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We give an overview of the EDA CAT B R&D project ""Signal Processing for Enhanced Radar Imaging"" (SPERI). In this project, the benefits of applying two super-resolution methods Super Spatially Variant Apodization (SSVA) and Compressed Sensing (CS) to two-dimensional Inverse Synthetic Aperture Radar (ISAR) images of airborne radar targets were investigated with respect to the improvements in automatic target identification rates. The algorithms have been tested over a database of more than 1200 real radar images.

Background Elevation of right atrial pressure is a typical feature of acute heart failure (AHF), it is transmitted to renal veins leading to persistent kidney congestion. We aimed to evaluate the role of Doppler ultrasound in monitoring kidney congestion during diuretic therapy. Methods 71 patients (26 F - mean age 80.8±8.2 - mean EF 0.40±13.2) admitted for AHF underwent cardiac and renal Echo Doppler examination at day 1–3–5 of Hospital stay. Parameters of arterial and venous flow within cortical right kidney were recorded. Venous Doppler Profile (VDP) was classified as: continuous (C), pulsatile (P), biphasic (B) or monophasic (M) according to the growing degree of derangement. Arterial resistive index (RI) >0.8 was considered elevated. Correlation between renal hemodynamic changes and clinical outcome (Death and cardiovascular (CV) hospitalization) at 60 days was sought. Outcome VDP derangement (M or B) was detected in 57 patients (80.3%) at day 1 and in 36 at day 5 (52.2%, p After 60 days, 13 (18.3%) patients died and 8 (11.3%) had a CV hospitalization. Kaplan Meier analysis found a significant better outcome in those patients whose VDP did improve after diuretic therapy (Log Rank test p Conclusions Most patients admitted with AHF present deranged VDP. Diuretic treatment lead to VDP improvement and to renal RI decrease. In this perspective study, for the first time VDP improvement after endovenous diuretic treatment resulted associated to reduced risk of death and CV Hospitalization. Evaluation of VDP could become a useful tool in monitoring the efficacy of diuretic treatment in AHF. Funding Acknowledgement Type of funding sources: None. Table 1. Patients characteristics and VDPFigure 1. Kaplan-Meier estimate curve

BACKGROUND Acute heart failure (AHF) seems to provoke profound derangement of abdominal hemodynamic, which causes symptoms and impacts on renal function. METHODS 27 patients (10 F - age 78 - EF 0.39) admitted for AHF underwent cardiac and abdominal ultrasound at day 1 and 5. Arterial and venous flow within liver, spleen and kidney were recorded. Portal and Splenic Vein flow was described as continuous, pulsatile or reversed, whereas hepatic vein systolic and diastolic ratio was measured. Renal Venous Doppler Profile (VDP) was classified as: continuous, pulsatile, biphasic or monophasic. Arterial Resistive Index (RI) ≥0.7 was considered elevated. OUTCOME At day 1 most patients presented with some degree of deranged VDP and high RI in all examined organs. At day 5, a significant proportion of patients improved their VDP in Liver, Kidney and Spleen, while the percentage of patients with collapsing IVC did not significantly change. On the arterial side, the proportion of patients with high Hepatic RI dropped significantly. CONCLUSIONS Our preliminary data show that most deranged VDP in abdominal organs and Hepatic RI improve after decongestion despite a nonsignificant trend in improvement in IVC profile. RESULTS Classification day 1 day 5 p IVC Collapsing 24% 34% ns Portal Vein Continous 22% 50% Pulsatile 72% 50% Reversed 6% 0%

Background Acute heart failure (AHF) is often accompanied by impairment in renal function. A profound derangement of normal abdominal haemodynamic is always present during this clinical phase. Methods 14 patients (6 F – mean age 80 – mean EF 0.39) admitted for acute heart failure underwent cardiac and renal Echo Doppler examination at day 1-3-5 of Hospital stay. Parameters of arterial and venous flow within cortical right kidney were recorded. Venous Doppler Profile (VDP) was classified as: continuous (C), pulsatile (P), biphasic (B) or monophasic (M) according to the growing degree of derangement. Arterial resistive index (RI) >0.8 was considered elevated. Correlation between renal hemodynamic (and its changes) with biohumoral and echo parameters was sought. Outcome At day 1 VDP was M or B in 8 patients (57%) and in four (50%) of them dropped to C or P at day 5. RI was elevated in 8 patients at day 1 while only in 4 at day 5. VDP and RI were not related to EF or BNP values. One patient died before day 5, no other worsening heart failure episodes occurred. Two patients (14%) developed acute kidney injury but their VDP and RI were normal and did not change. Three patients (21%) did not improve their BNP (decrease >30%) but this was not associated with VDP or RI changes. Elevated derived pulmonary artery systolic pressure (>40 mmHg) was present in 6 out of 8 patients (75%) with M or B VDP and in all 4 patients with both elevated RI and M or B VDP. Venous Pattern Day 1 Day 3 Day 5 Continous 2 8 5 Pulsatile 4 2 4 Biphasic 2 1 2 Monophasic 6 3 2 Arterial RI >0.8 8 6 4 BNP, pg/ml 1060±1180* 372±281* 424±213* Creatinine, mg/dl 1.4±0.6 1.5±0.6 1.3±0.6 Hb, g/dl 12.1±2.3 12.3±3.6 13.2±2.3 *p>0.05. Conclusions This is the first study exploring changes in renal hemodynamic by echo Doppler during AHF. With respect to previous studies among stable patients, our preliminary data shows a higher proportion of deranged renal venous and/or arterial pattern. After diuretic therapy a trend towards improvement in VDP was recorded. No clear association with other clinical and hemodynamic parameters seems evident.

