Name: coordinate mapping of hyolaryngeal mechanics in swallowing
Uploaded: 2014-05-06T15:30:00
Description: Watch this Scientific Journal Video about Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing at JoVE.com

Les auteurs reconnaissent Kendrea Focht, cscd, CCC-SLP, et l&#39;Institut Trammell Evelyn pour la voix et de la déglutition à l&#39;Université médicale de Caroline du Sud, pour le partage de fichiers MBS d&#39;imagerie utilisés pour démontrer cette méthodologie. Ces données MBS ont été recueillies par le soutien extra-muros financé par Grant Nombre TL1TR000061 (PI: Focht) du Centre national pour l&#39;avancement des sciences translationnelle et par Grant Nombre 1K24DC12801 (PI: Martin Harris) de l&#39;Institut national sur la surdité et autres troubles de la communication, et soutien intra-muros de Mark Trammell et Evelyn Trust. Ces méthodes ont été initialement développées par le chercheur principal tout en étant soutenue par Grant Nombre F31DC011705 de l&#39;Institut national sur la surdité et autres troubles de la communication. Le contenu est exclusivement la responsabilité de leurs auteurs et ne représentent pas nécessairement les vues officielles de l&#39;Institut national sur la surdité et autres troubles de la communication ou les National Institutesde la Santé.

1. Configuration d&#39;un ordinateur <ol><li> Pour Macintosh, téléchargez l&#39;open source ou logiciel freeware qui suit: ImageJ, MacX Video Converter Free Edition (Mac) et QuickTime (voir tableau de matériel / équipement). </li><li> Pour un PC, téléchargez le open source qui suit ou un logiciel freeware: ImageJ, MPEG Streamclip (PC) et QuickTime (voir tableau de matériel / équipement). </li></ol> 2. Préparation des clips vidéo <ol><li> La conversion des fichiers. Convertir des fic...

<ol>
	<li>Leonard, R. J., Kendall, K. A., McKenzie, S., Gon&#231;alves, M. I., Walker, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Structural+Displacements+in+Normal+Swallowing:+A+Videofluoroscopic+Study.">Structural Displacements in Normal Swallowing: A Videofluoroscopic Study.</a> Dysphagia. 15, 146-152 (2000).</li><li>Molfenter, S. M., Steele, C. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Physiological+Variability+in+the+Deglutition+Literature:+Hyoid+and+Laryngeal+Kinematics.">Physiological Variability in the Deglutition Literature: Hyoid and Laryngeal Kinematics.</a> Dysphagia. 26, 67-74 (2010).</li><li>Pearson, W. G., Hindson, D. F., Langmore, S. E., Zumwalt, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluating+Swallowing+Muscles+Essential+for+Hyolaryngeal+Elevation+by+Using+Muscle+Functional+Magnetic+Resonance+Imaging.">Evaluating Swallowing Muscles Essential for Hyolaryngeal Elevation by Using Muscle Functional Magnetic Resonance Imaging.</a> International Journal of Radiation Oncology* Biology* Physics. 85, 735-740 (2013).</li><li>Pearson, W. G., Langmore, S. E., Yu, L. B., Zumwalt, A. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Structural+Analysis+of+Muscles+Elevating+the+Hyolaryngeal+Complex.">Structural Analysis of Muscles Elevating the Hyolaryngeal Complex.</a> Dysphagia. 27, 445-451 (2012).</li><li>Kim, Y., McCullough, G. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Maximum+hyoid+displacement+in+normal+swallowing.">Maximum hyoid displacement in normal swallowing.</a> Dysphagia. 23, 274-279 (2008).</li><li>Steele, C. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+relationship+between+hyoid+and+laryngeal+displacement+and+swallowing+impairment.">The relationship between hyoid and laryngeal displacement and swallowing impairment.</a> Clin. Otolaryngol. 36, 30-36 (2011).</li><li>Logemann, J. A., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporal+and+Biomechanical+Characteristics+of+Oropharyngeal+Swallow+in+Younger+and+Older+Men.">Temporal and Biomechanical Characteristics of Oropharyngeal Swallow in Younger and Older Men.</a> Journal of Speech, Language and Hearing Research. 43, 1264-1274 (2000).</li><li>Pearson, W., Langmore, S., Zumwalt, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluating+the+Structural+Properties+of+Suprahyoid+Muscles+and+their+Potential+for+Moving+the+Hyoid.">Evaluating the Structural Properties of Suprahyoid Muscles and their Potential for Moving the Hyoid.</a> Dysphagia. 26, 345-351 (2011).</li><li>Hopkins, W. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Measures+of+reliability+in+sports+medicine+and+science.">Measures of reliability in sports medicine and science.</a> Sports Med. 30, 1-15 (2000).</li><li>Bingjie, L., Zhang, T., Sun, X., Xu, J., Jiang, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quantitative+videofluoroscopic+analysis+of+penetration-aspiration+in+post-stroke+patients.">Quantitative videofluoroscopic analysis of penetration-aspiration in post-stroke patients.</a> Neurol. India. 58, 42-47 (2010).</li><li>Webster, M., Sheets, H. D., Alroy, J., Hunt, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+practical+introduction+to+landmark-based+geometric+morphometrics.">A practical introduction to landmark-based geometric morphometrics.</a> Quantitative Methods in Paleobiology. Paleontological Society Papers. 16, 163-188 (2010).</li><li>Inamoto, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Evaluation+of+swallowing+using+320-detector-row+multislice+CT.+Part+II:+Kinematic+analysis+of+laryngeal+closure+during+normal+swallowing.">Evaluation of swallowing using 320-detector-row multislice CT. Part II: Kinematic analysis of laryngeal closure during normal swallowing.</a> Dysphagia. 26, 209-217 (2011).</li></ol>

