Sample records for cardiac acoustic-radiation-force-driven shear

  1. Acoustic-radiation-force-induced shear wave propagation in cardiac tissue

    Bouchard, Richard R.; Wolf, Patrick D.; Hsu, Stephen J.; Dumont, Douglas M.; Trahey, Gregg E.


    Shear wave elasticity imaging (SWEI) was employed to track acoustic radiation force (ARF)-induced shear waves in the myocardium of a beating heart. Shear waves were generated in and tracked through the myocardium of the left ventricular free wall (LVFW) in an in vivo heart that was exposed through a thoracotomy; matched studies were also preformed on an ex vivo myocardial specimen. Average shear wave velocities ranged from 2.22 to 2.53 m/s for the ex vivo specimen and 1.5 to 2.9 m/s (1.5-2.09 m/s during diastole; 2.9 m/s during systole) for in vivo specimens. Despite the known rotation of myocardial fiber orientation with tissue depth, there was no statistically significant shear wave velocity depth dependence observed in any of the experimental trials.

  2. Cardiac shear-wave elastography using a transesophageal transducer: application to the mapping of thermal lesions in ultrasound transesophageal cardiac ablation

    Kwiecinski, Wojciech; Bessière, Francis; Constanciel Colas, Elodie; Apoutou N'Djin, W.; Tanter, Mickaël; Lafon, Cyril; Pernot, Mathieu


    Heart rhythm disorders, such as atrial fibrillation or ventricular tachycardia can be treated by catheter-based thermal ablation. However, clinically available systems based on radio-frequency or cryothermal ablation suffer from limited energy penetration and the lack of lesion’s extent monitoring. An ultrasound-guided transesophageal device has recently successfully been used to perform High-Intensity Focused Ultrasound (HIFU) ablation in targeted regions of the heart in vivo. In this study we investigate the feasibility of a dual therapy and imaging approach on the same transesophageal device. We demonstrate in vivo that quantitative cardiac shear-wave elastography (SWE) can be performed with the device and we show on ex vivo samples that transesophageal SWE can map the extent of the HIFU lesions. First, SWE was validated with the transesophageal endoscope in one sheep in vivo. The stiffness of normal atrial and ventricular tissues has been assessed during the cardiac cycle (n=11 ) and mapped (n= 7 ). Second, HIFU ablation has been performed with the therapy-imaging transesophageal device in ex vivo chicken breast samples (n  =  3), then atrial (left, n= 2 ) and ventricular (left n=1 , right n=1 ) porcine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. During the cardiac cycle stiffness varied from 0.5   ±   0.1 kPa to 6.0   ±   0.3 kPa in the atrium and from 1.3   ±   0.3 kPa to 13.5   ±   9.1 kPa in the ventricles. The thermal lesions were visible on all SWE maps performed after ablation. Shear modulus of the ablated zones increased to 16.3   ±   5.5 kPa (versus 4.4   ±   1.6 kPa before ablation) in the chicken breast, to 30.3   ±   10.3 kPa (versus 12.2   ±   4.3 kPa) in the atria and to 73.8   ±   13

  3. Cardiac rehabilitation

    ... attack or other heart problem. You might consider cardiac rehab if you have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery Heart transplant Procedures such as angioplasty and stenting In some ...

  4. Cardiac Rehabilitation

    Cardiac rehabilitation (rehab) is a medically supervised program to help people who have A heart attack Angioplasty or coronary artery bypass grafting for coronary heart disease A heart valve repair or replacement A ...

  5. Cardiac sarcoidosis

    Costello BT; Nadel J.; Taylor AJ


    Benedict T Costello,1,2 James Nadel,3 Andrew J Taylor,1,21Department of Cardiovascular Medicine, The Alfred Hospital, 2Baker IDI Heart and Diabetes Research Institute, Melbourne, VIC, 3School of Medicine, University of Notre Dame, Sydney, NSW, Australia Abstract: Cardiac sarcoidosis is a rare but life-threatening condition, requiring a high degree of clinical suspicion and low threshold for investigation to make the diagnosis. The cardiac manifestations include heart failure, conducting syst...

  6. Cardiac CT

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie


    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  7. Cardiac echinococcosis

    Ivanović-Krstić Branislava A.


    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  8. Cardiac sarcoidosis

    Smedema, J.P.; Zondervan, P.E.; van Hagen, P.; ten Cate, F.J.; Bresser, P.; Doubell, A.F.; Pattynama, P.; Hoogsteden, H.C.; Balk, A.H.M.M.


    Sarcoidosis is a multi-system granulomatous disorder of unknown aetiology. Symptomatic cardiac involvement occurs in approximately 5% of patients. The prevalence of sarcoidosis in the Netherlands is unknown, but estimated to be approximately 20 per 100,000 population (3200 patients). We report on five patients who presented with different manifestations of cardiac sarcoidosis, and give a brief review on the current management of this condition. Magnetic Resonance Imaging (MRI) can be of great help in diagnosing this condition as well as in the follow-up of the response to therapy. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6 PMID:25696121

  9. Cardiac Pacemakers

    A complete survey of physiological biophysical,clinical and engineering aspects of cardiac facing,including the history and an assessment of possible future developments.Among the topics studied are: pacemakers, energy search, heart stimulating with pacemakers ,mathematical aspects of the electric cardio stimulation chronic, pacemaker implants,proceeding,treatment and control

  10. Reduced shear power spectrum

    Dodelson, Scott; /Fermilab /Chicago U., Astron. Astrophys. Ctr. /Northwestern U.; Shapiro, Charles; /Chicago U. /KICP, Chicago; White, Martin J.; /UC, Berkeley, Astron.


    Measurements of ellipticities of background galaxies are sensitive to the reduced shear, the cosmic shear divided by (1-{kappa}) where {kappa} is the projected density field. They compute the difference between shear and reduced shear both analytically and with simulations. The difference becomes more important an smaller scales, and will impact cosmological parameter estimation from upcoming experiments. A simple recipe is presented to carry out the required correction.

  11. Cardiac rhabdomyosarcoma

    Chlumský, Jaromír; Holá, Dana; Hlaváček, Karel; Michal, Michal; Švec, Alexander; Špatenka, Jaroslav; Dušek, Jan


    Cardiac sarcoma is a very rare neoplasm and is difficult to diagnose. The case of a 51-year-old man with a left atrial tumour, locally recurrent three months after its surgical removal, is presented. Computed tomography showed metastatic spread to the lung parenchyma. On revised histology, the mass extirpated was a sarcoma. Because of the metastatic spread, further therapy was symptomatic only; the patient died 15 months after the first manifestation of his problems. Immunohistochemical stain...

  12. Cardiac Calcification

    Morteza Joorabian


    Full Text Available There is a spectrum of different types of cardiac"ncalcifications with the importance and significance"nof each type of cardiac calcification, especially"ncoronary artery calcification. Radiologic detection of"ncalcifications within the heart is quite common. The"namount of coronary artery calcification correlates"nwith the severity of coronary artery disease (CAD."nCalcification of the aortic or mitral valve may indicate"nhemodynamically significant valvular stenosis."nMyocardial calcification is a sign of prior infarction,"nwhile pericardial calcification is strongly associated"nwith constrictive pericarditis. A spectrum of different"ntypes of cardiac calcifications (linear, annular,"ncurvilinear,... could be seen in chest radiography and"nother imaging modalities. So a carful inspection for"ndetection and reorganization of these calcifications"nshould be necessary. Numerous modalities exist for"nidentifying coronary calcification, including plain"nradiography, fluoroscopy, intravascular ultrasound,"nMRI, echocardiography, and conventional, helical and"nelectron-beam CT (EBCT. Coronary calcifications"ndetected on EBCT or helical CT can be quantifie,"nand a total calcification score (Cardiac Calcification"nScoring may be calculated. In an asymptomatic"npopulation and/or patients with concomitant risk"nfactors like diabetes mellitus, determination of the"npresence of coronary calcifications identifies the"npatients at risk for future myocardial infarction and"ncoronary artery disease. In patients without coronary"ncalcifications, future cardiovascular events could"nbe excluded. Therefore, detecting and recognizing"ncalcification related to the heart on chest radiography"nand other imaging modalities such as fluoroscopy, CT"nand echocardiography may have important clinical"nimplications.

  13. Cardiac conduction system

    The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals ... to contract. The main components of the cardiac conduction system are the SA node, AV node, bundle ...

  14. Cardiac MRI in Athletes

    Luijkx, T.


    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  15. Cross Shear Roll Bonding

    Bay, Niels; Bjerregaard, Henrik; Petersen, Søren. B;


    The present paper describes an investigation of roll bonding an AlZn alloy to mild steel. Application of cross shear roll bonding, where the two equal sized rolls run with different peripheral speed, is shown to give better bond strength than conventional roll bonding. Improvements of up to 20......-23% in bond strength are found and full bond strength is obtained at a reduction of 50% whereas 65% is required in case of conventional roll bonding. Pseudo cross shear roll bonding, where the cross shear effect is obtained by running two equal sized rolls with different speed, gives the same results....

  16. Cardiac MR Elastography: Comparison with left ventricular pressure measurement

    Samani Abbas; Hamm Bernd; Schnorr Jörg; Kaufels Nikola; Laule Michael; Elgeti Thomas; Braun Jürgen; Sack Ingolf


    Abstract Purpose of study To compare magnetic resonance elastography (MRE) with ventricular pressure changes in an animal model. Methods Three pigs of different cardiac physiology (weight, 25 to 53 kg; heart rate, 61 to 93 bpm; left ventricular [LV] end-diastolic volume, 35 to 70 ml) were subjected to invasive LV pressure measurement by catheter and noninvasive cardiac MRE. Cardiac MRE was performed in a short-axis view of the heart and applying a 48.3-Hz shear-wave stimulus. Relative changes...

  17. Shear-Resistant Behavior Analysis of Light Composite Shear Walls

    李升才; 江见鲸; 于庆荣


    Shear test results for a composite wall panel in a light composite structure system are compared with test results for shear walls in Japan in this paper. The analysis results show that this kind of composite wall panel works very well, and can be regarded as a solid panel. The composite wall panel with a hidden frame is essential for bringing its effect on shear resistance into full play. Comprehensive analysis of the shear-resistant behavior of the composite wall panel suggests that the shear of the composite shear wall panel can be controlled by the cracking strength of the web shearing diagonal crack.

  18. Shear-resistant behavior of light composite shear wall

    李升才; 董毓利


    Shear test results for a composite wall panel in a light composite structure system are compared with test results for shear walls in Japan. The analysis results show that this kind of composite wall panel works very well, and can be regarded as a solid panel. The composite wall panel with a hidden frame is essential for bringing its effect on shear resistance into full play. Comprehensive analysis of the shear-resistant behavior of the composite wall panel suggests that the shear of the composite shear wall panel can be controlled by the cracking strength of the web shearing diagonal crack.

  19. Cardiac perception and cardiac control. A review.

    Carroll, D


    The evidence regarding specific cardiac perception and discrimination, and its relationship to voluntary cardiac control, is critically reviewed. Studies are considered in three sections, depending on the method used to assess cardiac perception: questionnaire assessment, discrimination procedures, and heartbeat tracking. The heartbeat tracking procedure would appear to suffer least from interpretative difficulties. Recommendations are made regarding the style of analysis used to assess heartbeat perception in such tracking tasks. PMID:348240

  20. Transport apparatus for location of shear pack in shear machine

    An apparatus for moving a shear pack of a shear machine between operative and inoperative position is described. It comprises a trolley to support the shear pack, the trolley being mounted on a bogie movable on rails between the inoperative position, at which the shear pack is loaded on to the trolley, and the operative position at which the shear pack is located at the shear machine. The trolley is mounted on inclined runners on the bogie and is releasably connected to the bogie by latching means. This permits the displacement of the trolley relative to the bogie to effect vertical displacement of the shear pack when the shear pack is at the shear machine. (author)

  1. What Is Cardiac Rehabilitation?

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  2. Diffuse infiltrative cardiac tuberculosis

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  3. Sheared solid materials

    Akira Onuki; Akira Furukawa; Akihiko Minami


    We present a time-dependent Ginzburg–Landau model of nonlinear elasticity in solid materials. We assume that the elastic energy density is a periodic function of the shear and tetragonal strains owing to the underlying lattice structure. With this new ingredient, solving the equations yields formation of dislocation dipoles or slips. In plastic flow high-density dislocations emerge at large strains to accumulate and grow into shear bands where the strains are localized. In addition to the elastic displacement, we also introduce the local free volume . For very small the defect structures are metastable and long-lived where the dislocations are pinned by the Peierls potential barrier. However, if the shear modulus decreases with increasing , accumulation of around dislocation cores eventually breaks the Peierls potential leading to slow relaxations in the stress and the free energy (aging). As another application of our scheme, we also study dislocation formation in two-phase alloys (coherency loss) under shear strains, where dislocations glide preferentially in the softer regions and are trapped at the interfaces.

  4. Keyed shear joints

    Hansen, Klaus

    This report gives a summary of the present information on the behaviour of vertical keyed shear joints in large panel structures. An attemp is made to outline the implications which this information might have on the analysis and design of a complete wall. The publications also gives a short...

  5. Cardiac tumours in children

    Parsons Jonathan M


    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  6. Plasticity Approach to Shear Design

    Hoang, Cao Linh; Nielsen, Mogens Peter


    The paper presents some plastic models for shear design of reinforced concrete beams. Distinction is made between two shear failure modes, namely web crushing and crack sliding. The first mentioned mode is met in beams with large shear reinforcement degrees. The mode of crack sliding is met in non...... uncracked concrete. Good agree between theory and tests has been found.Keywords: dsign, plasticity, reinforced concrete, reinforcement, shear, web crushing....

  7. Shear Behavior of Concrete Beams Reinforced with GFRP Shear Reinforcement

    Heecheul Kim; Min Sook Kim; Myung Joon Ko; Young Hak Lee


    This paper presents the shear capacities of concrete beams reinforced with glass fiber reinforced polymer (GFRP) plates as shear reinforcement. To examine the shear performance, we manufactured and tested a total of eight specimens. Test variables included the GFRP strip-width-to-spacing ratio and type of opening array. The specimen with a GFRP plate with a 3×2 opening array showed the highest shear strength. From the test results, the shear strength increased as the strip-width-to-strip-spac...

  8. Stimulating endogenous cardiac regeneration

    Amanda eFinan


    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  9. The Elemental Shear Dynamo

    McWilliams, James C


    A quasi-linear theory is presented for how randomly forced, barotropic velocity fluctuations cause an exponentially-growing, large-scale (mean) magnetic dynamo in the presence of a uniform shear flow, $\\vec{U} = S x \\vec{e}_y$. It is a "kinematic" theory for the growth of the mean magnetic energy from a small initial seed, neglecting the saturation effects of the Lorentz force. The quasi-linear approximation is most broadly justifiable by its correspondence with computational solutions of nonlinear magneto-hydrodynamics, and it is rigorously derived in the limit of large resistivity, $\\eta \\rightarrow \\infty$. Dynamo action occurs even without mean helicity in the forcing or flow, but random helicity variance is then essential. In a sufficiently large domain and with small wavenumber $k_z$ in the direction perpendicular to the mean shearing plane, a positive exponential growth rate $\\gamma$ can occur for arbitrary values of $\\eta$, the viscosity $\

  10. Gelation under shear

    Butler, B.D.; Hanley, H.J.M.; Straty, G.C. [National Institute of Standards and Technology, Boulder, CO (United States); Muzny, C.D. [Univ. of Colorado, Boulder, CO (United States)


    An experimental small angle neutron scattering (SANS) study of dense silica gels, prepared from suspensions of 24 nm colloidal silica particles at several volume fractions {theta} is discussed. Provided that {theta}{approx_lt}0.18, the scattered intensity at small wave vectors q increases as the gelation proceeds, and the structure factor S(q, t {yields} {infinity}) of the gel exhibits apparent power law behavior. Power law behavior is also observed, even for samples with {theta}>0.18, when the gel is formed under an applied shear. Shear also enhances the diffraction maximum corresponding to the inter-particle contact distance of the gel. Difficulties encountered when trying to interpret SANS data from these dense systems are outlined. Results of computer simulations intended to mimic gel formation, including computations of S(q, t), are discussed. Comments on a method to extract a fractal dimension characterizing the gel are included.

  11. Shear Behavior of Concrete Beams Reinforced with GFRP Shear Reinforcement

    Heecheul Kim


    Full Text Available This paper presents the shear capacities of concrete beams reinforced with glass fiber reinforced polymer (GFRP plates as shear reinforcement. To examine the shear performance, we manufactured and tested a total of eight specimens. Test variables included the GFRP strip-width-to-spacing ratio and type of opening array. The specimen with a GFRP plate with a 3×2 opening array showed the highest shear strength. From the test results, the shear strength increased as the strip-width-to-strip-spacing ratio increased. Also, we used the experimental results to evaluate whether the shear strength equations of ACI 318-14 and ACI 440.1R can be applied to the design of GFRP shear reinforcement. In the results, the ACI 440 equation underestimated the experimental results more than that of ACI 318.

  12. Holographic velocimetry for evaluation of cardiac valves

    Holographic velocimetry is a noninvasive method for fluid flow analysis, making it possible to determine flow field characteristics for any instant in a flow cycle. The use of holographic velocimetry to assess prosthetic heart valve performance has never before been accomplished. However, it seems readily apparent that much pertinent information will be gained from it, such as the exact location and quantitative analysis of stagnation zones, high shear and high velocity regions. A comparison of the results from holographic velocimetry are made with those of laser Doppler anemometry. The first study deals with steady state flow analysis at peak systolic flow rates for normal cardiac outputs

  13. Preoperative cardiac risk management

    Vidaković Radosav; Poldermans Don; Nešković Aleksandar N.


    Approximately 100 million people undergo noncardiac surgery annually worldwide. It is estimated that around 3% of patients undergoing noncardiac surgery experience a major adverse cardiac event. Although cardiac events, like myocardial infarction, are major cause of perioperative morbidity or mortality, its true incidence is difficult to assess. The risk of perioperative cardiac complications depends mainly on two conditions: 1) identified risk factors, and 2) the type of the surgical p...

  14. Elevated Shear Stress in Arteriovenous Fistulae: Is There Mechanical Homeostasis?

    McGah, Patrick; Leotta, Daniel; Beach, Kirk; Aliseda, Alberto


    Arteriovenous fistulae are created surgically to provide access for dialysis in patients with renal failure. The current hypothesis is that the rapid remodeling occurring after the fistula creation is in part a process to restore the mechanical stresses to some preferred level (i.e. mechanical homeostasis). Given that nearly 50% of fistulae require an intervention after one year, understanding the altered hemodynamic stress is important in improving clinical outcomes. We perform numerical simulations of four patient-specific models of functioning fistulae reconstructed from 3D Doppler ultrasound scans. Our results show that the vessels are subjected to `normal' shear stresses away from the anastomosis; about 1 Pa in the veins and about 2.5 Pa in the arteries. However, simulations show that part of the anastomoses are consistently subjected to very high shear stress (>10Pa) over the cardiac cycle. These elevated values shear stresses are caused by the transitional flows at the anastomoses including flow separation and quasiperiodic vortex shedding. This suggests that the remodeling process lowers shear stress in the fistula but that it is limited as evidenced by the elevated shear at the anastomoses. This constant insult on the arterialized venous wall may explain the process of late fistula failure in which the dialysis access become occluded after years of use. Supported by an R21 Grant from NIDDK (DK081823).

  15. Front tracking for shear bands in an antiplane shear model

    In this paper we describe a numerical algorithm for the study of shear band, formation and growth in two-dimensional antiplane shear. The constitutive model uses a non-associative flow rule. The numerical scheme is based on a Godunov method for updating the velocity, while the stress is updated via integration along particle paths. The scheme is coupled with a front tracking algorithm for careful evolution of the shear bands. The main challenges are the non-hyperbolicity of the shear band formation and growth (front tracking avoids the catastrophic effects of the loss of hyperbolicity in the Godunov-type numerical scheme), the existence of endpoints for the shear band (the tracked front does not separate the computational domain into disconnected regions), and the non-hyperbolic rate of growth of the shear band. We give examples of the success of the algorithm and show convergence tests. 69 refs., 13 figs

  16. The Elemental Shear Dynamo

    Mcwilliams, James C.


    A quasi-linear theory is presented for how randomly forced, barotropic velocity fluctuations cause an exponentially-growing, large-scale (mean) magnetic dynamo in the presence of a uniform shear flow, $\\vec{U} = S x \\vec{e}_y$. It is a "kinematic" theory for the growth of the mean magnetic energy from a small initial seed, neglecting the saturation effects of the Lorentz force. The quasi-linear approximation is most broadly justifiable by its correspondence with computational solutions of non...

