Single-laser approach for fluorescence guidance of excimer laser angioplasty at 308 nm: evaluation in vitro and during coronary angioplasty

BACKGROUND AND OBJECTIVE: Spectroscopic guidance of laser angioplasty has been attempted using a diagnostic He-Cd laser in addition to the therapeutic laser system. This study evaluated a single-laser approach for simultaneous ablation and fluorescence excitation. STUDY DESIGN/MATERIALS AND METHODS: A spectroscopy system was coupled to a clinical XeCl excimer laser. Ablation of 162 human aortic samples in saline and blood with 45 mJ/mm2 per pulse yielded 676 fluorescence spectra validated histologically. The same equipment was used in 16 patients for angioplasty of 18 coronary stenoses applying 500 to 1,725 pulses with 45 to 60 mJ/mm2 under saline flushing. A total of 783 spectra were recorded and validated by intracoronary ultrasound (categories: atheroma, fibrous plaque, calcified lesion). RESULTS: In vitro, 5 types of spectra could be differentiated: (1) atheroma, (2) fibrous plaque, (3) calcified lesion in saline, (4) media, and (5) calcified lesion in blood. Discriminant analysis prospectively classified 576 validation spectra with the following sensitivity and specificity for each type: (1) 83.5 and 97.1%, (2) 85.7 and 96.8% (3) 100 and 98.5%, (4) 98.1 and 99.3%, (5) 98.9 and 100%, respectively. In vivo type 1, 2, 3, and 5 spectra were also observed, but not the media spectrum. The predominant sonographic category also prevailed in spectroscopy. Calcified lesions yielded type 3 and 5 as well as mixed spectra. CONCLUSIONS: Using an excimer laser for angioplasty allows combining ablation and fluorescence excitation without a diagnostic laser. Principal types of atherosclerotic lesions and the media can be differentiated spectroscopically with this approach.     

Access and the project manager

The role of the project manager has traditionally concentrated upon the execution of a project, from conception to completion. The commissioning and operation have been a secondary priority, for good reasons which are discussed in this paper. Nowhere has this been more true than in building construction, despite the fact that a building is a place where there is maximum interaction with people of all types. Some 10% of people worldwide are disabled, which prevents them from using buildings and facilities designed for able-bodied people. All this is changing rapidly. No longer should buildings be designed to be accessible only to the majority, nor should special arrangements be provided as an ‘extra’ for disabled people. Design philosophy is being impelled to provide for all building users. Great impetus was provided by the 1981 International Year of Disabled Persons, designated by the United Nations. In the UK, The Prince of Wales' Advisory Group on Disability and the Access Committee for England are influential and active organizations that are exerting a powerful influence for change. New building regulations are introducing a statutory imperative. The attention of project managers is drawn to what is happening in this area, and it is suggested that in their unique position they can influence the bridging of the gap between designers and building operators, to ensure that buildings can be used by all, and that nothing is overlooked at any stage. Legislation alone cannot solve the problem, and a change in attitude is necessary.     

On the dissipation process in Bi2Sr2Ca2Cu3O10 tapes and bulk samples with preferential grain orientation in zero external magnetic field

Current-voltage characteristics of Bi₂Sr₂Ca₂Cu₃O₁₀ tapes and bulk samples with preferentially oriented crystallites have been measured in zero applied magnetic field and for temperatures close to the mean-field critical-temperature,T _c0. It was shown that the power-law dependence,V=AI ^a, valid for two-dimensional systems, does not correctly describe the data, which clearly indicate the existence of a finite critical-current density,J _c. The experimentalI-V curves are fitted quite well with the model which attributes the finite critical-current density to the coupling between the CuO₂ double layers. It was found thatJ _c vanishes at a temperature value belowT _c0. This behavior can result from the occurrence of vortex fluctuation-induced layer decoupling and/or from the contribution of entropy to the vortex unbinding process.     

Representation and uniformization of algebraic transductions

This paper explores different means of representation for algebraic transductions, i.e., word relations realized by pushdown transducers. The relevance of this work lies more in its point of view rather than any particular result. We are aiming at giving specific techniques for obtaining, or perhaps explaining, decompositions of algebraic (and incidentally, rational) relations, relying solely on their “machine” definition rather than some complex algebraic apparatus. From this point of view, we are hoping to have demystified the heavy formalism employed in the present literature. Some of the novelties of our work are: the use of “stack languages” and “embeddings,” which eliminate the need of arbitrary context-free languages in our characterizations, the study of uniformizations for algebraic transductions and the use of the so-called stack transductions for exposing the anatomy of pushdown transducers.This work was supported by the Natural Science and Engineering Research Council of Canada grants R220259 and OGP0041630.     

