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Sample records for aortic cusp guided

  1. Radiofrequency Ablation of an Atrial Tachycardia Emanating From the Non-coronary Aortic Cusp Guided by an Electroanatomic Navigation System

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    Agustin Bortone

    2010-02-01

    Full Text Available We report on an atrial tachycardia (AT, emanating from the non-coronary (NC aortic cusp, ablated with the aid of an electro-anatomical navigation system. In this setting, the electrocardiographic, electrophysiologic (EP, anatomical, and ablative considerations are discussed.Although NC aortic cusp focal ATs are an uncommon EP finding, their ablation is effective and safe, especially from an atrio-ventricular (AV conductive point of view. This origin of AT must be invoked and systematically disclosed when a peri-AV nodal AT origin is suspected, in order to avoid a potentially harmful energy application at the vicinity of the AV conductive tissue.

  2. Fibrin glue on an aortic cusp detected by transesophageal echocardiography after valve-sparing aortic valve replacement: a case report.

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    Nakahira, Junko; Ishii, Hisanari; Sawai, Toshiyuki; Minami, Toshiaki

    2015-03-07

    Fibrin glue is used commonly during cardiac surgery but can behave as an intracardiac abnormal foreign body following surgery. There have been few such cases reported, and they were typically noticed only because of the resulting catastrophic cardiac conditions, such as valvular malfunction. We report a case where, for the first time, transesophageal echocardiography was used to detected fibrin glue that was adherent to the ventricular side of a patient's aortic valve immediately after aortic declamping. A 45-year-old Japanese man with Marfan syndrome underwent an aortic valve-sparing operation to treat moderate aortic valve regurgitation resulting from enlargement of his right coronary cusp. Fibrin glue was lightly applied to the suture line between the previous and new grafts. Transesophageal echocardiography performed prior to weaning from the cardiopulmonary bypass revealed mild aortic valve regurgitation in addition to a mobile membranous structure attached to the ventricular side of his aortic valve. It was identified as fibrin glue. We resolved the regurgitation by removing the fibrin glue and repeating the aortic cusp plication. The patient had no complications during recovery. Fibrin glue can act as an intracardiac foreign body and lead to a potentially fatal embolism. We demonstrated the use of transesophageal echocardiography to detect a fibrin glue-derived intracardiac abnormal foreign body and to confirm its removal. To the best of our knowledge, this is the first case where fibrin glue adherent to the aortic valve was detected by transesophageal echocardiography. These findings demonstrate the importance of using transesophageal echocardiography during cardiac surgery that involves using biological glues.

  3. Inadvertent puncture of the aortic noncoronary cusp during postoperative left atrial tachycardia ablation

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    Dursun Aras, MD

    2015-08-01

    Full Text Available Transseptal catheterization has become part of the interventional electrophysiologist׳s technical armamentarium since the development of left atrial catheter ablation and percutaneous technologies for treating mitral and aortic valve disease. Although frequently performed, the procedure׳s most feared complication is aortic root penetration. Focal atrial tachycardia has been described as the most common late sequela of surgical valve replacements. We present a complicated case involving the inadvertent delivery of an 8 French sheath across the noncoronary cusp during radiofrequency catheter ablation for left atrial tachycardia originating from the mitral annulus in a patient with prior mitral valve replacement.

  4. [Aortic valve insufficiency due to rupture of the cusp in a patient with multiple trauma].

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    Vidmar, J; Brilej, D; Voga, G; Kovacic, N; Smrkolj, V

    2003-06-01

    Lesions of the heart valve caused by blunt chest trauma is rare, but when it does occur it can significantly injure the patient. On the basis of autopsy studies, research shows that heart valves are injured in less than 5% of patients who have died due to impact thoracic trauma. Among the heart valves, the aortic valve is the most often lacerated, which has been proved by relevant autopsy and clinical studies. Aortic valve lesions can be the only injury, but it is possible that additional heart or large vessel injuries are also present (myocardial contusion, rupture of the atrial septum, aortic rupture, rupture of the left common carotid artery). The force that causes such an injury is often great and often causes injuries to other organs and organ systems. In a multiple trauma patient, it is very important to specifically look for heart-related injuries because it is possible that they may be overlooked or missed by the surgeon, because of other obvious injuries. We describe the case of a 41-year-old man with multiple trauma who was diagnosed with aortic valve insufficiency due to rupture of the left coronary cusp 6 weeks after a road accident. Valvuloplasty was performed. Seven years later the patient is free of symptoms and is in good physical condition. Echocardiography showed normal dimensions of the heart chambers, a normal thickness of the heart walls, and normal systolic and diastolic function of the left ventricle. Heart valves are morphologically normal, and only an unimportant aortic insufficiency was noticed by echocardiography.

  5. Durability of Aortic Valve Cusp Repair With and Without Annular Support.

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    Zeeshan, Ahmad; Idrees, Jay J; Johnston, Douglas R; Rajeswaran, Jeevanantham; Roselli, Eric E; Soltesz, Edward G; Gillinov, A Marc; Griffin, Brian; Grimm, Richard; Hammer, Donald F; Pettersson, Gösta B; Blackstone, Eugene H; Sabik, Joseph F; Svensson, Lars G

    2018-03-01

    To determine the value of aortic valve repair rather than replacement for valve dysfunction, we assessed late outcomes of various repair techniques in the contemporary era. From January 2001 to January 2011, aortic valve repair was planned in 1,124 patients. Techniques involved commissural figure-of-8 suspension sutures (n = 63 [6.2%]), cusp repair with commissuroplasty (n = 481 [48%]), debridement (n = 174 [17%]), free-margin plication (n = 271 [27%]) or resection (n = 75) or both, or annulus repair with resuspension (n = 230 [23%]), root reimplantation (n = 252 [25%]), or remodeling (n = 35 [3.5%]). Planned repair was aborted for replacement in 115 patients (10%); risk factors included greater severity of aortic regurgitation (AR; p = 0.0002) and valve calcification (p < 0.0001). In-hospital outcomes for the remaining 1,009 patients included death (12 [1.2%]), stroke (13 [1.3%]), and reoperation for valve dysfunction (14 [1.4%]). Freedom from aortic valve reoperation at 1, 5, and 10 years was 97%, 93%, and 90%, respectively. Figure-of-8 suspension sutures, valve resuspension, and root repair and replacement were least likely to require reoperation; cusp repair with commissural sutures, plication, and commissuroplasty was most likely (p < 0.05). Survival at 1, 5, and 10 years was 96%, 92%, and 83%. Immediate postoperative AR grade was none-mild (94%), moderate (5%), and severe (1%). At 10 years after repair, AR grade was none (20%), mild (33%), moderate (26%), and severe (21%). Patients undergoing root procedures were less likely to have higher-grade postoperative AR (p < 0.0001). Valve repair is effective and durable for treating aortic valve dysfunction. Greater severity of AR preoperatively is associated with higher likelihood of repair failure. Commissural figure-of-8 suspension sutures and repair with annular support have the best long-term durability. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights

  6. Doubly committed subarterial ventricular septal defect with prolapsed right coronary cusp with moderate aortic regurgitation

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    Redoy Ranjan

    2017-11-01

    Full Text Available A 4 year old girl was presented with the respiratory tract infection, breathlessness after taking meal, failure to thrive, abnormal movement of the chest on left side overlying the area of heart and systolic murmur. She developed these symptoms gradually for the last 3.5 years. Echocardiography revealed doubly committed subarterial ventricular septal defect with moderate aortic regurgitation. The size of the ventricular septal defect was 7 x 9 mm at the left ventricular outflow tract. The right coronary cusp of the aortic valve was prolapsed. Left atrium and left ventricle were dilated. The pulmonary artery systolic pressure was 35 mm Hg. The ventricular septal defect was closed with the standard surgical procedure using cardiopulmonary bypass followed by aortotomy and right atriotomy. Immediate post-operative period of this case was uneventful and the patient was discharged on 9th post-operative day. Follow-up echocardiography showed no residual ventricular septal defect or aortic regurgitation and the ventricular function was good.

  7. Perforation of the right aortic valve cusp: complication of ventricular septal defect closure with a modified Rashkind umbrella.

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    Vogel, M; Rigby, M L; Shore, D

    1996-01-01

    An 18-month-old boy with a perimembranous ventricular septal defect (VSD) had undergone transcatheter closure of the defect with a modified 17 mm Rashkind umbrella device at age 4 months (weight 3.8 kg). The clinical signs of a VSD persisted, and he developed aortic incompetence, first detected 5 months after the procedure, which progressed from mild to moderate. A three-dimensional echocardiographic study demonstrated that one of the four arms holding the umbrella was protruding into the aortic valve and had perforated the right aortic valve cusp. This diagnosis was confirmed at subsequent surgery. Surgical repair of the perforated right aortic valve leaflet was necessary. The umbrella was adherent to the tricuspid valve and could not be removed. Instead it was left in situ, but three of the stainless steel arms were cut off. When umbrella closure of a perimembranous VSD is undertaken, the close proximity of part of the distal umbrella to the aortic valve can lead to aortic regurgitation.

  8. Successful catheter ablation of a left anterior accessory pathway from the non-coronary cusp of the aortic valve.

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    Laranjo, Sérgio; Oliveira, Mário; Trigo, Conceição

    2015-08-01

    Left anterior accessory pathways are considered to be rare findings. Catheter ablation of accessory pathways in this location remains a challenging target, and few reports about successful ablation of these accessory pathways are available. We describe our experience regarding a case of a manifest left anterior accessory pathway ablation using radiofrequency energy at the junction of the left coronary cusp with the non-coronary cusp.

  9. Aortic intracardiac echocardiography-guided septal puncture during mitral valvuloplasty.

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    Akkaya, Emre; Vuruskan, Ertan; Zorlu, Ali; Sincer, Isa; Kucukosmanoglu, Mehmet; Ardic, Idris; Yilmaz, Mehmet Birhan

    2014-01-01

    Transoesophageal echocardiography (TEE) and venous intracardiac echocardiography (ICE) are traditionally used to visualize the interatrial septum (IAS) and the tenting effect of the fossa ovalis in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). The aim of the present study was to assess the comparative efficacy and safety of arterial (intra-aortic) ICE and venous ICE, compared with TEE (traditional approach), in the patients undergoing PBMV. TEE, aortic ICE, and venous ICE were consecutively performed in 50 patients (40 ± 9 years, 86% female). The images of intracardiac structures were obtained from both aortic and right atrial loci. The IAS was visualized using TEE, aortic ICE, and venous ICE. The mean mitral valve area was 1.14 ± 0.2 cm(2), and the mean left atrial volume index was 57.5 ± 12 mL/m(2). The mean size of the visualized septal length was 48 ± 5 mm by TEE, 51 ± 5 mm by aortic ICE, and 33 ± 6 mm by venous ICE. The Bland-Altman test indicated that the 95% limits of agreement for the measurement of septal diameter ranged from -11.0 to +5.9 mm (mean -2.5 mm) between TEE and aortic ICE, -2.8 to +33.5 mm (mean +15.3 mm) between TEE and venous ICE, and -36.6 to +0.8 mm (mean -17.9 mm) between venous and aortic ICE. Standard venous ICE generally tended to yield smaller values compared with TEE and aortic ICE for the measurement of septal length. Furthermore, the view of fossa ovalis and 'tenting effect' was optimal in 11 patients on venous ICE; however, the fossa ovalis and tip of the needle were well visualized in all patients on aortic ICE (P < 0.001). There were no major complications with the use of aortic ICE. Aortic ICE is a superior alternative to venous ICE and facilitates trans-septal puncture in patients with mitral stenosis.

  10. Aortic stenosis: From diagnosis to optimal treatment

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    Tavčiovski Dragan

    2008-01-01

    Full Text Available Aortic stenosis is the most frequent valvular heart disease. Aortic sclerosis is the first characteristic lesion of the cusps, which is considered today as the process similar to atherosclerosis. Progression of the disease is an active process leading to forming of bone matrix and heavily calcified stiff cusps by inflammatory cells and osteopontin. It is a chronic, progressive disease which can remain asymptomatic for a long time even in the presence of severe aortic stenosis. Proper physical examination remains an essential diagnostic tool in aortic stenosis. Recognition of characteristic systolic murmur draws attention and guides further diagnosis in the right direction. Doppler echocardiography is an ideal tool to confirm diagnosis. It is well known that exercise tests help in stratification risk of asymptomatic aortic stenosis. Serial measurements of brain natriuretic peptide during a follow-up period may help to identify the optimal time for surgery. Heart catheterization is mostly restricted to preoperative evaluation of coronary arteries rather than to evaluation of the valve lesion itself. Currently, there is no ideal medical treatment for slowing down the disease progression. The first results about the effect of ACE inhibitors and statins in aortic sclerosis and stenosis are encouraging, but there is still not enough evidence. Onset symptoms based on current ACC/AHA/ESC recommendations are I class indication for aortic valve replacement. Aortic valve can be replaced with a biological or prosthetic valve. There is a possibility of percutaneous aortic valve implantation and transapical operation for patients that are contraindicated for standard cardiac surgery.

  11. Facial talon cusps.

    LENUS (Irish Health Repository)

    McNamara, T

    1997-12-01

    This is a report of two patients with isolated facial talon cusps. One occurred on a permanent mandibular central incisor; the other on a permanent maxillary canine. The locations of these talon cusps suggests that the definition of a talon cusp include teeth in addition to the incisor group and be extended to include the facial aspect of teeth.

  12. JAG Tearing Technique with Radiofrequency Guide Wire for Aortic Fenestration in Thoracic Endovascular Aneurysm Repair

    International Nuclear Information System (INIS)

    Ricci, Carmelo; Ceccherini, Claudio; Leonini, Sara; Cini, Marco; Vigni, Francesco; Neri, Eugenio; Tucci, Enrico; Benvenuti, Antonio; Tommasino, Giulio; Sassi, Carlo

    2012-01-01

    An innovative approach, the JAG tearing technique, was performed during thoracic endovascular aneurysm repair in a patient with previous surgical replacement of the ascending aorta with a residual uncomplicated type B aortic dissection who developed an aneurysm of the descending thoracic aorta with its lumen divided in two parts by an intimal flap. The proximal landing zone was suitable to place a thoracic stent graft. The distal landing zone was created by cutting the intimal flap in the distal third of the descending thoracic aorta with a radiofrequency guide wire and intravascular ultrasound catheter.

  13. The novel echo-guided ProGlide technique during percutaneous transfemoral transcatheter aortic valve implantation.

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    Honda, Yohsuke; Araki, Motoharu; Yamawaki, Masahiro; Tokuda, Takahiro; Tsutumi, Masakazu; Mori, Shinsuke; Sakamoto, Yasunari; Kobayashi, Norihiro; Hirano, Keisuke; Ito, Yoshiaki

    2018-04-01

    The aim of this study was to assess clinical benefit of the Echo-guided ProGlide technique in patients undergoing percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI). The efficacy of the Echo-guided ProGlide technique during percutaneous TF-TAVI was not previously clarified. A total of 121 consecutive patients who underwent percutaneous TF-TAVI at our institution between February 2014 and July 2017 were enrolled in this study. According to the introduction of this novel technique in March 2016, patients were divided into two groups (echo-guided group who underwent TAVI from March 2016 to July 2017, n = 63; not echo-guided group who underwent TAVI from February 2014 to February 2016, n = 58). The incidence of major vascular complications, defined per the Valve Academic Research Consortium-2 criteria, and ProGlide complications including acute femoral artery stenosis or occlusion and bleeding requiring any intervention. The incidence of major vascular complication and ProGlide complication were significantly lower in the echo-guided group than in not echo-guided group (1.6% vs 17.2%, P guided ProGlide technique was independently associated with prevention of ProGlide complications (odds ratio, 0.11; 95% confidential interval, 0.01-0.76; P = 0.03). This novel Echo-guided ProGlide technique was associated with a lower rate of major vascular complications, particularly ProGlide complications during percutaneous TF-TAVI. © 2017, Wiley Periodicals, Inc.

  14. Supracristal ventricular septal defect with severe right coronary cusp prolapse

    International Nuclear Information System (INIS)

    Hussain, A.H.; Hanif, B.; Khan, G.; Hasan, K.

    2011-01-01

    The case of a 20 years old male, diagnosed as supracristal ventricular septal defect (VSD) for last 6 years is being presented. He came in emergency department with decompensated congestive cardiac failure. After initial stabilization, he underwent trans thoracic echocardiogram which showed large supracristal VSD, severely prolapsing right coronary cusp, severe aortic regurgitation and severe pulmonary hypertension. Right heart catheterization was performed which documented reversible pulmonary vascular resistance after high flow oxygen inhalation. He underwent VSD repair, right coronary cusp was excised and aortic valve was replaced by mechanical prosthesis. Post operative recovery was uneventful. He was discharged home in one week.The case of a 20 years old male, diagnosed as supracristal ventricular septal defect (VSD) for last 6 years is being presented. He came in emergency department with decompensated congestive cardiac failure. After initial stabilization, he underwent trans thoracic echocardiogram which showed large supracristal VSD, severely prolapsing right coronary cusp, severe aortic regurgitation and severe pulmonary hypertension. Right heart catheterization was performed which documented reversible pulmonary vascular resistance after high flow oxygen inhalation. He underwent VSD repair, right coronary cusp was excised and aortic valve was replaced by mechanical prosthesis. Post operative recovery was uneventful. He was discharged home in one week. (author)

  15. Cluster observations of two separated cusp populations: double cusp or motion of the cusp?

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    Escoubet, C.-Philippe; Berchem, Jean; Trattner, Karlheinz; Pitout, Frederic; Richard, Robert; Taylor, Matt; Soucek, Jan; Grison, Benjamin; Laakso, Harri; Masson, Arnaud; Dunlop, Malcolm; Dandouras, Iannis; Reme, Henri; Fazakerley, Andrew; Daly, Patrick

    2013-04-01

    Modelling plasma entry in the polar cusp has been successful in reproducing ion dispersions observed in the cusp at low and mid-altitudes. The use of a realistic convection pattern allowed Wing et al. (2001) to predict double cusp signatures that were subsequently observed by the DMSP spacecraft. In this paper, we present a cusp crossing where two cusp populations are observed, separated by a gap around 1° ILAT wide. Cluster 1 (C1) and Cluster 2 (C2) observed these two cusp populations with a time delay of three minutes and about 15 and 42 minutes later, Cluster 4 (C4) and Cluster 3 (C3) observed, respectively, a single cusp population. A peculiarity of this event is the fact that the second cusp population seen on C1 and C2 was observed at the same time as the first cusp population on C4. This would tend to suggest that the two cusp populations were spatial features similar to the double cusp. Due to the nested crossing of C1 and C2 through the gap between the two cusp encounters, C2 being first to leave the cusp and last to re-enter it, these observations cannot be explained by two stable cusps with a gap of precipitation in between. On the other hand these observations are in agreement with a motion of the cusp first dawnward and then back duskward due to the effect of the IMF-By component.

  16. Aortic regurgitation after valve-sparing aortic root replacement: modes of failure.

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    Oka, Takanori; Okita, Yutaka; Matsumori, Masamichi; Okada, Kenji; Minami, Hitoshi; Munakata, Hiroshi; Inoue, Takeshi; Tanaka, Akiko; Sakamoto, Toshihito; Omura, Atsushi; Nomura, Takuo

    2011-11-01

    Despite the positive clinical results of valve-sparing aortic root replacement, little is known about the causes of reoperations and the modes of failure. From October 1999 to June 2010, 101 patients underwent valve-sparing aortic root replacement using the David reimplantation technique. The definition of aortic root repair failure included the following: (1) intraoperative conversion to the Bentall procedure; (2) reoperation performed because of aortic regurgitation; and (3) aortic regurgitation equal to or greater than a moderate degree at the follow-up. Sixteen patients were considered to have repair failure. Three patients required intraoperative conversion to valve replacement, 3 required reoperation within 3 months, and another 8 required reoperation during postoperative follow-up. At initial surgery 5 patients had moderate to severe aortic regurgitation, 6 patients had acute aortic dissections, 3 had Marfan syndrome, 2 had status post Ross operations, 3 had bicuspid aortic valves, and 1 had aortitis. Five patients had undergone cusp repair, including Arantius plication in 3 and plication at the commissure in 2. The causes of early failure in 6 patients included cusp perforation (3), cusp prolapse (3), and severe hemolysis (1). The causes of late failure in 10 patients included cusp prolapse (4), commissure dehiscence (3), torn cusp (2), and cusp retraction (1). Patients had valve replacements at a mean of 23 ± 20.9 months after reimplantation and survived. Causes of early failure after valve-sparing root replacement included technical failure, cusp lesions, and steep learning curve. Late failure was caused by aortic root wall degeneration due to gelatin-resorcin-formalin glue, cusp degeneration, or progression of cusp prolapse. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Double cusp encounter by Cluster: double cusp or motion of the cusp?

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    Escoubet, C. P.; Berchem, J.; Trattner, K. J.; Pitout, F.; Richard, R.; Taylor, M. G. G. T.; Soucek, J.; Grison, B.; Laakso, H.; Masson, A.; Dunlop, M.; Dandouras, I.; Reme, H.; Fazakerley, A.; Daly, P.

    2013-04-01

    Modelling plasma entry in the polar cusp has been successful in reproducing ion dispersions observed in the cusp at low and mid-altitudes. The use of a realistic convection pattern, when the IMF-By is large and stable, allowed Wing et al. (2001) to predict double cusp signatures that were subsequently observed by the DMSP spacecraft. In this paper we present a cusp crossing where two cusp populations are observed, separated by a gap around 1° Invariant Latitude (ILAT) wide. Cluster 1 (C1) and Cluster 2 (C2) observed these two cusp populations with a time delay of 3 min, and about 15 and 42 min later Cluster 4 (C4) and Cluster 3 (C3) observed, respectively, a single cusp population. A peculiarity of this event is the fact that the second cusp population seen on C1 and C2 was observed at the same time as the first cusp population on C4. This would tend to suggest that the two cusp populations had spatial features similar to the double cusp. Due to the nested crossing of C1 and C2 through the gap between the two cusp populations, C2 being first to leave the cusp and last to re-enter it, these observations are difficult to be explained by two distinct cusps with a gap in between. However, since we observe the cusp in a narrow area of local time post-noon, a second cusp may have been present in the pre-noon sector but could not be observed. On the other hand, these observations are in agreement with a motion of the cusp first dawnward and then back duskward due to the effect of the IMF-By component.

  18. Double cusp encounter by Cluster: double cusp or motion of the cusp?

    Directory of Open Access Journals (Sweden)

    C. P. Escoubet

    2013-04-01

    Full Text Available Modelling plasma entry in the polar cusp has been successful in reproducing ion dispersions observed in the cusp at low and mid-altitudes. The use of a realistic convection pattern, when the IMF-By is large and stable, allowed Wing et al. (2001 to predict double cusp signatures that were subsequently observed by the DMSP spacecraft. In this paper we present a cusp crossing where two cusp populations are observed, separated by a gap around 1° Invariant Latitude (ILAT wide. Cluster 1 (C1 and Cluster 2 (C2 observed these two cusp populations with a time delay of 3 min, and about 15 and 42 min later Cluster 4 (C4 and Cluster 3 (C3 observed, respectively, a single cusp population. A peculiarity of this event is the fact that the second cusp population seen on C1 and C2 was observed at the same time as the first cusp population on C4. This would tend to suggest that the two cusp populations had spatial features similar to the double cusp. Due to the nested crossing of C1 and C2 through the gap between the two cusp populations, C2 being first to leave the cusp and last to re-enter it, these observations are difficult to be explained by two distinct cusps with a gap in between. However, since we observe the cusp in a narrow area of local time post-noon, a second cusp may have been present in the pre-noon sector but could not be observed. On the other hand, these observations are in agreement with a motion of the cusp first dawnward and then back duskward due to the effect of the IMF-By component.

  19. The dynamic cusp

    International Nuclear Information System (INIS)

    Potemra, T.A.; Erlandson, R.E.; Zanetti, L.J.; Arnoldy, R.L.; Woch, J.; Friis-Christensen, E.

    1992-01-01

    A unique alignment of the Viking satellite with respect to a network of magnetometers in Greenland has provided the opportunity to study the relationship of pulsations and plasma characteristics in the dayside cusp. The presence of Pc 1 bursts, Pc 4-5 pulsations, and a tailward traveling twin vortex pattern of ionospheric convection suggests that the magnetosphere may have been temporarily compressed. Magnetic field data acquired at synchrotrons altitude from GOES 5 and on the ground from Huancayo support this suggestion. Plasma with ion dispersion characteristics associated with a cusp during southward IMF was detected by Viking over a 3.5 degree range of latitude. The presence of standing Alfven waves and ring current ions suggest that this cusplike plasma was observed on closed geomagnetic field lines. As Viking moved further poleward, it detected a different region of plasma with characteristics associated with a cusp during northward IMF. The presence of plasma on closed field lines with southward IMF ion dispersion characteristics can be explained with a poleward moving plasma source. The authors suggest that the magnetosphere, during a northward IMF, is temporarily compressed by a solar wind pressure enhancement that produces the Pc 1 bursts, Pc 4-5 pulsations, and ionospheric vortices. As the magnetosphere recovers to its precompressed shape, the source of cusp plasma will move poleward until it reaches an equilibrium position for northward IMF. The Viking satellite, following in the wake of this source, will detect plasma with southward IMF characteristics until it reaches the latitude of the actual northward IMF cusp

  20. Repair-oriented classification of aortic insufficiency: impact on surgical techniques and clinical outcomes.

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    Boodhwani, Munir; de Kerchove, Laurent; Glineur, David; Poncelet, Alain; Rubay, Jean; Astarci, Parla; Verhelst, Robert; Noirhomme, Philippe; El Khoury, Gébrine

    2009-02-01

    Valve repair for aortic insufficiency requires a tailored surgical approach determined by the leaflet and aortic disease. Over the past decade, we have developed a functional classification of AI, which guides repair strategy and can predict outcome. In this study, we analyze our experience with a systematic approach to aortic valve repair. From 1996 to 2007, 264 patients underwent elective aortic valve repair for aortic insufficiency (mean age - 54 +/- 16 years; 79% male). AV was tricuspid in 171 patients bicuspid in 90 and quadricuspid in 3. One hundred fifty three patients had type I dysfunction (aortic dilatation), 134 had type II (cusp prolapse), and 40 had type III (restrictive). Thirty six percent (96/264) of the patients had more than one identified mechanism. In-hospital mortality was 1.1% (3/264). Six patients experienced early repair failure; 3 underwent re-repair. Functional classification predicted the necessary repair techniques in 82-100% of patients, with adjunctive techniques being employed in up to 35% of patients. Mid-term follow up (median [interquartile range]: 47 [29-73] months) revealed a late mortality rate of 4.2% (11/261, 10 cardiac). Five year overall survival was 95 +/- 3%. Ten patients underwent aortic valve reoperation (1 re-repair). Freedoms from recurrent Al (>2+) and from AV reoperation at 5 years was 88 +/- 3% and 92 +/- 4% respectively and patients with type I (82 +/- 9%; 93 +/- 5%) or II (95 +/- 5%; 94 +/- 6%) had better outcomes compared to type III (76 +/- 17%; 84 +/- 13%). Aortic valve repair is an acceptable therapeutic option for patients with aortic insufficiency. This functional classification allows a systematic approach to the repair of Al and can help to predict the surgical techniques required as well as the durability of repair. Restrictive cusp motion (type III), due to fibrosis or calcification, is an important predictor for recurrent Al following AV repair.

  1. The Polar Cusp

    International Nuclear Information System (INIS)

    Holtet, J.A.; Egeland, A.

    1985-01-01

    The upper atmosphere at high latitudes is often called the ''earth's window to outer space.'' Through various electrodynamic coupling processes, as well as direct transfer of particles, many of the geophysical effects displayed are direct manifestations of phenomena occurring in deep space. The high latitude ionosphere also exerts a feedback on the regions of the magnetosphere and atmosphere to which it is coupled. Of particular interest are the sections of the near space known as the Polar Cusp. A vast portion of the Earth's magnetic field envelope is electrically connected to these regions. This geometry results in a spatial mapping of the magnetospheric processes and a focusing on the ionosphere. In the Polar Cusps, the solar wind plasma also has direct access to the upper atmosphere

  2. Mid-term outcomes of endovascular aortic aneurysm repair with carbon dioxide-guided angiography.

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    Takeuchi, Yuriko; Morikage, Noriyasu; Matsuno, Yutaro; Nakamura, Tamami; Samura, Makoto; Ueda, Koshiro; Harada, Takasuke; Ikeda, Yoshitaka; Suehiro, Kotaro; Ito, Hiroshi; Sakata, Kensuke; Hamano, Kimikazu

    2018-05-14

    Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO 2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO 2 -guided angiography. Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO 2 -EVAR group (n=30). Subjects in the CO 2 -EVAR group had severe renal dysfunction (n=27) and IC allergy (n=4). Intraoperative, postoperative, and follow-up variables were compared. Compared to the IC-EVAR group, preoperative serum creatinine level was significantly higher (2.0 vs. 0.92 mg/dL, P < .0001) and mean IC dose significantly lower (18 vs. 55 mL P < .0001) in the CO 2 -EVAR group. The fluoroscopy time, operative time, number of stent grafts placed, and technical success rates of the groups were similar; no type I and/or type III endoleaks were detected on completion angiography. There was no acute kidney injury and one case of intestinal necrosis in the CO 2 -EVAR group, potentially due to cholesterol embolism. Postoperative endoleak, enlargement of aneurysms, survival, freedom from secondary intervention, and renal function change up to 3 months postoperatively were similar between groups. CO 2 -EVAR is technically feasible and exhibits prominent renal protection. However, consideration of the aortic lumen status remains an important challenge. Copyright © 2018. Published by Elsevier Inc.

  3. ECC cusp analysis

    Energy Technology Data Exchange (ETDEWEB)

    Pregliasco, R.G. (Centro Atomico Bariloche and CONICET, S.C. de Bariloche (Argentina)); Garibotti, C.R. (Centro Atomico Bariloche and CONICET, S.C. de Bariloche (Argentina)); Barrachina, R. (Centro Atomico Bariloche and CONICET, S.C. de Bariloche (Argentina))

    1994-03-01

    We measured the ionization double differential cross section for the H[sup +][yields]He 100 keV collision at the proximities of the ECC cusp and all around 0 . We propose an angular function expansion and a procedure for data analysis. We demonstrate that, in this way, the difficulties and shortcomings presented in the standard data processing are overcome. In our experimental results we distinguish the presence of characteristic shapes for the ionization depending on whether the module of the electron velocity is greater or smaller than the projectile velocity. (orig.)

  4. Bicuspid aortic valves: Diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, David J., E-mail: david.murphy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); McEvoy, Sinead H., E-mail: s.mcevoy@st-vincents.ie [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland); Iyengar, Sri, E-mail: sri.iyengar@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Feuchtner, Gudrun, E-mail: Gudrun.Feuchtner@i-med.ac.at [Department of Radiology, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck (Austria); Cury, Ricardo C., E-mail: r.cury@baptisthealth.net [Department of Radiology, Baptist Cardiac and Vascular Institute, 8900 North Kendall Drive, Miami, FL 33176 (United States); Roobottom, Carl, E-mail: carl.roobottom@nhs.net [Department of Radiology, Plymouth Hospitals NHS Trust, Plymouth Devon PL6 8DH (United Kingdom); Plymouth University Peninsula Schools of Medicine and Dentistry (United Kingdom); Baumueller, Stephan, E-mail: Hatem.Alkadhi@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Alkadhi, Hatem, E-mail: stephan.baumueller@usz.ch [Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, CH-8091 Zurich (Switzerland); Dodd, Jonathan D., E-mail: jonniedodd@gmail.com [Department of Radiology, St Vincent' s University Hospital, Elm Park, Dublin 4 (Ireland)

    2014-08-15

    Objectives: To assess the diagnostic accuracy of standard axial 64-slice chest CT compared to aortic valve image plane ECG-gated cardiac CT for bicuspid aortic valves. Materials and methods: The standard axial chest CT scans of 20 patients with known bicuspid aortic valves were blindly, randomly analyzed for (i) the appearance of the valve cusps, (ii) the largest aortic sinus area, (iii) the longest aortic cusp length, (iv) the thickest aortic valve cusp and (v) valve calcification. A second blinded reader independently analyzed the appearance of the valve cusps. Forty-two age- and sex-matched patients with known tricuspid aortic valves were used as controls. Retrospectively ECG-gated cardiac CT multiphase reconstructions of the aortic valve were used as the gold-standard. Results: Fourteen (21%) scans were scored as unevaluable (7 bicuspid, 7 tricuspid). Of the remainder, there were 13 evaluable bicuspid valves, ten of which showed an aortic valve line sign, while the remaining three showed a normal Mercedes-Benz appearance owing to fused valve cusps. The 35 evaluable tricuspid aortic valves all showed a normal Mercedes-Benz appearance (P = 0.001). Kappa analysis = 0.62 indicating good interobserver agreement for the aortic valve cusp appearance. Aortic sinus areas, aortic cusp lengths and aortic cusp thicknesses of ≥3.8 cm{sup 2}, 3.2 cm and 1.6 mm respectively on standard axial chest CT best distinguished bicuspid from tricuspid aortic valves (P < 0.0001 for all). Of evaluable scans, the sensitivity, specificity, positive and negative predictive values of standard axial chest CT in diagnosing bicuspid aortic valves was 77% (CI 0.54–1.0), 100%, 100% and 70% respectively. Conclusion: The aortic valve is evaluable in approximately 80% of standard chest 64-slice CT scans. Bicuspid aortic valves may be diagnosed on evaluable scans with good diagnostic accuracy. An aortic valve line sign, enlarged aortic sinuses and elongated, thickened valve cusps are specific CT

  5. 3D printed abdominal aortic aneurysm phantom for image guided surgical planning with a patient specific fenestrated endovascular graft system

    Science.gov (United States)

    Meess, Karen M.; Izzo, Richard L.; Dryjski, Maciej L.; Curl, Richard E.; Harris, Linda M.; Springer, Michael; Siddiqui, Adnan H.; Rudin, Stephen; Ionita, Ciprian N.

    2017-03-01

    Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training. Using the Vascular Modeling Toolkit (VMTK), 3D Data from a CTA imaging of a patient scheduled for Fenestrated EndoVascular Aortic Repair (FEVAR) was segmented to isolate the aortic lumen, thrombus, and calcifications. A stereolithographic mesh (STL) was generated and then modified in Autodesk MeshMixer for fabrication via a Stratasys Eden 260 printer in a flexible photopolymer to simulate arterial compliance. Fluoroscopic guided simulation of the patient-specific FEVAR procedure was performed by interventionists using all demonstration endografts and accessory devices. Analysis compared treatment strategy between the planned procedure, the simulation procedure, and the patient procedure using a derived scoring scheme. Results: With training on the patient-specific 3D printed AAA phantom, the clinical team optimized their procedural strategy. Anatomical landmarks and all devices were visible under x-ray during the simulation mimicking the clinical environment. The actual patient procedure went without complications. Conclusions: With advances in 3D printing, fabrication of patient specific AAA phantoms is possible. Simulation with 3D printed phantoms shows potential to inform clinical interventional procedures in addition to CTA diagnostic imaging.

  6. Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery.

    Science.gov (United States)

    Hanke, Thorsten; Charitos, Efstratios I; Stierle, Ulrich; Robinson, Derek; Gorski, Armin; Sievers, Hans-H; Misfeld, Martin

    2009-02-01

    Early results after aortic valve-sparing root reconstruction are excellent. Longer-term follow-up, especially with regard to aortic valve function, is required for further judgment of these techniques. Between July of 1993 and September of 2006, 108 consecutive patients (mean age 53.0 +/- 15.8 years) underwent the Yacoub operation (group Y) and 83 patients underwent the David operation (group D). Innovative multilevel hierarchic modeling methods were used to analyze aortic regurgitation over time. In general, aortic regurgitation increased with time in both groups. Factors associated with the development of a significant increase in aortic regurgitation were Marfan syndrome, concomitant cusp intervention, and preoperative aortic anulus dimension. In Marfan syndrome, the initial aortic regurgitation was higher in group Y versus group D (0.56 aortic regurgitation vs 0.29 aortic regurgitation, P = .049), whereas the mean annual progression rate of aortic regurgitation was marginally higher in group Y (0.132 aortic regurgitation vs 0.075 aortic regurgitation, P = .1). Concomitant cusp intervention was associated with a significant aortic regurgitation increase in both groups (P Marfan syndrome and a large preoperative aortic annulus diameter were better treated with the reimplantation technique, whereas those with a smaller diameter were better treated with the remodeling technique. Concomitant free-edge plication of prolapsing cusps was disadvantageous in both groups. Considering these factors may serve to improve the aortic valve longevity after valve-sparing aortic root surgery.

  7. Randomized trial of guiding hypertension management using central aortic blood pressure compared with best-practice care: principal findings of the BP GUIDE study.

    Science.gov (United States)

    Sharman, James E; Marwick, Thomas H; Gilroy, Deborah; Otahal, Petr; Abhayaratna, Walter P; Stowasser, Michael

    2013-12-01

    Arm cuff blood pressure (BP) may overestimate cardiovascular risk. Central aortic BP predicts mortality and could be a better method for patient management. We sought to determine the usefulness of central BP to guide hypertension management. This was a prospective, open-label, blinded-end point study in 286 patients with hypertension randomized to treatment decisions guided by best-practice usual care (n=142; using office, home, and 24-hour ambulatory BP) or, in addition, by central BP intervention (n=144; using SphygmoCor). Therapy was reviewed every 3 months for 12 months, and recommendations were provided to each patient and his/her doctor on antihypertensive medication titration. Outcome measures were as follows: medication quantity (daily defined dose), quality of life, and left ventricular mass (3-dimensional echocardiography). There was 92% compliance with recommendations on medication titration, and quality of life improved in both groups (post hoc P0.10), but with intervention there was a significant stepwise decrease in daily defined dose from baseline to 3 months (P=0.008) and each subsequent visit (all P0.05). We conclude that guidance of hypertension management with central BP results in a significantly different therapeutic pathway than conventional cuff BP, with less use of medication to achieve BP control and no adverse effects on left ventricular mass, aortic stiffness, or quality of life.

  8. Aortic valve replacement for Libman-Sacks endocarditis.

    Science.gov (United States)

    Keenan, Jack B; Janardhanan, Rajesh; Larsen, Brandon T; Khalpey, Zain

    2016-10-04

    A 24-year-old man with systemic lupus erythematosus and antiphospholipid syndrome complicated by lupus nephritis presented with acute limb ischaemia secondary to an embolus. Following embolectomy, the patient underwent a transthoracic echocardiogram which revealed a large vegetation on all three cusps of the aortic valve. The patient was taken for an urgent aortic valve replacement with a mechanical valve. Cultures of one cusp remained sterile. Histopathological examination of the remaining two cusps revealed sterile fibrin-rich thrombotic vegetations characteristic of non-bacterial thrombotic endocarditis. 2016 BMJ Publishing Group Ltd.

  9. Cusp effects in meson decays

    Directory of Open Access Journals (Sweden)

    Kubis B.

    2010-04-01

    Full Text Available The pion mass difference generates a pronounced cusp in the π0 π0 invariant mass distribution of K+ → π0 π0 π+ decays. As originally pointed out by Cabibbo, an accurate measurement of the cusp may allow one to pin down the S-wave pion–pion scattering lengths to high precision. We present the non-relativistic effective field theory framework that permits to determine the structure of this cusp in a straightforward manner, including the effects of radiative corrections. Applications of the same formalism to other decay channels, in particular η and η′ decays, are also discussed.

  10. Coronary ostium occlusion by coronary cusp displacement in Williams syndrome.

    Science.gov (United States)

    Shiohama, Tadashi; Fujii, Katsunori; Ebata, Ryota; Funabashi, Nobusada; Matsumiya, Goro; Saito, Yuko Kazato; Takechi, Fumie; Yonemori, Yoko; Nakatani, Yukio; Shimojo, Naoki

    2016-06-01

    Williams syndrome is a contiguous gene deletion syndrome resulting from a heterozygous deletion on chromosome 7q11.23, and is characterized by distinctive facial features and supravalvular aortic stenosis (SVAS). This syndrome rarely presents unpredictable cardiac death, and yet, as illustrated in the present case, it is still not possible to predict it, even on close monitoring. We herein describe the case of a 6-year-old Japanese girl with Williams syndrome, who had sudden cardiac collapse due to cardiac infarction after pharyngitis. Cardiac failure followed a critical course that did not respond to catecholamine support or heart rest with extracardiac mechanical support. Although marked coronary stenosis was not present, the left coronary cusp abnormally adhered to the aortic wall, which may synergistically cause coronary ostium occlusion with SVAS. Altered hemodynamic state, even that caused by the common cold, may lead to critical myocardial events in Williams syndrome with SVAS. © 2015 Japan Pediatric Society.

  11. Impact of primary para-aortic lymphadenectomy on distant failure in locally advanced cervical cancer patients treated in the era of image-guided adaptive brachytherapy.

    Science.gov (United States)

    Chargari, Cyrus; Mazeron, Renaud; Dunant, Ariane; Gouy, Sébastien; Petit, Claire; Maroun, Pierre; Uzan, Catherine; Annede, Pierre; Bentivegna, Enrica; Balleyguier, Corinne; Genestie, Catherine; Pautier, Patricia; Leary, Alexandra; Lhomme, Catherine; Deutsch, Eric; Morice, Philippe; Haie-Meder, Christine

    2016-12-01

    To investigate the impact of a primary para-aortic lymphadenectomy (PAL) in locally advanced cervical cancer patients receiving definitive chemoradiation, we reviewed the clinical records of consecutive patients treated in our Institution and receiving an external beam irradiation followed with an image-guided adaptive brachytherapy for a locally advanced cervical cancer. We examined the impact of performing a primary PAL as part of primary staging for guiding irradiation fields in patients without extra-pelvic PET uptake. The outcome of patients presenting para-aortic lymph node uptake (PALNU) was also examined. 186 patients were identified. Median follow-up was 44.4 months. Patients receiving a primary PAL (PAL group) and those who received upfront pelvic chemoradiation (no-PAL group) did not significantly differ for loco-regional failures. Survival without distant failure (DFFS), including para-aortic relapses, was at 3 years 87 % (95 % CI 84-90 %) in PAL group, 67 % (95 % CI 59-85 %) in the no-PAL group and 44 % (95 % CI 32-66 %) in the PALNU group (p = 0.04 for comparison between PAL and no-PAL groups). In a multivariate model including para-aortic lymphadenectomy, pelvic nodal uptake and high-risk clinical target volume as adjustment variables, a para-aortic lymphadenectomy was significant for DFS (HR = 0.47, 95 % CI 0.26-0.84, p = 0.01). Although confounding factors could account for these retrospective results, a primary PAL with tailored irradiation fields based on para-aortic histological findings seems to be associated with a better control for distant metastases. A randomized trial is testing the benefit of this strategy.

  12. Estudo comparativo da eficácia do etanol e do ácido L-glutâmico na prevenção da calcificação das cúspides e parede aórtica porcina: estudo experimental em ratos Comparative study on the efficacy of ethanol and of l-glutamic acid for preventing calcification of pig cusps and aortic wall: experimental study in rats

    Directory of Open Access Journals (Sweden)

    George Ronald Soncini da ROSA

    2002-06-01

    álcio/ mg tecido, E80% 30 dias (9,47 ± 2,59mg cálcio/mg tecido e E80% 60 dias (23,56±7,75 mg cálcio/mg tecido no grupo de AG 0,8% 15 dias (4,31±0,85 mg cálcio/mg tecido, AG 0,8% 30 dias (7,69±1,48 mg cálcio/mg tecido e AG 0,8% 60 dias (20,50± 1,22 mg cálcio/mg tecido com o grupo controle GDA 15 dias (7,34±1,32 mg cálcio/mg tecido, GDA 30 dias (9,28±0,76 mg cálcio/mg tecido e GDA 60 dias (27,60±1,08 mg cálcio/mg tecido. Na avaliação microscópica da cúspide aórtica houve uma progressiva calcificação naquelas submetidas à fixação com GDA. Este processo foi parcialmente encontrado com o AG 0,8% e totalmente ausente com o E80%. Quanto à avaliação referente aos segmentos da parede aórtica, também evidenciou-se progressiva calcificação, não sendo inibida pelos tratamentos com AG 0,8% e E80%. CONCLUSÕES: O pré-tratamento com etanol a 80% inibiu a calcificação nas cúspides aórticas porcinas, entretanto, não teve a mesma eficácia na parede aórtica. Contudo, o ácido L-glutâmico a 0,8% demonstrou minimizar a calcificação na parede aórtica. Estudos devem ser feitos para evidenciar se a ação anticalcificante do etanol a 80% mantém-se nas biopróteses aórticas porcinas se estas forem implantadas no sistema circulatório.INTRODUCTION: The glutataldehyde (GDA treated pigs cusps are one of most employed tissues in bioprosthesis, but is late post-implant calcification is main cause of its failure. BACKGROUND: This study aims at comparing and analyzing two methods (ethanol 80% and l-glutamic acid 0.8% to prevent calcification in pig cusps and aortic wall implanted subcutaneously in rats, the cusps and aortic wall segments of the control were in glutaraldehyde (GDA, during a 15, 30 and 60 days period after the implant. MATERIAL AND METHODS: We used 45 young rats, distributed in 3 groups of 15 rats each, which in turn were subdivided in 3 subgroups of 5 rats each, in which we implanted one cusp and one aortic wall segment in 2 subcutaneous

  13. Double cusp encounter by Cluster: double cusp or motion of the cusp?

    Czech Academy of Sciences Publication Activity Database

    Escoubet, C. P.; Berchem, J.; Trattner, K. J.; Pitout, F.; Richard, R.; Taylor, M. G. G. T.; Souček, Jan; Grison, Benjamin; Laakso, H.; Masson, A.; Dunlop, M.; Dandouras, I.; Reme, H.; Fazakerley, A.; Daly, P.

    2013-01-01

    Roč. 31, č. 4 (2013), s. 713-723 ISSN 0992-7689 R&D Projects: GA ČR(CZ) GPP209/11/P848 Institutional support: RVO:68378289 Keywords : Magnetospheric physics * Magnetopause * cusp * boundary layers Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 1.676, year: 2013 http://www.ann-geophys.net/31/713/2013/

  14. Cusps in K->3{pi} decays

    Energy Technology Data Exchange (ETDEWEB)

    Colangelo, G. [Institute for Theoretical Physics, University of Bern, Sidlerstr. 5, CH-3012 Bern (Switzerland); Gasser, J. [Institute for Theoretical Physics, University of Bern, Sidlerstr. 5, CH-3012 Bern (Switzerland); Kubis, B. [Helmholtz-Institut fuer Strahlen- und Kernphysik, Universitaet Bonn, Nussallee 14-16, D-53115 Bonn (Germany); Rusetsky, A. [Helmholtz-Institut fuer Strahlen- und Kernphysik, Universitaet Bonn, Nussallee 14-16, D-53115 Bonn (Germany)]. E-mail: rusetsky@itkp.uni-bonn.de

    2006-07-06

    pion mass difference generates a pronounced cusp in K->3{pi} decays. As has recently been pointed out by Cabibbo and Isidori, an accurate measurement of the cusp may allow one to pin down the S-wave {pi}{pi} scattering lengths to high precision. Here, we present and illustrate an effective field theory framework that allows one to determine the structure of this cusp in a straightforward manner. The strictures imposed by analyticity and unitarity are respected automatically.

  15. Cusps in K->3π decays

    International Nuclear Information System (INIS)

    Colangelo, G.; Gasser, J.; Kubis, B.; Rusetsky, A.

    2006-01-01

    The pion mass difference generates a pronounced cusp in K->3π decays. As has recently been pointed out by Cabibbo and Isidori, an accurate measurement of the cusp may allow one to pin down the S-wave ππ scattering lengths to high precision. Here, we present and illustrate an effective field theory framework that allows one to determine the structure of this cusp in a straightforward manner. The strictures imposed by analyticity and unitarity are respected automatically

  16. Magnetic field structure influence on primary electron cusp losses for micro-scale discharges

    International Nuclear Information System (INIS)

    Dankongkakul, Ben; Araki, Samuel J.; Wirz, Richard E.

    2014-01-01

    An experimental effort was used to examine the primary electron loss behavior for micro-scale (≲3 cm diameter) discharges. The experiment uses an electron flood gun source and an axially aligned arrangement of ring-cusps to guide the electrons to a downstream point cusp. Measurements of the electron current collected at the point cusp show an unexpectedly complex loss pattern with azimuthally periodic structures. Additionally, in contrast to conventional theory for cusp losses, the overall radii of the measured collection areas are over an order of magnitude larger than the electron gyroradius. Comparing these results to Monte Carlo particle tracking simulations and a simplified analytical analysis shows that azimuthal asymmetries of the magnetic field far upstream of the collection surface can substantially affect the electron loss structure and overall loss area

  17. Transretroperitoneal CT-guided Embolization of Growing Internal Iliac Artery Aneurysm after Repair of Abdominal Aortic Aneurysm: A Transretroperitoneal Approach with Intramuscular Lidocaine Injection Technique

    Energy Technology Data Exchange (ETDEWEB)

    Park, Joon Young, E-mail: pjy1331@hanmail.net; Kim, Shin Jung, E-mail: witdd2@hanmail.net; Kim, Hyoung Ook, E-mail: chaos821209@hanmail.net [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Kim, Yong Tae, E-mail: mono-111@hanmail.net [Chonnam National University Hwasun Hospital, Department of Radiology (Korea, Republic of); Lim, Nam Yeol, E-mail: apleseed@hanmail.net; Kim, Jae Kyu, E-mail: kjkrad@jnu.ac.kr [Chonnam National University Hospital, Department of Radiology (Korea, Republic of); Chung, Sang Young, E-mail: sycpvts@jnu.ac.kr; Choi, Soo Jin Na, E-mail: choisjn@jnu.ac.kr; Lee, Ho Kyun, E-mail: mhaha@hanmail.net [Chonnam National University Hospital, Department of Surgery (Korea, Republic of)

    2015-02-15

    This study was designed to evaluate the efficacy and safety of CT-guided embolization of internal iliac artery aneurysm (IIAA) after repair of abdominal aortic aneurysm by transretroperitoneal approach using the lidocaine injection technique to iliacus muscle, making window for safe needle path for three patients for whom CT-guided embolization of IIAA was performed by transretroperitoneal approach with intramuscular lidocaine injection technique. Transretroperitoneal access to the IIAA was successful in all three patients. In all three patients, the IIAA was first embolized using microcoils. The aneurysmal sac was then embolized with glue and coils without complication. With a mean follow-up of 7 months, the volume of the IIAAs remained stable without residual endoleaks. Transretroperitoneal CT-guided embolization of IIAA using intramuscular lidocaine injection technique is effective, safe, and results in good outcome.

  18. Electromagnetic Ion Cyclotron Waves in the High Altitude Cusp: Polar Observations

    Science.gov (United States)

    Le, Guan; Blanco-Cano, X.; Russell, C. T.; Zhou, X.-W.; Mozer, F.; Trattner, K. J.; Fuselier, S. A.; Anderson, B. J.; Vondrak, Richard R. (Technical Monitor)

    2001-01-01

    High-resolution magnetic field data from the Polar Magnetic Field Experiment (MFE) show that narrow band waves at frequencies approximately 0.2 to 3 Hz are a permanent feature in the vicinity of the polar cusp. The waves have been found in the magnetosphere adjacent to the cusp (both poleward and equatorward of the cusp) and in the cusp itself. The occurrence of waves is coincident with depression of magnetic field strength associated with enhanced plasma density, indicating the entry of magnetosheath plasma into the cusp region. The wave frequencies are generally scaled by the local proton cyclotron frequency, and vary between 0.2 and 1.7 times local proton cyclotron frequency. This suggests that the waves are generated in the cusp region by the precipitating magnetosheath plasma. The properties of the waves are highly variable. The waves exhibit both lefthanded and right-handed polarization in the spacecraft frame. The propagation angles vary from nearly parallel to nearly perpendicular to the magnetic field. We find no correlation among wave frequency, propagation angle and polarization. Combined magnetic field and electric field data for the waves indicate that the energy flux of the waves is guided by the background magnetic field and points downward toward the ionosphere.

  19. Electromagnetic Ion Cyclotron Waves in the High-Altitude Cusp: Polar Observations

    Science.gov (United States)

    Le, G.; Blanco-Cano, X.; Russell, C. T.; Zhou, X.-W.; Mozer, F.; Trattner, K. J.; Fuselier, S. A.; Anderson, B. J.

    2005-01-01

    High-resolution magnetic field data from the Polar Magnetic Field Experiment (MFE) show that narrow-band waves at frequencies approx. 0.2-3 Hz are a permanent feature in the vicinity of the polar cusp. The waves have been found in the magnetosphere adjacent to the cusp (both poleward and equatorward of the cusp) and in the cusp itself. The occurrence of waves is coincident with depression of magnetic field strength associated with enhanced plasma density, indicating the entry of magnetosheath plasma into the cusp region. The wave frequencies are generally scaled by the local proton cyclotron frequency and vary between 0.2 and 1.7 times local proton cyclotron frequency. This suggests that the waves are generated in the cusp region by the precipitating magnetosheath plasma. The properties of the waves are highly variable. The waves exhibit both left-handed and right-handed polarization in the spacecraft frame. The propagation angles vary from nearly parallel to nearly perpendicular to the magnetic field. We find no correlation among wave frequency, propagation angle, and polarization. Combined magnetic field and electric field data for the waves indicate that the energy flux of the waves is guided by the background magnetic field and points downward toward the ionosphere.

  20. Dayside merging and cusp geometry

    International Nuclear Information System (INIS)

    Crooker, N.U.

    1979-01-01

    Geometrical considerations are presented to show that dayside magnetic merging when constrained to act only where the fields are antiparallel results in lines of merging that converge at the polar cusps. An important consequence of this geometry is that no accelerated flows are predicted across the dayside magnetopause. Acceleration owing to merging acts in opposition to the magnetosheath flow at the merging point and produces the variably directed, slower-than-magnetosheath flows observed in the entry layer. Another consequence of the merging geometry is that much of the time closed field lines constitute the subsolar region of the magnetopause. The manner in which the polar cap convection patterns predicted by the proposed geometry change as the interplanetary field is rotated through 360 0 provides a unifying description of how the observed single circular vortex and the crescent-shaped double vortex patterns mutually evolve under the influence of a single operating principle

  1. First Magnetic Resonance Imaging-Guided Aortic Stenting and Cava Filter Placement Using a Polyetheretherketone-Based Magnetic Resonance Imaging-Compatible Guidewire in Swine: Proof of Concept

    International Nuclear Information System (INIS)

    Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H.; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M.; Borm, Paul J. A.; Jacob, Augustinus L.; Bilecen, Deniz

    2009-01-01

    The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

  2. First magnetic resonance imaging-guided aortic stenting and cava filter placement using a polyetheretherketone-based magnetic resonance imaging-compatible guidewire in swine: proof of concept.

    Science.gov (United States)

    Kos, Sebastian; Huegli, Rolf; Hofmann, Eugen; Quick, Harald H; Kuehl, Hilmar; Aker, Stephanie; Kaiser, Gernot M; Borm, Paul J A; Jacob, Augustinus L; Bilecen, Deniz

    2009-05-01

    The purpose of this study was to demonstrate feasibility of percutaneous transluminal aortic stenting and cava filter placement under magnetic resonance imaging (MRI) guidance exclusively using a polyetheretherketone (PEEK)-based MRI-compatible guidewire. Percutaneous transluminal aortic stenting and cava filter placement were performed in 3 domestic swine. Procedures were performed under MRI-guidance in an open-bore 1.5-T scanner. The applied 0.035-inch guidewire has a PEEK core reinforced by fibres, floppy tip, hydrophilic coating, and paramagnetic markings for passive visualization. Through an 11F sheath, the guidewire was advanced into the abdominal (swine 1) or thoracic aorta (swine 2), and the stents were deployed. The guidewire was advanced into the inferior vena cava (swine 3), and the cava filter was deployed. Postmortem autopsy was performed. Procedural success, guidewire visibility, pushability, and stent support were qualitatively assessed by consensus. Procedure times were documented. Guidewire guidance into the abdominal and thoracic aortas and the inferior vena cava was successful. Stent deployments were successful in the abdominal (swine 1) and thoracic (swine 2) segments of the descending aorta. Cava filter positioning and deployment was successful. Autopsy documented good stent and filter positioning. Guidewire visibility through applied markers was rated acceptable for aortic stenting and good for venous filter placement. Steerability, pushability, and device support were good. The PEEK-based guidewire allows either percutaneous MRI-guided aortic stenting in the thoracic and abdominal segments of the descending aorta and filter placement in the inferior vena cava with acceptable to good device visibility and offers good steerability, pushability, and device support.

  3. Aortic insufficiency

    Science.gov (United States)

    ... page, please enable JavaScript. Aortic insufficiency is a heart valve disease in which the aortic valve does not close ... aortic insufficiency Images Aortic insufficiency References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil ...

  4. Correction of aortic insufficiency with an external adjustable prosthetic aortic ring.

    Science.gov (United States)

    Gogbashian, Andrew; Ghanta, Ravi K; Umakanthan, Ramanan; Rangaraj, Aravind T; Laurence, Rita G; Fox, John A; Cohn, Lawrence H; Chen, Frederick Y

    2007-09-01

    Less invasive, valve-sparing options are needed for patients with aortic insufficiency (AI). We sought to evaluate the feasibility of reducing AI with an external adjustable aortic ring in an ovine model. To create AI, five sheep underwent patch plasty enlargement of the aortic annulus and root by placement of a 10 x 15 mm pericardial patch between the right and noncoronary cusps. An adjustable external ring composed of a nylon band was fabricated and placed around the aortic root. Aortic flow, aortic pressure, and left ventricular pressures were measured with the ring loose (off) and tightened (on). Mean regurgitant orifice area decreased by 86%, from 0.07 +/- 0.03 cm2 (ring loose, off) to 0.01 +/- 0.00 cm2 (ring tightened, on) [p < 0.01]. The regurgitant fraction decreased from 18 +/- 4% to 2 +/- 1% [p < 0.01]. The ring did not significantly affect stroke volume and aortic pressure. An ovine model of aortic root dilatation resulting in acute AI has been developed. In this model, application of an external, adjustable constricting aortic ring eliminated AI. An aortic ring may be a useful adjunct in reducing AI secondary to annular dilatation.

  5. Density Variations in the Earth's Magnetospheric Cusps

    Science.gov (United States)

    Walsh, B. M.; Niehof, J.; Collier, M. R.; Welling, D. T.; Sibeck, D. G.; Mozer, F. S.; Fritz, T. A.; Kuntz, K. D.

    2016-01-01

    Seven years of measurements from the Polar spacecraft are surveyed to monitor the variations of plasma density within the magnetospheric cusps. The spacecraft's orbital precession from 1998 through 2005 allows for coverage of both the northern and southern cusps from low altitude out to the magnetopause. In the mid- and high- altitude cusps, plasma density scales well with the solar wind density (n(sub cusp)/n(sub sw) approximately 0.8). This trend is fairly steady for radial distances greater then 4 R(sub E). At low altitudes (r less than 4R(sub E)) the density increases with decreasing altitude and even exceeds the solar wind density due to contributions from the ionosphere. The density of high charge state oxygen (O(greater +2) also displays a positive trend with solar wind density within the cusp. A multifluid simulation with the Block-Adaptive-Tree Solar Wind Roe-Type Upwind Scheme MHD model was run to monitor the relative contributions of the ionosphere and solar wind plasma within the cusp. The simulation provides similar results to the statistical measurements from Polar and confirms the presence of ionospheric plasma at low altitudes.

  6. Towards real-time cardiovascular magnetic resonance-guided transarterial aortic valve implantation: In vitro evaluation and modification of existing devices

    Directory of Open Access Journals (Sweden)

    Ladd Mark E

    2010-10-01

    Full Text Available Abstract Background Cardiovascular magnetic resonance (CMR is considered an attractive alternative for guiding transarterial aortic valve implantation (TAVI featuring unlimited scan plane orientation and unsurpassed soft-tissue contrast with simultaneous device visualization. We sought to evaluate the CMR characteristics of both currently commercially available transcatheter heart valves (Edwards SAPIEN™, Medtronic CoreValve® including their dedicated delivery devices and of a custom-built, CMR-compatible delivery device for the Medtronic CoreValve® prosthesis as an initial step towards real-time CMR-guided TAVI. Methods The devices were systematically examined in phantom models on a 1.5-Tesla scanner using high-resolution T1-weighted 3D FLASH, real-time TrueFISP and flow-sensitive phase-contrast sequences. Images were analyzed for device visualization quality, device-related susceptibility artifacts, and radiofrequency signal shielding. Results CMR revealed major susceptibility artifacts for the two commercial delivery devices caused by considerable metal braiding and precluding in vivo application. The stainless steel-based Edwards SAPIEN™ prosthesis was also regarded not suitable for CMR-guided TAVI due to susceptibility artifacts exceeding the valve's dimensions and hindering an exact placement. In contrast, the nitinol-based Medtronic CoreValve® prosthesis was excellently visualized with delineation even of small details and, thus, regarded suitable for CMR-guided TAVI, particularly since reengineering of its delivery device toward CMR-compatibility resulted in artifact elimination and excellent visualization during catheter movement and valve deployment on real-time TrueFISP imaging. Reliable flow measurements could be performed for both stent-valves after deployment using phase-contrast sequences. Conclusions The present study shows that the Medtronic CoreValve® prosthesis is potentially suited for real-time CMR-guided placement

  7. The ASACUSA CUSP: an antihydrogen experiment

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, N., E-mail: kuroda@phys.c.u-tokyo.ac.jp [University of Tokyo, Graduate School of Arts and Sciences (Japan); Ulmer, S. [RIKEN, Ulmer Initiative Research Unit (Japan); Murtagh, D. J.; Gorp, S. Van [RIKEN, Atomic Physics Laboratory (Japan); Nagata, Y. [Tokyo University of Agriculture and Technology, Department of Applied Physics (Japan); Diermaier, M. [Boltzmangasse 3, Stefan Meyer Institut für Subatomare Physik (Austria); Federmann, S. [CERN (Switzerland); Leali, M. [Università di Brescia & Instituto Nazionale di Fisica Nucleare, Dipartimento di Chimica e Fisica per l’Ingegneria e per i Materiali (Italy); Malbrunot, C. [CERN (Switzerland); Mascagna, V. [Università di Brescia & Instituto Nazionale di Fisica Nucleare, Dipartimento di Chimica e Fisica per l’Ingegneria e per i Materiali (Italy); Massiczek, O. [Boltzmangasse 3, Stefan Meyer Institut für Subatomare Physik (Austria); Michishio, K. [Tokyo University of Science, Department of Physics (Japan); Mizutani, T. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Mohri, A. [Kyoto University, Graduate School of Human and Environmental Sciences (Japan); Nagahama, H.; Ohtsuka, M. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Radics, B. [RIKEN, Atomic Physics Laboratory (Japan); Sakurai, S. [Hiroshima University, Graduate School of Advanced Science of Matter (Japan); Sauerzopf, C.; Suzuki, K. [Boltzmangasse 3, Stefan Meyer Institut für Subatomare Physik (Austria); and others

    2015-11-15

    In order to test CPT symmetry between antihydrogen and its counterpart hydrogen, the ASACUSA collaboration plans to perform high precision microwave spectroscopy of ground-state hyperfine splitting of antihydrogen atom in-flight. We have developed an apparatus (“cusp trap”) which consists of a superconducting anti-Helmholtz coil and multiple ring electrodes. For the preparation of slow antiprotons and positrons, Penning-Malmberg type traps were utilized. The spectrometer line was positioned downstream of the cusp trap. At the end of the beamline, an antihydrogen beam detector was located, which comprises an inorganic Bismuth Germanium Oxide (BGO) single-crystal scintillator housed in a vacuum duct and surrounding plastic scintillators. A significant fraction of antihydrogen atoms flowing out the cusp trap were detected.

  8. Incidence and progression of mild aortic regurgitation after Tirone David reimplantation valve-sparing aortic root replacement.

    Science.gov (United States)

    Stephens, Elizabeth H; Liang, David H; Kvitting, John-Peder Escobar; Kari, Fabian A; Fischbein, Michael P; Mitchell, R Scott; Miller, D Craig

    2014-01-01

    The study objective was to determine whether recurrent or residual mild aortic regurgitation, which occurs after valve-sparing aortic root replacement, progresses over time. Between 2003 and 2008, 154 patients underwent Tirone David-V valve-sparing aortic root replacement; 96 patients (62%) had both 1-year (median, 12 ± 4 months) and mid-term (62 ± 22 months) transthoracic echocardiograms available for analysis. Age of patients averaged 38 ± 13 years, 71% were male, 31% had a bicuspid aortic valve, 41% had Marfan syndrome, and 51% underwent aortic valve repair, predominantly cusp free margin shortening. Forty-one patients (43%) had mild aortic regurgitation on 1-year echocardiogram. In 85% of patients (n = 35), mild aortic regurgitation remained stable on the most recent echocardiogram (median, 57 ± 20 months); progression to moderate aortic regurgitation occurred in 5 patients (12%) at a median of 28 ± 18 months and remained stable thereafter; severe aortic regurgitation developed in 1 patient, eventually requiring reoperation. Five patients (5%) had moderate aortic regurgitation at 1 year, which did not progress subsequently. Two patients (2%) had more than moderate aortic regurgitation at 1 year, and both ultimately required reoperation. Although mild aortic regurgitation occurs frequently after valve-sparing aortic root replacement, it is unlikely to progress over the next 5 years and should not be interpreted as failure of the valve-preservation concept. Further, we suggest that mild aortic regurgitation should not be considered nonstructural valve dysfunction, as the 2008 valve reporting guidelines would indicate. We need 10- to 15-year follow-up to learn the long-term clinical consequences of mild aortic regurgitation early after valve-sparing aortic root replacement. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  9. Characteristic Morphologies of the Bicuspid Aortic Valve in Patients with Genetic Syndromes.

    Science.gov (United States)

    Niaz, Talha; Poterucha, Joseph T; Olson, Timothy M; Johnson, Jonathan N; Craviari, Cecilia; Nienaber, Thomas; Palfreeman, Jared; Cetta, Frank; Hagler, Donald J

    2018-02-01

    In patients with bicuspid aortic valve (BAV), complications including progressive aortic stenosis and aortic dilatation develop over time. The morphology of cusp fusion is one of the determinants of the type and severity of these complications. We present the association of morphology of cusp fusion in BAV patients with distinctive genetic syndromes. The Mayo Clinic echocardiography database was retrospectively reviewed to identify patients (age ≤ 22 years) diagnosed with BAV from 1990 to 2016. Cusp fusion morphology was determined from the echocardiographic studies, while coexisting cardiac defects and genetic syndromes were determined from chart review. A total of 1,037 patients with BAV were identified: 550 (53%) had an isolated BAV, 299 (29%) had BAV and a coexisting congenital heart defect, and 188 (18%) had BAV and a coexisting genetic syndrome or disorder. There were no differences in distribution of morphology across the three groups. However, right-noncoronary (RN) cusp fusion was the predominant morphology associated with Down syndrome (P = .002) and right-left (RL) cusp fusion was the predominant morphology associated with Turner syndrome (P = .02), DiGeorge syndrome (P = .02), and Shone syndrome (P = .0007), when compared with valve morphology in patients with isolated BAV. Isolated BAV patients with RN cusp fusion had larger ascending aorta diameter (P = .001) and higher number of patients with ≥ moderate aortic regurgitation (P = .02), while those with RL cusp fusion had larger sinus of Valsalva diameter (P = .0006). Morphological subtypes of BAV are associated with different genetic syndromes, suggesting distinct perturbations of developmental pathways in aortic valve malformation. Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

  10. Opening the cusp. [using magnetic field topology

    Science.gov (United States)

    Crooker, N. U.; Toffoletto, F. R.; Gussenhoven, M. S.

    1991-01-01

    This paper discusses the magnetic field topology (determined by the superposition of dipole, image, and uniform fields) for mapping the cusp to the ionosphere. The model results are compared to both new and published observations and are then used to map the footprint of a flux transfer event caused by a time variation in the merging rate. It is shown that the cusp geometry distorts the field lines mapped from the magnetopause to yield footprints with dawn and dusk protrusions into the region of closed magnetic flux.

  11. A study of extracellular matrix remodeling in aortic heart valves using a novel biaxial stretch bioreactor.

    Science.gov (United States)

    Lei, Ying; Masjedi, Shirin; Ferdous, Zannatul

    2017-11-01

    In aortic valves, biaxial cyclic stretch is known to modulate cell differentiation, extracellular matrix (ECM) synthesis and organization. We designed a novel bioreactor that can apply independent and precise stretch along radial and circumferential directions in a tissue culture environment. While this bioreactor can be used for either native or engineered tissues, this study determined matrix remodeling and strain distribution of aortic cusps after culturing under biaxial stretch for 14 days. The contents of collagen and glycosaminoglycans were determined using standard biochemical assays and compared with fresh controls. Strain fields in static cusps were more uniform than those in stretched cusps, which indicated degradation of the ECM fibers. The glycosaminoglycan content was significantly elevated in the static control as compared to fresh or stretched cusps, but no difference was observed in collagen content among the groups. The strain profile of freshly isolated fibrosa vs. ventricularis and left, right, and noncoronary cusps were also determined by Digital Image Correlation technique. Distinct strain patterns were observed under stretch on fibrosa and ventricularis sides and among the three cusps. This work highlights the critical role of the anisotropic ECM structure for proper functions of native aortic valves and the beneficial effects of biaxial stretch for maintenance of the native ECM structure. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Turbulence in a cusp Q device

    DEFF Research Database (Denmark)

    D'Angelo, N.; Pécseli, Hans; Petersen, P. I.

    1974-01-01

    Spectral measurements are reported of plasma turbulence in the Cs plasma of a Q device, modified to a magnetic cusp geometry. The excitation mechanism for the fluctuations appears to be the centrifugal instability discussed by Chen. A transition from an f−5 to an f−3 power spectrum is observed...

  13. The Magnetospheric Cusps Structure and Dynamics

    CERN Document Server

    Fritz, Theodore A

    2005-01-01

    This collection of papers will address the question "What is the Magnetospheric Cusp?" and what is its role in the coupling of the solar wind to the magnetosphere as well as its role in the processes of particle transport and energization within the magnetosphere. The cusps have traditionally been described as narrow funnel-shaped regions that provide a focus of the Chapman-Ferraro currents that flow on the magnetopause, a boundary between the cavity dominated by the geomagnetic field (i.e., the magnetosphere) and the external region of the interplanetary medium. Measurements from a number of recent satellite programs have shown that the cusp is not confined to a narrow region near local noon but appears to encompass a large portion of the dayside high-latitude magnetosphere and it appears that the cusp is a major source region for the production of energetic charged particles for the magnetosphere. Audience: This book will be of interest to space science research organizations in governments and industries, ...

  14. ANALYSIS OF TRANSONIC FLOW PAST CUSPED AIRFOILS

    Directory of Open Access Journals (Sweden)

    Jiří Stodůlka

    2015-06-01

    Full Text Available Transonic flow past two cusped airfoils is numerically solved and achieved results are analyzed by means of flow behavior and oblique shocks formation.Regions around sharp trailing edges are studied in detail and parameters of shock waves are solved and compared using classical shock polar approach and verified by reduction parameters for symmetric configurations.

