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Magnetic resonance imaging (MRI), or Nuclear magnetic resonance imaging (NMRI), is primarily a medical imaging technique most commonly used in radiology to visualize the structure and function of the body. It provides detailed images of the body in any plane. MRI provides much greater contrast between the different soft tissues of the body than computed tomography (CT) does, making it especially useful in neurological (brain), musculoskeletal, cardiovascular, and oncological (cancer) imaging. Unlike CT, it uses no ionizing radiation, but uses a powerful magnetic field to align the nuclear magnetization of (usually) hydrogen atoms in water in the body. Radiofrequency fields are used to systematically alter the alignment of this magnetization, causing the hydrogen nuclei to produce a rotating magnetic field detectable by the scanner. This signal can be manipulated by additional magnetic fields to build up enough information to construct an image of the body.
MRI is a relatively new technology, which has been in use for little more than 30 years (compared with over 110 years for X-ray radiography). The first MR Image was published in 1973 and the first study performed on a human took place on July 3, 1977.
Magnetic resonance imaging was developed from knowledge gained in the study of nuclear magnetic resonance. In its early years the technique was referred to as nuclear magnetic resonance imaging (NMRI). However, as the word nuclear was associated in the public mind with ionizing radiation exposure it is generally now referred to simply as MRI. Scientists still use the term NMRI when discussing non-medical devices operating on the same principles. The term Magnetic Resonance Tomography (MRT) is also sometimes used. One of the contributors to modern MRI, Paul Lauterbur, originally named the technique zeugmatography, a Greek term meaning "that which is used for joining". The term referred to the interaction between the static, radiofrequency, and gradient magnetic fields necessary to create an image, but this term was not adopted.
When a person lies in a scanner, the hydrogen nuclei (i.e., protons) found in abundance in the human body in water molecules, align with the strong main magnetic field. A second electromagnetic field, which oscillates at radiofrequencies and is perpendicular to the main field, is then pulsed to push a proportion of the protons out of alignment with the main field. These protons then drift back into alignment with the main field, emitting a detectable radiofrequency signal as they do so.
Since protons in different tissues of the body (e.g., fat vs. muscle) realign at different speeds, the different structures of the body can be revealed.
Contrast agents may be injected intravenously to enhance the appearance of blood vessels, tumors or inflammation. Contrast agents may also be directly injected into a joint, in the case of arthrograms, MR images of joints. Unlike CT scanning MRI uses no Ionizing Radiation and is generally a very safe procedure. Patients with some metal implants and cardiac pacemakers are prevented from having an MRI scan due to effects of the strong magnetic field and powerful radiofrequency pulses.
MRI is used to image every part of the body, but is particularly useful in neurological conditions, disorders of the muscles and joints, for evaluating tumors and showing abnormalities in the heart and blood vessels.
Subatomic particles such as protons have the quantum mechanical property of spin. Certain nuclei such as 1H (protons), 2H, 3He, 23Na or 31P, have a non–zero spin and therefore a magnetic moment. In the case of the so-called spin-1/2 nuclei, such as 1H, there are two spin states, sometimes referred to as "up" and "down". Nuclei such as 12C have no unpaired neutrons or protons, and no net spin: however the isotope 13C (referred to as "carbon 13") does.
When these spins are placed in a strong external magnetic field they precess around an axis along the direction of the field. Protons align in two energy eigenstates (Zeeman effect) one low-energy, and one high-energy, which are separated by a certain splitting energy.
In the static magnetic fields commonly used in MRI, the energy difference between the nuclear spin states corresponds to a photon at radio frequency (rf) wavelengths. Resonant absorption of energy by the protons due to an external oscillating magnetic field will occur at the Larmor frequency for the particular nucleus.
The net magnetization vector has two components. The longitudinal magnetization is due to a tiny excess of protons in the lower energy state. This gives a net polarization parallel to the external field. Application of an rf pulse can destroy (with a so-called 90° pulse) or even reverse (with a so-called 180° pulse) this polarization vector. The transverse magnetization is due to coherences forming between the two proton energy states following an rf pulse typically of 90°. This gives a net polarization perpendicular to the external field in the transverse plane. The recovery of longitudinal magnetization is called longitudinal or relaxation and occurs exponentially with a time constant . The loss of phase coherence in the transverse plane is called transverse or relaxation. is thus associated with the enthalpy of the spin system while is associated with its entropy.
When the radio frequency pulse is turned off, the transverse vector component produces an oscillating magnetic field which induces a small current in the receiver coil. This signal is called the free induction decay (FID). In an idealized nuclear magnetic resonance experiment, the FID decays approximately exponentially with a time constant , but in practical MRI small differences in the static magnetic field at different spatial locations ("inhomogeneities") cause the Larmor frequency to vary across the body creating destructive interference which shortens the FID. The time constant for the observed decay of the FID is called the T2* ("T 2 star") relaxation time, and is always shorter than . Also, when the radio frequency pulse is turned off, the longitudinal magnetization starts to recover exponentially with a time constant
In MRI, the static magnetic field is caused to vary across the body (a field gradient), so that different spatial locations become associated with different precession frequencies. Usually these field gradients are pulsed, and it is the almost infinite variety of rf and gradient pulse sequences that gives MRI its versatility. Application of field gradient destroys the FID signal, but this can be recovered and measured by a refocusing gradient (to create a so-called "gradient echo"), or by a radio frequency pulse (to create a so-called "spin-echo"). The whole process can be repeated when some -relaxation has occurred and the thermal equilibrium of the spins has been more or less restored.
Typically in soft tissues is around 1 second while and T2* are a few tens of milliseconds, but these values vary widely between different tissues (and different external magnetic fields), giving MRI its tremendous soft tissue contrast.
Contrast agents work by altering (shortening) the relaxation parameters, especially .
Slice selection is achieved by applying a magnetic gradient in addition to the external magnetic field during the radio frequency pulse. Only one plane within the object will have protons that are on–resonance and contribute to the signal.
A real image can be considered as being composed of a number of spatial frequencies at different orientations. A two–dimensional Fourier transformation of a real image will express these waves as a matrix of spatial frequencies known as k–space. Low spatial frequencies are represented at the center of k–space and high spatial frequencies at the periphery. Frequency and phase encoding are used to measure the amplitudes of a range of spatial frequencies within the object being imaged.
The frequency encoding gradient is applied during readout of the signal and is orthogonal to the slice selection gradient. During application of the gradient the frequency differences in the readout direction progressively change. At the midpoint of the readout these differences are small and the low spatial frequencies in the image are sampled filling the center of k-space. Higher spatial frequencies will be sampled towards the beginning and end of the readout filling the periphery of k-space.
Phase encoding is applied in the remaining orthogonal plane and uses the same principle of sampling the object for different spatial frequencies. However, it is applied for a brief period before the readout and the strength of the gradient is changed incrementally between each radio frequency pulse. For each phase encoding step a line of k–space is filled.
Either a spin echo or a gradient echo can be used to refocus the magnetisation.
The 3DFT technique is rather similar except that there is no slice selection and phase-encoding is performed two separate directions.
Another scheme which is sometimes used, especially in brain scanning or where images are needed very rapidly, is called echo-planar imaging (EPI): in this case each rf excitation is followed by a whole train of gradient echoes with different spatial encoding.
Image contrast is created by differences in the strength of the NMR signal recovered from different locations within the sample. This depends upon the relative density of excited nuclei (usually water protons), on differences in relaxation times (, and ) of those nuclei after the pulse sequence, and often on other parameters discussed below under "specialized MR scans". Contrast in most MR images is actually a mixture of all these effects, but careful design of the imaging pulse sequence allows one contrast mechanism to be emphasized while the others are minimized. The ability to choose different contrast mechanisms gives MRI tremendous flexibility. In the brain, -weighting causes the nerve connections of white matter to appear white, and the congregations of neurons of gray matter to appear gray, while cerebrospinal fluid (CSF) appears dark. The contrast of white matter, gray matter and cerebrospinal fluid is reversed using or imaging, whereas proton-density-weighted imaging provides little contrast in healthy subjects. Additionally, functional parameters such as cerebral blood flow (CBF), cerebral blood volume (CBV) or blood oxygenation can affect , and and so can be encoded with suitable pulse sequences.
In some situations it is not possible to generate enough image contrast to adequately show the anatomy or pathology of interest by adjusting the imaging parameters alone. In this case a contrast agent may be administered. A contrast agent may be as simple as water, taken orally, for imaging the stomach and small bowel. However, most contrast agents used in MR are selected for their specific magnetic properties. Most commonly, a paramagnetic contrast agent (usually a gadolinium compound) is given. Gadolinium-enhanced tissues and fluids appear extremely bright on T1-weighted images. This provides high sensitivity for detection of vascular tissues (e.g. tumors) and permits assessment of brain perfusion (e.g. in stroke). There have been concerns raised recently regarding the toxicity of gadolinium-based contrast agents and their impact on persons with impaired kidney function. The American College of Radiology released screening criteria for patients intended to be given Gadolinium-based contrast agents to identify potential risk factors for negative reactions. Special actions may be taken, such as hemodialysis following a contrast MRI scan for renally-impaired patients.
More recently, superparamagnetic contrast agents (e.g. iron oxide nanoparticles) have become available. These agents appear very dark on T2*-weighted images and may be used for liver imaging, as normal liver tissue retains the agent, but abnormal areas (e.g. scars, tumors) do not. They can also be taken orally, to improve visualization of the gastrointestinal tract, and to prevent water in the gastrointestinal tract from obscuring other organs (e.g. pancreas). Diamagnetic agents such as barium sulfate have also been studied for potential use in the gastrointestinal tract, but are less frequently used.
In 1983 Ljunggren and Tweig independently introduced the k-space formalism, a technique that proved invaluable in unifying different MR imaging techniques. They showed that the demodulated MR signal generated by freely precessing nuclear spins in the presence of a linear magnetic field gradient equals the Fourier transform of the effective spin density i.e.
In other words, as time progresses the signal traces out a trajectory in k-space with the velocity vector of the trajectory proportional to the vector of the applied magnetic field gradient. By the term effective spin density we mean the true spin density corrected for the effects of preparation, decay, dephasing due to field inhomogeneity, flow, diffusion, etc. and any other phenomena that affect that amount of transverse magnetization available to induce signal in the RF probe.
From the basic k-space formula, it follows immediately that we reconstruct an image simply by taking the inverse Fourier transform of the sampled data viz.
Using the k-space formalism, a number of seemingly complex ideas became simple. For example, it becomes very easy to understand the role of phase encoding (the so-called spin-warp method). In a standard spin echo or gradient echo scan, where the readout (or view) gradient is constant (e.g. ), a single line of k-space is scanned per RF excitation. When the phase encoding gradient is zero, the line scanned is the axis. When a non-zero phase-encoding pulse is added in between the RF excitation and the commencement of the readout gradient, this line moves up or down in k-space i.e. we scan the line =constant.
The k-space formalism also makes it very easy to compare different scanning techniques. In single-shot EPI, all of k-space is scanned in a single shot, following either a sinusoidal or zig-zag trajectory. Since alternating lines of k-space are scanned in opposite directions, this must be taken into account in the reconstruction. Multi-shot EPI and fast spin echo techniques acquire only part of k-space per excitation. In each shot, a different interleaved segment is acquired, and the shots are repeated until k-space is sufficiently well-covered. Since the data at the center of k-space represent lower spatial frequencies than the data at the edges of k-space, the value for the center of k-space determines the image's contrast.
The importance of the center of k-space in determining image contrast can be exploited in more advanced imaging techniques. One such technique is spiral acquisition - a rotating magnetic field gradient is applied, causing the trajectory in k-space to trace out spiral out from the center to the edge. Due to and decay the signal is greatest at the start of the acquisition, hence acquiring the center of k-space first improves contrast to noise ratio (CNR) when compared to conventional zig-zag acquisitions, especially in the presence of rapid movement.
Since and are conjugate variables (with respect to the Fourier transform) we can use the Nyquist theorem to show that the step in k-space determines the field of view of the image (maximum frequency that is correctly sampled) and the maximum value of k sampled determines the resolution i.e..
(these relationships apply to each axis [X, Y, and Z] independently).
