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Sample records for cardiac outflow tract

  1. Cardiac outflow tract malformations in chick embryos exposed to homocysteine

    NARCIS (Netherlands)

    M.J. Boot (Marit); R.P.M. Steegers-Theunissen (Régine); R.E. Poelmann (Robert); L. van Iperen (Liesbeth); A.C. Gittenberger-De Groot (Adriana)

    2004-01-01

    textabstractIncreased homocysteine concentrations have been associated with cardiac outflow tract defects. It has been hypothesized that cardiac neural crest cells were the target cells in these malformations. Cardiac neural crest cells migrate from the neural tube and contribute to the condensed

  2. The right ventricular outflow tract in tetralogy of Fallot by preoperative cardiac angiography

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    Lee, Yong Chul; Lee, Jung Sook; Yoo, Soo Woong; Yu, Hoe Sung; Kim, Han Suk [National Medical Center, Seoul (Korea, Republic of)

    1979-06-15

    The underdevelopment of the right ventricular outflow tract is the essence among the main components of the tetralogy of Fallot. The detail and exact information about the states of the outflow tract in each patients with tetralogy of Fallot are very important to cardiac surgery. Fourteen patients of tetralogy of Fallet (12 undergone open heart surgery and 2, palliative) are available for their clinical chart and for cardiac angiography reviews. Analysis of them focusing the right ventricular outflow tract discloses the following results: 1. Average ratios of the systole to diastole of the pulmonary infundibulum are 0.63 {+-} 0.03 with the range of 0.44 to 1.0 cm P-A, and 0.64 {+-} 0.12 with the range of 0.5 to 0.83 on lateral projections. These results indicate relatively fixed infundibular stenosis of TOF. 2. Average infundibular systole to pulmonary bulb ratios are 0.24 {+-} 0.05 on P-A, and 0.36 {+-} 0.17 on lateral projections, which mean the underdeveloped and narrowed infundibulum more than the pulmonary truck in TOF. 3. Average pulmonary to aortic bulb ratios are 0.59 {+-} 0.01 on P-A, 0.54 {+-} 0.01 on lateral projections. These suggest hypoplasia of the pulmonary truck and anteriorly displaced conus septum and truncus septum from a developmental point of view. 4. The overriding degree of the aorta in our series are from 25% to 50% by Kjellberg et al classification.

  3. The right ventricular outflow tract in tetralogy of Fallot by preoperative cardiac angiography

    International Nuclear Information System (INIS)

    Lee, Yong Chul; Lee, Jung Sook; Yoo, Soo Woong; Yu, Hoe Sung; Kim, Han Suk

    1979-01-01

    The underdevelopment of the right ventricular outflow tract is the essence among the main components of the tetralogy of Fallot. The detail and exact information about the states of the outflow tract in each patients with tetralogy of Fallot are very important to cardiac surgery. Fourteen patients of tetralogy of Fallet (12 undergone open heart surgery and 2, palliative) are available for their clinical chart and for cardiac angiography reviews. Analysis of them focusing the right ventricular outflow tract discloses the following results: 1. Average ratios of the systole to diastole of the pulmonary infundibulum are 0.63 ± 0.03 with the range of 0.44 to 1.0 cm P-A, and 0.64 ± 0.12 with the range of 0.5 to 0.83 on lateral projections. These results indicate relatively fixed infundibular stenosis of TOF. 2. Average infundibular systole to pulmonary bulb ratios are 0.24 ± 0.05 on P-A, and 0.36 ± 0.17 on lateral projections, which mean the underdeveloped and narrowed infundibulum more than the pulmonary truck in TOF. 3. Average pulmonary to aortic bulb ratios are 0.59 ± 0.01 on P-A, 0.54 ± 0.01 on lateral projections. These suggest hypoplasia of the pulmonary truck and anteriorly displaced conus septum and truncus septum from a developmental point of view. 4. The overriding degree of the aorta in our series are from 25% to 50% by Kjellberg et al classification.

  4. Dishevelled 2 is essential for cardiac outflow tract development, somite segmentation and neural tube closure.

    Science.gov (United States)

    Hamblet, Natasha S; Lijam, Nardos; Ruiz-Lozano, Pilar; Wang, Jianbo; Yang, Yasheng; Luo, Zhenge; Mei, Lin; Chien, Kenneth R; Sussman, Daniel J; Wynshaw-Boris, Anthony

    2002-12-01

    The murine dishevelled 2 (Dvl2) gene is an ortholog of the Drosophila segment polarity gene Dishevelled, a member of the highly conserved Wingless/Wnt developmental pathway. Dvl2-deficient mice were produced to determine the role of Dvl2 in mammalian development. Mice containing null mutations in Dvl2 present with 50% lethality in both inbred 129S6 and in a hybrid 129S6-NIH Black Swiss background because of severe cardiovascular outflow tract defects, including double outlet right ventricle, transposition of the great arteries and persistent truncus arteriosis. The majority of the surviving Dvl2(-/-) mice were female, suggesting that penetrance was influenced by sex. Expression of Pitx2 and plexin A2 was attenuated in Dvl2 null mutants, suggesting a defect in cardiac neural crest development during outflow tract formation. In addition, approximately 90% of Dvl2(-/-) mice have vertebral and rib malformations that affect the proximal as well as the distal parts of the ribs. These skeletal abnormalities were more pronounced in mice deficient for both Dvl1 and Dvl2. Somite differentiation markers used to analyze Dvl2(-/-) and Dvl1(-/-);Dvl2(-/-) mutant embryos revealed mildly aberrant expression of Uncx4.1, delta 1 and myogenin, suggesting defects in somite segmentation. Finally, 2-3% of Dvl2(-/-) embryos displayed thoracic spina bifida, while virtually all Dvl1/2 double mutant embryos displayed craniorachishisis, a completely open neural tube from the midbrain to the tail. Thus, Dvl2 is essential for normal cardiac morphogenesis, somite segmentation and neural tube closure, and there is functional redundancy between Dvl1 and Dvl2 in some phenotypes.

  5. Primary cardiac tumor presenting as left ventricular outflow tract obstruction and complex arrhythmia.

    Science.gov (United States)

    Fries, R; Achen, S; O'Brien, M T; Jackson, N D; Gordon, S

    2017-10-01

    An adult female mixed breed dog presented for recurrent collapsing episodes over several weeks. Holter evaluation revealed periods of sinus arrest and echocardiography identified a soft tissue mass with subsequent severe dynamic obstruction of the left ventricular outflow tract. The patient was euthanized five days after presentation for severe dyspnea. Necropsy revealed an irregular mass circumferentially lining the left ventricular outflow tract as well as multiple myocardial metastases. The final diagnosis was an undifferentiated pleomorphic endocardial sarcoma. Published by Elsevier B.V.

  6. Assessment of cardiac blood pool imaging in patients with left ventricular outflow tract stenosis

    International Nuclear Information System (INIS)

    Nakamura, Yutaka; Ono, Yasuo; Kohata, Tohru; Tsubata, Shinichi; Kamiya, Tetsuroh.

    1993-01-01

    We performed cardiac blood pool imagings with Tc-99m at rest and during supine ergometer exercise to evaluate left ventricular performance in 14 patients with left ventricular outflow tract stenosis. All catheterized patients were divided into two subgroups: 8 patients with peak systolic left ventricular to descending aortic pressure gradients of less than 50 mmHg (LPG group) and 6 patients with peak systolic gradients of more than 50 mmHg (HPG group). Control group included 10 patients without stenotic coronary lesions after Kawasaki disease. Left ventricular ejection fraction (LVEF) was obtained as systolic index; both filling fraction during the first third of diastole (1/3FF) and mean filling rate during the first third of diastole (1/3FR mean) were obtained as diastolic indices. None of the patients had abnormal findings on 201 Tl imaging. LVEF at rest in HPG group was significantly higher than those in control group, but LVEF in HPG group did not increase after exercise. It increased significantly in control group and LPG group. 1/3 FF in HPG group was significantly lower not only at rest but also during exercise. 1/3 FR mean at rest was not different significantly among the 3 groups. However, 1/3FR mean during exercise in LPG group was significantly lower; and 1/3 FR mean during exercise was significantly lower in HPG group than LPG group. The ratio of left ventricular muscular mass to left ventricular end-diastolic volume (M/V) calculated from left ventricular cineangiograms was different significantly among the 3 groups. The M/V ratio showed a correlation with LVEF and 1/3 FF both at rest and during exercise. These results would indicate that systolic function was impaired on exercise in severe left ventricular outflow tract stenosis and diastolic function was impaired on exercise in mild and severe left ventricular outflow tract stenosis. This may correlate with left ventricular hypertrophy and interaction of systolic function. (author)

  7. Extracting cardiac shapes and motion of the chick embryo heart outflow tract from four-dimensional optical coherence tomography images

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    Yin, Xin; Liu, Aiping; Thornburg, Kent L.; Wang, Ruikang K.; Rugonyi, Sandra

    2012-09-01

    Recent advances in optical coherence tomography (OCT), and the development of image reconstruction algorithms, enabled four-dimensional (4-D) (three-dimensional imaging over time) imaging of the embryonic heart. To further analyze and quantify the dynamics of cardiac beating, segmentation procedures that can extract the shape of the heart and its motion are needed. Most previous studies analyzed cardiac image sequences using manually extracted shapes and measurements. However, this is time consuming and subject to inter-operator variability. Automated or semi-automated analyses of 4-D cardiac OCT images, although very desirable, are also extremely challenging. This work proposes a robust algorithm to semi automatically detect and track cardiac tissue layers from 4-D OCT images of early (tubular) embryonic hearts. Our algorithm uses a two-dimensional (2-D) deformable double-line model (DLM) to detect target cardiac tissues. The detection algorithm uses a maximum-likelihood estimator and was successfully applied to 4-D in vivo OCT images of the heart outflow tract of day three chicken embryos. The extracted shapes captured the dynamics of the chick embryonic heart outflow tract wall, enabling further analysis of cardiac motion.

  8. Inactivation of Bmp4 from the Tbx1 Expression Domain Causes Abnormal Pharyngeal Arch Artery and Cardiac Outflow Tract Remodeling

    Science.gov (United States)

    Nie, Xuguang; Brown, Christopher B.; Wang, Qin; Jiao, Kai

    2011-01-01

    Maldevelopment of outflow tract and aortic arch arteries is among the most common forms of human congenital heart diseases. Both Bmp4 and Tbx1 are known to play critical roles during cardiovascular development. Expression of these two genes partially overlaps in pharyngeal arch areas in mouse embryos. In this study, we applied a conditional gene inactivation approach to test the hypothesis that Bmp4 expressed from the Tbx1 expression domain plays a critical role for normal development of outflow tract and pharyngeal arch arteries. We showed that inactivation of Bmp4 from Tbx1-expressing cells leads to the spectrum of deformities resembling the cardiovascular defects observed in human DiGeorge syndrome patients. Inactivation of Bmp4 from the Tbx1 expression domain did not cause patterning defects, but affected remodeling of outflow tract and pharyngeal arch arteries. Our further examination revealed that Bmp4 is required for normal recruitment/differentiation of smooth muscle cells surrounding the PAA4 and survival of outflow tract cushion mesenchymal cells. PMID:21123999

  9. Prediction and characterisation of a highly conserved, remote and cAMP responsive enhancer that regulates Msx1 gene expression in cardiac neural crest and outflow tract.

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    Miller, Kerry Ann; Davidson, Scott; Liaros, Angela; Barrow, John; Lear, Marissa; Heine, Danielle; Hoppler, Stefan; MacKenzie, Alasdair

    2008-05-15

    Double knockouts of the Msx1 and Msx2 genes in the mouse result in severe cardiac outflow tract malformations similar to those frequently found in newborn infants. Despite the known role of the Msx genes in cardiac formation little is known of the regulatory systems (ligand receptor, signal transduction and protein-DNA interactions) that regulate the tissue-specific expression of the Msx genes in mammals during the formation of the outflow tract. In the present study we have used a combination of multi-species comparative genomics, mouse transgenic analysis and in-situ hybridisation to predict and validate the existence of a remote ultra-conserved enhancer that supports the expression of the Msx1 gene in migrating mouse cardiac neural crest and the outflow tract primordia. Furthermore, culturing of embryonic explants derived from transgenic lines with agonists of the PKC and PKA signal transduction systems demonstrates that this remote enhancer is influenced by PKA but not PKC dependent gene regulatory systems. These studies demonstrate the efficacy of combining comparative genomics and transgenic analyses and provide a platform for the study of the possible roles of Msx gene mis-regulation in the aetiology of congenital heart malformation.

  10. 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.

