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Sample records for cardiac outflow tract

  1. Heart fossilization is possible and informs the evolution of cardiac outflow tract in vertebrates

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    Maldanis, Lara; Carvalho, Murilo; Almeida, Mariana Ramos; Freitas, Francisco Idalécio; de Andrade, José Artur Ferreira Gomes; Nunes, Rafael Silva; Rochitte, Carlos Eduardo; Poppi, Ronei Jesus; Freitas, Raul Oliveira; Rodrigues, Fábio; Siljeström, Sandra; Lima, Frederico Alves; Galante, Douglas; Carvalho, Ismar S; Perez, Carlos Alberto; de Carvalho, Marcelo Rodrigues; Bettini, Jefferson; Fernandez, Vincent; Xavier-Neto, José

    2016-01-01

    Elucidating cardiac evolution has been frustrated by lack of fossils. One celebrated enigma in cardiac evolution involves the transition from a cardiac outflow tract dominated by a multi-valved conus arteriosus in basal actinopterygians, to an outflow tract commanded by the non-valved, elastic, bulbus arteriosus in higher actinopterygians. We demonstrate that cardiac preservation is possible in the extinct fish Rhacolepis buccalis from the Brazilian Cretaceous. Using X-ray synchrotron microtomography, we show that Rhacolepis fossils display hearts with a conus arteriosus containing at least five valve rows. This represents a transitional morphology between the primitive, multivalvar, conal condition and the derived, monovalvar, bulbar state of the outflow tract in modern actinopterygians. Our data rescue a long-lost cardiac phenotype (119-113 Ma) and suggest that outflow tract simplification in actinopterygians is compatible with a gradual, rather than a drastic saltation event. Overall, our results demonstrate the feasibility of studying cardiac evolution in fossils. DOI: http://dx.doi.org/10.7554/eLife.14698.001 PMID:27090087

  2. Developmental remodeling and shortening of the cardiac outflow tract involves myocyte programmed cell death.

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    Watanabe, M; Choudhry, A; Berlan, M; Singal, A; Siwik, E; Mohr, S; Fisher, S A

    1998-10-01

    The embryonic outflow tract is a simple tubular structure that connects the single primitive ventricle with the aortic sac and aortic arch arteries. This structure undergoes a complex sequence of morphogenetic processes to become the portion of the heart that aligns the right and left ventricles with the pulmonary artery and aorta. Abnormalities of the outflow tract are involved in many clinically significant congenital cardiac defects; however, the cellular and molecular processes governing the development of this important structure are incompletely understood. Histologic and tissue-tagging studies indicate that the outflow tract tissues compact and are incorporated predominantly into a region of the right ventricle. The hypothesis tested in the current study was that cell death or apoptosis in the muscular portion of the outflow tract is an important cellular mechanism for outflow tract shortening. The tubular outflow tract myocardium was specifically marked by infecting myocytes of the chicken embryo heart with a recombinant replication-defective adenovirus expressing beta-galactosidase (beta-gal) under the control of the cytomegalovirus promoter. Histochemical detection of the beta -gal-labeled outflow tract myocytes revealed that the tubular structure shortened to become a compact ring at the level of the pulmonic infundibulum over several days of development (stages 25-32, embryonic days 4-8). The appearance of apoptotic cardiomyocytes was correlated with OFT shortening by two histologic assays, TUNEL labeling of DNA fragments and AnnexinV binding. The rise and fall in the number of apoptotic myocytes detected by histologic analyses paralleled the change in activity levels of Caspase-3, a protease in the apoptotic cascade, measured in outflow tract homogenates. These results suggest that the elimination of myocytes by programmed cell death is one mechanism by which the outflow tract myocardium remodels to form the proper connection between the ventricular

  3. Epicardial regeneration is guided by cardiac outflow tract and Hedgehog signalling.

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    Wang, Jinhu; Cao, Jingli; Dickson, Amy L; Poss, Kenneth D

    2015-06-11

    In response to cardiac damage, a mesothelial tissue layer enveloping the heart called the epicardium is activated to proliferate and accumulate at the injury site. Recent studies have implicated the epicardium in multiple aspects of cardiac repair: as a source of paracrine signals for cardiomyocyte survival or proliferation; a supply of perivascular cells and possibly other cell types such as cardiomyocytes; and as a mediator of inflammation. However, the biology and dynamism of the adult epicardium is poorly understood. To investigate this, we created a transgenic line to ablate the epicardial cell population in adult zebrafish. Here we find that genetic depletion of the epicardium after myocardial loss inhibits cardiomyocyte proliferation and delays muscle regeneration. The epicardium vigorously regenerates after its ablation, through proliferation and migration of spared epicardial cells as a sheet to cover the exposed ventricular surface in a wave from the chamber base towards its apex. By reconstituting epicardial regeneration ex vivo, we show that extirpation of the bulbous arteriosus-a distinct, smooth-muscle-rich tissue structure that distributes outflow from the ventricle-prevents epicardial regeneration. Conversely, experimental repositioning of the bulbous arteriosus by tissue recombination initiates epicardial regeneration and can govern its direction. Hedgehog (Hh) ligand is expressed in the bulbous arteriosus, and treatment with a Hh signalling antagonist arrests epicardial regeneration and blunts the epicardial response to muscle injury. Transplantation of Sonic hedgehog (Shh)-soaked beads at the ventricular base stimulates epicardial regeneration after bulbous arteriosus removal, indicating that Hh signalling can substitute for the influence of the outflow tract. Thus, the ventricular epicardium has pronounced regenerative capacity, regulated by the neighbouring cardiac outflow tract and Hh signalling. These findings extend our understanding of

  4. The anatomical components of the cardiac outflow tract of the gray bichir, Polypterus senegalus: their evolutionary significance.

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    Durán, Ana C; Reyes-Moya, Ismael; Fernández, Borja; Rodríguez, Cristina; Sans-Coma, Valentín; Grimes, Adrian C

    2014-12-01

    It has been reported that in chondrichthyans the cardiac outflow tract is composed of the myocardial conus arteriosus, while in most teleosteans it consists of the nonmyocardial bulbus arteriosus. Classical studies already indicated that a conus and a bulbus coexist in several ancient actinopterygian and teleost groups. Recent work has shown that a cardiac outflow tract consisting of a conus and a bulbus is common to both cartilaginous and bony fishes. Nonetheless and despite their position at the base of the actinopterygian phylogenetic lineage, the anatomical arrangement of the cardiac outflow tract of the Polypteriformes remained uncertain. The present study of hearts from gray bichirs was intended to fill this gap. The cardiac outflow tract of the bichir consists of two main components, namely a very long conus arteriosus, furnished with valves, and a short, intrapericardial, arterial-like bulbus arteriosus, which differs from the ventral aorta because it is covered by epicardium, shows a slightly different spatial arrangement of the histological elements and is crossed by coronary arteries. Histomorphologically, the outflow tract consists of three longitudinal regions, distal, middle and proximal, an arrangement which has been suggested to be common to all vertebrates. The distal region corresponds to the bulbus, while the conus comprises the middle and proximal regions. The present findings reinforce the notion that the bulbus arteriosus of fish has played an essential role in vertebrate heart evolution as it is the precursor of the intrapericardial trunks of the aorta and pulmonary artery of birds and mammals.

  5. Vangl2-regulated polarisation of second heart field-derived cells is required for outflow tract lengthening during cardiac development.

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    Ramsbottom, Simon A; Sharma, Vipul; Rhee, Hong Jun; Eley, Lorraine; Phillips, Helen M; Rigby, Hannah F; Dean, Charlotte; Chaudhry, Bill; Henderson, Deborah J

    2014-12-01

    Planar cell polarity (PCP) is the mechanism by which cells orient themselves in the plane of an epithelium or during directed cell migration, and is regulated by a highly conserved signalling pathway. Mutations in the PCP gene Vangl2, as well as in other key components of the pathway, cause a spectrum of cardiac outflow tract defects. However, it is unclear why cells within the mesodermal heart tissue require PCP signalling. Using a new conditionally floxed allele we show that Vangl2 is required solely within the second heart field (SHF) to direct normal outflow tract lengthening, a process that is required for septation and normal alignment of the aorta and pulmonary trunk with the ventricular chambers. Analysis of a range of markers of polarised epithelial tissues showed that in the normal heart, undifferentiated SHF cells move from the dorsal pericardial wall into the distal outflow tract where they acquire an epithelial phenotype, before moving proximally where they differentiate into cardiomyocytes. Thus there is a transition zone in the distal outflow tract where SHF cells become more polarised, turn off progenitor markers and start to differentiate to cardiomyocytes. Membrane-bound Vangl2 marks the proximal extent of this transition zone and in the absence of Vangl2, the SHF-derived cells are abnormally polarised and disorganised. The consequent thickening, rather than lengthening, of the outflow wall leads to a shortened outflow tract. Premature down regulation of the SHF-progenitor marker Isl1 in the mutants, and accompanied premature differentiation to cardiomyocytes, suggests that the organisation of the cells within the transition zone is important for maintaining the undifferentiated phenotype. Thus, Vangl2-regulated polarisation and subsequent acquisition of an epithelial phenotype is essential to lengthen the tubular outflow vessel, a process that is essential for on-going cardiac morphogenesis.

  6. Vangl2-regulated polarisation of second heart field-derived cells is required for outflow tract lengthening during cardiac development.

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    Simon A Ramsbottom

    2014-12-01

    Full Text Available Planar cell polarity (PCP is the mechanism by which cells orient themselves in the plane of an epithelium or during directed cell migration, and is regulated by a highly conserved signalling pathway. Mutations in the PCP gene Vangl2, as well as in other key components of the pathway, cause a spectrum of cardiac outflow tract defects. However, it is unclear why cells within the mesodermal heart tissue require PCP signalling. Using a new conditionally floxed allele we show that Vangl2 is required solely within the second heart field (SHF to direct normal outflow tract lengthening, a process that is required for septation and normal alignment of the aorta and pulmonary trunk with the ventricular chambers. Analysis of a range of markers of polarised epithelial tissues showed that in the normal heart, undifferentiated SHF cells move from the dorsal pericardial wall into the distal outflow tract where they acquire an epithelial phenotype, before moving proximally where they differentiate into cardiomyocytes. Thus there is a transition zone in the distal outflow tract where SHF cells become more polarised, turn off progenitor markers and start to differentiate to cardiomyocytes. Membrane-bound Vangl2 marks the proximal extent of this transition zone and in the absence of Vangl2, the SHF-derived cells are abnormally polarised and disorganised. The consequent thickening, rather than lengthening, of the outflow wall leads to a shortened outflow tract. Premature down regulation of the SHF-progenitor marker Isl1 in the mutants, and accompanied premature differentiation to cardiomyocytes, suggests that the organisation of the cells within the transition zone is important for maintaining the undifferentiated phenotype. Thus, Vangl2-regulated polarisation and subsequent acquisition of an epithelial phenotype is essential to lengthen the tubular outflow vessel, a process that is essential for on-going cardiac morphogenesis.

  7. GATA6 mutations cause human cardiac outflow tract defects by disrupting semaphorin-plexin signaling

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    Kodo, Kazuki; Nishizawa, Tsutomu; Furutani, Michiko; Arai, Shoichi; Yamamura, Eiji; Joo, Kunitaka; Takahashi, Takao; Matsuoka, Rumiko; Yamagishi, Hiroyuki

    2009-01-01

    Congenital heart diseases (CHD) occur in nearly 1% of all live births and are the major cause of infant mortality and morbidity. Although an improved understanding of the genetic causes of CHD would provide insight into the underlying pathobiology, the genetic etiology of most CHD remains unknown. Here we show that mutations in the gene encoding the transcription factor GATA6 cause CHD characteristic of a severe form of cardiac outflow tract (OFT) defect, namely persistent truncus arteriosus (PTA). Two different GATA6 mutations were identified by systematic genetic analysis using DNA from patients with PTA. Genes encoding the neurovascular guiding molecule semaphorin 3C (SEMA3C) and its receptor plexin A2 (PLXNA2) appear to be regulated directly by GATA6, and both GATA6 mutant proteins failed to transactivate these genes. Transgenic analysis further suggests that, in the developing heart, the expression of SEMA3C in the OFT/subpulmonary myocardium and PLXNA2 in the cardiac neural crest contributing to the OFT is dependent on GATA transcription factors. Together, our data implicate mutations in GATA6 as genetic causes of CHD involving OFT development, as a result of the disruption of the direct regulation of semaphorin-plexin signaling. PMID:19666519

  8. MCTP2 is a dosage-sensitive gene required for cardiac outflow tract development

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    Lalani, Seema R.; Ware, Stephanie M.; Wang, Xueqing; Zapata, Gladys; Tian, Qi; Franco, Luis M.; Jiang, Zhengxin; Bucasas, Kristine; Scott, Daryl A.; Campeau, Philippe M.; Hanchard, Neil; Umaña, Luis; Cast, Ashley; Patel, Ankita; Cheung, Sau W.; McBride, Kim L.; Bray, Molly; Craig Chinault, A.; Boggs, Barbara A.; Huang, Miao; Baker, Mariah R.; Hamilton, Susan; Towbin, Jeff; Jefferies, John L.; Fernbach, Susan D.; Potocki, Lorraine; Belmont, John W.

    2013-01-01

    Coarctation of the aorta (CoA) and hypoplastic left heart syndrome (HLHS) have been reported in rare individuals with large terminal deletions of chromosome 15q26. However, no single gene important for left ventricular outflow tract (LVOT) development has been identified in this region. Using array-comparative genomic hybridization, we identified two half-siblings with CoA with a 2.2 Mb deletion on 15q26.2, inherited from their mother, who was mosaic for this deletion. This interval contains an evolutionary conserved, protein-coding gene, MCTP2 (multiple C2-domains with two transmembrane regions 2). Using gene-specific array screening in 146 individuals with non-syndromic LVOT obstructive defects, another individual with HLHS and CoA was found to have a de novo 41 kb intragenic duplication within MCTP2, predicted to result in premature truncation, p.F697X. Alteration of Mctp2 gene expression in Xenopus laevis embryos by morpholino knockdown and mRNA overexpression resulted in the failure of proper OT development, confirming the functional importance of this dosage-sensitive gene for cardiogenesis. Our results identify MCTP2 as a novel genetic cause of CoA and related cardiac malformations. PMID:23773997

  9. Relationship of basal-septal fibrosis with LV outflow tract obstruction in hypertrophic cardiomyopathy: insights from cardiac magnetic resonance analysis.

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    Nakamura, Takashi; Iwanaga, Yoshitaka; Yasuda, Masakazu; Kawamura, Takayuki; Miyaji, Yuki; Morooka, Hanako; Miyazaki, Shunichi

    2016-04-01

    Myocardial fibrosis is frequently observed and may be associated with the prognosis in patients with hypertrophic cardiomyopathy (HCM); however, the clinical pathophysiological features, particularly in terms of fibrosis, of hypertrophic obstructive cardiomyopathy (HOCM) remain unclear. This study aimed to determine a role of local fibrosis in HOCM using cardiac magnetic resonance (CMR). 108 consecutive HCM patients underwent CMR. HOCM was defined as a left ventricular outflow tract (LVOT) pressure gradient ≥30 mmHg at rest. Myocardial mass and fibrosis mass by late gadolinium-enhancement CMR (LGE-CMR) were calculated and the distribution/pattern was analyzed using the AHA 17-segment model. LV ejection fraction (LVEF) was significantly higher in patients with HOCM (n = 19) than in those with nonobstructive HCM (n = 89) (P < 0.05). Both total myocardial and fibrosis masses in LV were similar in the two groups (P = 0.385 and P = 0.859, respectively). However, fibrosis in the basal septum was significantly less frequent in the HOCM group than in the nonobstructive HCM group (P < 0.01). The LVOT pressure gradient was significantly higher in the basal-septal non-fibrosis group than in the fibrosis group (23.6 ± 37.3 vs. 4.8 ± 11.4 mmHg, P < 0.01). Multivariate analysis revealed that basal-septal fibrosis was an independent negative predictor of LVOT obstruction in addition to the local wall thickness and LVEF as positive predictors in HCM patients. In conclusion, a significant association was observed between LVOT obstruction and basal septal fibrosis by LGE-CMR in HCM patients. In addition to negative impact of basal-septal fibrosis, basal-septal hypertrophy and preserved global LV contractility may be associated with the pathophysiological features of LVOT obstruction.

  10. Optical coherence tomography provides an ability to assess mechanical property of cardiac wall of developing outflow tract in embryonic heart in vivo

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    Li, Peng; Wang, Ruikang K.

    2012-12-01

    Knowledge of the biomechanical/elastic property of the cardiac wall is of fundamental importance in improving our understanding of cardiac development, particularly the interaction between the wall dynamics and hemodynamics in the developing outflow tract (OFT). We describe a method that employs optical coherence tomography (OCT) as a means to noninvasively measure the local elastic property of the cardiac wall in vivo. The method uses a time-lapse sequence of OCT images that represent the dynamic behavior of the OFT longitudinal section to calculate the regional wall pulse wave velocity (PWV), upon which the Young's modulus of the cardiac wall is deduced by the use of the Moens-Korteweg equation. The experimental results show that the foot-to-foot PWV ranges from 3.2 to 6.6 mm/s with a mean of 4.7 mm/s, and the averaged Young's modulus is 0.36 Pa, both of which are comparable to the documented values of stage HH17 atrioventricular canal tissue. The proposed method that provides the quantitative mechanical assessment may play a significant role in the understanding of the cardiac development.

  11. Prickle1 mutation causes planar cell polarity and directional cell migration defects associated with cardiac outflow tract anomalies and other structural birth defects

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    Brian C. Gibbs

    2016-03-01

    Full Text Available Planar cell polarity (PCP is controlled by a conserved pathway that regulates directional cell behavior. Here, we show that mutant mice harboring a newly described mutation termed Beetlejuice (Bj in Prickle1 (Pk1, a PCP component, exhibit developmental phenotypes involving cell polarity defects, including skeletal, cochlear and congenital cardiac anomalies. Bj mutants die neonatally with cardiac outflow tract (OFT malalignment. This is associated with OFT shortening due to loss of polarized cell orientation and failure of second heart field cell intercalation mediating OFT lengthening. OFT myocardialization was disrupted with cardiomyocytes failing to align with the direction of cell invasion into the outflow cushions. The expression of genes mediating Wnt signaling was altered. Also noted were shortened but widened bile ducts and disruption in canonical Wnt signaling. Using an in vitro wound closure assay, we showed Bj mutant fibroblasts cannot establish polarized cell morphology or engage in directional cell migration, and their actin cytoskeleton failed to align with the direction of wound closure. Unexpectedly, Pk1 mutants exhibited primary and motile cilia defects. Given Bj mutant phenotypes are reminiscent of ciliopathies, these findings suggest Pk1 may also regulate ciliogenesis. Together these findings show Pk1 plays an essential role in regulating cell polarity and directional cell migration during development.

  12. Prickle1 mutation causes planar cell polarity and directional cell migration defects associated with cardiac outflow tract anomalies and other structural birth defects.

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    Gibbs, Brian C; Damerla, Rama Rao; Vladar, Eszter K; Chatterjee, Bishwanath; Wan, Yong; Liu, Xiaoqin; Cui, Cheng; Gabriel, George C; Zahid, Maliha; Yagi, Hisato; Szabo-Rogers, Heather L; Suyama, Kaye L; Axelrod, Jeffrey D; Lo, Cecilia W

    2016-02-16

    Planar cell polarity (PCP) is controlled by a conserved pathway that regulates directional cell behavior. Here, we show that mutant mice harboring a newly described mutation termed Beetlejuice (Bj) in Prickle1 (Pk1), a PCP component, exhibit developmental phenotypes involving cell polarity defects, including skeletal, cochlear and congenital cardiac anomalies. Bj mutants die neonatally with cardiac outflow tract (OFT) malalignment. This is associated with OFT shortening due to loss of polarized cell orientation and failure of second heart field cell intercalation mediating OFT lengthening. OFT myocardialization was disrupted with cardiomyocytes failing to align with the direction of cell invasion into the outflow cushions. The expression of genes mediating Wnt signaling was altered. Also noted were shortened but widened bile ducts and disruption in canonical Wnt signaling. Using an in vitro wound closure assay, we showed Bj mutant fibroblasts cannot establish polarized cell morphology or engage in directional cell migration, and their actin cytoskeleton failed to align with the direction of wound closure. Unexpectedly, Pk1 mutants exhibited primary and motile cilia defects. Given Bj mutant phenotypes are reminiscent of ciliopathies, these findings suggest Pk1 may also regulate ciliogenesis. Together these findings show Pk1 plays an essential role in regulating cell polarity and directional cell migration during development.

  13. Murine dishevelled 3 functions in redundant pathways with dishevelled 1 and 2 in normal cardiac outflow tract, cochlea, and neural tube development.

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    S Leah Etheridge

    2008-11-01

    Full Text Available Dishevelled (Dvl proteins are important signaling components of both the canonical beta-catenin/Wnt pathway, which controls cell proliferation and patterning, and the planar cell polarity (PCP pathway, which coordinates cell polarity within a sheet of cells and also directs convergent extension cell (CE movements that produce narrowing and elongation of the tissue. Three mammalian Dvl genes have been identified and the developmental roles of Dvl1 and Dvl2 were previously determined. Here, we identify the functions of Dvl3 in development and provide evidence of functional redundancy among the three murine Dvls. Dvl3(-/- mice died perinatally with cardiac outflow tract abnormalities, including double outlet right ventricle and persistent truncus arteriosis. These mutants also displayed a misorientated stereocilia in the organ of Corti, a phenotype that was enhanced with the additional loss of a single allele of the PCP component Vangl2/Ltap (LtapLp/+. Although neurulation appeared normal in both Dvl3(-/- and LtapLp/+ mutants, Dvl3(+/-;LtapLp/+ combined mutants displayed incomplete neural tube closure. Importantly, we show that many of the roles of Dvl3 are also shared by Dvl1 and Dvl2. More severe phenotypes were observed in Dvl3 mutants with the deficiency of another Dvl, and increasing Dvl dosage genetically with Dvl transgenes demonstrated the ability of Dvls to compensate for each other to enable normal development. Interestingly, global canonical Wnt signaling appeared largely unaffected in the double Dvl mutants, suggesting that low Dvl levels are sufficient for functional canonical Wnt signals. In summary, we demonstrate that Dvl3 is required for cardiac outflow tract development and describe its importance in the PCP pathway during neurulation and cochlea development. Finally, we establish several developmental processes in which the three Dvls are functionally redundant.

  14. Inflammatory Pseudotumor Originating from the Right Ventricular Outflow Tract

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    Mohita Singh

    2016-01-01

    Full Text Available Introduction. Inflammatory pseudotumor is an uncommon entity, and its cardiac origin is exceedingly rare. Case History. A previously healthy 27-year-old man was found to have a systolic murmur during preemployment screening evaluation. A transthoracic echocardiogram revealed a 4 × 2.5 cm mass originating from the right ventricle (RV outflow tract extending into the aortic root. A computed tomography guided biopsy confirmed an IgG4-related inflammatory pseudotumor. Patient was started on oral prednisone with subsequent reduction in mass size. Conclusion. Cardiac inflammatory pseudotumors are markedly rare tumors that should be considered in the differential of intracardiac tumors which otherwise includes cardiac fibromas, myxomas, and sarcomas.

  15. The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy patients with or without left ventricular outflow tract obstruction: Assessment with first-pass perfusion imaging using 3.0-T cardiac magnetic resonance

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    Xu, Hua-yan [Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Yang, Zhi-gang, E-mail: yangzg666@163.com [Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Sun, Jia-yu; Wen, Ling-yi; Zhang, Ge; Zhang, Shuai [Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Guo, Ying-kun [Department of Radiology, West China Second University Hospital, Sichuan University (China)

    2014-04-15

    Purpose: To assess regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction using 3.0-T cardiac magnetic resonance (CMR) first-pass perfusion imaging. Materials and methods: Forty-two HCM patients, including 25 HCM patients with left ventricular outflow tract obstruction (HOCM), 17 HCM patients without left ventricular outflow tract obstruction (NOHCM), and 14 healthy subjects underwent CMR. The left ventricular (LV) function, left ventricular end-diastolic wall thickness (EDTH), and diameter of left ventricular outflow tract (LVOT) were measured and calculated. Based on the signal–time curve of the first-pass myocardium perfusion imaging, perfusion parameters including upslope, time to peak, and peak intensity, were assessed and compared by using one-way analysis of variance and independent t tests. Results: On the first-pass perfusion imaging, lower upslope and peak intensity and longer time to peak were found in HCM patients compared with normal subjects (all p < 0.05). In contrast to the NOHCM group, the average time to peak of the HOCM group was increased (13.30 ± 4.82 s vs 16.28 ± 4.90 s, p < 0.05), but first-pass perfusion upslope was reduced (4.96 ± 2.55 vs 2.58 ± 0.77, p < 0.05). According to the bull's-eye model, the HOCM group's average thickness of basal segments was thicker than the NOHCM group, especially the anteroseptal, inferolateral, and anterior wall values, with a corresponding lower first-pass perfusion upslope than the NOHCM group (all p < 0.05). A significant correlation was observed between first-pass perfusion upslope and LV EDTH (r = −0.551, p < 0.001) and LVOT diameter (r = 0.472, p < 0.001). Conclusions: The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction can be detected with first-pass perfusion CMR

  16. [Long-term effect of polystan monocusp ventricular outflow patch after right ventricular outflow tract reconstruction].

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    Sugita, T; Matsumoto, M; Ogino, H; Nishizawa, J; Matsuyama, K; Yoshimura, S; Yoshioka, T; Tokuda, Y; Matsumura, M; Suda, K; Ueda, Y

    2000-09-01

    Forty-eight patients who underwent right ventricular outflow tract reconstruction with Monocusp Ventricular Outflow Patch (MVOP) fifty-five times and survived surgery, were reviewed in this study. Mean age at surgery was 6.4 years-old and mean follow-up interval was 75.2 months. There was no late death, however reoperation was performed 7 times. Freedom from reoperation rate was 97.2% and 80.7% after 5 and 10 years after surgery, respectively. The main cause for reoperation were right ventricular outflow obstruction RVOTO (5 cases). All of the RVOTO occurred at the distal end of the anastomosis. However, there was no RVOTO in patients who underwent RVOTR with MVOP during the past ten years. So, we considered the cause of RVOTO a technical problem. Pulmonary regurgitation was one to two degree early after surgery, and had worsened by almost two or three degrees more than 5 years after surgery. Moreover, five of six patients who underwent cardiac catheterization more than 10 years after surgery had three degrees of pulmonary regurgitation as well as a large CTR. In conclusion, according to long-term results, especially more than 10 years post operatively, pulmonary regurgitation was the most important problem.

  17. Fibulin-1 suppresses endothelial to mesenchymal transition in the proximal outflow tract

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    Harikrishnan, K.; Cooley, M. A.; Sugi, Y.;

    2015-01-01

    Endothelial to mesenchymal transition (EMT) that occurs during cardiac outflow tract (OFT) development is critical for formation of the semilunar valves. Fibulin-1 (Fbln1) is an extracellular matrix protein that is present at several sites of EMT, including the OFT (i.e., E9.5-10.5). The aim...

  18. OBSTRUCTION OF RIGHT VENTRICULAR OUTFLOW TRACT CAUSED BY INTRACAVITARY METASTATIC DISEASE OF PANCREATIC TUMOR

    Institute of Scientific and Technical Information of China (English)

    Meng-tao Li; Wen-ling Zhu

    2005-01-01

    @@ THE pericardium (90%) is the most common loca tion of cardiac involvement by secondary tumor,followed by myocardium and endocardium (10%).1 Cases of right ventricular outflow tract obstruction caused by intracavitary metastatic tumor growth were rarely reported, al though clinical presentation were unique. We herein reported such a case with literature review in order to improve the understanding of malignant cardiac metastasis.

  19. Autosomal dominant inheritance of left ventricular outflow tract obstruction

    NARCIS (Netherlands)

    Wessels, Marjolein; Berger, Rudolphus; Frohn-Mulder, Ingrid M E; Roos-Hesselink, Jolien W; Hoogeboom, Jeanette J M; Mancini, Grazia S; Bartelings, Margot M; Krijger, Ronald de; Wladimiroff, Jury W; Niermeijer, Martinus F; Grossfeld, Paul; Willems, Patrick J

    2005-01-01

    Most nonsyndromic congenital heart malformations (CHMs) in humans are multifactorial in origin, although an increasing number of monogenic cases have been reported recently. We describe here four new families with presumed autosomal dominant inheritance of left ventricular outflow tract obstruction

  20. Asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract.

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    Mustelier, Juan Valiente; Rego, Julio Oscar Cabrera; Aquiles, Eddy W Olivares; Llerena, Luis Roberto

    2010-12-01

    Coronary artery fistulas are unusual congenital or acquired coronary artery abnormalities in which blood is shunted into a cardiac chamber, great vessel or other structure, bypassing the myocardial capillary network (Jung et al. in Cardiovasc Ultrasound 5:10, 2007). We present a young adult patient with an asymptomatic fistula from a giant aneurysmatic left anterior descending artery to the right ventricular outflow tract, first diagnosed by echocardiography examination and further confirmed by 128-slice computed tomography coronary angiography.

  1. Obstruction of left ventricular outflow tract by vegetation and periaortic abscess.

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    Basmadjian, A J; Ducharme, A; Ugolini, P; Petitclerc, R; Leung, T K; Tardif, J C

    2000-09-01

    Echocardiography is the modality of choice for the noninvasive recognition of vegetations and abscesses that complicate endocarditis. Vegetation size is highly variable, and it has been suggested that large vegetations are related to a more complicated course. The case we present is unusual in that the echocardiographically detected vegetation was very large, highly mobile, and caused severe obstruction of the left ventricular outflow tract, which led to impaction and cardiac arrest.

  2. Transcatheter stenting of the right ventricular outflow tract augments pulmonary arterial growth in symptomatic infants with right ventricular outflow tract obstruction and hypercyanotic spells.

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    McGovern, Eimear; Morgan, Conall T; Oslizlok, Paul; Kenny, Damien; Walsh, Kevin P; McMahon, Colin J

    2016-10-01

    We retrospectively reviewed all the children with right ventricular outflow tract obstruction, hypoplastic pulmonary annulus, and pulmonary arteries who underwent stenting of the right ventricular outflow tract for hypercyanotic spells at our institution between January, 2008 and December, 2013; nine patients who underwent cardiac catheterisation at a median age of 39 days (range 12-60 days) and weight of 3.6 kg (range 2.6-4.3 kg) were identified. The median number of stents placed was one stent (range 1-4). The median oxygen saturation increased from 60% to 96%. The median right pulmonary artery size increased from 3.3 to 5.5 mm (-2.68 to -0.92 Z-score), and the median left pulmonary artery size increased from 3.4 to 5.5 mm (-1.93 to 0 Z-scores). Among all, one patient developed transient pulmonary haemorrhage, and one patient had pericardial tamponade requiring drainage. Complete repair of tetralogy of Fallot +/- atrioventricular septal defect or double-outlet right ventricle was achieved in all nine patients. Transcatheter stent alleviation of the right ventricular outflow tract obstruction resolves hypercyanotic spells and allows reasonable growth of the pulmonary arteries to facilitate successful surgical repair. This represents a viable alternative to placement of a systemic-to-pulmonary artery shunt, particularly in small neonates.

  3. [Obstruction of outflow tracts in complete transposition of great arteries].

    Science.gov (United States)

    Muñoz Castellanos, Luis; Kuri Nivon, Magdalena; Quiñones Cárdenas, Alma Rosa

    2002-01-01

    The obstructive lesions in the outflow tracts of hearts with complete transposition of the great arteries determine the clinical evolution, prognosis, and the selection of surgical procedures. Their knowledge is basic to interpret the imaging findings. From the pathologic specimens collection of the Instituto Nacional de Cardiología "Ignacio Chávez", seventy-tree hearts with this cardiopathy were studied morphologically with the sequential segmental system. Thirty-two hearts had outflow tracts anomalies, being obstructive twenty-eight; among these lesions were: malposition of the infundibular septum, hipertrophyc left infundibulum, prolapse of tricuspid valve tissue through a ventricular septal defect, accessory mitral valve tissue, septal hipertrophy at the left outflow tract level, abnormal insertion of cord tendinae of the mitral valve, anticlockwise malposition of the mitral valve (first report in the literature). The left outflow tract presented obstructive lesions (92.85%) more frequently than the right one. These lesions produce left ventricular hipertrophy, a fundamental feature for the anatomic surgical procedures to be made.

  4. Changes in strain and blood flow in the outflow tract of chicken embryo hearts observed with spectral domain optical coherence tomography after outflow tract banding

    Science.gov (United States)

    Ma, Zhenhe; Du, Linlin; Wang, Qiaoyun; Chu, Zhongdi; Zang, Xuan; Wang, Fengwen; Wang, Ruikang K.

    2013-02-01

    In this paper, we demonstrated the use of a spectral domain optical coherence tomography (OCT) in visualizing and quantifying changes in cardiac wall strain and blood-flow velocities under normal and altered hemodynamic conditions in chicken embryos at an early stage of development, focusing on the heart outflow tract (OFT). OCT imaging allowed in vivo evaluation strain and strain rate of the myocardium of the OFT through analyzing the periodic variation of the myocardial wall thickness. We found that alterations in hemodynamic conditions, through OFT banding, Changed strain and blood-flow velocities through the OFT as expected.

  5. [Reconstruction of the pulmonary outflow tract without external conduit].

    Science.gov (United States)

    Yoshimura, N; Yamaguchi, M; Oka, S; Ootaki, Y; Yoshida, M; Hayashi, T; Shinkawa, T; Tei, T; Kuroe, K; Kido, S; Tsukuda, K; Oshima, Y

    2001-07-01

    Between October 1987 and December 2000, 50 patients underwent reconstruction of the pulmonary outflow tract without external conduit. The primary malformation was tetralogy of Fallot with pulmonary atresia in 37, double outlet of right ventricle in 4, corrected transposition of the great arteries in 4, transposition of the great arteries with ventricular septal defect and pulmonary stenosis in 4, and double outlet of left ventricle in 2. Mean age at operation was 7.2 years, and mean body weight was 18.3 kg. To reconstruct posterior wall of the pulmonary outflow tract, interposition of autologous pericardium was performed in 24, direct anastomosis between pulmonary trunk and ventriculotomy in 13, longitudinal incision from ventriculotomy through pulmonary trunk in 12, and interposition of left atrial appendage in 1. Anterior wall was reconstructed with monocusp valved outflow patch (MVOP). There was one hospital death and no late death. At 10 years, the freedom from reoperation for pulmonary outflow tract obstruction was 100%, and freedom from reoperation for any cause was 86.6%. Transcatheter stenting for peripheral pulmonary stenosis was performed in 6 patients 2 to 10 months after operation.

  6. Hes1 is expressed in the second heart field and is required for outflow tract development.

    Directory of Open Access Journals (Sweden)

    Francesca Rochais

    Full Text Available BACKGROUND: Rapid growth of the embryonic heart occurs by addition of progenitor cells of the second heart field to the poles of the elongating heart tube. Failure or perturbation of this process leads to congenital heart defects. In order to provide further insight into second heart field development we characterized the insertion site of a transgene expressed in the second heart field and outflow tract as the result of an integration site position effect. RESULTS: Here we show that the integration site of the A17-Myf5-nlacZ-T55 transgene lies upstream of Hes1, encoding a basic helix-loop-helix containing transcriptional repressor required for the maintenance of diverse progenitor cell populations during embryonic development. Transgene expression in a subset of Hes1 expression sites, including the CNS, pharyngeal epithelia, pericardium, limb bud and lung endoderm suggests that Hes1 is the endogenous target of regulatory elements trapped by the transgene. Hes1 is expressed in pharyngeal endoderm and mesoderm including the second heart field. Analysis of Hes1 mutant hearts at embryonic day 15.5 reveals outflow tract alignment defects including ventricular septal defects and overriding aorta. At earlier developmental stages, Hes1 mutant embryos display defects in second heart field proliferation, a reduction in cardiac neural crest cells and failure to completely extend the outflow tract. CONCLUSIONS: Hes1 is expressed in cardiac progenitor cells in the early embryo and is required for development of the arterial pole of the heart.

  7. Hes1 Is Expressed in the Second Heart Field and Is Required for Outflow Tract Development

    Science.gov (United States)

    Mesbah, Karim; Jarry, Thérèse; Mattei, Marie-Geneviève; Kelly, Robert G.

    2009-01-01

    Background Rapid growth of the embryonic heart occurs by addition of progenitor cells of the second heart field to the poles of the elongating heart tube. Failure or perturbation of this process leads to congenital heart defects. In order to provide further insight into second heart field development we characterized the insertion site of a transgene expressed in the second heart field and outflow tract as the result of an integration site position effect. Results Here we show that the integration site of the A17-Myf5-nlacZ-T55 transgene lies upstream of Hes1, encoding a basic helix-loop-helix containing transcriptional repressor required for the maintenance of diverse progenitor cell populations during embryonic development. Transgene expression in a subset of Hes1 expression sites, including the CNS, pharyngeal epithelia, pericardium, limb bud and lung endoderm suggests that Hes1 is the endogenous target of regulatory elements trapped by the transgene. Hes1 is expressed in pharyngeal endoderm and mesoderm including the second heart field. Analysis of Hes1 mutant hearts at embryonic day 15.5 reveals outflow tract alignment defects including ventricular septal defects and overriding aorta. At earlier developmental stages, Hes1 mutant embryos display defects in second heart field proliferation, a reduction in cardiac neural crest cells and failure to completely extend the outflow tract. Conclusions Hes1 is expressed in cardiac progenitor cells in the early embryo and is required for development of the arterial pole of the heart. PMID:19609448

  8. Isolated Left Ventricular Apical Hypoplasia with Right Ventricular Outflow Tract Obstruction: A Rare Combination.

    Science.gov (United States)

    Zhao, Yonghui; Zhang, Jiaying; Zhang, Jing

    2015-09-01

    Isolated left ventricular (LV) apical hypoplasia is a unusual and recently recognized congenital cardiac anomaly. A 19-year-old man was found to have an abnormal ECG and cardiac murmur identified during a routine health check since joining work. His ECG revealed normal sinus rhythm, right-axis deviation, poor R wave progression, and T wave abnormalities. On physical examination, a 2/6~3/6 systolic murmur was heard at the second intercostal space along the left sternal border. Subsequent echocardiography and cardiac magnetic resonance imaging confirmed the LV apical hypoplasia. Of note, we first found that LV apical hypoplasia was accompanied by RV outflow tract obstruction due to exaggerated rightward bulging of the basal-anterior septum during systole. A close follow-up was performed for the development of heart failure, pulmonary hypertension, and potentially tachyarrhythmia.

  9. Right ventricular outflow tract reconstructive model in adult sheep.

    Science.gov (United States)

    Rakow, Nancy; Barka, Noah; Nelson, Dale; Allen, Nan; Gringaard, Robyn; Falkner, Phillip; Wahlberg, Phil; Lemmon, Jack; Phillips, Lynette; Billstrom, Tina; Hill, Alex; Shecterle, Linda M; St Cyr, J A

    2007-01-01

    Patients born with congenital right ventricular outflow tract lesions are faced with invasive procedures to establish hemodynamic and physiological stability. Commonly, multiple subsequent surgical procedures are required due to deterioration of a previous repair. These procedures carry additive risks of mortality and morbidity. Less aggressive procedures with accompanying lower risk is ideal. Success in percutaneously placing a transcatheter valve has previously been reported; however, continued safety and efficacy of any technique needs continual assessment. We developed a model for preclinical evaluation of a percutaneous placement of a pulmonic transcatheter valve in adult sheep, including preoperative, surgical, and postoperative techniques for long-term evaluation. Adult sheep were assessed and determined to be acceptable for study enrollment. Perioperative antibiotics and analgesics were given prior to a left thoracotomy. A Medtronic, Hancock 1 valve conduit was inserted for reconstruction of the right ventricular outflow tract. The Hancock 1 valve conduit alone represented the control group and the test animals comprised the addition of a Melodytrade mark transcatheter pulmonary valve (TPV), within the Hancock 1 valve conduit. Fifteen adult sheep survived the surgical implant procedure with no perioperative mortality. There were four early postoperative deaths, three due to infection and one due to heart failure, secondary to intraoperative heart block. The remaining 11 animals remained healthy, gained weight, and survived to termination at 5 months. An initial definite-sized valve conduit was implanted, followed by inserting a single size TPV, which allowed a more accurate physiological assessment of any chosen valve. Our developed adult sheep model for percutaneous TPV implantation for right ventricular outflow tract lesions was successful for long-term assessment by utilizing our preoperative, surgical, and postoperative techniques.

  10. [Right ventricular outflow tract reconstruction with monocusp patch].

    Science.gov (United States)

    Ikeda, T; Yokota, Y; Okamoto, F; Nakayama, S; Matsuno, S; Ohtani, S; Nakanishi, K; Nishimori, H

    1990-02-01

    Two kinds of monocusp patch were used for reconstruction of right ventricular outflow tract in patients with a variety of congenital heart defects. A bovine pericardial patch with monocusp (MVOP) was used in 11 patients (group M), and a separate transannular outflow patch (STOP) with turned-down equine pericardial monocusp was used in 10 patients (group S). Mean age at operation was 9 years 5 months in group M, and 7 years 9 months in group S. There was one operative death in group M. Survivors have completed a mean follow-up of 19 months. There were no late deaths. In early postoperative period, mean peak systolic pressure gradient between right ventricle and main pulmonary artery was 21 +/- 11 mmHg in group M and 21 +/- 11 mmHg in group S, which were not statistically significant. During follow-up period, no significant increase of peak systolic pressure gradient was noted in both groups. In late postoperative period, pulmonary regurgitation was moderate in 7 and severe in 1 in group M, while it was non-significant in 1, mild in 6 and moderate in 2 in group S. The difference between two groups was significant (p < 0.005). In conclusion, both types of patches equally relieved right ventricular outflow obstruction, but STOP prevented postoperative pulmonary regurgitation more effectively.

  11. Downregulation of Rho associated coiled-coil forming protein kinase 1 in the process of delayed myocardialization of cardiac proximal outflow tract septum in connexin 43 knockout mice embryo

    Institute of Scientific and Technical Information of China (English)

    QI Chun-hua; ZHAO Xiao-qing; MA Duan; MA Xiao-jing; ZHOU Guo-min; HUANG Guo-ying

    2011-01-01

    Background The connexln43 knockout (Cx43 KO) mouse dies at birth with an enlarged conotruncal region, which leads to the obstruction of the right outflow tract (OFT). Since myocardialization of the proximal OFT septum is one of the key events during heart development, we investigated the process in the Cx43 KO embryo hearts. Rho associated coiled-coil forming protein kinase 1 (ROCK1), is a recently found key molecule to regulate the myocardialization of OFT, but its spatiotemporal expression pattern during myocardialization remains unknown. The objective of this study was to investigate the differentially expressed pattern of ROCK1 between Cx43 KO and wild type embryo hearts, and its relationship with the delayed myocardialization in Cx43 KO embryo hearts.Methods Using immunohistochemistry, the processes of myocardiolization were investigated both in Cx43 KO and wild type embryo hearts. The differentially expressed pattern of ROCK1 between Cx43 KO and wildtype embryo hearts was evaluated both at the mRNA and protein level by real-time RT-PCR and immunohistochemistry.Results The expression of α-sarcomeric actin (α-SCA) in the proximal OFT septum of Cx43 KO embryos was delayed. Meanwhile, it was shown that the downregulation of ROCK1 coincided with delayed myocardialization. The expression of ROCK1 protein was mainly limited to the proximal outflow tract septum from embryo day (E) E11.5 to E15.5. Its expression pattern was similar with that of α-SCA. Real-time RT-PCR found that the expression level of Rock-1 mRNA began at a low level on E11.5 and reached peak at E13.5 and E14.5.Conclusions ROCK1 may have an important role in the process of myocardialization of the proximal OFT septum. Downregulation of ROCK1 is likely to contribute to the aberrant myocardialization in Cx43 KO embryo hearts.

  12. Fetal atrioventricular and outflow tract flow velocity waveforms during conducted and blocked supraventricular extrasystoles

    NARCIS (Netherlands)

    K. van der Mooren (K.); J.W. Wladimiroff (Juriy); Th. Stijnen (Theo)

    1992-01-01

    textabstractMaximum flow velocity waveforms at atrioventricular and outflow tract level were studied cross‐sectionally in 19 human fetuses with conducted and/or blocked supraventricular extrasystoles ranging from 25 to 38 weeks of gestation. At outflow tract level, peak systolic velocity and acceler

  13. The role of local voltage potentials in outflow tract ectopy

    DEFF Research Database (Denmark)

    Thomsen, P.E.B.; Johannessen, A.; Jons, C.;

    2010-01-01

    Discrete, fragmented, local voltage potentials (LVPs) have been observed in electrograms recorded at the ablation site in patients undergoing radiofrequency ablation for arrhythmias originating in both the right and left ventricular outflow tract; however, the incidence and the significance...... for supraventricular arrhythmias served as controls. During sinus rhythm, LVPs were recorded in 24 of the 25 patients, 10-85 ms (41 +/- 19 ms) after the onset of the QRS complex, duration 33 +/- 11 ms, voltage 2.0 +/- 1.5 mV. The same potential was recorded 10-52 ms (mean 37 +/- 11 ms) prior to the V potential...... in the ventricular premature beats. In 10 patients, ventricular parasystole was suggested by varying coupling intervals > 100 ms, and fusion beats allowing for the estimation of the least common denominator of R-R intervals. In 23 of the 25 patients, the 12-lead electrocardiogram (ECG) and intracardiac contact...

  14. Second heart field and the development of the outflow tract in human embryonic heart.

    Science.gov (United States)

    Yang, Yan-Ping; Li, Hai-Rong; Cao, Xi-Mei; Wang, Qin-Xue; Qiao, Cong-Jin; Ya, Jing

    2013-04-01

    The second heart field (SHF) is indicated to contribute to the embryonic heart development. However, less knowledge is available about SHF development of human embryo due to the difficulty of collecting embryos. In this study, serial sections of human embryos from Carnegie stage 10 (CS10) to CS16 were stained with antibodies against Islet-1 (Isl-1), Nkx2.5, GATA4, myosin heavy chain (MHC) and α-smooth muscle actin (α-SMA) to observe spatiotemporal distribution of SHF and its contribution to the development of the arterial pole of cardiac tube. Our findings suggest that during CS10 to CS12, SHF of the human embryo is composed of the bilateral pharyngeal mesenchyme, the central mesenchyme of the branchial arch and splanchnic mesoderm of the pericardial cavity dorsal wall. With development, SHF translocates and consists of ventral pharyngeal mesenchyme and dorsal wall of the pericardial cavity. Hence, the SHF of human embryo shows a dynamic spatiotemporal distribution pattern. The formation of the Isl-1 positive condense cell prongs provides an explanation for the saddle structure formation at the distal pole of the outflow tract. In human embryo, the Isl-1 positive cells of SHF may contribute to the formation of myocardial outflow tract (OFT) and the septum during different development stages.

  15. Accessory mitral valve tissue causing severe left ventricular outflow tract obstruction in a post-Senning patient with transposition of the great arteries

    Directory of Open Access Journals (Sweden)

    Abdullah Al-Farqani

    2011-06-01

    Full Text Available Accessory mitral valve tissue is a rare congenital anomaly associated with congenital cardiac defects and is usually detected in the first decade of life. We describe the case of an 18-year old post-Senning asymptomatic patient who was found to have accessory mitral valve tissue on transthoracic echocardiography producing severe left ventricular outflow tract obstruction.

  16. Septation and shortening of outflow tract in embryonic mouse heart involve changes in cardiomyocyte phenotype and α-SMA positive cells in the endocardium

    Institute of Scientific and Technical Information of China (English)

    杨艳萍; 李海荣; 景雅

    2004-01-01

    Background Studies on human, rat and chicken embryos have demonstrated that during the period of outflow tract septation, retraction of the distal myocardial margin of the outflow tract from the junction with aortic sac to the level of semilunar valves leads to the shortening of the myocardial tract. However, the mechanism is not clear. So we investigated the mechanism of outflow tract shortening and remodeling and the spatio-temporal distribution pattern of α-SMA positive cells in the outflow tract cushion during septation of the outflow tract in the embryonic mouse heart. Methods Serial sections of mouse embryos from embryonic day 9 (ED 9) to embryonic day 16 (ED 16) were stained with monoclonal antibodies against α-SCA, α-SMA, or desmin, while apoptosis was assessed using the terminal deoxyribonucleotidy transferase-mediated dUTP-digoxigenin nick-end labeling (TUNEL) assay. Results Between ED 11 and ED 12, the cardiomyocytes in the distal portion of the outflow tract were observed losing their myocardial phenotype without going into apoptosis, suggesting that trans-differentiation of cardiomyocytes into the cell components of the free walls of the intrapericardial ascending aorta and pulmonary trunk. The accumulation of α-SMA positive cells in the cardiac jelly began on ED 10 and participated in the ridge fusion and septation of the outflow tract. Fusion of the distal ridges resulted in the formation of the facing walls of the intrapericardial ascending aorta and pulmonary trunk. Fusion of the proximal ridges was accompanied by the accumulation of α-SMA positive cells into a characteristic central whorl, in which cell apoptosis could be observed. Subsequent myocardialization resulted in the formation of the partition between the subaortic and subpulmonary vestibules. Conclusions The shortening of the embryonic heart outflow tract in mice may result not from apoptosis, but from the trans-differentiation of cells with cardiomyocyte phenotype in the distal

  17. Left Ventricular Outflow Tract Obstruction after Bioprosthetic Mitral Valve Replacement with Posterior Mitral Leaflet Preservation

    OpenAIRE

    Guler, Niyazi; Ozkara, Cenap; Akyol, Aytac

    2006-01-01

    We present a case of transient left ventricular outflow tract obstruction after mitral valve replacement with a high-profile bioprosthesis; only the posterior native mitral valve leaflet was preserved.

  18. Echocardiographic diagnosis of left ventricular outflow tract obstruction after mitral valve replacement with subvalvular preservation

    NARCIS (Netherlands)

    Rietman, GW; van der Maaten, JMAA; Douglas, YL; Boonstra, PW

    2002-01-01

    We describe two cases of left ventricular outflow tract obstruction after mitral valve replacement with complete retention of the subvalvular apparatus. The first patient deteriorated immediately after insertion of a high-profile bioprosthesis. In the second patient, chronic left ventricular outflow

  19. Dihydrofolate reductase is required for the development of heart and outflow tract in zebrafish

    Institute of Scientific and Technical Information of China (English)

    Shuna Sun; Yonghao Gui; Qiu Jiang; Houyan Song

    2011-01-01

    Folic acid is very important for embryonic development and folic acid inhibition can cause congenital heart defects in vertebrates.Dihydrofolate reductase (DHFR) is a key enzyme in folate-mediated metabolism.The dysfunction of DHFR disrupts the key biological processes which folic acid participates in.DHFR gene is conserved during vertebrate evolution.It is important to investigate the roles of DHFR in cardiac developments.In this study,we showed that DHFR knockdown resulted in the abnormal developments of zebrafish embryos in the early stages.Obvious malformations in heart and outflow tract (OFT) were also observed in DHFR knockdown embryos.DHFR overexpression rescued the abnormal phenotypes in the DHFR knockdown group.DHFR knockdown had negative impacts on the expressions of NKX2.5 (NK2 transcription factor-related 5),MEF2C (myocyte-specific enhancer factor 2C),TBX20 (T-box 20),and TBX1 (T-box 1) which are important transcriptional factors during cardiac development process,while DHFR overexpression had positive effects.DHFR was required for Hedgehog pathway.DHFR knockdown caused reduced cell proliferation and increased apoptosis,while its overexpression promoted cell proliferation and inhibited apoptosis.Taken together,our study suggested that DHFR plays crucial roles in the development of heart and OFT in zebrafish by regulating gene transcriptions and affecting cell proliferation and apoptosis.

  20. Obstruction of left ventricular outflow tract by a calcified mass at mitral valve

    Directory of Open Access Journals (Sweden)

    Miro Bakula

    2010-08-01

    Full Text Available A case of an unusual left ventricular outflow tract obstruction by mitral valve pathology in a 35-year old female with diabetes and end-stage renal disease is presented in the study. The patient sufferedfrom fever of an unknown origin after lower-leg amputation. Although the wound healed well, fever persisted for three weeks despite a triple antibiotic treatment until the infection was resolved with vancomycin.Three months later echocardiography displayed a floating mass attached to mitral valve, producing a newly developed systolicmurmur and a mild haemodynamic obstruction of the left ventricular outflow tract. The calcified vegetation was probably formed during an unrecognized subacute infective endocarditis.

  1. Manifestation of Latent Left Ventricular Outflow Tract Obstruction in the Acute Phase of Takotsubo Cardiomyopathy

    Science.gov (United States)

    Ozaki, Kazuyuki; Okubo, Takeshi; Tanaka, Komei; Hosaka, Yukio; Tsuchida, Keiichi; Takahashi, Kazuyoshi; Oda, Hirotaka; Minamino, Tohru

    2016-01-01

    Objective Left ventricular outflow tract (LVOT) obstruction is a complication in 15-25% of patients with Takotsubo cardiomyopathy and sometimes leads to catastrophic outcomes, such as cardiogenic shock or cardiac rupture. However, the underlying mechanisms have not been clarified. Methods and Results We experienced 22 cases of Takotsubo cardiomyopathy during 3 years, and 4 of these 22 cases were complicated with LVOT obstruction in the acute phase (mean age 79±5 years, 1 man, 21 women). The LVOT pressure gradient in the acute phase was 100±17 mmHg. Transthoracic echocardiogram (TTE) revealed left ventricular hypertrophy (LVH) in one case and sigmoid-shaped septum without LVH in three cases. The complete resolution of the LVOT obstruction was achieved in a few days with normalization of the left ventricular wall motion following administration of beta-blockers. A dobutamine provocation test after normalization of the left ventricular wall motion reproduced the LVOT obstruction in all cases and revealed the presence of latent LVOT obstruction. Conclusion The manifestation of latent LVOT obstruction in the acute phase of Takotsubo cardiomyopathy is one potential reason for the complication of LVOT obstruction with Takotsubo cardiomyopathy. PMID:27904102

  2. Summary of Clinical Experience of Modified Double Root Translocation in the Management of Complete Transposition of Great Arteries With Left Ventricular Outflow Tract Obstruction.

    Science.gov (United States)

    Yang, Bin; Xu, Jing; Zhou, Zhiming; Wang, Ke; Chen, Jianchao; Chen, Hongling; Wen, Meng; Liang, Qiaoru

    2016-07-27

    To summarize the therapeutic effects of modified double root translocation (MDRT) in the management of congenital heart disease-transposition of great arteries (TGA) with ventricular septum defect (VSD) and left ventricular outflow tract obstruction (LVOTO). From May 2013 to March 2015, we treated 6 patients (4 males, 2 females, aged from 1 year and 8 months old to 5 years old) with complete transposition of great arteries with left ventricular outflow tract obstruction, SaO2 54 ± 7.3%; the outflow velocity of the left ventricular or pulmonary valve measured by Doppler was 4.46 ± 0.15 m/s, and the Nakata index was 217 ± 32 cm(2)/m(2). We carried out a double root translocation operation on these 6 patients.One patient developed low cardiac output syndrome 4 hours after the operation. Extracorporeal membrane oxygenation (ECMO) was performed, but the patient died of multiple organ failure. The other 5 patients all recovered and were discharged from the hospital. During the 3-month to 2-year follow-up period, these 5 patients all demonstrated NYHA Class I or NYHA Class II LVEF (65 ± 2.7) %; 4 had mild pulmonary regurgitation, 1 moderate pulmonary regurgitation; 3 no aortic regurgitation, and 2 micro aortic regurgitation, SaO2 99 ± 0.4%.Modified double root translocation is an effective treatment method in the management of complete transposition of great arteries with left ventricular outflow tract obstruction.

  3. Blood flowing state analysis in outflow tract of chick embryonic heart based on spectral domain optical coherence tomography

    Science.gov (United States)

    Zhao, Yuqian; Suo, Yanyan; Liang, Chengbo; Ma, Zhenhe

    2016-03-01

    The cardiac development is a complicated process affected by genetic and environmental factors. Wall shear stress (WSS) and periodic stress (WPS) are the components which have been proved to influence the morphogenesis during early stages of cardiac development. The vessel wall will be deformed by the blood pressure and produce natural elastic force acting on the blood. Because blood flowing in different flow state and show different characteristics of fluid, which influence the calculation of WSS and WPS directly, it is necessary to study the blood flow state. In this paper, we introduce a method to quantify the blood flowing state of early stage chick embryonic heart based on high speed spectral domain optical coherence tomography (SDOCT).4D (x,y,z,t) scan was performed on the outflow tract (OFT) of HH18 (~3 days of incubation) chick embryonic heart. By processing the structural image, the geometric parameters were obtained. Blood flow velocity distribution in the OFT were calculated by Doppler OCT method. Hemodynamic parameters were obtained at different times during the cardiac cycle used biofluid mechanics theory, such as Reynolds number and Womersley number.

  4. Dynamic left ventricular outflow tract obstruction complicating aortic valve replacement: A hidden malefactor revisited

    Directory of Open Access Journals (Sweden)

    Panduranga Prashanth

    2010-01-01

    Full Text Available It is known that a dynamic left ventricular outflow tract (LVOT obstruction exists in patients, following aortic valve replacement (AVR and is usually considered to be benign. We present a patient with dynamic LVOT obstruction following AVR, who developed refractory cardiogenic shock and expired inspite of various treatment strategies. This phenomenon must be diagnosed early and should be considered as a serious and potentially fatal complication following AVR. The possible mechanisms and treatment options are reviewed.

  5. Comparison of Valsalva manoeuvre and exercise in echocardiographic evaluation of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten Krogh; Havndrup, Ole; Pecini, Redi;

    2010-01-01

    Several methods are used to induce latent left ventricular outflow tract (LVOT) gradients in patients with hypertrophic cardiomyopathy (HCM). We compared LVOT gradients induced by Valsalva manoeuvre (VM) and exercise echocardiography (EE) in patients with HCM treated with percutaneous translumina...

  6. An evaluation of range gated pulsed Doppler echocardiography for detecting pulmonary outflow tract obstruction in d-transposition of the great vessels.

    Science.gov (United States)

    Areias, J C; Goldberg, S J; Spitaels, S E; de Villeneuve, V H

    1978-10-01

    The aim of this study was to determine the accuracy of range gated pulsed Doppler (RGPD) echocardiography for detecting obstruction to the pulmonary outflow tract in children with d-transposition of the great vessels (d-TGV). Twenty-one children were randomly selected for those available with d-TGV and were studied by precordial and suprasternal RGPD echocardiography. Three were excluded, leaving a population of 18 subjects. The exclusive criterion used to judge the RGPD results was the output of the time interval histogram (TIH). Coherence of the TIH was considered to represent laminar flow. Dispersion of the TIH was considered evidence of flow disturbance and obstruction to the outflow tract. With the range gating feature, the first site of disturbance could be localized. Information was handled by a technique that decreased bias. RGPD results were then compared to diagnoses of the outflow tract established at cardiac catheterization or operation. Comparison of these results indicated that all seven children with obstruction were correctly identified by RGPD study, and the level of the first obstruction was correctly identified. With one exception, all children without pulmonary obstruction were correctly identified by the examination.

  7. Disheveled mediated planar cell polarity signaling is required in the second heart field lineage for outflow tract morphogenesis.

    Science.gov (United States)

    Sinha, Tanvi; Wang, Bing; Evans, Sylvia; Wynshaw-Boris, Anthony; Wang, Jianbo

    2012-10-01

    Disheveled (Dvl) is a key regulator of both the canonical Wnt and the planar cell polarity (PCP) pathway. Previous genetic studies in mice indicated that outflow tract (OFT) formation requires Dvl1 and 2, but it was unclear which pathway was involved and whether Dvl1/2-mediated signaling was required in the second heart field (SHF) or the cardiac neural crest (CNC) lineage, both of which are critical for OFT development. In this study, we used Dvl1/2 null mice and a set of Dvl2 BAC transgenes that function in a pathway-specific fashion to demonstrate that Dvl1/2-mediated PCP signaling is essential for OFT formation. Lineage-specific gene-ablation further indicated that Dvl1/2 function is dispensable in the CNC, but required in the SHF for OFT lengthening to promote cardiac looping. Mutating the core PCP gene Vangl2 and non-canonical Wnt gene Wnt5a recapitulated the OFT morphogenesis defects observed in Dvl1/2 mutants. Consistent with genetic interaction studies suggesting that Wnt5a signals through the PCP pathway, Dvl1/2 and Wnt5a mutants display aberrant cell packing and defective actin polymerization and filopodia formation specifically in SHF cells in the caudal splanchnic mesoderm (SpM), where Wnt5a and Dvl2 are co-expressed specifically. Our results reveal a critical role of PCP signaling in the SHF during early OFT lengthening and cardiac looping and suggest that a Wnt5a→ Dvl PCP signaling cascade may regulate actin polymerization and protrusive cell behavior in the caudal SpM to promote SHF deployment, OFT lengthening and cardiac looping.

  8. Dynamic obstruction of the left ventricular outflow tract in four young dogs.

    Science.gov (United States)

    Connolly, D J; Boswood, A

    2003-07-01

    Four young dogs presented for evaluation of left-sided systolic heart murmurs all showed echocardiographic changes consistent with dynamic left ventricular outflow tract (LVOT) obstruction and subjective evidence of concentric left ventricular hypertrophy. In three of the dogs, abnormal mitral valve apparatus and systolic anterior motion of the anterior mitral valve leaflet with associated mitral insufficiency were also detected. All dogs were medicated with a beta1-adrenergic antagonist. Subsequent examinations showed that the dynamic LVOT obstruction and left ventricular concentric hypertrophy had almost completely resolved. Dynamic LVOT obstruction is a rare condition of young dogs of different breeds. The precise aetiology of the condition remains uncertain. Whether resolution of the outflow obstruction in these four cases was a consequence of treatment or due to changes in ventricular architecture brought about by ageing cannot be established.

  9. Biomechanics of the chick embryonic heart outflow tract at HH18 using 4D optical coherence tomography imaging and computational modeling.

    Directory of Open Access Journals (Sweden)

    Aiping Liu

    Full Text Available During developmental stages, biomechanical stimuli on cardiac cells modulate genetic programs, and deviations from normal stimuli can lead to cardiac defects. Therefore, it is important to characterize normal cardiac biomechanical stimuli during early developmental stages. Using the chicken embryo model of cardiac development, we focused on characterizing biomechanical stimuli on the Hamburger-Hamilton (HH 18 chick cardiac outflow tract (OFT, the distal portion of the heart from which a large portion of defects observed in humans originate. To characterize biomechanical stimuli in the OFT, we used a combination of in vivo optical coherence tomography (OCT imaging, physiological measurements and computational fluid dynamics (CFD modeling. We found that, at HH18, the proximal portion of the OFT wall undergoes larger circumferential strains than its distal portion, while the distal portion of the OFT wall undergoes larger wall stresses. Maximal wall shear stresses were generally found on the surface of endocardial cushions, which are protrusions of extracellular matrix onto the OFT lumen that later during development give rise to cardiac septa and valves. The non-uniform spatial and temporal distributions of stresses and strains in the OFT walls provide biomechanical cues to cardiac cells that likely aid in the extensive differential growth and remodeling patterns observed during normal development.

  10. Left ventricular outflow tract pseudoaneurysm formation following three aortic valve replacement surgeries

    Directory of Open Access Journals (Sweden)

    Nasrien E Ibrahim

    2015-01-01

    Full Text Available We present a case of a pseudoaneurysm arising from the left ventricular outflow tract/aortic root as a complication of aortic valve surgery. A 45-year-old Nigerian female presented to our institution′s emergency department with chest discomfort. She had three bioprosthetic aortic valve replacements in the preceding year at an outside institution for aortic regurgitation and wanted a second opinion on remaining surgical options. The learning points relevant to this case are as follows: (1 Recognizing potential complications postmultiple valve surgeries, (2 screening patients for chronic infections and rheumatologic conditions that can contribute to failed valve surgeries.

  11. Sub-aortic obstruction of left ventricular outflow tract secondary to benfluorex-induced endocardial fibrosis

    Directory of Open Access Journals (Sweden)

    Catherine Szymanski

    2015-12-01

    Full Text Available Patients exposed to benfluorex have an increased risk of restrictive organic valvular heart disease. Aortic and mitral regurgitations caused by fibrotic valve disease are the most common features observed in exposure to fenfluramine derivatives in general and benfluorex in particular. We report here, for the first time to our knowledge, a well-documented case in which obstructive sub-aortic endocardium fibrosis within the left ventricular outflow tract is related with exposure to a drug that modifies the metabolism of serotonin. It now remains to be established whether extensive fibrosis of the myocardium in addition to well-documented valvular fibrosis may develop in patients exposed to amphetamine-derived drugs affecting the serotonin system.

  12. Outflow tract segmental arrhythmogenic right ventricular cardiomyopathy in an English Bulldog.

    Science.gov (United States)

    Santilli, Roberto A; Bontempi, Luigi V; Perego, Manuela; Fornai, Lara; Basso, Cristina

    2009-06-01

    A 5-year-old English Bulldog was presented for acute onset of syncope and fatigue caused by sustained ventricular tachycardia with left bundle block morphology and inferior axis. This arrhythmia had the electrocardiographic features of a ventricular tachycardia arising from the right ventricular outflow tract (RVOT), as described in an experimental canine model and in people. Since a RVOT aneurysm was identified by echocardiography, a segmental form of arrhythmogenic right ventricular cardiomyopathy (ARVC) was suspected. Gross examination of the heart confirmed the bulging of the RVOT and histological examination of the ventricular myocardium revealed segmental involvement of the RVOT with transmural fibro-fatty degeneration. To the authors' knowledge, this is the first reported case of AVRC in an English Bulldog and the first example of segmental AVRC described in the dog.

  13. Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy.

    LENUS (Irish Health Repository)

    Shah, J S

    2008-10-01

    Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain.

