Study of the Ubiquitous Hog Farm System Using Wireless Sensor Networks for Environmental Monitoring and Facilities Control

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Jeonghwan Hwang

2010-12-01

Full Text Available Many hog farmers are now suffering from high pig mortality rates due to various wasting diseases and increased breeding costs, etc. It is therefore necessary for hog farms to implement systematic and scientific pig production technology to increase productivity and produce high quality pork in order to solve these problems. In this study, we describe such a technology by suggesting a ubiquitous hog farm system which applies WSN (Wireless Sensor Network technology to the pig industry. We suggest that a WSN and CCTV (Closed-circuit television should be installed on hog farms to collect environmental and image information which shall then help producers not only in monitoring the hog farm via the Web from outside the farm, but also facilitate the control of hog farm facilities in remote locations. In addition, facilities can be automatically controlled based on breeding environment parameters which are already set up and a SMS notice service to notify of deviations shall provide users with convenience. Hog farmers may increase production and improve pork quality through this ubiquitous hog farm system and prepare a database with information collected from environmental factors and the hog farm control devices, which is expected to provide information needed to design and implement suitable control strategies for hog farm operation.

Modelling the Asymmetric Volatility in Hog Prices in Taiwan : The Impact of Joining the WTO

NARCIS (Netherlands)

C-L. Chang (Chia-Lin); B-W. Huang (Bing-Wen); M-G. Chen (Meng-Gu)

2010-01-01

textabstractPrices in the hog industry in Taiwan are determined according to an auction system. There are significant differences in hog prices before, during and after joining the World Trade Organization (WTO). The paper models growth rates and volatility in daily hog prices in Taiwan from 23

Assessing hog lagoon waste contamination in the Cape Fear Watershed using Bacteroidetes 16S rRNA gene pyrosequencing.

Science.gov (United States)

Arfken, Ann M; Song, Bongkeun; Mallin, Michael A

2015-09-01

Hog lagoons can be major sources of waste and nutrient contamination to watersheds adjacent to pig farms. Fecal source tracking methods targeting Bacteroidetes 16S rRNA genes in pig fecal matter may underestimate or fail to detect hog lagoon contamination in riverine environments. In order to detect hog lagoon wastewater contamination in the Cape Fear Watershed, where a large number of hog farms are present, we conducted pyrosequencing analyses of Bacteroidetes 16S rRNA genes in hog lagoon waste and identified new hog lagoon-specific marker sequences. Additional pyrosequencing analyses of Bacteroidetes 16S rRNA genes were conducted with surface water samples collected at 4 sites during 5 months in the Cape Fear Watershed. Using an operational taxonomic unit (OTU) identity cutoff value of 97 %, these newly identified hog lagoon markers were found in 3 of the river samples, while only 1 sample contained the pig fecal marker. In the sample containing the pig fecal marker, there was a relatively high percentage (14.1 %) of the hog lagoon markers and a low pig fecal marker relative abundance of 0.4 % in the Bacteroidetes 16S rRNA gene sequences. This suggests that hog lagoon contamination must be somewhat significant in order for pig fecal markers to be detected, and low levels of hog lagoon contamination cannot be detected targeting only pig-specific fecal markers. Thus, new hog lagoon markers have a better detection capacity for lagoon waste contamination, and in conjunction with a pig fecal marker, provide a more comprehensive and accurate detection of hog lagoon waste contamination in susceptible watersheds.

Human gait recognition by pyramid of HOG feature on silhouette images

Science.gov (United States)

Yang, Guang; Yin, Yafeng; Park, Jeanrok; Man, Hong

2013-03-01

As a uncommon biometric modality, human gait recognition has a great advantage of identify people at a distance without high resolution images. It has attracted much attention in recent years, especially in the fields of computer vision and remote sensing. In this paper, we propose a human gait recognition framework that consists of a reliable background subtraction method followed by the pyramid of Histogram of Gradient (pHOG) feature extraction on the silhouette image, and a Hidden Markov Model (HMM) based classifier. Through background subtraction, the silhouette of human gait in each frame is extracted and normalized from the raw video sequence. After removing the shadow and noise in each region of interest (ROI), pHOG feature is computed on the silhouettes images. Then the pHOG features of each gait class will be used to train a corresponding HMM. In the test stage, pHOG feature will be extracted from each test sequence and used to calculate the posterior probability toward each trained HMM model. Experimental results on the CASIA Gait Dataset B1 demonstrate that with our proposed method can achieve very competitive recognition rate.

The volume-expanding effects of autologous liquid stored plasma following hemorrhage

DEFF Research Database (Denmark)

Bentzer, Peter; Thomas, Owain D; Westborg, Johan

2012-01-01

of plasma transfusion on plasma volume. We report a prospective interventional study in which the plasma volume-expanding effect of autologous plasma was investigated after a controlled hemorrhage. Methods. Plasma obtained by plasmapheresis from nine healthy regular blood donors was stored at 2-6°C. Five...

Overexpression of OLE1 enhances stress tolerance and constitutively activates the MAPK HOG pathway in Saccharomyces cerevisiae.

Science.gov (United States)

Nasution, Olviyani; Lee, Young Mi; Kim, Eunjung; Lee, Yeji; Kim, Wankee; Choi, Wonja

2017-03-01

OLE1 of Saccharomyces cerevisiae encodes the sole and essential Δ-9 desaturase catalyzing the conversion of saturated to unsaturated fatty acids. Upon ectopic overexpression of OLE1 in S. cerevisiae, significant increases in the membrane oleic acid content were observed. OLE1-overexpressing strains displayed enhanced tolerance to various stresses, better proton efflux, lower membrane permeability, and lessened internal hydrogen peroxide content. The OLE1-mediated enhanced stress tolerance was considerably diminished upon deletion of HOG1, which encodes the mitogen-activated protein kinase (MAPK) Hog1 of the high osmolarity glycerol (HOG) pathway. Furthermore, OLE1 overexpression constitutively activated Hog1, which remained in the cytoplasm. Hog1 activation was accomplished through the MAPK kinase kinase (MAPKKK) Ssk2, but not Ste11 and Ssk22, the other MAPKKKs of the HOG pathway. Despite its cytoplasmic location, activated Hog1 was able to activate the expression of its canonical targets, including CTT1, HSP12, and STL1, and further, the cAMP and stress response elements present in the promoter. OLE1 overexpression neither caused nor relieved endoplasmic reticulum stress. Individually or in combination, the physiological and molecular changes caused by OLE1 overexpression may contribute to enhanced tolerance to various types of stress. Biotechnol. Bioeng. 2017;114: 620-631. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Prediction of acute cardiac rejection by changes in left ventricular volumes

International Nuclear Information System (INIS)

Novitzky, D.; Cooper, D.K.; Boniaszczuk, J.

1988-01-01

Sixteen patients underwent heart transplantation (11 orthotopic, five heterotopic). Monitoring for acute rejection was by both endomyocardial biopsy (EMB) and multigated equilibrium blood pool scanning with technetium 99m-labelled red blood cells. From the scans information was obtained on left ventricular volumes (stroke, end-diastolic, and end-systolic), ejection fraction, and heart rate. Studies (208) were made in the 16 patients. There was a highly significant correlation between the reduction in stroke volume and end-diastolic volume (and a less significant correlation in end-systolic volume) and increasing acute rejection seen on EMB. Heart rate and ejection fraction did not correlate with the development of acute rejection. Correlation of a combination of changes in stroke volume and end-diastolic volume with EMB showed a sensitivity of 85% and a specificity of 96%. Radionuclide scanning is therefore a useful noninvasive tool for monitoring acute rejection

Hog Producers' Risk Management Attitudes and Desire for Additional Risk Management Education

OpenAIRE

Patrick, George F.; Peiter, Amy J.; Knight, Thomas O.; Coble, Keith H.; Baquet, Alan E.

2007-01-01

Hog producers in Indiana and Nebraska were surveyed about sources of risk, effectiveness of risk management strategies, and prior participation in and desire for additional risk management education. Ownership of hogs by the producer, size of the operation, and age did have significant effects on ratings of both sources of risk and effectiveness of risk management strategies. Probit analysis found age, prior attendance, knowledge and prior use of the tool, level of integration, and concern ab...

Plasma volume in acute hypoxia

DEFF Research Database (Denmark)

Poulsen, T D; Klausen, T; Richalet, J P

1998-01-01

Exposure to acute hypoxia is associated with changes in body fluid homeostasis and plasma volume (PV). This study compared a dye dilution technique using Evans' blue (PV[Evans']) with a carbon monoxide (CO) rebreathing method (PV[CO]) for measurements of PV in ten normal subjects at sea level...

Agrobacterium tumefaciens-Mediated Transformation of Pseudocercospora fijiensis to Determine the Role of PfHog1 in Osmotic Stress Regulation and Virulence Modulation

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Francis Onyilo

2017-05-01

Full Text Available Black Sigatoka disease, caused by Pseudocercospora fijiensis is a serious constraint to banana production worldwide. The disease continues to spread in new ecological niches and there is an urgent need to develop strategies for its control. The high osmolarity glycerol (HOG pathway in Saccharomyces cerevisiae is well known to respond to changes in external osmolarity. HOG pathway activation leads to phosphorylation, activation and nuclear transduction of the HOG1 mitogen-activated protein kinases (MAPKs. The activated HOG1 triggers several responses to osmotic stress, including up or down regulation of different genes, regulation of protein translation, adjustments to cell cycle progression and synthesis of osmolyte glycerol. This study investigated the role of the MAPK-encoding PfHog1 gene on osmotic stress adaptation and virulence of P. fijiensis. RNA interference-mediated gene silencing of PfHog1 significantly suppressed growth of P. fijiensis on potato dextrose agar media supplemented with 1 M NaCl, indicating that PfHog1 regulates osmotic stress. In addition, virulence of the PfHog1-silenced mutants of P. fijiensis on banana was significantly reduced, as observed from the low rates of necrosis and disease development on the infected leaves. Staining with lacto phenol cotton blue further confirmed the impaired mycelial growth of the PfHog1 in the infected leaf tissues, which was further confirmed with quantification of the fungal biomass using absolute- quantitative PCR. Collectively, these findings demonstrate that PfHog1 plays a critical role in osmotic stress regulation and virulence of P. fijiensis on its host banana. Thus, PfHog1 could be an interesting target for the control of black Sigatoka disease in banana.

Agrobacterium tumefaciens-Mediated Transformation of Pseudocercospora fijiensis to Determine the Role of PfHog1 in Osmotic Stress Regulation and Virulence Modulation.

Science.gov (United States)

Onyilo, Francis; Tusiime, Geoffrey; Chen, Li-Hung; Falk, Bryce; Stergiopoulos, Ioannis; Tripathi, Jaindra N; Tushemereirwe, Wilberforce; Kubiriba, Jerome; Changa, Charles; Tripathi, Leena

2017-01-01

Black Sigatoka disease, caused by Pseudocercospora fijiensis is a serious constraint to banana production worldwide. The disease continues to spread in new ecological niches and there is an urgent need to develop strategies for its control. The high osmolarity glycerol (HOG) pathway in Saccharomyces cerevisiae is well known to respond to changes in external osmolarity. HOG pathway activation leads to phosphorylation, activation and nuclear transduction of the HOG1 mitogen-activated protein kinases (MAPKs). The activated HOG1 triggers several responses to osmotic stress, including up or down regulation of different genes, regulation of protein translation, adjustments to cell cycle progression and synthesis of osmolyte glycerol. This study investigated the role of the MAPK-encoding PfHog1 gene on osmotic stress adaptation and virulence of P. fijie nsis. RNA interference-mediated gene silencing of PfHog1 significantly suppressed growth of P. fijiensis on potato dextrose agar media supplemented with 1 M NaCl, indicating that PfHog1 regulates osmotic stress. In addition, virulence of the PfHog1 -silenced mutants of P. fijiensis on banana was significantly reduced, as observed from the low rates of necrosis and disease development on the infected leaves. Staining with lacto phenol cotton blue further confirmed the impaired mycelial growth of the PfHog1 in the infected leaf tissues, which was further confirmed with quantification of the fungal biomass using absolute- quantitative PCR. Collectively, these findings demonstrate that PfHog1 plays a critical role in osmotic stress regulation and virulence of P. fijiensis on its host banana. Thus, PfHog1 could be an interesting target for the control of black Sigatoka disease in banana.

Population characteristics and viability of the introduced hog deer (Axis porcinus Zimmermann, 1780 in Phu Khieo Wildlife Sanctuary, Thailand

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Worawidh Wajjwalku

2012-07-01

Full Text Available The purposes of this study were to study population characteristics of hog deer released into the wild, namely: density,age structure, sex ratio, recruitment rate, threats to hog deer, carrying capacity and inter-specific relationships, as well as toassess the population viability over time. In this study, direct observation was used to study the hog deer population characteristics,and population density was estimated from the pellet-group count method. Vortex program was used to analyze thepopulation viability. Results showed that the population density of hog deer at Thung Ka Mung (TKM in Phu Khieo WildlifeSanctuary (PKWS was 2.03-2.04 individuals/hectare (SD = 1.25. The population structure showed that the average herd sizewas 9.57 individuals. Hog deer in TKM preferred to stay with a group (91.5%, rather than being solitary (8.5%. The sex ratiofor males to females was 54.64:100, and for females to fawns was 100:26.18. The annual recruitment rate was 16.98 %. Theirpredators were Asian wild dogs, Burmese pythons, Asiatic jackals, leopard cats and clouded leopards. The mortality rate ofthe existing hog deer in TKM during the study period was 18.1%. The habitat sharing by camera traps revealed 4 ungulatespecies. They were sambar deer, barking deer, wild boar, and elephant, and their relative abundance were 28.41%, 7.38%,4.70%, and 2.01% respectively. Fifty-year simulation modeling using population viability analysis indicated the sustainabilityof this population. Hog deer population in the simulations did not exhibit sensitivity to an increase or decrease in carryingcapacity. Habitat management should be carried out continuously in TKM area, which is the main habitat for hog deer inPKWS.

A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure

OpenAIRE

Guldager, Henrik; Nielsen, Soeren L; Carl, Peder; Soerensen, Mogens B

1997-01-01

Background: The aim of this study was to test the hypothesis that a new mode of ventilation (pressure-regulated volume control; PRVC) is associated with improvements in respiratory mechanics and outcome when compared with conventional volume control (VC) ventilation in patients with acute respiratory failure. We conducted a randomised, prospective, open, cross over trial on 44 patients with acute respiratory failure in the general intensive care unit of a university hospital. After a stabiliz...

Reconstruction of the High-Osmolarity Glycerol (HOG) Signaling Pathway from the Halophilic Fungus Wallemia ichthyophaga in Saccharomyces cerevisiae.

Science.gov (United States)

Konte, Tilen; Terpitz, Ulrich; Plemenitaš, Ana

2016-01-01

The basidiomycetous fungus Wallemia ichthyophaga grows between 1.7 and 5.1 M NaCl and is the most halophilic eukaryote described to date. Like other fungi, W. ichthyophaga detects changes in environmental salinity mainly by the evolutionarily conserved high-osmolarity glycerol (HOG) signaling pathway. In Saccharomyces cerevisiae, the HOG pathway has been extensively studied in connection to osmotic regulation, with a valuable knock-out strain collection established. In the present study, we reconstructed the architecture of the HOG pathway of W. ichthyophaga in suitable S. cerevisiae knock-out strains, through heterologous expression of the W. ichthyophaga HOG pathway proteins. Compared to S. cerevisiae, where the Pbs2 (ScPbs2) kinase of the HOG pathway is activated via the SHO1 and SLN1 branches, the interactions between the W. ichthyophaga Pbs2 (WiPbs2) kinase and the W. ichthyophaga SHO1 branch orthologs are not conserved: as well as evidence of poor interactions between the WiSho1 Src-homology 3 (SH3) domain and the WiPbs2 proline-rich motif, the absence of a considerable part of the osmosensing apparatus in the genome of W. ichthyophaga suggests that the SHO1 branch components are not involved in HOG signaling in this halophilic fungus. In contrast, the conserved activation of WiPbs2 by the S. cerevisiae ScSsk2/ScSsk22 kinase and the sensitivity of W. ichthyophaga cells to fludioxonil, emphasize the significance of two-component (SLN1-like) signaling via Group III histidine kinase. Combined with protein modeling data, our study reveals conserved and non-conserved protein interactions in the HOG signaling pathway of W. ichthyophaga and therefore significantly improves the knowledge of hyperosmotic signal processing in this halophilic fungus.

Efficacy of different bone volume expanders for augmenting lumbar fusions.

Science.gov (United States)

Epstein, Nancy E

2008-01-01

A wide variety of bone volume expanders are being used in performing posterolateral lumbar noninstrumented and instrumented lumbar fusions. This article presents a review of their efficacy based on fusion rates, complications, and outcomes. Lumbar noninstrumented and instrumented fusions frequently use laminar autografts and different bone graft expanders. This review presents the utility of multiple forms/ratios of DBMs containing allografts. It also discusses the efficacy of artificial bone graft substitutes, including HA and B-TCP. Dynamic x-ray and/or CT examinations were used to document fusion in most series. Outcomes were variously assessed using Odom's criteria or different outcome questionnaires (Oswestry Questionnaire, SF-36, Dallas Pain Questionnaire, and/or Low Back Pain Rating Scale). Performing noninstrumented and instrumented lumbar posterolateral fusions resulted in comparable fusion rates in many series. Similar outcomes were also documented based on Odom's criteria or the multiple patient-based questionnaires. However, in some studies, the addition of spinal instrumentation increased the reoperation rate, operative time, blood loss, and cost. Various forms of DBMs, applied in different ratios to autografts, effectively supplemented spinal fusions in animal models and patient series. beta-Tricalcium phosphate, which is used to augment autograft fusions addressing idiopathic scoliosis or lumbar disease, also proved to be effective. Different types of bone volume expanders, including various forms of allograft-based DBMs, and artificial bone graft substitutes (HA and B-TCP) effectively promote posterolateral lumbar noninstrumented and instrumented fusions when added to autografts.

Project recovers free wasted energy from an OSB dryer while eliminating a hog boiler

Energy Technology Data Exchange (ETDEWEB)

Normandin, A.; Levesque, S.; Laflamme, Y.; Charron, R. [Mesar-Environair Inc., Quebec, PQ (Canada)

2008-09-15

This article described how a mill producing oriented strand board (OSB) in Quebec optimized its energy balance with the installation of a flue gas heat recovery (FGHR) system developed by Mesar-Environair Inc. Many OSB mills produce enough wood waste heat to supply their hog boilers with valuable, yet inexpensive, fuel. The objective of this project was to recover waste heat and to find an application in the milling process to re-valorize it. The plant was using 3 hog boilers to heat thermal oil for their process, but only the newest hog boiler was in compliance for particulate emissions levels. The solution involved the use of a direct contact heat exchanger to meet the mill's requirements. The process consisted of pumping the log pond water in a counter-current direction to the humid OSB dryer flue gas. The energy was transferred from the gas to the water via vapor condensation. The customized equipment recovered most of the wasted heat and transferred it to the plant's log ponds. Cool process water from the log ponds was then recirculated through the condenser to trap the wasted energy. The efficiency of the main hog boiler and the chip dry was about 80 per cent. The FGHR process was designed to recover 85 per cent of the wasted energy that was directed to the atmosphere. The heat recovery unit can typically generate temperatures of 70 to 80 degrees C. In addition to fewer emissions of carbon dioxide and nitrogen oxides going out the stack, the FGHR system offers the advantages of heating the process water without additional fuel, and shutting down an old hog boiler. 1 tabs., 3 figs.

The HOG pathway controls osmotic regulation of transcription via the stress response element (STRE) of the Saccharomyces cerevisiae CTT1 gene.

Science.gov (United States)

Schüller, C; Brewster, J L; Alexander, M R; Gustin, M C; Ruis, H

1994-09-15

The HOG signal pathway of the yeast Saccharomyces cerevisiae is defined by the PBS2 and HOG1 genes encoding members of the MAP kinase kinase and of the MAP kinase family, respectively. Mutations in this pathway (deletions of PBS2 or HOG1, or point mutations in HOG1) almost completely abolish the induction of transcription by osmotic stress that is mediated by stress response elements (STREs). We have demonstrated previously that STREs also mediate induction of transcription by heat shock, nitrogen starvation and oxidative stress. This study shows that they are also activated by low external pH, sorbate, benzoate or ethanol stress. Induction by these other stress signals appears to be HOG pathway independent. HOG1-dependent osmotic induction of transcription of the CTT1 gene encoding the cytosolic catalase T occurs in the presence of a protein synthesis inhibitor and can be detected rapidly after an increase of tyrosine phosphorylation of Hog1p triggered by high osmolarity. Consistent with a role of STREs in the induction of stress resistance, a number of other stress protein genes (e.g. HSP104) are regulated like CTT1. Furthermore, catalase T was shown to be important for viability under severe osmotic stress, and heat shock was demonstrated to provide cross-protection against osmotic stress.

Improving HOG with image segmentation: application to human detection

NARCIS (Netherlands)

Salas, Y.S.; Bermudez, D.V.; Peña, A.M.L.; Gomez, D.G.; Gevers, T.

2012-01-01

In this paper we improve the histogram of oriented gradients (HOG), a core descriptor of state-of-the-art object detection, by the use of higher-level information coming from image segmentation. The idea is to re-weight the descriptor while computing it without increasing its size. The benefits of

A New Method of Histogram Computation for Efficient Implementation of the HOG Algorithm

Directory of Open Access Journals (Sweden)

Mariana-Eugenia Ilas

2018-03-01

Full Text Available In this paper we introduce a new histogram computation method to be used within the histogram of oriented gradients (HOG algorithm. The new method replaces the arctangent with the slope computation and the classical magnitude allocation based on interpolation with a simpler algorithm. The new method allows a more efficient implementation of HOG in general, and particularly in field-programmable gate arrays (FPGAs, by considerably reducing the area (thus increasing the level of parallelism, while maintaining very close classification accuracy compared to the original algorithm. Thus, the new method is attractive for many applications, including car detection and classification.

CaZF, a plant transcription factor functions through and parallel to HOG and calcineurin pathways in Saccharomyces cerevisiae to provide osmotolerance.

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Deepti Jain

Full Text Available Salt-sensitive yeast mutants were deployed to characterize a gene encoding a C2H2 zinc finger protein (CaZF that is differentially expressed in a drought-tolerant variety of chickpea (Cicer arietinum and provides salinity-tolerance in transgenic tobacco. In Saccharomyces cerevisiae most of the cellular responses to hyper-osmotic stress is regulated by two interconnected pathways involving high osmolarity glycerol mitogen-activated protein kinase (Hog1p and Calcineurin (CAN, a Ca(2+/calmodulin-regulated protein phosphatase 2B. In this study, we report that heterologous expression of CaZF provides osmotolerance in S. cerevisiae through Hog1p and Calcineurin dependent as well as independent pathways. CaZF partially suppresses salt-hypersensitive phenotypes of hog1, can and hog1can mutants and in conjunction, stimulates HOG and CAN pathway genes with subsequent accumulation of glycerol in absence of Hog1p and CAN. CaZF directly binds to stress response element (STRE to activate STRE-containing promoter in yeast. Transactivation and salt tolerance assays of CaZF deletion mutants showed that other than the transactivation domain a C-terminal domain composed of acidic and basic amino acids is also required for its function. Altogether, results from this study suggests that CaZF is a potential plant salt-tolerance determinant and also provide evidence that in budding yeast expression of HOG and CAN pathway genes can be stimulated in absence of their regulatory enzymes to provide osmotolerance.

Rent Sharing in Multi-Site Hog Production

OpenAIRE

Brian P. Cozzarin; Randall E. Westgren

2000-01-01

A firm-level model of three-site hog production is used compare a franchise organizational structure to a three-firm alliance. The results of the simulations imply that the franchise system is better equipped to mitigate underproduction in the nursery and finishing units, the nursery and finishing units lose relatively more profit than they otherwise would in an alliance. The pig-space guatantee does little to offset the financial risk for the nursery and finishing units when underproduction ...

Hydroquinone, a benzene metabolite, induces Hog1-dependent stress response signaling and causes aneuploidy in Saccharomyces cerevisiae

International Nuclear Information System (INIS)

Shiga, Takeki; Suzuki, Hiroyuki; Yamamoto, Hiroaki; Yamamoto, Kazuo; Yamamoto, Ayumi

2010-01-01

Previously, we have shown that phenyl hydroquinone, a hepatic metabolite of the Ames test-negative carcinogen o-phenylphenol, efficiently induced aneuploidy in Saccharomyces cerevisiae by arresting the cell cycle at the G2/M transition as a result of the activation of the Hog1 (p38 MAPK homolog)-Swe1 (Wee1 homolog) pathway. In this experiment, we examined the aneuploidy forming effects of hydroquinone, a benzene metabolite, since both phenyl hydroquinone and hydroquinone are Ames-test negative carcinogens and share similar molecular structures. As was seen in phenyl hydroquinone, hydroquinone induced aneuploidy in yeast by delaying the cell cycle at the G2/M transition. Deficiencies in SWE1 and HOG1 abolished the hydroquinone-induced delay at the G2/M transition and aneuploidy formation. Furthermore, Hog1 was phosphorylated by hydroquinone, which may stabilize Swe1. These data indicate that the hydroquinone-induced G2/M transition checkpoint, which is activated by the Hog1-Swe1 pathway, plays a role in the formation of aneuploidy. (author)

Humoral Na+-K+ pump inhibitory activity in essential hypertension and in normotensive subjects after acute volume expansion

International Nuclear Information System (INIS)

Pamnani, M.B.; Burris, J.F.; Jemionek, J.F.; Huot, S.J.; Price, M.; Freis, E.D.; Haddy, F.J.

1989-01-01

Plasma from black male patients with essential hypertension was bioassayed for vascular Na+-K+ pump inhibitory activity. Halves of the same rat tail artery were incubated for two hours in boiled plasma supernates from a hypertensive patient and a paired age-, sex-, and race-matched normotensive subject and then ouabain-sensitive 86 Rb uptake was measured. Ouabain-sensitive 86 Rb uptake by their leukocytes was also measured. Eighteen pairs of subjects were studied. The uptakes were not significantly different in the hypertensive patients and control subjects. However, when we selected from the eighteen hypertensive patients, nine with low plasma renin activity on the day of the study, uptakes were reduced in the hypertensive patients relative to the paired control subjects. We also assayed plasma supernates from normotensive black and white male subjects before and after acute volume expansion (2.5 L saline IV + 1.5 L distilled water orally over a three-hour period) and from paired normotensive subjects before and after sham volume expansion and obtained a positive bioassay in the expanded subjects both on intraindividual and interindividual comparisons. These studies demonstrate increased vascular Na+-K+ pump inhibitory activity in the plasma of black male patients with low renin essential hypertension and in the plasma of normotensive subjects after acute volume expansion. The findings suggest that the inhibitory activity in the hypertensive subjects' plasma is related to volume expansion, relative or absolute

Ship detection based on rotation-invariant HOG descriptors for airborne infrared images

Science.gov (United States)

Xu, Guojing; Wang, Jinyan; Qi, Shengxiang

2018-03-01

Infrared thermal imagery is widely used in various kinds of aircraft because of its all-time application. Meanwhile, detecting ships from infrared images attract lots of research interests in recent years. In the case of downward-looking infrared imagery, in order to overcome the uncertainty of target imaging attitude due to the unknown position relationship between the aircraft and the target, we propose a new infrared ship detection method which integrates rotation invariant gradient direction histogram (Circle Histogram of Oriented Gradient, C-HOG) descriptors and the support vector machine (SVM) classifier. In details, the proposed method uses HOG descriptors to express the local feature of infrared images to adapt to changes in illumination and to overcome sea clutter effects. Different from traditional computation of HOG descriptor, we subdivide the image into annular spatial bins instead of rectangle sub-regions, and then Radial Gradient Transform (RGT) on the gradient is applied to achieve rotation invariant histogram information. Considering the engineering application of airborne and real-time requirements, we use SVM for training ship target and non-target background infrared sample images to discriminate real ships from false targets. Experimental results show that the proposed method has good performance in both the robustness and run-time for infrared ship target detection with different rotation angles.

An evolutionarily stable strategy and the critical point of hog futures trading entities based on replicator dynamic theory: 2006-2015 data for China's 22 provinces.

Science.gov (United States)

Pang, Jinbo; Deng, Lingfei; Wang, Gangyi

2017-01-01

Although frequent fluctuations in domestic hog prices seriously affect the stability and robustness of the hog supply chain, hog futures (an effective hedging instrument) have not been listed in China. To better understand hog futures market hedging, it is important to study the steady state of intersubjective bidding. This paper uses evolutionary game theory to construct a game model between hedgers and speculators in the hog futures market, and replicator dynamic equations are then used to obtain the steady state between the two trading entities. The results show that the steady state is one in which hedgers adopt a "buy" strategy and speculators adopt a "do not speculate" strategy, but this type of extreme steady state is not easily realized. Thus, to explore the rational proportion of hedgers and speculators in the evolutionary stabilization strategy, bidding processes were simulated using weekly average hog prices from 2006 to 2015, such that the conditions under which hedgers and speculators achieve a steady state could be analyzed. This task was performed to achieve the stability critical point, and we show that only when the value of λ is satisfied and the conditions of hog futures price changes and futures price are satisfied can hedgers and speculators achieve a rational proportion and a stable hog futures market. This market can thus provide a valuable reference for the development of the Chinese hog futures market and the formulation and guidance of relevant departmental policies.

Using infrared HOG-based pedestrian detection for outdoor autonomous searching UAV with embedded system

Science.gov (United States)

Shao, Yanhua; Mei, Yanying; Chu, Hongyu; Chang, Zhiyuan; He, Yuxuan; Zhan, Huayi

2018-04-01

Pedestrian detection (PD) is an important application domain in computer vision and pattern recognition. Unmanned Aerial Vehicles (UAVs) have become a major field of research in recent years. In this paper, an algorithm for a robust pedestrian detection method based on the combination of the infrared HOG (IR-HOG) feature and SVM is proposed for highly complex outdoor scenarios on the basis of airborne IR image sequences from UAV. The basic flow of our application operation is as follows. Firstly, the thermal infrared imager (TAU2-336), which was installed on our Outdoor Autonomous Searching (OAS) UAV, is used for taking pictures of the designated outdoor area. Secondly, image sequences collecting and processing were accomplished by using high-performance embedded system with Samsung ODROID-XU4 and Ubuntu as the core and operating system respectively, and IR-HOG features were extracted. Finally, the SVM is used to train the pedestrian classifier. Experiment show that, our method shows promising results under complex conditions including strong noise corruption, partial occlusion etc.

Sistem Verifikasi Tanda Tangan Off-Line Berdasar Ciri Histogram Of Oriented Gradient (HOG Dan Histogram Of Curvature (HoC

Directory of Open Access Journals (Sweden)

Agus Wahyu Widodo

2015-08-01

Full Text Available Abstrak Tanda tangan dengan sifat uniknya merupakan salah satu dari sekian banyak atribut personal yang diterima secara luas untuk verifikasi indentitas seseorang, alat pembuktian kepemilikan berbagai transaksi atau dokumen di dalam masyarakat. Keberhasilan penggunaan ciri gradien dan curvature dalam bidang-bidang penelitian pengenalan pola dan bahwa tanda tangan dapat dikatakan merupakan hasil tulisan tangan yang tersusun atas beragam garis dan lengkungan (curve yang memiliki arah atau orientasi merupakan alasan bahwa kedua ciri tersebut digunakan sebagai metoda verifikasi tanda tangan offline di penelitian ini. Berbagai implementasi dari pre-processing, ekstraksi dan representasi ciri, dan pembelajaran SVM serta usaha perbaikan yang telah dilakukan dalam penelitian ini menunjukkan hasil bahwa ciri HOG dan HoC mampu dimanfaatkan dalam proses verifikasi tanda tangan secara offline.  Pada basis data GPDS960Signature, HOG dan HoC yang dihitung pada ukuran sel 30 x 30 piksel memberikan dengan nilai %FRR terbaik 26,90 dan %FAR 37,56.  Sedangkan pada basis data FUM-PHSDB, HOG dn HoC yang dihitung pada ukuran 60 x 60 piksel memberikan nilai %FRR terbaik 4 dan %FAR 57. Kata kunci: verifikasi tanda tangan, curvature, orientation, gradient, histogram of curvature (HoC, histogram of oriented gradient (HOG Abstract Signature with unique properties is one of the many personal attributes that are widely accepted to verify a person's identity, proof of ownership transactions instrument or document in the community. The successful use of gradient and curvature feature in the research fields of pattern recognition is the reason that both of these features are used as an offline signature verification method in this study. Various implementations of preprocessing, feature extraction and representation, and SVM learning has been done in the study showed results that HOG and HoC feature can be utilized in the process of offline signature verification.  HOG and

Mean Platelet volume in diagnosis of acute appendicitis in children ...

African Journals Online (AJOL)

Background: The clinical diagnosis of acute appendicitis (AA) in children is still problematic in status. Objectives: To investigate the diagnostic value of mean platelet volume (MPV) in acute AA at childhood. Methods: One hundred patients diagnosed as AA patients and 100 healthy individuals. Laboratory tests were studied ...

SAR Target Recognition via Supervised Discriminative Dictionary Learning and Sparse Representation of the SAR-HOG Feature

Directory of Open Access Journals (Sweden)

Shengli Song

2016-08-01

Full Text Available Automatic target recognition (ATR in synthetic aperture radar (SAR images plays an important role in both national defense and civil applications. Although many methods have been proposed, SAR ATR is still very challenging due to the complex application environment. Feature extraction and classification are key points in SAR ATR. In this paper, we first design a novel feature, which is a histogram of oriented gradients (HOG-like feature for SAR ATR (called SAR-HOG. Then, we propose a supervised discriminative dictionary learning (SDDL method to learn a discriminative dictionary for SAR ATR and propose a strategy to simplify the optimization problem. Finally, we propose a SAR ATR classifier based on SDDL and sparse representation (called SDDLSR, in which both the reconstruction error and the classification error are considered. Extensive experiments are performed on the MSTAR database under standard operating conditions and extended operating conditions. The experimental results show that SAR-HOG can reliably capture the structures of targets in SAR images, and SDDL can further capture subtle differences among the different classes. By virtue of the SAR-HOG feature and SDDLSR, the proposed method achieves the state-of-the-art performance on MSTAR database. Especially for the extended operating conditions (EOC scenario “Training 17 ∘ —Testing 45 ∘ ”, the proposed method improves remarkably with respect to the previous works.

Estimation of the dynamics and rate of transmission of classical swine fever (hog cholera) in wild pigs.

Science.gov (United States)

Hone, J; Pech, R; Yip, P

1992-04-01

Infectious diseases establish in a population of wildlife hosts when the number of secondary infections is greater than or equal to one. To estimate whether establishment will occur requires extensive experience or a mathematical model of disease dynamics and estimates of the parameters of the disease model. The latter approach is explored here. Methods for estimating key model parameters, the transmission coefficient (beta) and the basic reproductive rate (RDRS), are described using classical swine fever (hog cholera) in wild pigs as an example. The tentative results indicate that an acute infection of classical swine fever will establish in a small population of wild pigs. Data required for estimation of disease transmission rates are reviewed and sources of bias and alternative methods discussed. A comprehensive evaluation of the biases and efficiencies of the methods is needed.

Price Density Forecasts in the U.S. Hog Market: Composite Procedures

NARCIS (Netherlands)

Trujillo Barrera, A.A.; Garcia, P.; Mallory, M.

2013-01-01

Abstract We develop and evaluate quarterly out-of-sample individual and composite density forecasts for U.S. hog prices using data from 1975.I to 2010.IV. Individual forecasts are generated from time series models and the implied distribution of USDA outlook forecasts. Composite density forecasts

HOG MAP kinase regulation of alternariol biosynthesis in Alternaria alternata is important for substrate colonization.

Science.gov (United States)

Graf, Eva; Schmidt-Heydt, Markus; Geisen, Rolf

2012-07-16

Strains of the genus Alternaria are ubiquitously present and frequently found on fruits, vegetables and cereals. One of the most commonly found species from this genus is A. alternata which is able to produce the mycotoxin alternariol among others. To date only limited knowledge is available about the regulation of the biosynthesis of alternariol, especially under conditions relevant to food. Tomatoes are a typical substrate of A. alternata and have a high water activity. On the other hand cereals with moderate water activity are also frequently colonized by A. alternata. In the current analysis it was demonstrated that even minor changes in the osmotic status of the substrate affect the alternariol biosynthesis of strains from vegetables resulting in nearly complete inhibition. High osmolarity in the environment is usually transmitted to the transcriptional level of downstream regulated genes by the HOG signal cascade (high osmolarity glycerol cascade) which is a MAP kinase transduction pathway. The phosphorylation status of the A. alternata HOG (AaHOG) was determined. Various concentrations of NaCl induce the phosphorylation of AaHOG in a concentration, time and strain dependent manner. A strain with a genetically inactivated aahog gene was no longer able to produce alternariol indicating that the activity of the aahog gene is required for alternariol biosynthesis. Further experiments revealed that the biosynthesis of alternariol is important for the fungus to colonize tomato tissue. The tight water activity dependent regulation of alternariol biosynthesis ensures alternariol biosynthesis at conditions which indicate an optimal colonization substrate for the fungus. Copyright © 2012 Elsevier B.V. All rights reserved.

Finisher hog production in the Southeastern United States: Ancillary measurements derived from the National Air Emissions Monitoring Study (NAEMS)

Science.gov (United States)

Robarge, W. P.; Lee, S.; Walker, J. T.

2010-12-01

Measurements of emissions of gases and fine particulate matter from swine animal feeding operations (AFOs) in the southeastern US have typically been confined to relatively short periods (days to several weeks) and have generally focused on waste lagoons. Access to swine animal housing units and other ancillary information has been limited. The National Air Emissions Monitoring Study (NAEMS) provided a unique opportunity to characterize emissions from swine housing units for an extended period of time (~ 2 years), and allowed access to ancillary measurements regarding nutrient flows (feed amounts and composition), manure dynamics, animal inventories, water usage and farm management. Presented here is a summary of the observations made for a NAEMS finisher site (NC3B) selected as being representative of swine production in the southeastern US. Finisher hogs are raised in rotations (~ 140 days) with a target market weight of 123 kg/hog. Among the population during a rotation (700-800 hogs/barn) the actual growth rate varies with a series of “grade-outs” of market-weight hogs starting ~ 110 days from initial load-in. Derivation of the standing live-weight in the barns during a rotation therefore requires use of a growth model and summation over several different “populations” of hogs within a single barn. Up to 5 different feed formulations are fed during a rotation with %N content ranging from (3.4 to 2.2% N; total feed consumed 181,000 kg/barn). Across 4 complete rotations, N consumed was ~50 g N per hog/day. Of this amount, we estimate ~ 60% is excreted as fecal matter and urine. The TAN (NH3 + NH4+) content of the shallow pits is consistently higher (1880 ±390 mg TAN/L) than that found in the anaerobic lagoon (800 ±70 mg TAN/L), except immediately after recharge following pit-pull (pH of the two liquids was similar). The presence of a recalcitrant layer of sludge in the shallow pits (liquid height = 20 cm; sludge depth = 5-10 cm; TAN = 2500 mg N/L; total

The Hog1p kinase regulates Aft1p transcription factor to control iron accumulation.

Science.gov (United States)

Martins, Telma S; Pereira, Clara; Canadell, David; Vilaça, Rita; Teixeira, Vítor; Moradas-Ferreira, Pedro; de Nadal, Eulàlia; Posas, Francesc; Costa, Vítor

2018-01-01

Iron acquisition systems have to be tightly regulated to assure a continuous supply of iron, since it is essential for survival, but simultaneously to prevent iron overload that is toxic to the cells. In budding yeast, the low‑iron sensing transcription factor Aft1p is a master regulator of the iron regulon. Our previous work revealed that bioactive sphingolipids modulate iron homeostasis as yeast cells lacking the sphingomyelinase Isc1p exhibit an upregulation of the iron regulon. In this study, we show that Isc1p impacts on iron accumulation and localization. Notably, Aft1p is activated in isc1Δ cells due to a decrease in its phosphorylation and an increase in its nuclear levels. Consistently, the expression of a phosphomimetic version of Aft1p-S210/S224 that favours its nuclear export abolished iron accumulation in isc1Δ cells. Notably, the Hog1p kinase, homologue of mammalian p38, interacts with and directly phosphorylates Aft1p at residues S210 and S224. However, Hog1p-Aft1p interaction decreases in isc1Δ cells, which likely contributes to Aft1p dephosphorylation and consequently to Aft1p activation and iron overload in isc1Δ cells. These results suggest that alterations in sphingolipid composition in isc1Δ cells may impact on iron homeostasis by disturbing the regulation of Aft1p by Hog1p. To our knowledge, Hog1p is the first kinase reported to directly regulate Aft1p, impacting on iron homeostasis. Copyright © 2017 Elsevier B.V. All rights reserved.

Production Contracts and the Spot Market Price of Hogs

OpenAIRE

Key, Nigel D.

2010-01-01

The increasing use of production contracts in the hog sector has reduced the number of spot market transactions, raised concerns about price manipulation and helped to spur legislation requiring price reporting by packers. Using data from the 2002 and 2007 Censuses of Agriculture, this study looks for evidence of market manipulation by examining whether the local prevalence of contracting affects the average price received by independent producers. The empirical approach uses a fixed-effects ...

Expanding the treatment window with mechanical thrombectomy in acute ischemic stroke

Energy Technology Data Exchange (ETDEWEB)

Layton, Kennith F.; Cloft, Harry J.; Kallmes, David F. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); White, J. Bradley [Mayo Clinic, Department of Neurosurgery, Rochester, MN, (United States); Manno, Edward M. [Mayo Clinic, Department of Neurology, Rochester, MN, (United States)

2006-06-15

Acute ischemic stroke is a common disease associated with high mortality and significant long-term disability. Treatment options for acute ischemic stroke continue to evolve and include pharmaceutical and mechanical therapies. With the recent US Food and Drug Administration approval of a new device for mechanical thrombectomy, the options available for treatment of acute ischemic stroke have been expanded. Thrombolytic therapy is generally given intravenously in the first 3 h and up to 6 h via the intraarterial route for pharmacological clot disruption. The maximum time-frame for mechanical thrombectomy devices has yet to be determined. A 78-year-old female presented to the emergency room with a dense right hemiparesis, leftward gaze preference and dense global aphasia. Eight hours after symptom onset, left carotid angiography confirmed a left internal carotid artery terminus occlusion. A single pass was made through the clot with an X6 Merci Retriever device. After a single pass, the vessel was reopened and normal flow in the left internal carotid artery was demonstrated. At the time of discharge, her neurological deficits had improved significantly. Furthermore, the final infarct area, as demonstrated on magnetic resonance imaging, was probably much smaller than it would have been if the vessel had not been recanalized. (orig.)

Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

International Nuclear Information System (INIS)

Wagner, Marlies; Kyriakou, Yiannis; Mesnil de Rochemont, Richard du; Singer, Oliver C.; Berkefeld, Joachim

2013-01-01

PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy

Role of Self-Expandable Metal Stents in Acute Variceal Bleeding

Directory of Open Access Journals (Sweden)

Fuad Maufa

2012-01-01

Full Text Available Acute variceal bleeding continues to be associated with significant mortality. Current standard of care combines hemodynamic stabilization, antibiotic prophylaxis, pharmacological agents, and endoscopic treatment. Rescue therapies using balloon tamponade or transjugular intrahepatic portosystemic shunt are implemented when first-line therapy fails. Rescue therapies have many limitations and are contraindicated in some cases. Placement of fully covered self-expandable metallic stent is a promising therapeutic technique that can be used to control bleeding in cases of refractory esophageal bleeding as an alternative to balloon tamponade. These stents can be left in place for as long as two weeks, allowing for improvement in liver function and institution of a more definitive treatment.

78 FR 45057 - Safety Zone; Alpena Area HOG Rally Fireworks, Alpena, Michigan

Science.gov (United States)

2013-07-26

...-AA00 Safety Zone; Alpena Area HOG Rally Fireworks, Alpena, Michigan AGENCY: Coast Guard, DHS. ACTION... rally in Alpena, Michigan with a fireworks display. Fireworks will be launched near the end of Mason Street, South of State Avenue, approximately 50 yards west of Thunder Bay in Alpena, Michigan. The...

Simulation of the Impact of SRT on Anaerobic Digestability of Ultrasonicated Hog Manure

Directory of Open Access Journals (Sweden)

Elsayed Elbeshbishy

2010-05-01

Full Text Available Ultrasonication at a specific energy of 500 kJ/kgTS was applied to hog manure in a continuous mode completely mixed anaerobic digestion. A process model in BioWin was developed, calibrated and tested at different solids retention times (SRTs to evaluate the process economics. The results showed that there was a 36% increase in volatile suspended solids (VSS removal efficiency, a 20% increase in methane production rate, a 13.5% increase in destruction of bound proteins, and a reduction from 988 to 566 ppm in H2S concentration in the digester headspace. Furthermore, a calibrated model of the process using BioWin to assess the impact of SRTs on the economics of anaerobic digestion for unsonicated and sonicated hog manure revealed that ultrasonication resulted in a net benefit of $42–46/ton dry solids at SRTs of 15–30 days.

Simulation of the impact of SRT on anaerobic digestability of ultrasonicated hog manure

Energy Technology Data Exchange (ETDEWEB)

Elbeshbishy, E.; Hafez, H.; Nakhla, G. [Department of Civil and Environmental Engineering, University of Western Ontario, London, Ontario N6A 5B9 (Canada); Nakevski, A.; Ray, M. [Department of Chemical and Biochemical Engineering, University of Western Ontario, London, Ontario N6A 5B9 (Canada)

2010-07-01

Ultrasonication at a specific energy of 500 kJ/kgTS was applied to hog manure in a continuous mode completely mixed anaerobic digestion. A process model in BioWin was developed, calibrated and tested at different solids retention times (SRTs) to evaluate the process economics. The results showed that there was a 36% increase in volatile suspended solids (VSS) removal efficiency, a 20% increase in methane production rate, a 13.5% increase in destruction of bound proteins, and a reduction from 988 to 566 ppm in H{sub 2}S concentration in the digester headspace. Furthermore, a calibrated model of the process using BioWin to assess the impact of SRTs on the economics of anaerobic digestion for unsonicated and sonicated hog manure revealed that ultrasonication resulted in a net benefit of $42-46/ton dry solids at SRTs of 15-30 days. (author)

The volume of fluid injected into the tissue expander and the tissue expansion

Directory of Open Access Journals (Sweden)

Mahmood Omranifard

2014-01-01

Full Text Available Background: Replacement of the lost tissue is the major concerns of the plastic surgeons. Expanded area should be coherent with the surrounding tissue. Tissue expansion technique is the reforming methods the skin tissue scarcities. Several methods for tissue expansion are available; including usage of silicon balloon and injecting fluid into the tissue expander. Materials and Methods: In a clinical trial study, 35 patients, with burn scars, in the face, skull and neck area were studied. We provided a tissue expander device with capacities of 125, 250 and 350cc. Fluid was injected inside the device, 3 consecutive weeks with 1-week interval. After 3 months the device was set out and the tissue expansion was measured using a transparent board and the results were analyzed. Multiple regression was done by SPSS 20 to analyze the data. Results: Regression model showed Skin expansion was positively correlated with the volume of the injected fluid. For each centimeter square of skin expansion, about 6-8 ml of fluid must be injected. Conclusion: Correction of skin defects resulting from burning scar is possible using tissue expanders. The tissue expansion is correlated with the amount of the injected fluid.

Failure of Noninvasive Ventilation for De Novo Acute Hypoxemic Respiratory Failure: Role of Tidal Volume.

Science.gov (United States)

Carteaux, Guillaume; Millán-Guilarte, Teresa; De Prost, Nicolas; Razazi, Keyvan; Abid, Shariq; Thille, Arnaud W; Schortgen, Frédérique; Brochard, Laurent; Brun-Buisson, Christian; Mekontso Dessap, Armand

2016-02-01

A low or moderate expired tidal volume can be difficult to achieve during noninvasive ventilation for de novo acute hypoxemic respiratory failure (i.e., not due to exacerbation of chronic lung disease or cardiac failure). We assessed expired tidal volume and its association with noninvasive ventilation outcome. Prospective observational study. Twenty-four bed university medical ICU. Consecutive patients receiving noninvasive ventilation for acute hypoxemic respiratory failure between August 2010 and February 2013. Noninvasive ventilation was uniformly delivered using a simple algorithm targeting the expired tidal volume between 6 and 8 mL/kg of predicted body weight. Expired tidal volume was averaged and respiratory and hemodynamic variables were systematically recorded at each noninvasive ventilation session. Sixty-two patients were enrolled, including 47 meeting criteria for acute respiratory distress syndrome, and 32 failed noninvasive ventilation (51%). Pneumonia (n = 51, 82%) was the main etiology of acute hypoxemic respiratory failure. The median (interquartile range) expired tidal volume averaged over all noninvasive ventilation sessions (mean expired tidal volume) was 9.8 mL/kg predicted body weight (8.1-11.1 mL/kg predicted body weight). The mean expired tidal volume was significantly higher in patients who failed noninvasive ventilation as compared with those who succeeded (10.6 mL/kg predicted body weight [9.6-12.0] vs 8.5 mL/kg predicted body weight [7.6-10.2]; p = 0.001), and expired tidal volume was independently associated with noninvasive ventilation failure in multivariate analysis. This effect was mainly driven by patients with PaO2/FIO2 up to 200 mm Hg. In these patients, the expired tidal volume above 9.5 mL/kg predicted body weight predicted noninvasive ventilation failure with a sensitivity of 82% and a specificity of 87%. A low expired tidal volume is almost impossible to achieve in the majority of patients receiving noninvasive ventilation

Osmostress induces autophosphorylation of Hog1 via a C-terminal regulatory region that is conserved in p38α.

Directory of Open Access Journals (Sweden)

Inbal Maayan

Full Text Available Many protein kinases require phosphorylation at their activation loop for induction of catalysis. Mitogen-activated protein kinases (MAPKs are activated by a unique mode of phosphorylation, on neighboring Tyrosine and Threonine residues. Whereas many kinases obtain their activation via autophosphorylation, MAPKs are usually phosphorylated by specific, dedicated, MAPK kinases (MAP2Ks. Here we show however, that the yeast MAPK Hog1, known to be activated by the MAP2K Pbs2, is activated in pbs2Δ cells via an autophosphorylation activity that is induced by osmotic pressure. We mapped a novel domain at the Hog1 C-terminal region that inhibits this activity. Removal of this domain provides a Hog1 protein that is partially independent of MAP2K, namely, partially rescues osmostress sensitivity of pbs2Δ cells. We further mapped a short domain (7 amino acid residues long that is critical for induction of autophosphorylation. Its removal abolishes autophosphorylation, but maintains Pbs2-mediated phosphorylation. This 7 amino acids stretch is conserved in the human p38α. Similar to the case of Hog1, it's removal from p38α abolishes p38α's autophosphorylation capability, but maintains, although reduces, its activation by MKK6. This study joins a few recent reports to suggest that, like many protein kinases, MAPKs are also regulated via induced autoactivation.

Osmostress induces autophosphorylation of Hog1 via a C-terminal regulatory region that is conserved in p38α.

Science.gov (United States)

Maayan, Inbal; Beenstock, Jonah; Marbach, Irit; Tabachnick, Shira; Livnah, Oded; Engelberg, David

2012-01-01

Many protein kinases require phosphorylation at their activation loop for induction of catalysis. Mitogen-activated protein kinases (MAPKs) are activated by a unique mode of phosphorylation, on neighboring Tyrosine and Threonine residues. Whereas many kinases obtain their activation via autophosphorylation, MAPKs are usually phosphorylated by specific, dedicated, MAPK kinases (MAP2Ks). Here we show however, that the yeast MAPK Hog1, known to be activated by the MAP2K Pbs2, is activated in pbs2Δ cells via an autophosphorylation activity that is induced by osmotic pressure. We mapped a novel domain at the Hog1 C-terminal region that inhibits this activity. Removal of this domain provides a Hog1 protein that is partially independent of MAP2K, namely, partially rescues osmostress sensitivity of pbs2Δ cells. We further mapped a short domain (7 amino acid residues long) that is critical for induction of autophosphorylation. Its removal abolishes autophosphorylation, but maintains Pbs2-mediated phosphorylation. This 7 amino acids stretch is conserved in the human p38α. Similar to the case of Hog1, it's removal from p38α abolishes p38α's autophosphorylation capability, but maintains, although reduces, its activation by MKK6. This study joins a few recent reports to suggest that, like many protein kinases, MAPKs are also regulated via induced autoactivation.

A clinical evaluation of endoscopically placed self-expanding metallic stents in patients with acute large bowel obstruction

DEFF Research Database (Denmark)

Pommergaard, H C; Vilmann, P; Jakobsen, H L

2009-01-01

BACKGROUND AND AIMS: Self-expanding metallic stents (SEMS) have since 1991 established themselves as an option in the treatment of large bowel obstruction. The aim of this study was to evaluate the use of SEMS in management of acute colorectal obstructions at a Danish Surgical Gastroenterology...

Five-dimensional Monopole Equation with Hedge-Hog Ansatz and Abel's Differential Equation

OpenAIRE

Kihara, Hironobu

2008-01-01

We review the generalized monopole in the five-dimensional Euclidean space. A numerical solution with the Hedge-Hog ansatz is studied. The Bogomol'nyi equation becomes a second order autonomous non-linear differential equation. The equation can be translated into the Abel's differential equation of the second kind and is an algebraic differential equation.

Expanding the pool of kidney donors: use of kidneys with acute renal dysfunction

OpenAIRE

Matos, Ana Cristina Carvalho de; Requião-Moura, Lúcio Roberto; Clarizia, Gabriela; Durão Junior, Marcelino de Souza; Tonato, Eduardo José; Chinen, Rogério; Arruda, Érika Ferraz de; Filiponi, Thiago Corsi; Pires, Luciana Mello de Mello Barros; Bertocchi, Ana Paula Fernandes; Pacheco-Silva, Alvaro

2015-01-01

ABSTRACT Given the shortage of organs transplantation, some strategies have been adopted by the transplant community to increase the supply of organs. One strategy is the use of expanded criteria for donors, that is, donors aged >60 years or 50 and 59 years, and meeting two or more of the following criteria: history of hypertension, terminal serum creatinine >1.5mg/dL, and stroke as the donor´s cause of death. In this review, emphasis was placed on the use of donors with acute renal failure, ...

Expander Codes

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 10; Issue 1. Expander Codes - The Sipser–Spielman Construction. Priti Shankar. General Article Volume 10 ... Author Affiliations. Priti Shankar1. Department of Computer Science and Automation, Indian Institute of Science Bangalore 560 012, India.

Acute volume expansion preserves orthostatic tolerance during whole-body heat stress in humans.

Science.gov (United States)

Keller, David M; Low, David A; Wingo, Jonathan E; Brothers, R Matthew; Hastings, Jeff; Davis, Scott L; Crandall, Craig G

2009-03-01

Whole-body heat stress reduces orthostatic tolerance via a yet to be identified mechanism(s). The reduction in central blood volume that accompanies heat stress may contribute to this phenomenon. The purpose of this study was to test the hypothesis that acute volume expansion prior to the application of an orthostatic challenge attenuates heat stress-induced reductions in orthostatic tolerance. In seven normotensive subjects (age, 40 +/- 10 years: mean +/- S.D.), orthostatic tolerance was assessed using graded lower-body negative pressure (LBNP) until the onset of symptoms associated with ensuing syncope. Orthostatic tolerance (expressed in cumulative stress index units, CSI) was determined on each of 3 days, with each day having a unique experimental condition: normothermia, whole-body heating, and whole-body heating + acute volume expansion. For the whole-body heating + acute volume expansion experimental day, dextran 40 was rapidly infused prior to LBNP sufficient to return central venous pressure to pre-heat stress values. Whole-body heat stress alone reduced orthostatic tolerance by approximately 80% compared to normothermia (938 +/- 152 versus 182 +/- 57 CSI; mean +/- S.E.M., P body heating completely ameliorated the heat stress-induced reduction in orthostatic tolerance (1110 +/- 69 CSI, P stress results in many cardiovascular and neural responses that directionally challenge blood pressure regulation, reduced central blood volume appears to be an underlying mechanism responsible for impaired orthostatic tolerance in the heat-stressed human.

Ambient temperature and volume of perihematomal edema in acute intracerebral haemorrhage: the INTERACT1 study.

Science.gov (United States)

Zheng, Danni; Arima, Hisatomi; Heeley, Emma; Karpin, Anne; Yang, Jie; Chalmers, John; Anderson, Craig S

2015-01-01

As no human data exist, we aimed to determine the relation between ambient temperature and volume of perihematomal 'cerebral' edema in acute spontaneous intracerebral haemorrhage (ICH) among Chinese participants of the pilot phase, Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT1). INTERACT1 was a multicenter, open, blind outcome assessed, randomized controlled trial of intensive (systolic target ambient temperature (mean, minimum, maximum, and range) on the day of each participant's ICH obtained from China Meteorological Data Sharing Service System were linked to other data including edema volumes. Multivariable regression analyses were performed to evaluate association between ambient temperature and edema volumes. A generalized linear regression model with a generalized estimating equations approach (GEE) was used to assess any association of ambient temperature and change in edema volume over 72 h. A total of 250 of all 384 Chinese participants had complete data that showed positive associations between ambient temperature (mean and minimum temperatures) and edema volumes at each time point over 72 h after hospital admission (all P ambient temperature and perihematomal edema volume in acute spontaneous ICH. © 2014 World Stroke Organization.

Do Transaction Costs and Risk Preferences Influence Marketing Arrangements in the Illinois Hog Industry?

NARCIS (Netherlands)

Franken, J.R.V.; Pennings, J.M.E.; Garcia, P.

2008-01-01

Studies of hog industry structure often invoke risk reduction and transaction costs explanations for empirical observations but fail to directly examine the core concepts of risk behavior and transaction costs theories. Using a more unified conceptual framework and unique survey and accounting data,

COUNTRY OF ORIGIN LABELING: IMPLICATIONS FOR THE MANITOBA HOG INDUSTRY

OpenAIRE

Grier, Kevin; Martin, Larry J.; Mayer, Holly

2002-01-01

This project was undertaken at the request of the Manitoba Pork Council in order to assess the impact of the Country Of Origin Labeling (COL) provisions of the US Farm Bill. The Council needs to know the consequences (economic and otherwise) of COL upon Manitoba hog farmers. The Farm Security and Rural Investment Act of 2002 (the Farm Bill) contains a provision that requires the United States Department of Agriculture (USDA) to issue country of origin labeling guidelines for voluntary use by ...

Automatic Samples Selection Using Histogram of Oriented Gradients (HOG Feature Distance

Directory of Open Access Journals (Sweden)

Inzar Salfikar

2018-01-01

Full Text Available Finding victims at a disaster site is the primary goal of Search-and-Rescue (SAR operations. Many technologies created from research for searching disaster victims through aerial imaging. but, most of them are difficult to detect victims at tsunami disaster sites with victims and backgrounds which are look similar. This research collects post-tsunami aerial imaging data from the internet to builds dataset and model for detecting tsunami disaster victims. Datasets are built based on distance differences from features every sample using Histogram-of-Oriented-Gradient (HOG method. We use the longest distance to collect samples from photo to generate victim and non-victim samples. We claim steps to collect samples by measuring HOG feature distance from all samples. the longest distance between samples will take as a candidate to build the dataset, then classify victim (positives and non-victim (negatives samples manually. The dataset of tsunami disaster victims was re-analyzed using cross-validation Leave-One-Out (LOO with Support-Vector-Machine (SVM method. The experimental results show the performance of two test photos with 61.70% precision, 77.60% accuracy, 74.36% recall and f-measure 67.44% to distinguish victim (positives and non-victim (negatives.

Cold exposure affects carbohydrates and lipid metabolism, and induces Hog1p phosphorylation in Dekkera bruxellensis strain CBS 2499.

Science.gov (United States)

Galafassi, Silvia; Toscano, Marco; Vigentini, Ileana; Zambelli, Paolo; Simonetti, Paolo; Foschino, Roberto; Compagno, Concetta

2015-05-01

Dekkera bruxellensis is a yeast known to affect the quality of wine and beer. This species, due to its high ethanol and acid tolerance, has been reported also to compete with Saccharomyces cerevisiae in distilleries producing fuel ethanol. In order to understand how this species responds when exposed to low temperatures, some mechanisms like synthesis and accumulation of intracellular metabolites, changes in lipid composition and activation of the HOG-MAPK pathway were investigated in the genome sequenced strain CBS 2499. We show that cold stress caused intracellular accumulation of glycogen, but did not induce accumulation of trehalose and glycerol. The cellular fatty acid composition changed after the temperature downshift, and a significant increase of palmitoleic acid was observed. RT-PCR analysis revealed that OLE1 encoding for Δ9-fatty acid desaturase was up-regulated, whereas TPS1 and INO1 didn't show changes in their expression. In D. bruxellensis Hog1p was activated by phosphorylation, as described in S. cerevisiae, highlighting a conserved role of the HOG-MAP kinase signaling pathway in cold stress response.

Volume and hormonal effects for acute side effects of rectum and bladder during conformal radiotherapy for prostate cancer

International Nuclear Information System (INIS)

Peeters, Stephanie T.H.; Hoogeman, Mischa S.; Heemsbergen, Wilma D.; Slot, Annerie; Tabak, Hans; Koper, Peter C.M.; Lebesque, Joos V.

2005-01-01

Purpose: To identify dosimetric variables predictive of acute gastrointestinal (GI) and genitourinary (GU) toxicity and to determine whether hormonal therapy (HT) is independently associated with acute GI and GU toxicity in prostate cancer patients treated with conformal radiotherapy (RT). Methods and Materials: This analysis was performed on 336 patients participating in a multicenter (four hospitals) randomized trial comparing 68 Gy and 78 Gy. The clinical target volume consisted of the prostate with or without the seminal vesicles, depending on the risk of seminal vesicle involvement. The margin from the clinical target volume to the planning target volume was 1 cm. For these patients, the treatment plan for a total dose of 68 Gy was used, because nearly all toxicity appeared before the onset of the 10-Gy boost. Acute toxicity ( 3 months before RT). Results: Acute GI toxicity Grade 2 or worse was seen in 46% of the patients. Patients with long-term neoadjuvant HT experienced less Grade 2 or worse toxicity (27%) compared with those receiving short-term neoadjuvant HT (50%) and no HT (50%). The volumes of the prostate and seminal vesicles were significantly smaller in both groups receiving neoadjuvant HT compared with those receiving no HT. In multivariate logistic regression analysis, including the two statistically significant clinical variables neoadjuvant HT and hospital, a volume effect was found for the relative, as well as absolute, rectal wall volumes exposed to intermediate and high doses. Of all the length parameters, the relative rectal length irradiated to doses of ≥5 Gy and ≥30 Gy and absolute lengths receiving ≥5-15 and 30 Gy were significant. Acute GU toxicity Grade 2 or worse was reported in 56% of cases. For patients with pretreatment GU symptoms, the rate was 93%. The use of short-term and long-term neoadjuvant HT resulted in more GU toxicity (73% and 71%) compared with no HT (50%). In multivariate analysis, containing the variables

Detection and segmentation of virus plaque using HOG and SVM: toward automatic plaque assay.

Science.gov (United States)

Mao, Yihao; Liu, Hong; Ye, Rong; Shi, Yonghong; Song, Zhijian

2014-01-01

Plaque assaying, measurement of the number, diameter, and area of plaques in a Petri dish image, is a standard procedure gauging the concentration of phage in biology. This paper presented a novel and effective method for implementing automatic plaque assaying. The method was mainly comprised of the following steps: In the training stage, after pre-processing the images for noise suppression, an initial training set was readied by sampling positive (with a plaque at the center) and negative (plaque-free) patches from the training images, and extracting the HOG features from each patch. The linear SVM classifier was trained in a self-learnt supervised learning strategy to avoid possible missing detection. Specifically, the training set which contained positive and negative patches sampled manually from training images was used to train the preliminary classifier which exhaustively searched the training images to predict the label for the unlabeled patches. The mislabeled patches were evaluated by experts and relabeled. And all the newly labeled patches and their corresponding HOG features were added to the initial training set to train the final classifier. In the testing stage, a sliding-window technique was first applied to the unseen image for obtaining HOG features, which were inputted into the classifier to predict whether the patch was positive. Second, a locally adaptive Otsu method was performed on the positive patches to segment the plaques. Finally, after removing the outliers, the parameters of the plaques were measured in the segmented plaques. The experimental results demonstrated that the accuracy of the proposed method was similar to the one measured manually by experts, but it took less than 30 seconds.

[Life cycle of Gongylonema mucronatum Seurat, 1916, parasite of the African hedge-hog (author's transl)].

Science.gov (United States)

Quentin, J C; Seguignes, M

1979-01-01

The Gongylonematid Nematode parasite of the Tunisian hedge-hog has been identified as Gongylonema mucronatum Seurat, 1916. The infective larva has been obtained from Locusta migratoria as intermediate host. The larval characters of this Gongylonema link it to the species G. pulchrum.

Acute changes in forearm venous volume and tone using radionuclide plethysmography

International Nuclear Information System (INIS)

Manyari, D.E.; Malkinson, T.J.; Robinson, V.; Smith, E.R.; Cooper, K.E.

1988-01-01

In this investigation blood pool scintigraphy was validated as a method to study acute changes in human forearm veins. Changes in regional forearm vascular volume (capacity) and the occluding pressure-volume (P-V) relationship induced by sublingual nifedipine (NIF) and nitroglycerin (GTN) were recorded in 16 patients with simultaneous data collection by the radionuclide and the mercury-in-rubber strain-gauge techniques. The standard error of estimate (Syx) between successive control measurements using the radionuclide method was 3.1% compared with 3.2% for the strain-gauge method. The venous P-V curves were highly reproducible using both techniques. Strain gauge and radionuclide measurements of acute changes in forearm venous volume correlated well (r = 0.86; Syx = 7%, n = 156). After 20 mg of NIF or 0.6 mg of GTN, mean heart rate increased from 71 +/- 10 to 77 +/- 9 and from 68 +/- 10 to 75 +/- 11 beats/min, respectively, and group systolic blood pressure decreased from 128 +/- 22 to 120 +/- 19 and from 136 +/- 18 to 126 +/- 23 mmHg, respectively (P less than 0.05). At venous occluding pressures of 0 and 30 mmHg, the forearm vascular volume did not change after NIF (2 +/- 4 and -1 +/- 4%; P greater than 0.05), whereas it increased after GTN (8 +/- 5 and 12 +/- 7%; P less than 0.001). The forearm venous P-V relationship did not change after NIF, whereas a significant rightward shift (venodilation, with an increase in unstressed volume) occurred after GTN

The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.

Science.gov (United States)

Thongprayoon, Charat; Cheungpasitporn, Wisit; Podboy, Alexander J; Gillaspie, Erin A; Greason, Kevin L; Kashani, Kianoush B

2016-11-01

The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury. A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method. Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62). Our meta-analysis shows no significant association between contrast media volume and risk of acute kidney injury after transcatheter aortic valve replacement. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Enzyme-catalyzed degradation of biodegradable polymers derived from trimethylene carbonate and glycolide by lipases from Candida antarctica and Hog pancreas.