Cette étude démontre l&#39;utilité d&#39;une méthode utilisant des données de coordonnées de points de repère anatomiques pour calculer plusieurs mesures cinématiques du mouvement hyolaryngeal à avaler. Le coefficient d&#39;objectivité de six évaluateurs, y compris les deux évaluateurs novices, pour les coordonnées et les variables calculées était forte (ICC&gt; 0,90). Les résultats représentatifs d&#39;un échantillon aléatoire de la santé chez les adultes non atteints de dysphagie ont montré des di...

La phase pharyngée de la déglutition est un processus complexe impliquant plus de vingt muscles squelettiques et des éléments multiples pour le transfert d&#39;un bolus de la cavité orale dans l&#39;œsophage tout en protégeant les voies aériennes. Précédent pharyngée constriction, des éléments de la hyolaryngeal complexe (os hyoïde, du larynx et des structures connexes, y compris le sphincter oesophagien supérieur) sont déplacés pour convertir un conduit respiratoire dans un tube digestif. Le larynx est re-trouve en avant à une distance de la trajectoire d&#39;un bolus venant en sens inverse, et le sphincter oesophagien supérieur est étirée ouverte. Mesures cinématiques tirées d&#39;études de déglutition radioscopiques vidéo (également connus sous le nom d&#39;un MBS ou de baryum modifié études Swallow) sont la méthodologie de la recherche primaire pour quantifier les multiples mouvements du complexe hyolaryngeal 1. Bien que des mesures quantitatives de la vidéo radioscopiques sont utiles pour mesurer la déglutition fonction, différents axes de référenceet scalaires de résultat de la mesure dans les résultats qui sont incompatibles entre les différentes méthodes de mesures cinématiques 2. Le mouvement du patient et de radioscopie sous contrôle manuel de clinicien confond aussi la précision de la mesure de ce processus physiologique complexe. Plus important encore, les mesures cinématiques ne reflètent pas nécessairement les relations structure-fonction à importantes pour l&#39;évaluation de la déglutition désordonnée. Cinématique de l&#39;os hyoïde en particulier, ont été conçus pour suivre le mouvement dans une direction antérieure ou supérieure en référence à un plan anatomique aligné avec les vertèbres. Toutefois, cette configuration ne représente pas la ligne d&#39;action des muscles qui suspendent l&#39;os hyoïde. Un mécanisme à deux porte-bébé de hyolaryngeal élévation dans la phase pharyngée de la déglutition a été identifiée (figure 1) 3,4. Les muscles sus-hyoïdiens comprennent la fronde musculaire antérieure, et les muscles du pharynx longues comprennent le posterior fronde musculaire. Ces muscles élèvent différents éléments du complexe hyolaryngeal y compris l&#39;os hyoïde, du larynx et des structures qui forment le sphincter oesophagien supérieur. Coordonner la cartographie de la mécanique hyolaryngeal utilise neuf repères anatomiques facilement identifiables à la carte trois leviers squelettiques et les caractéristiques des points hyolaryngeal complexes représentant de fixation de la partie antérieure et élingues musculaires postérieures (figure 2). Lors de la déglutition, chaque levier squelettique et fonction du complexe hyolaryngeal est en mouvement. Par la collecte de coordonnées, le système peut être capturé dans un laps de temps. Conversion trigonométrique de coordonnées peut être utilisé pour générer de multiples mesures cinématiques du mouvement hyolaryngeal lors de la déglutition. Les variables peuvent être calculées pour la comparaison avec les résultats rapportés dans la littérature, ou utilisés pour générer de nouvelles mesures représentant des relations d&#39;intérêt structure à fonction. L&#39;objectif principal de cet article est de démontrer un procédé de génération de multiples mesures cinématiques calculées à partir d&#39;un seul ensemble de coordonnées de point de repère anatomiques recueillies auprès de baryum modifié Swallow (MBS) études. Nous documentons la fiabilité de cette méthode en utilisant des coefficients de corrélation intraclasse pour déterminer la fiabilité inter-évaluateur de 6 enquêteurs différents, y compris un expert, trois évaluateurs avec l&#39;expérience, et deux novices. A partir des résultats cinématiques, les différences dans la mécanique avaler par la cohérence de bolus sont évalués. Enfin, la question proposée par Molefenter et Steele sur l&#39;importance de l&#39;axe de référence utilisé pour mesurer le mouvement hyoïde est adressée. Pour aborder cette question, nous comparons les mesures de hyoïde excursion en référence aux vertèbres et en référence à la mandibule, calculé à partir du même ensemble de coordonnées pour les deux types de bolus. Si ces deux méthodes de mesure de mouvement hyoïde représentent la même structure à la fonction relationshanche, les résultats devraient être fortement corrélées. Pour cette étude, 40 latérales études vue de MBS ont été choisis au hasard à partir d&#39;une collection de 139 études normales en vertu d&#39;un protocole de recherche approuvé par le Conseil de l&#39;Université Institutional Review Géorgie Regents et en collaboration de recherche avec l&#39;Institut Trammell Evelyn pour la voix et de la déglutition à l&#39;Université médicale de Caroline du Sud. Pour démontrer l&#39;utilité de ce procédé, dix variables caractérisant cinématique hyolaryngeal ont été calculées à partir du même ensemble de données de coordonnées (tableau 1). Sept de ces mesures ont déjà été calculées dans la littérature, y compris: antérieure et mesures de distance hyoïde supérieures en référence aux vertèbres 5; antérieure et hyoïde déplacement supérieur comme un rapport de C2-4 longueur, également en référence aux vertèbres 6; mouvement supérieure du larynx en référence aux vertèbres sept; ENVIRON hyolaryngealion 1; et excursion hyoïde maximale en référence aux vertèbres 1. En outre, trois nouvelles mesures ont été calculés: le raccourcissement du pharynx rapprochant les pièces jointes du muscle Palatopharyngien, élévation du larynx suivant une ligne d&#39;action qui représente le stylo-pharyngien, et excursion hyoïde approchant les pièces jointes des muscles sus-hyoïdiens 4,8. Tête d&#39;experts et anatomiste du cou (WP), trois chercheurs ayant de l&#39;expérience en prenant des mesures limitées (CJ, SR, TT), et deux enquêteurs débutants (RS, JT) obtenus des données de coordonnées de mapping utilisant le protocole décrit ci-dessous. L&#39;expert (WP) a formé les trois évaluateurs avec l&#39;expérience, à leur tour, formé des deux évaluateurs novices. Le coefficient d&#39;objectivité de coordonner les données et les résultats calculés à partir des coordonnées par thème a été déterminé par des coefficients de corrélation intra-9. Deux tests t bilatéraux ont été effectuées sur chaque variable pour déterminer statisticalldifférences significatives y en types de bolus. Un coefficient de corrélation de Pearson et un coefficient de détermination ont été utilisés pour évaluer la concordance entre les résultats de hyoïde excursion calculées avec les vertèbres comme un axe de référence par rapport excursion hyoïde avec la mandibule comme un axe de référence pour la 5 ml hirondelle mince liquide et 5 ml pouding hirondelle.

