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1.
Nat Mater ; 13(9): 857-61, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25038729

RESUMO

The simultaneous ordering of different degrees of freedom in complex materials undergoing spontaneous symmetry-breaking transitions often involves intricate couplings that have remained elusive in phenomena as wide ranging as stripe formation, unconventional superconductivity or colossal magnetoresistance. Ultrafast optical, X-ray and electron pulses can elucidate the microscopic interplay between these orders by probing the electronic and lattice dynamics separately, but a simultaneous direct observation of multiple orders on the femtosecond scale has been challenging. Here we show that ultrabroadband terahertz pulses can simultaneously trace the ultrafast evolution of coexisting lattice and electronic orders. For the example of a charge density wave (CDW) in 1T-TiSe2, we demonstrate that two components of the CDW order parameter--excitonic correlations and a periodic lattice distortion (PLD)--respond very differently to 12-fs optical excitation. Even when the excitonic order of the CDW is quenched, the PLD can persist in a coherently excited state. This observation proves that excitonic correlations are not the sole driving force of the CDW transition in 1T-TiSe2, and exemplifies the sort of profound insight that disentangling strongly coupled components of order parameters in the time domain may provide for the understanding of a broad class of phase transitions.

2.
Nature ; 449(7165): 1029-32, 2007 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-17960239

RESUMO

Comprehensive knowledge of the dynamic behaviour of electrons in condensed-matter systems is pertinent to the development of many modern technologies, such as semiconductor and molecular electronics, optoelectronics, information processing and photovoltaics. Yet it remains challenging to probe electronic processes, many of which take place in the attosecond (1 as = 10(-18) s) regime. In contrast, atomic motion occurs on the femtosecond (1 fs = 10(-15) s) timescale and has been mapped in solids in real time using femtosecond X-ray sources. Here we extend the attosecond techniques previously used to study isolated atoms in the gas phase to observe electron motion in condensed-matter systems and on surfaces in real time. We demonstrate our ability to obtain direct time-domain access to charge dynamics with attosecond resolution by probing photoelectron emission from single-crystal tungsten. Our data reveal a delay of approximately 100 attoseconds between the emission of photoelectrons that originate from localized core states of the metal, and those that are freed from delocalized conduction-band states. These results illustrate that attosecond metrology constitutes a powerful tool for exploring not only gas-phase systems, but also fundamental electronic processes occurring on the attosecond timescale in condensed-matter systems and on surfaces.

3.
Nature ; 446(7136): 627-32, 2007 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-17410167

RESUMO

Atoms exposed to intense light lose one or more electrons and become ions. In strong fields, the process is predicted to occur via tunnelling through the binding potential that is suppressed by the light field near the peaks of its oscillations. Here we report the real-time observation of this most elementary step in strong-field interactions: light-induced electron tunnelling. The process is found to deplete atomic bound states in sharp steps lasting several hundred attoseconds. This suggests a new technique, attosecond tunnelling, for probing short-lived, transient states of atoms or molecules with high temporal resolution. The utility of attosecond tunnelling is demonstrated by capturing multi-electron excitation (shake-up) and relaxation (cascaded Auger decay) processes with subfemtosecond resolution.

4.
Phys Rev Lett ; 106(10): 107401, 2011 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-21469832

RESUMO

A time-resolved study of core-level chemical shifts in a monolayer of aromatic molecules reveals complex photoinduced reaction dynamics. The combination of electron spectroscopy for chemical analysis and ultrashort pulse excitation in the extreme ultraviolet allows performing time-correlated 4d-core-level spectroscopy of iodine atoms that probe the local chemical environment in the adsorbate molecule. The selectivity of the method unveils metastable molecular configurations that appear about 50 ps after the excitation and are efficiently quenched back to the ground state.

5.
Nature ; 427(6977): 817-21, 2004 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-14985755

RESUMO

In Bohr's model of the hydrogen atom, the electron takes about 150 attoseconds (1 as = 10(-18) s) to orbit around the proton, defining the characteristic timescale for dynamics in the electronic shell of atoms. Recording atomic transients in real time requires excitation and probing on this scale. The recent observation of single sub-femtosecond (1 fs = 10(-15) s) extreme ultraviolet (XUV) light pulses has stimulated the extension of techniques of femtochemistry into the attosecond regime. Here we demonstrate the generation and measurement of single 250-attosecond XUV pulses. We use these pulses to excite atoms, which in turn emit electrons. An intense, waveform-controlled, few cycle laser pulse obtains 'tomographic images' of the time-momentum distribution of the ejected electrons. Tomographic images of primary (photo)electrons yield accurate information of the duration and frequency sweep of the excitation pulse, whereas the same measurements on secondary (Auger) electrons will provide insight into the relaxation dynamics of the electronic shell following excitation. With the current approximately 750-nm laser probe and approximately 100-eV excitation, our transient recorder is capable of resolving atomic electron dynamics within the Bohr orbit time.

