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Sample records for arterial compliance volume

  1. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Fuglsang, S; Bendtsen, F; Christensen, E

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40...... predictors of SV/PP (P compliance is elevated in cirrhosis. A simplified SV/PP index seems to reflect abnormalities in the arterial compliance of these patients....

  2. Arterial compliance in patients with cirrhosis: stroke volume-pulse pressure ratio as simplified index

    DEFF Research Database (Denmark)

    Henriksen, J H; Fuglsang, Stefan; Bendtsen, Flemming;

    2001-01-01

    Arterial function may be altered in patients with cirrhosis. We determined compliance of the arterial tree (C(1)) in relation to systemic and splanchnic hemodynamic derangement and clinical variables. C(1) and the stroke volume-pulse pressure index (SV/PP) were significantly higher (+62% and +40...... predictors of SV/PP (P index seems to reflect abnormalities in the arterial compliance of these patients....

  3. Arterial hypertension in cirrhosis: arterial compliance, volume distribution, and central haemodynamics

    DEFF Research Database (Denmark)

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

    2006-01-01

    were 130 normotensive cirrhotic patients, 19 controls with normal arterial blood pressure and without liver disease, and 16 patients with essential arterial hypertension. All groups underwent haemodynamic investigation with determination of cardiac output (CO), plasma volume (PV), central blood volume...

  4. Plasma volume expansion by albumin in cirrhosis. Relation to blood volume distribution, arterial compliance and severity of disease

    DEFF Research Database (Denmark)

    Brinch, Kim; Bendtsen, Flemming; Becker, Povl Ulrik;

    2003-01-01

    BACKGROUND/AIMS: The aim of the study was to investigate the effect of a standard albumin load on blood volume distribution, arterial compliance, and the renin-angiotensin-aldosterone system in patients with different degrees of cirrhosis. METHODS: 31 patients with cirrhosis (Child classes A/B/C=...... effective arterial blood volume of such patients, which may be important in the prevention of circulatory dysfunction....

  5. Obesity and arterial compliance alterations.

    Science.gov (United States)

    Seifalian, Alexander M; Filippatos, Theodosios D; Joshi, Jatin; Mikhailidis, Dimitri P

    2010-03-01

    Obesity is associated with increased cardiovascular disease (CVD) risk, especially when excess body fat is distributed preferentially within the abdominal region. Obese subjects usually have increased arterial stiffness compared with non-obese subjects of similar age. The factors associated with increased arterial stiffness in obesity include endothelial dysfunction (decreased nitric oxide bioavailability), impaired smooth muscle cell function, insulin resistance, as well as elevated cholesterol and C-peptide levels. Furthermore, visceral fat, the adipose tissue-related renin-angiotensin-aldosterone system and hyperleptinaemia contribute to the obesity-associated impaired arterial compliance. Weight loss improves CVD risk factors and arterial compliance. Because increased arterial stiffness is a marker of CVD risk these findings support the concept that the presence of obesity has vascular implications.

  6. Irbesartan improves arterial compliance more than lisinopril

    Science.gov (United States)

    Ali, Khalid; Rajkumar, Chakravarthi; Fantin, Francesco; Schiff, Rebekah; Bulpitt, Christopher J

    2009-01-01

    Background Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB) irbesartan and an angiotensin converting enzyme inhibitor (ACEI) lisinopril improved arterial compliance. Methods A randomized, double-blind, double-dummy, controlled crossover trial. Fifteen hypertensive patients, mean age 65.5 ± 8.9 years (mean ± SD) were given irbesartan (150 to 300 mg/day) or lisinopril (10 to 20 mg/day) for 12 weeks and then crossed over for 12 weeks. Pulse wave velocity (PWV) in the carotid-femoral (CF), carotid-radial (CR), and femoral dorsalis-pedis (FD) were measured using a Complior® PWV system. Results After 12 weeks, systolic blood pressure (SBP) decreased from 162.4 ± 12.9 to 134.5 ± 14.8 with irbesartan and to 145.2 ± 25 mmHg with lisinopril. Irbesartan and lisinopril reduced PWV (CF) in the elastic arterial system from 15.1 ± 5 to 13.3 ± 2.6 (p < 0.005) and to 14 ± 4.7 (p < 0.05) m/s respectively (p = 0.345). Irbesartan reduced PWV (CR) and PWV (FD), whereas lisinopril did not. The difference between treatments was significant after SBP adjustment (p = 0.037 for PWV (CR) and p < 0.001 for PWV (FD)). Conclusions Irbesartan improved arterial compliance in elastic and muscular arteries, whereas lisinopril improved it only in elastic arteries. PMID:19649309

  7. Irbesartan improves arterial compliance more than lisinopril

    Directory of Open Access Journals (Sweden)

    Khalid Ali

    2009-07-01

    Full Text Available Khalid Ali,1 Chakravarthi Rajkumar,1 Francesco Fantin,2 Rebekah Schiff,3 Christopher J Bulpitt31Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, UK; 2Department of Geriatrics, University of Verona, Italy; 3Section of Geriatric Medicine, Imperial College School of Medicine, London, UKBackground: Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB irbesartan and an angiotensin converting enzyme inhibitor (ACEI lisinopril improved arterial compliance.Methods: A randomized, double-blind, double-dummy, controlled crossover trial. Fifteen hypertensive patients, mean age 65.5 ± 8.9 years (mean ± SD were given irbesartan (150 to 300 mg/day or lisinopril (10 to 20 mg/day for 12 weeks and then crossed over for 12 weeks. Pulse wave velocity (PWV in the carotid-femoral (CF, carotid-radial (CR, and femoral dorsalis-pedis (FD were measured using a Complior® PWV system.Results: After 12 weeks, systolic blood pressure (SBP decreased from 162.4 ± 12.9 to 134.5 ± 14.8 with irbesartan and to 145.2 ± 25 mmHg with lisinopril. Irbesartan and lisinopril reduced PWV (CF in the elastic arterial system from 15.1 ± 5 to 13.3 ± 2.6 (p < 0.005 and to 14 ± 4.7 (p < 0.05 m/s respectively (p = 0.345. Irbesartan reduced PWV (CR and PWV (FD, whereas lisinopril did not. The difference between treatments was significant after SBP adjustment (p = 0.037 for PWV (CR and p < 0.001 for PWV (FD.Conclusions: Irbesartan improved arterial compliance in elastic and muscular arteries, whereas lisinopril improved it only in elastic arteries.Keywords: arterial compliance, angiotensin receptor blockers, ACE inhibitors, hypertension

  8. Radial arterial compliance measurement by fiber Bragg grating pulse recorder.

    Science.gov (United States)

    Sharath, U; Shwetha, C; Anand, K; Asokan, S

    2014-12-01

    In the present work, we report a novel, in vivo, noninvasive technique to determine radial arterial compliance using the radial arterial pressure pulse waveform (RAPPW) acquired by fiber Bragg grating pulse recorder (FBGPR). The radial arterial compliance of the subject can be measured during sphygmomanometric examination by the unique signatures of arterial diametrical variations and the beat-to-beat pulse pressure acquired simultaneously from the RAPPW recorded using FBGPR. This proposed technique has been validated against the radial arterial diametrical measurements obtained from the color Doppler ultrasound. Two distinct trials have been illustrated in this work and the results from both techniques have been found to be in good agreement with each other.

  9. Elevated arterial compliance in patients with cirrhosis is not related to arterial endothelin-1

    DEFF Research Database (Denmark)

    Møller, Søren; Gülberg, V; Becker, Povl Ulrik

    2002-01-01

    study was to investigate a potential relation between altered arterial compliance and arterial ET-1 in patients with cirrhosis. As ET-1 may be manipulated by somastostatin, the study includes infusion of octreotide in a subset of patients. METHODS: A total of 67 patients with cirrhosis and 27 controls...... (P relationships could be established between arterial compliance and arterial ET-1 (r = -0.15 to 0.23, ns). Intravenous bolus injection and infusion of octreotide (100 pg + 100 microg/h, n = 9) did...

  10. Arterial compliance measurement using a noninvasive laser Doppler measurement system

    Science.gov (United States)

    Hast, Jukka T.; Myllylae, Risto A.; Sorvoja, Hannu; Nissilae, Seppo M.

    2000-11-01

    The aim of this study was to study the elasticity of the arterial wall using a non-invasive laser Doppler measurement system. The elasticity of the arterial wall is described by its compliance factor, which can be determined when both blood pressure and the radial velocity of the arterial wall are known. To measure radical velocity we used a self- mixing interferometer. The compliance factors were measured from six healthy volunteers, whose ages were varied from 21 to 32. Although a single volunteer's compliance factor is presented as an example, this paper treated the volunteers as a group. First, the elastic modulus, which is inversely proportional to the compliance factor, was determined. Then, an exponential curve was fitted into the measured data and a characteristic equation for the elastic modulus of the arterial wall was determined. The elastic modulus was calculated at different pressures and the results were compared to the static incremental modulus of a dog's femoral artery. The results indicate that there is a correlation between human elastic and canine static incremental modulus for blood pressures varying from 60 to 110 mmHg.

  11. Effects of Long Duration Spaceflight on Venous and Arterial Compliance

    Science.gov (United States)

    Ribeiro, L. C.; Lee, S. M. C.; Martin, D. S.; Ploutz-Snyder, R.; Stenger, M. B.; Westby, C. M.; Platts, S. H.

    2014-01-01

    The visual impairment and intracranial pressure syndrome (VIIP) is a newly described space flight-associated medical condition made up of a constellation of symptoms affecting at least 34% of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures, and is thought to be related to elevated intracranial pressure secondary to space flightinduced cephalad fluid shifts. Loss of visual acuity could be a significant threat to crew health and performance and may be suggestive of other adaptations with implications for years post-flight. Our primary objective is to determine whether vascular compliance is altered by space flight and whether such adaptations are related to the incidence of VIIP. In particular, we will measure ocular parameters and vascular compliance in vessels of the head and neck in astronauts who have no space flight experience, in astronauts before, during, and after space flight, and in bed rest subjects with conditions similar to space flight. Additionally, we will analyze astronaut data from the Lifetime Surveillance of Astronaut Health (LSAH) archive to determine which factors might be predictive of the development of VIIP. The project will be conducted in four separate but related parts. To understand the baseline condition of astronauts without any prior space flight experience, we will study 10 astronauts who have never flown in space by performing a comprehensive evaluation of the vasculature of the head, neck and eyes. Hemodynamic data (stroke volume and blood pressure), ocular (tonometry and ocular ultrasound), venous and arterial parameters will be acquired across a range of tilt angles (20, 10, 0, -10, -20 degrees). Vessels to be studied include the temporal, jugular, and vertebral veins and the cerebral, carotid and vertebral arteries. Ophthalmic data from the annual physical will be obtained through data sharing. To examine

  12. [Alterations in arterial compliance of dyslipidemic patients].

    Science.gov (United States)

    Clara, Fernando Mario; Corral, Pablo; Blanco, Gustavo Hector; Scandurra, Adriana Graciela; Meschino, Gustavo Javier

    2015-01-01

    We studied the alteration on the distensibility of the arterial walls caused by dyslipidemia LDLc dependent, along the decades of life, by means of a study of the radial artery pulse wave. We made an analysis of the radial artery pulse wave records acquired by means a movement displacement sensor, placed on radial palpation area. We recruited 100 dyslipidemic men without other cardiovascular risk factors, between the 3rd and the 6th decade. We identified the reflected wave in the records and we computed the augmentation index in order to quantify its amplitude and position. This index is useful to assess the endothelial dysfunction. Besides, we defined a velocity coefficient as the ratio between the size of the individuals and the delay time between the peak of the systolic wave and the arrival of the reflected wave. Results were compared against those obtained in a group of 161 healthy volunteers. We found that dyslipidemic patients presented augmentation index values similar to controls until the fourth decade, increasing thereafter with significant differences only in the 6th decade. No significant differences were found in the velocity index in any of the ages studied. We conclude that alterations produced by dyslipidemia take decades to manifest, and they begin affecting the mechanism of vasodilation of distal arteries with highest proportion of smooth muscle, without altering the proximal conduit arteries with more elastin content. Copyright © 2013 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

  13. Irbesartan improves arterial compliance more than lisinopril

    OpenAIRE

    2009-01-01

    Khalid Ali,1 Chakravarthi Rajkumar,1 Francesco Fantin,2 Rebekah Schiff,3 Christopher J Bulpitt31Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, UK; 2Department of Geriatrics, University of Verona, Italy; 3Section of Geriatric Medicine, Imperial College School of Medicine, London, UKBackground: Antihypertensive agents can reduce arterial stiffness. We hypothesized that an angiotensin receptor blocker (ARB) irbesartan and an angiotensin converting enzyme inhibit...

  14. Assessment of arterial stiffness among schizophrenia-spectrum disorders using aortic pulse wave velocity and arterial compliance: a pilot study.

    Science.gov (United States)

    Phillips, Aaron A; Warburton, Darren E R; Flynn, Sean W; Fredrikson, Diane; Lang, Donna J

    2014-01-30

    Cardiovascular disease (CVD) is the leading cause of death in individuals with chronic schizophrenia. Arterial stiffness provides a non-invasive indication of cardiovascular disease risk. To date, arterial stiffness, which has been shown to have independent predictive value for CVD morbidity and mortality, has not been evaluated in this population. We aimed to examine aortic pulse wave velocity (aPWV) as well as large and small artery compliance (Comp1 and Comp2) in patients being treated for schizophrenia, compared to healthy volunteers. Ten patients and 10 age and gendermatched volunteers underwent a comprehensive evaluation of arterial stiffness including: aPWV, Comp1, Comp2, stroke volume, cardiac output, and systemic vascular resistance. Patient aPWV was significantly elevated compared to healthy volunteers (9.1 ± 4.11 vs. 5.7 ± 1.4, P=0.03). Increased age, blood pressure, heart rate, and cigarettes/day were associated with reduced arterial health in patients. This is the first time aPWV has been described in those treated for schizophrenia. Arterial stiffness is increased in this population. Measuring arterial stiffness is a non-invasive, sensitive and effective tool for evaluating CVD risk in this population. © 2013 Published by Elsevier Ireland Ltd.

  15. Clinical Significance of Evaluating Antihypertensive Effect with Arterial Compliance

    Institute of Scientific and Technical Information of China (English)

    李新立; 倪春辉; 王震震

    2002-01-01

    Objective To evaluate the clinical significance of antihypertensive effect witharterial compliance. Methods In males, 72 cases were control group, 35 cases were EH-controlled,and 35 cases were EH-uncontrolled groups. Blood pressure and arterial compliance (C1 and C2) weredetected by HDI DO-2020. Results In the EH-uncontrolled group,the values of systolic blood pres-sure (SBP) , diastolic blood pressure (DBP) , mean arterial pressure (MAP), and pulse pressure(PP) were significantly higher than those of the control and the EH-controlled groups (P<0.01),however ,there was no difference between the control and the EH-controlled groups. In the EH-uncon-trolled group,the values of C1 and C2 were lower tlan those of both the control and the EH-controlledgroups (P<0.01) ,again,with no difference between the control and the EH-controlled groups. Con-clttsion Arterial compliance (C1 and C2) measurements may serve as a sensitive indicator of evalu-ating antihypertensive effect.

  16. National Environmental Policy Act compliance guide. Volume II (reference book)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-09-01

    This document (Volume II of the National Environmental Policy Act Compliance Guide) contains current copies of regulations and guidance from the Council on Environmental Quality, the Department of Energy, the Department of State, and the Environmental Protection Agency, related to compliance with the National Environmental Policy Act of 1969 (NEPA).

  17. Atherosclerosis measured by whole body magnetic resonance angiography and carotid artery ultrasound is related to arterial compliance, but not to endothelium-dependent vasodilation - the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.

    Science.gov (United States)

    Lind, Lars; Andersson, Jessika; Hansen, Tomas; Johansson, Lars; Ahlström, Håkan

    2009-09-01

    Arterial compliance and endothelium-dependent vasodilation are two characteristics of the vessel wall. In the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study, we studied the relationships between arterial compliance and endothelium-dependent vasodilation versus atherosclerosis as measured with two imaging modalities. In the population-based PIVUS study (1016 subjects aged 70), arterial compliance was determined by ultrasound in the carotid artery and the stroke volume to pulse pressure ratio by echocardiography, while endothelium-dependent vasodilation was assessed by the invasive forearm technique with acetylcholine and brachial artery ultrasound. Intima-media thickness was evaluated by ultrasound in the carotid artery (n = 954). Stenosis in the carotid, aorta, renal, upper and lower leg arteries were determined by magnetic resonance angiography in a random subsample of 306 subjects. After adjustments for gender, Framingham risk score, obesity, myocardial infarction and stroke, distensibility in the carotid artery and the stroke volume to pulse pressure ratio were both significantly related to a weighted index of stenosis in the five arterial territories evaluated by magnetic resonance angiography (p<0.02 for both). Distensibility in the carotid artery (P = 0.021), but not the stroke volume to pulse pressure ratio (P = 0.08), was also significantly related to intima-media thickness. In the elderly population, atherosclerosis is mainly related to arterial compliance, but not to endothelium-dependent vasodilation in peripheral conduit or resistance vessels.

  18. Directory of Certificates of Compliance for radioactive materials packages: Certificates of Compliance. Volume 2, Revision 18

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 of approved QA programs. The reports include a listing of all users of each package design and approved QA programs prior to the publication date.

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

    Directory of Open Access Journals (Sweden)

    Graça J.R.V.

    2002-01-01

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

  20. Relation of epicardial adipose tissue with arterial compliance and stiffness in patients with hypertension.

    Science.gov (United States)

    Korkmaz, Levent; Cirakoglu, Omer Faruk; Ağaç, Mustafa Tarik; Erkan, Hakan; Korkmaz, Ayca Ata; Acar, Zeydin; Kul, Selim; Hatem, Engin; Çelik, Şükrü

    2014-09-01

    The main aim of the present study was to investigate the association between epicardial adipose tissue (EAT) and arterial function in patients with asymptomatic hypertension. Patients with hypertension (n = 155) were enrolled consecutively. Patients with decreased arterial compliance (AC) and increased cardioankle vascular index (CAVI) had higher EAT values compared with those with normal AC and CAVI (6.23 ± 1.67 vs 4.91 ± 1.40, P arterial function in patients with asymptomatic hypertension. The link between EAT and arterial stiffness deserves further investigation.

  1. Microalbuminuria associated with systolic blood pressure and arterial compliance in Chinese metabolic syndrome patients

    Institute of Scientific and Technical Information of China (English)

    LI Xin-li; XU Qiong; TONG Min; LU Xin-zheng; ZHANG Hai-feng; ZHOU Yan-li; CAO Ke-jiang; HUANG Jun

    2007-01-01

    Background There is significant evidence showing that microalbuminuria and arterial compliance are sensitive markers for early cardiovascular diseases. However, whether microalbuminuria is associated with reduced arterial compliance in Chinese metabolic syndrome (MS) patients remains unknown.Methods According to the definition of MS proposed by ATPⅢ in 2001, USA, subjects (n=362) were divided into three groups according to the number of risk factors: group 1 (control), group 2 (medium, < 3 risk factors) and group 3 (MS, ≥ 3 risk factors). Both large artery compliance (C1) and small artery compliance (C2) were measured with the CVProfilor DO-2020 Cardiovascular Profiling System, and microalbuminuria was evaluated with the ratio of albumin to urine creatinine.Results (1) As C1 and C2 levels elasticity decreased, albumin creatinine ratio (ACR) and the prevalence of microalbuminuria increased within those groups with MS risk factors. C1 and C2 were negatively correlated with the ranking of MS risk factors, ACR was positively correlated with the ranking of MS risk factors (all P<0.05). (2) Subjects were also categorized into a microalbuminuria group and a normal group, C1 and C2 in the microalbuminuria group were lower than in the normal group. (3) Multivariate regression analysis showed that increased systolic blood pressure (SBP) and reduced arterial compliance were the main risk factors for microalbuminuria in the MS group.Conclusions The risk of developing microalbuminuria was higher in the subjects with multiple metabolic abnormalities.Increased systolic blood pressure and reduced arterial compliance may be the main predictors for microalbuminuria in MS.

  2. Electrical stimulation alters FMD and arterial compliance in extremely inactive legs

    NARCIS (Netherlands)

    Groot, P.C.E. de; Crozier, J.; Rakobowchuk, M.; Hopman, M.T.E.; MacDonald, M.

    2005-01-01

    PURPOSE: The main aim of the study was to assess the effect and time course of 4 wk of electrically induced leg training on arterial compliance and endothelial function. METHODS: Six spinal cord-injured (SCI) individuals participated in 4 wk of daily one-leg functional electrical stimulation (FES) t

  3. Clinical characteristic of pulse wave velocity and arterial compliance in elderly patients with diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    张红

    2013-01-01

    Objective To explore the clinical characteristics of pulse wave velocity,arterial compliance and cardiovascular risk factors in elderly patients with type 2 diabetes mellitus.Methods A total of 363 patients were selected and divided into 4 groups:diabetic group,diabetic

  4. Association of metabolic syndrome with arterial compliance in children and adolescents

    Institute of Scientific and Technical Information of China (English)

    ZHANG Li; MI Jie; LI Ming; JIANG Benyu

    2007-01-01

    The association of metabolic syndrome (MS)with arterial compliance in children and adolescents was explored.337 subjects (188 men and 149 women) aged 6-18 (10.95±3.01) years,out of "Beijing Child Metabolic Syndrome Study",were divided into three ease groups (one component,two components,three & more components of MS) and one control group based on the Cook's MS definition in children and adolescents.Measurements including anthropometry,blood pressure,fasting plasma glucose and insulin,serum lipid profile were done.Homeostasis model assessment for insulin resistance (HOMA-IR) index was calculated for estimating individual insulin resistance.Arterial compliance was measured using digital pulse wave analyzing method from the pulse trace machine (Micro medical,London),and then the stiffness index (SI) was determined.The mean value of SI in MS group was significant higher than that in control group [(7.69±1.63) vs (6.25 + 0.86) m/s,P < 0.01 ].With the increase of the clustering of MS components,SI and HOMA-IR were gradually increased.After taking account of gender,age and pubertal development,the partial correlation analysis showed that the amount of components of MS and HOMA-IR were positively correlated with SI (both P values were less than 0.05).The arterial compliance of MS group was significantly lowered in children and adolescents,and with the increase of the clustering of MS components,arterial compliance was gradually decreased.It was suggested that arterial compliance assessment in children and adolescents was important for early prevention of cardiovascular diseases.

  5. Influence of arterial wall-stenosis compliance on the coronary diagnostic parameters.

    Science.gov (United States)

    Konala, Bhaskar Chandra; Das, Ashish; Banerjee, Rupak K

    2011-03-15

    Functional diagnostic parameters such as Fractional Flow Reserve (FFR), which is calculated from pressure measurements across stenosed arteries, are often used to determine the functional severity of coronary artery stenosis. This study evaluated the effect of arterial wall-stenosis compliance, with limiting scenarios of stenosis severity, on the diagnostic parameters. The diagnostic parameters considered in this study include an established index, FFR and two recently developed parameters: Pressure Drop Coefficient (CDP) and Lesion Flow Coefficient (LFC). The parameters were assessed for rigid artery (RR; signifying high plaque elasticity), compliant artery with calcified plaque (CC; intermediate plaque elasticity) and compliant artery with smooth muscle cell proliferation (CS; low plaque elasticity), with varying degrees of epicardial stenosis. A hyperelastic Mooney-Rivlin model was used to model the arterial wall and plaque materials. Blood was modeled as a shear thinning, non-Newtonian fluid using the Carreau model. The arterial wall compliance was evaluated using the finite element method. The present study found that, with an increase in stenosis severity, FFR decreased whereas CDP and LFC increased. The cutoff value of 0.75 for FFR was observed at 78.7% area stenosis for RR, whereas for CC and CS the cutoff values were obtained at higher stenosis severities of 81.3% and 82.7%, respectively. For a fixed stenosis, CDP value decreased and LFC value increased with a decrease in plaque elasticity (RR to CS). We conclude that the differences in diagnostic parameters with compliance at intermediate stenosis (78.7-82.7% area blockage) could lead to misinterpretation of the stenosis severity. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Screening aortic drug treatments through arterial compliance measurements.

    Science.gov (United States)

    Rentschler, Mark E; Baxter, B Timothy

    2008-10-01

    Abdominal aortic aneurysm (AAA) is a common and deadly problem. The aortic diameter increases in association with a complex remodeling process that includes changes in the structure and content of key proteins, elastin and collagen. As these changes occur, the tissue mechanical properties also change. The natural history of AAA is progressive enlargement to a point of mechanical tissue failure typically followed by death. Currently, the marker used to predict the risk of impending rupture is the largest transverse diameter. After reaching a diameter threshold of 5.5 cm the AAA needs to be surgically repaired. This criterion does not consider any patient-specific information or heterogeneity of the AAA that may, in some cases, lead to rupture before the AAA reaches the standard intervention threshold. Conversely, in many patients, continued observation beyond this threshold is safe. While no medical treatment is yet approved, doxycycline (Doxy) has been shown to greatly reduce AAA growth in animal models and has been shown to slow growth in 1 small clinical trial. While larger prospective randomized trials are needed, one unknown is what effect Doxy has on the structural integrity of the aortic wall. That is, does slowed AAA growth, by Doxy treatment, prevent rupture, or does the wall continue to weaken and the AAA instead ruptures at a smaller diameter? Using an established animal model of AAA, we begun to determine the changes in tissue mechanics compliance of the aorta as the AAA develops. Our current research is focused on verifying that these changes mimic the observed changes seen in the human population as reported by other researchers, so that we can confidently study how potential drug therapies may affect wall strength and compliance in the human population. The long-term objectives are to understand better factors related to progression of AAA and help verify that drug therapy with Doxy will decrease the chance of rupture by preventing wall weakening and

  7. Task force on compliance and enforcement. Final report. Volume 2

    Energy Technology Data Exchange (ETDEWEB)

    1978-03-01

    Recommendations for measures to strengthen the FEA enforcement program in the area of petroleum price regulation are presented. Results of task force efforts are presented in report and recommendations sections concerned with pending cases, compliance program organization, enforcement powers, compliance strategy, and audit staffing and techniques. (JRD)

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

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming; Henriksen, Jens Henrik

    1995-01-01

    and in controls. METHODS: Thirty-nine patients with cirrhosis (12 patients with Child-Turcotte class A, 14 with class B, and 13 with class C) and 6 controls were studied. During hepatic vein catheterization, cardiac output, systemic vascular resistance, central and arterial blood volume, noncentral blood volume...... in patients with either class B or class C. Conversely, the noncentral blood volume increased in patients with class B and C. In both patients and controls, the cardiac output increased and the systemic vascular resistance decreased, whereas the mean arterial blood pressure did not change significantly......BACKGROUND & AIMS: Systemic vasodilatation in cirrhosis may lead to hemodynamic alterations with reduced effective blood volume and decreased arterial blood pressure. This study investigates the response of acute volume expansion on hemodynamics and regional blood volumes in patients with cirrhosis...

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

    Directory of Open Access Journals (Sweden)

    Yannick Molgat-Seon

    2017-03-01

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

  10. Supervised exercise therapy in the management of peripheral arterial disease - an assessment of compliance.

    Science.gov (United States)

    Aherne, Thomas M; Kheirelseid, Elrasheid A H; Boland, Michael; Carr, Shane; Al-Zabi, Thekra; Bashar, Khalid; Moneley, Daragh; Leahy, Austin; McCaffrey, Noel; Naughton, Peter

    2017-05-01

    Supervised exercise therapy (SET) is an effective option in the management of peripheral arterial disease (PAD). Unfortunately, poor compliance remains prevalent. This study aimed to assess patient exercise compliance and to identify factors influencing symptomatic improvement and SET participation. Data regarding attendance at SET for this cohort study were extracted from a prospectively maintained database of patients with claudication attending SET at Dublin City University. All patients had ankle brachial index confirmed PAD with associated intermittent claudication. Exercise performance and symptomatic data were gathered retrospectively using patient charts and interviews. Ninety-eight patients were referred for SET during the study period. The mean age was 69.2 (± 10.1) with 18 % being female. Median follow-up was 25.1 months (IQ range 17.0-31.6). Overall, the mean number of sessions attended per patient was 19.5. Exercise compliance was associated with a significant improvement in symptoms (p = 0.001). Other factors including anatomical level of claudication (P = 0.042) and educational level (p = 0.007) were found to affect the outcome of SET. Multivariate analysis revealed hypertension as a predictor of symptomatic outcome after SET (p = 0.045). Furthermore, ex-smokers (p = 0.021) and those previously diagnosed with hypercholesterolaemia (p = 0.020) or ischaemic heart disease (p = 0.029) had superior exercise compliance. Using linear regression, smoking history (p = 0.024) was identified as a predictor of compliance to SET. Establishing exercise compliance remains challenging in the PAD cohort. Pre-exercise patient education and personalised exercise prescriptions may result in improvements in function and compliance.

  11. The relationship between aortic calcification volume and obstructive coronary artery disease: comparison with coronary calcification volume

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Seok; Kim, Jeong Ho; Park, Chul Hi; Park, Seon Young; Choe, Soo Jin; Hwang, Hee Young; Kim, Hyung Sik [Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2007-12-15

    We compared the diagnostic performance of aortic calcification volume with that of coronary artery calcification volume at CT in diagnosing obstructive coronary artery disease (OCAD). A total of 308 patients (M: F 141: 167) underwent coronary CT angiography using a 64-slice MDCT. We measured the calcification volume (mm{sup 3}) of coronary artery (CAC), thoracic aorta (TAC), abdominal aorta (AAC), and whole aorta (AC) at unenhanced CT. OCAD was defined as the significant stenosis ({>=} 50%) in any coronary artery at CT angiography. The diagnostic performance for OCAD was evaluated by calculating the area under the receiver operating characteristic (ROC) curve. Among the 308 patients studied, 45 patients were diagnosed with OCAD. The mean volumes of TAC, AAC, AC, and CAC were 518.8 mm{sup 3}, 551.5 mm{sup 3}, 1069.9 mm{sup 3}, 57.6 mm{sup 3} respectively. The areas under the ROC curve of TAC, AAC, AC, and CAC for OCAD were 0.766 (0.694 < 95% confidence interval < 0.838), 0.837 (0.784 < 95% confidence interval < 0.892), 0.814 (0.755 < 95% confidence interval < 0.873), 0.871 (0.812 < 95% confidence interval < 0.930), respectively. The volume of aortic calcification as well as coronary artery calcification is associated with obstructive coronary artery disease.

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

    DEFF Research Database (Denmark)

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

    1995-01-01

    and in controls. METHODS: Thirty-nine patients with cirrhosis (12 patients with Child-Turcotte class A, 14 with class B, and 13 with class C) and 6 controls were studied. During hepatic vein catheterization, cardiac output, systemic vascular resistance, central and arterial blood volume, noncentral blood volume...

  13. [Value of dynamic arterial elastance in the predication of arterial pressure response to volume loading in shock patients].

    Science.gov (United States)

    Gong, Mao-lei; Liu, Da-wei; Wang, Xiao-ting; Chen, Xiu-kai

    2013-05-07

    To explore the value of dynamic arterial elastance (Eadyn) in the predication of arterial pressure response to volume loading in shock patients. A total of 32 patients with pulse indicator continuous cardiac output (PICCO) monitoring at our intensive care unit from January 2011 to December 2012 were retrospectively studied. The decision of fluid replacement was based upon the presence of shock (mean arterial pressure (MAP) ≤ 65 mm Hg, systolic arterial pressure arterial pressure response to volume loading. Significantly different between MAP responders and MAP nonresponders, baseline Eadyn was an effective predictor of MAP increase after volume loading. The area under the ROC curve was 0.95 for the prediction of volume loading on MAP for Eadyn at baseline (P 0.85 predicted a MAP increase after volume administration with a sensitivity of 89.5% and a specificity of 92.3%. Baseline Eadyn may predict accurately arterial pressure response in MAP to volume loading in shock patients.

  14. Acute effects of supramaximal exercise on carotid artery compliance and pulse pressure in young men and women.

    Science.gov (United States)

    Rossow, Lindy; Fahs, Christopher A; Guerra, Myriam; Jae, Sae Young; Heffernan, Kevin S; Fernhall, Bo

    2010-11-01

    The purpose of this study was to determine the cumulative effects of repeated cycling sprints (Wingate tests) on carotid compliance and blood pressure (BP). Fourteen young, healthy men and women completed this study. Vascular and hemodynamic measurements were taken at rest, 5 min following a first Wingate test, 25 min following the first Wingate test, 5 min following a second Wingate test, and 25 min following the second Wingate test. At each time point, the measurements taken included brachial and carotid pulse pressure (PP), heart rate, carotid artery maximum and minimum diameters, and carotid compliance. Carotid BP was obtained with applanation tonometry. Carotid diameters were obtained using ultrasonography and compliance was calculated from carotid diameters and BP. Carotid and brachial PP increased significantly (P sprint, carotid arterial compliance decreased significantly more than 5 min following the first sprint (P sprint reduces carotid artery compliance immediately after exercise. Performance of a second identical cycling sprint further compounds this vascular change, reducing carotid artery compliance beyond levels seen following a single cycling sprint.

  15. An inverse approach to determining spatially varying arterial compliance using ultrasound imaging

    Science.gov (United States)

    Mcgarry, Matthew; Li, Ronny; Apostolakis, Iason; Nauleau, Pierre; Konofagou, Elisa E.

    2016-08-01

    The mechanical properties of arteries are implicated in a wide variety of cardiovascular diseases, many of which are expected to involve a strong spatial variation in properties that can be depicted by diagnostic imaging. A pulse wave inverse problem (PWIP) is presented, which can produce spatially resolved estimates of vessel compliance from ultrasound measurements of the vessel wall displacements. The 1D equations governing pulse wave propagation in a flexible tube are parameterized by the spatially varying properties, discrete cosine transform components of the inlet pressure boundary conditions, viscous loss constant and a resistance outlet boundary condition. Gradient descent optimization is used to fit displacements from the model to the measured data by updating the model parameters. Inversion of simulated data showed that the PWIP can accurately recover the correct compliance distribution and inlet pressure under realistic conditions, even under high simulated measurement noise conditions. Silicone phantoms with known compliance contrast were imaged with a clinical ultrasound system. The PWIP produced spatially and quantitatively accurate maps of the phantom compliance compared to independent static property estimates, and the known locations of stiff inclusions (which were as small as 7 mm). The PWIP is necessary for these phantom experiments as the spatiotemporal resolution, measurement noise and compliance contrast does not allow accurate tracking of the pulse wave velocity using traditional approaches (e.g. 50% upstroke markers). Results from simulations indicate reflections generated from material interfaces may negatively affect wave velocity estimates, whereas these reflections are accounted for in the PWIP and do not cause problems.

  16. Mean platelet volume in patients with coronary artery ectasia.

    Science.gov (United States)

    Sen, Nihat; Tavil, Yusuf; Yazici, Hüseyin Ugur; Hizal, Fatma; Açikgöz, Sadik Kadri; Abaci, Adnan; Cengel, Atiye

    2007-08-01

    Mean platelet volume (MPV) is an indicator of platelet activation, a central process in the pathophysiology of coronary heart disease. The importance of coronary artery ectasia (CAE) lies in the fact that in 85% of cases it is accompanied by atherosclerotic coronary disease. The present study was designed to investigate MPV values in CAE patients in comparison with individuals with normal coronary angiograms. MPV was measured in 67 consecutive patients (mean age: 55.3+/-9.7 years) with isolated CAE and 55 control subjects (mean age: 53.6+/-10.1 years). Coronary artery ectasia was defined as without any stenotic lesion, on visual assessment, of the coronary arteries with a luminal dilatation 1.5-fold or more of the adjacent normal coronary segments. Four subgroups were composed according to the extension of CAE in coronary arteries. MPV was significantly higher in patients with CAE than in the control group (9.27+/-1.32 vs. 8.40+/-0.95, p<0.001). There were no statistically significant differences in MPV among the subgroups with different CAE severity. It was shown for the first time that patients with CAE have higher MPVs than control subjects with normal coronary angiograms. Hence MPV might be used as a follow-up marker in patients with CAE with or without coronary artery disease.

  17. Effect of beta-adrenergic blockade on elevated arterial compliance and low systemic vascular resistance in cirrhosis

    DEFF Research Database (Denmark)

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

    2001-01-01

    with beta-blockers, but the effect of this treatment on arterial compliance has not been investigated. The aim of the present study was therefore to assess the effects of propranolol on the arterial compliance of patients with cirrhosis. METHODS: Twenty patients with cirrhosis underwent a haemodynamic......) of 17.8 mmHg, and responded to beta-blocker treatment with a significant reduction in the HVPG (-16%; P beta-adrenergic blockade (1.27 versus 1.29 ml/mmHg, +2%, ns), whereas...... with beta-blockers increases small vessel (arteriolar) vascular tone towards the normal level, but does not affect the elevated compliance of the larger arteries in patients with cirrhosis....

  18. Volume-targeted ventilation and arterial carbon dioxide in neonates.

    Science.gov (United States)

    Dawson, Catherine; Davies, Mark William

    2005-01-01

    To review the arterial carbon dioxide tensions (PaCO(2)) in newborn infants ventilated using synchronized intermittent mandatory ventilation (SIMV) in volume guarantee mode (using the Dräger Babylog 8000+) with a unit policy targeting tidal volumes of approximately 4 mL/kg. Data on ventilator settings and arterial PaCO(2) levels were collected on all arterial blood gases (ABG; n = 288) from 50 neonates ( 65 mmHg) were determined. The mean (SD) PaCO(2) during the first 48 h was 46.6 (9.0) mmHg. The mean (SD) PaCO(2) on the first blood gas of those infants commenced on volume guarantee from admission was 45.1 (12.5) mmHg. Severe hypo- or hypercapnoea occurred in 8% of infants at the time of their first blood gas measurement, and in levels at the first blood gas measurement and during the first 48 h of life; and avoid severe hypo- or hypercapnoea over 90% of the time.

  19. Effects of pressure-dependent segmental arterial compliance and postural changes on pulse wave transmission in an arterial model of the human upper limb.

    Science.gov (United States)

    Xu, Ke; Butlin, Mark; Avolio, Alberto P

    2011-01-01

    With increasing interest in the effect of postural changes on arterial blood pressure and vascular properties, it is important to understand effects of pressure-dependent arterial compliance. This study investigates effects of pressure-dependent compliance on pulse wave velocity (PWVar), pressure wave shape, and transmission characteristics in an arterial model of the human arm from heart to radial artery from supine to standing. Estimated central pressure waveform was used as the input for the model, calculated using a validated transfer function (SphygmoCor, AtCor Medical) from recorded radial pulses in 10 healthy male subjects (53.8 ± 7.9 years) during 0, 30, 60 and 90 degree head-up tilt. A 5-segment linear model was optimized using estimated central and recorded radial arterial pulse; each segment represented by an equivalent inductance, resistance and capacitance (compliance (C)) Pressure-dependent compliance (C(P)=a · e(b · P) was added to develop a nonlinear model, and the radial pulse calculated. Comparison of the radial pulse calculated by the linear and nonlinear models showed no statistical difference in systolic, diastolic, mean, and pulse pressure in any position of tilt. However, waveform shape was increasingly divergent at higher angles of tilt (RMS error 2.3 ± 1.2 mmHg supine, 6.5 ± 3.0 mmHg standing) as was PWVar (0% increase from supine to standing in the linear model, 16.7% increase in nonlinear model). Fourier analysis demonstrated peak amplitude of transmission being at higher frequencies and phase delay being lower in the nonlinear model relative to the linear model. Pressure-dependent arterial compliance, whilst having no effect on peak values of pressure, has significant effects on waveform shape and transmission speed, especially with a more upright position.

  20. Effects of Long Duration Spaceflight on Venous and Arterial Compliance in Astronants

    Science.gov (United States)

    Platts, Steven; Ribeiro, L. Christine

    2014-01-01

    1. Project Overview Visual impairment and intracranial pressure (VIIP) is a spaceflight-associated medical condition affecting at least a third of American astronauts who have flown International Space Station (ISS) missions. VIIP is defined primarily by visual acuity deficits and anatomical changes to eye structures. In some astronauts, eye-related changes do not revert back to the preflight state upon return to Earth. Our team will study some of the possible causes for this syndrome. This will be achieved by reviewing previous astronaut data for factors that may predispose astronauts to higher rates of developing this syndrome or greater severity of symptoms. Additionally, we will conduct 3 separate experiments that will characterize vessels in the head and neck and measure the effects of the experimental conditions on ocular structures and function. 2. Technical Summary The primary objective of this study is to determine whether vascular compliance is altered by spaceflight and whether such adaptations are related to the incidence of the VIIP. In particular, we will measure ocular parameters and vascular compliance in vessels of the head and neck in astronauts who have no spaceflight experience (Ground), in astronauts before, during, and after spaceflight (Flight), and in bed rest subjects with conditions similar to spaceflight (Bed Rest). Additionally, we will analyze astronaut data from the Lifetime Surveillance of Astronaut Health (LSAH) archives to determine which factors might be predictive of the development of VIIP (Data Mining). The project will be conducted in four separate, but related parts. Hypothesis The central hypothesis of this proposal is that exposure to the spaceflight environment aboard the ISS may lead to development of the VIIP syndrome (increased intracranial pressure and impaired visual acuity) and that this may be related to alterations in venous and/or arterial compliance in the head and neck. Specific Aims 1. To determine whether

  1. Non-invasive quantification of peripheral arterial volume distensibility and its non-linear relationship with arterial pressure.

    Science.gov (United States)

    Zheng, Dingchang; Murray, Alan

    2009-05-29

    Arterial wall function is associated with different physiological and clinical factors. Changes in arterial pressure cause major changes in the arterial wall. This study presents a simple non-invasive method to quantify arterial volume distensibility changes with different arterial pressures. The electrocardiogram, finger and ear photoplethysmogram were recorded from 15 subjects with the right arm at five different positions (90 degrees , 45 degrees , 0 degrees , -45 degrees and -90 degrees referred to the horizontal level). Arm pulse propagation time was determined by subtracting ear pulse transit time from finger pulse transit time, and was used to obtain arterial volume distensibility. The mean arterial blood pressure with the arm at the horizontal level was acquired, and changes with position were calculated using the hydrostatic principle that blood pressure in the arm is linearly related to its vertical distance from the horizontal level. The mean arm pulse propagation times for the five different positions were 88, 72, 57, 54 and 52ms, with the corresponding mean arterial volume distensibility of 0.234%, 0.158%, 0.099%, 0.088% and 0.083% per mmHg. For all consecutive changes in arm position, arm pulse propagation time and arterial volume distensibility, were significantly different (all probability Ppressure decreased significantly between each consecutive arm position from 90 degrees to -45 degrees (all Ppressure changes from 101 to 58mmHg. In conclusion, the inverse and non-linear relationship between arterial volume distensibility and arterial pressure has been quantified using a simple arm positioning procedure, with the greatest effect at low pressures. This work is an important step in developing a simple non-invasive technique for assessing peripheral arterial volume distensibility.

  2. Associations of blood pressure and arterial compliance with occupational noise exposure in female workers of textile mill

    Institute of Scientific and Technical Information of China (English)

    NI Chun-hui; ZHANG Yu-jun; CHEN Zhi-yong; ZHOU Yin; ZHOU Jian-wei; Pan Jing-jing; LIU Nian; WANG Jun; LIANG Chen-ke; ZHANG Zhi-zhong

    2007-01-01

    Background There are few studies on the arterial compliance of noise exposure. The purpose of this study was to understand the relationship between hearing loss, blood pressure and arterial compliance of female workers who exposed to occupational noise in a textile mill.Methods The noise levels in the workplace were measured with a HS6288 sound level meter. Cumulated noise exposure (CNE) was calculated according to the noise intensity and the exposure period. Hearing ability and arterial compliance were measured in 618 noise exposed workers. The database was set up with EpiData and the statistical analysis was performed with SAS software 9.1.3.Results The noise levels were 80.1dB(A) to 113.5dB(A), of which the levels at 92.5% of the noise monitoring sites were over the national standard. The incidence of high frequency hearing loss (HFHL) was 24.43% and language frequency hearing impairment (LFHI) was 0.81%. The incidence of hypertension was 7.93%. Both systolic blood pressure (SBP)and diastolic blood pressure (DBP) in the high frequency hearing loss group were significantly higher than those in the normal hearing group (P<0.05), while C1 (large artery compliance) and C2 (small artery compliance) were significantly lower (P<0.05). The high frequency hearing threshold (HFHT) of the hypertension group was significantly higher than in the normal blood pressure group (P<0.05), while C1 and C2 were significantly lower (P<0.05). C1 and C2 had a negative correlation with HFHT, SBP, DBP, mean of arterial pressure (MAP), pulse pressure (PP) and pulse rate (PR) (P<0.05).The multiple regression analyses showed that blood pressure and PR were the main influencing factors on C1 and C2.LFHT was an influence on C2 and HFHT on C1.Conclusions Textile mill noise pollution is very serious and has an obvious influence on worker's auditory function. The female workers with Iow artery compliance or with high blood pressure might be suffering from hearing loss; those with noise

  3. Federal Facilities Compliance Act, Draft Site Treatment Plan: Background Volume, Part 2, Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-08-31

    This Draft Site Treatment Plan was prepared by Ames Laboratory to meet the requirements of the Federal Facilities Compliance Act. Topics discussed include: purpose and scope of the plan; site history and mission; draft plant organization; waste minimization; waste characterization; preferred option selection process; technology for treating low-level radioactive wastes and TRU wastes; future generation of mixed waste streams; funding; and process for evaluating disposal issues in support of the site treatment plan.

  4. Influence of arterial compliance on presence and extent of ischaemia during stress echocardiography

    Science.gov (United States)

    Haluska, B A; Matthys, K; Fathi, R; Rozis, E; Carlier, S G; Marwick, T H

    2006-01-01

    Objective To seek an association between total arterial compliance (TAC) and the extent of ischaemia at stress echocardiography. Design Cohort study. Setting Regional cardiac centre. Methods 255 consecutive patients (147 men; mean (SD) age 58 (8)) presenting for stress echocardiography for clinical indications were studied. Wall motion score index (WMSI) was calculated and ischaemia was defined by an inducible or worsening wall motion abnormality. Peak WMSI was used to reflect the extent of dysfunction (ischaemia or scar), and ΔWMSI was indicative of extent of ischaemia. TAC was assessed at rest by simultaneous radial applanation tonometry and pulsed wave Doppler in all patients. Results Ischaemia was identified by stress echocardiography in 65 patients (25%). TAC was similar in the groups with negative and positive echocardiograms (1.08 (0.41) v 1.17 (0.51) ml/mm Hg, not significant). However, the extent of dysfunction was associated with TAC independently of age, blood pressure, risk factors, and use of a β blocker. Moreover, the extent of ischaemia was determined by TAC, risk factors, and use of a β blocker. Conclusion While traditional cardiovascular risk factors are strong predictors of ischaemia on stress echocardiography, TAC is an independent predictor of the extent of ischaemia. PMID:16365349

  5. Rationale and methodology of monitoring ambulatory blood pressure and arterial compliance in the Hypertension in the Very Elderly Trial

    OpenAIRE

    2006-01-01

    OBJECTIVE: This article describes the rationale and methodology for the monitoring of ambulatory blood pressure and arterial compliance in hypertensive patients aged 80 years and above. This is a side project of the Hypertension in the Very Elderly Trial. METHODS: The hypertension in the Very Elderly Trial is a multicentre, double-blind, randomized, placebo-controlled trial aiming to investigate the effect of active treatment on cardiovascular and other outcomes in hypertensive patients aged ...

  6. Normal reference values for vertebral artery flow volume by color Doppler sonography in Korean adults

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Sook; Cha, Jang Gyu; Park, Seong Jin; Joh, Joon Hee; Park, Jai Soung; Kim, Dae Ho; Lee, Hae Kyung; Ahn, Hyun Cheol [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2003-09-15

    Vertebrobasilar ischemia has been attributed to a reduction of net vertebral artery flow volume. This study was to establish the reference values for the flow volume of the vertebral artery using color Doppler sonography in the normal Korea adults. Thirty five normal Korea adults without any underlying disease including hypertension, hyperlipidemia, diabetes, heart disease, obesity (body mas index>30), or carotid artery stenosis was included. There were 17 males and 18 females, age ranged from 20 to 53 years (average=32.86 years). Flow velocities and vessel diameters were recorded in the intertransverse (V2) segment, usually at C5-6 level, bilaterally. The flow volume (Q) was calculated. (Q=time averaged mean velocity x cross sectional area of vessel) A lower Flow velocity and smaller vessel diameter were measured on the right side compared to those of the left side, resulting in a lower flow volume. The calculated flow volumes using the equation were 77.0 +- 39.7 ml/min for the right side and 127.6 +- 71.0 ml/min for the left side (p=0.0001) while the net vertebral artery flow volume was 204.6 +- 81.8 ml/min. Decrease in the vertebral artery flow volume was statistically significant with advanced age. (r=-0.36, p=0.032). Vertebral artery blood flow volume was 191.20 +- 59.19 ml/min in male, and 217.28 +- 98.67 ml/min in female (p=0.6). The normal range for the net vertebral artery flow volume defined by the 5th to 95th percentiles was between 110.06 and 364.1 ml/min. The normal range for the net vertebral artery flow volume was between 110.06 and 364.1 ml/min. Vertebral artery flow volume decreased with the increase of age. However, gender did not affect the blood flow volume.

  7. Effect of beta-adrenergic blockade on elevated arterial compliance and low systemic vascular resistance in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming; Henriksen, Jens Henrik

    2001-01-01

    ) of 17.8 mmHg, and responded to beta-blocker treatment with a significant reduction in the HVPG (-16%; P controls 1.01 ml/mmHg; P ... systemic vascular resistance increased substantially (1083 versus 1378 dyn x s x cm-5, +27%; P blood pressure (-6%; P blood flow (-22%; P ... with beta-blockers increases small vessel (arteriolar) vascular tone towards the normal level, but does not affect the elevated compliance of the larger arteries in patients with cirrhosis....

  8. Arterial Pulse Pressure and Its Association With Reduced Stroke Volume During Progressive Central Hypovolemia

    Science.gov (United States)

    2006-09-01

    Measurement of Stroke Volume Stroke volume (SV) was measured noninvasively using thoracic electrical bioimpedance (TEB). TEB was measured using four...tients who did not die. For the current study, we measured mean arterial blood pressure (MAP), pulse pressure (PP), SV, and muscle sympathetic nerve...hemorrhagic shock. The vital sign monitors placed in emergency transport vehicles provide the medic with routine measures of arterial systolic, diastolic and

  9. Finite volume numerical solution to a blood flow problem in human artery

    Science.gov (United States)

    Wijayanti Budiawan, Inge; Mungkasi, Sudi

    2017-01-01

    In this paper, we solve a one dimensional blood flow model in human artery. This model is of a non-linear hyperbolic partial differential equation system which can generate either continuous or discontinuous solution. We use the Lax–Friedrichs finite volume method to solve this model. Particularly, we investigate how a pulse propagates in human artery. For this simulation, we give a single sine wave with a small time period as an impluse input on the left boundary. The finite volume method is successful in simulating how the pulse propagates in the artery. It detects the positions of the pulse for the whole time period.

  10. Continuous stroke volume monitoring by modelling flow from non-invasive measurement of arterial pressure in humans under orthostatic stress

    NARCIS (Netherlands)

    Harms, M.P.M.; Wesseling, K.H.; Pott, F.; Jenstrup, M.; Goudoever, J. van; Secher, N.H.; Lieshout, J.J. van

    1999-01-01

    The relationship between aortic flow and pressure is described by a three-element model of the arterial input impedance, including continuous correction for variations in the diameter and the compliance of the aorta (Modelflow). We computed the aortic flow from arterial pressure by this model, and

  11. Magnetic Resonance Venous Volume Measurements in Peripheral Artery Disease (from ELIMIT).

    Science.gov (United States)

    Kamran, Hassan; Nambi, Vijay; Negi, Smita; Yang, Eric Y; Chen, Changyi; Virani, Salim S; Kougias, Panos; Lumsden, Alan B; Morrisett, Joel D; Ballantyne, Christie M; Brunner, Gerd

    2016-11-01

    The relation between the arterial and venous systems in patients with impaired lower extremity blood flow remains poorly described. The objective of this secondary analysis of the Effectiveness of Intensive Lipid Modification Medication in Preventing the Progression on Peripheral Artery Disease Trial was to determine the association between femoral vein (FV) volumes and measurements of peripheral artery disease. FV wall, lumen, and total volumes were quantified with fast spin-echo proton density-weighted magnetic resonance imaging scans in 79 patients with peripheral artery disease over 2 years. Reproducibility was excellent for FV total vessel (intraclass correlation coefficient 0.924, confidence interval 0.910 to 0.935) and lumen volumes (intraclass correlation coefficient 0.893, confidence interval 0.873 to 0.910). Baseline superficial femoral artery volumes were directly associated with FV wall (r = 0.46, p <0.0001), lumen (r = 0.42, p = 0.0001), and total volumes (r = 0.46, p <0.0001). The 2-year change in maximum walking time was inversely associated with the 24-month change in FV total volume (r = -0.45, p = 0.03). In conclusion, FV volumes can be measured reliably with fast spin-echo proton density-weighted magnetic resonance imaging, and baseline superficial femoral artery plaque burden is positively associated with FV volumes, whereas the 2-year change in FV volumes and leg function show an inverse relation.

  12. The relationship of pulmonary vascular resistance and compliance to pulmonary artery wedge pressure during submaximal exercise in healthy older adults

    Science.gov (United States)

    Wright, Stephen P.; Granton, John T.; Esfandiari, Sam; Goodman, Jack M.

    2016-01-01

    Key points A consistent inverse hyperbolic relationship has been observed between pulmonary vascular resistance and compliance, although changes in pulmonary artery wedge pressure (PAWP) may modify this relationship.This relationship predicts that pulmonary artery systolic, diastolic and mean pressure maintain a consistent relationship relative to the PAWP.We show that, in healthy exercising human adults, both pulmonary vascular resistance and compliance decrease in relation to exercise‐associated increases in PAWP.Pulmonary artery systolic, diastolic and mean pressures maintain a consistent relationship with one another, increasing linearly with increasing PAWP.Increases in PAWP in the setting of exercise are directly related to a decrease in pulmonary vascular compliance, despite small decreases in pulmonary vascular resistance, thereby increasing the pulsatile afterload to the right ventricle. Abstract The resistive and pulsatile components of right ventricular afterload (pulmonary vascular resistance, Rp; compliance, Cp) are related by an inverse hyperbolic function, expressed as their product known as RpCp‐time. The RpCp‐time exhibits a narrow range, although it may be altered by the pulmonary artery wedge pressure (PAWP). Identifying the determinants of RpCp‐time should improve our understanding of the physiological behaviour of pulmonary arterial systolic (PASP), diastolic (PADP) and mean (mPAP) pressures in response to perturbations. We examined the effect of exercise in 28 healthy non‐athletic adults (55 ± 6 years) who underwent right heart catheterization to assess haemodynamics and calculate Rp and Cp. Measurements were made at rest and during two consecutive 8–10 min stages of cycle ergometry, at targeted heart‐rates of 100 beats min–1 (Light) and 120 beats min–1 (Moderate). Cardiac output increased progressively during exercise. PASP, PADP, mPAP and PAWP increased for Light exercise, without any further rise for Moderate

  13. Effects of Long Duration Spaceflight on Venous and Arterial Compliance: Bed Rest

    Science.gov (United States)

    Ribeiro, L. Christine; Platts, Steven H.; Laurie, Steven S.; Lee, Stuart M. C.; Martin, David S.; Ploutz-Snyder, Robert J.; Stenger, Michael B.

    2017-01-01

    The primary objective was to determine whether a high sodium diet during bed rest induced alterations in vascular compliance and was related to the incidence of VIIP. Ocular structural and functional measures and vascular ultrasound of the head and neck were acquired in bed rest subjects completing 10-14 days in 6deg head-down tilt.

  14. Relative value of pressures and volumes in assessing fluid responsiveness after valvular and coronary artery surgery.

    Science.gov (United States)

    Breukers, Rose-Marieke B G E; Trof, Ronald J; de Wilde, Rob B P; van den Berg, Paul C M; Twisk, Jos W R; Jansen, Jos R C; Groeneveld, Johan

    2009-01-01

    Cardiac function may differ after valvular (VS) and coronary artery (CAS) surgery and this may affect assessment of fluid responsiveness. The aim of the study was to compare VS and CAS in the value of cardiac filling pressures and volumes herein. There were eight consecutive patients after VS and eight after CAS, with femoral and pulmonary artery catheters in place. In each patient, five sequential fluid loading steps of 250 ml of colloid each were done. We measured central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP) and, by transpulmonary thermodilution, cardiac index (CI) and global end-diastolic (GEDVI) and intrathoracic blood volume (ITBVI) indices. Fluid responsiveness was defined by a CI increase >5% or >10% per step. Global ejection fraction was lower and PAOP was higher after VS than CAS. In responding steps after VS (n=9-14) PAOP and volumes increased, while CVP and volumes increased in responding steps (n=12-19) after CAS. Baseline PAOP was lower in responding steps after VS only. Hence, baseline PAOP as well as changes in PAOP and volumes were of predictive value after VS and changes in CVP and volumes after CAS, in receiver operating characteristic curves. After VS, PAOP and volume changes equally correlated to CI changes. After CAS, only changes in CVP and volumes correlated to those in CI. While volumes are equally useful in monitoring fluid responsiveness, the predictive and monitoring value of PAOP is greater after VS than after CAS. In contrast, the CVP is of similar value as volume measurements in monitoring fluid responsiveness after CAS. The different value of pressures rather than of volumes between surgery types is likely caused by systolic left ventricular dysfunction in VS. The study suggests an effect of systolic cardiac function on optimal parameters of fluid responsiveness and superiority of the pulmonary artery catheter over transpulmonary dilution, for haemodynamic monitoring of VS patients.

  15. Relationship between pulmonary artery volumes at computed tomography and pulmonary artery pressures in patients with- and without pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Froelich, Jens J. [Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: jens.froelich@klinikum-hef.de; Koenig, Helmut [Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: helmut.koenig@siemens.com; Knaak, Lennard [Department of Medicine, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: froehlic@staff.uni-marburg.de; Krass, Stefan [MeVis Research, Universitaetsallee 29, 28359 Bremen (Germany)], E-mail: krass@mevis.de; Klose, Klaus J. [Department of Radiology, Philipps-University Hospital, Baldingerstrasse, 35043 Marburg (Germany)], E-mail: klose@med.uni-marburg.de

    2008-09-15

    Objectives: This study was designed to determine the relationship between pulmonary artery (PA) volumes at computed tomography (CT) and PA pressures at right-sided heart catheterization in patients with and without pulmonary hypertension (PAH) to develop a noninvasive CT method of PA pressure quantification. Materials and methods: Sixteen patients with chronic sleep apnea syndrome underwent contrast enhanced helical CT (slice thickness 3 mm; pitch 2; increment 2 mm) at inspiration. Eight patients had PAH while cardiopulmonary disease has been excluded in eight other patients. Vascular volumes were determined using a 3D technique (threshold seeded vascular tracing algorithm; thresholds -600 H [lower] and 3000 H [upper]). Right-sided heart catheterization measurements were available for linear regression analysis of PA volumes and pressures. Results: Correlation between PA pressures and volumes (normalized for BMI), was high in both groups (without PAH: r = .85; with PAH .90, Pearson). Compared to elevated PA pressures in patients with pulmonary hypertension (p < .005), PA volumes also were significantly increased (p < .05) among the groups. Conclusions: High correlation was found between PA volumes and mean PA pressures in patients with- and without PAH. Significant differences in PA volumes at CT-volumetry may admit non-invasive determination of pulmonary hypertension.

  16. Localization of relaxin receptors in arteries and veins, and region-specific increases in compliance and bradykinin-mediated relaxation after in vivo serelaxin treatment.

    Science.gov (United States)

    Jelinic, Maria; Leo, Chen-Huei; Post Uiterweer, Emiel D; Sandow, Shaun L; Gooi, Jonathan H; Wlodek, Mary E; Conrad, Kirk P; Parkington, Helena; Tare, Marianne; Parry, Laura J

    2014-01-01

    Relaxin is a potent vasodilator of small resistance arteries and modifies arterial compliance in some systemic vascular beds, yet receptors for relaxin, such as RXFP1, have only been localized to vascular smooth muscle. This study first aimed to localize RXFP1 in rat arteries and veins from different organ beds and determine whether receptors are present in endothelial cells. We then tested the hypothesis that region-specific vascular effects of relaxin may be influenced by the cellular localization of RXFP1 within different blood vessels. The aorta, vena cava, mesenteric artery, and vein had significantly higher (Pdifferential distribution of RXFP1 on endothelial and smooth muscle across the vasculature. In rats, mesenteric arteries exhibit the greatest functional response to chronic serelaxin treatment.

  17. Effects of hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume

    Energy Technology Data Exchange (ETDEWEB)

    Manning, R.D. Jr.

