Assessment of mitral regurgitation severity by Doppler color flow mapping of the vena contracta

BACKGROUND: Although Doppler color flow mapping is widely used to assess the severity of mitral regurgitation (MR), a simple, accurate, and quantitative marker of MR by color flow mapping remains elusive. We hypothesized that vena contracta width by color flow mapping would accurately predict the severity of MR. METHODS AND RESULTS: We studied 80 patients with MR. Vena contracta width was measured in multiple views with zoom mode and nonstandard angulation to optimize its visualization. Flow volumes across the left ventricular outflow tract and mitral annulus were calculated by pulsed-Doppler technique to determine regurgitant volume. Effective regurgitant orifice area was calculated by dividing the regurgitant volume by the continuous-wave Doppler velocity-time integral of the MR jet. The cause of MR was ischemia in 24, dilated cardiomyopathy in 34 mitral valve prolapse in 12, endocarditis in 2, rheumatic disease in 2, mitral annular calcification in 1, and uncertain in 5. Regurgitant volumes ranged from 2 to 191 mL. Regurgitant orifice area ranged from 0.01 to 1.47 cm2. Single-plane vena contracta width from the parasternal long-axis view correlated well with regurgitant volume (r = .85, SEE = 20 mL) and regurgitant orifice area (r = .86, SEE = 0.15 cm2). Biplane vena contracta width from apical views correlated well with regurgitant volume (r = .85, SEE = 19 mL) and regurgitant orifice area (r = .88, SEE = 0.14 cm2). A biplane vena contracta width > or = 0.5 cm was always associated with a regurgitant volume > 60 mL and a regurgitant orifice area > 0.4 cm2. A biplane vena contracta width < or = 0.3 cm predicted a regurgitant volume < 60 mL and a regurgitant orifice area < 0.4 cm2 in 24 of 29 patients. No other parameter, including jet area, left atrial size, pulmonary flow reversal, or semiquantitative MR grade, correlated significantly with regurgitant volume or regurgitant orifice area in a multivariate analysis. CONCLUSIONS: Our results demonstrate that careful color flow mapping of the vena contracta of the MR jet provides a simple quantitative assessment of MR that correlates well with quantitative Doppler techniques.     

Computing occluding and transparent motions

Computing the motions of several moving objects in image sequences involves simultaneous motion analysis and segmentation. This task can become complicated when image motion changes significantly between frames, as with camera vibrations. Such vibrations make tracking in longer sequences harder, as temporal motion constancy cannot be assumed. The problem becomes even more difficult in the case of transparent motions.A method is presented for detecting and tracking occluding and transparent moving objects, which uses temporal integration without assuming motion constancy. Each new frame in the sequence is compared to a dynamic internal representation image of the tracked object. The internal representation image is constructed by temporally integrating frames after registration based on the motion computation. The temporal integration maintains sharpness of the tracked object, while blurring objects that have other motions. Comparing new frames to the internal representation image causes the motion analysis algorithm to continue tracking the same object in subsequent frames, and to improve the segmentation.     

Electromyography in nutritional osteomalacic myopathy

Electromyographic studies in 15 women with nutritional osteomalacia and proximal muscle weakness showed brief duration motor unit action potentials of normal amplitude and increased proportion of polyphasic motor unit potentials in the majority of them. By employing quantitative methods of electromyography, more positive results were obtained, thus reducing the sampling data. The histology showed non-specific muscle fibre atrophy without degenerative changes and the clinical and electromyographic examinations together showed clear evidence of a myopathy, suggesting a reversible transient block of the muscle fibres. Contrary to a recent suggestion, the nature of muscular change in osteomalacia remains the same regardless of its cause being nutritional or otherwise.     

Long-term results in the treatment of femoral-shaft fractures in young children by immediate spica immobilization

Manual traction reduction without anesthesia and immediate immobilization in a spica cast were used to treat eighty-five children ranging in age from birth to ten years old who had closed femoral-shaft fractures and no associated injuries. Up to two centimeters of overriding, 30 degrees of anterior angulation, and 15 degrees of medial angulation were accepted. Any angulation in excess of these amounts, or lateral or posterior angulation, was corrected by wedging the cast at the fracture site. Further telescoping of the fracture fragments in the case was attributed to the child pressing the foot against the bottom of the cast and was prevented by removing the sole of the cast. Of the seventy-five children examined two to eighteen years after fracture, none had any residual skeletal deformity or joint stiffness. The length discrepancies of the fractured limbs ranged from 1.7 centimeters of shortening to 0.9 centimeter of overgrowth.     