Science.gov (United States)

Liu, Feng; Yang, Jian; Fan, Zhongyong; Li, Suming; Kasperczyk, Janusz; Dobrzynski, Piotr

2012-01-01

Enzyme-catalyzed degradation of poly(trimethylene carbonate) homo-polymer (PTMC) and poly(trimethylene carbonate-co-glycolide) co-polymer (PTGA) was investigated in the presence of lipases from Candida antarctica and Hog pancreas. Degradation was monitored by gravimetry, size-exclusion chromatography (SEC), nuclear magnetic resonance (NMR), tensiometry and environmental scanning electron microscopy (ESEM). PTMC can be rapidly degraded by Candida antarctica lipase with 98% mass loss after 9 days, while degradation by Hog pancreas lipase leads to 27% mass loss. Introduction of 16% glycolide units in PTMC chains strongly affects the enzymatic degradation. Hog pancreas lipase becomes more effective to PTGA co-polymer with a mass loss of 58% after 9 days, while Candida antarctica lipase seems not able to degrade PTGA. Bimodal molecular weight distributions are observed during enzymatic degradation of both PTMC and PTGA, which can be assigned to the fact that the surface is largely degraded while the internal part remains intact. The composition of the PTGA co-polymer remains constant, and ESEM shows that the polymers are homogeneously eroded during enzymatic degradation. Contact angle measurements confirm the enzymatic degradation mechanism, i.e., enzyme adsorption on the polymer surface followed by enzyme-catalyzed chain cleavage.

In Vitro Comparison of Self-Expanding Versus Balloon-Expandable Stents in a Human Ex Vivo Model

International Nuclear Information System (INIS)

Grenacher, Lars; Rohde, Stefan; Gaenger, Ellen; Deutsch, Jochen; Kauffmann, Guenter W.; Richter, Goetz M.

2006-01-01

The objective was to compare the radial strength and expansile precision of self-expanding stents and balloon-expandable stents in a human cadaver bifurcation model. Seven different self-expanding (LUMINEXX, JOSTENT SelfX, JOSTENT SelfX hrf, Sinus-Repo, Sinus SuperFlex, Easy Wallstent, SMART) and four different balloon-expandable stent models (Palmaz, Sinus Stent, SAXX Medium, JOSTENT peripheral), each type 10 stents (total n = 110 stents) were implanted into the common iliac arteries of human cadaver corpses. The maximum stent diameter was 10 mm for all models. After stent implantation, the specimens were filled with silicone caoutchouc. After 24 h, the vascular walls including the stents were removed from the hardened casts. Diameters were taken and the weight of the cast cylinders was measured in air and in purified water to calculate the volume of the bodies (according to Archimedes Law) as a relative but precise degree for the radial strength of the implanted stents. The cylindrical casts of the self-expanding stents showed lower mean diameters (8.2 ± 1.0 mm) and mean volumes (0.60 ± 0.14 ml/cm) than in the balloon-expandable stent group (10.1 ± 0.3 mm and 0.71 ± 0.04 ml/cm, respectively; p < 0.01). The nominal maximum diameter of 10 mm was not achieved in any of the self-expanding stents, but this was achieved in more than 70% (29/40) of the balloon-expandable stent specimens (p < 0.05). The variation between achieved volumes was significantly larger in self-expanding (range: 0.23-0.78 ml/cm) than in balloon-expandable stents (range: 0.66-0.81 ml/cm; p < 0.05). Self-expanding stents presented considerably lower radial expansion force and lower degree of precision than balloon-expandable stents

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

OpenAIRE

Lipes, Jed; Bojmehrani, Azadeh; Lellouche, Francois

2012-01-01

Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung inj...

A comparison of volume control and pressure-regulated volume control ventilation in acute respiratory failure

Science.gov (United States)

Guldager, Henrik; Nielsen, Soeren L; Carl, Peder; Soerensen, Mogens B

1997-01-01

Background: The aim of this study was to test the hypothesis that a new mode of ventilation (pressure-regulated volume control; PRVC) is associated with improvements in respiratory mechanics and outcome when compared with conventional volume control (VC) ventilation in patients with acute respiratory failure. We conducted a randomised, prospective, open, cross over trial on 44 patients with acute respiratory failure in the general intensive care unit of a university hospital. After a stabilization period of 8 h, a cross over trial of 2 × 2 h was conducted. Apart from the PRVC/VC mode, ventilator settings were comparable. The following parameters were recorded for each patient: days on ventilator, failure in the assigned mode of ventilation (peak inspiratory pressure > 50 cmH2O) and survival. Results: In the crossover trial, peak inspiratory pressure was significantly lower using PRVC than with VC (20 cmH2O vs 24 cmH2O, P < 0.0001). No other statistically significant differences were found. Conclusions: Peak inspiratory pressure was significantly lower during PRVC ventilation than during VC ventilation, and thus PRVC may be superior to VC in certain patients. However, in this small group of patients, we could not demonstrate that PRVC improved outcome. PMID:11056699

The Impact of Pretreatment Prostate Volume on Severe Acute Genitourinary Toxicity in Prostate Cancer Patients Treated With Intensity-Modulated Radiation Therapy

International Nuclear Information System (INIS)

Aizer, Ayal A.; Anderson, Nicole S.; Oh, Steven C.; Yu, James B.; McKeon, Anne M.; Decker, Roy H.; Peschel, Richard E.

2011-01-01

Purpose: To assess the impact of pretreatment prostate volume on the development of severe acute genitourinary toxicity in patients undergoing intensity-modulated radiation therapy (IMRT) for prostate cancer. Methods and Materials: Between 2004 and 2007, a consecutive sample of 214 patients who underwent IMRT (75.6 Gy) for prostate cancer at two referral centers was analyzed. Prostate volumes were obtained from computed tomography scans taken during treatment simulation. Genitourinary toxicity was defined using the National Cancer Institute Common Terminology Criteria for Adverse Events Version 3.0 guidelines. Acute toxicity was defined as any toxicity originating within 90 days of the completion of radiation therapy. Patients were characterized as having a small or large prostate depending on whether their prostate volume was less than or greater than 50 cm 3 , respectively. Genitourinary toxicity was compared in these groups using the chi-square or Fisher's exact test, as appropriate. Bivariate and multivariate logistic regression analysis was performed to further assess the impact of prostate volume on severe (Grade 3) acute genitourinary toxicity. Results: Patients with large prostates (>50 cm 3 ) had a higher rate of acute Grade 3 genitourinary toxicity (p = .02). Prostate volume was predictive of the likelihood of developing acute Grade 3 genitourinary toxicity on bivariate (p = .004) and multivariate (p = .006) logistic regression. Every 27.0 cm 3 increase in prostate volume doubled the likelihood of acute Grade 3 genitourinary toxicity. Conclusions: Patients with larger prostates are at higher risk for the development of severe acute genitourinary toxicity when treated with IMRT for prostate cancer.

Early changes in left atrial volume after acute myocardial infarction

DEFF Research Database (Denmark)

Bakkestrom, R.; Andersen, Mads J; Ersboll, M.

2016-01-01

. The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45%, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h......Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise...... of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22...

A Comparative Study of Pituitary Volume Variations in MRI in Acute Onset of Psychiatric Conditions.

Science.gov (United States)

Soni, Brijesh Kumar; Joish, Upendra Kumar; Sahni, Hirdesh; George, Raju A; Sivasankar, Rajeev; Aggarwal, Rohit

2017-02-01

The growing belief that endocrine abnormalities may underlie many mental conditions has led to increased use of imaging and hormonal assays in patients attending to psychiatric OPDs. People who are in an acute phase of a psychiatric disorder show Hypothalamic Pituitary Adrenal (HPA) axis hyperactivity, but the precise underlying central mechanisms are unclear. To assess the pituitary gland volume variations in patients presenting with new onset acute psychiatric illness in comparison with age and gender matched controls by using MRI. The study included 50 patients, with symptoms of acute psychiatric illness presenting within one month of onset of illness and 50 age and gender matched healthy controls. Both patients and controls were made to undergo MRI of the Brain. A 0.9 mm slices of entire brain were obtained by 3 dimensional T1 weighted sequence. Pituitary gland was traced in all sagittal slices. Anterior pituitary and posterior pituitary bright spot were measured separately in each slice. Volume of the pituitary (in cubic centimetre- cm 3 ) was calculated by summing areas. Significance of variations in pituitary gland volumes was compared between the cases and controls using Analysis of Covariance (ANOVA). There were significantly larger pituitary gland volumes in the cases than the controls, irrespective of psychiatric diagnosis (ANOVA, f=15.56; p=0.0002). Pituitary volumes in cases were 15.36% (0.73 cm 3 ) higher than in controls. There is a strong likelihood of HPA axis overactivity during initial phase of all mental disorders along with increased pituitary gland volumes. Further studies including hormonal assays and correlation with imaging are likely to provide further insight into neuroanatomical and pathological basis of psychiatric disorders.

Ex vivo-expanded bone marrow CD34(+) for acute myocardial infarction treatment: in vitro and in vivo studies.

Science.gov (United States)

Gunetti, Monica; Noghero, Alessio; Molla, Fabiola; Staszewsky, Lidia Irene; de Angelis, Noeleen; Soldo, Annarita; Russo, Ilaria; Errichiello, Edoardo; Frasson, Chiara; Rustichelli, Deborah; Ferrero, Ivana; Gualandris, Anna; Berger, Massimo; Geuna, Massimo; Scacciatella, Paolo; Basso, Giuseppe; Marra, Sebastiano; Bussolino, Federico; Latini, Roberto; Fagioli, Franca

2011-10-01

Bone marrow (BM)-derived cells appear to be a promising therapeutic source for the treatment of acute myocardial infarction (AMI). However, the quantity and quality of the cells to be used, along with the appropriate time of administration, still need to be defined. We thus investigated the use of BM CD34(+)-derived cells as cells suitable for a cell therapy protocol (CTP) in the treatment of experimental AMI. The need for a large number of cells was satisfied by the use of a previously established protocol allowing the expansion of human CD34(+) cells isolated from neonatal and adult hematopoietic tissues. We evaluated gene expression, endothelial differentiation potential and cytokine release by BM-derived cells during in vitro culture. Basal and expanded CD34(+) cells were used as a delivery product in a murine AMI model consisting of a coronary artery ligation (CAL). Cardiac function recovery was evaluated after injecting basal or expanded cells. Gene expression analysis of in vitro-expanded cells revealed that endothelial markers were up-regulated during culture. Moreover, expanded cells generated a CD14(+) subpopulation able to differentiate efficiently into VE-cadherin-expressing cells. In vivo, we observed a cardiac function recovery in mice sequentially treated with basal and expanded cells injected 4 h and 7 days after CAL, respectively. Our data suggest that combining basal and expanded BM-derived CD34(+) cells in a specific temporal pattern of administration might represent a promising strategy for a successful cell-based therapy.

Dosimetric Coverage of the Prostate, Normal Tissue Sparing, and Acute Toxicity with High-Dose-Rate Brachytherapy for Large Prostate Volumes

Directory of Open Access Journals (Sweden)

George Yang

2015-06-01

Full Text Available ABSTRACTPurposeTo evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes.Materials and MethodsOne hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL were treated with high-dose-rate (HDR brachytherapy ± intensity modulated radiation therapy (IMRT to 4,500 cGy in 25 daily fractions between 2009 and 2013. HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks. Twelve of 32 (38% unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.ResultsMedian follow-up was 14 months. Dosimetric goals were achieved in over 90% of cases. Three of 102 (3% patients developed Grade 2 acute proctitis. No variables were significantly associated with Grade 2 acute proctitis. Seventeen of 102 (17% patients developed Grade 2 acute urinary retention. American Urological Association (AUA symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p=0.04. There was no ≥ Grade 3 acute toxicity.ConclusionsDosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL. Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention. However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes.

Dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with high-dose-rate brachytherapy for large prostate volumes

Energy Technology Data Exchange (ETDEWEB)

Yang, George; Strom, Tobin J.; Shrinath, Kushagra; Mellon, Eric A.; Fernandez, Daniel C.; Biagioli, Matthew C. [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States); Wilder, Richard B., E-mail: mcbiagioli@yahoo.com [Cancer Treatment Centers of America, Newnan, GA (United States)

2015-05-15

Purpose: to evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes. Materials and methods: one hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL) were treated with high-dose-rate (HDR) brachytherapy ± intensity modulated radiation therapy (IMRT) to 4,500 cGy in 25 daily fractions between 2009 and 2013. HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks. Twelve of 32 (38%) unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy. Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4. Results: median follow-up was 14 months. Dosimetric goals were achieved in over 90% of cases. Three of 102 (3%) patients developed Grade 2 acute proctitis. No variables were significantly associated with Grade 2 acute proctitis. Seventeen of 102 (17%) patients developed Grade 2 acute urinary retention. American Urological Association (AUA) symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p-0.04). There was no ≥ Grade 3 acute toxicity. Conclusions: dosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL. Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention. However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes. (author)

HedgeHOGS: A Rapid Nuclear Hedge Sizing and Analysis Tool

Energy Technology Data Exchange (ETDEWEB)

Reynolds, Adam F. [United States Military Academy, West Point, NY (United States); Steinfeldt, Bradley Alexander [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Lafleur, Jarret Marshall [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Hawley, Marilyn F. [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Shannon, Lisa M. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

2017-07-01

The U.S. nuclear stockpile hedge is an inventory of non-deployed nuclear warheads and a force structure capable of deploying those warheads. Current guidance is to retain this hedge to mitigate the risk associated with the technical failure of any single warhead type or adverse geopolitical developments that could require augmentation of the force. The necessary size of the hedge depends on the composition of the nuclear stockpile and assumed constraints. Knowing the theoretical minimum hedge given certain constraints is useful when considering future weapons policy. HedgeHOGS, an Excel-based tool, was developed to enable rapid calculation of the minimum hedge size associated with varying active stockpile composition and hedging strategies.

Effects of tidal volume on work of breathing during lung-protective ventilation in patients with acute lung injury and acute respiratory distress syndrome.

Science.gov (United States)

Kallet, Richard H; Campbell, Andre R; Dicker, Rochelle A; Katz, Jeffrey A; Mackersie, Robert C

2006-01-01

To assess the effects of step-changes in tidal volume on work of breathing during lung-protective ventilation in patients with acute lung injury (ALI) or the acute respiratory distress syndrome (ARDS). Prospective, nonconsecutive patients with ALI/ARDS. Adult surgical, trauma, and medical intensive care units at a major inner-city, university-affiliated hospital. Ten patients with ALI/ARDS managed clinically with lung-protective ventilation. Five patients were ventilated at a progressively smaller tidal volume in 1 mL/kg steps between 8 and 5 mL/kg; five other patients were ventilated at a progressively larger tidal volume from 5 to 8 mL/kg. The volume mode was used with a flow rate of 75 L/min. Minute ventilation was maintained constant at each tidal volume setting. Afterward, patients were placed on continuous positive airway pressure for 1-2 mins to measure their spontaneous tidal volume. Work of breathing and other variables were measured with a pulmonary mechanics monitor (Bicore CP-100). Work of breathing progressively increased (0.86 +/- 0.32, 1.05 +/- 0.40, 1.22 +/- 0.36, and 1.57 +/- 0.43 J/L) at a tidal volume of 8, 7, 6, and 5 mL/kg, respectively. In nine of ten patients there was a strong negative correlation between work of breathing and the ventilator-to-patient tidal volume difference (R = -.75 to -.998). : The ventilator-delivered tidal volume exerts an independent influence on work of breathing during lung-protective ventilation in patients with ALI/ARDS. Patient work of breathing is inversely related to the difference between the ventilator-delivered tidal volume and patient-generated tidal volume during a brief trial of unassisted breathing.

FRUIT FLIES (DIPTERA: TEPHRITIDAE AND THEIR PARASITOIDS ASSOCIATED WITH DIFFERENT HOG PLUM GENOTYPES IN TERESINA, PIAUÍ

Directory of Open Access Journals (Sweden)

LEONARDO DA SILVA SOUSA

2017-10-01

Full Text Available ABSTRACT The aim of this work was to identify and quantify the infestation of fruit fly species and their parasitoids, associated with 20 hog plum genotypes (Spondias mombin L. in a commercial orchard in Teresina, Piauí, Brazil. The survey was conducted by fruit sampling and monitoring through traps stocked with bait food, in the period from January to December 2012. Overall, 6560 fruits were collected (79.58 kg, resulting in 23059 pupae, of which 10080 fruit flies of the genus Anastrepha and 4984 braconid parasitoids emerged. Anastrepha obliqua species was the predominant with 99.92%. F16P13 and F11P10 genotypes had the highest infestation indexes and F15P11 and F04P01 genotypes, the lowest. The main parasitoids collected were Opius bellus (77.65%, Doryctobracon areolatus (19.88% and Utetes anastrephae (2.47%. The average parasitism rate among genotypes was of 30.46%. In traps, a total of 1434 fruit flies were collected, whose species were: A. obliqua (97.6%, A. serpentina (1.4%, A. fraterculus (0.4%, A. striata (0.4%, A. dissimilis (0.1%, A. pseudoparallela (0.1%. Anastrepha obliqua species was predominant in the area, based on faunistic analysis. The infestation index in the orchard was relevant for five months (January-May, coinciding with the period of availability of hog plum fruits, reaching the highest peak in March (2.86 FAT. There was a significant negative correlation between number of fruit flies in the orchard and the average air temperature, and a significant positive correlation with rainfall and relative humidity. However, the main factor that influenced the observed infestation index in the hog plum orchard was fruit availability.

Nitrous oxide emissions and soil mineral nitrogen status following application of hog slurry and inorganic fertilisers to acidic soils under forage grass

International Nuclear Information System (INIS)

Mkhabela, M.S.; Gordon, R.; Madani, A.; Burton, D.; Hart, W.

2008-01-01

This paper examined the influence of hog slurry and inorganic fertilizers on nitrous oxide (N 2 O) emissions and soil inorganic nitrogen (N) composition. Factors controlling N 2 O production were also identified. The study was comprised of 3 field experiments conducted during the summer months of 2005 on 2 acidic soils seeded with forage grass at a site in Nova Scotia. Treatments included hog slurry; ammonium sulphate; potassium nitrate; and an unamended control site. Emissions were measured using vented polyvinyl chloride static chambers. Gas fluxes and NO 2 measurements were analyzed using gas chromatography. Data were then subjected to analysis of variance (ANOVA). N 2 O flux and soil mineral N data from each sampling day were analyzed separately. Cumulative N 2 O losses were also calculated. Results demonstrated that the addition of hog slurry resulted in lower N 2 O emissions than the samples containing potassium nitrate fertilizer. The study also demonstrated that nitrate (NO 3 ) production drives NO 2 production in acidic soils. It was concluded that further research is needed to verify results obtained during the study. 29 refs., 3 tabs., 3 figs

Acute volume expansion attenuates hyperthermia-induced reductions in cerebral perfusion during simulated hemorrhage

DEFF Research Database (Denmark)

Schlader, Zachary J; Seifert, Thomas; Wilson, Thad E

2013-01-01

Hyperthermia reduces the capacity to withstand a simulated hemorrhagic challenge, but volume loading preserves this capacity. This study tested the hypotheses that acute volume expansion during hyperthermia increases cerebral perfusion and attenuates reductions in cerebral perfusion during...... infusion while hyperthermic. Primary dependent variables were mean middle cerebral artery blood velocity (MCAvmean), serving as an index of cerebral perfusion; mean arterial pressure (MAP); and cardiac output (thermodilution). During baseline, hyperthermia reduced MCAvmean (P = 0.001) by 12 ± 9% relative...

Simulation of the Impact of SRT on Anaerobic Digestability of Ultrasonicated Hog Manure

OpenAIRE

Elbeshbishy; Nakevski; Hafez; Ray; Nakhla

2010-01-01

Ultrasonication at a specific energy of 500 kJ/kgTS was applied to hog manure in a continuous mode completely mixed anaerobic digestion. A process model in BioWin was developed, calibrated and tested at different solids retention times (SRTs) to evaluate the process economics. The results showed that there was a 36% increase in volatile suspended solids (VSS) removal efficiency, a 20% increase in methane production rate, a 13.5% increase in destruction of bound proteins, and a reduction from ...

Fluoroscopically guided placement of self-expandable metallic stents and stent-grafts in the treatment of acute malignant colorectal obstruction.

Science.gov (United States)

Kim, Honsoul; Kim, Seung Hyoung; Choi, Sun Young; Lee, Kwang-Hun; Won, Jong Yoon; Lee, Do Yun; Lee, Jong Tae

2008-12-01

To evaluate the technical feasibility and clinical effectiveness of fluoroscopically guided placement of self-expandable metallic stents and stent-grafts for acute malignant colorectal obstruction. Radiologic images and clinical reports of 42 patients (22 men, 20 women; age range, 28-93 years; median age, 65.5 years) who underwent fluoroscopically guided colorectal stent insertion without endoscopic assistance for acute malignant obstruction were reviewed retrospectively. Eighteen patients received bare stents as a bridge to surgery. Twenty-four patients received 27 insertions of either a bare stent (n = 15) or a stent-graft (n = 12) for palliation. The obstruction was located in the rectum (n = 8), sigmoid (n = 17), descending colon (n = 8), splenic flexure (n = 3), and transverse colon (n = 6). Clinical success, defined as more than 50% dilatation of the stent with subsequent symptomatic improvement, was achieved in 41 of the 42 patients (98%). No major procedure-related complications occurred. Minor complications occurred in eight of the 45 procedures (18%). No perioperative mortalities occurred within 1 month after surgery. In the palliative group, the median stent patency was 62 days (range, 0-1,014 days). There was no statistically significant difference in stent patency between the bare stents (range, 0-855 days; median, 68 days) and stent-grafts (range, 1-1,014 days; median, 81 days). Fluoroscopically guided placement of self-expandable metallic stents and stent-grafts for the relief of acute malignant colorectal obstruction was technically feasible without endoscopic assistance-even in lesions proximal to the splenic flexure and transverse colon-and clinically effective in both bridge to surgery and palliative management.

Arabic sign language recognition based on HOG descriptor

Science.gov (United States)

Ben Jmaa, Ahmed; Mahdi, Walid; Ben Jemaa, Yousra; Ben Hamadou, Abdelmajid

2017-02-01

We present in this paper a new approach for Arabic sign language (ArSL) alphabet recognition using hand gesture analysis. This analysis consists in extracting a histogram of oriented gradient (HOG) features from a hand image and then using them to generate an SVM Models. Which will be used to recognize the ArSL alphabet in real-time from hand gesture using a Microsoft Kinect camera. Our approach involves three steps: (i) Hand detection and localization using a Microsoft Kinect camera, (ii) hand segmentation and (iii) feature extraction using Arabic alphabet recognition. One each input image first obtained by using a depth sensor, we apply our method based on hand anatomy to segment hand and eliminate all the errors pixels. This approach is invariant to scale, to rotation and to translation of the hand. Some experimental results show the effectiveness of our new approach. Experiment revealed that the proposed ArSL system is able to recognize the ArSL with an accuracy of 90.12%.

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Directory of Open Access Journals (Sweden)

Jed Lipes

2012-01-01

Full Text Available Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI and acute respiratory distress syndrome (ARDS. Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges.

Low Tidal Volume Ventilation in Patients without Acute Respiratory Distress Syndrome: A Paradigm Shift in Mechanical Ventilation

Science.gov (United States)

Lipes, Jed; Bojmehrani, Azadeh; Lellouche, Francois

2012-01-01

Protective ventilation with low tidal volume has been shown to reduce morbidity and mortality in patients suffering from acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Low tidal volume ventilation is associated with particular clinical challenges and is therefore often underutilized as a therapeutic option in clinical practice. Despite some potential difficulties, data have been published examining the application of protective ventilation in patients without lung injury. We will briefly review the physiologic rationale for low tidal volume ventilation and explore the current evidence for protective ventilation in patients without lung injury. In addition, we will explore some of the potential reasons for its underuse and provide strategies to overcome some of the associated clinical challenges. PMID:22536499

Expandable stents.

Science.gov (United States)

Nesbitt, J C; Carrasco, H

1996-05-01

tissue is less likely to occur in areas of established scar than in areas of acute inflammation. In circumstances in which it is essential that a stent remain only temporarily, an expandable stent should not be inserted in favor of a silicone stent, which can be removed. In the future, expandable stents may have silicone coverings or may be constructed of materials that facilitate removal. Until that time, expandable stents should be considered permanent and nonremovable. Subtle differences exist among the available stents. Standard is low-profile expandable construction from wire mesh. A relatively minor difference is the slightly wider expansibility of the Gianturco stent, a quality that makes it the best suited of the three stents for lesions that involve tracheomalacia. Perhaps the only major difference between the Wallstent and the Gianturco and Palmaz stents is its better ability to conform to tortuous lesions. In an acutely angled stricture, a Wallstent offers a better opportunity for successful placement than other stents. The filamentous meshwork of the Wallstent allows it to bend and conform better to distorted airways. The Gianturco and Palmaz stents have little longitudinal elasticity, which makes them less effective in a tortuous or highly angulated airway stenosis. Expandable stents have demonstrated their efficacy and exposed their limitations in the treatment of airway stenoses. Refinements in design should help to lessen specific disadvantages and problems. Covered expandable stents, a realistic prospect, have specific advantages over standard expandable stents; they will be removable and prevent tumor ingrowth. Current investigative work with such prostheses for the vascular system may provide the foundation for their investigative use in the airway. In essence, two categories of expandable stents are evolving, covered and uncovered, each having unique features adaptable to the specific clinical needs.

Low-temperature anaerobic treatment of hog manure and transformation of biogas into green energy

Energy Technology Data Exchange (ETDEWEB)

Van-Anh Truong, L.; Royer, R.

2004-08-01

A new environmental solution for hog manure management has been developed by Bio-Terre Systems Inc. in collaboration with Agriculture and Agri-Food Canada. The technical approach combines low-temperature anaerobic digestion, concentration of solids and production of biogas, a renewable energy source. Both small and large agricultural producers can benefit from this approach which helps transform organic matter into value-added by-products. They can fertilize their land with the liquid fraction, supply energy for their buildings with the biogas produced, and export surplus nutrients with the solid fraction. The technology also solves odour problems and destroys pathogenic microorganisms. No pretreatment is needed for this technology which makes use of robust anaerobic microorganisms that are low temperature tolerant. It is a stable process that provides continuous production of biogas with high energy potential. The automated system does not require much monitoring or maintenance. The environmental advantages include the production of biogas rich in methane, which can be used for electrical energy on the farm or sent to the electric power grids; production of high-value, odorless liquid fertilizer; a 50 per cent reduction of the amount of phosphorous in the liquid fraction; and, a 90 per cent reduction in greenhouse gas emissions from hog manure. The profitability of capital investment is assured by both the energy-savings and the agricultural benefits. 1 tab., 1 fig.

A novel technique for hydrogen production from hog-manure in supercritical partial oxidation (SCWPO)

Energy Technology Data Exchange (ETDEWEB)

Youssef, Emhemmed A.; Charpentier, Paul [Western Ontario Univ., London, ON (Canada). Dept. of Chemical and Biochemical Engineering; Nakhla, George [Western Ontario Univ., London, ON (Canada). Dept. of Chemical and Biochemical Engineering; Western Ontario Univ., London, ON (Canada). Dept. of Civil and Environmental Engineering; Elbeshbishy, Elsayed; Hafez, Hisham [Western Ontario Univ., London, ON (Canada). Dept. of Civil and Environmental Engineering

2010-07-01

In this study, the catalytic hydrogen production from hog manure using supercritical water partial oxidation was investigated in a batch reactor at a temperature of 500 C, and pressure of 28 MPa using several metallic catalysts. Hog manure was characterized by a total and soluble chemical oxygen demand (TCOD, SCOD) of 57000 and 28000 mg/L, total and volatile suspended solids (TSS, VSS) of 25000, 19000, and ammonia of 2400 mg/L, respectively. The order of H{sub 2} production was the following: Pd/AC > Ru/Al{sub 2}O{sub 3} > Ru/AC > AC > NaOH. The order of COD reduction efficiency was as follows: NaOH > Ru/AC > AC > Ru/Al{sub 2}O{sub 3} > Pd/AC. The behaviour of the volatile fatty acids (VFA's), ethanol, methanol, ammonia, H{sub 2}S, and Sulfate was investigated experimentally and discussed. A 35 % reduction in the H{sub 2} and CH{sub 4} yields was observed in the sequential gasification partial oxidation (oxidant at an 80 % of theoretical requirement) experiments compared to the gasification experiments (catalyst only). Moreover, this reduction in gas yields was coincided with a 45 % reduction in the liquid effluent chemical oxygen demand (COD), 60 % reduction of the ammonia concentration in the liquid effluent, and 20 % reduction in the H{sub 2}S concentration in the effluent gas. (orig.)

Mammalian folylpoly-γ-glutamate synthetase. 1. Purification and general properties of the hog liver enzyme

International Nuclear Information System (INIS)

Cichowicz, D.J.; Shane, B.

1987-01-01

Folylpolyglutamate synthetase was purified 30,000-150,000-fold from hog liver. Purification required the use of protease inhibitors, and the protein was purified to homogeneity in two forms. Both forms of the enzyme were monomers of M/sub r/ 62,000 and had similar specific activities. The specific activity of the homogeneous protein was over 2000-fold higher than reported for partially purified folylpolyglutamate synthetases from other mammalian sources. Enzyme activity was absolutely dependent on the presence of a reducing agent and a monovalent cation, of which K + was most effective. The purified enzyme catalyzed a MgATP-dependent addition of glutamate to tetrahydrofolate with the concomitant stoichiometric formation of MgADP and phosphate. Under conditions that resembled the expected substrate and enzyme concentrations in hog liver, tetrahydrofolate was metabolized to long glutamate chain length derivatives with the hexaglutamate, the major in vivo folate derivative, predominating. Enzyme activity was maximal at about pH 9.5. The high-pH optimum was primarily due to an increase in the K/sub m/ value for the L-glutamate substrate at lower pH values, and the reaction proceeded effectively at physiological pH provided high levels of glutamate were supplied

Short-term results of self-expanding metal stents for acute malignant large bowel obstruction

DEFF Research Database (Denmark)

Kobborg, M; Broholm, M; Frostberg, E

2017-01-01

AIM: Self-expanding metal stents (SEMSs) can be used as a palliative treatment or to initially decompress colon prior to definitive surgery (as a so-called 'bridge to surgery'). The purpose of this study was to investigate the efficacy and safety of SEMS used as palliation and bridge to surgery...... for malignant large bowel obstruction. METHOD: A multicentre retrospective study was conducted from January 2010 to December 2013 to identify patients undergoing stent placement for acute large bowel obstruction. Patients were included from four Danish colorectal centres. Outcomes identified included clinical...... success, 30-day mortality, stent related complications and surgery related complications. Furthermore, we analysed for predictive factors for successful stenting. Clinical success was defined as relief of obstructive symptoms, without the need of other additional surgical interventions during the hospital...

Cerebral blood volume changes in cats with acute increased intracranial pressure

International Nuclear Information System (INIS)

Kondo, Takashi; Kano, Mitsumasa; Ikeda, Takuya.

1984-01-01

We measured the changes in cerebral blood volume in cats with increased intracranial pressure with a high-speed CT scanner, employing contrast effects by the iodine agent. In acute increased intracranial pressure caused by raising the extradural pressure by 20 mmHg, cerebral blood volume showed a significant decrease by 32% in comparison with that at normal intracranial pressure. There was also a tendency that a decline of iodine was delayed with time at increased intracranial pressure than that at normal pressure. This was supposed to be a delay of cerebral circulation due to venous congestion. This experimental model and measuring method provide the changes in CBV in the same individual without any tedious procedure, and therefore this is a reliable method with respect to precision. (author)

Whole-brain perfusion CT using a toggling table technique to predict final infarct volume in acute ischemic stroke.

Science.gov (United States)

Schrader, I; Wilk, D; Jansen, O; Riedel, C

2013-09-01

To evaluate how accurately final infarct volume in acute ischemic stroke can be predicted with perfusion CT (PCT) using a 64-MDCT unit and the toggling table technique. Retrospective analysis of 89 patients with acute ischemic stroke who underwent CCT, CT angiography (CTA) and PCT using the "toggling table" technique within the first three hours after symptom onset. In patients with successful thrombolytic therapy (n = 48) and in those without effective thrombolytic therapy (n = 41), the infarct volume and the volume of the penumbra on PCT were compared to the infarct size on follow-up images (CT or MRI) performed within 8 days. The feasibility of complete infarct volume prediction by 8 cm cranio-caudal coverage was evaluated. The correlation between the volume of hypoperfusion on PCT defined by cerebral blood volume reduction and final infarct volume was strongest in patients with successful thrombolytic therapy with underestimation of the definite infarct volume by 8.5 ml on average. The CBV map had the greatest prognostic value. In patients without successful thrombolytic therapy, the final infarct volume was overestimated by 12.1 ml compared to the MTT map on PCT. All infarcts were detected completely. There were no false-positive or false-negative results. Using PCT and the "toggling table" technique in acute stroke patients is helpful for the rapid and accurate quantification of the minimal final infarct and is therefore a prognostic parameter which has to be evaluated in further studies to assess its impact on therapeutic decision. ▶ Using PCT and the “toggling table technique” allows accurate quantification of the infarct core and penumbra. ▶ It is possible to record dynamic perfusion parameters quickly and easily of almost the entire supratentorial brain volume on a 64-slice MDCT unit. ▶ The technique allows identification of those patients who could profit from thrombolytic therapy outside the established time intervals. © Georg Thieme Verlag

Use of fractional dose–volume histograms to model risk of acute rectal toxicity among patients treated on RTOG 94-06

International Nuclear Information System (INIS)

Tucker, Susan L.; Michalski, Jeff M.; Bosch, Walter R.; Mohan, Radhe; Dong, Lei; Winter, Kathryn; Purdy, James A.; Cox, James D.

2012-01-01

Background and purpose: For toxicities occurring during the course of radiotherapy, it is conceptually inaccurate to perform normal-tissue complication probability analyses using the complete dose–volume histogram. The goal of this study was to analyze acute rectal toxicity using a novel approach in which the fit of the Lyman–Kutcher–Burman (LKB) model is based on the fractional rectal dose–volume histogram (DVH). Materials and methods: Grade ⩾2 acute rectal toxicity was analyzed in 509 patients treated on Radiation Therapy Oncology Group (RTOG) protocol 94-06. These patients had no field reductions or treatment-plan revisions during therapy, allowing the fractional rectal DVH to be estimated from the complete rectal DVH based on the total number of dose fractions delivered. Results: The majority of patients experiencing Grade ⩾2 acute rectal toxicity did so before completion of radiotherapy (70/80 = 88%). Acute rectal toxicity depends on fractional mean rectal dose, with no significant improvement in the LKB model fit when the volume parameter differs from n = 1. The incidence of toxicity was significantly lower for patients who received hormone therapy (P = 0.024). Conclusions: Variations in fractional mean dose explain the differences in incidence of acute rectal toxicity, with no detectable effect seen here for differences in numbers of dose fractions delivered.

Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications in Patients Without Acute Respiratory Distress Syndrome: A Systematic Review and Individual Patient Data Analysis.

Science.gov (United States)

Neto, Ary Serpa; Simonis, Fabienne D; Barbas, Carmen S V; Biehl, Michelle; Determann, Rogier M; Elmer, Jonathan; Friedman, Gilberto; Gajic, Ognjen; Goldstein, Joshua N; Linko, Rita; Pinheiro de Oliveira, Roselaine; Sundar, Sugantha; Talmor, Daniel; Wolthuis, Esther K; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J

2015-10-01

Protective mechanical ventilation with low tidal volumes is standard of care for patients with acute respiratory distress syndrome. The aim of this individual patient data analysis was to determine the association between tidal volume and the occurrence of pulmonary complications in ICU patients without acute respiratory distress syndrome and the association between occurrence of pulmonary complications and outcome in these patients. Individual patient data analysis. ICU patients not fulfilling the consensus criteria for acute respiratory distress syndrome at the onset of ventilation. Mechanical ventilation with low tidal volume. The primary endpoint was development of a composite of acute respiratory distress syndrome and pneumonia during hospital stay. Based on the tertiles of tidal volume size in the first 2 days of ventilation, patients were assigned to a "low tidal volume group" (tidal volumes ≤ 7 mL/kg predicted body weight), an "intermediate tidal volume group" (> 7 and volume group" (≥ 10 mL/kg predicted body weight). Seven investigations (2,184 patients) were included. Acute respiratory distress syndrome or pneumonia occurred in 23% of patients in the low tidal volume group, in 28% of patients in the intermediate tidal volume group, and in 31% of the patients in the high tidal volume group (adjusted odds ratio [low vs high tidal volume group], 0.72; 95% CI, 0.52-0.98; p = 0.042). Occurrence of pulmonary complications was associated with a lower number of ICU-free and hospital-free days and alive at day 28 (10.0 ± 10.9 vs 13.8 ± 11.6 d; p volumes is associated with a lower risk of development of pulmonary complications in patients without acute respiratory distress syndrome.

The dose-volume relationship of acute small bowel toxicity from concurrent 5-FU-based chemotherapy and radiation therapy for rectal cancer

International Nuclear Information System (INIS)

Baglan, Kathy L.; Frazier, Robert C.; Yan Di; Huang, Raywin R.; Martinez, Alvaro A.; Robertson, John M.

2002-01-01

Purpose: A direct relationship between the volume of small bowel irradiated and the degree of acute small bowel toxicity experienced during concurrent 5-fluorouracil (5-FU)-based chemoradiotherapy for rectal carcinoma is well recognized but poorly quantified. This study uses three-dimensional treatment-planning tools to more precisely quantify this dose-volume relationship. Methods and Materials: Forty patients receiving concurrent 5-FU-based chemotherapy and pelvic irradiation for rectal carcinoma had treatment-planning CT scans with small bowel contrast. A median isocentric dose of 50.4 Gy was delivered using a posterior-anterior and opposed lateral field arrangement. Bowel exclusion techniques were routinely used, including prone treatment position on a vacuum bag cradle to allow anterior displacement of the abdominal contents and bladder distension. Individual loops of small bowel were contoured on each slice of the planning CT scan, and a small bowel dose-volume histogram was generated for the initial pelvis field receiving 45 Gy. The volume of small bowel receiving each dose between 5 and 40 Gy was recorded at 5-Gy intervals. Results: Ten patients (25%) experienced Common Toxicity Criteria Grade 3+ acute small bowel toxicity. A highly statistically significant association between the development of Grade 3+ acute small bowel toxicity and the volume of small bowel irradiated was found at each dose level. Specific dose-volume threshold levels were found, below which no Grade 3+ toxicity occurred and above which 50-60% of patients developed Grade 3+ toxicity. The volume of small bowel receiving at least 15 Gy (V 15 ) was strongly associated with the degree of toxicity. Univariate analysis of patient and treatment-related factors revealed no other significant predictors of severe toxicity. Conclusions: A strong dose-volume relationship exists for the development of Grade 3+ acute small bowel toxicity in patients receiving concurrent 5-FU-based chemoradiotherapy

Three-dimensional whole-brain perfused blood volume imaging with multimodal CT for evaluation of acute ischaemic stroke

International Nuclear Information System (INIS)

Lu, J.; Zhang, M.; Cao, Y.; Ma, Q.; Chen, J.; Ji, X.; Li, K.

2011-01-01

Aim: To determine the diagnostic value of integrating three-dimensional perfused blood volume (3D PBV) with multimodal computed tomography (CT) [non-enhanced CT (NECT), CT perfusion (CTP), and CT angiography (CTA)] in acute ischaemic stroke. Materials and methods: NECT, CTP, and CTA were performed in 25 acute ischaemic stroke patients. The ischaemia detection rate of 3D PBV was compared with the results of baseline NECT and CTP. The correlation of ischaemic lesion volume between 3D PBV, CTP images, and follow-up NECT were analysed. Results: NECT demonstrated ischaemic signs in 12 of 25 patients with proven infarction. CTP maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) all demonstrated perfusion deficits in 21 of 25 patients. However, 3D PBV demonstrated perfusion deficits in all of the 25 patients. Among the 25 patients, a strong correlation was found between PBV and the follow-up NECT infarct (r = 0.858). The correlation between CTP and the follow-up NECT infarct as following: CBF (r = 0.718), CBV (r = 0.785), and TTP (r = 0.569). In 14 thrombolytic patients, strong correlation was found between the ischaemic volume on 3D PBV and follow-up NECT (r = 0.798). Conclusion: In acute stroke patients, the combination of 3D PBV and multimodal CT (NECT, CTP, and CTA) can improve the detection rate of ischaemia and enable assessment of the full extent of ischaemia, which correlates well with follow-up NECT.

The effect of hospital volume on patient outcomes in severe acute pancreatitis

Directory of Open Access Journals (Sweden)

Shen Hsiu-Nien

2012-08-01

Full Text Available Abstract Background We investigated the relation between hospital volume and outcome in patients with severe acute pancreatitis (SAP. The determination is important because patient outcome may be improved through volume-based selective referral. Methods In this cohort study, we analyzed 22,551 SAP patients in 2,208 hospital-years (between 2000 and 2009 from Taiwan’s National Health Insurance Research Database. Primary outcome was hospital mortality. Secondary outcomes were hospital length of stay and charges. Hospital SAP volume was measured both as categorical and as continuous variables (per one case increase each hospital-year. The effect was assessed using multivariable logistic regression models with generalized estimating equations accounting for hospital clustering effect. Adjusted covariates included patient and hospital characteristics (model 1, and additional treatment variables (model 2. Results Irrespective of the measurements, increasing hospital volume was associated with reduced risk of hospital mortality after adjusting the patient and hospital characteristics (adjusted odds ratio [OR] 0.995, 95% confidence interval [CI] 0.993-0.998 for per one case increase. The patients treated in the highest volume quartile (≥14 cases per hospital-year had 42% lower risk of hospital mortality than those in the lowest volume quartile (1 case per hospital-year after adjusting the patient and hospital characteristics (adjusted OR 0.58, 95% CI 0.40-0.83. However, an inverse relation between volume and hospital stay or hospital charges was observed only when the volume was analyzed as a categorical variable. After adjusting the treatment covariates, the volume effect on hospital mortality disappeared regardless of the volume measures. Conclusions These findings support the use of volume-based selective referral for patients with SAP and suggest that differences in levels or processes of care among hospitals may have contributed to the volume

The effect of different volumes of acute resistance exercise on elderly individuals with treated hypertension.

Science.gov (United States)

Scher, Luria M L; Ferriolli, Eduardo; Moriguti, Julio C; Scher, Ricardo; Lima, Nereida K C

2011-04-01

Acute resistance exercise can reduce the blood pressure (BP) of hypertensive subjects. The aim of this study was to evaluate the effect of different volumes of acute low-intensity resistance exercise over the magnitude and the extent of BP changes in treated hypertensive elderly individuals. Sixteen participants (7 men, 9 women), with mean age of 68 ± 5 years, performed 3 independent randomized sessions: Control (C: 40 minutes of rest), Exercise 1 (E1: 20 minutes, 1 lap in the circuit), and Exercise 2 (E2: 40 minutes, 2 laps in the circuit) with the intensity of 40% of 1 repetition maximum. Blood pressure was measured before (during 20 minutes) and after each session (every 5 minutes during 60 minutes) using both a mercury sphygmomanometer and a semiautomatic device (Omrom-HEM-431). After that, 24-hour ambulatory blood pressure monitoring was performed (Dyna-MAPA). Blood pressure decreased during the first 60 minutes (systolic: p exercise sessions. Only the highest volume session promoted a reduction of mean systolic 24-hour BP and awake BP (p exercise, with higher diastolic BP during sleep (p exercise sessions in a circuit with different volumes reduced BP during the first 60 minutes after exercise in elderly individuals with treated hypertension. However, only the highest volume promoted a reduction of mean 24-hour and awake systolic BP.

Expanding severe acute respiratory infection (SARI) surveillance beyond influenza: The process and data from 1 year of implementation in Vietnam.

Science.gov (United States)

Alroy, Karen A; Do, Trang Thuy; Tran, Phu Dac; Dang, Tan Quang; Vu, Long Ngoc; Le, Nga Thi Hang; Dang, Anh Duc; Ngu, Nghia Duy; Ngo, Tu Huy; Hoang, Phuong Vu Mai; Phan, Lan Trong; Nguyen, Thuong Vu; Nguyen, Long Thanh; Nguyen, Thinh Viet; Vien, Mai Quang; Le, Huy Xuan; Dao, Anh The; Nguyen, Trieu Bao; Pham, Duoc Tho; Nguyen, Van Thi Tuyet; Pham, Thanh Ngoc; Phan, Binh Hai; Whitaker, Brett; Do, Thuy Thi Thu; Dao, Phuong Anh; Balajee, S Arunmozhi; Mounts, Anthony W

2018-05-13

In 2016, as a component of the Global Health Security Agenda, the Vietnam Ministry of Health expanded its existing influenza sentinel surveillance for severe acute respiratory infections (SARI) to include testing for 7 additional viral respiratory pathogens. This article describes the steps taken to implement expanded SARI surveillance in Vietnam and reports data from 1 year of expanded surveillance. The process of expanding the suite of pathogens for routine testing by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) included laboratory trainings, procurement/distribution of reagents, and strengthening and aligning SARI surveillance epidemiology practices at sentinel sites and regional institutes (RI). Surveillance data showed that of 4003 specimens tested by the RI laboratories, 20.2% (n = 810) were positive for influenza virus. Of the 3193 influenza-negative specimens, 41.8% (n = 1337) were positive for at least 1 non-influenza respiratory virus, of which 16.2% (n = 518), 13.4% (n = 428), and 9.6% (n = 308) tested positive for respiratory syncytial virus, rhinovirus, and adenovirus, respectively. The Government of Vietnam has demonstrated that expanding respiratory viral surveillance by strengthening and building upon an influenza platform is feasible, efficient, and practical. © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Validation of enzyme immunoassay applied to the serological diagnosis of hog brucellosis

International Nuclear Information System (INIS)

Ramondino, Romina; Marticorena, Damian

1997-01-01

The application of an enzyme immunization test in the serological diagnostic of a disease demands its validation as a previous stage. A test validation requires to know: cut off, diagnostic and relative specificity and sensitivity and harmonization grade between the new test and the classical test in use. The purpose of this work is the following: a) To determine the cut off and to calculate the specificity of two immunization tests, indirect (I-ELISA) and competitive (C-ELISA) by the analysis of serum coming from Canada (country free of this disease); b) To calculate the values of relative sensitivity of the tests with serum coming from infected populations and diagnostic sensitivity with samples of serum from hogs with positive isolation to Brucella suis

Thermography hogging the limelight at Big Sky

Energy Technology Data Exchange (ETDEWEB)

Plastow, C. [Fluke Electronics Canada, Mississauga, ON (Canada)

2010-02-15

The high levels of humidity and ammonia found at hog farms can lead to premature corrosion of electrical systems and create potential hazards, such as electrical fires. Big Sky Farms in Saskatchewan has performed on-site inspections at its 44 farms and 16 feed mills using handheld thermography technology from Fluke Electronics. Ti thermal imaging units save time and simplify inspections. The units could be used for everything, from checking out the bearings at the feed mills to electrical circuits and relays. The Ti25 is affordable and has the right features for a preventative maintenance program. Operators of Big Sky Farms use the Ti25 to inspect all circuit breakers of 600 volts or lower as well as transformers where corrosion often causes connections to break off. The units are used to look at bearings, do scanning and thermal imaging on motors. To date, the Ti25 has detected and highlighted 5 or 6 problems on transformers alone that could have been major issues. At one site, the Ti25 indicated that all 30 circuit breakers had loose connections and were overeating. Big Sky Farms fixed the problem right away before a disaster happened. In addition to reducing inspection times, the Ti25 can record all measurements and keep a record of all the readings for downloading. 2 figs.

Role of cardiac volume receptors in the control of ADH release during acute simulated weightlessness in man

Science.gov (United States)

Convertino, V. A.; Benjamin, B. A.; Keil, L. C.; Sandler, H.

1984-01-01

Hemodynamic responses and antidiuretic hormone (ADH) were measured during body position changes, designed to induce central blood volume shifts in ten cardiac and one heart-lung transplant recipients, to assess the contribution of cardiac volume receptors in the control of ADH release during the initial acute phase of exposure to weightlessness. Each subject underwent 15 min of a sitting-control period (C) followed by 30 min of 6 deg headdown tilt (T) and 30 min of resumed sitting (S). Venous blood samples and cardiac dimensions were taken at 0 and 15 min of C; 5, 15, and 30 min of T; and 5, 15, and 30 min of S. Blood samples were analyzed for hematocrit, plasma osmolality, plasma renin activity (PRA), and ADH. Heart rate and blood pressure were recorded every two min. Plasma osmolality was not altered by posture changes. Mean left ventricular end-diastolic volume increased (P less than 0.05) from 90 ml in C to 106 ml in T and returned to 87 ml in S. Plasma ADH was reduced by 20 percent (P less than 0.05) with T, and returned to control levels with S. These responses were similar in six normal cardiac-innervated control subjects. These data may suggest that cardiac volume receptors are not the primary mechanism for the control of ADH release during acute central volume shifts in man.

Assessment of Collateral Status by Dynamic CT Angiography in Acute MCA Stroke: Timing of Acquisition and Relationship with Final Infarct Volume

NARCIS (Netherlands)

van den Wijngaard, I. R.; Holswilder, G.; Wermer, M. J. H.; Boiten, J.; Algra, A.; Dippel, D. W. J.; Dankbaar, J. W.; Velthuis, B. K.; Boers, A. M. M.; Majoie, C. B. L. M.; van Walderveen, M. A. A.

2016-01-01

Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up. We selected patients with acute ischemic stroke due to

Subcortical volume and cortical surface architecture in women with acute and remitted anorexia nervosa: An exploratory neuroimaging study.

Science.gov (United States)

Miles, Amy E; Voineskos, Aristotle N; French, Leon; Kaplan, Allan S

2018-04-13

Anorexia nervosa (AN) is a highly heritable psychiatric disorder characterized by starvation and emaciation and associated with changes in brain structure. The precise nature of these changes remains unclear, as does their developmental time course and capacity for reversal with weight-restoration. In this comprehensive neuroimaging study, we sought to characterize these changes by measuring subcortical volume and cortical surface architecture in women with acute and remitted AN. Structural magnetic resonance imaging data was acquired from underweight women with a current diagnosis of AN (acAN: n = 23), weight-recovered women with a past diagnosis of AN (recAN: n = 24), and female controls (HC: n = 24). Subcortical segmentation and cortical surface reconstruction were performed with FreeSurfer 6.0.0, and group differences in regional volume and vertex-wise, cortex-wide thickness, surface area, and local gyrification index (LGI), a measure of folding, were tested with separate univariate analyses of covariance. Mean hippocampal and thalamic volumes were significantly reduced in acAN participants, as was mean cortical thickness in four frontal and temporal clusters. Mean LGI was significantly reduced in acAN and recAN participants in five frontal and parietal clusters. No significant group differences in cortical surface area were detected. Reductions in subcortical volume, cortical thickness, and right postcentral LGI were unique to women with acute AN, indicating state-dependence and pointing towards cellular remodeling and sulcal widening as consequences of disease manifestation. Reductions in bilateral frontal LGI were observed in women with acute and remitted AN, suggesting a role of atypical neurodevelopment in disease vulnerability. Copyright © 2018. Published by Elsevier Ltd.

Enhanced Gender Recognition System Using an Improved Histogram of Oriented Gradient (HOG Feature from Quality Assessment of Visible Light and Thermal Images of the Human Body

Directory of Open Access Journals (Sweden)

Dat Tien Nguyen

2016-07-01

Full Text Available With higher demand from users, surveillance systems are currently being designed to provide more information about the observed scene, such as the appearance of objects, types of objects, and other information extracted from detected objects. Although the recognition of gender of an observed human can be easily performed using human perception, it remains a difficult task when using computer vision system images. In this paper, we propose a new human gender recognition method that can be applied to surveillance systems based on quality assessment of human areas in visible light and thermal camera images. Our research is novel in the following two ways: First, we utilize the combination of visible light and thermal images of the human body for a recognition task based on quality assessment. We propose a quality measurement method to assess the quality of image regions so as to remove the effects of background regions in the recognition system. Second, by combining the features extracted using the histogram of oriented gradient (HOG method and the measured qualities of image regions, we form a new image features, called the weighted HOG (wHOG, which is used for efficient gender recognition. Experimental results show that our method produces more accurate estimation results than the state-of-the-art recognition method that uses human body images.

Enhanced Gender Recognition System Using an Improved Histogram of Oriented Gradient (HOG) Feature from Quality Assessment of Visible Light and Thermal Images of the Human Body.

Science.gov (United States)

Nguyen, Dat Tien; Park, Kang Ryoung

2016-07-21

With higher demand from users, surveillance systems are currently being designed to provide more information about the observed scene, such as the appearance of objects, types of objects, and other information extracted from detected objects. Although the recognition of gender of an observed human can be easily performed using human perception, it remains a difficult task when using computer vision system images. In this paper, we propose a new human gender recognition method that can be applied to surveillance systems based on quality assessment of human areas in visible light and thermal camera images. Our research is novel in the following two ways: First, we utilize the combination of visible light and thermal images of the human body for a recognition task based on quality assessment. We propose a quality measurement method to assess the quality of image regions so as to remove the effects of background regions in the recognition system. Second, by combining the features extracted using the histogram of oriented gradient (HOG) method and the measured qualities of image regions, we form a new image features, called the weighted HOG (wHOG), which is used for efficient gender recognition. Experimental results show that our method produces more accurate estimation results than the state-of-the-art recognition method that uses human body images.

Tidal volume in acute respiratory distress syndrome: how best to select it.

Science.gov (United States)

Umbrello, Michele; Marino, Antonella; Chiumello, Davide

2017-07-01

Mechanical ventilation is the type of organ support most widely provided in the intensive care unit. However, this form of support does not constitute a cure for acute respiratory distress syndrome (ARDS), as it mainly works by buying time for the lungs to heal while contributing to the maintenance of vital gas exchange. Moreover, it can further damage the lung, leading to the development of a particular form of lung injury named ventilator-induced lung injury (VILI). Experimental evidence accumulated over the last 30 years highlighted the factors associated with an injurious form of mechanical ventilation. The present paper illustrates the physiological effects of delivering a tidal volume to the lungs of patients with ARDS, and suggests an approach to tidal volume selection. The relationship between tidal volume and the development of VILI, the so called volotrauma, will be reviewed. The still actual suggestion of a lung-protective ventilatory strategy based on the use of low tidal volumes scaled to the predicted body weight (PBW) will be presented, together with newer strategies such as the use of airway driving pressure as a surrogate for the amount of ventilatable lung tissue or the concept of strain, i.e., the ratio between the tidal volume delivered relative to the resting condition, that is the functional residual capacity (FRC). An ultra-low tidal volume strategy with the use of extracorporeal carbon dioxide removal (ECCO 2 R) will be presented and discussed. Eventually, the role of other ventilator-related parameters in the generation of VILI will be considered (namely, plateau pressure, airway driving pressure, respiratory rate (RR), inspiratory flow), and the promising unifying framework of mechanical power will be presented.

Hospital volumes and later year of operation correlates with better outcomes in acute Type A aortic dissection

DEFF Research Database (Denmark)

Geirsson, Arnar; Ahlsson, Anders; Franco-Cereceda, Anders

2018-01-01

and C and cardiopulmonary bypass time, whereas later calendar year and higher hospital operative volumes predicted improved survival. CONCLUSIONS: Surgical mortality for acute Type A aortic dissection remains high but has decreased significantly over the last decade. This correlated with later year...... A Aortic Dissection is a retrospective database comprising 1159 patients (mean age 61.6 ± 12.2 years, 68% male) treated for acute Type A aortic dissection at 8 centres in Denmark, Finland, Iceland and Sweden from 2005 to 2014. Data gathered included demographics, symptoms, type of procedure, complications...

Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

International Nuclear Information System (INIS)

Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M.; Renker, Matthias; Ackermann, Hanns; Schoepf, U.J.

2011-01-01

To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p 5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

Feeding habits of Molina's hog-nosed skunk, Conepatus chinga (Carnivora: Mephitidae) in the extreme south of Brazil

OpenAIRE

Peters, Felipe Bortolotto; Roth, Paulo Ricardo de Oliveira; Christoff, Alexandre Uarth

2011-01-01

Feeding habits of the Molina's hog-nosed skunk, Conepatus chinga (Molina, 1782) in the extreme south of Brazil. We analyzed 60 stomachs of road-kills of C. chinga in the extreme south of Brazil. The contents revealed 808 prey parts, including invertebrates (frequency of occurrence - FO = 96.7% and relative abundance - RA = 94.7%), vertebrates (FO = 18.3% and RA = 2.8%) and plants (FO = 31.7% and RA = 2.3%). We identified 18 kinds of food, including the invertebrate order Coleoptera which show...

An assay for serum vitamin-B12 and for intrinsic factor antibody type I by means of hog intrinsic factor

International Nuclear Information System (INIS)

Hudak, J.; Berger, Z.; Varga, L.

1980-01-01

A new radioassay method was elaborated for the determination of the plasma level of vitamin B 12 and of the intrinsic factor antibody type I. The assay applies vitamin-B 12 labelled with 58 Co, but replaces human intrinsic factor by hog intrinsic factor. 124 cases were investigated by both the original and this modified method, and the results were in very good agreement. (L.E.)

Reperfusion is a more accurate predictor of follow-up infarct volume than recanalization: a proof of concept using CT in acute ischemic stroke patients.

Science.gov (United States)

Soares, Bruno P; Tong, Elizabeth; Hom, Jason; Cheng, Su-Chun; Bredno, Joerg; Boussel, Loic; Smith, Wade S; Wintermark, Max

2010-01-01

The purpose of this study was to compare recanalization and reperfusion in terms of their predictive value for imaging outcomes (follow-up infarct volume, infarct growth, salvaged penumbra) and clinical outcome in acute ischemic stroke patients. Twenty-two patients admitted within 6 hours of stroke onset were retrospectively included in this study. These patients underwent a first stroke CT protocol including CT-angiography (CTA) and perfusion-CT (PCT) on admission, and similar imaging after treatment, typically around 24 hours, to assess recanalization and reperfusion. Recanalization was assessed by comparing arterial patency on admission and posttreatment CTAs; reperfusion, by comparing the volumes of CBV, CBF, and MTT abnormality on admission and posttreatment PCTs. Collateral flow was graded on the admission CTA. Follow-up infarct volume was measured on the discharge noncontrast CT. The groups of patients with reperfusion, no reperfusion, recanalization, and no recanalization were compared in terms of imaging and clinical outcomes. Reperfusion (using an MTT reperfusion index >75%) was a more accurate predictor of follow-up infarct volume than recanalization. Collateral flow and recanalization were not accurate predictors of follow-up infarct volume. An interaction term was found between reperfusion and the volume of the admission penumbra >50 mL. Our study provides evidence that reperfusion is a more accurate predictor of follow-up infarct volume in acute ischemic stroke patients than recanalization. We recommend an MTT reperfusion index >75% to assess therapy efficacy in future acute ischemic stroke trials that use perfusion-CT.

Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction

International Nuclear Information System (INIS)

Russo, James K; Armeson, Kent E; Rhome, Ryan; Spanos, Michele; Harper, Jennifer L

2011-01-01

To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT) following tissue expander placement. Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. The mean coverage of the level I/II axillary volume by the 95% isodose line (V D95% ) was 23.9% (range 0.3 - 65.4%). The mean Ipsilateral Lung V D50% was 8.8% (2.2-20.9). Ipsilateral and contralateral expander volume correlated to Axillary V D95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively) but not those with ipsilateral only reconstruction (p = 0.60). Ipsilateral Lung V D50% correlated with angle of the expander from midline (p = 0.05). In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated

Management of acute malignant colorectal obstruction with a novel self-expanding metallic stent as a bridge to surgery

International Nuclear Information System (INIS)

Li Yongdong; Cheng Yingsheng; Li Minghua; Fan Youben; Chen Niwei; Wang Yu; Zhao Jungong

2010-01-01

Purpose: To prospectively evaluate the safety and clinical efficacy of a newly designed self-expandable metallic stent (SEMS) in the treatment of patients with acute malignant colorectal obstruction. Methods: Between April 2001 and October 2007, 52 patients with acute malignant colorectal obstruction were treated with a new designed SEMS as an investigational bridge to surgery. Patients were prospectively followed and relevant data collection was collected, including details regarding technique, clinical symptoms, complications, need for elective surgery, and overall survival. Results: Stent placement was technically successful in all but two patients (due to complete obstruction) with no procedure-related complications. Complications included stent migration (n = 4), anal pain (n = 2) and stool impaction (n = 1). Clinical success was achieved in 49 (98%) of 50 patients with resolution of bowel obstruction within 2 days of stent placement. In one patient with stool impaction 2 days after stent placement, endoscopic disimpaction was successfully performed. An elective one-stage surgical procedure was performed in all 50 patients who successfully received a SEMS as a bridge to surgery within a mean of 8 ± 2 days (range: 4-11 days) after stent placement. Mean follow-up time was 36 ± 12 months (range 3-70 months), and all patients remained alive at the time of this report. Conclusion: The newly designed SEMS placement as a bridge to surgery was a safe and effective intervention for colonic decompression in patients with acute malignant colorectal obstruction and allowed a high proportion of patients to be successfully proceeded to elective surgery.

Management of acute malignant colorectal obstruction with a novel self-expanding metallic stent as a bridge to surgery

Energy Technology Data Exchange (ETDEWEB)

Li Yongdong [Department of Radiology and Research Institute of Radiology, Sixth Affiliated People' s Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai 200233 (China); Cheng Yingsheng [Department of Radiology and Research Institute of Radiology, Sixth Affiliated People' s Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai 200233 (China); Department of Radiology, Tenth Affiliated People' s Hospital, Shanghai Tong Ji University, No. 301, Middle Yan Chang Road, Shanghai 200072 (China)], E-mail: chengys@sh163.net; Li Minghua [Department of Radiology and Research Institute of Radiology, Sixth Affiliated People' s Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai 200233 (China); Fan Youben; Chen Niwei; Wang Yu [Department of Gastroenterology, Sixth Affiliated People' s Hospital, Shanghai Jiao Tong University (China); Zhao Jungong [Department of Radiology and Research Institute of Radiology, Sixth Affiliated People' s Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai 200233 (China)

2010-03-15

Purpose: To prospectively evaluate the safety and clinical efficacy of a newly designed self-expandable metallic stent (SEMS) in the treatment of patients with acute malignant colorectal obstruction. Methods: Between April 2001 and October 2007, 52 patients with acute malignant colorectal obstruction were treated with a new designed SEMS as an investigational bridge to surgery. Patients were prospectively followed and relevant data collection was collected, including details regarding technique, clinical symptoms, complications, need for elective surgery, and overall survival. Results: Stent placement was technically successful in all but two patients (due to complete obstruction) with no procedure-related complications. Complications included stent migration (n = 4), anal pain (n = 2) and stool impaction (n = 1). Clinical success was achieved in 49 (98%) of 50 patients with resolution of bowel obstruction within 2 days of stent placement. In one patient with stool impaction 2 days after stent placement, endoscopic disimpaction was successfully performed. An elective one-stage surgical procedure was performed in all 50 patients who successfully received a SEMS as a bridge to surgery within a mean of 8 {+-} 2 days (range: 4-11 days) after stent placement. Mean follow-up time was 36 {+-} 12 months (range 3-70 months), and all patients remained alive at the time of this report. Conclusion: The newly designed SEMS placement as a bridge to surgery was a safe and effective intervention for colonic decompression in patients with acute malignant colorectal obstruction and allowed a high proportion of patients to be successfully proceeded to elective surgery.

Perception of Job-Related Risk, Training, and Use of Personal Protective Equipment (PPE among Latino Immigrant Hog CAFO Workers in Missouri: A Pilot Study

Directory of Open Access Journals (Sweden)

Athena K. Ramos

2016-11-01

Full Text Available Hog production in the United States is a large industry that has seen dramatic changes over the last few decades. Concentrated animal feeding operations (CAFOs are growing in number throughout the country. This pilot study explores the perception of risk, receipt of work-related training, provision and usage of personal protective equipment (PPE, and prevention preferences of Latino immigrant hog CAFO workers in Missouri. Forty workers (M age = 36.08 years, SD = 10.04; 92.5% male; 70.0% Mexican were interviewed. Results indicate that most workers did not perceive their job as dangerous. Limited English proficient workers were significantly less likely to report receiving any work-related training. Although most workers had access to employer provided PPE, usage was inconsistent. As the demographic composition of the farmworker population in the Midwest becomes increasingly comprised of hired immigrant workers, it will be imperative to develop occupational safety and health educational and outreach efforts focused on the needs of these workers.

Perception of Job-Related Risk, Training, and Use of Personal Protective Equipment (PPE) among Latino Immigrant Hog CAFO Workers in Missouri: A Pilot Study.

Science.gov (United States)

Ramos, Athena K; Fuentes, Axel; Trinidad, Natalia

2016-01-01

Hog production in the United States is a large industry that has seen dramatic changes over the last few decades. Concentrated animal feeding operations (CAFOs) are growing in number throughout the country. This pilot study explores the perception of risk, receipt of work-related training, provision and usage of personal protective equipment (PPE), and prevention preferences of Latino immigrant hog CAFO workers in Missouri. Forty workers (M age = 36.08 years, SD = 10.04; 92.5% male; 70.0% Mexican) were interviewed. Results indicate that most workers did not perceive their job as dangerous. Limited English proficient workers were significantly less likely to report receiving any work-related training. Although most workers had access to employer provided PPE, usage was inconsistent. As the demographic composition of the farmworker population in the Midwest becomes increasingly comprised of hired immigrant workers, it will be imperative to develop occupational safety and health educational and outreach efforts focused on the needs of these workers.

High initial tidal volumes in emergency department patients at risk for acute respiratory distress syndrome.

Science.gov (United States)

Allison, Michael G; Scott, Michael C; Hu, Kami M; Witting, Michael D; Winters, Michael E

2015-04-01

Emergency department (ED) patients are at high risk for the acute respiratory distress syndrome (ARDS). Settings only 1 mL/kg above recommended tidal volumes confers harm for these patients. The purpose of this study was to determine whether ED physicians routinely initiate mechanical ventilation with low tidal volumes in patients at risk for ARDS. We retrospectively reviewed the charts of all adult patients who were intubated in an urban, academic ED. The charts were analyzed to identify patients in whom ARDS developed within 48 hours after ED admission. Patients were eligible for inclusion if they had bilateral infiltrates on imaging, had a Pao2/Fio2 ratio less than 300 mm Hg and did not have heart failure contributing to their presentation. The tidal volumes set in the ED were then compared with the recommended tidal volume of 6 mL/kg of predicted body weight. The initial tidal volumes set in the ED were higher than recommended by an average of 80 mL (95% confidence interval, 60-110, P tidal volume ventilation setting. In an academic, tertiary hospital, newly intubated ED patients in whom ARDS developed within 48 hours after intubation were ventilated with tidal volumes that exceeded recommendations by an average of 1.5 mL/kg. Copyright © 2014 Elsevier Inc. All rights reserved.

Very low tidal volume ventilation with associated hypercapnia--effects on lung injury in a model for acute respiratory distress syndrome.

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Hans Fuchs

Full Text Available BACKGROUND: Ventilation using low tidal volumes with permission of hypercapnia is recommended to protect the lung in acute respiratory distress syndrome. However, the most lung protective tidal volume in association with hypercapnia is unknown. The aim of this study was to assess the effects of different tidal volumes with associated hypercapnia on lung injury and gas exchange in a model for acute respiratory distress syndrome. METHODOLOGY/PRINCIPAL FINDINGS: In this randomized controlled experiment sixty-four surfactant-depleted rabbits were exposed to 6 hours of mechanical ventilation with the following targets: Group 1: tidal volume = 8-10 ml/kg/PaCO(2 = 40 mm Hg; Group 2: tidal volume = 4-5 ml/kg/PaCO(2 = 80 mm Hg; Group 3: tidal volume = 3-4 ml/kg/PaCO(2 = 120 mm Hg; Group 4: tidal volume = 2-3 ml/kg/PaCO(2 = 160 mm Hg. Decreased wet-dry weight ratios of the lungs, lower histological lung injury scores and higher PaO(2 were found in all low tidal volume/hypercapnia groups (group 2, 3, 4 as compared to the group with conventional tidal volume/normocapnia (group 1. The reduction of the tidal volume below 4-5 ml/kg did not enhance lung protection. However, oxygenation and lung protection were maintained at extremely low tidal volumes in association with very severe hypercapnia and no adverse hemodynamic effects were observed with this strategy. CONCLUSION: Ventilation with low tidal volumes and associated hypercapnia was lung protective. A tidal volume below 4-5 ml/kg/PaCO(2 80 mm Hg with concomitant more severe hypercapnic acidosis did not increase lung protection in this surfactant deficiency model. However, even at extremely low tidal volumes in association with severe hypercapnia lung protection and oxygenation were maintained.

