545 research outputs found

    Pattern and degree of left ventricular remodeling following a tailored surgical approach for hypertrophic obstructive cardiomyopathy.

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    Background The role of a tailored surgical approach for hypertrophic cardiomyopathy (HCM) on regional ventricular remodelling remains unknown. The aims of this study were to evaluate the pattern, extent and functional impact of regional ventricular remodelling after a tailored surgical approach. Methods From 2005 to 2008, 44 patients with obstructive HCM underwent tailored surgical intervention. Of those, 14 were ineligible for cardiac magnetic resonance (CMR) studies. From the remainder, 14 unselected patients (42±12 years) underwent pre- and post-operative CMR studies at a median 12 months post-operatively (range 4-37 months). Regional changes in left ventricular (LV) thickness as well as global LV function following surgery were assessed using CMR Tools (London, UK). Results Pre-operative mean echocardiographic septal thickness was 21±4 mm and mean LV outflow gradient was 69±32 mmHg. Following surgery, there was a significant degree of regional regression of LV thickness in all segments of the LV, ranging from 16% in the antero-lateral midventricular segment to 41% in the anterior basal segment. Wall thickening was significantly increased in basal segments but showed no significant change in the midventricular or apical segments. Globally, mean indexed LV mass decreased significantly after surgery (120±29g/m2 versus 154±36g/m2; p<0.001). There was a trend for increased indexed LV end-diastolic volume (70±13 mL versus 65±11 mL; p=0.16) with a normalization of LV ejection fraction (68±7% versus 75±9%; p<0.01). Conclusion Following a tailored surgical relief of outflow obstruction for HCM, there is a marked regional reverse LV remodelling. These changes could have a significant impact on overall ventricular dynamics and function

    Cortical depth dependent functional responses in humans at 7T: improved specificity with 3D GRASE

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    Ultra high fields (7T and above) allow functional imaging with high contrast-to-noise ratios and improved spatial resolution. This, along with improved hardware and imaging techniques, allow investigating columnar and laminar functional responses. Using gradient-echo (GE) (T2* weighted) based sequences, layer specific responses have been recorded from human (and animal) primary visual areas. However, their increased sensitivity to large surface veins potentially clouds detecting and interpreting layer specific responses. Conversely, spin-echo (SE) (T2 weighted) sequences are less sensitive to large veins and have been used to map cortical columns in humans. T2 weighted 3D GRASE with inner volume selection provides high isotropic resolution over extended volumes, overcoming some of the many technical limitations of conventional 2D SE-EPI, whereby making layer specific investigations feasible. Further, the demonstration of columnar level specificity with 3D GRASE, despite contributions from both stimulated echoes and conventional T2 contrast, has made it an attractive alternative over 2D SE-EPI. Here, we assess the spatial specificity of cortical depth dependent 3D GRASE functional responses in human V1 and hMT by comparing it to GE responses. In doing so we demonstrate that 3D GRASE is less sensitive to contributions from large veins in superficial layers, while showing increased specificity (functional tuning) throughout the cortex compared to GE

    Tumeurs primitives de l’orbite traitement chirurgical

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    Les tumeurs primitives de l’orbite sont des affections rares, leurs  manifestation cliniques sont tardives et variées pouvant êtres trompeuses. L’imagerie TDM et surtout IRM est capitale pour le diagnostic et la prise en charge. Le traitement est souvent chirurgical, le choix de la technique dépend de la taille et la topographie tumorale. Nous rapportons 13 cas de tumeurs orbitaires colligés entre 2004 et 2010. L’âge moyen de nos patients est de 36 ans, l’exophtalmie a été le maitre symptôme. Tous nos patients ont été opérés. Après étude histologique de la pièce d’exérèse opératoire il s’agissait de: 5 hémangiomes caverneux, 4 tumeurs mixtes, 2 neurinomes, 1 kyste hydatique et 1 angiome. Un seul cas de récidive tumorale a été noté.Mots clés : tumeur de l’orbite, hémangiome caverneux, shwannome, chirurgie

