Aneurysm clips: evaluation of magnetic field interactions and translational attraction by use of "long-bore" and "short-bore" 3.0-T MR imaging systems. (65/2752)

BACKGROUND AND PURPOSE: The use of 3.0-T MR systems is increasing worldwide. We evaluated magnetic field interactions and translational attraction for 32 aneurysm clips in association with exposure to "long-bore" and "short-bore" 3.0-T MR imaging systems. METHODS: Thirty-two different aneurysm clips were evaluated in this investigation. Each aneurysm clip was qualitatively evaluated for magnetic field interactions and quantitatively assessed for translational attraction by using the deflection angle test. The deflection angle tests were performed at the points of the highest spatial gradients for long-bore and short-bore 3.0-T MR imaging systems. RESULTS: Seventeen of the 32 aneurysm clips showed positive magnetic field interactions. Deflection angles for the aneurysm clips were significantly (P <.001) higher on the short-bore (range, 0-18 degrees) compared with those recorded on the long-bore (range, 0-16 degrees) 3.0-T MR imaging system. Aneurysm clips made from commercially pure titanium and titanium alloy displayed no translational attraction (n = 15), whereas those made from stainless steel alloy, Phynox, and Elgiloy displayed positive deflection angles (n = 17). CONCLUSION: The 32 different aneurysm clips passed (angle <45 degrees) the deflection angle test by using the long- and short-bore 3.0-T MR imaging systems, indicating that they are safe for patients and other persons in these MR environments (ie, immediate area of MR imaging systems). However, only clips made from the titanium and titanium alloy are entirely safe for patients undergoing MR imaging procedures because of the total lack of magnetic field interactions. The remaining clips require characterization of magnetic field-induced torque. Because of possible differences in the points of the highest spatial gradients for different 3.0-T MR imaging systems, the results are specific to the imaging units and bore designs used in this investigation.  (+info)

Gas generation and clot formation during electrolytic detachment of Guglielmi detachable coils: in vitro observations and animal experiment. (66/2752)

BACKGROUND AND PURPOSE: Recent reports describe a high rate of thromboembolic events related to Guglielmi detachable coil (GDC) use in the treatment of cerebral aneurysms. The purpose of this study was to investigate electrolysis-related changes of blood as a potential cause of thromboembolic complications associated with GDC use. METHODS: For in vitro observations, 15 GDCs (10 conventional coils and five insulated coils) were experimentally detached under microscopic observation. Three coils were detached in normal saline, five in human serum, and seven in heparinized human blood. For animal experiments, two coils were detached in two canine normal common carotid arteries with systemic heparinization. Immediately after detachment, the arteries were exposed, and clot formations were observed. RESULTS: Significant amounts of gas bubbles were observed in all in vitro observations; more were seen in conventional coils, which required longer detachment times, than in insulated coils. Gas generation started with the growth of tiny bubbles into larger ones. In insulated coils, gas was generated only at the detachment zone, and no difference between saline, serum, and blood environments was observed. During detachment within heparinized blood, clot formations of 2-3-mm diameter were observed at the detachment zones of insulated coils. Animal experiments showed clot formation at the detachment zone, and bubble entrapments around the clots were also found. CONCLUSION: The electrolytic detachment mechanism of the platinum coil can generate gas bubbles during the application of electric current. In association with electrothrombosis, this phenomenon may be a potential cause of thromboembolic complications during the treatment of cerebral aneurysms by use of GDCs.  (+info)

An ex vivo investigation to compare orthodontic bonding using a 4-META-based adhesive or a composite adhesive to acid-etched and sandblasted enamel. (67/2752)