  15. Dynamics of Triaxial Elliptical Galaxies with Cusps

    Science.gov (United States)

    Fridman, Tema

    1997-06-01

    The gravitational potentials, orbital properties, and self-consistent equilibria of triaxial stellar systems with central density cusps are examined. Observations of the nuclei of early-type galaxies with the Hubble Space Telescope (HST) suggest that their surface brightness profiles fall into two categories: the 'cores' and the 'power laws.' We show that this dichotomy results from an optical illusion associated with projection onto the plane of the sky. Galaxies of both types have deprojected density profiles that are well-described as power-laws at small radii, with slopes 0≤γ 0.8. Regular box orbits, which depend for their existence on the stability of the long-axis orbit, do not exist in these models. The next-lowest resonance, the 2: 1 banana family, is present whenever the long-axis orbit is unstable. However the banana orbits have a very restricted range of shapes and are thicker than the model isodensity surfaces when c/a/ ~self-consistent models of triaxial galaxies with Dehnen's (1993) density law. We consider central density cusps defined by γ = 1 (weak cusp) and γ = 2 (strong cusp). These values are representative of the nuclear density profiles of bright ('core') and faint ('power-law') galaxies as observed with HST. Both mass models have short-to-long axis ratios of 1:2 and are maximally triaxial. We compute libraries of ~7000 orbits in each of the models and map them as a function of energy. A large fraction of the orbits in both model potentials are stochastic, which diffuse relatively quickly through their allowed phase-space in the strong-cusp potential (~103 dynamical times) and more slowly in the weak-cusp potential (104 dynamical times or longer). Attempts to construct self-consistent solutions using just the regular orbits failed for both mass models. Quasi-equilibrium solutions that include the stochastic orbits exist for both models; however, real galaxies constructed in this way would evolve near the center due to the continued

  16. Inhibitory role of Notch1 in calcific aortic valve disease.

    Directory of Open Access Journals (Sweden)

    Asha Acharya

    Full Text Available Aortic valve calcification is the most common form of valvular heart disease, but the mechanisms of calcific aortic valve disease (CAVD are unknown. NOTCH1 mutations are associated with aortic valve malformations and adult-onset calcification in families with inherited disease. The Notch signaling pathway is critical for multiple cell differentiation processes, but its role in the development of CAVD is not well understood. The aim of this study was to investigate the molecular changes that occur with inhibition of Notch signaling in the aortic valve. Notch signaling pathway members are expressed in adult aortic valve cusps, and examination of diseased human aortic valves revealed decreased expression of NOTCH1 in areas of calcium deposition. To identify downstream mediators of Notch1, we examined gene expression changes that occur with chemical inhibition of Notch signaling in rat aortic valve interstitial cells (AVICs. We found significant downregulation of Sox9 along with several cartilage-specific genes that were direct targets of the transcription factor, Sox9. Loss of Sox9 expression has been published to be associated with aortic valve calcification. Utilizing an in vitro porcine aortic valve calcification model system, inhibition of Notch activity resulted in accelerated calcification while stimulation of Notch signaling attenuated the calcific process. Finally, the addition of Sox9 was able to prevent the calcification of porcine AVICs that occurs with Notch inhibition. In conclusion, loss of Notch signaling contributes to aortic valve calcification via a Sox9-dependent mechanism.

  17. [Pannus Formation Two Years after Bioprosthetic Aortic Valve Implantation;Report of a Case].

    Science.gov (United States)

    Ono, Kimiyo; Kuroda, Hiroaki

    2015-08-01

    We report a case of early deterioration of the bioprosthetic aortic valve 23 months postoperatively. A 77-year-old man who had undergone aortic valve replacement with a 23-mm Epic valve( St. Jude Medical [SJM])presented to us after a syncopal episode. Echocardiography revealed severe aortic stenosis, and redo aortic valve replacement with a 21-mm SJM mechanical valve was performed. All 3 cusps of the tissue valve were thickened by fibrous pannus overgrowth. Neither calcification nor invasion of inflammatory cells was observed. The cause of pannus formation at such an early stage after implantation remains unknown.

  18. Tooth cusp sharpness as a dietary correlate in great apes.

    Science.gov (United States)

    Berthaume, Michael A

    2014-02-01

    Mammalian molars have undergone heavy scrutiny to determine correlates between morphology and diet. Here, the relationship between one aspect of occlusal morphology, tooth cusp radius of curvature (RoC), and two broad dietary categories, folivory and frugivory, is analyzed in apes. The author hypothesizes that there is a relationship between tooth cusp RoC and diet, and that folivores have sharper teeth than frugivores, and further test the correlation between tooth cusp RoC and tooth cusp size. Eight measures of tooth cusp RoC (two RoCs per cusp) were taken from 53 M(2) s from four species and subspecies of frugivorous apes (Pongo pygmaeus, Pan troglodytes troglodytes, Pan troglodytes schweinfurthii, and Gorilla gorilla gorilla) and two subspecies of folivorous apes (Gorilla beringei beringei, and Gorilla beringei graueri). Phylogenetically corrected ANOVAs were run on the full dataset and several subsets of the full dataset, revealing that, when buccolingual RoCs are taken into account, tooth cusp RoCs can successfully differentiate folivores and frugivores. PCAs revealed that folivores consistently had duller teeth than frugivores. In addition, a weak, statistically significant positive correlation exists between tooth cusp size and tooth cusp RoC. The author hypothesizes differences in tooth cusp RoC are correlated with wear rates, where, per vertical unit of wear, duller cusps will have a longer length of exposed enamel ridge than sharper cusps. More data need to be gathered to determine if the correlation between tooth cusp RoC and tooth cusp size holds true when small primates are considered. Copyright © 2013 Wiley Periodicals, Inc.

  19. Survival and freedom from aortic valve-related reoperation after valve-sparing aortic root replacement in 1015 patients.

    Science.gov (United States)

    Kari, Fabian A; Doll, Kai-Nicolas; Hemmer, Wolfgang; Liebrich, Markus; Sievers, Hans-Hinrich; Richardt, Doreen; Reichenspurner, Hermann; Detter, Christian; Siepe, Matthias; Czerny, Martin; Beyersdorf, Friedhelm

    2016-04-01

    The aim of this study was to characterize mortality and aortic valve replacement after valve-sparing aortic root replacement (V-SARR) in a multicentre cohort. Between 1994 and 2014, 1015 patients had V-SARR with (n = 288, 28%) or without cusp/commissure repair (n = 727, 72%) at the centres of Lübeck (n = 343, 34%), Stuttgart (n = 346, 34%), Hamburg (n = 109, 11%) and Freiburg (n = 217, 21%), Germany. Comparative survival of an age- and gender-matched general population was calculated. Log-rank tests and multiple logistic regression were used to identify risk factors. The mean follow-up was 5.2 ± 3.9 years. Cumulative follow-up comprised 2933 patient-years. Early survival was 98%. NYHA status and aneurysm size were predictive of death during mid-term follow-up (P = 0.025). Freedom from aortic valve replacement was 90% at 8 years, with the type of V-SARR (root remodelling, David II) being a risk factor (P = 0.015). Bicuspid aortic valve (P = 0.26) and initial valve function (P = 0.4) did not impact reoperation. The need of additional valve repair (cusps/commissures) was not linked to reoperation: freedom from aortic valve replacement at 8 years was 84% if cusp repair was performed versus 90% if V-SARR alone was performed (P = 0.218). Marfan syndrome had no impact on survival or on aortic valve replacement. Mid-term survival of patients after V-SARR is comparable with that of a matched general population. The regurgitant bicuspid aortic valve is a favourable substrate for V-SARR. Prophylactic surgery should be performed before symptoms or large aneurysms are present to achieve optimal mid-term outcomes. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. Resurgence of the cusp anomalous dimension

    Energy Technology Data Exchange (ETDEWEB)

    Dorigoni, Daniele; Hatsuda, Yasuyuki [DESY Theory Group, DESY Hamburg,Notkestrasse 85, D-22603 Hamburg (Germany)

    2015-09-21

    We revisit the strong coupling limit of the cusp anomalous dimension in planar N=4 super Yang-Mills theory. It is known that the strong coupling expansion is asymptotic and non-Borel summable. As a consequence, the cusp anomalous dimension receives non-perturbative corrections, and the complete strong coupling expansion should be a resurgent transseries. We reveal that the perturbative and non-perturbative parts in the transseries are closely interrelated. Solving the Beisert-Eden-Staudacher equation systematically, we analyze in detail the large order behavior in the strong coupling perturbative expansion and show that the non-perturbative information is indeed encoded there. An ambiguity of (lateral) Borel resummations of the perturbative expansion is precisely canceled by the contributions from the non-perturbative sectors, and the final result is real and unambiguous.

  1. Resurgence of the Cusp Anomalous Dimension

    Energy Technology Data Exchange (ETDEWEB)

    Dorigoni, Daniele; Hatsuda, Yasuyuki [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany). Theory Group

    2015-06-15

    We revisit the strong coupling limit of the cusp anomalous dimension in planar N=4 super Yang-Mills theory. It is known that the strong coupling expansion is asymptotic and non-Borel summable. As a consequence, the cusp anomalous dimension receives non-perturbative corrections, and the complete strong coupling expansion should be a resurgent transseries. We reveal that the perturbative and non-perturbative parts in the transseries are closely interrelated. Solving the Beisert-Eden-Staudacher equation systematically, we analyze in detail the large order behavior in the strong coupling perturbative expansion and show that the non-perturbative information is indeed encoded there. An ambiguity of (lateral) Borel resummations of the perturbative expansion is precisely canceled by the contributions from the non-perturbative sectors, and the final result is real and unambiguous.

  2. Resurgence of the Cusp Anomalous Dimension

    International Nuclear Information System (INIS)

    Dorigoni, Daniele; Hatsuda, Yasuyuki

    2015-06-01

    We revisit the strong coupling limit of the cusp anomalous dimension in planar N=4 super Yang-Mills theory. It is known that the strong coupling expansion is asymptotic and non-Borel summable. As a consequence, the cusp anomalous dimension receives non-perturbative corrections, and the complete strong coupling expansion should be a resurgent transseries. We reveal that the perturbative and non-perturbative parts in the transseries are closely interrelated. Solving the Beisert-Eden-Staudacher equation systematically, we analyze in detail the large order behavior in the strong coupling perturbative expansion and show that the non-perturbative information is indeed encoded there. An ambiguity of (lateral) Borel resummations of the perturbative expansion is precisely canceled by the contributions from the non-perturbative sectors, and the final result is real and unambiguous.

  3. Cusps in KL→3π decays

    International Nuclear Information System (INIS)

    Bissegger, M.; Fuhrer, A.; Gasser, J.; Kubis, B.; Rusetsky, A.

    2008-01-01

    The pion mass difference generates a pronounced cusp in K→3π decays, the strength of which is related to the ππ S-wave scattering lengths. We apply an effective field theory framework developed earlier to evaluate the amplitudes for K L →3π decays in a systematic manner, where the strictures imposed by analyticity and unitarity are respected automatically. The amplitudes for the decay η→3π are also given

  4. Cost estimate for electrostatically plugged cusp reactor

    International Nuclear Information System (INIS)

    Dolan, T.J.

    1977-01-01

    A preliminary design of an electrostatically plugged cusp reactor was presented in (UCRL-52142(1976)). The capital costs of the various components of this reactor are estimated and totaled for two different blanket configurations: one having an energy multiplication factor M = 1.2, and the other having M = 1.68. The unoptimized direct capital costs for these cases are found to be about 1400 and 950 $/kWe, respectively

  5. Particle loss from magnetic cusp field

    International Nuclear Information System (INIS)

    Namba, C.; Kawamura, T.; Obayashi, H.

    1974-12-01

    The motion of charged particles in an axially symmetric magnetic field of cusp configuration is studied by means of numerical calculations. A particular attention is paid to a non-adiabatic zone. The computer results are compared with a simplified loss cone model and it is shown that there is a critical value of non-adiabaticity parameter which defines an effective size of the non-adiabatic zone. (auth.)

  6. Mechanisms of recurrent aortic regurgitation after aortic valve repair: predictive value of intraoperative transesophageal echocardiography.

    Science.gov (United States)

    le Polain de Waroux, Jean-Benoît; Pouleur, Anne-Catherine; Robert, Annie; Pasquet, Agnès; Gerber, Bernhard L; Noirhomme, Philippe; El Khoury, Gébrine; Vanoverschelde, Jean-Louis J

    2009-08-01

    The aim of the present study was to examine the intraoperative echocardiographic features associated with recurrent severe aortic regurgitation (AR) after an aortic valve repair surgery. Surgical valve repair for AR has significant advantages over valve replacement, but little is known about the predictors and mechanisms of its failure. We blindly reviewed all clinical, pre-operative, intraoperative, and follow-up transesophageal echocardiographic data of 186 consecutive patients who underwent valve repair for AR during a 10-year period and in whom intraoperative and follow-up echo data were available. After a median follow-up duration of 18 months, 41 patients had recurrent 3+ AR, 23 patients presented with residual 1+ to 2+ AR, and 122 had no or trivial AR. In patients with recurrent 3+ AR, the cause of recurrent AR was the rupture of a pericardial patch in 3 patients, a residual cusp prolapse in 26 patients, a restrictive cusp motion in 9 patients, an aortic dissection in 2 patients, and an infective endocarditis in 1 patient. Pre-operatively, all 3 groups were similar for aortic root dimensions and prevalence of bicuspid valve (overall 37%). Patients with recurrent AR were more likely to display Marfan syndrome or type 3 dysfunction pre-operatively. At the opposite end, patients with continent AR repair at follow-up were more likely to have type 2 dysfunction pre-operatively. After cardiopulmonary bypass, a shorter coaptation length, the degree of cusp billowing, a lower level of coaptation (relative to the annulus), a larger diameter of the aortic annulus and the sino-tubular junction, the presence of a residual AR, and the width of its vena contracta were associated with the presence of AR at follow-up. Multivariate Cox analysis identified a shorter coaptation length (odds ratio [OR]: 0.8, p = 0.05), a coaptation occurring below the level of the aortic annulus (OR: 7.9, p < 0.01), a larger aortic annulus (OR: 1.2, p = 0.01), and residual aortic regurgitation

  7. Low pressure hugoniot cusp in polymeric materials

    Science.gov (United States)

    Sheffield, S. A.; Bloomquist, D. D.

    1982-04-01

    It has previously been shown that polymethyl methacrylate (PMMA) exhibits a cusp in the shock Hugoniot at about 2.0 GPa which corresponds with the beginning of shock-induced polarization and the beginning of an exothermic reaction measured in thermocouple and resistivity gauge temperature studies. We now report results we have recently obtained from an ongoing study which indicate that other polymers have similar behavior at about the same pressure. Quartz gauge impact experiments have been performed using polypyro-ellitimide (Vespel) and polysulfone impactors to obtain Hugoniot information and the stress history at the impact plane. In the case of Vespel a slight Hugoniot cusp was observed at about 1.8 GPa which coincides with the start of shock-induced polarization. Polysulfone does not appear to have a cusp but does show stress relaxation at the impact plane beginning at about 1.8 GPa, again coinciding with the start of shock-induced polarization. It has been suggested earlier that the abnormal behavior in PMMA is the result of a shock-induced chemical reaction. This new information suggests that a stress of about 2 GPa is a threshold for shock-induced chemical reaction in several polymers.

  8. Aortic stenosis

    Science.gov (United States)

    ... Images Aortic stenosis Heart valves References Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil ... ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/ ...

  9. Preliminary experiments with a cusp-field ion source

    International Nuclear Information System (INIS)

    Bickes, R.W. Jr.; O'Hagan, J.B.

    1980-12-01

    Preliminary experiments with a cusp field ion source have been completed. Measurements were made of the total ion current and mass and energy distributions as a function of source operating conditions and cusp field geometry. These experiments have indicated that a cusp field source may be used in the Sandia Neutron Generator for Cancer Therapy and may permit the incorporation of a simplified unpumped accelerator design. Suggestions for future work are briefly outlined

  10. Aortic valve-sparing surgery in Marfan syndrome.

    Science.gov (United States)

    Nachum, Eyal; Shinfeld, Amichay; Kogan, Alexander; Preisman, Sergey; Levin, Shany; Raanani, Ehud

    2013-08-01

    Patients with Marfan syndrome are referred for cardiac surgery due to root aneurysm with or without aortic valve regurgitation. Because these patients are young and frequently present with normal-appearing aortic cusps, valve sparing is often recommended. However, due to the genetic nature of the disease, the durability of such surgery remains uncertain. Between February 2004 and June 2012, 100 patients in our department suffering from aortic aneurysm with aortic valve regurgitation underwent elective aortic valve-sparing surgery. Of them, 30 had Marfan syndrome, were significantly younger (30 +/- 13 vs. 53 +/- 16 years), and had a higher percentage of root aneurysm, compared with ascending aorta aneurysm in their non-Marfan counterparts. We evaluated the safety, durability, clinical and echocardiographic mid-term results of these patients. While no early deaths were reported in either group, there were a few major early complications in both groups. At follow-up (reaching 8 years with a mean of 34 +/- 26 months) there were no late deaths, and few major late complications in the Marfan group. Altogether, 96% and 78% of the patients were in New York Heart Association functional class I-II in the Marfan and non-Marfan groups respectively. None of the Marfan patients needed reoperation on the aortic valve. Freedom from recurrent aortic valve regurgitation > 3+ was 94% in the Marfan patients. Aortic valve-sparing surgery in Marfan symdrome patients is safe and yields good mid-term clinical outcomes.

  11. Cusps enable line attractors for neural computation

    International Nuclear Information System (INIS)

    Xiao, Zhuocheng; Zhang, Jiwei; Sornborger, Andrew T.; Tao, Louis

    2017-01-01

    Here, line attractors in neuronal networks have been suggested to be the basis of many brain functions, such as working memory, oculomotor control, head movement, locomotion, and sensory processing. In this paper, we make the connection between line attractors and pulse gating in feed-forward neuronal networks. In this context, because of their neutral stability along a one-dimensional manifold, line attractors are associated with a time-translational invariance that allows graded information to be propagated from one neuronal population to the next. To understand how pulse-gating manifests itself in a high-dimensional, nonlinear, feedforward integrate-and-fire network, we use a Fokker-Planck approach to analyze system dynamics. We make a connection between pulse-gated propagation in the Fokker-Planck and population-averaged mean-field (firing rate) models, and then identify an approximate line attractor in state space as the essential structure underlying graded information propagation. An analysis of the line attractor shows that it consists of three fixed points: a central saddle with an unstable manifold along the line and stable manifolds orthogonal to the line, which is surrounded on either side by stable fixed points. Along the manifold defined by the fixed points, slow dynamics give rise to a ghost. We show that this line attractor arises at a cusp catastrophe, where a fold bifurcation develops as a function of synaptic noise; and that the ghost dynamics near the fold of the cusp underly the robustness of the line attractor. Understanding the dynamical aspects of this cusp catastrophe allows us to show how line attractors can persist in biologically realistic neuronal networks and how the interplay of pulse gating, synaptic coupling, and neuronal stochasticity can be used to enable attracting one-dimensional manifolds and, thus, dynamically control the processing of graded information.

  12. Cusps enable line attractors for neural computation

    Science.gov (United States)

    Xiao, Zhuocheng; Zhang, Jiwei; Sornborger, Andrew T.; Tao, Louis

    2017-11-01

    Line attractors in neuronal networks have been suggested to be the basis of many brain functions, such as working memory, oculomotor control, head movement, locomotion, and sensory processing. In this paper, we make the connection between line attractors and pulse gating in feed-forward neuronal networks. In this context, because of their neutral stability along a one-dimensional manifold, line attractors are associated with a time-translational invariance that allows graded information to be propagated from one neuronal population to the next. To understand how pulse-gating manifests itself in a high-dimensional, nonlinear, feedforward integrate-and-fire network, we use a Fokker-Planck approach to analyze system dynamics. We make a connection between pulse-gated propagation in the Fokker-Planck and population-averaged mean-field (firing rate) models, and then identify an approximate line attractor in state space as the essential structure underlying graded information propagation. An analysis of the line attractor shows that it consists of three fixed points: a central saddle with an unstable manifold along the line and stable manifolds orthogonal to the line, which is surrounded on either side by stable fixed points. Along the manifold defined by the fixed points, slow dynamics give rise to a ghost. We show that this line attractor arises at a cusp catastrophe, where a fold bifurcation develops as a function of synaptic noise; and that the ghost dynamics near the fold of the cusp underly the robustness of the line attractor. Understanding the dynamical aspects of this cusp catastrophe allows us to show how line attractors can persist in biologically realistic neuronal networks and how the interplay of pulse gating, synaptic coupling, and neuronal stochasticity can be used to enable attracting one-dimensional manifolds and, thus, dynamically control the processing of graded information.

  13. Role of multiple cusps in tooth fracture.

    Science.gov (United States)

    Barani, Amir; Bush, Mark B; Lawn, Brian R

    2014-07-01

    The role of multiple cusps in the biomechanics of human molar tooth fracture is analysed. A model with four cusps at the bite surface replaces the single dome structure used in previous simulations. Extended finite element modelling, with provision to embed longitudinal cracks into the enamel walls, enables full analysis of crack propagation from initial extension to final failure. The cracks propagate longitudinally around the enamel side walls from starter cracks placed either at the top surface (radial cracks) or from the tooth base (margin cracks). A feature of the crack evolution is its stability, meaning that extension occurs steadily with increasing applied force. Predictions from the model are validated by comparison with experimental data from earlier publications, in which crack development was followed in situ during occlusal loading of extracted human molars. The results show substantial increase in critical forces to produce longitudinal fractures with number of cuspal contacts, indicating a capacity for an individual tooth to spread the load during mastication. It is argued that explicit critical force equations derived in previous studies remain valid, at the least as a means for comparing the capacity for teeth of different dimensions to sustain high bite forces. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Observations of the cusp region under northward IMF

    Directory of Open Access Journals (Sweden)

    F. Pitout

    2001-09-01

    Full Text Available We present a comparative study of the cusp region using the EISCAT Svalbard Radars (ESR and the Cluster spacecraft. We focus in this paper on 2 February 2001, over the time period from 07:30 UT to 12:00 UT when the oblique ESR antenna pointing northward at a low elevation recorded latitudinal motions of the cusp region in response to the IMF. Meanwhile, the Cluster satellites were flying over the EISCAT Svalbard Radar field-of-view around local magnetic noon. The spacecraft first flew near ESR, northeast of Svalbard and then passed over the field-of-view of the antenna at about 11:30 UT. From 08:00 UT to 09:00 UT, the IMF remains primarily southward yet several variations in the Z-component are seen to move the cusp. Around 09:00 UT, an abrupt northward turning of the IMF moves the cusp region to higher latitudes. As a result, the Cluster satellites ended up in the northernmost boundary of the high-altitude cusp region where the CIS instrument recorded highly structured plasma due to ion injections in the lobe of the magnetosphere. After 09:00 UT, the IMF remains northward for more than two hours. Over this period, the ESR records sunward plasma flow in the cusp region due to lobe reconnection, while Cluster spacecraft remain in the high-altitude cusp.Key words. Magnetospheric physics (magnetopause, cusp, and boundary layers; plasma convection Ionosphere (polar ionosphere

  15. Talon′s cusp: Report of four unusual cases

    Directory of Open Access Journals (Sweden)

    Tulunoglu O

    2007-03-01

    Full Text Available Talon cusp is a developmental dental anomaly thought to arise as a result of evagination on the surface of a tooth crown before calcification has occurred. The etiology remains unknown. The incidence is 0.04-10%. Any tooth may have a talon cusp but most of the cases involve maxillary lateral incisors, with some instances of bilateral involvement. The anomaly has been reported to be rare in the mandible. This article reports four cases of talon cusp. The first and the second cases describe bilateral involvement of talon cusp on palatal surfaces of maxillary primary centrals; in the third case talon tubercle occurs on palatal surfaces of both maxillary permanent lateral incisors and the maxillary left central incisor and in the last case a talon cusp in the lingual surface of mandibular permanent lateral incisor.

  16. Reimplantation valve-sparing aortic root replacement with the Valsalva graft: what have we learnt after 100 cases?

    Science.gov (United States)

    Settepani, Fabrizio; Bergonzini, Marcello; Barbone, Alessandro; Citterio, Enrico; Basciu, Alessio; Ornaghi, Diego; Gallotti, Roberto; Tarelli, Giuseppe

    2009-07-01

    Reimplantation valve-sparing aortic root replacement has been increasingly performed with improving perioperative and mid-term results. The success of this operation primarily depends on preserving the highly sophisticated dynamic function of the aortic valve by recreating an anatomical three-dimensional configuration similar to the normal aortic root, thus minimizing the mechanical stress and strain on the cusps. Over the years several techniques have been proposed to reproduce the sinuses of Valsalva. We reviewed our experience with aortic valve reimplantation by means of a modified Dacron graft that incorporates sinuses of Valsalva, in a series of 100 consecutive patients. During a 60-month period, 100 patients with aortic root aneurysm underwent aortic valve reimplantation using the Gelweave Valsalva prosthesis. There were 74 males and the mean age was 60+/-12 years (range 28-83 years). Five patients had the Marfan's syndrome, 15 had a bicuspid aortic valve. Cusp repair was performed in five patients. The mean follow-up time was 28.6 months (range 1-60). Transesophageal echocardiogram was performed at the end of each procedure to assess the aortic valve in terms of competence, dynamic motion and level of coaptation within the graft. There was one hospital death and two late deaths. Overall survival at 60 months was 91.7+/-5.1%. Five patients developed severe aortic incompetence (AI) during follow-up requiring aortic valve replacement (AVR). The 60 months freedom from re-operation due to AI was 90.9+/-4.4%. One patient had moderate AI at latest echocardiographic study. The 60 months freedom from AI>2+ was 91.6+/-7.9%. Cox regression identified cusp's repair as independent risk factor (P=0.001) for late reimplantation failure (AVR or AI>2+). There were no episodes of endocarditis and the majority of the patients (88%) were in New York Heart Association functional class I. The aortic valve reimplantation with the Gelweave Valsalva prosthesis provided satisfactory

  17. Type A aortic dissection associated with Dietzia maris.

    Science.gov (United States)

    Reyes, Guillermo; Navarro, José-Luis; Gamallo, Carlos; delas Cuevas, María-Carmen

    2006-10-01

    Aortitis is a rare cause of aortic dissection. We report the unusual presentation of a 77-year-old male patient who underwent emergency surgery for an aortic dissection type A. A purulent pericardial fluid and inflammatory aorta were found after chest opening. Several samples were sent for analysis. The ascending aorta presented a mild dilatation with a large haematoma infiltrating the aortic root. The distal part of the ascending aorta seemed unaffected. The aortic rupture was found one centimetre above the non-coronary cusp. Aortic wall tissues were extremely fragile and with an inflammatory aspect. The patient died in the theatre room. In the histological study one out of three fragments of ascending aorta displayed longitudinal splitting of the outer media, with blood extravasation in the adventitial layer. In this level, the presence of a detritus material that reminded of bacterial colonies was noteworthy, together with abundant fibrinous exudates. In the laboratory a new specimen, Dietzia maris, was found in the pericardial liquid and in the aortic wall. We believe that this is the first reported finding of Dietzia maris in a patient with aortic disease.

  18. Cusp-Shaped Elastic Creases and Furrows

    Science.gov (United States)

    Karpitschka, S.; Eggers, J.; Pandey, A.; Snoeijer, J. H.

    2017-11-01

    The surfaces of growing biological tissues, swelling gels, and compressed rubbers do not remain smooth, but frequently exhibit highly localized inward folds. We reveal the morphology of this surface folding in a novel experimental setup, which permits us to deform the surface of a soft gel in a controlled fashion. The interface first forms a sharp furrow, whose tip size decreases rapidly with deformation. Above a critical deformation, the furrow bifurcates to an inward folded crease of vanishing tip size. We show experimentally and numerically that both creases and furrows exhibit a universal cusp shape, whose width scales like y3 /2 at a distance y from the tip. We provide a similarity theory that captures the singular profiles before and after the self-folding bifurcation, and derive the length of the fold from finite deformation elasticity.

  19. Source of the dayside cusp aurora.

    Science.gov (United States)

    Mende, S B; Frey, H U; Angelopoulos, V

    2016-08-01

    Monochromatic all-sky imagers at South Pole and other Antarctic stations of the Automatic Geophysical Observatory chain recorded the aurora in the region where the Time History of Events and Macroscale Interactions during Substorms (THEMIS) satellites crossed the dayside magnetopause. In several cases the magnetic field lines threading the satellites when mapped to the atmosphere were inside the imagers' field of view. From the THEMIS magnetic field and the plasma density measurements, we were able to locate the position of the magnetopause crossings and map it to the ionosphere using the Tsyganenko-96 field model. Field line mapping is reasonably accurate on the dayside subsolar region where the field is strong, almost dipolar even though compressed. From these coordinated observations, we were able to prove that the dayside cusp aurora of high 630 nm brightness is on open field lines, and it is therefore direct precipitation from the magnetosheath. The cusp aurora contained significant highly structured N 2 + 427.8 nm emission. The THEMIS measurements of the magnetosheath particle energy and density taken just outside the magnetopause compared to the intensity of the structured N 2 + 427.8 nm emissions showed that the precipitating magnetosheath particles had to be accelerated. The most likely electron acceleration mechanism is by dispersive Alfvén waves propagating along the field line. Wave-accelerated suprathermal electrons were seen by FAST and DMSP. The 427.8 nm wavelength channel also shows the presence of a lower latitude hard-electron precipitation zone originating inside the magnetosphere.

  20. High-Energy Electron Confinement in a Magnetic Cusp Configuration

    Directory of Open Access Journals (Sweden)

    Jaeyoung Park

    2015-06-01

    Full Text Available We report experimental results validating the concept that plasma confinement is enhanced in a magnetic cusp configuration when β (plasma pressure/magnetic field pressure is of order unity. This enhancement is required for a fusion power reactor based on cusp confinement to be feasible. The magnetic cusp configuration possesses a critical advantage: the plasma is stable to large scale perturbations. However, early work indicated that plasma loss rates in a reactor based on a cusp configuration were too large for net power production. Grad and others theorized that at high β a sharp boundary would form between the plasma and the magnetic field, leading to substantially smaller loss rates. While not able to confirm the details of Grad’s work, the current experiment does validate, for the first time, the conjecture that confinement is substantially improved at high β. This represents critical progress toward an understanding of the plasma dynamics in a high-β cusp system. We hope that these results will stimulate a renewed interest in the cusp configuration as a fusion confinement candidate. In addition, the enhanced high-energy electron confinement resolves a key impediment to progress of the Polywell fusion concept, which combines a high-β cusp configuration with electrostatic fusion for a compact, power-producing nuclear fusion reactor.

  1. Aortic root surgery in Marfan syndrome.

    Science.gov (United States)

    Sheick-Yousif, Basheer; Sheinfield, Ami; Tager, Salis; Ghosh, Probal; Priesman, Sergey; Smolinsky, Aram K; Raanani, Ehud

    2008-03-01

    As the shortcomings of the Bentall operation and its variants in the Marfan syndrome have become apparent, the recent cusp-sparing techniques (remodeling or reimplantation) bear promise of better mid-term and long-term outcomes. To examine the results of aortic root surgery in patients with Marfan syndrome. During the period March 1994 to September 2007, 220 patients underwent aortic valve-sparing surgery; 20 were Marfan patients (group 1) who were compared with another 20 Marfan patients undergoing composite aortic root replacement (group 2). Fourteen patients had aortic dissection and 26 had thoracic aortic aneurysm. There were 31 males and 9 females with a mean age of 37.9 +/- 13.8 years. In group 1, reimplantation was used in 13 patients, remodeling in 4, and aortic valve repair with sinotubular junction replacement in 3. In group 2, a mechanical valve conduit was used. Mean logistic Euroscore was 12.27 +/- 14.6% for the whole group, five of whom were emergent cases Group 2 had more previous cardiac procedures compared to group 1 (9 vs. 2, P = 0.03) and shorter cross-clamp time (122 +/- 27.1 vs. 153.9 +/- 23.7 minutes, P = 0.0004). Overall mortality was 10%. Early mortality was 10% in group 2 and 5% in group 1 (NS). Mean follow-up time was 25 months for group 2 and 53 months for group 1. Three patients were reoperated; all had undergone the remodeling. Five year freedom from reoperation and death was 86% and 90% in group 2 and 70% and 95% in group 1 (P = 0.6, P = 0.6), respectively. Late survival of patients with Marfan syndrome was similar in both groups. Root reconstruction tends towards a higher incidence of late reoperations if the remodeling technique is used. We now prefer to use the reimplantation technique.

  2. Genetic integration of molar cusp size variation in baboons.

    Science.gov (United States)

    Koh, Christina; Bates, Elizabeth; Broughton, Elizabeth; Do, Nicholas T; Fletcher, Zachary; Mahaney, Michael C; Hlusko, Leslea J

    2010-06-01

    Many studies of primate diversity and evolution rely on dental morphology for insight into diet, behavior, and phylogenetic relationships. Consequently, variation in molar cusp size has increasingly become a phenotype of interest. In 2007 we published a quantitative genetic analysis of mandibular molar cusp size variation in baboons. Those results provided more questions than answers, as the pattern of genetic integration did not fit predictions from odontogenesis. To follow up, we expanded our study to include data from the maxillary molar cusps. Here we report on these later analyses, as well as inter-arch comparisons with the mandibular data. We analyzed variation in two-dimensional maxillary molar cusp size using data collected from a captive pedigreed breeding colony of baboons, Papio hamadryas, housed at the Southwest National Primate Research Center. These analyses show that variation in maxillary molar cusp size is heritable and sexually dimorphic. We also estimated additive genetic correlations between cusps on the same crown, homologous cusps along the tooth row, and maxillary and mandibular cusps. The pattern for maxillary molars yields genetic correlations of one between the paracone-metacone and protocone-hypocone. Bivariate analyses of cuspal homologues on adjacent teeth yield correlations that are high or not significantly different from one. Between dental arcades, the nonoccluding cusps consistently yield high genetic correlations, especially the metaconid-paracone and metaconid-metacone. This pattern of genetic correlation does not immediately accord with the pattern of development and/or calcification, however these results do follow predictions that can be made from the evolutionary history of the tribosphenic molar. Copyright 2009 Wiley-Liss, Inc.

  3. Transcatheter aortic valve replacement

    Science.gov (United States)

    ... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

  4. Synthesis of antihydrogen atoms in a CUSP trap

    International Nuclear Information System (INIS)

    Kuroda, Naofumi; Enomoto, Yoshinori; Michishio, Koji; Kim, Chanhyoun; Higaki, Hiroyuki; Nagata, Yugo; Kanai, Yasuyuki; Torii, Hiroyuki A.; Corradini, Maurizzio; Leali, Marco; Lodi-Rizzini, Evandro; Mascagna, Valerio; Venturelli, Luca; Zurlo, Nicola; Fujii, Koki; Ohtsuka, Miki; Tanaka, Kazuo; Imao, Hiroshi; Nagashima, Yasuyuki; Matsuda, Yasuyuki

    2012-01-01

    ASACUSA collaboration has been making a path to realize high precision microwave spectroscopy of ground-state hyperfine transitions of antihydrogen atom in flight for stringent test of the CPT symmetry. Recently, we have succeeded in synthesizing our first cold antihydrogen atoms employing a CUSP trap. It is expected that synthesized antihydrogen atoms in the low-field-seeking states are preferentially focused along the cusp magnetic field axis whereas those in the high-field-seeking states are not focused, resulting in the formation of a spin-polarized antihydrogen beam. We report the recent results of antihydrogen atom synthesis and beam production developed with the CUSP trap.

  5. Synthesis of antihydrogen atoms in a CUSP trap

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Naofumi, E-mail: kuroda@phys.c.u-tokyo.ac.jp [University of Tokyo, Graduate School of Arts and Sciences (Japan); Enomoto, Yoshinori [RIKEN Advanced Science Institute (Japan); Michishio, Koji [Tokyo University of Science, Department of Physics (Japan); Kim, Chanhyoun [University of Tokyo, Graduate School of Arts and Sciences (Japan); Higaki, Hiroyuki [Hiroshima University, Graduate School of Advanced Science of Matter (Japan); Nagata, Yugo; Kanai, Yasuyuki [RIKEN Advanced Science Institute (Japan); Torii, Hiroyuki A. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Corradini, Maurizzio; Leali, Marco; Lodi-Rizzini, Evandro; Mascagna, Valerio; Venturelli, Luca; Zurlo, Nicola [Universita di Brescia and Instituto Nazionale di Fisica Nucleare, Dipartimento di Chimica e Fisica per l' Ingegneria e per i Materiali (Italy); Fujii, Koki; Ohtsuka, Miki; Tanaka, Kazuo [University of Tokyo, Graduate School of Arts and Sciences (Japan); Imao, Hiroshi [RIKEN Nishina Center for Accelerator-Based Science (Japan); Nagashima, Yasuyuki [Tokyo University of Science, Department of Physics (Japan); Matsuda, Yasuyuki [University of Tokyo, Graduate School of Arts and Sciences (Japan); and others

    2012-05-15

    ASACUSA collaboration has been making a path to realize high precision microwave spectroscopy of ground-state hyperfine transitions of antihydrogen atom in flight for stringent test of the CPT symmetry. Recently, we have succeeded in synthesizing our first cold antihydrogen atoms employing a CUSP trap. It is expected that synthesized antihydrogen atoms in the low-field-seeking states are preferentially focused along the cusp magnetic field axis whereas those in the high-field-seeking states are not focused, resulting in the formation of a spin-polarized antihydrogen beam. We report the recent results of antihydrogen atom synthesis and beam production developed with the CUSP trap.

  6. Protection motivation theory and cigarette smoking among vocational high school students in China: a cusp catastrophe modeling analysis.

    Science.gov (United States)

    Xu, Yunan; Chen, Xinguang

    2016-01-01

    Tobacco use is one of the greatest public health problems worldwide and the hazards of cigarette smoking to public health call for better recognition of cigarette smoking behaviors to guide evidence-based policy. Protection motivation theory (PMT) provides a conceptual framework to investigate tobacco use. Evidence from diverse sources implies that the dynamics of smoking behavior may be quantum in nature, consisting of an intuition and an analytical process, challenging the traditional linear continuous analytical approach. In this study, we used cusp catastrophe, a nonlinear analytical approach to test the dual-process hypothesis of cigarette smoking. Data were collected from a random sample of vocational high school students in China ( n = 528). The multivariate stochastic cusp modeling was used and executed with the Cusp Package in R. The PMT-based Threat Appraisal and Coping Appraisal were used as the two control variables and the frequency of cigarette smoking (daily, weekly, occasional, and never) in the past month was used as the outcome variable. Consistent with PMT, the Threat Appraisal (asymmetry, α 1 = 0.1987, p < 0.001) and Coping Appraisal (bifurcation, β 2 = 0.1760, p < 0.05) significantly predicted the smoking behavior after controlling for covariates. Furthermore, the cusp model performed better than the alternative linear and logistic regression models with regard to higher R 2 (0.82 for cusp, but 0.21 for linear and 0.25 for logistic) and smaller AIC and BIC. Study findings support the conclusion that cigarette smoking in adolescents is a quantum process and PMT is relevant to guide studies to understand smoking behavior for smoking prevention and cessation.

  7. Enabling Ring-Cusp Ion Thruster Technology for NASA Missions

    Data.gov (United States)

    National Aeronautics and Space Administration — ESA is flying T6 Kaufman ion thrusters on the BepiColombo Mission to Mercury in 2018. They are planning to develop a longer life, higher performing, 30-cm ring-cusp...

  8. Structure and function of the tricuspid and bicuspid regurgitant aortic valve: an echocardiographic study.

    Science.gov (United States)

    Rönnerfalk, Mattias; Tamás, Éva

    2015-07-01

    The emerging new treatment options for aortic valve disease call for more sophisticated diagnostics. We aimed to describe the echocardiographic pathophysiology and characteristics of the purely regurgitant aortic valve in detail. Twenty-nine men, with chronic aortic regurgitation without concomitant heart disease referred for aortic valve intervention, underwent 2D transoesophageal echocardiographic (TEE) examination prior to surgery according to a previously published matrix. Measurements of the aortic valve apparatus in long and short axis view were made in systole and diastole and analysed off-line. The aortic valves were grouped as tricuspid (TAV) or bicuspid (BAV), and classified by regurgitation mechanism. Twenty-four examinations were eligible for analysis of which 13 presented TAV and 11 BAV. The regurgitation mechanism was classified as dilatation of the aorta in 6 cases, as prolapse in 11 cases and as poor cusp tissue quality or quantity in 7 cases. The ventriculo-aortic junction (VAJ) and valve opening were closely related (TAV r = 0.5, BAV r = 0.73) but no correlation was found between the VAJ and the maximal sinus diameter (maxSiD) or the sinotubular junction (STJ). However, the STJ and maxSiD were significantly related (TAV vs BAV: systole r = 0.9, r = 0.8; diastole r = 0.9, r = 0.7), forming an entity. The conjoined BAV cusps were shorter than the anterior cusps when closed (P = 0.002); the inter-commissural distances of the cusps in the BAV group were significantly different (P = 0.001 resp. 0.03) in both systole and diastole. The VAJ was independent of other aortic dimensions and should thereby be considered as a separate entity with influence on valve opening. The detailed 2D TEE measurements of this study add further important information to our knowledge about the function and echocardiographic anatomy of the pathological aortic valve and root either as a stand-alone examination or as a benchmark and complement to 3D echocardiography. This may

  9. A quarter of a century of experience with aortic valve-sparing operations.

    Science.gov (United States)

    David, Tirone E; Feindel, Christopher M; David, Carolyn M; Manlhiot, Cedric

    2014-09-01

    To examine the late outcomes of aortic valve-sparing operations to treat patients with aortic root aneurysm with and without aortic insufficiency (AI) in a cohort of patients followed up prospectively since 1988. A total of 371 consecutive patients had undergone aortic valve-sparing surgery (mean age, 47 ± 15 years; 78% men) from 1988 through 2010. In addition to the aortic root aneurysm, 47% had moderate or severe AI, 35.5% had Marfan syndrome, 12.1% had type A aortic dissection, 9.2% had bicuspid aortic valve, 8.4% had mitral insufficiency, 16.1% had aortic arch aneurysm, and 10.2% had coronary artery disease. Reimplantation of the aortic valve was used in 296 patients and remodeling of the aortic root in 75. Cusp repair by plication of the free margin along the nodule of Arantius was used in 36.6% of patients, and reinforcement of the free margin with a double layer of fine Gore-Tex suture in 24.2%. The patients were followed up prospectively with images of the aortic root for a median follow-up of 8.9 ± 5.2 years. A total of 4 operative and 39 late deaths occurred. Survival at 18 years was 76.8% ± 4.31%, lower than that for the general population matched for age and gender. Age, type A aortic dissection, impaired ventricular function, and preoperative AI were associated with increased mortality on multivariable analysis. Reoperations on the aortic valve were performed in 8 patients for recurrent AI and in 2 for infective endocarditis. Freedom from reoperation on the aortic valve at 18 years was 94.8% ± 2.0%. No predictors of the need for reoperation were found on multivariable analysis. Eighteen patients developed AI greater than mild. Freedom from AI greater than mild at 18 years was 78.0% ± 4.8%. No predictors of recurrent AI were identified on multivariable analysis. Aortic valve-sparing operations continue to provide excellent clinical outcomes, although a slow but progressive deterioration of aortic valve function seems to occur during the first 2

  10. [Long-term outcome of aortic valve sparing procedures in connective tissue disorders].

    Science.gov (United States)

    Tanaka, Hiroshi; Ogino, H; Matsuda, H; Minatoya, K; Sasaki, N

    2009-10-01

    The aim of this study is to determine the long-term outcome of aortic valve sparing procedures for patients having connective tissue disorder. Between 1993 and 2008, the aortic valve sparing surgery was performed in 94 patients having aortic root dilatation. Eighty patients of them (37.2 +/- 13.4 years, 50 male) had cystic medial necrosis in the aortic wall, which was confirmed the pathological examination. We reviewed these patients. Sixty percent (48/80) had Marfan syndrome, 5% (4/80) had Loeyz-Dietz syndrome, 2% (2/80) had bicuspid aortic valve, and 11% (9/80) had aortic dissection. Our reimplantation procedure has been refined as followed: with a tube graft in 41, a tube graft with creation of neo-sinuses in 11, and a Valsalva graft in 14. Fourteen patients underwent the remodeling procedure. The follow-up rate was 100% with the duration of 3.7+/- 3.4 years. There were no operative death but six late deaths. Seventeen (21.3%) patients required aortic valve replacement, for recurrent aortic insufficiency in 13 and infection in 4. Freedom from reoperation was 80%, 43%, and freedom from moderate or severe aortic insufficiency was 80%, 54%, at 5 and 10 years, respectively. Pathological findings of the aortic valve obtained in the reoperations showed elongation and prolapse of the aortic valve due to myxomatous degeneration and fibrous thickening caused by aortic insufficiency. Even in connective tissue disorders, aortic valve sparing operation is associated with acceptable long-term durability, although cusp degeneration resulting in recurrent aortic insufficiency might be progressive.

  11. Are dayside long-period pulsations related to the cusp?

    Directory of Open Access Journals (Sweden)

    V. Pilipenko

    2015-03-01

    Full Text Available We compare simultaneous observations of long-period ultra-low-frequency (ULF wave activity from a Svalbard/IMAGE fluxgate magnetometer latitudinal profile covering the expected cusp geomagnetic latitudes. Irregular Pulsations at Cusp Latitudes (IPCL and narrowband Pc5 waves are found to be a ubiquitous element of ULF activity in the dayside high-latitude region. To identify the ionospheric projections of the cusp, we use the width of return signal of the Super Dual Auroral Radar Network (SuperDARN radar covering the Svalbard archipelago, predictions of empirical cusp models, augmented whenever possible by Defense Meteorological Satellite Program (DMSP identification of magnetospheric boundary domains. The meridional spatial structure of broadband dayside Pc5–6 pulsation spectral power has been found to have a localized latitudinal peak, not under the cusp proper as was previously thought, but several degrees southward from the equatorward cusp boundary. The earlier claims of the dayside monochromatic Pc5 wave association with the open–closed boundary also seems doubtful. Transient currents producing broadband Pc5–6 probably originate at the low-latitude boundary layer/central plasma sheet (LLBL/CPS interface, though such identification with available DMSP data is not very precise. The occurrence of broadband Pc5–6 pulsations in the dayside boundary layers is a challenge to modelers because so far their mechanism has not been firmly identified.

  12. Latitudinal variation of the polar cusp during a geomagnetic storm

    International Nuclear Information System (INIS)

    Meng, C.

    1982-01-01

    Large amplitude latitudinal variation of the polar cusp position was observed during the intense geomagnetic storm of 15--16 February 1980. The observation of the polar cusp, identified as the region of intense but extremely soft electron precipitation, was made by two nearly noon-midnight orbit DMSP satellites over both northern and southern hemispheres. The latitudinal shift of the polar cusp is observed to be related to the intensity variation of the ring current indicated by the hourly Dst values. The polar cusp region moved from its normal location at approx.76 0 gm lat down to approx.62 0 gm lat at the peak of this storm. This movement took about 5 hours and was detected over both hemispheres. A drastic variation in the width of the cusp region was also observed; it is very narrow (approx.1 0 ) during the equatorial shift and expands to > or approx. =5 0 during the poleward recovery. Variation of the polar cusp latitude with that of the Dst index was also seen during the period before the intense storm

  13. Association of aortic valve calcification severity with the degree of aortic regurgitation after transcatheter aortic valve implantation.

    Science.gov (United States)

    Koos, Ralf; Mahnken, Andreas Horst; Dohmen, Guido; Brehmer, Kathrin; Günther, Rolf W; Autschbach, Rüdiger; Marx, Nikolaus; Hoffmann, Rainer

    2011-07-15

    This study sought to examine a possible relationship between the severity of aortic valve calcification (AVC), the distribution of AVC and the degree of aortic valve regurgitation (AR) after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS). 57 patients (22 men, 81 ± 5 years) with symptomatic AS and with a logistic EuroSCORE of 24 ± 12 were included. 38 patients (67%) received a third (18F)-generation CoreValve® aortic valve prosthesis, in 19 patients (33%) an Edwards SAPIEN™ prosthesis was implanted. Prior to TAVI dual-source computed tomography for assessment of AVC was performed. To determine the distribution of AVC the percentage of the calcium load of the most severely calcified cusp was calculated. After TAVI the degree of AR was determined by angiography and echocardiography. The severity of AR after TAVI was related to the severity and distribution of AVC. There was no association between the distribution of AVC and the degree of paravalvular AR after TAVI as assessed by angiography (r = -0.02, p = 0.88). Agatston AVC scores were significantly higher in patients with AR grade ≥ 3 (5055 ± 1753, n = 3) than in patients with AR grade AVC scores > 3000 were associated with a relevant paravalvular AR and showed a trend for increased need for second manoeuvres. There was a significant correlation between the severity of AVC and the degree of AR after AVR (r = 0.50, p AVC have an increased risk for a relevant AR after TAVI as well as a trend for increased need for additional procedures. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  14. Statistical Study in the mid-altitude cusp region: wave and particle data comparison using a normalized cusp crossing duration

    Science.gov (United States)

    Grison, B.; Escoubet, C. P.; Pitout, F.; Cornilleau-Wehrlin, N.; Dandouras, I.; Lucek, E.

    2009-04-01

    In the mid altitude cusp region the DC magnetic field presents a diamagnetic cavity due to intense ion earthward flux coming from the magnetosheath. A strong ultra low frequency (ULF) magnetic activity is also commonly observed in this region. Most of the mid altitude cusp statistical studies have focused on the location of the cusp and its dependence and response to solar wind, interplanetary magnetic field, dipole tilt angle parameters. In our study we use the database build by Pitout et al. (2006) in order to study the link of wave power in the ULF range (0.35-10Hz) measured by STAFF SC instrument with the ion plasma properties as measured by CIS (and CODIF) instrument as well as the diamagnetic cavity in the mid-altitude cusp region with FGM data. To compare the different crossings we don`t use the cusp position and dynamics but we use a normalized cusp crossing duration that permits to easily average the properties over a large number of crossings. As usual in the cusp, it is particularly relevant to sort the crossings by the corresponding interplanetary magnetic field (IMF) orientation in order to analyse the results. In particular we try to find out what is the most relevant parameter to link the strong wave activity with. The global statistic confirms previous single case observations that have noticed a simultaneity between ion injections and wave activity enhancements. We will also present results concerning other ion parameters and the diamagnetic cavity observed in the mid altitude cusp region.

  15. Aortic valve-sparing operations in aortic root aneurysms: remodeling or reimplantation?

    Science.gov (United States)

    Rahnavardi, Mohammad; Yan, Tristan D; Bannon, Paul G; Wilson, Michael K

    2011-08-01

    successful restoration of normal cusp geometry are the keys to success in aortic valve-sparing operations.

  16. Aortic valve bypass

    DEFF Research Database (Denmark)

    Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik

    2013-01-01

    In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI). ...

  17. Valve-sparing aortic root replacement†.

    Science.gov (United States)

    Koolbergen, David R; Manshanden, Johan S J; Bouma, Berto J; Blom, Nico A; Mulder, Barbara J M; de Mol, Bas A J M; Hazekamp, Mark G

    2015-02-01

    To evaluate our results of valve-sparing aortic root replacement and associated (multiple) valve repair. From September 2003 to September 2013, 97 patients had valve-sparing aortic root replacement procedures. Patient records and preoperative, postoperative and recent echocardiograms were reviewed. Median age was 40.3 (range: 13.4-68.6) years and 67 (69.1%) were male. Seven (7.2%) patients were younger than 18 years, the youngest being 13.4 years. Fifty-four (55.7%) had Marfan syndrome, 2 (2.1%) other fibrous tissue diseases, 15 (15.5%) bicuspid aortic valve and 3 (3.1%) had earlier Fallot repair. The reimplantation technique was used in all, with a straight vascular prosthesis in 11 (26-34 mm) and the Valsalva prosthesis in 86 (26-32 mm). Concomitant aortic valve repair was performed in 43 (44.3%), mitral valve repair in 10 (10.3%), tricuspid valve repair in 5 (5.2%) and aortic arch replacement in 3 (3.1%). Mean follow-up was 4.2 ± 2.4 years. Follow-up was complete in all. One 14-year old patient died 1.3 years post-surgery presumably of ventricular arrhythmia. One patient underwent reoperation for aneurysm of the proximal right coronary artery after 4.9 years and 4 patients required aortic valve replacement, 3 of which because of endocarditis after 0.1, 0.8 and 1.3 years and 1 because of cusp prolapse after 3.8 years. No thrombo-embolic complications occurred. Mortality, root reoperation and aortic regurgitation were absent in 88.0 ± 0.5% at 5-year follow-up. Results of valve-sparing root replacement are good, even in association with a high incidence of concomitant valve repair. Valve-sparing aortic root replacement can be performed at a very young age as long as an adult size prosthesis can be implanted. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Black Holes and Galactic Density Cusps II Spherically Symmetric Anisotropic Cusps

    CERN Document Server

    Henriksen, Richard N; Macmillan, Joseph D

    2010-01-01

    Aims. In this paper we study density cusps that may contain central black holes. The actual co-eval self-similar growth would not distinguish between the central object and the surroundings. Methods. To study the environment of a growing black hole we seek descriptions of steady 'cusps' that may contain a black hole and that retain at least a memory of self-similarity. We refer to the environment in brief as the 'bulge' and on smaller scales, the 'halo'. Results. We find simple descriptions of the simulations of collisionless matter by comparing predicted densities, velocity dispersions and distribution functions with the simulations. In some cases central point masses may be included by iteration. We emphasize that the co-eval self-similar growth allows an explanation of the black hole bulge mass correlation between approximately similar collisionless systems. Conclusions. We have derived our results from first principles assuming adiabatic self-similarity and either self-similar virialisation or normal stea...

  19. [Pannus Formation Six-years after Aortic and Mitral Valve Replacement with Tissue Valves;Report of a Case].

    Science.gov (United States)

    Nakamura, Makoto; Muraoka, Arata; Aizawa, Kei; Akutsu, Hirohiko; Kurumisawa, Soki; Misawa, Yoshio

    2015-07-01

    A 77-year-old man presented with exertional dyspnea. He had undergone aortic and mitral valve replacement with tissue valves 6-years earlier. The patient's hemoglobin level was 9.8 g/dl and serum aspartate aminotransferase (70 mU/ml) and lactate dehydrogenase (1,112 mU/ml) were elevated. Echocardiography revealed stenosis of the prosthetic valve in the aortic position with peak flow velocity of 3.8 m/second and massive mitral regurgitation. The patient underwent repeat valve replacement. Pannus formation around both implanted valves was observed. The aortic valve orifice was narrowed by the pannus, and one cusp of the prosthesis in the mitral position was fixed and caused the regurgitation, but they were free from cusp laceration or calcification. The patient's postoperative course was uneventful, and he continues to do well 14 months after surgery.

  20. Cusp singularities in f(R) gravity: pros and cons

    International Nuclear Information System (INIS)

    Chen, Pisin; Yeom, Dong-han

    2015-01-01

    We investigate cusp singularities in f(R) gravity, especially for Starobinsky and Hu-Sawicki dark energy models. We illustrate that, by using double-null numerical simulations, a cusp singularity can be triggered by gravitational collapses. This singularity can be cured by adding a quadratic term, but this causes a Ricci scalar bump that can be observed by an observer outside the event horizon. Comparing with cosmological parameters, it seems that it would be difficult to see super-Planckian effects by astrophysical experiments. On the other hand, at once there exists a cusp singularity, it can be a mechanism to realize a horizon scale curvature singularity that can be interpreted by a firewall

  1. Cluster observations of ion dispersion discontinuities in the polar cusp

    Science.gov (United States)

    Escoubet, C. P.; Berchem, J.; Pitout, F.; Richard, R. L.; Trattner, K. J.; Grison, B.; Taylor, M. G.; Masson, A.; Dunlop, M. W.; Dandouras, I. S.; Reme, H.; Fazakerley, A. N.

    2009-12-01

    The reconnection between the interplanetary magnetic field (IMF) and the Earth’s magnetic field is taking place at the magnetopause on magnetic field lines threading through the polar cusp. When the IMF is southward, reconnection occurs near the subsolar point, which is magnetically connected to the equatorward boundary of the polar cusp. Subsequently the ions injected through the reconnection point precipitate in the cusp and are dispersed poleward. If reconnection is continuous and operates at constant rate, the ion dispersion is smooth and continuous. On the other hand if the reconnection rate varies, we expect interruption in the dispersion forming energy steps or staircase. Similarly, multiple entries near the magnetopause could also produce steps at low or mid-altitude when a spacecraft is crossing subsequently the field lines originating from these multiple sources. In addition, motion of the magnetopause induced by solar wind pressure changes or erosion due to reconnection can also induce a motion of the polar cusp and a disruption of the ions dispersion observed by a spacecraft. Cluster with four spacecraft following each other in the mid-altitude cusp can be used to distinguish between these “temporal” and “spatial” effects. We will present a cusp crossing with two spacecraft, separated by around two minutes. The two spacecraft observed a very similar dispersion with a step in energy in its centre and two other dispersions poleward. We will show that the steps could be temporal (assuming that the time between two reconnection bursts corresponds to the time delay between the two spacecraft) but it would be a fortuitous coincidence. On the other hand the steps and the two poleward dispersions could be explained by spatial effects if we take into account the motion of the open-closed boundary between the two spacecraft crossings.

  2. Relation of Bicuspid Aortic Valve Morphology to the Dilatation Pattern of the Proximal Aorta: Focus on the Transvalvular Flow

    Directory of Open Access Journals (Sweden)

    Evaldas Girdauskas

    2012-01-01

    Full Text Available Whether the dilatation of proximal aorta in patients with bicuspid aortic valve is secondary to hemodynamic effects related to the abnormal aortic valve or a primary manifestation of the genetic disorder remains controversial. We discuss in this paper the recent data on the BAV function and transvalvular flow patterns in relation with the dilatation type of the proximal aorta. Different morphological forms of bicuspid aortic valve in relation with the specific transvalvular blood flow patterns are focus of the first paragraph of this paper. In the second part of this paper we present the pathogenetic insight into the different clinically observed phenotypes of bicuspid aortic valve disease (i.e., association of proximal aortic shapes with the specific cusp fusion patterns, based on the data from recent rheological studies.

  3. Aortic Annular Enlargement during Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Selman Dumani

    2016-09-01

    Full Text Available In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.

  4. Rip Currents, Mega-Cusps, and Eroding Dunes

    OpenAIRE

    Thornton, E.B.; MacMahan, J.; Sallenger, A.H.

    2006-01-01

    Submitted to Marine Geology 1 November 2006 Dune erosion is shown to occur at the embayment of beach mega-cusps O(200m alongshore) that are associated with rip currents. The beach is the narrowest at the embayment of the mega-cusps allowing the swash of large storm waves coincident with high tides to reach the toe of the dune, to undercut the dune and to cause dune erosion. Field measurements of dune, beach, and rip current morphology are acquired along an 18 km shoreline in southern Mont...

  5. Multi-point observations of intermittency in the cusp regions

    Directory of Open Access Journals (Sweden)

    M. M. Echim

    2007-08-01

    Full Text Available In this paper we investigate the statistical properties of magnetic field fluctuations measured by the four Cluster spacecraft in the cusp and close to the interface with the magnetospheric lobes, magnetopause and magnetosheath. At lower altitudes along the outbound orbit of 26 February 2001, the magnetic field fluctuations recorded by all four spacecraft are random and their Probability Distribution Functions (PDFs are Gaussian at all scales. The flatness parameter, F – related to the kurtosis of the time series, is equal to 3. At higher altitudes, in the cusp and its vicinity, closer to the interface with the magnetopause and magnetosheath, the PDFs from all Cluster satellites are non-Gaussian and show a clear intermittent behavior at scales smaller than τG≈ 61 s (or 170 km. The flatness parameter increases to values greater than 3 for scales smaller than τG. A Haar wavelet transform enables the identification of the "events" that produce sudden variations of the magnetic field and of the scales that have most of the power. The LIM parameter (i.e. normalized wavelet power indicates that events for scales below 65 s are non-uniformly distributed throughout the cusp passage. PDFs, flatness and wavelet analysis show that at coarse-grained scales larger than τG the intermittency is absent in the cusp. Fluctuations of the magnetic energy observed during the same orbit in the magnetosheath show PDFs that tend toward a Gaussian at scales smaller than τG found in the cusp. The flatness analysis confirms the decreasing of τG from cusp to magnetosheath. Our analysis reveals the turbulent cusp as a transition region from a non-intermittent turbulent state inside the magnetosphere to an intermittent turbulent state in the magnetosheath that has statistical properties resembling the solar wind turbulence. The observed turbulent fluctuations in the cusp suggests a phenomenon of nonlinear

  6. Maass Cusp Forms on Singly Punctured Two-Torus

    International Nuclear Information System (INIS)

    Siddig, Abubaker Ahmed Mohamed; Shah, Nurisya Mohd; Zainuddin, Hishamuddin

    2009-01-01

    Quantum mechanical systems on punctured surfaces modeled by hyperbolic spaces can play an interesting role in exploring quantum chaos and in studying behaviour of future quantum nano-devices. The case of singly-punctured two-torus, for example, has been well-studied in the literature particularly for its scattering states. However, the bound states on the punctured torus given by Maass cusp forms are lesser known. In this note, we report on the algorithm of numerically computing these functions and we present ten lower-lying eigenvalues for each odd and even Maass cusp forms.

  7. Characteristics of aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve morphology

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Hong Ju [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiovascular Surgery, Seoul (Korea, Republic of); Yonsei University College of Medicine, Department of Cardiovascular Surgery, Seoul (Korea, Republic of); Shin, Je Kyoun; Chee, Hyun Kun; Kim, Jun Suk [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Cardiovascular Surgery, Seoul (Korea, Republic of); Ko, Sung Min [Konkuk University Medical Center, Konkuk University School of Medicine, Department of Radiology, Seoul (Korea, Republic of)

    2015-07-15

    To characterize aortic valve dysfunction and ascending aorta dimensions according to bicuspid aortic valve (BAV) morphology using computed tomography (CT) and surgical findings. We retrospectively enrolled 209 patients with BAVs who underwent transthoracic echocardiography (TTE) and CT. BAVs were classified as anterior-posterior (BAV-AP) or lateral (BAV-LA) orientation of the cusps and divided according to the presence (raphe+) or absence (raphe-) of a raphe. Ascending aortic dimensions were measured by CT at four levels. BAV-AP was present in 129 patients (61.7 %) and raphe+ in 120 (57.4 %). Sixty-nine patients (33.0 %) had aortic regurgitation (AR), 70 (33.5 %) had aortic stenosis (AS), and 58 (27.8 %) had combined AS and AR. AR was more common in patients with BAV-AP and raphe+; AS was more common with BAV-LA and raphe-.Annulus/body surface area and tubular portion/body surface area diameters in patients with BAV-AP (17.1 ± 2.3 mm/m{sup 2} and 24.2 ± 5.3 mm/m{sup 2}, respectively) and raphe+ (17.3 ± 2.2 mm/m{sup 2} and 24.2 ± 5.5 mm/m{sup 2}, respectively) were significantly different from those with BAV-LA (15.8 ± 1.9 mm/m{sup 2} and 26.4 ± 5.5 mm/m{sup 2}, respectively) and raphe- (15.7 ± 1.9 mm/m{sup 2} and 26.2 ± 5.4 mm/m{sup 2}, respectively). The morphological characteristics of BAV might be associated with the type of valvular dysfunction, and degree and location of an ascending aorta dilatation. (orig.)

  8. Aortic valve surgery - open

    Science.gov (United States)

    ... gov/ency/article/007408.htm Aortic valve surgery - open To use the sharing features on this page, ... separates the heart and aorta. The aortic valve opens so blood can flow out. It then closes ...

  9. Abdominal Aortic Aneurysm (AAA)

    Science.gov (United States)

    ... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

  10. Detecting atheromatous plaques in the aortic arch or supra-aortic arteries for more accurate stroke subtype classification.

    Science.gov (United States)

    Cui, Xiaoyang; Wu, Simiao; Zeng, Quantao; Xiao, Jiahe; Liu, Ming

    2015-02-01

    To investigate the correlations of atheromatous plaques in the aortic arch or supra-aortic arteries with intracranial arterial stenosis and carotid plaques in stroke patients, and to determine whether taking these plaques into account will reduce the proportion of patients in the undetermined etiology group. We prospectively enrolled 308 ischemic stroke patients, whose clinical characteristics and A-S-C-O classifications were compared with analyses of intracranial arteries, carotid arteries, aortic arch, and supra-aortic arteries. 125(40.6%) patients had plaques in the aortic arch or supra-aortic arteries, of which 106 (84.8%) had complex plaques. No correlations were observed between these plaques and carotid plaques ( p = 0.283) or intracranial arterial stenosis ( p = 0.097). After detecting the mobile thrombi in the aortic arch and supra-aortic arteries, the proportion of patients in the atherothrombosis group was increased from 33.8% to 55.5% ( p = 0.00), whereas the proportion of patients in stroke of undetermined etiology group was decreased from 19.2% to 11.0% ( p = 0.00). Examining only the carotid and intracranial arteries may not provide adequate information about large arteries in stroke patients. Therefore, it would be better to include a search for relevant plaques in the aortic arch or supra-aortic arteries in modern stroke workup, for it may lead to more accurate stroke subtype classification and guide secondary prevention.

  11. Elimination of cusps in dimension 4 and its applications

    NARCIS (Netherlands)

    Behrens, S.|info:eu-repo/dai/nl/380140217; Hayano, Kenta

    2016-01-01

    We study a class of homotopies between maps from 4-manifolds to surfaces which we call cusp merges. These homotopies naturally appear in the uniqueness problems for certain pictorial descriptions of 4-manifolds derived from maps to the 2-sphere (for example, broken Lefschetz fibrations, wrinkled

  12. Mandibular Facial Talon Cusp: A Rare Case Report | Prabhu ...

    African Journals Online (AJOL)

    Talon cusp (TC) is a relatively uncommon developmental anomaly characterized by cusp‑like projections from the cemento‑enamel junction to a variable distance toward the incisal edge of an anterior tooth. It usually presents on palatal/lingual surface of the anterior teeth. Studies have revealed that it consists of enamel, ...

  13. Observations of an enhanced convection channel in the cusp ionosphere

    International Nuclear Information System (INIS)

    Pinnock, M.; Rodger, A.S.; Dudeney, J.R.; Baker, K.B.; Neweli, P.T.; Greenwald, R.A.; Greenspan, M.E.

    1993-01-01

    Transient or patchy magnetic field line merging on the dayside magnetopause, giving rise to flux transfer events (FTEs), is thought to play a significant role in energizing high-latitude ionospheric convection during periods of southward interplanetary magnetic field. Several transient velocity patterns in the cusp ionosphere have been presented as candidate FTE signatures. Instrument limitations, combined with uncertainties about ionospheric signature of FTEs have yet to be presented. This paper describes combined observations by the PACE HF backscatter radar and the DMSP F9 polar-orbiting satellite of a transient velocity signature in the southern hemispheric cusp. The prevailing solar wind conditions suggest that it is the result of enhanced magnetic merging at the magnetopause. The satellite particle precipitation data associated with the transient are typically cusplike in nature. The presence of spatially discrete patches of accelerated ions at the equatorward edge of the cusp is consistent with the ion acceleration that could occur with merging. The combined radar line-of-sight velocity data and the satellite transverse plasma drift data are consistent with a channel of enhanced convection superposed on the ambient cusp plasma flow. This channel is at least 900 km in longitudinal extent but only 100 km wide. It is zonally aligned for most of its extent, except at the western limit where it rotates sharply poleward. Weak return flow is observed outside the channel. These observations are compared with and contrasted to similar events seen by the EISCAT radar and by optical instruments. 30 refs., 2 figs

  14. ULF Narrowband Emissions Analysis in the Terrestrial Polar Cusps

    Science.gov (United States)

    Grison, B.; Pisa, D.

    2013-05-01

    Polar cusps are known to be a key region for transfer of mass and momentum between the adjacent magnetosheath and the magnetosphere. The 4 spacecraft of the Cluster ESA mission crossed the polar cusps in their most distant part to the Earth in the early years of the mission (2000-2004) because of their highly eccentric orbit. The ULF wave activity in the cusp region has been linked with the magnetosheath plasma penetration since HEOS observations (D'Angelo et al., 1974). Wave and particle interaction play an important role in this colisionless plasma. The observed wave activity certainly results from both distant and local generation mechanisms. From Cluster case studies we propose to focus on one aspect for each of this place of generation. Concerning the distant generation, the possibility of a wave generation at the magnetopause itself is investigated. For this purpose we compare the propagation of the emissions on each side of the magnetopasue, i.e. in the cusp and in the magnetosheath. Concerning the local generation, the presence of locally generated waves above the local proton gyrofrequency that display a left hand polarization has been reported in Polar and Cluster studies (Le et al., 2001; Nykyri et al., 2003 ). The Doppler shift was not large enough to explain the observed frequency. We propose here to combine various techniques (k-filtering analysis, WHAMP simulations) to achieve a precise wave vector estimation and to explain these observations. References: D'Angelo, N., A. Bahnsen, and H. Rosenbauer (1974), Wave and particle measurements at the polar cusp, J. Geophys. Res., 79( 22), 3129-3134, doi:10.1029/JA079i022p03129. Le, G., X. Blanco-Cano, C. T. Russell, X.-W. Zhou, F. Mozer, K. J. Trattner, S. A. Fuselier, and B. J. Anderson (2001), Electromagnetic ion cyclotron waves in the high-altitude cusp: Polar observations, J. Geophys. Res., 106(A9), 19067-19079, doi:10.1029/2000JA900163. Nykyri, K., P. J. Cargill, E. A. Lucek, T. S. Horbury, A. Balogh

  15. Cluster Observations of Particle Injections in the Exterior Cusp

    Science.gov (United States)

    Escoubet, C. P.; Grison, B.; Berchem, J.; Trattner, K. J.; Lavraud, B.; Pitout, F.; Soucek, J.; Richard, R. L.; Laakso, H. E.; Masson, A.; Dunlop, M. W.; Dandouras, I. S.; Reme, H.; Fazakerley, A. N.; Daly, P. W.

    2014-12-01

    The main process that injects solar wind plasma into the polar cusp is now generally accepted to be magnetic reconnection. Depending on the IMF direction, this process takes place equatorward (for IMF southward), poleward (for IMF northward) or on the dusk or dawn sides (for IMF azimuthal) of the cusp. We report a Cluster crossing on 5 January 2002 near the exterior cusp on the southern dusk side. The IMF was mainly azimuthal (IMF-By around -5 nT), the solar wind speed lower than usual around 280 km/s with the density of order 5 cm-3. The four Cluster spacecraft had an elongated configuration near the magnetopause. C4 was the first spacecraft to enter the cusp around 19:52:04 UT, followed by C2 at 19:52:35 UT, C1 at 19:54:24 UT and C3 at 20:13:15 UT. C4 and C1 observed two ion energy dispersions at 20:10 UT and 20:40 UT and C3 at 20:35 UT and 21:15 UT. Using the time of flight technique on the upgoing and downgoing ions, which leads to energy dispersions, we obtain distances of the ion sources between 14 and 20 RE from the spacecraft. Using Tsyganenko model, we find that these sources are located on the dusk flank, past the terminator. The first injection by C3 is seen at approximately the same time as the 2nd injection on C1 but their sources at the magnetopause were separated by more than 7 RE. This would imply that two distinct sources were active at the same time on the dusk flank of the magnetosphere. In addition, a flow reversal was observed at the magnetopause on C4 which would be an indication that reconnection is taking place near the exterior cusp.