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coordinate mapping of hyolaryngeal mechanics in swallowing

Caractériser mouvement hyolaryngeal est important à la recherche de la dysphagie. Les procédés antérieurs nécessitent plusieurs mesures pour obtenir une mesure cinématique alors coordonner la cartographie de la mécanique hyolaryngeal utilisant modification hirondelle de baryum (MBS) utilise un ensemble de coordonnées pour calculer plusieurs variables d&#39;intérêt. Pour des fins de démonstration, dix mesures cinématiques ont été générées à partir d&#39;un ensemble de coordonnées pour déterminer les différences à avaler deux types de bolus différentes. Calculs de hyoïde excursion contre les vertèbres et la mandibule sont corrélées pour déterminer l&#39;importance d&#39;axes de référence. Pour démontrer coordonner méthodologie de cartographie, 40 MBS études ont été choisis au hasard à partir d&#39;un ensemble de données de sujets normaux en bonne santé sans altération avaler connue. A 5 ml bolus mince liquide et à 5 ml hirondelles pudding ont été mesurés pour chaque sujet. Neuf coordonnées, la cartographie la base du crâne, la mandibule, vertèbres et des éléments de la hyocomplexe du larynx, ont été enregistrés à des cadres de randonnée hyolaryngeal minimum et maximum. Les coordonnées ont été mathématiquement convertis en dix variables de la mécanique hyolaryngeal. Le coefficient d&#39;objectivité a été évalué par des coefficients de corrélation intraclasse (ICC). Des tests t bilatéraux ont été utilisés pour évaluer les différences dans la cinématique de viscosité de bolus. Mesures d&#39;excursions hyoïdes contre différents axes de référence ont été corrélées. Le coefficient d&#39;objectivité parmi six évaluateurs pour les coordonnées 18 allait de la CPI = 0,90 à 0,97. Une liste de dix mesures cinématiques a été comparée par sujet entre les six évaluateurs. Une valeur aberrante a été rejetée, et la moyenne des scores de fiabilité restants était ICC = 0,91, de 0,84 à 0,96, IC à 95%. Bilatéraux t-tests avec Bonferroni corrections comparant dix variables cinématiques (5 ml mince liquides hirondelles vs 5 ml pudding) ont montré des différences statistiquement significatives dans hyoïde excursion, mouvement laryngé supérieur, et du pharynx Shortening (p &lt;0,005). Corrélations de Pearson de mesures d&#39;excursion de hyoïdes de deux axes différents de référence sont: r = 0,62, r 2 = 0,38, (mince liquide); r = 0,52, r 2 = 0,27, (pouding). L&#39;obtention des coordonnées de point de repère est une méthode fiable pour générer plusieurs variables cinématiques à partir d&#39;images radioscopiques vidéo utiles dans la recherche de la dysphagie.