OBJECTIVE: This study investigates the shear-peel orthodontic bond strengths of brackets bonded with an unfilled acrylic resin containing 4-META (MCP Bond or a no-mix composite adhesive (Right On) to acid-etched or sandblasted enamel. DESIGN: Ex vivo. MATERIALS AND METHODS: Eighty human pre-molar teeth were separated into four equal groups, according to the adhesive used and method of enamel pre-treatment. Group I-Right On with enamel etched using phosphoric acid for 30 seconds. Group II-Right On with enamel sandblasted using 50- microm alumina particles at 80 psi for 3 seconds. Group III-MCP Bond with enamel etched using phosphoric acid for 30 seconds. Group IV-MCP Bond with enamel sandblasted using 50- microm alumina particles at 80 psi for 3 seconds. Subsequently, the specimens were stored in distilled water for 24 hours prior to bond strength testing using an Instron universal testing machine. Each debonded tooth was scored using the adhesive remnant index (ARI) to determine the site of bond failure. RESULTS: The mean bond strength (1 SD) were Group I: 10.7 (2.7) MPa, Group II: 5.3 (1.3) MPa, Group III: 15.9 (3.4) MPa, Group IV: 15.0 (2.2) MPa. Statistical analysis using one-way analysis of variance and Tukey test found no statistical difference between Group III and Group IV (P > 0.05), but the other groups were statistically different from each other (P < 0.05). The data were found to fit the Weibull distribution and Weibull analysis showed stress required for a 5 per cent probability of failure was: Group I: 5.77 MPa; Group II: 3.32 MPa; Group III: 10.31 MPa; Group IV: 10.58 MPa. Chi-square test showed a statistically significant difference existed between the ARI scores (P < 0.001), principally through less adhesive remnants being observed on the sandblasted specimens. CONCLUSION: The adhesive containing 4-META achieved significantly higher bond strengths than the composite adhesive, particularly in the case of sandblasted enamel.  (+info)

Longevity of Masimo and Nellcor pulse oximeter sensors in the care of infants. (68/2752)

OBJECTIVE: Pulse oximetry is a standard of care for monitoring oxygenation in neonates. Associated with the use of pulse oximetry is the cost of patient sensors, especially if the sensor is designed for single-patient use. Pulse oximetry monitoring of sick newborns is routine and often lengthy and, if the pulse oximeter sensor is short-lived, can result in a significant portion in the cost of intensive care. METHODS: We evaluated, in the NICUs of two hospitals and one step-down nursery, the useful life of disposable neonatal pulse oximeter sensors from two manufacturers: Masimo and Nellcor. The only requisites were ethics committee approval and need for monitoring. The timed of PO sensor placement and replacement were noted along with the reason for changing the sensor. The standard care practices for PO and sensor use in the respective institutions were followed. RESULTS: A total of 835.5 patient days of monitoring were accumulated with 65 infants in the Masimo group and 56 using Nellcor. The Masimo Neo sensors had over twice (2.33) the useful life of the Nellcor N-25 (9.05+/-4.4 versus 3.9+/-2.3 days (range of 7.2-11.8 and 2.5-5.8 days, respectively, p<0.05)). The magnitude of useful life between the two institutions was not significantly different in the Masimo group (2.35- versus 2.22-fold). PO sensors were replaced due to impaired adhesion (38 Masimo and 32 Nellcor) and no signal (six Masimo and four Nellcor). CONCLUSIONS: We found a more than two-fold increase in the life of Masimo versus Nellcor sensors. This difference was consistent between various caregivers in multiple settings and corroborates the experience of another, more limited study. A cost savings should result from the use of Masimo versus Nellcor disposable pulse oximeter sensors in neonatal routine care  (+info)

Increased volumetric wear of polyethylene liners with more than 3 years of shelf-life time. (69/2752)

We analyzed 20 retrieved gamma-sterilized polyethylene liners (Biomet Hexloc). The long-term durability varied significantly depending on shelf-life time before implantation. Liners with a shelf-life time of 3 years or more evinced significantly ( P 0.002) higher volumetric wear than those with a shelf life time less than 3 years. Infrared spectroscopy and scanning calorimetry showed that all explanted implants underwent substantial in vivo oxidation and crystallization. The oxidative ageing of polyethylene renders the polyethylene liner susceptible to severe wear. Scanning electron microscopy of the bearing surface of the liner revealed abrasive wear as a dominant mechanism. Moreover, poor acetabular design produces excessively thin liners, substandard locking mechanism, and backside wear of the liner. The primary reason for severe wear in the Hexloc liner was poor modular design and oxidative degradation of the polyethylene.  (+info)

