Identification of Candida albicans and non-MRSA Staphylococcus aureus in free-living amoebae isolated from the hospital wards; an alarm for distribution of nosocomial infections via FLA

Free-living amoebae (FLA) are isolated from the hospital environments and known as Trojan horses for medical essential microorganisms. This study aimed to investigate the prevalence and the presence of FLA and two critical agents of nosocomial infections, in the hospital wards. Sixty samples were collected from four communities and cultured onto non-nutrient agar (NNA). After total DNA extraction, FLA were characterized using PCR and sequencing. The presence of Candida albicans and Staphylococcus aureus was evaluated using real-time and conventional PCR, respectively. Acanthamoeba sp. was characterized in 30 (50%) samples. Two (6.6%) and one (3.3%) samples were positive for Vahlkampfiidae and Vermamoeba vermiformis, respectively . S. aureus was detected in 13 (43.3%) of samples, while none of them were positive for methicillin-resistant gene. C. albicans DNA was detected in one (3.3%) FLA-positive sample. The isolation of FLA from hospital suggests an essential role these eukaryotes in the inter-ward circulation of nosocomial infections.

Molecular identification, phylogenetic analysis and histopathological study of pathogenic free-living amoebae isolated from discus fish (Symphysodon aequifasciatus) in Iran: 2020-2022

Free-living amoebae (FLA) are capable of inhabiting diverse reservoirs independently, without relying on a host organism, hence their designation as "free-living". The majority of amoebae that infect freshwater or marine fish are amphizoic, or free-living forms that may colonize fish under particular circumstances. Symphysodon aequifasciatus, commonly referred to as the discus, is widely recognized as a popular ornamental fish species. The primary objective of the present study was to determine the presence of pathogenic free-living amoebae (FLA) in samples of discus fish. Fish exhibiting clinical signs, sourced from various fish farms, were transferred to the ornamental fish clinic. The skin, gills, and intestinal mucosa of the fish were collected and subjected to culturing on plates containing a 1% non-nutrient agar medium. The detection of FLA was conducted through morphological, histopathological and molecular methods. The construction of the phylogenetic tree for Acanthamoeba genotypes was achieved using the maximum likelihood approach. The molecular sequence analysis revealed that all cultures that tested positive for FLA were T4 genotype of Acanthamoeba and Acanthamoeba sp. The examination of gill samples using histopathological methods demonstrated the presence of lamellar epithelial hyperplasia, significant fusion of secondary lamellae, and infiltration of inflammatory cells. A multitude of cysts, varying in shape from circular to elliptical, were observed within the gills. The occurrence of interlamellar vesicles and amoeboid organisms could be observed within the epithelial tissue of the gills. In the current study, presence of the Acanthamoeba T4 genotype on the skin and gills of discus fish exhibiting signs of illness in freshwater ornamental fish farms was identified. This observation suggests the potential of a transmission of amoebic infection from ornamental fish to humans, thereby highlighting the need for further investigation into this infection among ornamental fish maintained as pets, as well as individuals who interact with them and their environment.

Contamination of fresh vegetables in municipal stores with pathogenic Acanthamoeba genotypes; a public health concern

Acanthamoeba spp. cause keratitis and encephalitis, and are a proper carrier of foodborne pathogens. A total of 70 samples including garden cress, chives, mint, parsley, and basil were collected. Samples were cultured onto a 2% non-nutrient agar medium. The cultures were analyzed using morphological and molecular techniques. In total, 18 (25.7%) out of 70 samples were positive including garden cress 10/22 (45.45%), chives 3/12 (25%), mint 2/13 (15.38%), basil 2/13 (15.38%), and parsley 1/10 (10%). The diagnostic fragment 3 was successfully sequenced in 15 samples and represented 11 (73.3%) T4, three (20%) T5, and one T9 genotypes. In addition, three, two, and one strains, belonging to the genotypes T4, T5, and T9 were ranked highly pathogenic. This is the first study reporting contamination of the most commonly consumed fresh vegetables with pathogenic Acanthamoeba genotypes. Our findings signify the public health concerns due the contamination of vegetables in municipal public markets.