  14. Use of a circular mapping and ablation catheter for ablation of atypical right ventricular outflow tract arrhythmia.

    Science.gov (United States)

    Katritsis, Demosthenes G; Giazitzoglou, Eleftherios; Paxinos, George

    2010-02-01

    A new technique for ablation of persistent ectopic activity with atypical electrocardiographic characteristics at the vicinity of the right ventricular outflow tract is described. A new circular mapping and ablation catheter initially designed for pulmonary vein ablation was used. Abolition of ectopic activity was achieved with minimal fluoroscopy and ablation times.

  15. Effect of right ventricular outflow tract pacing and right ventricular apex pacing on cardiac function by tissue Doppler imaging%组织多普勒成像评价右心室心尖部与右心室流出道间隔部起搏对心功能的影响

    Institute of Scientific and Technical Information of China (English)

    卜婕; 俞杉; 吴强; 安亚平

    2011-01-01

    Objective To explore the effects of right ventricular apex(RVA) pacing and right ventricular outflow tract (RVOT) pacing on cardiac function using tissue Doppler imaging technique.Methods 65 lentitude arrhythmia patients were randomly divided into RVA pacing group ( n =30), RVOT pacing group ( n =35).Before the pacemaker implantation, after 1 month, 3 months, 6 months and 12 months respectively, early diastolic mitral annulus velocity(E a), systolic velocity (Sa), Tel index were measured by tissue velocity-time curve; left ventricular ejection fraction(LVEF) was measured by SIMPSON method; mitral early diastolic peak velocity(E) was measured by pulsed Doppler,E,E and Ea ratio (E/Ea) were calculated.Results RVA and RVOT both groups before and after 1,3 months,all the indicators were not statistically significant.After 1, 3 months in the above two groups, LVEF was respectively(61.8913.37) % vs(61.51±3.11)% ,(60.22±4.85)% vs(60.32±4.25) % ,Sa (11.38± 1.14) cm/s vs (11.44±2.14) cm/s,(10.88±1.91) cm/s vs (11.02± 1.31) cm/s, E/A 0.96±0.19 vs 0.97± 0.23,0.95±0.15 vs 0.96±0.13,E/Ea 8.8±3.6 vs 8.4±4.3,9.1±4.3 vs 8.8±3.2,Tei index 0.48±0.05 vs 0.47±0.08,0.50±0.20 vs 0.47±0.11(all P >0.05).After 6 months,RVA pacing and RVOT pacing compared with tissue Doppler indexes,Tel index and E/Ea increased 0.76±0.26 vs 0.67 ± 0.32, 10.9 ± 3.96 vs 9.0 ± 2.8, all P < 0.05), after 12 months, Sa decreased, (8.22 ± 1.72) cm/s vs (9.52± 2.56) cm/s( P <0.05).Conclusion RVA pacing induced heart contractions are not synchronized to the detriment of left ventricular systolic and diastolic function.RVOT septai pacing obtains more optimal parameters of heart function than RVA pacing,and RVOT septal pacing is a good right ventricular pacing site.%目的 运用组织多普勒成像技术(TDI)比较右心室流出道(RVOT)间隔部起搏和右心室心尖部(RVA)起搏对心功能的影响.方法 将缓慢心律失常患者65例随机分为RVA起搏组(n=30)

  16. Effect of Left Ventricular Outflow Tract Obstruction on Left Atrial Mechanics in Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Lynne K. Williams

    2015-01-01

    Full Text Available Left atrial (LA volumes are known to be increased in hypertrophic cardiomyopathy (HCM and are a predictor of adverse outcome. In addition, LA function is impaired and is presumed to be due to left ventricular (LV diastolic dysfunction as a result of hypertrophy and myocardial fibrosis. In the current study, we assess the incremental effect of outflow tract obstruction (and concomitant mitral regurgitation on LA function as assessed by LA strain. Patients with HCM (50 obstructive, 50 nonobstructive were compared to 50 normal controls. A subset of obstructive patients who had undergone septal myectomy was also studied. Utilising feature-tracking software applied to cardiovascular magnetic resonance images, LA volumes and functional parameters were calculated. LA volumes were significantly elevated and LA ejection fraction and strain were significantly reduced in patients with HCM compared with controls and were significantly more affected in patients with obstruction. LA volumes and function were significantly improved after septal myectomy. LVOT obstruction and mitral regurgitation appear to further impair LA mechanics. Septal myectomy results in a significant reduction in LA volumes, paralleled by an improvement in function.

  17. An organized approach to the localization, mapping, and ablation of outflow tract ventricular arrhythmias.

    Science.gov (United States)

    Hutchinson, Mathew D; Garcia, Fermin C

    2013-10-01

    The outflow tract (OT) regions of the right and left ventricles, common sites of origin for idiopathic ventricular arrhythmias (VA), have complex three-dimensional anatomical relationships. The understanding of in situ or "attitudinal" relationships not only informs the electrocardiographic interpretation of VA site of origin, but also facilitates their catheter-based mapping and ablation strategies. By viewing each patient as his or her own "control," the expected changes in ECG morphology (i.e., frontal plane QRS axis and precordial transition) between adjacent intracardiac structures (e.g., RVOT and aortic root) can be reliably predicted. Successful mapping of OT VAs involve a combination of activation and pacemapping guided by fluoroscopy, electroanatomical mapping, and intracardiac echocardiography. The purpose of this manuscript is to provide a simple, reliable strategy for catheter based mapping and ablation of OT VAs. We also discuss 2 specific challenges in OT VA mapping: (1) differentiating posterior RVOT from right coronary cusp VA origin; and (2) mapping VAs originating from the LV summit.

  18. In vitro evaluation of valve hemodynamics in the pediatric pulmonary outflow tract

    Science.gov (United States)

    Schiavone, Nicole; Elkins, Chris; McElhinney, Doff; Eaton, John; Marsden, Alison

    2016-11-01

    Tetraology of Fallot (ToF) is a congenital heart disease that affects 1 in every 2500 newborns each year and requires surgical repair of the right ventricular outflow tract (RVOT) and subsequent placement of an artificial pulmonary valve. While a wide variety of artificial valves are available, essentially all of them become subject to degradation and dysfunction during the patient's lifetime, which leads to additional interventions. However, there is little understanding about the mechanical function of replacement pulmonary valves and no quantitative placement guidelines to ensure maximum failure-free lifetime. This work aims to experimentally assess the biomechanics of pulmonary valves in realistic RVOT geometries using magnetic resonance velocimetry (MRV), which can measure 3D, three-component phase-averaged velocity fields. The RVOT geometries are constructed using 3D printing, allowing for variation in crucial geometric parameters such as the radius of curvature of the main pulmonary artery (MPA) and the dilation of the artery downstream of the valve. A St. Jude Medical Epic valve is secured inside the RVOT geometry and can be interchanged, allowing for variation of the ratio between valve diameter and MPA diameter. This work will discuss the use of MRV to capture the flow structure in the RVOT and evaluate pulmonary valve performance under different conditions.

  19. Transcatheter Pulmonary Valve Replacement for Right Ventricular Outflow Tract Conduit Dysfunction After the Ross Procedure

    DEFF Research Database (Denmark)

    Gillespie, Matthew J; McElhinney, Doff B; Kreutzer, Jacqueline

    2015-01-01

    BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review of databa...... early outcomes and durable valve function in the majority of Ross patients. Recurrent RVOT obstruction associated with stent fracture was the main reason for reintervention. Coronary compression is not uncommon in Ross patients and should be assessed prior to TPVR....... of databases from 3 prospective Melody TPV (Medtronic Inc, Minneapolis, MN) trials. RESULTS: Among 358 patients who were catheterized with the intent to implant a Melody TPV for RVOT conduit stenosis or regurgitation (PR) as part of 3 prospective multicenter studies, 67 (19%) had a prior Ross procedure....... Of these, 56 (84%) received a Melody valve; in 5 of the 11 patients who did not, the implant was aborted due to concern for coronary artery compression, and 1 implanted patient required emergent surgery for left coronary compression. The RVOT gradient decreased from a median 38 mm Hg to 13.5 mm Hg (p

  20. Murine Jagged1/Notch signaling in the second heart field orchestrates Fgf8 expression and tissue-tissue interactions during outflow tract development

    Science.gov (United States)

    High, Frances A.; Jain, Rajan; Stoller, Jason Z.; Antonucci, Nicole B.; Lu, Min Min; Loomes, Kathleen M.; Kaestner, Klaus H.; Pear, Warren S.; Epstein, Jonathan A.

    2009-01-01

    Notch signaling is vital for proper cardiovascular development and function in both humans and animal models. Indeed, mutations in either JAGGED or NOTCH cause congenital heart disease in humans and NOTCH mutations are associated with adult valvular disease. Notch typically functions to mediate developmental interactions between adjacent tissues. Here we show that either absence of the Notch ligand Jagged1 or inhibition of Notch signaling in second heart field tissues results in murine aortic arch artery and cardiac anomalies. In mid-gestation, these mutants displayed decreased Fgf8 and Bmp4 expression. Notch inhibition within the second heart field affected the development of neighboring tissues. For example, faulty migration of cardiac neural crest cells and defective endothelial-mesenchymal transition within the outflow tract endocardial cushions were observed. Furthermore, exogenous Fgf8 was sufficient to rescue the defect in endothelial-mesenchymal transition in explant assays of endocardial cushions following Notch inhibition within second heart field derivatives. These data support a model that relates second heart field, neural crest, and endocardial cushion development and suggests that perturbed Notch-Jagged signaling within second heart field progenitors accounts for some forms of congenital and adult cardiac disease. PMID:19509466

  1. Defective ALK5 signaling in the neural crest leads to increased postmigratory neural crest cell apoptosis and severe outflow tract defects

    Directory of Open Access Journals (Sweden)

    Sucov Henry M

    2006-11-01

    Full Text Available Abstract Background Congenital cardiovascular diseases are the most common form of birth defects in humans. A substantial portion of these defects has been associated with inappropriate induction, migration, differentiation and patterning of pluripotent cardiac neural crest stem cells. While TGF-β-superfamily signaling has been strongly implicated in neural crest cell development, the detailed molecular signaling mechanisms in vivo are still poorly understood. Results We deleted the TGF-β type I receptor Alk5 specifically in the mouse neural crest cell lineage. Failure in signaling via ALK5 leads to severe cardiovascular and pharyngeal defects, including inappropriate remodeling of pharyngeal arch arteries, abnormal aortic sac development, failure in pharyngeal organ migration and persistent truncus arteriosus. While ALK5 is not required for neural crest cell migration, our results demonstrate that it plays an important role in the survival of post-migratory cardiac neural crest cells. Conclusion Our results demonstrate that ALK5-mediated signaling in neural crest cells plays an essential cell-autonomous role in the pharyngeal and cardiac outflow tract development.

  2. [Long-term results of Rygg's monocusp ventricular outflow patch for the reconstruction of right ventricular outflow tract in tetralogy of Fallot].

    Science.gov (United States)

    Morikawa, M; Abe, T; Takagi, N; Ito, T; Hachiro, Y; Sato, S; Komatsu, K; Kikuchi, S

    2001-07-01

    Thirty surviving patients after corrective surgery for tetralogy of Fallot with right ventricular outflow tract reconstruction (RVOTR) using monocusp ventricular outflow patch (MVOP) were reviewed retrospectively to determine the long-term results. The age at operation ranged from 2 to 55 years with a mean of 19 years, and follow-up extended to 18.2 years (cumulative: 345.4 patient-year). There were 4 late deaths (1.2% per patient-year), and the cumulative survival rate was 85.3% at 18 years after the corrective surgery. Eight patients (2.3% per patient-year) required intracardiac reoperations mostly resulted from problems after RVOTR with MVOP, such as recurrent stenosis of right ventricular outflow tract (3 cases) or pulmonary valvular incompetence (4 cases). In addition, one patient underwent balloon angioplasty for the recurrent stenosis located in the distal end of MVOP. Freedom from surgical or catheter reintervention for the MVOP-related complication was 60.6% at 18 years after the corrective surgery. MVOP caused compression of the pulmonary artery at the distal end of the anastomosis and reoperation in a younger patients quite early after the corrective surgery. Like other transannular patches, tissue failure and degeneration of MVOP were inevitable, and resulted in severe pulmonary valvular incompetence that required the valve replacement in 4 patients (1.3% per patient-year). Freedom from pulmonary valve replacement was 71.2% at 18 years after the corrective surgery. As long-term results, our experiences emphasize the need for an innovative transannular patch that possesses significantly better long-term durability.

  3. Pulmonary endoderm, second heart field and the morphogenesis of distal outflow tract in mouse embryonic heart

    Institute of Scientific and Technical Information of China (English)

    SHI Liang; JING Ya; LI Huichao; WANG Yunxiu; WU Shanshan; CAI Yujin; CUI Huilin; YANG Yanping

    2015-01-01

    Objective:The second heart field ( SHF) , foregut endoderm and sonic hedgehog ( SHH) signa-ling pathway are associate with normal morphogenesis and septation of outflow tract ( OFT) . However, the morpho-logical relationships of the development of foregut endoderm and expression of SHH signaling pathway members with the development of surrounding SHF and OFT are seldom described. In this study, serial sections of mouse embryos from ED9 to ED13 ( midgestation) were stained with a series of marker antibodies for specifically highlighting SHF ( Isl-1 ) , endoderm ( Foxa2 ) , basement membrane ( Laminin ) , myocardium ( MHC ) and smooth muscle (α-SMA) respectively, or SHH receptors antibodies including patched1 (Ptc1), patched2 (Ptc2) and smoothened, to observe the spatiotemporal relationship between them and their contributions to OFT morphogenesis. Results: Our results demonstrated that the development of an Isl-1 positive field in the splanchnic mesoderm ventral to foregut, a subset of SHF, was closely coupled with pulmonary endoderm or tracheal groove, the Isl-1 positive cells sur-rounding pulmonary endoderm were distributed in a special cone-shaped pattern and contributed to the formation of the lateral walls of the intrapericardial aorta and pulmonary trunk and the transient aortic-pulmonary septum, and Ptc1 and Ptc2 were exclusively expressed in pulmonary endoderm during this Isl-l positive field development, suggesting special roles played in inducing the Isl-l positive field formation by pulmonary endoderm. Conclusions: Pulmonary endoderm plays a role in the development and specification of SHF in midgestation, and that pulmonary endoderm-associated Isl-l positive field is involved in patterning the morphogenesis and septation of the intrapericardial arterial trunks.

  4. Pulmonary endoderm, second heart field and the morphogenesis of distal outflow tract in mouse embryonic heart.

    Science.gov (United States)

    Liang, Shi; Li, Hui-Chao; Wang, Yun-Xiu; Wu, Shan-Shan; Cai, Yu-Jin; Cui, Hui-Lin; Yang, Yan-Ping; Ya, Jing

    2014-05-01

    The second heart field (SHF), foregut endoderm and sonic hedgehog (SHH) signaling pathway are all reported to associate with normal morphogenesis and septation of outflow tract (OFT). However, the morphological relationships of the development of foregut endoderm and expression of SHH signaling pathway members with the development of surrounding SHF and OFT are seldom described. In this study, serial sections of mouse embryos from ED9 to ED13 (midgestation) were stained with a series of marker antibodies for specifically highlighting SHF (Isl-1), endoderm (Foxa2), basement membrane (Laminin), myocardium (MHC) and smooth muscle (α-SMA) respectively, or SHH receptors antibodies including patched1 (Ptc1), patched2 (Ptc2) and smoothened, to observe the spatiotemporal relationship between them and their contributions to OFT morphogenesis. Our results demonstrated that the development of an Isl-1 positive field in the splanchnic mesoderm ventral to foregut, a subset of SHF, is closely coupled with pulmonary endoderm or tracheal groove, the Isl-1 positive cells surrounding pulmonary endoderm are distributed in a special cone-shaped pattern and take part in the formation of the lateral walls of the intrapericardial aorta and pulmonary trunk and the transient aortic-pulmonary septum, and Ptc1 and Ptc2 are exclusively expressed in pulmonary endoderm during this Isl-l positive field development, suggesting special roles played in inducing the Isl-l positive field formation by pulmonary endoderm. It is indicated that pulmonary endoderm plays a role in the development and specification of SHF in midgestation, and that pulmonary endoderm-associated Isl-l positive field is involved in patterning the morphogenesis and septation of the intrapericardial arterial trunks.

  5. Patients' and physicians' needs, experiences and preferences in the treatment of right ventricular outflow tract dysfunction

    Directory of Open Access Journals (Sweden)

    Luciana Scalone

    2012-06-01

    Full Text Available

    Background: patients with congenital heart defects, developing right ventricular outflow tract (rVoT dysfunction, can face repeated open chest interventions over their lifetime. repeating surgery increases difficulties and procedural risks, and exposes patients to burdensome and long recovery times that may induce them to postpone the treatment, with possible severe and irreversible consequences for their health. The percutaneous procedure was introduced to delay the need for open chest surgery. uncertainties still exist regarding the lifelong consequences that may result from adopting different treatment strategies. current decisions on treatment depend on patients’ clinical needs, but also on physicians’ experience and opinion, patients’ preferences, and procedural costs. The objective is to identify which treatment characteristics influence decisions on how to treat patients with rVoT dysfunction.

    Methods: a literature review was conducted, followed by a discussion with a panel of experts. Ten treatment characteristics, potentially relevant for treatment, were identified and rated in a survey, according to the importance assigned to each characteristic by specialist physicians, patients and/or their caregivers.

    Results: while some characteristics appear to be more important (risk of severe complications associated with intervention delays or less important (scar to both physicians and patients/caregivers, other characteristics are rated differently in importance depending on subjects consulted, e.g., risk of complications during the months post intervention was among the most important characteristics for patients/caregivers, but the fifth most important characteristic for physicians.

    Conclusions: to optimize benefits and efficiency of the treatment strategies, perceptions and opinions from the different subjects involved, together with patients

  6. [Right ventricular outflow tract reconstruction using monocusp valved outflow patch for pulmonary atresia with ventricular septal defect: influence of the presence of major aorto-pulmonary collateral arteries].

    Science.gov (United States)

    Hisamochi, K; Ishino, K; Kawada, M; Ohshima, Y; Aoki, A; Arai, S; Sano, S

    2001-07-01

    We have preferably utilized monocusp valved outflow patch (MVOP) for right ventricular outflow tract (RVOT) reconstruction in pulmonary atresia with ventricular septal defect (PA + VSD). The purpose of this study was to evaluate the influence of the presence of major aorto-pulmonary collateral arteries (MAPCAs) on probability of MVOP reconstruction and development of RVOT restenosis in midterm. 49 patients underwent complete repair (either MVOP reconstruction or Rastelli procedure) of PA + VSD in our service. These patients were divided into 2 groups: group 1; 21 patients with MAPCAs, group 2; 28 patients without MAPCAs. There was one operative death (group 1). The probably of MVOP reconstruction was similar between group 1 and group 2 (71 vs 79%, p = 0.57, chi 2 test). Follow-up was completed for 48 survivors with the period ranged 3-108 months (mean 47 months). In group 1, one patient died suddenly at home 10 months after surgery. For 47 long-term patients, the ratio of freedom from RVOT restenosis was 72% (95% CI: 52-92%, Kaplan-Meier method) at 5 year. There was no difference between 2 groups (group 1; 73%, 95% CI: 45-100%, group 2; 74%, 95% CI: 48-99%, respectively, p = 0.85 by Log-Rank test). The presence of MAPCAs in PA + VSD was not a risk factor for either the probably of MVOP reconstruction or development of RVOT restenosis in midterm.

  7. Assessment of right ventricular outflow tract in children by two-dimensional echocardiography using a new subcostal view. Angiocardiographic and morphologic correlative study.

    Science.gov (United States)

    Isaaz, K; Cloez, J L; Danchin, N; Marçon, F; Worms, A M; Pernot, C

    1985-09-15

    Evaluation of the right ventricular (RV) outflow tract in congenital heart disease is extremely important for surgical management. Therefore, the value of 2-dimensional echocardiography (2-D echo) to assess the RV outflow tract was studied using a new approach: the subcostal elongated right oblique view. Twenty normal children and 49 children with congenital heart disease, aged 1 day to 11 years, were studied. Significant pulmonary infundibular obstruction was present in 22 patients with conotruncal malformations. To obtain the subcostal elongated right oblique view from the short-axis view at the aortic valve level, the transducer was slightly rotated clockwise with an anterior angulation of about 30 degrees so that the ascending aorta was seen in its long axis, providing an image similar to that obtained by a right ventriculogram in the elongated right anterior oblique view. The deviation of infundibular septum was appreciated by measurement of the angle alpha, defined by the long axis of the infundibular septum and the plane of aortic cusps. This view could be obtained in 64 patients (92%). In correlation with angiographic or anatomic data, the subcostal elongated right oblique view permitted recognition of several types of RV outflow tract: type I--normally formed RV outflow tract; type II--disorganized RV outflow tract with obstruction (alpha less than 90 degrees); type III and IV--disorganized RV outflow tract with obstruction (alpha greater than 90 degrees). This view could visualize the crista supraventricularis in type I, but also the anatomic components of RV outflow tract that may contribute to obstruction in the other types: infundibular septum, septoparietal trabeculations and trabecula septomarginalis.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Concomitant Right Ventricular Outflow Tract Cryoablation during Pulmonary Valve Replacement in a Patient with Tetralogy of Fallot

    Science.gov (United States)

    Shin, Hong Ju; Song, Seunghwan; Shin, Yu Rim; Park, Han Ki; Park, Young Hwan

    2017-01-01

    A 38-year-old female patient with a history of tetralogy of Fallot repair at 10 years of age underwent pulmonary valve replacement with a mechanical prosthesis, tricuspid annuloplasty, and right ventricular outflow tract cryoablation due to pulmonary regurgitation, tricuspid regurgitation, and multiple premature ventricular contractions with sustained ventricular tachycardia. After surgery, she had an uneventful postoperative course with arrhythmia monitoring. She was discharged without incident, and a follow-up Holter examination showed a decrease in the number of ventricular ectopic beats from 702 to 41. PMID:28180102

  9. Use of the Konno procedure in an 80-year-old woman with aortic stenosis, a narrow left ventricular outflow tract, and a small aortic annulus.

    Science.gov (United States)

    Misumi, Hiroyasu; Katayama, Yukihiro; Takaji, Kentaro; Oshitomi, Takashi; Uesugi, Hideyuki; Hirayama, Touitsu; Takeuchi, Takamasa

    2014-01-01

    This report describes a technique for repairing an aortic stenosis in an elderly patient with a small aortic annulus and a narrow left ventricular outflow tract. Preoperative echocardiography in an 80-year-old woman showed severe aortic stenosis with a narrow outflow tract: the aortic valve area was 0.48 cm(2), the aortic annular diameter was 14 mm, and the left ventricular outflow tract diameter was 14 mm. The Konno procedure was used to enlarge both the small aortic annulus and the left ventricular outflow tract, and a 19-mm Carpentier-Edwards bioprosthetic valve was implanted. The patient's postoperative course was uneventful. The left ventricular mass decreased from a preoperative value of 236 g to 96 g, 3 years after surgery. Only a few reports have described the use of the Konno operation in adult patients. In the present case, the Konno operation was demonstrated to be a good option for aortic stenosis accompanied by a small aortic annulus and a narrow left ventricular outflow tract, even in an elderly patient.

  10. Extra-anatomic right ventricle to pulmonary artery conduit: the apical-aortic equivalent for complex right ventricular outflow tract reconstruction.

    Science.gov (United States)

    Mori, Makoto; Siddharthan, Ragavan; Kogon, Brian

    2015-03-01

    We describe the case of a 22-year-old with tetralogy of Fallot, who underwent complete repair with ventricular septal defect closure and right ventricle to pulmonary artery conduit placement. She has undergone numerous subsequent conduit changes, each complicated by early stenosis and failure. Unfortunately, serial conduit changes can become increasingly challenging. While extra-anatomic conduits have been described for complex left ventricular outflow tract obstruction, they have not been described for right-sided obstruction. Herein, we present a patient who underwent successful placement of an extra-anatomic valved right ventricle to pulmonary artery conduit in the setting of complex right ventricular outflow tract obstruction.

  11. Isolated Pulmonary Infective Endocarditis with Septic Pulmonary Embolism Complicating a Right Ventricular Outflow Tract Obstruction: Scarce and Devious Presentation

    Directory of Open Access Journals (Sweden)

    Abdelrahmen Abdelbar

    2013-01-01

    Full Text Available We present a case of a fifty-three-year-old male who presented with severe sepsis. He had been treated as a pneumonia patient for five months before the admission. Investigations revealed isolated pulmonary valve endocarditis and septic pulmonary embolism in addition to undiagnosed right ventricular outflow tract (RVOT obstruction. The patient underwent surgery for the relief of RVOT obstruction by substantial muscle resection of the RVOT, pulmonary artery embolectomy, pulmonary valve replacement, and reconstruction of RVOT and main pulmonary artery with two separate bovine pericardial patches. He was discharged from our hospital after 6 weeks of intravenous antibiotics. He recovered well on follow-up 16 weeks after discharge. A high-suspicion index is needed to diagnose right-side heart endocarditis. Blood cultures and transesophageal echocardiogram are the key diagnostic tools.

  12. Fetal Intervention in Right Outflow Tract Obstructive Disease: Selection of Candidates and Results

    Science.gov (United States)

    Gómez Montes, E.; Herraiz, I.; Mendoza, A.; Galindo, A.

    2012-01-01

    Objectives. To describe the process of selection of candidates for fetal cardiac intervention (FCI) in fetuses diagnosed with pulmonary atresia-critical stenosis with intact ventricular septum (PA/CS-IVS) and report our own experience with FCI for such disease. Methods. We searched our database for cases of PA/CS-IVS prenatally diagnosed in 2003–2012. Data of 38 fetuses were retrieved and analyzed. FCI were offered to 6 patients (2 refused). In the remaining it was not offered due to the presence of either favourable prognostic echocardiographic markers (n = 20) or poor prognostic indicators (n = 12). Results. The outcome of fetuses with PA/CS-IVS was accurately predicted with multiparametric scoring systems. Pulmonary valvuloplasty was technically successful in all 4 fetuses. The growth of the fetal right heart and hemodynamic parameters showed a Gaussian-like behaviour with an improvement in the first weeks and slow worsening as pregnancy advanced, probably indicating a restenosis. Conclusions. The most likely type of circulation after birth may be predicted in the second trimester of pregnancy by means of combining cardiac dimensions and functional parameters. Fetal pulmonary valvuloplasty in midgestation is technically feasible and in well-selected cases may improve right heart growth, fetal hemodynamics, and postnatal outcome. PMID:22928144

  13. Prdm1 functions in the mesoderm of the second heart field, where it interacts genetically with Tbx1, during outflow tract morphogenesis in the mouse embryo.

    Science.gov (United States)

    Vincent, Stéphane D; Mayeuf-Louchart, Alicia; Watanabe, Yusuke; Brzezinski, Joseph A; Miyagawa-Tomita, Sachiko; Kelly, Robert G; Buckingham, Margaret

    2014-10-01

    Congenital heart defects affect at least 0.8% of newborn children and are a major cause of lethality prior to birth. Malformations of the arterial pole are particularly frequent. The myocardium at the base of the pulmonary trunk and aorta and the arterial tree associated with these great arteries are derived from splanchnic mesoderm of the second heart field (SHF), an important source of cardiac progenitor cells. These cells are controlled by a gene regulatory network that includes Fgf8, Fgf10 and Tbx1. Prdm1 encodes a transcriptional repressor that we show is also expressed in the SHF. In mouse embryos, mutation of Prdm1 affects branchial arch development and leads to persistent truncus arteriosus (PTA), indicative of neural crest dysfunction. Using conditional mutants, we show that this is not due to a direct function of Prdm1 in neural crest cells. Mutation of Prdm1 in the SHF does not result in PTA, but leads to arterial pole defects, characterized by mis-alignment or reduction of the aorta and pulmonary trunk, and abnormalities in the arterial tree, defects that are preceded by a reduction in outflow tract size and loss of caudal pharyngeal arch arteries. These defects are associated with a reduction in proliferation of progenitor cells in the SHF. We have investigated genetic interactions with Fgf8 and Tbx1, and show that on a Tbx1 heterozygote background, conditional Prdm1 mutants have more pronounced arterial pole defects, now including PTA. Our results identify PRDM1 as a potential modifier of phenotypic severity in TBX1 haploinsufficient DiGeorge syndrome patients.

  14. A comparative study of right ventricular outflow tract pacing and right ventricular apical pacing in children%儿童右室流出道起搏与右室心尖起搏的对比研究

    Institute of Scientific and Technical Information of China (English)

    陈晶; 曾国洪; 曾少颖; 王树水

    2014-01-01

    目的:回顾性对比研究儿童行VVI起搏治疗的右室流出道起搏与右室心尖部起搏对近期心功能、QRS波时限及起搏参数的影响。方法:回顾2006年7月至2013年11月,在我科行VVI起搏治疗的38例患儿病例资料,根据术中记录螺旋电极植入的部位分为右室流出道组(n=22)和右室心尖部组(n=16)。记录术前和术后的心脏彩超心功能指标及QRS波时限,术中与术后起搏参数指标进行比较。结果:右室流出道组与右室心尖组在术前及术后心功能指标、术中及术后的起搏阈值差值、导线阻抗差值、R波幅度差值差异无统计学意义。右室流出道起搏组与右室心尖起搏组术后QRS波时限增宽,差异有统计学意义。术前与术后的QRS波时限差值[(134.95±12.86)ms vs(147.44±22.35)ms,t=1.35,P=0.01],差异有统计学意义。结论:儿童右室流出道起搏安全可行,两者起搏术后QRS波时限增宽,但右室心尖起搏组QRS波时限增宽更明显。%Objective To compare the impacts of right ventricular outflow tract pacing and right ventricular apical pacing on short-term cardiac function, QRS duration and pacing parameters in children undergoing VVI pacemaker therapy. Methods The clinical data of 38 children undergoing VVI pacemaker treatment in our department from July 2006 to November 2013 were retrospectively reviewed and analyzed to make grouping: 22 with right ventricular outflow tract pacing based on the operational records were assigned in one group and 16 with right ventricular apical pacing as the other group. The two groups were compared in terms of cardiac function indexes , QRS complex width and intra- and post- operative parameters of the implanted pacemakers. Results There were no significant differences between the two groups in pre-and post-operative cardiac function indexes , intra- and post-operative difference in pacing thresholds

  15. A Small Molecule Inhibitor of Sarcomere Contractility Acutely Relieves Left Ventricular Outflow Tract Obstruction in Feline Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Stern, Joshua A.; Markova, Svetlana; Ueda, Yu; Kim, Jae B.; Pascoe, Peter J.; Evanchik, Marc J.; Green, Eric M.; Harris, Samantha P.

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is an inherited disease of the heart muscle characterized by otherwise unexplained thickening of the left ventricle. Left ventricular outflow tract (LVOT) obstruction is present in approximately two-thirds of patients and substantially increases the risk of disease complications. Invasive treatment with septal myectomy or alcohol septal ablation can improve symptoms and functional status, but currently available drugs for reducing obstruction have pleiotropic effects and variable therapeutic responses. New medical treatments with more targeted pharmacology are needed, but the lack of preclinical animal models for HCM with LVOT obstruction has limited their development. HCM is a common cause of heart failure in cats, and a subset exhibit systolic anterior motion of the mitral valve leading to LVOT obstruction. MYK-461 is a recently-described, mechanistically novel small molecule that acts at the sarcomere to specifically inhibit contractility that has been proposed as a treatment for HCM. Here, we use MYK-461 to test whether direct reduction in contractility is sufficient to relieve LVOT obstruction in feline HCM. We evaluated mixed-breed cats in a research colony derived from a Maine Coon/mixed-breed founder with naturally-occurring HCM. By echocardiography, we identified five cats that developed systolic anterior motion of the mitral valve and LVOT obstruction both at rest and under anesthesia when provoked with an adrenergic agonist. An IV MYK-461 infusion and echocardiography protocol was developed to serially assess contractility and LVOT gradient at multiple MYK-461 concentrations. Treatment with MYK-461 reduced contractility, eliminated systolic anterior motion of the mitral valve and relieved LVOT pressure gradients in an exposure-dependent manner. Our findings provide proof of principle that acute reduction in contractility with MYK-461 is sufficient to relieve LVOT obstruction. Further, these studies suggest that feline

  16. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, Maria Irene; Vink, Aryan; Bergmann, Wilhelmina; Szatmári, Viktor

    2016-01-01

    BACKGROUND: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. CASE PRESENTATION: A previously healthy 12-year-old male West Highland white terrier was found dead

  17. Left ventricular cardiac myxoma and sudden death in a dog

    NARCIS (Netherlands)

    de Nijs, M.I.; Vink, Aryan; Bergmann, W.; Szatmári, V.

    2016-01-01

    Background: Myxoma is a very rare benign cardiac tumor in dogs. This is the first description of a cardiac myxoma originating from the left ventricular outflow tract, presumably causing sudden death. Case presentation: A previously healthy 12-year-old male West Highland white terrier was found dead

  18. Implantation of Lumenless Pacing Leads at the Inter-atrial Septum and Right Ventricular Outflow Tract with Deflectable Catheter-sheath

    Institute of Scientific and Technical Information of China (English)

    Rong BAI; Ruth KAM; Chi Keong CHING; Li Fern HSU; Wee Siong TEO

    2008-01-01

    Current permanent fight ventricular and fight atrial endocardial pacing leads are implanted utilizing a central lumen stylet. Right ventricular apex pacing initiates an abnormal asyno chronous electrical activation pattern, which results in asynchronous ventricular contraction and re-laxation. When pacing from right atrial appendage, the conduction time between two atria will be prolonged, which results in heterogeneity for both depolarization and repolarization. Six patients with Class Ⅰ indication for permanent pacing were implanted with either single chamber or dual chamber pacemaker. The SelectSecure 3830 4-French (Fr) lumenless lead and the SelectSite C304 8.5-Fr steerable catheter-sheath (Medtronic Inc., USA) were used. Pre-selected pacing sites included inter-atrial septum and right ventricular outflow tract, which were defined by ECG and fluoroscopic criteria. All the implanting procedures were successful without complication. Testing results (mean atrial pacing threshold: 0.87 V; mean P wave amplitude: 2.28 mV; mean ventricular pacing threshold:0.53V; mean R wave amplitude: 8.75 mV) were satisfactory. It is concluded that implantation of a 4-Fr lumenless pacing lead by using a streerable catheter-sheath to achieve inter-atrial septum or right ventricular outflow tract pacing is safe and feasible.

  19. One case of tachycardia-induced cardiomyopathy caused by right ventricular outflow tract-ventricular tachycardia%右室流出道室性心动过速诱发心动过速性心肌病1例

    Institute of Scientific and Technical Information of China (English)

    王广强; 杨洋; 张博; 孙健

    2013-01-01

    A 36-year-old woman has suffered from paroxysmal palpitations, chest tightness and shortness of breath for more than 10 years. ECG showed broad QRS, ventricular tachycardia and atrioventricular separation. The ECG pointed to an origin in the right ventricular outflow tract. Echocardiography showed that the left ventricular end-diastolic diameter was 53 mm and the ejection fraction was 40%. B type natriuretic peptide was 7 920 pg/ ml. A single radiofrequency application at the site of ectopy was immediately effective. Holter monitoring was normal after ablation. Final diagnosis was right ventricular outflow tract-ventricular tachycardia, tachycardia-induced cardiomyopathy.

  20. Right ventricular outflow tract stenting in a low birth weight infant born with tetralogy of fallot and prostaglandin e1 dependency.

    Science.gov (United States)

    Bang, Sunhee; Ko, Hong Ki; Yu, Jeong Jin; Han, Myung-Ki; Kim, Young-Hwue; Ko, Jae-Kon; Park, In-Sook

    2011-12-01

    Surgical skill and strategy for the correction of tetralogy of Fallot (TOF) have improved and resulted in satisfactory outcomes. However, prematurity and low birth weight continue to remain risk factors for poor outcomes. We present a case of a 2,150 g neonate born with TOF, in whom palliation was achieved with right ventricular outflow tract (RVOT) stenting. Seventy-seven days after the procedure, stenosis of RVOT below the stent was identified. At that time his body weight was 4.9 kg and total corrective surgery was deemed feasible. Eight months following surgical repair, the patient remained well without medical intervention. RVOT stenting may be a viable interim procedure while waiting for a low birth weight neonate born with TOF and prostaglandin E1 dependency to reach optimal weight to undergo corrective surgery.

  1. The incidence and mechanisms of spike potentials in origin regions of outflow tract premature ventricular contraction%流出道室性早搏起源处异常电位的分布和意义

    Institute of Scientific and Technical Information of China (English)

    贾玉和; 韦维; 丁立刚; 赵英杰; 王靖; 楚建民; 张澍

    2011-01-01

    Objective To investigate the incidence and mechanisms of spike potential (SP) in premature ventricular contractions (PVCs) originating from outflow tract in structurally normal heart. Methods Fifty-four consecutive cases with symptomatic PVCs originating from ventricular outflow tract who have been successfully performed radiofrequency catheter ablation were investigated. The incidence and patterns of SP recorded at the successful ablation sites were analyzed. The SP was divided into 4 types. The pattern of SP recorded in sinus rhythm but not in PVCs was defined as type I. SP occurred in both sinus rhythm and PVCs was defined as type II which was further divided into 2 subtypes: type II a and type II b. SP buried within QRS complex wave during sinus beats and reversal preceding to QRS complex wave during PVC named type II a , while SP remained within QRS complex wave without reversion during PVC named type II b. SP occurred neither in sinus rhythm nor PVCs was defined as type Ⅲ. SP existed in PVCs without occurred in sinus rhythm was defined as type IV. Results In SP patterns of all 54 cases, 2 cases were type I , 21 were type Ⅱa, 12 were type Ⅱb , 6 were type Ⅲ , 13 were type IV. SP incidence in final successful ablation sites during PVCs was 85.2% (46/54) . Successful ablation site located at right ventricular outflow tract in 44 patients and left ventricular outflow tract in 10 patients. 4 of fifty-four cases recurrence after first ablation procedure, and 3 of them received ablation again. Patient 1 changed its SP pattern from type I to Ⅱa during second ablation session. Also, Patient 2 and patient 3 changed their SP patterns from II b to II a. Conclusion SP can be recorded at the origin site in the majority of outflow tract premature ventricular contractions.The reversal of SP preceding to QRS complex wave of PVC may be a successful ablation indicator. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2011,25(4) ;323 -325]%目的 分析流出

  2. Role of temporary pacing at the right ventricular outflow tract in anesthetic management of a patient with asymptomatic sick sinus syndrome.

    Science.gov (United States)

    Nag, Kusha; Nagella, Amrutha Bindu; Kumar, V R Hemanth; Singh, Dewan Roshan; Ravishankar, M

    2015-01-01

    A 60-year-old woman posted for percutaneous nephrolithotomy with ureterolithotripsy was found to have a history of hypertension and ischemic heart disease from past 6 months on regular treatment. Pulse rate was irregularly irregular in a range of 56-60/min, unresponsive to atropine, with a sinus pause on the electrocardiogram. Although the patient was asymptomatic, anticipating unmasking of the sick sinus syndrome during general anesthesia in the prone position, a temporary pacemaker was implanted at right ventricular outflow tract (RVOT) septum before the scheduled surgery. A balanced anesthesia technique with endotracheal intubation was administered. There were several episodes of continuous pacing by the temporary pacemaker intraoperatively, which may be attributed to unmasking of the sinus node dysfunction due to general anesthesia. At the end of surgery, patient was extubated after adequate reversal from neuromuscular blockade. Postoperative period remained uneventful, and the pacemaker wires were removed on the 2(nd) postoperative day. With this case report, we highlight the importance of inserting a temporary pacemaker prior to anesthesia even in an asymptomatic patient if a sinus node dysfunction is suspected preoperatively and if intraoperative access to transvenous pacing is difficult such as in prone position. Pacing at RVOT septum minimizes ventricular dyssynchrony and improves hemodynamic parameters.

  3. Combined Right Ventricular Outflow Tract Epicardial and Endocardial Late Potential Ablation for Treatment of Brugada Storm: A Case Report and Review of the Literature.

    Science.gov (United States)

    Saha, Sandeep A; Krishnan, Kousik; Madias, Christopher; Trohman, Richard G

    2016-12-01

    A 34-year-old man with Brugada syndrome (BrS) presented with electrical storm, manifested as multiple appropriate shocks from his implantable cardioverter-defibrillator over a period of 7 hours. He had not tolerated prior treatment with quinidine, and had self-discontinued cilostazol citing persistent palpitations. After stabilization with intravenous isoproterenol, an electrophysiology study was performed but no spontaneous or induced ventricular ectopic beats were identified. A three-dimensional (3D) endocardial electro-anatomic map of the right ventricular outflow tract (RVOT), pulmonic valve, and pulmonary artery, as well as a 3D epicardial map of the RVOT, were created. Low voltage, complex, fractionated electrograms and late potentials were targeted for irrigated radiofrequency ablation both endocardially and epicardially. Post-procedure, he was maintained on cilostazol (referring clinician preference), and has had no further ventricular tachyarrhythmia episodes over the past forty-one months. We propose that this novel ablation strategy may be useful for acute management of selected patients with BrS.

  4. Autosomal dominant inheritance of cardiac valves anomalies in two families: extended spectrum of left-ventricular outflow tract obstruction.

    NARCIS (Netherlands)

    Wessels, M.W.; Laar, I.M. van de; Roos-Hesselink, J.W.; Strikwerda, S.; Majoor-Krakauer, D.F.; Vries, L.B.A. de; Kerstjens-Frederikse, W.S.; Vos, Y.J.; Graaf, B.M. de; Bertoli-Avella, A.M.; Willems, P.J.

    2009-01-01

    Only a limited number of families with clear monogenic inheritance of nonsyndromic forms of congenital valve defects have been described. We describe two multiplex pedigrees with a similar nonsyndromic form of heart valve anomalies that segregate as an autosomal dominant condition. The first family

  5. Autosomal Dominant Inheritance of Cardiac Valves Anomalies in Two Families : Extended Spectrum of Left-Ventricular Outflow Tract Obstruction

    NARCIS (Netherlands)

    Wessels, Maria W.; van de Laar, Ingrid M. B. H.; Roos-Hesselink, Jolien; Strikwerda, Sipke; Majoor-Krakauer, Danielle F.; de Vries, Bert B. A.; Kerstjens-Frederikse, Wilhelmina S.; Vos, Yvonne J.; de Graaf, Bianca M.; Bertoli-Avella, Aida M.; Willems, Patrick J.

    2009-01-01

    Only a limited number of families with clear monogenic inheritance of nonsyndromic forms of congenital valve defects have been described. We describe two multiplex pedigrees with a similar nonsyndromic form of heart valve anomalies that segregate as an autosomal dominant condition. The first family

  6. Conservative management of a left ventricle cardiac fibroma in an asymptomatic child patient.

    Science.gov (United States)

    Ünsal, Handan; Ekici, Enver

    2015-07-01

    Primary cardiac tumors in infancy and childhood are rare and usually benign. Fibroma is the second most common bening cardiac tumor after rhabdomyoma. Surgery is required when fibromas cause ventricular outflow tract obstruction, ventricular dysfunction and life-threatening arrhythmia. This case report describes a 9-year-old asymptomatic male presenting with a giant left ventricular cardiac fibroma who was followed up using conservative treatment.

  7. 特发性流出道室性心律失常研究:基本原理和设计方案%Idiopathic outflow tract ventricular arrhythmias study (IOTVA Study) :rationale and design

    Institute of Scientific and Technical Information of China (English)

    曹克将; 张澍; 姚焰; 吴书林; 陈明龙; 张凤祥; 杨兵; 李小荣; 魏薇

    2014-01-01

    Background Idiopathic ventricular arrhythmias (IOTVA) in patients without structural heart disease mostly originate from left or right ventricular outflow tract.Data about the epidemiology,nature prognosis and treatment of idiopathic outflow tract premature ventricular complexes/nonsustained ventricular tachycardia (IOTPVC/NSVT),which based on the large sample of clinical trial,are scarce at present.Rationale Some studies have demonstrated that effects on cardiac function of IOTPVC/NSVT are related to its burden.Antiarrhythmic drugs (class IC agents and β-blockers) and catheter ablation are effective for IOTVA.This study will assess effects on cardiac function of IOTPVC burden and compare safety and effectiveness of antiarrhythmic drugs with catheter ablation in patients with IOTPVC/NSVT.Design The IOTVA study will includes the following:①to investigate the proportion of IOTVA to ventricular arrhythmias in outpatients and inpatients at the department of cardiology; ②to inquire the prognosis and its cardiac function in IOTVA patients without any treatment; ③to assess the safety of antiarrhythmic drugs therapy compared with control therapy in IOTVA patients; ④to compare safety and effectiveness of antiarrhythmic drugs with catheter ablation in IOTPVC/NSVT patients with PVCs burden more than 15%.Based on these studies,we would establish the clinical treatment approach for IOTVA.Conclusion IOTVA study will assess effects on cardiac function of IOTPVC burden and evaluate safety and effectiveness of antiarrhythmic drugs and catheter ablation in patients with IOTPVC/NSVT.%背景 发生在无器质性心脏病的室性心律失常又称为特发性室性心律失常(IVA),其中大多数起源于左心室或右心室流出道.目前关于特发性流出道室性早搏(IOTPVC)与非持续性室性心动过速(NSVT)的流行病学调查、预后以及临床干预均缺乏大样本的循证医学证据.基本原理 相关研究表明,不同负荷的IOTPVC/NSVT可

  8. Risk factors in the origin of congenital left-ventricular outflow-tract obstruction defects of the heart: a population-based case-control study.

    Science.gov (United States)

    Csáky-Szunyogh, Melinda; Vereczkey, Attila; Kósa, Zsolt; Gerencsér, Balázs; Czeizel, Andrew E

    2014-01-01

    The aim of our project was to study possible etiological factors in the origin of congenital heart defects (CHDs) because in the majority of patients the underlying causes are unclear. Cases with different CHD entities as homogeneously as possible were planned for evaluation in the population-based large data set of the Hungarian Case Control Surveillance of Congenital Abnormalities. Dead or surgically corrected 302 live-born cases with different types of left-ventricular outflow tract obstructive defects (LVOT, i.e., valvular aortic stenosis 76, hypoplastic left heart syndrome 76, coarctation of the aorta 113, and other congenital anomalies of aorta 32) were compared with 469 matched controls, 38,151 controls without any defects, and 20,750 malformed controls with other isolated defects. Medically recorded pregnancy complications and chronic diseases were evaluated based on prenatal maternity logbooks, whereas acute diseases, drug treatments, and folic acid/multivitamin supplementation were analyzed both on the basis of retrospective maternal information and medical records. The results of the study showed the role of maternal diabetes in the origin of LVOT in general, while panic disorder was associated with a higher risk of hypoplastic left heart syndrome and ampicillin treatment with a higher risk of coarctation of the aorta (COA). High doses of folic acid had a protective effect regarding the manifestation of LVOT, particularly COA. In conclusion, only a minor portion of causes was shown in our study; thus, further studies are needed to understand better the underlying causal factors in the origin of LVOT.

  9. The Different Substrate Characteristics of Arrhythmogenic Triggers in Idiopathic Right Ventricular Outflow Tract Tachycardia and Arrhythmogenic Right Ventricular Dysplasia: New Insight from Noncontact Mapping.

    Directory of Open Access Journals (Sweden)

    Van Buu Dan Do

    Full Text Available The aim of this study was to investigate the different substrate characteristics of repetitive premature ventricular complexed (PVC trigger sites by the non-contact mapping (NCM.Thirty-five consecutive patients, including 14 with arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC and 21 with idiopathic right ventricular outflow tract tachycardia (RVOT VT, were enrolled for electrophysiological study and catheter ablation guided by the NCM. Substrate and electrogram (Eg characteristics of the earliest activation (EA and breakout (BO sites of PVCs were investigated, and these were confirmed by successful PVC elimination.Overall 35 dominant focal PVCs were identified. PVCs arose from the focal origins with preferential conduction, breakout, and spread to the whole right ventricle. The conduction time and distance from EA to BO site were both longer in the ARVC than the RVOT group. The conduction velocity was similar between the 2 groups. The negative deflection of local unipolar Eg at the EA site (EA slope3,5,10ms values was steeper in the RVOT, compared to ARVC patients. The PVCs of ARVC occurred in the diseased substrate in the ARVC patients. More radiofrequency applications were required to eliminate the triggers in ARVC patients.The substrate characteristics of PVC trigger may help to differentiate between idiopathic RVOT VT and ARVC. The slowing and slurred QS unipolar electrograms and longer distance from EA to BO in RVOT endocardium suggest that the triggers of ARVC may originate from mid- or sub-epicardial myocardium. More extensive ablation to the trigger site was required in order to create deeper lesions for a successful outcome.

  10. Cardiac neural crest contributes to cardiomyogenesis in zebrafish.

    Science.gov (United States)

    Sato, Mariko; Yost, H Joseph

    2003-05-01

    In birds and mammals, cardiac neural crest is essential for heart development and contributes to conotruncal cushion formation and outflow tract septation. The zebrafish prototypical heart lacks outflow tract septation, raising the question of whether cardiac neural crest exists in zebrafish. Here, results from three distinct lineage-labeling approaches identify zebrafish cardiac neural crest cells and indicate that these cells have the ability to generate MF20-positive muscle cells in the myocardium of the major chambers during development. Fate-mapping demonstrates that cardiac neural crest cells originate both from neural tube regions analogous to those found in birds, as well as from a novel region rostral to the otic vesicle. In contrast to other vertebrates, cardiac neural crest invades the myocardium in all segments of the heart, including outflow tract, atrium, atrioventricular junction, and ventricle in zebrafish. Three distinct groups of premigratory neural crest along the rostrocaudal axis have different propensities to contribute to different segments in the heart and are correspondingly marked by unique combinations of gene expression patterns. Zebrafish will serve as a model for understanding interactions between cardiac neural crest and cardiovascular development.

  11. Evaluation of global and regional left ventricular systolic function in patients with frequent isolated premature ventricular complexes from the right ventricular outflow tract

    Institute of Scientific and Technical Information of China (English)

    YAO Jing; XU Jing; YONG Yong-hong; CAO Ke-jiang; CHEN Shao-liang; XU Di

    2012-01-01

    Background Frequent premature ventricular complexes from the right ventricular outflow tract (RVOT-PVCs) are associated with left ventricular dysfunction.This study adopted two-dimensional speckle tracking imaging to evaluate global and regional left ventricular myocardial function in patients with frequent RVOT-PVCs.Methods This study included 30 patients with frequent RVOT-PVCs and 30 healthy subjects.Aortic systolic velocity-time integral (AoVTI) and myocardium strain in circumferential (CS),radial (RS) and longitudinal (LS) directions were evaluated by conventional echocardiography and speckle tracking imaging.All values of patients with RVOT-PVCs were recorded during sinus (PVC-S) and PVC beats (PVC-V).Results Significant differences were demonstrated in global CS,RS and LS between the control subjects and the PVC-V (CS:(17.46±2.48)% vs.(11.52±3.28)%,RS:(48.26±10.20)% vs.(20.92±9.78)%,LS:(19.89±2.62)% vs.(11.79±3.66)%,P <0.01),and in segmental RS and LS of nearly all the left ventricular segments.Statistical differences in segmental CS between the PVC-V and the control subjects were only observed in anterior,anteroseptal and septal segments (only seen in anteroseptal and septal segments at apex).Furthermore,V/S AoVTI (AoVTI during the PVC beat divided by AoVTI during the sinus beat,then multiplied by 100%) correlated with coupling interval (r=0.67,P <0.001) and global strain (CS:r=0.48,P=0.007; RS:r=0.65,P <0.001; LS:r=0.65,P <0.001).Conclusions Frequent RVOT-PVCs can induce global and regional left ventricular systolic dysfunction.The reduction of hemodynamic parameters relates to the coupling interval and the global systolic function.

  12. Dynamic conduction and repolarisation changes in early arrhythmogenic right ventricular cardiomyopathy versus benign outflow tract ectopy demonstrated by high density mapping & paced surface ECG analysis.

    Directory of Open Access Journals (Sweden)

    Malcolm C Finlay

    Full Text Available AIMS: The concealed phase of arrhythmogenic right ventricular cardiomyopathy (ARVC may initially manifest electrophysiologically. No studies have examined dynamic conduction/repolarization kinetics to distinguish benign right ventricular outflow tract ectopy (RVOT ectopy from ARVC's early phase. We investigated dynamic endocardial electrophysiological changes that differentiate early ARVC disease expression from RVOT ectopy. METHODS: 22 ARVC (12 definite based upon family history and mutation carrier status, 10 probable patients without right ventricular structural anomalies underwent high-density non-contact mapping of the right ventricle. These were compared to data from 14 RVOT ectopy and 12 patients with supraventricular tachycardias and normal hearts. Endocardial & surface ECG conduction and repolarization parameters were assessed during a standard S1-S2 restitution protocol. RESULTS: Definite ARVC without RV structural disease could not be clearly distinguished from RVOT ectopy during sinus rhythm or during steady state pacing. Delay in Activation Times at coupling intervals just above the ventricular effective refractory period (VERP increased in definite ARVC (43 ± 20 ms more than RVOT ectopy patients (36 ± 14 ms, p = 0.03 or Normals (25 ± 16 ms, p = 0.008 and a progressive separation of the repolarisation time curves between groups existed. Repolarization time increases in the RVOT were also greatest in ARVC (definite ARVC: 18 ± 20 ms; RVOT ectopy: 5 ± 14, Normal: 1 ± 18, p<0.05. Surface ECG correlates of these intracardiac measurements demonstrated an increase of greater than 48 ms in stimulus to surface ECG J-point pre-ERP versus steady state, with an 88% specificity and 68% sensitivity in distinguishing definite ARVC from the other groups. This technique could not distinguish patients with genetic predisposition to ARVC only (probable ARVC from controls. CONCLUSIONS: Significant changes in dynamic conduction and repolarization

  13. Association of neuropeptide Y promoter polymorphism (rs16147) with perceived stress and cardiac vagal outflow in humans

    Science.gov (United States)

    Chang, Hsin-An; Fang, Wen-Hui; Chang, Tieh-Ching; Huang, San-Yuan; Chang, Chuan-Chia

    2016-01-01

    Neuropeptide Y (NPY) is involved in resilience to stress, and higher vagal (parasympathetic) activity has been associated with greater stress resilience. Thus, we examined whether rs16147, a functional promoter polymorphism (C>T) of the NPY gene, could influence vagal tone during chronic high stress levels. NPY genotyping, chronic psychological stress level measurement (using the Perceived Stress Scale [PSS]), cardiac autonomic function assessment (using short-term heart rate variability [HRV]) were performed in 1123 healthy, drug-free Han Chinese participants who were divided into low- and high-PSS groups. In the high-PSS group (n = 522), the root mean square of successive heartbeat interval differences and high frequency power (both HRV indices of parasympathetic activity) were significantly increased in T/T homozygotes compared to C/C homozygotes. However, no significant between-genotype difference was found in any HRV variable in the low-PSS group (n = 601). Our results are the first to demonstrate that functional NPY variation alters chronic stress-related vagal control, suggesting a potential parasympathetic role for NPY gene in stress regulation. PMID:27527739

  14. 频发右心室流出道室性期前收缩对右心室流出道结构影响的研究%Effect of frequent idiopathic ventricular premature contractions from right ventricular outflow tract on structure of right ventricular outflow tract

    Institute of Scientific and Technical Information of China (English)

    孔强; 史力生; 张钰聪; 陈宇嘉; 张帆; 徐东

    2012-01-01

    目的 探讨右心室流出道(RVOT)起源频发室性期前收缩对RVOT结构的影响.方法 选取2009~2011年行射频消融治疗的频发RVOT起源室性期前收缩患者30例,分析其心电图特征、动态心电图、心脏彩色超声结果及术中精确定位,分析室性期前收缩对RVOT结构的影响.结果 射频消融术前RVOT直径为(31.76±3.33)mm,术后6个月为(30.93±2.68)mm(P<0.01);相关性分析显示:RVOT直径与室性期前收缩负荷呈正相关(r=0.484,P<0.05).RVOT间隔部来源室性期前收缩QRS时限为(157.69±18.33) ms,游离壁来源室性期前收缩QRS时限为(179.23±16.05)ms(P<0.01),QRS时限与来源部位相关(r=0.566,P<0.01).室性期前收缩QRS时限与RVOT直径无相关性(r=0.097,P>0.05).结论 RVOT来源室性期前收缩经射频消融治疗后,RVOT直径有减小的趋势,其与室性期前收缩负荷呈正相关,与室性期前收缩形态无相关性.%Objective To investigate the effect of frequent ventricular premature contractions(VPCs) from right ventricular outflow tract (RVOT) on the structure of right ventricular outflow tract. Methods 30 patients with frequent VPCs from RVOT who underwent radiofrequency ablation from 2009 to 2011 were enrolled. The site of origin of VPCs was identified by the characters of ECG according to the stepwise electrocardiographic algorithm and the accurate anatomical location was identified by 3D electroanatomical non-contact mapping. Parameters of haemodynamic were accessed by means of transthoracic echocardiography before and 6 months after intervention. The average daily amount of VPCs was evaluated by Holter and the ECG characters of VPCs were also analyzed. Results Before and 6 months after intervention, the diameter of RVOT was (31. 76 ±3. 33) mm and (30. 93 ±2. 68) mm( P 0. 05). Conclusion The diameter of RVOT decreased after radiofrequency ablation for the patients with VPCs from RVOT and it correlated positively with the average daily

  15. 59. Urinary tract infection in children after cardiac surgery: Incidence, risk factors and outcome

    Directory of Open Access Journals (Sweden)

    Rehana Shafi

    2015-10-01

    Conclusions: Foley catheter duration, presence of syndrome and prolonged PCICU and hospital stay were the main risk factors for CAUTI in postoperative pediatric cardiac patients. Resistant Gram-negative were the main cause for BSI with one third of CAUTI cases caused by MDRO or ESBL organisms. The cases with CAUTI were generally sicker and with more morbidity. The study will establish a baseline clinical indicator for monitoring quality improvement and the future measures to minimize CAUTI incidence, and its co-morbidity.

  16. Protostellar Outflows

    Science.gov (United States)

    Bally, John

    2016-09-01

    Outflows from accreting, rotating, and magnetized systems are ubiquitous. Protostellar outflows can be observed from radio to X-ray wavelengths in the continuum and a multitude of spectral lines that probe a wide range of physical conditions, chemical phases, radial velocities, and proper motions. Wide-field visual and near-IR data, mid-IR observations from space, and aperture synthesis with centimeter- and millimeterwave interferometers are revolutionizing outflow studies. Many outflows originate in multiple systems and clusters. Although most flows are bipolar and some contain highly collimated jets, others are wide-angle winds, and a few are nearly isotropic and exhibit explosive behavior. Morphologies and velocity fields indicate variations in ejection velocity, mass-loss rate, and in some cases, flow orientation and degree of collimation. These trends indicate that stellar accretion is episodic and often occurs in a complex dynamical environment. Outflow power increases with source luminosity but decreases with evolutionary stage. The youngest outflows are small and best traced by molecules such as CO, SiO, H2O, and H2. Older outflows can grow to parsec scales and are best traced by shock-excited atoms and ions such as hydrogen-recombination lines, [Sii], and [Oii]. Outflows inject momentum and energy into their surroundings and provide an important mechanism in the self-regulation of star formation. However, momentum injection rates remain uncertain with estimates providing lower bounds.

  17. In vivo functional imaging of blood flow and wall strain rate in outflow tract of embryonic chick heart using ultrafast spectral domain optical coherence tomography

    Science.gov (United States)

    Li, Peng; Yin, Xin; Shi, Liang; Rugonyi, Sandra; Wang, Ruikang K.

    2012-09-01

    During cardiac development, the cardiac wall and flowing blood are two important cardiac tissues that constantly interact with each other. This dynamic interaction defines appropriate biomechanical environment to which the embryonic heart is exposed. Quantitative assessment of the dynamic parameters of wall tissues and blood flow is required to further our understanding of cardiac development. We report the use of an ultrafast 1310-nm dual-camera spectral domain optical coherence tomography (SDOCT) system to characterize/image, in parallel, the dynamic radial strain rate of the myocardial wall and the Doppler velocity of the underlying flowing blood within an in vivo beating chick embryo. The OCT system operates at 184-kHz line scan rate, providing the flexibility of imaging the fast blood flow and the slow tissue deformation within one scan. The ability to simultaneously characterize tissue motion and blood flow provides a useful approach to better understand cardiac dynamics during early developmental stages.

  18. Supravalvular aortic stenosis with sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Pradeep Vaideeswar

    2015-01-01

    Full Text Available Sudden cardiac death (SCD most commonly results from previously undiagnosed congenital, acquired, or hereditary cardiac diseases. Congenital aortic valvular, subvalvular, and supravalvular disease with left ventricular outflow tract obstruction is an important preventable cause of sudden death. This report documents sudden death presumably due to acute myocardial ischemia in a young male with an undiagnosed supravalvular aortic stenosis (SVAS due to a rare association of isolation of coronary sinuses of Valsalva. Congenital supravalvular pulmonary stenosis and mitral valvular dysplasia were also present.

  19. Pacing to treat low cardiac output syndrome following elective aortic valve replacement

    Directory of Open Access Journals (Sweden)

    Muhammad Ishaq

    2012-01-01

    Full Text Available We report a case of low cardiac output syndrome caused by dynamic left ventricular (LV outflow obstruction after aortic valve replacement (AVR. This recognized phenomenon probably occurs more frequently than appreciated, and the author suggests that this should be considered when managing patients with severe hemodynamic instability after AVR. In addition, we also focus on the fact that invasive pacemaker systems have significant effects on cardiac output augmentation postoperatively and in long-term management of patients with LV outflow tract (LVOT obstruction following AVR. The possible mechanisms and subsequent treatments are discussed.

  20. Regression of Cardiac Rhabdomyomas in a Neonate after Everolimus Treatment

    Directory of Open Access Journals (Sweden)

    Helen Bornaun

    2016-01-01

    Full Text Available Cardiac rhabdomyoma often shows spontaneous regression and usually requires only close follow-up. However, patients with symptomatic inoperable rhabdomyomas may be candidates for everolimus treatment. Our patient had multiple inoperable cardiac rhabdomyomas causing serious left ventricle outflow-tract obstruction that showed a dramatic reduction in the size after everolimus therapy, a mammalian target of rapamycin (mTOR inhibitor. After discontinuation of therapy, an increase in the diameter of masses occurred and everolimus was restarted. After 6 months of treatment, rhabdomyomas decreased in size and therapy was stopped. In conclusion, everolimus could be a possible novel therapy for neonates with clinically significant rhabdomyomas.

  1. 应用同种带瓣管道重建右室流出道的危险因素分析%Risk Factors of Using Valved Homograft Conduit for Right Ventricular Outflow Tract Reconstruction

    Institute of Scientific and Technical Information of China (English)

    董自超; 汪曾炜; 王辉山; 尹宗涛

    2011-01-01

    目的:评价采用同种带瓣管道行右室流出道重建术的临床效果.探讨影响手术效果及临床顸后的因素.方法:回顾2002年11月至2010年11月期间应用同种带瓣管道行右室流出道重建患者的临床资料,分析患者手术前后的一般信息、血流动力学表现与临床预后的关系.结果:行右室流出道重建术后49例痊愈出院,5例死亡,存活率90.7%,死亡率9.3%.手术前后比较右室流出道内径较术前明显增加,右室-左室收缩压比值、右室-肺动脉压差较术前明显降低,三尖瓣反流、肺动脉瓣反流较术前加重,肺动脉瓣狭窄较术前减轻.统计分析表明患者死亡的危险因素有术后右室平均压、术后肺动脉-主动脉收缩压比值、术后二尖瓣反流.术后心胸比、术后肺动脉收缩压、术后肺动脉-主动脉收缩压比值、术后三尖瓣反流可能和术后患者ICU时间延长有关.McGoon指数、术后心胸比、术后肺动脉收缩压、术后右室平均压、术后肺动脉-主动脉收缩压比值、合并动脉导管未闭、术后三尖瓣反流可能和术后患者呼吸机时间延长有关.结论:复杂先天性心脏病患者采用同种带瓣管道重建右室流出道可以取得较满意的临床效果,术后流出道梗阻矫正满意,可以防止肺动脉返流导致的心脏损害.%Objective: To investigate the effect of right ventricular outflow tract reconstruction by homografts.Methods: Patients who underwent valved homograft conduit reconstruction of the right ventricular outflow tract in our institution, between November 2002 and November 2010, were retrospectively reviewed.Results: Total hospital mortality was 9.3 % (5 of 54).The diameter of right ventricular outflow tract, tricuspid regurgitation and pulmonary regurgitation increased after operation.The ratio of the systolic pressure between right and 1eft ventricle, the pressure gradient between right ventricle and pulmonary and pulmonary

  2. 儿童流出道室性心律失常射频消融疗效探讨%Efficacy of radiofrequency catheter ablation of outflow tract ventricular arrhythmias in children

    Institute of Scientific and Technical Information of China (English)

    江河; 李小梅; 李延辉; 刘海菊; 张仪; 戈海延

    2016-01-01

    目的 探讨儿童流出道室性心律失常特点以及射频消融疗效及策略.方法 回顾性分析2012年1月至2015年7月因流出道室性心律失常在清华大学第一附属医院住院的53例患儿射频消融手术资料,其中男34例、女19例,年龄(8±3)岁,体重(33±13)kg.患儿均符合射频消融手术适应证而接受手术治疗,结合手术资料分析该类室性心律失常发病年龄、表现形式、好发部位以及消融疗效及策略.结果 53例流出道室性心律失常患儿平均发病年龄(8±4)岁.频发室性期前收缩为主要表现形式,占68%(36例).流出道室性心律失常主要起源于右室流出道,占66%(35例),以肺动脉瓣下1 cm区域(89%,31/35)及间隔(77%,27/35)多见.射频消融即时成功率为98%(52/53),远期复发率10% (5/52),手术并发症发生率2%(1/53).X线曝光量(743±323)mGay·cm2.6例患儿术中需要实施双侧标测消融.结论 儿童流出道室性心律失常以右室流出道起源最多见,射频消融治疗安全有效,部分病例术中需要实施双侧标测消融.%Objective To explore the features of outflow tract ventricular arrhythmias (OTVA) in children and evaluate the efficacy and experiences of radiofrequency catheter ablation (RFCA).Method Data were collected and analyzed on 53 consecutive pediatric patients who underwent RFCA for OTVA from January 2012 to July 2015 in the First Hospital of Tsinghua University.These children included 34 male and 19 female,whose average age was (8 ±3) years and body weight was (33 ± 13) kg.All the children met the indication criteria for RFCA of OTVA in children.Data were analyzed about the onset age,the forms and ablation efficacy and strategies of OTVA.Result The average age of onset was (8 ± 4) years.Of these children,68% (36/53) had frequent premature ventricular complex which was the main arrhythmia pattern.The proportion of 66% (35/53) were of right ventricular outflow tract (RVOT).The vast

  3. Mid-ventricular hypertrophy complicated with the lengthy of mitral valve leaflets lead to dynamic left ventricular outflow tract obstruction: A case report and literature review%左心室中部肥厚合并二尖瓣冗长致左室流出道梗阻——病例报告与文献复习

    Institute of Scientific and Technical Information of China (English)

    洪李锋; 罗松辉; 夏璐; 范莹; 胡良焱; 项金洲

    2013-01-01

    Objective:To investigate the etiology,manifestations and the progress regarding the diagnosis and treatment for left ventricular outflow tract obstruction.Methods:Diagnosis and treatment of one case with mid-ventricular hypertrophy complicated with the lengthy of mitral valve leaflets lead to dynamic left ventricnlar outflow tract obstruction was followed up and reviewed with related literatures.Resuhs:The etiology of ventricular outflow tract obstruction was complex and the incidence was rather high.Transthoracic two-dimensional exercise echocardiography with transesophageal echocardiography analysis is the most effective non-invasive screening and prognostic predictive tool for left ventricular outflow tract obstruction.Conclusions:It is mandatory to selectively conduct multiple imaging examinations which mainly include exercise echocardiography and selectively left ventriculography in order to successfully improve the diagnosis of left ventricular outflow tract obstruction.%目的:探讨左室流出道梗阻的病因分类、临床表现和诊治进展.方法:对1例左心室中部肥厚合并二尖瓣前叶冗长致隐匿性左室流出道梗阻患者的诊治过程进行全程追踪随访,结合复习相关文献.结果:左室流出道梗阻病因复杂,发生率较高;超声心动图运动试验结合经食道超声探查是左室流出道梗阻最有效的无创筛查和随访评价手段,必要时左心室造影和测压可进一步明确诊断.结论:对左心室肥厚患者常规开展运动超声心动图、必要时左心室造影等多种影像学检查可以有效提高左室流出道梗阻及其病因的诊断正确率.