This paper deals with the automatic classification of Drones using a surveillance radar signal. We show that, using state-of-the-art feature-based machine learning techniques, UAV tracks can be automatically distinguished from other object (e.g. bird, airplane, car) tracks. In fact, on a collection of real data, we measure an accuracy higher than 98%. We have also exploited the possibility of using the same features to distinguish the type of the wing of drone, between Fixed Wing and Rotary Wing, reaching an accuracy higher than 93%.

Hintergrund: Evaluierung der klinischen Ergebnisse 3 Monate nach Implantation einer neuen diffraktiven multifokalen Intraokularlinse (MIOL) mit einer reduzierten Nahaddition von + 2,75 dpt. Methoden: Im Rahmen einer prospektiven Studie wurden Patienten nach erfolgreicher Kataraktoperation oder refraktivem Linsenaustausch mit Implantation einer MIOL (Tecnis ZKB00, Abbott Medical Optics, Santa Ana, California, USA) eingeschlossen. Drei Monate postoperativ wurde die Sehscharfe in unterschiedlichen Testentfernungen bewertet. Bei den postoperativen Untersuchungen nach einer bilateralen IOL-Implantation wurde zusatzlich ein Fragebogen zur Evaluierung der subjektiven Zufriedenheit, der Sehqualitat und der Tragegewohnheiten einer Brille vorgelegt und in die Auswertung mit einbezogen. Ergebnisse: Es wurde zwischen Oktober 2013 und August 2014 bei 115 Augen von 62 Patienten die ZKB00-IOL implantiert. Die postoperative Refraktion lag im spharischen Aquivalent bei − 0,27 ± 0,44 dpt. Der korrigierte binokulare Fernvisus lag bei − 0,01 ± 0,3 logMAR. Der unkorrigierte binokulare Fernvisus wurde mit 0,06 ± 0,08 logMAR nach 3 Monaten ermittelt. Im Nahbereich konnte die unkorrigierte binokulare Sehscharfe mit 0,07 ± 0,10 logMAR nach 3 Monaten postoperativ bestimmt werden. Schlussfolgerung: Die ZKB00-IOL gehort einer neuen Generation von MIOL an, die einen deutlich verbesserten Intermediarvisus anbieten. Unsere Studie belegte fur die Implantation dieser IOL eine ausgezeichnete Sehfunktion in allen Bereichen in Korrelation mit einer sehr hohen allgemeinen Patientenzufriedenheit und einer subjektiv hohen Abbildungsqualitat.

Coastline detection in synthetic aperture radar (SAR) images is crucial in many application fields, from coastal erosion monitoring to navigation, from damage assessment to security planning for port facilities. The backscattering difference between land and sea is not always documented in SAR imagery, due to the severe speckle noise, especially in 1-look data with high spatial resolution, high sea state, or complex coastal environments. This paper presents an unsupervised, computationally efficient solution to extract the coastline acquired by only one single-polarization 1-look SAR image. Extensive tests on Spotlight COSMO-SkyMed images of complex coastal environments and objective assessment demonstrate the validity of the proposed procedure which is compared to state-of-the-art methods through visual results and with an objective evaluation of the distance between the detected and the true coastline provided by regional authorities.

In the context of automatic image processing, the noise nearly always represents the hardest problem to cope with. This is particularly true on images corrupted by multiplicative speckle noise, such as Synthetic Aperture Radar (SAR) images. To tackle such an issue, this paper proposes a novel anisotropic diffusion filter that manages to fulfill simultaneously two competing requirements: noise reduction on homogeneous regions and edge enhancement. To prove the capabilities of our filter, we compare it to two non-local diffusion (NLD) filters applied on Lena image corrupted by a multiplicative speckle noise and on a real SAR image acquired by the COSMO-SkyMed (CSK) satellite constellation.