Isolation and genotyping of Acanthamoeba species and Vahlkampfiidae in the harsh environmental conditions in the centre of Iran

Different species of free-living amoeba (FLA) have been abundantly isolated in harsh environmental conditions such as hot springs and brackish water. The present study aimed to isolate, genotype, and evaluate the pathogenicity of FLAs in Qom Roud, a large river, in the centre of Iran. About 500 mL of water samples (n = 30) were collected from each sampling site and were investigated for the presence of FLAs using morphological and molecular characters. Genotype identification was performed using DNA sequencing and a phylogenetic tree was constructed with the MEGA X software. The pathogenic potential of all positive isolates was evaluated using the tolerance ability test. Morphological and molecular analysis indicated that 14 (46.66%) and two (6.66%) water samples were positive for Acanthamoeba species and Vahlkampfiidae, respectively. According to sequence analysis, Acanthamoeba isolates related to the T4 genotype and Vahlkampfiidae sequences were similar to Naegleria philippinensis. In the next step, thermo- and osmotolerance tests indicated four Acanthamoeba strains are extremely pathogenic. Our data showed the presence of potentially pathogenic Acanthamoeba T4 genotype and N. philippinensis in the super harsh Qom Roud. Contamination of water with virulent T4 genotype of Acanthamoeba may pose risk factors for contact lens users, children, and immunocompromised people.

A Comparative Morphometric Study on Odontobuthus bidentatus and Odontobuthus doriae (Scorpionida: Buthidae) in Iran

Scorpions are one of the most venomous animals which cause serious public health problems. The sting of scorpions can sometimes be fatal depending on the scorpion species involved. So far, sixty-six (66) scorpion species have been identified in Iran. Annually, about 40-50000 cases of scorpionism are reported in Iran. Odontobuthus doriae and O. bidentatus are among the most medically important scorpion species in Iran, and they are very similar to each other in coloration, carination, and trichobotrial patterns. This morphometric study aimed to compare some of the important morphological characteristics in order to identify the key differences between these two species. A total of 45 morphological characters were measured using calipers and stereomicroscope, and 55 morphological characters and ratios (relative of length to width ratio of morphological characters of scorpions) were analyzed. The independent sample t-test in SPSS software (version 24) was used for the statistical analyses in this study. The mean total length, carapace width, length of fixed and moveable fingers, and chelicerae length of O. doriae were greater than those of O. bidentatus in our study area. The morphological measurements displayed a clear distinction between O. doriae and O. bidentatus in our study area; therefore, they can be used as morphological identification keys for distinguishing between these two species.

Isolation and identification of potentially pathogenic free-living amoeba in drinking, surface, and stagnant water sources from Alborz Province, Iran

Free-living amoebas (FLAs) can cause neurological and ocular complications in humans. Water supplies play a critical role in transmitting FLAs to humans. The aim of the present study was to investigate the presence of FLAs in various aquatic sources including drinking water, stagnant water, and surface water in Alborz province, northern Iran, using morphological and molecular techniques. A total of 70 water samples were collected from 34 drinking waters, 23 surface waters, and 13 stagnant waters. Filtration and cultivation were employed to isolate FLAs. PCR assay was applied by using the genus-specific primers on positive samples. Pathogenicity tests (osmo- and thermo-tolerance properties) were performed for Acanthamoeba spp., positive sample. Considering the morphological criteria, four positive samples of Acanthamoeba sp., three Vermamoeba sp., two mixed Vermamoeba sp. with Vahlkamfiids, and one mixed Acanthamoeba sp. with Vahlkamfiids were isolated. Five Acanthamoeba sp. isolates were amplified using the JDP primer pairs. Among them, two genotypes, T4 (three isolates) and T5 (two isolates) corresponding to A. lenticulata, were identified. Four V. vermiformis samples were confirmed using the sequencing. This study highlighted the occurrence of potentially pathogenic waterborne FLAs in water habitats associated with high human activity. The results of such research on the prevalence of FLAs, as a human hazard, should be communicated to health policymakers.

