Correlation length ratio as a parameter for determination of fiber-like structures in soft tissues.

Quantitative ultrasound methods can provide valuable information about the microstructure of a material or tissue. This works well when the common assumptions of homogeneity, isotropy, and diffuse scattering conditions are valid. In biological tissues, however, these assumptions are often violated because the microstructure of biological tissues is often heterogeneous and anisotropic. The microstructure of biological tissues can change with disease, and therefore accurate identification and description of a tissue's microstructure can offer important clinical insight. To address the challenge of evaluating the microstructure of biological tissues, here we introduce a novel parameter called the correlation length ratio (CLR), a ratio of lateral to axial correlation lengths for backscattered echo signals. We developed it to determine the presence of fiber-like structures in soft tissues by comparing this value in tissue to a threshold determined from a reference material that is homogeneous, isotropic, and provides diffuse scattering. We tested this novel parameter in phantoms with spherical scattering sources, in an anisotropic phantom (containing elongated fibers), and in human biceps muscle. We found that the CLR accurately detected the presence of elongated structures in both the anisotropic phantom and muscle. These results encourage further exploration of this novel parameter in microstructurally complex tissues.

Comparative genomic identification and validation of ß-defensin genes in the Ovis aries genome.

BACKGROUND: ß-defensins are small, cationic, antimicrobial peptides found in species across the plant and animal kingdoms. In addition to microbiocidal activity, roles in immunity as well as reproduction have more recently been documented. ß-defensin genes in Ovis aries (domestic sheep) have been poorly annotated, having been identified only by automatic gene prediction algorithms. The objective of this study was to use a comparative genomics approach to identify and characterise the ß-defensin gene repertoire in sheep using the bovine genome as the primary reference. RESULTS: All 57 currently predicted bovine ß-defensin genes were used to find orthologous sequences in the most recent version of the sheep genome (OAR v4.0). Forty three genes were found to have close genomic matches (>70% similarity) between sheep and cattle. The orthologous genes were located in four clusters across the genome, with 4 genes on chromosome 2, 19 genes on chromosome 13, 5 genes on chromosome 20 and 15 genes on chromosome 26. Conserved gene order for the ß-defensin genes was apparent in the two smaller clusters, although gene order was reversed on chromosome 2, suggesting an inversion between sheep and cattle. Complete conservation of gene order was also observed for chromosome 13 ß-defensin orthologs. More structural differences were apparent between chromosome 26 genes and the orthologous region in the bovine reference genome, which is known to be copy-number variable. In this cluster, the Defensin-beta 1 (DEFB1) gene matched to eleven Bovine Neutrophil beta-Defensin (BNBD) genes on chromosome 27 with almost uniform similarity, as well as to tracheal, enteric and lingual anti-microbial peptides (TAP, EAP and LAP), suggesting that annotation of the bovine reference sequence is still incomplete. qPCR was used to profile the expression of 34 ß-defensin genes, representing each of the four clusters, in the ram reproductive tract. Distinct site-specific and differential expression profiles were detected across the reproductive tract of mature rams with preferential ß-defensin gene expression in the epididymis, recapitulating observations for orthologous genes in other species. CONCLUSIONS: This is the first comprehensive analysis of ß-defensin genes encoded by the ovine reference sequence, and the first report of an expanded repertoire of ß-defensin genes in this species. The preferential expression of these genes in the epididymis suggests a role in fertility, possibly providing immunoprotection for sperm within the female reproductive tract.

Changes in shear wave speed pre- and post-induction of labor: a feasibility study.