    1987-01-01

    The effects of long-term hypoproteinemia on renal hemodynamics, arterial pressure, and fluid volume were studied in eight conscious dogs over a 34-day period. Plasma protein concentration (PPC) was decreased by daily plasmapheresis, and the effects of decreasing and increasing sodium intake were measured. By the 12th day of plasmapheresis PPC had decreased to 2.5 g/dl from a control value of 7.2 g/dl, mean arterial pressure had decreased to 78% of control, glomerular filtration rate (GFR) was 75.2% of control, and urinary sodium excretion was decreased. By day 18 of plasmapheresis, estimated renal plasma flow (ERPF) was decreased to 60% of control due to the decreased arterial pressure and an increase in renal vascular resistance. GFR and ERPF were determined from the total clearance of (/sup 125/I)iothalamate and (/sup 131/I)iodohippurate. Also, plasma renin activity and plasma aldosterone concentration were both increased, and the relationship between mean arterial pressure and urinary sodium excretion was distinctly shifted to the left along the arterial pressure axis. In contradistinction to acute experiments, chronic hypoproteinemia results in decreases in GFR, ERPF, and urinary sodium excretion and has marked effects on both fluid volume and arterial pressure regulation.

  18. Changes of Blood Flow Volume in the Superior Mesenteric Artery and Brachial Artery with Abdominal Thermal Stimulation

    Directory of Open Access Journals (Sweden)

    Shin Takayama

    2011-01-01

    Full Text Available In traditional Chinese medicine, moxibustion is a local thermal therapy that is used for several conditions. Quantifying the effects of moxibustion therapy has been difficult because the treatment temperature depends on the physician's experience, and the temperature distribution in the target area is not uniform. This prospective observational study aims to quantify the effect of local thermal stimulation to the abdomen. We developed a heat transfer control device (HTCD for local thermal stimulation. Twenty-four healthy subjects were enrolled and they underwent abdominal thermal stimulation to the para-umbilical region with the device for 20 min. Blood flow volume in the superior mesenteric artery (SMA and brachial artery (BA, the heart rate and the blood pressure were measured at rest, 15 min after starting thermal stimulation and 10, 20, 30 and 40 min after completing thermal stimulation. Blood flow parameters were measured by high-resolution ultrasound. In the SMA, blood flow volume was significantly increased during thermal stimulation (, as well as at 10 min ( and 20 min ( after stimulation. In the BA, blood flow volume decreased at 40 min after stimulation (. In conclusion we could quantify the effect of local thermal stimulation with an HTCD and high-resolution ultrasound. Thermal stimulation of the para-umbilical region increased blood flow in the SMA 20 min after stimulation in healthy subjects.

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

    Science.gov (United States)

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

    2014-01-01

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

  20. Directory of Certificates of Compliance for radioactive materials packages: Report of NRC approved packages. Volume 1, Revision 18

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 of approved QA programs. The reports include a listing of all users of each package design and approved QA programs prior to the publication date.

  1. Arterial diameter during central volume depletion in humans

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Madsen, P; Matzen, S;

    1995-01-01

    .3) to 2.2 (SEM 0.3) 1.min-1] and heart rate [HR, from 64 (SEM 3) to 100 (SEM 7) beats.min-1], mean arterial pressure (MAP, from 77 (SEM 4) to 89 (SEM 2) mmHg [10.3 (SEM 0.53 to 11.9 (SEM 0.27) kPa]) and total peripheral resistance (TPR, from 19 (SEM 2) to 34 (SEM 4) mmHg.min.1-1 [2.5 (SEM 0.27) to 4.......5 (SEM 0.53) kPa.min.1-1]) increased; but with the appearance of presyncopal symptoms, HR, MAP and TPR were reduced to 65 (SEM 8) beats.min-1, 46 (SEM 4) mmHg [6.1 (SEM 0.53) kPa] and 18 (SEM 3) mmHg.min.1-1 [2.4 (SEM 0.4) kPa.min-1.1-1], respectively (P

  2. THE IMPORTANCE OF THE COMPLIANCE TO A MEDICAL TREATMENT OF A PATIENT WITH A VERY HIGH CARDIOVASCULAR RISK AND COMORBIDITY: ARTERIAL HYPERTENSION, ATRIAL FIBRILLATION AND DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    T. V. Zolotarova

    2016-12-01

    Full Text Available The ultimate goal of any prescribed medical therapy is to achieve certain desired results in the patients concerned. Compliance to medical recommendations not only includes patient compliance with medication but also with diet, exercise, or lifestyle changes. Considered a clinical example of the patient of a very high cardiovascular risk with comorbid pathology: arterial hypertension, atrial fibrillation and diabetes mellitus. We have shown with this case as in comorbid patients with high cardiovascular risk could be organized medical treatment without polypharmacy.

  3. Mean Platelet Volume and Arterial Stiffness – Clinical Relationship and Common Genetic Variability

    Science.gov (United States)

    Panova-Noeva, Marina; Arnold, Natalie; Hermanns, M. Iris; Prochaska, Jürgen H.; Schulz, Andreas; Spronk, Henri M.; Binder, Harald; Pfeiffer, Norbert; Beutel, Manfred; Blankenberg, Stefan; Zeller, Tanja; Lotz, Johannes; Münzel, Thomas; Lackner, Karl J.; ten Cate, Hugo; Wild, Philipp S.

    2017-01-01

    Vessel wall stiffening is an important clinical parameter, but it is unknown whether platelets, key elements in the pathogenesis of arterial thrombosis, are associated with arterial stiffness. The present studies sought to determine whether mean platelet volume (MPV), a potential marker of platelet activation, is linked to vascular elasticity as assessed by the augmentation index (AIx), in 15,010 individuals from the population-based Gutenberg Health Study. Multivariable analysis showed that MPV in both males (β 0.776; 95thCI [0.250;1.16]; p = 0.0024) and females (β 0.881[0.328;1.43]; p = 0.0018) is strongly associated with AIx. Individuals with MPV and AIx above the sex-specific medians had worse survival. Association analysis between MPV-related genetic variants and arterial stiffness identified four genetic variants in males and one in females related with AIx. Cox regression analysis for mortality identified one of these joint genetic variants close to ring finger protein 145 gene (RNF145, rs10076782) linked with increased mortality (hazard ratio 2.02; 95thCI [1.35;3.02]; p = 0.00061). Thus, these population-based data demonstrate a close relation between platelet volume as a potential marker of platelet activation and arterial stiffness in both sexes. Further research is warranted to further elucidate the mechanisms underlying larger platelets‘ role in arterial stiffening including the role of shared common genetics. PMID:28059166

  4. Changes in superior mesenteric artery Doppler waveform during reduction of cardiac stroke volume and hypotension

    DEFF Research Database (Denmark)

    Perko, M J; Perko, Grazyna; Just, S

    1996-01-01

    Influence of stroke volume reduction and hypotension on the superior mesenteric artery (SMA) Doppler waveform was evaluated during head-up tilt-induced central hypovolemia in 11 healthy volunteers. During normotensive reduction in stroke volume, peak systolic velocity (pV), mean velocity, pulsati......Influence of stroke volume reduction and hypotension on the superior mesenteric artery (SMA) Doppler waveform was evaluated during head-up tilt-induced central hypovolemia in 11 healthy volunteers. During normotensive reduction in stroke volume, peak systolic velocity (pV), mean velocity...... of the study indicate that alterations in stroke volume induce consequential changes in the SMA Doppler waveform. These changes originate from both direct influence of stroke volume and/or pressure on blood flow velocity, and alterations in SMA peripheral resistance that follow variations in stroke volume....... Presented interdependencies should be taken into consideration while studying mesenteric physiology with the use of Doppler technique and while interpreting the duplex results in patients suffering from diseases that may influence flow velocity and mimic or obscure Doppler effects of the SMA stenosis....

  5. Environmental permit tracking and compliance: Central Artery/Tunnel Project, Boston, MA

    Energy Technology Data Exchange (ETDEWEB)

    Forbush, L. (BSC Group, Boston, MA (United States))

    1993-01-01

    The Central Artery/Tunnel (CA/T) Project in Boston, Massachusetts involves the replacement of the existing I-93 interstate highway (Central Artery) and the extension of I-90 (Massachusetts Turnpike) to Logan International Airport. To date, approximately 95 environmental and related permits have been obtained for the CA/T Project. At least 200 permits from federal, state and local regulatory agencies will be acquired for the entire Project. The proposed action includes construction activities and permanent structures related to the crossing of three bodies of water: Charles River, Fort Point Channel, and Boston Inner Harbor. The Project also includes work in Massachusetts filled tidelands, relocation or construction of outfalls, disposition of construction dewatering and tunnel drainage fluids, and capping of an abandoned landfill. The number of permits, interrelationships between permits and interfaces with design and construction schedules have necessitated the development and implementation of a permit tracking system. The system tracks permit applications from preparation through public and agency review to permit issuance. The issues are discussed in detail: Phased development of the tracking system; Utilization of Project standard scheduling system software, Primavera Project Planner; How the information generated by the tracking system is used at the Project; Report format and production; Construction phase services and the multidiscipline, integrated Project schedule.

  6. Mean platelet volume in patients with metabolic syndrome and its relationship with coronary artery disease.

    Science.gov (United States)

    Tavil, Yusuf; Sen, Nihat; Yazici, Hüseyin Uğur; Hizal, Fatma; Abaci, Adnan; Cengel, Atiye

    2007-01-01

    Mean platelet volume (MPV) is an indicator of platelet activation which is a central process in the pathophysiology of coronary heart disease. The metabolic syndrome (MS) is characterized as the clustering of closely associated and interdependent atherosclerotic risk factors. MS has also been shown to be strongly associated with poor outcome in patients with coronary artery disease (CAD). The present study was designed to investigate MPV values in patients MS and to interrogate the association with CAD. We measured MPV in 205 consecutive patients with metabolic syndrome (mean age, 53+/-7 years) and 140 control subjects without metabolic syndrome (mean age, 52+/-6 years). All patients were selected from individuals who underwent coronary angiography in our hospital with a suspicion of coronary artery disease. To evaluate the severity of coronary artery disease, the patients with MS were subdivided depending upon the coexistence of coronary artery disease: normal coronary arteries, having coronary stenotic lesions of 50%. The MPV was significantly higher in patients with MS than in the control group (10.19+/-1.49 fl vs 8.21+/-1.02 fl, p<0.001). According to the CAD severity, there were no statistically significant differences in MPV among these subgroups. We have shown for the first time that patients with MS have higher MPV compared to control subjects with normal coronary angiograms and to be associated with CAD. Hence MPV can be used as a follow up marker in patients with MS in the point of CAD.

  7. The role of vascular and interstitial compliance and vascular volume in the regulation of blood volume in two species of anuran.

    Science.gov (United States)

    Hillman, Stanley S; Degrauw, Edward A; Hoagland, Todd; Hancock, Thomas; Withers, Philip

    2010-01-01

    The objectives of this study were (1) to measure plasma (V(p)), blood (V(b)), extracellular (V(e)), and interstitial fluid (V(ist)) volumes using the same techniques; (2) to measure the rate of plasma turnover; and (3) to characterize the three important variables required to interpret transvascular flux at an organismal level (vascular compliance [C(vas)], interstitial compliance [C(ist)], and the whole-body transvascular filtration coefficient [F(c)]) in two species of anurans that differ in their capacity to regulate blood volume during dehydrational and hemorrhagic stress. The disappearance curve of Evans blue-labeled native plasma protein fitted a two-component exponential decay model for both species, indicating that plasma proteins exchanged quickly between two kinetically distinct compartments, V(p) and V(e). V(p) calculated using serial sampling times change data). Functionally, these circulatory/interstitial exchange variables of both anuran species exemplify a circulatory system with high rates of filtration (lymph formation) and with no capacity for transcapillary fluid uptake, hence requiring substantial lymphatic return to maintain vascular volume. The large C(ist) of both species provides a capacity to store extravascular volume with little perturbation of vascular pressure, but the resulting low interstitial pressures would create difficulties for extravascular fluid return to the dorsally located lymph hearts. The principal interspecific differences of greater V(b), V(p), V(ist), and C(vas) for the more terrestrial species, C. marinus, would stabilize cardiac function during hypovolemia (e.g., hemorrhage) and increase resistance to dehydration. This is consistent with this species' enhanced capacity to manage dehydrational and hemorrhagic challenges to blood volume regulation compared to L. catesbeiana.

  8. Draft Title 40 CFR 191 compliance certification application for the Waste Isolation Pilot Plant. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-31

    The Waste Isolation Pilot Plant (WIPP) is a research and development facility for the demonstration of the permanent isolation of transuranic radioactive wastes in a geologic formation. The facility was constructed in southeastern New Mexico in a manner intended to meet criteria established by the scientific and regulatory community for the safe, long-term disposal of transuranic wastes. The US Department of Energy (DOE) is preparing an application to demonstrate compliance with the requirements outlined in Title 40, Part 191 of the Code of Federal Regulations (CFR) for the permanent disposal of transuranic wastes. As mandated by the Waste Isolation Pilot Plant (WIPP) Land Withdrawal Act of 1992, the US Environmental Protection Agency (EPA) must evaluate this compliance application and provide a determination regarding compliance with the requirements within one year of receiving a complete application. Because the WIPP is a very complex program, the DOE has planned to submit the application as a draft in two parts. This strategy will allow for the DOE and the EPA to begin technical discussions on critical WIPP issues before the one-year compliance determination period begins. This report is the first of these two draft submittals.

  9. Patient-specific coronary artery blood flow simulation using myocardial volume partitioning

    Science.gov (United States)

    Kim, Kyung Hwan; Kang, Dongwoo; Kang, Nahyup; Kim, Ji-Yeon; Lee, Hyong-Euk; Kim, James D. K.

    2013-03-01

    Using computational simulation, we can analyze cardiovascular disease in non-invasive and quantitative manners. More specifically, computational modeling and simulation technology has enabled us to analyze functional aspect such as blood flow, as well as anatomical aspect such as stenosis, from medical images without invasive measurements. Note that the simplest ways to perform blood flow simulation is to apply patient-specific coronary anatomy with other average-valued properties; in this case, however, such conditions cannot fully reflect accurate physiological properties of patients. To resolve this limitation, we present a new patient-specific coronary blood flow simulation method by myocardial volume partitioning considering artery/myocardium structural correspondence. We focus on that blood supply is closely related to the mass of each myocardial segment corresponding to the artery. Therefore, we applied this concept for setting-up simulation conditions in the way to consider many patient-specific features as possible from medical image: First, we segmented coronary arteries and myocardium separately from cardiac CT; then the myocardium is partitioned into multiple regions based on coronary vasculature. The myocardial mass and required blood mass for each artery are estimated by converting myocardial volume fraction. Finally, the required blood mass is used as boundary conditions for each artery outlet, with given average aortic blood flow rate and pressure. To show effectiveness of the proposed method, fractional flow reserve (FFR) by simulation using CT image has been compared with invasive FFR measurement of real patient data, and as a result, 77% of accuracy has been obtained.

  10. Testosterone Treatment and Coronary Artery Plaque Volume in Older Men With Low Testosterone

    Science.gov (United States)

    Budoff, Matthew J.; Ellenberg, Susan S.; Lewis, Cora E.; Mohler, Emile R.; Wenger, Nanette K.; Bhasin, Shalender; Barrett-Connor, Elizabeth; Swerdloff, Ronald S.; Stephens-Shields, Alisa; Cauley, Jane A.; Crandall, Jill P.; Cunningham, Glenn R.; Ensrud, Kristine E.; Gill, Thomas M.; Matsumoto, Alvin M.; Molitch, Mark E.; Nakanishi, Rine; Nezarat, Negin; Matsumoto, Suguru; Hou, Xiaoling; Basaria, Shehzad; Diem, Susan J.; Wang, Christina; Cifelli, Denise; Snyder, Peter J.

    2017-01-01

    IMPORTANCE Recent studies have yielded conflicting results as to whether testosterone treatment increases cardiovascular risk. OBJECTIVE To test the hypothesis that testosterone treatment of older men with low testosterone slows progression of noncalcified coronary artery plaque volume. DESIGN, SETTING, AND PARTICIPANTS Double-blinded, placebo-controlled trial at 9 academic medical centers in the United States. The participants were 170 of 788 men aged 65 years or older with an average of 2 serum testosterone levels lower than 275 ng/dL (82 men assigned to placebo, 88 to testosterone) and symptoms suggestive of hypogonadism who were enrolled in the Testosterone Trials between June 24, 2010, and June 9, 2014. INTERVENTION Testosterone gel, with the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. MAIN OUTCOMES AND MEASURES The primary outcome was non calcified coronary artery plaque volume, as determined by coronary computed tomographic angiography. Secondary outcomes included total coronary artery plaque volume and coronary artery calcium score (range of 0 to >400 Agatston units, with higher values indicating more severe atherosclerosis). RESULTS Of 170 men who were enrolled, 138 (73 receiving testosterone treatment and 65 receiving placebo) completed the study and were available for the primary analysis. Among the 138 men, the mean (SD) age was 71.2 (5.7) years, and 81%were white. At baseline, 70 men (50.7%) had a coronary artery calcification score higher than 300 Agatston units, reflecting severe atherosclerosis. For the primary outcome, testosterone treatment compared with placebo was associated with a significantly greater increase in noncalcified plaque volume from baseline to 12 months (from median values of 204 mm3 to 232 mm3 vs 317 mm3 to 325 mm3, respectively; estimated difference, 41 mm3; 95%CI, 14 to 67 mm3; P = .003). For the secondary outcomes, the median total plaque volume increased

  11. Feasibility of contrast material volume reduction in coronary artery imaging using 320-slice volume CT

    Energy Technology Data Exchange (ETDEWEB)

    Hein, Patrick A.; May, Juliane; Rogalla, Patrik; Hamm, Bernd; Lembcke, Alexander [Charite-University Hospital, Department of Radiology, Berlin (Germany); Butler, Craig [Charite-University Hospital, Department of Radiology, Berlin (Germany); University of Alberta, Department of Cardiology, Edmonton, Alberta (Canada)

    2010-06-15

    To assess reduced volumes of contrast agent on image quality for coronary computed tomography angiography (CCTA) by using single-beat cardiac imaging with 320-slice CT. Forty consecutive male patients (mean age: 55.8 years) undergoing CCTA with body weight {<=}85 kg, heart rate {<=}65 bpm, and ejection fraction {>=}55% were included. Image acquisition protocol was standardized (120 kV, 400 mA, and prospective ECG-triggered single-beat nonspiral CCTA). Patients were randomly assigned to one of four groups (G1: received 40 ml, G2: 50 ml, G3: 60 ml, G4: 70 ml). Groups were compared with respect to aortic attenuation, image noise, and image quality. CT values (mean {+-} standard deviation) in the aortic root were measured as 423 {+-} 38 HU in G1, and 471 {+-} 68, 463 {+-} 60, and 476 {+-} 78 HU in G2-4, respectively. There were no statistically significant differences in attenuation among the groups (P > 0.068). All 40 CT datasets were rated diagnostic, and image noise and image quality were not statistically different among groups. Using 320-slice volume CT, diagnostic image quality can be achieved with 40 ml of contrast material in CCTA in patients with normal body weight, cardiac function, and low heart rate. (orig.)

  12. Effect of low-grade conductive heating on vascular compliance during in vitro balloon angioplasty.

    Science.gov (United States)

    Mitchel, J F; Fram, D B; Aretz, T A; Gillam, L D; Woronick, C; Waters, D D; McKay, R G

    1994-07-01

    Radiofrequency-powered, thermal balloon angioplasty is a new technique that enhances luminal dilatation with less dissection than conventional angioplasty. The purpose of this study was to assess the effect of radiofrequency heating of balloon fluid on the pressure-volume mechanics of in vitro balloon angioplasty and to determine the histologic basis for thermal-induced compliance changes. In vitro, radiofrequency-powered, thermal balloon angioplasty was performed on 46 paired iliac segments freshly harvested from 23 nonatherosclerotic pigs. Balloon inflations at 60 degrees C were compared to room temperature inflations in paired arterial segments. Intraballoon pressure and volume were recorded during each inflation as volume infusion increased pressure over a 0 to 10 atm range. Pressure-volume compliance curves were plotted for all dilatations. Six segments were stained to assess the histologic abnormalities associated with thermal compliance changes. Radiofrequency heating acutely shifted the pressure-volume curves rightward in 20 of 23 iliac segments compared to nonheated controls. This increase in compliance persisted after heating and exceeded the maximum compliance shift caused by multiple nonheated inflations in a subset of arterial segments. Histologically, heated segments showed increased thinning and compression of the arterial wall, increased medial cell necrosis and altered elastic tissue fibers compared to nonheated specimens. In conclusion, radiofrequency heating of intraballoon fluid to 60 degrees C acutely increases vascular compliance during in vitro balloon angioplasty of nonatherosclerotic iliac arteries. The increased compliance persists after heating and can be greater than the compliance shifts induced by multiple conventional dilatations. Arterial wall thinning and irreversible alteration of elastic tissue fibers probably account for thermal compliance changes.

  13. Comparison of partial volume effects in arterial and venous contrast curves in CT brain perfusion imaging.

    Directory of Open Access Journals (Sweden)

    Alan J Riordan

    Full Text Available PURPOSE: In brain CT perfusion (CTP, the arterial contrast bolus is scaled to have the same area under the curve (AUC as the venous outflow to correct for partial volume effects (PVE. This scaling is based on the assumption that large veins are unaffected by PVE. Measurement of the internal carotid artery (ICA, usually unaffected by PVE due to its large diameter, may avoid the need for partial volume correction. The aims of this work are to examine i the assumptions behind PVE correction and ii the potential of selecting the ICA obviating correction for PVE. METHODS: The AUC of the ICA and sagittal sinus were measured in CTP datasets from 52 patients. The AUCs were determined by i using commercial CTP software based on a Gaussian curve-fitting to the time attenuation curve, and ii by simple integration of the time attenuation curve over a time interval. In addition, frames acquired up to 3 minutes after first bolus passage were used to examine the ratio of arterial and venous enhancement. The impact of selecting the ICA without PVE correction was illustrated by reporting cerebral blood volume (CBV measurements. RESULTS: In 49 of 52 patients, the AUC of the ICA was significantly larger than that of the sagittal sinus (p = 0.017. Measured after the first pass bolus, contrast enhancement remained 50% higher in the ICA just after the first pass bolus, and 30% higher 3 minutes later. CBV measurements were significantly lowered when the ICA was used without PVE correction. CONCLUSIONS: Contradicting the assumptions underlying PVE correction, contrast in the ICA was significantly higher than in the sagittal sinus, even 3 minutes after the first pass of the contrast bolus. PVE correction might lead to overestimation of CBV if the CBV is calculated using the AUC of the time attenuation curves.

  14. High arterial compliance in cirrhosis is related to low adrenaline and elevated circulating calcitonin gene related peptide but not to activated vasoconstrictor systems

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren; Schifter, S

    2001-01-01

    catecholamines, renin activity, endothelin-1, and calcitonin gene related peptide (CGRP) at baseline and during oxygen inhalation. RESULTS: COMP(art) was significantly increased in cirrhotic patients compared with controls (1.32 v 1.06 ml/mm Hg; padrenaline levels (r=-0.......001) and central circulation time (r=-0.49; padrenaline (-16%; p... to COMP(art) disappeared. The relation of COMP(art) to CGRP and circulatory variables remained unchanged. CONCLUSION: Elevated arterial compliance in cirrhosis is related to low adrenaline, high CGRP, and systemic hyperdynamics but not to indicators of the activated vasoconstrictor systems (noradrenaline...

  15. Relations between a novel, reliable, and rapid index of arterial compliance (PP-HDI) and well-established inidices of arterial blood pressure (ABP) in a sample of hypertensive elderly subjects.

    Science.gov (United States)

    Bergamini, L; Finelli, M E; Bendini, C; Ferrari, E; Veschi, M; Neviani, F; Manni, B; Pelosi, A; Rioli, G; Neri, M

    2009-01-01

    Hypertension is a risk factor for a long-lasting arterial wall-remodelling leading to stiffness. The rapid method measuring the pulse pressure (PP) by means of the tool of Hypertension Diagnostic Instruments (HDI) called PP-HDI, overcomes some of the problems arising with more-time consuming methods, like ambulatory blood pressure monitoring (ABPM), and give information about the elasticity of the arterial walls. We studied the relationship between the PP-HDI, the large artery compliance (LA-C) and small artery compliance (SA-C) and few well-established indices of arterial blood pressure (ABP) in a sample of 75 hypertensive subjects, aged 65 years and over. Significant correlations between LA-C and heart rate (HR), PP-ABPM and PP-HDI were found. SA-C relates with HR and systolic blood pressure (SBP) measured in lying and standing positions. Applying a stepwise regression analysis, we found that LA-C variance stems from PP-HDI and HR, while SA-C variance stems from SBP in lying position. Receiver operator characteristic (ROC) curves for thresholds of PP showed that PP-HDI reached levels of sensitivity/specificity similar to PP-ABPM. In conclusion, surveillance of ABP through hemo-dynamic indices, in particular of SBP, is essential, nevertheless the advantage of this control is not known in an elderly population where the organ damage is already evident. PP needs necessarily an instrumental measurement. The PP-HDI result is similar in reliability with respect to PPABPM, but is more rapid and well applicable in an elderly population.

  16. Role of Doppler ultrasonography evaluation of superior mesenteric artery flow volume in the assessment of Crohn's disease activity

    Directory of Open Access Journals (Sweden)

    Fabiana Paiva Martins

    2013-09-01

    Full Text Available Objective To investigate superior mesenteric artery flow measurement by Doppler ultrasonography as a means of characterizing inflammatory activity in Crohn's disease. Materials and Methods Forty patients were examined and divided into two groups – disease activity and remission – according to their Crohn's disease activity index score. Mean superior mesenteric artery flow volume was calculated for each group and correlated with Crohn's disease activity index score. Results The mean superior mesenteric artery flow volume was significantly greater in the patients with active disease (626 ml/min ± 236 × 376 ml/min ± 190; p = 0.001. As a cut off corresponding to 500 ml/min was utilized, the superior mesenteric artery flow volume demonstrated sensitivity of 83% and specificity of 82% for the diagnosis of Crohn's disease activity. Conclusion The present results suggest that patients with active Crohn's disease have increased superior mesenteric artery flow volume as compared with patients in remission. Superior mesenteric artery flow measurement had a good performance in the assessment of disease activity in this study sample.

  17. Peripheral arterial volume distensibility: significant differences with age and blood pressure measured using an applied external pressure.

    Science.gov (United States)

    Zheng, Dingchang; Murray, Alan

    2011-05-01

    A new arterial distensibility measurement technique was assessed in 100 healthy normotensive subjects. Arterial transmural pressures on the whole right arm were reduced with a 50 cm long cuff inflated to 10, 20, 30 and 40 mmHg. The electrocardiogram, and finger and ear photoplethysmograms were recorded simultaneously. Arm pulse propagation time, pulse wave velocity (PWV) and arterial volume distensibility were determined. With a 40 mmHg reduction in transmural pressure, arm pulse propagation time increased from 61 to 83 ms, PWV decreased from 12 to 8 m s(-1) and arterial distensibility increased from 0.102% to 0.232% per mmHg (all P pressures, arterial distensibility was significantly related to resting mean arterial pressure (MAP), diastolic blood pressure (DBP) and age, and for systolic blood pressure at 30 and 40 mmHg (all P pressure, arterial distensibility fell by 54% for a MAP increase from 75 to 105 mmHg, 57% for a DBP increase from 60 to 90 mmHg and 47% for an age increase from 20 to 70 years. These changes were more than double than those without cuff pressure. Our technique showed that systemic volume distensibility of the peripheral arm artery reduced with age, with a greater effect at higher external and lower transmural pressures.

  18. Compliance problems of small utility systems with the Powerplant and Industrial Fuel Use Act of 1978: volume II - appendices

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-01-01

    A study of the problems of compliance with the Powerplant and Industrial Fuel Use Act of 1978 experienced by electric utility systems which have a total generating capacity of less than 2000 MW is presented. This volume presents the following appendices: (A) case studies (Farmington, New Mexico; Lamar, Colorado; Dover, Delaware; Wolverine Electric Cooperative, Michigan; Central Telephone and Utilities, Kansas; Sierra Pacific Power Company, Nevada; Vero Beach, Florida; Lubbock, Texas; Western Farmers Cooperative, Oklahoma; and West Texas Utilities Company, Texas); (B) contacts and responses to study; (C) joint action legislation chart; (D) Texas Municipal Power Agency case study; (E) existing generating units jointly owned with small utilities; (F) future generating units jointly owned with small utilities; (G) Federal Register Notice of April 17, 1980, and letter of inquiry to utilities; (H) small utility responses; and (I) Section 744, PIFUA. (WHK)

  19. Compliance of energy-dense, small volume oral nutritional supplements in the daily clinical practice on a geriatric ward--an observational study.

    Science.gov (United States)

    Lombard, K; van Steijn, J; Schuur, T; Kuhn, M; Rouws, C; Huinink, E-L; van der Hooft, C; van Asselt, D

    2014-07-01

    Compliance is important in optimizing the clinical effectiveness of oral nutritional supplements (ONS). Small volume, energy-dense ONS (ED-ONS; ≥ 2 kcal/ml) have been shown to improve compliance in clinical trial settings. However, data from clinical practice is still lacking. The aim of the present study was to evaluate the effect of ED-ONS on the compliance in an observational set-up to obtain data from daily clinical practice on a geriatric ward. Geriatric inpatients, undernourished or at risk of undernutrition received two servings of either ED-ONS (125 ml, 2.4 kcal/ml: Nutridrink Compact Energy, Nutricia) or a standard ONS (S-ONS; 200 ml, 1.5 kcal/ml: Nutridrink) as part of their daily routine care. Patients were allocated to a group according to availability of beds and placement on the ward. Compliance (kcal/day and % of prescribed volume) was assessed by weighing returned bottles. Data were analyzed via Mixed Model for Repeated Measures. Forty-seven patients received ED-ONS, and 61 patients received S-ONS. Compliance was significantly higher with ED-ONS in geriatric inpatients compared to S-ONS ( 378 ± 14.0 kcal/day vs. 337 ± 13.6 kcal/day (mean ± SEM), p = 0.039, 63.0 ± 2.34% vs. 56.2 ± 2.26%, p = 0.039). Moreover, a trend (p=0.078) was observed towards an increasing difference in compliance over time. This study shows that compliance to ED-ONS is significantly better than to S-ONS in daily clinical practice. Although small, the difference in compliance seems to increase over time, suggesting clinical relevance with longer treatment.

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

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

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

  1. Differential effects of relaxin deficiency on vascular aging in arteries of male mice.

    Science.gov (United States)

    Jelinic, Maria; Tare, Marianne; Conrad, Kirk P; Parry, Laura J

    2015-08-01

    Exogenous treatment with the naturally occurring peptide relaxin increases arterial compliance and reduces vascular stiffness. In contrast, relaxin deficiency reduces the passive compliance of small renal arteries through geometric and compositional vascular remodeling. The role of endogenous relaxin on passive mechanical wall properties in other vascular beds is unknown. Importantly, no studies have investigated the effects of aging in arteries of relaxin-deficient mice. Therefore, we tested the hypothesis that mesenteric and femoral arteries stiffen with aging, and this is exacerbated with relaxin deficiency. Male wild-type (Rln (+/+)) and relaxin knockout (Rln (-/-)) mice were aged to 3, 6, 12, 18, and 23 months. Passive mechanical wall properties were assessed by pressure myography. In both genotypes, there was a significant increase in circumferential stiffening in mesenteric arteries with aging, whereas in the femoral artery, aging reduced volume compliance. This was associated with a reduced ability of the artery to lengthen with aging. The predominant phenotype observed in Rln (-/-) mice was reduced volume compliance in young mice in both mesenteric and femoral arteries. In summary, aging induces circumferential stiffening in mesenteric arteries and axial stiffening in femoral arteries. Passive mechanical wall properties of Rln (-/-) mouse arteries predominantly differ at younger ages compared with Rln (+/+) mice, suggesting that a lack of endogenous relaxin only has a minor effect on vascular aging.

  2. Loss of alveolar membrane diffusing capacity and pulmonary capillary blood volume in pulmonary arterial hypertension

    Science.gov (United States)

    2013-01-01

    Background Reduced gas transfer in patients with pulmonary arterial hypertension (PAH) is traditionally attributed to remodeling and progressive loss of pulmonary arterial vasculature that results in decreased capillary blood volume available for gas exchange. Methods We tested this hypothesis by determination of lung diffusing capacity (DL) and its components, the alveolar capillary membrane diffusing capacity (Dm) and lung capillary blood volume (Vc) in 28 individuals with PAH in comparison to 41 healthy individuals, and in 19 PAH patients over time. Using single breath simultaneous measure of diffusion of carbon monoxide (DLCO) and nitric oxide (DLNO), DL and Dm were respectively determined, and Vc calculated. Dm and Vc were evaluated over time in relation to standard clinical indicators of disease severity, including brain natriuretic peptide (BNP), 6-minute walk distance (6MWD) and right ventricular systolic pressure (RVSP) by echocardiography. Results Both DLCO and DLNO were reduced in PAH as compared to controls and the lower DL in PAH was due to loss of both Dm and Vc (all p DLNO decreased by 24 ml/min/mmHg/year (p = 0.01). Consequently, Dm decreased and Vc tended to increase over time, which led to deterioration of the Dm/Vc ratio, a measure of alveolar-capillary membrane functional efficiency without changes in clinical markers. Conclusions The findings indicate that lower than normal gas transfer in PAH is due to loss of both Dm and Vc, but that deterioration of Dm/Vc over time is related to worsening membrane diffusion. PMID:23339456

  3. Compliance Framing - Framing Compliance

    OpenAIRE

    Lutz-Ulrich Haack; Martin C. Reimann

    2012-01-01

    Corporations have to install various organizational measures to comply with legal as well as internal guidelines systematically. Compliance management systems have the challenging task to make use of an internal compliance-marketing approach in order to ensure not only an adequate but also effective compliance-culture. Compliance-literature and findings of persuasive goal-framing-theory give opposite implications for establishing a rather values- versus rule-based compliance-culture respectiv...

  4. Response of fibroblast growth factor 23 to volume interventions in arterial hypertension and diabetic nephropathy

    Science.gov (United States)

    Humalda, Jelmer K.; Seiler-Mußler, Sarah; Kwakernaak, Arjan J.; Vervloet, Marc G.; Navis, Gerjan; Fliser, Danilo; Heine, Gunnar H.; de Borst, Martin H.

    2016-01-01

    Abstract Fibroblast growth factor 23 (FGF-23) rises progressively in chronic kidney disease and is associated with adverse cardiovascular outcomes. FGF-23 putatively induces volume retention by upregulating the sodium-chloride cotransporter (NCC). We studied whether, conversely, interventions in volume status affect FGF-23 concentrations. We performed a post hoc analysis of 1) a prospective saline infusion study with 12 patients with arterial hypertension who received 2 L of isotonic saline over 4 hours, and 2) a randomized controlled trial with 45 diabetic nephropathy (DN) patients on background angiotensin-converting enzyme -inhibition (ACEi), who underwent 4 6-week treatment periods with add-on hydrochlorothiazide (HCT) or placebo, combined with regular sodium (RS) or low sodium (LS) diet in a cross-over design. Plasma C-terminal FGF-23 was measured by ELISA (Immutopics) after each treatment period in DN and before and after saline infusion in hypertensives. The patients with arterial hypertension were 45 ± 13 (mean ± SD) years old with an estimated glomerular filtration rate (eGFR) of 101 ± 18 mL/min/1.73 m2. Isotonic saline infusion did not affect FGF-23 (before infusion: 68 median [first to third quartile: 58–97] relative unit (RU)/mL, after infusion: 67 [57–77] RU/mL, P = 0.37). DN patients were 65 ± 9 years old. During ACEi + RS treatment, eGFR was 65 ± 25 mL/min/1.73 m2 and albuminuria 649 mg/d (230–2008 mg/d). FGF23 level was 94 (73–141) RU/mL during ACEi therapy. FGF-23 did not change significantly by add-on HCT (99 [74–148] RU/mL), LS diet (99 [75–135] RU/mL), or their combination (111 [81–160] RU/mL, P = 0.15). Acute and chronic changes in volume status did not materially change FGF-23 in hypertensive patients and DN, respectively. Our data do not support a direct feedback loop between volume status and FGF-23 in hypertension or DN. PMID:27861335

  5. Comparison of vertebral artery velocity and flow volume measurements for diagnosis of vertebrobasilar insufficiency using color duplex sonography

    Energy Technology Data Exchange (ETDEWEB)

    Acar, Murat [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey)]. E-mail: drmacar@hotmail.com; Degirmenci, Bumin [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Yucel, Aylin [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Albayrak, Ramazan [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Haktanir, Alpay [Department of Radiology, Faculty of Medicine, Afyon Kocatepe University, Kirmizi Hastane, 03200 Afyon (Turkey); Yaman, Mehmet [Department of Neurology, Faculty of Medicine, Afyon Kocatepe University, 03200 Afyon (Turkey)

    2005-05-01

    Introduction: The aim of this study was to compare the measurements of vertebral artery (VA) systolic flow velocity and flow volume for diagnosis of vertebrobasilar insufficiency (VBI). Material and methods: We examined 96 patients who were referred for evaluation of VBI. Net vertebral artery flow volume and mean systolic flow velocity were determined by using color duplex sonography. We had grouped the patients into three according to VA flow volume: group 1 was consisted of patients with severely damped VA flow volume (lower than 120 mL/min), group 2 was consisted of patients with moderately damped VA flow volume (120-200 mL/min), group 3 was consisted of patients with normal VA flow volume (>200 mL/min). The mean systolic flow velocities in each group were compared by one-way ANOVA. Results: Mean VA systolic flow velocities of groups 1, 2 and 3 were 32 {+-} 12, 42 {+-} 10 and 46 {+-} 8 cm/s, respectively. Mean VA systolic flow velocity in group 1 was significantly lower than that of group 2 (P = 0.001). However, there were no significant differences between VA systolic flow velocities in groups 2 and 3 (P = 0.2). Conclusions: According to our findings, measurement of volume in addition to velocity is more valuable in detection of moderately damped VA flow volumes in diagnosis of VBI.

  6. Mock Circulatory Loop Compliance Chamber Employing a Novel Real-Time Control Process.

    Science.gov (United States)

    Taylor, Charles E; Miller, Gerald E

    2012-12-01

    The use of compliance chambers in mock circulatory loop construction is the predominant means of simulating arterial compliance. Utilizing mock circulatory loops as bench test methods for cardiac assist technologies necessitates that they must be capable of reproducing the circulatory conditions that would exist physiologically. Of particular interest is the ability to determine instantaneous compliance of the system, and the ability to change the compliance in real-time. This capability enables continuous battery testing of conditions without stopping the flow to change the compliance chamber settings, and the simulation of dynamic changes in arterial compliance. The method tested involves the use of a compliance chamber utilizing a circular natural latex rubber membrane separating the fluid and air portions of the device. Change in system compliance is affected by the airspace pressure, which creates more reaction force at the membrane to the fluid pressure. A pressure sensor in the fluid portion of the chamber and a displacement sensor monitoring membrane center deflection allow for real-time inputs to the control algorithm. A predefined numerical model correlates the displacement sensor data to the volume displacement of the membrane. The control algorithm involves a tuned π loop maintaining the volume distention of the membrane via regulation of the air space pressure. The proportional integral (PI) controller tuning was achieved by creating a computational model of the compliance chamber using Simulink™ Simscape(®) toolboxes. These toolboxes were used to construct a model of the hydraulic, mechanical, and pneumatic elements in the physical design. Parameter Estimation™ tools and Design Optimization™ methods were employed to determine unknown physical parameters in the system, and tune the process controller used to maintain the compliance setting. It was found that the resulting control architecture was capable of maintaining compliance along a

  7. Directory of Certificates of Compliance for radioactive materials packages: Report of NRC approved quality assurance programs for radioactive materials packages. Volume 3, Revision 15

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    The purpose of this directory is to make available a convenient source of information on packagings which have been approved by the US Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 of approved QA programs. The reports include a listing of all users of each package design and approved QA programs prior to the publication date.

  8. Apoyo familiar en el apego al tratamiento de la hipertensión arterial esencial Family support and drug therapy compliance in essential hypertension

    Directory of Open Access Journals (Sweden)

    Florentina Marín-Reyes

    2001-08-01

    Full Text Available Objetivo. Determinar la asociación entre apoyo familiar (AF y apego al tratamiento de la hipertensión arterial esencial (HAS. Material y métodos. Estudio de casos y controles al que se integraron 80 sujetos con diagnóstico establecido de HAS, con 40 pacientes en cada grupo. Se consideró como casos a los pacientes con apego y como controles a los pacientes sin apego al tratamiento. El estudio se realizó de mayo a diciembre de 1999, en el Hospital Regional del IMSS, en la ciudad de Durango, Durango, México. La edad, género, duración de la HAS, escolaridad y estado civil fueron criterios de pareamiento. Las diferencias se establecieron con las pruebas ji cuadrada y t de student. Se calculó la razón de momios para estimar la fuerza de asociación. El diagnóstico de hipertensión arterial secundaria, o de otras enfermedades crónicas fueron criterios de exclusión. Resultados. No hubo diferencias entre los grupos respecto a las variables sociodemográficas, modalidad de tratamiento ni conocimiento que el enfermo tenía sobre su enfermedad. Tenían control de la presión arterial 31 (77.5% pacientes con apego y 11 (27.5% sin apego, p= 0.003. El AF se asoció de manera independiente con apego al tratamiento, RM 6.9, IC 95% 2.3-21.1. Conclusiones. El apego se vincula de forma significativa con el apoyo que los familiares otorgan al enfermo. El texto completo en inglés de este artículo está disponible en: http://www.insp.mx/salud/index.htmlObjective. To assess the relationship between family support and drug therapy compliance in essential hypertension. Material and methods. A case-control study was conducted between May and December 1999, at Mexican Institute of Social Security Regional Hospital in Durango, among 80 hypertensive subjects; 40 were cases and 40 controls. Cases were subjects who complied with drug therapy and controls were those who did not, matched by age, gender, schooling, hypertensive disease duration, and marital status

  9. Surgery-related thrombosis critically affects the brain infarct volume in mice following transient middle cerebral artery occlusion.

    Directory of Open Access Journals (Sweden)

    Xiaojie Lin

    Full Text Available Transient middle cerebral artery occlusion (tMCAO model is widely used to mimic human focal ischemic stroke in order to study ischemia/reperfusion brain injury in rodents. In tMCAO model, intraluminal suture technique is widely used to achieve ischemia and reperfusion. However, variation of infarct volume in this model often requires large sample size, which hinders the progress of preclinical research. Our previous study demonstrated that infarct volume was related to the success of reperfusion although the reason remained unclear. The aim of present study is to explore the relationship between focal thrombus formation and model reproducibility with respect to infarct volume. We hypothesize that suture-induced thrombosis causes infarct volume variability due to insufficient reperfusion after suture withdrawal. Seventy-two adult male CD-1 mice underwent 90 minutes of tMCAO with or without intraperitoneal administration of heparin. Dynamic synchrotron radiation microangiography (SRA and laser speckle contrast imaging (LSCI were performed before and after tMCAO to observe the cerebral vascular morphology and to measure the cerebral blood flow in vivo. Infarct volume and neurological score were examined to evaluate severity of ischemic brain injury. We found that the rate of successful reperfusion was much higher in heparin-treated mice compared to that in heparin-free mice according to the result of SRA and LSCI at 1 and 3 hours after suture withdrawal (p<0.05. Pathological features and SRA revealed that thrombus formed in the internal carotid artery, middle cerebral artery or anterior cerebral artery, which blocked reperfusion following tMCAO. LSCI showed that cortical collateral circulation could be disturbed by thrombi. Our results demonstrated that suture-induced thrombosis was a critical element, which affects the success of reperfusion. Appropriate heparin management provides a useful approach for improving reproducibility of reperfusion

  10. Intensity modulated radiotherapy for localized prostate cancer: rigid compliance to dose-volume constraints as a warranty of acceptable toxicity?

    Directory of Open Access Journals (Sweden)

    Moreira Frederico R

    2007-01-01

    Full Text Available Abstract Background To report the toxicity after intensity modulated radiotherapy (IMRT for patients with localized prostate cancer, as a sole treatment or after radical prostatectomy. Methods Between August 2001 and December 2003, 132 patients with prostate cancer were treated with IMRT and 125 were evaluable to acute and late toxicity analysis, after a minimum follow-up time of one year. Clinical and treatment data, including normal tissue dose-volume histogram (DVH constraints, were reviewed. Gastro-intestinal (GI and genito-urinary (GU signs and symptoms were evaluated according to the Radiation Therapy Oncology Group (RTOG toxicity scales. Median prescribed dose was 76 Gy. Median follow-up time was of 26.1 months. Results From the 125 patients, 73 (58.4% presented acute Grade 1 or Grade 2 GI and 97 (77.2% presented acute Grade 1 or Grade 2 GU toxicity. Grade 3 GI acute toxicity occurred in only 2 patients (1.6% and Grade 3 GU acute toxicity in only 3 patients (2.4%. Regarding Grade 1 and 2 late toxicity, 26 patients (20.8% and 21 patients (16.8% presented GI and GU toxicity, respectively. Grade 2 GI late toxicity occurred in 6 patients (4.8% and Grade 2 GU late toxicity in 4 patients (3.2%. None patient presented any Grade 3 or higher late toxicity. Non-conformity to DVH constraints occurred in only 11.2% of treatment plans. On univariate analysis, no significant risk factor was identified for Grade 2 GI late toxicity, but mean dose delivered to the PTV was associated to higher Grade 2 GU late toxicity (p = 0.042. Conclusion IMRT is a well tolerable technique for routine treatment of localized prostate cancer, with short and medium-term acceptable toxicity profiles. According to the data presented here, rigid compliance to DHV constraints might prevent higher incidences of normal tissue complication.

  11. Left Atrial Volume and Pulmonary Artery Diameter Are Noninvasive Measures of Age-Related Diastolic Dysfunction in Mice.

    Science.gov (United States)

    Medrano, Guillermo; Hermosillo-Rodriguez, Jesus; Pham, Thuy; Granillo, Alejandro; Hartley, Craig J; Reddy, Anilkumar; Osuna, Patricia Mejia; Entman, Mark L; Taffet, George E

    2016-09-01

    Impaired cardiac diastolic function occurs with aging in many species and may be difficult to measure noninvasively. In humans, left atrial (LA) volume is a robust measure of chronic diastolic function as the LA is exposed to increased left ventricular filling pressures. We hypothesized that LA volume would be a useful indicator of diastolic function in aging mice. Further, we asked whether pressures were propagated backwards affecting pulmonary arteries (PAs) and right ventricle (RV). We measured LA, PA, and RV infundibulum dimensions with echocardiography and used mouse-specific Doppler systems and pressure catheters for noninvasive and invasive measures. As C57BL/6 mice aged from 3 to 29-31 months, LA volume almost tripled. LA volume increases correlated with traditional diastolic function measures. Within groups of 14- and 31-month-old mice, LA volume correlated with diastolic function measured invasively. In serial studies, mice evaluated at 20 and 24 months showed monotonic increases in LA volume; other parameters changed less predictably. PA diameters, larger in 30-month-old mice than 6-month-old mice, correlated with LA volumes. Noninvasive LA volume and PA diameter assessments are useful and state independent measures of diastolic function in mice, correlating with other measures of diastolic dysfunction in aging. Furthermore, serial measurements over 4 months demonstrated consistent increases in LA volume suitable for longitudinal cardiac aging studies.

  12. Ambulatory instrument for monitoring indirect beat-to-beat blood pressure in superficial temporal artery using volume-compensation method.

    Science.gov (United States)

    Tanaka, S; Yamakoshi, K

    1996-11-01

    A portable instrument, based on a volume-compensation technique, is designed for ambulatory monitoring of indirect beat-to-beat blood pressure (BP) in the superficial temporal artery. The instrument consists of a small disc-type cuff and a portable unit carried by the subject. Several components are integrated in the cuff for applying counter-pressure to the artery, i.e. a reflectance-type photo-plethysmographic sensor for arterial volume detection, a pressure sensor for cuff pressure Pc measurement and a nozzle flapper-type- electro-pneumatic convertor for controlling Pc. The portable unit includes volume servo control circuitry and a microprocessor-based signal-processing and recording unit. This automatically performs all the necessary measurement procedures and stores into a memory IC element the processed systolic, mean and diastolic blood pressure data, together with pulse intervals on a beat-to-beat basis from the servo-controlled Pc (indirectly measured BP waveform). With this instrument, momentary changes in BP during ambulatory situations such as bicycle ergometer exercise and daily activities including motorway driving are successfully recorded. From the results of simultaneous measurement of the subject's posture changes, the effect of posture change on blood pressure, e.g. baroreceptor-cardiac reflex, is also clearly demonstrated.

  13. Arterial pressure allows monitoring the changes in cardiac output induced by volume expansion but not by norepinephrine.

    Science.gov (United States)

    Monnet, Xavier; Letierce, Alexia; Hamzaoui, Olfa; Chemla, Denis; Anguel, Nadia; Osman, David; Richard, Christian; Teboul, Jean-Louis

    2011-06-01

    To evaluate to which extent the systemic arterial pulse pressure could be used as a surrogate of cardiac output for assessing the effects of a fluid challenge and of norepinephrine. Observational study. Medical intensive care unit. Patients with an acute circulatory failure who received a fluid challenge (228 patients, group 1) or in whom norepinephrine was introduced or increased (145 patients, group 2). We measured the systolic, diastolic, and mean arterial pressure, pulse pressure, and the transpulmonary thermodilution cardiac output before and after the therapeutic interventions. In group 1, the fluid challenge significantly increased cardiac output by 24% ± 25%. It significantly increased cardiac output by ≥15% (+35% ± 27%) in 142 patients ("responders"). The fluid-induced changes in cardiac output were correlated with the changes in pulse pressure (r = .56, p arterial pressure (r = .55, p arterial pressure (r = .37, p arterial pressure (r = .52, p pressure were significantly related to changes in stroke volume (multiple r = .52) and to age (r = .12). A fluid-induced increase in pulse pressure of ≥17% allowed detecting a fluid-induced increase in cardiac output of ≥15% with a sensitivity of 65[56-72]% and a specificity of 85[76-92]%. The area under the receiver operating characteristic curves for the fluid-induced changes in mean arterial pressure and in diastolic arterial pressure was significantly lower than for pulse pressure. In group 2, the introduction/increase of norepinephrine significantly increased cardiac output by 14% ± 18%. The changes in cardiac output induced by the introduction/increase in the dose of norepinephrine were correlated with the changes in pulse pressure and systolic arterial pressure (r = .21 and .29, respectively, p = .001) but to a significantly lesser extent than in group 1. Pulse pressure and systolic arterial pressure could be used for detecting the fluid-induced changes in cardiac output, in spite of a significant

  14. Estimation of an image derived input function with MR-defined carotid arteries in FDG-PET human studies using a novel partial volume correction method

    DEFF Research Database (Denmark)

    Sari, Hasan; Erlandsson, Kjell; Law, Ian

    2017-01-01

    Kinetic analysis of (18)F-fluorodeoxyglucose positron emission tomography data requires an accurate knowledge the arterial input function. The gold standard method to measure the arterial input function requires collection of arterial blood samples and is an invasive method. Measuring an image...... segmentation of the carotid arteries from MR images. The simulation study results showed that at least 92% of the true intensity could be recovered after the partial volume correction. Results from 19 subjects showed that the mean cerebral metabolic rate of glucose calculated using arterial samples and partial...... volume corrected image derived input function were 26.9 and 25.4 mg/min/100 g, respectively, for the grey matter and 7.2 and 6.7 mg/min/100 g for the white matter. No significant difference in the estimated cerebral metabolic rate of glucose values was observed between arterial samples and corrected...

  15. High volume practice proved the safety of off-pump coronary artery bypass surgery in left main coronary artery lesions:a two-year single center experience

    Institute of Scientific and Technical Information of China (English)

    LIU Tong; LU Chun-shan; LU Jia-kai; GAN Hui-li; ZHANG Jian-qun; HUANG Fang-jong; GU Cheng-xiong; KONG Qing-yu; CAO Xiang-rong; BO Ping

    2012-01-01

    Background Left main coronary artery (LMCA) stenosis has been recognized as a risk factor for early death among patients undergoing coronary artery bypass grafting (CABG).This study aimed to assess if LMCA lesions pose an additional risk of early or mid-term mortality and/or a major adverse cardiac and cerebrovascular event (MACCE) after off-pump coronary artery bypass grafting (OPCABG),compared with non-left main coronary artery stenosis (non-mainstem disease).Methods From January 1,2009 to December 31,2010,4869 patients had a primary isolated OPCABG procedure at Beijing Anzhen Hospital.According to the pathology of LMCA lesions,they were retrospectively classified as a non-mainstem disease group (n=3933) or a LMCA group (n=936).Propensity scores were used to match the two groups,patients from the non-mainstem disease group (n=831) were also randomly selected to match patients from the LMCA group (n=831).Freedom from MACCE in the two groups was calculated using the Kaplan-Meier method.Results The difference in the mortality and the rate of MACCE during the first 30 days between the non-mainstem disease group and the LMCA group did not reach statistical significance (P=0.429,P=0.127 respectively).With a mean follow-up of (12.8±7.5) months and a cumulative follow-up of 1769.6 patient-years,the difference in the freedom from MACCEs between the two groups,calculated through Kaplan-Meier method,did not reach statistical significance (P=0.831).Conclusion Analysis of a high volume of OPCABG procedures proved that LMCA lesions do not pose additional early and mid-term risk to OPCABG.Therefore,a LMCA lesion is as safe as non-mainstem disease lesion during the OPCABG procedure.

  16. Evaluation of low tidal volume with positive end-expiratory pressure application effects on arterial blood gases during laparoscopic surgery.

    Science.gov (United States)

    Baki, Elif Dogan; Kokulu, Serdar; Bal, Ahmet; Ela, Yüksel; Sivaci, Remziye Gül; Yoldas, Murat; Çelik, Fatih; Ozturk, Nilgun Kavrut

    2014-07-01

    Pneumoperitoneum (PNP) and patient positions required for laparoscopy can induce pathophysiological changes that complicate anesthetic management during laparoscopic procedures. This study investigated whether low tidal volume and positive end-expiratory pressure (PEEP) application can improve ventilatory and oxygenation parameters during laparoscopic surgery. A total of 60 patients undergoing laparoscopic surgery were randomized to either the conventional group (n = 30, tidal volume = 10 mL/kg, rate = 12/minute, PEEP = 0 cm H(2)O) or the low tidal group with PEEP group (n = 30, tidal volume = 6 mL/kg, rate = 18/minute, PEEP = 5 cm H(2)O) at maintenance of anesthesia. Hemodynamic parameters, peak plateau pressure (Pplat) and arterial blood gases results were recorded before and after PNP. There was a significant increase in the partial pressure of arterial carbon dioxide (PaCO(2)) values after PNP in the conventional group in the reverse Trendelenburg (41.28 mmHg) and Trendelenburg positions (44.80 mmHg;p = 0.001), but there was no difference in the low tidal group at any of the positions (36.46 and 38.56, respectively). We saw that PaO(2) values recorded before PNP were significantly higher than the values recorded 1 hour after PNP in the two groups at all positions. No significant difference was seen in peak inspiratory pressure (Ppeak) at the reverse Trendelenburg position before and after PNP between the groups, but there was a significant increase at the Trendelenburg position in both groups (conventional; 21.67 cm H(2)O, p = 0.041, low tidal; 23.67 cm H(2)O, p = 0.004). However, Pplat values did not change before and after PNP in the two groups at all positions. The application of low tidal volume + PEEP + high respiratory rate during laparoscopic surgeries may be considered to improve good results of arterial blood gases. Copyright © 2014. Published by Elsevier B.V.

  17. Increased regional epicardial fat volume associated with reversible myocardial ischemia in patients with suspected coronary artery disease.

    Science.gov (United States)

    Khawaja, Tuba; Greer, Christine; Thadani, Samir R; Kato, Tomoko S; Bhatia, Ketan; Shimbo, Daichi; Kontak, Andrew; Konkak, Andrew; Bokhari, Sabahat; Einstein, Andrew J; Schulze, P Christian

    2015-04-01

    Epicardial adipose tissue is a source of pro-inflammatory cytokines and has been linked to the development of coronary artery disease. No study has systematically assessed the relationship between local epicardial fat volume (EFV) and myocardial perfusion defects. We analyzed EFV in patients undergoing SPECT myocardial perfusion imaging combined with computed tomography (CT) for attenuation correction. Low-dose CT without contrast was performed in 396 consecutive patients undergoing SPECT imaging for evaluation of coronary artery disease. Regional thickness, cross-sectional areas, and total EFV were assessed. 295 patients had normal myocardial perfusion scans and 101 had abnormal perfusion scans. Mean EFVs in normal, ischemic, and infarcted hearts were 99.8 ± 82.3 cm(3), 156.4 ± 121.9 cm(3), and 96.3 ± 102.1 cm(3), respectively (P coronary artery (87.1 ± 76.4 vs 46.7 ± 40.6 cm(3); P = 0.005). Our results demonstrate increased regional epicardial fat in patients with active myocardial ischemia compared to patients with myocardial scar or normal perfusion on nuclear perfusion scans. Our results suggest a potential role for cardiac CT to improve risk stratification in patients with suspected coronary artery disease.

  18. Cerebral blood flow volume measurements of the carotid artery and ipsilateral branches using two-dimensional phase-contrast magnetic resonance angiography

    Institute of Scientific and Technical Information of China (English)

    Gang Guo; Yonggui Yang; Weiqun Yang

    2011-01-01

    The optimal velocity encoding of phase-contrast magnetic resonance angiography (PC MRA) in measuring cerebral blood flow volume (BFV) ranges from 60 to 80 cm/s. To verify the accuracy of two-dimensional (2D) PC MRA, the present study localized the region of interest at blood vessels of the neck using PC MRA based on three-dimensional time-of-flight sequences, and the velocity encodingwas set to 80 cm/s. Results of the measurements showed that the error rate was 7.0 ± 6.0%in the estimation of BFV in the internal carotid artery, the external carotid artery and the ipsilateralcommon carotid artery. There was no significant difference, and a significant correlation in BFV between internal carotid artery + external carotid artery and ipsilateral common carotid artery. Inaddition, the BFV of the common carotid artery was correlated with that of the ipsilateral internal carotid artery. The main error was attributed to the external carotid artery and its branches. Therefore,after selecting the appropriate scanning parameters and protocols, 2D PC MRA is more accuratein the determination of BFV in the carotid arteries.

  19. Pulmonary intravascular blood volume changes through the cardiac cycle in healthy volunteers studied by cardiovascular magnetic resonance measurements of arterial and venous flow

    Directory of Open Access Journals (Sweden)

    Arheden Hakan

    2009-10-01

    Full Text Available Abstract Background This study aims to present a novel method for using cardiovascular magnetic resonance (CMR to non-invasively quantify the variation in pulmonary blood volume throughout the cardiac cycle in humans. Methods 10 healthy volunteers (7 males, 3 female, age range 21-32 years were studied. The blood flow in the pulmonary artery and all pulmonary veins was quantified during free breathing using phase contrast velocity encoded CMR. The difference in flow between the pulmonary artery and the pulmonary veins was integrated to calculate the change in pulmonary blood volume throughout the cardiac cycle. Results The stroke volumes in the pulmonary artery and the sum of the pulmonary veins were (mean ± SEM 103 ± 6 ml and 95 ± 6 ml, respectively. The pulmonary blood volume variation (PBVV was 48 ± 5 ml, and the PBVV expressed as percent of the pulmonary artery stroke volume was 46 ± 3%. The maximum increase in pulmonary blood volume occurred 310 ± 12 ms after the R-wave from the ECG (32 ± 2% of the cardiac cycle. PBVV did not correlate to change in cross-sectional area in the pulmonary artery (R2 = 0.03, p = 0.66. Conclusion It is feasible to non-invasively quantify the change in pulmonary blood volume during the cardiac cycle in humans using CMR. The average pulmonary blood volume variation in healthy volunteers was approximately 50 ml and this was approximately 50% of the stroke volume. Further studies are needed to assess the utility of the pulmonary blood volume variation as a measure for identifying cardiac and pulmonary vascular disease.

  20. Correcting partial volume artifacts of the arterial input function in quantitative cerebral perfusion MRI

    NARCIS (Netherlands)

    van Osch, MJP; Vonken, EJPA; Bakker, CJG; Viergever, MA

    2001-01-01

    To quantify cerebral perfusion with dynamic susceptibility contrast MRI (DSC-MRI), one needs to measure the arterial input function (AIF). Conventionally, one derives the contrast concentration from the DSC sequence by monitoring changes in either the amplitude or the phase signal on the assumption

  1. 3D flow study in a mildly stenotic coronary artery phantom using a whole volume PIV method.