Chitosan particles agglomerated scaffolds for cartilage and osteochondral tissue engineering approaches with adipose tissue derived stem cells

In the XML file of the original article, H. Redl’s affiliation is incorrect. It is listed correctly in both the paper and PDF versions of the article, and can be found below: The online version of the original article can be found at     

Conformational stability of factor VIIa: biophysical studies of thermal and guanidine hydrochloride-induced denaturation

The binding of the multidomain protein factor VIIa (fVIIa) to tissue factor provides the interprotein communication necessary to make fVIIa an efficient catalyst of the initial event in the extrinsic pathway of blood coagulation. We have investigated the stability of individual domains in fVIIa and the influence of Ca2+ and an irreversible active-site inhibitor (FFR-chloromethyl ketone). Equilibrium guanidine hydrochloride (GuHCl)-induced unfolding monitored by tryptophan fluorescence and far-UV circular dichroism (CD) demonstrated that the gamma-carboxyglutamic acid (Gla) domain unfolds at 0.3 M GuHCl and the serine protease (SP) domain at 3 M GuHCl and that Ca2+ is a prerequisite for the formation of an ordered, compact structure in the Gla domain. The loss of amidolytic activity coincides with the first transition, which is stabilized by the active-site inhibitor, and a change in the environment of the active site is demonstrated using a fluorescent inhibitor (DEGR-chloromethyl ketone). Thermal unfolding monitored by differential scanning calorimetry (DSC) reveals that Ca2+ stabilizes the SP domain slightly, increasing the unfolding temperature by 2.7 degrees C. In addition, Ca2+ is required for a large enthalpy change concomitant with unfolding of the Gla domain, and this unfolding enthalpy is only detectable in the presence of the SP domain, indicating some kind of interaction between these domains. Thermal unfolding measured by CD indicates secondary structural changes at the same temperature as the heat absorption in the DSC but only when both the Gla domain and the SP domain are present together with Ca2+ ions. Taken together, these results indicate a Ca2+-dependent interaction between the Gla domain and the SP domain, implying a high degree of flexibility of the domains in free fVIIa. It is also shown that the epidermal growth factor-like domains are stable at elevated temperatures and high GuHCl concentrations. Moreover, already at physiological temperature, subtle structural changes take place which influence the overall shape of fVIIa and are detrimental to its enzymatic activity.     

Automatic verification of concurrent stochastic systems

Formal Methods in System Design - Automated verification techniques for stochastic games allow formal reasoning about systems that feature competitive or collaborative behaviour among rational...     

A new approach to predict ulcerative colitis activity through standard clinical–biological parameters using a robust neural network model

Neural Computing and Applications - Colonoscopy is the “gold” standard for evaluating disease activity in ulcerative colitis (UC). An important area of research is finding a...     

Preparation of grids for simulations of groundwater flow in fractured porous media

This work presents an extension of grid generation techniques for finite-volume discretizations of density-driven flow in fractured porous media, in which fractures are considered as low-dimensional manifolds and are resolved by sides of grid elements. The proposed technique introduces additional degrees of freedom for the unknowns assigned to the fractures and thus allows to reconstruct jumps of the solution over a fracture. Through the concept of degenerated elements, the proposed technique can be used for arbitrary junctions of fractures but is sufficiently simple regarding the implementation and allows for the application of conventional numerical solvers. Numerical experiments presented at the end of the paper demonstrate the applicability of this technique in two and three dimensions for complicated fracture networks.     

Fabry Disease and the Heart: A Comprehensive Review

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by mutations of the GLA gene that result in a deficiency of the enzymatic activity of α-galactosidase A and consequent accumulation of glycosphingolipids in body fluids and lysosomes of the cells throughout the body. GB3 accumulation occurs in virtually all cardiac cells (cardiomyocytes, conduction system cells, fibroblasts, and endothelial and smooth muscle vascular cells), ultimately leading to ventricular hypertrophy and fibrosis, heart failure, valve disease, angina, dysrhythmias, cardiac conduction abnormalities, and sudden death. Despite available therapies and supportive treatment, cardiac involvement carries a major prognostic impact, representing the main cause of death in FD. In the last years, knowledge has substantially evolved on the pathophysiological mechanisms leading to cardiac damage, the natural history of cardiac manifestations, the late-onset phenotypes with predominant cardiac involvement, the early markers of cardiac damage, the role of multimodality cardiac imaging on the diagnosis, management and follow-up of Fabry patients, and the cardiac efficacy of available therapies. Herein, we provide a comprehensive and integrated review on the cardiac involvement of FD, at the pathophysiological, anatomopathological, laboratory, imaging, and clinical levels, as well as on the diagnosis and management of cardiac manifestations, their supportive treatment, and the cardiac efficacy of specific therapies, such as enzyme replacement therapy and migalastat.