6.
Ultramicroscopy ; 102(2): 93-100, 2005 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-15590132

RESUMO

Coherent soft X-ray sources open the way to new capabilities in high-resolution imaging, site- and element-specific spectroscopy and biomicroscopy. In this paper we demonstrate imaging with a table-top soft X-ray microscope. By combining a laser driven high-harmonic light source, optimized for having the maximum brightness at around 100 eV, a pair of multilayer mirrors to select a narrow spectral band and acting simultaneously as a condenser and a Fresnel zone plate as microscope objective, we were able to resolve 200 nm structures of a diatom sample. Further, the pulsed nature of our X-ray source offers the possibility of time-resolved spectromicroscopy with a temporal resolution in the order of a few femtoseconds.


Assuntos
Diagnóstico por Imagem/instrumentação , Microscopia/instrumentação , Animais , Diatomáceas/ultraestrutura , Óptica e Fotônica , Raios X
7.
Sci Total Environ ; 346(1-3): 244-55, 2005 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-15993698

RESUMO

Bioaerosols suspended in ambient air were collected with single-stage impactors at a semiurban site in southern Germany during late summer and early autumn. Sampling was mostly carried out at a nozzle velocity of 35 m/s, corresponding to a minimum aerodynamic diameter (cut-off diameter) of aerosol particles of 0.8 mum. The collected particles, sampled for short periods ( approximately 15 min) to avoid pile-up, were characterized by scanning electron microscopy (SEM). The observed bioaerosols include brochosomes, fungal spores, hyphae, insect scales, hairs of plants and, less commonly, bacteria and epicuticular wax. Brochosomes, which serve as a highly water repellent body coating of leafhoppers, are hollow spheroids with diameters around 400 nm, resembling C(60) or footballs (soccer balls). They are usually airborne not as individuals but in the form of large clusters containing up to 10,000 individual species or even more. Various types of spores and scales were observed, but assignment turned out be difficult due to the large number of fungi and insects from which they may have originated. Pollens were observed only once. The absence these presumably elastic particles suggests that they are frequently lost, at the comparatively high velocities, due to bounce-off from the nonadhesive impaction surfaces.


Assuntos
Aerossóis/análise , Pólen , Esporos , Movimentos do Ar , Animais , Bactérias , Monitoramento Ambiental , Fungos , Alemanha , Insetos , Microscopia Eletrônica de Varredura , Tamanho da Partícula , Estações do Ano
8.
Thromb Haemost ; 74(3): 916-22, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8571321

RESUMO

Deposition of blood components in branching flow has been investigated primarily with regard to platelets. We instead examined thrombin-induced fibrin clot formation in separated laminar as well as turbulent branching flow. The most rapid clot growth and largest clot was obtained at the lowest inflow rate. Increased inflow reduced the clot size and turbulence completely prevented clot formation. Examination of corresponding flow conditions revealed the recirculation zone in laminar flow to be characterized by two stationary, counterrotating vortices. Niches of stagnant flow, exhibiting long residence times, low wall shear rates and characterized by convergent flow, were spared between the bulk flow and these vortices. Here, fibrin clot growth continued even when shear rates were increased more than 100-fold. Our results indicate that, in branching flow, the long residence times and convergent flow characteristic of flow niches rather than shear rate are critical for fibrin clot formation.


