Disorder-to-order transition of long fibers contained in evaporating sessile drops

A liquid drop containing a long fiber is a complex system whose configuration is determined by an interplay of elastic stresses in the fiber and capillary forces due to the liquid. We study the morphological evolution of fibers that are much longer than the drop diameter in evaporating sessile drops. After insertion, the fibers are either found in an ordered or disordered state, with increasing disorder for increasing fiber length. Upon evaporation, the order increases, in such a way that the final configuration deposited on the solid surface is either a circle, an ellipse, or 8-shaped. The morphology of the deposit depends on the fiber length and the elastocapillary length, both non-dimensionalized with the characteristic drop size, which we classify in a morphology regime map. The disorder-to-order transition allows depositing ordered fiber structures on solid surfaces even in cases of a strongly disordered state after fiber insertion. Combined with technologies such as inkjet printing, this process could open new avenues to decorate surfaces with filamental structures whose morphology can be controlled by varying the fiber length.

Recommendations for return to sports after total hip arthroplasty are becoming less restrictive as implants improve

INTRODUCTION

Total hip arthroplasty (THA) surgeries are expected to exponentially increase in the upcoming years, likely because of the overall broader indication of THAs. With these developments, an increasing number of younger (< 50 years) and active patients will receive surgical interventions, and expectations for an active lifestyle will accordingly increase. In addition, surgeons now have a growing array of techniques and implant materials to choose from. Despite these developments, evidence to provide the best standard-of-care to patients with high expectations for return to sports (RTS) is scarce and urgently needed. What recommendations do arthroplasty surgeons currently make to patients with high return to sports expectations, what factors may influence their recommendations and what surgical techniques and implant specifications are considered favorable in the treatment of patients with a more active lifestyle? This study was conducted to analyze the current recommendations, patient assessment, and patient counseling after THA to identify trends and relevant factors for surgical decision-making in patients with high-RTS expectations.

MATERIAL AND METHODS

We designed a questionnaire comprising five general items and 19 specific items that included 46 sub-items for hip arthroplasty and conducted a survey among 300 German surgeons specialized in arthroplasty at the German Arthroplasty Society (AE) to assess expert opinions, recommendations, surgical decision-making, and patient counseling for patients with high expectations for RTS after THA.

RESULTS

The majority of surgeons (81.9%) were in favor of RTS after THA. Risks associated with sports after THA were considered minimal (1%), with periprosthetic fractures ranking highest, followed by hip dislocation and polyethylene wear. Some surgical decision-making was influenced by high-RTS expectations in regard to implant fixation, stem type, femoral head diameter, and bearing-surface tribology. We observed an increasingly liberal counseling of patients for high-impact sports.

CONCLUSION

With the improvement of implants and surgical techniques, surgeons are more willing to encourage patients to adopt a more active lifestyle. However, the true long-term limitations need further investigation in future studies.

LEVEL OF EVIDENCE

5 Expert opinions.

Protein Transport and Concentration by Electrophoresis in Two-phase Microflows

This work aims at a new class of methods for electric field-mediated separation of biomolecules. In contrast to standard techniques, electrophoretic transport was not performed in a single-phase homogenous fluid, but in a system of stratified layers. The large surface-to-volume ratio characteristic for microfluidic systems allows the interactions of biomolecules with liquid/liquid interfaces to be examined and the suitability of corresponding effects for applications in the field of biomolecular separations and enrichment to be assessed. To perform these types of studies, a micro flow cell was fabricated into which two coflowing immiscible liquid phases can be introduced. Subsequently, the electrophoretic transport of biomolecules driven by an electric field perpendicular to the channel was examined.

To investigate the transport phenomena related to electrophoresis in stratified two-phase systems, aqueous solutions consisting of polyethylene glycol and dextran were prepared, which allowed a stable interface to develop. Transport within one phase and an enrichment of proteins at the phase boundary has been established. In addition, other kinds of fluid combinations such as water and propylene carbonate have been examined, also supporting the enrichment of proteins at the phase boundary.