  4. 室早 TpR 指数与特发性流出道室早症状的关系%Relationship between TpR index and symptoms of idiopathic outflow tract premature ventricu-lar contraction

    Institute of Scientific and Technical Information of China (English)

    张奇; 赵春梅; 王德国; 杨琴; 李小荣; 张凤祥; 曹克将

    2016-01-01

    Objective To analyze the relationship between arrhythmic symptoms of the patients with outflow tract premature ventricular contraction (PVC)and characteristics of surface electrocardi-ogram(ECG),and to explore its clinical significance.Methods According to the existence of PVC-related arrhythmic symptoms,97 outflow tract PVC patients were divided into two group:symptomatic group(60 cases)and asymptomatic group(37 cases).The examination of echocardio-graphy and standard 1 2 lead surface ECG were performed on all the patients.The measured parame-ters included PVC burden,the width of PVC complex,coupling interval,index of PVC coupling in-terval(PVC coupling interval ÷sinus RR cycle ×1 00%),TpR interval of PVC(the duration from si-nus T peak before PVC to the starting point of PVC)and TpR index of PVC(TpR interval of PVC ÷sinus TpR interval ×1 00%).The relationship between the above measured parameters and arrhyth-mic symptoms was analyzed.Results In the symptomatic group,the index of PVC coupling inter-val,TpR interval of PVC and TpR index of PVC were significantly higher than those in the asympto-matic group(P <0.05).However,there was no statistically significant difference of PVC burden, origin of PVC or other ECG parameters between the two groups.Spearman correlation analysis showed that PVC-related symptoms were significantly positively correlated with the index of PVC coupling interval(r =0.324,P <0.05),TpR interval of PVC(r =0.272,P <0.05)and TpR in-dex of PVC(r =0.457,P <0.05).Conclusion PVC-related symptoms are associated with higher index of PVC coupling interval and TpR index for patients with outflow tract PVC.Those symptoms are related to the delayed emergence of PVC,which is helpful in the control of PVC clinically.%目的:分析流出道室早(premature ventricular contraction,PVC)患者心律失常症状与体表心电图特征的关系及其临床意义。方法将97例流出道室早患者根据有无心律失常症

  5. Localization of precise origin of idiopathic ventricular tachycardia from the right ventricular outflow tract by a 12-lead ECG: a study of pace mapping using a multielectrode "basket" catheter.

    Science.gov (United States)

    Yoshida, Y; Hirai, M; Murakami, Y; Kondo, T; Inden, Y; Akahoshi, M; Tsuda, M; Okamoto, M; Yamada, T; Tsuboi, N; Hirayama, H; Ito, T; Toyama, J; Saito, H

    1999-12-01

    Radiofrequency catheter ablation guided by pace-mapping techniques has proven effective in eliminating idiopathic ventricular tachycardia (VT) originating from the right ventricular outflow tract (RVOT). A method for rapidly identifying the origin of VT from 12-lead electrocardiogram (ECG) findings would be helpful for the catheter ablation procedure. The purpose of this study is to precisely localize the origin of idiopathic VT from the RVOT by a 12-lead ECG from a study of multipoint pace mapping. In one patient with premature ventricular complex (PVC) and 3 with VT, a "basket" catheter was deployed in the RVOT for bipolar pacing from 56 sites in the endocardium of RVOT. Under fluoroscopy the pacing sites were classified into the septum and free wall. We investigated the QRS morphology in leads, I, II, and III; the depth of the QS wave in leads aVR and aVL; and the height of the initial r wave in leads V1 and V2. Pacing was captured in 30-47 of 56 sites (54%-84%). As the pacing sites changed from the anterior to posterior of the septum, the QS notch (-) type in lead I shifted through rs to R, while a shift from R type to rR' or Rr' was noted in leads II and III. As the pacing sites changed from the anterior to posterior of the free wall, lead I showed a shift from the QS notch (+) type to R, while a shift from rR' to Rr' (or rR' unchanged) was found in leads II and III. The depth of the QS wave in leads aVR and aVL showed a tendency for aVR to be deeper than aVL toward the posterolateral attachment of both the septum and free wall, whereas aVL tended to be deeper than aVR toward the anterior attachment. The initial r waves in V1 and V2 became greater as the pacing site was positioned at a higher or more posterior location. These findings may provide more precise and clinically useful diagnostic information on the site of the origin of idiopathic VT originating from the RVOT by a 12-lead ECG.

  6. Role of ionotropic GABA, glutamate and glycine receptors in the tonic and reflex control of cardiac vagal outflow in the rat

    Directory of Open Access Journals (Sweden)

    Goodchild Ann K

    2010-10-01

    Full Text Available Abstract Background Cardiac vagal preganglionic neurons (CVPN are responsible for the tonic, reflex and respiratory modulation of heart rate (HR. Although CVPN receive GABAergic and glutamatergic inputs, likely involved in respiratory and reflex modulation of HR respectively, little else is known regarding the functions controlled by ionotropic inputs. Activation of g-protein coupled receptors (GPCR alters these inputs, but the functional consequence is largely unknown. The present study aimed to delineate how ionotropic GABAergic, glycinergic and glutamatergic inputs contribute to the tonic and reflex control of HR and in particular determine which receptor subtypes were involved. Furthermore, we wished to establish how activation of the 5-HT1A GPCR affects tonic and reflex control of HR and what ionotropic interactions this might involve. Results Microinjection of the GABAA antagonist picrotoxin into CVPN decreased HR but did not affect baroreflex bradycardia. The glycine antagonist strychnine did not alter HR or baroreflex bradycardia. Combined microinjection of the NMDA antagonist, MK801, and AMPA antagonist, CNQX, into CVPN evoked a small bradycardia and abolished baroreflex bradycardia. MK801 attenuated whereas CNQX abolished baroreceptor bradycardia. Control intravenous injections of the 5-HT1A agonist 8-OH-DPAT evoked a small bradycardia and potentiated baroreflex bradycardia. These effects were still observed following microinjection of picrotoxin but not strychnine into CVPN. Conclusions We conclude that activation of GABAA receptors set the level of HR whereas AMPA to a greater extent than NMDA receptors elicit baroreflex changes in HR. Furthermore, activation of 5-HT1A receptors evokes bradycardia and enhances baroreflex changes in HR due to interactions with glycinergic neurons involving strychnine receptors. This study provides reference for future studies investigating how diseases alter neurochemical inputs to CVPN.

  7. Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Y. Daralammouri

    2012-01-01

    Full Text Available Hypertrophic cardiomyopathy is the most common genetic disease of the heart. We report a rare case of hypertrophic obstructive cardiomyopathy mimicking an acute anterior myocardial infarction associated with sudden cardiac death. The patient presented with acute ST elevation myocardial infarction and significant elevation of cardiac enzymes. Cardiac catheterization showed some atherosclerotic coronary artery disease, without significant stenosis. Echocardiography showed left ventricular hypertrophy with a left ventricular outflow tract obstruction; the pressure gradient at rest was 20 mmHg and became severe with the Valsalva maneuver (100 mmHg. There was no family history of sudden cardiac death. Six days later, the patient suffered a syncope on his way to magnetic resonance imaging. He was successfully resuscitated by ventricular fibrillation.

  8. Cardiovascular Development and the Colonizing Cardiac Neural Crest Lineage

    Directory of Open Access Journals (Sweden)

    Paige Snider

    2007-01-01

    Full Text Available Although it is well established that transgenic manipulation of mammalian neural crest-related gene expression and microsurgical removal of premigratory chicken and Xenopus embryonic cardiac neural crest progenitors results in a wide spectrum of both structural and functional congenital heart defects, the actual functional mechanism of the cardiac neural crest cells within the heart is poorly understood. Neural crest cell migration and appropriate colonization of the pharyngeal arches and outflow tract septum is thought to be highly dependent on genes that regulate cell-autonomous polarized movement (i.e., gap junctions, cadherins, and noncanonical Wnt1 pathway regulators. Once the migratory cardiac neural crest subpopulation finally reaches the heart, they have traditionally been thought to participate in septation of the common outflow tract into separate aortic and pulmonary arteries. However, several studies have suggested these colonizing neural crest cells may also play additional unexpected roles during cardiovascular development and may even contribute to a crest-derived stem cell population. Studies in both mice and chick suggest they can also enter the heart from the venous inflow as well as the usual arterial outflow region, and may contribute to the adult semilunar and atrioventricular valves as well as part of the cardiac conduction system. Furthermore, although they are not usually thought to give rise to the cardiomyocyte lineage, neural crest cells in the zebrafish (Danio rerio can contribute to the myocardium and may have different functions in a species-dependent context. Intriguingly, both ablation of chick and Xenopus premigratory neural crest cells, and a transgenic deletion of mouse neural crest cell migration or disruption of the normal mammalian neural crest gene expression profiles, disrupts ventral myocardial function and/or cardiomyocyte proliferation. Combined, this suggests that either the cardiac neural crest

  9. Sex-Based Differences in Cardiac Arrhythmias, ICD Utilisation and Cardiac Resynchronisation Therapy.

    Science.gov (United States)

    Ghani, A; Maas, A H E M; Delnoy, P P H M; Ramdat Misier, A R; Ottervanger, J P; Elvan, A

    2011-01-01

    Many important differences in the presentation and clinical course of cardiac arrhythmias are present between men and women that should be accounted for in clinical practice. In this paper, we review published data on gender differences in cardiac excitable properties, supraventricular tachycardias, ventricular tachycardias, sudden cardiac death, and the utilisation of implantable defibrillators and cardiac resynchronisation therapy. Women have a higher heart rate at rest, and a longer QT interval than men. They further have a narrower QRS complex and lower QRS voltages on the 12-lead ECG with more often non-specific repolarisation abnormalities at rest. Supraventricular tachycardias, such as AV nodal reentrant tachycardia, are twice as frequent in women compared with men. Atrial fibrillation, however, has a 1.5-fold higher prevalence in men. The triggers for idiopathic right ventricular outflow tract tachycardia (VT) initiation are gender specific, i.e. hormonal changes play an important role in the occurrence of these VTs in women. There are clear-cut gender differences in acquired and congenital LQTS. Brugada syndrome affects men more commonly and severely than women. Sudden cardiac death is less prevalent in women at all ages and occurs 10 years later in women than in men. This may be related to the later onset of clinically manifest coronary heart disease in women. Among patients who receive ICDs and CRT devices, women appear to be under-represented, while they may benefit even more from these novel therapies.

  10. 肾上腺素对离体豚鼠左心室流出道组织自律性电活动的影响%Electrophysiological Effects of Epinephrine on Pacemaker Cells in Guinea-pig Left Ventricular Outflow Tract

    Institute of Scientific and Technical Information of China (English)

    陈立锋; 徐涛; 范凌; 陈少峰; 孙琳; 尹万斌; 赵兰平

    2009-01-01

    Objective:To explore the effects of epinephrine(E)on spontaneous slow action potentials(APs)of guinea-pig left ventricular outflow tract cells.Methods:By using standard intracellular microelectrode technique to record APs,E was used to investigate the electrophysiological features of left ventricular outflow tract cells.Electrophysiological parameters examined were:maximal diastolic potential(MDP),amplitude of action potential(APA),maximal rate of depolarization(Vmax),velocity of diastolic depolarization(VDD),rate of pacemaker firing(RPF),50% and 90% of duration of action potential(APD50 and APD90).Results:The results obtained were as follows:Application of 100μmol/L E resulted in a significant increase in VDD(P<0.05),RPF(P<0.01),APA(P<0.05),MDP(P<0.05)and Vmax(P<0.05);a notable shorteness in and APD90(P<0.01)in the pacemaker cells.Conclusion:These results suggested that E should excite the pacemaker cells of left ventricular outflow tract.%目的:观察肾上腺素(E)对离体豚鼠左心室流出道组织自发慢反应电位的影响.方法:采用标准玻璃微电极细胞内记录技术,观察E对离体豚鼠左心室流出道组织自发慢反应电位的影响.观测指标有:最大舒张电位(MDP),动作电位幅度(APA),0期最大除极速度(Vmax),4期自动除极速度(VDD),自发放电频率(RPF),复极50%和90%时间(APD50、APD90).结果:用100μmol/L E灌流,豚鼠左心室流出道自律组织动作电位APA明显增大(P<0.01),Vmax明显增快(P<0.05),MDP显著增大(P<0.05),APD90显著缩短(P<0.01);RPF明显增快(P<0.01),VDD明显加快(P<0.05).结论:E对左心室流出道组织自律细胞有兴奋作用.

  11. A new electrocardiographic algorithm for localizing idiopathic right ventricular outflow tract premature ventricular contraction%右心室流出道室性早搏的定位与导管消融

    Institute of Scientific and Technical Information of China (English)

    张凤祥; 陈明龙; 杨兵; 陈红武; 居维竹; 徐东杰; 曹克将

    2010-01-01

    目的 本文旨在探索判断右心室流出道室性早搏(室早)起源的新流程,以便快速、准确地找到消融靶点.方法 采用非接触三维标测系统对右心室流出道室早进行标测与导管消融,并分析右心室流出道室早体表心电图特征.根据三维标测与导管消融结果,并结合先前报道的室早起源判断流程,设计新的判断室早起源流程.结果 标测与消融结果显示21例患者室早起源于右心室流出道间隔部,其中5例起源于前间隔,4例起源于中间隔,12例起源于后间隔;17例患者室早起源于右心室流出道游离壁,其中5例起源于前游离壁,2例起源于中游离壁,10例起源于后游离壁;1例患者室早起源于希氏束附近.判断室早起源新流程的总阳性预测值(77.3%)较Ito等报道的73.3%、Joshi等报道的73.3%、Dixit等报道的53.8%显著提高(P<0.05).新流程在判断室早具体起源部位较Ito等、Joshi等与Dixit等报道的室早起源部位判断流程有较大的优势,其敏感性、特异性与阳性预测值分别为78.1%,88.9%与84.2%,Joshi等报道的流程分别为32.9%,65.8%与48.1%,Dixit等报道的流程分别为50.7%,63.9%和55.2%(P均<0.05).结论 非接触三维标测系统指导右心室流出道室早消融成功率高,判断室早起源新流程的敏感性、特异性与阳性预测值较先前报道的高,有良好的临床应用价值.%Objective In this study, we explored a new electrocardiographic algorithm for localizing idiopathic right ventricular outflow tract (RVOT)premature ventricular contraction (PVC). Methods A total of 39 patients [23 female, mean age (41.8±13.1) years] with RVOT-PVC enrolled in this study. Ablation was performed under the guidance of 3D non-contact mapping, and a newly proposed ECG algorithm. Results As guided by 3D mapping, the successful ablation was achieved at sites of RVOT septum (n=21), RVOT free wall (n=17) and His region (n=1). Among those PVCs originated from the

  12. Molecules in Bipolar Outflows

    CERN Document Server

    Tafalla, Mario

    2012-01-01

    Bipolar outflows constitute some of the best laboratories to study shock chemistry in the interstellar medium. A number of molecular species have their abundance enhanced by several orders of magnitude in the outflow gas, likely as a combined result of dust mantle disruption and high temperature gas chemistry, and therefore become sensitive indicators of the physical changes taking place in the shock. Identifying these species and understanding their chemical behavior is therefore of high interest both to chemical studies and to our understanding of the star-formation process. Here we review some of the recent progress in the study of the molecular composition of bipolar outflows, with emphasis in the tracers most relevant for shock chemistry. As we discuss, there has been rapid progress both in characterizing the molecular composition of certain outflows as well as in modeling the chemical processes likely involved. However, a number of limitations still affect our understanding of outflow chemistry. These i...

  13. Simulations of heart mechanics over the cardiac cycle

    Science.gov (United States)

    Tavoularis, Stavros; Doyle, Matthew; Bourgault, Yves

    2009-11-01

    This study is concerned with the numerical simulation of blood flow and myocardium motion with fluid-structure interaction of the left ventricle (LV) of a canine heart over the entire cardiac cycle. The LV geometry is modeled as a series of nested prolate ellipsoids and is capped with cylindrical tubes representing the inflow and outflow tracts. The myocardium is modeled as a multi-layered, slightly compressible, transversely isotropic, hyperelastic material, with each layer having different principal directions to approximate the fibrous structure. Blood is modeled as a slightly compressible Newtonian fluid. Blood flow into and out of the LV is driven by left atrial and aortic pressures applied at the distal ends of the inflow and outflow tracts, respectively, along with changes in the stresses in the myocardium caused by time-dependent changes in its material properties, which simulate the cyclic contraction and relaxation of the muscle fibers. Numerical solutions are obtained with the use of a finite element code. The computed temporal and spatial variations of pressure and velocity in the blood and stresses and strains in the myocardium will be discussed and compared to physiological data. The variation of the LV cavity volume over the cardiac cycle will also be discussed.

  14. 苦参碱对低钾致兔左心室流出道细胞电生理异常保护作用及其机制%Protective Effects of Matrine on Hypokalemia-induced Abnormal Electrophysiology in Rabbits Left Ventricular Outflow Tract Cell and Its Mechanism

    Institute of Scientific and Technical Information of China (English)

    王雪芳; 刘艳明; 吕英雷

    2011-01-01

    目的探讨苦参碱对低钾致兔左心室流出道细胞电生理异常保护作用及其机制.方法应用常规玻璃微电极细胞内记录技术,观察正常灌流液、低钾灌流液、低钾+苦参碱(50μmol/L)灌流液对兔左心室流出道慢反应自律细胞最大舒张电位(MDP),动作电位0相幅值(APA),50%复极化时间(APD50),90%复极化时间(APD90),4相自动去极速度(Vmax),自发放电频率(RPF)的影响.结果与正常对照组相比,低钾灌流液组左心室流出道慢反应自律细胞20min后APD50、APD90均明显缩短(P〈0.05);APA、Vmax、RPF显著变快(P〈0.01);在低钾灌流液组中加入苦参碱可明显延缓APD50、APD90(P〈0.05);并使APA缩短、Vmax、RPF逐渐变慢(P〈0.01),稳定20min后,RPF基本恢复正常的节律.结论低钾可明显影响兔左心室流出道慢反应自律细胞电活动,使其自律性发生改变,而苦参碱能拮抗这种作用,降低低钾诱发所导致的RPF的升高,提示苦参碱对低钾性左心室流出道慢反应自律细胞具有明显的电生理保护作用.%Objective To study the electrophysiology effects of Matrine on hypokalemia of guinea pigs left ventricular outflow tract cells.Methods The action potentials were recorded by conventional intracellular microelectrode technique,while the amplitude of action potential(APA),maximal rate of depolarization(Vmax),50% and 90% of duration of action potential(APD50 and APD90) and the rate of potential frequency(RPF) in guinea pigs left ventricular outflow tract pacemaker cells of normal control group,hypokalemia group and hypokalemia adding Matrine group were observed.Results Compared with the results of normal controls,action potentials of APD50、APD90 of left ventricular outflow tract pacemaker cells in hypokalemia group were decreased(P0.05),APA、Vmax、and RPF significantly increased(P0.01),and there existed arrhythmia.The addition of

  15. 兔特发性室性心动过速心室流出道HCN4蛋白表达的实验观察%Expression of HCN4 protein in ventricular outflow tract of rabbit with idiopathic ventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    吴晓羽; 姜晓慧; 李怀娜; 田平; 周中华; 时珊珊; 于静; 丁玲玲

    2015-01-01

    目的 探讨超极化激活的环核苷酸门控离子通道亚型4 (HCN4)蛋白在室性心动过速(室速)中的作用.方法 数字随机选择新西兰大白兔10只,应用HE染色及免疫组织化学检测中间神经纤维丝(NF-M),观察心室流出道组织是否存在浦肯野纤维.另选择新西兰大白兔40只平均分4组即对照组(SO)、室速组(ⅤT)、室速+艾司洛尔干预组(ⅤT+ ESM)、室速+伊伐布雷定干预组(ⅤT+ⅣA).采用免疫组化方法检测心室流出道HCN4蛋白的表达,观察并记录各组诱发室速时所需电压的输出幅值、停止刺激后自发性室速发生的次数及持续时间.结果 (1)兔心室流出道存在浦肯野纤维.(2)左、右心室流出道HCN4蛋白的表达ⅤT组与SO组比较明显增多(左室:97.6±16.7与29.0±8.0,P<0.01;右室:92.7±12.3与26.0±10.8,P<0.01);ⅤT+ ⅣA组与ⅤT组比较明显减少(左室:32.0±9.4与97.6±16.7,P<0.01;右室:30.8±12.4与92.7±12.3,P<0.01).(3)ⅤT +ESM组和ⅤT+ ⅣA组与YT组相比,在同等高频刺激的条件下诱发流出道室速所需的输出电压幅值增加(P<0.01),停止刺激后自发性室速的发生次数减少(P<0.01),自发性室速持续时间缩短(P<0.01).结论 (1)心室流出道存在浦肯野纤维,且室速发生时HCN4蛋白表达上调;(2)艾司洛尔及伊伐布雷定可以预防及减少室速的发生,伊伐布雷定作为HCN通道的特异性通道抑制剂效果更强.%Objective To confirm the existence of purkinje fibers in rabbit outflow tract tissue and explore the role of Hyperpolarization-Activated Cyclic Nucleotide-Gated Channel 4 (HCN4) protein in idiopathic ventricular tachycardia.Methods A total of ten New Zealand white rabbits were randomly selected to observe whether there were pukinje fibers in outflow tract by the methods of HE staining and immunohistochemical detection of midsize neurofilament (NF-M).Forty rabbits were randomly divided into four groups : normal control group (SO

  16. Mechanisms of cardiac pain.

    Science.gov (United States)

    Foreman, Robert D; Garrett, Kennon M; Blair, Robert W

    2015-04-01

    Angina pectoris is cardiac pain that typically is manifested as referred pain to the chest and upper left arm. Atypical pain to describe localization of the perception, generally experienced more by women, is referred to the back, neck, and/or jaw. This article summarizes the neurophysiological and pharmacological mechanisms for referred cardiac pain. Spinal cardiac afferent fibers mediate typical anginal pain via pathways from the spinal cord to the thalamus and ultimately cerebral cortex. Spinal neurotransmission involves substance P, glutamate, and transient receptor potential vanilloid-1 (TRPV1) receptors; release of neurokinins such as nuclear factor kappa b (NF-kb) in the spinal cord can modulate neurotransmission. Vagal cardiac afferent fibers likely mediate atypical anginal pain and contribute to cardiac ischemia without accompanying pain via relays through the nucleus of the solitary tract and the C1-C2 spinal segments. The psychological state of an individual can modulate cardiac nociception via pathways involving the amygdala. Descending pathways originating from nucleus raphe magnus and the pons also can modulate cardiac nociception. Sensory input from other visceral organs can mimic cardiac pain due to convergence of this input with cardiac input onto spinothalamic tract neurons. Reduction of converging nociceptive input from the gallbladder and gastrointestinal tract can diminish cardiac pain. Much work remains to be performed to discern the interactions among complex neural pathways that ultimately produce or do not produce the sensations associated with cardiac pain.

  17. Löffler endocarditis: a rare cause of acute cardiac failure

    Directory of Open Access Journals (Sweden)

    Niemeijer Nicolasine D

    2012-10-01

    Full Text Available Abstract We describe a patient with acute cardiogenic shock due to cardiac involvement in idiopathic hypereosinophilic syndrome (Löffler endocarditis. At the echocardiography, there was a huge mass in the left ventricular cavity, resulting in inflow- and outflow tract obstruction. The posterior leaflet of the mitral valve apparatus was completely embedded in a big (organized thrombus mass. The patient was treated with high dose corticosteroids, however without effect. Partial remission was achieved after treatment with hydroxycarbamide. He was also treated with anticoagulants and high dose beta-blockers. The patient’s condition improved remarkably after correction of the mitral valve insufficiency by a mitral valve bioprosthesis.

  18. A retinoic acid responsive Hoxa3 transgene expressed in embryonic pharyngeal endoderm, cardiac neural crest and a subdomain of the second heart field.

    Directory of Open Access Journals (Sweden)

    Nata Y S-G Diman

    Full Text Available A transgenic mouse line harbouring a β-galacdosidase reporter gene controlled by the proximal 2 kb promoter of Hoxa3 was previously generated to investigate the regulatory cues governing Hoxa3 expression in the mouse. Examination of transgenic embryos from embryonic day (E 8.0 to E15.5 revealed regionally restricted reporter activity in the developing heart. Indeed, transgene expression specifically delineated cells from three distinct lineages: a subpopulation of the second heart field contributing to outflow tract myocardium, the cardiac neural crest cells and the pharyngeal endoderm. Manipulation of the Retinoic Acid (RA signaling pathway showed that RA is required for correct expression of the transgene. Therefore, this transgenic line may serve as a cardiosensor line of particular interest for further analysis of outflow tract development.

  19. A Retinoic Acid Responsive Hoxa3 Transgene Expressed in Embryonic Pharyngeal Endoderm, Cardiac Neural Crest and a Subdomain of the Second Heart Field

    Science.gov (United States)

    Diman, Nata Y. S.-G.; Remacle, Sophie; Bertrand, Nicolas; Picard, Jacques J.; Zaffran, Stéphane; Rezsohazy, René

    2011-01-01

    A transgenic mouse line harbouring a β-galacdosidase reporter gene controlled by the proximal 2 kb promoter of Hoxa3 was previously generated to investigate the regulatory cues governing Hoxa3 expression in the mouse. Examination of transgenic embryos from embryonic day (E) 8.0 to E15.5 revealed regionally restricted reporter activity in the developing heart. Indeed, transgene expression specifically delineated cells from three distinct lineages: a subpopulation of the second heart field contributing to outflow tract myocardium, the cardiac neural crest cells and the pharyngeal endoderm. Manipulation of the Retinoic Acid (RA) signaling pathway showed that RA is required for correct expression of the transgene. Therefore, this transgenic line may serve as a cardiosensor line of particular interest for further analysis of outflow tract development. PMID:22110697

  20. Disks and Outflows

    Science.gov (United States)

    Rodriguez, L. F.

    2002-05-01

    The presence of disks and outflows characterizes the earliest stages of stellar evolution. I will review recent results that exemplify how the radio observations have become powerful tools in the study of these extremely young objects. Binarity and multiplicity seem to be factors that we are only starting to understand. Outflows are now seen as laboratories for the chemistry of shocked regions. Finally, the efforts to extend the paradigm for low-mass stellar formation to more massive protostars can be tested critically in the radio wavelengths. I acknowledge the support from CONACyT, Mexico.

  1. Electrocardiographic characteristics and radiofrequency catheter ablation of ventricular tachycardia and frequent ventricular premature contractions originating from left ventricular outflow tract%射频消融治疗起源于左室流出道的室性心动过速和频发室性期前收缩

    Institute of Scientific and Technical Information of China (English)

    陈宏; 张薇薇; 李荣琴; 李占全; 崔然

    2008-01-01

    目的 探讨源自左室流出道部位的室性心动过速(室速)和室性期前收缩(室早)的心电图特点和射频消融的安全性.方法 对9例于左室流出道部位消融的室速/室早病例的心电图和射频消融情况进行归纳总结.结果 消融成功部位6例在左冠窦内,3例在主动脉瓣下.心电图特点:(1)Ⅱ、Ⅲ、avF导联均呈高R波;(2)aVR和aVL导联均呈QS型,且aVL振幅多大于aVR;(3)Ⅰ导联多呈QS型;(4)V1导联R波偏高:R/S>0.62;(5)胸前导联R波移行不规则;(6)V5、V6多呈R型.9例均消融成功,无复发病例,无左主干及主动脉瓣损伤.结论 源自左室流出道的室速/室早具有独特的心电图表现,射频消融能安全有效地根治此类心律失常.%Objective To investigate the electrocardiographic(ECG) characteristics and assess the safety of radiofrequency catheter ablation (RFCA) of ventricular tachyeardia (VT), and frequent ventricular premature con- tractious(VPCs) originating from left ventricular outflow tract(LVOT). Methods Twelve-lead ECG analysis and RFCA were performed in 9 patient with VT or VPCs originating from LVOT. Results The sites to be successfully ablated were in left valsalva sinus in 6 patients,and subaortic valve in 3 patient. ECG revealed tall R wave in leads Ⅱ, Ⅲ ,aVF, V5 and V6. QS morphology in both leads aVR and aVL,QS morphology in lead Ⅰ in most cases. R wave in lead Ⅰ was relative tall, the R/S wave amplitude in lead V1 was over 0.62 ,and precordia R wave transition was irregular. All 9 patients were successfully ablated. No death or recurrenced case during follow-up. Conclusion Ventricular taehycardia and frequent ventricular premature rcontractions originating from left ventricutar outflow tract could be known by some specific ECG characteristics and could be radically treated safely by RFCA.

  2. Síncope em pacientes com extra-sístoles de via de saída de ventrículo direito e sem cardiopatia estrutural aparente Syncope in patients with right ventricle outflow tract premature beats and no apparent structural cardiopathy

    Directory of Open Access Journals (Sweden)

    Ana Cristina Ludovice

    2006-11-01

    ventricular premature beats, with right ventricle outflow tract morphology (RVOT and no apparent structural cardiopathy. METHODS: Ninety patients (66 women, mean age 40.2±16.95 years of age with monomorphic premature beats originated at RVOT were evaluated prospectively. Fifty-four patients reported syncopes or near-syncopes associated to palpitations or not; twenty-seven presented palpitations with no pre-syncope or syncope, and nine were asymptomatic. All patients were submitted to echocardiogram, high resolution ECG and cardiac MRI to rule out structural cardiopathy, to exertion test to rule out adrenergic dependent ventricular tachycardia, and ECG prolonged outpatient monitoring (Holter and symptomatic events monitor to correlate symptoms and ventricular arrhythmias. Investigation on the susceptibility to neurocardiogenic syncope was evaluated by Tilt Table Test (TTT. Groups were compared regarding gender, age, premature beats frequency and complexity, at exertion or not, TTT results and clinical course. RESULTS: In the syncope and pre-syncope groups, TTT was positive for 38% of cases, and in groups with palpitations and assymptomatics, it was positive for 11% (p = 0.0257. After recommendations and treatment of neurocardiogenic syncope, 85% of syncope and pre-syncope patients and positive TTT was asymptomatic along the 40-month follow-up. Two patients with syncope and negative TTT presented spontaneous, sustained ventricular tachycardia during clinic course. CONCLUSION: The prevalence of neurocardiogenic syncope in patients with idiopathic RVOT premature beats is high. Patients with recurrent, unexplained syncope and idiopathic VE must be kept under investigation.

  3. Mediterranean Outflow Mixing Dynamics

    Science.gov (United States)

    1993-02-01

    tugal. G. Parrnlla is at Instituto EspaWol Oceanografia , Fig. 2A. [Adapted from (36)] (C) The maximum observed velocity of outflow currents in the eastern...its sur- Oceanografia Fisica del Estrecho de Gibraltar, J. of Mediterranean water that we observed at the roundings (34) and retains its chemical L

  4. GALAXY OUTFLOWS WITHOUT SUPERNOVAE

    Energy Technology Data Exchange (ETDEWEB)

    Sur, Sharanya [Indian Institute of Astrophysics, 2nd Block, Koramangala, Bangalore 560034 (India); Scannapieco, Evan [School of Earth and Space Exploration, Arizona State University, P.O. Box 876004, Tempe-85287 (United States); Ostriker, Eve C., E-mail: sharanya.sur@iiap.res.in, E-mail: sharanya.sur@asu.edu [Department of Astrophysical Sciences, Princeton University, Princeton, NJ 08544 (United States)

    2016-02-10

    High surface density, rapidly star-forming galaxies are observed to have ≈50–100 km s{sup −1} line of sight velocity dispersions, which are much higher than expected from supernova driving alone, but may arise from large-scale gravitational instabilities. Using three-dimensional simulations of local regions of the interstellar medium, we explore the impact of high velocity dispersions that arise from these disk instabilities. Parametrizing disks by their surface densities and epicyclic frequencies, we conduct a series of simulations that probe a broad range of conditions. Turbulence is driven purely horizontally and on large scales, neglecting any energy input from supernovae. We find that such motions lead to strong global outflows in the highly compact disks that were common at high redshifts, but weak or negligible mass loss in the more diffuse disks that are prevalent today. Substantial outflows are generated if the one-dimensional horizontal velocity dispersion exceeds ≈35 km s{sup −1}, as occurs in the dense disks that have star-formation rate (SFR) densities above ≈0.1 M{sub ⊙} yr{sup −1} kpc{sup −2}. These outflows are triggered by a thermal runaway, arising from the inefficient cooling of hot material coupled with successive heating from turbulent driving. Thus, even in the absence of stellar feedback, a critical value of the SFR density for outflow generation can arise due to a turbulent heating instability. This suggests that in strongly self-gravitating disks, outflows may be enhanced by, but need not caused by, energy input from supernovae.

  5. Coffin-Siris syndrome with the rarest constellation of congenital cardiac defects: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Lalita Nemani

    2014-01-01

    Full Text Available We report a case of type-A Coffin-Siris syndrome (CSS with a unique constellation of congenital heart defects. A 17-year-old Indian boy was referred to our hospital for central cyanosis with features of right heart failure. The cardiac abnormalities included biventricular outflow tract obstruction, small atrial septal defect (ASD, subaortic ventricular septal defect, drainage of left superior venacava to left atrial appendage, and aortic arch anomaly. Patient underwent successful right ventricular infundibular resection, subaortic membrane resection, closure of atrial and ventricular septal defect, rerouting left superior vena cava to left pulmonary artery and aortic valve replacement.

  6. Reference values of MRI flow measurements of the pulmonary outflow tract in healthy children; Erstellung von Referenzwerten fuer die MRT-basierte Flussmessung im Truncus pulmonalis bei gesunden Kindern und Jugendlichen

    Energy Technology Data Exchange (ETDEWEB)

    Abolmaali, N.D.; Feist, P.; Vogl, T.J. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Esmaeili, A. [Frankfurt Univ. (Germany). Klinik fuer Paediatrische Kardiologie; Ackermann, H. [Frankfurt Univ. (Germany). Zentrum fuer Informatik; Requardt, M. [Siemens Medical Solutions, Erlangen (Germany); Schmidt, H. [Frankfurt Univ. (Germany). Funktionsbereich Paediatrische Radiologie

    2004-06-01

    Purpose: To provide reference values for MRI-based flow measurements in the main pulmonary artery in healthy children. Materials and Methods: In 98 healthy children (age: 3-17 years, median: 11 years), the main pulmonary artery was examined using MRI-based flow measurements with high temporal resolution (9.6 ms per cardiac phase). Results: The acceleration time revealed a distinct age dependency and varied between 90 and 155 ms (mean: 124 ms{+-}14). The relative acceleration time (related to the RR-interval) varied between 12.7 and 27% (mean: 18%{+-}2.6). The mean values and the standard deviations for the determined values were as follows: cardiac output (5.4 l/min{+-}1.4), cardiac output normalized to the body surface area (4.2 [l/min]/m{sup 2}{+-}0.8), average systolic flow velocity (66 cm/s{+-}12), maximum systolic flow (309 ml/s{+-}79), mean flow (110 ml/s{+-}30), distensibility of the wall of the main pulmonary artery (79%{+-}26), peak velocity (96 cm/s{+-}15), pressure gradient along the pulmonary valve (3.8 mm Hg{+-}1.2), stroke volume (63.2 ml{+-}17.9), acceleration volume (23.7 ml{+-}8.7), maximum acceleration of flow (4924 ml/s{sup 2}{+-}1431), and reverse volume (0.2 ml{+-}0.3). Conclusions: The acquired values of reference are applicable to all pediatric patients and serve as a framework for the communication between the radiologist and the pediatric cardiologists. High temporal resolution of the measurement sequence is mandatory. Noticeable deviations of these values should induce additional (probably invasive) evaluation. (orig.) [German] Ziel: Erstellung von Referenzwerten fuer die MRT-basierte Flussmessung im Truncus pulmonalis bei gesunden Kindern und Jugendlichen. Methode: 98 anamnestisch herzgesunde Kinder (Alter: 3-17 Jahre, Median: 11 Jahre) wurden mit einer zeitlich hoch aufloesenden MRT-Flussmessung (9,6 ms pro Herzphase) im Truncus pulmonalis untersucht. Ergebnisse: Die Akzelerationszeit wies eine starke Altersabhaengigkeit auf und

  7. 单导管射频消融治疗右室流出道室性期前收缩%Radiofrequency catheter ablation of premature ventricular contractions from right ventricular outflow tract by single catheter electrode

    Institute of Scientific and Technical Information of China (English)

    梁锦军; 黄鹤; 杨波; 万军; 唐艳红; 江洪; 黄从新

    2011-01-01

    AIM: To assess the clinical effects of ablation of premature ventricular contractions ( PVCs ) in right ventricular outflow tracl ( RVOT) using a single catheter electrode. METHODS: Single catheter technique for radiofrequency catheter ablation ( RFCA) was performed in 65 consecutive patients with severe symptomatic monomorphic PVCs originating within the RVOT. A 7-Fr, 4-mm-tip catheter was used for both mapping and ablation. Target sites were localized by pace mapping. Pace mapping demonstrated identical QRS complex configurations during pacing and during arrhythmia in at least 11 leads. RESULTS; Acute ablation success was achieved in 63/65 patients (96. 9% ). During the follow-up of ( 28 ± 13) months, recurrence and reablation were done in three patients (4. 6% ). Two of these patients remained arrhythmia-free. Surgical time was (50+27) min, and fluoroscopy time was (8. 1 ±3. 8) min. No ablation-related complications occurred during the follow-up of 15 -40 months. CONCLUSIONS; Single catheter technique is safe and effective for mapping and ablation of PVCs from RVOT.%目的:观察单导管射频消融治疗右室流出道室性期前收缩(室性早搏,室早)的安全性和临床效果.方法:经常规体检、生化检查、X线胸片、心脏彩超、长程心电图等各种检查后,入选65例患者,采用温控消融导管以起搏为主的方法进行标测,并对单导管射频消融的安全性和临床效果进行总结.结果:消融即刻成功率97%( 63/65),其中2例放弃消融术;随访15~40个月,有3例复发并再次手术,成功2例,总成功率为95%( 62/65),无复发.电生理检测和消融时间:(50±27) min;曝光时间:(8.1±3.8)min,所有患者术中及术后均未发生消融相关并发症.结论:单导管射频消融治疗右室流出道室早安全有效,并能减少消融操作及X线暴露时间.

  8. Impact of intra-aortic balloon counterpulsation with different balloon volumes on cardiac performance in humans.

    Science.gov (United States)

    Cohen, Marc; Fasseas, Panayotis; Singh, Varinder P; McBride, Ruth; Orford, James L; Kussmaul, William G

    2002-10-01

    Intra-aortic balloon (IAB) counterpulsation can augment the cardiac output. However, the effect of different IAB volumes on cardiac performance has not been adequately evaluated in humans. Eighty-two patients (52 males [63%]; mean age, 65 +/- 12 years; mean body surface area [BSA], 1.8 +/- 0.2 m(2)) had IAB counterpulsation for cardiogenic shock, refractory angina, and preoperatively for high-risk cardiac surgery. Cardiac hemodynamics were prospectively studied during IAB with inflation volumes of 32 vs. 40 cc. Hemodynamic data collected included aortic pressure, pulmonary artery pressure, systemic and mixed venous oxygen saturations, and cardiac output (by Fick). Transthoracic echocardiography (TTE) was used to obtain both velocity time integrals (VTIs) and the area of the left ventricular outflow tract (LVOT). Left ventricular stroke volume was then calculated as LVOT area x VTI. Cardiac output (CO) determined by the Fick method and VTI did not differ significantly (P = NS) between the two inflation volumes (y = 0.002 + 0.97x). In a subgroup of 33 patients with BSA

  9. Development of the hearts of lizards and snakes and perspectives to cardiac evolution.

    Science.gov (United States)

    Jensen, Bjarke; van den Berg, Gert; van den Doel, Rick; Oostra, Roelof-Jan; Wang, Tobias; Moorman, Antoon F M

    2013-01-01

    Birds and mammals both developed high performance hearts from a heart that must have been reptile-like and the hearts of extant reptiles have an unmatched variability in design. Yet, studies on cardiac development in reptiles are largely old and further studies are much needed as reptiles are starting to become used in molecular studies. We studied the growth of cardiac compartments and changes in morphology principally in the model organism corn snake (Pantherophis guttatus), but also in the genotyped anole (Anolis carolinenis and A. sagrei) and the Philippine sailfin lizard (Hydrosaurus pustulatus). Structures and chambers of the formed heart were traced back in development and annotated in interactive 3D pdfs. In the corn snake, we found that the ventricle and atria grow exponentially, whereas the myocardial volumes of the atrioventricular canal and the muscular outflow tract are stable. Ventricular development occurs, as in other amniotes, by an early growth at the outer curvature and later, and in parallel, by incorporation of the muscular outflow tract. With the exception of the late completion of the atrial septum, the adult design of the squamate heart is essentially reached halfway through development. This design strongly resembles the developing hearts of human, mouse and chicken around the time of initial ventricular septation. Subsequent to this stage, and in contrast to the squamates, hearts of endothermic vertebrates completely septate their ventricles, develop an insulating atrioventricular plane, shift and expand their atrioventricular canal toward the right and incorporate the systemic and pulmonary venous myocardium into the atria.

  10. Galaxy Outflows Without Supernovae

    CERN Document Server

    Sur, Sharanya; Ostriker, Eve C

    2016-01-01

    High surface density, rapidly star-forming galaxies are observed to have $\\approx 50-100\\,{\\rm km\\,s^{-1}}$ line-of-sight velocity dispersions, which are much higher than expected from supernova driving alone, but may arise from large-scale gravitational instabilities. Using three-dimensional simulations of local regions of the interstellar medium, we explore the impact of high velocity dispersions that arise from these disk instabilities. Parametrizing disks by their surface densities and epicyclic frequencies, we conduct a series of simulations that probe a broad range of conditions. Turbulence is driven purely horizontally and on large scales, neglecting any energy input from supernovae. We find that such motions lead to strong global outflows in the highly-compact disks that were common at high redshifts, but weak or negligible mass loss in the more diffuse disks that are prevalent today. Substantial outflows are generated if the one-dimensional horizontal velocity dispersion exceeds $\\approx 35\\,{\\rm km\\...

  11. A rare case of cardiac anomaly: prenatally diagnosed ectopia cordis.

    Science.gov (United States)

    Çelik, Yalçın; Hallıoğlu, Olgu; Basut, Nursel; Demetgül, Hasan; Esin Kibar, A

    2015-06-01

    Ectopia cordis is a rare congenital malformation in which the heart is located partially or totally outside the thoracic cavity. The estimated prevalence of ectopia cordis is 5.5-7.9 per million births and it comprises 0.1% of congenital heart diseases. Ectopia cordis is associated with other congenital heart diseases and various tissue and organ disorders. Common cardiac anomalies associated with ectopia cordis include ventricular septal defect, atrial septal defect, pulmonary stenosis, right ventricular diverticulum, double right ventricular outflow tract and tetralogy of Fallot. Extracardiac anomalies associated with ectopia cordis reported in the literature include omphalocele, gastrochisis, cleft lip and palate, scollosis and central nervous system malformations. Here we report a newborn with ectopia cordis who was diagnosed prenatally.

  12. Searching for Brown Dwarf Outflows

    CERN Document Server

    Whelan, E T; Bacciotti, F; Randich, S; Natta, A

    2009-01-01

    As outflow activity in low mass protostars is strongly connected to ac- cretion it is reasonable to expect accreting brown dwarfs to also be driving out- flows. In the last three years we have searched for brown dwarf outflows using high quality optical spectra obtained with UVES on the VLT and the technique of spectro-astrometry. To date five brown dwarf outflows have been discovered. Here the method is discussed and the results to date outlined.

  13. Study of left ventricular systolic synchrony and sequence in patients with premature ventricular complexes from right ventricular outflow tract%右心室流出道起源室性期前收缩患者左心室收缩同步性及时序的研究

    Institute of Scientific and Technical Information of China (English)

    姚静; 许迪; 陆凤翔; 雍永宏; 庄燕; 季玲; 曹克将

    2010-01-01

    目的 分析正常人及右室流出道(right ventricular outflow tract,RVOT)起源室性期前收缩(premature ventricular complexes,PVCs)患者收缩期应变达峰时间,探讨RVOT起源PVCs患者心肌收缩同步性及时序规律.方法 应用斑点追踪成像(speckle tracking imaging,STI)技术测量30例RVOT起源PVCs患者在窦性心搏、室性心搏时及30例正常人纵向(TsL)、环周(TsC)、径向(TsR)收缩期应变达峰时间,分别计算标准差,并分析室性心搏时各方向应变达峰时间时序分布规律.结果 与正常对照组比较,RVOT起源PVCs患者在室性心搏时TsL、TsC、TsR标准差均增大,窦性心搏时TsC、TsR标准差增大.室性心搏时,TsL、TsR从心尖至基底的不同层面间差异显著;TsL、TsC在不同室壁间差异显著.结论 RVOT起源PVCs患者在窦性心搏及室性心搏时均存在失同步状态,其中室性心搏时各方向应变达峰时间时序分布存在规律.%Objective To evaluate left ventricular(LV) systolic synchrony and sequence in patients with premature ventricular complexes(PVCs) from right ventricular outflow tract (RVOT).Methods Thirty patients with frequent isolated PVCs from RVOT and 30 healthy subjects as control were included.Speckle tracking imaging (STI) was performed to assess the time-to-peak segmental systolic strain in longit udinal(TsL), circumferential (TsC) and radial (TsR) direction.The standard deviation (SD) of TsL,TsC and TsR of 18 LV segments were calculated respectively.All values of patients with PVCs were recorded during sinus beats(PVC-S) and PVC beats(PVC-V) respectively.LV systolic sequence in PVC-V was analyzed.Results Significant differences were observed in the SD values between the PVC-V and control subjects in three directions,as well as between the PVC-S and control subjects in circumferential and radial direction.In PVC-V significance difference was seen in TsL and TsR from apical to basal level,as well as in TsL and TsC in different

  14. 流出道起源室性早搏心电图特征及其对射频消融靶点的判断价值%ECG characteristics of outflow tract originated premature ventricular contraction and their location value for radiofrequency ablation target

    Institute of Scientific and Technical Information of China (English)

    孙卫红; 李文华

    2016-01-01

    目的:研究室性早搏(室早)的心电图特征及对流出道室早的定位价值。方法回顾68例成功消融的右室流出道(RVOT)和左室流出道(LOVT)室早患者的图形,测量胸前导联 R/S值、R/S 转换部位、V2导联 QRS 波时限、V2导联 R 波振幅指数和 R 波时限指数,探讨其与射频消融靶点的关系。结果54例起源于 RVOT 与14例起源于 LVOT 的室早患者一般情况无显著差异。RVOT 室早比 LVOT 室早时限更短(P <0.05),R/S 转换在 V1~V2导联的有12例,其中LVOT 11例,特异性91.67%,敏感性78.57%;转换在 V3导联的24例,其中 RVOT 21例,特异性87.50%,敏感性38.89%;转换在 V4~V6导联的为32例 RVOT 患者,特异性100%,敏感性59.26%;V2导联 R 波振幅指数和时限指数对 RVOT 室早的定位价值低于对 LVOT 室早的定位价值(P <0.05)。结论R/S 转换在 V2或 V2之前对 LVOT 的诊断价值大;转换在 V4或 V4之后对 ROVT 的诊断价值大;对于 R/S 转换在 V2~V3导联时,V2导联 QRS 波时限、R 波时限指数和 R 波振幅指数三个指标对确定室早的起源部位具有重要的价值。%Objective To explore the ECG characteristics of premature ventricular contraction (PVC)and their location value for outflow tract originated PVC.Methods Retrospective analysis was performed on the figures of 68 successfully ablated cases with right ventricular outflow tract (RVOT)PVC or left ventricular outflow tract (LVOT)PVC.We measured R/S value of precordial leads,switch site of R/S,QRS complex duration of V2 lead,amplitude and duration indices of R wave in V2 lead,and then discussed the relationship between each of the above index and radiofre-quency ablation target.Results There was no significant difference in general circumstances be-tween 54 RVOT-PVC and 1 4 LVOT-PVC patients.The duration of RVOT-PVC was shorter than that of LVOT-PVC(P <0

  15. Electrophysiological effects of lidocaine on myocardial tissue in guinea-pig left ventricular outflow tract under conditions of hypoxia, acidosis and treatment with epinephrine%利多卡因对低氧、酸中毒及肾上腺素条件下豚鼠左心室流出道心肌组织电活动的影响

    Institute of Scientific and Technical Information of China (English)

    赵兰平; 王雪芳; 杜会博; 薛淑芳; 陈彦静

    2013-01-01

    AIM; To study the electrophysiological effects of lidocaine on the myocardial tissue in guinea-pig left ventricular outflow tract under the conditions of hypoxia, acidosis and treatment with epinephrine. METHODS: The action potentials of pacemaker cells in guinea-pig left ventricular outflow tract were recorded by conventional technique with intracellular microelectrodes. The effects of lidocaine on the spontaneous slow response potentials were investigated under the conditions of hypoxia, acidosis and treatment with epinephrine (EPI). RESULTS: Lidocaine markedly decreased the rate of pacemaker firing ( RPF) , the velocity of diastolic depolarization ( VDD) , the maximal rate of depolarization ( Vmax), the maximal diastolic potential (MDP) and the amplitude of action potential ( APA). Lidocaine also shortened the 50% and 80% of duration of action potential (APD50 and APD80). At the concentrations from 0.1 μmol/L to 10 μmol/L, the effects of lidocaine were more significant. Under the condition of hypoxia and perfusion with deprived glucose content for 15 min, VDD, RPF, Vmax, MDP and APA significantly decreased, and APD50 notably shortened. Under the condition of hypoxia, lidocaine at 1 μmol/L significantly decreased VDD, RPF, Vmax and APA as compared with the cells treated with hypoxia only. Perfusion with pH 6.8 solution for 10 min, VDD, RPF, Vmax and APA significantly decreased, MDP notably increased, and APD50 and APD80 markedly shortened. Under the condition of acidosis for 10 min, lidocaine significantly decreased VDD, RPF and Vmax, and lengthened APD50 and APD80 as compared with the cells under the condition of acidosis alone. Perfusion with EPI at 10 μmol/L for 10 min resulted in significant increases in VDD, RPF, Vmax, MDP and APA, and notable shortenings of APD50 and APD80, were also observed. Compared with 10 μmol/L EPI group, 1 μmol/L lidocaine +10 μmol/L EPI significantly reduced VDD, RPF, MDP and APA, and lengthened APD50, and APD80. CONCLUSION

  16. Galnt1 is required for normal heart valve development and cardiac function.

    Directory of Open Access Journals (Sweden)

    E Tian

    Full Text Available Congenital heart valve defects in humans occur in approximately 2% of live births and are a major source of compromised cardiac function. In this study we demonstrate that normal heart valve development and cardiac function are dependent upon Galnt1, the gene that encodes a member of the family of glycosyltransferases (GalNAc-Ts responsible for the initiation of mucin-type O-glycosylation. In the adult mouse, compromised cardiac function that mimics human congenital heart disease, including aortic and pulmonary valve stenosis and regurgitation; altered ejection fraction; and cardiac dilation, was observed in Galnt1 null animals. The underlying phenotype is aberrant valve formation caused by increased cell proliferation within the outflow tract cushion of developing hearts, which is first detected at developmental stage E11.5. Developing valves from Galnt1 deficient animals displayed reduced levels of the proteases ADAMTS1 and ADAMTS5, decreased cleavage of the proteoglycan versican and increased levels of other extracellular matrix proteins. We also observed increased BMP and MAPK signaling. Taken together, the ablation of Galnt1 appears to disrupt the formation/remodeling of the extracellular matrix and alters conserved signaling pathways that regulate cell proliferation. Our study provides insight into the role of this conserved protein modification in cardiac valve development and may represent a new model for idiopathic valve disease.

  17. Absorbing Outflows in AGN

    Science.gov (United States)

    Mathur, Smita

    2002-01-01

    The goal of this program was a comprehensive multiwavelength study of absorption phenomena in active galactic nuclei (AGN). These include a variety of associated absorption systems: X-ray warm absorbers, X-ray cold absorbers. UV absorbers with high ionization lines, MgII absorbers, red quasars and BALQSOs. The aim is to determine the physical conditions in the absorbing outflows, study their inter-relations and their role in AGN. We designed several observing programs to achieve this goal: X-ray spectroscopy, UV spectroscopy, FLAY spectroscopy and X-ray imaging. We were very successful towards achieving the goal over the five year period as shown through following observing programs and papers. Copies of a few papers are attached with this report.

  18. Astrophysical Jets and Outflows

    CERN Document Server

    De Gouveia dal Pino, E M

    2004-01-01

    Highly collimated supersonic jets and less collimated outflows are observed to emerge from a wide variety of astrophysical objects. They are seen in young stellar objects (YSOs), proto-planetary nebulae, compact objects (like galactic black holes or microquasars, and X-ray binary stars), and in the nuclei of active galaxies (AGNs). Despite their different physical scales (in size, velocity, and amount of energy transported), they have strong morphological similarities. What physics do they share? These systems either hydrodynamic or magnetohydrodynamic (MHD) in nature and are, as such, governed by non-linear equations. While theoretical models helped us to understand the basic physics of these objects, numerical simulations have been allowing us to go beyond the one-dimensional, steady-state approach extracting vital information. In this lecture, the formation, structure, and evolution of the jets are reviewed with the help of observational information, MHD and purely hydrodynamical modeling, and numerical si...

  19. Human fetal cardiac progenitors: The role of stem cells and progenitors in the fetal and adult heart.

    Science.gov (United States)

    Bulatovic, Ivana; Månsson-Broberg, Agneta; Sylvén, Christer; Grinnemo, Karl-Henrik

    2016-02-01

    The human fetal heart is formed early during embryogenesis as a result of cell migrations, differentiation, and formative blood flow. It begins to beat around gestation day 22. Progenitor cells are derived from mesoderm (endocardium and myocardium), proepicardium (epicardium and coronary vessels), and neural crest (heart valves, outflow tract septation, and parasympathetic innervation). A variety of molecular disturbances in the factors regulating the specification and differentiation of these cells can cause congenital heart disease. This review explores the contribution of different cardiac progenitors to the embryonic heart development; the pathways and transcription factors guiding their expansion, migration, and functional differentiation; and the endogenous regenerative capacity of the adult heart including the plasticity of cardiomyocytes. Unfolding these mechanisms will become the basis for understanding the dynamics of specific congenital heart disease as well as a means to develop therapy for fetal as well as postnatal cardiac defects and heart failure.

  20. Intra-cardiac echocardiography in alcohol septal ablation

    DEFF Research Database (Denmark)

    Cooper, Robert M; Shahzad, Adeel; Newton, James;

    2015-01-01

    Alcohol septal ablation (ASA) in hypertrophic obstructive cardiomyopathy reduces left ventricular outflow tract gradients. A third of patients do not respond; inaccurate localisation of the iatrogenic infarct can be responsible. Transthoracic echocardiography (TTE) using myocardial contrast can b...

  1. Efficacy and safety of radiofrequency catheter ablation of premature ventricular contractions origina ting from the right ventricular outflow tract%右心室流出道室性早搏射频消融治疗的有效性和安全性评价

    Institute of Scientific and Technical Information of China (English)

    朱文青; 王张生; 巫慧钧; 周一泉; 许澎; 孙万峰; 冯凯; 谷慧敏; 葛均波

    2009-01-01

    目的 评价应用Carto系统射频消融治疗右心室流出道起源性室性早搏(室早)有效性和安全性.方法 选择2005年5月至2007年12月临床治疗的47例室早患者,其中男性21例,女性26例,平均年龄(34.5±19.2)岁,病程3~38个月.射频所用能量为40 W,时间为120~240 s,温度设定为60℃.分别在消融术前和术后1、3和12个月进行动态心电图检查.结果 47例中成功45例,有效率为95.8%.2例1年后复发新的早搏,未发现任何并发症.结论 应用Carto系统对右心室流出道起源性室早经射频消融治疗是有效和安全的.%Objective To assess efficacy and safety in patients with right ventricular outflow tract (RVOT) arrhythmias treated with radiofrequency catheter ablation (RFCA) combined with electro-anatomical mapping system (Carto). Methods The study group consisted of 47 consecutive patients (mean age 34. 5 ± 19.2 years,range 18~61 years,21 males,26 females) with symptomatic arrhythmias originating from RVOT, who underwent RFCA between Oct. 2005 and Dec. 2007. RFCA was performed with the use of the Carto system. The power of RF current was set at 40 Watts,duration 120~240 seconds,and maximal temperature 60 degrees C. In order to assess RFCA efficacy,a 24-hour Holter ECG monitoring was performed before RFCA and shortly after the procedure as well as one, three and twelve months afterwards. Results Holter ECG monitoring after RFCA showed that the procedure was successful in 45 (95. 8%) patients. In the remaining two patients no sig nificant reduction in the frequency of ventricular ectopy was noted,however,no complex ventricular arrhythmias were observed. None of the complications were observed. Conclusion RFCA with the use of the Carto system is effective and safe in the treatment of arrhythmias originating from RVOT.

  2. 单中心流出道室性早搏门诊调查与心电图特征分析%The investigation of the occurrence and characteristics of outpatients with premature ventricular contractions origi-nating from ventricular outflow tract detected by electrocardiogram in a single center

    Institute of Scientific and Technical Information of China (English)

    满艺龙; 杨兵; 汪道武; 陈明龙; 曹克将; 李小荣; 肖峰; 杜为; 刘榜霞; 陈惠平; 王子盾; 郑雅云; 张凤祥

    2014-01-01

    Objective To investigate the occurrence and characteristics of outpatients with premature ventricular con-tractions originating from ventricular outflow tract ( OT-PVC) detected by electrocardiogram ( ECG) in a single center. Methods We collected and analyzed the general characteristics and ECG of outpatients who were diagnosed as OT-PVC from January 01, 2013 to June 30, 2013 in the department of cardiology of the First Affiliated Hospital of Nanjing Medical University. Results ECG of 5545 outpatients were obtained in six months, in whom there were 160 patients (2. 89%) with OT-PVC, including 62 males(38. 75%) and 98 females(61. 25%). Thirty eight patients with OT-PVC (3. 53%) were between 50 and 60 years old and its ratio was higher than the other OT-PVC patients who were less than 50 and more than 60 years old. The ECG in 71 patients (44. 38%) with OT-PVC showed the following abnormalities, including T-wave inversion, ST-segment depression, atrial fibrillation, over-loading of left atrium and premature atrial complex. The average age of patients with ECG abnormalities was elder than that of patients without ECG abnormality [(62. 18±12. 03) vs (46. 37±16. 30) years old, P50~60)岁年龄段患者38例,占3.53%,高于其他年龄段。71例OT鄄PVC患者(44.38%)合并其他类型的心电图异常,依次为T波倒置、ST压低、心房颤动、左房负荷异常及房性早搏。分析发现这71例患者与未合并上述心电图异常的89例OT鄄PVC患者相比平均年龄偏大[(62.2±12.0)岁 vs (46.4±16.3)岁, P<0.05]。结论单中心心血管病门诊就诊人群心电图OT鄄PVC检出率为2.89%,其中(逸50~60)岁人群的OT鄄PVC检出率高于其他年龄段。随着年龄的增长,OT鄄PVC患者更易合并其他类型的心电图异常。

  3. Astrophysical jets and outflows

    Science.gov (United States)

    de Gouveia Dal Pino, Elisabete M.

    Highly collimated supersonic jets and less collimated outflows are observed to emerge from a wide variety of astrophysical objects. They are seen in young stellar objects (YSOs), proto-planetary nebulae, compact objects (like galactic black holes or microquasars, and X-ray binary stars), and in the nuclei of active galaxies (AGNs). Despite their different physical scales (in size, velocity, and amount of energy transported), they have strong morphological similarities. What physics do they share? These systems are either hydrodynamic or magnetohydrodynamic (MHD) in nature and are, as such, governed by non-linear equations. While theoretical models helped us to understand the basic physics of these objects, numerical simulations have been allowing us to go beyond the one-dimensional, steady-state approach extracting vital information. In this lecture, the formation, structure, and evolution of the jets are reviewed with the help of observational information, MHD and purely hydrodynamical modeling, and numerical simulations. Possible applications of the models particularly to YSOs and AGN jets are addressed.

  4. Energy exchanges in reconnection outflows

    Science.gov (United States)

    Lapenta, Giovanni; Goldman, Martin V.; Newman, David L.; Markidis, Stefano

    2017-01-01

    Reconnection outflows are highly energetic directed flows that interact with the ambient plasma or with flows from other reconnection regions. Under these conditions the flow becomes highly unstable and chaotic, as any flow jets interacting with a medium. We report here massively parallel simulations of the two cases of interaction between outflow jets and between a single outflow with an ambient plasma. We find in both case the development of a chaotic magnetic field, subject to secondary reconnection events that further complicate the topology of the field lines. The focus of the present analysis is on the energy balance. We compute each energy channel (electromagnetic, bulk, thermal, for each species) and find where the most energy is exchanged and in what form. The main finding is that the largest energy exchange is not at the reconnection site proper but in the regions where the outflowing jets are destabilized.