Molecular Identification of Pathogenic Free-Living Amoeba from Household Biofilm Samples in Iran: A Risk Factor for Acanthamoeba Keratitis

Free-living amoeba (FLA) are ubiquitously distributed in the environment. However, they are also the causative agents of opportunistic infections in humans and other animals. A biofilm comprises any syntrophic consortium of microorganisms in which cells stick to each other and often also to a surface. Moreover, FLA have been detected in various biofilms around the world. Therefore, the present study aimed to check for presence of FLA in samples from household biofilms in Iran and to characterize them at the molecular level. A total of 69 biofilm samples collected from showerheads, kitchen areas, and bathroom sinks were analyzed. Positive samples for FLA were characterized at the morphological and molecular levels. Furthermore, the results of morphology analysis indicated that 26.08% (18/69) of biofilm samples were positive for Acanthamoeba spp., Vermamoeba genus, and Vahlkampfiids. According to sequence analysis, five strains of Acanthamoeba isolates related to the T4 genotype and two strains belonged to the T2 genotype. In addition, the pathogenic potential of Acanthamoeba-positive isolates was conducted using the tolerance ability test. The results of BLASTn of Vermamoeba sequences were similar to what was expected for Vermamoeba vermiformis. The above-mentioned reasons revealed that the relative high contamination of household biofilm samples with FLA may pose a risk for people using soft contact lenses and for patients with traumatic cataract. Our finding proposes that filtration should be performed in shower heads and indicates the need to monitor people at increased risk of Acanthamoeba keratitis.

Ultrasound elastography using a regularized modified error in constitutive equations (MECE) approach: a comprehensive phantom study

Many of the current techniques in transient elastography, such as shear wave elastography (SWE) assume a dominant planar shear wave propagating in an infinite medium. This underlying assumption, however, can be easily violated in real scenarios in vivo, leading to image artifacts and reconstruction errors. Other approaches that are not bound to planar shear wave assumption, such solutions based on the partial differential equation, can potentially overcome the shortcomings of the conventional SWE. The main objective of this paper is to demonstrate the advantages of the modified error in constitutive equations (MECE) formulation with total variation regularization (MECE + TV) over SWE in reconstructing the elastic moduli of different tissue-mimicking phantoms. Experiments were conducted on phantoms with inclusions of well-defined shapes to study the reconstruction of specific features relevant to practical applications. We compared the performances of MECE + TV and SWE in terms of quantitative metrics to estimate reconstruction accuracy, inclusion shape recovery, edge preservation and edge sharpness, inclusion size representation, and shear elasticity and contrast accuracies. The results indicate that the MECE + TV approach outperforms SWE based on several of these metrics. It is concluded that, with further development, the proposed method may offer elastography reconstructions that are superior to SWE in clinical applications.

Study on the reaction mechanism and kinetics of CO hydrogenation on a fused Fe–Mn catalyst

The kinetics of the CO hydrogenation reaction over a Fe–Mn fused catalyst was investigated in a fixed-bed micro-reactor.

Registration of Vibro-acoustography Images and X-ray Mammography

Image registration has been widely used for generating more diagnostic and clinical values in medical imaging. On the other hand, inaccurate image registration and incorrect localization of region of interest risks a potential impact on patients. Vibro-acoustography (VA) is a new imaging modality that has been applied to both medical and industrial imaging. Combining unique diagnostic information of VA with other medical imaging is one of our research interests. In this work, we studied the VA and x-ray image pairs and adopted a flexible control-point selection technique for image registration. A modified second-order polynomial, which leads to a scale/rotation/translation invariant registration, was used. The results of registration were used to spatially transform the breast VA images to map with the x-ray mammography with a registration error of less than 1.65 mm. These two completely different modalities were combined to generate an image including a ratio of each image pixel value. Therefore, the proposed technique allows clinicians to maximize their insight by combining the information from x-ray mammogram and VA modalities into a single image.

Integration of vibro-acoustography imaging modality with the traditional mammography

Vibro-acoustography (VA) is a new imaging modality that has been applied to both medical and industrial imaging. Integrating unique diagnostic information of VA with other medical imaging is one of our research interests. In this work, we establish correspondence between the VA images and traditional X-ray mammogram by adopting a flexible control-point selection technique for image registration. A modified second-order polynomial, which simply leads to a scale/rotation/translation invariant registration, was used. The results of registration were used to spatially transform the breast VA images to map with the X-ray mammography with a registration error of less than 1.65 mm. The fused image is defined as a linear integration of the VA and X-ray images. Moreover, a color-based fusion technique was employed to integrate the images for better visualization of structural information.