  17. Plasticity Approach to Shear Design

    Hoang, Cao Linh; Nielsen, Mogens Peter


    The paper presents some plastic models for shear design of reinforced concrete beams. Distinction is made between two shear failure modes, namely web crushing and crack sliding. The first mentioned mode is met in beams with large shear reinforcement degrees. The mode of crack sliding is met in no...... uncracked concrete. Good agree between theory and tests has been found.Keywords: dsign, plasticity, reinforced concrete, reinforcement, shear, web crushing.......The paper presents some plastic models for shear design of reinforced concrete beams. Distinction is made between two shear failure modes, namely web crushing and crack sliding. The first mentioned mode is met in beams with large shear reinforcement degrees. The mode of crack sliding is met in non......-shear reinforced beams as well as in lightly shear reinforced beams. For such beams the shear strength is determined by the recently developed crack sliding model. This model is based upon the hypothesis that cracks can be transformed into yield lines, which have lower sliding resistance than yield lines formed in...

  18. Reconstruction of a tissue shear modulus together with mechanical sources

    To achieve a differential diagnosis of cancerous disease in human soft tissues in vivo in organs such as the liver, breast etc., of cardiac dynamics with myocardial infarction etc. and hemodynamics or atherosclerosis etc., various strain measurement based shear modulus reconstruction methods have been developed. The strain tensor in a region of interest (ROI) is measured using ultrasound (US) or magnetic resonance (MR) imaging. The shear modulus reconstruction methods have also been applied to confirm the effectiveness of thermal treatments such as in human liver in vivo, exempli gratia (e.g.), regeneration, coagulation etc. In this study, the previously developed shear modulus reconstruction methods are extended, so that arbitrary internal mechanical sources expressed as a static or dynamic pressure, or as a force vector in a region of interest can be reconstructed together with a shear modulus such as a high intensity focused ultrasound (HIFU) and a radiation force for a tissue deformation as well as for treatments, static compressors, vibrators, heart motion and pulsation. Originally, the methods assumed that mechanical sources existed outside of a ROI (id est (i.e.), external sources). The new methods are also expected to be able to deal with an internal mechanical source combined with other unknowns, except for the shear modulus, e.g., inertia and mean normal stress. For the purpose of shear modulus reconstructions, such a decrease in the number of unknowns decrease computational time and increase the reconstruction accuracy and stability. The performed simulations show that the extended reconstruction methods have a high potential for yielding an arbitrary internal mechanical source reconstruction together with shear modulus reconstruction. The extension of the reconstruction methods will increase the applications of shear modulus reconstruction, e.g., a deeply situated tissue can be dealt with, and an image during a treatment with a HIFU or radiation force

  19. Wall shear stress indicators in abnormal aortic geometries

    Prahl Wittberg, Lisa; van Wyk, Stevin; Fuchs, Laszlo; Gutmark, Ephraim; Gutmark-Little, Iris


    Cardiovascular disease, such as atherosclerosis, occurs at specific locations in the arterial tree. Characterizing flow and forces at these locations is crucial to understanding the genesis of disease. Measures such as time average wall shear stress, oscillatory shear index, relative residence time and temporal wall shear stress gradients have been shown to identify plaque prone regions. The present paper examines these indices in three aortic geometries obtained from patients whose aortas are deformed due to a genetic pathology and compared to one normal geometry. This patient group is known to be prone to aortic dissection and our study aims to identify early indicators that will enable timely intervention. Data obtained from cardiac magnetic resonance imaging is used to reconstruct the aortic arch. The local unsteady flow characteristics are calculated, fully resolving the flow field throughout the entire cardiac cycle. The Quemada model is applied to account for the non-Newtonian properties of blood, an empirical model valid for different red blood cell loading. The impact of the deformed aortic geometries is analyzed to identify flow patterns that could lead to arterial disease at certain locations.

  20. Blunt cardiac rupture.

    Martin, T D; Flynn, T C; Rowlands, B J; Ward, R E; Fischer, R P


    Blunt injury to the heart ranges from contusion to disruption. This report comprises 14 patients seen during a 6-year period with cardiac rupture secondary to blunt trauma. Eight patients were injured in automobile accidents, two patients were injured in auto-pedestrian accidents, two were kicked in the chest by ungulates, and two sustained falls. Cardiac tamponade was suspected in ten patients. Five patients presented with prehospital cardiac arrest or arrested shortly after arrival. All underwent emergency department thoracotomy without survival. Two patients expired in the operating room during attempted cardiac repair; both had significant extracardiac injury. Seven patients survived, three had right atrial injuries, three had right ventricular injuries, and one had a left atrial injury. Cardiopulmonary bypass was not required for repair of the surviving patients. There were no significant complications from the cardiac repair. The history of significant force dispersed over a relatively small area of the precordium as in a kicking injury from an animal or steering wheel impact should alert the physician to possible cardiac rupture. Cardiac rupture should be considered in patients who present with signs of cardiac tamponade or persistent thoracic bleeding after blunt trauma. PMID:6708151

  1. Biomaterials for cardiac regeneration

    Ruel, Marc


    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  2. Mathematical cardiac electrophysiology

    Colli Franzone, Piero; Scacchi, Simone


    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  3. Analysis of shearing stress in the limited durability of bovine pericardium used as a biomaterial.

    Carrera San Martin, A; García Paez, J M; García Sestafe, J V; Herrero, E J; Navidad, R; Cordón, A; Castillo-Olivares, J L


    The objective of the study was to determine the shearing stress exerted by the suture thread under conditions of normal working stress. Thirty-six samples of calf pericardium, similar to that employed in the manufacture of bioprosthetic cardiac valve leaflets, were subjected to tensile testing. Prior to the trial, a continuous suture was sewn in the central zone of each sample, at a 45 degrees angle to the longest axis of the sample, using commercially-available threads (silk, Gore-Tex, Surgilene and nylon). Application of the Mohr circle for combined wear revealed that the shearing stress ranged between 2.68-fold greater (for samples sewn with silk) and 5.48-fold greater (for samples sewn with nylon) than the working tensile stress in the region of the suture. It is concluded that the shearing stress is responsible for the limited durability of sutured samples of calf pericardium prepared to simulate bioprosthetic cardiac valve leaflets. PMID:15348911

  4. Inductive shearing of drilling pipe

    Ludtka, Gerard M.; Wilgen, John; Kisner, Roger; Mcintyre, Timothy


    Induction shearing may be used to cut a drillpipe at an undersea well. Electromagnetic rings may be built into a blow-out preventer (BOP) at the seafloor. The electromagnetic rings create a magnetic field through the drillpipe and may transfer sufficient energy to change the state of the metal drillpipe to shear the drillpipe. After shearing the drillpipe, the drillpipe may be sealed to prevent further leakage of well contents.

  5. Shear viscosity of nuclear matter

    This paper reports my recent study[1] on the shear viscosity of neutron-rich nuclear matter from a relaxation time approach. An isospin- and momentum-dependent interaction is used in the study. Dependence of density, temperature, and isospin asymmetry of nuclear matter on its shear viscosity have been discussed. Similar to the symmetry energy, the symmetry shear viscosity is defined and its density and temperature dependence are studied. (authors)

  6. Proteins in a shear flow

    Szymczak, P.; Cieplak, Marek


    The conformational dynamics of a single protein molecule in a shear flow is investigated using Brownian dynamics simulations. A structure-based coarse grained model of a protein is used. We consider two proteins, ubiquitin and integrin, and find that at moderate shear rates they unfold through a sequence of metastable states - a pattern which is distinct from a smooth unraveling found in homopolymers. Full unfolding occurs only at very large shear rates. Furthermore, the hydrodynamic interact...

  7. Shear strength of non-shear reinforced concrete elements

    Hoang, Cao linh


    The paper deals with the shear strength of prestressed hollow-core slabs determined by the theory of plasticity. Two failure mechanisms are considered in order to derive the solutions.In the case of sliding failure in a diagonal crack, the shear strength is determined by means of the crack sliding...

  8. [Cardiac evaluation before non-cardiac surgery].

    Menzenbach, Jan; Boehm, Olaf


    Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices. Application of diagnostic means, should be used adjusted to this risk estimation. Cardiac biomarkers are useful to discover risk of complications or mortality, that cannot be assessed by clinical signs. After preoperative optimization and perioperative cardiac protection, the observation of the postoperative period remains, to prohibit complications or even death. In consideration of limited resources of intensive care department, postoperative ward rounds beyond intensive care units are considered to be an appropriate instrument to avoid or recognize complications early to reduce postoperative mortality. PMID:27479258

  9. Cardiac metabolism and arrhythmias

    Barth, Andreas S.; Tomaselli, Gordon F.


    Sudden cardiac death remains a leading cause of mortality in the Western world, accounting for up to 20% of all deaths in the U.S.1, 2 The major causes of sudden cardiac death in adults age 35 and older are coronary artery disease (70–80%) and dilated cardiomyopathy (10–15%).3 At the molecular level, a wide variety of mechanisms contribute to arrhythmias that cause sudden cardiac death, ranging from genetic predisposition (rare mutations and common polymorphisms in ion channels and structural...

  10. [Cardiac Rehabilitation 2015].

    Hoffmann, Andreas


    The goals of cardiac rehabilitation are (re-)conditioning and secondary prevention in patients with heart disease or an elevated cardiovascular risk profile. Rehabilitation is based on motivation through education, on adapted physical activity, instruction of relaxation techniques, psychological support and optimized medication. It is performed preferably in groups either in outpatient or inpatient settings. The Swiss working group on cardiac rehabilitation provides a network of institutions with regular quality auditing. Positive effects of rehabilitation programs on mortality and morbidity have been established by numerous studies. Although a majority of patients after cardiac surgery are being referred to rehabilitation, these services are notoriously underused after catheter procedures. PMID:26602848

  11. Comprehensive cardiac rehabilitation

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;


    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed for...... uncertain and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  12. Molecular Basis of Cardiac Myxomas

    Pooja Singhal


    Full Text Available Cardiac tumors are rare, and of these, primary cardiac tumors are even rarer. Metastatic cardiac tumors are about 100 times more common than the primary tumors. About 90% of primary cardiac tumors are benign, and of these the most common are cardiac myxomas. Approximately 12% of primary cardiac tumors are completely asymptomatic while others present with one or more signs and symptoms of the classical triad of hemodynamic changes due to intracardiac obstruction, embolism and nonspecific constitutional symptoms. Echocardiography is highly sensitive and specific in detecting cardiac tumors. Other helpful investigations are chest X-rays, magnetic resonance imaging and computerized tomography scan. Surgical excision is the treatment of choice for primary cardiac tumors and is usually associated with a good prognosis. This review article will focus on the general features of benign cardiac tumors with an emphasis on cardiac myxomas and their molecular basis.

  13. A Piezoelectric Shear Stress Sensor

    Kim, Taeyang; Saini, Aditya; Kim, Jinwook; Gopalarathnam, Ashok; Zhu, Yong; Palmieri, Frank L.; Wohl, Christopher J.; Jiang, Xiaoning


    In this paper, a piezoelectric sensor with a floating element was developed for shear stress measurement. The piezoelectric sensor was designed to detect the pure shear stress suppressing effects of normal stress generated from the vortex lift-up by applying opposite poling vectors to the: piezoelectric elements. The sensor was first calibrated in the lab by applying shear forces and it showed high sensitivity to shear stress (=91.3 +/- 2.1 pC/Pa) due to the high piezoelectric coefficients of PMN-33%PT (d31=-1330 pC/N). The sensor also showed almost no sensitivity to normal stress (less than 1.2 pC/Pa) because of the electromechanical symmetry of the device. The usable frequency range of the sensor is 0-800 Hz. Keywords: Piezoelectric sensor, shear stress, floating element, electromechanical symmetry

  14. Automatic Implantable Cardiac Defibrillator

    Full Text Available Automatic Implantable Cardiac Defibrillator February 19, 2009 Halifax Health Medical Center, Daytona Beach, FL Welcome to Halifax Health Daytona Beach, Florida. Over the next hour you' ...

  15. Sudden Cardiac Arrest

    ... scan, or MUGA, which shows how well your heart is pumping blood. Magnetic resonance imaging (MRI) which gives doctors detailed pictures of your heart. How is SCA treated? Sudden cardiac arrest should ...

  16. Sudden Cardiac Arrest

    ... Heart Risk Factors & Prevention Heart Diseases & Disorders Atrial Fibrillation (AFib) Sudden Cardiac Arrest (SCA) SCA: Who's At Risk? Prevention of SCA What Causes SCA? SCA Awareness Atrial Flutter Heart Block Heart Failure Sick Sinus Syndrome Substances & Heart Rhythm Disorders Symptoms & ...

  17. Sudden cardiac death

    Aranđelović Aleksandra Č.


    Full Text Available Sudden cardiac death in an athlete is rare and tragic event. An athlete's death draws high public attention given that athletes are considered the healthiest category of society. The vast majority of sudden cardiac death in young athletes is due to congenital cardiac malformations such as hypertrophie cardiomyopathy and various coronary artery anomalies. In athletes over age 35, the usual cause of sudden cardiac death is coronary artery disease. With each tragic death of a young athlete, there is a question why this tragedy has not been prevented. The American College of Sports Medicine and the American Heart Association recommend that a pre-participation exam should include a complete cardiovascular history and physical examination.

  18. Cardiac Risk Assessment

    ... to assess cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring ... LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, ...

  19. Cardiac arrest - cardiopulmonary resuscitation

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi


    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  20. Awareness in cardiac anesthesia.

    Serfontein, Leon


    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  1. Safety in cardiac surgery

    Siregar, S.


    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for Cardio-Thoracic Surgery (NVT) database. The safety of care is usually measured using patient outcomes. If outcomes are not available, the process and structure of care may be used. Outcomes should be adjusted ...

  2. Cardiac rehabilitation in Germany.

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna


    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  3. Ranolazine in Cardiac Arrhythmia.

    Saad, Marwan; Mahmoud, Ahmed; Elgendy, Islam Y; Richard Conti, C


    Ranolazine utilization in the management of refractory angina has been established by multiple randomized clinical studies. However, there is growing evidence showing an evolving role in the field of cardiac arrhythmias. Multiple experimental and clinical studies have evaluated the role of ranolazine in prevention and management of atrial fibrillation, with ongoing studies on its role in ventricular arrhythmias. In this review, we will discuss the pharmacological, experimental, and clinical evidence behind ranolazine use in the management of various cardiac arrhythmias. PMID:26459200

  4. Cardiac tumours in infancy

    Yadava, O.P.


    Cardiac tumours in infancy are rare and are mostly benign with rhabdomyomas, fibromas and teratomas accounting for the majority. The presentation depends on size and location of the mass as they tend to cause cavity obstruction or arrhythmias. Most rhabdomyomas tend to regress spontaneously but fibromas and teratomas generally require surgical intervention for severe haemodynamic or arrhythmic complications. Other relatively rare cardiac tumours too are discussed along with an Indian perspect...

  5. Cardiac Image Registration


    Full Text Available Long procedure time and somewhat suboptimal results hinder the widespread use of catheter ablation of complex arrhythmias such as atrial fibrillation (AF. Due to lack of contrast differentiation between the area of interest and surrounding structures in a moving organ like heart, there is a lack of proper intraprocedural guidance using current imaging techniques for ablation. Cardiac image registration is currently under investigation and is in clinical use for AF ablation. Cardiac image registration, which involves integration of two images in the context of left atrium (LA, is intermodal, with the acquired image and the real-time reference image residing in different image spaces, and involves optimization, where one image space is transformed into the other. Unlike rigid body registration, cardiac image registration is unique and challenging due to cardiac motion during the cardiac cycle and due to respiration. This review addresses the basic principles of the emerging technique of registration and the inherent limitations as they relate to cardiac imaging and registration.

  6. Cardiac Image Registration

    Jasbir Sra


    Full Text Available Long procedure time and somewhat suboptimal results hinder the widespread use of catheter ablation of complex arrhythmias such as atrial fibrillation (AF. Due to lack of contrast differentiation between the area of interest and surrounding structures in a moving organ like heart, there is a lack of proper intraprocedural guidance using current imaging techniques for ablation. Cardiac image registration is currently under investigation and is in clinical use for AF ablation. Cardiac image registration, which involves integration of two images in the context of the left atrium (LA, is intermodal, with the acquired image and the real-time reference image residing in different image spaces, and involves optimization, where one image space is transformed into the other. Unlike rigid body registration, cardiac image registration is unique and challenging due to cardiac motion during the cardiac cycle and due to respiration. This review addresses the basic principles of the emerging technique of registration and the inherent limitations as they relate to cardiac imaging and registration.

  7. Postoperative cardiac arrest due to cardiac surgery complications

    To examine the role of anesthetists in the management of cardiac arrest occurring in association with cardiac anesthesia. In this retrospective study we studied the potential performances for each of the relevant incidents among 712 patients undergoing cardiac operations at Golestan and Naft Hospitals Ahwaz between November 2006 and July 2008. Out of total 712 patients undergoing cardiac surgery, cardiac arrest occurred in 28 cases (3.9%) due to different postoperative complications. This included massive bleeding (50% of cardiac arrest cases, 1.9% of patients); pulseless supra ventricular tachycardia (28.5% of cardiac arrest cases, 1.1% of patients); Heart Failure (7% of cardiac arrest cases, 0.2% of patients); Aorta Arc Rapture (3.5% of cardiac arrest cases, 0.1% of patients); Tamponade due to pericardial effusion (3.5% of cardiac arrest cases, 0.1% of total patients); Right Atrium Rupture (3.5% of cardiac arrest cases, 0.1% of patients) were detected after cardiac surgery. Out of 28 cases 7 deaths occurred (25% of cardiac arrest cases, 0.1% of patients). The most prevalent reason for cardiac arrest during post operative phase was massive bleeding (50%) followed by pulseless supra ventricular tachycardia (28.5%). Six patients had some morbidity and the remaining 15 patients recovered. There are often multiple contributing factors to a cardiac arrest under cardiac anesthesia, as much a complete systematic assessment of the patient, equipment, and drugs should be completed. We also found that the diagnosis and management of cardiac arrest in association with cardiac anesthesia differs considerably from that encountered elsewhere. (author)

  8. Improvement of Shear Wave Motion Detection Using Harmonic Imaging in Healthy Human Liver.

    Amador, Carolina; Song, Pengfei; Meixner, Duane D; Chen, Shigao; Urban, Matthew W


    Quantification of liver elasticity is a major application of shear wave elasticity imaging (SWEI) to non-invasive assessment of liver fibrosis stages. SWEI measurements can be highly affected by ultrasound image quality. Ultrasound harmonic imaging has exhibited a significant improvement in ultrasound image quality as well as for SWEI measurements. This was previously illustrated in cardiac SWEI. The purpose of this study was to evaluate liver shear wave particle displacement detection and shear wave velocity (SWV) measurements with fundamental and filter-based harmonic ultrasound imaging. In a cohort of 17 patients with no history of liver disease, a 2.9-fold increase in maximum shear wave displacement, a 0.11 m/s decrease in the overall interquartile range and median SWV and a 17.6% increase in the success rate of SWV measurements were obtained when filter-based harmonic imaging was used instead of fundamental imaging. PMID:26803391

  9. Shear amorphization of boron suboxide

    We report for the first time the shear-induced local amorphization of boron suboxide subjected to nanoindentation. The amorphous bands have a width of ∼1–3 nm and a length of 200–300 nm along the (01¯11) crystal plane. We show direct experimental evidence that the amorphous shear bands of boron suboxide are driven from the coalescence of dislocation loops under high shear stresses. These observations provide insights into the microscopic deformation and failure of high-strength and lightweight ceramics

  10. Shear Banding of Complex Fluids

    Divoux, Thibaut; Fardin, Marc A.; Manneville, Sebastien; Lerouge, Sandra


    Even in simple geometries, many complex fluids display nontrivial flow fields, with regions where shear is concentrated. The possibility for such shear banding has been known for several decades, but in recent years, we have seen an upsurge in studies offering an ever-more precise understanding of the phenomenon. The development of new techniques to probe the flow on multiple scales with increasing spatial and temporal resolution has opened the possibility for a synthesis of the many phenomena that could only have been thought of separately before. In this review, we bring together recent research on shear banding in polymeric and soft glassy materials and highlight their similarities and disparities.