Clinical application of self-expanding metallic stent in the management of acute left-sided colorectal malignant obstruction

Institute of Scientific and Technical Information of China (English)

You-Ben Fan; Ying-Sheng Cheng; Ni-Wei Chen; Hui-Min Xu; Zhe Yang; Yue Wang; Yu-Yao Huang; Qi Zheng

2006-01-01

AIM: To summarize our experience with the application of self-expanding metallic stent (SEMS) in the management of acute left-sided colorectal malignant obstruction.METHODS: A retrospective chart review of all patients undergoing placement of SEMS between April 2000 and January 2004 was performed.RESULTS: Insertion of SEMS was attempted in 26patients under fluoroscopic guidance with occasional endoscopic assistance. The sites of lesions were located in splenic flexure of two patients, left colon of seven patients, sigmoid colon of eight patients and rectum of nine patients. The intended uses of SEMS were for palliation in 7 patients and as a bridge to elective surgery in 19 patients. In the latter group, placement of SEMS allowed for preoperative systemic and bowel preparation and the following one-stage anastomosis. Successful stent placement was achieved in 22 (85%) of the 26patients. The clinical bowel obstruction resolved 24 hours after successful stent placement in 21 (95%) patients.Three SEMS-related minor complications occurred, two stents migrated and one caused anal pain.CONCLUSION: SEMS represents an effective and safe tool in the management of acute malignant colorectal obstruction. As a bridge to surgery, SEMS can provide time for systematic support and bowel preparation and obviate the need for fecal diversion or on-table lavage.As a palliative measure, SEMS can eliminate the need for emergent colostomy.

Dual energy CT pulmonary blood volume assessment in acute pulmonary embolism - correlation with D-dimer level, right heart strain and clinical outcome

Energy Technology Data Exchange (ETDEWEB)

Bauer, Ralf W.; Frellesen, Claudia; Schell, Boris; Lehnert, Thomas; Jacobi, Volkmar; Vogl, Thomas J.; Kerl, J.M. [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Renker, Matthias [Clinic of the Goethe University, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States); Ackermann, Hanns [Clinic of the Goethe University, Department of Biostatistics and Mathematical Modelling, Frankfurt (Germany); Schoepf, U.J. [Medical University of South Carolina, Heart and Vascular Center, Ashley River Tower, Charleston, SC (United States)

2011-09-15

To investigate the role of perfusion defect (PD) size on dual energy CT pulmonary blood volume assessment as predictor of right heart strain and patient outcome and its correlation with d-dimer levels in acute pulmonary embolism (PE). 53 patients with acute PE who underwent DECT pulmonary angiography were retrospectively analyzed. Pulmonary PD size caused by PE was measured on DE iodine maps and quantified absolutely (VolPD) and relatively to the total lung volume (RelPD). Signs of right heart strain (RHS) on CT were determined. Information on d-dimer levels and readmission for recurrent onset of PE and death was collected. D-dimer level was mildly (r = 0.43-0.47) correlated with PD size. Patients with RHS had significantly higher VolPD (215 vs. 73 ml) and RelPD (9.9 vs. 2.9%) than patients without RHS (p < 0.003). There were 2 deaths and 1 readmission due of PE in 18 patients with >5% RelPD, while no such events were found for patients with <5% RelPD. Pulmonary blood volume on DECT in acute PE correlates with RHS and appears to be a predictor of patient outcome in this pilot study. (orig.)

Effects of vertical positioning on gas exchange and lung volumes in acute respiratory distress syndrome.

Science.gov (United States)

Richard, Jean-Christophe M; Maggiore, Salvatore Maurizio; Mancebo, Jordi; Lemaire, François; Jonson, Bjorn; Brochard, Laurent

2006-10-01

Supine position may contribute to the loss of aerated lung volume in patients with acute respiratory distress syndrome (ARDS). We hypothesized that verticalization increases lung volume and improves gas exchange by reducing the pressure surrounding lung bases. Prospective observational physiological study in a medical ICU. In 16 patients with ARDS we measured arterial blood gases, pressure-volume curves of the respiratory system recorded from positive-end expiratory pressure (PEEP), and changes in lung volume in supine and vertical positions (trunk elevated at 45 degrees and legs down at 45 degrees ). Vertical positioning increased PaO(2) significantly from 94+/-33 to 142+/-49 mmHg, with an increase higher than 40% in 11 responders. The volume at 20 cmH(2)O measured on the PV curve from PEEP increased using the vertical position only in responders (233+/-146 vs. -8+/-9 1ml in nonresponders); this change was correlated to oxygenation change (rho=0.55). End-expiratory lung volume variation from supine to vertical and 1 h later back to supine, measured in 12 patients showed a significant increase during the 1-h upright period in responders (n=7) but not in nonresponders (n=5; 215+/-220 vs. 10+/-22 ml), suggesting a time-dependent recruitment. Vertical positioning is a simple technique that may improve oxygenation and lung recruitment in ARDS patients.

Free-piston reciprocating cryogenic expander utilizing phase controller

Science.gov (United States)

Cha, Jeongmin; Park, Jiho; Kim, Kyungjoong; Jeong, Sangkwon

2017-02-01

In a free-piston expander which eliminates mechanical linkages, a prescribed behaviour of the free-piston movement is the key to an expander performance. In this paper, we have proposed an idea of reducing complexity of the free-piston expander. It is to replace both multiple solenoid valves and reservoirs that are indispensable in a previous machine with a combination of a single orifice-reservoir assembly. It functions as a phase controller like that of a pulse tube refrigerator so that it generates time-delay of pressure variation between the warm-end and the reservoir resulting in the intended expansion of the cold-end volume down to the pre-set reservoir pressure. The modeling of this unique free-piston reciprocating expander utilizing phase controller is developed to understand and predict the performance of the new-type expander. Additionally, the operating parameters are analysed at the specified conditions to enable one to develop a more efficient free-piston type cryogenic expander.

Association Between Use of Lung-Protective Ventilation With Lower Tidal Volumes and Clinical Outcomes Among Patients Without Acute Respiratory Distress Syndrome A Meta-analysis

NARCIS (Netherlands)

Serpa Neto, Ary; Cardoso, Sérgio Oliveira; Manetta, José Antônio; Pereira, Victor Galvão Moura; Espósito, Daniel Crepaldi; Pasqualucci, Manoela de Oliveira Prado; Damasceno, Maria Cecília Toledo; Schultz, Marcus J.

2012-01-01

Context Lung-protective mechanical ventilation with the use of lower tidal volumes has been found to improve outcomes of patients with acute respiratory distress syndrome (ARDS). It has been suggested that use of lower tidal volumes also benefits patients who do not have ARDS. Objective To determine

Variations in gastric compliance induced by acute blood volume changes in anesthetized rats

Directory of Open Access Journals (Sweden)

Graça J.R.V.

2002-01-01

Full Text Available The impact of acute volume imbalances on gastric volume (GV was studied in anesthetized rats (250-300 g. After cervical and femoral vessel cannulation, a balloon catheter was positioned in the proximal stomach. The opposite end of the catheter was connected to a barostat with an electronic sensor coupled to a plethysmometer. A standard ionic solution was used to fill the balloon (about 3.0 ml and the communicating vessel system, and to raise the reservoir liquid level 4 cm above the animals' xiphoid appendix. Due to constant barostat pressure, GV values were considered to represent the gastric compliance index. All animals were monitored for 90 min. After a basal interval, they were randomly assigned to normovolemic, hypervolemic, hypovolemic or restored protocols. Data were compared by ANOVA followed by Bonferroni's test. Mean arterial pressure (MAP, central venous pressure (CVP and GV values did not change in normovolemic animals (N = 5. Hypervolemic animals (N = 12 were transfused at 0.5 ml/min with a suspension of red blood cells in Ringer-lactate solution with albumin (12.5 ml/kg, which reduced GV values by 11.3% (P0.05. MAP and CVP values increased (P<0.05 after hypervolemia but decreased (P<0.05 with hypovolemia. In conclusion, blood volume level modulates gastric compliance, turning the stomach into an adjustable reservoir, which could be part of the homeostatic process to balance blood volume.

Variations in gastric emptying of liquid elicited by acute blood volume changes in awake rats

Directory of Open Access Journals (Sweden)

Gondim F. de-A.A.

1998-01-01

Full Text Available We have observed that acute blood volume expansion increases the gastroduodenal resistance to the flow of liquid in anesthetized dogs, while retraction decreases it (Santos et al. (1991 Acta Physiologica Scandinavica, 143: 261-269. This study evaluates the effect of blood volume expansion and retraction on the gastric emptying of liquid in awake rats using a modification of the technique of Scarpignato (1980 (Archives Internationales de Pharmacodynamie et de Therapie, 246: 286-294. Male Wistar rats (180-200 g were fasted for 16 h with water ad libitum and 1.5 ml of the test meal (0.5 mg/ml phenol red solution in 5% glucose was delivered to the stomach immediately after random submission to one of the following protocols: 1 normovolemic control (N = 22, 2 expansion (N = 72 by intravenous infusion (1 ml/min of Ringer-bicarbonate solution, volumes of 1, 2, 3 or 5% body weight, or 3 retraction (N = 22 by controlled bleeding (1.5 ml/100 g. Gastric emptying of liquid was inhibited by 19-51.2% (P<0.05 after blood volume expansion (volumes of 1, 2, 3 or 5% body weight. Blood volume expansion produced a sustained increase in central venous pressure while mean arterial pressure was transiently increased during expansion (P<0.05. Blood volume retraction increased gastric emptying by 28.5-49.9% (P<0.05 and decreased central venous pressure and mean arterial pressure (P<0.05. Infusion of the shed blood 10 min after bleeding reversed the effect of retraction on gastric emptying. These findings suggest that gastric emptying of liquid is subject to modulation by the blood volume.

Tissue Expander Overfilling: Achieving New Dimensions of Customization in Breast Reconstruction.

Science.gov (United States)

Treiser, Matthew D; Lahair, Tracy; Carty, Matthew J

2016-02-01

Overfill of tissue expanders is a commonly used modality to achieve customized dimensions in breast reconstruction. Little formal study of the dynamics of hyperexpansion of these devices has been performed to date, however. Overfill trials were performed using both Natrelle 133 MV and Mentor 8200 tissue expanders of indicated capacities ranging from 250 to 800 mL. Each expander was initially filled to its indicated capacity with normal water and then injected in regular increments to 400% overfill. Measurements of each expander's width, height, and projection were made at indicated capacity and with each successive incremental overfill injection, and these results were then recorded, collated, and analyzed. Over the first 50% overfill, all expanders demonstrated a logarithmic increase in projection (mean increase, 143 ± 9%) while maintaining essentially stable base dimensions. Overfill levels in excess of 50% were accompanied by linear increases in height, width, and projection, during which projection approached, but never equaled, base dimensions. Stress versus strain analyses demonstrated nonlinear biomechanical dynamics during the first 50% overfill, followed by standard elastic dynamics up to 400% overfill. At no point during the study, did expander tensions outstrip elastic properties, thereby explaining the lack of device rupture. Through overfilling, tunable geometries of tissue expanders can be accessed that may provide for increasing customization of reconstructions, particularly at overfill volumes up to 50% over indicated capacity. This study should serve to guide tissue expander selection and fill volumes that surgeons may implement in obtaining ideal reconstructed breast shapes.

Expanded-boundary approach to impurity control in tokamaks

International Nuclear Information System (INIS)

Ohyabu, N.

1981-01-01

It is proposed to expand the outermost flux surfaces in tokamaks to divert the heat flux emerging from the plasma core. The expanded flux surfaces provide a large volume for radiative cooling. The radiative power at the boundary is enhanced by the effects of plasma flow as well as by a volumetric factor, and the resultant edge cooling and reduced heat load on the limiter may significantly retard impurity generation. Furthermore, it seems to be compatible with reactor engineering requirements. (author)

Visual Localization by Place Recognition Based on Multifeature (D-λLBP++HOG

Directory of Open Access Journals (Sweden)

Yongliang Qiao

2017-01-01

Full Text Available Visual localization is widely used in the autonomous navigation system and Advanced Driver Assistance Systems (ADAS. This paper presents a visual localization method based on multifeature fusion and disparity information using stereo images. We integrate disparity information into complete center-symmetric local binary patterns (CSLBP to obtain a robust global image description (D-CSLBP. In order to represent the scene in depth, multifeature fusion of D-CSLBP and HOG features provides valuable information and permits decreasing the effect of some typical problems in place recognition such as perceptual aliasing. It improves visual recognition performance by taking advantage of depth, texture, and shape information. In addition, for real-time visual localization, local sensitive hashing method (LSH was used to compress the high-dimensional multifeature into binary vectors. It can thus speed up the process of image matching. To show its effectiveness, the proposed method is tested and evaluated using real datasets acquired in outdoor environments. Given the obtained results, our approach allows more effective visual localization compared with the state-of-the-art method FAB-MAP.

Lung volume recruitment acutely increases respiratory system compliance in individuals with severe respiratory muscle weakness

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Yannick Molgat-Seon

2017-03-01

Full Text Available The aim of the present study was to determine whether lung volume recruitment (LVR acutely increases respiratory system compliance (Crs in individuals with severe respiratory muscle weakness (RMW. Individuals with RMW resulting from neuromuscular disease or quadriplegia (n=12 and healthy controls (n=12 underwent pulmonary function testing and the measurement of Crs at baseline, immediately after, 1 h after and 2 h after a single standardised session of LVR. The LVR session involved 10 consecutive supramaximal lung inflations with a manual resuscitation bag to the highest tolerable mouth pressure or a maximum of 50 cmH2O. Each LVR inflation was followed by brief breath-hold and a maximal expiration to residual volume. At baseline, individuals with RMW had lower Crs than controls (37±5 cmH2O versus 109±10 mL·cmH2O−1, p0.05. LVR had no significant effect on measures of pulmonary function at any time point in either group (all p>0.05. During inflations, mean arterial pressure decreased significantly relative to baseline by 10.4±2.8 mmHg and 17.3±3.0 mmHg in individuals with RMW and controls, respectively (both p<0.05. LVR acutely increases Crs in individuals with RMW. However, the high airway pressures during inflations cause reductions in mean arterial pressure that should be considered when applying this technique.

Large volume unresectable locally advanced non-small cell lung cancer: acute toxicity and initial outcome results with rapid arc

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Fogliata Antonella

2010-10-01

Full Text Available Abstract Background To report acute toxicity, initial outcome results and planning therapeutic parameters in radiation treatment of advanced lung cancer (stage III with volumetric modulated arcs using RapidArc (RA. Methods Twenty-four consecutive patients were treated with RA. All showed locally advanced non-small cell lung cancer with stage IIIA-IIIB and with large volumes (GTV:299 ± 175 cm3, PTV:818 ± 206 cm3. Dose prescription was 66Gy in 33 fractions to mean PTV. Delivery was performed with two partial arcs with a 6 MV photon beam. Results From a dosimetric point of view, RA allowed us to respect most planning objectives on target volumes and organs at risk. In particular: for GTV D1% = 105.6 ± 1.7%, D99% = 96.7 ± 1.8%, D5%-D95% = 6.3 ± 1.4%; contra-lateral lung mean dose resulted in 13.7 ± 3.9Gy, for spinal cord D1% = 39.5 ± 4.0Gy, for heart V45Gy = 9.0 ± 7.0Gy, for esophagus D1% = 67.4 ± 2.2Gy. Delivery time was 133 ± 7s. At three months partial remission > 50% was observed in 56% of patients. Acute toxicities at 3 months showed 91% with grade 1 and 9% with grade 2 esophageal toxicity; 18% presented grade 1 and 9% with grade 2 pneumonia; no grade 3 acute toxicity was observed. The short follow-up does not allow assessment of local control and progression free survival. Conclusions RA proved to be a safe and advantageous treatment modality for NSCLC with large volumes. Long term observation of patients is needed to assess outcome and late toxicity.

Numerical simulation of a twin screw expander for performance prediction

Science.gov (United States)

Papes, Iva; Degroote, Joris; Vierendeels, Jan

2015-08-01

With the increasing use of twin screw expanders in waste heat recovery applications, the performance prediction of these machines plays an important role. This paper presents a mathematical model for calculating the performance of a twin screw expander. From the mass and energy conservation laws, differential equations are derived which are then solved together with the appropriate Equation of State in the instantaneous control volumes. Different flow processes that occur inside the screw expander such as filling (accompanied by a substantial pressure loss) and leakage flows through the clearances are accounted for in the model. The mathematical model employs all geometrical parameters such as chamber volume, suction and leakage areas. With R245fa as working fluid, the Aungier Redlich-Kwong Equation of State has been used in order to include real gas effects. To calculate the mass flow rates through the leakage paths formed inside the screw expander, flow coefficients are considered as constant and they are derived from 3D Computational Fluid Dynamic calculations at given working conditions and applied to all other working conditions. The outcome of the mathematical model is the P-V indicator diagram which is compared to CFD results of the same twin screw expander. Since CFD calculations require significant computational time, developed mathematical model can be used for the faster performance prediction.

Early changes of parotid density and volume predict modifications at the end of therapy and intensity of acute xerostomia

International Nuclear Information System (INIS)

Belli, Maria Luisa; Broggi, Sara; Scalco, Elisa; Rizzo, Giovanna; Sanguineti, Giuseppe; Fiorino, Claudio; Cattaneo, Giovanni Mauro; Dinapoli, Nicola; Valentini, Vincenzo; Ricchetti, Francesco

2014-01-01

To quantitatively assess the predictive power of early variations of parotid gland volume and density on final changes at the end of therapy and, possibly, on acute xerostomia during IMRT for head-neck cancer. Data of 92 parotids (46 patients) were available. Kinetics of the changes during treatment were described by the daily rate of density (rΔρ) and volume (rΔvol) variation based on weekly diagnostic kVCT images. Correlation between early and final changes was investigated as well as the correlation with prospective toxicity data (CTCAEv3.0) collected weekly during treatment for 24/46 patients. A higher rΔρ was observed during the first compared to last week of treatment (-0,50 vs -0,05HU, p-value = 0.0001). Based on early variations, a good estimation of the final changes may be obtained (Δρ: AUC = 0.82, p = 0.0001; Δvol: AUC = 0.77, p = 0.0001). Both early rΔρ and rΔvol predict a higher ''mean'' acute xerostomia score (≥ median value, 1.57; p-value = 0.01). Median early density rate changes for patients with mean xerostomia score ≥ / 3 /day for rΔρ and rΔvol respectively. Further studies are necessary to definitively assess the potential of early density/volume changes in identifying more sensitive patients at higher risk of experiencing xerostomia. (orig.) [de

Mesenchymal stromal cells from patients with acute myeloid leukemia have altered capacity to expand differentiated hematopoietic progenitors.

Science.gov (United States)

Chandran, Priya; Le, Yevgeniya; Li, Yuhua; Sabloff, Mitchell; Mehic, Jelica; Rosu-Myles, Michael; Allan, David S

2015-04-01

The bone marrow microenvironment may be permissive to the emergence and progression of acute myeloid leukemia (AML). Studying interactions between the microenvironment and leukemia cells should provide new insight for therapeutic advances. Mesenchymal stromal cells (MSCs) are central to the maintenance of the hematopoietic niche. Here we compared the functions and gene expression patterns of MSCs derived from bone marrow aspirates of healthy donors and patients with AML. MSCs expanded from AML patients had heterogeneous morphology and displayed a wide range of proliferation capacity compared to MSCs from healthy controls. The ability of AML-MSCs to support the expansion of committed hematopoietic progenitors from umbilical cord blood-derived CD34+ cells may be impaired while the expression of genes associated with maintaining hematopoietic quiescence appeared to be increased in AML-MSCs compared to healthy donors. These results highlight important potential differences in the biologic profile of MSCs from AML patients compared to healthy donors that may contribute to the emergence or progression of leukemia. Copyright © 2015 Elsevier Ltd. All rights reserved.

Assessment of collateral status by dynamic ct angiography in acute mca stroke : Timing of acquisition and relationship with final infarct volume

NARCIS (Netherlands)

Van Den Wijngaard, I. R.; Holswilder, G.; Wermer, M. J H; Boiten, J.; Algra, A.; Dippel, D. W J; Dankbaar, J. W.; Velthuis, B. K.; Boers, A. M M; Majoie, C. B L M; Van Walderveen, M. A A

2016-01-01

BACKGROUND AND PURPOSE: Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up. MATERIALS AND METHODS: We selected

Assessment of collateral status by dynamic ct angiography in acute mca stroke: Timing of acquisition and relationship with final infarct volume

NARCIS (Netherlands)

I.R. Van Den Wijngaard (Ido R.); G. Holswilder (Ghislaine); M.J.H. Wermer (Marieke); J. Boiten (Jelis); A. Algra (Ale); D.W.J. Dippel (Diederik); J.W. Dankbaar (Jan); B.K. Velthuis (Birgitta); A.M.M. Boers (Anna); C.B. Majoie (Charles); M.A.A. van Walderveen (Marianne)

2016-01-01

textabstractBACKGROUND AND PURPOSE: Dynamic CTA is a promising technique for visualization of collateral filling in patients with acute ischemic stroke. Our aim was to describe collateral filling with dynamic CTA and assess the relationship with infarct volume at follow-up. MATERIALS AND METHODS: We

Ventilation with lower tidal volumes for critically ill patients without the acute respiratory distress syndrome: a systematic translational review and meta-analysis

NARCIS (Netherlands)

Serpa Neto, Ary; Nagtzaam, Liselotte; Schultz, Marcus J.

2014-01-01

There is convincing evidence for benefit from lung-protective mechanical ventilation with lower tidal volumes in patients with the acute respiratory distress syndrome (ARDS). It is uncertain whether this strategy benefits critically ill patients without ARDS as well. This manuscript systematically

Baroreflex Responses to Acute Changes in Blood Volume in Humans

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Thompson, Cynthia A.; Tatro, Dana L.; Ludwig, David A.; Convertino, Victor A.

1990-01-01

To test the hypothesis that acute changes in plasma volume affect the stimulus-response relations of high- and low- pressure baroreflexes, eight men (27-44 yr old) underwent measurements for carotid-cardiac and cardiopulmonary baro-reflex responses under the following three volemic conditions: hypovolemic, normovolemic, and hypervolemic. The stimulus- response relation of the carotid-cardiac response curve was generated using a neck cuff device, which delivered pressure changes between +40 and -65 mmHg in continuous steps of 15 mmHg. The stimulus-response relationship, of the cardio-pulmonary baroreflex were studied by measurements of Forearm Vascular Resistance (FVR) and Peripheral Venous Pressure (PVP) during low levels of lower body negative pressure (O to -20 mmHg). The results indicate greater demand for vasoconstriction for equal reductions in venous pressure during progressive hypovolemia; this condition may compromise the capacity to provide adequate peripheral resistance during severe orthostatic stress. Fluid loading before reentry after spaceflight may act to restore vasoconstrictive capacity of the cardiopulmonary baroreflex but may not be an effective countermeasure against potential post- flight impairment of the carotid-cardiac baroreflex.

Grazing incidence beam expander

Energy Technology Data Exchange (ETDEWEB)

Akkapeddi, P.R.; Glenn, P.; Fuschetto, A.; Appert, Q.; Viswanathan, V.K.

1985-01-01

A Grazing Incidence Beam Expander (GIBE) telescope is being designed and fabricated to be used as an equivalent end mirror in a long laser resonator cavity. The design requirements for this GIBE flow down from a generic Free Electron Laser (FEL) resonator. The nature of the FEL gain volume (a thin, pencil-like, on-axis region) dictates that the output beam be very small. Such a thin beam with the high power levels characteristic of FELs would have to travel perhaps hundreds of meters or more before expanding enough to allow reflection from cooled mirrors. A GIBE, on the other hand, would allow placing these optics closer to the gain region and thus reduces the cavity lengths substantially. Results are presented relating to optical and mechanical design, alignment sensitivity analysis, radius of curvature analysis, laser cavity stability analysis of a linear stable concentric laser cavity with a GIBE. Fabrication details of the GIBE are also given.

Flexural Behaviour Of Reinforced Concrete Beams Containing Expanded Glass As Lightweight Aggregates

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Khatib Jamal

2015-12-01

Full Text Available The flexural properties of reinforced concrete beams containing expanded glass as a partial fine aggregate (sand replacement are investigated. Four concrete mixes were employed to conduct this study. The fine aggregate was replaced with 0%, 25%, 50% and 100% (by volume expanded glass. The results suggest that the incorporation of 50% expanded glass increased the workability of the concrete. The compressive strength was decreasing linearly with the increasing amount of expanded glass. The ductility of the concrete beam significantly improved with the incorporation of the expanded glass. However, the load-carrying capacity of the beam and load at which the first crack occurs was reduced. It was concluded that the inclusion of expanded glass in structural concrete applications is feasible.

Removal of carbon, nitrogen and phosphorus from the separated liquid phase of hog manure by the multi-zone BioCAST technology.

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Yerushalmi, Laleh; Alimahmoodi, Mahmood; Afroze, Niema; Godbout, Stephane; Mulligan, Catherine N

2013-06-15

The removal of chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) at concentrations of 960 ± 38 to 2400 ± 96 mg/L, 143 ± 9 to 235 ± 15 mg/L and 25 ± 2 to 57 ± 4 mg/L, respectively, from the separated liquid phase of hog manure by the multi-zone BioCAST technology is discussed. Despite the inhibitory effect of hog waste toward microbial activities, removal efficiencies up to 89.2% for COD, 69.2% for TN and 47.6% for TP were obtained during 185 d of continuous operation. The free ammonia inhibition was postulated to be responsible for the steady reduction of COD and TP removal with the increase of TN/TP ratio from 3.6 to 5.8. On the contrary, the increase of COD/TN ratio from 4.8 to 14.1 improved the removal of all contaminants. Nitrogen removal did not show any dependence on the COD/TP ratio, despite the steady increase of COD and TP removal with this ratio in the range of 19.3-50.6. The removal efficiencies of organic and inorganic contaminants increased progressively owing to the adaptation of microbial biomass, resulting from the presence of suspended biomass in the mixed liquor that circulated continuously between the three zones of aerobic, microaerophilic and anoxic, as well as the attached biomass immobilized inside the aerobic zone. Copyright © 2013 Elsevier B.V. All rights reserved.

Lung-Protective Ventilation With Low Tidal Volumes and the Occurrence of Pulmonary Complications in Patients Without Acute Respiratory Distress Syndrome: A Systematic Review and Individual Patient Data Analysis

NARCIS (Netherlands)

Neto, Ary Serpa; Simonis, Fabienne D.; Barbas, Carmen S. V.; Biehl, Michelle; Determann, Rogier M.; Elmer, Jonathan; Friedman, Gilberto; Gajic, Ognjen; Goldstein, Joshua N.; Linko, Rita; Pinheiro de Oliveira, Roselaine; Sundar, Sugantha; Talmor, Daniel; Wolthuis, Esther K.; Gama de Abreu, Marcelo; Pelosi, Paolo; Schultz, Marcus J.

2015-01-01

Protective mechanical ventilation with low tidal volumes is standard of care for patients with acute respiratory distress syndrome. The aim of this individual patient data analysis was to determine the association between tidal volume and the occurrence of pulmonary complications in ICU patients

Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?

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Celet Ozden, Burcu; Guven, Erdem; Aslay, Isik; Kemikler, Gonul; Olgac, Vakur; Soluk Tekkesin, Merva; Serarslan, Bengul; Tumerdem Ulug, Burcak; Bilgin Karabulut, Aylin; Arinci, Atilla; Emekli, Ufuk

2012-02-20

The optimum protocol for expander volume adjustment with respect to the timing and application of radiotherapy remains controversial. Eighteen New Zealand rabbits were divided into three groups. Metallic port integrated anatomic breast expanders of 250 cc were implanted on the back of each animal and controlled expansion was performed. Group I underwent radiotherapy with full expanders while in Group II, expanders were partially deflated immediately prior to radiotherapy. Control group did not receive radiotherapy.The changes in blood flow at different volume adjustments were investigated in Group II by laser Doppler flowmetry. Variations in the histopathologic properties of the irradiated tissues including the skin, capsule and the pocket floor, were compared in the biopsy specimens taken from different locations in each group. A significant increase in skin blood flow was detected in Group II with partial expander deflation. Overall, histopathologic exam revealed aggravated findings of chronic radiodermatitis (epidermal atrophy, dermal inflammation and fibrosis, neovascularisation and vascular changes as well as increased capsule thickness) especially around the lower expander pole, in Group II. Expander deflation immediately prior to radiotherapy, may augment the adverse effects, especially in the lower expander pole, possibly via enhanced radiosensitization due to a relative increase in the blood flow and tissue oxygenation.

Does partial expander deflation exacerbate the adverse effects of radiotherapy in two-stage breast reconstruction?

Directory of Open Access Journals (Sweden)

Celet Ozden Burcu

2012-02-01

Full Text Available Abstract Background The optimum protocol for expander volume adjustment with respect to the timing and application of radiotherapy remains controversial. Methods Eighteen New Zealand rabbits were divided into three groups. Metallic port integrated anatomic breast expanders of 250 cc were implanted on the back of each animal and controlled expansion was performed. Group I underwent radiotherapy with full expanders while in Group II, expanders were partially deflated immediately prior to radiotherapy. Control group did not receive radiotherapy. The changes in blood flow at different volume adjustments were investigated in Group II by laser Doppler flowmetry. Variations in the histopathologic properties of the irradiated tissues including the skin, capsule and the pocket floor, were compared in the biopsy specimens taken from different locations in each group. Results A significant increase in skin blood flow was detected in Group II with partial expander deflation. Overall, histopathologic exam revealed aggravated findings of chronic radiodermatitis (epidermal atrophy, dermal inflammation and fibrosis, neovascularisation and vascular changes as well as increased capsule thickness especially around the lower expander pole, in Group II. Conclusions Expander deflation immediately prior to radiotherapy, may augment the adverse effects, especially in the lower expander pole, possibly via enhanced radiosensitization due to a relative increase in the blood flow and tissue oxygenation.

Expandable Cryogenic Tankage for On Orbit Depot Storage, Phase I

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National Aeronautics and Space Administration — The proposed expandable depot storage tanks would make it possible to have an on-orbit tank larger in volume than any existing or planned launch vehicles. The size...

Correlation of symptom depression levels with mean platelet volume rate on patients of acute coronary syndrome

Science.gov (United States)

Hasugian, L.; Hanum, H.; Hanida, W.; Safri, Z.

2018-03-01

Patients with Depression and the acute coronary syndrome (ACS) is rarely detected, although in some studies say that depression can worsen cardiovascularly and increase mortality. From research, Canan F et al found that increasing levels of Mean platelet volume (MPV) as a risk factor for atherosclerosis and MPV was higher in patients with depression compared with patients without depression. In this study used observational methods of measurement of cross-sectional data. Research began in November 2015 - May 2016 against General Hospital inpatients H. Adam Malik Medan. There are 64 patients with a diagnosis of ACS were given quieter Beck Depression Inventory (BDI), then calculated a score of BDI patients and MPV levels were seen when they first entered the hospital before being given treatment. Patients answered quieter on days 3-7 after diagnosis ACS. ACS Patients were divided into 3 groups: acute myocardial infarction with ST elevation, acute myocardial infarction with non-ST elevation and unstable angina pectoris. The level of depression is grouped into not depression, mild depression, moderate depression and severe depression. Statistically significant with p-value<0.05Based on the linear correlation analysis, it was found a positive correlation with r=0.542. And the relationship is statistically significant with p-value 0.000003.

Work of breathing during lung-protective ventilation in patients with acute lung injury and acute respiratory distress syndrome: a comparison between volume and pressure-regulated breathing modes.

Science.gov (United States)

Kallet, Richard H; Campbell, Andre R; Dicker, Rochelle A; Katz, Jeffrey A; Mackersie, Robert C

2005-12-01

Pressure-control ventilation (PCV) and pressure-regulated volume-control (PRVC) ventilation are used during lung-protective ventilation because the high, variable, peak inspiratory flow rate (V (I)) may reduce patient work of breathing (WOB) more than the fixed V (I) of volume-control ventilation (VCV). Patient-triggered breaths during PCV and PRVC may result in excessive tidal volume (V(T)) delivery unless the inspiratory pressure is reduced, which in turn may decrease the peak V (I). We tested whether PCV and PRVC reduce WOB better than VCV with a high, fixed peak V (I) (75 L/min) while also maintaining a low V(T) target. Fourteen nonconsecutive patients with acute lung injury or acute respiratory distress syndrome were studied prospectively, using a random presentation of ventilator modes in a crossover, repeated-measures design. A target V(T) of 6.4 + 0.5 mL/kg was set during VCV and PRVC. During PCV the inspiratory pressure was set to achieve the same V(T). WOB and other variables were measured with a pulmonary mechanics monitor (Bicore CP-100). There was a nonsignificant trend toward higher WOB (in J/L) during PCV (1.27 + 0.58 J/L) and PRVC (1.35 + 0.60 J/L), compared to VCV (1.09 + 0.59 J/L). While mean V(T) was not statistically different between modes, in 40% of patients, V(T) markedly exceeded the lung-protective ventilation target during PRVC and PCV. During lung-protective ventilation, PCV and PRVC offer no advantage in reducing WOB, compared to VCV with a high flow rate, and in some patients did not allow control of V(T) to be as precise.

Acute Arterial Hypertension in Acute Pulmonary Edema: Mostly a Trigger or an Associated Phenomenon?

Science.gov (United States)

Figueras, Jaume; Bañeras, Jordi; Peña-Gil, Carlos; Masip, Josep; Barrabés, José A; Rodriguez Palomares, Jose; Garcia-Dorado, David

2016-10-01

The role of acute arterial hypertension in acute pulmonary edema (APE) as an associated or triggering phenomenon has been poorly investigated and is relevant to patient management. This was a prospective observational study of clinical, electrocardiographic, and echocardiographic characteristics of patients with APE. Potential triggers, including acute coronary syndrome (ACS), rapid atrial fibrillation (AF) (≥ 120 bpm in AF), fever > 38°C or volume overload, isolated acute hypertension (systolic blood pressure ≥ 170 mm Hg), and unknown factors were investigated. There were 742 patients, 578 with coronary artery disease (78%), 116 with valvular heart disease or cardiomyopathy (16%), and 47 without identifiable heart disease (6%). ACS was present in 482 (65%) patients (silent in 154 of them), AF was present in 76 (10%) patients, fever/volume overload was present in 62 (8%) patients, acute hypertension was present in 50 (7%) patients, and no apparent trigger was seen in 72 (10%) patients. Admission hypertension occurred in 260 patients (35%): 155 (60%) with ACS (silent in 49 [32%]), 36 (14%) with AF, 19 (7%) with fever/volume overload, and 59 (19%) as an isolated trigger. Similar results were obtained when analyzing patients using coronary angiography (467 patients [63%]). Acute hypertension was present more frequently in patients with severe hypoventilation (arterial Pco 2 > 60 mm Hg) than in those without (57% vs 29%; P acute hypertension is often present but mainly as an associated/reactive phenomenon and seems favoured by severe hypoventilation. Silent myocardial ischemia/necrosis deserves systematic investigation because it is not rare that it may be the underlying cause of APE. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

NT-pro-BNP levels in patients with acute pulmonary embolism are correlated to right but not left ventricular volume and function.

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Pasha, Sharif M; Klok, Frederikus A; van der Bijl, Noortje; de Roos, Albert; Kroft, Lucia J M; Huisman, Menno V

2012-08-01

N-terminal pro-Brain Natriuretic Peptide (NT-pro-BNP) is primarily secreted by left ventricular (LV) stretch and wall tension. Notably, NT-pro-BNP is a prognostic marker in acute pulmonary embolism (PE), which primarily stresses the right ventricle (RV). We sought to evaluate the relative contribution of the RV to NT-pro-BNP levels during PE. A post-hoc analysis of an observational prospective outcome study in 113 consecutive patients with computed tomography (CT)-proven PE and 226 patients in whom PE was clinically suspected but ruled out by CT. In all patients RV and LV function was established by assessing ECG-triggered-CT measured ventricular end-diastolic-volumes and ejection fraction (EF). NT-pro-BNP was assessed in all patients. The correlation between RV and LV end-diastolic-volumes and systolic function was evaluated by multiple linear regression corrected for known confounders. In the PE cohort increased RVEF (β-coefficient (95% confidence interval [CI]) -0.044 (± -0.011); p<0.001) and higher RV end-diastolic-volume (β-coefficient 0.005 (± 0.001); p<0.001) were significantly correlated to NT-pro-BNP, while no correlation was found with LVEF (β-coefficient 0.005 (± 0.010); p=0.587) and LV end-diastolic-volume (β-coefficient -0.003 (± 0.002); p=0.074). In control patients without PE we found a strong correlation between NT-pro-BNP levels and LVEF (β-coefficient -0.027 (± -0.006); p<0.001) although not LV end-diastolic-volume (β-coefficient 0.001 (± 0.001); p=0.418). RVEF (β-coefficient -0.002 (± -0.006); p=0.802) and RV end-diastolic-volume (β-coefficient <0.001 (± 0.001); p=0.730) were not correlated in patients without PE. In PE patients, lower RVEF and higher RV end-diastolic-volume were significantly correlated to NT-pro-BNP levels as compared to control patients without PE. These observations provide pathophysiological ground for the well-known prognostic value of NT-pro-BNP in acute PE.

RNAi-mediated silencing of MAP kinase signalling genes (Fmk1, Hog1, and Pbs2) in Fusarium oxysporum reduces pathogenesis on tomato plants.

Science.gov (United States)

Pareek, Manish; Rajam, Manchikatla Venkat

2017-09-01

Fusarium oxysporum is a soil-borne plant fungal pathogen, and causes colossal losses in several crop plants including tomato. Effective control measures include the use of harmful fungicides and resistant cultivars, but these methods have shown limited success. Conventional methods to validate fungal pathogenic genes are labour intensive. Therefore, an alternative strategy is required to efficiently characterize unknown pathogenic genes. RNA interference (RNAi) has emerged as a potential tool to functionally characterize novel fungal pathogenic genes and also to control fungal diseases. Here, we report an efficient method to produce stable RNAi transformants of F. oxysporum using Agrobacterium-mediated transformation (AMT). We have transformed F. oxysporum spores using RNAi constructs of Fmk1, Hog1, and Pbs2 MAP kinase signalling genes. Fmk1 RNAi fungal transformants showed loss of surface hydrophobicity, reduced invasive growth on tomato fruits and hypo-virulence on tomato seedlings. Hog1 and Pbs2 RNAi transformants showed altered conidial size, and reduced invasive growth and pathogenesis. These results showed that AMT using RNAi constructs is an effective approach for dissecting the role of genes involved in pathogenesis in F. oxysporum and this could be extended for other fungal systems. The obtained knowledge can be easily translated for developing fungal resistant crops by RNAi. Copyright © 2017 British Mycological Society. Published by Elsevier Ltd. All rights reserved.

Self-expandable Metallic Stents Contribute to Reducing Perioperative Complications in Colorectal Cancer Patients with Acute Obstruction.

Science.gov (United States)

Furuke, Hirotaka; Komatsu, Shuhei; Ikeda, Jun; Tanaka, Sachie; Kumano, Tatsuya; Imura, Ken-Ichiro; Shimomura, Katsumi; Taniguchi, Fumihiro; Ueshima, Yasuo; Takashina, Ken-Ichiro; Lee, Chol Joo; Deguchi, Eiichi; Ikeda, Eito; Otsuji, Eigo; Shioaki, Yasuhiro

2018-03-01

The self-expandable metallic stent (SEMS) is an excellent non-invasive tool for emergent bowel obstruction. This study was designed to evaluate the clinical usefulness of the SEMS for avoiding perioperative complications. We analyzed a total of 47 consecutive patients who had a bowel obstruction due to colorectal cancer at initial diagnosis between 2012 and 2017 from hospital records. Perioperative complications occurred in 30% (14/47) of patients. Univariate and multivariate logistic regression analyses identified an age of more than 75 years [p=0.037, OR=6.84 (95% CI=1.11-41.6)] and the absence of an SEMS treatment [p=0.028, OR=18.5 (95% CI=1.36-250.0)] as independent risk factors for perioperative complications. Pneumonia (12.7% (6/47)) was the most common complication. There were no pneumonia patients (0% (0/15)) who were treated with the SEMS. In contrast to patients with the non-SEMS treatment, 18.7% (6/32) of all patients and 35.7% (5/14) of elderly patients had pneumonia. The SEMS is a safe and effective treatment for avoiding perioperative complications, particularly pneumonia, and may be a crucial strategy in elderly patients with acute obstruction due to colorectal cancer. Copyright© 2018, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Parameter estimation for an expanding universe

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Jieci Wang

2015-03-01

Full Text Available We study the parameter estimation for excitations of Dirac fields in the expanding Robertson–Walker universe. We employ quantum metrology techniques to demonstrate the possibility for high precision estimation for the volume rate of the expanding universe. We show that the optimal precision of the estimation depends sensitively on the dimensionless mass m˜ and dimensionless momentum k˜ of the Dirac particles. The optimal precision for the ratio estimation peaks at some finite dimensionless mass m˜ and momentum k˜. We find that the precision of the estimation can be improved by choosing the probe state as an eigenvector of the hamiltonian. This occurs because the largest quantum Fisher information is obtained by performing projective measurements implemented by the projectors onto the eigenvectors of specific probe states.

Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome

International Nuclear Information System (INIS)

Yi, Chin A; Na, Dong Gyu; Ryoo, Jae Wook; Moon, Chan Hong; Byun, Hong Sik; Roh, Hong Gee; Moon, Won Jin; Lee, Kwang Ho; Lee, Soo Joo

2002-01-01

To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy. Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores. Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R2=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R2=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p≤0.007). CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome

Persistence of livestock-associated antibiotic-resistant Staphylococcus aureus among industrial hog operation workers in North Carolina over 14 days

Science.gov (United States)

Nadimpalli, Maya; Rinsky, Jessica L; Wing, Steve; Hall, Devon; Stewart, Jill; Larsen, Jesper; Nachman, Keeve E; Love, Dave C; Pierce, Elizabeth; Pisanic, Nora; Strelitz, Jean; Harduar-Morano, Laurel; Heaney, Christopher D

2015-01-01

Objectives This study aimed to evaluate the persistence of nasal carriage of Staphylococcus aureus, methicillin-resistant S. aureus and multidrug-resistant S. aureus over 14 days of follow-up among industrial hog operation workers in North Carolina. Methods Workers anticipating at least 24 h away from work were enrolled June–August 2012. Participants self-collected a nasal swab and completed a study journal on the evening of day 1, and each morning and evening on days 2–7 and 14 of the study. S. aureus isolated from nasal swabs were assessed for antibiotic susceptibility, spa type and absence of the scn gene. Livestock association was defined by absence of scn. Results Twenty-two workers provided 327 samples. S. aureus carriage end points did not change with time away from work (mean 49 h; range >0–96 h). Ten workers were persistent and six were intermittent carriers of livestock-associated S. aureus. Six workers were persistent and three intermittent carriers of livestock-associated multidrug-resistant S. aureus. One worker persistently carried livestock-associated methicillin-resistant S. aureus. Six workers were non-carriers of livestock-associated S. aureus. Eighty-two per cent of livestock-associated S. aureus demonstrated resistance to tetracycline. A majority of livestock-associated S. aureus isolates (n=169) were CC398 (68%) while 31% were CC9. No CC398 and one CC9 isolate was detected among scn-positive isolates. Conclusions Nasal carriage of livestock-associated S. aureus, multidrug-resistant S. aureus and methicillin-resistant S. aureus can persist among industrial hog operation workers over a 14-day period, which included up to 96 h away from work. PMID:25200855

Persistence of livestock-associated antibiotic-resistant Staphylococcus aureus among industrial hog operation workers in North Carolina over 14 days.

Science.gov (United States)

Nadimpalli, Maya; Rinsky, Jessica L; Wing, Steve; Hall, Devon; Stewart, Jill; Larsen, Jesper; Nachman, Keeve E; Love, Dave C; Pierce, Elizabeth; Pisanic, Nora; Strelitz, Jean; Harduar-Morano, Laurel; Heaney, Christopher D

2015-02-01

This study aimed to evaluate the persistence of nasal carriage of Staphylococcus aureus, methicillin-resistant S. aureus and multidrug-resistant S. aureus over 14 days of follow-up among industrial hog operation workers in North Carolina. Workers anticipating at least 24 h away from work were enrolled June-August 2012. Participants self-collected a nasal swab and completed a study journal on the evening of day 1, and each morning and evening on days 2-7 and 14 of the study. S. aureus isolated from nasal swabs were assessed for antibiotic susceptibility, spa type and absence of the scn gene. Livestock association was defined by absence of scn. Twenty-two workers provided 327 samples. S. aureus carriage end points did not change with time away from work (mean 49 h; range >0-96 h). Ten workers were persistent and six were intermittent carriers of livestock-associated S. aureus. Six workers were persistent and three intermittent carriers of livestock-associated multidrug-resistant S. aureus. One worker persistently carried livestock-associated methicillin-resistant S. aureus. Six workers were non-carriers of livestock-associated S. aureus. Eighty-two per cent of livestock-associated S. aureus demonstrated resistance to tetracycline. A majority of livestock-associated S. aureus isolates (n=169) were CC398 (68%) while 31% were CC9. No CC398 and one CC9 isolate was detected among scn-positive isolates. Nasal carriage of livestock-associated S. aureus, multidrug-resistant S. aureus and methicillin-resistant S. aureus can persist among industrial hog operation workers over a 14-day period, which included up to 96 h away from work. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Viabilidade econômica da implantação de uma unidade de abate e processamento de suínos = Economic feasibility of installing a hog slaughter and processing facility

Directory of Open Access Journals (Sweden)

Leonardo Feron Bisognin

2015-01-01

Full Text Available Tradicionalmente as famílias da região Centro-Serra do estado do Rio Grande do Sul criam suínos (Sus scrofa domesticus como fonte de subsistência, porém nesta região estão inseridas apenas algumas pequenas agroindústrias de abate e processamento de carne suína. Uma destas agroindústrias possui certificação para comercialização apenas em território municipal, no entanto devido ao interesse na ampliação do negócio para o território estadual, é necessária a construção de uma nova planta industrial. Deste modo, com o objetivo de analisar a viabilidade econômica da implantação de uma nova unidade industrial nesta região, foi utilizado um questionário de campo e pesquisas de mercado, além de análises do orçamento de infraestrutura para o levantamento dos custos de implantação de uma nova unidade. Os dados obtidos foram lançados em um fluxo de caixa com prazo de dez anos na intenção de avaliar a viabilidade econômica. Foram utilizados os indicadores Taxa Interna de Retorno – TIR, Valor Presente Líquido – VPL, e o tempo de retorno do capital investido – Payback, como forma de analisar o investimento. A análise econômica resultou em uma TIR de 22%, VPL de R$ 271.099,67 para uma taxa de atratividade de 10 %, e Payback de três anos e onze meses. Com esses resultados positivos, do ponto de vista econômico, a implantação de uma nova unidade de abate e processamento de suínos para a referida região apresenta-se como um investimento altamente atrativo. = Despite families of the Centro-Serra of Rio Grande do Sul traditionally raises hogs as a source of living, there are some small slaughters and pork processing facilities in this region. One of these agro industries has certification for marketing in municipality. Due the interest in expanding the business all over the state, it is necessary to build a new industrial plant. In this context, the present study aims to analyze the economic feasibility of

The Hog Cycle of Law Professors: An Econometric Time Series Analysis of the Entry-Level Job Market in Legal Academia.

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Engel, Christoph; Hamann, Hanjo

2016-01-01

The (German) market for law professors fulfils the conditions for a hog cycle: In the short run, supply cannot be extended or limited; future law professors must be hired soon after they first present themselves, or leave the market; demand is inelastic. Using a comprehensive German dataset, we show that the number of market entries today is negatively correlated with the number of market entries eight years ago. This suggests short-sighted behavior of young scholars at the time when they decide to prepare for the market. Using our statistical model, we make out-of-sample predictions for the German academic market in law until 2020.

Self-expandable metallic stent placement plus laparoscopy for acute malignant colorectal obstruction.

Science.gov (United States)

Zhou, Jia-Min; Yao, Li-Qing; Xu, Jian-Min; Xu, Mei-Dong; Zhou, Ping-Hong; Chen, Wei-Feng; Shi, Qiang; Ren, Zhong; Chen, Tao; Zhong, Yun-Shi

2013-09-07

To investigate the clinical advantages of the stent-laparoscopy approach to treat colorectal cancer (CRC) patients with acute colorectal obstruction (ACO). From April 2008 to April 2012, surgery-related parameters, complications, overall survival (OS), and disease-free survival (DFS) of 74 consecutive patients with left-sided CRC presented with ACO who underwent self-expandable metallic stent (SEMS) placement followed by one-stage open (n = 58) or laparoscopic resection (n = 16) were evaluated retrospectively. The stent-laparoscopy group was also compared with a control group of 96 CRC patients who underwent regular laparoscopy without ACO between January 2010 and December 2011 to explore whether SEMS placement influenced the laparoscopic procedure or reduced long-term survival by influencing CRC oncological characteristics. The characteristics of patients among these groups were comparable. The rate of conversion to open surgery was 12.5% in the stent-laparoscopy group. Bowel function recovery and postoperative hospital stay were significantly shorter (3.3 ± 0.9 d vs 4.2 ± 1.5 d and 6.7 ± 1.1 d vs 9.5 ± 6.7 d, P = 0.016 and P = 0.005), and surgical time was significantly longer (152.1 ± 44.4 min vs 127.4 ± 38.4 min, P = 0.045) in the stent-laparoscopy group than in the stent-open group. Surgery-related complications and the rate of admission to the intensive care unit were lower in the stent-laparoscopy group. There were no significant differences in the interval between stenting and surgery, intraoperative blood loss, OS, and DFS between the two stent groups. Compared with those in the stent-laparoscopy group, all surgery-related parameters, complications, OS, and DFS in the control group were comparable. The stent-laparoscopy approach is a feasible, rapid, and minimally invasive option for patients with ACO caused by left-sided CRC and can achieve a favorable long-term prognosis.

Acute small bowel toxicity and preoperative chemoradiotherapy for rectal cancer: Investigating dose-volume relationships and role for inverse planning

International Nuclear Information System (INIS)

Tho, Lye Mun; Glegg, Martin; Paterson, Jennifer; Yap, Christina; MacLeod, Alice; McCabe, Marie; McDonald, Alexander C.

2006-01-01

Purpose: The relationship between volume of irradiated small bowel (VSB) and acute toxicity in rectal cancer radiotherapy is poorly quantified, particularly in patients receiving concurrent preoperative chemoradiotherapy. Using treatment planning data, we studied a series of such patients. Methods and Materials: Details of 41 patients with locally advanced rectal cancer were reviewed. All received 45 Gy in 25 fractions over 5 weeks, 3-4 fields three-dimensional conformal radiotherapy with daily 5-fluorouracil and folinic acid during Weeks 1 and 5. Toxicity was assessed prospectively in a weekly clinic. Using computed tomography planning software, the VSB was determined at 5 Gy dose intervals (V 5 , V 1 , etc.). Eight patients with maximal VSB had dosimetry and radiobiological modeling outcomes compared between inverse and conformal three-dimensional planning. Results: VSB correlated strongly with diarrheal severity at every dose level (p 5 and V 15 . Conclusions: A strong dose-volume relationship exists between VSB and acute diarrhea at all dose levels during preoperative chemoradiotherapy. Our constructed model may be useful in predicting toxicity, and this has been derived without the confounding influence of surgical excision on bowel function. Inverse planning can reduce calculated dose to small bowel and late NTCP, and its clinical role warrants further investigation

Orbit Transfer Vehicle (OTV) advanced expander cycle engine point design study. Volume 1: Executive summary

Science.gov (United States)

1981-01-01

The objective of the study was to generate the system design of a performance-optimized, advanced LOX/hydrogen expander cycle space engine. The engine requirements are summarized, and the development and operational experience with the expander cycle RL10 engine were reviewed. The engine development program is outlined.

Distinct Trajectories of Cortisol Response to Prolonged Acute Stress Are Linked to Affective Responses and Hippocampal Gray Matter Volume in Healthy Females.

Science.gov (United States)

Admon, Roee; Treadway, Michael T; Valeri, Linda; Mehta, Malavika; Douglas, Samuel; Pizzagalli, Diego A

2017-08-16

The development of robust laboratory procedures for acute stress induction over the last decades has greatly advanced our understanding of stress responses in humans and their underlying neurobiological mechanisms. Nevertheless, attempts to uncover linear relationships among endocrine, neural, and affective responses to stress have generally yielded inconsistent results. Here, 79 healthy females completed a well established laboratory procedure of acute stress induction that was modified to prolong its effect. Endocrinological and subjective affect assessments revealed stress-induced increases in cortisol release and negative affect that persisted 65 and 100 min after stress onset, respectively, confirming a relatively prolonged acute stress induction. Applying latent class linear mixed modeling on individuals' patterns of cortisol responses identified three distinct trajectories of cortisol response: the hyper-response ( n = 10), moderate-response ( n = 21), and mild-response ( n = 48) groups. Notably, whereas all three groups exhibited a significant stress-induced increase in cortisol release and negative affect, the hyper-response and mild-response groups both reported more negative affect relative to the moderate-response group. Structural MRI revealed no group differences in hippocampal and amygdala volumes, yet a continuous measure of cortisol response (area under the curve) showed that high and low levels of stress-induced cortisol release were associated with less hippocampal gray matter volume compared with moderate cortisol release. Together, these results suggest that distinct trajectories of cortisol response to prolonged acute stress among healthy females may not be captured by conventional linear analyses; instead, quadratic relations may better describe links between cortisol response to stress and affective responses, as well as hippocampal structural variability. SIGNIFICANCE STATEMENT Despite substantial research, it is unclear whether and how

Low Tidal Volume versus Non-Volume-Limited Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

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Walkey, Allan J; Goligher, Ewan C; Del Sorbo, Lorenzo; Hodgson, Carol L; Adhikari, Neill K J; Wunsch, Hannah; Meade, Maureen O; Uleryk, Elizabeth; Hess, Dean; Talmor, Daniel S; Thompson, B Taylor; Brower, Roy G; Fan, Eddy

2017-10-01

Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10 to 15 ml/kg among patients with ARDS. This is a systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies. We used random effects models to evaluate the effect of LTV on 28-day mortality, organ failure, ventilator-free days, barotrauma, oxygenation, and ventilation. Our primary analysis excluded trials for which the LTV strategy was combined with the additional strategy of higher positive end-expiratory pressure (PEEP), but these trials were included in a stratified sensitivity analysis. We performed metaregression of tidal volume gradient achieved between intervention and control groups on mortality effect estimates. We used Grading of Recommendations Assessment, Development, and Evaluation methodology to determine the quality of evidence. Seven randomized trials involving 1,481 patients met eligibility criteria for this review. Mortality was not significantly lower for patients receiving an LTV strategy (33.6%) as compared with control strategies (40.4%) (relative risk [RR], 0.87; 95% confidence interval [CI], 0.70-1.08; heterogeneity statistic I 2  = 46%), nor did an LTV strategy significantly decrease barotrauma or ventilator-free days when compared with a lower PEEP strategy. Quality of evidence for clinical outcomes was downgraded for imprecision. Metaregression showed a significant inverse association between larger tidal volume gradient between LTV and control groups and log odds ratios for mortality (β, -0.1587; P = 0.0022). Sensitivity analysis including trials that protocolized an LTV/high PEEP cointervention showed lower mortality associated with LTV (nine trials and 1

Timing of low tidal volume ventilation and intensive care unit mortality in acute respiratory distress syndrome. A prospective cohort study.

Science.gov (United States)

Needham, Dale M; Yang, Ting; Dinglas, Victor D; Mendez-Tellez, Pedro A; Shanholtz, Carl; Sevransky, Jonathan E; Brower, Roy G; Pronovost, Peter J; Colantuoni, Elizabeth

2015-01-15

Reducing tidal volume decreases mortality in acute respiratory distress syndrome (ARDS). However, the effect of the timing of low tidal volume ventilation is not well understood. To evaluate the association of intensive care unit (ICU) mortality with initial tidal volume and with tidal volume change over time. Multivariable, time-varying Cox regression analysis of a multisite, prospective study of 482 patients with ARDS with 11,558 twice-daily tidal volume assessments (evaluated in milliliter per kilogram of predicted body weight [PBW]) and daily assessment of other mortality predictors. An increase of 1 ml/kg PBW in initial tidal volume was associated with a 23% increase in ICU mortality risk (adjusted hazard ratio, 1.23; 95% confidence interval [CI], 1.06-1.44; P = 0.008). Moreover, a 1 ml/kg PBW increase in subsequent tidal volumes compared with the initial tidal volume was associated with a 15% increase in mortality risk (adjusted hazard ratio, 1.15; 95% CI, 1.02-1.29; P = 0.019). Compared with a prototypical patient receiving 8 days with a tidal volume of 6 ml/kg PBW, the absolute increase in ICU mortality (95% CI) of receiving 10 and 8 ml/kg PBW, respectively, across all 8 days was 7.2% (3.0-13.0%) and 2.7% (1.2-4.6%). In scenarios with variation in tidal volume over the 8-day period, mortality was higher when a larger volume was used earlier. Higher tidal volumes shortly after ARDS onset were associated with a greater risk of ICU mortality compared with subsequent tidal volumes. Timely recognition of ARDS and adherence to low tidal volume ventilation is important for reducing mortality. Clinical trial registered with www.clinicaltrials.gov (NCT 00300248).

Dose-Volume Relationships for Acute Bowel Toxicity in Patients Treated With Pelvic Nodal Irradiation for Prostate Cancer

International Nuclear Information System (INIS)

Fiorino, Claudio; Alongi, Filippo; Perna, Lucia; Broggi, Sara; Cattaneo, Giovanni Mauro; Cozzarini, Cesare; Di Muzio, Nadia; Fazio, Ferruccio; Calandrino, Riccardo

2009-01-01

Purpose: To find correlation between dose-volume histograms (DVHs) of the intestinal cavity (IC) and moderate-severe acute bowel toxicity in men with prostate cancer treated with pelvic nodal irradiation. Methods and Materials: The study group consisted of 191 patients with localized prostate cancer who underwent whole-pelvis radiotherapy with radical or adjuvant/salvage intent during January 2004 to November 2007. Complete planning/clinical data were available in 175 of these men, 91 of whom were treated with a conventional four-field technique (50.4 Gy, 1.8 Gy/fraction) and 84 of whom were treated with IMRT using conventional Linac (n = 26, 50.4 Gy, 1.8 Gy/fraction) or Helical TomoTherapy (n = 58, 50-54 Gy, 1.8-2 Gy/fraction). The IC outside the planning target volume (PTV) was contoured and the DVH for the first 6 weeks of treatment was recovered in all patients. The correlation between a number of clinical and DVH (V10-V55) variables and toxicity was investigated in univariate and multivariate analyses. The correlation between DVHs for the IC outside the PTV and DVHs for the whole IC was also assessed. Results: Twenty-two patients experienced toxicity (3/22 in the IMRT/tomotherapy group). Univariate analyses showed a significant correlation between V20-V50 and toxicity (p = 0.0002-0.001), with a higher predictive value observed for V40-V50. Previous prostatectomy (p = 0.066) and abdominal/pelvic surgery (p = 0.12) also correlated with toxicity. Multivariate analysis that included V45, abdominal/pelvic surgery, and prostatectomy showed that the most predictive parameters were V45 (p = 0.002) and abdominal/pelvic surgery (p = 0.05, HR = 2.4) Conclusions: Our avoidance IMRT approach drastically reduces the incidence of acute bowel toxicity. V40-V50 of IC and, secondarily, previous abdominal/pelvic surgery were the main predictors of acute bowel toxicity.

Early changes of parotid density and volume predict modifications at the end of therapy and intensity of acute xerostomia.

Science.gov (United States)

Belli, Maria Luisa; Scalco, Elisa; Sanguineti, Giuseppe; Fiorino, Claudio; Broggi, Sara; Dinapoli, Nicola; Ricchetti, Francesco; Valentini, Vincenzo; Rizzo, Giovanna; Cattaneo, Giovanni Mauro

2014-10-01

To quantitatively assess the predictive power of early variations of parotid gland volume and density on final changes at the end of therapy and, possibly, on acute xerostomia during IMRT for head-neck cancer. Data of 92 parotids (46 patients) were available. Kinetics of the changes during treatment were described by the daily rate of density (rΔρ) and volume (rΔvol) variation based on weekly diagnostic kVCT images. Correlation between early and final changes was investigated as well as the correlation with prospective toxicity data (CTCAEv3.0) collected weekly during treatment for 24/46 patients. A higher rΔρ was observed during the first compared to last week of treatment (-0,50 vs -0,05HU, p-value = 0.0001). Based on early variations, a good estimation of the final changes may be obtained (Δρ: AUC = 0.82, p = 0.0001; Δvol: AUC = 0.77, p = 0.0001). Both early rΔρ and rΔvol predict a higher "mean" acute xerostomia score (≥ median value, 1.57; p-value = 0.01). Median early density rate changes for patients with mean xerostomia score ≥ / xerostomia is well predicted by higher rΔρ and rΔvol in the first two weeks of treatment: best cut-off values were -0.50 HU/day and -380 mm(3)/day for rΔρ and rΔvol respectively. Further studies are necessary to definitively assess the potential of early density/volume changes in identifying more sensitive patients at higher risk of experiencing xerostomia.

Comparison of expandable electrodes in percutaneous radiofrequency ablation of renal cell carcinoma

International Nuclear Information System (INIS)

Gulesserian, Talin; Mahnken, Andreas H.; Schernthaner, Ruediger; Memarsadeghi, Mazda; Weber, Michael; Tacke, A.; Kettenbach, Joachim

2006-01-01

Objective: To compare two different expandable electrodes in radiofrequency ablation of renal cell carcinoma. Methods: Percutaneous ablation was performed at two centers using either an expandable 7F umbrella-shaped LeVeen TM probe (diameter 2-4 cm) and a 200-W generator (group A), or an expandable Starburst XL TM electrode with a 150-W generator (group B). From each center, eight patients with one tumor each were matched retrospectively with regard to tumor volume, which was 9.71 ± 6.43 cm 3 for group A and 8.74 ± 4.35 cm 3 for group B (mean tumor diameter: 2.47 ± 0.9 cm versus 2.50 ± 0.4 cm, respectively). An unpaired t-test showed no significant difference in tumor volume between the two groups (p = 0.820). Results: Sixteen patients with 16 tumors were treated. The primary technical success of radiofrequency ablation was 94% (15 of 16 patients). After retreatment of residual tumor in one patient from group B, secondary technical success was 100%. No major complications were observed. The resulting mean volume of the almost spherical necroses was 21.1 ± 9.1 cm 3 versus 14.6 ± 6.7 cm 3 for groups A and B (diameter of necrosis: 3.5 ± 0.7 cm versus 3.1 ± 0.6 cm, respectively). A Mann-Whitney U-test showed no significant difference in necrosis volume between the two groups (CI [-0.215; 0.471]; p = 0.2892). The calculated shape value of S (ratio of length to height of the coagulation necrosis) was 0.9 ± 0.1 and 1.0 ± 0.1 for groups A and B, respectively. No local recurrence was observed during a mean follow-up of 14.8 ± 11.6 months, while extrarenal tumor progression occurred in three patients. Conclusions: No significant differences in coagulation volume and shape were found after RF ablation of renal cell carcinoma using two different expandable electrodes. To avoid local recurrence, however, accurate placement of probes and appropriate expansion of the electrode is necessary

Ischemic Volume and Neurological Deficit: Correlation of Computed Tomography Perfusion with the National Institutes of Health Stroke Scale Score in Acute Ischemic Stroke.

Science.gov (United States)

Furlanis, Giovanni; Ajčević, Miloš; Stragapede, Lara; Lugnan, Carlo; Ridolfi, Mariana; Caruso, Paola; Naccarato, Marcello; Ukmar, Maja; Manganotti, Paolo

2018-04-30

The National Institutes of Health Stroke Scale (NIHSS) is the most adopted stroke patients' evaluation tool in emergency settings to assess the severity of stroke and to determine the patients' eligibility for specific treatments. Computed tomography perfusion (CTP) is crucial to identify salvageable tissue that can benefit from the reperfusion treatment. The aim of this study is to identify the relation between the NIHSS scores and the hypoperfused volumes evaluated by CTP in patients with hyperacute ischemic stroke. This retrospective study was conducted on 105 patients with ischemic stroke who underwent NIHSS assessment and CTP in the hyperacute phase. Hypoperfused volume was evaluated by CTP maps processed with semi-automatic algorithm. An analysis was conducted to determine the degree of correlation between the NIHSS scores and the ischemic lesion volumes and to investigate the relation between the anterior and the posterior circulation strokes, as well as between the right and the left hemispheric strokes. A significant correlation was found between ischemic volume and NIHSS score at baseline (r = .82; P correlation was identified in the anterior circulation stroke (r = .76; P correlated for the left and the right hemispheric strokes (r = .83 and .81; P correlation between the baseline NIHSS score and the ischemic volume estimated by CTP. We confirmed that NIHSS is a reliable predictor of perfusion deficits in acute ischemic stroke. CTP allows fast imaging assessment in the hyperacute phase. The results highlight the importance of these diagnostic tools in the assessment of stroke severity and in acute decision-making. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Photon beam dose distributions for patients with implanted temporary tissue expanders

Science.gov (United States)

Asena, A.; Kairn, T.; Crowe, S. B.; Trapp, J. V.

2015-01-01

This study examines the effects of temporary tissue expanders (TTEs) on the dose distributions of photon beams in breast cancer radiotherapy treatments. EBT2 radiochromic film and ion chamber measurements were taken to quantify the attenuation and backscatter effects of the inhomogeneity. Results illustrate that the internal magnetic port present in a tissue expander causes a dose reduction of approximately 25% in photon tangent fields immediately downstream of the implant. It was also shown that the silicone elastomer shell of the tissue expander reduced the dose to the target volume by as much as 8%. This work demonstrates the importance for an accurately modelled high-density implant in the treatment planning system for post-mastectomy breast cancer patients.

The natural history of Becker expandable breast implants: a single-center 10-year experience.