Shear wave dispersion ultrasonic vibrometry for measuring prostate shear stiffness and viscosity: an in vitro pilot study

This paper reports shear stiffness and viscosity "virtual biopsy" measurements of the three excised noncancerous human prostates using a new tool known as shear wave dispersion ultrasound vibrometry (SDUV) in vitro. Improved methods for prostate guided-biopsy are required to effectively guide needle biopsy to the suspected site. In addition, tissue stiffness measurement helps in identifying a suspected site to perform biopsy because stiffness has been shown to correlate with pathologies, such as cancerous tissue. More importantly, early detection of prostate cancer may guide minimally invasive therapy and eliminate insidious procedures. In this paper, "virtual biopsies" were taken in multiple locations in three excised prostates; SDUV shear elasticity and viscosity measurements were performed at the selected "suspicious" locations within the prostates. SDUV measurements of prostate elasticity and viscosity are generally in agreement with preliminary values previously reported in the literature. It is, however, important to emphasize here that the obtained viscoelastic parameters values are local, and not a mean value for the whole prostate.

Vibro-acoustography imaging of permanent prostate brachytherapy seeds in an excised human prostate--preliminary results and technical feasibility

OBJECTIVE

The objective in this work is to investigate the feasibility of using a new imaging tool called vibro-acoustography (VA) as a means of permanent prostate brachytherapy (PPB) seed localization to facilitate post-implant dosimetry (PID).

METHODS AND MATERIALS

Twelve OncoSeed (standard) and eleven EchoSeed (echogenic) dummy seeds were implanted in a human cadaver prostate. Seventeen seeds remained after radical retropubic prostatectomy. VA imaging was conducted on the prostate that was cast in a gel phantom and placed in a tank of degassed water. 2-D magnitude and phase VA image slices were obtained at different depths within the prostate showing location and orientation of the seeds.

RESULTS

VA demonstrates that twelve of seventeen (71%) seeds implanted were visible in the VA image, and the remainder were obscured by intra-prostatic calcifications. Moreover, it is shown here that VA is capable of imaging and locating PPB seeds within the prostate independent of seed orientation, and the resulting images are speckle free.

CONCLUSION

The results presented in this research show that VA allows seed detection within a human prostate regardless of their orientation, as well as imaging intra-prostatic calcifications.

In vitro comparative study of vibro-acoustography versus pulse-echo ultrasound in imaging permanent prostate brachytherapy seeds

BACKGROUND

Permanent prostate brachytherapy (PPB) is a common treatment for early stage prostate cancer. While the modern approach using trans-rectal ultrasound guidance has demonstrated excellent outcome, the efficacy of PPB depends on achieving complete radiation dose coverage of the prostate by obtaining a proper radiation source (seed) distribution. Currently, brachytherapy seed placement is guided by trans-rectal ultrasound imaging and fluoroscopy. A significant percentage of seeds are not detected by trans-rectal ultrasound because certain seed orientations are invisible making accurate intra-operative feedback of radiation dosimetry very difficult, if not impossible. Therefore, intra-operative correction of suboptimal seed distributions cannot easily be done with current methods. Vibro-acoustography (VA) is an imaging modality that is capable of imaging solids at any orientation, and the resulting images are speckle free.

OBJECTIVE AND METHODS

The purpose of this study is to compare the capabilities of VA and pulse-echo ultrasound in imaging PPB seeds at various angles and show the sensitivity of detection to seed orientation. In the VA experiment, two intersecting ultrasound beams driven at f(1)=3.00 MHz and f(2)=3.020 MHz respectively were focused on the seeds attached to a latex membrane while the amplitude of the acoustic emission produced at the difference frequency 20 kHz was detected by a low frequency hydrophone.

RESULTS

Finite element simulations and results of experiments conducted under well-controlled conditions in a water tank on a series of seeds indicate that the seeds can be detected at any orientation with VA, whereas pulse-echo ultrasound is very sensitive to the seed orientation.

CONCLUSION

It is concluded that vibro-acoustography is superior to pulse-echo ultrasound for detection of PPB seeds.

Continuous-wave ultrasound reflectometry for surface roughness imaging applications

BACKGROUND

Measurement of surface roughness irregularities that result from various sources such as manufacturing processes, surface damage, and corrosion, is an important indicator of product quality for many nondestructive testing (NDT) industries. Many techniques exist, however because of their qualitative, time-consuming and direct-contact modes, it is of some importance to work out new experimental methods and efficient tools for quantitative estimation of surface roughness.