  11. 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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    Etheridge, S Leah; Ray, Saugata; Li, Shuangding; Hamblet, Natasha S; Lijam, Nardos; Tsang, Michael; Greer, Joy; Kardos, Natalie; Wang, Jianbo; Sussman, Daniel J; Chen, Ping; Wynshaw-Boris, Anthony

    2008-11-01

    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.

  12. 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.

  13. 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.

  14. Systemic Embolization from an Unusual Intracardiac Mass in the Left Ventricular Outflow Tract

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    Kelechukwu U. Okoro

    2017-01-01

    Full Text Available Endocarditis can affect any endocardial surface; in the vast majority of cases, the cardiac valves are involved. It is exceedingly rare to develop infective endocarditis on the endocardium of the left ventricular outflow tract due to the high velocity of blood that traverses this area. Herein, we present a rare case of left ventricular outflow tract endocarditis that likely occurred secondary to damage to the aortic valve leaflets (from healed prior aortic valve endocarditis causing a high velocity aortic valve regurgitant jet that impinged upon the interventricular septum which damaged the endocardium and resulted in a fibrotic “jet lesion.” This fibrous jet lesion served as a nidus for bacterial proliferation and vegetation formation. The high shear stress (due to high blood flow velocity through the left ventricular outflow tract likely promoted the multiple embolic events observed in this case. Our patient was successfully treated with aortic valve replacement, vegetation resection, and antibiotics.

  15. Acromegaly-induced cardiomyopathy with dobutamine-induced outflow tract obstruction.

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    Abdelsalam, Mahmoud A; Nippoldt, Todd B; Geske, Jeffrey B

    2016-03-09

    A 50-year-old man with a history of acromegaly was referred for preoperative cardiac evaluation preceding trans-sphenoidal resection of a pituitary macroadenoma. Dobutamine stress echocardiography was negative for myocardial ischaemia. Resting left ventricular (LV) LV ejection fraction (LVEF) was 64% and there was hypertrophy of ventricular septum (18 mm) without resting LV outflow tract obstruction. With 40 µg/kg/min of dobutamine, the LVEF became hyperdynamic at 80%, and there was a maximal instantaneous LV outflow tract gradient of 77 mm Hg. There was no delayed myocardial enhancement on cardiac MRI and the pattern of hypertrophy was concentric. Acromegaly-induced cardiomyopathy can mimic hypertrophic cardiomyopathy in the setting of dobutamine provocation. Because cardiomyopathy is an important cause of mortality in acromegaly, diagnosis and appropriate management are critical to improve survival. 2016 BMJ Publishing Group Ltd.

  16. [The reasonable use of right ventricular protection strategy in right ventricular outflow tract reconstruction].

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    Zhang, Y; Yuan, H Y; Liu, X B; Wen, S S; Xu, G; Cui, H J; Zhuang, J; Chen, J M

    2018-06-01

    As a result of right ventricular outflow tract reconstruction, which is the important and basic step of complex cardiac surgery, the blood flow of right ventricular outflow tract is unobstructed, while pulmonary valve regurgitation and right heart dysfunction could be happened. These problems are often ignored in early days, more and more cases of right heart dysfunction need clinical intervention, which is quite difficult and less effective. How to protect effectively the right ventricular function is the focus. At present main methods to protect the right ventricular function include trying to avoid or reduce length of right ventricular incision, reserving or rebuilding the function of the pulmonary valve, using growth potential material for surgery. The protection of the right ventricular function is a systemic project, it involves many aspects, single measures is difficult to provide complete protection, only the comprehensive use of various protection strategy, can help to improve the long-term prognosis.

  17. Outflow tract septation and the aortic arch system in reptiles: lessons for understanding the mammalian heart

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    Robert E. Poelmann

    2017-05-01

    Full Text Available Abstract Background Cardiac outflow tract patterning and cell contribution are studied using an evo-devo approach to reveal insight into the development of aorto-pulmonary septation. Results We studied embryonic stages of reptile hearts (lizard, turtle and crocodile and compared these to avian and mammalian development. Immunohistochemistry allowed us to indicate where the essential cell components in the outflow tract and aortic sac were deployed, more specifically endocardial, neural crest and second heart field cells. The neural crest-derived aorto-pulmonary septum separates the pulmonary trunk from both aortae in reptiles, presenting with a left visceral and a right systemic aorta arising from the unseptated ventricle. Second heart field-derived cells function as flow dividers between both aortae and between the two pulmonary arteries. In birds, the left visceral aorta disappears early in development, while the right systemic aorta persists. This leads to a fusion of the aorto-pulmonary septum and the aortic flow divider (second heart field population forming an avian aorto-pulmonary septal complex. In mammals, there is also a second heart field-derived aortic flow divider, albeit at a more distal site, while the aorto-pulmonary septum separates the aortic trunk from the pulmonary trunk. As in birds there is fusion with second heart field-derived cells albeit from the pulmonary flow divider as the right 6th pharyngeal arch artery disappears, resulting in a mammalian aorto-pulmonary septal complex. In crocodiles, birds and mammals, the main septal and parietal endocardial cushions receive neural crest cells that are functional in fusion and myocardialization of the outflow tract septum. Longer-lasting septation in crocodiles demonstrates a heterochrony in development. In other reptiles with no indication of incursion of neural crest cells, there is either no myocardialized outflow tract septum (lizard or it is vestigial (turtle. Crocodiles

  18. Outflow tract septation and the aortic arch system in reptiles: lessons for understanding the mammalian heart.

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    Poelmann, Robert E; Gittenberger-de Groot, Adriana C; Biermans, Marcel W M; Dolfing, Anne I; Jagessar, Armand; van Hattum, Sam; Hoogenboom, Amanda; Wisse, Lambertus J; Vicente-Steijn, Rebecca; de Bakker, Merijn A G; Vonk, Freek J; Hirasawa, Tatsuya; Kuratani, Shigeru; Richardson, Michael K

    2017-01-01

    Cardiac outflow tract patterning and cell contribution are studied using an evo-devo approach to reveal insight into the development of aorto-pulmonary septation. We studied embryonic stages of reptile hearts (lizard, turtle and crocodile) and compared these to avian and mammalian development. Immunohistochemistry allowed us to indicate where the essential cell components in the outflow tract and aortic sac were deployed, more specifically endocardial, neural crest and second heart field cells. The neural crest-derived aorto-pulmonary septum separates the pulmonary trunk from both aortae in reptiles, presenting with a left visceral and a right systemic aorta arising from the unseptated ventricle. Second heart field-derived cells function as flow dividers between both aortae and between the two pulmonary arteries. In birds, the left visceral aorta disappears early in development, while the right systemic aorta persists. This leads to a fusion of the aorto-pulmonary septum and the aortic flow divider (second heart field population) forming an avian aorto-pulmonary septal complex. In mammals, there is also a second heart field-derived aortic flow divider, albeit at a more distal site, while the aorto-pulmonary septum separates the aortic trunk from the pulmonary trunk. As in birds there is fusion with second heart field-derived cells albeit from the pulmonary flow divider as the right 6th pharyngeal arch artery disappears, resulting in a mammalian aorto-pulmonary septal complex. In crocodiles, birds and mammals, the main septal and parietal endocardial cushions receive neural crest cells that are functional in fusion and myocardialization of the outflow tract septum. Longer-lasting septation in crocodiles demonstrates a heterochrony in development. In other reptiles with no indication of incursion of neural crest cells, there is either no myocardialized outflow tract septum (lizard) or it is vestigial (turtle). Crocodiles are unique in bearing a central shunt, the

  19. Right Ventricular Outflow Tract Tachycardia with Structural Abnormalities of the Right Ventricle and Left Ventricular Diverticulum

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    Bortolo Martini

    2015-01-01

    Full Text Available A 43-year-old woman presented to the emergency room with a sustained ventricular tachycardia (VT. ECG showed a QRS in left bundle branch block morphology with inferior axis. Echocardiography, ventricular angiography, and cardiac magnetic resonance imaging (CMRI revealed a normal right ventricle and a left ventricular diverticulum. Electrophysiology studies with epicardial voltage mapping identified a large fibrotic area in the inferolateral layer of the right ventricular wall and a small area of fibrotic tissue at the anterior right ventricular outflow tract. VT ablation was successfully performed with combined epicardial and endocardial approaches.

  20. Changes in dynamic embryonic heart wall motion in response to outflow tract banding measured using video densitometry

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    Stovall, Stephanie; Midgett, Madeline; Thornburg, Kent; Rugonyi, Sandra

    2016-11-01

    Abnormal blood flow during early cardiovascular development has been identified as a key factor in the pathogenesis of congenital heart disease; however, the mechanisms by which altered hemodynamics induce cardiac malformations are poorly understood. This study used outflow tract (OFT) banding to model increased afterload, pressure, and blood flow velocities at tubular stages of heart development and characterized the immediate changes in cardiac wall motion due to banding in chicken embryo models with light microscopy-based video densitometry. Optical videos were used to acquire two-dimensional heart image sequences over the cardiac cycle, from which intensity data were extracted along the heart centerline at several locations in the heart ventricle and OFT. While no changes were observed in the synchronous contraction of the ventricle with banding, the peristaltic-like wall motion in the OFT was significantly affected. Our data provide valuable insight into early cardiac biomechanics and its characterization using a simple light microscopy-based imaging modality.

  1. Recognition and treatment of outflow tract stenosis during and after endovascular exclusion for abdominal aortic aneurysm

    International Nuclear Information System (INIS)

    Lu Qingsheng; Jing Zaiping; Zhao Zhiqing; Bao Junmin; Zhao Jun; Feng Xiang; Feng Rui; Huang Sheng

    2003-01-01

    Objective: To study the cognition and treatment of outflow tract stenosis in and after endovascular exclusion for abdominal aortic aneurysm. Methods: From Mar 1997 to Oct 2002, in 136 patients undergoing abdominal aortic aneurysm endovascular exclusion, 8 patients had outflow tract stenosis during the operation, and 3 patients had outflow tract stenosis after operation. The stenosis of 5 patients occurred at the crotch of the graft-stent. PTA was done in 7 patients and stents were placed in stenotic segment in 2 patients. 2 patients were treated with crossover operation. Results: Following up 1 month to 2 years, all patients have no lower limbs ischemia. Conclusions: The diagnosis of outflow tract stenosis during and after abdominal endovascular exclusion for aortic aneurysm must be in time. The treatment should be according to the different causes of stenosis

  2. Dysregulated endocardial TGFβ signaling and mesenchymal transformation result in heart outflow tract septation failure.

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    Ma, Mancheong; Li, Peng; Shen, Hua; Estrada, Kristine D; Xu, Jian; Kumar, S Ram; Sucov, Henry M

    2016-01-01

    Heart outflow tract septation in mouse embryos carrying mutations in retinoic acid receptor genes fails with complete penetrance. In this mutant background, ectopic TGFβ signaling in the distal outflow tract is responsible for septation failure, but it was uncertain what tissue was responsive to ectopic TGFβ and why this response interfered with septation. By combining RAR gene mutation with tissue-specific Cre drivers and a conditional type II TGFβ receptor (Tgfbr2) allele, we determined that ectopic activation of TGFβ signaling in the endocardium is responsible for septation defects. Ectopic TGFβ signaling results in ectopic mesenchymal transformation of the endocardium and thereby in improperly constituted distal OFT cushions. Our analysis highlights the interactions between myocardium, endocardium, and neural crest cells in outflow tract morphogenesis, and demonstrates the requirement for proper TGFβ signaling in outflow tract cushion organization and septation. Copyright © 2015. Published by Elsevier Inc.

  3. [Surgical treatment of congenital obstruction of the left ventricular outflow tract].

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    Biocina, B; Sutlić, Z; Husedinović, I; Letica, D; Sokolić, J

    1993-01-01

    This report presents the classification and all types of left ventricular outflow tract obstructions. The possibilities of operative therapies are surveyed as well. Results of surgical treatment in 34 patients with obstruction to left ventricular outflow are shown. The majority of patients underwent operation under extracorporeal circulation (84.4%), while the rest were operated by means of the inflow occlusion technique (14.7%). The obtained results were compared with those from the literature. The importance of echocardiographic evaluation of location of the left ventricular outflow tract obstruction and the appropriate choice of a surgical technique according to the patient's age are emphasized.

  4. Left ventricular outflow tract arrhythmias with divergent QRS morphology: mapping of different exits and ablation strategy.