In the timing diagram, the horizontal axis represents time. The vertical axis represents: (top row) amplitude of radiofrequency pulses; (middle rows) amplitudes of the three orthogonal magnetic field gradient pulses; and (bottom row) receiver analog-to-digital converter (ADC). Radiofrequencies are transmitted at the Larmor frequency of the nuclide to be imaged: for example for 1H in a magnetic field of 1T, a frequency of 42.5781 MHz would be employed. The three field gradients are labeled GX (typically corresponding to a patient's Left-to-Right direction and colored red in diagram), GY (typically corresponding to a patient's Front-to-Back direction and colored green in diagram), and GZ (typically corresponding to a patient's Head-to-Toe direction and colored blue in diagram). Where negative-going gradient pulses are shown, they represent reversal of the gradient direction, i.e. Right-to-Left, Back-to-Front or Toe-to-Head. For human scanning gradient strengths of 1-100 mT/m are employed: higher gradient strengths permit better resolution and faster imaging. The pulse sequence shown here would produce a transverse (axial) image.
The first part of the pulse sequence, SS, achieves Slice Selection. A shaped pulse (shown here with a sinc modulation) causes a 90° (π/2 radian) nutation of longitudinal nuclear magnetization within a slab, or slice, creating transverse magnetization. The second part of the pulse sequence, PE, imparts a phase shift upon the slice-selected nuclear magnetization, varying with its location in the Y direction. The third part of the pulse sequence, another Slice Selection (of the same slice) uses another shaped pulse to cause a 180° (π radian) rotation of transverse nuclear magnetization within the slice. This transverse magnetisation refocuses to form a spin echo at a time TE. During the spin echo, a frequency-encoding (FE) or readout gradient is applied, making the resonant frequency of the nuclear magnetization vary with its location in the X direction. The signal is sampled nFE times by the ADC during this period, as represented by the vertical lines. Typically nFE of between 128 and 512 samples are taken.
The longitudinal relaxation is then allowed to recover somewhat and after a time TR the whole sequence is repeated nPE times, but with the phase-encoding gradient incremented (indicated by the horizontal hatching in the green gradient block). Typically nPE of between 128 and 512 repetitions are made.
The negative-going lobes in GX and GZ are imposed to ensure that, at time TE (the spin echo maximum), phase only encodes spatial location in the Y direction.
Typically TE is between 5 ms and 100 ms, while TR is between 100 ms and 2000 ms.
After the two-dimensional matrix (typical dimension between 128x128 and 512x512) has been acquired, producing the so-called K-space data, a two-dimensional Fourier transform is performed to provide the familiar MR image. Either the magnitude or phase of the Fourier transform can be taken, the former being far more common.
The three systems described above form the major components of an MRI scanner: a static magnetic field, an RF transmitter and receiver, and three orthogonal, controllable magnetic gradients.
Most superconducting magnets have their coils of superconductive wire immersed in liquid helium, inside a vessel called a cryostat. Despite thermal insulation, ambient heat causes the helium to slowly boil off. Such magnets, therefore, require regular topping-up with liquid helium. Generally a cryocooler, also known as a coldhead, is used to recondense some helium vapor back into the liquid helium bath. Several manufacturers now offer 'cryogenless' scanners, where instead of being immersed in liquid helium the magnet wire is cooled directly by a cryocooler.
Magnets are available in a variety of shapes. However, permanent magnets are most frequently 'C' shaped, and superconducting magnets most frequently cylindrical. However, C-shaped superconducting magnets and box-shaped permanent magnets have also been used.
Magnetic field strength is an important factor in determining image quality. Higher magnetic fields increase signal-to-noise ratio, permitting higher resolution or faster scanning. However, higher field strengths require more costly magnets with higher maintenance costs, and have increased safety concerns. 1.0 - 1.5T field strengths are a good compromise between cost and performance for general medical use. However, for certain specialist uses (e.g., brain imaging), field strengths up to 3.0 T may be desirable.
A recent development in MRI technology has been the development of sophisticated multi-element phased array coils which are capable of acquiring multiple channels of data in parallel. This 'parallel imaging' technique uses unique acquisition schemes that allow for accelerated imaging, by replacing some of the spatial coding originating from the magnetic gradients with the spatial sensitivity of the different coil elements. However, the increased acceleration also reduces the signal-to-noise ratio and can create residual artifacts in the image reconstruction. Two frequently used parallel acquisition and reconstruction schemes are known as SENSE and GRAPPA. A detailed review of parallel imaging techniques can be found here:
Gradient coils are usually resistive electromagnets powered by sophisticated amplifiers which permit rapid and precise adjustments to their field strength and direction. Typical gradient systems are capable of producing gradients from 20 mT/m to 100 mT/m (i.e. in a 1.5 T magnet, when a maximal z-axis gradient is applied the field strength may be 1.45 T at one end of a 1 m long bore, and 1.55 T at the other). It is the magnetic gradients that determine the plane of imaging - because the orthogonal gradients can be combined freely, any plane can be selected for imaging.
Scan speed is dependent on performance of the gradient system. Stronger gradients allow for faster imaging, or for higher resolution; similarly, gradients systems capable of faster switching can also permit faster scanning. However, gradient performance is limited by safety concerns over nerve stimulation.
Some important characteristic of gradient amplifiers and gradient coil are: slew rate and gradient strength. As mentioned earlier, a gradient coil will create an additional, linearly varying magnetic field that adds or subtracts from the main magnetic field. This additional magnetic field will be have components in all 3 directions, viz. X, Y and Z; however, only the component along the magnetic field (usually called the Z-axis, hence denoted ) is useful for imaging. Along any given axis, the gradient will add to the magnetic field on one side of the zero position and subtract from it on the other side. Since the additional field is a gradient, it has units of Gauss per cm or miliTesla (mT) per meter. High performance gradient coils used in MRI are typically capable of producing a gradient magnetic field of approximate 30 mT per meter or higher for a 1.5 T MRI. The slew rate of a gradient system is a measure of how quickly the gradients can be ramped on or off. Typical higher performance gradients have a slew rate of up to 100-200 Tesla per meter per second. The slew rate depends both on the gradient coil (it takes more time to ramp up or down a large coil than a small coil) and the performance of the gradient amplifier (it takes a lot of voltage to overcome the inductance of the coil)and has adequate influence on image quality.
While CT provides good spatial resolution (the ability to distinguish two structures an arbitrarily small distance from each other as separate), MRI provides comparable resolution with far better contrast resolution (the ability to distinguish the differences between two arbitrarily similar but not identical tissues). The basis of this ability is the complex library of pulse sequences that the modern medical MRI scanner includes, each of which is optimized to provide image contrast based on the chemical sensitivity of MRI.
For example, with particular values of the echo time (TE) and the repetition time (TR), which are basic parameters of image acquisition, a sequence will take on the property of T2-weighting. On a T2-weighted scan,water- and fluid-containing tissues are bright (most modern T2 sequences are actually fast T2 sequences) and fat-containing tissues are dark. The reverse is true for T1-weighted images. Damaged tissue tends to develop edema, which makes a T2-weighted sequence sensitive for pathology, and generally able to distinguish pathologic tissue from normal tissue. With the addition of an additional radio frequency pulse and additional manipulation of the magnetic gradients, a T2-weighted sequence can be converted to a FLAIR sequence, in which free water is now dark, but edematous tissues remain bright. This sequence in particular is currently the most sensitive way to evaluate the brain for demyelinating diseases, such as multiple sclerosis.
The typical MRI examination consists of 5-20 sequences, each of which are chosen to provide a particular type of information about the subject tissues. This information is then synthesized by the interpreting physician.
Diffusion MRI measures the diffusion of water molecules in biological tissues. In an isotropic medium (inside a glass of water for example) water molecules naturally move randomly according to Brownian motion. In biological tissues however, the diffusion may be anisotropic. For example a molecule inside the axon of a neuron has a low probability of crossing the myelin membrane. Therefore the molecule will move principally along the axis of the neural fiber. If we know that molecules in a particular voxel diffuse principally in one direction we can make the assumption that the majority of the fibers in this area are going parallel to that direction.
The recent development of diffusion tensor imaging (DTI) enables diffusion to be measured in multiple directions and the fractional anisotropy in each direction to be calculated for each voxel. This enables researchers to make brain maps of fiber directions to examine the connectivity of different regions in the brain (using tractography) or to examine areas of neural degeneration and demyelination in diseases like Multiple Sclerosis.
Another application of diffusion MRI is diffusion-weighted imaging (DWI). Following an ischemic stroke, DWI is highly sensitive to the changes occurring in the lesion. It is speculated that increases in restriction (barriers) to water diffusion, as a result of cytotoxic edema (cellular swelling), is responsible for the increase in signal on a DWI scan. The DWI enhancement appears within 5-10 minutes of the onset of stroke symptoms (as compared with computed tomography, which often does not detect changes of acute infarct for up to 4-6 hours) and remains for up to two weeks. Coupled with imaging of cerebral perfusion, researchers can highlight regions of "perfusion/diffusion mismatch" that may indicate regions capable of salvage by reperfusion therapy.
Like many other specialized applications, this technique is usually coupled with a fast image acquisition sequence, such as echo planar imaging sequence.
In magnetic resonance imaging of molecular solutions, such as protein solutions, two types of water molecules, free (bulk) and hydration, are found. Free water protons have faster average rotational frequency and hence less fixed water molecules that may cause local field inhomogeneity. Because of this uniformity, most free water protons have resonance frequency lying narrowly around the normal proton resonance frequency of 63 MHz (at 1.5 tesla). This also results in slower transverse magnetization dephasing and hence longer T2. Conversely, hydration water molecules are slowed down by interaction with solute molecules and hence create field inhomogeneities that lead to wider resonance frequency spectrum.
Magnetic resonance angiography (MRA) is used to generate pictures of the arteries in order to evaluate them for stenosis (abnormal narrowing) or aneurysms (vessel wall dilatations, at risk of rupture). MRA is often used to evaluate the arteries of the neck and brain, the thoracic and abdominal aorta, the renal arteries, and the legs (called a "run-off"). A variety of techniques can be used to generate the pictures, such as administration of a paramagnetic contrast agent (gadolinium) or using a technique known as "flow-related enhancement" (e.g. 2D and 3D time-of-flight sequences), where most of the signal on an image is due to blood which has recently moved into that plane, see also FLASH MRI. Magnetic resonance venography (MRV) is a similar procedure that is used to image veins. In this method the tissue is now excited inferiorly while signal is gathered in the plane immediately superior to the excitation plane, and thus imaging the venous blood which has recently moved from the excited plane.
Magnetic resonance spectroscopic imaging (MRSI) combines both spectroscopic and imaging methods to produce spatially localized spectra from within the sample or patient. The spatial resolution is much lower (limited by the available SNR), but the spectra in each voxel contains information about many metabolites. Because the available signal is used to encode spatial and spectral information, MRSI requires high SNR achievable only at higher field strengths (1.5T and above).
Functional MRI (fMRI) measures signal changes in the brain that are due to changing neural activity. The brain is scanned at low resolution but at a rapid rate (typically once every 2-3 seconds). Increases in neural activity cause changes in the MR signal via T2* changes; this mechanism is referred to as the BOLD (blood-oxygen-level dependent) effect. Increased neural activity causes an increased demand for oxygen, and the vascular system actually overcompensates for this, increasing the amount of oxygenated hemoglobin relative to deoxygenated hemoglobin. Because deoxygenated hemoglobin attenuates the MR signal, the vascular response leads to a signal increase that is related to the neural activity. The precise nature of the relationship between neural activity and the BOLD signal is a subject of current research. The BOLD effect also allows for the generation of high resolution 3D maps of the venous vasculature within neural tissue.
While BOLD signal is the most common method employed for neuroscience studies in human subjects, the flexible nature of MR imaging provides means to sensitize the signal to other aspects of the blood supply. Alternative techniques employ arterial spin labeling (ASL) or weight the MRI signal by cerebral blood flow (CBF) and cerebral blood volume (CBV). The CBV method requires injection of a class of MRI contrast agents that are now in human clinical trials. Because this method has been shown to be far more sensitive than the BOLD technique in preclinical studies, it may potentially expand the role of fMRI in clinical applications. The CBF method provides more quantitative information than the BOLD signal, albeit at a significant loss of detection sensitivity.
Here is a video compiled of MRI scans showing two arachnoid cysts: http://www.youtube.com/watch?v=PF_mDsdxSsg
A specialized growing subset of interventional MRI is that of intraoperative MRI in which the MRI is used in the surgical process. Some specialized MRI systems have been developed that allow imaging concurrent with the surgical procedure. More typical, however, is that the surgical procedure is temporarily interrupted so that MR images can be acquired to verify the success of the procedure or guide subsequent surgical work.