    Science.gov (United States)

    Brunette, J; Mongrain, R; Laurier, J; Galaz, R; Tardif, J C

    2008-11-01

    Blood flow dynamics has an important role in atherosclerosis initiation, progression, plaque rupture and thrombosis eventually causing myocardial infarction. In particular, shear stress is involved in platelet activation, endothelium function and secondary flows have been proposed as possible variables in plaque erosion. In order to investigate these three-dimensional flow characteristics in the context of a mild stenotic coronary artery, a whole volume PIV method has been developed and applied to a scaled-up transparent phantom. Experimental three-dimensional velocity data was processed to estimate the 3D shear stress distributions and secondary flows within the flow volume. The results show that shear stress reaches values out of the normal and atheroprotective range at an early stage of the obstructive pathology and that important secondary flows are also initiated at an early stage of the disease. The results also support the concept of a vena contracta associated with the jet in the context of a coronary artery stenosis with the consequence of higher shear stresses in the post-stenotic region in the blood domain than at the vascular wall.

  2. A adesão ao tratamento na hipertensão arterial: análise da produção científica Compliance in antihypertensive therapy: analyses in scientific articles

    Directory of Open Access Journals (Sweden)

    Leila Maria Mansano Sarquis

    1998-12-01

    Full Text Available O estudo teve como objetivo avaliar a produção científica publicada entre 1991 e 1995, para identificar como o assunto adesão ao tratamento anti-hipertensivo vem sendo abordado. Foram analisados 107 artigos científicos. Os resultados mostraram que a adesão foi abordada da seguinte maneira: 68% relacionaram ao paciente, 63% ao tratamento farmacológico, 62% a aspectos gerais, 39% ao tratamento não farmacológico, 34% a fatores institucionais, e 8% relativos à, doença. A adesão ao tratamento anti-hipertensivo tem sido um desafio no controle da hipertensão arterial e conhecer como este assunto está sendo enfocado na literatura pode contribuir para aumentar adesão ao tratamento na hipertensão arterial.The aim of this study was to evaluate scientific articles published between 1991-1995, in order to identify the compliance in antihypertensive therapy. One hundred seven scientific articles were evaluated. The results showed that 68% were related to patient, 63% to pharmacological treatment, 62% general, 39% non pharmacological treatment, 34% organizational factors, and 8% related to desease. Compliance with antihypertensive therapy was the major challenge of hypertension management and to know how this aspect was focalized in scientific articles possible reduce non compliance in hypertension.

  3. Relative value of pressures and volumes in assessing fluid responsiveness after valvular and coronary artery surgery

    NARCIS (Netherlands)

    Breukers, R.B.G.E.; Trof, R.J.; Wilde, de R.; Berg, van den P.A.W.; Twisk, J.W.R.; Jansen, J.H.; Groeneveld, A.B.J.

    2009-01-01

    10% per step. Results: Global ejection fraction was tower and PAOP was higher after VS than CAS. In responding steps after VS (n = 9-14) PACP and volumes increased, white CVP and volumes increased in responding steps (n = 12-19) after CAS. Baseline PAOP was tower in responding steps after VS only.

  4. Relationship between white matter hyperintensities volume and the circle of Willis configurations in patients with carotid artery pathology.

    Science.gov (United States)

    Saba, Luca; Sanfilippo, Roberto; Porcu, Michele; Lucatelli, Pierleone; Montisci, Roberto; Zaccagna, Fulvio; Suri, Jasjit; Anzidei, Michele; Wintermark, Max

    2017-04-01

    We aimed to assess if there is a difference of distribution and volume of white matter hyperintensities (WMH) in the brain according to the Circle of Willis (CoW) configuration in patients with carotid artery pathology. One-hundred consecutive patients (79 males, 21 females; mean age 70 years; age range 46-84 years) that underwent brain MRI before carotid endarterectomy (CEA) were included. FLAIR-WMH lesion volume was performed using a semi-automated segmentation technique and the status of the circle of Willis was assessed by two neuroradiologists in consensus. We found a prevalence of 55% of variants in the CoW configuration; 22 cases had one variants (40%); 25 cases had two variants (45.45%) and 8 cases showed 3 variants (14.55%). The configuration that was associated with the biggest WMH volume and number of lesions was the A1+PcoA+PcoA. The PcoA variants were the most prevalent and there was no statistically significant difference in number of lesions and WMH for each vascular territory assessed and the same results were found for AcoA and A1 variants. Results of our study suggest that the more common CoW variants are not associated with the presence of an increased WMH or number of lesions whereas uncommon configurations, in particular when 2 or more segment are missing increase the WMH volume and number of lesions. The WHM volume of the MCA territory seems to be more affected by the CoW configuration. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Arterial pressure variations as parameters of brain perfusion in response to central blood volume depletion and repletion

    Directory of Open Access Journals (Sweden)

    Anne-Sophie G.T. Bronzwaer

    2014-04-01

    Full Text Available Rationale:A critical reduction in central blood volume (CBV is often characterized by hemodynamic instability. Restoration of a volume deficit may be established by goal-directed fluid therapy guided by respiration-related variation in systolic- and pulse pressure (SPV and PPV. Stroke volume index (SVI serves as a surrogate end-point of a fluid challenge but tissue perfusion itself has not been addressed. Objective: To delineate the relationship between arterial pressure variations, SVI and regional brain perfusion during CBV depletion and repletion in spontaneously breathing volunteers. Methods: This study quantified in 14 healthy subjects (11 male the effects of CBV depletion (by 30 and 70 degrees passive head-up tilt (HUT and a fluid challenge (by tilt back on CBV (thoracic admittance, mean middle cerebral artery (MCA blood flow velocity (Vmean, SVI, cardiac index (CI , PPV and SPV. Results: PPV (103±89%, p< 0.05 and SPV (136±117%, p< 0.05 increased with progression of central hypovolemia manifested by a reduction in thoracic admittance (11±5%, p< 0.001, SVI (28±6%, p< 0.001, CI (6±8%, p< 0.001 and MCAVmean (17±7%, p< 0.05 but not in arterial pressure. The reduction in MCAVmean correlated to the fall in SVI (R2=0.52, p< 0.0001 and inversely to PPV and SPV (R2=0.46 (p< 0.0001 and R2=0.45 (p< 0.0001, respectively. PPV and SPV predicted a ≥15% reduction in MCAVmean and SVI with comparable sensitivity (67%/ 67% vs. 63%/ 68% respectively and specificity (89%/94% vs. 89%/94%, respectively. A rapid fluid challenge by tilt-back restored all parameters to baseline values within one minute. Conclusion: In spontaneously breathing subjects, a reduction in MCAVmean was related to an increase in PPV and SPV during graded CBV depletion and repletion. Specifically, PPV and SPV predicted changes in both SVI and MCAVmean with comparable sensitivity and specificity, however the predictive value is limited in spontaneously breathing subjects.

  6. Cerebral blood volume and blood flow at varying arterial carbon dioxide tension levels in rabbits during propofol anesthesia.

    Science.gov (United States)

    Cenic, A; Craen, R A; Howard-Lech, V L; Lee, T Y; Gelb, A W

    2000-06-01

    There are little data on the effects of propofol on cerebral blood volume (CBV). We studied the effects of changes in PaCO(2) on CBV and cerebral blood flow (CBF) during propofol anesthesia in eight New Zealand white rabbits. We also investigated the effects of propofol over time on CBV and CBF during normocapnia (control group). At normocapnia, the mean (+/- SD) CBV and CBF values were 2.41 +/- 0.68 mL/100 g and 56 +/- 28 mL/100 g/min, respectively,. When PaCO(2) was reduced from 41 to 27 mm Hg, no significant change in either CBV or CBF was observed (P > 0.10). However, increasing PaCO(2) from 41 to 58 mm Hg resulted in a 30% increase in CBV (3.08 +/- 0.86 mL/100 g, P 0.10) during 2 h of propofol anesthesia. These results indicate that, during propofol anesthesia, cerebrovascular reactivity of blood flow and blood volume is maintained during hypercapnia but is markedly diminished during hypocapnia. During propofol anesthesia in rabbits with normal brains, a reduction in the arterial carbon dioxide level may not always be accompanied by a reduction in brain blood flow and blood volume.

  7. Draft Title 40 CFR 191 compliance certification application for the Waste Isolation Pilot Plant. Volume 2: Appendices, AAC, BECR, BH

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-31

    This report describes the conceptual design of a system the Department of Energy (DOE) may implement for compliance with the requirement to control access to the disposal site. In addition, this report addresses the scheduling process for control of inspection, maintenance, and periodic reporting related to Long Term Monitoring which addresses the monitoring of disposal system performance, environmental monitoring in accordance with the Consultation and Cooperation Agreement between the DOE and the state of New Mexico, and evaluation of testing activities related to the Permanent Marker System design. In addition to access control addressed by this report, the controlling or cleaning up of releases from the site is addressed in the Conceptual Decontamination and Decommissioning Plan. The monitoring of parameters related to disposal system performance is addressed in the Long Term Monitoring Design Concept Description. Together, these three documents address the full range of active institutional controls planned after disposal of the TRU waste in the WIPP repository.

  8. Estimation of regional myocardial mass at risk based on distal arterial lumen volume and length using 3D micro-CT images.

    Science.gov (United States)

    Le, Huy; Wong, Jerry T; Molloi, Sabee

    2008-09-01

    The determination of regional myocardial mass at risk distal to a coronary occlusion provides valuable prognostic information for a patient with coronary artery disease. The coronary arterial system follows a design rule which allows for the use of arterial branch length and lumen volume to estimate regional myocardial mass at risk. Image processing techniques, such as segmentation, skeletonization and arterial network tracking, are presented for extracting anatomical details of the coronary arterial system using micro-computed tomography (micro-CT). Moreover, a method of assigning tissue voxels to their corresponding arterial branches is presented to determine the dependent myocardial region. The proposed micro-CT technique was utilized to investigate the relationship between the sum of the distal coronary arterial branch lengths and volumes to the dependent regional myocardial mass using a polymer cast of a porcine heart. The correlations of the logarithm of the total distal arterial lengths (L) to the logarithm of the regional myocardial mass (M) for the left anterior descending (LAD), left circumflex (LCX) and right coronary (RCA) arteries were log(L)=0.73log(M)+0.09 (R=0.78), log(L)=0.82log(M)+0.05 (R=0.77) and log(L)=0.85log(M)+0.05 (R=0.87), respectively. The correlation of the logarithm of the total distal arterial lumen volumes (V) to the logarithm of the regional myocardial mass for the LAD, LCX and RCA were log(V)=0.93log(M)-1.65 (R=0.81), log(V)=1.02log(M)-1.79 (R=0.78) and log(V)=1.17log(M)-2.10 (R=0.82), respectively. These morphological relations did not change appreciably for diameter truncations of 600-1400microm. The results indicate that the image processing procedures successfully extracted information from a large 3D dataset of the coronary arterial tree to provide prognostic indications in the form of arterial tree parameters and anatomical area at risk.

  9. Prevalence of coronary artery ectasia in older adults and the relationship with epicardial fat volume by cardiac computed tomography angiography

    Institute of Scientific and Technical Information of China (English)

    Jun-Jie Yang; Xia Yang; Zhi-Ye Chen; Qi Wang; Bai He; Luo-Shan Du; Yun-Dai Chen

    2013-01-01

    Objective Coronary artery ectasia (CAE) refers to abnormal dilation of coronary artery segments to 1.5 times of adjacent normal ones. Epicardial fat is associated with cardiovascular risk factors. The relationship between CAE and epicardial fat has not yet been investigated. This study aimed to assess the relationship between CAE and epicardial fat volume (EFV) in older people by dual-source computed tomography coronary angiography (CTCA). Methods We prospectively enrolled 1400 older adults who were scheduled for dual-source CTCA. Under reconstruction protocols, patients with abnormal segments 1.5 times larger than the adjacent segments were accepted as CAE. EFV was measured by semi-automated software. Traditional risk factors in CAE patients, as well as the extent of EFV, were analyzed and compared to non-CAE group. Results A total of 885 male and 515 female older patients were enrolled. CAE was identified by univariable analysis in 131 patients and significantly correlated to hypertension, smoking, hyperlipidemia, prior percutaneous coronary intervention and ascending aorta aneurysm. EFV was shown to be significantly higher in CAE patients than patients without ectasia. In multivariable analyses, EFV (P = 0.018), hypertension (P < 0.001) and hyperlipidemia (P < 0.001) were significantly correlated to CAE. There was a significant negative correlation between EFV and Markis classification. Conclusions CAE can be reliably recognized by dual-source CTCA. Epicardial fat might play a role in etiopathogenesis and progression of CAE, providing a new target for treating ectasia.

  10. Analysis of Partial Volume Effects on Arterial Input Functions Using Gradient Echo: A Simulation Study

    DEFF Research Database (Denmark)

    Kjølby, Birgitte Fuglsang; Mikkelsen, Irene Klærke; Pedersen, Michael

    2009-01-01

    perfusion metrics was investigated for the gradient echo pulse sequence at 1.5 T and 3.0 T. It is shown that the tissue contribution broadens and introduces fluctuations in the AIF. Furthermore, partial volume effects bias perfusion metrics in a nonlinear fashion, compromising quantitative perfusion...

  11. Brain volume and cognitive function in patients with revascularized coronary artery disease

    NARCIS (Netherlands)

    Ottens, Thomas H; Hendrikse, Jeroen|info:eu-repo/dai/nl/266590268; Nathoe, Hendrik M|info:eu-repo/dai/nl/267961472; Biessels, Geert Jan|info:eu-repo/dai/nl/165576367; van Dijk, Diederik|info:eu-repo/dai/nl/241616301

    2017-01-01

    BACKGROUND: The pathogenesis of cognitive dysfunction in patients with CAD remains unclear. CAD is associated with brain atrophy and specific lesions. Detailed knowledge about the association of brain volume measured with MRI, and cognitive function in patients with CAD is lacking. We therefore

  12. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    OpenAIRE

    Rozie, S.; de Weert, T. T.; de Monyé, C.; Homburg, P. J.; Tanghe, H L J; Dippel, D W J; van der Lugt, A

    2009-01-01

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic a...

  13. Effect of fixed-dose ACE-inhibitor/calcium channel blocker combination therapy vs. ACE-inhibitor monotherapy on arterial compliance in hypertensive patients with type 2 diabetes.

    Science.gov (United States)

    Winer, Nathaniel; Folker, Amy; Murphy, Julie A; Hung, Elena; Bard, Mara; Perkelvald, Alexander; Sowers, James R; Bakris, George L

    2005-01-01

    Assessment of vascular compliance may be a useful measurement of the clinical effects of antihypertensive treatment. Both angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers are known to improve vascular elasticity. A study was performed to test the hypothesis that combined therapy with an ACE inhibitor and a calcium channel blocker would have additive benefits on vascular compliance at similar levels of blood pressure (BP), as compared with monotherapy with an ACE inhibitor. This 12-week, double-blind study was a substudy of a larger clinical hypertension study conducted in patients with hypertension and type 2 diabetes. Subjects (N = 20) were randomized to either a fixed-dose combination of amlodipine besylate/benazepril HCl or to enalapril monotherapy. BP, heart rate, large- and small-vessel compliance, systemic vascular resistance, and urinary microalbumin excretion were assessed at baseline and after treatment. Both treatments were similarly effective in lowering BP, reducing systemic vascular resistance, and decreasing urinary microalbumin excretion. Improvement in large-vessel compliance was significantly greater among subjects who received ACE-inhibitor/calcium channel blocker combination therapy (52%) as compared with those who received ACE-inhibitor monotherapy (32%; p < 0.05). No significant change in small-vessel compliance was observed with either treatment. Greater improvement in large-vessel compliance with combination therapy was independent of BP lowering.

  14. Guidebook for performance assessment parameters used in the Waste Isolation Pilot Plant compliance certification application. Volume 1: Main report

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, S.M.; Martell, M.A.; Weiner, R. [Sandia National Labs., Albuquerque, NM (United States); Lattier, C. [GRAM, Inc., Albuquerque, NM (United States)

    1998-06-01

    The Waste Isolation Pilot Plant (WIPP) Compliance Certification Application (CCA) Performance Assessment (PA) Parameter Database and its ties to supporting information evolved over the course of two years. When the CCA was submitted to the Environmental Protection Agency (EPA) in October 1996, information such as identification of parameter value or distribution source was documented using processes established by Sandia National Laboratories WIPP Quality Assurance Procedures. Reviewers later requested additional supporting documentation, links to supporting information, and/or clarification for many parameters. This guidebook is designed to document a pathway through the complex parameter process and help delineate flow paths to supporting information for all WIPP CCA parameters. In addition, this report is an aid for understanding how model parameters used in the WIPP CCA were developed and qualified. To trace the source information for a particular parameter, a dual-route system was established. The first route uses information from the Parameter Records Package as it existed when the CCA calculations were run. The second route leads from the EPA Parameter Database to additional supporting information.

  15. Guidebook for performance assessment parameters used in the Waste Isolation Pilot Plant compliance certification application. Volume 2: Appendices

    Energy Technology Data Exchange (ETDEWEB)

    Howarth, S.M.; Martell, M.A.; Weiner, R. [Sandia National Labs., Albuquerque, NM (United States); Lattier, C. [GRAM, Inc., Albuquerque, NM (United States)

    1998-06-01

    The Waste Isolation Pilot Plant (WIPP) Compliance Certification Application (CCA) Performance Assessment (PA) Parameter Database and its ties to supporting information evolved over the course of two years. When the CCA was submitted to the Environmental Protection Agency (EPA) in October 1996, information such as identification of parameter value or distribution source was documented using processes established by Sandia National Laboratories WIPP Quality Assurance Procedures. Reviewers later requested additional supporting documentation, links to supporting information, and/or clarification for many parameters. This guidebook is designed to document a pathway through the complex parameter process and help delineate flow paths to supporting information for all WIPP CCA parameters. In addition, this report is an aid for understanding how model parameters used in the WIPP CCA were developed and qualified. To trace the source information for a particular parameter, a dual-route system was established. The first route uses information from the Parameter Records package as it existed when the CCA calculations were run. The second route leads from the EPA Parameter Database to additional supporting information.

  16. [Obesity as pathology of adipocytes: number of cells, volume of arterial bloodstream,local pools of circulation in vivo, natriuretic peptides and arterial hypertension].

    Science.gov (United States)

    Titov, V N; Dmitriev, V A

    2015-03-01

    The non-specific systemic biological reaction of arterial pressure from the level of organism. vasomotor center and proximal section of arterial bloodstream is appealed to compensate disorders of metabolism and microcirculation in distal section of arteries. This phenomenon occurs in several cases. The primarily local disorders of metabolism at autocrine level, physiological (aphysiological) death of cells, "littering" of intercellular medium become the cause of disorder of microcirculation in paracrin cenosises and deteriorate realization of biological functions of homeostasis, trophology, endoecology and adaptation. The local compensation of affected perfusion in paracrin cenosises at the expense of function of peripheral peristaltic pumps, redistribution of local bloodflow in biological reaction of endothelium-depended vaso-dilation has no possibility to eliminate disorders in realization of biological functions. The systemic increase of arterial pressure under absence of specific symptoms of symptomatic arterial hypertension is a test to detect disorder of biological functions of homeostasis, trophology, biological function of endoecology and adaptation. Allforms of arterial hypertension develop by common algorithm independently from causes of disorders of blood flow, microcirculation in distal section of arteries. The non-specific systemic compensation ofdisorders of metabolism from level of organism, in proximal section of arterial bloodstream always is the same one and results in aphysiological alterations in organs-targets. To comprehend etiological characteristics of common pathogenesis of arterial hypertension is possible in case of application of such technically complicated and still unclear in differential diagnostic of deranged functions modes of metabolomics.

  17. The effect on patency of type, shape and volume of a vein collar used at the distal anastomis of PTFE-bypass to arteries below-knee

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    The aim of this paper was to study the effect on patency rate of different types of vein collar (Miller's original or St Mary's boot), different length/height shapes of vein collar, and different vein collar volumes at the distal anastomosis of PTFE-bypass grafts to below-knee arteries in patients...

  18. Towards the development of a fully coupled arterial-venous 1D model: suitability of using a 1D finite volume method with staggered spatial discretization

    CSIR Research Space (South Africa)

    Bogaers, Alfred EJ

    2012-07-01

    Full Text Available In this paper we outline the development of a 1D finite volume model to solve for blood flow through the arterial system. The model is based on a staggered spatial discretization which leads to a stable solution scheme. This scheme can accurately...

  19. Asymmetry in the brain influenced the neurological deficits and infarction volume following the middle cerebral artery occlusion in rats

    Directory of Open Access Journals (Sweden)

    Zhang Meizeng

    2008-12-01

    Full Text Available Abstract Background Paw preference in rats is similar to human handedness, which may result from dominant hemisphere of rat brain. However, given that lateralization is the uniqueness of the humans, many researchers neglect the differences between the left and right hemispheres when selecting the middle cerebral artery occlusion (MCAO in rats. The aim of this study was to evaluate the effect of ischemia in the dominant hemisphere on neurobehavioral function and on the cerebral infarction volume following MCAO in rats. Methods The right-handed male Sprague-Dawley rats asserted by the quadrupedal food-reaching test were subjected to 2 hours MCA occlusion and then reperfusion. Results The neurological scores were significantly worse in the left MCAO group than that in the right MCAO group at 1 h, 24 h, 48 h and 72 h (p 0.05 respectively. There was a trend toward better neurobehavioral function recovery in the right MCAO group than in the left MCAO group. The total infarct volume in left MCAO was significantly larger than that in the right (p Conclusion The neurobehavioral function result and the pathological result were consistent with the hypothesis that paw preference in rats is similar to human handedness, and suggested that ischemia in dominant hemisphere caused more significant neurobehavioral consequence than in another hemisphere following MCAO in adult rats. Asymmetry in rat brain should be considered other than being neglected in choice of rat MCAO model.

  20. Dynamic contrast-enhanced MRI assessment of hyperemic fractional microvascular blood plasma volume in peripheral arterial disease: initial findings.

    Directory of Open Access Journals (Sweden)

    Bas Versluis

    Full Text Available OBJECTIVES: The aim of the current study was to describe a method that assesses the hyperemic microvascular blood plasma volume of the calf musculature. The reversibly albumin binding contrast agent gadofosveset was used in dynamic contrast-enhanced magnetic resonance imaging (DCE MRI to assess the microvascular status in patients with peripheral arterial disease (PAD and healthy controls. In addition, the reproducibility of this method in healthy controls was determined. MATERIALS AND METHODS: Ten PAD patients with intermittent claudication and 10 healthy control subjects were included. Patients underwent contrast-enhanced MR angiography of the peripheral arteries, followed by one DCE MRI examination of the musculature of the calf. Healthy control subjects were examined twice on different days to determine normative values and the interreader and interscan reproducibility of the technique. The MRI protocol comprised dynamic imaging of contrast agent wash-in under reactive hyperemia conditions of the calf musculature. Using pharmacokinetic modeling the hyperemic fractional microvascular blood plasma volume (V(p, unit: % of the anterior tibial, gastrocnemius and soleus muscles was calculated. RESULTS: V(p was significantly lower for all muscle groups in PAD patients (4.3±1.6%, 5.0±3.3% and 6.1±3.6% for anterior tibial, gastrocnemius and soleus muscles, respectively compared to healthy control subjects (9.1±2.0%, 8.9±1.9% and 9.3±2.1%. Differences in V(p between muscle groups were not significant. The coefficient of variation of V(p varied from 10-14% and 11-16% at interscan and interreader level, respectively. CONCLUSIONS: Using DCE MRI after contrast-enhanced MR angiography with gadofosveset enables reproducible assessment of hyperemic fractional microvascular blood plasma volume of the calf musculature. V(p was lower in PAD patients than in healthy controls, which reflects a promising functional (hemodynamic biomarker for the

  1. Diurnal and seasonal variations of NO, NO2 and PM2.5 mass as a function of traffic volumes alongside an urban arterial

    Science.gov (United States)

    Kendrick, Christine M.; Koonce, Peter; George, Linda A.

    2015-12-01

    Urban arterial corridors are landscapes that give rise to short and long-term exposures to transportation-related pollution. With high traffic volumes and a wide mix of road users, urban arterial environments are important targets for improved exposure assessment to traffic-related pollution. A common method to estimate exposure is to use traffic volumes as a proxy. The study presented here analyzes a unique yearlong dataset of simultaneous roadside air quality and traffic observations for a U.S. arterial to assess the reliability of using traffic volumes as a proxy for traffic-related exposure. Results show how the relationships of traffic volumes with NO and NO2 vary not only by time of day and season but also by time aggregation. At short-term aggregations (15 min) nitrogen oxides were found to have a significant linear relationship with traffic volumes during morning hours for all seasons although variability was still high (r2 = 0.1-0.45 NO, r2 = 0.14-0.27 NO2), and little to no relationship during evening periods (r2 traffic volumes to estimate annual exposure concentrations for morning periods (r2 = 0.89 NO, r2 = 0.87 NO2) and evening NO2 (r2 = 0.46). Traffic volumes are a weak or poor predictor for annual evening NO (r2 = -0.09) and short-term 15 min aggregations. Seasonal and diurnal characterizations show that roadside PM2.5 (mass) measurements do not have a relationship with local traffic volumes, leading us to conclude that PM2.5 mass is more tied to regional sources and meteorological conditions. As epidemiology and personal exposure assessment research aims to study health impacts and pollutant levels encountered by pedestrians, bicyclists, those waiting for transit, and other road users, these results show when traffic volumes alone can be a reliable proxy for exposure and when this approach is not warranted.

  2. Atherosclerotic plaque volume and composition in symptomatic carotid arteries assessed with multidetector CT angiography; relationship with severity of stenosis and cardiovascular risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Rozie, S.; Weert, T.T. de; Monye, C. de; Homburg, P.J.; Tanghe, H.L.J.; Lugt, A. van der [Erasmus MC, University Medical Center Rotterdam, Departments of Radiology, Rotterdam (Netherlands); Dippel, D.W.J. [Erasmus MC, University Medical Center Rotterdam, Department of Neurology, PO Box 2040, Rotterdam (Netherlands)

    2009-09-15

    The purpose of this study was to examine the volume and the composition of atherosclerotic plaque in symptomatic carotid arteries and to investigate the relationship between these plaque features and the severity of stenosis and the presence of cardiovascular risk factors. One hundred patients with cerebrovascular symptoms underwent CT angiography. We measured plaque volume (PV) and the relative contribution of plaque components (calcifications, fibrous tissue, and lipid) in the symptomatic artery. The contribution of different components was measured as the number of voxels within defined ranges of HU values (calcification >130 HU, fibrous tissue 60-130 HU, lipid core <60 HU). Fifty-seven patients had atherosclerotic plaque in the symptomatic carotid artery. The severity of stenosis and PV were moderately correlated. Age and smoking were independently related to PV. Patients with hypercholesterolemia had significantly less lipid and more calcium in their plaques than patients without hypercholesterolemia. Other cardiovascular risk factors were not significantly related to PV or plaque composition. Luminal stenosis of the carotid artery partly reflects the amount of atherosclerotic carotid disease. Plaque volume and plaque composition are associated with cardiovascular risk factors. (orig.)

  3. [Frequency dependance of compliance].

    Science.gov (United States)

    Gayrard, P

    1975-01-01

    Resistance of peripheral or "small" airways is only a small part of the total pulmonary resistance (Raw). Even considerable obstruction in these airways will have little effect on total resistance. Conversely this will lead to inequality in the time constants of units in parallel, and dynamic lung compliance (C dyn) shall fall as respiratory frequence increases. C dyn is measured from simultaneous recordings of transpulmonary pressure (esophageal balloon) and volume obtained from a volume displacement plethysmograph. If Raw and static compliance are found to be normal, the frequency dependance of compliance will result from peripheral airway obstruction only. Early stages of chronic airway obstruction can be established by this method. However this appear not suitable for wide-scale studies.

  4. Can prostatic arterial embolisation (PAE) reduce the volume of the peripheral zone? MRI evaluation of zonal anatomy and infarction after PAE

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Yen-Ting [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Department of Radiology, Taichung Veterans General Hospital, Taichung City (China); Amouyal, Gregory; Pereira, Helena; Del Giudice, Costantino; Dean, Carole [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Correas, Jean-Michel [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Hopital Necker, Radiology Department, Paris (France); Pellerin, Olivier; Sapoval, Marc [Assistance Publique Hopitaux de Paris. Hopital Europeen Georges-Pompidou, Vascular and Oncological Interventional Radiology, Paris (France); Inserm (Institut national de la sante et de la recherche medicale) U970, Paris (France); Universite Paris Descartes, Paris (France); Thiounn, Nicolas [Assistance Publique Hopitaux de Paris, Hopital Europeen Georges-Pompidou, Urology, Paris (France)

    2016-10-15

    To assess the impact of prostatic arterial embolisation (PAE) on various prostate gland anatomical zones. We retrospectively reviewed paired MRI scans obtained before and after PAE for 25 patients and evaluated changes in volumes of the median lobe (ML), central gland (CG), peripheral zone (PZ) and whole prostate gland (WPV) following PAE. We used manual segmentation to calculate volume on axial view T2-weighted images for ML, CG and WPV. We calculated PZ volume by subtracting CG volume from WPV. Enhanced phase on dynamic contrasted-enhanced MRI was used to evaluate the infarction areas after PAE. Clinical results of International Prostate Symptom Score and International Index of Erectile Function questionnaires and the urodynamic study were evaluated before and after PAE. Significant reductions in volume were observed after PAE for ML (26.2 % decrease), CG (18.8 %), PZ (16.4 %) and WPV (19.1 %; p < 0.001 for all these volumes). Patients with clinical failure had smaller volume reductions for WPV, ML and CG (all p < 0.05). Patients with significant CG infarction after PAE displayed larger WPV, ML and CG volume reductions (all p < 0.01). PAE can significantly decrease WPV, ML, CG and PZ volumes, and poor clinical outcomes are associated with smaller volume reductions. (orig.)

  5. Roles of myocardial blood volume and flow in coronary artery disease: an experimental MRI study at rest and during hyperemia

    Energy Technology Data Exchange (ETDEWEB)

    McCommis, Kyle S.; Goldstein, Thomas A.; Pilgram, Thomas [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Abendschein, Dana R. [Washington University School of Medicine, Center for Cardiovascular Research, St. Louis, MO (United States); Misselwitz, Bernd [Bayer Schering Pharma AG, Berlin (Germany); Gropler, Robert J. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Washington University School of Medicine, Center for Cardiovascular Research, St. Louis, MO (United States); Zheng, Jie [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Cardiovascular Imaging Lab, St. Louis, MO (United States)

    2010-08-15

    To validate fast perfusion mapping techniques in a setting of coronary artery stenosis, and to further assess the relationship of absolute myocardial blood volume (MBV) and blood flow (MBF) to global myocardial oxygen demand. A group of 27 mongrel dogs were divided into 10 controls and 17 with acute coronary stenosis. On 1.5-T MRI, first-pass perfusion imaging with a bolus injection of a blood-pool contrast agent was performed to determine myocardial perfusion both at rest and during either dipyridamole-induced vasodilation or dobutamine-induced stress. Regional values of MBF and MBV were quantified by using a fast mapping technique. Color microspheres and {sup 99m}Tc-labeled red blood cells were injected to obtain respective gold standards. Microsphere-measured MBF and {sup 99m}Tc-measured MBV reference values correlated well with the MR results. Given the same changes in MBF, changes in MBV are twofold greater with dobutamine than with dipyridamole. Under dobutamine stress, MBV shows better association with total myocardial oxygen demand than MBF. Coronary stenosis progressively reduced this association in the presence of increased stenosis severity. MR first-pass perfusion can rapidly estimate regional MBF and MBV. Absolute quantification of MBV may add additional information on stenosis severity and myocardial viability compared with standard qualitative clinical evaluations of myocardial perfusion. (orig.)

  6. A study on variation types in celiac axis and superior mesenteric artery using 3D volume rendering of MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Keun; Jang, Seong Joo [Dept. of Radiological physics Graduate School of Dongshin University, Naju (Korea, Republic of); Jang, Young Ill [Dept. of Radiological Technology of Kwangyang Health College, Kwangyang (Korea, Republic of)

    2013-06-15

    The aim of this study was to evaluate the variation which based on Celiac axis and SMA using by CT volume rendering images. 613 patients underwent abdominal CTA, there were 552 patients (99.05%, TypeⅠ, Ⅱ ) with normal anatomical form and 61 (9.95%, Type Ⅲ-Ⅻ) with variation. TypeⅠ was 339(55.31%), Type Ⅱ was 213 (34.74%), Type Ⅲ was 18 (2.93%), Type Ⅳ was 12 patients (1.95%), Type Ⅴ was 11 patient (1.79%), Type Ⅵ was 9 patients (1.46%), Type Ⅶ was 6 patients (0.97%), Type Ⅷ was 1 patient (0.16%), Type Ⅸ was 1 patient (0.16%), Type Ⅹ was 1 patient (0.16%), Type Ⅺ was 1 patient (0.16%), and Type Ⅻ was 1 patient (0.16%) into totally new types of variation. In conclusion, we could found 9 new types of variation by classifying based on celiac axis and superior mesenteric artery. These results were considered to be an important opportunity for a new vessel map.

  7. Quantifying [{sup 18}F]fluorodeoxyglucose uptake in the arterial wall: the effects of dual time-point imaging and partial volume effect correction

    Energy Technology Data Exchange (ETDEWEB)

    Blomberg, Bjoern A. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Bashyam, Arjun; Ramachandran, Abhinay; Gholami, Saeid; Houshmand, Sina; Salavati, Ali; Werner, Tom; Alavi, Abass [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, Geneva (Switzerland); University of Groningen, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen (Netherlands)

    2015-08-15

    The human arterial wall is smaller than the spatial resolution of current positron emission tomographs. Therefore, partial volume effects should be considered when quantifying arterial wall {sup 18}F-FDG uptake. We evaluated the impact of a novel method for partial volume effect (PVE) correction with contrast-enhanced CT (CECT) assistance on quantification of arterial wall {sup 18}F-FDG uptake at different imaging time-points. Ten subjects were assessed by CECT imaging and dual time-point PET/CT imaging at approximately 60 and 180 min after {sup 18}F-FDG administration. For both time-points, uptake of {sup 18}F-FDG was determined in the aortic wall by calculating the blood pool-corrected maximum standardized uptake value (cSUV{sub MAX}) and cSUV{sub MEAN}. The PVE-corrected SUV{sub MEAN} (pvcSUV{sub MEAN}) was also calculated using {sup 18}F-FDG PET/CT and CECT images. Finally, corresponding target-to-background ratios (TBR) were calculated. At 60 min, pvcSUV{sub MEAN} was on average 3.1 times greater than cSUV{sub MAX} (P <.0001) and 8.5 times greater than cSUV{sub MEAN} (P <.0001). At 180 min, pvcSUV{sub MEAN} was on average 2.6 times greater than cSUV{sub MAX} (P <.0001) and 6.6 times greater than cSUV{sub MEAN} (P <.0001). This study demonstrated that CECT-assisted PVE correction significantly influences quantification of arterial wall {sup 18}F-FDG uptake. Therefore, partial volume effects should be considered when quantifying arterial wall {sup 18}F-FDG uptake with PET. (orig.)

  8. Arterial distensibility as a possible compensatory mechanism in chronic aortic regurgitation

    Directory of Open Access Journals (Sweden)

    Kopel Liliane

    2001-01-01

    Full Text Available OBJECTIVE: To evaluate elastic properties of conduit arteries in asymptomatic patients who have severe chronic aortic regurgitation. METHODS: Twelve healthy volunteers aged 30±1 years (control group and 14 asymptomatic patients with severe aortic regurgitation aged 29±2 years and left ventricular ejection fraction of 0.61±0.02 (radioisotope ventriculography were studied. High-resolution ultrasonography was performed to measure the systolic and diastolic diameters of the common carotid artery. Simultaneous measurement of blood pressure enabled the calculation of arterial compliance and distensibility. RESULTS: No differences were observed between patients with aortic regurgitation and the control group concerning age, sex, body surface, and mean blood pressure. Pulse pressure was significantly higher in the aortic regurgitation group compared with that in the control group (78±3 versus 48±1mmHg, P<0.01. Arterial compliance and distensibility were significantly greater in the aortic regurgitation group compared with that in the control group (11.0±0.8 versus 8.1±0.7 10-10 N-1 m4, P=0.01 e and 39.3±2.6 versus 31.1±2.0 10-6 N-1 m², P=0.02, respectively. CONCLUSION: Patients with chronic aortic regurgitation have increased arterial distensibility. Greater vascular compliance, to lessen the impact of systolic volume ejected into conduit arteries, represents a compensatory mechanism in left ventricular and arterial system coupling.

  9. Compliance status

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the activities conducted to ensure that the Hanford Site is in compliance with federal environmental protection statutes and related Washington State and local environmental protection regulations and the status of Hanford`s compliance with these requirements. Environmental permits required under the environmental protection regulations are discussed under the applicable statute.

  10. Late Cardiac Toxicity After Mediastinal Radiation Therapy for Hodgkin Lymphoma: Contributions of Coronary Artery and Whole Heart Dose-Volume Variables to Risk Prediction.

    Science.gov (United States)

    Hahn, Ezra; Jiang, Haiyan; Ng, Angela; Bashir, Shaheena; Ahmed, Sameera; Tsang, Richard; Sun, Alexander; Gospodarowicz, Mary; Hodgson, David

    2017-08-01

    Mediastinal radiation therapy (RT) for Hodgkin lymphoma (HL) is associated with late cardiotoxicity, but there are limited data to indicate which dosimetric parameters are most valuable for predicting this risk. This study investigated which whole heart dosimetric measurements provide the most information regarding late cardiotoxicity, and whether coronary artery dosimetry was more predictive of this outcome than whole heart dosimetry. A random sample of 125 HL patients treated with mediastinal RT was selected, and 3-dimensional cardiac dose-volume data were generated from historical plans using validated methods. Cardiac events were determined by linking patients to population-based datasets of inpatient and same-day hospitalizations and same-day procedures. Variables collected for the whole heart and 3 coronary arteries included the following: Dmean, Dmax, Dmin, dose homogeneity, V5, V10, V20, and V30. Multivariable competing risk regression models were generated for the whole heart and coronary arteries. There were 44 cardiac events documented, of which 70% were ischemic. The best multivariable model included the following covariates: whole heart Dmean (hazard ratio [HR] 1.09, P=.0083), dose homogeneity (HR 0.94, P=.0034), male sex (HR 2.31, P=.014), and age (HR 1.03, P=.0049). When any adverse cardiac event was the outcome, models using coronary artery variables did not perform better than models using whole heart variables. However, in a subanalysis of ischemic cardiac events only, the model using coronary artery variables was superior to the whole heart model and included the following covariates: age (HR 1.05, Pcoronary artery models. However, when events were limited to ischemic cardiotoxicity, the coronary artery-based model was superior. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Lung volumes, ventricular function and pulmonary arterial flow in children operated on for left-sided congenital diaphragmatic hernia: long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Abolmaali, Nasreddin; Koch, Arne [Dresden University of Technology, OncoRay - Molecular and Biological Imaging, Medical Faculty Carl Gustav Carus, Dresden (Germany); Goetzelt, Knut; Vogelberg, Christian [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatrics - Pediatric Pulmonology, Dresden (Germany); Hahn, Gabriele [University Clinics Carl Gustav Carus, Dresden University of Technology, Institute and Policlinic for Radiology - Pediatric Radiology, Dresden (Germany); Fitze, Guido [University Clinics Carl Gustav Carus, Dresden University of Technology, Clinic and Policlinic for Pediatric Surgery, Dresden (Germany)

    2010-07-15

    To compare MRI-based functional pulmonary and cardiac measurements in the long-term follow-up of children operated on for left-sided congenital diaphragmatic hernia (CDH) with age- and body size-matched healthy controls. Twelve children who received immediate postnatal surgery for closure of isolated left-sided CDH were included and received basic medical examinations, pulmonary function testing and echocardiography. MRI included measurement of lung volume, ventricular function assessment and velocity-encoded imaging of the pulmonary arteries and was compared with the data for 12 healthy children matched for age and body size. While patients' clinical test results were not suspicious, comparison between the MRI data for patients and those for healthy controls revealed significant differences. In patients, the volumes of the left lungs were increased and the tidal volume was larger on the right side. While the stroke volumes of both ventricles were reduced, heart rate and ejection fraction were increased. Flow, acceleration time and cross-sectional area of the left pulmonary artery were reduced. Functional MRI detected pulmonary and cardiac findings in the late follow-up of CDH children which may be missed by standard clinical methods and might be relevant for decisions regarding late outcome and treatment. (orig.)

  12. [Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test].

    Science.gov (United States)

    Bokov, P; Delclaux, C

    2016-02-01

    Resting pulmonary function tests (PFT) include the assessment of ventilatory capacity: spirometry (forced expiratory flows and mobilisable volumes) and static volume assessment, notably using body plethysmography. Spirometry allows the potential definition of obstructive defect, while static volume assessment allows the potential definition of restrictive defect (decrease in total lung capacity) and thoracic hyperinflation (increase in static volumes). It must be kept in mind that this evaluation is incomplete and that an assessment of ventilatory demand is often warranted, especially when facing dyspnoea: evaluation of arterial blood gas (searching for respiratory insufficiency) and measurement of the transfer coefficient of the lung, allowing with the measurement of alveolar volume to calculate the diffusing capacity of the lung for CO (DLCO: assessment of alveolar-capillary wall and capillary blood volume). All these pulmonary function tests have been the subject of an Americano-European Task force (standardisation of lung function testing) published in 2005, and translated in French in 2007. Interpretative strategies for lung function tests have been recommended, which define abnormal lung function tests using the 5th and 95th percentiles of predicted values (lower and upper limits of normal values). Thus, these recommendations need to be implemented in all pulmonary function test units. A methacholine challenge test will only be performed in the presence of an intermediate pre-test probability for asthma (diagnostic uncertainty), which is an infrequent setting. The most convenient exertional test is the 6-minute walk test that allows the assessment of walking performance, the search for arterial desaturation and the quantification of dyspnoea complaint.

  13. COMBINED REDUCED FORCED EXPIRATORY VOLUME IN 1-SECOND (FEV1) AND PERIPHERAL ARTERY DISEASE IN SEDENTARY ELDERS WITH FUNCTIONAL LIMITATIONS

    Science.gov (United States)

    Vaz Fragoso, Carlos A.; Hsu, Fang-Chi; Brinkley, Tina; Church, Timothy; Liu, Christine K.; Manini, Todd; Newman, Anne B.; Stafford, Randall S.; McDermott, Mary M.; Gill, Thomas M.

    2014-01-01

    Objectives Because they are potentially modifiable and may coexist, we evaluated the combined occurrence of a reduced forced expiratory volume in 1-second (FEV1) and peripheral artery disease (PAD), including its association with exertional symptoms, physical inactivity, and impaired mobility, in sedentary elders with functional limitations. Design Cross-sectional. Setting Lifestyle Interventions and Independence in Elder (LIFE) Study. Participants 1307 sedentary community-dwelling persons, mean age 78.9, with functional limitations (Short Physical Performance Battery [SPPB] <10). Measurements A reduced FEV1 was defined by a Z-score <-1.64 (< lower limit of normal), while PAD was defined by an ankle-brachial index <1.00. Exertional dyspnea was defined as moderate-to-severe (modified Borg index), immediately after a 400-meter walk test (400MWT). Exertional leg symptoms were established by the San Diego Claudication Questionnaire. Physical inactivity was evaluated by percent of accelerometry wear-time with activity <100 counts/min (top quartile established high sedentary-time). Mobility was evaluated by the 400MWT (gait-speed <0.8 m/s defined as slow) and SPPB (≤7 defined moderate-to-severe mobility impairment). Results A combined reduced FEV1 and PAD was established in 6.0% (78/1307) of participants. However, among those who had a reduced FEV1, 34.2% (78/228) also had PAD, while 20.8% (78/375) of those who had PAD also had a reduced FEV1. The two combined conditions were associated with exertional dyspnea (adjusted odds ratio [adjOR] 2.59 [1.20, 5.60]) and slow gait-speed (adjOR 3.15 [1.72, 5.75]) but not with exertional leg symptoms, high sedentary-time, and moderate-to-severe mobility impairment. Conclusions In sedentary community-dwelling elders with functional limitations, a reduced FEV1 and PAD frequently coexisted and, in combination, were strongly associated with exertional dyspnea and slow gait-speed (a frailty indicator that increases the risk of

  14. Reduced blood pressure of CFTR-F508del carriers correlates with diminished arterial reactivity rather than circulating blood volume in mice.

    Directory of Open Access Journals (Sweden)

    Veronica A Peotta

    Full Text Available The F508del mutation of the cystic fibrosis transmembrane conductance regulator (CFTR is the most common cause of cystic fibrosis (CF. Both CF patients and F508del carriers have decreased blood pressure. While this has been attributed to salt depletion, recent studies have shown F508del expression interferes with smooth muscle cell calcium mobilization. We tested the hypothesis that carriers of the F508del mutation have lower adult blood pressures and reduced aortic contractility without a reduction in circulating blood volume. By radiotelemetry, F508del heterozygous mice had significantly lower arterial pressures than wild-type C57BL/6 controls, with the greatest effect seen at the time of dark-to-light cycle transition (mean difference of 10 mmHg. To replicate the vascular effects of sympathetic arousal, isoproterenol and epinephrine were co-infused, and F508del mice again had significantly reduced arterial pressures. Aortas isolated from F508del heterozygous mice had significantly decreased constriction to noradrenaline (0.9 ± 0.2 versus 2.9 ± 0.7 mN. Inhibition of wild-type CFTR or the inositol triphosphate receptor replicated the phenotype of F508del aortas. CFTR carrier status did not alter circulating blood volume. We conclude the CFTR-F508del mutation decreases aortic contractility and lowers arterial pressures. As a cAMP-activated chloride channel that facilitates calcium mobilization, we speculate wild-type CFTR co-activation during adrenergic receptor stimulation buffers the vasodilatory response to catecholamines, and loss of this compensatory vasoconstrictor tone may contribute to the lower arterial pressures seen in heterozygote carriers of a CFTR-F508del mutation.

  15. Preoperative assessment of vascular anatomy of inferior mesenteric artery by volume-rendered 3D-CT for laparoscopic lymph node dissection with left colic artery preservation in lower sigmoid and rectal cancer

    Institute of Scientific and Technical Information of China (English)

    Michiya Kobayashi; Satoshi Morishita; Takehiro Okabayashi; Kana Miyatake; Ken Okamoto; Tsutomu Namikawa; Yasuhiro Ogawa; Keijiro Araki

    2006-01-01

    AIM: To determine the distance between the branching point of the left colic artery (LCA) and the inferior mesenteric artery (IMA) by computed tomography (CT) scanning, for preoperative evaluation before laparoscopic colorectal operation.METHODS: From February 2004 to May 2005, 100patients (63 men, 37 women) underwent angiography performed with a 16-scanner multi-detector row CT unit (Toshiba, Aquilion 16). All images were analyzed on a workstation (AZE Ltd, Virtual Place Advance 300). The distance from the root of the IMA to the bifurcation of the LCA was measured by curved multi-planar reconstruction on a workstation.RESULTS: The IMA could be visualized in all the cases,but the LCA was missing in two patients. The mean distance from the root of the IMA to the root of the LCA was 42.0 mm (range, 23.2-75.0 mm). There were no differences in gender, arterial branching types, body weight, height, and body mass index.CONCLUSION: Volume-rendered 3D-CT is helpful to assess the vascular branching anatomy for laparoscopic surgery.

  16. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release of...

  17. High arterial compliance in cirrhosis is related to low adrenaline and elevated circulating calcitonin gene related peptide but not to activated vasoconstrictor systems

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, S; Schifter, S;

    2001-01-01

    , vasoactivity was manipulated by inhalation of oxygen. STUDY POPULATION AND METHODS: In 20 patients with alcoholic cirrhosis and 12 controls we determined COMP(art) (stroke volume relative to pulse pressure), cardiac output, plasma volume, systemic vascular resistance, central circulation time, plasma...... catecholamines, renin activity, endothelin-1, and calcitonin gene related peptide (CGRP) at baseline and during oxygen inhalation. RESULTS: COMP(art) was significantly increased in cirrhotic patients compared with controls (1.32 v 1.06 ml/mm Hg; p

  18. The pathophysiology of the aqueduct stroke volume in normal pressure hydrocephalus: can co-morbidity with other forms of dementia be excluded?

    Energy Technology Data Exchange (ETDEWEB)

    Bateman, Grant A. [John Hunter Hospital, Department of Medical Imaging, Newcastle (Australia); Levi, Christopher R.; Wang, Yang; Lovett, Elizabeth C. [Hunter Medical Research Institute, Clinical Neurosciences Program, Newcastle (Australia); Schofield, Peter [James Fletcher Hospital, Neuropsychiatry Unit, Newcastle (Australia)

    2005-10-01

    Variable results are obtained from the treatment of normal pressure hydrocephalus (NPH) by shunt insertion. There is a high correlation between NPH and the pathology of Alzheimer's disease (AD) on brain biopsy. There is an overlap between AD and vascular dementia (VaD), suggesting that a correlation exists between NPH and other forms of dementia. This study seeks to (1) understand the physiological factors behind, and (2) define the ability of, the aqueduct stroke volume to exclude dementia co-morbidity. Twenty-four patients from a dementia clinic were classified as having either early AD or VaD on the basis of clinical features, Hachinski score and neuropsychological testing. They were compared with 16 subjects with classical clinical findings of NPH and 12 aged-matched non-cognitively impaired subjects. MRI flow quantification was used to measure aqueduct stroke volume and arterial pulse volume. An arterio-cerebral compliance ratio was calculated from the two volumes in each patient. The aqueduct stroke volume was elevated in all three forms of dementia, with no significant difference noted between the groups. The arterial pulse volume was elevated by 24% in VaD and reduced by 35% in NPH, compared to normal (P=0.05 and P=0.002, respectively), and was normal in AD. There was a spectrum of relative compliance with normal compliance in VaD and reduced compliance in AD and NPH. The aqueduct stroke volume depends on the arterial pulse volume and the relative compliance between the arterial tree and brain. The aqueduct stroke volume cannot exclude significant co-morbidity in NPH. (orig.)

  19. Performing compliance

    DEFF Research Database (Denmark)

    Wimmelmann, Camilla Lawaetz

    2017-01-01

    the local policy workers front-staged some practices in the implementation process and back-staged others. The local policy workers deliberately performed ‘guideline compliance’ by using information control and impression management techniques. The findings suggest that local guideline compliance should......Guidelines are increasingly used to regulate how local authorities engage in practices. Focusing on the Danish national health promotion guidelines, this article reveals that the local policy workers did not implement the guidelines as proposed. Using a dramaturgical framework, it illustrates how...... be regarded as a staged performance in which deliberate techniques are used to produce and manage certain impressions of compliance....

  20. Handwashing compliance.

    Science.gov (United States)

    Antoniak, Jeannie

    2004-09-01

    Undeniably, handwashing remains the single most effective and cost-efficient method for preventing and reducing the transmission of nosocomial infections. Yet the rates and outbreaks of nosocomial infections in Canadian and international healthcare institutions continue to increase. Shaikh Khalifa Medical Center developed and implemented a multidisciplinary approach to address the challenges of handwashing compliance among nurses and healthcare workers in its workplace setting. Supported by evidence-based research, the approach consisted of three components: collaboration, implementation and evaluation. The use of the alcohol-based hand rub sanitizer or "solution" was integral to the multidisciplinary approach. Ongoing education, communication and a committed leadership were essential to promote and sustain handwashing compliance.

  1. Time constant of the cerebral arterial bed.

    Science.gov (United States)

    Kasprowicz, Magdalena; Diedler, Jennifer; Reinhard, Matthias; Carrera, Emmanuel; Smielewski, Peter; Budohoski, Karol P; Sorrentino, Enrico; Haubrich, Christina; Kirkpatrick, Peter J; Pickard, John D; Czosnyka, Marek

    2012-01-01

    We have defined a novel cerebral hemodynamic index, a time constant of the cerebral arterial bed (τ), the product of arterial compliance (C(a)) and cerebrovascular resistance (CVR). C(a) and CVR were calculated based on the relationship between pulsatile arterial blood pressure (ABP) and transcranial Doppler cerebral blood flow velocity. This new parameter theoretically estimates how fast the cerebral arterial bed is filled by blood volume after a sudden change in ABP during one cardiac cycle. We have explored this concept in 11 volunteers and in 25 patients with severe stenosis of the internal carotid artery (ICA). An additional group of 15 subjects with non-vascular dementia was studied to assess potential age dependency of τ. The τ was shorter (p = 0.011) in ICA stenosis, both unilateral (τ = 0.18 ± 0.04 s) and bilateral (τ = 0.16 ± 0.03 s), than in controls (τ = 0.22 ± 0.0 s). The τ correlated with the degree of stenosis (R = -0.62, p = 0.001). In controls, τ was independent of age. Further study during cerebrovascular reactivity tests is needed to establish the usefulness of τ for quantitative estimation of haemodynamics in cerebrovascular disease.

  2. Three-dimensional volume-rendered multidetector CT imaging of the posterior inferior pancreaticoduodenal artery: its anatomy and role in diagnosing extrapancreatic perineural invasion

    Science.gov (United States)

    Giacomini, Craig; Brooke Jeffrey, R.; Willmann, Juergen K.; Olcott, Eric

    2013-01-01

    Abstract Extrapancreatic perineural spread in pancreatic adenocarcinoma contributes to poor outcomes, as it is known to be a major contributor to positive surgical margins and disease recurrence. However, current staging classifications have not yet taken extrapancreatic perineural spread into account. Four pathways of extrapancreatic perineural spread have been described that conveniently follow small defined arterial pathways. Small field of view three-dimensional (3D) volume-rendered multidetector computed tomography (MDCT) images allow visualization of small peripancreatic vessels and thus perineural invasion that may be associated with them. One such vessel, the posterior inferior pancreaticoduodenal artery (PIPDA), serves as a surrogate for extrapancreatic perineural spread by pancreatic adenocarcinoma arising in the uncinate process. This pictorial review presents the normal and variant anatomy of the PIPDA with 3D volume-rendered MDCT imaging, and emphasizes its role as a vascular landmark for the diagnosis of extrapancreatic perineural invasion from uncinate adenocarcinomas. Familiarity with the anatomy of PIPDA will allow accurate detection of extrapancreatic perineural spread by pancreatic adenocarcinoma involving the uncinate process, and may potentially have important staging implications as neoadjuvant therapy improves. PMID:24434918

  3. Ground-water monitoring compliance projects for Hanford Site Facilities: Progress report for the period April 1--June 30, 1988: Volume 1, Text

    Energy Technology Data Exchange (ETDEWEB)

    1988-09-01

    This is Volume 1 of a two-volume set of documents that describes the progress of 10 Hanford Site ground-water monitoring projects for the period April 1 to June 30, 1988. This volume discusses the projects; Volume 2 provides as-built diagrams, drilling logs, and geophysical logs for wells drilled during this period in the 100-N Area and near the 216-A-36B Crib.

  4. O volume plaquetário médio abaixo do normal está associado com extensão reduzida de doença arterial coronariana Lower than normal mean platelet volume is associated with reduced extent of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Tolga Sinan Güvenç

    2013-03-01

    Full Text Available FUNDAMENTO: A extensão da doença arterial coronariana aterosclerótica em pacientes com angina estável tem importantes implicações prognósticas e terapêuticas. Em modelos atuais de evolução de placas, os trombócitos desempenham um papel importante no crescimento de placas. O volume plaquetário médio é um marcador facilmente determinado, com evidência de correlação com a agregabilidade plaquetária in vitro, além de valores comprovadamente maiores após eventos vasculares agudos. OBJETIVO: No presente estudo, investigou-se a relação entre o volume plaquetário médio e a extensão angiográfica da doença arterial coronariana em pacientes com angina estável. MÉTODOS: Foram analisados prontuários, hemograma completo e dados angiográficos anteriores de 267 pacientes elegíveis com angina estável. A extensão angiográfica da doença arterial coronariana foi avaliada à luz de dados angiográficos, com o uso por um especialista do escore de Gensini em uma cardiologia invasiva. Os valores para o volume plaquetário médio foram obtidos a partir de hemogramas completos, obtidos um dia antes da angiografia. Com relação ao intervalo populacional para o volume plaquetário médio, os pacientes foram agrupados dentro (n = 176 e abaixo (n = 62 do referido intervalo. Foi realizada uma comparação entre grupos e uma análise correlacional. RESULTADOS: Não houve correlação linear entre o escore de Gensini total e o volume plaquetário médio (p = 0,29, ao passo que a contagem total de trombócitos apresentou correlação inversa com o volume plaquetário médio (p BACKGROUND: Extent of atherosclerotic coronary artery disease in patients with stable angina has important prognostic and therapeutic implications. In current models of plaque evolution, thrombocytes play an important role in plaque growth. Mean platelet volume is a readily obtainable marker that was shown to correlate with platelet aggregability in vitro and increased

  5. Adolescent and adult uterine volume and uterine artery Doppler blood flow among subjects treated with bone marrow transplantation or chemotherapy in pediatric age: a case-control study.

    Science.gov (United States)

    Beneventi, Fausta; Locatelli, Elena; Giorgiani, Giovanna; Zecca, Marco; Mina, Tommaso; Simonetta, Margherita; Cavagnoli, Chiara; Albanese, Mara; Spinillo, Arsenio

    2015-02-01

    To compare uterine and ovarian volumes and uterine artery (UA) Doppler blood flow among women who were treated with antineoplastic regimens when pediatric aged versus healthy controls. Case-control study. Tertiary obstetric and gynecologic center. One hundred twenty-seven women who were treated for childhood cancer with bone marrow transplantation (BMT) and∖or chemotherapy and total body irradiation (TBI) and 64 age-matched healthy controls. Ultrasonographic and clinical evaluations. Uterine and ovarian volume, detection of follicles, and UA pulsatility index (PI). Median uterus and ovarian volumes were reduced by 64% (95% CI, 56.6-70.6) and 83.6% (95% CI, 79.6-86.7), respectively, among cases compared with controls. Median UA PI among cases was increased by 30.3% (95% CI, 19.6-40.8) compared with controls. Ovarian follicles were identified in 24 (18.9%) of 127 cases and 25 (39%) of 64 controls. Uterine volume was reduced after TBI (percent reduction 81.9%; 95% CI, 71.8-87.8) or busulfan (percentage reduction 67.4%; 95% CI, 58.5-75.6) compared with those who had not received a conditioning regimen (percentage reduction 24.4%; 95% CI, 7.6-38.2). The only factors independently associated with reduced uterine and ovarian volumes compared with controls were TBI, busulfan, and BMT. The worst effect on UA PI resulted from BMT and a diagnosis of hematologic disease. Bone marrow transplantation as main treatment and TBI and busulfan as conditioning regimens had the worst effect on uterine and ovarian sizes compared with controls. These data should be considered in counseling families on preserving future fertility in children undergoing BMT. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  6. Ground-water monitoring compliance projects for Hanford Site facilities: Progress report for the period April 1 to June 30, 1988: Volume 2, Appendices

    Energy Technology Data Exchange (ETDEWEB)

    1988-09-01

    This is Volume 2 of a two-volume set of documents that describes the progress of 10 Hanford Site ground-water monitoring projects for the period April 1 to June 30, 1988. This volume discusses as-built diagrams, drilling logs, and geophysical logs for wells drilled during this period in the 100-N Area (Appendix A) and near the 216-A-36B Crib (Appendix B). Volume 1 discusses the 10 projects. This work was supported by the US Department of Energy under Contract AC06-76RL01830.

  7. Mass transport of low density lipoprotein in reconstructed hemodynamic environments of human carotid arteries: the role of volume and solute flux through the endothelium.

    Science.gov (United States)

    Kim, Sungho; Giddens, Don P

    2015-04-01

    The accumulation of low density lipoprotein (LDL) in the arterial intima is a critical step in the initiation and progression of atheromatous lesions. In this study we examine subject-specific LDL transport into the intima of carotid bifurcations in three human subjects using a three-pore model for LDL mass transfer. Subject-specific carotid artery computational models were derived using magnetic resonance imaging (MRI) to obtain the geometry and phase-contract MRI (PC-MRI) to acquire pulsatile inflow and outflow boundary conditions for each subject. The subjects were selected to represent a wide range of anatomical configurations and different stages of atherosclerotic development from mild to moderate intimal thickening. A fluid-solid interaction (FSI) model was implemented in the computational fluid dynamics (CFD) approach in order to consider the effects of a compliant vessel on wall shear stress (WSS). The WSS-dependent response of the endothelium to LDL mass transfer was modeled by multiple pathways to include the contributions of leaky junctions, normal junctions, and transcytosis to LDL solute and plasma volume flux from the lumen into the intima. Time averaged WSS (TAWSS) over the cardiac cycle was computed to represent the spatial WSS distribution, and wall thickness (WTH) was determined from black blood MRI (BBMRI) so as to visualize intimal thickening patterns in the bifurcations. The regions which are exposed to low TAWSS correspond to elevated WTH and higher mass and volume flux via the leaky junctions. In all subjects, the maximum LDL solute flux was observed to be immediately downstream of the stenosis, supporting observations that existing atherosclerotic lesions tend to progress in the downstream direction of the stenosis.