This study explores the potential of Synthetic Aperture Radar (SAR) to aid Unmanned Aerial Vehicle (UAV) navigation when Inertial Navigation System (INS) measurements are not accurate enough to eliminate drifts from a planned trajectory. This problem can affect medium-altitude long-endurance (MALE) UAV class, which permits heavy and wide payloads (as required by SAR) and flights for thousands of kilometres accumulating large drifts. The basic idea is to infer position and attitude of an aerial platform by inspecting both amplitude and phase of SAR images acquired onboard. For the amplitude-based approach, the system navigation corrections are obtained by matching the actual coordinates of ground landmarks with those automatically extracted from the SAR image. When the use of SAR amplitude is unfeasible, the phase content can be exploited through SAR interferometry by using a reference Digital Terrain Model (DTM). A feasibility analysis was carried out to derive system requirements by exploring both radiometric and geometric parameters of the acquisition setting. We showed that MALE UAV, specific commercial navigation sensors and SAR systems, typical landmark position accuracy and classes, and available DTMs lead to estimated UAV coordinates with errors bounded within ±12 m, thus making feasible the proposed SAR-based backup system.

Correct identification of obstacles at the periphery of airports is an important issue to ensure safe takeoff, flight, and landing to aircrafts. This work is carried on as part of the obstacle risk assessment and risk mitigation operations in the aviation security framework. This paper presents a novel fully automatic remote sensing methodology for the detection, shape and signature extraction and classification of obstacles to air navigation from very high resolution (VHR) multispectral (MS) satellite stereo couples images, here defined feature extraction (FE). In order to reduce the costs, the proposed technique is applied only on detailed areas where orographic/topographic changes potentially associated with variations in the obstacles to air navigation in wide areas have been previously detected through a low-cost pre-screening change detection (CD) methodology applied to cheaper high resolution (HR) satellite imagery. The combination of CD and FE strategies offers a low-cost and fast solution to the problem of updating airport obstacle chart.

In this paper a high-frequency large-bandwidth synthetic aperture penetrating radar intended for the inspection of masonry walls, and its application to intrawall investigation of an important Heritage structure in Florence, Italy, are described. The radar system has been conceived and designed for non-contact operation, in particular for allowing walls covered by paintings to be inspected avoiding damages to the surface artworks. The radar signal was a Continuous-Wave Step-Frequency (CW-SF) waveform, sampling a 4 GHz bandwidth at 10 GHz center frequency, thus providing relatively high resolution images of the investigated structures. Cross-range resolution is provided by applying a synthetic aperture approach, obtained by mechanically moving the radar antenna along a 2 m length aperture. In order to assess the radar performances and its detection capability, laboratory tests on masonry facilities were preliminarily performed. Finally, an extensive measurement campaign was carried out on a famous 16th century structure: the ‘Hall of 500’, in Palazzo Vecchio (Old Palace), in Florence (Italy). This investigation was aimed at finding evidence of possible discontinuities in the masonry walls, where fragments of the famous fresco the ‘Battle of Anghiari’ by Leonardo da Vinci could be hidden.

In synthetic aperture radar (SAR) images, the speckle noise often corrupts salient information that is of interest (e.g. textures, small hard targets, object boundaries, etc.). To tackle such an issue, proposed is a novel anisotropic diffusion filter that manages to simultaneously fulfil competing requirements: noise reduction on homogeneous regions, weak edges preservation, and keeping hard targets intact. The capabilities of the proposed filter were proved by comparing it with another two non-linear diffusion filters applied on a Lena image corrupted by a multiplicative speckle noise and on a real SAR image acquired by the Cosmo-SkyMed satellite constellation.

We report a case of aortocaval fistula demonstrated with gadolinium-enhanced magnetic resonance (MR) angiography. Specific radiographic features of this rare complication, such as early and intense enhancement of the inferior vena cava, are underlined with MR imaging. The exact location of the fistula can also be assessed with this noninvasive imaging technique. Moreover, the absence of iodinated contrast media makes it particularly suited for stable patients with renal insufficiency. A complete preoperative assessment of abdominal aortic aneurysm can be performed with MR imaging.

The authors propose the use of a high-speed interferometric radar for remotely measuring both transient displacements and steady-state vibrations of architectural heritage structures in order to test their stability conditions. Demonstrative results of application of the technique to a prominent cultural heritage artwork, the tower of Giotto in Florence, Italy, are reported.

In the context of high spatial resolution Synthetic Aperture Radar (SAR) images, this paper deals with a new computationally efficient algorithm which allows us to accurately detect ships of certain dimensions, which can span in a range supposed known. The topic of ship detection in SAR imagery has been extensively analyzed in literature. However, little is known about such application on SAR data acquired by COSMO-SkyMed (CSK) satellite constellation. Commonly, in SAR images, ship detection methods rely on sea (background) statistical characterization. Nevertheless, such approaches typically require a high computational load. Thus, the time required by classic detection algorithms (e.g. Constant False Alarm Rate - CFAR) may become critical in the context of ship detection for maritime surveillance. In this paper we present a new computationally efficient algorithm for ship detection in SAR images, which is not a CFAR approach. Our algorithm is obtained modifying the classical two-classes segmentation provided by Otsu's histogram thresholding algorithm. Such modifications are necessary to apply Otsu's algorithm in SAR images. They are based on the geometrical proprieties of the target to be detected, i.e. ships whose dimensions can span in a range a priori known. Proofs of the goodness of our algorithm are given on a CSK image acquired over New York.