  16. Cluster Observations of Ion Dispersions near the Exterior Cusp

    Science.gov (United States)

    Escoubet, C.; Grison, B.; Berchem, J.; Trattner, K. J.; Pitout, F.; Richard, R. L.; Taylor, M. G.; Laakso, H. E.; Masson, A.; Dunlop, M. W.; Dandouras, I. S.; Reme, H.; Fazakerley, A. N.; Daly, P. W.

    2013-12-01

    The cusps are the places where the Earth's magnetic field lines, connected to the inner side of the magnetopause, converge. It is therefore the place where signatures of processes occurring near the subsolar point, in the tail lobes, as well as near the dawn and dusk flanks are observed. The main process that injects solar wind plasma into the polar cusp is now generally accepted to be magnetic reconnection. Depending on the IMF direction, this process will take place equatorward (for IMF southward), poleward (for IMF northward) or on the side (for IMF azimuthal) of the cusp. We report a Cluster crossing on 5 January 2002 near the exterior cusp on the southern dusk side. The IMF was mainly azimuthal (IMF-By around -5 nT), the solar wind speed around 280 km/s and the density around 5 cm-3. The four Cluster spacecraft were still in the "magnetotail" configuration with two perfect tetrahedra of 2000 km around apogee and turning into an elongated configuration near the magnetopause. C4 was the first spacecraft to enter the cusp around 19:52:04 UT, followed by C2 at 19:52:35 UT, C1 at 19:54:24 UT and C3 at 20:13:15 UT. C4 and C1 observed two ion energy dispersions at 20:10 UT and 20:40 UT and C3 at 20:35 UT and 21:15 UT. We will investigate the origin of the injections forming the dispersions and if these can be explained by the reconnection between the interplanetary magnetic field and the Earth's magnetic field.

  17. Acceleration of O+ from the cusp to the plasma sheet

    Science.gov (United States)

    Liao, J.; Kistler, L. M.; Mouikis, C. G.; Klecker, B.; Dandouras, I.

    2015-02-01

    Heavy ions from the ionosphere that are accelerated in the cusp/cleft have been identified as a direct source for the hot plasma in the plasma sheet. However, the details of the acceleration and transport that transforms the originally cold ions into the hot plasma sheet population are not fully understood. The polar orbit of the Cluster satellites covers the main transport path of the O+ from the cusp to the plasma sheet, so Cluster is ideal for tracking its velocity changes. However, because the cusp outflow is dispersed according to its velocity as it is transported to the tail, due to the velocity filter effect, the observed changes in beam velocity over the Cluster orbit may simply be the result of the spacecraft accessing different spatial regions and not necessarily evidence of acceleration. Using the Cluster Ion Spectrometry/Composition Distribution Function instrument onboard Cluster, we compare the distribution function of streaming O+ in the tail lobes with the initial distribution function observed over the cusp and reveal that the observations of energetic streaming O+ in the lobes around -20 RE are predominantly due to the velocity filter effect during nonstorm times. During storm times, the cusp distribution is further accelerated. In the plasma sheet boundary layer, however, the average O+ distribution function is above the upper range of the outflow distributions at the same velocity during both storm and nonstorm times, indicating that acceleration has taken place. Some of the velocity increase is in the direction perpendicular to the magnetic field, indicating that the E × B velocity is enhanced. However, there is also an increase in the parallel direction, which could be due to nonadiabatic acceleration at the boundary or wave heating.

  18. The dependence of cusp ion signatures on the reconnection rate

    Directory of Open Access Journals (Sweden)

    S. K. Morley

    2003-04-01

    Full Text Available The interpretation of structure in cusp ion dispersions is important for helping to understand the temporal and spatial structure of magnetopause reconnection. "Stepped" and "sawtooth" signatures have been shown to be caused by temporal variations in the reconnection rate under the same physical conditions for different satellite trajectories. The present paper shows that even for a single satellite path, a change in the amplitude of any reconnection pulses can alter the observed signature and even turn sawtooth into stepped forms and vice versa. On 20 August 1998, the Defense Meteorological Satellite Program (DMSP craft F-14 crossed the cusp just to the south of Longyearbyen, returning on the following orbit. The two passes by the DMSP F-14 satellites have very similar trajectories and the open-closed field line boundary (OCB crossings, as estimated from the SSJ/4 precipitating particle data and Polar UVI images, imply a similarly-shaped polar cap, yet the cusp ion dispersion signatures differ substantially. The cusp crossing at 08:54 UT displays a stepped ion dispersion previously considered to be typical of a meridional pass, whereas the crossing at 10:38 UT is a sawtooth form ion dispersion, previously considered typical of a satellite travelling longitudinally with respect to the OCB. It is shown that this change in dispersed ion signature is likely to be due to a change in the amplitude of the pulses in the reconnection rate, causing the stepped signature. Modelling of the low-energy ion cutoff under different conditions has reproduced the forms of signature observed.Key words. Ionosphere (particle precipitation Magnetospheric physics (energetic particles, precipitating, magnetopause, cusp and boundary layers

  19. Midterm outcome of valve-sparing aortic root replacement in inherited connective tissue disorders.

    Science.gov (United States)

    Tanaka, Hiroshi; Ogino, Hitoshi; Matsuda, Hitoshi; Minatoya, Kenji; Sasaki, Hiroaki; Iba, Yutaka

    2011-11-01

    This study determined the midterm outcome of valve-sparing aortic root replacement for patients with inherited connective tissue disorders. From 1993 to 2008, 94 patients underwent valve-sparing aortic root replacement. Sixty patients (64%), average age 33 years (range, 15 to 61 years), had inherited connective tissue disorders: Marfan syndrome, 54 (92%); Loeys-Dietz syndrome, 5 (8%); and smooth muscle α-actin (ACTA2) mutation in 1. Median preoperative sinus diameter was 52 mm (range, 42 to 76 mm), and moderate/severe aortic regurgitation was present in 14 (23%). Seven (12%, 1993 to 1999) underwent remodeling procedures, and 53 had reimplantation procedures. Cusp repair was performed in 4. Median follow-up was 55 months (range, 1 to 149 months). There were 15 patients in the early term (1993 to 2000) and 45 in the late term (2001 to 2008). Four late deaths occurred (cardiac, 3; aortic, 1), with 10-year survival of 86%. Rates of freedom from aortic valve replacement at 5 and 10 years were 85% and 58% in remodeling and 96% and 58% in reimplantation. Risk factors for reoperations were postprocedure intraoperative aortic insufficiency greater than mild (p = 0.046), remodeling procedure (p = 0.016), and early term (p = 0.0002). One patient (2%) with none/trivial postprocedure aortic insufficiency required aortic valve replacement. Freedom from reoperation in patients with none/trivial postprocedure aortic insufficiency at 5 and 10 years was 100% and 67%. Meticulous control of aortic insufficiency during operation would bring favorable midterm durability in valve-sparing aortic root replacement using a reimplantation technique, even in patients with inherited connective tissue disorders. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Quantification of abdominal aortic deformation after EVAR

    Science.gov (United States)

    Demirci, Stefanie; Manstad-Hulaas, Frode; Navab, Nassir

    2009-02-01

    Quantification of abdominal aortic deformation is an important requirement for the evaluation of endovascular stenting procedures and the further refinement of stent graft design. During endovascular aortic repair (EVAR) treatment, the aortic shape is subject to severe deformation that is imposed by medical instruments such as guide wires, catheters, and, the stent graft. This deformation can affect the flow characteristics and morphology of the aorta which have been shown to be elicitors for stent graft failures and be reason for reappearance of aneurysms. We present a method for quantifying the deformation of an aneurysmatic aorta imposed by an inserted stent graft device. The outline of the procedure includes initial rigid alignment of the two abdominal scans, segmentation of abdominal vessel trees, and automatic reduction of their centerline structures to one specified region of interest around the aorta. This is accomplished by preprocessing and remodeling of the pre- and postoperative aortic shapes before performing a non-rigid registration. We further narrow the resulting displacement fields to only include local non-rigid deformation and therefore, eliminate all remaining global rigid transformations. Finally, deformations for specified locations can be calculated from the resulting displacement fields. In order to evaluate our method, experiments for the extraction of aortic deformation fields are conducted on 15 patient datasets from endovascular aortic repair (EVAR) treatment. A visual assessment of the registration results and evaluation of the usage of deformation quantification were performed by two vascular surgeons and one interventional radiologist who are all experts in EVAR procedures.

  1. Black Holes and Galactic Density Cusps I Radial Orbit Cusps and Bulges

    CERN Document Server

    Henriksen, Richard N; Macmillan, Joseph D

    2011-01-01

    Aims. In this paper we study density cusps made from radial orbits that may contain central black holes. The actual co-eval self-similar growth would not distinguish between the central object and the surroundings. Methods. To study the environment of an existing black hole we seek distribution functions that may contain a black hole and that retain at least a memory of self-similarity. We refer to the environment in brief as the 'bulge' or sometimes the 'halo'. This depends on whether the black hole is a true singularity dominating its halo or rather a core mass concentration that dominates a larger bulge. The hierarchy might extend to include galactic bulge and halo. Results.We find simple descriptions of simulated collisionless matter in the process of examining the presence of central masses. The Fridmann & Polyachenko distribution function describes co-eval growth of a bulge and black hole that might explain the observed mass correlation. Conclusions. We derive our results from first principles assum...

  2. Radiological evaluation of ventricular septal defect with aortic insufficiency - An analysis of cineangiography in 15 cases -

    International Nuclear Information System (INIS)

    Park, Jae Hyung; Yeon, Kyung Mo; Han, Man Chung

    1981-01-01

    Fifteen cases of ventricular septal defect with aortic insufficiency were diagnosed radiographically and confirmed after operation at Seoul National University Hospital in recent two half years since 1979. Cineangiographies of ascending aorta and left ventricle were done in those cases and revealed some characteristic findings. The results of the analysis are as follow: 1. Among the 15 cases, 14 cases were male and 1 case was female. Age distribution was from 7 years to 23 years. 2. Those 15 cases were corresponded to 8% among total 193 cases of ventricular septal defect, to 11% among total 135 cases of aortic insufficiency and especially to 48% among 48 cases of aortic insufficiency below age of 20 years. 3. After operation, 11 cases were confirmed as subpulmonary type ventricular septal defect and 4 cases as subcristal type. The sizes of the ventricular septal defects were ranged between 0.6 and 2.5 cm in diameter. 4. Regurgitation of contrast media was noticed in cine aortography of all cases, and the grades of regurgitation were II-III/IV in 13 cases. 5. Various types of herniated aortic cusp through ventricular septal defect were seen. In the cases of subpulmonary ventricular septal defect characteristic saccular aneurysm was found in 7 cases. Asymmetry or mild bulging of aortic sinus was found in the cases of subcristal ventricular septal defect. 6. Infundibular stenosis was found in 3 cases with right ventriculography and those were caused by the herniated saccular aneurysm of aortic cusp. 7. It is essential for the diagnosis of ventricular septal defect with aortic insufficiency to undertake biplane cineangiography of ascending aorta and left ventricle in long axial view and right ventriculography should be done in suspicion of infundibular pulmonary stenosis

  3. Distribution of Mitral Annular and Aortic Valve Calcium as Assessed by Unenhanced Multidetector Computed Tomography.

    Science.gov (United States)

    Koshkelashvili, Nikoloz; Codolosa, Jose N; Goykhman, Igor; Romero-Corral, Abel; Pressman, Gregg S

    2015-12-15

    Aging is associated with calcium deposits in various cardiovascular structures, but patterns of calcium deposition, if any, are unknown. In search of such patterns, we performed quantitative assessment of mitral annular calcium (MAC) and aortic valve calcium (AVC) in a broad clinical sample. Templates were created from gated computed tomography (CT) scans depicting the aortic valve cusps and mitral annular segments in relation to surrounding structures. These were then applied to CT reconstructions from ungated, clinically indicated CT scans of 318 subjects, aged ≥65 years. Calcium location was assigned using the templates and quantified by the Agatston method. Mean age was 76 ± 7.3 years; 48% were men and 58% were white. Whites had higher prevalence (p = 0.03) and density of AVC than blacks (p = 0.02), and a trend toward increased MAC (p = 0.06). Prevalence of AVC was similar between men and women, but AVC scores were higher in men (p = 0.008); this difference was entirely accounted for by whites. Within the aortic valve, the left cusp was more frequently calcified than the others. MAC was most common in the posterior mitral annulus, especially its middle (P2) segment. For the anterior mitral annulus, the medial (A3) segment calcified most often. In conclusion, AVC is more common in whites than blacks, and more intense in men, but only in whites. Furthermore, calcium deposits in the mitral annulus and aortic valve favor certain locations. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

    DEFF Research Database (Denmark)

    Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U

    2015-01-01

    PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...

  5. Aortic valve calcification as a predictor of location and severity of paravalvular regurgitation after transcatheter aortic valve implantation.

    Science.gov (United States)

    Koh, Ezra Y; Lam, Kayan Y; Bindraban, Navin R; Cocchieri, Riccardo; Planken, R Nils; Koch, Karel T; Baan, Jan; de Mol, Bas A; Marquering, Henk A

    2015-03-01

    To determine whether the location of aortic valve calcium (AVC) influences the location of paravalvular regurgitation (PR). PR is an adverse effect of transcatheter aortic valve implantation (TAVI) with a negative effect on long-term patient survival. The relationship between AVC and the occurrence of PR has been documented. However, the relationship between the distribution of AVC and the location of PR is still sparsely studied. The purpose of this study was to correlate severity and location of AVC with PR in patients treated with TAVI. Fifty-six consecutive patients who underwent transaortic or transapical TAVI and had preoperative computed tomography scans were included in this retrospective study. The volume, mass and location of AVC was determined and compared between patients with and without PR using a non-parametric t-test. Postoperative echocardiography was performed to determine the presence and location of PR, which was associated with the cusp with highest AVC using a χ(2) test. Valve deployment was successful in all 56 patients. PR was present in 38 patients (68%) after TAVI. There was a non-significantly higher volume of AVC in the PR group [214 (70-418) vs 371 (254-606) cm(3), P = 0.15]. AVC mass was significantly higher in patients with PR than in patients without PR [282 (188-421) vs 142 (48-259) mg, respectively, P = 0.043]. The location of PR was determined in 36 of these patients. Of these 36 patients, PR occurred at the cusp with the highest AVC in 20 patients (56%, χ(2) P = 0.030). In our population, PR was associated with greater AVC mass. Moreover, the location of PR was associated with the cusp with the highest amount of AVC. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. Apex Dips of Experimental Flux Ropes: Helix or Cusp?

    Energy Technology Data Exchange (ETDEWEB)

    Wongwaitayakornkul, Pakorn; Haw, Magnus A.; Bellan, Paul M. [Applied Physics, California Institute of Technology, Pasadena, CA 91125 (United States); Li, Hui [Theoretical Division, Los Alamos National Laboratory, Mail Stop B227, Los Alamos, NM 87545 (United States); Li, Shengtai, E-mail: pwongwai@caltech.edu, E-mail: mhaw@caltech.edu [Mathematical Modeling and Analysis, Los Alamos National Laboratory, Mail Stop B284, Los Alamos, NM 87545 (United States)

    2017-10-20

    We present a new theory for the presence of apex dips in certain experimental flux ropes. Previously such dips were thought to be projections of a helical loop axis generated by the kink instability. However, new evidence from experiments and simulations suggest that the feature is a 2D cusp rather than a 3D helix. The proposed mechanism for cusp formation is a density pileup region generated by nonlinear interaction of neutral gas cones emitted from fast-gas nozzles. The results indicate that density perturbations can result in large distortions of an erupting flux rope, even in the absence of significant pressure or gravitational forces. The density pileup at the apex also suppresses the m = 1 kink mode by acting as a stationary node. Consequently, more accurate density profiles should be considered when attempting to model the stability and shape of solar and astrophysical flux ropes.

  7. Can a stochastic cusp catastrophe model explain stock market crashes?

    Czech Academy of Sciences Publication Activity Database

    Baruník, Jozef; Vošvrda, Miloslav

    2009-01-01

    Roč. 33, č. 10 (2009), s. 1824-1836 ISSN 0165-1889 R&D Projects: GA ČR GD402/09/H045; GA ČR GA402/09/0965 Grant - others:GAUK(CZ) 46108 Institutional research plan: CEZ:AV0Z10750506 Keywords : Stochastic cusp catastrophe * Bifurcations * Singularity * Nonlinear dynamics * Stock market crash Subject RIV: AH - Economics Impact factor: 1.097, year: 2009

  8. Rip currents, mega-cusps, and eroding dunes

    Science.gov (United States)

    Thornton, E.B.; MacMahan, J.; Sallenger, A.H.

    2007-01-01

    Dune erosion is shown to occur at the embayment of beach mega-cusps O(200 m alongshore) that are associated with rip currents. The beach is the narrowest at the embayment of the mega-cusps allowing the swash of large storm waves coincident with high tides to reach the toe of the dune, to undercut the dune and to cause dune erosion. Field measurements of dune, beach, and rip current morphology are acquired along an 18 km shoreline in southern Monterey Bay, California. This section of the bay consists of a sandy shoreline backed by extensive dunes, rising to heights exceeding 40 m. There is a large increase in wave height going from small wave heights in the shadow of a headland, to the center of the bay where convergence of waves owing to refraction over the Monterey Bay submarine canyon results in larger wave heights. The large alongshore gradient in wave height results in a concomitant alongshore gradient in morphodynamic scale. The strongly refracted waves and narrow bay aperture result in near normal wave incidence, resulting in well-developed, persistent rip currents along the entire shoreline. The alongshore variations of the cuspate shoreline are found significantly correlated with the alongshore variations in rip spacing at 95% confidence. The alongshore variations of the volume of dune erosion are found significantly correlated with alongshore variations of the cuspate shoreline at 95% confidence. Therefore, it is concluded the mega-cusps are associated with rip currents and that the location of dune erosion is associated with the embayment of the mega-cusp.

  9. Localized Models of Charged Particle Motion in Martian Crustal Magnetic Cusps

    Science.gov (United States)

    Brain, D. A.; Poppe, A. R.; Jarvinen, R.; Dong, Y.; Egan, H. L.; Fang, X.

    2017-12-01

    The induced magnetosphere of Mars is punctuated by localized but strong crustal magnetic fields that are observed to play host to a variety of phenomena typically associated with global magnetic fields, such as auroral processes and particle precipitation, field-aligned current systems, and ion outflow. Each of these phenomena occur on the night side, in small-scale magnetic `cusp' regions of vertically aligned field. Cusp regions are not yet capable of being spatially resolved in global scale models that include the ion kinetics necessary for simulating charged particle transport along cusps. Local models are therefore necessary if we are to understand how cusp processes operate at Mars. Here we present the first results of an effort to model the kinetic particle motion and electric fields in Martian cusps. We are adapting both a 1.5D Particle-in-Cell (PIC) model for lunar magnetic cusps regions to the Martian case and a hybrid model framework (used previously for the global Martian plasma interaction and for lunar magnetic anomaly regions) to cusps in 2D. By comparing the models we can asses the importance of electron kinetics in particle transport along cusp field lines. In this first stage of our study we model a moderately strong nightside cusp, with incident hot hydrogen plasma from above, and cold planetary (oxygen) plasma entering the simulation from below. We report on the spatial and temporal distribution of plasma along cusp field lines for this initial case.

  10. UV Observations of Atomic Oxygen in the Cusp Region

    Science.gov (United States)

    Fritz, B.; Lessard, M.; Dymond, K.; Kenward, D. R.; Lynch, K. A.; Clemmons, J. H.; Hecht, J. H.; Hysell, D. L.; Crowley, G.

    2017-12-01

    The Rocket Experiment for Neutral Upwelling (RENU) 2 launched into the dayside cusp on 13 December, 2015. The sounding rocket payload carried a comprehensive suite of particle, field, and remote sensing instruments to characterize the thermosphere in a region where pockets of enhanced neutral density have been detected [Lühr et al, 2004]. An ultraviolet photomultiplier tube (UV PMT) was oriented to look along the magnetic field line and remotely detect neutral atomic oxygen (OI) above the payload. The UV PMT measured a clear enhancement as the payload descended through a poleward moving auroral form, an indicator of structure in both altitude and latitude. Context for the UV PMT measurement is provided by the Special Sensor Ultraviolet Imager (SSULI) instrument on the Defense Meteorological Space Program (DMSP) satellite, which also measured OI as it passed through the cusp. UV tomography of SSULI observations produces a two-dimensional cross-section of volumetric emission rates in the high-latitude thermosphere prior to the RENU 2 flight. The volume emission rate may then be inverted to produce a profile of neutral density in the thermosphere. A similar technique is used to interpret the UV PMT measurement and determine structure in the thermosphere as RENU 2 descended through the cusp.

  11. Preliminary results in double cusp tandem mirror MM-4U

    International Nuclear Information System (INIS)

    Ming Linzhou; Tian Zhongyu; Feng Xiaozhen

    1990-10-01

    MM-4U device and preliminary experimental results are presented. Main results are as follows: The plasma has been produced by means of the injection of strong electron current; the axial profile of the plasma potential and the plasma electron density have been obtained respectively, they had a simular form; the plasma potential in the centre of the east cusp, the west cusp and the simple mirror; V e = -180V, V w = -164V, V m -1.8V; the electron density: n e = 1.7 x 10 11 cm -3 , n w = 4.7 x 10 10 cm -3 , n m = 7.5 x 10 7 cm -3 ; the electron temperature: T e = (19.9 ± 1.6) eV, T w = (20.7 ± 1.7) eV; the plasma pressure at 8 cm on the right of the west cusp centre is about 6.76 Pa, β ≅ 1.7 x 10 -3 . The plasma instability has been observed in the simple mirror, its vibration frequency was 7∼9.2 kHz. The results are discussed. The next new task of the physical experiment are proposed

  12. On a new process for cusp irregularity production

    Directory of Open Access Journals (Sweden)

    H. C. Carlson

    2008-09-01

    Full Text Available Two plasma instability mechanisms were thought until 2007 to dominate the formation of plasma irregularities in the F region high latitude and polar ionosphere; the gradient-drift driven instability, and the velocity-shear driven instability. The former mechanism was accepted as accounting for plasma structuring in polar cap patches, the latter for plasma structuring in polar cap sun aligned arcs. Recent work has established the need to replace this view of the past two decades with a new patch plasma structuring process (not a new mechanism, whereby shear-driven instabilities first rapidly structure the entering plasma, after which gradient drift instabilities build on these large "seed" irregularities. Correct modeling of cusp and early polar cap patch structuring will not be accomplished without allowing for this compound process. This compound process explains several previously unexplained characteristics of cusp and early polar cap patch irregularities. Here we introduce additional data, coincident in time and space, to extend that work to smaller irregularity scale sizes and relate it to the structured cusp current system.

  13. Design study of electrostatically plugged cusp fusion reactor

    International Nuclear Information System (INIS)

    Dolan, T.J.

    1976-01-01

    This study concentrates on the following aspects of an electrostatically plugged cusp reactor that will be different from other fusion reactor designs: the coil geometry and structural supports, high voltage electrodes, plasma parameters, power balance, and operating cycle. Assuming the electron density distribution in the anodes to have a characteristic width of two electron Larmor radii, which is consistent with present experimental results, the theory predicts that a device with a magnetic field strength, B = 8 T sustained solely by electron beam injection at 300 kV will have a power gain ratio, Q, of about 5. A toroidal multipole cusp configuration with six cusps was selected for the present design, based on a study of the ratio of plasma volume to coil volume. Coil forces are sustained by cryogenic trusses between like coils, fiberglass compression columns, and room temperature hoops. Radiation collimators in front of the high voltage electrodes greatly reduce the radiation impinging on the cathodes, helping to avoid breakdown and to prolong insulator life. The operating cycle consists of a startup period of about 20 s, followed by a fusion burn period lasting about 200 s (limited by impurity buildup) and a 20-s flushing period

  14. Cusp-core problem and strong gravitational lensing

    International Nuclear Information System (INIS)

    Li Nan; Chen Daming

    2009-01-01

    Cosmological numerical simulations of galaxy formation have led to the cuspy density profile of a pure cold dark matter halo toward the center, which is in sharp contradiction with the observations of the rotation curves of cold dark matter-dominated dwarf and low surface brightness disk galaxies, with the latter tending to favor mass profiles with a flat central core. Many efforts have been devoted to resolving this cusp-core problem in recent years, among them, baryon-cold dark matter interactions are considered to be the main physical mechanisms erasing the cold dark matter (CDM) cusp into a flat core in the centers of all CDM halos. Clearly, baryon-cold dark matter interactions are not customized only for CDM-dominated disk galaxies, but for all types, including giant ellipticals. We first fit the most recent high resolution observations of rotation curves with the Burkert profile, then use the constrained core size-halo mass relation to calculate the lensing frequency, and compare the predicted results with strong lensing observations. Unfortunately, it turns out that the core size constrained from rotation curves of disk galaxies cannot be extrapolated to giant ellipticals. We conclude that, in the standard cosmological paradigm, baryon-cold dark matter interactions are not universal mechanisms for galaxy formation, and therefore, they cannot be true solutions to the cusp-core problem.

  15. Sex assessment efficacy of permanent maxillary first molar cusp dimensions in Indians

    Directory of Open Access Journals (Sweden)

    Achla Bharti Yadav

    2015-01-01

    Full Text Available Background: The human first maxillary molar provides clues about evolution and is functionally important. It has four main cusps, and each cusp has an independent growth pattern and different evolutionary background. Though less explored, the analysis based on measurement of each cusp appears to be more meaningful biologically than conventional measurements of the whole crown. Aim: This study aimed to demonstrate the extent of sexual dimorphism in permanent maxillary first molar cusp diameters and their potential utility in sex prediction among Indians using logistic regression analysis (LRA. Materials and Methods: The mesiodistal and buccolingual (BL crown diameters along with cusp dimensions and cusp indices of right maxillary first molar were measured in an Indian sample (149 males, 151 females; age range of 18–30 years. The possible sex dimorphism in these parameters was evaluated, and LRA was performed to ascertain their usefulness in sex prediction. Results: BL crown dimension and the hypocone (distolingual cusp showed the highest sexual dimorphism. The combination of metacone and hypocone, i.e., distal cusp diameters among cusp parameters showed the highest accuracy (61.3%. While, on combining all the crown and cusp diameters together the overall accuracy was raised (64.3%. Conclusion: This study supports the ontogeny hypothesis suggesting that early-forming mesial cusps demonstrate less sexual variation as compared to subsequently formed distal cusps in the maxillary molar. Though the sex identification accuracy for cusp diameters of the permanent maxillary first molar in Indians is relatively moderate (≈61%, it can be used as an adjunct for sexing of adult Indians in forensic contexts.

  16. 3-D mesoscale MHD simulations of magnetospheric cusp-like configurations: cusp diamagnetic cavities and boundary structure

    Directory of Open Access Journals (Sweden)

    E. Adamson

    2012-02-01

    Full Text Available We present results from mesoscale simulations of the magnetospheric cusp region for both strongly northward and strongly southward interplanetary magnetic field (IMF. Simulation results indicate an extended region of depressed magnetic field and strongly enhanced plasma β which exhibits a strong dependence on IMF orientation. These structures correspond to the Cusp Diamagnetic Cavities (CDC's. The typical features of these CDC's are generally well reproduced by the simulation. The inner boundaries between the CDC and the magnetosphere are gradual transitions which form a clear funnel shape, regardless of IMF orientation. The outer CDC/magnetosheath boundary exhibits a clear indentation in both the x-z and y-z planes for southward IMF, while it is only indented in the x-z plane for northward, with a convex geometry in the y-z plane. The outer boundary represents an Alfvénic transition, mostly consistent with a slow-shock, indicating that reconnection plays an important role in structuring the high-altitude cusp region.

  17. Aortic arch malformations

    Energy Technology Data Exchange (ETDEWEB)

    Kellenberger, Christian J. [University Children' s Hospital, Department of Diagnostic Imaging, Zuerich (Switzerland)

    2010-06-15

    Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

  18. Imaging in aortic dissection

    International Nuclear Information System (INIS)

    Yu-Qing Liu, M.D.

    1995-01-01

    Aortic dissection (AD) is a catastrophic aortic disease. Imaging techniques play an invaluable role in the diagnostic evaluation and management of patients with AD. Major signs of AD with different imaging modalities are described in this article with a pertinent discussion on guidelines for the optimized approach of imaging study (13 refs.)

  19. Aortic arch malformations

    International Nuclear Information System (INIS)

    Kellenberger, Christian J.

    2010-01-01

    Although anomalies of the aortic arch and its branches are relatively uncommon malformations, they are often associated with congenital heart disease. Isolated lesions may be clinically significant when the airways are compromised by a vascular ring. In this article, the development and imaging appearance of the aortic arch system and its various malformations are reviewed. (orig.)

  20. Imaging in aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Yu-Qing Liu, M D [Chinese Academy of Medical Sciences, Beijing, BJ (China). Dept. of Radiology, Fu Wai Hospital and Cardiovascular Inst.

    1996-12-31

    Aortic dissection (AD) is a catastrophic aortic disease. Imaging techniques play an invaluable role in the diagnostic evaluation and management of patients with AD. Major signs of AD with different imaging modalities are described in this article with a pertinent discussion on guidelines for the optimized approach of imaging study (13 refs.).

  1. Bovine aortic arch with supravalvular aortic stenosis.

    Science.gov (United States)

    Idhrees, Mohammed; Cherian, Vijay Thomas; Menon, Sabarinath; Mathew, Thomas; Dharan, Baiju S; Jayakumar, K

    2016-09-01

    A 5-year-old boy was diagnosed to have supravalvular aortic stenosis (SVAS). On evaluation of CT angiogram, there was associated bovine aortic arch (BAA). Association of BAA with SVAS has not been previously reported in literature, and to best of our knowledge, this is the first case report of SVAS with BAA. Recent studies show BAA as a marker for aortopathy. SVAS is also an arteriopathy. In light of this, SVAS can also possibly be a manifestation of aortopathy associated with BAA. Copyright © 2015 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  2. Bovine aortic arch with supravalvular aortic stenosis

    Directory of Open Access Journals (Sweden)

    Mohammed Idhrees

    2016-09-01

    Full Text Available A 5-year-old boy was diagnosed to have supravalvular aortic stenosis (SVAS. On evaluation of CT angiogram, there was associated bovine aortic arch (BAA. Association of BAA with SVAS has not been previously reported in literature, and to best of our knowledge, this is the first case report of SVAS with BAA. Recent studies show BAA as a marker for aortopathy. SVAS is also an arteriopathy. In light of this, SVAS can also possibly be a manifestation of aortopathy associated with BAA.

  3. THE CUSP/CORE PROBLEM AND THE SECONDARY INFALL MODEL

    International Nuclear Information System (INIS)

    Del Popolo, A.

    2009-01-01

    We study the cusp/core problem using a secondary infall model that takes into account the effect of ordered and random angular momentum, dynamical friction, and baryons adiabatic contraction (AC). The model is applied to structures on galactic scales (normal and dwarfs spiral galaxies) and on clusters of galaxies scales. Our analysis suggest that angular momentum and dynamical friction are able, on galactic scales, to overcome the competing effect of AC eliminating the cusp. The slope of density profile of inner halos flattens with decreasing halo mass and the profile is well approximated by a Burkert's profile. In order to obtain the Navarro-Frenk-White (NFW) profile, starting from the profiles obtained from our model, the magnitude of angular momentum and dynamical friction must be reduced with respect to the values predicted by the model itself. The rotation curves of four lower sideband galaxies from Gentile et al. are compared to the rotation curves obtained by the model in the present paper obtaining a good fit to the observational data. The time evolution of the density profile of a galaxy of 10 8 -10 9 M sun shows that after a transient steepening, due to the AC, the density profile flattens to α ≅ 0. On cluster scales we observe a similar evolution of the dark matter (DM) density profile but in this case the density profile slope flattens to α ≅ 0.6 for a cluster of ≅10 14 M sun . The total mass profile, differently from that of DM, shows a central cusp well fitted by an NFW model.

  4. Cusp catastrophe model for binge drinking in a college population.

    Science.gov (United States)

    Smerz, Kelly E; Guastello, Stephen J

    2008-04-01

    A cusp catastrophe model for binge drinking behavior was developed and tested with attitude toward alcohol consumption and peer influence as the two control parameters. Similar models were also developed for frequency and quantity of alcohol use. Participants were 1,247 students who completed the Long Form of the Core Alcohol and Drug Survey. The results were strongest for the binge drinking criterion (R(2) = .90), compared to a linear model (R(2) = .34) that is usually associated with the Theory of Planned Behavior or Theory of Reasoned Action. The results have numerous implications for the development of interventions and for future research.

  5. A cusp electron gun for millimeter wave gyrodevices

    Science.gov (United States)

    Donaldson, C. R.; He, W.; Cross, A. W.; Li, F.; Phelps, A. D. R.; Zhang, L.; Ronald, K.; Robertson, C. W.; Whyte, C. G.; Young, A. R.

    2010-04-01

    The experimental results of a thermionic cusp electron gun, to drive millimeter and submillimeter wave harmonic gyrodevices, are reported in this paper. Using a "smooth" magnetic field reversal formed by two coils this gun generated an annular-shaped, axis-encircling electron beam with 1.5 A current, and an adjustable velocity ratio α of up to 1.56 at a beam voltage of 40 kV. The beam cross-sectional shape and transported beam current were measured by a witness plate technique and Faraday cup, respectively. These measured results were found to be in excellent agreement with the simulated results using the three-dimensional code MAGIC.

  6. In vitro fracture resistance of fiber reinforced cusp-replacing composite restorations.

    NARCIS (Netherlands)

    Fennis, W.M.M.; Tezvergil, A.; Kuijs, R.H.; Lassila, L.V.; Kreulen, C.M.; Creugers, N.H.J.; Vallittu, P.K.

    2005-01-01

    OBJECTIVES: To assess the fracture resistance and failure mode of fiber reinforced composite (FRC) cusp-replacing restorations in premolars. METHODS: Forty-five extracted sound upper premolars were randomly divided into three groups. Identical MOD cavities with simulated buccal cusp fracture and

  7. A comparison of fatigue resistance of three materials for cusp-replacing adhesive restorations.

    NARCIS (Netherlands)

    Kuijs, R.H.; Fennis, W.M.M.; Kreulen, C.M.; Roeters, F.J.M.; Verdonschot, N.J.J.; Creugers, N.H.J.

    2006-01-01

    OBJECTIVES: To investigate the fatigue resistance and failure behaviour of cusp-replacing restorations in premolars using different types of adhesive restorative materials. METHODS: A class 2 cavity was prepared and the buccal cusp was removed in an extracted sound human upper premolar. By using a

  8. Enamel microstructure and microstrain in the fracture of human and pig molar cusps.

    Science.gov (United States)

    Popowics, T E; Rensberger, J M; Herring, S W

    2004-08-01

    The role of microstructure in enamel strain and breakage was investigated in human molar cusps and those of the pig, Sus scrofa. Rosette strain gauges were affixed to cusp surfaces (buccal human M3, n=15, and lingual pig M1, n=13), and a compressive load was applied to individual cusps using an MTS materials testing machine. Load and strain data were recorded simultaneously until cusp fracture, and these data were used to estimate enamel stresses, principal strains, and stiffness. Fractured and polished enamel fragments were examined in multiple planes using scanning electron microscopy (SEM). Human cusp enamel showed greater stiffness than pig enamel (P=0.02), and tensile stress at yield was higher (17.9 N/mm2 in humans versus 8.9 N/mm2 in pigs, P=0.06). SEM revealed enamel rod decussation in both human and pig enamel; however, only pig enamel showed a decussation plane between rod and inter-rod crystallites. Human inter-rod enamel was densely packed between rods, whereas in pig enamel, inter-rod enamel formed partitions between rows of enamel rods. Overall, human enamel structure enabled molar cusps to withstand horizontal tensile stress during both elastic and plastic phases of compressive loading. In contrast, pig cusp enamel was less resistant to horizontal tensile stresses, but appeared to fortify the enamel against crack propagation in multiple directions. These structural and biomechanical differences in cusp enamel are likely to reflect species-level differences in occlusal function.

  9. Average spatial distributions of energetic particles in the midaltitude cusp/cleft region observed by Viking

    International Nuclear Information System (INIS)

    Kremser, G.; Lundin, R.

    1990-01-01

    The cusp/cleft region provides an entrance for magnetosheath particles into the magnetosphere and a sink for magnetospheric particles. In addition, strong acceleration and/or scattering of particles takes place. The Swedish satellite Viking crossed this region at midaltitudes. Measurements from this spacecraft were used to determine the average spatial distributions of H + and He ++ ions in the energy/charge range 2 keV/e ≤ E/Q ≤ 60 keV/e and of electrons with 7 keV ≤ E ≤ 97 keV. The data supply information on the structure of the midaltitude cusp/cleft region, the particle sources, and dynamical processes. Four different parts can be distinguished: (1) The cusp extends from about 76 degree to 82 degree invariant latitude (INL) and from 0800 to 1400 MLT. It is characterized by the presence of magnetosheath origin particles and important electron acceleration signatures. (2) A smaller region inside the cusp (77 degree-82 degree INL, 1000-1330 MLT) contains magnetosheath origin ions without electron acceleration. This is regarded as the cusp proper connected to the exterior cusp. (3) Poleward of the cusp magnetosheath origin ions are still present, but no magnetosheath electrons. This region is related to the plasma mantle. (4) Another region without magnetosheath origin ions but with strong electron acceleration extends equatorward of the cusp and probably constitutes part of the cleft, likely to be connected to the low-altitude boundary layer

  10. Quantitative assessment of an aortic and pulmonary valve function according to valve fenestration

    International Nuclear Information System (INIS)

    Mirkhani, S.H.; Golestani, M.G.; Hosini, M.; Kazemian, A.

    1999-01-01

    There are some reasons for malfunction of aortic and pulmonary valve like fibrosis, calcification, and atheroma. Although, in some papers fenestration were known as a pathologic sign, but it is not generally accepted, while this matter is important in choosing suitable Homograft Heart Valve. In this paper fenestrations and its size, numbers and situation effect was studied. We collected 98 hearts, the donors died because of accident, we excluded valves with atheroma, calcification, fibrosis and unequal cusps, 91 aortic and 93 pulmonary valves were given further consideration. We classified valves according to situation, number and size of fenestration. Each valve was tested with 104 cm of non-nal saline column pressure which is equal to 76 mm Hg. Valve efficacy was detected by fluid flow assay. With study of 184 valves, 95 had no fenestration, 64 had less than 2 fenestration and 25 had more than 2 fenestration. Valve efficacy in condition of less than 2 fenestration was more than others (p <0.01). Malfunction effects of fenestration increased in larger valve and it will be decreased if their situation would be marginal (free margin of cusp). In the comparison of aortic and pulmonary valve we saw that malfunction effect of fenestration in pulmonary valve was more than aortic valve. Our experience in Immam Khomeini Homograft Valve Bank has shown that a great deal of valves is fenestrated. It seems that fenestration must be considered as a quality criterion in homograft valve preparation, especially in pulmonary and large aortic valves; but complementary studies is necessary

  11. Percutaneous implantation of the first repositionable aortic valve prosthesis in a patient with severe aortic stenosis.

    Science.gov (United States)

    Buellesfeld, Lutz; Gerckens, Ulrich; Grube, Eberhard

    2008-04-01

    Percutaneous aortic valve replacement is a new less-invasive alternative for high-risk surgical candidates with aortic stenosis. However, the clinical experience is still limited, and the currently available 'first-generation devices' revealed technical shortcomings, such as lack of repositionability and presence of paravalvular leakages. We report the first-in-man experience with the new self-expanding Lotus Valve prosthesis composed of a nitinol frame with implemented bovine pericardial leaflets which is designed to address these issues, being repositionable and covered by a flexible membrane to seal paravalvular gaps. We implanted this prosthesis in a 93-year old patient presenting with severe symptomatic aortic stenosis (valve area: 0.6 cm(2)). Surgical valve replacement had been declined due to comorbidities. We used a retrograde approach for insertion of the 21-French Lotus catheter loaded with the valve prosthesis via surgical cut-down to the external iliac artery. Positioning of the valve was guided by transesophageal echo and supra-aortic angiograms. The prosthesis was successfully inserted and deployed within the calcified native valve. Echocardiography immediately after device deployment showed a significant reduction of the transaortic mean pressure gradient (32 to 9 mmHg; final valve area 1.7 cm(2)) without evidence of residual aortic regurgitation. The postprocedural clinical status improved from NYHA-IV to NYHA-II. These results remained unchanged up to the 3 month follow-up. Successful percutaneous aortic valve replacement can be performed using the new self-expanding and repositionable Lotus valve for treatment of high-risk patients with aortic valve stenosis. Further studies are mandatory to assess device safety and efficacy in larger patient populations. Copyright 2008 Wiley-Liss, Inc.

  12. Traumatic Aortic Injury

    Directory of Open Access Journals (Sweden)

    Brianna Miner

    2016-09-01

    Full Text Available History of present illness: A 48-year-old male with unknown past medical history presents as a trauma after being hit by a car traveling approximately 25 miles per hour. On initial presentation, the patient is confused, combative, and not answering questions appropriately. The patient is hypotensive with a blood pressure of 68/40 and a heart rate of 50 beats per minute, with oxygen saturation at 96% on room air. FAST scan is positive for fluid in Morrison’s pouch, splenorenal space, and pericardial space. Significant findings: The initial chest x-ray showed an abnormal superior mediastinal contour (blue line, suggestive of a possible aortic injury. The CT angiogram showed extensive circumferential irregularity and outpouching of the distal aortic arch (red arrows compatible with aortic transection. In addition, there was a circumferential intramural hematoma, which extended through the descending aorta to the proximal infrarenal abdominal aorta (green arrow. There was also an extensive surrounding mediastinal hematoma extending around the descending aorta and supraaortic branches (purple arrows. Discussion: Traumatic aortic injury is a life-threatening event. The incidence of blunt thoracic aortic injury is low, between 1 to 2 percent of those patients with blunt thoracic trauma.1 However, approximately 80% of patients with traumatic aortic injury die at the scene.2 Therefore it is imperative to diagnose traumatic aortic injury in a timely fashion. The diagnosis can be difficult due to the non-specific signs and symptoms and other distracting injuries. Clinical suspicion should be based on the mechanism of the injury and the hemodynamic status of the patient. In any patient with blunt or penetrating trauma to the chest that is hemodynamically unstable, traumatic aortic injury should be on the differential. Chest x-ray can be used as a screening tool. A normal chest x-ray has a negative predictive value of approximately 97%. CTA chest is the

  13. Methods for quantitative measurement of tooth wear using the area and volume of virtual model cusps.

    Science.gov (United States)

    Kim, Soo-Hyun; Park, Young-Seok; Kim, Min-Kyoung; Kim, Sulhee; Lee, Seung-Pyo

    2018-04-01

    Clinicians must examine tooth wear to make a proper diagnosis. However, qualitative methods of measuring tooth wear have many disadvantages. Therefore, this study aimed to develop and evaluate quantitative parameters using the cusp area and volume of virtual dental models. The subjects of this study were the same virtual models that were used in our former study. The same age group classification and new tooth wear index (NTWI) scoring system were also reused. A virtual occlusal plane was generated with the highest cusp points and lowered vertically from 0.2 to 0.8 mm to create offset planes. The area and volume of each cusp was then measured and added together. In addition to the former analysis, the differential features of each cusp were analyzed. The scores of the new parameters differentiated the age and NTWI groups better than those analyzed in the former study. The Spearman ρ coefficients between the total area and the area of each cusp also showed higher scores at the levels of 0.6 mm (0.6A) and 0.8A. The mesiolingual cusp (MLC) showed a statistically significant difference ( P <0.01) from the other cusps in the paired t -test. Additionally, the MLC exhibited the highest percentage of change at 0.6A in some age and NTWI groups. Regarding the age groups, the MLC showed the highest score in groups 1 and 2. For the NTWI groups, the MLC was not significantly different in groups 3 and 4. These results support the proposal that the lingual cusp exhibits rapid wear because it serves as a functional cusp. Although this study has limitations due to its cross-sectional nature, it suggests better quantitative parameters and analytical tools for the characteristics of cusp wear.

  14. Plasma Structure and Behavior of Miniature Ring-Cusp Discharges

    Science.gov (United States)

    Mao, Hann-Shin

    Miniature ring-cusp ion thrusters provide a unique blend of high efficiencies and millinewton level thrust for future spacecraft. These thrusters are attractive as a primary propulsion for small satellites that require a high delta V, and as a secondary propulsion for larger spacecraft that require precision formation flying, disturbance rejection, or attitude control. To ensure desirable performance throughout the life of such missions, an advancement in the understanding of the plasma structure and behavior of miniature ring-cusp discharges is required. A research model was fabricated to provide a simplified experimental test bed for the analysis of the plasma discharge chamber of a miniature ion thruster. The plasma source allowed for spatially resolved measurements with a Langmuir probe along a meridian plane. Probe measurements yielded plasma density, electron temperature, and plasma potential data. The magnetic field strength was varied along with the discharge current to determine the plasma behavior under various conditions. The structure of the plasma properties were found to be independent of the discharge power under the proper scaling. It was concluded that weaker magnetic fields can improve the overall performance for ion thruster operation. To further analyze the experimental measurements, a framework was developed based on the magnetic field. A flux aligned coordinate system was developed to decouple the perpendicular and parallel plasma motion with respect to the magnetic field. This was done using the stream function and magnetic scalar potential. Magnetic formulae provided intuition on the field profiles dependence on magnet dimensions. The flux aligned coordinate system showed that the plasma was isopycnic along constant stream function values. This was used to develop an empirical relation suitable for estimating the spatial behavior and to determine the plasma volume and loss areas. The plasma geometry estimates were applied to a control volume

  15. Transport of transient solar wind particles in Earth's cusps

    International Nuclear Information System (INIS)

    Parks, G. K.; Lee, E.; Teste, A.; Wilber, M.; Lin, N.; Canu, P.; Dandouras, I.; Reme, H.; Fu, S. Y.; Goldstein, M. L.

    2008-01-01

    An important problem in space physics still not understood well is how the solar wind enters the Earth's magnetosphere. Evidence is presented that transient solar wind particles produced by solar disturbances can appear in the Earth's mid-altitude (∼5 R E geocentric) cusps with densities nearly equal to those in the magnetosheath. That these are magnetosheath particles is established by showing they have the same ''flattop'' electron distributions as magnetosheath electrons behind the bow shock. The transient ions are moving parallel to the magnetic field (B) toward Earth and often coexist with ionospheric particles that are flowing out. The accompanying waves include electromagnetic and broadband electrostatic noise emissions and Bernstein mode waves. Phase-space distributions show a mixture of hot and cold electrons and multiple ion species including field-aligned ionospheric O + beams

  16. Cusp-Gun Sixth-Harmonic Slotted Gyrotron

    Science.gov (United States)

    Stutzman, R. C.; McDermott, D. B.; Hirata Luhmann, Y., Jr.; Gallagher, D. A.; Spencer, T. A.

    2000-10-01

    A high-harmonic slotted gyrotron has been constructed at UC Davis to be driven by a 70 kV, 3.5 A, axis-encircling electron beam from a Northrop Grumman Cusp gun. The 94 GHz, slotted sixth-harmonic gyrotron is predicted to generate 50 kW with an efficiency of 20%. Using the profile of the adiabatic field reversal from the UC Davis superconducting test-magnet, EGUN simulations predict that an axis-encircling electron beam will be generated with an axial velocity spread of Δ v_z/v_z=10% for the desired velocity ratio of α =v_z/v_z=1.5. The design will also be presented for an 8th-harmonic W-band gyrotron whose magnetic field can be supplied by a lightweight permanent magnet.

  17. Hot electron confinement in a microwave heated spindle cusp

    International Nuclear Information System (INIS)

    Prelas, M.A.

    1991-08-01

    The Plasma Research Laboratory at the University of Missouri-Columbia was established with awards from the McDonnel Douglas Foundation, ARMCO, Union Electric, Black and Vetch, Kansas City Power and Light, the National Science Foundation, and DOE. The Plasma Research Lab's major effort is the Missouri Magnetic Mirror (MMM or M 3 ) Project. The technical goals of MMM have been (1) Diagnostic Development, (2) Plasma Physics in the Cusp geometry, (3) plasma-wall interactions, (4) impurity effects in a steady-state plasma, and (5) Development of Diagnostics for use in harsh plasma processing environments. The other major goal of MMM has remained providing a facility for hands-on training in experimental plasma physics. The major experimental facility of MMM is the MMM Modified Experiment (M4X). Other research efforts in the Plasma Research Laboratory include small efforts in cold fusion, toroidal magnetic confinement, and inertial confinement and a potentially major effort in direct conversion of nuclear energy

  18. Dual cusped protostylid: Case report and clinical significance

    Directory of Open Access Journals (Sweden)

    Preeti Bhattacharya

    2016-01-01

    Full Text Available Protostylids are superstructures on maxillary or mandibular molars, which have rarely been reported in literature, and the significance of their presence has also been underestimated. The dental practitioners may easily misdiagnose a tooth, with such conical tubercles as malformed tooth. Interestingly, this is neither a malformation nor an anomaly but rather an important morphological trait of an individual. Once in a while, one may come across such a distinct morphological trait without being able to diagnose. To the authors' best knowledge, only one similar case has been reported previously, and the second such case internationally. Bearing all such facts in mind, the authors attempt to educate the readers towards the existence of such a trait so that it can be identified and studied in larger numbers. Hence, it is the authors' endeavor to report an unusual case of dual cusped maxillary protostylid along with its clinical significance.

  19. Aortic valve replacement for aortic stenosis caused by alkaptonuria.

    Science.gov (United States)

    Hiroyoshi, Junko; Saito, Aya; Panthee, Nirmal; Imai, Yasushi; Kawashima, Dai; Motomura, Noboru; Ono, Minoru

    2013-03-01

    We report a case of aortic stenosis associated with ochronosis in a 70-year-old man who underwent biologic aortic valve replacement. Intraoperative findings included ochronosis of a severely calcified pigmented aortic valve along with pigmentation of the intima of the aorta. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Distribution in magnetotail of O+ ions from Cusp/Cleft ionosphere: A possible substorm trigger

    International Nuclear Information System (INIS)

    Cladis, J.B.; Francis, W.E.

    1992-01-01

    The transport of O + ions from the cusp/cleft ionosphere to the magnetotail during highly disturbed times was determined by computing the guiding-center trajectories of the ions to a distance of 6 R E from the ionosphere and the full-motion trajectories at later times. Case histories were tallied in six planes perpendicular to the X GSM axis, three planes perpendicular to the Y GSM axis, and in the center plane of the tail. At various times relatives to the enhancement of the convection electric field, the following ion properties were constructed from the case histories; number density, mean energy, energy and pitch angle distributions of the flux, and ion pressure components parallel and perpendicular to the magnetic field. It was found that after about 1.7 hours the ion flux in the near-Earth magnetotail increased dramatically and the spectrum hardened, much as observed during periods just preceding substorms. This increase is attributed to (1) the increase in the O + outflux from the ionosphere, (2) the increased energization of the ions by the convection electric field, and (3) ion trapping, which generally occurs because the ion magnetic generally increase after the ions first cross the geomagnetotail center plane. Moreover, the parallel pressure of the ions exceeds the energy density of the magnetic field at X GSM E . On the basis of the expected alterations of the magnetic and electric fields in response to this O + pressure, a substorm trigger mechanism is suggested

  1. Auroral and magnetic variations in the polar cusp and cleft. Signatures of magnetopause boundary layer dynamics

    International Nuclear Information System (INIS)

    Sandholt, P.E.; Egeland, A.

    1987-10-01

    By combining continous ground-based observations of polar cleft/cusp auroras and local magnetic variations with electromagnetic parameters obtained from satellites in polar orbit (low-altitude cleft/cusp) and in the magnetosheath/interplanetary space, different electrodynamic processes in the polar cleft/cusp have been investigated. One of the more controversial questions in this field is related to the observed shifts in latitude of cleft/cusp auroras and the relationships with the interplanetary magnetic field (IMF) orientation, local magnetic disturbances (DP2 and DPY modes) and magnetospheric substorms. A new approach which may contribute to clarifying these complicated relationships, simultaneous groundbased observations of the midday and evening-midnight sectors of the auroral oval, is illustrated. A related topic is the spatial relationship between the cleft/cusp auroras and the ionospheric convection currents. A characteristic feature of the polar cusp and cleft regions during negative IMF B z is repeated occurrence of certain short-lived auroral structures moving in accordance with the local convection pattern. Satellite measurements of particle precipitation, magnetic field and ion drift components permit detailed investigations of the electrodynamics of these cusp/cleft structures. Information on electric field components, Birkeland currents, Poynting flux, height-integrated Pedersen conductivity and Joule heat dissipation rate has been derived. These observations are discussed in relation to existing models of temporal plasma injections from the magnetosheath

  2. Pathogenetic Basis of Aortopathy and Aortic Valve Disease

    Science.gov (United States)

    2018-02-19

    Aortopathies; Thoracic Aortic Aneurysm; Aortic Valve Disease; Thoracic Aortic Disease; Thoracic Aortic Dissection; Thoracic Aortic Rupture; Ascending Aortic Disease; Descending Aortic Disease; Ascending Aortic Aneurysm; Descending Aortic Aneurysm; Marfan Syndrome; Loeys-Dietz Syndrome; Ehlers-Danlos Syndrome; Shprintzen-Goldberg Syndrome; Turner Syndrome; PHACE Syndrome; Autosomal Recessive Cutis Laxa; Congenital Contractural Arachnodactyly; Arterial Tortuosity Syndrome

  3. Tunable system for production of mirror and cusp configurations using chassis of permanent magnets

    Science.gov (United States)

    Hyde, Alexander; Bushmelov, Maxim; Batishchev, Oleg

    2018-03-01

    Compact arrays of permanent magnets have shown promise as replacements for electromagnets in applications requiring magnetic cusps and mirrors. An adjustable system capable of suspending and translating a pair of light, nonmagnetic chassis carrying such sources of magnetic field has been designed and constructed. Using this device to align two cylindrical chassis, strong solenoid-like domains of field, as well as classic biconic cusp and magnetic mirror topologies, are generated. Employing a pair of ring-shaped chassis instead, the superposition of their naturally-emitted cusps is demonstrated to produce sextupolar and octupolar magnetic fields.

  4. Classical description of the electron capture to the continuum cusp formation in ion-atom collisions

    International Nuclear Information System (INIS)

    Illescas, Clara; Pons, B.; Riera, A.

    2002-01-01

    Classical calculations are used to describe the dynamics of the electron capture to the continuum (ECC) cusp formation in H + +He collisions. We illustrate the frontier character of the ECC electrons between capture and ionization, and confirm that it is a temporary capture, through projectile focusing, that is responsible for the ECC cusp. Furthermore, the cusp is not a divergence smoothed by the experiment, and is slightly shifted from the impact-velocity value because of the residual pull from the target after ionization. This shift is larger the smaller the nuclear velocity

  5. Determination of polar cusp position by low-energy particle measurements made aboard AUREOLE satellite

    International Nuclear Information System (INIS)

    Gladyshev, V.A.; Jorjio, M.V.; Shuiskaya, F.K.; Crasnier, J.; Sauvaud, J.A.

    1974-01-01

    The Franco-Soviet experiment ARCAD, launched aboard the satellite AUREOLE December 27, 1971, has verified the existence of a particle penetration from the transition zone up to ionospheric altitudes across the polar cusp. The polar cusp is characterized by proton fluxes >10 7 particles/(cm 2 .s.sr.KeV) at 0.5KeV, with energy spectra similar to those in the transition zone. The position and form of the polar cusp are studied from measurements of protons in the range 0.4 to 30KeV during geomagnetically quiet periods (Kp [fr

  6. Experimental investigation of plasma sheaths in magnetic mirror and cusp configurations

    Science.gov (United States)

    Jiang, Zhengqi; Wei, Zi-an; Ma, J. X.

    2017-11-01

    Sheath structures near a metal plate in a magnetized plasma were experimentally investigated in magnetic mirror and cusp configurations. Plasma parameters and the sheath potential distributions were probed by a planar and an emissive probe, respectively. The measured sheath profiles in the mirror configuration show that the sheath thickness first decreases and then increases when the magnetic strength is raised. A magnetic flux-tube model was used to explain this result. In the cusp configuration, the measured sheath thickness decreases with the increase of the coil current creating the magnetic cusp. However, when normalized by the electron Debye length, the dependence of the sheath thickness on the coil current is reversed.

  7. On the Casimir scaling violation in the cusp anomalous dimension at small angle

    Science.gov (United States)

    Grozin, Andrey; Henn, Johannes; Stahlhofen, Maximilian

    2017-10-01

    We compute the four-loop n f contribution proportional to the quartic Casimir of the QCD cusp anomalous dimension as an expansion for small cusp angle ϕ. This piece is gauge invariant, violates Casimir scaling, and first appears at four loops. It requires the evaluation of genuine non-planar four-loop Feynman integrals. We present results up to O({φ}^4) . One motivation for our calculation is to probe a recent conjecture on the all-order structure of the cusp anomalous dimension. As a byproduct we obtain the four-loop HQET wave function anomalous dimension for this color structure.

  8. Connection of the positive phase of ionospheric storms with the day-time cusp

    International Nuclear Information System (INIS)

    Morozova, L.D.; Danilov, A.D.

    1986-01-01

    Data on the relation of ionospheric storms with the day-time cusp are considered. Experimental data on the velocity and direction of wind from the day-time cusp region, obtained for perturbed conditions on 30.12.1981, are analyzed. It is shown that perturbed wind from the cusp results in the increase of the value δf 0 F2 and under conditions before magnetic storm onset unambiguously causes positive ionosheric perturbation, and under conditions of a developed magnetic storm-either a positive perturbation or a decrease in the amplitude of negative perturbation

  9. Neurocardiogenic Syncope and Supraventricular Tachycardia in Association with a Rare Congenital Aortic Valve Abnormality

    Directory of Open Access Journals (Sweden)

    Yashwant Agrawal

    2016-01-01

    Full Text Available We report a case of a 26-year-old woman who presented with multiple episodes of syncope over a five-months period of time. Transthoracic echocardiogram had shown a normal functioning quadricuspid aortic valve (QAV which was also confirmed on a transesophageal echocardiogram. Computed tomographic angiography of heart and coronary arteries showed the QAV with equal size of all aortic cusps and normal coronary arteries. Intermittent chest pain and palpitations warranted an exercise stress test. The stress test revealed normal aerobic exertion, with achievement of 101% of maximal peak heart rate. However, during peak stress, we noted a drop in her blood pressure significantly resulting in dizziness. No arrhythmias were noted during the stress test. With recurrent syncope episodes and palpitations, Holter monitoring was done, revealing supraventricular tachycardia (SVT. We discuss current available literature and coassociations with QAV. New association of QAV with SVT needs further analysis.

  10. Cine MRI of the ascending aorta in the elderly with respect to the flow signal void and aortic valve morphology

    International Nuclear Information System (INIS)

    Nakayama, Masafumi; Kyomasu, Yoshinori; Suzuki, Yasuko; Mashima, Yasuoki; Tanno, Munehiko; Endo, Kazuo; Yamada, Hideo

    1990-01-01

    Cine flow MRI was performed on a 1.5 Tesla system to observe signal intensity of blood flow within the ascending aorta in the elderly who had no aortic stenosis and to determine frequency of the flow signal void. Coronal and sagittal imaging planes of the ascending aorta were obtained in 27 aged patients with no known cardiac diseases (14 men and 13 women, mean age of 76) and 7 young volunteers (7 men, mean age of 24), utilizing ECG-gating, GRASS (gradient-recalled acquisition in steady state), and a flow compensation sequence. The young volunteers presented little or no signal void within the ascending aorta. In 26 (96%) of the 27 aged patients, on the other hand, signal void was demonstrated in the blood flow distal to the aortic valve during systole. The maximum length of the signal void that was measured at 318∼632 msec after the R wave of ECG ranged from 33 to 97 mm. Conventional and Doppler echocardiography was used to evaluate motion and morphology of the aortic valve in 19 of the 27 aged patients. Eighteen of these 19 subjects had aortic signal void on cine MRI. Echocardiography showed sclerotic changes of the aortic valve (i.e., increased echogenicity of the cusps and/or commissure fusion) in 10 (53%) of the 19 subjects. The mean maximum length of the signal void in the 10 patients with aortic valve sclerosis was significantly greater than that in the 9 patients with echocardiographically normal valve (68 vs.45 mm, p<0.01). These results suggest that signal void of blood flow in the ascending aorta, which is recognized as one of the characteristic findings in patients with aortic stenosis, is not a specific feature for this disease but rather a commom one in the elderly particularly those with sclerotic changes of the aortic valve. However, the length of the signal void may distinguish between nonstenotic and stenotic aortic valves. (author)

  11. The role of annular dimension and annuloplasty in tricuspid aortic valve repair.

    Science.gov (United States)

    de Kerchove, Laurent; Mastrobuoni, Stefano; Boodhwani, Munir; Astarci, Parla; Rubay, Jean; Poncelet, Alain; Vanoverschelde, Jean-Louis; Noirhomme, Philippe; El Khoury, Gebrine

    2016-02-01

    Valve sparing reimplantation can improve the durability of bicuspid aortic valve repair compared with subcommissural annuloplasty, especially in patients with a large basal ring. This study analyses the effect of basal ring size and annuloplasty on valve repair in the setting of a tricuspid aortic valve. From 1995 to 2013, 382 patients underwent elective tricuspid aortic valve repair. We included only those undergoing subcommissural annuloplasty, valve sparing reimplantation or no annuloplasty and in whom intraoperative transoesophageal echocardiography images were available for retrospective pre- and post-repair basal ring measurements (n = 323, subcommissural annuloplasty: 146, valve sparing reimplantation: 154, no annuloplasty: 23). In a subgroup of patients with available echocardiographic images, basal ring was retrospectively measured at the latest follow-up or prior to reoperation. subcommissural annuloplasty and valve sparing reimplantation were compared after matching for degree of aortic regurgitation and root size. All three groups differed significantly for most of preoperative characteristics. Hospital mortality was 0.9%. The median follow-up was 4.7 years. At 8 years, overall survival was 80 ± 5%. Freedom from reoperation and freedom from aortic regurgitation >1+ were 92 ± 5% and 71 ± 8%, respectively. In multivariate analysis, predictors of aortic regurgitation >1+ were left ventricular end-diastolic diameter (P = 0.003), cusp repair (P = 0.006), body surface area (P = 0.01) and subcommissural annuloplasty (P = 0.05). In subcommissural annuloplasty, freedom from aortic regurgitation >1+ was lower for patients with basal ring ≥28 mm compared with patients with basal ring 1+ was independent of basal ring size (P = 0.38). In matched comparison between subcommissural annuloplasty and valve sparing reimplantation, freedom from aortic regurgitation >1+ was not significantly different (P = 0.06), but in patients with basal ring ≥28 mm, valve sparing

  12. Robotic aortic surgery.

    Science.gov (United States)

    Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean

    2011-01-01

    Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

  13. Aortic valve replacement

    DEFF Research Database (Denmark)

    Kapetanakis, Emmanouil I; Athanasiou, Thanos; Mestres, Carlos A

    2008-01-01

    mortality were collected. Group analysis by patient geographic distribution and by annular diameter of the prosthesis utilized was conducted. Patients with a manufacturer's labeled prosthesis size > or = 21 mm were assigned to the 'large' aortic size subset, while those with a prosthesis size ... differences in the distribution of either gender or BSA. In the multivariable model, south European patients were seven times more likely to receive a smaller-sized aortic valve (OR = 6.5, 95% CI = 4.82-8.83, p

  14. The JUPITER registry: 1-year results of transapical aortic valve implantation using a second-generation transcatheter heart valve in patients with aortic stenosis.

    Science.gov (United States)

    Silaschi, Miriam; Treede, Hendrik; Rastan, Ardawan J; Baumbach, Hardy; Beyersdorf, Friedhelm; Kappert, Utz; Eichinger, Walter; Rüter, Florian; de Kroon, Thomas L; Lange, Rüdiger; Ensminger, Stephan; Wendler, Olaf

    2016-11-01

    Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with aortic stenosis (AS) at high surgical risk. The JenaValve™ is a second-generation, self-expanding transcatheter heart valve (THV), implanted through transapical access (TA). During stent deployment, a specific 'clipping-mechanism' engages native aortic valve cusps for fixation. We present 1-year outcomes of the JUPITER registry, a post-market registry of the JenaValve for TA-TAVR. The JUPITER registry is a prospective, multicentre, uncontrolled and observational European study to evaluate the long-term safety and effectiveness of the Conformité Européenne-marked JenaValve THV. A total of 180 patients with AS were enrolled between 2012 and 2014. End-points were adjudicated in accordance with the valve academic research consortium document no. 1 definitions. The mean age was 80.4 ± 5.9 years and the mean logistic European system for cardiac operative risk evaluation I 21.2 ± 14.7%. The procedure was successful in 95.0% (171/180), implantation of a second THV (valve-in-valve) was performed in 2.2% (4/180) and conversion to surgical aortic valve replacement (SAVR) was necessary in 2.8% (5/180). No annular rupture or coronary ostia obstruction occurred. Two patients required SAVR after the day of index procedure (1.1%). All-cause mortality at 30 days was 11.1% (20/180), being cardiovascular in 7.2% (13/180). A major stroke occurred in 1.1% (2/180) at 30 days, no additional major strokes were observed during 1 year. All-cause mortality after 30 days was 13.1% (21/160) and combined efficacy at 1 year was 80.8% (122/151). At 1-year follow-up, no patient presented with more than moderate paravalvular leakage, while 2 patients (3.2%) showed moderate, 12 (19.0%) mild and 49 (82.4%) trace/none paravalvular regurgitation. In a high-risk cohort of patients undergoing TA-TAVR for AS, the use of the JenaValve THV is safe and effective. In patients at higher risk for coronary ostia

  15. Risk Factors for Late Aortic Valve Dysfunction After the David V Valve-Sparing Root Replacement.

    Science.gov (United States)

    Esaki, Jiro; Leshnower, Bradley G; Binongo, Jose N; Lasanajak, Yi; McPherson, LaRonica; Guyton, Robert A; Chen, Edward P

    2017-11-01

    Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR. The mean age was 46.4 years. Sixty-four patients (22.7%) had bicuspid valves, and 41 patients (14.5%) had Marfan syndrome. The incidence of reoperations was 27 (9.6%), and 42 cases (14.9%) presented with acute type A dissection. Operative mortality was 8 (2.8%). Seven-year survival was 90.9%. Seven-year cumulative incidence of reoperation, greater than 2+ AI and greater than moderate AS were 3.1%, 2.2%, and 0.8%, respectively. Multivariable analysis showed aortic root size 55 mm or larger (hazard ratio 3.44, 95% confidence interval: 1.27 to 9.29, p = 0.01) to be a risk factor for late AI whereas bicuspid valve (hazard ratio 16.07, 95% confidence interval: 3.12 to 82.68, p = 0.001) and cusp repair were found to be risk factors (hazard ratio 5.91, 95% confidence interval: 1.17 to 29.86, p = 0.03) for late AS. Valve-sparing root replacement can be performed with low operative risk and good overall long-term survival even in complex clinical settings. Durable valve function can be expected; however, aortic root size 55 cm or more, bicuspid valve anatomy, and cusp repair represent independent risk factors for late aortic valve dysfunction after these procedures. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. [Reliability study in the measurement of the cusp inclination angle of a chairside digital model].

    Science.gov (United States)

    Xinggang, Liu; Xiaoxian, Chen

    2018-02-01

    This study aims to evaluate the reliability of the software Picpick in the measurement of the cusp inclination angle of a digital model. Twenty-one trimmed models were used as experimental objects. The chairside digital impression was then used for the acquisition of 3D digital models, and the software Picpick was employed for the measurement of the cusp inclination of these models. The measurements were repeated three times, and the results were compared with a gold standard, which was a manually measured experimental model cusp angle. The intraclass correlation coefficient (ICC) was calculated. The paired t test value of the two measurement methods was 0.91. The ICCs between the two measurement methods and three repeated measurements were greater than 0.9. The digital model achieved a smaller coefficient of variation (9.9%). The software Picpick is reliable in measuring the cusp inclination of a digital model.

  17. Scattering Study of a Modified Cusp Potential in Conformable Fractional Formalism

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Won Sang [Gyeongsang National University, Jinju (Korea, Republic of); Zarrinkamar, Saber [Islamic Azad University, Garmsar (Iran, Islamic Republic of); Zare, Soroush [Islamic Azad University North Tehran Branch, Tehran (Iran, Islamic Republic of); Hassanabadi, Hassan [Shahrood University of Technology, Shahrood (Iran, Islamic Republic of)

    2017-02-15

    The fractional Schr¨odinger equation is considered with a cusp interaction. Exact analytical solutions are obtained and thereby the scattering states as well as transmission and reflection coefficients are determined.

  18. The cusp effect in {eta}'{yields}{eta}{pi}{pi} decays

    Energy Technology Data Exchange (ETDEWEB)

    Kubis, Bastian; Schneider, Sebastian P. [Universitaet Bonn, Helmholtz-Institut fuer Strahlen- und Kernphysik (Theorie) and Bethe Center for Theoretical Physics, Bonn (Germany)

    2009-08-15

    Strong final-state interactions create a pronounced cusp in {eta}'{yields}{eta}{pi}{sup 0}{pi}{sup 0} decays. We adapt and generalize the non-relativistic effective field theory framework developed for the extraction of {pi}{pi} scattering lengths from K{yields}3{pi} decays to this case. The cusp effect is predicted to have an effect of more than 8% on the decay spectrum below the {pi}{sup +}{pi}{sup -} threshold. (orig.)

  19. The cusp effect in η'→ηππ decays

    International Nuclear Information System (INIS)

    Kubis, Bastian; Schneider, Sebastian P.

    2009-01-01

    Strong final-state interactions create a pronounced cusp in η'→ηπ 0 π 0 decays. We adapt and generalize the non-relativistic effective field theory framework developed for the extraction of ππ scattering lengths from K→3π decays to this case. The cusp effect is predicted to have an effect of more than 8% on the decay spectrum below the π + π - threshold. (orig.)

  20. Transport coefficients for laminar and turbulent flow through a four-cusp channel

    International Nuclear Information System (INIS)

    Souza Dutra, A. de; Parise, J.A.R.; Souza Mendes, P.R. de.

    1986-01-01

    The heat transfer coefficients for laminar and turbulent flow in a four-cusp channel were determined. A numerical solution was developed for laminar flow an and experimental study for turbulent flow was carried out. Systematic variations of the Reynolds number were done in the range 900-30000. The results show that the heat transfer coefficients for the four-cusp channel are much lower than the coefficients for the circular tube. (author) [pt

  1. Double aortic arch

    Science.gov (United States)

    Surgery can be done to fix double aortic arch. The surgeon ties off the smaller branch and separates it from the larger branch. Then the surgeon closes the ends of the aorta with stitches. This relieves pressure on the esophagus and windpipe.

  2. Bicuspid aortic valve

    Science.gov (United States)

    ... aortic disease. In: Otto CM, Bonow RO, eds. Valvular Heart Disease: A Companion to Braunwald’s Heart Disease . 4th ed. ... PA: Elsevier Saunders; 2014:chap 13. Carabello BA. Valvular heart disease. In: Goldman L, Schafer AI, eds. Goldman’s Cecil ...

