Transcutaneous balloon angioplasty in the treatment of subclavian steal syndrome. Characteristics of vertebral basal flow with transcranial Doppler technique

Subclavian steal syndrome (SSS) appears when the origin of the subclavian artery (SA) is occluded or stenosed. Introduction of transcranial Doppler sonography (TCD) provided an opportunity to evaluate parameters of the blood flow in the vertebral (VA) and basilar artery (BA). Measurements of blood flow velocities performed at rest and after the brachial hyperemia test allow one to classify hemodynamic types of SSS. The aim of the study was to categorize types of steal and to compare the differences of flow patterns before and after percutaneous transluminal SA balloon angioplasty (SA-PTA). Fourty-eight patients with angiographically confirmed SSS (aged from 27 to 68 years, mean 53; 2/1 f/m ratio) were examined with 2 MHz range-gated, pulsed transcranial Doppler device (TC 2-64B EME). Both VA and BA were evaluated by the transoccipital approach at rest and during the brachial hyperemia. In 5 cases (10.4%) permanent reversal blood flow in the BA was observed (complete basilar steal). In flow in the BA blood flow was in the normal direction at rest and altered (reversed or decreased) when induced with brachial hyperemia test (transient basilar steal). In the next 14 patients (29.2%) permanently reversed VA blood flow was observed with only a slight or no alterations of the BA flow after the hyperemia test (complete vertebral steal). In the last 19 cases (39.6%) alterations of the VA blood flow without changes in BA flow were observed (latent vertebral steal). Between 1991 and 1994 twenty seven symptomatic patients with different hemodynamic types of SSS were treated with SA-PTA. TCD evaluation of VA's and BA using the hyperemia test was performed before, 3 to 7 days and 3 months after morphologically and hemodynamically successful subclavian artery balloon PTA. Normal results of vertebrobasilar examinations were obtained in 26 cases after this procedure. In one case the latent vertebral steal was detected. The 28 months mean follow-up revealed no significant changes in TCD flow patterns recorded from VA's and BA. After collecting data of about 60 patients with SSS we examined with TCD we conclude that: in patients with a hemodynamically significant SA stenosis the presence of reversed ipsilateral VA blood flow (a radiologic steal) its not a good determinant of either the presence or type of presenting symptoms and after successful PTA or recanalisation and PTA of SA in almost all cases we examined close to normal TCD recordings in BA and VA.     

ISDN and new services in Poland: opportunities and obstacles

Presents an overview of problems involved in introducing ISDN and new services in the public network of Poland. The technical aspects of the assumed network and services development strategy are considered. The focus is on development alternatives and the process of establishing national requirements for the development     

Response correction techniques for surrogate‐based design optimization of microwave structures

Simulation‐based optimization has become an important design tool in microwave engineering. However, using electromagnetic (EM) solvers in the design process is a challenging task, primarily due to a high‐computational cost of an accurate EM simulation. In this article, we present a review of EM‐based design optimization techniques exploiting response‐corrected physically based low‐fidelity models. The surrogate models created through such a correction can be used to yield a reasonable approximation of the optimal design of the computationally expensive structure under consideration (high‐fidelity model). Several approaches using this idea are reviewed including output space mapping, manifold mapping, adaptive response correction, and shape‐preserving response prediction. A common feature of these methods is that they are easy to implement and computationally efficient. Application examples are provided. © 2011 Wiley Periodicals, Inc. Int J RF and Microwave CAE, 2012.     

Precise control of reflection response in bandwidth‐enhanced planar antennas

In this work, the issues of bandwidth enhancement of planar antennas and the relevance of precise and automated response control through numerical optimization have been investigated. Using an example of a planar antenna with parasitic radiator we illustrate possible effects of even minor modifications of the antenna geometry (here, applied to the ground plane) on its reflection performance. In particular, a proper handling of geometry parameters may lead to considerable broadening of the antenna bandwidth. For the sake of computational efficiency, the adjustment of geometry parameters is carried out using surrogate‐based optimization methods exploiting coarse‐discretization EM simulations as the underlying low‐fidelity antenna model. Additionally, suitably defined penalty function allows us to precisely control the maximum in‐band reflection so that sufficient margin to accommodate possible manufacturing tolerances can be achieved. The optimized designs of the two antenna structures considered in this work exhibit over 1.75 GHz (>31%) and 2.15 GHz (>38%) bandwidth, respectively, for the center frequency of 5.6 GHz. Simulation results are validated using measurements of the fabricated prototypes. Comparison with state‐of‐the‐art designs is also provided. © 2016 Wiley Periodicals, Inc. Int J RF and Microwave CAE 26:653–659, 2016.     

Path Loss Modelling for Location Service Applications

The aim of this paper is the path loss modelling for the radiolocation services in radio communication networks, particularly in cellular networks. The main results of the measurements obtained in the physical layer of the UMTS are introduced. A new method for the utilization of the multipath propagation phenomenon to improve the estimation of the distance between the MS （mobile station） and the BS （base station） is outlined. This method significantly increases the quality of location services in systems which use a radio interface with DS （direct sequence） CDMA （code division multiple access）.     