  11. Grafted polymer under shear flow

    Kumar, Sanjiv; Foster, Damien P.; Giri, Debaprasad; Kumar, Sanjay


    A self-attracting-self-avoiding walk model of polymer chain on a square lattice has been used to gain an insight into the behaviour of a polymer chain under shear flow in a slit of width L. Using exact enumeration technique, we show that at high temperature, the polymer acquires the extended state continuously increasing with shear stress. However, at low temperature the polymer exhibits two transitions: a transition from the coiled to the globule state and a transition to a stem-flower like state. For a chain of finite length, we obtained the exact monomer density distributions across the layers at different temperatures. The change in density profile with shear stress suggests that the polymer under shear flow can be used as a molecular gate with potential application as a sensor.

  12. Shear instabilities in granular flows.

    Goldfarb, David J; Glasser, Benjamin J; Shinbrot, Troy


    Unstable waves have been long studied in fluid shear layers. These waves affect transport in the atmosphere and oceans, in addition to slipstream stability behind ships, aeroplanes and heat-transfer devices. Corresponding instabilities in granular flows have not been previously documented, despite the importance of these flows in geophysical and industrial systems. Here we report that breaking waves can form at the interface between two streams of identical grains flowing on an inclined plane downstream of a splitter plate. Changes in either the shear rate or the angle of incline cause such waves to appear abruptly. We analyse a granular flow model that agrees qualitatively with our experimental data; the model suggests that the waves result from competition between shear and extensional strains in the flowing granular bed. We propose a dimensionless shear number that governs the transition between steady and wavy flows. PMID:11797003

  13. SEDflume - High Shear Stress Flume

    Federal Laboratory Consortium — The U.S. Army Corps of Engineers High Shear Stress flume (SEDflume) is designed for estimating erosion rates of fine-grained and mixed fine/coarse grained sediments...

  14. Proteins in a shear flow

    Szymczak, P.; Cieplak, Marek


    The conformational dynamics of a single protein molecule in a shear flow is investigated using Brownian dynamics simulations. A structure-based coarse grained model of a protein is used. We consider two proteins, ubiquitin and integrin, and find that at moderate shear rates they unfold through a sequence of metastable states—a pattern which is distinct from a smooth unraveling found in homopolymers. Full unfolding occurs only at very large shear rates. Furthermore, the hydrodynamic interactions between the amino acids are shown to hinder the shear flow unfolding. The characteristics of the unfolding process depend on whether a protein is anchored or not, and if it is, on the choice of an anchoring point.

  15. Shear Banding of Complex Fluids

    Divoux, Thibaut; Fardin, Marc-Antoine; Manneville, Sebastien; Lerouge, Sandra


    Even in simple geometries many complex fluids display non-trivial flow fields, with regions where shear is concentrated. The possibility for such shear banding has been known since several decades, but the recent years have seen an upsurge of studies offering an ever more precise understanding of the phenomenon. The development of new techniques to probe the flow on multiple scales and with increasing spatial and temporal resolution has opened the possibility for a synthesis of the many pheno...

  16. Shear Alfven waves in tokamaks

    Shear Alfven waves in an axisymmetric tokamak are examined within the framework of the linearized ideal MHD equations. Properties of the shear Alfven continuous spectrum are studied both analytically and numerically. Implications of these results in regards to low frequency rf heating of toroidally confined plasmas are discussed. The structure of the spatial singularities associated with these waves is determined. A reduced set of ideal MHD equations is derived to describe these waves in a very low beta plasma

  17. Ranolazine inhibits shear sensitivity of endogenous Na+ current and spontaneous action potentials in HL-1 cells

    Strege, Peter; Beyder, Arthur; Bernard, Cheryl; Crespo-Diaz, Ruben; Behfar, Atta; Terzic, Andre; Ackerman, Michael; Farrugia, Gianrico


    NaV1.5 is a mechanosensitive voltage-gated Na+ channel encoded by the gene SCN5A, expressed in cardiac myocytes and required for phase 0 of the cardiac action potential (AP). In the cardiomyocyte, ranolazine inhibits depolarizing Na+ current and delayed rectifier (IKr) currents. Recently, ranolazine was also shown to be an inhibitor of NaV1.5 mechanosensitivity. Stretch also accelerates the firing frequency of the SA node, and fluid shear stress increases the beating rate of cultured cardiomy...

  18. Pediatric cardiac postoperative care

    Auler Jr. José Otávio Costa


    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  19. Giant Cardiac Cavernous Hemangioma.

    Unger, Eric; Costic, Joseph; Laub, Glenn


    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  20. Experimental observation of shear thickening oscillation

    Nagahiro, Shin-ichiro; Nakanishi, Hiizu; Mitarai, Namiko


    We report experimental observations of the shear thickening oscillation, i.e. the spontaneous macroscopic oscillation in the shear flow of severe shear thickening fluid. Using a density-matched starch-water mixture, in the cylindrical shear flow of a few centimeters flow width, we observed that w...

  1. Radiography in cardiology [cardiac disorders, cardiac insufficiency

    The diagnostic procedure in cardiology nearly always requires an X-ray examination of the thorax. This examination is very informative when it is correctly performed and interpreted. The radiographs need to be read precisely and comprehensively: this includes the evaluation of the silhouette of the heart (size, form and position) as well as the examination of extra-cardiac thoracic structures allowing among other things to search for signs of cardiac insufficiency. The conclusion of the X-ray examination can be drawn after having brought together information concerning the case history, the clinical examination and the study of the radiographs. The radiologist finds himself in one of three situations: (1) the information provided by the X-ray pictures is characteristic of a disease and permits a diagnosis, (2) the X-ray pictures indicate a group of hypotheses; further complementary tests could be useful and (3) the X-ray pictures provide ambiguous even contradictory information; it is necessary to complete the radiological examination by other techniques such as an ultrasonographic study of the heart

  2. Serum myoglobin after cardiac catheterisation.

    McComb, J. M.; McMaster, E A


    Study of 80 consecutive patients undergoing elective diagnostic cardiac catheterisation showed that after the procedure 25 (31%) developed myoglobinaemia. This was attributed to complications of the catheterisation in two. The remaining 23 had received premedication by intramuscular injection. In patients without intramuscular injections myoglobinaemia did not occur after uncomplicated cardiac catheterisation. The study did not support the proposition that cardiac catheterisation results in m...

  3. Yield shear stress and disaggregating shear stress of human blood

    Jung, Jinmu; Lee, Byoung-Kwon; Shin, Sehyun


    This review presents two distinct rheological parameters of blood that have the potential to indicate blood circulation adequacy: yield shear stress (YSS) and disaggregating shear stress (DSS). YSS and DSS reflect the strength of red blood cell (RBC) aggregation in suspension under static and dynamic conditions, respectively. YSS, defined as the critical stress to disperse RBC aggregates under static conditions, was found to be dependent upon hematocrit, fibrinogen, and red cell deformability, but not temperature. DSS, defined as the minimum shear stress to disperse RBC aggregates under dynamic conditions, is dependent upon fibrinogen, red cell deformability, and temperature but not hematocrit. Owing to recent advances in measurement technology, these two parameters can be easily measured, and thus, their clinical significance in blood circulation can be verified.

  4. Bicontinuous Microemulsions under Steady Shear Flow

    Kodama, Hiroya; Komura, Shigeyuki


    Dynamic response of microemulsions to shear deformation on the basis of two-order-parameter time dependent Ginzburg-Landau model is investigated by means of cell dynamical system approach. Time evolution of anisotropic factor and excess shear stress under steady shear flow is studied by changing shear rate and total amount of surfactant. As the surfactant concentration is increased, overshoot peak height of the anisotropic factor increases whereas that of the excess shear stress is almost unc...

  5. Shear strength of non-shear reinforced concrete elements

    Hoang, Cao linh


    The report deals with the shear strength of statically indeterminate reinforced concrete beams without shear reinforcement. Solutions for a number of beams with different load and support conditions have been derived by means of the crack sliding model developed by Jin- Ping Zhang.This model is...... based upon the hypothesis that cracks can be transformed into yield lines, which have lower sliding resistance than yield lines formed in uncracked concrete.Proposals have been made on how the derived standard solutions may be applied to more complicated cases, such as continuous beams, beams with...... combined loading, prestressed beams and beams with different reinforcement area at top and bottom....

  6. Hepato-cardiac disorders

    Yasser; Mahrous; Fouad; Reem; Yehia


    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  7. Primary cardiac tumors

    Cardiac tumors happen to be among the less known pathologies without clear treatment standards. Even one decade ago most of the cardiac tumor diagnosis were made post mortem, and only reports of isolated cases could be found in the literature, showing the lack of interest in the investigation of these pathologies by cardiology and cardiovascular surgery specialists. With the development of echocardiography and of cardiovascular surgery, more cases of primary and metastatic cardiac tumors have been diagnosed. Many cases have been treated by palliative or curative surgical interventions, thus increasing the reports in the world literature and the experience in this field, and pointing out the real incidence of these pathologies, not being as bizarre as it had been considered. a revision of the literature will be made, in which the frequency and the suggested interventions will be reported, as well as the cases of cardiac pathology in two cardiovascular centers of the country known by the author. The echocardiographic, pathologic and histological characteristics of the representative cases will be presented, without a greater evidence level, due to the problem's incidence and the few cases reported by these centers

  8. Cardiac MRI tagging

    Cardiac MRI tagging is an original technique based upon the perturbation of the magnetization of determined regions of the myocardium (tags). The motion of the tags accurately reflects the deformation of the underlying tissue. Data analysis requires special techniques to reconstruct the 3D motion of the heart, and to evaluate the myocardial strain, locally and throughout the whole heart. (authors)

  9. Automatic Implantable Cardiac Defibrillator

    Full Text Available ... Over the next hour you'll see the implantation of an automated implantable cardiac defibrillator. The surgery ... evening we're going to be discussing the implantation of a defibrillator. It’s a battery-powered implantable ...

  10. Cardiac effects of vasopressin.

    Pelletier, Jean-Sébastien; Dicken, Bryan; Bigam, David; Cheung, Po-Yin


    Vasopressin is an essential hormone involved in the maintenance of cardiovascular homeostasis. It has been in use therapeutically for many decades, with an emphasis on its vasoconstrictive and antidiuretic properties. However, this hormone has a ubiquitous influence and has specific effects on the heart. Although difficult to separate from its powerful vascular effects in the clinical setting, a better understanding of vasopressin's direct cardiac effects could lead to its more effective clinical use for a variety of shock states by maximizing its therapeutic benefit. The cardiac-specific effects of vasopressin are complex and require further elucidation. Complicating our understanding include the various receptors and secondary messengers involved in vasopressin's effects, which may lead to various results based on differing doses and varying environmental conditions. Thus, there have been contradictory reports on vasopressin's action on the coronary vasculature and on its effect on inotropy. However, beneficial results have been found and warrant further study to expand the potential therapeutic role of vasopressin. This review outlines the effect of vasopressin on the coronary vasculature, cardiac contractility, and on hypertrophy and cardioprotection. These cardiac-specific effects of vasopressin represent an interesting area for further study for potentially important therapeutic benefits. PMID:24621650

  11. Cardiac pacemaker power sources

    A review of chemical and radioisotope batteries used in cardiac pacemakers is presented. The battery systems are examined in terms of longevity, reliability, cost, size and shape, energy density, weight, internal resistance versus time, end-of-life voltage, chemical compatibility, and potential failure mechanisms

  12. [Cardiac amyloidosis. General review].

    Laraki, R


    Cardiac amyloidosis, most often of AL type, is a non-exceptional disease as it represents 5 to 10% of non-ischemic cardiomyopathies. It realizes typically a restrictive cardiomyopathy. Nevertheless the wide diversity of possible presentation makes it a "big shammer" which must be evoked in front of every unexplained cardiopathy after the age of forty. If some associated manifestations can rapidly suggest the diagnosis, as a peripheric neuropathy especially a carpal tunnel syndrome or palpebral ecchymosis, cardiac involvement can also evolve in an apparently isolated way. The most suggestive paraclinic elements for the diagnosis are, in one hand, the increased myocardial echogenicity with a "granular sparkling" appearance seen throughout all walls of the left ventricle and, in the other hand, the association of a thickened left ventricle and a low voltage (electrocardiogram could also show pseudo-infarct Q waves). In front of such aspects, the proof of amyloidosis is brought by an extra-cardiac biopsy or by scintigraphy with labelled serum amyloid P component, so that the indications of endomyocardial biopsy are very limited today. The identification of the amyloid nature of a cardiopathy has an direct therapeutic implication: it contra-indicates the use of digitalis, calcium channel blockers and beta-blockers. The treatment of AL amyloidosis (chemotherapy with alkylant agents) remains very unsatisfactory especially in the cardiac involvement which is the most frequent cause of death (in AL amyloidosis). Last, cardiac amyloidosis is a bad indication for transplantation which results are burden by rapid progression of deposits especially in the gastro-intestinal tract and the nervous system. PMID:8059146

  13. Cardiac surgery outcomes.

    Halpin, Linda S; Barnett, Scott D; Beachy, Jim


    Accrediting organizations and payers are demanding valid and reliable data that demonstrate the value of services. Federal agencies, healthcare industry groups, and healthcare watchdog groups are increasing the demand for public access to outcomes data. A new and growing outcomes dynamic is the information requested by prospective patients in an increasingly consumer-oriented business. Patients demand outcomes, and resources are developing to meet these demands. Physicians are increasingly confronted with requests for information about their mortality and morbidity rates, malpractice suits, and disciplinary actions received. For example, in Virginia, prospective patients have access to data provided by the nonprofit group Virginia Health Information. After numerous resolutions by the Virginia Senate since 1999, the prospective Virginia medical consumer now has access to several annual publications: Virginia Hospitals: A Consumer's Guide, 1999 Annual Report and Strategic Plan Update, and the 1999 Industry Report: Virginia Hospitals and Nursing Facilities. Consumers have access to cardiac outcomes data stratified by hospital, gender, and cardiac service line (cardiac surgery, noninvasive cardiology, and invasive cardiology). This is particularly relevant to IHI because Virginia Health Information specifically targets cardiac care. IHI has a sizable investment in cardiovascular outcomes and has found outcomes measurement and research are key to providing quality care. IHI's goal is to move from an outcomes management model to a disease management model. The hope is to incorporate all aspects of the patient's continuum of care, from preoperative and diagnostic services through cardiac interventions to postoperative rehabilitation. Furthermore, every step along the way will be supported with functional status and quality of life assessments. Although these goals are ambitious and expensive, the return on investment is high. PMID:14618772

  14. Shear Brillouin light scattering microscope.

    Kim, Moonseok; Besner, Sebastien; Ramier, Antoine; Kwok, Sheldon J J; An, Jeesoo; Scarcelli, Giuliano; Yun, Seok Hyun


    Brillouin spectroscopy has been used to characterize shear acoustic phonons in materials. However, conventional instruments had slow acquisition times over 10 min per 1 mW of input optical power, and they required two objective lenses to form a 90° scattering geometry necessary for polarization coupling by shear phonons. Here, we demonstrate a confocal Brillouin microscope capable of detecting both shear and longitudinal phonons with improved speeds and with a single objective lens. Brillouin scattering spectra were measured from polycarbonate, fused quartz, and borosilicate in 1-10 s at an optical power level of 10 mW. The elastic constants, phonon mean free path and the ratio of the Pockels coefficients were determined at microscopic resolution. PMID:26832263

  15. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina;


    causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P ...AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...

  16. Shear loading of costal cartilage

    Subit, Damien


    A series of tests were performed on a single post-mortem human subject at various length scales. First, tabletop tests were performed. Next, the ribs and intercostal muscles were tested with the view to characterize the load transfer between the ribs. Finally, the costal cartilage was tested under shear loading, as it plays an important in the transfer of the load between the ribs and the sternum. This paper reports the results of dynamic shear loading tests performed on three samples of costal cartilage harvested from a single post-mortem human subject, as well as the quantification of the effective Young's modulus estimated from the amount of cartilage calcification.

  17. Cosmic Shear Bias and Calibration in Cosmic Shear Studies

    Taylor, A N


    With the advent of large-scale weak lensing surveys there is a need to understand how realistic, scale-dependent systematics bias cosmic shear and dark energy measurements, and how they can be removed. Here we describe how spatial variations in the amplitude and orientation of realistic image distortions convolve with the measured shear field, mixing the even-parity convergence and odd-parity modes, and bias the shear power spectrum. Many of these biases can be removed by calibration to external data, the survey itself, or by modelling in simulations. The uncertainty in the calibration must be marginalised over and we calculate how this propagates into parameter estimation, degrading the dark energy Figure-of-Merit. We find that noise-like biases affect dark energy measurements the most, while spikes in the bias power have the least impact, reflecting their correlation with the effect of cosmological parameters. We argue that in order to remove systematic biases in cosmic shear surveys and maintain statistica...

  18. Shear strength of non-shear reinforced concrete elements

    Hoang, Cao linh


    . The position of the crack in which sliding takes place is determined by the crack sliding model developed by Jin-Ping Zhang. The theoretical calculations are compared with test results reported in the literature. A good agreement has been found.A simplified method to calculate the shear capacity of T...

  19. Active Control of Shear Thickening in Suspensions

    Lin, Neil Y C; Cates, Michael E; Sun, Jin; Cohen, Itai


    Shear thickening, an increase of viscosity with shear rate, is a ubiquitous phenomena in suspended materials that has implications for broad technological applications. Controlling this thickening behavior remains a major challenge and has led to empirical strategies ranging from altering the particle surfaces and shape to modifying the solvent properties. However, none of these methods allow for active control of flow properties during shear itself. Here, we demonstrate that by strategic imposition of a high-frequency and low-amplitude shear perturbation orthogonal to the primary shearing flow, we can largely eradicate shear thickening. The orthogonal shear effectively becomes a regulator for controlling thickening in the suspension, allowing the viscosity to be reduced by up to two decades on demand. In a separate setup, we show that such effects can be induced by simply agitating the sample transversely to the primary shear direction. Overall, the ability of in situ manipulation of shear thickening paves a...

  20. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)


    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  1. Grouted Connections with Shear Keys

    Pedersen, Ronnie; Jørgensen, M. B.; Damkilde, Lars;


    This paper presents a finite element model in the software package ABAQUS in which a reliable analysis of grouted pile-to-sleeve connections with shear keys is the particular purpose. The model is calibrated to experimental results and a consistent set of input parameters is estimated so that...... different structural problems can be reproduced successfully....

  2. Cardiac arrest in children

    Tress Erika


    Full Text Available Major advances in the field of pediatric cardiac arrest (CA were made during the last decade, starting with the publication of pediatric Utstein guidelines, the 2005 recommendations by the International Liaison Committee on Resuscitation, and culminating in multicenter collaborations. The epidemiology and pathophysiology of in-hospital and out-of-hospital CA are now well described. Four phases of CA are described and the term "post-cardiac arrest syndrome" has been proposed, along with treatment goals for each of its four phases: immediate post-arrest, early post-arrest, intermediate and recovery phase. Hypothermia is recommended to be considered as a therapy for post-CA syndrome in comatose patients after CA, and large multicenter prospective studies are underway. We reviewed landmark articles related to pediatric CA published during the last decade. We present the current knowledge of epidemiology, pathophysiology and treatment of CA relevant to pre-hospital and acute care health practitioners.

  3. Cardiac arrest in children.

    Tress, Erika E; Kochanek, Patrick M; Saladino, Richard A; Manole, Mioara D


    Major advances in the field of pediatric cardiac arrest (CA) were made during the last decade, starting with the publication of pediatric Utstein guidelines, the 2005 recommendations by the International Liaison Committee on Resuscitation, and culminating in multicenter collaborations. The epidemiology and pathophysiology of in-hospital and out-of-hospital CA are now well described. Four phases of CA are described and the term "post-cardiac arrest syndrome" has been proposed, along with treatment goals for each of its four phases: immediate post-arrest, early post-arrest, intermediate and recovery phase. Hypothermia is recommended to be considered as a therapy for post-CA syndrome in comatose patients after CA, and large multicenter prospective studies are underway. We reviewed landmark articles related to pediatric CA published during the last decade. We present the current knowledge of epidemiology, pathophysiology and treatment of CA relevant to pre-hospital and acute care health practitioners. PMID:20930971

  4. Socially differentiated cardiac rehabilitation

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;


    recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated...... standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social...

  5. Cardiac metastases of osteosarcoma

    Osteosarcoma is a malignancy whose various sites of metastasis greatly modify its ultimate prognosis. We report a case of simultaneous pulmonary and cardiac metastases in a 41-year-old male patient with osteosarcoma of the tibia, presenting after more then one year of completion of adjuvant therapy with progressive dyspnea and cyanosis. Diagnosis was made on computerized tomogram and echocardiogram. The metastatic mass entirely occupying the right ventricle and the pulmonary artery proved fatal. (author)

  6. Cardiac Tissue Engineering



    We hypothesized that clinically sized (1-5 mm thick),compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3) can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of p...