  3. Aortic Valve Stenosis

    Science.gov (United States)

    ... most cases, doctors don't know why a heart valve fails to develop properly, so it isn't something you could have prevented. Calcium buildup on the valve. With age, heart valves may accumulate deposits of calcium (aortic valve ...

  4. Fracture resistance of weakened teeth restored with condensable resin with and without cusp coverage

    Directory of Open Access Journals (Sweden)

    Rafael Francisco Lia Mondelli

    2009-06-01

    Full Text Available OBJECTIVES: This in vitro study evaluated the fracture resistance of weakened human premolars (MOD cavity preparation and pulp chamber roof removal restored with condensable resin composite with and without cusp coverage. MATERIAL AND METHODS: Thirty human maxillary premolars were divided into three groups: Group A (control, sound teeth; Group B, wide MOD cavities prepared and the pulp chamber roof removed and restored with resin composite without cusp coverage; Group C, same as Group B with 2.0 mm of buccal and palatal cusps reduced and restored with the same resin. The teeth were included in metal rings with self-curing acrylic resin, stored in water for 24 h and thereafter subjected to a compressive axial load in a universal testing machine at 0.5 mm/min. RESULTS: The mean fracture resistance values ± standart deviation (kgf were: group A: 151.40 ± 55.32, group B: 60.54 ± 12.61, group C: 141.90 ± 30.82. Statistically significant differences were found only between Group B and the other groups (p<0.05. The condensable resin restoration of weakened human premolars with cusp coverage significantly increased the fracture resistance of the teeth as compared to teeth restored without cusp coverage. CONCLUSION: The results showed that cusp coverage with condensable resin might be a safe option for restoring weakened endodontically treated teeth.

  5. Papillary fibroelastoma of the aortic valve - a case report and literature review

    Directory of Open Access Journals (Sweden)

    Von Canal Friederike

    2010-10-01

    Full Text Available Abstract The prevalence of primary cardiac tumour ranges from 0.0017-0.28% and papillary fibroelastoma is rare but not uncommon benign cardiac neoplasm. Currently, with the advent of higher-resolution imaging technology especially transoesophageal echocardiography such cases being recognized frequently. The clinical presentation of these tumours varies from asymptomatic to severe ischaemic or embolic complications. We herein, present a 50-year-old female patient with a papillary fibroelastoma of the aortic valve arising from the endocardium of the right coronary cusp very close to the commissure between the right and non-coronary cusps. The patient presented with angina-like chest pain and was investigated using echocardiography and CT angiographic modalities in addition to the usual investigations. The differential diagnosis considered was a thrombus, myxoma, Lambl's excrescence and infective vegetation. The surgical management included a prompt resection of the tumour on cardiopulmonary bypass avoiding injury to the aortic valve. The patient recovered well. A review of the literature suggests that the cardiac papillary fibroelastoma is a rare but potentially treatable cause of embolic stroke and other fatal complications, therefore, a strong suspicion; appropriate use of imaging modality, preoperative anticoagulation and urgent surgical resection is warranted. Also, possibility of this diagnosis should be kept in mind while managing cardiac or valvular tumours.

  6. The outcome after aortic valve-sparing (David) operation in 179 patients: a single-centre experience.

    Science.gov (United States)

    Leontyev, Sergey; Trommer, Constanze; Subramanian, Sreekumar; Lehmann, Sven; Dmitrieva, Yaroslava; Misfeld, Martin; Mohr, Friedrich W; Borger, Michael A

    2012-08-01

    The David aortic valve-sparing reimplantation (AVr-D) operation is increasingly being used in patients with aortic root aneurysmal disease and pliable aortic cusps. The objective of this study was to assess our early and medium-term outcomes with the AVr-D operation. Between 2003 and 2011, a total of 179 patients underwent AVr-D procedures. The mean patient age was 49.7 ± 15.1 years, and 23.5% (n = 42) were females. Marfan syndrome was present in 17.3% of patients (n = 31), and acute Type A aortic dissection in 15.6% (n = 28). Clinical follow-up was 100% complete and was 1.8 ± 1.6 years (0 days to 7.5 years) long. Echocardiographic follow-up was performed 2.2 ± 1.5 years (0 days to 7.5 years) postoperatively and was 77% complete. Early mortality was 1.1% (n = 2), with both deaths occurring in patients with Type A dissection. Pre-discharge echocardiography revealed no patients with >2+ aortic insufficiency (AI), 19.6% of patients (n = 34) with 1+ or 2+ AI and 80.4% of patients (n = 145) with trace or no AI. Left ventricular end-diastolic diameters decreased significantly from 5.6 ± 0.9 to 5.1 ± 0.8 cm early postoperatively (P valve re-replacement during follow-up, two due to early endocarditis and two due to non-coronary leaflet prolapse in Marfan patients. Five-year freedom from aortic valve reoperation was 95.9 ± 2.0%. AVr-D is associated with a low mortality and morbidity rate, even in patients with Type A aortic dissection. Although a slightly higher rate of recurrent AI may be present in patients with Marfan syndrome, freedom from recurrent AI and reoperation remains excellent during medium-term follow-up. The David operation should be considered the gold standard for patients with proximal aortic root pathology (aneurysm or dissection) and pliable aortic cusps.

  7. Transfer of Siegel cusp forms of degree 2

    CERN Document Server

    Pitale, Ameya; Schmidt, Ralf

    2014-01-01

    Let \\pi be the automorphic representation of \\textrm{GSp}_4(\\mathbb{A}) generated by a full level cuspidal Siegel eigenform that is not a Saito-Kurokawa lift, and \\tau be an arbitrary cuspidal, automorphic representation of \\textrm{GL}_2(\\mathbb{A}). Using Furusawa's integral representation for \\textrm{GSp}_4\\times\\textrm{GL}_2 combined with a pullback formula involving the unitary group \\textrm{GU}(3,3), the authors prove that the L-functions L(s,\\pi\\times\\tau) are "nice". The converse theorem of Cogdell and Piatetski-Shapiro then implies that such representations \\pi have a functorial lifting to a cuspidal representation of \\textrm{GL}_4(\\mathbb{A}). Combined with the exterior-square lifting of Kim, this also leads to a functorial lifting of \\pi to a cuspidal representation of \\textrm{GL}_5(\\mathbb{A}). As an application, the authors obtain analytic properties of various L-functions related to full level Siegel cusp forms. They also obtain special value results for \\textrm{GSp}_4\\times\\textrm{GL}_1 and \\tex...

  8. Impact of Aortic Insufficiency on Ascending Aortic Dilatation and Adverse Aortic Events After Isolated Aortic Valve Replacement in Patients With a Bicuspid Aortic Valve.

    Science.gov (United States)

    Wang, Yongshi; Wu, Boting; Li, Jun; Dong, Lili; Wang, Chunsheng; Shu, Xianhong

    2016-05-01

    Aberrant flow pattern and congenital fragility bestows bicuspid aortic valve (BAV) with a propensity toward ascending aorta dilatation, aneurysm, and dissection. Whether isolated aortic valve replacement (AVR) can prevent further dilatation in BAV ascending aorta and what indicates concurrent aortic intervention in the case of valve operation remain controversial. From June 2006 to January 2009, patients with a BAV who underwent isolated AVR were consecutively included and categorized into aortic insufficiency (BAV-AI, n = 84) and aortic stenosis (n = 112) groups, and another population of patients with a tricuspid aortic valve with aortic insufficiency (n = 149) was also recruited during the same period for comparison of annual aortic dilatation rate and adverse aortic events after isolated AVR. With a median follow-up period of 72 months (interquartile range, 66 to 78 months), ascending aorta dilatation rates were faster in the BAV-AI group than the BAV plus aortic stenosis and tricuspid aortic valve with aortic insufficiency groups (both p regression analysis identified aortic insufficiency (hazard ratio, 3.7; 95% confidence interval, 1.2 to 11.1; p = 0.019) as an independent risk factor for adverse aortic events among patients with BAV in general, whereas preoperative ascending aortic diameter larger than 45 mm (hazard ratio, 13.8; 95% confidence interval, 3.0 to 63.3; p = 0.001) served as a prognostic indicator in the BAV-AI group. An aggressive policy of preventive aortic interventions seemed appropriate in patients with BAV-AI during AVR, and BAV phenotype presenting as either insufficiency or stenosis should be taken into consideration when contemplating optimal surgical strategies for BAV aortopathy. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch.

    Science.gov (United States)

    Millan-Iturbe, Oscar; Sawaya, Fadi J; Bieliauskas, Gintautas; Chow, Danny H F; De Backer, Ole; Søndergaard, Lars

    2017-09-01

    Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for high/intermediate-risk patients with severe symptomatic aortic stenosis (AS). Although TAVR is used to treat bicuspid severe AS, the large randomized trials typically excluded bicuspid AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a "gothic aortic arch"; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled a sharply angulated aortic arch. This life-threatening complication was successfully treated by thoracic endovascular aortic repair. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  10. On the cusp anomalous dimension in the ladder limit of N=4 SYM

    Energy Technology Data Exchange (ETDEWEB)

    Beccaria, Matteo; Fachechi, Alberto; Macorini, Guido [Dipartimento di Matematica e Fisica “Ennio De Giorgi”, Università del Salento,Via Arnesano, 73100 Lecce (Italy); INFN,Via Arnesano, 73100 Lecce (Italy)

    2016-06-01

    We analyze the cusp anomalous dimension in the (leading) ladder limit of N=4 SYM and present new results for its higher-order perturbative expansion. We study two different limits with respect to the cusp angle ϕ. The first is the light-like regime where x=e{sup i} {sup ϕ}→0. This limit is characterised by a non-trivial expansion of the cusp anomaly as a sum of powers of log x, where the maximum exponent increases with the loop order. The coefficients of this expansion have remarkable transcendentality features and can be expressed by products of single zeta values. We show that the whole logarithmic expansion is fully captured by a solvable Woods-Saxon like one-dimensional potential. From the exact solution, we extract generating functions for the cusp anomaly as well as for the various specific transcendental structures appearing therein. The second limit that we discuss is the regime of small cusp angle. In this somewhat simpler case, we show how to organise the quantum mechanical perturbation theory in a novel efficient way by means of a suitable all-order Ansatz for the ground state of the associated Schrödinger problem. Our perturbative setup allows to systematically derive higher-order perturbative corrections in powers of the cusp angle as explicit non-perturbative functions of the effective coupling. This series approximation is compared with the numerical solution of the Schrödinger equation to show that we can achieve very good accuracy over the whole range of coupling and cusp angle. Our results have been obtained by relatively simple techniques. Nevertheless, they provide several non-trivial tests useful to check the application of Quantum Spectral Curve methods to the ladder approximation at non zero ϕ, in the two limits we studied.

  11. Observations of beach cusp evolution using a stationary, shore-based lidar system

    Science.gov (United States)

    O'Dea, A.; Whitesides, E. T.; Brodie, K.; Spore, N.

    2016-12-01

    Although beach cusps are common features on beaches around the world, questions still remain regarding the range of conditions in which they form, the initial forcing conditions under which they form, and the erosive or accretionary nature of cusp events. While many prior studies have focused on the formation and morphology of beach cusps, many of these are limited in the spatial extent of observations, in their spatial or temporal resolution, or in the availability of accompanying hydrodynamic data. In this study, beach cusp formation and evolution is investigated using an automated lidar system that provides hourly three-dimensional scans of subaerial beach topography with high spatial resolution ([O(1 cm)]). The stationary lidar scanner is mounted on a 4-m tower located on the crest of a shore-backing dune on an Atlantic Ocean beach near Duck, North Carolina. The device measures a 237°-framescan of the nearshore region over a 15 minute period each hour. Individual scans are coregistered to a baseline scan using an iterative closest point (ICP) algorithm and then filtered to remove noise, dune vegetation, and water. To assess the accuracy of the coregistration algorithm, the 3-dimensional location of five permanent reflectors near the device are found for each scan and compared to their measured GPS location. Precisely coregistered scans allow for an assessment of elevation change across cuspate features in addition to traditional measurements of cusp wavelength. Beach cusp events are assessed over a three month period from September through November 2015. Wave and current data from a cross-shore array of sensors deployed continuously throughout the three month period as well as from two alongshore arrays of ADV sensors deployed from October 13 through November 1 are used to determine the forcing conditions under which the cusps formed and evolved. Funded by the USACE Coastal Field Data Collection Program.

  12. Cluster survey of the high-altitude cusp properties: a three-year statistical study

    Directory of Open Access Journals (Sweden)

    B. Lavraud

    2004-09-01

    Full Text Available The global characteristics of the high-altitude cusp and its surrounding regions are investigated using a three-year statistical survey based on data obtained by the Cluster spacecraft. The analysis involves an elaborate orbit-sampling methodology that uses a model field and takes into account the actual solar wind conditions and level of geomagnetic activity. The spatial distribution of the magnetic field and various plasma parameters in the vicinity of the low magnetic field exterior cusp are determined and it is found that: 1 The magnetic field distribution shows the presence of an intermediate region between the magnetosheath and the magnetosphere: the exterior cusp, 2 This region is characterized by the presence of dense plasma of magnetosheath origin; a comparison with the Tsyganenko (1996 magnetic field model shows that it is diamagnetic in nature, 3 The spatial distributions show that three distinct boundaries with the lobes, the dayside plasma sheet and the magnetosheath surround the exterior cusp, 4 The external boundary with the magnetosheath has a sharp bulk velocity gradient, as well as a density decrease and temperature increase as one goes from the magnetosheath to the exterior cusp, 5 While the two inner boundaries form a funnel, the external boundary shows no clear indentation, 6 The plasma and magnetic pressure distributions suggest that the exterior cusp is in equilibrium with its surroundings in a statistical sense, and 7 A preliminary analysis of the bulk flow distributions suggests that the exterior cusp is stagnant under northward IMF conditions but convective under southward IMF conditions.

  13. Valve-Sparing Root Replacement Compared With Composite Valve Graft Procedures in Patients With Aortic Root Dilation.

    Science.gov (United States)

    Ouzounian, Maral; Rao, Vivek; Manlhiot, Cedric; Abraham, Nachum; David, Carolyn; Feindel, Christopher M; David, Tirone E

    2016-10-25

    Although aortic valve-sparing (AVS) operations are established alternatives to composite valve graft (CVG) procedures for patients with aortic root aneurysms, comparative long-term outcomes are lacking. This study sought to compare the results of patients undergoing AVS procedures with those undergoing CVG operations. From 1990 to 2010, a total of 616 patients age Marfan syndrome and lower rates of bicuspid aortic valve than those undergoing bio-CVG or m-CVG procedures. In-hospital mortality (0.3%) and stroke rate (1.3%) were similar among groups. After adjusting for clinical covariates, both bio-CVG and m-CVG procedures were associated with increased long-term major adverse valve-related events compared with patients undergoing AVS (hazard ratio [HR]: 3.4, p = 0.005; and HR: 5.2, p valve-related complications when compared with bio-CVG and m-CVG. AVS is the treatment of choice for young patients with aortic root aneurysm and normal or near-normal aortic cusps. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. First records of talon cusps on baboon maxillary incisors argue for standardizing terminology and prompt a hypothesis of their formation.

    Science.gov (United States)

    Heaton, Jason L; Pickering, Travis Rayne

    2013-12-01

    Dental characters can provide vital clues for understanding intra- and intertaxonomic morphological variation and its underlying genetic and environmental components. However, the unambiguous identification of particular traits and their comparative study is often confounded by lack of consistent terminology in the relevant literature. This difficulty is exacerbated when the etiologies are not completely understood, as is the case with talon cusps. To date, research on talon cusps has focused on modern humans. In many instances, descriptions of talon cusps appear in clinical case studies focusing on their treatment and removal. What is lacking in those discussions, though, is a comparative framework, in which the occurrence of talon cusps in nonhuman primates, and possibly other mammals, is established and understood. Here, we report on a taloned upper central incisor of a wild baboon (Papio hamadryas ursinus) from South Africa. The anomalous incisor of this individual includes an exaggerated accessory cusp diagnosed as a Type II talon. Microcomputed tomographic and radiographic analyses show that the taloned cusp possesses enamel, dentin, and pulp. In addition, we identified an unclassifiable talon cusp on a central maxillary incisor of a baboon skull housed in the Smithsonian Institution's Natural History Museum collection. Our observations of talon cusps on baboon incisors demonstrate that, with regard to this phenomenon, systematic study of nonhuman primates is much needed, along with a consistent use of terminology in the anatomical and anthropological literature. Finally, we present a hypothesis of the formation of talon cusps on mammalian incisors. Copyright © 2013 Wiley Periodicals, Inc.

  15. Residual and Progressive Aortic Regurgitation After Valve-Sparing Root Replacement: A Propensity-Matched Multi-Institutional Analysis in 764 Patients.

    Science.gov (United States)

    Kari, Fabian A; Doll, Kai-Nicolas; Hemmer, Wolfgang; Liebrich, Markus; Sievers, Hans-Hinrich; Richardt, Doreen; Reichenspurner, Hermann; Detter, Christian; Siepe, Matthias; Czerny, Martin; Beyersdorf, Friedhelm

    2016-04-01

    Residual/progressive aortic regurgitation (rAR, pAR) after valve-sparing aortic root replacement (V-SARR) can lead to reoperations. We sought to characterize risk factors of mild rAR and pAR after V-SARR in a multicenter cohort. The effect of additional cusp repair on valve function was analyzed using propensity matching. A total of 1,015 patients after V-SARR were identified with (n = 288, 28%) or without additional cusp/commissure repair (n = 727, 72%) at four cardiac units in Germany. A total of 764 patients fulfilling transthoracic echocardiography follow-up-criteria comprised the study cohort. Logistic regression was used for risk factor analysis with endpoints rAR, new onset AR, and pAR. t tests and analyses of variance were used for between-group differences. The effects of additional cusp repair on valve function were studied comparing propensity-matched quintiles. The incidence of rAR was 29%, with influencing factors aneurysm size (p = 0.07) and preoperative aortic valve function (p = 0.08). It was found more often among nonsyndromic patients (34% vs. 14%; OR, 0.4; p < 0.001). Progression of rAR was detectable in 30% after a mean of 4.3 years. The progression rate of rAR ∼ 0.3 grades per patient-year within the first 5 years. When quintiles identified by propensity score were compared, additional cusp repair was linked to new onset AR (p = 0.016) while it was not linked to rAR (p = 0.14) or pAR (p = 0.5). The incidences of rAR and pAR are considerable after V-SARR. Patients should be operated on before large aneurysms are present. New onset AR after an initially good functional result is more likely after an additional cusp repair, while rAR and pAR are not influenced by cusp repair. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  16. Neonatal aortic stenosis.

    Science.gov (United States)

    Drury, Nigel E; Veldtman, Gruschen R; Benson, Lee N

    2005-09-01

    Neonatal aortic stenosis is a complex and heterogeneous condition, defined as left ventricular outflow tract obstruction at valvular level, presenting and often requiring treatment in the first month of life. Initial presentation may be catastrophic, necessitating hemodynamic, respiratory and metabolic resuscitation. Subsequent management is focused on maintaining systemic blood flow, either via a univentricular Norwood palliation or a biventricular route, in which the effective aortic valve area is increased by balloon dilation or surgical valvotomy. In infants with aortic annular hypoplasia but adequately sized left ventricle, the Ross-Konno procedure is also an attractive option. Outcomes after biventricular management have improved in recent years as a consequence of better patient selection, perioperative management and advances in catheter technology. Exciting new developments are likely to significantly modify the natural history of this disorder, including fetal intervention for the salvage of the hypoplastic left ventricle; 3D echocardiography providing better definition of valve morphology and aiding patient selection for a surgical or catheter-based intervention; and new transcutaneous approaches, such as duel beam echo, to perforate the valve.

  17. Observations of EMIC Waves in the Exterior Cusp Region and in the Nearby Magnetosheath

    Science.gov (United States)

    Grison, B.; Escoubet, C. P.; Santolik, O.; Lavraud, B.; Cornilleau-Wehrlin, N.

    2014-12-01

    In the early years (2000-2004) of the mission, Cluster crossed the most distant part of the polar cusps. On 05/01/2002, Cluster enters the distant cusp region on the duskside of the southern hemisphere (inbound). The spacecraft are successively crossing the magnetopause between 19:50 UT (SC4) and 20:15 UT (SC3). The interplanetary conditions during the crossing were stable with a dominant negative By. The magnetometer (FGM) data indicates that the entry into the cusp takes place in a region where the magnetic field lines in the magnetosheath are anti-parallel with the field lines in the magnetosphere. Despite this clear picture, the global encounter is rather complex: one can notice partial magnetopause crossings, magnetic null points, and intense monochromatic waves on both sides of the magnetopause.We investigate electromagnetic ion cyclotron (EMIC) waves observed in the cusp and in the nearby magnetosheath, just before the magnetopause crossing by the spacecraft. Left-handed monochromatic waves observed in the cusp display different duration and frequency (below and above the local proton gyrofrequency) on each spacecraft. Both the Poynting flux of these emissions and the simultaneously recorded ion flows propagate in the same direction - toward the Earth. The wavenumber are determined in two ways: considering the Doppler shift and from direct measurements of the refractive index. We analyze these wave parameters and the local plasma conditions to explain the wave generation process on each side of the magnetopause.

  18. Some low-altitude cusp dependencies on the interplanetary magnetic field

    International Nuclear Information System (INIS)

    Newell, P.T.; Meng, C.; Sibeck, D.G.; Lepping, R.

    1989-01-01

    Although it has become well established that the low-altitude polar cusp moves equatorward during intervals of southward interplanetary magnetic field (IMF B z y negative (positive) in the northern (southern) hemisphere and postnoon for B y positive (negative) in the northern (southern) hemisphere. The B y induced shift is much more pronounced for southward than for northward B z , a result that appears to be consistent with elementary considerations from, for example, the antiparallel merging model. No interhemispherical latitudinal differences in cusp positions were found that could be attributed to the IMF B x component. As expected, the cusp latitudinal position correlated reasonably well (0.70) with B z when the IMF had a southward component; the previously much less investigated correlation for B z northward proved to be only 0.18, suggestive of a half-wave rectifier effect. The ratio of cusp ion number flux precipitation for B z southward to that for B z northward was 1.75±0.12. The statistical local time (full) width of the cusp proper was found to be 2.1 hours for B z northward and 2.8 hours for B z southward. copyright American Geophysical Union 1989

  19. Case studies of the storm time variation of the polar cusp

    International Nuclear Information System (INIS)

    Meng, C.

    1983-01-01

    The latitudinal variations of the polar cusp region were examined during three intense geomagnetic storms. The variations were compared with the intensity of storm time ring current inferred from the Dst index, with the magnitude of the north-south component B/sub z/ of the interplanetary magnetic field and with substorm activity. The common feature is that the rapid equatorward shift occurred during the increase of the ring current growth and during the southward turning of the interplanetary magnetic field orientation. The equatorwardmost latitude of the cusp was reached before the peak of the ring current intensity, by a few to several hours, coinciding with the occurrence of the largest magnitude of the southward interplanetary magnetic field component. However, details of the polar cusp latitudinal movement differ from storm to storm. During the three storms studied, the poleward recovery commenced at the peak magnitude of the negative IMF B/sub z/ component, but the recovery proceeded without a clear relation to variations of the interplanetary B/sub z/ component, to the ring current intensity, or to the substorm activity. The lowest cusp latitude observed was at approx.61.7 0 , and the magnitude of this shift seems to be related to the magnitudes of -B/sub z/. It is further observed that the approximate rates of the cusp macroscopic equatorward and poleward movements are about 3 0 and 1.5 0 per hour, respectively

  20. Field lin topology in the dayside cusp region inferred from low altitude particle observations

    International Nuclear Information System (INIS)

    Soeraas, F.

    1977-12-01

    Dayside low altitude satellite observations of the pitch angle and energy distribution of electrons and protons in the energy range 1 keV to 100 keV during quiet geomagnetic conditions reveal that at times there is a clear latitudinal separation between the precipitating low energy (keV) electrons and protons, with the protons precipitating poleward of the electrons. The high energy (100keV) proton precipitation overlaps both the low energy electron and proton precipitation. These observations are consistent with a model where magnetosheath particles stream in along the cusp field lines and are at the same time convected poleward by an electric field. Electrons with energies of a few keV move fast and give the ''ionospheric footprint'' of the distant cusp. The protons are partly convected poleward of the cusp and into the polar cap. Here the mirroring protons populate the plasma mantle. Equatorward of the cusp the pitch angle distribution of both electrons and protons with energies above a few keV have a pancake shaped distribution indicating closed geomagnetic field lines. The 1 keV electrons penetrate into this region of closed field line structure maintaining an isotropic pitch angle distribution. The intensity is, however, reduced with respect to what it was in the cusp region. It is suggested that these electrons, the lowest measured on the satellite, are associated with the entry layer.(Auth.)

  1. A Collaborative Learning Network Approach to Improvement: The CUSP Learning Network.

    Science.gov (United States)

    Weaver, Sallie J; Lofthus, Jennifer; Sawyer, Melinda; Greer, Lee; Opett, Kristin; Reynolds, Catherine; Wyskiel, Rhonda; Peditto, Stephanie; Pronovost, Peter J

    2015-04-01

    Collaborative improvement networks draw on the science of collaborative organizational learning and communities of practice to facilitate peer-to-peer learning, coaching, and local adaption. Although significant improvements in patient safety and quality have been achieved through collaborative methods, insight regarding how collaborative networks are used by members is needed. Improvement Strategy: The Comprehensive Unit-based Safety Program (CUSP) Learning Network is a multi-institutional collaborative network that is designed to facilitate peer-to-peer learning and coaching specifically related to CUSP. Member organizations implement all or part of the CUSP methodology to improve organizational safety culture, patient safety, and care quality. Qualitative case studies developed by participating members examine the impact of network participation across three levels of analysis (unit, hospital, health system). In addition, results of a satisfaction survey designed to evaluate member experiences were collected to inform network development. Common themes across case studies suggest that members found value in collaborative learning and sharing strategies across organizational boundaries related to a specific improvement strategy. The CUSP Learning Network is an example of network-based collaborative learning in action. Although this learning network focuses on a particular improvement methodology-CUSP-there is clear potential for member-driven learning networks to grow around other methods or topic areas. Such collaborative learning networks may offer a way to develop an infrastructure for longer-term support of improvement efforts and to more quickly diffuse creative sustainment strategies.

  2. Ethnic Association of Cusp of Carabelli Trait and Shoveling Trait in an Indian Population

    Science.gov (United States)

    Manju, M; Praveen, R; Umesh, W

    2016-01-01

    Introduction Variations in the structure of teeth have always been of great interest to the dentist from the scientific as well as practical point of view. Additionally, ever since decades inter trait relationships have been a useful means to categorize populations to which an individual belongs. Aim To determine the association between Cusp of Carabelli and Shoveling Trait in a selected Indian population native of Bangalore city, Karnataka, India. Materials and Methods A cross-sectional study was carried out in 1885 children aged between 7-10 years. Casts of the study subjects were made to study the presence of Cusp of Carabelli of right maxillary permanent molar and shoveling trait of right maxillary permanent central incisor using the Dahlberg’s classification and Hrdliucka’s classification respectively. Linear regression was used to assess the association of cusp of carabelli trait with the tooth dimensions and logistic regression was used to evaluate the association of the carabelli trait with gender and presence/absence of shoveling. Results A 40.5% of subjects had Cusp of Carabelli on first molar and 68.2% had shoveling on upper central incisor. The study revealed positive association between the two traits studied in the population. A significant difference was also found with presence of Cusp of Carabelli and the buccolingual tooth dimension of the maxillary molar (pshoveling trait in the present study population, and this will be valuable in the determination of ethnic origin of an individual. PMID:27135008

  3. Incremental value of three-dimensional transesophageal echocardiography over two-dimensional transesophageal echocardiography in the assessment of Lambl's excrescences and nodules of Arantius on the aortic valve.

    Science.gov (United States)

    Dumaswala, Bhavin; Dumaswala, Komal; Hsiung, Ming Chon; Quiroz, Luis David Meggo; Sungur, Aylin; Escanuela, Maximilliano German Amado; Mehta, Kruti; Oz, Tugba Kemaloglu; Bhagatwala, Kunal; Karia, Nidhi M; Nanda, Navin C

    2013-09-01

    In this retrospective study, we identified 7 cases where Lambl's excrescences were identified by two-dimensional transesophageal echocardiography (2DTEE) and also had live/real time three-dimensional transesophageal echocardiography (3DTEE) studies available for comparison. We subsequently assessed them for the presence of Lambl's excrescences (LE) and nodules of Arantius (NA) on the aortic valve. After their identification, we qualitatively and quantitatively organized our findings by number, cusp location, measurements, and orientation if applicable. A greater number of LE was found by 3DTEE than 2DTEE (19 vs. 11, respectively). In all 3DTEE studies, their cusp attachment site, their x-, y-, and z-axis measurements, and orientation were clearly visualized and described. Only 3DTEE studies provided confident visualization of the cusp attachment sites. Similarly, a greater number of NA was found by 3DTEE than 2DTEE (21 vs. 5, respectively). The triad of NA was visualized in all 3DTEE studies and each was described using its x-, y-, and z- axis measurements. Only three 2DTEE studies provided reliable identification of the NA. In conclusion, we present further evidence of the incremental value of 3DTEE over 2DTEE in the qualitative and quantitative assessment of cardiac structures including LE and NA on the aortic valve. © 2013, Wiley Periodicals, Inc.

  4. Anesthetic management for combined mitral valve replacement and aortic valve repair in a patient with osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Huang Jiapeng

    2011-01-01

    Full Text Available Osteogenesis imperfecta is a rare disorder of connective tissues and presents multiple challenges, including difficult airway, hyperthermia, coagulopathy and respiratory dysfunction, for anesthesiologists, especially during cardiac surgery. We present anesthetic management of a patient with osteogenesis impertecta during double valve surgery. Dexmedetomidine infusion minimized the risks of malignant hyperthermia. Glidescope and in-line stabilization facilitated endotracheal intubation and protected his oral structures and cervical spine. Transesophageal echocardiography (TEE diagnosed a flail A3 segment and redundant left coronary cusp causing mitral and aortic regurgitation. The mitral valve was replaced and the aortic valve repaired. Coagulopathy was corrected according to comprehensive coagulation analysis. Glidescope, dexmedetomidine, coagulation analysis and TEE could facilitate anesthetic management in these patients.

  5. Optimal C-arm angulation during transcatheter aortic valve replacement: Accuracy of a rotational C-arm computed tomography based three dimensional heart model.

    Science.gov (United States)

    Veulemans, Verena; Mollus, Sabine; Saalbach, Axel; Pietsch, Max; Hellhammer, Katharina; Zeus, Tobias; Westenfeld, Ralf; Weese, Jürgen; Kelm, Malte; Balzer, Jan

    2016-10-26

    To investigate the accuracy of a rotational C-arm CT-based 3D heart model to predict an optimal C-arm configuration during transcatheter aortic valve replacement (TAVR). Rotational C-arm CT (RCT) under rapid ventricular pacing was performed in 57 consecutive patients with severe aortic stenosis as part of the pre-procedural cardiac catheterization. With prototype software each RCT data set was segmented using a 3D heart model. From that the line of perpendicularity curve was obtained that generates a perpendicular view of the aortic annulus according to the right-cusp rule. To evaluate the accuracy of a model-based overlay we compared model- and expert-derived aortic root diameters. For all 57 patients in the RCT cohort diameter measurements were obtained from two independent operators and were compared to the model-based measurements. The inter-observer variability was measured to be in the range of 0°-12.96° of angular C-arm displacement for two independent operators. The model-to-operator agreement was 0°-13.82°. The model-based and expert measurements of aortic root diameters evaluated at the aortic annulus ( r = 0.79, P optimal C-arm configuration, potentially simplifying current clinical workflows before and during TAVR.

  6. Aortic obstruction: anatomy and echocardiography

    Directory of Open Access Journals (Sweden)

    Keirns Candace

    2006-09-01

    Full Text Available Abstract Echocardiography is a valuable non-invasive technique for identifying the site and type of aortic obstruction. Knowledge of the morphological details of each type of obstruction is the basis for correct interpretation of the diagnostic images and clinical decisions. This study was undertaken to correlate the echocardiographic images with anatomic specimens of equivalent valvular and supravalvular aortic obstruction. Specimens were part of the collection of the Department of Embryology. Fifty six patients were studied, and forty specimens with aortic obstruction were analyzed. Echocardiographic characteristics: Thirty one (55.3% patients were women and twenty five (44.7% men. Valvular aortic obstruction was found in Thirty six patients (64.3 % and supravalvular aortic obstruction in twenty (35.7%. Anatomic characteristics: Of the forty specimens examined, twenty one (52.5% had valvular aortic obstruction and nineteen (47.5% supravalvular aortic obstruction. The anatomoechocardiographic correlation clearly showed that the anatomic findings of the specimen hearts and aortas corresponded to echocardiographic images of valvular and supravalvular aortic obstruction and provided solid corroboration of echocardiographic diagnoses.

  7. Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch

    DEFF Research Database (Denmark)

    Millan-Iturbe, Oscar; Sawaya, Fadi J.; Bieliauskas, Gintautas

    2017-01-01

    AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a “gothic aortic arch”; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled...

  8. Studies of small-scale plasma inhomogeneities in the cusp ionosphere using sounding rocket data

    Science.gov (United States)

    Chernyshov, Alexander A.; Spicher, Andres; Ilyasov, Askar A.; Miloch, Wojciech J.; Clausen, Lasse B. N.; Saito, Yoshifumi; Jin, Yaqi; Moen, Jøran I.

    2018-04-01

    Microprocesses associated with plasma inhomogeneities are studied on the basis of data from the Investigation of Cusp Irregularities (ICI-3) sounding rocket. The ICI-3 rocket is devoted to investigating a reverse flow event in the cusp F region ionosphere. By numerical stability analysis, it is demonstrated that inhomogeneous-energy-density-driven (IEDD) instability can be a mechanism for the excitation of small-scale plasma inhomogeneities. The Local Intermittency Measure (LIM) method also applied the rocket data to analyze irregular structures of the electric field during rocket flight in the cusp. A qualitative agreement between high values of the growth rates of the IEDD instability and the regions with enhanced LIM is observed. This suggests that IEDD instability is connected to turbulent non-Gaussian processes.

  9. On the energy shift the ECC cusp. Does the shift really exist?

    International Nuclear Information System (INIS)

    Sarkadi, L.; Barrachina, R.O.

    2004-01-01

    The cusplike 'electron capture to the continuum' (ECC) peak appearing in the spectrum of the forward emitted electrons in ion-atom collisions are generally thought to be a divergence. Recently Shah et al., however, claimed that 'the ECC cusp is indeed a cusp, and not a divergence smoothed by the experiment'. These authors measured the ECC cusp for collisions of 10- and 20-keV protons with H 2 and He, and found that the peak was shifted to lower velocity than its expected position. We also carried out CTMC calculations (for the case of 20-keV protons on He) by which we demonstrated that the shift really exists but its value depends on the angular window of the electron detection. (K.A.)

  10. Antihydrogen atom formation in a CUSP trap towards spin polarized beams

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, N., E-mail: kuroda@radphys4.c.u-tokyo.ac.jp [University of Tokyo, Graduate School of Arts and Sciences (Japan); Enomoto, Y. [RIKEN Advanced Science Institute (Japan); Michishio, K. [Tokyo University of Science, Department of Physics (Japan); Kim, C. H. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Higaki, H. [Hiroshima University, Graduate School of Advanced Science of Matter (Japan); Nagata, Y.; Kanai, Y. [RIKEN Advanced Science Institute (Japan); Torii, H. A. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Corradini, M.; Leali, M.; Lodi-Rizzini, E.; Venturelli, L.; Zurlo, N. [Universita di Brescia and Instituto Nazionale di Fisica Nucleare, Dipartimento di Chimica e Fisica per l' Ingegneria e per i Materiali (Italy); Fujii, K.; Ohtsuka, M.; Tanaka, K. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Imao, H. [RIKEN Nishina Center for Accelerator-Based Science (Japan); Nagashima, Y. [Tokyo University of Science, Department of Physics (Japan); Matsuda, Y. [University of Tokyo, Graduate School of Arts and Sciences (Japan); Juhasz, B. [Stefan Meyer Institut fuer Subatomare Physik (Austria); and others

    2012-12-15

    The ASACUSA collaboration has been making a path to realize high precision microwave spectroscopy of ground-state hyperfine transitions of antihydrogen atom in flight for stringent test of the CPT symmetry. For this purpose, an efficient extraction of a spin polarized antihydrogen beam is essential. In 2010, we have succeeded in synthesizing our first cold antihydrogen atoms employing a CUSP trap. The CUSP trap confines antiprotons and positrons simultaneously with its axially symmetric magnetic field to form antihydrogen atoms. It is expected that antihydrogen atoms in the low-field-seeking states are preferentially focused along the cusp magnetic field axis whereas those in the high-field-seeking states are defocused, resulting in the formation of a spin-polarized antihydrogen beam.

  11. Study of a new cusp field for an 18 GHz ECR ion source

    Science.gov (United States)

    Rashid, M. H.; Nakagawa, T.; Goto, A.; Yano, Y.

    2007-08-01

    A feasibility study was performed to generate new sufficient mirror cusp magnetic field (CMF) by using the coils of the existing room temperature traditional 18 GHz electron cyclotron resonance ion source (ECRIS) at RIKEN. The CMF configuration was chosen because it contains plasma superbly and no multipole magnet is needed to make the contained plasma quiescent with no magneto-hydrodynamic (MHD) instability and to make the system cost-effective. The least magnetic field, 13 kG is achieved at the interior wall of the plasma chamber including the point cusps (PC) on the central axis and the ring cusp (RC) on the mid-plane. The mirror ratio calculation and electron simulation were done in the computed CMF. It was found to contain the electrons for longer time than in traditional field. It is proposed that a powerful CMF ECRIS can be constructed, which is capable of producing intense highly charged ion (HCI) beam for light and heavy elements.

  12. Reimplantation valve-sparing aortic root replacement in Marfan syndrome using the Valsalva conduit: an intercontinental multicenter study.

    Science.gov (United States)

    Settepani, Fabrizio; Szeto, Wilson Y; Pacini, Davide; De Paulis, Ruggero; Chiariello, Luigi; Di Bartolomeo, Roberto; Gallotti, Roberto; Bavaria, Joseph E

    2007-02-01

    Introduced by DePaulis in 2000, the Gelweave Valsalva graft (Sulzer Vascutek, Refrewshire, Scotland) is a modified Dacron conduit (DuPont, Wilmington, DE), with prefashioned sinuses of Valsalva. The aim of this study was to evaluate the mid-term results of the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis in Marfan syndrome patients. A retrospective review was performed of 35 patients with Marfan syndrome in four centers who underwent the reimplantation valve-sparing aortic root replacement using the Gelweave Valsalva prosthesis. The patients were predominantly men, with a mean age of 36.5 +/- 12.6 years (range, 14 to 62 years). Two patients presented with acute type A dissections and underwent emergent operations. Elective hemiarch reconstruction using hypothermic circulatory arrest was required in 11 patients. Aortic valve cusp repair was performed in 2 patients. There were no operative or hospital deaths, and no patients died during follow-up. The mean follow-up was 19 months (range, 1 to 60 months). Significant (>2+) aortic insufficiency (AI), requiring aortic valve replacement, developed in 3 patients during follow-up that requiring aortic valve replacement. The 5-year freedom from reoperation owing to structural valve deterioration was 88.9% +/- 8.1%. There were no episodes of clinically significant thromboembolism. Reimplantation valve-sparing aortic root replacement with the Gelweave Valsalva prosthesis in Marfan patients provides satisfactory mid-term results, thus encouraging further use of this type of repair. However, long-term results are needed in order to define the durability of this technique.

  13. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  14. The polar cusp from a particle point of view: A statistical study based on Viking data

    International Nuclear Information System (INIS)

    Aparicio, B.; Thelin, B.; Lundin, R.

    1991-01-01

    The authors present results from the particle measurements made on board the Viking satellite. For the period of interest the Viking orbits covered at high latitudes the whole dayside sector. Data from the Viking V-3 particle experiment acquired during the Polar Region Outer Magnetospheric International Study period have been used to study the extension of the cusp and cleft in magnetic local time and invariant latitude, and furthermore, their dependence on solar wind and interplanetary magnetic field parameters. The study is limited to the MLT range from 0900 to 1500 and to invariant latitudes (ILAT) from 74 degree to 82 degree. This region is divided into bins of size. The authors concentrated on the region where magnetosheath solar wind plasma penetrates more directly into the magnetosphere and is measured at Viking altitudes. This region is called the cusp proper, to be distinguished from a broader region denoted the cleft, where more energetic particles are observed. Statistically, they find the cusp proper to extend from invariant latitudes of 75 degree to 82 degree and magnetic local times from 0930 to 1400 MLT. The width in ILAT is found to be on average ∼2 degree and in MLT ∼2 hours. It is shown that a clear correlation exists between the densities in the cusp proper calculated from the Viking V-3 experiment in the cusp proper and those in the solar wind calculated from IMP 8 measurements. It is also shown that the position of the cusp proper in MLT depends on the sense of the By component of the interplanetary magnetic field (IMF By), giving a well-defined displacement of the region of maximum occurrence toward earlier MLTs for IMF By 0

  15. First Cluster results of the magnetic field structure of the mid- and high-altitude cusps

    Directory of Open Access Journals (Sweden)

    P. J. Cargill

    Full Text Available Magnetic field measurements from the four Cluster spacecraft from the mid- and high-altitude cusp are presented. Cluster underwent two encounters with the mid-altitude cusp during its commissioning phase (24 August 2000. Evidence for field-aligned currents (FACs was seen in the data from all three operating spacecraft from northern and southern cusps. The extent of the FACs was of the order of 1 RE in the X-direction, and at least 300 km in the Y-direction. However, fine-scale field structures with scales of the order of the spacecraft separation (300 km were observed within the FACs. In the northern crossing, two of the spacecraft appeared to lie along the same magnetic field line, and observed very well matched signals. However, the third spacecraft showed evidence for structuring transverse to the field on scales of a few hundred km. A crossing of the high-altitude cusp from 13 February 2001 is presented. It is revealed to be a highly dynamic structure with the boundaries moving with velocities ranging from a few km/s to tens of km/s, and having structure on timescales ranging from less than one minute up to several minutes. The cusp proper is associated with the presence of a very disordered magnetic field, which is entirely different from the magnetosheath turbulence.

    Key words. Magnetospheric physics (current systems; magnetopause, cusp, and boundary layers – Space plasma physics (discontinuities

  16. Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome.

    Science.gov (United States)

    Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

    2012-12-01

    Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitation and chronic descending aortic dissection immediately after Cesarean section. Regular follow-up will be needed to monitor the descending aortic dissection.

  17. Cusp anomalous dimension and rotating open strings in AdS/CFT

    Science.gov (United States)

    Espíndola, R.; García, J. Antonio

    2018-03-01

    In the context of AdS/CFT we provide analytical support for the proposed duality between a Wilson loop with a cusp, the cusp anomalous dimension, and the meson model constructed from a rotating open string with high angular momentum. This duality was previously studied using numerical tools in [1]. Our result implies that the minimum of the profile function of the minimal area surface dual to the Wilson loop, is related to the inverse of the bulk penetration of the dual string that hangs from the quark-anti-quark pair (meson) in the gauge theory.

  18. Multi-point observations of Ion Dispersions near the Exterior Cusp with Cluster

    Science.gov (United States)

    Escoubet, C.-Philippe; Grison, Benjamin; Berchem, Jean; Trattner, Kralheinz; Pitout, Frederic; Richard, Robert; Taylor, Matt; Soucek, Jan; Laakso, Harri; Masson, Arnaud; Dunlop, Malcolm; Dandouras, Iannis; Reme, Henri; Fazakerley, Andrew; Daly, Patrick

    2014-05-01

    The exterior cusp is the most external region of the polar magnetosphere in direct contact with the plasma and the magnetic field from the solar wind. Unlike the rest of the magnetopause surface, the exterior cusp is a singular region with small and turbulent magnetic field and where large entry of plasma from solar origin takes place. The main process that injects solar wind plasma into the polar cusp is now generally accepted to be magnetic reconnection. Depending on the IMF direction, this process will take place equatorward (for IMF southward), poleward (for IMF northward) or on the dusk or dawn sides (for IMF azimuthal) of the cusp. We report a Cluster crossing on 5 January 2002 near the exterior cusp on the southern dusk side. The IMF was mainly azimuthal (IMF-By around -5 nT), the solar wind speed lower than usual around 280 km/s and the density around 5 cm-3. The four Cluster spacecraft were still in the "magnetotail" configuration with two perfect tetrahedra of 2000 km around apogee and turning into an elongated configuration near the magnetopause. C4 was the first spacecraft to enter the cusp around 19:52:04 UT, followed by C2 at 19:52:35 UT, C1 at 19:54:24 UT and C3 at 20:13:15 UT. C4 and C1 observed two ion energy dispersions at 20:10 UT and 20:40 UT and C3 at 20:35 UT and 21:15 UT. Using the time of flight technique on the upgoing and downgoing ions in the dispersions, we obtain an altitude of the sources of these ions between 14 and 20 RE. Using Tsyganenko model, these sources are located on the dusk flank, past the terminator. In addition, before entering the cusp, the magnetopause crossing was characterized by a large shear in By and bipolar plasma flows, suggesting that reconnection was taking place near the exterior cusp. We will discuss the extent of the reconnection line along the flank of the magnetopause based on these observations.

  19. IMF By-Related Cusp Currents Observed from the Ørsted Satellite and from Ground

    DEFF Research Database (Denmark)

    Stauning, P.; Primdahl, Fritz; Watermann, J.

    2001-01-01

    Orsted is the first satellite to conduct high-precision magnetometer observations from low-altitude noonmidnight orbits passing through the polar cusp regions. Field-aligned currents (FAC) derived from Orsted magnetic field measurements have been combined with ionospheric current patterns inferred...... statistical analysis defines for the noon region the variations in FAC latitude with IMF B-Z. Comparisons with the statistical cusp location indicate that the more equatorward region of IMF B-gamma-while the more B related FAC is located on field lines closing at the dayside poleward FAC are on "open" field...

  20. Cusp electron production in 75--300 keV He+ + Ar collisions

    International Nuclear Information System (INIS)

    Plano, V.L.; Sarkadi, L.; Zavodszky, P.; Berenyi, D.; Palinkas, J.; Gulyas, L.; Takacs, E.; Toth, L.; Tanis, J.A.

    1992-01-01

    Cusp-electron production has been investigated in collisions of 75--300 keV He + with Ar. The relative contributions from electron capture to the continuum (ECC), transfer ionization (TI), and electron loss to the continuum (ELC) to the total cusp electron production were measured. Over the energy range investigated, ECC was found to decrease from about 86% to 80%, TI decreased from about 12% to 1%, and ELC increased from about 2% to 20%. The present results are consistent with earlier work for He + and O q+ projectiles

  1. Axis-encircling electron beam generation using a smooth magnetic cusp for gyrodevices

    International Nuclear Information System (INIS)

    He, W.; Whyte, C. G.; Rafferty, E. G.; Cross, A. W.; Phelps, A. D. R.; Ronald, K.; Young, A. R.; Robertson, C. W.; Speirs, D. C.; Rowlands, D. H.

    2008-01-01

    The generation of an annular-shaped axis-encircling electron beam using a smooth magnetic cusp was studied through numerical simulations and experiments for harmonic operation of a gyrodevice. Two magnetic coils were used to form a magnetic cusp located just downstream from the velvet cathode of an accelerator diode. An electron beam of current 34 A and voltage 130 kV with an adjustable velocity ratio α up to 1.2 was fully transported to the downstream uniform magnetic field region and used to drive a gyrotron traveling wave amplifier into saturation

  2. Abdominal Aortic Emergencies.

    Science.gov (United States)

    Lech, Christie; Swaminathan, Anand

    2017-11-01

    This article discusses abdominal aortic emergencies. There is a common thread of risk factors and causes of these diseases, including age, male gender, hypertension, dyslipidemia, and connective tissue disorders. The most common presenting symptom of these disorders is pain, usually in the chest, flank, abdomen, or back. Computed tomography scan is the gold standard for diagnosis of pathologic conditions of the aorta in the hemodynamically stable patient. Treatment consists of a combination of blood pressure and heart rate control and, in many cases, emergent surgical intervention. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Are small-scale field-aligned currents and magneto sheath-like particle precipitation signatures of the same low-altitude cusp?

    DEFF Research Database (Denmark)

    Watermann, J.; Stauning, P.; Luhr, H.

    2009-01-01

    We examined some 75 observations from the low-altitude Earth orbiting DMSP, Orsted and CHAMP satellites which were taken in the region of the nominal cusp. Our objective was to determine whether the actually observed cusp locations as inferred from magnetosheath-like particle precipitation...... ("particle cusp") and intense small-scale magnetic field variations ("current cusp"), respectively, were identical and were consistent with the statistically expected latitude of the cusp derived from a huge number of charged particle spectrograms ("statistical cusp"). The geocentric coordinates...... of the satellites were converted into AACGM coordinates, and the geomagnetic latitude of the cusp boundaries (as indicated by precipitating particles and small-scale field-aligned currents) set in relation to the IMF-B-z dependent latitude of the equatorward boundary of the statistical cusp. We find...

  4. Reliability and Identification of Aortic Valve Prolapse in the Horse

    Directory of Open Access Journals (Sweden)

    Hallowell Gayle D

    2013-01-01

    Full Text Available Abstract Background The objectives were to determine and assess the reliability of criteria for identification of aortic valve prolapse (AVP using echocardiography in the horse. Results Opinion of equine cardiologists indicated that a long-axis view of the aortic valve (AoV was most commonly used for identification of AVP (46%; n=13. There was consensus that AVP could be mimicked by ultrasound probe malignment. This was confirmed in 7 healthy horses, where the appearance of AVP could be induced by malalignment. In a study of a further 8 healthy horses (5 with AVP examined daily for 5 days, by two echocardiographers standardized imaging guidelines gave good to excellent agreement for the assessment of AVP (kappa>0.80 and good agreement between days and observers (kappa >0.6. The technique allowed for assessment of the degree of prolapse and measurement of the prolapse distance that provided excellent agreement between echocardiographers, days and observers (kappa/ICC>0.8. Assessments made using real-time zoomed images provided similar measurements to the standard views (ICC=0.9, with agreement for the identification of AVP (kappa>0.8. Short axis views of the AoV were used for identification of AVP by fewer respondents (23%, however provided less agreement for the identification of AVP (kappa>0.6 and only adequate agreement with observations made in long axis (kappa>0.5, with AVP being identified more often in short axis (92% compared to long axis (76%. Orthogonal views were used by 31% of respondents to identify the presence of AVP, and 85% to identify cusp. Its identification on both views on 4 days was used to categorise horses as having AVP, providing a positive predictive value of 79% and negative predictive value of 18%. Only the non-coronary cusp (NCC of the AoV was observed to prolapse in these studies. Prolapse of the NCC was confirmed during the optimisation study using four-dimensional echocardiography, which concurred with the findings

  5. Acute Type II Aortic Dissection with Severe Aortic Regurgitation and Chronic Descending Aortic Dissection in Pregnant Patient with Marfan Syndrome

    OpenAIRE

    Lee, Seok-Soo; Jung, Tae-Eun; Lee, Dong Hyup

    2012-01-01

    Aortic dilatation and dissection are severe complications during pregnancy that can be fatal to both the mother and the fetus. The risks of these complications are especially high in pregnant patients with Marfan syndrome; however, incidents of descending aortic dissection are very rare. This case report involves a successful Bentall procedure for and recovery from a rare aortic dissection in a pregnant Marfan patient who developed acute type II aortic dissection with severe aortic regurgitat...

  6. Valve-sparing aortic root replacement and aortic valve repair in a patient with acromegaly and aortic root dilatation

    Directory of Open Access Journals (Sweden)

    Karel Van Praet

    2015-07-01

    Full Text Available Aortic regurgitation and dilatation of the aortic root and ascending aorta are severe complications of acromegaly. The current trend for management of an aortic root aneurysm is valve-sparing root replacement as well as restoring the diameter of the aortic sinotubular junction (STJ and annulus. Our case report supports the recommendation that in patients with acromegaly, severe aortic root involvement may indicate the need for surgery.

  7. Involvement of proinflammatory S100A9/A8 in the atherocalcinosis of aortic valves

    Directory of Open Access Journals (Sweden)

    R. А. Moskalenko

    2017-04-01

    Full Text Available According to the results of the Euro-Heart Survey on Vascular Heart Disease the most common pathology is nonrheumatic aortic stenosis, it is also called as calcific aortic valve stenosis (CAVS, as in its pathogenesis the process of biomineralization of valve cusps and ring plays the main role. The aim of the work is the immunohistochemical study of mineralized tissue of aortic heart valves, which are affected by atherocalcinosis. Materials and methods. 30 samples of mineralized aortic valves (I group and 10 samples of aortic valve without evidence of biomineralization (II group -– control were studied. Immunohistochemical study of expression of collagen (Collagen I, CD68, myeloperoxidase (MPO, calgranulin A (S100A8, calgranulin B (S100A9, caspase 3 (Casp 3 and osteopontin (OPN was conducted in AV tissue of both groups. Results. In CAV tissues the fibrillar component (collagen I growths was found, but the quantitative and qualitative compositions of CD68+ circulating inflammatory cells are not significantly different from the control group. CAVs contain much more MPO+ -cells (p <0.001 in comparison to the group of AVs without biomineralization. Our data show a significant increase of the S100A9 and OPN expression in the mineralized tissue of AVs (p < 0.01. Also, a higher expression level of Casp3 and MPO was found in CAVs (p < 0.05. Comparing the first and the second groups of AVs connection between the expression of S100A8 was not determined. Conclusion. High Casp 3 expression confirms the increased level of cell elimination in the CAVs tissue, which is obviously connected with the impact of high local concentrations of S100A9. These facts can contribute to the development of pathological biomineralization of AV. Since osteopontin inhibits the hydroxyapatite formation by binding to the surface of the crystals, its hyperproduction is a counteracting factor against biomineralization in AV tissue.

  8. A general three-dimensional parametric geometry of the native aortic valve and root for biomechanical modeling.

    Science.gov (United States)

    Haj-Ali, Rami; Marom, Gil; Ben Zekry, Sagit; Rosenfeld, Moshe; Raanani, Ehud

    2012-09-21

    The complex three-dimensional (3D) geometry of the native tricuspid aortic valve (AV) is represented by select parametric curves allowing for a general construction and representation of the 3D-AV structure including the cusps, commissures and sinuses. The proposed general mathematical description is performed by using three independent parametric curves, two for the cusp and one for the sinuses. These curves are used to generate different surfaces that form the structure of the AV. Additional dependent curves are also generated and utilized in this process, such as the joint curve between the cusps and the sinuses. The model's feasibility to generate patient-specific parametric geometry is examined against 3D-transesophageal echocardiogram (3D-TEE) measurements from a non-pathological AV. Computational finite-element (FE) mesh can then be easily constructed from these surfaces. Examples are given for constructing several 3D-AV geometries by estimating the needed parameters from echocardiographic measurements. The average distance (error) between the calculated geometry and the 3D-TEE measurements was only 0.78±0.63mm. The proposed general 3D parametric method is very effective in quantitatively representing a wide range of native AV structures, with and without pathology. It can also facilitate a methodical quantitative investigation over the effect of pathology and mechanical loading on these major AV parameters. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Studies on the effect of radio frequency field in a cusp-type charge separation device for direct energy conversion

    International Nuclear Information System (INIS)

    Hamabe, Masaki; Izawa, Hiroaki; Takeno, Hiromasa; Nakamoto, Satoshi; Ichimura, Kazuya; Nakashima, Yousuke

    2016-01-01

    In D- 3 He fusion power generation, an application of direct energy conversion is expected in which separation of charged particles is necessary. A cusp-type direct energy converter (CuspDEC) was proposed as a charge separation device, but its performance was degraded for a high density plasma. The goal of the present study is to establish an additional method to assist charge separation by using a nonlinear effect of a radio frequency (rf) electric field. Following to the previous study, we experimentally examine the effect of an rf field to electron motion in a CuspDEC device. Two ring electrodes were newly installed in a CuspDEC simulator and the current flowing into the electron collector located in the line cusp region was measured on an rf field application. The significant variation in the current was found, and an improvement of the charge separation can be expected by using the phenomenon appropriately. (author)

  10. Valve-sparing root replacement in children with aortic root aneurysm: mid-term results.

    Science.gov (United States)

    Lange, Rüdiger; Badiu, Catalin C; Vogt, Manfred; Voss, Bernhard; Hörer, Jürgen; Prodan, Zsolt; Schreiber, Christian; Mazzitelli, Domenico

    2013-05-01

    We aimed at evaluating the results of aortic valve-sparing root replacement (AVSRR) in children with aortic root aneurysm (ARA) due to genetic disorders in terms of mortality, reoperation and recurrent aortic valve regurgitation (AVR). Thirteen patients (mean age 9.7 ± 6.5 years, 10 months-18 years) underwent AVSRR for ARA between 2002 and 2011. Six of the 13 patients had Marfan syndrome, 3 Loeys-Dietz syndrome (LDS), 2 bicuspid aortic valve syndrome and 2 an unspecified connective tissue disorder. AVR was graded as none/trace, mild and severe in 5, 7 and 1 patient, respectively. The mean pre-operative root diameter was 45 ± 10 mm (mean Z-score 10.3 ± 2.0). Remodelling of the aortic root was performed in 4 patients, reimplantation of the aortic valve in 9 and a concomitant cusp repair in 4. The diameter of the prostheses used for root replacement varied from 22 to 30 mm (mean Z-score = 2.3 ± 3). The follow-up was 100% complete with a mean follow-up time of 3.7 years. There was no operative mortality. One patient with LDS died 2.5 years after the operation due to spontaneous rupture of the descending aorta. Root re-replacement with mechanical conduit was necessary in 1 patient for severe recurrent AVR 8 days after remodelling of the aortic root. At final follow-up, AVR was graded as none/trace and mild in all patients. Eleven patients presented in New York Heart Association functional Class I and 1 in Class II. In paediatric patients with ARA, valve-sparing root replacement can be performed with low operative risk and excellent mid-term valve durability. Hence, prosthetic valve-related morbidity may be avoided. Due to the large diameters of the aortic root and the ascending aorta, the size of the implanted root prostheses will not limit later growth of the native aorta.

  11. Unusual Case of Overt Aortic Dissection Mimicking Aortic Intramural Hematoma

    Directory of Open Access Journals (Sweden)

    Kushtrim Disha

    2016-04-01

    Full Text Available We report an interesting case in which overt aortic dissection mimicked two episodes of aortic intramural hematoma (IMH (Stanford A, DeBakey I. This took place over the course of four days and had a major influence on the surgical treatment strategy. The first episode of IMH regressed completely within 15 hours after it was clinically diagnosed and verified using imaging techniques. The recurrence of IMH was detected three days thereafter, resulting in an urgent surgical intervention. Overt aortic dissection with evidence of an intimal tear was diagnosed intraoperatively.

  12. Aortic root replacement after previous surgical intervention on the aortic valve, aortic root, or ascending aorta.

    Science.gov (United States)

    Kirsch, E W Matthias; Radu, N Costin; Mekontso-Dessap, Armand; Hillion, Marie-Line; Loisance, Daniel

    2006-03-01

    Aortic root replacement after a previous operation on the aortic valve, aortic root, or ascending aorta remains a major challenge. Records of 56 consecutive patients (44 men; mean age, 56.4 +/- 13.6 years) undergoing reoperative aortic root replacement between June 1994 and June 2005 were reviewed retrospectively. Reoperation was performed 9.4 +/- 6.7 years after the last cardiac operation. Indications for reoperation were true aneurysm (n = 14 [25%]), false aneurysm (n = 10 [18%]), dissection or redissection (n = 9 [16%]), structural or nonstructural valve dysfunction (n = 10 [18%]), prosthetic valve-graft infection (n = 12 [21%]), and miscellaneous (n = 1 [2%]). Procedures performed were aortic root replacement (n = 47 [84%]), aortic root replacement plus mitral valve procedure (n = 5 [9%]), and aortic root replacement plus arch replacement (n = 4 [7%]). In 14 (25%) patients coronary artery bypass grafting had to be performed unexpectedly during the same procedure or immediately after the procedure to re-establish coronary perfusion. Hospital mortality reached 17.9% (n = 10). Multivariate logistic regression analysis revealed the need for unplanned perioperative coronary artery bypass grafting as the sole independent risk factor for hospital death (P = .005). Actuarial survival was 83.8% +/- 4.9% at 1 month, 73.0% +/- 6.3% at 1 year, and 65.7% +/- 9.0% at 5 years after the operation. One patient had recurrence of endocarditis 6.7 months after the operation and required repeated homograft aortic root replacement. Reoperative aortic root replacement remains associated with a high postoperative mortality. The need to perform unplanned coronary artery bypass grafting during reoperative aortic root replacement is a major risk factor for hospital death. The optimal technique for coronary reconstruction in this setting remains to be debated.

  13. Reinforced aortic root reconstruction for acute type A aortic dissection involving the aortic root

    Directory of Open Access Journals (Sweden)

    Han Qing-qi

    2013-06-01

    Full Text Available OBJECTIVE: There are debates regarding the optimal approach for AAAD involving the aortic root. We described a modified reinforced aortic root reconstruction approach for treating AAAD involving the aortic root. METHODS: A total of 161 patients with AAAD involving the aortic root were treated by our modified reinforced aortic root reconstruction approach from January 1998 to December 2008. Key features of our modified approach were placement of an autologous pericardial patch in the false lumen, lining of the sinotubular junction lumen with a polyester vascular ring, and wrapping of the vessel with Teflon strips. Outcome measures included post-operative mortality, survival, complications, and level of aortic regurgitation. RESULTS: A total of 161 patients were included in the study (mean age: 43.3 1 15.5 years. The mean duration of follow-up was 5.1 1 2.96 years (2-12 years. A total of 10 (6.2% and 11 (6.8% patients died during hospitalization and during follow-up, respectively. Thirty-one (19.3% patients experienced postoperative complications. The 1-, 3-, 5-, and 10-year survival rates were 99.3%, 98%, 93.8%, and 75.5%, respectively. There were no instances of recurrent aortic dissection, aortic aneurysm, or pseudoaneurysm during the entire study period. The severity of aortic regurgitation dramatically decreased immediately after surgery (from 28.6% to 0% grade 3-4 and thereafter slightly increased (from 0% to 7.2% at 5 years and 9.1% at 10 years. CONCLUSION: This modified reinforced aortic root reconstruction was feasible, safe and durable/effective, as indicated by its low mortality, low postoperative complications and high survival rate.

  14. Aortic mass in a newborn infant with respiratory distress

    Directory of Open Access Journals (Sweden)

    Michelle J. Vaz

    2017-10-01

    Full Text Available Thrombotic disease is rare in neonates. Many of the cases reported in literature are attributed to the placement of central catheters. We report on a case of aortic thrombosis in a newborn infant with significant respiratory distress due to meconium aspiration, necessitating intubation and placement of central catheters. Due to the location and size of the thrombus in our case, various subspecialties were involved, which ultimately guided therapy to anti-coagulate the patient.

  15. Current indications for stentless aortic bioprostheses.

    Science.gov (United States)

    Hegazy, Yasser Y; Rayan, Amr; Bauer, Stefan; Keshk, Noha; Bauer, Kerstin; Ennker, Ina; Ennker, Jürgen

    2018-01-01

    The best aortic prostheses have been debated for decades. The introduction of stentless aortic bioprostheses was aimed at improving hemodynamics and potentially the durability of aortic bioprostheses. Despite the good short- and long-term outcomes after implantation of stentless aortic bioprostheses, their use remains limited owing to the technically demanding implantation techniques. Nevertheless, stentless aortic bioprostheses might be of special benefit in certain indications, where they could be a valuable addition to the surgical armamentarium.

  16. Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report

    Directory of Open Access Journals (Sweden)

    Heena M Desai

    2015-01-01

    Full Text Available Mitral valve prolapse (MVP is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifice was stenotic and the leaflets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

  17. Tobacco smoking and aortic aneurysm

    DEFF Research Database (Denmark)

    Sode, Birgitte F; Nordestgaard, Børge; Grønbæk, Morten

    2013-01-01

    BACKGROUND: We determined the predictive power of tobacco smoking on aortic aneurysm as opposed to other risk factors in the general population. METHODS: We recorded tobacco smoking and other risk factors at baseline, and assessed hospitalization and death from aortic aneurysm in 15,072 individuals...... aneurysm in males and females consuming above 20g tobacco daily was 3.5% and 1.3%, among those >60years with plasma cholesterol >5mmol/L and a systolic blood pressure >140mmHg. CONCLUSIONS: Tobacco smoking is the most important predictor of future aortic aneurysm outcomes in the general population...

  18. Weak annihilation cusp inside the dark matter spike about a black hole.

    Science.gov (United States)

    Shapiro, Stuart L; Shelton, Jessie

    2016-06-15

    We reinvestigate the effect of annihilations on the distribution of collisionless dark matter (DM) in a spherical density spike around a massive black hole. We first construct a very simple, pedagogic, analytic model for an isotropic phase space distribution function that accounts for annihilation and reproduces the "weak cusp" found by Vasiliev for DM deep within the spike and away from its boundaries. The DM density in the cusp varies as r -1/2 for s -wave annihilation, where r is the distance from the central black hole, and is not a flat "plateau" profile. We then extend this model by incorporating a loss cone that accounts for the capture of DM particles by the hole. The loss cone is implemented by a boundary condition that removes capture orbits, resulting in an anisotropic distribution function. Finally, we evolve an initial spike distribution function by integrating the Boltzmann equation to show how the weak cusp grows and its density decreases with time. We treat two cases, one for s -wave and the other for p -wave DM annihilation, adopting parameters characteristic of the Milky Way nuclear core and typical WIMP models for DM. The cusp density profile for p -wave annihilation is weaker, varying like ~ r -0.34 , but is still not a flat plateau.

  19. EISCAT observations of plasma patches at sub-auroral cusp latitudes

    Directory of Open Access Journals (Sweden)

    J. Moen

    2006-09-01

    Full Text Available A sequence of 3 patches of high-density (1012 m−3 cold plasma on a horizontal scale-size of 300–700 km was observed near magnetic noon by the EISCAT VHF radar above Svalbard on 17 December 2001. The patches followed a trajectory towards the cusp inflow region. The combination of radar and all-sky observations demonstrates that the patches must have been segmented equatorward of the cusp/cleft auroral display, and hence their properties had not yet been influenced by cusp particle showers and electrodynamics on open flux tubes. The last patch in the sequence was intersected by radio tomography observations, and was found to be located adjacent to a broader region of the same high electron density further south. The patches occurred under moderately active conditions (Kp=3 and the total electron content (TEC of the high-density plasma was 45 TEC units. The train of patches appeared as a segmentation of the tongue of ionization. The sequence of patches occurred in association with a sequence of flow bursts in the dusk cell return flow. It is proposed that reconnection driven pulsed convection is able to create sub-auroral patches in the region where high density mid-latitude plasma is diverted poleward toward the cusp. It is the downward Birkeland current sheet located at the equatorward boundary of the flow disturbance that represents the actual cutting mechanism.

  20. EISCAT observations of plasma patches at sub-auroral cusp latitudes

    Directory of Open Access Journals (Sweden)

    J. Moen

    2006-09-01

    Full Text Available A sequence of 3 patches of high-density (1012 m−3 cold plasma on a horizontal scale-size of 300–700 km was observed near magnetic noon by the EISCAT VHF radar above Svalbard on 17 December 2001. The patches followed a trajectory towards the cusp inflow region. The combination of radar and all-sky observations demonstrates that the patches must have been segmented equatorward of the cusp/cleft auroral display, and hence their properties had not yet been influenced by cusp particle showers and electrodynamics on open flux tubes. The last patch in the sequence was intersected by radio tomography observations, and was found to be located adjacent to a broader region of the same high electron density further south. The patches occurred under moderately active conditions (Kp=3 and the total electron content (TEC of the high-density plasma was 45 TEC units. The train of patches appeared as a segmentation of the tongue of ionization. The sequence of patches occurred in association with a sequence of flow bursts in the dusk cell return flow. It is proposed that reconnection driven pulsed convection is able to create sub-auroral patches in the region where high density mid-latitude plasma is diverted poleward toward the cusp. It is the downward Birkeland current sheet located at the equatorward boundary of the flow disturbance that represents the actual cutting mechanism.

  1. Influence of cusps and intersections on the Wilson loop in ν-dimensional space

    International Nuclear Information System (INIS)

    Bezerra, V.B.

    1984-01-01

    A discussion is given about the influence of cusps and intersections on the calculation of the Wilson loop in ν-dimensional space. In particular, for the two-dimensional case, it is shown that there are no divergences. (Author) [pt

  2. Four point measurements of electrons using PEACE in the high-altitude cusp

    Czech Academy of Sciences Publication Activity Database

    Taylor, M. G. G. T.; Fazakerley, A. N.; Krauklis, I. C.; Owen, C.; Trávníček, Pavel; Dunlop, M. W.; Carter, P. J.; Coates, A. J.; Szita, S.; Watson, G.; Wilson, R. J.

    2001-01-01

    Roč. 19, - (2001), s. 1567-1578 ISSN 0992-7689 Grant - others:European Space Agency - Prodex(XE) IMF CS/SFe/571/2000 Institutional research plan: CEZ:AV0Z3042911 Keywords : magnetospheric physics * magnetopause * cusp and boundary layers Subject RIV: BE - Theoretical Physics Impact factor: 1.199, year: 2001

  3. Prevalence of talon cusps in a Portuguese population: Forensic identification significance of a rare trait

    Directory of Open Access Journals (Sweden)

    Ricardo Jorge Simões

    2014-01-01

    Full Text Available Background: Dental techniques are frequently used in human identification; some of those include comparative analyses of dental features that, being rare or unique to an individual, can establish a positive identification. The usefulness of each feature depends on its population, frequency, and uniqueness. The aim of this study was to determine the prevalence of talon cusps in a Portuguese population. Materials and Methods: A prospective study was performed. Three hundred and two patients were studied, and talon cusps presence was assessed. Statistical tests were carried out using Statistical Package for the Social Sciences (SPSS 17 software (SPSS Inc., Chicago, IL, USA. Statistical analysis relied primarily on descriptive statistics and crosstabs, with Chi-square analysis. Results: Results showed that talon cusps were observed in only 6.3% of patients. The maxillary lateral incisors were the most common teeth showing this feature (82.1% of all teeth. Conclusion: It can be concluded that talon cusps are an uncommon trait in these Portuguese population, and therefore, it is a feature that can be potentially very useful in forensic human identification, when antemortem dental records are available.