OBJECTIVE: To explore the feasibility of using shear wave speed (SWS) estimates to detect differences in cervical softening pre- and post-ripening in women undergoing induction of labor. METHODS: Subjects at 37-41 weeks' gestation undergoing cervical ripening before induction of labor were recruited (n = 20). Examinations, performed prior to administration of misoprostol and 4 h later included Bishop score, transvaginal ultrasound measurement of cervical length, and 10 replicate SWS measurements using an ultrasound system equipped with a prototype transducer (128 element, 3 mm diameter, 14 mm aperture) attached to the clinician's hand. Subjects were divided into two groups, 'not-in-labor' and 'marked-progression', based on cervical evaluation at the second examination. Measurements were compared via individual paired hypotheses tests and using a linear mixed model, with the latter also used to compare groups. Spearman's rank correlation coefficient was used to compare SWS with Bishop score. The linear mixed model can take into account clustered data and accommodate multiple predictors simultaneously. RESULTS: The Wilcoxon signed-rank paired test established a significant difference in pre- and post-ripening SWS, with mean SWS estimates of 2.53 ± 0.75 and 1.54 ± 0.31 m/s, respectively (P < 0.001) in the not-in-labor group (decrease in stiffness) and 1.58 ± 0.33 and 2.35 ± 0.65 m/s for the marked-progression group (increase in stiffness). The linear mixed model corroborated significant differences in pre- and post-ripening measurements in individual subjects (P < 0.001) as well as between groups (P < 0.0001). SWS estimates were significantly correlated with digitally-assessed cervical softness and marginally correlated with Bishop score as assessed by Spearman's rank correlation coefficient. CONCLUSIONS: In-vivo SWS estimates detected stiffness differences before and after misoprostol-induced softening in term pregnancies. This ultrasonic shear elasticity imaging technique shows promise for assessing cervical softness.

Estimation of shear wave speed in the human uterine cervix.

OBJECTIVES: To explore spatial variability within the cervix and the sensitivity of shear wave speed (SWS) to assess softness/stiffness differences in ripened (softened) vs unripened tissue. METHODS: We obtained SWS estimates from hysterectomy specimens (n = 22), a subset of which were ripened (n = 13). Multiple measurements were made longitudinally along the cervical canal on both the anterior and posterior sides of the cervix. Statistical tests of differences in the proximal vs distal, anterior vs posterior and ripened vs unripened cervix were performed with individual two-sample t-tests and a linear mixed model. RESULTS: Estimates of SWS increase monotonically from distal to proximal longitudinally along the cervix, they vary in the anterior compared to the posterior cervix and they are significantly different in ripened vs unripened cervical tissue. Specifically, the mid position SWS estimates for the unripened group were 3.45 ± 0.95 m/s (anterior; mean ± SD) and 3.56 ± 0.92 m/s (posterior), and 2.11 ± 0.45 m/s (anterior) and 2.68 ± 0.57 m/s (posterior) for the ripened group (P < 0.001). CONCLUSIONS: We propose that SWS estimation may be a valuable research and, ultimately, diagnostic tool for objective quantification of cervical stiffness/softness.

The impact of laterally coupled grating microstructure on effective coupling coefficients.

Lithographic fabrication may be used to define laterally coupled gratings of high refractive index contrast on waveguide ridges, eliminating the need for regrowth steps in such distributed feedback lasers. These may be made more amenable to fabrication by employing higher-order gratings. Reliable exploration of the laser design space requires that the radiating partial waves be accurately incorporated in numerical simulations. We modify the coupled-mode approach to fully consider the two-dimensional cross section, analyzing rectangular, sinusoidal, triangular and trapezoidal grating shapes. Effective coupling coefficients are determined for grating orders from first to third. We show that, by tailoring the grating microstructure, effective coupling coefficients up to double that of a 0.5 duty cycle rectangular grating can be achieved. The actual grating microstructure of an as-fabricated grating was analyzed and its effective coupling coefficient predicted as [Formula: see text]. This was found to be in excellent agreement with the value extracted from the amplified spontaneous emission spectrum, [Formula: see text].

Performance of ultramicrofibre cleaning technology with or without addition of a novel copper-based biocide.