  8. Ground-water monitoring compliance projects for Hanford site facilities: Progress report for January 1 to March 31, 1988: Volume 9: Appendix C

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    The appendix is one of nine volumes, and presents data describing wells completed at the Hanford Site during the first quarter of calendar year 1988 (January through March). The data in this volume of Appendix C cover the following wells: 199-N-58; 199-N-59; 199-N-60; 199-N-61; 199-N-67. The data are presented in the following order: Well Completion Report/Title III Inspection List, As-Built Diagram, Logging Charts, and Drill Logs.

  9. Volume mediano efetivo de cristaloides na prevenção de hipotensão arterial em pacientes submetidas à cesariana com raquianestesia

    Directory of Open Access Journals (Sweden)

    Xu ShiQin

    2012-06-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A hipotensão materna associada à raquianestesia no parto cesáreo é a complicação mais frequente e problemática, com sérios riscos para a mãe e comprometimento do bem-estar neonatal. Nesse contexto, o volume efetivo de cristaloides por via intravenosa como uma estratégia de prevensão ainda não foi estimado. MÉTODOS: Oitenta e cinco parturientes com estado físico ASA I/II submetidas à cesariana seletiva foram selecionadas e 67 mulheres elegíveis foram designadas para receber uma pré-carga de cristaloides com 2 mL de bupivacaína hiperbárica a 0,5% (10 mg mais 50 µg de morfina. O volume de cristaloides foi determinado por um método sequencial up-and-down. Os cristaloides foram infundidos a uma taxa de 100 a 150 mL.min-1 antes da anestesia espinal. O volume inicial de cristaloides foi de 5 mL.kg-1. Os dados do efeito do volume foram ajustados para o modelo sigmoidal de máxima eficácia e a mediana do volume efetivo (VE50 e seu intervalo de confiança (IC de 95% foram calculados usando a estimativa de máxima verossimilhança e a regressão logística de Firth corrigida. RESULTADOS: Sessenta e sete parturientes completaram o estudo e foram analisadas. Vinte e oito pacientes (41,8% desenvolveram hipotensão, com queda da pressão arterial sistólica (PAS superior a 20% do valor basal. O VE50 de cristaloides foi de 12,6 mL.kg-1 (IC 95%, 11,6 a 14,8 mL.kg-1. Com a correção de Firth, a probabilidade conjunta do volume efetivo de cristaloides a 13 mL.kg-1 foi de 50,2% (IC 95%, 30,0% a 83,1%. CONCLUSÕES: O VE50 estimado da pré-carga de cristaloides necessário para prevenir a hipotensão induzida por anestesia espinhal em parto cesáreo é de 13 mL.kg-1 (valor aproximado. Porém, a profilaxia ou terapia com vasoconstritores também deve ser preparada e administrada no momento oportuno.

  10. Draft Title 40 CFR 191 compliance certification application for the Waste Isolation Pilot Plant. Volume 9: Appendices RM, SCR, SER, SUM, WRAC

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-31

    The Rock Mechanics Program is important to the establishment of a radioactive waste repository in salt because rock mechanics deals with the prediction of creep closure and eventual encapsulation of the waste. The intent of this paper is to give the current status of the program. This program consists of three major modeling efforts: continuum creep, fracture, and the disturbed rock zone. These models, together with laboratory material parameters, plastic flow potentials, initial and boundary input data, and other peripheral information forms the predictive technology. The extent to which the predictive technology is validated against in situ test data adds certainty to the method. Application of the technology is through simulations of the test results, design, or performance using numerical codes. In summary, the predictive capabilities are technically sound and reasonable. The current status of the program is that which would be advanced for compliance.

  11. Potential of right to left ventricular volume ratio measured on chest CT for the prediction of pulmonary hypertension: correlation with pulmonary arterial systolic pressure estimated by echocardiography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon [Soon Chun Hyang University, Department of Radiology, Bucheon (Korea, Republic of); Kim, Seok Yeon [Seoul Medical Center, Department of Cardiology, Seoul (Korea, Republic of); Lee, Soo Jeong [Terarecon Korea, Seoul (Korea, Republic of); Kim, Jae Kyun [Chung-Ang University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Reddy, Ryan P.; Schoepf, U.J. [Medical University of South Carolina, Department of Radiology and Radiological Science and Division of Cardiology, Department of Medicine, Charleston, SC (United States)

    2012-09-15

    To investigate the correlation of right ventricular (RV) to left ventricular (LV) volume ratio measured by chest CT with pulmonary arterial systolic pressure (PASP) estimated by echocardiography. 104 patients (72.47 {+-} 13.64 years; 39 male) who had undergone chest CT and echocardiography were divided into two groups (hypertensive and normotensive) based upon an echocardiography-derived PASP of 25 mmHg. RV to LV volume ratios (RV{sub V}/LV{sub V}) were calculated. RV{sub V}/LV{sub V} was then correlated with PASP using regression analysis. The Area Under the Curve (AUC) for predicting pulmonary hypertension on chest CT was calculated. In the hypertensive group, the mean PASP was 46.29 {+-} 14.42 mmHg (29-98 mmHg) and there was strong correlation between the RV{sub V}/LV{sub V} and PASP (R = 0.82, p < 0.001). The intraobserver and interobserver correlation coefficients for RV{sub V}/LV{sub V} were 0.990 and 0.892. RV{sub V}/LV{sub V} was 1.01 {+-} 0.44 (0.51-2.77) in the hypertensive and 0.72 {+-} 0.14 (0.52-1.11) in the normotensive group (P <0.05). With 0.9 as the cutoff for RV{sub V}/LV{sub V}, sensitivity and specificity for predicting pulmonary hypertension over 40 mmHg were 79.5 % and 90 %, respectively. The AUC for predicting pulmonary hypertension was 0.87 RV/LV volume ratios on chest CT correlate well with PASP estimated by echocardiography and can be used to predict pulmonary hypertension over 40 mmHg with high sensitivity and specificity. (orig.)

  12. Ground-water monitoring compliance projects for Hanford site facilities: Progress report for the period January 1 to March 31, 1988: Volume 4, Appendix A (contd)

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    This appendix is one of nine volumes, and presents data describing wells completed at the Hanford Site during the fourth quarter of calendar year 1987 (October through December). The data in this volume of Appendix A cover the following wells: 299-E33-30; 299-E34-2; 299-E34-3; 299-E34-4; 299-E34-5; 299-E34-6. The data are presented in the following order: Well Completion Report/Title III Inspection List, Inspection Plan, As-Built Diagram, Logging Charts, and Drill Logs.

  13. Ground-water monitoring compliance projects for Hanford site facilities: Progress report for the period January 1 to March 31, 1988: Volume 2, Appendix A

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    This appendix is one of nine volumes, and presents data describing wells completed at the Hanford Site during the fourth quarter of calendar year 1987 (October through December). The data in this volume of Appendix A cover the following wells: 299-E27-8; 299-E27-9; 299-E27-10; 299-E28-26; 299-E28-27. The data are presented in the following order: Well Completion Report/Title III Inspection List, Inspection Plan, As-Built Diagram, Logging Charts, and Drill Logs.

  14. Ground-water monitoring compliance projects for Hanford Site facilities: Progress report, January 1-March 31, 1988: Volume 3, Appendix A

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    This appendix is one of nine volumes, and presents data describing wells completed at the Hanford Site during the fourth quarter of calendar year 1987 (October through December). The data in this volume of Appendix A cover the following wells: 299-E32-2; 299-E32-3; 299-E32-4; 299-E33-28; 299-E33-29. The data are presented in the following order: Well Completion Report/Title III Inspection List, Inspection Plan, As-Built Diagram, Logging Charts, and Drill Logs.

  15. Ground-water monitoring compliance projects for Hanford site facilities: Progress report for the period January 1 to March 31, 1988: Volume 7, Appendix B (contd)

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    This appendix is one of nine volumes, and presents data describing wwlls completed at the Hanford Site during the fourth quarter of calendar year 1987 (October through December). The data in this volume of Appendix B cover the following wells: 299-W10-14; 299-W15-15; 299-W15-16; 299-W15-17; 299-W15-18. The data are presented in the following order: Well Completion Report/Title III Inspection List, Inspection Plan, As-Built Diagram, Logging Charts, and Drill Logs.

  16. Ground-water monitoring compliance projects for Hanford site facilities: Progress report for the period January 1 to March 31, 1988: Volume 5, Appendix B

    Energy Technology Data Exchange (ETDEWEB)

    None

    1988-05-01

    This appendix is one of nine volumes, and presents data describing wells completed at the Hanford Site during the fourth quarter of calendar year 1987 (October through December). The data in this volume of Appendix B cover the following wells: 299-W6-2; 299-W7-1; 299-W7-2; 299-W7-3; 299-W7-4. The data are presented in the following order: Well Completion Report/Title III Inspection List, Inspection Plan, As-Built Diagram, Logging Charts, and Drill Logs.

  17. Increased arterial compliance in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, Søren; Schifter, S

    1999-01-01

    in patients with biopsy-verified cirrhosis (Child-Turcotte classes A/B/C=10/15/6). RESULTS: COMPart was significantly higher in cirrhotic patients (n=31) than in controls (n=10) (1.44 vs 1.00 x 10(-3) l/mmHg, pTurcotte classes A, B, and C (1.02, 1.47, and 2...

  18. Eleventh annual Department of Energy low-level waste management conference. Volume 2: Low-level waste strategy and planning, decontamination and decommissioning, compliance monitoring

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1989-11-01

    Nineteen papers are presented in volume 2. The 11 papers in the LLW Strategy and Planning section discuss plans for disposal facilities in Texas, Pennsylvania, Hanford, the Southwest and Southeast Compacts, and others. Three papers discuss decontamination technology and activities. Environmental monitoring requirements and recommendations at LLW facilities are discussed in 5 papers. Papers have been processed separately for inclusion on the data base.

  19. The arterial load in pulmonary hypertension

    Directory of Open Access Journals (Sweden)

    A. Vonk-Noordegraaf

    2010-09-01

    Full Text Available The anatomical differences between the pulmonary and systemic arterial system are the main cause of the difference in distribution of compliance. In the pulmonary arterial system compliance is distributed over the entire arterial system, and stands at the basis of the constancy of the RC-time. This distribution depends on the number of peripheral vessels, which is ∼8–10 times more in the pulmonary system than the systemic tree. In the systemic arterial tree the compliance is mainly located in the aorta (80% of total compliance in thoracic-abdominal aorta. The constant RC-time in the pulmonary bed results in proportionality of systolic and diastolic pressure with mean pressure and, in turn, in the constant ratio of oscillatory and mean power.

  20. Ground-water monitoring compliance projects for Hanford Site facilities: Progress report for the period January 1--March 31, 1988: Volume 1, Text

    Energy Technology Data Exchange (ETDEWEB)

    1988-05-01

    This report describes the progress of eight Hanford Site ground-water monitoring projects for the period January 1 to March 31, 1988. The facilities represented by the eight projects are the 300 Area Process trenches, 183-H Solar Evaporation Basins, 200 Areas Low-Level Burial Grounds, Nonradioactive Dangerous Waste Landfill, 216-A-36B Crib, 1301-N Liquid Waste Disposal Facility, 1325-N Liquid Waste Disposal Facility, and 1324-N/NA Surface Impoundment and Percolation Ponds. The latter four projects are included in this series of quarterly reports for the first time. This report is the seventh in a series of periodic status reports; the first six cover the period from May 1, 1986, through December 31, 1987 (PNL 1986; 1987a, b, c, d; 1988a). This report satisfies the requirements of Section 17B(3) of the Consent Agreement and Compliance Order issued by the Washington State Department of Ecology (1986a) to the US Department of Energy-Richland Operations Office. 13 refs., 19 figs., 24 tabs.

  1. Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery.

    Science.gov (United States)

    Maimaituxun, Gulinu; Shimabukuro, Michio; Salim, Hotimah Masdan; Tabata, Minoru; Yuji, Daisuke; Morimoto, Yoshihisa; Akasaka, Takeshi; Matsuura, Tomomi; Yagi, Shusuke; Fukuda, Daiju; Yamada, Hirotsugu; Soeki, Takeshi; Sugimoto, Takaki; Tanaka, Masashi; Takanashi, Shuichiro; Sata, Masataka

    2017-01-01

    Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown. Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG). In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers were comparable between CABG and non-CABG groups. Multivariate logistic regression analysis showed that in men, CABG was determined by EATV Index and other ASCVD risk factors including hypertension, dyslipidemia, adiponectin, high sensitive C-reactive protein (hsCRP) and type 2 diabetes mellitus (Corrected R2 = 0.262, p < 0.0001), while in women, type 2 diabetes mellitus is a single strong predictor for CABG, excluding EATV Index (Corrected R2 = 0.266, p = 0.005). Our study found that multiple risk factors, including epicardial adipose tissue volume and traditional ASCVD factors are determinants for CABG in men, but type 2 diabetes mellitus was the sole determinant in women. Gender-specific disparities in risk factors of CABG prompt us to evaluate new diagnostic and treatment strategies and to seek underlying mechanisms.

  2. Membrane diffusion- and capillary blood volume measurements are not useful as screening tools for pulmonary arterial hypertension in systemic sclerosis: a case control study

    Directory of Open Access Journals (Sweden)

    Spreeuwenberg Marieke D

    2008-10-01

    Full Text Available Abstract Background There is no optimal screening tool for the assessment of pulmonary arterial hypertension (PAH in patients with systemic sclerosis (SSc. A decreasing transfer factor of the lung for CO (TLCO is associated with the development of PAH in SSc. TLCO can be partitioned into the diffusion of the alveolar capillary membrane (Dm and the capillary blood volume (Vc. The use of the partitioned diffusion to detect PAH in SSc is not well established yet. This study evaluates whether Dm and Vc could be candidates for further study of the use for screening for PAH in SSc. Methods Eleven SSc patients with PAH (SScPAH+, 13 SSc patients without PAH (SScPAH- and 10 healthy control subjects were included. Pulmonary function testing took place at diagnosis of PAH. TLCO was partitioned according to Roughton and Forster. As pulmonary fibrosis in SSc influences values of the (partitioned TLCO, these were adjusted for fibrosis score as assessed on HRCT. Results TLCO as percentage of predicted (% was lower in SScPAH+ than in SScPAH- (41 ± 7% vs. 63 ± 12%, p vs. 39 ± 12%, p Conclusion SScPAH+ patients have lower Dm% than SScPAH- patients. There are no correlations between Dm% and hemodynamic parameters of PAH in SScPAH+. These findings do not support further study of the role of partitioning TLCO in the diagnostic work- up for PAH in SSc.

  3. Quantitative agreement between [(15)O]H2O PET and model free QUASAR MRI-derived cerebral blood flow and arterial blood volume.

    Science.gov (United States)

    Heijtel, D F R; Petersen, E T; Mutsaerts, H J M M; Bakker, E; Schober, P; Stevens, M F; van Berckel, B N M; Majoie, C B L M; Booij, J; van Osch, M J P; van Bavel, E T; Boellaard, R; Lammertsma, A A; Nederveen, A J

    2016-04-01

    The purpose of this study was to assess whether there was an agreement between quantitative cerebral blood flow (CBF) and arterial cerebral blood volume (CBVA) measurements by [(15)O]H2O positron emission tomography (PET) and model-free QUASAR MRI. Twelve healthy subjects were scanned within a week in separate MRI and PET imaging sessions, after which quantitative and qualitative agreement between both modalities was assessed for gray matter, white matter and whole brain region of interests (ROI). The correlation between CBF measurements obtained with both modalities was moderate to high (r(2): 0.28-0.60, P QUASAR significantly underestimated CBF by 30% (P QUASAR yielding values that were only 27% of the [(15)O]H2O-derived values (P QUASAR MRI, indicating similar qualitative CBVA and CBF information by both modalities. In conclusion, the results of this study demonstrate that QUASAR MRI and [(15)O]H2O PET provide similar CBF and CBVA information, but with systematic quantitative discrepancies. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Combined measurement of fetal lung volume and pulmonary artery resistance index is more accurate for prediction of neonatal respiratory distress syndrome in preterm fetuses: A Pilot Study.

    Science.gov (United States)

    Laban, Mohamed; Mansour, Ghada; El-Kotb, Ahmed; Hassanin, Alaa; Laban, Zina; Saleh, Abdelrahman

    2017-10-02

    To estimate optimal cut-off values for mean fetal lung volume (FLV) and pulmonary artery resistance index (PA-RI) as noninvasive measures to predict neonatal respiratory distress syndrome (RDS) in preterm fetuses. A prospective study conducted at Ain Shams University Maternity Hospital, Egypt from May 2015 to July 2017: eighty eligible women diagnosed with preterm labor were recruited at 32-36 weeks' gestation. Before delivery, three-dimensional ultrasound was used to estimate FLV using virtual organ computer-aided analysis (VOCAL), while PA-RI was measured by Doppler ultrasonography. A total of 80 women were examined. 37 (46%) of the newborns developed neonatal RDS. FLV was significantly lower in neonates who developed RDS (p = 0.04), whereas PARI was significantly higher in those who didn't (p = 0.02). Cut-off values of FLV ≤ 27.2 cm(3) and PARI ≥ 0.77 predicted the subsequent development of RDS. Combining both cut-offs generated a more sensitive and specific methodical approach for the prediction of RDS (sensitivity 100%, specificity 88.5%). Measurement of FLV or PA-RI can predict RDS in preterm fetuses. Combined use of both measures bolstered their predictive significance.

  5. Left atrial volume index and aortic stiffness index in adult hemodialysed patients - link between compliance and pressure mediated by endothelium dysfunction; a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Zapolski Tomasz

    2012-11-01

    Full Text Available Abstract Background This study was performed to investigate the relationship between elastic properties of aorta and left atrium volume index (LAVI in hemodialyzed (HD patients. Methods Study group was consisted of 73 patients (age 51,6 ± 7,6 years treated by hemodialysis. In all patients standard echocardiography was performed. Aortic stiffness index (ASI was calculated using formula: ASI = log (SBP/DBP/[(Aomax-Aomin/Aomin]. LAVI was calculated according to the formula: LAVI = [π/6 x (LAmax x LAshort x LAlong]/m2. Additionally several indices were calculated: left ventricle mass (LVM, left ventricle mass index (LVMI, midwall fractional shortening (mFS, endsystolic stress (ESS, mFS/ESS. Additionally the laboratory parameters including lipidogram, troponin T (cTnT, NT-proBNP and asymmetric dimethylarginine (ADMA were measured. Results The ASI was strong and significantly correlated with left atrium volume (LAV and LAVI (respectively: 0,601; p  Conclusions There is correlation between ASI and ADMA, marker of endothelium dysfunction. There is also association between LAVI and NT-proBNP, signs of elevated left atrium pressure. The strong correlation between ASI and LAVI, improved by associations of specific biochemical markers with these echocardiographic indices, suggests there is the link between elastic properties of aorta and left atrium pressure in hemodialysed patients mediated by endothelial dysfunction.

  6. In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29, entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC Score in Chronic Ischemic Stroke Patient "

    Directory of Open Access Journals (Sweden)

    Moh Hasan Machfoed

    2016-06-01

    Full Text Available  In connection with the publication in Bali Med J 2016, Volume 5, Number 2: 25-29, entitled "Intra-Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC Score in Chronic Ischemic Stroke Patient ", herewith, please allow us to do reviews of the study discussion. By assessing the discussion, it can be proved whether there are references that support the results of study.

  7. Deadline Compliance Status Reports

    Data.gov (United States)

    Department of Housing and Urban Development — These monthly Deadline Compliance Status Reports assist Participating Jurisdictions and HUD Field Offices in monitoring compliance with the 2-year commitment and...

  8. Novel system using microliter order sample volume for measuring arterial radioactivity concentrations in whole blood and plasma for mouse PET dynamic study.

    Science.gov (United States)

    Kimura, Yuichi; Seki, Chie; Hashizume, Nobuya; Yamada, Takashi; Wakizaka, Hidekatsu; Nishimoto, Takahiro; Hatano, Kentaro; Kitamura, Keishi; Toyama, Hiroshi; Kanno, Iwao

    2013-11-21

    This study aimed to develop a new system, named CD-Well, for mouse PET dynamic study. CD-Well allows the determination of time-activity curves (TACs) for arterial whole blood and plasma using 2-3 µL of blood per sample; the minute sample size is ideal for studies in small animals. The system has the following merits: (1) measures volume and radioactivity of whole blood and plasma separately; (2) allows measurements at 10 s intervals to capture initial rapid changes in the TAC; and (3) is compact and easy to handle, minimizes blood loss from sampling, and delay and dispersion of the TAC. CD-Well has 36 U-shaped channels. A drop of blood is sampled into the opening of the channel and stored there. After serial sampling is completed, CD-Well is centrifuged and scanned using a flatbed scanner to define the regions of plasma and blood cells. The length measured is converted to volume because the channels have a precise and uniform cross section. Then, CD-Well is exposed to an imaging plate to measure radioactivity. Finally, radioactivity concentrations are computed. We evaluated the performance of CD-Well in in vitro measurement and in vivo (18)F-fluorodeoxyglucose and [(11)C]2-carbomethoxy-3β-(4-fluorophenyl) tropane studies. In in vitro evaluation, per cent differences (mean±SE) from manual measurement were 4.4±3.6% for whole blood and 4.0±3.5% for plasma across the typical range of radioactivity measured in mouse dynamic study. In in vivo studies, reasonable TACs were obtained. The peaks were captured well, and the time courses coincided well with the TAC derived from PET imaging of the heart chamber. The total blood loss was less than 200 µL, which had no physiological effect on the mice. CD-Well demonstrates satisfactory performance, and is useful for mouse PET dynamic study.

  9. Arterial waveform analysis.

    Science.gov (United States)

    Esper, Stephen A; Pinsky, Michael R

    2014-12-01

    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration.

  10. A structure-based model of arterial remodeling in response to sustained hypertension.

    Science.gov (United States)

    Tsamis, Alkiviadis; Stergiopulos, Nikos; Rachev, Alexander

    2009-10-01

    A novel structure-based mathematical model of arterial remodeling in response to a sustained increase in pressure is proposed. The model includes two major aspects of remodeling in a healthy matured vessel. First, the deviation of the wall stress and flow-induced shear stress from their normal physiological values drives the changes in the arterial geometry. Second, the new mass that is produced during remodeling results from an increase in the mass of smooth muscle cells and collagen fibers. The model additionally accounts for the effect of the average pulsatile strain on the recruitment of collagen fibers in load bearing. The model was used to simulate remodeling of a human thoracic aorta, and the results are in good agreement with previously published model predictions and experimental data. The model predicts that the total arterial volume rapidly increases during the early stages of remodeling and remains virtually constant thereafter, despite the continuing stress-driven geometrical remodeling. Moreover, the effects of a perfect or incomplete restoration of the arterial compliance on the remodeling outputs were analyzed. For instance, the model predicts that the pattern of the time course of the opening angle depends on the extent to which the average pulsatile strain is restored at the end of the remodeling process. Future experimental studies on the time course of compliance, opening angle, and mass fractions of collagen, elastin, and smooth muscle cells can validate and improve the introduced hypotheses of the model.

  11. O volume plaquetário médio abaixo do normal está associado com extensão reduzida de doença arterial coronariana

    Directory of Open Access Journals (Sweden)

    Tolga Sinan Güvenç

    2013-03-01

    Full Text Available FUNDAMENTO: A extensão da doença arterial coronariana aterosclerótica em pacientes com angina estável tem importantes implicações prognósticas e terapêuticas. Em modelos atuais de evolução de placas, os trombócitos desempenham um papel importante no crescimento de placas. O volume plaquetário médio é um marcador facilmente determinado, com evidência de correlação com a agregabilidade plaquetária in vitro, além de valores comprovadamente maiores após eventos vasculares agudos. OBJETIVO: No presente estudo, investigou-se a relação entre o volume plaquetário médio e a extensão angiográfica da doença arterial coronariana em pacientes com angina estável. MÉTODOS: Foram analisados prontuários, hemograma completo e dados angiográficos anteriores de 267 pacientes elegíveis com angina estável. A extensão angiográfica da doença arterial coronariana foi avaliada à luz de dados angiográficos, com o uso por um especialista do escore de Gensini em uma cardiologia invasiva. Os valores para o volume plaquetário médio foram obtidos a partir de hemogramas completos, obtidos um dia antes da angiografia. Com relação ao intervalo populacional para o volume plaquetário médio, os pacientes foram agrupados dentro (n = 176 e abaixo (n = 62 do referido intervalo. Foi realizada uma comparação entre grupos e uma análise correlacional. RESULTADOS: Não houve correlação linear entre o escore de Gensini total e o volume plaquetário médio (p = 0,29, ao passo que a contagem total de trombócitos apresentou correlação inversa com o volume plaquetário médio (p < 0,001, r = 0,41. Os pacientes com volume plaquetário médio abaixo do normal apresentaram um escore de Gensini (36,73 ± 32,5 vs. 45,63 ± 32,63; p = 0,023 e doença coronariana triarterial (18% VS. 36%; p = 0,007 significativamente inferiores se comparados com aqueles apresentando valores de volume plaquetário médio dentro dos intervalos populacionais. CONCLUS

  12. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...

  13. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...... likely includes the combination of vasodilatation and vasoconstriction in parallel. Arterial compliance; Central vascular filling; Chyperdynamic circulation; Kidney function, Nitric oxide; Blood pressure regulation; Renin–angiotensin–aldosterone system; Sympathetic nervous system; Vasodilatation...

  14. Effect of long-term treatment with antioxidants (vitamin C, vitamin E, coenzyme Q10 and selenium on arterial compliance, humoral factors and inflammatory markers in patients with multiple cardiovascular risk factors

    Directory of Open Access Journals (Sweden)

    Debby Ortal

    2010-07-01

    Full Text Available Abstract Background Antioxidant supplementations have the potential to alleviate the atherosclerotic damage caused by excessive production of reactive oxygen species (ROS. The present study evaluated the effects of prolonged antioxidant treatment on arterial elasticity, inflammatory and metabolic measures in patients with multiple cardiovascular risk factors. Methods Study participants were randomly assigned to two groups. Group 1 received oral supplementation with 2 capsules per day of Mid Life Guard, SupHerb, Israel. In each capsule vitamin C (500 mg vitamin E (200 iu, co-enzyme Q10 (60 mg and selenium (100 mcg, Group 2 received matching placebo(SupHerb for 6 months. Patients were evaluated for lipid profile, HbA1C, insulin, C-peptide, hs-CRP, endothelin, aldosterone, plasma renin activity and Homeostasis model assessment-insulin resistance (HOMA-IR. Arterial elasticity was evaluated using pulse wave contour analysis (HDI CR 2000, Eagan, Minnesota. Results Antioxidant-treated patients exhibited significant increases in large arterial elasticity index (LAEI as well as small arterial elasticity index (SAEI. A significant decline HbA1C and a significant increase in HDL-cholesterol were also observed. In the placebo group, significant changes in LAEI, SAEI or metabolic measures were not observed. Conclusions Antioxidant supplementation significantly increased large and small artery elasticity in patients with multiple cardiovascular risk factors. This beneficial vascular effect was associated with an improvement in glucose and lipid metabolism as well as decrease in blood pressure.

  15. Influência do treinamento resistido realizado em intensidades diferentes e mesmo volume de trabalho sobre a pressão arterial de idosas hipertensas

    Directory of Open Access Journals (Sweden)

    Philippe Manoel de Barros Carvalho Canuto

    2011-08-01

    Full Text Available A hipertensão arterial sistêmica (HAS é uma doença de natureza multifatorial com alta prevalência na população idosa, sendo o exercício resistido (ER preconizado para aquela moléstia. No entanto, a literatura carece de trabalhos que evidenciem o efeito hipotensor agudo do ER em idosos hipertensos. O objetivo do presente estudo foi comparar o efeito da hipotensão pós-exercício (HPE durante 60 minutos entre duas sessões de exercícios resistidos realizados com intensidades diferentes, mas com igual relação carga-repetição em idosas hipertensas. A amostra foi composta de 32 mulheres, divididas aleatoriamente em dois grupos, contendo 16 pacientes no grupo com carga de leve intensidade (G1 e 16 pacientes no grupo com carga de alta intensidade (G2, porém, ambos com mesmo volume de treinamento. Após duas semanas de adaptação, as idosas realizaram três sessões de exercício resistido e logo em seguida foram aferidas as pressões arteriais sistólica e diastólica durante uma hora, a cada 10 minutos. Para a análise estatística, utilizaram-se os testes t de Student para amostras independentes, exato de Fischer e a análise de variância (ANOVA com uma entrada. Considerou-se significativo p < 0,05. Não houve diferença significativa das pressões arteriais sistólica e diastólica pós-exercício entre os indivíduos dos grupos G1 e G2, bem como intragrupo. No entanto, observou-se tendência à redução pressórica no grupo G1 quando comparado ao grupo G2. Nossos dados sugerem que a sequência de exercícios resistidos com duração de três sessões não resultou em HPE em idosas hipertensas, não havendo diferenças significativas quanto às pressões sistólica e diastólica entre os grupos com intensidades leve e alta.

  16. Upper Body Venous Compliance Exceeds Lower Body Venous Compliance in Humans

    Science.gov (United States)

    Watenpaugh, Donald E.

    1996-01-01

    Human venous compliance hypothetically decreases from upper to lower body as a mechanism for maintenance of the hydrostatic indifference level 'headward' in the body, near the heart. This maintains cardiac filling pressure, and thus cardiac output and cerebral perfusion, during orthostasis. This project entailed four steps. First, acute whole-body tilting was employed to alter human calf and neck venous volumes. Subjects were tilted on a tilt table equipped with a footplate as follows: 90 deg, 53 deg, 30 deg, 12 deg, O deg, -6 deg, -12 deg, -6 deg, O deg, 12 deg, 30 deg, 53 deg, and 90 deg. Tilt angles were held for 30 sec each, with 10 sec transitions between angles. Neck volume increased and calf volume decreased during head-down tilting, and the opposite occurred during head-up tilt. Second, I sought to cross-validate Katkov and Chestukhin's (1980) measurements of human leg and neck venous pressures during whole-body tilting, so that those data could be used with volume data from the present study to calculate calf and neck venous compliance (compliance = (Delta)volume/(Delta)pressure). Direct measurements of venous pressures during postural chances and whole-body tilting confirmed that the local changes in venous pressures seen by Katkov and Chestukhin (1980) are valid. The present data also confirmed that gravitational changes in calf venous pressure substantially exceed those changes in upper body venous pressure. Third, the volume and pressure data above were used to find that human neck venous compliance exceeds calf venous compliance by a factor of 6, thereby upholding the primary hypothesis. Also, calf and neck venous compliance correlated significantly with each other (r(exp 2) = 0.56). Fourth, I wished to determine whether human calf muscle activation during head-up tilt reduces calf venous compliance. Findings from tilting and from supine assessments of relaxed calf venous compliance were similar, indicating that tilt-induced muscle activation is

  17. [A new method of short-term high volume (6 g of 5-FU in a week) intermittent hepatic arterial infusion using repeated transient catheter insertion].

    Science.gov (United States)

    Hasuike, Yasunori; Tanigawa, Takahiko; Yamada, Masaharu; Minami, Yukiko; Ezumi, Koji; Okada, Atsuya

    2009-11-01

    We report a case of liver metastases, which had hepatectomy twice and a partial lung resection after sigmoidectomy with partial bladder resection for advanced sigmoid colon cancer. The patient could not be tolerated the systemic chemotherapy, and percutaneous implantation of a catheter also could not have done with subcutaneous reservoir for hepatic arterial infusion because of an anomaly of hepatic artery branched-out from super mesenteric artery. Therefore, we tried an intermittent hepatic arterial infusion using a transient insertion of catheter to control the liver metastases' growth. A total amount of 6 g of 5-FU was continuously injected in a week by one insertion of catheter at the hepatic artery taking one day rest at day 4. During the next 21 months, a total of 11 courses have been done. CEA and CA19-9 were changed from 15 ng/mL, 48 U/ mL to 18, 30, respectively. The patient was able to keep working except for the duration of this treatment. This procedure could be one of the hepatic arterial infusion options.

  18. Mapping Tax Compliance

    DEFF Research Database (Denmark)

    Boll, Karen

    2014-01-01

    Tax compliance denotes the act of reporting and paying taxes in accordance with the tax laws. Current social science scholarship on tax compliance can almost entirely be divided into behavioural psychology analyses and critical tax studies. This article, which presents two cases of how tax...... that studies tax compliance where it takes place as well as what it is made of. Consequently, this article argues that tax compliance is a socio-material assemblage and that complying is a distributed action. The article concludes by highlighting how an ANT approach contributes to the further theoretical...

  19. Regulatory Enforcement and Compliance

    DEFF Research Database (Denmark)

    May, Peter J.; Winter, Søren

    1999-01-01

    agencies. The latter are shown to be more important in bringing about compliance than are inspectors' enforcement styles. Municipal agencies are shown to increase compliance through the use of third parties, more frequent inspection, and setting priorities for inspection of major items. The findings about...

  20. Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function

    Directory of Open Access Journals (Sweden)

    André Bernardo

    2011-08-01

    Full Text Available RESUMO OBJETIVO: Avaliar o impacto da embolização arterial de miomas (EAM sobre o volume uterino (VU, na função ovariana. MÉTODOS: Trinta pacientes com leiomioma se submeteram à EAM. Foram realizados exames de USPTV e FSH antes e três meses após a EAM. Foram analisados o VU em cm³, o diâmetro do mioma dominante (DMD em cm e o FSH em UI/mL, expressos por média desvio padrão (DP e submetidos a análise estatística pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Foram incluidos na análise 29 casos. A média do VU pré-EAM foi 402,4 165,9 cm³, DMD pré-EAM 5,9 2,1 cm. O VU pós-EAM foi 258,9 118,6 cm³, DMD pós-EAM foi 4,6 1,8 cm. A média da dosagem de FSH pré-EAM foi 4,9 3,5 UI/mL e pós-EAM foi 5,5 4,7 UI/mL com p=0,5. Houve redução de 35% do VU, de 22% no DMD e a EAM não alterou significativamente os valores de FSH após três meses. CONCLUSÃO: O procedimento diminui significativamente o VU e DMD e, não há aumento significativo dos níveis séricos de FSH, não havendo, portanto, alterações na função ovariana.PURPOSE: To evaluate the impact of uterine artery embolization (UAE on uterine volume (UV, greater myoma diameter (GMD and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS and by the determination of follicle-stimulating hormone (FSH. METHODS: Thirty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22

  1. Dobutamine-induced increase of right ventricular contractility without increased stroke volume in adolescent patients with transposition of the great arteries : Evaluation with magnetic resonance imaging

    NARCIS (Netherlands)

    Tulevski, I.I.; Lee, PL; Groenink, M; van der Wall, EE; Pieper, PG; Romkes, H; Mulder, BJM; Stoker, J

    2000-01-01

    Objective: Prognosis in patients with surgically corrected (Senning or Mustard) transposition of the great arteries (TGA) depends mainly on right ventricular (RV) function and RV functional reserve. We examined the role of dobutamine stress in the early detection of RV dysfunction in asymptomatic or

  2. The free radical spin-trap alpha-PBN attenuates periinfarct depolarizations following permanent middle cerebral artery occlusion in rats without reducing infarct volume

    DEFF Research Database (Denmark)

    Christensen, Thomas; Bruhn, Torben; Diemer, Nils Henrik

    2003-01-01

    The effect of the free radical spin-trap alpha-phenyl-butyl-tert-nitrone (alpha-PBN) in permanent focal cerebral ischemia in rats was examined in two series of experiments. In the first, rats were subjected to permanent occlusion of the middle cerebral artery (MCAO) and treated 1 h after occlusion...

  3. Volume adaptation in chronic liver disease: on the static and dynamic location of water, salt, protein and red cells in cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl

    2004-01-01

    in haemodynamic and homoeostatic mechanisms in patients with cirrhosis. Infusion of oncotic material (preferably albumin) may prevent circulatory dysfunction during certain types of stress. Volume expansion in advanced cirrhosis is qualitatively and quantitively different from that of healthy subjects and those......Adequate size and distribution of the circulating medium are important for cardiovascular function, tissue oxygenation and fluid homoeostasis. Patients with cirrhosis have an abnormal distribution of increased blood volume, increased total vascular compliance and increased arterial compliance....... The pattern and temporal relations of plasma and blood volume expansion are important for pathophysiological, diagnostic and therapeutic purposes and depend highly on the type of load (water, saline, oncotic material, red blood cells). In some aspects patients with cirrhosis respond differently from healthy...

  4. Compliance and Enforcement Actions (CEA) -

    Data.gov (United States)

    Department of Transportation — Compliance and Enforcement Actions application provides process assistance / improvements for conducting investigation and enforcement activities. The Compliance and...

  5. Respiratory compliance but not gas exchange correlates with changes in lung aeration after a recruitment maneuver: an experimental study in pigs with saline lavage lung injury

    Science.gov (United States)

    Henzler, Dietrich; Pelosi, Paolo; Dembinski, Rolf; Ullmann, Annette; Mahnken, Andreas H; Rossaint, Rolf; Kuhlen, Ralf

    2005-01-01

    Introduction Atelectasis is a common finding in acute lung injury, leading to increased shunt and hypoxemia. Current treatment strategies aim to recruit alveoli for gas exchange. Improvement in oxygenation is commonly used to detect recruitment, although the assumption that gas exchange parameters adequately represent the mechanical process of alveolar opening has not been proven so far. The aim of this study was to investigate whether commonly used measures of lung mechanics better detect lung tissue collapse and changes in lung aeration after a recruitment maneuver as compared to measures of gas exchange Methods In eight anesthetized and mechanically ventilated pigs, acute lung injury was induced by saline lavage and a recruitment maneuver was performed by inflating the lungs three times with a pressure of 45 cmH2O for 40 s with a constant positive end-expiratory pressure of 10 cmH2O. The association of gas exchange and lung mechanics parameters with the amount and the changes in aerated and nonaerated lung volumes induced by this specific recruitment maneuver was investigated by multi slice CT scan analysis of the whole lung. Results Nonaerated lung correlated with shunt fraction (r = 0.68) and respiratory system compliance (r = 0.59). The arterial partial oxygen pressure (PaO2) and the respiratory system compliance correlated with poorly aerated lung volume (r = 0.57 and 0.72, respectively). The recruitment maneuver caused a decrease in nonaerated lung volume, an increase in normally and poorly aerated lung, but no change in the distribution of a tidal breath to differently aerated lung volumes. The fractional changes in PaO2, arterial partial carbon dioxide pressure (PaCO2) and venous admixture after the recruitment maneuver did not correlate with the changes in lung volumes. Alveolar recruitment correlated only with changes in the plateau pressure (r = 0.89), respiratory system compliance (r = 0.82) and parameters obtained from the pressure-volume curve

  6. Peripheral "oscillatory" compliance is associated with aortic augmentation index

    NARCIS (Netherlands)

    Segers, P; Qasem, A; De Backer, T; Carlier, S; Verdonck, P; Avolio, A

    2001-01-01

    The augmentation index (AIx) and "oscillatory" compliance (C-2) are wave contour analysis parameters for the central aorta (P-ao) and radial artery pressure wave (P-rad)(x) respectively. Both are sensitive to cardiovascular risk factors such as aging, hypertension, and diabetes and have been propose

  7. Ventricular Volume Load Reveals the Mechanoelastic Impact of Communicating Hydrocephalus on Dynamic Cerebral Autoregulation.

    Directory of Open Access Journals (Sweden)

    Christina Haubrich

    Full Text Available Several studies have shown that the progression of communicating hydrocephalus is associated with diminished cerebral perfusion and microangiopathy. If communicating hydrocephalus similarly alters the cerebrospinal fluid circulation and cerebral blood flow, both may be related to intracranial mechanoelastic properties as, for instance, the volume pressure compliance. Twenty-three shunted patients with communicating hydrocephalus underwent intraventricular constant-flow infusion with Hartmann's solution. The monitoring included transcranial Doppler (TCD flow velocities (FV in the middle (MCA and posterior cerebral arteries (PCA, intracranial pressure (ICP, and systemic arterial blood pressure (ABP. The analysis covered cerebral perfusion pressure (CPP, the index of pressure-volume compensatory reserve (RAP, and phase shift angles between Mayer waves (3 to 9 cpm in ABP and MCA-FV or PCA-FV. Due to intraventricular infusion, the pressure-volume reserve was exhausted (RAP 0.84+/-0.1 and ICP was increased from baseline 11.5+/-5.6 to plateau levels of 20.7+/-6.4 mmHg. The ratio dRAP/dICP distinguished patients with large 0.1+/-0.01, medium 0.05+/-0.02, and small 0.02+/-0.01 intracranial volume compliances. Both M wave phase shift angles (r = 0.64; p<0.01 and CPP (r = 0.36; p<0.05 displayed a gradual decline with decreasing dRAP/dICP gradients. This study showed that in communicating hydrocephalus, CPP and dynamic cerebral autoregulation in particular, depend on the volume-pressure compliance. The results suggested that the alteration of mechanoelastic characteristics contributes to a reduced cerebral perfusion and a loss of autonomy of cerebral blood flow regulation. Results warrant a prospective TCD follow-up to verify whether the alteration of dynamic cerebral autoregulation may indicate a progression of communicating hydrocephalus.

  8. Relationship between stroke volume and pulse pressure during blood volume perturbation: a mathematical analysis.

    Science.gov (United States)

    Bighamian, Ramin; Hahn, Jin-Oh

    2014-01-01

    Arterial pulse pressure has been widely used as surrogate of stroke volume, for example, in the guidance of fluid therapy. However, recent experimental investigations suggest that arterial pulse pressure is not linearly proportional to stroke volume. However, mechanisms underlying the relation between the two have not been clearly understood. The goal of this study was to elucidate how arterial pulse pressure and stroke volume respond to a perturbation in the left ventricular blood volume based on a systematic mathematical analysis. Both our mathematical analysis and experimental data showed that the relative change in arterial pulse pressure due to a left ventricular blood volume perturbation was consistently smaller than the corresponding relative change in stroke volume, due to the nonlinear left ventricular pressure-volume relation during diastole that reduces the sensitivity of arterial pulse pressure to perturbations in the left ventricular blood volume. Therefore, arterial pulse pressure must be used with care when used as surrogate of stroke volume in guiding fluid therapy.

  9. Compliance for Green IT

    CERN Document Server

    Calder, Alan

    2009-01-01

    The growing range of Green IT regulations are challenging more and more organisations to take specific steps to ensure they are in compliance with sometimes complex regulations, ranging from cap & trade requirements through to regulations concerning IT equipment disposal.

  10. Environmental Compliance Issue Coordination

    Science.gov (United States)

    An order to establish the Department of Energy (DOE) requirements for coordination of significant environmental compliance issues to ensure timely development and consistent application of Departmental environmental policy and guidance

  11. Environmental Compliance Guide

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects.

  12. Arterial elastance and heart-arterial coupling in aortic regurgitation are determined by aortic leak severity

    NARCIS (Netherlands)

    Segers, P; Morimont, P; Kolh, P; Stergiopulos, N; Westerhof, N; Verdonck, P

    2002-01-01

    Background In aortic valve regurgitation (AR), aortic leak severity modulates left ventricle (LV) arterial system interaction. The aim of this study was to assess (1) how arterial elastance (E-a), calculated as the ratio of LV end-systolic pressure and stroke volume, relates to arterial properties a

  13. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  14. Recapitulation of Developing Artery Muscularization in Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Abdul Q. Sheikh

    2014-03-01

    Full Text Available Excess smooth muscle accumulation is a key component of many vascular disorders, including atherosclerosis, restenosis, and pulmonary artery hypertension, but the underlying cell biological processes are not well defined. In pulmonary artery hypertension, reduced pulmonary artery compliance is a strong independent predictor of mortality, and pathological distal arteriole muscularization contributes to this reduced compliance. We recently demonstrated that embryonic pulmonary artery wall morphogenesis consists of discrete developmentally regulated steps. In contrast, poor understanding of distal arteriole muscularization in pulmonary artery hypertension severely limits existing therapies that aim to dilate the pulmonary vasculature but have modest clinical benefit and do not prevent hypermuscularization. Here, we show that most pathological distal arteriole smooth muscle cells, but not alveolar myofibroblasts, derive from pre-existing smooth muscle. Furthermore, the program of distal arteriole muscularization encompasses smooth muscle cell dedifferentiation, distal migration, proliferation, and then redifferentiation, thereby recapitulating many facets of arterial wall development.

  15. Arterial function of carotid and brachial arteries in postmenopausal vegetarians.

    Science.gov (United States)

    Su, Ta-Chen; Torng, Pao-Ling; Jeng, Jiann-Shing; Chen, Ming-Fong; Liau, Chiau-Suong

    2011-01-01

    Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited. This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD), compliance (BAC), and resistance (BAR). Fasting blood levels of glucose, lipids, lipoprotein (a), high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured. Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a) and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity. Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than omnivores. Prevention of vitamin B12 deficiency might be beneficial for cardiovascular health in vegetarians.

  16. A Retrospective Volume Matched Analysis of the Submental Artery Island Pedicled Flap as Compared to the Forearm Free Flap: Is It a Good Alternative Choice for the Reconstruction of Defects of the Oral Cavity and Oropharynx?

    Science.gov (United States)

    Aslam-Pervez, Nawaf; Caldroney, Steven J; Isaiah, Amal; Lubek, Joshua E

    2017-08-12

    The submental artery island pedicled flap (SMIF) is an underused alternative for reconstruction of head and neck defects after tumor ablation. The purpose of this study was to perform a comparative evaluation of reconstructive outcomes based on surgical site and ablative defect volume in patients who underwent reconstruction with the SMIF versus the forearm free flap (FFF). A retrospective cohort study of all patients with oral cavity and oropharyngeal defects reconstructed with the SMIF and a cohort of patients with similar volume defects reconstructed with the FFF were compared for oncologic safety and viability of equivalent reconstructive outcomes. All statistical comparisons were assessed by analysis of variance and Fisher exact test. Average age was 61.8 years in the SMIF group versus 57.9 years in the FFF group. The most common defect was located in the tongue, with squamous cell carcinoma being the most common pathology identified. Flap volumes were similar (SMIF, 38.79 cm(3); FFF, 39.77 cm(3)). Significant comparative outcomes identified with SMIF versus FFF reconstruction included shorter anesthesia times (815 vs 1,209 minutes; P speech and swallowing function. Mean follow-up was 15.5 months. This is the first study to compare the SMIF with the FFF for reconstruction of oral cavity defects based on ablative volume deficit. The SMIF is a viable surgical option compared with the FFF that can be considered oncologically safe in the N0 neck, allowing for an excellent esthetic reconstruction, with decreased operative time, hospital stay, and donor site morbidity. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Relationship among coronary plaque compliance, coronary risk factors and tissue characteristics evaluated by integrated backscatter intravascular ultrasound

    Directory of Open Access Journals (Sweden)

    Ishihara Yoshiyuki

    2012-07-01

    Full Text Available Abstract Background The purpose of the present study was to evaluate the mechanical properties of coronary plaques and plaque behavior, and to elucidate the relationship among tissue characteristics of coronary plaques, mechanical properties and coronary risk factors using integrated backscatter intravascular ultrasound (IB-IVUS. Methods Non-targeted plaques with moderate stenosis (plaque burden at the minimal lumen site: 50-70% located proximal to the site of the percutaneous coronary intervention target lesions were evaluated by IB-IVUS. Thirty-six plaques (less calcified group: an arc of calcification ≤10° in 36 patients and 22 plaques (moderately calcified group: 10°  Results In the less calcified group, there was a significant correlation between EEMV compliance and the relative lipid volume (r = 0.456, p = 0.005. There was a significant inverse correlation between EEM area stiffness index and the relative lipid volume (p = 0.032, r = −0.358. The LV compliance and EEM area stiffness index were significantly different in the diabetes mellitus (DM group than in the non-DM group (1.32 ± 1.49 vs. 2.47 ± 1.79%/10 mmHg, p =0.014 and 28.3 ± 26.0 vs. 15.7 ± 17.2, p =0.020. The EEMV compliance and EEM area stiffness index were significantly different in the hypertension (HTN group than in the non-HTN group (0.77 ± 0.68 vs. 1.57 ± 0.95%/10 mmHg, p =0.012 and 26.5 ± 24.3 vs. 13.0 ± 16.7, p =0.020. These relationships were not seen in the moderately calcified group. Conclusion The present study provided new findings that there was a significant correlation between mechanical properties and tissue characteristics of coronary arteries. In addition, our results suggested that the EEMV compliance and the LV compliance were independent and the compliance was significantly impaired in the patients with DM and/or HTN. Assessment of coronary mechanical properties during PCI may provide us with

  18. Liver cirrhosis and arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Jens H Henriksen; Soren Moller

    2006-01-01

    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system,sympathetic nervous system, release of vasopressin),and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators,and is most pronounced in the splanchnic area.This constitutes an effective (although relative)counterbalance to increased arterial blood pressure.This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most likely includes the combination of vasodilatation and vasoconstriction in parallel.

  19. Magnetic resonance imaging of the coronary arteries : anatomy of the coronary arteries and veins in three-dimensional imaging

    NARCIS (Netherlands)

    van Geuns, R J; Wielopolski, P A; Rensing, B J; van Ooijen, P M; Oudkerk, M; de Feyter, P J

    Magnetic resonance imaging of coronary arteries will visualize, besides the arteries, the myocardium, blood in the cavities and cardiac veins. This will hamper the application of projectional visualization techniques such as those used in conventional coronary angiography. Volume rendering, a

  20. Effect of frailty syndrome on treatment compliance in older hypertensive patients

    Directory of Open Access Journals (Sweden)

    Chudiak A

    2017-05-01

    Full Text Available Anna Chudiak, Beata Jankowska-Polańska, Izabella Uchmanowicz Department of Clinical Nursing, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Background: Frailty syndrome (FS is an important problem in older persons. It may develop concomitantly to many aging-related diseases, including arterial hypertension, and exerts detrimental effects on both their outcomes and treatment compliance.Objective: To analyze the effect of FS on treatment compliance in older hypertensive patients.Materials and methods: This study of 300 hypertensive patients (167 women and 133 men aged between 65 and 91 years (mean 71.75±7.79 years was based on the analysis of medical documentation and survey with the Tilburg Frailty Indicator (TFI and Hill-Bone High Blood Pressure Compliance Scale.Results: Mean systolic and diastolic blood pressure values of the study subjects were 141.97 and 85.16 mm Hg, respectively. Mean time elapsed since the diagnosis of arterial hypertension was 13.74 years. FS was diagnosed in 65.67% of the study subjects. Mean global score of the Hill-Bone High Blood Pressure Compliance Scale was 20.75 points. TFI scores correlated significantly with the global score of the Hill-Bone High Blood Pressure Compliance Scale (R=0.509, P<0.001 and the values of its 2 subscales: Appointment Keeping (R=0.34, P<0.001 and Medication Taking (R=0.537, P<0.001.Conclusion: FS exerts a significant effect on treatment compliance of older hypertensive patients. Treatment compliance is modulated by patients’ sex (worse compliance in men, education (better compliance in subjects with higher education, and TFI scores (worse compliance in patients with FS. Keywords: frailty syndrome, compliance, adherence, arterial hypertension, older age

  1. The added value of cardiac index and pulse pressure variation monitoring to mean arterial pressure-guided volume therapy in moderate-risk abdominal surgery (COGUIDE): a pragmatic multicentre randomised controlled trial.

    Science.gov (United States)

    Stens, J; Hering, J-P; van der Hoeven, C W P; Boom, A; Traast, H S; Garmers, L E; Loer, S A; Boer, C

    2017-09-01

    There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre. All patients had mean arterial pressure, cardiac index and pulse pressure variation measured continuously. In one group, healthcare professionals were blinded to cardiac index and pulse pressure variation values and were asked to guide haemodynamic therapy only based on mean arterial pressure (control group). In the second group, cardiac index and pulse pressure variation values were displayed and kept within target ranges following a pre-defined algorithm (CI-PPV group). The primary endpoint was the incidence of postoperative complications within 30 days. One hundred and seventy-five patients were eligible for final analysis. Overall complication rates were similar (42/94 (44.7%) vs. 38/81 (46.9%) in the control and CI-PPV groups, respectively; p = 0.95). The CI-PPV group had lower mean (SD) pulse pressure variation values (9.5 (2.0)% vs. 11.9 (4.6)%; p = 0.003) and higher mean (SD) cardiac indices (2.76 (0.62) l min(-1) .m(-2) vs. 2.53 (0.66) l min(-1) .m(-2) ; p = 0.004) than the control group. In moderate-risk abdominal surgery, we observed no additional value of cardiac index and pulse pressure variation-guided haemodynamic therapy to mean arterial pressure-guided volume therapy with regard to postoperative complications. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  2. ICIS FE&C Compliance Monitoring Screens

    Data.gov (United States)

    U.S. Environmental Protection Agency — Web Based Training for Integrated Compliance Information System Updated Compliance Monitoring Training for ICIS Federal Enforcement and Compliance User. This...

  3. Influencia de la sustitución de medicamentos de marca por genéricos en el cumplimiento terapéutico de la hipertensión arterial y la dislipidemia Influence of substitution of brand name for generic drugs on therapeutic compliance in hypertension and dyslipidemia

    Directory of Open Access Journals (Sweden)

    Antoni Sicras Mainar

    2010-12-01

    Full Text Available Objetivo: Determinar el cumplimiento terapéutico al sustituir amlodipino y simvastatina de marca por genéricos (especialidad farmacéutica genérica [EFG], y conocer la opinión de médicos y pacientes sobre ello. Pacientes y métodos: Diseño observacional con grupo control, realizado mediante revisión de los registros de seis centros de atención primaria. Pacientes >40 años de edad que iniciaron tratamiento con marca (periodo inicial y posteriormente se cambió por una EFG (periodo final. Subgrupos de estudio: hipertensión arterial (amlodipino y dislipidemia (simvastatina. Principales mediciones: comorbilidad, cumplimiento, tiempo de tratamiento, determinaciones bioquímicas y opinión de los profesionales y los pacientes (entrevistas. Seguimiento: antes de la fecha de la sustitución, cada paciente estuvo como mínimo 1 año con un medicamento de marca, y luego al menos 1 año con una EFG (seguimiento mínimo por paciente: 24 meses. Resultados: De los 1.252 pacientes, el 49,5% recibían amlodipino y el 50,5% simvastatina. Los tratados con amlodipino (comparando los periodos muestran un mejor cumplimiento (65,8 frente a 61,3%; p=0,037 y un mejor control de la presión arterial (48,5 frente a 45,8%; p=0,039 con el tratamiento de marca. Con simvastatina los porcentajes fueron del 62,8 frente al 58,4% (p=0,041, respectivamente. Un 73,6% de los médicos entrevistados prescriben EFG y un 59,2% creen que tienen igual eficacia. De los pacientes entrevistados, el 79,8% (intervalo de confianza del 95% [IC95%]: 74,3-85,3% aceptaron la sustitución; un 55,3% (IC95%: 48,5-62,1% recibió la información adecuada y a un 61,5% les generan confusión los diferentes productos. Un 18,2% manifiestan que incumplen el tratamiento. Conclusión: En los pacientes en tratamiento con amlodipino o simvastatina, el cumplimiento desciende con el tiempo independientemente de que se cambie o no a una EFG.Objective: To determine therapeutic compliance when brand name

  4. Difficulties in high blood pressure treatment compliance: considerations based on a qualitative study in a primary health care unit Dificuldades de adesão ao tratamento na hipertensão arterial sistêmica: considerações a partir de um estudo qualitativo em uma unidade de Atenção Primária à Saúde

    Directory of Open Access Journals (Sweden)

    Angélica Manfroi

    2010-11-01

    professionals know the patients’ difficulties to be compliant with anti-hypertensive treatment so they can try correcting the problems together with the patient for a better control of HBP. It has to be pointed out that the trust resulting from a good doctor/patient relationship contributes greatly to a better treatment compliance of the patient.

    A hipertensão arterial sistêmica (HAS é uma doença crônica, cujo controle é essencial para a prevenção de complicações, em longo prazo, relacionadas à morbidade e à mortalidade cardiovascular e cerebral, dentre outras. O tratamento da HAS baseia-se em medidas não-farmacológicas e farmacológicas. Considerase adesão a um tratamento o grau de coincidência entre a orientação médica e o comportamento do paciente. Na Unidade de Saúde Parque dos Maias, observa-se a dificuldade na manutenção da pressão arterial dos hipertensos, de forma continuada, que pode estar relacionada à falta de adesão destes pacientes ao tratamento. O objetivo do estudo é avaliar os fatores envolvidos na dificuldade de adesão ao tratamento anti-hipertensivo sob o ponto de vista do paciente. Para isso, partimos da pesquisa qualitativa, com entrevistas abertas e semi-estruturadas, individuais, com 13 pacientes adultos hipertensos, inscritos no Programa de Hipertensos da Unidade de Saúde Parque dos Maias. Como resultado, verificamos questões que dificultam a adesão ao tratamento: a fase inicial assintomática; b uso de medicamento somente quando pensam que a pressão está elevada (relacionam o aumento a sintomas que crêem ser ligados à HAS, como cefaléia, náuseas, ou quando “ficam nervosos”; c impressão de cura com conseqüente abandono dos fármacos, quando, na realidade, a pressão está controlada; d desgosto de ter de tomar remédios continuamente, de ser “dependentes” deles; e sintomas adversos dos fármacos como disfunção erétil e tosse; f dieta hipossódica é difícil de ser seguida, principalmente pelo fato

  5. Gamma-Hydroxybutyrate (GHB), gamma-butyrolactone (GBL), and 1,4-butanediol (1,4-BD) reduce the volume of cerebral infarction in rodent transient middle cerebral artery occlusion.

    Science.gov (United States)

    Sadasivan, Shankar; Maher, Timothy J; Quang, Lawrence S

    2006-08-01

    gamma-Hydroxybutyric acid (GHB), an endogenous organic acid catabolite of gamma-aminobutyric acid (GABA), has been shown to have tissue-protective effects in various organs, including the brain. We examined the potential neuroprotective effect of GHB and its chemical precursors, gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD), in the rodent ischemic stroke model by intraluminal filament middle cerebral artery occlusion (MCAO). Adult male Sprague-Dawley rats underwent transient left-sided MCAO and received intraperitoneal treatment with 300 mg/kg of GHB, GBL, 1,4-BD, or control vehicle given at 30 min before, as well as 180 and 360 min after the onset of ischemia. Infarct volumes were determined 24 h after MCAO. In transient MCAO, the mean volume of infarction for control rats was 464.4 +/- 17.9 cu.mm versus 273.6 +/- 53.1, 233.3 +/- 44.7, and 275.4 +/- 39.9 cu.mm for rats treated with 1,4-BD (P GBL (P GBL, and 1,4-BD protect against rat focal cerebral ischemia from transient MCAO.

  6. 心周脂肪组织与冠心病及代谢综合征的关系%The relationship of pericardial adipose tissue volume with coronary artery disease and metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    刘瑛琪; 费军; 刘莉; 刘军华; 王晓非; 郑冬; 张朝利

    2011-01-01

    摘要:目的 探讨心周脂肪组织(pericardial adipose tissue,PAT)容量与冠心病及代谢综合征(metabolic syndrome,MS)的关系.方法 回顾性分析1102例患者的双源CT冠状动脉造影资料,采用平扫图像测定PAT容量.根据代谢危险因素的数量和冠状动脉狭窄程度,将患者分为MS组338例和无MS组764例及≥50%狭窄组492例和<50%狭窄组610例.结果 MS组PAT容量较无MS组明显增多,≥50%狭窄组PAT容量较<50%狭窄组明显增多(P<0.01).随着代谢危险因素数目的增加,PAT容量呈上升趋势,差异有统计学意义(P<0.01).多元回归分析显示,PAT容量与≥50%狭窄(回归系数=17.78,P<0.01)、体重指数(回归系数=7.32,P<0.01)、腹围(回归系数=2.51,P<0.01)和LDL-C(回归系数=16.94,P< 0.05)相关.结论 多层螺旋CT测定PAT容量是提示患者冠心痛和代谢风险的方法 之一.%Objective To study the relationship of volume of pericardial adipose tissue(PAT) with coronary artery disease and metabolic syndrome(MS). Methods The computed tomography angi-ography data of 1102 consecutive patients were analyzed retrospectively. Pericardial adipose tissue volume was measured using non-enhanced image. According to the number of metabolic risk factors and the extent of coronary stenosis,the patients were divided into MS group (n = 338)and non-MS group (w = 764),and ≥50% stenosis group (n = 492)or <50% stenosis group( n = 610). Results Pericardial adipose tissue volume increased significantly in MS group compared with non-MS group. It also increased significantly in ≥50% stenosis group compared with <50% stenosis group. As the number of metabolic risk factors increased, the volume of pericardial adipose tissue increased correspondingly. Multiple regression analysis showed that 2≥50% stenosis (coefficient=17. 78, P < 0. 01) ,BMI(coefficient = 7. 32, P < 0. 01) ,waist circumference(coeffi-cient = 2. 51, P < 0. 01) and LDL-C level(coefficient = 16. 94

  7. Hemodynamics and wall mechanics of a compliance matching stent: in vitro and in vivo analysis.

    Science.gov (United States)

    Berry, Joel L; Manoach, Emil; Mekkaoui, Choukri; Rolland, Pierre H; Moore, J E; Rachev, Alexander

    2002-01-01

    Evidence is emerging that the abrupt compliance mismatch that exists at the junction between the stent ends and the host arterial wall disturbs both the vascular hemodynamics and the natural wall stress distribution. These stent-induced alterations are greatly reduced by smoothing the compliance mismatch between the stent and host vessel. A stent that provides this smooth transition in compliance, the compliance matching stent (CMS), has been developed. This study attempts to evaluate the hemodynamics and wall mechanical consequences of the CMS both in vitro and in vivo. Finite element analysis was used to assess the solid mechanical behavior (compliance and stress) of the CMS in a stent/artery hybrid structure. A similar analysis was performed with a Palmaz stent. In vivo hemodynamics and wall mechanical changes induced by the CMS were investigated in a swine model from direct measurements of flow, pressure, diameter, and histology in the stented segment of superficial femoral arteries after 7 days. Finite element analysis showed that the abrupt compliance mismatch was substantially smoothed between the vessel portions with and without the stent with CMS segments. Circumferential stress was also markedly reduced with the CMS compared to other stent. The in vivo results showed that the CMS was efficient in compliance matching and did not dampen flow or pressure waves downstream the stent. Concurrent histology showed limited thrombus and inflammatory cell accumulation around the stent struts. These results indicate that the stent/artery hybrid structure can be compliance matched with proper stent design and that this structure limits solid mechanical stress and hemodynamic disturbances. It remains to be seen whether compliance-matched vascular stents reduce in-stent restenosis.