  4. Antihydrogen synthesis in a double-CUSP trap towards test of the CPT-symmetry

    Energy Technology Data Exchange (ETDEWEB)

    Radics, B., E-mail: balint.radics@cern.ch [ETH Zürich, Institute for Particle Physics (Switzerland); Ishikawa, S.; Kuroda, N. [University of Tokyo, Institute of Physics, Graduate School of Arts and Sciences (Japan); Murtagh, D. J.; Nagata, Y. [RIKEN, Atomic Physics Laboratory (Japan); Tajima, M. [University of Tokyo, Institute of Physics, Graduate School of Arts and Sciences (Japan); Gorp, S. Van [RIKEN, Atomic Physics Laboratory (Japan); Abo, Y. [Hiroshima University, Graduate School of Advanced Sciences of Matter (Japan); Dupre, P. [RIKEN, Atomic Physics Laboratory (Japan); Higashi, Y. [University of Tokyo, Institute of Physics, Graduate School of Arts and Sciences (Japan); Kaga, C. [Hiroshima University, Graduate School of Advanced Sciences of Matter (Japan); Leali, M.; Mascagna, V.; Venturelli, L.; Zurlo, N. [Universita di Brescia, Dipartimento di Ingegneria dell Informazione (Italy); Breuker, H. [CERN (Switzerland); Higaki, H. [Hiroshima University, Graduate School of Advanced Sciences of Matter (Japan); Kanai, Y. [RIKEN, Atomic Physics Laboratory (Japan); Rizzini, E. Lodi [Universita di Brescia, Dipartimento di Ingegneria dell Informazione (Italy); Matsuda, Y. [University of Tokyo, Institute of Physics, Graduate School of Arts and Sciences (Japan); and others

    2016-12-15

    The aim of the ASACUSA-CUSP experiment at CERN is to produce a cold, polarised antihydrogen beam and perform a high precision measurement of the ground-state hyperfine transition frequency of the antihydrogen atom and compare it with that of the hydrogen atom using the same spectroscopic beam line. Towards this goal a significant step was successfully accomplished: synthesised antihydrogen atoms have been produced in a CUSP magnetic configuration and detected at the end of our spectrometer beam line in 2012 [1]. During a long shut down at CERN the ASACUSA-CUSP experiment had been renewed by introducing a new double-CUSP magnetic configuration and a new semi-cylindrical tracking detector (AMT) [2], and by improving the transport feature of low energy antiproton beams. The new tracking detector monitors the antihydrogen synthesis during the mixing cycle of antiprotons and positrons. In this work the latest results and improvements of the antihydrogen synthesis will be presented including highlights from the last beam time.

  5. Spectral estimates for Dirichlet Laplacians and Schrodinger operators on geometrically nontrivial cusps

    Czech Academy of Sciences Publication Activity Database

    Exner, Pavel; Barseghyan, Diana

    2013-01-01

    Roč. 3, č. 4 (2013), s. 465-484 ISSN 1664-039X R&D Projects: GA ČR GAP203/11/0701 Institutional support: RVO:61389005 Keywords : Dirichlet Laplacian * cusp-shaped region * Lieb-Thirring inequalities * bending and twisting Subject RIV: BE - Theoretical Physics

  6. Effects of cusped field thruster on the performance of drag-free control system

    Science.gov (United States)

    Cui, K.; Liu, H.; Jiang, W. J.; Sun, Q. Q.; Hu, P.; Yu, D. R.

    2018-03-01

    With increased measurement tasks of space science, more requirements for the spacecraft environment have been put forward. Those tasks (e.g. the measurement of Earth's steady state gravity field anomalies) lead to the desire for developing drag-free control. Higher requirements for the thruster performance are made due to the demand for the drag-free control system and real-time compensation for non-conservative forces. Those requirements for the propulsion system include wide continuous throttling ability, high resolution, rapid response, low noise and so on. As a promising candidate, the cusped field thruster has features such as the high working stability, the low erosion rate, a long lifetime and the simple structure, so that it is chosen as the thruster to be discussed in this paper. Firstly, the performance of a new cusped field thruster is tested and analyzed. Then a drag-free control scheme based on the cusped field thruster is designed to evaluate the performance of this thruster. Subsequently, the effects of the thrust resolution, transient response time and thrust uncertainty on the controller are calculated respectively. Finally, the performance of closed-loop system is analyzed, and the simulation results verify the feasibility of applying cusped field thruster to drag-free flight in the space science measurement tasks.

  7. A web-based tool for the Comprehensive Unit-based Safety Program (CUSP).

    Science.gov (United States)

    Pronovost, Peter J; King, Jay; Holzmueller, Christine G; Sawyer, Melinda; Bivens, Shauna; Michael, Michelle; Haig, Kathy; Paine, Lori; Moore, Dana; Miller, Marlene

    2006-03-01

    An organization's ability to change is driven by its culture, which in turn has a significant impact on safety. The six-step Comprehensive Unit-Based Safety Program (CUSP) is intended to improve local culture and safety. A Web-based project management tool for CUSP was developed and then pilot tested at two hospitals. HOW ECUSP WORKS: Once a patient safety concern is identified (step 3), a unit-level interdisciplinary safety committee determines issue criticality and starts up the projects (step 4), which are managed using project management tools within eCUSP (step 5). On a project's completion, the results are disseminated through a shared story (step 6). OSF St. Joseph's Medical Center-The Medical Birthing Center (Bloomington, Illinois), identified 11 safety issues, implemented 11 projects, and created 9 shared stories--including one for its Armband Project. The Johns Hopkins Hospital (Baltimore) Medical Progressive Care (MPC4) Unit identified 5 safety issues and implemented 4 ongoing projects, including the intravenous (IV) Tubing Compliance Project. The eCUSP tool's success depends on an organizational commitment to creating a culture of safety.

  8. Characterizing nanoscale topography of the aortic heart valve basement membrane for tissue engineering heart valve scaffold design.

    Science.gov (United States)

    Brody, Sarah; Anilkumar, Thapasimuthu; Liliensiek, Sara; Last, Julie A; Murphy, Christopher J; Pandit, Abhay

    2006-02-01

    A fully effective prosthetic heart valve has not yet been developed. A successful tissue-engineered valve prosthetic must contain a scaffold that fully supports valve endothelial cell function. Recently, topographic features of scaffolds have been shown to influence the behavior of a variety of cell types and should be considered in rational scaffold design and fabrication. The basement membrane of the aortic valve endothelium provides important parameters for tissue engineering scaffold design. This study presents a quantitative characterization of the topographic features of the native aortic valve endothelial basement membrane; topographical features were measured, and quantitative data were generated using scanning electron microscopy (SEM), atomic force microscopy (AFM), transmission electron microscopy (TEM), and light microscopy. Optimal conditions for basement membrane isolation were established. Histological, immunohistochemical, and TEM analyses following decellularization confirmed basement membrane integrity. SEM and AFM photomicrographs of isolated basement membrane were captured and quantitatively analyzed. The basement membrane of the aortic valve has a rich, felt-like, 3-D nanoscale topography, consisting of pores, fibers, and elevations. All features measured were in the sub-100 nm range. No statistical difference was found between the fibrosal and ventricular surfaces of the cusp. These data provide a rational starting point for the design of extracellular scaffolds with nanoscale topographic features that mimic those found in the native aortic heart valve basement membrane.

  9. Modeling transverse heating and outflow of ionospheric ions from the dayside cusp/cleft. 2 Applications

    Directory of Open Access Journals (Sweden)

    M. Bouhram

    2003-08-01

    Full Text Available In this paper, we consider major ion energization mechanisms in the dayside cusp/cleft region. This includes transverse ion heating by ion cyclotron resonance (ICR, ion energization through structures of field-aligned electric potential drops, and transverse heating by lower hybrid (LH waves. First, we present and discuss three typical cusp/cleft crossings associated with one of the first two mechanisms mentioned above. Then, we develop a procedure for finding the altitude dependence of ICR heating for any data set in the high-altitude cusp/cleft under the absence of field-aligned potential drops. This has been accomplished using a large set of numerical simulations from a two-dimensional, steady-state, Monte Carlo, trajectory-based code, as discussed in detail in the first companion paper (Bouhram et al., 2003. The procedure is applied and tested successfully for the first two events, by using patterns of ion moments along the satellite track as constraints. Then, we present a statistical study that uses 25 cusp/cleft crossings associated with steady IMF conditions, where ICR heating is expected to occur alone. It is pointed out that the ICR heating increases gradually versus geocentric distance as s 3.3 ± 1.8 . The inferred values of the wave power and the spectral index associated with the component responsible for ICR heating are lower than those characterizing the broad-band, extremely low-frequency (BBELF turbulence usually observed in the cusp/cleft. This strengthens the idea that more than one wave-mode is contained in the BBELF turbulence, and only a small fraction of the observed turbulence is responsible for ICR heating. Then, we study the occurrence versus magnetic local time (MLT of field-aligned potential drops. According to previous statistical studies, such structures are not common in the cusp and tend to be associated with the cleft region. We also discuss the effects of LH heating in the cusp on the observed ion distributions

  10. Inter-ethnic differences in valve morphology, valvular dysfunction, and aortopathy between Asian and European patients with bicuspid aortic valve.

    Science.gov (United States)

    Kong, William K F; Regeer, Madelien V; Poh, Kian K; Yip, James W; van Rosendael, Philippe J; Yeo, Tiong C; Tay, Edgar; Kamperidis, Vasileios; van der Velde, Enno T; Mertens, Bart; Ajmone Marsan, Nina; Delgado, Victoria; Bax, Jeroen J

    2018-04-14

    Transcatheter aortic valve replacement (TAVR) has been shown safe and feasible in patients with bicuspid aortic valve (BAV) morphology. Evaluation of inter-ethnic differences in valve morphology and function and aortic root dimensions in patients with BAV is important for the worldwide spread of this therapy in this subgroup of patients. Comparisons between large European and Asian cohorts of patients with BAV have not been performed, and potential differences between populations may have important implications for TAVR. The present study evaluated the differences in valve morphology and function and aortic root dimensions between two large cohorts of European and Asian patients with BAV. Aortic valve morphology was defined on transthoracic echocardiography according to the number of commissures and raphe: type 0 = no raphe and two commissures, type 1 = one raphe and two commissures, type 2 = two raphes and one commissure. Aortic stenosis and regurgitation were graded according to current recommendations. For this study, aortic root dimensions were manually measured on transthoracic echocardiograms at the level of the aortic annulus, sinus of Valsalva (SOV), sinotubular junction (STJ), and ascending aorta (AA). Of 1427 patients with BAV (45.2 ± 18.1 years, 71.9% men), 794 (55.6%) were Europeans and 633 (44.4%) were Asians. The groups were comparable in age and proportion of male sex. Asians had higher prevalence of type 1 BAV with raphe between right and non-coronary cusps than Europeans (19.7% vs. 13.6%, respectively; P < 0.001), whereas the Europeans had higher prevalence of type 0 BAV (two commissures, no raphe) than Asians (14.5% vs. 6.8%, respectively; P < 0.001). The prevalence of moderate and severe aortic regurgitation was higher in Europeans than Asians (44.2% vs. 26.8%, respectively; P < 0.001) whereas there were no differences in BAV with normal function or aortic stenosis. After adjusting for demographics, comorbidities

  11. Reoperative Aortic Root Replacement in Patients with Previous Aortic Root or Aortic Valve Procedures

    Directory of Open Access Journals (Sweden)

    Byung Kwon Chong

    2016-08-01

    Full Text Available Background: Generalization of standardized surgical techniques to treat aortic valve (AV and aortic root diseases has benefited large numbers of patients. As a consequence of the proliferation of patients receiving aortic root surgeries, surgeons are more frequently challenged by reoperative aortic root procedures. The aim of this study was to evaluate the outcomes of redo-aortic root replacement (ARR. Methods: We retrospectively reviewed 66 patients (36 male; mean age, 44.5±9.5 years who underwent redo-ARR following AV or aortic root procedures between April 1995 and June 2015. Results: Emergency surgeries comprised 43.9% (n=29. Indications for the redo-ARR were aneurysm (n=12, pseudoaneurysm (n=1, or dissection (n=6 of the residual native aortic sinus in 19 patients (28.8%, native AV dysfunction in 8 patients (12.1%, structural dysfunction of an implanted bioprosthetic AV in 19 patients (28.8%, and infection of previously replaced AV or proximal aortic grafts in 30 patients (45.5%. There were 3 early deaths (4.5%. During follow- up (median, 54.65 months; quartile 1–3, 17.93 to 95.71 months, there were 14 late deaths (21.2%, and 9 valve-related complications including reoperation of the aortic root in 1 patient, infective endocarditis in 3 patients, and hemorrhagic events in 5 patients. Overall survival and event-free survival rates at 5 years were 81.5%±5.1% and 76.4%±5.4%, respectively. Conclusion: Despite technical challenges and a high rate of emergency conditions in patients requiring redo-ARR, early and late outcomes were acceptable in these patients.

  12. Under the sword of Damocles: plausible regeneration of dark matter cusps at the smallest galactic scales

    Science.gov (United States)

    Laporte, Chervin F. P.; Peñarrubia, Jorge

    2015-04-01

    We study the evolution of the dark matter (DM) halo profiles of dwarf galaxies driven by the accretion of DM substructures through controlled N-body experiments. Our initial conditions assume that early supernova feedback erases the primordial DM cusps of haloes with z = 0 masses of 109 - 1010 M⊙. The orbits and masses of the infalling substructures are borrowed from the Aquarius cosmological simulations. Our experiments show that a fraction of haloes that undergo 1:3 down to 1:30 mergers are susceptible to reform a DM cusp by z ≈ 0. Cusp regrowth is driven by the accretion of DM substructures that are dense enough to reach the central regions of the main halo before being tidally disrupted. The infall of substructures on the mean of the reported mass-concentration relation and a mass ratio above 1:6 systematically leads to cusp regrowth. Substructures with 1:6-1:8, and 1:8-1:30 only reform DM cusps if their densities are 1σ and 2σ above the mean, respectively. The merging time-scales of these dense, low-mass substructures is relatively long (5 - 11 Gyr), which may pose a time-scale problem for the longevity of DM cores in dwarfs galaxies and possibly explain the existence of dense dwarfs-like Draco. These results suggest that within cold dark matter a non-negligible level of scatter in the mass profiles of galactic haloes acted on by feedback is to be expected given the stochastic mass accretion histories of low-mass haloes and the diverse star formation histories observed in the Local Group dwarfs.

  13. The Polar Cusp Observed by Cluster Under Constant Imf-Bz Southward

    Science.gov (United States)

    Escoubet, C. P.; Berchem, J.; Pitout, F.; Trattner, K. J.; Richard, R. L.; Taylor, M. G.; Soucek, J.; Grison, B.; Laakso, H. E.; Masson, A.; Dunlop, M. W.; Dandouras, I. S.; Reme, H.; Fazakerley, A. N.; Daly, P. W.

    2011-12-01

    The Earth's magnetic field is influenced by the interplanetary magnetic field (IMF), specially at the magnetopause where both magnetic fields enter in direct contact and magnetic reconnection can be initiated. In the polar regions, the polar cusp that extends from the magnetopause down to the ionosphere is also directly influenced. The reconnection not only allow ions and electrons from the solar wind to enter the polar cusp but also give an impulse to the magnetic field lines threading the polar cusp through the reconnection electric field. A dispersion in energy of the ions is subsequently produced by the motion of field lines and the time-of-flight effect on down-going ions. If reconnection is continuous and operates at constant rate, the ion dispersion is smooth and continuous. On the other hand if the reconnection rate varies, we expect interruption in the dispersion forming energy steps or staircase. Similarly, multiple entries near the magnetopause could also produce steps at low or mid-altitude when a spacecraft is crossing subsequently the field lines originating from these multiple sources. Cluster with four spacecraft following each other in the mid-altitude cusp can be used to distinguish between these "temporal" and "spatial" effects. We will show two Cluster cusp crossings where the spacecraft were separated by a few minutes. The energy dispersions observed in the first crossing were the same during the few minutes that separated the spacecraft. In the second crossing, two ion dispersions were observed on the first spacecraft and only one of the following spacecraft, about 10 min later. The detailed analysis indicates that these steps result from spatial structures.

  14. Low and middle altitude cusp particle signatures for general magnetopause reconnection rate variations. 1: Theory

    Science.gov (United States)

    Lockwood, M.; Smith, M. F.

    1994-01-01

    We present predictions of the signatures of magnetosheath particle precipitation (in the regions classified as open low-latitude boundary layer, cusp, mantle and polar cap) for periods when the interplanetary magnetic field has a southward component. These are made using the 'pulsating cusp' model of the effects of time-varying magnetic reconnection at the dayside magnetopause. Predictions are made for both low-altitude satellites in the topside ionosphere and for midaltitude spacecraft in the magnetosphere. Low-altitude cusp signatures, which show a continuous ion dispersion signature, reveal 'quasi-steady reconnection' (one limit of the pulsating cusp model), which persists for a period of at least 10 min. We estimate that 'quasi-steady' in this context corresponds to fluctuations in the reconnection rate of a factor of 2 or less. The other limit of the pulsating cusp model explains the instantaneous jumps in the precipitating ion spectrum that have been observed at low altitudes. Such jumps are produced by isolated pulses of reconnection: that is, they are separated by intervals when the reconnection rate is zero. These also generate convecting patches on the magnetopause in which the field lines thread the boundary via a rotational discontinuity separated by more extensive regions of tangential discontinuity. Predictions of the corresponding ion precipitation signatures seen by midaltitude spacecraft are presented. We resolve the apparent contradiction between estimates of the width of the injection region from midaltitude data and the concept of continuous entry of solar wind plasma along open field lines. In addition, we reevaluate the use of pitch angle-energy dispersion to estimate the injection distance.

  15. The bicuspid aortic valve and its relation to aortic dilation

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2010-01-01

    Full Text Available BACKGROUND: A bicuspid aortic valve (BAV is a common congenital heart disease, which affects 1-2% of the population. However, the relationship between BAVs and aortic dilation has not been sufficiently elucidated. METHODS: A total of 241 BAV patients who were referred to this hospital for cardiac surgey over a 4.75-year period were included in this study. In addition to the clinical characteristics of the included patients, the morphological features of the aortic valve and aorta, the length of the left main coronary artery, and the laboratory findings (the coagulation and hematological parameters as well as the total cholesterol concentration were determined and compared with those of the tricuspid aortic valve (TAV patients. RESULTS: The BAV patients were younger than the TAV patients for a valve surgery in the last 3 months of the study period. The BAV patients were predominantly male. Most of the BAVs that were surgically treated were stenotic, regurgitant, or combined, and only 19 (7.88% were normally functioning valves. According to echocardiography or operative records, 148 (78.31% were type A, 31 (16.40% were type B, and 10 (5.29% were type C. The left main coronary artery was much shorter in the BAV patients than it was in the TAV patients. There was no significant difference between BAV and TAV patients in the total cholesterol concentrations; whereas differences were noted between patients receiving lipid-lowering therapy and those not receiving lipid-lowering therapy. The dimensions of the aortic root, sinotubular junction, and ascending aorta were beyond normal limits, while they were significantly smaller in the BAV patients than in the TAV patients. They were also much smaller in patients receiving statin therapy than those not receiving statin therapy in both groups. Moreover, the aortic dilation in the BAV group was found to be significantly associated with patient age. CONCLUSIONS: The BAV patients developed aortic wall and

  16. Abdominal aortic aneurysms

    DEFF Research Database (Denmark)

    Lindholt, Jes S.

    2010-01-01

    Although the number of elective operations for abdominal aortic aneurysms (AAA) is increasing, the sex- and age-standardised mortality rate of AAAs continues to rise, especially among men aged 65 years or more. The lethality of ruptured AAA continues to be 80-95%, compared with 5-7% by elective...... surgery of symptomfree AAA. In order to fulfil all WHO, European, and Danish criteria for screening, a randomised hospitalbased screening trial of 12,639 65-73 year old men in Viborg County (Denmark) was initiated in 1994. It seemed that US screening is a valid, suitable and acceptable method of screening...... patients without previous hospital discharge diagnoses due to cardiovascular disease than among similar men without AAA. The absolute risk difference after 5 years was 16%. So, they will benefit from general cardiovascular preventive action as smoking cessation, statins and low-dose aspirin, which could...

  17. Abdominal aortic aneurysm surgery

    DEFF Research Database (Denmark)

    Gefke, K; Schroeder, T V; Thisted, B

    1994-01-01

    The goal of this study was to identify patients who need longer care in the ICU (more than 48 hours) following abdominal aortic aneurysm (AAA) surgery and to evaluate the influence of perioperative complications on short- and long-term survival and quality of life. AAA surgery was performed in 553...... patients, 51 (9%) of whom died within the first 48 hours. Of the 502 patients who survived for more than 48 hours, 109 required ICU therapy for more than 48 hours, whereas 393 patients were in the ICU for less than 48 hours. The incidence of preoperative risk factors was similar for the two groups...... combined failed to permit identification of patients in whom the perioperative survival rate was 0%. Even 20% of patients with multiorgan failure survived for 6 months. Of those patients who needed ICU therapy for more than 48 hours, 41 (38%) were alive at the end of 1988. In response to a questionnaire...

  18. Evaluation of the aortic anulus

    International Nuclear Information System (INIS)

    Link, K.M.; Margosian, P.

    1991-01-01

    This paper evaluates the efficacy of echocardiography and MR imaging for measuring the aortic anulus in patients who are candidates for aortic valve replacement. The MR imaging study was performed on a 1.5-T system, and the results were compared with echocardiography results obtained with use of a Toshiba system with a 2.5-mHz transducer. The aortic valve anulus was evaluated in the coronal, long-axis, and short-axis views with the MR imaging technique and in the right parasternal suprasternal, and apical projections with the echocardiographic technique. Twenty-four patients studied with MR imaging and echocardiography went on to have aortic valve replacement. When compared with surgical results, MR imaging had an r value of .95 while echocardiography had an r value of .70

  19. Imaging techniques in transcatheter aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Quaife RA

    2013-11-01

    Full Text Available Robert A Quaife, Jennifer Dorosz, John C Messenger, Ernesto E Salcedo Division of Cardiology, University of Colorado, Aurora, CO, USA Abstract: Calcific aortic stenosis is now understood as a complex valvular degenerative process sharing many risk factors with atherosclerosis. Once patients develop symptomatic calcific aortic stenosis, the only effective treatment is aortic valve replacement. In the past decade, transcatheter aortic valve replacement (TAVR has been developed as an alternative to surgery to treat severe calcific aortic stenosis. Cardiac imaging plays a pivotal role in the contemporary management of patients with calcific aortic stenosis, and particularly in patients being considered for TAVR, who demand detailed imaging of the aortic valve apparatus. In this review, we highlight the role of cardiac imaging for patient selection, procedural guidance, and evaluation of results of TAVR. Keywords: aortic stenosis, cardiovascular imaging, transcutaneous aortic valve replacement

  20. The left ventricle in aortic stenosis--imaging assessment and clinical implications.

    Science.gov (United States)

    Călin, Andreea; Roşca, Monica; Beladan, Carmen Cristiana; Enache, Roxana; Mateescu, Anca Doina; Ginghină, Carmen; Popescu, Bogdan Alexandru

    2015-04-29

    Aortic stenosis has an increasing prevalence in the context of aging population. In these patients non-invasive imaging allows not only the grading of valve stenosis severity, but also the assessment of left ventricular function. These two goals play a key role in clinical decision-making. Although left ventricular ejection fraction is currently the only left ventricular function parameter that guides intervention, current imaging techniques are able to detect early changes in LV structure and function even in asymptomatic patients with significant aortic stenosis and preserved ejection fraction. Moreover, new imaging parameters emerged as predictors of disease progression in patients with aortic stenosis. Although proper standardization and confirmatory data from large prospective studies are needed, these novel parameters have the potential of becoming useful tools in guiding intervention in asymptomatic patients with aortic stenosis and stratify risk in symptomatic patients undergoing aortic valve replacement.This review focuses on the mechanisms of transition from compensatory left ventricular hypertrophy to left ventricular dysfunction and heart failure in aortic stenosis and the role of non-invasive imaging assessment of the left ventricular geometry and function in these patients.

  1. Alkaptonuria-associated aortic stenosis.

    Science.gov (United States)

    Lok, Zoe S Y; Goldstein, Jacob; Smith, Julian A

    2013-07-01

    Alkaptonuria is an autosomal recessive disorder of tyrosine metabolism, which results in accumulation of unmetabolized homogentisic acid and its oxidized product in various tissues, including the heart. Cardiovascular involvement is a rare but serious complication of the disease. We present two patients who have undergone successful aortic valve replacement for alkaptonuria-associated aortic stenosis along with a review of the literature. © 2013 Wiley Periodicals, Inc.

  2. Aortic Stent-Graft Infection Following Septic Complications of a Kidney Stone

    International Nuclear Information System (INIS)

    Berg, H. Rogier van den; Leijdekkers, Vanessa J.; Vahl, Anco

    2006-01-01

    A 73-year-old man was treated because of a renal pelvis blowout of the left kidney for which he received a nephrostomy catheter without antibiotic prophylaxis. Almost a year previously this patient had undergone endovascular repair of a symptomatic infrarenal abdominal aorta aneurysm. Four weeks after the diagnosis and treatment of the ruptured renal pelvis, a new computed tomography scan and ultrasound-guided fine needle aspiration confirmed the diagnosis of infected aortic stent-graft. An extra-anatomic axillo-uniiliac bypass and graft excision was performed. Two weeks after discharge the patient returned to the hospital with an occlusion of his left renal artery and died of renal failure. This is the first time an infected aortic stent-graft after a renal pelvis blowout has been reported. Although infections of aortic stent-grafts occur rarely, one should be aware of the possibility in aortic stent-graft patients undergoing abdominal procedures without antibiotic prophylaxis

  3. Results of aortic root reimplantation in patients with ascending aortic aneurysm and concomitant aortic insufficiency

    Directory of Open Access Journals (Sweden)

    А. М. Чернявский

    2016-01-01

    Full Text Available Objective. The research was designed to evaluate the results of valve-sparing operations: aortic root reimplantation versus aortic valve reimplantation when repairing an ascending aortic aneurysm with concomitant aortic insufficiency.Methods. Within a blind prospective randomized study conducted over a period from 2011 to 2015, 64 patients underwent aortic valve-sparing surgery. The inclusion criteria were the presence of an aortic aneurysm of the ascending aorta exceeding 4.5 cm and concomitant aortic insufficiency. All patients were divided into two groups: FS-group, aortic root reimplantation (modified Florida Sleeve technique (n = 32 and D-group, aortic valve reimplantation (David procedure (n = 32. The average age of patients was 57±13 (23–73 years in the FS-group and 55±11 (15–72 years in the D-group (p = 0.54. Both groups had 78% of males (p>0.99. A Marfan syndrome was identified in 6% and 9% in the FS-group and D-group respectively (p>0.99. Mean diameter of the sinuses of Valsalva was 51±7 mm and 56±10 mm (p = 0.09, aortic insufficiency 2.6±0.7 and 2.8±0.8 (p = 0.15 in the FS-group and D-group respectively. In the FS-group and D-group LVEDD amounted to 5.5±0.7 mm and 5.9±1.0 mm (p = 0.09 respectively. All patients took echocardiography in the preoperative, postoperative and follow-up periods.Results. In the long-term period, the degree of aortic regurgitation was 1.2±0.1 in the FS-group and 1.3±0.6 in the D-group (p = 0.72. LVEDD was 123±23 mm in the FS-group and 139.6±80 mm in the D-group at follow-up (p = 0.77. There were no statistically significant differences in the analysis of complications. Overall 30-day in-hospital mortality was 7.8%. There were 2 (6.3% deaths in the FS-group and 3 (9.4% in the D-group (p = 0.5.Late mortality was 6.3% in the FS-group and 3.1% in the D-group (p>0.99. Cumulative survival at 4 years was 84.3% and 84.8% in the FS-group and the D-group respectively (p = 0.94. Cumulative freedom from

  4. Wall stress on ascending thoracic aortic aneurysms with bicuspid compared with tricuspid aortic valve.

    Science.gov (United States)

    Xuan, Yue; Wang, Zhongjie; Liu, Raymond; Haraldsson, Henrik; Hope, Michael D; Saloner, David A; Guccione, Julius M; Ge, Liang; Tseng, Elaine

    2018-03-08

    Guidelines for repair of bicuspid aortic valve-associated ascending thoracic aortic aneurysms have been changing, most recently to the same criteria as tricuspid aortic valve-ascending thoracic aortic aneurysms. Rupture/dissection occurs when wall stress exceeds wall strength. Recent studies suggest similar strength of bicuspid aortic valve versus tricuspid aortic valve-ascending thoracic aortic aneurysms; thus, comparative wall stress may better predict dissection in bicuspid aortic valve versus tricuspid aortic valve-ascending thoracic aortic aneurysms. Our aim was to determine whether bicuspid aortic valve-ascending thoracic aortic aneurysms had higher wall stresses than their tricuspid aortic valve counterparts. Patients with bicuspid aortic valve- and tricuspid aortic valve-ascending thoracic aortic aneurysms (bicuspid aortic valve = 17, tricuspid aortic valve = 19) greater than 4.5 cm underwent electrocardiogram-gated computed tomography angiography. Patient-specific 3-dimensional geometry was reconstructed and loaded to systemic pressure after accounting for prestress geometry. Finite element analyses were performed using the LS-DYNA solver (LSTC Inc, Livermore, Calif) with user-defined fiber-embedded material model to determine ascending thoracic aortic aneurysm wall stress. Bicuspid aortic valve-ascending thoracic aortic aneurysms 99th-percentile longitudinal stresses were 280 kPa versus 242 kPa (P = .028) for tricuspid aortic valve-ascending thoracic aortic aneurysms in systole. These stresses did not correlate to diameter for bicuspid aortic valve-ascending thoracic aortic aneurysms (r = -0.004) but had better correlation to tricuspid aortic valve-ascending thoracic aortic aneurysms diameter (r = 0.677). Longitudinal stresses on sinotubular junction were significantly higher in bicuspid aortic valve-ascending thoracic aortic aneurysms than in tricuspid aortic valve-ascending thoracic aortic aneurysms (405 vs 329 kPa, P = .023). Bicuspid

  5. Direct determination of IMF B-Y-related cusp current systems, using SuperDARN radar and multiple ground magnetometer data: A link to theory on cusp current origin

    DEFF Research Database (Denmark)

    Amm, O.; Engebretson, M.J.; Greenwald, R.A.

    1999-01-01

    , respectively, with magnitudes of around 0.5 A/km(2). The geometry of the current system resembles a DPY current system [Friis-Christensen and Wilhjelm, 1975]. Using our results, we test alternative theories on cusp current origin that lead to different predictions of the relative location of the cusp current...... are caused by a rotational discontinuity of the magnetic field at the magnetopause. In contrast, the idea of Clauer and Banks [1986] that a mapping of the solar wind E-z component to the ionosphere is responsible for the cusp current system is not supported....... system with respect to the open-closed field line boundary. The location of this boundary is inferred from DMSP F10 satellite data. The center of our resulting current system is located clearly poleward of the open-closed field line boundary, thus favoring the idea of Lee et al. [1985] that the cusp FACs...

  6. Bovine aortic arch: A novel association with thoracic aortic dilation

    International Nuclear Information System (INIS)

    Malone, C.D.; Urbania, T.H.; Crook, S.E.S.; Hope, M.D.

    2012-01-01

    Aim: To investigate whether there is a link between bovine arch and thoracic aortic aneurysm. Materials and methods: Computed tomography (CT) and magnetic resonance imaging (MRI) images of the thorax of 191 patients with dilated thoracic aortas and 391 consecutive, unselected patients as controls were retrospectively reviewed. Bovine arch was considered present if either a shared origin of the left common carotid and innominate arteries or an origin of the left common carotid from the innominate artery was identified. A chi-square test was used to evaluate the significance of differences between subgroups. Results: A trend towards increased prevalence of bovine arch was seen in patients with dilated aortas (26.2%) compared to controls (20.5%, p = 0.12). The association was statistically significant in patients over 70 years old (31.9%, p = 0.019) and when dilation involved the aortic arch (47.6%, p = 0.003). Conclusions: An association between bovine arch and aortic dilation is seen in older patients, and when dilation involves the aortic arch. Bovine arch should be considered a potential risk factor for thoracic aortic aneurysm.

  7. Endoluminal treatment of aortic dissection

    Energy Technology Data Exchange (ETDEWEB)

    Chavan, Ajay; Lotz, Joachim; Galanski, Michael [Department of Diagnostic Radiology, Hannover Medical School, Carl Neuberg Strasse 1, 30625, Hannover (Germany); Oelert, Frank; Haverich, Axel; Karck, Matthias [Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl Neuberg Strasse 1, 30625, Hannover (Germany)

    2003-11-01

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86-100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature. (orig.)

  8. Endoluminal treatment of aortic dissection

    International Nuclear Information System (INIS)

    Chavan, Ajay; Lotz, Joachim; Galanski, Michael; Oelert, Frank; Haverich, Axel; Karck, Matthias

    2003-01-01

    Aortic dissection is most often a catastrophic medical emergency which, if untreated, can be potentially fatal. The intention of therapy in patients with aortic dissection is to prevent aortic rupture or aneurysm formation as well as to relieve branch vessel ischaemia. Patients with aortic dissection are often poor candidates for anaesthesia and surgery and the surgical procedure itself is challenging requiring thoracotomy, aortic cross clamping, blood transfusion as well as prolonged hospital stay in some cases. Operative mortality is especially high in patients with critical mesenteric or renal ischaemia. The past decade has experienced the emergence of a number of interventional radiological or minimally invasive techniques which have significantly improved the management of patients with aortic dissection. These include stent grafting for entry site closure to prevent aneurysmatic widening of the false lumen as well as percutaneous techniques such as balloon fenestration of the intimal flap and aortic true lumen stenting to alleviate branch vessel ischaemia. False lumen thrombosis following entry closure with stent grafts has been observed in 86-100% of patients, whereas percutaneous interventions are able to effectively relieve organ ischaemia in approximately 90% of the cases. In the years to come, it is to be expected that these endoluminal techniques will become the method of choice for treating most type-B dissections and will assist in significantly reducing the number of open surgical procedures required for type-A dissections. The intention of this article is to provide an overview of the current status of these endoluminal techniques based on our own experience as well as on a review of the relevant literature. (orig.)

  9. Left Ventricular Assist Device Implantation with Concomitant Aortic Valve and Ascending Aortic Replacement.

    Science.gov (United States)

    Huenges, Katharina; Panholzer, Bernd; Cremer, Jochen; Haneya, Assad

    2018-01-01

    Left ventricular assist device (LVAD) is nowadays a routine therapy for patients with advanced heart failure. We present the case of a 74-year-old male patient who was admitted to our center with terminal heart failure in dilated cardiomyopathy and ascending aortic aneurysm with aortic valve regurgitation. The LVAD implantation with simultaneous aortic valve and supracoronary ascending aortic replacement was successfully performed.

  10. Dynamics of the aortic annulus in 4D CT angiography for transcatheter aortic valve implantation patients

    NARCIS (Netherlands)

    Elattar, Mustafa A.; Vink, Leon W.; van Mourik, Martijn S.; Baan, Jan; Vanbavel, Ed T.; Planken, R. Nils; Marquering, Henk A.

    2017-01-01

    Transcatheter aortic valve implantation (TAVI) is a well-established treatment for patients with severe aortic valve stenosis. This procedure requires pre-operative planning by assessment of aortic dimensions on CT Angiography (CTA). It is well-known that the aortic root dimensions vary over the

  11. Bicuspid Aortic Valve Disease: A Comprehensive Review

    OpenAIRE

    Mordi, Ify; Tzemos, Nikolaos

    2012-01-01

    Bicuspid aortic valve is the commonest congenital cardiac abnormality in the general population. This paper article will discuss our current knowledge of the anatomy, pathophysiology, genetics, and clinical aspects of bicuspid aortic valve disease.

  12. Aortic compliance in patients with aortic regurgitation. Evaluation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Murai, Sachiko; Hamada, Seiki; Ueguchi, Takashi

    2005-01-01

    The purpose of this study was to assess by means of cine magnetic resonance imaging (MRI) aortic compliance before and after aortic valve replacement (AVR with SJM (St. Jude Medical, St paul, MN) valve) in patients with aortic regurgitation (AR). Two groups (healthy controls and patients with severe isolated AR) of 10 subjects each were included in this study. Cine MRI was performed at three locations of the aorta, and aortic compliance was calculated by dividing the maximum change in the aortic area by pulse pressure. Cine MRI is useful to assess abnormalities of aortic compliance in patients with AR. Compared with the control group, aortic compliance in the AR group was significantly less in the ascending aorta (p<0.05), decreasing in order of aortic location. After AVR, aortic compliance improved for all locations. Cine MRI enables assessment of aortic biophysical properties such as a compliance for evaluating the progression of AR and the efficacy of treatment. (author)

  13. Abdominal aortic feminism.

    Science.gov (United States)

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. 2014 BMJ Publishing Group Ltd.

  14. Aortic atresia with normal sized left ventricle

    OpenAIRE

    Priya Jagia; Arun Sharma; Saurabh K Gupta; Munish Guleria

    2016-01-01

    Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best ...

  15. A History of Thoracic Aortic Surgery.

    Science.gov (United States)

    McFadden, Paul Michael; Wiggins, Luke M; Boys, Joshua A

    2017-08-01

    Ancient historical texts describe the presence of aortic pathology conditions, although the surgical treatment of thoracic aortic disease remained insurmountable until the 19th century. Surgical treatment of thoracic aortic disease then progressed along with advances in surgical technique, conduit production, cardiopulmonary bypass, and endovascular technology. Despite radical advances in aortic surgery, principles established by surgical pioneers of the 19th century hold firm to this day. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Maxillary and Mandibular First Premolars Showing Three-Cusp Pattern: An Unusual Presentation

    Directory of Open Access Journals (Sweden)

    Ramakant Nayak

    2013-01-01

    Full Text Available Dental anatomy is the study of morphology of various teeth in human dentitions. The application of dental anatomy in clinical practice is important, and dentist should have a thorough knowledge regarding the morphology of the teeth. At times as a result of genetic variation, environmental factors, diet of an individual and race, variations in the morphology of the teeth can be observed. These variations have been extensively studied by the researcher in the field of anthropology to define a particular race. The most commonly observed changes include peg-shaped laterals, shovel-shaped incisors, and extra cusp on molar. Common variations documented with regard to maxillary and mandibular first premolars are the variation in the number of roots. But the variations with respect to crown morphology are few. We report a first documented unusual presentation of maxillary and mandibular first premolars with three-cusps pattern in a female patient.

  17. The polar cusp: Particle-, optical- and geomagnetic manifistations of solar wind - magnetosphere interaction

    International Nuclear Information System (INIS)

    Sandholt, P.E.; Egeland, A.; Lybekk, B.

    1985-08-01

    In this study observations of particle precipitation, optical emissions and geomagnetic disturbances associated with the low-altitude polar cusp are presented. The main observational basis is photometer data from two stations on Svalbard (Spitsbergen), Norway. These data have been used to map the location and dynamics of polar cusp auroras. One event with coordinated observations of low-energy precipitation from satellite HILAT and optical observations from the ground is discussed. Simultaneous photometer observations of the midday (Svalbard) and midnight (Alaska) sectors of the auroral oval are also presented. Thus, dynamical auroral phenomena with different temporal and spatial scales are investigated in relation to the interplanetary magnetic field and magnetospheric substorms. Certain large- and small-scale dynamics of the aurora and the geomagnetic field are shown to be consistent with the quasi steady-state/large-scale and impulsive/small-scale modes of magnetic reconnection at the frontside magnetopause

  18. The surface microstructure of cusps and leaflets in rabbit and mouse heart valves

    Directory of Open Access Journals (Sweden)

    Xia Ye

    2014-05-01

    Full Text Available In this investigation, scanning electron microscopy was used to characterize the microstructure on the surfaces of animal heart valve cusps/leaflets. The results showed that though these surfaces appear smooth to the naked eye, they are actually comprised of a double hierarchical structure consisting of a cobblestone-like microstructure and nano-cilia along with mastoids with a directional arrangement. Such nanostructures could play a very important role in the hemocompatibility characteristics of heart valves. On this basis, the model of the microstructure was constructed and theoretical analysis was used to obtain optimal geometric parameters for the rough surface of artificial valve cusps/leaflets. This model may help improve reconstructive techniques and it may be beneficial in the design and fabrication of valve substitutes or partial substitutes. Namely, the model may help ameliorate heart valve replacement surgery.

  19. Magnetic field and electric currents in the vicinity of polar cusps as inferred from Polar and Cluster data

    Directory of Open Access Journals (Sweden)

    N. A. Tsyganenko

    2009-04-01

    Full Text Available A detailed statistical study of the magnetic structure of the dayside polar cusps is presented, based on multi-year sets of magnetometer data of Polar and Cluster spacecraft, taken in 1996–2006 and 2001–2007, respectively. Thanks to the dense data coverage in both Northern and Southern Hemispheres, the analysis spanned nearly the entire length of the cusps, from low altitudes to the cusp "throat" and the magnetosheath. Subsets of data falling inside the polar cusp "funnels" were selected with the help of TS05 and IGRF magnetic field models, taking into account the dipole tilt and the solar wind/IMF conditions. The selection funnels were shifted within ±10° of SM latitude around the model cusp location, and linear regression parameters were calculated for each sliding subset, further divided into 10 bins of distance in the range 2≤R≤12 RE, with the following results. (1 Diamagnetic depression, caused by the penetrated magnetosheath plasma, becomes first visible at R~4–5 RE, rapidly deepens with growing R, peaks at R~6–9 RE, and then partially subsides and widens in latitude at the cusp's outer end. (2 The depression peak is systematically shifted poleward (by ~2° of the footpoint latitude with respect to the model cusp field line, passing through the min{|B|} point at the magnetopause. (3 At all radial distances, clear and distinct peaks of the correlation between the local By and By(IMF and of the corresponding proportionality coefficient are observed. A remarkably regular variation of that coefficient with R quantitatively confirms the field-aligned geometry of the cusp currents associated with the IMF By, found in earlier observations.

  20. The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth

    OpenAIRE

    Khalid A. Arafa

    2016-01-01

    Objectives: To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. Methods: A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group receive...

  1. Implementing the Comprehensive Unit-Based Safety Program (CUSP) to Improve Patient Safety in an Academic Primary Care Practice.

    Science.gov (United States)

    Pitts, Samantha I; Maruthur, Nisa M; Luu, Ngoc-Phuong; Curreri, Kimberly; Grimes, Renee; Nigrin, Candace; Sateia, Heather F; Sawyer, Melinda D; Pronovost, Peter J; Clark, Jeanne M; Peairs, Kimberly S

    2017-11-01

    While there is growing awareness of the risk of harm in ambulatory health care, most patient safety efforts have focused on the inpatient setting. The Comprehensive Unit-based Safety Program (CUSP) has been an integral part of highly successful safety efforts in inpatient settings. In 2014 CUSP was implemented in an academic primary care practice. As part of CUSP implementation, staff and clinicians underwent training on the science of safety and completed a two-question safety assessment survey to identify safety concerns in the practice. The concerns identified by team members were used to select two initial safety priorities. The impact of CUSP on safety climate and teamwork was assessed through a pre-post comparison of results on the validated Safety Attitudes Questionnaire. Ninety-six percent of staff completed science of safety training as part of CUSP implementation, and 100% of staff completed the two-question safety assessment. The most frequently identified safety concerns were related to medications (n = 11, 28.2), diagnostic testing (n = 9, 25), and communication (n = 5, 14). The CUSP team initially prioritized communication and infection control, which led to standardization of work flows within the practice. Six months following CUSP implementation, large but nonstatistically significant increases were found for the percentage of survey respondents who reported knowledge of the proper channels for questions about patient safety, felt encouraged to report safety concerns, and believed that the work setting made it easy to learn from the errors of others. CUSP is a promising tool to improve safety climate and to identify and address safety concerns within ambulatory health care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  2. Aortic or Mitral Valve Replacement With the Biocor and Biocor Supra

    Science.gov (United States)

    2017-04-26

    Aortic Valve Insufficiency; Aortic Valve Regurgitation; Aortic Valve Stenosis; Aortic Valve Incompetence; Mitral Valve Insufficiency; Mitral Valve Regurgitation; Mitral Valve Stenosis; Mitral Valve Incompetence

  3. Thoracic Endovascular Aortic Repair (TEVAR) in Proximal (Type A) Aortic Dissection: Ready for a Broader Application?

    OpenAIRE

    Nienaber, Christoph A.; Sakalihasan, Natzi; Clough, Rachel E.; Aboukoura, Mohamed; Mancuso, Enrico; Yeh, James S.M.; Defraigne, Jean-Olivier; Cheshire, Nick; Rosendahl, Ulrich Peter; Quarto, Cesare; Pepper, John

    2016-01-01

    ObjectiveThoracic endovascular aortic repair (TEVAR) has demonstrated encouraging results and is gaining increasing acceptance as a treatment option for aortic aneurysms and dissections. Yet, its role in managing proximal aortic pathologies is unknown - this is important because in proximal (Stanford type A) aortic dissections, 10-30% are not accepted for surgery, and 30-50% are technically amenable for TEVAR. We describe our case series of type A aortic dissections treated using TEVAR.Method...

  4. DISSECT: a new mnemonic-based approach to the categorization of aortic dissection.

    Science.gov (United States)

    Dake, M D; Thompson, M; van Sambeek, M; Vermassen, F; Morales, J P

    2013-08-01

    Classification systems for aortic dissection provide important guides to clinical decision-making, but the relevance of traditional categorization schemes is being questioned in an era when endovascular techniques are assuming a growing role in the management of this frequently complex and catastrophic entity. In recognition of the expanding range of interventional therapies now used as alternatives to conventional treatment approaches, the Working Group on Aortic Diseases of the DEFINE Project developed a categorization system that features the specific anatomic and clinical manifestations of the disease process that are most relevant to contemporary decision-making. The DISSECT classification system is a mnemonic-based approach to the evaluation of aortic dissection. It guides clinicians through an assessment of six critical characteristics that facilitate optimal communication of the most salient details that currently influence the selection of a therapeutic option, including those findings that are key when considering an endovascular procedure, but are not taken into account by the DeBakey or Stanford categorization schemes. The six features of aortic dissection include: duration of disease; intimal tear location; size of the dissected aorta; segmental extent of aortic involvement; clinical complications of the dissection, and thrombus within the aortic false lumen. In current clinical practice, endovascular therapy is increasingly considered as an alternative to medical management or open surgical repair in select cases of type B aortic dissection. Currently, endovascular aortic repair is not used for patients with type A aortic dissection, but catheter-based techniques directed at peripheral branch vessel ischemia that may complicate type A dissection are considered valuable adjunctive interventions, when indicated. The use of a new system for categorization of aortic dissection, DISSECT, addresses the shortcomings of well-known established schemes devised

  5. A Note On Signs Of Fourier Coefficients Of Two Cusp Forms

    Indian Academy of Sciences (India)

    10

    Abstract. Kohnen and Sengupta showed that if two Hecke eigen cusp forms of weight k1 and k2 respectively with 1 < k1 < k2 over. Γ0(N ), have totally real algebraic Fourier coefficients {a(n)} and. {b(n)} respectively for n ≥ 1 with a(1) = 1 = b(1), then there exists an element σ of the absolute Galois group Gal(Q/Q) such.

  6. Plasma polarization spectroscopy on the ECR helium plasma in a cusp magnetic field

    International Nuclear Information System (INIS)

    Sato, T.; Iwamae, A.; Fujimoto, T.; Uchida, M.; Maekawa, T.

    2004-01-01

    Helium emission lines have been observed on the ECR plasma in a cusp field with the polarized components resolved. The polarization map is constructed for the 501.6 nm (2 1 S-3 1 P) line emission. Lines from n 1 P and n 1 D levels are strongly polarized and those from n 3 D levels are weakly polarized. As the helium pressure increases the polarization degree decreases. (author)

  7. Performance optimization of a cusp-field ion source and high-perveance extractor

    International Nuclear Information System (INIS)

    Meyer, E.A.; Amstrong, D.D.; Schneider, D.

    1981-01-01

    The injector for the Fusion Materials Irradiation Test (FMIT) Facility must deliver a 110-mA dc beam of deuterons or H 2 + ions to the radio-frequency quadrupole (RFQ) accelerator at 75-keV energy. Operational parameters of a hydrogen-fed cusp-field ion source and a high-perveance extractor have been evaluated on a test stand and on the recently completed first stage of the prototype injector

  8. Cusps in K{sub L}{yields}3{pi} decays

    Energy Technology Data Exchange (ETDEWEB)

    Bissegger, M. [Institute for Theoretical Physics, University of Bern, Sidlerstr. 5, CH-3012 Bern (Switzerland); Fuhrer, A. [Institute for Theoretical Physics, University of Bern, Sidlerstr. 5, CH-3012 Bern (Switzerland)], E-mail: afuhrer@itp.unibe.ch; Gasser, J. [Institute for Theoretical Physics, University of Bern, Sidlerstr. 5, CH-3012 Bern (Switzerland); Kubis, B.; Rusetsky, A. [Helmholtz-Institut fuer Strahlen- und Kernphysik, Universitaet Bonn, Nussallee 14-16, D-53115 Bonn (Germany)

    2008-01-24

    The pion mass difference generates a pronounced cusp in K{yields}3{pi} decays, the strength of which is related to the {pi}{pi} S-wave scattering lengths. We apply an effective field theory framework developed earlier to evaluate the amplitudes for K{sub L}{yields}3{pi} decays in a systematic manner, where the strictures imposed by analyticity and unitarity are respected automatically. The amplitudes for the decay {eta}{yields}3{pi} are also given.

  9. Two Azimuthally Separated Regions of Cusp Ion Injection Observed via Energetic Neutral Atoms

    Science.gov (United States)

    Abe, M.; Taguchi, S.; Collier, M. R.; Moore, T. E.

    2011-01-01

    The low-energy neutral atom (LENA) imager on the IMAGE spacecraft can detect energetic neutral atoms produced by ion injection into the cusp through a charge exchange with the Earth's hydrogen exosphere. We examined the occurrence of the LENA cusp signal during positive IMF B(sub z) in terms of the arrival direction and the IMF clock angle theta(sub CA). Results of statistical analyses show that the occurrence frequency is high on the postnoon side when theta(sub CA) is between approximately 20 degrees and approximately 50 degrees. This is ascribed to ion injection caused by cusp reconnection typical of positive IMF B(sub z). Our results also show that there is another situation of high occurrence frequency, which can be identified with theta(sub CA) of approximately 30 degrees to approximately 80 degrees. When theta(sub CA) is relatively large (60 degrees - 80 degrees), occurrence frequencies are high at relatively low latitudes over a wide extent spanning both prenoon and postnoon sectors. This feature suggests that the ion injection is caused by reconnection at the dayside magnetopause. Its postnoon side boundary shifts toward the prenoon as theta(sub CA) decreases. When theta(sub CA) is less than approximately 50 degrees, the high occurrence frequency exists well inside the prenoon sector, which is azimuthally separated from the postnoon region ascribed to cusp reconnection. The prenoon region, which is thought due to ion injection caused by dayside reconnection, may explain the recent report that proton aurora brightening occurs in the unanticipated prenoon sector of the northern high-latitude ionosphere for IMF B(sub y) greater than 0 and B(sub z) greater than 0.

  10. Realizing stock market crashes: stochastic cusp catastrophe model of returns under time-varying volatility

    Czech Academy of Sciences Publication Activity Database

    Baruník, Jozef; Kukačka, Jiří

    2015-01-01

    Roč. 15, č. 6 (2015), s. 959-973 ISSN 1469-7688 R&D Projects: GA ČR GA402/09/0965; GA ČR GA13-32263S EU Projects: European Commission 612955 - FINMAP Institutional support: RVO:67985556 Keywords : Stochastic cusp catastrophe model * Realized volatility * Bifurcations * Stock market crash Subject RIV: AH - Economics Impact factor: 0.794, year: 2015 http://library.utia.cas.cz/separaty/2014/E/barunik-0434202.pdf

  11. Low momentum scattering of the Dirac particle with an asymmetric cusp potential

    International Nuclear Information System (INIS)

    Jiang, Yu.; Dong, Shi-Hai; Lozada-Cassou, M.; Antillon, A.

    2006-01-01

    We study the exact solutions of the bound and scattering states of the one-dimensional Dirac equation with an asymmetric cusp potential and derive the condition of the supercriticality for this quantum system. We find that the scattering properties are invariant under reflection of the potential's shape, and the supercritical value for the potential amplitude V 0 varies with the degree of the potential asymmetry. (orig.)

  12. Chorus observations by the Polar spacecraft near the mid-altitude cusp

    Czech Academy of Sciences Publication Activity Database

    Menietti, J. D.; Santolík, Ondřej; Abaci, P. C.

    2009-01-01

    Roč. 57, č. 12 (2009), s. 1412-1418 ISSN 0032-0633 R&D Projects: GA AV ČR IAA301120601 Grant - others:NSF(US) ATM-04-43531; NASA (US) NNG05GM52G.; GA MŠk(CZ) ME 842 Institutional research plan: CEZ:AV0Z30420517 Keywords : chorus * mid-altitude cusp * Polar spacecraft Subject RIV: BL - Plasma and Gas Discharge Physics Impact factor: 2.067, year: 2009

  13. His-Purkinje system-related incessant ventricular tachycardia arising from the left coronary cusp

    Directory of Open Access Journals (Sweden)

    Eiji Sato, MD

    2014-08-01

    Full Text Available We describe the case of a 23-year-old woman who had His-Purkinje system-related incessant ventricular tachycardia with a narrow QRS configuration. The ventricular tachycardia was ablated successfully in the left coronary cusp where the earliest endocardial activation had been recorded. We hypothesize that a remnant of the subaortic conducting tissue was the source of the ventricular arrhythmias.

  14. A statistical survey of heat input parameters into the cusp thermosphere

    Science.gov (United States)

    Moen, J. I.; Skjaeveland, A.; Carlson, H. C.

    2017-12-01

    Based on three winters of observational data, we present those ionosphere parameters deemed most critical to realistic space weather ionosphere and thermosphere representation and prediction, in regions impacted by variability in the cusp. The CHAMP spacecraft revealed large variability in cusp thermosphere densities, measuring frequent satellite drag enhancements, up to doublings. The community recognizes a clear need for more realistic representation of plasma flows and electron densities near the cusp. Existing average-value models produce order of magnitude errors in these parameters, resulting in large under estimations of predicted drag. We fill this knowledge gap with statistics-based specification of these key parameters over their range of observed values. The EISCAT Svalbard Radar (ESR) tracks plasma flow Vi , electron density Ne, and electron, ion temperatures Te, Ti , with consecutive 2-3 minute windshield-wipe scans of 1000x500 km areas. This allows mapping the maximum Ti of a large area within or near the cusp with high temporal resolution. In magnetic field-aligned mode the radar can measure high-resolution profiles of these plasma parameters. By deriving statistics for Ne and Ti , we enable derivation of thermosphere heating deposition under background and frictional-drag-dominated magnetic reconnection conditions. We separate our Ne and Ti profiles into quiescent and enhanced states, which are not closely correlated due to the spatial structure of the reconnection foot point. Use of our data-based parameter inputs can make order of magnitude corrections to input data driving thermosphere models, enabling removal of previous two fold drag errors.

  15. Energy and cusp-conditions study for the He isoelectronic sequence

    Energy Technology Data Exchange (ETDEWEB)

    Otranto, S. E-mail: sotranto@uns.edu.ar; Gasaneo, G. E-mail: ggasaneo@criba.edu.ar; Garibotti, C.R

    2004-03-01

    We present variational wave functions for He-like atoms with nuclear charge Z=1,...,10. We propose modifications of some usual simple correlated wave functions to account for the integration factor required in the evaluation of atomic ionization and excitation amplitudes with distorted wave methods. We determine the parameters of the trial functions and the resulting energies. We introduce new procedures to test the cusp conditions at the singularities of the Coulomb field.

  16. Unruptured Aneurysm of Sinus of Valsalva Coexisting with the Large Ventricular Septal Defect and Severe Aortic Regurgitation in a Young Man

    Directory of Open Access Journals (Sweden)

    Pouya Nezafati

    2015-01-01

    Full Text Available Introduction. Unruptured sinus of valsalva aneurysm (SVA is a rare congenital anomaly, particularly, when it coexists with a ventricular septal defect (VSD and aortic regurgitation due to the prolapse of the elongated aortic cusp into the VSD. In this report, we present the case of a 19-year-old young man with VSD challenging in spite of dyspnea and lower limb edema. Presentation of Case. Its diagnosis was made on the basis of transthoracic echocardiography results. Surgical management consisted of replacing the SVA with mechanical valve prosthesis. A Gore-Tex patch repaired the VSD. Discussion. In the follow-up periods, clinical and echocardiographic tests showed that the patient was in excellent status. Conclusion. SVA requires a surgical procedure due to its high risk of mortality in unoperated patients and a good safety of surgery.

  17. Influence of different cusp coverage methods for the extension of ceramic inlays on marginal integrity and enamel crack formation in vitro.

    Science.gov (United States)

    Krifka, Stephanie; Stangl, Martin; Wiesbauer, Sarah; Hiller, Karl-Anton; Schmalz, Gottfried; Federlin, Marianne

    2009-09-01

    No information is available to date about cusp design of thin (1.0 mm) non-functional cusps and its influence upon (1) marginal integrity of ceramic inlays (CI) and partial ceramic crowns (PCC) and (2) crack formation of dental tissues. The aim of this in vitro study was to investigate the effect of cusp coverage of thin non-functional cusps on marginal integrity and enamel crack formation. CI and PCC preparations were performed on extracted human molars. Non-functional cusps were adjusted to 1.0-mm wall thickness and 1.0-mm wall thickness with horizontal reduction of about 2.0 mm. Ceramic restorations (Vita Mark II, Cerec3 System) were adhesively luted with Excite/Variolink II. The specimens were exposed to thermocycling and central mechanical loading. Marginal integrity was assessed by evaluating dye penetration after thermal cycling and mechanical loading. Enamel cracks were documented under a reflective-light microscope. The data were statistically analysed with the Mann-Whitney U test, the Fishers exact test (alpha = 0.05) and the error rates method. PCC with horizontal reduction of non-functional cusps showed statistically significant less microleakage than PCC without such a cusp coverage. Preparation designs with horizontal reduction of non-functional cusps showed a tendency to less enamel crack formation than preparation designs without cusp coverage. Thin non-functional cusp walls of adhesively bonded restorations should be completely covered or reduced to avoid enamel cracks and marginal deficiency.

  18. Confinement of a non cylindrical z discharge by a cusp geometry

    International Nuclear Information System (INIS)

    Watteau, J.H.

    1968-03-01

    The plasma of a non-cylindrical z discharge is accumulated in the centre of a cusp geometry and then captured and confined by the rising cusp magnetic field. The cusp geometry is produced by two identical coaxial coils the currents of which are equal but in opposite directions. Stability and confinement properties of this zero minimum B geometry are recalled; in particular it is shown (the coils cross section being supposed punctual) that the magnetic well depth of the configuration without plasma is maximum for an optimum coils distance. Two modes of confinement are observed experimentally : - a collisional mode for which the plasma confinement is limited to 10 μsec (temperature 5 eV, density 7 x 10 16 cm -3 ) as a result of the gradual interpenetration of the plasma and of the magnetic field. - a collisionless mode (temperature 40 eV) where the radial leak thickness is of the order of the ion cyclotron radius. Plasma accumulation occurs even without confinement and is due to the non-cylindrical shape of the discharge chamber. The two-dimensional snow-plough model gives good account of the discharge dynamics. A comparison is made with plasma focus experiments: in particular experimental conditions (deuterium, pressure 1 torr,energy 3 kJ, current 100 kA) a 10 7 neutron yield is detected which appears to be connected with the unstable behavior of the discharge. (authors) [fr

  19. Manifolds with cusps of rank one spectral theory and L2-index theorem

    CERN Document Server

    Müller, Werner

    1987-01-01

    The manifolds investigated in this monograph are generalizations of (Mathematical Physics and Mathematics)-rank one locally symmetric spaces. In the first part of the book the author develops spectral theory for the differential Laplacian operator associated to the so-called generalized Dirac operators on manifolds with cusps of rank one. This includes the case of spinor Laplacians on (Mathematical Physics and Mathematics)-rank one locally symmetric spaces. The time-dependent approach to scattering theory is taken to derive the main results about the spectral resolution of these operators. The second part of the book deals with the derivation of an index formula for generalized Dirac operators on manifolds with cusps of rank one. This index formula is used to prove a conjecture of Hirzebruch concerning the relation of signature defects of cusps of Hilbert modular varieties and special values of L-series. This book is intended for readers working in the field of automorphic forms and analysis on non-compact Ri...

  20. A new multi-line cusp magnetic field plasma device (MPD) with variable magnetic field

    Science.gov (United States)

    Patel, A. D.; Sharma, M.; Ramasubramanian, N.; Ganesh, R.; Chattopadhyay, P. K.

    2018-04-01

    A new multi-line cusp magnetic field plasma device consisting of electromagnets with core material has been constructed with a capability to experimentally control the relative volume fractions of magnetized to unmagnetized plasma volume as well as accurate control on the gradient length scales of mean density and temperature profiles. Argon plasma has been produced using a hot tungsten cathode over a wide range of pressures 5 × 10-5 -1 × 10-3 mbar, achieving plasma densities ranging from 109 to 1011 cm-3 and the electron temperature in the range 1-8 eV. The radial profiles of plasma parameters measured along the non-cusp region (in between two consecutive magnets) show a finite region with uniform and quiescent plasma, where the magnetic field is very low such that the ions are unmagnetized. Beyond that region, both plasma species are magnetized and the profiles show gradients both in temperature and density. The electrostatic fluctuation measured using a Langmuir probe radially along the non-cusp region shows less than 1% (δIisat/Iisat physics parameter space relevant to both laboratory multi-scale plasmas and astrophysical plasmas.

  1. Distinct ion population in the polar cusp: possible signature of transient reconnection

    International Nuclear Information System (INIS)

    Escoubet, C.P.; Smith, M.F.; Bosqued, J.M.

    1992-01-01

    Observations of ion energy dispersion are a common feature of the polar cusp. Normally these dispersions show a continuous decrease in energy. However, they occasionally show step-like features in the dispersion. On 15 October 1981 Dynamics Explorer 2 (DE2) crossed the polar cusp at 1015 MLT and observed three distinct ion populations as the spacecraft moved poleward. These three populations had peak-flux energy around 2.7 keV, 850 eV and 360 eV. The first step coincided with a rotation of the flow; the flow being directed westward on the equatorward edge, poleward in the center and eastward on the poleward edge. The second and third steps showed a flow directed principally poleward. Furthermore, the magnetic and electric perturbations in the first step are well fitted by an elongated FTE footprint model. These results suggest that three consecutive Flux Transfer Events (FTEs) have injected solar wind plasma into the ionosphere forming the polar cusp. The small latitudinal size of these FTE footprints (∼ 40 km) and their short recurrence rate (3 and 6 min) would be consistent with an intermittent reconnection taking place at the subsolar point on a short time scale

  2. Evidence for storm-time ionospheric ion precipitation in the cusp with magnetosheath energy

    Directory of Open Access Journals (Sweden)

    H. Stenuit

    2004-04-01

    Full Text Available We present evidence for a sporadic precipitation into the north polar cusp of ionospheric O+ and He+ ions accelerated up to the magnetosheath flow speed during a magnetic storm. This is deduced from data obtained on board the Interball-Auroral satellite showing that the energy/charge ratios of the H+, He++, He+ and O+ populations are similar to those of ion masses. These measurements pertain to a very disturbed magnetic period. A storm was in progress with a Dst reaching -149nT during the cusp measurements, while the AE index reached values higher than 1000nT. This result is discussed in terms of ion circulation from the magnetosphere to the magnetosheath and back to the magnetosphere. We suggest that the acceleration of O+ and He+ ions up to a magnetosheath-like velocity is directly linked to the large By component of the IMF.Key words. Magnetospheric physics (magnetopause, cusp and boundary layers; magnetosheath; storms and substorms

  3. Cusp/cleft region as observed by the Viking UV imager

    International Nuclear Information System (INIS)

    Garbe, G.P.; Murphree, J.S.; Cogger, L.L.; Woch, J.

    1993-01-01

    The authors report data taken by the Viking satellite at mid-altitudes (11,000-13,000 km) during northern hemispheric crossings of the cusp/cleft region. Particle signatures were used to divide the region into different categories. Data was looked at from the ultraviolet imager and particle diagnostics, when available. The authors discuss in detail two cases of crossing the cusp/cleft region, in order to look at the dynamics of a specific event, as opposed to other data analyses which have used large data sets to acquire good statistics, but which can thereby obscure dynamics of the actual events. Particle data were taken by the electron spectrometer ESP 1 and the ion spectrometer PISP 1/2. They looked at the spectral range 0.01 to 40 keV. The UV imager recorded 1 sec exposures of the auroral distribution once per minute. The data shows instantaneous observations of emissions, and does so for a narrow path swept by the satellite. Data indicate that the entire region is not a homogeneous region, but rather a very dynamic object. Conclusions include that the emissions observed are located at the footprint of the cleft region. The cusp region is located poleward of the region with continuous emission. The emission is observed to remain at a constant magnetic latitude during the period with IMF data, though B z swung 8nT during a 30 minute period

  4. On the energy shift of the ECC cusp. Does the shift really exist?

    International Nuclear Information System (INIS)

    Barrachina, R.O.; Sarkadi, L.

    2004-01-01

    Full text: The cusplike 'electron capture to the continuum' (ECC) peak appearing in the spectrum of the forward emitted electrons in ion-atom collisions is generally thought to be a divergence. The peak is centered at electron velocity that matches that of the projectile. Recently Illescas et al. [1] claimed, however, that 'the cusp is not a divergence smoothed by the experiment, and is slightly shifted from the impact-velocity value'. In a subsequent work Shah et al. [2] measured the ECC cusp for collisions of 10- and 20- keV protons with H2 and He, and found that the peak was indeed shifted to a velocity below its expected position. Their classical trajectory Monte Carlo (CTMC) calculations reproduced the observation well. In the present work we demonstrate by our CTMC calculations (made for the case of 20-keV protons on He) that the intensity, width and position of the ECC cusp do depend on the experimental conditions by which the electrons are detected (first of all, the acceptance angle of the electron spectrometer). We also present experimental data for this collision system. While the latter data are well reproduced by our CTMC calculations, neither the theoretical results, nor the experimental data of the present work support of the findings of Shah et al. [2]. At the same time, analyzing the problem in the framework of the general final-state interaction theory of cusp formation [3], we concluded that 'rigorously' speaking Shah et al. [2] are right when they state that the ECC cusp is not a divergence. The divergence is smeared out by the scattering of the projectile. However, this effect is negligibly small at the lowest energy that was considered in their paper, 10 keV. At this impact energy the projectile motion is smeared within an angular region Δθ th ∼ 0.06 deg, which is much smaller than the acceptance angle of the experiment, Δθ exp ∼ 1.5 deg

  5. Aortic atresia with normal sized left ventricle

    Directory of Open Access Journals (Sweden)

    Priya Jagia

    2016-01-01

    Full Text Available Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best of our knowledge, use of multi-detector computed tomography in aortic atresia with well developed left ventricle has not been reported in literature till date.

  6. MMP-2 Isoforms in Aortic Tissue and Serum of Patients with Ascending Aortic Aneurysms and Aortic Root Aneurysms

    Science.gov (United States)

    Tscheuschler, Anke; Meffert, Philipp; Beyersdorf, Friedhelm; Heilmann, Claudia; Kocher, Nadja; Uffelmann, Xenia; Discher, Philipp; Siepe, Matthias; Kari, Fabian A.

    2016-01-01

    Objective The need for biological markers of aortic wall stress and risk of rupture or dissection of ascending aortic aneurysms is obvious. To date, wall stress cannot be related to a certain biological marker. We analyzed aortic tissue and serum for the presence of different MMP-2 isoforms to find a connection between serum and tissue MMP-2 and to evaluate the potential of different MMP-2 isoforms as markers of high wall stress. Methods Serum and aortic tissue from n = 24 patients and serum from n = 19 healthy controls was analyzed by ELISA and gelatin zymography. 24 patients had ascending aortic aneurysms, 10 of them also had aortic root aneurysms. Three patients had normally functioning valves, 12 had regurgitation alone, eight had regurgitation and stenosis and one had only stenosis. Patients had bicuspid and tricuspid aortic valves (9/15). Serum samples were taken preoperatively, and the aortic wall specimen collected during surgical aortic repair. Results Pro-MMP-2 was identified in all serum and tissue samples. Pro-MMP-2 was detected in all tissue and serum samples from patients with ascending aortic/aortic root aneurysms, irrespective of valve morphology or other clinical parameters and in serum from healthy controls. We also identified active MMP-2 in all tissue samples from patients with ascending aortic/aortic root aneurysms. None of the analyzed serum samples revealed signals relatable to active MMP-2. No correlation between aortic tissue total MMP-2 or tissue pro-MMP-2 or tissue active MMP-2 and serum MMP-2 was found and tissue MMP-2/pro-MMP-2/active MMP-2 did not correlate with aortic diameter. This evidence shows that pro-MMP-2 is the predominant MMP-2 species in serum of patients and healthy individuals and in aneurysmatic aortic tissue, irrespective of aortic valve configuration. Active MMP-2 species are either not released into systemic circulation or not detectable in serum. There is no reliable connection between aortic tissue—and serum MMP-2

  7. Stationary magnetospheric convection on November 24, 1981. 2. Small-scale structures in the dayside cusp/cleft

    Directory of Open Access Journals (Sweden)

    Y. I. Galperin

    Full Text Available A case study of the dayside cusp/cleft region during an interval of stationary magnetospheric convection (SMC on November, 24, 1981 is presented, based on detailed measurements made by the AUREOL-3 satellite. Layered small-scale field-aligned current sheets, or loops, superimposed to a narrow V-shaped ion dispersion structure, were observed just equatorward from the region of the "cusp proper". The equatorward sheet was accompanied by a very intense and short (less than 1 s ion intensity spike at 100 eV. No major differences were noted of the characteristics of the LLBL, or "boundary cusp", and plasma mantle precipitation during this SMC period from those typical of the cusp/cleft region for similar IMF conditions. Simultaneous NOAA-6 and NOAA-7 measurements described in Despirak et al. were used to estimate the average extent of the "cusp proper" (defined by dispersed precipitating ions with the energy flux exceeding 10-3 erg cm-2 s-1 during the SMC period, as ~0.73° ILAT width, 2.6-3.4 h in MLT, and thus the recently merged magnetic flux, 0.54-0.70 × 107 Wb. This, together with the average drift velocity across the cusp at the convection throat, ~0.5 km s-1, allowed to evaluate the cusp merging contribution to the total cross-polar cap potential difference, ~33.8-43.8 kV. It amounts to a quite significant part of the total cross-polar cap potential difference evaluated from other data. A "shutter" scenario is suggested for the ion beam injection/penetration through the stagnant plasma region in the outer cusp to explain the pulsating nature of the particle injections in the low- and medium-altitude cusp region.

    Key words. Magnetospheric physics (current systems; magnetopause · cusp · and boundary layers; solar wind-magnetosphere interactions.

  8. Aortic Root Enlargement or Sutureless Valve Implantation?

    Directory of Open Access Journals (Sweden)

    Nikolaos G. Baikoussis

    2016-11-01

    Full Text Available Aortic valve replacement (AVR in patients with a small aortic annulus is a challenging issue. The importance of prosthesis–patient mismatch (PPM post aortic valve replacement (AVR is controversial but has to be avoided. Many studies support the fact that PPM has a negative impact on short and long term survival. In order to avoid PPM, aortic root enlargement may be performed. Alternatively and keeping in mind that often some comorbidities are present in old patients with small aortic root, the Perceval S suturelles valve implantation could be a perfect solution. The Perceval sutureless bioprosthesis provides reasonable hemodynamic performance avoiding the PPM and providing the maximum of aortic orifice area. We would like to see in the near future the role of the aortic root enlargement techniques in the era of surgical implantation of the sutureless valve (SAVR and the transcatheter valve implantation (TAVI.