  7. Cardiac developmental toxicity

    Mahler, Gretchen J.; Jonathan T Butcher


    Congenital heart disease is a highly prevalent problem with mostly unknown origins. Many cases of CHD likely involve an environmental exposure coupled with genetic susceptibility, but practical and ethical considerations make nongenetic causes of CHD difficult to assess in humans. The development of the heart is highly conserved across all vertebrate species, making animal models an excellent option for screening potential cardiac teratogens. This review will discuss exposures known to cause ...

  8. Penetrating Cardiac Injuries



    Objectives: To present our experience of penetrating cardiac injuries treated at Atatürk University hospital; in 17 years 38 patients were analyzed. Methods: Patients were classified into three groups: group A (stable), 12; group B (shock), 21; and group C (agonal), five. Five patients were treated by pericardial window and three by pericardiocentesis. Two patients in group C, 19 patients in group B and five patients in group A underwent median sternotomy or thoracotomy in the operating room...

  9. Benign cardiac tumours: cardiac CT and MRI imaging appearances

    Full text: Primary benign cardiac tumours are rarely found in clinical practice and are generally evaluated with echocardiography. However, with the increasing usage of helical multislice CT, the initial detection and evaluation of these masses may be made by the radiologist during routine daily practice for other indications. The echocardiographic, CT and cardiac MRI appearances of various benign cardiac tumours and masses are described and illustrated in this review

  10. Cardiac tissue engineering



    Full Text Available We hypothesized that clinically sized (1-5 mm thick,compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3 can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of perfluorocarbons, or with electrical stimulation (continuous application of biphasic pulses, 2 ms, 5 V, 1 Hz. Tissue constructs cultured without perfusion or electrical stimulation served as controls. Medium perfusion and addition of perfluorocarbons resulted in compact, thick constructs containing physiologic density of viable, electromechanically coupled cells, in contrast to control constructs which had only a ~100 mm thick peripheral region with functionally connected cells. Electrical stimulation of cultured constructs resulted in markedly improved contractile properties, increased amounts of cardiac proteins, and remarkably well developed ultrastructure (similar to that of native heart as compared to non-stimulated controls. We discuss here the state of the art of cardiac tissue engineering, in light of the biomimetic approach that reproduces in vitro some of the conditions present during normal tissue development.

  11. Zipper and freeway shear zone junctions

    Passchier, Cees; Platt, John


    Ductile shear zones are usually presented as isolated planar high-strain domains in a less deformed wall rock, characterised by shear sense indicators such as characteristic deflected foliation traces. Many shear zones, however, form branched systems and if movement on such branches is contemporaneous, the resulting geometry can be complicated and lead to unusual fabric geometries in the wall rock. For Y-shaped shear zone junctions with three simultaneously operating branches, and with slip directions at a high angle to the branch line, eight basic types of shear zone triple junctions are possible, divided into three groups. The simplest type, called freeway junctions, have similar shear sense on all three branches. If shear sense is different on the three branches, this can lead to space problems. Some of these junctions have shear zone branches that join to form a single branch, named zipper junctions, or a single shear zone which splits to form two, known as wedge junctions. Closing zipper junctions are most unusual, since they form a non-active high-strain zone with opposite deflection of foliations. Shear zipper and shear wedge junctions have two shear zones with similar shear sense, and one with the opposite sense. All categories of shear zone junctions show characteristic flow patterns in the shear zone and its wall rock. Shear zone junctions with slip directions normal to the branch line can easily be studied, since ideal sections of shear sense indicators lie in the plane normal to the shear zone branches and the branch line. Expanding the model to allow slip oblique and parallel to the branch line in a full 3D setting gives rise to a large number of geometries in three main groups. Slip directions can be parallel on all branches but oblique to the branch line: two slip directions can be parallel and a third oblique, or all three branches can have slip in different directions. Such more complex shear zone junctions cannot be studied to advantage in a

  12. Indeterminacy of Spatiotemporal Cardiac Alternans

    Zhao, Xiaopeng


    Cardiac alternans, a beat-to-beat alternation in action potential duration (at the cellular level) or in ECG morphology (at the whole heart level), is a marker of ventricular fibrillation, a fatal heart rhythm that kills hundreds of thousands of people in the US each year. Investigating cardiac alternans may lead to a better understanding of the mechanisms of cardiac arrhythmias and eventually better algorithms for the prediction and prevention of such dreadful diseases. In paced cardiac tissue, alternans develops under increasingly shorter pacing period. Existing experimental and theoretical studies adopt the assumption that alternans in homogeneous cardiac tissue is exclusively determined by the pacing period. In contrast, we find that, when calcium-driven alternans develops in cardiac fibers, it may take different spatiotemporal patterns depending on the pacing history. Because there coexist multiple alternans solutions for a given pacing period, the alternans pattern on a fiber becomes unpredictable. Usin...

  13. Biosynthesis of cardiac natriuretic peptides

    Goetze, Jens Peter


    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac p...... competent endocrine cells. The structurally related atrial natriuretic peptide will be mentioned where appropriate, whereas C-type natriuretic peptide will not be considered as a cardiac peptide of relevance in mammalian physiology....... characterized. An ongoing characterization of the molecular heterogeneity will help appreciate the biosynthetic capacity of the endocrine heart and could introduce new diagnostic possibilities. Notably, different biosynthetic products may not be equal markers of the same pathophysiological processes. An...... inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  14. Biosynthesis of cardiac natriuretic peptides

    Goetze, Jens Peter


    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...... inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...... competent endocrine cells. The structurally related atrial natriuretic peptide will be mentioned where appropriate, whereas C-type natriuretic peptide will not be considered as a cardiac peptide of relevance in mammalian physiology....

  15. An overview of cardiac morphogenesis.

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile


    Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In this article we review the different steps of heart development, focusing on the processes of alignment and septation. We also show, as often as possible, the links between abnormalities of cardiac development and the main congenital heart defects. The development of animal models has permitted the unraveling of many mechanisms that potentially lead to cardiac malformations. A next step towards a better knowledge of cardiac development could be multiscale cardiac modelling. PMID:24138816

  16. Sudden Cardiac Death in Athletes.

    Wasfy, Meagan M; Hutter, Adolph M; Weiner, Rory B


    There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed. PMID:27486488

  17. Cardiac Rehabilitation: Guidelines and Recommendations

    Catherine Monpere


    Cardiac rehabilitation has been shown to improve exercise tolerance and symptomatology in patients experiencing angina or heart failure and reduce long term mortality after myocardial infarction, with a good cost-effectiveness ratio. In addition to these `hard' endpoints, cardiac rehabilitation improves the patient's quality of life and risk factor profile through a multifactorial intervention. Indeed, cardiac rehabilitation is no longer restricted to physical reconditioning, but should now b...

  18. Effects of shear on proteins in solution

    Thomas, C. R.; Geer, D.


    Abstract The effects of ?shear? on proteins in solution are described and discussed. Research on this topic covers many decades, beginning with investigations of possible denaturation of enzymes during processing, whilst more recent concerns are how the quality of therapeutic proteins might be affected by shear or shear related effects. The paradigm that emerges from most studies is that shear in the fluid mechanical sense is unlikely by itself to damage most proteins and that inte...

  19. Shear behaviour of reinforced phyllite concrete beams

    Highlights: ► Phyllite concrete beams often exhibited shear with anchorage bond failure. ► Different shear design provisions for reinforced phyllite beams are compared. ► Predicted shear capacity of phyllite beams must be modified by a reduction factor. -- Abstract: The shear behaviour of concrete beams made from phyllite aggregates subjected to monotonic and cyclic loading is reported. First diagonal shear crack load of beams with and without shear reinforcement was between 42–58% and 42–92% of the failure loads respectively. The phyllite concrete beams without shear links had lower post-diagonal cracking shear resistance compared to corresponding phyllite beams with shear links. As a result of hysteretic energy dissipation, limited cyclic loading affected the stiffness, strength and deformation of the phyllite beams with shear reinforcement. Generally, beams with and without shear reinforcement showed anchorage bond failure in addition to the shear failure due to high stress concentration near the supports. The ACI, BS and EC codes are conservative for the prediction of phyllite concrete beams without shear reinforcement but they all overestimate the shear strength of phyllite concrete beams with shear reinforcement. It is recommended that the predicted shear capacity of phyllite beams reinforced with steel stirrups be modified by a reduction factor of 0.7 in order to specify a high enough safety factor on their ultimate strength. It is also recommended that susceptibility of phyllite concrete beams to undergo anchorage bond failure is averted in design by the provision of greater anchorage lengths than usually permitted.

  20. Diagnostic imaging of cardiac hypertrophy

    As imaging techniques for cardiac hypertrophy, the ultrasonic dimension gauze technique, echocardiography, ventriculography and the RI technique including emission RI tomography were outlined. (Chiba, N.)

  1. Developments in Plasticity Approach to Shear

    Hoang, Cao Linh; Nielsen, Mogens Peter

    The paper deals with plastic methods applied to shear design of reinforced concrete beams. Emphasis is put on the recently developed crack sliding model applicable to non-shear reinforced and lightly shear reinforced beams and slabs. The model, which is an upper bound plasticity approach, takes...

  2. Shear instability of a gyroid diblock copolymer

    Eskimergen, Rüya; Mortensen, Kell; Vigild, Martin Etchells


    -induced destabilization is discussed in relation to analogous observations on shear-induced order-to-order and disorder-to-order transitions observed in related block copolymer systems and in microemulsions. It is discussed whether these phenomena originate in shear-reduced fluctuations or shear-induced dislocations....

  3. Statistical Model of Extreme Shear

    Larsen, Gunner Chr.; Hansen, Kurt Schaldemose


    In order to continue cost-optimisation of modern large wind turbines, it is important to continously increase the knowledge on wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... model that, on a statistically consistent basis, describe the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of high-sampled full-scale time series measurements. the...... consistent, given the inevitabel uncertainties associated with model as well as with the extreme value data analysis. Keywords: Statistical model, extreme wind conditions, statistical analysis, turbulence, wind loading, statistical analysis, turbulence, wind loading, wind shear, wind turbines....

  4. Cardiac manifestations of myotonic dystrophy type 1

    Petri, Helle; Vissing, John; Witting, Nanna; Bundgaard, Henning; Køber, Lars


    To estimate the degree of cardiac involvement regarding left ventricular ejection fraction, conduction abnormalities, arrhythmia, risk of sudden cardiac death (SCD) and the associations between cardiac involvement and cytosine-thymine-guanine (CTG)-repeat, neuromuscular involvement, age and gender...

  5. Kinematics and shear heat pattern of ductile simple shear zones with `slip boundary condition'

    Mulchrone, Kieran F.; Mukherjee, Soumyajit


    Extrusion by Poiseuille flow and simple shear of hot lower crust has been deciphered from large hot orogens, and partial-slip boundary condition has been encountered in analogue models. Shear heat and velocity profiles are deduced from a simplified form of Navier-Stokes equation for simple shear together with extrusive Poiseuille flow and slip boundary condition for Newtonian viscous rheology. A higher velocity at the upper boundary of the shear zone promotes higher slip velocity at the lower boundary. The other parameters that affect the slip are viscosity and thickness of the shear zone and the resultant pressure gradient that drives extrusion. In the partial-slip case, depending on flow parameters (resultant pressure gradient, density and viscosity) and thickness of the shear zone, the velocity profiles can curve and indicate opposite shear senses. The corresponding shear heat profiles can indicate temperature maximum inside shear zones near either boundaries of the shear zone, or equidistant from them.

  6. Antifibrinolytics in cardiac surgery

    Achal Dhir


    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  7. Single ventricle cardiac defect

    Single ventricle heart is defined as a rare cardiac abnormality with a single ventricle chamber involving diverse functional and physiological defects. Our case is of a ten month-old baby boy who died shortly after admission to the hospital due to vomiting and diarrhoea. Autopsy findings revealed cyanosis of finger nails and ears. Internal examination revealed; large heart, weighing 60 grams, single ventricle, without a septum and upper membranous part. Single ventricle is a rare pathology, hence, this paper aims to discuss this case from a medico-legal point of view. (author)

  8. Shear Strength of Reinforced Concrete Shear Walls under Eccentric Tensile Axial Force

    MIZOGUCHI, Mitsuo; ARAI, Yasuyuki; Hosoya, Koji


    Six reinforced concrete shear wall models were built and tested to investigate effects of cyclic lateral loading and an eccentric tensile axial force on their shear strength behavior. The following are confirmed from this test result. When the elongation at the bottom of the boundary column on the compression side for a lateral force is small, the shear strength of shear walls subjected to a tensile axial force at the boundary column can be evaluated by conventional shear strenght equations, ...

  9. Influence of shear stress on erythrocyte aggregation.

    Kim, Jeong-Ho; Lee, Hoyoon; Lee, Byoung-Kwon; Shin, Sehyun


    Shear stress is known to induce platelet activation and aggregation. The red blood cell (RBC) aggregation test requires the application of shear stress for the cells to disaggregate for initialization. We tested the hypothesis that applying shear stress may activate platelets, which can influence RBC aggregation. The present study used a commercial microchip-based aggregometer (RheoSCan-AnD300) with a rotating stirrer for RBC disaggregation. Whole blood samples were exposed to different magnitudes of shear stress with various shearing times. As the rotational speed was increased up to 2800 rpm, the RBC aggregation index (AI) of the whole blood increased by up to 30% (p <  0.05), whereas that of the platelet-excluded blood samples did not show any apparent alteration. The AI also increased in proportion with the stirring time. The data suggest that high shear stress affects RBC aggregation through shear-induced platelet aggregation. PMID:26444600

  10. Magnetic shear. II - Hale region 17244

    A B-gamma(delta) sunspot group with growing delta-spots of trailing polarity shows evidence in H-alpha filament structure of a transition from a state of weak magnetic shear to a state of strong shear. The shear develops in the chromosphere and transition region to the corona overlying the photospheric magnetic neutral line separating the delta-spots from the leading polarity at a time when the delta-spots are undergoing rapid growth. Several major flares occur along the sheared portion of the neutral line following the shear development. Other segments of the neutral line far removed from the delta-spots show similar evidence of shear in the H-alpha filament structure and in C IV velocity patterns as well. These quiescent regions of shear are relatively steady or decaying with time and show very little related activity. 11 references

  11. Hypokalemia and sudden cardiac death

    Kjeldsen, Keld


    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient...... of fatal arrhythmia and sudden cardiac death a patient is, the more attention should be given to the potassium homeostasis....

  12. Atrial tumors in cardiac MRI

    Cardiac magnetic resonance imaging (MRI) is an important tool for the diagnosis of cardiac masses. Various cardiac tumors are predisposed to occurring in atrial structures. The aim of this review article is the description of atrial tumors and their morphological features in MRI. In general, cardiac tumors are rare: approximately 0.001-0.03% in autopsy studies. About 75% of them are benign. The most common cardiac tumor is the myxoma. They are predisposed to occur in the atria and show a characteristically strong hyperintense signal on T2-wieghted images in MRI. In other sequences a heterogeneous pattern reflects its variable histological appearance. Lipomas exhibit a signal behavior identical to fatty tissue with a typical passive movement in cine imaging. Fibroelastomas are the most common tumors of the cardiac valves. Consisting of avascular fibrous tissue, they often present with hypointense signal intensities. Thrombi attached to their surface can cause severe emboli even in small tumors. Amongst primary cardiac malignancies, sarcomas are most common and favor the atria. Secondary malignancies of the heart are far more common than primary ones (20-40 times). In case of known malignancies, approximately 10% of patients develop cardiac metastasis at the end of their disease. Lymphogenic metastases favor the pericardium, while hematogenic spread prefers the myocardium. Since they are not real atrial tumors, thrombi and anatomical structures of the atria have to be differentiated from other pathologies. (orig.)

  13. Cardiac arrest – cardiopulmonary resuscitation

    Basri Lenjani


    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  14. Pneumothorax in cardiac pacing

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;


    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  15. Leadership in cardiac surgery.

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos


    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance. PMID:20884217

  16. Cardiac chamber scintiscanning

    The two methods of cardiac chamber scintiscanning, i.e. 'first pass' and 'ECG-triggered' examinations, are explained and compared. Two tables indicate the most significant radiation doses of the applied radio tracers, i.e. 99m-Tc-pertechnetate and 99m-Tc-HSA, to which a patient is exposed. These averaged values are calculated from various data given in specialised literature. On the basis of data given in literature, an effective half-life of approximately 5 hours in the intravascular space was calculated for the erythrocytes labelled with technetium 99m. On this basis, the radiation doses for the patients due to 99m-Tc-labelled erythrocytes are estimated. The advantages and disadvantages of the two methods applied for cardiac chamber scintiscanning are put into contrast and compared with the advantages and disadvantages of the quantitative X-ray cardiography of the left heart. The still existing problems connected with the assessment of ECG-triggered images are discussed in detail. The author performed investigations of his own, which concerned the above-mentioned problems. (orig./MG)

  17. Affect intensity and cardiac arousal.

    Blascovich, J; Brennan, K; Tomaka, J; Kelsey, R M; Hughes, P; Coad, M L; Adlin, R


    Relationships between affect intensity and basal, evoked, and perceived cardiac arousal were investigated in 3 experiments. Affect intensity was assessed using Larsen and Diener's (1987) Affect Intensity Measure (AIM). Cardiac arousal was evoked with exercise in the 1st study and with mental arithmetic in the 2nd and 3rd. Perceived cardiac arousal was measured under optimal conditions using a standard heartbeat discrimination procedure. Women as a group scored higher on the AIM. Affect intensity was unrelated to basal or evoked cardiac arousal and was negatively related to perceived cardiac arousal in all 3 studies. Data suggest that affect intensity, although unrelated to actual physiological arousal, is negatively related to the accuracy with which individuals perceive their own arousal. Results are discussed within the context of an expanded arousal-regulation model (Blascovich, 1990). PMID:1494983

  18. Magnetogenesis through Relativistic Velocity Shear

    Miller, Evan

    Magnetic fields at all scales are prevalent in our universe. However, current cosmological models predict that initially the universe was bereft of large-scale fields. Standard magnetohydrodynamics (MHD) does not permit magnetogenesis; in the MHD Faraday's law, the change in magnetic field B depends on B itself. Thus if B is initially zero, it will remain zero for all time. A more accurate physical model is needed to explain the origins of the galactic-scale magnetic fields observed today. In this thesis, I explore two velocity-driven mechanisms for magnetogenesis in 2-fluid plasma. The first is a novel kinematic 'battery' arising from convection of vorticity. A coupling between thermal and plasma oscillations, this non-relativistic mechanism can operate in flows that are incompressible, quasi-neutral and barotropic. The second mechanism results from inclusion of thermal effects in relativistic shear flow instabilities. In such flows, parallel perturbations are ubiquitously unstable at small scales, with growth rates of order with the plasma frequency over a defined range of parameter-space. Of these two processes, instabilities seem far more likely to account for galactic magnetic fields. Stable kinematic effects will, at best, be comparable to an ideal Biermann battery, which is suspected to be orders of magnitude too weak to produce the observed galactic fields. On the other hand, instabilities grow until saturation is reached, a topic that has yet to be explored in detail on cosmological scales. In addition to investigating these magnetogenesis sources, I derive a general dispersion relation for three dimensional, warm, two species plasma with discontinuous shear flow. The mathematics of relativistic plasma, sheared-flow instability and the Biermann battery are also discussed.

  19. Punching shear capacity of reinforced concrete slabs with headed shear studs

    Hoang, Linh Cao; Pop, Anamaria


    Punching shear in slabs is analogous to shear in beams. Despite this similarity, current design codes provide distinctly different methods for the design of shear reinforcement in the two situations. For example, the Eurocode method for beam shear design is founded on the theory of rigid plasticity....... To design shear reinforcement in slabs, on the other hand, the engineer must settle for an empirical equation. The aim of the study reported is to demonstrate that it is possible in a simple manner to design shear reinforcement in slabs based on the same rigid-plasticity foundation as for beam shear...... design. For this purpose, an extension of the upper-bound crack sliding model is proposed. This involves analysis of sliding mechanisms in yield lines developed both within and outside the zone with shear reinforcement. Various types of headed shear studs were considered. The results obtained using the...

