Two major players in the monitor sector have joined forces. The medical monitors business of Panasonic Healthcare Co., Ltd. (‘Panasonic Healthcare’) became part of the EIZO Corporation in August 2016. The business transfer allows EIZO to combine the expertise of the two leading monitor solution manufacturers, especially for applications in medical imaging. The acquisition allows Karlsruhe-based EIZO GmbH to offer the entire product range of medical monitors for minimally invasive surgery, including 2D, 3D and 4K models.
EIZO had already announced the planned expansion of its business in the healthcare market with a particular focus on the field of operating rooms in a mid-term business plan in 2015. ‘Uncompromising quality and innovative products are EIZO’s strengths,’ said Peter Ziegler, Managing Director of EIZO GmbH in Karlsruhe. ‘Acquiring monitor solutions from Panasonic Healthcare lets us extend this offer into endoscopic image display.’
Panasonic Healthcare has been expanding its endoscopy monitor business since August 2010. Over the years, the company has built strong global partnerships with manufacturers in both endoscopy and OR integration. Panasonic Healthcare products are used in operating rooms around the world where they offer medical specialists outstanding colour settings and accurate colour reproduction. Michael Unger, formerly General Manager at Panasonic Biomedical Sales Europe B.V., sees the merger as a positive step for the future. ‘The many years of experience which EIZO and Panasonic Healthcare have accumulated in the area of imaging technology will provide surgeons with an entirely new level of quality and support in the operating room. As General Manager of Endoscopic Imaging for EIZO GmbH, I am delighted to continue supporting ongoing medical advances through the sale of our medical monitors.’

www.eizo.com www.panasonic-healthcare.com/global/

A research team from the University of Bonn has succeeded for the first time in using light stimuli to stop life-threatening cardiac arrhythmia in mouse hearts. Furthermore, as shown in computer simulations at Johns Hopkins University, this technique could also be used successfully for human hearts. The study opens up a whole new approach to the development of implantable optical defibrillators, in which the strong electrical impulses of conventional defibrillators are replaced by gentler, pain-free light impulses.

Ventricular fibrillation! When the heart muscle races and no longer contracts in an orderly fashion, sudden death often follows due to the lack of blood circulation. In such an emergency, a defibrillator helps to restore normal heart activity by means of intense electrical shocks. In patients with a known risk for these arrhythmia, the prophylactic implantation of a defibrillator is the treatment of choice. If ventricular fibrillation is detected, a pulse of electricity is automatically generated, which normalizes the excitation of the heart muscle and saves the person’s life.

‘When an implanted defibrillator is triggered, which unfortunately can also happen because of false detection of arrhythmia, it is always a very traumatic event for the patient’, says the head of the study, Junior-Professor Philipp Sasse of the Institute of Physiology I at the University of Bonn. ‘The strong electrical shock is very painful and can even damage the heart further’. Therefore, Professor Sasse’s team investigated the principles for a pain-free, gentler alternative. As the scientists have now shown, ventricular fibrillation can be stopped by optical defibrillation.

The team used the new method of ‘optogenetic’ stimulation of mouse hearts, which had genes inserted for so-called channelrhodopsins. These channels are derived from a green algae and change the ion permeability of heart cell membranes when illuminated. When the researchers triggered ventricular fibrillation in the mouse heart, a light pulse of one second applied to the heart was enough to restore normal rhythm. ‘This is a very important result’, emphasizes lead author Dr. med. Tobias Brugmann of Professor Sasse’s team. ‘It shows for the first time experimentally in the heart that optogenetic stimulation can be used for defibrillation of cardiac arrhythmia’. It also worked in normal mice that received the channelrhodopsin through injection of a biotechnologically-produced virus. This shows a possible clinical application, because similar viruses have already been used for gene therapy in human patients.

But are the findings with mouse hearts applicable to humans? In order to answer this question, the scientists at the University of Bonn are working together with Prof. Natalia Trayanova’s Computational Cardiology Lab at the Institute for Computer Medicine and the Department of Biomedical Engineering at Johns Hopkins University (Baltimore, USA). There, optogenetic defibrillation is being tested in a computer model of the heart of a patient after cardiac infarction. ‘Our simulations show that a light pulse to the heart would also stop the cardiac arrhythmia of this patient’, reports Research Professor Patrick Boyle, who is also a lead author. To do so, however, the method from the University of Bonn had to be optimized for the human heart by using red light to stimulate the heart cells, instead of the blue light used in mice. This aspect of the study demonstrates the important role that can be played by computational modelling to guide and accelerate the systematic development of therapeutic applications for cardiac optogenetics, a technology that is still in its infancy.