OBJECTIVE AND METHOD

Here we present continuous-wave ultrasound reflectometry (CWUR) as a novel nondestructive modality for imaging and measuring surface roughness in a non-contact mode. In CWUR, voltage variations due to phase shifts in the reflected ultrasound waves are recorded and processed to form an image of surface roughness.

RESULTS

An acrylic test block with surface irregularities ranging from 4.22 microm to 19.05 microm as measured by a coordinate measuring machine (CMM), is scanned by an ultrasound transducer having a diameter of 45 mm, a focal distance of 70 mm, and a central frequency of 3 MHz. It is shown that CWUR technique gives very good agreement with the results obtained through CMM inasmuch as the maximum average percent error is around 11.5%.

CONCLUSION

Images obtained here demonstrate that CWUR may be used as a powerful non-contact and quantitative tool for nondestructive inspection and imaging of surface irregularities at the micron-size level with an average error of less than 11.5%.

A combined parabolic-integral equation approach to the acoustic simulation of vibro-acoustic imaging

This paper aims to model ultrasound vibro-acoustography to improve our understanding of the underlying physics of the technique thus facilitating the collection of better images. Ultrasound vibro-acoustography is a novel imaging technique combining the resolution of high-frequency imaging with the clean (speckle-free) images obtained with lower frequency techniques. The challenge in modeling such an experiment is in the variety of scales important to the final image. In contrast to other approaches for modeling such problems, we break the experiment into three parts: high-frequency propagation, non-linear interaction and the propagation of the low-frequency acoustic emission. We then apply different modeling strategies to each part. For the high-frequency propagation we choose a parabolic approximation as the field has a strong preferred direction and small propagation angles. The non-linear interaction is calculated directly with Fourier methods for computing derivatives. Because of the low-frequency omnidirectional nature of the acoustic emission field and the piecewise constant medium we model the low-frequency field with a surface integral approach. We use our model to compare with experimental data and to visualize the relevant fields at points in the experiment where laboratory data is difficult to collect, in particular the source of the low-frequency field. To simulate experimental conditions we perform the simulations with the two frequencies 3 and 3.05 MHz with an inclusion of varying velocity submerged in water.

Development and characterization of microsatellite markers for lippia (Phyla canescens: Verbenaceae)

Lippia (Phyla canescens: Verbenaceae) is a serious weed of wetlands, riparian zones and floodplains, particularly in eastern Australia where many Ramsar wetlands are threatened by hydrological changes precipitated by soil-accreting lippia mats. Enriched genomic DNA libraries were used to develop nine informative microsatellite markers. These markers will be valuable tools to understand the genetic structure of the lippia populations in different regions throughout the world.

Investigating the absolute phase information in acoustic wave resonance scattering

The aim of this work is to investigate the absolute phase information in resonance acoustic scattering by spheres and cylinders and place this work in the broader context of scattering in which the properties of the magnitude and (processed) phase have been examined in a more general way than in the classical resonance scattering theory (RST). Here, comparisons are made between the classical and modified RST formalisms of acoustic resonance scattering. Experimental and theoretical backscattering form functions are obtained and discussed. It is shown that the magnitude and processed (unwrapped) phase can be correctly obtained through the classical RST, suggesting that the modified RST formalism offers little new practical advantage. Furthermore, the absolute phase is shown to be very sensitive to object's resonances, suggesting that the unwrapped phase may be considered as an efficient tool, along with the magnitude information, to carry out remote (active) classification of targets in underwater acoustics applications. The combination of absolute phase information with the magnitude data offers a complementary advantage in the identification of resonances from cylinders and spheres.

Fusion of vibro-acoustography images and X-ray mammography

Image fusion, or combination of two images obtained by different techniques, has been widely used in medical imaging. Vibro-acoustography (VA) is a new imaging modality that has been applied to both medical and industrial imaging. Combining unique diagnostic information of VA with other medical imaging is one of our research interests. In this work, we studied the VA and X-ray image pairs and adopted two methods for fusing the registered VA and X-ray image. In the first method, the fused image is defined as a linear combination of the VA and X-ray images. Moreover, a color-based fusion technique was employed to combine the images for better visualization of structural information. By combining the information from X-ray mammogram and VA modalities into a single image, the accuracy of mammography interpretation which is important for women's health can be increased.