Science.gov (United States)

Sindali, Katia; Davis, Marcus; Mughal, Maleeha; Orkar, Kusu S

2013-09-01

Use of Becker expandable breast implants in single-stage breast surgery is a well-established technique; however, replacement with fixed-volume implants is common. The authors sought to analyze the long-term natural history of these implants over a wide range of surgical indications. A retrospective review of 330 consecutive patients who underwent 384 Becker expander breast reconstructions over a 10-year period in a dedicated plastic surgery unit was undertaken. Implant indication, Becker type, volume and site, complications, expander lifespan, and explant reasons were assessed. Two hundred twenty-eight patients (267 implants) and 102 patients (117 implants) underwent implantation for congenital deformities and breast cancer reconstruction, respectively. One hundred eighty-seven (48 percent) were explanted at a median period of 13.0 months (range, 9.0 to 26.0 months), 149 (39 percent) for aesthetic reasons and 38 (10 percent) for complications. Complication rates were higher in breast cancer reconstruction compared with congenital patients (19.6 percent versus 7.9 percent; p = 0.002), driven by an increased rate of wound complications (13.7 percent versus 4.4 percent; p = 0.003). Cancer-related surgery and advancing age were the only predictors of complication risk. The overall Becker expander retention rate was 24.9 percent and 46.8 percent at 150 months in the cancer reconstruction and congenital groups, respectively. Forty-seven percent of Becker implants were retained long term after congenital corrective surgery; only 25 percent were retained after postmastectomy reconstruction. Poor aesthetics was driving the exchange for fixed-volume implants, indicating that after breast cancer reconstruction, Becker expanders were being used as part of a two-stage reconstructive strategy.

Adaptive Support Ventilation May Deliver Unwanted Respiratory Rate-Tidal Volume Combinations in Patients with Acute Lung Injury Ventilated According to an Open Lung Concept

NARCIS (Netherlands)

Dongelmans, Dave A.; Paulus, Frederique; Veelo, Denise P.; Binnekade, Jan M.; Vroom, Margreeth B.; Schultz, Marcus J.

2011-01-01

Background: With adaptive support ventilation, respiratory rate and tidal volume (V(T)) are a function of the Otis least work of breathing formula. We hypothesized that adaptive support ventilation in an open lung ventilator strategy would deliver higher V(T)s to patients with acute lung injury.

Acute response of circulating vascular regulating microRNAs during and after high-intensity and high-volume cycling in children

Directory of Open Access Journals (Sweden)

Yvonne eKilian

2016-03-01

Full Text Available Aim: The aim of the present study was to analyze the response of vascular circulating microRNAs (miRNAs; miR-16, miR-21, miR-126 and the VEGF mRNA following an acute bout of HIIT and HVT in children. Methods: Twelve healthy competitive young male cyclists (14.4 ± 0.8 yrs; 57.9 ± 9.4 ml·min-1·kg-1 peak oxygen uptake performed one session of high intensity 4x4 min intervals (HIIT at 90-95% peak power output, each interval separated by 3 min of active recovery, and one high volume session (HVT consisting of a constant load exercise for 90 min at 60% peak power output. Capillary blood from the earlobe was collected under resting conditions, during exercise (d1 = 20 min, d2 = 30 min, d3 = 60 min, and 0, 30, 60, 180 min after the exercise to determine miR-16, -21, -126 and VEGF mRNA.Results: HVT significantly increased miR-16 and miR-126 during and after the exercise compared to pre values, whereas HIIT showed no significant influence on the miRNAs compared to pre values. VEGF mRNA significantly increased during and after HIIT (d1, 30`, 60`, 180` and HVT (d3, 0`, 60`. Conclusion: Results of the present investigation suggest a volume dependent exercise regulation of vascular regulating miRNAs (miR-16, miR-21, miR-126 in children. In line with previous data, our data show that acute exercise can alter circulating miRNAs profiles that might be used as novel biomarkers to monitor acute and chronic changes due to exercise in various tissues.

Carbohydrate plasma expanders for passive tumor targeting

DEFF Research Database (Denmark)

Hoffmann, Stefan; Caysa, Henrike; Kuntsche, Judith

2013-01-01

The objective of this study was to investigate the suitability of carbohydrate plasma volume expanders as a novel polymer platform for tumor targeting. Many synthetic polymers have already been synthesized for targeted tumor therapy, but potential advantages of these carbohydrates include inexpen...... was characterized in human colon carcinoma xenograft bearing nude mice. A tumor specific accumulation of HES 450 was observed, which proves it’s potential as carrier for passive tumor targeting....

ExpandED Options: Learning beyond High School Walls

Science.gov (United States)

ExpandED Schools, 2014

2014-01-01

Through ExpandED Options by TASC, New York City high school students get academic credit for learning career-related skills that lead to paid summer jobs. Too many high school students--including those most likely to drop out--are bored or see classroom learning as irrelevant. ExpandED Options students live the connection between mastering new…

Macelignan inhibits bee pathogenic fungi Ascophaera apis growth through HOG1 pathway

Directory of Open Access Journals (Sweden)

Y.K. Shin

2016-01-01

Full Text Available Ascosphaera apis is a bee pathogen that causes bee larvae infection disease, to which treatment is not yet well investigated. The aim of this study was to investigate antifungal susceptibility in vitro against A. apis and to identify a new antifungal agent for this pathogen through minimal inhibitory concentration (MIC assay and western blot analysis. Macelignan had 1.56 and 3.125 μg/mL MIC against A. apis after 24 and 48 h, respectively, exhibiting the strongest growth inhibition against A. apis among the tested compounds (corosolic acid, dehydrocostus lactone, loganic acid, tracheloside, fangchinoline and emodin-8-O-β-D-glucopyranoside. Furthermore, macelignan showed a narrow-ranged spectrum against various fungal strains without any mammalian cell cytotoxicity. In spite of miconazole having powerful broad-ranged anti-fungal activity including A. apis, it demonstrated strong cytotoxicity. Therefore, even if macelignan alone was effective as an antifungal agent to treat A. apis, combined treatment with miconazole was more useful to overcome toxicity, drug resistance occurrence and cost effectiveness. Finally, HOG1 was revealed as a target molecule of macelignan in the anti-A. apis activity by inhibiting phosphorylation using S. cerevisiae as a model system. Based on our results, macelignan, a food-grade antimicrobial compound, would be an effective antifungal agent against A. apis infection in bees.

Diagnostic value of mean platelet volume (MPV) to troponin T inpatients with acute coronary syndrome

Science.gov (United States)

Aryanto, D.; Isnanta, R.; Safri, Z.; Hasan, R.

2018-03-01

Acute Coronary Syndrome (ACS) is used to describe the spectrum of coronary artery disease (CAD). Troponin T is the determinant of the most sensitive marker of ACS, but there aren’t all hospitals have this because of expensiveness. Mean Platelet Volume (MPV) is one of the components of a complete blood routine examination and relatively cheap as a marker in ACS. Determining the sensitivity and specificity of MPV in detecting cases of the acute coronary syndrome, 325 subjects’ medical records were from the period of July 2013 to June 2014; 228 ACS patients met the inclusion criteria. 228 subjects showed a risk factor for age ≥45years of more 195 (85.5%). 122 subjects with hypertension (53.5%) and subjects who smoked 118 (51.8%) that suffered most ACS. Subjects with risk factors for diabetes mellitus, obesity, menopause and dyslipidemia in this study was lower than non-diabetic 161 (70.6%), obese189 (82.9%), nonmenopause 196 (86%) and normal lipid 210 (92.1%). But there was norelation between risk factor with MPV and troponin T statistically. The results of diagnostic tests MPV for the evaluation of patients with ACS, sensitivity 92%, specificity 71%, positive predictive value 95% and negative predictive value 58%.

Development of a novel anisotropic self-inflating tissue expander: in vivo submucoperiosteal performance in the porcine hard palate.

Science.gov (United States)

Swan, Marc C; Bucknall, David G; Czernuszka, Jan T; Pigott, David W; Goodacre, Timothy E E

2012-01-01

The advent of self-inflating hydrogel tissue expanders heralded a significant advance in the reconstructive potential of this technique. Their use, however, is limited by their uncontrolled isotropic (i.e., uniform in all directions) expansion. Anisotropy (i.e., directional dependence) was achieved by annealing a hydrogel copolymer of poly(methyl methacrylate-co-vinyl pyrrolidone) under a compressive load for a specified time period. The expansion ratio is dictated by the percentage of vinyl pyrrolidone content and the degree of compression. The expansion rate is modified by incorporating the polymer within a silicone membrane. The in vivo efficacy of differing prototype devices was investigated in juvenile pigs under United Kingdom Home Office Licence. The devices were implanted within a submucoperiosteal pocket in a total of six porcine palates; all were euthanized by 6 weeks after implantation. A longitudinal volumetric assessment of the expanded tissue was conducted, in addition to postmortem analysis of the bony and mucoperiosteal palatal elements. Uncoated devices caused excessive soft-tissue expansion that resulted in mucoperiosteal ulceration, thus necessitating animal euthanasia. The silicone-coated devices produced controlled soft-tissue expansion over the 6-week study period. There was a statistically significant increase in the volume of expanded soft tissue with no evidence of a significant acute inflammatory response to the implant, although peri-implant capsule formation was observed. Attenuation of the bony palatal shelf was noted. A unique anisotropic hydrogel device capable of controlled expansion has been developed that addresses a number of the shortcomings of the technology hitherto available.

Mean platelet volume and mean platelet volume/platelet count ratio

African Journals Online (AJOL)

Amira M. Elsayed

2016-03-30

Mar 30, 2016 ... The aim of this study was to compare the MPV and mean platelet volume/platelet count ... brain stroke, both in the acute phase and long after disease.17 ... males, while the healthy controls comprised 12 females and 8.

Effect of different seated positions on lung volume and oxygenation in acute respiratory distress syndrome.

Science.gov (United States)

Dellamonica, J; Lerolle, N; Sargentini, C; Hubert, S; Beduneau, G; Di Marco, F; Mercat, A; Diehl, J L; Richard, J C M; Bernardin, G; Brochard, L

2013-06-01

Lung volume available for ventilation is markedly decreased during acute respiratory distress syndrome. Body positioning may contribute to increase lung volume and partial verticalization is simple to perform. This study evaluated whether verticalization had parallel effects on oxygenation and end expiratory lung volume (EELV). Prospective multicenter study in 40 mechanically ventilated patients with ALI/ARDS in five university hospital MICUs. We evaluated four 45-min successive trunk position epochs (supine slightly elevated at 15°; semi recumbent with trunk elevated at 45°; seated with trunk elevated at 60° and legs down at 45°; back to supine). Arterial blood gases, EELV measured using the nitrogen washin/washout, and static compliance were measured. Responders were defined by a PaO₂/FiO₂ increase >20 % between supine and seated position. Results are median [25th-75th percentiles]. With median PEEP = 10 cmH₂O, verticalization increased lung volume but only responders (13 patients, 32 %) had a significant increase in EELV/PBW (predicted body weight) compared to baseline. This increase persisted at least partially when patients were positioned back to supine. Responders had a lower EELV/PBW supine [14 mL/kg (13-15) vs. 18 mL/kg (15-27) (p = 0.005)] and a lower compliance [30 mL/cmH₂O (22-38) vs. 42 (30-46) (p = 0.01)] than non-responders. Strain decreased with verticalization for responders. EELV/PBW increase and PaO₂/FiO₂ increase were not correlated. Verticalization is easily achieved and improves oxygenation in approximately 32 % of the patients together with an increase in EELV. Nonetheless, effect of verticalization on EELV/PBW is not predictable by PaO₂/FiO₂ increase, its monitoring may be helpful for strain optimization.

Meta-Analysis of Ultrafiltration versus Diuretics Treatment Option for Overload Volume Reduction in Patients with Acute Decompensated Heart Failure.

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Barkoudah, Ebrahim; Kodali, Sindhura; Okoroh, Juliet; Sethi, Rosh; Hulten, Edward; Suemoto, Claudia; Bittencourt, Marcio Sommer

2015-05-01

Although diuretics are mainly used for the treatment of acute decompensated heart failure (ADHF), inadequate responses and complications have led to the use of extracorporeal ultrafiltration (UF) as an alternative strategy for reducing volume overloads in patients with ADHF. The aim of our study is to perform meta-analysis of the results obtained from studies on extracorporeal venous ultrafiltration and compare them with those of standard diuretic treatment for overload volume reduction in acute decompensated heart failure. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched using a pre‑specified criterion. Pooled estimates of outcomes after 48 h (weight change, serum creatinine level, and all-cause mortality) were computed using random effect models. Pooled weighted mean differences were calculated for weight loss and change in creatinine level, whereas a pooled risk ratio was used for the analysis of binary all-cause mortality outcome. A total of nine studies, involving 613 patients, met the eligibility criteria. The mean weight loss in patients who underwent UF therapy was 1.78 kg [95% Confidence Interval (CI): -2.65 to -0.91 kg; p diuretic therapy. The post-intervention creatinine level, however, was not significantly different (mean change = -0.25 mg/dL; 95% CI: -0.56 to 0.06 mg/dL; p = 0.112). The risk of all-cause mortality persisted in patients treated with UF compared with patients treated with standard diuretics (Pooled RR = 1.00; 95% CI: 0.64-1.56; p = 0.993). Compared with standard diuretic therapy, UF treatment for overload volume reduction in individuals suffering from ADHF, resulted in significant reduction of body weight within 48 h. However, no significant decrease of serum creatinine level or reduction of all-cause mortality was observed.

RF Ablation of Giant Hemangiomas Inducing Acute Renal Failure: A Report of Two Cases

Energy Technology Data Exchange (ETDEWEB)

Tilborg, Aukje A. J. M. van, E-mail: a.vantilborg@vumc.nl [VU University Medical Center, Departments of Radiology and Nuclear Medicine (Netherlands); Dresselaars, Helena F. [VU University Medical Center, Department of Nefrology (Netherlands); Scheffer, Hester J. [VU University Medical Center, Departments of Radiology and Nuclear Medicine (Netherlands); Nielsen, Karin [VU University Medical Center (Netherlands); Sietses, Colin [Gelderse Vallei Hospital, Department of Surgical Oncology (Netherlands); Tol, Petrousjka M. van den [VU University Medical Center (Netherlands); Meijerink, Martijn R. [VU University Medical Center, Departments of Radiology and Nuclear Medicine (Netherlands)

2016-11-15

ObjectiveIn patients that require treatment for hepatic giant cavernous hemangiomas (GCH), radiofrequency ablation (RFA) has been suggested to represent a safe and effective alternative to invasive surgery. In a recent report of bipolar RFA, using two expandable needle electrodes, was uneventfully performed in patients with large GCH (>10 cm). The objective of this report is to present two cases in which bipolar RFA of symptomatic GCH was complicated by acute kidney injury.Materials and methodsIn 2015 we treated two patients for very large symptomatic GCH (15.7 and 25.0 cm) with bipolar RFA during open laparotomy.ResultsIn both patients the urine showed a red–brown discoloration directly after the ablation. They became anuric and presented with progressive dyspnea, tachypnea, and tachycardia, requiring hemodialysis for a period of 1 month in one case. Lab results revealed hemepigment-induced acute kidney. Both patients fully recovered and both showed a complete relief of symptoms at 3 months following the procedure.ConclusionRFA for large GCHs can cause hemepigment-induced acute kidney injury due to massive intravascular hemolysis. The presented cases suggest that caution is warranted and advocate an upper limit regarding the volume of GCHs that can be safely ablated.

Pre-operative renal volume predicts peak creatinine after congenital heart surgery in neonates.

Science.gov (United States)

Carmody, J Bryan; Seckeler, Michael D; Ballengee, Cortney R; Conaway, Mark; Jayakumar, K Anitha; Charlton, Jennifer R

2014-10-01

Acute kidney injury is common in neonates following surgery for congenital heart disease. We conducted a retrospective analysis to determine whether neonates with smaller pre-operative renal volume were more likely to develop post-operative acute kidney injury. We conducted a retrospective review of 72 neonates who underwent congenital heart surgery for any lesion other than patent ductus arteriosus at our institution from January 2007 to December 2011. Renal volume was calculated by ultrasound using the prolate ellipsoid formula. The presence and severity of post-operative acute kidney injury was determined both by measuring the peak serum creatinine in the first 7 days post-operatively and by using the Acute Kidney Injury Network scoring system. Using a linear change point model, a threshold renal volume of 17 cm³ was identified. Below this threshold, there was an inverse linear relationship between renal volume and peak post-operative creatinine for all patients (p = 0.036) and the subgroup with a single morphologic right ventricle (p = 0.046). There was a non-significant trend towards more acute kidney injury using Acute Kidney Injury Network criteria in all neonates with renal volume ≤17 cm³ (p = 0.11) and in the subgroup with a single morphologic right ventricle (p = 0.17). Pre-operative renal volume ≤17 cm³ is associated with a higher peak post-operative creatinine and potentially greater risk for post-operative acute kidney injury for neonates undergoing congenital heart surgery. Neonates with a single right ventricle may be at higher risk.

Improvement of Oxygenation in Severe Acute Respiratory Distress Syndrome With High-Volume Continuous Veno-venous Hemofiltration.

Science.gov (United States)

Yang, Wenmin; Hong, Jie; Zeng, Qiyi; Tao, Jianping; Chen, Feiyan; Dang, Run; Liang, Yufeng; Wu, Zhiyuan; Yang, Yiyu

2016-01-01

The efficacy and therapeutic mechanisms of continuous renal replacement therapy (CRRT) for improvement of oxygenation in acute respiratory distress syndrome (ARDS) remain controversial. These questions were addressed by retrospective analysis of severe ARDS patients admitted to the pediatric intensive care unit of our hospital from 2009 to 2015 who received high-volume continuous veno-venous hemofiltration during mechanical ventilation. There was a significant improvement in partial oxygen pressure/fraction of inspired oxygen (PaO2/FiO2) 24 hours after CRRT onset compared with baseline (median change = 51.5; range = -19 to 450.5; P Improvement in oxygenation is likely related to both restoration of fluid balance and clearance of inflammatory mediators.

Toxicity Profile With a Large Prostate Volume After External Beam Radiotherapy for Localized Prostate Cancer

International Nuclear Information System (INIS)

Pinkawa, Michael; Fischedick, Karin; Asadpour, Branka; Gagel, Bernd; Piroth, Marc D.; Nussen, Sandra; Eble, Michael J.

2008-01-01

Purpose: To assess the impact of prostate volume on health-related quality of life (HRQOL) before and at different intervals after radiotherapy for prostate cancer. Methods and Materials: A group of 204 patients was surveyed prospectively before (Time A), at the last day (Time B), 2 months after (Time C), and 16 months (median) after (Time D) radiotherapy, with a validated questionnaire (Expanded Prostate Cancer Index Composite). The group was divided into subgroups with a small (11-43 cm 3 ) and a large (44-151 cm 3 ) prostate volume. Results: Patients with large prostates presented with lower urinary bother scores (median 79 vs. 89; p = 0.01) before treatment. Urinary function/bother scores for patients with large prostates decreased significantly compared to patients with small prostates due to irritative/obstructive symptoms only at Time B (pain with urination more than once daily in 48% vs. 18%; p 3 vs. 47 cm 3 ; p < 0.01). Conclusions: Patients with a large prostate volume have a great risk of irritative/obstructive symptoms (particularly dysuria) in the acute radiotherapy phase. These symptoms recover rapidly and do not influence long-term HRQOL

Unexpected severe calcification after transplantation of bone marrow cells in acute myocardial infarction.

Science.gov (United States)

Yoon, Young-Sup; Park, Jong-Seon; Tkebuchava, Tengiz; Luedeman, Corinne; Losordo, Douglas W

2004-06-29

There has been a rapid increase in the number of clinical trials using unselected bone marrow (BM) cells or the mononuclear fraction of BM cells for treating ischemic heart diseases. Thus far, no significant deleterious effects or complications have been reported in any studies using BM-derived cells for treatment of various cardiac diseases. Seven-week-old female Fisher-344 rats underwent surgery to induce acute myocardial infarction and were randomized into 3 groups of 16 rats, each receiving intramyocardial injection of either 7x10(5) DiI-labeled total BM cells (TBMCs), the same number of DiI-labeled, clonally expanded BM multipotent stem cells, or the same volume of phosphate-buffered saline in the peri-infarct area. Echocardiography 2 weeks after cell transplantation indicated intramyocardial calcification in 4 of 14 surviving rats (28.5%) in the TBMC group. Histological examination with hematoxylin and eosin staining and von Kossa staining confirmed the presence of extensive intramyocardial calcification. Alkaline phosphatase staining revealed strong positivity surrounding the calcified area suggestive of ongoing osteogenic activity. Fluorescent microscopic examination revealed that acellular calcific areas were surrounded by DiI-labeled TBMCs, suggesting the direct involvement of transplanted TBMCs in myocardial calcification. In contrast, in hearts receiving equal volumes of saline or BM multipotent stem cells delivered in the same manner, there was no evidence of calcification. These results demonstrate that direct transplantation of unselected BM cells into the acutely infarcted myocardium may induce significant intramyocardial calcification.

Acute Cold / Restraint Stress in Castrated Rats

Directory of Open Access Journals (Sweden)

Farideh Zafari Zangeneh

2008-09-01

Full Text Available Objective: The present study aimed to determine whether castration altered osmotically stimulated vasopressin (VP release and urinary volume and what is the role of endocrine-stress axis in this process.Materials and methods: Totally 108 mice were studied in two main groups of castrated (n=78 and control (n=30. Each group was extracted by acute cold stress (4◦C for 2h/day, restraint stress (by syringes 60cc 2h/day and cold/restraint stress. The castrated group was treated in sub groups of testosterone, control (sesame oil as vehicle of testosterone. Propranolol as blocker of sympathetic nervous system was given to both groups of castrated mice and main control.Results: Our results showed that, there is interactions between testosterone and sympathetic nervous system on vasopressin, because urine volume was decreased only in testoctomized mice with cold/restraint and cold stress (P<0.001; propranolol as the antagonist of sympathetic nervous system could block and increase urine volume in castrated mice. This increased volume of urine was due to acute cold stress, not restraint stress (p<0.001. The role of testosterone, noradrenalin (NA and Vasopressin (VP in the acute cold stress is confirmed, because testosterone could return the effect of decreased urine volume in control group (P<0.001. Conclusion: Considering the effect of cold/restraint stress on urinary volume in castrated mice shows that there is interaction between sex hormone (testosterone, vasopressin and adrenergic systems.

Thallium pulmonary scintigraphy. Relationship to pulmonary fluid volumes during left atrial hypertension and the acute release of pressure

International Nuclear Information System (INIS)

Slutsky, R.A.

1984-01-01

To evaluate the relationship between thallium-201 lung activity and pulmonary fluid volumes, we compared thallium pulmonary scintigrams with measures of intravascular (PBV), extravascular (EVLW) and total lung water (TLW) during gradual left atrial (LA) hypertension and then serially after the acute release of pressure. The study group was composed of nine mongrel dogs who were each studied at seven levels of elevated LA pressure, and then every 15 minutes for 2 hours after the acute release of pressure. During LA pressure (congestion phase) elevation, lung counts (normalized for myocardial activity), correlated best with TLW (r . .91), rather than PBV (r . .84) or EVLW (r . .81). After the release of pressure (recovery phase), lung counts correlated well with EVLW (r . .92) and TLW (r . .82), but not with PBV (r . .28). Postmortem lung counts from 197 separate lung sections correlated well with the corresponding wet weight/dry weight ratio from that section (r . .81). Thus, we conclude that changes in pulmonary thallium emissions during cardiogenic pulmonary edema relate to corresponding changes in pulmonary fluid volumes. During congestion, the confounding effects of nonlinear increases in EVLW and PBV make thallium emissions more a marker of TLW than either the intravascular or extravascular pulmonary fluid compartment. After pressure release, PBV immediately returns to normal, at which time EVLW and pulmonary emissions correlate closely. These latter data, more applicable to postexercise stress thallium data, lend support to the hypothesis that elevated pulmonary emissions during postexercise thallium scintigrams reflect elevations in EVLW that develop during exercise

Association of oesophageal radiation dose volume metrics, neutropenia and acute radiation oesophagitis in patients receiving chemoradiotherapy for non-small cell lung cancer

International Nuclear Information System (INIS)

Everitt, Sarah; Duffy, Mary; Bressel, Mathias; McInnes, Belinda; Russell, Christine; Sevitt, Tim; Ball, David

2016-01-01

The relationship between oesophageal radiation dose volume metrics and dysphagia in patients having chemoradiation (CRT) for non-small cell lung cancer (NSCLC) is well established. There is also some evidence that neutropenia is a factor contributing to the severity of oesophagitis. We retrospectively analysed acute radiation oesophagitis (ARO) rates and severity in patients with NSCLC who received concurrent chemotherapy and high dose radiation therapy (CRT). We investigated if there was an association between grade of ARO, neutropenia and radiation dose volume metrics. Patients with NSCLC having concurrent CRT who had RT dose and toxicity data available were eligible. Exclusion criteria included previous thoracic RT, treatment interruptions and non-standard dose regimens. RT dosimetrics included maximum and mean oesophageal dose, oesophagus dose volume and length data. Fifty four patients were eligible for analysis. 42 (78 %) patients received 60 Gy. Forty four (81 %) patients received carboplatin based chemotherapy. Forty eight (89 %) patients experienced ARO ≥ grade 1 (95 % CI: 78 % to 95 %). ARO grade was associated with mean dose (r s = 0.27, p = 0.049), V20 (r s = 0.31, p = 0.024) and whole oesophageal circumference receiving 20 Gy (r s = 0.32 p = 0.019). In patients who received these doses, V20 (n = 51, r s = 0.36, p = 0.011), V35 (n = 43, r s = 0.34, p = 0.027) and V60 (n = 25, r s = 0.59, P = 0.002) were associated with RO grade. Eleven of 25 (44 %) patients with ARO ≥ grade 2 also had ≥ grade 2 acute neutropenia compared with 5 of 29 (17 %) patients with RO grade 0 or 1 (p = 0.035). In addition to oesophageal dose-volume metrics, neutropenia may also be a risk factor for higher grades of ARO

The Danish National Acute Leukemia Registry

DEFF Research Database (Denmark)

Østgård, Lene Sofie Granfeldt; Nørgaard, Jan Maxwell; Raaschou-Jensen, Klas Kræsten

2016-01-01

AIM OF DATABASE: The main aim of the Danish National Acute Leukemia Registry (DNLR) was to obtain information about the epidemiology of the hematologic cancers acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and myelodysplastic syndrome (MDS). STUDY POPULATION: The registry...... was established in January 2000 by the Danish Acute Leukemia Group and has been expanded over the years. It includes adult AML patients diagnosed in Denmark since 2000, ALL patients diagnosed since 2005, and MDS patients diagnosed since 2010. The coverage of leukemia patients exceeds 99%, and the coverage of MDS...... years. To ensure this high coverage, completeness, and quality of data, linkage to the Danish Civil Registration System and the Danish National Registry of Patients, and several programmed data entry checks are used. CONCLUSION: The completeness and positive predictive values of the leukemia data have...

Dose–Volume Effects on Patient-Reported Acute Gastrointestinal Symptoms During Chemoradiation Therapy for Rectal Cancer

International Nuclear Information System (INIS)

Chen, Ronald C.; Mamon, Harvey J.; Ancukiewicz, Marek; Killoran, Joseph H.; Crowley, Elizabeth M.; Blaszkowsky, Lawrence S.; Wo, Jennifer Y.; Ryan, David P.; Hong, Theodore S.

2012-01-01

Purpose: Research on patient-reported outcomes (PROs) in rectal cancer is limited. We examined whether dose–volume parameters of the small bowel and large bowel were associated with patient-reported gastrointestinal (GI) symptoms during 5-fluorouracil (5-FU)–based chemoradiation treatment for rectal cancer. Methods and Materials: 66 patients treated at the Brigham and Women’s Hospital or Massachusetts General Hospital between 2006 and 2008 were included. Weekly during treatment, patients completed a questionnaire assessing severity of diarrhea, urgency, pain, cramping, mucus, and tenesmus. The association between dosimetric parameters and changes in overall GI symptoms from baseline through treatment was examined by using Spearman’s correlation. Potential associations between these parameters and individual GI symptoms were also explored. Results: The amount of small bowel receiving at least 15 Gy (V15) was significantly associated with acute symptoms (p = 0.01), and other dosimetric parameters ranging from V5 to V45 also trended toward association. For the large bowel, correlations between dosimetric parameters and overall GI symptoms at the higher dose levels from V25 to V45 did not reach statistical significance (p = 0.1), and a significant association was seen with rectal pain from V15 to V45 (p < 0.01). Other individual symptoms did not correlate with small bowel or large bowel dosimetric parameters. Conclusions: The results of this study using PROs are consistent with prior studies with physician-assessed acute toxicity, and they identify small bowel V15 as an important predictor of acute GI symptoms during 5-FU–based chemoradiation treatment. A better understanding of the relationship between radiation dosimetric parameters and PROs may allow physicians to improve radiation planning to optimize patient outcomes.

Concentrations of cadmium, Cobalt, Lead, Nickel, and Zinc in Blood and Fillets of Northern Hog Sucker (Hypentelium nigricans) from streams contaminated by lead-Zinc mining: Implications for monitoring

Science.gov (United States)

Schmitt, C.J.; Brumbaugh, W.G.; May, T.W.

2009-01-01

Lead (Pb) and other metals can accumulate in northern hog sucker (Hypentelium nigricans) and other suckers (Catostomidae), which are harvested in large numbers from Ozark streams by recreational fishers. Suckers are also important in the diets of piscivorous wildlife and fishes. Suckers from streams contaminated by historic Pb-zinc (Zn) mining in southeastern Missouri are presently identified in a consumption advisory because of Pb concentrations. We evaluated blood sampling as a potentially nonlethal alternative to fillet sampling for Pb and other metals in northern hog sucker. Scaled, skin-on, bone-in "fillet" and blood samples were obtained from northern hog suckers (n = 75) collected at nine sites representing a wide range of conditions relative to Pb-Zn mining in southeastern Missouri. All samples were analyzed for cadmium (Cd), cobalt (Co), Pb, nickel (Ni), and Zn. Fillets were also analyzed for calcium as an indicator of the amount of bone, skin, and mucus included in the samples. Pb, Cd, Co, and Ni concentrations were typically higher in blood than in fillets, but Zn concentrations were similar in both sample types. Concentrations of all metals except Zn were typically higher at sites located downstream from active and historic Pb-Zn mines and related facilities than at nonmining sites. Blood concentrations of Pb, Cd, and Co were highly correlated with corresponding fillet concentrations; log-log linear regressions between concentrations in the two sample types explained 94% of the variation for Pb, 73-83% of the variation for Co, and 61% of the variation for Cd. In contrast, relations for Ni and Zn explained Fillet Pb and calcium concentrations were correlated (r = 0.83), but only in the 12 fish from the most contaminated site; concentrations were not significantly correlated across all sites. Conversely, fillet Cd and calcium were correlated across the range of sites (r = 0.78), and the inclusion of calcium in the fillet-to-blood relation explained an

Acute Toxicity in Definitive Versus Postprostatectomy Image-Guided Radiotherapy for Prostate Cancer

International Nuclear Information System (INIS)

Cheng, Jonathan C.; Schultheiss, Timothy E.; Nguyen, Khanh H.; Wong, Jeffrey Y.C.

2008-01-01

Purpose: To assess the incidence of acute gastrointestinal (GI) and genitourinary (GU) injury and the dose-volume response in patients with clinically localized prostate cancer treated with image-guided radiotherapy using helical tomotherapy. Methods and Materials: Between November 2004 and March 2007, 146 consecutive patients with localized prostate cancer were treated with helical tomotherapy at the City of Hope Medical Center. Of the 146 patients, 70 had undergone prostatectomy. Acute GI and GU toxicities were evaluated using the Radiation Therapy Oncology Group/European Organization for Research and Cancer of Medical scoring system. Events were scored for patients developing Grade 2 or greater morbidity within 90 days after the end of radiotherapy (RT). The dosimetric parameters included the minimal dose received by the highest 10%, 20%, 50%, 80%, and 90% of the target volume, the mean rectal dose, minimal rectal dose, maximal rectal dose, and the volume receiving ≥45, ≥65, and ≥70 Gy. These variables, plus the status of radical prostatectomy, hormonal therapy, RT techniques, and medical conditions, were included in a multivariate logistic regression analysis. A goodness-of-fit evaluation was done using the Hosmer-Lemeshow statistic. Results: A dose-response function for acute GI toxicity was elicited. The acute GI Grade 2 or greater toxicity was lower in the definitive RT group than in the postoperative RT group (25% vs. 41%, p <0.05). Acute GU Grade 2 or greater toxicity was comparable between the two groups. No grade 3 or greater complications were observed. No dosimetric variable was significant for GU toxicity. For acute GI toxicity, the significant dosimetric parameters were the minimal dose received by 10%, 20%, and 50% of the target volume and the mean rectal dose; the most predictive parameter was the minimal dose received by 10% of the target volume. The dose-modifying factor was 1.2 for radical prostatectomy. Conclusion: The results of our

ACUTE EFFECTS OF STATIC STRETCHING, DYNAMIC EXERCISES, AND HIGH VOLUME UPPER EXTREMITY PLYOMETRIC ACTIVITY ON TENNIS SERVE PERFORMANCE

Directory of Open Access Journals (Sweden)

Ertugrul Gelen

2012-12-01

Full Text Available The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg performed 4 different warm-up (WU routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice (TRAD; traditional WU and static stretching (TRSS; traditional WU and dynamic exercise (TRDE; and traditional WU and high volume upper extremity plyometric activity (TRPLYP. Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p 0.05. ICCs for ball speed showed strong reliability (0.82 to 0.93 for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players.

Tokyo Guidelines 2018: surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis (with videos)

NARCIS (Netherlands)

Wakabayashi, Go; Iwashita, Yukio; Hibi, Taizo; Takada, Tadahiro; Strasberg, Steven M.; Asbun, Horacio J.; Endo, Itaru; Umezawa, Akiko; Asai, Koji; Suzuki, Kenji; Mori, Yasuhisa; Okamoto, Kohji; Pitt, Henry A.; Han, Ho-Seong; Hwang, Tsann-Long; Yoon, Yoo-Seok; Yoon, Dong-Sup; Choi, In-Seok; Huang, Wayne Shih-Wei; Giménez, Mariano Eduardo; Garden, O. James; Gouma, Dirk J.; Belli, Giulio; Dervenis, Christos; Jagannath, Palepu; Chan, Angus C. W.; Lau, Wan Yee; Liu, Keng-Hao; Su, Cheng-Hsi; Misawa, Takeyuki; Nakamura, Masafumi; Horiguchi, Akihiko; Tagaya, Nobumi; Fujioka, Shuichi; Higuchi, Ryota; Shikata, Satoru; Noguchi, Yoshinori; Ukai, Tomohiko; Yokoe, Masamichi; Cherqui, Daniel; Honda, Goro; Sugioka, Atsushi; de Santibañes, Eduardo; Supe, Avinash Nivritti; Tokumura, Hiromi; Kimura, Taizo; Yoshida, Masahiro; Mayumi, Toshihiko; Kitano, Seigo; Inomata, Masafumi; Hirata, Koichi; Sumiyama, Yoshinobu; Inui, Kazuo; Yamamoto, Masakazu

2018-01-01

In some cases, laparoscopic cholecystectomy (LC) may be difficult to perform in patients with acute cholecystitis (AC) with severe inflammation and fibrosis. The Tokyo Guidelines 2018 (TG18) expand the indications for LC under difficult conditions for each level of severity of AC. As a result of

Poor Adherence to Lung-Protective Mechanical Ventilation in Pediatric Acute Respiratory Distress Syndrome.

Science.gov (United States)

Ward, Shan L; Quinn, Carson M; Valentine, Stacey L; Sapru, Anil; Curley, Martha A Q; Willson, Douglas F; Liu, Kathleen D; Matthay, Michael A; Flori, Heidi R

2016-10-01

To determine the frequency of low-tidal volume ventilation in pediatric acute respiratory distress syndrome and assess if any demographic or clinical factors improve low-tidal volume ventilation adherence. Descriptive post hoc analysis of four multicenter pediatric acute respiratory distress syndrome studies. Twenty-six academic PICU. Three hundred fifteen pediatric acute respiratory distress syndrome patients. All patients who received conventional mechanical ventilation at hours 0 and 24 of pediatric acute respiratory distress syndrome who had data to calculate ideal body weight were included. Two cutoff points for low-tidal volume ventilation were assessed: less than or equal to 6.5 mL/kg of ideal body weight and less than or equal to 8 mL/kg of ideal body weight. Of 555 patients, we excluded 240 for other respiratory support modes or missing data. The remaining 315 patients had a median PaO2-to-FIO2 ratio of 140 (interquartile range, 90-201), and there were no differences in demographics between those who did and did not receive low-tidal volume ventilation. With tidal volume cutoff of less than or equal to 6.5 mL/kg of ideal body weight, the adherence rate was 32% at hour 0 and 33% at hour 24. A low-tidal volume ventilation cutoff of tidal volume less than or equal to 8 mL/kg of ideal body weight resulted in an adherence rate of 58% at hour 0 and 60% at hour 24. Low-tidal volume ventilation use was no different by severity of pediatric acute respiratory distress syndrome nor did adherence improve over time. At hour 0, overweight children were less likely to receive low-tidal volume ventilation less than or equal to 6.5 mL/kg ideal body weight (11% overweight vs 38% nonoverweight; p = 0.02); no difference was noted by hour 24. Furthermore, in the overweight group, using admission weight instead of ideal body weight resulted in misclassification of up to 14% of patients as receiving low-tidal volume ventilation when they actually were not. Low

Self-expanding stent-assisted middle cerebral artery recanalization: technical note

International Nuclear Information System (INIS)

Sauvageau, Eric; Levy, Elad I.

2006-01-01

Investigation into pharmacological and mechanical means of improving recanalization rates by intraarterial therapy has led to technological development. Angiographic recanalization has been associated with improvement in clinical outcome. A clot retriever has recently joined an imperfect armamentarium for intraarterial stroke therapy. In this report, we describe successful recanalization of an acute thrombotic occlusion of the inferior division of the middle cerebral artery (MCA) achieved with a self-expanding stent. An 82-year-old woman with a history of coronary atherosclerosis and previous cerebellar hemorrhage presented with a National Institutes of Health Stroke Scale (NIHSS) score of 11. Perfusion computed tomography imaging showed a left MCA territory deficit. Diffusion-weighted magnetic resonance (MR) imaging revealed a small punctiform insular hyperintensity. Angiography documented occlusion of the inferior division of the left MCA (Thrombolysis in Myocardial Infarction or Thrombolysis in Cerebral Infarction, TIMI/TICI, grade 0). Intraarterial delivery of eptifibatide to the occlusion site failed to recanalize the vessel. Deployment of a self-expanding stent in the occluded segment resulted in complete revascularization of the distal vascular bed. Angiography performed on the next day confirmed patency of the stented vessel segment (TIMI/TICI 3). The patient was discharged 3 days after the procedure (NIHSS 3). MR angiography obtained 3 months after the procedure documented left MCA patency. This technique may have a role worthy of further investigation in acute stroke therapy. (orig.)

Positive outcome of average volume-assured pressure support mode of a Respironics V60 Ventilator in acute exacerbation of chronic obstructive pulmonary disease: a case report

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Okuda Miyuki

2012-09-01

Full Text Available Abstract Introduction We were able to treat a patient with acute exacerbation of chronic obstructive pulmonary disease who also suffered from sleep-disordered breathing by using the average volume-assured pressure support mode of a Respironics V60 Ventilator (Philips Respironics: United States. This allows a target tidal volume to be set based on automatic changes in inspiratory positive airway pressure. This removed the need to change the noninvasive positive pressure ventilation settings during the day and during sleep. The Respironics V60 Ventilator, in the average volume-assured pressure support mode, was attached to our patient and improved and stabilized his sleep-related hypoventilation by automatically adjusting force to within an acceptable range. Case presentation Our patient was a 74-year-old Japanese man who was hospitalized for treatment due to worsening of dyspnea and hypoxemia. He was diagnosed with acute exacerbation of chronic obstructive pulmonary disease and full-time biphasic positive airway pressure support ventilation was initiated. Our patient was temporarily provided with portable noninvasive positive pressure ventilation at night-time following an improvement in his condition, but his chronic obstructive pulmonary disease again worsened due to the recurrence of a respiratory infection. During the initial exacerbation, his tidal volume was significantly lower during sleep (378.9 ± 72.9mL than while awake (446.5 ± 63.3mL. A ventilator that allows ventilation to be maintained by automatically adjusting the inspiratory force to within an acceptable range was attached in average volume-assured pressure support mode, improving his sleep-related hypoventilation, which is often associated with the use of the Respironics V60 Ventilator. Polysomnography performed while our patient was on noninvasive positive pressure ventilation revealed obstructive sleep apnea syndrome (apnea-hypopnea index = 14, suggesting that his chronic

Emergent intracranial balloon angioplasty and bailout self-expandable stent placement in acute large vessel occlusion of the anterior circulation: Experience of a single institution

International Nuclear Information System (INIS)

Heo, Young Jin; Seo, Jung Hwa; Jeong, Hae Woong

2017-01-01

To evaluate the outcomes of angioplasty for recanalization after acute ischemic stroke (AIS). The study population was selected from 134 patients who underwent endovascular revascularization therapy (ERT) for AIS between October 2011 and May 2014. Of those 134 patients, 39 who underwent balloon angioplasty with or without stent insertion were included in this study. Balloon angioplasty was the primary treatment for nine patients and a rescue method for 30 patients. The revascularization rate at 7 days, procedure-related complications, and clinical outcomes at 3 months were analyzed. The occlusion sites were the middle cerebral artery (n = 26), intracranial internal carotid artery (n = 10), and middle cerebral artery branch (n = 3). Angioplasty achieved successful revascularization (Thrombolysis in Cerebral Ischemia grade 2b–3) in 76.9% of patients. Computed tomography angiography performed 7 days post-procedure revealed a maintained reperfusion in 82.8% of successful cases. Only two patients had symptomatic intracerebral hemorrhage. At the 3-month follow-up, 18 (48.6%) and 10 (27.0%) patients showed good and poor functional outcomes, respectively (modified Rankin Scale scores, 0–2 and 5–6). Emergent balloon angioplasty and bailout self-expandable stent placement may be safe and effective for achieving successful revascularization in acute large vessel occlusion of the anterior circulation. It could be a feasible rescue method as well as a primary method for ERT

Emergent intracranial balloon angioplasty and bailout self-expandable stent placement in acute large vessel occlusion of the anterior circulation: Experience of a single institution

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Heo, Young Jin; Seo, Jung Hwa; Jeong, Hae Woong [Busan Paik Hospital, Inje University, Busan (Korea, Republic of)

2017-06-15

To evaluate the outcomes of angioplasty for recanalization after acute ischemic stroke (AIS). The study population was selected from 134 patients who underwent endovascular revascularization therapy (ERT) for AIS between October 2011 and May 2014. Of those 134 patients, 39 who underwent balloon angioplasty with or without stent insertion were included in this study. Balloon angioplasty was the primary treatment for nine patients and a rescue method for 30 patients. The revascularization rate at 7 days, procedure-related complications, and clinical outcomes at 3 months were analyzed. The occlusion sites were the middle cerebral artery (n = 26), intracranial internal carotid artery (n = 10), and middle cerebral artery branch (n = 3). Angioplasty achieved successful revascularization (Thrombolysis in Cerebral Ischemia grade 2b–3) in 76.9% of patients. Computed tomography angiography performed 7 days post-procedure revealed a maintained reperfusion in 82.8% of successful cases. Only two patients had symptomatic intracerebral hemorrhage. At the 3-month follow-up, 18 (48.6%) and 10 (27.0%) patients showed good and poor functional outcomes, respectively (modified Rankin Scale scores, 0–2 and 5–6). Emergent balloon angioplasty and bailout self-expandable stent placement may be safe and effective for achieving successful revascularization in acute large vessel occlusion of the anterior circulation. It could be a feasible rescue method as well as a primary method for ERT.

Management of acute cholangitis as a result of occlusion from a self-expandable metallic stent in patients with malignant distal and hilar biliary obstructions.

Science.gov (United States)

Shiomi, Hideyuki; Matsumoto, Kazuya; Isayama, Hiroyuki

2017-04-01

Acute cholangitis as a result of common bile duct stones can be managed; however, cholangitis caused by occlusion with a biliary self-expandable metallic stent (SEMS) in patients with an unresectable malignant biliary obstruction has not been fully discussed. The acute cholangitis clinical guidelines (Tokyo Guidelines 2013) recommend following the same procedure as that used for cholangitis; however, the patient's condition, including performance status, tumor extension or staging, and prognosis must be considered. Most physicians manage cholangitis from a SEMS occlusion using a two-step procedure. They insert endoscopic drainage with a plastic stent or insert a nasobiliary drainage tube, which does not exacerbate sepsis. Addition or replacement of a biliary SEMS is required in many cases depending on the cause of the occlusion. Tumor ingrowth through the stent mesh is common in uncovered SEMS and requires placement of another stent in an in-stent method. However, covered SEMS tends to be occluded by sludge, so it must be replaced because of the bacterial biofilm that forms on the covering membrane. The location of the biliary stricture (hilar or distal) should also be considered. Strategies for managing cholangitis as a result of occlusion by a biliary SEMS remain controversial, so prospective clinical trials are needed. © 2017 The Authors. Digestive Endoscopy © 2017 Japan Gastroenterological Endoscopy Society.

Acellular dermal matrix slings in tissue expander breast reconstruction: are there substantial benefits?

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Collis, George N; TerKonda, Sarvam P; Waldorf, James C; Perdikis, Galen

2012-05-01

Acellular dermal matrix (ADM) slings in breast reconstruction are increasingly used but are not yet validated. This study compares immediate, expander-based breast reconstruction with and without the use of inferolateral ADM slings. There were 63 patients (106 breasts) in the ADM group and 42 patients (68 breasts) in the control group. Initial intraoperative fill volumes were significantly greater in the ADM group, median 69% full (250 mL) versus 50% full (180 mL; P < 0.001). However, the number of days to complete expansion between the 2 groups was similar. One less office visit was required to complete the fills in the ADM group (P < 0.01). Drains were removed 3 days later in the ADM group (P < 0.01). Overall complication rate was greater in the ADM group (18.9% vs. 7.4%, P < 0.05), with a slightly higher percentage of expanders requiring removal due to infection in the ADM group (5.7% vs. 4.4%, P = NS). This study suggests inferolateral ADM slings in expander-based breast reconstruction allow for significantly increased initial fill volumes and may offer an aesthetic advantage; however, its use is costly and increases complications.

Acute post-exercise myofibrillar protein synthesis is not correlated with resistance training-induced muscle hypertrophy in young men.

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Cameron J Mitchell

Full Text Available Muscle hypertrophy following resistance training (RT involves activation of myofibrillar protein synthesis (MPS to expand the myofibrillar protein pool. The degree of hypertrophy following RT is, however, highly variable and thus we sought to determine the relationship between the acute activation of MPS and RT-induced hypertrophy. We measured MPS and signalling protein activation after the first session of resistance exercise (RE in untrained men (n = 23 and then examined the relation between MPS with magnetic resonance image determined hypertrophy. To measure MPS, young men (24±1 yr; body mass index  = 26.4±0.9 kg•m² underwent a primed constant infusion of L-[ring-¹³C₆] phenylalanine to measure MPS at rest, and acutely following their first bout of RE prior to 16 wk of RT. Rates of MPS were increased 235±38% (P<0.001 above rest 60-180 min post-exercise and 184±28% (P = 0.037 180-360 min post exercise. Quadriceps volume increased 7.9±1.6% (-1.9-24.7% (P<0.001 after training. There was no correlation between changes in quadriceps muscle volume and acute rates of MPS measured over 1-3 h (r = 0.02, 3-6 h (r = 0.16 or the aggregate 1-6 h post-exercise period (r = 0.10. Hypertrophy after chronic RT was correlated (r = 0.42, P = 0.05 with phosphorylation of 4E-BP1(Thr37/46 at 1 hour post RE. We conclude that acute measures of MPS following an initial exposure to RE in novices are not correlated with muscle hypertrophy following chronic RT.

Myosin dephosphorylation during rapid relaxation of hog carotid artery smooth muscle.

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Driska, S P; Stein, P G; Porter, R

1989-02-01

Changes in myosin light chain phosphorylation were measured during histamine-induced rhythmic contractions of hog carotid artery smooth muscle strips. Histamine made the muscle strips contract spontaneously every 1-5 min, and this allowed measurement of the time course of phosphorylation in relation to force development under conditions where diffusion of the agonist through tissue would not complicate the interpretation of the data. In the absence of histamine, phosphorylation was low [0.12 +/- 0.04 mol P/mol of the 20,000-Da light chain (LC 20)]. Phosphorylation was slightly (but not significantly) higher in the presence of 10 microM histamine in the relaxed state between contractions (0.20 +/- 0.03 mol P/mol LC 20). In muscle strips frozen during force development, when force had reached half of its peak value, phosphorylation was 0.38 +/- 0.06 mol P/mol LC 20. The highest levels of phosphorylation (0.49 +/- 0.04 mol P/mol LC 20) were found in strips frozen at the peak of the rhythmic contractions. Strips frozen when force had declined to half of the peak force showed low levels of phosphorylation (0.17 +/- 0.07 mol P/mol LC 20), indicating that the myosin light chain phosphatase activity was quite high. Mathematical modeling of the kinase and phosphatase reactions suggested that the apparent first-order phosphatase rate constant was at least 0.08 s-1 under these conditions. To obtain a better estimate of this rate constant, a second series of phosphorylation measurements were made early in the relaxation phase of the rhythmic contractions. The highest phosphatase rate constant obtained from these measurements was 0.23 s-1.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute exercise improves motor memory

DEFF Research Database (Denmark)

Skriver, Kasper Christen; Roig, Marc; Lundbye-Jensen, Jesper

2014-01-01

We have recently shown that a single bout of acute cardiovascular exercise improves motor skill learning through an optimization of long-term motor memory. Here we expand this previous finding, to explore potential exercise-related biomarkers and their association with measures of motor memory...... practice whereas lactate correlated with better retention 1 hour as well as 24 hours and 7 days after practice. Thus, improvements in motor skill acquisition and retention induced by acute cardiovascular exercise are associated with increased concentrations of biomarkers involved in memory and learning...... processes. More mechanistic studies are required to elucidate the specific role of each biomarker in the formation of motor memory....

Palliative self-expandable metal stents for acute malignant colorectal obstruction: clinical outcomes and risk factors for complications.

Science.gov (United States)

Han, Jae Pil; Hong, Su Jin; Kim, Shin Hee; Choi, Jong Hyo; Jung, Hee Jae; Cho, Youn Hee; Ko, Bong Min; Lee, Moon Sung

2014-08-01

Self-expandable metal stents (SEMSs) have been used as palliative treatment or bridge to surgery for obstructions caused by colorectal cancer (CRC). We assessed the long-term outcomes of palliative SEMSs and evaluated the risk factors influencing complications. One hundred and seventy-five patients underwent SEMS placement for acute malignant colorectal obstruction. Of the 72 patients who underwent palliative treatment for primary CRC, 30 patients received chemotherapy (CT) for primary cancer (CT group) and 42 underwent best supportive treatment (BST) without CT (BST group). There was a significant difference in late migration between the CT group and the BST group (20.0% in CT group, 2.4% in BST group, p = 0.018). Response to CT influenced the rate of late obstruction (0% in disease control, 35.7% in disease progression, p = 0.014). However, late obstruction was not associated with stent properties, such as diameter or type (≤22 mm vs. >22 mm, 13.5% vs. 14.3%, p = 1.00; uncovered stent vs. covered stent, 15.5% vs. 7.1%, p = 0.675) and migration (≤22 mm vs. >22 mm, 16.2% vs. 2.9%, p = 0.108; uncovered stent vs. covered stent, 8.6% vs. 14.3%, p = 0.615) in palliative SEMS. The administration of CT increases the rate of stent migration, and disease control by CT can reduce the risk of obstruction by maintaining the luminal patency of palliative SEMSs.

Acute Disseminated Encephalomyelitis following Vaccination against Hepatitis B in a Child: A Case Report and Literature Review

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Jun-liang Yuan

2016-01-01

Full Text Available Acute disseminated encephalomyelitis (ADEM is an inflammatory demyelinating disease of the central nervous system, which has been associated with several vaccines such as rabies, diphtheria-tetanus-polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, and the Hog vaccine. Here, we presented a case of 12-year-old child who suffered from ADEM three weeks after hepatitis B vaccination. He was admitted to our hospital with symptoms of weakness of limbs, high fever, and alteration of consciousness. Some abnormalities were also found in CSF. Treatment with high-dose corticosteroids and intravenous immunoglobulin had significant effect, with marked improvement of the clinical symptoms and the results of CSF. The findings of MRI also detected some abnormal lesions located in both brain and spinal cord. The clinical features, the findings of CSF and MRI, and therapeutic effect may contribute to such diagnosis of ADEM.

Nuclear medicine in acute and chronic renal failure

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Sherman, R.A.; Byun, K.J.

1982-07-01

The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. /sup 131/I OIH, /sup 67/gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease.

Nuclear medicine in acute and chronic renal failure

International Nuclear Information System (INIS)

Sherman, R.A.; Byun, K.J.

1982-01-01

The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131 I OIH, 67 gallium, /sup 99m/TcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease

77 FR 49011 - Texas Mid-Coast National Wildlife Refuge Complex, Brazoria, Fort Bend, Matagorda, and Wharton...

Science.gov (United States)

2012-08-15

... all three moist soil units into Brazoria NWR and refuges. farming rotation at eliminate farming at... partnerships and to moist soil units structures. purchase of water during drought rights; expand periods; and... release natural but diversify the (Fauna). hogs. Baiting and predators to control types of management...

Left Atrial Volume Index and Prediction of Events in Acute Coronary Syndrome: Solar Registry

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Jose Alves Secundo Junior

2014-10-01

Full Text Available Background: According to some international studies, patients with acute coronary syndrome (ACS and increased left atrial volume index (LAVI have worse long-term prognosis. However, national Brazilian studies confirming this prediction are still lacking. Objective: To evaluate LAVI as a predictor of major cardiovascular events (MCE in patients with ACS during a 365-day follow-up. Methods: Prospective cohort of 171 patients diagnosed with ACS whose LAVI was calculated within 48 hours after hospital admission. According to LAVI, two groups were categorized: normal LAVI (≤ 32 mL/m2 and increased LAVI (> 32 mL/m2. Both groups were compared regarding clinical and echocardiographic characteristics, in- and out-of-hospital outcomes, and occurrence of ECM in up to 365 days. Results: Increased LAVI was observed in 78 patients (45%, and was associated with older age, higher body mass index, hypertension, history of myocardial infarction and previous angioplasty, and lower creatinine clearance and ejection fraction. During hospitalization, acute pulmonary edema was more frequent in patients with increased LAVI (14.1% vs. 4.3%, p = 0.024. After discharge, the occurrence of combined outcome for MCE was higher (p = 0.001 in the group with increased LAVI (26% as compared to the normal LAVI group (7% [RR (95% CI = 3.46 (1.54-7.73 vs. 0.80 (0.69-0.92]. After Cox regression, increased LAVI increased the probability of MCE (HR = 3.08, 95% CI = 1.28-7.40, p = 0.012. Conclusion: Increased LAVI is an important predictor of MCE in a one-year follow-up.

Plasma volume changes during hypoglycaemia

DEFF Research Database (Denmark)

Hilsted, J; Bendtsen, F; Christensen, N J

1990-01-01

To investigate whether previously reported changes in venous blood volume and composition induced by acute hypoglycaemia in humans are representative for the entire body we measured erythrocyte 51Cr content, haematocrit, plasma volume, intravascular albumin content and transcapillary escape rate...... of albumin in arterial and venous blood in seven healthy subjects before and during insulin-induced hypoglycaemia. In both vascular sites blood 51Cr content and the haematocrit increased, plasma volume and intravascular albumin content decreased and the transcapillary escape rate of albumin increased during...

Acute post-exercise myofibrillar protein synthesis is not correlated with resistance training-induced muscle hypertrophy in young men.

Science.gov (United States)

Mitchell, Cameron J; Churchward-Venne, Tyler A; Parise, Gianni; Bellamy, Leeann; Baker, Steven K; Smith, Kenneth; Atherton, Philip J; Phillips, Stuart M

2014-01-01

Muscle hypertrophy following resistance training (RT) involves activation of myofibrillar protein synthesis (MPS) to expand the myofibrillar protein pool. The degree of hypertrophy following RT is, however, highly variable and thus we sought to determine the relationship between the acute activation of MPS and RT-induced hypertrophy. We measured MPS and signalling protein activation after the first session of resistance exercise (RE) in untrained men (n = 23) and then examined the relation between MPS with magnetic resonance image determined hypertrophy. To measure MPS, young men (24±1 yr; body mass index  = 26.4±0.9 kg•m²) underwent a primed constant infusion of L-[ring-¹³C₆] phenylalanine to measure MPS at rest, and acutely following their first bout of RE prior to 16 wk of RT. Rates of MPS were increased 235±38% (Pmuscle volume and acute rates of MPS measured over 1-3 h (r = 0.02), 3-6 h (r = 0.16) or the aggregate 1-6 h post-exercise period (r = 0.10). Hypertrophy after chronic RT was correlated (r = 0.42, P = 0.05) with phosphorylation of 4E-BP1(Thr37/46) at 1 hour post RE. We conclude that acute measures of MPS following an initial exposure to RE in novices are not correlated with muscle hypertrophy following chronic RT.

Significance of left ventricular volume measurement after heart transplantation using radionuclide techniques

International Nuclear Information System (INIS)

Novitzky, D.; Cooper, D.; Boniaszczuk, J.

1985-01-01

Multigated equilibrium blood pool scanning using Technetium 99m labeled red blood cells was used to measure left ventricular volumes in three heterotopic and one orthotopic heart transplant recipient(s). Simultaneously, an endomyocardial biopsy was performed and the degree of acute rejection was assessed by a histological scoring system. The scores were correlated to changes in ejection fraction and heart rate. Technetium 99m scanning data were pooled according to the endomyocardial biopsy score: no rejection; mild rejection; moderate rejection, and severe rejection. In each group, the median of the left ventricular volume parameters was calculated and correlated with the endomyocardial biopsy score, using a non-parametric one-way analysis of variance. A decrease in stroke volume correlated best with the endomyocardial biopsy score during acute rejection. A decrease in end-diastolic left ventricular volumes did not correlate as well. Changes in the end-systolic left ventricular volumes were not statistically significant, but using a simple correlation between end-systolic left ventricular volumes and endomyocardial biopsy the correlation reached significance. Changes in left ventricular volumes measured by Technetium 99m scanning may be useful to confirm the presence or absence of acute rejection in patients with heart grafts

Effect of volume expansion on systemic hemodynamics and central and arterial blood volume in cirrhosis

DEFF Research Database (Denmark)

Møller, S; Bendtsen, F; Henriksen, Jens Henrik Sahl

1995-01-01

, and arterial pressure were determined before and during a volume expansion induced by infusion of a hyperosmotic galactose solution. RESULTS: During volume expansion, the central and arterial blood volume increased significantly in patients with class A and controls, whereas no significant change was found...... in patients with either class B or class C. Conversely, the noncentral blood volume increased in patients with class B and C. In both patients and controls, the cardiac output increased and the systemic vascular resistance decreased, whereas the mean arterial blood pressure did not change significantly......BACKGROUND & AIMS: Systemic vasodilatation in cirrhosis may lead to hemodynamic alterations with reduced effective blood volume and decreased arterial blood pressure. This study investigates the response of acute volume expansion on hemodynamics and regional blood volumes in patients with cirrhosis...

Transfusion related acute lung injury presenting with acute dyspnoea: a case report

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Haji Altaf

2008-10-01

Full Text Available Abstract Introduction Transfusion-related acute lung injury is emerging as a common cause of transfusion-related adverse events. However, awareness about this entity in the medical fraternity is low and it, consequently, remains a very under-reported and often an under-diagnosed complication of transfusion therapy. Case presentation We report a case of a 46-year old woman who developed acute respiratory and hemodynamic instability following a single unit blood transfusion in the postoperative period. Investigation results were non-specific and a diagnosis of transfusion-related acute lung injury was made after excluding other possible causes of acute lung injury. She responded to symptomatic management with ventilatory and vasopressor support and recovered completely over the next 72 hours. Conclusion The diagnosis of transfusion-related acute lung injury relies on excluding other causes of acute pulmonary edema following transfusion, such as sepsis, volume overload, and cardiogenic pulmonary edema. All plasma containing blood products have been implicated in transfusion-related acute lung injury, with the majority being linked to whole blood, packed red blood cells, platelets, and fresh-frozen plasma. The pathogenesis of transfusion-related acute lung injury may be explained by a "two-hit" hypothesis, involving priming of the inflammatory machinery and then activation of this primed mechanism. Treatment is supportive, with prognosis being substantially better than for most other causes of acute lung injury.

Prehospital tidal volume influences hospital tidal volume: A cohort study.

Science.gov (United States)

Stoltze, Andrew J; Wong, Terrence S; Harland, Karisa K; Ahmed, Azeemuddin; Fuller, Brian M; Mohr, Nicholas M

2015-06-01

The purposes of the study are to describe current practice of ventilation in a modern air medical system and to measure the association of ventilation strategy with subsequent ventilator care and acute respiratory distress syndrome (ARDS). Retrospective observational cohort study of intubated adult patients (n = 235) transported by a university-affiliated air medical transport service to a 711-bed tertiary academic center between July 2011 and May 2013. Low tidal volume ventilation was defined as tidal volumes less than or equal to 8 mL/kg predicted body weight. Multivariable regression was used to measure the association between prehospital tidal volume, hospital ventilation strategy, and ARDS. Most patients (57%) were ventilated solely with bag valve ventilation during transport. Mean tidal volume of mechanically ventilated patients was 8.6 mL/kg predicted body weight (SD, 0.2 mL/kg). Low tidal volume ventilation was used in 13% of patients. Patients receiving low tidal volume ventilation during air medical transport were more likely to receive low tidal volume ventilation in the emergency department (P tidal volume (P = .840). Low tidal volume ventilation was rare during air medical transport. Air transport ventilation strategy influenced subsequent ventilation but was not associated with ARDS. Copyright © 2015 Elsevier Inc. All rights reserved.

Downstream shift in sodium pump activity along the nephron during acute hypertension

DEFF Research Database (Denmark)

Magyar, C E; Zhang, Y; Holstein-Rathlou, N H

2001-01-01

Acute hypertension rapidly inhibits proximal tubule (PT) Na,K-ATPase activity and sodium reabsorption 30 to 40%, increasing sodium and volume delivery to the thick ascending loop of Henle (TALH) and macula densa, providing the error signal for tubuloglomerular feedback. The hypothesis was tested...... in rats that an acute increase in sodium and volume delivery to the TALH would acutely increase outer medulla Na,K-ATPase activity. Flow to the TALH was increased by either (1) elevating BP (102 to 160 mmHg) for 5 min by constricting arteries (hypertension) or (2) inhibiting PT sodium and volume...... reabsorption with the carbonic anhydrase inhibitor benzolamide: 2 mg/kg in 300 mM NaHCO(3) at 50 microl/min for 5 to 7 min. Both stimuli increased urine output and lithium clearance three- to four-fold and increased basolateral Na,K-ATPase activity about 40%. In homogenates, acute hypertension increased...

Tissue expander infections in children: look beyond the expander pocket.

Science.gov (United States)

Mason, A C; Davison, S P; Manders, E K

1999-11-01

Infection of the expander pocket is the most common complication encountered with soft-tissue expansion. It is usually due to direct inoculation with skin flora either at the time of expander insertion or from extrusion of the device. The authors report two cases of infection of tissue expanders in which the children had concomitant infected sites distant from the prosthesis. Etiological bacteria of common pediatric infections like otitis media and pharyngitis were cultured from the infected expander pocket, raising suspicion that translocation of the organism to the expander had occurred. Aggressive antibiotic treatment, removal of the prosthesis, and flap advancement is advocated.

Pharmacologic therapy for acute pancreatitis

Science.gov (United States)

Kambhampati, Swetha; Park, Walter; Habtezion, Aida

2014-01-01

While conservative management such as fluid, bowel rest, and antibiotics is the mainstay of current acute pancreatitis management, there is a lot of promise in pharmacologic therapies that target various aspects of the pathogenesis of pancreatitis. Extensive review of preclinical studies, which include assessment of therapies such as anti-secretory agents, protease inhibitors, anti-inflammatory agents, and anti-oxidants are discussed. Many of these studies have shown therapeutic benefit and improved survival in experimental models. Based on available preclinical studies, we discuss potential novel targeted pharmacologic approaches that may offer promise in the treatment of acute pancreatitis. To date a variety of clinical studies have assessed the translational potential of animal model effective experimental therapies and have shown either failure or mixed results in human studies. Despite these discouraging clinical studies, there is a great clinical need and there exist several preclinical effective therapies that await investigation in patients. Better understanding of acute pancreatitis pathophysiology and lessons learned from past clinical studies are likely to offer a great foundation upon which to expand future therapies in acute pancreatitis. PMID:25493000

Feeding habits of Molina's hog-nosed skunk, Conepatus chinga (Carnivora: Mephitidae in the extreme south of Brazil

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Felipe Bortolotto Peters

2011-04-01

Full Text Available Feeding habits of the Molina's hog-nosed skunk, Conepatus chinga (Molina, 1782 in the extreme south of Brazil. We analyzed 60 stomachs of road-kills of C. chinga in the extreme south of Brazil. The contents revealed 808 prey parts, including invertebrates (frequency of occurrence - FO = 96.7% and relative abundance - RA = 94.7%, vertebrates (FO = 18.3% and RA = 2.8% and plants (FO = 31.7% and RA = 2.3%. We identified 18 kinds of food, including the invertebrate order Coleoptera which showed the highest FO (86.7% and RA (75.2%. Other important orders were Orthoptera (FO = 35% and RA = 10.4% and Araneae (FO = 41.7% and RA = 4%. The combination of occurrence and abundance of the preys consumed allowed classifying C. chinga as an omnivorous with a predominance of insects, especially Coleoptera, consuming other invertebrates, vertebrates and plants in smaller numbers. Behavioral and morphological adaptations of C. chinga favor the predation of insects, which are preys that offer low physical resistance and are available in all terrestrial environments.

Distribution of the Multidrug Resistance Gene cfr in Staphylococcus Isolates from Pigs, Workers, and the Environment of a Hog Market and a Slaughterhouse in Guangzhou, China.

Science.gov (United States)

Wang, Jing; Lin, Da-Chuan; Guo, Xiao-Mu; Wei, Hong-Kun; Liu, Xiao-Qin; Chen, Xiao-Jie; Guo, Jian-Ying; Zeng, Zhen-Ling; Liu, Jian-Hua

2015-07-01

Bacteria harboring cfr, a multidrug resistance gene, have high prevalence in livestock in China and might be transmitted to humans through direct contact or via contaminated food products. To better understand the epidemiology of cfr producers in the food chain, the prevalence and genetic analysis of Staphylococcus isolates recovered from pigs, workers, and meat-handling facilities (a slaughterhouse and a hog market in Guangzhou, China) were examined. Twenty (4.5%) cfr-positive Staphylococcus isolates (18 Staphylococcus simulans, 1 S. cohnii, and 1 S. aureus) were derived from pigs (16/312), the environment (2/52), and workers (2/80). SmaI pulsed-field gel electrophoresis of 26 staphylococcal strains (22 S. simulans and 4 S. cohnii), including previously reported cfr-carrying staphylococci of animal food origin, exhibited 19 major pulsed-field gel electrophoresis patterns (A-S). Clonal spread of cfr-carrying staphylococci among pigs, workers, and meat products was detected. The genetic contexts of cfr in plasmids (pHNKF3, pHNZT2, and pHNCR35) obtained from S. simulans of swine or human origin were similar to that of Staphylococcus species isolated from human clinics and animal-derived food. The cfr-carrying S. aureus strain isolated from floor swabs of the hog market was spa-type t889 and belonged to the ST9 clonal lineage. In summary, both clonal spread and horizontal transmission via mobile elements contributed to cfr dissemination among staphylococcal isolates obtained from different sources. To monitor potential outbreaks of cfr-positive bacteria, continued surveillance of this gene in animals at slaughter and in animal-derived food is warranted.

