Atypical patterns of spinal segment degeneration in patients with abdominal aortic aneurysms

PURPOSE Abdominal aortic aneurysms (AAAs) affect the vascular perfusion of the lumbar spine. The treatment of AAAs with endovascular aortic aneurysm repair (EVAR) completely occludes the direct vascular supply to the lumbar spine. We hypothesized that patients with AAA who undergo EVAR show a different pattern of spinal degeneration than individuals without AAA. METHODS In this retrospective institutional review board-approved study, 100 randomly selected patients with AAA who underwent EVAR with computed tomography (CT) scans between 2005 and 2017 were compared with age- and gender-matched controls without AAA. In addition, long-term follow-up CT images (> 6 months before EVAR, at the time of EVAR, and > 12 months after EVAR) of the patients were analysed to compare the progression of degeneration from before to after EVAR. Degeneration scores, lumbar levels with the most severe degeneration, and lumbar levels with progressive degeneration were analysed in all CT images. Fisher's exact test, Wilcoxon signed-rank test, and Mann-Whitney U test were performed for statistical analyses. RESULTS Compared with the control group (n = 94), the most severe degeneration was more commonly detected in the mid-lumbar area in the patient group (n = 100, p = 0.016), with significantly more endplate erosions being detected in the lumbar spine (p = 0.015). However, EVAR did not result in significant additional acceleration of the degenerative process in the long-term follow-up analysis (n = 51). CONCLUSION AAA is associated with atypical, more cranially located spinal degradation, particularly in the mid-lumbar segments; however, EVAR does not seem to additionally accelerate the degenerative process. This observation underlines the importance of disc and endplate vascularization in the pathomechanism of spinal degeneration. LEVEL OF EVIDENCE I Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding

Load sensitive stable current source for complex precision pulsed electroplating

Electrodeposition is a highly versatile and well explored technology. However, it also depends strongly on the experience level of the operator. This experience includes the pretreatment of the sample, and the composition of the electrolyte settings of the plating parameters. Accurate control over the electroplating current is needed especially for the formation of small structures, where pulsed electrodeposition has proven to reduce many unwanted effects. To bring precision into the formation of optimal recipes, a highly flexible current source based on a microcontroller was developed. It allows a large variety of pulse waveforms, as well as maintaining a feedback loop that controls the current and monitors the output voltage, allowing for both galvanostatic (current driven) and potentiostatic (voltage driven) electrodeposition. The system has been implemented with multiple channels, permitting the simultaneous electrodeposition of multiple substrates in parallel. Being based on a microcomputer, the system can be programmed using predefined recipes individually for each channel, or even adapt the recipes during plating. All measurement values are continuously recorded for the purpose of documentation and diagnosis. The current source is based on a high power operational amplifier in a modified Howland current source configuration. This paper describes the functionality of the electrodeposition system, with a focus on the stability of the source current under different electrodeposition current densities and frequencies. The performance and high capability of the system is demonstrated by performing and analyzing two nontrivial plating applications

Uniaxial Magnetization Performance of Textured Fe Nanowire Arrays Electrodeposited by a Pulsed Potential Deposition Technique

Textured ferromagnetic Fe nanowire arrays were electrodeposited using a rectangular-pulsed potential deposition technique into anodized aluminum oxide nanochannels. During the electrodeposition of Fe nanowire arrays at a cathodic potential of ??1.2 V, the growth rate of the nanowires was ca. 200 nm s?1. The aspect ratio of Fe nanowires with a diameter of 30?±?5 nm reached ca. 2000. The long axis of Fe nanowires corresponded with the direction when a large overpotential during the on-time pulse was applied, whereas it orientated to the direction under the potentiostatic condition with a small overpotential. By shifting the on-time cathode potential up to ??1.8 V, the texture coefficient for the (200) plane, TC200, reached up to 1.94. Perpendicular magnetization performance was observed in Fe nanowire arrays. With increasing TC200, the squareness of Fe nanowire arrays increased up to 0.95 with the coercivity maintained at 1.4 kOe at room temperature. This research result has opened a novel possibility of Fe nanowire arrays that can be applied for a new permanent magnetic material without rare-earth metals

Ultrasound needle visibility in contrast mode imaging: an in vitro and ex vivo study