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    Reithmann, Christopher; Fiek, Michael

    2018-01-01

    Ventricular arrhythmias (VAs) from the left ventricular outflow tract (LVOT) can have multiple exits exhibiting divergent ECG features. In a series of 131 patients with VAs with LVOT origin, 10 patients presented with divergent QRS morphologies. Multisite endo- and epicardial mapping of different exit sites was performed. The earliest ventricular activity of 23 LVOT VAs in 10 patients was detected in the endocardium of the LV in 7 patients, the aortic sinuses of Valsalva (SoV) in 3 patients, the distal coronary sinus in 6 patients, the anterior interventricular vein in 3 patients, and the posterior right ventricular outflow tract (RVOT) in 4 patients. Simultaneous elimination of two divergent QRS morphologies of LVOT VAs by ablation from a single site was achieved in 5 patients (aorto-mitral continuity in 3 patients, SoV and RVOT in each 1 patient) using a mean maximum ablation energy of 46 ± 5 W. Sequential ablation from two or three different sites, including trans-pericardial and distal coronary sinus ablation in each 2 patients, led to elimination of the divergent VA QRS morphologies in the other 5 patients. During the follow-up of 28 ± 29 months, 4 of the 10 patients had recurrence of at least one LVOT VA. A 43-year-old patient with muscular dystrophy Curschmann-Steinert had recurrence of sustained LVOT VTs and died of sudden cardiac death. Multisite mapping of different exit sites of LVOT VAs can guide ablation of intramural foci but the recurrence rate after initially successful ablation was high.

  5. Stent migration after right ventricular outflow tract stenting in the severe cyanotic Tetralogy of Fallot case

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    Tamaki Hayashi

    2017-01-01

    Full Text Available We report our experience with a stent migration after right ventricle outflow tract stenting and converted to patent ductus arteriosus stenting in Tetralogy of Fallot (TOF with severe infundibular stenosis. Finally, the patient achieved to TOF repair, and the migrated stent was removed without any complication.

  6. The role of hemodynamics in the development of the outflow tract of the heart

    NARCIS (Netherlands)

    Loots, Erwin; Hillen, Berend; Veldman, Arthur E.P.

    The question whether, and if so to what extent, hemodynamic forces and mechanical stimuli do modulate the morphogenesis of the vascular system is a century-old problem. It is important especially in the outflow tract where a spiraling septum develops in and after a strong bend in the tube. Spiraling

  7. Discrete potentials guided radiofrequency ablation for idiopathic outflow tract ventricular arrhythmias.

    Science.gov (United States)

    Liu, Enzhao; Xu, Gang; Liu, Tong; Ye, Lan; Zhang, Qitong; Zhao, Yanshu; Li, Guangping

    2015-03-01

    Discrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias. The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs). Seventeen consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation were included. Intracardiac electrograms during the mapping and ablation were analysed. During sinus rhythm, sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular electrograms in all of the 17 patients, peak amplitude 0.51 ± 0.21 mV. The same potential was recorded prior to the local ventricular potential of the PVCs/VTs. Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram during the arrhythmias was noted. The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping. At the sites with DPs, lower unipolar and bipolar ventricular voltage of sinus beats were noted compared with the adjacent regions without DPs (unipolar: 6.1 ± 1.8 vs. 8.3 ± 2.3 mV, P Discrete potentials were not present in seven controls. Discrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias. Discrete potential- and substrate-guided ablation strategy will help to reduce the recurrence of idiopathic outflow tract arrhythmias. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  8. 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......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 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

  9. 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.

  10. Dynamic right ventricular outflow tract (infundibular) stenosis and pectus excavatum in a dog

    OpenAIRE

    Fournier, Tanya E.

    2008-01-01

    This is the first published report of a dog with dynamic right ventricular outflow tract (infundibular) stenosis, right ventricular hypertrophy, and pectus excavatum. A juvenile dog presented with a grade V/VI left base systolic heart murmur, tachycardia, and pectus excavatum. Diagnosis of the aforementioned conditions was based on radiography, electrocardiography, and echocardiography. At 9 1/2 wk of age the heart murmur was no longer audible and the right ventricular stenosis and hypertroph...

  11. Dynamic Changes of QRS Morphology of Premature Ventricular Contractions During Ablation in the Right Ventricular Outflow Tract: A Case Report.

    Science.gov (United States)

    Yue-Chun, Li; Jia-Feng, Lin; Jia-Xuan, Lin

    2015-10-01

    Electrocardiographic characteristics can be useful in differentiating between right ventricular outflow tract (RVOT) and aortic sinus cusp (ASC) ventricular arrhythmias. Ventricular arrhythmias originating from ASC, however, show preferential conduction to RVOT that may render the algorithms of electrocardiographic characteristics less reliable. Even though there are few reports describing ventricular arrhythmias with ASC origins and endocardial breakout sites of RVOT, progressive dynamic changes in QRS morphology of the ventricular arrhythmias during ablation obtained were rare.This case report describes a patient with symptomatic premature ventricular contractions of left ASC origin presenting an electrocardiogram (ECG) characteristic of right ventricular outflow tract before ablation. Pacing at right ventricular outflow tract reproduced an excellent pace map. When radiofrequency catheter ablation was applied to the right ventricular outflow tract, the QRS morphology of premature ventricular contractions progressively changed from ECG characteristics of right ventricular outflow tract origin to ECG characteristics of left ASC origin.Successful radiofrequency catheter ablation was achieved at the site of the earliest ventricular activation in the left ASC. The distance between the successful ablation site of the left ASC and the site with an excellent pace map of the RVOT was 20 mm.The ndings could be strong evidence for a preferential conduction via the myocardial bers from the ASC origin to the breakout site in the right ventricular outflow tract. This case demonstrates that ventricular arrhythmias with a single origin and exit shift may exhibit QRS morphology changes.

  12. Anesthetic management of Amplatzer atrial septal defect closure device embolization to right ventricular outflow tract

    Directory of Open Access Journals (Sweden)

    S Das

    2016-01-01

    Full Text Available Percutaneous device closure of atrial septal defect (ASD is an alternative treatment to surgery with advantages of avoidance of surgery, short procedure time, early discharge from hospital, and lower rates of complications. However, percutaneous device closure is associated with infrequent life-threatening complications such as device embolization. We report a case device embolization of the ASD occlude device into right ventricular outflow tract resulting progressive hypoxia. The role of anesthesiologist as a team leader in managing such emergency is discussed.

  13. Managing the right ventricular outflow tract for pulmonary regurgitation after tetralogy of Fallot repair

    Science.gov (United States)

    Hauser, Michael; Eicken, Andreas; Kuehn, Andreas; Hess, John; Fratz, Sohrab; Ewert, Peter; Kaemmerer, Harald

    2013-01-01

    The long-term outcome of patients with tetralogy of Fallot (TOF) with reconstruction of the right ventricular (RV) outflow tract is often complicated by the sequelae of severe pulmonary regurgitation. Progressive enlargement of the right ventricle, biventricular dysfunction and arrhythmia are apparent in more than 50% of the patients in the fourth decade of life. Pathophysiologic implications, clinical assessment and diagnostic modalities are discussed, whereas CMR imaging seems to be the procedure of choice. Therapeutical options for rereconstruction of the RV outflow tract are mentioned, surgical and interventional procedures are explained in detail. The optimal timing of reoperation for significant pulmonary regurgitation after TOF repair is still a matter of controversy given the limited runtime of the lately implanted prostheses and the risk of further reoperation. Early surgery is recommended in these patients before symptoms develop, or RV function has declined. Today we believe that waiting for the patient to become symptomatic is too late. All in all, pulmonary valve replacement is at least indicated in patients developing symptoms due to severe pulmonary regurgitation, particularly if associated with substantial or progressive RV dilatation, tricuspid regurgitation and/or supraventricular or ventricular arrhythmias. PMID:27326099

  14. Right ventricular outflow tract systolic function correlates with exercise capacity in patients with severe right ventricle dilatation after repair of tetralogy of Fallot.

    Science.gov (United States)

    Luo, Shuhua; Li, Jianhua; Yang, Dan; Zhou, Yaxin; An, Qi; Chen, Yucheng

    2017-05-01

    The relationship between exercise capacity and right ventricular (RV) components function in repaired tetralogy of Fallot patients with severely dilated right ventricles is poorly understood. The aim of this study was to characterize the exercise capacity and its relationship to RV global and components function in repaired tetralogy of Fallot patients with RV end-diastolic volume index  >150 ml/m 2 , a currently accepted threshold for pulmonary valve replacement. The medical records and results of cardiac magnetic resonance imaging and cardiopulmonary exercise testing of 25 consecutive eligible patients were reviewed. Twenty age- and gender-matched normal subjects were enrolled as cardiac magnetic resonance control. End-diastolic, end-systolic and stroke volumes, and ejection fraction (EF) were determined for the total RV and its components. Of the 25 patients, 44% maintained normal exercise capacity. RV outlet EF was higher ( P  = 0.02) and RV incisions smaller ( P  = 0.04) in patients with normal exercise capacity than those with subnormal exercise capacity. Predicted peak oxygen consumption correlated better with the RV outflow tract EF than with the EF of other components of the RV or the global EF ( r  = 0.59; P  = 0.002). Multivariate analysis showed the RV outflow tract EF to be the only independent predictor of exercise capacity (ß = 0.442; P  = 0.02). Exercise capacity is preserved in some tetralogy of Fallot patients with severe RV dilatation. RV outflow tract EF is independently associated with exercise capacity in such patients, and could be a reliable determinant of intrinsic RV performance. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  15. Preservation of Frontal Sinus Anatomy and Outflow Tract Following Frontal Trauma with Dural Defect

    Directory of Open Access Journals (Sweden)

    James Wei Ming Kwek, MBBS, MRCS

    2015-02-01

    Full Text Available Summary: Our case report describes a young male mechanic who was hit in his face by a spring while repairing a car, resulting in traumatic injury to the frontal sinus, with fractures of both the anterior and the posterior tables with dural defect and cerebrospinal fluid leak. Current guidelines recommend that comminuted and/or displaced fractures of the posterior table of the frontal sinus with dural defects should be either cranialized or obliterated. In this patient, instead of cranializing or obliterating the frontal sinus, we managed to preserve the frontal sinus anatomy and its outflow tract using a combined open bicoronal and nasoendoscopic approach. This avoids the long-term complications associated with cranialization or obliteration including mucocele formation and frontocutaneous fistula.

  16. 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.

  17. Stenting of right ventricular outflow tract in Tetralogy of Fallot with subarterial ventricular septal defect: A word of caution

    Directory of Open Access Journals (Sweden)

    Jonathan Lee

    2017-01-01

    Full Text Available We report a case of Tetralogy of Fallot with severe cyanosis who underwent a successful right ventricular outflow tract stenting. Follow-up echocardiography revealed moderate aortic regurgitation due to the impingement of the stent on the aortic valve. The patient underwent successful surgical correction at which time the stent was removed completely with a resolution of the aortic regurgitation.

  18. 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.

  19. Hemodynamic and metabolic characteristics associated with development of a right ventricular outflow tract pressure gradient during upright exercise

    NARCIS (Netherlands)

    van Riel, Annelieke C. M. J.; Systrom, David M.; Oliveira, Rudolf K. F.; Landzberg, Michael J.; Mulder, Barbara J. M.; Bouma, Berto J.; Maron, Bradley A.; Shah, Amil M.; Waxman, Aaron B.; Opotowsky, Alexander R.

    2017-01-01

    We recently reported a novel observation that many patients with equal resting supine right ventricular(RV) and pulmonary artery(PA) systolic pressures develop an RV outflow tract(RVOT) pressure gradient during upright exercise. The current work details the characteristics of patients who develop

  20. Contribution of mitral valve leaflet length and septal wall thickness to outflow tract obstruction in patients with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Morant, Kareem; Mikami, Yoko; Nevis, Immaculate; McCarty, David; Stirrat, John; Scholl, David; Rajchl, Martin; Giannoccaro, Peter; Kolman, Louis; Heydari, Bobby; Lydell, Carmen; Howarth, Andrew; Grant, Andrew; White, James A

    2017-08-01

    We sought to examine whether elongation of the mitral valve leaflets in patients with hypertrophic cardiomyopathy (HCM) is synergistic to septal wall thickness (SWT) in the development of left ventricular outflow tract obstruction (LVOTO). HCM is a common genetic cardiac disease characterized by asymmetric septal hypertrophy and predisposition towards LVOTO. It has been reported that elongation of the mitral valve leaflets may be a primary phenotypic feature and contribute to LVOTO. However, the relative contribution of this finding versus SWT has not been studied. 152 patients (76 with HCM and 76 non-diseased age, race and BSA-matched controls) and 18 young, healthy volunteers were studied. SWT and the anterior mitral valve leaflet length (AMVLL) were measured using cine MRI. The combined contribution of these variables (SWT × AMVLL) was described as the Septal Anterior Leaflet Product (SALP). Peak LVOT pressure gradient was determined by Doppler interrogation and defined as "obstructive" if ≥ 30 mmHg. Patients with HCM were confirmed to have increased AMVLL compared with controls and volunteers (p SALP were significantly higher in patients with LVOTO (N = 17) versus without. SALP showed modest improvement in predictive accuracy for LVOTO (AUC = 0.81) among the HCM population versus SWT alone (AUC = 0.77). However, in isolated patients this variable identified patients with LVOTO despite modest SWT. Elongation of the AMVLL is a primary phenotypic feature of HCM. While incremental contributions to LVOTO appear modest at a population level, specific patients may have dominant contribution to LVOTO. The combined marker of SALP allows for maintained identification of such patients despite modest increases in SWT.