University of Bonn www.uni-bonn.de/news/195-2016

Most filters – whether for water or a furnace – eventually need to be removed or replaced to avoid complications.

Blood clot filters, which are implanted in the veins of people at risk of developing blood clots in their legs, require a similar precaution.

Complications have been found to arise when the filters, even those intended to be permanent, are left in longer than three to six months. These complications may include part of the filter breaking off and traveling to the heart and lungs, abdominal pain, filter tilt, and the filter tearing or creating a blockage in the veins of the abdomen (inferior vena cava) or in the legs. The chance of complications increases the longer the filter has been in place. Blood clot filters, also known as inferior vena cava (IVC) filters, potentially are dangerous and require specialized techniques to remove them.

Interventional radiologists at Rush University Medical Center have pioneered methods to remove filters that previously couldn’t be removed for various reasons.

‘We have both the standard retrieval methods as well as the most advanced tools to remove any type of filter, and we have the medical expertise to treat any complications from the filter being implanted,’ says Osman Ahmed, MD, primary author and interventional radiologist at Rush University Medical Center and Rush Oak Park Hospital.

The techniques involve a careful method of catching or ‘snaring’ the filter to hold it in place and then covering it to prevent parts of it breaking free. The team also uses tools such as alligator forceps and excimer laser in removing filters.

Thanks to these methods, the Rush team has achieved a 100 percent retrieval rate over the past five years, including difficult-to-remove filters from patients who have been referred to Rush from other hospitals.

The minimally invasive procedure is performed on an outpatient basis using twilight (conscious) sedation in the interventional radiology suite, which is similar to an operating room but also includes special imaging equipment. More advanced retrievals are performed using general anaesthesia due to the time it may take to remove the filter.

The filter removal is performed through a small incision in the neck or groin (the maximum size is around 5 mm) and the filter is removed using X-ray guidance to manipulate wires, catheters, and other devices necessary to remove the filter, which can be up to 29 mm in length.

The Rush team lead by Bulent Arslan, MD, and Ulku Turba, MD, developed these techniques to remove IVC filters, which are implanted in the inferior vena cava, a large vein just below the kidneys, in order to trap blood clots before they travel to the heart and lungs and cause permanent damage.

Rush University Medical Center www.newswise.com/articles/pioneers-in-ivc-filter-removal

Titanium is the leading material for artificial knee and hip joints because it’s strong, wear-resistant and nontoxic, but an unexpected discovery by Rice University physicists shows that the gold standard for artifi cial joints can be improved with the addition of some actual gold.
‘It is about 3-4 times harder than most steels,’ said Emilia Morosan, the lead scientist on a new study in Science Advances that describes the properties of a 3-to-1 mixture of titanium and gold with a specific atomic structure that imparts hardness. ‘It’s four times harder than pure titanium, which is what’s currently being used in most dental implants and replacement joints.’
Morosan, a physicist who specializes in the design and synthesis of compounds with exotic electronic and magnetic properties, said the new study is ‘a first for me in a number of ways. This compound is not difficult to make, and it’s not a new material.’ In fact, the atomic structure of the material – its atoms are tightly packed in a ‘cubic’ crystalline structure that’s oft en associated with hardness – was previously known. It’s not even clear that Morosan and former graduate student Eteri Svanidze, the study’s lead co-author, were the first to make a pure sample of the ultrahard ‘beta’ form of the compound. But due to a couple of lucky breaks, they and their co-authors are the fi rst to document the material’s remarkable properties.
‘This began from my core research,’ said Morosan, professor of physics and astronomy, of chemistry and of materials science and nano-engineering at Rice. ‘We published a study not long ago on titanium-gold, a 1-to-1 ratio compound that was a magnetic material made from nonmagnetic elements. One of the things that we do when we make a new compound is try to grind it into powder for X-ray purposes. This helps with identifying the composition, the purity, the crystal structure and other structural properties. ‘When we tried to grind up titanium-gold, we couldn’t,’ she recalled. ‘I even bought a diamond (coated) mortar and pestle, and we still couldn’t grind it up.’
What the team didn’t know at the time was that making titanium- 3-gold at relatively high temperature produces an almost pure crystalline form of the beta version of the alloy – the crystal structure that’s four times harder than titanium. At lower temperatures, the atoms tend to arrange in another cubic structure – the alpha form of titanium-3-gold. The alpha structure is about as hard as regular titanium. It appears that labs that had previously measured the hardness of titanium-3-gold had measured samples that largely consisted of the alpha arrangement of atoms.
The team measured the hardness of the beta form of the crystal in conjunction with colleagues at Texas A&M University’s Turbomachinery Laboratory and at the National High Magnetic Field Laboratory at Florida State University; Morosan and Svanidze also performed other comparisons with titanium. For biomedical implants, for example, two key measures are biocompatibility and wear resistance. Because titanium and gold by themselves are among the most biocompatible metals and are oft en used in medical implants, the team believed titanium-3-gold would be comparable. In fact, tests by colleagues at the University of Texas MD Anderson Cancer Center in Houston determined that the new alloy was even more biocompatible than pure titanium. The story proved much the same for wear resistance: Titanium-3-gold also outperformed pure titanium.