This study compared the bacterial removal performance of ultramicrofibre cloths and mops (UMF) moistened with water (UMF+water), with those moistened with a novel copper-based biocide (UMF+CuWB50, 300ppm) in several working hospital environments, specifically accident and emergency (A&E) and three other wards. A total of 13 defined sampling sites (10 sites per ward) were sampled in order to retrieve, culture, and enumerate total viable (bacterial) counts (TVC) for each site. We sampled 1h before, and 1 and 4h after, cleaning three times per week. The trial ran for 7 weeks. Two wards were cleaned with UMF+water for 3 weeks, and UMF+CuWB50 for 4 weeks. The reverse applied to the other two wards in a cross-over design fashion, to eliminate ward- and time-specific bias. Multivariate statistical analyses were used to establish extent and significance of any perceived differences, and to eliminate the effects of potential confounders. Cleaning with UMF+water reduced TVC on the test surfaces by 30%, whereas cleaning with TVC+CuWB50 reduced TVC by 56%. CuWB50 had two separate effects; a direct antibacterial effect (evident shortly after cleaning), and a residual antibacterial effect that lasted approximately 2 weeks. The residual effect requires regular application of CuWB50 if it is to persist. This 'real life' hospital implementation study demonstrates encouraging microbiological cleaning performance for UMF, which is further enhanced with CuWB50.

Patterns of treatment of osteoradionecrosis with hyperbaric oxygen therapy in the United Kingdom.

We aimed to find out the number of patients with osteoradionecrosis (ORN) being treated by hyperbaric chambers in the UK during 2006-07, and the protocols that were being used. We did a telephone survey of 76 chambers to find out whether they treated patients with ORN, how many patients they treated in 2006-07, what chamber pressure they used, the duration of each session, and the total number of sessions/patient. A total of 25 chambers treated 273 patients with ORN in 2006-07; 10 were listed by the British Hyperbaric Association (BHA) and 15 were at multiple sclerosis (MS) centres. MS centres treated 23 (8%) of patients with ORN with a variable number of sessions of shorter duration and lower pressures than the chambers listed by the BHA. Most BHA chambers treated patients at 2.2 ATA for 90 min/session with 30 preoperative and 10 postoperative sessions/patient.

Instrument for determining the complex shear modulus of soft-tissue-like materials from 10 to 300 Hz.

Accurate determination of the complex shear modulus of soft tissues and soft-tissue-like materials in the 10-300 Hz frequency range is very important to researchers in MR elastography and acoustic radiation force impulse (ARFI) imaging. A variety of instruments for making such measurements has been reported, but none of them is easily reproduced, and none have been tested to conform to causality via the Kramers-Kronig (K-K) relations. A promising linear oscillation instrument described in a previous brief report operates between 20 and 160 Hz, but results were not tested for conformity to the K-K relations. We have produced a similar instrument with our own version of the electronic components and have also accounted for instrumental effects on the data reduction, which is not addressed in the previous report. The improved instrument has been shown to conform to an accurate approximation of the K-K relations over the 10-300 Hz range. The K-K approximation is based on the Weichert mechanical circuit model. We also found that the sample thickness must be small enough to obtain agreement with a calibrated commercial rheometer. A complete description of the improved instrument is given, facilitating replication in other labs.

Removing bacteria from hospital surfaces: a laboratory comparison of ultramicrofibre and standard cloths.

We compared the ability of ultramicrofibre-woven cloths with conventional cloths moistened with water only, for their ability to remove several types of organisms relevant to hospital-acquired infections from a variety of surfaces in hospitals. We showed that ultramicrofibre cloths consistently outperformed conventional cloths in their decontamination ability, across all surfaces, and irrespective of whether the bacteria were coated on to the surfaces with phosphate-buffered saline (PBS) or PBS containing horse serum to simulate real-life soiling. The ability of the cloths to remove bacteria from surfaces was assessed by contact plating and colony formation, and by swabbing and measurement of ATP bioluminescence. The results suggest potential for use of ultramicrofibre in healthcare environments. Further studies are required, however, to define accurately how these cloths, which are designed to be used without detergent or biocides, might be capable of safe and effective deployment and recycling in the healthcare environment.