  20. Magnetorheological Shear Flow Near Jamming

    Vågberg, Daniel; Tighe, Brian


    Flow in magnetorheological (MR) fluids and systems near jamming both display hallmarks of complex fluid rheology, including yield stresses and shear thinning viscosities. They are also tunable, which means that both phenomena can be used as a switching mechanism in ``smart'' fluids, i.e. fluids where properties can be tuned rapidly and reversibly by changing external parameters. We use numerical simulations to investigate the rheological properties of MR fluids close to the jamming transition as a function of the applied field and volume fraction. We are especially interested in the crossover region where both phenomena are needed to describe the observed dynamics. Funded by the Dutch Organization for Scientific Research (NWO).

  1. Statistical Model of Extreme Shear

    Hansen, Kurt Schaldemose; Larsen, Gunner Chr.


    In order to continue cost-optimisation of modern large wind turbines, it is important to continuously increase the knowledge of wind field parameters relevant to design loads. This paper presents a general statistical model that offers site-specific prediction of the probability density function...... model that, on a statistically consistent basis, describes the most likely spatial shape of an extreme wind shear event. Predictions from the model have been compared with results from an extreme value data analysis, based on a large number of full-scale measurements recorded with a high sampling rate...

  2. Mixing in shear thinning fluids

    H. Ameur


    Full Text Available In the present study, a CFD characterization of the flow generated by curved-blade impellers in a cylindrical unbaffled vessel was carried out. The tank diameter was 300 mm, with a flat bottom. The liquid height was equal to the vessel diameter. The fluids simulated have a shear thinning behavior. Analyses concern the effect of the impeller speed, the fluid rheology and the number of impeller blades on the induced flow patterns and the power consumption. The predictions were compared with literature data and a satisfactory agreement was found.

  3. Shear Mechanics of the TMJ Disc

    Juran, C.M.; Dolwick, M.F.; McFetridge, P.S.


    The temporomandibular joint (TMJ) is a complex hinge and gliding joint that induces significant shear loads onto the fibrocartilage TMJ disc during jaw motion. The purpose of this study was to assess regional variation in the disc’s shear loading characteristics under physiologically relevant loads and to associate those mechanical findings with common clinical observations of disc fatigue and damage. Porcine TMJ discs were compressed between an axially translating bottom platen and a 2.5-cm-diameter indenter within a hydrated testing chamber. Discs were cyclically sheared at 0.5, 1, or 5 Hz to 1, 3, or 5% shear strain. Within the anterior and intermediate regions of the disc when sheared in the anteroposterior direction, both shear and compressive moduli experienced a significant decrease from instantaneous to steady state, while the posterior region’s compressive modulus decreased approximately 5%, and no significant loss of shear modulus was noted. All regions retained their shear modulus within 0.5% of instantaneous values when shear was applied in the mediolateral direction. The results of the disc’s regional shear mechanics suggest an observable and predictable link with the common clinical observation that the posterior region of the disc is most often the zone in which fatigue occurs, which may lead to disc damage and perforation. PMID:23166043

  4. Cardiac potassium channel subtypes

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter


    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...... drive the late repolarization of the ventricle with some redundancy, and in atria this repolarization reserve is supplemented by the fairly atrial-specific KV1.5, Kir3, KCa, and K2P channels. The role of the latter two subtypes in atria is currently being clarified, and several findings indicate that...... they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K(+) channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure. The...

  5. Trends in Cardiac Pacemaker Batteries

    Venkateswara Sarma Mallela


    Full Text Available Batteries used in Implantable cardiac pacemakers-present unique challenges to their developers and manufacturers in terms of high levels of safety and reliability. In addition, the batteries must have longevity to avoid frequent replacements. Technological advances in leads/electrodes have reduced energy requirements by two orders of magnitude. Micro-electronics advances sharply reduce internal current drain concurrently decreasing size and increasing functionality, reliability, and longevity. It is reported that about 600,000 pacemakers are implanted each year worldwide and the total number of people with various types of implanted pacemaker has already crossed 3 million. A cardiac pacemaker uses half of its battery power for cardiac stimulation and the other half for housekeeping tasks such as monitoring and data logging. The first implanted cardiac pacemaker used nickel-cadmium rechargeable battery, later on zinc-mercury battery was developed and used which lasted for over 2 years. Lithium iodine battery invented and used by Wilson Greatbatch and his team in 1972 made the real impact to implantable cardiac pacemakers. This battery lasts for about 10 years and even today is the power source for many manufacturers of cardiac pacemakers. This paper briefly reviews various developments of battery technologies since the inception of cardiac pacemaker and presents the alternative to lithium iodine battery for the near future.

  6. Platelets and cardiac arrhythmia

    JonasSDe Jong


    Full Text Available Sudden cardiac death remains one of the most prevalent modes of death in industrialized countries, and myocardial ischemia due to thrombotic coronary occlusion is its primary cause. The role of platelets in the occurrence of SCD extends beyond coronary flow impairment by clot formation. Here we review the substances released by platelets during clot formation and their arrhythmic properties. Platelet products are released from three types of platelet granules: dense core granules, alpha-granules, and platelet lysosomes. The physiologic properties of dense granule products are of special interest as a potential source of arrhythmic substances. They are released readily upon activation and contain high concentrations of serotonin, histamine, purines, pyrimidines, and ions such as calcium and magnesium. Potential arrhythmic mechanisms of these substances, e.g. serotonin and high energy phosphates, include induction of coronary constriction, calcium overloading, and induction of delayed after-depolarizations. Alpha-granules produce thromboxanes and other arachidonic acid products with many potential arrhythmic effects mediated by interference with cardiac sodium, calcium and potassium channels. Alpha-granules also contain hundreds of proteins that could potentially serve as ligands to receptors on cardiomyocytes. Lysosomal products probably do not have an important arrhythmic effect. Platelet products and ischemia can induce coronary permeability, thereby enhancing interaction with surrounding cardiomyocytes. Antiplatelet therapy is known to improve survival after myocardial infarction. Although an important part of this effect results from prevention of coronary clot formation, there is evidence to suggest that antiplatelet therapy also induces anti-arrhythmic effects during ischemia by preventing the release of platelet activation products.

  7. Design of a Pulsatile Flow Facility to Evaluate Thrombogenic Potential of Implantable Cardiac Devices

    Arjunon, Sivakkumar; Ardana, Pablo Hidalgo; Saikrishnan, Neelakantan; Madhani, Shalv; Foster, Brent; Glezer, Ari; Yoganathan, Ajit P.


    Due to expensive nature of clinical trials, implantable cardiac devices should first be extensively characterized in vitro. Prosthetic heart valves (PHVs), an important class of these devices, have been shown to be associated with thromboembolic complications. Although various in vitro systems have been designed to quantify blood-cell damage and platelet activation caused by nonphysiological hemodynamic shear stresses in these PHVs, very few systems attempt to characterize both blood damage a...

  8. Metoclopramide-induced cardiac arrest

    Martha M. Rumore


    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  9. Local Gravitational Instability of Magnetized Shear Flows

    Howes, G G; McWilliams, J C; Howes, Gregory G.; Cowley, Steven C.; Williams, James C. Mc


    The effect of magnetic shear and shear flow on local gravitationally induced instabilities is investigated. A simple model is constructed allowing for an arbitrary entropy gradient and a shear plasma flow in the Boussinesq approximation. A transformation to shearing magnetic coordinates achieves a model with plasma flow along the magnetic field lines where the coordinate lines are coincident with the field lines. The solution for the normal modes of the system depends on two parameters: the Alfven Mach number of the plasma flow and the entropy gradient. The behavior of the unstable normal modes of this system is summarized by a stability diagram. Important characteristics of this stability diagram are the following: magnetic shear is stabilizing and the entropy gradient must exceed a threshold value for unstable mode growth to occur; flow acts to suppress mode growth in a substantially unstable regime as expected, yet near marginal stability it can lessen the stabilizing effect of magnetic shear and enhance t...

  10. Anisotropic thermal conductivity in sheared polypropylene

    Dai, Shao Cong; Tanner, Roger I. [The University of Sydney, Rheology Research Group, School of Aerospace, Mechanical and Mechatronic Engineering, Sydney, NSW (Australia)


    We discuss the anisotropy of the thermal conductivity tensor in polymer flow in this paper. Isotactic polypropylene (iPP) specimens were deformed by injection moulding at high shear rates and by steady shear at low shear rates, and were then quenched. The thermal conductivities parallel and perpendicular to the shear direction were measured using modulated differential scanning calorimetry (MDSC) in accordance with the ASTM E1952-01. The measured results showed that the thermal conductivity of the sheared polymer was anisotropic with an increase in the shear direction. The thermal conductivity can be regarded as varying either with the strain or the stress, as suggested by Van den Brule (1989). In addition to the Van den Brule mechanism, crystallization during flow also changes the thermal conductivity and this effect may often be dominant. Suggestions for procedures in processing computations, based on both effects, are given. (orig.)

  11. Shear banding in mesoscopic dusty plasma liquids

    We experimentally demonstrate shear banding and construct a microscopic dynamic picture of a sheared 2D mesoscopic dust Coulomb liquid at the kinetic level. Under the topological constraints from the discreteness and finite boundary, the nonlinear threshold-type response of motion to the local stress induced by thermal and external drives leads to shear thinning and the enhanced avalanche-type local topological transitions with stress relaxation in the form of clusters. It causes the formation of the outer shear bands in which the mean shear rate, the velocity fluctuations, and the structural rearrangement rate are all enhanced, and leaves a weakly perturbed center band. The typical size of the cooperative hopping vortex (about three interparticle distance) sets up a common length scale for the widths of the confinement induced layering and the shear band

  12. Hierarchical Cosmic Shear Power Spectrum Inference

    Alsing, Justin; Jaffe, Andrew H; Kiessling, Alina; Wandelt, Benjamin; Hoffmann, Till


    We develop a Bayesian hierarchical modelling approach for cosmic shear power spectrum inference, jointly sampling from the posterior distribution of the cosmic shear field and its (tomographic) power spectra. Inference of the shear power spectrum is a powerful intermediate product for a cosmic shear analysis, since it requires very few model assumptions and can be used to perform inference on a wide range of cosmological models \\emph{a posteriori} without loss of information. We show that joint posterior for the shear map and power spectrum can be sampled effectively by Gibbs sampling, iteratively drawing samples from the map and power spectrum, each conditional on the other. This approach neatly circumvents difficulties associated with complicated survey geometry and masks that plague frequentist power spectrum estimators, since the power spectrum inference provides prior information about the field in masked regions at every sampling step. We demonstrate this approach for inference of tomographic shear $E$-...

  13. Cardiac perioperative complications in noncardiac surgery

    Radovanović Dragana; Kolak Radmila; Stokić Aleksandar; Radovanović Zoran; Jovanović Gordana


    Anesthesiologists are confronted with an increasing population of patients undergoing noncardiac surgery who are at risk for cardiac complications in the perioperative period. Perioperative cardiac complications are responsible for significant mortality and morbidity. The aim of the present study was to determine the incidence of perioperative (operative and postoperative) cardiac complications and correlations between the incidence of perioperative cardiac complications and type of surgical ...

  14. Epigenetic regulation in cardiac fibrosis

    Li-Ming; Yu; Yong; Xu


    Cardiac fibrosis represents an adoptive response in the heart exposed to various stress cues. While resolution of the fibrogenic response heralds normalization of heart function, persistent fibrogenesis is usually associated with progressive loss of heart function and eventually heart failure. Cardiac fibrosis is regulated by a myriad of factors that converge on the transcription of genes encoding extracellular matrix proteins, a process the epigenetic machinery plays a pivotal role. In this minireview, we summarize recent advances regarding the epigenetic regulation of cardiac fibrosis focusing on the role of histone and DNA modifications and non-coding RNAs.

  15. Periodic Exponential Shear of Complex Fluids

    Kalelkar, Chirag; McKinley, Gareth


    We define a class of flows with exponential kinematics termed Periodic Exponential Shear (PES) flow which involve periodic exponential stretching of fluid elements along with their rotation. We exhibit analytical and numerical results for PES flow by using the Oldroyd-B model for viscoelastic fluids. We calculate the growth in the shear and the normal stresses analytically as well as demonstrate that repeated application of the flow leads to stable oscillatory shear and normal stresses. We de...

  16. Shear wall experiments and design in Japan

    Park, Y.J.; Hofmayer, C.


    This paper summarizes the results of recent survey studies on the available experimental data bases and design codes/standards for reinforced concrete (RC) shear wall structures in Japan. Information related to the seismic design of RC reactor buildings and containment structures was emphasized in the survey. The seismic requirements for concrete structures, particularly those related to shear strength design, are outlined. Detailed descriptions are presented on the development of Japanese shear wall equations, design requirements for containment structures, and ductility requirements.

  17. Interfacial Slip in Sheared Polymer Blends

    Lo, Tak Shing; Mihajlovic, Maja; Shnidman, Yitzhak; Li, Wentao; Gersappe, Dilip


    We have developed a dynamic self-consistent field theory, without any adjustable parameters, for unentangled polymer blends under shear. Our model accounts for the interaction between polymers, and enables one to compute the evolution of the local rheology, microstructure and the conformations of the polymer chains under shear self-consistently. We use this model to study the interfacial dynamics in sheared polymer blends and make a quantitative comparison between this model and Molecular Dyn...

  18. Shear wall experiments and design in Japan

    This paper summarizes the results of recent survey studies on the available experimental data bases and design codes/standards for reinforced concrete (RC) shear wall structures in Japan. Information related to the seismic design of RC reactor buildings and containment structures was emphasized in the survey. The seismic requirements for concrete structures, particularly those related to shear strength design, are outlined. Detailed descriptions are presented on the development of Japanese shear wall equations, design requirements for containment structures, and ductility requirements

  19. Dynamo efficiency with shear in helical turbulence .

    Leprovost, Nicolas; Kim, Eun-Jin


    To elucidate the influence of shear flow on the generation of magnetic fields through the modification of turbulence property, we consider the case where a large-scale magnetic field is parallel to a large-scale shear flow without direct interaction between the two in the kinematic limit where the magnetic field does not backreact on the velocity. By nonperturbatively incorporating the effect of shear in a helically forced turbulence, we show that turbulence intensity and turbulent transport ...

  20. Sources of helicopter rotor hub inplane shears

    Kottapalli, Sesi


    Sources of helicopter rotor hub inplane shears are identified using simplified equations and the full aeroelastic analysis code, CAMRAD/JA (Johnson, 1988). Analytical results are obtained for an articulated rotor operating at moderate thrust and high airspeed. It is found that the blade chordwise inplane shear, which includes the aerodynamic component, the Coriolis contribution, and the inertial component, and the hub inplane shears are strongly dependent on the out-of-plane response. The sources of helicopter rotor hub inplane shears lie not only in the inplane response but depend on the flap and elastic flatwise responses/modes.

  1. Determination of arterial wall shear stress


    The arteries can remodel their structure and function to adapt themselves to the mechanical environment. In various factors that lead to vascular remodeling, the shear stress on the arterial wall induced by the blood flow is of great importance. However, there are many technique difficulties in measuring the wall shear stress directly at present. In this paper, through analyzing the pulsatile blood flow in arteries, a method has been proposed that can determine the wall shear stress quantitatively by measuring the velocity on the arterial axis, and that provides a necessary means to discuss the influence of arterial wall shear stress on vascular remodeling.

  2. Dynamic shear deformation in high purity Fe

    Cerreta, Ellen K [Los Alamos National Laboratory; Bingert, John F [Los Alamos National Laboratory; Trujillo, Carl P [Los Alamos National Laboratory; Lopez, Mike F [Los Alamos National Laboratory; Gray, George T [Los Alamos National Laboratory


    The forced shear test specimen, first developed by Meyer et al. [Meyer L. et al., Critical Adiabatic Shear Strength of Low Alloyed Steel Under Compressive Loading, Metallurgical Applications of Shock Wave and High Strain Rate Phenomena (Marcel Decker, 1986), 657; Hartmann K. et al., Metallurgical Effects on Impact Loaded Materials, Shock Waves and High Strain rate Phenomena in Metals (Plenum, 1981), 325-337.], has been utilized in a number of studies. While the geometry of this specimen does not allow for the microstructure to exactly define the location of shear band formation and the overall mechanical response of a specimen is highly sensitive to the geometry utilized, the forced shear specimen is useful for characterizing the influence of parameters such as strain rate, temperature, strain, and load on the microstructural evolution within a shear band. Additionally, many studies have utilized this geometry to advance the understanding of shear band development. In this study, by varying the geometry, specifically the ratio of the inner hole to the outer hat diameter, the dynamic shear localization response of high purity Fe was examined. Post mortem characterization was performed to quantify the width of the localizations and examine the microstructural and textural evolution of shear deformation in a bcc metal. Increased instability in mechanical response is strongly linked with development of enhanced intergranular misorientations, high angle boundaries, and classical shear textures characterized through orientation distribution functions.

  3. Cyclic Shearing Deformation Behavior of Saturated Clays


    The apparatus for static and dynamic universal triaxial and torsional shear soil testing is employed to perform stress-controlled cyclic single-direction torsional shear tests and two-direction coupled shear tests under unconsolidated-undrained conditions. Through a series of tests on saturated clay, the effects of initial shear stress and stress reversal on the clay's strain-stress behavior are examined, and the behavior of pore water pressure is studied. The experimental results indicate that the patterns of stress-strain relations are distinctly influenced by the initial shear stress in the cyclic single-direction shear tests. When the initial shear stress is large and no stress reversal occurs, the predominant deformation behavior is characterized by an accumulative effect. When the initial shear stress is zero and symmetrical cyclic stress occurs, the predominant deformation behavior is characterized by a cyclic effect. The pore water pressure fluctuates around the confining pressure with the increase of cycle number. It seems that the fluctuating amplitude increases with the increase of the cyclic stress. But a buildup of pore water pressure does not occur. The deformations of clay samples under the complex initial and the cyclic coupled stress conditions include the normal deviatoric deformation and horizontal shear deformation, the average deformation and cyclic deformation. A general strain failure criterion taking into account these deformations is recommended and is proved more stable and suitable compared to the strain failure criteria currently used.

  4. Periodically sheared 2D Yukawa systems

    We present non-equilibrium molecular dynamics simulation studies on the dynamic (complex) shear viscosity of a 2D Yukawa system. We have identified a non-monotonic frequency dependence of the viscosity at high frequencies and shear rates, an energy absorption maximum (local resonance) at the Einstein frequency of the system at medium shear rates, an enhanced collective wave activity, when the excitation is near the plateau frequency of the longitudinal wave dispersion, and the emergence of significant configurational anisotropy at small frequencies and high shear rates


    Liu Zhao-rong; Liu Bao-yu; Qin Kai-rong


    In this paper, a method was proposed that the wall shear stress of artery could be determined by measuring the centerline axial velocity and radial motion of arterial wall simultaneously.The method is simple in application and can get higher precision when it is used to determine the shear stress of arterial wall in vivo.As an example, the shear stress distribution in periodic oscillatory flow of human carotid was calculated and discussed.The computed results show that the shear stress distribution at any given instant is almost uniform and will be zero at the centerline and tends to maximum at the vessel wall.

  6. Cardiac catheterization and angiography. Third edition

    This book discusses the papers on cardiac catheterization and angiography. The topics covered are: historical perspective and present practice of cardiac catheterization; angiography principles and utilization of radiologic and cineangiographic equipment; complications, incidence and prevention of side effects of cardiac catheterization; techniques; blood flow measurement of heart; pressure measurement; diagnostic techniques of angiography; special catheter techniques; coronary angiography, temporary and permanent pacemakers, potential role of lasers in the cardiac catheterization and evaluation of cardiac function

  7. Antifibrotic therapies to control cardiac fibrosis

    Fan, Zhaobo; Guan, Jianjun


    Cardiac fibrosis occurs naturally after myocardial infarction. While the initially formed fibrotic tissue prevents the infarcted heart tissue from rupture, the progression of cardiac fibrosis continuously expands the size of fibrotic tissue and causes cardiac function decrease. Cardiac fibrosis eventually evolves the infarcted hearts into heart failure. Inhibiting cardiac fibrosis from progressing is critical to prevent heart failure. However, there is no efficient therapeutic approach curren...

  8. Robotic Applications in Cardiac Surgery

    Alan P. Kypson


    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  9. Shear Behavior of Reinforced Concrete Shear Walls under Tensile Axial Force with Eccentricity

    MIZOGUCHI, Mitsuo; ARAI, Yasuyuki; KUCHIJI, Hideki


    A lateral loading test of six reinforced concrete shear walls subjected to an eccentric tensile axial force was carried out to examine their shear behavior. Next facts ware confirmed on the shear strength of the walls subjected to an eccentric tensile axial force. The test results can be evaluat by the shear strength equation [2] considering axial tensile stress. The calculated values given by the (AIJ "Design Guidelines for Earthquake Resistant Reinforced Concrete Buildings Based on Inelasti...

