BACKGROUND & AIMS: :Earlier studies have shown that the aortic root, in analogy with the mitral annulus, moves towards the left ventricular apex during systole. However, there are no earlier studies comparing the amplitude of the aortic annulus motion (AAM) with that of the mitral annulus (MAM), which was the main aim of the study. Another aim was to study the intra- and interobserver reproducibility (IIOR) of measuring AAM with M-mode and 2-D echocardiography as it is not obvious which of the methods that should be used. Twenty-one healthy subjects were examined by echocardiography. AAM and MAM were measured at different sites. IIOR was measured in 10 of the subjects. There was no significant difference between average AAM (15.3 +/- 1.5 mm) and average MAM (15.6 +/- 1.5 mm) and there was a rather good agreement between the variables. There was also no significant difference between AAM at the septal site (16.3 +/- 2 mm) and average MAM, but a significant difference between AAM at the lateral site (14.2 +/- 1.6 mm) and average MAM (P<0.001) and between the both sites of measuring AAM (P<0.001). The significant difference between the two sites of measuring AAM may have anatomical reasons but may also depend on difficulties in measuring AAM at the septal site where it has lower reproducibility than at the lateral site. IIOR of measuring AAM was good when using M-mode but poor when using 2-D echocardiography and AAM should preferably be measured using M-mode and not using 2-D echocardiography.

背景与目标： ：较早的研究表明，与二尖瓣环类似，主动脉根在收缩期向左心尖移动。但是，目前尚无比较主动脉瓣环运动幅度（AAM）和二尖瓣环运动（MAM）幅度的研究，这是该研究的主要目的。另一个目的是研究使用M型和二维超声心动图测量AAM的观察者之间和观察者之间的可重复性（IIOR），因为不明确应该使用哪种方法。通过超声心动图检查二十一名健康受试者。 AAM和MAM在不同的位置进行了测量。在10位受试者中测量了IIOR。平均AAM（15.3 /-1.5 mm）和平均MAM（15.6 /-1.5 mm）之间没有显着差异，并且变量之间有相当好的一致性。间隔部位的AAM（16.3 /-2 mm）与平均MAM之间也没有显着差异，但外侧部位的AAM（14.2 /-1.6 mm）与平均MAM（P <0.001）之间以及之间测量AAM的两个位置（P <0.001）。测量AAM的两个部位之间的显着差异可能是解剖学原因，但也可能取决于在可重复性低于外侧部位的间隔部位测量AAM的困难。使用M模式时，测量AAM的IIOR较好，而使用2-D超声心动图时，IIOR较差，最好使用M模式而不使用2-D超声心动图测量AAM。

BACKGROUND & AIMS: :A novel approach to DNase I-sensitivity analysis was applied to examining genes of the spermatogenic pathway, reflective of the substantial morphological and genomic changes that occur during this program of differentiation. A new real-time PCR-based strategy that considers the nuances of response to nuclease treatment was used to assess the nuclease susceptibility through differentiation. Data analysis was automated with the K-Lab PCR algorithm, facilitating the rapid analysis of multiple samples while eliminating the subjectivity usually associated with C(t) analyses. The utility of this assay and analytical paradigm as applied to nuclease-sensitivity mapping is presented.

背景与目标： ：一种新的DNase I敏感性分析方法被用于检查生精途径的基因，反映了分化过程中发生的实质性形态和基因组变化。一种新的基于实时PCR的策略考虑了对核酸酶处理反应的细微差别，用于通过分化评估核酸酶敏感性。数据分析使用K-Lab PCR算法实现自动化，有助于快速分析多个样品，同时消除了通常与C（t）分析相关的主观性。介绍了该测定法和分析范例应用于核酸酶敏感性作图的实用性。

BACKGROUND & AIMS: BACKGROUND:The fourth Millennium Development Goal (MDG) calls for a two-thirds' reduction between 1990 and 2015 in deaths of children younger than five years; achieving this will require widespread use of effective interventions, especially in poor countries. We present the first report of the Child Survival Countdown, a worldwide effort to monitor coverage of key child-survival interventions in 60 countries with the world's highest numbers or rates of child mortality. METHODS:In 2005, we developed a profile for each of the 60 countries to summarise information on coverage with essential child survival interventions. The profiles also present information on demographics, nutritional status, major causes of death in children under 5 years of age, and the status of selected health policies. Progress toward the fourth MDG is summarised by comparing the average annual rate of reduction in under-5 mortality in each country with that needed to achieve the goal. The profiles also include a comparison of the proportions of children in the poorest and richest quintiles of the population who received six or more essential prevention interventions. Each country's progress (as measured by defined indicators of intervention coverage) was put into one of three groups created on the basis of international targets: "on track"; "watch and act"; and "high alert". For indicators without targets, arbitrary thresholds for high, middle, and low performance across the 60 countries were used as a basis for categorisation. FINDINGS:Only seven countries are on track to met MDG-4, 39 countries are making some progress, although they need to accelerate the speed, and 14 countries are cause for serious concern. Coverage of the key child survival interventions remains critically low, although some countries have made substantial improvements in increasing the proportion of mothers and children with access to life saving interventions by as much as ten percentage points in 2 years. Children from the poorest families were less likely than those from wealthier families to have received at least six essential prevention interventions. INTERPRETATION:Our results show that tremendous efforts are urgently needed to achieve the MDG for child survival. Profiles for each country show where efforts need to be intensified, and highlight the extent to which prevention interventions are being delivered equitably and reaching poor families. This first report also shows country-specific improvements in coverage and highlights missed opportunities. The "Countdown to 2015" will report on progress every 2 years as a strategy for increasing accountability worldwide for progress in child survival.