Reachable volume RRT

KAUST Repository

McMahon, Troy

2015-05-01

© 2015 IEEE. Reachable volumes are a new technique that allows one to efficiently restrict sampling to feasible/reachable regions of the planning space even for high degree of freedom and highly constrained problems. However, they have so far only been applied to graph-based sampling-based planners. In this paper we develop the methodology to apply reachable volumes to tree-based planners such as Rapidly-Exploring Random Trees (RRTs). In particular, we propose a reachable volume RRT called RVRRT that can solve high degree of freedom problems and problems with constraints. To do so, we develop a reachable volume stepping function, a reachable volume expand function, and a distance metric based on these operations. We also present a reachable volume local planner to ensure that local paths satisfy constraints for methods such as PRMs. We show experimentally that RVRRTs can solve constrained problems with as many as 64 degrees of freedom and unconstrained problems with as many as 134 degrees of freedom. RVRRTs can solve problems more efficiently than existing methods, requiring fewer nodes and collision detection calls. We also show that it is capable of solving difficult problems that existing methods cannot.

Reachable volume RRT

KAUST Repository

McMahon, Troy; Thomas, Shawna; Amato, Nancy M.

2015-01-01

© 2015 IEEE. Reachable volumes are a new technique that allows one to efficiently restrict sampling to feasible/reachable regions of the planning space even for high degree of freedom and highly constrained problems. However, they have so far only been applied to graph-based sampling-based planners. In this paper we develop the methodology to apply reachable volumes to tree-based planners such as Rapidly-Exploring Random Trees (RRTs). In particular, we propose a reachable volume RRT called RVRRT that can solve high degree of freedom problems and problems with constraints. To do so, we develop a reachable volume stepping function, a reachable volume expand function, and a distance metric based on these operations. We also present a reachable volume local planner to ensure that local paths satisfy constraints for methods such as PRMs. We show experimentally that RVRRTs can solve constrained problems with as many as 64 degrees of freedom and unconstrained problems with as many as 134 degrees of freedom. RVRRTs can solve problems more efficiently than existing methods, requiring fewer nodes and collision detection calls. We also show that it is capable of solving difficult problems that existing methods cannot.

Large-volume multi-tined expandable RF ablation in pig livers: comparison of 2D and volumetric measurements of the ablation zone

International Nuclear Information System (INIS)

Bangard, Christopher; Roesgen, Silvia; Lackner, Klaus J.; Wahba, Roger; Stippel, Dirk L.; Wiemker, Rafael; Hellmich, Martin; Reiter, Hannah; Fischer, Juergen H.

2010-01-01

To compare two-dimensional (2D) and three-dimensional (3D) computed tomography (CT) measurements of ablation zones (AZs) related to the shaft of two different large-volume monopolar multi-tined expandable electrodes. Percutaneous radiofrequency (RF) ablation was performed in 12 pigs (81.6±7.8 kg) using two electrodes (LeVeen 5 cm, Rita XL 5 cm; n=6 in each group). Contrast-enhanced CT with the electrode shaft in place evaluated the AZ. The largest sphere centred on the electrode shaft within the AZ was calculated (1) based on the 2D axial CT image in the plane of the shaft assuming rotational symmetry of the AZ and (2) using prototype software and the 3D volume data of the AZ measured with CT. The mean largest diameter of a sphere centred on the electrode shaft was always smaller using the 3D data of the AZ than using 2D CT measurements assuming rotational symmetry of the AZ (3D vs 2D): LeVeen 18.2±4.8 mm; 24.5 ±3.1 mm; p=0.001; Rita XL 20.0±3.7 mm; 28.8±4.9 mm; p=0.0002. All AZ showed indentations around the tines. Two-dimensional CT measurements assuming rotational symmetry of the AZ overestimate the largest ablated sphere centred on the electrode shaft compared with 3D CT measurements. (orig.)

The acutely ACL injured knee assessed by MRI

DEFF Research Database (Denmark)

Frobell, R B; Roos, H P; Roos, E M

2008-01-01

OBJECTIVES: To map by magnetic resonance imaging (MRI) and quantitative MRI (qMRI) concomitant fractures and meniscal injuries, and location and volume of traumatic bone marrow lesions (BMLs) in the acutely anterior cruciate ligament (ACL) injured knee. To relate BML location and volume to cortic...

Preventive Ethics Through Expanding Education.

Science.gov (United States)

Ho, Anita; MacDonald, Lisa Mei-Hwa; Unger, David

2016-03-01

Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers' schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.

Comparison of Laparoscopic versus Open Surgery after Insertion of Self-Expandable Metallic Stents in Acute Malignant Colorectal Obstruction: A Case-Matched Study

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Chotirot Angkurawaranon

2017-03-01

Full Text Available Background: Self-expanding metallic stents (SEMS have been acknowledged in management of acute colorectal obstruction. The surgical approach after SEMS insertion varies from open approach to laparoscopic-assisted approach. The primary objective of this study was to compare the outcomes of laparoscopic approach and open approach after SEMS insertion. Methods: From January 2007 to December 2010, cross-sectional medical records reviewed a total of 76 patients who underwent colorectal stenting with SEMS. Patients and tumor characteristics, complications, morbidity and mortality were obtained. Results: Forty-three patients underwent SEMS placement as a bridge to surgery. Laparoscopic-assisted surgery (LS was performed in 24 patients (55.8%, and open surgery (OS was performed in 19 patients (44.2%. All clinicopathological parameters were matched. The technical success of SEMS was found in 42 patients (97.7%, and the clinical stent success was 100%. LS had a higher chance of primary anastomosis than OS (p=0.012; Odd ratio 2.717; 95%CI: 1.79-4.012. LS had a lower permanent ostomy rate (p=0.031; Odd ratio 0.385; 95%CI: 0.259-0.572 and lower estimated blood loss (p=0.024; Odd ratio 0.23; 95%CI: 0.006-0.086. The post-operative complications, mortality rate, recurrence rate, disease free status, and overall survival rates between the two groups were non-significant. Conclusion: Colonic stent is an effective treatment of acute malignant colonic obstruction. The authors suggest the advantage of laparoscopic approach resection after colonic stenting results in a higher primary anastomosis rate, and lower blood loss than open surgery.

Minimally Invasive Surgical Treatment of Acute Epidural Hematoma: Case Series

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Weijun Wang

2016-01-01

Full Text Available Background and Objective. Although minimally invasive surgical treatment of acute epidural hematoma attracts increasing attention, no generalized indications for the surgery have been adopted. This study aimed to evaluate the effects of minimally invasive surgery in acute epidural hematoma with various hematoma volumes. Methods. Minimally invasive puncture and aspiration surgery were performed in 59 cases of acute epidural hematoma with various hematoma volumes (13–145 mL; postoperative follow-up was 3 months. Clinical data, including surgical trauma, surgery time, complications, and outcome of hematoma drainage, recovery, and Barthel index scores, were assessed, as well as treatment outcome. Results. Surgical trauma was minimal and surgery time was short (10–20 minutes; no anesthesia accidents or surgical complications occurred. Two patients died. Drainage was completed within 7 days in the remaining 57 cases. Barthel index scores of ADL were ≤40 (n=1, 41–60 (n=1, and >60 (n=55; scores of 100 were obtained in 48 cases, with no dysfunctions. Conclusion. Satisfactory results can be achieved with minimally invasive surgery in treating acute epidural hematoma with hematoma volumes ranging from 13 to 145 mL. For patients with hematoma volume >50 mL and even cerebral herniation, flexible application of minimally invasive surgery would help improve treatment efficacy.

Acute toxicity of chemoradiation therapy (CRT) for rectal cancer: Impact of irradiated volume, type of surgery, sex and sequence of treatment modalities

International Nuclear Information System (INIS)

Fietkau, R.; Roedel, C.; Grabenbauer, G.G.; Kessler, H.; Martus, P.; Sauer, R.

1996-01-01

Purpose: In an attempt to reduce acute toxicity of CRT for rectal cancer we retrospectively evaluated potential factors that influence the severity of toxic side-effects. Materials and Methods: Between 1987 and 1995, 120 patients (pts, 73 with primary tumor, 47 with recurrent disease) received CRT for rectal cancer. RT was given by 3-4 field box technique with 6-10 MV-photons. Daily fraction size was 180 cGy, total dose 5040 cGy including 540 cGy local boost. Dose was specified to the ICRU reference point. During the first and fifth week of RT 5-FU (1000 mg/m 2 /24 h) was administered by continuous infusion for 120 hours. 56 pts received preoperative CRT, 64 pts were treated postoperatively. Toxicity was recorded following (modified) WHO-criteria. Results: Acute grade 4 toxicity was limited to 3 pts (leukopenia, sepsis, arrhythmia). Acute grade 3 toxicity occurred mainly as diarrhea (33%), perineal skin reaction (37%), and leukopenia (9%). Extension of the treatment volume including paraaortic lymph nodes (L3) led to a significant increase of grade 3 diarrhea (68% vs. 25%, p = 0,0003) and grade 3 leukopenia (18% vs. 8%, p = 0,03). After abdominoperineal resection less pts suffered from grade 3 diarrhea (8% vs. 47% after sphincter-preserving procedures, p = 0,0006), whereas severe perineal erythema occurred more frequently (56% vs. 29%, p = 0,02). Women had significantly more toxic side effects (grade 3 diarrhea: 39% vs. 16% in men, p = 0.04; grade 2 to 3 nausea/emesis: 21% vs. 8% in men, p = 0.018; grade 2 to 3 leukopenia: 53% vs. 31% in men, p = 0, 02). After preoperative CRT a significant reduction of grade 3 diarrhea (11% vs. 29%, p = 0.03) and grade 3 erythema (16% vs. 41%, p = 0.04) was noted. Conclusion: In order to reduce acute treatment related toxicity preoperative CRT deserves further evaluation. Careful attention should be paid to the extension of treatment volume to the paraaortic region. Individual adjustment of 5-FU dosage by monitoring its systemic

Performance of the constructed wetland systems in pollutants removal from hog wastewater

Directory of Open Access Journals (Sweden)

Wallison da Silva Freitas

2010-08-01

Full Text Available The main objective of this work was to evaluate the efficiency of a constructed wetland systems (CWS for pollutants removal, in mono crop and multi crop with three different species of plants, originated from hog wastewater treatment (HW. Therefore, 5 CWS of 24.0 m x 1.1 m x 0.7 m were constructed, sealed with a membrane of polyvinyl chloride (PVC and filled with 0.4 m of small gravel. In CWS1, CWS2 and CWS3 grown to cattail (Typha latifolia L., Alternanthera philoxeroides (Mart. Griseb. and Tifton 85 grass (Cynodon dactylon Pers., respectively. In the bed of CWS4 was planted at 1st third Alternanthera, cattail, in the 2nd third and tifton-85 grass and in the 3rd third of. The CWS5 was not planted and it was used as control. After passing through a filter filled with crushed bagasse of sugar cane, the HW was applied to the CWS in a flow of 0.8 m3 d-1, which corresponded to a hydraulic detention time of 4.8 days. According to the results it was shown that the five CWS(s had statistically nearly the same removal of pollutants, and the average removal efficiency of TSS, COD, BOD and Zn, were 91, 89, 86 and 94%, respectively. Also high removals were obtained concerning the ST, N-total, NH4+ and P-total, with average values of 62, 59, 52 and 50%, respectively. The plants in all planted CWS worked in a similar way maintaining the system efficiency and the non cultivated CWS presented analogous capacity of pollutants removal when compared to the cultivated CWS(s.

Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

International Nuclear Information System (INIS)

Didier, Ryne A.; Vajtai, Petra L.; Hopkins, Katharine L.

2015-01-01

Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI vol ). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI vol . Reduced CTDI vol was achieved primarily by reductions in effective tube current-time product (mAs eff ) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI vol , size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI vol was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI vol and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

Effects of silicone expanders and implants on echocardiographic image quality after breast reconstruction.

Science.gov (United States)

Pignatti, Marco; Mantovani, Francesca; Bertelli, Luca; Barbieri, Andrea; Pacchioni, Lucrezia; Loschi, Pietro; De Santis, Giorgio

2013-08-01

Use of silicone expanders and implants is the most common breast reconstruction technique after mastectomy. Postmastectomy patients often need echocardiographic monitoring of potential cardiotoxicity induced by cancer chemotherapy. The impairment of the echocardiographic acoustic window caused by silicone implants for breast augmentation has been reported. This study investigates whether the echocardiographic image quality was impaired in women reconstructed with silicone expanders and implants. The records of 44 consecutive women who underwent echocardiographic follow-up after breast reconstruction with expanders and implants at the authors' institution from January of 2000 to August of 2012 were reviewed. The population was divided into a study group (left or bilateral breast expanders/implants, n=30) and a control group (right breast expanders/implants, n=14). The impact of breast expanders/implants on echocardiographic image quality was tested (analysis of covariance model). Patients with a breast expander/implant (left or bilateral and right breast expanders/implants) were included. The mean volume of the breast devices was 353.2±125.5 cc. The quality of the echocardiographic images was good or sufficient in the control group; in the study group, it was judged as adequate in only 50 percent of cases (15 patients) and inadequate in the remaining 15 patients (pimplants in postmastectomy left breast reconstruction considerably reduce the image quality of echocardiography. This may have important clinical implications, given the need for periodic echocardiographic surveillance before and during chemotherapy. Therapeutic, III.

Intelligent Flexible Materials for Space Structures: Expandable Habitat Engineering Development Unit

Science.gov (United States)

Hinkle, Jon; Sharpe, George; Lin, John; Wiley, Cliff; Timmers, Richard

2010-01-01

Expandable habitable elements are an enabling technology for human exploration in space and on planetary surfaces. Large geometries can be deployed from a small launch volume, allowing greater mission capability while reducing mass and improving robustness over traditional rigid shells. This report describes research performed by ILC Dover under the Intelligent Flexible Materials for Space Structures program on the design and manufacture of softgoods for LaRC's Expandable Habitat Engineering Development Unit (EDU). The EDU is a full-scale structural test article of an expandable hybrid habitat, integrating an expandable softgoods center section with two rigid end caps. The design of the bladder, restraint layer and a mock-up Thermal Micrometeoroid Cover is detailed together with the design of the interface hardware used to attach them to the end caps. The integration and design of two windows and a floor are also covered. Analysis was performed to study the effects of the open weave design, and to determine the correct webbing and fabric configuration. Stress analyses were also carried out on the interfaces between the softgoods and the end caps and windows. Testing experimentally determined the strength of the fabric and straps, and component testing was used to proof several critical parts of the design. This program established new manufacturing and design techniques that can be applied to future applications in expandable structures.

Acute toxicity from baking soda ingestion.

Science.gov (United States)

Thomas, S H; Stone, C K

1994-01-01

Sodium bicarbonate is an extremely well-known agent that historically has been used for a variety of medical conditions. Despite the widespread use of oral bicarbonate, little documented toxicity has occurred, and the emergency medicine literature contains no reports of toxicity caused by the ingestion of baking soda. Risks of acute and chronic oral bicarbonate ingestion include metabolic alkalosis, hypernatremia, hypertension, gastric rupture, hyporeninemia, hypokalemia, hypochloremia, intravascular volume depletion, and urinary alkalinization. Abrupt cessation of chronic excessive bicarbonate ingestion may result in hyperkalemia, hypoaldosteronism, volume contraction, and disruption of calcium and phosphorus metabolism. The case of a patient with three hospital admissions in 4 months, all the result of excessive oral intake of bicarbonate for symptomatic relief of dyspepsia is reported. Evaluation and treatment of patients with acute bicarbonate ingestion is discussed.

A bibliometric analysis of the citation classics of acute appendicitis.

Science.gov (United States)

Varzgalis, Manvydas; Bowden, Dermot J; Mc Donald, Ciaran K; Kerin, Michael J

2017-07-01

Acute appendicitis is one of the most commonly encountered emergency surgical conditions. An understanding of the most highly cited research works in this field is key to good evidence based clinical practice. To perform a bibliometric analysis on the 100 most frequently cited articles in the field of acute appendicitis. The database of the Institute for Scientific Information (ISI) Web of Science Expanded citation index was searched to identify the 100 most frequently cited articles in the field of acute appendicitis. The web of science expanded citation index tracks article citations made since 1946. The top 100 most frequently cited articles were selected for analysis in this series. The most frequently cited article was cited 649 times and the least cited three article 93 times. The average number of citations per article was 167.74. The top 100 cited articles originated from 17 countries. Over half of the papers originated from the USA. Fifty-one of the papers concentrated on diagnostics of acute appendicitis. Thirty-six papers looked at the treatment of acute appendicitis with 30 of these dealing with the surgical management of the disease. There were 6 studies at level 1a, 20 studies at level 1b and 43,5,17 and 9 studies at levels 2, 3, 4 and 5 respectively. Bibliometric analysis of the citation classics in a given field can provide interesting insights into the relationship between the quality of research outputs and clinical practice. The study of acute appendicitis remains an active field of research with a growing body of higher quality evidence underpinning our clinical practice.

Numerical simulation of supersonic over/under expanded jets using adaptive grid

International Nuclear Information System (INIS)

Talebi, S.; Shirani, E.

2001-05-01

Numerical simulation of supersonic under and over expanded jet was simulated. In order to achieve the solution efficiently and with high resolution, adaptive grid is used. The axisymmetric compressible, time dependent Navier-Stokes equations in body fitted curvilinear coordinate were solved numerically. The equations were discretized by using control volume, and the Van Leer flux splitting approach. The equations were solved implicitly. The obtained computer code was used to simulate four different cases of moderate and strong under and over expanded jet flows. The results show that with the adaptation of the grid, the various features of this complicated flow can be observed. It was shown that the adaptation method is very efficient and has the ability to make fine grids near the high gradient regions. (author)

Correlation of Acute and Late Brainstem Toxicities With Dose-Volume Data for Pediatric Patients With Posterior Fossa Malignancies

Energy Technology Data Exchange (ETDEWEB)

Nanda, Ronica H., E-mail: rhazari@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University College of Medicine, Atlanta, Georgia (United States); Ganju, Rohit G.; Schreibmann, Edward [Department of Radiation Oncology, Winship Cancer Institute, Emory University College of Medicine, Atlanta, Georgia (United States); Chen, Zhengjia; Zhang, Chao [Department of Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University Rollins School of Public Health, Atlanta, Georgia (United States); Jegadeesh, Naresh; Cassidy, Richard; Deng, Claudia; Eaton, Bree R.; Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University College of Medicine, Atlanta, Georgia (United States)

2017-06-01

Purpose: Radiation-induced brainstem toxicity after treatment of pediatric posterior fossa malignancies is incompletely understood, especially in the era of intensity modulated radiation therapy (IMRT). The rates of, and predictive factors for, brainstem toxicity after photon RT for posterior fossa tumors were examined. Methods and Materials: After institutional review board approval, 60 pediatric patients treated at our institution for nonmetastatic infratentorial ependymoma and medulloblastoma with IMRT were included in the present analysis. Dosimetric variables, including the mean and maximum dose to the brainstem, the dose to 10% to 90% of the brainstem (in 10% increments), and the volume of the brainstem receiving 40, 45, 50, and 55 Gy were recorded for each patient. Acute (onset within 3 months) and late (>3 months of RT completion) RT-induced brainstem toxicities with clinical and radiographic correlates were scored using Common Terminology Criteria for Adverse Events, version 4.0. Results: Patients aged 1.4 to 21.8 years underwent IMRT or volumetric arc therapy postoperatively to the posterior fossa or tumor bed. At a median clinical follow-up period of 2.8 years, 14 patients had developed symptomatic brainstem toxicity (crude incidence 23.3%). No correlation was found between the dosimetric variables examined and brainstem toxicity. Vascular injury or ischemia showed a strong trend toward predicting brainstem toxicity (P=.054). Patients with grade 3 to 5 brainstem toxicity had undergone treatment to significant volumes of the posterior fossa. Conclusion: The results of the present series demonstrate a low, but not negligible, risk of brainstem radiation necrosis for pediatric patients with posterior fossa malignancies treated with IMRT. No specific dose-volume correlations were identified; however, modern treatment volumes might help limit the incidence of severe toxicity. Additional work investigating inherent biologic sensitivity might also provide

Feasibility and Acute Toxicity of Hypofractionated Radiation in Large-breasted Patients

International Nuclear Information System (INIS)

Dorn, Paige L.; Corbin, Kimberly S.; Al-Hallaq, Hania; Hasan, Yasmin; Chmura, Steven J.

2012-01-01

Purpose: To determine the feasibility of and acute toxicity associated with hypofractionated whole breast radiation (HypoRT) after breast-conserving surgery in patients excluded from or underrepresented in randomized trials comparing HypoRT with conventional fractionation schedules. Methods and Materials: A review was conducted of all patients consecutively treated with HypoRT at University of Chicago. All patients were treated to 42.56 Gy in 2.66 Gy daily fractions in either the prone or supine position. Planning was performed in most cases using wedges and large segments or a “field-in-field” technique. Breast volume was estimated using volumetric measurements of the planning target volume (PTV). Dosimetric parameters of heterogeneity (V105, V107, V110, and maximum dose) were recorded for each treatment plan. Acute toxicity was scored for each treated breast. Results: Between 2006 and 2010, 78 patients were treated to 80 breasts using HypoRT. Most women were overweight or obese (78.7%), with a median body mass index of 29.2 kg/m 2 . Median breast volume was 1,351 mL. Of the 80 treated breasts, the maximum acute skin toxicity was mild erythema or hyperpigmentation in 70.0% (56/80), dry desquamation in 21.25% (17/80), and focal moist desquamation in 8.75% (7/80). Maximum acute toxicity occurred after the completion of radiation in 31.9% of patients. Separation >25 cm was not associated with increased toxicity. Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (p = 0.01). Patients with breast volume >2,500 mL experienced focal moist desquamation in 27.2% of cases compared with 6.34% in patients with breast volume 25 cm and in patients with large breast volume when employing modern planning and positioning techniques. We recommend counseling regarding expected increases in skin toxicity in women with a PTV volume >2,500 mL.

Feasibility and Acute Toxicity of Hypofractionated Radiation in Large-breasted Patients

Energy Technology Data Exchange (ETDEWEB)

Dorn, Paige L., E-mail: pdorn@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States); Corbin, Kimberly S.; Al-Hallaq, Hania; Hasan, Yasmin; Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States)

2012-05-01

Purpose: To determine the feasibility of and acute toxicity associated with hypofractionated whole breast radiation (HypoRT) after breast-conserving surgery in patients excluded from or underrepresented in randomized trials comparing HypoRT with conventional fractionation schedules. Methods and Materials: A review was conducted of all patients consecutively treated with HypoRT at University of Chicago. All patients were treated to 42.56 Gy in 2.66 Gy daily fractions in either the prone or supine position. Planning was performed in most cases using wedges and large segments or a 'field-in-field' technique. Breast volume was estimated using volumetric measurements of the planning target volume (PTV). Dosimetric parameters of heterogeneity (V105, V107, V110, and maximum dose) were recorded for each treatment plan. Acute toxicity was scored for each treated breast. Results: Between 2006 and 2010, 78 patients were treated to 80 breasts using HypoRT. Most women were overweight or obese (78.7%), with a median body mass index of 29.2 kg/m{sup 2}. Median breast volume was 1,351 mL. Of the 80 treated breasts, the maximum acute skin toxicity was mild erythema or hyperpigmentation in 70.0% (56/80), dry desquamation in 21.25% (17/80), and focal moist desquamation in 8.75% (7/80). Maximum acute toxicity occurred after the completion of radiation in 31.9% of patients. Separation >25 cm was not associated with increased toxicity. Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (p = 0.01). Patients with breast volume >2,500 mL experienced focal moist desquamation in 27.2% of cases compared with 6.34% in patients with breast volume <2,500 mL (p = 0.03). Conclusions: HypoRT is feasible and safe in patients with separation >25 cm and in patients with large breast volume when employing modern planning and positioning techniques. We recommend counseling regarding expected increases in skin toxicity in women

Orbit transfer vehicle advanced expander cycle engine point design study. Volume 2: Study results

Science.gov (United States)

Diem, H. G.

1980-01-01

The design characteristics of the baseline engine configuration of the advanced expander cycle engine are described. Several aspects of engine optimization are considered which directly impact the design of the baseline thrust chamber. Four major areas of the power cycle optimization are emphasized: main turbine arrangement; cycle engine source; high pressure pump design; and boost pump drive.

Acute myeloid leukemia and background radiation in an expanded case-referent study

International Nuclear Information System (INIS)

Flodin, U.; Fredriksson, M.; Persson, B.; Axelson, O.

1990-01-01

A case-referent study that investigated possible associations between environmental and occupational exposures and acute myeloid leukemia was performed on 86 cases and 172 referents, all of whom were living. Exposure information was obtained through a questionnaire mailed to each subject. An association was found between time spent in concrete buildings at home and work and leukemia morbidity. In addition, extensive x-ray examinations that occurred more than 5 y prior to diagnosis were more common among cases than referents

Monitoring of pulmonary mechanics in acute respiratory distress syndrome to titrate therapy.

Science.gov (United States)

Gattinoni, Luciano; Eleonora, Carlesso; Caironi, Pietro

2005-06-01

This paper reviews recent findings regarding the respiratory mechanics during acute respiratory distress syndrome as a tool for tailoring its ventilatory management. The pressure-volume curve has been used for many years as a descriptor of the respiratory mechanics in patients affected by acute respiratory distress syndrome. The use of the sigmoidal equation introduced by Venegas for the analysis of the pressure-volume curve seems to be the most rigorous mathematical approach to assessing lung mechanics. Increasing attention has been focused on the deflation limb for titration of positive end-expiratory pressure. Based on physiologic reasoning, a novel parameter, the stress index, has been proposed for tailoring a safe mechanical ventilation, although its clinical impact has still to be proved. Evidence has confirmed that a variety of underlying pathologies may lead to acute respiratory distress syndrome, making unrealistic any attempt to unify the ventilatory approach. Although extensively proposed to tailor mechanical ventilation during acute respiratory distress syndrome, there is no evidence that the pressure-volume curve may be useful in setting a lung-protective strategy in the presence of different potentials for recruitment. The Venegas approach should be the standard analysis of pressure-volume curves. In any patient, the potential for recruitment should be assessed, as a basis for tailoring the most effective mechanical ventilation. Further studies are needed to clarify the potential use of the pressure-volume curve to guide a lung-protective ventilatory strategy.

Interaction of PLP with GFP-MAL2 in the human oligodendroglial cell line HOG.

Directory of Open Access Journals (Sweden)

Raquel Bello-Morales

Full Text Available The velocity of the nerve impulse conduction of vertebrates relies on the myelin sheath, an electrically insulating layer that surrounds axons in both the central and peripheral nervous systems, enabling saltatory conduction of the action potential. Oligodendrocytes are the myelin-producing glial cells in the central nervous system. A deeper understanding of the molecular basis of myelination and, specifically, of the transport of myelin proteins, will contribute to the search of the aetiology of many dysmyelinating and demyelinating diseases, including multiple sclerosis. Recent investigations suggest that proteolipid protein (PLP, the major myelin protein, could reach myelin sheath by an indirect transport pathway, that is, a transcytotic route via the plasma membrane of the cell body. If PLP transport relies on a transcytotic process, it is reasonable to consider that this myelin protein could be associated with MAL2, a raft protein essential for transcytosis. In this study, carried out with the human oligodendrocytic cell line HOG, we show that PLP colocalized with green fluorescent protein (GFP-MAL2 after internalization from the plasma membrane. In addition, both immunoprecipitation and immunofluorescence assays, indicated the existence of an interaction between GFP-MAL2 and PLP. Finally, ultrastructural studies demonstrated colocalization of GFP-MAL2 and PLP in vesicles and tubulovesicular structures. Taken together, these results prove for the first time the interaction of PLP and MAL2 in oligodendrocytic cells, supporting the transcytotic model of PLP transport previously suggested.

Radio-frequency ablation in patients with malignant hepatic tumor and experimental model: comparison of expandable needle and water-cooled needle

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Moon, Yong Ju; Jeong, Yong Yeon; Kim, Jeong; Yim, Nam yeol; Kang, Heoung Keun [School of Medicine, Chonnam National Univ., Gwangju (Korea, Republic of); Kim, Eun Ha; Yoon, Kwon Ha [School of Medicine, Wonkwang Univ., Iksan (Korea, Republic of); Ko, Seog Wan [School of Medicine, Chonbuk National Univ., Jeonju (Korea, Republic of)

2004-12-01

The purpose of this study was to compare the shape and volume of the radio-frequency induced lesions produced by two commercially available radio-frequency ablation (RFA) systems, the expandable and cooled-tip needles, in clinical patients and an experimental model. A twelve-array anchor expandable needle electrode and a single cooled-tip needle electrode were used to treat hepatic tumors with a single session in 23 patients (20 hepatocellular carcinomas and 3 hepatic metastases) and fourteen patients (10 hepatocellular carcinomas and 4 hepatic metastases), respectively. Twenty RFA induced lesions were created with each system in 10 explanted bovine livers. The shape of the RFA induced lesions were divided into oval lesions along or perpendicular to the axis of the electrode and spherical lesions, and we then calculated the volumes of the RFA induced lesions. Fourteen (61%) lesions of the 23 patients treated with the expandable system were oval perpendicular to the axis of the electrode and nine (39%) of the lesions were spherical. All the lesions (100%) of the 14 patients treated with the cooled-tip needle were ovaI along the axis of the electrode. In the ex vivo bovine livers, the shape of the all RFA induced lesions was oval perpendicular to the axis of the electrode for the expandable needle, and oval along the axis of the electrode for the cooled-tip needle. The mean diameter and volume of the RFA induced lesions in the patients were 3.35{+-}0.56 cm and 19.9{+-}6.53 cm{sup 3}, respectively, for the expandable needle and 3.58{+-}0.78 cm and 23.19{+-}5.27 cm{sup 3}, respectively, for the cooled-tip needle. In the ex vivo model, the mean diameter and volume of RFA induced lesions were 3.41{+-}0.59 cm and 26.59{+-}8.02 cm{sup 3}, respectively, for the expandable needle, and 4.04{+-}0.65 cm and 33.82{+-}6.16 cm{sup 3}, respectively, for the cooled-tip needle (p <0.05). These results indicate that the shape of RFA induced lesions with the expandable needle were oval

Self-expandable metallic stent as a bridge to elective surgery versus emergency surgery for acute malignant colorectal obstruction.

Science.gov (United States)

Li, Zhi-Xiong; Wu, Xiao-Hua; Wu, Hai-yan; Chang, Wen-Ju; Chang, Xiu-juan; Yi, Tuo; Shi, Qiang; Chen, Jing-Wen; Feng, Qing-Yang; Zhu, De-Xiang; Wei, Ye; Zhong, Yun-Shi; Xu, Jian-Min

2016-03-01

The efficacy and safety of self-expandable metallic stents (SEMSs) as a bridge for patients with acute malignant colorectal obstructions (AMCOs) are still controversial. We conducted this study to evaluate the outcomes of patients with AMCOs treated by different strategies. From January 2010 to March 2014, a total of 171 patients with AMCOs from Zhongshan Hospital were retrospectively enrolled in this study. One hundred twenty patients successfully received stent placement followed by one-stage laparoscopic or open resection in the stent group, and 51 patients received emergency operations in the emergency group. The operation duration and postoperative hospital stay were significantly shorter in the stent group (114.51 ± 28.65 vs. 160.39 ± 58.94 min, P stent group also had significantly reduced intraoperative blood loss and the incidence of postoperative complications compared with the emergency group (61.00 ± 43.70 vs. 121.18 ± 85.90 ml, P stent group was significantly longer than that in the emergency group (53 vs. 41 months, P = 0.034). In subgroup analysis of stent group, the stent laparoscopy group had significantly decreased postoperative complications (P = 0.025), and similar long-term survival (P = 0.81). Stent placement as a bridge to surgery is a safe and feasible procedure and provides significant advantages in terms of short-term outcomes and favorable prognoses for patients with AMCOs. Laparoscopic surgery could be considered as an optimal treatment after stent placement.

Breathing circuit compliance and accuracy of displayed tidal volume during pressure-controlled ventilation of infants: A quality improvement project.

Science.gov (United States)

Glenski, Todd A; Diehl, Carrie; Clopton, Rachel G; Friesen, Robert H

2017-09-01

Anesthesia machines have evolved to deliver desired tidal volumes more accurately by measuring breathing circuit compliance during a preuse self-test and then incorporating the compliance value when calculating expired tidal volume. The initial compliance value is utilized in tidal volume calculation regardless of whether the actual compliance of the breathing circuit changes during a case, as happens when corrugated circuit tubing is manually expanded after the preuse self-test but before patient use. We noticed that the anesthesia machine preuse self-test was usually performed on nonexpanded pediatric circuit tubing, and then the breathing circuit was subsequently expanded for clinical use. We aimed to demonstrate that performing the preuse self-test in that manner could lead to incorrectly displayed tidal volume on the anesthesia machine monitor. The goal of this quality improvement project was to change the usual practice and improve the accuracy of displayed tidal volume in infants undergoing general anesthesia. There were four stages of the project: (i) gathering baseline data about the performance of the preuse self-test and using infant and adult test lungs to measure discrepancies of displayed tidal volumes when breathing circuit compliance was changed after the initial preuse self-test; (ii) gathering clinical data during pressure-controlled ventilation comparing anesthesia machine displayed tidal volume with actual spirometry tidal volume in patients less than 10 kg before (machine preuse self-test performed while the breathing circuit was nonexpanded) and after an intervention (machine preuse self-test performed after the breathing circuit was fully expanded); (iii) performing department-wide education to help implement practice change; (iv) gathering postintervention data to determine the prevalence of proper machine preuse self-test. At constant pressure-controlled ventilation through fully expanded circuit tubing, displayed tidal volume was 83

Coupled Wave Energy and Erosion Dynamics along a Salt Marsh Boundary, Hog Island Bay, Virginia, USA

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Anthony M. Priestas

2015-09-01

Full Text Available The relationship between lateral erosion of salt marshes and wind waves is studied in Hog Island Bay, Virginia USA, with high-resolution field measurements and aerial photographs. Marsh retreat is compared to wave climate calculated in the bay using the spectral wave-model Simulating Waves Nearshore (SWAN. We confirm the existence of a linear relationship between long-term salt marsh erosion and wave energy, and show that wave power can serve as a good proxy for average salt-marsh erosion rates. At each site, erosion rates are consistent across several temporal scales, ranging from months to decades, and are strongly related to wave power. On the contrary, erosion rates vary in space and weakly depend on the spatial distribution of wave energy. We ascribe this variability to spatial variations in geotechnical, biological, and morphological marsh attributes. Our detailed field measurements indicate that at a small spatial scale (tens of meters, a positive feedback between salt marsh geometry and wave action causes erosion rates to increase with boundary sinuosity. However, at the scale of the entire marsh boundary (hundreds of meters, this relationship is reversed: those sites that are more rapidly eroding have a marsh boundary which is significantly smoother than the marsh boundary of sheltered and slowly eroding marshes.

Iterative reconstruction technique with reduced volume CT dose index: diagnostic accuracy in pediatric acute appendicitis

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Didier, Ryne A. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Vajtai, Petra L. [Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States); Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Hopkins, Katharine L. [Oregon Health and Science University, Department of Diagnostic Radiology, DC7R, Portland, OR (United States); Oregon Health and Science University, Department of Pediatrics, Portland, OR (United States)

2014-07-05

Iterative reconstruction technique has been proposed as a means of reducing patient radiation dose in pediatric CT. Yet, the effect of such reductions on diagnostic accuracy has not been thoroughly evaluated. This study compares accuracy of diagnosing pediatric acute appendicitis using contrast-enhanced abdominopelvic CT scans performed with traditional pediatric weight-based protocols and filtered back projection reconstruction vs. a filtered back projection/iterative reconstruction technique blend with reduced volume CT dose index (CTDI{sub vol}). Results of pediatric contrast-enhanced abdominopelvic CT scans done for pain and/or suspected appendicitis were reviewed in two groups: A, 192 scans performed with the hospital's established weight-based CT protocols and filtered back projection reconstruction; B, 194 scans performed with iterative reconstruction technique and reduced CTDI{sub vol}. Reduced CTDI{sub vol} was achieved primarily by reductions in effective tube current-time product (mAs{sub eff}) and tube peak kilovoltage (kVp). CT interpretation was correlated with clinical follow-up and/or surgical pathology. CTDI{sub vol}, size-specific dose estimates (SSDE) and performance characteristics of the two CT techniques were then compared. Between groups A and B, mean CTDI{sub vol} was reduced by 45%, and mean SSDE was reduced by 46%. Sensitivity, specificity and diagnostic accuracy were 96%, 97% and 96% in group A vs. 100%, 99% and 99% in group B. Accuracy in diagnosing pediatric acute appendicitis was maintained in contrast-enhanced abdominopelvic CT scans that incorporated iterative reconstruction technique, despite reductions in mean CTDI{sub vol} and SSDE by nearly half as compared to the hospital's traditional weight-based protocols. (orig.)

Intravenous Alteplase for Acute Ischemic Stroke in Taiwan: Can We Expand the National Health Insurance's Reimbursement Criteria?

Science.gov (United States)

Hsieh, Cheng-Yang

2017-03-15

lization of intravenous thrombolysis with alteplase was very low in Taiwanese patients with acute ischemic stroke(1). One of the reasons is the strict reimbursement guideline made by the Bureau of National Health Insurance (NHI) in 2004(2). In this issue of the Acta Neurologica Taiwanica, Yu-Hsiang Su and co-authors(3) retrospectively evaluated outcomes of their thrombolysed stroke patients who were "mismatched" between updated clinical practice guideline and NHI reimbursement criteria. They concluded that the outcomes of patients treated according to guidelines were comparable between the reimbursement and non-reimbursement groups. Despite the inherent selection bias and no comparison with the non-treated patients in this observational study, it might serve the an important local evidence for physicians in Taiwan when evaluating intravenous thrombolysis for acute ischemic stroke. SO, CAN WE EXPAND THE REIMBURSEMENT CRITERIA FOR INTRAVENOUS ALTEPLASE IN STROKE PATIENTS? At the present time, the answer may still probably be NO! The insurance payer, usually after an economic evaluation, may decide to pay a pharmaceutical product for its beneficiaries. As a rule of thumb, insurance reimbursement criteria should not be greater than the labelled prescribing information. Thus, the essence of this question should be back to the labelled indications and contraindications of alteplase for stroke, made by Taiwanese regulator in Nov 2002(4). Although data from high-quality meta-analyses(5,6) of new trials in the past decade challenged some of the major contraindications, such as onset > 3 hours or age > 80 years, the Taiwan's Food and Drug Administration has turned down twice the application by the manufacturer to change the package insert regarding those two contraindications. The reasons were mostly "insufficient of benefits". Without the change of labelled prescribing information, the NHI reimbursement criteria cannot be expanded. WHAT CAN WE DO NOW? Pragmatically

Endovascular stent-assisted thrombolysis in acute occlusive carotid artery dissection

Energy Technology Data Exchange (ETDEWEB)

Mourand, Isabelle [Hopital Gui de Chauliac, Department of Neurology, CHU Montpellier, Montpellier, Cedex 5 (France); Hopital Gui de Chauliac, Department of Neurology, Service de Neurologie, Montpellier, Cedex 5 (France); Brunel, Herve; Vendrell, Jean-Francois; Bonafe, Alain [Hopital Gui de Chauliac, Department of Neuroradiology, CHU Montpellier, Montpellier, Cedex 5 (France); Thouvenot, Eric [Hopital Gui de Chauliac, Department of Neurology, CHU Montpellier, Montpellier, Cedex 5 (France)

2010-02-15

Internal carotid artery dissection with tandem internal carotid and middle cerebral artery occlusion may be responsible for large cerebral infarction that carries a general poor prognosis. Recanalization of internal carotid artery (ICA) dissection by stent-assisted thrombolysis has been recently proposed. We report two cases of acute symptomatic ICA dissection with tandem occlusion successfully treated with emergent endovascular stent-assisted thrombolysis using new self-expandable intracranial stents. A 37-year-old woman and a 59-year-old man were admitted in our hospital after acute severe symptoms of right-hemispheric stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 15 and 18, respectively. In both cases, magnetic resonance angiography showed tandem occlusion and angiography confirmed tandem occlusion with ICA dissection. An extensive mismatch region was diagnosed by Perfusion-diffusion MRI of the brain within 3 h after symptoms onset. Treatment was initiated 4 h after symptom onset by implantation of self-expandable intracranial stents into the dissected ICA and administration of intra-arterial recombinant tissue plasminogen activator. Recanalization of the ICA and middle cerebral artery (MCA) was accomplished within 6 h after symptoms onset. In both cases, no periprocedural complication was observed and follow-up CT scan showed only a mild brain infarct in the MCA territory. After, respectively, 12 and 10 months follow-up, patients had a favorable outcome with NIHSS 0 and mRS {<=}1. Endovascular stent-assisted thrombolysis appears to be a promising treatment in tandem occlusion due to ICA dissection. Our work underline the potential use of self-expandable intracranial stents in symptomatic acute ICA dissection. (orig.)

What Expands in an Expanding Universe?

Science.gov (United States)

Pacheco, José A De Freitas

2015-01-01

In the present investigation, the possible effects of the expansion of the Universe on systems bonded either by gravitational or electromagnetic forces, are reconsidered. It will be shown that the acceleration (positive or negative) of the expanding background, is the determinant factor affecting planetary orbits and atomic sizes. In the presently accepted cosmology (ΛCDM) all bonded systems are expanding at a decreasing rate that tends to be zero as the universe enters in a de Sitter phase. It is worth mentioning that the estimated expansion rates are rather small and they can be neglected for all practical purposes.

What Expands in an Expanding Universe?

Directory of Open Access Journals (Sweden)

JOSÉ A. DE FREITAS PACHECO

2015-12-01

Full Text Available ABSTRACT In the present investigation, the possible effects of the expansion of the Universe on systems bonded either by gravitational or electromagnetic forces, are reconsidered. It will be shown that the acceleration (positive or negative of the expanding background, is the determinant factor affecting planetary orbits and atomic sizes. In the presently accepted cosmology (ΛCDM all bonded systems are expanding at a decreasing rate that tends to be zero as the universe enters in a de Sitter phase. It is worth mentioning that the estimated expansion rates are rather small and they can be neglected for all practical purposes.

Preferential effects of low volume versus high volume replacement with crystalloid fluid in a hemorrhagic shock model in pigs.

Science.gov (United States)

Ponschab, Martin; Schöchl, Herbert; Keibl, Claudia; Fischer, Henrik; Redl, Heinz; Schlimp, Christoph J

2015-10-06

Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hypothesis was that in comparison to high volume (HV), a lower crystalloid volume (LV) achieves a favorable coagulation profile and exerts sufficient haemodynamics in the acute phase of resuscitation. In 24 anaesthetized pigs, controlled arterial blood loss of 50 % of the estimated blood volume was either (n = 12) replaced with a LV (one-fold) or a HV (three-fold) volume of a balanced, acetated crystalloid solution at room temperature. Hemodynamic parameters, dilution effects and coagulation profile by standard coagulation tests and thromboelastometry at baseline and after resuscitation were determined in both groups. LV resuscitation increased MAP significantly less compared to the HV, 61 ± 7 vs. 82 ± 14 mmHg (p controlled blood loss, a one fold LV crystalloid replacement strategy is sufficient to adequately raise blood pressure up to a mean arterial pressure >50 mm Hg. The concept of damage control resuscitation (DCR) with permissive hypotension may be better met by using LV as compared to a three fold HV resuscitation strategy. High volume administration of an acetated balanced crystalloid does not lead to hyperchloraemic acidosis, but may negatively influence clinical parameters, such as higher blood pressure, lower body temperature and impaired coagulation parameters, which could potentially increase bleeding after trauma. Replacement of acute blood loss with just an equal amount of an acetated balanced crystalloid appears to be the preferential treatment strategy in the acute phase after controlled bleeding.

Expanding the calculation of activation volumes: Self-diffusion in liquid water

Science.gov (United States)

Piskulich, Zeke A.; Mesele, Oluwaseun O.; Thompson, Ward H.

2018-04-01

A general method for calculating the dependence of dynamical time scales on macroscopic thermodynamic variables from a single set of simulations is presented. The approach is applied to the pressure dependence of the self-diffusion coefficient of liquid water as a particularly useful illustration. It is shown how the activation volume associated with diffusion can be obtained directly from simulations at a single pressure, avoiding approximations that are typically invoked.

Safety and efficacy of self-expandable metal stents for obstructive proximal and distal large bowel cancer.

Science.gov (United States)

Mitra, V; Hu, M; Majumdar, D; Krishnan, V; Chaudhury, B; Hancock, J; Dwarakanath, D

2017-03-01

Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction). The majority (88%) had self-expanded metal stents inserted for palliation. Technical and clinical success rates were 98.7% and 91.2%, respectively. One patient had stent-related perforation; there was no procedure-related mortality. Conclusion This study shows that self-expanded metal stent insertion in malignant colorectal obstruction is safe and effective and can be successfully delivered in a district general hospital with high technical and clinical success rates.

Volume-rendered hemorrhage-responsible arteriogram created by 64 multidetector-row CT during aortography: utility for catheterization in transcatheter arterial embolization for acute arterial bleeding.

Science.gov (United States)

Minamiguchi, Hiroki; Kawai, Nobuyuki; Sato, Morio; Ikoma, Akira; Sanda, Hiroki; Nakata, Kouhei; Tanaka, Fumihiro; Nakai, Motoki; Sonomura, Tetsuo; Murotani, Kazuhiro; Hosokawa, Seiki; Nishioku, Tadayoshi

2014-01-01

Aortography for detecting hemorrhage is limited when determining the catheter treatment strategy because the artery responsible for hemorrhage commonly overlaps organs and non-responsible arteries. Selective catheterization of untargeted arteries would result in repeated arteriography, large volumes of contrast medium, and extended time. A volume-rendered hemorrhage-responsible arteriogram created with 64 multidetector-row CT (64MDCT) during aortography (MDCTAo) can be used both for hemorrhage mapping and catheter navigation. The MDCTAo depicted hemorrhage in 61 of 71 cases of suspected acute arterial bleeding treated at our institute in the last 3 years. Complete hemostasis by embolization was achieved in all cases. The hemorrhage-responsible arteriogram was used for navigation during catheterization, thus assisting successful embolization. Hemorrhage was not visualized in the remaining 10 patients, of whom 6 had a pseudoaneurysm in a visceral artery; 1 with urinary bladder bleeding and 1 with chest wall hemorrhage had gaze tamponade; and 1 with urinary bladder hemorrhage and 1 with uterine hemorrhage had spastic arteries. Six patients with pseudoaneurysm underwent preventive embolization and the other 4 patients were managed by watchful observation. MDCTAo has the advantage of depicting the arteries responsible for hemoptysis, whether from the bronchial arteries or other systemic arteries, in a single scan. MDCTAo is particularly useful for identifying the source of acute arterial bleeding in the pancreatic arcade area, which is supplied by both the celiac and superior mesenteric arteries. In a case of pelvic hemorrhage, MDCTAo identified the responsible artery from among numerous overlapping visceral arteries that branched from the internal iliac arteries. In conclusion, a hemorrhage-responsible arteriogram created by 64MDCT immediately before catheterization is useful for deciding the catheter treatment strategy for acute arterial bleeding.

A Study of Flexible Composites for Expandable Space Structures

Science.gov (United States)

Scotti, Stephen J.

2016-01-01

Payload volume for launch vehicles is a critical constraint that impacts spacecraft design. Deployment mechanisms, such as those used for solar arrays and antennas, are approaches that have successfully accommodated this constraint, however, providing pressurized volumes that can be packaged compactly at launch and expanded in space is still a challenge. One approach that has been under development for many years is to utilize softgoods - woven fabric for straps, cloth, and with appropriate coatings, bladders - to provide this expandable pressure vessel capability. The mechanics of woven structure is complicated by a response that is nonlinear and often nonrepeatable due to the discrete nature of the woven fiber architecture. This complexity reduces engineering confidence to reliably design and certify these structures, which increases costs due to increased requirements for system testing. The present study explores flexible composite materials systems as an alternative to the heritage softgoods approach. Materials were obtained from vendors who utilize flexible composites for non-aerospace products to determine some initial physical and mechanical properties of the materials. Uniaxial mechanical testing was performed to obtain the stress-strain response of the flexible composites and the failure behavior. A failure criterion was developed from the data, and a space habitat application was used to provide an estimate of the relative performance of flexible composites compared to the heritage softgoods approach. Initial results are promising with a 25% mass savings estimated for the flexible composite solution.

Self-Expandable Stenting over a Stent Graft for the Exclusion of a Carotid Stump: Troubleshooting for Device Incompatibility

International Nuclear Information System (INIS)

Youn, Sung Won; Kim, Ho Kyun; Do, Jin Kook; Kim, Young Whan

2011-01-01

Carotid stump, the blind remnant of an occluded internal carotid artery, can be a potential source of microemboli, and warrants its exclusion from the vascular lumen to prevent the recurrence of a microembolism. In a 69-year-old male with a symptomatic carotid stump and acute angle between left common carotid artery and aortic arch, a 7-Fr. shuttle sheath was scarcely placed into the left carotid artery but the 7-mm-diameter stent-graft-loading balloon could not be inserted into the 7-Fr. shuttle sheath. With the mounting a stent graft over a 5-mm balloon, the balloon-expandable stent graft was unfolded. The self-expandable stent was placed over the stent graft, and an 8-mm balloon was subsequently expanded. Self-expanding stenting can be useful for troubleshooting in a case of device incompatibility coming from the different calibers of the external and common carotid arteries for the successful exclusion of a symptomatic carotid stump.

Self-Expandable Stenting over a Stent Graft for the Exclusion of a Carotid Stump: Troubleshooting for Device Incompatibility

Energy Technology Data Exchange (ETDEWEB)

Youn, Sung Won; Kim, Ho Kyun [Dept. of Radiology, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of); Do, Jin Kook [Dept. of Neurology, Catholic University of Daegu School of Medicine, Daegu (Korea, Republic of); Kim, Young Whan [Dept. of Radiology, University College of Medicine, Daegu (Korea, Republic of)

2011-12-15

Carotid stump, the blind remnant of an occluded internal carotid artery, can be a potential source of microemboli, and warrants its exclusion from the vascular lumen to prevent the recurrence of a microembolism. In a 69-year-old male with a symptomatic carotid stump and acute angle between left common carotid artery and aortic arch, a 7-Fr. shuttle sheath was scarcely placed into the left carotid artery but the 7-mm-diameter stent-graft-loading balloon could not be inserted into the 7-Fr. shuttle sheath. With the mounting a stent graft over a 5-mm balloon, the balloon-expandable stent graft was unfolded. The self-expandable stent was placed over the stent graft, and an 8-mm balloon was subsequently expanded. Self-expanding stenting can be useful for troubleshooting in a case of device incompatibility coming from the different calibers of the external and common carotid arteries for the successful exclusion of a symptomatic carotid stump.

High tidal volume decreases adult respiratory distress syndrome, atelectasis, and ventilator days compared with low tidal volume in pediatric burned patients with inhalation injury.

Science.gov (United States)

Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

2015-04-01

Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of this study was to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia, and ARDS in pediatric burned patients with inhalation injury within 1 year post burn injury. From 1986 to 2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n = 932). Patients were divided into 3 groups: unventilated (n = 241), high tidal volume (HTV, 15 ± 3 mL/kg, n = 190), and low tidal volume (LTV, 9 ± 3 mL/kg, n = 501). High tidal volume was associated with significantly decreased ventilator days (p tidal volume significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared with low tidal volume in pediatric burned patients with inhalation injury. Therefore, the use of HTV may interrupt sequences leading to lung injury in our patient population. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Multi-detector computed tomography of acute abdomen

International Nuclear Information System (INIS)

Leschka, Sebastian; Alkadhi, Hatem; Wildermuth, Simon; Marincek, Borut; University Hospital of Zurich

2005-01-01

Acute abdominal pain is one of the most common causes for referrals to the emergency department. The sudden onset of severe abdominal pain characterising the ''acute abdomen'' requires rapid and accurate identification of a potentially life-threatening abdominal pathology to provide a timely referral to the appropriate physician. While the physical examination and laboratory investigations are often non-specific, computed tomography (CT) has evolved as the first-line imaging modality in patients with an acute abdomen. Because the new multi-detector CT (MDCT) scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of CT for abdominal imaging has increased rapidly. The goal of this article is to discuss the role of MDCT in the diagnostic work-up of acute abdominal pain. (orig.)

Ultra structure of the denervated vocal muscle mechanically in hogs (sus scrofa domestica

Directory of Open Access Journals (Sweden)

Leão, Henrique Zaquia

2010-03-01

Full Text Available Introduction: The literature is not clear in the ultra-structural manifestations of the vocal wrinkles after neural wound. Objective: To verify the alterations that occur in a vocal fold mechanically denervated. Method: In this prospective study, it were utilized 15 hogs of commercial race (Sus scrofa domesticates, with age of 4 to 12 weeks. The animals were distributed in three groups, chosen at random. Everybody was submitted to the denervation of the right vocal fold, with surgical removal of a segment with three centimeters of the recurring right laryngeal nerve. After 45, 90 and 180 days of the operations, it was proceeded the biopsy of the vocal muscles, it was prosecuted the samples for transmission electron microscopy and, for the ultra-structural study, utilized the transmission electron microscopy Philips, model EM208S. Results: The biopsied groups with 45 and 90 days after operation of mechanical denervation, presented disorganization miofibrilar, only vestigial lines Z in many samples, as well like altered mithochondrions presenting limited sizes, and matrix mithocondrial rarefied with rare mithocondrial cristae present. The biopsied group with 180 days after operation of denervation, presented regular sarcomeres, mithocondrions with sizes and regular number with correct positioning between the sarcomerical units. Conclusion: The finds in the ultra-structure of the vocal muscles suggest to re enervation of the muscle being that the muscular mithochondrions were the most sensible structures to the denervated condition, successions by the cytoarchiteture of the miofibrilas; the finds in the ultra-structure of the vocal muscles suggests to reinervation of the muscle in the period of approximately six months.

An Unusual Case of Colon Perforation Complicating Acute Pancreatitis

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Anthony A. Aghenta

2009-08-01

Full Text Available Colonic complications of severe acute pancreatitis occur rarely. Although there have been several theories on how pancreatic pseudocysts rupture into the colon, the exact pathogenesis remains unknown. We report an unusual case of pseudocysts complicating severe acute pancreatitis presenting with colonic perforation in a 71-year-old man with a history of chronic mesenteric ischemia. Pressure effects from a giant pseudocyst and intravascular volume depletion with acute insult on chronic mesenteric ischemia are highlighted as possible etiologic factors.

Novel 3D-CT evaluation of carotid stent volume: greater chronological expansion of stents in patients with vulnerable plaques.

Science.gov (United States)

Itami, Hisakazu; Tokunaga, Koji; Okuma, Yu; Hishikawa, Tomohito; Sugiu, Kenji; Ida, Kentaro; Date, Isao

2013-09-01

Although self-expanding carotid stents may dilate gradually, the degrees of residual stenosis have been quantified by the NASCET criteria, which is too simple to reflect the configuration of the stented artery. We measured the volumes of the stent lumens chronologically by 3D-CT in patients after carotid artery stenting (CAS), and analyzed the correlations between the volume change and medical factors. Fourteen patients with carotid artery stenosis were treated using self-expanding, open-cell stents. All patients underwent preoperative plaque MRI (magnetization-prepared rapid acquisition gradient-echo, MPRAGE) and chronological 3D-CT examinations of their stents immediately after their placement and 1 day, 1 week, and 1 month after the procedure. The volume of the stent lumen was measured using a 3D workstation. The correlations between stent volume and various factors including the presence of underlying diseases, plaque characteristics, and the results of the CAS procedure were analyzed. Stent volume gradually increased in each case and had increased by 1.04-1.55 (mean, 1.25)-fold at 1 postoperative month. The presence of underlying medical diseases, plaque length, the degree of residual stenosis immediately after CAS, and plaque calcification did not have an impact on the change in stent volume. On the other hand, the stent volume increase was significantly larger in the patients with vulnerable plaques that demonstrated high MPRAGE signal intensity (P stent volume. Self-expanding stents in carotid arteries containing vulnerable plaques expand significantly more than those without such plaques in a follow-up period.

The velocity of the expanding by-products and soil layer on top of a buried landmine

CSIR Research Space (South Africa)

Snyman, I.M

2012-09-01

Full Text Available This paper uses high-speed video images of the PHOTRON APX-RS high-speed camera to determine the velocity of the expanding volume of by-products of a buried landmine. The study analyses three experiments done with the Scientifically Instrumented...

Pazopanib-Induced Severe Acute Pancreatitis

Directory of Open Access Journals (Sweden)

Kazumichi Kawakubo

2015-08-01

Full Text Available Pazopanib is an oral angiogenesis inhibitor targeting vascular endothelial growth factor receptors, platelet-derived growth factor receptors, and c-Kit approved for the treatment of renal cell carcinoma and soft tissue sarcoma. Nonselective kinase inhibitors, such as sunitinib and sorafenib, are known to be associated with acute pancreatitis. There are few case reports of severe acute pancreatitis induced by pazopanib treatment. We present a case of severe acute pancreatitis caused by pazopanib treatment for cutaneous angiosarcoma. The patient was an 82-year-old female diagnosed with cutaneous angiosarcoma. She had been refractory to docetaxel treatment and began pazopanib therapy. Three months after pazopanib treatment, CT imaging of the abdomen showed the swelling of the pancreas and surrounding soft tissue inflammation without abdominal pain. After she continued pazopanib treatment for 2 months, she presented with nausea and appetite loss. Abdominal CT showed the worsening of the surrounding soft tissue inflammation of the pancreas. Serum amylase and lipase levels were 296 and 177 IU/l, respectively. She was diagnosed with acute pancreatitis induced by pazopanib treatment and was managed conservatively with discontinuation of pazopanib, but the symptoms did not improve. Subsequently, an abdominal CT scan demonstrated the appearance of a pancreatic pseudocyst. She underwent endoscopic ultrasound-guided pseudocyst drainage using a flared-end fully covered self-expandable metallic stent. Then, the symptoms resolved without recurrence. Due to the remarkable progress of molecular targeted therapy, the oncologist should know that acute pancreatitis was recognized as a potential adverse event of pazopanib treatment and could proceed to severe acute pancreatitis.

A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure.

Science.gov (United States)

Chang, Suchi; Shi, Jindong; Fu, Cuiping; Wu, Xu; Li, Shanqun

2016-01-01

COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. We evaluated pressure-regulated volume control (PRVC) ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation - volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2-4 hours and 48 hours. Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2), and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2) levels. The pH and PaCO2 levels at 2-4 hours were lower and higher, respectively, in the test group than those in the control group (P0.05). Vital signs during 2-4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05). The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2-4 hours and 48 hours was significantly lower than that in the control group (P0.05). Among elderly COPD patients with respiratory failure, application of PRVC resulted in rapid improvement in arterial blood gas analyses while maintaining a low peak inspiratory pressure. PRVC can reduce pulmonary barotrauma risk, making it a safer protective ventilation mode than synchronized intermittent mandatory ventilation - volume control.

High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

Science.gov (United States)

Stöggl, Thomas L.; Björklund, Glenn

2017-01-01

The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR) in well-trained endurance athletes. Methods: Thirty-six male (n = 33) and female (n = 3) runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak): 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT). A maximal anaerobic running/cycling test (MART/MACT) was performed prior to and following a 9-week training period. Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P 0.05). Acute HRR was improved in HIIT (11.2%, P = 0.002) and POL (7.9%, P = 0.023) with no change in the HVLIT oriented control group. Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT) had no effect on any performance or HRR outcomes. PMID:28824457

Merrill's Atlas of radiographic positions and radiologic procedures. Volumes 1-3. Sixth edition

International Nuclear Information System (INIS)

Ballinger, P.W.

1985-01-01

Merrill's Atlas describes and explains the routine and specialized radiologic procedures for all body systems. This edition thoroughly reorganized, updated and expanded. Volumes one and two describe all routine and flouroscopic procedures; and volume three describes more specialized areas in the profession

Substantial effect of acute hydration on blood pressure in patients with autonomic failure

DEFF Research Database (Denmark)

Mehlsen, J; Boesen, F

1987-01-01

fraction were measured in the supine position. Measurements were repeated after rapid infusion of 11 of isotonic saline. Acute hydration resulted in increased supine mean blood pressure levels (P less than 0.01) despite normal plasma volumes in all patients. The postural reductions in mean blood pressure......The effect of acute hydration on arterial blood pressure levels was investigated in ten patients with severe postural hypotension due to autonomic failure. Blood pressure and heart rate were determined in the supine and 60-degree head-up tilted position. Plasma volume and left ventricular ejection...... were reduced from 40 mmHg before to 20 mmHg after saline (median values, P less than 0.01). The results indicate that normal plasma volumes do not ensure optimal circulatory status in patients with autonomic failure. Acute hydration with isotonic saline may be used for immediate corrections of blood...

Endovascular stent-assisted thrombolysis in acute occlusive carotid artery dissection

International Nuclear Information System (INIS)

Mourand, Isabelle; Brunel, Herve; Vendrell, Jean-Francois; Bonafe, Alain; Thouvenot, Eric

2010-01-01

Internal carotid artery dissection with tandem internal carotid and middle cerebral artery occlusion may be responsible for large cerebral infarction that carries a general poor prognosis. Recanalization of internal carotid artery (ICA) dissection by stent-assisted thrombolysis has been recently proposed. We report two cases of acute symptomatic ICA dissection with tandem occlusion successfully treated with emergent endovascular stent-assisted thrombolysis using new self-expandable intracranial stents. A 37-year-old woman and a 59-year-old man were admitted in our hospital after acute severe symptoms of right-hemispheric stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 15 and 18, respectively. In both cases, magnetic resonance angiography showed tandem occlusion and angiography confirmed tandem occlusion with ICA dissection. An extensive mismatch region was diagnosed by Perfusion-diffusion MRI of the brain within 3 h after symptoms onset. Treatment was initiated 4 h after symptom onset by implantation of self-expandable intracranial stents into the dissected ICA and administration of intra-arterial recombinant tissue plasminogen activator. Recanalization of the ICA and middle cerebral artery (MCA) was accomplished within 6 h after symptoms onset. In both cases, no periprocedural complication was observed and follow-up CT scan showed only a mild brain infarct in the MCA territory. After, respectively, 12 and 10 months follow-up, patients had a favorable outcome with NIHSS 0 and mRS ≤1. Endovascular stent-assisted thrombolysis appears to be a promising treatment in tandem occlusion due to ICA dissection. Our work underline the potential use of self-expandable intracranial stents in symptomatic acute ICA dissection. (orig.)

Expanding subjectivities

DEFF Research Database (Denmark)

Lundgaard Andersen, Linda; Soldz, Stephen

2012-01-01

A major theme in recent psychoanalytic thinking concerns the use of therapist subjectivity, especially “countertransference,” in understanding patients. This thinking converges with and expands developments in qualitative research regarding the use of researcher subjectivity as a tool......-Saxon and continental traditions, this special issue provides examples of the use of researcher subjectivity, informed by psychoanalytic thinking, in expanding research understanding....

Extending the imaging volume for biometric iris recognition.

Science.gov (United States)

Narayanswamy, Ramkumar; Johnson, Gregory E; Silveira, Paulo E X; Wach, Hans B

2005-02-10

The use of the human iris as a biometric has recently attracted significant interest in the area of security applications. The need to capture an iris without active user cooperation places demands on the optical system. Unlike a traditional optical design, in which a large imaging volume is traded off for diminished imaging resolution and capacity for collecting light, Wavefront Coded imaging is a computational imaging technology capable of expanding the imaging volume while maintaining an accurate and robust iris identification capability. We apply Wavefront Coded imaging to extend the imaging volume of the iris recognition application.

Location of the carbohydrates present in the HK-ATPase vesicles isolated from hog gastric mucosa

International Nuclear Information System (INIS)

Hall, K.; Perez, G.; Anderson, D.; Gutierrez, C.; Munson, K.; Hersey, S.J.; Kaplan, J.H.; Sachs, G.

1990-01-01

The glycosylation of H+K(+)-ATPase vesicles isolated from hog gastric mucosa was investigated by various methods. Following protein separation on sodium dodecyl sulfate reducing gels and transfer to poly(vinyl difluoride) membranes, binding of concanavalin A was confined to the 94-kDa band which corresponds to the catalytic subunit. In contrast, wheat germ agglutinin binding occurred in a region below the 94-kDa subunit, corresponding to the 60-85-kDa region, and also to protein just above the catalytic subunit. Treatment with glycopeptidase F removed most of the concanavalin A staining and also the wheat germ agglutinin staining found below the 94-kDa region, but spared the higher molecular weight wheat germ agglutinin reactive material. During the deglycosylation experiments a protein of 35-kDa was produced. Sequencing analysis of V8 protease generated peptide fragments of the 35-kDa protein show at least 30% homology with the Na+K(+)-ATPase beta-subunits. Labeling of the carbohydrates by galactosyltransferase and [3H]uridine diphosphate-galactose showed that the sites of labeling were extracellular and were confined to the wheat germ agglutinin staining regions. Two molecular weight regions, below the 94-kDa region, of 60 and 85 kDa were identified. Electron microscopy using postembedding staining techniques showed that both concanavalin A and wheat germ agglutinin staining occurred on the extracellular face of the gastric vesicles

On Dark Energy and Matter of the Expanding Universe

Directory of Open Access Journals (Sweden)

Lehnert B.

2009-04-01

Full Text Available At present the expanding universe is observed to be dominated by the not fully under- stood concepts of dark energy and matter, in a conceived almost flat Euclidian geometry. As one of the possible efforts to understand the global behaviour of the expanding uni- verse, the present paper attempts to explain these concepts in terms of the pressure force and gravity of a spherical photon gas cloud of zero point energy, in a flat geometry. A difficult point of the conventional theory concerns the frequency distribution of the zero point energy oscillations which leads to the unacceptable result of an infinite total en- ergy per unit volume. A modification of this distribution is therefore proposed which results in finite energy density. A corresponding equilibrium state is investigated, as well as small dynamic deviations from it, to form a basis for a model of the expanding universe. Provided that the crucial points of the present approach hold true, the model satisfies the requirements of cosmic linear dimensions, results in an estimated accelera- tion of the expansion being of the order of the observed one, presents a possible solution of the coincidence problem of dark energy and matter, and provides one of the possible explanations of the observed excess of high-energy electrons and positrons in recent balloon and satellite experiments.

Bone bruise in acute traumatic patellar dislocation: volumetric magnetic resonance imaging analysis with follow-up mean of 12 months

International Nuclear Information System (INIS)

Paakkala, Antti; Paakkala, Timo; Sillanpaeae, Petri; Maeenpaeae, Heikki; Huhtala, Heini

2010-01-01

The aim of the study was to assess volumetric analysis of bone bruises in acute primary traumatic patellar dislocation by magnetic resonance imaging (MRI) and resolving resolution of bruises in follow-up MRI. MRI was performed in 23 cases. A follow-up examination was done at a mean of 12 months after dislocation. Volumes of patellar and femur bruises for every patient were evaluated separately by two musculoskeletal radiologists, and mean values of the bruises were assessed. Other MRI findings were evaluated, together with agreement by consensus. Bone bruise volumes were compared with other MR findings. In the acute study 100% of patients showed bruising of the lateral femoral condyle and 96% bruising of the patella. The bruise was located at the medial femoral condyle in 30% and at the patellar median ridge in 74% of patients. The median volume of the femoral bruise was 25,831 mm 3 and of the patellar bruise 2,832 mm 3 . At the follow-up study 22% of patients showed bruising of the lateral femoral condyle and 39% bruising of the patella, the median volumes of the bruises being 5,062 mm 3 and 1,380 mm 3 , respectively. Larger patellar bruise volume correlated with larger femur bruise volume in the acute (r=0.389, P=0.074) and the follow-up (r=1.000, P<0.01) studies. Other MRI findings did not correlate significantly with bone bruise volumes. Bone bruising is the commonest finding in cases of acute patellar dislocation, being seen even 1 year after trauma and indicating significant bone trabecular injury in the patellofemoral joint. A large bruise volume may be associated with subsequent chondral lesion progression at the patella. We concluded that the measurement of bone bruise volume in patients with acute patellar dislocation is a reproducible method but requires further studies to evaluate its clinical use. (orig.)