This paper presents selected results obtain under SARINA project. SARINA is a SAR-based Augmented Integrity Navigation Architecture proposed by authors of this paper. The main goal of the SARINA project was designing and assessing a novel aircraft Inertial Navigation System (INS) for missile and UAV that will make use of features extracted from SAR/InSAR imagery and on-board terrain landmark database in order to ensure robustness against uncompensated IMU errors due to possible GPS lack of.

This paper presents an automatic pre-screening algorithm of SAR images of huge size (more than 20;000×20;000 pixels), which is capable to identifying extended infrastructures in an effective and computationally efficient way. The algorithm is tested on true one-look Cosmo-SkyMed SAR image data for target detection purposes on an airport scenario. Both visual and objective results are presented to show the potentials of the proposed method.

We examined 166 patients with advanced chronic obstructive pulmonary disease (COPD) treated with long-term oxygen therapy (LTOT) in order to evaluate the prognostic factors of such patients. The mean observation period was 24 months (range 2-50 months) and the following variables were considered: age, forced expiratory volume in 1 s (FEV1), arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), hematocrit, right ventricular systolic pressure (RVSP; evaluated by Doppler echocardiography), number of hospitalizations in the 2 years prior to prescription of LTOT and body mass index. The overall survival rate was 78.3% at 24 months and 67.1% at 36 months. A univariate analysis identified three variables as significant predictors of survival: FEV1, PaO2 and RVSP. A multivariate analysis, using Cox's model, showed an independent predictive power for RVSP, age and FEV1. RVSP higher than 35 mm Hg, age greater than 70 years and FEV1 lower than 30% of the predicted value were associated with shortened survival. The importance of pulmonary hypertension as a predictor of death suggests that LTOT could be prescribed earlier for COPD patients with cor pulmonale, as oxygen has been shown to be the only effective therapy for improving the survival probability of these patients.

In the context of augmented integrity Inertial Navigation System (INS), recent technological developments have been focusing on landmark extraction from high-resolution synthetic aperture radar (SAR) images in order to retrieve aircraft position and attitude. The article puts forward a processing chain that can automatically detect linear landmarks on highresolution synthetic aperture radar (SAR) images and can be successfully exploited also in the context of augmented integrity INS. The processing chain uses constant false alarm rate (CFAR) edge detectors as the first step of the whole processing procedure. Our studies confirm that the ratio of averages (RoA) edge detector detects object boundaries more effectively than Student T-test and Wilcoxon-Mann-Whitney (WMW) test. Nevertheless, all these statistical edge detectors are sensitive to violation of the assumptions which underlie their theory. In addition to presenting a solution to the previous problem, we put forward a new post-processing algorithm useful to remove the main false alarms, to select the most probable edge position, to reconstruct broken edges and finally to vectorize them. SAR images from the “MSTAR clutter” dataset were used to prove the effectiveness of the proposed algorithms.

This paper presents the concept of Synthetic Aperture Radar (SAR) and Interferemetric SAR (InSAR) georeferencing algorithms dedicated for SAR based augmented Inertial Navigation Architecture (SARINA). The SARINA is a novel concept of the Inertial Navigation System (INS), which utilized the SAR radar as an additional sensor to provide information about the platform trajectory position and compensate an aircraft drift due to Inertial Measurement Unit (IMU) errors, Global Positioning System (GPS) lack of integrity, etc.

The purpose of this study was to investigate the feasibility of cardiac microdialysis for the in vivo estimation of cardiac interstitial peptide concentrations, and, to determine the changes in neuropeptide Y release in myocardial tissue during experimental brain death in pigs. Using a specifically designed concentric flexible probe, perfused with Ringer solution containing 0.5% of bovine serum albumin at a flow rate of 2 μl/min, allowed us to obtain a 23 ± 2% relative recovery rate in vitro. Based on these in vitro recovery data, a regional study of the kinetics of interstitial NPY levels following brain death was obtained by monitoring the changes in NPY dialysate levels recorded from dialysis probes implanted into the right and left ventricular walls of the beating heart in vivo. Basal dialysate NPY levels determined by radioimmunoassay were of 95.2 ± 7.0 and 93.2 ± 9.1 pmol/l in left and right ventricle, respectively. Brain death was followed by a sustained 2 h increase in NPY dialysate levels in both ventricles (peak levels: 173.2 ± 30.9 pmol/l in left ventricle, and 149.7 ± 23.9 pmol/l in right ventricle), which then returned to control levels. We conclude that cardiac microdialysis is a simple and promising new tool for evaluating the role of peptides in cardiovascular regulation.