  8. MRI evidence for altered venous drainage and intracranial compliance in mild traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Andreas Pomschar

    Full Text Available PURPOSE: To compare venous drainage patterns and associated intracranial hydrodynamics between subjects who experienced mild traumatic brain injury (mTBI and age- and gender-matched controls. METHODS: Thirty adult subjects (15 with mTBI and 15 age- and gender-matched controls were investigated using a 3T MR scanner. Time since trauma was 0.5 to 29 years (mean 11.4 years. A 2D-time-of-flight MR-venography of the upper neck was performed to visualize the cervical venous vasculature. Cerebral venous drainage through primary and secondary channels, and intracranial compliance index and pressure were derived using cine-phase contrast imaging of the cerebral arterial inflow, venous outflow, and the craniospinal CSF flow. The intracranial compliance index is the defined as the ratio of maximal intracranial volume and pressure changes during the cardiac cycle. MR estimated ICP was then obtained through the inverse relationship between compliance and ICP. RESULTS: Compared to the controls, subjects with mTBI demonstrated a significantly smaller percentage of venous outflow through internal jugular veins (60.9±21% vs. controls: 76.8±10%; p = 0.01 compensated by an increased drainage through secondary veins (12.3±10.9% vs. 5.5±3.3%; p<0.03. Mean intracranial compliance index was significantly lower in the mTBI cohort (5.8±1.4 vs. controls 8.4±1.9; p<0.0007. Consequently, MR estimate of intracranial pressure was significantly higher in the mTBI cohort (12.5±2.9 mmHg vs. 8.8±2.0 mmHg; p<0.0007. CONCLUSIONS: mTBI is associated with increased venous drainage through secondary pathways. This reflects higher outflow impedance, which may explain the finding of reduced intracranial compliance. These results suggest that hemodynamic and hydrodynamic changes following mTBI persist even in the absence of clinical symptoms and abnormal findings in conventional MR imaging.

  9. Interpersonal Communication and Compliance

    NARCIS (Netherlands)

    Fennis, Bob M.; Das, Enny; Pruyn, Ad Th.H.

    2006-01-01

    Two field experiments examined the impact of the Disrupt-Then-Reframe (DTR) technique on compliance. This recently identified technique consists of a subtle, odd element in a typical scripted request (the disruption) followed by a persuasive phrase (the reframing). The authors argued that its impact

  10. Environmental compliance and cleanup

    Energy Technology Data Exchange (ETDEWEB)

    Black, D.G.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report summarizes the roles of the principal agencies, organizations, and public in environmental compliance and cleanup of the Hanford Site. Regulatory oversight, the Federal Facility Agreement and Consent Order, the role of Indian tribes, public participation, and CERCLA Natural Resource Damage Assessment Trustee Activities are all discussed.

  11. Making corporate compliance programs work.

    Science.gov (United States)

    Chibbaro, M J; Colyer, C

    2000-05-01

    Healthcare organizations have created corporate compliance programs in an effort to adhere to Federal government recommendations, minimize the risk of wrongful behavior, and possibly reduce fines that may result from a government investigation. Compliance programs may have undetected weaknesses. Corporate compliance officers, executives, and board members need to be certain that their organization's program has sufficient infrastructure, oversight, and resources; effective education and training; an effective mechanism (hotline) to receive reports of compliance problems; and ongoing auditing and monitoring capabilities.

  12. Modeling and optimization of Look-Locker spin labeling for measuring perfusion and transit time changes in activation studies taking into account arterial blood volume.

    Science.gov (United States)

    Francis, S T; Bowtell, R; Gowland, P A

    2008-02-01

    This work describes a new compartmental model with step-wise temporal analysis for a Look-Locker (LL)-flow-sensitive alternating inversion-recovery (FAIR) sequence, which combines the FAIR arterial spin labeling (ASL) scheme with a LL echo planar imaging (EPI) measurement, using a multireadout EPI sequence for simultaneous perfusion and T*(2) measurements. The new model highlights the importance of accounting for the transit time of blood through the arteriolar compartment, delta, in the quantification of perfusion. The signal expected is calculated in a step-wise manner to avoid discontinuities between different compartments. The optimal LL-FAIR pulse sequence timings for the measurement of perfusion with high signal-to-noise ratio (SNR), and high temporal resolution at 1.5, 3, and 7T are presented. LL-FAIR is shown to provide better SNR per unit time compared to standard FAIR. The sequence has been used experimentally for simultaneous monitoring of perfusion, transit time, and T*(2) changes in response to a visual stimulus in four subjects. It was found that perfusion increased by 83 +/- 4% on brain activation from a resting state value of 94 +/- 13 ml/100 g/min, while T*(2) increased by 3.5 +/- 0.5%. (c) 2008 Wiley-Liss, Inc.

  13. Application of rotational DSA dual volume technology in the displaying of intracranial artery stent and its effective analysis%颅内动脉支架的旋转DSA双容积显示方法及效果分析

    Institute of Scientific and Technical Information of China (English)

    沈正林; 胡克琦; 闻宏斌; 李秀荣; 常丽英

    2016-01-01

    合显示技术能较好地表现血管内的支架情况。%Objective To investigate the implementation and application of rotational DSA dual volume technology in displaying the intracranial artery stent.Methods Firstly,the “stent opacity”single volume technology was used to display 5 types of stent which were released in 7 cases of pure intracranial artery stenting and 12 cases of stent-assisted aneurysm embolization.Then we applied “vessel translucent”and “vessel opacity”single volume technology to display corresponding vessel segments.Finally,by coalescing the single volume imaging of stent and vessel,the “vessel opacity + stent opacity”dual volume image and “vessel translucent+ stent opacity”dual volume image were performed.We compared the effects of two kinds of dual volume imaging and assessed the imaging characteristics and influencing factors of each method.Results (1)On the “stent opacity”single volume display mode,in 7 cases of pure intracranial artery stenting,the display effect of two Pipeline stents and three Apollo stents belongs to level 1,the display effect of two Enterprise stents belongs to level 2;In 12 cases of stent-assisted aneurysm embolization,in the stent segments which weren’t influenced by artifacts,the display effect of two LEVIS stents belongs to level 1,the display effects of 5 Enterprise stents and 2 Solitaire AB stents belongs to level 2;While in the stent segments which were influenced by the artifact of spring coil and bone,the display effect significantly reduced, three pieces of Enterprise stents were even unable to identify.(2)On the “vessel opacity”single volume display mode,1 9 cases of vessel segment at the stent completed opacity display.The surface structure of vessel was very clear,but the structure under the surface was completely being covered.On the “vessel translucent”single volume display mode,the surface structure of 19 cases of vessel segment at the stent displayed clear at the tangential position.The vessel

  14. Savannah River Site Approved Site Treatment Plan, 2001 Annual Update (Volumes I and II)

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, B.

    2001-04-30

    The Compliance Plan Volume (Volume I) identifies project activity scheduled milestones for achieving compliance with Land Disposal Restrictions. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume (Volume II) and is provided for information.

  15. Use of the Frank-Starling mechanism during exercise is linked to exercise-induced changes in arterial load.

    Science.gov (United States)

    Chantler, Paul D; Melenovsky, Vojtech; Schulman, Steven P; Gerstenblith, Gary; Becker, Lewis C; Ferrucci, Luigi; Fleg, Jerome L; Lakatta, Edward G; Najjar, Samer S

    2012-01-01

    Effective arterial elastance(E(A)) is a measure of the net arterial load imposed on the heart that integrates the effects of heart rate(HR), peripheral vascular resistance(PVR), and total arterial compliance(TAC) and is a modulator of cardiac performance. To what extent the change in E(A) during exercise impacts on cardiac performance and aerobic capacity is unknown. We examined E(A) and its relationship with cardiovascular performance in 352 healthy subjects. Subjects underwent rest and exercise gated scans to measure cardiac volumes and to derive E(A)[end-systolic pressure/stroke volume index(SV)], PVR[MAP/(SV*HR)], and TAC(SV/pulse pressure). E(A) varied with exercise intensity: the ΔE(A) between rest and peak exercise along with its determinants, differed among individuals and ranged from -44% to +149%, and was independent of age and sex. Individuals were separated into 3 groups based on their ΔE(A)I. Individuals with the largest increase in ΔE(A)(group 3;ΔE(A)≥0.98 mmHg.m(2)/ml) had the smallest reduction in PVR, the greatest reduction in TAC and a similar increase in HR vs. group 1(ΔE(A)<0.22 mmHg.m(2)/ml). Furthermore, group 3 had a reduction in end-diastolic volume, and a blunted increase in SV(80%), and cardiac output(27%), during exercise vs. group 1. Despite limitations in the Frank-Starling mechanism and cardiac function, peak aerobic capacity did not differ by group because arterial-venous oxygen difference was greater in group 3 vs. 1. Thus the change in arterial load during exercise has important effects on the Frank-Starling mechanism and cardiac performance but not on exercise capacity. These findings provide interesting insights into the dynamic cardiovascular alterations during exercise.

  16. Arterial Catheterization

    Science.gov (United States)

    ... way of keeping the blood pressure up. The arterial catheter allows accurate, second-to-second measurement of the blood pressure; repeated meas- urement is called monitoring. ■ High blood pressure (hypertension)— In some sit- uations, ...

  17. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    Directory of Open Access Journals (Sweden)

    Su T

    2011-08-01

    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  18. Arterial Stiffness.

    Science.gov (United States)

    Avolio, Alberto

    2013-04-01

    Stiffness of large arteries has been long recognized as a significant determinant of pulse pressure. However, it is only in recent decades, with the accumulation of longitudinal data from large and varied epidemiological studies of morbidity and mortality associated with cardiovascular disease, that it has emerged as an independent predictor of cardiovascular risk. This has generated substantial interest in investigations related to intrinsic causative and associated factors responsible for the alteration of mechanical properties of the arterial wall, with the aim to uncover specific pathways that could be interrogated to prevent or reverse arterial stiffening. Much has been written on the haemodynamic relevance of arterial stiffness in terms of the quantification of pulsatile relationships of blood pressure and flow in conduit arteries. Indeed, much of this early work regarded blood vessels as passive elastic conduits, with the endothelial layer considered as an inactive lining of the lumen and as an interface to flowing blood. However, recent advances in molecular biology and increased technological sophistication for the detection of low concentrations of biochemical compounds have elucidated the highly important regulatory role of the endothelial cell affecting vascular function. These techniques have enabled research into the interaction of the underlying passive mechanical properties of the arterial wall with the active cellular and molecular processes that regulate the local environment of the load-bearing components. This review addresses these emerging concepts.

  19. Thoracic sympathetic block reduces respiratory system compliance

    Directory of Open Access Journals (Sweden)

    Fábio Ely Martins Benseñor

    Full Text Available CONTEXT AND OBJECTIVE: Thoracic epidural anesthesia (TEA following thoracic surgery presents known analgesic and respiratory benefits. However, intraoperative thoracic sympathetic block may trigger airway hyperreactivity. This study weighed up these beneficial and undesirable effects on intraoperative respiratory mechanics. DESIGN AND SETTING: Randomized, double-blind clinical study at a tertiary public hospital. METHODS: Nineteen patients scheduled for partial lung resection were distributed using a random number table into groups receiving active TEA (15 ml 0.5% bupivacaine, n = 9 or placebo (15 ml 0.9% saline, n = 10 solutions that also contained 1:200,000 epinephrine and 2 mg morphine. Under general anesthesia, flows and airway and esophageal pressures were recorded. Pressure-volume curves, lower inflection points (LIP, resistance and compliance at 10 ml/kg tidal volume were established for respiratory system, chest wall and lungs. Student’s t test was performed, including confidence intervals (CI. RESULTS: Bupivacaine rose 5 ± 1 dermatomes upwards and 6 ± 1 downwards. LIP was higher in the bupivacaine group (6.2 ± 2.3 versus 3.6 ± 0.6 cmH2O, p = 0.016, CI = -3.4 to -1.8. Respiratory system and lung compliance were higher in the placebo group (respectively 73.3 ± 10.6 versus 51.9 ± 15.5, p = 0.003, CI = 19.1 to 23.7; 127.2 ± 31.7 versus 70.2 ± 23.1 ml/cmH2O, p < 0.001, CI = 61 to 53. Resistance and chest wall compliance showed no difference. CONCLUSION: TEA decreased respiratory system compliance by reducing its lung component. Resistance was unaffected. Under TEA, positive end-expiratory pressure and recruitment maneuvers are advisable.

  20. Compliance of laser-assisted microvascular anastomosis: a comparative study with manual anastomosis (preliminary results)

    Science.gov (United States)

    Demaria, Roland G.; Lhote, Francois-Marie; Dauzat, Michel; Juan, Jean-Marie; Oliva-Lauraire, Marie-Claire; Durrleman, Nicolas; Delacretaz, Guy P.; Albat, Bernard; Frapier, Jean-Marc; Chaptal, Paul-Andre; Godlewski, Guilhem

    1999-01-01

    The compliance of microvascular anastomosis is an important predictive factor for long term patency of graft or vascular reconstruction. This experimental study compare the compliance of manual suture and laser assisted end to end microvascular anastomosis. In nine New-Zealand white rabbits we performed manual end-to-end suture anastomosis on the left femoral artery and laser assisted anastomosis on the right femoral artery, with a diode laser (wavelength 988 nm, power output 500 mW). Compliance was obtained by echotracking (CBI 8000 sonomicrometry system with 20 MHz implantable microprobe from Crystal-Biotech, USA) on the anastomosis site as well as upstream, and downstream from the anastomosis. Vessel compliance was lower on the manual suture side compared to the laser assisted anastomosis side, especially downstream from the anastomosis.

  1. Agent Architectures for Compliance

    Science.gov (United States)

    Burgemeestre, Brigitte; Hulstijn, Joris; Tan, Yao-Hua

    A Normative Multi-Agent System consists of autonomous agents who must comply with social norms. Different kinds of norms make different assumptions about the cognitive architecture of the agents. For example, a principle-based norm assumes that agents can reflect upon the consequences of their actions; a rule-based formulation only assumes that agents can avoid violations. In this paper we present several cognitive agent architectures for self-monitoring and compliance. We show how different assumptions about the cognitive architecture lead to different information needs when assessing compliance. The approach is validated with a case study of horizontal monitoring, an approach to corporate tax auditing recently introduced by the Dutch Customs and Tax Authority.

  2. Checking Security Policy Compliance

    CERN Document Server

    Gowadia, Vaibhav; Kudo, Michiharu

    2008-01-01

    Ensuring compliance of organizations to federal regulations is a growing concern. This paper presents a framework and methods to verify whether an implemented low-level security policy is compliant to a high-level security policy. Our compliance checking framework is based on organizational and security metadata to support refinement of high-level concepts to implementation specific instances. Our work uses the results of refinement calculus to express valid refinement patterns and their properties. Intuitively, a low-level security policy is compliant to a high-level security policy if there is a valid refinement path from the high-level security policy to the low-level security policy. Our model is capable of detecting violations of security policies, failures to meet obligations, and capability and modal conflicts.

  3. Orchestrated Session Compliance

    Directory of Open Access Journals (Sweden)

    Franco Barbanera

    2015-08-01

    Full Text Available We investigate the notion of orchestrated compliance for client/server interactions in the context of session contracts. Devising the notion of orchestrator in such a context makes it possible to have orchestrators with unbounded buffering capabilities and at the same time to guarantee any message from the client to be eventually delivered by the orchestrator to the server, while preventing the server from sending messages which are kept indefinitely inside the orchestrator. The compliance relation is shown to be decidable by means of 1 a procedure synthesising the orchestrators, if any, making a client compliant with a server, and 2 a procedure for deciding whether an orchestrator behaves in a proper way as mentioned before.

  4. Estimation of Regurgitant Volume and Orifice in Aortic Regurgitation Combining CW Doppler and Parameter Estimation in a Windkessel Like Model

    Directory of Open Access Journals (Sweden)

    Bjørn A.J. Angelsen

    1991-01-01

    Full Text Available A method for noninvasive estimation of regurgitant orifice and volume in aortic regurgitation is proposed and tested in anaesthesized open chested pigs. The method can be used with noninvasive measurement of regurgitant jet velocity with continuous wave ultrasound Doppler measurements together with cuff measurements of systolic and diastolic systemic pressure in the arm. These measurements are then used for parameter estimation in a Windkessel-like model which include the regurgitant orifice as a parameter. The aortic volume compliance and the peripheral resistance are also included as parameters and estimated in the same process. For the test of the method, invasive measurements in the open chest pigs are used. Electromagnetic flow measurements in the ascending aorta and pulmonary artery are used for control, and a correlation between regurgitant volume obtained from parameter estimation and electromagnetic flow measurements of 0.95 over a range from 2.1 to 17.8 mL is obtained.

  5. Insulin resistance and associated dysfunction of resistance vessels and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2005-01-01

    vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counterregulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release of vasopressin), and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin...

  6. Testosterone suppression in men with prostate cancer leads to an increase in arterial stiffness and hyperinsulinaemia

    National Research Council Canada - National Science Library

    Dockery, Frances; Bulpitt, Christopher J; Agarwal, Sanjiv; Donaldson, Mandy; Rajkumar, Chakravarthi

    2003-01-01

    .... Arterial stiffness (or 'compliance') was measured in 16 men (71+/-9 years, mean+/-S.D.) prior to, and 3 months after, complete androgen suppression with gonadotrophin-releasing hormone analogues as treatment for prostate cancer...

  7. Carotid artery surgery

    Science.gov (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  8. Coronary artery anatomy and variants

    Energy Technology Data Exchange (ETDEWEB)

    Malago, Roberto; Pezzato, Andrea; Barbiani, Camilla; Alfonsi, Ugolino; Nicoli, Lisa; Caliari, Giuliana; Pozzi Mucelli, Roberto [Policlinico G.B. Rossi, University of Verona, Department of Radiology, Verona (Italy)

    2011-12-15

    Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions. (orig.)

  9. Angio-RM das artérias carótidas e vertebrais: análise de diferentes técnicas de volume e diluição de contraste em aparelho de 1,0 t e gradiente de 15 mt/m Contrast-enhanced MR angiography of the carotid and vertebral arteries: analysis of different contrast volumes and dilution techniques at 1.0 T with 15 mT/m gradient.

    Directory of Open Access Journals (Sweden)

    Luiz Guilherme C. Hartmann

    2001-08-01

    Full Text Available OBJETIVO: Avaliar as artérias cervicais (carótidas e vertebrais por meio da angio-RM, utilizando-se diferentes dosagens e diluições de contraste paramagnético. MATERIAIS E MÉTODOS: Estudo prospectivo em 15 pacientes, com análise de 30 artérias carótidas comuns, 30 artérias carótidas internas, 30 artérias carótidas externas e 30 artérias vertebrais, utilizando-se diferentes volumes e dosagens de contraste paramagnético: grupo I - dose única (14 ml de Gd-DTPA; grupo II -dose dupla (28 ml de Gd-DTPA; grupo III - dose única e diluída a 50%. A injeção de contraste foi realizada com a utilização de bomba injetora e com velocidades de injeção de 2 ml/s (grupo I e 3 ml/s (grupos II e III. Os segmentos arteriais foram analisados por três examinadores em consenso de forma subjetiva, avaliando-se o grau de visibilidade, intensidade de contrastação e definição de seus contornos. RESULTADOS: Em todos os itens analisados os pacientes do grupo II apresentaram melhor resultado (visibilização total, boa contrastação dos vasos e contornos bem definidos. No grupo I houve boa visibilização das artérias carótidas e vertebrais, porém a intensidade de contraste e a definição dos contornos apresentaram variabilidade qualitativa. O grupo III apresentou os piores resultados, com dificuldade de visibilização, intensidade de contrastação baixa e contornos mal definidos. CONCLUSÃO: Entre os grupos analisados, a técnica utilizando dose dupla de gadolínio é a que permite melhor avaliação das artérias cervicais. A utilização de contraste diluído prejudica a avaliação dos vasos do pescoço.PURPOSE: To evaluate the carotid and vertebral arteries by magnetic resonance angiography, using different contrast volumes and dilution techniques. SUBJECTS AND METHODS: Prospective study of 15 patients, which included the evaluation of 30 common carotid arteries, 30 internal carotid arteries, 30 external carotid arteries and 30

  10. Study on the relationship between mean platelet volume and platelet distribution width with coronary artery lesion in children with Kawasaki disease.

    Science.gov (United States)

    Liu, Ruixi; Gao, Fang; Huo, Junming; Yi, Qijian

    2012-01-01

    Mean platelet volume (MPV) and platelet distribution width (PDW) are correlated with platelet function and may be a more sensitive index than platelet number as a marker of clinical interest in various disorders. Therefore, this study was designed to answer the following questions: do MPV and PDW levels change in Kawasaki disease (KD), is there any relation between CAL in children with MPV and PDW and whether MPV and PDW might support a diagnosis of incomplete KD. A total of 309 KD patients and 160 sex-age matched healthy subjects were enrolled into the study. For all subjects following tests were performed: MPV, PDW, platelet count, white blood cells counts (WBC), C reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Patients with CALs were assigned to three groups depending on the extent of CALs which were visualized by echocardiography: dilatation and/or ectasia, aneurysm and giant aneurysms. We compared patients with fever and four or five of the principal criteria (complete KD, cKD) to the other patients (iKD). Compared with healthy controls a significant decrease in MPV and PDW (p platelet count, CRP and ESR (p all children with KD. There were no statistically differences in MPV and PDW between KD with CALs and KD without CALs (p > 0.05). However, MPV and PDW were significantly lower in patients with iKD than in group with cKD (p = 0.003, p = 0.014, respectively). It was first shown that patients with KD have lower MPV and PDW than control subjects. The diagnosis of iKD is challenging but can be supported by the presence of lower MPV and PDW.

  11. In vivo adaptive response of the peripheral conduit artery in patients with borderline systolic hypertension

    Institute of Scientific and Technical Information of China (English)

    陶军; 靳亚非; 王礼春; 唐安丽; 廖新学; 杨震; 马虹

    2003-01-01

    Objective To investigate elastic changes of the radial artery, a medium-sized muscular peripheral conduit artery, in patients with borderline systolic hypertension. Methods Using a non-invasive high-resolution echo-tracking device coupled to a photoplethysmography (Finapres system) allowing simultaneous arterial diameter and finger blood pressure monitoring, we measured radial artery elastic parameters of 20 patients with borderline systolic hypertension and 20 normal subjects according to Langewouters model.Results The diameter of the radial artery of control subjects and those with borderline systolic hypertension at the isobaric level of 100 mmHg and mean arterial pressure was similar, but the compliance and distensibility at similar conditions in patients with borderline systolic hypertension did not further reduced and even increased. Conclusion In patients with borderline systolic hypertension, the adaptive responses of the radial artery compliance and distensibility to increased pressure were directed to maintain its elasticity, contributing to the homeostasis of the cardiovascular system.

  12. Abnormal arterial flows by a distributed model of the fetal circulation.

    Science.gov (United States)

    van den Wijngaard, Jeroen P H M; Westerhof, Berend E; Faber, Dirk J; Ramsay, Margaret M; Westerhof, Nico; van Gemert, Martin J C

    2006-11-01

    Modeling the propagation of blood pressure and flow along the fetoplacental arterial tree may improve interpretation of abnormal flow velocity waveforms in fetuses. The current models, however, either do not include a wide range of gestational ages or do not account for variation in anatomical, vascular, or rheological parameters. We developed a mathematical model of the pulsating fetoumbilical arterial circulation using Womersley's oscillatory flow theory and viscoelastic arterial wall properties. Arterial flow waves are calculated at different arterial locations from which the pulsatility index (PI) can be determined. We varied blood viscosity, placental and brain resistances, placental compliance, heart rate, stiffness of the arterial wall, and length of the umbilical arteries. The PI increases in the umbilical artery and decreases in the cerebral arteries, as a result of increasing placental resistance or decreasing brain resistance. Both changes in resistance decrease the flow through the placenta. An increased arterial stiffness increases the PIs in the entire fetoplacental circulation. Blood viscosity and peripheral bed compliance have limited influence on the flow profiles. Bradycardia and tachycardia increase and decrease the PI in all arteries, respectively. Umbilical arterial length has limited influence on the PI but affects the mean arterial pressure at the placental cord insertion. The model may improve the interpretation of arterial flow pulsations and thus may advance both the understanding of pathophysiological processes and clinical management.

  13. Monitoring and Evaluation of Smolt Migration in the Columbia Basin : Volume VII : Evaluation of the Compliance Testing Framework for RPA Improvement as Stated in the 2000 Federal Columbia River Power System (FCRPS) Biological Opinion.

    Energy Technology Data Exchange (ETDEWEB)

    Skalski, John R.; Ngouenet, Roger F.

    2001-05-01

    Using the pre-2000 reach survival probabilities reported in the 2000 FCRPS Biological Opinion (BO) for three selected stocks: yearling and sub-yearling chinook and steelhead, power curves were constructed for each of the two statistical hypothesis tests suggested in the BO. These power calculation results were interpreted in terms of the ability of the statistical tests to correctly identify the true states of recovery (i.e., fail or succeed in fulfilling RPA expectations). The proposed one-sided tests have a moderate to low probability of correctly assessing the true status of the recovery by the years 2005 and 2008. The relatively poor odds of making the correct decision with the BO proposed Tests 1 and 2 suggest alternative decision rules need to be investigated and developed for assessing RPA compliance. Therefore, we propose to immediately examine alternative decision rules that might maximize the likelihood of correct decisions while minimizing the prospect of incorrect decisions. The Bayesian analysis will incorporate scientific/biological knowledge/expertise.

  14. Extrinsic incentives and tax compliance

    OpenAIRE

    Sour, Laura; Gutiérrez Andrade, Miguel Ángel

    2011-01-01

    This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

  15. Extrinsic incentives and tax compliance

    OpenAIRE

    Sour, Laura; Gutiérrez Andrade, Miguel Ángel

    2011-01-01

    This paper models the impact of extrinsic incentives in a tax compliance model. It also provides experimental evidence that confirms the existence of a positive relationship between rewards and tax compliance. If individuals are audited, rewards for honest taxpayers are effective in increasing the level of tax compliance. These results are particularly relevant in countries where there is little respect for tax law since rewards can contribute to crowding in the intrinsic motivation to comply.

  16. Coronary artery fistula

    Science.gov (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  17. Quantifying [F-18]fluorodeoxyglucose uptake in the arterial wall

    DEFF Research Database (Denmark)

    Blomberg, Björn Alexander; Bashyam, A.; Ramachandran, A.

    2015-01-01

    Purpose The human arterial wall is smaller than the spatial resolution of current positron emission tomographs. Therefore, partial volume effects should be considered when quantifying arterial wall F-18-FDG uptake. We evaluated the impact of a novel method for partial volume effect (PVE) correcti...

  18. Cardiovascular simulator improvement: pressure versus volume loop assessment.

    Science.gov (United States)

    Fonseca, Jeison; Andrade, Aron; Nicolosi, Denys E C; Biscegli, José F; Leme, Juliana; Legendre, Daniel; Bock, Eduardo; Lucchi, Julio Cesar

    2011-05-01

    This article presents improvement on a physical cardiovascular simulator (PCS) system. Intraventricular pressure versus intraventricular volume (PxV) loop was obtained to evaluate performance of a pulsatile chamber mimicking the human left ventricle. PxV loop shows heart contractility and is normally used to evaluate heart performance. In many heart diseases, the stroke volume decreases because of low heart contractility. This pathological situation must be simulated by the PCS in order to evaluate the assistance provided by a ventricular assist device (VAD). The PCS system is automatically controlled by a computer and is an auxiliary tool for VAD control strategies development. This PCS system is according to a Windkessel model where lumped parameters are used for cardiovascular system analysis. Peripheral resistance, arteries compliance, and fluid inertance are simulated. The simulator has an actuator with a roller screw and brushless direct current motor, and the stroke volume is regulated by the actuator displacement. Internal pressure and volume measurements are monitored to obtain the PxV loop. Left chamber internal pressure is directly obtained by pressure transducer; however, internal volume has been obtained indirectly by using a linear variable differential transformer, which senses the diaphragm displacement. Correlations between the internal volume and diaphragm position are made. LabVIEW integrates these signals and shows the pressure versus internal volume loop. The results that have been obtained from the PCS system show PxV loops at different ventricle elastances, making possible the simulation of pathological situations. A preliminary test with a pulsatile VAD attached to PCS system was made.

  19. Use of the Frank-Starling mechanism during exercise is linked to exercise-induced changes in arterial load

    Science.gov (United States)

    Chantler, Paul D.; Melenovsky, Vojtech; Schulman, Steven P.; Gerstenblith, Gary; Becker, Lewis C.; Ferrucci, Luigi; Fleg, Jerome L.; Najjar, Samer S.

    2012-01-01

    Effective arterial elastance(EA) is a measure of the net arterial load imposed on the heart that integrates the effects of heart rate(HR), peripheral vascular resistance(PVR), and total arterial compliance(TAC) and is a modulator of cardiac performance. To what extent the change in EA during exercise impacts on cardiac performance and aerobic capacity is unknown. We examined EA and its relationship with cardiovascular performance in 352 healthy subjects. Subjects underwent rest and exercise gated scans to measure cardiac volumes and to derive EA[end-systolic pressure/stroke volume index(SV)], PVR[MAP/(SV*HR)], and TAC(SV/pulse pressure). EA varied with exercise intensity: the ΔEA between rest and peak exercise along with its determinants, differed among individuals and ranged from −44% to +149%, and was independent of age and sex. Individuals were separated into 3 groups based on their ΔEAI. Individuals with the largest increase in ΔEA(group 3;ΔEA≥0.98 mmHg.m2/ml) had the smallest reduction in PVR, the greatest reduction in TAC and a similar increase in HR vs. group 1(ΔEAexercise vs. group 1. Despite limitations in the Frank-Starling mechanism and cardiac function, peak aerobic capacity did not differ by group because arterial-venous oxygen difference was greater in group 3 vs. 1. Thus the change in arterial load during exercise has important effects on the Frank-Starling mechanism and cardiac performance but not on exercise capacity. These findings provide interesting insights into the dynamic cardiovascular alterations during exercise. PMID:22003052

  20. Formalizing and applying compliance patterns for business process compliance

    NARCIS (Netherlands)

    Elgammal, A.F.S.A.; Türetken, O.; van den Heuvel, W.J.A.M.; Papazoglou, M.

    2016-01-01

    Today’s enterprises demand a high degree of compliance of business processes to meet diverse regulations and legislations. Several industrial studies have shown that compliance management is a daunting task, and organizations are still struggling and spending billions of dollars annually to ensure a

  1. Quality beyond compliance.

    Science.gov (United States)

    Centanni, N; Monroe, M; White, L; Larson, R

    1999-01-01

    The service sector within the biopharmaceutical industry has experienced phenomenal growth over the past decade. In the highly regulated Good Laboratory Practices environment, the need for timely, high-quality service, accurate results, and on-time deliverables becomes paramount for the success and profitability of biopharmaceutical companies. The quality assurance process is a vital component of this drug product-development cycle and ensures compliance to the highest domestic and international regulatory standards. Quality-assurance professionals historically have held the role of independent auditors of the processes, who certify that results meet current standards of practice. Covance, a contract research organization that includes Good Laboratory Practices laboratories, reorganized and expanded the functional responsibilities of its quality assurance team in 1997. Auditors and quality assurance professionals have assumed roles beyond traditional compliance auditing and are forging new leadership and mentoring roles as process-improvement specialists. The results have been tangible, measurable benefits for clients and the Covance organization. This article provides an overview of this cultural change and the processes put in place to improve efficiency, productivity, and customer and employee satisfaction.

  2. The Strategic Nature of Compliance

    DEFF Research Database (Denmark)

    König, Thomas; Mäder, Lars Kai

    2014-01-01

    This compliance study models correct and timely implementation of policies in a multilevel system as a strategic game between a central monitoring agency and multiple implementers and evaluates statistically the empirical implications of this model. We test whether compliance is determined...

  3. Unilateral absence of a pulmonary artery: Report of 3 cases

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Oh Keun; Choi, Chul Seung; Choi, Yo Won; Jeon, Seok Cheol; Seo, Heung Suk; Hahm, Chang Kok [College of Medicine, Hanyang University, Seoul (Korea, Republic of)

    1994-07-15

    Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PDA. We encountered three cases of isolated unilateral absence of a pulmonary artery; one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateral lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of acquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluation of the unilateral absence of a pulmonary artery.

  4. Compliance with Segment Disclosure Initiatives

    DEFF Research Database (Denmark)

    Arya, Anil; Frimor, Hans; Mittendorf, Brian

    2013-01-01

    Regulatory oversight of capital markets has intensified in recent years, with a particular emphasis on expanding financial transparency. A notable instance is efforts by the Financial Accounting Standards Board that push firms to identify and report performance of individual business units...... (segments). This paper seeks to address short-run and long-run consequences of stringent enforcement of and uniform compliance with these segment disclosure standards. To do so, we develop a parsimonious model wherein a regulatory agency promulgates disclosure standards and either permits voluntary...... compliance or mandates strict compliance from firms. Under voluntary compliance, a firm is able to credibly withhold individual segment information from its competitors by disclosing data only at the aggregate firm level. Consistent with regulatory hopes, we show that mandatory compliance enhances welfare...

  5. Functional impairment of precerebral arteries in Huntington disease.

    Science.gov (United States)

    Kobal, Jan; Cankar, Ksenija; Pretnar, Janja; Zaletel, Marjan; Kobal, Lucijan; Teran, Natasa; Melik, Ziva

    2017-01-15

    Cardiovascular pathology of Huntington disease (HD) appears to be complex; while microvascular dysfunction seems to appear early, deaths from cardiomyopathy and stroke might occur in the late phase of HD. Our study evaluated global risk factors for coronary heart disease (CHD), structure and function of precerebral arteries in 41 HD subjects and 41 matched controls. HD subjects were divided into groups by the United Huntington disease rating scale (presymptomatic-PHD, early-EHD, midstage-MHD and late-LHD). CHD risk factors assessment and Doppler examination of precerebral arteries were performed, including measurements of the carotid artery intima-media thickness (IMT), and parameters indicating local carotid artery distensibility (stiffness index β, pulse wave velocity, pressure strain elasticity module and carotid artery compliance). In the HD and controls we identified a comparable number of non-obstructive plaques (50% lumen narrowing) were found. There was significantly increased IMT in MHD. In PHD and EHD the parameters of arterial stiffness were significantly higher and the carotid artery compliance was significantly lower. Our results reveal functional vascular pathology in PHD, EHD, and MHD. Precerebral arteries dysfunction in HD therefore appears to be mostly functional and in agreement with recently described autonomic nervous system changes in HD. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Compliance with physical exercise

    DEFF Research Database (Denmark)

    Gram, Anne Sofie; Bønnelycke, Julie; Rosenkilde Larsen, Mads

    2014-01-01

    , a moderate (MOD; 300 kcal/day) or a high-dose (HIGH; 600 kcal/day) endurance exercise group for 12 weeks. A sub-set of the subjects were interviewed using pre-determined, qualitative questions to elucidate physical activity and health behaviour. In combination with the Theory of Planned Behaviour (TPB......Aims: Sixty-one healthy, sedentary, moderately overweight young men participated in a randomised controlled trial to examine the effects of two different doses of endurance exercise on health behaviour and exercise compliance. Methods: Participants were randomised to a sedentary control group...... improved various metabolic health parameters. The MOD group was untroubled by the exercise load and had a positive attitude towards exercise. The HIGH group expressed increased fatigue, less positivity and perceived exercise as time-consuming. The MOD group described themselves as more energetic...

  7. A method to quantify and visualize femoral head intraosseous arteries by micro-CT.

    Science.gov (United States)

    Qiu, Xing; Shi, Xiaotian; Ouyang, Jun; Xu, Dachuan; Zhao, Dewei

    2016-08-01

    We describe a technique for perfusing a barium sulphate suspension into the intraosseous artery. Following the perfusion of abarium sulphate suspension into 14 fresh lower limbs of Chinese cadavers, micro-CT scanning was applied to digitize, quantify and visualize the intraosseous arteries in the human femoral heads. Then, the femoral heads were removed and subjected to micro-CT scanning. The data were imported into the amira and mimics programs to reconstruct and quantify the intraosseous arteries. The femoral head intraosseous artery lengths, areas, volumes, and femoral head bone volumes were quantified. The artery densities and artery ratios were calculated and analysed with independent-samples t-tests. The intraosseous vasculature volume renderings were displayed as screenshots and videos made with amira. Many intraosseous artery study technologies were compared. The barium sulphate suspension was milky white in colour. The perfusion of the barium sulphate suspension followed by micro-CT scanning provided a good representation of the intraosseous artery. The femoral head intraosseous artery lengths, areas and volumes, and the femoral head bone volumes were displayed as the X¯±S . No differences were observed between the left and right femoral head intraosseous arteries in terms of the artery densities or artery ratios. The volume renderings and 3-D orthogonal projections displayed the overall distributions of the intraosseous arteries. The videos clearly demonstrated the entry sites of the nutrition-carrying arteries, their courses and branches, and the intraosseous arterial anastomoses. Our technique is the simplest and least time-consuming method of producing accurate vascular three-dimensional reconstructions. The perfusion of a barium sulphate suspension into intraosseous arteries combined with micro-CT scanning can deliver high-resolution 3-D digitized data and images of intraosseous arteries. This technique does not require bone decalcification or bone

  8. Evaluation of corporate income tax compliance costs and compliance behaviour under the self-assessment system

    OpenAIRE

    Sapiei, Noor Sharoja

    2017-01-01

    Commitment to compliance may cause taxpayers to experience unnecessary compliance costs burden resulting in non-compliance behaviour. This study evaluates the tax compliance costs of corporate taxpayers and their compliance with the corporate income tax (CIT) reporting requirements under the Self-Assessment System (SAS) environment. Tax compliance costs, corporate characteristics, tax attitudinal aspects and the likely compliance behaviour of public listed companies (PLCs) are integrated into...

  9. Acetylcholine's effect on vascular resistance and compliance in the pulmonary circulation.

    Science.gov (United States)

    Barman, S A; Senteno, E; Smith, S; Taylor, A E

    1989-10-01

    Acetylcholine's effect on the distribution of vascular resistance and compliance in the canine pulmonary circulation was determined under control and elevated vascular tone by the arterial, venous, and double occlusion techniques in isolated blood-perfused dog lungs at both constant flow and constant pressure. Large and small blood vessel resistances and compliances were studied in lungs given concentrations of acetylcholine ranging from 2.0 ng/ml to 200 micrograms/ml. The results of this study indicate that acetylcholine dilates large arteries at low concentrations (less than or equal to 20 ng/ml) and constricts small and large veins at concentrations of at least 2 micrograms/ml. Characterization of acetylcholine's effects at constant pulmonary blood flow indicates that 1) large artery vasodilation may be endothelial-derived relaxing factor-mediated because the dilation is blocked with methylene blue; 2) a vasodilator of the arachidonic acid cascade (blocked by ibuprofen), probably prostacyclin, lessens acetylcholine's pressor effects; 3) when vascular tone was increased, acetylcholine's hemodynamic effects were attenuated; and 4) acetylcholine decreased middle compartment and large vessle compliance under control but not elevated vascular tone. Under constant pressure at control vascular tone acetylcholine increases resistance in all segments except the large artery, and at elevated vascular tone the pressor effects were enhanced, and large artery resistance was increased.

  10. Oil Mist Compliance

    Energy Technology Data Exchange (ETDEWEB)

    Lazarus, Lloyd

    2009-02-02

    This report summarizes activities at the KCP related to evaluating and modifying machine tools in order to be in compliance with Section 23 of DOE 10 CFR 851, Worker Safety and Health Program. Section 851.23 (a) states that “Contractors must comply with the following safety and health standards that are applicable to the hazards in their covered workplace”, and subsection 9 contains the following applicable standard: “American Congress of Governmental Industrial Hygienists (ACGIH), ‘Threshold Limit Values for Chemical Substances and Physical Agents and Biological Exposure Indices,’ (2005) (incorporated by reference, see §851.27) when the ACGIH Threshold Limit Values are lower (more protective) than permissible exposure limits in 29 CFR 1910.” In the 2005 ACGIH – Threshold Limit Value book a Notice of Change was issued for exposure to mineral oil mist used in metalworking fluids (MWFs). The effects of planning for the new facility and which machine tools would be making the transition to the new facility affected which machine tools were modified.

  11. Aerobic exercise training increases plasma Klotho levels and reduces arterial stiffness in postmenopausal women.

    Science.gov (United States)

    Matsubara, Tomoko; Miyaki, Asako; Akazawa, Nobuhiko; Choi, Youngju; Ra, Song-Gyu; Tanahashi, Koichiro; Kumagai, Hiroshi; Oikawa, Satoshi; Maeda, Seiji

    2014-02-01

    The Klotho gene is a suppressor of the aging phenomena, and the secretion as well as the circulation of Klotho proteins decrease with aging. Although habitual exercise has antiaging effects (e.g., a decrease in arterial stiffness), the relationship between Klotho and habitual exercise remains unclear. In the present study, we investigated the effect of habitual exercise on Klotho, with a particular focus on arterial stiffness. First, we examined the correlation between plasma Klotho concentration and arterial stiffness (carotid artery compliance and β-stiffness index) or aerobic exercise capacity [oxygen uptake at ventilatory threshold (VT)] in 69 healthy, postmenopausal women (50-76 years old) by conducting a cross-sectional study. Second, we tested the effects of aerobic exercise training on plasma Klotho concentrations and arterial stiffness. A total of 19 healthy, postmenopausal women (50-76 years old) were divided into two groups: control group and exercise group. The exercise group completed 12 wk of moderate aerobic exercise training. In the cross-sectional study, plasma Klotho concentrations positively correlated with carotid artery compliance and VT and negatively correlated with the β-stiffness index. In the interventional study, aerobic exercise training increased plasma Klotho concentrations and carotid artery compliance and decreased the β-stiffness index. Moreover, the changes in plasma Klotho concentration and arterial stiffness were found to be correlated. These results suggest a possible role for secreted Klotho in the exercise-induced modulation of arterial stiffness.

  12. Air Compliance Complaint Database (ACCD)

    Data.gov (United States)

    U.S. Environmental Protection Agency — THIS DATA ASSET NO LONGER ACTIVE: This is metadata documentation for the Region 7 Air Compliance Complaint Database (ACCD) which logs all air pollution complaints...

  13. Integrated Compliance Information System (ICIS)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The purpose of ICIS is to meet evolving Enforcement and Compliance business needs for EPA and State users by integrating information into a single integrated data...

  14. 10 CFR 434.604 - Compliance.

    Science.gov (United States)

    2010-01-01

    ... energy consumption shall be measured at the building five foot line for all fuels. Energy consumed from... BUILDINGS Building Energy Compliance Alternative § 434.604 Compliance. 604.1 Compliance with this section is... 10 Energy 3 2010-01-01 2010-01-01 false Compliance. 434.604 Section 434.604 Energy DEPARTMENT...

  15. 14 CFR 26.49 - Compliance plan.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Compliance plan. 26.49 Section 26.49... Data for Repairs and Alterations § 26.49 Compliance plan. (a) Compliance plan. Except for applicants... January 11, 2008, each person identified in §§ 26.43, 26.45, and 26.47, must submit a compliance...

  16. 40 CFR 469.11 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 469.11 Section 469... Compliance dates. The compliance deadline for the BAT fluoride limitation shall be as soon as possible as... determined by the permit writer, but in no event later than July 1, 1984. The compliance date for PSES...

  17. 40 CFR 469.21 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 469.21 Section 469....21 Compliance dates. The compliance date for the BAT fluoride limitation is as soon as possible as determined by the permit writer but in no event later than November 8, 1985. The compliance date for PSES...

  18. Peripheral arterial line (image)

    Science.gov (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of ...

  19. Measuring on-line compliance in ventilated infants using hot wire anemometry.

    Science.gov (United States)

    Baboolal, R; Kirpalani, H

    1990-10-01

    We investigated the validity of using tidal volume (VT) as measured by the neonatal volume monitor (NVM) to derive respiratory compliance. The NVM is a noninvasive device that measures VT by hot wire anemometry. The quotient of VT and the inflation pressure amplitude from the mechanical ventilator provided a measure of respiratory compliance. This was validated against the single breath occlusion technique in 15 infants (birth weight 0.9 to 4.4 kg). To ensure fully passive expiration, only paralyzed or sedated patients were studied. Only 12 of the 15 infants were analyzed because of limitations in the single breath technique. In three infants the flow-volume curves obtained were alinear, indicating inhomogeneity. In the 12 infants with acceptable single breath data, agreement between the two methods was excellent. Using the expired volume, r2 was .99. We conclude that the NVM can be used to obtain valid estimates of respiratory compliance on-line in intubated infants.

  20. Multidetector CT of hepatic artery pathologies.

    Science.gov (United States)

    Karaosmanoglu, D; Erol, B; Karcaaltincaba, M

    2012-01-01

    The hepatic artery can be involved by a variety of pathology and diseases.Today MDCT enables high quality imaging of the hepatic artery using axial, MIP and volume rendered images. We illustrate MDCT findings of anatomical variations, aneurysm, dilatation, dissection, arteriovenous fistula, thrombosis and stenosis. Aneurysms can be saccular, fusiform and multiple and may develop due to atherosclerosis, vasculitis, trauma and biopsy. Dilatation of hepatic artery can be seen in portal hypertension, Osler-Weber-Rendu disease and hemangiomatosis. Hepatic artery can be occluded after trauma and transplantation. Dissection develops due to atherosclerosis, Marfan and Ehler Danlos syndromes and during pregnancy. Arteriovenous fistula can be congenital and acquired. We conclude that various hepatic artery pathologies can be confidently diagnosed by MDCT.

  1. Hazardous Waste Compliance Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Potter, G.L.; Holstein, K.A.

    1994-05-01

    The Hazardous Waste Compliance Program Plan (HWCPP) describes how the Rocky Flats Plant institutes a more effective waste management program designed to achieve and maintain strict adherence to the Resource Conservation and Recovery Act (RCRA) requirements. Emphasis is given to improve integration of line operations with programmatic and functional support activities necessary to achieve physical compliance to RCRA regulated equipment, facilities and operations at the floor level. This program focuses on specific activities occurring or which need to occur within buildings containing RCRA regulated units and activities. The plan describes a new approach to achieving and maintaining compliance. This approach concentrates authority and accountability for compliance with the line operating personnel, with support provided from the programmatic functions. This approach requires a higher degree of integration and coordination between operating and program support organizations. The principal changes in emphases are; (1) increased line operations involvement, knowledge and accountability in compliance activities, (2) improved management systems to identify, correct and/or avoid deficiencies and (3) enhanced management attention and employee awareness of compliance related matters.

  2. Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance

    Directory of Open Access Journals (Sweden)

    Darbà J

    2016-02-01

    Full Text Available Josep Darbà,1 Gabriela Ramírez,2 Antoni Sicras,3 Laura García-Bujalance,4 Saku Torvinen,5 Rainel Sánchez-de la Rosa6 1Department of Economics, Universitat de Barcelona, 2BCN Health Economics & Outcomes Research S.L., 3Department of Planning, Badalona Serveis Assistencials S.A., Barcelona, 4Market Access Department, Teva Pharmaceutical, Madrid, Spain; 5Market Access Department, Teva Pharmaceuticals Europe BV, Amsterdam, the Netherlands; 6Medical Department, Teva Pharmaceutical, Madrid, Spain Objective: To identify the impact of delivery device of inhaled corticosteroids and long-acting β2-agonist (ICS/LABA on asthma medication compliance, and investigate other factors associated with compliance. Materials and methods: We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213 whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler®, Turbuhaler®, and NEXThaler® or pressurized metered-dose inhalers (pMDI. Medication compliance included persistence outcomes through 18 months and medication possession ratios. Data on potential confounders of treatment compliance such as asthma exacerbations, comorbidities, demographic characteristics, and health care resource utilization were also explored. Results: The probability of asthma medication compliance in case of DPIs was lower compared to pMDIs, which suggests that inhaler devices influence inhalation therapies. There were additional confounding factors that were considered as explanatory variables of compliance. A worse measure of airflow obstruction (forced expiration volume in 1 second, comorbidities and general practitioner (GP consultations more than once per month decreased the probability of compliance. Within comorbidities, alcoholism was positively associated with compliance. Patients of 29–39, 40–50, and 51–61 age groups or suffering from more than two

  3. Compliant model of a coupled sequential coronary arterial bypass graft: effects of vessel wall elasticity and non-Newtonian rheology on blood flow regime and hemodynamic parameters distribution.

    Science.gov (United States)

    Kabinejadian, Foad; Ghista, Dhanjoo N

    2012-09-01

    We have recently developed a novel design for coronary arterial bypass surgical grafting, consisting of coupled sequential side-to-side and end-to-side anastomoses. This design has been shown to have beneficial blood flow patterns and wall shear stress distributions which may improve the patency of the CABG, as compared to the conventional end-to-side anastomosis. In our preliminary computational simulation of blood flow of this coupled sequential anastomoses design, the graft and the artery were adopted to be rigid vessels and the blood was assumed to be a Newtonian fluid. Therefore, the present study has been carried out in order to (i) investigate the effects of wall compliance and non-Newtonian rheology on the local flow field and hemodynamic parameters distribution, and (ii) verify the advantages of the CABG coupled sequential anastomoses design over the conventional end-to-side configuration in a more realistic bio-mechanical condition. For this purpose, a two-way fluid-structure interaction analysis has been carried out. A finite volume method is applied to solve the three-dimensional, time-dependent, laminar flow of the incompressible, non-Newtonian fluid; the vessel wall is modeled as a linearly elastic, geometrically non-linear shell structure. In an iteratively coupled approach the transient shell equations and the governing fluid equations are solved numerically. The simulation results indicate a diameter variation ratio of up to 4% and 5% in the graft and the coronary artery, respectively. The velocity patterns and qualitative distribution of wall shear stress parameters in the distensible model do not change significantly compared to the rigid-wall model, despite quite large side-wall deformations in the anastomotic regions. However, less flow separation and reversed flow is observed in the distensible models. The wall compliance reduces the time-averaged wall shear stress up to 32% (on the heel of the conventional end-to-side model) and somewhat

  4. Environmental Report 1995. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Harrach, R.J.; Failor, R.A.; Gallegos, G.M. [and others

    1996-09-01

    This report contains the results of Lawrence Livermore National Laboratory`s (LLNL) environmental monitoring and compliance effort and an assessment of the impact of LLNL operations on the environment and the public. This first volume describes LLNL`s environmental impact and compliance activities and features descriptive and explanatory text, summary data tables, and plots showing data trends. The summary data include measures of the center of data, their spread or variability, and their extreme values. Chapters on monitoring air, sewage, surface water, ground water, soil and sediment, vegetation and foodstuff, and environmental radiation are present.

  5. Abnormal pulmonary artery stiffness in pulmonary arterial hypertension: in vivo study with intravascular ultrasound.

    Directory of Open Access Journals (Sweden)

    Edmund M T Lau

    Full Text Available BACKGROUND: There is increasing recognition that pulmonary artery stiffness is an important determinant of right ventricular (RV afterload in pulmonary arterial hypertension (PAH. We used intravascular ultrasound (IVUS to evaluate the mechanical properties of the elastic pulmonary arteries (PA in subjects with PAH, and assessed the effects of PAH-specific therapy on indices of arterial stiffness. METHOD: Using IVUS and simultaneous right heart catheterisation, 20 pulmonary segments in 8 PAH subjects and 12 pulmonary segments in 8 controls were studied to determine their compliance, distensibility, elastic modulus and stiffness index β. PAH subjects underwent repeat IVUS examinations after 6-months of bosentan therapy. RESULTS: AT BASELINE, PAH SUBJECTS DEMONSTRATED GREATER STIFFNESS IN ALL MEASURED INDICES COMPARED TO CONTROLS: compliance (1.50±0.11×10(-2 mm(2/mmHg vs 4.49±0.43×10(-2 mm(2/mmHg, p<0.0001, distensibility (0.32±0.03%/mmHg vs 1.18±0.13%/mmHg, p<0.0001, elastic modulus (720±64 mmHg vs 198±19 mmHg, p<0.0001, and stiffness index β (15.0±1.4 vs 11.0±0.7, p = 0.046. Strong inverse exponential associations existed between mean pulmonary artery pressure and compliance (r(2 = 0.82, p<0.0001, and also between mean PAP and distensibility (r(2 = 0.79, p = 0.002. Bosentan therapy, for 6-months, was not associated with any significant changes in all indices of PA stiffness. CONCLUSION: Increased stiffness occurs in the proximal elastic PA in patients with PAH and contributes to the pathogenesis RV failure. Bosentan therapy may not be effective at improving PA stiffness.

  6. Comparison of the Detection Rate of Carotid Artery Therosclerosis Plaque by Means of 16-Director Spiral CT and 320-director Volume CT%16排螺旋CT与320排容积CT对颈动脉粥样硬化斑块检出率的比较研究

    Institute of Scientific and Technical Information of China (English)

    贾云生; 高明洋; 王焕君

    2016-01-01

    目的:比较16排螺旋CT与320排容积CT对于颈动脉粥样硬化斑块检出率的差异。方法选取缺血性脑血管病患者48例,男性22例,女性26例,平均年龄(56±8)岁。经16排螺旋CTA检出颈动脉粥样硬化斑块的患者,进一步行320排容积CTA扫描,并与16排螺旋CTA的粥样硬化斑块检出率进行比较。结果16排螺旋CT与320排容积CT对于颈动脉粥样硬化斑块的检出率无明显统计学差异。结论对于基层医院,建议使用16排螺旋CT检出颈动脉斑块,以利于临床诊断及治疗。%Objective To compare the detection rate of carotid artery therosclerosis plaque by means of 16-director spiral CT and 320- director volume CT.Methods 48 patients of ICVD, 22 males and 26 females, with average age of (56±8) years old, were chosen. The patients detected plaques by 16-director spiral CT scans were further performed 320-director volume CT scans, and we compared the detection rate between the two methods. Results The detection rate of carotid artery therosclerosis plaque between 16-director spiral CT scans and 320-director volume CT scans showed no significant difference. Conclusion We recommend utilizing 16-director spiral CT to detect carotid artery therosclerosis plaque for basic hospital, facilitating the clinical diagnosis and treatment.

  7. Experimental exposure to diesel exhaust increases arterial stiffness in man

    Directory of Open Access Journals (Sweden)

    Newby David E

    2009-03-01

    Full Text Available Abstract Introduction Exposure to air pollution is associated with increased cardiovascular morbidity, although the underlying mechanisms are unclear. Vascular dysfunction reduces arterial compliance and increases central arterial pressure and left ventricular after-load. We determined the effect of diesel exhaust exposure on arterial compliance using a validated non-invasive measure of arterial stiffness. Methods In a double-blind randomized fashion, 12 healthy volunteers were exposed to diesel exhaust (approximately 350 μg/m3 or filtered air for one hour during moderate exercise. Arterial stiffness was measured using applanation tonometry at the radial artery for pulse wave analysis (PWA, as well as at the femoral and carotid arteries for pulse wave velocity (PWV. PWA was performed 10, 20 and 30 min, and carotid-femoral PWV 40 min, post-exposure. Augmentation pressure (AP, augmentation index (AIx and time to wave reflection (Tr were calculated. Results Blood pressure, AP and AIx were generally low reflecting compliant arteries. In comparison to filtered air, diesel exhaust exposure induced an increase in AP of 2.5 mmHg (p = 0.02 and in AIx of 7.8% (p = 0.01, along with a 16 ms reduction in Tr (p = 0.03, 10 minutes post-exposure. Conclusion Acute exposure to diesel exhaust is associated with an immediate and transient increase in arterial stiffness. This may, in part, explain the increased risk for cardiovascular disease associated with air pollution exposure. If our findings are confirmed in larger cohorts of susceptible populations, this simple non-invasive method of assessing arterial stiffness may become a useful technique in measuring the impact of real world exposures to combustion derived-air pollution.

  8. Hand Hygiene Compliance in an Emergency Department: The Effect of Crowding.

    Science.gov (United States)

    Muller, Matthew P; Carter, Eileen; Siddiqui, Naureen; Larson, Elaine

    2015-10-01

    Emergency department (ED) crowding results from the need to see high volumes of patients of variable acuity within a limited physical space. ED crowding has been associated with poor patient outcomes and increased mortality. The authors evaluated whether ED crowding is also associated with reduced hand hygiene compliance among health care workers. A trained observer measured hand hygiene compliance using standardized definitions for 22 months in the 40-bed ED of a 475-bed academic hospital in Toronto, Ontario, Canada. ED crowding measures, including mean daily patient volumes, time to initial physician assessment, and daily nursing hours, were obtained from hospital administrative and human resource databases. Known predictors of hand hygiene compliance, including the indication for hand hygiene and the health care workers' professions, were also measured. Hand hygiene data, measured during 20-minute observation sessions, were linked to aggregate daily results for each crowding metric. Crowding metrics and known predictors of hand hygiene compliance were then included in a multivariate model if associated with hand hygiene compliance at a p-value of Hand hygiene compliance was 29% (325 of 1,116 opportunities). Alcohol-based hand rinse was used 66% of the time. Nurses accounted for 68% of hand hygiene opportunities and physicians for 18%, with the remaining 14% attributed to nonphysician, nonnurse health care workers. The most common indications for hand hygiene were hand hygiene prior to (35%) and hand hygiene following (52%) contact with the patient or his or her environment. In multivariate analysis, time to physician assessment > 1.5 hours was associated with lower compliance (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.51 to 0.89). Additionally, compliance was lower for nonnurse, nonphysician health care workers (OR = 0.51, 95% CI = 0.33 to 0.79) and higher for hand hygiene performed after contact with the patients or his/her environment

  9. Pulmonary artery haemodynamic properties in patients with pulmonary hypertension secondary to rheumatic mitral stenosis.

    Science.gov (United States)

    Yan, Tao; Zhang, Guan-xin; Li, Bai-lin; Zhong, Keng; Xu, Zhi-yun; Han, Lin

    2012-12-01

    We sought to explore the pulmonary haemodynamic changes in rheumatic mitral stenosis patients with secondary pulmonary hypertension. The pulmonary artery resistance and compliance of 35 patients with rheumatic mitral stenosis and 12 controls without cardiopulmonary vascular disease were evaluated by using an improved method, which is based on making calculations with parameters obtained from right heart catheterisation. The results are as follows: (1) pulmonary artery compliance in patients with secondary pulmonary hypertension was significantly lower than that of the control group (P0.05) The walls of pulmonary artery vessels in patients with pulmonary hypertension secondary to rheumatic mitral stenosis appeared to be remodelled by varying degrees as indicated by their haemodynamic properties. Structural remodelling may be a factor affecting preoperative pulmonary artery pressure. Mitral stenosis patients with severe pulmonary hypertension have significantly lower responses to sodium nitroprusside possibly due to aggradation and deposition of collagen in the artery walls, decreasing constriction and dilation, or atrophy of smooth muscle cells.

  10. Disease management and medication compliance.

    Science.gov (United States)

    Cohen, Joshua; Christensen, Kathyrn; Feldman, Lanna

    2012-02-01

    Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.

  11. The peptide hormone cholecystokinin modulates the tonus and compliance of the bulbus arteriosus and pre-branchial vessels of the rainbow trout (Oncorhynchus mykiss).