Multinuclear imaging is primarily a research technique at present. However, potential applications include functional imaging and imaging of organs poorly seen on 1H MRI (e.g. lungs and bones) or as alternative contrast agents. Inhaled hyperpolarized ³He can be used to image the distribution of air spaces within the lungs. Injectable solutions containing 13C or stabilized bubbles of hyperpolarized 129Xe have been studied as contrast agents for angiography and perfusion imaging. 31P can potentially provide information on bone density and structure, as well as functional imaging of the brain.
Susceptibility weighted imaging (SWI), is a new type of contrast in MRI different from spin density, T1, or T2 imaging. This method exploits the susceptibility differences between tissues and uses a fully velocity compensated, three dimensional, rf spoiled, high-resolution, 3D gradient echo scan. This special data acquisition and image processing produces an enhanced contrast magnitude image very sensitive to venous blood, hemorrhage and iron storage. It is used to enhance the detection and diagnosis of tumors, vascular and neurovascular diseases (stroke and hemorrhage, multiple sclerosis, Alzheimer's), and also detects traumatic brain injuries that may not be diagnosed using other methods.
MRI is a new and active field of research and new methods and variants are often published when they are able to get better results in specific fields. Examples of these recent improvements are T2-weighted turbo spin-echo (T2 TSE MRI), Double inversion recovery MRI (DIR-MRI) or Phase-sensitive inversion recovery MRI (PSIR-MRI), all of them able to improve imaging of the brain lesions.
Research with atomic magnetometers have discussed the possibility for cheap and portable MRI instruments without the large magnet.
CT may be enhanced by use of contrast agents containing elements of a higher atomic number than the surrounding flesh such as iodine or barium. Contrast agents for MRI are those which have paramagnetic properties, e.g. gadolinium and manganese.
Both CT and MRI scanners can generate multiple two-dimensional cross-sections (slices) of tissue and three-dimensional reconstructions. Unlike CT, which uses only X-ray attenuation to generate image contrast, MRI has a long list of properties that may be used to generate image contrast. By variation of scanning parameters, tissue contrast can be altered and enhanced in various ways to detect different features. (See Applications above.)
MRI can generate cross-sectional images in any plane (including oblique planes). In the past, CT was limited to acquiring images in the axial (or near axial) plane. The scans used to be called Computed Axial Tomography scans (CAT scans). However, the development of multi-detector CT scanners with near-isotropic resolution, allows the CT scanner to produce data that can be retrospectively reconstructed in any plane with minimal loss of image quality.
For purposes of tumor detection and identification in the brain, MRI is generally superior. However, in the case of solid tumors of the abdomen and chest, CT is often preferred due to less motion artifact. Furthermore, CT usually is more widely available, faster, much less expensive, and may be less likely to require the person to be sedated or anesthetized.
MRI is also best suited for cases when a patient is to undergo the exam several times successively in the short term, because, unlike CT, it does not expose the patient to the hazards of ionizing radiation.
For over a dozen years, MRI scanners have been significant sources of revenue for healthcare providers in the US. This is because of favorable reimbursement rates from insurers, both private and federal government programs. Insurance reimbursement has historically been provided in two components, technical for the actual performance of the MRI scan and professional for the radiologist's review of the images and/or data.
In the US, the 2007 Deficit Reduction Act (DRA) significantly reduced reimbursement rates paid by federal insurance programs for the technical component of many scans, shifting the economic landscape. Many private insurers have followed suit.
Though pacemakers receive significant attention(sometimes), it should also be noted that many other forms of medical or biostimulation implants may be contraindicated for MRI scans. These may include vagus nerve stimulators, implantable cardioverter-defibrillators, loop recorders, insulin pumps, cochlear implants, deep brain stimulators, and many others. Medical device patients should always present complete information (manufacturer, model, serial number and date of implantation) about all implants to both the referring physician and to the radiologist or technologist before entering the room for the MRI scan.
While these implants pose a current problem, scientists and manufacturers are working on improved designs which will further minimize the risks that MRI scans pose to medical device operations. One such development in the works is a nano-coating for implants intended to screen them from the radio frequency waves, helping to make MRI exams available to patients currently prohibited from receiving them. The current article for this is from New Scientist.
Ferromagnetic foreign bodies (e.g. shell fragments), or metallic implants (e.g. surgical prostheses, aneurysm clips) are also potential risks, and safety aspects need to be considered on an individual basis. Interaction of the magnetic and radio frequency fields with such objects can lead to: trauma due to movement of the object in the magnetic field, thermal injury from radio-frequency induction heating of the object, or failure of an implanted device. These issues are especially problematic when dealing with the eye. Most MRI centers require an orbital x-ray to be performed on anyone suspected of having metal fragments in their eyes, something not uncommon in metalworking.
Because of its non-ferromagnetic nature and poor electrical conductivity, titanium and its alloys are useful for long term implants and surgical instruments intended for use in image-guided surgery. In particular, not only is titanium safe from movement from the magnetic field, but artifacts around the implant are less frequent and less severe than with more ferromagnetic materials e.g. stainless steel. Artifacts from metal frequently appear as regions of empty space around the implant - frequently called 'black-hole artifact' e.g. a 3mm titanium alloy coronary stent may appear as a 5mm diameter region of empty space on MRI, whereas around a stainless steel stent, the artifact may extend for 10-20 mm or more.
In 2006, a new classification system for implants and ancillary clinical devices has been developed by ASTM International and is now the standard supported by the US Food and Drug Administration:
In the case of pacemakers, the risk is thought to be primarily RF induction in the pacing electrodes/wires causing inappropriate pacing of the heart, rather than the magnetic field affecting the pacemaker itself. Much research and development is being undertaken, and many tools are being developed in order to predict the effects of the RF fields inside the body.
Patients that have been prescribed MRI exams who are concerned about safety may be interested in the 10 Questions To Ask Your MRI Provider
MRI providers who wish to measure the degree to which they have effectively addressed the safety issues for patients and staff may be interested in the MRI Suite Safety Calculator provided through a radiology website.
In order to help reduce the risks of projectile accidents, ferrous objects and devices are typically prohibited in proximity to the MRI scanner, with non-ferromagnetic versions of many tools and devices typically retained by the scanning facility. Patients undergoing MRI examinations are required to remove all metallic objects, often by changing into a gown or scrubs.
New ferromagnetic-only detection devices are proving highly effective in supplementing conventional screening techniques in many leading hospitals and imaging centers and are now recommended by the American College of Radiology's Guidance Document for Safe MR Practices: 2007 and the Joint Commission's Sentinel Event Alert #38
The magnetic field and the associated risk of missile-effect accidents remains a permanent hazard — as superconductive MRI magnets retain their magnetic field, even in the event of a power outage.
Appropriate use of ear protection is essential for anyone inside the MRI scanner room during the examination.
An emergency shut-down of a superconducting electromagnet, an operation known as "quenching", involves the rapid boiling of liquid helium from the device. If the rapidly expanding helium cannot be dissipated through an external vent, sometimes referred to as 'quench pipe', it may be released into the scanner room where it may cause displacement of the oxygen and present a risk of asphyxiation.
Liquid helium, the most commonly used cryogen in MRI, undergoes near explosive expansion as it changes from liquid to a gaseous state. Rooms built in support of superconducting MRI equipment should be equipped with pressure relief mechanisms and an exhaust fan, in addition to the required quench pipe.
Since a quench results in rapid loss of all cryogens in the magnet, recommissioning the magnet is extremely expensive and time-consuming. Spontaneous quenches are uncommon, but may also be triggered by equipment malfunction, improper cryogen fill technique, contaminates inside the cryostat, or extreme magnetic or vibrational disturbances.
Although gadolinium agents have proved useful for patients with renal impairment, in patients with severe renal failure requiring dialysis there is a risk of a rare but serious illness, nephrogenic systemic fibrosis, that may be linked to the use of certain gadolinium-containing agents: the most frequently linked is gadodiamide, but other agents have been linked too. Although a causal link has not been definitively established, current guidelines in the United States are that dialysis patients should only receive gadolinium agents where essential, and that dialysis should be performed as soon as possible after the scan is complete, in order to remove the agent from the body promptly. In Europe where more gadolinium-containing agents are available, a classification of agents according to potential risks has been released.
Despite these concerns, MRI is rapidly growing in importance as a way of diagnosing and monitoring congenital defects of the fetus because it can provide more diagnostic information than ultrasound and it lacks the ionizing radiation of CT. MRI without contrast agents is the imaging mode of choice for pre-surgical, in-utero diagnosis and evaluation of fetal tumors, primarily teratomas, facilitating open fetal surgery, other fetal interventions, and planning for procedures (such as the EXIT procedure) to safely deliver and treat babies whose defects would otherwise be fatal.
Nervous patients may still find the following strategies helpful:
Alternative scanner designs, such as open or upright systems, can also be helpful where these are available. Though open scanners have increased in popularity, they produce inferior scan quality because they operate at lower magnetic fields than closed scanners. However, commercial 1 Tesla open systems have recently become available, providing much better image quality than previous lower field strength open models.
For babies and young children chemical sedation or general anesthesia are the norm, as these subjects cannot be instructed to hold still during the scanning session. Obese patients and pregnant women may find the MRI machine to be a tight fit. Pregnant women may also have difficulty lying on their backs for an hour or more without moving.
Acoustic noise associated with the operation of an MRI scanner can also exacerbate the discomfort associated with the procedure.
The directive applies to occupational exposure to electromagnetic fields (not medical exposure) and was intended to limit workers' acute exposure to strong electromagnetic fields, as may be found near electricity substations, radio or television transmitters or industrial equipment. However, the regulations impact significantly on MRI, with separate sections of the regulations limiting exposure to static magnetic fields, changing magnetic fields and radio frequency energy. Field strength limits are given which may not be exceeded for any period of time. An employer may commit a criminal offense by allowing a worker to exceed an exposure limit if that is how the Directive is implemented in a particular Member State.
The Directive is based on the international consensus of established effects of exposure to electromagnetic fields, and in particular the advice of the European Commissions's advisor, the International Commission on Non-Ionizing Radiation Protection (ICNIRP). The aims of the Directive, and the ICNIRP guidelines upon which it is based, are to prevent exposure to potentially harmful fields. The actual limits in the Directive are very similar to the limits advised by the Institute of Electrical and Electronics Engineers, with the exception of the frequencies produced by the gradient coils, where the IEEE limits are significantly higher.
Many Member States of the EU already have either specific EMF regulations or (as in the UK) a general requirement under workplace health and safety legislation to protect workers against electromagnetic fields. In almost all cases the existing regulations are aligned with the ICNIRP limits so that the Directive should, in theory, have little impact on any employer already meeting their legal responsibilities.
The introduction of the Directive has brought to light an existing potential issue with occupational exposures to MRI fields. There are at present very few data on the number or types of MRI practice that might lead to exposures in excess of the levels of the Directive. There is a justifiable concern amongst MRI practitioners that if the Directive were to be enforced more vigorously than existing legislation, the use of MRI might be restricted, or working practices of MRI personnel might have to change.
In the initial draft a limit of static field strength to 2 T was given. This has since been removed from the regulations, and whilst it is unlikely to be restored as it was without a strong justification, some restriction on static fields may be reintroduced after the matter has been considered more fully by ICNIRP. The effect of such a limit might be to restrict the installation, operation and maintenance of MRI scanners with magnets of 2 T and stronger. As the increase in field strength has been instrumental in developing higher resolution and higher performance scanners, this would be a significant step back. This is why it is unlikely to happen without strong justification.
Individual government agencies and the European Commission have now formed a working group to examine the implications on MRI and to try to address the issue of occupational exposures to electromagnetic fields from MRI.
The award was vigorously protested by Raymond Vahan Damadian, who claimed that he was the inventor of MRI, and that Lauterbur and Mansfield had merely refined the technology. An ad hoc group, called "The Friends of Raymond Damadian", took out full-page advertisements in the New York Times and The Washington Post entitled "The Shameful Wrong That Must Be Righted", demanding that he be awarded at least a share of the Nobel Prize . Also, in a letter to Physics Today, Herman Carr pointed out his own early use of field gradients for one-dimensional MR imaging.