  9. Aortic valve function after bicuspidization of the unicuspid aortic valve.

    Science.gov (United States)

    Aicher, Diana; Bewarder, Moritz; Kindermann, Michael; Abdul-Khalique, Hashim; Schäfers, Hans-Joachim

    2013-05-01

    Unicuspid aortic valve (UAV) anatomy leads to dysfunction of the valve in young individuals. We introduced a reconstructive technique of bicuspidizing the UAV. Initially we copied the typical asymmetry of a normal bicuspid aortic valve (BAV) (I), later we created a symmetric BAV (II). This study compared the hemodynamic function of the two designs of a bicuspidized UAV. Aortic valve function was studied at rest and during exercise in 28 patients after repair of UAV (group I, n = 8; group II, n = 20). There were no differences among the groups I and II with respect to gender, age, body size, or weight. All patients were in New York Heart Association class I. Six healthy adults served as control individuals. All patients were studied with transthoracic echocardiography between 4 and 65 months postoperatively. Systolic gradients were assessed by continuous wave Doppler while patients were at rest and exercising on a bicycle ergometer. Aortic regurgitation was grade I or less in all patients. Resting gradients were significantly elevated in group I compared with group II and control individuals (group I, peak 33.8 ± 7.8 mm Hg; mean 19.1 ± 5.4 mm Hg; group II, peak 15.8 ± 5.4, mean 8.2 ± 2.8 mm Hg; control individuals, peak 6.0 ± 1.6, mean 3.2 ± 0.8 mm Hg; p competence. A symmetric repair design leads to improved systolic aortic valve function at rest and during exercise. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

    DEFF Research Database (Denmark)

    Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

    2009-01-01

    Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

  11. Statins for aortic valve stenosis

    Directory of Open Access Journals (Sweden)

    Luciana Thiago

    Full Text Available ABSTRACT BACKGROUND: Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. OBJECTIVES: To evaluate the effectiveness and safety of statins in aortic valve stenosis. METHODS: Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus. These databases were searched from their inception to 24 November 2015. We also searched trials in registers for ongoing trials. We used no language restrictions. Selection criteria: Randomized controlled clinical trials (RCTs comparing statins alone or in association with other systemic drugs to reduce cholesterol levels versus placebo or usual care. Data collection and analysis: Primary outcomes were severity of aortic valve stenosis (evaluated by echocardiographic criteria: mean pressure gradient, valve area and aortic jet velocity, freedom from valve replacement and death from cardiovascular cause. Secondary outcomes were hospitalization for any reason, overall mortality, adverse events and patient quality of life. Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. The GRADE methodology was employed to assess the quality of result findings and the GRADE profiler (GRADEPRO was used to import data from Review Manager 5.3 to create a 'Summary of findings' table. MAIN RESULTS: We included four RCTs with 2360 participants comparing statins (1185 participants with placebo (1175 participants. We found low-quality evidence for our primary outcome of severity of aortic valve stenosis, evaluated by mean pressure gradient (mean difference (MD -0.54, 95% confidence interval (CI -1.88 to 0.80; participants = 1935; studies = 2, valve area (MD -0.07, 95% CI -0.28 to 0.14; participants = 127; studies = 2

  12. Statins for aortic valve stenosis.

    Science.gov (United States)

    Thiago, Luciana; Tsuji, Selma Rumiko; Nyong, Jonathan; Puga, Maria Eduarda Dos Santos; Góis, Aécio Flávio Teixeira de; Macedo, Cristiane Rufino; Valente, Orsine; Atallah, Álvaro Nagib

    2016-01-01

    Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. To evaluate the effectiveness and safety of statins in aortic valve stenosis. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus. These databases were searched from their inception to 24 November 2015. We also searched trials in registers for ongoing trials. We used no language restrictions.Selection criteria: Randomized controlled clinical trials (RCTs) comparing statins alone or in association with other systemic drugs to reduce cholesterol levels versus placebo or usual care. Data collection and analysis: Primary outcomes were severity of aortic valve stenosis (evaluated by echocardiographic criteria: mean pressure gradient, valve area and aortic jet velocity), freedom from valve replacement and death from cardiovascular cause. Secondary outcomes were hospitalization for any reason, overall mortality, adverse events and patient quality of life.Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. The GRADE methodology was employed to assess the quality of result findings and the GRADE profiler (GRADEPRO) was used to import data from Review Manager 5.3 to create a 'Summary of findings' table. We included four RCTs with 2360 participants comparing statins (1185 participants) with placebo (1175 participants). We found low-quality evidence for our primary outcome of severity of aortic valve stenosis, evaluated by mean pressure gradient (mean difference (MD) -0.54, 95% confidence interval (CI) -1.88 to 0.80; participants = 1935; studies = 2), valve area (MD -0.07, 95% CI -0.28 to 0.14; participants = 127; studies = 2), and aortic jet velocity (MD -0.06, 95% CI -0.26 to 0

  13. Cusp and W peak analysis in electron capture to the continuum of bare H and He projectiles from hydrocarbon and fluorocarbon gases

    Energy Technology Data Exchange (ETDEWEB)

    Joyce, J.M.; Bissinger, G.

    1987-04-01

    The ECC cusp and W peak shapes for continuum electron capture by approx. = MeV/u H/sup +/ and He/sup 2 +/ from hydrocarbon and fluorocarbon gas molecules are analyzed with the general parametric expression of Meckbach, Nemirovsky and Garibotti (i) to look for trends in the coefficients of these parameters, (ii) as a way of generating computed cusp shapes to reduce statistical fluctuations in cusp difference spectra, and (iii) to provide information on the deconvoluted d/sup 2/sigma/d..nu.. dtheta values for cusp and W peaks in the hydrocarbon gases.

  14. Valve-sparing aortic root repair in acute type A dissection: how many sinuses have to be repaired for curative surgery?

    Science.gov (United States)

    Urbanski, Paul P; Hijazi, Husam; Dinstak, Witold; Diegeler, Anno

    2013-09-01

    The aim of the study was to evaluate operative and long-term results of valve-sparing aortic root surgery in acute type A dissection. The repair consisted of selective replacement of all dissected and pathological sinuses. Forty-six patients (mean age 62 ± 14; range 29-88 years, 3 with Marfan syndrome), operated on between August 2001 and July 2011 due to acute type A aortic dissection, underwent valve-sparing root repair, resulting in a valve preservation rate of 56% in acute aortic dissection surgery involving the aortic root. Insufficiency grades of 0/1+, 2+, 3+ and 4+ were presented in 16, 17, 12 and 1 patients, respectively. Root repair with resection of the whole of the pathological aortic wall without the use of any glue was performed in all patients. Replacement of 1, 2 or 3 sinuses of Valsalva was performed in 29, 12 and 5 patients, respectively. Concomitant cusp repair was necessary in 7 patients. All perioperative data were collected prospectively and an intention-to-treat analysis was performed. A total of 6 patients (median age 76, range 63-81 years) died, on average 10 months (range 0.9-44) after surgery resulting in an overall survival of 87% at the mean follow-up of 54 ± 37, range 0.9-132 months. The linearized death rate was 2.9%/year, and the actuarial survival rate at 8 years was 85.5 ± 5.6%. No death was related to the aortic valve or aortic root. There were no valve-related events and no patient required reoperation on the proximal aorta/aortic valve during the follow-up. At the last echocardiography (47.8 ± 35.6 months after surgery), 33 patients showed no and 13 patients slight (1+) aortic insufficiency. Curative repair with replacement of all pathological sinuses of Valsalva leads to an excellent long-term outcome. Selected sinus repair is a simple and effective method of curative, valve-sparing root repair in acute aortic dissection because replacement of all sinuses is seldom necessary.

  15. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    Energy Technology Data Exchange (ETDEWEB)

    Bangard, Christopher; Franke, Mareike; Maintz, David; Chang, De-Hua [University Hospital, University of Cologne, Department of Radiology, Cologne (Germany); Pfister, Roman [University Hospital, University of Cologne, Department of Internal Medicine III, Cologne (Germany); Deppe, Antje-Christin [University Hospital, University of Cologne, Department of Cardiothoracic Surgery, Cologne (Germany); Matoussevitch, Vladimir [University Hospital, University of Cologne, Department of Vascular Surgery, Cologne (Germany)

    2014-06-15

    To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. (orig.)

  16. Thoracic type Ia endoleak: direct percutaneous coil embolization of the aortic arch at the blood entry site after TEVAR and double-chimney stent-grafts

    International Nuclear Information System (INIS)

    Bangard, Christopher; Franke, Mareike; Maintz, David; Chang, De-Hua; Pfister, Roman; Deppe, Antje-Christin; Matoussevitch, Vladimir

    2014-01-01

    To introduce a novel percutaneous technique to stop blood entry at the lesser aortic arch curvature by coil embolisation in type Ia endoleak after TEVAR. A 61-year-old Marfan patient presented with type Ia endoleak of the aortic arch and a growing aortic arch pseudoaneurysm after TEVAR. Multiple preceding operations and interventions made an endovascular approach unsuccessful. Direct percutaneous puncture of the aneurysmal sac would have cured the sign, but not the cause of blood entry at the lesser curvature of the aortic arch. Direct CT-guided percutaneous puncture of the blood entry site in the aortic arch with fluoroscopically guided coil embolisation using detachable extra-long coils was successfully performed. Three weeks after the intervention, the patient developed fever because of superinfection of the pseudoaneurysm. The blood cultures and CT-guided mediastinal aspirate were sterile. After intravenous administration of antibiotics, the fever disappeared and the patient recovered. Six-month follow-up showed permanent closure of the endoleak and a shrinking aneurysmal sac. Direct percutaneous puncture of the aortic arch at the blood entry site of a thoracic type Ia endoleak after TEVAR and double-chimney stent-grafts with coil embolisation of the wedge-shaped space between the lesser aortic curvature and the stent-graft is possible. (orig.)

  17. Aortic intramural hematoma : assessment of clinical and radiological features in comparison to acute aortic dissection

    International Nuclear Information System (INIS)

    Yoon, Kwon Ha; Hwang, Jae Cheol; Lee, Jin Seong; Kang, Duk Hyun; Song, Jae Kwan; Song, Koun Sik; Lim, Tae Hwan

    1996-01-01

    To compare the clinical and radiological features of aortic intramural hematoma(IMH) to those of acute aortic dissection(AD). We analyzed the clinical and radiological features of 12 patients with aortic IMH and 43 patients with acute AD. In aortic IMH, the diagnoses were made by means of both CT and transesophageal echocardiography(TEE) and included two surgically proven cases. In acute AD, the diagnoses were made by means of CT and TEE and included 21 surgically proven cases. We compared patients ages, etiologies, the extent of the disease, the presence or absence of aortic branch involvement, complications, and outcomes. Aortic IMH tended to develop in older patients (67.8±7.9 vs. 50.4±13.4, P .05). In aortic IMH, there was no involvement of aortic branches, whereas in acute AD, 14(33%) patients showed involvement of one or more aortic branches. Complications of aortic IMH included pericardial effusion (n=2) and pleural effusion (n=4);in acute AD, pericardial effusion (n=7), pleural effusion (n=4), aortic insufficiency (n=8), cerebral infarction (n=3), renal infarction (n=4) and spinal infarction (n=1) were seen. There was one (8%) death due to aortic IMH and ten (23%) deaths due to acute AD (p<.01). Aortic IMH is characterized by its occurrence in older patients with hypertension, a less frequent incidence of complications, and a more favorable outcome than acute AD

  18. Decreased expression of fibulin-4 in aortic wall of aortic dissection.

    Science.gov (United States)

    Huawei, P; Qian, C; Chuan, T; Lei, L; Laing, W; Wenlong, X; Wenzhi, L

    2014-02-01

    In this research, we will examine the expression of Fibulin-4 in aortic wall to find out its role in aortic dissection development. The samples of aortic wall were obtained from 10 patients operated for acute ascending aortic dissection and five patients for chronic ascending aortic dissection. Another 15 pieces of samples from patients who had coronary artery bypass were as controls. The aortic samples were stained with aldehyde magenta dyeing to evaluate the arrangement of elastic fibers. The Fibulin-4 protein and mRNA expression were both determined by Western blot and realtime quantitative polymerase chain reaction. Compared with the control group, both in acute and chronic ascending aortic dissection, elastic fiber fragments increased and the expression of fibulin-4 protein significantly decreased (P= 0.045 < 0.05). The level of fibulin-4 mRNA decreased in acute ascending aortic dissection (P= 0.034 < 0.05), while it increased in chronic ascending aortic dissection (P=0.004 < 0.05). The increased amounts of elastic fiber fragments were negatively correlated with the expression of fibulin-4 mRNA in acute ascending aortic dissection. In conclusion, in aortic wall of ascending aortic dissection, the expression of fibulin-4 protein decreased and the expression of fibulin-4 mRNA was abnormal. Fibulin-4 may play an important role in the pathogenesis of aortic dissection.

  19. Direct percutaneous transaortic approach for treatment of aortic pseudoaneurysms.

    Science.gov (United States)

    Pirelli, Luigi; Kliger, Chad; Fontana, Gregory P; Ruiz, Carlos E

    2015-05-01

    Aortic pseudoaneurysms (APAs) can develop months or years after aortic and cardiac surgery. If not treated appropriately, APAs can lead to fatal complications and ultimately death. We describe a case of a 61-year old patient with a diagnosed large pseudoaneurysm 5 years after his aortic valve surgery, who was treated with a novel transcatheter direct transaortic approach. The patient had dilated cardiomyopathy with an APA adjacent to the lower sternal plate. An Amplatzer septal occlusion device followed by coils was delivered transcutaneously through the APA to close its neck and fill the false aneurysm, respectively. Triple fusion multimodality imaging was used to guide the placement of the occlusion devices. The merging of computed tomography (CT) and echocardiography with real-time fluoroscopy was fundamental in procedural planning and guidance. Post-procedural transoesophageal echocardiogram (TOE) and CT angiography showed complete exclusion of the APA. A direct transaortic approach is a valid option for closure of an APA if the surgical risk is prohibitive, and the use of triple fusion technology is an essential tool in the hands of interventionalists and surgeons for preoperative planning and conduction of these procedures. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. [Thymic carcinoma involving aortic arch; report of a case].

    Science.gov (United States)

    Noriyuki, Toshio; Hamamoto, M; Takazawa, Y; Katoh, K; Hashimoto, M; Kuranishi, F; Nakahara, M; Fukuda, T; Ishizaki, Y; Okuda, H; Akimoto, E; Yonehara, S

    2009-05-01

    Adenocarcinoma of the thymus is a very rare malignant tumor. The standard treatment for advanced thymic carcinoma has not yet been established, and the prognosis is poor. We report a case of thymic carcinoma that involving the aortic arch and the innominate vein. A 78-year-old woman was admitted to our hospital complaining of hoarseness in April 2007. The computed tomography (CT) scan showed an anterior mediastinal tumor contiguous to the aortic arch and the innominate vein with swelling lymphnodes. Microspcopic examinations of specimens obtained by CT-guided needle biopsy revealed poorly differenciated adenocarcinoma. The carcinoembryonic antigen (CEA) level of serum elevated at 54.9 ng/ml. Thymic carcinoma was diagnosed. The chemoradiotherapy [concurrent, carboplatin (CBDCA) + paclitaxel(TXL)-->vinorelbine (NVB), 60 Gy] was performed, but the effect of the therapy was limited. The resection of the tumor with a part of aortic arch and other peripheral tissues was performed in Augast 2007. The postoperative course was uneventful and the CEA level of serum lowered to the normal. She was discharged 30 days after surgery.

  1. Molecular and cellular mechanisms of aortic stenosis.

    Science.gov (United States)

    Yetkin, Ertan; Waltenberger, Johannes

    2009-06-12

    Calcific aortic stenosis is the most common cause of aortic valve replacement in developed countries, and this condition increases in prevalence with advancing age. The fibrotic thickening and calcification are common eventual endpoint in both non-rheumatic calcific and rheumatic aortic stenoses. New observations in human aortic valves support the hypothesis that degenerative valvular aortic stenosis is the result of active bone formation in the aortic valve, which may be mediated through a process of osteoblast-like differentiation in these tissues. Additionally histopathologic evidence suggests that early lesions in aortic valves are not just a disease process secondary to aging, but an active cellular process that follows the classical "response to injury hypothesis" similar to the situation in atherosclerosis. Although there are similarities with the risk factor and as well as with the process of atherogenesis, not all the patients with coronary artery disease or atherosclerosis have calcific aortic stenosis. This review mainly focuses on the potential vascular and molecular mechanisms involved in the pathogenesis of aortic valve stenosis. Namely extracellular matrix remodeling, angiogenesis, inflammation, and eventually osteoblast-like differentiation resulting in bone formation have been shown to play a role in the pathogenesis of calcific aortic stenosis. Several mediators related to underlying mechanisms, including growth factors especially transforming growth factor-beta1 and vascular endothelial growth factors, angiogenesis, cathepsin enzymes, adhesion molecules, bone regulatory proteins and matrix metalloproteinases have been demonstrated, however the target to be attacked is not defined yet.

  2. The Effect of Composite Thickness on the Stress Distribution Pattern of Restored Premolar Teeth with Cusp Reduction.

    Science.gov (United States)

    Panahandeh, Narges; Torabzadeh, Hassan; Ziaee, Nargess; Mahdian, Mina; Tootiaee, Bahman; Ghasemi, Amir

    2017-07-01

    Different thicknesses of restorative material can alter the stress distribution pattern in remaining tooth structure. The assumption is that a thicker composite restoration will induce a higher fracture resistance. Therefore, the present study evaluated the effect of composite thickness on stress distribution in a restored premolar with cusp reduction. A 3D solid model of a maxillary second premolar was prepared and meshed. MOD cavities were designed with different cusp reduction thicknesses (0, 0.5, 1, 1.5, 2.5 mm). Cavities were restored with Valux Plus composite. They were loaded with 200 N force on the occlusal surface in the direction of the long axis. Von Mises stresses were evaluated with Abaqus software. Stress increased from occlusal to gingival and was maximum in the cervical region. The stressed area in the palatal cusp was more than that of the buccal cusp. Increasing the thickness of composite altered the shear stress to compressive stress in the occlusal area of the teeth. The model with 2.5 mm cusp reduction exhibited the most even stress distribution. © 2015 by the American College of Prosthodontists.

  3. Molar cusp deformation evaluated by micro-CT and enamel crack formation to compare incremental and bulk-filling techniques.

    Science.gov (United States)

    Oliveira, Laís Rani Sales; Braga, Stella Sueli Lourenço; Bicalho, Aline Arêdes; Ribeiro, Maria Tereza Hordones; Price, Richard Bengt; Soares, Carlos José

    2018-07-01

    To describe a method of measuring the molar cusp deformation using micro-computed tomography (micro-CT), the propagation of enamel cracks using transillumination, and the effects of hygroscopic expansion after incremental and bulk-filling resin composite restorations. Twenty human molars received standardized Class II mesio-occlusal-distal cavity preparations. They were restored with either a bulk-fill resin composite, X-tra fil (XTRA), or a conventional resin composite, Filtek Z100 (Z100). The resin composites were tested for post-gel shrinkage using a strain gauge method. Cusp deformation (CD) was evaluated using the images obtained using a micro-CT protocol and using a strain-gauge method. Enamel cracks were detected using transillumination. The post-gel shrinkage of Z100 was higher than XTRA (P cracks than XTRA (P = 0.012). Micro-CT was an effective method for evaluating the cusp deformation. Transillumination was effective for detecting enamel cracks. There were fewer negative effects of polymerization shrinkage in bulk-fill resin restorations using XTRA than for the conventional incremental filling technique using conventional composite resin Z100. Shrinkage and cusp deformation are directly related to the formation of enamel cracks. Cusp deformation and crack propagation may increase the risk of tooth fracture. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. Signatures of the high-altitude polar cusp and dayside auroral regions as seen by the Viking electric field experiment

    International Nuclear Information System (INIS)

    Marklund, G.T.; Blomberg, L.G.; Faelthammar, C.G.; Erlandson, R.E.; Potemra, T.A.

    1990-01-01

    Electric field and satellite potential observations along 42 Viking orbits in the high-altitude (2R E ) polar cusp and dayside auroral region have been examined. Within the cusp the plasma density usually reaches a maximum, and it is typically very homogeneous, in contrast to the irregular and lower density in the cleft and dayside auroral regions. The maxima in the plasma density are sometimes anticorrelated with the magnetic field strength, indicating a diamagnetic effect. The entire cusp and dayside auroral regions are characterized by irregular and burstlike electric fields, comprising field reversals on various scales (up to 3 min or 500 km), the larger scales, however, being rare in the cusp. Another common feature in these regions is the high correlation between mutually orthogonal components of the electric and magnetic fields, both for large-scale variations across spatial structures and for wave and pulsations in the ULF frequency range. The electric field signatures in the cusp (in the 1100-1300 MLT sector) are, however, characteristically different from the cleft and oval field signatures in that the electric field is usually less intense and less structured and not correlated with the substorm activity level

  5. A density cusp of quiescent X-ray binaries in the central parsec of the Galaxy

    Science.gov (United States)

    Hailey, Charles J.; Mori, Kaya; Bauer, Franz E.; Berkowitz, Michael E.; Hong, Jaesub; Hord, Benjamin J.

    2018-04-01

    The existence of a ‘density cusp’—a localized increase in number—of stellar-mass black holes near a supermassive black hole is a fundamental prediction of galactic stellar dynamics. The best place to detect such a cusp is in the Galactic Centre, where the nearest supermassive black hole, Sagittarius A*, resides. As many as 20,000 black holes are predicted to settle into the central parsec of the Galaxy as a result of dynamical friction; however, so far no density cusp of black holes has been detected. Low-mass X-ray binary systems that contain a stellar-mass black hole are natural tracers of isolated black holes. Here we report observations of a dozen quiescent X-ray binaries in a density cusp within one parsec of Sagittarius A*. The lower-energy emission spectra that we observed in these binaries is distinct from the higher-energy spectra associated with the population of accreting white dwarfs that dominates the central eight parsecs of the Galaxy. The properties of these X-ray binaries, in particular their spatial distribution and luminosity function, suggest the existence of hundreds of binary systems in the central parsec of the Galaxy and many more isolated black holes. We cannot rule out a contribution to the observed emission from a population (of up to about one-half the number of X-ray binaries) of rotationally powered, millisecond pulsars. The spatial distribution of the binary systems is a relic of their formation history, either in the stellar disk around Sagittarius A* (ref. 7) or through in-fall from globular clusters, and constrains the number density of sources in the modelling of gravitational waves from massive stellar remnants, such as neutron stars and black holes.

  6. Aorto-aortic intrathoracic bypass in surgical treatment of aortic

    International Nuclear Information System (INIS)

    Gutierrez Perez, F.; Duran Reyes, A.; Bigalli, D.; Filgueira Berobide, J.

    1998-01-01

    The prevalence of coarctation of the aorta is 6.5 percent of all congenital heart defects, according to national and international data. There is a restenosis rate of patients after surgery. Factors that influence this evolution depends on the age at which patients underwent surgery for the first time the anatomy of the aortic arch and type of surgical technique. Several procedures can be used to correct the coarctation, which include surgery and balloon catheter dilation. We present here a case of a patient of 22 years old, with a recurrent coarctation of the aorta studied by echocardiography and magnetic resonance imaging. The patient underwent surgery a third time. We used an anterior approach (median sternotomy) and performed an aortic bypass graft, intrathoracic, under cardiopulmonary bypass. Evolved favorably and was discharged on the sixth day of post operative day (Author) [es

  7. Root abnormalities, talon cusps, dentes invaginati with reduced alveolar bone levels: case report.

    LENUS (Irish Health Repository)

    McNamara, C M

    1998-03-01

    This is a case report of a Caucasian female who presented with an unusual combination of dental anomalies: short roots on the maxillary central incisors and premolars, talon cusps, dentes invaginati, low alveolar bone heights, tubercles of Carabelli on the maxillary first and second permanent molars, with pyramidal root morphology in three of the second permanent molars. None of the anomalies alone are particularly uncommon but they have not previously been reported together. The occurrence of the anomalies is probably incidental as the conditions are aetiologically unrelated.

  8. Flow with boiling in four-cusp channels simulating damaged core in PWR type reactors

    International Nuclear Information System (INIS)

    Esteves, M.M.

    1985-01-01

    The study of subcooled nucleate flow boiling in non-circular channels is of great importance to engineering applications in particular to Nuclear Engineering. In the present work, an experimental apparatus, consisting basically of a refrigeration system, running on refrigerant-12, has been developed. Preliminary tests were made with a circular tube. The main objective has been to analyse subcooled flow boiling in four-cusp channels simulating the flow conditions in a PWR core degraded by accident. Correlations were developed for the forced convection film coefficient for both single-phase and subcooled flow boiling. The incipience of boiling in such geometry has also been studied. (author) [pt

  9. A Step Towards Systematic Studies of the Cusp in η → 3π0 Decay

    International Nuclear Information System (INIS)

    Kupsc, A.; Rusetsky, A.; Gullstroem, C.-O.

    2009-01-01

    A realistic estimate of the cusp effect in the η → 3π 0 decay is required for the forthcoming high precision experiments. An estimate for the size of this effect was given recently within the framework of non-relativistic effective field theory. Here we present the next step towards the systematic way of fixing the parameters of the effective non-relativistic Lagrangian and consistency tests of the existing data on η → π 0 π 0 π 0 and η → π + π - π 0 decays. (author)

  10. Accurate and simple wavefunctions for the helium isoelectronic sequence with correct cusp conditions

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, K V [Departamento de Fisica, Universidad Nacional del Sur and Consejo Nacional de Investigaciones CientIficas y Tecnicas, 8000 BahIa Blanca, Buenos Aires (Argentina); Gasaneo, G [Departamento de Fisica, Universidad Nacional del Sur and Consejo Nacional de Investigaciones CientIficas y Tecnicas, 8000 BahIa Blanca, Buenos Aires (Argentina); Mitnik, D M [Instituto de AstronomIa y Fisica del Espacio, and Departamento de Fisica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, C C 67, Suc. 28 (C1428EGA) Buenos Aires (Argentina)

    2007-10-14

    Simple and accurate wavefunctions for the He atom and He-like isoelectronic ions are presented. These functions-the product of hydrogenic one-electron solutions and a fully correlated part-satisfy all the coalescence cusp conditions at the Coulomb singularities. Functions with different numbers of parameters and different degrees of accuracy are discussed. Simple analytic expressions for the wavefunction and the energy, valid for a wide range of nuclear charges, are presented. The wavefunctions are tested, in the case of helium, through the calculations of various cross sections which probe different regions of the configuration space, mostly those close to the two-particle coalescence points.

  11. Coulomb scatter of diamagnetic dust particles in a cusp magnetic trap under microgravity conditions

    Energy Technology Data Exchange (ETDEWEB)

    Myasnikov, M. I., E-mail: miasnikovmi@mail.ru; D’yachkov, L. G.; Petrov, O. F.; Vasiliev, M. M., E-mail: mixxy@mail.ru; Fortov, V. E. [Russian Academy of Sciences, Joint Institute for High Temperatures (Russian Federation); Savin, S. F.; Serova, E. O. [Korolev Rocket and Space Corporation Energia, ul. Lenina 4A (Russian Federation)

    2017-02-15

    The effect of a dc electric field on strongly nonideal Coulomb systems consisting of a large number (~10{sup 4}) of charged diamagnetic dust particles in a cusp magnetic trap are carried out aboard the Russian segment of the International Space Station (ISS) within the Coulomb Crystal experiment. Graphite particles of 100–400 μm in size are used in the experiments. Coulomb scatter of a dust cluster and the formation of threadlike chains of dust particles are observed experimentally. The processes observed are simulated by the molecular dynamics (MD) method.

  12. Aortic root geometry in aortic stenosis patients (a SEAS substudy)

    DEFF Research Database (Denmark)

    Bahlmann, Edda; Nienaber, Christoph A; Cramariuc, Dana

    2011-01-01

    -specified requirements for the aortic root geometry for current available prostheses, CoreValve and Edwards-Sapien. The ratio of sinus of Valsalva height to sinus width was 1:2. In multivariate linear regression analysis, larger sinus of Valsalva height was associated with older age, larger sinus of Valsalva diameter......, lower ejection fraction and smaller supracoronary diameter (multiple R(2) = 0.19, PSapien prosthesis in 66.9%. Overall, annular dimension feasible for TAVI using any available prosthesis was found...

  13. The cardiovascular effects of aortic clamping and unclamping

    African Journals Online (AJOL)

    aortic clamping is that afterload and blood pressure increase, and ... individually, albeit they interact with each other. The degree of ... position of the aortic clamp, the greater the increase ... the increase in preload in response to aortic clamping.

  14. Indexing aortic valve area by body surface area increases the prevalence of severe aortic stenosis

    DEFF Research Database (Denmark)

    Jander, Nikolaus; Gohlke-Bärwolf, Christa; Bahlmann, Edda

    2014-01-01

    To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are......To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are...

  15. Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil balloon catheters: practical considerations

    NARCIS (Netherlands)

    S. Plante (Sylvain); M.J.B.M. van den Brand (Marcel); L.C.P. van Veen; C. di Mario (Carlo); C.E. Essed; K.J. Beatt (Kevin); P.W.J.C. Serruys (Patrick)

    1990-01-01

    textabstractIn order to evaluate the relation between balloon design (monofoil, trefoil) and valvular configuration, experimental aortic valvuloplasty was performed in four post-mortem hearts with calcific aortic stenosis of various morphology. The degree of obstruction of the aortic orifice was

  16. Association Between Gout and Aortic Stenosis.

    Science.gov (United States)

    Chang, Kevin; Yokose, Chio; Tenner, Craig; Oh, Cheongeun; Donnino, Robert; Choy-Shan, Alana; Pike, Virginia C; Shah, Binita D; Lorin, Jeffrey D; Krasnokutsky, Svetlana; Sedlis, Steven P; Pillinger, Michael H

    2017-02-01

    An independent association between gout and coronary artery disease is well established. The relationship between gout and valvular heart disease, however, is unclear. The aim of this study was to assess the association between gout and aortic stenosis. We performed a retrospective case-control study. Aortic stenosis cases were identified through a review of outpatient transthoracic echocardiography (TTE) reports. Age-matched controls were randomly selected from patients who had undergone TTE and did not have aortic stenosis. Charts were reviewed to identify diagnoses of gout and the earliest dates of gout and aortic stenosis diagnosis. Among 1085 patients who underwent TTE, 112 aortic stenosis cases were identified. Cases and nonaortic stenosis controls (n = 224) were similar in age and cardiovascular comorbidities. A history of gout was present in 21.4% (n = 24) of aortic stenosis subjects compared with 12.5% (n = 28) of controls (unadjusted odds ratio 1.90, 95% confidence interval 1.05-3.48, P = .038). Multivariate analysis retained significance only for gout (adjusted odds ratio 2.08, 95% confidence interval 1.00-4.32, P = .049). Among subjects with aortic stenosis and gout, gout diagnosis preceded aortic stenosis diagnosis by 5.8 ± 1.6 years. The age at onset of aortic stenosis was similar among patients with and without gout (78.7 ± 1.8 vs 75.8 ± 1.0 years old, P = .16). Aortic stenosis patients had a markedly higher prevalence of precedent gout than age-matched controls. Whether gout is a marker of, or a risk factor for, the development of aortic stenosis remains uncertain. Studies investigating the potential role of gout in the pathophysiology of aortic stenosis are warranted and could have therapeutic implications. Published by Elsevier Inc.

  17. Complementary role of cardiac CT in the assessment of aortic valve replacement dysfunction

    Science.gov (United States)

    Moss, Alastair J; Dweck, Marc R; Dreisbach, John G; Williams, Michelle C; Mak, Sze Mun; Cartlidge, Timothy; Nicol, Edward D; Morgan-Hughes, Gareth J

    2016-01-01

    Aortic valve replacement is the second most common cardiothoracic procedure in the UK. With an ageing population, there are an increasing number of patients with prosthetic valves that require follow-up. Imaging of prosthetic valves is challenging with conventional echocardiographic techniques making early detection of valve dysfunction or complications difficult. CT has recently emerged as a complementary approach offering excellent spatial resolution and the ability to identify a range of aortic valve replacement complications including structural valve dysfunction, thrombus development, pannus formation and prosthetic valve infective endocarditis. This review discusses each and how CT might be incorporated into a multimodal cardiovascular imaging pathway for the assessment of aortic valve replacements and in guiding clinical management. PMID:27843568

  18. Low-gradient aortic stenosis.

    Science.gov (United States)

    Clavel, Marie-Annick; Magne, Julien; Pibarot, Philippe

    2016-09-07

    An important proportion of patients with aortic stenosis (AS) have a 'low-gradient' AS, i.e. a small aortic valve area (AVA gradient (gradient discrepancy raises uncertainty about the actual stenosis severity and thus about the indication for aortic valve replacement (AVR) if the patient has symptoms and/or left ventricular (LV) systolic dysfunction. The most frequent cause of low-gradient (LG) AS is the presence of a low LV outflow state, which may occur with reduced left ventricular ejection fraction (LVEF), i.e. classical low-flow, low-gradient (LF-LG), or preserved LVEF, i.e. paradoxical LF-LG. Furthermore, a substantial proportion of patients with AS may have a normal-flow, low-gradient (NF-LG) AS: i.e. a small AVA-low-gradient combination but with a normal flow. One of the most important clinical challenges in these three categories of patients with LG AS (classical LF-LG, paradoxical LF-LG, and NF-LG) is to differentiate a true-severe AS that generally benefits from AVR vs. a pseudo-severe AS that should be managed conservatively. A low-dose dobutamine stress echocardiography may be used for this purpose in patients with classical LF-LG AS, whereas aortic valve calcium scoring by multi-detector computed tomography is the preferred modality in those with paradoxical LF-LG or NF-LG AS. Although patients with LF-LG severe AS have worse outcomes than those with high-gradient AS following AVR, they nonetheless display an important survival benefit with this intervention. Some studies suggest that transcatheter AVR may be superior to surgical AVR in patients with LF-LG AS. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  19. Thoracic aortic aneurysms and dissections: endovascular treatment.

    Science.gov (United States)

    Baril, Donald T; Cho, Jae S; Chaer, Rabih A; Makaroun, Michel S

    2010-01-01

    The treatment of thoracic aortic disease has changed radically with the advances made in endovascular therapy since the concept of thoracic endovascular aortic repair was first described 15 years ago. Currently, there is a diverse array of endografts that are commercially available to treat the thoracic aorta. Multiple studies, including industry-sponsored and single-institution reports, have demonstrated excellent outcomes of thoracic endovascular aortic repair for the treatment of thoracic aortic aneurysms, with less reported perioperative morbidity and mortality in comparison with conventional open repair. Additionally, similar outcomes have been demonstrated for the treatment of type B dissections. However, the technology remains relatively novel, and larger studies with longer term outcomes are necessary to more fully evaluate the role of endovascular therapy for the treatment of thoracic aortic disease. This review examines the currently available thoracic endografts, preoperative planning for thoracic endovascular aortic repair, and outcomes of thoracic endovascular aortic repair for the treatment of both thoracic aortic aneurysms and type B aortic dissections. Mt Sinai J Med 77:256-269, 2010. (c) 2010 Mount Sinai School of Medicine.

  20. Hybrid treatment of penetrating aortic ulcer

    International Nuclear Information System (INIS)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi; Vazquez, Rosa Maria Lepe

    2015-01-01

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  1. Hybrid treatment of penetrating aortic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Lara, Juan Antonio Herrero; Martins-Romeo, Daniela de Araujo; Escudero, Carlos Caparros; Falcon, Maria del Carmen Prieto; Batista, Vinicius Bianchi, E-mail: jaherrero5@hotmail.com [Unidade de Gestao Clinica (UGC) de Diagnostico por Imagem - Hosppital Universitario Virgen Macarena, Sevilha (Spain); Vazquez, Rosa Maria Lepe [Unit of Radiodiagnosis - Hospital Nuestra Senora de la Merced, Osuna, Sevilha (Spain)

    2015-05-15

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. (author)

  2. Surgery for acute Type I aortic dissection without resection of supra-aortic entry sites leads to unfavourable aortic remodelling.

    Science.gov (United States)

    Heo, Woon; Song, Suk-Won; Lee, Kwang-Hun; Lee, Shin-Young; Kim, Tae-Hoon; Baek, Min-Young; Yoo, Kyung-Jong

    2018-01-29

    This study aimed to evaluate the impact of remnant re-entries in arch branches on postoperative change in the aortic arch and descending aortic diameters and the rate of major adverse aortic events. Between January 2010 and December 2016, 249 patients underwent surgery for acute Type I aortic dissection. Patients who underwent total arch replacement, had Marfan syndrome or had intramural haematoma were excluded. Seventy-two patients with predischarge and follow-up computed tomography scans were enrolled. Patients with and without re-entries in the arch branches after surgery were assigned to the supra-aortic entry (SAE, n = 21) and no supra-aortic entry (n = 51) groups, respectively. Diameters were measured at 7 levels: the innominate artery, left common carotid artery, left subclavian artery, 20 mm distal to the left subclavian artery, pulmonary artery bifurcation, coeliac axis and maximal diameter of the descending thoracic aorta. Growth rates at the levels of the pulmonary artery bifurcation and 20 mm distal to the left subclavian artery were significantly higher in the SAE group than in the no supra-aortic entry group. The rate of freedom from major adverse aortic events (annual growth >5 mm or maximal diameter of the descending thoracic aorta >50 mm) at 5 years was significantly higher in the no supra-aortic entry group than in the SAE group. Remnant SAE leads to unfavourable aortic remodelling after acute Type I aortic dissection repair. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. Optimal design of earth-moving machine elements with cusp catastrophe theory application

    Science.gov (United States)

    Pitukhin, A. V.; Skobtsov, I. G.

    2017-10-01

    This paper deals with the optimal design problem solution for the operator of an earth-moving machine with a roll-over protective structure (ROPS) in terms of the catastrophe theory. A brief description of the catastrophe theory is presented, the cusp catastrophe is considered, control parameters are viewed as Gaussian stochastic quantities in the first part of the paper. The statement of optimal design problem is given in the second part of the paper. It includes the choice of the objective function and independent design variables, establishment of system limits. The objective function is determined as mean total cost that includes initial cost and cost of failure according to the cusp catastrophe probability. Algorithm of random search method with an interval reduction subject to side and functional constraints is given in the last part of the paper. The way of optimal design problem solution can be applied to choose rational ROPS parameters, which will increase safety and reduce production and exploitation expenses.

  4. Automatic measurement of cusps in 2.5D dental images

    Science.gov (United States)

    Wolf, Mattias; Paulus, Dietrich W.; Niemann, Heinrich

    1996-01-01

    Automatic reconstruction of occlusal surfaces of teeth is an application which might become more and more urgent due to the toxicity of amalgam. Modern dental chairside equipment is currently restricted to the production of inlays. The automatic reconstruction of the occlusal surface is presently not possible. For manufacturing an occlusal surface it is required to extract features from which it is possible to reconstruct destroyed teeth. In this paper, we demonstrate how intact upper molars can be automatically extracted in dental range and intensity images. After normalization of the 3D location, the sizes of the cusps are detected and the distances between them are calculated. In the presented approach, the detection of the upper molar is based on a knowledge-based segmentation which includes anatomic knowledge. After the segmentation of the interesting tooth the central fossa is calculated. The normalization of the spatial location is archieved by aligning the detected fossa with a reference axis. After searching the cusp tips in the range image the image is resized. The methods have been successfully tested on 60 images. The results have been compared with the results of a dentist's evaluation on a sample of 20 images. The results will be further used for automatic production of tooth inlays.

  5. Origin of the turbulent spectra in the high-altitude cusp: Cluster spacecraft observations

    Directory of Open Access Journals (Sweden)

    K. Nykyri

    2006-05-01

    Full Text Available High-resolution magnetic field data from Cluster Flux Gate Magnetometer (FGM and the Spatio-Temporal Analysis of Field Fluctuations (STAFF instruments are used to study turbulent magnetic field fluctuations during the high-altitude cusp crossing on 17 March 2001. Despite the quiet solar wind conditions, the cusp was filled with magnetic field turbulence whose power correlates with the field-aligned ion plasma flux. The magnetic field wave spectra shows power law behavior with both double and single slopes with break in the spectra usually occurring in the vicinity of the local ion cyclotron frequency. Strong peaks in the wave power close to local ion cyclotron frequency were sometimes observed, with secondary peaks at higher harmonics indicative of resonant processes between protons and the waves. We show that the observed spectral break point may be caused partly by damping of obliquely propagating kinetic Alfvén (KAW waves and partly by cyclotron damping of ion cyclotron waves.

  6. LS1 Report: A brand new set-up for ASACUSA-CUSP

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    ASACUSA is running for the first time with a totally new set-up. Three new vital instruments have been designed, produced and installed during LS1 in addition to several other major modifications. The collaboration is now ready to perform the first high-precision measurement of the hyperfine structure of antihydrogen – a study that aims at comparing the inner properties of matter and antimatter.   The ASACUSA set-up. The ASACUSA-CUSP collaboration comprises about 30 scientists from various institutes in Europe and Japan. Because of the Japanese contribution, the experiment is often known by its Japanese pronunciation, the experiment’s logo is in Japanese, and the logbook uses Japanese time! This year, for the first time, the experiment is running with a completely new set-up, which now includes a new superconducting double cusp magnet, a new tracking detector and a new final antihydrogen detector. “The magnet is the heart of the ASACUSA experiment,” expl...

  7. Cluster observations of bounday layer structure and a flux transfer event near the cusp

    Directory of Open Access Journals (Sweden)

    R. C. Fear

    2005-10-01

    Full Text Available On the 25th January 2002 between 10:00 and 12:00 UT, the four Cluster spacecraft passed through the northern high-latitude cusp, the dayside magnetosphere and into the magnetosheath in a linear formation. In the magnetosphere the PEACE electron spectrometers on the four spacecraft all observed a series of transient bursts of magnetosheath-like plasma, but without bipolar magnetic signatures in the magnetopause normal component as might be expected if the plasma had been injected by transient reconnection (flux transfer events – FTEs. Reordering the data using the magnetopause transition parameter reveals that these plasma observations, the related variations in the magnetic field and the balance of magnetic and thermal gas pressures are consistent with transient entries into a stable high-latitude boundary layer structure. However, once some of the spacecraft entered the magnetosheath, FTE signatures were observed outside the magnetopause at the same time as some of the boundary layer entries occurred at the other spacecraft inside. Thus, (a the lack of a bipolar BN signature is inconsistent with the traditional picture of a magnetospheric FTE, and (b the cause of the observed entry of the spacecraft into the boundary layer (pressure pulse or passing magnetosheath FTE can only be determined by spacecraft observations in the magnetosheath. Keywords. Magnetospheric physics (Magnetopause, cusp and bondary layers; Solar wind- magnetosphere interactions; Magnetosheath

  8. Cluster observations of bounday layer structure and a flux transfer event near the cusp

    Directory of Open Access Journals (Sweden)

    R. C. Fear

    2005-10-01

    Full Text Available On the 25th January 2002 between 10:00 and 12:00 UT, the four Cluster spacecraft passed through the northern high-latitude cusp, the dayside magnetosphere and into the magnetosheath in a linear formation. In the magnetosphere the PEACE electron spectrometers on the four spacecraft all observed a series of transient bursts of magnetosheath-like plasma, but without bipolar magnetic signatures in the magnetopause normal component as might be expected if the plasma had been injected by transient reconnection (flux transfer events – FTEs. Reordering the data using the magnetopause transition parameter reveals that these plasma observations, the related variations in the magnetic field and the balance of magnetic and thermal gas pressures are consistent with transient entries into a stable high-latitude boundary layer structure. However, once some of the spacecraft entered the magnetosheath, FTE signatures were observed outside the magnetopause at the same time as some of the boundary layer entries occurred at the other spacecraft inside. Thus, (a the lack of a bipolar BN signature is inconsistent with the traditional picture of a magnetospheric FTE, and (b the cause of the observed entry of the spacecraft into the boundary layer (pressure pulse or passing magnetosheath FTE can only be determined by spacecraft observations in the magnetosheath.

    Keywords. Magnetospheric physics (Magnetopause, cusp and bondary layers; Solar wind- magnetosphere interactions; Magnetosheath

  9. Design and Fabrication of a Single Cusp Magnetic Field Type Hydrogen ion Source

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Hun

    1996-02-15

    A single-cusp type hydrogen ion source has been designed and fabricated. In order to increase the efficiency of the plasma production, a single-cusp type magnet circuit and an electrostatic reflector were installed. The Poission Group Code was used to predict the distribution of magnetic field in the plasma chamber. In order to design the accel.-decel. extraction part for forming the ion beam with low emmitance and high current density, EGUN code was used. The results of calculation show that the configuration of plasma electrode strongly affects the beam quality and the deceleration electrode only functions the repression of the electron stream. When the plasma-accel potential is -20kV and an accel.-decel. potential is 1kV, the calculated extraction current, normalized emittance and perveance are 20.6mA, 1.28x 10{sup -7} m {center_dot} rad and 7.87 x 10{sup -9}A {center_dot} V{sup -3/2}, respectively. This study on the improvement of beam quality and the achievement of high ion beam current will contribute to the analysis of fusion plasma and the research on the surface physics.

  10. Design and Fabrication of a Single Cusp Magnetic Field Type Hydrogen ion Source

    International Nuclear Information System (INIS)

    Kim, Su Hun

    1996-02-01

    A single-cusp type hydrogen ion source has been designed and fabricated. In order to increase the efficiency of the plasma production, a single-cusp type magnet circuit and an electrostatic reflector were installed. The Poission Group Code was used to predict the distribution of magnetic field in the plasma chamber. In order to design the accel.-decel. extraction part for forming the ion beam with low emmitance and high current density, EGUN code was used. The results of calculation show that the configuration of plasma electrode strongly affects the beam quality and the deceleration electrode only functions the repression of the electron stream. When the plasma-accel potential is -20kV and an accel.-decel. potential is 1kV, the calculated extraction current, normalized emittance and perveance are 20.6mA, 1.28x 10 -7 m · rad and 7.87 x 10 -9 A · V -3/2 , respectively. This study on the improvement of beam quality and the achievement of high ion beam current will contribute to the analysis of fusion plasma and the research on the surface physics

  11. Magnetosheath plasma precipitation in the polar cusp and its control by the interplanetary magnetic field

    International Nuclear Information System (INIS)

    Woch, J.; Lundin, R.

    1992-01-01

    Magnetosheath particle precipitation in the polar cusp region is studied based on Viking hot plasma data obtained on meridional cusp crossings. Two distinctively different regions are commonly encountered on a typical pass. One region is characterized by high-density particle precipitation, with an ion population characterized by a convecting Maxwellian distribution. Typical magnetosheath parameters are inferred for the spectrum of the source population. The spectral shape of the ion population encountered in the second region suggests that here the magnetosheath ions have been energized by about 1 keV, corresponding to an ion velocity gain of about twice the magnetosheath Alfven velocity. The location of the region containing the accelerated plasma is dependent on the IMF B z component. For southward IMF the acceleration region is bounded by the ring current population on the equatorward side and by the unaccelerated magnetosheath plasma precipitation on the poleward side. For northward IMF the region is located at the poleward edge of the region with unaccelerated precipitation. The accelerated ion population is obviously transported duskward (dawnward) for a dawnward (duskward) directed IMF. These observations are interpreted as evidence for plasma acceleration due to magnetopause current sheet disruptions/merging of magnetospheric and interplanetary magnetic flux tubes

  12. NATO Advanced Research Workshop on The Morphology and Dynamics of the Polar Cusp

    CERN Document Server

    Egeland, Alv

    1985-01-01

    These proceedings are based upon introductory talks, research reports and discussions from the NATO Advanced Workshop on the "Morphology and Dynamics of the Polar Cusp", held at Lillehammer, Norway, 7-12 May, 1984. The upper atmosphere at high latitudes is called the "Earth's win­ dow to outer space". Through various electrodynamic coupling process­ es as well as through direct transfer of particles many geophysical effects displayed there are direct manifestations of phenomena occurring in the deep space. The high latitude ionosphere will also exert a feedback on the regions of the magnetosphere and atmosphere to which it is coupled, acting as a momentum and energy source and sink, and a source of particles. Of particular interest are the sections of the near space known as the Polar Cusp. A vast portion of the earth's magnetic field envelope is electrically connected to these regions. This geometry results in a spatial mapping of the magnetospheric pro­ cesses and a focusing on to the ionosphere. In the ...

  13. CUSP-SHAPED STRUCTURE OF A JET OBSERVED BY IRIS AND SDO

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yuzong; Zhang, Jun, E-mail: yuzong@nao.cas.cn, E-mail: zjun@nao.cas.cn [Key Laboratory of Solar Activity, National Astronomical Observatories, Chinese Academy of Sciences, Beijing 100012 (China)

    2017-01-01

    On 2014 August 29, the trigger and evolution of a cusp-shaped jet were captured in detail at 1330 Å by the Interface Region Imaging Spectrograph . At first, two neighboring mini-prominences arose in turn from the low solar atmosphere and collided with a loop-like system over them. The collisions between the loop-like system and the mini-prominences lead to the blowout, and then a cusp-shaped jet formed with a spire and an arch-base. In the spire, many brightening blobs originating from the junction between the spire and the arch-base moved upward in a rotating manner and then in a straight line in the late phase of the jet. In the arch-base, dark and bright material simultaneously tracked in a fan-like structure, and the majority of the material moved along the fan's threads. At the later phase of the jet's evolution, bidirectional flows emptied the arch-base, while downflows emptied the spire, thus making the jet entirely vanish. The extremely detailed observations in this study shed new light on how magnetic reconnection alters the inner topological structure of a jet and provides a beneficial complement for understanding current jet models.

  14. New solar cell and clean unit system platform (CUSP) for earth and environmental science

    Science.gov (United States)

    Ishibashi, A.; Matsuoka, T.; Enomoto, R.; Yasutake, M.

    2017-11-01

    We have investigated InGaN-based multi-striped orthogonal photon-photocarrier propagation solar cell (MOP3SC) in which sunlight propagates in a direction being orthogonal to that of photocarriers generated by the sunlight. Thanks to the orthogonality, in MOP3SC, absorption of the sunlight and collection of the photocarriers can be simultaneously and independently optimized with no trade-off. Furthermore, by exploiting the degree of freedom along the photon propagation and using multi-semiconductor stripes in which the incoming photons first encounter the widest gap semiconductor, and the narrowest at last, we can convert the whole solar spectrum into electricity resulting in the high conversion efficiency. For processing MOP3SC, we have developed Clean Unit System Platform (CUSP), which turns out to be able to serve as clean versatile environment having low power-consumption and high cost-performance. CUSP is suitable not only for processing devices, but also for cross-disciplinary fields, including medical/hygienic applications.

  15. A Rare Bilateral Presentation of Multiple Dens Invaginatus, Shovel-Shaped Incisor and Talon Cusp With Mesiodens.

    Science.gov (United States)

    Hegde, S; Jain, M; Shubha, A B

    2014-01-01

    The aim of this paper is to describe a unique and unusual case of concomitant appearance of morphological dental anomalies in the maxillary anterior region, along with its management in a patient with no systemic abnormality. This case report describes the clinical and radiographic features of talon cusp, dens invaginatus, shovel-shaped incisors and a supernumerary tooth occurring in a single patient, which is a rare presentation. All 4 permanent maxillary incisors had dens invaginatus, the permanent maxillary canines showed the presence of talon cusps, the permanent maxillary central incisors were shovel-shaped and an erupted mesiodens was also observed. Treatment included restorative, surgical and orthodontic approaches.

  16. Transfer coefficients in a four-cusp duct simulating a typical nuclear reactor channel degraded by accident

    International Nuclear Information System (INIS)

    Souza Dutra, A. de.

    1985-01-01

    An experimental study on forced convection in a four-cusp duct simulating a typical nuclear reactor channel degraded by accident is presented. Transfer coefficients were obtained by using the analogy between heat and mass tranfer, with the naphtalene sublimation technique. The experiment consisted in forcing air past a four-cusp naphthalene moulded duct. Mass transfer coefficients were determined in nondimensional form as Sherwood number. Experimental curves correlating the Sherwood number with a nondimensional length, x + , were obtained for Reynolds number varying from 891 to 30.374. This range covers typical flow rates that are expected to exist in a degraded nuclear reactor core. (Author) [pt

  17. Studies on the Effect of Radio Frequency Field in a Cusp-Type Charge Separation Device for Direct Energy Conversion

    OpenAIRE

    HAMABE, Masaki; IZAWA, Hiroaki; TAKENO, Hiromasa; NAKAMOTO, Satoshi; ICHIMURA, Kazuya; NAKASHIMA, Yousuke

    2016-01-01

    In D-3He fusion power generation, an application of direct energy conversion is expected in which separation of charged particles is necessary. A cusp-type direct energy converter (CuspDEC) was proposed as a charge separation device, but its performance was degraded for a high density plasma. The goal of the present study is to establish an additional method to assist charge separation by using a nonlinear effect of a radio frequency (rf) electric field. Following to the previous study, we ex...

  18. 3D printing based on cardiac CT assists anatomic visualization prior to transcatheter aortic valve replacement.

    Science.gov (United States)

    Ripley, Beth; Kelil, Tatiana; Cheezum, Michael K; Goncalves, Alexandra; Di Carli, Marcelo F; Rybicki, Frank J; Steigner, Mike; Mitsouras, Dimitrios; Blankstein, Ron

    2016-01-01

    3D printing is a promising technique that may have applications in medicine, and there is expanding interest in the use of patient-specific 3D models to guide surgical interventions. To determine the feasibility of using cardiac CT to print individual models of the aortic root complex for transcatheter aortic valve replacement (TAVR) planning as well as to determine the ability to predict paravalvular aortic regurgitation (PAR). This retrospective study included 16 patients (9 with PAR identified on blinded interpretation of post-procedure trans-thoracic echocardiography and 7 age, sex, and valve size-matched controls with no PAR). 3D printed models of the aortic root were created from pre-TAVR cardiac computed tomography data. These models were fitted with printed valves and predictions regarding post-implant PAR were made using a light transmission test. Aortic root 3D models were highly accurate, with excellent agreement between annulus measurements made on 3D models and those made on corresponding 2D data (mean difference of -0.34 mm, 95% limits of agreement: ± 1.3 mm). The 3D printed valve models were within 0.1 mm of their designed dimensions. Examination of the fit of valves within patient-specific aortic root models correctly predicted PAR in 6 of 9 patients (6 true positive, 3 false negative) and absence of PAR in 5 of 7 patients (5 true negative, 2 false positive). Pre-TAVR 3D-printing based on cardiac CT provides a unique patient-specific method to assess the physical interplay of the aortic root and implanted valves. With additional optimization, 3D models may complement traditional techniques used for predicting which patients are more likely to develop PAR. Copyright © 2016 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  19. Early results of valve-sparing ascending aortic replacement in type A aortic dissection and aortic insufficiency

    Directory of Open Access Journals (Sweden)

    М. Л. Гордеев

    2016-08-01

    Full Text Available Aim: The study was designed to investigate predictors of effective valve-sparing ascending aortic replacement in patients with Stanford type A aortic dissection combined with aortic insufficiency and to analyze efficacy and safety of this kind of surgery.Methods: From January 2010 to December 2015, 49 patients with Stanford type A aortic dissection combined with aortic insufficiency underwent ascending aortic replacement. All patients were divided into 3 groups: valve-sparing procedures (group 1, n = 11, combined aortic valve and supracoronary ascending aortic replacement (group 2, n = 12, and Bentall procedure (group 3, n = 26. We assessed the initial status of patients, incidence of complications and efficacy of valve-sparing ascending aortic replacement.Results: The hospital mortality rate was 8.2% (4/49 patients. The amount of surgical correction correlated with the initial diameter of the aorta at the level of the sinuses of Valsalva. During the hospital period, none of patients from group 1 developed aortic insufficiency exceeding Grade 2 and the vast majority of patients had trivial aortic regurgitation. The parameters of cardiopulmonary bypass, cross-clamp time and circulatory arrest time did not correlate with the initial size of the ascending aorta and aortic valve blood flow impairment, neither did they influence significantly the incidence and severity of neurological complications. The baseline size of the ascending aorta and degree of aortic regurgitation did not impact the course of the early hospital period.Conclusions: Supracoronary ascending aortic replacement combined with aortic valve repair in ascending aortic dissection and aortic regurgitation is effective and safe. The initial size of the ascending aorta and aortic arch do not influence immediate results. The diameter of the aorta at the level of the sinuses of Valsalva and the condition of aortic valve leaflets could be considered as the limiting factors. Further long

  20. [Metabolic syndrome and aortic stiffness].

    Science.gov (United States)

    Simková, A; Bulas, J; Murín, J; Kozlíková, K; Janiga, I

    2010-09-01

    The metabolic syndrome (MS) is a cluster of risk factors that move the patient into higher level of risk category of cardiovascular disease and the probability of type 2 diabetes mellitus manifestation. Definition of MS is s based on the presence of selected risk factors as: abdominal obesity (lager waist circumpherence), atherogenic dyslipidemia (low value of HDL-cholesterol and increased level of triglycerides), increased fasting blood glucose (or type 2 DM diagnosis), higher blood pressure or antihypertensive therapy. In 2009 there were created harmonizing criteria for MS definition; the condition for assignment of MS is the presence of any 3 criteria of 5 mentioned above. The underlying disorder of MS is an insulin resistance or prediabetes. The patients with MS more frequently have subclinical (preclinical) target organ disease (TOD) which is the early sings of atherosclerosis. Increased aortic stiffness is one of the preclinical diseases and is defined by pathologically increased carotidofemoral pulse wave velocity in aorta (PWV Ao). With the aim to assess the influence of MS on aortic stiffness we examined the group of women with arterial hypertension and MS and compare them with the group of women without MS. The aortic stiffness was examined by Arteriograph--Tensiomed, the equipment working on the oscillometric principle in detection of pulsations of brachial artery. This method determines the global aortic stiffness based on the analysis of the shape of pulse curve of brachial artery. From the cohort of 49 pts 31 had MS, the subgroups did not differ in age or blood pressure level. The mean number of risk factors per person in MS was 3.7 comparing with 1.7 in those without MS. In the MS group there was more frequently abdominal obesity present (87% vs 44%), increased fasting blood glucose (81% vs 22%) and low HDL-cholesterol level. The pulse wave velocity in aorta, PWV Ao, was significantly higher in patients with MS (mean value 10,19 m/s vs 8,96 m

  1. Aortic elongation in aortic aneurysm and dissection: the Tübingen Aortic Pathoanatomy (TAIPAN) project.

    Science.gov (United States)

    Krüger, Tobias; Sandoval Boburg, Rodrigo; Lescan, Mario; Oikonomou, Alexandre; Schneider, Wilke; Vöhringer, Luise; Lausberg, Henning; Bamberg, Fabian; Blumenstock, Gunnar; Schlensak, Christian

    2018-01-24

    To study the lengths and diameters of aortic segments in healthy and diseased aortas and to assess the role of aortic elongation in Type A aortic dissection (TAD) prediction. Ectasia and aneurysm were defined by ascending aorta diameters of 45-54 mm and ≥55 mm, respectively. Computed tomography angiography studies of 256 healthy, 102 ectasia, 38 aneurysm, 17 pre-TAD and 166 TAD aortas were analysed using curved multiplanar reformats. The study groups were structurally equal. The diameter of the ascending aorta was 35 mm in the control group and was larger (P TAD (43 mm) and TAD (56 mm) groups. The length of the ascending aorta from the aortic annulus to the brachiocephalic trunk was 92 mm in the control group, 113 mm in the ectasia group, 120 mm in the aneurysm group and 111 mm and 118 mm in the pre-TAD and TAD groups (all P TAD group and 48% of the TAD group. The correlation between the diameter and the length of the ascending aorta was r = 0.752; therefore, both parameters must be examined separately. A score considering both parameters identified 23.5% of pre-TAD patients, significantly more than the diameter alone, and 31.4% of ectasia aortas were elongated. Patients with ectatic (45-54 mm diameter) and elongated (≥120 mm) ascending aortas represent a high-risk subpopulation for TAD. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Directional tip control technique for optimal stent graft alignment in angulated proximal aortic landing zones

    Directory of Open Access Journals (Sweden)

    Toshio Takayama, MD, PhD

    2017-06-01

    Full Text Available Angulated anatomy in the aorta, such as tortuous infrarenal aortic necks or steep aortic arches, is a significant challenge for endovascular aortic repair because it often causes inadequate sealing and fixation, which may lead to treatment failure. We have developed a technique using off-the-shelf equipment to precisely control the deployment of stent grafts in challenging landing zones. The key of this technique is to create a through-and-through wire between two access sites and to use a guiding device over the wire. This technique is best used with stent grafts without nose cones. We present an endovascular aneurysm repair case and a thoracic endovascular aortic repair case with challenging proximal landing zones treated by this technique. In both cases, technical success was attained, and follow-up imaging demonstrated well-aligned stent grafts. Our directional tip control technique is easy and effective. It can be a good technical solution for endovascular aortic treatment in angulated anatomy.

  3. Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults.

    Science.gov (United States)

    Eikendal, Anouk L M; Bots, Michiel L; Haaring, Cees; Saam, Tobias; van der Geest, Rob J; Westenberg, Jos J M; den Ruijter, Hester M; Hoefer, Imo E; Leiner, Tim

    2016-01-01

    Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25-30 and 30-35 years) and both sexes were tested. Aortic diameters and areas were higher in the older age group (all page or sex effect. This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing.

  4. Infected aortic aneurysm and inflammatory aortic aneurysm. In search of an optimal differential diagnosis

    International Nuclear Information System (INIS)

    Ishizaka, Nobukazu; Sohmiya, Koichi; Miyamura, Masatoshi; Umeda, Tatsuya; Tsuji, Motomu; Katsumata, Takahiro; Miyata, Tetsuro

    2012-01-01

    Infected aortic aneurysm and inflammatory aortic aneurysm each account for a minor fraction of the total incidence of aortic aneurysm and are associated with periaortic inflammation. Despite the similarity, infected aortic aneurysm generally shows a more rapid change in clinical condition, leading to a fatal outcome; in addition, delayed diagnosis and misuse of corticosteroid or immunosuppressing drugs may lead to uncontrolled growth of microorganisms. Therefore, it is mandatory that detection of aortic aneurysm is followed by accurate differential diagnosis. In general, infected aortic aneurysm appears usually as a saccular form aneurysm with nodularity, irregular configuration; however, the differential diagnosis may not be easy sometimes for the following reasons: symptoms, such as abdominal and/or back pain and fever, and blood test abnormalities, such as elevated C-reactive protein and enhanced erythrocyte sedimentation rate, are common in infected aortic aneurysm, but they are not found infrequently in inflammatory aortic aneurysm; some inflammatory aortic aneurysms are immunoglobulin (Ig) G4-related, but not all of them; the prevalence of IgG4 positivity in infected aortic aneurysm has not been well investigated; enhanced uptake of 18F-fluorodeoxyglucose (FDG) by 18F-FDG-positron emission tomography may not distinguish between inflammation mediated by autoimmunity and that mediated by microorganism infection. Here we discuss the characteristics of these two forms of aortic aneurysm and the points of which we have to be aware before reaching a final diagnosis. (author)

  5. Delayed Presentation of a Giant Ascending Aortic Aneurysm following Aortic Valve Replacement

    Directory of Open Access Journals (Sweden)

    Tugrul Göncü

    2009-01-01

    Full Text Available Giant ascending aortic aneurysm formation following aortic valve replacement is rare. A 28-year-old man who underwent aortic valve replacement with a prosthetic valve for aortic regurgitation secondary to congenital bicuspid aortic valve about 10 years ago was diagnosed with a giant ascending aortic aneurysm about 16 cm in diameter in follow-up. The aneurysm was resected leaving the functional old mechanical prosthesis in place and implanted a 34-mm Hemashield woven graft, associated with the left and right coronary artery button implantation. Histological findings of the aortic aneurysm wall showed cystic medial necrosis. The postoperative course was uneventful and postoperative examination demonstrated good surgical results.

  6. Transcatheter Aortic Valve Replacement in Europe

    DEFF Research Database (Denmark)

    Mylotte, Darren; Osnabrugge, Ruben L J; Windecker, Stephan

    2013-01-01

    The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.......The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy....

  7. Graft infections after surgical aortic reconstructions

    NARCIS (Netherlands)

    Berger, P.

    2015-01-01

    Prosthetic vascular grafts are frequently used to reconstruct (part) of the aorta. Every surgical procedure caries a certain risk for infection and when a prosthetic aortic graft is implanted, this may lead to an aortic graft infection (AGI). Endovascular techniques have gradually replaced open

  8. Severe aortic stenosis: diagnosis, treatment and prognosis

    NARCIS (Netherlands)

    M.W.A. van Geldorp (Martijn)

    2013-01-01

    textabstractDegenerative aortic stenosis is the most common valvular heart disease in developed countries. The prevalence of severe aortic stenosis increases with age from 1% in people below 65 years of age to nearly 6% in people over the age of 85. Since the population life expectancy continues to

  9. Valve-sparing aortic root replacement†

    NARCIS (Netherlands)

    Koolbergen, David R.; Manshanden, Johan S. J.; Bouma, Berto J.; Blom, Nico A.; Mulder, Barbara J. M.; de Mol, Bas A. J. M.; Hazekamp, Mark G.

    2015-01-01

    To evaluate our results of valve-sparing aortic root replacement and associated (multiple) valve repair. From September 2003 to September 2013, 97 patients had valve-sparing aortic root replacement procedures. Patient records and preoperative, postoperative and recent echocardiograms were reviewed.

  10. Ionospheric cusp flows pulsed by solar wind Alfvén waves

    Directory of Open Access Journals (Sweden)

    P. Prikryl

    2002-02-01

    Full Text Available Pulsed ionospheric flows (PIFs in the cusp foot-print have been observed by the SuperDARN radars with periods between a few minutes and several tens of minutes. PIFs are believed to be a consequence of the interplanetary magnetic field (IMF reconnection with the magnetospheric magnetic field on the dayside magnetopause, ionospheric signatures of flux transfer events (FTEs. The quasiperiodic PIFs are correlated with Alfvénic fluctuations observed in the upstream solar wind. It is concluded that on these occasions, the FTEs were driven by Alfvén waves coupling to the day-side magnetosphere. Case studies are presented in which the dawn-dusk component of the Alfvén wave electric field modulates the reconnection rate as evidenced by the radar observations of the ionospheric cusp flows. The arrival of the IMF southward turning at the magnetopause is determined from multipoint solar wind magnetic field and/or plasma measurements, assuming plane phase fronts in solar wind. The cross-correlation lag between the solar wind data and ground magnetograms that were obtained near the cusp footprint exceeded the estimated spacecraft-to-magnetopause propagation time by up to several minutes. The difference can account for and/or exceeds the Alfvén propagation time between the magnetopause and ionosphere. For the case of short period ( < 13 min PIFs, the onset times of the flow transients appear to be further delayed by at most a few more minutes after the IMF southward turning arrived at the magnetopause. For the case of long period (30 – 40 min PIFs, the observed additional delays were 10–20 min. We interpret the excess delay in terms of an intrinsic time scale for reconnection (Russell et al., 1997 which can be explained by the surface-wave induced magnetic reconnection mechanism (Uberoi et al., 1999. Here, surface waves with wavelengths larger than the thickness of the neutral layer induce a tearing-mode instability whose rise time explains the

  11. Influence of occlusal contact area on cusp defection and stress distribution.

    Science.gov (United States)

    Costa, Anna Karina Figueiredo; Xavier, Thaty Aparecida; Paes-Junior, Tarcisio José Arruda; Andreatta-Filho, Oswaldo Daniel; Borges, Alexandre Luiz Souto

    2014-11-01

    The purpose of this study was to evaluate the effect of occlusal contact area for loading on the cuspal defection and stress distribution in a first premolar restored with a high elastic modulus restorative material. The Rhinoceros 4.0 software was used for modeling the three-dimensional geometries of dental and periodontal structures and the inlay restoration. Thus, two different models, intact and restored teeth with three occlusal contact areas, 0.1, 0.5 and 0.75 mm(2), on enamel at the occlusal surface of buccal and lingual cusps. Finite element analysis (FEA) was performed with the program ANSYS (Workbench 13.0), which generated a mesh with tetrahedral elements with greater refinement in the regions of interest, and was constrained at the bases of cortical and trabecular bone in all axis and loaded with 100 N normal to each contact area. To analysis of maximum principal stress, the smaller occlusal contact area showed greater compressive stress in region of load application for both the intact and inlay restored tooth. However, tensile stresses at the occlusal isthmus were similar for all three tested occlusal contact areas (60 MPa). To displacement of the cusps was higher for teeth with inlay (0.46-0.48 mm). For intact teeth, the smaller contact area showed greater displacement (0.10 mm). For teeth with inlays, the displacement of the cusps were similar in all types of occlusal area. Cuspal displacement was higher in the restored tooth when compared to the intact tooth, but there were no significant variations even with changes in the occlusal contact area. RELEVANCE CLINICAL: Occlusal contacts have a great influence on the positioning of teeth being able to maintain the position and stability of the mandible. Axial loads would be able to generate more uniform stress at the root presenting a greater concentration of load application in the point and the occlusal surface. Thus, is necessary to analyze the relationship between these occlusal contacts as dental

  12. Distinct sources of particles near the cusp and the dusk flank of the magnetosphere

    Science.gov (United States)

    Escoubet, C. P.; Grison, B.; Berchem, J.; Trattner, K. J.; Lavraud, B.; Pitout, F.; Soucek, J.; Richard, R. L.; Laakso, H. E.; Masson, A.; Dunlop, M.; Dandouras, I. S.; Rème, H.; Fazakerley, A. N.; Daly, P. W.

    2015-12-01

    At the magnetopause, the location of the magnetic reconnection sites depends on the orientation of the interplanetary magnetic field (IMF) in the solar wind: on the dayside magnetosphere for an IMF southward, on the lobes for an IMF northward and on the flanks for an IMF in the East-West direction. Since most of observations of reconnection events have sampled a limited region of space simultaneously it is still not yet know if the reconnection line is extended over large regions of the magnetosphere or if is patchy and made of many reconnection lines. We report a Cluster crossing on 5 January 2002 near the exterior cusp on the southern dusk side where we observe multiple sources of reconnection/injections. The IMF was mainly azimuthal (IMF-By around -5 nT), the solar wind speed lower than usual around 280 km/s with the density of order 5 cm-3. The four Cluster spacecraft had an elongated configuration near the magnetopause. C4 was the first spacecraft to enter the cusp around 19:52:04 UT, followed by C2 at 19:52:35 UT, C1 at 19:54:24 UT and C3 at 20:13:15 UT. C4 and C1 observed two ion energy dispersions at 20:10 UT and 20:40 UT and C3 at 20:35 UT and 21:15 UT. Using the time of flight technique on the upgoing and downgoing ions, which leads to energy dispersions, we obtain distances of the ion sources between 14 and 20 RE from the spacecraft. The slope of the ion energy dispersions confirmed these distances. Using Tsyganenko model, we find that these sources are located on the dusk flank, past the terminator. The first injection by C3 is seen at approximately the same time as the 2nd injection on C1 but their sources at the magnetopause were separated by more than 7 RE. This would imply that two distinct sources were active at the same time on the dusk flank of the magnetosphere. In addition, a flow reversal was observed at the magnetopause on C4 which would be an indication that reconnection is also taking place near the exterior cusp quasi-simultaneously. A

  13. Cusp-latitude Pc3 spectra: band-limited and power-law components

    Directory of Open Access Journals (Sweden)

    P. V. Ponomarenko

    Full Text Available This work attempts to fill a gap in comparative studies of upstream-generated Pc3–4 waves and broad band ULF noise observed at cusp latitudes. We performed a statistical analysis of the spectral properties of three years of cusp-latitude ground magnetometer data, finding that the average daytime Pc3–4 spectra are characterized by two principal components: an upstream-related band-limited enhancement (‘signal’ and a power-law background (‘noise’ with S(f a  f -4 . Based on this information we developed an algorithm allowing for the deconvolution of these two components in the spectral domain. The frequency of the signal enhancement increases linearly with IMF magnitude as f [mHz] ~ 4.4 | BIMF | [nT], and its power maximizes around IMF cone angles qxB ~ 20 and 160° and at 10:30–11:00 MLT. Both spectral components exhibit similar semiannual variations with equinoctial maxima. The back-ground noise power grows with increasing southward Bz and remains nearly constant for northward Bz . Its diurnal variation resembles that of Pc5 field-line resonance power, with a maximum near 09:00 MLT. Both the band-limited signal and broad band noise components show power-law growth with solar wind velocity a V 5.71sw and a V 4.12sw, respectively. Thus, the effective signal-to-noise ratio increases with in-creasing Vsw. The observations suggest that the noise generation is associated with reconnection processes.

