Geometry-Assisted Topological Transitions in Spin Interferometry.

We identify a series of topological transitions occurring in electronic spin transport when manipulating spin-guiding fields controlled by the geometric shape of mesoscopic interferometers. They manifest as distinct inversions of the interference pattern in quantum conductance experiments. We establish that Rashba square loops develop weak-(anti)localization transitions (absent in other geometries as Rashba ring loops) as an in-plane Zeeman field is applied. These transitions, boosted by nonadiabatic spin scattering, prove to have a topological interpretation in terms of winding numbers characterizing the structure of spin modes in the Bloch sphere.

New perspectives for Rashba spin-orbit coupling.

In 1984, Bychkov and Rashba introduced a simple form of spin-orbit coupling to explain the peculiarities of electron spin resonance in two-dimensional semiconductors. Over the past 30 years, Rashba spin-orbit coupling has inspired a vast number of predictions, discoveries and innovative concepts far beyond semiconductors. The past decade has been particularly creative, with the realizations of manipulating spin orientation by moving electrons in space, controlling electron trajectories using spin as a steering wheel, and the discovery of new topological classes of materials. This progress has reinvigorated the interest of physicists and materials scientists in the development of inversion asymmetric structures, ranging from layered graphene-like materials to cold atoms. This Review discusses relevant recent and ongoing realizations of Rashba physics in condensed matter.

Acoustically induced spin-orbit interactions revealed by two-dimensional imaging of spin transport in GaAs.

Magneto-optic Kerr microscopy was employed to investigate the spin-orbit interactions of electrons traveling in semiconductor quantum wells using surface acoustic waves (SAWs). Two-dimensional images of the spin flow induced by SAWs exhibit anisotropic spin precession behaviors caused by the coexistence of different types of spin-orbit interactions. The dependence of spin-orbit effective magnetic fields on SAW intensity indicates the existence of acoustically controllable spin-orbit interactions resulting from the strain and Rashba contributions induced by the SAWs.

Drift transport of helical spin coherence with tailored spin-orbit interactions.

Most future information processing techniques using electron spins in non-magnetic semiconductors will require both the manipulation and transfer of spins without their coherence being lost. The spin-orbit effective magnetic field induced by drifting electrons enables us to rotate the electron spins in the absence of an external magnetic field. However, the fluctuations in the effective magnetic field originating from the random scattering of electrons also cause undesirable spin decoherence, which limits the length scale of the spin transport. Here we demonstrate the drift transport of electron spins adjusted to a robust spin structure, namely a persistent spin helix. We find that the persistent spin helix enhances the spatial coherence of drifting spins, resulting in maximized spin decay length near the persistent spin helix condition. Within the enhanced distance of the spin transport, the transport path of electron spins can be modulated by employing time-varying in-plane voltages.

Radiofrequency catheter ablation for management of symptomatic ventricular ectopic activity.

OBJECTIVES: This study assessed the useful role of intracardiac mapping and radiofrequency catheter ablation in eliminating drug-refractory monomorphic ventricular ectopic beats in severely symptomatic patients. BACKGROUND: Ventricular ectopic activity is commonly encountered in clinical practice. Usually, it is not associated with life-threatening consequences in the absence of significant structural heart disease. However, frequent ventricular ectopic beats can be extremely symptomatic and even incapacitating in some patients. Currently, reassurance and pharmacologic therapy are the mainstays of treatment. There has been little information on the use of catheter ablation in such patients. METHODS: Ten patients with frequent and severely symptomatic monomorphic ventricular ectopic beats were selected from three tertiary care centers. The mean frequency +/- SD of ventricular ectopic activity was 1,065 +/- 631 beats/h (range 280 to 2,094) as documented by baseline 24-h ambulatory electrocardiographic (ECG) monitoring. No other spontaneous arrhythmias were documented. These patients had previously been unable to tolerate or had been unsuccessfully treated with a mean of 5 +/- 3 antiarrhythmic drugs. The site of origin of ventricular ectopic activity was accurately mapped by using earliest endocardial activation time during ectopic activity or pace mapping, or both. RESULTS: During electrophysiologic study, no patient had inducible ventricular tachycardia. The ectopic focus was located in the right ventricular outflow tract in nine patients and in the left ventricular posteroseptal region in one patient. Frequent ventricular ectopic beats were successfully eliminated by catheter-delivered radiofrequency energy in all 10 patients. The mean number of radiofrequency applications was 2.6 +/- 1.3 (range 1 to 5). No complications were encountered. During a mean follow-up period of 10 +/- 4 months, no patient had a recurrence of symptomatic ectopic activity, and 24-h ambulatory ECG monitoring showed that the frequency of ventricular ectopic activity was 0 beat/h in seven patients, 1 beat/h in two patients and 2 beats/h in one patient. CONCLUSIONS: Radiofrequency catheter ablation can be successfully used to eliminate monomorphic ventricular ectopic activity. It may therefore be a reasonable alternative for the treatment of severely symptomatic, drug-resistant monomorphic ventricular ectopic activity in patients without significant structural heart disease.