背景与目标： 背景：第四项千年发展目标（MDG）要求在1990年至2015年之间将五岁以下儿童的死亡人数减少三分之二；要实现这一目标，就需要广泛使用有效的干预措施，尤其是在贫穷国家。我们将提交儿童生存倒计时的第一份报告，这是一项全球性的工作，目的是监测儿童死亡率或死亡率最高的60个国家/地区中主要儿童生存干预措施的覆盖率。
方法：2005年，我们为60个国家/地区中的每个国家/地区建立了概况，以总结有关基本儿童生存干预措施覆盖面的信息。简介还提供有关人口统计学，营养状况，5岁以下儿童主要死亡原因以及某些卫生政策状况的信息。通过将每个国家5岁以下儿童死亡率的年均降低速度与实现该目标所需的速度进行比较，总结了实现第四项千年发展目标的进展。概况还包括比较了接受六种或更多种基本预防干预措施的最贫穷和最富有的五分之一人口中儿童的比例。将每个国家的进展情况（按确定的干预覆盖率指标衡量）归入根据国际目标建立的三个小组之一： “观看并表演”；和“高度戒备”。对于没有指标的指标，将60个国家/地区的绩效中高，中，低水平的任意阈值用作分类的基础。
结果：只有七个国家有望实现MDG-4，尽管有39个国家需要加快速度，但仍取得了一些进展，还有14个国家引起了严重关注。关键的儿童生存干预措施的覆盖率仍然非常低，尽管一些国家在将获得救生干预措施的母亲和儿童的比例在两年内提高了十个百分点方面取得了实质性的改善。与最富裕家庭的孩子相比，最贫穷家庭的孩子接受至少六项基本预防干预的可能性较小。
解释：我们的结果表明，为实现儿童生存的千年发展目标，迫切需要付出巨大的努力。每个国家的概况显示了需要加强努力的地方，并强调了公平地实施预防干预措施并惠及贫困家庭的程度。该第一份报告还显示了特定国家/地区在覆盖率方面的改进，并重点介绍了错过的机会。 “到2015年倒计时”将每两年报告进展情况，以此作为在全球范围内增加对儿童生存进展的责任感的战略。

BACKGROUND & AIMS: OBJECTIVES:Pharmaceuticals in the environment are of growing public health concern. The main objectives of this study were to develop a new emission estimation model, identify factors critical to reducing emission, and demonstrate the model's applicability for screening and priority setting. METHODS:A new emission estimation model was developed covering the life cycle pathways of pharmaceuticals from supply to discharge into surface water. The emission estimates of the model were assessed by coupling with SimpleBox to give predicted concentrations and by comparing the predicted concentrations with measured concentrations in Korean surface waters for five selected pharmaceuticals (acetaminophen, cephradine, ibuprofen, mefenamic acid, and naproxen). RESULTS:The sensitivity analysis revealed that the biodegradation rate in the sewage treatment plant and the excretion rate of pharmaceuticals were the most important factors influencing the emission rate. The uncertainty of the emission estimate was found to increase with increases in the value of the emission estimate. Once the intrinsic properties of a pharmaceutical (excretion rate, biodegradation rate, and removal rate by sludge separation) were given, the patient behavior parameters, such as participation in a Take-back program and rate of administration, were determined to have a strong influence on the emission estimate. In our study, the predicted and measured concentrations agreed with each other within one order of magnitude. Several management implications were drawn from the analysis of model outcomes. CONCLUSIONS:The model outcomes, alone or in combination with toxicity data, may potentially be used for the purposes of screening, priority setting, and the design of management programs.