Statistical design of reverse dye microarrays. (70/2752)

MOTIVATION: In cDNA microarray experiments all samples are labelled with either Cy3 dye or Cy5 dye. Certain genes exhibit dye bias-a tendency to bind more efficiently to one of the dyes. The common reference design avoids the problem of dye bias by running all arrays 'forward', so that the samples being compared are always labelled with the same dye. But comparison of samples labelled with different dyes is sometimes of interest. In these situations, it is necessary to run some arrays 'reverse'-with the dye labelling reversed-in order to correct for the dye bias. The design of these experiments will impact one's ability to identify genes that are differentially expressed in different tissues or conditions. We address the design issue of how many specimens are needed, how many forward and reverse labelled arrays to perform, and how to optimally assign Cy3 and Cy5 labels to the specimens. RESULTS: We consider three types of experiments for which some reverse labelling is needed: paired samples, samples from two predefined groups, and reference design data when comparison with the reference is of interest. We present simple probability models for the data, derive optimal estimators for relative gene expression, and compare the efficiency of the estimators for a range of designs. In each case, we present the optimal design and sample size formulas. We show that reverse labelling of individual arrays is generally not required.  (+info)

Long-term follow-up of single-lead VDD pacing. (71/2752)

Long-term outcomes of single-lead VDD pacing were studied retrospectively and partly prospectively. Records were analysed of 81 patients out of 133 in whom a single-lead VDD pacemaker was implanted between January 1993 and December 1997 and who attended a follow-up clinic more than two years after the implant. Forty-eight of them attended a prospective follow-up 54 +/- 15 months after the implant. Sinus rhythm was present in 91.5% of the patients and atrial fibrillation in the remaining 8.5%. A-V synchronous pacing was documented in 91.9 to 94.9% at different follow-up periods; however, an intermittent asynchronous ventricular (VVI) pacing of more than 10% occurred intermittently in 19.1% of the patients. Chronic sensed P-wave amplitude was significantly lower than the implant P-wave amplitude (by 70%) and did not correlate with the implant amplitude. Postural changes (supine, sitting, standing, with normal breathing and during deep inspiration) did not have a significant impact on sensed P-wave amplitude more than four years after the implant. Rate histograms were remarkably stable over the years, with dominant heart rate 70 to 79 beats per minute observed for 25 to 30% of the monitored periods. Single-lead VDD pacing was found to be a reliable method of long-term physiological pacing in patients with heart block who returned for follow-up. Routine testing more than four years after the implant does not require postural manoeuvres.  (+info)

Microarray standard data set and figures of merit for comparing data processing methods and experiment designs. (72/2752)

MOTIVATION: There is a very large and growing level of effort toward improving the platforms, experiment designs, and data analysis methods for microarray expression profiling. Along with a growing richness in the approaches there is a growing confusion among most scientists as to how to make objective comparisons and choices between them for different applications. There is a need for a standard framework for the microarray community to compare and improve analytical and statistical methods. RESULTS: We report on a microarray data set comprising 204 in-situ synthesized oligonucleotide arrays, each hybridized with two-color cDNA samples derived from 20 different human tissues and cell lines. Design of the approximately 24 000 60mer oligonucleotides that report approximately 2500 known genes on the arrays, and design of the hybridization experiments, were carried out in a way that supports the performance assessment of alternative data processing approaches and of alternative experiment and array designs. We also propose standard figures of merit for success in detecting individual differential expression changes or expression levels, and for detecting similarities and differences in expression patterns across genes and experiments. We expect this data set and the proposed figures of merit will provide a standard framework for much of the microarray community to compare and improve many analytical and statistical methods relevant to microarray data analysis, including image processing, normalization, error modeling, combining of multiple reporters per gene, use of replicate experiments, and sample referencing schemes in measurements based on expression change. AVAILABILITY/SUPPLEMENTARY INFORMATION: Expression data and supplementary information are available at http://www.rii.com/publications/2003/HE_SDS.htm  (+info)