  5. 右室流出道起源的室性心律失常消融靶点与电压异常区位置分布的相关性研究%Correlation Study between the Ablation Target of Ventricular Arrhythmia Originated from Right Ventricular Outflow Tract and the Distribution of Abnormal Voltage Region

    Institute of Scientific and Technical Information of China (English)

    庞暘; 程宽; 徐烨; 陈庆兴; 朱文青

    2015-01-01

    目的:(1)探讨右室流出道(right ventricular outflow tract ,RVOT)起源室性早搏(premature ventricular complex , PVC)及室性心动过速(ventricular tachycardia ,VT)的消融靶点分布特点及其电压特点;(2)探讨 RVOT 起源心律失常与RVOT局部低电压区的关系。方法:对97例心电图提示RVOT 起源的室性心律失常患者行射频消融术,术中共记录到99种PVC、6种VT。在消融前行三维电压标测,电压小于0.5 mV的区域定义为低电压区,电压为0.5~1.5 mV的区域为电压移行区域,电压大于1.5 m V的区域为正常电压区域。结果:87例患者消融成功,10例患者消融失败。2例患者的室性心律失常起源于主动脉窦,95例患者的室性心律失常起源于RVOT。起源于RVOT 的PVC患者,8个靶点位于低电压区,59个靶点位于电压移行区,30个靶点位于正常电压区。靶点处电压异常的患者中,3例的消融靶点位于肺动脉瓣下低电压区及电压移行区,34例患者的消融靶点位于局部低电压区及电压移行区。结论:对RVOT起源的室性心律失常进行射频消融,成功靶点大多位于电压移行区;肺动脉瓣下肌袖组织及局部纤维脂肪化心肌组织是RVOT起源的室性心律失常的主要发病机制之一。%Objective:(1)To explore the distribution features of ablation target of premature ventricular complex(PVC) origi‐nated from right ventricular outflow tract(RVOT) and ventricular tachycardia(VT) and its voltage characteristics .(2)To ex‐plore the relationship between ventricular arrhythmia originated from RVOT and regional low voltage of ROVT .Methods:A to‐tal of 97 patients ,who were indicated as ventricular arrhythmia originated from RVOT by electrocardiogram ,underwent radio‐frequency catheter ablation (RFCA) .During the operation ,99 morphologies of PVC and 6 morphologies of VT were recorded . Detailed three

  6. Study of intracardiac flow patterns of left ventricle in patients with premature ventricular complexes from the right ventricular outflow tract%右心室流出道起源室性期前收缩患者左心室腔流场分布模式的研究

    Institute of Scientific and Technical Information of China (English)

    姚静; 许迪; 李相权; 吴红平; 雍永宏; 季玲; 陈莉

    2011-01-01

    Objective To evaluate the patterns of intracardiac flow of left ventricle (LV) in patients with premature ventricular complexes (PVCs) from the right ventricular outflow tract (RVOT) by analyzing the vortex during isovolumetric contraction phase and the distribution rules of flow-time curves in each layer of LV.Methods Twenty-seven patients with frequent isolated PVCs from RVOT were involved and 25 healthy subjects as control.The color Doppler image of LV at apical four-chamber view was acquired.Vector flow mapping (VFM) was performed to assess the parameters of vortex during isovolumic contraction phase, including diameter (transverse and vertical diameter), velocity (maximal positive and negative velocity) and the number of vortex rings.Positive flow during systole and negative flow during diastole of LV in each layer were measured by flow-time curve.All values of patients with PVCs were recorded during sinus beats (PVC-S) and PVC (PVC-V) respectively.Results Significant differences were demonstrated in all parameters of vortex between the PVC-V and control subjects.And the flow-time curves disarrayed in PVC-V.The velocity of vortex in PVC-S was lower than that in control subjects.And the distribution pattern of flow-time curves in LV of PVC-S differed from that of control subjects.Conclusions Alternation of intracardiac fluid pattern in LV was demonstrated in patients with PVCs from RVOT during both sinus beats and PVC.VFM can be used to analyze the intracardiac flow field in normal and pathological electrical activation.%目的 分析正常人及右室流出道(right ventricular outflow tract,RVOT)起源室性期前收缩(premature ventricular complexes,PVCs)患者左心室腔等容收缩期涡流及左心室腔不同层面时间-血流曲线分布规律,探讨RVOT起源PVCs对左心室腔流场分布模式的影响。方法 分别获取27例RVOT起源PVCs患者在窦性心搏、室性期前收缩时及25例正常人的心尖四腔观二维彩色多普勒

  7. Right ventricular outflow and apical pacing comparably worsen the echocardioghraphic normal left ventricle

    NARCIS (Netherlands)

    T.J.F. ten Cate (Tim); M.G. Scheffer (Michael); G.R. Sutherland (George); J.F. Verzijlbergen (Fred); N.M. van Hemel (Norbert)

    2008-01-01

    textabstractAims: A depressed left ventricular function (LVF) is sometimes observed during right ventricular apical (RVA) pacing, but any prediction of this adverse effect cannot be done. Right ventricular outflow tract (RVOT) pacing is thought to deteriorate LVF less frequently because of a more no

  8. Emergence of a Quasar Outflow

    CERN Document Server

    Hamann, F; Hidalgo, P Rodriguez; Prochaska, J X; Herbert-Fort, S

    2008-01-01

    We report the first discovery of the emergence of a high-velocity broad-line outflow in a luminous quasar, J105400.40+034801.2 at redshift z ~ 2.1. The outflow is evident in ultraviolet CIV and SiIV absorption lines with velocity shifts v ~ 26,300 km/s and deblended widths FWHM ~ 4000 km/s. These features are marginally strong and broad enough to be considered broad absorption lines (BALs), but their large velocities exclude them from the standard BAL definition. The outflow lines appeared between two observations in the years 2002.18 and 2006.96. A third observation in 2008.48 showed the lines becoming ~40% weaker and 10% to 15% narrower. There is no evidence for acceleration or for any outflow gas at velocities 21.2 and average space density n_H > 2 x 10^5 cm^-3. We attribute the emergence of the outflow lines to a substantial flow structure moving across our line of sight, possibly near the ragged edge of the main BAL flow or possibly related to the onset of a BAL evolutionary phase.

  9. Outflow from Hot Accretion Flows

    CERN Document Server

    Yuan, Feng; Wu, Maochun

    2012-01-01

    Numerical simulations of hot accretion flows have shown that the mass accretion rate decreases with decreasing radius. Two models have been proposed to explain this result. In the adiabatic inflow-outflow solution (ADIOS), it is thought to be due to the loss of gas in outflows. In the convection-dominated accretion flow (CDAF) model, it is explained as because that the gas is locked in convective eddies. In this paper we use hydrodynamical (HD) and magnetohydrodynamical (MHD) simulations to investigate which one is physical. We calculate and compare various properties of inflow (gas with an inward velocity) and outflow (gas with an outward velocity). Systematic and significant differences are found. For example, for HD flows, the temperature of outflow is higher than inflow; while for MHD flows, the specific angular momentum of outflow is much higher than inflow. We have also analyzed the convective stability of MHD accretion flow and found that they are stable. These results suggest that systematic inward an...

  10. Cardiac power integral: a new method for monitoring cardiovascular performance.

    Science.gov (United States)

    Rimehaug, Audun E; Lyng, Oddveig; Nordhaug, Dag O; Løvstakken, Lasse; Aadahl, Petter; Kirkeby-Garstad, Idar

    2013-11-01

    Cardiac power (PWR) is the continuous product of flow and pressure in the proximal aorta. Our aim was to validate the PWR integral as a marker of left ventricular energy transfer to the aorta, by comparing it to stroke work (SW) under multiple different loading and contractility conditions in subjects without obstructions in the left ventricular outflow tract. Six pigs were under general anesthesia equipped with transit time flow probes on their proximal aortas and Millar micromanometer catheters in their descending aortas to measure PWR, and Leycom conductance catheters in their left ventricles to measure SW. The PWR integral was calculated as the time integral of PWR per cardiac cycle. SW was calculated as the area encompassed by the pressure-volume loop (PV loop). The relationship between the PWR integral and SW was tested during extensive mechanical and pharmacological interventions that affected the loading conditions and myocardial contractility. The PWR integral displayed a strong correlation with SW in all pigs (R (2) > 0.95, P integral relationship was similar among all six animals, whereas loading and contractility conditions tended to affect the slope. The PWR integral followed SW and appeared to be a promising parameter for monitoring the energy transferred from the left ventricle to the aorta. This conclusion motivates further studies to determine whether the PWR integral can be evaluated using less invasive methods, such as echocardiography combined with a radial artery catheter.

  11. Permanent cardiac pacing in pediatric patients.

    Science.gov (United States)

    Lotfy, Wael; Hegazy, Ranya; AbdElAziz, Osama; Sobhy, Rodina; Hasanein, Hossam; Shaltout, Fawzan

    2013-02-01

    Pediatric pacemaker (PM) implants comprise less than 1 % of all PM implants. This study aimed to investigate permanent cardiac pacing among the pediatric population, identifying different indications and complications of pediatric cardiac pacing, especially focusing on the effect of the pacing sites, the PM lead type, and the indications for pacing. The current work is a cross-sectional study of 103 procedures for permanent PM insertion in pediatric patients between January 2001 and December 2010. The patients were followed up 1, 3, and 6 months after implantation, then every 6 months or as needed. Evaluation included routine clinical examination, electrocardiography, chest X-ray, echocardiography, and a full analysis of the pacing system measurements. The ages of the patients ranged from 0.09 to 12 years (median, 2.3 years). The most common indication for pacing was postoperative complete heart bock, noted in 54 patients (52.4 %). Transvenous endocardial PM insertion was performed in 92 procedures (89.3 %), whereas transthoracic epicardial insertion was performed in 11 procedures (10.7 %). The most common site of pacing was the right ventricular apex (n = 64, 62 %), followed by the right ventricular outflow tract (n = 25, 24.3 %). Transthoracic epicardial PM insertion was associated with a significantly higher percentage and greater severity of complications. In this study, 65 % of the patients with left ventricle (LV) dilation before pacing showed a significant improvement in LV dimensions and function after pacing. This was noted only in those with endocardially inserted PM leads in both the congenital and the postoperative groups regardless of the pacing site. Endocardial PM insertion in children is a safe procedure with fewer complications and a lower ventricular threshold than the epicardial route. Permanent single-chamber right ventricle pacing is safe and can lead to significant improvement in LV function and dimensions. However, long-term follow

  12. Differentially expressed genes in embryonic cardiac tissues of mice lacking Folr1 gene activity

    Directory of Open Access Journals (Sweden)

    Schwartz Robert J

    2007-11-01

    Full Text Available Abstract Background Heart anomalies are the most frequently observed among all human congenital defects. As with the situation for neural tube defects (NTDs, it has been demonstrated that women who use multivitamins containing folic acid peri-conceptionally have a reduced risk for delivering offspring with conotruncal heart defects 123. Cellular folate transport is mediated by a receptor or binding protein and by an anionic transporter protein system. Defective function of the Folr1 (also known as Folbp1; homologue of human FRα gene in mice results in inadequate transport, accumulation, or metabolism of folate during cardiovascular morphogenesis. Results We have observed cardiovascular abnormalities including outflow tract and aortic arch arterial defects in genetically compromised Folr1 knockout mice. In order to investigate the molecular mechanisms underlying the failure to complete development of outflow tract and aortic arch arteries in the Folr1 knockout mouse model, we examined tissue-specific gene expression difference between Folr1 nullizygous embryos and morphologically normal heterozygous embryos during early cardiac development (14-somite stage, heart tube looping (28-somite stage, and outflow track septation (38-somite stage. Microarray analysis was performed as a primary screening, followed by investigation using quantitative real-time PCR assays. Gene ontology analysis highlighted the following ontology groups: cell migration, cell motility and localization of cells, structural constituent of cytoskeleton, cell-cell adhesion, oxidoreductase, protein folding and mRNA processing. This study provided preliminary data and suggested potential candidate genes for further description and investigation. Conclusion The results suggested that Folr1 gene ablation and abnormal folate homeostasis altered gene expression in developing heart and conotruncal tissues. These changes affected normal cytoskeleton structures, cell migration and

  13. Molecular Outflows: Explosive versus Protostellar

    Science.gov (United States)

    Zapata, Luis A.; Schmid-Burgk, Johannes; Rodríguez, Luis F.; Palau, Aina; Loinard, Laurent

    2017-02-01

    With the recent recognition of a second, distinctive class of molecular outflows, namely the explosive ones not directly connected to the accretion–ejection process in star formation, a juxtaposition of the morphological and kinematic properties of both classes is warranted. By applying the same method used in Zapata et al., and using 12CO(J = 2-1) archival data from the Submillimeter Array, we contrast two well-known explosive objects, Orion KL and DR21, to HH 211 and DG Tau B, two flows representative of classical low-mass protostellar outflows. At the moment, there are only two well-established cases of explosive outflows, but with the full availability of ALMA we expect that more examples will be found in the near future. The main results are the largely different spatial distributions of the explosive flows, consisting of numerous narrow straight filament-like ejections with different orientations and in almost an isotropic configuration, the redshifted with respect to the blueshifted components of the flows (maximally separated in protostellar, largely overlapping in explosive outflows), the very-well-defined Hubble flow-like increase of velocity with distance from the origin in the explosive filaments versus the mostly non-organized CO velocity field in protostellar objects, and huge inequalities in mass, momentum, and energy of the two classes, at least for the case of low-mass flows. Finally, all the molecular filaments in the explosive outflows point back to approximately a central position (i.e., the place where its “exciting source” was located), contrary to the bulk of the molecular material within the protostellar outflows.

  14. Ablação com radiofreqüência de extra-sístoles da via de saída do ventrículo direito Radiofrequency catheter ablation of premature ventricular contractions originating in the right ventricular outflow tract

    Directory of Open Access Journals (Sweden)

    Francisco C. C. Darrieux

    2007-03-01

    Full Text Available OBJETIVOS: Avaliar se a ablação com radiofreqüência é um procedimento eficiente para o tratamento das extra-sístoles da via de saída do ventrículo direito (EVSVD, e se resulta em melhora dos sintomas. MÉTODOS: Estudo prospectivo, com 30 pacientes consecutivos (idade média de 40±13 anos, 25 do sexo feminino, sem cardiopatia estrutural aparente, com EVSVD, muito freqüentes (densidade média de 1.263±593/h, sintomáticos por mais de 1 ano (média =74 meses e refratários aos fármacos antiarrítmicos (3±1,7, incluindo os beta-bloqueadores, que foram submetidos à ablação com radiofreqüência. RESULTADOS: Após o primeiro procedimento, houve 23 sucessos iniciais (76,6% e 7 iniciais insucessos (23,4%. Quatro pacientes tiveram recorrências, sendo que dois desses não se submeteram ao segundo procedimento. O segundo procedimento foi realizado em 9 pacientes (7 insucessos iniciais e 2 recorrências, e o sucesso ocorreu em 5 pacientes adicionais, sendo 1 caso por acesso epicárdico. A taxa de sucesso final foi de 80% (24/30, e nenhuma complicação maior ocorreu. Após um seguimento médio de 14±6 meses, no grupo de sucesso final houve uma redução de mais de 90% na densidade das extra-sístoles(24/24; pOBJECTIVES: To evaluate if radiofrequency catheter ablation is an effective procedure for the treatment of right ventricular outflow tract premature ventricular contractions (RVOT-PVC and ascertain if it results in an improvement of symptoms. METHODS: A prospective study with 30 consecutive patients (mean age 40 ± 13 years, 25 females, with no apparent structural cardiopathy, with very frequent (mean density of 1,263 ± 593/h RVOT-PVC, symptomatic for more than one year (mean = 74 months and resistant to antiarrhythmic drugs (3 ± 1.7, including beta-blockers, who underwent radiofrequency catheter ablation. RESULTS: After the first procedure, there were 23 initial successful cases (76.6% and 7 initial failures (23.4%. Four patients

  15. 磁导航系统遥控导管消融治疗右心室流出道室性心动过速/室性早搏%Remote radiofrequency catheter ablation of right ventricular outflow tract ventricular tachycardia/pre-mature ventricular complexes using the magnetic navigation system combined with non-contact map-ping system

    Institute of Scientific and Technical Information of China (English)

    翟立上; 顾凯; 陈明龙; 曹克将; 杨兵; 孙建辉; 徐东杰; 张凤祥; 居维竹; 陈红武; 郦明芳; 杨刚

    2014-01-01

    Objective To evaluate the safety and efficacy of remote radiofrequency catheter ablation of right ventricular outflow tract ventricular tachycardia/premature ventricular complexes ( RVOT-VT/PVCs ) using the magnetic navigation system combined with the non-contact mapping system. Methods Totally 16 pa-tients with RVOT-VT/PVCs [12 women and 4 men,mean aged (44±15) years] were enrolled. The original site of arrhythmias was determined by non-contact activation mapping and conventional pace mapping. Ablation was performed using HeliosⅡmagnetic temperature-controled catheter manipulated by NiobeⅡmagnetic navi-gation system. If failed with magnetic system,the procedure would be transferred to manually controlled session. Results Among 10 of 16 subjects,documented RVOT-VT/PVCs were successfully abolished by remote abla-tion controlled by magnetic navigation system. In the other 6 patients,RVOT VT/PVCs were eliminated by man-ually controlled catheter ablation. The total procedure time was (190±42) min,and the mean ablation time was (240±33) s,and the average times of energy application were 3. 9±1. 6. The total X-ray exposure time was (4. 8±2. 6) min,which including (3. 2±2. 0) min for operators,and (1. 6±1. 0) min for remote ablation,respec-tively. No other complications were observed except one patient developed postoperative arteriovenous fistula. Conclusion Magnetic navigation system combined with non-contact mapping system was safe and effective for remote radiofrequency catheter ablation of RVOT-VT/PVCs. It may potentially reduce X-ray exposure time for both patients and operators.%目的:探讨应用磁导航遥控导管消融治疗右心室流出道起源的室性心动过速/室性早搏( RVOT-VT/PVCs)的安全性和有效性。方法2008年11月至2009年11月,在南京医科大学第一附属医院心血管内科行体表心电图检查,诊断为RVOT-VT/PVCs的患者共16例[女12例,男4例,平均年龄(44±15)岁],结合应用非接触标测系

  16. Therapeutic efficiency of catheter ablation in treatment of premature ventricular complexes originating from the right ventricular outflow tract accompanied with left ventricular enlargement: a 5-year follow-up investigation of 30 cases%导管法消融右室流出道室性早搏伴左心室增大30例5年随访观察

    Institute of Scientific and Technical Information of China (English)

    胡立禄; 刘世玉; 雷挺; 高全清; 唐力; 唐成玥; 苏代泉; 帅锋利

    2012-01-01

    目的 探讨导管法消融右室流出道室性早搏伴左心室增大患者的疗效.方法 对30例右室流出道室性早搏伴左心室增大的患者进行导管法射频消融(Radiofrequency cathter ablation,RFCA)治疗.术前常规完成心脏超声检查,成功消融术后5年每年随访超声心动图(ultrasound echocardiography,UCG)及动态心电图(Dynamic Electrocardiogram,DCG,又称Hol-ter).结果 30例患者即刻成功者20例,远期成功8例,无效者2例.术后1年随访20例即刻成功者,UCG结果提示18例患者左室舒张末期内径已在正常值范围内,与自身相比缩小值在3~7 mm以上;随访至第2、3、4、5年,UCG结果无明显变化.另2例患者心脏大小虽未达到正常值范围,但与自身相比较亦有相应缩小.8例远期成功者临床症状也有明显改善.结论 导管法消融治疗右室流出道室早伴左心室增大具有良好临床疗效.%Objective To investigate the therapeutic efficacy of catheter ablation in treatment of patients with premature ven-tricular complexes originating from the right venlricular outftow tract accompanied with left venlricular enlargement Methods The catheler ablalion was performed to 30 patients selected. The rouline cardiac ultrasound examination was carried out before operation. Af-ter surgery, the patients were followed-up for 5 years. During the period of follow-up, echocardiography and dynamic electrocardiogram DCG(Holter)monitoring were performed every year. Results In the 30 patients,20 were acute success,8 were effective,and 2 were in-effeclive. At the first year foltow-up, the UCG resulls showed that 18 of 20 acule success patients presenled a normal left venlricular end-diastolic diameler,and at least reduced 3 ~7 mm compared to pre-operation. During the periods of 2 ~ 5 years foltow-up, no further changes were observed. The heart size of another 2 acule success patients was also reduced although not reach to the normal range. The clinical symptoms of

  17. Knowledge Outflows from Foreign Subsidiaries

    DEFF Research Database (Denmark)

    Perri, Alessandra; Andersson, Ulf

    the value of the subsidiary’s knowledge stock is very high, the need for knowledge protection restrains reciprocity mechanisms in knowledge exchanges, thus reducing the extent of knowledge outflows to the host location. This study contributes to the literature on the firm-level antecedents of FDI...

  18. Protostellar Outflows in L1340

    CERN Document Server

    Walawender, Josh; Smutko, Michael; O'Linger-Luscusk, JoAnn; Moriarty-Schieven, Gerald

    2016-01-01

    We have searched the L1340 A, B, and C clouds for shocks from protostellar outflows using the H$_2$ 2.122 $\\mu$m near-IR line as a shock tracer. Substantial outflow activity has been found in each of the three regions of the cloud (L1340 A, L1340 B, & L1340 C). We find 42 distinct shock complexes (16 in L1340 A, 11 in L1340 B, and 15 in L1340 C). We were able to link 17 of those shock complexes in to 12 distinct outflows and identify candidate source stars for each. We examine the properties (A$_{V}$, T$_{bol}$, and L$_{bol}$) of the source protostars and compare that to the properties of the general population of Class 0/I and flat SED protostars and find that there is an indication, albeit at low statistical significance, that the outflow driving protostars are drawn from a population with lower A$_{V}$, higher L$_{bol}$, and lower T$_{bol}$ than the general population of protostars.

  19. Molecular outflows in starburst nuclei

    CERN Document Server

    Roy, Arpita; Sharma, Prateek; Shchekinov, Yuri

    2016-01-01

    Recent observations have detected molecular outflows in a few nearby starburst nuclei. We discuss the physical processes at work in such an environment in order to outline a scenario that can explain the observed parameters of the phenomenon, such as the molecular mass, speed and size of the outflows. We show that outflows triggered by OB associations, with $N_{OB}\\ge 10^5$ (corresponding to a star formation rate (SFR)$\\ge 1$ M$_{\\odot}$ yr$^{-1}$ in the nuclear region), in a stratified disk with mid-plane density $n_0\\sim 200\\hbox{--}1000$ cm$^{-3}$ and scale height $z_0\\ge 200 (n_0/10^2 \\, {\\rm cm}^{-3})^{-3/5}$ pc, can form molecules in a cool dense and expanding shell. The associated molecular mass is $\\ge 10^7$ M$_\\odot$ at a distance of a few hundred pc, with a speed of several tens of km s$^{-1}$. We show that a SFR surface density of $10 \\le \\Sigma_{SFR} \\le 50$ M$_\\odot$ yr$^{-1}$ kpc$^{-2}$ favours the production of molecular outflows, consistent with observed values.

  20. Outflow forces in intermediate mass star formation

    CERN Document Server

    van Kempen, T A; van Dishoeck, E F; Kristensen, L E; Belloche, A; Klaassen, P D; Leurini, S; Jose-Garcia, I San; Aykutalp, A; Choi, Y; Endo, A; Frieswijk, W; Harsono, D; Karska, A; Koumpia, E; van der Marel, N; Nagy, Z; Perez-Beaupuits, J P; Risacher, C; van Weeren, R J; Wyrowski, F; Yildiz, U A; Guesten, R; Boland, W; Baryshev, A

    2015-01-01

    Intermediate mass protostarsprovide a bridge between theories of low- and high-mass star formation. Emerging molecular outflows can be used to determine the influence of fragmentation and multiplicity on protostellar evolution through the correlation of outflow forces of intermediate mass protostars with the luminosity. The aim of this paper is to derive outflow forces from outflows of six intermediate mass protostellar regions and validate the apparent correlation between total luminosity and outflow force seen in earlier work, as well as remove uncertainties caused by different methodology. By comparing CO 6--5 observations obtained with APEX with non-LTE radiative transfer model predictions, optical depths, temperatures, densities of the gas of the molecular outflows are derived. Outflow forces, dynamical timescales and kinetic luminosities are subsequently calculated. Outflow parameters, including the forces, were derived for all sources. Temperatures in excess of 50 K were found for all flows, in line wi...

  1. 68. Unusual presentation of mediastinal lymphoma and role of cardiac MRI

    Directory of Open Access Journals (Sweden)

    N. Mahmood

    2016-07-01

    Full Text Available Diffuse large B cell lymphoma (DLBCL is the most common histologic subtype of non-Hodgkin lymphoma (NHL accounting for approximately 25% of NHL cases. One of the common subtype of DLBCL is primary DLBCL of the mediastinum. Case report this 65 year old female known to have diabetes and hypertension presented to our emergency department with history of epigastric pain for last 2 h. Her electrocardiogram (ECG showed right bundle block with left posterior hemi-block representing bi-fasicular block with minimal ST segment depression in leads V4–V6. Her initial routine laboratory results revealed normal renal function, blood counts and liver profile. Her cardiac bio-markers were elevated with Troponin I of 1.22 and CPK of 35. She was admitted by the cardiology team diagnosis of non-ST elevation myocardial infarction (NSTEMI. She was started with usual anti-ischemic. Next morning she had echocardiography which revealed a large mediastinal mass on the antero-lateral aspect of the left ventricle infiltrating the basal lateral and anterior wall. This mass was encasing the origin of the great vessels and also infiltrating the left atrium occluding the Left atrial appendage and left upper pulmonary vein. It was infiltrating the Right ventricular outflow tract causing obstruction to the flow with a gradient of 52 mmHg. Cardiac MRI showed multiple cardiac masses, the largest of which was originating from the anterior mediastinum and going posteriorly then infiltrating RV and within the right ventricular out-flow tract (RVOT causing significant obstruction. The magnetic resonance characteristics of the intra cardiac and extra cardiac masses were same and with features of central necrosis was highly suggestive of lymphoma. The CT scan of the chest and abdomen showed the same cardiac findings as of cardiac MRI and multiple enlarged thoracic, retroperitoneal, left common iliac lymph nodes. Patient had CT guided Lymph node biopsy from the mediastinal lymph

  2. Shining A Light On Galactic Outflows: Photo-Ionized Outflows

    CERN Document Server

    Chisholm, John; Leitherer, Claus; Chen, Yanmei; Wofford, Aida

    2016-01-01

    We study the ionization structure of galactic outflows in 37 nearby, star forming galaxies with the Cosmic Origins Spectrograph on the Hubble Space Telescope. We use the O I, Si II, Si III, and Si IV ultraviolet absorption lines to characterize the different ionization states of outflowing gas. We measure the equivalent widths, line widths, and outflow velocities of the four transitions, and find shallow scaling relations between them and galactic stellar mass and star formation rate. Regardless of the ionization potential, lines of similar strength have similar velocities and line widths, indicating that the four transitions can be modeled as a co-moving phase. The Si equivalent width ratios (e.g. Si IV/Si II) have low dispersion, and little variation with stellar mass; while ratios with O I and Si vary by a factor of 2 for a given stellar mass. Photo-ionization models reproduce these equivalent width ratios, while shock models under predict the relative amount of high ionization gas. The photo-ionization mo...

  3. Hot Outflows in Galaxy Clusters

    CERN Document Server

    Kirkpatrick, C C

    2015-01-01

    The gas-phase metallicity distribution has been analyzed for the hot atmospheres of 29 galaxy clusters using {\\it Chandra X-ray Observatory} observations. All host brightest cluster galaxies (BCGs) with X-ray cavity systems produced by radio AGN. We find high elemental abundances projected preferentially along the cavities of 16 clusters. The metal-rich plasma was apparently lifted out of the BCGs with the rising X-ray cavities (bubbles) to altitudes between twenty and several hundred kiloparsecs. A relationship between the maximum projected altitude of the uplifted gas (the "iron radius") and jet power is found with the form $R_{\\rm Fe} \\propto P_{\\rm jet}^{0.45}$. The estimated outflow rates are typically tens of solar masses per year but exceed $100 ~\\rm M_\\odot ~yr^{-1}$ in the most powerful AGN. The outflow rates are 10% to 20% of the cooling rates, and thus alone are unable to offset a cooling inflow. Nevertheless, hot outflows effectively redistribute the cooling gas and may play a significant role at ...

  4. Left ventricular outflow track obstruction and mitral valve regurgitation in a patient with takotsubo cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Yin Wu

    2015-12-01

    Full Text Available Introduction: Takotsubo cardiomyopathy (TCM can be complicated by left ventricular outflow tract (LVOT obstruction and severe acute mitral regurgitation (MR, leading to hemodynamic instability in an otherwise benign disorder. Despite the severity of these complications, there is a paucity of literature on the matter. Because up to 20–25% of TCM patients develop LVOT obstruction and/or MR, it is important to recognize the clinical manifestations of these complications and to adhere to specific management in order to reduce patient morbidity and mortality. We report the clinical history, imaging, treatment strategy, and clinical outcome of a patient with TCM that was complicated with severe MR and LVOT obstruction. We then discuss the pathophysiology, characteristic imaging, key clinical features, and current treatment strategy for this unique patient population. Case report: A postmenopausal woman with no clear risk factor for coronary artery disease (CAD presented to the emergency department with chest pain after an episode of mental/physical stress. Physical examination revealed MR, mild hypotension, and pulmonary vascular congestion. Her troponins were mildly elevated. Cardiac catheterization excluded obstructive CAD, but revealed severe apical hypokinesia and ballooning. Notably, multiple diagnostic tests revealed the presence of severe acute MR and LVOT obstruction. The patient was diagnosed with TCM complicated by underlying MR and LVOT obstruction, and mild hemodynamic instability. The mechanism of her LVOT and MR was attributed to systolic anterior motion of the mitral valve (SAM, which the transesophageal echocardiogram clearly showed during workup. She was treated with beta-blocker, aspirin, and ACE-I with good outcome. Nitroglycerin and inotropes were discontinued and further avoided. Conclusions: Our case illustrated LVOT obstruction and MR associated with underlying SAM in a patient with TCM. LVOT obstruction and MR are severe

  5. Spectrum of cardiac lesions associated with Isolated Cleft Mitral Valve and their impact on therapeutic choices

    Science.gov (United States)

    El hammiri, Ayoub; Drighil, Abdenasser; Benhaourech, Sanaa

    2016-01-01

    Background Isolated cleft mitral valve (ICMV) may occur alone or in association with other congenital heart lesions. The aim of this study was to describe the profile of cardiac lesions associated with ICMV and their potential impact on therapeutic management. Methods We conducted a descriptive study with data retrieved from the Congenital Heart Disease (CHD) single-center registry of our institution, including patients with ICMV registered between December 2008 and November 2014. Results Among 2177 patients retrieved from the CHD registry, 22 (1%) had ICMV. Median age at diagnosis was 5 years (6 days to 36 years). Nine patients (40.9%) had Down syndrome. Seventeen patients (77.3%) had associated lesions, including 11 (64.7%) with accessory chordae in the left ventricular outflow tract (LVOT) with no obstruction, 15 (88.2%) had ventricular septal defect (VSD), three had secundum atrial septal defect, and four had patent ductus arteriosus. Thirteen patients (59.1%) required surgical repair. The decision to proceed with surgery was mainly based on the severity of the associated lesion in eight patients (61.5%) and on the severity of the mitral regurgitation in four patients (30.8%). In one patient, surgery was decided based on the severity of both the associated lesion and mitral regurgitation. Conclusion Our study shows that ICMV is rare and strongly associated with Down syndrome. The most common associated cardiac abnormalities were VSD and accessory chordae in the LVOT. We conclude that cardiac lesions associated with ICMV are of major interest, since in this study patients with cardiac lesions were diagnosed earlier. The decision to operate on these patients must take into account the severity of both mitral regurgitation and associated cardiac lesions. PMID:27096525

  6. BMPER Promotes Epithelial-Mesenchymal Transition in the Developing Cardiac Cushions.

    Directory of Open Access Journals (Sweden)

    Laura Dyer

    Full Text Available Formation of the cardiac valves is an essential component of cardiovascular development. Consistent with the role of the bone morphogenetic protein (BMP signaling pathway in cardiac valve formation, embryos that are deficient for the BMP regulator BMPER (BMP-binding endothelial regulator display the cardiac valve anomaly mitral valve prolapse. However, how BMPER deficiency leads to this defect is unknown. Based on its expression pattern in the developing cardiac cushions, we hypothesized that BMPER regulates BMP2-mediated signaling, leading to fine-tuned epithelial-mesenchymal transition (EMT and extracellular matrix deposition. In the BMPER-/- embryo, EMT is dysregulated in the atrioventricular and outflow tract cushions compared with their wild-type counterparts, as indicated by a significant increase of Sox9-positive cells during cushion formation. However, proliferation is not impaired in the developing BMPER-/- valves. In vitro data show that BMPER directly binds BMP2. In cultured endothelial cells, BMPER blocks BMP2-induced Smad activation in a dose-dependent manner. In addition, BMP2 increases the Sox9 protein level, and this increase is inhibited by co-treatment with BMPER. Consistently, in the BMPER-/- embryos, semi-quantitative analysis of Smad activation shows that the canonical BMP pathway is significantly more active in the atrioventricular cushions during EMT. These results indicate that BMPER negatively regulates BMP-induced Smad and Sox9 activity during valve development. Together, these results identify BMPER as a regulator of BMP2-induced cardiac valve development and will contribute to our understanding of valvular defects.

  7. Localization of the origin of idiopathic ventricular tachycardia from right ventricular outflow tract by surface electrocardiogram%体表心电图特征对特发性右心室流出道室性心动过速和室性早搏起源点的定位价值

    Institute of Scientific and Technical Information of China (English)

    郑黎晖; 李晋新; 姚焰; 张奎俊; 张澍; 陈文生; 王方正; 陈新

    2009-01-01

    Objective The characteristics on 12-lead electrocardiogram(ECG) are useful in the identi-fication of idiopathic right ventricular outflow tract(RVOT) tachycardia origins. This study was aimed to develop a relative simple algorithm for localization the origin of RVOT ventricutar tachycardia(VT) or premature ventric-ular contraction(PVC)based on ECG. Methods The RVOT was anatomically classified into septum and free wall and the septum area was subdivided into nine regions. An algorithm was developed by correlating the ECG findings with the catheter ablation sites in 213 patients with RVOT VT/PVC. The algorithm was prospectively used to localize the origin of RVOT VT/PVC in 107 patients before ablation. Results The QRS morphology in lead I has a high specific diagnostic value for arrhythmia. Foci originating from anterior RVOT septal sites 3,6, 9 produced a dominant negative wave(QS,Qr or rS). R wave progression in Lead I from anterior to posterior or from superior to inferior septal RVOT was observed. The specific "M" type was mostly recorded in medium sep-tal RVOT(sites 2,5,8)and the notch in R wave was observed in posterior septum. In patients with RVOT free wall origin,the longer QRS duration was observed,with a taller R wave in Lead I and aVL,and a lower R wave in inferior leads(compared with the RVOT septum origin,P<0.05). In the prospective analysis,these parame-ters had a higher sensitivity,specificity with higher positive predictive value as well as negative predictive val-ue. Conclusion The ECG characteristics,especially QRS morphology in Lead I can serve as a useful and sim-ple template in predicting accurate origin site of RVOT arrhythmia.%目的 起源于右心室流出道(RVOT)不同位点的室性心动过速(VT)具有相应的心电图表现,本研究旨在摸索一种相对简单的根据体表心电图进行定位的方法 .方法 将RVOT分为游离壁和间隔而两大区,其中间隔面又分为9个区域.共320例RVOT-VT患者中,对213例既往

  8. 特发性右心室流出道室性心动过速/室性早搏的性别、年龄和临床特点%The gender, age and clinical feature of idiopathic right ventricular outflow tract ventricular tachycardia/premature ventricular complexes

    Institute of Scientific and Technical Information of China (English)

    陈刚; 张澍; 张奎俊; 陈新; 姚焰; 马坚; 楚建民; 方丕华; 贾玉和; 王方正

    2010-01-01

    目的 特发性右心室流出道室性心动过速(室速)/室性早搏(室早)是指不伴有明显器质性心脏病的起源于右心室流出道的室速/室早.对478例特发性右心室流出道室速/室早患者进行系统的回顾性分析,探讨其性别、年龄和临床特点.方法 478例患者,平均年龄(39.8±13.8)岁,在过去的15年里,先后因特发性室速/室早在我院住院治疗,并都接受了心内电生理检查和射频消融术治疗.这478例患者室速/室早的射频消融靶点均位于右心室流出道.结果 在478例患者中,女性288例(60.3%),男性190例(39.7%),女性/男性比为1.52.出现症状的年龄女性为(41.2±12.7)岁,男性为(37.6±15.0)岁(P<0.05),所有患者均有不同程度的心悸症状,478例患者中,67例(14.2%)曾出现过黑矇症状,13例(2.7%)曾经出现晕厥.263例(55%)患者在接受射频消融术前,接受过抗心律失常的药物治疗,药物治疗不成功.结论 特发性右心室流出道室速/室早患者女性较男性多,女性出现临床症状的平均年龄较男性大,对于这一现象的研究有助于揭示这种心律失常的发生机制.所有患者均有不同程度的心慌症状,有的患者甚至出现黑矇、晕厥.因此对于特发性右心室流出道室速/室早应当更加积极地治疗.%Objective The aim of this study was to clarify gender,age and clinical feature of idiopathic right ventricular outflow tract ventricular tachycardia/premature ventricular complexes(ROVT/PVC). Methods We studied 478 patients[mean age(39. 8 ± 13. 8)years]with idiopathic ROVT/PVC who were admitted to our center consecutively in past 15 years. All of them underwent catheter mapping and radiofrequency catheter ablation (RFCA), and the original sites of ventricular tachycardia/premature ventricular complexes were confirmed by catheter mapping and radiofrequency catheter ablation. Results Of 478 patients, 288 patients (60. 3% )were female, 190 patients(39. 7% )were male

  9. Clinical Experience for Treating the Infants With Critical Congenital Isolated Right Ventricular Outflow Tract Obstruction in 11 Years%治疗先天性重症孤立性右心室流出道梗阻11年的临床经验

    Institute of Scientific and Technical Information of China (English)

    张瑛; 杨克明; 张浩; 胡盛寿; 李守军; 刘迎龙; 闫军; 沈向东; 李永青; 花中东; 郑哲

    2011-01-01

    Objective: To compare the treating effect of infants with critical congenital isolated right ventricular outflow tract obstruction (RVOTO) by either traditional surgical operation or hybrid technique in 11 years.Methods:We summarized 127 infants with critical congential isolated RVOTO who underwent either surgical operation or bybrid technique in our hospital from 1998 to 2009. The infants were 2 days ~ 12 months(5. 7±0.3months) of age including 18 neonates and divided as follows:Group A,75 infants received traditional surgical operation, 13 of them suffering from pulmonary atresia with intact ventricular septum ( Al group)and 62 with critical pulmonary valve stenosis ( A2 group) ;and Group B,52 infants received hybrid technique treatment ( trans-ventricle balloon pulmonary valvuloplasty) ,2.5 of them suffering from pulmonary atresia with intact ventricular septum ( BI group) and 27 with critical pulmonary valve stenosis ( B2 group). We studied the in-hospital and follow-up conditions in all patients.Results:There were 12 in-hospital deaths in Group A as 4 in Al group and 8 in A2 group,no in-hospital death in Group B.100 patients were followed-up for the average of (24. 1±26.4)months ,and there were 5 late deaths in Group B,no late death in Group A during the follow-up period of time.Conclusion:Surgical trans-ventricle balloon pulmonary valvuloplasty can improve the survival rate of infants with isolated RVOTO at peri operation and create the chance for biventricular correction in the future. Meanwhile,an additional source of modified B-T shunt might be the important choice for infants with hyperplasia of right ventricle.%目的:介绍采用传统的外科手术与杂交技术治疗先天性重症孤立性右心室流出道梗阻11年的临床经验.方法:我院1998-01至2009-12治疗先天性重症孤立性右心室流出道梗阻小婴儿127例,年龄2天~12个月,平均年龄(5.7±0.3)个月,其中新生儿18例.127例患儿按照治疗方法和肺

  10. 单心动周期全容积成像对右心室流出道起源室性期前收缩患者左心室容积及收缩同步性的研究%Study of left ventricular systolic volume and synchrony in patients with premature ventricular complexes from the right ventricular outflow tract by instantaneous full-volume imaging

    Institute of Scientific and Technical Information of China (English)

    姚静; 许迪; 陆凤翔; 雍永宏; 吴红平; 陆美娟; 洪牮; 徐亮

    2011-01-01

    Objective To assess alternations in left ventricular volume and systolic synchrony in patients with frequent premature ventricular complexes(PVCs) from the right ventricular outflow tract(RVOT).Methods Twenty-nine patients with frequent isolated PVCs from RVOT were included and 30 healthy subjects as control.Instantaneous full-volume imaging(IFI) was performed to evaluate left ventricle volumetric parameters,including end-systolic volume (ESV),end-diastolic volume (EDV),stroke volume (SV),ejection fraction (EF),and systolic synchrony parameters,including systolic dyssynchrony index (SDI),dispersion end-systole (DISPES),mean end-systolic time (MES),pre-contraction time volume (PreContr) and post-contraction time volume (PostContr).Contraction front mapping was performed to visualize volumetric contraction sequence.All values of patients with PVCs were recorded during sinus beats (PVC-S) and premature ventricular beats (PVC-V) respectively.Results Significant differences were observed in left ventricular systolic volumetric and synchrony parameters between PVC-V and control subjects (P<0.01),as well as in MES and PreContr between PVC-S and control subjects (P<0.01).Conclusions Left ventricular systolic dysynchrony was demonstrated in patients with PVCs from RVOT.IFI was a novel tool to analyze left ventricular global and regional volumetric alternations.%目的 探讨正常人及频发右室流出道(right ventricular outflow tract,RVOT)起源室性期前收缩患者左室容积改变模式.方法 应用单心动周期全容积成像(instantaneous full-volume imaging,IFI)技术分析29例RVOT起源室性期前收缩患者在室性期前收缩、窦性心搏时以及30例正常人左室容积参数[收缩末容积(ESV)、舒张末容积(EDV)、每搏量(SV)、射血分数(EF)]和左室收缩期节段容积变化同步性参数[收缩失同步性指数(SDI)、收缩末离散度(DISPES)、平均收缩末时间(MES)、收缩前时间容积(PreContr)、收缩后时

  11. Feasibility Study on Prenatal Cardiac Screening Using Four-Dimensional Ultrasound with Spatiotemporal Image Correlation: A Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Liqing Zhao

    Full Text Available This study aimed at investigating the feasibility of using the spatiotemporal image correlation (STIC technology for prenatal cardiac screening, finding factors that influence the offline evaluation of reconstructed fetal heart, and establishing an optimal acquisition scheme.The study included 452 gravidae presenting for routine screening at 3 maternity centers at 20-38 gestational weeks. The factors influencing the quality of STIC volume data were evaluated using t test, chi-square test, and logistic regression analysis. The predictive power was evaluated using the receiver operating characteristic (ROC curve.Among the 452 fetuses enrolled, 353 (78.1% were identified as successful and 99 (21.9% as failure of evaluation of the reconstructed fetal heart. The total success rate of qualified STIC images was 78.1%. The display rates of reconstructed cardiac views were 86.5% (four-chamber view, 92.5% (left ventricular outflow tract view, 92.7% (right ventricular outflow tract view, 89.9% (three-vessel trachea view, 63.9% (aortic arch view, 81.4% (ductal arch view, 81% (short-axis view of great vessels, 80.1% (long-cava view, and 86.9% (abdominal view. A logistic regression analysis showed that more than 28 gestational weeks [OR = 0.39 (CI 95% 0.16, 0.19, P = 0.035], frequent fetal movements [OR = 0.37 (CI 95% 0.16, 0.87, P = 0.022], shadowing [OR = 0.36 (CI 95% 0.19, 0.72, P = 0.004], spine location at 10-2 o'clock [OR = 0.08 (CI 95% 0.02, 0.27, P = 0.0], and original cardiac view [OR = 0.51 (0.25, 0.89, P = 0.019] had a significant impact on the quality of STIC. The area under the ROC curve was 0.775.Fetal cardiac-STIC seems a feasible tool for prenatal screening of congenital heart diseases. The influence factors on the quality of STIC images included the intensity of training, gestational age, fetal conditions and parameter settings. The optimal acquisition scheme may improve the application and widespread use of cardiac STIC.

  12. Urinary tract infection - children

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000505.htm Urinary tract infection - children To use the sharing features on this page, please enable JavaScript. A urinary tract infection is an infection of the urinary tract. This ...

  13. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  14. SWAS Observations of Water in Molecular Outflows

    CERN Document Server

    Franklin, J; Kaufman, M J; Melnick, G J; Neufeld, D A; Hollenbach, D J; Bergin, E A

    2007-01-01

    We present SWAS detections of the ground-state 1(10)-1(01) transition of o-H2O at 557 GHz in 18 molecular outflows. These results are combined with ground-based observations of the J=1-0 transitions of 12CO and 13CO obtained at the FCRAO and, for a subset of the outflows, data from ISO. Assuming the SWAS water line emission originates from the same gas traced by CO emission, we find that the outflowing gas in most outflows has an o-H2O abundance relative to H2 of between 10(-7) and 10(-6). Analysis of the water abundance as a function of outflow velocity reveals a strong dependence. The water abundance increases with velocity, and at the highest outflow velocities some outflows have relative o-H2O abundances of order 10(-4). However the mass of gas with such elevated water abundances represents less that 1% of the total outflow gas mass. The ISO LWS observations of high-J rotational lines of CO and the 179.5 micron transition of o-H2O provide evidence for a warmer outflow component than required to produce ei...

  15. Morphologies of protostellar outflows: An ALMA view

    CERN Document Server

    Peters, Thomas; Seifried, Daniel; Banerjee, Robi; Klessen, Ralf S

    2014-01-01

    The formation of stars is usually accompanied by the launching of protostellar outflows. Observations with the Atacama Large Millimetre/sub-millimetre Array (ALMA) will soon revolutionalise our understanding of the morphologies and kinematics of these objects. In this paper, we present synthetic ALMA observations of protostellar outflows based on numerical magnetohydrodynamic collapse simulations. We find significant velocity gradients in our outflow models and a very prominent helical structure within the outflows. We speculate that the disk wind found in the ALMA Science Verification Data of HD 163296 presents a first instance of such an observation.

  16. The COMPLETE Survey of Outflows in Perseus

    CERN Document Server

    Arce, Hector G; Goodman, Alyssa A; Pineda, Jaime E; Halle, Michael W; 10.1088/0004-637X/715/2/1170

    2010-01-01

    We present a study on the impact of molecular outflows in the Perseus molecular cloud complex using the COMPLETE survey large-scale 12CO(1-0) and 13CO(1-0) maps. We used three-dimensional isosurface models generated in RA-DEC-Velocity space to visualize the maps. This rendering of the molecular line data allowed for a rapid and efficient way to search for molecular outflows over a large (~ 16 sq. deg.) area. Our outflow-searching technique detected previously known molecular outflows as well as new candidate outflows. Most of these new outflow-related high-velocity features lie in regions that have been poorly studied before. These new outflow candidates more than double the amount of outflow mass, momentum, and kinetic energy in the Perseus cloud complex. Our results indicate that outflows have significant impact on the environment immediately surrounding localized regions of active star formation, but lack the energy needed to feed the observed turbulence in the entire Perseus complex. This implies that oth...

  17. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  18. Brugada syndrome and right ventricle morphofunctional abnormalities on echocardiography in young male with family anamnesis of sudden cardiac death.

    Science.gov (United States)

    Steiner, Robert; Makarovic, Sandra; Makarovic, Zorin; Bilic-Curcic, Ines

    2014-03-01

    First presented by Brugada and Brugada in 1992, Brugada Syndrome (BrS) is a primary electrical disease of the heart that causes sudden cardiac death or life-threatening ventricular arrhythmias. This disease is hereditary autosomic dominant transmitted and genetically determined. The syndrome has been linked to mutations in SCN5A, the gene encoding for the a-subunit of the sodium channel. Electrocardiogram (ECG) abnormalities indicating Brugada syndrome, include repolarization and depolarization abnormalities in the absence of identifiable structural cardiac abnormalities or other conditions or agents known to lead to ST-segment elevation in the right precordial leads (V1-V3). Intravenous administration of sodium channel blocking drugs may modify the ECG pattern. Ajmaline, flecainide, procainamide and propafenone exaggerate the ST-segment elevation or unmask it when it is initially absent. An implantable cardioverter-defibrillator (ICD) is the only proven effective device treatment for the disease. Although BrS is primary electrical disease, some authors have suggested the presence of morphological and functional abnormalities mainly located in the right ventricle (RV), notably in the outflow tract (RVOT). In this short report we will present a young male, with predisposition and positive family history of sudden cardiac death, with complete diagnostic procedure including propafenon testing unmasking Brugada syndrome. An echosonography revealed dilated apical right ventricle, suggesting BrS is not only electrical disorder, but may include morphofunctional abnormalities, described in previous reports. In addition, we reviewed the possible connection between Brugada syndrome and morphological abnormalities in RV.

  19. Outflow - Core Interaction in Barnard 1

    CERN Document Server

    Hiramatsu, Masaaki; Takakuwa, Shigehisa

    2010-01-01

    In order to study how outflows from protostars influence the physical and chemical conditions of the parent molecular cloud, we have observed Barnard 1 (B1) main core, which harbors four Class 0 and three Class I sources, in the CO (J=1-0), CH3OH (J_K=2_K-1_K), and the SiO (J=1-0) lines using the NRO 45 m telescope. We have identified three CO outflows in this region; one is an elongated (~ 0.3 pc) bipolar outflow from a Class 0 protostar B1-c in the submillimeter clump SMM 2, another is a rather compact (~ 0.1 pc) outflow from a Class I protostar B1 IRS in the clump SMM 6, and the other is extended outflow from a Class I protostar in SMM 11. In the western lobe of the SMM 2 outflow, both the SiO and CH3OH lines show broad redshifted wings with the terminal velocities of 25 km/s and 13 km/s, respectively. It is likely that the shocks caused by the interaction between the outflow and ambient gas enhance the abundance of SiO and CH3OH in the gas phase. The total energy input rate by the outflows (1.1x10^{-3} Ls...

  20. Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report

    Directory of Open Access Journals (Sweden)

    Celermajer David S

    2007-02-01

    Full Text Available Abstract Background Apical ballooning syndrome (or Takotsubo cardiomyopathy is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy. Case Presentation We present the case of a 65 year-old lady referred to us from a rural hospital where she was treated with thrombolytic therapy for a presumed acute anterior myocardial infarction. Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect. Echocardiogram revealed severe mitral regurgitation, left ventricular apical ballooning, and systolic anterior motion of the mitral valve with significant left ventricular outflow tract gradient (60–70 mmHg. Coronary angiography revealed no obstructive coronary lesions. She had an intra-aortic balloon pump inserted with no improvement in her parlous haemodynamic state. We elected to replace her mitral valve to correct the outflow tract gradient and mitral regurgitation. Intra-operatively the mitral valve was mildly myxomatous but there were no structural abnormalities. She had a mechanical mitral valve replacement with a 29 mm St Jude valve. Post-operatively, her left ventricular outflow obstruction resolved and ventricular function returned to normal over the subsequent 10 days. She recovered well. Conclusion This case represents a serious and poorly understood association of Takotsubo cardiomyopathy with acute pulmonary oedema, severe mitral regurgitaton and systolic anterior motion of the mitral valve with significant left ventricular outflow tract obstruction. The

  1. [Multiplane transesophageal echocardiography for the monitoring of cardiac surgery].

    Science.gov (United States)

    Pepi, M; Barbier, P; Doria, E; Tamborini, G; Berti, M; Muratori, M; Guazzi, M; Maltagliati, A; Alimento, M; Celeste, F

    1994-08-01

    Multiplane transesophageal echocardiography (TEE) allows visualization of the heart and great vessels through an infinite number of imaging planes and improves the diagnostic capabilities of mono and biplane TEE. This study was undertaken to test whether MTEE is a useful intraoperative monitoring method during cardiac surgery. Intraoperative multiplane TEE was performed in 200 patients (mean age 56 +/- 19 years) as a part of the routine clinical care. We systematically acquired cardiac images from the gastric fundus (short and long axes of the ventricles), lower esophagus (four-chamber, two-chamber, and long axis), upper esophagus (13 views concerning the aorta, pulmonary artery, left and right atrium, systemic and pulmonary veins, coronary arteries, right ventricular outflow tract), and searched for complete views of the thoracic descending aorta. All views analyzed in the preoperative (immediately before cardiopulmonary bypass), intraoperative and postoperative phases evaluating: the angle between current and 0 degree at which each view was obtained; the success rate of each view; the usefulness of the different views in providing essential additional clinical information compared to 0 degrees and 90 degrees of the traditional biplane TEE. Most views of the heart and great vessels were visualized in oblique planes, and other views were significantly improved thanks to slight angle corrections. Multiplane TEE was particularly useful in the preoperative and postoperative phases of aortic dissection (11 cases), mitral valve repair (13 cases), left ventricular aneurysmectomy (9 cases), right atrial thrombosis (1 case), positioning of left ventricular hemopump (2 cases), mitral-aortic endocarditis (3 cases), bleeding from proximal suture of an aortic heterograft (1 case).(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Cardiac Sarcoidosis.

    Science.gov (United States)

    Birnie, David; Ha, Andrew C T; Gula, Lorne J; Chakrabarti, Santabhanu; Beanlands, Rob S B; Nery, Pablo

    2015-12-01

    Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic sarcoidosis have asymptomatic (clinically silent) cardiac involvement. An international guideline for the diagnosis and management of CS recommends that patients be screened for cardiac involvement. Most studies suggest a benign prognosis for patients with clinically silent CS. Immunosuppression therapy is advocated for clinically manifest CS. Device therapy, with implantable cardioverter defibrillators, is recommended for some patients.

  3. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  4. Radio jets and outflows of cold gas

    CERN Document Server

    Morganti, Raffaella

    2011-01-01

    Massive gas outflows are considered a key component in the process of galaxy formation and evolution. It is, therefore, not surprising that a lot of effort is going in quantifying their impact via detailed observations. This short contribution presents recent results obtained from HI and CO observations of different objects where the AGN - and in particular the radio jet - is likely playing an important role in producing the gas outflows. These preliminary results are reinforcing the conclusion that these outflows have a complex and multiphase structure where cold gas in different phases (atomic and molecular) is involved and likely represent a major component. These results will also provide important constraints for establishing how the interaction between AGN/radio jet and the surrounding ISM occurs and how efficiently the gas should cool to produce the observed properties of the outflowing gas. HI likely represents an intermediate phase in this process, while the molecular gas would be the final stage. Wh...

  5. Accretion and Outflow Activity in Brown Dwarfs

    CERN Document Server

    Riaz, B

    2013-01-01

    An investigation of the magnetospheric accretion and outflow signatures in sub-stellar objects is a natural extension of similar studies conducted on classical T Tauri stars (CTTS), and helps understand if brown dwarfs (BDs) follow the same formation mechanism as stars. Over the past decade, evidence for accretion in very low-mass stars (VLMs) and BDs has been accumulated using various techniques, which indicates that the overall accretion characteristics are continuous across the sub-stellar boundary. Outflow activity in VLMs and BDs has been confirmed based on spectro-astrometry of forbidden emission lines observed in the optical, and in millimetre continuum images of CO J=2-1 emission. This review summarizes the past and current state of observational work on accretion and outflow activity in VLMs and BDs, particularly with the advent of new instruments such as VLT/X-Shooter which has allowed the study of several accretion and outflow indicators over a wider wavelength range.

  6. Electron-positron outflow from black holes

    CERN Document Server

    Van Putten, M H P M

    2000-01-01

    Gamma-ray bursts (GRBs) appear as the brightest transient phenomena in the Universe. The nature of the central engine in GRBs is a missing link in the theory of fireballs to their stellar mass progenitors. Here it is shown that rotating black holes produce electron-positron outflow when brought into contact with a strong magnetic field. The outflow is produced by a coupling of the spin of the black hole to the orbit of the particles. For a nearly extreme Kerr black hole, particle outflow from an initial state of electrostatic equilibrium has a normalized isotropic emission of $\\sim external magnetic field strength, B_c=4.4 x 10^{13}G, and M is the mass of the black hole. This initial outflow has a half-opening angle given.

  7. Disks, accretion and outflows of brown dwarfs

    CERN Document Server

    Joergens, V; Liu, Y; Pascucci, I; Whelan, E; Alcala, J; Biazzo, K; Costigan, G; Gully-Santiago, M; Henning, Th; Natta, A; Rigliaco, E; Rodriguez-Ledesma, V; Sicilia-Aguilar, A; Tottle, J; Wolf, S

    2012-01-01

    Characterization of the properties of young brown dwarfs are important to constraining the formation of objects at the extreme low-mass end of the IMF. While young brown dwarfs share many properties with solar-mass T Tauri stars, differences may be used as tests of how the physics of accretion/outflow and disk chemistry/dissipation depend on the mass of the central object. This article summarizes the presentations and discussions during the splinter session on 'Disks, accretion and outflows of brown dwarfs' held at the CoolStars17 conference in Barcelona in June 2012. Recent results in the field of brown dwarf disks and outflows include the determination of brown dwarf disk masses and geometries based on Herschel far-IR photometry (70-160 um), accretion properties based on X-Shooter spectra, and new outflow detections in the very low-mass regime.

  8. Qualified Census Tracts

    Data.gov (United States)

    Department of Housing and Urban Development — A Qualified Census Tract (QCT) is any census tract (or equivalent geographic area defined by the Census Bureau) in which at least 50% of households have an income...

  9. Urinary tract infection - adults

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000521.htm Urinary tract infection - adults To use the sharing features on this page, please enable JavaScript. A urinary tract infection, or UTI, is an infection of the urinary ...

  10. Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction

    Directory of Open Access Journals (Sweden)

    Nikesh Thiruchelvam

    2014-01-01

    Full Text Available Monopolar transurethral resection of the prostate (TURP with endoscopic electrocautery remains the gold standard surgical technique for benign prostatic hypertrophy (BPH by which all new procedures are compared. We reviewed the current literature, and international urological guidelines and consensus opinion on various surgical options for BPH and present a brief overview of alternative techniques including bipolar TURP, transurethral incision of the prostate, transurethral vaporization of the prostate, laser prostatectomy (with holmium, thulium and potassium titanyl phosphate greenlight lasers and open prostatectomy (with mention of new techniques including laparoscopic and robotic prostatectomy. Emerging, experimental and less established techniques are also described including endoscopic heat generation (transurethral microwave thermotherapy, radiofrequency transurethral needle ablation of the prostate, high intensity focused ultrasound, hot water induced thermotherapy, pulsed electromagnetic radiofrequency, injection therapy (transurethral ethanol ablation and botulinum toxin and mechanical devices (intraprostatic stents and urethral lift devices. Despite a plethora of surgical options, none have realistically improved outcomes in the long-term compared with TURP. Improvements have been made on improving surgical morbidity and time in hospital. Questions remain in this area, including what specific elements of bladder outflow obstruction (BOO result in damage to the urinary tract, how does BPH contribute to BOO and how much prostate volume reduction is necessary to relieve BOO or lower urinary tract symptoms. Given these unanswered questions and the multitude of procedures available, it is clear that appropriate counselling is necessary in all men who undergo BPH surgery.

  11. Surgical therapy for benign prostatic hypertrophy/bladder outflow obstruction.

    Science.gov (United States)

    Thiruchelvam, Nikesh

    2014-04-01

    Monopolar transurethral resection of the prostate (TURP) with endoscopic electrocautery remains the gold standard surgical technique for benign prostatic hypertrophy (BPH) by which all new procedures are compared. We reviewed the current literature, and international urological guidelines and consensus opinion on various surgical options for BPH and present a brief overview of alternative techniques including bipolar TURP, transurethral incision of the prostate, transurethral vaporization of the prostate, laser prostatectomy (with holmium, thulium and potassium titanyl phosphate greenlight lasers) and open prostatectomy (with mention of new techniques including laparoscopic and robotic prostatectomy). Emerging, experimental and less established techniques are also described including endoscopic heat generation (transurethral microwave thermotherapy, radiofrequency transurethral needle ablation of the prostate, high intensity focused ultrasound, hot water induced thermotherapy, pulsed electromagnetic radiofrequency), injection therapy (transurethral ethanol ablation and botulinum toxin) and mechanical devices (intraprostatic stents and urethral lift devices). Despite a plethora of surgical options, none have realistically improved outcomes in the long-term compared with TURP. Improvements have been made on improving surgical morbidity and time in hospital. Questions remain in this area, including what specific elements of bladder outflow obstruction (BOO) result in damage to the urinary tract, how does BPH contribute to BOO and how much prostate volume reduction is necessary to relieve BOO or lower urinary tract symptoms. Given these unanswered questions and the multitude of procedures available, it is clear that appropriate counselling is necessary in all men who undergo BPH surgery.

  12. Detection of CO Outflow in Rotating Cores

    Institute of Scientific and Technical Information of China (English)

    Xin Guan; Yue-Fang Wu

    2008-01-01

    We investigate the effect of bulk motion on the detection of molecular outflows in the sources S 146, GGD27, and IRAS 22566+5830. The traditional techniques do allow for bulk motions or systematic VLSR shifts of the core emissions, which may cause contamination of the high velocity gas emissions, and outflows may either fail to be detected or have their properties miscalculated. We used a program to follow the systematic shift of VLSR and better results have been obtained.

  13. Fast cold gas in hot AGN outflows

    CERN Document Server

    Costa, Tiago; Haehnelt, Martin

    2014-01-01

    Observations of the emission from spatially extended cold gas around bright high-redshift QSOs reveal surprisingly large velocity widths exceeding 2000 km s^(-1), out to projected distances as large as 30 kpc. The high velocity widths have been interpreted as the signature of powerful AGN-driven outflows. Naively, these findings appear in tension with hydrodynamic models in which AGN-driven outflows are energy-driven and thus very hot with typical temperatures T = 10^6-7 K. Using the moving-mesh code Arepo, we perform 'zoom-in' cosmological simulations of a z = 6 QSO and its environment, following black hole growth and feedback via energy-driven outflows. In the simulations, the QSO host galaxy is surrounded by a clumpy circum-galactic medium pre-enriched with metals due to supernovae-driven galactic outflows. As a result, part of the AGN-driven hot outflowing gas can cool radiatively, leading to large amounts (> 10^9 M_sun) of cold gas comoving with the hot bipolar outflow. This results in velocity widths of...

  14. Theory of photospheric emission from relativistic outflows

    CERN Document Server

    Ruffini, R; Vereshchagin, G V

    2013-01-01

    (shortened) In this paper we reexamine the optical depth of ultrarelativistic spherically symmetric outflows and reevaluate the photospheric radius for each model during both the acceleration and coasting phases. It is shown that for both the wind and the shell models there are two asymptotic solutions for the optical depth during the coasting phase of the outflow. In particular we show that quite counterintuitively a geometrically thin shell may appear as a thick wind for photons propagating inside it. For this reason we introduce notions of photon thick and photon thin outflows, which appear more general and better physically motivated with respect to winds and shells. Photosphere of relativistic outflow is a dynamic surface. We study its geometry and find that the photosphere of photon thin outflow has always a convex shape, while in the photon thick one it is initially convex (there is always a photon thin layer in any outflow) and then it becomes concave asymptotically approaching the photosphere of an i...

  15. Quantifying Supernovae-Driven Multiphase Galactic Outflows

    CERN Document Server

    Li, Miao; Ostriker, Jeremiah P

    2016-01-01

    Galactic outflows are ubiquitously observed in star-forming disk galaxies and are critical for galaxy formation. Supernovae (SNe) play the key role in driving the outflows, but there is no consensus as to how much energy, mass and metal they can launch out of the disk. We perform 3D, high-resolution hydrodynamic simulations to study SNe-driven outflows from stratified media. Assuming SN rate scales with gas surface density $\\Sigma_{\\rm{gas}}$ as in the Kennicutt-Schmidt (KS) relation, we find the mass loading factor, defined as the mass outflow flux divided by the star formation surface density, decreases with increasing $\\Sigma_{\\rm{gas}}$ as $\\propto \\Sigma^{-0.61}_{\\rm{gas}}$. Approximately $\\Sigma_{\\rm{gas}} \\lesssim$ 50 $M_\\odot/pc^2$ marks when the mass loading factor $\\gtrsim$1. About 10-50\\% of the energy and 40-80\\% of the metals produced by SNe end up in the outflows. The tenuous hot phase ($T>3\\times 10^5$ K) carries the majority of the energy and metals in outflows. We discuss how various physical...

  16. Active Galactic Nuclei Feedback and Galactic Outflows

    Science.gov (United States)

    Sun, Ai-Lei

    Feedback from active galactic nuclei (AGN) is thought to regulate the growth of supermassive black holes (SMBHs) and galaxies. The most direct evidence of AGN feedback is probably galactic outflows. This thesis addresses the link between SMBHs and their host galaxies from four different observational perspectives. First, I study the local correlation between black hole mass and the galactic halo potential (the MBH - Vc relation) based on Very Large Array (VLA) HI observations of galaxy rotation curves. Although there is a correlation, it is no tighter than the well-studied MBH - sigma* relation between the black hole mass and the potential of the galactic bulge, indicating that physical processes, such as feedback, could link the evolution of the black hole to the baryons in the bulge. In what follows, I thus search for galactic outflows as direct evidence of AGN feedback. Second, I use the Atacama Large Millimeter Array (ALMA) to observe a luminous obscured AGN that hosts an ionized galactic outflow and find a compact but massive molecular outflow that can potentially quench the star formation in 10. 6 years.The third study extends the sample of known ionized outflows with new Magellan long-slit observations of 12 luminous obscured AGN. I find that most luminous obscured AGN (Lbol > 1046 ergs s-1) host ionized outflows on 10 kpc scales, and the size of the outflow correlates strongly with the luminosity of the AGN. Lastly, to capitalize on the power of modern photometric surveys, I experiment with a new broadband imaging technique to study the morphology of AGN emission line regions and outflows. With images from the Sloan Digital Sky Survey (SDSS), this method successfully constructs images of the [OIII]lambda5007 emission line and reveals hundreds of extended emission-line systems. When applied to current and future surveys, such as the Large Synoptic Survey Telescope (LSST), this technique could open a new parameter space for the study of AGN outflows. In

  17. A robust measurement of the mass outflow rate of the galactic outflow from NGC 6090

    Science.gov (United States)

    Chisholm, John; Tremonti Christy, A.; Leitherer, Claus; Chen, Yanmei

    2016-11-01

    To evaluate the impact of stellar feedback, it is critical to estimate the mass outflow rates of galaxies. Past estimates have been plagued by uncertain assumptions about the outflow geometry, metallicity, and ionization fraction. Here we use Hubble Space Telescope ultraviolet spectroscopic observations of the nearby starburst NGC 6090 to demonstrate that many of these quantities can be constrained by the data. We use the Si IV absorption lines to calculate the scaling of velocity (v), covering fraction (Cf), and density with distance from the starburst (r), assuming the Sobolev optical depth and a velocity law of the form: v ∝ (1 - Ri/r)β (where Ri is the inner outflow radius). We find that the velocity (β = 0.43) is consistent with an outflow driven by an r-2 force with the outflow radially accelerated, while the scaling of the covering fraction (Cf ∝ r-0.82) suggests that cool clouds in the outflow are in pressure equilibrium with an adiabatically expanding medium. We use the column densities of four weak metal lines and CLOUDY photoionization models to determine the outflow metallicity, the ionization correction, and the initial density of the outflow. Combining these values with the profile fitting, we find Ri = 63 pc, with most of the mass within 300 pc of the starburst. Finally, we find that the maximum mass outflow rate is 2.3 M⊙ yr-1 and the mass-loading factor (outflow divided by the star formation rate) is 0.09, a factor of 10 lower than the value calculated using common assumptions for the geometry, metallicity, and ionization structure of the outflow.