背景与目标： 目的：环境中的药品日益引起人们对公共卫生的关注。这项研究的主要目的是开发一个新的排放估算模型，确定对减少排放至关重要的因素，并证明该模型在筛选和确定优先级方面的适用性。
方法：建立了一个新的排放估算模型，该模型涵盖了药品从供应到排放到地表水中的生命周期路径。通过与SimpleBox耦合以给出预测浓度，并通过将预测浓度与五种选定药物（对乙酰氨基酚，头孢拉定，布洛芬，甲芬那酸和萘普生）在韩国地表水中的测量浓度进行比较，来评估模型的排放估算值。
结果：敏感性分析表明，污水处理厂的生物降解率和药物的排泄率是影响排放率的最重要因素。发现排放估算的不确定性随着排放估算值的增加而增加。一旦给出了药物的固有特性（排泄率，生物降解率和污泥分离去除率），就可以确定患者行为参数（例如参与“回收计划”和给药率）具有很强的影响力在排放量估算上。在我们的研究中，预测浓度和测量浓度在一个数量级内彼此一致。通过对模型结果的分析得出了一些管理上的含义。
结论：模型结果单独或与毒性数据结合可潜在地用于筛查，确定优先重点和设计管理程序的目的。

BACKGROUND & AIMS: :Although other imaging techniques, such as magnetic resonance imaging and computer tomography, are becoming more and more important in cardiology, two-dimensional echocardiography is still the most used technique in clinical cardiology. Quantification of left ventricular function and dimensions is important because therapeutic strategies, for example implanting an ICD after myocardial infarction, are based on ejection fraction measurements. Because of the sometimes low quality of echocardiographic images we started to use an ultrasound contrast agent and in this article we describe our experiences with SonoVue, a second-generation contrast agent, over a threeyear period in the Thoraxcentre. (Neth Heart J 2007;15:55-60.).

背景与目标： ：尽管其他成像技术（例如磁共振成像和计算机断层扫描）在心脏病学中变得越来越重要，但二维超声心动图仍是临床心脏病学中最常用的技术。量化左心室功能和大小很重要，因为治疗策略（例如心肌梗死后植入ICD）是基于射血分数测量的。由于有时超声心动图图像的质量较低，我们开始使用超声造影剂，在本文中，我们介绍了在胸部中心三年内使用第二代造影剂SonoVue的经验。 （Neth Heart J 2007; 15：55-60。）。

BACKGROUND & AIMS: BACKGROUND:Organ motion during treatment delivery in radiotherapy (RT) may lead to deterioration of the planned dose, but can be mitigated by dynamic multi-leaf collimator (DMLC) tracking. The purpose of this study was to implement and experimentally validate a method for time-resolved motion including dose reconstruction for volumetric modulated arc therapy (VMAT) treatments delivered with and without DMLC tracking. MATERIAL AND METHODS:Tracking experiments were carried out on a linear accelerator (Trilogy, Varian) with a prototype DMLC tracking system. A motion stage carrying a biplanar dosimeter phantom (Delta4PT, Scandidos) reproduced eight representative clinical tumor trajectories (four lung, four prostate). For each trajectory, two single-arc 6 MV VMAT treatments with low and high modulation were delivered to the moving phantom with and without DMLC tracking. An existing in-house developed program that adds target motion to treatment plans was extended with the ability to split an arc plan into any number of sub-arcs, allowing the calculated dose for different parts of the treatment to be examined individually. For each VMAT sub-arc, reconstructed and measured doses were compared using dose differences and 3%/3 mm γ-tests. RESULTS:For VMAT sub-arcs the reconstructed dose distributions had a mean root-mean-square (rms) dose difference of 2.1% and mean γ failure rate of 2.0% when compared with the measured doses. For final accumulated doses the mean rms dose difference was 1.6% and the γ failure rate was 0.7%. CONCLUSION:The time-resolved motion including dose reconstruction was experimentally validated for complex tracking and non-tracking treatments with patient-measured tumor motion trajectories. The reconstructed dose will be of high value for evaluation of treatment plan robustness facing organ motion and adaptive RT.

背景与目标： 背景：放射治疗（RT）进行治疗期间的器官运动可能会导致计划剂量的恶化，但可以通过动态多叶准直仪（DMLC）跟踪来缓解。这项研究的目的是实施并通过实验验证一种用于时间分辨运动的方法，包括采用和不采用DMLC跟踪进行体积调制电弧治疗（VMAT）治疗的剂量重建。
材料与方法：跟踪实验是在具有原型DMLC跟踪系统的线性加速器（Trilogy，Varian）上进行的。携带双平面剂量计体模（Delta4PT，Scandidos）的运动台可再现八种代表性的临床肿瘤轨迹（四肺，四前列腺）。对于每条轨迹，在有和没有DMLC跟踪的情况下，将两种具有低调制和高调制的单弧6 MV VMAT处理传递给运动体模。现有的内部开发程序可以将目标运动添加到治疗计划中，从而可以将电弧计划划分为任意数量的子弧，从而可以对治疗不同部分的计算出的剂量进行单独检查。对于每个VMAT子电弧，使用剂量差异和3％/ 3 mmγ测试比较重建和测量的剂量。
结果：对于VMAT亚弧，与测量剂量相比，重建的剂量分布的平均均方根（rms）剂量差异为2.1％，平均γ失效率为2.0％。对于最终累积剂量，平均均方根剂量差异为1.6％，γ失效率为0.7％。
结论：包括剂量重建在内的时间分辨运动已通过实验验证，可用于采用患者测量的肿瘤运动轨迹进行复杂的跟踪和非跟踪治疗。重建的剂量对于评估面向器官运动和适应性RT的治疗计划的鲁棒性将具有很高的价值。

