Relationship between haemodynamics and morphology in pulmonary hypertension. A quantitative intravascular ultrasound study

BACKGROUND: Intravascular ultrasound imaging of the pulmonary arteries has been demonstrated to be a reliable method of quantifying vessel diameter, luminal area and pulsatility. Simultaneous measurement of flow velocity and its response to vasodilators allows the relationship between morphology and functional compromise to be studied, especially endothelial dysfunction. METHODS: In 51 patients (mean age = 49.8 +/- 12.6 years, 17 female) we performed right heart catheterization and simultaneous intravascular ultrasound of pulmonary artery branches. The patients were divided in two groups: group 1 with normal pulmonary artery pressure and pulmonary vascular resistance, and group 2 with pulmonary hypertension (peak pulmonary artery pressure > 30 mmHg and/or mean pulmonary artery pressure > 20 mmHg). Vessel wall and lumen were studied using a 2.9 F intravascular ultrasound catheter with a 30 MHz phased array transducer. Measurement of blood flow velocity was accomplished by a Doppler flow wire (0.018 inch). The maximal flow change during acetylcholine infusion (adjusted to 10(-6); 10(-5), and 10(-4) M concentration in the blood vessel) was measured. RESULTS: There were no significant differences between groups 1 and 2 with respect to age (48.5 +/- 14.3 years vs 50.3 +/- 12.3 years; P = ns), gender (4 female/8 male vs 13 female/26 male; P = ns), luminal area of the vessel segment in which the intravascular ultrasound measurements were obtained (11.8 +/- 6.1 mm2 vs 16.7 +/- 14.3 mm2; P = ns), internal diameter (3.9 +/- 1.2 mm vs 4.2 +/- 1.7 mm; P = ns), and external diameter (6.1 +/- 1.3 mm vs 6.9 +/- 2.1 mm; P = ns). Cross-sectional images of the pulmonary artery wall demonstrated a single ring with high echodensity with a thin inner layer regarded as intima in group 1. In contrast, the majority of patients (n = 35/39) in group 2 demonstrated a thickening of the intimal layer and/or a disturbance of layering of the echogenic arterial wall. The relative wall thickness was higher in group 2 than in group 1 (22.5 +/- 10.4% vs 15.3 +/- 6.5%; P < 0.05). There were no significant correlations between pulmonary artery pressure and wall thickness pulmonary artery pressure and area change in the cardiac cycle, acetylcholine-dependent increase in pulmonary flow and morphological changes in the vessel wall. CONCLUSION: We conclude that intravascular ultrasound is capable of detecting morphological changes in the pulmonary vessel wall in pulmonary hypertension and that vessel wall hypertrophy of small pulmonary segment arteries, as detected by intravascular ultrasound, is not predictive of functional vasodilatory response of resistance vessels of the same vessel area.     

Continuous measurement of cardiac output by the Fick principle in infants and children: comparison with the thermodilution method

OBJECTIVE: To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. DESIGN: Prospective direct comparison of the above two techniques. SETTING: Pediatric intensive care unit of a university hospital. PATIENTS: 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. METHODS: The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20s. INTERVENTIONS: In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. RESULTS: Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found: r2 = 0.98; P < 0.001; SEE = 0.41 l/min. The bias is absolute values and in percent of average cardiac output was - 0.05 l/min or - 4.4% with a precision of 0.32 l/min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. CONCLUSION: Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.     

Synthesis, absolute configuration, and analysis of malathion, malaoxon, and isomalathion enantiomers

Syntheses of the enantiomers of malathion, malaoxon, and isomalathion are reported herein. Malathion enantiomers were prepared from (R)- or (S)-malic acid in three steps. Enantiomers of malathion were converted to the corresponding enantiomers of malaoxon in 52% yield by oxidation with monoperoxyphthalic acid, magnesium salt. The four isomalathion stereoisomers were prepared via two independent pathways using strychnine to resolve the asymmetric phosphorus moiety. The absolute configurations of the four stereoisomers of isomalathion were determined by X-ray crystallographic analysis of an alkaloid salt precursor. A high-performance liquid chromatography technique was developed to resolve the four stereoisomers of isomalathion, and to determine their stereoisomeric ratios.     

Limit of validity of the moisture diffusivity for the study of moisture transfer inside terracotta

In order to know the limit of validity of the concept of hydrical diffusivity, D_W, we tried to validate the Boltzmann's method used to identify it. We show that for a medium strictly satisfying the equation of diffusion, the method gives quite good results with nevertheless some inaccuracies for the extreme values of water contents. For the real studied material, a backed clay, its identification becomes more difficult because of the dispersion of the wetting phenomenon observed for different specimens of the same material. We are showing that the mean behaviour of one sample is near to be the same as the more probable behaviour of all the samples. Otherwise the values of D_W determined for a wetting cannot be used to describe a drying process. It practical interest is then considerably reduced. In order to test the influence of the gas phase pressure effects on the behaviour of the material, we have determined all the parameters necessary to describe, numerically, wetting and drying processes without to resort to D_W. We noticed an overpressure of the gas phase inside the material due to drying. If the gas pressure effects are, numerically, switched off, we cannot notice any influence on water content profiles for this type of material.     

Toward a unified theory of similarity and recognition.

A new theory of similarity, rooted in the detection and recognition literatures, is developed. The general recognition theory assumes that the perceptual effect of a stimulus is random but that on any single trial it can be represented as a point in a multidimensional space. Similarity is a function of the overlap of perceptual distributions. It is shown that the general recognition theory contains Euclidean distance models of similarity as a special case but that unlike them, it is not constrained by any distance axioms. Three experiments are reported that test the empirical validity of the theory. In these experiments the general recognition theory accounts for similarity data as well as the currently popular similarity theories do, and it accounts for identification data as well as the longstanding "champion" identification model does. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

New integrated buried laser-ridge modulator with identical active layer

Integrated laser modulators are attractive devices for wavelength-division-multiplexing optical systems due to their compactness, high output power, and low cost. Their fabrication simplicity is a way to decrease further the transmitter cost and address new opening markets of short range and metropolitan networks. We report a new integration scheme electroabsorption-modulator distributed feedback (DFB) laser based on well-established industrial solutions for discrete buried ridge (BRS) DFB lasers and discrete shallow ridge modulators. Processing simplification with an identical active layer has been possible due to a good behavior of strongly positively detuned BRS lasers. The integrated devices demonstrated 30-dB extinction ratio with 10-GHz bandwidth and P/sub out/=10 dBm for emission in 1.55-/spl mu/m range.     

SMC composites waste management as reinforcing fillers in polypropylene by combination of mechanical and chemical recycling processes

A new process of management of waste of composite materials from Sheet Moulding Compounds (SMC), as reinforcing fillers for thermoplastic materials, including both mechanical and chemical processes is proposed in this paper. Communited SMC being composed of coated glass fibres intimately mixed with calcium carbonate powder, their reinforcing power is low. First, the fibrous part was increased by partial dissolution of calcium carbonate present in the crushed products SMC. Second, a process of partial solvolysis was developed aiming at strong increasing the interfacial mechanical properties by functionalising of SMC load incorporated into polypropylene/grafted maleic anhydride polypropylene (PP/PP_gma). At this effect, we investigated a treatment with a hot triamine (diethylenetriamine, DETA) in order to create a functionalisation, after scission of the bond ester of unsaturated polyester, as bridging amino-succinimide.The effect of this recycling way by partial solvolysis was checked from the mechanical properties of the resulting reinforced PP/PP_gma material: Although a lower of Young modulus, better yield stress and especially resilience were observed.