Bone mineral imaged in vivo by 31P solid state MRI of human wrists

Purpose:

To implement solid state ³¹P MRI (³¹P SMRI) in a clinical scanner to visualize bone mineral.

Materials and Methods:

Wrists of seven healthy volunteers were scanned. A quadrature wrist ³¹P transmit/receive coil provided strong B₁ and good signal‐to‐noise ratio (SNR). A ¹H‐³¹P frequency converter was constructed to enable detection of the ³¹P signal by means of the ¹H channel. Data points lost in the receiver dead time were recovered by a second acquisition with longer dwell time and lower gradient strength.

Results:

Three‐dimensional ³¹P images, showing only bone mineral of the wrist, were obtained with a clinical 3 Tesla (T) scanner. In the best overall case an image with isotropic resolution of ～5.1 mm and SNR of 30 was obtained in 37 min. ³¹P NMR properties (resonance line width 2 kHz and T₁ 17–19 s) of in vivo human bone mineral were measured.

Conclusion:

In vivo ³¹P SMRI visualization of human wrist bone mineral with a clinical MR scanner is feasible with suitable modifications to circumvent the scanners' limitations in reception of short‐T₂ signals. Frequency conversion methodology is useful for implementing ³¹P SMRI measurements on scanners which do not have multinuclear capability or for which the multinuclear receiver dead time is excessive. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Power Independent of Number of Slices (PINS) radiofrequency pulses for low-power simultaneous multislice excitation

This communication describes radiofrequency pulses capable of performing spatially periodic excitation, inversion, and refocusing. The generation of such pulses either by multiplication of existing radiofrequency pulses by a Dirac comb function or by means of Fourier series expansion is described. Practical schemes for the implementation of such pulses are given, and strategies for optimizing the pulse profile at fixed pulse duration are outlined. The pulses are implemented using a spin-echo sequence. The power deposition is independent of the number of slices acquired, and hence the power deposition per slice is considerably reduced compared to multislice imaging. Excellent image quality is obtained both in phantoms and in images of the human head. These pulses should find widespread application for multiplexed imaging, in particular at high static magnetic field strengths and for pulse sequences that have a high radiofrequency power deposition and could lead to dramatic increases in scanning efficiency.     

2019 HRS expert consensus statement on evaluation,risk stratification,and management of arrhythmogenic cardiomyopathy: Executive summary

Arrhythmogenic cardiomyopathy (ACM) is an arrhythmogenic disorder of the myocardium not secondary to ischemic, hypertensive, or valvular heart disease. ACM incorporates a broad spectrum of genetic, systemic, infectious, and inflammatory disorders. This designation includes, but is not limited to, arrhythmogenic right/left ventricular cardiomyopathy, cardiac amyloidosis, sarcoidosis, Chagas disease, and left ventricular noncompaction. The ACM phenotype overlaps with other cardiomyopathies, particularly dilated cardiomyopathy with arrhythmia presentation that may be associated with ventricular dilatation and/or impaired systolic function. This expert consensus statement provides the clinician with guidance on evaluation and management of ACM and includes clinically relevant information on genetics and disease mechanisms. PICO questions were utilized to evaluate contemporary evidence and provide clinical guidance related to exercise in arrhythmogenic right ventricular cardiomyopathy. Recommendations were developed and approved by an expert writing group, after a systematic literature search with evidence tables, and discussion of their own clinical experience, to present the current knowledge in the field. Each recommendation is presented using the Class of Recommendation and Level of Evidence system formulated by the American College of Cardiology and the American Heart Association and is accompanied by references and explanatory text to provide essential context. The ongoing recognition of the genetic basis of ACM provides the opportunity to examine the diverse triggers and potential common pathway for the development of disease and arrhythmia.     

California gull chicks raised near colony edges have elevated stress levels

Coloniality in nesting birds represents an important life history strategy for maximizing reproductive success. Birds nesting near the edge of colonies tend to have lower reproductive success than individuals nesting near colony centers, and offspring of edge-nesting parents may be impaired relative to those of central-nesting parents. We used fecal corticosterone metabolites in California gull chicks (Larus californicus) to examine whether colony size or location within the colony influenced a chick’s physiological condition. We found that chicks being raised near colony edges had higher fecal corticosterone metabolite concentrations than chicks raised near colony centers, but that colony size (ranging from 150 to 11,554 nests) had no influence on fecal corticosterone levels. Fecal corticosterone metabolite concentrations also increased with chick age. Our results suggest that similarly aged California gull chicks raised near colony edges may be more physiologically stressed, as indicated by corticosterone metabolites, than chicks raised near colony centers.     