Ofloxacin penetration into heart tissue (valve and myocardium), mediastinal fat, and sternal bone marrow was the object of a prospective nonrandomized study. Thirty-six patients undergoing mitral and/or aortic valve replacement were included. Patients were divided into two groups of 18 patients each. Group 1 patients were administered a single 400-mg intravenous dose of ofloxacin over a 30-min period upon anesthesia (n = 6) or at 1 h (n = 6) or 6 h (n = 6) prior to surgery. Group 2 patients received a 200-mg oral dose of ofloxacin every 12 h during the 48 h preceding surgery. In this group, the final dose of ofloxacin was administered 3 h (n = 9) or 8 h (n = 9) before anesthesia. Plasma and tissue ofloxacin concentrations were assayed by high-pressure liquid chromatography. In group 1 patients, the peak level in plasma was 15.9 +/- 2.5 micrograms/ml. Peak ofloxacin levels in tissue were reached by hour 1 and were 8.89 +/- 2.16 micrograms/g in myocardium and 5 +/- 0.75 micrograms/g in heart valves. A significant decrease in ofloxacin levels in heart valve tissue and sternal bone marrow was observed after hour 3. Nevertheless, ofloxacin myocardial, heart valve, and sternal bone marrow levels remained higher than the MICs for the usually susceptible pathogens for at least 3 h. In group 2 patients, myocardial levels were long lasting (6.46 +/- 1.92 micrograms/g [4 to 8 h] and 5.92 +/- 0.95 micrograms/g [8 to 12 h]) and remained higher than those observed in the other tissues over the entire study period. A progressive but insignificant decrease in ofloxacin heart valve levels was observed (from 2.46 +/- 0.40 micrograms/g [4 to 8 h] to 1.57 +/- 0.22 micrograms/g [8 to 12 h]). In both groups, concentration in mediastinal fat were lower and tended to decrease with time. These were 1.83 +/- 0.61 micrograms/g with the first hour and 0.85 +/- 0.43 micrograms/g between hours 8 and 12 in group 1 and 1.74 +/- 0.52 micrograms/g between hours 4 and 8 and 0.67 +/- 0.11 micrograms/g between hours 8 and 12 in group 2. In conclusion, satisfactory diffusion of ofloxacin into heart tissue seems to favor use of the drug in the treatment of bacterial endocarditis due to susceptible pathogens. Furthermore, the progressively decreasing concentrations observed in heart valve and sternal bone marrow and the poor levels achieved in mediastinal fat suggest the need for renewing injection 3 h following initial infusion if the drug is used as an antibiotic prophylactic agent during cardiovascular surgery.

The purpose of this study was to compare the early postoperative effects of heart and heart-lung transplantation on the secretion of atrial natriuretic peptide (alpha-ANP), renin, aldosterone, and vasopressin. This was carried out from the first to the eighth postoperative day in ten heart and five heart-lung recipients. The changes in the release of these hormones were similar in both groups. Vasopressin release remained stable while that of the renin-angiotensin-aldosterone system progressively returned to more normal levels. Grafted heart tissue was capable of high alpha-ANP release early on in both heart and in heart-lung recipients. This sustained alpha-ANP release was not a function of the resulting overall atrial tissue mass. Our findings suggest that it might be the consequence of an intrinsic hypersecretion of alpha-ANP resulting from the loss of normal heart innervation occurring in both heart and heart-lung transplantation.

In chronic pulmonary vascular thrombotic disease, pulmonary thromboendarterectomy lure proved to be effective in reducing pulmonary hypertension and improving gas exchange. However, persistent pulmonary hypertension and unrelenting reperfusion edema are the main causes of death. We report a case of pulmonary thromboendarterectomy followed by an immediate unfavorable postoperative course with acute and persistent pulmonary hypertension, gas exchange impairment, and heart dysfunction. In this particular case, inhaled nitric oxide was successfully administered.

A case of post-transplant lymphoproliferative disease (PTLD) with donor heart involvement is reported. The 49-year-old patient presented with heart failure initially ascribed to acute graft rejection. The treatment with high doses of immunosuppressive agents was unsuccessful and the outcome rapidly fatal. This case suggests that cardiac failure occurring after high doses of immunosuppressive therapy could be a sign of early PTLD in heart transplant recipients.

In this paper we propose a two-dimensional fractal model of the sea surface defined by means of the solution of the sea hydrodynamic differential equations and based on the band-limited Weierstrass-Mandelbrot (WM) fractal functions. Fractal geometry is used to take into account of the multiscale nature of the sea and to give a better description of the fine structure of the sea surface. We determine a closed form expression of the directional sea wave spectrum, we derive the omnidirectional wave spectrum, the angular distribution function and we compare the results with the typical models proposed in the literature. The main contribution of the work is the definition of a new model of the directional sea wave spectrum. This is of interest to SAR imaging studies.