Coefficients de corrélation intraclasse (ICC) de coordonnées recueillies par six enquêteurs qui ont analysé indépendamment 80 fichiers vidéo radioscopiques (deux essais de bolus de 40 sujets) allaient de la CPI = de 0,90 à 0,97. La répartition de la CCI de de coordonnées par le groupe est la suivante: coordonne # 1 - 5 (éléments squelettiques à excursion hyolaryngeal minimum) moyenne = 0,93, 0,91 à 0,95, IC à 95%; coordonne n ° 6 - 9 (complexe hyolaryngeal à l&#39;excursion hyolaryngeal minimum) moyenne ...

Watch this Scientific Journal Video about Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing at JoVE.com

Coordinate Mapping of Hyolaryngeal Mechanics in Swallowing

Coordonner la cartographie est une méthode de documenter les principales caractéristiques de la biomécanique hyolaryngeal dans la phase pharyngée de la déglutition. Cette méthode utilise un logiciel d&#39;analyse d&#39;image pour enregistrer les coordonnées de points de repère anatomiques. Ces coordonnées sont importés dans une macro Excel et traduits en variables cinématiques d&#39;intérêt utiles dans la recherche de la dysphagie.

Coordonner la cartographie de Mécanique Hyolaryngeal à avaler

Characterizing hyolaryngeal movement is important to dysphagia research. Prior methods require multiple measurements to obtain one kinematic measurement ...

coordinate-mapping-of-hyolaryngeal-mechanics-in-swallowing

Research

JoVE Journal

Medicine

Guide Wire Assisted Catheterization and Colored Dye Injection for Vascular Mapping of Monochorionic Twin Placentas

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC twin pregnancies develop complications arising from the shared placenta and associated vascular connections1. Severe twin-to-twin syndrome (TTTS) is reported to account for approximately 20% of these complications2,3. Inter-twin vascular connections occur in almost all MC placentas and are related to the prognosis and outcome of these high-risk twin pregnancies. The number, size and type of connections have been implicated in the development of TTTS and other MC twin conditions. Three types of inter-twin vascular connections occur: 1) artery to vein connections (AVs) in which a branch artery carrying deoxygenated blood from one twin courses along the fetal surface of the placenta and dives into a placental cotyledon. Blood flows via a deep intraparenchymal capillary network into a draining vein that emerges at the fetal surface of the placenta and brings oxygenated blood toward the other twin. There is unidirectional flow from the twin supplying the afferent artery toward the twin receiving the efferent vein; 2) artery to artery connections (AAs) in which a branch artery from each twin meets directly on the superficial placental surface resulting in a vessel with pulsatile bidirectional flow, and 3) vein to vein connections (VVs) in which a branch vein from each twin meets directly on the superficial placental surface allowing low pressure bidirectional flow. In utero obstetric sonography with targeted Doppler interrogation has been used to identify the presence of AV and AA connections4. Prenatally detected AAs that have been confirmed by postnatal placental injection studies have been shown to be associated with an improved prognosis for both twins5. Furthermore, fetoscopic laser ablation of inter-twin vascular connections on the fetal surface of the shared placenta is now the preferred treatment for early, severe TTTS. 
Postnatal placental injection studies provide a valuable method to confirm the accuracy of prenatal Doppler ultrasound findings and the efficacy of fetal laser therapy6. Using colored dyes separately hand-injected into the arterial and venous circulations of each twin, the technique highlights and delineates AVs, AAs, and VVs. This definitive demonstration of MC placental vascular anatomy may then be correlated with Doppler ultrasound findings and neonatal outcome to enhance our understanding of the pathophysiology of MC twinning and its sequelae. Here we demonstrate our placental injection technique.

Vascular mapping of monochorionic (MC) twin placentas after birth provides a means for detailed demonstration of vascular connections between the twins&#x2019; circulations. 
Imbalance of these connections is thought to play a pivotal role in the development of complications of MC twinning including twin-to-twin transfusion syndrome.

Cathétérisme Guide fil assistée et coloré pour la cartographie d&#39;injection de colorant vasculaires de monochoriales placentas jumelles

Monochorionic (MC) twin pregnancies are associated with significantly higher morbidity and mortality rates than dichorionic twins. Approximately 50% of MC ...