BACKGROUND & AIMS: :Subvalvar left ventricular aneurysms are rare and occur predominantly in black Africans. A submitral left ventricular aneurysm was diagnosed on cross sectional echocardiography in a black woman born in the United Kingdom. The left parasternal long axis view showed a highly echogenic mass apparently attached to the wall of a dilated left atrium, but the apical two-chamber view showed that this was thrombus in the apex of a left ventricular aneurysm. The patient subsequently underwent surgical correction.

背景与目标： ：左室下动脉瘤很少见，主要发生在非洲黑人中。通过横断面超声心动图检查，在英国出生的一名黑人妇女被确诊为左心室动脉瘤。左胸骨旁长轴视图显示高度回声的肿块，明显附着在扩张的左心房壁上，但心尖两腔视图显示这是左心室动脉瘤顶点的血栓。患者随后接受了手术矫正。

BACKGROUND & AIMS: BACKGROUND:Cardiac output (CO) monitoring is a valuable tool for the diagnosis and management of critically ill patients. In the critical care setting, few studies have evaluated the level of agreement between CO estimated by transthoracic echocardiography (CO-TTE) and that measured by the reference method, pulmonary artery catheter (CO-PAC). The objective of the present study was to evaluate the precision and accuracy of CO-TTE relative to CO-PAC and the ability of transthoracic echocardiography to track variations in CO, in critically ill mechanically ventilated patients. METHODS:Thirty-eight mechanically ventilated patients fitted with a PAC were included in a prospective observational study performed in a 16-bed university hospital ICU. CO-PAC was measured via intermittent thermodilution. Simultaneously, a second investigator used standard-view TTE to estimate CO-TTE as the product of stroke volume and the heart rate obtained during the measurement of the subaortic velocity time integral. RESULTS:Sixty-four pairs of CO-PAC and CO-TTE measurements were compared. The two measurements were significantly correlated (r = 0.95; p < 0.0001). The median bias was 0.2 L/min, the limits of agreement (LOAs) were -1.3 and 1.8 L/min, and the percentage error was 25%. The precision was 8% for CO-PAC and 9% for CO-TTE. Twenty-six pairs of ΔCO measurements were compared. There was a significant correlation between ΔCO-PAC and ΔCO-TTE (r = 0.92; p < 0.0001). The median bias was -0.1 L/min and the LOAs were -1.3 and +1.2 L/min. With a 15% exclusion zone, the four-quadrant plot had a concordance rate of 94%. With a 0.5 L/min exclusion zone, the polar plot had a mean polar angle of 1.0° and a percentage error LOAs of -26.8 to 28.8°. The concordance rate was 100% between 30 and -30°. When using CO-TTE to detect an increase in ΔCO-PAC of more than 10%, the area under the receiving operating characteristic curve (95% CI) was 0.82 (0.62-0.94) (p < 0.001). A ΔCO-TTE of more than 8% yielded a sensitivity of 88% and specificity of 66% for detecting a ΔCO-PAC of more than 10%. CONCLUSION:In critically ill mechanically ventilated patients, CO-TTE is an accurate and precise method for estimating CO. Furthermore, CO-TTE can accurately track variations in CO.