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- Mona , drinking Peet's since 2002 11/19/14
- Los Angeles , CA
Amazing tea. The taste and aroma is magical.
- Jehu Bako , drinking Peet's since 2006 12/27/12
- Avalon, CA
Extracting this Formosa's delicate flavor cannot be achieved by merely following instructions. However, the solution is simple and the result is extraordinary! Applying freshly boiled water seemed to prevent a hidden "honey-peach" flavor from being unmasked behind the apricot flavor. As most Oolongs, this one must have a 2 minute wait to obtain 180-195 degrees to properly steep. Any higher would make this tea steep as a Pu-erh. Containing similar attributes and flavor to Bai Hoa Oolong, this tea must also be carefully infused. If infused for 3-4 minutes, it can reveal an explosion of smooth honey and sweet peach flavor while releasing a spicy floral fragrance!
- Jane Figueiredo , drinking Peet's since 2007 3/21/09
- Charlevoix, MI
I just did a taste test of the 3 teas- Golden Dragon Oolong, Phoenix Mountain Oolong and Amber Oolong - The rare Golden Dragon Oolong won hands down! It is well worth the extra cost. The downy tips and whole leaves unfurling beautifully make for a superior looking tea, and from the aroma alone, I could tell it is a really exceptional tea. The Phoenix Mountain Oolong is also good in aroma and taste. The Amber oolong- not so much. Thanks for making available a really superior tea!
- Alana 7/31/07
- Valencia, CA
Living in the heat of Southern California, I've come to appreciate a refreshing glass of iced tea. While a bit pricey for that use, GDO has fast become my favorite splurge. This is the only Oolong I've encountered without the characteristic bitter bite at the end, making it ideal for serving over ice. No sugar needed.
- Jim S. 9/28/01
- Marlboro, MA
The GDO blend is a very nice brew. Deep red, and very sweet. It appeals to my sweet tooth, and there is no bitterness. It has a fruity-floral aroma which adds to its appeal. So far, it is my favorite Peet's tea blend.
- Jessica Moore , drinking Peet's since 2007 12/5/10
- Shift Lead/C&T Specialist
- Treat & Oak Grove #177
- Treat & Oak Grove #177
This tea is such a treat for any day, hot or cold. As an oolong should, Gold Dragon has the best flavors of a Green and Black tea. Bright with peach undertones, a sweet malty flavor, all nicely steeped to a smooth and clean finish. Over ice the peach and fruit flavors stand out as if it were a green tea. My favorite oolong offered by Peet's.
- josh k 6/30/08
- 141
Useing the gongfu steeping method, ive been making customers an iced "green" and a hot "black" tea. This is one of the best qualities about Golden dragon. just the fact that they are getting two cups from one serving really gives it an advantage to get people interested in tea in a more pationate light and it makes it an easy sale. my customers are getting more into the story of tea and its origins and are now expanding there pallet in oolong teas, and single origin teas rather than the more typical teas like english breakfast or earl greys.
- Kate Robinson 9/10/06
- Coffee and Tea Specialist
- Brookline, Brookline,MA,
- Brookline, MA
I have really enjoyed my experience with Peet's Oolongs in general- but this Formosa offering has been especially intriguing. The very nature of this tea screams "hybrid". It boasts both the peach and the apricot aroma ; the wet and the oat texture- yet manages to remain a touch grassy at the finish. The leaves themselves are spectacular- but I usually rush to the cup.
- Ross Blum 7/17/05
- Retail sales/barista
- Berkeley, CA
- Berkeley, CA
What strikes me most emphatically is the rounded texture of this tea. The soft tannins are enveloped with the myriad expressions of citrus and flower on the palate while the aroma teases the senses, reminiscent of a fine Darjeeling. Since oolong teas hold a prominent place in tea ceremony as well as competitions among top tier producers, their pedigree is evident even at the uninfused stage midway between the ground in the country of origin and the brewed cup held in your hands. The leaves provide visual pleasures for those fortunate enough to have the opportunity to rest their eyes on the skillfully manipulated offerings form this Taiwanese camellia sinensis.
- Alberto Garcia 6/30/05
- Barista
- Pasadena/South Lake
- Pasadena/South Lake, CA
Golden Dragon Oolong is delightful. This tea is full of flavor, it is neither smoky nor grassy and as Goldie Locks would say,
- Suzin McLaughlin 6/23/99
- District Manager
- San Francisco, CA, USA
- San Francisco, CA
Golden Dragon Oolong tea is a fairly full bodied tea that tastes like you are drinking a cup of honey, but not quite as sweet. The thing I like most about it is, no matter how long you steep it, it still tastes good.