  1. Right ventricular outflow tract stent versus BT shunt palliation in Tetralogy of Fallot.

    Science.gov (United States)

    Quandt, Daniel; Ramchandani, Bharat; Penford, Gemma; Stickley, John; Bhole, Vinay; Mehta, Chetan; Jones, Timothy; Barron, David James; Stumper, Oliver

    2017-12-01

    This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period. Procedure-related morbidity, mortality and reintervention rates were assessed and compared. Admission rate to paediatric intensive care unit (PICU) was lower in the RVOT stent group (22% vs 100%; pFallot-type lesions can be accomplished safely, with lower PICU admission rate, a shorter hospital length of stay and shorter duration of palliation until complete repair compared with mBTS palliation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. 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.

  3. [Isoproterenol stress test for the evaluation of the residual stenosis of the right ventricular outflow tract].

    Science.gov (United States)

    Suzuki, T; Fukuda, T; Kashima, I; Sato, M; Miura, M; Ueda, H; Yoshiba, S

    2001-07-01

    Hemodynamic changes of the right side of the heart during isoproterenol stress test were assessed and analyzed in 36 patients who underwent definitive repair of tetralogy of Fallot or double outlet right ventricle with pulmonary stenosis. Patients having atresia of the pulmonary artery were excluded from the study. 24 of the patients had previously undergone reconstruction of the right ventricular outflow tract (RVOT) with preserving the pulmonary valvar annulus (group N), whilst the remaining 12 patients had undergone transannular enlargement of RVOT with a patch (group T). Preservation of the pulmonary valvar annulus was determined when the intra-operative measurement of diameter of the pulmonary valvar annulus showed values greater than 90% of normal. In both groups, the isoproterenol infusion increased the right to left ventricular peak pressure (RVP/LVP) ratio, pressure gradient between the right ventricle and main pulmonary artery (RV-mPAP), and pressure gradient between the main pulmonary artery and peripheral pulmonary artery (m-pPAP). These values were significantly higher than those measured at rest. When comparisons were made between groups, RV-mPAP of group N was significantly higher than that of group T, both at rest and during stress test. By contrast, m-pPAP of group T was significantly higher than that of group N, both at rest and during stress test. Although no significant difference was found between the groups in RVP/LVP at rest and during stress test, RVP/LVP of both groups increased to the level of more than 0.6 after the isoproterenol infusion. These results led us to conclude that preservation of the pulmonary valvar annulus was better to be applied only to the patients who fulfilled our criterions. Additionally, in the setting of patch reconstruction of the pulmonary artery, every effort should be made so as not to leave the residual stenosis of the peripheral pulmonary artery.

  4. Results of transcatheter pulmonary valvulation in native or patched right ventricular outflow tracts.

    Science.gov (United States)

    Malekzadeh-Milani, Sophie; Ladouceur, Magalie; Cohen, Sarah; Iserin, Laurence; Boudjemline, Younes

    2014-11-01

    Although widely accepted worldwide, indications for percutaneous valve replacement are limited to treatment of dysfunction of prosthetic conduits inserted in the right ventricular outflow tract (RVOT). There has been little evaluation of the use of the Melody(®) valve for patched non-circular pulmonary pathways. To evaluate the outcomes of Melody valve insertion in patients with a patched non-circular RVOT. We analysed procedural and outcomes data from 34 patients who underwent Melody valve implantation for a non-circular RVOT. RVOT preparation was done in all patients, using different techniques (conventional, Russian doll and/or PA jailing). Melody valve insertion was performed concomitantly in most patients. All procedures were successful. Sixteen patients had complex additional procedures, including the jailing technique (n=5), the Russian doll technique (n=6) and multiple stent implantations (Russian jailing; n=5). The remaining patients were treated using the conventional technique with systematic prestenting. Three early complications occurred: one haemoptysis; one residual RVOT obstruction needing recatheterization 48 hours after percutaneous pulmonary valve implantation; and one stent embolization during advancement of the Ensemble(®) delivery system. The mean follow-up period was 2.6 years postprocedure. There was no stent fracture, migration or embolization. Two patients developed a significant paraprosthetic leak and one received a second Melody valve. Careful patient selection, balloon sizing and RVOT preparation with prestenting are required to create a safe landing zone for the Melody valve. Short-term follow-up shows excellent results with no stent fracture or migration and appears promising. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Improving left ventricular outflow tract obstruction repair in common atrioventricular canal defects.

    Science.gov (United States)

    Myers, Patrick O; del Nido, Pedro J; Marx, Gerald R; Emani, Sitaram; Mayer, John E; Pigula, Frank A; Baird, Christopher W

    2012-08-01

    Left ventricular outflow tract obstruction (LVOTO) is the second most frequent reason for reoperation after atrioventricular canal (AVC) defect repair. Limited data are available on the mechanisms of LVOTO, their treatment, and outcomes. Between 1998 and 2010, 56 consecutive children with AVC underwent 68 LVOTO procedures. The AVC was partial in 4, transitional in 9, and complete in 43. The LVOTO procedure was required in 21 patients at the primary AVC repair, and the initial LVOTO procedure in 35 patients was a late reoperation after AVC repair. During a mean follow-up of 50±41 months, 5 patients (24%) with LVOTO repair at AVC repair required a reoperation for LVOTO, and 7 patients (20%) whose initial LVOTO repair was a reoperation required a second reoperation for LVOTO repair. Overall freedom from LVOTO reoperation was 98.5% at 1 year, 92.5% at 3 years, 81% at 5 years, 72.2% at 7 years, and 52.5% at 10 and 12 years. The freedom from reoperation was neither significantly different between partial, transitional, and complete AVC (p=0.78) nor between timing of the LVOT procedure (p=0.49). Modified single-patch AVC repair was associated with a higher LVOTO reoperation rate (p=0.04). Neither the mechanisms leading to LVOTO nor the surgical techniques used were independent predictors of reoperation. LVOTO in AVC is a complex and multifactorial disease. Aggressive surgical repair has improved late outcomes; however, risk factors for reoperation and the ideal approach for repair remain to be defined. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. 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

  7. Clinical significance of a presystolic wave on Doppler examination of the left ventricular outflow tract.

    Science.gov (United States)

    Joshi, Kamal R; Kabirdas, Deepa; Romero-Corral, Abel; Shah, Mahek; Figueredo, Vincent M; Pressman, Gregg S

    2014-11-15

    A presystolic wave (PSW) is commonly seen on Doppler examination of the left ventricular outflow tract (LVOT), but is little studied. We conducted a retrospective study to assess the prevalence of the PSW, correlations with various Doppler parameters, and its clinical significance. Two hundred echocardiograms, 100 with ejection fraction (EF) >55% and 100 with EF <45%, were reviewed. Mitral inflow velocities, septal annular velocities, LVOT, and PSW velocities were measured. Major adverse cardiovascular events (MACE [death, heart failure hospitalization, atrial fibrillation, and stroke]) were compared between those with and without a PSW, in both EF groups. Mean age was 58 ± 15 years; 56% were men and 69% were African-American. PSW prevalence was similar between normal (68%) and reduced EF groups (62%). However, its velocity was less in the low EF group (37 ± 10 vs 48 ± 16 cm/s, p <0.0001). In subjects with normal EF PSW velocity correlated with mitral A velocity (rho = 0.43, p = 0.0003). In subjects with reduced EF the association with A velocity was not significant (rho = 0.22, p = 0.09), but there was a significant association with annular a' velocity (rho = 0.38, p = 0.002). Over a mean follow-up of 1.7 ± 0.3 years, 57 subjects (28%) experienced MACE. Those without a PSW had more MACE (39% vs 23%, p = 0.02); PSW absence remained predictive of MACE after adjustment for multiple variables, especially in patients with reduced EF. In conclusion, PSW is common in the LVOT. Its presence and magnitude are associated with measures of atrial contraction. Its absence is associated with increased rates of adverse events, especially in patients with low EF. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Effect of right ventricular electrode location (outflow tract vs. apex) on mechanical Ventricular synchrony in patients that underwent pacemaker implant therapy

    International Nuclear Information System (INIS)

    Rincon, Oscar S; Saenz, Luis C; Salazar, Gabriel; Hernandez, Edgar

    2008-01-01

    Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials And Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent trans thoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group). There was no structural cardiopathy, ejection fraction was ? 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler) and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages.Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25%) a pre-implant ventricular asynchrony was found; in seven (70%) ventricular asynchrony post-implant in the right ventricle outflow tract and in 5 (50%) in the apex. Mean interventricular pot-implant delay was 21,6 ms in the right ventricular outflow tract and 11,5 ms in the apex (p = 0,8); mean septal to lateral wall delay was 73 ms in the right ventricular outflow tract and 26 ms in the apex (p = 0,8). QRS post-implant delay was 134 ms in the right ventricular outflow tract and 140 ms in the apex (p = 0,1). No differences between implant parameters and device programming were found. Conclusions: presence of ventricular asynchrony was evidenced in patients with normal QRS and structurally healthy heart. Ventricular stimulation with pacemaker from the apex or the right ventricular outflow tract suggests acute ventricular asynchrony at least in 60% of the cases, without statistically significant difference between both groups.

  9. Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma

    OpenAIRE

    AOKI, Takuma; SUNAHARA, Hiroshi; SUGIMOTO, Keisuke; ITO, Tetsuro; KANAI, Eiichi; NEO, Sakurako; FUJII, Yoko; WAKAO, Yoshito

    2015-01-01

    Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites....

  10. Cardiac parasympathetic outflow during dynamic exercise in humans estimated from power spectral analysis of P-P interval variability.

    Science.gov (United States)

    Takahashi, Makoto; Nakamoto, Tomoko; Matsukawa, Kanji; Ishii, Kei; Watanabe, Tae; Sekikawa, Kiyokazu; Hamada, Hironobu

    2016-03-01

    What is the central question of this study? Should we use the high-frequency (HF) component of P-P interval as an index of cardiac parasympathetic nerve activity during moderate exercise? What is the main finding and its importance? The HF component of P-P interval variability remained even at a heart rate of 120-140 beats min(-1) and was further reduced by atropine, indicating incomplete cardiac vagal withdrawal during moderate exercise. The HF component of R-R interval is invalid as an estimate of cardiac parasympathetic outflow during moderate exercise; instead, the HF component of P-P interval variability should be used. The high-frequency (HF) component of R-R interval variability has been widely used as an indirect estimate of cardiac parasympathetic (vagal) outflow to the sino-atrial node of the heart. However, we have recently found that the variability of the R-R interval becomes much smaller during dynamic exercise than that of the P-P interval above a heart rate (HR) of ∼100 beats min(-1). We hypothesized that cardiac parasympathetic outflow during dynamic exercise with a higher intensity may be better estimated using the HF component of P-P interval variability. To test this hypothesis, the HF components of both P-P and R-R interval variability were analysed using a Wavelet transform during dynamic exercise. Twelve subjects performed ergometer exercise to increase HR from the baseline of 69 ± 3 beats min(-1) to three different levels of 100, 120 and 140 beats min(-1). We also examined the effect of atropine sulfate on the HF components in eight of the 12 subjects during exercise at an HR of 140 beats min(-1) . The HF component of P-P interval variability was significantly greater than that of R-R interval variability during exercise, especially at the HRs of 120 and 140 beats min(-1). The HF component of P-P interval variability was more reduced by atropine than that of R-R interval variability. We conclude that cardiac parasympathetic outflow to the

  11. Dynamic left ventricular outflow tract obstruction secondary to hypovolemia in a German Shepard dog with splenic hemangiosarcoma.

    Science.gov (United States)

    Aoki, Takuma; Sunahara, Hiroshi; Sugimoto, Keisuke; Ito, Tetsuro; Kanai, Eiichi; Neo, Sakurako; Fujii, Yoko; Wakao, Yoshito

    2015-09-01

    Dynamic left ventricular outflow tract obstruction (DLVOTO) is a common condition in cats and humans. In this case report, a dog is described with DLVOTO secondary to severe intra-abdominal hemorrhage caused by a hemangiosarcoma. The dog was a 9-year-old, 35.7-kg, spayed female German Shepard dog that presented with a history of tachypnea and collapse. A Levine II/VI systolic murmur was present at the heart base. Abdominal ultrasonography revealed a splenic mass and a large amount of ascites. Echocardiography showed a reduced left ventricular diameter and an increased aortic velocity caused by systolic anterior motion (SAM) of the mitral valve apparatus. The heart murmur and the SAM were resolved after treatment including a splenectomy and a blood transfusion.

