In vivo 3D brain and extremity MRI at 50 mT using a permanent magnet Halbach array

Purpose To design a low-cost, portable permanent magnet-based MRI system capable of obtaining in vivo MR images within a reasonable scan time. Methods A discretized Halbach permanent magnet array with a clear bore diameter of 27 cm was designed for operation at 50 mT. Custom-built gradient coils, RF coil, gradient amplifiers, and RF amplifier were integrated and tested on both phantoms and in vivo. Results Phantom results showed that the gradient nonlinearity in the y-direction and z-direction was less than 5% over a 15-cm FOV and did not need correcting. For the x-direction, it was significantly greater, but could be partially corrected in postprocessing. Three-dimensional in vivo scans of the brain of a healthy volunteer using a turbo spin-echo sequence were acquired at a spatial resolution of 4 x 4 x 4 mm in a time of about 2 minutes. The T-1-weighted and T-2-weighted scans showed a good degree of tissue contrast. In addition, in vivo scans of the knee of a healthy volunteer were acquired at a spatial resolution of about 3 x 2 x 2 mm within 12 minutes to show the applicability of the system to extremity imaging. Conclusion This work has shown that it is possible to construct a low-field MRI unit with hardware components costing less than 10 000 Euros, which is able to acquire human images in vivo within a reasonable data-acquisition time. The system has a high degree of portability with magnet weight of approximately 75 kg, gradient and RF amplifiers each 15 kg, gradient coils 10 kg, and spectrometer 5 kg.Neuro Imaging Researc

Glucose and potassium derangements by glucose-insulin-potassium infusion in acute myocardial infarction

Background. High-dose glucose-insulin-potassium infusion (GIK) has been suggested to be beneficial in acute myocardial infarction (MI). Recently new large trials have shown no effect of GIK on mortality. To investigate whether metabolic derangement could have negated the potential beneficial effect, we studied the relation between systemic glucose and potassium levels and outcome. Methods. Patients with signs and symptoms of ST-segment-elevation MI and treated with primary percutaneous coronary intervention (PCI) were randomised to no infusion or high-dose GIK, i.e. 80 mmol potassium chloride in 500 ml 20% glucose at a rate of 3 ml/kg/hour and 50 units short-acting insulin in 50 ml 0.9% sodium chloride for 12 hours. Results. A total of 6991 glucose values and 7198 potassium values were obtained in 476 GIK patients and 464 controls. Mean serum glucose was significantly higher in the GIK group (9.3±4.5 mmol/l vs. 8.4±2.9 mmol/l, p&lt;0.001). Mean potassium level was significantly higher in the GIK group (4.2±0.5 mmol/l vs. 3.9±0.4 mmol/l, p&lt;0.001). Incidence of hyperglycaemia (glucose &gt;11.0 mmol/l) occurred in 70.8% of GIK patients and 33.8% of controls (p&lt;0.001). Hypokalaemia was less common in the GIK group (23.5 vs. 41.2%, p&lt;0.001). Incidence of hyperkalaemia and hypoglycaemia did not differ significantly between the two groups. In multivariate analysis age, previous cardiovascular disease, Killip class &gt;1, unsuccessful PCI and mean glucose after admission were associated with increased one-year mortality. Conclusion. In ST-segment-elevation MI patients treated with primary PCI, high-dose GIK induced hyperglycaemia and prevented hypokalaemia. Derangement of the glucose metabolism was related to one-year mortality.</p

Controlled production of atomic oxygen and nitrogen in a pulsed radio-frequency atmospheric-pressure plasma