Combined class I antiarrhythmic agents have differential effects on tonic and use dependent block of maximum rate of depolarisation of action potentials in guinea pig cardiac muscle.

OBJECTIVE: The aim was to study the difference between tonic and use dependent block of the cardiac sodium channel produced by the combined application of the same subclass of antiarrhythmic agents (class Ia or Ib). METHODS: Conventional glass microelectrode technique was used to record the maximum rate of depolarisation (dV/dtmax) of action potentials reflecting sodium channel availability, before and after the combined application of quinidine plus disopyramide, aprindine plus lignocaine, aprindine plus mexiletine, and lignocaine plus mexiletine. Guinea pig papillary muscles (n = 4-8 per experiment) were used for the study. RESULTS: All combinations increased tonic block additively compared to use of a single drug. On the other hand, use dependent block was increased by the combination of quinidine 10 microM plus disopyramide 30 microM compared to a single drug, and was not changed by lignocaine 50 microM plus mexiletine 20 microM, whereas it was decreased by aprindine 3 microM plus lignocaine 50 microM or mexiletine 20 microM. When concentrations of mexiletine and lignocaine were increased, both tonic and use dependent block in a single drug were increased dose dependently, whereas the combination produced an additive increase in tonic block but no change in use dependent block compared to a single drug. CONCLUSIONS: The results suggested that the binding and unbinding process of the drug to produce tonic block was different from that to produce use dependent block, and that combination of different drugs produced diverse effects on use dependent block even though state dependent affinity of individual drugs seemed similar. These two factors must be born in mind in evaluating the combination therapy.

Prognostic significance of sustained monomorphic ventricular tachycardia induced by programmed ventricular stimulation using up to triple extrastimuli in survivors of acute myocardial infarction.

The prognostic significance of sustained monomorphic ventricular tachycardia (VT) induced by programmed ventricular stimulation using up to 3 extrastimuli was evaluated in 133 consecutive survivors of acute myocardial infarction (AMI) at a mean interval of 1.8 +/- 1.1 months after onset. This was compared with hemodynamic and angiographic abnormalities shown by cardiac catheterization and ventricular ectopic activity detected by Holter monitoring. Sustained monomorphic VT was induced in 25 (19%) patients, sustained polymorphic VT in 11 (8%) patients, nonsustained monomorphic VT (greater than or equal to 10 beats) in 12 patients (9%) and nonsustained polymorphic VT in 9 patients (7%). Multivariate logistic regression analysis of clinical, angiographic, hemodynamic and electrocardiographic variables showed that the presence of a left ventricular aneurysm (p = 0.005) and Lown grade 4B ventricular ectopic activity (p less than 0.001) were independent predictors of inducibility of sustained monomorphic VT. During a mean follow-up of 21 +/- 13 months, there were 8 (6%) sudden cardiac deaths and 3 (2.3%) spontaneous occurrences of life-threatening sustained VT. The 2-year probability of freedom from sudden cardiac death or sustained ventricular tachyarrhythmias was 53 +/- 13% for patients with inducible sustained monomorphic VT, 70 +/- 10% for those with a left ventricular ejection fraction less than 40% and 58 +/- 13% for those with Lown grade 4B ventricular ectopic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Usefulness of early versus late programmed ventricular stimulation in acute myocardial infarction.