背景与目标： 背景：心脏输出（CO）监测是诊断和管理重症患者的宝贵工具。在重症监护环境中，很少有研究评估经胸超声心动图（CO-TTE）评估的CO与参考方法肺动脉导管（CO-PAC）评估的CO之间的一致性水平。本研究的目的是评估重症机械通气患者中CO-TTE相对于CO-PAC的准确性和准确性，以及经胸超声心动图追踪CO变化的能力。
方法：38名装有PAC的机械通气患者被纳入在16张病床的大学医院ICU中进行的前瞻性观察研究中。通过间歇热稀释法测量CO-PAC。同时，第二位研究者使用标准视野TTE来估计CO-TTE，作为中风量和在测量主动脉下时间积分时获得的心率的乘积。
结果：比较了64对CO-PAC和CO-TTE测量值。两次测量结果显着相关（r = 0.95； p <0.0001）。中位数偏差为0.2 L / min，一致极限（LOA）为-1.3和1.8 L / min，百分误差为25％。对于CO-PAC，精度为8％，对于CO-TTE，精度为9％。比较了26对ΔCO测量值。 ΔCO-PAC和ΔCO-TTE之间存在显着相关性（r = 0.92; p <0.0001）。平均偏差为-0.1 L / min，LOA为-1.3和1.2 L / min。具有15％的禁区，四象限地块的一致性率为94％。在0.5L / min的禁区下，极坐标图的平均极角为1.0°，LOA的百分比误差为-26.8至28.8°。在30至-30°之间的一致性率为100％。当使用CO-TTE检测到ΔCO-PAC的增加超过10％时，接收工作特性曲线下的面积（95％CI）为0.82（0.62-0.94）（p <0.001）。 ΔCO-TTE大于8％时，检测到ΔCO-PAC大于10％时，灵敏度为88％，特异性为66％。
结论：对于重症机械通气患者，CO-TTE是估算CO的准确方法。此外，CO-TTE可以准确跟踪CO的变化。

BACKGROUND & AIMS: :Objectives: We assessed the natural history of the different types of isolated ventricular septal defects (VSDs) diagnosed by fetal echocardiography and analyzed their postnatal outcomes.Methods: This is a retrospective cohort study of 86 fetuses with isolated VSDs, detected in 7466 sequential echocardiographic examinations. The subtype and size of the VSDs were assessed during fetal life and the following birth. Data on the spontaneous closure of the VSD, need for intervention, additional abnormalities and chromosomal aberrations was analyzed.Results: From the original cohort 75 cases of isolated VSDs with complete data on outcome were further analyzed. Muscular and perimembranous VSDs were found in 85.3 and 14.7%, respectively. Spontaneous closure of the VSDs occurred prenatally in 31/64 and 3/11 of fetuses with muscular VSD and perimembranous VSD, respectively. Spontaneous closure of the VSD by the age of 2 years occurred in 92.2 and 45.5% of cases with muscular and perimembranous VSDs respectively (p = 0.001).Conclusion: Isolated muscular VSDs usually close spontaneously during pregnancy or in the first 2 years of life and probably do not increase the risk for chromosomal aberrations. On the other hand, isolated perimembranous VSDs may need intervention following birth and may be associated with a chromosomal anomaly.

背景与目标： ：目的：我们评估了由胎儿超声心动图诊断出的不同类型的孤立室间隔缺损（VSD）的自然史，并分析了其出生后的结局。方法：这是一项回顾性队列研究，研究对象是7466例连续超声心动图检查的86例具有孤立VSD的胎儿。考试。在胎儿生命期间和以后的出生中评估了VSD的亚型和大小。分析了有关VSD自发闭合，需要干预，其他异常情况和染色体畸变的数据。结果：从最初的队列中分离出的75例VSD患者中，进一步获得了关于结局的完整数据。分别在85.3和14.7％处发现肌肉和膜周VSD。 VSDs的自发性关闭发生在产前分别为肌肉VSD和膜周VSD的胎儿的31/64和3/11。分别在92.2岁和24.5岁时出现肌肉和膜周VSD的患者自发关闭VSD，分别为92.2和45.5％（p = 0.001）。结论：孤立的肌肉VSD通常在怀孕期间或生命的前2年和5年内自发关闭。可能不会增加染色体畸变的风险。另一方面，孤立的膜周性VSD可能在出生后需要干预，并且可能与染色体异常有关。

BACKGROUND & AIMS: :Doppler ultrasound recordings of velocities of flow across the mitral and tricuspid valves and in the hepatic veins, and their variation with respiration, were recorded in seven patients with constrictive pericarditis and in six patients with restrictive cardiomyopathy. Deceleration of mitral and tricuspid flow was also evaluated during apnea. Color flow Doppler was performed in order to evaluate mitral and tricuspid regurgitation. Eight healthy adults served as controls. The patients with constrictive pericarditis showed higher peak diastolic velocities of mitral flow, as well as marked increase of velocity of flow at the onset of expiration and decrease at the onset of inspiration. Reciprocal respiratory variation of the velocities were also observed across the tricuspid valve. The patients with restrictive cardiomyopathy showed moderate or severe mitral and tricuspid regurgitation. They also showed shorter deceleration of flow across the mitral and tricuspid valves during apnea. The pattern of flow in the hepatic veins showed reversal during systole with accentuated reversion during inspiration. These results suggest that patient with constrictive pericarditis and restrictive cardiomyopathy can be differentiated by comparing Doppler echocardiographic data, along with changes induced by respiration.