Acoustic backscatter and effective scatterer size estimates using a 2D CMUT transducer.

Compared to conventional piezoelectric transducers, new capacitive microfabricated ultrasonic transducer (CMUT) technology is expected to offer a broader bandwidth, higher resolution and advanced 3D/4D imaging inherent in a 2D array. For ultrasound scatterer size imaging, a broader frequency range provides more information on frequency-dependent backscatter, and therefore, generally more accurate size estimates. Elevational compounding, which can significantly reduce the large statistical fluctuations associated with parametric imaging, becomes readily available with a 2D array. In this work, we show phantom and in vivo breast tumor scatterer size image results using a prototype 2D CMUT transducer (9 MHz center frequency) attached to a clinical scanner. A uniform phantom with two 1 cm diameter spherical inclusions of slightly smaller scatterer size was submerged in oil and scanned by both the 2D CMUT and a conventional piezoelectric linear array transducer. The attenuation and scatterer sizes of the sample were estimated using a reference phantom method. RF correlation analysis was performed using the data acquired by both transducers. The 2D CMUT results indicate that at a 2 cm depth (near the transmit focus for both transducers) the correlation coefficient reduced to less than 1/e for 0.2 mm lateral or 0.25 mm elevational separation between acoustic scanlines. For the conventional array this level of decorrelation requires a 0.3 mm lateral or 0.75 mm elevational translation. Angular and/or elevational compounding is used to reduce the variance of scatterer size estimates. The 2D array transducer acquired RF signals from 140 planes over a 2.8 cm elevational direction. If no elevational compounding is used, the fractional standard deviation of the size estimates is about 12% of the mean size estimate for both the spherical inclusion and the background. Elevational compounding of 11 adjacent planes reduces it to 7% for both media. Using an experimentally estimated attenuation of 0.6 dB cm(-1) MHz(-1), scatterer size estimates for an in vivo breast tumor also demonstrate improvements using elevational compounding with data from the 2D CMUT transducer.

The efficacy of the inorganic copper-based biocide CuWB50 is compromised by hard water.

AIMS: We sought to explain the unexpected failure of the inorganic copper-based biocide CuWB50 to effectively decontaminate microfibre cleaning cloths that became contaminated with Acinetobacter lwoffii. METHODS AND RESULTS: CuWB50 was diluted using distilled water or tap water obtained from two different ICUs. Microtitre plate assays were used to determine the minimum inhibitory concentration (MIC) for the implicated A. lwoffii. pH and oxidation-reduction potential (ORP) tests were performed and representative water samples were chemically analysed. When diluted in distilled water, the CuWB50 MIC for A. lwoffii was 9 mg l(-1) but in tap water from each ICU it was 37 and 75 mg l(-1) at hardness levels of 246 and 296 mg CaCO(3) l(-1) respectively. CuWB50-distilled water solutions consistently had a lower pH and higher ORP than CuWB50-tap water solutions. CONCLUSIONS: Hard water adversely affects the biocidal efficacy of CuWB50. SIGNIFICANCE AND IMPACT OF THE STUDY: Unintentional environmental contamination is a risk when using wet microfibre cloths. This occurred when cloths were stored in CuWB50 overnight combined with the unintentional but erroneous use of tap water. This study emphasizes the need for clearly documented cleaning protocols embedded within a culture of adequate training and constant supervision of cleaning staff.

A parallelizable real-time motion tracking algorithm with applications to ultrasonic strain imaging.