subset: commoncrawl


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Victorian Elegance® Barbie® Doll
Release Date: 1/1/1994
Product Code: 12579
Barbie® doll is an elegant beauty in this lavish maroon and brown faux fur skating costume. Her long skirt and matching bonnet create a warm vision for cold winter days. Victorian Elegance® Barbie® was originally inspired by an antique greeting card, and comes with two miniature greeting cards of her own.
Production doll may vary from the photo shown above. Mattel reserves the right to modify the fashion/fabrics, sculpt, hair color/style, and accessories. Doll cannot stand alone as shown.
Collector Photos
No one has uploaded any photos.


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How did three Danes end up being tortured in Lebanon?
Afghan women: the fight for survival
01 Jan 2008 06:11 GMT
Source: Agencies
PM set for clash with opposition over support for US-led mission in Afghanistan.
Committee votes to restart refuelling missions for US-led forces in Afghanistan.
The majority of Greeks refused the conditions of a new bailout package from the EU, but are unsure what to expect next.
Politics, Europe, Greece
London's tough response to 7/7 bombings thwarts attacks, but may not prevent radicalisation.
War & Conflict, Europe, United Kingdom
In Dallas, the Huey P Newton Gun Club organises 'manoeuvres' to show communities of colour they can police themselves.
Human Rights, US
A deep-seated cultural preference for boys is skewing India's sex ratio and making slaves of women.
Human Rights, Asia, India
In war-torn Afghanistan it is not the Taliban that poses the greatest threat to women - it is their own families.
Human Rights, Women, Afghanistan
From Democracy to the Market - we examine the devastating impact of the Greek financial crisis on ordinary citizens.
Business & Economy, Europe, Greece
Can Afghan archaeologists take on the Chinese and the Taliban to save a 5,000-year-old archaeological site?
Arts & Culture, Asia, Afghanistan
South Africa's miner strike led to the country's deadliest act of police violence since the end of apartheid.
South Africa, Politics, Protests


