Talk:Collaboration:Shriner - Revision history

Shingo at 17:12, 19 September 2009

2009-09-19T17:12:38Z

Shingo at 07:32, 19 September 2009

2009-09-19T07:32:41Z

Shingo at 07:30, 19 September 2009

2009-09-19T07:30:18Z

Shingo at 07:22, 19 September 2009

2009-09-19T07:22:35Z

Shingo at 07:22, 19 September 2009

2009-09-19T07:22:03Z

Shingo at 07:20, 19 September 2009

2009-09-19T07:20:44Z

Shingo at 07:19, 19 September 2009

2009-09-19T07:19:26Z

Shingo at 00:42, 19 September 2009

2009-09-19T00:42:10Z

Shingo at 23:56, 18 September 2009

2009-09-18T23:56:21Z

Shingo at 23:52, 18 September 2009

2009-09-18T23:52:45Z

← Older revision		Revision as of 17:12, 19 September 2009
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	'''Does our technology compete with the endoscopic microscope?'''		'''Does our technology compete with the endoscopic microscope?'''
		+
		+	It will not compete with endoscopic microscope. In fact, there is still no endoscopic microscope that incorporated the feed-back motion correction system to stabilize the image. Our technology will in fact have a synergestic effect on the improvement of the pre-existing endoscopic microscope, and vice versa.


	'''Is our technology designed more for open chest surgery, or for endovascular catheter-mediated method?'''		'''Is our technology designed more for open chest surgery, or for endovascular catheter-mediated method?'''
		+
		+	At this moment, with the specific grant proposal, it is designed for open-chest surgery for mice, and in the near future, for humans. However, catheter-mediated method should have a great impact on the study of atherosclerosis and vascular biology. Further discussion is going on how we can extraporate our technology into such direction. Hopefully, we might be able to find an appropriate collaborator with a background in such field.

← Older revision		Revision as of 07:32, 19 September 2009
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	'''Can't we just take out the tissue from the patient and study the histology?'''		'''Can't we just take out the tissue from the patient and study the histology?'''

−	This was a wonderful question. Of course, histology is important. Histological diagnosis has many strong points over our in vivo microscopic method. Our method has, however, many strong points, too, that will compensate the technical difficulties of the tissue histology. For example, if one want to analyze the 'function' of microcirculation, instead of the structural information of the microvessels, histology cannot provide too much information. One has to study the RBC flux of a capillary, of an arteriole in order to understand oxygen supply to the local. The velocity and flux can be sometimes discrepant, and can be important in many physiological regulation or the cause of some diseases. The blood flow can vary from one capillary to another, an important discussion basis for studying the distribution of blood flow, or the functional capillary density. Such information can only be attained by in vivo microscopy. For example, in the liver or in the lung, we know from the physiology textbook that these organs can sometimes show a misterious status, so called 'functional AV shunt'. Functional shunt is a shunt where the arterial blood bypasses into the vein without any obvious structural AV anastomosis. Such elusive pathological status can theoretically very well explained by dysregulation of microcirculation. For example, it is known that when there is irregular distribution of functional capillary, oxygen supply to the tissue becomes dramatically so poor even when the MACRO-scopic total blood flow remains the same. This means, functional shunt can very well derive from the dysregulation of microcirculation. This is only one example ~~of the reason~~ why in vivo microscopic diagnostic methods becomes more and more important in the future. Another example is, think about cases where one wants to detect and evaluate the complications of diabetes. Thus far, most common way has been either histological observation from biopsy, or MACRO-scopic methods. With these existing diagnostic tools, one can only detect abnormality when complication becomes so much, starts to affect the vascular structure, or becomes irreversible. By studying the 'function', or responsiveness of the microvessels by in vivo microscopy, it is likely that we can detect the complication at much, much earlier stages.	+	This was a wonderful question. Of course, histology is important. Histological diagnosis has many strong points over our in vivo microscopic method. Our method has, however, many strong points, too, that will compensate the technical difficulties of the tissue histology. For example, if one want to analyze the 'function' of microcirculation, instead of the structural information of the microvessels, histology cannot provide too much information. One has to study the RBC flux of a capillary, of an arteriole in order to understand oxygen supply to the local. The velocity and flux can be sometimes discrepant, and can be important in many physiological regulation or the cause of some diseases. The blood flow can vary from one capillary to another, an important discussion basis for studying the distribution of blood flow, or the functional capillary density. Such information can only be attained by in vivo microscopy. For example, in the liver or in the lung, we know from the physiology textbook that these organs can sometimes show a misterious status, so called 'functional AV shunt'. Functional shunt is a shunt where the arterial blood bypasses into the vein without any obvious structural AV anastomosis. Such elusive pathological status can theoretically very well explained by dysregulation of microcirculation. For example, it is known that when there is irregular distribution of functional capillary, oxygen supply to the tissue becomes dramatically so poor even when the MACRO-scopic total blood flow remains the same. This means, functional shunt can very well derive from the dysregulation of microcirculation. This is only one example among so many other reasons why in vivo microscopic diagnostic methods becomes more and more important in the future. Another example is, think about cases where one wants to detect and evaluate the complications of diabetes. Thus far, most common way has been either histological observation from biopsy, or MACRO-scopic methods. With these existing diagnostic tools, one can only detect abnormality when complication becomes so much, starts to affect the vascular structure, or becomes irreversible. By studying the 'function', or responsiveness of the microvessels by in vivo microscopy, it is likely that we can detect the complication at much, much earlier stages.

