Determination of laser-induced temperature distributions using echo-shifted turboflash

An echo-shifted TurboFLASH sequence implemented on a clinical whole body MR scanner was used to determine thermal changes in tissue. With this snapshot-like data acquisition, temperature-related phase shifts were measured with a temporal resolution of 1.3 s. For different types of tissue (postmortem porcine brain, liver, and muscle) the temperature coefficients of the proton chemical shift were recorded during uniform heating of the specimen in a water bath. The specific temperature-dependent frequency shifts appeared similar to the proton chemical shift of free water (-0.01 ppm/°C). With this method, laser-induced ablation in postmortem porcine brain was monitored by temperature mapping. Comparison of the induced temperature profiles measured with NiCrNi-thermocouples with the MR calculated profiles demonstrated excellent temperature sensitivity and accuracy for this method of MR thermometry, with a maximum deviation of the determined temperatures of only 1.8°C. This investigation was designed as a feasibility study for this rapid version of the phase mapping method, and no in vivo studies were performed.     

Computing conditional recombination probabilities given marker information

When a parent is homozygous, it is not possible to determine directly whether offspring share an allele identical by descent (IBD) from that parent. However, an IBD probability can be computed using information from linked loci where the parent is heterozygous. To solve this problem for the phase-known case, probability equations and a computer program were developed for efficient computation of conditional probabilities under a Sturt model of chiasma interference. Data are analyzed and contrasted with and without taking interference into account. The effect of failing to account for interference is very small, but the computational cost is also small. © 1995 Wiley-Liss, Inc.     

Verification of Linear Lesions Using a Noncontact Multielectrode Array Catheter versus Conventional Contact Mapping Techniques

INTRODUCTION: Creation of linear lesions is an established ablation goal. Verification of complete conduction block at the ablation line is required to determine ablation success. Conventional mapping techniques are sequential endocardial activation mapping and documentation of double potentials. Recently, a noncontact multielectrode array catheter was developed that allows instantaneous three-dimensional mapping by simultaneous reconstruction of > 3,000 electrograms. In this study, we prospectively compared the accuracy of noncontact mapping to identify discontinuities in linear lesions and to verify a conduction block with that of conventional mapping techniques. METHODS AND RESULTS: In 12 patients with atrial flutter, radiofrequency pulses were applied between the tricuspid annulus and either the inferior vena cava or the eustachian ridge. Following each application, pulse propagation at the ablation line was determined during pacing by conventional mapping techniques. The findings were compared to high-density isopotential mapping using the noncontact multielectrode array catheter. It was found that noncontact mapping reliably distinguished conduction delays from a conduction block as defined by contact mapping. In addition, noncontact mapping instantaneously identified the area where a discontinuity in the line of block was present. In these patients, complete conduction block was achieved by radiofrequency pulses guided by the noncontact mapping system. CONCLUSION: Noncontact mapping is highly accurate in distinguishing conduction delays from a complete conduction block. By providing an instantaneous high-density propagation vector at all sites along the ablation line, three-dimensional isopotential mapping is helpful in localizing discontinuities of linear lesions and, thus, may facilitate the creation of a complete conduction block.     

Virtual spatial registration of stand-alone fNIRS data to MNI space

The registration of functional brain data to common stereotaxic brain space facilitates data sharing and integration across different subjects, studies, and even imaging modalities. Thus, we previously described a method for the probabilistic registration of functional near-infrared spectroscopy (fNIRS) data onto Montreal Neurological Institute (MNI) coordinate space that can be used even when magnetic resonance images of the subjects are not available. This method, however, requires the careful measurement of scalp landmarks and fNIRS optode positions using a 3D-digitizer. Here we present a novel registration method, based on simulations in place of physical measurements for optode positioning. First, we constructed a holder deformation algorithm and examined its validity by comparing virtual and actual deformation of holders on spherical phantoms and real head surfaces. The discrepancies were negligible. Next, we registered virtual holders on synthetic heads and brains that represent size and shape variations among the population. The registered positions were normalized to MNI space. By repeating this process across synthetic heads and brains, we statistically estimated the most probable MNI coordinate values, and clarified errors, which were in the order of several millimeters across the scalp, associated with this estimation. In essence, the current method allowed the spatial registration of completely stand-alone fNIRS data onto MNI space without the use of supplementary measurements. This method will not only provide a practical solution to the spatial registration issues in fNIRS studies, but will also enhance cross-modal communications within the neuroimaging community.     

A syndactyly type IV locus maps to 7q36

Syndactyly occurs as an isolated abnormality or a part of a malformation syndrome. Syndactyly types I, II, III and V have been mapped to chromosomal regions 2q34–q36, 2q31–q32, 6q21–q23.2 and 2q31–q32, respectively, whereas syndactyly type IV (SD4) is extremely rare, and its gene localization has not yet been assigned. The SD4 manifests complete syndactyly of all fingers accompanied with polydactyly, and flexion of the fingers gives the hand a cup-shaped appearance. We performed a linkage and haplotype analysis of a Chinese pedigree with autosomal dominant, non-syndromic SD4 using a set of 406 microsatellite markers. The analysis gave the maximum two-point LOD score of 1.613 at recombination fraction of 0.00 and penetrance of 1.00. Thus, the SD4 locus in the family was likely assigned to a 17.39-cM region at a segment between markers D7S3070 and D7S559 at 7q36, although the LOD score obtained was not high enough to conclude the localization. Analysis of three candidate genes, LMBR1, SHH and ZRS, failed to identify any pathogenic mutations. Our gene mapping may give a clue to identify the putative SD4 gene and provide a better understanding of normal human limb development. Daisuke Sato and Desheng Liang equally contributed to this study.     