An attempt to determine the consequences of prolonged ischemia on simultaneous regional changes in norepinephrine (NE) and neuropeptide Y (NPY) interstitial myocardial concentrations in a pig model in vivo was made. The aim of the authors was to investigate further the mechanism of the major NE release previously observed in perfused hearts preserved using a Langendorff technique. Regional myocardial ischemia was induced by ligation of the left anterior descending coronary artery (LAD) in ten anesthetized pigs. NE and NPY release was studied using interstitial microdialysis, a technique initially used to monitor neurotransmitter kinetics in brain dialysate samples. Four dialysis probes were implanted into the left ventricular wall of the beating heart. Two were implanted into the ischemic region (LAD) (for NE and NPY determinations, respectively) and the remaining two into the non-ischemic left circumflex coronary artery region (LCX). Dialysate NE and NPY concentrations, as indices of interstitial myocardial NE and NPY concentrations, were measured by HPLC and RLA, respectively. A slight but significant increase in NPY levels was observed in both territories (LAD: from 190 +/- 27 to 349 +/- 62 pmol/l, LCX: 146 +/- 30 to 257 +/- 52 pmol/l) suggesting moderate stimulation of cardiac sympathetic nerve activity following LAD occlusion. On the contrary, a marked but progressive increase in NE release was observed in the ischemic region (from 8.8 +/- 1.0 to 251.4 +/- 44.8 nmol/l), when NE levels in the non-ischemic region remained stable (from 10.3 +/- 2.1 to 11.0 +/- 1.9 nmol/l). These results demonstrate the utility of regional in-vivo myocardial NE and NPY monitoring using microdialysis. The strong and sustained NE accumulation occurring in the ischemic region is consistent with the hypothesis of a local non-exocytotic metabolic NE release in case of prolonged myocardial ischemia, when exocytotic release remain only minimal as attested by the slight increase in NPY observed.

Background. Because of problems concerning the functional quality of heart transplants, more and more interest has been focused on the physiologic changes occurring during brain death, one of the major possible contributing factors to the myocardial alterations. Methods. The aim of this study was to describe the link between acute experimental brain death and myocardial metabolism. This was achieved by in vivo 3-hour hemodynamic and biological (myocardial lactate production) studies and then in vitro 6-hour phosphorus-31 nuclear magnetic resonance spectroscopy. Two groups of pigs were involved in the study: group I (n = 10) as control and group II (n = 10) as brain-dead animals. Results. Within the first hour, we observed a strong increase in myocardial activity associated with the onset of myocardial lactate production, lasting 2 hours and corresponding to a myocardial anaerobic metabolism period. Despite the apparent normalization before excision of the hearts, phosphorus-31 nuclear magentic resonance spectroscopy revealed to significant decrease in adenosine triphosphate levels in group II when compared with group I. Conclusions. We conclude that, in our study, acute experimental brain death is associated with an early and transient period of myocardial anaerobic metabolism and adenosine triphosphate consumption. These myocardial consequences of brain death could partially explain some observations of hear graft dysfunction.

Changes in hemodynamic and metabolic parameters (systemic oxygen delivery, [DO2], oxygen consumption [VO2], arterial lactate content) in brain-dead and control pigs in the absence of any inotropic or fluid support were studied. Brain death was induced by the inflation of a Foley catheter balloon placed into the subdural space of the animals. Serial atrial natriuretic peptide (ANP) determinations were performed to evaluate concomitant changes occurring in the endocrine function of the heart. Experiments were completed by a volume expansion protocol to provide a dynamic evaluation of these parameters. A significant increase in heart rate (from 113 +/- 5 to 176 +/- 11 beats/min), pulmonary capillary wedge pressure (from 7 +/- 1 to 12 +/- 3 mmHg), dP/dt (from 2040 +/- 340 to 4200 +/- 660 mmHg/sec-1), cardiac output (from 2.4 +/- 0.2 to 3.3 +/- 0.4 L/min), mean arterial pressure (from 66 +/- 8 to 93 +/- 14 mmHg), and systemic oxygen delivery (from 360 +/- 30 to 530 +/- 90 ml/min-1), was observed following brain death induction. These parameters returned below basal values within 60 min. On the contrary, serum lactate and VO2 remained unchanged. Following volume expansion, brain-dead pigs exhibited impaired hemodynamic response, with a significant decrease in dP/dt, MAP, and DO2. These changes were accompanied by a significant decrease in VO2 and a significant increase in lactate plasma levels. At the same time, a similar increase in ANP release was observed in both groups in response to volume expansion, suggesting that despite impaired myocardial contractility, endocrine function of the heart was preserved following brain death. We conclude that brain death leads to early impaired left ventricular contractility, which could be responsible for the changes observed in aerobic to anaerobic metabolism in response to rapid volume infusion. These results suggest that the use of fluid infusion to reduce the need in inotropic support in conventional therapeutic modalities should be used with care in the management of a brain-dead potential organ donor.