  18. NK4 antagonizes Tbx1/10 to promote cardiac versus pharyngeal muscle fate in the ascidian second heart field.

    Science.gov (United States)

    Wang, Wei; Razy-Krajka, Florian; Siu, Eric; Ketcham, Alexandra; Christiaen, Lionel

    2013-12-01

    The heart and head muscles share common developmental origins and genetic underpinnings in vertebrates, including humans. Parts of the heart and cranio-facial musculature derive from common mesodermal progenitors that express NKX2-5, ISL1, and TBX1. This ontogenetic kinship is dramatically reflected in the DiGeorge/Cardio-Velo-Facial syndrome (DGS/CVFS), where mutations of TBX1 cause malformations in the pharyngeal apparatus and cardiac outflow tract. Cardiac progenitors of the first heart field (FHF) do not require TBX1 and segregate precociously from common progenitors of the second heart field (SHF) and pharyngeal muscles. However, the cellular and molecular mechanisms that govern heart versus pharyngeal muscle specification within this lineage remain elusive. Here, we harness the simplicity of the ascidian larva to show that, following asymmetric cell division of common progenitors, NK4/NKX2-5 promotes GATAa/GATA4/5/6 expression and cardiac specification in the second heart precursors by antagonizing Tbx1/10-mediated inhibition of GATAa and activation of Collier/Olf/EBF (COE), the determinant of atrial siphon muscle (ASM) specification. Our results uncover essential regulatory connections between the conserved cardio-pharyngeal factor Tbx1/10 and muscle determinant COE, as well as a mutual antagonism between NK4 and Tbx1/10 activities upstream of GATAa and COE. The latter cross-antagonism underlies a fundamental heart versus pharyngeal muscle fate choice that occurs in a conserved lineage of cardio-pharyngeal progenitors. We propose that this basic ontogenetic motif underlies cardiac and pharyngeal muscle development and evolution in chordates.

  19. NK4 antagonizes Tbx1/10 to promote cardiac versus pharyngeal muscle fate in the ascidian second heart field.

    Directory of Open Access Journals (Sweden)

    Wei Wang

    2013-12-01

    Full Text Available The heart and head muscles share common developmental origins and genetic underpinnings in vertebrates, including humans. Parts of the heart and cranio-facial musculature derive from common mesodermal progenitors that express NKX2-5, ISL1, and TBX1. This ontogenetic kinship is dramatically reflected in the DiGeorge/Cardio-Velo-Facial syndrome (DGS/CVFS, where mutations of TBX1 cause malformations in the pharyngeal apparatus and cardiac outflow tract. Cardiac progenitors of the first heart field (FHF do not require TBX1 and segregate precociously from common progenitors of the second heart field (SHF and pharyngeal muscles. However, the cellular and molecular mechanisms that govern heart versus pharyngeal muscle specification within this lineage remain elusive. Here, we harness the simplicity of the ascidian larva to show that, following asymmetric cell division of common progenitors, NK4/NKX2-5 promotes GATAa/GATA4/5/6 expression and cardiac specification in the second heart precursors by antagonizing Tbx1/10-mediated inhibition of GATAa and activation of Collier/Olf/EBF (COE, the determinant of atrial siphon muscle (ASM specification. Our results uncover essential regulatory connections between the conserved cardio-pharyngeal factor Tbx1/10 and muscle determinant COE, as well as a mutual antagonism between NK4 and Tbx1/10 activities upstream of GATAa and COE. The latter cross-antagonism underlies a fundamental heart versus pharyngeal muscle fate choice that occurs in a conserved lineage of cardio-pharyngeal progenitors. We propose that this basic ontogenetic motif underlies cardiac and pharyngeal muscle development and evolution in chordates.

  20. Bursty star formation feedback and cooling outflows

    Science.gov (United States)

    Suarez, Teresita; Pontzen, Andrew; Peiris, Hiranya V.; Slyz, Adrianne; Devriendt, Julien

    2016-10-01

    We study how outflows of gas launched from a central galaxy undergoing repeated starbursts propagate through the circum-galactic medium (CGM), using the simulation code RAMSES. We assume that the outflow from the disc can be modelled as a rapidly moving bubble of hot gas at ˜1 kpc above disc, then ask what happens as it moves out further into the halo around the galaxy on ˜100 kpc scales. To do this, we run 60 two-dimensional simulations scanning over parameters of the outflow. Each of these is repeated with and without radiative cooling, assuming a primordial gas composition to give a lower bound on the importance of cooling. In a large fraction of radiative-cooling cases we are able to form rapidly outflowing cool gas from in situ cooling of the flow. We show that the amount of cool gas formed depends strongly on the `burstiness' of energy injection; sharper, stronger bursts typically lead to a larger fraction of cool gas forming in the outflow. The abundance ratio of ions in the CGM may therefore change in response to the detailed historical pattern of star formation. For instance, outflows generated by star formation with short, intense bursts contain up to 60 per cent of their gas mass at temperatures <5 × 104 K; for near-continuous star formation, the figure is ≲5 per cent. Further study of cosmological simulations, and of idealized simulations with e.g. metal-cooling, magnetic fields and/or thermal conduction, will help to understand the precise signature of bursty outflows on observed ion abundances.

  1. Optimization of the Outflow Graft Position and Angle in a Left Ventricular Assist Device

    Science.gov (United States)

    McGah, Patrick; Prisco, Anthony; Beckman, Jennifer; Mokadam, Nahush; Mahr, Claudius; Aliseda, Alberto

    2015-11-01

    The placement of the outflow graft in the aorta plays a key role in the hemodynamics of Left Ventricle Assist Devices (LVAD), a medical device with a growing importance in the treatment of end-stage heart failure. We use a patient-specific computational model of the VAD and the ascending aorta to investigate the impact of VAD outflow graft configuration on the residence time and wall shear stresses along the ascending aorta and the ostia of the upper branches. The flow induced by the combination of VAD output through the graft anastomosed to the aorta and the limited cardiac output through intermittent opening of the aortic valve is studied to determine the nature of thrombogenic flow patterns. Outflow grafts are virtually anastomosed along the ascending aorta or subclavian artery of the patient-specific model at different positions and angles that are surgically-informed. Detailed markers of thrombosis, such as cell residence time, wall shear stress, and shear stress gradients are analyzed and compared for the different configurations. The angle of incidence of the outflow graft critically influences the volume of recirculating flow between aortic valve and anastomosis, and the aortic pressure acting against aortic valve opening.

  2. Pressurized groundwater outflow experiments and numerical modeling for outflow channels on Mars

    NARCIS (Netherlands)

    Marra, Wouter A.; Hauber, Ernst; McLelland, Stuart J.; Murphy, Brendan J.; Parsons, Daniel R.; Conway, Susan J.; Roda, Manuel; Govers, Rob; Kleinhans, Maarten G.

    2014-01-01

    The landscape of Mars shows incised channels that often appear abruptly in the landscape, suggesting a groundwater source. However, groundwater outflow processes are unable to explain the reconstructed peak discharges of the largest outflow channels based on their morphology. Therefore, there is a d

  3. Protostellar Outflows and Radiative Feedback from Massive Stars. II. Feedback, Star Formation Efficiency, and Outflow Broadening

    CERN Document Server

    Kuiper, Rolf; Yorke, Harold W

    2016-01-01

    We perform two-dimensional axially symmetric radiation-hydrodynamic simulations to assess the impact of outflows and radiative force feedback from massive protostars by varying when the protostellar outflow starts, the ratio of ejection to accretion rates, and the strength of the wide angle disk wind component. The star formation efficiency, i.e. the ratio of final stellar mass to initial core mass, is dominated by radiative forces and the ratio of outflow to accretion rates. Increasing this ratio has three effects: First, the protostar grows slower with a lower luminosity at any given time, lowering radiative feedback. Second, bipolar cavities cleared by the outflow are larger, further diminishing radiative feedback on disk and core scales. Third, the higher momentum outflow sweeps up more material from the collapsing envelope, decreasing the protostar's potential mass reservoir via entrainment. The star formation efficiency varies with the ratio of ejection to accretion rates from 50% in the case of very we...

  4. Cardiac cameras.

    Science.gov (United States)

    Travin, Mark I

    2011-05-01

    Cardiac imaging with radiotracers plays an important role in patient evaluation, and the development of suitable imaging instruments has been crucial. While initially performed with the rectilinear scanner that slowly transmitted, in a row-by-row fashion, cardiac count distributions onto various printing media, the Anger scintillation camera allowed electronic determination of tracer energies and of the distribution of radioactive counts in 2D space. Increased sophistication of cardiac cameras and development of powerful computers to analyze, display, and quantify data has been essential to making radionuclide cardiac imaging a key component of the cardiac work-up. Newer processing algorithms and solid state cameras, fundamentally different from the Anger camera, show promise to provide higher counting efficiency and resolution, leading to better image quality, more patient comfort and potentially lower radiation exposure. While the focus has been on myocardial perfusion imaging with single-photon emission computed tomography, increased use of positron emission tomography is broadening the field to include molecular imaging of the myocardium and of the coronary vasculature. Further advances may require integrating cardiac nuclear cameras with other imaging devices, ie, hybrid imaging cameras. The goal is to image the heart and its physiological processes as accurately as possible, to prevent and cure disease processes.

  5. Cerebral venous outflow and cerebrospinal fluid dynamics

    Directory of Open Access Journals (Sweden)

    Clive B. Beggs

    2014-12-01

    Full Text Available In this review, the impact of restricted cerebral venous outflow on the biomechanics of the intracranial fluid system is investigated. The cerebral venous drainage system is often viewed simply as a series of collecting vessels channeling blood back to the heart. However there is growing evidence that it plays an important role in regulating the intracranial fluid system. In particular, there appears to be a link between increased cerebrospinal fluid (CSF pulsatility in the Aqueduct of Sylvius and constricted venous outflow. Constricted venous outflow also appears to inhibit absorption of CSF into the superior sagittal sinus. The compliance of the cortical bridging veins appears to be critical to the behaviour of the intracranial fluid system, with abnormalities at this location implicated in normal pressure hydrocephalus. The compliance associated with these vessels appears to be functional in nature and dependent on the free egress of blood out of the cranium via the extracranial venous drainage pathways. Because constricted venous outflow appears to be linked with increased aqueductal CSF pulsatility, it suggests that inhibited venous blood outflow may be altering the compliance of the cortical bridging veins.

  6. Evolution of Mass Outflow in Protostars

    CERN Document Server

    Watson, Dan M; Fischer, William J; Forrest, W J; Manoj, P; Megeath, S Thomas; Melnick, Gary J; Najita, Joan; Neufeld, David A; Sheehan, Patrick D; Stutz, Amelia M; Tobin, John J

    2015-01-01

    We have surveyed 84 Class 0, Class I, and flat-spectrum protostars in mid-infrared [Si II], [Fe II] and [S I] line emission, and 11 of these in far-infrared [O I] emission. We use the results to derive their mass outflow rates. Thereby we observe a strong correlation of mass outflow rates with bolometric luminosity, and with the inferred mass accretion rates of the central objects, which continues through the Class 0 range the trend observed in Class II young stellar objects. Along this trend from large to small mass-flow rates, the different classes of young stellar objects lie in the sequence Class 0 -- Class I/flat-spectrum -- Class II, indicating that the trend is an evolutionary sequence in which mass outflow and accretion rates decrease together with increasing age, while maintaining rough proportionality. The survey results include two which are key tests of magnetocentrifugal outflow-acceleration mechanisms: the distribution of the outflow/accretion branching ratio b, and limits on the distribution of...

  7. Bursty star formation feedback and cooling outflows

    CERN Document Server

    Suarez, Teresita; Peiris, Hiranya V; Slyz, Adrianne; Devriendt, Julien

    2016-01-01

    We study how outflows of gas launched from a central galaxy undergoing repeated starbursts propagate through the circumgalactic medium (CGM), using the simulation code RAMSES. We assume that the outflow from the disk can be modelled as a rapidly moving bubble of hot gas at $\\mathrm{\\sim1\\;kpc}$ above disk, then ask what happens as it moves out further into the halo around the galaxy on $\\mathrm{\\sim 100\\;kpc}$ scales. To do this we run 60 two-dimensional simulations scanning over parameters of the outflow. Each of these is repeated with and without radiative cooling, assuming a primordial gas composition to give a lower bound on the importance of cooling. In a large fraction of radiative-cooling cases we are able to form rapidly outflowing cool gas from in situ cooling of the flow. We show that the amount of cool gas formed depends strongly on the 'burstiness' of energy injection; sharper, stronger bursts typically lead to a larger fraction of cool gas forming in the outflow. The abundance ratio of ions in th...

  8. Observations of Protostellar Outflow Feedback in Clustered Star Formation

    CERN Document Server

    Nakamura, Fumitaka

    2015-01-01

    We discuss the role of protostellar outflow feedback in clustered star formation using the observational data of recent molecular outflow surveys toward nearby cluster-forming clumps. We found that for almost all clumps, the outflow momentum injection rate is significantly larger than the turbulence dissipation rate. Therefore, the outflow feedback is likely to maintain supersonic turbulence in the clumps. For less massive clumps such as B59, L1551, and L1641N, the outflow kinetic energy is comparable to the clump gravitational energy. In such clumps, the outflow feedback probably affects significantly the clump dynamics. On the other hand, for clumps with masses larger than about 200 M$_\\odot$, the outflow kinetic energy is significantly smaller than the clump gravitational energy. Since the majority of stars form in such clumps, we conclude that outflow feedback cannot destroy the whole parent clump. These characteristics of the outflow feedback support the scenario of slow star formation.

  9. Magnetospheric outflows in young stellar objects

    Directory of Open Access Journals (Sweden)

    Zanni Claudio

    2014-01-01

    Full Text Available Different classes of outflows are associated with the magnetospheric activity of accreting T Tauri protostars. Stellar winds are accelerated along the open field lines anchored in the stellar surface; disk winds (extended or X-type can be launched along the open magnetic surfaces threading the accretion disk; another type of ejection can arise from the region of interaction of the closed magnetosphere with the accretion disk (magnetospheric ejections, conical winds, where the magnetic surfaces undergo quasiperiodic episodes of inflation and reconnection. In this chapter I will present the main dynamical properties of these different types of outflow. Two main issues will be addressed. First, I will try to understand if these ejection phenomena can account for the origin of the jets often observed in young forming stellar systems. Second, I will evaluate the impact of these outflows on the angular momentum evolution of the central protostar.

  10. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

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

  11. Protostellar Outflow Evolution in Turbulent Environments

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, A; Frank, A; Carroll, J; Blackman, E; Quillen, A

    2008-04-11

    The link between turbulence in star formatting environments and protostellar jets remains controversial. To explore issues of turbulence and fossil cavities driven by young stellar outflows we present a series of numerical simulations tracking the evolution of transient protostellar jets driven into a turbulent medium. Our simulations show both the effect of turbulence on outflow structures and, conversely, the effect of outflows on the ambient turbulence. We demonstrate how turbulence will lead to strong modifications in jet morphology. More importantly, we demonstrate that individual transient outflows have the capacity to re-energize decaying turbulence. Our simulations support a scenario in which the directed energy/momentum associated with cavities is randomized as the cavities are disrupted by dynamical instabilities seeded by the ambient turbulence. Consideration of the energy power spectra of the simulations reveals that the disruption of the cavities powers an energy cascade consistent with Burgers-type turbulence and produces a driving scale-length associated with the cavity propagation length. We conclude that fossil cavities interacting either with a turbulent medium or with other cavities have the capacity to sustain or create turbulent flows in star forming environments. In the last section we contrast our work and its conclusions with previous studies which claim that jets can not be the source of turbulence.

  12. Accretion, Outflows, and Winds of Magnetized Stars

    CERN Document Server

    Romanova, M M

    2016-01-01

    Many types of stars have strong magnetic fields that can dynamically influence the flow of circumstellar matter. In stars with accretion disks, the stellar magnetic field can truncate the inner disk and determine the paths that matter can take to flow onto the star. These paths are different in stars with different magnetospheres and periods of rotation. External field lines of the magnetosphere may inflate and produce favorable conditions for outflows from the disk-magnetosphere boundary. Outflows can be particularly strong in the propeller regime, wherein a star rotates more rapidly than the inner disk. Outflows may also form at the disk-magnetosphere boundary of slowly rotating stars, if the magnetosphere is compressed by the accreting matter. In isolated, strongly magnetized stars, the magnetic field can influence formation and/or propagation of stellar wind outflows. Winds from low-mass, solar-type stars may be either thermally or magnetically driven, while winds from massive, luminous O and B type stars...

  13. Congenital optic tract hypoplasia.

    Science.gov (United States)

    Hatsukawa, Yoshikazu; Fujio, Takahiro; Nishikawa, Masanori; Taylor, David

    2015-08-01

    We report a case of isolated unilateral optic tract hypoplasia, described only twice previously. Bilateral optic disk hypoplasia was seen ophthalmoscopically and visual field studies showed an incongruous right homonymous hemianopia. Magnetic resonance imaging showed bilateral hypoplasia of both optic nerves and the left optic tract. Spectral domain optical coherence tomography mapping correlated well with the visual field studies.

  14. Pediatric Urinary Tract Infection

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and ... To protect the kidneys from damage – By preventing urinary tract infections (UTI) – By identifying and treating vesicoureteral remux (VUR). ...

  15. The Resolved Outflow from 3C 48

    Science.gov (United States)

    Shih, Hsin-Yi; Stockton, Alan

    2014-10-01

    We investigate the properties of the high-velocity outflow driven by the young radio jet of 3C 48, a compact-steep-spectrum source. We use the Space Telescope Imaging Spectrograph on board the Hubble Space Telecope to obtain (1) low-resolution UV and optical spectra and (2) multi-slit medium-resolution spectra of the ionized outflow. With supporting data from ground-based spectrographs, we are able to accurately measure the ratios of diagnostic emission lines such as [O III] λ5007, [O III] λ3727, [N II] λ6548, Hα, Hβ, [Ne V] λ3425, and [Ne III] λ3869. We fit the observed emission-line ratios using a range of ionization models, powered by active galactic nucleus (AGN) radiation and shocks, produced by the MAPPINGS code. We have determined that AGN radiation is likely the dominant ionization source. The outflow's density is estimated to be in the range n = 103-104 cm-3, the mass is ~6 × 106 M ⊙, and the metallicity is likely equal to or higher than solar. Compared with the typical outflows associated with more evolved radio jets, this young outflow is denser, less massive, and more metal rich. Multi-slit observations allow us to construct a two-dimensional velocity map of the outflow that shows a wide range of velocities with distinct velocity components, suggesting a wide-angle clumpy outflow. Based in part on observations made with the NASA/ESA Hubble Space Telescope, obtained at the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. These observations are associated with program GO-11574. Some of the data presented herein were obtained at the W. M. Keck Observatory, which is operated as a scientific partnership among the California Institute of Technology, the University of California and the National Aeronautics and Space Administration. The Observatory was made possible by the generous financial support of the W. M. Keck Foundation. Some of the

  16. Pacemaker optimization guided by echocardiography in cardiac resynchronization therapy

    Directory of Open Access Journals (Sweden)

    Trifunović Danijela

    2009-01-01

    Full Text Available Introduction. Cardiac resynchronization therapy (CRT or biventricular pacing is a contemporary treatment in the management of advanced heart failure. Echocardiography plays an evolving and important role in patient selection for CRT, follow-up of acute and chronic CRT effects and optimization of device settings after biventricular pacemaker implantation. In this paper we illustrate usefulness of echocardiography for successful AV and VV timing optimization in patients with CRT. A review of up-to-date literature concerning rationale for AV and VV delay optimization, echocardiographic protocols and current recommendations for AV and VV optimization after CRT are also presented. Outline of Cases. The first case is of successful AV delay optimization guided by echocardiography in a patient with dilated cardiomyopathy treated with CRT is presented. Pulsed blood flow Doppler was used to detect mitral inflow while programming different duration of AV delay. The AV delay with optimal transmittal flow was established. The optimal mitral flow was the one with clearly defined E and A waves and maximal velocity time integral (VTI of the mitral flow. Improvement in clinical status and reverse left ventricle remodelling with improvement of ejection fraction was registered in our patient after a month. The second case presents a patient with heart failure caused by dilated cardiomyopathy; six months after CRT implantation the patient was still NYHA class III and with a significantly depressed left ventricular ejection fraction. Optimization of VV interval guided by echocardiography was undertaken measuring VTI of the left ventricular outflow tract (LVOT during programming of different VV intervals. The optimal VV interval was determined using a maximal LVOT VTI. A month after VV optimization our patient showed improvement in LV ejection fraction. Conclusion. Optimal management of patients treated with CRT integrate both clinical and echocardiographic follow

  17. The Implications of Extreme Outflows from Extreme Starbursts

    OpenAIRE

    Heckman, Timothy M.; Borthakur, Sanchayeeta

    2016-01-01

    Interstellar ultraviolet absorption-lines provide crucial information about the properties of galactic outflows. In this paper, we augment our previous analysis of the systematic properties of starburst-driven galactic outflows by expanding our sample to include a rare population of starbursts with exceptionally high outflow velocities. In principle, these could be a qualitatively different phenomenon from more typical outflows. However, we find that instead these starbursts lie on, or along ...

  18. Cardiac Rehabilitation

    Science.gov (United States)

    ... your risk of future heart problems, and to improve your health and quality of life. Cardiac rehabilitation programs increase ... exercise routine at home or at a local gym. You may also continue to ... health concerns. Education about nutrition, lifestyle and weight loss ...

  19. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Tract Infections (UTIs) Print A A A What's in this article? What Exactly Is a Urinary Tract? ... happen because bacteria have caused an infection somewhere in your urinary tract. Let's find out more. What ...

  20. Clinical Assessment of Intraventricular Blood Transport in Patients Undergoing Cardiac Resynchronization Therapy

    Science.gov (United States)

    Rossini, Lorenzo; Martinez-Legazpi, P.; Benito, Y.; Perez Del Villar, C.; Gonzalez-Mansilla, A.; Barrio, A.; Yotti, R.; Kahn, A. M.; Shadden, S. C.; Fernandez-Aviles, F.; Bermejo, J.; Del Alamo, J. C.

    2015-11-01

    In the healthy heart, left ventricular (LV) filling generates flow patterns which have been proposed to optimize blood transport by coupling diastole and systole phases. We present a novel image-based method to assess how flow patterns influence LV blood transport in patients undergoing cardiac resynchronization therapy (CRT). Solving the advection equation with time-varying inflow boundary conditions allows to track the transport of blood entering the LV in the different filling waves, as well as the transport barriers which couple filling and ejection. The velocity fields were obtained using echocardiographic color Doppler velocimetry, which provides two-dimensional time-resolved flow maps in the apical long axis three-chamber view of the LV. We analyze flow transport in a group of patients with CRT devices as well as in healthy volunteers. In the patients under CRT, the device programming was varied to analyze flow transport under different values of the atrioventricular (AV) conduction delay and to model tachycardia. This analysis illustrates how CRT influences the transit of blood inside the LV, contributes to conserving kinetic energy and favors the generation of hemodynamic forces that accelerate blood in the direction of the LV outflow tract.

  1. Delayed cardiac metastasis from phyllodes breast tumor presenting as cardiogenic shock.

    Science.gov (United States)

    Garg, Naveen; Moorthy, Nagaraja; Agrawal, Surendra K; Pandey, Santanu; Kumari, Niraj

    2011-01-01

    Malignant metastases to the heart and pericardium, which occur far more often than do primary cardiac neoplasms, typically lead to fatal outcomes. The phyllodes tumor is a rare, predominantly benign fibroepithelial breast neoplasm with variable malignancy potential. Herein, we describe the case of a 35-year-old woman who, 3 years after undergoing a simple mastectomy for a rapidly enlarging breast neoplasm, presented with cardiogenic shock and was found to have a large right ventricular tumor that obstructed the right ventricular outflow tract. Despite successful resection of the ventricular mass and a right atrial mass of organized thrombus, the patient died 8 days postoperatively of multiorgan failure due to severe right ventricular dysfunction. Histopathologic analysis determined that the right ventricular mass was a malignant, metastatic phyllodes tumor. To our knowledge, this is only the 2nd reported case of a phyllodes tumor that metastasized to the heart and presented as an intracavitary mass with cardiogenic shock. In addition to discussing our patient's case, we review the pertinent medical literature.

  2. Abnormal splicing in the N-terminal variable region of cardiac troponin T impairs systolic function of the heart with preserved Frank-Starling compensation.

    Science.gov (United States)

    Feng, Han-Zhong; Chen, Guozhen; Nan, Changlong; Huang, Xupei; Jin, Jian-Ping

    2014-09-01

    Abnormal splice-out of the exon 7-encoded segment in the N-terminal variable region of cardiac troponin T (cTnT-ΔE7) was found in turkeys and, together with the inclusion of embryonic exon (eTnT), in adult dogs with a correlation with dilated cardiomyopathy. Overexpression of these cTnT variants in transgenic mouse hearts significantly decreased cardiac function. To further investigate the functional effect of cTnT-ΔE7 or ΔE7+eTnT in vivo under systemic regulation, echocardiography was carried out in single and double-transgenic mice. No atrial enlargement, ventricular hypertrophy or dilation was detected in the hearts of 2-month-old cTnT-ΔE7 and ΔE7+eTnT mice in comparison to wild-type controls, indicating a compensated state. However, left ventricular fractional shortening and ejection fraction were decreased in ΔE7 and ΔE7+eTnT mice, and the response to isoproterenol was lower in ΔE7+eTnT mice. Left ventricular outflow tract velocity and gradient were decreased in the transgenic mouse hearts, indicating decreased systolic function. Ex vivo working heart function showed that high afterload or low preload resulted in more severe decreases in the systolic function and energetic efficiency of cTnT-ΔE7 and ΔE7+eTnT hearts. On the other hand, increases in preload demonstrated preserved Frank-Starling responses and minimized the loss of cardiac function and efficiency. The data demonstrate that the N-terminal variable region of cardiac TnT regulates systolic function of the heart.

  3. Influence of Mediterranean Outflow on climate

    Science.gov (United States)

    Rahmstorf, Stefan

    A cover article in Eos last year [Johnson, 1997] called for a dam across the Strait of Gibraltar to prevent a new Ice Age. In this article, R. G. Johnson argued that reduced Nile River flow after building the Aswan Dam increases Mediterranean Sea salinity, leading to enhanced outflow of salty water into the Atlantic Ocean. This, in turn, would alter the thermohaline (that is, temperature and salinity driven) circulation of the Atlantic, heat up the Labrador Sea and enhance evaporation there, and increase snowfall in Canada until a new ice sheet builds up. Ocean circulation model experiments, however, suggest that this fear is unfounded. While Mediterranean saltwater outflow (Figure 1a) does appear to have some effect on North Atlantic circulation and surface climate, the change in Mediterranean salt budget resulting from the Aswan Dam is far too small to have any noticeable impact.

  4. Protostellar outflows with Smoothed Particle Magnetohydrodynamics (SPMHD)

    CERN Document Server

    Bürzle, Florian; Stasyszyn, Federico; Dolag, Klaus; Klessen, Ralf S

    2011-01-01

    The protostellar collapse of a molecular cloud core is usually accompanied by outflow phenomena. The latter are thought to be driven by magnetorotational processes from the central parts of the protostellar disc. While several 3D AMR/nested grid studies of outflow phenomena in collapsing magnetically supercritical dense cores have been reported in the literature, so far no such simulation has been performed using the Smoothed Particle Hydrodynamics (SPH) method. This is mainly due to intrinsic numerical difficulties in handling magnetohydrodynamics within SPH, which only recently were partly resolved. In this work, we use an approach where we evolve the magnetic field via the induction equation, augmented with stability correction and divergence cleaning schemes. We consider the collapse of a rotating core of one solar mass, threaded by a weak magnetic field initially parallel to the rotation axis so that the core is magnetically supercritical. We show, that Smoothed Particle Magnetohydrodynamics (SPMHD) is a...

  5. Hepatic venous outflow obstruction: Three similar syndromes

    Institute of Scientific and Technical Information of China (English)

    Ulas Darda Bayraktar; Soley Seren; Yusuf Bayraktar

    2007-01-01

    Our goal is to provide a detailed review of venoocclusive disease (VOD), Budd-Chiari syndrome (BCS),and congestive hepatopathy (CH), all of which results in hepatic venous outflow obstruction. This is the first article in which all three syndromes have been reviewed,enabling the reader to compare the characteristics of these disorders. The histological findings in VOD, BCS,and CH are almost identical: sinusoidal congestion and cell necrosis mostly in perivenular areas of hepatic acini which eventually leads to bridging fibrosis between adjacent central veins. Tender hepatomegaly with jaundice and ascites is common to all three conditions.However, the clinical presentation depends mostly on the extent and rapidity of the outflow obstruction.Although the etiology and treatment are completely different in VOD, BCS, and CH; the similarities in clinical manifestations and liver histology may suggest a common mechanism of hepatic injury and adaptation in response to increased sinusoidal pressure.

  6. Cardiac Calcification

    Directory of Open Access Journals (Sweden)

    Morteza Joorabian

    2011-05-01

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

  7. In vivo mechanical study of helical cardiac pacing electrode interacting with canine myocardium

    Institute of Scientific and Technical Information of China (English)

    Xiangming Zhang; Nianke Ma; Hualin Fan; Guodong Niu; Wei Yang

    2007-01-01

    Cardiac pacing is a medical device to help human to overcome arrhythmia and to recover the regular beats of heart. A helical configuration of electrode tip is a new type of cardiac pacing lead distal tip. The helical electrode attaches itself to the desired site of heart by screwing its helical tip into the myocardium. In vivo experiments on anesthetized dogs were carried out to measure the acute interactions between helical electrode and myocardium during screw-in and pull-out processes. These data would be helpful for electrode tip design and electrode/myocardium adherence safety evaluation. They also provide reliability data for clinical site choice of human heart to implant and to fix the pacing lead.A special design of the helical tip using strain gauges is instrumented for the measurement of the screw-in and pull-out forces. We obtained the data of screw-in torques and pull-out forces for five different types of helical electrodes at nine designed sites on ten canine hearts. The results indicate that the screw-in torques increased steplike while the torque-time curves presente saw-tooth fashion. The maximum torque has a range of 0.3-1.9N mm. Obvious differences are observed for different types of helical tips and for different test sites.Large pull-out forces are frequently obtained at epicardium of left ventricle and right ventricle lateral wall, and the forces obtained at right ventricle apex and outflow tract of right ventricle are normally small. The differences in pull-out forces are dictated by the geometrical configuration of helix and regional structures of heart muscle.

  8. In situ cardiac perfusion reveals interspecific variation of intraventricular flow separation in reptiles.

    Science.gov (United States)

    Joyce, William; Axelsson, Michael; Altimiras, Jordi; Wang, Tobias

    2016-07-15

    The ventricles of non-crocodilian reptiles are incompletely divided and provide an opportunity for mixing of oxygen-poor blood and oxygen-rich blood (intracardiac shunting). However, both cardiac morphology and in vivo shunting patterns exhibit considerable interspecific variation within reptiles. In the present study, we develop an in situ double-perfused heart approach to characterise the propensity and capacity for shunting in five reptile species: the turtle Trachemys scripta, the rock python Python sebae, the yellow anaconda Eunectes notaeus, the varanid lizard Varanus exanthematicus and the bearded dragon Pogona vitticeps To simulate changes in vascular bed resistance, pulmonary and systemic afterloads were independently manipulated and changes in blood flow distribution amongst the central outflow tracts were monitored. As previously demonstrated in Burmese pythons, rock pythons and varanid lizards exhibited pronounced intraventricular flow separation. As pulmonary or systemic afterload was raised, flow in the respective circulation decreased. However, flow in the other circulation, where afterload was constant, remained stable. This correlates with the convergent evolution of intraventricular pressure separation and the large intraventricular muscular ridge, which compartmentalises the ventricle, in these species. Conversely, in the three other species, the pulmonary and systemic flows were strongly mutually dependent, such that the decrease in pulmonary flow in response to elevated pulmonary afterload resulted in redistribution of perfusate to the systemic circuit (and vice versa). Thus, in these species, the muscular ridge appeared labile and blood could readily transverse the intraventricular cava. We conclude that relatively minor structural differences between non-crocodilian reptiles result in the fundamental changes in cardiac function. Further, our study emphasises that functionally similar intracardiac flow separation evolved independently in

  9. Urinary Tract Infections

    OpenAIRE

    Bjerklund Johansen, Truls E.; Naber, Kurt G.

    2014-01-01

    Urinary tract infections (UTI) are among the most frequently acquired infections in the community, but also in hospitals and other health care institutions, causing a huge amount of antibiotic consumption. During the last decade we have seen significant changes in the field of urinary tract infections regarding causative pathogens and antibiotic treatment calling for an update of current trends. The worldwide increase of uropathogens resistant to former first line antibiotics, such as cotrim...

  10. Magnotospheric imaging of high latitude ion outflows

    Directory of Open Access Journals (Sweden)

    D. E. Garrido

    Full Text Available High latitude ion outflows mostly consist of upward streaming O+ and He+ emanating from the ionosphere. At heights above 1000 km, these flows consist of cold and hot components which resonantly scatter solar extreme ultraviolet (EUV light, however, the ion populations respond differently to Doppler shifting resulting from the large relative velocities between the ions and the Sun. The possibility of optical detection of the Doppler effect on the scattering rate will be discussed for the O+ (83.4 nm ions. We have contrasted the EUV solar resonance images of these outflows by simulations of the 30.4 nm He+ and 83.4 nm O+ emissions for both quiet and disturbed geomagnetic conditions. Input data for the 1000 km level has been obtained from the EICS instrument aboard the Dynamics Explorer satellite. Our results show emission rates of 50 and 56 milli-Rayleighs at 30.4 nm for quiet and disturbed conditions and 65 and 75 milli-Rayleighs at 83.4 nm for quiet and disturbed conditions, respectively, obtained for a polar orbiting satellite and viewing radially outward. We also find that an imager at an equatorial distance of 9 RE or more is in a favourable position for detecting ion outflows, particularly when the plasmapause is depressed in latitude. However, an occultation disk is necessary to obscure the bright plasmaspheric emissions.

  11. DLA kinematics and outflows from starburst galaxies

    CERN Document Server

    Razoumov, Alexei O

    2008-01-01

    We present results from a numerical study of the multiphase interstellar medium in sub-Lyman-break galaxy protogalactic clumps. Such clumps are abundant at z=3 and are thought to be a major contributor to damped Ly-alpha absorption. We model the formation of winds from these clumps and show that during star formation episodes they feature outflows with neutral gas velocity widths up to several hundred km/s. Such outflows are consistent with the observed high-velocity dispersion in DLAs. In our models thermal energy feedback from winds and supernovae results in efficient outflows only when cold (~ 300 K), dense (> 100 msun/pc^3) clouds are resolved at grid resolution of 12 pc. At lower 24 pc resolution the first signs of the multiphase medium are spotted; however, at this low resolution thermal injection of feedback energy cannot yet create hot expanding bubbles around star-forming regions -- instead feedback tends to erase high-density peaks and suppress star formation. At 12 pc resolution feedback compresses...

  12. Hot Electromagnetic Outflows I: Acceleration and Spectra

    CERN Document Server

    Russo, Matthew

    2013-01-01

    The theory of cold, relativistic, magnetohydrodynamic outflows is generalized by the inclusion of an intense radiation source. In some contexts, such the breakout of a gamma-ray burst jet from a star, the outflow is heated to a high temperature at a large optical depth. Eventually it becomes transparent and is pushed to a higher Lorentz factor by a combination of the Lorentz force and radiation pressure. We obtain its profile, both inside and outside the fast magnetosonic critical point, when the poloidal magnetic field is radial and monopolar. Most of the energy flux is carried by the radiation field and the toroidal magnetic field that is wound up close to the rapidly rotating engine. Although the entrained matter carries little energy, it couples the radiation field to the magnetic field. Then the fast critical point is pushed inward from infinity and, above a critical radiation intensity, the outflow is accelerated mainly by radiation pressure. We identify a distinct observational signature of this hybrid...

  13. Outflows of stars due to quasar feedback

    CERN Document Server

    Zubovas, Kastytis; Sazonov, Sergey; Sunyaev, Rashid

    2013-01-01

    Quasar feedback outflows are commonly invoked to drive gas out of galaxies in the early gas-rich epoch to terminate growth of galaxies. Here we present simulations that show that AGN feedback may drive not only gas but also stars out of their host galaxies under certain conditions. The mechanics of this process is as following: (1) AGN-driven outflows accelerate and compress gas filling the host galaxy; (2) the accelerated dense shells become gravitationally unstable and form stars on radial trajectories. For the spherically symmetric initial conditions explored here, the black hole needs to exceed the host's M_sigma mass by a factor of a few to accelerate the shells and the new stars to escape velocities. We discuss potential implications of these effects for the host galaxies: (i) radial mixing of bulge stars with the rest of the host; (ii) contribution of quasar outflows to galactic fountains as sources of high-velocity clouds; (iii) wholesale ejection of hyper velocity stars out of their hosts, giving ris...

  14. A Robust Measurement of the Mass Outflow Rate of the Galactic Outflow from NGC 6090

    CERN Document Server

    Chisholm, John; Leitherer, Claus; Chen, Yanmei

    2016-01-01

    To evaluate the impact of stellar feedback, it is critical to estimate the mass outflow rates of galaxies. Past estimates have been plagued by uncertain assumptions about the outflow geometry, metallicity, and ionization fraction. Here we use Hubble Space Telescope ultraviolet spectroscopic observations of the nearby starburst NGC 6090 to demonstrate that many of these quantities can be constrained by the data. We use the Si~{\\sc IV} absorption lines to calculate the scaling of velocity (v), covering fraction (C$_f$), and density with distance from the starburst (r), assuming the Sobolev optical depth and a velocity law of the form: $v \\propto(1 -R_i/r )^\\beta$ (were R$_i$ is the inner outflow radius). We find that the velocity ($\\beta$=0.43) is consistent with an outflow driven by an r$^{-2}$ force, while the scaling of the covering fraction ($C_f \\propto r^{-0.82}$) suggests that cool clouds in the outflow are in pressure equilibrium with an adiabatically expanding medium. We use the column densities of fou...

  15. Kidney and Urinary Tract

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    2011229 Combined detection of markers in the early diagnosis of acute kidney injury following cardiac surgery. CHE Miaolin (车妙琳) ,et al. Renal Division,Renji Hosp,Med Sch,Shanghai Jiaotong Univ, Shanghai 200127.

  16. The Prevalence of Gas Outflows in Type 2 AGNs. II. 3D Biconical Outflow Models

    Science.gov (United States)

    Bae, Hyun-Jin; Woo, Jong-Hak

    2016-09-01

    We present 3D models of biconical outflows combined with a thin dust plane for investigating the physical properties of the ionized gas outflows and their effect on the observed gas kinematics in type 2 active galactic nuclei (AGNs). Using a set of input parameters, we construct a number of models in 3D and calculate the spatially integrated velocity and velocity dispersion for each model. We find that three primary parameters, i.e., intrinsic velocity, bicone inclination, and the amount of dust extinction, mainly determine the simulated velocity and velocity dispersion. Velocity dispersion increases as the intrinsic velocity or the bicone inclination increases, while velocity (i.e., velocity shifts with respect to systemic velocity) increases as the amount of dust extinction increases. Simulated emission-line profiles well reproduce the observed [O iii] line profiles, e.g., narrow core and broad wing components. By comparing model grids and Monte Carlo simulations with the observed [O iii] velocity-velocity dispersion distribution of ˜39,000 type 2 AGNs, we constrain the intrinsic velocity of gas outflows ranging from ˜500 to ˜1000 km s-1 for the majority of AGNs, and up to ˜1500-2000 km s-1 for extreme cases. The Monte Carlo simulations show that the number ratio of AGNs with negative [O iii] velocity to AGNs with positive [O iii] velocity correlates with the outflow opening angle, suggesting that outflows with higher intrinsic velocity tend to have wider opening angles. These results demonstrate the potential of our 3D models for studying the physical properties of gas outflows, applicable to various observations, including spatially integrated and resolved gas kinematics.

  17. Assessment of infective urinary tract disorders

    Energy Technology Data Exchange (ETDEWEB)

    Sixt, R.; Stokland, E. [Goteborg, Sahlgrenska Univ. Hospital/Ostra (Sweden). Dept. of Pediatric Clinical Physiology and Dept. of Pediatric Radiology

    1998-06-01

    Urinary tracts infection (UTI) is common in children, particularly in the youngest age groups. There is a risk for progressive deterioration of renal function in these children if aggravating factors such as gross reflux and/or outflow obstruction of the urinary tract are present. In this review the pros and cons of available scintigrafic and radiological imaging techniques for the work-up of these children are presented. Ultrasound can be used in the acute phase to exclude obstruction but can not reliably show transient or permanent parenchymal lesions. The presence of reflux can be established with X-ray or direct nuclide cystography. The X-ray technique gives good morphological information and has a grading system with prognostic relevance. Both techniques are invasive and great care must be taken to keep the radiation burden down with the X-ray technique. Indirect nuclide cystography following a renographic study is non-invasive but has a lower sensitivity than direct techniques. More experience is needed with the indirect technique to evaluate the consequences of its apparently low sensitivity. Urography has a limited place in the acute work-up of urinary tract infection but can be used to look for renal scarring 1-2 years after an acute pyelonephritis. The {sup 99m}Tc dimercaptosuccinic acid (DMSA) scan can be used during the acute UTI to show pyelonephritic lesions with good accuracy and/or during the follow-up after six months to show permanent lesions. The acute DMSA scan can be omitted.

  18. [Left ventricular synchrony with septum stimulation vs. septal ventricular outflow tract in complete atrioventricular block].

    Science.gov (United States)

    Rodríguez-Serrano, Gustavo; Lara-Vaca, Susano; Pereyra-Nobara, Texar; Bernal-Ruiz, Enrique

    2016-01-01

    Introducción: el objetivo del presente estudio fue determinar si existe diferencia en la función sistólica y la sincronía del ventrículo izquierdo con estimulación del septum medio o tracto de salida del ventrículo derecho en pacientes con bloqueo auriculoventricular portadores de marcapaso. Métodos: estudio observacional, analítico, transversal. Se seleccionaron todos los pacientes mayores de 18 años portadores de marcapaso con diagnóstico de bloqueo auriculoventricular. Se analizaron dos grupos acorde al sitio de colocación del electrodo de estimulación en región septal media o tracto de salida del ventrículo derecho. Se determinó la fracción de expulsión y sincronía del ventrículo izquierdo. Resultados: se incluyeron 54 pacientes por cada grupo, siendo las características de ambos similares, excepto el tiempo de colocación del electrodo de estimulación ventricular (p = < 0.001). No hubo diferencia significativa en la fracción de expulsión o sincronía del ventrículo izquierdo. Conclusiones: no se encontró diferencia en la fracción de expulsión o sincronía del ventrículo izquierdo independientemente del sitio de colocación del electrodo de estimulación.

  19. A resolved outflow of matter from a Brown Dwarf

    CERN Document Server

    Whelan, E T; Bacciotti, F; Natta, A; Testi, L; Randich, S; Whelan, Emma T.; Ray, Thomas P.; Bacciotti, Francesca; Natta, Antonella; Testi, Leonardo; Randich, Sofia

    2005-01-01

    The birth of stars involves not only accretion but also, counter-intuitively, the expulsion of matter in the form of highly supersonic outflows. Although this phenomenon has been seen in young stars, a fundamental question is whether it also occurs amongst newborn brown dwarfs: these are the so-called 'failed stars', with masses between stars and planets, that never manage to reach temperatures high enough for normal hydrogen fusion to occur. Recently, evidence for accretion in young brown dwarfs has mounted, and their spectra show lines that are suggestive of outflows. Here we report spectro-astrometric data that spatially resolve an outflow from a brown dwarf. The outflow's characteristics appear similar to, but on a smaller scale than, outflows from normal young stars. This result suggests that the outflow mechanism is universal, and perhaps relevant even to the formation of planets.

  20. A resolved outflow of matter from a brown dwarf.

    Science.gov (United States)

    Whelan, Emma T; Ray, Thomas P; Bacciotti, Francesca; Natta, Antonella; Testi, Leonardo; Randich, Sofia

    2005-06-01

    The birth of stars involves not only accretion but also, counter-intuitively, the expulsion of matter in the form of highly supersonic outflows. Although this phenomenon has been seen in young stars, a fundamental question is whether it also occurs among newborn brown dwarfs: these are the so-called 'failed stars', with masses between stars and planets, that never manage to reach temperatures high enough for normal hydrogen fusion to occur. Recently, evidence for accretion in young brown dwarfs has mounted, and their spectra show lines that are suggestive of outflows. Here we report spectro-astrometric data that spatially resolve an outflow from a brown dwarf. The outflow's characteristics appear similar to, but on a smaller scale than, outflows from normal young stars. This result suggests that the outflow mechanism is universal, and perhaps relevant even to the formation of planets.

  1. Upper urinary tract tumors

    DEFF Research Database (Denmark)

    Gandrup, Karen L; Nordling, Jørgen; Balslev, Ingegerd

    2014-01-01

    BACKGROUND: Computed tomography urography (CTU) is used widely in the work-up of patients with symptoms of urinary tract lesions. Preoperative knowledge of whether a tumor is invasive or non-invasive is important for the choice of surgery. So far there are no studies about the distinction...... of invasive and non-invasive tumors in ureter and renal pelvis based on the enhancement measured with Hounsfield Units. PURPOSE: To examine the value of CTU using split-bolus technique to distinguish non-invasive from invasive urothelial carcinomas in the upper urinary tract. MATERIAL AND METHODS: Patients...... obtained at CTU could distinguish between invasive and non-invasive lesions. No patients had a CTU within the last year before the examination that resulted in surgery. CONCLUSION: A split-bolus CTU cannot distinguish between invasive and non-invasive urothelial tumors in the upper urinary tract...

  2. Interferometric Mapping of Perseus Outflows with MASSES

    Science.gov (United States)

    Stephens, Ian; Dunham, Michael; Myers, Philip C.; MASSES Team

    2017-01-01

    The MASSES (Mass Assembly of Stellar Systems and their Evolution with the SMA) survey, a Submillimeter Array (SMA) large-scale program, is mapping molecular lines and continuum emission about the 75 known Class 0/I sources in the Perseus Molecular Cloud. In this talk, I present some of the key results of this project, with a focus on the CO(2-1) maps of the molecular outflows. In particular, I investigate how protostars inherit their rotation axes from large-scale magnetic fields and filamentary structure.

  3. ATOMIC HYDROGEN IN A GALACTIC CENTER OUTFLOW

    Energy Technology Data Exchange (ETDEWEB)

    McClure-Griffiths, N. M.; Green, J. A.; Hill, A. S. [Australia Telescope National Facility, CSIRO Astronomy and Space Science, Marsfield, NSW 2122 (Australia); Lockman, F. J. [National Radio Astronomy Observatory, Green Bank, WV 24944 (United States); Dickey, J. M. [School of Physics and Mathematics, University of Tasmania, TAS 7001 (Australia); Gaensler, B. M.; Green, A. J., E-mail: naomi.mcclure-griffiths@csiro.au [Sydney Institute for Astronomy, School of Physics, The University of Sydney, NSW 2006 (Australia)

    2013-06-10

    We describe a population of small, high-velocity, atomic hydrogen clouds, loops, and filaments found above and below the disk near the Galactic center. The objects have a mean radius of 15 pc, velocity widths of {approx}14 km s{sup -1}, and are observed at |z| heights up to 700 pc. The velocity distribution of the clouds shows no signature of Galactic rotation. We propose a scenario where the clouds are associated with an outflow from a central star-forming region at the Galactic center. We discuss the clouds as entrained material traveling at {approx}200 km s{sup -1} in a Galactic wind.

  4. Functional Anatomy of the Outflow Facilities.

    Science.gov (United States)

    Pizzirani, Stefano; Gong, Haiyan

    2015-11-01

    In order to understand the pathophysiology, select optimal therapeutic options for patients and provide clients with honest expectations for cases of canine glaucoma, clinicians should be familiar with a rational understanding of the functional anatomy of the ocular structures involved in this group of diseases. The topographical extension and the structural and humoral complexity of the regions involved with the production and the outflow of aqueous humor undergo numerous changes with aging and disease. Therefore, the anatomy relative to the fluid dynamics of aqueous has become a pivotal yet flexible concept to interpret the different phenotypes of glaucoma.

  5. Misalignment of Magnetic Fields and Outflows in Protostellar Cores

    OpenAIRE

    Hull, Charles L. H.; Plambeck, Richard L.; Bolatto, Alberto D.; Bower, Geoffrey C.; Carpenter, John M.; Crutcher, Richard M.; Fiege, Jason D.; Franzmann, Erica; Hakobian, Nicholas S.; Heiles, Carl; Houde, Martin; Hughes, A. Meredith; Jameson, Katherine; Kwon, Woojin; Lamb, James W.

    2012-01-01

    We present results of λ1.3 mm dust-polarization observations toward 16 nearby, low-mass protostars, mapped with ~2."5 resolution at CARMA. The results show that magnetic fields in protostellar cores on scales of ~1000 AU are not tightly aligned with outflows from the protostars. Rather, the data are consistent with scenarios where outflows and magnetic fields are preferentially misaligned (perpendicular), or where they are randomly aligned. If one assumes that outflows emerge along the rotati...

  6. Jet driven molecular outflows in Orion

    CERN Document Server

    Rodríguez-Franco, A; Wilson, T L

    1999-01-01

    We present high sensitivity and high angular resolution images of the high velocity (vLSR>30kms^-1) CO emission in the J=1-0 and J=2-1 lines of the Orion KL region. These results reveal the morphology of the high-velocity CO emission at the most extreme velocities. High velocity emission have been only detected in two regions: BN/KL (IRc2/I) and Orion-S. The Orion-S region contains a very young (dynamical age of 10^3years), very fast (~110kms^-1) and very compact (<0.16pc) bipolar outflow. From the morphology of the high-velocity gas we estimate that the position of the powering source must be ~20'' north of FIR4. For the IRc2/I molecular outflow the morphology of the moderate velocity (<60kms^-1) gas shows a weak bipolarity around IRc2/I. The gas at the most extreme velocities does not show any bipolarity around IRc2/I, if any, it is found ~30'' north from these sources. The blue and redshifted gas at moderate velocities shows similar spatial distribution with a systematic trend for the size of the hig...

  7. Ionized Outflows from Compact Steep Spectrum Sources

    CERN Document Server

    Shih, Hsin-Yi; Kewley, Lisa

    2013-01-01

    Massive outflows are known to exist, in the form of extended emission-line regions (EELRs), around about one-third of powerful FR II radio sources. We investigate the origin of these EELRs by studying the emission-line regions around compact-steep-spectrum (CSS) radio galaxies that are younger (10$^3$ to 10$^5$ years old) versions of the FR II radio galaxies. We have searched for and analyzed the emission-line regions around 11 CSS sources by taking integral field spectra using GMOS on Gemini North. We fit the [\\ion{O}{3}] $\\lambda 5007$ line and present the velocity maps for each detected emission-line region. We find, in most cases, that the emission-line regions have multi-component velocity structures with different velocity dispersions and/or flux distributions for each component. The velocity gradients of the emission-line gas are mostly well aligned with the radio axis, suggesting a direct causal link between the outflowing gas and the radio jets. The complex velocity structure may be a result of diffe...

  8. Quasar feedback revealed by giant molecular outflows

    CERN Document Server

    Feruglio, Chiara; Piconcelli, Enrico; Menci, Nicola; Aussel, Herve'; Lamastra, Alessandra; Fiore, Fabrizio

    2010-01-01

    In the standard scenario for galaxy evolution the transformation of young star-forming galaxies into red bulge-dominated spheroids, where star formation has been quenched, is often explained by invoking a strong negative feedback generated by accretion onto a central super-massive black hole. The depletion of gas resulting from quasar-driven outflows should eventually stop star-formation across the host galaxy and lead to the black hole "suicide" for starvation. Direct observational evidence for a major quasar feedback onto the host galaxy is still missing, since outflows previously observed in quasars are associated with the ionized component of the gas, which only accounts for a minor fraction of the total gas content, and typically occur in the central regions. We used the IRAM PdBI to observe the CO(1-0) transition in Mrk 231, the closest quasar known. We detect broad wings of the CO line, with velocities up to 750 km/s and spatially resolved on the kpc scale. Such broad CO wings trace a giant molecular o...

  9. Multidimensional chemical modelling, II. Irradiated outflow walls

    CERN Document Server

    Bruderer, Simon; Doty, Steven D; van Dishoeck, Ewine F; Bourke, Tyler L

    2009-01-01

    Observations of the high-mass star forming region AFGL 2591 reveal a large abundance of CO+, a molecule known to be enhanced by far UV (FUV) and X-ray irradiation. In chemical models assuming a spherically symmetric envelope, the volume of gas irradiated by protostellar FUV radiation is very small due to the high extinction by dust. The abundance of CO+ is thus underpredicted by orders of magnitude. In a more realistic model, FUV photons can escape through an outflow region and irradiate gas at the border to the envelope. Thus, we introduce the first 2D axi-symmetric chemical model of the envelope of a high-mass star forming region to explain the CO+ observations as a prototypical FUV tracer. The model assumes an axi-symmetric power-law density structure with a cavity due to the outflow. The local FUV flux is calculated by a Monte Carlo radiative transfer code taking scattering on dust into account. A grid of precalculated chemical abundances, introduced in the first part of this series of papers, is used to ...

  10. Shocks in nova outflows. I. Thermal emission

    CERN Document Server

    Metzger, Brian D; Vurm, Indrek; Beloborodov, Andrei M; Chomiuk, Laura; Sokoloski, J L; Nelson, Thomas

    2014-01-01

    Evidence for shocks in nova outflows include (1) multiple velocity components in the optical spectra; (2) keV X-ray emission weeks to months after the outburst; (3) early radio flare on timescales of months, in excess of that predicted from the freely expanding photo-ionized gas; and (4) ~ GeV gamma-rays. We present a 1D model for the shock interaction between the fast nova outflow and a dense external shell (DES) and its associated thermal X-ray, optical, and radio emission. The forward shock is radiative initially when the density of shocked gas is highest, at which times radio emission originates from the dense cooling layer immediately downstream of the shock. The radio light curve is characterized by sharper rises to maximum and later peak times at progressively lower frequencies, with a peak brightness temperature that is approximately independent of frequency. We apply our model to the recent gamma-ray classical nova V1324 Sco, obtaining an adequate fit to the early radio maximum for reasonable assumpt...

  11. 2,3,7,8-Tetrachlorodibenzo-p-dioxin exposure prevents cardiac valve formation in developing zebrafish.

    Science.gov (United States)

    Mehta, Vatsal; Peterson, Richard E; Heideman, Warren

    2008-08-01

    Cardiovascular malformations are one of the most common congenital birth defects observed in humans. Defects in cardiac valves disrupt normal blood flow. Zebrafish are an outstanding experimental model for studying the effects that environmental contaminants have on developmental processes. Previous research has shown that 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) causes blood regurgitation in the heart and reduces peripheral blood flow in embryonic zebrafish, suggesting some form of valve failure. To test this we used video microscopy to examine valve function and structure in developing zebrafish exposed to TCDD. TCDD exposure produced blood regurgitation at both the atrioventricular (AV) and bulboventricular (BV) junctions. In marked contrast to control embryos exposed to the vehicle dimethyl sulfoxide, embryos exposed to TCDD failed to form valve leaflets as the heart matured. In addition, whereas TCDD did not block initial formation of the bulbus arteriosus, we found that TCDD exposure prevented the normal growth and development of this portion of the outflow tract. TCDD altered the localization of endothelial cells at the AV and BV junctions and altered the localized expression of mRNAs bmp4 and notch1b normally associated with the nascent valves. Taken together, our results demonstrate that although TCDD does not prevent the initial specification of the presumptive valve locations, TCDD exposure produces severe alterations in valve development, leading to blood regurgitation and failing circulation in the developing zebrafish.

  12. The gastrointestinal tract

    DEFF Research Database (Denmark)

    Bartels, Else M.; Harrison, Adrian Paul

    2009-01-01

    The gastrointestinal tract (GIT) has always been and remains a major source of interest in terms of both its function, and its malfunction. Our current knowledge of age-related changes in this system, as well as drug-food interactions, however, remains relatively limited. Paradoxically, the GIT i...

  13. Urinary Tract Infections.

    Science.gov (United States)

    Plummer, Nancy; Michael, Nancy, Ed.

    This module on urinary tract infections is intended for use in inservice or continuing education programs for persons who administer medications in long-term care facilities. Instructor information, including teaching suggestions, and a listing of recommended audiovisual materials and their sources appear first. The module goal and objectives are…

  14. Venous Outflow Reconstruction in Adult Living Donor Liver Transplant: Outcome of a Policy for Right Lobe Grafts without the Middle Hepatic Vein

    OpenAIRE

    Mohamed Ghazaly; Badawy, Mohamad T.; Hosam El-Din Soliman; Magdy El-Gendy; Tarek Ibrahim; Davidson, Brian R.

    2013-01-01

    Introduction. The difficulty and challenge of recovering a right lobe graft without MHV drainage is reconstructing the outflow tract of the hepatic veins. With the inclusion or the reconstruction of the MHV, early graft function is satisfactory. The inclusion of the MHV or not in the donor's right lobectomy should be based on sound criteria to provide adequate functional liver mass for recipient, while keeping risk to donor to the minimum. Objective. Reviewing the results of a policy for righ...

  15. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

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

  16. Measurement of Outflow Facility Using iPerfusion.

    Directory of Open Access Journals (Sweden)

    Joseph M Sherwood

    Full Text Available Elevated intraocular pressure (IOP is the predominant risk factor for glaucoma, and reducing IOP is the only successful strategy to prevent further glaucomatous vision loss. IOP is determined by the balance between the rates of aqueous humour secretion and outflow, and a pathological reduction in the hydraulic conductance of outflow, known as outflow facility, is responsible for IOP elevation in glaucoma. Mouse models are often used to investigate the mechanisms controlling outflow facility, but the diminutive size of the mouse eye makes measurement of outflow technically challenging. In this study, we present a new approach to measure and analyse outflow facility using iPerfusion™, which incorporates an actuated pressure reservoir, thermal flow sensor, differential pressure measurement and an automated computerised interface. In enucleated eyes from C57BL/6J mice, the flow-pressure relationship is highly non-linear and is well represented by an empirical power law model that describes the pressure dependence of outflow facility. At zero pressure, the measured flow is indistinguishable from zero, confirming the absence of any significant pressure independent flow in enucleated eyes. Comparison with the commonly used 2-parameter linear outflow model reveals that inappropriate application of a linear fit to a non-linear flow-pressure relationship introduces considerable errors in the estimation of outflow facility and leads to the false impression of pressure-independent outflow. Data from a population of enucleated eyes from C57BL/6J mice show that outflow facility is best described by a lognormal distribution, with 6-fold variability between individuals, but with relatively tight correlation of facility between fellow eyes. iPerfusion represents a platform technology to accurately and robustly characterise the flow-pressure relationship in enucleated mouse eyes for the purpose of glaucoma research and with minor modifications, may be applied

  17. Cardioverter-defibrillator implantation to treat cardiac fibroma-induced ventricular tachycardia in a 70-year-old woman.

    Science.gov (United States)

    Hakim, Fayaz Ahmad; Pandit, Anil; Mookadam, Farouk; Mamby, Sylvia

    2014-06-01

    Benign cardiac fibroma is rarely reported in adults. Its clinical symptoms are related to outflow obstruction or dysrhythmias. We present the case of a 70-year-old woman who had a syncopal episode from ventricular tachycardia caused by cardiac fibroma. Because of unfavorable tumor anatomy, the patient was not a candidate for surgical excision, and she declined orthotopic heart transplantation. To prevent sudden cardiac death, we placed an implantable cardioverter-defibrillator, and the patient remained well throughout the 2-year follow-up period. To our knowledge, this is the first report of implantable cardioverter-defibrillator therapy to treat an adult patient's unresectable cardiac fibroma.

  18. Abnormal Cardiac Autonomic Regulation in Mice Lacking ASIC3

    Directory of Open Access Journals (Sweden)

    Ching-Feng Cheng

    2014-01-01

    Full Text Available Integration of sympathetic and parasympathetic outflow is essential in maintaining normal cardiac autonomic function. Recent studies demonstrate that acid-sensing ion channel 3 (ASIC3 is a sensitive acid sensor for cardiac ischemia and prolonged mild acidification can open ASIC3 and evoke a sustained inward current that fires action potentials in cardiac sensory neurons. However, the physiological role of ASIC3 in cardiac autonomic regulation is not known. In this study, we elucidate the role of ASIC3 in cardiac autonomic function using Asic3−/− mice. Asic3−/− mice showed normal baseline heart rate and lower blood pressure as compared with their wild-type littermates. Heart rate variability analyses revealed imbalanced autonomic regulation, with decreased sympathetic function. Furthermore, Asic3−/− mice demonstrated a blunted response to isoproterenol-induced cardiac tachycardia and prolonged duration to recover to baseline heart rate. Moreover, quantitative RT-PCR analysis of gene expression in sensory ganglia and heart revealed that no gene compensation for muscarinic acetylcholines receptors and beta-adrenalin receptors were found in Asic3−/− mice. In summary, we unraveled an important role of ASIC3 in regulating cardiac autonomic function, whereby loss of ASIC3 alters the normal physiological response to ischemic stimuli, which reveals new implications for therapy in autonomic nervous system-related cardiovascular diseases.

  19. Measuring the seeds of thermal ion outflow

    Science.gov (United States)

    Fernandes, Philip A.

    The ionosphere is the primary source for heavy ions which are ubiquitous in the terrestrial magnetosphere. Low-altitude energization in the auroral ionosphere results in bulk heating and transverse acceleration of ions, which begin to upwell and/or be accelerated upward by the mirror force, starting upflow and leading to the outflow process. The details of the processes that seed ion outflow at low altitudes are difficult to measure in situ and thus remain an open question. We examine the observational parameter regime in which ion upflow/outflow initiates. Emphasis is placed on making measurements of the thermal ion kinetic distribution function, allowing for accounting of processes which affect in situ plasma measurements. We consider an electrostatic analyzer (ESA) instrument capable of making the measurements necessary to quantify the roles of various heating mechanisms in initiating ion upflow in the low-altitude auroral ionosphere. We present the difficulties associated with making these measurements and identify instrument design choices that mitigate some of these measurement challenges. Analysis of ESA measurements of the thermal ion distribution function taken on the MICA auroral sounding rocket is presented. Using a Maxwellian model to replicate possible measured spectra, we calculate integrated parameters from the model and compare with equivalent parameters calculated from the in situ data. Through Liouville's theorem and the thin-sheath approximation we couple the measured and forward-modeled parameters such that measurements inside the sheath provide information about the state of the plasma outside the sheath. Throughout the MICA flight, ion upflow is observed and attributed to ambipolar electric fields and/or ion-neutral interactions. Late in the flight we observe quasi-static frictional process driving the ion temperature. Early in the flight we observe ion heating weakly correlated with ELF wave activity; our analysis suggests we must consider

  20. Scaling Relations Between Warm Galactic Outflows and Their Host Galaxies

    CERN Document Server

    Chisholm, John; Leitherer, Claus; Chen, Yanmei; Wofford, Aida; Lundgren, Britt

    2014-01-01

    We report on a sample of 51 nearby, star-forming galaxies observed with the Cosmic Origin Spectrograph on the Hubble Space Telescope. We calculate Si II kinematics and densities arising from warm gas entrained in galactic outflows. We use multi-wavelength ancillary data to estimate stellar masses (M$_\\ast$), star-formation rates (SFR), and morphologies. We derive significant correlations between outflow velocity and SFR$^{\\sim 0.1}$, M$_\\ast^{\\sim 0.1}$ and v$_\\text{circ}^{\\sim 1/2}$. Some mergers drive outflows faster than these relations prescribe, launching the outflow faster than the escape velocity. Calculations of the mass outflow rate reveal strong scaling with SFR$^{\\sim 1/2}$ and M$_\\ast^{\\sim 1/2}$. Additionally, mass-loading efficiency factors (mass outflow rate divided by SFR) scale approximately as M$_\\ast^{-1/2}$. Both the outflow velocity and mass-loading scaling suggest that these outflows are powered by supernovae, with only 0.7% of the total supernovae energy converted into the kinetic energ...

  1. Standing Shocks around Black Holes and Estimation of Outflow Rates

    Indian Academy of Sciences (India)

    Santabrata Das; Sandip K. Chakrabarti

    2002-03-01

    We self-consistently obtain shock locations in an accretion flow by using an analytical method. One can obtain the spectral properties, quasi-periodic oscillation frequencies and the outflowrates when the inflow parameters are known. Since temperature of the CENBOL decides the spectral states of the black hole, and also the outflow rate, the outflow rate is directly related to the spectral states.

  2. Collective outflow from a small multiple stellar system

    Energy Technology Data Exchange (ETDEWEB)

    Peters, Thomas [Institut für Theoretische Physik, Universität Zürich, Winterthurerstrasse 190, CH-8057 Zürich (Switzerland); Klaassen, Pamela D. [Leiden Observatory, Leiden University, P.O. Box 9513, 2300 RA Leiden (Netherlands); Mac Low, Mordecai-Mark [Department of Astrophysics, American Museum of Natural History, 79th Street at Central Park West, New York, NY 10024-5192 (United States); Schrön, Martin; Klessen, Ralf S. [Zentrum für Astronomie der Universität Heidelberg, Institut für Theoretische Astrophysik, Albert-Ueberle-Strasse 2, D-69120 Heidelberg (Germany); Federrath, Christoph [Monash Centre for Astrophysics, School of Mathematical Sciences, Monash University, Vic 3800 (Australia); Smith, Michael D., E-mail: tpeters@physik.uzh.ch [Centre for Astrophysics and Space Science, University of Kent, Canterbury, CT2 7NH (United Kingdom)

    2014-06-10

    The formation of high-mass stars is usually accompanied by powerful protostellar outflows. Such high-mass outflows are not simply scaled-up versions of their lower-mass counterparts, since observations suggest that the collimation degree degrades with stellar mass. Theoretically, the origins of massive outflows remain open to question because radiative feedback and fragmentation of the accretion flow around the most massive stars, with M > 15 M {sub ☉}, may impede the driving of magnetic disk winds. We here present a three-dimensional simulation of the early stages of core fragmentation and massive star formation that includes a subgrid-scale model for protostellar outflows. We find that stars that form in a common accretion flow tend to have aligned outflow axes, so that the individual jets of multiple stars can combine to form a collective outflow. We compare our simulation to observations with synthetic H{sub 2} and CO observations and find that the morphology and kinematics of such a collective outflow resembles some observed massive outflows, such as Cepheus A and DR 21. We finally compare physical quantities derived from simulated observations of our models to the actual values in the models to examine the reliability of standard methods for deriving physical quantities, demonstrating that those methods indeed recover the actual values to within a factor of two to three.