  12. 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.

  13. Right Ventricular Outflow Tract Stenting in Tetralogy of Fallot Infants With Risk Factors for Early Primary Repair.

    Science.gov (United States)

    Sandoval, Juan Pablo; Chaturvedi, Rajiv R; Benson, Lee; Morgan, Gareth; Van Arsdell, Glen; Honjo, Osami; Caldarone, Christopher; Lee, Kyong-Jin

    2016-12-01

    Tetralogy of Fallot with cyanosis requiring surgical repair in early infancy reflects poor anatomy and is associated with more clinical instability and longer hospitalization than those who can be electively repaired later. We bridged symptomatic infants with risk factors for early primary repair by right ventricular outflow tract stenting (stent). Four groups of tetralogy of Fallot with confluent central pulmonary arteries were studied: stent group (n=42), primary repair (aged 3mo group; n=45). Stent patients had the smallest pulmonary arteries with a median (95% credible intervals) Nakata index (mm 2 /m 2 ) of 79 (66-85) compared with the early-PA 139 (129-154), early-PS 136 (121-153), and surg>3mo 167 (153-200) groups. Only stent infants required unifocalization of aortopulmonary collaterals (17%). Stent and early-PA infants had younger age and lower weight than early-PS infants. Stent infants had the most multiple comorbidities. Stenting allowed deferral of complete surgical repair to an age (6 months), weight (6.3 [5.8-7.0] kg), and Nakata index (147 [132-165]) similar to the low-risk surg>3mo group. The 3 early treatment groups had similar intensive care unit/hospital stays and high reintervention rates in the first 12 months after repair, compared with the surg>3mo group. Right ventricular outflow tract stenting of symptomatic tetralogy of Fallot with poor anatomy (small pulmonary arteries) and adverse factors (multiple comorbidities, low weight) relieves cyanosis and defers surgical repair. This allowed pulmonary arterial and somatic growth with clinical results comparable to early surgical repair in more favorable patients. © 2016 American Heart Association, Inc.

  14. Percutaneous pulmonary valve implantation in patients with dysfunction of a "native" right ventricular outflow tract - Mid-term results.

    Science.gov (United States)

    Georgiev, Stanimir; Tanase, Daniel; Ewert, Peter; Meierhofer, Christian; Hager, Alfred; von Ohain, Jelena Pabst; Eicken, Andreas

    2018-05-01

    To investigate the feasibility and mid-term results of percutaneous pulmonary valve implantation (PPVI) in patients with conduit free or "native" right ventricular outflow tracts (RVOT). We identified all 18 patients with conduit free or "native" right ventricular outflow tract, who were treated with percutaneous pulmonary valve implantation (PPVI) in our institution. They were divided into two groups - these in whom the central pulmonary artery was used as an anchoring point for the preparation of the landing zone (n=10) for PPVI and these, in whom a pulmonary artery branch was used for this purpose (n=8). PPVI was performed successfully in all patients with significant immediate RVOT gradient and pulmonary regurgitation grade reduction. Four patients had insignificant paravalvular regurgitation. In one patient the valve was explanted after 4months because of bacterial endocarditis. A follow-up of 19 (4-60) months showed sustained good function of the other implanted valves. The MRI indexed right ventricular end diastolic volume significantly decreased from 108(54-174) ml/m 2 before the procedure to 76(60-126) ml/m 2 six months after PPVI, p=0.01. PPVI is feasible with good mid-term results in selected patients with a "native" RVOT without a previously implanted conduit. Creating a stable landing zone with a diameter less than the largest available valve (currently 29mm) is crucial for the technical success of the procedure. Further studies and the development of new devices could widen the indications for this novel treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Is there an anatomic basis for subvalvular right ventricular outflow tract obstruction after an arterial switch repair for complete transposition? A morphometric study and review

    NARCIS (Netherlands)

    Akiba, T.; Neirotti, R.; Becker, A. E.

    1993-01-01

    The study was initiated by reports on right ventricular outflow tract obstruction in complete transposition of the great arteries after an arterial switch repair. We investigated 39 heart specimens with native, unoperated transposition of the great arteries. Of these, 14 hearts had a ventricular

  16. Left ventricular outflow tract to left atrial communication secondary to rupture of mitral-aortic intervalvular fibrosa in infective endocarditis: diagnosis by transesophageal echocardiography and color flow imaging.

    Science.gov (United States)

    Bansal, R C; Graham, B M; Jutzy, K R; Shakudo, M; Shah, P M

    1990-02-01

    Infection of the mitral-aortic intervalvular fibrosa occurs most commonly in association with infective endocarditis of the aortic valve. Infection of the aortic valve results in a regurgitant jet that presumably strikes this subaortic interannular zone of fibrous tissue and produces a secondary site of infection. Infection of this interannular zone then leads to the formation of subaortic abscess or pseudoaneurysm of the left ventricular outflow tract. This infected zone of mitral-aortic intervalvular fibrosa or subaortic aneurysm can subsequently rupture into the left atrium with systolic ejection of blood from the left ventricular outflow tract to the left atrium. This report describes the echocardiographic findings in three patients with pathologically proved left ventricular outflow tract to left atrial communication. Precise preoperative diagnosis is important, and this lesion should be differentiated from ruptured aneurysm of the sinus of Valsalva and perforation of the anterior mitral leaflet. Transthoracic echocardiography using color flow imaging and conventional Doppler techniques may show an eccentric mitral regurgitation type of signal in the left atrium originating from the region of the left ventricular outflow tract. However, transesophageal echocardiography provides an accurate preoperative diagnosis and should be used intraoperatively during repair of such lesions.

  17. Canadian Cardiovascular Society 2009 Consensus Conference on the management of adults with congenital heart disease: Outflow tract obstruction, coarctation of the aorta, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome

    Science.gov (United States)

    Silversides, Candice K; Beauchesne, Luc; Bradley, Timothy; Connelly, Michael; Niwa, Koichiro; Mulder, Barbara; Webb, Gary; Colman, Jack; Therrien, Judith

    2010-01-01

    With advances in pediatric cardiology and cardiac surgery, the population of adults with congenital heart disease (CHD) has increased. In the current era, there are more adults with CHD than children. This population has many unique issues and needs. Since the 2001 Canadian Cardiovascular Society Consensus Conference report on the management of adults with CHD, there have been significant advances in the field of adult CHD. Therefore, new clinical guidelines have been written by Canadian adult CHD physicians in collaboration with an international panel of experts in the field. Part II of the guidelines includes recommendations for the care of patients with left ventricular outflow tract obstruction and bicuspid aortic valve disease, coarctation of the aorta, right ventricular outflow tract obstruction, tetralogy of Fallot, Ebstein anomaly and Marfan’s syndrome. Topics addressed include genetics, clinical outcomes, recommended diagnostic workup, surgical and interventional options, treatment of arrhythmias, assessment of pregnancy risk and follow-up requirements. The complete document consists of four manuscripts that are published online in the present issue of The Canadian Journal of Cardiology. The complete document and references can also be found at www.ccs.ca or www.cachnet.org. PMID:20352138

  18. 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

  19. Transcatheter balloon dilation for recurrent right ventricular outflow tract obstruction following valve-sparing repair of tetralogy of Fallot.

    Science.gov (United States)

    Gellis, Laura; Banka, Puja; Marshall, Audrey; Emani, Sitaram; Porras, Diego

    2015-10-01

    Valve-sparing repair in patients with tetralogy of Fallot (TOF) carries the risk of residual or recurrent right ventricular outflow tract (RVOT) obstruction, which is often treated with transcatheter balloon dilation (BD). The outcomes and associated complications of BD of the RVOT in this scenario remain unknown. Retrospective review of the records of the Department of Cardiology at Boston Children's Hospital from 2000 to 2013 was performed. 34 patients had initial valve-sparing repair of tetralogy of Fallot followed by BD of the RVOT during the study period. Following BD, the RVOT gradient decreased from a median of 43 mm Hg (range 13 to 79 mm Hg) to 28 mm Hg (range 0 to 73 mm Hg) (P 1 and a final RVOT gradient of ≥40 post-BD were associated with shorter freedom from reintervention (P < 0.001). BD in patients with recurrent RVOT obstruction following valve-sparing repair of TOF acutely reduces the RVOT gradient, but commonly results in increased PR and is associated with a high reintervention rate. Patients with stenosis solely at the level of the valve had a better response to this type of intervention. © 2015 Wiley Periodicals, Inc.

  20. Experimental assessment of valve performance in healthy and diseased right ventricular outflow tracts using magnetic resonance velocimetry

    Science.gov (United States)

    Schiavone, Nicole; Elkins, Christopher; McElhinney, Doff; Eaton, John K.; Marsden, Alison

    2017-11-01

    Tetralogy of Fallot (ToF), the most common type of cyanotic congenital heart defect, affects 1 in every 2500 newborns annually and typically requires surgical repair of the right ventricular outflow tract (RVOT) and placement of an artificial pulmonary valve. All artificial valves are subject to dysfunction, but their longevity is highly variable. Clinical observation reveals large variations in RVOT anatomy in ToF patients, which may affect longevity. This work aims to experimentally assess the performance of artificial pulmonary valves in anatomically realistic healthy and diseased RVOT geometries using magnetic resonance velocimetry (MRV). With MRV, we can capture 3D, three-component, phase-averaged velocity fields in 3D printed RVOT geometries. The experiment is designed to ensure physiological flow rate and pressure waveforms, while the RVOT geometries are based on anatomies seen clinically in ToF patients. Two models are used in the current work: an idealized RVOT based on healthy subjects aged eleven to thirteen and a diseased geometry with a dilation of 150% in vessel diameter downstream of the pulmonary valve. We will also present preliminary rigid-wall blood flow simulations in each model, towards the ultimate goal of experimental validation of valve simulations.

  1. Left Ventricular Function Improves after Pulmonary Valve Replacement in Patients with Previous Right Ventricular Outflow Tract Reconstruction and Biventricular Dysfunction

    Science.gov (United States)

    Kane, Colin; Kogon, Brian; Pernetz, Maria; McConnell, Michael; Kirshbom, Paul; Rodby, Katherine; Book, Wendy M.

    2011-01-01

    Congenital heart defects that have a component of right ventricular outflow tract obstruction, such as tetralogy of Fallot, are frequently palliated in childhood by disruption of the pulmonary valve. Although this can provide an initial improvement in quality of life, these patients are often left with severe pulmonary valve insufficiency. Over time, this insufficiency can lead to enlargement of the right ventricle and to the deterioration of right ventricular systolic and diastolic function. Pulmonary valve replacement in these patients decreases right ventricular volume overload and improves right ventricular performance. To date, few studies have examined the effects of pulmonary valve replacement on left ventricular function in patients with biventricular dysfunction. We sought to perform such an evaluation. Records of adult patients who had undergone pulmonary valve replacement from January 2003 through November 2006 were analyzed retrospectively. We reviewed preoperative and postoperative echocardiograms and calculated left ventricular function in 38 patients. In the entire cohort, the mean left ventricular ejection fraction increased by a mean of 0.07 after pulmonary valve replacement, which was a statistically significant change (P < 0.01). In patients with preoperative ejection fractions of less than 0.50, mean ejection fractions increased by 0.10. We conclude that pulmonary valve replacement in patients with biventricular dysfunction arising from severe pulmonary insufficiency and right ventricular enlargement can improve left ventricular function. Prospective studies are needed to verify this finding. PMID:21720459

  2. Further analysis of the inhibition by agmatine on the cardiac sympathetic outflow: Role of the α2-adrenoceptor subtypes.