Isotachophoresis with emulsions

An experimental study on isotachophoresis (ITP) in which an emulsion is used as leading electrolyte (LE) is reported. The study aims at giving an overview about the transport and flow phenomena occurring in that context. Generally, it is observed that the oil droplets initially dispersed in the LE are collected at the ITP transition zone and advected along with it. The detailed behavior at the transition zone depends on whether or not surfactants (polyvinylpyrrolidon, PVP) are added to the electrolytes. In a system without surfactants, coalescence is observed between the droplets collected at the ITP transition zone. After having achieved a certain size, the droplets merge with the channel walls, leaving an oil film behind. In systems with PVP, coalescence is largely suppressed and no merging of droplets with the channel walls is observed. Instead, at the ITP transition zone, a droplet agglomerate of increasing size is formed. In the initial stages of the ITP experiments, two counter rotating vortices are formed inside the terminating electrolyte. The vortex formation is qualitatively explained based on a hydrodynamic instability triggered by fluctuations of the number density of oil droplets.

Liquefaction necrosis of mitral annulus calcification in a patient with chronic renal failure: an unrecognized diagnosis

Mitral annulus calcification is one of the most common cardiac calcifications. In patients with end-stage renal disease undergoing echocardiography, it can be detected in more than 40%. A specific form of mitral annulus calcification is liquefaction necrosis. It is often not adequately recognized by echocardiographers or clinicians and can be mistaken for cardiac tumor or infective vegetation. Here we report a case of liquefaction necrosis of mitral annulus calcification, mimicking an infective vegetation of the mitral valve apparatus in a patient with chronic renal failure.

Electrophoretic partitioning of proteins in two-phase microflows

This work reports on protein transport phenomena discovered in partitioning experiments with a novel setup for continuous-flow two-phase electrophoresis consisting of a microchannel in which a phase boundary is formed in flow direction. Proteins can be partitioned exploiting their affinity to different aqueous phases in two-phase systems. This separation process may be enhanced or extended by applying an electric field perpendicular to the phase boundary. In this context, microsystems offer new possibilities, as interfacial forces usually dominate over volume forces, thus allowing a superior control of the formation and arrangement of liquid/liquid phase boundaries. The two immiscible phases which are injected separately into the microchannel are taken from a polyethylene glycol (PEG)-dextran system. The side walls of the channel are partially made of gel material which serves as an ion conductor and decouples the channel from the electrodes, thus preventing bubble generation inside the separation channel. The experiments show that the electrophoretic transport of proteins between the laminated liquid phases is characterized by a strong asymmetry. When bovine serum albumin (BSA) is introduced into the PEG-rich phase, it can easily be transferred into the dextran-rich phase via an applied electric field of low strength or just by diffusion. In the reverse case, up to a certain field strength the transfer to the opposing phase is strongly inhibited. Only if the field strength is further increased will the BSA molecules leave the dextran-rich phase almost completely.

Electroosmotic flow patterning using microfluidic delay loops

A theoretical and experimental investigation of alternating electroosmotic flow patterns by means of specially designed delay loops is presented. Using elementary methods of compact network modeling and detailed FEM simulations the flow behavior and, in particular, the rearrangement of sample plugs is modeled. The proposed designs rely on flow splitting in combination with electroosmotic delay loops leading to a runtime difference or phase shift between two sub-streams. Due to this phase shift, a new fluid interface is generated at the merging point. The approach is experimentally validated by injection of a Rhodamine 6G solution into an aqueous sodium tetraborate buffer.

Real-time contrast-enhanced sonography of renal transplant recipients predicts chronic allograft nephropathy

Real-time contrast-enhanced sonography (RT-CES) can assess microvascular tissue perfusion using gas-filled microbubbles. The study was performed to evaluate the feasibility of RT-CES in detecting chronic allograft nephropathy (CAN) in comparison to color Doppler ultrasonography (CDUS). A total of 26 consecutive renal transplant recipients were prospectively studied using RT-CES and conventional CDUS. Transplant tissue perfusion imaging was performed by low-power imaging during i.v. administration of the sonocontrast Optison. Renal tissue perfusion was assessed quantitatively using flash replenishment kinetics of microbubbles to estimate renal blood flow A *beta (A = peak signal intensity, beta= slope of signal intensity rise). In contrast to conventional CDUS resistance and pulsatility indices, renal blood flow estimated by CES was highly significant related to S-creatinine (r =-0.62, p = 0.0004). Determination of renal blood flow by CES reached a higher sensitivity (91% vs. 82%, p < 0.05), specificity (82% vs. 64%, p < 0.05) and accuracy (85% vs. 73%, p < 0.05) for the diagnosis of CAN as compared to conventional CDUS resistance indices. Perfusion parameters derived from RT-CES significantly improve the early detection of CAN compared to conventional CDUS. RT-CES using low-power real-time perfusion imaging is a feasible method to evaluate microvascular perfusion in renal allograft recipients.