Expedited simulation‐driven design optimization of UWB antennas by means of response features

In this work, a method for fast design optimization of broadband antennas is considered. The approach is based on a feature‐based optimization (FBO) concept where reflection characteristics of the structure at hand are formulated in terms of suitably defined feature points. Redefinition of the design problem allows for reducing the design optimization cost, because the dependence of feature point coordinates on antenna dimensions is less nonlinear than for the original frequency characteristics (here, S‐parameters). This results in faster convergence of the optimization algorithm. The cost of the design process is further reduced using variable‐fidelity electromagnetic (EM) simulation models. In case of UWB antennas, the feature points are defined, among others, as the levels of the reflection characteristic at its local in‐band maxima, as well as location of the frequency point which corresponds to acceptable reflection around the lower corner frequency within the UWB band. Also, the number of characteristic points depends on antenna topology and its dimensions. Performance of FBO‐based design optimization is demonstrated using two examples of planar UWB antennas. Moreover, the computational cost of the approach is compared with conventional optimization driven by a pattern search algorithm. Experimental validation of the numerical results is also provided.     

Role of Obesity,Physical Exercise,Adipose Tissue-Skeletal Muscle Crosstalk and Molecular Advances in Barrett’s Esophagus and Esophageal Adenocarcinoma

Both obesity and esophageal adenocarcinoma (EAC) rates have increased sharply in the United States and Western Europe in recent years. EAC is a classic example of obesity-related cancer where the risk of EAC increases with increasing body mass index. Pathologically altered visceral fat in obesity appears to play a key role in this process. Visceral obesity may promote EAC by directly affecting gastroesophageal reflux disease and Barrett’s esophagus (BE), as well as a less reflux-dependent effect, including the release of pro-inflammatory adipokines and insulin resistance. Deregulation of adipokine production, such as the shift to an increased amount of leptin relative to “protective” adiponectin, has been implicated in the pathogenesis of BE and EAC. This review discusses not only the epidemiology and pathophysiology of obesity in BE and EAC, but also molecular alterations at the level of mRNA and proteins associated with these esophageal pathologies and the potential role of adipokines and myokines in these disorders. Particular attention is given to discussing the possible crosstalk of adipokines and myokines during exercise. It is concluded that lifestyle interventions to increase regular physical activity could be helpful as a promising strategy for preventing the development of BE and EAC.     

Potential Application of Curcumin and Its Analogues in the Treatment Strategy of Patients with Primary Epithelial Ovarian Cancer

Recent findings on the molecular basis of ovarian cancer development and progression create new opportunities to develop anticancer medications that would affect specific metabolic pathways and decrease side systemic toxicity of conventional treatment. Among new possibilities for cancer chemoprevention, much attention is paid to curcumin—A broad-spectrum anticancer polyphenolic derivative extracted from the rhizome of Curcuma longa L. According to ClinicalTrials.gov at present there are no running pilot studies, which could assess possible therapeutic benefits from curcumin supplementation to patients with primary epithelial ovarian cancer. Therefore, the goal of this review was to evaluate potential preclinical properties of curcumin and its new analogues on the basis of in vivo and in vitro ovarian cancer studies. Curcumin and its different formulations have been shown to display multifunctional mechanisms of anticancer activity, not only in platinum-resistant primary epithelial ovarian cancer, but also in multidrug resistant cancer cells/xenografts models. Curcumin administered together with platinum-taxane chemotherapeutics have been reported to demonstrate synergistic effects, sensitize resistant cells to drugs, and decrease their biologically effective doses. An accumulating body of evidence suggests that curcumin, due to its long-term safety and an excellent profile of side effects should be considered as a beneficial support in ovarian cancer treatment strategies, especially in patients with platinum-resistant primary epithelial recurrent ovarian cancer or multidrug resistant disease. Although the prospect of curcumin and its formulations as anticancer agents in ovarian cancer treatment strategy appears to be challenging, and at the same time promising, there is a further need to evaluate its effectiveness in clinical studies.     

Relaxation processes and intermolecular interactions in PVME hydrogels in sub-zero temperatures: Glass transition and pre-melting of ice

The phase transition observed by various methods in poly(vinyl methyl ether)/water systems at around 18 °C has been assigned by some investigators to the pre-melting of water and by others to a glass transition of the polymer. In this study, broadband dielectric spectroscopy and temperature modulated differential scanning calorimetry were used to identify this transition in radiationally crosslinked poly(vinyl methyl ether) hydrogels, as well as to analyse sub-zero relaxation processes in such a three-phase (polymer/ice/liquid water) system. The process at 18 °C was related to the pre-melting of water induced by the segmental motions of the polymer; however, it was seen to be one transition due to the cooperative motions of both compounds. The atypical (two regimes) temperature dependence of the segmental motion process was observed and was related to confinement of the polymer chains between ice clusters below approximately ?24 °C; furthermore, the main dielectric process of hexagonal ice was identified and a Maxwell-Wagner effect was observed.