Assuntos
Fibrina/química , Trombose/fisiopatologia , Artérias , Velocidade do Fluxo Sanguíneo , Modelos Lineares , Estresse Mecânico
9.
Thromb Haemost ; 74(3): 853-8, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8571310

RESUMO

Fibrinogen substitution can correct bleeding in afibrinogenemia. We assessed the effect of fibrinogen substitution in a patient lacking immunoreactive fibrinogen. Fibrinogen and thrombin time were not measurable before, but became detectable within 30 min after substitution, parallelled by an increase in ADP-induced platelet aggregation from < 10% to 32%. Platelet adhesion, measured by Stagnation Point Flow Adhesio- Aggregometry, was not detectable prior to substitution but attained normal values thereafter. Scanning electron microscopy of adhering platelets revealed pseudopodia protrusion and spreading. Morphometry revealed two populations of spread platelets one of which demonstrated inhibited spreading as compared to healthy controls. Immunoelectron microscopy revealed normal GPIIb/IIIa receptor expression, both before and after substitution. Dynamic and kinematic viscosity of plasma and whole blood remained below the 99.9% confidence border of a healthy control group. In afibrinogenemia fibrinogen levels as low as 10% of normal concentration sufficed to normalize coagulation, platelet adhesion, and, partially, spreading.


Assuntos
Afibrinogenemia/tratamento farmacológico , Coagulação Sanguínea/efeitos dos fármacos , Viscosidade Sanguínea/efeitos dos fármacos , Fibrinogênio/uso terapêutico , Adesividade Plaquetária/efeitos dos fármacos , Agregação Plaquetária/efeitos dos fármacos , Adulto , Proteínas Sanguíneas/metabolismo , Feminino , Humanos , Masculino , Valores de Referência , Estresse Mecânico , Tempo de Trombina
10.
Environ Health Perspect ; 109 Suppl 4: 547-51, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11544161

RESUMO

The cardiovascular system is currently considered a target for particulate matter, especially for ultrafine particles. In addition to autonomic or cytokine mediated effects, the direct interaction of inhaled materials with the target tissue must be examined to understand the underlying mechanisms. In the first approach, pulmonary and systemic distribution of inhaled ultrafine elemental silver (EAg) particles was investigated on the basis of morphology and inductively coupled plasma mass spectrometry (ICP-MS) analysis. Rats were exposed for 6 hr at a concentration of 133 microg EAg m(3) (3 x 10(6) cm(3), 15 nm modal diameter) and were sacrificed on days 0, 1, 4, and 7. ICP-MS analysis showed that 1.7 microg Ag was found in the lungs immediately after the end of exposure. Amounts of Ag in the lungs decreased rapidly with time, and by day 7 only 4% of the initial burden remained. In the blood, significant amounts of Ag were detected on day 0 and thereafter decreased rapidly. In the liver, kidney, spleen, brain, and heart, low concentrations of Ag were observed. Nasal cavities, especially the posterior portion, and lung-associated lymph nodes showed relatively high concentrations of Ag. For comparison, rats received by intratracheal instillation either 150 microL aqueous solution of 7 microg silver nitrate (AgNO(3) (4.4 microg Ag) or 150 microL aqueous suspension of 50 microg agglomerated ultrafine EAg particles. A portion of the agglomerates remained undissolved in the alveolar macrophages and in the septum for at least 7 days. In contrast, rapid clearance of instilled water-soluble AgNO(3) from the lung was observed. These findings show that although instilled agglomerates of ultrafine EAg particles were retained in the lung, Ag was rapidly cleared from the lung after inhalation of ultrafine EAg particles, as well as after instillation of AgNO(3), and entered systemic pathways.


Assuntos
Poluentes Atmosféricos/farmacocinética , Pulmão/metabolismo , Prata/farmacocinética , Administração por Inalação , Poluentes Atmosféricos/sangue , Animais , Feminino , Pulmão/ultraestrutura , Macrófagos Alveolares/metabolismo , Macrófagos Alveolares/ultraestrutura , Ratos , Ratos Endogâmicos F344 , Prata/administração & dosagem , Prata/sangue , Distribuição Tecidual
11.
Phys Rev Lett ; 85(24): 5074-7, 2000 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-11102189

RESUMO

The linear magnetic dichroism in the angular distribution of Tl 5d and 6p photoelectrons and their dynamical spin polarization have been measured between hnu = 30 and 50 eV. In contrast to the Xe 5p photoionization at the 4d threshold, our results show that above the Tl 5d threshold strong interchannel coupling effects induce a sudden increase in the asymptotic phase difference of the s and d waves for the Tl 6p ionization. This shows that the valence excitation is different for resonant (Xe 4d) and nonresonant (Tl 5d) excitation from subvalence shells.