Usefulness of myocardial parametric imaging to evaluate myocardial viability in experimental and in clinical studies

OBJECTIVE

To evaluate whether myocardial parametric imaging (MPI) is superior to visual assessment for the evaluation of myocardial viability.

METHODS AND RESULTS

Myocardial contrast echocardiography (MCE) was assessed in 11 pigs before, during, and after left anterior descending coronary artery occlusion and in 32 patients with ischaemic heart disease by using intravenous SonoVue administration. In experimental studies perfusion defect area assessment by MPI was compared with visually guided perfusion defect planimetry. Histological assessment of necrotic tissue was the standard reference. In clinical studies viability was assessed on a segmental level by (1) visual analysis of myocardial opacification; (2) quantitative estimation of myocardial blood flow in regions of interest; and (3) MPI. Functional recovery between three and six months after revascularisation was the standard reference. In experimental studies, compared with visually guided perfusion defect planimetry, planimetric assessment of infarct size by MPI correlated more significantly with histology (r2 = 0.92 versus r2 = 0.56) and had a lower intraobserver variability (4% v 15%, p < 0.05). In clinical studies, MPI had higher specificity (66% v 43%, p < 0.05) than visual MCE and good accuracy (81%) for viability detection. It was less time consuming (3.4 (1.6) v 9.2 (2.4) minutes per image, p < 0.05) than quantitative blood flow estimation by regions of interest and increased the agreement between observers interpreting myocardial perfusion (kappa = 0.87 v kappa = 0.75, p < 0.05).

CONCLUSION

MPI is useful for the evaluation of myocardial viability both in animals and in patients. It is less time consuming than quantification analysis by regions of interest and less observer dependent than visual analysis. Thus, strategies incorporating this technique may be valuable for the evaluation of myocardial viability in clinical routine.

Real-time myocardial contrast echocardiography for the detection of stress-induced myocardial ischemia. Comparison with 99mTc-sestamibi single photon emission computed tomography

BACKGROUND

Real-time contrast echocardiography (MCE) is a new promising technique for assessing myocardial perfusion. The purpose of this study was to test whether realtime MCE can be used to detect functionally significant coronary artery stenosis in patients with known or suspected coronary artery disease. Myocardial contrast echocardiographic studies were compared with nearly simultaneous 99mTc-sestamibi single photon emission computed tomography (SPECT) as a clinical standard reference to evaluate regional myocardial perfusion defects.

METHODS

Real-time MCE based on continuous infusion of Optison (8-10 ml/h) was performed in 66 patients during standard 99mTc-SPECT dipyridamole (0.56 mg/kg x 4 min) stress testing. Images were obtained in apical 4- and 2-chamber views, each divided into 6 segments. Tracer uptake and myocardial opacification were visually analyzed for each segment by two pairs of blinded observers and graded as normal, mildly reduced, severely reduced, or absent. In 792 myocardial segments, myocardial opacification by MCE was uninterpretable in 143 (18%) segments and tracer uptake by SPECT was not clearly defined in 92 (12%) segments. Interobserver variability for MCE was good with concordance rates of 83% (kappa=0.72) for rest- and 86% (kappa=0.76) for stress images. Overall concordance between MCE and SPECT was good (83%, kappa=0.63) at a segmental level. In the diagnosis of fixed and reversible defects, and of normal perfusion, concordance rates were 73, 65 and 83%, respectively. When analysis was performed at the regional level, we found comparable levels of concordance rates for LAD (83%, kappa=0.59), LCX (86%, kappa=0.64) and RCA (80%, kappa=0.68) perfusion territories.

CONCLUSIONS

These findings suggest that realtime MCE is a clinically acceptable method to evaluate myocardial perfusion defects during dipyridamole stress testing.