背景与目标： 多普勒超声记录了二尖瓣和三尖瓣以及肝静脉中的流速及其随呼吸的变化，记录了7例收缩性心包炎患者和6例限制性心肌病患者。在呼吸暂停期间还评估了二尖瓣和三尖瓣血流的减速度。进行彩色多普勒检查以评估二尖瓣和三尖瓣关闭不全。八名健康成年人作为对照。收缩性心包炎患者的二尖瓣血流舒张峰值速度较高，并且在呼气开始时血流速度明显增加，在吸气开始时血流速度明显降低。在三尖瓣上也观察到速度的相互呼吸变化。限制性心肌病患者表现为中度或重度二尖瓣和三尖瓣关闭不全。他们还显示了在呼吸暂停期间，穿过二尖瓣和三尖瓣的血流的减速更短。肝静脉的血流模式在收缩期出现逆转，在吸气时出现明显的逆转。这些结果表明，可以通过比较多普勒超声心动图数据以及呼吸引起的变化来区分患有缩窄性心包炎和缩窄性心肌病的患者。

BACKGROUND & AIMS: OBJECTIVE:Cardiac involvement is the most important cause of mortality in juvenile systemic sclerosis (JSSc). Recent reports in adult patients underline that traditional techniques of imaging are inadequate to assess the subclinical cardiac involvement, while speckle tracking echocardiography (STE) is able to identify ventricular dysfunctions in the early stages. The aim of our study was to assess the role of STE in JSSc. METHODS:Demographic, clinical and laboratory data were collected from patients with JSSc. Cardiac investigations performed at baseline (T0) and 18 (T18) and 36 months (T36) follow-up included electrocardiography, conventional echocardiography with measurement of the ejection fraction (EF) and STE with assessment of left and right ventricular global longitudinal strain (LV-GLS and RV-GLS). Cardiac parameters have been compared with demographic characteristics and disease severity, assessed by the Juvenile Systemic Sclerosis Severity Score (J4S). RESULTS:A total of 18 patients, 12 (67%) females, entered the study. At T0, electrocardiography was abnormal in three patients, EF was reduced in one, LV-GLS was abnormal in three (16.7%) and RV-GLS was abnormal in five (27.8%). At T18, EF remained stable while at T36 the result decreased in seven of nine patients. At the same time, LV-GLS also worsened (from -21.6% to -18.2%, P = 0.01). LV-GLS and RV-GLS at baseline showed a significant correlation with J4S (P = 0.012 and P = 0.02, respectively). CONCLUSION:STE is more sensitive than standard echocardiography to identify cardiac involvement in JSSc. Over time, we observed a gradual worsening of LV-GLS, a sign of left ventricular dysfunction, that anticipated by several months the decrease of EF.

背景与目标： 目的：心脏受累是青少年系统性硬化症（JSSc）死亡的最重要原因。成人患者的最新报道强调，传统的成像技术不足以评估亚临床心脏受累，而散斑跟踪超声心动图（STE）能够在早期识别出心室功能障碍。我们研究的目的是评估STE在JSSc中的作用。
方法：收集JSSc患者的人口统计学，临床和实验室数据。在基线（T0），18（T18）和36个月（T36）随访时进行的心脏检查包括心电图检查，常规超声心动图检查（测量射血分数（EF））和STE（评估左心室和右心室总纵向应变（LV）） -GLS和RV-GLS）。已通过青少年系统性硬化症严重程度评分（J4S）对心脏参数与人口统计学特征和疾病严重程度进行了比较。
结果：总共18位患者，其中12位女性（67％）进入了研究。在T0时，三名患者的心电图异常，一例EF降低，三例（16.7％）的LV-GLS异常，五例（27.8％）的RV-GLS异常。在T18时，EF保持稳定，而在T36时，九名患者中的七名患者的结果下降。同时，LV-GLS也恶化了（从-21.6％降至-18.2％，P = 0.01）。基线时的LV-GLS和RV-GLS与J4S呈显着相关性（分别为P = 0.012和P = 0.02）。
结论：STE比标准超声心动图对识别JSSc的心脏受累更为敏感。随着时间的流逝，我们观察到左室功能不全的迹象LV-GLS逐渐恶化，预计几个月后EF会下降。

