Contour Detector and Data Acquisition System for the Left Ventricular Outline

A real-time contour detector and data acquisition system is described for an angiographic apparatus having a video scanner for converting an X-ray image of a structure characterized by a change in brightness level compared with its surrounding into video format and displaying the X-ray image in recurring video fields. The real-time contour detector and data acqusition system includes track and hold circuits; a reference level analog computer circuit; an analog compartor; a digital processor; a field memory; and a computer interface

Real-time detection and data acquisition system for the left ventricular outline

To automate the data acquisition procedure, a real-time contour detection and data acquisition system for the left ventricular outline was developed using video techniques. The X-ray image of the contrast-filled left ventricle is stored for subsequent processing on film (cineangiogram), video tape or disc. The cineangiogram is converted into video format using a television camera. The video signal from either the TV camera, video tape or disc is the input signal to the system. The contour detection is based on a dynamic thresholding technique. Since the left ventricular outline is a smooth continuous function, for each contour side a narrow expectation window is defined in which the next borderpoint will be detected. A computer interface was designed and built for the online acquisition of the coordinates using a PDP-12 computer. The advantage of this system over other available systems is its potential for online, real-time acquisition of the left ventricular size and shape during angiocardiography

Dedicated bifurcation analysis: basic principles

Over the last several years significant interest has arisen in bifurcation stenting, in particular stimulated by the European Bifurcation Club. Traditional straight vessel analysis by QCA does not satisfy the requirements for such complex morphologies anymore. To come up with practical solutions, we have developed two models, a Y-shape and a T-shape model, suitable for bifurcation QCA analysis depending on the specific anatomy of the coronary bifurcation. The principles of these models are described in this paper, as well as the results of validation studies carried out on clinical materials. It can be concluded that the accuracy, precision and applicability of these new bifurcation analyses are conform the general guidelines that have been set many years ago for conventional QCA-analyses

A Review of the “Open” and “Closed” Circulatory Systems: New Terminology for Complex Invertebrate Circulatory Systems in Light of Current Findings

Invertebrate cardiovascular systems have historically been viewed as sluggish, poorly regulated, and “open”, where blood bathes the tissues directly as it moves through a system of ill-defined sinuses and/or lacunae without an endothelial boundary. When examining cardiovascular/circulatory morphology and physiology in a broader evolutionary context, one can question the very nature of the definition of a “closed” versus “open” circulatory system. Viewed in this context a number of invertebrates have evolved incomplete or even completely cell-lined vessels and or lacunae with a highly branched vasculature that allows for the production of significant driving pressures and flows to meet relatively high metabolic demands driven by active life styles. In light of our current understanding of invertebrate cardiovascular systems and their paralleled complexity to vertebrate systems, a number of long established paradigms must be questioned and new definitions presented to better align our understanding of the nature of “open” versus “closed” cardiovascular systems

Oral health of seafarers - a review

The research base needs to be expanded to cover all seafarers. Dental professional expertise should be sought in policy and guideline development relevant to oral health. A strategy comprising preventive, screening, and treatment service components should be developed and a certificate of dental health introduced. Funding strategies in a complex environment of transnational stakeholders for the improvement of oral-health services for seafarers are needed. Aspects of military oral health care systems could be an example for civilian operators

Three-dimensional reconstruction of myocardial contrast perfusion from biplane cineangiograms by means of linear programming techniques

The assessment of coronary flow reserve from the instantaneous distribution of the contrast agent within the coronary vessels and myocardial muscle at the control state and at maximal flow has been limited by the superimposition of myocardial regions of interest in the two-dimensional images. To overcome these limitations, we are in the process of developing a three-dimensional (3D) reconstruction technique to compute the contrast distribution in cross sections of the myocardial muscle from two orthogonal cineangiograms. To limit the number of feasible solutions in the 3D-reconstruction space, the 3D-geometry of the endo- and epicardial boundaries of the myocardium must be determined. For the geometric reconstruction of the epicardium, the centerlines of the left coronary arterial tree are manually or automatically traced in the biplane views. Next, the bifurcations are detected automatically and matched in these two views, allowing a 3D-representation of the coronary tree. Finally, the circumference of the left ventricular myocardium in a selected cross section can be computed from the intersection points of this cross section with the 3D coronary tree using B-splines. For the geometric reconstruction of the left ventricular cavity, we envision to apply the elliptical approximation technique using the LV boundaries defined in the two orthogonal views, or by applying more complex 3D-reconstruction techniques including densitometry. The actual 3D-reconstruction of the contrast distribution in the myocardium is based on a linear programming technique (Transportation model) using cost coefficient matrices. Such a cost coefficient matrix must contain a maximum amount of a priori information, provided by a computer generated model and updated with actual data from the angiographic views. We have only begun to solve this complex problem. However, based on our first experimental results we expect that the linear programming approach with advanced cost coefficient matrices and computed model will lead to a

New approaches for the assessment of vessel sizes in quantitative (cardio-)vascular X-ray analysis

This paper presents new approaches for the assessment of the arterial and reference diameters in (cardio-)vascular X-ray images, designed to overcome the problems experienced in conventional quantitative coronary and vascular angiography approaches. In single or “straight” vessel segments, the arterial and reference diameter directions were made independent of each other in order to be able to measure the minimal lumen diameter (MLD) more accurately, especially in curved vessel segments. For ostial segments, an extension of this approach was used, to allow measurement of ostial lesions in sidebranches more proximal than using conventional methods. Furthermore, two new bifurcation approaches were developed. The validation study shows that the straight segment approach results in significant smaller MLDs (on average 0.032 mm) and the ostial approach achieves on average an increase in %DS of 3.8% and an increase in lesion length of 0.59 mm due to loosening the directional constraint. The validation of our new bifurcation approaches in phantom data as well as clinical data shows only small differences between pre- and post-intervention measurements of the reference diameters outside the bifurcation core (errors smaller than 0.06 mm) and the bifurcation core area (errors smaller than 1.4% for phantom data). In summary, these new approaches have led to further improvements in the quantitative analyses of (cardio-)vascular X-ray angiographies