  10. Inverse Magnetic/Shear Catalysis

    McInnes, Brett


    It is well known that very large magnetic fields are generated when the Quark-Gluon Plasma is formed during peripheral heavy-ion collisions. Lattice, holographic, and other studies strongly suggest that these fields may, for observationally relevant field values, induce ``inverse magnetic catalysis'', signalled by a lowering of the critical temperature for the chiral/deconfinement transition. The theoretical basis of this effect has recently attracted much attention; yet so far these investigations have not included another, equally dramatic consequence of the peripheral collision geometry: the QGP acquires a large angular momentum vector, parallel to the magnetic field. Here we use holographic techniques to argue that the angular momentum can also, independently, have an effect on transition temperatures, and we obtain a rough estimate of the relative effects of the presence of both a magnetic field and an angular momentum density. We find that the shearing angular momentum reinforces the effect of the magne...

  11. Shear Viscosity from Lattice QCD

    Mages, Simon W; Fodor, Zoltán; Schäfer, Andreas; Szabó, Kálmán


    Understanding of the transport properties of the the quark-gluon plasma is becoming increasingly important to describe current measurements at heavy ion collisions. This work reports on recent efforts to determine the shear viscosity h in the deconfined phase from lattice QCD. The main focus is on the integration of the Wilson flow in the analysis to get a better handle on the infrared behaviour of the spectral function which is relevant for transport. It is carried out at finite Wilson flow time, which eliminates the dependence on the lattice spacing. Eventually, a new continuum limit has to be carried out which sends the new regulator introduced by finite flow time to zero. Also the non-perturbative renormalization strategy applied for the energy momentum tensor is discussed. At the end some quenched results for temperatures up to 4 : 5 T c are presented

  12. Cardiac manifestations in systemic sclerosis

    Sevdalina; Lambova


    Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.

  13. Computational Modeling of Cardiac Electromechanics

    Krishnamoorthi, Shankarjee


    Cardiac arrhythmias are a leading cause of death worldwide. Notably, the electrophysiologiy and microstructural requirements for a fatal ventricular arrhythmia remain incompletely understood, thereby the treatment remains largely empirical. Standard antiarrhythmic drug therapy has failed to reduce, and in some instances has increased, the incidence of Sudden Cardiac Death (SCD). Hence, a more complete understanding of the mechanisms that foment a fatal arrhythmia is needed and computational m...

  14. Cardiac Biomarkers in Hyperthyroid Cats

    Sangster, Jodi Kirsten


    Background: Hyperthyroidism has substantial effects on the circulatory system. The cardiac biomarkers NT-proBNP and troponin I (cTNI) have proven useful in identifying cats with myocardial disease but have not been as extensively investigated in hyperthyroidism.Hypothesis: Plasma NT-proBNP and cTNI concentrations are higher in cats with primary cardiac disease than in cats with hyperthyroidism and higher in cats with hyperthyroidism than in healthy control cats.Animals: Twenty-three hyperthyr...

  15. Current trends in cardiac rehabilitation

    Dafoe, W; Huston, P


    Cardiac rehabilitation can reduce mortality and morbidity for patients with many types of cardiac disease cost-effectively, yet is generally underutilized. Rehabilitation is helpful not only for patients who have had a myocardial infarction but also for those with stable angina or congestive heart failure or those who have undergone myocardial revascularization procedures, a heart transplant or heart valve surgery. The beneficial effects of rehabilitation include a reduction in the rate of de...

  16. An overview of cardiac morphogenesis.

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile


    International audience Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In th...

  17. Gastrointestinal Complications and Cardiac Surgery

    Allen, Sara J.


    Gastrointestinal (GI) complications are an uncommon but potentially devastating complication of cardiac surgery. The reported incidence varies between .3% and 5.5% with an associated mortality of .3–87%. A wide range of GI complications are reported with bleeding, mesenteric ischemia, pancreatitis, cholecystitis, and ileus the most common. Ischemia is thought to be the main cause of GI complications with hypoperfusion during cardiac surgery as well as systemic inflammation, hypothermia, drug ...

  18. Cardiac abnormalities after subarachnoid hemorrhage

    Bilt, I.A.C. van der


    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syndrome) that has been described after acute stress. It is a reversible cardiac dysfunction with distinct imaging features(the echocardiographic or left ventricular angiographic image resembles a Tak...

  19. FGF21 and cardiac physiopathology

    Anna ePlanavila


    Full Text Available The heart is not traditionally considered either a target or a site of fibroblast growth factor-21 (FGF21 production. However, recent findings indicate that FGF21 can act as a cardiomyokine; that is, it is produced by cardiac cells at significant levels and acts in an autocrine manner on the heart itself. The heart is sensitive to the effects of FGF21, both systemic and locally generated, owing to the expression in cardiomyocytes of β-Klotho, the key co-receptor known to confer specific responsiveness to FGF21 action. FGF21 has been demonstrated to protect against cardiac hypertrophy, cardiac inflammation, and oxidative stress. FGF21 expression in the heart is induced in response to cardiac insults, such as experimental cardiac hypertrophy and myocardial infarction in rodents, as well as in failing human hearts. Intracellular mechanisms involving PPARα and Sirt1 mediate transcriptional regulation of the FGF21 gene in response to exogenous stimuli. In humans, circulating FGF21 levels are elevated in coronary heart disease and atherosclerosis, and are associated with a higher risk of cardiovascular events in patients with type 2 diabetes. These findings provide new insights into the role of FGF21 in the heart and may offer potential therapeutic strategies for cardiac disease.

  20. Physiological and pathological cardiac hypertrophy.

    Shimizu, Ippei; Minamino, Tohru


    The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy. PMID:27262674

  1. Cardiac MRI in suspected myocarditis

    Purpose: To evaluate the potential of ECG-gated breath-hold MRI in diagnosing acute myocardidits. Material and methods: Cardiac MRI was performed on 21 consecutive patients with suspected myocarditis. ECG-gated breath-hold T2-weighted images with fat suppression were acquired in 3 standard views. T1-weighted imaging (FLASH) was performed 10 min after IV administration of Gd-DTPA. Laboratory data included creatine kinase, troponin T and serological tests, ECG findings and echocardiography. Imaging findings were retrospectively compared to the discharge diagnoses. Signal alterations were semiquantitatively classified. Results: Acute myocarditis was diagnosed in 9 patients and cardiac sarcoidosis in 2 patients. Late enhancement was observed in 4 patients with acute myocarditis and in both patients with cardiac sarcoidosis. Semiquantitative evaluation revealed 9 true positive, 9 true negative, 1 false positive and 2 false negative results. Conclusion: Cardiac MRI has the potential to detect acute myocarditis and to diagnose cardiac sarcoidosis. Late enhancement of Gd-DTPA can be found in both viral myocarditis and cardiac sarcoidosis. (orig.)

  2. Cardiac imaging. A multimodality approach

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  3. Cardiac involvement in myotonic dystrophy

    Lund, Marie; Diaz, Lars Jorge; Ranthe, Mattis Flyvholm;


    genetic testing for DM1. Information on incident cardiac diseases was obtained from the NPR. We estimated standardized incidence ratios (SIRs) of cardiac disease compared with the background population, overall and according to selected diagnostic subgroups (cardiomyopathy, heart failure, conduction...... disorders, arrhythmias, and device implantation). In the DM cohort, SIR for any cardiac disease was 3.42 [95% confidence interval (CI) 3.01-3.86]; for a cardiac disease belonging to the selected subgroups 6.91 (95% CI: 5.93-8.01) and for other cardiac disease 2.59 (95% CI: 2.03-3.25). For a cardiac disease...... belonging to the selected subgroups, the risk was particularly high in the first year after DM diagnosis [SIR 15.4 (95% CI: 10.9-21.3)] but remained significantly elevated in subsequent years [SIR 6.07 (95% CI: 5.11-7.16]). The risk was higher in young cohort members [e.g. 20-39 years: SIR 18.1 (95% CI: 12...

  4. Cardiac output during exercise

    Siebenmann, C; Rasmussen, P.; Sørensen, H.;


    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from the...... right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported a...... progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0.001] and...

  5. Study of shear-stiffened elastomers

    Tian, Tongfei; Li, Weihua; Ding, Jie; Alici, Gursel; Du, Haiping


    Shear thickening fluids, which are usually concentrated colloidal suspensions composed of non-aggregating solid particles suspended in fluids, exhibit a marked increase in viscosity beyond a critical shear rate. This increased viscosity is seen as being both 'field-activated', due to the dependence on shearing rate, as well as reversible. Shear thickening fluids have found good applications as protection materials, such as in liquid body armor, vibration absorber or dampers. This research aims to expand the protection material family by developing a novel solid status shear thickening material, called shear-stiffened elastomers. These new shear-stiffened elastomers were fabricated with the mixture of silicone rubber and silicone oil. A total of four SSE samples were fabricated in this study. Their mechanical and rheological properties under both steady-state and dynamic loading conditions were tested with a parallel-plate. The effects of silicone oil composition and angular frequency were summarized. When raising the angular frequency in dynamic shear test, the storage modulus of conventional silicone rubber shows a small increasing trend with the frequency. However, if silicone oil is selected to be mixed with silicone rubber, the storage modulus increases dramatically when the frequency and strain are both beyond the critical values.

  6. On the shear instability of fluid interfaces

    Alexakis, A.; Young, Y; Rosner, R


    We examine the linear stability of fluid interfaces subjected to a shear flow. Our main object is to generalize previous work to arbitrary Atwood number, and to allow for surface tension and weak compressibility. The motivation derives from instances in astrophysical systems where mixing across material interfaces driven by shear flows may significantly affect the dynamical evolution of these systems.

  7. Dynamics of colloidal crystals in shear flow

    Derks, D.; Wu, Y.L.; van Blaaderen, A.; Imhof, A.


    We investigate particle dynamics in nearly hard sphere colloidal crystals submitted to a steady shear flow. Both the fluctuations of single colloids and the collective motion of crystalline layers as a whole are studied by using a home-built counter rotating shear cell in combination with confocal m

  8. Sheared Ising models in three dimensions

    Hucht, Alfred; Angst, Sebastian


    The nonequilibrium phase transition in sheared three-dimensional Ising models is investigated using Monte Carlo simulations in two different geometries corresponding to different shear normals [A. Hucht and S. Angst, EPL 100, 20003 (2012)]. We demonstrate that in the high shear limit both systems undergo a strongly anisotropic phase transition at exactly known critical temperatures Tc which depend on the direction of the shear normal. Using dimensional analysis, we determine the anisotropy exponent θ = 2 as well as the correlation length exponents ν∥ = 1 and ν⊥ = 1 / 2 . These results are verified by simulations, though considerable corrections to scaling are found. The correlation functions perpendicular to the shear direction can be calculated exactly and show Ornstein-Zernike behavior. Supported by CAPES-DAAD through PROBRAL as well as by the German Research Society (DFG) through SFB 616 ``Energy Dissipation at Surfaces.''

  9. Trapped Electron Precession Shear Induced Fluctuation Decorrelation

    We consider the effects of trapped electron precession shear on the microturbulence. In a similar way the strong E x B shear reduces the radial correlation length of ambient fluctuations, the radial variation of the trapped electron precession frequency can reduce the radial correlation length of fluctuations associated with trapped electrons. In reversed shear plasmas, with the explicit dependence of the trapped electron precession shearing rate on B(subscript)theta, the sharp radial gradient of T(subscript)e due to local electron heating inside qmin can make the precession shearing mechanism more effective, and reduce the electron thermal transport constructing a positive feedback loop for the T(subscript)e barrier formation

  10. Numerical analysis of cross shear plate rolling

    Zhang, Wenqi; Bay, Niels


    shear zone between the forward and backward slip zones in the deformation zone thus lowering the rolling load. A numerical analysis of the cross shear rolling process is carried out based on the slab method adopting Wanheim and Bay's general friction model. The pressure distribution along the contact......The rolling process is widely applied for industrial production of metal plates. In conventional plate rolling the two work rolls are rotating at the same peripheral speed. By introducing a specific difference in the speed of the two work rolls, cross shear rolling is introduced forming a central...... are in the roll gap, the position and the size of the shear zone and the rolling load are calculated. Experimental results are presented verifying the calculations. The numerical analysis facilitates a better understanding of the mechanics in cross shear plate rolling....

  11. Experimental study on the adiabatic shear bands

    Four martensitic steels (Z50CDV5 steel, 28CND8 steel, 35NCDV16 steel and 4340 steel) with different hardness between 190 and 600 Hsub(B) (Brinell hardness), have been studied by means of dynamic compressive tests on split Hopkinson pressure bar. Microscopic observations show that the fracture are associated to the development of adiabatic shear bands (except 4340 steel with 190 Hsub(B) hardness). By means of tests for which the deformation is stopped at predetermined levels, the measurement of shear and hardness inside the band and the matrix indicates the chronology of this phenomenon: first the localization of shear, followed by the formation of adiabatic shear band and ultimatly crack initiation and propagation. These results correlated with few simulations by finite elements have permitted to suggest two mecanisms of deformation leading to the formation of adiabatic shear bands in this specific test

  12. Three dimensional fabric evolution of sheared sand

    Hasan, Alsidqi; Alshibli, Khalid (UWA)


    Granular particles undergo translation and rolling when they are sheared. This paper presents a three-dimensional (3D) experimental assessment of fabric evolution of sheared sand at the particle level. F-75 Ottawa sand specimen was tested under an axisymmetric triaxial loading condition. It measured 9.5 mm in diameter and 20 mm in height. The quantitative evaluation was conducted by analyzing 3D high-resolution x-ray synchrotron micro-tomography images of the specimen at eight axial strain levels. The analyses included visualization of particle translation and rotation, and quantification of fabric orientation as shearing continued. Representative individual particles were successfully tracked and visualized to assess the mode of interaction between them. This paper discusses fabric evolution and compares the evolution of particles within and outside the shear band as shearing continues. Changes in particle orientation distributions are presented using fabric histograms and fabric tensor.

  13. Squirming through shear-thinning fluids

    Datt, Charu; Elfring, Gwynn J; Pak, On Shun


    Many microorganisms find themselves immersed in fluids displaying non-Newtonian rheological properties such as viscoelasticity and shear-thinning viscosity. The effects of viscoelasticity on swimming at low Reynolds numbers have already received considerable attention, but much less is known about swimming in shear-thinning fluids. A general understanding of the fundamental question of how shear-thinning rheology influences swimming still remains elusive. To probe this question further, we study a spherical squirmer in a shear-thinning fluid using a combination of asymptotic analysis and numerical simulations. Shear-thinning rheology is found to affect a squirming swimmer in nontrivial and surprising ways; we predict and show instances of both faster and slower swimming depending on the surface actuation of the squirmer. We also illustrate that while a drag and thrust decomposition can provide insights into swimming in Newtonian fluids, extending this intuition to problems in complex media can prove problemat...

  14. Quantitative shear wave imaging optical coherence tomography for noncontact mechanical characterization of myocardium

    Wang, Shang; Lopez, Andrew L.; Morikawa, Yuka; Tao, Ge; Li, Jiasong; Larina, Irina V.; Martin, James F.; Larin, Kirill V.


    Optical coherence elastography (OCE) is an emerging low-coherence imaging technique that provides noninvasive assessment of tissue biomechanics with high spatial resolution. Among various OCE methods, the capability of quantitative measurement of tissue elasticity is of great importance for tissue characterization and pathology detection across different samples. Here we report a quantitative OCE technique, termed quantitative shear wave imaging optical coherence tomography (Q-SWI-OCT), which enables noncontact measurement of tissue Young's modulus based on the ultra-fast imaging of the shear wave propagation inside the sample. A focused air-puff device is used to interrogate the tissue with a low-pressure short-duration air stream that stimulates a localized displacement with the scale at micron level. The propagation of this tissue deformation in the form of shear wave is captured by a phase-sensitive OCT system running with the scan of the M-mode imaging over the path of the wave propagation. The temporal characteristics of the shear wave is quantified based on the cross-correlation of the tissue deformation profiles at all the measurement locations, and linear regression is utilized to fit the data plotted in the domain of time delay versus wave propagation distance. The wave group velocity is thus calculated, which results in the quantitative measurement of the Young's modulus. As the feasibility demonstration, experiments are performed on tissuemimicking phantoms with different agar concentrations and the quantified elasticity values with Q-SWI-OCT agree well with the uniaxial compression tests. For functional characterization of myocardium with this OCE technique, we perform our pilot experiments on ex vivo mouse cardiac muscle tissues with two studies, including 1) elasticity difference of cardiac muscle under relaxation and contract conditions and 2) mechanical heterogeneity of the heart introduced by the muscle fiber orientation. Our results suggest the

  15. Transient dynamics in dense colloidal suspensions under shear: shear rate dependence

    A combination of confocal microscopy and rheology experiments, Brownian dynamics (BD) and molecular dynamics (MD) simulations and mode coupling theory (MCT) have been applied in order to investigate the effect of shear rate on the transient dynamics and stress-strain relations in supercooled and glassy systems under shear. Immediately after shear is switched on, the microscopic dynamics display super-diffusion and the macroscopic rheology a stress overshoot, which become more pronounced with increasing shear rate. MCT relates both to negative sections of the generalized shear modulus, which grow with increasing shear rate. When the inverse shear rate becomes much smaller than the structural relaxation time of the quiescent system, relaxation through Brownian motion becomes less important. In this regime, larger stresses are accumulated before the system yields and the transition from localization to flow occurs earlier and more abruptly.

  16. Computed tomography of cardiac pseudotumors and neoplasms.

    Anavekar, Nandan S; Bonnichsen, Crystal R; Foley, Thomas A; Morris, Michael F; Martinez, Matthew W; Williamson, Eric E; Glockner, James F; Miller, Dylan V; Breen, Jerome F; Araoz, Philip A


    Important features of cardiac masses can be clearly delineated on cardiac computed tomography (CT) imaging. This modality is useful in identifying the presence of a mass, its relationship with cardiac and extracardiac structures, and the features that distinguish one type of mass from another. A multimodality approach to the evaluation of cardiac tumors is advocated, with the use of echocardiography, CT imaging and magnetic resonance imaging as appropriately indicated. In this article, various cardiac masses are described, including pseudotumors and true cardiac neoplasms, and the CT imaging findings that may be useful in distinguishing these rare entities are presented. PMID:20705174

  17. Cardiac output monitoring

    Mathews Lailu


    Full Text Available Minimally invasive and non-invasive methods of estimation of cardiac output (CO were developed to overcome the limitations of invasive nature of pulmonary artery catheterization (PAC and direct Fick method used for the measurement of stroke volume (SV. The important minimally invasive techniques available are: oesophageal Doppler monitoring (ODM, the derivative Fick method (using partial carbon dioxide (CO 2 breathing, transpulmonary thermodilution, lithium indicator dilution, pulse contour and pulse power analysis. Impedance cardiography is probably the only non-invasive technique in true sense. It provides information about haemodynamic status without the risk, cost and skill associated with the other invasive or minimally invasive techniques. It is important to understand what is really being measured and what assumptions and calculations have been incorporated with respect to a monitoring device. Understanding the basic principles of the above techniques as well as their advantages and limitations may be useful. In addition, the clinical validation of new techniques is necessary to convince that these new tools provide reliable measurements. In this review the physics behind the working of ODM, partial CO 2 breathing, transpulmonary thermodilution and lithium dilution techniques are dealt with. The physical and the physiological aspects underlying the pulse contour and pulse power analyses, various pulse contour techniques, their development, advantages and limitations are also covered. The principle of thoracic bioimpedance along with computation of CO from changes in thoracic impedance is explained. The purpose of the review is to help us minimize the dogmatic nature of practice favouring one technique or the other.

  18. Inverse magnetic/shear catalysis

    McInnes, Brett


    It is well known that very large magnetic fields are generated when the Quark-Gluon Plasma is formed during peripheral heavy-ion collisions. Lattice, holographic, and other studies strongly suggest that these fields may, for observationally relevant field values, induce "inverse magnetic catalysis", signalled by a lowering of the critical temperature for the chiral/deconfinement transition. The theoretical basis of this effect has recently attracted much attention; yet so far these investigations have not included another, equally dramatic consequence of the peripheral collision geometry: the QGP acquires a large angular momentum vector, parallel to the magnetic field. Here we use holographic techniques to argue that the angular momentum can also, independently, have an effect on transition temperatures, and we obtain a rough estimate of the relative effects of the presence of both a magnetic field and an angular momentum density. We find that the shearing angular momentum reinforces the effect of the magnetic field at low values of the baryonic chemical potential, but that it can actually decrease that effect at high chemical potentials.