International audienceRadio-frequency driven atmospheric pressure plasmas are efficient sources for the production of reactive species at ambient pressure and close to room temperature. Pulsing the radio-frequency power input provides additional control over species production and gas temperature. Here, we demonstrate the controlled production of highly reactive atomic oxygen and nitrogen in a pulsed radio-frequency ( ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn001.gif] 13.56 MHz) atmospheric-pressure plasma, operated with a small ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn002.gif] 0.1 % air-like admixture ( ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn003.gif] \rm N_2 / ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn004.gif] \rm O_2 at ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn005.gif] 4:1 ) through variations in the duty cycle. Absolute densities of atomic oxygen and nitrogen are determined through vacuum-ultraviolet absorption spectroscopy using the DESIRS beamline at the SOLEIL synchrotron coupled with a high resolution Fourier-transform spectrometer. The neutral-gas temperature is measured using nitrogen molecular optical emission spectroscopy. For a fixed applied-voltage amplitude (234?V), varying the pulse duty cycle from 10% to 100% at a fixed 10?kHz pulse frequency enables us to regulate the densities of atomic oxygen and nitrogen over the ranges of ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn006.gif] (0.18±0.03) ? ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn007.gif] (3.7±0.1)× 10^20 ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn008.gif] \rm m^-3 and ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn009.gif] (0.2±0.06) ? ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn010.gif] (4.4±0.8) × 10^19 ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn011.gif] \rm m^-3 , respectively. The corresponding 11?K increase in the neutral-gas temperature with increased duty cycle, up to a maximum of ##IMG## [http://ej.iop.org/images/0022-3727/50/45/455204/daa8da2ieqn012.gif] (314±4) K, is relatively small. This additional degree of control, achieved through regulation of the pulse duty cycle and time-averaged power, could be of particular interest for prospective biomedical applications

Health-Related Quality of Life and Mortality in a General and Elderly Population of Patients With Type 2 Diabetes (ZODIAC-18)

OBJECTIVE- Diabetes negatively impacts the health-related quality of life (HRQOL) of patients with type 2 diabetes. An earlier analysis showed HRQOL to be associated with mortality, which suggests that measuring HRQOL could have clinical implications. We studied the association between HRQOL and total and cardiovascular mortality in patients with type 2 diabetes during long-term follow-up and specifically focused on old age and sex differences. RESEARCH DESIGN AND METHODS- HRQOL was measured in a prospectively followed cohort of 1,353 patients with type 2 diabetes using the RAND-36. Cox proportional hazard models were used to measure the independent effect of baseline HRQOL on mortality. RESULTS- During a mean follow-up of 9.6 years, 570 (42%) patients died, 280 of whom died of cardiovascular disease (49%). The Physical Component Score (PCS) and the Mental Component Score (MCS) were inversely associated with total mortality, with hazard ratios of 0.988(95% CI 0.983-0.993) and 0.990(95% CI 0.985-0.995), respectively. A 10-point-higher score on the PCS and MCS decreased the risk for total mortality by 11 and 10%, respectively. An inverse relationship with mortality was also seen for men, women, and for patients aged >75 years. Mental health was significantly related to mortality in men but not in women. CONCLUSIONS- Lower physical and mental HRQOL was associated with a higher total mortality and cardiovascular mortality in patients with type 2 diabetes; this is also the case when studying men and women and the elderly separately. The dimension mental health, related to depression and anxiety, was only associated with mortality in men, not in women

Veliparib in Combination with Carboplatin and Etoposide in Patients with Treatment-Naive Extensive-Stage Small Cell Lung Cancer:A Phase 2 Randomized Study

Purpose: This study investigated the efficacy and safety of oral PARP inhibitor veliparib, plus carboplatin and etoposide in patients with treatment-naive, extensive-stage small cell lung cancer (ED-SCLC). Patients and Methods: Patients were randomized 1:1:1 to veliparib [240 mg twice daily (BID) for 14 days] plus chemotherapy followed by veliparib maintenance (400 mg BID; veliparib throughout), veliparib plus chemotherapy followed by placebo (veliparib combination only), or placebo plus chemotherapy followed by placebo (control). Patients received 4-6 cycles of combination therapy, then maintenance until unacceptable toxicity/progression. The primary endpoint was progression-free survival (PFS) with veliparib throughout versus control. Results: Overall (N = 181), PFS was improved with veliparib throughout versus control [hazard ratio (HR), 0.67; 80% confidence interval (CI), 0.50-0.88; P = 0.059]; median PFS was 5.8 and 5.6 months, respectively. There was a trend toward improved PFS with veliparib throughout versus control in SLFN11-positive patients (HR, 0.6; 80% CI, 0.36-0.97). Median overall survival (OS) was 10.1 versus 12.4 months in the veliparib throughout and control arms, respectively (HR, 1.43; 80% CI, 1.09-1.88). Grade 3/4 adverse events were experienced by 82%, 88%, and 68% of patients in the veliparib throughout, veliparib combination-only and control arms, most commonly hematologic. Conclusions: Veliparib plus platinum chemotherapy followed by veliparib maintenance demonstrated improved PFS as first-line treatment for ED-SCLC with an acceptable safety profile, but there was no corresponding benefit in OS. Further investigation is warranted to define the role of biomarkers in this setting