Recherche

Médecine

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation

Atrial fibrillation (AF) is a complex cardiac arrhythmia with high morbidity and mortality.1,2 It is the most common sustained cardiac rhythm disturbance seen in clinical practice and its prevalence is expected to increase in the coming years.3 Increased intra-atrial pressure and dilatation have been long recognized to lead to AF,1,4 which highlights the relevance of using animal models and stretch to study AF dynamics. Understanding the mechanisms underlying AF requires visualization of the cardiac electrical waves with high spatial and temporal resolution. While high-temporal resolution can be achieved by conventional electrical mapping traditionally used in human electrophysiological studies, the small number of intra-atrial electrodes that can be used simultaneously limits the spatial resolution and precludes any detailed tracking of the electrical waves during the arrhythmia. The introduction of optical mapping in the early 90's enabled wide-field characterization of fibrillatory activity together with sub-millimeter spatial resolution in animal models5,6 and led to the identification of rapidly spinning electrical wave patterns (rotors) as the sources of the fibrillatory activity that may occur in the ventricles or the atria.7-9 Using combined time- and frequency-domain analyses of optical mapping it is possible to demonstrate discrete sites of high frequency periodic activity during AF, along with frequency gradients between left and right atrium. The region with fastest rotors activates at the highest frequency and drives the overall arrhythmia.10,11 The waves emanating from such rotor interact with either functional or anatomic obstacles in their path, resulting in the phenomenon of fibrillatory conduction.12 Mapping the endocardial surface of the posterior left atrium (PLA) allows the tracking of AF wave dynamics in the region with the highest rotor frequency. Importantly, the PLA is the region where intracavitary catheter-based ablative procedures are most successful terminating AF in patients,13 which underscores the relevance of studying AF dynamics from the interior of the left atrium. Here we describe a sheep model of acute stretch-induced AF, which resembles some of the characteristics of human paroxysmal AF. Epicardial mapping on the left atrium is complemented with endocardial mapping of the PLA using a dual-channel rigid borescope c-mounted to a CCD camera, which represents the most direct approach to visualize the patterns of activation in the most relevant region for AF maintenance.

This report provides a detailed description of the methodology and results of simultaneous endocardial and epicardial optical mapping of electrical excitation in the intact left atrium of a Langendorff-perfused sheep heart during stretch-induced atrial fibrillation.

High-Resolution cartographie endocardique et épicardique optique dans un modèle de moutons de Stretch-Induced fibrillation auriculaire

 Atrial fibrillation (AF) is a complex cardiac arrhythmia with high morbidity and mortality.1,2 It is the most common sustained cardiac rhythm disturbance ...

Heterogeneity Mapping of Protein Expression in Tumors using Quantitative Immunofluorescence

Morphologic heterogeneity within an individual tumor is well-recognized by histopathologists in surgical practice. While this often takes the form of areas of distinct differentiation into recognized histological subtypes, or different pathological grade, often there are more subtle differences in phenotype which defy accurate classification (Figure 1). Ultimately, since morphology is dictated by the underlying molecular phenotype, areas with visible differences are likely to be accompanied by differences in the expression of proteins which orchestrate cellular function and behavior, and therefore, appearance. The significance of visible and invisible (molecular) heterogeneity for prognosis is unknown, but recent evidence suggests that, at least at the genetic level, heterogeneity exists in the primary tumor1,2, and some of these sub-clones give rise to metastatic (and therefore lethal) disease. 
Moreover, some proteins are measured as biomarkers because they are the targets of therapy (for instance ER and HER2 for tamoxifen and trastuzumab (Herceptin), respectively). If these proteins show variable expression within a tumor then therapeutic responses may also be variable. The widely used histopathologic scoring schemes for immunohistochemistry either ignore, or numerically homogenize the quantification of protein expression. Similarly, in destructive techniques, where the tumor samples are homogenized (such as gene expression profiling), quantitative information can be elucidated, but spatial information is lost. Genetic heterogeneity mapping approaches in pancreatic cancer have relied either on generation of a single cell suspension3, or on macrodissection4. A recent study has used quantum dots in order to map morphologic and molecular heterogeneity in prostate cancer tissue5, providing proof of principle that morphology and molecular mapping is feasible, but falling short of quantifying the heterogeneity. Since immunohistochemistry is, at best, only semi-quantitative and subject to intra- and inter-observer bias, more sensitive and quantitative methodologies are required in order to accurately map and quantify tissue heterogeneity in situ.
We have developed and applied an experimental and statistical methodology in order to systematically quantify the heterogeneity of protein expression in whole tissue sections of tumors, based on the Automated QUantitative Analysis (AQUA) system6. Tissue sections are labeled with specific antibodies directed against cytokeratins and targets of interest, coupled to fluorophore-labeled secondary antibodies. Slides are imaged using a whole-slide fluorescence scanner. Images are subdivided into hundreds to thousands of tiles, and each tile is then assigned an AQUA score which is a measure of protein concentration within the epithelial (tumor) component of the tissue. Heatmaps are generated to represent tissue expression of the proteins and a heterogeneity score assigned, using a statistical measure of heterogeneity originally used in ecology, based on the Simpson's biodiversity index7.
To date there have been no attempts to systematically map and quantify this variability in tandem with protein expression, in histological preparations. Here, we illustrate the first use of the method applied to ER and HER2 biomarker expression in ovarian cancer. Using this method paves the way for analyzing heterogeneity as an independent variable in studies of biomarker expression in translational studies, in order to establish the significance of heterogeneity in prognosis and prediction of responses to therapy.