    Science.gov (United States)

    Cobos-Puc, Luis; Aguayo-Morales, Hilda; Ventura-Sobrevilla, Janeth; Luque-Contreras, Diana; Chin-Chan, Miguel

    2017-06-15

    This study has investigated the role of the α 2 -adrenoceptor subtypes involved in the inhibition of the cardiac sympathetic outflow induced by intravenous (i.v) infusions of agmatine. Therefore, we analysed the effect of an i.v. bolus injections of the selective antagonists BRL 44408 (300μg/kg; α 2A ), imiloxan (3000μg/kg; α 2B ), and JP-1302 (300μg/kg; α 2C ) given separately, and their combinations: BRL 44408 plus Imiloxan, JP 1302 plus imiloxan, BRL 44408 plus JP-1302, BRL 44408 plus imiloxan plus JP-1302 on the cardiac sympatho-inhibition of agmatine. Also, the effect of the combination BRL 44408 plus JP-1302 plus AGN 192403 (3000μg/kg; I 1 antagonist) was evaluated. In this way, i.v. infusions of 1000μg/kg min of agmatine, but not 300, inhibited the tachycardic response induced by electrical stimulation. Furthermore, the antagonists used or their combinations had no effect on the electrically-induced tachycardic response. On the other hand, the inhibitory response of agmatine was: (1) partially antagonized by BRL 44408 or JP-1302 given separately, a similar response was observed when we administered their combination with imiloxan, but not by imiloxan alone, (2) antagonized in greater magnitude by the combination BRL 44408 plus JP-1302 or the combination BRL 44408 plus imiloxan plus JP-1302, and (3) abolished by the combination BRL 44408 plus JP-1302 plus AGN 192403. Taken together, these results demonstrate that the α 2A - and α 2C -adrenoceptor subtypes and I 1 -imidazoline receptors are involved in the inhibition of the cardiac sympathetic outflow induced by agmatine. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Left ventricular outflow obstruction as a result of external cardiac compression by a mediastinal tumor; Zwezenie drogi odplywu lewej komory wywolane uciskiem przeez guz srodpiersia

    Energy Technology Data Exchange (ETDEWEB)

    Rydlewska-Sadowska, W.; Kowalski, M.; Borowiecka, E.; Polkowski, J.; Szaroszyk, W. [Klinika Szybkiej Diagnostyki, Zaklad Radiologii, Instytut Kardiologii, Warsaw (Poland)

    1993-12-31

    A case of left ventricular outflow tract stenosis resulted from compression of the heart is presented. This symptomatic cardiovascular lesion was produced by extensive growth of mediastinal tumour. Numerous noninvasive methods were necessary to establish this difficult diagnosis. The patient underwent surgery that disclosed a benign process (of neurofibroma). After tumour`s resection marked hemodynamic signs subsided. (author) 12 refs, 6 figs

  4. Optimal sizing for SAPIEN 3 transcatheter aortic valve replacement in patients with or without left ventricular outflow tract calcification.

    Science.gov (United States)

    Maeno, Yoshio; Abramowitz, Yigal; Jilaihawi, Hasan; Israr, Sharjeel; Yoon, Sunghan; Sharma, Rahul P; Kazuno, Yoshio; Kawamori, Hiroyuki; Miyasaka, Masaki; Rami, Tanya; Mangat, Geeteshwar; Takahashi, Nobuyuki; Okuyama, Kazuaki; Kashif, Mohammad; Chakravarty, Tarun; Nakamura, Mamoo; Cheng, Wen; Makkar, Raj R

    2017-04-07

    The impact of left ventricular outflow tract calcification (LVOT-CA) on SAPIEN 3 transcatheter aortic valve replacement (S3-TAVR) is not well understood. The aims of the present study were to determine optimal device sizing for S3-TAVR in patients with or without LVOT-CA and to evaluate the influence of residual paravalvular leak (PVL) on survival after S3-TAVR in these patients. This study analysed 280 patients (LVOT-CA=144, no LVOT-CA=136) undergoing S3-TAVR. Optimal annular area sizing was defined as % annular area sizing related to lower rates of ≥mild PVL. Annular area sizing was determined as follows: (prosthesis area/CT annulus area-1)×100. Overall, ≥mild PVL was present in 25.7%. Receiver operating characteristic curve analysis for prediction of ≥mild PVL in patients with LVOT-CA showed that 7.2% annular area sizing was identified as the optimal threshold (area under the curve [AUC] 0.71). Conversely, annular area sizing for no LVOT-CA appeared unrelated to PVL (AUC 0.58). Aortic annular injury was seen in four patients (average 15.5% annular area oversizing), three of whom had LVOT-CA. Although there was no difference in one-year survival between patients with ≥mild PVL and without PVL (log-rank p=0.91), subgroup analysis demonstrated that patients with ≥moderate LVOT-CA who had ≥mild PVL had lower survival compared to patients with ≥mild PVL and none or mild LVOT-CA (log-rank p=0.010). In the setting of LVOT-CA, an optimally sized S3 valve is required to reduce PVL and to increase survival following TAVR.

  5. Erythrocyte creatine as a marker of intravascular hemolysis due to left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kubo, Toru; Okumiya, Toshika; Baba, Yuichi; Hirota, Takayoshi; Tanioka, Katsutoshi; Yamasaki, Naohito; Sugiura, Tetsuro; Doi, Yoshinori L; Kitaoka, Hiroaki

    2016-03-01

    Erythrocyte creatine, a marker of erythrocyte age that increases with shortening of erythrocyte survival, has been reported to be a quantitative and reliable marker for intravascular hemolysis. We hypothesized that hemolysis could also occur due to intraventricular obstruction in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to examine the presence of subclinical hemolysis and the relation between intravascular hemolysis and intraventricular pressure gradient (IVPG). We measured erythrocyte creatine in 92 HCM patients. Twelve patients had left ventricular outflow tract obstruction (LVOTO), 4 had midventricular obstruction (MVO), and the remaining 76 were non-obstructive. Erythrocyte creatine levels ranged from 0.92 to 4.36μmol/g hemoglobin. Higher levels of erythrocyte creatine were associated with higher IVPG (r=0.437, pcreatine levels are high (≥1.8μmol/g hemoglobin), subclinical hemolysis is considered to be present. Half of LVOTO patients and no MVO patients showed high erythrocyte creatine levels. Although non-obstructive patients did not show significant intraventricular obstruction at rest, some showed high erythrocyte creatine levels. When LVOT-PG was measured during the strain phase of the Valsalva maneuver in 20 non-obstructive patients, 7 of those 20 patients showed LVOTO. In the 20 patients, there was no relation between erythrocyte creatine levels and LVOT-PG before the Valsalva maneuver (r=0.125, p=0.600), whereas there was a significant correlation between erythrocyte creatine and LVOT-PG provoked by the Valsalva maneuver (r=0.695, p=0.001). There is biochemical evidence of subclinical hemolysis in patients with HCM, and this hemolysis seems to be associated with LVOTO provoked by daily physical activities. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  6. HRV changes before and after radiofrequency ablation in patients with different origin of right ventricular outflow tract ventricular premature contraction

    Directory of Open Access Journals (Sweden)

    Yi-Ming Ma

    2017-04-01

    Full Text Available Objective: To observe the HRV changes before and after the radiofrequency current catheter ablationventricular premature beats originated from different site of right ventricular outflow tract. Methods: A total of 102 patients with frequent RVOT-VPC admitted to our hospital were accepted radiofrequency current catheter ablation (RF. According to the origin of RVOT-VPC, it was divided into 2 groups, one is from ventricular septum, and the other one is from free wall, and in each group, male and female are observed separately. Results: (1 HRV before RF ablation: 1 rMSSD in the female patients with RVOT-VPC from free wall was significantly lower than those from septum; 2 frequency domain index (W, LF were higher than normal range, and in male patients, LF/HF1. (2 HRV after RF ablation: 1 Significant changes were found in female patients with RVOT-VPC from septum, rMSSD, PNN50, HF and LF decreased; 2 In female patients with RVOT-VPC from free wall, rMSSD decreased; 3 In male patients, there were no significant HRV changes found before and after RF ablation. (3 Heart rate changes: 1 In female patients with RVOT-VPC from septum, heart rate decreased significantly [(76.47±9.47 bpm vs (69.29±14.59 bpm]. 2 No significant changes were found in male patients. Conclusion: In patients with RVOT-PVC sympathetic and vagus excitability increased, and after catheter ablation, in female patients with RVOT-PVC originated from septum, the HRV index relating to sympathetic and vagus excitability significantly decreased.

  7. Right-ventricular and left-ventricular function parameters in patients with and without outflow tract patches as determined by radionuclide methods at least 10 years following surgical correction of Fallot's tetralogy in the adult individuals

    International Nuclear Information System (INIS)

    Seidel, P.

    1988-01-01

    During a period starting in 1983 and ending in April 1984 radionuclide ventriculography was performed in 26 patients subjected to surgical correction of Fallot's tetralogy after having reached adulthood. They were divided into two groups according to the surgical methods used. Patients showing no right-ventricular outflow patch were assigned to group I, while group II was made up of individuals that had received outflow tract patches of Dacron or Teflon for pressure reduction in the right ventricle. The parameters registered during radionuclide ventriculography, in which the tracer substance TC 99m was administered into a peripheral vein, included the endiastolic volume, endsystolic volume, stroke volume, global ejection fraction and cardiac index. For resting patients, these values were calculated using the first-pass technique, the determinations during exercise on the ergometer were based on equilibrium radionuclide ventriculography. It could be concluded from the results obtained here that non-invasive endocardial scintigraphy is a sensitive method that can be used both at rest and during exercise on the ergometer to detect function disorders of the right and left ventricles. (orig./MG) [de

  8. Distinct subsets of Eve-positive pericardial cells stabilise cardiac outflow and contribute to Hox gene-triggered heart morphogenesis in Drosophila.

    Science.gov (United States)

    Zmojdzian, Monika; de Joussineau, Svetlana; Da Ponte, Jean Philippe; Jagla, Krzysztof

    2018-01-17

    The Drosophila heart, composed of discrete subsets of cardioblasts and pericardial cells, undergoes Hox-triggered anterior-posterior morphogenesis, leading to a functional subdivision into heart proper and aorta, with its most anterior part forming a funnel-shaped cardiac outflow. Cardioblasts differentiate into Tin-positive 'working myocytes' and Svp-expressing ostial cells. However, developmental fates and functions of heart-associated pericardial cells remain elusive. Here, we show that the pericardial cells that express the transcription factor Even Skipped adopt distinct fates along the anterior-posterior axis. Among them, the most anterior Antp-Ubx-AbdA - negative cells form a novel cardiac outflow component we call the outflow hanging structure, whereas the Antp-expressing cells differentiate into wing heart precursors. Interestingly, Hox gene expression in the Even Skipped-positive cells not only underlies their antero-posterior diversification, but also influences heart morphogenesis in a non-cell-autonomous way. In brief, we identify a new cardiac outflow component derived from a subset of Even Skipped-expressing cells that stabilises the anterior heart tip, and demonstrate non-cell-autonomous effects of Hox gene expression in the Even Skipped-positive cells on heart morphogenesis. © 2018. Published by The Company of Biologists Ltd.

  9. Pericardial tissue valves and Gore-Tex conduits as an alternative for right ventricular outflow tract replacement in children.

    Science.gov (United States)

    Allen, Bradley S; El-Zein, Chawki; Cuneo, Betina; Cava, Joseph P; Barth, Mary Jane; Ilbawi, Michel N

    2002-09-01

    There is still no perfect conduit for reconstruction of the right ventricular outflow tract (RVOT) in children. Homografts are not always available in the appropriate size, and degenerate in a few years. This study evaluates the pericardial valve with Gore-Tex conduit as an alternative for RVOT construction. From January 1, 1993, to September 30, 1999, a pericardial tissue valve was inserted in all patients undergoing RVOT reconstruction or pulmonary valve replacement (PVR) who were large enough to accommodate a tissue valve. In patients without a native main pulmonary artery, a new technique was used to construct an RV-PA conduit out of a flat sheet of Gore-Tex, as Dacron frequently leads to stenosis. Data were collected by retrospective review, follow-up echocardiograms, and assessment by a single cardiologist. There were 48 patients, 22 undergoing a PVR alone and 26 a RV-PA valved Gore-Tex conduit. Diagnosis included tetralogy of Fallot (n = 25); truncus arteriosis (n = 9); ventricular septal defect with PA (n = 5); DORV (n = 4); D-TGA with PS (n = 2); and 1 each IAA with sub AS, VSD with PI, and PS s/p Ross procedure. Patient age ranged from 3 to 33 years and 98% were reoperations. The valve sizes ranged from 19 to 33 mm and the median hospital length of stay was 4 days. There were 2 (4.2%) perioperative and 1 (2.1%) late deaths, none related to the valve or Gore-Tex conduit. At a follow-up of 15 to 86 months (mean 43 +/- 16 months), all remaining 45 patients are New York Heart Association class I, all valves are functional, and no patient has required valve or conduit replacement or revision; more importantly, echocardiogram revealed no significant valve or conduit stenosis (mean gradient 16 +/- 8 mm Hg) and no evidence of regurgitation or structural degeneration. A pericardial tissue valve and Gore-Tex conduit provides a reliable alternative for RVOT reconstruction in pediatric patients. It is readily available, molds in the limited retrosternal space, and

  10. Expression of cardiac neural crest and heart genes isolated by modified differential display.

    Science.gov (United States)

    Martinsen, Brad J; Groebner, Nathan J; Frasier, Allison J; Lohr, Jamie L

    2003-08-01

    The invasion of the cardiac neural crest (CNC) into the outflow tract (OFT) and subsequent outflow tract septation are critical events during vertebrate heart development. We have performed four modified differential display screens in the chick embryo to identify genes that may be involved in CNC, OFT, secondary heart field, and heart development. The screens included differential display of RNA isolated from three different axial segments containing premigratory cranial neural crest cells; of RNA from distal outflow tract, proximal outflow tract, and atrioventricular tissue of embryonic chick hearts; and of RNA isolated from left and right cranial tissues, including the early heart fields. These screens have resulted in the identification of the five cDNA clones presented here, which are expressed in the cardiac neural crest, outflow tract and developing heart in patterns that are unique in heart development.