To determine the influence of timing on the prognostic value of programmed ventricular stimulation after acute myocardial infarction (AMI), 32 patients were studied on day 19 (early study) and again on day 36 (late study) after AMI using up to 3 extrastimuli. At the early study, sustained monomorphic ventricular tachycardia (VT) was induced in 12 patients (38%), sustained polymorphic VT in 8 (25%), nonsustained monomorphic VT in 1 (3%), nonsustained polymorphic VT in 1 (3%) and no inducible arrhythmia in 10 (31%). At the late study, sustained monomorphic VT, nonsustained monomorphic VT and nonsustained polymorphic VT were induced in 8 patients (25%) each, and no inducible arrhythmia in 8 (25%). Of the 12 patients who had inducible sustained monomorphic VT at the early study, 7 had noninducibility of sustained monomorphic VT at the late study. Of the 20 patients who had noninducibility of sustained monomorphic VT at the early study, 3 had inducible sustained monomorphic VT at the late study. During the follow-up period (mean +/- standard deviation 21 +/- 8 months), there were 2 sudden cardiac deaths and 3 occurrences of sustained VT. Univariate analysis revealed both inducibilities of sustained monomorphic VT at the early study (p = 0.045) and at the late study (p less than 0.001) to be predictive of sudden cardiac death or clinical occurrence of sustained VT. However, inducibility of sustained monomorphic VT at the late study had a higher sensitivity (100%), specificity (89%), positive predictive value (63%) and negative predictive value (100%) than at the early study (80, 70, 33 and 95%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Long-term follow-up of heart transplant recipients requiring permanent pacemakers.

BACKGROUND: Permanent pacemaker implantation after heart transplantation is contentious. Indications for these devices in this population are uncertain. The goals of this project were to (1) analyze the time course of donor sinus node dysfunction and atrioventricular block after heart transplantation; (2) evaluate which selected parameters (donor age, ischemic time, heart rate before pacer insertion, and number of rejection episodes) might relate to persistent permanent pacing need, and (3) assess pacemaker complications during follow-up. METHODS: A retrospective analysis of pacemaker implantations (22 cases) was performed in 286 consecutive heart transplantations performed between February 1984 and April 1994 at The Methodist Hospital and Baylor College of Medicine, Houston, Texas. RESULTS: Permanent pacemakers were inserted early after transplantation in 19 patients (mean 24 days); 14 pacemakers were for sinus node dysfunction (bradycardia in five, sinus arrest with junctional escape in eight, and optimization of hemodynamics in one). Symptomatic complete heart block prompted insertion late in two patients (3 and 47 months), and symptomatic sinus pause was the indication for late insertion in one. Recipient mean age was 52.4 years, with mean donor age 29.7 years in patients with pacemakers. By 3 months, 13 of 19 patients receiving pacemakers early (mean preinsertion heart rate 58.3 beats/min) became pacer independent with subsequent mean intrinsic heart rate of 97 beats/min. Recipient or donor age, ischemic time, and rejection episodes did not appear related to long-term pacing need early or late after transplantation. CONCLUSIONS: Inferences from these observations include the fact that many patients with early sinus node dysfunction and bradycardia are not pacer dependent at 3 months. However, those with atrioventricular block early appear to require long-term pacing support. However, the possibility that more aggressive and long-term oral chronotropic medication use after transplantation would obviate early permanent pacemaker need is not addressed. Finally, prospective clinical trials are necessary to precisely characterize benefit of permanent pacemakers and define optimal pacing modes after heart transplantation.

States and sites of actions of flecainide on guinea-pig cardiac sodium channels.

The states and sites of actions of flecainide on sodium channels were investigated in guinea-pig single cardiac cells, using the whole-cell voltage-clamp technique at 22 degrees C. External application of flecainide caused tonic and use-dependent block of the sodium current (INa). The tonic block and the steady state use-dependent block increased with increasing drug concentrations. The dose-response curve for the use-dependent block was fitted by the equation for 1:1 drug-receptor binding and yielded a KD of 7.0 microM flecainide. At 5 microM flecainide, the use-dependent block of INa with 10 and 200 ms depolarizing pulses at an interpulse interval of 400 ms was 31.1 +/- 2.7 (mean +/- S.E.) and 36.8 +/- 2.7%, respectively. The two values were not significantly different. The block developed as a single exponential function with onset rate of 0.041 +/- 0.005/pulse. Recovery from flecainide block consisted of two components as reported previously. The mean time constant of the initial fast component was 48 +/- 17 ms, which was comparable but significantly longer than that in the absence of the drug. The late slow component was only seen after drug application and the time constant was 26 +/- 7 s at -100 mV. Internal application of 5 and 50 microM flecainide for 30 min after rupture of the cell membrane produced a non-significant block and values of 1.7 +/- 0.8 and 6.9 +/- 2.4%, respectively, for the use-dependent block of INa.(ABSTRACT TRUNCATED AT 250 WORDS)

Color Doppler ultrasound imaging in the emergency management of an intracerebral hematoma caused by cerebral arteriovenous malformations: technical case report.