    Science.gov (United States)

    Seth, Henrik; Axelsson, Michael; Gräns, Albin

    2014-12-01

    The bulbus arteriosus is a compliant structure between the ventricle and ventral aorta of teleost fish. It serves as a "wind-kessel" that dampens pressure variations during the cardiac cycle allowing a continuous flow of blood into the gills. The bulbus arteriosus receives sympathetic innervation and is affected by several circulating substances, indicating neurohumoral control. We have previously shown that the peptide hormone, cholecystokinin (CCK), affects the hemodynamics of the cardiovascular system in rainbow trout (Oncorhynchus mykiss) by increasing flow pulse amplitude without affecting cardiac output. We hypothesized that this could be explained by an altered tonus or compliance/distensibility of the bulbus arteriosus. Our results show that there is a substantial effect of CCK on the bulbus arteriosus. Concentrations of CCK that altered the cardiac function of in situ perfused hearts also contracted the bulbus arteriosus in vitro. Pressure-volume curves revealed a change in both the tonus and the compliance/distensibility of this structure. Furthermore, the stimulatory (constricting) effect of CCK was also evident in the ventricle and vasculature leading to the gills, but absent in the atrium, efferent branchial arteries and dorsal aorta. In conclusion, CCK alters the mechanical properties of the ventricle, bulbus arteriosus, ventral aorta and afferent gill vasculature, thus maintaining adequate branchial and systemic blood flow and pressure when cardiorespiratory demands change, such as after feeding.

  12. Proposed Site Treatment Plan (PSTP). Volumes 1 and 2 and Reference Document

    Energy Technology Data Exchange (ETDEWEB)

    Helmich, E.; Noller, D.K.; Wierzbicki, K.S.; Bailey, L.L.

    1994-12-22

    The Compliance Plan Volume provides overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) and contains procedures to establish milestones to be enforced under the Order. Information regarding the technical evaluation of treatment options for SRS mixed wastes is contained in the Background Volume and is provided for informational purposes only.

  13. Corporate compliance and voluntary disclosure.

    Science.gov (United States)

    Schiff, A B

    1995-09-01

    In any event, the decision to institute a corporate compliance program is a relatively simple one. In view of the ambiguity surrounding certain fraud and abuse provisions, and the corporate "death sentence" that may result from program exclusion, a compliance program is always sound corporate policy. To be sure, if the compliance program is administered improperly, it can actually increase the likelihood of whistleblower actions and create a body of potentially hurtful documentation. But these dangers can be minimized by structuring the program to protect the self-evaluative process through relevant privileges. The risks also pale in comparison to the exposure to criminal or exclusionary sanctions when improper conduct goes undetected by an organization.

  14. Hemodynamic Assessment of Compliance of Pre-Stressed Pulmonary Valve-Vasculature in Patient Specific Geometry Using an Inverse Algorithm

    Science.gov (United States)

    Hebbar, Ullhas; Paul, Anup; Banerjee, Rupak

    2016-11-01

    Image based modeling is finding increasing relevance in assisting diagnosis of Pulmonary Valve-Vasculature Dysfunction (PVD) in congenital heart disease patients. This research presents compliant artery - blood interaction in a patient specific Pulmonary Artery (PA) model. This is an improvement over our previous numerical studies which assumed rigid walled arteries. The impedance of the arteries and the energy transfer from the Right Ventricle (RV) to PA is governed by compliance, which in turn is influenced by the level of pre-stress in the arteries. In order to evaluate the pre-stress, an inverse algorithm was developed using an in-house script written in MATLAB and Python, and implemented using the Finite Element Method (FEM). This analysis used a patient specific material model developed by our group, in conjunction with measured pressure (invasive) and velocity (non-invasive) values. The analysis was performed on an FEM solver, and preliminary results indicated that the Main PA (MPA) exhibited higher compliance as well as increased hysteresis over the cardiac cycle when compared with the Left PA (LPA). The computed compliance values for the MPA and LPA were 14% and 34% lesser than the corresponding measured values. Further, the computed pressure drop and flow waveforms were in close agreement with the measured values. In conclusion, compliant artery - blood interaction models of patient specific geometries can play an important role in hemodynamics based diagnosis of PVD.

  15. Social influence: compliance and conformity.

    Science.gov (United States)

    Cialdini, Robert B; Goldstein, Noah J

    2004-01-01

    This review covers recent developments in the social influence literature, focusing primarily on compliance and conformity research published between 1997 and 2002. The principles and processes underlying a target's susceptibility to outside influences are considered in light of three goals fundamental to rewarding human functioning. Specifically, targets are motivated to form accurate perceptions of reality and react accordingly, to develop and preserve meaningful social relationships, and to maintain a favorable self-concept. Consistent with the current movement in compliance and conformity research, this review emphasizes the ways in which these goals interact with external forces to engender social influence processes that are subtle, indirect, and outside of awareness.

  16. Tax Compliance Inventory: TAX-I Voluntary tax compliance, enforced tax compliance, tax avoidance, and tax evasion.

    Science.gov (United States)

    Kirchler, Erich; Wahl, Ingrid

    2010-06-01

    Surveys on tax compliance and non-compliance often rely on ad hoc formulated items which lack standardization and empirical validation. We present an inventory to assess tax compliance and distinguish between different forms of compliance and non-compliance: voluntary versus enforced compliance, tax avoidance, and tax evasion. First, items to measure voluntary and enforced compliance, avoidance, and evasion were drawn up (collected from past research and newly developed), and tested empirically with the aim of producing four validated scales with a clear factorial structure. Second, findings from the first analyses were replicated and extended to validation on the basis of motivational postures. A standardized inventory is provided which can be used in surveys in order to collect data which are comparable across research focusing on self-reports. The inventory can be used in either of two ways: either in its entirety, or by applying the single scales independently, allowing an economical and fast assessment of different facets of tax compliance.

  17. ASPRE trial: influence of compliance on beneficial effect of aspirin in prevention of preterm preeclampsia.

    Science.gov (United States)

    Wright, David; Poon, Liona C; Rolnik, Daniel L; Syngelaki, Argyro; Delgado, Juan Luis; Vojtassakova, Denisa; de Alvarado, Mercedes; Kapeti, Evgenia; Rehal, Anoop; Pazos, Andrea; Carbone, Ilma Floriana; Dutemeyer, Vivien; Plasencia, Walter; Papantoniou, Nikos; Nicolaides, Kypros H

    2017-09-06

    To examine the influence of compliance on the beneficial effect of aspirin in prevention of preterm preeclampsia in the Combined Multimarker Screening and Randomized Patient Treatment with Aspirin for Evidence-Based Preeclampsia Prevention (ASPRE) trial. This was a secondary analysis of data from the ASPRE trial. In this multicenter-study women with singleton pregnancies had screening by means of an algorithm that combines maternal factors and biomarkers (mean arterial pressure, uterine-artery pulsatility index, and maternal serum pregnancy-associated plasma protein A and placental growth factor) at 11-13 weeks' gestation. Those with an estimated risk for preterm preeclampsia of >1 in 100 were invited to participate in a double-blind trial of aspirin (150 mg per day) vs. placebo from 11 to 14 until 36 weeks' gestation. Preterm preeclampsia with delivery at 90%, after adjustment for the estimated risk of preterm preeclampsia at screening and the participating center. The choice of cut-off of 90% was based on an exploratory analysis of the treatment effect. Logistic regression analysis was used to investigate predictors of compliance >90% among maternal characteristics and medical history. Preterm preeclampsia occurred in 5/555 (0.9%) participants in the aspirin group with compliance ≥90%, in 8/243 (3.3%) of participants in the aspirin group with compliance 90% and 0.59 (95% confidence interval, 0.23 to 1.53) for compliance <90%. Compliance was positively associated with family history of preeclampsia and negatively associated with smoking, maternal age <25 years, Afro-Caribbean and South Asian racial origin, and history of preeclampsia in a previous pregnancy. The beneficial effect of aspirin in the prevention of preterm preeclampsia appears to depend on compliance. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Does PGA external stenting reduce compliance mismatch in venous grafts?

    Directory of Open Access Journals (Sweden)

    Zou Liang-jian

    2007-04-01

    Full Text Available Abstract Background Autogenous vein grafting is widely used in regular bypassing procedures. Due to its mismatch with the host artery in both mechanical property and geometry, the graft often over expands under high arterial blood pressure and forms a step-depth where eddy flow develops, thus causing restenosis, fibrous graft wall, etc. External stents, such as sheaths being used to cuff the graft, have been introduced to eliminate these mismatches and increase the patency. Although histological and immunochemical studies have shown some positive effects of the external stent, the mechanical mismatch under the protection of an external stent remains poorly analyzed. Methods In this study, the jugular veins taken from hypercholesterolemic rabbits were transplanted into the carotid arteries, and non-woven polyglycolic acid (PGA fabric was used to fabricate the external stents to study the effect of the biodegradable external stent. Eight weeks after the operation, the grafts were harvested to perform mechanical tests and histological examinations. An arc tangent function was suggested to describe the relationship between pressure and cross-sectional area to analyse the compliance of the graft. Results The results from the mechanical tests indicated that grafts either with or without external stents displayed large compliance in the low-pressure range and were almost inextensible in the high-pressure range. This was very different from the behavior of the arteries or veins in vivo. The data from histological tests showed that, with external stents, collagen fibers were more compact, whilst those in the graft without protection were looser and thicker. No elastic fiber was found in either kind of grafts. Furthermore, grafts without protection were over-expanded which resulted in much bigger cross-sectional areas. Conclusion The PGA external extent contributes little to the reduction of the mechanical mismatch between the graft and its host artery

  19. Algorithm for quantifying advanced carotid artery atherosclerosis in humans using MRI and active contours

    Science.gov (United States)

    Adams, Gareth; Vick, G. W., III; Bordelon, Cassius; Insull, William; Morrisett, Joel

    2002-05-01

    A new algorithm for measuring carotid artery volumes and estimating atherosclerotic plaque volumes from MRI images has been developed and validated using pressure-perfusion-fixed cadaveric carotid arteries. Our method uses an active contour algorithm with the generalized gradient vector field force as the external force to localize the boundaries of the artery on each MRI cross-section. Plaque volume is estimated by an automated algorithm based on estimating the normal wall thickness for each branch of the carotid. Triplicate volume measurements were performed by a single observer on thirty-eight pairs of cadaveric carotid arteries. The coefficient of variance (COV) was used to quantify measurement reproducibility. Aggregate volumes were computed for nine contiguous slices bounding the carotid bifurcation. The median (mean +/- SD) COV for the 76 aggregate arterial volumes was 0.93% (1.47% +/- 1.52%) for the lumen volume, 0.95% (1.06% +/- 0.67%) for the total artery volume, and 4.69% (5.39% +/- 3.97%) for the plaque volume. These results indicate that our algorithm provides repeatable measures of arterial volumes and a repeatable estimate of plaque volume of cadaveric carotid specimens through analysis of MRI images. The algorithm also significantly decreases the amount of time necessary to generate these measurements.

  20. Mobile Source Emissions Regulatory Compliance Data

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Engine and Vehicle Compliance Certification and Fuel Economy Inventory contains measured emissions and fuel economy compliance information for all types of...

  1. Clean Air Markets - Compliance Query Wizard

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Compliance Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://ampd.epa.gov/ampd/. The Compliance module provides...

  2. Client Compliance with Homework Directives during Counseling.

    Science.gov (United States)

    Worthington, Everett L., Jr.

    1986-01-01

    Investigated compliance as a function of counselor, client, and therapy variables. Results indicated that variables associated with the conduct of counseling more strongly influenced compliance with homework than did either counselor or client variables. (Author/BL)

  3. 24 CFR 108.25 - Compliance meeting.

    Science.gov (United States)

    2010-04-01

    ... COMPLIANCE PROCEDURES FOR AFFIRMATIVE FAIR HOUSING MARKETING § 108.25 Compliance meeting. (a) Scheduling... the goals of the AFHM plan may not be achieved, or that the implementation of the Plan should...

  4. Mobile Source Emissions Regulatory Compliance Data Inventory

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Mobile Source Emissions Regulatory Compliance Data Inventory data asset contains measured summary compliance information on light-duty, heavy-duty, and non-road...

  5. ETHICS AND COMPLIANCE IN BUSINESS

    Directory of Open Access Journals (Sweden)

    ANDREESCU Nicoleta Alina

    2015-05-01

    Full Text Available In this paper, we have studied the evolution of the business ethics concept through the prism of definitions from some renowned authors in the field and through the approach model of the business ethics and by implementing it in the company level. We have found out that in the last 40 years this concept has evolved from a theoretical aspect, as well as a practical one. Companies are motivated to implement ethics and compliance programs in business so that they can manage the changes that come from society. If, until recently, all that mattered for a company was profit, in the last decades, the situation changed. In order to develop a durable business, it is essential to have a good reputation. Owning and implementing an ethics and compliance program in business has become an imperative for companies, regardless of their activity sector. The role of the compliance department becomes more pregnant in each company: the employees need safety, the existence of communication lines provides comfort. From the partners in business’ point of view, owning such a program is a necessity, a condition, and not conforming to the principles of business ethics can lead to the isolation of the company. The ethics and compliance programs in business are instruments that protect the company by implementing certain proactive identification mechanisms that ensure the development of an ethical organizational culture.

  6. Corporate compliance: implications for trustees.

    Science.gov (United States)

    Commins, K

    1998-01-01

    In this era of fraud and abuse enforcement efforts, hospital trustees are facing potential liability in the event that an investigation reveals the hospital has violated state or federal provisions pertaining to fraud and abuse. This liability can be minimized, or avoided, by ensuring that an effective compliance plan is in place prior to such an investigation.

  7. Best Practices and Simultaneous Compliance

    Science.gov (United States)

    This wrap-up presentation to the workshop covers several topics concerning how lead and copper compliance under the Lead and Copper Rule should be integrated into an overall “simultaneous compliance” framework with other organizations. The LCR requires “optimization” of lead leve...

  8. Audit-based compliance control

    NARCIS (Netherlands)

    Cederquist, J.G.; Corin, R.; Dekker, M.A.C.; Etalle, S.; Hartog, J.I. den; Lenzini, G.

    2007-01-01

    In this paper we introduce a new framework for controlling compliance to discretionary access control policies [Cederquist et al. in Proceedings of the International Workshop on Policies for Distributed Systems and Networks (POLICY), 2005; Corin et al. in Proceedings of the IFIP Workshop on Formal A

  9. Project Compliance with Enterprise Architecture

    NARCIS (Netherlands)

    Foorthuis, R.M.

    2012-01-01

    This research project set out to identify effective practices and models for working with projects that are required to comply with Enterprise Architecture (EA), and investigate the benefits and drawbacks brought about by compliance. Research methods used are canonical action research, a statistical

  10. Project Compliance with Enterprise Architecture

    NARCIS (Netherlands)

    Foorthuis, R.M.

    2012-01-01

    This research project set out to identify effective practices and models for working with projects that are required to comply with Enterprise Architecture (EA), and investigate the benefits and drawbacks brought about by compliance. Research methods used are canonical action research, a statistical

  11. Arterial Wall Properties and Womersley Flow in Fabry Disease

    Directory of Open Access Journals (Sweden)

    Dimitriadis Emilios

    2002-01-01

    Full Text Available Abstract Background Fabry disease is an X-linked recessive lysosomal storage disease resulting in the cellular accumulation of globotriaosylceramide particularly globotriaosylceramide. The disease is characterized by a dilated vasculopathy with arterial ectasia in muscular arteries and arterioles. Previous venous plethysomographic studies suggest enhanced endothelium-dependent vasodilation in Fabry disease indicating a functional abnormality of resistance vessels. Methods We examined the mechanical properties of the radial artery in Fabry disease, a typical fibro-muscular artery. Eight control subjects and seven patients with Fabry disease had a right brachial arterial line placed allowing real time recording of intra-arterial blood pressure. Real time B-mode ultrasound recordings of the right radial artery were obtained simultaneously allowing calculation of the vessel wall internal and external diameter, the incremental Young's modulus and arterial wall thickness. By simultaneously measurement of the distal index finger-pulse oximetry the pulse wave speed was calculated. From the wave speed and the internal radial artery diameter the volume flow was calculated by Womersley analysis following truncation of the late diastolic phase. Results No significant difference was found between Fabry patients and controls for internal or external arterial diameters, the incremental Young's modulus, the arterial wall thickness, the pulse wave speed and the basal radial artery blood flow. Further, no significant difference was found for the radial artery blood flow in response to intra-arterial acetylcholine or sodium nitroprusside. Both drugs however, elevated the mean arterial flow. Conclusions The current study suggests that no structural or mechanical abnormality exists in the vessel wall of fibro-muscular arteries in Fabry disease. This may indicate that a functional abnormality downstream to the conductance vessels is the dominant feature in

  12. Developing a nursing corporate compliance program.

    Science.gov (United States)

    Bartis, Janice A; Sullivan, Trent

    2002-09-01

    This article presents the process that a large urban tertiary care hospital engaged in when developing a corporate compliance program for nursing. The purpose of this article is to demonstrate how nurse executives can successfully implement a comprehensive and practical nursing corporate compliance program. This article describes in detail the 5 steps the hospital took to develop its nursing corporate compliance program and provides examples of tools to guide you in developing a nursing corporate compliance program.

  13. Compliance Study of Endovascular Stent Grafts Incorporated with Polyester and Polyurethane Graft Materials in both Stented and Unstented Zones

    Directory of Open Access Journals (Sweden)

    Ying Guan

    2016-08-01

    Full Text Available Compliance mismatch between stent graft and host artery may induce complications and blood flow disorders. However, few studies have been reported on stent graft compliance. This study aims to explore the deformation and compliance of stent graft in stented and unstented zones under three pressure ranges. Compliance of two stent grafts incorporated with polyurethane graft (nitinol-PU and polyester graft (nitinol-PET materials respectively were tested; the stents used in the two stent grafts were identical. For the circumferential deformation of the stent grafts under each pressure range, the nitinol-PET stent graft was uniform in both zones. The nitinol-PU stent graft was circumferentially uniform in the stented zone, however, it was nonuniform in the unstented zone. The compliance of the PU graft material was 15 times higher than that of the PET graft. No significant difference in compliance was observed between stented and unstented zones of the nitinol-PET stent graft regardless of the applied pressure range. However, for the nitinol-PU stent graft, compliance of the unstented PU region was approximately twice that of the stented region; thus, compliance along the length of the nitinol-PU stent graft was not constant and different from that of the nitinol-PET stent graft.

  14. Corporate compliance: framework and implementation.

    Science.gov (United States)

    Fowler, N

    1999-01-01

    The federal government has created numerous programs to combat fraud and abuse. The government now encourages healthcare facilities to have a corporate compliance program (CCP), a plan that reduces the chances that the facility will violate laws or regulations. A CCP is an organization-wide program comprised of a code of conduct and written policies, internal monitoring and auditing standards, employee training, feedback mechanisms and other features, all designed to prevent and detect violations of governmental laws, regulations and policies. It is a system or method ensuring that employees understand and will comply with laws that apply to what they do every day. Seven factors, based on federal sentencing guidelines, provide the framework for developing a CCP. First, a facility must establish rules that are reasonably capable of reducing criminal conduct. Second, high-level personnel must oversee the compliance effort. Third, a facility must use due care in delegating authority in the compliance initiative. Fourth, standards must be communicated effectively to employees, and fifth, a facility must take reasonable steps to achieve compliance. Sixth, standards must be enforced consistently across the organization and last, standards must be modified or changed for reported concerns, to ensure they are not repeated. PROMINA Health System, Inc. in Atlanta, Ga., designed a program to meet federal guidelines. It started with a self-assessment to define its areas or risk. Next, it created the internal structure and assigned organizational responsibility for running the CCP. PROMINA then developed standards of business and professional conduct, established vehicles of communication and trained employees on the standards. Finally, it continues to develop evidence of the program's effectiveness by monitoring and documenting its compliance activities.

  15. Measurement of Blood Flow in an Intracranial Artery Bypass From the Internal Maxillary Artery by Intraoperative Duplex Sonography.

    Science.gov (United States)

    Yu, Zaitao; Shi, Xiang'en; Brohi, Shams Raza; Qian, Hai; Liu, Fangjun; Yang, Yang

    2017-02-01

    This study explored the hemodynamic characteristics of a subcranial-intracranial bypass from the internal maxillary artery by measuring blood flow on intraoperative duplex sonography. The hemodynamic parameters of the internal maxillary artery (n = 20), radial artery (n = 20), internal maxillary artery-middle cerebral artery bypass (n = 42), and internal maxillary artery-posterior cerebral artery bypass (n = 9) were measured by intraoperative duplex sonography. There was no significant difference in the internal diameters of the internal maxillary and radial arteries (mean ± SD, 2.51 ± 0.34 versus 2.56 ± 0.22 mm; P = .648). The mean radial artery graft length for subcranial-intracranial bypasses was 88.5 ± 12.78 mm (95% confidence interval [CI], 80.8-90.2 mm). Internal maxillary artery-middle cerebral artery bypasses required a shorter radial artery graft than internal maxillary artery-posterior cerebral artery bypasses (77.8 ± 2.47 versus 104.8 ± 4.77 mm; P = .001). The mean flow volumes were 85.3 ± 18.5 mL/min (95% CI, 76.6-93.9 mL/min) for the internal maxillary artery, 72.6 ± 26.4 mL/min (95% CI, 64.3-80.9 mL/min) for internal maxillary artery-middle cerebral artery bypasses, and 45.4 ± 6.7 mL/min (95% CI, 40.7-50.0 mL/min) for internal maxillary artery-posterior cerebral artery bypasses. All grafts were opened after the success of the salvage procedures had been established, and the early patency rates (1 month after the operation) were 95% for internal maxillary artery-middle cerebral artery bypasses and 100% the internal maxillary artery-posterior cerebral artery bypasses. Measurement of blood flow by intraoperative sonography can be helpful in decision making and predicting graft patency and success after neurosurgical bypass procedures.

  16. 42 CFR 3.308 - Compliance reviews.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance reviews. 3.308 Section 3.308 Public... ORGANIZATIONS AND PATIENT SAFETY WORK PRODUCT Enforcement Program § 3.308 Compliance reviews. The Secretary may conduct compliance reviews to determine whether a respondent is complying with the applicable...

  17. 14 CFR 1252.400 - Compliance reviews.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Compliance reviews. 1252.400 Section 1252..., and Enforcement Procedures § 1252.400 Compliance reviews. (a) NASA may conduct compliance reviews and pre-award reviews of recipients or use other similar procedures that will permit it to investigate and...

  18. Monitoring Compliance with Open Access policies

    OpenAIRE

    Picarra, Mafalda

    2015-01-01

    In parallel to implementing Open Access policies, institutions and research funders are also engaged in developing mechanisms to monitor compliance with the existing policies. This study highlights why policy compliance must be monitored and how it can be done. A series of case studies illustrate where compliance is being effectively monitored.

  19. Tax compliance depends on voice of taxpayers

    NARCIS (Netherlands)

    Casal, Sandro; Kogler, C.; Mittone, Luigi; Kirchler, Erich

    2016-01-01

    Reducing the social distance between taxpayers and tax authorities boosts taxpayers' acceptance of tax load and tax compliance. In the present experiment participants had the opportunity to pay their tax due either as one single compliance decision or as separate compliance decisions for each type o

  20. 38 CFR 18.6 - Compliance information.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Compliance information... THE CIVIL RIGHTS ACT OF 1964 General § 18.6 Compliance information. (a) Cooperation and assistance... compliance reports at such times, and in such form and containing such information, as the responsible...

  1. 22 CFR 209.6 - Compliance information.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 209.6 Section 209.6... § 209.6 Compliance information. (a) Cooperation and assistance. The Administrator shall to the fullest... and accurate compliance reports at such times, and in such form and containing such information,...

  2. 40 CFR 503.2 - Compliance period.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance period. 503.2 Section 503.2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SEWAGE SLUDGE STANDARDS FOR THE USE OR DISPOSAL OF SEWAGE SLUDGE General Provisions § 503.2 Compliance period. (a) Compliance with the standards...

  3. Tax compliance depends on voice of taxpayers

    NARCIS (Netherlands)

    Casal, Sandro; Kogler, C.; Mittone, Luigi; Kirchler, Erich

    2016-01-01

    Reducing the social distance between taxpayers and tax authorities boosts taxpayers' acceptance of tax load and tax compliance. In the present experiment participants had the opportunity to pay their tax due either as one single compliance decision or as separate compliance decisions for each type o

  4. 40 CFR 425.05 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Compliance dates. 425.05 Section 425... STANDARDS LEATHER TANNING AND FINISHING POINT SOURCE CATEGORY General Provisions § 425.05 Compliance dates. The compliance date for new source performance standards (NSPS) and pretreatment standards for...

  5. Tools for NEPA compliance: Baseline reports and compliance guides

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, T.A. [Sandia National Labs., Albuquerque, NM (United States); Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

    1994-12-31

    Environmental baseline documents and NEPA compliance guides should be carried in every NEPA implementation ``tool kit``. These two indispensable tools can play a major role in avoiding repeated violations of NEPA requirements that have occurred over the past 26 years. This paper describes these tools, discusses their contents, and explains how they are used to prepare better NEPA documents more cost-effectively. Focus is on experience at Sandia Laboratories (NM).

  6. Coronary Artery Disease

    Science.gov (United States)

    Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death ... happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due ...

  7. Mesenteric artery ischemia

    Science.gov (United States)

    ... medlineplus.gov/ency/article/001156.htm Mesenteric artery ischemia To use the sharing features on this page, please enable JavaScript. Mesenteric artery ischemia occurs when there is a narrowing or blockage ...

  8. Occlusive Peripheral Arterial Disease

    Science.gov (United States)

    ... off and blocks an artery downstream, if blood seeps into the lining of the artery causing a ... supply to heart muscle is adequate. Exposure to cold, which causes blood vessels to narrow (constrict) and ...

  9. Short- and Long-Term Effects of Inhaled Iloprost Therapy in Children With Pulmonary Arterial Hypertension

    Science.gov (United States)

    Ivy, D. Dunbar; Doran, Aimee K.; Smith, Kelly J.; Mallory, George B.; Beghetti, Maurice; Barst, Robyn J.; Brady, Daniela; Law, Yuk; Parker, Donna; Claussen, Lori; Abman, Steven H.

    2011-01-01

    Objectives This study investigated the short- and long-term outcome of children with pulmonary arterial hypertension (PAH) treated with inhaled iloprost. Background Inhaled iloprost has been approved for the treatment of adults with PAH, but little is known about the effects in children with PAH. Methods We evaluated the acute effects of inhaled iloprost on hemodynamic status and lung function and the response to long-term therapy in 22 children (range 4.5 to 17.7 years) with PAH (idiopathic, n = 12; congenital heart disease, n = 10). Cardiac catheterization, standard lung function testing before and after iloprost inhalation, 6-min walk test, World Health Organization functional class, and hemodynamic parameters were monitored. Results Acute administration of inhaled iloprost lowered mean pulmonary artery pressure equivalent to the response to inhaled nitric oxide with oxygen. Acute iloprost inhalation reduced forced expiratory volume in 1 s and mid-volume forced expiratory flow by 5% and 10%, respectively, consistent with acute bronchoconstriction. At 6 months, functional class improved in 35%, decreased in 15%, and remained unchanged in 50% of children. Sixty-four percent of patients continued receiving long-term iloprost therapy, 36% stopped iloprost, due to lower airway reactivity, clinical deterioration, or death. In 9 patients on chronic intravenous prostanoids, 8 transitioned from intravenous prostanoids to inhaled iloprost, which continued during follow-up. Conclusions Inhaled iloprost caused sustained functional improvement in some children with PAH, although inhaled iloprost occasionally induced bronchoconstriction. Most patients tolerated the transition from intravenous to inhaled prostanoid therapy. Clinical deterioration, side effects, and poor compliance, owing to the frequency of treatments, could limit chronic treatment in children. PMID:18191742

  10. Upper limb arterial thromboembolism

    DEFF Research Database (Denmark)

    Andersen, L V; Lip, Gregory Y.H.; Lindholt, J S;

    2013-01-01

    The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF).......The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF)....

  11. Diets rich in conjugated linoleic acid and vaccenic acid have no effect on blood pressure and isobaric arterial elasticity in healthy young men

    DEFF Research Database (Denmark)

    Raff, M.; Tholstrup, T.; Sejrsen, K.

    2006-01-01

    The objective of this study was to examine the effect on blood pressure (BP) and isobaric arterial elasticity (AE), as a measure of arterial health, of a commercial mixture of conjugated linoleic acids (CLA) and of milk fat produced through livestock feeding to have a high content of vaccenic acid...... of the test diets did not differ on any outcome variable: e.g., systolic- and diastolic blood pressure (SBP and DBP), pulse pressure (PP), isobaric arterial compliance (AC), distensibility (AD), or volume (AV). In conclusion, diets rich in milk fat and either CLA or VA have no effect on BP or AE indices...... (VA). Healthy young men (n = 60) with a BMI of 22.5 +/- 2 kg/m(2) (mean +/- SD) participated in this double-blind, randomized, 5-wk, parallel intervention study. The participants substituted 115 g of their daily fat intake with fat from 1 of 3 test diets: 1) CLA-diet rich in CLA (4.7 g/d of c9, t11...

  12. Coronary Artery Bypass Surgery

    Science.gov (United States)

    In coronary artery disease (CAD), the arteries that supply blood and oxygen to your heart muscle grow hardened and narrowed. You may try ... these treatments don't help, you may need coronary artery bypass surgery. The surgery creates a new ...

  13. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

    Energy Technology Data Exchange (ETDEWEB)

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico [Dept. of Surgical and Oncological Disciplines, University of Palermo, Palermo (Italy); Anastasi, Giuseppe; Milardi, Demetrio; Favaloro, Angelo; Caradonna, Luigi; Cutroneo, Giuseppina [Biomorphology and Biotechnologies, University of Messina, Messina (Italy); De Pietro, Anita; Angileri, Tommaso Maurizio [Villa Santa Teresa, Diagnostica per Immagini, Palermo (Italy)

    2013-03-15

    The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint.

  14. Plasma volume changes during hypoglycaemia

    DEFF Research Database (Denmark)

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

    1990-01-01

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

  15. [Upper extremity arterial diseases].

    Science.gov (United States)

    Becker, F

    2007-02-01

    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  16. Modeling of the wave transmission properties of large arteries using nonlinear elastic tubes.

    Science.gov (United States)

    Pythoud, F; Stergiopulos, N; Meister, J J

    1994-11-01

    We propose a new, simple way of constructing elastic tubes which can be used to model the nonlinear elastic properties of large arteries. The tube models are constructed from a silicon elastomer (Sylgard 184, Dow Corning), which exhibits a nonlinear behavior with increased stiffness at high strains. Tests conducted on different tube models showed that, with the proper choice of geometric parameters, the elastic properties, in terms of area-pressure relation and compliance, can be similar to that of real arteries.

  17. Hipertensión arterial refractaria y uso de drogas anticonvulsivantes: Caso clínico

    OpenAIRE

    Downey C,Patricio; Fajuri N,Alejandro; Valdés S,Gloria

    2001-01-01

    Resistant arterial hypertension is uncommon when there is good compliance to antihypertensive therapy and secondary causes have been ruled out. We report a 41 years old male that suffered hypertensive encephalopathy and received prophylactic anticonvulsant therapy showing progressive raise of arterial pressure levels. Renovascular hypertension, aldosteronism and pheochromocytoma were discarded and, in spite of combined use of antihypertensive drugs, he did not achieve normal blood pressure. W...

  18. An object-oriented modelling framework for the arterial wall.

    Science.gov (United States)

    Balaguera, M I; Briceño, J C; Glazier, J A

    2010-02-01

    An object-oriented modelling framework for the arterial wall is presented. The novelty of the framework is the possibility to generate customizable artery models, taking advantage of imaging technology. In our knowledge, this is the first object-oriented modelling framework for the arterial wall. Existing models do not allow close structural mapping with arterial microstructure as in the object-oriented framework. In the implemented model, passive behaviour of the arterial wall was considered and the tunica adventitia was the objective system. As verification, a model of an arterial segment was generated. In order to simulate its deformation, a matrix structural mechanics simulator was implemented. Two simulations were conducted, one for an axial loading test and other for a pressure-volume test. Each simulation began with a sensitivity analysis in order to determinate the best parameter combination and to compare the results with analogue controls. In both cases, the simulated results closely reproduced qualitatively and quantitatively the analogue control plots.

  19. Volume Entropy

    CERN Document Server

    Astuti, Valerio; Rovelli, Carlo

    2016-01-01

    Building on a technical result by Brunnemann and Rideout on the spectrum of the Volume operator in Loop Quantum Gravity, we show that the dimension of the space of the quadrivalent states --with finite-volume individual nodes-- describing a region with total volume smaller than $V$, has \\emph{finite} dimension, bounded by $V \\log V$. This allows us to introduce the notion of "volume entropy": the von Neumann entropy associated to the measurement of volume.

  20. Transradial artery coronary angioplasty.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G J; de Melker, E

    1995-01-01

    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. 心外膜脂肪体积与冠状动脉粥样硬化及左心室舒张功能的相关性研究%Association of epicardial adipose tissue volume with coronary artery atherosclerosis and left ventricular diastolic function

    Institute of Scientific and Technical Information of China (English)

    张福庄; 赵怡; 陶红; 王永梅; 王文川; 高秀莹; 袁仙仙; 李彭; 张兆琪; 周迎生

    2012-01-01

    Objective;To measure epicardial adipose tissue (EAT) volume by the three-dimensional volume-rendering reconstruction technique of dual-source 64 slice computed tomography, and then explore the correlations of ETA volume with the severity of coronary artery atherosclerosis, the coronary artery vulnerable plaques and the diastolic function of left ventricular. Methods: Dual-source 64 slice computed tomography was performed in 131 consecutive patients with suspected coronary artery disease (CAD) (93 males and 38 females). The ages ranged from 37 to 79 years with a mean ± standard deviation (SD) of (56 ± 10) years. For each patient, body mass index ( BMI) , waist circumference (WC) and blood biochemical parameters were measured. Transthoracic echocardiographic examination was performed to assess the left ventricular diastolic function. EAT volume was determined by cardiac fat software on a workstation (Vitrea FX, Vital Images). Percutaneous coronary angiography was applied to confirm CAD in patients and assess the severity of coronary ath-erosclerosis. Results; (1) The volume of EAT in patients with CAD (n = 63) was higher than that in patients without CAD (n =68) (P =0. 003). (2) The volume of EAT was significantly higher in patients with three-vessel lesion (P<0.05). (3) EAT volume was significantly larger in patients with non-calcified plaque compared to that in those with calcified plaque or no plaque (all P <0. 001). (4) EAT volume was positively correlated with WC and BMI ( r = 0.475 ,P <0.001; r = 0. 386 ,P < 0. 001). After adjusting for confounding risk variables by logistic regression analysis, EAT volume was found as an independent predictor of CAD (odds ratio = 1.018,95% confidence interval 1.004-1.033, P=0.011). (5) EAT volume increased in patients with left ventricular diastolic dysfunction (P < 0. 05 ). EAT volume was positively correlated with left ventricular internal diameter in diastole ( LVIDd) and interventricular septum thickness (IVSDd

  2. Empirical description of bronchial and nonbronchial arteries with MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Yu Hong, E-mail: yuhong.2002@hotmail.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Liu Shiyuan, E-mail: cjr.liushiyuan@vip.163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Li Huimin, E-mail: yuhongphd@163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Xiao Xiangsheng, E-mail: cjr.xxsh@vip.163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China); Dong Weihua, E-mail: dongweihua2000@163.co [Department of Imageology, Changzheng hospital, Second Military Medical University, Shanghai 200003 (China)

    2010-08-15

    Purpose: We aimed to retrospectively evaluate bronchial and nonbronchial systemic arteries using multi-detector row helical computed tomographic (MDCT) angiography in patients with pulmonary disorders. Materials and Methods: Thirty-nine patients (24 men, 15 women; mean age, 63.4 years; range, 20-82 years) with congenital and acquired pulmonary disorders of the bronchial and nonbronchial systemic arteries underwent multi-detector row helical computed tomographic angiography of the thorax using a 16-detector row scanner. Each of these patients had experienced an episode of hemoptysis. Computed tomographic angiogram data, which included maximum intensity projections, multiplanar reconstruction, and three-dimensional volume-rendered images, were used to retrospectively analyse the characteristics of the bronchial and nonbronchial systemic arteries. Results: We identified a total of 128 bronchial arteries (76 on the right side and 52 on the left) in 39 patients. We detected 42 nonbronchial systemic artery branches, including 19 internal mammary artery branches, 8 subclavian artery branches, 8 inferior phrenic artery branches, 5 intercostal artery branches, 1 thyrocervical trunk branch, and 1 celiac trunk branch. Thirty-five dilated and tortuous nonbronchial systemic arteries entered into the lung parenchyma and extended down to the lesions. Every case, except the one case of sequestration, was associated with pleural thickening where the vascular structures passed through the extrapleural fat. Conclusions: The variations in both the bronchial artery anatomy and the location and type of the nonbronchial arteries were great. Nonbronchial arteries may be a significant source of hemoptysis. MDCT angiography can be used to detect detailed anatomical information about the origins and courses of bronchial and nonbronchial systemic arteries and their pathophysiologic features.

  3. Carotid artery stenting will replace carotid endarterectomy.

    Science.gov (United States)

    McCormick, Daniel J; Vlad, Tudor; Fasseas, Panayotis

    2007-09-01

    Stroke is the third leading cause of death in the United States. Carotid artery stenosis represents one of the most common etiologies of stroke. The current treatment modalities available for the treatment of carotid artery stenosis are carotid endarterectomy (CEA) and carotid artery stenting (CAS). Several clinical trials comparing CEA with medical management showed superiority of the surgical arm; however, the applicability of these results to the general population is limited by the fact that the patients and surgeons enrolled in these trials were carefully selected, and the optimal medical therapy used does not meet the current treatment standards. Carotid artery stenting has emerged as a treatment alternative to CEA, as shown in randomized trials comparing the 2 treatment modalities. Recent data from large-volume CAS registries indicate that percutaneous treatment of carotid artery stenosis compares favorably to CEA. Furthermore, the CAS trial designs make these results more applicable to the community standards. These data suggest that CAS will become the treatment of choice in patients with carotid artery stenosis.

  4. 冠心病合并2型糖尿病患者平均血小板体积的相关性研究%Mean platelet volume in patients with type 2 diabetes mellitus and coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    许文亮; 池一凡; 武越; 王旭; 邵一兵

    2013-01-01

    冠心病合并2型糖尿病患者平均血小板体积(MPV)显著升高.急性冠脉综合征、多支病变、肥胖、既往糖尿病和HbA1C高值(>7%)者MPV升高更显著.冠脉病变积分、空腹血糖、高密度脂蛋白胆固醇和HbA1C是MPV的独立影响因素.%Mean platelet volume (MPV) in patients with type 2 diabetes mellitus (DM) and coronary artery disease was increased significantly.In those with acute coronary syndrome,multi-vascular disease,obesity,and highvalue of HbA1C(>7%),the MPV was much higher.Gisini coronary score,fasting blood glucose,high density lipoprotein cholesterol and HbA1C were the independent predictors of MPV in patients with DM and coronary artery disease.

  5. 40 CFR Table 6 to Subpart Dddd of... - Initial Compliance Demonstrations for Work Practice Requirements

    Science.gov (United States)

    2010-07-01

    ... Composite Wood Products Pt. 63, Subpt. DDDD, Table 6 Table 6 to Subpart DDDD of Part 63—Initial Compliance... § 63.2263). (2) Hardwood veneer dryer Process less than 30 volume percent softwood species You meet the... that the dryer meets the criteria of a “hardwood veneer dryer” AND you have a record of the...

  6. Acute occlusion of the left subclavian artery with artery dissection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Subclavian steal syndrome is cerebral or brain stem ischemia resulting from diversion of blood flow from the basilar artery to the subclavian artery, which is caused by occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. In the patients with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.

  7. Compliance management and corporate governance; Compliance Management und Corporate Governance

    Energy Technology Data Exchange (ETDEWEB)

    Becker, Uwe [Stadt Frankfurt am Main (Germany); Alsheimer, Constantin; Kassebohm, Kristian; Reutler, Susanne [Mainova AG, Frankfurt (Germany)

    2009-08-15

    Starting in the year 2009, numerous changes in the financial system and accountancy a well as in the corporate law come into effect for enterprises. Thereby, the requirements substantially are intensified to their corporate governance. The actual well-known reproaches of bribery, corruption and injuries of data protection intensify the pressure on executive committees and supervisory boards in order to meet normative and ethical requirements. All the more is valid for power suppliers whose reputation can already carry damage out with the first suspicion. Already in 2008, Mainova AG (Frnkfurt/Main, Federal Republic of Germany) implemented a compliance management.

  8. Arterial Windkessels in marine mammals.

    Science.gov (United States)

    Shadwick, R E; Gosline, J M

    1995-01-01

    In marine mammals, the aortic arch is enlarged relative to the descending aorta to varying degrees in different species. The ratio of maximal diameter of the arch to that of the thoracic aorta is about 2.3 in the harbour seal (Phoca vitulina), 3.6 in the Weddell seal (Leptonychotes weddelli) and 3.2 in the fin whale (Balaenoptera physalus), compared with only 1.4 in the dog. This anatomical specialisation probably provides increased volume capacitance in the arterial circulation as an adaptation to diving bradycardia. Data on the morphometric and mechanical properties of aortic tissues from seals and fin whale are compared. In the harbour seal, more than 80% of the volume change in the entire thoracic aorta that results from a pressure pulse occurs in the bulbous arch, and this is more than 90% in the Weddell seal and fin whale. The enhanced capacitance of the arch in the harbour seal is primarily due to its larger diameter, as the relative wall thickness and elasticity of the arch and thoracic aorta are the same. A similar situation appears to exist in the larger Weddell seal, although extrapolation of the pressure-volume curves suggests that the arch might be somewhat less stiff than the thoracic aorta. In addition to being greatly expanded, the aortic arch of the fin whale is also much more distensible than the relatively thin-walled and much stiffer descending aorta. At the estimated mean blood pressure, the elastic modulus of this vessel is 12 MPa, or 30 times that of the aortic arch. The major haemodynamic consequence of this type of arterial modification is that the aortic arch acts as a Windkessel, i.e. the capacitance of the aorta is increased significantly close to the heart, leading to a reduced characteristic impedance and probably reduced pulsatility in the descending aorta. In the extreme case of the whale, the arterial capacitance is shifted entirely to the arch, and the impedance change at the entrance to the thoracic aorta is so high that this

  9. Arterial pulse wave velocity, inflammatory markers, pathological GH and IGF states, cardiovascular and cerebrovascular disease

    Directory of Open Access Journals (Sweden)

    Michael R Graham

    2008-12-01

    Full Text Available Michael R Graham1, Peter Evans2, Bruce Davies1, Julien S Baker11Health and Exercise Science Research Unit, Faculty of Health Sport and Science, University of Glamorgan, Pontypridd, Wales, United Kingdom; 2Royal Gwent Hospital, Newport, Gwent, United KingdomAbstract: Blood pressure (BP measurements provide information regarding risk factors associated with cardiovascular disease, but only in a specific artery. Arterial stiffness (AS can be determined by measurement of arterial pulse wave velocity (APWV. Separate from any role as a surrogate marker, AS is an important determinant of pulse pressure, left ventricular function and coronary artery perfusion pressure. Proximal elastic arteries and peripheral muscular arteries respond differently to aging and to medication. Endogenous human growth hormone (hGH, secreted by the anterior pituitary, peaks during early adulthood, declining at 14% per decade. Levels of insulin-like growth factor-I (IGF-I are at their peak during late adolescence and decline throughout adulthood, mirror imaging GH. Arterial endothelial dysfunction, an accepted cause of increased APWV in GH deficiency (GHD is reversed by recombinant human (rh GH therapy, favorably influencing the risk for atherogenesis. APWV is a noninvasive method for measuring atherosclerotic and hypertensive vascular changes increases with age and atherosclerosis leading to increased systolic blood pressure and increased left ventricular hypertrophy. Aerobic exercise training increases arterial compliance and reduces systolic blood pressure. Whole body arterial compliance is lowered in strength-trained individuals. Homocysteine and C-reactive protein are two infl ammatory markers directly linked with arterial endothelial dysfunction. Reviews of GH in the somatopause have not been favorable and side effects of treatment have marred its use except in classical GHD. Is it possible that we should be assessing the combined effects of therapy with rhGH and rh

  10. Estimation of beat-to-beat changes in stroke volume from arterial pressure: A comparison of two pressure wave analysis techniques during head- up tilt testing in young, healthy men

    NARCIS (Netherlands)

    Jellema, W.T.; Imholz, B.P.M.; Oosting, H.; Wesseling, K.H.; Lieshout, J.J. van

    1999-01-01

    Objective: The aim of this study was to compare beat-to-beat changes in stroke volume (SV) estimated by two different pressure wave analysis techniques during orthostatic stress testing: pulse contour analysis and Modelflow, ie, simulation of a three-element model of aortic input impedance. Methods:

  11. Bilateral accessory thoracodorsal artery.

    Science.gov (United States)

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis

    2006-09-01

    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  12. New therapies for arterial hypertension.

    Science.gov (United States)

    Pagliaro, Beniamino; Santolamazza, Caterina; Rubattu, Speranza; Volpe, Massimo

    2016-03-01

    Arterial hypertension is the most common chronic disease in developed countries and it is the leading risk factor for stroke, ischemic heart disease, congestive heart failure, chronic renal failure and peripheral artery disease. Its prevalence appears to be about 30-45% of the general population. Recent European guidelines estimate that up to 15-20% of the hypertensive patients are not controlled on a dual antihypertensive combination and they require three or more different antihypertensive drug classes to achieve adequate blood pressure control. The guidelines confirmed that diuretics, beta-blockers, calcium-channel blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are suitable for the initiation and maintenance of antihypertensive treatment, either as monotherapy or in combination therapy. Very few antihypertensive agents have reached the market over the last few years, but no new therapeutic class has really emerged. The long-term adherence to cardiovascular drugs is still low in both primary and secondary prevention of cardiovascular diseases. In particular, the issue of compliance is persistently high in hypertension, despite the fixed-dose combination therapy. As a consequence, a cohort of high-risk hypertensive population, represented by patients affected by refractory and resistant hypertension, can be identified. Therefore, the need of controlling BP in high-risk patients may be addressed, in part, by the development of new drugs, devices and procedures that are designed to treat hypertension and comorbidities. In this review we will comprehensively discuss the current literature on recent therapeutic advances in hypertension, including both medical therapy and interventional procedures.

  13. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication

    Directory of Open Access Journals (Sweden)

    Chang Kyu Sung

    2016-01-01

    Full Text Available Purpose: The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI by using an electrical circuit model to simulate renal blood flow. Methods: In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoff’s current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Results: Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. Conclusion: This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings.

  14. Factors influencing the renal arterial Doppler waveform: a simulation study using an electrical circuit model (secondary publication)

    Energy Technology Data Exchange (ETDEWEB)

    Sung, Chang Kyu [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul (Korea, Republic of); Han, Bong Soo [Dept. of Radiological Science, College of Health Science, Yonsei University, Wonju (Korea, Republic of); Kim, Seung Hyup [Dept. of Radiology, Institute of Radiation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    The goal of this study was to evaluate the effect of vascular compliance, resistance, and pulse rate on the resistive index (RI) by using an electrical circuit model to simulate renal blood flow. In order to analyze the renal arterial Doppler waveform, we modeled the renal blood-flow circuit with an equivalent simple electrical circuit containing resistance, inductance, and capacitance. The relationships among the impedance, resistance, and compliance of the circuit were derived from well-known equations, including Kirchhoff’s current law for alternating current circuits. Simulated velocity-time profiles for pulsatile flow were generated using Mathematica (Wolfram Research) and the influence of resistance, compliance, and pulse rate on waveforms and the RI was evaluated. Resistance and compliance were found to alter the waveforms independently. The impedance of the circuit increased with increasing proximal compliance, proximal resistance, and distal resistance. The impedance decreased with increasing distal compliance. The RI of the circuit decreased with increasing proximal compliance and resistance. The RI increased with increasing distal compliance and resistance. No positive correlation between impedance and the RI was found. Pulse rate was found to be an extrinsic factor that also influenced the RI. This simulation study using an electrical circuit model led to a better understanding of the renal arterial Doppler waveform and the RI, which may be useful for interpreting Doppler findings in various clinical settings.

  15. Internal compliance investigations can reduce government sanctions.

    Science.gov (United States)

    Mustokoff, M M; Yecies, M S

    1997-10-01

    An effective corporate compliance program is facilitated by three essential elements: a well-qualified compliance officer; a policy of immediate investigation of every report of potential fraud and abuse; and clearly defined roles for both corporate and outside counsel in conducting the investigations. A government agency is less likely to exercise the full extent of its powers when these elements are in place and three is evidence of a sincere compliance effort.

  16. Active Compliance And Damping In Telemanipulator Control

    Science.gov (United States)

    Kim, Won S.; Bejczy, Antal K.; Hannaford, Blake

    1991-01-01

    Experimental telemanipulator system of force-reflecting-hand-controller type provides for active compliance and damping in remote, robotic manipulator hand. Distributed-computing and -control system for research in various combinations of force-reflecting and active-compliance control regimes. Shared compliance control implemented by low-pass-filtered force/torque feedback. Variable simulated springs and shock absorbers soften collisions and increase dexterity.

  17. Monitoring managers through corporate compliance programs

    OpenAIRE

    Angelucci, C.; Han, M.A.

    2010-01-01

    Compliance programs entail monitoring of employees' behavior with the claimed objective of fighting corporate crime. (Competition) Authorities promote such intra-firm monitoring. In a three-tier hierarchy model, authority-shareholder-manager, we study the impact of monitoring through a compliance program on contracting within the firm and the authority's optimal sanctions and leniency policy. We find that compliance programs are beneficial in the fight against corporate crime if and only if t...

  18. Federal government expands compliance initiatives.

    Science.gov (United States)

    Dugan, J K

    1997-09-01

    In 1995, the Federal government initiated Operation Restore Trust to increase enforcement of fraud and abuse regulations in Medicare and Medicaid programs. With the success of the original initiative, the government is expanding the project to additional states and program areas. The initial scrutiny of home health agencies, nursing homes, hospice care, and durable medical equipment is being expanded to managed care plans and acute care hospitals with an eye toward DRG creep. To manage this increased enforcement activity, healthcare organizations should institute comprehensive corporate compliance programs. Such programs should provide a framework that delineates responsibilities and provides a systematic means to resolve issues in a timely manner.

  19. Strategies for Addressing Spreadsheet Compliance Challenges

    CERN Document Server

    Weber, Brandon

    2006-01-01

    Most organizations today use spreadsheets in some form or another to support critical business processes. However the financial resources, and developmental rigor dedicated to them are often minor in comparison to other enterprise technology. The increasing focus on achieving regulatory and other forms of compliance over key technology assets has made it clear that organizations must regard spreadsheets as an enterprise resource and account for them when developing an overall compliance strategy. This paper provides the reader with a set of practical strategies for addressing spreadsheet compliance from an organizational perspective. It then presents capabilities offered in the 2007 Microsoft Office System which can be used to help customers address compliance challenges.

  20. EPA Enforcement and Compliance History Online

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Environmental Protection Agency's Enforcement and Compliance History Online (ECHO) website provides customizable and downloadable information about environmental...

  1. Compliance with Corporate Governance Principles: Australian Evidence

    National Research Council Canada - National Science Library

    Maryam Safari; Soheila Mirshekary; Victoria Wise

    2015-01-01

      This study investigates the association between the level of compliance of Australian listed companies with Australian corporate governance principles, in aggregate, and the level of discretionary...

  2. Theory of Regulatory Compliance for Requirements Engineering

    CERN Document Server

    Jureta, Ivan; Mylopoulos, John; Perini, Anna; Susi, Angelo

    2010-01-01

    Regulatory compliance is increasingly being addressed in the practice of requirements engineering as a main stream concern. This paper points out a gap in the theoretical foundations of regulatory compliance, and presents a theory that states (i) what it means for requirements to be compliant, (ii) the compliance problem, i.e., the problem that the engineer should resolve in order to verify whether requirements are compliant, and (iii) testable hypotheses (predictions) about how compliance of requirements is verified. The theory is instantiated by presenting a requirements engineering framework that implements its principles, and is exemplified on a real-world case study.

  3. Quantificação volumétrica da hiperplasia neointimal em artérias ilíacas após implante de suporte intravascular metálico Volumetric assessment of neointimal hyperplasia in iliac arteries after metal stent implantation

    Directory of Open Access Journals (Sweden)

    Samuel Martins Moreira

    2009-08-01

    Full Text Available OBJETIVO: Quantificar a hiperplasia neointimal em artérias ilíacas após stent, correlacionando fatores clínicos, arteriais e materiais dos stents. MATERIAIS E MÉTODOS: De junho de 2003 a agosto de 2005, 60 pacientes realizaram angioplastia transluminal percutânea e stent. Desses, 30 foram reestudados com ultrassonografia intravascular. Os dados foram analisados no laboratório de análise quantitativa. RESULTA-DOS: Dezesseis pacientes eram do sexo masculino (53,3% e 14 (46,7%, do sexo feminino. A média de idade foi de 60,3 anos. Apresentaram hipertensão arterial 22 pacientes (73,3%, tabagismo, 18 (62,1%, hiperlipidemia, 20 (66,7%, e diabetes, 9 (30%. Foram implantados 20 stents de nitinol (66,7% e 10 de aço inoxidável (33,3%. Quatro pacientes eram TASC A (13,3%, 15 eram TASC B (50% e 11, TASC C (36,7%. O volume da hiperplasia variou de 49,02 mm³ a 112,87 mm³ (média de 80,33 mm³. O percentual de obstrução intra-stent variou de 18% a 47% (média de 27,4%. Os resultados clínicos obtidos com stent se mantiveram até o reestudo. CONCLUSÃO: A hiperplasia neointimal sempre ocorre após a angioplastia transluminal percutânea e stent, porém os percentuais de obstrução não foram superiores a 50% em nenhum caso. Não houve diferença estatisticamente significante dos percentuais de obstrução intra-stent quanto aos materiais dos stents, aos fatores clínicos e aos fatores arteriais.OBJECTIVE: To quantify neointimal hyperplasia in iliac arteries after stent implantation, correlating clinical, arterial factors and stent material. MATERIALS AND METHODS: In the period from June/2003 to August/ 2005, 60 patients were submitted to percutaneous transluminal angioplasty and stenting. Among these patients, 30 were followed-up with intravascular ultrasonography. Data were analyzed in a laboratory of quantitative analysis by means of a specific software. RESULTS: Sixteen (53.3% patients were men, and 14 (46.7%, women, and the mean age was 60

  4. Structural-and-functional alterations in the arterial wall and clinical manifestations of nonspecific aortoarteritis.

    Science.gov (United States)

    Pokrovskiĭ, A V; Kuntsevich, G I; Zotikov, E A; Burtseva, E A; Kulbak, V A

    2009-01-01

    The authors studied structural-and-functional properties of the arterial wall, also assessing elastic properties of the common femoral artery and the brachial artery flow-dependent dilatation (FDD) index in a total of thirty-six patients presenting with nonspecific aortoarteritis (NAA). The overwhelming majority of the patients, i. e., twenty-four (89%), showed a statistically significant decrease in the FDD as compared with the control-group patients (P<0.05). We revealed a statistically reliable (P=0.0005) inverse correlation between the level of systolic arterial pressure and an increase in the rigidity index of the common femoral artery wall. Also determined was a correlation of the femoral artery wall rigidity (systolic AP equalling 140 mm Hg and higher) and the brachial artery flow-dependent dilatation index (r=-0.61). All the patients suffering from non-specific aortoarteritis were diagnosed as having a decrease in the elasticity values, accompanied by an increase in systolic arterial pressure (r=0.36; P=0.07). Comparing the level of systolic arterial pressure with the values of the distensibility coefficient and compliance coefficient revealed a weak inverse correlation (r=-0.28 and 0.21, respectively). Evaluating the impact of duration of the disease on the distensibility coefficient, compliance coefficient and the rigidity index made it possible to detect a statistically significant (P=0.0039) direct correlation between the rigidity index and the duration of non-specific aortoarteritis. To a leaser degree, the duration of the inflammatory process influenced the distensibility coefficient and compliance coefficient (r=-0.28; r=-0.30, respectively; P=0.06).

  5. Postoperative volume balance

    DEFF Research Database (Denmark)

    Frost, H; Mortensen, C.R.; Secher, Niels H.

    2017-01-01

    In healthy humans, stroke volume (SV) and cardiac output (CO) do not increase with expansion of the central blood volume by head-down tilt or administration of fluid. Here, we exposed 85 patients to Trendelenburg's position about one hour after surgery while cardiovascular variables were determined...... non-invasively by Modelflow. In Trendelenburg's position, SV (83 ± 19 versus 89 ± 20 ml) and CO (6·2 ± 1·8 versus 6·8 ± 1·8 l/min; both Pheart rate (75 ± 15 versus 76 ± 14 b min(-1) ) and mean arterial pressure were unaffected (84 ± 15 versus 84 ± 16 mmHg). For the 33 patients......, determination of SV and/or CO in Trendelenburg's position can be used to evaluate whether a patient is in need of IV fluid as here exemplified after surgery....

  6. Immunoglobulin E anaphylaxis in rabbits: mechanisms of pulmonary resistance and compliance changes.

    Science.gov (United States)

    Habib, M P; Dunn, A M; Sobonya, R E; Baumgartener, C C; Newell, J D; Halonen, M

    1988-03-01

    Factors causing changes in pulmonary resistance and dynamic compliance with immunoglobulin (Ig) E anaphylaxis in spontaneously breathing rabbits were assessed in ventilated rabbits using tantalum bronchography and wet-to-dry wt ratios. Ventilated rabbits demonstrated changes in resistance and compliance similar to spontaneously breathing rabbits. Chlorpheniramine pretreatment prevented increases in resistance but not decreases in compliance. Anaphylaxis constricted small (less than 1 mm) airways 20.9 +/- 16.0% (mean +/- SD) and intermediate (between 1 and 3 mm) airways 21.8 +/- 19.8%. Chlorpheniramine (10 mg/kg) prevented small airway changes and attenuated those in intermediate airways. Chlorpheniramine prevented histamine-induced constriction of small (23.6 +/- 15.7%) and intermediate (17.6 +/- 15.0%) airways. Lung wet-to-dry wt ratios were unchanged. Changes in resistance and compliance during rabbit IgE anaphylaxis are not due to changes in tidal volume or frequency. Histamine, via H1 receptors, is the principal mediator of pulmonary resistance increases but not dynamic compliance reductions. Chlorpheniramine-sensitive increases in resistance are caused by constrictions of intermediate and small airways, whereas the chlorpheniramine-resistant decrease in compliance is not caused directly by constriction of the smallest measurable airways (0.25 mm) or changes in lung water.

  7. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P

    2010-01-01

    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  8. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan

    2013-01-01

    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  9. 40 CFR 160.12 - Statement of compliance or non-compliance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Statement of compliance or non-compliance. 160.12 Section 160.12 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... non-compliance. Any person who submits to EPA an application for a research or marketing permit...

  10. The blood pressure variability, arterial elasticity and humoral factors in subjects with family history of hypertension.

    Science.gov (United States)

    Rafidah, H M; Azizi, A; Suhaimi, H; Noriah, M N

    2008-03-01

    Normotensive subjects with family history of hypertension (FHT) have been reported to have increased left ventricular mass index and reduced ventricular compliance. Of interest is whether blood pressure variability (BPV), which has been associated with target organ damage, is then part of this complex inherited syndrome? The objectives of this study are to determine whether there are any significant differences in BPV, arterial compliance and humoral factors in subjects with FHT as compared to controls. Thirty-five subjects with self reported FHT and 35 matched controls underwent 24 hour BP monitoring (BR-102, Schiller Inc. Germany). Arterial compliance was measured using systolic pulse wave tonometry (HDI/Pulsewave Cardiovascular Profiling Instrument, Hypertension Diagnostic Inc. USA). None of the subjects were hypertensive or diabetic. Out of these numbers, 25 subjects with FHT and 26 controls had measurements of plasma catecholamines, plasma renin and serum aldosterone. Catecholamines were assayed with high performance liquid chromatography, while both renin and aldosterone measurements were by radioimmunoassay. Subjects with FHT have higher night time BPV. There was no significant difference in arterial compliances between both groups. There were increased level of norepinephrine (NE) in subjects with FHT but epinephrine (E), renin and aldosterone levels were similar in both groups. There were no correlations between NE and BPV but E was negatively associated with daytime and mean arterial systolic BPV. In conclusion subjects with FHT demonstrated a higher night time BPV and NE level as compared to controls.

