Current-conveyor-based wide-band current driver for electrical impedance tomography.

OBJECTIVE: In this paper a wide-band integrated current driver for electrical impedance tomography (EIT) is presented. The application is primarily for prostate and breast cancer detection which require the tissue to be interrogated at frequencies up to 10 MHz while achieving low harmonic distortion and high accuracy. APPROACH: The current driver is based on current conveyor architecture and can deliver 1.2 mA of peak to peak ac current between frequencies of 100 Hz-10 MHz. It is fabricated in CMOS 0.18 [Formula: see text]m technology with a power supply of 3.3 V, and occupies a core area of 0.26 [Formula: see text]. MAIN RESULTS: The measured harmonic distortion for a peak current of 1.2 mA is <[Formula: see text] for frequencies less than 100 kHz, and increases to [Formula: see text] at 10 MHz. The measured output impedance of the current driver is 101 k[Formula: see text] at 1 MHz and 19.5 k[Formula: see text] at 10 MHz. SIGNIFICANCE: The circuit is suitable for high frequency active electrode applications.

Contrast-enhanced MR angiography is not more accurate than unenhanced 2D time-of-flight MR angiography for determining > or = 70% internal carotid artery stenosis.

BACKGROUND AND PURPOSE: Internal carotid artery (ICA) atheromatous disease is an important cause of ischemic stroke, and endarterectomy or stent placement is typically indicated for symptomatic patients with > or = 70% stenosis. Our purpose was to compare contrast-enhanced MR angiography (CE-MRA) with unenhanced 2D time-of-flight MR angiography (2D TOF MRA) in detecting hemodynamically significant ICA stenosis, by using CT angiography (CTA) as the reference standard. MATERIALS AND METHODS: This was an institutional review board-approved retrospective study. We identified 177 consecutive patients (354 ICAs) who received correlative CE-MRA, 2D TOF MRA, and CTA. Two neuroradiologists blinded to the CTA data graded the degree of ICA stenosis according to a 5-point scale. Additionally, luminal signal-intensity characteristics including 1) signal intensity drop-out, 2) distal-vessel narrowing, and 3) distal-vessel signal-intensity reduction were recorded. MRA results were correlated with those of CTA, and receiver-operating-characteristic (ROC) curves were constructed. RESULTS: On CTA, there were 55 ICAs with and 299 without > or = 70% stenosis. CE-MRA was 84% sensitive and 96% specific for detecting > or = 70% stenosis; 2D TOF MRA was 80% sensitive and 95% specific. The area under the ROC curve was 0.97 for CE-MRA and 0.95 for 2D TOF MRA (P = .51, not significant). For both MRA studies, each of the luminal signal-intensity characteristics had high specificity (> 98%) but poor-to-mild sensitivity (35%-66%) in detecting > or = 70% stenosis. CONCLUSIONS: Although it is established that CE-MRA more accurately delineates neurovascular anatomy than does unenhanced 2D TOF MRA, the administration of gadolinium did not offer a significant advantage in distinguishing surgically treatable ICA stenosis. This conclusion may be important in patients with contraindications to gadolinium.

Reconstructions of conductive and insulating targets using the D-bar method on an elliptical domain.

The D-bar algorithm based on A Nachman's 2D global uniqueness proof for the inverse conductivity problem (Nachman 1996 Ann. Math. 143 71-96) is implemented on an elliptical domain. The scattering transform is computed on an ellipse and the complete electrode model (CEM) for the forward problem is computed with the finite element method (FEM) in order to obtain static conductivity reconstructions of conductive and insulating targets in a saline-filled tank. It is demonstrated that the spatial artifacts in the image are significantly reduced when the domain is properly modeled in the reconstruction, as opposed to being modeled as a disk.

Region-specific regulation of glucocorticoid receptor/HSP90 expression and interaction in brain.

The hippocampal glucocorticoid receptor (GR) is involved in negative feedback regulation of the hypothalamo-pituitary-adrenal axis and is believed to transduce the deleterious effects of glucocorticoids in depression and age-related memory loss. Regulation and intracellular trafficking of the GR are critical determinants of GR action in both health and disease. Here, we show dynamic regulation of GR and its interaction with its principal intracellular chaperone, heat-shock protein (HSP) 90, across the circadian cycle. Our initial experiments indicate that cytosolic hippocampal GR protein is elevated in the evening (PM), whereas nuclear GR and cytosolic HSP90, HSP70 and heat-shock cognate 70 (HSC70), are unchanged. In contrast, there are no changes in examined proteins in the hypothalamus. Immunoprecipitation experiments reveal increased GR-HSP90 associations in the hippocampus in the PM, whereas binding in the hypothalamus is decreased in the PM. Given that GR requires HSP90 for ligand binding, the data suggest that circadian GR signaling capacity is regulated in a region-specific pattern.

Corticotropin-releasing hormone (CRH) expression and protein kinase A mediated CRH receptor signalling in an immortalized hypothalamic cell line.