Here we describe a method to quantify molecular heterogeneity in histological sections of tumor material using quantitative immunofluorescence, image analysis, and a statistical measure of heterogeneity. The method is intended for use in clinical biomarker development and analysis.

Cartographie hétérogénéité d&#39;expression des protéines dans les tumeurs par immunofluorescence quantitative

Morphologic heterogeneity within an individual tumor is well-recognized by histopathologists in surgical practice. While this often takes the form of ...

Label-free Isolation and Enrichment of Cells Through Contactless Dielectrophoresis

Dielectrophoresis (DEP) is the phenomenon by which polarized particles in a non-uniform electric field undergo translational motion, and can be used to direct the motion of microparticles in a surface marker-independent manner. Traditionally, DEP devices include planar metallic electrodes patterned in the sample channel. This approach can be expensive and requires a specialized cleanroom environment. Recently, a contact-free approach called contactless dielectrophoresis (cDEP) has been developed. This method utilizes the classic principle of DEP while avoiding direct contact between electrodes and sample by patterning fluidic electrodes and a sample channel from a single polydimethylsiloxane (PDMS) substrate, and has application as a rapid microfluidic strategy designed to sort and enrich microparticles. Unique to this method is that the electric field is generated via fluidic electrode channels containing a highly conductive fluid, which are separated from the sample channel by a thin insulating barrier. Because metal electrodes do not directly contact the sample, electrolysis, electrode delamination, and sample contamination are avoided. Additionally, this enables an inexpensive and simple fabrication process.
cDEP is thus well-suited for manipulating sensitive biological particles. The dielectrophoretic force acting upon the particles depends not only upon spatial gradients of the electric field generated by customizable design of the device geometry, but the intrinsic biophysical properties of the cell. As such, cDEP is a label-free technique that avoids depending upon surface-expressed molecular biomarkers that may be variably expressed within a population, while still allowing characterization, enrichment, and sorting of bioparticles.
Here, we demonstrate the basics of fabrication and experimentation using cDEP. We explain the simple preparation of a cDEP chip using soft lithography techniques. We discuss the experimental procedure for characterizing crossover frequency of a particle or cell, the frequency at which the dielectrophoretic force is zero. Finally, we demonstrate the use of this technique for sorting a mixture of ovarian cancer cells and fluorescing microspheres (beads).

Contactless dielectrophoresis (cDEP) achieves sorting and enrichment of particles via their intrinsic dielectric properties. Fluidic electrode channels replace metallic electrodes traditional to DEP, suiting cDEP to non-damaging sterile characterization and sorting of biological particles. We demonstrate how to prepare a cDEP microdevice and conduct cell characterization and sorting experiments.

L&#39;isolement et l&#39;enrichissement des cellules sans étiquette Grâce contact Diélectrophorèse

Dielectrophoresis (DEP) is the phenomenon by which polarized particles in a non-uniform electric field undergo translational motion, and can be used to ...

MRI Mapping of Cerebrovascular Reactivity via Gas Inhalation Challenges

The brain is a spatially heterogeneous and temporally dynamic organ, with different regions requiring different amount of blood supply at different time. Therefore, the ability of the blood vessels to dilate or constrict, known as Cerebral-Vascular-Reactivity (CVR), represents an important domain of vascular function. An imaging marker representing this dynamic property will provide new information of cerebral vessels under normal and diseased conditions such as stroke, dementia, atherosclerosis, small vessel diseases, brain tumor, traumatic brain injury, and multiple sclerosis. In order to perform this type of measurement in humans, it is necessary to deliver a vasoactive stimulus such as CO2 and/or O2 gas mixture while quantitative brain magnetic resonance images (MRI) are being collected. In this work, we presented a MR compatible gas-delivery system and the associated protocol that allow the delivery of special gas mixtures (e.g., O2, CO2, N2, and their combinations) while the subject is lying inside the MRI scanner. This system is relatively simple, economical, and easy to use, and the experimental protocol allows accurate mapping of CVR in both healthy volunteers and patients with neurological disorders. This approach has the potential to be used in broad clinical applications and in better understanding of brain vascular pathophysiology. In the video, we demonstrate how to set up the system inside an MRI suite and how to perform a complete experiment on a human participant.

Non-invasive imaging of the brain vasculature&#8217;s ability to dilate or constrict may allow a better understanding of cerebrovascular pathophysiology in various neurological diseases. The present report describes a reproducible and patient-comfortable protocol to perform vascular reactivity imaging in humans using magnetic resonance imaging (MRI).