Brain death is a pathophysiological condition associated with major hemodynamic changes, temporary myocardial ischemia, and histological damage of the heart. These modifications could be related to a major local release of norepinephrine from myocardial sympathetic nerve endings leading to norepinephrine cardiotoxicity. This study was designed to evaluate the utility of cardiac microdialysis to measure interstitial myocardial norepinephrine release resulting from brain death. The dialysis probe consisted in a 10 x 0.20-mm dialysis fiber with a 18,000 mol wt cutoff. Dialysis probes were implanted into the right and left ventricular walls of the beating heart in anesthetized pigs and perfused with Ringer solution at 2 microliters/min. Dialysate norepinephrine concentration was measured using HPLC with electrochemical detection. The relative recovery rate of norepinephrine in vivo was 34 +/- 4%. Interstitial fluid concentrations were obtained using the following formula: [C]interstitium = [C]dialysate/Recovery in vivo. After brain death, a transient increase in interstitial norepinephrine concentration was observed (from 0.74 +/- 0.20 to 4.50 +/- 0.60 ng/ml and 0.76 +/- 0.20 to 6.2 +/- 0.9 ng/ml in left and right ventricle, respectively, P < 0.01) which far exceeded plasma level increase (from 0.50 +/- 0.10 ng/ml to 0.91 +/- 0.20 ng/ml, P < 0.05). This increase in myocardial norepinephrine was, moreover, biphasic, with a second peak occurring 40 min after brain death. The present study confirms the onset of a dramatic increase in cardiac norepinephrine release from myocardial nerve endings following brain death, and demonstrate the utility of the new cardiac microdialysis technique to assess changes in interstitial fluid content.

1.3-μm uncooled cylindrical and receptable lasers are on the threshold of large-scale implementation for fiber-in-the-loop application. This demands a high-performance chip that can operate over a wide temperature range, can achieve sufficient fiber-coupled power by using low-cost packaging and optics, and can be manufactured at low cost. We achieved a solution to this challenge by using a compressively strained deep-quantum-well AlGaInAs structure combined with a ridge-waveguide (RWG) chip.

Background —Phosphorus nuclear magnetic resonance spectroscopy has been proposed as a method of studying the metabolism of the myocardium in patients. Little is known about 31 P nuclear magnetic resonance spectroscopy of diseased human hearts. Methods —Two donor hearts meeting the requirements for heart transplantation and 11 diseased hearts were removed during a transplantation procedure and were studied in a horizontal 2·35 T superconducting magnet. Spectra were obtained at 0°C about 30 minutes after the excision. The areas of the inorganic phosphate peak (Pi) and of the phosphocreatine peak (PCr) were summed and expressed as a ratio with respect to the area of the β ATP peak. Results —The ratio (Pi + Pcr)/β ATP was found to be significantly lower in five hearts with a myocardial infarct (0·77 (0·18)) than in hearts with dilated cardiomyopathy (1·25 (0·29)) and in normal hearts (1·69 (0·11)). The area of the phosphodiester peak was expressed as a ratio with respect to the area of the β ATP peak: no differences were found between the three groups. Conclusions —These results suggest that the phosphocreatine concentration is lower in ischaemic heart disease than in dilated cardiomyopathy and that the phosphodiester peak is probably not useful in distinguishing between these two types of heart disease.

We describe the main features of our computerized Database for the management of an out-patient cardiology clinic.

The authors consider the problem of motion compensation in the inverse synthetic aperture radar (ISAR) imaging technique. A novel autofocusing technique based on maximum-likelihood (ML) estimation of the focusing parameters is proposed. The likelihood function is computed by using as observed data samples of the instantaneous frequency (IF) of the received signal. A statistical analysis of the IF is performed, both to determine the likelihood function and to define a criterion for the choice of IF samples to be processed. The effectiveness of the autofocusing algorithm is shown by presenting and discussing some simulation results.

A reactive ion etching process and system using iodine containing plasmas for etching InP, InGaAs, and InGaAsP is described. A special system was constructed to deliver iodine to an etching chamber and trap the iodine to prevent damage to the pumping system. Etch rates and profiles were determined using both large area and grating test patterns with linewidths as small as 20 nm. Using mixtures of Ar:I2 and H2 :HI:CH4 at a substrate temperature of 100 °C, lines 20 nm wide and 1 μm deep with vertical sidewalls were etched in InP at a rate of 200 nm/min using a Ni mask. The use of this etching technique in the fabrication of highly reliable InGaAsP distributed feedback lasers with a unique structure is also described.