Mapping and ablation procedures for the treatment of ventricular tachycardia

Introduction: Ventricular tachycardia (VT) may occur in the presence or absence of structural heart disease. Given that the management of VT hinges on the presence of symptoms and risk of sudden cardiac death (SCD), the main treatment goals are elimination of symptoms (including frequent implantable cardioverter defibrillator [ICD] therapies) and prevention of SCD. Unfortunately, medical management is suboptimal in a significant proportion of patients. As such, ablative therapy plays a prominent role in the treatment of ventricular tachycardia.

Areas covered: In this review, we will discuss various VT disorders that are encountered in patients with and without structural heart disease. Further, we will highlight salient features regarding mapping and ablation of the various VT syndromes. Finally, we will discuss what lies on the horizon for VT ablation.

Expert commentary: Meticulous mapping should aim to find the region that is most likely to be successful and least likely to result in a complication. Although recognition of the various mechanisms of VT, familiarity with different methods to mapping and ablation, and awareness of potential limitations of current approaches is critical, a thorough understanding of the fundamental principles and nuances of each facet within EP is required to ensure optimal outcomes for our patients.     

思维导图在医学组织学胚胎学实验教学中的应用

目的思维导图是一种简单有效的可视化学习工具,本研究为探讨思维导图教学法在医学组织学胚胎学实验教学中的应用效果。方法在我校2015级两个同样学制班级73名学生中实施,对照班采用传统教学模式,实验班在教学过程中引入思维导图,进行问卷调查,比较分析两个班的期末成绩。结果实验班在教学启发性及期末理论考试成绩方面均明显提高(P<0.05)。结论相比传统的教学方法,思维导图更有新颖性、易用性、启发性和拓展性;在医学组织学胚胎学实验教学中应用思维导图,可能是提高医学生学习效率的一种有效手段。     

Clinical experience with electroanatomic mapping of ectopic atrial tachycardia

The aim of this study was to evaluate the clinical use of a new three-dimensional mapping system as a guide for catheter ablation of ectopic atrial tachycardia. A series of 42 consecutive patients with drug refractory ectopic atrial tachycardia was studied in a prospective observational trial with the electroanatomic mapping system CARTO. The arrhythmogenic focus was found in the right atrium in 30 patients and in the left atrium in 12 patients. The construction of a complete electroanatomic map of the right or left atrium was possible in 37 of 42 consecutive patients with ectopic atrial tachycardia. Mean activation time of the right atrium, including the proximal coronary sinus, was 94 +/- 25 ms for right atrial tachycardias; left atrial activation time during left atrial tachycardias was 86 +/- 17 ms. Average mapping time was 30 minutes for right atrial tachycardias and 22 minutes for left atrial tachycardias, allowing the collection of 86 +/- 50 and 65 +/- 28 catheter positions, respectively. The size of the area of earliest atrial activation calculated from the electroanatomic map amounted to 0.6 +/- 0.4 cm2 in right atrial tachycardias and 1.0 +/- 0.9 cm2 in left atrial tachycardias. In the right atrium the most common locations of the 33 arrhythmogenic foci in 30 patients were the high or mid-lateral right atrium (n = 10) and the inferoparaseptal region near the coronary sinus ostium (n = 7). Ectopic left atrial foci were most commonly located in an inferior position near the mitral annulus (n = 5) and in proximity to the ostium of the pulmonary veins (n = 4). Biatrial electroanatomic mapping allowed visualization of earliest right atrial activation during left atrial tachycardia at the high interatrial septum or near the coronary sinus ostium. Catheter ablation was successful in 85% of right atrial tachycardias and 82% of left atrial tachycardias. In patients with ectopic atrial tachycardia electroanatomic mapping is a safe and feasible technique that allows three-dimensional visualization of the automatic focus in a precise anatomic reconstruction of the atria. This novel mapping technology facilitates catheter ablation of complex ectopic atrial tachycardia.     

Arrhythmia vulnerability assessment using magnetic field maps and body surface potential maps

Magnetic field maps and body surface potential maps can be used to measure cardiac activity. The ability of magnetic and potential body surface maps to identify patients' vulnerable to recurrent sustained ventricular arrhythmia (VA) were compared. Magnetic field maps (MFM) and body surface potential mapping (BSPM) were obtained from 76 normal (N) subjects, 15 myocardial infarct (MI) patients, and 15 VA patients. QRST integral maps were calculated for each subject and nondipolar content was determined using Karhunen-Loeve transform eigen-maps. Although differences in nondipolar content were significant between the normal and patient groups (P = 2.4 x 10(-5) for BSPM and P = 6.0 x 10(-8) for MFM), differences in nondipolar content between MI and VA patients using QRST integral BSPM and MFM maps were not significant. The trajectory of the location of the maxima and minima on the map area during the QRS and ST-T intervals were also constructed. Discrimination between MI and VA patients was based on intergroup differences in the amount of fragmentation of the trajectory plots. The ST-T trajectory plots were significantly more fragmented (P < 0.0001 and P < 0.05 for MFM and BSPM, respectively) for VA than for MI patients. The ST-T interval MFM and BSPM trajectory plots enabled separation of MI and VA patients with accuracies of 83% and 73%, respectively. These results suggest that repolarization MFM and BSPM extrema trajectory plots can be used effectively as a means of identifying patients at risk for VA.