Is the "candy-wrapper" effect of (32)P radioactive beta-emitting stents due to remodeling or neointimal hyperplasia? Insights from intravascular ultrasound

A recognized limitation of radioactive stents is the development of restenosis at the stent edges, known as the "candy-wrapper" effect. The mechanisms of this effect remain incompletely understood and controversial. The aim of this study is to assess the effect of endovascular irradiation on neointima formation and vascular remodeling. (32)P Palmaz-Schatz stents (1.5-4 microCi) were implanted in 11 patients with restenosis after previous percutaneous transluminal coronary angioplasty (PTCA). Intravascular ultrasound (IVUS) images of target sites and adjunct vessel segments were acquired both during intervention and after 6 months. The angiographic restenosis rate was 54%, and the MLD decreased from 2.21 +/- 0.6 mm to 1.38 +/- 0.4 mm at follow-up (P < 0.01). IVUS analysis demonstrated that late lumen loss was the result of neointimal tissue proliferation, which was nonuniformly distributed and exaggerated at both the central articulation and the distal stent edges. Negative remodeling did not contribute to restenosis. In contrast, we found a linear relationship between increase of area stenosis and a positive remodeling index (r = 0.84, P < 0.0001). Restenosis after implantation of (32)P Palmaz-Schatz stents was mainly the result of neointimal tissue proliferation which tended to be nonuniformly distributed in the stent articulation and edges. Negative remodeling or stent recoil was not observed. Cathet Cardiovasc Intervent 2001;54:41-48.

Hypothesis: Beta-adrenergic receptor blockers and weight gain: A systematic analysis

One of the arguments put forward against the primary use of beta-blockers has been concern about adverse metabolic effects, such as unfavorable effects on lipids or insulin sensitivity. Another less-appreciated potential drawback is their propensity to cause weight gain in some patients. In 8 evaluable prospective randomized controlled trials that lasted >/=6 months, body weight was higher in the beta-blocker than in the control group at the end of the study. The median difference in body weight was 1.2 kg (range -0.4 to 3.5 kg). A regression analysis suggested that beta-blockers were associated with an initial weight gain during the first few months. Thereafter, no further weight gain compared with controls was apparent. There was no relationship between demographic characteristics and changes in body weight. Based on these observations, the first-line use of beta-blockers in obese hypertensive patients should be reviewed. Obesity management in overweight hypertensive patients may be more difficult in the face of beta-blocker treatment.

Influence of catheter position and equipment-related factors on the accuracy of intravascular ultrasound measurements

BACKGROUND

Intravascular ultrasound (IVUS) is frequently used as an adjunct to coronary angiography to guide revascularization procedures and, more recently, to estimate atherosclerotic plaque volumes. Although accuracy of IVUS imaging and analysis is crucial for these measurements, available data are scarce. The purpose of this in vitro study is to determine the extent to which transducer position and equipment-related factors influence measurement accuracy.

METHODS

Cross-sectional views of tubular vessel phantoms (diameter 2-14 mm) were acquired using 3.2 French catheters in coaxially centered, eccentric and oblique positions. Catheters were sequentially connected to two different ultrasound systems (A and B) to estimate equipment-related variability. In system B, two software versions were used to analyze ultrasound images. Longitudinal views of phantom segments were reconstructed to document transducer misplacement.

RESULTS

Oblique transducer positioning resulted in a non-linear overestimation of phantom areas that was independent of lumen size and also resulted in dramatic distortions of three-dimensionally reconstructed phantom geometry. Eccentric positioning did not significantly influence measurement accuracy. In coaxial positioning, differences between measured and true areas increased non-linearly from 0.36 to 4.5 mm2 in system B and in a linear fashion from -0.01 to 2.68 mm2 in system A with increasing phantom diameters. Relative differences decreased from 11.4% to 2.9% with increasing reference areas in system B (positive off-set error). When using updated software in system B, the off-set error was negative and relative error diminished from -1.34% to 0.44% with increasing phantom size.

CONCLUSION

Transducer position and equipment-related factors influence the accuracy of intravascular ultrasound, which may lead to misinterpretation of vessel size and geometry even in straight vessel segments. Transducer position may be controlled by the reconstruction of longitudinal images. Ultrasound equipment should be calibrated before using it for quantitative measurements.

Intraluminal ultrasound imaging of the fallopian tube wall: results of standardized in vitro investigations of pig and human tubal specimens

OBJECTIVE

To investigate to what extent anatomic structures of the tubal wall can be identified reproducibly and whether altered areas can be detected and delimited by intraluminal ultrasound.

DESIGN

Standardized in vitro experiment with descriptive evaluation of findings, comparative analysis of apparative and morphologic data, and determination of interobserver variability (video documentation, blinded reviewer).

SETTING

Department of Gynecology and Obstetrics, University of Heidelberg, Germany. SPECIMEN(S): Seventy-two human and pig fallopian tubes.