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To find a doctor, call 800-667-5356 or click below:
Find a Doctor
Request an Appointment
En Español (Spanish Version)
| Causes
| Risk Factors
| Symptoms
| Diagnosis
| Treatment
| Prevention
Immune thrombocytopenia purpura (ITP) is a bleeding disorder. It is a reduction in the number of platelets in your blood. Platelets are small cells in your blood that stick together to form blood clots. These clots help stop bleeding at injury sites. Low platelet levels with ITP makes it easier to develop bruises or bleed even with minor injuries.
There are two types of ITP:
ITP is caused by a problem with the immune system. The immune system places a tag on platelet cells. This tag mistakenly identifies platelets as foreign material. Organs like the spleen and liver will then remove the tagged platelets as they pass through in the blood. Gradually, this process will reduce the number of platelet in your blood. Eventually, the decreased levels of platelets will be severe enough to interfere with the blood's ability to clot.
Copyright © Nucleus Medical Media, Inc.
For most ITP, it is not clear what causes the problem with immune system. In children, ITP is often associated with a recent infection with a virus. ITP in adults has not been linked to viruses.
Some cases of ITP are thought to be caused by drugs or other immune disorders.
Factors that may increase your chances of developing ITP include:
Both adults and children may notice the following symptoms:
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Blood tests will be done. The doctor may use these test to:
Platelets are created in your bone marrow. If your platelets are low, then your doctor may sample your blood marrow. This is done to eliminate conditions that may be interfering with the production of platelet cells.
Treatment for ITP is different for children and adults. ITP is short term in most children. Most children will recover without any treatment. Adults are more likely to develop a chronic form of ITP. Not all of these chronic ITPs will require treatment. Talk with your doctor about the best plan for you.
Some treatment options include:
Medication may help to either slow the destruction of platelet cells or increase production of platelets. The overall goal is to maintain a healthy level of platelets in the blood.
To increase platelet counts in the blood, your doctor may recommend:
Both of these treatments work, but both can have side effects.
Two drugs are being used to stimulate platelet production:
Use of these and a medication called
may prevent the need for surgery.
platelet transfusion may be used to prevent the platelet count from dropping too low.
may be done if medication is not effective.
A splenectomy is the removal of the spleen. The spleen is the main site of platelet destruction. Without your spleen, your platelet levels should begin to improve. However, the missing spleen also makes you more likely to get certain infections. This surgery is usually not done until all medication options have been tried.
You may be asked to avoid certain activities when your platelet counts are low. This may include avoiding contact sports or wearing a helmet.
Since the cause of ITP is unknown, there are no specific ways of preventing it. However, bleeding and injury can be serious for people with ITP. To decrease the chance of bleeding injuries:
Last reviewed July 2013 by Michael Woods, MD
All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Editorial Policy | Privacy Policy | Terms and Conditions | SupportCopyright © 2008 EBSCO Publishing All rights reserved.
© 2015 Beth Israel Deaconess Medical Center
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Only hotels in Lyndhurst are listed below. Search for cheap and discounted hotel and motel rates in or near Lyndhurst, NJ for your upcoming personal or group travel. We provide the best Lyndhurst New Jersey hotel rooms. Review the Lyndhurst hotel list below to find the perfect lodging. We also have a map of the Lyndhurst hotels. Group booking? Search Lyndhurst Group Hotel DiscountsThe Lyndhurst center point is around 1 mile from Izod Center - NJ Nets - NJ Devils and 2 miles from Giants Stadium - New York Giants - New York Jets.
Lyndhurst Hotels, Motels & Accommodations
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Below are reviews of the city of Lyndhurst, NJ from an actual visitor's perspective.
|Jennifer D., from
|Date of Review:
|Score of City:
4.0 / 5
"Small and Busy"
Small, busy neighborhood.


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MDWFP Commission Meeting
Wednesday September 17, 2014 2:30 p.m.Location: Commission Conference Room, 1505 Eastover Drive, Jackson, MS 39211
County: Hinds
For more information please contact Sharon Polzin at 601.432.2009.
Meetings are usually held monthly by the Commission. The date and meeting place are tentative and subject to change, please check back closer to time for confirmation. The meeting is open to the general public and all interested persons are invited to attend.
Any person who would like to comment to the Commission about a specific agenda item must make a written request to the Executive Director at least two weeks prior to the meeting. Speakers will be limited to three to five minutes each and number of speakers may be limited. Only agenda items are considered for Commission action.


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WeatherBug Mobile Web
Kanarraville, UT 84742
WeatherBug Mobile
WeatherBug for Mobile Smartphones m.weatherbug.com
Now, mobile users can take the power of the WeatherBug weather network wherever they go - FREE!* Smartphone users simply need to enter "m.weatherbug.com" into their mobile browser in order to get easy access to live, local current weather conditions, extended forecast, severe weather alerts, interactive radar and maps… and much more!
Enter your city or ZIP code and instantly get access to detailed weather information for your location and thousands of cities around the world.
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- Access to the WeatherBug Network — the source for truly live, local weather with the largest network of professional weather stations in the U.S. and thousands of locations around the world.
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- Detailed radar and maps, including: Doppler Radar, Infrared Satellite, Lightning, Current Temperature, Today's High Temperature, Tonight's Low Temperature, Tomorrow's High Temperature
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Unsettled weather will trigger Mother Nature`s fireworks across the Plains and Southeast today, with damaging winds and…More >
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Authorities in Puerto Rico say a worsening drought has killed thousands of fish in one reservoir as a result of dwindling…More >
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You too can help save our planet and put money back in your wallet. Learn how you can take the first steps to reduce your environmental impact, including driving green, easy ways you can conserve water, and energy saving tips. To learn more and discover the benefits of going green, visit WeatherBug's green living section. More >
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The Hamburg region stands out from the crowd due to its strengths in energy + the environment, transport + logistics and technology + innovation. It plays a key role in the area of renewable energies, which are a focus of industry, the research community and politics in equal measure. The Port of Hamburg is one of the major gateways to Europe, e.g. for China, and therefore one of the major reasons that logistics companies settle here and profit from the infrastructure.
The Hamburg region plays a central role in German energy policy. The free Hanseatic city is the headquarters for many industrial corporations and simultaneously an important centre for service companies. Virtually all the important energy suppliers and service providers have facilities here including manufacturers of wind energy plants such as REpower Systems, Nordex, Siemens, General Electric, AREVA Wind or Vestas. In addition, the city is a central planning location for solar parks throughout Germany and the world. With companies such as Conergy Deutschland, BP Solar, Voltwerk and Velux, the necessary technological expertise is always close at hand. The region's agricultural tradition in cultivating rapeseed, agricultural grass and maize provides an outstanding foundation for the biomass and biogas industries. More than 240 larger and smaller biogas plants are in operation, e.g. the biomass power station run by NovusEnergy generating 60 million KW per year.
Information technology, telecommunications and media and communications are the key areas in the technology + innovation sector. IT and telecommunications are excellently positioned with more than 9,000 companies providing everything from hardware and software development to manufacturing of devices and components to data processing services and games.
Media and multimedia companies are also an important engine of growth in the city. The weekly publications "DER SPIEGEL" and "DIE ZEIT", two of the most respected German titles on the country's news stands, are both produced in Hamburg. Moreover, Hamburg's publishers print well-known magazines such as "Stern", "GEO", "Brigitte", "Für Sie" and "PRINZ". As well as traditional publishing houses and broadcasters, the Hanseatic city has developed a new focus on the area of entertainment software. 180 companies operate here in the gaming sector alone. The region has also seized upon the latest developments in the area of digital film and is promoting trends and market processes in the areas of IPTV, web TV, video-on-demand and mobile phone TV as part of the "New TV" cluster.
In the transport + logistics sector, and particularly in logistics and aviation, Hamburg takes on a leading role as the most important port for trade with the Far East and China's gateway to Europe. Seven major shipping lines from China, Japan, Korea and Taiwan have chosen Hamburg. In addition, Hamburg has the largest railway junction in Northern Europe, the world's largest and Europe's most modern marshalling yard and the most technologically advanced container terminal on the planet. Yet Hamburg not only offers the highest skill levels in land and sea logistics, it is also a specialist in every facet of aircraft construction, maintenance and airport management. As well as three major companies in Airbus, Lufthansa Technik and Flughafen Hamburg, over 300 small and medium-sized companies as well as a variety of technological and scientific institutions contribute to the location's outstanding know-how. The aviation industry employs more than 39,000 highly qualified staff and makes Hamburg one of the world's most important sites for the civil aviation industry.
Contacts for further information:
Hamburg Office for Economic Development
Metropolitan Region of Hamburg
Hamburg Convention Bureau GmbH


text:
Product Details
KILIS Chrome wheels by Giovanna®. Giovanna wheels are made to complement the design of the most beautiful cars on the global market. They are one-piece cast aluminum wheels made to the highest possible standard. These are super wheels for super cars, made to satisfy the most discerning car customers in the world. Giovanna Wheels are leading the market in style and quality and will give your car a completely new look.
The Giovanna Wheels are one-piece cast aluminum wheels manufactured to the highest standard, matching the standard of manufacturing used in building the best cars in the world. They are designed to be the jewelry that draw attention to the most perfect of automobile bodies, to turn the elegant into the exotic and exciting, to make the exclusive car an individual vehicle that reflects the personal preferences of the owner. The advanced customizing system offered for the Giovanna Rims gives the customer a wide choice of finishes for the eight different components and/or faces of the wheel. This allows for an almost endless number of color schemes, giving full freedom for customer creativity. No other wheel company can match the styling possibilities offered by Giovanna Wheels.
Casting, machining and finishing quality wheels is an art that only a select few can master. Especially when it comes to the kind of advanced design elements used for the Giovanna wheels. Giovanna uses a range of different casting, machining and finishing technologies to give their wheels the exclusive look that is the hallmark of the brand. New casting technology has made it possible to cast wheels with thinner profiles without any reduction in strength. Giovanna is using this technology to refine the design of high-end cast wheels, making them both lighter and more elegant.
446.25 589.05
- One Piece Cast Aluminum Wheels
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- Available In Custom Color Combinations
- All Wheels Are Custom Made For Each Customer And Are Therefore Non-Cancelable And Non-Returnable
- Wheel and or Wheel & Tire orders are special ordered and cannot be cancelled or returned
Regardless of what styles or sizes you're interested in, the one thing you can depend on to come with every wheels or wheels and tires order is the best buying experience in the business. From fitment help from our in-house wheel experts to shipping packages certified by UPS, we'll take care of you and your order every step of the way. We know how much of a financial investment you're making in a set of wheels or wheels and tires, and in return we'll deliver service and product that is second to none.CARiD ADVANTAGE
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We take pride in our fitment information and don't take our fitment guarantee lightly. You can depend on the fitment advice from our professionals because they have decades of knowledge and experience to draw from. Research the brands of equipment we use and the wheel accessories we offer and you'll find they're the finest in the industry, because we want you to have the best. The combination of products and services we provide cannot be matched, especially by a local tire store.
The first line of wheels from WTW, the Giovanna™, was introduced in 1997 and was received with enthusiasm by the select group of automobile lovers who buy the best and most expensive cars. Now they could make their exclusive cars even more exclusive and personalize them to their own taste. The success of the Giovanna inspired WTW to introduce the Gianelle™ two years later, to be followed by the GFG™ brand, featuring forged modular high performance wheels, and the Koko Kuture™ brand introducing novel design concepts, each equally well received by the market. The four innovative lines of high performance wheels designed specifically for the very best of luxury and exotic cars have made WTW Corporation to the leading design brand for high-end aftermarket wheels.
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You will never pay more with CARiD! Not only will we match prices from any competitor's website or other reputable source, we will continue to honor that promise for up to one year after your purchase.
We'll match the price at time of purchase, or refund you the difference if done after the purchase. Either way, we are totally committed to providing you the best online shopping experience.
We're car and truck enthusiasts, just like you! And it's enthusiasts we hire in our Sales and Service Centers. Many of our staff are ASE certified and have spent years in the retail auto business.
We conduct our own in-house training, and we even bring vendors to us for hands-on product training demonstrations. You're getting true expertise when you phone or email us!
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Our huge database is regularly cross-checked to keep it current and optimized. At times, our thoroughness makes our data even more accurate than our suppliers! This rigorous process means that you can always order with confidence.
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- Save money on installation since we install TPMS sensors at no charge
- Save money on shipping since shipping wheels and tires separately costs substantially more
- Save money on assembly since we mount and balance at no charge