  11. Successful radiofrequency catheter ablation assisted by the CartoSound® system for outflow tract origin nonsustained ventricular tachycardia in a patient with a severely deformed thorax

    Directory of Open Access Journals (Sweden)

    Naoaki Onishi

    2014-02-01

    Full Text Available We report the case of a 72-year-old man with a nonsustained ventricular tachycardia and a history of palpitations. He had a severely deformed thorax since childhood due to spinal caries. An integrated computed tomography image of the outflow tract region from the CartoSound® system revealed the detailed anatomical information around the origin of the tachycardia and that the left anterior descending coronary artery was very close (<10 mm to the target site. We carefully ablated that site with a 3.5-mm cooled-tip catheter while confirming it in the sound view, and succeeded without any complications.

  12. Stenting of the right ventricular outflow tract in 2 dogs for palliation of dysplastic pulmonary valve stenosis and right-to-left intracardiac shunting defects.

    Science.gov (United States)

    Scansen, Brian A; Kent, Agnieszka M; Cheatham, Sharon L; Cheatham, John P; Cheatham, John D

    2014-09-01

    Two dogs with severe dysplastic pulmonary valve stenosis and right-to-left shunting defects (patent foramen ovale, perimembranous ventricular septal defect) underwent palliative stenting of the right ventricular outflow tract and pulmonary valve annulus using balloon expandable stents. One dog received 2 over-lapping bare metal stents placed 7 months apart; the other received a single covered stent. Both procedures were considered technically successful with a reduction in the transpulmonary valve pressure gradient from 202 to 90 mmHg in 1 dog and from 168 to 95 mmHg in the other. Clinical signs of exercise intolerance and syncope were temporarily resolved in both dogs. However, progressive right ventricular concentric hypertrophy, recurrent stenosis, and erythrocytosis were observed over the subsequent 6 months leading to poor long-term outcomes. Stenting of the right ventricular outflow tract is feasible in dogs with severe dysplastic pulmonary valve stenosis, though further study and optimization of the procedure is required. Copyright © 2014 Elsevier B.V. All rights reserved.

  13. Comparison of peak flow velocity through the left ventricular outflow tract and effective orifice area indexed to body surface area in Golden Retriever puppies to predict development of subaortic stenosis in adult dogs.

    Science.gov (United States)

    Javard, Romain; Bélanger, Marie-Claude; Côté, Etienne; Beauchamp, Guy; Pibarot, Philippe

    2014-12-15

    To evaluate the usefulness of Doppler-derived peak flow velocity through the left ventricular outflow tract (LVOT Vmax) and effective orifice area indexed to body surface area (EOAi) in puppies to predict development of subaortic stenosis (SAS) in the same dogs as adults. Prospective, longitudinal, observational study. 38 Golden Retrievers. Cardiac auscultation and echocardiography were performed on 2- to 6-month-old puppies, then repeated at 12 to 18 months. Subaortic stenosis was diagnosed when LVOT Vmax was ≥ 2.3 m/s in adult dogs with left basilar systolic murmurs. All puppies with EOAi 2.3 m/s in puppyhood was 63% sensitive and 100% specific for SAS in adulthood. In puppies, LVOT Vmax was more strongly associated with a future diagnosis of SAS (area under the curve [AUC], 0.89) than was EOAi (AUC, 0.80). In puppies, the combination of LVOT Vmax and EOAi yielded slightly higher sensitivity (69%) and specificity (100%) for adult SAS than did LVOT Vmax alone. In unaffected and affected dogs, LVOT Vmax increased significantly from puppyhood to adulthood but EOAi did not. In Golden Retriever puppies, LVOT Vmax > 2.3 m/s and EOAi < 1.46 cm(2)/m(2) were both associated with a diagnosis of SAS at adulthood. The combination of these 2 criteria may result in higher sensitivity for SAS screening. Unlike LVOT Vmax, EOAi did not change during growth in either unaffected Golden Retrievers or those with SAS.

  14. Stent fracture, valve dysfunction, and right ventricular outflow tract reintervention after transcatheter pulmonary valve implantation: patient-related and procedural risk factors in the US Melody Valve Trial.

    Science.gov (United States)

    McElhinney, Doff B; Cheatham, John P; Jones, Thomas K; Lock, James E; Vincent, Julie A; Zahn, Evan M; Hellenbrand, William E

    2011-12-01

    Among patients undergoing transcatheter pulmonary valve (TPV) replacement with the Melody valve, risk factors for Melody stent fracture (MSF) and right ventricular outflow tract (RVOT) reintervention have not been well defined. From January 2007 to January 2010, 150 patients (median age, 19 years) underwent TPV implantation in the Melody valve Investigational Device Exemption trial. Existing conduit stents from a prior catheterization were present in 37 patients (25%, fractured in 12); 1 or more new prestents were placed at the TPV implant catheterization in 51 patients. During follow-up (median, 30 months), MSF was diagnosed in 39 patients. Freedom from a diagnosis of MSF was 77±4% at 14 months (after the 1-year evaluation window) and 60±9% at 39 months (3-year window). On multivariable analysis, implant within an existing stent, new prestent, or bioprosthetic valve (combined variable) was associated with longer freedom from MSF (Pbioprosthetic valve was associated with lower risk of MSF and reintervention.

  15. 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

  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. Small-sized conduits in the right ventricular outflow tract in young children: bicuspidalized homografts are a good alternative to standard conduits.

    Science.gov (United States)

    François, Katrien; De Groote, Katya; Vandekerckhove, Kristof; De Wilde, Hans; De Wolf, Daniel; Bové, Thierry

    2017-10-03

    Downsizing a homograft (HG) through bicuspidalization has been used for more than 2 decades to overcome the shortage of small-sized conduits for reconstruction of the right ventricular outflow tract (RVOT) in young children. Our goal was to investigate the durability of bicuspidalized HGs compared with other small HGs. A retrospective analysis of 93 conduits ≤20 mm, implanted over 23 years, was performed. The end-points were survival, structural valve degeneration and conduit replacement. The conduits comprised 40 pulmonary HGs, 12 aortic HGs, 17 bicuspidalized HGs and 24 xenografts. The median age, mean conduit diameter and z-value at implantation were 1.4 (interquartile range 0.3-3) years, 16.5 ± 2.7 mm and 2.8 ± 1.3, respectively. Valve position was heterotopic in 59 patients and orthotopic in 34 patients. At a mean follow-up period of 7.6 ± 5.9 years, the hospital survival rate was 89%. Freedom from explant at 5 and 10 years was 83 ± 5% and 52 ± 6%, respectively. Freedom from structural valve degeneration was 79 ± 5% at 5 years and 47 ± 6% at 10 years [68 ± 8% for pulmonary HG, 42 ± 16% for bicuspidalized HG, 31 ± 15% for aortic HG and 20 ± 9% for xenografts (log rank P right ventricular outflow tract conduit in young children. However, when a small pulmonary HG is unavailable, bicuspidalization offers a valid alternative, preferable to xenograft conduits, at mid-term follow-up. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Hepatic Cyst Compressing The Right Atrial and Ventricular Inflow Tract: An Uncommon Cardiac Complication.

    Science.gov (United States)

    Panchal, Maulik; Alansari, Ahmed; Wallack, Marc; Visco, Ferdinand; Williams, Susan; Sy, Alexander M

    2018-01-01

    Commonly reported complications of hepatic cysts are spontaneous hemorrhage, rupture into the peritoneal cavity, infection and compression of the biliary tree however cardiac complications are not commonly reported. We are presenting a case of a large liver cyst presenting with right atrial and ventricular inflow tract impingement resulting in cardiac symptoms. A 68 year-old Hispanic female presented with one month of fatigue and shortness of breath after household work and walking less than one block, right upper quadrant pain and weight loss. She had history of multiple hepatic cysts for more than 12 years, well-controlled diabetes and hypertension. Examination of the heart revealed tachycardia with regular heart sounds. There were no murmurs. She had tenderness in her right upper quadrant on palpation and an enlarged smooth liver. Rest of physical examination was unremarkable. CT scan of the abdomen showed multiple non-enhancing liver cysts in both lobes, with the largest measuring 12 x 15 x 17 cm which was significantly increased from her baseline of 7 x 8 x 10 cm in 2003. Echocardiogram showed normal left ventricular ejection fraction, grade 1 diastolic dysfunction and a hepatic cyst impinging RA and RV inflow tract. She had successful laparoscopic enucleation of liver cyst and subsequent relief from tachycardia, fatigue and shortness of breath. In conclusion, this case illustrates that hepatic cysts may become symptomatic after remaining quiescent for an extended period. They may present with unusual symptoms and clinicians should be mindful of rare complications, such as in this case.

  19. Radiofrequency catheter ablation of idiopathic ventricular arrhythmias originating from intramural foci in the left ventricular outflow tract: efficacy of sequential versus simultaneous unipolar catheter ablation.

    Science.gov (United States)

    Yamada, Takumi; Maddox, William R; McElderry, H Thomas; Doppalapudi, Harish; Plumb, Vance J; Kay, G Neal

    2015-04-01

    Idiopathic ventricular arrhythmias (VAs) originating from the left ventricular outflow tract (LVOT) sometimes require catheter ablation from the endocardial and epicardial sides for their elimination, suggesting the presence of intramural VA foci. This study investigated the efficacy of sequential and simultaneous unipolar radiofrequency catheter ablation from the endocardial and epicardial sides in treating intramural LVOT VAs. Fourteen consecutive LVOT VAs, which required sequential or simultaneous irrigated unipolar radiofrequency ablation from the endocardial and epicardial sides for their elimination, were studied. The first ablation was performed at the site with the earliest local ventricular activation and best pace map on the endocardial or epicardial side. When the first ablation was unsuccessful, the second ablation was delivered on the other surface. If this sequential unipolar ablation failed, simultaneous unipolar ablation from both sides was performed. The first ablation was performed on the epicardial side in 9 VAs and endocardial side in 5 VAs. The intramural LVOT VAs were successfully eliminated by the sequential (n=9) or simultaneous (n=5) unipolar catheter ablation. Simultaneous ablation was most likely to be required for the elimination of the VAs when the distance between the endocardial and epicardial ablation sites was >8 mm and the earliest local ventricular activation time relative to the QRS onset during the VAs of sequential unipolar radiofrequency ablation and sometimes required simultaneous ablation from both the endocardial and epicardial sides. © 2015 American Heart Association, Inc.

  20. Real-time three-dimensional color Doppler echocardiography for characterizing the spatial velocity distribution and quantifying the peak flow rate in the left ventricular outflow tract

    Science.gov (United States)

    Tsujino, H.; Jones, M.; Shiota, T.; Qin, J. X.; Greenberg, N. L.; Cardon, L. A.; Morehead, A. J.; Zetts, A. D.; Travaglini, A.; Bauer, F.; hide

    2001-01-01

    Quantification of flow with pulsed-wave Doppler assumes a "flat" velocity profile in the left ventricular outflow tract (LVOT), which observation refutes. Recent development of real-time, three-dimensional (3-D) color Doppler allows one to obtain an entire cross-sectional velocity distribution of the LVOT, which is not possible using conventional 2-D echo. In an animal experiment, the cross-sectional color Doppler images of the LVOT at peak systole were derived and digitally transferred to a computer to visualize and quantify spatial velocity distributions and peak flow rates. Markedly skewed profiles, with higher velocities toward the septum, were consistently observed. Reference peak flow rates by electromagnetic flow meter correlated well with 3-D peak flow rates (r = 0.94), but with an anticipated underestimation. Real-time 3-D color Doppler echocardiography was capable of determining cross-sectional velocity distributions and peak flow rates, demonstrating the utility of this new method for better understanding and quantifying blood flow phenomena.

  1. [Incidence of urinary tract infections after cardiac surgery: comparative study accordind to catheterization device].