Ultrasound-based mechanical strain imaging systems utilize signals from conventional diagnostic ultrasound systems to image tissue elasticity contrast that provides new diagnostically valuable information. Previous works (Hall et al 2003 Ultrasound Med. Biol. 29 427, Zhu and Hall 2002 Ultrason. Imaging 24 161) demonstrated that uniaxial deformation with minimal elevation motion is preferred for breast strain imaging and real-time strain image feedback to operators is important to accomplish this goal. The work reported here enhances the real-time speckle tracking algorithm with two significant modifications. One fundamental change is that the proposed algorithm is a column-based algorithm (a column is defined by a line of data parallel to the ultrasound beam direction, i.e. an A-line), as opposed to a row-based algorithm (a row is defined by a line of data perpendicular to the ultrasound beam direction). Then, displacement estimates from its adjacent columns provide good guidance for motion tracking in a significantly reduced search region to reduce computational cost. Consequently, the process of displacement estimation can be naturally split into at least two separated tasks, computed in parallel, propagating outward from the center of the region of interest (ROI). The proposed algorithm has been implemented and optimized in a Windows system as a stand-alone ANSI C++ program. Results of preliminary tests, using numerical and tissue-mimicking phantoms, and in vivo tissue data, suggest that high contrast strain images can be consistently obtained with frame rates (10 frames s(-1)) that exceed our previous methods.

Spectral and scatterer-size correlation during angular compounding: simulations and experimental studies.

In a previous study, theoretical expressions were derived for the correlation between ultrasonic scatterer-size estimates and their associated spectral measures when echo data are acquired from the same location but at different angles. The results were verified using simulations. In the present work, we further analyze simulation data for these conditions; in addition, we measure the correlations using a cylindrical tissue-mimicking phantom. Experimental and theoretical results show that the relationship of scatterer-size correlation to insonification angle depends on gate duration, gate type and beam profile. Some discrepancies are noted between experimental results and theoretical predictions, particularly when using smaller gated windows. The sources of the discrepancies are discussed. Experimental results using a 6-MHz linear array suggest that, to save acquisition and processing time while reducing variance, a 2 degree-3 degree angular increment step provides efficient angular compounding for scatterer-size imaging with this array. Theoretical predictions can provide estimates of expected correlations between angular acquisitions when compounding with other transducers.

Low-reflection-coefficient liquid interfaces for system characterization.

The use of liquid brominated hydrocarbons to form a planar reflecting interface with water is described. Gravity-based planar reflecting surfaces with known reflection coefficients can be used in system characterization for quantitative ultrasonics, and a set of surfaces with a range of reflection coefficients allows calibration of the output power and receiver gain of ultrasonic imaging systems. The substances reported here are immiscible in water and form interfaces with water, resulting in a broad range of acoustic reflection coefficients. Reflection coefficients were measured at temperatures from 18-24 degrees C for "pure" substances and for mixtures of two brominated hydrocarbons. Results show that reflection coefficients are weakly dependent on temperature and that, at a specific temperature, a significant range of arbitrarily small reflection coefficients is available, in the case of the mixtures, by the appropriate choice of weight-percents of the two brominated hydrocarbons.

Ultrasonic properties of random media under uniaxial loading.

Acoustic properties of two types of soft tissue-like media were measured as a function of compressive strain. Samples were subjected to uniaxial strains up to 40% along the axis of the transducer beam. Measurements were analyzed to test a common assumption made when using pulse-echo waveforms to track motion in soft tissues--that local properties of wave propagation and scattering are invariant under deformation. Violations of this assumption have implications for elasticity imaging procedures and could provide new opportunities for identifying the sources of backscatter in biological media such as breast parenchyma. We measured speeds of sound, attenuation coefficients, and echo spectra in compressed phantoms containing randomly positioned scatterers either stiffer or softer than the surrounding gelatin. Only the echo spectra of gel media with soft scatterers varied significantly during compression. Centroids of the echo spectra were found to be shifted to higher frequencies in proportion to the applied strain up to 10%, and increased monotonically up to 40% at a rate depending on the scatterer size. Centroid measurements were accurately modeled by assuming incoherent scattering from oblate spheroids with an eccentricity that increases with strain. While spectral shifts can be accurately modeled, recovery of lost echo coherence does not seem possible. Consequently, spectral variance during compression may ultimately limit the amount of strain that can be applied between two data fields in heterogeneous media such as lipid-filled tissues. It also appears to partially explain why strain images often produce greater echo decorrelation in tissues than in commonly used graphite-gelatin test phantoms.