Prospective evaluation of an educational programme for physicians involved in the management of syncope

AIM

Management of patients (pts) presenting syncope diverges markedly from the guidelines of the European Society of Cardiology (ESC). To improve this management, the easiest option seemed to be to educate physicians. The aim of the study was to evaluate the impact of an educational process on the use of unnecessary neurological investigations.

METHODS AND RESULTS

Charts of pts presenting syncope during two 12-month periods (1999-2000 and 2002-2003) to the emergency department were systematically reviewed. Between the two periods, all physicians in charge of pts with syncope attended educational meetings. During these meetings recommendations of the ESC were presented with a special emphasis on the uselessness of neurological investigations. Four hundred and fifty-four pts (1.2%) presented to the emergency department for syncope during study period 1, and 524 (1.3%) during study period 2. Nineteen of the 169 pts (11%) directly discharged from the emergency department, had neurological investigations during study period 1 and 22 of the 279 (8%) during study period 2 (NS). In pts who were hospitalized, 48% had neurological investigations in groups 1 and 2.

CONCLUSION

Education of physicians in charge of patients with syncope is inadequate to improve the cost effectiveness of the management of these patients.

Chirp imaging vibro-acoustography for removing the ultrasound standing wave artifact

Vibro-acoustography (VA) is an imaging technique that uses the dynamic (oscillatory) radiation force of two continuous-wave (CW) ultrasound to image objects at low frequency (within the kHz range). In this technique, the dynamic radiation force is created by means of a confocused transducer emitting two ultrasound beams at slightly-shifted frequencies f1 and f2 = f1 + deltaf. It has been demonstrated previously that high-resolution images of various types of inclusions and tissues can be obtained using this technique. However, if the targeted object reflects ultrasound directly back to the transducer, standing waves are produced that result in an artifact in the VA image. The goal of this study is to remove the standing wave artifact and improve VA images by means of a new process called chirp imaging. The procedure consists of sweeping the frequencies of the primary ultrasound beams in a selected bandwidth while keeping deltaf constant during the sweep. The chirp image is produced by averaging the amplitude of the acoustic emission produced during the sweep. Vibro-acoustography chirp imaging experiments are performed on a stainless-steel sphere attached to a latex sheet in a tank of degassed water. The resulting chirp images demonstrate remarkable reduction of the standing wave artifact compared to the "fixed frequency" VA images.

Dynamic acoustic radiation force acting on cylindrical shells: theory and simulations

An object placed in an acoustic field is known to experience a force due to the transfer of momentum from the wave to the object itself. This force is known to be steady when the incident field is considered to be continuous with constant amplitude. One may define the dynamic (oscillatory) radiation force for a continuous wave-field whose intensity varies slowly with time. This paper extends the theory of the dynamic acoustic radiation force resulting from an amplitude-modulated progressive plane wave-field incident on solid cylinders to the case of solid cylindrical shells with particular emphasis on their thickness and contents of their hollow regions. A new factor corresponding to the dynamic radiation force is defined as Y(d) and stands for the dynamic radiation force per unit energy density and unit cross sectional surface. The results of numerical calculations are presented, indicating the ways in which the form of the dynamic radiation force function curves are affected by variations in the material mechanical parameters and by changes in the interior fluid inside the shell's hollow region. It was shown that the dynamic radiation force function Y(d) deviates from the static radiation force function for progressive waves Y(p) when the modulation frequency increases. These results indicate that the theory presented here is broader than the existing theory on cylinders.

Absolute measurement of lattice parameter in single crystals and epitaxic layers on a double-crystal X-ray diffractometer

Details of the recently developed 'zone technique' for the absolute measurement of lattice parameter and strain in single-crystal solids and thin films are presented. The method is based on measuring X-ray rocking curves from a few equatorial planes within a suitable zone and correcting their peak positions at once with a single zero offset. In contrast to the comparative method, which usually requires use of two opposite azimuthal directions, those in the zone technique can often be completed in only one azimuthal setting. A typical strained layer in the cubic system can be fully and rapidly characterized with only three rocking curves. The technique is suitable for routine applications under typical laboratory conditions, and for high-precision measurements of nearly perfect crystals in a controlled environment, with a potential parts in 10 million accuracy. This degree of accuracy is a direct consequence of the zero offset correction procedure, which effectively cancels a large portion of the misalignment errors in the diffractometer. The use of the (n, -n) geometry substantially reduces the errors of eccentricity compared to the Bond technique, and its stronger reflections enable the measurement of small samples about 0.05 mm in length with relative ease. The technique is illustrated with examples, and its extension to the triple-axis (omega-2theta) instruments is discussed.