Rice University http://tinyurl.com/jto5exc

‘Atrial fibrillation is thought to be responsible for 20 to 30 percent of all strokes in the United States,’ said Northwestern’s Michael Markl, the Lester B. and Frances T. Knight Professor of Cardiac Imaging. ‘While atrial fibrillation is easy to detect and diagnose, it’s not easy to predict who will suffer a stroke because of it.’

Markl, who is a professor of biomedical engineering in the McCormick School of Engineering and of radiology in the Feinberg School of Medicine, has developed a new imaging technique that can help predict who is most at risk for stroke. This breakthrough could lead to better treatment and outcomes for patients with atrial fibrillation.

Atrial fibrillation is linked to stroke because it slows the patient’s blood flow. The slow, sluggish blood flow can lead to blood clots, which can then travel to the brain and initiate stroke. Markl’s cardiac magnetic resonance (CMR) imaging test can detect the blood’s velocity through the heart and body. Called ‘atrial 4D flow CMR,’ the technique is non-invasive and does not require contrast agents. The imaging program, which images blood flow dynamically and in the three spatial dimensions, comes in the form of software that can also be integrated into current MRI equipment without the need of special hardware and scanners or equipment upgrades.

4D flow CMR can be employed to measure in-vivo 3D blood flow dynamics in the heart and atria. Derived flow stasis maps in the left atrium and left atrial appendage are a novel concept to visualize and quantify regions with low flow, known to cause clot formation and risk for stroke.
‘We simply programmed the scanner to generate information differently – in a way that wasn’t previously available,’ Markl said. ‘It allows you to measure flow, diffusion of molecules, and tissue elasticity. You can interrogate the human body in a very detailed manner.’

Historically, physicians have attempted to assess stroke risk in atrial fibrillation patients by using a risk scoring system, which takes risk factors, such as age, general health, and gender, into account. Higher risk patients are then given medicine to prevent blood clots that lead to stroke.

‘It’s very well accepted that these therapies significantly reduce the risk of stroke,’ Markl said. ‘But they also increase risk of bleeding complications. It’s a dilemma that physicians face. They want to reduce one risk without introducing another risk. It’s particularly difficult for younger patients who might be on these medications for a long period of time. Maybe the risk of bleeding is initially small. But after taking medication for 20 or 30 years, it’s more and more likely that they’ll experience complications.’

Markl’s 4D flow imaging technique can give a more precise assessment of who needs the medication, preventing physicians from over treating their patients. In a pilot study with 60 patients and a control group, Markl found that atrial fibrillation patients who would have been considered high risk for stroke by the traditional scoring system in fact had normal blood flow, while patients who were considered lower risk sometimes had the slow blood flow indicative of potential clotting.

‘About 50 or 60 percent of patients who you would consider high risk actually had normal flows,’ Markl said. ‘You could then hypothesize that those 50 percent don’t really need the treatment.’

Northwestern University www.mccormick.northwestern.edu/news/articles/2016/10/imaging-stroke-risk-in-4d.html