BACKGROUND & AIMS: :The aims of this study were to review the prevalence and outcome of all surgically treated upper and lower limb emboli presenting to one vascular unit in the last 3 years and to compare transthoracic with transesophageal echocardiography for defining the source of the embolus. All patients who underwent surgical embolectomy for acute limb ischemia from January 2001 to June 2004 were reviewed. Transthoracic and transesophageal echocardiography were carried out on a subset of consecutive unselected patients. Forty-two patients, with a mean age of 80 years, underwent surgical embolectomy from January 2001 to June 2004 (M/F 1:1.8): 27 for lower limb ischemia and 15 for upper limb ischemia. Two thirds of these patients were found to be in atrial fibrillation at presentation (n = 28), of whom less than a third were receiving anticoagulants or antiplatelet agents (n = 8). The mean hospital stay was 15 days with 36 patients (86%) being fully anticoagulated before discharge from hospital. The 30-day mortality rate was 11% (n = 3/27) with 5 patients requiring fasciotomies (12%) and 3 patients requiring an amputation of the lower limb (11%). Postoperatively, 34 patients (81%) had transthoracic echocardiography (TTE), which demonstrated a source or potential source for thrombus in 19 (56%). Fifteen patients (36%) had transesophageal echocardiography (TEE), which changed the subsequent management in 3 patients. All patients in whom TEE altered clinical management would have required this investigation if standard clinical guidelines were followed. TEE did not identify any additional patients with cardiac embolic sources that were not detected by TTE. Arterial limb emboli are still prevalent, but limb salvage and mortality rates appear to be improving. Despite clear guidelines on anticoagulation for patients in atrial fibrillation, many are not receiving appropriate treatment. Transthoracic echocardiography is a good screening tool for detecting a potential cardiac source for peripheral embolism, with transesophageal echocardiography being reserved for specific indications.

背景与目标： ：这项研究的目的是回顾过去3年中所有接受手术治疗的上肢和下肢栓塞在一个血管内的发生率和结局，并比较经胸和经食道超声心动图检查来确定栓子的来源。回顾性分析了2001年1月至2004年6月所有因急性肢体缺血而行外科手术栓塞切除术的患者。经胸和经食道超声心动图检查是对连续的未选择患者的子集进行的。 2001年1月至2004年6月，平均年龄为80岁的42例患者接受了手术栓塞切除术（M / F 1：1.8）：下肢缺血27例，上肢缺血15例。这些患者中有三分之二被发现存在房颤（n = 28），其中不到三分之一接受抗凝剂或抗血小板药物（n = 8）。平均住院时间为15天，其中36例患者（86％）在出院前已充分抗凝。 30天死亡率为11％（n = 3/27），其中5位需要进行筋膜切开术的患者（12％）和3位需要下肢截肢的患者（11％）。术后34例（81％）患者经胸超声心动图（TTE），其中19例（56％）证明有血栓来源或潜在来源。 15例患者（36％）进行了食管超声心动图检查（TEE），这改变了3例患者的后续治疗方法。如果遵循标准的临床指南，所有TEE改变了临床管理的患者都需要进行此项调查。 TEE并未发现TTE未发现的任何其他具有心脏栓塞源的患者。动脉肢体栓塞仍很普遍，但肢体抢救和死亡率似乎正在提高。尽管对房颤患者的抗凝治疗有明确的指导原则，但许多人并未得到适当的治疗。经胸超声心动图检查是一种很好的筛查工具，可用于检测周围性栓塞的潜在心脏源，保留经食道超声心动图检查以用于特定适应症。

BACKGROUND & AIMS: :Automated visual tracking of cells from video microscopy has many important biomedical applications. In this paper, we track human monocyte cells in a fluorescent microscopic video using matching and linking of bipartite graphs. Tracking of cells over a pair of frames is modeled as a maximum cardinality minimum weight matching problem for a bipartite graph with a novel cost function. The tracking results are further refined using a rank-based filtering mechanism. Linking of cell trajectories over different frames are achieved through composition of bipartite matches. The proposed solution does not require any explicit motion model, is highly scalable, and, can effectively handle the entry and exit of cells. Our tracking accuracy of (97.97±0.94)% is superior than several existing methods [(95.66±2.39)%, (94.42±2.08)%, (81.22±5.75)%, (78.31±4.70)%] and is highly comparable (98.20±1.22)% to a recently published algorithm.

背景与目标： 从视频显微镜对细胞进行自动视觉跟踪具有许多重要的生物医学应用。在本文中，我们使用二分图的匹配和链接在荧光显微视频中跟踪人单核细胞。一对框架上的单元格跟踪被建模为具有新颖成本函数的二部图的最大基数最小权重匹配问题。使用基于等级的过滤机制进一步完善跟踪结果。通过二分匹配的组成，可以实现不同框架上细胞轨迹的链接。提出的解决方案不需要任何显式的运动模型，具有高度可伸缩性，并且可以有效地处理单元的进入和退出。我们的（97.97±0.94）％跟踪精度优于几种现有方法[（95.66±2.39）％，（94.42±2.08）％，（81.22±5.75）％，（78.31±4.70）％]，并且具有很高的可比性（ 98.20±1.22）％至最近发布的算法。