Medicare Post-Acute Care Episodes and Payment Bundling

Data.gov (United States)

U.S. Department of Health & Human Services — Published in Volume 4, Issue 1, of Medicare and Medicaid Research Review, this paper provides an overview of results examining alternative Medicare post-acute care...

Study on the Characteristics of Expander Power Output Used for Offsetting Pumping Work Consumption in Organic Rankine Cycles

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Yu-Ting Wu

2014-07-01

Full Text Available The circulation pump in an organic Rankine cycle (ORC increases the pressure of the liquid working fluid from low condensing pressure to high evaporating pressure, and the expander utilizes the pressure difference to generate work. A portion of the expander output power is used to offset the consumed pumping work, and the rest of the expander power is exactly the net work produced by the ORC system. Because of the relatively great theoretical pumping work and very low efficiency of the circulation pump reported in previous papers, the characteristics of the expander power used for offsetting the pumping work need serious consideration. In particular, the present work examines those characteristics. It is found that the characteristics of the expander power used for offsetting the pumping work are satisfactory only under the condition that the working fluid absorbs sufficient heat in the evaporator and its specific volume at the evaporator outlet is larger than or equal to a threshold value.

Aging models of acute seizures and epilepsy.

Science.gov (United States)

Kelly, Kevin M

2010-01-01

Aged animals have been used by researchers to better understand the differences between the young and the aged brain and how these differences may provide insight into the mechanisms of acute seizures and epilepsy in the elderly. To date, there have been relatively few studies dedicated to the modeling of acute seizures and epilepsy in aged, healthy animals. Inherent challenges to this area of research include the costs associated with the purchase and maintenance of older animals and, at times, the unexpected and potentially confounding comorbidities associated with aging. However, recent studies using a variety of in vivo and in vitro models of acute seizures and epilepsy in mice and rats have built upon early investigations in the field, all of which has provided an expanded vision of seizure generation and epileptogenesis in the aged brain. Results of these studies could potentially translate to new and tailored interventional approaches that limit or prevent the development of epilepsy in the elderly.

[Experimental study of acute brain swelling under acute intracranial hypertension (author's transl)].

Science.gov (United States)

Shigemori, M; Watanabe, M; Kuramoto, S

1976-12-01

blood volume with increase of blood volume in the superior sagitta sinus during cerebral vasoparesis under intracranial hypertension is presumed. It is suggested from the superior sagittal sinus pressure in various experimental groups that the site, reactivity and disturbed degree of the cerebral venous system are changed by the difference of respiratory or ventrilatory state and the cerebral venous circulatory disturbance has also reference to the occurrence of acute brain swelling. 3) During cerebral vasopareris under acute intracranial hypertension, remarkable supression of respiration, increased central venous pressure and increased common carotid blood flow were observed. It is concluded that the reaction of systemic hemodynamics following respiratory change effects on cerebral circulation markedly and they are being important factors to occurrence of acute brain swelling.

Atrophy of Swallowing Muscles Is Associated With Severity of Dysphagia and Age in Patients With Acute Stroke.

Science.gov (United States)

Sporns, Peter B; Muhle, Paul; Hanning, Uta; Suntrup-Krueger, Sonja; Schwindt, Wolfram; Eversmann, Julian; Warnecke, Tobias; Wirth, Rainer; Zimmer, Sebastian; Dziewas, Rainer

2017-07-01

Sarcopenia has been identified as an independent risk factor for dysphagia. Dysphagia is one of the most important and prognostically relevant complications of acute stroke. The role of muscle atrophy as a contributing factor for the occurrence of poststroke dysphagia is yet unclear. To assess whether there is a correlation between age and muscle volume and whether muscle volume is related to dysphagia in acute stroke patients. This retrospective, single-center study included 73 patients with acute ischemic or hemorrhagic stroke who underwent computed tomography angiography on admission and an objective dysphagia assessment by Fiberoptic Endoscopic Evaluation of Swallowing within 72 hours from admission. With the help of semiautomated muscle segmentation and 3-dimensional reconstruction volumetry of the digastric, temporal, and geniohyoid muscles was performed. For further analysis, participants were first divided into 4 groups according to their age (dysphagia severity using the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) (FEDSS 1 and 2, n = 25; FEDSS 3 and 4, n = 32; FEDSS 5 and 6, n = 16). Correlation of muscle volumes with age and dysphagia severity. Muscle volumes of single muscles (except for geniohyoid and the right digastric muscles) as well as the sum muscle volume were significantly and inversely related to dysphagia severity. We found a significant decline of muscle volume with advancing age for most muscle groups and, in particular, for the total muscle volume. Apart from features being determined by the acute stroke itself (eg, site and size of stroke), also premorbid conditions, in particular age-related muscle atrophy, have an impact on the complex pathophysiology of swallowing disorders poststroke. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Stimuli-responsive transformation in carbon nanotube/expanding microsphere–polymer composites

International Nuclear Information System (INIS)

Loomis, James; Xu Peng; Panchapakesan, Balaji

2013-01-01

Our work introduces a class of stimuli-responsive expanding polymer composites with the ability to unidirectionally transform their physical dimensions, elastic modulus, density, and electrical resistance. Carbon nanotubes and core–shell acrylic microspheres were dispersed in polydimethylsiloxane, resulting in composites that exhibit a binary set of material properties. Upon thermal or infrared stimuli, the liquid cores encapsulated within the microspheres vaporize, expanding the surrounding shells and stretching the matrix. The microsphere expansion results in visible dimensional changes, regions of reduced polymeric chain mobility, nanotube tensioning, and overall elastic to plastic-like transformation of the composite. Here, we show composite transformations including macroscopic volume expansion (>500%), density reduction (>80%), and elastic modulus increase (>675%). Additionally, conductive nanotubes allow for remote expansion monitoring and exhibit distinct loading-dependent electrical responses. With the ability to pattern regions of tailorable expansion, strength, and electrical resistance into a single polymer skin, these composites present opportunities as structural and electrical building blocks in smart systems. (paper)

Dynamical evolution of domain walls in an expanding universe

Science.gov (United States)

Press, William H.; Ryden, Barbara S.; Spergel, David N.

1989-01-01

Whenever the potential of a scalar field has two or more separated, degenerate minima, domain walls form as the universe cools. The evolution of the resulting network of domain walls is calculated for the case of two potential minima in two and three dimensions, including wall annihilation, crossing, and reconnection effects. The nature of the evolution is found to be largely independent of the rate at which the universe expands. Wall annihilation and reconnection occur almost as fast as causality allows, so that the horizon volume is 'swept clean' and contains, at any time, only about one, fairly smooth, wall. Quantitative statistics are given. The total area of wall per volume decreases as the first power of time. The relative slowness of the decrease and the smoothness of the wall on the horizon scale make it impossible for walls to both generate large-scale structure and be consistent with quadrupole microwave background anisotropy limits.

Very Low Cerebral Blood Volume Predicts Parenchymal Hematoma in Acute Ischemic Stroke

DEFF Research Database (Denmark)

Hermitte, Laure; Cho, Tae-Hee; Ozenne, Brice

2013-01-01

BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to exp......BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective...

The influence of a fentanyl and dexmedetomidine combination on external respiratory functions in acute hemorrhage model

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Nikolay G. Vengerovich

2017-01-01

Full Text Available Background. The synthetic opioid analgesic fentanyl is widely used for prophylaxis and therapy of traumatic shock associated with massive bleeding. Its side effects – skeletal muscle rigidity and respiratory center depression – are especially pronounced with repeated administration. It is rational to apply fentanyl in diminished doses in combination with non-opioid analgesics in order to reduce respiratory disturbances risk.Aim. The aim of the work is to justify the influence of opioid analgesic fentanyl and α2 -adrenomimetic dexmedetomidine combination on external respiratory functions in acute hemorrhage model.Materials and methods. Acute loss of 35–40% of circulating blood volume was modeled in experiments on 75 white mongrel male rats. The external respiratory functions (respiratory rate, respiratory volume, breath volume per minute were estimated in animals of 5 groups: 1 – rats without analgesic help (controls; 2–3 – rats receiving a single fentanyl intramuscular injection (ED99 98,96 mcg/kg or fentanyl together with dexme detomidine (ED99 of combination 67,94 mcg/kg 15 min after acute blood loss; 4–5 – rats receiving the same drugs 15 min, 30, 45 and 60 min later.Results. In experimental acute loss of 35–40% of circulating blood volume, 15 min later a secondary acute respiratory failure developed with a drop of respiratory rate, respiratory volume and volume of breath per minute by 30%, 21 and 47% (p < 0,05. The external respiratory functions recoverеd after 4 h mainly due to the increase of respiratory volume. A single intramuscular injection of fentanyl caused respiratory depression 15 min after experimental blood loss which resulted in the decrease of breath volume per minute to 30–61% (p < 0,05 for 90 min. Four intramuscular injections of fentanyl 15 min, 30, 45 and 60 min after hemorrhage caused a severe respiratory dysfunction, accompanied by apnea periods and Biot’s respiration. Respiratory rate was reduced

Expanding Thurston maps

CERN Document Server

Bonk, Mario

2017-01-01

This monograph is devoted to the study of the dynamics of expanding Thurston maps under iteration. A Thurston map is a branched covering map on a two-dimensional topological sphere such that each critical point of the map has a finite orbit under iteration. It is called expanding if, roughly speaking, preimages of a fine open cover of the underlying sphere under iterates of the map become finer and finer as the order of the iterate increases. Every expanding Thurston map gives rise to a fractal space, called its visual sphere. Many dynamical properties of the map are encoded in the geometry of this visual sphere. For example, an expanding Thurston map is topologically conjugate to a rational map if and only if its visual sphere is quasisymmetrically equivalent to the Riemann sphere. This relation between dynamics and fractal geometry is the main focus for the investigations in this work.

Early changes of parotid density and volume predict modifications at the end of therapy and intensity of acute xerostomia

Energy Technology Data Exchange (ETDEWEB)

Belli, Maria Luisa; Broggi, Sara [Ospedale San Raffaele Scientific Institute, Medical Physics, Milano (Italy); Scalco, Elisa; Rizzo, Giovanna [CNR, Istituto di Bioimmagini e Fisiologia Molecolare, Milano (Italy); Sanguineti, Giuseppe [Regina Elena National Cancer Institute, Department of Radiation Oncology, Rome (Italy); Fiorino, Claudio; Cattaneo, Giovanni Mauro [Ospedale San Raffaele Scientific Institute, Medical Physics, Milano (Italy); CNR, Istituto di Bioimmagini e Fisiologia Molecolare, Milano (Italy); Dinapoli, Nicola; Valentini, Vincenzo [Universita Cattolica del Sacro Cuore, Radiotherapy, Rome (Italy); Ricchetti, Francesco [Ospedale Sacro Cuore, Radiotherapy, Negrar (Italy)

2014-11-15

To quantitatively assess the predictive power of early variations of parotid gland volume and density on final changes at the end of therapy and, possibly, on acute xerostomia during IMRT for head-neck cancer. Data of 92 parotids (46 patients) were available. Kinetics of the changes during treatment were described by the daily rate of density (rΔρ) and volume (rΔvol) variation based on weekly diagnostic kVCT images. Correlation between early and final changes was investigated as well as the correlation with prospective toxicity data (CTCAEv3.0) collected weekly during treatment for 24/46 patients. A higher rΔρ was observed during the first compared to last week of treatment (-0,50 vs -0,05HU, p-value = 0.0001). Based on early variations, a good estimation of the final changes may be obtained (Δρ: AUC = 0.82, p = 0.0001; Δvol: AUC = 0.77, p = 0.0001). Both early rΔρ and rΔvol predict a higher ''mean'' acute xerostomia score (≥ median value, 1.57; p-value = 0.01). Median early density rate changes for patients with mean xerostomia score ≥ / < 1.57 were -0.98 vs -0.22 HU/day respectively (p = 0.05). Early density and volume variations accurately predict final changes of parotid glands. A higher longitudinally assessed score of acute xerostomia is well predicted by higher rΔρ and rΔvol in the first two weeks of treatment: best cut-off values were -0.50 HU/day and -380 mm{sup 3}/day for rΔρ and rΔvol respectively. Further studies are necessary to definitively assess the potential of early density/volume changes in identifying more sensitive patients at higher risk of experiencing xerostomia. (orig.) [German] Ziel der Studie ist die Untersuchung der praediktiven Aussagekraft von fruehen Veraenderungen in Volumen und Dichte der Ohrspeicheldruese in Bezug auf die finale Verformung zum Ende der Therapie sowie das Risiko von Xerostomie waehrend der intesitaetsmodulierten Strahlentherapie (IMRT) bei Kopf und Hals Tumoren. Die Studie

Expanding services in a shrinking economy: desktop document delivery in a dental school library.

Science.gov (United States)

Gushrowski, Barbara A

2011-07-01

How can library staff develop and promote a document delivery service and then expand the service to a wide audience? The setting is the library at the Indiana University School of Dentistry (IUSD), Indianapolis. A faculty survey and a citation analysis were conducted to determine potential use of the service. Volume of interlibrary loan transactions and staff and equipment capacity were also studied. IUSD Library staff created a desktop delivery service (DDSXpress) for faculty and then expanded the service to practicing dental professionals and graduate students. The number of faculty using DDSXpress remains consistent. The number of practicing dental professionals using the service is low. Graduate students have been quick to adopt the service. Through careful analysis of capacity and need for the service, staff successfully expanded document delivery service without incurring additional costs. Use of DDSXpress is continually monitored, and opportunities to market the service to practicing dental professionals are being investigated.

New biomarkers of acute kidney injury

Directory of Open Access Journals (Sweden)

Ruya Ozelsancak

2013-04-01

Full Text Available Acute kidney injury is a clinical syndrome which is generally defined as an abrupt decline in glomerular filtration rate causing accumulation of nitrogenous products and rapid development of fluid, electrolyte and acid-base disorders. It is an important clinical problem increasing mortality in patient with several co-morbid conditions. The frequency of acute kidney injury occurrence varies from 5% on the inpatients wards to 30-50% in patients from intensive care units. Serial measurement of creatinine and urine volume do not make it possible to diagnose acute kidney injury at early stages. Serum creatinine may be influenced by age, weight, hydration status and become apparent only when the kidneys have lost 50% of their function. For that reasons we need new markers. Here, we are reviewing the most promising new acute kidney injury markers, neutrophil gelatinase associated lipocalin, cystatin-C, kidney injury molecule-1, liver fatty acid binding proteins and IL-18. [Archives Medical Review Journal 2013; 22(2.000: 221-229

Treatment with a belly-board device significantly reduces the volume of small bowel irradiated and results in low acute toxicity in adjuvant radiotherapy for gynecologic cancer: results of a prospective study

International Nuclear Information System (INIS)

Martin, Joseph; Fitzpatrick, Kathryn; Horan, Gail; McCloy, Roisin; Buckney, Steve; O'Neill, Louise; Faul, Clare

2005-01-01

Background and purpose: To determine whether treatment prone on a belly-board significantly reduces the volume of small bowel irradiated in women receiving adjuvant radiotherapy for gynecologic cancer, and to prospectively study acute small bowel toxicity using an accepted recording instrument. Material and methods: Thirty-two gynecologic patients underwent simulation with CT scanning supine and prone. Small bowel was delineated on every CT slice, and treatment was prone on the belly-board using 3-5 fields-typically Anterior, Right and Left Lateral, plus or minus Lateral Boosts. Median prescribed dose was 50.4 Gy and all treatments were delivered in 1.8 Gy fractions. Concomitant Cisplatin was administered in 13 patients with cervical carcinoma. Comparison of small bowel dose-volumes was made between supine and prone, with each subject acting as their own matched pair. Acute small bowel toxicity was prospectively measured using the Common Toxicity Criteria: Version 2.0. Results: Treatment prone on the belly-board significantly reduced the volume of small bowel receiving ≥100; ≥95; ≥90; and ≥80% of the prescribed dose, but not ≥50%. This was found whether volume was defined in cubic centimeters or % of total small bowel volume. Of 29 evaluable subjects, 2 (7%) experienced 1 episode each of grade 3 diarrhoea. All other toxicity events were grade 2 or less and comprised diarrhoea (59%), abdominal pain or cramping (48%), nausea (38%), anorexia (17%), vomiting (10%). There were no Grade 4 events and no treatment days were lost due to toxicity. Conclusions: Treatment prone on a belly-board device results in significant small bowel sparing, during adjuvant radiotherapy for gynecologic cancer. The absence of Grade 4 events or Treatment Days Lost compares favorably with the published literature

NPR hazards review: (Phase 1, Production only appendixes). Volume 2

Energy Technology Data Exchange (ETDEWEB)

Miller, N.R.; Trumble, R.E.

1962-08-15

The NPR Hazards Review is being issued in a series of volumes. Volume 1, which has already been published, was of the nature of an expanded summary. It included the results of hazards analyses with some explanatory material to put the results in context. Volume 2 presents results of reviews made after the preparation of Volume 1. It also contains supporting material and details not included in Volume 1. Volumes 1 and 2 together provide a nearly complete ``Design Hazards Review of the NPR.`` However, certain remaining problems still exist and are to be the subject of a continuing R&D program. These problems and programs are discussed in Appendix H. Neither Volume 1 nor Volume 2 treat operational aspects of reactor hazards in detail. This area of concern will be the primary subject of a third volume of the NPR Hazards Review. This third volume, to be prepared and issued at a later date, may also contain information supplementing Volumes 1 and 2.

Power Doppler ultrasound phenotyping of expanding versus collapsed popliteal lymph nodes in murine inflammatory arthritis.

Directory of Open Access Journals (Sweden)

Echoe M Bouta

Full Text Available Rheumatoid arthritis is a chronic inflammatory disease manifested by episodic flares in affected joints that are challenging to predict and treat. Longitudinal contrast enhanced-MRI (CE-MRI of inflammatory arthritis in tumor necrosis factor-transgenic (TNF-Tg mice has demonstrated that popliteal lymph nodes (PLN increase in volume and contrast enhancement during the pre-arthritic "expanding" phase of the disease, and then suddenly "collapse" during knee flare. Given the potential of this biomarker of arthritic flare, we aimed to develop a more cost-effective means of phenotyping PLN using ultrasound (US imaging. Initially we attempted to recapitulate CE-MRI of PLN with subcutaneous footpad injection of US microbubbles (DEFINITY®. While this approach allowed for phenotyping via quantification of lymphatic sinuses in PLN, which showed a dramatic decrease in collapsed PLN versus expanding or wild-type (WT PLN, electron microscopy demonstrated that DEFINITY® injection also resulted in destruction of the lymphatic vessels afferent to the PLN. In contrast, Power Doppler (PD US is innocuous to and efficiently quantifies blood flow within PLN of WT and TNF-Tg mice. PD-US demonstrated that expanding PLN have a significantly higher normalized PD volume (NPDV versus collapsed PLN (0.553 ± 0.007 vs. 0.008 ± 0.003; p0.030 and lower (<0.016 quartile NPDVs in this cohort of mice, which serve as conservative thresholds to phenotype PLN as expanding and collapsed, respectively. Interestingly, of the 12 PLN phenotyped by the two methods, there was disagreement in 4 cases in which they were determined to be expanding by CE-MRI and collapsed by PD-US. Since the adjacent knee had evidence of synovitis in all 4 cases, we concluded that the PD-US phenotyping was correct, and that this approach is currently the safest and most cost-effective in vivo approach to phenotype murine PLN as a biomarker of arthritic flare.

The effect of performance-volume limit on the DRG based acute care hospital financing in Hungary.

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Endrei, Dóra; Zemplényi, Antal; Molics, Bálint; Agoston, István; Boncz, Imre

2014-04-01

The aim of our paper is to analyse the effect of the so-called performance volume limit (PVL) financing method on acute hospital care. The data were derived from the nationwide administrative dataset of the National Health Insurance Fund Administration (OEP) covering the period 2003-2008. We analysed the trends in the DRG cost-weights, number of cases, case-mix, and average length of stay. We calculated the average annual reimbursement rate per DRG cost-weight with and without the application of PVL degression according to the hospital type and medical professions. Our results showed that although the national case mix (i.e., the sum of all of the DRG cost-weights produced in one year) did not change between 2003-2006, the trend of the annual number of cases increased, and the average length of stay decreased. During 2007-2008, a significant decline was found in each indicator. The introduction of the PVL resulted in a health insurance budget saving of 1.9% in 2004, 2.6% in 2005, 3.4% in 2006, 5.6% in 2007, and 3.2% in 2008. We found the lowest reimbursement rate per DRG cost-weight at the university medical schools (HUF 138,200 or € 550) and children's hospitals (HUF 132,547 or € 528), whereas the highest was at the county hospitals (HUF 143,451 or € 571) and city hospitals (HUF 142, 082 or € 565). The implementation of the PVL reduced the acute care hospital activity and reimbursement. The effect of the PVL was different on the different types of hospitals, and it had a serious disadvantageous effect on the university medical schools and children's hospitals. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Tomotherapy for prostate adenocarcinoma: A report on acute toxicity

International Nuclear Information System (INIS)

Keiler, Louis; Dobbins, Donald; Kulasekere, Ravi; Einstein, Douglas

2007-01-01

Background and purpose: To analyze the impact of Tomotherapy (TOMO) intensity modulated radiotherapy (IMRT) on acute gastrointestinal (GI) and genitourinary (GU) toxicity in prostate cancer. Materials and methods: The records of 55 consecutively treated TOMO patients were reviewed. Additionally a well-matched group of 43 patients treated with LINAC-based step and shoot IMRT (LINAC) was identified. Acute toxicity was scored according to Radiation Therapy Oncology Group acute toxicity criterion. Results: The grade 2-3 acute GU toxicity rates for the TOMO vs. LINAC groups were 51% vs. 28% (p = 0.001). Acute grade 2 GI toxicity was 25% vs. 40% (p = 0.024), with no grade 3 GI toxicity in either group. In univariate analysis, androgen deprivation, prostate volume, pre-treatment urinary toxicity, and prostate dose homogeneity correlated with acute GI and GU toxicity. With multivariate analysis use of Tomotherapy, median bladder dose and bladder dose homogeneity remained significantly correlated with GU toxicity. Conclusions: Acute GI toxicity for prostate cancer is improved with Tomotherapy at a cost of increased acute GU toxicity possibly due to differences in bladder and prostate dose distribution

Insertion of self-expanding metal stent for treatment of malignant obstruction in a pregnant woman

Directory of Open Access Journals (Sweden)

Noelia Alonso-Lázaro

2014-03-01

Full Text Available Colorectal cancer (CRC is the second most frequent cancer both in incidence and mortality in women, especially in those over 60 years of age. Diagnosis in women at gestational age is rare, so its incidence during pregnancy is low. However, an increase in its diagnosis is expected during the next years because of the raise in the average age of pregnancy. In most cases, the diagnosis is delayed because symptoms related to CRC can be attributed to pregnancy itself. Up to 30 % of CRC cases may present as an intestinal obstruction. In this situation, the main objective is to solve the clinical emergency in the safest way for mother and fetus, together with performing an accurate diagnostic approach to offer the best possible therapeutic management knowing the limitations and difficulties related to pregnancy. The self-expanding metallic stent (SEMS can be particularly useful in colon obstruction in a pregnant patient with CRC because it allows solving the acute condition providing time to perform a more accurate staging study and to prepare the patient for surgery, thus reducing both post-surgical morbidity and mortality. We report on the case of a patient who early in the second trimester of pregnancy presented with an acute colonic obstruction due to CRC which was successfully managed with the placement of a self-expanding metal stent.

Comparison of self-expandable and balloon-expanding stents for hybrid ductal stenting in hypoplastic left heart complex.

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Goreczny, Sebastian; Qureshi, Shakeel A; Rosenthal, Eric; Krasemann, Thomas; Nassar, Mohamed S; Anderson, David R; Morgan, Gareth J

2017-07-01

We aimed to compare the procedural and mid-term performance of a specifically designed self-expanding stent with balloon-expandable stents in patients undergoing hybrid palliation for hypoplastic left heart syndrome and its variants. The lack of specifically designed stents has led to off-label use of coronary, biliary, or peripheral stents in the neonatal ductus arteriosus. Recently, a self-expanding stent, specifically designed for use in hypoplastic left heart syndrome, has become available. We carried out a retrospective cohort comparison of 69 neonates who underwent hybrid ductal stenting with balloon-expandable and self-expanding stents from December, 2005 to July, 2014. In total, 43 balloon-expandable stents were implanted in 41 neonates and more recently 47 self-expanding stents in 28 neonates. In the balloon-expandable stents group, stent-related complications occurred in nine patients (22%), compared with one patient in the self-expanding stent group (4%). During follow-up, percutaneous re-intervention related to the ductal stent was performed in five patients (17%) in the balloon-expandable stent group and seven patients (28%) in self-expanding stents group. Hybrid ductal stenting with self-expanding stents produced favourable results when compared with the results obtained with balloon-expandable stents. Immediate additional interventions and follow-up re-interventions were similar in both groups with complications more common in those with balloon-expandable stents.

Effect of large volume paracentesis on plasma volume--a cause of hypovolemia

International Nuclear Information System (INIS)

Kao, H.W.; Rakov, N.E.; Savage, E.; Reynolds, T.B.

1985-01-01

Large volume paracentesis, while effectively relieving symptoms in patients with tense ascites, has been generally avoided due to reports of complications attributed to an acute reduction in intravascular volume. Measurements of plasma volume in these subjects have been by indirect methods and have not uniformly confirmed hypovolemia. We have prospectively evaluated 18 patients (20 paracenteses) with tense ascites and peripheral edema due to chronic liver disease undergoing 5 liter paracentesis for relief of symptoms. Plasma volume pre- and postparacentesis was assessed by a 125 I-labeled human serum albumin dilution technique as well as by the change in hematocrit and postural blood pressure difference. No significant change in serum sodium, urea nitrogen, hematocrit or postural systolic blood pressure difference was noted at 24 or 48 hr after paracentesis. Serum creatinine at 24 hr after paracentesis was unchanged but a small but statistically significant increase in serum creatinine was noted at 48 hr postparacentesis. Plasma volume changed -2.7% (n = 6, not statistically significant) during the first 24 hr and -2.8% (n = 12, not statistically significant) during the 0- to 48-hr period. No complications from paracentesis were noted. These results suggest that 5 liter paracentesis for relief of symptoms is safe in patients with tense ascites and peripheral edema from chronic liver disease

Bone bruise in acute traumatic patellar dislocation: volumetric magnetic resonance imaging analysis with follow-up mean of 12 months

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Paakkala, Antti; Paakkala, Timo [Tampere University Hospital, Department of Radiology, Tampere (Finland); Sillanpaeae, Petri; Maeenpaeae, Heikki [Tampere University Hospital, Department of Orthopaedics and Traumatology, Tampere (Finland); Huhtala, Heini [University of Tampere, School of Public Health, Tampere (Finland)

2010-07-15

The aim of the study was to assess volumetric analysis of bone bruises in acute primary traumatic patellar dislocation by magnetic resonance imaging (MRI) and resolving resolution of bruises in follow-up MRI. MRI was performed in 23 cases. A follow-up examination was done at a mean of 12 months after dislocation. Volumes of patellar and femur bruises for every patient were evaluated separately by two musculoskeletal radiologists, and mean values of the bruises were assessed. Other MRI findings were evaluated, together with agreement by consensus. Bone bruise volumes were compared with other MR findings. In the acute study 100% of patients showed bruising of the lateral femoral condyle and 96% bruising of the patella. The bruise was located at the medial femoral condyle in 30% and at the patellar median ridge in 74% of patients. The median volume of the femoral bruise was 25,831 mm{sup 3} and of the patellar bruise 2,832 mm{sup 3}. At the follow-up study 22% of patients showed bruising of the lateral femoral condyle and 39% bruising of the patella, the median volumes of the bruises being 5,062 mm{sup 3} and 1,380 mm{sup 3}, respectively. Larger patellar bruise volume correlated with larger femur bruise volume in the acute (r=0.389, P=0.074) and the follow-up (r=1.000, P<0.01) studies. Other MRI findings did not correlate significantly with bone bruise volumes. Bone bruising is the commonest finding in cases of acute patellar dislocation, being seen even 1 year after trauma and indicating significant bone trabecular injury in the patellofemoral joint. A large bruise volume may be associated with subsequent chondral lesion progression at the patella. We concluded that the measurement of bone bruise volume in patients with acute patellar dislocation is a reproducible method but requires further studies to evaluate its clinical use. (orig.)

Acute vision loss: a fuzzy presentation of sarcoidosis.

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Austin, Andrea L; Day, Luke T; Bishop, Frank M

2013-04-01

Acute vision loss is a devastating problem for patients and a challenging diagnostic dilemma for Emergency Physicians. This chief complaint is one in which we must be adept at quickly evaluating and initiating either care or referral. This case reviews the approach to acute vision loss and shows the importance of expanding the differential in atypical and complex presentations. A 31-year-old, previously healthy, white woman presented to the Emergency Department (ED) with 1 day of painless right eye vision loss. Ocular ultrasound and slit-lamp examination were unremarkable. Fundoscopic examination revealed retinal hemorrhages and papillitis. Her chest X-ray study was significant for bilateral hilar adenopathy, and subsequent lymph node biopsy confirmed the diagnosis of sarcoidosis. Although sarcoidosis is more common in African Americans, it must be considered in all patients in the appropriate clinical context. Sarcoidosis is an important diagnosis to include on the differential of many chief complaints that present to the ED, including acute vision loss and dyspnea. Published by Elsevier Inc.

Lowering bronchoaspiration rate in an acute stroke unit by means of a 2 volume/3 texture dysphagia screening test with pulsioximetry.

Science.gov (United States)

Cocho, D; Sagales, M; Cobo, M; Homs, I; Serra, J; Pou, M; Perez, G; Pujol, G; Tantinya, S; Bao, P; Aloy, A; Sabater, R; Gendre, J; Otermin, P

During acute stroke, 30% of all patients present dysphagia and 50% of that subgroup will experience bronchoaspiration. Our aim was to compare mortality and bronchoaspiration rates associated with the water test compared to those associated with a 2 volume/3 texture test controlled with pulse oximetry (2v/3t-P test) in our stroke unit. Over a 5-year period, we performed a prospective analysis of all consecutive acute ischaemic stroke patients hospitalised in the Stroke Unit. Dysphagia was evaluated using the water test between 2008 and 2010 (group 0 or G0), and the 2v/3t-P test (group 1 or G1) between 2011 and 2012. We analysed demographic data, vascular risk factors, neurological deficit on the NIHSS, aetiological subtype according to TOAST criteria, clinical subtype according to the Oxfordshire classification, prevalence of dysphagia, percentage of patients with bronchoaspiration, and mortality. We examined 418 patients with acute stroke (G0=275, G1=143). There were significant differences between the 2 groups regarding the percentage of patients with TACI (17% in G0 vs. 29% in G1, P=.005) and median NIHSS score (4 points in G0 vs. 7 points in G1, P=.003). Since adopting the new swallowing test, we detected a non-significant increase in the percentage of dysphagia (22% in G0 vs. 25% in G1, P=.4), lower mortality (1.7% in G0 vs. 0.7% in G1, P=.3) and a significant decrease in the bronchoaspiration rate (6.2% in G0 vs. 2.1% in G1, P=.05). Compared to the water test used for dysphagia screening, the new 2v/3t-P test lowered bronchoaspiration rates in acute stroke patients. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

January 2015 Phoenix pulmonary journal club: noninvasive ventilation in acute respiratory failure

Directory of Open Access Journals (Sweden)

Mathew M

2015-01-01

Full Text Available No abstract available. Article truncated after 150 words. Noninvasive positive pressure ventilation has expanded its role in the treatment of both chronic and acute respiratory failure. Its initial use in conditions such as obstructive sleep apnea, neuromuscular disease and tracheobronchomalacia, have been shown to improve quality of life and reduce mortality. Over the past 20 years studies have looked at using noninvasive ventilation in the management of acute respiratory failure from pulmonary edema, asthma and COPD exacerbations. During this month's journal club we reviewed 3 articles evaluating the efficacy of noninvasive ventilation in acute respiratory failure. Gupta D, Nath A, Agarwal R, Behera D. A prospective randomized controlled trial on the efficacy of noninvasive ventilation in severe acute asthma. Respir Care. 2010;55(5:536-43. [PubMed] This was a small unblinded randomized controlled trial (RCT looking at the efficacy using noninvasive ventilation (NIV in acute asthma. A total of 53 patients were included and divided into 2 groups of 28 patients ...

Do Age and Anticoagulants Affect the Natural History of Acute Subdural Hematomas?

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Lucke-Wold, Brandon P; Turner, Ryan C; Josiah, Darnell; Knotts, Chelsea; Bhatia, Sanjay

2016-01-01

Acute subdural hematoma is a serious complication following traumatic brain injury. Large volume hematomas or those with underlying brain injury can cause mass effect, midline shift, and eventually herniation of the brain. Acute subdural hematomas in the young are associated with high-energy trauma and often have underlying contusions, while acute subdural hematomas in the elderly are associated with minor trauma and an absence of underlying contusions, even though the elderly are more likely to be on anticoagulants or anti-platelet therapy. In the young patients with high impact injuries the hematomas tend to be small and the underlying brain injury and swelling is responsible for the increased intracranial pressure and midline shift. In the elderly, the injuries are low impact (e.g fall from standing), the underlying brain is intact, and the volume of the hematoma itself produces symptoms. In addition the use of anticoagulants and antiplatelet agents in the elderly population has been thought to be a poor prognostic indicator and is considered to be responsible for larger hematomas and poor outcome. When managed conservatively, acute subdural hematomas can sometimes progress to chronic subdural hematoma formation, further enlargement, seizures, and progressive midline shift. Another potential difference in the young and the elderly is brain atrophy, which increases the potential space to accommodate a larger hematoma. It is not known if these two groups differ in other ways that might have implications for treatment or prognosis. In this paper, we investigate the clinical course of 80 patients admitted to our institution with acute subdural hematomas, to identify differences in patients above or below the age of 65 years. The natural progression/resolution of acute subdural hematomas was mapped by measuring volume expansion/regression over time. In this retrospective chart review, we investigated clinical baseline metrics and subsequent volumetric expansion

Temporary stenting and retrieval of the self-expandable, intracranial stent in acute middle cerebral artery occlusion

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Suh, Sang Hyun; Chung, Tae-Sub [Yonsei University College of Medicine, Department of Radiology, Gangnam Severance Hospital, Seoul (Korea); Lee, Kyung-Yul [Yonsei University College of Medicine, Department of Neurology, Gangnam Severance Hospital, Seoul (Korea); Hong, Chang Ki; Kim, Chang-Hyun [Yonsei University College of Medicine, Department of Neurosurgery, Gangnam Severance Hospital, Seoul (Korea); Kim, Byung Moon; Kim, Dong Ik [Yonsei University College of Medicine, Department of Radiology, Seoul (Korea)

2009-08-15

We describe our experience in which a retrievable Enterprise stent was used as a temporary recanalization and embolectomy device in an acute middle cerebral artery (MCA) occlusion after urgent stenting for ipsilateral carotid artery stenosis. (orig.)

Fluid Volume Expansion and Depletion in Hemodialysis Patients Lack Association with Clinical Parameters

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Sylvia Kalainy

2015-12-01

Full Text Available Background: Achievement of normal volume status is crucial in hemodialysis (HD, since both volume expansion and volume contraction have been associated with adverse outcome and events. Objectives: The objectives of this study are to assess the prevalence of fluid volume expansion and depletion and to identify the best clinical parameter or set of parameters that can predict fluid volume expansion in HD patients. Design: This study is cross-sectional. Setting: This study was conducted in three hemodialysis units. Patients: In this study, there are 194 HD patients. Methods: Volume status was assessed by multifrequency bio-impedance spectroscopy (The Body Composition Monitor, Fresenius prior to the mid-week HD session. Results: Of all patients, 48 % ( n = 94 were volume-expanded and 9 % of patients were volume-depleted ( n = 17. Interdialytic weight gain was not different between hypovolemic, normovolemic, and hypervolemic patients. Fifty percent of the volume-expanded patients were hypertensive. Paradoxical hypertension was very common (31 % of all patients; its incidence was not different between patient groups. Intradialytic hypotension was relatively common and was more frequent among hypovolemic patients. Multivariate regression analysis identified only four predictors for volume expansion (edema, lower BMI, higher SBP, and smoking. None of these parameters displayed both a good sensitivity and specificity. Limitations: The volume assessment was performed once. Conclusions: The study indicates that volume expansion is highly prevalent in HD population and could not be identified using clinical parameters alone. No clinical parameters were identified that could reliably predict volume status. This study shows that bio-impedance can assist to determine volume status. Volume status, in turn, is not related to intradialytic weight gain and is unable to explain the high incidence of paradoxical hypertension.

Blood products, volume control, and renal support in the coagulopathy of liver disease.

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Argo, Curtis K; Balogun, Rasheed A

2009-02-01

Plasma-based products are commonly used in patients who have chronic liver disease to treat perceived coagulopathy despite unproven efficacy and potentially severe risks, such as transfusion-related acute lung injury, which carries a high mortality rate. Moreover, volume expansion may acutely worsen portal hypertension and increase bleeding from the collateral portal vascular bed. Although factor replacement therapy may be warranted in selected situations, its use should be restricted because of the limitations of target tests, such as international normalized ratio, which poorly reflects presence of bleeding diatheses in patients who have cirrhosis. Renal replacement therapies are frequent adjuncts in patients who have cirrhosis and are acutely decompensated, and may correct uremia-related bleeding diathesis and assist in controlling vascular volume, although they are generally limited to use as a bridge to liver transplantation. Novel extracorporeal therapies are emerging and may also have significant interaction with the hemostatic system. Volume contraction and blood conservation therapies are relatively new and promising approaches to reduce use of blood products in liver transplantation.

Application of a novel retrievable self-expanding stent in intracranial aneurysm treatment

International Nuclear Information System (INIS)

Yang Zhigang; Liu Jianmin; Xu Yi; Huang Qinghai; Hong Bo; Zhao Wenyuan; Zhao Rui

2008-01-01

Objective: To assess the value of a novel retrievable self-expanding stent system (LEO) in intracranial aneurysm treatment. Methods: 43 patients with 44 intracranial aneurysms treated with LEO stent were retrospectively analized, including 16 aneurysms with single-stent deployment, 25 with stent-assisted technique, 2 with double-stent deployment and one with double-stent assisted coils. Follow up was carried out through imaging and clinical course. Results: The stent was easy for repositioning and all the stents were delivered successfully, except 1 stent with unsatisfactory position, 1 with acute in-stent thrombosis. During follow up, 1 case showed chronic in-stent thrombus and one with intimal hyperplasia. 22 aneurysms got compact coiled during procedure. Among 29 follow up cases, 72.4% aneurysms were cured or improved, 13.8% were stable and three dissection aneurysms enlarged within short period and two patients died. Conclusion: The new retrievable self-expanding stent (LEO), with the advantages of controlled delivery, easy deployment and choice for various types is a valuable system for vascular reconstruction of intracranial aneurysm with thrombosis. (authors)

Two Types of Expanding Lie Algebra and New Expanding Integrable Systems

International Nuclear Information System (INIS)

Dong Huanhe; Yang Jiming; Wang Hui

2010-01-01

From a new Lie algebra proposed by Zhang, two expanding Lie algebras and its corresponding loop algebras are obtained. Two expanding integrable systems are produced with the help of the generalized zero curvature equation. One of them has complex Hamiltion structure with the help of generalized Tu formula (GTM). (general)

Acute Vagal Nerve Stimulation Lowers α2 Adrenoceptor Availability

DEFF Research Database (Denmark)

Landau, Anne M.; Dyve, Suzan; Jakobsen, Steen

2015-01-01

Background Vagal nerve stimulation (VNS) emerged as an anti-epileptic therapy, and more recently as a potential antidepressant intervention. Objective/hypothesis We hypothesized that salutary effects of VNS are mediated, at least in part, by augmentation of the inhibitory effects of cortical...... monoaminergic neurotransmission at appropriate receptors, specifically adrenoceptors. Our objective was to measure the effect of acute VNS on α2 adrenoceptor binding. Methods Using positron emission tomography (PET), we measured changes in noradrenaline receptor binding associated with acute VNS stimulation...... electrode in minipigs before and within 30 min of the initiation of 1 mA stimulation. Kinetic analysis with the Logan graphical linearization generated tracer volumes of distribution for each condition. We used an averaged value of the distribution volume of non-displaceable ligand (VND), to calculate...

Acute toxicity after a diverting stoma and spacer prior to chemoradiation in locally advanced rectal cancer

International Nuclear Information System (INIS)

Voort van Zyp, Jochem R.N. van der; Ceha, Heleen M.; Niehe, Valerie; Marinelli, Andreas W.K.S.; Putter, Hein; Marijnen, Corrie A.M.

2015-01-01

Background and purpose: Chemoradiotherapy (CRT) followed by surgery is the standard of care for locally advanced rectal cancer (LARC). For grade ⩾3 acute diarrhea there is a relationship between dose and irradiated small bowel volume. The aim of this study was to evaluate whether combined placement of a diverting stoma and sigmoid spacer (DSSS) led to reduced irradiated small bowel volume and less grade ⩾3 acute diarrhea in the treatment of LARC. Materials/methods: Between 2003 and 2010, 54 of 189 LARC patients treated with CRT in two institutions had a DSSS prior to CRT. Data on patient and treatment characteristics and outcomes were collected retrospectively. Delineation of small bowel was performed with planning CT-scans. CTCAE version 4.0 was used for acute toxicity. Results: Patients with a DSSS had significantly less small bowel volume irradiated up to doses of 20 Gy. This difference was not observed for the higher dose levels. CRT induced grade ⩾3 acute diarrhea was not different between the two groups (8.3% vs. 12.8%; p = 0.41). Conclusion: DSSS is not clearly beneficial to reduce grade ⩾3 acute diarrhea, and it must be considered whether placement of a DSSS is justified for this purpose

High Intensity Interval Training Leads to Greater Improvements in Acute Heart Rate Recovery and Anaerobic Power as High Volume Low Intensity Training

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Thomas L. Stöggl

2017-08-01

Full Text Available The purpose of the current study was to explore if training regimes utilizing diverse training intensity distributions result in different responses on neuromuscular status, anaerobic capacity/power and acute heart rate recovery (HRR in well-trained endurance athletes.Methods: Thirty-six male (n = 33 and female (n = 3 runners, cyclists, triathletes and cross-country skiers [peak oxygen uptake: (VO2peak: 61.9 ± 8.0 mL·kg−1·min−1] were randomly assigned to one of three groups (blocked high intensity interval training HIIT; polarized training POL; high volume low intensity oriented control group CG/HVLIT applying no HIIT. A maximal anaerobic running/cycling test (MART/MACT was performed prior to and following a 9-week training period.Results: Only the HIIT group achieved improvements in peak power/velocity (+6.4%, P < 0.001 and peak lactate (P = 0.001 during the MART/MACT, while, unexpectedly, in none of the groups the performance at the established lactate concentrations (4, 6, 10 mmol·L−1 was changed (P > 0.05. Acute HRR was improved in HIIT (11.2%, P = 0.002 and POL (7.9%, P = 0.023 with no change in the HVLIT oriented control group.Conclusion: Only a training regime that includes a significant amount of HIIT improves the neuromuscular status, anaerobic power and the acute HRR in well-trained endurance athletes. A training regime that followed more a low and moderate intensity oriented model (CG/HVLIT had no effect on any performance or HRR outcomes.

Relationship Between Collateral Status, Contrast Transit, and Contrast Density in Acute Ischemic Stroke.

Science.gov (United States)

Kawano, Hiroyuki; Bivard, Andrew; Lin, Longting; Spratt, Neil J; Miteff, Ferdinand; Parsons, Mark W; Levi, Christopher R

2016-03-01

Collateral circulation is recognized to influence the life expectancy of the ischemic penumbra in acute ischemic stroke. The best method to quantify collateral status on acute imaging is uncertain. We aimed to determine the relationship between visual collateral status, quantitative collateral assessments, baseline computed tomographic perfusion measures, and tissue outcomes on follow-up imaging. Sixty-six consecutive patients with acute ischemic stroke clinically eligible for recanalization therapy and with M1 or M2 middle cerebral artery occlusion were evaluated. We compared the visual collateral scoring with measures of contrast peak time delay and contrast peak density. We also compared these measures for their ability to predict perfusion lesion and infarct core volumes, final infarct, and infarct growth. Shorter contrast peak time delay (P=0.041) and higher contrast peak density (P=0.002) were associated with good collateral status. Shorter contrast peak time delay correlated with higher contrast peak density (β=-4.413; P=0.037). In logistic regression analysis after adjustment for age, sex, onset-computed tomographic time, and occlusion site, higher contrast peak density was independently associated with good collateral status (P=0.009). Multiple regression analysis showed that higher contrast peak density was an independent predictor of smaller perfusion lesion volume (P=0.029), smaller ischemic core volume (P=0.044), smaller follow-up infarct volume (P=0.005), and smaller infarct growth volume (P=0.010). Visual collateral status, contrast peak density, and contrast peak time delay were inter-related, and good collateral status was strongly associated with contrast peak density. Contrast peak density in collateral vessel may be an important factor in tissue fate in acute ischemic stroke. © 2016 American Heart Association, Inc.

Clinical and microbiological characteristics of spontaneous acute prostatitis and transrectal prostate biopsy-related acute prostatitis: Is transrectal prostate biopsy-related acute prostatitis a distinct acute prostatitis category?

Science.gov (United States)

Kim, Jong Wook; Oh, Mi Mi; Bae, Jae Hyun; Kang, Seok Ho; Park, Hong Seok; Moon, Du Geon

2015-06-01

This study aimed to compare the clinical and microbiological characteristics between acute bacterial prostatitis and transrectal biopsy-related acute prostatitis. We retrospectively reviewed the records of 135 patients hospitalized for acute prostatitis in three urological centers between 2004 and 2013. Acute bacterial prostatitis was diagnosed according to typical symptoms, findings of physical examination, and laboratory test results. Clinical variables, laboratory test results, and anti-microbial susceptibility results were reviewed. Patients were classified into the spontaneous acute prostatitis group (S-ABP) or biopsy-related acute prostatitis (Bx-ABP) for comparison of their clinical, laboratory, and microbiological findings. The mean age of all patients was 61.7 ± 12.9 years. Compared with S-ABP patients, Bx-ABP patients were significantly older, had larger prostate volumes, higher PSA values, higher peak fever temperatures, and higher incidence of septicemia and antibiotic-resistant bacteria. Overall, of the 135 patients, 57.8% had positive bacterial urine and/or blood cultures. Bx-ABP patients had a higher incidence of bacterial (urine and/or blood) positive cultures compared to S-ABP patients (66.7% versus 55.6%). Escherichia coli was the predominant organism in both groups, but it was more common in Bx-ABP (88.9%) than in S-ABP (66.7%). Extended spectrum beta-lactamase -producing bacteria accounted for 64.7% of culture-positive patients in the Bx-ABP group compared to 13.3% in the S-ABP group. Bx-ABP patients showed a higher incidence of septicemia and antibiotic-resistant bacteria than S-ABP patients. These results have important implications for the management and antimicrobial treatment of Bx-ABP, which may well deserve to be considered a distinct prostatitis category. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Massive Fermi gas in the expanding universe

Energy Technology Data Exchange (ETDEWEB)

Trautner, Andreas, E-mail: atrautner@uni-bonn.de [Bethe Center for Theoretical Physics and Physikalisches Institut der Universität Bonn, Nussallee 12, 53115 Bonn (Germany)

2017-03-01

The behavior of a decoupled ideal Fermi gas in a homogeneously expanding three-dimensional volume is investigated, starting from an equilibrium spectrum. In case the gas is massless and/or completely degenerate, the spectrum of the gas can be described by an effective temperature and/or an effective chemical potential, both of which scale down with the volume expansion. In contrast, the spectrum of a decoupled massive and non-degenerate gas can only be described by an effective temperature if there are strong enough self-interactions such as to maintain an equilibrium distribution. Assuming perpetual equilibration, we study a decoupled gas which is relativistic at decoupling and then is red-shifted until it becomes non-relativistic. We find expressions for the effective temperature and effective chemical potential which allow us to calculate the final spectrum for arbitrary initial conditions. This calculation is enabled by a new expansion of the Fermi-Dirac integral, which is for our purpose superior to the well-known Sommerfeld expansion. We also compute the behavior of the phase space density under expansion and compare it to the case of real temperature and real chemical potential. Using our results for the degenerate case, we also obtain the mean relic velocity of the recently proposed non-thermal cosmic neutrino background.

Alternative and Natural Therapies for Acute Lung Injury and Acute Respiratory Distress Syndrome

Directory of Open Access Journals (Sweden)

Vipul J. Patel

2018-01-01

Full Text Available Introduction. Acute respiratory distress syndrome (ARDS is a complex clinical syndrome characterized by acute inflammation, microvascular damage, and increased pulmonary vascular and epithelial permeability, frequently resulting in acute respiratory failure and death. Current best practice for ARDS involves “lung-protective ventilation,” which entails low tidal volumes and limiting the plateau pressures in mechanically ventilated patients. Although considerable progress has been made in understanding the pathogenesis of ARDS, little progress has been made in the development of specific therapies to combat injury and inflammation. Areas Covered. In recent years, several natural products have been studied in experimental models and have been shown to inhibit multiple inflammatory pathways associated with acute lung injury and ARDS at a molecular level. Because of the pleiotropic effects of these agents, many of them also activate antioxidant pathways through nuclear factor erythroid-related factor 2, thereby targeting multiple pathways. Several of these agents are prescribed for treatment of inflammatory conditions in the Asian subcontinent and have shown to be relatively safe. Expert Commentary. Here we review natural remedies shown to attenuate lung injury and inflammation in experimental models. Translational human studies in patients with ARDS may facilitate treatment of this devastating disease.

MIT wavelength tables. Volume 2. Wavelengths by element

International Nuclear Information System (INIS)

Phelps, F.M. III.

1982-01-01

This volume is the first stage of a project to expand and update the MIT wavelength tables first compiled in the 1930's. For 109,325 atomic emission lines, arranged by element, it presents wavelength in air, wavelength in vacuum, wave number and intensity. All data are stored on computer-readable magnetic tape

Classification of molecular structure images by using ANN, RF, LBP, HOG, and size reduction methods for early stomach cancer detection

Science.gov (United States)

Aytaç Korkmaz, Sevcan; Binol, Hamidullah

2018-03-01

Patients who die from stomach cancer are still present. Early diagnosis is crucial in reducing the mortality rate of cancer patients. Therefore, computer aided methods have been developed for early detection in this article. Stomach cancer images were obtained from Fırat University Medical Faculty Pathology Department. The Local Binary Patterns (LBP) and Histogram of Oriented Gradients (HOG) features of these images are calculated. At the same time, Sammon mapping, Stochastic Neighbor Embedding (SNE), Isomap, Classical multidimensional scaling (MDS), Local Linear Embedding (LLE), Linear Discriminant Analysis (LDA), t-Distributed Stochastic Neighbor Embedding (t-SNE), and Laplacian Eigenmaps methods are used for dimensional the reduction of the features. The high dimension of these features has been reduced to lower dimensions using dimensional reduction methods. Artificial neural networks (ANN) and Random Forest (RF) classifiers were used to classify stomach cancer images with these new lower feature sizes. New medical systems have developed to measure the effects of these dimensions by obtaining features in different dimensional with dimensional reduction methods. When all the methods developed are compared, it has been found that the best accuracy results are obtained with LBP_MDS_ANN and LBP_LLE_ANN methods.

Expander for Thin-Wall Tubing

Science.gov (United States)

Pessin, R.

1983-01-01

Tool locally expands small-diameter tubes. Tube expander locally expands and deforms tube: Compressive lateral stress induced in elastomeric sleeve by squeezing axially between two metal tool parts. Adaptable to situations in which tube must have small bulge for mechanical support or flow control.

Role of Acute Lesion Topography in Initial Ischemic Stroke Severity and Long-Term Functional Outcomes.

Science.gov (United States)

Wu, Ona; Cloonan, Lisa; Mocking, Steven J T; Bouts, Mark J R J; Copen, William A; Cougo-Pinto, Pedro T; Fitzpatrick, Kaitlin; Kanakis, Allison; Schaefer, Pamela W; Rosand, Jonathan; Furie, Karen L; Rost, Natalia S

2015-09-01

Acute infarct volume, often proposed as a biomarker for evaluating novel interventions for acute ischemic stroke, correlates only moderately with traditional clinical end points, such as the modified Rankin Scale. We hypothesized that the topography of acute stroke lesions on diffusion-weighted magnetic resonance imaging may provide further information with regard to presenting stroke severity and long-term functional outcomes. Data from a prospective stroke repository were limited to acute ischemic stroke subjects with magnetic resonance imaging completed within 48 hours from last known well, admission NIH Stroke Scale (NIHSS), and 3-to-6 months modified Rankin Scale scores. Using voxel-based lesion symptom mapping techniques, including age, sex, and diffusion-weighted magnetic resonance imaging lesion volume as covariates, statistical maps were calculated to determine the significance of lesion location for clinical outcome and admission stroke severity. Four hundred ninety subjects were analyzed. Acute stroke lesions in the left hemisphere were associated with more severe NIHSS at admission and poor modified Rankin Scale at 3 to 6 months. Specifically, injury to white matter (corona radiata, internal and external capsules, superior longitudinal fasciculus, and uncinate fasciculus), postcentral gyrus, putamen, and operculum were implicated in poor modified Rankin Scale. More severe NIHSS involved these regions, as well as the amygdala, caudate, pallidum, inferior frontal gyrus, insula, and precentral gyrus. Acute lesion topography provides important insights into anatomic correlates of admission stroke severity and poststroke outcomes. Future models that account for infarct location in addition to diffusion-weighted magnetic resonance imaging volume may improve stroke outcome prediction and identify patients likely to benefit from aggressive acute intervention and personalized rehabilitation strategies. © 2015 American Heart Association, Inc.

Acute Low-Volume High-Intensity Interval Exercise and Continuous Moderate-Intensity Exercise Elicit a Similar Improvement in 24-h Glycemic Control in Overweight and Obese Adults.

Science.gov (United States)

Parker, Lewan; Shaw, Christopher S; Banting, Lauren; Levinger, Itamar; Hill, Karen M; McAinch, Andrew J; Stepto, Nigel K

2016-01-01

Background: Acute exercise reduces postprandial oxidative stress and glycemia; however, the effects of exercise intensity are unclear. We investigated the effect of acute low-volume high-intensity interval-exercise (LV-HIIE) and continuous moderate-intensity exercise (CMIE) on glycemic control and oxidative stress in overweight and obese, inactive adults. Methods: Twenty-seven adults were randomly allocated to perform a single session of LV-HIIE (9 females, 5 males; age: 30 ± 1 years; BMI: 29 ± 1 kg·m -2 ; mean ± SEM) or CMIE (8 females, 5 males; age: 30 ± 2.0; BMI: 30 ± 2.0) 1 h after consumption of a standard breakfast. Plasma redox status, glucose and insulin were measured. Continuous glucose monitoring (CGM) was conducted during the 24-h period before (rest day) and after exercise (exercise day). Results: Plasma thiobarbituric acid reactive substances (TBARS; 29 ±13%, p improvement in 24-h average glucose levels (-5 ± 2%, p improving 24-h glycemic control in overweight and obese adults.

Variation in critical care unit admission rates and outcomes for patients with acute coronary syndromes or heart failure among high- and low-volume cardiac hospitals.

Science.gov (United States)

van Diepen, Sean; Bakal, Jeffrey A; Lin, Meng; Kaul, Padma; McAlister, Finlay A; Ezekowitz, Justin A

2015-02-27

Little is known about cross-hospital differences in critical care units admission rates and related resource utilization and outcomes among patients hospitalized with acute coronary syndromes (ACS) or heart failure (HF). Using a population-based sample of 16,078 patients admitted to a critical care unit with a primary diagnosis of ACS (n=14,610) or HF (n=1467) between April 1, 2003 and March 31, 2013 in Alberta, Canada, we stratified hospitals into high (>250), medium (200 to 250), or low (<200) volume based on their annual volume of all ACS and HF hospitalization. The percentage of hospitalized patients admitted to critical care units varied across low, medium, and high-volume hospitals for both ACS and HF as follows: 77.9%, 81.3%, and 76.3% (P<0.001), and 18.0%, 16.3%, and 13.0% (P<0.001), respectively. Compared to low-volume units, critical care patients with ACS and HF admitted to high-volume hospitals had shorter mean critical care stays (56.6 versus 95.6 hours, P<0.001), more critical care procedures (1.9 versus 1.2 per patient, <0.001), and higher resource-intensive weighting (2.8 versus 1.5, P<0.001). No differences in in-hospital mortality (5.5% versus 6.2%, adjusted odds ratio 0.93; 95% CI, 0.61 to 1.41) were observed between high- and low-volume hospitals; however, 30-day cardiovascular readmissions (4.6% versus 6.8%, odds ratio 0.77; 95% CI, 0.60 to 0.99) and cardiovascular emergency-room visits (6.6% versus 9.5%, odds ratio 0.80; 95% CI, 0.69 to 0.94) were lower in high-volume compared to low-volume hospitals. Outcomes stratified by ACS or HF admission diagnosis were similar. Cardiac patients hospitalized in low-volume hospitals were more frequently admitted to critical care units and had longer hospitals stays despite lower resource-intensive weighting. These findings may provide opportunities to standardize critical care utilization for ACS and HF patients across high- and low-volume hospitals. © 2015 The Authors. Published on behalf of the American

Non-animal Replacements for Acute Toxicity Testing.

Science.gov (United States)

Barker-Treasure, Carol; Coll, Kevin; Belot, Nathalie; Longmore, Chris; Bygrave, Karl; Avey, Suzanne; Clothier, Richard

2015-07-01

Current approaches to predicting adverse effects in humans from acute toxic exposure to cosmetic ingredients still heavily necessitate the use of animals under EU legislation, particularly in the context of the REACH system, when cosmetic ingredients are also destined for use in other industries. These include the LD50 test, the Up-and-Down Procedure and the Fixed Dose Procedure, which are regarded as having notable scientific deficiencies and low transferability to humans. By expanding on previous in vitro tests, such as the animal cell-based 3T3 Neutral Red Uptake (NRU) assay, this project aims to develop a truly animal-free predictive test for the acute toxicity of cosmetic ingredients in humans, by using human-derived cells and a prediction model that does not rely on animal data. The project, funded by Innovate UK, will incorporate the NRU assay with human dermal fibroblasts in animal product-free culture, to generate an in vitro protocol that can be validated as an accepted replacement for the currently available in vivo tests. To date, the project has successfully completed an assessment of the robustness and reproducibility of the method, by using sodium lauryl sulphate (SLS) as a positive control, and displaying analogous results to those of the original studies with mouse 3T3 cells. Currently, the testing of five known ingredients from key groups (a surfactant, a preservative, a fragrance, a colour and an emulsifier) is under way. The testing consists of initial range-finding runs followed by three valid runs of a main experiment with the appropriate concentration ranges, to generate IC50 values. Expanded blind trials of 20 ingredients will follow. Early results indicate that this human cell-based test holds the potential to replace aspects of in vivo animal acute toxicity testing, particularly with reference to cosmetic ingredients. 2015 FRAME.

Value of Quantitative Collateral Scoring on CT Angiography in Patients with Acute Ischemic Stroke.

Science.gov (United States)

Boers, A M M; Sales Barros, R; Jansen, I G H; Berkhemer, O A; Beenen, L F M; Menon, B K; Dippel, D W J; van der Lugt, A; van Zwam, W H; Roos, Y B W E M; van Oostenbrugge, R J; Slump, C H; Majoie, C B L M; Marquering, H A

2018-06-01

Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship. From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. The relation with outcome and the association with treatment effect were estimated. The influence of the CTA acquisition phase on the relation of collateral scores with outcome was determined. A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score (ρ = 0.75) and was an independent predictor of mRS (adjusted odds ratio = 0.81; 95% CI, .77-.86) and follow-up infarct volume (exponent β = 0.88; P quantitative collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0-2) and follow-up infarct volume of >90 mL, respectively. We found significant interaction of the quantitative collateral score with the endovascular therapy effect in unadjusted analysis on the full ordinal mRS scale ( P = .048) and on functional independence ( P = .049). Modification of the quantitative collateral score by acquisition phase on outcome was significant (mRS: P = .004; follow-up infarct volume: P quantitative collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral

Mechanical Recanalization of Cerebral Artery Embolic Occlusion Using a Self-Expanding Stent: Experimental Analysis in Canine Model

International Nuclear Information System (INIS)

Choi, Jin Woo; Kim, Snag Joon; Lee, Deok Hee; Suh, Dae Chul

2011-01-01

To evaluate the feasibility of a self-expanding stent for acute embolic occlusion, and recanalization mechanism by histologic examination. Five mongrel dogs were used as study subjects. Each vertebral artery was occluded, and a self-expanding stent was used for recanalization. We evaluated the technical success rate for the placement of the stent to the targeted vessel, the recanalization rate, and residual stenosis. We obtained two specimens of the stented vertebral arteries for histologic evaluation. One dog died of an unknown cause during the induction of anesthesia. In two dogs, only one side of the vertebral artery was used, whereas both vertebral arteries were used in the remaining dogs. A total of six vertebral arteries were successfully occluded. The technical success rate for stenting without complication was 66.7%. The immediate recanalization rate after stenting was 100%. The residual stenosis was 35.6 ± 18.6%. On microscopic examination, the stent concentrically displaced the clot and the clot was captured between the stent mesh and arterial wall. Self-expanding stents were effective in revascularizing the cerebrovascular embolic occlusion. The self-expanding stent seemed to achieve recanalization by pushing the clot to the arterial wall and capturing the clot between the stent mesh and arterial wall.

Mechanical Recanalization of Cerebral Artery Embolic Occlusion Using a Self-Expanding Stent: Experimental Analysis in Canine Model

Energy Technology Data Exchange (ETDEWEB)

Choi, Jin Woo; Kim, Snag Joon; Lee, Deok Hee; Suh, Dae Chul [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

2011-07-15

To evaluate the feasibility of a self-expanding stent for acute embolic occlusion, and recanalization mechanism by histologic examination. Five mongrel dogs were used as study subjects. Each vertebral artery was occluded, and a self-expanding stent was used for recanalization. We evaluated the technical success rate for the placement of the stent to the targeted vessel, the recanalization rate, and residual stenosis. We obtained two specimens of the stented vertebral arteries for histologic evaluation. One dog died of an unknown cause during the induction of anesthesia. In two dogs, only one side of the vertebral artery was used, whereas both vertebral arteries were used in the remaining dogs. A total of six vertebral arteries were successfully occluded. The technical success rate for stenting without complication was 66.7%. The immediate recanalization rate after stenting was 100%. The residual stenosis was 35.6 {+-} 18.6%. On microscopic examination, the stent concentrically displaced the clot and the clot was captured between the stent mesh and arterial wall. Self-expanding stents were effective in revascularizing the cerebrovascular embolic occlusion. The self-expanding stent seemed to achieve recanalization by pushing the clot to the arterial wall and capturing the clot between the stent mesh and arterial wall.

Partial pressure (or fugacity) of carbon dioxide, salinity and other variables collected from time series observations using Bubble type equilibrator for autonomous carbon dioxide (CO2) measurement, Carbon dioxide (CO2) gas analyzer and other instruments from MOORING_HOG_REEF_64W_32N in the North Atlantic Ocean from 2010-12-05 to 2015-01-07 (NODC Accession 0117060)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NCEI Accession 0117060 includes chemical, meteorological, physical and time series data collected from MOORING_HOG_REEF_64W_32N in the North Atlantic Ocean from...

Kocuria kristinae infection associated with acute cholecystitis.

Science.gov (United States)

Ma, Edmond S K; Wong, Chris L P; Lai, Kristi T W; Chan, Edmond C H; Yam, W C; Chan, Angus C W

2005-07-19

Kocuria, previously classified into the genus of Micrococcus, is commonly found on human skin. Two species, K. rosea and K. kristinae, are etiologically associated with catheter-related bacteremia. We describe the first case of K. kristinae infection associated with acute cholecystitis. The microorganism was isolated from the bile of a 56-year old Chinese man who underwent laparoscopic cholecystectomy. He developed post-operative fever that resolved readily after levofloxacin treatment. Our report of K. kristinae infection associated with acute cholecystitis expands the clinical spectrum of infections caused by this group of bacteria. With increasing number of recent reports describing the association between Kocuria spp. and infectious diseases, the significance of their isolation from clinical specimens cannot be underestimated. A complete picture of infections related to Kocuria spp. will have to await the documentation of more clinical cases.

Pericardial adipose tissue and the metabolic syndrome is increased in patients with chronic major depressive disorder compared to acute depression and controls.

Science.gov (United States)

Kahl, K G; Herrmann, J; Stubbs, B; Krüger, T H C; Cordes, J; Deuschle, M; Schweiger, U; Hüper, K; Helm, S; Birkenstock, A; Hartung, D

2017-01-04

Major depressive disorder (MDD) is associated with an estimated fourfold risk for premature death, largely attributed to cardiovascular disorders. Pericardial adipose tissue (PAT), a fat compartment surrounding the heart, has been implicated in the development of coronary artery disease. An unanswered question is whether people with chronic MDD are more likely to have elevated PAT volumes versus acute MDD and controls (CTRL). The study group consists of sixteen patients with chronic MDD, thirty-four patients with acute MDD, and twenty-five CTRL. PAT and adrenal gland volume were measured by magnetic resonance tomography. Additional measures comprised factors of the metabolic syndrome, cortisol, relative insulin resistance, and pro-inflammatory cytokines (interleukin-6; IL-6 and tumor necrosis factor-α, TNF-α). PAT volumes were significantly increased in patients with chronic MDD>patients with acute MDD>CTRL. Adrenal gland volume was slightly enlarged in patients with chronic MDD>acute MDD>CTRL, although this difference failed to reach significance. The PAT volume was correlated with adrenal gland volume, and cortisol concentrations were correlated with depression severity, measured by BDI-2 and MADRS. Group differences were found concerning the rate of the metabolic syndrome, being most frequent in chronic MDD>acute MDD>CTRL. Further findings comprised increased fasting cortisol, increased TNF-α concentration, and decreased physical activity level in MDD compared to CTRL. Our results extend the existing literature in demonstrating that patients with chronic MDD have the highest risk for developing cardiovascular disorders, indicated by the highest PAT volume and prevalence of metabolic syndrome. The correlation of PAT with adrenal gland volume underscores the role of the hypothalamus-pituitary-adrenal system as mediator for body-composition changes. Metabolic monitoring, health advices and motivation for the improvement of physical fitness may be recommended in

Role of light in the mediation of acute effects of a single afternoon ...

Indian Academy of Sciences (India)

Home; Journals; Journal of Biosciences; Volume 25; Issue 3. Role of light in the mediation of acute effects of a single afternoon melatonin injection on steroidogenic activity of testis in the rat. Saumen K Maitra Arun K Ray. Articles Volume 25 Issue 3 September 2000 pp 253-256 ...