  19. Animal models of cardiac cachexia.

    Molinari, Francesca; Malara, Natalia; Mollace, Vincenzo; Rosano, Giuseppe; Ferraro, Elisabetta


    Cachexia is the loss of body weight associated with several chronic diseases including chronic heart failure (CHF). The cachectic condition is mainly due to loss of skeletal muscle mass and adipose tissue depletion. The majority of experimental in vivo studies on cachexia rely on animal models of cancer cachexia while a reliable and appropriate model for cardiac cachexia has not yet been established. A critical issue in generating a cardiac cachexia model is that genetic modifications or pharmacological treatments impairing the heart functionality and used to obtain the heart failure model might likely impair the skeletal muscle, this also being a striated muscle and sharing with the myocardium several molecular and physiological mechanisms. On the other hand, often, the induction of heart damage in the several existing models of heart failure does not necessarily lead to skeletal muscle loss and cachexia. Here we describe the main features of cardiac cachexia and illustrate some animal models proposed for cardiac cachexia studies; they include the genetic calsequestrin and Dahl salt-sensitive models, the monocrotaline model and the surgical models obtained by left anterior descending (LAD) ligation, transverse aortic constriction (TAC) and ascending aortic banding. The availability of a specific animal model for cardiac cachexia is a crucial issue since, besides the common aspects of cachexia in the different syndromes, each disease has some peculiarities in its etiology and pathophysiology leading to cachexia. Such peculiarities need to be unraveled in order to find new targets for effective therapies. PMID:27317993

  20. Vitamin D and Cardiac Differentiation.

    Kim, Irene M; Norris, Keith C; Artaza, Jorge N


    Calcitriol (1,25-dihydroxycholecalciferol or 1,25-D3) is the hormonally active metabolite of vitamin D. Experimental studies of vitamin D receptors and 1,25-D3 establish calcitriol to be a critical regulator of the structure and function of the heart. Clinical studies link vitamin D deficiency with cardiovascular disease (CVD). Emerging evidence demonstrates that calcitriol is highly involved in CVD-related signaling pathways, particularly the Wnt signaling pathway. Addition of 1,25-D3 to cardiomyocyte cells and examination of its effects on cardiomyocytes and mainly Wnt11 signaling allowed the specific characterization of the role of calcitriol in cardiac differentiation. 1,25-D3 is demonstrated to: (i) inhibit cell proliferation without promoting apoptosis; (ii) decrease expression of genes related to the regulation of the cell cycle; (iii) promote formation of cardiomyotubes; (iv) induce expression of casein kinase-1-α1, a negative regulator of the canonical Wnt signaling pathway; and (v) increase expression of noncanonical Wnt11, which has been recognized to induce cardiac differentiation during embryonic development and in adult cells. Thus, it appears that vitamin D promotes cardiac differentiation through negative modulation of the canonical Wnt signaling pathway and upregulation of noncanonical Wnt11 expression. Future work to elucidate the role(s) of vitamin D in cardiovascular disorders will hopefully lead to improvement and potentially prevention of CVD, including abnormal cardiac differentiation in settings such as postinfarction cardiac remodeling. PMID:26827957

  1. Cardiac factors in orthostatic hypotension

    Löllgen, H.; Dirschedl, P.; Koppenhagen, K.; Klein, K. E.

    Cardiac function is determined by preload, afterload, heart rate and contractility. During orthostatic stress, the footward blood shift is compensated for by an increase of afterload. LBNP is widely used to analyze effects of volume displacement during orthostatic stress. Comparisons of invasive ( right heart catheterization) and non-invasive approach (echocardiography) yielded similar changes. Preload and afterload change with graded LBNP, heart rate increases, and stroke volume and cardiac output decrease. Thus, the working point on the left ventricular function curve is shifted to the left and downward, similar to hypovolemia. However, position on the Frank-Starling curve, the unchanged ejection fraction, and the constant Vcf indicate a normal contractile state during LBNP. A decrease of arterial oxygen partial pressure during LBNP shwos impaired ventilation/perfusion ratio. Finally, LBNP induced cardiac and hemodynamic changes can be effectively countermeasured by dihydroergotamine, a potent venoconstrictor. Comparison of floating catheter data with that of echocardiography resulted in close correlation for cardiac output and stroke volume. In addition, cardiac dimensions changed in a similar way during LBNP. From our findings, echocardiography as a non-invasive procedure can reliably used in LBNP and orthostatic stress tests. Some informations can be obtained on borderline values indicating collaps or orthostatic syncope. Early fainters can be differentiated from late fainters by stroke volume changes.

  2. Cardiac Penetrating Injuries and Pseudoaneurysm

    CHEN Shifeng


    Objective To discuss the early diagnosis and treatment of cardiac penetrating injuries and pseudoaneurysm. Methods 18 cases of cardiac penetrating injuries, in which 2 cases were complicated with pseudoaneurysm, were diagnosed by emergency operation and color Doppler echocardiography between May 1973 and Dec. 2001 in our hospital. The basis for emergency operation is the injured path locating in cardiac dangerous zone, severe shock or pericardial tamponade. ResultsAmong 18 cases of this study, 17 cases underwent emergency operation. During the operation, 11 cases were found injured in right ventricle, 2 cases were found injured in right atrium, 1 case was found injured in pulmonary artery,4 cases were found injured in left ventricle, 2 cases were found complicated with pseudoaneurysm. 17cases underwent cardiac repair including 1 case of rupture of aneurysm. 1 case underwent elective aneurysm resection. In whole group, 15 cases survived(83.33% ), 3 cases died( 16.67%). The cause of death is mainly hemorrhagic shock. Conclusion Highly suspicious cardiac penetrating injuries or hemopericaridium should undergo direct operative exploration. Pseudoaneurysm should be resected early,which can prevent severe complications.


    Philippe Lopez


    Full Text Available Through laboratory research performed over the past ten years, many of the critical links between fracture characteristics and hydromechanical and mechanical behaviour have been made for individual fractures. One of the remaining challenges at the laboratory scale is to directly link fracture morphology of shear behaviour with changes in stress and shear direction. A series of laboratory experiments were performed on cement mortar replicas of a granite sample with a natural fracture perpendicular to the axis of the core. Results show that there is a strong relationship between the fracture's geometry and its mechanical behaviour under shear stress and the resulting damage. Image analysis, geostatistical, stereological and directional data techniques are applied in combination to experimental data. The results highlight the role of geometric characteristics of the fracture surfaces (surface roughness, size, shape, locations and orientations of asperities to be damaged in shear behaviour. A notable improvement in shear understanding is that shear behaviour is controlled by the apparent dip in the shear direction of elementary facets forming the fracture.

  4. Hierarchical cosmic shear power spectrum inference

    Alsing, Justin; Heavens, Alan; Jaffe, Andrew H.; Kiessling, Alina; Wandelt, Benjamin; Hoffmann, Till


    We develop a Bayesian hierarchical modelling approach for cosmic shear power spectrum inference, jointly sampling from the posterior distribution of the cosmic shear field and its (tomographic) power spectra. Inference of the shear power spectrum is a powerful intermediate product for a cosmic shear analysis, since it requires very few model assumptions and can be used to perform inference on a wide range of cosmological models a posteriori without loss of information. We show that joint posterior for the shear map and power spectrum can be sampled effectively by Gibbs sampling, iteratively drawing samples from the map and power spectrum, each conditional on the other. This approach neatly circumvents difficulties associated with complicated survey geometry and masks that plague frequentist power spectrum estimators, since the power spectrum inference provides prior information about the field in masked regions at every sampling step. We demonstrate this approach for inference of tomographic shear E-mode, B-mode and EB-cross power spectra from a simulated galaxy shear catalogue with a number of important features; galaxies distributed on the sky and in redshift with photometric redshift uncertainties, realistic random ellipticity noise for every galaxy and a complicated survey mask. The obtained posterior distributions for the tomographic power spectrum coefficients recover the underlying simulated power spectra for both E- and B-modes.

  5. Shear Reinforcements in the Reinforced Concrete Beams

    Moayyad M. Al-Nasra


    Full Text Available - This study focuses on the use of different types of shear reinforcement in the reinforced concrete beams. Four different types of shear reinforcement are investigated; traditional stirrups, welded swimmer bars, bolted swimmer bars, and u-link bolted swimmer bars. Beam shear strength as well as beam deflection are the main two factors considered in this study. Shear failure in reinforced concrete beams is one of the most undesirable modes of failure due to its rapid progression. This sudden type of failure made it necessary to explore more effective ways to design these beams for shear. The reinforced concrete beams show different behavior at the failure stage in shear compare to the bending, which is considered to be unsafe mode of failure. The diagonal cracks that develop due to excess shear forces are considerably wider than the flexural cracks. The cost and safety of shear reinforcement in reinforced concrete beams led to the study of other alternatives. Swimmer bar system is a new type of shear reinforcement. It is a small inclined bars, with its both ends bent horizontally for a short distance and welded or bolted to both top and bottom flexural steel reinforcement. Regardless of the number of swimmer bars used in each inclined plane, the swimmer bars form plane-crack interceptor system instead of bar-crack interceptor system when stirrups are used. Several reinforced concrete beams were carefully prepared and tested in the lab. The results of these tests will be presented and discussed. The deflection of each beam is also measured at incrementally increased applied load.

  6. Shear viscosity of liquid mixtures: Mass dependence

    Expressions for zeroth, second, and fourth sum rules of transverse stress autocorrelation function of two component fluid have been derived. These sum rules and Mori's memory function formalism have been used to study shear viscosity of Ar-Kr and isotopic mixtures. It has been found that theoretical result is in good agreement with the computer simulation result for the Ar-Kr mixture. The mass dependence of shear viscosity for different mole fraction shows that deviation from ideal linear model comes even from mass difference in two species of fluid mixture. At higher mass ratio shear viscosity of mixture is not explained by any of the emperical model. (author)

  7. CT diagnosis of cardiac lipoma

    Objective: To investigate the application of CT in the diagnosis of cardiac lipoma. Methods: Retrospective analysis of 6 patients with cardiac lipoma confirmed by operation and pathology was done. Four patients had singles slice electron beam CT plain and contrast and movie scan. Two patients had 64-slice CT plain and enhanced scan. Results: (1) One patient was isolated intracavitary lipoma in the right artrium, 1 patient was isolated intrapericardial lipoma and 4 patients were intramural lipomas. Of the 4 intramural lipoma, 2 were infiltrative lipomas located in the left ventricle wall or the right ventricle and septum, 2 patients were isolated in the atrio-ventricular septum. (2) CT and three-dimensional reconstruction could depict the location, shape, size, margin and characteristic fat density of lipoma, indicating the diagnosis and classifications. The displacement of coronary artery, pulmonary inflammation and effusions of pericardium and pleural cavity could also be revealed. Conclusion: Cardiac lipoma can be accurately diagnosed and classified by CT. (authors)

  8. Mechanical Regulation of Cardiac Development



    Full Text Available Mechanical forces are an essential contributor to and unavoidable component of cardiac formation, both inducing and orchestrating local and global molecular and cellular changes. Experimental animal studies have contributed substantially to understanding the mechanobiology of heart development. More recent integration of high-resolution imaging modalities with computational modeling has greatly improved our quantitative understanding of hemodynamic flow in heart development. Merging these latest experimental technologies with molecular and genetic signaling analysis will accelerate our understanding of the relationships integrating mechanical and biological signaling for proper cardiac formation. These advances will likely be essential for clinically translatable guidance for targeted interventions to rescue malforming hearts and/or reconfigure malformed circulations for optimal performance. This review summarizes our current understanding on the levels of mechanical signaling in the heart and their roles in orchestrating cardiac development.

  9. Complications after cardiac implantable electronic device implantations

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;


    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  10. How Is Sudden Cardiac Arrest Diagnosed?

    ... heart (a sign of CHD). MUGA Test or Cardiac MRI A MUGA (multiple gated acquisition) test shows how ... create pictures of many parts of your heart. Cardiac MRI (magnetic resonance imaging) is a safe procedure that ...

  11. An update on insertable cardiac monitors

    Olsen, Flemming J; Biering-Sørensen, Tor; Krieger, Derk W


    Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring...

  12. Sudden Cardiac Arrest (SCA) Risk Assessment

    ... Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...

  13. Magnetized stratified rotating shear waves.

    Salhi, A; Lehner, T; Godeferd, F; Cambon, C


    We present a spectral linear analysis in terms of advected Fourier modes to describe the behavior of a fluid submitted to four constraints: shear (with rate S), rotation (with angular velocity Ω), stratification, and magnetic field within the linear spectral theory or the shearing box model in astrophysics. As a consequence of the fact that the base flow must be a solution of the Euler-Boussinesq equations, only radial and/or vertical density gradients can be taken into account. Ertel's theorem no longer is valid to show the conservation of potential vorticity, in the presence of the Lorentz force, but a similar theorem can be applied to a potential magnetic induction: The scalar product of the density gradient by the magnetic field is a Lagrangian invariant for an inviscid and nondiffusive fluid. The linear system with a minimal number of solenoidal components, two for both velocity and magnetic disturbance fields, is eventually expressed as a four-component inhomogeneous linear differential system in which the buoyancy scalar is a combination of solenoidal components (variables) and the (constant) potential magnetic induction. We study the stability of such a system for both an infinite streamwise wavelength (k(1) = 0, axisymmetric disturbances) and a finite one (k(1) ≠ 0, nonaxisymmetric disturbances). In the former case (k(1) = 0), we recover and extend previous results characterizing the magnetorotational instability (MRI) for combined effects of radial and vertical magnetic fields and combined effects of radial and vertical density gradients. We derive an expression for the MRI growth rate in terms of the stratification strength, which indicates that purely radial stratification can inhibit the MRI instability, while purely vertical stratification cannot completely suppress the MRI instability. In the case of nonaxisymmetric disturbances (k(1) ≠ 0), we only consider the effect of vertical stratification, and we use Levinson's theorem to demonstrate the

  14. Cardiac Metastasis from Invasive Thymoma Via the Superior Vena Cava: Cardiac MRI Findings

    Cardiac tumors are rare, and metastatic deposits are more common than primary cardiac tumors. We present cardiac magnetic resonance imaging (MRI) findings of a 50-year-old woman with invasive thymoma. Cardiac MRI revealed a heterogeneous, lobulated anterior mediastinal mass invading the superior vena cava and extending to the right atrium. In cine images there was no invasion to the right atrial wall.

  15. Pregnancy as a cardiac stress model

    Chung, Eunhee; Leinwand, Leslie A.


    Cardiac hypertrophy occurs during pregnancy as a consequence of both volume overload and hormonal changes. Both pregnancy- and exercise-induced cardiac hypertrophy are generally thought to be similar and physiological. Despite the fact that there are shared transcriptional responses in both forms of cardiac adaptation, pregnancy results in a distinct signature of gene expression in the heart. In some cases, however, pregnancy can induce adverse cardiac events in previously healthy women witho...

  16. Regulation of Cardiac Hypertrophy: the nuclear option

    Kuster, Diederik


    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, cardiac hypertrophy is an independent risk factor for the development of heart failure and is therefore called pathological hypertrophy. That hypertrophy is not bad per se, is illustrated by the hyp...

  17. Traumatic Tricuspid Regurgitation Following Cardiac Massage

    Na, Sungwon; Nam, Sang Beom; Lee, Yong Kyung; Oh, Young Jun; Kwak, Young-Lan


    We report a 66-yr-old male patient who developed tricuspid regurgitation secondary to internal cardiac massage. After uneventful off-pump coronary artery bypass surgery, the subject experienced cardiac arrest in the intensive care unit. External cardiac massage was initiated and internal cardiac massage was performed eventually. A transesophageal echocardiography revealed avulsion of the anterior papillary muscle and chordae to the anterior leaflet after successful cardiopulmonary resuscitati...

  18. [Cardiac output monitoring by impedance cardiography in cardiac surgery].

    Shimizu, H; Seki, S; Mizuguchi, A; Tsuchida, H; Watanabe, H; Namiki, A


    The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients. PMID:2362347

  19. Health Literacy Predicts Cardiac Knowledge Gains in Cardiac Rehabilitation Participants

    Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James


    Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…

  20. Shear strength measurements of ductile polymer films with controlled normal to shear plane angles

    Graphical abstract: The unique test fixture that is capable of controlling the normal to shear plane angle in a confined testing space was able to measure the shear strength of polymer films exclusively in cohesive failure. Two specimens were loaded in series such that as one fractured the other was in a state just prior to fracture and could be used for the investigation of shear bands. Highlights: → We design a novel method to measure the cohesive shear strength of polymer films. → The measured shear strength can be regarded as an intrinsic property. → The test fixture is capable of controlling the normal to shear plane angle in a confined space. → Two specimens are loaded in series such that as one fractures the other will be ready for fracture. - Abstract: Shear strength of the adhesives and polymer films was usually measured by lap shear test method. However, their fracture often associates with the combination of interfacial, interfacial-cohesive and cohesive failures. To confine the shear failure exclusively in cohesion so that the reported shear strength can be regarded as an intrinsic property of the polymer films, in this study we designed a unique test fixture that is capable of controlling the normal to shear plane angle in a confined testing space. Two poly(methyl acrylate-co-methyl methacrylate) film specimens were loaded in series in the test fixture such that as one fractured the other was in a state just prior to fracture and could be used for the investigation of shear bands by scanning electron microscopy (SEM). As the normal to shear plane angle was increased from 30 to 60o, the shear bands were more concentrated on the center region owing to the higher normal compressive stress. For the fractured specimen, the fracture surface investigated by SEM showed the striations which can be related to the shear bands. As the normal to shear plane angle was increased from 30 to 45o, the concentrated shear bands caused less striations perpendicular

  1. Wall Shear Rates in Taylor Vortex Flow

    V. Sobolik


    Full Text Available Wall shear rate and its axial and azimuthal components were evaluated in stable Taylor vortices. The measurements were carried out in a broad interval of Taylor numbers (52-725 and several gap width (R1/R2 = 0.5 – 0.8 by two three-segment electrodiffusion probes and three single probes flush mounted in the wall of the outer fixed cylinder. The axial distribution of wall shear rate components was obtained by sweeping the vortices along the probes using a slow axial flow. The experimental results were verified by CFD simulations. The knowledge of local wall shear rates and its fluctuations is of primordial interest for industrial applications like tangential filtration, membrane reactors and bioreactors containing shear sensitive cells.

  2. Localization in inelastic rate dependent shearing deformations

    Katsaounis, Theodoros


    Metals deformed at high strain rates can exhibit failure through formation of shear bands, a phenomenon often attributed to Hadamard instability and localization of the strain into an emerging coherent structure. We verify formation of shear bands for a nonlinear model exhibiting strain softening and strain rate sensitivity. The effects of strain softening and strain rate sensitivity are first assessed by linearized analysis, in- dicating that the combined effect leads to Turing instability. For the nonlinear model a class of self-similar solutions is constructed, that depicts a coherent localizing struc- ture and the formation of a shear band. This solution is associated to a heteroclinic orbit of a dynamical system. The orbit is constructed numerically and yields explicit shear localizing solutions.

  3. Mesoscale Elucidation of Biofilm Shear Behavior

    Barai, Pallab; Mukherjee, Partha P


    Formation of bacterial colonies as biofilm on the surface/interface of various objects has the potential to impact not only human health and disease but also energy and environmental considerations. Biofilms can be regarded as soft materials, and comprehension of their shear response to external forces is a key element to the fundamental understanding. A mesoscale model has been presented in this article based on digitization of a biofilm microstructure. Its response under externally applied shear load is analyzed. Strain stiffening type behavior is readily observed under high strain loads due to the unfolding of chains within soft polymeric substrate. Sustained shear loading of the biofilm network results in strain localization along the diagonal direction. Rupture of the soft polymeric matrix can potentially reduce the intercellular interaction between the bacterial cells. Evolution of stiffness within the biofilm network under shear reveals two regions: a) initial increase in stiffness due to strain stiffe...