BACKGROUND & AIMS: OBJECTIVE:To evaluate the feasibility of electron beam tomography (EBT) for morphological assessment of congenital heart disease. MATERIALS AND METHODS:Sixteen subjects were examined by EBT, transthoracic echocardiography, cardiac cine angiography and surgery. EBT scan was performed using single slice continuous volume mode to acquire high-resolution static image. Double dose contrast medium was injected by bolus technique after measuring scan delay time and calculation of proper injection rate. The results of EBT and echocardiography were compared based on the results of cardiac cine angiography and surgical findings. All anomalous components were evaluated in all subjects and grouped according to major cardiac structures. Statistical analysis was performed to compare two modalities' ability to evaluate the anomalies of major structures. RESULTS:EBT was more sensitive to evaluate the anomalies of systemic vessels, pulmonary vessels and small systemic arteries such as coronary artery. EBT was less sensitive to identify the abnormality of cardiac valves such as valvular regurgitation. There was no difference of sensitivity in evaluation of cardiac chambers and septa between the two modalities. CONCLUSION:EBT assisted by transthoracic echocardiography is excellent noninvasive modality to diagnose congenital heart disease.

背景与目标： 目的：评价电子束断层扫描（EBT）在先天性心脏病形态学评估中的可行性。
材料与方法：对16名受试者进行了EBT，经胸超声心动图，心脏血管造影和手术检查。使用单切片连续体积模式执行EBT扫描，以获取高分辨率的静态图像。在测量扫描延迟时间并计算适当的注射速率后，通过推注技术注射双剂量造影剂。根据心脏血管造影结果和手术结果比较了EBT和超声心动图检查的结果。在所有受试者中评估所有异常成分，并根据主要心脏结构进行分组。进行统计分析以比较两种方式评估主要结构异常的能力。
结果：EBT对评估系统性血管，肺血管和小系统性动脉（如冠状动脉）异常更为敏感。 EBT对识别心脏瓣膜异常（如瓣膜返流）的敏感性较低。两种方式之间在评估心腔和间隔方面的敏感性没有差异。
结论：经胸超声心动图辅助EBT是诊断先天性心脏病的极佳无创方法。

BACKGROUND & AIMS: OBJECTIVES:This study investigated whether the measurement of mitral annulus displacement by the tissue-tracking method with Doppler-tissue images can provide more accurate information on the severity of heart failure compared to conventional methods, such as left ventricular ejection fraction (LVEF). BACKGROUND:Impaired left ventricular function is an important predictor of poor prognosis. Although LVEF has been used to assess left ventricular function, such indicators do not necessarily correlate well to clinical variables such as New York Heart Association (NYHA) functional class or plasma brain natriuretic peptide (BNP) concentration. METHODS:In 90 subjects with or without various heart diseases, mitral annulus displacement was measured by the tissue-tracking method with Doppler-tissue images and the correlations evaluated with NYHA functional class, plasma BNP concentration, left ventricular mass index and Tei index. RESULTS:Mitral annulus displacement by the tissue-tracking method with Doppler-tissue images was well correlated with NYHA functional class and plasma BNP concentration. LVEF was also correlated with these clinical variables, but significantly more weakly. Furthermore, mitral annulus displacement by the tissue-tracking method with Doppler-tissue images was correlated with left ventricular mass index and Tei index, which indicate left ventricular systolic and diastolic function. CONCLUSIONS:The present study suggests that mitral annulus displacement measured by our technique is a useful and reliable method for assessing the severity of heart failure.

背景与目标： 目的：本研究调查了使用多普勒组织图像的组织追踪方法测量二尖瓣环移位是否可以提供比常规方法（如左心室射血分数（LVEF））更准确的心力衰竭严重程度信息。
背景：左心室功能受损是预后不良的重要预测指标。尽管LVEF已用于评估左心室功能，但此类指标不一定与临床变量（例如纽约心脏协会（NYHA）功能类别或血浆脑钠肽（BNP）浓度）具有良好的相关性。
方法：对90例患有或未患有多种心脏病的受试者，采用多普勒组织图像组织追踪法测量二尖瓣环移位，并通过NYHA功能类别，血浆BNP浓度，左心室质量指数和Tei指数评估相关性。
结果：采用多普勒组织图像的组织追踪法检测二尖瓣环移位与NYHA功能类别和血浆BNP浓度密切相关。 LVEF也与这些临床变量相关，但明显较弱。此外，采用多普勒组织图像的组织追踪法进行的二尖瓣环移位与左心室质量指数和Tei指数相关，表明左心室收缩和舒张功能。
结论：本研究表明，用我们的技术测量的二尖瓣环移位是评估心力衰竭严重程度的一种有用且可靠的方法。