IRM Cartographie des cérébrovasculaire Réactivité via gaz Inhalation défis

The brain is a spatially heterogeneous and temporally dynamic organ, with different regions requiring different amount of blood supply at different time. ...

Surgical Models of Gastroesophageal Reflux with Mice

Multiple surgical procedures have been reported to induce gastroesophageal reflux in animals. Herein, we report three surgical models with mice aiming to induce reflux of gastric contents, duodenal contents or mixed contents. Surgical procedures and general principles have been described in detail. A researcher with surgical experience should be able to grasp the technique after a short period of practice. After surgery, most mice can survive and develop reflux esophagitis similar to that in humans. However, it should be noted that histological differences between mouse and human esophagus are the inherent limitations of these surgical models. If used for research on Barrett&#8217;s esophagus and adenocarcinoma, these procedures may need to be combined with genetic modifications.

This article demonstrates surgical procedures of gastroesophageal reflux with mice. These models are useful tools for research on mechanisms and treatment of gastroesophageal reflux disease and potentially Barrett&#8217;s esophagus and esophageal adenocarcinoma.

Les modèles de chirurgie de reflux gastro-œsophagien avec des souris

Multiple surgical procedures have been reported to induce gastroesophageal reflux in animals. Herein, we report three surgical models with mice aiming to ...

Electrophysiological Assessment of Murine Atria with High-Resolution Optical Mapping

Recent genome-wide association studies targeting atrial fibrillation (AF) have indicated a strong association between the genotype and electrophysiological phenotype in the atria. That encourages us to utilize a genetically-engineered mouse model to elucidate the mechanism of AF. However, it is difficult to evaluate the electrophysiological properties in murine atria due to their small size. This protocol describes the electrophysiological evaluation of atria using an optical mapping system with a high temporal and spatial resolution in Langendorff perfused murine hearts. The optical mapping system is assembled with dual high-speed complementary metal oxide semiconductor cameras and high magnification objective lenses, to detect the fluorescence of a voltage-sensitive dye and Ca2+ indicator. To focus on the assessment of murine atria, optical mapping is performed with an area of 2 mm &#215; 2 mm or 10 mm x 10 mm, with a 100 &#215; 100 resolution (20 &#181;m/pixel or 100 &#181;m/pixel) and sampling rate of up to 10 kHz (0.1 ms) at maximum. A 1-French size quadripolar electrode pacing catheter is placed into the right atrium through the superior vena cava avoiding any mechanical damage to the atrium, and pacing stimulation is delivered through the catheter. An electrophysiological study is performed with programmed stimulation including constant pacing, burst pacing, and up to triple extrastimuli pacing. Under a spontaneous or pacing rhythm, the optical mapping recorded the action potential duration, activation map, conduction velocity, and Ca2+ transient individually in the right and left atria. In addition, the programmed stimulation also determines the inducibility of atrial tachyarrhythmias. Precise activation mapping is performed to identify the propagation of the excitation in the atrium during an induced atrial tachyarrhythmia. Optical mapping with a specialized setting enables a thorough electrophysiological evaluation of the atrium in murine pathological models.

This protocol describes the electrophysiological evaluation of murine atria utilizing an optical mapping system with a high temporal and spatial resolution, including dual recordings of the membrane voltage and Ca2+ transient under programmed stimulation through a specialized electrode catheter.

Évaluation électrophysiologique des oreillettes murins avec cartographie optique à haute résolution

Recent genome-wide association studies targeting atrial fibrillation (AF) have indicated a strong association between the genotype and ...

Quantitative Mapping of Specific Ventilation in the Human Lung using Proton Magnetic Resonance Imaging and Oxygen as a Contrast Agent

Specific ventilation imaging (SVI) is a functional magnetic resonance imaging technique capable of quantifying specific ventilation &#8213; the ratio of the fresh gas entering a lung region divided by the region&#8217;s end-expiratory volume &#8213; in the human lung, using only inhaled oxygen as a contrast agent. Regional quantification of specific ventilation has the potential to help identify areas of pathologic lung function. Oxygen in solution in tissue shortens the tissue&#8217;s longitudinal relaxation time (T1), and thus a change in tissue oxygenation can be detected as a change in T1-weighted signal with an inversion recovery acquired image. Following an abrupt change between two concentrations of inspired oxygen, the rate at which lung tissue within a voxel equilibrates to a new steady-state reflects the rate at which resident gas is being replaced by inhaled gas. This rate is determined by specific ventilation. To elicit this sudden change in oxygenation, subjects alternately breathe 20-breath blocks of air (21% oxygen) and 100% oxygen while in the MRI scanner. A stepwise change in inspired oxygen fraction is achieved through use of a custom three-dimensional (3D)-printed flow bypass system with a manual switch during a short end-expiratory breath hold. To detect the corresponding change in T1, a global inversion pulse followed by a single shot fast spin echo sequence was used to acquire two-dimensional T1-weighted images in a 1.5&#160;T MRI scanner, using an eight-element torso coil. Both single slice and multi-slice imaging are possible, with slightly different imaging parameters. Quantification of specific ventilation is achieved by correlating the time-course of signal intensity for each lung voxel with a library of simulated responses to the air/oxygen stimulus. SVI estimations of specific ventilation heterogeneity have been validated against multiple breath washout and proved to accurately determine the heterogeneity of the specific ventilation distribution.