  4. Childhood cancer survivors: cardiac disease & social outcomes

    E.A.M. Feijen


    The thesis is divided in two parts; Cardiac health problems and healthcare consumption & social outcomes in CCS. The general aims of part 1 creates optimal conditions for the evaluation of cardiac events in 5-year childhood cancer survivors, evaluation of the long term risk of cardiac events, and to

  5. MRI of cardiac rhabdomyoma in the fetus

    Kivelitz, Dietmar E.; Muehler, Matthias [Institut fuer Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Rake, Annett; Chaoui, Rabih [Klinik fuer Gynaekologie und Geburtshilfe, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Scheer, Ianina [Klinik fuer Strahlenheilkunde, Abteilung Paediatrische Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany)


    Primary cardiac tumors are rarely diagnosed in utero and are usually seen on prenatal echocardiography. Cardiac rhabdomyomata can be associated with tuberous sclerosis. Prenatal MRI can be performed to assess associated malformations. This case report illustrates the ability of fetal MRI to image cardiac rhabdomyata and compares it with prenatal and postnatal echocardiography. (orig.)

  6. Telocytes in exercise-induced cardiac growth.

    Xiao, Junjie; Chen, Ping; Qu, Yi; Yu, Pujiao; Yao, Jianhua; Wang, Hongbao; Fu, Siyi; Bei, Yihua; Chen, Yan; Che, Lin; Xu, Jiahong


    Exercise can induce physiological cardiac growth, which is featured by enlarged cardiomyocyte cell size and formation of new cardiomyocytes. Telocytes (TCs) are a recently identified distinct interstitial cell type, existing in many tissues and organs including heart. TCs have been shown to form a tandem with cardiac stem/progenitor cells in cardiac stem cell niches, participating in cardiac regeneration and repair. Although exercise-induced cardiac growth has been confirmed as an important way to promote cardiac regeneration and repair, the response of cardiac TCs to exercise is still unclear. In this study, 4 weeks of swimming training was used to induce robust healthy cardiac growth. Exercise can induce an increase in cardiomyocyte cell size and formation of new cardiomyocytes as determined by Wheat Germ Lectin and EdU staining respectively. TCs were identified by three immunofluorescence stainings including double labelling for CD34/vimentin, CD34/platelet-derived growth factor (PDGF) receptor-α and CD34/PDGF receptor-β. We found that cardiac TCs were significantly increased in exercised heart, suggesting that TCs might help control the activity of cardiac stem/progenitor cells, cardiomyocytes or endothelial cells. Adding cardiac TCs might help promote cardiac regeneration and renewal. PMID:26987685

  7. Cardiac, Skeletal, and smooth muscle mitochondrial respiration

    Park, Song-Young; Gifford, Jayson R; Andtbacka, Robert H I; Hyngstrom, John R; Garten, Ryan S; Diakos, Nikolaos A; Ives, Stephen J; Dela, Flemming; Larsen, Steen; Drakos, Stavros; Richardson, Russell S


    Unlike cardiac and skeletal muscle, little is known about vascular smooth muscle mitochondrial function. Therefore, this study examined mitochondrial respiratory rates in the smooth muscle of healthy human feed arteries and compared with that of healthy cardiac and skeletal muscle. Cardiac, skele...

  8. Technique for producing cardiac radionuclide motion images

    Sequential frames of different portions of the cardiac cycle are gated into a minicomputer by using an EKG signal recorded onto digital tape simultaneously with imaging information. Serial display of these frames on the computer oscilloscope or projection of 35-mm half frames of these images provides a cardiac motion image with information content adequate for qualitatively assessing cardiac motion. (U.S.)

  9. Regulation of Cardiac Hypertrophy: the nuclear option

    D.W.D. Kuster (Diederik)


    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, c

  10. Assessment of Shear Strength in Silty Soils

    Stefaniak Katarzyna


    Full Text Available The article presents a comparison of shear strength values in silty soils from the area of Poznań, determined based on selected Nkt values recommended in literature, with values of shear strength established on the basis of Nkt values recommended by the author. Analysed silty soils are characterized by the carbonate cementation zone, which made it possible to compare selected empirical coefficients both in normally consolidated and overconsolidated soils

  11. Linear Shear Rheology of Incompressible Foams

    Buzza, D.; D. Lu, C.-Y.; Cates, M.


    We discuss various mechanisms for viscous dissipation in the linear response to oscillatory shear of incompressible foams (such as biliquid foams or dense emulsions). These include viscous flow of liquid in films and plateau borders; intrinsic viscosity of the surfactant layers; and diffusion resistance. Marangoni-type and marginal regeneration mechanisms are considered for the transport of surfactant. We predict (on the basis of typical parameters for biliquid foams) that the zero shear visc...

  12. Liquid migration in sheared unsaturated granular media

    Mani, Roman; Kadau, Dirk; Herrmann, Hans J.


    We show how liquid migrates in sheared unsaturated granular media using a grain scale model for capillary bridges. Liquid is redistributed to neighboring contacts after rupture of individual capillary bridges leading to redistribution of liquid on large scales. The liquid profile evolution coincides with a recently developed continuum description for liquid migration in shear bands. The velocity profiles which are linked to the migration of liquid as well as the density profiles of wet and dr...

  13. Dynamo quenching due to shear flow

    Leprovost, Nicolas; Kim, Eun-Jin


    We provide a theory of dynamo ($\\alpha$ effect) and momentum transport in three-dimensional magnetohydrodynamics. For the first time, we show that the $\\alpha$ effect is severely reduced by the shear even in the absence of magnetic field. The $\\alpha$ effect is further suppressed by magnetic fields well below equipartition (with the large-scale flow) with different scalings depending on the relative strength of shear and magnetic field. The turbulent viscosity is also found to be significantl...

  14. Transthoracic Cardiac Acoustic Radiation Force Impulse Imaging

    Bradway, David Pierson

    This dissertation investigates the feasibility of a real-time transthoracic Acoustic Radiation Force Impulse (ARFI) imaging system to measure myocardial function non-invasively in clinical setting. Heart failure is an important cardiovascular disease and contributes to the leading cause of death for developed countries. Patients exhibiting heart failure with a low left ventricular ejection fraction (LVEF) can often be identified by clinicians, but patients with preserved LVEF might be undetected if they do not exhibit other signs and symptoms of heart failure. These cases motivate development of transthoracic ARFI imaging to aid the early diagnosis of the structural and functional heart abnormalities leading to heart failure. M-Mode ARFI imaging utilizes ultrasonic radiation force to displace tissue several micrometers in the direction of wave propagation. Conventional ultrasound tracks the response of the tissue to the force. This measurement is repeated rapidly at a location through the cardiac cycle, measuring timing and relative changes in myocardial stiffness. ARFI imaging was previously shown capable of measuring myocardial properties and function via invasive open-chest and intracardiac approaches. The prototype imaging system described in this dissertation is capable of rapid acquisition, processing, and display of ARFI images and shear wave elasticity imaging (SWEI) movies. Also presented is a rigorous safety analysis, including finite element method (FEM) simulations of tissue heating, hydrophone intensity and mechanical index (MI) measurements, and thermocouple transducer face heating measurements. For the pulse sequences used in later animal and clinical studies, results from the safety analysis indicates that transthoracic ARFI imaging can be safely applied at rates and levels realizable on the prototype ARFI imaging system. Preliminary data are presented from in vivo trials studying changes in myocardial stiffness occurring under normal and abnormal

  15. Schematic mode coupling theories for shear thinning, shear thickening, and jamming

    Cates, Michael E.; Holmes, Colin B.; Fuchs, Matthias; Henrich, Oliver


    Mode coupling theory (MCT) appears to explain several, though not all, aspects of the glass transition in colloids (particularly when short-range attractions are present). Developments of MCT, from rational foundations in statistical mechanics, account qualitatively for nonlinear flow behaviour such as the yield stress of a hard-sphere colloidal glass. Such theories so far only predict shear thinning behaviour, whereas in real colloids both shear thinning and shear thickening can be found. Th...

  16. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    O'Donnell, David H


    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  17. The Radiation Hydrodynamics of Relativistic Shear Flows

    Coughlin, Eric R.; Begelman, Mitchell C.


    We present a method for analyzing the interaction between radiation and matter in regions of intense, relativistic shear that can arise in many astrophysical situations. We show that there is a simple velocity profile that should be manifested in regions of large shear that have “lost memory” of their boundary conditions, and we use this self-similar velocity profile to construct the surface of last scattering, or the τ ≃ 1 surface, as viewed from any comoving point within the flow. We demonstrate that a simple treatment of scattering from this τ ≃ 1 surface exactly conserves photon number, and we derive the rate at which the radiation field is heated due to the shear present in the flow. The components of the comoving radiation energy–momentum tensor are calculated, and we show that they have relatively simple, approximate forms that interpolate between the viscous (small shear) and streaming (large shear) limits. We put our expression for the energy–momentum tensor in a covariant form that does not depend on the explicit velocity profile within the fluid and, therefore, represents a natural means for analyzing general, radiation-dominated, relativistic shear flows.

  18. Behavior of Tilted Angle Shear Connectors.

    Koosha Khorramian

    Full Text Available According to recent researches, angle shear connectors are appropriate to transfer longitudinal shear forces across the steel-concrete interface. Angle steel profile has been used in different positions as L-shaped or C-shaped shear connectors. The application of angle shear connectors in tilted positions is of interest in this study. This study investigates the behaviour of tilted-shaped angle shear connectors under monotonic loading using experimental push out tests. Eight push-out specimens are tested to investigate the effects of different angle parameters on the ultimate load capacity of connectors. Two different tilted angles of 112.5 and 135 degrees between the angle leg and steel beam are considered. In addition, angle sizes and lengths are varied. Two different failure modes were observed consisting of concrete crushing-splitting and connector fracture. By increasing the size of connector, the maximum load increased for most cases. In general, the 135 degrees tilted angle shear connectors have a higher strength and stiffness than the 112.5 degrees type.

  19. Analysis of shear banding in twelve materials

    Batra, R. C.; Kim, C. H.

    The problem of the initiation and growth of shear bands in 12 different materials, namely, OFHC copper, Cartridge brass, Nickel 200, Armco IF (interstitial free) iron, Carpenter electric iron, 1006 steel, 2024-T351 aluminum, 7039 aluminum, low alloy steel, S-7 tool steel, Tungsten alloy, and Depleted Uranium (DU -0.75 Ti) is studied with the objectives of finding out when a shear band initiates, and upon what parameters does the band width depend. The nonlinear coupled partial differential equations governing the overall simple shearing deformations of a thermally softening viscoplastic block are analyzed. It is assumed that the thermomechanical response of these materials can be adequately represented by the Johnson-Cook law, and the only inhomogeneity present in the block is the variation in its thickness. The effect of the defect size on the initiation and subsequent growth of the band is also studied. It is found that, for each one of these 12 materials, the deformation has become nonhomogeneous by the time the maximum shear stress occurs. Also the band width, computed when the shear stress has dropped to 85 percent of its peak value, does not correlate well with the thermal conductivity of the material. The band begins to grow rapidly when the shear stress has dropped to 90 percent of its maximum value.

  20. Cosmology with cosmic shear observations: a review.

    Kilbinger, Martin


    Cosmic shear is the distortion of images of distant galaxies due to weak gravitational lensing by the large-scale structure in the Universe. Such images are coherently deformed by the tidal field of matter inhomogeneities along the line of sight. By measuring galaxy shape correlations, we can study the properties and evolution of structure on large scales as well as the geometry of the Universe. Thus, cosmic shear has become a powerful probe into the nature of dark matter and the origin of the current accelerated expansion of the Universe. Over the last years, cosmic shear has evolved into a reliable and robust cosmological probe, providing measurements of the expansion history of the Universe and the growth of its structure. We review here the principles of weak gravitational lensing and show how cosmic shear is interpreted in a cosmological context. Then we give an overview of weak-lensing measurements, and present the main observational cosmic-shear results since it was discovered 15 years ago, as well as the implications for cosmology. We then conclude with an outlook on the various future surveys and missions, for which cosmic shear is one of the main science drivers, and discuss promising new weak cosmological lensing techniques for future observations. PMID:26181770

  1. Accurate shear measurement with faint sources

    Zhang, Jun; Foucaud, Sebastien [Center for Astronomy and Astrophysics, Department of Physics and Astronomy, Shanghai Jiao Tong University, 955 Jianchuan road, Shanghai, 200240 (China); Luo, Wentao, E-mail:, E-mail:, E-mail: [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Nandan Road 80, Shanghai, 200030 (China)


    For cosmic shear to become an accurate cosmological probe, systematic errors in the shear measurement method must be unambiguously identified and corrected for. Previous work of this series has demonstrated that cosmic shears can be measured accurately in Fourier space in the presence of background noise and finite pixel size, without assumptions on the morphologies of galaxy and PSF. The remaining major source of error is source Poisson noise, due to the finiteness of source photon number. This problem is particularly important for faint galaxies in space-based weak lensing measurements, and for ground-based images of short exposure times. In this work, we propose a simple and rigorous way of removing the shear bias from the source Poisson noise. Our noise treatment can be generalized for images made of multiple exposures through MultiDrizzle. This is demonstrated with the SDSS and COSMOS/ACS data. With a large ensemble of mock galaxy images of unrestricted morphologies, we show that our shear measurement method can achieve sub-percent level accuracy even for images of signal-to-noise ratio less than 5 in general, making it the most promising technique for cosmic shear measurement in the ongoing and upcoming large scale galaxy surveys.

  2. Two-dimensional magnetic colloids under shear.

    Mohorič, Tomaž; Dobnikar, Jure; Horbach, Jürgen


    Complex rheological properties of soft disordered solids, such as colloidal gels or glasses, inspire a range of novel applications. However, the microscopic mechanisms of their response to mechanical loading are not well understood. Here, we elucidate some aspects of these mechanisms by studying a versatile model system, i.e. two-dimensional superparamagnetic colloids in a precessing magnetic field, whose structure can be tuned from a hexagonal crystal to a disordered gel network by varying the external field opening angle θ. We perform Langevin dynamics simulations subjecting these structures to a constant shear rate and observe three qualitatively different types of material response. In hexagonal crystals (θ = 0°), at a sufficiently low shear rate, plastic flow occurs via successive stress drops at which the stress releases due to the formation of dislocation defects. The gel network at θ = 48°, on the contrary, via bond rearrangement and transient shear banding evolves into a homogeneously stretched network at large strains. The latter structure remains metastable after switching off of the shear. At θ = 50°, the external shear makes the system unstable against phase separation and causes a failure of the network structure leading to the formation of hexagonal close packed clusters interconnected by particle chains. At a microcopic level, our simulations provide insight into some of the mechanisms by which strain localization as well as material failure occur in a simple gel-like network. Furthermore, we demonstrate that new stretched network structures can be generated by the application of shear. PMID:26877059

  3. A new look on blood shear thinning

    Abkarian, Manouk; Lanotte, Luca; Fromental, Jean-Marc; Mendez, Simon; Fedosov, Dmitry; Gompper, Gerhard; Mauer, Johannes; Claveria, Viviana


    Blood is a shear-thinning fluid. At shear rates γ˙ rouleaux'' formed by stacked red blood cells (RBCs). For higher γ˙ in the range 10 - 1000 s-1 , where RBCs flow as single elements, studies demonstrated that RBCs suspended in a viscous fluid mimicking the viscosity of whole blood, deformed into ellipsoids aligned steadily in the direction of the flow, while their membrane rotated about their center of mass like a tank-tread. Such drop-like behavior seemed to explain shear-thinning. Here, using rheometers, microfluidics and simulations, we show that the dynamics of single RBCs in plasma-like fluids display a different sequence of deformation for increasing shear rates going from discocytes to successively, stomatocytes, folded stomatocytes, trilobes and tetralobes, but never ellipsoids. This result is also identical for physiological hematocrits. We correlate this shape diagram to the different regimes in blood rheology for high shear rates and propose a new-look on the interpretation of blood shear-thinning behavior.

  4. Influence of Shear on Rotation Capacity of Reinforced Concrete Members Without Shear Reinforcement

    Vaz Rodrigues, Rui; Muttoni, Aurelio; Fernández Ruiz, Miguel


    The influence of shear on the rotation capacity of one-way slabs without shear reinforcement is investigated in this paper by means of an experimental study. The experimental program consisted of 11 slab strips 8400 mm (331 in.) long and 450 mm (17.7 in.) thick with a flexural reinforcement ratio of 0.79%. The rotation capacity was investigated for various values of the shear span and for two types of flexural reinforcement (hot-rolled and cold-worked bars). The specimens developed shear fail...

  5. Response to cardiac resynchronization therapy

    Versteeg, Henneke; Schiffer, Angélique A; Widdershoven, Jos W; Meine, Mathias M; Doevendans, Pieter A; Pedersen, Susanne S.


    Cardiac resynchronization therapy (CRT) is a promising treatment for a subgroup of patients with advanced congestive heart failure and a prolonged QRS interval. Despite the majority of patients benefiting from CRT, 10-40% of patients do not respond to this treatment and are labeled as nonresponders...

  6. Rejection in the cardiac transplant

    Standard chest radiography remains the most frequent applied method for monitoring post surgical cardiac transplant patients. Evidence suggests that after the 1st month cardiac enlargement is indeed a useful indicator of rejection, sometimes being caused by pericardial effusion and/or changes in left ventricular mass. Opportunistic infections, either pulmonary lesions or mediastinal abscesses, as well as malignant tumours may all occur and require evaluation or exclusion. Conventional computed transmission tomography is an excellent technique for surveying the entire thorax relatively non-invasively and is recommended whenever pulmonary, cardiac or mediastinal changes are unexplained. Coronary arteriography with or without digital subtraction remains the definitive method for examining the coronary arteries. Left ventricular function can be evaluated with either angiography or other non-invasive methods including such techniques as echocardiography and nuclear medicine. More recently monoclonal antibody labels for antimyosin show promise for identifying rejection. Ultrafast CT scanning is now available in a number of centres. It allows millisecond cross-sectional cine-tomography of the heart as well as of the whole chest, and also provides 3-D quantitative analyses of end-diastolic and systolic function including regional wall thickening dynamics and estimations of myocardial mass. Right, as well as left-sided cardiac chambers, are demonstrated routinely during the same ultrafast CT procedure. MRI, like ultrafast CT, is a new technique still being explored. MRI as well as MR spectroscopy are regarded as diagnostic radiology procedures. (author). 32 refs.; 3 figs.; 3 tabs

  7. Cardiac functional analysis with MRI

    Cardiovascular diseases (CVD) are among the leading causes of death worldwide. Even in the 21st century CVD will still be the most frequent cause of morbidity and mortality. Precise evaluation of cardiac function is therefore mandatory for therapy planning and monitoring. In this article the contribution of MRI-based analysis of cardiac function will be addressed. Nowadays cine-MRI is considered as the standard of reference (SOR) in cardiac functional analysis. ECG-triggered steady-state free precession (SSFP) sequences are mainly used as they stand out due to short acquisition times and excellent contrast between the myocardium and the ventricular cavity. An indispensible requirement for cardiac functional analysis is an exact planning of the examination and based on that the coverage of the whole ventricle in short axial slices. By means of dedicated post-processing software, manual or semi-automatic segmentation of the endocardial and epicardial contours is necessary for functional analysis. In this way end-diastolic volume (EDV), end-systolic volume (ESV) and the ejection fraction (EF) are defined and regional wall motion abnormalities (RWMA) can be detected. (orig.)

  8. Molecular therapies for cardiac arrhythmias

    G.J.J. Boink


    Despite the ongoing advances in pharmacology, devices and surgical approaches to treat heart rhythm disturbances, arrhythmias are still a significant cause of death and morbidity. With the introduction of gene and cell therapy, new avenues have arrived for the local modulation of cardiac disease. Th

  9. The cardiac patient in Ramadan.

    Chamsi-Pasha, Majed; Chamsi-Pasha, Hassan


    Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1.6 billion Muslims worldwide observe an absolute fast from dawn to sunset without any drink or food. Our review shows that the impact of fasting during Ramadan on patients with stable cardiac disease is minimal and does not lead to any increase in acute events. Most patients with the stable cardiac disease can fast safely. Most of the drug doses and their regimen are easily manageable during this month and may need not to be changed. Ramadan fasting is a healthy nonpharmacological means for improving cardiovascular risk factors. Most of the Muslims, who suffer from chronic diseases, insist on fasting Ramadan despite being exempted by religion. The Holy Quran specifically exempts the sick from fasting. This is particularly relevant if fasting worsens one's illness or delays recovery. Patients with unstable angina, recent myocardial infarction, uncontrolled hypertension, decompensated heart failure, recent cardiac intervention or cardiac surgery or any debilitating diseases should avoid fasting. PMID:27144139

  10. Cardiac pacemakers and nuclear batteries

    Following the introduction giving the indications for cardiac pacemaker therapy with special regard to the use of pacemakers powered by nuclear batteries, reference is made to the resulting radiation exposure of the patient. The activities of the Federal Health Office in this field such as recommendations and surveys including the entire Federal Republic are outlined. (orig.)