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There will be a Starkville High School football reunion among coaches tonight in Quitman.
When Quitman hosts Laurel for the Class 4A South State Championship, it will be a chance for Quitman assistant coaches Jim Abraham and Will Staggers to renew acquaintances with Laurel head coach Milton Smith.
Smith was a quarterback and kicker with the Yellowjackets from 1983-85, while Abraham was a quarterback at SHS in 1994-95 and Staggers was a signal caller with the Jackets from 2003-06.
Reaching the South State was pretty much expected for Laurel, but that was not the case for Quitman.
"We weren't anticipating this kind of year," Staggers said. "We felt good about our region and how we'd stack up. At the end of July, if you told us we'd be a couple of rounds deep into the playoffs, I would have been surprised.
"Being in the South State, we are beyond thrilled to be here. These kids have gone at it since August and this is like week 18 in football. Everybody is beat up and battered, but you give a lot of credit to the kids we've got around here. They won't give up and haven't taken a rep off in the drills."
Staggers coaches the linebackers for Quitman, while Abraham works with the wide receivers and is the head baseball coach. Staggers will help Abraham with baseball in the spring and have a good relationship.
"We both played quarterback at Starkville High," Staggers said. "We joke about it all of the time because we had a lot of the same role. When he was there, he was on a team that won two state championships and I was on one that made it all of the way to the North Half until we ran into Panola my sophomore year."
Quitman (10-4) was a third seed out of their region which put them on the road in the first round of the playoffs, while Laurel (13-1) has played at home in all three rounds so far. That has set up the meeting in Laurel.
Abraham is good friends with Quitman head coach John Douglas and looks forward to sharing the experience of the South State Championship with him as well as Staggers.
"Playing for a South State Championship, we're pretty excited," Abraham said. "With both of us being here and to be able to help and contribute, it's going to be fun.".


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A Washington state man who illegally fired a shotgun blamed his action on a piece of advice doled out by Vice President Joe Biden earlier this year.
"I did what Joe Biden told me to do," Jeffrey Barton told Washington affiliate KOIN. "I went outside and fired my shotgun in the air."


text:
* Refer to bulletin 3193 for purification conditions. ** For example, Profinity GST resin is available only in prepacked cartridges. ***Profinity eXact Purification Resin.
Affi-Gel boronate-derivatized polyacrylamide gel has affinity for coplanar adjacent cis-hydroxyl groups (cis-diols) and a high binding capacity, which provides highly efficient separation of low molecular weight molecules, such as nucleotides, nucleosides, catecholamines, and sugars. It has a sorbitol capacity of 130 µmol/ml.
Other features include:
What is the education discount policy?
For more than 15 years, Bio-Rad has made science education a major priority. To support this effort, the company has implemented a discount policy that allows high school and college teaching laboratories to purchase kits, instruments, reagents, and other equipment at preferred prices.
How do I apply for the education discount?
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5 g, ready-to-use affinity chromatography support, for small MW molecules (nucleotides, nucleosides, catecholamines, and sugars)
50 g, boronate affinity chromatography media, for small MW molecules (nucleotides, nucleosides, catecholamines, and sugars)
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Events Calendar
November 2012
Phi U Donation Drive for CAPSA
Phi Upsilon Omicron Honors Society invites you to support CAPSA (Community Abuse Prevention Services Agency) by donating non-edible items families need when they are in the shelter or are making a new start for themselves after leaving the shelter. Purple boxes with CAPSA-Phi U signs will be placed around campus Nov. 12-16. Please find these boxes (Library, TSC, Family Life building, and more) to donate new, unused items such as: toiletries, including toothbrushes, toothpaste, shampoo/conditioner, toilet paper, dish/laundry soap, lotion; baby items, including diapers, wet wipes, bottles; kitchen items, including disposable dishes and silverware, sponges, dish soap. More information about CAPSA (http://www.capsa.org/site/index.php). Phi U: (http://www.usu.edu/asusu/clubsandorgs/viewClub.cfm?id=395&f=col&colID=3). Thank you for helping us support CAPSA,Phi U.


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Proposal Location: Grand Canyon,
United States
Wedding Location: Middleburg, VA,
United States
To start my story, I need to explain that I have two brothers in the Marine Corps who both fly helicopters. To Bill's surprise, I'd never flown in a helicopter, even after working for the Helicopter Association International!
I am from Arizona so I was spending Christmas at my parent's house. Bill's from Maryland so he met me in Arizona after Christmas, and then we both headed to Las Vegas for New Years, where Bill's family was already checked into hotels to enjoy the New Years festivities.
New Years Eve we woke up and Bill suggested that we take a stroll down the strip and that I should put comfortable walking shoes on. That sounded like a fabulous idea. So, we departed the hotel on a beautifully sunny morning. Before I could put my sun glasses on, I heard, "Mr. Smith?" coming from a parked limo.
It was for us!
We climbed in and all I was thinking was... "okay, what's going on here??!!" After about 20 minutes of anticipation, the divider window slid down and the limo driver said, "we're about 10 minutes from the heli-pad!" The HELI-PAD!
We were dropped off and registered for our helicopter flight. I was thinking to myself how sweet it was that Bill was gifting a first helicopter flight to me for New Years! Little did I know what was to come!
The helicopter flew over the Las Vegas strip - and started flying east ... over and INTO the Grand Canyon. Then, our helicopter perched in the canyon, allowing Bill and I to walk around and take pictures of the amazing scenery. There were cliffs above and below us, we were perched half-way down. It was amazing. I was kneeling down, capturing cacti and the canyon scene when Bill took my hand and led me to a secluded spot.
And right there amidst the immense red rocks – with canyon wind twirling through my hair, and with the sun rising over the cliffs, Bill kneeled down, took off his cap, and proposed. I was so excited, I fell to my knees too!
Upon walking back to our helicopter, our pilot was uncorking a bottle of champagne for us! And on the helicopter flight back to Vegas, he kept joking that my ring was blinding him and that he was having a hard time flying the helicopter!
As you can imagine, Bill's family threw a huge celebration for us - and I felt like a princess the entire day. To this day, no one has 'trumped' my proposal story!
Adventurous: 110
Creative: 72
Extravagant: 73
Humorous: 12
Romantic: 87


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This year it was curtains for many hedge funds
All is not well in the boardrooms of Mayfair and Greenwich. On the face of it, business is booming. Assets in the global hedge fund industry hit a high of $2.2 trillion at the end of the third quarter, and the total number of single manager hedge funds reached a record 7,867 funds, according to data provider Hedge Fund Research.
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Everyone knows that ASR is about two things: tits and ass. If you've ever walked around the crowded, beer-soaked floors at ASR, you know there's t-n-a every direction you look. And we wouldn't have it any other way. So we decided to bring you the Top 25 hotties of this year's ASR. Enjoy…
CATEGORIZED: Features, Photos
TAGS: ASR Tradeshow, bikinis
TAGS: ASR Tradeshow, bikinis


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Following are current and upcoming events at the Charles Whitehead Public Library in Wewahitchka.
At 3 p.m. CT on Aug. 6, Linda Bannister and James E. Hurd, Jr. will be signing copies of their book "Turpentine Jake".
Story time for students in K through fifth grade will be held 3:30 p.m. CT on Aug. 13.
Story time for students K through fifth grade will be held again Sept. 10.
Wee Read for pre-school age children is held at 9:30 a.m. CT each Monday.
For more information on these and other events at the library contact 639-2419.


