The Right Ventricle in Cardiorespiratory Failure

Abstract

Purpose of Review

Thorough evaluation of the hypotensive or dyspneic patient requires an understanding of the physiology and common pathologies that relate to the right ventricle (RV). This review focuses on the role of point-of-care ultrasound (PoCUS) in evaluating the RV and discusses common clinical scenarios where PoCUS provides value.

Recent Findings

There are several signs of underlying RV pathology that can be detected using PoCUS; these including alterations in RV size, wall thickness, interventricular septal deviation, and RV function. These indicators help in differentiating between acute and chronic RV dysfunction. Recent findings include the role of more advanced and quantitative measures such as TAPSE, including their use in complex clinical situations such as acute cor pulmonale.

Summary

PoCUS can be used to supplement the history and physical examination in critically ill patients, specifically in the evaluation of RV dysfunction. This bedside tool is a valuable aid in guiding both diagnosis and management.

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SOP – Schmerztherapie bei Palliativpatienten

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Application of Adipose-Derived Stem Cells to Observe the Morphological Changes by Induction with Decellularized Corneal Extracellular Matrix and Specified Medium

Abstract

In recent years, many researches have focused on the behaviors of ADSCs induced with tissue-specific environment such as corneal extracellular matrix (ECM) due to their same embryonic origin from neural crest. In this study, human ADSCs were cultivated on bovine ECM (bECM) with different culture medium, including ADSC preserved medium (APM), supplemented hormonal epithelial medium (SHEM) and keratinocyte serum free medium (KSFM), compared to TCPS substrate. Cell morphology, proliferation and cytoskeleton markers were examined. The induction results implicated by morphology and immunostaining evidence showed that ADSCs exhibited spindle-shaped morphology on bECM cultured with APM and SHEM, while it displayed dendritic phenotype on bECM in KSFM. Moreover, the F-actin staining demonstrated a diffused expression in KSFM condition, which is different from a dense and thickened expression pattern in APM and SHEM when ADSCs were cultured on bECM. The ADSCs induced with serum-free medium and decellularized corneal ECM showed altered morphology and cytoskeleton structures different from serum-containing medium, which implied the differentiation potential of ADSCs and potential characteristics of corneal stromal cells.

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Investigation of the Possibility to Reduce Susceptibility Artifacts in MRI Knee Examination

Abstract

The aim of this present study is to evaluate the reduction of susceptibility artifacts by increasing bandwidth (BW) and echo train length (ETL) in proton density turbo spin echo (PD TSE) sequences with and without fat saturation (FS) and in turbo inversion recovery magnitude (TIRM) sequences. We compared: (1) TIRM coronal (COR) with TIRM COR with high (H) BW and Long ETL; (2) PD TSE sagittal (SAG) FS with the PD TSE SAG FS with (H) BW; (3) PD TSE SAG with PD TSE SAG with (H) BW; (4) PD TSE SAG with PD TSE SAG with (H) BW and Long ETL. A quantitative analysis measured the extent of the susceptibility artifacts. A qualitative analysis evaluated the susceptibility artifacts, image distortion and effectiveness of fat suppression. The depiction of cartilage, menisci, muscles, tendons and bone marrow were also qualitatively analyzed. In the quantitative analysis, modified TIRM appears superior. In the qualitative analysis, the modified TIRM appears superior in 8/10 characteristics. The modified PD TSE FS is superior to the conventional regarding the susceptibility artifacts, image distortion and the depiction of bone marrow and cartilage and fat saturation. The modified PD TSE with (H) BW is found to be superior to the conventional PD TSE only in cartilage. In these sequences, when ETL was increased there were significant differences in four characteristics (ghost artifacts, cartilage, menisci and muscles). TIRM sequences with an increased BW and ETL are proposed to be used in daily clinical practice.

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Optomagnetic Imaging Spectroscopy Application in Cervical Dysplasia and Cancer Detection: Comparation of Stained and Unstained Papanicolaou Smears

Abstract

Cervical cancer is the fourth most common cancer worldwide. The fact that cervical cancer takes many years to develop indicates that mortality rates can be significantly decreased with early detection. This is why screening tests for early cervical cancer detection are so important, especially in developing countries where screening programs are not available to the same extent as in developed countries. About 84% of all cervical cancer cases in 2012 occurred in less developed countries mainly due to the lack of effective screening programs. Even if the necessary infrastructure in one country exists, the cost of screening test is usually too high. Finally, the accuracy of screening test needs to be satisfying in order to detect all the abnormal cases and treat them effectively. Papanicolaou test is still the most effective screening test for cervical cancer detection so far. However, the accuracy of Papanicolaou test is closely related to the expertise of the cytopathologist and therefore the accuracy varies producing relatively low sensitivity of Papanicolaou test (50–85%). HPV DNA test is approved as primary screening test, but so far it gives better results when it is used in conjunction with cytology. We present a method and device for detection of cervical cancer based on optomagnetic imaging spectroscopy (OMIS) and compare the results for cancer detection using stained and fresh unstained cervical cell samples. Compared to stained samples, unstained fresh sample classification by OMIS into healthy/cancerous group with Naïve Bayes classifier gave higher accuracy (96% compared to 85,18%).

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Comment to: “Management and outcome of gastrointestinal bleeding in patients taking oral anticoagulants or antiplatelet drugs”

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Spreading of Pathology in Alzheimer’s Disease

Abstract

The senile plaques (SPs) and neurofibrillary tangles (NFTs) are the two major pathological hallmarks of AD, which are composed of β-amyloid protein and Tau protein. So the β-amyloid protein (Aβ) and Tau oligomers (oTau) are the majority in the pathology of AD. Recently, the spreading of Aβ and oTau in the brain of AD patients has received heated value. In this review, we summarize recent research progress and aim to figure out the spreading mechanism of Aβ and Tau in AD via introduction of the formation, release, uptake, diffusion between different brain regions, and the propagation principle of Aβ and Tau. Although the mechanisms of the spreading pathology in AD are still not very clear, increasing discoveries confirm that Aβ and oTau could transmit from one neuron to another along the anatomical connected synapses. Meanwhile, a mass of studies also report that they have a totally opposite hierarchical spatiotemporal pattern of spreading in cerebral areas. In addition, Tau proteins might mediate Aβ toxicity in the brain, and they might have synergistic roles with each other. So some therapies have emerged, such as inhibiting the release, preventing the oligomerization, and blocking the uptake. This review would be helpful to comprehend the mechanism of transmission in AD and provide a new way to the targeted therapy.

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