Spondylocostal dysostosis

Spondylocostal dysostosis is a rare condition characterized by short stature due to a short trunk, multiple morphological abnormalities of the vertebrae and ribs due to malsegmentation of the axial skeleton. Radiological features include reduced number of vertebrae and ribs, hemivertebrae, fused or sagitally cleft vertebrae or multiple rib fusions. Three distinct clinical entities are described. We report nine cases of this syndrome, seven were infants and presented with an abnormal shape of the thorax. Two of them had a meningocoele, and one succumbed to the CNS anomalies on the third day of life. The other two cases were two and eight years of age. Cardiac lesion was detected in one case and renal malformations in three cases. Reduction in the rib number was present in all cases, and rib fusion in seven cases. Thoracic vertebral dysegmentation was noted in all, lumbar in three and cervical in one case. This is the first large series from India. No clear single etiology was established.     

The Land Analysis System (LAS) for multispectral image processing

The Land Analysis System (LAS) is an interactive software system available in the public domain for the analysis, display, and management of multispectral and other digital image data. LAS provides over 240 applications functions and utilities, a flexible user interface, complete online and hard-copy documentation, extensive image-data file management, reformatting, conversion utilities, and high-level device independent access to image display hardware. The authors summarize the capabilities of the current release of LAS (version 4.0) and discuss plans for future development. Particular emphasis is given to the issue of system portability and the importance of removing and/or isolating hardware and software dependencies     

Towards equilibrium during tempering a high-speed steel

The present investigation outlines the sequence of secondary carbide precipitation at various stages of tempering a quenched T42 high-speed steel. Samples from both conventional cast and wrought and the more recently developed powder metallurgy routes have been studied. By using a Holloman and Jaffe construction combined with transmission electron microscopy, it has been possible to follow the influence of various microstructural features and their evolution on mechanical properties. It was established that while the production route had no apparent effect on the observed precipitation reaction, MC type carbides were the primary contribution to the secondary hardening phenomenon. Furthermore, by studying overaged microstructures it has been possible to suggest a probable reason for the degradation of cutting tools during service.     

Space-time super-resolution

We propose a method for constructing a video sequence of high space-time resolution by combining information from multiple low-resolution video sequences of the same dynamic scene. Super-resolution is performed simultaneously in time and in space. By "temporal super-resolution," we mean recovering rapid dynamic events that occur faster than regular frame-rate. Such dynamic events are not visible (or else are observed incorrectly) in any of the input sequences, even if these are played in "slow-motion." The spatial and temporal dimensions are very different in nature, yet are interrelated. This leads to interesting visual trade-offs in time and space and to new video applications. These include: 1) treatment of spatial artifacts (e.g., motion-blur) by increasing the temporal resolution and 2) combination of input sequences of different space-time resolutions (e.g., NTSC, PAL, and even high quality still images) to generate a high quality video sequence. We further analyze and compare characteristics of temporal super-resolution to those of spatial super-resolution. These include: the video cameras needed to obtain increased resolution; the upper bound on resolution improvement via super-resolution; and, the temporal analogue to the spatial "ringing" effect.     

Quantitative applications of high-resolution proton magnetic resonance measurements in the characterization of detergent chemicals

Quantitative hydrogen nuclear magnetic resonance measurements are used for the determination of average structures of detergent chemicals. For alkylbenzenes, alkylphenols, and ethylene oxide (EO) adducts of alkylphenols, the following quantities can be measured: average lengths of alkyl chains, average molecular weights, degree and kind of branching in the alkyl chain, ortho-para distribution of aryl substituents, and average lengths of BO chains. Accuracy is of the the order of ± 2% of the total hydrogen. The method is nondestructive, and sample volumes as small as 0.007 ml have been used.     

The mechanism of crystallographic ordering in CuPt

The present paper is primarily a study of the ordering characteristics within the CuPt system, near the CuPt composition, using X-ray diffraction, optical microscopy (in conjunction with polarized light), high-voltage electron microscopy and dilatometry.In platinum-rich off-stoichiometric alloys, a wide two-phase region consisting of ordered + disordered platelets was established and the phase boundaries were accurately located. For isothermally ordered stoichiometric alloys, in general two categories of diffraction sequences were observed, depending on the annealing temperature. For anneals in the range 620°C<T<815°C (=T_c), a series of broad, asymmetric X-ray line profiles were obtained during the early part of the ordering cycle: this represents a continuous reaction. However, when samples were annealed a temperatures lower than 620°C, there was unmistakable micrographic evidence of the coexistence of both the ordered and disordered phases: this represents a discontinuous reaction. After making allowances for a number of side-effects which had broadened X-ray reflections at high temperatures, a nucleation-and-growth model is proposed for CuPt at all ordering temperatures.The parallel microscopic studies also exhibited quite contrasting morphologies above and below 620°C: a lamellar structure is the product at high temperatures, whereas a grain-boundary reaction, generating very coarse domains, is observed at lower temperatures. A modified microstructure was observed for samples annealed at T<475°C, when ordered spherulites were seen to grow within the grains. Samples cooled slowly through T _c order by a diffusion-controlled shear process.