(s)
Cesárea/veterinaria , Enfermedades de los Perros/tratamiento farmacológico , Naloxona/uso terapéutico , Insuficiencia Respiratoria/veterinaria , Resucitación/veterinaria , Animales , Animales Recién Nacidos , Cesárea/efectos adversos , Perros , Femenino , Inyecciones Intravenosas/veterinaria , Naloxona/administración & dosificación , Embarazo , Insuficiencia Respiratoria/tratamiento farmacológicoRESUMEN
The influence of the opioid antagonist naltrexone on myometrial activity of cows was tested during the early postpartum period, when uterine contractions are a highly sensitive indicator of oxytocin actions. Registering intrauterine pressure oscillations in five first calf heifers revealed that myometrial activity was enhanced after naltrexone was administered (0.02 mg/kg BW). However, plasma concentrations of oxytocin were not consistently elevated. In addition, naltrexone did not reliably potentiate the suckling-induced peak of oxytocin release in plasma. In all cases, naltrexone injections caused increases in the cows' respiratory rates and distinct behavioral changes during the first days postpartum, but not later. We conclude that: 1) In the early postpartum period, an inhibitory opioidergic control of myometrial activity may exist in cattle. 2) This control does not seem to be caused by a change in circulating oxytocin levels. 3) Opioids may exert an inhibitory influence on respiratory functions in cattle.
RESUMEN
The consequent use of the Munich obstetrics instruments can lower the dystochia rate of cows. Based upon the measured traction energy, it is possible to give an objective prognosis of the further process of parturition. By the aid of the traction energy, measured during one labour, the decision to the C. section at the time can get easier. Beside the better survival changes of the calf, injuries of the cow, happened during the delivery, will be extensively avoidable.
Asunto(s)
Enfermedades de los Bovinos/cirugía , Extracción Obstétrica/veterinaria , Complicaciones del Trabajo de Parto/veterinaria , Animales , Bovinos , Enfermedades de los Bovinos/prevención & control , Distocia/prevención & control , Distocia/veterinaria , Extracción Obstétrica/instrumentación , Femenino , Complicaciones del Trabajo de Parto/cirugía , EmbarazoAsunto(s)
Enfermedades de los Perros/inducido químicamente , Estradiol/análogos & derivados , Estradiol/envenenamiento , Animales , Transfusión Sanguínea/veterinaria , Médula Ósea/patología , Enfermedades de los Perros/patología , Enfermedades de los Perros/terapia , Perros , Estradiol/administración & dosificación , Femenino , Glucocorticoides/uso terapéutico , Hemorragia/inducido químicamente , Hemorragia/veterinaria , PronósticoRESUMEN
Cutaneous pigmentation, lingual leukoplasia and dystrophic changes of nails are present in the two cases. The other clinical manifestations are dental alterations, epiphora, loss of dermal ridges of the pulp with hyperhidrosis, atrophic skin of the dorsum of the hands. Dysphagia and bone marrow hypoplasia are present in one case. The proband (case 1) has normal values for the following: hemoglobin electrophoresis, pyruvate kinase, marrow and blood chromosome analysis. Biopsy of pigmented skin showed an atrophic epidermis with orthokeratotic-hyperkeratosis; in the higher dermis there were several melanophores. Multiple layers of vasal lamina are seen under electron microscopy. The parents and the two daughters are free of clinical or hematologic manifestations. The mother and her two affected sons have A1-BW 27 HLA haplotype. X-linked transmission is discussed.