    Key words. Magnetospheric physics (magnetopause, cusp, and boundary layers; MHD waves and instabilities; solar wind magnetosphere interactions

  14. MRI evaluation of the aortic disease

    International Nuclear Information System (INIS)

    Kapuscinski, O.; Polkowski, J.; Zaleska, T.; Walecki, J.; Biesiadko, M.

    1994-01-01

    The goal of our study was to establish the value of MRI in diagnosing aortic disease. During 3 years period 46 patients were examined (12 women aged from 6 to 62 years and 34 men aged from 8 to 72 years). In 28 cases the thoracic aorta was examined, in 6 cases the abdominal aorta and in 12 - both the thoracic and the abdominal aorta. MR images were performed on MRT 50 A Toshiba unit 0.5 T. MR images demonstrated aortic aneurysm (caused by atherosclerosis or trauma), aortic dissections, aortic anomalies (i.e. in Turner syndrome) and non-specific aortitis and vasculitis. We regard MRI as preferable noninvasive imaging technique in diagnosing aortic disease. (author)

  15. Cusps in the center of galaxies: a real conflict with observations or a numerical artefact of cosmological simulations?

    Energy Technology Data Exchange (ETDEWEB)

    Baushev, A.N.; Valle, L. del; Campusano, L.E.; Escala, A.; Muñoz, R.R. [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Correo Central, Santiago (Chile); Palma, G.A., E-mail: baushev@gmail.com, E-mail: ldelvalleb@gmail.com, E-mail: luis@das.uchile.cl, E-mail: aescala@das.uchile.cl, E-mail: rmunoz@das.uchile.cl, E-mail: gpalmaquilod@ing.uchile.cl [Departamento de Física, FCFM, Universidad de Chile, Blanco Encalada 2008, Santiago (Chile)

    2017-05-01

    Galaxy observations and N-body cosmological simulations produce conflicting dark matter halo density profiles for galaxy central regions. While simulations suggest a cuspy and universal density profile (UDP) of this region, the majority of observations favor variable profiles with a core in the center. In this paper, we investigate the convergency of standard N-body simulations, especially in the cusp region, following the approach proposed by [1]. We simulate the well known Hernquist model using the SPH code Gadget-3 and consider the full array of dynamical parameters of the particles. We find that, although the cuspy profile is stable, all integrals of motion characterizing individual particles suffer strong unphysical variations along the whole halo, revealing an effective interaction between the test bodies. This result casts doubts on the reliability of the velocity distribution function obtained in the simulations. Moreover, we find unphysical Fokker-Planck streams of particles in the cusp region. The same streams should appear in cosmological N-body simulations, being strong enough to change the shape of the cusp or even to create it. Our analysis, based on the Hernquist model and the standard SPH code, strongly suggests that the UDPs generally found by the cosmological N-body simulations may be a consequence of numerical effects. A much better understanding of the N-body simulation convergency is necessary before a 'core-cusp problem' can properly be used to question the validity of the CDM model.

  16. The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth

    Directory of Open Access Journals (Sweden)

    Khalid A. Arafa

    2016-01-01

    Full Text Available Objectives: To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. Methods: A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods. Results: Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups (p>0.05. There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion. Conclusion: Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts.

  17. The impact on bone tissues of immediate implant-supported mandibular overdentures with cusped and cuspless teeth.

    Science.gov (United States)

    Arafa, Khalid A

    2016-01-01

    To examine the effects on bone tissues of immediate implant-supported mandibular overdentures with cusped or cuspless teeth. A randomized controlled trial was conducted at the Dental Clinic, Faculty of Dentistry, Al-Azhar University, Assiut Branch, Egypt, over a 12-month period from September 2013 to September 2014. Twenty patients were treated with immediate implant-supported overdentures: one group received overdentures with cusped teeth, and the other group received overdentures with cuspless teeth. The rate of implant success was assessed clinically and radiographically at 3, 6, 9, and 12 months. The data were collected by a questionnaire, an observation checklist, and radiography. The data were then analyzed using computerized methods.  Overdentures with cusped teeth showed a significant improvement in the clinical criteria, including the absence of clinical implant mobility, pain, and bone resorption, while the clinical criteria for the absence of peri-implant radiolucency were insignificantly different between the 2 groups (p more than 0.05). There were no significant differences in the clinical evaluations for bone levels at the time of insertion or 3 months after insertions, while significant differences were found at 6, 9, and 12 months after insertion. Overdentures with cusped teeth supported by immediate implants were found superior regarding many clinical criteria than those cuspless counterparts.

  18. Influence of cusps and intersections on the calculation of the Wilson loop in ν-dimensional space

    International Nuclear Information System (INIS)

    Bezerra, V.B.

    1984-01-01

    A discussion is given about the influence of cusps and intersections on the calculation of the Wilson Loop in ν-dimensional space. In particular, for the two-dimensional case, it is shown that there are no divergences. (Author) [pt

  19. Cusps in the center of galaxies: a real conflict with observations or a numerical artefact of cosmological simulations?

    International Nuclear Information System (INIS)

    Baushev, A.N.; Valle, L. del; Campusano, L.E.; Escala, A.; Muñoz, R.R.; Palma, G.A.

    2017-01-01

    Galaxy observations and N-body cosmological simulations produce conflicting dark matter halo density profiles for galaxy central regions. While simulations suggest a cuspy and universal density profile (UDP) of this region, the majority of observations favor variable profiles with a core in the center. In this paper, we investigate the convergency of standard N-body simulations, especially in the cusp region, following the approach proposed by [1]. We simulate the well known Hernquist model using the SPH code Gadget-3 and consider the full array of dynamical parameters of the particles. We find that, although the cuspy profile is stable, all integrals of motion characterizing individual particles suffer strong unphysical variations along the whole halo, revealing an effective interaction between the test bodies. This result casts doubts on the reliability of the velocity distribution function obtained in the simulations. Moreover, we find unphysical Fokker-Planck streams of particles in the cusp region. The same streams should appear in cosmological N-body simulations, being strong enough to change the shape of the cusp or even to create it. Our analysis, based on the Hernquist model and the standard SPH code, strongly suggests that the UDPs generally found by the cosmological N-body simulations may be a consequence of numerical effects. A much better understanding of the N-body simulation convergency is necessary before a 'core-cusp problem' can properly be used to question the validity of the CDM model.

  20. Treatment strategy for ruptured abdominal aortic aneurysms.

    Science.gov (United States)

    Davidovic, L

    2014-07-01

    Rupture is the most serious and lethal complication of the abdominal aortic aneurysm. Despite all improvements during the past 50 years, ruptured abdominal aortic aneurysms are still associated with very high mortality. Namely, including patients who die before reaching the hospital, the mortality rate due to abdominal aortic aneurysm rupture is 90%. On the other hand, during the last twenty years, the number of abdominal aortic aneurysms significantly increased. One of the reasons is the fact that in majority of countries the general population is older nowadays. Due to this, the number of degenerative AAA is increasing. This is also the case for patients with abdominal aortic aneurysm rupture. Age must not be the reason of a treatment refusal. Optimal therapeutic option ought to be found. The following article is based on literature analysis including current guidelines but also on my Clinics significant experience. Furthermore, this article show cases options for vascular medicine in undeveloped countries that can not apply endovascular procedures at a sufficient level and to a sufficient extent. At this moment the following is evident. Thirty-day-mortality after repair of ruptured abdominal aortic aneurysms is significantly lower in high-volume hospitals. Due to different reasons all ruptured abdominal aortic aneurysms are not suitable for EVAR. Open repair of ruptured abdominal aortic aneurysm should be performed by experienced open vascular surgeons. This could also be said for the treatment of endovascular complications that require open surgical conversion. There is no ideal procedure for the treatment of AAA. Each has its own advantages and disadvantages, its own limits and complications, as well as indications and contraindications. Future reductions in mortality of ruptured abdominal aortic aneurysms will depend on implementation of population-based screening; on strategies to prevent postoperative organ injury and also on new medical technology

  1. [Modern aortic surgery in Marfan syndrome--2011].

    Science.gov (United States)

    Kallenbach, K; Schwill, S; Karck, M

    2011-09-01

    Marfan syndrome is a hereditary disease with a prevalence of 2-3 in 10,000 births, leading to a fibrillin connective tissue disorder with manifestations in the skeleton, eye, skin, dura mater and in particular the cardiovascular system. Since other syndromes demonstrate similar vascular manifestations, but therapy may differ significantly, diagnosis should be established using the revised Ghent nosology in combination with genotypic analysis in specialized Marfan centres. The formation of aortic root aneurysms with the subsequent risk of acute aortic dissection type A (AADA) or aortic rupture limits life expectancy in patients with Marfan syndrome. Therefore, prophylactic replacement of the aortic root needs to be performed before the catastrophic event of AADA can occur. The goal of surgery is the complete resection of pathological aortic tissue. This can be achieved with excellent results by using a (mechanically) valved conduit that replaces both the aortic valve and the aortic root (Bentall operation). However, the need for lifelong anticoagulation with Coumadin can be avoided using the aortic valve sparing reimplantation technique according to David. The long-term durability of the reconstructed valve is favourable, and further technical improvements may improve longevity. Although results of prospective randomised long-term studies comparing surgical techniques are lacking, the David operation has become the surgical method of choice for aortic root aneurysms, not only at the Heidelberg Marfan Centre. Replacement of the aneurysmal dilated aortic arch is performed under moderate hypothermic circulatory arrest combined with antegrade cerebral perfusion using a heart-lung machine, which we also use in thoracic or thoracoabdominal aneurysms. Close post-operative follow-up in a Marfan centre is pivotal for the early detection of pathological changes on the diseased aorta.

  2. IMF control of cusp proton emission intensity and dayside convection: implications for component and anti-parallel reconnection

    Directory of Open Access Journals (Sweden)

    M. Lockwood

    2003-04-01

    Full Text Available We study a brightening of the Lyman-a emission in the cusp which occurred in response to a short-lived south-ward turning of the interplanetary magnetic field (IMF during a period of strongly enhanced solar wind plasma concentration. The cusp proton emission is detected using the SI-12 channel of the FUV imager on the IMAGE spacecraft. Analysis of the IMF observations recorded by the ACE and Wind spacecraft reveals that the assumption of a constant propagation lag from the upstream spacecraft to the Earth is not adequate for these high time-resolution studies. The variations of the southward IMF component observed by ACE and Wind allow for the calculation of the ACE-to-Earth lag as a function of time. Application of the derived propagation delays reveals that the intensity of the cusp emission varied systematically with the IMF clock angle, the relationship being particularly striking when the intensity is normalised to allow for the variation in the upstream solar wind proton concentration. The latitude of the cusp migrated equatorward while the lagged IMF pointed southward, confirming the lag calculation and indicating ongoing magnetopause reconnection. Dayside convection, as monitored by the SuperDARN network of radars, responded rapidly to the IMF changes but lagged behind the cusp proton emission response: this is shown to be as predicted by the model of flow excitation by Cowley and Lockwood (1992. We use the numerical cusp ion precipitation model of Lockwood and Davis (1996, along with modelled Lyman-a emission efficiency and the SI-12 instrument response, to investigate the effect of the sheath field clock angle on the acceleration of ions on crossing the dayside magnetopause. This modelling reveals that the emission commences on each reconnected field line 2–2.5 min after it is opened and peaks 3–5 min after it is opened. We discuss how comparison of the Lyman-a intensities with oxygen emissions observed simultaneously by the SI-13

  3. IMF control of cusp proton emission intensity and dayside convection: implications for component and anti-parallel reconnection

    Directory of Open Access Journals (Sweden)

    M. Lockwood

    Full Text Available We study a brightening of the Lyman-a emission in the cusp which occurred in response to a short-lived south-ward turning of the interplanetary magnetic field (IMF during a period of strongly enhanced solar wind plasma concentration. The cusp proton emission is detected using the SI-12 channel of the FUV imager on the IMAGE spacecraft. Analysis of the IMF observations recorded by the ACE and Wind spacecraft reveals that the assumption of a constant propagation lag from the upstream spacecraft to the Earth is not adequate for these high time-resolution studies. The variations of the southward IMF component observed by ACE and Wind allow for the calculation of the ACE-to-Earth lag as a function of time. Application of the derived propagation delays reveals that the intensity of the cusp emission varied systematically with the IMF clock angle, the relationship being particularly striking when the intensity is normalised to allow for the variation in the upstream solar wind proton concentration. The latitude of the cusp migrated equatorward while the lagged IMF pointed southward, confirming the lag calculation and indicating ongoing magnetopause reconnection. Dayside convection, as monitored by the SuperDARN network of radars, responded rapidly to the IMF changes but lagged behind the cusp proton emission response: this is shown to be as predicted by the model of flow excitation by Cowley and Lockwood (1992. We use the numerical cusp ion precipitation model of Lockwood and Davis (1996, along with modelled Lyman-a emission efficiency and the SI-12 instrument response, to investigate the effect of the sheath field clock angle on the acceleration of ions on crossing the dayside magnetopause. This modelling reveals that the emission commences on each reconnected field line 2–2.5 min after it is opened and peaks 3–5 min after it is opened. We discuss how comparison of the Lyman-

  4. MR imaging of aortic coarctation

    International Nuclear Information System (INIS)

    Beslic, S.

    2004-01-01

    Purpose. The purpose of this paper is to analyse the contribution of MRI as diagnostic procedure in the preoperative diagnosis of aortic coarctation (CoA), in patients with clinical and echocardiographic suspicion for this disease. Patients and methods. During the period of three years, eight patients were examined, 5 (62.5%) male and 3 (37.5%) female patients with clinical echocardiographic suspicion of CoA. The ratio between male and female patients was 1.7 : 1. The youngest patient was 3 and the oldest 46 years (median age was 15 years). Without administration of contrast media and using body coil the examinations were performed with MR machine Magnetom 1.0 Tesla ( S iemens ) , with the slice thickness of 6 mm, Fast spin-echo (FSE) T1W sequences, Cine gradient echo (GRE) sequence with slab 7 mm and time of flight (TOF) sequence with MIP reconstructions were applied. During the examinations the patients underwent also ECG gating. Examinations were done in axial, coronal and oblique sagittal projections with measuring of the dimensions of cardiovascular structures. Results. CoA was found in 8 (100%) patients. In 7 (87.5%) cases, coarctation developed at isthmus and in one case, coarctation was detected at the horizontal part of aortic arch, between the truncus arteriosus of the left carotid communis artery. Aortal insufficiency was found in 7 (87.5%) patients; in four of them (50%), bicuspidia was confirmed (bicuspid aortic valve), 7 (87.5%) patients had slightly expressed hypertrophy of the left ventricle. Two (25%) patients had dilatation of the ascendant aorta, six (75%) wider outgoing vessels of the aortic arch, four (50%) had well developed arterial collaterals and 2 (25%) patients rib notching. In 2 (25%) patients as side finding thymus persistent was found. Average diameter of coarctation was 10 mm. In one patient, CoA was accompanied with stenosis of pulmonary artery, in one with ventricular septal defect, and one with tricuspid insufficiency. The results

  5. Imaging techniques in aortic valve and root surgery

    NARCIS (Netherlands)

    Regeer, M.V.

    2017-01-01

    Aortic valve sparing surgery for aortic regurgitation and/or aortopathy serves as an alternative to aortic valve and root replacement. One of the advantages of aortic valve sparing surgery over conventional replacement is that there is no need for life-long anticoagulation, which is particularly

  6. Quantum Spectral Curve for a cusped Wilson line in N=4 SYM

    Energy Technology Data Exchange (ETDEWEB)

    Gromov, Nikolay [King’s College London, Department of Mathematics, The Strand, London WC2R 2LS (United Kingdom); St. Petersburg INP,Gatchina, 188 300, St.Petersburg (Russian Federation); Levkovich-Maslyuk, Fedor [King’s College London, Department of Mathematics, The Strand, London WC2R 2LS (United Kingdom)

    2016-04-20

    We show that the Quantum Spectral Curve (QSC) formalism, initially formulated for the spectrum of anomalous dimensions of all local single trace operators in N=4 SYM, can be extended to the generalized cusp anomalous dimension for all values of the parameters. We find that the large spectral parameter asymptotics and some analyticity properties have to be modified, but the functional relations are unchanged. As a demonstration, we find an all-loop analytic expression for the first two nontrivial terms in the small |ϕ±θ| expansion. We also present nonperturbative numerical results at generic angles which match perfectly 4-loop perturbation theory and the classical string prediction. The reformulation of the problem in terms of the QSC opens the possibility to explore many open questions. We attach to this paper several Mathematica notebooks which should facilitate future studies.

  7. Quantum Spectral Curve for a cusped Wilson line in N=4 SYM

    International Nuclear Information System (INIS)

    Gromov, Nikolay; Levkovich-Maslyuk, Fedor

    2016-01-01

    We show that the Quantum Spectral Curve (QSC) formalism, initially formulated for the spectrum of anomalous dimensions of all local single trace operators in N=4 SYM, can be extended to the generalized cusp anomalous dimension for all values of the parameters. We find that the large spectral parameter asymptotics and some analyticity properties have to be modified, but the functional relations are unchanged. As a demonstration, we find an all-loop analytic expression for the first two nontrivial terms in the small |ϕ±θ| expansion. We also present nonperturbative numerical results at generic angles which match perfectly 4-loop perturbation theory and the classical string prediction. The reformulation of the problem in terms of the QSC opens the possibility to explore many open questions. We attach to this paper several Mathematica notebooks which should facilitate future studies.

  8. Countering the stray magnetic field of the CUSP trap by using additional coils

    CERN Document Server

    Thole, Jelle

    2016-01-01

    The ASACUSA experiment at the Antiproton Decelerator (AD) at CERN tries to measure the Hyperfine Structure (HFS) of Antihydrogen (H ̄) using a Rabi spectroscopy set-up. In measuring this HFS it will yield a very precise test of CPT-symmetry. For this set-up to work a homogeneous magnetic field is needed in the cavity where the Hyperfine transition of H ̄ occurs. Due to the stray fields from the CUSP trap, where H ̄ is produced, additional coils are needed to counter these fields. It is found, using COMSOL simulations, that two coils are suitable for this. Leading to a relative standard deviation of the magnetic field of σB/B = 1.06%.

  9. Atypical presentation of bilateral supplemental maxillary central incisors with unusual talon cusp

    Directory of Open Access Journals (Sweden)

    Sivakumar Nuvvula

    2011-01-01

    Full Text Available Delayed eruption of maxillary permanent central incisors in a child poses a distressing esthetic quandary to parents, by virtue of its location in the dental architecture. Well-aligned anterior teeth add confidence to smile and have enhanced self-esteem, which is critical even in early life. Impaction of the maxillary central incisors compared to third molars or the canines is less reported; bilateral supplemental maxillary central incisors related to impacted permanent maxillary central incisors are rare and one of the supplemental central incisors showing unusual talon is still infrequent. A case of impacted maxillary permanent central incisors related to supplemental maxillary central incisors, with one of them showing an unusual talon cusp, is presented.

  10. Ultra-low energy electrons from fast heavy-ion helium collisions: the `target Cusp`

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, W. [Freiburg Univ. (Germany)]|[Gesellschaft fuer Schwerionenforschung mbH, Darmstadt (Germany); Moshammer, R.; Kollmus, H.; Ullrich, J. [Freiburg Univ. (Germany); O`Rourke, F.S.C. [Queen`s Univ., Belfast, Northern Ireland (United Kingdom); Sarkadi, L. [Magyar Tudomanyos Akademia, Debrecen (Hungary). Atommag Kutato Intezete; Mann, R. [Gesellschaft fuer Schwerionenforschung mbH, Darmstadt (Germany); Hagmann, S. [Kansas State Univ., Manhattan, KS (United States). J.R. MacDonald Lab.; Olson, R.E. [Missouri Univ., Rolla, MO (United States). Dept. of Physics

    1998-09-01

    Doubly differential cross sections d{sup 2}{sigma}/dv {sub parallel} dv {sub perpendicular} {sub to} have been obtained by mapping the 3-dimensional velocity space of ultra-low and low-energy electrons (1.5 meV{<=} E{sub e}{<=}100 eV) emitted in singly ionizing 3.6 MeV/u Au{sup 53+} on helium collisions. A sharp ({Delta}E{sub e} {sub perpendicular} {sub to} {sup FWHM} {<=} 22 meV) asymmetric peak centered at vertical stroke anti {nu} vertical stroke =0 is observed to emerge at ultra-low energies from the strongly forward shifted low-energy electron velocity distribution. The shape of this ``target cusp``, which is very sensitive on the details of the two-center potential, is in excellent accord with theoretical CTMC and CDW-EIS predictions. (orig.)

  11. The use of transcatheter aortic valve replacement vs surgical aortic valve replacement for the treatment of aortic stenosis

    Directory of Open Access Journals (Sweden)

    Jensen HA

    2015-08-01

    Full Text Available Hanna A Jensen, Lillian L Tsai, Vinod H Thourani Division of Cardiothoracic Surgery, Joseph B Whitehead Department of Surgery, Structural Heart and Valve Center, Emory University School of Medicine, Atlanta, GA, USA Abstract: Severe aortic stenosis (AS is associated with considerable morbidity and mortality and is increasing in prevalence as the global population increases. Since AS primarily affects the elderly, many of these patients have comorbidities that make them poor candidates for the gold standard treatment for AS, surgical aortic valve replacement. Transcatheter aortic valve replacement has emerged as a novel technology for the management of AS in higher risk patients over the past decade. Randomized trials have established the safety and efficacy of transcatheter aortic valve replacement, and the medical community has rallied to identify the patients who are most suitable for this transformative treatment. This review focuses on outlining the key procedural differences, describing the unique challenges of both operations, and finally assessing and comparing outcomes both on a general level and in challenging patient subgroups. Keywords: aortic valve replacement, transcatheter aortic valve replacement, surgical aortic valve replacement 

  12. Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting.

    Science.gov (United States)

    Karck, Matthias; Kallenbach, Klaus; Hagl, Christian; Rhein, Christine; Leyh, Rainer; Haverich, Axel

    2004-02-01

    The objective of this study was to compare the results of aortic valve-sparing reimplantation and aortic root replacement with mechanical valve conduits in patients with Marfan syndrome undergoing operation for aortic root aneurysms. Patients and methods Between March 1979 and April 2002, 119 patients with clinical evidence of Marfan syndrome underwent composite graft replacement with mechanical valve conduits (n = 74) or aortic valve-sparing reimplantation according to David (n = 45). The underlying causes were aortic dissection type A (43 patients) and aneurysms (76 patients). Patients undergoing aortic valve reimplantation were younger compared with patients undergoing composite grafting (28 vs 35 years, P =.002) and had longer intraoperative aortic crossclamp times (125 vs 78 minutes, P valve reimplantation (P =.15). Mean follow-up was 30 months for patients undergoing aortic valve reimplantation and 114 months for patients undergoing composite grafting. Freedom from reoperation and death after 5 years postoperatively was 92% and 89% in patients undergoing composite grafting and 84% and 96% in patients undergoing aortic valve reimplantation (P =.31; P =.54), respectively. Thromboembolic complications or late postoperative bleeding occurred in 17 patients undergoing composite grafting, and an early postoperative event occurred in 1 patient undergoing aortic valve reimplantation. The results of aortic valve reimplantation and composite grafting of the aortic valve and ascending aorta with mechanical valve conduits are similar with regard to early and mid-term postoperative mortality and to the incidence of late reoperations in patients with Marfan syndrome. The low risk of thromboembolic or bleeding complications favors aortic valve reimplantation in these patients.

  13. Maintaining and sustaining the On the CUSP: stop BSI model in Hawaii.

    Science.gov (United States)

    Lin, Della M; Weeks, Kristina; Holzmueller, Christine G; Pronovost, Peter J; Pham, Julius Cuong

    2013-02-01

    Hawaii joined the On the CUSP: Stop BSI national effort in the United States in 2009 (CUSP stands for Comprehensive Unit-based Safety Program). In the initial 18-month study evaluation, adult ICUs decreased central line-associated bloodstream infection (CLABSI) rates by 61%. The impact of a series of novel strategies/tools in reducing infections and sustaining the collaborative in ICUs and non-ICUs in Hawaii was assessed. This cohort collaborative consisted of 20 adult ICUs and 18 nonadult ICUs in 16 hospitals. Hawaii developed and implemented six tools between July 2010 and August 2011: a tool to investigate CLABSIs, a video to address cultural barriers, a standardized dressing change kit, a map of the cohort's journey, a 12-strategies leadership dashboard, and a geometric plot of consecutive infection-free days. The primary outcome measure was overall CLABSI rates (mean infections per 1,000 catheter-days). A comparison of baseline data from 28 ICUs with 12-quarter (36-month) postimplementation data indicated that the CLABSI rate decreased across the entire state: overall, 1.57 to 0.29 infections/1,000 catheter-days; adult ICUs, 1.49 to 0.25 infections/1,000 catheter-days; nonadult ICUs, 2.54 to 0.33 infections/1,000 catheter-days, non-ICUs (N= 14), 4.52 to 0.25 infections/1,000 catheter-days, and PICU/NICU (N = 4), 2.05 to 0.53 infections/1,000 catheter-days. Days between CLABSIs in the adult ICUs statewide increased from a median of 5 days in 2009 to 70 days in 2011. Hawaii successfully spread the program beyond adult ICUs and implemented a series of tools for maintenance and sustainment. Use of the tools shaped a culture around the continued belief that CLABSIs can be eradicated, and infections further reduced.

  14. Plasma and magnetic field characteristics of the distant polar cusp near local noon: The entry layer

    International Nuclear Information System (INIS)

    Paschmann, G.; Haerendel, G.; Sckopke, N.; Rosenbauer, H.; Hedgecock, P.C.

    1976-01-01

    Heos 2 plasma and magnetic field measurements in the distant polar cusp region reveal the existence of a plasma layer on day side field lines just inside the magnetopause. Density and temperature in this layer are nearly the same as they are in the adjacent magnetosheath, but the flow lacks the order existing both in the magnetosheath and in the plasma mantle. Flow directions toward and away from the sun but, in general, parallel to the field lines have been found. The magnetopause (as defined by a sudden rotation of the magnetic field vector) mostly coincides with the transition to ordered magnetosheath flow. The inner boundary of the layer is located just within the outer boundary of the hot ring current plasma. In the region of overlap the hot electrons have the signature of trapped particles, though often at reduced intensity. The magnetic field is strongly fluctuating in magnitude, while its orientation is more stable, consistent with a connection to the earth, but is systematically distorted out of the meridian plane. The layer is thought to be a consequence of the entry of magnetosheath plasma, which does not appear to be unobstructed, as has been claimed in the concept of a magnetospheric cleft. The magnetopause has a cusplike indentation which is elongated in local time. The existence of field-aligned currents (total strength approx. =10 6 A) and their location of flow in the inner part of the entry layer (into the ionosphere before noon and out of it after noon) are inferred from the systematic bending of field lines. It is proposed that the dynamo of the related current system is provided by the transfer of perpendicular momentum resulting from the plasma entry into the layer. The essential features of the entry layer might be compatible with the model of plasma flow through the magnetopause of Levy et al. (1964) if a 'dam' effect caused by the cusp geometry were added

  15. Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection

    International Nuclear Information System (INIS)

    Chen, I-Ming; Chen, Po-Lin; Huang, Chun-Yang; Weng, Shih-Hsien; Chen, Wei-Yuan; Shih, Chun-Che

    2017-01-01

    PurposeThe purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection.Materials and MethodsThe patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen.ResultsA total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively.ConclusionsIncreased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection.Level of EvidenceIII.

  16. Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection

    Energy Technology Data Exchange (ETDEWEB)

    Chen, I-Ming [National Yang Ming University, Institute of Clinical Medicine, School of Medicine (China); Chen, Po-Lin; Huang, Chun-Yang [National Yang Ming University, Department of Medicine, School of Medicine (China); Weng, Shih-Hsien; Chen, Wei-Yuan; Shih, Chun-Che, E-mail: ccshih@vghtpe.gov.tw [National Yang Ming University, Institute of Clinical Medicine, School of Medicine (China)

    2017-05-15

    PurposeThe purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection.Materials and MethodsThe patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen.ResultsA total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively.ConclusionsIncreased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection.Level of EvidenceIII.

  17. Aortography following subdiaphragmal aortic biopsy

    International Nuclear Information System (INIS)

    Schimmler, J.

    1982-01-01

    A juxtaposition of the subdiaphragmal and infrarenal translumbar aortic biopsy sites showed decisive advantages in favour of the higher site: a more stable position because of better anatomic fixation and rarer incidence of vascular alterations, a wider vascular lumen. Disadvantages lie in the fact that the large visceral arteries (especially Tr. coeliacus) branch off nearly and in the close anatomic relationship to large abdominal organs and the thoracal region. Evaluation of the radiographical image of the vascular tree after subdiaphragmal aortic biopsy showed an average 82% of the vessels to the area of the Knees to be assessable (renal arteries approximately 93%, popliteal arteries approximately 70%). Beyong, the method proved unsatisfactory: 52% of the vessels could not, or not safety, be evaluated. A relatively broad spectrum of indications by comparison with transfemoral catheter aortography had no influence on the rate of complications with reference to either method. A comparison of the topographic conditions shows the need for even more scrupulons observation of the technique in subdiaphragmal biopsy than in the infrarenal one. To sum up the results obtained, subdiaphregmal translumbar aortography is to be preferred to the infrarenal one where transfemoral catheter aortography is contra-indicated, within the limits mentioned. (orig.) [de

  18. Imaging of thoracic aortic dissection

    International Nuclear Information System (INIS)

    Vu, F.H.; Young, N.; Soo, Y.S.

    1994-01-01

    Acute thoracic aortic dissection has a high mortality rate if untreated, so the diagnosis must be rapidly made. Multiple imaging techniques are often used. This retrospective study from 1988 to 1993 assesses the usefulness in diagnosis of chest X-rays, computed tomography (CT) scanning, aortography, magnetic resonance imaging (MRI), trans-thoracic (TTE) and trans-oesophageal (TOE) echocardiography. Forty-two patients with a final clinical diagnosis of dissection were studied. The diagnosis was confirmed in 16 (13 at surgery and three at autopsy). Three died with dissection given as the only cause of death. Chest X-ray abnormalities were seen in all 19 patients with surgery or death from dissection, with a widened mediastinum and/or dilated aorta being present in 17. In the group of 16 patients with surgery or autopsy proof, CT scans found dissections in 9 out of 12 patients studied and correctly classified the type in only five. Aortography was preformed in five, with accurate depiction of dissection and type in all. TTE found dissections in three of eight patients imaged by this method. MRI and TOE were preformed each on two patients, with accurate depiction of dissection and type in each. Because of the relatively low sensitivity of CT scanning in defining aortic dissections Westmead Hospital is currently assessing the use of TOE as the prime imaging modality prior to surgical intervention. 17 refs., 4 tabs., 4 figs

  19. Ascending aortic injuries following blunt trauma.

    Science.gov (United States)

    Sun, Xiumei; Hong, Jenny; Lowery, Robert; Goldstein, Steven; Wang, Zuyue; Lindsay, Joseph; Hill, Peter C; Corso, Paul J

    2013-11-01

    The diagnosis and the management of traumatic thoracic aortic injuries have undergone significant changes due to new technology and improved prehospital care. Most of the discussions have focused on descending aortic injuries. In this review, we discuss the recent management of ascending aortic injuries. We found 5 cohort studies on traumatic aortic injuries and 11 case reports describing ascending aortic injuries between 1998 to the present through Medline research. Among case reports, 78.9% of cases were caused by motor vehicle accidents (MVA). 42.1% of patients underwent emergent open repair and the operative mortality was 12.5%. 36.8% underwent delayed repair. Associated injuries occurred in 84.2% of patients. Aortic valve injury was concurrent in 26.3% of patients. The incidence of ascending aortic injury ranged 1.9-20% in cohort studies. Traumatic injuries to the ascending aorta are relatively uncommon among survivors following blunt trauma. Aortography has been replaced by computed tomography and echocardiography as a diagnostic tool. Open repair, either emergent or delayed, remains the treatment of choice. © 2013 Wiley Periodicals, Inc.

  20. Aortic stenosis and vascular calcifications in alkaptonuria.

    Science.gov (United States)

    Hannoush, Hwaida; Introne, Wendy J; Chen, Marcus Y; Lee, Sook-Jin; O'Brien, Kevin; Suwannarat, Pim; Kayser, Michael A; Gahl, William A; Sachdev, Vandana

    2012-02-01

    Alkaptonuria is a rare metabolic disorder of tyrosine catabolism in which homogentisic acid (HGA) accumulates and is deposited throughout the spine, large joints, cardiovascular system, and various tissues throughout the body. In the cardiovascular system, pigment deposition has been described in the heart valves, endocardium, pericardium, aortic intima and coronary arteries. The prevalence of cardiovascular disease in patients with alkaptonuria varies in previous reports. We present a series of 76 consecutive adult patients with alkaptonuria who underwent transthoracic echocardiography between 2000 and 2009. A subgroup of 40 patients enrolled in a treatment study underwent non-contrast CT scans and these were assessed for vascular calcifications. Six of the 76 patients had aortic valve replacement. In the remaining 70 patients, 12 patients had aortic sclerosis and 7 patients had aortic stenosis. Unlike degenerative aortic valve disease, we found no correlation with standard cardiac risk factors. There was a modest association between the severity of aortic valve disease and joint involvement, however, we saw no correlation with urine HGA levels. Vascular calcifications were seen in the coronaries, cardiac valves, aortic root, descending aorta and iliac arteries. These findings suggest an important role for echocardiographic screening of alkaptonuria patients to detect valvular heart disease and cardiac CT to detect coronary artery calcifications. Published by Elsevier Inc.

  1. Aortic reconstruction with bovine pericardial grafts

    Directory of Open Access Journals (Sweden)

    Silveira Lindemberg Mota

    2003-01-01

    Full Text Available INTRODUCTION: Glutaraldehyde-treated crimped bovine pericardial grafts are currently used in aortic graft surgery. These conduits have become good options for these operations, available in different sizes and shapes and at a low cost. OBJECTIVE:To evaluate the results obtained with bovine pericardial grafts for aortic reconstruction, specially concerning late complications. METHOD: Between January 1995 and January 2002, 57 patients underwent different types of aortic reconstruction operations using bovine pericardial grafts. A total of 29 (50.8% were operated on an urgent basis (mostly acute Stanford A dissection and 28 electively. Thoracotomy was performed in three patients for descending aortic replacement (two patients and aortoplasty with a patch in one. All remaining 54 underwent sternotomy, cardiopulmonary bypass and aortic resection. Deep hypothermia and total circulatory arrest was used in acute dissections and arch operations. RESULTS: Hospital mortality was 17.5%. Follow-up was 24.09 months (18.5 to 29.8 months confidence interval and complication-free actuarial survival curve was 92.3% (standard deviation ± 10.6. Two patients lately developed thoracoabdominal aneurysms following previous DeBakey II dissection and one died from endocarditis. One "patch" aortoplasty patient developed local descending aortic pseudoaneurysm 42 months after surgery. All other patients are asymptomatic and currently clinically evaluated with echocardiography and CT scans, showing no complications. CONCLUSION: Use of bovine pericardial grafts in aortic reconstruction surgery is adequate and safe, with few complications related to the conduits.

  2. Altered aortic shape in bicuspid aortic valve relatives influences blood flow patterns.

    Science.gov (United States)

    Schnell, Susanne; Smith, Danielle A; Barker, Alex J; Entezari, Pegah; Honarmand, Amir R; Carr, Maria L; Malaisrie, S Chris; McCarthy, Patrick M; Collins, Jeremy; Carr, James C; Markl, Michael

    2016-11-01

    Bicuspid aortic valve (BAV) is known to exhibit familial inheritance and is associated with aortopathy and altered aortic haemodynamics. However, it remains unclear whether BAV-related aortopathy can be inherited independently of valve morphology. Four-dimensional flow magnetic resonance imaging for the in vivo assessment of thoracic aortic 3D blood flow was performed in 24 BAV relatives with trileaflet aortic valves (age = 40 ± 14 years) and 15 healthy controls (age = 37 ± 10 years). Data analysis included aortic dimensions, shape (round/gothic/cubic), and 3D blood flow characteristics (semi-quantitative vortex/helix grading and peak velocities). Cubic and gothic aortic shapes were markedly more prevalent in BAV relatives compared with controls (38 vs. 7%). Ascending aorta (AAo) vortex flow in BAV relatives was significantly increased compared with controls (grading = 1.5 ± 1.0 vs. 0.6 ± 0.9, P = 0.015). Aortic haemodynamics were influenced by aortic shape: peak velocities were reduced for gothic aortas vs. round aortas (P = 0.003); vortex flow was increased for cubic aortas in the AAo (P gothic aortas in the AAo and descending aorta (P = 0.003, P = 0.029). Logistic regression demonstrated significant associations of shape with severity of vortex flow in AAo (P < 0.001) and aortic arch (P = 0.016) in BAV relatives. BAV relatives expressed altered aortic shape and increased vortex flow despite the absence of valvular disease or aortic dilatation. These data suggest a heritable component of BAV-related aortopathy affecting aortic shape and aberrant blood flow, independent of valve morphology. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  3. Combined Repair of Ascending Aortic Pseudoaneurysm and Abdominal Aortic Aneurysm in a Patient with Marfan Syndrome

    OpenAIRE

    Kokotsakis, John N.; Lioulias, Achilleas G.; Foroulis, Christophoros N.; Skouteli, Eleni Anna T.; Milonakis, Michael K.; Bastounis, Elias A.; Boulafendis, Dimitrios G.

    2003-01-01

    Pseudoaneurysms of the ascending aorta after the original inclusion/wrap technique of the Bentall procedure present a difficult surgical management problem and are associated with substantial morbidity and mortality. Patients with Marfan syndrome frequently develop aneurysms and dissections that involve multiple aortic segments. We present the case of a Marfan patient who successfully underwent repair of a giant ascending aortic pseudoaneurysm and concomitant repair of an abdominal aortic ane...

  4. The future of aortic surgery in Europe

    DEFF Research Database (Denmark)

    Czerny, Martin; Bachet, Jean; Bavaria, Joseph

    2012-01-01

    the interested reader with an overview of how aortic surgery and (perhaps more accurately) aortic medicine has evolved in Europe, and its present standing; also to provide a glimpse into the future, trying to disseminate the thoughts of a group of people actively involved in the development of aortic medicine......At least every ten years, each specialty should reflect upon its past, its present and its future, in order to be able to reconfirm the direction in which it is headed, to adopt suggestions from inside and outside and, consequently, to improve. As such, the aim of this manuscript is to provide...

  5. Mycotic Aneurysm of the Aortic Arch

    Directory of Open Access Journals (Sweden)

    Ji Hye Seo

    2014-08-01

    Full Text Available A mycotic aneurysm of the thoracic aorta is rare. We report a case of mycotic aneurysm that developed in the aortic arch. An 86-year-old man was admitted with fever and general weakness. Blood culture yielded methicillin-resistant Staphylococcus aureus. Chest X-ray showed an enlarged aortic arch, and computed tomography scan revealed an aneurysm in the aortic arch. The patient was treated only with antibiotics and not surgically. The size of the aneurysm increased rapidly, resulting in bronchial obstruction and superimposed pneumonia. The patient died of respiratory failure.

  6. Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm

    Directory of Open Access Journals (Sweden)

    Ludovic Canaud, MD, PhD

    2018-06-01

    Full Text Available A 79-year-old woman was admitted with a large chronic dissecting ascending aortic aneurysm starting 5 mm distal to the ostia of the left coronary artery and ending immediately proximal to the innominate artery. A reverse extra-anatomic aortic arch debranching procedure was performed. During the same operative time, through a transapical approach, a thoracic stent graft was deployed with the proximal landing zone just distal to the coronary ostia and the distal landing zone excluding the origin of the left common carotid artery. The postoperative course was uneventful. Computed tomography at 12 months documented patent extra-anatomic aortic arch debranching and no evidence of endoleak. Keywords: Ascending aorta, Thoracic aorta, Aortic dissection, Stent graft

  7. The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

    International Nuclear Information System (INIS)

    Knollmann, Friedrich D.; Lacomis, Joan M.; Ocak, Iclal; Gleason, Thomas

    2013-01-01

    Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes

  8. Stroke Volume estimation using aortic pressure measurements and aortic cross sectional area: Proof of concept.

    Science.gov (United States)

    Kamoi, S; Pretty, C G; Chiew, Y S; Pironet, A; Davidson, S; Desaive, T; Shaw, G M; Chase, J G

    2015-08-01

    Accurate Stroke Volume (SV) monitoring is essential for patient with cardiovascular dysfunction patients. However, direct SV measurements are not clinically feasible due to the highly invasive nature of measurement devices. Current devices for indirect monitoring of SV are shown to be inaccurate during sudden hemodynamic changes. This paper presents a novel SV estimation using readily available aortic pressure measurements and aortic cross sectional area, using data from a porcine experiment where medical interventions such as fluid replacement, dobutamine infusions, and recruitment maneuvers induced SV changes in a pig with circulatory shock. Measurement of left ventricular volume, proximal aortic pressure, and descending aortic pressure waveforms were made simultaneously during the experiment. From measured data, proximal aortic pressure was separated into reservoir and excess pressures. Beat-to-beat aortic characteristic impedance values were calculated using both aortic pressure measurements and an estimate of the aortic cross sectional area. SV was estimated using the calculated aortic characteristic impedance and excess component of the proximal aorta. The median difference between directly measured SV and estimated SV was -1.4ml with 95% limit of agreement +/- 6.6ml. This method demonstrates that SV can be accurately captured beat-to-beat during sudden changes in hemodynamic state. This novel SV estimation could enable improved cardiac and circulatory treatment in the critical care environment by titrating treatment to the effect on SV.

  9. The role of aortic wall CT attenuation measurements for the diagnosis of acute aortic syndromes

    Energy Technology Data Exchange (ETDEWEB)

    Knollmann, Friedrich D., E-mail: friedrich.knollmann@ucdmc.ucdavis.edu [Department of Radiology, University of California, Davis, 4860 Y Street, Sacramento, CA 95817 (United States); Departments of Radiology and Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213 (United States); Lacomis, Joan M.; Ocak, Iclal; Gleason, Thomas [Department of Radiology, University of California, Davis, 4860 Y Street, Sacramento, CA 95817 (United States); Departments of Radiology and Cardiothoracic Surgery, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213 (United States)

    2013-12-01

    Objectives: To determine if measurements of aortic wall attenuation can improve the CT diagnosis of acute aortic syndromes. Methods: CT reports from a ten year period were searched for acute aortic syndromes (AAS). Studies with both an unenhanced and a contrast enhanced (CTA) series that had resulted in the diagnosis of intramural hematoma (IMH) were reviewed. Diagnoses were confirmed by medical records. The attenuation of aortic wall abnormalities was measured. The observed attenuation threshold was validated using studies from 39 new subjects with a variety of aortic conditions. Results: The term “aortic dissection” was identified in 1206, and IMH in 124 patients’ reports. IMH was confirmed in 31 patients, 21 of whom had both unenhanced and contrast enhanced images. All 21 had pathologic CTA findings, and no CTA with IMH was normal. Attenuation of the aortic wall was greater than 45 HUs on the CTA images in all patients with IMH. When this threshold was applied to the new group, sensitivity for diagnosing AAS was 100% (19/19), and specificity 94% (16/17). Addition of unenhanced images did not improve accuracy. Conclusions: Measurements of aortic wall attenuation in CTA have a high negative predictive value for the diagnosis of acute aortic syndromes.

  10. Aortic root reimplantation procedure: a new milestone in aortic valve-sparing operations

    Directory of Open Access Journals (Sweden)

    А. М. Чернявский

    2016-08-01

    Full Text Available Aim: Emphasis in this study was placed on clinical and functional assessment of a modified "Florida Sleeve" procedure during surgical correction of ascending aorta aneurysms with concomitant aortic insufficiency.Methods: 32 patients with an aneurysm of the ascending aorta and aortic insufficiency underwent a modified "Florida Sleeve" procedure. The average follow-up was 17 (0-60 months. The average age of patients was 57±13 (23-73 years 56±13 years.Results: The expected 4-year cumulative survival rate was 84.3%. Overall freedom from aortic insufficiency in the late period was 88.9%. Median aortic regurgitation was 1+ (1; 2. Long-term follow-up revealed no valve-associated complications.Conclusion: The aortic root reimplantation procedure enables optimal correction of the existing lesions of the aortic root without performing aortic valve replacement and demonstrates stable clinical and functional outcomes in the long-term period.Key words: aortic aneurysm; aortic valve; valve-sparing operations.FundingThe study had no sponsorship.Conflict of interestThe authors declare no conflict of interest.

  11. Incidence and predictors of permanent pacemaker implantation following treatment with the repositionable Lotus™ transcatheter aortic valve.

    Science.gov (United States)

    Zaman, Sarah; McCormick, Liam; Gooley, Robert; Rashid, Hashrul; Ramkumar, Satish; Jackson, Damon; Hui, Samuel; Meredith, Ian T

    2017-07-01

    To determine the incidence and predictors of permanent pacemaker (PPM) requirement following transcatheter aortic valve replacement (TAVR) with the mechanically expanded Lotus TM Valve System (Boston Scientific). Pacemaker implantation is the most common complication following TAVR. Predictors of pacing following TAVR with the Lotus valve have not been systematically assessed. Consecutive patients with severe aortic stenosis who underwent Lotus valve implantation were prospectively recruited at a single-centre. Patients with a pre-existing PPM were excluded. Baseline ECG, echocardiographic and multiple detector computed tomography as well as procedural telemetry and depth of implantation were independently analyzed in a blinded manner. The primary endpoint was 30-day incidence of pacemaker requirement (PPM implantation or death while pacing-dependent). Multivariate analysis was performed to identify independent predictors of the primary endpoint. A total of 104 consecutive patients underwent TAVR with the Lotus valve with 9/104 (9%) with a pre-existing PPM excluded. New or worsened procedural LBBB occurred in 78%. Thirty-day incidence of the primary pacing endpoint was 28%. The most common indication for PPM implantation was complete heart block (CHB) (69%). Independent predictors of the primary endpoint included pre-existing RBBB (hazard ratio [HR] 2.8, 95% CI 1.1-7.0; P = 0.032) and depth of implantation below the noncoronary cusp (NCC) (HR 2.4, 95% CI 1.0-5.7; P = 0.045). Almost a third of Lotus valve recipients require pacemaker implantation within 30 days. The presence of pre-existing RBBB and the depth of prosthesis implantation below the NCC were significant pacing predictors. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. Origin of energetic ions in the polar cusp inferred from ion composition measurements by the Viking satellite

    Directory of Open Access Journals (Sweden)

    G. Kremser

    1995-06-01

    Full Text Available The magnetospheric ion composition spectrometer MICS on the Swedish Viking satellite provided measurements of the ion composition in the energy range 10.1 keV/e\\leqE/Q\\leq326.0 keV/e. Data obtained during orbit 842 were used to investigate the ion distribution in the northern polar cusp and its vicinity. The satellite traversed the outer ring current, boundary region, cusp proper and plasma mantle during its poleward movement. H+ and He++ ions were encountered in all of these regions. He+ ions were present only in the ring current. The number of O+ and O++ ions was very small. Heavy high-charge state ions typical for the solar wind were observed for the first time, most of them in the poleward part of the boundary region and in the cusp proper. The H+ ions exhibited two periods with high intensities. One of them, called the BR/CP event, appeared at energies up to 50 keV. It started at the equatorward limit of the boundary region and continued into the cusp proper. Energy spectra indicate a ring current origin for the BR/CP event. Pitch angle distributions show downward streaming of H+ ions at its equatorward limit and upward streaming on the poleward side. This event is interpreted as the result of pitch angle scattering of ring current ions by fluctuations in the magnetopause current layer in combination with poleward convection. The other of the two periods with high H+ ion intensities, called the accelerated ion event, was superimposed on the BR/CP event. It was restricted to energies \\leq15 keV and occurred in the poleward part of the boundary region. This event is regarded as the high-energy tail of magnetosheath ions that were accelerated while penetrating into the magnetosphere. The cusp region thus contains ions of magnetospheric as well as of magnetosheath origin. The appearance of the ions depends, in addition to the ion source, on the magnetic field configuration and dynamic processes inside and close to the cusp.

  13. Origin of energetic ions in the polar cusp inferred from ion composition measurements by the Viking satellite

    Directory of Open Access Journals (Sweden)

    G. Kremser

    Full Text Available The magnetospheric ion composition spectrometer MICS on the Swedish Viking satellite provided measurements of the ion composition in the energy range 10.1 keV/eleqE/Qleq326.0 keV/e. Data obtained during orbit 842 were used to investigate the ion distribution in the northern polar cusp and its vicinity. The satellite traversed the outer ring current, boundary region, cusp proper and plasma mantle during its poleward movement. H+ and He++ ions were encountered in all of these regions. He+ ions were present only in the ring current. The number of O+ and O++ ions was very small. Heavy high-charge state ions typical for the solar wind were observed for the first time, most of them in the poleward part of the boundary region and in the cusp proper. The H+ ions exhibited two periods with high intensities. One of them, called the BR/CP event, appeared at energies up to 50 keV. It started at the equatorward limit of the boundary region and continued into the cusp proper. Energy spectra indicate a ring current origin for the BR/CP event. Pitch angle distributions show downward streaming of H+ ions at its equatorward limit and upward streaming on the poleward side. This event is interpreted as the result of pitch angle scattering of ring current ions by fluctuations in the magnetopause current layer in combination with poleward convection. The other of the two periods with high H+ ion intensities, called the accelerated ion event, was superimposed on the BR/CP event. It was restricted to energies leq15 keV and occurred in the poleward part of the boundary region. This event is regarded as the high-energy tail of magnetosheath ions that were accelerated while penetrating into the magnetosphere. The cusp region thus contains ions of magnetospheric as well as of magnetosheath origin. The appearance of the ions depends, in addition to the ion source, on the

  14. Dissecting aortic aneurysm in maintenance hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Ounissi M

    2009-01-01

    Full Text Available The dissecting aortic aneurysm (DAA is a rare pathology that may result in fatal outcome. We report follow up of three cases of DAA patients undergoing maintenance hemo-dialysis who were managed conservatively.

  15. Traumatic aortic dissection presenting with respiratory arrest

    Directory of Open Access Journals (Sweden)

    C.C. Meyer

    2015-03-01

    Conclusion: Blunt aortic injury is a major cause of death in blunt chest trauma. Signs and symptoms of this injury are nonspecific and other injuries often take precedence, which makes a relatively difficult diagnosis even more challenging.

  16. Aortic root reoperations after pulmonary autograft implantation

    NARCIS (Netherlands)

    J.A. Bekkers (Jos); L.M.A. Klieverik (Loes Maria Anne); G. Bol-Raap (Goris); J.J.M. Takkenberg (Hanneke); A.J.J.C. Bogers (Ad)

    2010-01-01

    textabstractObjective: To report the results of aortic root reoperations after pulmonary autograft implantation. Methods: All consecutive patients in our prospective Ross research database were selected for analysis, and additional information for patients requiring reoperation was obtained from the

  17. [Aortic valve-sparing root reconstruction in Marfan syndrome].

    Science.gov (United States)

    Ogino, H; Sasaki, H; Hanafusa, Y; Hirata, M; Numata, S; Ando, M; Yagihara, T; Kitamura, S

    2002-07-01

    The outcome of aortic valve-sparing root reconstruction in Marfan syndrome was reviewed. Thirteen patients with Marfan syndrome underwent aortic valve-sparing root reconstruction for annuloaortic ectasia or aortic root dissection between 1994 and 1999. The grade of preoperative aortic regurgitation was I in 4, II in 2, III in 5, IV in 2 patients. The procedures of aortic valve-sparing were reimplantation in 7 and remodeling in 5 patients. There was no hospital and late death. Recurrence of aortic regurgitation greater than moderate grade developed in 1 patient immediately after the surgery and in the other 4 patients in the late stage. One patient of them required aortic valve replacement for it. Aortic valve-sparing root reconstruction is applicable in Marfan patients, although the indication should be cautious. Close observation is needed for recurrence of aortic regurgitation.

  18. CT diagnosis of acute aortic dissection

    International Nuclear Information System (INIS)

    Ogawa, Noriko; Kobayashi, Takeshi

    1989-01-01

    Sixteen (47.5%) of 35 patients with acute aortic dissection showed a non-opacified crescent in the aorta on an initial contrast CT. Seven of these 16 patients underwent cineangiography soon after the initial CT, and in all 7 patients, neither an intimal tear nor an intimal flap was obtained. All but one of above 16 patients were followed by CT. Mean duration of follow-up was 9.6 months. In 10 of 15 patients with non-opacified false lumen, the false lumen remained non-opacified until the last examination. Moreover, in 6 of these 10 patients, the false lumen shrunk, and in the other 3, it disappeared completely on follow-up CT. On the other hand, in remaining 5 of these 15 patients who were initially diagnosed to have non-opacified false lumen, the false lumen became opacified and enlarged in size on follow-up CT performed in the first 14 weeks. Moreover, in 4 of these 5 patients, the false lumen became opacified in the only first 6 weeks. No matter how intensive care should be paid at least for the first 6 weeks, it seems that patients with aortic dissection which have non-opacified false lumen had good prognosis in comparison to patients with ordinary aortic dissections which have opacified false lumen. We believe aortic dissection with non-opacified false lumen may consist of two type of aortic dissection, one has no intimal tear, the other has some intimal tears and a thrombosed false lumen. In conclusion, CT is the most useful modality in diagnosing acute aortic dissection. The reasons are the incidence of acute aortic dissection with non-opacified false lumen was high, patients with non-opacified false lumen had good prognosis, and it was difficult to diagnose aortic dissection with non-opacified false lumen by conventional cineangiography and/or DSA. (author)

  19. Graft infections after surgical aortic reconstructions

    OpenAIRE

    Berger, P.

    2015-01-01

    Prosthetic vascular grafts are frequently used to reconstruct (part) of the aorta. Every surgical procedure caries a certain risk for infection and when a prosthetic aortic graft is implanted, this may lead to an aortic graft infection (AGI). Endovascular techniques have gradually replaced open surgical reconstructions as first line of treatment for aorto-iliac diseases. Nowadays, open reconstructions are primarily reserved for patients unsuitable for endovascular reconstructions or for redo ...

  20. Aortic dissection. Basic aspects and endovascular management

    International Nuclear Information System (INIS)

    Jaramillo, Nicolas I; Alviar, Carlos I

    2005-01-01

    Treatment of thoracic aortic pathology is complicated by the morbidity associated to the surgical procedure and to the frailty of an elderly and difficult population. Surgical operation in this kind of population frequently bears a significant incidence of death and long-term disability. In an effort to reduce the incidence of negative outcomes, minimally invasive techniques in the form of endovascular stenting have been introduced during the past decade. The technology, originally described by Parodi, and initially designed for its use in abdominal aortic aneurysms, has been adapted for the treatment of thoracic aortic aneurysms. Furthermore, an improved understanding of the pathophysiology and the natural history of thoracic aortic disease as well as the analysis of the outcomes have facilitated our treatment decisions in terms of the timing for an appropriate intervention. Treatment of thoracic aortic dissection using endovascular Stent is one of the more recent advances in this condition and is receiving increasing attention, as it is a less invasive alternative to an open surgical repair. Although this technology is still innovative, significant improvements have been made lately in the design and deployment of the endovascular Stent-grafts. These prostheses have been increasingly used to treat aneurysms, dissections and traumatic ruptures, as well as giant penetrating ulcers and intramural hematomas of the descending thoracic aorta with good early and mid-term outcomes. The rareness, complexity and severity of the pathology and the theoretically high risk of complications should render the surgeon extremely cautious especially with young patients. Conceptually, the endo luminal treatment in the acute phase seems to be the solution and will probably become a preferred therapy while technical refinement is under way. Worldwide experience is growing and with this a better understanding of the indications and limitations of this innovative therapy will be

  1. Retrograde ascending aortic dissection during or after thoracic aortic stent graft placement: insight from the European registry on endovascular aortic repair complications

    DEFF Research Database (Denmark)

    Eggebrecht, Holger; Thompson, Matt; Rousseau, Hervé

    2009-01-01

    BACKGROUND: Single-center reports have identified retrograde ascending aortic dissection (rAAD) as a potentially lethal complication of thoracic endovascular aortic repair (TEVAR). METHODS AND RESULTS: Between 1995 and 2008, 28 centers participating in the European Registry on Endovascular Aortic...

  2. Long-Term Risk for Aortic Complications After Aortic Valve Replacement in Patients With Bicuspid Aortic Valve Versus Marfan Syndrome.

    Science.gov (United States)

    Itagaki, Shinobu; Chikwe, Joanna P; Chiang, Yuting P; Egorova, Natalia N; Adams, David H

    2015-06-09

    Bicuspid aortic valves are associated with valve dysfunction, ascending aortic aneurysm and dissection. Management of the ascending aorta at the time of aortic valve replacement (AVR) in these patients is controversial and has been extrapolated from experience with Marfan syndrome, despite the absence of comparative long-term outcome data. This study sought to assess whether the natural history of thoracic aortopathy after AVR in patients with bicuspid aortic valve disease is substantially different from that seen in patients with Marfan syndrome. In this retrospective comparison, outcomes of 13,205 adults (2,079 with bicuspid aortic valves, 73 with Marfan syndrome, and 11,053 control patients with acquired aortic valve disease) who underwent primary AVR without replacement of the ascending aorta in New York State between 1995 and 2010 were compared. The median follow-up time was 6.6 years. The long-term incidence of thoracic aortic dissection was significantly higher in patients with Marfan syndrome (5.5 ± 2.7%) compared with those with bicuspid valves (0.55 ± 0.21%) and control group patients (0.41 ± 0.08%, p Marfan syndrome (10.8 ± 4.4%) compared with those with bicuspid valves (4.8 ± 0.8%) and control group patients (1.4 ± 0.2%) (p Marfan syndrome were significantly more likely to undergo thoracic aortic surgery in late follow-up (10.4 ± 4.3%) compared with those with bicuspid valves (2.5 ± 0.6%) and control group patients (0.50 ± 0.09%) (p Marfan syndrome compared with those with bicuspid aortic valves confirm that operative management of patients with bicuspid aortic valves should not be extrapolated from Marfan syndrome and support discrete treatment algorithms for these different clinical entities. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Aortic Dissection Type A in Alpine Skiers

    Directory of Open Access Journals (Sweden)

    Thomas Schachner

    2013-01-01

    Full Text Available Patients and Methods. 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April. We analyzed cases of ascending aortic dissection associated with alpine skiing. Results. In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172–200 cm versus 175 (157–191 cm, and heavier (90 (68–125 kg versus 80 (45–110 kg, than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers (. Hospital mortality of skiers was 6% versus 13% in nonskiers (. The skiers live at an altitude of 170 (0–853 m.a.s.l. and experience their dissection at 1602 (1185–3105; m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. Conclusion. Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good.

  4. Aortic Dissection Type A in Alpine Skiers

    Science.gov (United States)

    Schachner, Thomas; Fischler, Nikolaus; Dumfarth, Julia; Bonaros, Nikolaos; Krapf, Christoph; Schobersberger, Wolfgang; Grimm, Michael

    2013-01-01

    Patients and Methods. 140 patients with aortic dissection type A were admitted for cardiac surgery. Seventy-seven patients experienced their dissection in the winter season (from November to April). We analyzed cases of ascending aortic dissection associated with alpine skiing. Results. In 17 patients we found skiing-related aortic dissections. Skiers were taller (180 (172–200) cm versus 175 (157–191) cm, P = 0.008) and heavier (90 (68–125) kg versus 80 (45–110) kg, P = 0.002) than nonskiers. An extension of aortic dissection into the aortic arch, the descending thoracic aorta, and the abdominal aorta was found in 91%, 74%, and 69%, respectively, with no significant difference between skiers and nonskiers. Skiers experienced RCA ostium dissection requiring CABG in 17.6% while this was true for 5% of nonskiers (P = 0.086). Hospital mortality of skiers was 6% versus 13% in nonskiers (P = 0.399). The skiers live at an altitude of 170 (0–853) m.a.s.l. and experience their dissection at 1602 (1185–3105; P < 0.001) m.a.s.l. In 82% symptom start was during recreational skiing without any trauma. Conclusion. Skiing associated aortic dissection type A is usually nontraumatic. The persons affected live at low altitudes and practice an outdoor sport at unusual high altitude at cold temperatures. Postoperative outcome is good. PMID:23971024

  5. Left ventricular mechanical adaptation to chronic aortic regurgitation in intact dogs

    International Nuclear Information System (INIS)

    Florenzano, F.; Glantz, S.A.

    1987-01-01

    Increased and end-diastolic wall stress has been hypothesized to stimulate left ventricular (LV) hypertrophy following volume overload. The authors instrumented intact-chest dogs with radiopaque markers in both ventricles and created volume overload by puncturing one aortic valve cusp. An x-ray system with biplane fluoroscopic and cineradiographic capabilities was used. End-diastolic stress increased immediately, then fell over 3 mo as the heart hypertrophied. End-systolic stress did not change significantly. Chamber contractility, quantified as E/sub max/, the end-systolic pressure-volume line slope, increased. E/sub max/ normalized by multiplying by LV mass increased following the lesion before but not after β-blockade with propranolol and did not change significantly over time, suggesting that chamber contractility changed because of increased mass and sympathetic tone rather than changed intrinsic muscle function. LV mass did not initially correlate with lesion size, but steady-state mass did. Over the range of lesions the authors produced, increased end-diastolic wall stress appears to stimulate hypertrophy at a fixed rate, which stops when end-diastolic wall stress has been reduced to an acceptable level

  6. Aortic calcified particles modulate valvular endothelial and interstitial cells

    NARCIS (Netherlands)

    van Engeland, N.C.A.; Bertazzo, S.; Sarathchandra, P.; McCormack, A.; Bouten, C.V.C.; Yacoub, M.H.; Chester, A.H.; Latif, N.

    2017-01-01

    BACKGROUND: Normal and calcified human valve cusps, coronary arteries, and aortae harbor spherical calcium phosphate microparticles of identical composition and crystallinity, and their role remains unknown. OBJECTIVE: The objective was to examine the direct effects of isolated calcified particles

  7. A cusp catastrophe model of mid-long-term landslide evolution over low latitude highlands of China

    Science.gov (United States)

    Tao, Yun; Cao, Jie; Hu, Jinming; Dai, Zhicheng

    2013-04-01

    Based on a model describing a certain landslide case and catastrophe theory, we derived a cusp catastrophe model and corresponding inversion method to study mid-long-term landslide evolution. According to data of landslides, precipitation, and socioeconomic development from 1976 to 2008, the cusp catastrophe model describing this landslide evolution across a low-latitude highland area in China is obtained with the least squares method. Results of the model indicate that human activity determines landslide intensity. Local precipitation also impacts yearly landslide intensity to some extent, and controls the time when a strong and abrupt change in landslides occurs. During the period 1976-2008, there was an abrupt decrease of landslide intensity during 1994-1995, and an abrupt increase during 1995-1996. Since then, there have been frequent landslides in the low-latitude highland, with greater intensity. All these factors provide a scientific basis for formulating a contingency plan regarding landslide disasters.

  8. Study of NΣ cusp in p+p → p+K{sup +}+Λ with partial wave analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lu, S.; Muenzer, R.; Epple, E.; Fabbietti, L. [Excellenz Cluster Universe, Technische Universitaet Muenchen (Germany); Ritman, J.; Roderburg, E.; Hauenstein, F. [FZ Juelich (Germany); Collaboration: Hades and FOPI Collaboration

    2016-07-01

    In the last years, an analysis of exclusive reaction of p+p → p+K{sup +}+Λ has been carried out using Bonn-Gatchina Partial Wave Analysis. In a combined analysis of data from Hades, Fopi, Disto and Cosy-TOF, an energy dependent production process is determined. This analysis has shown that a sufficient description of the p+p → p+K{sup +}+Λ is quite challenging due to the presence of resonances N* and interference, which requires Partial Wave Analysis. A pronounced narrow structure is observed in its projection on the pΛ-invariant mass. This peak structure, which appears around the NΣ threshold, has a strongly asymmetric structure and is interpreted a NΣ cusp effect. In this talk, the results from a combined analysis will be shown, with a special focus on the NΣ cusp structure and a description using Flatte parametrization.

  9. Geometric Deformations of the Thoracic Aorta and Supra-Aortic Arch Branch Vessels Following Thoracic Endovascular Aortic Repair.

    Science.gov (United States)

    Ullery, Brant W; Suh, Ga-Young; Hirotsu, Kelsey; Zhu, David; Lee, Jason T; Dake, Michael D; Fleischmann, Dominik; Cheng, Christopher P

    2018-04-01

    To utilize 3-D modeling techniques to better characterize geometric deformations of the supra-aortic arch branch vessels and descending thoracic aorta after thoracic endovascular aortic repair. Eighteen patients underwent endovascular repair of either type B aortic dissection (n = 10) or thoracic aortic aneurysm (n = 8). Computed tomography angiography was obtained pre- and postprocedure, and 3-D geometric models of the aorta and supra-aortic branch vessels were constructed. Branch angle of the supra-aortic branch vessels and curvature metrics of the ascending aorta, aortic arch, and stented thoracic aortic lumen were calculated both at pre- and postintervention. The left common carotid artery branch angle was lower than the left subclavian artery angles preintervention ( P Supra-aortic branch vessel angulation remains relatively static when proximal landing zones are distal to the left common carotid artery.

  10. Aortopathy in Congenital Heart Disease in Adults: Aortic Dilatation with Decreased Aortic Elasticity that Impacts Negatively on Left Ventricular Function.

    Science.gov (United States)

    Niwa, Koichiro

    2013-04-01

    Bicuspid aortic valve and/or coarctation of the aorta are consistently associated with ascending aortic and para-coarctation medial abnormalities. Medial abnormalities in the ascending aorta are prevalent in other types of patients with a variety of forms congenital heart disease (CHD), such as single ventricle, persistent truncus arteriosus, transposition of the great arteries, hypoplastic left heart syndrome, tetralogy of Fallot. These abnormalities encompass a wide age range, and may predispose to dilatation, aneurysm, and rupture that necessitates aortic valve and root surgery. This dilatation can develop in CHD patients without stenotic region. These CHDs exhibit ongoing dilatation of the aortic root and reduced aortic elasticity and increased aortic stiffness that may relate to intrinsic properties of the aortic root. The concept of aortic dilatation is shifting a paradigm of aortic dilatation, as so called post stenotic dilatation, to primary intrinsic aortopahy. These aortic dilatation and increased stiffness can induce aortic aneurysm, rupture of the aorta and aortic regurgitation, but also provoke left ventricular hypertrophy, reduced coronary artery flow and left ventricular failure. We can recognize this association of aortic pathophysiological abnormality, aortic dilation and aorto-left ventricular interaction as a new clinical entity: "aortopathy".

  11. Aortic events in a nationwide Marfan syndrome cohort

    DEFF Research Database (Denmark)

    Groth, Kristian A; Krag, Kirstine Stochholm; Hove, Hanne

    2017-01-01

    BACKGROUND: Marfan syndrome is associated with morbidity and mortality due to aortic dilatation and dissection. Preventive aortic root replacement has been the standard treatment in Marfan syndrome patients with aortic dilatation. In this study, we present aortic event data from a nationwide Marfan...... syndrome cohort. METHOD: The nationwide cohort of Danish Marfan syndrome patients was established from the Danish National Patient Registry and the Cause of Death Register, where we retrieved information about aortic surgery and dissections. We associated aortic events with age, sex, and Marfan syndrome...

  12. [Aortic elastic properties and its clinical significance in intracranial aneurysms].

    Science.gov (United States)

    Pu, Zhao-xia; You, Xiang-dong; Weng, Wen-chao; Wang, Jian-an; Shi, Jian

    2011-09-01

    To investigate the aortic elastic properties and its clinical significance in intracranial aneurysms (IAs). One hundred and seven IAs patients (57 with hypertension) and 108 healthy subjects were recruited. The internal aortic diameters in systole and diastole were measured by the M-mode echocardiography, the aortic elasticity indexes were calculated and compared. The aortic distensibility (DIS) was lower and the aortic stiffness index (SI) was higher in IAs patients than those in controls (both P IAs patients with hypertension (IAs-HP) than those in IAs with no hypertension (P IAs patients and hypertension is closely related to the severity of aortic elasticity.

  13. Do Transient Electrodynamic Processes Support Enhanced Neutral Mass Densities in Earth's Cusp-Region Thermosphere via Divergent Upward Winds?

    Science.gov (United States)

    Conde, M.; Larsen, M. F.; Troyer, R.; Gillespie, D.; Kosch, M.

    2017-12-01

    Satellite accelerometer measurements show that Earth's thermosphere contains two substantial and permanent regions of enhanced mass density that are located at around 400 km altitude near the footprints of the north and south geomagnetic cusps. The additional mass in these regions must be supported against gravity, which requires that similarly localized perturbations must occur in one or more of the other fields (beyond mass density) that appear in the momentum conservation equation for the thermospheric neutral fluid. However more than a decade after the density enhancements were first discovered, there are still no observations of any other corresponding perturbations to terms appearing directly in this equation that would indicate what is supporting the extra mass. To date, most candidate mechanisms involve high-altitude transient electrodynamic heating (at 250 km and above) that drives upwelling and associated horizontal divergence. Indeed, there are very few viable mechanisms that don't ultimately cause substantial localized neutral wind perturbations to occur near the density anomalies. Thus, we report here on a study to search for signatures of these localized perturbations in winds, using several data sources. These are the WATS instrument that flew aboard the DE-2 spacecraft, the C-REX-1 rocket flight through the CUSP in 2014, and two ground-based Fabry-Perot instruments that are located in Antarctica at latitudes that pass under the geomagnetic cusps - i.e. at McMurdo and South Pole stations. Using these data, we will present both climatological averages and also individual case studies to illustrate what localized signatures occur (if any) in the neutral wind fields near the cusp-region density anomalies.