The impact of feedback on self-rated driving ability and driving self-regulation among older adults

In 129 community-dwelling older adults, feedback regarding qualification for an insurance discount (based on a visual speed of processing test; Useful Field of View) was examined as a prospective predictor of change in self-reported driving ability, driving avoidance, and driving exposure over 3 months, along with physical, visual, health, and cognitive variables. Multiple regression models indicated that after controlling for baseline scores on the outcome measures, failure to qualify was a significant predictor of increased avoidance over 3 months (p = .02) but not change in self-rated driving ability or exposure. Female gender (p = .03) was a significant predictor of subsequent lower self-rated driving ability. Overall, the findings of this study provide support for the role of feedback in the self-monitoring of older adults' driving behavior through avoidance of challenging driving situations but not through driving exposure or self-rated driving ability.     

Phase II study assessing the effectiveness of Biafine cream as a prophylactic agent for radiation-induced acute skin toxicity to the breast in women undergoing radiotherapy with concomitant CMF chemotherapy

PURPOSE: To assess the efficacy of Biafine cream in preventing Grade 2 acute radiation dermatitis, according to the National Cancer Institute of Canada skin radiation toxicity criteria in patients undergoing concomitant adjuvant chemotherapy and radiotherapy to the breast. METHODS AND MATERIALS: Sixty patients participated in this study. Patients were treated with a lumpectomy followed by concomitant chemotherapy and radiotherapy to the breast. Biafine cream was applied daily, starting on the first day and ending 2 weeks post-radiotherapy. Patients underwent weekly skin assessments throughout radiotherapy and at 2 and 4 weeks after treatment. Outcome measures were assessed using a Skin Assessment Questionnaire that was scored according to the National Cancer Institute of Canada skin radiation toxicity criteria and a self-administered questionnaire that evaluated skin symptoms. RESULTS: The maximum skin toxicity observed during the course of treatment was as follows: less than Grade 2 toxicity, 15% (9 patients); Grade 2, 83% (50 patients); Grade 3, 2% (1 patient); Grade 4, 0% (0 patients). The majority of the radiation dermatitis was observed after 3 weeks of radiotherapy. CONCLUSION: The majority of patients who underwent concomitant chemo- and radiotherapy for breast cancer developed Grade 2 radiation dermatitis with the use of Biafine cream. However, no treatment delays or interruptions were observed because of skin toxicity.     

Cellular Changes that Accompany Shedding of Human Corneocytes

Corneocyte desquamation has been ascribed to the following: 1) proteolytic degradation of corneodesmosomes (CDs); 2) disorganization of extracellular lamellar bilayers; and/or 3) "swell-shrinkage-slough" from hydration/dehydration. To address the cellular basis for normal exfoliation, we compared changes in lamellar bilayer architecture and CD structure in D-Squame strips from the first versus fifth stripping ("outer" vs. "mid"-stratum corneum (SC), respectively) from nine normal adult forearms. Strippings were either processed for standard electron microscopy (EM) or for ruthenium-, or osmium-tetroxide vapor fixation, followed by immediate epoxy embedment, an artifact-free protocol, which, to our knowledge, is previously unreported. CDs are largely intact in the mid-SC, but replaced by electron-dense (hydrophilic) clefts (lacunae) that expand laterally, splitting lamellar arrays in the outer SC. Some undegraded desmoglein 1/desmocollin 1 redistribute uniformly into corneocyte envelopes (CEs) in the outer SC (shown by proteomics, Z-stack confocal imaging, and immunoEM). CEs then thicken, likely facilitating exfoliation by increasing corneocyte rigidity. In vapor-fixed images, hydration only altered the volume of the extracellular compartment, expanding lacunae, further separating membrane arrays. During dehydration, air replaced water, maintaining the expanded extracellular compartment. Hydration also provoked degradation of membranes by activating contiguous acidic ceramidase activity. Together, these studies identify several parallel mechanisms that orchestrate exfoliation from the surface of normal human skin.