  3. Simulating Supersonic Turbulence in Galaxy Outflows

    CERN Document Server

    Scannapieco, Evan

    2010-01-01

    We present three-dimensional, adaptive mesh simulations of dwarf galaxy out- flows driven by supersonic turbulence. Here we develop a subgrid model to track not only the thermal and bulk velocities of the gas, but also its turbulent velocities and length scales. This allows us to deposit energy from supernovae directly into supersonic turbulence, which acts on scales much larger than a particle mean free path, but much smaller than resolved large-scale flows. Unlike previous approaches, we are able to simulate a starbursting galaxy modeled after NGC 1569, with realistic radiative cooling throughout the simulation. Pockets of hot, diffuse gas around individual OB associations sweep up thick shells of material that persist for long times due to the cooling instability. The overlapping of high-pressure, rarefied regions leads to a collective central outflow that escapes the galaxy by eating away at the exterior gas through turbulent mixing, rather than gathering it into a thin, unstable shell. Supersonic, turbul...

  4. Relativistic Outflows in Gamma-Ray Bursts

    CERN Document Server

    Aloy, M A

    2007-01-01

    The possibility that gamma-ray bursts (GRBs) were not isotropic emissions was devised theoretically as a way to ameliorate the huge energetic budget implied by the standard fireball model for these powerful phenomena. However, the mechanism by which after the quasy-isotropic release of a few $10^{50} $erg yields a collimated ejection of plasma could not be satisfactory explained analytically. The reason being that the collimation of an outflow by its progenitor system depends on a very complex and non-linear dynamics. That has made necessary the use of numerical simulations in order to shed some light on the viability of some likely progenitors of GRBs. In this contribution I will review the most relevant features shown by these numerical simulations and how they have been used to validate the collapsar model (for long GRBs) and the model involving the merger of compact binaries (for short GRBs).

  5. FIRE simulations: galactic outflows and their consequences

    Science.gov (United States)

    Keres, Dusan; FIRE Team

    2016-06-01

    We study gaseous outflows and their consequences in high-resolution galaxy formation simulations with explicit stellar feedback from the Feedback in Realistic Environments project. Collective, galaxy scale, effect of stellar feedback results in episodic ejections of large amount of gas and heavy elements into the circum-galactic medium. Gas ejection episodes follow strong bursts of star formation. Properties of galactic star formation and ejection episodes depend on galaxy mass and redshift and, together with gas infall and recycling, shape the evolution of the circum-galactic medium and galaxies. As a consequence, our simulated galaxies have masses, star formation histories and heavy element content in good agreement with the observed population of galaxies.

  6. An Intergalactic Magnetic Field from Quasar Outflows

    CERN Document Server

    Furlanetto, S; Furlanetto, Steven; Loeb, Abraham

    2001-01-01

    Outflows from quasars inevitably pollute the intergalactic medium (IGM) with magnetic fields. The short-lived activity of a quasar leaves behind an expanding magnetized bubble in the IGM. We model the expansion of the remnant quasar bubbles and calculate their distribution as a function magnetic field strength at different redshifts. We find that by a redshift z ~ 3, about 5-80% of the IGM volume is filled by magnetic fields with an energy density > 10% of the mean thermal energy density of a photo-ionized IGM (at ~ 10^4 K). As massive galaxies and X-ray clusters condense out of the magnetized IGM, the adiabatic compression of the magnetic field could result in the fields observed in these systems without a need for further dynamo amplification.

  7. Ice sculpture in the Martian outflow channels

    Science.gov (United States)

    Lucchitta, B. K.

    1982-01-01

    Viking Orbiter and terrestrial satellite images are examined at similar resolution to compare features of the Martian outflow channels with features produced by the movement of ice on earth, and many resemblances are found. These include the anastomoses, sinuosities, and U-shaped cross profiles of valleys; hanging valleys; linear scour marks on valley walls; grooves and ridges on valley floors; and the streamlining of bedrock highs. Attention is given to the question whether ice could have moved in the Martian environment. It is envisaged that springs or small catastrophic outbursts discharged fluids from structural outlets or chaotic terrains. These fluids built icings that may have grown into substantial masses and eventually flowed like glaciers down preexisting valleys. An alternative is that the fluids formed rivers or floods that in turn formed ice jams and consolidated into icy masses in places where obstacles blocked their flow.

  8. The Implications of Extreme Outflows from Extreme Starbursts

    CERN Document Server

    Heckman, Timothy M

    2016-01-01

    Interstellar ultraviolet absorption-lines provide crucial information about the properties of galactic outflows. In this paper, we augment our previous analysis of the systematic properties of starburst-driven galactic outflows by expanding our sample to include a rare population of starbursts with exceptionally high outflow velocities. In principle, these could be a qualitatively different phenomenon from more typical outflows. However, we find that instead these starbursts lie on, or along the extrapolation of, the trends defined by the more typical systems studied previously by us. We exploit the wide dynamic range provided by this new sample to determine scaling relations of outflow velocity with galaxy stellar mass (M*), circular velocity, star-formation rate (SFR), SFR/M*, and SFR/area. We argue that these results can be accommodated within the general interpretational framework we previously advocated, in which a population of ambient interstellar or circum-galactic clouds is accelerated by the combine...

  9. Searching for molecular outflows in Hyper-Luminous Infrared Galaxies

    CERN Document Server

    Calderón, D; Veilleux, S; Graciá-Carpio, J; Sturm, E; Lira, P; Schulze, S; Kim, S

    2016-01-01

    We present constraints on the molecular outflows in a sample of five Hyper-Luminous Infrared Galaxies using Herschel observations of the OH doublet at 119 {\\mu}m. We have detected the OH doublet in three cases: one purely in emission and two purely in absorption. The observed emission profile has a significant blueshifted wing suggesting the possibility of tracing an outflow. Out of the two absorption profiles, one seems to be consistent with the systemic velocity while the other clearly indicates the presence of a molecular outflow whose maximum velocity is about ~1500 km/s. Our analysis shows that this system is in general agreement with previous results on Ultra-luminous Infrared Galaxies and QSOs, whose outflow velocities do not seem to correlate with stellar masses or starburst luminosities (star formation rates). Instead the galaxy outflow likely arises from an embedded AGN.

  10. Postcircumcision urinary tract infection.

    Science.gov (United States)

    Cohen, H A; Drucker, M M; Vainer, S; Ashkenasi, A; Amir, J; Frydman, M; Varsano, I

    1992-06-01

    The possible association of urinary tract infection (UTI) with ritual circumcision on the eighth day of life was studied by analyzing the epidemiology of urinary tract infections during the first year of life in 169 children with UTI (56 males and 113 females) born in Israel from 1979 to 1984. Forty-eight percent of the episodes of UTI occurring in males appeared during the 12 days following circumcision, and the increased incidence during that period was highly significant. The median age of the males at the time of the UTI was 16 days, compared with seven months in females. Ritual Jewish circumcision as practiced in Israel may be a predisposing factor for UTI during the 12-day period following that procedure.

  11. Radiology illustrated. Gastrointestinal tract

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Byung Ihn (ed.) [Seoul National University Hospital (Korea, Republic of). Dept. of Radiology

    2015-02-01

    Radiology Illustrated: Gastrointestinal Tract is the second of two volumes designed to provide clear and practical guidance on the diagnostic imaging of abdominal diseases. The book presents approximately 300 cases with 1500 carefully selected and categorized illustrations of gastrointestinal tract diseases, along with key text messages and tables that will help the reader easily to recall the relevant images as an aid to differential diagnosis., Essential points are summarized at the end of each text message to facilitate rapid review and learning. Additionally, brief descriptions of each clinical problem are provided, followed by case studies of both common and uncommon pathologies that illustrate the roles of the different imaging modalities, including ultrasound, radiography, computed tomography, and magnetic resonance imaging.

  12. Evolution of active region outflows throughout an active region lifetime

    Science.gov (United States)

    Zangrilli, L.; Poletto, G.

    2016-10-01

    Context. We have shown previously that SOHO/UVCS data allow us to detect active region (AR) outflows at coronal altitudes higher than those reached by other instrumentation. These outflows are thought to be a component of the slow solar wind. Aims: Our purpose is to study the evolution of the outflows in the intermediate corona from AR 8100, from the time the AR first forms until it dissolves, after several transits at the solar limb. Methods: Data acquired by SOHO/UVCS at the time of the AR limb transits, at medium latitudes and at altitudes ranging from 1.5 to 2.3 R⊙, were used to infer the physical properties of the outflows through the AR evolution. To this end, we applied the Doppler dimming technique to UVCS spectra. These spectra include the H i Lyα line and the O vi doublet lines at 1031.9 and 1037.6 Å. Results: Plasma speeds and electron densities of the outflows were inferred over several rotations of the Sun. AR outflows are present in the newly born AR and persist throughout the entire AR life. Moreover, we found two types of outflows at different latitudes, both possibly originating in the same negative polarity area of the AR. We also analyzed the behavior of the Si xii 520 Å line along the UVCS slit in an attempt to reveal changes in the Si abundance when different regions are traversed. Although we found some evidence for a Si enrichment in the AR outflows, alternative interpretations are also plausible. Conclusions: Our results demonstrate that outflows from ARs are detectable in the intermediate corona throughout the whole AR lifetime. This confirms that outflows contribute to the slow wind.

  13. Managing urinary tract infections

    OpenAIRE

    Saadeh, Sermin A.; Mattoo, Tej K.

    2011-01-01

    Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-sta...

  14. Feedback from Mass Outflows in Nearby Active Galactic Nuclei. II. Outflows in the Narrow-Line Region of NGC 4151

    CERN Document Server

    Crenshaw, D M; Kraemer, S B; Schmitt, H R

    2014-01-01

    We present a detailed study of AGN feedback in the narrow-line region (NLR) of the Seyfert 1 galaxy NGC 4151. We illustrate the data and techniques needed to determine the mass outflow rate and kinetic luminosity of the outflowing ionized gas as a function of position in the NLR. We find that the mass outflow rate peaks at a value of 3 solar masses per year at a distance of 70 pc from the central supermassive black hole (SMBH), which is about 10 times the outflow rate coming from inside 13 pc, and 230 times the mass accretion rate inferred from the bolometric luminosity of NGC 4151. Thus, most of the outflow must arise from "in situ" acceleration of ambient gas throughout the NLR. The kinetic luminosity peaks at 90 pc and drops rapidly thereafter, indicating that most of the kinetic energy is deposited within about 100 pc from the SMBH. Both values exceed the mass outflow rate and kinetic luminosity determined for the UV/X-ray absorber outflows in NGC 4151, indicating the importance of NLR outflows in providi...

  15. Influence of ion outflow in coupled geospace simulations: 2. Sawtooth oscillations driven by physics-based ion outflow

    Science.gov (United States)

    Varney, R. H.; Wiltberger, M.; Zhang, B.; Lotko, W.; Lyon, J.

    2016-10-01

    We present the first simulations of magnetospheric sawtooth oscillations under steady solar wind conditions that are driven internally by heavy ion outflow from a physics-based model. The simulations presented use the multifluid Lyon-Fedder-Mobarry magnetohydrodynamics model two-way coupled to the ionosphere/polar wind model (IPWM). Depending on the type of wave-particle interactions utilized within IPWM, the coupled simulations exhibit either sawtooth oscillations or steady magnetospheric convection. Contrasting the simulations that do and do not develop sawtooth oscillations yields insights into the relationship between outflow and sawtooth oscillations. The total outflow rate is not an adequate predictor of the convection mode that will emerge. The simulations that develop sawtooth oscillations are characterized by intense outflow concentrated in the midnight auroral region. This outflow distribution mass loads the tail reconnection region without excessively mass loading the dayside reconnection region and leads to an imbalance between the dayside and nightside reconnection rates.

  16. Suppression of galactic outflows by cosmological infall and circumgalactic medium

    CERN Document Server

    Singh, Priyanka; Bagla, Jasjeet S; Nath, Biman B

    2016-01-01

    We investigate the relative importance of two galactic outflow suppression mechanisms : a) Cosmological infall of the intergalactic gas onto the galaxy, and b) the existence of a hot circumgalactic medium (CGM). Considering only radial motion, the infall reduces the speed of outflowing gas and even halts the outflow, depending on the mass and redshift of the galaxy. For star forming galaxies there exists an upper mass limit beyond which outflows are suppressed by the gravitational field of the galaxy. We find that infall can reduce this upper mass limit approximately by a factor of two (independent of the redshift). Massive galaxies ($\\gtrsim 10^{12} M_{\\odot}$) host large reservoir of hot, diffuse CGM around the central part of the galaxy. The CGM acts as a barrier between the infalling and outflowing gas and provides an additional source of outflow suppression. We find that at low redshifts ($z\\lesssim3.5$), the CGM is more effective than the infall in suppressing the outflows. Together, these two processes...

  17. Multiple Fast Molecular Outflows in the PPN CRL 618

    CERN Document Server

    Lee, Chin-Fei; Contreras, Carmen Sánchez; Huang, Po-Sheng; Tay, Jeremy Jian Hao

    2013-01-01

    CRL 618 is a well-studied pre-planetary nebula. It has multiple highly collimated optical lobes, fast molecular outflows along the optical lobes, and an extended molecular envelope that consists of a dense torus in the equator and a tenuous round halo. Here we present our observations of this source in CO J=3-2 and HCN J=4-3 obtained with the Submillimeter Array at up to ~ 0.3" resolutions. We spatially resolve the fast molecular-outflow region previously detected in CO near the central star and find it to be composed of multiple outflows that have similar dynamical ages, and are oriented along the different optical lobes. We also detect fast molecular outflows further away from the central star near the tips of the extended optical lobes and a pair of equatorial outflows inside the dense torus. We find that two episodes of bullet ejections in different directions are needed, one producing the fast molecular outflows near the central star, and one producing the fast molecular outflows near the tips of the ext...

  18. Collective outflow from a small multiple stellar system

    CERN Document Server

    Peters, Thomas; Mac Low, Mordecai-Mark; Schrön, Martin; Federrath, Christoph; Smith, Michael D; Klessen, Ralf S

    2014-01-01

    The formation of high-mass stars is usually accompanied by powerful protostellar outflows. Such high-mass outflows are not simply scaled-up versions of their lower-mass counterparts, since observations suggest that the collimation degree degrades with stellar mass. Theoretically, the origins of massive outflows remain open to question because radiative feedback and fragmentation of the accretion flow around the most massive stars, with M > 15 M_Sun, may impede the driving of magnetic disk winds. We here present a three-dimensional simulation of the early stages of core fragmentation and massive star formation that includes a subgrid-scale model for protostellar outflows. We find that stars that form in a common accretion flow tend to have aligned outflow axes, so that the individual jets of multiple stars can combine to form a collective outflow. We compare our simulation to observations with synthetic H_2 and CO observations and find that the morphology and kinematics of such a collective outflow resembles s...

  19. Simulation of California's Major Reservoirs Outflow Using Data Mining Technique

    Science.gov (United States)

    Yang, T.; Gao, X.; Sorooshian, S.

    2014-12-01

    The reservoir's outflow is controlled by reservoir operators, which is different from the upstream inflow. The outflow is more important than the reservoir's inflow for the downstream water users. In order to simulate the complicated reservoir operation and extract the outflow decision making patterns for California's 12 major reservoirs, we build a data-driven, computer-based ("artificial intelligent") reservoir decision making tool, using decision regression and classification tree approach. This is a well-developed statistical and graphical modeling methodology in the field of data mining. A shuffled cross validation approach is also employed to extract the outflow decision making patterns and rules based on the selected decision variables (inflow amount, precipitation, timing, water type year etc.). To show the accuracy of the model, a verification study is carried out comparing the model-generated outflow decisions ("artificial intelligent" decisions) with that made by reservoir operators (human decisions). The simulation results show that the machine-generated outflow decisions are very similar to the real reservoir operators' decisions. This conclusion is based on statistical evaluations using the Nash-Sutcliffe test. The proposed model is able to detect the most influential variables and their weights when the reservoir operators make an outflow decision. While the proposed approach was firstly applied and tested on California's 12 major reservoirs, the method is universally adaptable to other reservoir systems.

  20. The role of cosmic ray pressure in accelerating galactic outflows

    CERN Document Server

    Simpson, Christine M; Marinacci, Federico; Pfrommer, Christoph; Springel, Volker; Glover, Simon C O; Clark, Paul C; Smith, Rowan J

    2016-01-01

    We study the formation of galactic outflows from supernova explosions (SNe) with the moving-mesh code AREPO in a stratified column of gas with a surface density similar to the Milky Way disk at the solar circle. We compare different simulation models for SNe placement and energy feedback, including cosmic rays (CR), and find that models that place SNe in dense gas and account for CR diffusion are able to drive outflows with similar mass loading as obtained from a random placement of SNe with no CRs. Despite this similarity, CR-driven outflows differ in several other key properties including their overall clumpiness and velocity. Moreover, the forces driving these outflows originate in different sources of pressure, with the CR diffusion model relying on non-thermal pressure gradients to create an outflow driven by internal pressure and the random-placement model depending on kinetic pressure gradients to propel a ballistic outflow. CRs therefore appear to be non-negligible physics in the formation of outflows...

  1. High-velocity molecular outflows hear massive young stellar objects

    Institute of Scientific and Technical Information of China (English)

    吴月芳; 李月兴; 杨传义; 雷成明; 孙金江; 吕静; 韩溥

    1999-01-01

    By mapping the 12CO J=1—0 lines in IRAS 05391-0217, 06114+1745 and 06291+0421, three new high-velocity bipolar molecular outflows are found. Parameters of these outflows are derived, which suggest that they are massive and energetic outflows with total kinetic energies of about 1038 J and mass loss rates about 10-5 M⊙/a. The driving sources are identified by analyzing the positions, intensities and color temperatures of the associated infrared sources. These outflows are most likely driven by single sources which correspond to massive young stellar objects. In these regions H2O masers have been detected located near the embedded infrared sources, which indicates that their exciting mechanism may be correlated with that of the CO outflows. The relationship between the parameters of outflows and central sources shows that high-velocity outflow and thermal radiation of a star are two basic correlated but different features in the evolution of young stars.

  2. The trabecular meshwork outflow pathways: structural and functional aspects.

    Science.gov (United States)

    Tamm, Ernst R

    2009-04-01

    The major drainage structures for aqueous humor (AH) are the conventional or trabecular outflow pathways, which are comprised of the trabecular meshwork (made up by the uveal and corneoscleral meshworks), the juxtacanalicular connective tissue (JCT), the endothelial lining of Schlemm's canal (SC), the collecting channels and the aqueous veins. The trabecular meshwork (TM) outflow pathways are critical in providing resistance to AH outflow and in generating intraocular pressure (IOP). Outflow resistance in the TM outflow pathways increases with age and primary open-angle glaucoma. Uveal and corneoscleral meshworks form connective tissue lamellae or beams that are covered by flat TM cells which rest on a basal lamina. TM cells in the JCT are surrounded by fibrillar elements of the extracellular matrix (ECM) to form a loose connective tissue. In contrast to the other parts of the TM, JCT cells and ECM fibrils do not form lamellae, but are arranged more irregularly. SC inner wall endothelial cells form giant vacuoles in response to AH flow, as well as intracellular and paracellular pores. In addition, minipores that are covered with a diaphragm are observed. There is considerable evidence that normal AH outflow resistance resides in the inner wall region of SC, which is formed by the JCT and SC inner wall endothelium. Modulation of TM cell tone by the action of their actomyosin system affects TM outflow resistance. In addition, the architecture of the TM outflow pathways and consequently outflow resistance appear to be modulated by contraction of ciliary muscle and scleral spur cells. The scleral spur contains axons that innervate scleral spur cells or that have the ultrastructural characteristics of mechanosensory nerve endings.

  3. ALMA OBSERVATIONS OF THE HH 46/47 MOLECULAR OUTFLOW

    Energy Technology Data Exchange (ETDEWEB)

    Arce, Hector G. [Department of Astronomy, Yale University, P.O. Box 208101, New Haven, CT 06520-8101 (United States); Mardones, Diego; Garay, Guido [Departamento de Astronomia, Universidad de Chile, Casilla 36-D, Santiago (Chile); Corder, Stuartt A. [Joint ALMA Observatory, Av. Alonso de Cordova 3107, Vitacura, Santiago (Chile); Noriega-Crespo, Alberto [Infrared Processing and Analysis Center, California Institute of Technology, Pasadena, CA 91125 (United States); Raga, Alejandro C. [Instituto de Ciencias Nucleares, UNAM, Ap. 70-543, 04510 D.F. (Mexico)

    2013-09-01

    The morphology, kinematics, and entrainment mechanism of the HH 46/47 molecular outflow were studied using new ALMA Cycle 0 observations. Results show that the blue and red lobes are strikingly different. We argue that these differences are partly due to contrasting ambient densities that result in different wind components having a distinct effect on the entrained gas in each lobe. A 29 point mosaic, covering the two lobes at an angular resolution of about 3'', detected outflow emission at much higher velocities than previous observations, resulting in significantly higher estimates of the outflow momentum and kinetic energy than previous studies of this source, using the CO(1-0) line. The morphology and the kinematics of the gas in the blue lobe are consistent with models of outflow entrainment by a wide-angle wind, and a simple model describes the observed structures in the position-velocity diagram and the velocity-integrated intensity maps. The red lobe exhibits a more complex structure, and there is evidence that this lobe is entrained by a wide-angle wind and a collimated episodic wind. Three major clumps along the outflow axis show velocity distribution consistent with prompt entrainment by different bow shocks formed by periodic mass ejection episodes which take place every few hundred years. Position-velocity cuts perpendicular to the outflow cavity show gradients where the velocity increases toward the outflow axis, inconsistent with outflow rotation. Additionally, we find evidence for the existence of a small outflow driven by a binary companion.

  4. Isolated cardiac metastasis from plasmacytoid urothelial carcinoma of the bladder

    Directory of Open Access Journals (Sweden)

    Peck Joshua R

    2012-06-01

    Full Text Available Abstract A 57-year-old male with a history of hypertension presented with shortness of breath, intermittent substernal chest pain, subjective fevers, and a 30-pound weight loss. He was found to have a bladder mass four months prior to presentation, for which he underwent cystoscopy and surgical removal. Pathology demonstrated high-grade superficial plasmacytoid urothelial carcinoma extending into the submucosa but not the muscularis propria. Given the superficial nature of his bladder cancer, a cystectomy was deferred. He was subsequently lost to follow-up care. On arrival, physical exam was notable for tachycardia, tachypnea, and distant heart sounds. An ECG showed an incomplete right bundle branch block and sinus tachycardia. Computed tomography pulmonary angiography revealed a three-cm pericardial effusion. Transthoracic echocardiography confirmed this finding and revealed a mass in the right ventricle (RV extending into the outflow tract and infiltrating the free wall. The RV was dilated with an estimated RV systolic pressure of 37 mmHg. Pericardiocentesis yielded nearly one liter of serosanguinous fluid with non-diagnostic cytology. Partial median sternotomy with biopsy showed pathologic findings consistent with metastatic urothelial carcinoma, plasmacytoid variant. A PET scan showed increased uptake exclusively in the heart. The oncology team discussed options with the patient including chemotherapy and palliative care. The patient decided to withhold further therapy and went home with hospice care. He died two months later. Discussion Bladder cancer is the fourth most common cancer in men in the United States. Most patients (69% with metastatic bladder cancer have multiple organs involved; conversely, our patient had a PET scan indicating his disease was localized to the heart. Plasmacytoid urothelial carcinoma is a rare subtype of bladder cancer, and is estimated to make up less than three percent of all invasive bladder carcinomas. At

  5. Outflows of neutral (and ionized) gas in radio galaxies

    OpenAIRE

    Morganti, R.; Oosterloo, T.; Tadhunter, C.

    2004-01-01

    Outflows up to 1500 km/s of atomic neutral hydrogen are detected in a growing number of radio galaxies. Outflows with similar velocities are also detected in ionized gas, suggesting a common origin for the extreme kinematics of these two phases of the gas. The high detection rate ofsuch outflows in young (or restarted) radio sources appears to be related to the existence of a dense ISM around these objects. Such a dense ISM can have important consequences for the evolution of the radio source...

  6. Misalignment of Magnetic Fields and Outflows in Protostellar Cores

    CERN Document Server

    Hull, Charles L H; Bolatto, Alberto D; Bower, Geoffrey C; Carpenter, John M; Crutcher, Richard M; Fiege, Jason D; Franzmann, Erica; Hakobian, Nicholas S; Heiles, Carl; Houde, Martin; Hughes, A Meredith; Jameson, Katherine; Kwon, Woojin; Lamb, James W; Looney, Leslie W; Matthews, Brenda C; Mundy, Lee; Pillai, Thushara; Pound, Marc W; Stephens, Ian W; Tobin, John J; Vaillancourt, John E; Volgenau, N H; Wright, Melvyn C H

    2012-01-01

    Theoretical models of star formation generally assume that bipolar outflows are parallel to the mean magnetic-field direction in protostellar cores. Here we present results of \\lambda1.3 mm dust polarization observations toward 16 nearby, low-mass protostars, mapped with ~2.5" resolution at CARMA. The results show that magnetic fields in protostellar cores on scales of ~1000 AU are not tightly aligned with outflows from the protostars. If one assumes that outflows emerge along the rotation axes of circumstellar disks, then our results imply that these disks are not aligned with the fields in the cores from which they formed.

  7. Cardiac tamponade (image)

    Science.gov (United States)

    Cardiac tamponade is a condition involving compression of the heart caused by blood or fluid accumulation in the space ... they cannot adequately fill or pump blood. Cardiac tamponade is an emergency condition that requires hospitalization.

  8. What Is Cardiac Rehabilitation?

    Science.gov (United States)

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

  9. Optically thick outflows in ultraluminous supersoft sources

    CERN Document Server

    Urquhart, Ryan

    2015-01-01

    Ultraluminous supersoft sources (ULSs) are defined by a thermal spectrum with colour temperatures ~0.1 keV, bolometric luminosities ~ a few 10^39 erg/s, and almost no emission above 1 keV. It has never been clear how they fit into the general scheme of accreting compact objects. To address this problem, we studied a sample of seven ULSs with extensive Chandra and XMM-Newton coverage. We find an anticorrelation between fitted temperatures and radii of the thermal emitter, and no correlation between bolometric luminosity and radius or temperature. We compare the physical parameters of ULSs with those of classical supersoft sources, thought to be surface-nuclear-burning white dwarfs, and of ultraluminous X-ray sources (ULXs), thought to be super-Eddington stellar-mass black holes. We argue that ULSs are the sub-class of ULXs seen through the densest wind, perhaps an extension of the soft-ultraluminous regime. We suggest that in ULSs, the massive disk outflow becomes effectively optically thick and forms a large ...

  10. Bipolar outflows in OH/IR stars

    CERN Document Server

    Zijlstra, A A; Hekkert, P L; Likkel, L; Comeron, F; Norris, R P; Molster, F J; Cohen, R J; Zijlstra, Albert A.

    2000-01-01

    We investigate the development of bipolar outflows during the early post-AGB evolution. A sample of ten OH/IR stars is observed at high angular resolution, including bipolar nebulae (OH231.8+4.2), bright post-AGB stars (HD 101584) and reflection nebulae (e.g. Roberts 22). The IRAS colour--colour diagram separates the sample into different types of objects. One group may contain the progenitors to the (few) extreme bipolar planetary nebulae. Two objects show colours and chemistry very similar to the planetary nebulae with late IR-[WC] stars. One object is a confirmed close binary. A model is presented consisting of an outer AGB wind which is swept up by a faster post-AGB wind, with either wind being non-spherically symetric. The interface of the two winds is shown to exhibit a linear relation between velocity and distance from the star. The OH data confirms the predicted linear velocity gradients, and reveals torus-like, uniformly expanding components. All sources are discussed in detail using optical/HST imag...

  11. Simulating galactic outflows with kinetic supernova feedback

    CERN Document Server

    Vecchia, Claudio Dalla

    2008-01-01

    Feedback from star formation is thought to play a key role in the formation and evolution of galaxies, but its implementation in cosmological simulations is currently hampered by a lack of numerical resolution. We present and test a sub-grid recipe to model feedback from massive stars in cosmological smoothed particle hydrodynamics simulations. The energy is distributed in kinetic form among the gas particles surrounding recently formed stars. The impact of the feedback is studied using a suite of high-resolution simulations of isolated disc galaxies embedded in dark halos with total mass 10^{10} and 10^{12} M_sol/h. We focus in particular on the effect of pressure forces within the disc, which we turn off temporarily in some of our runs to mimic a recipe that has been widely used in the literature. We find that (ram) pressure forces on expanding superbubbles determine both the structure of the disc and the development of large-scale outflows. Pressure forces exerted by expanding superbubbles puff up the disc...

  12. Intergalactic Magnetic Fields from Quasar Outflows

    CERN Document Server

    Furlanetto, S; Furlanetto, Steven; Loeb, Abraham

    2001-01-01

    Outflows from quasars inevitably pollute the intergalactic medium (IGM) with magnetic fields. The short-lived activity of a quasar leaves behind an expanding magnetized bubble in the IGM. We model the expansion of the remnant quasar bubbles and calculate their distribution as a function of size and magnetic field strength at different redshifts. We generically find that by a redshift z=3, about 5-20% of the IGM volume is filled by magnetic fields with an energy density >10% of the mean thermal energy density of a photo-ionized IGM (at T=10^4 K). As massive galaxies and X-ray clusters condense out of the magnetized IGM, the adiabatic compression of the magnetic field could result in the field strength observed in these systems without a need for further dynamo amplification. The intergalactic magnetic field could also provide a nonthermal contribution to the pressure of the photo-ionized gas that may account for the claimed discrepancy between the simulated and observed Doppler width distributions of the Ly-al...

  13. Radiation Transport for Explosive Outflows: Opacity Regrouping

    CERN Document Server

    Wollaeger, Ryan T

    2014-01-01

    Implicit Monte Carlo (IMC) and Discrete Diffusion Monte Carlo (DDMC) are methods used to stochastically solve the radiative transport and diffusion equations, respectively. These methods combine into a hybrid transport-diffusion method we refer to as IMC-DDMC. We explore a multigroup IMC-DDMC scheme that, in DDMC, combines frequency groups with sufficient optical thickness. We term this procedure "opacity regrouping". Opacity regrouping has previously been applied to IMC-DDMC calculations for problems in which the dependence of the opacity on frequency is monotonic. We generalize opacity regrouping to non-contiguous groups and implement this in \\supernu, a code designed to do radiation transport in high-velocity outflows with non-monotonic opacities. We find that regrouping of non-contiguous opacity groups generally improves the speed of IMC-DDMC radiation transport. We present an asymptotic analysis that informs the nature of the Doppler shift in DDMC groups and summarize the derivation of the Gentile-Fleck ...

  14. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    Amin, A.S.; Asghari-Roodsari, A.; Tan, H.L.

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  15. Hyperammonemia in Urinary Tract Infections

    OpenAIRE

    Tsuneaki Kenzaka; Ken Kato; Akihito Kitao; Koki Kosami; Kensuke Minami; Shinsuke Yahata; Miho Fukui; Masanobu Okayama

    2015-01-01

    Objectives The present study investigated the incidence of hyperammonemia in urinary tract infections and explored the utility of urinary obstruction relief and antimicrobial administration to improve hyperammonemia. Methods This was an observational study. Subjects were patients who were diagnosed with urinary tract infection and hospitalized between June 2008 and June 2009. We measured plasma ammonia levels on admission in patients who were clinically diagnosed with urinary tract infection ...

  16. CDBG Activity Funding by Tract

    Data.gov (United States)

    Department of Housing and Urban Development — All CDBG activities in the categories of acquisition, economic development, housing, public improvements, public services, and other summarized by Census Tract.

  17. About the seasonal and fortnightly variabilities of the Mediterranean outflow

    Directory of Open Access Journals (Sweden)

    C. Millot

    2011-06-01

    Full Text Available CTD time series from the HYDRO-CHANGES programme and INGRES projects have been collected simultaneously (2004–2008 on the shelf of Morocco and at the sills of Camarinal and Espartel in the strait of Gibraltar. They provide information that supports results recently obtained from the analysis of the two former time series, as well as from a reanalysis of GIBEX CTD profiles (1985–1986. The outflow of Mediterranean Waters, which does not show a clear seasonal variability before entering the strait, strongly mixes within the strait, due mainly to the internal tide, with the seasonally variable inflow of Atlantic Water. The outflow thus gets marked seasonal and fortnightly variabilities within the strait. Furthermore, since the outflowing waters entering the strait display marked spatial heterogeneity and long-term temporal variabilities, accurately predicting the characteristics of the Mediterranean outflow into the North Atlantic Ocean appears almost impossible.

  18. Outflows of neutral (and ionized) gas in radio galaxies

    CERN Document Server

    Morganti, R; Tadhunter, C

    2004-01-01

    Outflows up to 1500 km/s of atomic neutral hydrogen are detected in a growing number of radio galaxies. Outflows with similar velocities are also detected in ionized gas, suggesting a common origin for the extreme kinematics of these two phases of the gas. The high detection rate ofsuch outflows in young (or restarted) radio sources appears to be related to the existence of a dense ISM around these objects. Such a dense ISM can have important consequences for the evolution of the radio source and the galaxy as a whole. Here we summarize the recent results obtained and the characteristics derived so far for these outflows. We also discuss possible mechanisms (e.g. interaction between the radio plasma and the ISM and adiabatically expanding broad emission lines clouds) that can be at the origin of these phenomena.

  19. Estimation of cold plasma outflow during geomagnetic storms

    CERN Document Server

    Haaland, S; André, M; Maes, L; Baddeley, L; Barakat, A; Chappell, R; Eccles, V; Johnsen, C; Lybekk, B; Li, K; Pedersen, A; Schunk, R; Welling, D

    2016-01-01

    Low-energy ions of ionospheric origin constitute a significant contributor to the magnetospheric plasma population. Measuring cold ions is difficult though. Observations have to be done at sufficiently high altitudes and typically in regions of space where spacecraft attain a positive charge due to solar illumination. Cold ions are therefore shielded from the satellite particle detectors. Furthermore, spacecraft can only cover key regions of ion outflow during segments of their orbit, so additional complications arise if continuous longtime observations, such as during a geomagnetic storm, are needed. In this paper we suggest a new approach, based on a combination of synoptic observations and a novel technique to estimate the flux and total outflow during the various phases of geomagnetic storms. Our results indicate large variations in both outflow rates and transport throughout the storm. Prior to the storm main phase, outflow rates are moderate, and the cold ions are mainly emanating from moderately sized ...

  20. MISALIGNMENT OF MAGNETIC FIELDS AND OUTFLOWS IN PROTOSTELLAR CORES

    Energy Technology Data Exchange (ETDEWEB)

    Hull, Charles L. H.; Plambeck, Richard L.; Bower, Geoffrey C.; Heiles, Carl; Meredith Hughes, A. [Astronomy Department and Radio Astronomy Laboratory, University of California, Berkeley, CA 94720-3411 (United States); Bolatto, Alberto D.; Jameson, Katherine; Mundy, Lee; Pound, Marc W. [Astronomy Department and Laboratory for Millimeter-wave Astronomy, University of Maryland, College Park, MD 20742 (United States); Carpenter, John M.; Lamb, James W.; Pillai, Thushara [Department of Astronomy, California Institute of Technology, 1200 E. California Blvd., MC 249-17, Pasadena, CA 91125 (United States); Crutcher, Richard M.; Hakobian, Nicholas S.; Kwon, Woojin; Looney, Leslie W. [Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 W Green Street, Urbana, IL 61801 (United States); Fiege, Jason D.; Franzmann, Erica [Department of Physics and Astronomy, University of Manitoba, Winnipeg, MB R3T 2N2 (Canada); Houde, Martin [Department of Physics and Astronomy, University of Western Ontario, London, ON N6A 3K7 (Canada); Matthews, Brenda C., E-mail: chat@astro.berkeley.edu [Department of Physics and Astronomy, University of Victoria, 3800 Finnerty Rd., Victoria, BC V8P 5C2 (Canada); and others

    2013-05-10

    We present results of {lambda}1.3 mm dust-polarization observations toward 16 nearby, low-mass protostars, mapped with {approx}2.''5 resolution at CARMA. The results show that magnetic fields in protostellar cores on scales of {approx}1000 AU are not tightly aligned with outflows from the protostars. Rather, the data are consistent with scenarios where outflows and magnetic fields are preferentially misaligned (perpendicular), or where they are randomly aligned. If one assumes that outflows emerge along the rotation axes of circumstellar disks, and that the outflows have not disrupted the fields in the surrounding material, then our results imply that the disks are not aligned with the fields in the cores from which they formed.

  1. Ultra-fast outflows (aka UFOs) from AGNs and QSOs

    Science.gov (United States)

    Cappi, M.; Tombesi, F.; Giustini, M.

    During the last decade, strong observational evidence has been accumulated for the existence of massive, high velocity winds/outflows (aka Ultra Fast Outflows, UFOs) in nearby AGNs and in more distant quasars. Here we briefly review some of the most recent developments in this field and discuss the relevance of UFOs for both understanding the physics of accretion disk winds in AGNs, and for quantifying the global amount of AGN feedback on the surrounding medium.

  2. Collapse and Outflow Towards an Integrated Theory of Star Formation

    CERN Document Server

    Pudritz, R E; Ouyed, R

    1997-01-01

    Observational advances over the last decade reveal that star formation is associated with the simultaneous presence of gravitationally collapsing gas, bipolar outflow, and an accretion disk. Two theoretical views of star formation suppose that either stellar mass is determined from the outset by gravitational instability, or by the outflow which sweeps away the collapsing envelope of initially singular density distributions. Neither picture appears to explain all of the facts. This contribution examines some of the key issues facing star formation theory.

  3. Wien Fireball Model of Relativistic Outflows in Active Galactic Nuclei

    OpenAIRE

    岩本, 静男; イワモト, シズオ

    2003-01-01

    We study steady and spherically symmetric outflows of pure electron-positron pair plasma as a possible acceleration mechanism of relativistic jets up to the bulk Lorentz factor of greater than 10. These outflows are initiated by the ``Wien fireball'', which is optically thick to Compton scattering but thin to absorption and in a Wien equilibrium state between pairs and photons at a relativistic temperature.

  4. Ultra-fast outflows (aka UFOs) from AGNs and QSOs

    CERN Document Server

    Cappi, M; Giustini, M

    2013-01-01

    During the last decade, strong observational evidence has been accumulated for the existence of massive, high velocity winds/outflows (aka Ultra Fast Outflows, UFOs) in nearby AGNs and in more distant quasars. Here we briefly review some of the most recent developments in this field and discuss the relevance of UFOs for both understanding the physics of accretion disk winds in AGNs, and for quantifying the global amount of AGN feedback on the surrounding medium.

  5. Characterization of molecular outflows in the substellar domain

    Energy Technology Data Exchange (ETDEWEB)

    Phan-Bao, Ngoc; Dang-Duc, Cuong [Department of Physics, International University-Vietnam National University HCM, Block 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City (Viet Nam); Lee, Chin-Fei; Ho, Paul T. P. [Institute of Astronomy and Astrophysics, Academia Sinica, P.O. Box 23-141, Taipei 106, Taiwan (China); Li, Di, E-mail: pbngoc@hcmiu.edu.vn, E-mail: pbngoc@asiaa.sinica.edu.tw [National Astronomical Observatories, Chinese Academy of Science, Chaoyang District Datun Rd A20, Beijing (China)

    2014-11-01

    We report here our latest search for molecular outflows from young brown dwarfs and very low-mass stars in nearby star-forming regions. We have observed three sources in Taurus with the Submillimeter Array and the Combined Array for Research in Millimeter-wave Astronomy at 230 GHz frequency to search for CO J = 2 → 1 outflows. We obtain a tentative detection of a redshifted and extended gas lobe at about 10 arcsec from the source GM Tau, a young brown dwarf in Taurus with an estimated mass of 73 M {sub J}, which is right below the hydrogen-burning limit. No blueshifted emission around the brown dwarf position is detected. The redshifted gas lobe that is elongated in the northeast direction suggests a possible bipolar outflow from the source with a position angle of about 36°. Assuming that the redshifted emission is outflow emission from GM Tau, we then estimate a molecular outflow mass in the range from 1.9 × 10{sup –6} M {sub ☉} to 2.9 × 10{sup –5} M {sub ☉} and an outflow mass-loss rate from 2.7 × 10{sup –9} M {sub ☉} yr{sup –1} to 4.1 × 10{sup –8} M {sub ☉} yr{sup –1}. These values are comparable to those we have observed in the young brown dwarf ISO-Oph 102 of 60 M {sub J} in ρ Ophiuchi and the very low-mass star MHO 5 of 90 M {sub J} in Taurus. Our results suggest that the outflow process in very low-mass objects is episodic with a duration of a few thousand years and the outflow rate of active episodes does not significantly change for different stages of the formation process of very low-mass objects. This may provide us with important implications that clarify the formation process of brown dwarfs.

  6. The Implications of Extreme Outflows from Extreme Starbursts

    Science.gov (United States)

    Heckman, Timothy M.; Borthakur, Sanchayeeta

    2016-05-01

    Interstellar ultraviolet absorption lines provide crucial information about the properties of galactic outflows. In this paper, we augment our previous analysis of the systematic properties of starburst-driven galactic outflows by expanding our sample to include a rare population of starbursts with exceptionally high outflow velocities. In principle, these could be a qualitatively different phenomenon from more typical outflows. However, we find that instead these starbursts lie on, or along the extrapolation of, the trends defined by the more typical systems studied previously by us. We exploit the wide dynamic range provided by this new sample to determine scaling relations of outflow velocity with galaxy stellar mass (M *), circular velocity, star formation rate (SFR), SFR/M *, and SFR/area. We argue that these results can be accommodated within the general interpretational framework we previously advocated, in which a population of ambient interstellar or circumgalactic clouds is accelerated by the combined forces of gravity and the momentum flux from the starburst. We show that this simple physical picture is consistent with both the strong cosmological evolution of galactic outflows in typical star-forming galaxies and the paucity of such galaxies with spectra showing inflows. We also present simple parameterizations of these results that can be implemented in theoretical models and numerical simulations of galaxy evolution.

  7. Characterization of Molecular Outflows in The Substellar Domain

    CERN Document Server

    Phan-Bao, Ngoc; Ho, Paul T P; Dang-Duc, Cuong; Li, Di

    2014-01-01

    We report here our latest search for molecular outflows from young brown dwarfs and very low-mass stars in nearby star-forming regions. We have observed three sources in Taurus with the Submillimeter Array and the Combined Array for Research in Millimeter-wave Astronomy at 230 GHz frequency to search for CO J=2-1 outflows. We obtain a tentative detection of a redshifted and extended gas lobe at about 10 arcsec from the source GM Tau, a young brown dwarf in Taurus with an estimated mass of 73 M_J, which is right below the hydrogen-burning limit. No blueshifted emission around the brown dwarf position is detected. The redshifted gas lobe that is elongated in the northeast direction suggests a possible bipolar outflow from the source with a position angle of about 36 degrees. Assuming that the redshifted emission is outflow emission from GM Tau, we then estimate a molecular outflow mass in the range from 1.9x10^-6 M_Sun to 2.9x10^-5 M_Sun and an outflow mass-loss rate from 2.7x10^-9 M_Sun yr^-1 to 4.1x10^-8 M_Su...

  8. Discovery of Relativistic Outflow in the Seyfert Galaxy Ark 564

    CERN Document Server

    Gupta, A; Krongold, Y; Nicastro, F

    2013-01-01

    We present Chandra high energy transmission grating spectra of the narrow-line Seyfert-1 galaxy Ark 564. The spectrum shows numerous absorption lines which are well modeled with low velocity outflow components usually observed in Seyfert galaxies (Gupta et al. 2013). There are, however, some residual absorption lines which are not accounted for by low-velocity outflows. Here we present identifications of the strongest lines as K{\\alpha} transitions of OVII(two lines) and OVI at outflow velocities of ~0.1c. These lines are detected at 6.9{\\sigma}, 6.2{\\sigma}, and 4.7{\\sigma} respectively and cannot be due to chance statistical fluctuations. Photoionization models with ultra-high velocity components improves the spectral fit significantly, providing further support for the presence of relativistic outflow in this source. Without knowing the location of the absorber, its mass and energy outflow rates cannot be well constrained; we find E$\\dot{E}(outflow)/L_{bo}$ ranging from < 0.001% to 60% using different a...

  9. Evolution of active region outflows throughout an active region lifetime

    CERN Document Server

    Zangrilli, L

    2016-01-01

    We have shown previously that SOHO/UVCS data allow us to detect active region (AR) outflows at coronal altitudes higher than those reached by other instrumentation. These outflows are thought to be a component of the slow solar wind. Our purpose is to study the evolution of the outflows in the intermediate corona from AR 8100, from the time the AR first forms until it dissolves, after several transits at the solar limb. Data acquired by SOHO/UVCS at the time of the AR limb transits, at medium latitudes and at altitudes ranging from 1.5 to 2.3 R_sun, were used to infer the physical properties of the outflows through the AR evolution. To this end, we applied the Doppler dimming technique to UVCS spectra. These spectra include the H I Lyman alpha line and the O VI doublet lines at 1031.9 and 1037.6 A. Plasma speeds and electron densities of the outflows were inferred over several rotations of the Sun. AR outflows are present in the newly born AR and persist throughout the entire AR life. Moreover, we found two t...

  10. MOS Mapping of the NIR Outflow HH 223

    Science.gov (United States)

    López, R.; Acosta-Pulido, J. A.; Estalella, R.; Gómez, G.; García-Lorenzo, B.

    2016-10-01

    The Multi-Object-Spectroscopy (MOS) mode of LIRIS was used to map the near-IR stellar outflow HH 223, in the dark cloud Lynds 723 (L723). HH 223 spatially coincides with the east-west component of the L723 quadrupolar CO outflow. The radio continuum source SMA2, towards the center of the quadrupolar CO outflow, hides the YSO that seems to power both the near-IR and the CO outflows. To map the S-shaped, near-IR emission of HH 223, extending ˜ 5', an appropriate mask was designed, with 16 rectangular slitlets. J, H and K-band spectra (R ˜eq 2500) were obtained through the mask. The kinematics of the neutral (H2) and ionized ([FeII]) gas outflow was derived from these data. The results confirm that both the near-IR and the CO outflows have a common driving source. To our knowledge, this is the first use of the MOS-LIRIS observing mode with the mask designed ad hoc to fit several extended, nonaligned targets.

  11. Energy- and momentum-conserving AGN feedback outflows

    CERN Document Server

    Zubovas, Kastytis

    2014-01-01

    It is usually assumed that outflows from luminous AGN are either in the energy-conserving (non-radiative) or in the momentum-conserving (radiative) regime. We show that in a non-spherical geometry the effects of both regimes may manifest at the same time, and that it is the momentum of the outflow that sets the $M_{\\rm BH}-\\sigma$ relation. Considering an initially elliptical distribution of gas in the host galaxy, we show that a non-radiative outflow opens up a wide ``escape route'' over the paths of least resistance. Most of the outflow energy escapes in that direction. At the same time, in the directions of higher resistance, the ambient gas is affected mainly by the incident momentum from the outflow. Quenching SMBH growth requires quenching gas delivery along the paths of highest resistance, and therefore, it is the momentum of the outflow that limits the black hole growth. We present an analytical argument showing that such energy-conserving feedback bubbles driving leaky ambient shells will terminate S...

  12. A COMPLETE Search for Molecular Outflows in Perseus

    Science.gov (United States)

    Fallscheer, C.; Borkin, M.; Ridge, N.; Schnee, S.; Goodman, A.

    2003-12-01

    Using 12CO data collected in the Coordinated Molecular Probe Line Extinction Thermal Emission (COMPLETE) Survey, we have carried out an unbiased search for molecular outflows. To begin the search, we analyzed maps of the Spectral Correlation Function (SCF) of the 12CO spectra, at a variety of spatial lags. The known outflows were all apparent in the SCF maps as regions of either very low or very high spectral correlation. Other regions identified by the SCF as having low or high spectral correlation in the data cube were examined by hand in order to assess the possibility that they harbored previously unknown outflows. Upon making customized "channel" maps of these 15 suspect regions, we have now confidently identified 4 new outflows, and 11 other regions with unusual spectral properties potentially associated with outflow. This work is still in progress, but we can say with certainty that COMPLETE has identified several new molecular outflows in Perseus. This work was supported in part by the SAO intern program under NSF grant AST-9731923.

  13. Determining the Spatially Resolved Mass Outflow Rate in Markarian 573

    Science.gov (United States)

    Revalski, Mitchell; Crenshaw, D. Michael; Fischer, Travis C.; Kraemer, Steven B.; Schmitt, Henrique R.

    2017-01-01

    We report on current progress in calculating the narrow line region (NLR) mass outflow rate in the Seyfert 2 galaxy Markarian 573. Our goal is to determine the mass outflow rate as a function of distance from the nucleus in 10 nearby Active Galactic Nuclei (AGN) with spatially resolved NLRs. These nearby AGN allow us to study the feeding and feedback of supermassive black holes (SMBHs) that may play an important role in understanding large scale structure, enrichment of the interstellar medium, and coevolution of SMBHs with their host galaxies. Utilizing archival spectra from the Space Telescope Imaging Spectrograph (STIS) on the Hubble Space Telescope (HST) we measured emission line ratios from a wide range of ionized species. Next we used the line ratios to find a reddening correction and determined the physical conditions in the ionized gas using the photoionization code Cloudy. Specifically, we derived the mass of the ionized gas and then estimate the total mass outside of the spectral slit using HST [O III] images. Combined with kinematic models of the outflows we will determine the mass outflow rate and kinetic luminosity as a function of distance from the central AGN. Ultimately, we aim to determine if NLR outflows are effective in regulating AGN feedback by comparing our observed outflow rates with theoretical models.

  14. Identifying the outflow driving sources in Orion-KL

    CERN Document Server

    Beuther, H

    2008-01-01

    The enigmatic outflows of the Orion-KL region have raised discussions about their potential driving sources for several decades. Here, we present C18O(2-1) observations combined from the Submillimeter Array and the IRAM30m telescope. The molecular gas is associated on large scales with the famous northwest-southeast high-velocity outflow whereas the high-velocity gas on small spatial scales traces back to the recently identified submm source SMA1. Therefore, we infer that SMA1 may host the driving source of this outflow. Based on the previously published thermal and maser SiO data, source I is the prime candidate to drive the northeast-southwest low-velocity outflow. The source SMA1 is peculiar because it is only detected in several submm wavelength bands but neither in the infrared nor cm regime. We discuss that it may be a very young intermediate- to high-mass protostar. The estimated outflow masses are high whereas the dynamical time-scale of the outflow is short of the order 10^3yrs.

  15. The Prevalence of Ionized Gas Outflows in Type 2 AGNs II. 3-D Biconical Outflow Models

    CERN Document Server

    Bae, Hyun-Jin

    2016-01-01

    We present 3-D models of biconical outflows combined with a thin dust plane for investigating the physical properties of the ionized gas outflows and their effect on the observed gas kinematics in type 2 active galactic nuclei (AGNs). Using a set of input parameters, we construct a number of models in 3-D and calculate the spatially integrated velocity and velocity dispersion for each model. We find that three primary parameters, i.e., intrinsic velocity, bicone inclination, and the amount of dust extinction, mainly determine the simulated velocity and velocity dispersion. Velocity dispersion increases as the intrinsic velocity or the bicone inclination increases, while velocity (i.e., velocity shift with respect to systemic velocity) increases as the amount of dust extinction increases. Simulated emission-line profiles well reproduce the observed [O III] line profiles, e.g., a narrow core and a broad wing components. By comparing model grids and Monte Carlo simulations with the observed [O III] velocity-velo...

  16. RADIATION TRANSPORT FOR EXPLOSIVE OUTFLOWS: OPACITY REGROUPING

    Energy Technology Data Exchange (ETDEWEB)

    Wollaeger, Ryan T. [Department of Nuclear Engineering and Engineering Physics, University of Wisconsin, Madison 1500 Engineering Drive, 410 ERB, Madison, WI 53706 (United States); Van Rossum, Daniel R., E-mail: wollaeger@wisc.edu, E-mail: daan@flash.uchicago.edu [Flash Center for Computational Science, Department of Astronomy and Astrophysics, University of Chicago, Chicago, IL 60637 (United States)

    2014-10-01

    Implicit Monte Carlo (IMC) and Discrete Diffusion Monte Carlo (DDMC) are methods used to stochastically solve the radiative transport and diffusion equations, respectively. These methods combine into a hybrid transport-diffusion method we refer to as IMC-DDMC. We explore a multigroup IMC-DDMC scheme that in DDMC, combines frequency groups with sufficient optical thickness. We term this procedure ''opacity regrouping''. Opacity regrouping has previously been applied to IMC-DDMC calculations for problems in which the dependence of the opacity on frequency is monotonic. We generalize opacity regrouping to non-contiguous groups and implement this in SuperNu, a code designed to do radiation transport in high-velocity outflows with non-monotonic opacities. We find that regrouping of non-contiguous opacity groups generally improves the speed of IMC-DDMC radiation transport. We present an asymptotic analysis that informs the nature of the Doppler shift in DDMC groups and summarize the derivation of the Gentile-Fleck factor for modified IMC-DDMC. We test SuperNu using numerical experiments including a quasi-manufactured analytic solution, a simple 10 group problem, and the W7 problem for Type Ia supernovae. We find that opacity regrouping is necessary to make our IMC-DDMC implementation feasible for the W7 problem and possibly Type Ia supernova simulations in general. We compare the bolometric light curves and spectra produced by the SuperNu and PHOENIX radiation transport codes for the W7 problem. The overall shape of the bolometric light curves are in good agreement, as are the spectra and their evolution with time. However, for the numerical specifications we considered, we find that the peak luminosity of the light curve calculated using SuperNu is ∼10% less than that calculated using PHOENIX.

  17. Neonatal Staphylococcus lugdunensis urinary tract infection.

    Science.gov (United States)

    Hayakawa, Itaru; Hataya, Hiroshi; Yamanouchi, Hanako; Sakakibara, Hiroshi; Terakawa, Toshiro

    2015-08-01

    Staphylococcus lugdunensis is a known pathogen of infective endocarditis, but not of urinary tract infection. We report a previously healthy neonate without congenital anomalies of the kidney and urinary tract who developed urinary tract infection due to Staphylococcus lugdunensis, illustrating that Staphylococcus lugdunensis can cause urinary tract infection even in those with no urinary tract complications.

  18. Isolated Fetal Ascite Associated with Cardiac Diseases

    Directory of Open Access Journals (Sweden)

    Vehbi Doğan

    2014-12-01

    Full Text Available Fetal ascite is defined as fluid accumulation in peritoneal cavity. It can be seen as isolated disease or an early sign of hydrops fetalis. Once fetal ascite is detected, a careful examination for hydops fetalis and possible underlying disease is necessary, since its prognosis and treatment depends mostly on the cause. Non-immunologic fetal ascite is an uncommon problem occurring for many reasons, such as urinary tract obstruction, congenital infections, genetic and metabolic diseases, gastrointestinal diseases and cardiovascular diseases. Here in this report we present two isolated fetal ascite that occurred secondary to cardiac diseases.

  19. Managing urinary tract infections.

    Science.gov (United States)

    Saadeh, Sermin A; Mattoo, Tej K

    2011-11-01

    Urinary tract infections (UTI) are common in childhood. Presence of pyuria and bacteriuria in an appropriately collected urine sample are diagnostic of UTI. The risk of UTI is increased with an underlying urological abnormality such as vesicoureteral reflux, constipation, and voiding dysfunction. Patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure. The relevance and the sequence of the renal imaging following initial UTI, and the role of antimicrobial prophylaxis and surgical intervention are currently undergoing an intense debate. Prompt treatment of UTI and appropriate follow-up of those at increased risk of recurrence and/or renal scarring are important.

  20. Protostellar Outflows and Radiative Feedback from Massive Stars. II. Feedback, Star-formation Efficiency, and Outflow Broadening

    Science.gov (United States)

    Kuiper, Rolf; Turner, Neal J.; Yorke, Harold W.

    2016-11-01

    We perform two-dimensional axially symmetric radiation hydrodynamic simulations to assess the impact of outflows and radiative force feedback from massive protostars by varying when the protostellar outflow starts, and to determine the ratio of ejection to accretion rates and the strength of the wide-angle disk wind component. The star-formation efficiency, i.e., the ratio of final stellar mass to initial core mass, is dominated by radiative forces and the ratio of outflow to accretion rates. Increasing this ratio has three effects. First, the protostar grows slower with a lower luminosity at any given time, lowering radiative feedback. Second, bipolar cavities cleared by the outflow become larger, further diminishing radiative feedback on disk and core scales. Third, the higher momentum outflow sweeps up more material from the collapsing envelope, decreasing the protostar's potential mass reservoir via entrainment. The star-formation efficiency varies with the ratio of ejection to accretion rates from 50% in the case of very weak outflows to as low as 20% for very strong outflows. At latitudes between the low-density bipolar cavity and the high-density accretion disk, wide-angle disk winds remove some of the gas, which otherwise would be part of the accretion flow onto the disk; varying the strength of these wide-angle disk winds, however, alters the final star-formation efficiency by only ±6%. For all cases, the opening angle of the bipolar outflow cavity remains below 20° during early protostellar accretion phases, increasing rapidly up to 65° at the onset of radiation pressure feedback.

  1. Kiloparsec-scale outflows are prevalent among luminous AGN: outflows and feedback in the context of the overall AGN population

    CERN Document Server

    Harrison, C M; Mullaney, J R; Swinbank, A M

    2014-01-01

    We present integral field unit (IFU) observations covering the [O III]4959,5007 and H-Beta emission lines of sixteen z~(6-16) kpc in all targets and observe signatures of spherical outflows and bi-polar superbubbles. We show that our targets are representative of z 5x10^41 erg/s) type 2 AGN and that ionised outflows are not only common but also in >=70% (3 sigma confidence) of cases, they are extended over kiloparsec scales. Our study demonstrates that galaxy-wide energetic outflows are not confined to the most extreme star-forming galaxies or radio-luminous AGN; however, there may be a higher incidence of the most extreme outflow velocities in quasars hosted in ultra-luminous infrared galaxies. Both star formation and AGN activity appear to be energetically viable to drive the outflows and we find no definitive evidence that favours one process over the other. Although highly uncertain, we derive mass outflow rates (typically ~10x the SFRs), kinetic energies (~0.5-10% of L[AGN]) and momentum rates (typically...

  2. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

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

  3. Flux-Velocity Relation for H2 Outflows

    Science.gov (United States)

    Salas, Luis; Cruz-González, Irene

    2002-06-01

    We present an analysis of velocity-resolved near-IR molecular hydrogen observations of a variety of protostellar outflows with very different energetics, degrees of collimation, and morphologies. Observations in the 2.12 μm line of H2 were obtained using an IR Fabry-Pérot interferometer with a spectral resolution of 23 km s-1. The integrated flux-velocity diagrams for each outflow show a flat spectrum for low velocities followed by a decreasing power law dF/dv~vγ, with γ between -1.8 and -2.6, for velocities higher than a clearly defined break velocity at 2-17 km s-1. Contrary to shock model predictions, it is shown that the H2 intensity is constant with velocity. We argue that the flux-velocity relation can then be interpreted as a mass-velocity relation, in striking similarity to the power-law mass spectra observed in CO outflows. By comparing H2 and CO mass-velocity spectra, it is shown that there is a velocity regime in which both molecules coexist and produce similar γ-values. Evolution effects in outflows appear as a correlation between outflow length and γ as outflows age, the spectra becomes steeper. Our results support a common physical origin for both CO and H2 emission and a strong association between the molecular outflows traced in each molecule. Based on observations obtained at the Observatorio Astronómico Nacional at San Pedro Mártir, Mexico.

  4. OUTFLOW AND HOT DUST EMISSION IN HIGH-REDSHIFT QUASARS

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Huiyuan; Xing, Feijun; Wang, Tinggui; Zhou, Hongyan [Key Laboratory for Research in Galaxies and Cosmology, Department of Astronomy, University of Science and Technology of China, Chinese Academy of Sciences, Hefei, Anhui 230026 (China); Zhang, Kai [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan Road, Shanghai 200030 (China); Zhang, Shaohua, E-mail: whywang@mail.ustc.edu.cn [Polar Research Institute of China, Jinqiao Road 451, Shanghai 200136 (China)

    2013-10-10

    Correlations of hot dust emission with outflow properties are investigated, based on a large z ∼ 2 non-broad absorption line quasar sample built from the Wide-field Infrared Survey and the Sloan Digital Sky Survey data releases. We use the near-infrared slope and the infrared to UV luminosity ratio to indicate the hot dust emission relative to the emission from the accretion disk. In our luminous quasars, these hot dust emission indicators are almost independent of the fundamental parameters, such as luminosity, Eddington ratio and black hole mass, but moderately dependent on the blueshift and asymmetry index (BAI) and FWHM of C IV lines. Interestingly, the latter two correlations dramatically strengthen with increasing Eddington ratio. We suggest that, in high Eddington ratio quasars, C IV regions are dominated by outflows so the BAI and FWHM (C IV) can reliably reflect the general properties and velocity of outflows, respectively. In low Eddington ratio quasars, on the other hand, C IV lines are primarily emitted by virialized gas so the BAI and FWHM (C IV) become less sensitive to outflows. Therefore, the correlations for the highest Eddington ratio quasars are more likely to represent the true dependence of hot dust emission on outflows and the correlations for the entire sample are significantly diluted by the low Eddington ratio quasars. Our results show that an outflow with a large BAI or velocity can double the hot dust emission on average. We suggest that outflows either contain hot dust in themselves or interact with the dusty interstellar medium or torus.

  5. Population-based evaluation of a suggested anatomic and clinical classification of congenital heart defects based on the International Paediatric and Congenital Cardiac Code

    Directory of Open Access Journals (Sweden)

    Goffinet François

    2011-10-01

    Full Text Available Abstract Background Classification of the overall spectrum of congenital heart defects (CHD has always been challenging, in part because of the diversity of the cardiac phenotypes, but also because of the oft-complex associations. The purpose of our study was to establish a comprehensive and easy-to-use classification of CHD for clinical and epidemiological studies based on the long list of the International Paediatric and Congenital Cardiac Code (IPCCC. Methods We coded each individual malformation using six-digit codes from the long list of IPCCC. We then regrouped all lesions into 10 categories and 23 subcategories according to a multi-dimensional approach encompassing anatomic, diagnostic and therapeutic criteria. This anatomic and clinical classification of congenital heart disease (ACC-CHD was then applied to data acquired from a population-based cohort of patients with CHD in France, made up of 2867 cases (82% live births, 1.8% stillbirths and 16.2% pregnancy terminations. Results The majority of cases (79.5% could be identified with a single IPCCC code. The category "Heterotaxy, including isomerism and mirror-imagery" was the only one that typically required more than one code for identification of cases. The two largest categories were "ventricular septal defects" (52% and "anomalies of the outflow tracts and arterial valves" (20% of cases. Conclusion Our proposed classification is not new, but rather a regrouping of the known spectrum of CHD into a manageable number of categories based on anatomic and clinical criteria. The classification is designed to use the code numbers of the long list of IPCCC but can accommodate ICD-10 codes. Its exhaustiveness, simplicity, and anatomic basis make it useful for clinical and epidemiologic studies, including those aimed at assessment of risk factors and outcomes.

  6. Catheter-Associated Urinary Tract Infections

    Science.gov (United States)

    ... Submit Button Frequently Asked Questions about Catheter-associated Urinary Tract Infections Recommend on Facebook Tweet Share Compartir What is ... an incision above the pubis. What is a urinary tract infection? A urinary tract infection (UTI) is an infection ...

  7. Exercise-induced intra-ventricular gradients as a frequent potential cause of myocardial ischemia in cardiac syndrome X patients

    Directory of Open Access Journals (Sweden)

    Almeida Ana G

    2008-01-01

    Full Text Available Abstract Background The development of intra-ventricular gradients (IVG during dobutamine or exercise stress is not infrequent, and can be associated to symptoms during stress. The purpose of this study was to assess the occurrence of IVG during exercise stress echocardiography in cardiac syndrome X patients. Methods We prospectively evaluated 91 patients (pts mean aged 51 ± 12 years (age ranged 20 to 75 years old, 44 of whom were women. All pts had angina, positive exercise ECG treadmill testing, normal rest echocardiogram and no coronary artery disease on coronary angiogram (cardiac X syndrome. After complete Doppler echocardiographic evaluation with determination of left ventricular outflow tract index (LVOTi, relative left ventricular wall thickness (RLVWT and left ventricular end-diastolic volume index (LVDVi, all patients underwent stress echocardiography with two-dimensional and Doppler echographic evaluation during and after treadmill exercise. Results For analysis purpose patients were divided in 2 groups, according to the development of IVG. Doppler evidence of IVG was found in 33 (36% of the patients (Group A, with mean age 47 ± 14 years old (age ranged 20 to 72 years and with a mean end-systolic peak gradient of 86 ± 34 mmHg (ranging from 30 to 165 mmHg. The IVG development was accompanied by SAM of the mitral valve in 23 pts. Three of these pts experienced symptomatic hypotension. Ten were women (30% pts. 58 pts in group B, 34 of whom were women (59% (p = 0,01 vs group A, mean aged 53,5 ± 10,9 years old (age ranged 34 to 75 years (p = 0,03 vs group A, did not develop IVG. LVOTi was 10,29 ± 0,9 mm/m2 in group A and 11,4 ± 1 mm/m2 in group B (p 2 in group A and 56 ± 11,6 ml/m2 in group B (p = 0,000. Conclusion 1. A significant number of patients with cardiac X syndrome developed IVG during upright exercise in treadmill. These pts (group A are mainly males and younger than those who did not develop IVG. 2. The development of IVG

  8. Line-driven radiative outflows in luminous quasars

    CERN Document Server

    Bowler, Rebecca A A; Allen, James T; Ferland, Gary J

    2014-01-01

    An analysis of ~19500 narrow (<200 km/s) CIV 1548.2,1550.8 absorbers in ~34000 Sloan Digital Sky Survey quasar spectra is presented. The statistics of the number of absorbers as a function of outflow-velocity shows that in approximately two-thirds of outflows, with multiple CIV absorbers present, absorbers are line-locked at the 500 km/s velocity separation of the CIV absorber doublet; appearing as 'triplets' in the quasar spectra. Line-locking is an observational signature of radiative line driving in outflowing material, where the successive shielding of 'clouds' of material in the outflow locks the clouds together in outflow velocity. Line-locked absorbers are seen in both broad absorption line quasars (BALs) and non-BAL quasars with comparable frequencies and with velocities out to at least 20000 km/s. There are no detectable differences in the absorber properties and the dust content of single CIV doublets and line-locked CIV doublets. The gas associated with both single and line-locked CIV absorption...