12.
Radiat Res ; 158(4): 505-15, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12236818

RESUMO

The low-energy secondary electrons emerging from the entrance surface of an X-irradiated gold foil increase the dose to cells in contact with or at micrometer distances from this surface (Radiat. Res. 150, 92-100, 1998). We examined the effect of the spectrum of these low-energy electrons on the RBE for cytogenetic effects and showed that this RBE was increased. A monolayer of surface-attached human T lymphocytes was exposed to 60 kV X rays in the absence or presence of a gold foil positioned immediately behind the cell layer or separated from it by a Mylar foil 0.9 or 2 microm thick. The enhancement of dose in the cell nuclei caused by the photoelectrons and Auger electrons emerging from the entrance surface of the gold foil was measured by TSEE dosimetry. Dose enhancement factors of 55.7, 46.6 and 37.5 were obtained with 0, 0.9 and 2 microm of Mylar inserted between the gold surface and the cell layer. This large enhancement results from the photoelectric effect in the gold foil, as shown by the accompanying Monte Carlo calculations of the secondary electron spectra at the gold surface. Auger electrons from the gold foil generally were not able to penetrate into the cell nuclei except for that fraction of the cells that had a very thin (< 0.7 microm) layer of cytoplasm and membranes between gold surface and cell nucleus. The dose-yield curves for dicentric chromosomes plus centric rings and for acentric fragments obtained after exposures without or with the gold foil were linear-quadratic. The coefficient alpha, the slope of the linear yield component, was increased in the presence of the gold foil and showed RBE values ranging from 1.7 to 2.2 compared to exposures in absence of the gold foil. The ratio of the yield of interstitial deletions and dicentrics (H ratio) was significantly increased from about 0.17 in the absence of the gold foil to about 0.22 in the presence of the gold foil. The increases in the RBE and the H ratio are interpreted in microdosimetric terms: The preferred occurrence of electron track ends in the vicinity of the gold surface causes an increase in the dose-mean restricted linear energy transfer in cell nuclei exposed to the photoelectrons and Auger electrons.


Assuntos
Aberrações Cromossômicas , Elétrons , Ouro , Relação Dose-Resposta à Radiação , Ouro/efeitos da radiação , Humanos , Transferência Linear de Energia , Linfócitos/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Eficiência Biológica Relativa , Raios X
13.
Schizophr Res ; 3(5-6): 295-301, 1990.
Artigo em Inglês | MEDLINE | ID: mdl-2282334

RESUMO

Volumes of the hippocampal formation, external and internal pallidum, caudate, putamen, and nucleus accumbens were measured in both hemispheres of recently collected post-mortem brains of 18 chronically ill schizophrenics and 21 control subjects. In the schizophrenic group, the hippocampal formation and the internal pallidum were significantly smaller in the right and left hemisphere, whereas external pallidum, putamen, caudate and accumbens were not significantly changed. Volumes of the hippocampus and of all evaluated parts of the basal ganglia were in the male schizophrenics more reduced than in the female patients. The right and left hemispheres were equally affected in both sexes. Since the mean brain weight was in patients and controls nearly identical, the volume differences can not be explained by a general brain atrophy or hypoplasia but rather indicate a more focal lack of brain tissue, by which some clinical features of the disease might be explained.


Assuntos
Gânglios da Base/patologia , Sistema Límbico/patologia , Esquizofrenia/patologia , Psicologia do Esquizofrênico , Adulto , Idoso , Doença Crônica , Dominância Cerebral/fisiologia , Feminino , Hipocampo/patologia , Humanos , Masculino , Pessoa de Meia-Idade
14.
J Biotechnol ; 112(1-2): 115-25, 2004 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-15288947

RESUMO

The growth structure of DMPC lipid layers on hydrophobic and hydrophilic alkylsilane-based self-assembled monolayers adsorbed on silicon has been investigated by means of X-ray reflectometry and atomic force microscopy. Hydrophilic modification of hydrophobically terminated ODS-SAMs has been achieved by dose-controlled irradiation with DUV light. While island formation of small DMPC bilayer islands is observed on hydrophobic SAM surfaces, closed layers of DMPC monolayers are formed on hydrophilic SAM surfaces. Furthermore, DMPC adsorption on chemically micropatterned substrates with alternating hydrophobic/hydrophilic surface properties has been studied by imaging ellipsometry and photoemission microscopy. Indication for at least partial bridging of hydrophobic areas by an adsorbed DMPC monolayer has been found.


