利用神经网络构建超声多普勒栓子信号自动检测系统

对血液中栓子的早期检测有着重要的临床诊断意义。超声多普勒技术使栓子的无损检测成为可能,但是目前的检测尚依赖于医生的手动操作和临床经验,仍缺乏可靠的自动检测系统。本文基于小波包变换和主元分析提取对栓子敏感的特征参数,并利用神经网络构建超声多普勒栓子信号的自动检测系统。仿真研究和临床实验表明:该系统有效提高了栓子检测的准确性,有望应用于临床诊断。     

Collapse of Water-Stress Emboli in the Tracheids of Thuja occidentalis L

We report the kinetics of embolus formation and collapse in the tracheids of Thuja occidentalis L. stem segments. Radial wood sections were trimmed to 4 mm long paralleling the tracheids by 1 mm wide and 0.1 mm thick. They were observed under a dissecting microscope at 128x while sections were dehydrated and rehydrated. During dehydration, cavitations resulted in the formation of emboli in tracheids, but we concluded that the cavitated tracheids did not immediately fill with air at atmospheric pressure. This conclusion was based on the time required for the emboli to collapse after the rewetting of the dehydrated segment. By hypothesis, the time for the emboli to collapse should be proportional to the amount of air in the emboli. The time for all the emboli to collapse was a linear function of the dehydration time for times up to 15 min. For dehydrations greater than 80 min, the time for collapse after rewetting was constant, and we concluded that the tracheids have saturated with air by 80 min of dehydration. The kinetics of embolus formation is discussed in terms of the air-seeding hypothesis for cavitation, and collapse is discussed in terms of the physics of gas dissolution and diffusion. Embolus formation and dissolution in intact herbaceous and woody plants should follow the same physical laws.     

Prophylactic Anticoagulant Therapy against Pulmonary Emboli in Acute Paraplegia

Prophylactic anticoagulant therapy within a few days of admitting a patient with a spinal injury appears to offer advantages in preventing pulmonary emboli. It was not found to hinder the patient''s management.     

Alkoxylipids from the mammalian heart

The phospholipid composition of the cardiac muscle was studied in mammals. The quantitative ratio of three forms--acyl, alkyl and alkenyl (plasmalogenic)--was determined in phospholipids of the heart: phosphatidylethanolamine and phosphatidylcholine. The total quantity of alkoxylipids (plasmalogens and alkyl esters) in various animals amounts to 23-42% of total phospholipids.     

CT Pulmonary Angiography: Increasingly Diagnosing Less Severe Pulmonary Emboli

Background

It is unknown whether the observed increase in computed tomography pulmonary angiography (CTPA) utilization has resulted in increased detection of pulmonary emboli (PEs) with a less severe disease spectrum.

Methods

Trends in utilization, diagnostic yield, and disease severity were evaluated for 4,048 consecutive initial CTPAs performed in adult patients in the emergency department of a large urban academic medical center between 1/1/2004 and 10/31/2009. Transthoracic echocardiography (TTE) findings and peak serum troponin levels were evaluated to assess for the presence of PE-associated right ventricular (RV) abnormalities (dysfunction or dilatation) and myocardial injury, respectively. Statistical analyses were performed using multivariate logistic regression.

Results

268 CTPAs (6.6%) were positive for acute PE, and 3,780 (93.4%) demonstrated either no PE or chronic PE. There was a significant increase in the likelihood of undergoing CTPA per year during the study period (odds ratio [OR] 1.05, 95% confidence interval [CI] 1.04–1.07, P<0.01). There was no significant change in the likelihood of having a CTPA diagnostic of an acute PE per year (OR 1.03, 95% CI 0.95–1.11, P = 0.49). The likelihood of diagnosing a less severe PE on CTPA with no associated RV abnormalities or myocardial injury increased per year during the study period (OR 1.39, 95% CI 1.10–1.75, P = 0.01).

Conclusions

CTPA utilization has risen with no corresponding change in diagnostic yield, resulting in an increase in PE detection. There is a concurrent rise in the likelihood of diagnosing a less clinically severe spectrum of PEs.     

Calpain protects the heart from hemodynamic stress

Calpains make up a family of Ca(2+)-dependent intracellular cysteine proteases that include ubiquitously expressed μ- and m-calpains. Both are heterodimers consisting of a distinct large catalytic subunit (calpain 1 for μ-calpain and calpain 2 for m-calpain) and a common regulatory subunit (calpain 4). The physiological roles of calpain remain unclear in the organs, including the heart, but it has been suggested that calpain is activated by Ca(2+) overload in diseased hearts, resulting in cardiac dysfunction. In this study, cardiac-specific calpain 4-deficient mice were generated to elucidate the role of calpain in the heart in response to hemodynamic stress. Cardiac-specific deletion of calpain 4 resulted in decreased protein levels of calpains 1 and 2 and showed no cardiac phenotypes under base-line conditions but caused left ventricle dilatation, contractile dysfunction, and heart failure with interstitial fibrosis 1 week after pressure overload. Pressure-overloaded calpain 4-deficient hearts took up a membrane-impermeant dye, Evans blue, indicating plasma membrane disruption. Membrane repair assays using a two-photon laser-scanning microscope revealed that calpain 4-deficient cardiomyocytes failed to reseal a plasma membrane that had been disrupted by laser irradiation. Thus, the data indicate that calpain protects the heart from hemodynamic stresses, such as pressure overload.