OBJECTIVE AND IMPORTANCE: Ruptured arteriovenous malformations (AVMs) are important causes of spontaneous intracerebral hemorrhages. This is a report of emergency hematoma removal, avoiding damage to the nidus of the AVM, using intraoperative color Doppler imaging. CLINICAL PRESENTATION: A 38-year-old woman suddenly presented with coma. The patient underwent emergency surgery immediately after admission, without preoperative angiographic examination, because of progressive neurological deterioration caused by a massive hematoma in the right basal ganglia, as diagnosed with computed tomographic scanning. INTERVENTION: A right frontotemporoparietal craniotomy was performed. Intraoperative ultrasound imaging with a color Doppler system (EUP-NS32, 5 MHz; Hitachi Medical, Tokyo, Japan) clearly demonstrated a nidus complex in the hematoma. Based on the imaging, effective decompression of the hematoma was performed without damage to the AVM complex. CONCLUSION: Color Doppler imaging (with real-time availability) of an atypical hematoma provided significant information on the vascular lesion causing the hematoma and could reduce the surgical risks during emergency evacuation of large intracerebral hemorrhages resulting from ruptured AVMs.

Giant aneurysms of the horizontal segment of the anterior cerebral artery: report of two cases.

Two cases of giant aneurysm of the horizontal segment of the anterior cerebral artery (A1) are presented. The rare occurrence of a giant aneurysm in this location necessitates evaluation of the cross-flow through the anterior communicating artery when planning surgical strategy. On the basis of angiographic findings, trapping of the A1 on both sides of the aneurysm neck was performed in Case 1, and aneurysmorrhaphy utilizing an angioplastic multiple-clipping method of A1 endarterectomy was accomplished in Case 2. The postoperative courses of both patients were satisfactory.

Atypical pleomorphic astrocytoma in the pineal gland: case report.

OBJECTIVE AND IMPORTANCE: We report a rare case of pleomorphic astrocytoma in the pineal region that took a benign course despite pleomorphism. CLINICAL PRESENTATION: A 30-year-old woman suddenly developed right hemiparesis followed by loss of consciousness. A computed tomographic scan revealed a mass in the pineal region accompanied by obstructive hydrocephalus. Her symptoms improved after ventriculoperitoneal shunt surgery. INTERVENTION: The tumor was totally removed in an en bloc fashion using the occipital interhemispheric transtentorial route. Light microscopy revealed that the tumor had marked pleomorphism and multinucleated, bizarre giant cells, but neither mitosis nor necrosis was seen. Glial fibrillary acid protein was immunohistochemically positive in a few tumor cells. Retinal soluble antigen was negative. No reticulin network between the tumor cells was observed. A histological diagnosis of atypical pleomorphic astrocytoma was made. CONCLUSION: No signs of recurrence have been observed for 7 years after surgery without adjuvant therapy. Histologically, the tumor resembled pleomorphic xanthoastrocytoma or pleomorphic granular cell astrocytoma, but the immunohistochemical findings were not completely compatible with either diagnosis. This benign astrocytoma in the pineal gland with unique features is the first such case reported.

Anchoring method for hemifacial spasm associated with vertebral artery: technical note.

OBJECTIVE: We describe an easy and useful method for treating hemifacial spasm related to the vertebral artery. METHODS: The technique entails the manufacture of a dural belt harvested from the cerebellar convexity dura and a dural bridge made at the petrous dura combined with the use of an aneurysm clip. The dural belt holds the vertebral artery and is anchored to the dural bridge by fixation with an aneurysm clip after the vertebral artery is transposed to an appropriate position. RESULTS: The technique proved to be safe and effective in a series of six patients with hemifacial spasm who were followed up for a period of 2 months to more than 10 years after surgery. All patients were affected on the left side. Multiple offending arteries were present in three cases. Hemifacial spasm completely disappeared in all patients. CONCLUSION: This method represents a feasible option for the treatment of hemifacial spasm caused by a tortuous, elongated, or enlarged vertebral artery.

Extradural extension of glioblastoma multiforme into the oral cavity: case report.

A rare case of glioblastoma multiforme with oral extension is presented in a 41-year-old female. She underwent two surgical treatments and both radiotherapy and chemotherapy for the right temporoparietal glioblastoma multiforme. A follow-up computed tomographic scan and magnetic resonance imaging demonstrated destruction of the temporal base and extradural extension of the tumor into the orbital, nasal, and oral cavities. This is the first report of the oral extension of glioblastoma multiforme. The mechanism for the extradural extension is discussed.