Assuntos
Biomimética/métodos , Cristalização/métodos , Dimiristoilfosfatidilcolina/química , Bicamadas Lipídicas/química , Fluidez de Membrana , Adsorção , Substâncias Macromoleculares , Conformação Molecular , Propriedades de Superfície
15.
J Biotechnol ; 112(1-2): 139-49, 2004 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-15288949

RESUMO

Self-assembled monolayer films based on iodobenzoyloxy-functionalized resorc[4]arenes were prepared on gold substrates to serve as model systems for future time-resolved studies of molecular recognition, a mechanism of outstanding importance in bioorganic systems. The film properties were tested using X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM) and imaging ellipsometry. An apparatus for time-resolved electron spectroscopy utilizing femtosecond soft X-ray pulses is capable of detecting iodine core-level photolines and the photoinduced dissociation after ultraviolet illumination. The developed technique holds promise for tracking the temporal evolution of chemical shifts of atomic markers as local probes for the dynamics of the guest-host interaction.


Assuntos
Benzoatos/química , Biopolímeros/análise , Biopolímeros/química , Membranas Artificiais , Microscopia Eletrônica de Transmissão por Filtração de Energia/métodos , Sondas Moleculares/química , Mapeamento de Interação de Proteínas/métodos , Difração de Raios X/métodos , Cinética , Microscopia Eletrônica de Transmissão por Filtração de Energia/instrumentação , Mapeamento de Interação de Proteínas/instrumentação , Fatores de Tempo , Difração de Raios X/instrumentação
16.
Thromb Res ; 74(6): 629-41, 1994 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-8091405

RESUMO

In vivo arterial thrombosis occurs preferentially at curvatures and branchings, i.e. regions of flow separation and recirculation where blood is retained orders of magnitude longer than within straight vessel sections. To examine the effect of such disturbed flow on endothelial thromboresistance glass T-branchings lined with endothelial cells from human umbilical cord veins (HUVEC) were perfused with buffered fibrinogen solution (3mg/ml). The flow was adjusted to form a large recirculation zone and flow conditions were determined beforehand by means of flow visualization via dye injection as well as by laser ultramicroscope anemometry. Thrombus formation, which was registered on-line by video and evaluated planimetrically, was induced by injection of thrombin at concentrations ranging from 0.3 to 2.0 units/ml. Fibrin thrombus growth always began within the flow niche at the point of flow separation and extended downstream along the wall and into the vessel lumen finally occluding up to 80% of the lumen. Light and electron microscopy revealed that overall thrombus form as well as the orientation of single fibrin fibers were correlated strictly to the prevailing streamlines. Despite the integrity of the endothelial lining fibrin thrombus formation occurred. The fibrin fibers closely contacted the endothelial surface. These results indicate that recirculation zones promote fibrin thrombus formation sufficient to obstruct the vessel lumen and that intact endothelium alone is insufficient in preventing adhesion of fibrin to its surface.


Assuntos
Endotélio Vascular/metabolismo , Fibrina/metabolismo , Trombose/metabolismo , Artérias , Endotélio Vascular/citologia , Humanos , Modelos Cardiovasculares , Fluxo Sanguíneo Regional/fisiologia
17.
Anticancer Res ; 17(4B): 3145-7, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9329622

RESUMO

The ganglioside GD2 is highly expressed on human tumors of neuroectodermal origin. We investigated by scanning electron microscopy the ganglioside GD2 distribution on the surface of spheroids of the neuroblastoma cell line SK-N-LO. About 50% of cells showed GD2 on the plasma membrane and the distribution of GD2 on most of these cells was heterogeneous, with more GD2 at the contact sites of the cells. The binding kinetics of the chimeric anti-GD2 antibody ch14.18 labelled with I-125 on spheroids (average diameter: 450 microns) was determined by gamma counting. Over 4 hours the antibody concentration was raised substantially but up to 24 hours there was only a very slow further increase. A clustered pattern of bound chimeric anti-GD2 antibody ch14.18 was found on a cross-section of the spheroid by autoradiography.