  9. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  10. Epidemiology of urinary tract infections in Hiroshima

    Energy Technology Data Exchange (ETDEWEB)

    Freedman, L.R.; Phair, J.P.; Seki, Masafumi; Hamilton, H.B.; Nefzger, M.D.

    1964-08-19

    The present study was conducted at ABCC on a sample of Hiroshima residents systematically seleced for determining the influence on general health status of exposure to the atomic bomb of 1945. A survey for urinary infections was taken on persons in the sample examined in the ABCC clinic over a 1-year period: approximately 3000 women and 2000 men. The purpose of the study was to determine the prevalence of urinary infection and to study the relation between bacteriuria and various aspects of the general examination, particularly blood pressure. In addition, the rates of urinary tract infection in the clinic were compared with the rates of chronic pyelonephritis at autopsy. Results showed that infections were much more common in women than in men and rose with age in both sexes. The greatest increase in the prevalence was found in women age 60 years and over was due to coliform bacteria in all but a few instances. There was no difference in hematuria, glycosuria, diabetes, serum cholesterol, blood groups, electrocardiograms, audiometry, vibrometry, hemoglobin levels or height-weight ratios. Blood pressure is higher in infected women as compared with noninfected women and the finding of higher rates for cardiac enlargement suggests that this small difference in blood pressures may have biological significance. However, the data do not permit a conclusion as to whether the urinary infections were responsible for the higher blood pressure levels, or whether the higher blood pressure levels increased the frequency of detectable infection. The difference between the clinical rates of urinary infection in men and women, and the pathological diagnosis of pyelonephritis in the same population, supports a previous suggestion that much of what is called pyelonephritis at autopsy is not due to urinary tract infection. 27 references, 2 figures, 10 tables.

  11. Laparoscopic living donor right hemihepatectomy with venous outflow reconstruction using cadaveric common iliac artery allograft

    Science.gov (United States)

    Li, Jiaxin; Huang, Jiwei; Wu, Hong; Zeng, Yong

    2017-01-01

    should have rich open living donor liver transplantation experience and skilled laparoscopic techniques. Venous outflow tract reconstruction is necessary if orifice diameter of short hepatic vein is greater than 0.5 cm on the graft cutting surface. PMID:28207553

  12. The Outflow-Disc Interaction in Young Stellar Objects

    CERN Document Server

    Pestalozzi, M R

    2000-01-01

    In this work the most spectacular phenomena occurring during the formation of a star are briefly reviewed: accretion through a rotating disc of matter and outflow through the poles of the new stellar object. Magnetic fields have been proposed to be principally responsible for the coexistence of these opposed mechanisms of accretion and outflowing. According to different models, the magnetic fields are either twisted or stretched by the accretion disc, allowing the formation of polar channels through which part of the accreting matter can escape. The high degree of coupling between the physical parameters describing the young stellar object (e.g. circular velocity of the disc and the central object, viscosity, strength and freezing of magnetic fields, etc.) makes detailed understanding of the interaction between accretion discs and outflows very difficult. The models presented here provide only a partial answer to this difficult problem.

  13. Precessing jets and molecular outflows a 3-D numerical study

    CERN Document Server

    Cliffe, J A; Frank, Adam

    1996-01-01

    We present 3-D numerical hydrodynamical simulations of precessing supersonic heavy jets to explore how well they serve as a model for generating molecular outflows from Young Stellar Objects. The dynamics are studied with a number of high resolution simulations on a Cartesian grid (128x128x128 zones) using a high order finite difference method. A range of cone angles and precession rates were included in the study. Two higher resolution runs (256x256x256 zones) were made for comparison in order to confirm numerical convergence of global flow characteristics. Morphological, kinematical and dynamical characteristics of precessing jets are described and compared to important properties of straight jets and also to observations of YSOs. In order to examine the robustness of precessing jets as a mean to produce molecular outflows around Young Stellar Objects, ``synthetic observations'' of the momentum distributions of the simulated precessing jets are compared to observations of molecular outflows. It is found tha...

  14. About the seasonal and fortnightly variabilities of the Mediterranean outflow

    Directory of Open Access Journals (Sweden)

    C. Millot

    2010-12-01

    Full Text Available CTD time series from the HYDRO-CHANGES programme and INGRES projects have been collected simultaneously (2004–2008 on the Moroccan shelf and at the Camarinal and Espartel Sills in the strait of Gibraltar. They provide information that supports results recently obtained from the analysis of the two former time series, as well as from a reanalysis of CTD GIBEX profiles (1985–1986. The outflow of Mediterranean Waters, which does not show a clear seasonal variability before entering the strait, strongly mixes within the strait, due mainly to the internal tide, with the seasonally variable inflow of Atlantic Water. The outflow thus gets marked seasonal and fortnightly variabilities within the strait. Furthermore, since the outflow entering the strait displays marked spatial heterogeneity and long-term temporal variabilities, predicting its characteristics when in the ocean appears almost impossible.

  15. Starburst Galaxies: Outflows of Metals and Energy into the IGM

    CERN Document Server

    Strickland, David K; Ptak, Andrew; Schlegel, Eric; Tremonti, Christy; Tsuru, Takeshi; Tuellmann, Ralph; Zezas, Andreas

    2009-01-01

    What is the contribution of mass, metals and energy from starburst galaxies to the Intergalactic Medium? Starburst galaxies drive galactic-scale outflows or "superwinds" that may be responsible for removing metals from galaxies and polluting the Intergalactic Medium (IGM). In the last decade tremendous progress was made in mapping cool entrained gas in superwinds through UV/optical imaging and absorption line spectroscopy. These studies demonstrated that superwinds are ubiquitous in galaxies forming stars at high surface densities and that the most powerful starbursts can drive outflows near escape velocity. Theoretical models of galaxy evolution have begun to incorporate superwinds, using various ad-hoc prescriptions based on our knowledge of the cool gas. However, these efforts are fundamentally impeded by our lack of information about the hot phase of these outflows. The hot X-ray emitting phase of a superwind contains the majority of its energy and newly-synthesized metals, and given its high specific ene...

  16. The Massive Bipolar Outflow in IRAS 20110+3321

    Institute of Scientific and Technical Information of China (English)

    LI Jing-Jing; XU Ye; MIYAZAKI Atsushi; SHEN Zhi-Qiang; CHEN Xi

    2006-01-01

    @@ Mapping observations were made towards IRAS 20110+3321 using the Nobeyama 45 m and the Delingha 13.7m radio telescopes. The high angular resolution (~ 21″) image with the 45m telescope shows that there is a highvelocity bipolar molecular outflow in this region, which is in the NW-SE direction with a collimation factor of ~ 2.2. The outflow has significantly higher mass loss rate and mechanical luminosity than those from low mass YSOs, indicating that the outflow is driven by the IRAS source. A dense massive core was detected by mapping C18O (J= 1 - 0) line in the area with the 13.7m telescope. The IRAS source lies within the core but slightly offsets from its emission peak.

  17. Simulations of Metal Enrichment in Galaxy Clusters by AGN Outflows

    CERN Document Server

    Moll, R; Domainko, W; Kapferer, W; Mair, M; Van Kampen, E; Kronberger, T; Kimeswenger, S; Ruffert, M

    2006-01-01

    We assess the importance of AGN outflows with respect to the metal enrichment of the intracluster medium (ICM) in galaxy clusters. We use combined N-body and hydrodynamic simulations, along with a semi-numerical galaxy formation and evolution model. Using assumptions based on observations, we attribute outflows of metal-rich gas initiated by AGN activity to a certain fraction of our model galaxies. The gas is added to the model ICM, where the evolution of the metallicity distribution is calculated by the hydrodynamic simulations. For the parameters describing the AGN content of clusters and their outflow properties, we use the observationally most favorable values. We find that AGNs have the potential to contribute significantly to the metal content of the ICM or even explain the complete abundance, which is typically ~0.5 Z_sun in core regions. Furthermore, the metals end up being inhomogeneously distributed, in accordance with observations.

  18. Mapping Large-Scale Gaseous Outflows in Ultraluminous Infrared Galaxies with Keck II ESI Spectra: Spatial Extent of the Outflow

    CERN Document Server

    Martin, C L

    2006-01-01

    The kinematics of neutral gas and warm ionized gas have been mapped in one-dimension across ultraluminous starburst galaxies using interstellar absorption and emission lines, in Keck II ESI spectra. Blue-shifted absorption is found along more of the slit than anticipated, exceeding scales of 15 kpc across several systems. The large velocity gradient measured across some of these outflows is inconsistent with a flow diverging from the central starburst -- angular momentum conservation reduces the rotational velocity of an outflow as it expands. More widespread star formation, likely triggered by the merger, probably drives these outflows, although some models suggest the collision itself could generate a wind by shock heating interstellar gas throughout the disk. Young mergers with separated nuclei present the highest outflow masses, due mainly to the larger area over which the cool gas can be detected. In a typical ULIG, the mass carried by the cool phase of the outflow is around 10^8Msun, or a few percent of...

  19. Studying the Outflow-Core Interaction with ALMA Cycle 1 Observations of the HH 46/47 Molecular Outflow

    CERN Document Server

    Zhang, Yichen; Mardones, Diego; Cabrit, Sylvie; Dunham, Michael M; Garay, Guido; Noriega-Crespo, Alberto; Offner, Stella S R; Raga, Alejandro C; Corder, Stuartt A

    2016-01-01

    We present ALMA Cycle 1 observations of the HH 46/47 molecular outflow using combined 12m array and 7m array observations. We use 13CO and C18O emission to correct for the 12CO optical depth, to accurately estimate the outflow mass, momentum and kinetic energy. Applying the optical depth correction increases the mass estimate by a factor of 14, the momentum by a factor of 6, and the kinetic energy by a factor of about 2. The new 13CO(1-0) and C18O(1-0) data also allow us to trace denser and slower outflow material than that traced by 12CO. These species are only detected within about 1~2 km/s from the cloud velocity. The cavity wall of the red lobe appears at very low velocities (~0.2 km/s). Combing the material traced only by 13CO and C18O, the measured total mass of the CO outflow is 1.4 Msun, the total momentum is 1.7 Msun km/s and the total energy is 4.7e43 erg, assuming Tex=15 K. The improved angular resolution and sensitivity in 12CO reveal more details of the outflow structure. Specifically, we find th...

  20. SiO: Not the perfect outflow tracer: Outflow studies of the massive star formation region IRAS 19410+2336

    CERN Document Server

    Widmann, Felix; Schilke, Peter; Stanke, Thomas

    2016-01-01

    Aims: Previous observations of the young massive star formation region IRAS 19410+2336 have revealed strong outflow activity with several interacting outflows. We aim to get a better understanding of the outflow activity in this region by observing the SiO and H$^{13}$CO$^+$ emission with high angular resolution. SiO is known to trace shocked gas, which is often associated with young energetic outflows. With the H$^{13}$CO$^+$ data, we intend to better understand the distribution of the quiescent gaseous component of the region. Methods: The SiO observations in the J=2-1 v=0 transition and H$^{13}$CO$^+$ J=1-0 observations were performed by the Plateau de Bure Interferometer, combined with IRAM 30 m single-dish observations, in order to get the missing short-spacing information. We complement this new high-resolution observation with earlier CO and H$_2$ data. Results: The SiO observations do not trace the previously in CO and H$_2$ identified outflows well. Although we identify regions of highly increased Si...

  1. Successful resection of a primary cardiac fibroma in a neonate: report of a case.

    Science.gov (United States)

    Yan, Xian-Gang; Jia, Bing; Zhu, Bing-Xue; Hu, Xi-Hong

    2014-09-01

    During the fetal-neonatal period, a primary cardiac tumor may be completely asymptomatic and such tumors may be incidentally discovered by echocardiography. A four-hour-old male was diagnosed to have a cardiac tumor by post-natal echocardiography and was observed closely. Surgery was indicated immediately at the 3 week follow-up examination when the tumor was found to have obstructed the right ventricle outflow. The tumor was resected successfully and its histopathology indicated that it was a fibroma. Follow-up echocardiograms and magnetic resonance imaging 5 months postoperatively demonstrated no evidence of any remaining tumor and his RV function was good.

  2. Feline Lower Urinary Tract Disease

    Science.gov (United States)

    ... of your cat’s urinary tract with bacteria, fungi, parasites or possibly even viruses can cause signs of ... of their urine prevents infection. Diseases such as kidney disease and diabetes are more common in cats ...

  3. Urinary Tract Infections in Adults

    Science.gov (United States)

    ... Palermo JJ, Schilling JD, et al. Intracellular bacterial biofilm-like pods in urinary tract infections. Science. 2003; ... for questions about any medications, contact the U.S. Food and Drug Administration toll-free at 1-888- ...

  4. Urinary Tract Infections in Children

    Directory of Open Access Journals (Sweden)

    Mustafa Taskesen

    2009-04-01

    Full Text Available Urinary tract infections (UTI are frequent conditions in children. Untreated urinary tract infections can lead to serious kidney problems that could threaten the life of the child. Therefore, early detection and treatment of urinary tract infection is important. In older children, urinary tract infections may cause obvious symptoms such as stomach ache and disuria. In infants and young children, UTIs may be harder to detect because of less specific symptoms. Recurrences are common in children with urinary abnormalities such as neurogenic bladder, vesicourethral reflux or those with very poor toilet and hygiene habits. This article reviews the diagnostic approach and presents the current data related to the roles of radiologic imaging, surgical correction and antibiotic prophylaxis of UTIs in children. [Archives Medical Review Journal 2009; 18(2.000: 57-69

  5. How stellar feedback simultaneously regulates star formation and drives outflows

    Science.gov (United States)

    Hayward, Christopher C.; Hopkins, Philip F.

    2017-02-01

    We present an analytic model for how momentum deposition from stellar feedback simultaneously regulates star formation and drives outflows in a turbulent interstellar medium (ISM). Because the ISM is turbulent, a given patch of ISM exhibits sub-patches with a range of surface densities. The high-density patches are `pushed' by feedback, thereby driving turbulence and self-regulating local star formation. Sufficiently low-density patches, however, are accelerated to above the escape velocity before the region can self-adjust and are thus vented as outflows. When the gas fraction is ≳ 0.3, the ratio of the turbulent velocity dispersion to the circular velocity is sufficiently high that at any given time, of the order of half of the ISM has surface density less than the critical value and thus can be blown out on a dynamical time. The resulting outflows have a mass-loading factor (η ≡ dot{M}_{out}/M_{star}) that is inversely proportional to the gas fraction times the circular velocity. At low gas fractions, the star formation rate needed for local self-regulation, and corresponding turbulent Mach number, declines rapidly; the ISM is `smoother', and it is actually more difficult to drive winds with large mass-loading factors. Crucially, our model predicts that stellar-feedback-driven outflows should be suppressed at z ≲ 1 in M⋆ ≳ 1010 M⊙ galaxies. This mechanism allows massive galaxies to exhibit violent outflows at high redshifts and then `shut down' those outflows at late times, thereby enabling the formation of a smooth, extended thin stellar disc. We provide simple fitting functions for η that should be useful for sub-resolution and semi-analytic models.

  6. River Outflow of the Conterminous United States, 1939-1988.

    Science.gov (United States)

    Guetter, Alexandre K.; Georgakakos, Konstantine P.

    1993-10-01

    A record of 50 years of daily outflows through the boundaries of the continental United States has been assembled based on observations recorded by U.S. Geological Survey streamflow stations. Only stations with continuous records from 1939 through 1988 were included. These stations (197 total) are near the outlets of rivers located at the vicinity of the Canadian, Mexican, Atlantic (including the Gulf of Mexico), and Pacific borders of the continental United States. The drainage area of the selected stations covers 77% of the conterminous United States, whereas the existing network of gauging stations covers 83% of the conterminous U.S. area. Station daily data were aggregated over the entire boundary of the United States and were integrated in monthly and annual totals. The 50-year average annual streamflow divergence normalized by the aggregated drainage area is 210.2 mm yr1, reaching a peak in April with 27.3 mm month1 and a minimum in September with 8.7 mm month1. The Mississippi-Missouri Basin comprises 50% of the gauged area and dominates the absolute value of the outflow discharge. Spectral analysis of the monthly outflow anomalies shows an 11-year dominant cycle. The 1939-1988 period contains four notable droughts. Two droughts are partially registered in the limits of the records characterized by the negative anomalies extending from 1939 to 1941 and by the 1987-1988 anomalies for the late 1980s drought. The middle 1950s and early 1960s droughts are fully included in the dataset. Periods of high outflows were registered in the middle 1940s, early 1970s, and early 1980s. Analysis of the spatial coherence of the annual anomalies shows large-scale features, whereas analysis of the monthly anomalies yields the frequency and persistence patterns of floods and droughts. An estimate of the climatological land-surface water budget for the continental United States was done based on recorded precipitation, panevaporation, and outflow. Eigenvector analysis of the

  7. Outflow channel sources, reactivation, and chaos formation, Xanthe Terra, Mars

    Science.gov (United States)

    Rodriguez, J.A.P.; Sasaki, S.; Kuzmin, R.O.; Dohm, J.M.; Tanaka, K.L.; Miyamoto, H.; Kurita, K.; Komatsu, G.; Fairen, A.G.; Ferris, J.C.

    2005-01-01

    The undulating, warped, and densely fractured surfaces of highland regions east of Valles Marineris (located north of the eastern Aureum Chaos, east of the Hydraotes Chaos, and south of the Hydaspis Chaos) resulted from extensional surface warping related to ground subsidence, caused when pressurized water confined in subterranean caverns was released to the surface. Water emanations formed crater lakes and resulted in channeling episodes involved in the excavation of Ares, Tiu, and Simud Valles of the eastern part of the circum-Chryse outflow channel system. Progressive surface subsidence and associated reduction of the subsurface cavernous volume, and/or episodes of magmatic-driven activity, led to increases of the hydrostatic pressure, resulting in reactivation of both catastrophic and non-catastrophic outflow activity. Ancient cratered highland and basin materials that underwent large-scale subsidence grade into densely fractured terrains. Collapse of rock materials in these regions resulted in the formation of chaotic terrains, which occur in and near the headwaters of the eastern circum-Chryse outflow channels. The deepest chaotic terrain in the Hydaspis Chaos region resulted from the collapse of pre-existing outflow channel floors. The release of volatiles and related collapse may have included water emanations not necessarily linked to catastrophic outflow. Basal warming related to dike intrusions, thermokarst activity involving wet sediments and/or dissected ice-enriched country rock, permafrost exposed to the atmosphere by extensional tectonism and channel incision, and/or the injection of water into porous floor material, may have enhanced outflow channel floor instability and subsequent collapse. In addition to the possible genetic linkage to outflow channel development dating back to at least the Late Noachian, clear disruption of impact craters with pristine ejecta blankets and rims, as well as preservation of fine tectonic fabrics, suggest that

  8. Heating of the Intracluster Medium by Quasar Outflows

    Indian Academy of Sciences (India)

    Suparna Roychowdhury; Biman B. Nath

    2002-03-01

    We study the possibility of quasar outflows in clusters and groups of galaxies heating the intracluster gas in order to explain the recent observation of excess entropy in this gas. We show that radio galaxies alone cannot provide the energy required to explain the observations but the inclusion of Broad Absorption Line (BAL) outflows can do so, and that in this scenario most of the heating takes place at ∼ 1–4, the ``preheating” epoch being at a lower redshift for lower mass clusters.

  9. Cardiac Procedures and Surgeries

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Cardiac Procedures and Surgeries Updated:Sep 16,2016 If you've had ... degree of coronary artery disease (CAD) you have. Cardiac Procedures and Surgeries Angioplasty Also known as Percutaneous Coronary Interventions [PCI], ...

  10. [Advances in cardiac pacing].

    Science.gov (United States)

    de Carranza, María-José Sancho-Tello; Fidalgo-Andrés, María Luisa; Ferrer, José Martínez; Mateas, Francisco Ruiz

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed.

  11. (abstract) A Test of the Theoretical Models of Bipolar Outflows: The Bipolar Outflow in Mon R2

    Science.gov (United States)

    Xie, Taoling; Goldsmith, Paul; Patel, Nimesh

    1993-01-01

    We report some results of a study of the massive bipolar outflow in the central region of the relatively nearby giant molecular cloud Monoceros R2. We make a quantative comparison of our results with the Shu et al. outflow model which incorporates a radially directed wind sweeping up the ambient material into a shell. We find that this simple model naturally explains the shape of this thin shell. Although Shu's model in its simplest form predicts with reasonable parameters too much mass at very small polar angles, as previously pointed out by Masson and Chernin, it provides a reasonable good fit to the mass distribution at larger polar angles. It is possible that this discrepancy is due to inhomogeneities of the ambient molecular gas which is not considered by the model. We also discuss the constraints imposed by these results on recent jet-driven outflow models.

  12. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

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

  13. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

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

  14. Functional cardiac MRI for assessment of aortic valve disease; Aortenklappenstenose im MRT mit Dynamik und 3D

    Energy Technology Data Exchange (ETDEWEB)

    Sagmeister, F.; Ritter, C.; Machann, W.; Koestler, H.; Hahn, D.; Beer, M. [Universitaetsklinikum Wuerzburg, Institut fuer Roentgendiagnostik, Wuerzburg (Germany); Herrmann, S.; Voelker, W.; Weidemann, F. [Universitaetsklinikum Wuerzburg, Medizinische Klinik I, Wuerzburg (Germany)

    2010-06-15

    Aortic valve disease shows a rising incidence with the increasing mean age of Western populations. The detection of hemodynamic parameters, which transcends the mere assessment of valve morphology, has an important future potential concerning classification of the severity of disease. MRI allows a non-invasive and a spatially flexible view of the aortic valve and the adjacent anatomic region, left ventricular outflow tract (LVOT) and ascending aorta. Moreover, the technique allows the determination of functional hemodynamic parameters, such as flow velocities and effective orifice areas. The new approach of a serial systolic planimetry velocity-encoded MRI sequence (VENC-MRI) facilitates the sizing of blood-filled cardiac structures with the registration of changes in magnitude during systole. Additionally, the subvalvular VENC-MRI measurements improve the clinically important exact determination of the LVOT area with respect to its specific eccentric configuration and its systolic deformity. (orig.) [German] Erworbene Erkrankungen der Aortenklappe wie die Aortenklappenstenose zeigen mit zunehmender Alterungstendenz unserer Gesellschaft eine ansteigende Inzidenz. Die Erfassung ueber die reine Klappenmorphologie hinausgehender haemodynamischer Parameter hat ein wichtiges zukuenftiges Potenzial zur Schweregradeinschaetzung. Die MRT erlaubt eine nichtinvasive und raeumlich flexible Darstellung der Aortenklappe sowie ihrer benachbarten anatomischen Strukturen (linksventrikulaerer Ausflusstrakt/LVOT, Aorta ascendens). Darueber hinaus ist eine Bestimmung funktioneller haemodynamischer Parameter wie Flussgeschwindigkeiten und effektiven Oeffnungsflaechen (EOeF) moeglich. Der neue Ansatz einer seriellen Planimetrie geschwindigkeitskodierter MRT-Sequenzen (Velocity-encoding- [VENC-]MRT) erlaubt die Groessenbestimmung flussdurchstroemter kardialer Strukturen und die Aufzeichnung ihrer dynamischen Groessenveraenderung waehrend der Systole. Zusaetzlich ermoeglicht die

  15. Nanofiber-reinforced biological conduit in cardiac surgery: preliminary report.

    Science.gov (United States)

    Guhathakurta, Soma; Galla, Satish; Ramesh, Balasundari; Venugopal, Jayarama Reddy; Ramakrishna, Seeram; Cherian, Kotturathu Mammen

    2011-06-01

    Several options are available for right ventricular outflow tract reconstruction, including commercially available bovine jugular vein and cryo-preserved homografts. Homograft non-availability and the problems of commercially available conduits led us to develop indigenously processed bovine jugular vein conduits with competent valves. They were made completely acellular and strengthened by non-conventional cross-linking without disturbing the extracellular matrix, which improved the luminal surface characteristics for hemocompatibility. Biocompatibility in vitro and in vivo, along with thermal stability, matrix stability, and mechanical strength have been evaluated. Sixty-nine patients received these conduits for right ventricular outflow tract reconstruction. Seven conduits dilated and 4 required replacement. To counteract dilatation, biodegradable polymeric nanofibers in various combinations and in isolation (collagen, polycaprolactone, polylactic acid) were characterized and used to reinforce the conduit circumferentially. Physical validation by mechanical testing, scanning electron microscopy, and in-vitro cytotoxicity was conducted. Thermal stability, spectroscopy studies of the polymer, and preclinical studies of the coated bovine jugular vein in animals are in progress. The feasibility studies have been completed, and the final polymer selection depends on evaluation of the functional superiority of the coated bovine jugular vein.

  16. Quantifying the Multiphase Galactic Outflows Driven by Supernovae

    Science.gov (United States)

    Li, Miao; Bryan, Greg; Ostriker, Jeremiah P.

    2017-01-01

    Galactic outflows are ubiquitously observed in star-forming disk galaxies and are critical for galaxy formation. Supernovae (SN) play a key role in driving the outflows, but there is no consensus as to how much energy, mass and metals they can launch out of the disk. We perform 3D, high-resolution hydrodynamic simulations to study SN-driven outflows from stratified media. We study various conditions along the Kennicutt-Schmidt relation, and examine the loading factors of energy, mass and metals as a function of the star formation rate. We find that the hot phase, being fast and metal-enriched, would have a broad impact on the circum-galactic medium. We explore how various physical processes, including SN scale height, photoelectric heating, external gravitational field and SN rate, affect the loading factors. We find that the mass loading factor can achieve unity for a gas surface density similar to the solar neighborhood, but is lower for higher densities. The mass loading is in general a factor of a few smaller than what is currently adopted in cosmological simulations. SN-driven outflows are expected to efficiently transport out of the galaxies both energy and metals.

  17. The Production of Cold Gas Within Galaxy Outflows

    Science.gov (United States)

    Scannapieco, Evan

    2017-03-01

    I present a suite of three-dimensional simulations of the evolution of initially hot material ejected by starburst-driven galaxy outflows. The simulations are conducted in a comoving frame that moves with the material, tracking atomic/ionic cooling, Compton cooling, and dust cooling and destruction. Compton cooling is the most efficient of these processes, while the main role of atomic/ionic cooling is to enhance density inhomogeneities. Dust, on the other hand, has little effect on the outflow evolution, and is rapidly destroyed in all the simulations except for the case with the smallest mass flux. I use the results to construct a simple steady-state model of the observed UV/optical emission from each outflow. The velocity profiles in this case are dominated by geometric effects, and the overall luminosities are extremely strong functions of the properties of the host system, as observed in ultra-luminous infrared galaxies (ULIRGs). Furthermore the luminosities and maximum velocities in several models are consistent with emission-line observations of ULIRGs, although the velocities are significantly greater than observed in absorption-line studies. It may be that absorption line observations of galaxy outflows probe entrained cold material at small radii, while emission-line observations probe cold material condensing from the initially hot medium at larger distances.

  18. Outflow and hot dust emission in broad absorption line quasars

    CERN Document Server

    Zhang, Shaohua; Wang, Tinggui; Xing, Feijun; Zhang, Kai; Zhou, Hongyan; Jiang, Peng

    2014-01-01

    We have investigated a sample of 2099 broad absorption line (BAL) quasars with z=1.7-2.2 built from the Sloan Digital Sky Survey Data Release Seven and the Wide-field Infrared Survey. This sample is collected from two BAL quasar samples in the literature, and refined by our new algorithm. Correlations of outflow velocity and strength with hot dust indicator (beta_NIR) and other quasar physical parameters, such as Eddington ratio, luminosity and UV continuum slope, are explored in order to figure out which parameters drive outflows. Here beta_NIR is the near-infrared continuum slope, a good indicator of the amount of hot dust emission relative to accretion disk emission. We confirm previous findings that outflow properties moderately or weakly depends on Eddington ratio, UV slope and luminosity. For the first time, we report moderate and significant correlations of outflow strength and velocity with beta_NIR in BAL quasars. It is consistent with the behavior of blueshifted broad emission lines in non-BAL quasa...

  19. The Physics and Physical Properties of Quasar Outflows

    CERN Document Server

    Hamann, Fred; Chartas, George; McGraw, Sean; Hidalgo, Paola Rodriguez; Shields, Joseph; Charlton, Jane; Eracleous, Michael

    2013-01-01

    We describe two studies designed to characterize the total column densities, kinetic energies, and acceleration physics of broad absorption line (BAL) outflows in quasars. The first study uses new Chandra X-ray and ground-based rest-frame UV observations of 7 quasars with mini-BALs at extreme high speeds, in the range 0.1c to 0.2c, to test the idea that strong radiative shielding is needed to moderate the mini-BAL ionizations and facilitate their acceleration to extreme speeds. We find that the X-ray absorption is weak or absent, with generally N_H 15% of the UV continuum source along our lines of sight (based on measured line depths), then the radial thickness of these outflows is only Delta_R 8 x 10^15 cm. Thus the outflow regions have the shape of very thin "pancakes" viewed face-on, or they occupy larger volumes like a spray of dense cloudlets with a very small volume filling factor. We speculate that this situation (with ineffective shielding and small dense outflow substructures) applies to most quasar...

  20. Ionization driven molecular outflow in K3-50A

    CERN Document Server

    Klaassen, P D; Peters, T; Longmore, S N; Maercker, M

    2013-01-01

    Whether high mass stars continue to accrete material beyond the formation of an HII region is still an open question. Ionized infall and outflow have been seen in some sources, but their ties to the surrounding molecular gas are not well constrained. We aim to quantify the ionized and molecular gas dynamics in a high mass star forming region (K3-50A) and their interaction. We present CARMA observations of the 3mm continuum, H41\\alpha, and HCO+ emission, and VLA continuum observations at 23 GHz and 14.7 GHz to quantify the gas and its dynamics in K3-50A. We find large scale dynamics consistent with previous observations. On small scales, we find evidence for interaction between the ionized and molecular gas which suggests the ionized outflow is entraining the molecular one. This is the first time such an outflow entrained by photo ionized gas has been observed. Accretion may be ongoing in K3-50A because an ionized bipolar outflow is still being powered, which is in turn entraining part of the surrounding molec...

  1. IC 5063 : AGN driven outflow of warm and cold gas

    NARCIS (Netherlands)

    Morganti, R.; Holt, J.; Saripalli, L.; Oosterloo, T. A.; Tadhunter, C. N.

    2007-01-01

    We present new ATCA 17- and 24- GHz radio images and ESO- NTT optical spectra of the radio- loud Seyfert galaxy IC 5063, the first galaxy in which a fast (similar to 600 km s(-1)) outflow of neutral hydrogen was discovered. The new radio data confirm the triple radio structure with a central, unreso

  2. Protostellar Jet and Outflow in the Collapsing Cloud Core

    CERN Document Server

    Machida, Masahiro N; Matsumoto, Tomoaki

    2009-01-01

    We investigate the driving mechanism of outflows and jets in star formation process using resistive MHD nested grid simulations. We found two distinct flows in the collapsing cloud core: Low-velocity outflows (sim 5 km/s) with a wide opening angle, driven from the first adiabatic core, and high-velocity jets (sim 50 km/s) with good collimation, driven from the protostar. High-velocity jets are enclosed by low-velocity outflow. The difference in the degree of collimation between the two flows is caused by the strength of the magnetic field and configuration of the magnetic field lines. The magnetic field around an adiabatic core is strong and has an hourglass configuration. Therefore, the low-velocity outflow from the adiabatic core are driven mainly by the magnetocentrifugal mechanism and guided by the hourglass-like field lines. In contrast, the magnetic field around the protostar is weak and has a straight configuration owing to Ohmic dissipation in the high-density gas region. Therefore, high-velocity jet ...

  3. Methanol Maser Associated Outflows: Detection statistics and properties

    CERN Document Server

    de Villiers, H M; Thompson, M A; Ellingsen, S P; Urquhart, J S; Breen, S L; Burton, M G; Csengeri, T; Ward-Thompson, D

    2014-01-01

    We have selected the positions of 54 6.7GHz methanol masers from the Methanol Multibeam Survey catalogue, covering a range of longitudes between $20^{\\circ}$ and $34^{\\circ}$ of the Galactic Plane. These positions were mapped in the J=3-2 transition of both the $\\rm{^{13}CO}$ and $\\rm{C^{18}O}$ lines. A total of 58 $\\rm{^{13}CO}$ emission peaks are found in the vicinity of these maser positions. We search for outflows around all $\\rm{^{13}CO}$ peaks, and find evidence for high-velocity gas in all cases, spatially resolving the red and blue outflow lobes in 55 cases. Of these sources, 44 have resolved kinematic distances, and are closely associated with the 6.7GHz masers, a sub-set referred to as Methanol Maser Associated Outflows (MMAOs). We calculate the masses of the clumps associated with each peak using 870 $\\rm{\\mu m}$ continuum emission from the ATLASGAL survey. A strong correlation is seen between the clump mass and both outflow mass and mechanical force, lending support to models in which accretion is...

  4. Tracing Inflows and Outflows with Absorption Lines in Circumgalactic Gas

    CERN Document Server

    Ford, Amanda Brady; Oppenheimer, Benjamin D; Katz, Neal; Kollmeier, Juna A; Thompson, Robert; Weinberg, David H

    2013-01-01

    We examine how HI and metal absorption lines within low-redshift galaxy halos trace the dynamical state of circumgalactic gas, using cosmological hydrodynamic simulations that include a well-vetted heuristic model for galactic outflows. We categorize inflowing, outflowing, and ambient gas based on its history and fate as tracked in our simulation. Following our earlier work showing that the ionisation level of absorbers was a primary factor in determining the physical conditions of absorbing gas, we show here that it is also a governing factor for its dynamical state. Low-ionisation metal absorbers (e.g. MgII) tend to arise in gas that will fall onto galaxies within several Gyr, while high-ionisation metal absorbers (e.g. OVI) generally trace material that was deposited by outflows many Gyr ago. Inflowing gas is dominated by enriched material that was previously ejected in an outflow, hence accretion at low redshifts is typically substantially enriched. Recycling wind material is preferentially found closer t...

  5. Mechanisms for pressurized groundwater outflow channels, implications for Mars

    NARCIS (Netherlands)

    Marra, Wouter; Kleinhans, Maarten; Hauber, E.; McLelland, Stuart J.; Murphy, Brendan J.; Parsons, Daniel R.; Conway, Susan J.

    2014-01-01

    Various valleys on Mars show evidence for extensive fluvial activity in the past. The largest valleys on Mars are several tens to hundreds of kilometers wide and are thought to have originated from outflow of pressurized groundwater. However, exact mechanisms of these processes are lacking, which ha

  6. Chandra Observations of Outflows from PSR J1509-5850

    CERN Document Server

    Klingler, Noel; Rangelov, Blagoy; Pavlov, George G; Posselt, Bettina; Ng, C -Y

    2016-01-01

    PSR J1509-5850 is a middle-aged pulsar with the period P ~ 89 ms, spin-down power Edot = 5.1 x 10^35 erg/s, at a distance of about 3.8 kpc. We report on deep Chandra X-ray Observatory observations of this pulsar and its pulsar wind nebula (PWN). In addition to the previously detected tail extending up to 7' southwest from the pulsar (the southern outflow), the deep images reveal a similarly long, faint diffuse emission stretched toward the north (the northern outflow) and the fine structure of the compact nebula (CN) in the pulsar vicinity. The CN is resolved into two lateral tails and one axial tail pointing southwest (a morphology remarkably similar to that of the Geminga PWN), which supports the assumption that the pulsar moves towards the northeast. The luminosities of the southern and northern outflows are about 1 x 10^33 and 4 x 10^32 erg/s, respectively. The spectra extracted from four regions of the southern outflow do not show any softening with increasing distance from the pulsar. The lack of synchr...

  7. Misalignment of magnetic fields and outflows in protostellar cores

    NARCIS (Netherlands)

    Hull, Charles L. H.; Plambeck, Richard L.; Bolatto, Alberto D.; Bower, Geoffrey C.; Carpenter, John M.; Crutcher, Richard M.; Fiege, Jason D.; Franzmann, Erica; Hakobian, Nicholas S.; Heiles, Carl; Houde, Martin; Hughes, A. Meredith; Jameson, Katherine; Kwon, Woojin; Lamb, James W.; Looney, Leslie W.; Matthews, Brenda C.; Mundy, Lee; Pillai, Thushara; Pound, Marc W.; Stephens, Ian W.; Tobin, John J.; Vaillancourt, John E.; Volgenau, N. H.; Wright, Melvyn C. H.

    2013-01-01

    We present results of lambda 1.3 mm dust-polarization observations toward 16 nearby, low-mass protostars, mapped with similar to 2 ''.5 resolution at CARMA. The results show that magnetic fields in protostellar cores on scales of similar to 1000 AU are not tightly aligned with outflows from the prot

  8. Fueling AGN II: Spatially Resolved Molecular Inflows and Outflows

    CERN Document Server

    Davies, R I; Hicks, E K S; Emsellem, E; Erwin, P; Burtscher, L; Dumas, G; Lin, M; Malkan, M A; Mueller-Sanchez, F; de Xivry, G Orban; Rosario, D J; Schnorr-Mueller, A; Tran, A

    2014-01-01

    We analyse the 2-dimensional distribution and kinematics of the stars as well as molecular and ionised gas in the central few hundred parsecs of 5 active and 5 matched inactive galaxies. The equivalent widths of the Br-gamma line indicate there is no on-going star formation in their nuclei, although recent (terminated) starbursts are possible in the active galaxies. The stellar velocity fields show no signs of non-circular motions, while the 1-0S(1) H_2 kinematics exhibit significant deviations from simple circular rotation. In the active galaxies the H_2 kinematics reveal inflow and outflow superimposed on disk rotation. Steady-state circumnuclear inflow is seen in three AGN, and hydrodynamical models indicate it can be driven by a large scale bar. In three of the five AGN, molecular outflows are spatially resolved. The outflows are oriented such that they intersect, or have an edge close to, the disk - which may be the source of molecular gas in the outflow. The relatively low speeds imply the gas will fall...

  9. Radiation pressure confinement - IV. Application to broad absorption line outflows

    CERN Document Server

    Baskin, Alexei; Stern, Jonathan

    2014-01-01

    A fraction of quasars present broad absorption lines, produced by outflowing gas with typical velocities of 3000 - 10,000 km/s. If the outflowing gas fills a significant fraction of the volume where it resides, then it will be highly ionized by the quasar due to its low density, and will not produce the observed UV absorption. The suggestion that the outflow is shielded from the ionizing radiation was excluded by recent observations. The remaining solution is a dense outflow with a filling factor $f<10^{-3}$. What produces such a small $f$? Here we point out that radiation pressure confinement (RPC) inevitably leads to gas compression and the formation of dense thin gas sheets/filaments, with a large gradient in density and ionization along the line of sight. The total column of ionized dustless gas is a few times $10^{22}$ cm$^{-2}$, consistent with the observed X-ray absorption and detectable P V absorption. The predicted maximal columns of various ions show a small dependence on the system parameters, a...

  10. Possible Outflow Formation in the Central Engine of GRBs

    Indian Academy of Sciences (India)

    Tong Liu; Wei-Min Gu; Ju-Fu Lu

    2011-03-01

    We investigate the vertical structure of neutrino-dominated accretion flows in spherical coordinates. In our calculation, the empty funnel along the rotation axis can naturally explain the neutrino annihilable ejection. The outflow is possible due to the positive Bernoulli function, and the luminosity of neutrino annihilation is enhanced by one or two orders of magnitude.

  11. ALMA Observations of the HH 46/47 Molecular Outflow

    CERN Document Server

    Arce, Hector G; Corder, Stuartt; Garay, Guido; Noriega-Crespo, Alberto; Raga, Alejandro C; Cabrit, Sylvie

    2013-01-01

    The morphology, kinematics and entrainment mechanism of the HH 46/47 molecular outflow were studied using new ALMA Cycle 0 observations. Results show that the blue and red lobes are strikingly different. We argue that these differences are partly due to contrasting ambient densities that result in different wind components having a distinct effect on the entrained gas in each lobe. A 29-point mosaic, covering the two lobes at an angular resolution of about 3", detected outflow emission at much higher velocities than previous observations, resulting in significantly higher estimates of the outflow momentum and kinetic energy than previous studies of this source, using the CO(1-0) line. The morphology and the kinematics of the gas in the blue lobe are consistent with models of outflow entrainment by a wide-angle wind, and a simple model may describe the observed structures in the position-velocity diagram and the integrated intensity map. The red lobe exhibits a more complex structure, and there is evidence tha...

  12. On the Formation of Molecular Clumps in QSO Outflows

    Science.gov (United States)

    Ferrara, A.; Scannapieco, E.

    2016-12-01

    We study the origin of the cold molecular clumps in quasar outflows, recently detected in CO and HCN emission. We first describe the physical properties of such radiation-driven outflows and show that a transition from a momentum- to an energy-driven flow must occur at a radial distance of R≈ 0.25 {kpc}. During this transition, the shell of swept-up material fragments due to Rayleigh-Taylor instabilities, but these clumps contain little mass and are likely to be rapidly ablated by the hot gas in which they are immersed. We then explore an alternative scenario in which clumps form from thermal instabilities at R≳ 1 {kpc}, possibly containing enough dust to catalyze molecule formation. We investigate this process with 3D two-fluid (gas+dust) numerical simulations of a kpc3 patch of the outflow, including atomic and dust cooling, thermal conduction, dust sputtering, and photoionization from the QSO radiation field. In all cases, dust grains are rapidly destroyed in ≈ {10}4 years; and while some cold clumps form at later times, they are present only as transient features, which disappear as cooling becomes more widespread. In fact, we only find a stable two-phase medium with dense clumps if we artificially enhance the QSO radiation field by a factor of 100. This result, together with the complete destruction of dust grains, renders the interpretation of molecular outflows a very challenging problem.

  13. Fast outflows and star formation quenching in quasar host galaxies

    CERN Document Server

    Carniani, S; Maiolino, R; Balmaverde, B; Brusa, M; Cano-Díaz, M; Cicone, C; Comastri, A; Cresci, G; Fiore, F; Feruglio, C; La Franca, F; Mainieri, V; Mannucci, F; Nagao, T; Netzer, H; Piconcelli, E; Risaliti, G; Schneider, R; Shemmer, O

    2016-01-01

    Negative feedback from active galactic nuclei (AGN) is considered a key mechanism in shaping galaxy evolution. Fast, extended outflows are frequently detected in the AGN host galaxies at all redshifts and luminosities, both in ionised and molecular gas. However, these outflows are only "potentially" able to quench star formation and we are still missing a decisive evidence of negative feedback in action. Here we present Spectrograph for INtegral Field Observations in the Near Infrared (SINFONI) H- and K-band integral-field spectroscopic observations of two quasars at $z\\sim$2.4 characterised by fast, extended outflows detected through the [OIII]$\\lambda$5007 line (Carniani et al. 2015). The high signal-to-noise ratio of our observations allows us to identify faint narrow (FWHM $< 500$ km/s), and spatially extended components in [OIII]$\\lambda$5007 and H$\\alpha$ emission associated with star formation in the host galaxy. Such star-formation powered emission is spatially anti-correlated with the fast outflow...

  14. PROTOSTELLAR OUTFLOW HEATING IN A GROWING MASSIVE PROTOCLUSTER

    Energy Technology Data Exchange (ETDEWEB)

    Wang Ke; Wu Yuefang; Zhang Huawei [Department of Astronomy, School of Physics, Peking University, Beijing 100871 (China); Zhang Qizhou [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Li Huabai, E-mail: kwang@cfa.harvard.edu [Max-Planck Institute for Astronomy, Koenigstuhl 17, D-69117 Heidelberg (Germany)

    2012-02-15

    The dense molecular clump P1 in the infrared dark cloud complex G28.34+0.06 harbors a massive protostellar cluster at its extreme youth. Our previous Submillimeter Array observations revealed several jet-like CO outflows emanating from the protostars, indicative of intense accretion and potential interaction with ambient natal materials. Here, we present the Expanded Very Large Array spectral line observations toward P1 in the NH{sub 3} (J,K) = (1,1), (2,2), (3,3) lines, as well as H{sub 2}O and class I CH{sub 3}OH masers. Multiple NH{sub 3} transitions reveal the heated gas widely spread in the 1 pc clump. The temperature distribution is highly structured; the heated gas is offset from the protostars, and morphologically matches the outflows very well. Hot spots of spatially compact, spectrally broad NH{sub 3} (3,3) emission features are also found coincident with the outflows. A weak NH{sub 3} (3,3) maser is discovered at the interface between an outflow jet and the ambient gas. These findings suggest that protostellar heating may not be effective in suppressing fragmentation during the formation of massive cores.

  15. Protostellar Outflow Heating in a Growing Massive Protocluster

    CERN Document Server

    Wang, Ke; Wu, Yuefang; Li, Hua-bai; Zhang, Huawei

    2011-01-01

    The dense molecular clump P1 in the infrared dark cloud (IRDC) complex G28.34+0.06 harbors a massive protostellar cluster at its extreme youth. Our previous Submillimeter Array (SMA) observations revealed several jet-like CO outflows emanating from the protostars, indicative of intense accretion and potential interaction with ambient natal materials. Here we present the Expanded Very Large Array (EVLA) spectral line observations toward P1 in the NH3 (J,K) = (1,1), (2,2), (3,3) lines, as well as H2O and class I CH3OH masers. Multiple NH3 transitions reveal the heated gas widely spread in the 1 pc clump. The temperature distribution is highly structured; the heated gas is offset from the protostars, and morphologically matches the outflows very well. Hot spots of spatially compact, spectrally broad NH3 (3,3) emission are also found coincident with the outflows. A weak NH3 (3,3) maser is discovered at the interface between an outflow jet and the ambient gas. These findings suggest that protostellar heating may n...

  16. Triggering the Formation of Halo Globular Clusters with Galaxy Outflows

    CERN Document Server

    Scannapieco, E; Harlow, F; Scannapieco, Evan; Weisheit, Jon; Harlow, Francis

    2004-01-01

    We investigate the interactions of high-redshift galaxy outflows with low-mass virialized (Tvir 20% of the cloud. Such estimates ignore the likely presence of large-scale vortices, however, which would further enhance turbulence generation. Thus quantitative mixing predictions must await more detailed numerical studies.

  17. THE JET-DRIVEN BOW SHOCK IN OUTFLOWS

    Institute of Scientific and Technical Information of China (English)

    ZhangQing; ZhengXingwu

    1999-01-01

    Recent high resolution observations show the high collimated bipolar molecular outflows from young stellar objects, such as NGC 2 264G and NGC 2 024. Existing models can not yet give complete interpretations of the structure and properties of the observed flow. Here, we propose a jet-driven bow

  18. Are molecular outflows around high-mass stars driven by ionization feedback?

    CERN Document Server

    Peters, Thomas; Mac Low, Mordecai-Mark; Klessen, Ralf S; Banerjee, Robi

    2012-01-01

    The formation of massive stars exceeding 10 solar masses usually results in large-scale molecular outflows. Numerical simulations, including ionization, of the formation of such stars show evidence for ionization-driven molecular outflows. We here examine whether the outflows seen in these models reproduce the observations. We compute synthetic ALMA and CARMA maps of CO emission lines of the outflows, and compare their signatures to existing single-dish and interferometric data. We find that the ionization-driven models can only reproduce weak outflows around high-mass star-forming regions. We argue that expanding H II regions probably do not represent the dominant mechanism for driving observed outflows. We suggest instead that observed outflows are driven by the collective action of the outflows from the many lower-mass stars that inevitably form around young massive stars in a cluster.

  19. ARE MOLECULAR OUTFLOWS AROUND HIGH-MASS STARS DRIVEN BY IONIZATION FEEDBACK?

    Energy Technology Data Exchange (ETDEWEB)

    Peters, Thomas; Klessen, Ralf S. [Institut fuer Theoretische Astrophysik, Universitaet Heidelberg, Zentrum fuer Astronomie, Albert-Ueberle-Str. 2, D-69120 Heidelberg (Germany); Klaassen, Pamela D. [European Southern Observatory, Karl-Schwarzschild-Strasse 2, D-85748 Garching (Germany); Mac Low, Mordecai-Mark [Department of Astrophysics, American Museum of Natural History, 79th Street at Central Park West, New York, NY 10024-5192 (United States); Banerjee, Robi, E-mail: tpeters@physik.uzh.ch [Hamburger Sternwarte, Gojenbergsweg 112, D-21029 Hamburg (Germany)

    2012-11-20

    The formation of massive stars exceeding 10 M {sub Sun} usually results in large-scale molecular outflows. Numerical simulations, including ionization, of the formation of such stars show evidence for ionization-driven molecular outflows. Here we examine whether the outflows seen in these models reproduce the observations. We compute synthetic ALMA and CARMA maps of CO emission lines of the outflows, and compare their signatures to existing single-dish and interferometric data. We find that the ionization-driven models can only reproduce weak outflows around high-mass star-forming regions. We argue that expanding H II regions probably do not represent the dominant mechanism for driving observed outflows. We suggest instead that observed outflows are driven by the collective action of the outflows from the many lower-mass stars that inevitably form around young massive stars in a cluster.

  20. Impact of Protostellar Outflow on Star Formation: Effects of Initial Cloud Mass

    CERN Document Server

    Machida, Masahiro N

    2011-01-01

    Star formation efficiency controlled by the protostellar outflow in a single cloud core is investigated by three-dimensional resistive MHD simulations. Starting from the prestellar cloud core, the star formation process is calculated until the end of the main accretion phase. In the calculations, the mass of the prestellar cloud is parameterized. During the star formation, the protostellar outflow is driven by the circumstellar disk. The outflow extends also in the transverse direction until its width becomes comparable to the initial cloud scale, and thus, the outflow has a wide opening angle of >40 degrees. As a result, the protostellar outflow sweeps up a large fraction of the infalling material and ejects it into the interstellar space. The outflow can eject at most over half of the host cloud mass, significantly decreasing star formation efficiency. The outflow power is stronger in clouds with a greater initial mass. Thus, the protostellar outflow effectively suppresses star formation efficiency in a mas...

  1. Vangl2及平面细胞极化信号通路在心脏发育中的作用%Vangl2 and planar cell polarity signaling in cardiac development

    Institute of Scientific and Technical Information of China (English)

    袁媛

    2012-01-01

    Planar cell polarity pathway regulates cell polarity and polarized cell movements.Recent studies in mouse models have found mutations in several genes in this pathway and specifically in the Vangl2 gene,which results in abnormalities in cardiac development,suggesting Vangl2 and this pathway play an important role in heart development.This review mainly elucidates the mechanisms regulated by the Vangl2 gene and PCP pathway during outflow tract development and the formation of the coronary vasculature.%平面细胞极化(planar cell polarity,PCP)信号通路负责调控细胞的极性和极化细胞的运动,研究发现Vangl2基因以及PCP信号通路其他基因的突变导致了心脏的异常发育,提示Vangl2基因以及此信号通路在心脏发育过程中扮演了重要角色.该文主要阐述Vangl2基因及PCP信号通路在心脏流出道发育中的贡献以及在冠脉形成过程中的作用.

  2. Cardiac tumors: echo assessment.

    Science.gov (United States)

    Mankad, Rekha; Herrmann, Joerg

    2016-12-01

    Cardiac tumors are exceedingly rare (0.001-0.03% in most autopsy series). They can be present anywhere within the heart and can be attached to any surface or be embedded in the myocardium or pericardial space. Signs and symptoms are nonspecific and highly variable related to the localization, size and composition of the cardiac mass. Echocardiography, typically performed for another indication, may be the first imaging modality alerting the clinician to the presence of a cardiac mass. Although echocardiography cannot give the histopathology, certain imaging features and adjunctive tools such as contrast imaging may aid in the differential diagnosis as do the adjunctive clinical data and the following principles: (1) thrombus or vegetations are the most likely etiology, (2) cardiac tumors are mostly secondary and (3) primary cardiac tumors are mostly benign. Although the finding of a cardiac mass on echocardiography may generate confusion, a stepwise approach may serve well practically. Herein, we will review such an approach and the role of echocardiography in the assessment of cardiac masses.

  3. Overconsumption, outflows and the quenching of satellite galaxies

    Science.gov (United States)

    McGee, Sean L.; Bower, Richard G.; Balogh, Michael L.

    2014-07-01

    The baryon cycle of galaxies is a dynamic process involving the intake, consumption and ejection of vast quantities of gas. In contrast, the conventional picture of satellite galaxies has them methodically turning a large gas reservoir into stars until this reservoir is forcibly removed due to external ram pressure. This picture needs revision. Our modern understanding of the baryon cycle suggests that in some regimes the simple interruption of the fresh gas supply may quench satellite galaxies long before stripping events occur, a process we call overconsumption. We compile measurements from the literature of observed satellite quenching times at a range of redshifts to determine if satellites are principally quenched through orbit-based gas stripping events - either direct stripping of the disc (ram pressure stripping) or the extended gas halo (strangulation) - or from internally driven star formation outflows via overconsumption. These time-scales show significant deviations from the evolution expected for gas stripping mechanisms and suggest that either ram pressure stripping is much more efficient at high redshift, or that secular outflows quench satellites before orbit-based stripping occurs. Given the strong redshift evolution of star formation rates, at high redshift even moderate outflow rates will lead to extremely short delay times with the expectation that high-redshift (z > 1.5) satellites will be quenched almost immediately following the cessation of cosmological inflow. Observations of high-redshift satellites give an indirect but sensitive measure of the outflow rate, with current measurements suggesting that outflows are no larger than 2.5 times the star formation rate for galaxies with a stellar mass of 1010.5 M⊙.

  4. Fast neutral outflows in nearby radio galaxies : a major source of feedback

    NARCIS (Netherlands)

    Morganti, R.; Tadhunter, C.; Oosterloo, T.; Holt, J.; Emonts, B.

    2007-01-01

    Abstract: Fast (~1000 km/s) outflows of neutral gas (from 21-cm HI absorption) are detected in strong radio sources. The outflows occur, at least in some cases, at distances from the radio core that range between few hundred parsecs and kpc. These HI outflows likely originate from the interaction be

  5. Molecular Basis of Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Pooja Singhal

    2014-01-01

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

  6. Syntactic processing depends on dorsal language tracts.

    Science.gov (United States)

    Wilson, Stephen M; Galantucci, Sebastiano; Tartaglia, Maria Carmela; Rising, Kindle; Patterson, Dianne K; Henry, Maya L; Ogar, Jennifer M; DeLeon, Jessica; Miller, Bruce L; Gorno-Tempini, Maria Luisa

    2011-10-20

    Frontal and temporal language areas involved in syntactic processing are connected by several dorsal and ventral tracts, but the functional roles of the different tracts are not well understood. To identify which white matter tract(s) are important for syntactic processing, we examined the relationship between white matter damage and syntactic deficits in patients with primary progressive aphasia, using multimodal neuroimaging and neurolinguistic assessment. Diffusion tensor imaging showed that microstructural damage to left hemisphere dorsal tracts--the superior longitudinal fasciculus including its arcuate component--was strongly associated with deficits in comprehension and production of syntax. Damage to these dorsal tracts predicted syntactic deficits after gray matter atrophy was taken into account, and fMRI confirmed that these tracts connect regions modulated by syntactic processing. In contrast, damage to ventral tracts--the extreme capsule fiber system or the uncinate fasciculus--was not associated with syntactic deficits. Our findings show that syntactic processing depends primarily on dorsal language tracts.

  7. Urinary Tract Infections in Adults

    Directory of Open Access Journals (Sweden)

    Evan B. Cohn

    2004-01-01

    Full Text Available Urinary tract infection (UTI is an exceedingly common problem prompting seven million office visits and one million hospitalizations in the United States each year (1. Advances in the understanding of both host and bacterial factors involved in UTI have led to many improvements in therapy. While there have also been advances in the realm of antimicrobials, there have been numerous problems with multiple drug resistant organisms. Providing economical care while minimizing drug resistance requires appropriate diagnosis, evaluation, and treatment of urinary tract infections.

  8. Malakoplakia of the Urogenital Tract

    Directory of Open Access Journals (Sweden)

    Huan Dong

    2015-01-01

    Full Text Available Malakoplakia is a rare, granulomatous condition most commonly found in the genitourinary tract. It can present in a myriad of ways depending on the organ involved, thus presenting a huge diagnostic challenge. We present 4 patients with genitourinary malakoplakia, who manifested with recurrent urinary tract infection (UTI and hematuria in all except one, who presented with hydronephrosis secondary to a large pelvic mass. We discuss the need for a high index of suspicion and careful scrutiny of histology to order to avoid misdiagnosis as simple long term antibiotics are an effective treatment in all but those with large pelvic masses.

  9. Urinary tract infections in adults

    OpenAIRE

    Wei Tan, Chee; Chlebicki, Maciej Piotr

    2016-01-01

    A urinary tract infection (UTI) is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. The incidence of UTIs in adult males aged under 50 years is low, with adult women being 30 times more likely than men to develop a UTI. Appropriate classification of UTI into simple or complicated forms guides its management and the ORENUC classification can be used. Diagnosis of a UTI is based on a focused history, with...

  10. Cardiac Tumors; Tumeurs cardiaques

    Energy Technology Data Exchange (ETDEWEB)

    Laissy, J.P.; Fernandez, P. [Centre Hospitalier Universitaire Bichat Claude Bernard, Service d' Imagerie, 76 - Rouen (France); Mousseaux, E. [Hopital Europeen Georges Pompidou (HEGP), Service de Radiologie Cardio Vasculaire et Interventionnelle, 75 - Paris (France); Dacher, J.N. [Centre Hospitalier Universitaire Charles Nicolle, 75 - Rouen (France); Crochet, D. [Centre Hospitalier Universitaire, Hopital Laennec, Centre Hemodynamique, Radiologie Thoracique et Vasculaire, 44 - Nantes (France)

    2004-04-01

    Metastases are the most frequent tumors of the heart even though they seldom are recognized. Most primary cardiac tumors are benign. The main role of imaging is to differentiate a cardiac tumor from thrombus and rare pseudo-tumors: tuberculoma, hydatid cyst. Echocardiography is the fist line imaging technique to detect cardiac tumors, but CT and MRl arc useful for further characterization and differential diagnosis. Myxoma of the left atrium is the most frequent benign cardiac tumor. It usually is pedunculated and sometimes calcified. Sarcoma is the most frequent primary malignant tumor and usually presents as a sessile infiltrative tumor. Lymphoma and metastases are usually recognized by the presence of known tumor elsewhere of by characteristic direct contiguous involvement. Diagnosing primary and secondary pericardial tumors often is difficult. Imaging is valuable for diagnosis, characterization, pre-surgical evaluation and follow-up. (author)

  11. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

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

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  12. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  13. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  14. Port Access Cardiac Surgery.

    Science.gov (United States)

    Viganó, Mario; Minzioni, Gaetano; Spreafico, Patrizio; Rinaldi, Mauro; Pasquino, Stefano; Ceriana, Piero; Locatelli, Alessandro

    2000-10-01

    The port-access technique for cardiac surgery was recently developed at Stanford University in California as a less invasive method to perform some cardiac operations. The port-access system has been described in detail elsewhere. It is based on femoral arterial and venous access for cardiopulmonary bypass (CPB) and on the adoption of a specially designed triple-lumen catheter described originally by Peters, and subsequently modified and developed in the definitive configuration called the endoaortic clamp.

  15. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

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

  16. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery, i...... on the coronary vessels, with cardiac tamponade and chronic pericardial exudate. In the lighter cases, PCIS may be treated with NSAID and, in the more severe cases, with systemic glucocorticoid which has a prompt effect....

  17. Autonomic cardiac innervation

    OpenAIRE

    Hasan, Wohaib

    2013-01-01

    Autonomic cardiac neurons have a common origin in the neural crest but undergo distinct developmental differentiation as they mature toward their adult phenotype. Progenitor cells respond to repulsive cues during migration, followed by differentiation cues from paracrine sources that promote neurochemistry and differentiation. When autonomic axons start to innervate cardiac tissue, neurotrophic factors from vascular tissue are essential for maintenance of neurons before they reach their targe...

  18. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  19. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  20. [Urinary tract infections in adults].

    Science.gov (United States)

    Ali, Adel Ben; Bagnis, Corinne Isnard

    2014-09-01

    Urinary tract infections in adults are frequent and can induce several septic situations. Their economic cost (drugs, microbiologic samples, consultations and/or hospitalizations and stop working) and ecologic cost (second reasons of antibiotic prescription in winter and first in the rest of the year) are important. A better respect of recommendations can improve the outcome of this different infections and decrease their cost.

  1. The influence of outflow in supercritical accretion flows

    CERN Document Server

    Zeraatgari, Fatemeh Zahra; Mosallanezhad, Amin

    2016-01-01

    We solve the radiation-hydrodynamic (RHD) equations of supercritical accretion flows in the presence of radiation force and outflow by using self similar solutions. Compare with the pioneer works, in this paper we consider power-law function for mass inflow rate as $ \\dot{M} \\propto r^{s} $. We found that $ s = 1 $ when the radiative cooling term is included in the energy equation. Correspondingly, the effective temperature profile with respect to the radius was obtained as $ T_{\\text{eff}} \\varpropto r^{-1/2} $. In addition, we investigated the influence of the outflow on the dynamics of the accretion flow. We also calculated the continuum spectrum emitted from the disk surface as well as the bolometric luminosity of the accretion flow. Furthermore, our results show that the advection parameter, $ f $, strongly depends on mass inflow rate.

  2. Observing the onset of outflow collimation in a massive protostar

    CERN Document Server

    Carrasco-González, C; Cantó, J; Curiel, S; Surcis, G; Vlemmings, W H T; van Langevelde, H J; Goddi, C; Anglada, G; Kim, S -W; Kim, J -S; Gómez, J F

    2015-01-01

    The current paradigm of star formation through accretion disks, and magnetohydrodynamically driven gas ejections, predicts the development of collimated outflows, rather than expansion without any preferential direction. We present radio continuum observations of the massive protostar W75N(B)-VLA 2, showing that it is a thermal, collimated ionized wind and that it has evolved in 18 years from a compact source into an elongated one. This is consistent with the evolution of the associated expanding water-vapor maser shell, which changed from a nearly circular morphology, tracing an almost isotropic outflow, to an elliptical one outlining collimated motions. We model this behavior in terms of an episodic, short-lived, originally isotropic, ionized wind whose morphology evolves as it moves within a toroidal density stratification.

  3. AGN Feedback Driven Molecular Outflow in NGC 1266

    CERN Document Server

    Alatalo, K; Graves, G; Deustua, S; Wrobel, J; Young, L M; Davis, T A; Bureau, M; Bayet, E; Blitz, L; Bois, M; Bournaud, F; Cappellari, M; Davies, R L; de Zeeuw, P T; Emsellem, E; Khochfar, S; Krajnovic, D; Kuntschner, H; Martin, S; McDermid, R M; Morganti, R; Naab, T; Oosterloo, T; Sarzi, M; Scott, N; Serra, P; Weijmans, A

    2012-01-01

    NGC 1266 is a nearby field galaxy observed as part of the ATLAS3D survey (Cappellari et al. 2011). NGC 1266 has been shown to host a compact (< 200 pc) molecular disk and a mass-loaded molecular outflow driven by the AGN (Alatalo et al. 2011). Very Long Basline Array (VLBA) observations at 1.65 GHz revealed a compact (diameter < 1.2 pc), high bright- ness temperature continuum source most consistent with a low-level AGN origin. The VLBA continuum source is positioned at the center of the molecular disk and may be responsible for the expulsion of molecular gas in NGC 1266. Thus, the candidate AGN-driven molecular outflow in NGC 1266 supports the picture in which AGNs do play a significant role in the quenching of star formation and ultimately the evolution of the red sequence of galaxies.

  4. Experimental demonstration of an inertial collimation mechanism in nested outflows

    CERN Document Server

    Yurchak, R; Pelka, A; Pikuz, S; Falize, E; Vinci, T; Koenig, M; Loupias, B; Benuzzi-Mounaix, A; Fatenejad, M; Tzeferacos, P; Lamb, D Q; Blackman, E G

    2014-01-01

    Interaction between a central outflow and a surrounding wind is common in astrophysical sources powered by accretion. Understanding how the interaction might help to collimate the inner central outflow is of interest for assessing astrophysical jet formation paradigms. In this context, we studied the interaction between two nested supersonic plasma flows generated by focusing a long pulse high-energy laser beam onto a solid target. A nested geometry was created by shaping the energy distribution at the focal spot with a dedicated phase plate. Optical and X-ray diagnostics were used to study the interacting flows. Experimental results and numerical hydrodynamic simulations indeed show the formation of strongly collimated jets. Our work experimentally confirms the "shock-focused inertial confinement" mechanism proposed in previous theoretical astrophysics investigations.

  5. Incidence of galactic outflows: EAGLE simulations vs SAMI observations

    Science.gov (United States)

    Tescari, E.

    2016-06-01

    I presented the results of the joint SAMI-EAGLE project on outflows I lead at the University of Melbourne. We use the highest resolution EAGLE cosmological simulations to study the incidence of supernova driven winds ejected from galaxies on the main sequence. We produce synthetic SAMI observations of outflows that we compare directly with real data. While winds are observed in only a fraction of SAMI galaxies, they appear ubiquitous among simulated star forming objects. Moreover, the velocity dispersion distribution is only weakly dependent on stellar mass (M*) and sSFR (SFR/M*). I presented additional analyses and discuss the implications of these results and how they provide important constraints to ongoing and future IFS surveys.