    Mapping the Organization of Axis of Motion Selective Features in Human Area MT Using High-Field fMRI

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    Functional magnetic resonance imaging (fMRI) at high magnetic fields has made it possible to investigate the columnar organization of the human brain in vivo with high degrees of accuracy and sensitivity. Until now, these results have been limited to the organization principles of early visual cortex (V1). While the middle temporal area (MT) has been the first identified extra-striate visual area shown to exhibit a columnar organization in monkeys, evidence of MT's columnar response properties and topographic layout in humans has remained elusive. Research using various approaches suggests similar response properties as in monkeys but failed to provide direct evidence for direction or axis of motion selectivity in human area MT. By combining state of the art pulse sequence design, high spatial resolution in all three dimensions (0.8 mm isotropic), optimized coil design, ultrahigh field magnets (7 Tesla) and novel high resolution cortical grid sampling analysis tools, we provide the first direct evidence for large-scale axis of motion selective feature organization in human area MT closely matching predictions from topographic columnar-level simulations

    Role and possible mechanisms of clenbuterol in enhancing reverse remodelling during mechanical unloading in murine heart failure

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    Aims Combined left ventricular assist device (LVAD) and pharmacological therapy has been proposed to favour myocardial recovery in patients with end-stage heart failure (HF). Clenbuterol (Clen), a b 2 -adrenoceptor (b 2 -AR) agonist, has been used as a part of this strategy. In this study, we investigated the direct effects of clenbuterol on unloaded myocardium in HF. Methods and results Left coronary artery ligation or sham operation was performed in male Lewis rats. After 4-6 weeks, heterotopic abdominal transplantation of the failing hearts into normal recipients was performed to induce LV unloading (UN). Recipient rats were treated with saline (Sal) or clenbuterol (2 mg/kg/day) via osmotic minipumps (HF þ UN þ Sal or HF þ UN þ Clen) for 7 days. Non-transplanted HF animals were treated with Sal (Sham þ Sal, HF þ Sal) or clenbuterol (HF þ Clen). LV myocytes were isolated and studied using optical, fluorescence, and electrophysiological techniques. Conclusion Clenbuterol treatment of failing rat hearts, alone or in combination with mechanical unloading, improves LV function at the whole-heart and cellular levels by affecting cell morphology, excitation-contraction coupling, and myofilament sensitivity to calcium. This study supports the use of this drug in the strategy to enhance recovery in HF patients treated with LVADs and also begins to elucidate some of the possible cellular mechanisms responsible for the improvement in LV function

    Log-moment estimators of the Nakagami-lognormal distribution

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    [EN] In this paper, estimators of the Nakagami-lognormal (NL) distribution based on the method of log-moments have been derived and thoroughly analyzed. Unlike maximum likelihood (ML) estimators, the log-moment estimators of the NL distribution are obtained using straightforward equations with a unique solution. Also, their performance has been evaluated using the sample mean, confidence regions and normalized mean square error (NMSE). The NL distribution has been extensively used to model composite small-scale fading and shadowing in wireless communication channels. This distribution is of interest in scenarios where the small-scale fading and the shadowing processes cannot be easily separated such as the vehicular environment.This work has been funded in part by the Programa de Estancias de Movilidad de Profesores e Investigadores en Centros Extranjeros de Ensenanza Superior e Investigacion of the Ministerio de Educacion, Cultura y Deporte, Spain, PR2015-00151 and by the Ministerio de Economia, Industria y Competitividad of the Spanish Government under the national project TEC2017-86779-C2-2-R, through the Agencia Estatal de Investigacion (AEI) and the Fondo Europeo de Desarrollo Regional (FEDER).Reig, J.; Brennan, C.; Rodrigo Peñarrocha, VM.; Rubio Arjona, L. (2019). Log-moment estimators of the Nakagami-lognormal distribution. EURASIP Journal on Wireless Communications and Networking. 1-10. https://doi.org/10.1186/s13638-018-1328-6S110J. M. Ho, G. L. 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