  14. CUSP9* treatment protocol for recurrent glioblastoma: aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, ritonavir, sertraline augmenting continuous low dose temozolomide.

    Science.gov (United States)

    Kast, Richard E; Karpel-Massler, Georg; Halatsch, Marc-Eric

    2014-09-30

    CUSP9 treatment protocol for recurrent glioblastoma was published one year ago. We now present a slight modification, designated CUSP9*. CUSP9* drugs--aprepitant, artesunate, auranofin, captopril, celecoxib, disulfiram, itraconazole, sertraline, ritonavir, are all widely approved by regulatory authorities, marketed for non-cancer indications. Each drug inhibits one or more important growth-enhancing pathways used by glioblastoma. By blocking survival paths, the aim is to render temozolomide, the current standard cytotoxic drug used in primary glioblastoma treatment, more effective. Although esthetically unpleasing to use so many drugs at once, the closely similar drugs of the original CUSP9 used together have been well-tolerated when given on a compassionate-use basis in the cases that have come to our attention so far. We expect similarly good tolerability for CUSP9*. The combined action of this suite of drugs blocks signaling at, or the activity of, AKT phosphorylation, aldehyde dehydrogenase, angiotensin converting enzyme, carbonic anhydrase -2,- 9, -12, cyclooxygenase-1 and -2, cathepsin B, Hedgehog, interleukin-6, 5-lipoxygenase, matrix metalloproteinase -2 and -9, mammalian target of rapamycin, neurokinin-1, p-gp efflux pump, thioredoxin reductase, tissue factor, 20 kDa translationally controlled tumor protein, and vascular endothelial growth factor. We believe that given the current prognosis after a glioblastoma has recurred, a trial of CUSP9* is warranted.

  15. Mechanical interactions of cuspal-coverage designs and cement thickness in a cusp-replacing ceramic premolar restoration: a finite element study.

    Science.gov (United States)

    Chang, Yen-Hsiang; Lin, Wen-Hsueng; Kuo, Wen-Chieh; Chang, Chia-Yu; Lin, Chun-Li

    2009-04-01

    The aim of this study was to investigate the biomechanical interactions between cuspal preparation designs and cement thickness in a cusp-replacing ceramic premolar restoration. The cavity was designed in a typical MODP (mesial-occlusal-distal- palatal) restoration failure shape when the palatal cusp has been lost. Twelve 3D finite element (FE) models with four cavity preparations (without coverage and with buccal cuspal coverage in 1.0, 1.5 and 2.0 mm reducing in cuspal height) and three cement thicknesses (50, 100 and 150 microm) were constructed to perform the simulations. The results indicated that enamel and cement stresses in designs with no buccal cusp replacement or a 1.0 mm thick buccal cusp replacement were higher than the designs with 1.5 and 2.0 mm thick replacement. No apparent differences were found in the dentin, enamel, and cement stresses based on cement thicknesses of 50, 100, or 150 microm. This study concluded that when cusp replacement is indicated, reduction of the buccal cusp by 1.5 mm at least could reduce stress.

  16. Aortic annulus and ascending aorta: Comparison of preoperative and periooperative measurement in patients with aortic stenosis

    International Nuclear Information System (INIS)

    Smid, Michal; Ferda, Jiri; Baxa, Jan; Cech, Jakub; Hajek, Tomas; Kreuzberg, Boris; Rokyta, Richard

    2010-01-01

    Background: Precise determination of the aortic annulus size constitutes an integral part of the preoperative evaluation prior to aortic valve replacement. It enables the estimation of the size of prosthesis to be implanted. Knowledge of the size of the ascending aorta is required in the preoperative analysis and monitoring of its dilation enables the precise timing of the operation. Our goal was to compare the precision of measurement of the aortic annulus and ascending aorta using magnetic resonance (MR), multidetector-row computed tomography (MDCT), transthoracic echocardiography (TTE), and transoesophageal echocardiography (TEE) in patients with degenerative aortic stenosis. Methods and results: A total of 15 patients scheduled to have aortic valve replacement were enrolled into this prospective study. TTE was performed in all patients and was supplemented with TEE, CT and MR in the majority of patients. The values obtained were compared with perioperative measurements. For the measurement of aortic annulus, MR was found to be the most precise technique, followed by MDCT, TTE, and TEE. For the measurement of ascending aorta, MR again was found to be the most precise technique, followed by MDCT, TEE, and TTE. Conclusion: In our study, magnetic resonance was found to be the most precise technique for the measurement of aortic annulus and ascending aorta in patients with severe degenerative aortic stenosis.

  17. Systematic review of the outcome of aortic valve replacement in patients with aortic stenosis

    NARCIS (Netherlands)

    Sharma, Umesh C.; Barenbrug, Paul; Pokharel, Saraswati; Dassen, Willem R. M.; Pinto, Yigal M.; Maessen, Jos G.

    2004-01-01

    BACKGROUND: After the establishment of aortic valve replacement procedure for aortic stenosis, there are heterogeneous studies and varying reports on outcome. An analysis that compares individual studies to summarize the overall effect is still lacking. This study systematically analyzes the change

  18. Aortic stiffness and diameter predict progressive aortic dilatation in patients with Marfan syndrome

    NARCIS (Netherlands)

    Nollen, Gijs J.; Groenink, Maarten; Tijssen, Jan G. P.; van der Wall, Ernst E.; Mulder, Barbara J. M.

    2004-01-01

    Aim Patients with Marfan syndrome may develop dissection due to progressive dilatation in the entire aorta, which is not always predictable by mere anatomic assessment of the aortic diameter, especially of the descending aorta. The aim of this study was to identify the predictive value of aortic

  19. Transcatheter aortic valve implantation: emerging role in poor left ventricular function severe aortic stenosis?

    Directory of Open Access Journals (Sweden)

    K. M. John Chan

    2014-01-01

    Full Text Available Transcatheter aortic valve implantation (TAVI has become an established treatment option for high risk elderly patients with symptomatic severe aortic stenosis. Its role in less high risk patients is being evaluated in clinical trials. Patients with severely impaired left ventricular function may be another group who may benefit from this emerging percutaneous treatment option.

  20. Effect of candesartan treatment on left ventricular remodeling after aortic valve replacement for aortic stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbaek, Lars; Poulsen, Mikael K

    2010-01-01

    In hypertension, angiotensin receptor blockers can augment regression of left ventricular (LV) hypertrophy. It is not known whether this also is the case after aortic valve replacement (AVR) for severe aortic stenosis (AS). To test the hypothesis that treatment with candesartan in addition to con...

  1. The dynamic cusp at low altitudes: A case study combining Viking, DMSP, and Sondrestrom incoherent scatter radar observations

    International Nuclear Information System (INIS)

    Watermann, J.; Delabeaujardiere, O.; Lummerzheim, D.; Woch, J.; Newell, P.T.; Potemra, T.A.; Rich, F.J.; Shapshak, M.

    1992-01-01

    A case study involving data from three satellites and a ground-based radar are presented. Focus is on a detailed discussion of observations of the dynamic cusp made on 24 Sep. 1986 in the dayside high-latitude ionosphere and interior magnetosphere. The relevant data from space-borne and ground-based sensors is presented. They include in-situ particle and field measurements from the DMSP-F7 and Viking spacecraft and Sondrestrom radar observations of the ionosphere. These data are augmented by observations of the IMF and the solar wind plasma. The observations are compared with predictions about the ionospheric response to the observed particle precipitation, obtained from an auroral model. It is shown that observations and model calculations fit well and provide a picture of the ionospheric footprint of the cusp in an invariant latitude versus local time frame. The combination of Viking, Sondrestrom radar, and IMP-8 data suggests that an ionospheric signature of the dynamic cusp was observed. Its spatial variation over time which appeared closely related to the southward component of the IMF was monitored

  2. Successful Ablation of Antero-septal Accessory Pathway in the Non-Coronary Cusp in a Child

    Directory of Open Access Journals (Sweden)

    Daisuke Kobayashi, MD

    2012-05-01

    Full Text Available A 15-year-old boy with Wolff-Parkinson-White syndrome underwent an electrophysiology study for symptoms of palpitations and persistence of pre-excitation during peak exercise. He was detected to have right antero-septal accessory pathway with relatively long effective refractory period and no inducible tachycardia. He had only transient normalization with cryoablation. Eight months later, he presented again with two episodes of seizures with preceding palpitations. Neurology evaluation was unremarkable with a normal electroencephalogram. In view of his symptoms in association with evidence of pre-excitation, he underwent a second electrophysiology study with ablation. Cryoablation in the anterior septum again achieved only transient normalization. Mapping in the non-coronary cusp identified an earliest accessory pathway potential. RF ablation was performed in the non- coronary cusp with immediate normalization of his electrocardiogram. At 6 month follow-up, he continues to have no pre-excitation on his EKG. Ablation of the anteroseptal accessory pathway in the non-coronary cusp can be safely performed in patients’ refractory to conventional ablation sites and techniques.

  3. Magnetic Cusp and Electric Nested- or Single-Well Configurations for High Density Antihydrogen and Fusion Nonneutral Plasma Applications

    International Nuclear Information System (INIS)

    C.A. Ordonez

    1999-01-01

    Malmberg-Penning traps have had limited uses for applications that require high density nonneutral plasma confinement. For such traps, the density is severely limited because a magnetic field is used to provide a radially inward force to balance both self-electric and centrifugal radially outward forces. A possible way to confine higher density nonneutral plasmas is to use a magnetic cusp configuration. An annular nonneutral plasma would be confined in the radial magnetic field of a magnetic cusp such that radial confinement is provided by an externally produced electric potential well while axial confinement is provided by the magnetic field. In addition, a radial electric potential profile having a nested-well configuration can be used to simultaneously confine two oppositely signed plasma species (e.g., positrons and antiprotons) that overlap. In the work reported, various aspects of using magnetic cusp configurations and electric nested-well configurations are considered. Plasma confinement with these configurations may be useful for obtaining fast antihydrogen recombination and trapping rates and for achieving practical fusion power production

  4. Magnetic cusp and electric nested- or single-well configurations for high density antihydrogen and fusion nonneutral plasma applications

    International Nuclear Information System (INIS)

    Ordonez, C. A.

    1999-01-01

    Malmberg-Penning traps have had limited uses for applications that require high density nonneutral plasma confinement. For such traps, the density is severely limited because a magnetic field is used to provide a radially inward force to balance both self-electric and centrifugal radially outward forces. A possible way to confine higher density nonneutral plasmas is to use a magnetic cusp configuration. An annular nonneutral plasma would be confined in the radial magnetic field of a magnetic cusp such that radial confinement is provided by an externally produced electric potential well while axial confinement is provided by the magnetic field. In addition, a radial electric potential profile having a nested-well configuration can be used to simultaneously confine two oppositely signed plasma species (e.g., positrons and antiprotons) that overlap. In the work reported, various aspects of using magnetic cusp configurations and electric nested-well configurations are considered. Plasma confinement with these configurations may be useful for obtaining fast antihydrogen recombination and trapping rates and for achieving practical fusion power production

  5. Overlapping ion structures in the mid-altitude cusp under northward IMF: signature of dual lobe reconnection?

    Directory of Open Access Journals (Sweden)

    F. Pitout

    2012-03-01

    Full Text Available On some rare occasions, data from the Cluster Ion Spectrometer (CIS in the mid-altitude cusp reveal overlapping ion populations under northward interplanetary magnetic field (IMF. While the poleward part of the cusp exhibits the expected reverse dispersion due to lobe reconnection, its equatorward part shows a second ion population at higher-energy that coexists with the low energy tail of the dispersion. This second population is either dispersionless or slightly dispersed with energies increasing with increasing latitudes, indicative of lobe reconnection as well. Our analysis of a case that occurred 3 September 2002 when the IMF stayed northward for more than two hours suggests that the second population comes from the opposite hemisphere and is very likely on newly-closed field lines. We interpret this overlap of cusp populations as a clear mid-altitude signature of re-closed magnetic field lines by double lobe reconnection (reconnection in both hemispheres under northward IMF. This interpretation is supported by modelling performed with the Cooling model and an MHD model.

  6. Studies on density dependence of charge separation in a direct energy converter using slanted Cusp magnetic field

    International Nuclear Information System (INIS)

    Munakata, Yoshiro; Kawaguchi, Takashi; Takeno, Hiromasa; Yasaka, Yasuyoshi; Ichimura, Kazuya; Nakashima, Yousuke

    2012-01-01

    In an advanced fusion, fusion-produced charged particles must be separated from each other for efficient energy conversion to electricity. The CuspDEC performs this function of separation and direct energy conversion. Analysis of working characteristics of CuspDEC on plasma density is an important subject. This paper summarizes and discusses experimental and theoretical works for high density plasma by using a small scale experimental device employing a slanted cusp magnetic field. When the incident plasma is low-density, good separation of the charged particles can be accomplished and this is explained by the theory based on a single particle motion. In high density plasma, however, this theory cannot be always applied due to space charge effects. In the experiment, as gradient of the field line increases, separation capability of the charged particles becomes higher. As plasma density becomes higher, however, separation capability becomes lower. This can be qualitatively explained by using calculations of the modified Störmer potential including space charge potential. (author)

  7. Particle-In-Cell Simulations of the Solar Wind Interaction with Lunar Crustal Magnetic Anomalies: Magnetic Cusp Regions

    Science.gov (United States)

    Poppe, A. R.; Halekas, J. S.; Delory, G. T.; Farrell, W. M.

    2012-01-01

    As the solar wind is incident upon the lunar surface, it will occasionally encounter lunar crustal remanent magnetic fields. These magnetic fields are small-scale, highly non-dipolar, have strengths up to hundreds of nanotesla, and typically interact with the solar wind in a kinetic fashion. Simulations, theoretical analyses, and spacecraft observations have shown that crustal fields can reflect solar wind protons via a combination of magnetic and electrostatic reflection; however, analyses of surface properties have suggested that protons may still access the lunar surface in the cusp regions of crustal magnetic fields. In this first report from a planned series of studies, we use a 1 1/2-dimensional, electrostatic particle-in-cell code to model the self-consistent interaction between the solar wind, the cusp regions of lunar crustal remanent magnetic fields, and the lunar surface. We describe the self-consistent electrostatic environment within crustal cusp regions and discuss the implications of this work for the role that crustal fields may play regulating space weathering of the lunar surface via proton bombardment.

  8. Application of thoracic endovascular aortic repair (TEVAR) in treating dwarfism with Stanford B aortic dissection

    Science.gov (United States)

    Qiu, Jian; Cai, Wenwu; Shu, Chang; Li, Ming; Xiong, Qinggen; Li, Quanming; Li, Xin

    2018-01-01

    Abstract Rationale: To apply thoracic endovascular aortic repair (TEVAR) to treat dwarfism complicated with Stanford B aortic dissection. Patient concerns: In this report, we presented a 63-year-old male patient of dwarfism complicated with Stanford B aortic dissection successfully treated with TEVAR. Diagnoses: He was diagnosed with dwarfism complicated with Stanford B aortic dissection. Interventions: After conservative treatment, the male patient underwent TEVAR at 1 week after hospitalization. After operation, he presented with numbness and weakness of his bilateral lower extremities, and these symptoms were significantly mitigated after effective treatment. At 1- and 3-week after TEVAR, the aorta status was maintained stable and restored. Outcomes: The patient obtained favorable clinical prognosis and was smoothly discharged. During subsequent follow-up, he remained physically stable. Lessons: TEVAR is probably an option for treating dwarfism complicated with Stanford B aortic dissection, which remains to be validated by subsequent studies with larger sample size. PMID:29703033

  9. Muscle activity and masticatory efficiency with bilateral extension base removable partial dentures with different cusp angles.

    Science.gov (United States)

    Al-Omiri, Mahmoud K

    2018-03-01

    Whether masticatory efficiency and electromyographic activity are influenced by type of artificial teeth and food is unclear. The purpose of this clinical study was to evaluate the influence of extension base removable partial dentures (RPDs) with different cusp angles: anatomic (33 degrees), semianatomic (20 degrees), and nonanatomic (0 degrees) teeth on masticatory efficiency and muscle activity during the mastication of test foods with different textures. Twelve participants with RPDs were selected to perform masticatory efficiency and electromyographic tests. Surface electromyograms (EMGs) were used to record the activities of the masseter and temporalis muscles during the mastication of different types of test foods. The maximal voltage and duration were measured on the integrated EMG signal in each muscle during food mastication, and the mean reading of both sides was then recorded. Analysis of variance and the Tukey post hoc test were used to perform statistical analyses (α=.05). The masticatory efficiency of RPDs with nonanatomic teeth was significantly inferior to that of RPDs with anatomic and semianatomic teeth (P.05). Also, muscle activity (according to EMG) with RPDs with NA teeth was significantly higher than that with anatomic and semianatomic teeth (P<.05). RPDs with NA teeth were associated with higher EMG muscle activity and reduced masticatory efficiency than anatomic or semianatomic teeth. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  10. Discrete prepotential as an indicator of successful ablation in patients with coronary cusp ventricular arrhythmia.

    Science.gov (United States)

    Hachiya, Hitoshi; Yamauchi, Yasuteru; Iesaka, Yoshito; Yagishita, Atsuhiko; Sasaki, Takeshi; Higuchi, Koji; Kawabata, Mihoko; Sugiyama, Koji; Tanaka, Yasuaki; Kusa, Shigeki; Nakamura, Hiroaki; Miyazaki, Shinsuke; Taniguchi, Hiroshi; Isobe, Mitsuaki; Hirao, Kenzo

    2013-10-01

    Although coronary cusp (CC) ventricular arrhythmia (VA) can be treated by catheter ablation, reliable indicators of successful ablation sites have not been fully identified. This study comprised 392 patients undergoing radiofrequency catheter ablation for outflow tract-VA at 3 institutions from January 2007 to August 2012. The successful ablation site was on the left CC or right CC in 35 (8.9%) of the 392 patients. In 9 (26%) of these 35 patients, a discrete prepotential was recognized, 5 of whom had left CC-VAs and 4 of whom had right CC-VAs. Radiofrequency catheter ablation was successful at the site of the prepotential in all 9 of these patients. The duration of the isoelectric line between the end of the discrete prepotential and the onset of the ventricular electrogram was 27±13 ms. The time from onset of the discrete prepotential at the successful ablation site on the CC to the QRS onset (activation time) was 69±20 ms (range, 50-98 ms). Pace mapping was graded as excellent at the successful ablation site in only 1 patient. No discrete prepotential was recorded in any successful right outflow tract-VA ablation case in this study. A discrete prepotential was seen in 9 (26%) of 35 patients with CC-VA. In left and right CC-VA, the site of a discrete prepotential with ≥50 ms activation time may indicate a successful ablation site.

  11. Wave particle interactions in the high-altitude polar cusp: a Cluster case study

    Directory of Open Access Journals (Sweden)

    B. Grison

    2005-12-01

    Full Text Available On 23 March 2002, the four Cluster spacecraft crossed in close configuration (~100 km separation the high-altitude (10 RE cusp region. During a large part of the crossing, the STAFF and EFW instruments have detected strong electromagnetic wave activity at low frequencies, especially when intense field-aligned proton fluxes were detected by the CIS/HIA instrument. In all likelihood, such fluxes correspond to newly-reconnected field lines. A focus on one of these ion injection periods highlights the interaction between waves and protons. The wave activity has been investigated using the k-filtering technique. Experimental dispersion relations have been built in the plasma frame for the two most energetic wave modes. Results show that kinetic Alfvén waves dominate the electromagnetic wave spectrum up to 1 Hz (in the spacecraft frame. Above 0.8 Hz, intense Bernstein waves are also observed. The close simultaneity observed between the wave and particle events is discussed as an evidence for local wave generation. A mechanism based on current instabilities is consistent with the observations of the kinetic Alfvén waves. A weak ion heating along the recently-opened field lines is also suggested from the examination of the ion distribution functions. During an injection event, a large plasma convection motion, indicative of a reconnection site location, is shown to be consistent with the velocity perturbation induced by the large-scale Alfvén wave simultaneously detected.

  12. Wave particle interactions in the high-altitude polar cusp: a Cluster case study

    Directory of Open Access Journals (Sweden)

    B. Grison

    2005-12-01

    Full Text Available On 23 March 2002, the four Cluster spacecraft crossed in close configuration (~100 km separation the high-altitude (10 RE cusp region. During a large part of the crossing, the STAFF and EFW instruments have detected strong electromagnetic wave activity at low frequencies, especially when intense field-aligned proton fluxes were detected by the CIS/HIA instrument. In all likelihood, such fluxes correspond to newly-reconnected field lines. A focus on one of these ion injection periods highlights the interaction between waves and protons. The wave activity has been investigated using the k-filtering technique. Experimental dispersion relations have been built in the plasma frame for the two most energetic wave modes. Results show that kinetic Alfvén waves dominate the electromagnetic wave spectrum up to 1 Hz (in the spacecraft frame. Above 0.8 Hz, intense Bernstein waves are also observed. The close simultaneity observed between the wave and particle events is discussed as an evidence for local wave generation. A mechanism based on current instabilities is consistent with the observations of the kinetic Alfvén waves. A weak ion heating along the recently-opened field lines is also suggested from the examination of the ion distribution functions. During an injection event, a large plasma convection motion, indicative of a reconnection site location, is shown to be consistent with the velocity perturbation induced by the large-scale Alfvén wave simultaneously detected.

  13. Determination of Local Magnetic Dipole Moment of the Plasma at the PUPR Cusp-Mirror Machine

    International Nuclear Information System (INIS)

    Leal-Quiros, Edbertho; Prelas, Mark

    2006-01-01

    A novel diagnostic that allows measurement of the magnetic moment μ has been designed. The μ-Analyzer consists of a Directional Energy Analyzer and a Magnetic Hall Probe in the same detector miniature case. The Directional Energy Analyzer measures the ion temperature in the perpendicular direction to the magnetic field. On the other side, the Hall Probe measures the magnetic field. The μ-Analyzer is a miniature analyzer to avoid plasma perturbation. This allows the measurement of the ion temperature and the local magnetic field at the same point at the same time, therefore μ, the first adiabatic invariant is found. From the above parameters, the local Larmor radius also will be calculated. From the analysis of the data simultaneously in time and space, the μ of the Local Plasma has been determined. This result is a very important quantity, among other properties that permit one to know the stability of the magnetic confinement device using the MHD Stability Criterium, and also very important in Space Plasma Research. In addition to the above, a direct measurement of the Larmor radius of each position is also possible. The experiments have been made in a Cusp/Mirror Plasma Machine where plasma parameters such as Density and Temperature are relatively easy to change in a very wide range

  14. High Fidelity Multi-Objective Design Optimization of a Downscaled Cusped Field Thruster

    Directory of Open Access Journals (Sweden)

    Thomas Fahey

    2017-11-01

    Full Text Available The Cusped Field Thruster (CFT concept has demonstrated significantly improved performance over the Hall Effect Thruster and the Gridded Ion Thruster; however, little is understood about the complexities of the interactions and interdependencies of the geometrical, magnetic and ion beam properties of the thruster. This study applies an advanced design methodology combining a modified power distribution calculation and evolutionary algorithms assisted by surrogate modeling to a multi-objective design optimization for the performance optimization and characterization of the CFT. Optimization is performed for maximization of performance defined by five design parameters (i.e., anode voltage, anode current, mass flow rate, and magnet radii, simultaneously aiming to maximize three objectives; that is, thrust, efficiency and specific impulse. Statistical methods based on global sensitivity analysis are employed to assess the optimization results in conjunction with surrogate models to identify key design factors with respect to the three design objectives and additional performance measures. The research indicates that the anode current and the Outer Magnet Radius have the greatest effect on the performance parameters. An optimal value for the anode current is determined, and a trend towards maximizing anode potential and mass flow rate is observed.

  15. On the altitude dependence of transversely heated O+ distributions in the cusp/cleft

    Directory of Open Access Journals (Sweden)

    L. Kistler

    2004-04-01

    Full Text Available The present paper focuses on the altitude dependence of oxygen ion conics in the dayside cusp/cleft region. Here, combining oxygen data from the Akebono, Interball-2 and Cluster satellites allows, for the first time, one to follow the global development of energetic (up to ~10keV ion outflow over a continuous and broad altitude range up to about 5.5 Earth radii (RE. According to earlier statistical studies, the results are consistent with a height-integrated energization of ions at altitudes up to 3.5 RE. Higher up, the results inferred from Cluster observations put forward evidence of a saturation of both a transverse energization rate and ion gyroradii. We suggest that such results may be interpreted as finite perpendicular wavelength effects (a few tens of km in the wave-particle interactions. To substantiate the suggestion, we carry out two-dimensional, Monte Carlo simulations of ion conic production that incorporate such effects and limited residence times due to the finite latitudinal extent of the heating region.Key words. Magnetospheric physics (auroral phenomena – Space plasma physics (charged particle motion and acceleration; wave-particle interactions

  16. Cusping, transport and variance of solutions to generalized Fokker-Planck equations

    Science.gov (United States)

    Carnaffan, Sean; Kawai, Reiichiro

    2017-06-01

    We study properties of solutions to generalized Fokker-Planck equations through the lens of the probability density functions of anomalous diffusion processes. In particular, we examine solutions in terms of their cusping, travelling wave behaviours, and variance, within the framework of stochastic representations of generalized Fokker-Planck equations. We give our analysis in the cases of anomalous diffusion driven by the inverses of the stable, tempered stable and gamma subordinators, demonstrating the impact of changing the distribution of waiting times in the underlying anomalous diffusion model. We also analyse the cases where the underlying anomalous diffusion contains a Lévy jump component in the parent process, and when a diffusion process is time changed by an uninverted Lévy subordinator. On the whole, we present a combination of four criteria which serve as a theoretical basis for model selection, statistical inference and predictions for physical experiments on anomalously diffusing systems. We discuss possible applications in physical experiments, including, with reference to specific examples, the potential for model misclassification and how combinations of our four criteria may be used to overcome this issue.

  17. Cluster observations of high-frequency waves in the exterior cusp

    Directory of Open Access Journals (Sweden)

    Y. Khotyaintsev

    2004-07-01

    Full Text Available We study wave emissions, in the frequency range from above the lower hybrid frequency up to the plasma frequency, observed during one of the Cluster crossings of a high-beta exterior cusp region on 4 March 2003. Waves are localized near narrow current sheets with a thickness a few times the ion inertial length; currents are strong, of the order of 0.1-0.5μA/m2 (0.1-0.5mA/m2 when mapped to ionosphere. The high frequency part of the waves, frequencies above the electron-cyclotron frequency, is analyzed in more detail. These high frequency waves can be broad-band, can have spectral peaks at the plasma frequency or spectral peaks at frequencies below the plasma frequency. The strongest wave emissions usually have a spectral peak near the plasma frequency. The wave emission intensity and spectral character change on a very short time scale, of the order of 1s. The wave emissions with strong spectral peaks near the plasma frequency are usually seen on the edges of the narrow current sheets. The most probable generation mechanism of high frequency waves are electron beams via bump-on-tail or electron two-stream instability. Buneman and ion-acoustic instability can be excluded as a possible generation mechanism of waves. We suggest that high frequency waves are generated by electron beams propagating along the separatrices of the reconnection region.

  18. Stability of interbed for salt cavern gas storage in solution mining considering cusp displacement catastrophe theory

    Directory of Open Access Journals (Sweden)

    Le Yu

    2015-03-01

    Full Text Available Cusp displacement catastrophe theory can be introduced to propose a new method about instability failure of the interbed for gas storage cavern in bedded salt in solution mining. We can calculate initial fracture drawing pace of this interbed to obtain 2D and 3D gas storage shapes at this time. Moreover, Stability evaluation of strength reduction finite element method (FEM based on this catastrophe theory can used to evaluate this interbed stability after initial fracture. A specific example is simulated to obtain the influence of the interbed depth, cavern internal pressure, and cavern building time on stability safety factor (SSF. The results indicate: the value of SSF will be lower with the increase of cavern building time in solution mining and the increase of interbed depth and also this value remains a rise with the increase of cavern internal pressure Especially, we can conclude that the second-fracture of the interbed may take place when this pressure is lower than 6 MPa or after 6 days later of the interbed after initial fracture. According to above analysis, some effective measures, namely elevating the tube up to the top of the interbed, or changing the circulation of in-and-out lines, can be introduced to avoid the negative effects when the second-fracture of the interbed may occur.

  19. Black Holes and Galactic Density Cusps III From Black Hole to Bulge

    CERN Document Server

    Henriksen, Richard N; Macmillan, Joseph D

    2011-01-01

    Aims. In this paper we continue our study of density cusps that may contain central black holes. Methods. We recall our attempts to use distribution functions with a memory of self-similar relaxation, but mostly they apply only in restricted regions of the global system. We are forced to consider related distribution functions that are steady but not self-similar. Results. One remarkably simple distribution function that has a filled loss cone describes a bulge that transits from a near black hole domain to an outer 'zero flux' regime where$\\rho\\propto r^{-7/4}$. The transition passes from an initial inverse square profile through a region having a 1/r density profile. The structure is likely to be developed at an early stage in the growth of a galaxy. A central black hole is shown to grow exponentially in this background with an e-folding time of a few million years. Conclusions. We derive our results from first principles, using only the angular momentum integral in spherical symmetry. The initial relaxatio...

  20. Polar spacecraft observations of the turbulent outer cusp/magnetopause boundary layer of Earth

    Directory of Open Access Journals (Sweden)

    J. S. Pickett

    1999-01-01

    Full Text Available The orbit of the Polar spacecraft has been ideally suited for studying the turbulent region of the cusp that is located near or just outside the magnetopause current sheet at 7-9 RE. The wave data obtained in this region show that electromagnetic turbulence is dominant in the frequency range 1-10 Hz. The waves responsible for this turbulence usually propagate perpendicular to the local magnetic field and have an index of refraction that generally falls between the estimated cold plasma theoretical values of the electromagnetic lower hybrid and whistler modes and may be composed of both modes in concert with kinetic Alfvén waves and/or fast magnetosonic waves. Fourier spectra of the higher frequency wave data also show the electromagnetic turbulence at frequencies up to and near the electron cyclotron frequency. This higher frequency electromagnetic turbulence is most likely associated with whistler mode waves. The lower hybrid drift and current gradient instabilities are suggested as possible mechanisms for producing the turbulence. The plasma and field environment of this turbulent region is examined and found to be extremely complex. Some of the wave activity is associated with processes occurring locally, such as changes in the DC magnetic field, while others are associated with solar wind and interplanetary magnetic field changes.

  1. Polar Spacecraft Observations of the Turbulent Outer Cusp/Magnetopause Boundary Layer of Earth

    Science.gov (United States)

    Pickett, J. S.; Menietti, J. D.; Dowell, J. H.; Gurnett, D. A.; Scudder, J. D.

    1999-01-01

    The orbit of the Polar spacecraft has been ideally suited for studying the turbulent region of the cusp that is located near or just outside the magnetopause current sheet at 7-9 R(sub E). The wave data obtained in this region show that electromagnetic turbulence is dominant in the frequency range 1-10 Hz. The waves responsible for this turbulence usually propagate perpendicular to the local magnetic field and have an index of refraction that generally falls between the estimated cold plasma theoretical values of the electromagnetic lower hybrid and whistler modes and may be composed of both modes in concert with kinetic Alfven waves and/or fast magnetosonic waves. Fourier spectra of the higher frequency wave data also show the electromagnetic turbulence at frequencies up to and near the electron cyclotron frequency. This higher frequency electromagnetic turbulence is most likely associated with whistler mode waves. The lower hybrid drift and current gradient instabilities are suggested as possible mechanisms for producing the turbulence. The plasma and field environment of this turbulent region is examined and found to be extremely complex. Some of the wave activity is associated with processes occurring locally, such as changes in the DC magnetic field, while others are associated with solar wind and interplanetary magnetic field changes.

  2. Deformation of the Galactic Centre stellar cusp due to the gravity of a growing gas disc

    Science.gov (United States)

    Kaur, Karamveer; Sridhar, S.

    2018-06-01

    The nuclear star cluster surrounding the massive black hole at the Galactic Centre consists of young and old stars, with most of the stellar mass in an extended, cuspy distribution of old stars. The compact cluster of young stars was probably born in situ in a massive accretion disc around the black hole. We investigate the effect of the growing gravity of the disc on the orbits of the old stars, using an integrable model of the deformation of a spherical star cluster with anisotropic velocity dispersions. A formula for the perturbed phase-space distribution function is derived using linear theory, and new density and surface density profiles are computed. The cusp undergoes a spheroidal deformation with the flattening increasing strongly at smaller distances from the black hole; the intrinsic axis ratio ˜0.8 at ˜0.15 pc. Stellar orbits are deformed such that they spend more time near the disc plane and sample the dense inner parts of the disc; this could result in enhanced stripping of the envelopes of red giant stars. Linear theory accounts only for orbits whose apsides circulate. The non-linear theory of adiabatic capture into resonance is needed to understand orbits whose apsides librate. The mechanism is a generic dynamical process, and it may be common in galactic nuclei.

  3. Magnetic Field Effects on the Plume of a Diverging Cusped-Field Thruster

    KAUST Repository

    Matlock, Taylor

    2010-07-25

    The Diverging Cusped-Field Thruster (DCFT) uses three permanent ring magnets of alternating polarity to create a unique magnetic topology intended to reduce plasma losses to the discharge chamber surfaces. The magnetic field strength within the DCFT discharge chamber (up to 4 kG on axis) is much higher than in thrusters of similar geometry, which is believed to be a driving factor in the high measured anode efficiencies. The field strength in the near plume region is large as well, which may bear on the high beam divergences measured, with peaks in ion current found at angles of around 30-35 from the thruster axis. Characterization of the DCFT has heretofore involved only one magnetic topology. It is then the purpose of this study to investigate changes to the near-field plume caused by altering the shape and strength of the magnetic field. A thick magnetic collar, encircling the thruster body, is used to lower the field strength outside of the discharge chamber and thus lessen any effects caused by the external field. Changes in the thruster plume with field topology are monitored by the use of normal Langmuir and emissive probes interrogating the near-field plasma. Results are related to other observations that suggest a unified conceptual framework for the important near-exit region of the thruster.

  4. Cluster observations of the high-latitude magnetopause and cusp: initial results from the CIS ion instruments

    Directory of Open Access Journals (Sweden)

    J. M. Bosqued

    2001-09-01

    Full Text Available Launched on an elliptical high inclination orbit (apogee: 19.6 RE since January 2001 the Cluster satellites have been conducting the first detailed three-dimensional studies of the high-latitude dayside magnetosphere, including the exterior cusp, neighbouring boundary layers and magnetopause regions. Cluster satellites carry the CIS ion spectrometers that provide high-precision, 3D distributions of low-energy (<35 keV/e ions every 4 s. This paper presents the first two observations of the cusp and/or magnetopause behaviour made under different interplanetary magnetic field (IMF conditions. Flow directions, 3D distribution functions, density profiles and ion composition profiles are analyzed to demonstrate the high variability of high-latitude regions. In the first crossing analyzed (26 January 2001, dusk side, IMF-BZ < 0, multiple, isolated boundary layer, magnetopause and magnetosheath encounters clearly occurred on a quasi-steady basis for ~ 2 hours. CIS ion instruments show systematic accelerated flows in the current layer and adjacent boundary layers on the Earthward side of the magnetopause. Multi-point analysis of the magnetopause, combining magnetic and plasma data from the four Cluster spacecraft, demonstrates that oscillatory outward-inward motions occur with a normal speed of the order of ± 40 km/s; the thickness of the high-latitude current layer is evaluated to be of the order of 900–1000 km. Alfvénic accelerated flows and D-shaped distributions are convincing signatures of a magnetic reconnection occurring equatorward of the Cluster satellites. Moreover, the internal magnetic and plasma structure of a flux transfer event (FTE is analyzed in detail; its size along the magnetopause surface is ~ 12 000 km and it convects with a velocity of ~ 200 km/s. The second event analyzed (2 February 2001 corresponds to the first Cluster pass within the cusp when the IMF-BZ component was northward directed. The analysis of relevant CIS plasma

  5. Cluster observations of the high-latitude magnetopause and cusp: initial results from the CIS ion instruments

    Directory of Open Access Journals (Sweden)

    J. M. Bosqued

    Full Text Available Launched on an elliptical high inclination orbit (apogee: 19.6 RE since January 2001 the Cluster satellites have been conducting the first detailed three-dimensional studies of the high-latitude dayside magnetosphere, including the exterior cusp, neighbouring boundary layers and magnetopause regions. Cluster satellites carry the CIS ion spectrometers that provide high-precision, 3D distributions of low-energy (<35 keV/e ions every 4 s. This paper presents the first two observations of the cusp and/or magnetopause behaviour made under different interplanetary magnetic field (IMF conditions. Flow directions, 3D distribution functions, density profiles and ion composition profiles are analyzed to demonstrate the high variability of high-latitude regions. In the first crossing analyzed (26 January 2001, dusk side, IMF-BZ < 0, multiple, isolated boundary layer, magnetopause and magnetosheath encounters clearly occurred on a quasi-steady basis for ~ 2 hours. CIS ion instruments show systematic accelerated flows in the current layer and adjacent boundary layers on the Earthward side of the magnetopause. Multi-point analysis of the magnetopause, combining magnetic and plasma data from the four Cluster spacecraft, demonstrates that oscillatory outward-inward motions occur with a normal speed of the order of ± 40 km/s; the thickness of the high-latitude current layer is evaluated to be of the order of 900–1000 km. Alfvénic accelerated flows and D-shaped distributions are convincing signatures of a magnetic reconnection occurring equatorward of the Cluster satellites. Moreover, the internal magnetic and plasma structure of a flux transfer event (FTE is analyzed in detail; its size along the magnetopause surface is ~ 12 000 km and it convects with a velocity of ~ 200 km/s. The second event analyzed (2 February 2001 corresponds to the first Cluster pass within the cusp when the IMF-BZ component was northward directed. The analysis of

  6. Automated Normalized Cut Segmentation of Aortic Root in CT Angiography

    NARCIS (Netherlands)

    Elattar, Mustafa; Wiegerinck, Esther; Planken, Nils; VanBavel, Ed; van Assen, Hans; Baan, Jan Jr; Marquering, Henk

    2014-01-01

    Transcatheter Aortic Valve Implantation (TAVI) is a new minimal-invasive intervention for implanting prosthetic valves in patients with aortic stenosis. This procedure is associated with adverse effects like paravalvular leakage, stroke, and coronary obstruction. Accurate automated sizing for

  7. Cirurgia das dissecções crónicas da aorta ascendente com insuficiência valvar Surgery of chronic aortic dissection with aortic insufficiency

    Directory of Open Access Journals (Sweden)

    Paulo M Pêgo-Fernandes

    1990-12-01

    menor índice de complicações a médio prazo do que a substituição valvar; 2 a identificação do mecanismno da insuficiência valvar é fundamental para decisão da tática operatória; 3 o uso da cola biológica facilita o manuseio da aorta e pode diminuir o sangramento intra-operatório; 4 quando é necessária a substituição valvar tem-se preferido empregar prótese mecânica dada a maior dificuldade técnica na reoperaçáo nesses pacientes; 5 a aortoplastia não deve ser utilizada devido à alta incidência de redissecção aórtica.In the period of January 1980 to December 1988, 44 patients with chronic aortic dissections and aortic insufficiency were operated on. This group of patients was analized in order to evaluate the evolution of those in which the aortic valve was preserved compared to the group of patients submitted to valvular replacement. The overall preoperative characteristics of these two groups were similar. Valvular replacement was the elected procedure in cases of valvular degeneration or of aortic annular ectasia. In cases of cusp prolapse with enlarged annulus a plastic procedure was used; in 48% of the cases it was possible to preserve the valve. In the 23 patients submitted to valve replacement, the Bentall and De Bono technique was utilized. In six patientes other surgical procedures were associated. Biological adhesives were utilized in every patient operated on from 1986 on. In 41 patients (93% the proximal aorta was substituted and in the remaining three an aortoplasty was performed. Five patients (11% had hospitalar deaths, three due to low-output syndrome, one due to bleeding and one on account of neurological complications. Late death occurred in two patients (4%. The follow-up of the 37 surviving patients varied from two to 108 months (mean: 18 months; of these, 78% were in fuctional class I, and the others in class II. Two patients that had their aortic valve preserved presented mild aortic insufficiency. Three patients with

  8. Quantification of aortic regurgitation by magnetic resonance velocity mapping

    DEFF Research Database (Denmark)

    Søndergaard, Lise; Lindvig, K; Hildebrandt, P

    1993-01-01

    The use of magnetic resonance (MR) velocity mapping in the quantification of aortic valvular blood flow was examined in 10 patients with angiographically verified aortic regurgitation. MR velocity mapping succeeded in identifying and quantifying the regurgitation in all patients, and the regurgit......The use of magnetic resonance (MR) velocity mapping in the quantification of aortic valvular blood flow was examined in 10 patients with angiographically verified aortic regurgitation. MR velocity mapping succeeded in identifying and quantifying the regurgitation in all patients...

  9. Hybrid treatment of aortic arch disease

    Science.gov (United States)

    Metzger, Patrick Bastos; Rossi, Fabio Henrique; Moreira, Samuel Martins; Issa, Mario; Izukawa, Nilo Mitsuru; Dinkhuysen, Jarbas J.; Spina Neto, Domingos; Kambara, Antônio Massamitsu

    2014-01-01

    Introduction The management of thoracic aortic disease involving the ascending aorta, aortic arch and descending thoracic aorta are technically challenging and is an area in constant development and innovation. Objective To analyze early and midterm results of hybrid treatment of arch aortic disease. Methods Retrospective study of procedures performed from January 2010 to December 2012. The end points were the technical success, therapeutic success, morbidity and mortality, neurologic outcomes, the rate of endoleaks and reinterventions. Results A total of 95 patients treated for thoracic aortic diseases in this period, 18 underwent hybrid treatment and entered in this study. The average ages were 62.3 years. The male was present in 66.7%. The technical and therapeutic success was 94.5% e 83.3%. The perioperative mortality rate of 11.1%. There is any death during one-year follow- up. The reoperation rates were 16.6% due 2 cases of endoleak Ia and one case of endoleak II. There is any occlusion of anatomic or extra anatomic bypass during follow up. Conclusion In our study, the hybrid treatment of aortic arch disease proved to be a feasible alternative of conventional surgery. The therapeutic success rates and re- interventions obtained demonstrate the necessity of thorough clinical follow-up of these patients in a long time. PMID:25714205

  10. Qureshi-5 Catheter for Complex Supra- and Abdominal-Aortic Catheterization.

    Science.gov (United States)

    Qureshi, Adnan I; Xiao, WeiGang; Liu, HongLiang

    2015-10-01

    The use of previously described catheter technique was expanded to complex supra- and abdominal- aortic catheterizations. A new (Qureshi 5) catheter with curved shape at the distal end that has two lumens was used. One of lumens can accommodate a 0.035-inch guide wire and the second lumen can accommodate a 0.018-inch guide wire and terminates at the beginning of the distal curve of the first lumen. The manipulation and engagement of the curved distal end catheter was facilitated by rotation and movement of the J-shaped 0.018-inch guide wire extended coaxial and beyond the distal end of catheter. Subsequently, either contrast was injected or a 0.035-inch guide wire advanced into the target artery. The catheters were used in one patient to perform diagnostic cerebral and abdominal angiography through a 6F introducer sheath placed in the right common femoral artery. The catheterization was complex because of severe tortuosity of arch and descending aorta secondary to kyphosis. The left and right internal carotid arteries and left and right vertebral arteries, left renal artery, and superior mesenteric artery were catheterized in patient (fluoroscopy time 19:46 min). No complications were observed in the patient. The Qureshi-5 catheter was successful in complex supra- and abdominal-aortic catheterizations.

  11. Impact of bicuspid aortic valve on complications and death in infective endocarditis of native aortic valves.

    Science.gov (United States)

    Kahveci, Gokhan; Bayrak, Fatih; Pala, Selcuk; Mutlu, Bulent

    2009-01-01

    We retrospectively investigated the impact of bicuspid aortic valve on the prognosis of patients who had definite infective endocarditis of the native aortic valve.Of 51 patients, a bicuspid aortic valve was present in 22 (43%); the other 29 had tricuspid aortic valves. On average, the patients who had bicuspid valves were younger than those who had tricuspid valves. Patients with a tricuspid valve had larger left atrial diameters and were more likely to have severe mitral regurgitation.Periannular complications, which we detected in 19 patients (37%), were much more common in the patients who had a bicuspid valve (64% vs 17%, P = 0.001). The presence of a bicuspid valve was the only significant independent predictor of periannular complications. The in-hospital mortality rate in the bicuspid group was lower than that in the tricuspid group; however, this figure did not reach statistical significance (9% vs 24%, P = 0.15). In multivariate analysis, left atrial diameter was the only independent predictor associated with an increased risk of death (hazard ratio, 2.19; 95% confidence interval, 1.1-4.5; P = 0.031).In our study, patients with infective endocarditis in a bicuspid aortic valve were younger and had a higher incidence of periannular complications. Although a worse prognosis has been reported previously, we found that infective endocarditis in a native bicuspid aortic valve is not likely to increase the risk of death in comparison with infective endocarditis in native tricuspid aortic valves.

  12. Total Endovascular Aortic Repair in a Patient with Marfan Syndrome.

    Science.gov (United States)

    Amako, Mau; Spear, Rafaëlle; Clough, Rachel E; Hertault, Adrien; Azzaoui, Richard; Martin-Gonzalez, Teresa; Sobocinski, Jonathan; Haulon, Stéphan

    2017-02-01

    The aim of this study is to describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement. In 2013, the patient presented with endocarditis and pulmonary infection, which necessitated tracheostomy and temporary dialysis. In 2014, the first stage of the endovascular repair was performed using an inner branched endograft to exclude a 77-mm distal arch and descending thoracic aortic aneurysm. In 2015, a 63-mm thoracoabdominal aortic aneurysm was excluded by implantation of a 4-fenestrated endograft. Follow-up after both endovascular repairs was uneventful. Total aortic endovascular repair was successfully performed to treat a patient with arch and thoraco-abdominal aortic aneurysm associated with chronic aortic dissection and Marfan syndrome. The postoperative images confirmed patency of the endograft and its branches, and complete exclusion of the aortic false lumen. Endovascular repair is a treatment option in patients with connective tissue disease who are not candidates for open surgery. Long-term follow-up is required to confirm these favorable early outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Aortic valve replacement and the stentless Freedom SOLO valve

    NARCIS (Netherlands)

    Wollersheim, L.W.L.M.

    2016-01-01

    Aortic valve stenosis has become the most prevalent valvular heart disease in Europe and North America, and is generally caused by age-related calcification of the aortic valve. For most patients, severe symptomatic aortic stenosis needs effective mechanical relief in the form of valve replacement

  14. Intermittent, Non Cyclic Severe Mechanical Aortic Valve Regurgitation

    Science.gov (United States)

    Choi, Jong Hyun; Song, Seunghwan; Lee, Myung-Yong

    2013-01-01

    Mechanical aortic prosthesis dysfunction can result from thrombosis or pannus formation. We describe an unusual case of intermittent, non cyclic mechanical aortic prosthesis dysfunction due to pannus formation with thrombus in the absence of systolic restriction of disk excursion, that presented with intermittent severe aortic regurgitation. PMID:24459568

  15. Aortic microcalcification is associated with elastin fragmentation in Marfan syndrome

    NARCIS (Netherlands)

    Wanga, Shaynah; Hibender, Stijntje; Ridwan, Yanto; van Roomen, Cindy; Vos, Mariska; van der Made, Ingeborg; van Vliet, Nicole; Franken, Romy; van Riel, Luigi Amjg; Groenink, Maarten; Zwinderman, Aeilko H.; Mulder, Barbara Jm; de Vries, Carlie Jm; Essers, Jeroen; de Waard, Vivian

    2017-01-01

    Marfan syndrome (MFS) is a connective tissue disorder in which aortic rupture is the major cause of death. MFS patients with an aortic diameter below the advised limit for prophylactic surgery ( <5 cm) may unexpectedly experience an aortic dissection or rupture, despite yearly monitoring. Hence,

  16. Challenging Friesian horse diseases : aortic rupture and megaesophagus

    NARCIS (Netherlands)

    Ploeg, M.

    2015-01-01

    Aortic rupture is quite rare in Warmblood horses and is best known as an acute and fatal rupture of the aortic root in older breeding stallions. It has now become clear that aortic rupture, which is diagnosed around an age of 4 years, is more frequent in the Friesian breed than in others. The high

  17. Descriptive Analysis of In Vitro Cutting of Swine Mitral Cusps: Comparison of High-Power Laser and Scalpel Blade Cutting Techniques.

    Science.gov (United States)

    Pinto, Nathali Cordeiro; Pomerantzeff, Pablo Maria Alberto; Deana, Alessandro; Zezell, Denise; Benetti, Carolina; Aiello, Vera Demarchi; Lopes, Luciana Almeida; Jatene, Fabio Biscegli; Chavantes, M Cristina

    2017-02-01

    The most common injury to the heart valve with rheumatic involvement is mitral stenosis, which is the reason for a big number of cardiac operations in Brazil. Commissurotomy is the traditional technique that is still widely used for this condition, although late postoperative restenosis is concerning. This study's purpose was to compare the histological findings of porcine cusp mitral valves treated in vitro with commissurotomy with a scalpel blade to those treated with high-power laser (HPL) cutting, using appropriate staining techniques. Five mitral valves from healthy swine were randomly divided into two groups: Cusp group (G1), cut with a scalpel blade (n = 5), and Cusp group (G2), cut with a laser (n = 5). G2 cusps were treated using a diode laser (λ = 980 nm, power = 9.0 W, time = 12 sec, irradiance = 5625 W/cm 2 , and energy = 108 J). In G1, no histological change was observed in tissue. A hyaline basophilic aspect was focally observed in G2, along with a dark red color on the edges and areas of lower birefringence, when stained with hematoxylin-eosin, Masson's trichrome, and Sirius red. Further, the mean distances from the cutting edge in cusps submitted to laser application and stained with Masson's trichrome and Sirius red were 416.7 and 778.6 μm, respectively, never overcoming 1 mm in length. Thermal changes were unique in the group submitted to HPL and not observed in the cusp group cut with a scalpel blade. The mean distance of the cusps' collagen injury from the cutting edge was less than 1 mm with laser treatment. Additional studies are needed to establish the histological evolution of the laser cutting and to answer whether laser cutting may avoid valvular restenosis better than blade cutting.

  18. Dissection of Retroesophageal Aortic Diverticulum and Descending Aorta in a Patient with Right Aortic Arch: Magnetic Resonance Demonstration

    International Nuclear Information System (INIS)

    Ko, S.-F.; Ng, S.-H.; Fu, Morgan; Lo, P.-H.; Cheng, Y.-F.; Lee, T.-Y.

    1996-01-01

    An acute aortic dissection involved the retroesophageal aortic diverticulum (RAD) and descending thoracic aorta in a patient with right aortic arch. The RAD, which was separated into false and true lumens by an intimal flap-the classic diagnostic sign of aortic dissection-was overlooked on transesophageal echocardiography and computed tomography but was clearly depicted on magnetic resonance imaging (MRI). It was found that MRI can delineate the anatomy of a congenital arch anomaly complicated by great vessels disease

  19. Microarray analysis to identify the similarities and differences of pathogenesis between aortic occlusive disease and abdominal aortic aneurysm.

    Science.gov (United States)

    Wang, Guofu; Bi, Lechang; Wang, Gaofeng; Huang, Feilai; Lu, Mingjing; Zhu, Kai

    2018-06-01

    Objectives Expression profile of GSE57691 was analyzed to identify the similarities and differences between aortic occlusive disease and abdominal aortic aneurysm. Methods The expression profile of GSE57691 was downloaded from Gene Expression Omnibus database, including 20 small abdominal aortic aneurysm samples, 29 large abdominal aortic aneurysm samples, 9 aortic occlusive disease samples, and 10 control samples. Using the limma package in R, the differentially expressed genes were screened. Followed by enrichment analysis was performed for the differentially expressed genes using database for annotation, visualization, and integrated discovery online tool. Based on string online tool and Cytoscape software, protein-protein interaction network and module analyses were carried out. Moreover, integrated TF platform database and Cytoscape software were used for constructing transcriptional regulatory networks. Results As a result, 1757, 354, and 396 differentially expressed genes separately were identified in aortic occlusive disease, large abdominal aortic aneurysm, and small abdominal aortic aneurysm samples. UBB was significantly enriched in proteolysis related pathways with a high degree in three groups. SPARCL1 was another gene shared by these groups and regulated by NFIA, which had a high degree in transcriptional regulatory network. ACTB, a significant upregulated gene in abdominal aortic aneurysm samples, could be regulated by CLIC4, which was significantly enriched in cell motions. ACLY and NFIB were separately identified in aortic occlusive disease and small abdominal aortic aneurysm samples, and separately enriched in lipid metabolism and negative regulation of cell proliferation. Conclusions The downregulated UBB, NFIA, and SPARCL1 might play key roles in both aortic occlusive disease and abdominal aortic aneurysm, while the upregulated ACTB might only involve in abdominal aortic aneurysm. ACLY and NFIB were specifically involved in aortic occlusive

  20. Deep venous thrombosis: The valve cusp hypoxia thesis and its incompatibility with modern orthodoxy.

    Science.gov (United States)

    Malone, P Colm; Agutter, Paul S

    2016-01-01

    The valve cusp hypoxia thesis (VCHT) of the aetiology of deep venous thrombosis (DVT) was adumbrated in this journal in 1977 and fully articulated in 2008, the original hypothesis having been strongly corroborated by experiments published in 1981 and 1984. It presents a unitary account of the pathogenesis of venous thrombosis and embolism that is rooted in the pathophysiological tradition of Hunter, Virchow, Lister, Welch and Aschoff, a tradition traceable back to Harvey. In this paper we summarise the thesis in its mature form, consider its compatibility with recent advances in the DVT field, and ask why it has not yet been assimilated into the mainstream literature, which during the past half century has been dominated by a haematology-orientated 'consensus model'. We identify and discuss seven ways in which the VCHT is incompatible with these mainstream beliefs about the aetiology of venous thrombosis, drawing attention to: (1) the spurious nature of 'Virchow's triad'; (2) the crucial differences between 'venous thrombus' and 'clot'; the facts that (3) venous thrombi form in the valve pockets (VVPs), (4) DVT is not a primarily haematological condition, (5) the so-called 'thrombophilias' are not thrombogenic per se; (6) the conflict between the single unitary aetiology of DVT and the tacit assumption that the condition is 'multicausal'; (7) the inability of anticoagulants to prevent the initiation of venous thrombogenesis, though they do prevent the growth of thrombi to clinically significant size. In discussing point (7), we show that the VCHT indicates new approaches to mechanical prophylaxis against DVT. These approaches are then formulated as experimentally testable hypotheses, and we suggest methods for testing them preclinically using animal trials. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Combined Repair of Ascending Aortic Pseudoaneurysm and Abdominal Aortic Aneurysm in a Patient with Marfan Syndrome

    Science.gov (United States)

    Kokotsakis, John N.; Lioulias, Achilleas G.; Foroulis, Christophoros N.; Skouteli, Eleni Anna T.; Milonakis, Michael K.; Bastounis, Elias A.; Boulafendis, Dimitrios G.

    2003-01-01

    Pseudoaneurysms of the ascending aorta after the original inclusion/wrap technique of the Bentall procedure present a difficult surgical management problem and are associated with substantial morbidity and mortality. Patients with Marfan syndrome frequently develop aneurysms and dissections that involve multiple aortic segments. We present the case of a Marfan patient who successfully underwent repair of a giant ascending aortic pseudoaneurysm and concomitant repair of an abdominal aortic aneurysm. An aggressive surgical strategy followed by life-long cardiovascular monitoring is warranted in order to prolong the survival of these patients. (Tex Heart Inst J 2003;30:233–5) PMID:12959210

  2. New-Onset Atrial Fibrillation After Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Implantation

    DEFF Research Database (Denmark)

    Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav

    2015-01-01

    Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...... (NOAF) is 31%-64% and 4%-32%, respectively. NOAF is independently associated with adverse events such as stroke, death, and increased length of hospital stay. Increasing the knowledge of predisposing factors, optimal postprocedural monitoring, and prophylactic antiarrhythmic and antithrombotic therapy...

  3. New-onset atrial fibrillation after surgical aortic valve replacement and transcatheter aortic valve implantation

    DEFF Research Database (Denmark)

    Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav

    2015-01-01

    Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...... (NOAF) is 31%-64% and 4%-32%, respectively. NOAF is independently associated with adverse events such as stroke, death, and increased length of hospital stay. Increasing the knowledge of predisposing factors, optimal postprocedural monitoring, and prophylactic antiarrhythmic and antithrombotic therapy...

  4. Refractory pulmonary edema secondary to severe aortic valvular stenosis - aortic valvuloplasty as bridge therapy to surgery

    International Nuclear Information System (INIS)

    Santiago, Salazar; Hanna, Franklin; Capasso, Aminta

    2009-01-01

    Aortic valve stenosis is a progressive disease; when it is severe and symptomatic has a bleak prognosis that affects adversely the patient survival. In these cases, the treatment of choice is valve replacement surgery that under certain circumstances can bear a huge risk that forces the physician to consider less aggressive management alternatives to solve the problem. The case of a 65 years old male with severe aortic valve stenosis is reported. He developed pulmonary edema refractory to medical treatment that was solved by aortic valvuloplasty as bridge therapy to surgery.

  5. Proposed new mechanism of traumatic aortic rupture

    International Nuclear Information System (INIS)

    Crass, J.R.; Cohen, A.M.; Motta, A.O.; Tomashefski, J.F.; Wiesen, E.

    1990-01-01

    The currently accepted mechanism to explain traumatic aortic rupture from rapid deceleration invokes a combination of traction, torsion, and hydrostatic forces. None of these forces individually is of adequate magnitude to result in aortic disruption. This paper proposes a theory, that aortic lacerations result from a pinch of the aorta between the spine and the anterior bony thorax during the chest compression caused by abrupt deceleration. Three sets of experiments were performed. Geometric analysis of CT images and compression of an articulated skeleton were performed to assess where the anterior and posterior osseous structures would contact if maximally compressed. Fresh dog aortas were pinched in a manner that would mimic the manubrium impacting the spine. Finally, attempts were made to tear an aorta via traction and torsion (whiplash)

  6. Global Strain in Severe Aortic Valve Stenosis

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K

    2012-01-01

    Score, history with ischemic heart disease and ejection fraction. CONCLUSIONS: -In patients with symptomatic severe aortic stenosis undergoing AVR reduced GLS provides important prognostic information beyond standard risk factors. Clinical Trial Registration-URL: http://www.clinicaltrial.gov. Unique identifier......BACKGROUND: -Global longitudinal systolic strain (GLS) is often reduced in aortic stenosis despite normal ejection fraction. The importance of reduced preoperative GLS on long-term outcome after aortic valve replacement (AVR) is unknown. METHODS AND RESULTS: -A total of 125 patients with severe...... and mortality. In a stepwise cox model with forward selection GLS was the sole independent predictor HR=1.13 (95% confidence interval 1.02-1.25), p=0.04. Comparing the overall log likelihood χ(2) of the predictive power of the multivariable model containing GLS was statistically superior to models based on Euro...

  7. Flow measurement at the aortic root

    DEFF Research Database (Denmark)

    Bertelsen, Litten; Svendsen, Jesper Hastrup; Køber, Lars

    2016-01-01

    during CMR and aortic stenosis were excluded from the analyses. Stroke volumes were measured volumetrically (SVref) from steady-state free precision short axis images covering the entire left ventricle, excluding the papillary muscles and including the left ventricular outflow tract. Flow sequences......BACKGROUND: Cardiovascular magnetic resonance (CMR) is considered the gold standard of cardiac volumetric measurements. Flow in the aortic root is often measured at the sinotubular junction, even though placing the slice just above valve level may be more precise. It is unknown how much flow...... theoretically be equal to flow measurements, SVV and SVST were compared to SVref. RESULTS: Initially, 152 patients were included. 22 were excluded because of arrhythmias during scans and 9 were excluded for aortic stenosis. Accordingly, data from 121 patients were analysed and of these 63 had visually evident...

  8. A geometric reappraisal of proximal landing zones for thoracic endovascular aortic repair according to aortic arch types

    NARCIS (Netherlands)

    Marrocco-Trischitta, Massimiliano M.; de Beaufort, Hector W.; Secchi, Francesco; van Bakel, Theodorus M.; Ranucci, Marco; van Herwaarden, Joost A.; Moll, Frans L.; Trimarchi, Santi

    Objective: This study assessed whether the additional use of the aortic arch classification in type I, II, and III may complement Ishimaru's aortic arch map and provide valuable information on the geometry and suitability of proximal landing zones for thoracic endovascular aortic repair. Methods:

  9. Diagnostic imaging of acute aortic dissection

    International Nuclear Information System (INIS)

    Ohya, Tohru; Kumazaki, Tatsuo

    1991-01-01

    One hundred and nineteen patients with aortic dissection who underwent diagnostic imaging were reviewed and angiographic findings as well as those of CT were analysed. Thirty eight cases (43.1%) had non-contrast opacified false lumen, the type of which we call 'thrombosed type aortic dissection'. A comparative study of the thrombosed type with the patent type of false lumens was made particularly from the stand point of the characteristic diagnostic imagings (CT and angiography). At the same time, the pitfalls of these imagings in thrombosed type aortic dissection were studied. At the onset the average age of thrombosed type was 62.3 years old, while that of the patent type was 57.3. A statistical significance between the two groups was p<0.05. Thrombosed type in all cases was caused by atherosclerosis, whereas patent type was caused by the Marfan's syndrome in 11 cases. Other clinical findings, such as initial symptoms and blood pressure revealed no significant differences between the two groups. Pre-contrast CT in acute thrombosed type aortic dissection showed 'hyperdense crescent sign' in 89.4%. However, in 3 cases with thrombosed type in which the pre-contrast CT showed 'hyperdense crescent sign' contrast-enhanced CT detected no clear evidence of aortic dissection in the same site. This was due to obscurity induced by contrast medium. Angiographic findings of thrombosed type were classified into 3 groups: normal type, stenosed true lumen type and ulcer-like projection type. The incidence of normal type was estimated to be 48.4%, whereas stenosed true lumen type was 24.2% and ulcer-like projection was 27.7%. The present study concluded that thrombosed type is not rare in acute aortic dissection and contrast-enhanced CT as well as pre-contrast CT, is of great value in diagnosing thrombosed type. 'Hyperdense crescent sign' in pre-contrast CT is characteristic of intramural hematoma. (author)

  10. Bentall Procedure Using Cryopreserved Valved Aortic Homografts

    Science.gov (United States)

    Christenson, Jan T.; Sierra, Jorge; Trindade, Pedro T.; Didier, Dominique; Kalangos, Afksendiyos

    2004-01-01

    The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 ± 21 years (range, 15–74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 ± 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6–72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft. PMID:15745290

  11. Anesthesia Approach in Endovascular Aortic Reconstruction

    Directory of Open Access Journals (Sweden)

    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  12. Aortic valve replacement in octogenarians

    Directory of Open Access Journals (Sweden)

    Dark John H

    2007-07-01

    Full Text Available Abstract Background and Aims As our population ages and life expectancy increases the number of people aged over 80 and more referred for cardiac surgery is growing. This study sought to identify the outcome of aortic valve replacement (AVR in octogenarians. Methods 68 patients aged 80 years or more underwent AVR at the Freeman Hospital, between April 2001 and April 2004. A retrospective review of the notes and outcomes from the patients' GP and the NHS strategic tracking service was performed. 54% (37 underwent isolated AVR whilst 46% (31 underwent combined AVR and CABG. Results Follow up was 100% complete. The mean age was 83.1 ± s.d. 2.9 years, a mean gradient of 83 ± s.d. 31 mmHg and mean AVA of 0.56 cm2. The mean additive EuroSCORE was 8.6 ± s.d. 1.2, the logistic EuroSCORE mean 12.0 ± s.d. 5.9. In hospital 30 day mortality was 13 %. Survival was 80% at 1 year and 78% at 2 years. Median follow up was for 712 days. Stepwise logistic regression identified chronic obstructive airways disease as an independent predictor of mortality (p Conclusion Our study demonstrates that the operative mortality for AVR in the over eighties is good, whilst the mid to long term outcome is excellent There is a very low attrition rate with those undergoing the procedure living as long than their age matched population. This study confirms AVR is a safe, acceptable treatment for octogenarians with excellent mid term outcomes.

  13. Supravalvular aortic stenosis with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Pradeep Vaideeswar

    2015-01-01

    Full Text Available Sudden cardiac death (SCD most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

  14. Ruptured Aortic Aneurysm Presenting as a Stridor

    Directory of Open Access Journals (Sweden)

    Feng Lin

    2010-06-01

    Full Text Available Stridor is an abnormal, high-pitched, whining breathing sound caused by a blockage in the throat or larynx that is usually heard in children. We describe an unusual case of an 81-year-old man brought to our emergency department with sudden onset of dyspnea and shortness of breath. Stridor could be heard without a stethoscope. We found a huge mass over the left upper chest on chest radiography, suggesting an aortic aneurysm. We believed that these symptoms were caused by a huge thoracic aortic aneurysm with trachea/bronchi compression. Chest computed tomography confirmed the diagnosis.

  15. Infective endocarditis following transcatheter aortic valve replacement-

    DEFF Research Database (Denmark)

    Loh, Poay Huan; Bundgaard, Henning; S�ndergaard, Lars

    2013-01-01

    Transcatheter aortic valve replacement (TAVR) can improve the symptoms and prognosis of patients with severe aortic stenosis who, due to a high expected operative risk, would not have otherwise been treated surgically. If these patients develop prosthetic valve endocarditis, their presentations may...... be atypical causing a delay in the diagnosis and treatment. The management is also complicated by their comorbidities, and surgical treatment may not be feasible leading to a significant morbidity and mortality. We describe a case of an 85-year-old man with TAVI prosthetic valve endocarditis successfully...

  16. A bovine aortic arch in humans

    Directory of Open Access Journals (Sweden)

    María Elena Arnáiz-García

    2014-05-01

    Full Text Available We describe a curious congenital variation of human aortic arch (AA branching pattern termed the “bovine aortic arch”. Rather than arising directly from the AA as a separate branch as occurs in the most common AA branching pattern, the left common carotid artery moves to the right and merges from the brachiocephalic trunk. It is the normal AA branching pattern presented in a number of animals (canines, felines or Macaque monkeys but it has nothing to do with anatomy of AA in ruminant animals, including cattle and buffalo. That is why it is one of the most widely misnomers used in medical literature whose origin is nowadays unknown.

  17. Preventative Valve-Sparing Aortic Root Replacement and Pregnancy Outcome in Marfan Syndrome

    OpenAIRE

    Sokol, Vesna; Zlopaša, Gordan; Herman, Mislav; Planinić, Pavao; Micevska, Ana

    2012-01-01

    In Marfan syndrome, with dilatation of the aortic root secondary to an underlying connective tissue defect, pregnancy can cause hemodynamic stress leading to the development of an aortic aneurysm and even a fatal aortic dissection. In the presence of existing aortic root enlargement and a family history of aortic dissection, preventative elective surgery is suggested. Aortic root replacement with or without a valve-sparing procedure is superior to total aortic root replacement with ...

  18. The dynamic cusp at low altitudes: a case study utilizing Viking, DMSP-F7, and Sondrestrom incoherent scatter radar observations

    Directory of Open Access Journals (Sweden)

    J. Watermann

    Full Text Available Coincident multi-instrument magnetospheric and ionospheric observations have made it possible to determine the position of the ionospheric footprint of the magnetospheric cusp and to monitor its evolution over time. The data used include charged particle and magnetic field measurements from the Earth-orbiting Viking and DMSP-F7 satellites, electric field measurements from Viking, interplanetary magnetic field and plasma data from IMP-8, and Sondrestrom incoherent scatter radar observations of the ionospheric plasma density, temperature, and convection. Viking detected cusp precipitation poleward of 75.5° invariant latitude. The ionospheric response to the observed electron precipitation was simulated using an auroral model. It predicts enhanced plasma density and elevated electron temperature in the upper E- and F-regions. Sondrestrom radar observations are in agreement with the predictions. The radar detected a cusp signature on each of five consecutive antenna elevation scans covering 1.2 h local time. The cusp appeared to be about 2° invariant latitude wide, and its ionospheric footprint shifted equatorward by nearly 2° during this time, possibly influenced by an overall decrease in the IMF Bz component. The radar plasma drift data and the Viking magnetic and electric field data suggest that the cusp was associated with a continuous, rather than a patchy, merging between the IMF and the geomagnetic field.

  19. Excitation of transient lobe cell convection and auroral arc at the cusp poleward boundary during a transition of the interplanetary magnetic field from south to north

    Directory of Open Access Journals (Sweden)

    P. E. Sandholt

    2001-05-01

    Full Text Available We document the activation of transient polar arcs emanating from the cusp within a 15 min long intermediate phase during the transition from a standard two-cell convection pattern, representative of a strongly southward interplanetary magnetic field (IMF, to a "reverse" two-cell pattern, representative of strongly northward IMF conditions. During the 2–3 min lifetime of the arc, its base in the cusp, appearing as a bright spot, moved eastward toward noon by ~ 300 km. As the arc moved, it left in its "wake" enhanced cusp precipitation. The polar arc is a tracer of the activation of a lobe convection cell with clockwise vorticity, intruding into the previously established large-scale distorted two-cell pattern, due to an episode of localized lobe reconnection. The lobe cell gives rise to strong flow shear (converging electric field and an associated sheet of outflowing field-aligned current, which is manifested by the polar arc. The enhanced cusp precipitation represents, in our view, the ionospheric footprint of the lobe reconnection process.Key words. Magnetospheric physics (auroral phenomena; magnetopause, cusp, and boundary layers; plasma convection

  20. Doppler-guided retrograde catheterization system

    Science.gov (United States)

    Frazin, Leon J.; Vonesh, Michael J.; Chandran, Krishnan B.; Khasho, Fouad; Lanza, George M.; Talano, James V.; McPherson, David D.

    1991-05-01

    The purpose of this study was to investigate a Doppler guided catheterization system as an adjunctive or alternative methodology to overcome the disadvantages of left heart catheterization and angiography. These disadvantages include the biological effects of radiation and the toxic and volume effects of iodine contrast. Doppler retrograde guidance uses a 20 MHz circular pulsed Doppler crystal incorporated into the tip of a triple lumen multipurpose catheter and is advanced retrogradely using the directional flow information provided by the Doppler waveform. The velocity detection limits are either 1 m/second or 4 m/second depending upon the instrumentation. In a physiologic flow model of the human aortic arch, multiple data points revealed a positive wave form when flow was traveling toward the catheter tip indicating proper alignment for retrograde advancement. There was a negative wave form when flow was traveling away from the catheter tip if the catheter was in a branch or bent upon itself indicating improper catheter tip position for retrograde advancement. In a series of six dogs, the catheter was able to be accurately advanced from the femoral artery to the left ventricular chamber under Doppler signal guidance without the use of x-ray. The potential applications of a Doppler guided retrograde catheterization system include decreasing time requirements and allowing safer catheter guidance in patients with atherosclerotic vascular disease and suspected aortic dissection. The Doppler system may allow left ventricular pressure monitoring in the intensive care unit without the need for x-ray and it may allow left sided contrast echocardiography. With pulse velocity detection limits of 4 m/second, this system may allow catheter direction and passage into the aortic root and left ventricle in patients with aortic stenosis. A modification of the Doppler catheter may include transponder technology which would allow precise catheter tip localization once the