Corticotropin-releasing hormone (CRH) is a 41 amino acid neuropeptide which plays an important role in the stress response in the hypothalamus. We describe the development of an immortalized hypothalamic cell line which expresses CRH. We hypothesized that this cell line would possess the relevant characteristics of parvocellular CRH-expressing neurones such as glucocorticoid receptor (GR) expression and vasopressin (VP) coexpression. For production of hypothalamic cells, embryonic day 19 rat pup hypothalami were dissected and dissociated into tissue culture dishes. They were immortalized by retrovirus-mediated transfer of the SV40 large T antigen gene at 3 days of culture and then screened for expression of CRH following dilution cloning. One cell line was chosen (IVB) which exhibited CRH-like immunoreactivity (CRH-LI) and expressed CRH, VP and CRH1 receptor RNA via the reverse transcriptase-polymerase chain reaction. In addition, the cell line expressed the neuronal marker, microtubule-associated protein-2. We verified that the CRH-LI from IVB cell lysates coeluted with CRH standard via reversed-phase high-performance liquid chromatography (HPLC). Furthermore, oxidation of the lysate converted its HPLC profile to that identical with oxidized CRH standard. In addition, IVB cells exhibited high affinity binding to CRH. Incubation of IVB cells with CRH lead to increases in cAMP levels and protein kinase A activity in a concentration-dependent manner. Incubation of IVB cells with CRH also resulted in increases in phospho-cyclic-AMP response element binding protein (CREB) immunostaining as detected by immunocytochemical analysis. Finally, CRH treatment of IVB cell lines has been linked to CREB-mediated gene expression as determined via the PathDetect CREB trans-reporting system. The characteristics of IVB cells, such as CRH and VP coexpression, GR expression and a biologically active CRH-R1-mediated signalling pathway, suggest that this neuronal cell line may serve as model of parvocellular CRH neurones.

Corticotropin-releasing hormone receptor blockade fails to alter stress-evoked catecholamine release in prefrontal cortex of control or chronically stressed rats.

Although it is well documented that stress can increase the activity of central dopamine and norepinephrine neurons, little is known about the role of other neurotransmitters in modulating this response. Previous studies have implicated corticotropin-releasing hormone in modulating stress-evoked changes in the activity of locus coeruleus neurons. The present study examines whether corticotropin-releasing hormone contributes to stress-evoked increases in extracellular norepinephrine and dopamine in rat medial prefrontal cortex, as monitored by in vivo microdialysis. As noted previously, 30 min of tail-shock increased extracellular levels of norepinephrine and dopamine in the medial prefrontal cortex of naïve rats, and this was enhanced in rats previously exposed to chronic cold ( approximately 5 degrees C for 2-3 weeks). Previous intraventricular administration of a corticotropin-releasing hormone antagonist (D-Phe-corticotropin-releasing hormone; 3 and 9 microg) did not alter the tail-shock evoked in increase in extracellular levels of norepinephrine and dopamine in either naïve or chronically cold-exposed rats. Intraventricular administration of 3 microg of D-Phe-corticotropin-releasing hormone attenuated the increase in extracellular norepinephrine induced by co-administration of 3 microg of corticotropin-releasing hormone, confirming the efficacy of this compound. Results of the present study suggest that endogenous corticotropin-releasing hormone does not play a role in modulating the release of norepinephrine and dopamine occurring in response to acute tail-shock or the expression of a potentiated response to tail-shock in rats exposed chronically to cold.

"Captain of the ship" doctrine continues to take on water.

The captain of the ship doctrine, which has been interpreted to mean that the surgeon's mere presence in the OR subjects him or her to legal liability for everyone's negligence in that room (akin to the responsibility of the captain of a ship who is held responsible for everything that happens on that ship), emerged in 1949 and grew in popularity through the 1950s. The major reason for this doctrine's popularity was that injured patients were precluded from suing hospitals under the then applicable charitable immunity doctrine. Charitable immunity declined in the 1960s, and by the 1970s, so too was the captain of the ship doctrine in decline. Pennsylvania, which first used the picturesque phrase in 1949, rejected the doctrine in 1974. In the meantime, it has come under much criticism, even among states that adopted it. Despite this decline and despite court language that sometimes borders on ridicule (e.g., anachronistic, prostrate doctrine, indiscriminate repetition), the felicity of the phrase has kept it alive in some states and in many ORs, even in states that have expressly rejected the doctrine. Even more than 20 years after its first rejection, however, courts still are being asked to adopt the doctrine. In 2001, the Wisconsin Supreme Court declined to adopt the doctrine, adding to the litany of states that have taken an express position against it.

Individual malpractice insurance decisions revisited.

Nurses' professional obligations to their patients include financial accountability. Whether nurses best provide this through self-insurance, coverage by an employer's insurance policy, or by purchase of an individual policy remains a personal decision. Changes in law and the health care market, however, should prompt a revisiting of this decision because the relative costs and benefits of each option may have changed. The pace of these changes, the unexpected consequences of some of the legal changes, and the individual differences in each nurse's situation may require seeking legal counsel to identify and evaluate the risk/benefits in that situation. The cost of that counsel may well exceed the cost of the policy premium.