Specific ventilation imaging is a functional magnetic resonance imaging technique that allows for quantification of regional specific ventilation in the human lung, using inhaled oxygen as a contrast agent. Here, we present a protocol to collect and analyze specific ventilation imaging data.

Cartographie quantitative de la ventilation spécifique dans le poumon humain utilisant l’imagerie par résonance magnétique de proton et l’oxygène comme agent de contraste

Specific ventilation imaging (SVI) is a functional magnetic resonance imaging technique capable of quantifying specific ventilation &#8213; the ratio of ...

High-Throughput Analysis of Optical Mapping Data Using ElectroMap

Optical mapping is an established technique for high spatio-temporal resolution study of cardiac electrophysiology in multi-cellular preparations. Here we present, in a step-by-step guide, the use of ElectroMap for analysis, quantification, and mapping of high-resolution voltage and calcium datasets acquired by optical mapping. ElectroMap analysis options cover a wide variety of key electrophysiological parameters, and the graphical user interface allows straightforward modification of pre-processing and parameter definitions, making ElectroMap applicable to a wide range of experimental models. We show how built-in pacing frequency detection and signal segmentation allows high-throughput analysis of entire experimental recordings, acute responses, and single beat-to-beat variability. Additionally, ElectroMap incorporates automated multi-beat averaging to improve signal quality of noisy datasets, and here we demonstrate how this feature can help elucidate electrophysiological changes that might otherwise go undetected when using single beat analysis. Custom modules are included within the software for detailed investigation of conduction, single file analysis, and alternans, as demonstrated here. This software platform can be used to enable and accelerate the processing, analysis, and mapping of complex cardiac electrophysiology.

This protocol describes the setup and use of ElectroMap, a MATLAB-based open-source software platform for analysis of cardiac optical mapping data. ElectroMap provides a versatile high-throughput tool for analysis of optical mapping voltage and calcium datasets across a wide range of cardiac experimental models.

Analyse à haut débit des données de cartographie optique à l'aide d'ElectroMap

Optical mapping is an established technique for high spatio-temporal resolution study of cardiac electrophysiology in multi-cellular preparations. Here we ...

Sarcomere Shortening of Pluripotent Stem Cell-Derived Cardiomyocytes using Fluorescent-Tagged Sarcomere Proteins.

Pluripotent stem cell-derived cardiomyocytes (PSC-CMs) can be produced from both embryonic and induced pluripotent stem (ES/iPS) cells. These cells provide promising sources for cardiac disease modeling. For cardiomyopathies, sarcomere shortening is one of the standard physiological assessments that are used with adult cardiomyocytes to examine their disease phenotypes. However, the available methods are not appropriate to assess the contractility of PSC-CMs, as these cells have underdeveloped sarcomeres that are invisible under phase-contrast microscopy. To address this issue and to perform sarcomere shortening with PSC-CMs, fluorescent-tagged sarcomere proteins and fluorescent live-imaging were used. Thin Z-lines and an M-line reside at both ends and the center of a sarcomere, respectively. Z-line proteins &#8212;&#160;&#945;-Actinin (ACTN2), Telethonin (TCAP), and actin-associated LIM protein (PDLIM3) &#8212; and one M-line protein &#8212; Myomesin-2 (Myom2) &#8212;&#160;were tagged with fluorescent proteins. These tagged proteins can be expressed from endogenous alleles as knock-ins or from adeno-associated viruses (AAVs). Here, we introduce the methods to differentiate mouse and human pluripotent stem cells to cardiomyocytes, to produce AAVs, and to perform and analyze live-imaging. We also describe the methods for producing polydimethylsiloxane (PDMS) stamps for a patterned culture of PSC-CMs, which facilitates the analysis of sarcomere shortening with fluorescent-tagged proteins. To assess sarcomere shortening, time-lapse images of the beating cells were recorded at a high framerate (50-100 frames per second) under electrical stimulation (0.5-1 Hz). To analyze sarcomere length over the course of cell contraction, the recorded time-lapse images were subjected to SarcOptiM, a plug-in for ImageJ/Fiji. Our strategy provides a simple platform for investigating cardiac disease phenotypes in PSC-CMs.

This method can be used to examine sarcomere shortening using pluripotent stem cell-derived cardiomyocytes with fluorescent-tagged sarcomere proteins.

Raccourcissement de Sarcomere de cardiomyocytes dérivés de cellules souches pluripotentes à l’aide de protéines sarcomères marquées par fluorescence.

Pluripotent stem cell-derived cardiomyocytes (PSC-CMs) can be produced from both embryonic and induced pluripotent stem (ES/iPS) cells. These cells ...