INTERVENTION(S)

Catheterization with a 2.9F or 3.2F ultrasound catheter and sonographic depiction of the fallopian tube, with either simultaneous manual and sonographic wall-thickness measurement or coagulation of the tubal wall.

MAIN OUTCOME MEASURE(S)

A correlation coefficient of r = 0.76 for manual and sonographic tubal wall measurements and K = 0.88 (with 95% confidence interval of 0.74-1.0) for interobserver variability in recognizing coagulated areas.

RESULT(S)

Tubal wall anatomy and artificially altered (coagulated) areas were displayed reproducibly with intraluminal ultrasound, thus giving a characteristic, recognizable pattern of the tubal wall.

CONCLUSION(S)

These in vitro experiments provide evidence that intraluminal ultrasound may expand the current diagnostic possibilities in cases of tubal pathology, providing nonsurgical access to the tubal wall.

[Recognition of cardiac normal variants as the cause of cerebral ischemia: significance of transesophageal echocardiography]

The significance of cardiac normal variants such as patent foramen ovale (PFO), mitral valve prolapse (MVP) and atrial septal aneurysm (ASA) as potential intracardiac sources of embolism in patients with cerebral ischemia is still discussed controversially. In the present study, we determined the prevalence of PFO, MVP and ASA in patients with suspected embolic cerebral events after exclusion of cerebrovascular disease. Therefore, 164 consecutive patients with suspected embolic cerebral events as suggested by cranial computer tomography or clinical neurological examination were divided into two groups: patients with "classical" potential cardiac source of embolism (group I, n = 81, age 52 +/- 10 years) and patients without such potential cardiac sources of embolism (group II, n = 83, age 56 +/- 12 years). The prevalence of PFO, but not that of MVP and ASA, was significantly higher in group I than in group II (group I: 33.3% vs. group II: 2.4%; chi-square 88.5, p < 0.0001). In the absence of "classical" potential cardiac sources of embolism transesophageal echocardiography reveals a PFO in approximately 30% of the cases. This finding supports the significance of PFO as a potential cardiac source of embolism.

[Evaluation of atrial septum defects in adulthood using echocardiography methods]

Two-dimensional and Doppler echocardiographic methods are used to noninvasively detect atrial septal defects. The value of these methods to predict the magnitude of intracardiac left-to-right shunts has not been thoroughly investigated. In this study, we derived right ventricular (RV) and septal defect dimensions, and Qp/Qs-ratios from two-dimensional and Doppler echocardiography in 30 consecutive patients (17 females, 3 males, age 37 +/- 17 years) with invasively confirmed atrial septal defects. Noninvasively obtained parameters were compared to atrial shunt size as measured by oxymetry. RV dimensions correlated only poorly (RV length: r = 0.53, p < 0.005; RV-diameter r = 0.45 p < 0.05), but septal defect dimensions (r = 0.67, p < 0.001) and Qp/Qs-index (r = 0.65, p < 0.05) correlated fairly with shunt size. RV dilatation was highly sensitive (100%) but only moderately specific (67%) as an indicator of shunts > 30%. A defect length > or = 15 mm was moderately sensitive (81%) but highly specific (100%) and a Qp/Qs-index > or = 1.45 was highly sensitive (100%) and specific (76%) to detect shunts > 30%. None of the noninvasive parameters investigated in this study was able to differentiate moderate (> 30% but < 50%) from large ( > or = 50%) intracardiac left-to-right shunts.

A brief description of I.C.E.: the integrated crystallographic environment

We describe the current status of the program I.C.E., the Integrated Crystallographic Environment. I.C.E. is a windows-based, menu-driven image processing package mainly aimed toward crystallographic image processing, although some of its functions have been used in analyzing single particle data and helical objects. The system can take individual images of crystals through the entire process of data analysis, from windowing the raw image through to the final evaluation of defocus, symmetry and creation of projection reconstructions. Current plans are to incorporate a three-dimensional database of images and electron diffraction patterns, and 3-D merging and visualization.

CTF determination of images of ice-embedded single particles using a graphics interface

We implement a graphical user interface in an X-window/UNIX environment to compute and display the incoherently averaged Fourier transforms of electron images of single particles embedded in ice and the simulated contrast transfer function with or without envelope functions. This interface provides an easy and efficient operation for the determination of defocus value and the evaluation of the extent of Fourier amplitude falloff. This computational procedure is crucial for prescreening image data and performing image correction of contrast transfer function in high-resolution three-dimensional reconstruction of single particles.