  11. Practical issues in medication compliance in hypertensive patients

    Directory of Open Access Journals (Sweden)

    Krzesinski J

    2011-06-01

    Full Text Available Jean-Marie Krzesinski1, Marc Leeman21Nephrology Transplantation Department, Domaine Universitaire, Liège, Belgium; 2Department of Internal Medicine and Hypertension Clinic, Erasme University Hospital, Brussels, BelgiumAbstract: Unsatisfactory compliance in the treatment of high blood pressure is frequently due to sequential barriers, such as insufficient patient education about the illness and low motivation to receive any treatment, existence of a large gap between physicians' perceptions of the problem and clinical reality, complexity of the treatment potentially generating adverse effects, and a health care environment with few public education campaigns and incentives for better coordinated supportive care. In order to improve drug compliance, establishment of personalized plans adapted to each patient is required. First, a good doctor–patient relationship is mandatory, with regular education of the patient about hypertension and its risks, discussion about adverse drug effects, and the complexity and cost of treatment. Second, to have any chance of success, the provider should offer convenient appointments and tailor the treatment regimen to the patient's lifestyle and needs, with written instructions. Third, there is a need to promote active patient collaboration with treatment. An innovative combination of home self-measurement of blood pressure, use of new technology options, eg, texting or telemedicine, and creation of a multidisciplinary working team can offer new, effective opportunities. This approach could reduce cardiovascular complications by improving the control of high blood pressure, and thereby the overall costs of hypertension to the health care system.Keywords: arterial hypertension, therapeutic adherence, drug compliance, persistence

  12. Oral contraceptive compliance during adolescence.

    Science.gov (United States)

    Serfaty, D

    1997-06-17

    A review of the available literature suggests that adolescent lack of compliance with oral contraceptives (OCs) is a multifactorial problem that requires a multifactorial solution. Because of their lack of experience with contraception, higher frequency of intercourse, higher intrinsic fertility, and pattern of frequent stopping or switching of methods, adolescents experience higher OC failure rates than do adult women. Adolescents also are more likely to forget to take the pill or to discontinue due to side effects, without consulting their physician. A survey of European young women identified contraceptive protection without weight gain as the most necessary change in OCs. Adolescents must be counseled not to miss a single pill, observe the pill-free interval, take phasic formulations in the right order, and use a back-up method in case of diarrhea and vomiting or when certain medications (e.g., antibiotics and anti-epileptics) are used concurrently, and be informed of steps to take in the event of side effects and unprotected intercourse. The quality of the counseling appears to be more important to compliance than the quantity of information provided. Pharmacists should complete the counseling initiated by the physician and explain prescription use. The most significant predictor of consistent OC use is the adolescent's motivation.

  13. Explaining G20 and BRICS Compliance

    Directory of Open Access Journals (Sweden)

    Marina Larionova

    2016-11-01

    Full Text Available This article explores the internal and external factors influencing the compliance performance of the Group of 20 (G20 and the BRICS. The authors start with an overview of the G20 and BRICS compliance patterns using comparative data onthe number of commitments made by the two institutions, the level of institutional compliance, and distribution of commitments and compliance across issue areas. G20 compliance is traced since the leaders’ first 2008 summit in Washington. The BRICS compliance performance record includes data since the third stand alone summit in Sanya in 2011.The study then takes stock of compliance catalysts embedded in the summits’ discourse: priority placements, numerical targets, timelines, self-accountability pledges and mandates to implement and/or monitor implementation. The authors review trends in the use of catalysts in different years and issue areas and identify commonalities and differences.The analysis then turns to external causes of compliance and focuses on demand for collective actions and members’ collective power to respond and deliver on their pledges. Here the study explores whether the self-accountability mechanisms created by the institutions in response to the demand for effectiveness and legitimacy facilitate compliance.The article concludes by highlighting catalysts, causes of compliance and their combinations with the greatest power to encourage implementation, explaining trends in G20 and BRICS compliance performance. The data sets on G20 and BRICS differ in terms of scale. The G20 data set contains 1,511 commitments of which 114 have been monitored, and the BRICS data set contains 231 commitments of which 23 have been monitored.

  14. Directory of certificates of compliance for radioactive materials packages

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The purpose of this directory is to make available a convenient source of information on packagings approved by the U.S. Nuclear Regulatory Commission. To assist in identifying packaging, an index by Model Number and corresponding Certificate of Compliance Number is included at the front of Volumes 1 and 2. An alphabetical listing by user name is included in the back of Volume 3 for approved Quality Assurance programs. The reports include a listing of all users of each package design and approved Quality Assurance programs prior to the publication date of the directory. Comments to make future revisions of this directory more useful are invited and should be directed to the Spent Fuel Project Office, U.S. Nuclear Regulatory Commission.

  15. 320排动态容积CT冠状动脉成像在川崎病冠状动脉瘤远期随访中应用%Application of 320-detector row dynamic volume CT angiography in follow up of coronary artery aneurysms caused by Kawasaki disease

    Institute of Scientific and Technical Information of China (English)

    刘俊; 于明华; 许开元; 向峰; 周乾潮

    2015-01-01

    目的:探讨320排动态容积CT冠状动脉成像(CTA)及经胸超声心动图(TTE)对川崎病(KD)合并冠状动脉瘤(CAA)中远期随访的应用价值。方法采用320排CTA、TTE进行中远期追踪随访8例KD合并CAA患儿。结果8例患儿平均发病年龄(41.63±22.70)月,随访时间(43.50±10.99)月。急性期TTE诊断冠状动脉巨大瘤(GCAA)3例,中小瘤5例,共累及冠状动脉16/32支(50.0%)。随访观察终点时TTE示GCAA 3例及中小瘤2例仍存在,另3例小瘤消退,仍累及冠状动脉6/32支(18.6%)。随访观察终点时320排CTA检查示累及冠状动脉7/32支(21.9%),分布部位与TTE基本一致;另发现左回旋支扩张1例,右冠状动脉(RCA)远段GCAA 1处、血栓2处、狭窄1处、钙化2处。结论KD引起的CAA可长期存在, GCAA后期可发生冠状动脉血栓、狭窄或钙化。TTE观察近中段冠脉改变敏感可靠,但对于中远段冠脉损害的观察有局限性。320排CTA能较全面地观察各支冠状动脉的病变,尤其对急性期后冠状动脉血栓,钙化及近、远端狭窄的观察敏感可靠。%ObjectiveTo assess the values of 320-detector row dynamic volume CT angiography (CTA) and transthoracic echocardiography (TTE) in follow up of coronary artery aneurysm (CAA) caused by Kawasaki disease (KD).Methods320-de-tector row CTA and TTE were applied in long-term follow-up of 8 patients with CAA caused by KD.ResultsIn 8 patients, the mean age at onset was 41.63±22.70 months and the mean follow up time was 43.50±10.99 months. In acute phase, 3 cases of giant coronary artery aneurysms (GCAA) and 5 cases of mid-small CAA were diagnosed by TTE. A total of 16/32 arteries (50%) were involved. At the end of follow-up, 3 cases of GCAA and 2 cases of mid-small CAA were still diagnosed by TTE, and small CAAs were regressed in another 3 cases. A total of 6/32 arteries (18.75%) were involved. Simultaneously at the end of follow-up, a total of 7/32 arteries (21

  16. Anomalous origin of right coronary artery from pulmonary artery

    Directory of Open Access Journals (Sweden)

    Rajat Gupta

    2012-01-01

    Full Text Available Anomalous origin of coronary artery from the pulmonary artery is a rare anomaly that most frequently involves the left coronary artery and very rarely the right coronary artery. These lesions can be missed on echocardiography unless carefully looked for. We describe a case of isolated anomalous origin of right coronary artery from pulmonary artery diagnosed on echocardiography and confirmed by computed tomography (CT angiography.

  17. Motivation for Compliance with Environmental Regulation

    DEFF Research Database (Denmark)

    Winter, Søren; May, Peter J.

    2001-01-01

    A combination of calculated, normative, and social motivations as well as awareness of rules and capacity to comply are thought to foster compliance with regulations. Hypotheses about these factors were tested with data concerning Danish farmers’ compliance with agro-environmental regulations...

  18. Determinants of Compliance among Pediatric Amblyopia Patients.

    Science.gov (United States)

    Wolff, Hans; Juhasz, Anne McCreary

    Given the recent focus on patient responsibility for health status and improvement, it is important to understand the dynamics involved in patient compliance to treatment regimens. The determinants of patching compliance among 30 pediatric amblyopia patients and their parents were investigated by means of parent, patient, and physician…

  19. 45 CFR 3.3 - Compliance.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Compliance. 3.3 Section 3.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE General § 3.3 Compliance. A person must comply with the regulations...

  20. 40 CFR 52.1335 - Compliance schedules.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Compliance schedules. 52.1335 Section 52.1335 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Effective date Final compliance date Pilot Knob Pelleting Co Pilot Knob, MO V(10 CSR 10-3.050) Oct. 19,...

  1. 47 CFR 2.1077 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... RULES AND REGULATIONS Equipment Authorization Procedures Declaration of Conformity § 2.1077 Compliance information. (a) If a product must be tested and authorized under a Declaration of Conformity, a compliance... the following information: (1) Identification of the product, e.g., name and model number; (2) A...

  2. Implementing compliance controls in public administration

    NARCIS (Netherlands)

    Boer, A.; van Engers, T.

    2011-01-01

    This paper presents a monitoring and diagnosis component of a knowledge cquisition, design, and simulation framework for implementation of compliance in public administration. A major purpose of the framework is to give a methodological justification for the exploration of compliance control policie

  3. Monitoring managers through corporate compliance programs

    NARCIS (Netherlands)

    Angelucci, C.; Han, M.A.

    2011-01-01

    Compliance programs entail monitoring of employees' behavior with the claimed objective of fighting corporate crime. (Competition) Authorities promote such intra-firm monitoring. In a three-tier hierarchy model, authority-shareholder-manager, we study the impact of monitoring through a compliance pr

  4. 40 CFR 63.403 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Compliance dates. 63.403 Section 63.403 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) NATIONAL... Hazardous Air Pollutants for Industrial Process Cooling Towers § 63.403 Compliance dates. The...

  5. Tax Compliance over the Firm Life Course

    NARCIS (Netherlands)

    Stam, F.C.; Verbeeten, F.H.M.

    2017-01-01

    This article provides a new model of tax compliance over the firm life course, focusing on the dynamics in the underlying motivations and capacities for tax compliance. We review and structure the relevant literature on the early life course of firms: the traditional stages of growth models and a le

  6. Correlates of exercise compliance in physical therapy.

    NARCIS (Netherlands)

    Sluijs, E.M.; Kok, G.J.; Zee, J. van der

    1993-01-01

    BACKGROUND AND PURPOSE: This correlational study describes factors that are related to patient compliance with exercise regimens during physical therapy. We investigated whether patient compliance was related to characteristics of the patient or the patient's illness, to the patient's attitude, or t

  7. 45 CFR 80.6 - Compliance information.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Compliance information. 80.6 Section 80.6 Public... THE CIVIL RIGHTS ACT OF 1964 § 80.6 Compliance information. (a) Cooperation and assistance. The... reports at such times, and in such form and containing such information, as the responsible...

  8. 22 CFR 141.5 - Compliance information.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Compliance information. 141.5 Section 141.5... DEPARTMENT OF STATE-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 § 141.5 Compliance information... such information, as a responsible Departmental official or his designee may determine to be...

  9. 33 CFR 104.120 - Compliance documentation.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Compliance documentation. 104.120... SECURITY MARITIME SECURITY: VESSELS General § 104.120 Compliance documentation. (a) Each vessel owner or... maintain the documentation described in paragraphs (a)(1), (2), or (3) of this section. The letter...

  10. 33 CFR 105.120 - Compliance documentation.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Compliance documentation. 105.120... SECURITY MARITIME SECURITY: FACILITIES General § 105.120 Compliance documentation. Each facility owner or... documentation are available at the facility and are made available to the Coast Guard upon request: (a)...

  11. Maternal Responsiveness and Subsequent Child Compliance.

    Science.gov (United States)

    Parpal, Mary; Maccoby, Eleanor E.

    1985-01-01

    Contrasts effects of three modes of mother/child interaction on children's subsequent compliance with maternal directives. Subjects were 39 children from lower-middle-class families, ranging in age from approximately three to four-and-a-half. Responsive play and noninteractive conditions produced higher levels of compliance than the untrained free…

  12. 30 CFR 90.207 - Compliance sampling.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Compliance sampling. 90.207 Section 90.207... MANDATORY HEALTH STANDARDS-COAL MINERS WHO HAVE EVIDENCE OF THE DEVELOPMENT OF PNEUMOCONIOSIS Sampling Procedures § 90.207 Compliance sampling. (a) The operator shall take five valid respirable dust samples...

  13. Environmental Compliance Audit& Assessment Program Manual

    Energy Technology Data Exchange (ETDEWEB)

    Thorson, Patrick; Baskin, David; Borglin, Ned; Fox, Robert; Wahl, Linnea; Hatayama, Howard; Pauer, Ronald

    2009-03-13

    This document describes the elements, schedule, roles, and responsibilities of the Lawrence Berkeley National Laboratory (LBNL) Environmental Compliance Audit & Assessment Program (ECAAP). The ECAAP has been developed to meet the requirements of DOE Order 450.1A,1 and Executive Order 13423.2 These referenced Orders stipulate that government agencies must develop environmental compliance audit programs to monitor and improve compliance with environmental regulations. As stated specifically in the DOE Order, as a part of a DOE facility's Environmental Management System (EMS), 'An environmental compliance audit and review program that identifies compliance deficiencies and root causes of non-compliance' shall be developed and implemented. The ECAAP has also been developed to satisfy LBNL's institutional technical assurance assessment requirements promulgated in the Environment, Safety and Health (ES&H) Self-Assessment Program (LBNL/PUB-5344) and described by the ES&H Technical Assurance Program (TAP) Manual (LBNL/PUB-913E). The ES&H TAP Manual provides the framework for systematic reviews of ES&H programs with the intent to provide assurance that these programs comply with their guiding regulations, are effective, and are properly implemented. As required by the DOE and Executive Orders and by LBNL's TAP, the goal of the ECAAP is to identify environmental regulatory compliance deficiencies and to determine their respective causes. The ECAAP then provides a means of correcting any deficiencies identified, and leads to continually improving environmental compliance performance.

  14. 5 CFR 900.406 - Compliance information.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Compliance information. 900.406 Section... Compliance information. (a) Cooperation and assistance. OPM, to the fullest extent practicable, shall seek... at the times, and in the form and containing the information OPM may determine necessary to enable...

  15. [Predictors for compliance in orthodontic treatment].

    Science.gov (United States)

    Müssig, E; Berger, M; Komposch, G; Brunner, M

    2008-03-01

    Having established the importance of compliance as a significant factor of a successful orthodontic treatment, the aim of the present study was to evaluate intrapersonal and interpersonal factors which could help predict patient compliance. The attributional style of 58 patients was assessed by a standardised questionnaire. An individual questionnaire was designed to determine attitudes concerning orthodontic treatment, the doctor-patient relationship, the wearing behaviour and control behaviour. The questionnaire was answered by the patient and by the orthodontist. The compliance was evaluated by the orthodontist on the basis of commonly used indicators for compliance: wearing time, oral hygiene and reliability of keeping the appointments. The results showed a significant correlation between the compliance and the attributional style of the patients in positive situations, but not between the compliance and the wearing behaviour estimated by the patient. The interpersonal comparison revealed a lack of knowledge on the part of the orthodontist about the patients' daily activities and their ability to correctly wear their appliances. The questionnaire answers show compliance to be a subjective construct of the orthodontist demonstrating mostly social-emotional matters. There is no consistency with compliance and the patients' statement concerning their wearing behaviour but with a positive attitude on the part of the patients demonstrating independent responsibility.

  16. 33 CFR 106.110 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Compliance dates. 106.110 Section... MARINE SECURITY: OUTER CONTINENTAL SHELF (OCS) FACILITIES General § 106.110 Compliance dates. (a) On or... TWIC under this part may enroll beginning after the date set by the Coast Guard in a Notice to...

  17. 49 CFR 214.305 - Compliance dates.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Compliance dates. 214.305 Section 214.305..., DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Roadway Worker Protection § 214.305 Compliance dates. Each program adopted by a railroad shall comply not later than the date specified in the...

  18. 40 CFR 63.1545 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 12 2010-07-01 2010-07-01 true Compliance dates. 63.1545 Section 63.1545 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... for Hazardous Air Pollutants for Primary Lead Smelting § 63.1545 Compliance dates. (a) Each owner...

  19. 33 CFR 105.115 - Compliance dates.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Compliance dates. 105.115 Section... MARITIME SECURITY: FACILITIES General § 105.115 Compliance dates. (a) On or before December 31, 2003... required to obtain a TWIC under this part may enroll beginning after the date set by the Coast Guard in...

  20. A new technique for assessing arterial pressure wave forms and central pressure with tissue Doppler

    Science.gov (United States)

    Haluska, Brian A; Jeffriess, Leanne; Mottram, Phillip M; Carlier, Stephane G; Marwick, Thomas H

    2007-01-01

    Background Non-invasive assessment of arterial pressure wave forms using applanation tonometry of the radial or carotid arteries can be technically challenging and has not found wide clinical application. 2D imaging of the common carotid arteries is routinely used and we sought to determine whether arterial waveform measurements could be derived from tissue Doppler imaging (TDI) of the carotid artery. Methods We studied 91 subjects (52 men, age 52 ± 14 years) with and without cardiovascular disease. Tonometry was performed on the carotid artery simultaneously with pulsed wave Doppler of the LVOT and acquired digitally. Longitudinal 2D images of the common carotid artery with and without TDI were also acquired digitally and both TDI and tonometry were calibrated using mean and diastolic cuff pressure and analysed off line. Results Correlation between central pressure by TDI and tonometry was excellent for maximum pressure (r = 0.97, p < 0.0001). The mean differences between central pressures derived by TDI and tonometry were minimal (systolic 5.36 ± 5.5 mmHg; diastolic 1.2 ± 1.2 mmHg). Conclusion Imaging of the common carotid artery motion with tissue Doppler may permit acquisition of a waveform analogous to that from tonometry. This method may simplify estimation of central arterial pressure and calculation of total arterial compliance. PMID:17266772

  1. Culture and compliance: an anthropologist’s view

    OpenAIRE

    Sampson, Steven

    2014-01-01

    The concept of "culture" is often used improperly in the literature and training on business ethics and compliance. A more sophisticated view of 'culture of compliance' is required. Published in a magazine for ethics and compliance professionals

  2. 41 CFR 60-2.30 - Corporate management compliance evaluations.

    Science.gov (United States)

    2010-07-01

    ... Relating to Public Contracts OFFICE OF FEDERAL CONTRACT COMPLIANCE PROGRAMS, EQUAL EMPLOYMENT OPPORTUNITY, DEPARTMENT OF LABOR 2-AFFIRMATIVE ACTION PROGRAMS Miscellaneous § 60-2.30 Corporate management compliance evaluations. (a) Purpose. Corporate Management Compliance Evaluations are designed to ascertain...

  3. EPA Enforcement and Compliance History Online: Water Effluent Charts Summaries

    Data.gov (United States)

    U.S. Environmental Protection Agency — Summary of compliance status each outfall and parameter for one Clean Water Act discharge permit. Provides the current compliance status and overall compliance...

  4. International Criminal Justice and the Politics of Compliance

    NARCIS (Netherlands)

    Lamont, Christopher

    2010-01-01

    International Criminal Justice and the Politics of Compliance provides a comprehensive study of compliance with legal obligations derived from the International Criminal Tribunal for the former Yugoslavia's (ICTY) Statute and integrates theoretical debates on compliance into international justice sc

  5. A Review of Factors for Tax Compliance

    Directory of Open Access Journals (Sweden)

    Nicoleta BARBUTA-MISU

    2011-03-01

    Full Text Available The aim of this paper is to identify the variables of tax compliance analysed by researchers from various countries and adapting them to the Romanian conditions to create a model to include factors that influence decision of tax compliance. Tax compliance has been studied in economics by analysing the individual decision of a representative person between paying taxes and evading taxes. In the research of tax compliance have been done many empirical studies that emphasized the impact of a wide variety of potential determinants of voluntary compliance with individual income/profit tax filing and reporting obligations. The most important determinants identified are: economic factors as the level of income, audit probabilities, tax audit, tax rate, tax benefits, penalties, fines and other non-economic factors as attitudes toward taxes, personal, social and national norms, perceived fairness etc.

  6. Renal subcapsular haematoma: an unusual complication of renal artery stenting

    Institute of Scientific and Technical Information of China (English)

    XIA Dan; CHEN Shan-wen; ZHANG Hong-kun; WANG Shuo

    2011-01-01

    After successful renal artery angioplasty and stent placement, a patient in a fully anticoagulated state developed hypotension and flank pain. Computed tomography (CT) of the abdomen revealed a large renal subcapsular haematoma which was successfully managed conservatively without embolotherapy and surgical intervention. To prevent hemorrhage after renal artery stenting, it is necessary to underscore the importance of reducing the contrast volume and pressure of angiography, controlling systemic blood pressure, and monitoring guide wire position at all times.

  7. Physical inactivity and arterial stiffness in COPD

    Directory of Open Access Journals (Sweden)

    Sievi NA

    2015-09-01

    Full Text Available Noriane A Sievi,1 Daniel Franzen,1 Malcolm Kohler,1,2 Christian F Clarenbach1 1Division of Pulmonology, University Hospital of Zurich, 2Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland Background: Arterial stiffness is an important predictor of cardiovascular risk besides classic cardiovascular risk factors. Previous studies showed that arterial stiffness is increased in patients with COPD compared to healthy controls and exercise training may reduce arterial stiffness. Since physical inactivity is frequently observed in patients with COPD and exercise training may improve arterial stiffness, we hypothesized that low daily physical activity may be associated with increased arterial stiffness. Methods: In 123 patients with COPD (72% men; mean [standard deviation] age: 62 [7.5] years; median [quartile] forced expiratory volume in 1 second 35 [27/65] %predicted, arterial stiffness was assessed by augmentation index (AI. Daily physical activity level (PAL was measured by an activity monitor (SenseWear Pro™ >1 week. The association between AI and PAL was investigated by univariate and multivariate regression analysis, taking into account disease-specific characteristics and comorbidities. Results: Patients suffered from moderate (35%, severe (32%, and very severe (33% COPD, and 22% were active smokers. Median (quartile PAL was 1.4 (1.3/1.5 and mean (standard deviation AI 26% (9.2%. PAL showed a negative association with AI (B=-9.32, P=0.017 independent of age, sex, blood pressure, and airflow limitation. Conclusion: In COPD patients, a higher PAL seems to favorably influence arterial stiffness and therefore may reduce cardiovascular risk. Clinical Trial Registration: www.ClinicalTrials.gov, NCT01527773 Keywords: activity monitor, airflow limitation, COPD, physical activity level

  8. Metabolic syndrome patient compliance with drug treatment

    Directory of Open Access Journals (Sweden)

    Nilcéia Lopes

    2008-01-01

    Full Text Available OBJECTIVES: 1 To evaluate the compliance with drug treatment in patients with metabolic syndrome. 2 To determine association between access to and use of medicines, as well as the level of knowledge of cardiovascular risk factors and compliance. INTRODUCTION: Low compliance has been one of the greatest challenges for the successful treatment of chronic diseases. Although this issue has been widely studied in patients with isolated hypertension, diabetes and dyslipidemia, compliance studies involving patients with these concomitant diseases or with metabolic syndrome diagnosis are scarce. METHODS: This was a cross-sectional study involving patients who have been diagnosed with metabolic syndrome according to the IDF criteria. Patients were being treated in a Health-Medical School Center bound to the Public Brazilian Healthcare System. This study was conducted in two phases. Phase I was characterized by analyzing medical records and Phase II involved interviewing the patients. A variation of the Morisky-Green Test was used to evaluate compliance. Compliance was the dependent variable and the independent variables included access to medicines, the use of medicines and the level of knowledge concerning cardiovascular risk factors. RESULTS: Two hundred and forty-three patients were identified as being eligible for Phase II, and 75 were included in the study. The average level of compliance was 5.44 points (standard deviation of 0.68, on a scale ranging from 1.00 to 6.00 points. There was no statistically meaningful association between independent variables and compliance. The level of patient knowledge of diet and dyslipidemia was considered to be low. CONCLUSIONS: Patients involved in this study exhibited a high level of compliance with drug treatment. Further research is needed to better elucidate the compliance behavior of patients who have been diagnosed with metabolic syndrome.

  9. Paradoxical centrally increased diffusivity in perinatal arterial ischemic stroke

    Energy Technology Data Exchange (ETDEWEB)

    Stence, Nicholas V.; Mirsky, David M.; Deoni, Sean C.L. [University of Colorado Anschutz School of Medicine, Department of Radiology, Aurora, CO (United States); Children' s Hospital Colorado, Department of Radiology, Aurora, CO (United States); Armstrong-Wells, Jennifer [University of Colorado Anschutz School of Medicine, Department of Pediatrics (Neurology) and OB/GYN, Aurora, CO (United States); University of Colorado Hemophilia and Thrombosis Center, Aurora, CO (United States)

    2016-01-15

    Restricted diffusion on acute MRI is the diagnostic standard for perinatal arterial ischemic stroke. In a subset of children with perinatal arterial ischemic stroke, primarily those with large infarct volumes, we noted a core of centrally increased diffusivity with a periphery of restricted diffusion. Given the paradoxical diffusion-weighted imaging (DWI) appearance observed in some children with perinatal arterial ischemic stroke, we sought to determine its significance and hypothesized that: (1) centrally increased diffusivity is associated with larger infarcts in perinatal arterial ischemic stroke and (2) this tissue is irreversibly injured (infarcted). We reviewed all perinatal arterial ischemic stroke cases in a prospective cohort study from Aug. 1, 2000, to Jan. 1, 2012. Infarct volumes were measured by drawing regions of interest around the periphery of the area of restricted diffusion on DWI. The Mann-Whitney U test was used to compare means between groups. Of 25 eligible cases, centrally increased diffusivity was seen in 4 (16%). Cases with centrally increased diffusivity had larger average infarct volumes (mean 117,182 mm{sup 3} vs. 36,995 mm{sup 3}; P = 0.008), higher average apparent diffusion coefficient (ADC) values in the infarct core (1,679 x 10{sup -6} mm{sup 2}/s vs. 611 x 10{sup -6} mm{sup 2}/s, P < 0.0001), and higher ADC ratio (1.2 vs. 0.5, P < 0.0001). At last clinical follow-up, children with perinatal arterial ischemic stroke and centrally increased diffusivity were more often treated for ongoing seizures (75% vs. 0%; P < 0.001) than those without. Centrally increased diffusivity was associated with larger stroke volume and the involved tissue was confirmed to be infarcted on follow-up imaging. Radiologists should be aware of this unusual appearance of perinatal arterial ischemic stroke in order to avoid underestimating infarct volume or making an incorrect early diagnosis. (orig.)

  10. Artery by Neuropeptides

    Directory of Open Access Journals (Sweden)

    Esmeralda Sofia Costa Delgado

    2012-01-01

    Methods. Isolated rabbit eyes (n=12 were perfused in situ with tyrode through the external ophthalmic artery. Effects of intra-arterial injections of NPY 200 μg/ml (Group A; n=6 and VIP 200 μg/ml (Group B; n=6 on the recorded pressure were obtained. For statistical analysis, Student's paired t-test and Fast Fourier Transform were used. Results. Spontaneous oscillations were observed before any drug administration in the 12 rabbit models. NPY produced an increase in total vascular resistance and a higher frequency and amplitude of oscillations, while VIP evoked the opposite effects. Conclusions. This study provides evidence of vasomotion in basal conditions in rabbit external ophthalmic artery. Concerning drug effects, NPY increased arterial resistance and enhanced vasomotion while VIP produced opposite effects which demonstrates their profound influence in arterial vasomotion.

  11. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E

    1998-01-01

    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic......%, 96%, 96%, and 93% (NS). So2 was below the lower limit of 92% in 0%, 9%, 7%, and 24% (p arterial carbon dioxide tension, a low systemic vascular...... resistance, and a low indocyanine green clearance (p arterial hypoxaemia in cirrhosis is about 22% in patients without encephalopathy, but it varies from 10-40% depending on the degree of hepatic dysfunction. Arterial hypoxaemia in patients with cirrhosis of differing...

  12. Analysis of Arterial Mechanics During Head-Down-Tilt Bed Rest

    Science.gov (United States)

    Elliott, Morgan B.; Martin, David S.; Westby, Christian M.; Stenger, Michael B.; Platts, Steven H.

    2014-01-01

    Carotid, brachial, and tibial arteries reacted differently to HDTBR. Previous studies have not analyzed the mechanical properties of the human brachial or anterior tibial arteries. After slight variations during bed-rest, arterial mechanical properties and IMT returned to pre-bed rest values, with the exception of tibial stiffness and PSE, which continued to be reduced post-bed rest while the DC remained elevated. The tibial artery remodeling was probably due to decreased pressure and volume. Resulting implications for longer duration spaceflight are unclear. Arterial health may be affected by microgravity, as shown by increased thoracic aorta stiffness in other ground based simulations (Aubert).

  13. Investigation of Brain Arterial Circle Malformations Using Electrical Modelling and Simulation

    Directory of Open Access Journals (Sweden)

    Klara Capova

    2006-01-01

    Full Text Available The paper deals with the cerebral arterial system investigation by means of electrical modelling and simulations. The main attention is paid to the brain arterial circle malformations (stenoses and aneurysms and their determination and evaluation by computer-aided methods as tools of a non-invasive diagnostics. The compensation possibilities of brain arterial circle in case of presence of concrete arterial malformations are modelled and simulated. The simulation results of brain arteries blood pressures and volume flow velocities time dependences are presented and discussed under various health conditions.

  14. 40 CFR 194.55 - Results of compliance assessments.

    Science.gov (United States)

    2010-07-01

    ...) Compliance assessments shall consider and document uncertainty in the performance of the disposal system. (b) Probability distributions for uncertain disposal system parameter values used in compliance assessments...

  15. Avaliação da adesão de médicos ao protocolo de hipertensão arterial da secretaria municipal de saúde de Curitiba Evaluación de la adhesión de médicos al protocolo de hipertensión arterial de la Secretaría Municipal de Salud de Curitiba Evaluation of physicians' compliance with the hypertension protocol of the Municipal Health Department of the city of Curitiba

    Directory of Open Access Journals (Sweden)

    Ivan Maluf Jr

    2010-01-01

    Full Text Available FUNDAMENTO: Em Curitiba, a hipertensão arterial sistêmica (HAS é a segunda causa de internamento hospitalar e a primeira causa de morte por doenças cardiovasculares. Os protocolos de atendimento aos hipertensos sistematizam a atenção ao paciente com o intuito de aprimorar a resolutividade e a qualidade dos serviços de saúde. OBJETIVO: Avaliar a adesão dos profissionais médicos ao protocolo do programa de hipertensos da Secretaria Municipal de Saúde (SMS de Curitiba. MÉTODOS: Este é um estudo transversal e observacional. A coleta de dados referentes ao trabalho foi realizada em quatro unidades de saúde de Curitiba. A amostra foi constituída de 200 pacientes hipertensos cadastrados no programa de HAS. Os dados coletados eram referentes às duas primeiras consultas. A fonte de dados foi o prontuário eletrônico das unidades de saúde. O protocolo utilizado para análise comparativa foi o da SMS de Curitiba. RESULTADOS: A não conformidade entre a prática clínica e o protocolo na primeira consulta foi de 56,8% quanto à classificação de grau, 63,8% quanto ao risco cardiovascular e de 54% quanto ao tratamento. Na segunda consulta, em 67% não houve concordância com o protocolo quanto ao risco e em 51,3% quanto ao tratamento. CONCLUSÃO: A não conformidade entre a prática clínica e a adesão ao protocolo da SMS de Curitiba mostrou-se evidente na classificação de grau, risco cardiovascular e tratamento do paciente hipertenso. O não seguimento do protocolo pode representar uma baixa resolutividade do serviço de saúde, o qual perde a oportunidade de reduzir a morbidade e mortalidade por doenças cardiovasculares na população.FUNDAMENTO: En Curitiba, la hipertensión arterial sistémica (HAS es la segunda causa de internamiento hospitalario y la primera causa de muerte por enfermedades cardiovasculares. Los protocolos de atención a los hipertensos sistematizan la atención al paciente con la intención de perfeccionar la

  16. Control of arterial pressure in aquatic sea snakes.

    Science.gov (United States)

    Lillywhite, H B; Pough, F H

    1983-01-01

    Cardiovascular responses to head-up tilt, acutely graded hemorrhage, and pharmacologic stimulation by principal autonomic drugs were studied in four species of marine snakes, principally Aipysurus laevis (family Hydrophiidae). Arterial pressure varied inversely with tilt angle and blood volume deficit in conscious snakes outside of water, indicating that physiological regulation was poor or lacking. Calculated arterial pressures at head level typically diminished to zero in A. laevis tilted to angles greater than or equal to 30 degrees. Arterial pressure (corrected for external water pressure) did not change when these snakes were tilted in seawater. Changes of arterial pressure induced by tilt, blood loss, or autonomic drugs elicited reflex adjustments in heart activity, but the magnitude of these responses was less than that observed in terrestrial species of snake. It is concluded that baroreflexes are present but comparatively ineffective in sea snakes. Snakes tolerated large losses of blood volume, and extravascular fluids were absorbed into the circulation during hemorrhage; both hemorrhage and estimated hemodilution volumes exceeded 100% of the initial blood volume in Acalyptophis peronii. Thus, in marine snakes major fluid shifts between nonvascular and vascular compartments significantly compensate hypovolemia but, because of minor autonomic adjustments, do not result in a well-regulated arterial pressure.

  17. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Sørensen, T I

    1989-01-01

    for measuring the central blood volume. We have developed a method that enables us to determine directly the central blood volume, i.e., the blood volume in the heart cavities, lungs, and central arterial tree. In 60 patients with cirrhosis and 16 control subjects the central blood volume was assessed according...... flow, or sequestration of fluid in the peritoneal cavity, or any combination thereof. The present results indicate that central circulatory underfilling is an integral part of the hemodynamic and homeostatic derangement observed in cirrhosis....

  18. GENDER AND ETHNICITY DIFFERENCES IN TAX COMPLIANCE

    Directory of Open Access Journals (Sweden)

    Jeyapalan Kasipillai

    2006-01-01

    Full Text Available The purpose of this study is to investigate whether gender and ethnicity differences occur in relation to tax compliance attitude and behavior. Prior studies on tax compliance have focused little on gender as a predictor of compliance. In Malaysia, ethnic background of a taxpayer could be a major determinant of tax compliance. A personal interview approach is used to obtain information from taxpayers in urban towns. A t-test suggests that males and females were found to have similar compliant attitude. As for ethnicity, asimilar result was observed. Results of a regression analysis indicate that gender, academic qualification, and the person preparing tax return were statistically significant as determinants of non-compliant attitude. In terms of compliant behavior, a regression analysis revealed that "attitude towards non-compliance" and "receipt of cash income" were two significant explanatory variables of tax non-compliance behavior of understating income knowingly. The findings of this study are useful for policyimplications in identifying groups that require additional attention to increase voluntary tax compliance.

  19. Drug compliance in patients with systemic scleroderma.

    Science.gov (United States)

    Hromadkova, Lucie; Soukup, Tomas; Cermakova, Eva; Vlcek, Jiri

    2012-11-01

    Although drug compliance is a crucial component of treatment effectiveness in chronic diseases, it has never been evaluated in patients with systemic scleroderma. Therefore, the aim of this descriptive study was to determine the drug compliance rate in systemic scleroderma patients and to identify risk factors for noncompliance in these patients. A cross-sectional observational study was conducted. All patients with systemic scleroderma (n = 41) who visited a rheumatic center and signed an informed consent form were included. Data were obtained during structured interviews with patients and from medical records. The Compliance Questionnaire Rheumatology (CQR) was used to determine patient compliance. The relationships between compliance rate and demographic and clinical characteristics were examined. The mean CQR score was 75 %. Based on a dichotomous rating, only 42 % of the patients achieved a satisfactory compliance rate (≥80 %). No relationships between various demographic and clinical characteristics and CQR score expressed as continuous or dichotomous variables were found. This study represents the first evaluation of drug compliance in patients with systemic scleroderma. Many noncompliant patients were identified, but no common risk factors for noncompliance were discovered. The reasons for noncompliance seem to depend on the personal features of the patients.

  20. [Drug compliance of patients on anticoagulant treatment].

    Science.gov (United States)

    Gadó, Klára; Kocsis, Eszter; Zelkó, Romána; Hankó, Balázs; Kovácsné Balogh, Judit; Forczig, Mónika; Domján, Gyula

    2015-08-09

    Despite several therapeutic possibilities the morbidity and mortality of thromboembolic disorders remain high. Improving drug compliance - i. e. keeping up the doctor's prescriptions - may be an effective tool to reach better results. To improve patients' compliance, the risk factors of non-compliance should be recognized. Among these patients' fear of adverse effects of drugs, their lack of knowledge about their illness and medication, forgetfulness, and other social, economic factors may be the most important. Furthermore, adherence may be worsened when the patient feels that the decision has been made over his/her head. Sustained medical adherence is important because anticoagulation may be a life-long treatment. The new oral anticoagulants make the matter of compliance to be current. These new type of drugs do not need regular laboratory monitoring and, therefore, compliance cannot be strictly followed. There are several studies concerning drug compliance to anticoagulant medications. Improvement of adherence is based on regular patient education after reviewing the factors of non-compliance, which needs teamwork with important roles of doctors, pharmacists, dietetics and nurses. Careful and accurate work of the participants of primary care might be complemented by the activity of anticoagulant clinics.

  1. The effect of body temperature on the dynamic respiratory system compliance-breathing frequency relationship in the rat.

    Science.gov (United States)

    Rubini, Alessandro; Bosco, Gerardo

    2013-06-01

    The mechanical inhomogeneity of the respiratory system is frequently investigated by measuring the frequency dependence of dynamic compliance, but no data are currently available describing the effects of body temperature variations. The aim of the present report was to study those effects in vivo. Peak airway pressure was measured during positive pressure ventilation in eight anesthetized rats while breathing frequency (but not tidal volume) was altered. Dynamic compliance was calculated as the tidal volume/peak airway pressure, and measurements were taken in basal conditions (mean rectal temperature 37.3 °C) as well as after total body warming (mean rectal temperature 39.7 °C). Due to parenchymal mechanical inhomogeneity and stress relaxation-linked effects, the normal rat respiratory system exhibited frequency dependence of dynamic lung compliance. Even moderate body temperature increments significantly reduced the decrements in dynamic compliance linked to breathing rate increments. The results were analyzed using Student's and Wilcoxon's tests, which yielded the same results (p temperature variations are known to influence respiratory mechanics. The frequency dependence of dynamic compliance was found, in the experiments described, to be temperature-dependent as temperature variations affected parenchymal mechanical inhomogeneity and stress relaxation. These results suggest that body temperature variations should be taken into consideration when the dynamic compliance-breathing frequency relationship is being examined during clinical assessment of inhomogeneity of lung parenchyma in patients.

  2. Compliance Notices – A New Tool in Environmental Enforcement

    Directory of Open Access Journals (Sweden)

    LA Feris

    2006-12-01

    Full Text Available This note examines compliance notices, a new administrative remedy that has been created to assist in compliance and enforcement of environmental laws. The note considers the aim and scope of compliance and the process of issuing a compliance notice. In addition, it reflects on objections to compliance notices as well as the effect of non-compliance with compliance notices. It furthermore considers the mandate of Environmental Management Inspectors (EMIs to issue compliance notices, the legislation in terms of which they may issue compliance notices and the ability of EMIs to issue compliance notices beyond the designated legislation. The note also assesses the overall effectiveness of compliance notices and the extent to which it is likely to be utilised by EMIs in the exercise of their mandate.

  3. [Compliance of treatment in glaucoma patients].

    Science.gov (United States)

    Banc, Ana; Stan, Cristina

    2013-01-01

    To evaluate the treatment compliance level of glaucoma patients and the correlation between the compliance level and a series of patient's demographic characteristics. We conducted an observational study in which we studied 100 glaucoma patients who answered the questions we included into a questionnaire. We defined and calculated a broad compliance score and a narrow score, and we investigated the connection between the first score and age, gender, demographic location (urban versus rural), education level, current occupation and duration of disease respectively. The mean of the broad compliance score was 9.64 +/- 1.72, which represents 80% of the maximum value of the score, and the mean of the narrow compliance score was 4.73 +/- 1.12, (78% of the maximum value). The correlation coefficient between score and age was z = -0.09 (p value = 0.19), the Z value for the evaluation of the connection between score and gender was -1.16 (p value = 0.24), and for the connection between compliance score and demographic location Z value = -2.42 (p value = 0.01). Chi-square value for the evaluation of the relation between the score and education level was 14.66 (p value = 0.001), and for the current occupation Chi-square value = 3.47 (p value = 0.06). The correlation coefficient between score and disease duration was tau = 0.09 (p value = 0.23). According to the answers the patients gave, we identified the parameters that require more attention in the ophthalmologist - glaucoma patient communication: genetic transmission of glaucoma, treatment's side effects, number of visits to the ophthalmologist, awareness of the life-long gradului period of treatment. In this study, the compliance level of glaucoma patients is relatively high and we observe a correlation between the compliance level and demographic location, and between the compliance level and patient's education level respectively.,

  4. Motivation and compliance with intraoral elastics.

    Science.gov (United States)

    Veeroo, Helen J; Cunningham, Susan J; Newton, Jonathon Timothy; Travess, Helen C

    2014-07-01

    Intraoral elastics are commonly used in orthodontics and require regular changing to be effective. Unfortunately, poor compliance with elastics is often encountered, especially in adolescents. Intention for an action and its implementation can be improved using "if-then" plans that spell out when, where, and how a set goal, such as elastic wear, can be put into action. Our aim was to determine the effect of if-then plans on compliance with elastics. To identify common barriers to compliance with recommendations concerning elastic wear, semistructured interviews were carried out with 14 adolescent orthodontic patients wearing intraoral elastics full time. Emerging themes were used to develop if-then plans to improve compliance with elastic wear. A prospective pilot study assessed the effectiveness of if-then planning aimed at overcoming the identified barriers on compliance with elastic wear. Twelve participants were randomized equally into study and control groups; the study group received information about if-then planning. The participants were asked to collect used elastics, and counts of these were used to assess compliance. A wide range of motivational and volitional factors were described by the interviewed participants, including the perceived benefits of elastics, cues to remember, pain, eating, social situations, sports, loss of elastics, and breakages. Compliance with elastic wear was highly variable among patients. The study group returned more used elastics, suggesting increased compliance, but the difference was not significant. The use of if-then plans might improve compliance with elastic wear when compared with routine clinical instructions. Copyright © 2014 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  5. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Sørensen, T I

    1989-01-01

    for measuring the central blood volume. We have developed a method that enables us to determine directly the central blood volume, i.e., the blood volume in the heart cavities, lungs, and central arterial tree. In 60 patients with cirrhosis and 16 control subjects the central blood volume was assessed according......The pathogenesis of ascites formation in cirrhosis is uncertain. It is still under debate whether the effective blood volume is reduced (underfilling theory) or whether the intravascular compartment is expanded (overflow theory). This problem has not yet been solved because of insufficient tools...... to the kinetic theory as the product of cardiac output and mean transit time of the central vascular bed. Central blood volume was significantly smaller in patients with cirrhosis than in controls (mean 21 vs. 27 ml/kg estimated ideal body weight, p less than 0.001; 25% vs. 33% of the total blood volume, p less...

  6. Information security policy development for compliance

    CERN Document Server

    Williams, Barry L

    2013-01-01

    Although compliance standards can be helpful guides to writing comprehensive security policies, many of the standards state the same requirements in slightly different ways. Information Security Policy Development for Compliance: ISO/IEC 27001, NIST SP 800-53, HIPAA Standard, PCI DSS V2.0, and AUP V5.0 provides a simplified way to write policies that meet the major regulatory requirements, without having to manually look up each and every control. Explaining how to write policy statements that address multiple compliance standards and regulatory requirements, the book will he

  7. Touch, compliance, and awareness of tactile contact.

    Science.gov (United States)

    Joule, Robert-Vincent; Guéguen, Nicolas

    2007-04-01

    Many experimental studies have shown that touch increases compliance with a request; however, the difference between the effect of touch on compliance between participants who notice and those who do not notice such contact remains in question. An experiment was conducted in which a female confederate asked 368 female smokers to give her a cigarette. In the Touch condition, when making her request, the confederate slightly touched the participant on her forearm. Analysis showed the touch was associated with significantly higher compliance to the request, and a difference was evident in the Touch condition between subjects who had noticed the tactile contact and those who had not.

  8. An analysis of aircrew procedural compliance

    Science.gov (United States)

    Schofield, J. E.; Giffin, W. C.

    1981-01-01

    This research examines the relationships between aircrew compliance with procedures and operator errors. The data for this analysis were generated by reexamination of a 1976 experiment in full mission simulation conducted by Dr. H. P. Ruffell Smith (1979) for the NASA-Ames Research Center. The character of individual operators, the chemistry of crew composition, and complex aspects of the operational environment affected procedural compliance by crew members. Associations between enumerated operator errors and several objective indicators of crew coordination were investigated. The correspondence among high operator error counts and infrequent compliance with specific crew coordination requirements was most notable when copilots were accountable for control of flight parameters.

  9. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut

    2011-01-01

    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  10. Coronary artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Koischwitz, D.; Harder, T.; Schuppan, U.; Thurn, P.

    1982-04-01

    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment.

  11. Effects of pressure-controlled and volume-controlled ventilation on respiratory mechanics and systemic stress response during laparoscopic cholecystectomy.

    Science.gov (United States)

    Sen, Oznur; Umutoglu, Tarik; Aydın, Nurdan; Toptas, Mehmet; Tutuncu, Ayse Cigdem; Bakan, Mefkur

    2016-01-01

    Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its high and decelerating inspiratory flow, PCV has faster tidal volume delivery and different gas distribution. The same tidal volume setting, delivered by PCV versus volume-controlled ventilation (VCV), will result in a lower peak airway pressure and reduced risk of barotrauma. We hypothesized that PCV instead of VCV during laparoscopic surgery could achieve lower airway pressures and reduce the systemic stress response. Forty ASA I-II patients were randomly selected to receive either the PCV (Group PC, n = 20) or VCV (Group VC, n = 20) during laparoscopic cholecystectomy. Blood sampling was made for baseline arterial blood gases (ABG), cortisol, insulin, and glucose levels. General anesthesia with sevoflurane and fentanyl was employed to all patients. After anesthesia induction and endotracheal intubation, patients in Group PC were given pressure support to form 8 mL/kg tidal volume and patients in Group VC was maintained at 8 mL/kg tidal volume calculated using predicted body weight. All patients were maintained with 5 cmH2O positive-end expiratory pressure (PEEP). Respiratory parameters were recorded before and 30 min after pneumoperitonium. Assessment of ABG and sampling for cortisol, insulin and glucose levels were repeated 30 min after pneumoperitonium and 60 min after extubation. The P-peak levels observed before (18.9 ± 3.8 versus 15 ± 2.2 cmH2O) and during (23.3 ± 3.8 versus 20.1 ± 2.9 cmH2O) pneumoperitoneum in Group VC were significantly higher. Postoperative partial arterial oxygen pressure (PaO2) values are higher (98 ± 12 versus 86 ± 11 mmHg) in Group PC. Arterial carbon dioxide pressure (PaCO2) values (41.8 ± 5.4 versus 36.7 ± 3.5 mmHg) during pneumoperitonium and post-operative mean cortisol and insulin levels were higher in Group VC. When compared to VCV mode, PCV mode may improve compliance during pneumoperitoneum

  12. Automatic segmentation of vertebral arteries in CT angiography using combined circular and cylindrical model fitting

    Science.gov (United States)

    Lee, Min Jin; Hong, Helen; Chung, Jin Wook

    2014-03-01

    We propose an automatic vessel segmentation method of vertebral arteries in CT angiography using combined circular and cylindrical model fitting. First, to generate multi-segmented volumes, whole volume is automatically divided into four segments by anatomical properties of bone structures along z-axis of head and neck. To define an optimal volume circumscribing vertebral arteries, anterior-posterior bounding and side boundaries are defined as initial extracted vessel region. Second, the initial vessel candidates are tracked using circular model fitting. Since boundaries of the vertebral arteries are ambiguous in case the arteries pass through the transverse foramen in the cervical vertebra, the circle model is extended along z-axis to cylinder model for considering additional vessel information of neighboring slices. Finally, the boundaries of the vertebral arteries are detected using graph-cut optimization. From the experiments, the proposed method provides accurate results without bone artifacts and eroded vessels in the cervical vertebra.

  13. Temporal pattern of left ventricular structural and functional remodeling following reversal of volume overload heart failure

    Science.gov (United States)

    Hutchinson, Kirk R.; Guggilam, Anuradha; Cismowski, Mary J.; Galantowicz, Maarten L.; West, Thomas A.; Stewart, James A.; Zhang, Xiaojin; Lord, Kevin C.

    2011-01-01

    Current surgical management of volume overload-induced heart failure (HF) leads to variable recovery of left ventricular (LV) function despite a return of LV geometry. The mechanisms that prevent restoration of function are unknown but may be related to the timing of intervention and the degree of LV contractile impairment. This study determined whether reduction of aortocaval fistula (ACF)-induced LV volume overload during the compensatory stage of HF results in beneficial LV structural remodeling and restoration of pump function. Rats were subjected to ACF for 4 wk; a subset then received a load-reversal procedure by closing the shunt using a custom-made stent graft approach. Echocardiography or in vivo pressure-volume analysis was used to assess LV morphology and function in sham rats; rats subjected to 4-, 8-, or 15-wk ACF; and rats subjected to 4-wk ACF followed by 4- or 11-wk reversal. Structural and functional changes were correlated to LV collagen content, extracellular matrix (ECM) proteins, and hypertrophic markers. ACF-induced volume overload led to progressive LV chamber dilation and contractile dysfunction. Rats subjected to short-term reversal (4-wk ACF + 4-wk reversal) exhibited improved chamber dimensions (LV diastolic dimension) and LV compliance that were associated with ECM remodeling and normalization of atrial and brain natriuretic peptides. Load-independent parameters indicated LV systolic (preload recruitable stroke work, Ees) and diastolic dysfunction (tau, arterial elastance). These changes were associated with an altered α/β-myosin heavy chain ratio. However, these changes were normalized to sham levels in long-term reversal rats (4-wk ACF + 11-wk reversal). Acute hemodynamic changes following ACF reversal improve LV geometry, but LV dysfunction persists. Gradual restoration of function was related to normalization of eccentric hypertrophy, LV wall stress, and ECM remodeling. These results suggest that mild to moderate LV systolic

  14. Meta-analysis: diagnostic accuracy of coronary CT angiography with prospective ECG gating based on step-and-shoot, Flash and volume modes for detection of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Linfeng; Zhou, Tao; Zhang, Ruijie; Peng, Zhaohui; Ding, Juan; Wang, Sen; Li, Min; Sun, Gang [Jinan Military General Hospital, Department of Medical Imaging, Jinan, Shandong Province (China); Xu, Lin [Jinan Military General Hospital, Department of Medical Cardiology, Jinan, Shandong Province (China)

    2014-10-15

    To investigate the diagnostic performance of coronary computed tomographic angiography (CCTA) with prospective electrocardiograph (ECG) gating based on step-and-shoot (SAS), Flash and volume imaging modes. We searched the electronic databases PubMed for all published studies regarding CCTA. We used an exact binomial rendition of the bivariate mixed-effects regression model developed for synthesis of diagnostic data. A total of 21,852 segments, 4,851 vessels and 1,375 patients were identified using database searches. Patient-level pooled sensitivity was 0.99 (95 % confidence interval [CI], 0.98-1.00); specificity was 0.88 (CI, 0.85-0.91). The results showed that the sensitivity and specificity for detection of significant stenosis did not differ in the three protocols (P = 0.24). No heterogeneity was found at the patient level for sensitivity (Q = 26.23; P = 0.12; I {sup 2} = 27.56 % [CI, 0.00-67.02 %]) and specificity (Q = 19.54; P = 0.42; I {sup 2} = 2.78 % [CI, 0.00-66.26 %]). CCTA with prospective ECG gating has similar high diagnostic value to rule out CAD in all three presented modes. (orig.)

  15. Tracheal compliance and limit flow rate changes in a murine model of asthma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Trachea is the unique passage for air to flow in and out. Its tone is of importance for the respiration system. However, investigation on how tracheal tone changes due to asthma is limited. Aiming at studying how the mechanical property changes due to asthma as well as the compliance and flow limitation, the following methods are adopted. Static and passive pressure-volume tests of rats’ trachea of the asthmatic and control groups are carried out and a new type of tube law is formulated to fit the experimental data, based on which changes of compliance and limit flow rate are investigated. In order to give explanation to such changes, histological examinations with tracheal soft tissues are made. The results show that compliance, limit flow rate and material constants included in the tube law largely depend on the longitudinal stretching ratio. Compared with the control group, the tracheal compliance of asthmatic animals decreases significantly, which results in an increased limit flow rate. Histological studies indicate that asthma can lead to hyperplasia/hypertrophy of smooth muscle cells, and increase elastin and collagen fibres in the muscular membrane. Though decreasing compliance increases sta- bility, during the onset of asthma, limit flow rate is much smaller due to the lower transmural pressure. Asthma leads to a stiffer trachea and the obtained results reveal some aspects relevant to asthma-induced tracheal remodelling.

  16. Tracheal compliance and limit flow rate changes in a urine model of asthma

    Institute of Scientific and Technical Information of China (English)

    TENG ZhongZhao; WANG YiQin; LI FuFeng; YAN HaiXia; LIU ZhaoRong

    2008-01-01

    Trachea is the unique passage for air to flow in and out. Its tone is of importance for the respiration system. However, investigation on how tracheal tone changes due to asthma is limited. Aiming at studying how the mechanical property changes due to asthma as well as the compliance and flow limitation, the following methods are adopted. Static and passive pressure-volume tests of rats' trachea of the asthmatic and control groups are carried out and a new type of tube law is formulated to fit the experimental data, based on which changes of compliance and limit flow rate are investigated. In order to give explanation to such changes, histological examinations with tracheal soft tissues are made. The results show that compliance, limit flow rate and material constants included in the tube law largely depend on the longitudinal stretching ratio. Compared with the control group, the tracheal compliance of asthmatic animals decreases significantly, which results in an increased limit flow rate. Histological studies indicate that asthma can lead to hyperplasia/hypertrophy of smooth muscle cells, and increase elastin and collagen fibres in the muscular membrane. Though decreasing compliance increases sta-bility, during the onset of asthma, limit flow rate is much smaller due to the lower transmural pressure. Asthma leads to a stiffer trachea and the obtained results reveal some aspects relevant to asthma-induced tracheal remodelling.

  17. Local Government Internal Audit Compliance

    Directory of Open Access Journals (Sweden)

    Greg Jones

    2015-09-01

    Full Text Available Local government councils (LGC rely on a number of funding sources including state and federal governments as well as their community constituents to enable them to provide a range of public services. Given the constraints on these funding sources councils need to have in place a range of strategies and policies capable of providing good governance and must appropriately discharge their financial accountabilities. To assist LGC with meeting their governance and accountability obligations they often seek guidance from their key stakeholders. For example, in the Australian State of New South Wales (NSW, the Office of Local Government has developed a set of guidelines, the Internal Audit Guidelines. In 2010 the NSW Office of Local Government issued revised guidelines emphasising that an internal audit committee is an essential component of good governance. In addition, the guidelines explained that to improve the governance and accountability of the councils, these committees should be composed of a majority of independent members. To maintain committee independence the guidelines indicated that the Mayor should not be a member of the committee. However these are only guidelines, not legislated requirements and as such compliance with the guidelines, before they were revised, has been demonstrated to be quite low (Jones & Bowrey 2013. This study, based on a review of NSW Local Government Councils’ 2012/2013 reports, including Annual Reportsrelation to internal audit committees, to determine if the guidelines are effective in improving local government council governance.

  18. Pulmonary Arterial Hypertension

    Science.gov (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  19. Neonatal pulmonary artery thrombosis

    Directory of Open Access Journals (Sweden)

    Mangesh Jadhav

    2012-01-01

    Full Text Available Pulmonary artery thrombosis in neonates is a rare entity. We describe two neonates with this diagnosis; their presentation, evaluation, and management. These cases highlight the importance of this differential diagnosis when evaluating the cyanotic neonate.

  20. Renal arteries (image)

    Science.gov (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  1. Accommodation and Compliance Series: Employees with Arthritis

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Arthritis By Beth Loy, Ph.D. Preface Introduction Information ... SOAR) at http://AskJAN.org/soar . Information about Arthritis How prevalent is arthritis? An estimated 50 million ...

  2. Consolidated Audit And Compliance System (CACS)

    Data.gov (United States)

    US Agency for International Development — Consolidated Audit and Compliance System: is an audit findings management and reporting system. CACS is an implementation of the Agency Secure Image and Storage...

  3. 40 CFR 264.96 - Compliance period.

    Science.gov (United States)

    2010-07-01

    ....96 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Releases From Solid Waste Management Units § 264.96 Compliance period. (a) The Regional Administrator...

  4. Iowa Compliance Implementation and Evaluation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.

    2012-09-04

    This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

  5. Nevada Compliance Implementation and Evaluation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.

    2012-08-30

    This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

  6. Utah Compliance Implementation and Evaluation Guide

    Energy Technology Data Exchange (ETDEWEB)

    Cole, Pamala C.

    2012-08-30

    This Guide is designed to assist state and local code jurisdictions in achieving statewide compliance with the 2009 International Energy Conservation Code (IECC) for residential buildings and ANSI/ASHRAE/IESNA Standard 90.1-2007 for commercial buildings.

  7. Enforcement and Compliance History Online (ECHO) Facilities

    Data.gov (United States)

    U.S. Environmental Protection Agency — ECHO provides integrated compliance and enforcement information for about 800,000 regulated facilities nationwide. Its features range from simple to advanced,...

  8. 7 CFR 15.5 - Compliance.

    Science.gov (United States)

    2010-01-01

    ... Department of Agriculture-Effectuation of Title VI of the Civil Rights Act of 1964 § 15.5 Compliance. (a... racial and ethnic data showing the extent to which members of minority groups are beneficiaries...

  9. Information communication Technology (ICT) compliance among ...

    African Journals Online (AJOL)

    Information communication Technology (ICT) compliance among ... The one with very strong effect is the high cost of hardware and software including fear of virus ... requisite education and upgrade themselves through training programme to ...

  10. Heritability of cilioretinal arteries

    DEFF Research Database (Denmark)

    Taarnhøj, Nina Charlotte; Munch, Inger C; Kyvik, Kirsten O;

    2005-01-01

    PURPOSE: To determine whether the presence of one or more cilioretinal arteries, a distinct element of the pattern of fundus vessels, is genetically programmed, influenced by environmental factors, or the result of random mechanisms of vascular development. METHODS: The fundi of 112 pairs...... environmental factors. CONCLUSIONS: The presence or absence of one or more cilioretinal arteries in healthy persons is markedly influenced by genetic factors....

  11. 41 CFR 60-2.35 - Compliance status.

    Science.gov (United States)

    2010-07-01

    ... 2-AFFIRMATIVE ACTION PROGRAMS Miscellaneous § 60-2.35 Compliance status. No contractor's compliance... 11246 and the regulations in this chapter. Each contractor's compliance with its affirmative action... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Compliance status....

  12. 42 CFR 93.413 - HHS compliance actions.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false HHS compliance actions. 93.413 Section 93.413... Compliance Issues § 93.413 HHS compliance actions. (a) An institution's failure to comply with its assurance... requirements of this part, HHS may take some or all of the following compliance actions: (1) Issue a letter...

  13. Compliance and patching and atropine amblyopia treatments.

    Science.gov (United States)

    Wang, Jingyun

    2015-09-01

    In the past 20 years, there has been a great advancement in knowledge pertaining to compliance with amblyopia treatments. The occlusion dose monitor introduced quantitative monitoring methods in patching, which sparked our initial understanding of the dose-response relationship for patching amblyopia treatment. This review focuses on current compliance knowledge and the impact it has on patching and atropine amblyopia treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Compliance with occlusion therapy for childhood amblyopia.

    Science.gov (United States)

    Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

    2013-09-17

    Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

  15. THE ROLE OF FAIRNESS IN TAX COMPLIANCE

    OpenAIRE

    Verboon, Peter; Goslinga, Sjoerd

    2010-01-01

    The purpose of this paper is to study the relation between fairness considerations and tax compliance attitudes and intentions. Data from a large panel survey among small business owners in the Netherlands have been analyzed. Besides a number of background and control variables the questionnaire contained measures of personal norms, procedural and distributive justice, tax compliance attitudes and intentions to comply with tax rules. Results support the hypothesis that personal norms and just...

  16. 40 CFR 156.159 - Compliance date.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Compliance date. 156.159 Section 156... REQUIREMENTS FOR PESTICIDES AND DEVICES Container Labeling § 156.159 Compliance date. Any pesticide product...(d)(7), 156.10(f), 156.10(i)(2)(ix), 156.140, 156.144, 156.146, and 156.156. Effective Date Note:...