  6. The JCMT Gould Belt Survey: Understanding the influence of molecular outflows on Gould Belt clouds

    CERN Document Server

    Drabek-Maunder, E; Buckle, J V; Di Francesco, J; Richer, J

    2015-01-01

    Using JCMT Gould Belt Survey data from CO J=3-2 isotopologues, we present a meta-analysis of the outflows and energetics of star-forming regions in several Gould Belt clouds. The majority of the regions are strongly gravitationally bound. There is evidence that molecular outflows transport large quantities of momentum and energy. Outflow energies are at least 20 per cent of the total turbulent kinetic energies in all of the regions studied and greater than the turbulent energy in half of the regions. However, we find no evidence that outflows increase levels of turbulence, and there is no correlation between the outflow and turbulent energies. Even though outflows in some regions contribute significantly to maintaining turbulence levels against dissipation, this relies on outflows efficiently coupling to bulk motions. Other mechanisms (e.g. supernovae) must be the main drivers of turbulence in most if not all of these regions.

  7. Determinants of Foreign Direct Investments Outflow From a Developing Country: the Case of Turkey

    Directory of Open Access Journals (Sweden)

    Gokhan Onder

    2013-09-01

    Full Text Available Foreign direct investments (FDI outflows of Turkey have remarkably been raising over the last decade. This rapid increase brings about the need for questioning the determinants of FDI outflows. The aim of this paper is to estimate the factors affecting outflow FDI from Turkey from 2002 to 2011 by using Prais-Winsten regression analysis. According to estimation results, population, infrastructure, percapita gross domestic product of the host country, and home country exports to the host country are the factors having positive effects on outflow FDI. We found, on the other hand, that the annual inflation rate of the host country, its tax rate collected from commercial profit, and its distance from Turkey have a negative relation with investment outflows. Moreover our results show that while investment outflows to developed countries are in the form of horizontal investments, investment outflows to developing countries are in the form of vertical investments.

  8. Isotropically Driven versus Outflow Driven Turbulence: Observational Consequences for Molecular Clouds

    CERN Document Server

    Carroll, Jonathan J; Blackman, Eric G

    2010-01-01

    Feedback from protostellar outflows can influence the nature of turbulence in star forming regions even if they are not the primary source of velocity dispersion for all scales of molecular clouds. For the rate and power expected in star forming regions, we previously (Carroll et al. 2009) demonstrated that outflows could drive supersonic turbulence at levels consistent with the scaling relations from Matzner 2007 although with a steeper velocity power spectrum than expected for an isotropically driven supersonic turbulent cascade. Here we perform higher resolution simulations and combine simulations of outflow driven turbulence with those of isotropically forced turbulence. We find that the presence of outflows within an ambient isotropically driven turbulent environment produces a knee in the velocity power spectrum at the outflow scale and a steeper slope at sub-outflow scales than for a purely isotropically forced case. We also find that the presence of outflows flattens the density spectrum at large scal...

  9. Buoyant Outflows in the Presence of Ccomplex Topography

    Science.gov (United States)

    2010-09-30

    Balopoulos, 1999. Climatic changes in the Aegean Sea influence the eastern Mediterranean thermohaline circulation (1986– 1997). Geophys. Res. Lett...Georgopoulos and P. G. Drakopoulos, 2000. The role of the North Aegean in triggering the recent Eastern Mediterranean climate changes . J. Geophys. Res., 105...if the inter-annual variability of the Dardanelles plume (in the context of changing outflow properties and regional atmospheric forcing) is related

  10. [Psychosomatic aspects of cardiac arrhythmias].

    Science.gov (United States)

    Siepmann, Martin; Kirch, Wilhelm

    2010-07-01

    Emotional stress facilitates the occurrence of cardiac arrhythmias including sudden cardiac death. The prevalence of anxiety and depression is increased in cardiac patients as compared to the normal population. The risk of cardiovascular mortality is enhanced in patients suffering from depression. Comorbid anxiety disorders worsen the course of cardiac arrhythmias. Disturbance of neurocardiac regulation with predominance of the sympathetic tone is hypothesized to be causative for this. The emotional reaction to cardiac arrhythmias is differing to a large extent between individuals. Emotional stress may result from coping with treatment of cardiac arrhythmias. Emotional stress and cardiac arrhythmias may influence each other in the sense of a vicious circle. Somatoform cardiac arrhythmias are predominantly of psychogenic origin. Instrumental measures and frequent contacts between physicians and patients may facilitate disease chronification. The present review is dealing with the multifaceted relationships between cardiac arrhythmias and emotional stress. The underlying mechanisms and corresponding treatment modalities are discussed.

  11. Tract profiles of white matter properties: automating fiber-tract quantification.

    Directory of Open Access Journals (Sweden)

    Jason D Yeatman

    Full Text Available Tractography based on diffusion weighted imaging (DWI data is a method for identifying the major white matter fascicles (tracts in the living human brain. The health of these tracts is an important factor underlying many cognitive and neurological disorders. In vivo, tissue properties may vary systematically along each tract for several reasons: different populations of axons enter and exit the tract, and disease can strike at local positions within the tract. Hence quantifying and understanding diffusion measures along each fiber tract (Tract Profile may reveal new insights into white matter development, function, and disease that are not obvious from mean measures of that tract. We demonstrate several novel findings related to Tract Profiles in the brains of typically developing children and children at risk for white matter injury secondary to preterm birth. First, fractional anisotropy (FA values vary substantially within a tract but the Tract FA Profile is consistent across subjects. Thus, Tract Profiles contain far more information than mean diffusion measures. Second, developmental changes in FA occur at specific positions within the Tract Profile, rather than along the entire tract. Third, Tract Profiles can be used to compare white matter properties of individual patients to standardized Tract Profiles of a healthy population to elucidate unique features of that patient's clinical condition. Fourth, Tract Profiles can be used to evaluate the association between white matter properties and behavioral outcomes. Specifically, in the preterm group reading ability is positively correlated with FA measured at specific locations on the left arcuate and left superior longitudinal fasciculus and the magnitude of the correlation varies significantly along the Tract Profiles. We introduce open source software for automated fiber-tract quantification (AFQ that measures Tract Profiles of MRI parameters for 18 white matter tracts. With further

  12. Theodore Roosevelt Island Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  13. Colorado National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  14. Piscataway Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  15. Fort Donelson National Battlefield Tract & Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  16. Pinnacles National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  17. Cabrillo National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  18. Chiricahua National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  19. Hovenweep National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  20. Navajo National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  1. Saguaro National Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  2. Antietam National Battlefield Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  3. Wupatki National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  4. Vietnam Vetrans Memorial Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  5. Zion National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  6. Catoctin Mountain Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  7. Pipestone National Monument Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  8. Canyonlands National Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  9. Boundaries, Tracts (Published 2006), Petrified Forest, AZ

    Data.gov (United States)

    National Park Service, Department of the Interior — This is an ESRI shapefile of National Park Service tract data. Tracts are numbered and created by the regional cartographic staff at the Land Resources Program...

  10. Haleakala National Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  11. Noatak National Preserve Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that were created by the Land Resources Division. Tracts are numbered and created by the...

  12. Badlands National Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  13. Alagnak Wild River Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that were created by the Land Resources Division. Tracts are numbered and created by the...

  14. Petersburg National Battlefield Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  15. Sequoia National Park Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  16. Buffalo National River Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  17. Chamizal National Memorial Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  18. Urinary tract infection in older adults.

    Science.gov (United States)

    Rowe, Theresa A; Juthani-Mehta, Manisha

    2013-10-01

    Urinary tract infection and asymptomatic bacteriuria are common in older adults. Unlike in younger adults, distinguishing symptomatic urinary tract infection from asymptomatic bacteriuria is problematic, as older adults, particularly those living in long-term care facilities, are less likely to present with localized genitourinary symptoms. Consensus guidelines have been published to assist clinicians with diagnosis and treatment of urinary tract infection; however, a single evidence-based approach to diagnosis of urinary tract infection does not exist. In the absence of a gold standard definition of urinary tract infection that clinicians agree upon, overtreatment with antibiotics for suspected urinary tract infection remains a significant problem, and leads to a variety of negative consequences including the development of multidrug-resistant organisms. Future studies improving the diagnostic accuracy of urinary tract infections are needed. This review will cover the prevalence, diagnosis and diagnostic challenges, management, and prevention of urinary tract infection and asymptomatic bacteriuria in older adults.

  19. Mojave National Preserve Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  20. Coronado National Memorial Tract and Boundary Data

    Data.gov (United States)

    National Park Service, Department of the Interior — These ESRI shape files are of National Park Service tract and boundary data that was created by the Land Resources Division. Tracts are numbered and created by the...

  1. A young bipolar outflow from IRAS 15398-3359

    CERN Document Server

    Bjerkeli, P; Brinch, C

    2016-01-01

    Changing physical conditions in the vicinity of protostars allow for a rich and interesting chemistry to occur. Heating and cooling of the gas allows molecules to be released from and frozen out on dust grains. These changes in physics, traced by chemistry, as well as the kinematical information allows us to distinguish between different scenarios describing the infall of matter and the launching of molecular outflows and jets. We aim at determining the spatial distribution of different species, of different chemical origin. This is to examine the physical processes in play in the observed region. From the kinematical information of the emission lines we aim at determining the nature of the infalling and outflowing gas in the system. We also aim at determining the physical properties of the outflow. Maps from the Sub-Millimeter Array reveal the spatial distribution of the gaseous emission toward IRAS15398-3359. The line radiative transfer code LIME is used to construct a full 3D model of the system taking all...

  2. Diagnostics of a subsurface radial outflow from a sunspot

    CERN Document Server

    Braun, D; Lindsey, C; Jefferies, S M

    1996-01-01

    We measure the mean frequencies of acoustic waves propagating toward and away from a sunspot employing a spot-centered Fourier-Hankel decomposition of p-mode amplitudes as measured from a set of observations made at the South Pole in 1991. We demonstrate that there is a significant frequency shift between the inward and outward traveling waves which is consistent with the Doppler effect of a radial outflow from the sunspot. For p-modes of temporal frequencies of 3 mHz it is observed that the frequency shift decreases slightly with spatial frequency, for modes with degree l between 160 to 600. From the l dependence of the frequency shift, we infer that the mean radial outflow within the observed annular region (which extends between 30 and 137 Mm from the spot) increases nearly linearly with depth, reaching a magnitude of about 200 m/s at a depth of 20 Mm. This outflow exhibits properties similar to flows recently reported by Lindsey, et al. (1996) using spatially sensitive local helioseismic techniques.

  3. Spin properties of supermassive black holes with powerful outflows

    Science.gov (United States)

    Daly, Ruth. A.

    2016-05-01

    Relationships between beam power and accretion disc luminosity are studied for a sample of 55 high excitation radio galaxies (HERG), 13 low excitation radio galaxies (LERG), and 29 radio loud quasars (RLQ) with powerful outflows. The ratio of beam power to disc luminosity tends to be high for LERG, low for RLQ, and spans the full range of values for HERG. Writing general expressions for the disc luminosity and beam power and applying the empirically determined relationships allows a function that parametrizes the spins of the holes to be estimated. Interestingly, one of the solutions that is consistent with the data has a functional form that is remarkably similar to that expected in the generalized Blandford-Znajek model with a magnetic field that is similar in form to that expected in magnetically arrested disk (MAD) and advection-dominated accretion flow (ADAF) models. Values of the spin function, obtained independent of specific outflow models, suggest that spin and active galactic nucleus type are not related for these types of sources. The spin function can be used to solve for black hole spin in the context of particular outflow models, and one example is provided.

  4. An Analytic Model of Galactic Winds and Mass Outflows

    Institute of Scientific and Technical Information of China (English)

    Cheng-Gang Shu; Hou-Jun Mo; Shu-De Mao

    2005-01-01

    Galactic winds and mass outflows are observed both in nearby starburst galaxies and in high-redshift star-forming galaxies. We develop a simple analytic model to understand the observed superwind phenomenon with a discussion of the model uncertainties. Our model is built upon the model of McKee & Ostriker for the interstellar medium. It allows one to predict how properties of a superwind,such as wind velocity and mass outflow rate, are related to properties of its star forming host galaxy, such as size, gas density and star formation rate. The model predicts a threshold of star formation rate density for the generation of observable galactic winds. Galaxies with more concentrated star formation activities produce superwinds with higher velocities. The predicted mass outflow rates are compara ble to (or slightly larger than) the corresponding star formation rates. We apply our model to both local starburst galaxies and high-redshift Lyman break galaxies, and find its predictions to be in good agreement with current observations. Our model is simple and so can be easily incorporated into numerical simulations and semi-analytical models of galaxy formation.

  5. Outflow and hot dust emission in high redshift quasars

    CERN Document Server

    Wang, Huiyuan; Zhang, Kai; Wang, Tinggui; Zhou, Hongyan; Zhang, Shaohua

    2013-01-01

    Correlations of hot dust emission with outflow properties are investigated, based on a large z~2 non-BAL quasar sample built from the Wide-field Infrared Survey and the Sloan Digital Sky Survey data releases. We use the near infrared (NIR) slope and the infrared to UV luminosity ratio to indicate the hot dust emission relative to the emission from accretion disk. In our luminous quasars, these hot dust emission indicators are almost independent of the fundamental parameters, such as luminosity, Eddington ratio and black hole mass, but moderately dependent on the blueshift and asymmetry index (BAI) and FWHM of CIV lines. Interestingly, the latter two correlations dramatically strengthen with increasing Eddington ratio. We suggest that, in high Eddington ratio quasars, CIV regions are dominated by outflows so BAI and FWHM(CIV) can reliably reflect the general property and velocity of outflows, respectively. While in low Eddington ratio quasars, CIV lines are primarily emitted by virialized gas so BAI and FWHM(C...

  6. Constraining FeLoBAL outflows from absorption line variability

    CERN Document Server

    McGraw, S M; Hamann, F W; Capellupo, D M; Gallagher, S C; Brandt, W N

    2015-01-01

    FeLoBALs are a rare class of quasar outflows with low-ionization broad absorption lines (BALs), large column densities, and potentially large kinetic energies that might be important for `feedback' to galaxy evolution. In order to probe the physical properties of these outflows, we conducted a multiple-epoch, absorption line variability study of 12 FeLoBAL quasars spanning a redshift range between 0.7 and 1.9 over rest frame time-scales of approximately 10 d to 7.6 yr. We detect absorption line variability with greater than 8 sigma confidence in 3 out of the 12 sources in our sample over time-scales of 0.6 to 7.6 yr. Variable wavelength intervals are associated with ground and excited state Fe II multiplets, the Mg II 2796, 2803 doublet, Mg I 2852, and excited state Ni II multiplets. The observed variability along with evidence of saturation in the absorption lines favors transverse motions of gas across the line of sight (LOS) as the preferred scenario, and allows us to constrain the outflow distance from th...

  7. A Variable PV Broad Absorption Line and Quasar Outflow Energetics

    CERN Document Server

    Capellupo, Daniel M; Barlow, Tom A

    2014-01-01

    Broad absorption lines (BALs) in quasar spectra identify high velocity outflows that might exist in all quasars and could play a major role in feedback to galaxy evolution. The viability of BAL outflows as a feedback mechanism depends on their kinetic energies, as derived from the outflow velocities, column densities, and distances from the central quasar. We estimate these quantities for the quasar, Q1413+1143 (redshift $z_e = 2.56$), aided by the first detection of PV $\\lambda\\lambda$1118,1128 BAL variability in a quasar. In particular, PV absorption at velocities where the CIV trough does not reach zero intensity implies that the CIV BAL is saturated and the absorber only partially covers the background continuum source (with characteristic size 22.3 (cm^-2). Variability in the PV and saturated CIV BALs strongly disfavors changes in the ionization as the cause of the BAL variability, but supports models with high-column density BAL clouds moving across our lines of sight. The observed variability time of ...

  8. Clustered star formation and outflows in AFGL 2591

    CERN Document Server

    Sanna, A; Carrasco-Gonzàlez, C; Menten, K M; Brunthaler, A; Moscadelli, L; Rygl, K L J

    2011-01-01

    We report on a detailed study of the water maser kinematics and radio continuum emission toward the most massive and young object in the star-forming region AFGL 2591. Our analysis shows at least two spatial scales of multiple star formation, one projected across 0.1 pc on the sky and another one at about 2000 AU from a ZAMS star of about 38 Solar masses. This young stellar object drives a powerful jet- and wind-driven outflow system with the water masers associated to the outflow walls, previously detected as a limb-brightened cavity in the NIR band. At about 1300 AU to the north of this object a younger protostar drives two bow shocks, outlined by arc-like water maser emission, at 200 AU either side of the source. We have traced the velocity profile of the gas that expands along these arc-like maser structures and compared it with the jet-driven outflow model. This analysis suggests that the ambient medium around the northern protostar is swept up by a jet-driven shock (>66 km/s) and perhaps a lower-velocit...

  9. Large sea ice outflow into the Nares Strait in 2007

    DEFF Research Database (Denmark)

    Kwok, R.; Pedersen, L.T.; Gudmandsen, Preben

    2010-01-01

    ice in the 13-year record between 1997 and 2009. The 2007 area and volume outflows of 87 x 10(3) km(2) and 254 km(3) are more than twice their 13-year means. This contributes to the recent loss of the thick, multiyear Arctic sea ice and represents similar to 10% of our estimates of the mean ice export......Sea ice flux through the Nares Strait is most active during the fall and early winter, ceases in mid- to late winter after the formation of ice arches along the strait, and re-commences after breakup in summer. In 2007, ice arches failed to form. This resulted in the highest outflow of Arctic sea...... at Fram Strait. Clearly, the ice arches control Arctic sea ice outflow. The duration of unobstructed flow explains more than 84% of the variance in the annual area flux. In our record, seasonal stoppages are always associated with the formation of an arch near the same location in the southern Kane Basin...

  10. Hot Jupiter Breezes: Time-dependent Outflows from Extrasolar Planets

    CERN Document Server

    Owen, James E

    2015-01-01

    We explore the dynamics of magnetically controlled outflows from Hot Jupiters, where these flows are driven by UV heating from the central star. In these systems, some of the open field lines do not allow the flow to pass smoothly through the sonic point, so that steady-state solutions do not exist in general. This paper focuses on this type of magnetic field configuration, where the resulting flow becomes manifestly time-dependent. We consider the case of both steady heating and time-variable heating, and find the time scales for the corresponding time variations of the outflow. Because the flow cannot pass through the sonic transition, it remains subsonic and leads to so-called breeze solutions. One manifestation of the time variability is that the flow samples a collection of different breeze solutions over time, and the mass outflow rate varies in quasi-periodic fashion. Because the flow is subsonic, information can propagate inward from the outer boundary, which determines, in part, the time scale of the...

  11. On the Formation of Molecular Clumps in QSO Outflows

    CERN Document Server

    Ferrara, Andrea

    2016-01-01

    We study the origin of the cold molecular clumps in quasar outflows, recently detected in CO and HCN emission. We first describe the physical properties of such radiation-driven outflows and show that a transition from a momentum- to an energy-driven flow must occur at a radial distance of R ~ 0.25 kpc. During this transition, the shell of swept up material fragments due to Rayleigh-Taylor instabilities, but these clumps contain little mass and are likely to be rapidly ablated by the hot gas in which they are immersed. We then explore an alternative scenario in which clumps form from thermal instabilities at R >~ 1 kpc, possibly containing enough dust to catalyze molecule formation. We investigate this processes with 3D two-fluid (gas+dust) numerical simulations of a kpc^3 patch of the outflow, including atomic and dust cooling, thermal conduction, dust sputtering, and photoionization from the QSO radiation field. In all cases, dust grains are rapidly destroyed in ~10,000 years; and while some cold clumps for...

  12. How stellar feedback simultaneously regulates star formation and drives outflows

    CERN Document Server

    Hayward, Christopher C

    2015-01-01

    We present an analytic model for how momentum deposition from stellar feedback simultaneously regulates star formation and drives outflows in a turbulent interstellar medium (ISM). Because the ISM is turbulent, a given patch of ISM exhibits sub-patches with a range of surface densities. The high-density patches are 'pushed' by feedback, thereby driving turbulence and self-regulating local star formation. Sufficiently low-density patches, however, are accelerated to above the escape velocity before the region can self-adjust and are thus vented as outflows. In the turbulent-pressure-supported regime, when the gas fraction is $\\gtrsim 0.3$, the ratio of the turbulent velocity dispersion to the circular velocity is sufficiently high that at any given time, of order half of the ISM has surface density less than the critical value and thus can be blown out on a dynamical time. The resulting outflows have a mass-loading factor ($\\eta \\equiv M_{\\rm out}/M_{\\star}$) that is inversely proportional to the gas fraction ...

  13. Relationship of Fault Geometry to Catastrophic Outflow on Mars

    Science.gov (United States)

    Davatzes, A.; Gulick, V.

    2006-12-01

    We present results from studies of large outflow channels on Mars that suggest fault morphology is a critical factor for the trapping and catastrophic release of water on Mars, resulting in large flooding events. On Earth, hot springs are commonly concentrated around fault relays, bends, and fault tips, where jointing forms in zones of concentrated stress promoting tensile failure. Examples of fault controlled hydrothermal activity have been documented in the Coso Geothermal Field in California, Southern Seismic Zone in Iceland, Waiotapu Geothermal Field in New Zealand, Killoran Fault in Ireland, and throughout the southwestern United States. On Earth, abrupt changes in the water table, as well as the formation of sand-boils and springs, are associated with earthquakes, and their spatial distribution is related to the geometry of the earthquake slip patch. A similar process may occur on Mars, where hydrothermal waters collect in highly fractured zones at fault relays, and are released catastrophically during an earthquake event. Two examples of large outflow channels on Mars, Mangala and Athabasca Valles, appear to be sourced in a relay zone. Other Martian examples show sourcing at fault bends and fault tips. Data from the instruments on Mars Reconnaissance Orbiter will help us to further understand this mechanism by which large flood events may occur. High resolution images from HiRISE will be used to map these fault systems and estimate outflow rates, and data from CRISM will be used to identify regions of past high temperature fluid flow on the surface of Mars.

  14. Spin Properties of Supermassive Black Holes with Powerful Outflows

    CERN Document Server

    Daly, Ruth A

    2016-01-01

    Relationships between beam power and accretion disk luminosity are studied for a sample of 55 HERG, 13 LERG, and 29 RLQ with powerful outflows. The ratio of beam power to disk luminosity tends to be high for LERG, low for RLQ, and spans the full range of values for HERG. Writing general expressions for the disk luminosity and beam power and applying the empirically determined relationships allows a function that parameterizes the spins of the holes to be estimated. Interestingly, one of the solutions that is consistent with the data has a functional form that is remarkably similar to that expected in the generalized Blandford-Znajek model with a magnetic field that is similar in form to that expected in MAD and ADAF models. Values of the spin function, obtained independent of specific outflow models, suggest that spin and AGN type are not related for these types of sources. The spin function can be used to solve for black hole spin in the context of particular outflow models, and one example is provided.

  15. Eruptive Variable Stars and Outflows in Serpens NW

    CERN Document Server

    Hodapp, Klaus W; Watermann, Ramon; Lemke, Roland

    2011-01-01

    We study the outflow activity, photometric variability and morphology of three very young stellar objects in the Serpens NW star forming region: OO Serpentis, EC 37 (V370 Ser) and EC 53 (V371 Ser). High spatial resolution Keck/NIRC2 laser guide star adaptive optics images obtained in 2007 and 2009 in broad-band K and in a narrow-band filter centered on the 1-0 S(1) emission line of molecular hydrogen allow us to identify the outflows from all three objects. We also present new, seeing-limited data on the photometric evolution of the OO Ser reflection nebula and re-analyze previously published data. We find that OO Ser declined in brightness from its outburst peak in 1995 to about 2003, but that this decline has recently stopped and actually reversed itself in some areas of the reflection nebula. The morphology and proper motions of the shock fronts MHO 2218 near EC 37 suggest that they all originate in EC 37 and that this is an outflow seen nearly along its axis. We identify a molecular hydrogen jet emerging ...

  16. Jets and Outflows From Star to Cloud: Observations Confront Theory

    CERN Document Server

    Frank, A; Cabrit, S; Hartigan, P; Arce, H G; Bacciotti, F; Bally, J; Benisty, M; Eislöffel, J; Güdel, M; Lebedev, S; Nisini, B; Raga, A

    2014-01-01

    In this review we focus on the role jets and outflows play in the star and planet formation process. Our essential question can be posed as follows: are jets/outflows merely an epiphenomenon associated with star formation or do they play an important role in mediating the physics of assembling stars both individually and globally? We address this question by reviewing the current state of observations and their key points of contact with theory. Our review of jet/outflow phenomena is organized into three length-scale domains: Source and Disk Scales ($0.1-10^2$ au) where the connection with protostellar and disk evolution theories is paramount; Envelope Scales ($10^2-10^5$ au) where the chemistry and propagation shed further light on the jet launching process, its variability and its impact on the infalling envelope; Parent Cloud Scales ($10^5-10^6$ au) where global momentum injection into cluster/cloud environments become relevant. Issues of feedback are of particular importance on the smallest scales where p...

  17. Generation of iPSC from cardiac and tail-tip fibroblasts derived from a second heart field reporter mouse.

    Science.gov (United States)

    Linares, Javier; Arellano-Viera, Estibaliz; Iglesias-García, Olalla; Ferreira, Carmen; Iglesias, Elena; Abizanda, Gloria; Prósper, Felipe; Carvajal-Vergara, Xonia

    2016-05-01

    Mef2c Anterior Heart Field (AHF) enhancer is activated during embryonic heart development and it is expressed in multipotent cardiovascular progenitors (CVP) giving rise to endothelial and myocardial components of the outflow tract, right ventricle and ventricular septum. Here we have generated iPSC from transgenic Mef2c-AHF-Cre x Ai6(RCLZsGreen) mice. These iPSC will provide a novel tool to investigate the AHF-CVP and their cell progeny.

  18. Generation of iPSC from cardiac and tail-tip fibroblasts derived from a second heart field reporter mouse

    Directory of Open Access Journals (Sweden)

    Javier Linares

    2016-05-01

    Full Text Available Mef2c Anterior Heart Field (AHF enhancer is activated during embryonic heart development and it is expressed in multipotent cardiovascular progenitors (CVP giving rise to endothelial and myocardial components of the outflow tract, right ventricle and ventricular septum. Here we have generated iPSC from transgenic Mef2c-AHF-Cre x Ai6(RCLZsGreen mice. These iPSC will provide a novel tool to investigate the AHF-CVP and their cell progeny.

  19. 57. Growth of left ventricular outflow tract after repair of ventricular septal defect and aortic arch obstruction

    Directory of Open Access Journals (Sweden)

    Abdulraouf Jijeh

    2015-10-01

    Conclusion: There is significant LVOT growth expected after repair of VSD and aortic arch obstruction. Small aortic valve and LVOT at diagnosis of those cases are not correlating with the need of surgical reintervention for LVOT obstruction.

  20. Utilizing left ventricular outflow tract velocity changes to predict fluid responsiveness in septic patients: a case report.

    Science.gov (United States)

    Chiem, Alan T; Turner, Elizabeth

    2014-03-01

    Toxin-mediated vasodilation in the sepsis syndrome can lead to end-organ dysfunction and shock. Assessing for fluid responsiveness and preload optimization with intravenous fluids is a central tenet in the management of sepsis. Aggressive fluid administration can lead to pulmonary edema and heart failure, whereas premature inotropic or vasopressor support can worsen organ perfusion. Inferior vena cava ultrasonography is commonly used to assess for fluid responsiveness but has multiple limitations.

  1. Effect of Cerium on Cardiac Muscle of Rat and Guinea Pig

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The effect of Ce3+ on cardiac muscle of rat and guinea pig was studied. In vitro, 0.05 mmol.L-1 solution of Ce3+ inhibited the contraction of guinea pig atria. The change of action potential duration(APD) of guinea pig papillary muscle exposed to 0.4 mmol·L-1 Ce3+ was significant, and those exposed to 0.1 and 0.2 mmol·L-1 Ce3+ were not significant. In vivo, compared with the control group, the APD for rat cardiac muscle after long-term feed on Ce3+ was significantly delayed in high dose, and that was not significantly delayed in low dose. The results suggest that Ce3+ with long-term high dose intake might affect the influx of Ca2+, Na+ and outflow of K+ for rat cardiac muscle.

  2. Influence of surgical implantation angle of left ventricular assist device outflow graft and management of aortic valve opening on the risk of stroke in heart failure patients

    Science.gov (United States)

    Chivukula, V. Keshav; McGah, Patrick; Prisco, Anthony; Beckman, Jennifer; Mokadam, Nanush; Mahr, Claudius; Aliseda, Alberto

    2016-11-01

    Flow in the aortic vasculature may impact stroke risk in patients with left ventricular assist devices (LVAD) due to severely altered hemodynamics. Patient-specific 3D models of the aortic arch and great vessels were created with an LVAD outflow graft at 45, 60 and 90° from centerline of the ascending aorta, in order to understand the effect of surgical placement on hemodynamics and thrombotic risk. Intermittent aortic valve opening (once every five cardiac cycles) was simulated and the impact of this residual native output investigated for the potential to wash out stagnant flow in the aortic root region. Unsteady CFD simulations with patient-specific boundary conditions were performed. Particle tracking for 10 cardiac cycles was used to determine platelet residence times and shear stress histories. Thrombosis risk was assessed by a combination of Eulerian and Lagrangian metrics and a newly developed thrombogenic potential metric. Results show a strong influence of LVAD outflow graft angle on hemodynamics in the ascending aorta and consequently on stroke risk, with a highly positive impact of aortic valve opening, even at low frequencies. Optimization of LVAD implantation and management strategies based on patient-specific simulations to minimize stroke risk will be presented

  3. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  4. Trasplante de homoinjertos valvulares cardiacos y vasculares Cardiac and vascular homograft valves transplant

    Directory of Open Access Journals (Sweden)

    J. M. Herreros

    2006-08-01

    for heart transplant; c Cadaver donors with asystolia of less than 8 hours. Homograft cardiac valves are the substitute of choice in aortic valve endocarditis, patients with counter-indications for anticoagulation, reconstruction of the outflow tract of the right ventricle, aortic valve replacement in children and young adults through the Ross operation, and an optional indication is the aortic valve and/or rising aorta replacement in patients over 60 years of age. Although there are not sufficiently broad series of homogratfs with arterial substitutes, with respect to the number of patients and time of evolution, the results suggest that this can benefit patients with vascular infection, immunodepressed patients or complex patients whose technique during the operation might require a homograft.

  5. Uncovering the Outflow Driven by the Brown Dwarf LS-RCr A1: H-alpha as a Tracer of Outflow Activity in Brown Dwarfs

    CERN Document Server

    Whelan, E T; Bacciotti, F

    2009-01-01

    It is now apparent that classical T Tauri-like outflows commonly accompany the formation of young brown dwarfs. To date two optical outflows have been discovered and results presented in this paper increase this number to three. Using spectro-astrometry the origin of the LS-RCrA 1 forbidden emission lines in a blue-shifted outflow is confirmed. The non-detection of the red-shifted component of the outflow in forbidden lines, along with evidence for some separation between low and high velocity outflow components, do not support the hypothesis that LS-RCrA 1 has an edge-on accretion disk. The key result of this analysis is the discovery of an outflow component to the H-alpha line. The H-alpha line profile has blue and red-shifted features in the wings which spectro-astrometry reveals to also originate in the outflow. The discovery that H-alpha emission in BDs can have a significant contribution from an outflow suggests the use of H-alpha line widths as a proxy of mass accretion in BDs is not clear-cut. This me...

  6. Momentum-driven outflow emission from an O-type YSO: Comparing the radio jet with the molecular outflow

    CERN Document Server

    Sanna, A; Cesaroni, R; Garatti, A Caratti o; Goddi, C; Carrasco-González, C

    2016-01-01

    Aims: We want to study the physical properties of the ionized jet emission in the vicinity of an O-type young stellar object (YSO), and estimate how efficient is the transfer of energy and momentum from small- to large-scale outflows. Methods: We conducted Karl G. Jansky Very Large Array (VLA) observations, at both 22 and 45 GHz, of the compact and faint radio continuum emission in the high-mass star-forming region G023.01-00.41, with an angular resolution between 0.3" and 0.1", and a thermal rms of the order of 10 uJy/beam. Results: We discovered a collimated thermal (bremsstrahlung) jet emission, with a radio luminosity (L_rad) of 24 mJy kpc^2 at 45 GHz, in the inner 1000 AU from an O-type YSO. The radio thermal jet has an opening angle of 44 degrees and brings a momentum rate of 8 10^-3 M_sun yr^-1 km/s. By combining the new data with previous observations of the molecular outflow and water maser shocks, we can trace the outflow emission from its driving source through the molecular clump, across more than...

  7. Developing the Next Generation of Tools for Simulating Galaxy Outflows

    Science.gov (United States)

    Scannapieco, Evan

    Outflows are observed in starbursting galaxies of all masses and at all cosmological epochs. They play a key role throughout the history of the Universe: shaping the galaxy mass-metallicity relation, drastically affecting the content and number density of dwarf galaxies, and transforming the chemical composition of the intergalactic medium. Yet, a complete model of galaxy out ows has proven to be elusive, as it requires both a better understanding of the evolution of the turbulent, multiphase gas in and around starbursting galaxies, and better tools to reproduce this evolution in galaxy-scale simulations. Here we propose to conduct a detailed series of numerical simulations designed to help develop such next-generation tools for the simulation of galaxy outflows. The program will consist of three types of direct numerical simulations, each of which will be targeted to allow galaxy-scale simulations to more accurately model key microphysical processes and their observational consequences. Our first set of simulations will be targeted at better modeling the starbursting interstellar medium (ISM) from which galaxy outflows are driven. The surface densities in starbursting galaxies are much larger than those in the Milky Way, resulting in larger gravitational accelerations and random velocities exceeding 30 or even 100 km/s. Under these conditions, the thermal stability of the ISM is changed dramatically, due to the sharp peak in gas cooling efficiency at H 200,000 K. Our simulations will carefully quantify the key ways in which this medium differs from the local ISM, and the consequences of these differences for when, where, and how outflows are driven. A second set of simulations will be targeted at better modeling the observed properties of rapidly cooling, highly turbulent gas. Because gas cooling in and around starbursts is extremely efficient, turbulent motions are often supersonic, which leads to a distribution of ionization states that is vastly different than

  8. Acute impact of pacing at different cardiac sites on left ventricular rotation and twist in dogs.

    Directory of Open Access Journals (Sweden)

    Zhi-Wen Zhou

    Full Text Available We evaluated the acute impact of different cardiac pacing sites on two-dimensional speckle-tracking echocardiography (STE derived left ventricular (LV rotation and twist in healthy dogs.Twelve dogs were used in this study. The steerable pacing electrodes were positioned into right heart through the superior or inferior vena cava, into LV through aorta across the aortic valve. The steerable pacing electrodes were positioned individually in the right atrium (RA, right ventricular apex (RVA, RV outflow tract (RVOT, His bundle (HB, LV apex (LVA and LV high septum (LVS, individual pacing mode was applied at 10 minutes interval for at least 5 minutes from each position under fluoroscopy and ultrasound guidance and at stabilized hemodynamic conditions. LV short-axis images at the apical and basal levels were obtained during sinus rhythm and pacing. Offline STE analysis was performed. Rotation, twist, time to peak rotation (TPR, time to peak twist (TPT, and apical-basal rotation delay (rotational synchronization index, RSI values were compared at various conditions. LV pressure was monitored simultaneously.Anesthetic death occurred in 1 dog, and another dog was excluded because of bad imaging quality. Data from 10 dogs were analyzed. RVA, RVOT, HB, LVA, LVS, RARV (RA+RVA pacing resulted in significantly reduced apical and basal rotation and twist, significantly prolonged apical TPR, TPT and RSI compared to pre-pacing and RA pacing (all P<0.05. The apical and basal rotation and twist values were significantly higher during HB pacing than during pacing at ventricular sites (all P<0.05, except basal rotation at RVA pacing. The apical TPR during HB pacing was significantly shorter than during RVOT and RVA pacing (both P<0.05. The LV end systolic pressure (LVESP was significantly lower during ventricular pacing than during pre-pacing and RA pacing.Our results show that RA and HB pacing results in less acute reduction on LV twist, rotation and LVESP compared

  9. Gene mutations in cardiac arrhythmias: a review of recent evidence in ion channelopathies

    Directory of Open Access Journals (Sweden)

    Hsiao PY

    2013-01-01

    Full Text Available Pi-Yin Hsiao,1 Hui-Chun Tien,2 Chu-Pin Lo,2 Jyh-Ming Jimmy Juang,3 Yi-Hsin Wang,2 Ruey J Sung41Institute of Life Sciences, National Central University, Taoyuan, Taiwan; 2Department of Financial and Computational Mathematics, Providence University, Taichung, Taiwan; 3Cardiovascular Center and Department of Cardiology, National Taiwan University, Taipei, Taiwan; 4Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USAAbstract: Over the past 15 years, molecular genetic studies have linked gene mutations to many inherited arrhythmogenic disorders, in particular, "ion channelopathies", in which mutations in genes encode functional units of ion channels and/or their transporter-associated proteins in patients without primary cardiac structural abnormalities. These disorders are exemplified by congenital long QT syndrome (LQTS, short QT syndrome, Brugada syndrome (BrS and catecholaminergic polymorphic ventricular tachycardia (CPVT. Functional and pathophysiological studies have led to better understanding of the clinical spectrum, ion channel structures and cellular electrophysiology involving dynamics of intracellular calcium cycling in many subtypes of these disorders and more importantly, development of potentially more effective pharmacological agents and even curative gene therapy. In this review, we have summarized (1 the significance of unveiling mutations in genes encoding transporter-associated proteins as the cause of congenital LQTS, (2 the technique of catheter ablation applied at the right ventricular outflow tract may be curative for severely symptomatic BrS, (3 mutations with channel function modulated by protein Kinase A-dependent phosphorylation can be the culprit of CPVT mimicry in Andersen-Tawil syndrome (LQT7, (4 ablation of the ion channel anchoring protein may prevent arrhythmogenesis in Timothy syndrome (LQT8, (5 altered intracellular Ca2+ cycling can be the basis of effective targeted

  10. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

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

  11. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

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

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  12. Toothache of cardiac origin.

    Science.gov (United States)

    Kreiner, M; Okeson, J P

    1999-01-01

    Pain referred to the orofacial structures can sometimes be a diagnostic challenge for the clinician. In some instances, a patient may complain of tooth pain that is completely unrelated to any dental source. This poses a diagnostic and therapeutic problem for the dentist. Cardiac pain most commonly radiates to the left arm, shoulder, neck, and face. In rare instances, angina pectoris may present as dental pain. When this occurs, an improper diagnosis frequently leads to unnecessary dental treatment or, more significantly, a delay of proper treatment. This delay may result in the patient experiencing an acute myocardial infarction. It is the dentist's responsibility to establish a proper diagnosis so that the treatment will be directed toward the source of pain and not to the site of pain. This article reviews the literature concerning referred pain of cardiac origin and presents a case report of toothache of cardiac origin.

  13. Pharmacological Evidence that Histamine H3 Receptors Mediate Histamine-Induced Inhibition of the Vagal Bradycardic Out-flow in Pithed Rats.

    Science.gov (United States)

    García, Mónica; García-Pedraza, José Ángel; Villalón, Carlos M; Morán, Asunción

    2016-02-01

    In vivo stimulation of cardiac vagal neurons induces bradycardia by acetylcholine (ACh) release. As vagal release of ACh may be modulated by autoreceptors (muscarinic M2 ) and heteroreceptors (including serotonin 5-HT1 ), this study has analysed the pharmacological profile of the receptors involved in histamine-induced inhibition of the vagal bradycardic out-flow in pithed rats. For this purpose, 180 male Wistar rats were pithed, artificially ventilated and pre-treated (i.v.) with 1 mg/kg atenolol, followed by i.v. administration of physiological saline (1 ml/kg), histamine (10, 50, 100 and 200 μg/kg) or the selective histamine H1 (2-pyridylethylamine), H2 (dimaprit), H3 (methimepip) and H4 (VUF 8430) receptor agonists (1, 10, 50 and 100 μg/kg each). Under these conditions, electrical stimulation (3, 6 and 9 Hz; 15 ± 3 V and 1 ms) of the vagus nerve resulted in frequency-dependent bradycardic responses, which were (i) unchanged during the infusions of saline, 2-pyridylethylamine, dimaprit or VUF 8430; and (ii) dose-dependently inhibited by histamine or methimepip. Moreover, the inhibition of the bradycardia caused by 50 μg/kg of either histamine or methimepip (which failed to inhibit the bradycardic responses to i.v. bolus injections of acetylcholine; 1-10 μg/kg) was abolished by the H3 receptor antagonist JNJ 10181457 (1 mg/kg, i.v.). In conclusion, our results suggest that histamine-induced inhibition of the vagal bradycardic out-flow in pithed rats is mainly mediated by pre-junctional activation of histamine H3 receptors, as previously demonstrated for the vasopressor sympathetic out-flow and the vasodepressor sensory CGRPergic (calcitonin gene-related peptide) out-flow.

  14. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  15. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  16. A jet-induced outflow of warm gas in 3C 293

    CERN Document Server

    Emonts, B H C; Tadhunter, C N; Oosterloo, T A; Holt, J; Van der Hulst, J M

    2005-01-01

    Using long slit emission-line spectra we detect a fast outflow of ionized gas, with velocities up to 1000 km/s, in the nearby powerful radio galaxy 3C 293 (z = 0.045). The fast outflow is located about 1 kpc east of the nucleus, in a region of enhanced radio emission due to the presence of a distorted radio jet. We present results that indicate that this fast outflow is caused by a jet-ISM interaction. The kinematics of the outflowing ionized gas are very similar to those of a fast outflow of neutral hydrogen gas in this galaxy, suggesting that both outflows are the result of the same driving mechanism. While the mass of the outflowing ionized gas is about 1 x 10e5 M_sun, the total HI mass involved in the neutral outflow is about 100 times higher (10e7 M_sun). This shows that, despite the high energies that must be involved in driving the outflow, most of the gas remains, or becomes again, neutral. Other outflows of ionized gas, although not as pronounced as in the region of the enhanced radio emission, are a...

  17. First Detection of A Sub-kpc Scale Molecular Outflow in the Starburst Galaxy NGC 3628

    CERN Document Server

    Tsai, An-Li; Kong, Albert K H; Matsumoto, Hironori; Kohno, Kotaro

    2012-01-01

    We successfully detected a molecular outflow with a scale of 370-450 pc in the central region of the starburst galaxy NGC 3628 through deep CO(1-0) observations by using the Nobeyama Millimeter Array (NMA). The mass of the outflowing molecular gas is ~2.8x10^7 M_sun, and the outflow velocity is ~90(+/-10) km s^{-1}. The expansion timescale of the outflow is 3.3-6.8 Myr, and the molecular gas mass flow rate is 4.1-8.5 M_sun yr^{-1}. It requires mechanical energy of (1.8-2.8)x10^{54} erg to create this sub-kpc scale molecular outflow. In order to understand the evolution of the molecular outflow, we compare the physical properties between the molecular outflow observed from our NMA CO(1-0) data and the plasma gas from the soft X-ray emission of the Chandra X-ray Observatory (CXO) archival data. We found that the distribution between the molecular outflow and the strong plasma outflow seems to be in a similar region. In this region, the ram pressure and the thermal pressure of the plasma outflow are 10^{-(8-10)}...

  18. Pharmacological characterization of the inhibition by moxonidine and agmatine on the cardioaccelerator sympathetic outflow in pithed rats.

    Science.gov (United States)

    Cobos-Puc, Luis E; Villalón, Carlos M; Ramírez-Rosas, Martha B; Sánchez-López, Araceli; Lozano-Cuenca, Jair; Gómez-Díaz, Benjamín; MaassenVanDenBrink, Antoinette; Centurión, David

    2009-08-15

    This study analysed the inhibition produced by the agonists moxonidine (imidazoline I(1) receptors>alpha(2)-adrenoceptors) and agmatine (endogenous ligand of imidazoline I(1)/I(2) receptors), using B-HT 933 (6-ethyl-5,6,7,8-tetrahydro-4H-oxazolo[4,5-d]azepin-2-amine dihydrochloride; alpha(2)-adrenoceptors) for comparison, on the rat cardioaccelerator sympathetic outflow. Male Wistar rats were pithed and prepared to stimulate the cardiac sympathetic outflow or to receive i.v. bolus of exogenous noradrenaline. Sympathetic stimulation or noradrenaline produced, respectively, frequency-dependent and dose-dependent tachycardic responses. I.v. continuous infusions of moxonidine (3 and 10 microg/kg min), agmatine (1000 and 3000 microg/kg min) and B-HT 933 (30 and 100 microg/kg min) inhibited the tachycardic responses to sympathetic stimulation, but not those to noradrenaline. The cardiac sympatho-inhibition by either moxonidine (3 microg/kg min) or B-HT 933 (30 microg/kg min) was not modified by i.v. injections of saline or the antagonists AGN192403 [(+/-)-2-endo-Amino-3-exo-isopropylbicyclo[2.2.1]heptane hydrochloride; 3000microg/kg; imidazoline I(1) receptors] or BU224 (2-(4,5-dihydroimidazol-2-yl)quinoline hydrochloride; 300 microg/kg; imidazoline I(2) receptors) and abolished by rauwolscine (300 microg/kg; alpha(2)-adrenoceptors). At the same doses of these compounds, the sympatho-inhibition to moxonidine (10 microg/kg min) and agmatine (1000 microg/kg min) was: (1) not modified by saline, AGN192403 or BU224; (2) partially blocked by rauwolscine or the combination of rauwolscine plus BU224; and (3) abolished by the combination of rauwolscine plus AGN192403. These results demonstrate that the cardiac sympatho-inhibition to: (1) 3 microg/kg min moxonidine or 30 microg/kg min B-HT 933 involves alpha(2)-adrenoceptors; and (2) 10 microg/kg min moxonidine or 1000 microg/kg min agmatine involves alpha(2)-adrenoceptors and imidazoline I(1) receptors.

  19. Extensive upper respiratory tract sarcoidosis.

    Science.gov (United States)

    Soares, Mafalda Trindade; Sousa, Carolina; Garanito, Luísa; Freire, Filipe

    2016-04-18

    Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea.

  20. Musculature of the alimentary tract.

    Science.gov (United States)

    Skandalakis, J E

    2000-04-01

    Leiomyomas and leiomyosarcomas are derived from smooth muscle tissues. Smooth muscle cells also surround the blood vessels that supply the alimentary tract. These cells have at times been said to contribute to the formation of smooth muscle tumors in the alimentary canal. With such an abundance of smooth muscle, there is little reason at present to implicate the smooth muscle elements of blood vessel walls.

  1. Urinary Tract Infections in Adults

    OpenAIRE

    Cohn, Evan B.; Schaeffer, Anthony J.

    2004-01-01

    Urinary tract infection (UTI) is an exceedingly common problem prompting seven million office visits and one million hospitalizations in the United States each year (1). Advances in the understanding of both host and bacterial factors involved in UTI have led to many improvements in therapy. While there have also been advances in the realm of antimicrobials, there have been numerous problems with multiple drug resistant organisms. Providing economical care while minimizing drug resistance req...

  2. Multi-epoch subarcsecond [Fe II] spectroimaging of the DG Tau outflows with NIFS - II. On the nature of the bipolar outflow asymmetry

    Science.gov (United States)

    White, M. C.; Bicknell, G. V.; McGregor, P. J.; Salmeron, R.

    2014-07-01

    The origin of bipolar outflow asymmetry in young stellar objects (YSOs) remains poorly understood. It may be due to an intrinsically asymmetric outflow launch mechanism, or it may be caused by the effects of the ambient medium surrounding the YSO. Answering this question is an important step in understanding outflow launching. We have investigated the bipolar outflows driven by the T Tauri star DG Tauri on scales of hundreds of astronomical units, using the Near-infrared Integral Field Spectrograph on Gemini-North. The approaching outflow consists of a well-collimated jet, nested within a lower-velocity disc wind. The receding outflow is composed of a single-component bubble-like structure. We analyse the kinematics of the receding outflow using kinetic models, and determine that it is a quasi-stationary bubble with an expanding internal velocity field. We propose that this bubble forms because the receding counterjet from DG Tau is obstructed by a clumpy ambient medium above the circumstellar disc surface, based on similarities between this structure and those found in the modelling of active galactic nuclei outflows. We find evidence of interaction between the obscured counterjet and clumpy ambient material, which we attribute to the large molecular envelope around the DG Tau system. An analytical model of a momentum-driven bubble is shown to be consistent with our interpretation. We conclude that the bipolar outflow from DG Tau is intrinsically symmetric, and the observed asymmetries are due to environmental effects. This mechanism can potentially be used to explain the observed bipolar asymmetries in other YSO outflows.

  3. Immune cells in the female reproductive tract.

    Science.gov (United States)

    Lee, Sung Ki; Kim, Chul Jung; Kim, Dong-Jae; Kang, Jee-Hyun

    2015-02-01

    The female reproductive tract has two main functions: protection against microbial challenge and maintenance of pregnancy to term. The upper reproductive tract comprises the fallopian tubes and the uterus, including the endocervix, and the lower tract consists of the ectocervix and the vagina. Immune cells residing in the reproductive tract play contradictory roles: they maintain immunity against vaginal pathogens in the lower tract and establish immune tolerance for sperm and an embryo/fetus in the upper tract. The immune system is significantly influenced by sex steroid hormones, although leukocytes in the reproductive tract lack receptors for estrogen and progesterone. The leukocytes in the reproductive tract are distributed in either an aggregated or a dispersed form in the epithelial layer, lamina propria, and stroma. Even though immune cells are differentially distributed in each organ of the reproductive tract, the predominant immune cells are T cells, macrophages/dendritic cells, natural killer (NK) cells, neutrophils, and mast cells. B cells are rare in the female reproductive tract. NK cells in the endometrium significantly expand in the late secretory phase and further increase their number during early pregnancy. It is evident that NK cells and regulatory T (Treg) cells are extremely important in decidual angiogenesis, trophoblast migration, and immune tolerance during pregnancy. Dysregulation of endometrial/decidual immune cells is strongly related to infertility, miscarriage, and other obstetric complications. Understanding the immune system of the female reproductive tract will significantly contribute to women's health and to success in pregnancy.

  4. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  5. Common arterial trunk and ventricular non-compaction in Lrp2 knockout mice indicate a crucial role of LRP2 in cardiac development.

    Science.gov (United States)

    Baardman, Maria E; Zwier, Mathijs V; Wisse, Lambertus J; Gittenberger-de Groot, Adriana C; Kerstjens-Frederikse, Wilhelmina S; Hofstra, Robert M W; Jurdzinski, Angelika; Hierck, Beerend P; Jongbloed, Monique R M; Berger, Rolf M F; Plösch, Torsten; DeRuiter, Marco C

    2016-04-01

    Lipoprotein-related receptor protein 2 (LRP2) is important for development of the embryonic neural crest and brain in both mice and humans. Although a role in cardiovascular development can be expected, the hearts ofLrp2knockout (KO) mice have not yet been investigated. We studied the cardiovascular development ofLrp2KO mice between embryonic day 10.5 (E10.5) and E15.5, applying morphometry and immunohistochemistry, using antibodies against Tfap2α (neural crest cells), Nkx2.5 (second heart field), WT1 (epicardium derived cells), tropomyosin (myocardium) and LRP2. TheLrp2KO mice display a range of severe cardiovascular abnormalities, including aortic arch anomalies, common arterial trunk (persistent truncus arteriosus) with coronary artery anomalies, ventricular septal defects, overriding of the tricuspid valve and marked thinning of the ventricular myocardium. Both the neural crest cells and second heart field, which are essential for the lengthening and growth of the right ventricular outflow tract, are abnormally positioned in theLrp2KO. This explains the absence of the aorto-pulmonary septum, which leads to common arterial trunk and ventricular septal defects. Severe blebbing of the epicardial cells covering the ventricles is seen. Epithelial-mesenchymal transition does occur; however, there are fewer WT1-positive epicardium-derived cells in the ventricular wall as compared to normal, coinciding with the myocardial thinning and deep intertrabecular spaces. LRP2 plays a crucial role in cardiovascular development in mice. This corroborates findings of cardiac anomalies in humans withLRP2mutations. Future studies should reveal the underlying signaling mechanisms in which LRP2 is involved during cardiogenesis.

  6. Relation of fragmented QRS complex to right ventricular fibrosis detected by late gadolinium enhancement cardiac magnetic resonance in adults with repaired tetralogy of fallot.

    Science.gov (United States)

    Park, Seung-Jung; On, Young Keun; Kim, June Soo; Park, Seung Woo; Yang, Ji-Hyuk; Jun, Tae-Gook; Kang, I-Seok; Lee, Heung Jae; Choe, Yeon Hyeon; Huh, June

    2012-01-01

    Fragmented QRS (fQRS) on 12-lead electrocardiography reflects conduction delay caused by myocardial fibrosis and dysfunction. Ventricular fibrosis detected by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) is reportedly correlated with worse clinical outcomes in adults with repaired tetralogy of Fallot (TOF). The aim of this study was to assess whether the presence of fQRS is associated with right ventricular (RV) fibrosis or dysfunction in this patient group. In 37 consecutive patients (median age 30 years, median age at repair 6.6 years), the number of leads showing fQRS, defined as the presence of >2 notches on the R/S wave in ≥2 contiguous leads, was counted. RV systolic function, dilatation, and LGE score were measured using LGE CMR. Ventricular LGE was observed mainly at the previous surgical sites: the RV outflow tract (33 of 37), ventricular septal defect patch region (15 of 37), and RV anterior wall (11 of 37). Fragmented QRS was found mostly in the right and mid precordial leads. The fQRS group (n = 20) demonstrated higher RV LGE scores (p <0.001) and lower RV ejection fractions (p = 0.02) and a trend toward larger RV end-diastolic and end-systolic volumes (p = 0.12 and p = 0.06, respectively) compared to the non-fQRS group (n = 17). The number of electrocardiographic leads showing fQRS was positively correlated with RV LGE score (r = 0.75, p <0.001). The presence of fQRS remained independently associated with the presence of supramedian RV LGE score, even after adjusting for relevant parameters. In conclusion, fQRS was closely associated with more extensive RV fibrosis and dysfunction in adults with repaired tetralogy of Fallot.

  7. Data analysis in cardiac arrhythmias.

    Science.gov (United States)

    Rodrigo, Miguel; Pedrón-Torecilla, Jorge; Hernández, Ismael; Liberos, Alejandro; Climent, Andreu M; Guillem, María S

    2015-01-01

    Cardiac arrhythmias are an increasingly present in developed countries and represent a major health and economic burden. The occurrence of cardiac arrhythmias is closely linked to the electrical function of the heart. Consequently, the analysis of the electrical signal generated by the heart tissue, either recorded invasively or noninvasively, provides valuable information for the study of cardiac arrhythmias. In this chapter, novel cardiac signal analysis techniques that allow the study and diagnosis of cardiac arrhythmias are described, with emphasis on cardiac mapping which allows for spatiotemporal analysis of cardiac signals.Cardiac mapping can serve as a diagnostic tool by recording cardiac signals either in close contact to the heart tissue or noninvasively from the body surface, and allows the identification of cardiac sites responsible of the development or maintenance of arrhythmias. Cardiac mapping can also be used for research in cardiac arrhythmias in order to understand their mechanisms. For this purpose, both synthetic signals generated by computer simulations and animal experimental models allow for more controlled physiological conditions and complete access to the organ.

  8. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...

  9. Cardiac troponins and high-sensitivity cardiac troponin assays.

    Science.gov (United States)

    Conrad, Michael J; Jarolim, Petr

    2014-03-01

    Measurement of circulating cardiac troponins I and T has become integral to the diagnosis of myocardial infarction. This article discusses the structure and function of the troponin complex and the release of cardiac troponin molecules from the injured cardiomyocyte into the circulation. An overview of current cardiac troponin assays and their classification according to sensitivity is presented. The diagnostic criteria, role, and usefulness of cardiac troponin for myocardial infarction are discussed. In addition, several examples are given of the usefulness of high-sensitivity cardiac troponin assays for short-term and long-term prediction of adverse events.

  10. Molecular outflows identified in the FCRAO CO survey of the Taurus Molecular Cloud

    Science.gov (United States)

    Narayanan, Gopal; Snell, Ronald; Bemis, Ashley

    2012-10-01

    Jets and outflows are an integral part of the star formation process. While there are many detailed studies of molecular outflows towards individual star-forming sites, few studies have surveyed an entire star-forming molecular cloud for this phenomenon. The 100-deg2 Five College Radio Astronomy Observatory CO survey of the Taurus Molecular Cloud provides an excellent opportunity to undertake an unbiased survey of a large, nearby, molecular cloud complex for molecular outflow activity. Our study provides information on the extent, energetics and frequency of outflows in this region, which are then used to assess the impact of outflows on the parent molecular cloud. The search identified 20 outflows in the Taurus region, eight of which were previously unknown. Both 12CO and 13CO data cubes from the Taurus molecular map were used, and dynamical properties of the outflows are derived. Even for previously known outflows, our large-scale maps indicate that many of the outflows are much larger than previously suspected, with eight of the outflows (40 per cent) being more than a parsec long. The mass, momentum and kinetic energy from the 20 outflows are compared to the repository of turbulent energy in Taurus. Comparing the energy deposition rate from outflows to the dissipation rate of turbulence, we conclude that outflows by themselves cannot sustain the observed turbulence seen in the entire cloud. However, when the impact of outflows is studied in selected regions of Taurus, it is seen that locally outflows can provide a significant source of turbulence and feedback. The L1551 dark cloud which is just south of the main Taurus complex was not covered by this survey, but the outflows in L1551 have much higher energies compared to the outflows in the main Taurus cloud. In the L1551 cloud, outflows can not only account for the turbulent energy present, but are probably also disrupting their parent cloud. We conclude that for a molecular cloud like Taurus, an L1551-like

  11. The Turbulent Origin of Outflow and Spin Misalignment in Multiple Star Systems

    CERN Document Server

    Offner, Stella S R; Lee, Katherine I; Arce, Hector G; Fielding, Drummond B

    2016-01-01

    The protostellar outflows of wide-separation forming binaries frequently appear misaligned. We use magneto-hydrodynamic simulations to investigate the alignment of protostellar spin and molecular outflows for forming binary pairs. We show that the protostellar pairs, which form from turbulent fragmentation within a single parent core, have randomly oriented angular momenta. Although the pairs migrate to closer separations, their spins remain partially misaligned. We produce $^{12}$CO(2-1) synthetic observations of the simulations and characterize the outflow orientation in the emission maps. The CO-identified outflows exhibit a similar random distribution and are also statistically consistent with the observed distribution of molecular outflows. We conclude that observed misalignment provides a clear signature of binary formation via turbulent fragmentation. The persistence of misaligned outflows and stellar spins following dynamical evolution may provide a signature of binary origins for more evolved multipl...

  12. The Turbulent Origin of Outflow and Spin Misalignment in Multiple Star Systems

    Science.gov (United States)

    Offner, Stella S. R.; Dunham, Michael M.; Lee, Katherine I.; Arce, Héctor G.; Fielding, Drummond B.

    2016-08-01

    The protostellar outflows of wide-separation forming binaries frequently appear misaligned. We use magneto-hydrodynamic simulations to investigate the alignment of protostellar spin and molecular outflows for forming binary pairs. We show that the protostellar pairs, which form from turbulent fragmentation within a single parent core, have randomly oriented angular momentum. Although the pairs migrate to closer separations, their spins remain partially misaligned. We produce 12CO(2-1) synthetic observations of the simulations and characterize the outflow orientation in the emission maps. The CO-identified outflows exhibit a similar random distribution and are also statistically consistent with the observed distribution of molecular outflows. We conclude that the observed misalignment provides a clear signature of binary formation via turbulent fragmentation. The persistence of misaligned outflows and stellar spins following dynamical evolution may provide a signature of binary origins for more evolved multiple star systems.

  13. Effect of the flow composition on outflow rates from accretion discs around black holes

    CERN Document Server

    Kumar, Rajiv; Chattopadhyay, Indranil; Chakrabarti, Sandip K

    2013-01-01

    We studied the outflow behaviour from accretion discs around black holes taking into account the vertical equilibrium accretion flow model. The outflow rate is found to depend crucially on flow composition. Our approach is to study the outflow behaviour as function of inflow around black holes with an equation of state which allows flow to be thermally relativistic close to black holes and non relativistic far away from black holes. We studied shock ejection model. A pure electron positron pair flow never undergoes shock transition while presence of some baryons (common in outflows and jets) makes it possible to have standing shock waves in the flow. It can be concluded that the presence of protons is necessary for the flow to show the outflow behaviour. The outflow rate is maximum when the flow contains the proton number density which is 27% of the electron number density. We conclude that a pure electron-positron jet is unlikely to form.

  14. A study of outflow activity around EGO sources

    Science.gov (United States)

    Farina, C.; Paron, S.; Ortega, M.; Astort, A.; Rubio, M.

    2013-06-01

    Extended green objects (EGOs) were identified in Spitzer-IRAC images as they present a particular extended "green" emission at 4.5 μm, hence their name. An EGO is probably a massive young stellar object driving outflows, with the extended emission at 4.5 μm likely due to H2 lines and CO band-heads excited by the shock of the outflow propagating in the interstellar medium. Therefore, the dedicated observation and study of EGOs and their close environments can provide additional insight into our understanding of massive-star formation processes. In this context, based on previous studies we have selected a set of particularly interesting EGOs with the aim of analysing and characterising their outflow activity and its impact on the interstellar medium around them. This is a work in progress in which new observations at molecular and near-infrared wavelengths have recently been carried out towards some of the selected EGOs and more observations will be done in the following semesters. Here we report the results obtained so far from the data analysis of the images towards EGO, G45.47+0.05 and EGO, G35.04-0.47. For these two targets the molecular line observations were acquired using the Atacama Submillimiter Telescope Experiment (ASTE) and the near-infrared images for EGO, G45.47+0.05 were taken with Gemini-NIRI. The near future plans of this project include new images from WHT-LIRIS for EGO, G035.20-0.74 and EGO, G035.03+0.35.

  15. DENSE CLUMPS AND CANDIDATES FOR MOLECULAR OUTFLOWS IN W40

    Energy Technology Data Exchange (ETDEWEB)

    Shimoikura, Tomomi; Dobashi, Kazuhito [Department of Astronomy and Earth Sciences, Tokyo Gakugei University, Koganei, Tokyo 184-8501 (Japan); Nakamura, Fumitaka; Hara, Chihomi; Kawabe, Ryohei [National Astronomical Observatory of Japan, Mitaka, Tokyo 181-8588 (Japan); Tanaka, Tomohiro [Department of Physical Science, Osaka Prefecture University, Sakai, Osaka 599-8531 (Japan); Shimajiri, Yoshito [Laboratoire AIM, CEA/DSM-CNRS-Université Paris Diderot, IRFU/Service d’Astrophysique, CEA Saclay, F-91191 Gif-sur-Yvette (France); Sugitani, Kouji, E-mail: ikura@u-gakugei.ac.jp [Graduate School of Natural Sciences, Nagoya City University, Mizuho-ku, Nagoya 467-8501 (Japan)

    2015-06-20

    We report the results of the {sup 12}CO (J = 3−2) and HCO{sup +} (J = 4−3) observations of the W40 H ii region with the Atacama Submillimeter Telescope Experiment (ASTE) 10 m telescope (HPBW ≃ 22″) to search for molecular outflows and dense clumps. We found that the velocity field in the region is highly complex, consisting of at least four distinct velocity components at V{sub LSR} ≃ 3, 5, 7, and 10 km s{sup −1}. The ∼7 km s{sup −1} component represents the systemic velocity of cold gas surrounding the entire region, and causes heavy absorption in the {sup 12}CO spectra over the velocity range 6 ≲ V{sub LSR} ≲ 9 km s{sup −1}. The ∼5 and ∼10 km s{sup −1} components exhibit high {sup 12}CO temperature (≳40 K) and are found mostly around the H ii region, suggesting that these components are likely to be tracing dense gas interacting with the expanding shell around the H ii region. Based on the {sup 12}CO data, we identified 13 regions of high velocity gas, which we interpret as candidate outflow lobes. Using the HCO{sup +} data, we also identified six clumps and estimated their physical parameters. On the basis of the ASTE data and near-infrared images from 2MASS, we present an updated three-dimensional model of this region. In order to investigate molecular outflows in W40, the SiO (J = 1−0, v = 0) emission line and some other emission lines at 40 GHz were also observed with the 45 m telescope at the Nobeyama Radio Observatory, but they were not detected at the present sensitivity.

  16. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

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

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...

  17. Cardiac Risk Assessment

    Science.gov (United States)

    ... Risk Assessment Related tests: Lipid Profile , VLDL Cholesterol , hs-CRP , Lp(a) Overview | Common Questions | Related Pages What ... cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring CRP with a ...

  18. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  19. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

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

  20. Atmospheric pollutant outflow from southern Asia: a review

    Science.gov (United States)

    Lawrence, M. G.; Lelieveld, J.

    2010-11-01

    Southern Asia, extending from Pakistan and Afghanistan to Indonesia and Papua New Guinea, is one of the most heavily populated regions of the world. Biofuel and biomass burning play a disproportionately large role in the emissions of most key pollutant gases and aerosols there, in contrast to much of the rest of the Northern Hemisphere, where fossil fuel burning and industrial processes tend to dominate. This results in polluted air masses which are enriched in carbon-containing aerosols, carbon monoxide, and hydrocarbons. The outflow and long-distance transport of these polluted air masses is characterized by three distinct seasonal circulation patterns: the winter monsoon, the summer monsoon, and the monsoon transition periods. During winter, the near-surface flow is mostly northeasterly, and the regional pollution forms a thick haze layer in the lower troposphere which spreads out over millions of square km between southern Asia and the Intertropical Convergence Zone (ITCZ), located several degrees south of the equator over the Indian Ocean during this period. During summer, the heavy monsoon rains effectively remove soluble gases and aerosols. Less soluble species, on the other hand, are lifted to the upper troposphere in deep convective clouds, and are then transported away from the region by strong upper tropospheric winds, particularly towards northern Africa and the Mediterranean in the tropical easterly jet. Part of the pollution can reach the tropical tropopause layer, the gateway to the stratosphere. During the monsoon transition periods, the flow across the Indian Ocean is primarily zonal, and strong pollution plumes originating from both southeastern Asia and from Africa spread across the central Indian Ocean. This paper provides a review of the current state of knowledge based on the many observational and modeling studies over the last decades that have examined the southern Asian atmospheric pollutant outflow and its large scale effects. An outlook