Faculty Bibliography

PURPOSE/OBJECTIVE:To validate conventional phase-contrast MRI (PC-MRI) measurements of steady and pulsatile flows through stenotic phantoms with various degrees of narrowing at Reynolds numbers mimicking flows in the human iliac artery using stereoscopic particle image velocimetry (SPIV) as gold standard. MATERIALS AND METHODS/METHODS:A series of detailed experiments are reported for validation of MR measurements of steady and pulsatile flows with SPIV and CFD on three different stenotic models with 50%, 74%, and 87% area occlusions at three sites: two diameters proximal to the stenosis, at the throat, and two diameters distal to the stenosis. RESULTS:Agreement between conventional spin-warp PC-MRI with Cartesian read-out and SPIV was demonstrated for both steady and pulsatile flows with mean Reynolds numbers of 130, 160, and 190 at the inlet by evaluating the linear regression between the two methods. The analysis revealed a correlation coefficient of > 0.99 and > 0.96 for steady and pulsatile flows, respectively. Additionally, it was found that the most accurate measures of flow by the sequence were at the throat of the stenosis (error < 5% for both steady and pulsatile mean flows). The flow rate error distal to the stenosis was primarily found to be a function of narrowing severity including dependence on proper Venc selection. CONCLUSION/CONCLUSIONS:SPIV and CFD provide excellent approaches to in vitro validation of new or existing PC-MRI flow measurement techniques.

We present a case of an acquired, transient, rotated right kidney in a 43-year-old woman with an enterocutaneous fistula who presented with acute pulmonary embolism. This non-ptotic rotated kidney returned to its normal orientation within 10 days. We postulate that this transient kidney rotation is due to transient hepatomegaly and passive renal congestion secondary to pulmonary embolism. While in this patient there were no untoward sequelae, it has been reported that ureteral obstruction or vascular occlusion can occur in patients with ptotic and malrotated kidneys, and radiologists, therefore, should be aware of this unusual occurrence and the potential complications.

The viability and a number of morphological properties of in situ astrocytes of rat spinal cord cultures including changes in surface area and migration of both cell body and nucleus were investigated at magnetic field intensities comparable to those currently used for magnetic resonance imaging. Viability of rat spinal astrocytes was studied after up to 72 hours of 2.1T static magnetic field exposure. Surface areas and two-dimensional centroids of both soma and nucleus after 2 hours of magnetic field exposure were determined and compared with those of the same cells before magnetic field exposure. Cell membrane ruffling was quantified using fractal analysis. Viability of astrocytes remained unchanged at 4, 16, 24, 48 and 72 hours. The mean soma area before and after 2 hours of field exposure was 6450 microm(2) and 6299 microm(2), respectively, whereas the values for nuclear area were 185.6 microm(2) and 185.7 microm(2). The mean displacement of the centroid of soma parallel and perpendicular to the magnetic field direction was 1.07 microm and 0.78 microm, respectively. The corresponding quantities for nuclei were 0.29 microm and -2.00 microm. None of these changes were statistically significant. No membrane protrusion was observed by fractal analysis. In conclusion, strong static magnetic field at 2.1 T does not significantly affect the viability and morphological properties of rat astrocytes.

Pressure gradient across a Gaussian-shaped 87% area stenosis phantom was estimated by solving the pressure Poisson equation (PPE) for a steady flow mimicking the blood flow through the human iliac artery. The velocity field needed to solve the pressure equation was obtained using particle image velocimetry (PIV). A steady flow rate of 46.9 ml/s was used, which corresponds to a Reynolds number of 188 and 595 at the inlet and stenosis throat, respectively (in the range of mean Reynolds number encountered in-vivo). In addition, computational fluid dynamics (CFD) simulation of the same flow was performed. Pressure drops across the stenosis predicted by PPE/PIV and CFD were compared with those measured by a pressure catheter transducer. RMS errors relative to the measurements were 17% and 10% for PPE/PIV and CFD, respectively.

AIM/OBJECTIVE:To compare the response of standard hepatitis B virus (HBV) vaccination between patients with chronic hepatitis C virus (HCV) infection and healthy individuals. METHODS:This is a prospective case-control study. A total of 38 patients with chronic HCV infection and 40 healthy controls were included. Vaccination was performed by injection of 20 microg recombinant HBsAg into the deltoid muscle at mo 0, 1 and 6. Anti-HBs concentration was determined 3 mo after the last dose and compared between the two groups. The response pattern was characterized as (1) high-response when the anti-HBs antibody titer was > 100 IU/L, (2) low-response when the titer was 10-100 IU/L and (3) no-response when the titer was < 10 IU/L. RESULTS:In the patient group, there were 10/38 (26.3%) non-responders, 8/38 (21.1%) low-responders and 20/38 (52.6%) high-responders. The corresponding values in the control group were 2/40 (5.0%), 7/40 (17.5%) and 31/40 (77.5%), respectively. The response pattern was statistically different between the two groups. In multivariate analysis, smoking was a significant confounder, while HCV infection lost its significant correlation with lower antibody response. CONCLUSION/CONCLUSIONS:Patients with chronic HCV infection tend to respond weakly to HBV vaccination compared to healthy individuals, though this correlation is not independent according to multivariate analysis.

The anxiety-related effects of noscapine were investigated using male Balb-c mice. Since noscapine-induced locomotion may alter the animals' activity level in the dark-light model, the anxiety-related effects of noscapine were studied at doses with no effect on locomotion (0.1, 0.2, 0.3, 0.4, 0.5, 0.8, 1, 1.5 and 2 mg/kg). The parameter measured in dark-light model was the time spent in lit compartment. Intraperitoneal administration of noscapine (0.1-0.5 mg/kg) did not produce a significant effect on the time spent in the light, whereas higher doses (0.8, 1, 1.5 and 2 mg/kg) increased it significantly, implying an anxiolytic effect.

A mathematical model using simple concepts of repeated games is proposed to model the course and prognosis of factitious disorders. Although simple, the model seems capable of explaining the yet unknown mechanisms underlying the variable course of factitious disorders. One of the notable results of this study is the significant effect of involved physicians in the treatment process on the course of the disease. Particularly, the doctor's error rate in realizing whether the symptoms are real or factitious can considerably affect the course of the disease. This is the first paper to apply a mathematical model to factitious disorders.

A nonlinear model of the atrioventricular (AV) node physiology in atrial fibrillation (AF) is proposed based on three assumptions: (1) normal distribution of atrial impulses, (2) right-skewed distribution of R-R intervals, (3) increase in the refractory period of the AV node due to rapid bombardment from the atria. Simulation resulted in the following conclusions, all of which are in agreement with previous experience: (1) the entry speed of atrial impulses into the AV node in AF is inversely proportional to the ventricular rate, (2) the autocorrelation function of R-R intervals is zero at all delays, (3) a newly introduced index, sign of first difference, has a negative autocorrelation function at the first delay and zero ones at all others. In spite of its simplicity, the model is able to explain what happens in atrial premature complexes, sinus tachycardia and sinus bradycardia. Different rhythms, some of which rarely seen clinically, can be reproduced by changing input patterns or by slightly manipulating the model parameters. In order to make possible a long irregular time series of R-R interval, aperiodic changes in atrial signals are shown to be necessary. In conclusion, we proposed a simple model for the AV node physiology capable of explaining the previously known facts about AF as well as predicting interesting properties of some other supraventricular arrhythmias.