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How to Contour Your Face
Want sculpted cheeks and a slimmer nose -- instantly? We asked a pro to show us the simplest and most effective face contouring techniques
SEE NEXT PAGE: Round: Where to contour
Older comments
Thanks for sharing!
by daddylonglegs24 Sunday, May 12, 2013 at 11:12PM Report as inappropriate
Great tricks to soften my square face! Great tips for every face shape.
by GigiSD Sunday, April 28, 2013 at 06:42PM Report as inappropriate
I have a square face and through years of trial and error had figured out the highlighting tricks, but didn't know about the shading tricks (and never would have guessed on my own). I'm eager to give them a try.
by purple9a Saturday, March 9, 2013 at 07:51AM Report as inappropriate
Thanks for the info
by EricaF123 Saturday, December 29, 2012 at 06:52AM Report as inappropriate
This is very helpful i am a make-up student and i didn't quite understand contouring it seemed very technical ,but this makes it really simple
by reneeslimz Sunday, November 11, 2012 at 11:06AM Report as inappropriate
I have never thought about my face shape or contouring until reading this story. I am going to try contouring my round face.
by Lamexicana1 Friday, November 9, 2012 at 07:44PM Report as inappropriate
This is so cool! I always wanted to learn how to contour my face . I like how it shows how to do it according to the face shape you have. Very helpful!
by Ladybugg9 Saturday, October 27, 2012 at 01:03AM Report as inappropriate
how do you know which face shape you are? mine could almost be any of these!
by Chris213 Friday, October 12, 2012 at 07:22AM Report as inappropriate
I have a heart shaped face. Have great cheekbones but a huge nose. I just kind of work with the cheekbones and distract from the nose. Good pointers. Some of the models did look a bit too darkened.
by Nicole1021 Thursday, August 16, 2012 at 08:27PM Report as inappropriate
I don't really know what my face shape is...
by rachaellh13 Tuesday, July 10, 2012 at 05:33PM Report as inappropriate
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What walks on four feet in the morning, two in the afternoon and three at night?
What walks on four feet in the morning?
a man riding a horse
two in the afternoon ?
a man thats fell of the horse
three at night?
the man with a walking stick after falling off the horse and twisting his ankle
close ?


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Moderators: Tonyblack, Jason, Toothy
meerkat wrote:Um I think it is explained if not drawn in Feet of Clay. Probably wrong but you never know. There might be one on the Paul Kidby site.
Sjoerd3000 wrote:I thought the coat of arms was explained
Dotsie wrote:I think Sjoerd means that it was the coat of arms that was explained in Feet of Clay, rather than the flag, to save you searching for it.
If it's described anywhere, I would think it would be Jingo, although I think that the regiments all had different flags.
From The Fifth Elephant
Lady Sybil: I'll tell Willikins to pack winter clothes. It'll be pretty cold up there at this time of year. Sam Vimes: Yes. That's a good idea. Lady Sybil: We'll have to host a party ourselves, I expect, so we ought to take a cartload of typical Ankh-Morpork food. Show the flag, you know. Do you think I should take a cook along? Sam Vimes: Yes dear. That would be a good idea. No one outside the city knows how to make a knuckle sandwich properly. Lady Sybil: Do you think we ought to take the alligator with us? Sam Vimes: Yes, that might be advisable.... What alligator?
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These redesigned, fourth-generation Type-R subwoofers include several enhanced features to achieve even cleaner, deeper bass extension, faster, more accurate transients and even greater output capability than before.
(Sold as single woofer)
Price: U.S. $180.00
(Now Available)
Professional installation available at authorized retailers.
The Type R Subs have been completely redesigned to offer more installation flexibility and application versatility, for the ideal sound system. At 5-7/8" for the 10" and 6-3/8" for the 12", these new designs offer a near 20% reduction in mounting depth, while offering even greater output capability. The new 8"models come in at a scant 4-1/2" deep, allowing fitment into the tiniest of spaces.
The new FEA-Optomized Motor Structure together with our revolutionary High-Amplitude Multi Roll (HAMR) Suspension Design gives the new Type-R Subwoofers the highest X-max and SPL output in the category.
With a real-world, measured 21mm (14mm) of Xmax, the new Type R Subwoofers deliver best-in-class output, ultra-low distortion, and unparalleled sound quality.
These two graphs are from the industry standard measuring system, Klippel which illustrates the excursion of the subwoofer both relative to the strength of the magnet system, and the stiffness and linearity of the suspension.
Starting with a new 10 piece, segmented magnet structure, the new Type-R subwoofer has over 20% more motor force than its predecessor. (The 6 piece segmented, double-stacked magnet structure proves incredible motor force to while ensuring linear, low-distortion output even at high levels.) This new magnet assembly is also an integral part of the next generation of Alpine's Patented Radial Vented VC cooling system.
Alpine's Patented Radial Vented VC Heatsink and Airflow Management System (US Patent #7,634,101) helps to minimize power compression and ensures reliable long playing time by actively eliminating output-robbing heat away from the Voice Coil. The new one-piece cast aluminum frame with integrated shorting sleeve uses the entire frame as a heatsink, to allow for sustained power output and handling, even in the most extreme of applications.
Alpine's Patented Compound Radius Curve pole geometry (US Patent # 6,639,993) ensure for an ultra symmetrical magnetic field, while optimizing flux density to greatly reduce distortion, while further improving power handling and output. Furthermore, the massive one-piece cast aluminum shorting ring helps tame sound quality robbing distortions, greatly improving sound quality for tight, accurate bass.
The oversized 65 mm voice coil offers more than 35% more voice coil surface area, allowing for increased power handling to 600W RMS / 1800W Peak. The large 40mm 4-layer voice coil offers increased surface area to keep things cool, even at sustained power levels as high as 350W RMS / 1000W Peak. To get the best performance pair your Type-R subs with Alpine's new MRX and PDX digital amplifiers.
The High-Amplitude Multi Roll Surround Design allows for extreme excursions without sacrificing valuable cone area. FEA Optimized for linearity and made with injection-molded Santoprene ®, the HAMR surround is a key part of the suspension system that allows for extreme excursions with accurate, distortion-free control.
Ensures reliable and consistent control of the tinsel-leads to eliminate any possible mechanical noises or interference typical of many high-excursion designs.
Actively manages voice coil temperatures by forcing air directly across the heatsink system.
Creates a symmetrical magnetic field while optimizing flux density to greatly reduce distortion, while further improving power handling and output.


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Olive Oil Clarifies Thinking
SLU Animal Research Reinforces Conventional Wisdom: EVOO Is Good for You
ST. LOUIS -- Olive oil, a staple of a Mediterranean diet, reverses memory loss and improves learning, a study in an animal model at Saint Louis University found.
|Susan Farr, Ph.D.
"Our research strengthens the case for olive oil," said Susan Farr, Ph.D., research professor of geriatrics at Saint Louis University School of Medicine. "Our research with mice lends credibility to the idea that extra virgin olive oil is really good for you and could even help if you already have some mild dementia. The take home message is to use extra virgin olive oil in your cooking."
The Mediterranean diet has long been associated with good health -- reduced heart disease, fewer cases of cancer, less obesity and a reduced risk of Alzheimer's disease. Farr wanted to test one of the most critical parts of the Mediterranean diet -- extra virgin olive oil (EVOO) -- to see if it improved memory, learning and thinking.
As the first oil pressed from olives, extra virgin olive oil is particularly healthy because it retains rich antioxidants called polyphenols.
Farr compared three types of fat -- EVOO, coconut oil and butter -- in mice that have an age-related impairment in learning and memory that is similar to Alzheimer's disease. EVOO is a monounsaturated fat known to boost good cholesterol and lower bad cholesterol. Both coconut oil and butter are saturated fats that increase bad cholesterol and reduce the good.
The mice were divided into four groups and received either EVOO, EVOO that was enhanced with extra polyphenols, coconut oil or butter for four weeks. During the experiment, the mice took tests of recognizing objects and navigating a maze that indicate memory and learning. In addition, their levels of oxidative stress in the brain were assessed.
The mice that were given EVOO with extra polyphenols did the best. They had the most improved learning, thinking and memory, and less oxidative brain damage than the other mice. The mice that consumed EVOO fared better than the other mice; the mice that consumed coconut oil had improved memory but no better learning than did the mice fed butter.
"Olive oil reversed the signs of memory deficiency in mice that represent a model of early Alzheimer's disease," Farr said. "This stands to reason. People in the Mediterranean region who eat a lot of olive oil have fewer cases of heart disease and Alzheimer's disease."
Farr previously studied the effect of fish oil, found in another staple of the Mediterranean diet, in mice that have a model of Alzheimer's disease.
"It also works to improve thinking skills," Farr said. "You'd probably want to cook your fish in extra virgin olive oil."
The research, which was supported by the VA Medical Center in St. Louis, is published electronically ahead of the print edition of the Journal of Alzheimer's Disease.
Established in 1836, the School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: infectious disease, liver disease, aging and brain disease, cancer and heart/lung disease. The school's department of internal medicine celebrates its centennial in 2011.
Find out about a new clinical trial for Alzheimer's disease.
Learn about the Division of Geriatric Medicine.
Read about U.S. News' rankings for geriatrics.