← Older revision		Revision as of 07:30, 19 September 2009
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	'''Does our technology compete with the endoscopic microscope?'''		'''Does our technology compete with the endoscopic microscope?'''
		+
		+
		+	'''Is our technology designed more for open chest surgery, or for endovascular catheter-mediated method?'''

@@ Line 27: / Line 27: @@
 (B) Impact in the long-term
-In my idea, this grant proposal is about a completely new technology, and the potential application in the human health is virtually infinite.
+This grant proposal is about a completely new technology, and the potential application in the human health is virtually infinite.
 The impact on the study of pathophysiology in the cardiac diseases with this new technology is enormous.  This space is too small to list up all such diseases or potential experiments.  However, the study of pathophysiology is more about basic science, though it is difficult not to imagine that such finding from basic pathophysiology impacting heavily on clinical science.

← Older revision		Revision as of 07:22, 19 September 2009
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	In the experimental setting, we are already at the stage where we are, on the regular basis, observing calcium waves in detail, measuring practically all the different parameters of microcirculation, movement of the myofibers, detailed morphology, cell death, autophagy, extent of NO production, ROS production, etc, all in the muscles of live mice.		In the experimental setting, we are already at the stage where we are, on the regular basis, observing calcium waves in detail, measuring practically all the different parameters of microcirculation, movement of the myofibers, detailed morphology, cell death, autophagy, extent of NO production, ROS production, etc, all in the muscles of live mice.

−	~~Why not imagine~~ these techniques ~~all combined, might~~ serve to improve those difficult cardiac surgery?	+	It would be beneficial to extrapolate these techniques in the future to serve to improve those difficult cardiac surgery.

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 If one can somehow "see" the focus of arrhythmia, it becomes so much easier to determine which portion to cut out by Maze Operation, based on such information.  If one can visualize which part of the left ventricle has poor contractility, has more fibrosis than other parts, or has poor shedding of blood vessels due to such fibrotic changes, it becomes easier for one to decide the dissection area.
-In the experimental setting, we are already at the stage we are, on the regular basis, observing calcium waves in detail, measuring practically all the different parameters of microcirculation, movement of the myofibers, detailed morphology, cell death, autophagy, extent of NO production, ROS production, etc, all in the muscles of live mice.
+In the experimental setting, we are already at the stage where we are, on the regular basis, observing calcium waves in detail, measuring practically all the different parameters of microcirculation, movement of the myofibers, detailed morphology, cell death, autophagy, extent of NO production, ROS production, etc, all in the muscles of live mice.
 Why not imagine these techniques all combined, might serve to improve those difficult cardiac surgery?

@@ Line 15: / Line 15: @@
 I will list up a few example, out of so many.
-In the field of cardiac surgery, there are two famous operations; Maze Operation for atrial fibrillation, and Batista Operation for dilated myopathy.  Both operations are about dissecting out some unnecessary/harmful portion of the heart either to improve the cardiac output, or to treat arrhythmia.  Both operations are, however, extremely difficult and requires skill, especially when we try to evaluate where to dissect.  Clearly, no one wants to remove too much of the healthy part of the heart.  So, question has always been, how one can distinguish the normal portion and abnormal portion?
+In the field of cardiac surgery, there are two famous operations; Maze Operation for atrial fibrillation, and Batista Operation for dilated myopathy.  Both operations are about dissecting out some unnecessary/harmful portion of the heart either to improve the cardiac output, or to treat arrhythmia.  Both operations are, however, extremely difficult and requires skill, especially when we try to evaluate what part to dissect.  Clearly, no one wants to remove too much of the healthy part of the heart.  So, question has always been, how one can distinguish the normal portion and abnormal portion?
 If one can somehow "see" the focus of arrhythmia, it becomes so much easier to determine which portion to cut out by Maze Operation, based on such information.  If one can visualize which part of the left ventricle has poor contractility, has more fibrosis than other parts, or has poor shedding of blood vessels due to such fibrotic changes, it becomes easier for one to decide the dissection area.

@@ Line 48: / Line 48: @@
 So, this will lead to the equation, the dynamic range of the motion-correction is a function of angle x focus distance.
-We are using long-focal distance, sometimes, like >4cm.  The moving range thus can be as large as >3cm.  It can probably become much larger, if we design such optical light path.
+We are using long-focal distance, sometimes, like >4cm.  The moving range thus can be as large as >2cm.  It can probably become much larger, if we design such optical light path.
 Even under the current setting, this range of motion will be big enough to cover that of human heart beat.
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 We are already aware of such potential problem, and have been discussing this issue intensely.  To overcome this problem, we are already trying to install multiple PMTs (detectors) in order to attain '''multi-focus''' confocal microscope.  This new setting will be capturing multiple slices simultaneously.  Once the image is captured, the computer will reconstitute the image into 3D.  Thus, by using this technique, we will be able to capture obliquely aligned cells or structures in the heart.

← Older revision		Revision as of 23:56, 18 September 2009
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−	(A) More shot-term, direct impact on clinical setting;	+	(A) More shot-term, direct impact in the clinical setting;

	I will list up a few example, out of so many.		I will list up a few example, out of so many.

← Older revision	Revision as of 23:52, 18 September 2009
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	+	(C) About the future NIH Grant proposal:
	+	We should study the cardiac complications in the Duchenne Muscular Dystrophy. We should also study ischemic heart disease. These will be discussed later on.