Measurements of erythrocyte flow velocity by means of grating laser microscope.

The possibility of measuring erythrocyte flow velocity by means of grating laser microscope has been examined in an in vitro test using erythrocytes smeared on glass plates and in vivo using microvessels in the web of a frog foot. Magnified projections of flowing erythrocytes are spatially filtered by a simple glass plate grating and then detected by a photomultiplier. Output signals from the photomultiplier are first electronically filtered so as to yield oscillating burst-like wave signals. Moving erythrocytes resulted in burst-like oscillation in output signals whose wave period (T) changed with their velocities. These results suggest that the velocity (V) of erythrocytes could be given by V = d/MT, where d and M represent the grating constant and the optical magnification, respectively. The requirement for the establishment of this relation was examined by the microscopic observation of smeared erythrocyte preparation. It was shown that the flow velocity of erythrocyte could be measured even when the size of magnified images of erythrocytes strongly exceeded the value of d and even when many erythrocytes existed. A preliminary experiment to confirm the possibility of methodological adaptation was made by measuring the flow velocity in venules of foot web of frogs. Heart rate increased in all six frogs studied when the frog body was warmed. However, the peripheral flow velocity increased only in three frogs, while it remained almost unaffected in the other three. This result suggests that the frog peripheral microcirculation is affected by complicated intrinsic factors.

Isocentric head fixation for microscopic neurosurgery.

The significance of isocentering in head fixation during micro-neurosurgery is described. The approach angle to the lesion could be changeable without adjusting the focus and placement of the operating microscope by rotating the head holder when the lesion is fixed at the isocenter of the rotatable.

Surgery on lesions involving cavernous sinus.

Selection of the operative route for cavernous sinus related lesions, the extent of the exposure necessary, the need for intraoperative control of the carotid artery and feasibility and need of radical resection depend on the histological nature of the tumour. The age and sex of the patient, principal presenting signs, size of the tumour, extent of cranial nerve and carotid artery involvement, imaging characters and other such features are helpful in estimating the consistency and vascularity of the lesion, site of origin and direction of its spread, and the extent and nature of cavernous sinus involvement. Evaluation of the histology of the lesion on the basis of the radiological and clinical parameters and the impact on decision regarding the surgical strategy is discussed in the present report.

Dynamics of membrane structure of frog erythrocyte ghosts measured with a nanosecond fluorometer.

The dynamics of membrane microstructure was studied as molecular motions of phospholipids for bullfrog erythrocyte ghosts by the DPH fluorescence depolarization technique with a nanosecond fluorometer. The bullfrog erythrocyte ghosts were obtained by hypotonic lysis and collagenase treatment. The constituents of membrane proteins were confirmed by the disk gel electrophoresis. The viscosity of erythrocyte membrane ghosts was estimated to be 3.3 +/- 1.0 at 10 degrees C, and 2.1 +/- 0.1 at 20 degrees C and 1.3 +/- 0.2 at 30 degrees C in the unit of poise and the wobbling angle of lipid molecule was 35 +/- 1, 41 +/- 1 and 43 +/- 1 degree at the respective temperatures on an average and +/- S.D. The viscosity is lower than that of human erythrocytes. The relatively low viscous phospholipid bilayer may be one of the factors for the deformability of bullfrog erythrocytes.

Viscosity and order in erythrocyte membranes studied with nanosecond fluorometry.

The viscosity and the order in the interior of human erythrocyte membranes were investigated by the fluorescence depolarization technique in the nanosecond region with 1,6-diphenyl-1,3,5-hexatriene (DPH). After pulsed excitation with a polarized light, the fluorescence anisotropy ratio of DPH in membranes rapidly decreased and gave a final value (r infinity). The rate of initial decrease and the value of r infinity related to the viscosity in the interior of the membranes and a wobbling angle of DPH which reflects a size of range for the phospholipid motion relating to the order of membrane structure. For normal human erythrocyte membranes the viscosity and the wobbling angle were obtained to be 0.82 poise and 42 degrees, at 37 degrees C. Similar values were obtained for spectrin-free membranes. Hardened membranes by the cross-linking of the cytoskeletal proteins with glutaraldehyde showed a small wobbling angle of 37 degrees, but the viscosity of them was unchanged.