Stage progression and neurological symptoms in Trypanosoma brucei rhodesiense sleeping sickness: role of the CNS inflammatory response

Background: Human African trypanosomiasis progresses from an early (hemolymphatic) stage, through CNS invasion to the late (meningoencephalitic) stage. In experimental infections disease progression is associated with neuroinflammatory responses and neurological symptoms, but this concept requires evaluation in African trypanosomiasis patients, where correct diagnosis of the disease stage is of critical therapeutic importance. Methodology/Principal Findings: This was a retrospective study on a cohort of 115 T.b.rhodesiense HAT patients recruited in Eastern Uganda. Paired plasma and CSF samples allowed the measurement of peripheral and CNS immunoglobulin and of CSF cytokine synthesis. Cytokine and immunoglobulin expression were evaluated in relation to disease duration, stage progression and neurological symptoms. Neurological symptoms were not related to stage progression (with the exception of moderate coma). Increases in CNS immunoglobulin, IL-10 and TNF-α synthesis were associated with stage progression and were mirrored by a reduction in TGF-β levels in the CSF. There were no significant associations between CNS immunoglobulin and cytokine production and neurological signs of disease with the exception of moderate coma cases. Within the study group we identified diagnostically early stage cases with no CSF pleocytosis but intrathecal immunoglobulin synthesis and diagnostically late stage cases with marginal CSF pleocytosis and no detectable trypanosomes in the CSF. Conclusions: Our results demonstrate that there is not a direct linkage between stage progression, neurological signs of infection and neuroinflammatory responses in rhodesiense HAT. Neurological signs are observed in both early and late stages, and while intrathecal immunoglobulin synthesis is associated with neurological signs, these are also observed in cases lacking a CNS inflammatory response. While there is an increase in inflammatory cytokine production with stage progression, this is paralleled by increases in CSF IL-10. As stage diagnostics, the CSF immunoglobulins and cytokines studied do not have sufficient sensitivity to be of clinical value

Effects of Chronic Low Dose Anti-Telomerase and Chemotherapeutic Drugs on Breast Cancer Cells

Breast cancer is the second leading cause of death among women in the United States. Among the different molecular sub-groups of breast cancer, the most invasive is Triple-Negative Breast Cancer (TNBC). TNBC has the worst prognosis, decreased overall survival rate and no targeted therapy available. On-going research is investigating new strategies and therapies for TNBC. Therefore, this study’s objective was to compare and contrast the effects of continuous low-dose of BIBR 1532, a novel analogue of BIBR1532 (GV6), Paclitaxel and Doxorubicin on breast cancer (MDA-MB 231) cells. Culture flasks (T-25) were seeded with approximately 5.0x105 cells/ml and supplemented with GV6 (n=4-8) or BIBR 1532 (n=4-8) or Doxorubicin (n=4-8) or Paclitaxel (n=4-8) or non-drug supplemented media (Control, n=4-8) for 21 days. Trypan Blue (Gibco) exclusion test was utilized to assess the viability of the cells. BIBR 1532, Doxorubicin and Paclitaxel reduced (P\u3c0.05) proliferation of the cancer cells by approximately 20-35% by day 7 of treatment compared to the Control. By day 21 of low-dose GV6, BIBR1532, Doxorubicin and Paclitaxel supplementation, the cell counts dropped to about 25% (P\u3c0.05), 55% (P\u3c0.05), 75% (P\u3c0.05) and 50% (P\u3c0.05) of Control, respectively. Our results indicate that continuous low dose anti-telomerase and chemotherapeutic drugs do inhibit breast cancer cell proliferation and merits further investigation

769-2 Progression and Regression of Coronary Atherosclerosis Occur within the Same Patient During Placebo Treatment and During Lipid-Lowering Therapy with Pravastatin

REGRESS (Regression Growth Evaluation Statin Study) is a placebo controlled multicenter study to asses the effect of 2-yr treatment with Pravastatin (PRAV) on progression and regression of angiographically documented coronary atherosclerosis (CA) in patients with a serum cholesterol between 4–8mmol/l (155-310mg/dl). Analyses of the coronary arteriograms were performed by quantitative computer analysis. The primary endpoints of the study, change in Mean Segment Diameter and Minimum Obstruction Diameter (MOD) averaged per patient, showed significant retardation of mean progression of CA in the PRAY-group as compared to the placebo (PLAC)-group. However, these mean changes per treatment group are hardly informative about individual CA-behavior. Therefore we determined for all 641 patients included in the primary MOD-analysis: 1. a mean progression score (MPS)-cumulative value of all >0.4mm progressing obstructions divided by the number of contributing obstructions-, and 2. a mean regression score (MRS)-cumulative value of all>0.4mm regressing obstructions divided by the number of contributing obstructions. Obstructions changing ≤0.4mm were considered stable and do not contribute to the scores. Thus, each patient is characterized by a MPS and a MRS. An overview of the patient MPS and MRS is presented in the figure below.Conclusionsignificant progression and regression of CA within the same patient occurred in 41 (13%) PRAY-patients and in 27 (9%) PLAC-patients. Thus, although pravastatin slows mean progression of CA, progression and regression of CA within the same patient still occurs in a considerable number of patients during lipid lowering therapy