1. Benzodiazepine receptors were studied in rats with hepatic encephalopathy due to fulminant hepatic failure induced by galactosamine. [3H]-Diazepam binding studies on brain synaptic membranes of rats with mild and severe encephalopathy show a significant increase in the number of receptors in both stages of coma. 2. [3H]Diazepam binding to synaptic membrane preparations from rats in the mild or severe stage of encephalopathy hyper-responded to the stimulatory effect of γ-aminobutyric acid (GABA) applied in vitro at doses which for control rat preparations were in a subthreshold range. The effect of GABA was shown to be specific, since it was blocked by bicuculline methiodide. The sensitivity of benzodiazepine receptors in hepatic encephalopathy to nanomolar concentrations of GABA, which induced a significant increase in their affinity, seems to indicate a functional supersensitivity of benzodiazepine receptors in vivo in both mild and severe stages of encephalopathy. 3. The phenomena described may be attributed to a partial degeneration of nerve terminals in hepatic encephalopathy, leading to a supersensitivity of benzodiazepine receptors, which parallels the previously described denervation supersensitivity of GABA receptors present in this animal model of fulminant hepatic failure. These findings may account for the brain hypersensitivity to sedatives administered to patients with liver diseases. 4. The administration in vivo of a benzodiazepine antagonist, 2-phenylpyrazolo [4,3-c]-quinolin-3(5H)-one, counteracted the hypersensitivity of benzodiazepine receptors in the mild stage of encephalopathy. In fact, electrophysiological studies with visually evoked potential recordings in rats in the mild stage of encephalopathy 30-60 min after the administration of the drug showed a recovery of the wave pattern, and this electrophysiological finding was substantiated by the demonstration that both the number and the affinity of benzodiazepine receptors were strongly reduced.

Visual evoked potential recordings were examined in 45 liver cirrhosis patients with (n = 29) and without (n = 16) encephalopathy, in 15 normal volunteers, and in one patient with an opioid induced stupor state. Visual evoked potential parameters were classified on the basis of EEG recordings. Plasma concentrations of amino acids, octopamine, and ammonia were assayed in order to document the metabolic change of hepatic encephalopathy. Latencies and wave patterns recorded after flash stimulation differentiated the four degrees of the coma one from another according to EEG classification in the 29 patients with encephalopathy. In the group of 16 patients without clinical and EEG evidence of encephalopathy the visual potential recordings discriminated a group of patients (n = 10) in a preclinical stage of encephalopathy. Biochemical parameters and subsequent clinical observation of patients confirmed our judgement of a preclinical stage of encephalopathy. These results suggest that visual evoked potentials are a simple, suitable and objective method for differentiating the degrees of encephalopathy and for identifying the preclinical stage of encephalopathy.

Summary Clinical observation has indicated a supersensitivity to morphine in patients with hepatic encephalopathy. With the aim of clarifying the issue, radioreceptor binding studies of opiate receptors were performed in frontal cortex and hypothalamus of 6 dogs with mild portal-systemic encephalopathy induced by chronic treatment with dimethylnitrosamine followed by porto-caval shunt end-to-side. β -Endorphin assays were performed in the same areas with radioimmunoassay. Opiate receptors labeled with [ 3 H]naloxone in both areas showed a significant increase in the receptor densities (B max ) without changes in the dissociation constant ( K D ). In parallel β -endorphin levels showed a decline during the development of encephalopathy in both areas. The increased densities of opiate receptors in the mild stage of encephalopathy may explain the supersensitivity to morphine in patients with liver diseases.

The monitoring of the cerebral dysfunctions of patients with hepatic encephalopathy (HE) due to liver cirrhosis or to fulminant hepatic failure is still empirical and imprecise.

none 9 Abstract Background: Signs of serious clinical events overlap with those of sepsis. We hypothesised that any education on severe sepsis/septic shock may affect the outcome of all hospital patients. We designed this study to assess the trend of the mortality rate of adults admitted to hospital for at least one night in relationship with a hospital staff educational program dedicated to severe sepsis/septic shock. Methods: This study was performed in six Italian hospitals in the same region. Multidisciplinary Sepsis Teams members were selected by each hospital management among senior staff. The education included the following steps: i) the Teams were taught about adult learning, problem based learning, and Surviving Sepsis guidelines, and provided with educational material (literature, electronic presentations, scenarios of clinical cases for training and booklets); ii) they started delivering courses and seminars each to their own hospital staff in the last quarter of 2007. To analyse mortality, we selected adult patients, admitted for at least one night to the wards or units present in all the study hospitals and responsible for 80% of hospital deaths. We fitted a Poisson model with monthly hospital mortality rates from December 2003 to August 2009 as dependent variable. The effect of the educational program on hospital mortality was measured as two dummy variables identifying a first (November 2007 to December 2008) and a second (January to August 2009) education period. The analysis was adjusted for a linear time trend, seasonality and monthly average values of age, Charlson score, length of stay in hospital and urgent/non-urgent admission. Results: The hospital staff educated reached 30.6% at the end of June 2009. In comparison with the pre-education period, the Relative Risk of death of the patient population considered was 0.93 (95% confidence interval [CI] 0.87-0.99; p 0.025) for in-patients in the first, and 0.89 (95% CI 0.81-0.98; p 0.012) for those in the second period after education. Conclusion: Our hypothesis that a program educating hospital staff to early detection and treatment of severe sepsis/septic shock may affect the outcome of all hospital patients is original, but it has to be corroborated by other experiences. M. Capuzzo; M. Rambaldi; G. Pinelli; M. Campesato; A. Pigna; M. Zanello; M. Barbagallo; M. Girardis; E. Toschi M. Capuzzo; M. Rambaldi; G. Pinelli; M. Campesato; A. Pigna; M. Zanello; M. Barbagallo; M. Girardis; E. Toschi