Thermodynamic Simulation on the Performance of Twin Screw Expander Applied in Geothermal Power Generation

Directory of Open Access Journals (Sweden)

Yuanqu Qi

2016-08-01

Full Text Available A three-dimensional (3D geometry model of twin screw expander has been developed in this paper to measure and analyze geometric parameters such as groove volume, suction port area, and leakage area, which can be described as functions of rotation angle of male rotor. Taking the suction loss, leakage loss, and real gas effect into consideration, a thermodynamic model is developed using continuity and energy conservation equation. The developed model is verified by comparing predicted results of power output and internal efficiency with experimental data. Based on the model, the relationship between mass flow rate through inlet port and leakage path with rotation angle of male rotor as well as effects of the inlet parameter and operating parameter on the performance of the expander are analyzed.

Combining creatinine and volume kinetics identifies missed cases of acute kidney injury following cardiac arrest

Science.gov (United States)

2013-01-01

Introduction Fluid resuscitation in the critically ill often results in a positive fluid balance, potentially diluting the serum creatinine concentration and delaying diagnosis of acute kidney injury (AKI). Methods Dilution during AKI was quantified by combining creatinine and volume kinetics to account for fluid type, and rates of fluid infusion and urine output. The model was refined using simulated patients receiving crystalloids or colloids under four glomerular filtration rate (GFR) change scenarios and then applied to a cohort of critically ill patients following cardiac arrest. Results The creatinine concentration decreased during six hours of fluid infusion at 1 litre-per-hour in simulated patients, irrespective of fluid type or extent of change in GFR (from 0% to 67% reduction). This delayed diagnosis of AKI by 2 to 9 hours. Crystalloids reduced creatinine concentration by 11 to 19% whereas colloids reduced concentration by 36 to 43%. The greatest reduction was at the end of the infusion period. Fluid dilution alone could not explain the rapid reduction of plasma creatinine concentration observed in 39 of 49 patients after cardiac arrest. Additional loss of creatinine production could account for those changes. AKI was suggested in six patients demonstrating little change in creatinine, since a 52 ± 13% reduction in GFR was required after accounting for fluid dilution and reduced creatinine production. Increased injury biomarkers within a few hours of cardiac arrest, including urinary cystatin C and plasma and urinary Neutrophil-Gelatinase-Associated-Lipocalin (biomarker-positive, creatinine-negative patients) also indicated AKI in these patients. Conclusions Creatinine and volume kinetics combined to quantify GFR loss, even in the absence of an increase in creatinine. The model improved disease severity estimation, and demonstrated that diagnostic delays due to dilution are minimally affected by fluid type. Creatinine sampling should be delayed at least

Sensors and signal transduction pathways in vertebrate cell volume regulation

DEFF Research Database (Denmark)

Hoffmann, Else K; Pedersen, Stine F

2006-01-01

The ability to control cell volume is fundamental for proper cell function. This review highlights recent advances in the understanding of the complex sequences of events by which acute cell volume perturbation alters the activity of osmolyte transport proteins in cells from vertebrate organisms...... will be discussed. In contrast to the simple pathway of osmosensing in yeast, cells from vertebrate organisms appear to exhibit multiple volume sensing systems, the specific mechanism(s) activated being cell type- and stimulus-dependent. Candidate sensors include integrins and growth factor receptors, while other...

Utilization of the lower inflection point of the pressure-volume curve results in protective conventional ventilation comparable to high frequency oscillatory ventilation in an animal model of acute respiratory distress syndrome

Directory of Open Access Journals (Sweden)

Felipe S. Rossi

2008-01-01

Full Text Available INTRODUCTION: Studies comparing high frequency oscillatory and conventional ventilation in acute respiratory distress syndrome have used low values of positive end-expiratory pressure and identified a need for better recruitment and pulmonary stability with high frequency. OBJECTIVE: To compare conventional and high frequency ventilation using the lower inflection point of the pressure-volume curve as the determinant of positive end-expiratory pressure to obtain similar levels of recruitment and alveolar stability. METHODS: After lung lavage of adult rabbits and lower inflection point determination, two groups were randomized: conventional (positive end-expiratory pressure = lower inflection point; tidal volume=6 ml/kg and high frequency ventilation (mean airway pressures= lower inflection point +4 cmH2O. Blood gas and hemodynamic data were recorded over 4 h. After sacrifice, protein analysis from lung lavage and histologic evaluation were performed. RESULTS: The oxygenation parameters, protein and histological data were similar, except for the fact that significantly more normal alveoli were observed upon protective ventilation. High frequency ventilation led to lower PaCO2 levels. DISCUSSION: Determination of the lower inflection point of the pressure-volume curve is important for setting the minimum end expiratory pressure needed to keep the airways opened. This is useful when comparing different strategies to treat severe respiratory insufficiency, optimizing conventional ventilation, improving oxygenation and reducing lung injury. CONCLUSIONS: Utilization of the lower inflection point of the pressure-volume curve in the ventilation strategies considered in this study resulted in comparable efficacy with regards to oxygenation and hemodynamics, a high PaCO2 level and a lower pH. In addition, a greater number of normal alveoli were found after protective conventional ventilation in an animal model of acute respiratory distress syndrome.

Do Age and Anticoagulants Affect the Natural History of Acute Subdural Hematomas?

Science.gov (United States)

Lucke-Wold, Brandon P.; Turner, Ryan C.; Josiah, Darnell; Knotts, Chelsea; Bhatia, Sanjay

2016-01-01

Acute subdural hematoma is a serious complication following traumatic brain injury. Large volume hematomas or those with underlying brain injury can cause mass effect, midline shift, and eventually herniation of the brain. Acute subdural hematomas in the young are associated with high-energy trauma and often have underlying contusions, while acute subdural hematomas in the elderly are associated with minor trauma and an absence of underlying contusions, even though the elderly are more likely to be on anticoagulants or anti-platelet therapy. In the young patients with high impact injuries the hematomas tend to be small and the underlying brain injury and swelling is responsible for the increased intracranial pressure and midline shift. In the elderly, the injuries are low impact (e.g fall from standing), the underlying brain is intact, and the volume of the hematoma itself produces symptoms. In addition the use of anticoagulants and antiplatelet agents in the elderly population has been thought to be a poor prognostic indicator and is considered to be responsible for larger hematomas and poor outcome. When managed conservatively, acute subdural hematomas can sometimes progress to chronic subdural hematoma formation, further enlargement, seizures, and progressive midline shift. Another potential difference in the young and the elderly is brain atrophy, which increases the potential space to accommodate a larger hematoma. It is not known if these two groups differ in other ways that might have implications for treatment or prognosis. In this paper, we investigate the clinical course of 80 patients admitted to our institution with acute subdural hematomas, to identify differences in patients above or below the age of 65 years. The natural progression/resolution of acute subdural hematomas was mapped by measuring volume expansion/regression over time. In this retrospective chart review, we investigated clinical baseline metrics and subsequent volumetric expansion

Importance of hemoglobin concentration to exercise: acute manipulations

DEFF Research Database (Denmark)

Calbet, José A L; Lundby, Carsten; Koskolou, Maria

2006-01-01

An acute reduction of blood hemoglobin concentration ([Hb]), even when the circulating blood volume is maintained, results in lower (.)V(O(2)(max) and endurance performance, due to the reduction of the oxygen carrying capacity of blood. Conversely, an increase of [Hb] is associated with enhanced...

Evolution of turbulence in the expanding solar wind, a numerical study

International Nuclear Information System (INIS)

Dong, Yue; Grappin, Roland; Verdini, Andrea

2014-01-01

We study the evolution of turbulence in the solar wind by solving numerically the full three-dimensional (3D) magnetohydrodynamic (MHD) equations embedded in a radial mean wind. The corresponding equations (expanding box model or EBM) have been considered earlier but never integrated in 3D simulations. Here, we follow the development of turbulence from 0.2 AU up to about 1.5 AU. Starting with isotropic spectra scaling as k –1 , we observe a steepening toward a k –5/3 scaling in the middle of the wave number range and formation of spectral anisotropies. The advection of a plasma volume by the expanding solar wind causes a non-trivial stretching of the volume in directions transverse to radial and the selective decay of the components of velocity and magnetic fluctuations. These two effects combine to yield the following results. (1) Spectral anisotropy: gyrotropy is broken, and the radial wave vectors have most of the power. (2) Coherent structures: radial streams emerge that resemble the observed microjets. (3) Energy spectra per component: they show an ordering in good agreement with the one observed in the solar wind at 1 AU. The latter point includes a global dominance of the magnetic energy over kinetic energy in the inertial and f –1 range and a dominance of the perpendicular-to-the-radial components over the radial components in the inertial range. We conclude that many of the above properties are the result of evolution during transport in the heliosphere, and not just the remnant of the initial turbulence close to the Sun.

The value of serum mean platelet volume in ischaemic stroke patient

International Nuclear Information System (INIS)

Tamer, F.; Fevzi, Y.; Deniz, A.E.; Cemil, K.; Cihat, Y.; Muhittin, Y.; Serkan, Y.M.; Ali, C.M.; Faith, B.

2013-01-01

Objective: To investigate the value of serum Mean Platelet Volume in acute ischaemic stroke patients. Method: The retrospective case-control study was conducted at Ankara Numune Training and Research Hospital in Turkey and comprised record of patients of acute ischaemic stroke admitted to the Emergency Department between June 2010 and January 2012. The two groups were statistically compared using SPSS 18.0. Result: Overall, there were 482 stroke patients (Group 1) and 315 subjects as controls (Group 2). The median value in Group 1 was 9.0 (2.1) (fL), while in Group 2 it was 8.80 (2.4) (fL). The difference was statistically significant (Z=-2.80; p<0.05). Conclusion: Mean Platelet Volume increased in the stroke patients. (author)

The yeast osmostress response is carbon source dependent

DEFF Research Database (Denmark)

Babazadeh, Roja; Lahtvee, Petri-Jaan; Adiels, Caroline B.

2017-01-01

. Remarkably, yeast cells do not accumulate glycerol under these conditions and it appears that trehalose may partly take over the role as compatible solute. The HOG pathway is activated in very much the same way as during growth on glucose and is also required for osmotic adaptation. Slower volume recovery...

Ibuprofen-associated acute kidney injury in dehydrated children with acute gastroenteritis.

Science.gov (United States)

Balestracci, Alejandro; Ezquer, Mauricio; Elmo, María Eugenia; Molini, Andrea; Thorel, Claudia; Torrents, Milagros; Toledo, Ismael

2015-10-01

Non-steroidal anti-inflammatory drugs (NSAIDs) induce acute kidney injury (AKI) in volume-depleted patients; however the prevalence of this complication is likely underestimated. We assessed the impact of ibuprofen exposure on renal function among dehydrated children with acute gastroenteritis (AGE) to further characterize NSAID-associated AKI. Over a 1-year period dehydrated children with AGE (n = 105) were prospectively enrolled and grouped as cases, presenting with AKI (n = 46) or controls, not presenting with AKI (n = 59). AKI was defined by pediatric RIFLE (pRIFLE) criteria. Among the children enrolled in the study, AKI prevalence was 44 %, and 34 (54 %) of the 63 patients who received ibuprofen developed renal impairment. Relative to the controls, children presenting with AKI were younger (median age 0.66 vs. 1.74 years; p dehydration, ibuprofen exposure remained an independent risk factor for AKI (p dehydrated children with AGE. Drug exposure increased the risk for developing AKI by more than twofold, independent of the magnitude of the dehydration.

Microbial Biofilms and Breast Tissue Expanders

Directory of Open Access Journals (Sweden)

Melissa J. Karau

2013-01-01

Full Text Available We previously developed and validated a vortexing-sonication technique for detection of biofilm bacteria on the surface of explanted prosthetic joints. Herein, we evaluated this technique for diagnosis of infected breast tissue expanders and used it to assess colonization of breast tissue expanders. From April 2008 to December 2011, we studied 328 breast tissue expanders at Mayo Clinic, Rochester, MN, USA. Of seven clinically infected breast tissue expanders, six (85.7% had positive cultures, one of which grew Propionibacterium species. Fifty-two of 321 breast tissue expanders (16.2%, 95% CI, 12.3–20.7% without clinical evidence of infection also had positive cultures, 45 growing Propionibacterium species and ten coagulase-negative staphylococci. While vortexing-sonication can detect clinically infected breast tissue expanders, 16 percent of breast tissue expanders appear to be asymptomatically colonized with normal skin flora, most commonly, Propionibacterium species.

Real-time bladder volume monitoring by the application of a new implantable bladder volume sensor for a small animal model

Directory of Open Access Journals (Sweden)

Dong Sup Lee

2011-04-01

Full Text Available Although real-time monitoring of bladder volume together with intravesical pressure can provide more information for understanding the functional changes of the urinary bladder, it still entails difficulties in the accurate prediction of real-time bladder volume in urodynamic studies with small animal models. We studied a new implantable bladder volume monitoring device with eight rats. During cystometry, microelectrodes prepared by the microelectromechanical systems process were placed symmetrically on both lateral walls of the bladder, and the expanded bladder volume was calculated. Immunohistological study was done after 1 week and after 4 weeks to evaluate the biocompatibility of the microelectrode. From the point that infused saline volume into the bladder was higher than 0.6 mL, estimated bladder volume was statistically correlated with the volume of saline injected (p<0.01. Additionally, the microelectromechanical system microelectrodes used in this study showed reliable biocompatibility. Therefore, the device can be used to evaluate changes in bladder volume in studies with small animals, and it may help to provide more information about functional changes in the bladder in laboratory studies. Furthermore, owing to its biocompatibility, the device could be chronically implanted in conscious ambulating animals, thus allowing a novel longitudinal study to be performed for a specific purpose.

Potential Expanded Indications for Neprilysin Inhibitors

Science.gov (United States)

Riddell, Elizabeth; Vader, Justin M.

2017-01-01

Purpose of review The goal of this article is to review potential expanded indications for neprilysin inhibitors. This article reviews the rationale and design for ongoing and future trials of sacubitril/valsartan in cardiovascular and non-cardiovascular disease. Recent findings Randomized trial data are lacking for use of sacubitril/valsartan in acute heart failure and advanced heart failure. Mechanistic data from animal studies suggest a role for neprilysin inhibition in the treatment of post-myocardial infarction systolic dysfunction and heart failure with preserved ejection fraction. Beyond the cardiovascular system, renal and neurological function may be impacted by neprilysin inhibition. Forthcoming randomized trials will address the clinical impact of sacubitril/valsartan on these conditions. Summary Neprolysin inhibition with sacubitril/valsartan offers a new therapeutic strategy with a broad range of potential therapeutic actions. In PARADIGM-HF, the combination of neprolysin and RAAS inhibition was proven to be superior to enalapril for patients with stable NYHA class II–III heart failure and reduced left ventricular ejection fraction. Preliminary data suggests it may also have a role in other cardiovascular and non-cardiovascular disease. Several ongoing and planned studies will determine the extent of its benefit for these other indications. PMID:28281174

SCINTIGRAPHY IN URGENT CONDITIONS AND COMPLICATIONS OF ACUTE DISEASES AND TRAUMAS

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N. Ye. Kudryashova

2014-01-01

Full Text Available ABSTRACT. The data generalized in the review characterize radionuclide method as a high informative technique in diagnosis of the row of acute diseases and traumas and complications of them. It was shown that each radionuclide technique decides the concrete clinical tests and has a strictly definite place in the diagnostic algorithm. Urgent radionuclide techniques give the important information for the choice of the treatment’s policy or operation’s volume in such acute diseases as tromboembolism, arterial occlusions, small bowel obstruction, acute cholecystitis and cholelithiasis, acute myocardial infarct, rhabdomyolysis, differentiation of acute urological and acute abdominal surgical diseases and so on. The main aim of the work of our radionuclide department is to perfect, modificate of urgent radionuclide techniques and to correct the place of them in urgent conditions’s diagnostic algorithm for increasing of the quality and the rapidity in diagnosis. 

Acute GI obstruction.

Science.gov (United States)

Hucl, Tomas

2013-10-01

Acute gastrointestinal obstruction occurs when the normal flow of intestinal contents is interrupted. The blockage can occur at any level throughout the gastrointestinal tract. The clinical symptoms depend on the level and extent of obstruction. Various benign and malignant processes can produce acute gastrointestinal obstruction, which often represents a medical emergency because of the potential for bowel ischemia leading to perforation and peritonitis. Early recognition and appropriate treatment are thus essential. The typical clinical symptoms associated with obstruction include nausea, vomiting, dysphagia, abdominal pain and failure to pass bowel movements. Abdominal distention, tympany due to an air-filled stomach and high-pitched bowel sounds suggest the diagnosis. The diagnostic process involves imaging including radiography, ultrasonography, contrast fluoroscopy and computer tomography in less certain cases. In patients with uncomplicated obstruction, management is conservative, including fluid resuscitation, electrolyte replacement, intestinal decompression and bowel rest. In many cases, endoscopy may aid in both the diagnostic process and in therapy. Endoscopy can be used for bowel decompression, dilation of strictures or placement of self-expandable metal stents to restore the luminal flow either as a final treatment or to allow for a delay until elective surgical therapy. When gastrointestinal obstruction results in ischemia, perforation or peritonitis, emergency surgery is required. Copyright © 2013. Published by Elsevier Ltd.

A Contemporary Assessment of Acute Mechanical Ventilation in Beijing: Description, Costs, and Outcomes.

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Ye, Yanping; Zhu, Bo; Jiang, Li; Jiang, Qi; Wang, Meiping; Hua, Lin; Xi, Xiuming

2017-07-01

To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. A prospective observational cohort study. Fourteen ICUs among 13 hospitals in Beijing, China. Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. None. The mean age was 64 years. Sixty-three percent were male. New acute respiratory failure accounted for 85.5% of mechanical ventilation cases. Only 4.7% of the patients received mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease. The most widely used ventilation mode was the combination of synchronized intermittent mandatory ventilation and pressure support (43.6%). Use of lung-protective ventilation is widespread with tidal volumes of 7.1 mL/kg (2.1 mL/kg). The ICU/hospital mortality was 27.6%/29.3%, respectively (8.5%/9.7% for surgical patients and 41.3%/43.2% for medical patients, respectively). The mean level of ICU/hospital cost per patient was $15,271 (18,940)/$22,946 (25,575), respectively. The mean daily ICU cost per patient was $1,212. For the first time, we obtained a preliminary epidemiology data of mechanical ventilation in Beijing, China, through the study. Compared with the other nations, our patients are older, predominantly male, and treated according to prevailing international guidelines yet at a relatively high cost and high mortality. The expanding elderly population predicts increase demand for mechanical ventilation that must be met by continuous improvement in quality and efficiency of critical care services.

Prediction of Tissue Outcome and Assessment of Treatment Effect in Acute Ischemic Stroke Using Deep Learning

DEFF Research Database (Denmark)

Nielsen, Anne; Hansen, Mikkel Bo; Tietze, Anna

2018-01-01

of automatically identifying and combining acute imaging features to accurately predict final lesion volume. METHODS: Using acute magnetic resonance imaging, we developed and trained a deep convolutional neural network (CNNdeep) to predict final imaging outcome. A total of 222 patients were included, of which 187...

Effects of high-volume plasmapheresis on ammonia, urea, and amino acids in patients with acute liver failure.

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Clemmesen, J O; Kondrup, J; Nielsen, L B; Larsen, F S; Ott, P

2001-04-01

In acute liver failure (ALF), urea production is severely impaired, and detoxification of ammonia by glutamine synthesis plays an important protective role. The aim of this study was to examine the effects of therapeutic high-volume plasmapheresis (HVP) on arterial concentrations and splanchnic exchange rates of ammonia, urea, and amino acids-in particular, glutamine. A quantity of 8 L of plasma was exchanged over the course of 7 h in 11 patients with ALF after development of hepatic encephalopathy grade III-IV. Splanchnic exchange rates of ammonia, urea, and amino acids were measured by use of liver vein catheterization. HVP removed ammonia and glutamine at a rate of 1 micromol/min and 27 micromol/min, respectively. Arterial ammonia decreased from 160 +/- 65 to 114 +/- 50 micromol/L (p HVP) were as follows: for ammonia, -93 +/- 101 versus -70 +/- 80 micromol/min (NS); urea-nitrogen, 0.08 +/- 1.64 versus -0.31 +/- 0.45 mmol/min (NS); alanine, -73 +/- 151 versus 12 +/- 83 micromol/min (p HVP in patients with ALF. The data suggest that this effect of HVP could be explained by increased hepatic urea synthesis and possibly by increased glutamine synthesis in muscle tissue.

Kocuria kristinae infection associated with acute cholecystitis

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Chan Edmond CH

2005-07-01

Full Text Available Abstract Background Kocuria, previously classified into the genus of Micrococcus, is commonly found on human skin. Two species, K. rosea and K. kristinae, are etiologically associated with catheter-related bacteremia. Case presentation We describe the first case of K. kristinae infection associated with acute cholecystitis. The microorganism was isolated from the bile of a 56-year old Chinese man who underwent laparoscopic cholecystectomy. He developed post-operative fever that resolved readily after levofloxacin treatment. Conclusion Our report of K. kristinae infection associated with acute cholecystitis expands the clinical spectrum of infections caused by this group of bacteria. With increasing number of recent reports describing the association between Kocuria spp. and infectious diseases, the significance of their isolation from clinical specimens cannot be underestimated. A complete picture of infections related to Kocuria spp. will have to await the documentation of more clinical cases.

Left ventricle expands maximally preceding end-diastole. Radionuclide ventriculography study

International Nuclear Information System (INIS)

Horinouchi, Osamu

2002-01-01

It has been considered that left ventricle (LV) expands maximally at the end-diastole. However, is it exactly coincident with this point? This study was aimed to determine whether the maximal expansion of LV coincides with the peak of R wave on electrocardiogram. Thirty-three angina pectoris patients with normal LV motion were examined using radionuclide ventriculography. Data were obtained from every 30 ms backward frame from the peak of R wave. All patients showed the time of maximal expansion preceded the peak of R wave. The intervals from the peak of R wave and the onset of P wave to maximal expansion of LV was 105±29 ms and 88±25 ms, respectively. This period corresponds to the timing of maximal excurtion of mitral valve by atrial contraction, and the centripetal motion of LV without losing its volume before end-diastole may be interpreted on account of the movement of mitral valve toward closure. These findings suggest that LV expands maximally between P and R wave after atrial contraction, preceding the peak of R wave thought conventionally as the end-diastole. (author)

Diagnostic imaging procedure volume in the United States

International Nuclear Information System (INIS)

Johnson, J.L.; Abernathy, D.L.

1983-01-01

Comprehensive data on 1979 and 1980 diagnostic imaging procedure volume were collected from a stratified random sample of U.S. short-term general-care hospitals and private practices of radiologists, cardiologists, obstetricians/gynecologists, orthopedic surgeons, and neurologists/neurosurgeons. Approximately 181 million imaging procedures (within the study scope) were performed in 1980. Despite the rapidly increasing use of newer imaging methods, plain film radiography (140.3 million procedures) and contrast studies (22.9 million procedures) continue to comprise the vast majority of diagnostic imaging volume. Ultrasound, computed tomography, nuclear medicine, and special procedures make up less than 10% of total diagnostic imaging procedures. Comparison of the data from this study with data from an earlier study indicates that imaging procedure volume in hospitals expanded at an annual growth rate of almost 8% from 1973 to 1980

Expanding Clinical Laboratory Tobacco Product Evaluation Methods to Loose-leaf Tobacco Vaporizers

Science.gov (United States)

Lopez, Alexa A.; Hiler, Marzena; Maloney, Sarah; Eissenberg, Thomas; Breland, Alison

2016-01-01

Background Novel tobacco products entering the US market include electronic cigarettes (ECIGs) and products advertised to “heat, not burn” tobacco. There is a growing literature regarding the acute effects of ECIGs. Less is known about “heat, not burn” products. This study’s purpose was to expand existing clinical laboratory methods to examine, in cigarette smokers, the acute effects of a “heat, not burn” “loose-leaf tobacco vaporizer” (LLTV). Methods Plasma nicotine and breath carbon monoxide (CO) concentration and tobacco abstinence symptom severity were measured before and after two 10-puff (30-sec interpuff interval) product use bouts separated by 60 minutes. LLTV effects were compared to participants’ own brand (OB) cigarettes and an ECIG (3.3 V; 1.5 Ohm; 18 mg/ml nicotine). Results Relative to OB, LLTV increased plasma nicotine concentration to a lesser degree, did not increase CO, and appeared to not reduce abstinence symptoms as effectively. Relative to ECIG, LLTV nicotine and CO delivery and abstinence symptom suppression did not differ. Participants reported that both the LLTV and ECIG were significantly less satisfying than OB. Conclusions Results demonstrate that LLTVs are capable of delivering nicotine and suppressing tobacco abstinence symptoms partially; acute effects of these products can be evaluated using existing clinical laboratory methods. Results can inform tobacco product regulation and may be predictive of the extent that these products have the potential to benefit or harm overall public health. PMID:27768968

ERic Acute StrokE Recanalization: A study using predictive analytics to assess a new device for mechanical thrombectomy.

Science.gov (United States)

Siemonsen, Susanne; Forkert, Nils D; Bernhardt, Martina; Thomalla, Götz; Bendszus, Martin; Fiehler, Jens

2017-08-01

Aim and hypothesis Using a new study design, we investigate whether next-generation mechanical thrombectomy devices improve clinical outcomes in ischemic stroke patients. We hypothesize that this new methodology is superior to intravenous tissue plasminogen activator therapy alone. Methods and design ERic Acute StrokE Recanalization is an investigator-initiated prospective single-arm, multicenter, controlled, open label study to compare the safety and effectiveness of a new recanalization device and distal access catheter in acute ischemic stroke patients with symptoms attributable to acute ischemic stroke and vessel occlusion of the internal cerebral artery or middle cerebral artery. Study outcome The primary effectiveness endpoint is the volume of saved tissue. Volume of saved tissue is defined as difference of the actual infarct volume and the brain volume that is predicted to develop infarction by using an optimized high-level machine learning model that is trained on data from a historical cohort treated with IV tissue plasminogen activator. Sample size estimates Based on own preliminary data, 45 patients fulfilling all inclusion criteria need to complete the study to show an efficacy >38% with a power of 80% and a one-sided alpha error risk of 0.05 (based on a one sample t-test). Discussion ERic Acute StrokE Recanalization is the first prospective study in interventional stroke therapy to use predictive analytics as primary and secondary endpoint. Such trial design cannot replace randomized controlled trials with clinical endpoints. However, ERic Acute StrokE Recanalization could serve as an exemplary trial design for evaluating nonpivotal neurovascular interventions.

Effect of acute postural variation on diabetic macular oedema

DEFF Research Database (Denmark)

Vinten, Martin; la Cour, Morten; Lund-Andersen, Henrik

2010-01-01

This study aimed to study the pathophysiology of diabetic macular oedema (DMO) by analysis of concomitant changes in macular volume (MV), mean arterial blood pressure (MABP), intraocular pressure (IOP), and retinal artery and vein diameters in response to acute postural changes in patients with DMO...

Comparison of Reconstructive Outcomes in Breast Cancer Patients With Preexisting Subpectoral Implants: Implant-Sparing Mastectomy With Delayed Implant Exchange Versus Immediate Tissue Expander Reconstruction.

Science.gov (United States)

Parabkaharan, Sangeetha; Melody, Megan; Trotta, Rose; Lleshi, Amina; Sun, Weihong; Smith, Paul D; Khakpour, Nazanin; Dayicioglu, Deniz

2016-06-01

Women who have undergone prior augmentation mammoplasty represent a unique subset of breast cancer patients with several options available for breast reconstruction. We performed a single institution review of surgical outcomes of breast reconstruction performed in patients with breast cancer with prior history of subpectoral breast augmentation. Institutional review board-approved retrospective review was conducted among patients with previously mentioned criteria treated at our institution between 2000 and 2014. Reconstructions were grouped into 2 categories as follows: (1) removal of preexisting subpectoral implant during mastectomy with immediate tissue expander placement and (2) implant-sparing mastectomy followed by delayed exchange to a larger implant. We reviewed demographics, tumor features, and reconstruction outcomes of these groups. Fifty-three patients had preexisting subpectoral implants. Of the 63 breast reconstructions performed, 18 (28.6%) had immediate tissue expander placed and 45 (71.4%) had implant-sparing mastectomy followed by delayed implant exchange. The groups were comparable based on age, body mass index, cancer type, tumor grade, TNM stage at presentation, and hormonal receptor status. No significant difference was noted between tumor margins or subsequent recurrence, mastectomy specimen weight, removed implant volume, volume of implant placed during reconstruction, or time from mastectomy to final implant placement. Rates of complications were significantly higher in the tissue expander group compared to the implant-sparing mastectomy group 7 (38.9%) versus 4 (8.9%) (P = 0.005). Implant-sparing mastectomy with delayed implant exchange in patients with preexisting subpectoral implants is safe and has fewer complications compared to tissue expander placement. There was no difference noted in the final volume of implant placed, time interval for final implant placement, or tumor margins.

Plasma volume changes during hypoglycaemia: the effect of arterial blood sampling

DEFF Research Database (Denmark)

Hilsted, J; Bendtsen, F; Christensen, N J

1990-01-01

To investigate whether previously reported changes in venous blood volume and composition induced by acute hypoglycaemia in humans are representative for the entire body we measured erythrocyte 51Cr content, haematocrit, plasma volume, intravascular albumin content and transcapillary escape rate...... hypoglycaemia. The magnitude of the changes in arterial and venous blood were not significantly different. These results indicate that the above changes in blood volume and composition are whole-body phenomena: furthermore, the major part of the changes are likely to occur in tissues other than upper extremity...

Diagnostic value of serum creatine kinase-BB for acute meningitis in adults

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Seyed Mohammad Alavi

2017-01-01

Full Text Available Objective: To find out an easy and feasible test instead of cerebrospinal fluid analysis for the diagnosis of acute meningitis. Methods: This cross-sectional study was conducted in 2013 in Ahvaz, a city located in the Southwest Iran including 75 patients with clinical diagnosis of fever, headache, vomiting and neck stiffness suspected to have acute meningitis based on cerebrospinal fluid analysis. In the beginning, the patients were divided into two categories as acute meningitis, and non-acute meningitis. Then, 5 L of blood was taken from each patient to determine serum creatine kinase isoenzyme-BB by using ELISA method. After that, the related data including demographics, clinical and laboratory results were analyzed by SPSS software version 16 using Chi-square test for qualitative variables and student’s t-test for quantitative variables. Results: Among the total 75 patients, 37 (49.3% were males and 38 (50.7% were females including 45 patients (60% with acute meningitis and 30 patients (40% without acute meningitis. On the other hand, CK-BB serum levels in acute meningitis and non-acute meningitis patients were 18.23 ± 7.56 and 2.67 ± 1.62, respectively, so significant difference was found between acute meningitis group and non-acute meningitis group (P < 0.000 1. Conclusions: Serum creatine kinase isoenzyme-BB test is a useful test to differentiate acute meningitis from non-acute meningitis among suspected cases of meningitis disease, so measuring the CK-BB serum level in Iran's health system with an expanded health setting especially in remote areas will be useful and helpful in prompt diagnosis and treatment of the acute meningitis.

Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut in patients with severe acute pancreatitis: a prospective feasibility study.

Science.gov (United States)

Plaudis, H; Pupelis, G; Zeiza, K; Boka, V

2012-01-01

Experience with administration of synbiotics (prebiotics/probiotics) in patients with severe acute pancreatitis (SAP) has demonstrated immunomodulatory capacity. The aim of this trial was evaluation of the feasibility and perspective of early clinical application of oral synbiotic/prebiotic supplements in patients with SAP. 90 SAP patients were enrolled during the period from 2005-2008. Patients were stratified according to the feeding mode. CONTROL (n = 32) group received standard whole protein feeding formula. SYNBIO (n = 30) and FIBRE groups (n = 28) received early (within first 24-48 hours) synbiotic or prebiotic supplements. Oral administration of synbiotics or prebiotics was commenced when patients were able to sip water. Daily provided average volume and calories of synbiotic/prebiotic blends were smaller compared to the CONTROL, p = 0.001. Oral administration of synbiotic/prebiotic supplements was associated with lower infection rate (pancreatic and peripancreatic necrosis) compared to the CONTROL, (p = 0.03; p = 0.001), lower rate of surgical interventions, p = 0.005, shorter ICU (p = 0.05) and hospital stay (p = 0.03). Synbiotic supplemented enteral stimulation of the gut resulted in reduced mortality rate compared to the CONTROL, p = 0.02. Early low volume oral synbiotic/prebiotic supplemented enteral stimulation of the gut seems to be a potentially valuable complement to the routine treatment protocol of SAP.

Atrial distension, haemodilution, and acute control of renin release during water immersion in humans

DEFF Research Database (Denmark)

Gabrielsen, A; Pump, B; Bie, P

2002-01-01

immersion. During WI, central venous pressure (CVP) and left atrial diameter (LAD) increased (P ... is not the single pivotal stimulus for the acute suppression of renin release in response to intravascular volume expansion by water immersion in humans. Haemodilution constitutes a significant and conceivably the principal stimulus for the acute immersion-induced suppression of renin-angiotensin system activity....

Change of mean platelet volume values in asthmatic children as an inflammatory marker.

Science.gov (United States)

Tuncel, T; Uysal, P; Hocaoglu, A B; Erge, D O; Karaman, O; Uzuner, N

2012-01-01

Asthma is the most common chronic disease of childhood in industrialised countries. T helper-2 (Th-2) cells, mast cells and eosinophils have a role in inflammation of asthma. Recently it was shown that platelets also play a role in asthma. Mean platelet volume shows platelet size and reflects platelet activation. The aim of this retrospective study is to evaluate levels of mean platelet volume in asthmatic patients during asymptomatic periods and exacerbations compared with healthy controls. The study consisted of 100 asthmatic patients (male/female: 55/45, mean age: 8.2±3.3) and 49 age and sex matched healthy children as a control group. Mean platelet volume values of asthmatic patients during asymptomatic period were 7.7±0.8fL while mean platelet volume values in asthmatics during exacerbation were 7.8±0.9fL. Comparison of mean platelet volume values of asthmatic patients and healthy controls both in acute asthmatic attack and asymptomatic period showed no difference (p>0.05). Comparison of mean platelet volume values at asthmatic attack and asymptomatic period also had no difference (p>0.05). The presence of atopy, infection, eosinophilia, elevated immunoglobulin E, and severity of acute asthmatic attack did not influence mean platelet volume values. The results of our study suggest that mean platelet volume values may not be used as a marker in bronchial asthma, although prospective studies with larger number of patients are needed to evaluate the role of mean platelet volume in asthma. Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

Factors influencing incidence of acute grade 2 morbidity in conformal and standard radiation treatment of prostate cancer

International Nuclear Information System (INIS)

Hanks, Gerald E.; Schultheiss, Timothy E.; Hunt, Margie A.; Epstein, Barry

1995-01-01

Purpose: The fundament hypothesis of conformal radiation therapy is that tumor control can be increased by using conformal treatment techniques that allow a higher tumor dose while maintaining an acceptable level of complications. To test this hypothesis, it is necessary first to estimate the incidence of morbidity for both standard and conformal fields. In this study, we examine factors that influence the incidence of acute grade 2 morbidity in patients treated with conformal and standard radiation treatment for prostate cancer. Methods and Materials: Two hundred and forty-seven consecutive patients treated with conformal technique are combined with and compared to 162 consecutive patients treated with standard techniques. The conformal technique includes special immobilization by a cast, careful identification of the target volume in three dimensions, localization of the inferior border of the prostate using the retrograde urethrogram, and individually shaped portals that conform to the Planning Target Volume (PTV). Univariate analysis compares differences in the incidence of RTOG-EORTC grade two acute morbidity by technique, T stage, age, irradiated volume, and dose. Multivariate logistic regression includes these same variables. Results: In nearly all categories, the conformal treatment group experienced significantly fewer acute grade 2 complications than the standard treatment group. Only volume (prostate ± whole pelvis) and technique (conformal vs. standard) were significantly related to incidence of morbidity on multivariate analysis. When dose is treated as a continuous variable (rather than being dichotomized into two levels), a trend is observed on multivariate analysis, but it does not reach significant levels. The incidence of acute grade 2 morbidity in patients 65 years or older is significantly reduced by use of the conformal technique. Conclusion: The conformal technique is associated with fewer grade 2 acute toxicities for all patients. This

Silicon microfabricated beam expander

Science.gov (United States)

Othman, A.; Ibrahim, M. N.; Hamzah, I. H.; Sulaiman, A. A.; Ain, M. F.

2015-03-01

The feasibility design and development methods of silicon microfabricated beam expander are described. Silicon bulk micromachining fabrication technology is used in producing features of the structure. A high-precision complex 3-D shape of the expander can be formed by exploiting the predictable anisotropic wet etching characteristics of single-crystal silicon in aqueous Potassium-Hydroxide (KOH) solution. The beam-expander consist of two elements, a micromachined silicon reflector chamber and micro-Fresnel zone plate. The micro-Fresnel element is patterned using lithographic methods. The reflector chamber element has a depth of 40 µm, a diameter of 15 mm and gold-coated surfaces. The impact on the depth, diameter of the chamber and absorption for improved performance are discussed.

Bigelow Expandable Activity Module Project

Data.gov (United States)

National Aeronautics and Space Administration — The Bigelow Expandable Activity Module (BEAM) project is a NASA-industry partnership with Bigelow Aerospace (BA) that has developing the first human-rated expandable...

Effect of hog production wastewater in the development and quality of Eucalyptus urophylla substrate produced in urban solid waste

Directory of Open Access Journals (Sweden)

Raquel Oliveira Batista

2013-08-01

Full Text Available The objective of this study was to analyze the use of hog production wastewater in the production of seedlings of Eucalyptus urophylla, using a compound of municipal solid waste (SRSU as substrate, and evaluating the effect of different proportions of ARS and of seedling ages in their morphological and nutritional quality. The experiment was conducted in a greenhouse at the Experimental Hydraulics, Irrigation and Drainage, Department of Agricultural Engineering. The statistical design was randomized blocks with different numbers of repetitions, consisting of 10 treatments in a 5 x 2 factorial design (5 proportions of ARS supplemented with nitrogen fertilization and 2 seedling ages. The variables measured were shoot height (H, stem diameter (SD, shoot dry matter (SDM, root dry mass (RDM, total dry matter (TDM, ratio of seedling height / diameter of the girth (H / SD, ratio of dry weight of shoot / root dry mass (SDM / RDM, Dickson quality index (DQI and concentrations of nutrients in the plants leaf, stem and root. These characteristics were evaluated at 75 and 90 days after seeding (DAS. It was concluded that the proportion of 50% ARS improved the nutritional and morphological characteristics of eucalyptus. The seedlings achieved morphological characteristics suitable for planting in the field 90 days after sowing and showed appropriate levels for most nutrients at both ages.

The acute effects of manipulating volume and load of back squats on countermovement vertical jump performance.

Science.gov (United States)

Moir, Gavin L; Mergy, David; Witmer, Ca; Davis, Shala E

2011-06-01

The acute effects of manipulating the volume and load of back squats on subsequent countermovement vertical jump performance were investigated in the present study. Eleven National Collegiate Athletic Association division II female volleyball players performed 10 countermovement vertical jumps (CMJs) on a force platform 2 minutes after the last squat repetition of a high-load (HL) or high-volume (HV) squat protocol. Two minutes of rest was provided between each CMJ. The HL protocol culminated in the subjects having to perform 3 repetitions with a load equivalent to 90% 1 repetition maximum (1RM) back squat, whereas 12 repetitions with a load equivalent to 37% 1RM were performed in the HV protocol. During an initial familiarization session, knee angles were recorded during a series of CMJs, and these angles were used to control the depth of descent during all subsequent back squats. Jump height (JH) and vertical stiffness (VStiff) were calculated during each of the 10 CMJ, and the change in these variables after the 2 squat protocols was assessed using an analysis of variance model with repeated measures on 2 factors (Protocol [2-levels]; Time [2-levels]). There was no significant difference in JH after the HL and HV protocols (p > 0.05). A significant Protocol × Time interaction for VStiff resulted from the increase after the HL protocol being greater than that after the HV protocol (p = 0.03). The knee angles before the HL and HV protocols were significantly greater than those measured during the initial familiarization session (p = 0.001). Although neither squat protocol provided any benefit in improving JH, the heavy squat protocol produced greater increases in VStiff during the CMJ. Because of the increased VStiff caused by the HL protocol, volleyball coaches may consider using such protocols with their players to improve performance in jumps performed from a run such as the spike and on-court agility.

Neutron guide geometries for homogeneous phase space volume transformation

Energy Technology Data Exchange (ETDEWEB)

Stüßer, N., E-mail: stuesser@helmholtz-berlin.de; Bartkowiak, M.; Hofmann, T.

2014-06-01

We extend geometries for recently developed optical guide systems that perform homogeneous phase space volume transformations on neutron beams. These modules allow rotating beam directions and can simultaneously compress or expand the beam cross-section. Guide systems combining these modules offer the possibility to optimize ballistic guides with and without direct view on the source and beam splitters. All systems are designed for monochromatic beams with a given divergence. The case of multispectral beams with wavelength-dependent divergence distributions is addressed as well. - Highlights: • Form invariant volume transformation in phase space. • Geometrical approach. • Ballistic guide, beam splitter, beam bender.

Neutron guide geometries for homogeneous phase space volume transformation

International Nuclear Information System (INIS)

Stüßer, N.; Bartkowiak, M.; Hofmann, T.

2014-01-01

We extend geometries for recently developed optical guide systems that perform homogeneous phase space volume transformations on neutron beams. These modules allow rotating beam directions and can simultaneously compress or expand the beam cross-section. Guide systems combining these modules offer the possibility to optimize ballistic guides with and without direct view on the source and beam splitters. All systems are designed for monochromatic beams with a given divergence. The case of multispectral beams with wavelength-dependent divergence distributions is addressed as well. - Highlights: • Form invariant volume transformation in phase space. • Geometrical approach. • Ballistic guide, beam splitter, beam bender

Impacts of acute severe pulmonary regurgitation on right ventricular geometry and contractility assessed by tissue-Doppler echocardiography

DEFF Research Database (Denmark)

Kjaergaard, Jesper; K. Iversen, Kasper; G Vejlstrup, Niels

2010-01-01

AIMS: Little is known of the impact of acute right ventricular (RV) volume overload on RV function. We assessed the impact of acute severe pulmonary regurgitation (PR) on global and regional RV function by applying novel quantitative echocardiographic markers of myocardial performance in an animal...

Impacts of acute severe pulmonary regurgitation on right ventricular geometry and contractility assessed by tissue-Doppler echocardiography

DEFF Research Database (Denmark)

Kjaergaard, Jesper; Iversen, Kasper K; Vejlstrup, Niels G

2010-01-01

Little is known of the impact of acute right ventricular (RV) volume overload on RV function. We assessed the impact of acute severe pulmonary regurgitation (PR) on global and regional RV function by applying novel quantitative echocardiographic markers of myocardial performance in an animal model....

Association Between Contrast Media Volume-Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention.

Science.gov (United States)

Celik, Omer; Ozturk, Derya; Akin, Fatih; Ayca, Burak; Yalcın, Ahmet Arif; Erturk, Mehmet; Bıyık, Ismail; Ayaz, Ahmet; Akturk, Ibrahim Faruk; Enhos, Asım; Aslan, Serkan

2015-07-01

We hypothesized that contrast media volume-estimated glomerular filtration rate (CV-e-GFR) ratio may be a predictor of contrast media-induced acute kidney injury (CI-AKI). We investigated the associations between CV-e-GFR ratio and CI-AKI in 597 patients undergoing primary percutaneous coronary intervention (pPCI). An absolute ≥0.3 mg/dL increase in serum creatinine compared with baseline levels within 48 hours after the procedure was considered as CI-AKI; 78 (13.1%) of the 597 patients experienced CI-AKI. The amount of contrast during procedure was higher in the CI-AKI group than in those without CI-AKI (153 vs 135 mL, P = .003). The CV-e-GFR ratio was significantly higher in patients with CI-AKI than without (2.3 vs 1.5, P 2 (P < .001, OR = 5.917). In conclusion, CV-e-GFR ratio is significantly associated with CI-AKI after pPCI. © The Author(s) 2014.

Thermodynamic analysis and kinetic modelling of dioxin formation and emissions from power boilers firing salt-laden hog fuel.

Science.gov (United States)

Duo, Wenli; Leclerc, Denys

2007-04-01

Both organic chlorine (e.g. PVC) and inorganic chlorides (e.g. NaCl) can be significant chlorine sources for dioxin and furan (PCDD/F) formation in combustion processes. This paper presents a thermodynamic analysis of high temperature salt chemistry. Its influence on PCDD/F formation in power boilers burning salt-laden wood waste is examined through the relationships between Cl2, HCl, NaCl(g) and NaCl(c). These analyses show that while HCl is a product of combustion of PVC-laden municipal solid waste, NaCl can be converted to HCl in hog fuel boilers by reactions with SO2 or alumino-silicate materials. Cl2 is a strong chlorinating agent for PCDD/F formation. HCl can be oxidized to Cl2 by O2, and Cl2 can be reduced back to HCl by SO2. The presence of sulphur at low concentrations thus enhances PCDD/F formation by increasing HCl concentrations. At high concentrations, sulphur inhibits de novo formation of PCDD/Fs through Cl2 reduction by excess SO2. The effect of NH3, CO and NOx on PCDD/F formation is also discussed. A semi-empirical kinetic model is proposed. This model considers both precursor and de novo formation mechanisms. A simplified version is used as a stack emission model. The kinetic model indicates that stack dioxin emissions will increase linearly with decreasing electrostatic precipitator (ESP) efficiency and exponentially with increasing ESP temperature.

Acute effects of volume-oriented incentive spirometry on chest wall volumes in patients after a stroke.

Science.gov (United States)

Lima, Illia Ndf; Fregonezi, Guilherme Af; Melo, Rodrigo; Cabral, Elis Ea; Aliverti, Andrea; Campos, Tânia F; Ferreira, Gardênia Mh

2014-07-01

The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. Twenty poststroke patients and 20 age-matched healthy subjects were studied by optoelectronic plethysmography during spontaneous quiet breathing (QB), during incentive spirometry, and during the recovery period after incentive spirometry. Incentive spirometry was associated with an increased chest wall volume measured at the pulmonary rib cage, abdominal rib cage and abdominal compartment (P = .001) and under 3 conditions (P spirometry, and postincentive spirometry, respectively. Under all 3 conditions, the contribution of the abdominal compartment to VT was greater in the stroke subjects (54.1, 43.2, and 48.9%) than in the control subjects (43.7, 40.8, and 46.1%, P = .039). In the vast majority of subjects (13/20 and 18/20 during QB and incentive spirometry, respectively), abdominal expansion precedes rib cage expansion during inspiration. Greater asymmetry between the right and left hemithoracic expansions occurred in stroke subjects compared with control subjects, but it decreased during QB (62.5%, P = .002), during incentive spirometry (19.7%), and postincentive spirometry (67.6%, P = .14). Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation. Copyright © 2014 by Daedalus Enterprises.

Helium turbo-expander with an alternator

International Nuclear Information System (INIS)

Akiyama, Yoshitane

1980-01-01

Study was made on a helium turbo-expander, the heart of helium refrigerator systems, in order to develop a system which satisfies the required conditions. A helium turbo-expander with externally pressurized helium gas bearings at the temperature of liquid nitrogen and an alternator as a brake have been employed. The essential difference between a helium turbo-expander and a nitrogen turbo-expander was clarified. The gas bearing lubricated with nitrogen at room temperature and the gas bearing lubricated with helium at low temperature were tested. The flow rate of helium in a helium refrigerator for a large superconducting magnet is comparatively small, therefore a helium turbine must be small, but the standard for large turbine design can be applied to such small turbine. Using the alternator as a brake, the turbo-expander was easily controllable electrically. The prototype turbo-expander was made, and the liquefaction test with it and MHD power generation test were carried out. (Kako, I.)

Predicted Hematologic and Plasma Volume Responses Following Rapid Ascent to Progressive Altitudes

Science.gov (United States)

2014-06-01

Detection of unethical and illegal manipulation of erythrocyte volume by following changes in hemoglobin concentration ([Hb]) in elite athletes is a...tolerance to environmental extremes [2,3] and such manipulation often results in acute plasma volume (PV) loss and elevated hemoglobin concentrations [3...bodies to detect "unfair practices" in athletes seeking to gain an edge in their performance through illegal manipulation of their erythrocyte

40 CFR 180.420 - Fluridone; tolerances for residues.

Science.gov (United States)

2010-07-01

... Parts per million Cattle, fat 0.05 Cattle, kidney .1 Cattle, liver .1 Cattle, meat .05 Cattle, meat byproducts .05 Egg .05 Goat, fat .05 Goat, kidney .1 Goat, liver .1 Goat, meat .05 Goat, meat byproducts .05 Hog, fat .05 Hog, kidney .1 Hog, liver .1 Hog, meat .05 Hog, meat byproducts .05 Horse, fat .05 Horse...

Optimizing the performance of small-scale organic Rankine cycle that utilizes a single-screw expander

International Nuclear Information System (INIS)

Ziviani, D.; Gusev, S.; Lecompte, S.; Groll, E.A.; Braun, J.E.; Horton, W.T.; Broek, M. van den; De Paepe, M.

2017-01-01

Highlights: • A total of 102 steady-state points with R245fa and SES336 have been collected. • R245fa led to 10% higher power output despite lower expander isentropic efficiency. • The ORC running with SES36 presented a better matching between expander and cycle. • The theoretical matching between expander volume ratio and cycle efficiency is determined. • Steady-state performance maps are used to build a feed-forward controller. - Abstract: This paper deals with the operation and optimization of a down-scaled industrial organic Rankine cycle (ORC) for low-grade waste heat recovery. The system is a sub-critical regenerative ORC with a nominal power output of 11 kW. The ORC unit has been assembled using off-the-shelf components including three identical plate heat exchangers, a liquid receiver, a multi-stage centrifugal pump and a single-screw compressor adapted to operate as an expander. The experimental results are used to evaluate the influence of the expander performance on the behavior of the ORC system at nominal and part-load conditions. The matching between the volumetric expander and the system operating conditions is also analyzed. Results showed that in the case of SES36, both the expander efficiency and system performance were maximized for a pressure ratio between 7 and 9. In the case of R245fa, while the system efficiency achieved values similar to SES36, but the expander maximum isentropic efficiency was 17% lower. Two analyses are carried out to optimize the operation of the ORC unit with R245fa. At first, the insights gained by analyzing the experimental data are used to evaluate the theoretical matching between volumetric expander and the system maximum efficiency in terms of the Second Law of thermodynamics. Secondly, a control-oriented steady-state cycle model based on empirical correlations calibrated on the experimental results is developed. The model is used to implement a feed-forward control strategy based on predetermined steady

Acute exacerbation of COPD.

Science.gov (United States)

Ko, Fanny W; Chan, Ka Pang; Hui, David S; Goddard, John R; Shaw, Janet G; Reid, David W; Yang, Ian A

2016-10-01

The literature of acute exacerbation of chronic obstructive pulmonary disease (COPD) is fast expanding. This review focuses on several aspects of acute exacerbation of COPD (AECOPD) including epidemiology, diagnosis and management. COPD poses a major health and economic burden in the Asia-Pacific region, as it does worldwide. Triggering factors of AECOPD include infectious (bacteria and viruses) and environmental (air pollution and meteorological effect) factors. Disruption in the dynamic balance between the 'pathogens' (viral and bacterial) and the normal bacterial communities that constitute the lung microbiome likely contributes to the risk of exacerbations. The diagnostic approach to AECOPD varies based on the clinical setting and severity of the exacerbation. After history and examination, a number of investigations may be useful, including oximetry, sputum culture, chest X-ray and blood tests for inflammatory markers. Arterial blood gases should be considered in severe exacerbations, to characterize respiratory failure. Depending on the severity, the acute management of AECOPD involves use of bronchodilators, steroids, antibiotics, oxygen and noninvasive ventilation. Hospitalization may be required, for severe exacerbations. Nonpharmacological interventions including disease-specific self-management, pulmonary rehabilitation, early medical follow-up, home visits by respiratory health workers, integrated programmes and telehealth-assisted hospital at home have been studied during hospitalization and shortly after discharge in patients who have had a recent AECOPD. Pharmacological approaches to reducing risk of future exacerbations include long-acting bronchodilators, inhaled steroids, mucolytics, vaccinations and long-term macrolides. Further studies are needed to assess the cost-effectiveness of these interventions in preventing COPD exacerbations. © 2016 Asian Pacific Society of Respirology.

Silicon microfabricated beam expander

International Nuclear Information System (INIS)

Othman, A.; Ibrahim, M. N.; Hamzah, I. H.; Sulaiman, A. A.; Ain, M. F.

2015-01-01

The feasibility design and development methods of silicon microfabricated beam expander are described. Silicon bulk micromachining fabrication technology is used in producing features of the structure. A high-precision complex 3-D shape of the expander can be formed by exploiting the predictable anisotropic wet etching characteristics of single-crystal silicon in aqueous Potassium-Hydroxide (KOH) solution. The beam-expander consist of two elements, a micromachined silicon reflector chamber and micro-Fresnel zone plate. The micro-Fresnel element is patterned using lithographic methods. The reflector chamber element has a depth of 40 µm, a diameter of 15 mm and gold-coated surfaces. The impact on the depth, diameter of the chamber and absorption for improved performance are discussed

Silicon microfabricated beam expander

Energy Technology Data Exchange (ETDEWEB)

Othman, A., E-mail: aliman@ppinang.uitm.edu.my; Ibrahim, M. N.; Hamzah, I. H.; Sulaiman, A. A. [Faculty of Electrical Engineering, Universiti Teknologi MARA Malaysia, 40450, Shah Alam, Selangor (Malaysia); Ain, M. F. [School of Electrical and Electronic Engineering, Engineering Campus, Universiti Sains Malaysia, Seri Ampangan, 14300,Nibong Tebal, Pulau Pinang (Malaysia)

2015-03-30

The feasibility design and development methods of silicon microfabricated beam expander are described. Silicon bulk micromachining fabrication technology is used in producing features of the structure. A high-precision complex 3-D shape of the expander can be formed by exploiting the predictable anisotropic wet etching characteristics of single-crystal silicon in aqueous Potassium-Hydroxide (KOH) solution. The beam-expander consist of two elements, a micromachined silicon reflector chamber and micro-Fresnel zone plate. The micro-Fresnel element is patterned using lithographic methods. The reflector chamber element has a depth of 40 µm, a diameter of 15 mm and gold-coated surfaces. The impact on the depth, diameter of the chamber and absorption for improved performance are discussed.

Influence of dosing volume on the neurotoxicity of bifenthrin.

Science.gov (United States)

Wolansky, M J; McDaniel, K L; Moser, V C; Crofton, K M

2007-01-01

Pyrethroids are pesticides with high insecticidal activity and relatively low potency in mammals. The influence of dosing volume on the neurobehavioral syndrome following oral acute exposure to the Type-I pyrethroid insecticide bifenthrin in corn oil was evaluated in adult male Long Evans rats. We tested bifenthrin effects at 1 and 5 ml/kg, two commonly used dose volumes in toxicological studies. Two testing times (4 and 7 h) were used in motor activity and functional observational battery (FOB) assessments. Four to eight doses were examined at either dosing condition (up to 20 or 26 mg/kg, at 1 and 5 ml/kg, respectively). Acute oral bifenthrin exposure produced toxic signs typical of Type I pyrethroids, with dose-related increases in fine tremor, decreased motor activity and grip strength, and increased pawing, head shaking, click response, and body temperature. Bifenthrin effects on motor activity and pyrethroid-specific clinical signs were approximately 2-fold more potent at 1 ml/kg than 5 ml/kg. This difference was clearly evident at 4 h and slightly attenuated at 7 h post-dosing. Benchmark dose (BMD) modeling estimated similar 2-fold potency differences in motor activity and pyrethroid-specific FOB data. These findings demonstrate that dose volume, in studies using corn oil as the vehicle influences bifenthrin potency. Further, these data suggest that inconsistent estimates of pyrethroid potency between laboratories are at least partially due to differences in dosing volume.

The acute effects of body position strategies and respiratory therapy in paralyzed patients with acute lung injury.

Science.gov (United States)

Davis, K; Johannigman, J A; Campbell, R S; Marraccini, A; Luchette, F A; Frame, S B; Branson, R D

2001-01-01

Routine turning of critically ill patients is a standard of care. In recent years, specialized beds that provide automated turning have been introduced. These beds have been reported to improve lung function, reduce hospital-acquired pneumonia, and facilitate secretion removal. This trial was designed to measure the physiological effects of routine turning and respiratory therapy in comparison with continuous lateral rotation (CLR). The study was a prospective, quasi-experimental, random assignment, trial with patients serving as their own controls. Paralyzed, sedated patients with acute respiratory distress syndrome were eligible for study. Patients were randomized to receive four turning and secretion management regimens in random sequence for 6 h each over a period of 24 h: (1) routine turning every 2 h from the left to right lateral position; (2) routine turning every 2 h from the left to right lateral position including a 15-min period of manual percussion and postural drainage (P&PD); (3) CLR with a specialized bed that turned patients from left to right lateral position, pausing at each position for 2 min; and (4) CLR with a specialized bed that turned patients from left to right lateral position pausing at each position for 2 min, and a 15-min period of percussion provided by the pneumatic cushions of the bed every 2 h. Nineteen patients were entered into the study. There were no statistically significant differences in the measured cardiorespiratory variables. There was a tendency for the ratio of partial pressure of arterial oxygen to fractional inspired oxygen concentration (PaO2/FIO2) to increase (174 +/- 31 versus 188 +/- 36; P = 0.068) and for the ratio of deadspace to tidal volume (Vd/Vt) to decrease (0.62 +/- 0.18 versus 0.59 +/- 0.18; P = 0.19) during periods of CLR, but these differences did not achieve statistical significance. There were statistically significant increases in sputum volume during the periods of CLR. The addition of P&PD did not

Diffusion tensor imaging correlates with lesion volume in cerebral hemisphere infarctions

International Nuclear Information System (INIS)

Rossi, Maija E; Jason, Eeva; Marchesotti, Silvia; Dastidar, Prasun; Ollikainen, Jyrki; Soimakallio, Seppo

2010-01-01

Both a large lesion volume and abnormalities in diffusion tensor imaging are independently associated with a poor prognosis after cerebral infarctions. Therefore, we assume that they are associated. This study assessed the associations between lesion volumes and diffusion tensor imaging in patients with a right-sided cerebral infarction. The lesion volumes of 33 patients (age 65.9 ± 8.7, 26 males and 7 females) were imaged using computed tomography (CT) in the acute phase (within 3-4 hours) and magnetic resonance imaging (MRI) in the chronic phase (follow-up at 12 months, with a range of 8-27 months). The chronic-phase fractional anisotropy (FA) and mean diffusivity (MD) values were measured at the site of the infarct and selected white matter tracts. Neurological tests in both the acute and chronic phases, and DTI lateralization were assessed with the Wilcoxon signed-rank test. The effects of thrombolytic therapy (n = 10) were assessed with the Mann-Whitney U test. The correlations between the measured parameters were analysed with Spearman's rho correlation. Bonferroni post-hoc correction was used to compensate for the familywise error rate in multiple comparisons. Several MD values in the right hemisphere correlated positively and FA values negatively with the lesion volumes. These correlations included both lesion area and healthy tissue. The results of the mini-mental state examination and the National Institutes of Health Stroke Scale also correlated with the lesion volume. A larger infarct volume is associated with more pronounced tissue modifications in the chronic stage as observed with the MD and FA alterations

A comparison of synchronized intermittent mandatory ventilation and pressure-regulated volume control ventilation in elderly patients with acute exacerbations of COPD and respiratory failure

Directory of Open Access Journals (Sweden)

Chang SC

2016-05-01

Full Text Available Suchi Chang,1 Jindong Shi,2 Cuiping Fu,1 Xu Wu,1 Shanqun Li1 1Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, 2Department of Respiratory Medicine, The Fifth People’s Hospital of Shanghai, Fudan University, Shanghai, People’s Republic of China Background: COPD is the third leading cause of death worldwide. Acute exacerbations of COPD may cause respiratory failure, requiring intensive care unit admission and mechanical ventilation. Intensive care unit patients with acute exacerbations of COPD requiring mechanical ventilation have higher mortality rates than other hospitalized patients. Although mechanical ventilation is the most effective intervention for these conditions, invasive ventilation techniques have yielded variable effects. Objective: We evaluated pressure-regulated volume control (PRVC ventilation treatment efficacy and preventive effects on pulmonary barotrauma in elderly COPD patients with respiratory failure. Patients and methods: Thirty-nine intubated patients were divided into experimental and control groups and treated with the PRVC and synchronized intermittent mandatory ventilation – volume control methods, respectively. Vital signs, respiratory mechanics, and arterial blood gas analyses were monitored for 2–4 hours and 48 hours. Results: Both groups showed rapidly improved pH, partial pressure of oxygen (PaO2, and PaO2 per fraction of inspired O2 levels and lower partial pressure of carbon dioxide (PaCO2 levels. The pH and PaCO2 levels at 2–4 hours were lower and higher, respectively, in the test group than those in the control group (P<0.05 for both; after 48 hours, blood gas analyses showed no statistical difference in any marker (P>0.05. Vital signs during 2–4 hours and 48 hours of treatment showed no statistical difference in either group (P>0.05. The level of peak inspiratory pressure in the experimental group after mechanical ventilation for 2–4 hours and 48�

Self-expandable stent loaded with {sup 125}I seeds: Feasibility and safety in a rabbit model

Energy Technology Data Exchange (ETDEWEB)

Guo Jinhe [Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009 (China); Teng Gaojun [Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009 (China)]. E-mail: gjteng@vip.sina.com; Zhu Guangyu [Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009 (China); He Shicheng [Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009 (China); Deng Gang [Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009 (China); He Jie [Department of Radiology, Zhong-Da Hospital, Southeast University, 87 Dingjiaqiao Road, Nanjing 210009 (China)

2007-02-15

Objective: To evaluate technical feasibility and acute and subacute radiotolerance of a self-expandable stent loaded with {sup 125}I seeds in the rabbit esophagus. Methods: A self-expandable stent designed for esophageal application was made of 0.16 mm nitinol wire and loaded with {sup 125}I seeds (CIAE-6711). Twenty-seven stents with three different radioactive dosages (n = 9 in each dosage group) were implanted in the esophagus of healthy rabbits, while nine stents alone were used as controls. The stents were perorally deployed into the esophagus under fluoroscopic guidance. Radiological follow-up included plain chest film, CT scan, and barium esophagography which were undertaken in all rabbits of each group at 2, 4, and 8 weeks, respectively, which were correlated to histopathological findings. The stented esophageal segments along with their adjacent tissues were harvested for histopathological examinations. Results: The stent was successfully deployed into the targeted esophageal segment in all rabbits. Neither {sup 125}I seeds dislodged from the stent during the deployment, nor they did during the follow-up period. The greatest (16.2 Gy) absorbed dose was found in the tissue 10 mm from {sup 125}I seeds at 8 weeks. Slight epithelial hyperplasia on the stent surface and submucosal inflammatory process developed at 2 weeks, which reached the peak at 8 weeks after the procedure. Significant thickness of the esophageal muscular layer was found at 8 weeks only in the groups with {sup 125}I seeds. On radiologic follow-up, moderate strictures on both ends of the stents developed at 4 weeks and became severe at 8 weeks after the procedure in all groups. Conclusion: Deployment of a self-expandable stent loaded with {sup 125}I seeds is technically feasible and safe within the first 8 weeks. Acute and subacute radiotolerance of the treated esophagus and its adjacent tissues by {sup 125}I seeds is well preserved in a healthy rabbit model.

Effect of tidal volume on extravascular lung water content during one-lung ventilation for video-assisted thoracoscopic surgery: a randomised, controlled trial.

Science.gov (United States)

Qutub, Hatem; El-Tahan, Mohamed R; Mowafi, Hany A; El Ghoneimy, Yasser F; Regal, Mohamed A; Al Saflan, AbdulHadi A

2014-09-01

The use of low tidal volume during one-lung ventilation (OLV) has been shown to attenuate the incidence of acute lung injury after thoracic surgery. To test the effect of tidal volume during OLV for video-assisted thoracoscopic surgery on the extravascular lung water content index (EVLWI). A randomised, double-blind, controlled study. Single university hospital. Thirty-nine patients scheduled for elective video-assisted thoracoscopic surgery. Patients were randomly assigned to one of three groups (n = 13 per group) to ventilate the dependent lung with a tidal volume of 4, 6 or 8 ml  kg(-1) predicted body weight with I:E ratio of 1:2.5 and PEEP of 5 cm H2O. The primary outcomes were perioperative changes in EVLWI and EVLWI to intrathoracic blood volume index (ITBVI) ratio. Secondary outcomes included haemodynamics, oxygenation indices, incidences of postoperative acute lung injury, atelectasis, pneumonia, morbidity and 30-day mortality. A tidal volume of 4 compared with 6 and 8 ml  kg(-1) after 45 min of OLV resulted in an EVLWI of 4.1 [95% confidence interval (CI) 3.5 to 4.7] compared with 7.7 (95% CI 6.7 to 8.6) and 8.6 (95% CI 7.5 to 9.7) ml  kg(-1), respectively (P tidal volume of 4 ml kg during OLV was associated with less lung water content than with larger tidal volumes of 6 to 8 ml kg(-1), although no patient developed acute lung injury. Further studies are required to address the usefulness of EVLWI as a marker for the development of postoperative acute lung injury after the use of a low tidal volume during OLV in patients undergoing pulmonary resection. Clinicaltrials.gov identifier: NCT01762709.

Changes in circulating blood volume after infusion of hydroxyethyl starch 6% in critically ill patients

DEFF Research Database (Denmark)

Christensen, P; Andersson, J; Rasmussen, S E

2001-01-01

The cardiovascular response to a volume challenge with hydroxyethyl starch (HES) (200/0.5) 6% depends on the relation between the volume of HES 6% infused and the expansion of the blood volume in critically ill patients. However, only relatively limited data exist on the plasma expanding effect...... of infusion of HES 6% in critically ill patients. The purpose of the study was to evaluate the variation in the expansion of the circulating blood volume (CBV) in critically ill patients after infusion of 500 ml of colloid (HES (200/0.5) 6%) using the carbon monoxide method....

The use of expanded clay dust in paint manufacturing

Science.gov (United States)

Sverguzova, S. V.; Sapronova, Zh A.; Starostina, Yu L.; Belovodskiy, E. A.

2018-01-01

Production increase of useful products is accompanied by the formation and the accumulation of the vast amounts of industrial wastes, the bulk of which is not involved in the recycling processes. An example of such wastes is dust bag filters of ceramsite production. At the large enterprises, the volume of its formation can reach 7-8 tons of dust per day, which is 10-15% of feedstock mass. The studies on the use of ceramsite production dust as filler pigment in the composition of organic mixed primer of red-brown color are carried out in this work. For comparison, red iron oxide pigment (Pg FGM) was used. The results showed that, primer with the use of expanded clay dust is characterized by the short drying time and meets all regulatory requirements.

Acute Toxicity Comparison of Single-Walled Carbon Nanotubes in Various Freshwater Organisms

Directory of Open Access Journals (Sweden)

Eun Kyung Sohn

2015-01-01

Full Text Available While the commercialization of single-walled carbon nanotubes (SWCNTs is rapidly expanding, the environmental impact of this nanomaterial is not well understood. Therefore, the present study evaluates the acute aquatic toxicity of SWCNTs towards two freshwater microalgae (Raphidocelis subcapitata and Chlorella vulgaris, a microcrustacean (Daphnia magna, and a fish (Oryzias latipes based on OECD test guidelines (201, 202, and 203. According to the results, the SWCNTs inhibited the growth of the algae R. subcapitata and C. vulgaris with a median effective concentration (EC50 of 29.99 and 30.96 mg/L, respectively, representing “acute category 3” in the Globally Harmonized System (GHS of classification and labeling of chemicals. Meanwhile, the acute toxicity test using O. latipes and D. magna did not show any mortality/immobilizing effects up to a concentration of 100.00 mg/L SWCNTs, indicating no hazard category in the GHS classification. In conclusion, SWCNTs were found to induce acute ecotoxicity in freshwater microalgae, yet not in D. magna and medaka fish.