[A multicentre trial of the diagnostic value and cost of electrocardiography in symptoms suggesting arrhythmia with a new event recorder with transtelephonic transmission]

Events recorders are used for electrocardiographic documentation of symptoms of arrhythmia too sporadic and short lasting to be recorded by 24 hour Holter monitoring. However, there are no French studies comparing the value and cost of event recorders with conventional diagnostic methods. Recently, a new telediagnostic device has become available in France leading to an assessment of the technique. The aim of this study was to determine the value of this event recorder and the cost of diagnostic ECG in the assessment of presumed arrhythmic symptoms such as palpitations or rare tachycardia (<3 episodes per week) of short duration, compared with conventional techniques. Fifty-eight patients with these criteria were randomised, 30 to Survcard (Group I) and 28 to conventional diagnostic methods (Group II). The patients were comparable with respect to age, sex distribution, type of symptoms and associated cardiac disease. The ECG diagnosis of the symptoms was established in 20 cases (66.6%) of patients in Group I in 17 +/- 16 days, and in 14 cases (50.0%) of Group II in 23 +/- 28 days. The difference between the two groups was not statistically significant. The cost of a positive diagnosis for Group I (Survcard) varied from 0 to 228.47 Euro with an average of 71.22 +/- 117.02 Euro. The cost of positive diagnosis in Group II varied from 76.80 to 2340.41 Euro with an average of 480.39 +/- 797.41 Euro. In conclusion, this study showed that the percentage of patients with a positive diagnosis was comparable in the two groups but that the cost was 6 times higher in the group investigated by conventional methods than in the Survcard group because of more costly medical intervention.

Short and long-term single-centre experience with an S-shaped unipolar lead for left ventricular pacing

Left ventricular-based pacing is an established method for treatment of congestive heart failure in patients with ventricular dyssynchrony. The transvenous epicardial approach is the method of choice to pace the left ventricle.

AIMS

To evaluate short and long-term stability and pacing and sensing performance of an S-shaped non-steroid unipolar lead.

METHODS

Forty-eight procedures were performed in 43 consecutive patients (mean age: 70+/-8 years, 32 males) with severe congestive heart failure. The left ventricular lead was placed into a coronary sinus tributary. Pacing and sensing thresholds and pacing impedance were measured at implant, 1 and 6 months.

RESULTS

The mean procedure time was 90.0+/-35.5 min. Pacing thresholds at implant, 1 and 6 months were 1.1+/-0.8 V, 1.9+/-1.3 V and 1.9+/-1.5 V respectively. In 7 patients, lead implantation was unsuccessful. One of them had a successful second attempt. Lead revision was performed in 5 patients for loss of capture.

CONCLUSION

The S-shaped unipolar lead evaluated in this study provides stable long-term position and pacing thresholds. Recent improvement of this S-shaped lead model will hopefully reduce the rate of implantation failures and acute dislodgements.

Noncontact ultrasound stimulated optical vibrometry study of coupled vibration of arterial tubes in fluids

Coupled vibration of arterial tubes is analyzed with the wave propagation approach and first-order shear deformation theory. Both the interior and exterior fluids are considered as compressible so that acoustic waves can be generated and propagated in the fluids. Results obtained using the theory have been evaluated against those available in the literature and the agreement has been found to be good. The theory can be used for future research on the vibration and acoustics of arterial walls. Vibration experiments were carried out on a silicone rubber tube in a water tank with a novel ultrasound stimulated optical vibrometry system. This system uses the radiation force of ultrasound to vibrate the tube at low frequency and records the resulting response by a laser vibrometer. Both the excitation and measurement are remote and noncontact. The silicone rubber tube was chosen because it has mechanical properties close to those of arteries. The fundamental frequency is well excited by the radiation force and measured with the laser. The measured fundamental frequency is in good agreement with the present theory.

Stent implantation for the treatment of superior vena cava syndrome related to pacemaker leads

This is a case-report of two patients with superior vena cava syndrome related to pacemaker leads. Both patients were treated successfully using intravenous stenting.