PURPOSE: To evaluate needle visibility in ultrasound under contrast mode conditions. MATERIALS AND METHODS: Needle visibility was evaluated for bevel, EchoTip (®) and shaft of 18G Chiba biopsy needle with a 9 MHz linear probe (GE Logiq E9). Insertion angles varied between 30°(steep) and 90°(parallel to the probe surface). The acoustic output varied from 5-28%. 2 different contrast mode presets with either 'Amplitude Modulation' (Penetration) or 'Phase Inversion Harmonics' (High Resolution) were assessed. All other imaging parameters were kept constant. The visibility of bevel, EchoTip (®) and shaft was assessed for grayscale and color-coded images with a 3-point Likert-like scale (not, poorly, well visible) by 2 independent readers. The echogenicity of the needle bevel, EchoTip (®) and shaft was assessed in deciBel (dB) on the color-coded images. RESULTS: With the parallel insertion angle, all needle areas were well visible. With steep insertion the EchoTip (®) was the only visible area. High Resolution was superior to Penetration (p<0.001). The visibility and echogenicity of the needle bevel ( rgrayscale =0.109, p grayscale =0.178; rcolor-coded =0.236, p color-coded =0.266; rdB =0.956, p dB =0.001), EchoTip (®) ( rgrayscale += 0.477, p grayscale += 0.018; rcolor-coded =0.540, p color-coded += 0.006; rdB =0.911, p dB =0.001) and shaft ( rgrayscale =0.124, p grayscale =0.563; rcolor-coded =0.061, p color-coded += 0.775; rdB += 0.926, p dB =0.001) increased with increasing acoustic output. Grayscale images were superior to color-coded images for needle visibility (p=0.004). CONCLUSION: Parallel needle insertion, use of an echogenic tip, adequate choice of presets, increased acoustic output, and dual view of grayscale and color-coded images improve needle visibility in ultrasound under contrast mode conditions

Photostructured coating on a voltage degrader for a Time Projection Chamber (TPC)

Fibreglass-reinforced epoxy (Stesalit) tubes and rods were coated with a photostructured metal layer system of copper, nickel and gold for a voltage degrader built in a particle detector at CERN, Geneva. The metal layers were applied with galvanotechnical processes involving an original photolithographic exposure in three dimensions to produce a complex electrical circuit design able to provide the correct potential to 420 different conductors. The Stesalit substrate material, even after a first layer of electroless copper, is electrically quite resistive, creating problems for the electrodeposition of the subsequent nickel layer. A mathematical simulation of the plating thickness distribution showed that the electrolytic nickel deposition was suitable for short rods but electroless nickel was needed for the long rods. The functional properties of the metallized Stesalit components are satisfactory: no degradation of the gas quality within the Time Projection Chamber is observed; the potential distribution along the field cage is precise and, under electric fields exceeding 10 kV/cm, the leakages are below 10 nA, indicating very low microdischarge and corona effects

Mid-term results of zone 0 thoracic endovascular aneurysm repair after ascending aorta wrapping and supra-aortic debranching in high-risk patients

OBJECTIVES: Surgical repair of aneurysmal disease involving the ascending aorta, aortic arch and eventually the descending aorta is generally associated with significant morbidity and mortality. A less invasive approach with the ascending wrapping technique (WT), supra-aortic vessel debranching (SADB) and thoracic endovascular aneurysm repair (TEVAR) in zone 0 was developed to reduce the associated risk in these patients. METHODS: During a 10-year period, consecutive patients treated by the ascending WT, SADB and TEVAR in zone 0 were included. All patients were considered at high risk for conventional surgery. Measured outcomes included perioperative deaths and morbidity, maximal aortic transverse diameter (TD) and its postoperative evolution, endoleak, survival, freedom from cardiovascular reinterventions, SADB freedom from occlusion and aortic valve function during follow-up. Median follow-up was 37.4 [mean = 34; range, 0-65; standard deviation (SD) = 20] months. RESULTS: Twenty-six cases were included with a mean age of 71.88 (r = 56-87; SD = 8) years. A mean of 2.9 supra-aortic vessels (75) per patient was debranched from the ascending aorta. The mean time interval from WT/SADB and TEVAR was 29 (r = 0-204; SD = 48) days. TEVAR was associated with chimney and/or periscope grafts in 6 (23%) patients, and extra-anatomical supra-aortic bypasses were performed in 6 (23%) patients. Perioperative mortality was 7.7% (2/26). Neurological events were registered in 3 (11.5%) cases, and a reintervention was required in 3 (11.5%) cases. After the WT, the ascending diameter remained stable during the follow-up period in all cases. At mean follow-up, significant shrinkage of the arch/descending aorta diameter was observed. A type I/III endoleak occurred in 3 cases. At 5 years, the rates of survival, freedom from cardiovascular reinterventions and SADB freedom from occlusion were 71.7, 82.3 and 96%, respectively. CONCLUSIONS: The use of the ascending WT, SADB and TEVAR in selected patients with complex thoracic aorta disease is safe and shows promising mid-term results at 3 years. The combination of these techniques could represent an alternative to the standard open surgical repair, especially in older patients or in patients unfit for cardiopulmonary bypass