Comparison of Tidal Volumes at the Endotracheal Tube and at the Ventilator.

Science.gov (United States)

Kim, Paul; Salazar, Adler; Ross, Patrick A; Newth, Christopher J L; Khemani, Robinder G

2015-11-01

Lung protective ventilation for children with acute respiratory distress syndrome requires accurate assessment of tidal volume. Although modern ventilators compensate for ventilator tubing compliance, tidal volume measured at the ventilator may not be accurate, particularly in small children. Although ventilator-specific proximal flow sensors that measure tidal volume at the endotracheal tube have been developed, there is little information regarding their accuracy. We sought to test the accuracy of ventilator measured tidal volume with and without proximal flow sensors against a calibrated pneumotachometer in children. Prospective, observational. Tertiary care PICU. Fifty-one endotracheally intubated and mechanically ventilated children younger than 18 years. Tidal volumes were measured at the ventilator, using a ventilator-specific flow sensor, and a calibrated pneumotachometer connected to the SensorMedics 2600A Pediatric Pulmonary Function Cart. In a pressure control mode of ventilation: median tidal volume measured with the pneumotachometer (9.5 mL/kg [interquartile range, 8.2-11.7 mL/kg]) was significantly higher than tidal volume measured either at the ventilator (8.2 mL/kg [7.1-9.6 mL/kg]) or at the proximal flow sensor (8.1 mL/kg [7.2-10.0 mL/kg]) (p tidal volume measured with the pneumotachometer (10.2 mL/kg [8.8-12.4 mL/kg]) was significantly higher than tidal volume measured either at the ventilator (8.0 mL/kg [7.1-9.7 mL/kg]) or at the proximal flow sensor (8.5 mL/kg [7.3-10.4 mL/kg]) (p Tidal volume measured either at the endotracheal tube with a proximal flow sensor or at the ventilator with compensation for tubing compliance are both significantly lower than tidal volume measured with a calibrated pneumotachometer. This underestimation of delivered tidal volume may be particularly important when managing children with acute respiratory distress syndrome.

[Treatment of acute respiratory distress syndrome using pressure and volume controlled ventilation with lung protective strategy].

Science.gov (United States)

Ge, Ying; Wan, Yong; Wang, Da-qing; Su, Xiao-lin; Li, Jun-ying; Chen, Jing

2004-07-01

To investigate the significance and effect of pressure controlled ventilation (PCV) as well as volume controlled ventilation (VCV) by lung protective strategy on respiratory mechanics, blood gas analysis and hemodynamics in patients with acute respiratory distress syndrome (ARDS). Fifty patients with ARDS were randomly divided into PCV and VCV groups with permissive hypercapnia and open lung strategy. Changes in respiratory mechanics, blood gas analysis and hemodynamics were compared between two groups. Peak inspiration pressure (PIP) in PCV group was significantly lower than that in VCV group, while mean pressure of airway (MPaw) was significantly higher than that in VCV after 24 hours mechanical ventilation. After 24 hours mechanical ventilation, there were higher central venous pressure (CVP) and slower heart rate (HR) in two groups, CVP was significantly higher in VCV compared with PCV, and PCV group had slower HR than VCV group, the two groups had no differences in mean blood pressure (MBP) at various intervals. All patients showed no ventilator-induced lung injury. Arterial blood oxygenations were obviously improved in two groups after 24 hours mechanical ventilation, PCV group had better partial pressure of oxygen in artery (PaO2) than VCV group. Both PCV and VCV can improve arterial blood oxygenations, prevent ventilator-induced lung injury, and have less disturbance in hemodynamic parameters. PCV with lung protective ventilatory strategy should be early use for patients with ARDS.

MODEL PERUBAHAN VOLUME KERIPIK BUAH SELAMA PROSES PENGGORENGAN SECARA VAKUM [Model for Volume Changes in Fruit Chips during Vacuum Frying

Directory of Open Access Journals (Sweden)

Jamaluddin1*

2011-06-01

Full Text Available Expansion and puffing are specific characteristics of fried products critical for consumer preferences. To obtain expanded and puffed dried products that fit well with consumer acceptance criteria, it is necessary to pay attention to the process conditions which change the raw material characteristics during frying. The important changes include volume and density ratio of the products during frying. Hypothetically, these changes are due to water vaporization and the decrease dry matter in the products. The objective of this research is to develop a mathematical model of volume and density ratio changes for jack fruit during vacuum frying as a function of water and starch content reductions. Samples were vacuum fried at 70–100OC and pressure of 80-90 kPa for 15–60 min. The parameters observed were volume and density as well as water and starch contents of samples before and after vacuum frying. The results showed that the developed model can be used to predict changes in volume and density ratio of jack fruit during vacuum frying.

Injúria Renal Aguda no paciente politraumatizado Acute Renal Injury in polytrauma patients

Directory of Open Access Journals (Sweden)

Thiago Gomes Romano

2013-03-01

Full Text Available A Injúria Renal Aguda (IRA no contexto do paciente politraumatizado ocorre, na maioria das vezes, por uma conjuntura de fatores que passam por eventos correlacionados à ressuscitação volêmica inicial, ao grau de resposta inflamatória sistêmica associada ao trauma, ao uso de contraste iodado para procedimentos diagnósticos, à rabdomiólise e à síndrome compartimental abdominal. Atualmente, passamos por uma fase de uniformização dos critérios diagnósticos da IRA com o Acute Kidney Injury Network (AKIN, sendo a referência mais aceita. Consequentemente, o estudo da IRA no politraumatismo também passa por uma fase de reformulação. Esta revisão da literatura médica visa trazer dados epidemiológicos, fisiológicos e de implicação clínica para o manuseio destes pacientes, bem como expor os riscos do uso indiscriminado de expansores volêmicos e particularidades sobre a instituição de terapia renal substitutiva em indivíduos sob risco de hipertensão intracraniana.Acute Kidney Injury (AKI in trauma is, in most cases, multifactorial. Factors related to the initial ressuscitation protocol, degree of the systemic inflamatory response to trauma, contrast nephropathy in diagnostic procedures, rhabdomyolysis and abdominal compartment syndrome are some of those factors. Nowadays a uniformization in diagnostic criteria for AKI has been proposed by the Acute Kidney Injury Network (AKIN and as a result the incidence of AKI and its impact in outcomes in trauma patients also needs to be reconsider. In this review we aim to approach epidemiologic, physiologic and clinical relevant data in the critical care of patients victims of trauma and also to expose the risks of indiscriminate use of volume expanders and the interaction between renal replacement theraphy and intracranial hypertension.

77 FR 14291 - Penthiopyrad; Pesticide Tolerances

Science.gov (United States)

2012-03-09

... 0.09 Goat, fat 0.03 Goat, meat 0.03 Goat, meat byproducts 0.09 Horse, fat 0.03 Horse, meat 0.03...-methyl-3-trifluoromethyl-1H-pyrazole-4-carboxamide) in animal commodities hog, meat at 0.01 ppm; hog, fat at 0.01 ppm; hog, liver at 0.01 ppm; hog, kidney at 0.01 ppm; hog, meat byproducts at 0.01 ppm...

Postmastectomy intensity modulated radiation therapy following immediate expander-implant reconstruction

International Nuclear Information System (INIS)

Koutcher, Lawrence; Ballangrud, Ase; Cordeiro, Peter G.; McCormick, Beryl; Hunt, Margie; Zee, Kimberly J. Van; Hudis, Clifford; Beal, Kathryn

2010-01-01

Background/purpose: To evaluate radiation plans of patients undergoing mastectomy with immediate expander-implant reconstruction followed by postmastectomy radiation therapy (PMRT). Materials/methods: We identified 41 patients from June 2004 to May 2007 who underwent mastectomy, immediate expander-implant reconstruction, and PMRT with intensity-modulated radiation therapy. We assessed chest wall (CW) coverage and volume of heart and lung irradiated. Results: In 73% of patients, all CW borders were adequately covered, and in 22%, all but 1 border were adequately covered. The total lung V 20 was 20 was 13% (range, 3-23%), and the mean heart D mean was 2.81 Gy (range, 0.53-9.60 Gy). In patients with left-sided lesions without internal mammary nodes (IMNs) treatment (n = 22), the mean lung V 20 was 12.6% and the mean heart D mean was 3.90 Gy, and in the patient with IMN treatment, the lung V 20 was 18% and heart D mean was 8.04 Gy. For right-sided lesions without IMN treatment (n = 12), the mean lung V 20 was 12.4% and the mean heart D mean was 0.90 Gy, and in patients with IMN treatment (n = 6), these numbers were 17.8% and 1.76 Gy. At a median follow-up of 29 months, the 30-month actuarial local control was 97%. Conclusions: In women undergoing immediate expander-implant reconstruction, PMRT can achieve excellent local control with acceptable heart and lung doses. These results can be achieved even when the IMN are being treated, although doses to the heart and lungs will be higher.

Limiting volume with modern ventilators.

Science.gov (United States)

Wing, Thomas J; Haan, Lutana; Ashworth, Lonny J; Anderson, Jeff

2015-06-01

The acute respiratory distress syndrome (ARDS) network low tidal-volume study comparing tidal volumes of 12 ml/kg versus 6 ml/kg was published in 2000. The study was stopped early as data revealed a 22% relative reduction in mortality rate when using 6 ml/kg tidal volume. The current generation of critical care ventilators allows the tidal volume to be set during volume-targeted, assist/control (volume A/C); however, some ventilators include options that may prevent the tidal volume from being controlled. The purpose of this bench study was to evaluate the delivered tidal volume, when these options are active, in a spontaneously breathing lung model using an electronic breathing simulator. Four ventilators were evaluated: CareFusion AVEA (AVEA), Dräger Evita® XL (Evita XL), Covidien Puritan Bennett® 840(TM) (PB 840), and Maquet SERVO-i (SERVO-i). Each ventilator was connected to the Hans Rudolph Electronic Breathing Simulator at an amplitude of 0 cm H2O and then 10 cm H2O. All four ventilators were set to deliver volume A/C, tidal volume 400 ml, respiratory rate 20 bpm, positive end-expiratory pressure 5 cm H2O, peak flowrate 60 L/min. The displayed tidal volume was recorded for each ventilator at the above settings with additional options OFF and then ON. The AVEA has two options in volume A/C: demand breaths and V-sync. When activated, these options allow the patient to exceed the set tidal volume. When using the Evita XL, the option AutoFlow can be turned ON or OFF, and when this option is ON, the tidal volume may vary. The PB 840 does not have any additional options that affect volume delivery, and it maintains the set tidal volume regardless of patient effort. The SERVO-i's demand valve allows additional flow if the patient's inspiratory flowrate exceeds the set flowrate, increasing the delivered tidal volume; this option can be turned OFF with the latest software upgrade. Modern ventilators have an increasing number of optional settings. These settings may

Treatment of symptomatic high-grade intracranial stenoses with the balloon-expandable Pharos stent: initial experience

International Nuclear Information System (INIS)

Kurre, W.; Berkefeld, J.; Mesnil de Rochemont, R. du; Sitzer, M.; Neumann-Haefelin, T.

2008-01-01

We report our first clinical experience with a CE-marked flexible monorail balloon-expandable stent for treatment of high-grade intracranial stenoses. Between April 2006 and November 2007 21 patients with symptomatic intracranial stenoses (>70%) were treated with the PHAROS stent. In seven patients, the procedure was performed during acute stroke intervention. Procedural success, clinical complication rates and mid-term follow-up data were prospectively recorded. During a median follow-up period of 7.3 months one additional patient died of an unknown cause 3 months after the intervention. A patient with a significant residual stenosis presented with a new stroke after further progression of the residual stenosis. None of the successfully treated patients experienced ipsilateral stroke. Recanalization of intracranial stenoses with the balloon-expandable Pharos stent is technically feasible. The periprocedural complication rate and mid-term follow-up results were in the range of previously reported case series. This pilot study was limited by the small sample size and severe morbidity of the included patients. Final evaluation of the efficacy of Pharos stent treatment demands further investigation. (orig.)

Relative nephroprotection during Escherichia coli O157:H7 infections: association with intravenous volume expansion.

Science.gov (United States)

Ake, Julie A; Jelacic, Srdjan; Ciol, Marcia A; Watkins, Sandra L; Murray, Karen F; Christie, Dennis L; Klein, Eileen J; Tarr, Phillip I

2005-06-01

The hemolytic uremic syndrome (HUS) consists of hemolytic anemia, thrombocytopenia, and renal failure. HUS is often precipitated by gastrointestinal infection with Shiga toxin-producing Escherichia coli and is characterized by a variety of prothrombotic host abnormalities. In much of the world, E coli O157:H7 is the major cause of HUS. HUS can be categorized as either oligoanuric (which probably signifies acute tubular necrosis) or nonoligoanuric. Children with oligoanuric renal failure during HUS generally require dialysis, have more complicated courses, and are probably at increased risk for chronic sequelae than are children who experience nonoligoanuric HUS. Oligoanuric HUS should be avoided, if possible. The presentation to medical care of a child with definite or possible E coli O157:H7 infections but before HUS ensues affords a potential opportunity to ameliorate the course of the subsequent renal failure. However, it is not known whether events that occur early in E coli O157:H7 infections, particularly measures to expand circulating volume, affect the likelihood of experiencing oligoanuric HUS if renal failure develops. We attempted to assess whether pre-HUS interventions and events, especially the volume and sodium content of intravenous fluids administered early in illness, affect the risk for developing oligoanuric HUS after E coli O157:H7 infections. We performed a prospective cohort study of 29 children with HUS that was confirmed microbiologically to be caused by E coli O157:H7. Infected children were enrolled when they presented with acute bloody diarrhea or as contacts of patients who were known to be infected with E coli O157:H7, or if they had culture-confirmed infection, or if they presented with HUS. HUS was defined as hemolytic anemia (hematocrit parenteral fluid administered, were recorded and entered into analysis. Estimates of odds ratios were adjusted for possible confounding effects using logistic regression analysis. Twenty-nine children

Automated detection of acute haemorrhagic stroke in non-contrasted CT images

International Nuclear Information System (INIS)

Meetz, K.; Buelow, T.

2007-01-01

An efficient treatment of stroke patients implies a profound differential diagnosis that includes the detection of acute haematoma. The proposed approach provides an automated detection of acute haematoma, assisting the non-stroke expert in interpreting non-contrasted CT images. It consists of two steps: First, haematoma candidates are detected applying multilevel region growing approach based on a typical grey value characteristic. Second, true haematomas are differentiated from partial volume artefacts, relying on spatial features derived from distance-based histograms. This approach achieves a specificity of 77% and a sensitivity of 89.7% in detecting acute haematoma in non-contrasted CT images when applied to a set of 25 non-contrasted CT images. (orig.)

Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents alveolar coagulation in patients without lung injury

NARCIS (Netherlands)

Choi, Goda; Wolthuis, Esther K.; Bresser, Paul; Levi, Marcel; van der Poll, Tom; Dzoljic, Misa; Vroom, Margreeth B.; Schultz, Marcus J.

2006-01-01

BACKGROUND: Alveolar fibrin deposition is a hallmark of acute lung injury, resulting from activation of coagulation and inhibition of fibrinolysis. Previous studies have shown that mechanical ventilation with high tidal volumes may aggravate lung injury in patients with sepsis and acute lung injury.

Reduced microvascular volume and hemispherically deficient vasoreactivity to hypercapnia in acute ischemia: MRI study using permanent middle cerebral artery occlusion rat model.

Science.gov (United States)

Suh, J Y; Shim, Woo H; Cho, Gyunggoo; Fan, Xiang; Kwon, Seon J; Kim, Jeong K; Dai, George; Wang, Xiaoying; Kim, Young R

2015-06-01

Vasoreactivity to hypercapnia has been used for assessing cerebrovascular tone and control altered by ischemic stroke. Despite the high prognostic potential, traits of hypercapnia-induced hemodynamic changes have not been fully characterized in relation with baseline vascular states and brain tissue damage. To monitor cerebrovascular responses, T2- and T2*-weighted magnetic resonance imaging (MRI) images were acquired alternatively using spin- and gradient-echo echo plannar imaging (GESE EPI) sequence with 5% CO2 gas inhalation in normal (n=5) and acute stroke rats (n=10). Dynamic relative changes in cerebrovascular volume (CBV), microvascular volume (MVV), and vascular size index (VSI) were assessed from regions of interest (ROIs) delineated by the percent decrease of apparent diffusion coefficient (ADC). The baseline CBV was not affected by middle cerebral artery occlusion (MCAO) whereas the baseline MVV in ischemic areas was significantly lower than that in the rest of the brain and correlated with ADC. Vasoreactivity to hypercapnic challenge was considerably attenuated in the entire ipsilesional hemisphere including normal ADC regions, in which unsolicited, spreading depression-associated increases of CBV and MVV were observed. The lesion-dependent inhomogeneity in baseline MVV indicates the effective perfusion reserve for accurately delineating the true ischemic damage while the cascade of neuronal depolarization is probably responsible for the hemispherically lateralized changes in overall neurovascular physiology.

Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

Energy Technology Data Exchange (ETDEWEB)

Park, Jong Woong; Jung, Gyoo Sik; Kim, Seong Min; Lee, Seung Ryong; Kim, Hyun Sook; Huh, Jin Do; Joh, Young Duk [Kosin Medical College, Pusan (Korea, Republic of)

1998-05-01

The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs.

Expandable metallic stents in the palliative treatment of malignant tracheobronchial stenosis

International Nuclear Information System (INIS)

Park, Jong Woong; Jung, Gyoo Sik; Kim, Seong Min; Lee, Seung Ryong; Kim, Hyun Sook; Huh, Jin Do; Joh, Young Duk

1998-01-01

The purpose of this study is to report the outcome of using expandable metallic stent in the management of malignant tracheobronchial stenosis with dyspnea. Under fluoroscopic and bronchoscopic guidance, seven patients with malignant airway stenosis were treated with ten expandable metallic stents. The cause of stenosis was metastasis from esophageal cancer in five patients, recurrent adenoid cystic carcinoma of the trachea in one, and primary lung cancer in one. The major sites of obstruction were the trachea in four patients, the left main bronchus in one, the trachea and left main bronchus in one, and the trachea and both bronchi in one. Chest radiography (n=7), bronchoscopy (n=5), pulmonary function test (PFT)(n=3), and spirometry(n=1) were performed before and after stent placement. In all seven patients, the stent was successfully placed at the lesion sites and dyspnea began to improve immediately. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After the procedure, chest radiography and bronchoscopy showed an increase in airway diameter. After stent placement, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) improved 53% and 56%, respectively. Peak flow velocity also changed from 46 L/min to 200 L/min. During median follow-up of 67 (41-1565) days, one stent migration occurred. In one patient, proximal tumor overgrowth occurred, and in one, tumor ingrowth was treated with balloon dilatation. For in the palliative treatment of malignant tracheobronchial stenosis with dyspnea, placement of expandable metal stents is safe and effective. (author). 21 refs., 1 tabs., 3 figs

78 FR 33785 - Receipt of Several Pesticide Petitions Filed for Residues of Pesticide Chemicals in or on Various...

Science.gov (United States)

2013-06-05

..., pads at 0.9 ppm; cattle/goat/hog/horse/sheep, fat at 0.5 ppm; cattle/goat/hog/horse/sheep, meat at 1 ppm; cattle/goat/hog/horse/ sheep, meat byproducts at 2 ppm; milk at 0.3 ppm; poultry, eggs at 0.3 ppm..., liver at 0.01 ppm; goat, meat at 0.01 ppm; goat, meat byproducts at 0.01 ppm; hog, fat at 0.01 ppm; hog...

The expanding universe: an introduction

OpenAIRE

Pössel, Markus

2017-01-01

An introduction to the physics and mathematics of the expanding universe, using no more than high-school level / undergraduate mathematics. Covered are the basics of scale factor expansion, the dynamics of the expanding universe, various distance concepts and the generalized redshift-luminosity relation, among other topics.

Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents pulmonary inflammation in patients without preexisting lung injury

NARCIS (Netherlands)

Wolthuis, Esther K.; Choi, Goda; Dessing, Mark C.; Bresser, Paul; Lutter, Rene; Dzoljic, Misa; van der Poll, Tom; Vroom, Margreeth B.; Hollmann, Markus; Schultz, Marcus J.

2008-01-01

Background: Mechanical ventilation with high tidal volumes aggravates lung injury in patients with acute lung injury or acute respiratory distress syndrome. The authors sought to determine the effects of short-term mechanical ventilation on local inflammatory responses in patients without

Multidisciplinary acute care research organization (MACRO): if you build it, they will come.

Science.gov (United States)

Early, Barbara J; Huang, David T; Callaway, Clifton W; Zenati, Mazen; Angus, Derek C; Gunn, Scott R; Yealy, Donald M; Unikel, Daniel; Billiar, Timothy R; Peitzman, Andrew B; Sperry, Jason L

2013-07-01

Clinical research will increasingly play a core role in the evolution and growth of acute care surgery program development across the country. What constitutes an efficient and effective clinical research infrastructure in the current fiscal and academic environment remains obscure. We sought to characterize the effects of implementation of a multidisciplinary acute care research organization (MACRO) at a busy tertiary referral university setting. In 2008, to minimize redundancy and cost as well as to maximize existing resources promoting acute care research, MACRO was created, unifying clinical research infrastructure among the Departments of Critical Care Medicine, Emergency Medicine, and Surgery. During the periods 2008 to 2012, we performed a retrospective analysis and determined volume of clinical studies, patient enrollment for both observational and interventional trials, and staff growth since MACRO's origination and characterized changes over time. From 2008 to 2011, the volume of patients enrolled in clinical studies, which MACRO facilitates has significantly increased more than 300%. The percentage of interventional/observational trials has remained stable during the same period (50-60%). Staff has increased from 6 coordinators to 10, with an additional 15 research associates allowing 24/7 service. With this significant growth, MACRO has become financially self-sufficient, and additional outside departments now seek MACRO's services. Appropriate organization of acute care clinical research infrastructure minimizes redundancy and can promote sustainable, efficient growth in the current academic environment. Further studies are required to determine if similar models can be successful at other acute care surgery programs.

DYNAMICS OF HOSPITALIZATION OF PATIENTS WITH ACUTE SURGICAL PATHOLOGY OF ABDOMINAL AND ABDOMINAL ORGANS IN KUZBASS

Directory of Open Access Journals (Sweden)

Валерий Иванович Подолужный

2018-03-01

Full Text Available Publications of recent years do not reflect the regional dynamics of hospitalization of patients with acute surgical pathology of the abdominal cavity and anterior abdominal wall. Goal – to determine the volume of hospitalizations and treatment of patients with acute surgical pathology of the abdominal and anterior abdominal wall in the Kuzbass in the dynamics from 1993 to 2016. Materials and methods. A comparative analysis of the volume of treatment of patients with acute appendicitis, acute cholecystitis, acute pancreatitis, intestinal obstruction, perforated ulcer of the stomach and duodenum and strangulated hernia in surgical departments of Kuzbass from 1993 to 2016 to understand the changes occurring in abdominal surgery. Estimated in the comparative aspect for two decades (1993-2002 and 2007-2016 the average annual number of treated. The estimation of indicators in calculation on 100000 population is executed. The statistical processing was carried out using IBM SPSS Statistica computer version 24 and the nonparametric Mann-Whitney test. Result. Statistically significantly decreased the number of patients with acute appendicitis and perforated ulcers of the stomach and duodenum. The average annual hospitalization of patients with acute pancreatitis and strangulated abdominal hernias has significantly increased in the last decade. There are no significant differences in the increase in the total number of patients with acute cholecystitis and acute intestinal obstruction. Conclusions: 1. Over the past decade compared with 1993-2002, the incidence of acute appendicitis per 100000 thousand of the population decreased in the region by 39.9 %, the incidence of perforated gastric ulcer and duodenal ulcer by 30.2 %. 2. At this time, the number of people treated with 100000 people with acute pancreatitis increased by 94.7 %; with acute cholecystitis by 12.4 %; with an acute intestinal obstruction by 9.8 % and with a strangulated

Occurrence of Staphylococcus aureus in swine and swine workplace environments on industrial and antibiotic-free hog operations in North Carolina, USA: A One Health pilot study.

Science.gov (United States)

Davis, Meghan F; Pisanic, Nora; Rhodes, Sarah M; Brown, Alexis; Keller, Haley; Nadimpalli, Maya; Christ, Andrea; Ludwig, Shanna; Ordak, Carly; Spicer, Kristoffer; Love, David C; Larsen, Jesper; Wright, Asher; Blacklin, Sarah; Flowers, Billy; Stewart, Jill; Sexton, Kenneth G; Rule, Ana M; Heaney, Christopher D

2018-05-01

Occupational exposure to swine has been associated with increased Staphylococcus aureus carriage, including antimicrobial-resistant strains, and increased risk of infections. To characterize animal and environmental routes of worker exposure, we optimized methods to identify S. aureus on operations that raise swine in confinement with antibiotics (industrial hog operation: IHO) versus on pasture without antibiotics (antibiotic-free hog operation: AFHO). We associated findings from tested swine and environmental samples with those from personal inhalable air samplers on worker surrogates at one IHO and three AFHOs in North Carolina using a new One Health approach. We determined swine S. aureus carriage status by collecting swab samples from multiple anatomical sites, and we determined environmental positivity for airborne bioaerosols with inhalable and impinger samplers and a single-stage impactor (ambient air) cross-sectionally. All samples were analyzed for S. aureus, and isolates were tested for antimicrobial susceptibility, absence of scn (livestock marker), and spa type. Seventeen of twenty (85%) swine sampled at the one IHO carried S. aureus at >1 anatomical sites compared to none of 30 (0%) swine sampled at the three AFHOs. All S. aureus isolates recovered from IHO swine and air samples were scn negative and spa type t337; almost all isolates (62/63) were multidrug resistant. S. aureus was recovered from eight of 14 (67%) ambient air and two (100%) worker surrogate personal air samples at the one IHO, whereas no S. aureus isolates were recovered from 19 ambient and six personal air samples at the three AFHOs. Personal worker surrogate inhalable sample findings were consistent with both swine and ambient air data, indicating the potential for workplace exposure. IHO swine and the one IHO environment could be a source of potential pathogen exposure to workers, as supported by the detection of multidrug-resistant S. aureus (MDRSA) with livestock-associated spa

Is pulmonary resistance constant, within the range of tidal volume ventilation, in patients with ARDS?

Science.gov (United States)

Mols, G; Kessler, V; Benzing, A; Lichtwarck-Aschoff, M; Geiger, K; Guttmann, J

2001-02-01

When managing patients with acute respiratory distress syndrome (ARDS), respiratory system compliance is usually considered first and changes in resistance, although recognized, are neglected. Resistance can change considerably between minimum and maximum lung volume, but is generally assumed to be constant in the tidal volume range (V(T)). We measured resistance during tidal ventilation in 16 patients with ARDS or acute lung injury by the slice method and multiple linear regression analysis. Resistance was constant within V(T) in only six of 16 patients. In the remaining patients, resistance decreased, increased or showed complex changes. We conclude that resistance within V(T) varies considerably from patient to patient and that constant resistance within V(T) is not always likely.

Acute stroke: automatic perfusion lesion outlining using level sets.

Science.gov (United States)

Mouridsen, Kim; Nagenthiraja, Kartheeban; Jónsdóttir, Kristjana Ýr; Ribe, Lars R; Neumann, Anders B; Hjort, Niels; Østergaard, Leif

2013-11-01

To develop a user-independent algorithm for the delineation of hypoperfused tissue on perfusion-weighted images and evaluate its performance relative to a standard threshold method in simulated data, as well as in acute stroke patients. The study was approved by the local ethics committee, and patients gave written informed consent prior to their inclusion in the study. The algorithm identifies hypoperfused tissue in mean transit time maps by simultaneously minimizing the mean square error between individual and mean perfusion values inside and outside a smooth boundary. In 14 acute stroke patients, volumetric agreement between automated outlines and manual outlines determined in consensus among four neuroradiologists was assessed with Bland-Altman analysis, while spatial agreement was quantified by using lesion overlap relative to mean lesion volume (Dice coefficient). Performance improvement relative to a standard threshold approach was tested with the Wilcoxon signed rank test. The mean difference in lesion volume between automated outlines and manual outlines was -9.0 mL ± 44.5 (standard deviation). The lowest mean volume difference for the threshold approach was -25.8 mL ± 88.2. A significantly higher Dice coefficient was observed with the algorithm (0.71; interquartile range [IQR], 0.42-0.75) compared with the threshold approach (0.50; IQR, 0.27- 0.57; P , .001). The corresponding agreement among experts was 0.79 (IQR, 0.69-0.83). The perfusion lesions outlined by the automated algorithm agreed well with those defined manually in consensus by four experts and were superior to those obtained by using the standard threshold approach. This user-independent algorithm may improve the assessment of perfusion images as part of acute stroke treatment. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13121622/-/DC1. RSNA, 2013

Cerebral collateral therapeutics in acute ischemic stroke: A randomized preclinical trial of four modulation strategies.

Science.gov (United States)

Beretta, Simone; Versace, Alessandro; Carone, Davide; Riva, Matteo; Dell'Era, Valentina; Cuccione, Elisa; Cai, Ruiyao; Monza, Laura; Pirovano, Silvia; Padovano, Giada; Stiro, Fabio; Presotto, Luca; Paternò, Giovanni; Rossi, Emanuela; Giussani, Carlo; Sganzerla, Erik P; Ferrarese, Carlo

2017-10-01

Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat stroke model of transient middle cerebral artery (MCA) occlusion. A composed randomization design was used to assign rats (n = 118) to receive phenylephrine (induced hypertension), polygeline (intravascular volume load), acetazolamide (cerebral arteriolar vasodilation), head down tilt (HDT) 15° (cerebral blood flow diversion), or no treatment, starting 30 min after MCA occlusion. Compared to untreated animals, treatment with collateral therapeutics was associated with lower infarct volumes (62% relative mean difference; 51.57 mm 3 absolute mean difference; p Collateral therapeutics acutely increased cerebral perfusion in the medial (+40.8%; p collaterals is feasible and provides a tissue-saving effect in the hyperacute phase of ischemic stroke prior to recanalization therapy.

77 FR 27164 - Butylate, Clethodim, Dichlorvos, Dicofol, Isopropyl Carbanilate, et al.; Proposed Tolerance Actions

Science.gov (United States)

2012-05-09

... byproducts, except liver; egg; goat, fat; goat, liver; goat, meat; goat, meat byproducts, except liver; hog...; beet, sugar, roots; beet, sugar, tops; egg; cattle, fat; cattle, meat; cattle, meat byproducts; goat, fat; goat, meat; goat, meat byproducts; hog, fat; hog, meat; hog, meat byproducts; horse, fat; horse...

Prediction of acute cardiac rejection using radionuclide techniques

International Nuclear Information System (INIS)

Novitzky, D.; Bonioszczuk, J.; Cooper, D.K.C.; Isaacs, S.; Rose, A.G.; Smith, J.A.; Uys, C.J.; Barnard, C.N.; Fraser, R.

1984-01-01

Radionuclide scanning of the donor left ventricle using technetium-99m-labelled red cells was used to monitor acute rejection after heterotopic heart transplantation and compared with histopathological evidence of rejection obtained at examination of an endomyocardial biopsy specimen. The ejection fraction and end-diastolic, end-systolic and stroke volumes were calculated at each examination; an equation was derived from these data to predict the degree of acute rejection, using histopathological examination of endomyocardial biopsy specimens as criteria of the presence and severity of rejection. A highly significant multiple correlation between radionuclide scanning parameters and endomyocardial biopsy was found. The advantages of non-invasive radionuclide scanning over the invasive procedure of endomyocardial biopsy are discussed

A Rapidly Expanding Bose-Einstein Condensate: An Expanding Universe in the Lab

Science.gov (United States)

Eckel, S.; Kumar, A.; Jacobson, T.; Spielman, I. B.; Campbell, G. K.

2018-04-01

We study the dynamics of a supersonically expanding, ring-shaped Bose-Einstein condensate both experimentally and theoretically. The expansion redshifts long-wavelength excitations, as in an expanding universe. After expansion, energy in the radial mode leads to the production of bulk topological excitations—solitons and vortices—driving the production of a large number of azimuthal phonons and, at late times, causing stochastic persistent currents. These complex nonlinear dynamics, fueled by the energy stored coherently in one mode, are reminiscent of a type of "preheating" that may have taken place at the end of inflation.

Acute effects of whole body gamma irradiation on exocrine pancreatic secretion in the pig

International Nuclear Information System (INIS)

Monti, P.; Scanff, P.; Joubert, C.; Vergnet, M.; Grison, S.; Griffiths, N.

2004-01-01

Reports on radiation damage to the pancreas deal essentially with long-term morphological changes with few data on pancreatic exocrine function. The aim of this work was to study the acute effects of whole body irradiation on volume and enzyme activities in the pancreatic juice. A whole body gamma irradiation (6 Gy) was investigated in pigs with continuous sampling of pancreatic juice before and after exposure via an indwelling catheter in the pancreatic duct. For each sample collected, total protein concentration and enzyme activities of trypsin, chymotrypsin, elastase, lipase and amylase were determined. Pancreatic juice volume was monitored during all periods of collection. The volume of pancreatic juice secreted daily decreased one day after irradiation and remained lower than the control values over the experimental period. Total proteins secreted in the pancreatic juice and total activities of pancreatic enzymes were reduced similarly. On the other hand, only specific activities of elastase and lipase were affected by irradiation. Whole body gamma irradiation resulted in a rapid and marked decrease of exocrine pancreatic secretion, in terms of volume as well as secreted enzymes. This may contribute in part to the intestinal manifestations of the acute and/or late radiation syndrome. (author)

Low Tidal Volume Reduces Lung Inflammation Induced by Liquid Ventilation in Piglets With Severe Lung Injury.

Science.gov (United States)

Jiang, Lijun; Feng, Huizhen; Chen, Xiaofan; Liang, Kaifeng; Ni, Chengyao

2017-05-01

Total liquid ventilation (TLV) is an alternative treatment for severe lung injury. High tidal volume is usually required for TLV to maintain adequate CO 2 clearance. However, high tidal volume may cause alveolar barotrauma. We aim to investigate the effect of low tidal volume on pulmonary inflammation in piglets with lung injury and under TLV. After the establishment of acute lung injury model by infusing lipopolysaccharide, 12 piglets were randomly divided into two groups, TLV with high tidal volume (25 mL/kg) or with low tidal volume (6 mL/kg) for 240 min, respectively. Extracorporeal CO 2 removal was applied in low tidal volume group to improve CO 2 clearance and in high tidal volume group as sham control. Gas exchange and hemodynamic status were monitored every 30 min during TLV. At the end of the study, pulmonary mRNA expression and plasmatic concentration of interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured by collecting lung tissue and blood samples from piglets. Arterial blood pressure, PaO 2 , and PaCO 2 showed no remarkable difference between groups during the observation period. Compared with high tidal volume strategy, low tidal volume resulted in 76% reduction of minute volume and over 80% reduction in peak inspiratory pressure during TLV. In addition, low tidal volume significantly diminished pulmonary mRNA expression and plasmatic level of IL-6 and IL-8. We conclude that during TLV, low tidal volume reduces lung inflammation in piglets with acute lung injury without compromising gas exchange. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.

Science.gov (United States)

Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D

2015-01-01

Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Alternative fuels for vehicles fleet demonstration program. Final report, volume 2: Appendices

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-06-01

The Alternative Fuels for Vehicles Fleet Demonstration Program (AFV-FDP) was a multiyear effort to collect technical data for use in determining the costs and benefits of alternative-fuel vehicles (AFVs) in typical applications in New York State. This report, Volume 2, includes 13 appendices to Volume 1 that expand upon issues raised therein. Volume 1 provides: (1) Information about the purpose and scope of the AFV-FDP; (2) A summary of AFV-FDP findings organized on the basis of vehicle type and fuel type; (3) A short review of the status of AFV technology development, including examples of companies in the State that are active in developing AFVs and AFV components; and (4) A brief overview of the status of AFV deployment in the State. Volume 3 provides expanded reporting of AFV-FDP technical details, including the complete texts of the brochure Garage Guidelines for Alternative Fuels and the technical report Fleet Experience Survey Report, plus an extensive glossary of AFV terminology. The appendices cover a wide range of issues including: emissions regulations in New York State; production and health effects of ozone; vehicle emissions and control systems; emissions from heavy-duty engines; reformulated gasoline; greenhouse gases; production and characteristics of alternative fuels; the Energy Policy Act of 1992; the Clean Fuel Fleet Program; garage design guidelines for alternative fuels; surveys of fleet managers using alternative fuels; taxes on conventional and alternative fuels; and zero-emission vehicle technology.

Decreased right heart blood volume determined by magnetic resonance imaging: evidence of central underfilling in cirrhosis

DEFF Research Database (Denmark)

Møller, S; Søndergaard, L; Møgelvang, J

1995-01-01

mL, NS), and left atrial volume (70 vs. 57 mL, P = .08) were normal or slightly increased. The right ejection fraction (68% vs. 53%, P fraction was slightly reduced (61% vs. 69%, NS). The central and arterial blood volume (CBV), assessed......Whether the central blood volume is reduced or expanded in cirrhosis is still under debate. Accordingly, the current study was undertaken to assess the volume of the heart cavities. Ten cirrhotic patients and matched controls had their right and left ventricular end-diastolic volumes (RVDV and LVDV...... as the cardiac output (CO) multiplied by the central circulation time, was significantly decreased (1.47 vs. 1.81 L, P blood volume (4.43 vs. 3.64 L, P

Comparison of acute and chronic traumatic brain injury using semi-automatic multimodal segmentation of MR volumes.

Science.gov (United States)

Irimia, Andrei; Chambers, Micah C; Alger, Jeffry R; Filippou, Maria; Prastawa, Marcel W; Wang, Bo; Hovda, David A; Gerig, Guido; Toga, Arthur W; Kikinis, Ron; Vespa, Paul M; Van Horn, John D

2011-11-01

Although neuroimaging is essential for prompt and proper management of traumatic brain injury (TBI), there is a regrettable and acute lack of robust methods for the visualization and assessment of TBI pathophysiology, especially for of the purpose of improving clinical outcome metrics. Until now, the application of automatic segmentation algorithms to TBI in a clinical setting has remained an elusive goal because existing methods have, for the most part, been insufficiently robust to faithfully capture TBI-related changes in brain anatomy. This article introduces and illustrates the combined use of multimodal TBI segmentation and time point comparison using 3D Slicer, a widely-used software environment whose TBI data processing solutions are openly available. For three representative TBI cases, semi-automatic tissue classification and 3D model generation are performed to perform intra-patient time point comparison of TBI using multimodal volumetrics and clinical atrophy measures. Identification and quantitative assessment of extra- and intra-cortical bleeding, lesions, edema, and diffuse axonal injury are demonstrated. The proposed tools allow cross-correlation of multimodal metrics from structural imaging (e.g., structural volume, atrophy measurements) with clinical outcome variables and other potential factors predictive of recovery. In addition, the workflows described are suitable for TBI clinical practice and patient monitoring, particularly for assessing damage extent and for the measurement of neuroanatomical change over time. With knowledge of general location, extent, and degree of change, such metrics can be associated with clinical measures and subsequently used to suggest viable treatment options.

The relationship between mean platelet volume and coronary collateral vessels in patients with acute coronary syndromes

Directory of Open Access Journals (Sweden)

Gaurav Singhal

2016-01-01

Full Text Available Background: Elevated mean platelet volume (MPV has been proposed as a risk factor for coronary artery disease (CAD and is associated with poor clinical outcome in acute coronary syndrome (ACS. However, some studies have contradictory findings. Hence, we aimed to evaluate the association of MPV with the presence of coronary collateral vessel (CCV in patients with ACS. Objective: To find MPV value in ACS patients and to find the predictive value of MPV in the spectrum of CAD and to examine whether levels of MPV predict the presence of CCVs. Methods: A total of 180 patients with first ACS were included in the study. MPV was measured. All patients underwent coronary angiography to know disease severity and CCVs. The CCVs are graded according to the Rentrop scoring system and according to coronary angiography results; patients were divided into two groups as Group 1 (poor CCV and Group 2 (good CCV. Results: The MPV was 10.74 ± 2 fl in poor collateral group patients and 11.01 ± 1.7 fl in good collateral group (P = 0.421. The presence of CCV was not significantly associated with high levels of MPV. MPV value did not show any prediction of the spectrum of CAD. Conclusion: MPV on admission was not associated with the development of CCV positively in patients with ACS. Furthermore, it is not associated with a number of vessel involvements.

Expanding ART for Treatment and Prevention of HIV in South Africa: Estimated Cost and Cost-Effectiveness 2011-2050

Science.gov (United States)

Granich, Reuben; Kahn, James G.; Bennett, Rod; Holmes, Charles B.; Garg, Navneet; Serenata, Celicia; Sabin, Miriam Lewis; Makhlouf-Obermeyer, Carla; De Filippo Mack, Christina; Williams, Phoebe; Jones, Louisa; Smyth, Caoimhe; Kutch, Kerry A.; Ying-Ru, Lo; Vitoria, Marco; Souteyrand, Yves; Crowley, Siobhan; Korenromp, Eline L.; Williams, Brian G.

2012-01-01

Background Antiretroviral Treatment (ART) significantly reduces HIV transmission. We conducted a cost-effectiveness analysis of the impact of expanded ART in South Africa. Methods We model a best case scenario of 90% annual HIV testing coverage in adults 15–49 years old and four ART eligibility scenarios: CD4 count ART costs reflect South African data and international generic prices. ART reduces transmission by 92%. We conducted sensitivity analyses. Results Expanding ART to CD4 count ART and monitoring costs, all CD4 levels saves $0.6 billion versus current; other ART scenarios cost $9–194 per DALY averted. If ART reduces transmission by 99%, savings from all CD4 levels reach $17.5 billion. Sensitivity analyses suggest that poor retention and predominant acute phase transmission reduce DALYs averted by 26% and savings by 7%. Conclusion Increasing the provision of ART to ART uptake, retention, and adherence should be evaluated. PMID:22348000

The Chronic and Acute Effects of Exercise Upon Selected Blood Measures.

Science.gov (United States)

Roitman, J. L.; Brewer, J. P.

This study investigated the effects of chronic and acute exercise upon selected blood measures and indices. Nine male cross-country runners were studied. Red blood count, hemoglobin, and hematocrit were measured using standard laboratory techniques; mean corpuscular volume (MCV), mean corpuscular hemoglobin, and mean corpuscular hemoglobin…

Response of cardiac endothelial nitric oxide synthase to plasma viscosity modulation in acute isovolemic hemodilution

Directory of Open Access Journals (Sweden)

Kanyanatt Kanokwiroon

2014-01-01

Full Text Available Background: Endothelial nitric oxide synthase (eNOS is generally expressed in endocardial cells, vascular endothelial cells and ventricular myocytes. However, there is no experimental study elucidating the relationship between cardiac eNOS expression and elevated plasma viscosity in low oxygen delivery pathological conditions such as hemorrhagic shock-resuscitation and hemodilution. This study tested the hypothesis that elevated plasma viscosity increases cardiac eNOS expression in a hemodilution model, leading to positive effects on cardiac performance. Materials and Methods: Two groups of golden Syrian hamster underwent an acute isovolemic hemodilution where 40% of blood volume was exchanged with 2% (low-viscogenic plasma expander [LVPE] or 6% (high-viscogenic plasma expander [HVPE] of dextran 2000 kDa. In control group, experiment was performed without hemodilution. All groups were performed in awake condition. Experimental parameters, i.e., mean arterial blood pressure (MAP, heart rate, hematocrit, blood gas content and viscosity, were measured. The eNOS expression was evaluated by eNOS Western blot analysis. Results: After hemodilution, MAP decreased to 72% and 93% of baseline in the LVPE and HVPE, respectively. Furthermore, pO 2 in the LVPE group increased highest among the groups. Plasma viscosity in the HVPE group was significantly higher than that in control and LVPE groups. The expression of eNOS in the HVPE group showed higher intensity compared to other groups, especially compared with the control group. Conclusion: Our results demonstrated that cardiac eNOS has responded to plasma viscosity modulation with HVPE and LVPE. This particularly supports the previous studies that revealed the positive effects on cardiac function in animals hemodiluted with HVPE.

Key performance indicators in an acute surgical unit: have we made an impact?

Science.gov (United States)

Hsee, Li; Devaud, Marcelo; Civil, Ian

2012-10-01

Timely access to acute surgery is a worldwide issue and New Zealand is similarly affected. Auckland City Hospital is one of the largest metropolitan public hospitals in New Zealand where more than 60 % of surgical admissions fit into the acute category. In January 2009, an Acute Surgical Unit (ASU) was set up to improve acute surgical flow. Key performance indicators (KPIs) were identified as valuable tools in evaluating ASU service performance. Our goals were to describe the current acute patient pathway, present the early trend of KPIs for the ASU and determine whether an impact has been made on acute surgical patients. A retrospective review of patients admitted with acute general surgical conditions from January 2008 (pre-ASU) to October 2010 was performed. Patient data were identified through hospital electronic records. KPIs assessed included: (1) time to assess referred patients from the emergency department (ED) and from GPs [where patient assessment occurs in the assessment and planning unit (APU)]; (2) preoperative length of stay (LOS[PO]); (3) length of stay of nonadmitted patients (LOS[NA]); (4) case volume "in h" (0730-1730) versus "after h"; and (5) readmission rate. Statistical analysis was performed with one-way ANOVA, regression, and χ(2) tests. Results show a reduction of mean time from referral to assessment from 2.28 to 1.6 h in the ED (p ≤ 0.001). Patients are seen in APU after GP referral sooner as well as the time from referral to assessment reducing from 2 to 1.76 h (p < 0.001). The LOS[PO] has not changed significantly overall (34.58 vs. 34.88 h, p = not significant [NS]). However, there are encouraging signs in high-volume procedures, such as appendicectomy. The mean LOS[PO] for appendicectomy was 7.81 h but is now 6.53 h (p ≤ 0.005). The LOS[NA] has decreased from 15.23 to 9.48 h (p < 0.005). Since the development of the ASU, the number of cases operated on "in hours" is increasing with a corresponding decrease in "after hours

A Rapidly Expanding Bose-Einstein Condensate: An Expanding Universe in the Lab

Directory of Open Access Journals (Sweden)

S. Eckel

2018-04-01

Full Text Available We study the dynamics of a supersonically expanding, ring-shaped Bose-Einstein condensate both experimentally and theoretically. The expansion redshifts long-wavelength excitations, as in an expanding universe. After expansion, energy in the radial mode leads to the production of bulk topological excitations—solitons and vortices—driving the production of a large number of azimuthal phonons and, at late times, causing stochastic persistent currents. These complex nonlinear dynamics, fueled by the energy stored coherently in one mode, are reminiscent of a type of “preheating” that may have taken place at the end of inflation.

Personalizing mechanical ventilation for acute respiratory distress syndrome

OpenAIRE

Berngard, S. Clark; Beitler, Jeremy R.; Malhotra, Atul

2016-01-01

Lung-protective ventilation with low tidal volumes remains the cornerstone for treating patient with acute respiratory distress syndrome (ARDS). Personalizing such an approach to each patient's unique physiology may improve outcomes further. Many factors should be considered when mechanically ventilating a critically ill patient with ARDS. Estimations of transpulmonary pressures as well as individual's hemodynamics and respiratory mechanics should influence PEEP decisions as well as response ...

Plasma volume changes during hypoglycaemia: the effect of arterial blood sampling

DEFF Research Database (Denmark)

Hilsted, J; Bendtsen, Flemming; Christensen, N J

1990-01-01

To investigate whether previously reported changes in venous blood volume and composition induced by acute hypoglycaemia in humans are representative for the entire body we measured erythrocyte 51Cr content, haematocrit, plasma volume, intravascular albumin content and transcapillary escape rate...... hypoglycaemia. The magnitude of the changes in arterial and venous blood were not significantly different. These results indicate that the above changes in blood volume and composition are whole-body phenomena: furthermore, the major part of the changes are likely to occur in tissues other than upper extremity...... of albumin in arterial and venous blood in seven healthy subjects before and during insulin-induced hypoglycaemia. In both vascular sites blood 51Cr content and the haematocrit increased, plasma volume and intravascular albumin content decreased and the transcapillary escape rate of albumin increased during...

Acute Liver Allograft Antibody-Mediated Rejection: an inter-institutional study of routine histopathological features

OpenAIRE

O'Leary, Jacqueline G.; Shiller, S. Michelle; Bellamy, Christopher; Nalesnik, Michael A.; Kaneku, Hugo; Terasaki, Paul I.; Klintmalm, Göran B.; Demetris, Anthony J.

2014-01-01

Acute antibody-mediated rejection (AMR) occurs in a minority of sensitized liver transplant recipients. Although histopathologic characteristics have been described, a generalizable scoring system used to trigger a more in-depth analysis is needed to screen for this rare but important finding. Toward this goal, we created a training and validation cohort from 3 high volume liver transplant programs of putative acute AMR and control cases that were evaluated blindly by 4 independent transplant...

A low temperature anaerobic digestion system reduces instability and produces optimal methane yield : case study of a Farrow to Finish farm marketing 10,000 hogs per year in Quebec

Energy Technology Data Exchange (ETDEWEB)

Villeneuve, E.; Boivin, S.; Hince, J.-F. [Bio-Terre Systems, Sherbrooke, PQ (Canada); Masse, D. [Agriculture and Agri-Food Canada, Ottawa, ON (Canada)

2008-07-01

This presentation described a joint collaboration between Agriculture and Agri-Food Canada (AAFC) and Bio-Terre Systems that resulted in the development of an innovative environmental solution for manure management. The solution which combines low-temperature anaerobic digestion, concentration of solids and production of green energy, responds to the growth of hog production in North America. A case study of a Farrow to Finish farm marketing 10,000 swine in St.-Hilaire, Quebec was presented with particular reference to background information on the farm, process stability and process performance. The Bio-Terre technology was discussed in detail including a discussion of the psychrophilic anaerobic digestion and microorganisms and sequencing batch reactor (SBR) process. The advantages and disadvantages of this process were presented. It was concluded that the process offers many benefits, including energy economy, improved health of animals, odorless spreading, better fertilizer, and reduction of land required. tabs., figs.

99MTc - DMSA renal scintigraphy in the diagnosis and follow-up of acute pyelonephritis in children

International Nuclear Information System (INIS)

Wallin, L.

1997-06-01

The aim of the present thesis was to define and evaluate a strategy for identification of children who are at risk of developing progressive renal lesions after acute pyelonephritis. Qualitative and quantitative evaluation standards were elaborated to improve the interpretation of DMSA scintigraphy. The normal DMSA distribution pattern, the average background uptake, and scintigraphic kidney length according to age were assessed in 95 presumably healthy kidneys. Furthermore, typical DMSA distribution patterns in acute pyelonephritis were assessed on 65 kidneys in 38 children, and typical DMSA distribution patterns of 152 kidneys with VUR in 101 children with and without previous pyelonephritis. Measurement of scintigraphic kidney length, width and volume was validated in piglets and on a kidney phantom. The scintigraphic kidney length was found to be an accurate measure of renal size, whereas kidney width and volume were less reliable, at least on small kidneys. Criteria of kidney swelling in acute pyelonephritis were defined, and found to be beneficial for identifying reinfections in the absence of clinical symptoms. In 34 children with acute pyelonephritis quantitative and qualitative DMSA scintigraphic findings were correlated to clinical symptoms and laboratory data, in the acute stage and at follow up. We found that quantitative DMSA scintigraphy in the acute stage of pyelonephritis and again after one year will identify children who are at risk of developing progressive renal lesions. Qualitative assessment of DMSA distribution pattern is not reliable enough in this respect. 116 refs., 7 figs

Acute kidney injury in pediatric patients: diagnosis and management in the emergency department [digest].

Science.gov (United States)

Mohrer, Daniel; Langhan, Melissa; Chaudhari, Pradip

2017-05-22

Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children. The management of pediatric acute kidney injury focuses on identifying patients at high risk, monitoring intravascular volume status, avoiding nephrotoxic medication exposure, and involving a pediatric nephrologist once acute kidney injury is diagnosed. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

Four evolving strategies in the emergent treatment of acute ischemic stroke.

Science.gov (United States)

Thurman, R Jason; Jauch, Edward C; Panagos, Peter D; Reynolds, Matthew R; Mocco, J

2012-07-01

Stroke is the leading cause of long-term disability in the United States and is the fourth leading cause of death, affecting nearly 800,000 patients each year. The physical, emotional, and financial toll stroke inflicts on patients and their families cannot be overstated. At the forefront of acute stroke care, emergency clinicians are positioned to have a major impact on the quality of care that stroke patients receive. This issue outlines and reviews the literature on 4 evolving strategies reflecting developing advancements in the care of acute ischemic stroke and their potential to impact patients in the emergency department setting: (1) the expanding window for intravenous rt-PA, (2) the use of multimodal computed tomographic scanning in emergent diagnostic imaging, (3) endovascular therapies for stroke, and (4) stroke systems of care. Whether practicing in a tertiary care environment or in a remote emergency department, emergency clinicians will benefit from familiarizing themselves with these advancements and should consider how these new approaches might influence their management of patients with acute ischemic stroke.

Treatment of severe acute pancreatitis

Directory of Open Access Journals (Sweden)

Praznik Ivan

2014-01-01

Full Text Available Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or other organ systems. The severe form of the disease occurs in 10-20% of cases, and usually requires prolonged hospitalization due to a frequent local and systemic complications. Additionally, considerable mortality despite diagnostic and therapeutic advances, makes this disease a serious health problem nowadays. The aim of this study was to conduct a review of randomized controlled trials to determine differences in the efficiency between standard methods of treatment for severe acute pancreatitis and new treatment ways in terms of decreased mortality. Search of the 'Medline' database of original scientific papers and systematic review articles was made, using a combination of the following keywords: acute pancreatitis, treatment, mortality. In total 914 papers were found, published in the last 13 years; 14 of 64 randomized controlled clinical trials met the selection criteria and were eligible for inclusion. From a total of 16 papers, the conservative treatment was related to 11, which includes some of the new treatment methods, while the effects of new methods of treatment have been the subject of research in the four studies. Combined endoscopic and surgical treatment was applied in only one study. The largest sample of 290 patients was included in the study with platelet activation factor antagonist, while the smallest sample of 22 patients was used in the study that compared total parenteral with enteral nutrition. Continuous regional arterial infusion of protease inhibitors in combination with antibiotics, intravenous supplementation of alanyl-glutamine dipeptide and the early, high-volume continuous veno-venous hemofiltration showed the best results in the treatment of patients with severe acute pancreatitis. Also, the use of low molecular weight heparin and enteral nutrition significantly reduced mortality.

Assessment of suitability of selected rice varieties for production of expanded rice

Directory of Open Access Journals (Sweden)

Vijayalaxmi Kamaraddi

2015-12-01

Full Text Available Expanded rice, prepared from pre-gelatinized milled rice by sand roasting method, is a popular snack food of India. Five high-yielding rice varieties of Hill zone of Karnataka state, viz., IET-13901, KHP-2, KHP-5, KHP-10, and Intan were screened for puffing quality based on their physicochemical, functional, nutritional and organoleptic parameters with Rajamudi as local check. The effect of varietal differences on expansion/puffing quality parameters, in vitro digestibility of starch and protein as well as bioaccessibility of iron, zinc, and calcium were determined. Results indicated a strong positive correlation between amylose content and expansion ratio and a negative correlation between protein and amylose content, length expansion ratio and volume expansion ratio. Expansion characteristics showed that the varieties suitable for production of puffed rice were KHP-2, IET-13901 and Intan. Nutritional analysis showed following ranges of nutrient content in expanded rice: protein, 6.22–8.17%; fat, 0.06–0.14%; and as mg/100 g calcium, 20.5–23.5; iron, 2.01–2.72; zinc, 1.22–1.82; thiamine, 0.315–0.470; riboflavin, 0.051–0.069; and niacin, 3.18–4.68. Nearly 80.3–80.8% starch and 67.6–83.2% protein was digestible. Among all varieties, KHP-2 had lowest amount of rapidly digestible starch (61.4%. Mineral bioaccessibility ranged from 42.7 to 52.1%. Sensory analysis indicated that Intan and KHP-2 were superior and suited for production of expanded rice.

Variability in Usual Care Mechanical Ventilation for Pediatric Acute Respiratory Distress Syndrome: Time for a Decision Support Protocol?

Science.gov (United States)

Newth, Christopher J L; Sward, Katherine A; Khemani, Robinder G; Page, Kent; Meert, Kathleen L; Carcillo, Joseph A; Shanley, Thomas P; Moler, Frank W; Pollack, Murray M; Dalton, Heidi J; Wessel, David L; Berger, John T; Berg, Robert A; Harrison, Rick E; Holubkov, Richard; Doctor, Allan; Dean, J Michael; Jenkins, Tammara L; Nicholson, Carol E

2017-11-01

Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol. Prospective observational study. Eight tertiary care U.S. PICUs, October 2011 to April 2012. One hundred twenty patients (age range 17 d to 18 yr) with acute lung injury/acute respiratory distress syndrome. Two thousand hundred arterial and capillary blood gases, 3,964 oxygen saturation by pulse oximetry, and 2,757 end-tidal CO2 values were associated with 3,983 ventilator settings. Ventilation mode at study onset was pressure control 60%, volume control 19%, pressure-regulated volume control 18%, and high-frequency oscillatory ventilation 3%. Clinicians changed FIO2 by ±5 or ±10% increments every 8 hours. Positive end-expiratory pressure was limited at ~10 cm H2O as oxygenation worsened, lower than would have been recommended by the protocol. In the first 72 hours of mechanical ventilation, maximum tidal volume/kg using predicted versus actual body weight was 10.3 (8.5-12.9) (median [interquartile range]) versus 9.2 mL/kg (7.6-12.0) (p Ventilator management varies substantially in children with acute respiratory distress syndrome. Opportunities exist to minimize variability and potentially injurious ventilator settings by using a pediatric mechanical ventilation protocol offering adequately explicit instructions for given clinical situations. An accepted protocol could also reduce confounding by mechanical

The Expanding Universe: Dark Energy

Energy Technology Data Exchange (ETDEWEB)

Lincoln, Don [Fermilab; Nord, Brian [Fermilab

2014-09-01

In 1998, observations of distant supernovae led physicists that not only was the universe expanding, but the expansion was speeding up. In this article, we describe the evidence for an expanding universe and describe what physicists and cosmologists have learned in the intervening years. The target audience for this article is high school physics teachers and college physics professors at teaching institutions.

[Intervention priorities in the acute stage of complex emergencies drafted by nine humanitarian aid agencies].

Science.gov (United States)

Carrillo Jaimes, Carmen Sofía; Arcos González, Pedro Ignacio

2004-01-01

Complex Emergencies are an international Public Health problem currently becoming increasingly more frequent and of growing proportions which lead to major death and disease rates, especially during the acute stage thereof. This study is aimed at identifying and analyzing the top-priority areas of intervention in the acute stage of a complex emergency drafted in the operating manuals of the main aid agencies, as well as the degree of development and structuring of the activities proposed in each area on which priority has been placed. The intervention manuals drafted by nine major aid agencies were used as study material. A quantitative analysis was then made of the 16 intervention priorities set out, as well as of the degree to which each priority was defined based on the development of 73 variables of aspects of the proposals set out in the manuals. The ACNUR manual includes 90% of the 73 variables for further expansion upon the priorities, the UN Humanitarian Affaire Coordination Office manual including 35% of the 73 variables. ACNUR better expands upon the non-healthcare variables, followed by MSF and USAID. Doctors without borders shows a 97.3% degree of expansion of the healthcare variables) followed by ACNUR (94.7%), USAID (92.1%). ACNUR has been found to have the most integral proposal, the UN Humanitarian Affairs Coordination Office having the most discreet. There is a general trend towad further expanding upon and unifying the health indicators, whilst other aspects are not further expanded upon.

Post-acute referral patterns for hospitals and implications for bundled payment initiatives.

Science.gov (United States)

Lau, Christopher; Alpert, Abby; Huckfeldt, Peter; Hussey, Peter; Auerbach, David; Liu, Hangsheng; Sood, Neeraj; Mehrotra, Ateev

2014-09-01

Under new bundled payment models, hospitals are financially responsible for post-acute care delivered by providers such as skilled nursing facilities (SNFs) and home health agencies (HHAs). The hope is that hospitals will use post-acute care more prudently and better coordinate care with post-acute providers. However, little is known about existing patterns in hospitals׳ referrals to post-acute providers. Post-acute provider referrals were identified using SNF and HHA claims within 14 days following hospital discharge. Hospital post-acute care network size and concentration were estimated across hospital types and regions. The 2008 Medicare Provider Analysis and Review claims for acute hospitals and SNFs, and the 100% HHA Standard Analytic Files were used. The mean post-acute care network size for U.S. hospitals included 57.9 providers with 37.5 SNFs and 23.4 HHAs. The majority of these providers (65.7% of SNFs, 60.9% of HHAs) accounted for 1 percent or less of a hospital׳s referrals and classified as "low-volume". Other post-acute providers we classified as routine. The mean network size for routine providers was greater for larger hospitals, teaching hospitals and in regions with higher per capita post-acute care spending. The average hospital works with over 50 different post-acute providers. Moreover, the size of post-acute care networks varies considerably geographically and by hospital characteristics. These results provide context on the complex task hospitals will face in coordinating care with post-acute providers and cutting costs under new bundled payment models. Copyright © 2014 Elsevier Inc. All rights reserved.

Neurally adjusted ventilatory assist decreases ventilator-induced lung injury and non-pulmonary organ dysfunction in rabbits with acute lung injury

NARCIS (Netherlands)

Brander, Lukas; Sinderby, Christer; Lecomte, François; Leong-Poi, Howard; Bell, David; Beck, Jennifer; Tsoporis, James N.; Vaschetto, Rosanna; Schultz, Marcus J.; Parker, Thomas G.; Villar, Jesús; Zhang, Haibo; Slutsky, Arthur S.

2009-01-01

OBJECTIVE: To determine if neurally adjusted ventilatory assist (NAVA) that delivers pressure in proportion to diaphragm electrical activity is as protective to acutely injured lungs (ALI) and non-pulmonary organs as volume controlled (VC), low tidal volume (Vt), high positive end-expiratory

Dynamic tests and adaptive control of a bottoming organic Rankine cycle of IC engine using swash-plate expander

International Nuclear Information System (INIS)

Torregrosa, A.; Galindo, J.; Dolz, V.; Royo-Pascual, L.; Haller, R.; Melis, J.

2016-01-01

Highlights: • An experimental testing of a bottoming Rankine Cycle is presented and applied to a 2 l turbocharged gasoline engine. • Both stationary and transient tests were performed, including the NEDC cycle. • Indicated diagrams of the swash-plate expander during these transients were presented and analyzed. - Abstract: This paper deals with the experimental testing of a bottoming Organic Rankine Cycle (ORC) integrate in a 2 l turbocharged gasoline engine using ethanol as working fluid. The main components of the cycle are a boiler, a condenser, a pump and a swash-plate expander. Both steady and transient tests were performed in three engine operating points to understand the behavior and inertia of the system. Pressure-Volume diagram during these transients were presented and analyzed. Operating parameters of the expander, such as expander speed and boiler power, were shifted. The objective of these tests is to understand the inertia of the system and to have a robust control in all the possible transient tests. New European Driving Cycle was tested with and without the expander because it is supposed to represent the typical usage of a car in Europe. It was used to validate the control of the ORC in realistic dynamic conditions of the engine. The importance of each parameter was analyzed by fixing all the parameters, changing each time one specific value. The main result of this paper is that using a slightly simple and robust control based on adaptive PIDs, the two dynamic effects of an ORC could be taken into account, i.e. high inertia effects (boiler and condenser) and low inertia effects (pump and volumetric expander).

Diffusion Kurtosis Imaging of Acute Infarction: Comparison with Routine Diffusion and Follow-up MR Imaging.

Science.gov (United States)

Yin, Jianzhong; Sun, Haizhen; Wang, Zhiyun; Ni, Hongyan; Shen, Wen; Sun, Phillip Zhe

2018-05-01

Purpose To determine the relationship between diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in patients with acute stroke at admission and the tissue outcome 1 month after onset of stroke. Materials and Methods Patients with stroke underwent DWI (b values = 0, 1000 sec/mm 2 along three directions) and DKI (b values = 0, 1000, 2000 sec/mm 2 along 20 directions) within 24 hours after symptom onset and 1 month after symptom onset. For large lesions (diameter ≥ 1 cm), acute lesion volumes at DWI and DKI were compared with those at follow-up T2-weighted imaging by using Spearman correlation analysis. For small lesions (diameter the number of acute lesions at DWI and DKI and follow-up T2-weighted imaging was counted and compared by using the McNemar test. Results Thirty-seven patients (mean age, 58 years; range, 35-82 years) were included. There were 32 large lesions and 138 small lesions. For large lesions, the volumes of acute lesions on kurtosis maps showed no difference from those on 1-month follow-up T2-weighted images (P = .532), with a higher correlation coefficient than those on the apparent diffusion coefficient and mean diffusivity maps (R 2 = 0.730 vs 0.479 and 0.429). For small lesions, the number of acute lesions on DKI, but not on DWI, images was consistent with that on the follow-up T2-weighted images (P = .125). Conclusion DKI complements DWI for improved prediction of outcome of acute ischemic stroke. © RSNA, 2018.

77 FR 26477 - Receipt of a Pesticide Petition Filed for Residues of Pesticide Chemicals in or on Various...

Science.gov (United States)

2012-05-04

..., granules/flakes at 5.5 ppm; cattle, goat, hog, horse, sheep, fat at 1.0 ppm; cattle, goat, hog, horse, sheep, liver at 0.5 ppm; cattle, goat, hog, horse, sheep, meat at 0.2 ppm; cattle, goat, hog, horse, sheep, meat byproducts at 0.4 ppm; and milk, fat at 0.5 ppm. The High-performance Liquid Chromatograph...

Interleukin-6 is increased in plasma and cerebrospinal fluid of community-dwelling domestic dogs with acute ischaemic stroke

DEFF Research Database (Denmark)

Gredal, Hanne; Thomsen, Barbara B; Boza-Serrano, Antonio

2017-01-01

and cerebrospinal fluid (CSF) in dogs with acute ischaemic stroke and to search for correlations between infarct volume and cytokine concentrations. Blood and CSF were collected from dogs less than 72 h after a spontaneous ischaemic stroke. Infarct volumes were estimated on MRIs. Interleukin (IL)-2, IL-6, IL-8, IL...

Screw expander for light duty diesel engines

Science.gov (United States)

1983-01-01

Preliminary selection and sizing of a positive displacement screw compressor-expander subsystem for a light-duty adiabatic diesel engine; development of a mathematical model to describe overall efficiencies for the screw compressor and expander; simulation of operation to establish overall efficiency for a range of design parameters and at given engine operating points; simulation to establish potential net power output at light-duty diesel operating points; analytical determination of mass moments of inertia for the rotors and inertia of the compressor-expander subsystem; and preparation of engineering layout drawings of the compressor and expander are discussed. As a result of this work, it was concluded that the screw compressor and expander designed for light-duty diesel engine applications are viable alternatives to turbo-compound systems, with acceptable efficiencies for both units, and only a moderate effect on the transient response.

Perfusion differences on SPECT and PWI in patients with acute ischemic stroke