  17. Calf venous compliance measured by venous occlusion plethysmography: methodological aspects.

    Science.gov (United States)

    Skoog, Johan; Zachrisson, Helene; Lindenberger, Marcus; Ekman, Mikael; Ewerman, Lea; Länne, Toste

    2015-02-01

    Calf venous compliance (C calf) is commonly evaluated with venous occlusion plethysmography (VOP) during a standard cuff deflation protocol. However, the technique relies on two not previously validated assumptions concerning thigh cuff pressure (P cuff) transmission and the impact of net fluid filtration (F filt) on C calf. The aim was to validate VOP in the lower limb and to develop a model to correct for F filt during VOP. Strain-gauge technique was used to study calf volume changes in 15 women and 10 age-matched men. A thigh cuff was inflated to 60 mmHg for 4 and 8 min with a subsequent decrease of 1 mmHg s(-1). Intravenous pressure (P iv) was measured simultaneously. C calf was determined with the commonly used equation [Compliance = β 1 + 2β 2 × P cuff] describing the pressure-compliance relationship. A model was developed to identify and correct for F filt. Transmission of P cuff to P iv was 100 %. The decrease in P cuff correlated well with P iv reduction (r = 0.99, P < 0.001). Overall, our model showed that C calf was underestimated when F filt was not accounted for (all P < 0.01). F filt was higher in women (P < 0.01) and showed a more pronounced effect on C calf compared to men (P < 0.05). The impact of F filt was similar during 4- and 8-min VOP. P cuff is an adequate substitute for P iv in the lower limb. F filt is associated with an underestimation of C calf and differences in the effect of F filt during VOP can be accounted for with the correction model. Thus, our model seems to be a valuable tool in future studies of venous wall function.

  18. Third-party biller compliance guidance emphasizes risk awareness.

    Science.gov (United States)

    Saner, R J

    1999-03-01

    The voluntary compliance guidance for third-party billing companies released by the HHS Office of Inspector General (OIG) in December 1998, like the OIG's previously released guidance directed at hospitals, home health agencies, and clinical laboratories, identifies seven minimum elements for an effective corporate compliance program: written compliance policies, designation of a compliance officer, ongoing training, open lines of communication, guidelines to ensure the enforcement of compliance standards, internal monitoring and auditing of compliance activity, and procedures to respond to and correct errors. Three areas of concern for third-party billing companies are emphasized in the new guidance document: compliance risk, claims documentation, and disclosure of suspected misconduct or fraud.

  19. Compliance with RSV prophylaxis: Global physicians’ perspectives

    Directory of Open Access Journals (Sweden)

    Kari S Anderson

    2009-07-01

    Full Text Available Kari S Anderson, Victoria M Mullally, Linda M Fredrick, Andrew L CampbellAbbott Laboratories, Abbott Park, IL, USAAbstract: Respiratory syncytial virus (RSV is a significant cause of morbidity in high-risk infants. Palivizumab is proven to prevent serious RSV disease, but compliance with prophylaxis (monthly doses during the RSV season is essential to ensure protection. We invited 453 pediatricians to participate in a survey to identify their perspectives of barriers to compliance and interventions to improve compliance with palivizumab prophylaxis schedules. One hundred physicians from five continents completed the survey, identifying caregiver inconvenience, distance to clinic, cost of prophylaxis, and lack of understanding of the severity of RSV as the most common reasons for noncompliance. They recommended provision of educational materials about RSV, reminders from hospital or clinic, and administration of prophylaxis at home to increase compliance. Globally, physicians recognize several obstacles to prophylaxis compliance. This survey suggests that focused proactive interventions such as empowering caregivers with educational materials and reducing caregiver inconvenience may be instrumental to increase compliance.Keywords: medication adherence, respiratory syncytial virus infections, infant, premature, immunization, passive

  20. Photoacoustic tomography of vascular compliance in humans

    Science.gov (United States)

    Hai, Pengfei; Zhou, Yong; Liang, Jinyang; Li, Chiye; Wang, Lihong V.

    2015-12-01

    Characterization of blood vessel elastic properties can help in detecting thrombosis and preventing life-threatening conditions such as acute myocardial infarction or stroke. Vascular elastic photoacoustic tomography (VE-PAT) is proposed to measure blood vessel compliance in humans. Implemented on a linear-array-based photoacoustic computed tomography system, VE-PAT can quantify blood vessel compliance changes due to simulated thrombosis and occlusion. The feasibility of the VE-PAT system was first demonstrated by measuring the strains under uniaxial loading in perfused blood vessel phantoms and quantifying their compliance changes due to the simulated thrombosis. The VE-PAT system detected a decrease in the compliances of blood vessel phantoms with simulated thrombosis, which was validated by a standard compression test. The VE-PAT system was then applied to assess blood vessel compliance in a human subject. Experimental results showed a decrease in compliance when an occlusion occurred downstream from the measurement point in the blood vessels, demonstrating VE-PAT's potential for clinical thrombosis detection.

  1. A General Framework for Measuring VAT Compliance Rates

    OpenAIRE

    J. A. Giesecke; Tran Hoang Nhi

    2010-01-01

    Summary measures of VAT compliance rates are valuable for identifying problem areas in VAT implementation. They are also essential for meaningful cross-country and cross-time comparisons of VAT compliance. We present a comprehensive and general framework for calculating VAT compliance rates at both the economy-wide and detailed sectoral levels. Unlike existing measures of VAT compliance, our framework isolates a compliance measure from the effects on VAT receipts of detailed features of VAT s...

  2. Environmental report 1994. Volume No. 2

    Energy Technology Data Exchange (ETDEWEB)

    Rath, K.S. [ed.; Harrach, R.J.; Gallegos, G.M.; Failor, R.A.; Christofferson, E. [and others

    1995-09-01

    This volume 2 of the Lawrence Livermore National Laboratory`s (LLNL`s) annual Environmental Report 1994 is a detailed data report that provides individual data points, where applicable, along with some summary data and more detailed accounts of sample collection and analytical methods. Six chapters have information on monitoring of air, surface water, groundwater, soil and sediment, vegetation and foodstuffs, and environmental radiation; two other chapters cover compliance sel-monitoring and quality assurance.

  3. High resolution ultrasound and arterial wall changes in early atherosclerosis

    Science.gov (United States)

    Renton, Sophie Caroline

    Non-invasive vascular testing evolved initially to meet the needs of the surgeon to identify haemodynamically significant lesions. However, with refinement of techniques and the development of high resolution ultrasound, it has become possible to detect early lesions and to measure the thickness of die arterial wall with an accuracy of 0.2mm. Such measurements have epidemiological and prognostic potential. They may allow the study of progression (or regression) of atherosclerotic disease before symptoms develop. The aim of this thesis was to assess the value of arterial wall measurements of intima-media thickness and compliance of the common carotid artery in the prediction of early atherosclerotic disease. Four different anatomical patterns of carotid bulb morphology have been identified, according to the position of the bulb origin in relation to the flow divider. It has been demonstrated that bulb morphology influences the site of early plaque formation. The presence of plaque at the carotid and femoral bifurcations was found to be associated with increased intima-media thickening of the common carotid artery. Histological analysis of common carotid arteries taken at post-mortem showed that this diffuse intima-media thickening is the result of deposition of cholesterol crystals, medial atrophy, fatty and fibrous change, and accumulation of necrotic debris, the features characteristic of plaques, even though discrete plaques rarely occur at this site. Subsequently, a number of clinical studies were undertaken which demonstrated that the intima-media thickness is increased in diabetics, hypopituitary patients and claudicants as compared to controls. It was found that the intima-media thickness of the common carotid artery could be used to predict the presence of bifurcation plaques and macrovascular disease. The work of this thesis has demonstrated that high resolution ultrasound is a powerful technique for die study of the arterial wall and should be tested in

  4. N-butyl Cyanoacrylate Glue Embolization of Arterial Networks to Facilitate Hepatic Arterial Skeletonization before Radioembolization

    Energy Technology Data Exchange (ETDEWEB)

    Samuelson, Shaun D.; Louie, John D.; Sze, Daniel Y., E-mail: dansze@stanford.edu [Stanford University School of Medicine, Division of Interventional Radiology (United States)

    2013-06-15

    Purpose. Avoidance of nontarget microsphere deposition via hepatoenteric anastomoses is essential to the safety of yttrium-90 radioembolization (RE). The hepatic hilar arterial network may remain partially patent after coil embolization of major arteries, resulting in persistent risk. We retrospectively reviewed cases where n-butyl cyanoacrylate (n-BCA) glue embolization was used to facilitate endovascular hepatic arterial skeletonization before RE. Methods. A total of 543 RE procedures performed between June 2004 and March 2012 were reviewed, and 10 were identified where n-BCA was used to embolize hepatoenteric anastomoses. Arterial anatomy, prior coil embolization, and technical details were recorded. Outcomes were reviewed to identify subsequent complications of n-BCA embolization or nontarget RE. Results. The rate of complete technical success was 80 % and partial success 20 %, with one nontarget embolization complication resulting in a minor change in treatment plan. No evidence of gastrointestinal or biliary ischemia or infarction was identified, and no microsphere-related gastroduodenal ulcerations or other evidence of nontarget RE were seen. Median volume of n-BCA used was <0.1 ml. Conclusion. n-BCA glue embolization is useful to eliminate hepatoenteric networks that may result in nontarget RE, especially in those that persist after coil embolization of major vessels such as the gastroduodenal and right gastric arteries.

  5. Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

    Directory of Open Access Journals (Sweden)

    Huas Dominique

    2010-08-01

    Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

  6. Coronary anomaly: the single coronary artery

    Institute of Scientific and Technical Information of China (English)

    QIN Xu-guang; XIONG Wei-guo; LU Chun-peng; GONG Cheng-jie; SHANG Li-hua

    2010-01-01

    @@ Single coronary artery (SCA), defined as an artery that arises from the arterial trunk and nourishes the entire myocardium, is rare. We report two cases of SCA, one is the right coronary artery (RCA) originating from the middle of left descending artery (LAD), and the other is the left main coronary artery (LMCA) arising from the proximal right coronary artery.

  7. Coronary Artery and Pulmonary Artery Fistula Originated from Significant Stenosis in the Left Anterior Descending Artery

    Directory of Open Access Journals (Sweden)

    Alper Sami Kunt

    2013-01-01

    Full Text Available Coronary artery fistula (CAF is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA. CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment options.

  8. Magnetic resonance of carotid artery ageing in healthy subjects.

    Science.gov (United States)

    Keenan, Niall G; Locca, Didier; Varghese, Anitha; Roughton, Michael; Gatehouse, Peter D; Hooper, James; Firmin, David N; Pennell, Dudley J

    2009-07-01

    To assess how the arterial wall of the carotid artery changes with age in normal subjects by cardiovascular magnetic resonance (CMR). Carotid CMR was performed in 100 normal subjects (10 per sex per decade) who were free of atherosclerotic risk factors and carotid atherosclerosis. Using three-dimensional computer modeling, the volumes of the arterial wall, lumen, and the total vessel were calculated, and the wall/outer wall (W/OW) ratio was derived. Wall volume and total vessel volume increased significantly with age in both sexes (pW/OW ratio also increased significantly with age (p<0.001). Lumen volume increased significantly with age in males (p<0.001), but not in females (p=0.1). In normal subjects, carotid wall volume increases with age. In men, this vessel wall volume increase is associated with significant remodeling of the lumen and outer wall. These data relating normal carotid findings with ageing are important for further CMR studies of early atherosclerosis.

  9. Effect of angiotensin II-induced arterial hypertension on the voltage-dependent contractions of mouse arteries.

    Science.gov (United States)

    Fransen, Paul; Van Hove, Cor E; Leloup, Arthur J A; Schrijvers, Dorien M; De Meyer, Guido R Y; De Keulenaer, Gilles W

    2016-02-01

    Arterial hypertension (AHT) affects the voltage dependency of L-type Ca(2+) channels in cardiomyocytes. We analyzed the effect of angiotensin II (AngII)-induced AHT on L-type Ca(2+) channel-mediated isometric contractions in conduit arteries. AHT was induced in C57Bl6 mice with AngII-filled osmotic mini-pumps (4 weeks). Normotensive mice treated with saline-filled osmotic mini-pumps were used for comparison. Voltage-dependent contractions mediated by L-type Ca(2+) channels were studied in vaso-reactive studies in vitro in isolated aortic and femoral arteries by using extracellular K(+) concentration-response (KDR) experiments. In aortic segments, AngII-induced AHT significantly sensitized isometric contractions induced by elevated extracellular K(+) and depolarization. This sensitization was partly prevented by normalizing blood pressure with hydralazine, suggesting that it was caused by AHT rather than by direct AngII effects on aortic smooth muscle cells. The EC50 for extracellular K(+) obtained in vitro correlated significantly with the rise in arterial blood pressure induced by AngII in vivo. The AHT-induced sensitization persisted when aortic segments were exposed to levcromakalim or to inhibitors of basal nitric oxide release. Consistent with these observations, AngII-treatment also sensitized the vaso-relaxing effects of the L-type Ca(2+) channel blocker diltiazem during K(+)-induced contractions. Unlike aorta, AngII-treatment desensitized the isometric contractions to depolarization in femoral arteries pointing to vascular bed specific responses of arteries to hypertension. AHT affects the voltage-dependent L-type Ca(2+) channel-mediated contraction of conduit arteries. This effect may contribute to the decreased vascular compliance in AHT and explain the efficacy of Ca(2+) channel blockers to reduce vascular stiffness and central blood pressure in AHT.

  10. [Importance of compliance in nutritional management. Case report].

    Science.gov (United States)

    Mikulka, Ilona

    2016-04-10

    Disease-related malnutrition is usually caused by the joint action of the underlying disease itself and dietary deficiency. The consequences of malnutrition, if left untreated, are serious, causing a marked decline in physical and psychological health and function, and an increased rate of complications and decreased effectiveness of the medical treatments. In case a functional gastrointestinal tract is present, the recommended form of nutritional management is the use of oral nutritional supplements. However, just like to any other therapy, compliance to oral nutritional supplements is highly influenced by the consistency, taste, smell, volume consumed, and side effects. The aim of the present case report is to illustrate that nutritional management is a successful and effective treatment option of disease-related malnutrition when the selection of the oral nutritional supplement takes into consideration patient's preferences as well.

  11. 平均血小板体积与动脉性勃起功能障碍的相关性研究%Correlation between mean platelet volume and arterial erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    郭立强; 孙文东; 刘玉强; 邵光峰; 赵升田; 袁明振

    2014-01-01

    目的:评估平均血小板体积(MPV)与动脉性勃起功能障碍(ED)之间的关系。方法选取动脉性ED患者153例,正常对照150例,比较两组年龄、体重、BMI、血小板数量、MPV、血小板分布宽度(PDW)、性腺六项、血脂、白细胞数、血红蛋白等指标,通过 Logistic 回归分析评价MPV与动脉性ED的相关性。结果两组年龄、体重、BMI、血小板数量,性腺六项、血脂、白细胞、血红蛋白及 PDW 等之间差异无统计学意义,MPV 动脉性 ED 组明显高于对照组[(9.90±0.98)fl vs.(9.14±1.03)fl,P<0.01]。多因素Logistic回归分析结果显示:MPV与动脉性 ED 发生具有独立相关性(优势比:3.774,95%可信区间:1.435~9.928;P<0.01)。结论 MPV作为评价血小板活性的指标,在动脉性ED患者中明显升高,是动脉性ED的独立危险因素。%ObjectiveTo evaluate the relationship between the mean platelet volume (MPV) and arteriogenic erectile dysfunction (ED). MethodsBiochemical profile and MPV were measured in 153 patients with arteriogenic ED and 150 healthy controls. The diagnosis of ED was based on the findings from detailed sexual history, physical examination, laboratory assessment , and color Doppler ultrasound. Logistic analysis were employed to clarify the relationship between variables and arteriogenic ED. ResultsThe MPV values were statistically significantly higher in arteriogenic ED group than in control group [(9.90±0.98)flvs. (9.14±1.03)fl,P<0.01]. Multiple logistic analysis demonstrated that MPV were independently associated with the occurrence of arteriogenic ED (OR: 3.774,95%CI: 1.435-9.928;P<0.01).ConclusionThe MPV was detected to be increased in patients with arteriogenic ED, which is used widely to measure the size of platelets and indicates platelet reactivity, can provide guidance in the investigation of arteriogenic ED pathophysiology and are an independent risk factor for the

  12. Moment-specific compliance with hand hygiene.

    Science.gov (United States)

    Lau, Tiffany; Tang, Grace; Mak, Ka-lun; Leung, Gilberto

    2014-06-01

    Hand hygiene is an important component of patient-safety education. The World Health Organization recommends the use of hand hygiene measures at five clinical moments. While previous studies have treated hand hygiene as a single entity, we investigated whether and how the compliance of students may vary across the five clinical moments. We also studied their reasons for non-compliance with a view to inform teaching. A voluntary self-administered questionnaire survey was conducted on a convenient sample of 339 medical and nursing students. The five clinical moments studied were: before touching a patient (moment 1); before a clean/aseptic procedure (moment 2); after body fluid exposure risk (moment 3); after touching a patient (moment 4); and after touching the patient's surroundings (moment 5). The overall reported compliance rate was 83.0 per cent. The compliance rates were significantly lower at moments 1 and 5. Nursing students reported better overall compliance (p = 0.01), and at moments 2 (p = 0.0001) and 3 (p = 0.0001), than medical students. Medical students fared better at moment 4 (p = 0.009). The most common reason reported for non-compliance was 'forgetfulness'. We identified differences in compliance rates across the five clinical moments of hand hygiene. Education programmes should not treat the hand hygiene process as a single entity, but should adopt a moment-specific approach to promote recall, with particular emphases on moments 1 and 5. Nursing and medical students may require different education strategies. Future studies on hand hygiene may also adopt a moment-specific approach. © 2014 John Wiley & Sons Ltd.

  13. 40 CFR 63.772 - Test methods, compliance procedures, and compliance demonstrations.

    Science.gov (United States)

    2010-07-01

    ... Oil and Natural Gas Production Facilities § 63.772 Test methods, compliance procedures, and compliance... procedures documented in the Gas Research Institute (GRI) report entitled “Atmospheric Rich/Lean Method for...) report entitled “Atmospheric Rich/Lean Method for Determining Glycol Dehydrator Emissions”...

  14. 24 CFR 108.21 - Civil rights/compliance reviewing office compliance responsibility.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Civil rights/compliance reviewing office compliance responsibility. 108.21 Section 108.21 Housing and Urban Development Regulations Relating to Housing and Urban Development OFFICE OF ASSISTANT SECRETARY FOR EQUAL OPPORTUNITY,...

  15. NCAA Compliance: An Examination of NCAA Division I Compliance Officers' Perceptions on the Educative Process

    Science.gov (United States)

    Gimbert, Tonya L.

    2013-01-01

    A review of the literature indicates an absence of studies about compliance officers working in higher education institutions belonging to the National Collegiate Athletic Association (NCAA). The current qualitative study explored the perceptions of compliance officers in the field of intercollegiate athletics at NCAA Division I institutions in…

  16. Arterial Stiffening With Exercise in Patients With Heart Failure and Preserved Ejection Fraction.

    Science.gov (United States)

    Reddy, Yogesh N V; Andersen, Mads J; Obokata, Masaru; Koepp, Katlyn E; Kane, Garvan C; Melenovsky, Vojtech; Olson, Thomas P; Borlaug, Barry A

    2017-07-11

    Aortic stiffening and reduced nitric oxide (NO) availability may contribute to the pathophysiology of heart failure with preserved ejection fraction (HFpEF). This study compared indices of arterial stiffness at rest and during exercise in subjects with HFpEF and hypertensive control subjects to examine their relationships to cardiac hemodynamics and determine whether exertional arterial stiffening can be mitigated by inorganic nitrite. A total of 22 hypertensive control subjects and 98 HFpEF subjects underwent hemodynamic exercise testing with simultaneous expired gas analysis to measure oxygen consumption. Invasively measured radial artery pressure waveforms were converted to central aortic waveforms by transfer function to assess integrated measures of pulsatile aortic load, including arterial compliance, resistance, elastance, and wave reflection. Arterial load and wave reflections in HFpEF were similar to those in control subjects at rest. During submaximal exercise, HFpEF subjects displayed reduced total arterial compliance and higher effective arterial elastance despite similar mean arterial pressures in control subjects. This was directly correlated with higher ventricular filling pressures and depressed cardiac output reserve (both p exercise, increased wave reflections, impaired compliance, and increased resistance and elastance were observed in subjects with HFpEF. A subset of HFpEF subjects (n = 52) received sodium nitrite or placebo therapy in a 1:1 double-blind, randomized fashion. Compared to placebo, nitrite decreased aortic wave reflections at rest and improved arterial compliance and elastance and central hemodynamics during exercise. Abnormal pulsatile aortic loading during exercise occurs in HFpEF independent of hypertension and is correlated with classical hemodynamic derangements that develop with stress. Inorganic nitrite mitigates arterial stiffening with exercise and improves hemodynamics, indicating that arterial stiffening with

  17. Multi-detector Computed Tomography Angiography of the Hepatic Artery in Liver Transplant Recipients

    Energy Technology Data Exchange (ETDEWEB)

    Boraschi, P.; Donati, F.; Cossu, M.C.; Gigoni, R.; Vignali, C.; Filipponi, F.; Bartolozzi, C.; Falaschi, F. [Pisa Univ. Hospital (Italy). 2nd Dept. of Radiology

    2005-08-01

    PURPOSE: To evaluate the ability of multi-detector row computed tomography angiography (CTA) in detecting hepatic artery complications in the follow-up of liver transplant patients, performing volume-rendering as reconstruction technique. MATERIAL AND METHODS: The anatomy of hepatic artery was studied in 27 liver transplant recipients with a four-row CT scanner using the following parameters: collimation, 1 mm; slice width, 1 mm; table feed, 6-8 mm/s; spiral reconstruction time, 0.5 s; reconstruction interval, 0.5 mm; mAs, 160; kVp, 120. Before the study, the patients received 1000 ml of water as oral contrast agent to produce negative contrast in the stomach and the small bowel. A non-ionic contrast medium was infused intravenously at a rate of 5 ml/s with a bolus tracking system. Volume-rendering of hepatic artery was performed with the 3D Virtuoso software. RESULTS: The celiac trunk, the hepatic artery, and the right and left hepatic arteries were successfully displayed in high detail in all patients. Side branches, including small collaterals, and hepatic artery anastomosis could also be readily visualized. Volume-rendered CTA detected six hepatic artery stenoses, two hepatic artery thromboses, and two intrahepatic pseudoaneurysms. In two cases, CT detected hepatic artery stenosis with a diameter reduction of less than 50%, while digital subtraction angiography showed a normal artery. CONCLUSION: Volume-rendered multi-detector CTA is a promising non-invasive technique, since it allows images of high quality to be generated with excellent anatomical visualization of the hepatic artery and its complications in liver transplant recipients.

  18. Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke

    Directory of Open Access Journals (Sweden)

    Hakimelahi Reza

    2012-11-01

    Full Text Available Abstract Background We tested the hypothesis that in patients with occlusion of the terminal internal carotid artery and/or the proximal middle cerebral artery, a diffusion abnormality of 70 ml or less is accompanied by a diffusion/perfusion mismatch of at least 100%. Methods Sixty-eight consecutive patients with terminal ICA and/or proximal MCA occlusions and who underwent diffusion/perfusion MRI within 24 hours of stroke onset were retrospectively identified. DWI and mean transit time (MTT volumes were measured. Prospectively, 48 consecutive patients were identified with the same inclusion criteria. DWI and time to peak (TTP lesion volumes were measured. A large mismatch volume was defined as an MTT or TTP abnormality at least twice the DWI lesion volume. Results In the retrospective study, 49 of 68 patients had a DWI lesion volume ≤ 70 ml (mean 20.2 ml; SEM 2.9 ml. A DWI/MTT mismatch of > 100% was observed in all 49 patients (P  100% was present in all 35 (P  Conclusions Acute stroke patients with major anterior circulation artery occlusion are exceedingly likely to have a major diffusion/perfusion mismatch if the diffusion lesion volume is 70 ml or less. This suggests that physiology-based patient assessments may be made using only vessel imaging and diffusion MRI as a simple alternative to perfusion imaging.

  19. A review of wave mechanics in the pulmonary artery with an emphasis on wave intensity analysis.

    Science.gov (United States)

    Su, J; Hilberg, O; Howard, L; Simonsen, U; Hughes, A D

    2016-12-01

    Mean pulmonary arterial pressure and pulmonary vascular resistance (PVR) remain the most common haemodynamic measures to evaluate the severity and prognosis of pulmonary hypertension. However, PVR only captures the non-oscillatory component of the right ventricular hydraulic load and neglects the dynamic compliance of the pulmonary arteries and the contribution of wave transmission. Wave intensity analysis offers an alternative way to assess the pulmonary vasculature in health and disease. Wave speed is a measure of arterial stiffness, and the magnitude and timing of wave reflection provide information on the degree of impedance mismatch between the proximal and distal circulation. Studies in the pulmonary artery have demonstrated distinct differences in arterial wave propagation between individuals with and without pulmonary vascular disease. Notably, greater wave speed and greater wave reflection are observed in patients with pulmonary hypertension and in animal models exposed to hypoxia. Studying wave propagation makes a valuable contribution to the assessment of the arterial system in pulmonary hypertension, and here, we briefly review the current state of knowledge of the methods used to evaluate arterial waves in the pulmonary artery.

  20. Traumatic Distal Ulnar Artery Thrombosis

    Directory of Open Access Journals (Sweden)

    Ahmet A. Karaarslan

    2014-01-01

    Full Text Available This paper is about a posttraumatic distal ulnar artery thrombosis case that has occurred after a single blunt trauma. The ulnar artery thrombosis because of chronic trauma is a frequent condition (hypothenar hammer syndrome but an ulnar artery thrombosis because of a single direct blunt trauma is rare. Our patient who has been affected by a single blunt trauma to his hand and developed ulnar artery thrombosis has been treated by resection of the thrombosed ulnar artery segment. This report shows that a single blunt trauma can cause distal ulnar artery thrombosis in the hand and it can be treated merely by thrombosed segment resection in suitable cases.

  1. Coronary Artery Imaging in Children

    Science.gov (United States)

    2015-01-01

    Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acquired coronary artery abnormalities in children, such as coronary artery anomalies, aberrant coronary artery anatomy specific to congenital heart disease, Kawasaki disease, Williams syndrome, and cardiac allograft vasculopathy. PMID:25741188

  2. Polymeric Materials for Tissue Engineering of Arterial Substitutes

    Science.gov (United States)

    Ravi, Swathi; Qu, Zheng; Chaikof, Elliot L.

    2009-01-01

    Cardiovascular disease is the leading cause of mortality in the United States. The limited availability of healthy autologous vessels for bypass grafting procedures has led to the fabrication of prosthetic vascular conduits. Synthetic polymeric materials, while providing the appropriate mechanical strength, lack the compliance and biocompatibility that bioresorbable and naturally occurring protein polymers offer. Vascular tissue engineering approaches have emerged in order to meet the challenges of designing a vascular graft with long-term patency. In vitro culture techniques that have been explored with vascular cell seeding of polymeric scaffolds and the use of bioactive polymers for in situ arterial regeneration have yielded promising results. This review describes the development of polymeric materials in various tissue engineering strategies for the improvement in the mechanical and biological performance of an arterial substitute. PMID:19426609

  3. Comparison of efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery%腹腔镜手术患儿压力控制通气和容量控制通气效果的比较

    Institute of Scientific and Technical Information of China (English)

    冯继峰; 郑剑秋; 周蜀克

    2014-01-01

    Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in children undergoing laparoscopic surgery.Methods Thirty ASA Ⅰ or Ⅱ children of both sexes,aged 12-36 months,weighing 9-15 kg,scheduled for laparoscopic surgery,were randomly divided into two groups (n =15 each):pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group Ⅴ).After anesthesia was induced with propofol 2-4 mg/kg,vecuronium 0.1 mg/kg and fentanyl 2 μg/kg,the children received endotracheal intubation and mechanical ventilation.The maximum inspiratory pressure was adjusted to make the tidal volume (VT) achieve 12 ml/kg in group P and the VT was set at 12 ml/kg in group V.The end-tidal pressure of carbon dioxide (PET CO2) was controlled at 35-45 mm Hg.The mean arterial blood pressure (MAP),heart rate (HR),arterial carbpn dioxide tension (PaCO2),PETCO2,minute ventilation and peak airway pressure were recorded immediately after intubation (T0),immediately before skin incision (T1),after 30 minutes of pneumoperitoneum (T2) and 15 minutes after the end of pneumoperitoneum (T3).Arterial blood samples were taken at the same time points mentioned above for blood gas analysis.Dynamic lung compliance and the ratio of the physiological dead space to the tidal volume were calculated.Results Compared with group Ⅴ,PaCO2 and PET CO2 were significantly decreased and dynamic lung compliance was significantly increased at T1-2,and minute ventilation and peak airway pressure were significantly decreased at T0-3 in group P (P < 0.01).There was no significant difference in MAP,HR and the ratio of the physiological dead space to the tidal volume between the two groups (P > 0.05).Conclusion Compared with volume-controlled ventilation,pressure-controlled ventilation can better improve the ventilatory efficacy,is more beneficial to gas exchange and reduces the influence of pneumoperitoneum on respiratory function in children

  4. Left Coronary Artery-Pulmonary Artery Fistula in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Orhan Veli Doğan

    2012-08-01

    Full Text Available Coroner artery fistula which is rare and congenital or acquired arise from whole coroner artery drainage all of cardiac chamber and great artery. Although coroner artery fistula is uncommon, it can cause significant mortality and morbidity rates. The article is presented which coroner artery disease and coroner-pulmonary artery fistula was accomplishment committed. Sixty three year-old male patient admitted to the hospital with chest pain. Non-ST myocardial infarction was diagnosed in the examinations. After coroner angiography, it was found coronary artery disease in addition between LAD proximal portion and main pulmonary artery fistula. Fistula repair and coronary bypass were performed successfully under cardiopulmonary bypass. Without hemodynamic problem in intensive care and service follow-up, the patient was discharged from the hospital in the seventh postoperative day. We think that surgical treatment of coronary fistulas in patients with coronary artery lesion is done at the earliest time would enable improvement in mortality and morbidity rates.

  5. Evaluation of the internal mammary artery graft: Usefulness of transcutaneous Doppler sonography

    Energy Technology Data Exchange (ETDEWEB)

    Jae, Hwan Jun; Koh, Young Hwan; Kim, Hyung Beom; Kim, Ki Bong; Chung, Jin Wook; Park, Jae Hyung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2000-03-15

    The purpose of this study is to evaluate the usefulness of transcutaneous Doppler sonography for assessment of internal mammary artery graft patency after coronary bypass graft. Doppler sonography of internal mammary artery was performed in 23 patients, who underwent postoperative cardiac catheterization studies. Doppler signals from the proximal part of the internal mammary artery graft were studied from the supraclavicular fossa in the left internal mammary artery and from the high intercostal space in the right internal mammary artery. According to the coronary angiographic studies, internal mammary artery grafts were divided into two groups: Group A with significant stenosis (>75% stenosis) of the internal mammary artery, and Group B with no significant stenosis of the internal mammary artery. The diastolic/systolic peak velocity ration and diastolic/systolic flow-volume ratio between the two groups were analyzed. Doppler spectrum of the internal mammary artery were obtained from 21 patients, but not from 2 patients, because of the poor sonic window. According to the coronary angiographic studies, there were 6 cases in Group A and 16 cases in Group B. The diastolic/systolic peak velocity ration and diastolic/systolic flow-volume ration in Group A were significantly smaller than in group B (p<0.05). A diastolic/systolic peak velocity ratio <0.4 predicted significant internal mammary artery graft stenosis (>75% stenosis) with a sensitivity and specificity of 100% and 75% respectively. A diastolic/ systolic flow-volume ratio <0.45 predicted significant internal mammary artery graft stenosis (>75% stenosis) with a sensitivity and specificity of 83% and 88% respectively. Transcutaneous doppler sonography is useful for non-invasive assessment of the internal mammary artery graft patency.

  6. Restaurant inspection frequency and food safety compliance.

    Science.gov (United States)

    Newbold, K Bruce; McKeary, Marie; Hart, Robert; Hall, Robert

    2008-11-01

    Although food premises are regularly inspected, little information is available on the effect of inspections on compliance records, particularly with respect to the impact of the frequency of inspection on compliance. The following presents the outcome of a study designed to assess the impact of increased inspection frequency on compliance measures in Hamilton, Ontario, in the absence of any other changes to food handler/safety programs or legislation. High-risk food inspection premises were randomly assigned three, four, or five inspections per year. Results indicate that no statistical difference existed in outcome measures based on frequency of inspection. When premises were grouped based on the average time between inspections, premises with greater time between inspections scored better compliance measures relative to premises that were inspected more frequently. The study was also unique for the level of consultation and collaboration sought from the public health inspectors (PHIs) assigned to the Food Safety Program. Their knowledge and experience with respect to the critical variables associated with compliance were a complementary component to the literature review conducted by the research team.

  7. Space Telecommunications Radio System (STRS) Compliance Testing

    Science.gov (United States)

    Handler, Louis M.

    2011-01-01

    The Space Telecommunications Radio System (STRS) defines an open architecture for software defined radios. This document describes the testing methodology to aid in determining the degree of compliance to the STRS architecture. Non-compliances are reported to the software and hardware developers as well as the NASA project manager so that any non-compliances may be fixed or waivers issued. Since the software developers may be divided into those that provide the operating environment including the operating system and STRS infrastructure (OE) and those that supply the waveform applications, the tests are divided accordingly. The static tests are also divided by the availability of an automated tool that determines whether the source code and configuration files contain the appropriate items. Thus, there are six separate step-by-step test procedures described as well as the corresponding requirements that they test. The six types of STRS compliance tests are: STRS application automated testing, STRS infrastructure automated testing, STRS infrastructure testing by compiling WFCCN with the infrastructure, STRS configuration file testing, STRS application manual code testing, and STRS infrastructure manual code testing. Examples of the input and output of the scripts are shown in the appendices as well as more specific information about what to configure and test in WFCCN for non-compliance. In addition, each STRS requirement is listed and the type of testing briefly described. Attached is also a set of guidelines on what to look for in addition to the requirements to aid in the document review process.

  8. Elastic and Muscular Arteries Differ in Structure, Basal NO Production and Voltage-Gated Ca(2+)-Channels.

    Science.gov (United States)

    Leloup, Arthur J A; Van Hove, Cor E; Heykers, Annick; Schrijvers, Dorien M; De Meyer, Guido R Y; Fransen, Paul

    2015-01-01

    In the last decades, the search for mechanisms underlying progressive arterial stiffening and for interventions to avoid or reverse this process has gained much attention. In general, arterial stiffening displays regional variation and is, for example, during aging more prominent in elastic than in muscular arteries. We hypothesize that besides passive also active regulators of arterial compliance [i.e., endothelial and vascular smooth muscle cell (VSMC) function] differ between these arteries. Hence, it is conceivable that these vessel types will display different time frames of stiffening. To investigate this hypothesis segments of muscular arteries such as femoral and mesenteric arteries and elastic arteries such as the aorta and carotid artery were isolated from female C57Bl6 mice (5-6 months of age, n = 8). Both microscopy and passive stretching of the segments in a myograph confirmed that passive mechanical properties (elastin, collagen) of elastic and muscular arteries were significantly different. Endothelial function, more specifically basal nitric oxide (NO) efficacy, and VSMC function, more specifically L-type voltage-gated Ca(2+) channel (VGCC)-mediated contractions, were determined by α1-adrenoceptor stimulation with phenylephrine (PE) and by gradual depolarization with elevated extracellular K(+) in the absence and presence of eNOS inhibition with L-NAME. PE-mediated isometric contractions significantly increased after inhibition of NO release with L-NAME in elastic, but not in muscular vessel segments. This high basal eNOS activity in elastic vessels was also responsible for shifts of K(+) concentration-contraction curves to higher external K(+). VGCC-mediated contractions were similarly affected by depolarization with elevated K(+) in muscular artery segments or in elastic artery segments in the absence of basal NO. However, K(+)-induced contractions were inhibited by the VGCC blocker diltiazem with significantly higher sensitivity in the muscular

  9. Elastic and muscular arteries differ in structure, basal NO production and voltage-gated Ca2+-channels

    Directory of Open Access Journals (Sweden)

    Arthur J.A. Leloup

    2015-12-01

    Full Text Available In the last decades, the search for mechanisms underlying progressive arterial stiffening and for interventions to avoid or reverse this process has gained much attention. In general, arterial stiffening displays regional variation and is, for example, during aging more prominent in elastic than in muscular arteries. We hypothesize that besides passive also active regulators of arterial compliance (i.e. endothelial and vascular smooth muscle cell (VSMC function differ between these arteries. Hence, it is conceivable that these vessel types will display different time frames of stiffening. To investigate this hypothesis segments of muscular arteries such as femoral and mesenteric arteries and elastic arteries such as the aorta and carotid artery were isolated from female C57Bl6 mice (5-6 months of age, n=8. Both microscopy and passive stretching of the segments in a myograph confirmed that passive mechanical properties (elastin, collagen of elastic and muscular arteries were significantly different. Endothelial function, more specifically basal nitric oxide (NO efficacy, and VSMC function, more specifically L-type voltage-gated Ca2+ channel (VGCC-mediated contractions, were determined by α1-adrenoceptor stimulation with phenylephrine (PE and by gradual depolarization with elevated extracellular K+ in the absence and presence of eNOS inhibition with L-NAME. PE-mediated isometric contractions significantly increased after inhibition of NO release with L-NAME in elastic, but not in muscular vessel segments. This high basal eNOS activity in elastic vessels was also responsible for shifts of K+ concentration-contraction curves to higher external K+. VGCC-mediated contractions were similarly affected by depolarization with elevated K+ in muscular artery segments or in elastic artery segments in the absence of basal NO. However, K+-induced contractions were inhibited by the VGCC blocker diltiazem with significantly higher sensitivity in the muscular

  10. Response of Arterial Stiffness Four Weeks After Terminating Short-term Aerobic Exercise Training in a Sedentary Lifestyle.

    Science.gov (United States)

    Baykara, Murat; Demirel, Adnan; Yavuzatmaca, İhsan; Bilgen, Mehmet

    2017-02-01

    The purpose of this study was to investigate the response of arterial stiffness in individuals with a sedentary lifestyle at 4 weeks after terminating a 2-week aerobic exercise session. Arterial stiffness was evaluated in 38 participants before starting and after completing a prescribed aerobic exercise program and also at 4 weeks after returning back to their sedentary lifestyle. Parameters regarding arterial compliance, distensibility, wall stress, and the elastic modulus were estimated from the information gained from sonography on the dimensions of carotid and femoral arteries and a sphygmomanometer on the pulse pressure. Primary outcomes included whether short-term aerobic exercise reduced the heart rate, arterial pressure, and intima-media thickness and improved vascular biomechanics in physically inactive but otherwise healthy individuals. The benefits gained in arterial compliance and distensibility deteriorated with termination of exercise, but diastolic wall stress and the elastic modulus improved further. In individuals with sedentary lifestyles, short-term aerobic exercise has strong four-week residual benefits on diastolic wall stress and the elastic modulus, but the effects appear to be negligible on arterial stiffness and distensibility. © 2016 by the American Institute of Ultrasound in Medicine.

  11. Idiopathic pulmonary artery aneurysm.

    Science.gov (United States)

    Kotwica, Tomasz; Szumarska, Joanna; Staniszewska-Marszalek, Edyta; Mazurek, Walentyna; Kosmala, Wojciech

    2009-05-01

    Pulmonary artery aneurysm (PAA) is an uncommon lesion, which may be associated with different etiologies including congenital cardiovascular diseases, systemic vasculitis, connective tissue diseases, infections, and trauma. Idiopathic PAA is sporadically diagnosed by exclusion of concomitant major pathology. We report a case of a 56-year-old female with an idiopathic pulmonary artery dilatation identified fortuitously by echocardiography and confirmed by contrast-enhanced computed tomography. Neither significant pulmonary valve dysfunction nor pulmonary hypertension and other cardiac abnormalities which might contribute to the PAA development were found. Here, we describe echocardiographic and computed tomography findings and review the literature on PAA management.

  12. Transbrachial artery approach for selective cerebral angiography

    Energy Technology Data Exchange (ETDEWEB)

    Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Morisako, Toshitaka; Numazawa, Shinichi; Yamada, Keisuke; Nagai, Shigeki; Shibamoto, Kenji (Osaka Neurological Inst., Toyonaka (Japan))

    1990-02-01

    Transaxillary or transbrachial approaches to the cerebral vessels have been reported, but selective angiography of all four vessels has not been possible through one route. In this report, a new technique for selective cerebral angiography with transbrachial approach is described. One hundred and twenty three patients with cerebral infarction, vertebrobasilar insufficiency, intracerebral hemorrhage, epilepsy, or cerebral tumor were examined. Those patients consisted of 85 outpatients and 38 inpatients whose age ranged from 15 years old to 82 years old. The patients were examined via the transbrachial approach (97 cases via the right brachial, 29 cases via the left). Materials included a DSA system (Digital Fluorikon 5000, General Electric Co.), a 4 French tight J-curved Simmons 80-cm catheter, a 19-gauge extra-thin-wall Seldinger needle, and a J/Straight floppy 125-cm guide-wire. Generally, the volume of the contrast agent (300 mgI/ml iopamidol) used in the common carotid artery angiogram was 6 ml, while that used in the vertebral artery angiogram was 4 ml. If catheterization of the vertebral artery or right common carotid artery was unsuccessful, about 8 ml of the contrast agent was injected into the subclavian or branchiocephalic artery. Definitive diagnosis and a decision on proper treatment of the patients can be easily obtained, and the results were clinically satisfactory. Moreover, no complications were encountered in this study. This new technique making a transbrachial approach to the cerebral vessels using the DSA system is introduced here. Neurosurgeons can use this technique easily, and they will find that it provides them with all the information they need about the patient. (author).

  13. Site Environmental Report for 1999 - Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Ruggieri, M

    2000-08-12

    Each year, Ernest Orlando Lawrence Berkeley National Laboratory prepares an integrated report on its environmental programs to satisfy the requirements of United States Department of Energy Order 231.1. The Site Environmental Report for 1999 is intended to summarize Berkeley Lab's compliance with environmental standards and requirements, characterize environmental management efforts through surveillance and monitoring activities, and highlight significant programs and efforts for calendar year 1999. The report is separated into two volumes. Volume I contains a general overview of the Laboratory, the status of environmental programs, and summary results from surveillance and monitoring activities. Each chapter in Volume I begins with an outline of the sections that follow, including any tables or figures found in the chapter. Readers should use section numbers (e.g., {section}1.5) as navigational tools to find topics of interest in either the printed or the electronic version of the report. Volume II contains the individual data results from monitoring programs.

  14. Pulmonary arterial hypertension in children after neonatal arterial switch operation

    NARCIS (Netherlands)

    Zijlstra, Willemijn Mh; Elmasry, Ola; Pepplinkhuizen, Shari; Ivy, D Dunbar; Bonnet, Damien; Lévy, Marilyne; Gavilan, Jose Luis; Torrent-Vernetta, Alba; Mendoza, Alberto; Del Cerro, Maria Jesus; Moledina, Shahin; Berger, Rolf M. F.

    2017-01-01

    OBJECTIVES: Paediatric pulmonary arterial hypertension (PAH) after neonatal arterial switch operation (ASO) for transposition of the great arteries (TGA) is a clinically recognised entity with an estimated incidence of 0.6%-1.0%. Nevertheless, a clinical characterisation is lacking. We present an in

  15. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege

    2011-12-01

    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  16. Analysis of regional compliance in a porcine model of acute lung injury.

    Science.gov (United States)

    Czaplik, Michael; Biener, Ingeborg; Dembinski, Rolf; Pelosi, Paolo; Soodt, Thomas; Schroeder, Wolfgang; Leonhardt, Steffen; Marx, Gernot; Rossaint, Rolf; Bickenbach, Johannes

    2012-10-15

    Lung protective ventilation in acute lung injury (ALI) focuses on using low tidal volumes and adequate levels of positive end-expiratory pressure (PEEP). Identifying optimal pressure is difficult because pressure-volume (PV) relations differ regionally. Precise analysis demands local measurements of pressures and related alveolar morphologies. In a porcine model of surfactant depletion (n=24), we combined measuring static pressures with endoscopic microscopy and electrical impedance tomography (EIT) to examine regional PV loops and morphologic heterogeneities between healthy (control group; CON) and ALI lungs ventilated with low (LVT) or high tidal volumes (HVT). Quantification included indices for microscopy (Volume Air Index (VAI), Heterogeneity and Circularity Index), EIT analysis and calculation of regional compliances due to generated PV loops. We found that: (1) VAI decreased in lower lobe after ALI, (2) electrical impedance decreased in dorsal regions and (3) PV loops differed regionally. Further studies should prove the potentials of these techniques on individual respiratory settings and clinical outcome.

  17. Corporate compliance: critical to organizational success.

    Science.gov (United States)

    Cantone, L

    1999-01-01

    Operation Restore Trust (ORT) has focused increased governmental attention on health care fraud and abuse activities, making it more costly to be noncompliant, and thus has led to significant behavioral changes within the health care industry. Initially five states (California, Florida, Illinois, New York, & Texas) were included in the 1997 ORT pilot program. This has been expanded to include Arizona, Colorado, Georgia, Louisiana, Massachusetts, Missouri, New Jersey, Ohio, Pennsylvania, Tennessee, Virginia, and Washington. The author presents a road map for developing of a compliance program that includes suggested strategies for staff training in anticipation of heightened scrutiny of compliance standards and procedures. Effective Corporate Compliance Programs (CCPs) should include policies and procedures and monitoring systems that can provide reasonable assurance that fraud, abuse, and systematic billing errors are detected in a timely manner.

  18. Value-Based Argumentation for Justifying Compliance

    Science.gov (United States)

    Burgemeestre, Brigitte; Hulstijn, Joris; Tan, Yao-Hua

    Compliance is often achieved 'by design' through a coherent system of controls consisting of information systems and procedures . This system-based control requires a new approach to auditing in which companies must demonstrate to the regulator that they are 'in control'. They must determine the relevance of a regulation for their business, justify which set of control measures they have taken to comply with it, and demonstrate that the control measures are operationally effective. In this paper we show how value-based argumentation theory can be applied to the compliance domain. Corporate values motivate the selection of control measures (actions) which aim to fulfill control objectives, i.e. adopted norms (goals). In particular, we show how to formalize the dialogue in which companies justify their compliance decisions to regulators using value-based argumentation. The approach is illustrated by a case study of the safety and security measures adopted in the context of EU customs regulation.

  19. Ecological Monitoring and Compliance Program 2013 Report

    Energy Technology Data Exchange (ETDEWEB)

    Hall, Derek B.; Anderson, David C.; Greger, Paul D.

    2014-06-05

    The Ecological Monitoring and Compliance Program (EMAC), funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO, formerly Nevada Site Office), monitors the ecosystem of the Nevada National Security Site (NNSS) and ensures compliance with laws and regulations pertaining to NNSS biota. This report summarizes the program’s activities conducted by National Security Technologies, LLC (NSTec), during calendar year 2013. Program activities included (a) biological surveys at proposed activity sites, (b) desert tortoise compliance, (c) ecosystem monitoring, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, and (f) habitat restoration monitoring. During 2013, all applicable laws, regulations, and permit requirements were met, enabling EMAC to achieve its intended goals and objectives.

  20. Ecological Monitoring and Compliance Program 2012 Report

    Energy Technology Data Exchange (ETDEWEB)

    Hall, Derek B.; Anderson, David C.; Greger, Paul D.; Ostler, W. Kent; Hansen, Dennis J.

    2013-07-03

    The Ecological Monitoring and Compliance Program (EMAC), funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Field Office (NNSA/NFO, formerly Nevada Site Office), monitors the ecosystem of the Nevada National Security Site (NNSS) and ensures compliance with laws and regulations pertaining to NNSS biota. This report summarizes the program’s activities conducted by National Security Technologies, LLC (NSTec), during calendar year 2012. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem monitoring, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat restoration monitoring, and (g) monitoring of the Nonproliferation Test and Evaluation Complex (NPTEC). During 2012, all applicable laws, regulations, and permit requirements were met, enabling EMAC to achieve its intended goals and objectives.

  1. Ecological Monitoring and Compliance Program 2011 Report

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, D. J.; Anderson, D. C.; Hall, D. B.; Greger, P. D.; Ostler, W. K.

    2012-06-13

    The Ecological Monitoring and Compliance (EMAC) Program, funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, monitors the ecosystem of the Nevada National Security Site and ensures compliance with laws and regulations pertaining to NNSS biota. This report summarizes the program's activities conducted by National Security Technologies, LLC, during calendar year 2011. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem monitoring, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat restoration monitoring, and (g) monitoring of the Nonproliferation Test and Evaluation Complex. During 2011, all applicable laws, regulations, and permit requirements were met, enabling EMAC to achieve its intended goals and objectives.

  2. Ecological Monitoring and Compliance Program 2009 Report

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, J. Dennis; Anderson, David C.; Hall, Derek B.; Greger, Paul D.; Ostler, W. Kent

    2010-07-13

    The Ecological Monitoring and Compliance Program (EMAC), funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, monitors the ecosystem of the Nevada Test Site and ensures compliance with laws and regulations pertaining to NTS biota. This report summarizes the program’s activities conducted by National Security Technologies, LLC, during calendar year 2009. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem mapping and data management, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat monitoring, (g) habitat restoration monitoring, and (h) monitoring of the Nonproliferation Test and Evaluation Complex. During 2009, all applicable laws, regulations, and permit requirements were met, enabling EMAC to achieve its intended goals and objectives.

  3. Ecological Monitoring and Compliance Program 2010 Report

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, D.J.; Anderson, D.C.; Hall, D.B.; Greger, P.D.; Ostler, W.K.

    2011-07-01

    The Ecological Monitoring and Compliance (EMAC) Program, funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO), monitors the ecosystem of the Nevada National Security Site (NNSS) and ensures compliance with laws and regulations pertaining to NNSS biota. This report summarizes the program’s activities conducted by National Security Technologies, LLC (NSTec), during calendar year 2010. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem monitoring, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat restoration monitoring, and (g) monitoring of the Nonproliferation Test and Evaluation Complex (NPTEC). During 2010, all applicable laws, regulations, and permit requirements were met, enabling EMAC to achieve its intended goals and objectives.

  4. Ecological Monitoring and Compliance Program 2008 Report

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Dennis J.; Anderson, David C.; Hall, Derek B.; Greger, Paul D.; Ostler, W. Kent

    2009-04-30

    The Ecological Monitoring and Compliance Program, funded through the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO), monitors the ecosystem of the Nevada Test Site (NTS) and ensures compliance with laws and regulations pertaining to NTS biota. This report summarizes the program’s activities conducted by National Security Technologies, LLC (NSTec), during calendar year 2008. Program activities included (a) biological surveys at proposed construction sites, (b) desert tortoise compliance, (c) ecosystem mapping and data management, (d) sensitive plant species monitoring, (e) sensitive and protected/regulated animal monitoring, (f) habitat monitoring, (g) habitat restoration monitoring, and (h) monitoring of the Nonproliferation Test and Evaluation Complex (NPTEC).

  5. The assessment of 24 24-h urine volume by measurement of urine specific gravity with dipstick in adults with nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Mohamad Hatef Khorami

    2012-01-01

    Conclusion: The use of behavioral modification with dipstick is an effective method for control and maintenance of optimal urine volume, and it has resulted in more patient compliance for drinking water and is more effective for prevention of renal stone.

  6. Renormalized Volume

    Science.gov (United States)

    Gover, A. Rod; Waldron, Andrew

    2017-09-01

    We develop a universal distributional calculus for regulated volumes of metrics that are suitably singular along hypersurfaces. When the hypersurface is a conformal infinity we give simple integrated distribution expressions for the divergences and anomaly of the regulated volume functional valid for any choice of regulator. For closed hypersurfaces or conformally compact geometries, methods from a previously developed boundary calculus for conformally compact manifolds can be applied to give explicit holographic formulæ for the divergences and anomaly expressed as hypersurface integrals over local quantities (the method also extends to non-closed hypersurfaces). The resulting anomaly does not depend on any particular choice of regulator, while the regulator dependence of the divergences is precisely captured by these formulæ. Conformal hypersurface invariants can be studied by demanding that the singular metric obey, smoothly and formally to a suitable order, a Yamabe type problem with boundary data along the conformal infinity. We prove that the volume anomaly for these singular Yamabe solutions is a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. Recently, Graham proved that the first variation of the volume anomaly recovers the density obstructing smooth solutions to this singular Yamabe problem; we give a new proof of this result employing our boundary calculus. Physical applications of our results include studies of quantum corrections to entanglement entropies.

  7. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre

    2011-09-10

    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  8. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance

  9. Early sepsis bundle compliance for non-hypotensive patients with intermediate versus severe hyperlactemia.

    Science.gov (United States)

    Leisman, Daniel E; Zemmel D'Amore, Jason A; Gribben, Jeanie L; Ward, Mary Frances; Masick, Kevin D; Bianculli, Andrea R; Bradburn, Kathryn H; D'Angelo, John K; Doerfler, Martin E

    2017-06-01

    To compare the association of 3-h sepsis bundle compliance with hospital mortality in non-hypotensive sepsis patients with intermediate versus severe hyperlactemia. This was a cohort study of all non-hypotensive, hyperlactemic sepsis patients captured in a prospective quality-improvement database, treated October 2014 to September 2015 at five tertiary-care centers. We defined sepsis as 1) infection, 2) ≥2 SIRS criteria, and 3) ≥1 organ dysfunction criterion. "Time-zero" was the first time a patient met all sepsis criteria. systolic blood pressure>90 mmHg, mean arterial pressure>65 mmHg, and serum lactate≥2.2 mmol/L. Primary exposures: 1) intermediate(2.2-3.9 mmol/L) versus severe(≥4.0 mmol/L) hyperlactemia and 2) full 3-h bundle compliance. Bundle elements: The primary outcome was 60-day in-hospital mortality. 2417 patients met inclusion criteria. 704(29%) had lactate≥4.0 mmol/L versus 1775 patients with lactate 2.2-3.9 mmol/L. Compliance was 75% for antibiotics and 53% for fluids. Full-compliance was comparable between lactate groups (n=200(29%) and 488(28%), respectively). We observed 424(17.5%) mortalities: intermediate/non-compliant - 182(14.9%), intermediate/compliant - 41(8.4%), severe/non-compliant - 147(29.2%), severe/compliant - 54(27.0%) [difference-of-differences=4.3%, CI=2.6-5.9%]. In multivariable regression, mortality predictors included severe hyperlactemia (OR=1.99, CI=1.51-2.63) and bundle compliance (OR=0.62, CI=0.42-0.90), and their interaction was significant: p(interaction)=0.022. We observed a significant interaction between 3-h bundle compliance and initial hyperlactemia. Bundle compliance may be associated with greater mortality benefit for non-hypotensive sepsis patients with less severe hyperlactemia. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The SEA of the Future: Prioritizing Productivity. Volume 2

    Science.gov (United States)

    Gross, Betheny, Ed.; Jochim, Ashley, Ed.

    2013-01-01

    "The SEA of the Future" is an education publication series examining how state education agencies can shift from a compliance to a performance-oriented organization through strategic planning and performance management tools to meet growing demands to support education reform while improving productivity. This volume, the second in the…

  11. Increased arterial stiffness and extracellular matrix reorganization in intrauterine growth–restricted fetal sheep

    Science.gov (United States)

    Dodson, Reuben Blair; Rozance, Paul J.; Fleenor, Bradley S.; Petrash, Carson C.; Shoemaker, Lauren G.; Hunter, Kendall S.; Ferguson, Virginia L.

    2013-01-01

    BACKGROUND Fetal intrauterine growth restriction (IUGR) results in increased placental resistance to blood flow, fetal hypertension, and increased pulsatility stresses shown to lead to vascular remodeling. We tested our hypothesis that IUGR causes decreased compliance in the carotid and umbilical arteries due to altered extracellular matrix (ECM) composition and structure. METHODS A sheep model of placental insufficiency–induced IUGR (PI-IUGR) was created by exposure of the pregnant ewe to elevated ambient temperatures. Umbilical and carotid arteries from near-term fetuses were tested with pressure–diameter measurements to compare passive compliance in control and PI-IUGR tissues. ECM composition was measured via biochemical assay, and the organization was determined by using histology and second-harmonic generation imaging. RESULTS We found that PI-IUGR increased arterial stiffness with increased collagen engagement, or transition stretch. PI-IUGR carotid arteries exhibited increased collagen and elastin quantity, and PI-IUGR umbilical arteries exhibited increased sulfated glycosaminoglycans. Histomorphology showed altered collagen-to-elastin ratios with altered cellular proliferation. Increased stiffness indicates altered collagen-to-elastin ratios with less elastin contribution leading to increased collagen engagement. CONCLUSION Because vessel stiffness is a significant predictor in the development of hypertension, disrupted ECM deposition in IUGR provides a potential link between IUGR and adult hypertension. PMID:23154756

  12. Tube-Load Model Parameter Estimation for Monitoring Arterial Hemodynamics

    Directory of Open Access Journals (Sweden)

    Guanqun eZhang

    2011-11-01

    Full Text Available A useful model of the arterial system is the uniform, lossless tube with parametric load. This tube-load model is able to account for wave propagation and reflection (unlike lumped-parameter models such as the Windkessel while being defined by only a few parameters (unlike comprehensive distributed-parameter models. As a result, the parameters may be readily estimated by accurate fitting of the model to available arterial pressure and flow waveforms so as to permit improved monitoring of arterial hemodynamics. In this paper, we review tube-load model parameter estimation techniques that have appeared in the literature for monitoring wave reflection, large artery compliance, pulse transit time, and central aortic pressure. We begin by motivating the use of the tube-load model for parameter estimation. We then describe the tube-load model, its assumptions and validity, and approaches for estimating its parameters. We next summarize the various techniques and their experimental results while highlighting their advantages over conventional techniques. We conclude the review by suggesting future research directions and describing potential applications.

  13. Tube-Load Model Parameter Estimation for Monitoring Arterial Hemodynamics

    Science.gov (United States)

    Zhang, Guanqun; Hahn, Jin-Oh; Mukkamala, Ramakrishna

    2011-01-01

    A useful model of the arterial system is the uniform, lossless tube with parametric load. This tube-load model is able to account for wave propagation and reflection (unlike lumped-parameter models such as the Windkessel) while being defined by only a few parameters (unlike comprehensive distributed-parameter models). As a result, the parameters may be readily estimated by accurate fitting of the model to available arterial pressure and flow waveforms so as to permit improved monitoring of arterial hemodynamics. In this paper, we review tube-load model parameter estimation techniques that have appeared in the literature for monitoring wave reflection, large artery compliance, pulse transit time, and central aortic pressure. We begin by motivating the use of the tube-load model for parameter estimation. We then describe the tube-load model, its assumptions and validity, and approaches for estimating its parameters. We next summarize the various techniques and their experimental results while highlighting their advantages over conventional techniques. We conclude the review by suggesting future research directions and describing potential applications. PMID:22053157

  14. Pulmonary artery sling: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gil Hyun; Lee, Sun Wha; Cha, Sung Ho [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    1993-09-15

    Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly,which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case were identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.

  15. Variable-Compliance Couplings For Heavy Lifting

    Science.gov (United States)

    Kerley, James; Eklund, Wayne; Burkhardt, Raymond; Richardson, George W.

    1992-01-01

    New coupling devices contain manual or electronically controlled, motorized drives that vary stiffnesses. Short, clamped lengths of cable provide compliance. Using threaded rods, cables stretched, relaxed, or folded to make coupling more or less stiff. In more-advanced device, brackets holding cables moved by stepping motor via gearbox and ball screw. Motor operates under computer control with position feedback. Control computer commands greater stiffness during operations requiring precise positioning, and greater compliance to accommodate manufacturing tolerances. Intended for use in wrist joints of robotic manipulators and other industrial equipment that must lift heavy objects.

  16. Compliance or patient empowerment in online communities

    DEFF Research Database (Denmark)

    Wentzer, Helle; Bygholm, Ann

    2010-01-01

    New technologies enable a different organization of the public’s admission to health care services. The article discusses whether online support groups in patient treatment are to be understood in the light of patient empowerment or within the tradition of compliance. The back-ground material...... of opening up health care to the critical voice of the public, the quantitative and qualitative studies surprisingly point to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. Thereby the critical potential of online communities in health care services seems...... reverted into configuring ideal patients from diverse users....

  17. Hanford Site Comprehensive site Compliance Evaluation Report

    Energy Technology Data Exchange (ETDEWEB)

    Tollefson, K.S.

    1997-08-05

    This document is the second annual submittal by WHC, ICF/KH, PNL and BHI and contains the results of inspections of the stormwater outfalls listed in the Hanford Site Storm Water Pollution Prevention Plan (SWPPP) (WHC 1993a) as required by General Permit No. WA-R-00-000F (WA-R-00-A17F): This report also describes the methods used to conduct the Storm Water Comprehensive Site Compliance Evaluation, as required in Part IV, Section D, {ampersand} C of the General Permit, summarizes the results of the compliance evaluation, and documents significant leaks and spills.

  18. Popliteal artery entrapment syndrome

    DEFF Research Database (Denmark)

    Altintas, Ümit; Helgstrand, Ulf Johan Vilhelm; Hansen, Marc A;

    2013-01-01

    The purpose of this study was to report our experience with popliteal artery entrapment syndrome (PAES) with special emphasis on the applicability of duplex ultrasound scanning (DUS) when diagnosing PAES. In addition to examining the correlation between DUS and intraoperative findings...

  19. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    2014-01-01

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  20. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.

    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be