Assuntos
Anticorpos Monoclonais/imunologia , Gangliosídeos/análise , Neuroblastoma/química , Autorradiografia , Gangliosídeos/imunologia , Humanos , Esferoides Celulares , Células Tumorais Cultivadas
18.
Int J Radiat Biol ; 55(5): 821-7, 1989 May.
Artigo em Inglês | MEDLINE | ID: mdl-2565942

RESUMO

Exposure of the mouse fetus (NMRI-strain) to 1.0 Gy X-irradiation has a marked effect on postnatally xenotransplanted glioma cells. In comparison to non-irradiated animals, irradiation on gestation day 14 resulted in: (a) a significantly higher rate of animals which failed to develop visible tumours growing from the inoculum; (b) a significant inhibition of the growth rate of solid gliomas; (c) a pronounced granulocytic and mast cell infiltration, and tissue necrosis, in the invading gliomas. The results suggest that irradiation in prenatal life exerts an amplifying effect on the antitumour response in postnatal life.


Assuntos
Astrocitoma/imunologia , Feto/efeitos da radiação , Efeitos Tardios da Exposição Pré-Natal , Animais , Feminino , Feto/imunologia , Camundongos , Transplante de Neoplasias , Gravidez , Ratos , Transplante Heterólogo
19.
Toxicol Lett ; 72(1-3): 145-50, 1994 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-8202926

RESUMO

Morphologic changes were observed in nasal cavities of beagle dogs after long-term exposure to a respirable sulfur(IV) aerosol at a concentration equivalent to a sulfur dioxide (SO2) concentration of 0.6 mg/m3. The changes were characterized by a thickened epithelial layer resulting from epithelial proliferation, by a loss of secretory material, and by moderate mononuclear cell infiltration.


Assuntos
Cavidade Nasal/efeitos dos fármacos , Enxofre/toxicidade , Administração por Inalação , Aerossóis , Poluentes Atmosféricos/toxicidade , Animais , Cães , Masculino , Cavidade Nasal/anatomia & histologia , Cavidade Nasal/citologia , Oxirredução , Enxofre/química , Dióxido de Enxofre/química , Dióxido de Enxofre/toxicidade , Óxidos de Enxofre/química , Óxidos de Enxofre/toxicidade , Fatores de Tempo
20.
Eur J Cardiothorac Surg ; 20(2): 290-8, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11463546

RESUMO

OBJECTIVE: It has been demonstrated that positron emission tomography (PET) predicts the functional recovery of viable but ischemically compromised myocardium. Reversible contractile dysfunction after revascularization has been reported for 'hibernating myocardium' and stunned myocardium, however, there are little data concerning the time-course and the extent of improvement of the two different pathophysiological conditions. METHODS: Twenty-nine patients with advanced coronary artery disease and severely reduced left ventricular function (EF 18--35%) who were referred for isolated coronary artery bypass grafting underwent preoperative PET viability assessment and were functionally assessed by two-dimensional echocardiography preoperatively at 11 days, 14 weeks, and more than 12 months after surgical revascularization. Intraoperative biopsies were taken from dysfunctional areas defined by PET as segments of normal perfusion and normal metabolism (stunned myocardium) and from areas with a 'mismatch' between perfusion and metabolism (hibernating myocardium). The degree of morphological alterations was evaluated by electron microscopy. RESULTS: In 70% of the 240 dysfunctional segments, 'stunned myocardium' was present whereas 'hibernating myocardium' could be detected in only 24% (P < 0.01). Hibernating myocardium was associated with more severe preoperative wall motion abnormalities and incomplete postoperative recovery. After 1 year, 31% of 'stunned' segments vs. only 18% of 'hibernating' segments showed complete functional restoration (P < 0.05). This incomplete improvement was associated with more severe morphological alterations including depletion of sarcomeres, accumulation of glycogen, loss of sarcoplasmatic reticulum, and cellular sequestration. CONCLUSIONS: These data indicate that in patients with severe ischemic left ventricular dysfunction 'stunned myocardium' is more prevalent than 'hibernation'. Functional normalization is more frequent in 'stunned' segments, whereas areas of 'hibernation' showed more severe tissue injury and protracted recovery. Different degrees of myocardial injury coexist in most patients, which determines the time-course and the extent of improvement after revascularization.


Assuntos
Contração Miocárdica , Isquemia Miocárdica/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Idoso , Ponte de Artéria Coronária , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/patologia , Isquemia Miocárdica/cirurgia , Miocárdio Atordoado/fisiopatologia , Miocárdio/metabolismo , Miocárdio/patologia , Ultrassonografia , Disfunção Ventricular Esquerda/diagnóstico por imagem
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