Development and evaluation of matrix application techniques for high throughput mass spectrometry imaging of tissues in the clinic.

Matrix-assisted laser desorption ionization (MALDI) mass spectrometry imaging (MSI) is a sensitive label-free technique that can be used to study a wide variety of clinical phenotypes. In this context, MSI offers huge diagnostic potential by supporting decision making in the determination of personalized treatment strategies. However, improvements in throughput and robustness are still needed before it finds a place in routine application. While the field has seen tremendous improvements in the throughput of data acquisition, robust and high-throughput sample preparation methods compatible with these acquisition methods need to be developed. To address this challenge, we have developed several methods to reduce the matrix application time to less than 5 min, while maintaining sensitivity and reproducibility. Workflows incorporating these methods provide a pipeline analysis time for MSI sample preparation and acquisition of less than 30 min. The reduced time for these analyses will contribute towards the integration of MSI into routine molecular pathology for clinical diagnostics.

The "Spacemaker", a New Device for Minimally Invasive Cardiothoracic Surgery: An Evaluation and Feasibility Study.

OBJECTIVE: Our aim was to evaluate a new inflatable lung retractor, the "Spacemaker", and its efficacy in facilitating minimally invasive cardiothoracic surgery without the need of one lung ventilation or carbon dioxide overpressure insufflation. METHODS: The device was tested in 12 anesthetized pigs (90-100 kg) placed on standard endotracheal ventilation. The device was introduced into the right or left side of the chest, depending on the intended procedure to be performed, via a 3-cm incision in the fifth intercostal space. A total of seven animals were used to evaluate hemodynamic and respiratory response to the device, whereas another five animals were used to assess the feasibility of a variety of minimally invasive cardiothoracic surgical procedures. RESULTS: Introduction was easy and unhindered. The device was inflated up to 0.6 bar, thereby pushing the lung tissue gently away cranially, posteriorly, and caudally without interfering with pulmonary function or resulting in respiratory compromise. In addition, hemodynamics remained stable throughout the experiments. Different closed-chest surgical procedures such as left atrial appendage exclusion, pulmonary vein exposure, pacemaker lead placement, and endoscopic stabilization for coronary surgery, were successfully performed. Removal was quick and complete in all cases, and lung tissue showed no remnant atelectasis. CONCLUSIONS: The "Spacemaker" may represent a reliable alternative to current conventional techniques to facilitate minimally invasive cardiothoracic surgery. Further research is warranted to confirm the effectiveness and the safety of this device and to optimize the model before its use in humans and its introduction into clinical practice.

Experimental testing of a new left ventricular assist device--the microdiagonal blood pump.

All existing ventricular assist devices are associated with a considerable number of serious complications. This article reports on the first animal tests with a newly developed microdiagonal blood pump (MDP). Six adult female sheep weighing 80 to 90 kg underwent implantation of the microdiagonal blood pump. The inflow and outflow conduits were anastomosed to the left atrium and the descending aorta. Pump flow was adjusted to 2-3 L/minute. Hemodynamic and echocardiographic data, as well as blood samples, were measured over the entire test period of 7 days. All internal organs and the pump were explanted for thorough examination at the end of the trial. Mean arterial (range 88.5 +/- 13.1-103.7 +/- 10.7 mm Hg) and mean pulmonary arterial (18.3 +/- 2.7-21.6 +/- 20.5 mm Hg) pressures, as well as the pulmonary capillary wedge pressure (14.2 +/- 3.0 - 16.6 +/- 4.0 mm Hg), remained stable during the whole test period. Cardiac output (4.9 +/- 0.7 --> 3.2 +/- 0.5 L/minute) decreased postoperatively caused by partial unloading of the heart. Left ventricular end diastolic (4.1 +/- 0.5 --> 3.6 +/- 0.3 cm) and end systolic (3.2 +/- 0.4 --> 2.8 +/- 0.5 cm) diameters, as well as the ejection fraction (57 +/- 9 --> 42 +/- 5%), decreased after MDP implantation and did not change during the test period. Mean number of platelets (428 +/- 54 --> 286 +/- 66 x 10(3)/microL) and hemoglobin (9.8 +/- 1.3 --> 6.3 +/- 0.8 g/dL) decreased perioperatively because of surgical reasons and increased continuously in the postoperative course (platelet count and hemoglobin on day 7:441 +/- 74 x 10(3)/microL and 7.2 +/- 1.1 g/dL, respectively). Free hemoglobin was not enhanced in the postoperative course (mean value during the test period: 18.8 mmoL/L). Histologic examination of the organs did not demonstrate any infarctions of internal organs other than typical operative sequelae such as chronic pericarditis and some degree of atelectasis of the left lungs. These results demonstrate that the microdiagonal pump may be a promising alternative to the currently used ventricular assist devices, if long-term trials support these results.