    Science.gov (United States)

    Hidalgo Fabrellas, I; Rebollo Pavón, M; Planas Canals, M; Barbero Cabezas, M

    2015-01-01

    Urinary tract infections (UTI) associated with urethral catheterization are the second cause of nosocomial infections in Intensive care units. We confirm a UTI when we get a result of 100,000 CFU/ml with at least one microorganism in a urine culture. Compare and determine the incidence of UTI in cardiac surgery postpoperative patients according to the catheterization device. A prospective, randomized analytical observational study of patients in the immediate cardiac surgery postoperative period. One group was probed with catheter Foley and one was inserted the catheter BIPFoley-Bactiguard® (CBF). The CBF is coated with noble metals (silver, gold and palladium) and biocompatible antimicrobial properties, covering the entire surface of the device and prevents the formation of biofilm, microbial adherence and colonization. 116 cases, 59.5% (69 cases) were negative for UTI and 40.5% (47 cases) were positive. Out of the positive UTI results, 25% were carriers of catheter Foley and 15.5% of CBF. Most common etiologic microorganisms: Escherichia coli 29.8% Klebsiella pneumonia 29.8%, Klebsiella oxytoca 9%. With the data we have observed that patients catheterized BIPfoley-Bactiguard® are infected to a lesser extent than Foley carriers. Copyright © 2013 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  2. Factors influencing left ventricular outflow tract obstruction following a mitral valve-in-valve or valve-in-ring procedure, part 1.

    Science.gov (United States)

    Bapat, Vinnie; Pirone, Francesco; Kapetanakis, Stam; Rajani, Ronak; Niederer, Steven

    2015-10-01

    To determine the factors influencing left ventricular outflow tract (LVOT) area reduction after a mitral valve-in-valve (VIV) or a valve-in-ring (VIR) procedure. Transcatheter heart valves (THVs) are increasingly used in performing a VIV or a VIR procedure in high-risk patients. Although less invasive, a potential complication is LVOT obstruction. However, the factors predisposing to LVOT obstruction are ill defined. To understand the effects of the various factors, the study was carried out in three parts: To understand the effect of VIV and VIR on reduction in LVOT area with special attention to different surgical heart valve (SHV) orientations and depth of THV implant. This was carried out in porcine and cadaver hearts. To quantify aorto-mitral-annular (AMA) angle in 20 patients with or without mitral disease and to derive a static computational model to predict LVOT obstruction. To study the effect of SHV design on LVOT obstruction after VIV. This was carried out as a bench test. LVOT area reduction was similar after VIV irrespective of orientation of the mitral SHV implantation as it pinned open the SHV leaflets. Similar effect was seen after VIR. The degree of LVOT obstruction was partly determined by AMAangle and was inversely proportional. SHV design, ring design, and depth of SPAIEN XT implantation also had effect on LVOT obstruction. A possibility of LVOT obstruction should be considered when performing a VIV and VIR procedure. Type of SHV, flexible ring, less obtuse AMA angle, and depth of SAPIEN XT implant can influence the risk. © 2015 Wiley Periodicals, Inc.

  3. Comparison between biventricular cine MRI and MR flow quantification in ascending aorta and pulmonary outflow tract for the assessment of intracardial shunt volumes

    International Nuclear Information System (INIS)

    Rominger, M.B.; Kluge, A.; Bachmann, G.F.; Dinkel, H.P.

    2002-01-01

    Purpose: Comparison between biventricular volumetric measurements and flow measurements in ascending aorta (Ao) and pulmonary outflow tract (Pu) for quantification of intracardial shunts, and evaluation of the combination of biventricular cine MRI with flow measurements for the assessment of RV and LV heart failure and valvular regurgitation (VR). Material and Methods: In 24 patients, right (RV) and left (LV) ventricular volumetric and flow measurements were performed in the Ao and Pu to assess the ratio of RV stroke volume (SV) or, respectively, pulmonary SV to LV SV or, respectively, systemic aortic SV (Qp/Qs). 34 patients without echocardiographically proven shunt or VR served as control group for measurement accuracy. Left-to-right shunt ratios were calculated from RV and LV SV, Pu and Ao SV, Pu and LV SV, and RV and Ao SV. Left ventricular VR was calculated by the difference of LV SV and Ao SV, and right ventricular VR by the difference of RV SV and Pu SV. Global systolic function was evaluated by biventricular cine MRI. Results: Intracardial shunts with Qp/Qs>1,16 can be quantified by flow measurements in Ao and Pu. Using biventricular volumetric measurements in cases without VR, requires a Qp/Qs>1.21. 17 of 18 intracardiac shunts were identified on MRI, and all 8 hemodynamically significant shunts were quantitatively confirmed. The diagnosis of complete shunt closure or absent shunt was correctly made in all 6 cases RV EF reduction was found in 6 of 24 patients. LV EF reduction was also found in 6 of 24 patients. Conclusion: Flow measurements in Ao and Pu are more accurate than biventricular cine MRI for the assessment of Qp/Qs ratios. Flow measurements in Ao and Pu combined with biventricular cine MRI enables the quantification of hemodynamic significant shunts, higher grade VR and biventricular global systolic function with a single examination. (orig.) [de

  4. Defects in cardiac outflow tract formation and pro-B-lymphocyte expansion in mice lacking Sox-4

    NARCIS (Netherlands)

    Schilham, M. W.; Oosterwegel, M. A.; Moerer, P.; Ya, J.; de Boer, P. A.; van de Wetering, M.; Verbeek, S.; Lamers, W. H.; Kruisbeek, A. M.; Cumano, A.; Clevers, H.

    1996-01-01

    A striking example of the relationship between regulation of transcription and phenotype is the central role of the Y-chromosomal gene Sry in mammalian sex determination. Sry is the founding member of a large family of so-called Sox genes. During murine embryogenesis, the transcriptional activator

  5. Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study

    Directory of Open Access Journals (Sweden)

    Mohamed S. Kabbani

    2016-09-01

    Full Text Available Summary: Nosocomial urinary tract infection (UTI increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU in 2012, and we divided the patients into two groups: the UTI (UTI group and the non-UTI (control group. We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7% had UTIs after cardiac surgery (UTI group, and 384 (93% were free from UTIs (control group. All UTI cases were catheter-associated UTIs (CAUTIs. A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (p < 0.001, presence of congenital abnormalities of kidney and urinary tract (CAKUT (p < 0.0041 and the presence of certain syndromes (Down, William, and Noonan (p < 0.02. Gram-negative bacteria accounted for 63% of the CAUTI. The main causes of CAUTI were Klebsiella (27%, Candida (24% and Escherichia coli (21%. Resistant organisms caused 34% of CAUTI. Two patients (7% died in the UTI group compared with the one patient (0.3% who died in the control group (p < 0.05. Based on these findings, we concluded that an increased duration of the urinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Keywords: Urinary tract infection, Cardiac surgery, Nosocomial

  6. Stenting of the right ventricular outflow tract after thrombosis of the modified Blalock-Taussig shunt in a 8 month old infant with tetralogy of Fallot and right pulmonary artery agenesis

    Directory of Open Access Journals (Sweden)

    I. A. Soynov

    2017-01-01

    Full Text Available Pulmonary artery agenesis combined with tetralogy of Fallot is the most rarely seen congenital heart disease. Children with this anomaly are an especially problematic category of patients undergoing staged surgical repair. The postoperative period quite often is complicated with shunt thrombosis while a redo open surgery is associated with a very high risk; therefore, endovascular repair is a preferred procedure. We describe a case of right ventricular outflow tract stenting in a 8 month old girl with tetralogy of Fallot and right pulmonary artery agenesis. The patient was admitted at 3 month after performing of a left-sided modified Blalock-Taussig shunt with severe signs of heart failure and desaturation caused by shunt thrombosis. Assessments performed at 2 months after stenting of the outflow tract demonstrated good oxygen saturation in arterial blood (80% and above and improvement of heart failure symptoms to NYHA II class.

  7. Satisfactory rate of postprocessing visualization of standard fetal cardiac views from 4-dimensional cardiac volumes acquired during routine ultrasound practice by experienced sonographers in peripheral centers.

    Science.gov (United States)

    Rizzo, Giuseppe; Capponi, Alessandra; Pietrolucci, Maria Elena; Capece, Giuseppe; Cimmino, Ernesto; Colosi, Enrico; Ferrentino, Salvatore; Sica, Carmine; Di Meglio, Aniello; Arduini, Domenico

    2011-01-01

    The aim of this study was to evaluate the feasibility of visualizing standard cardiac views from 4-dimensional (4D) cardiac volumes obtained at ultrasound facilities with no specific experience in fetal echocardiography. Five sonographers prospectively recorded 4D cardiac volumes starting from the 4-chamber view on 500 consecutive pregnancies at 19 to 24 weeks' gestation undergoing routine ultrasound examinations (100 pregnancies for each sonographer). Volumes were sent to the referral center, and 2 independent reviewers with experience in 4D fetal echocardiography assessed their quality in the display of the abdominal view, 4-chamber view, left and right ventricular outflow tracts, and 3-vessel and trachea view. Cardiac volumes were acquired in 474 of 500 pregnancies (94.8%). The 2 reviewers respectively acknowledged the presence of satisfactory images in 92.4% and 93.6% of abdominal views, 91.5% and 93.0% of 4-chamber views, in 85.0% and 86.2% of left ventricular outflow tracts, 83.9% and 84.5% of right ventricular outflow tracts, and 85.2% and 84.5% of 3-vessel and trachea views. The presence of a maternal body mass index of greater than 30 altered the probability of achieving satisfactory cardiac views, whereas previous maternal lower abdominal surgery did not affect the quality of reconstructed cardiac views. In conclusion, cardiac volumes acquired by 4D sonography in peripheral centers showed high enough quality to allow satisfactory diagnostic cardiac views.

  8. Urinary tract infection in children after cardiac surgery: Incidence, causes, risk factors and outcomes in a single-center study.

    Science.gov (United States)

    Kabbani, Mohamed S; Ismail, Sameh R; Fatima, Anis; Shafi, Rehana; Idris, Julinar A; Mehmood, Akhter; Singh, Reetam K; Elbarabry, Mahmoud; Hijazi, Omar; Hussein, Mohamed A

    2016-01-01

    Nosocomial urinary tract infection (UTI) increases hospitalization, cost and morbidity. In this cohort study, we aimed to determine the incidence, risk factors, etiology and outcomes of UTIs in post-operative cardiac children. To this end, we studied all post-operative patients admitted to the Pediatric Cardiac Intensive Care Unit (PCICU) in 2012, and we divided the patients into two groups: the UTI (UTI group) and the non-UTI (control group). We compared both groups for multiple peri-operative risk factors. We included 413 children in this study. Of these, 29 (7%) had UTIs after cardiac surgery (UTI group), and 384 (93%) were free from UTIs (control group). All UTI cases were catheter-associated UTIs (CAUTIs). A total of 1578 urinary catheter days were assessed in this study, with a CAUTI density rate of 18 per 1000 catheter days. Multivariate logistic regression analysis demonstrated the following risk factors for CAUTI development: duration of urinary catheter placement (purinary tract (CAKUT) (purinary catheter, the presence of CAKUT, and the presence of syndromes comprised the main risk factors for CAUTI. Gram-negative organisms were the main causes for CAUTI, and one-third of them found to be resistant in this single-center study. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  9. Right-ventricular and left-ventricular function parameters in patients with and without outflow tract patches as determined by radionuclide methods at least 10 years following surgical correction of Fallot's tetralogy in the adult individuals. Nuklearmedizinische Bestimmung der rechts- und linksventrikulaeren Funktionsparameter von Patienten ohne und mit Ausflusstraktpatch - mindestens 10 Jahre nach operativer Korrektur der Fallot'schen Tetralogie im Erwachsenenalter

    Energy Technology Data Exchange (ETDEWEB)

    Seidel, P.

    1988-12-15

    During a period starting in 1983 and ending in April 1984 radionuclide ventriculography was performed in 26 patients subjected to surgical correction of Fallot's tetralogy after having reached adulthood. They were divided into two groups according to the surgical methods used. Patients showing no right-ventricular outflow patch were assigned to group I, while group II was made up of individuals that had received outflow tract patches of Dacron or Teflon for pressure reduction in the right ventricle. The parameters registered during radionuclide ventriculography, in which the tracer substance TC 99m was administered into a peripheral vein, included the endiastolic volume, endsystolic volume, stroke volume, global ejection fraction and cardiac index. For resting patients, these values were calculated using the first-pass technique, the determinations during exercise on the ergometer were based on equilibrium radionuclide ventriculography. It could be concluded from the results obtained here that non-invasive endocardial scintigraphy is a sensitive method that can be used both at rest and during exercise on the ergometer to detect function disorders of the right and left ventricles. (orig./MG).

  10. 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.

  11. 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.

  12. Comparing Methods for Cardiac Output

    DEFF Research Database (Denmark)

    Graeser, Karin; Zemtsovski, Mikhail; Kofoed, Klaus F

    2018-01-01

    of the left ventricular outflow tract. METHODS: The primary aim was a systematic comparison of CO with Doppler-derived 3D TEE and CO by thermodilution in a broad population of patients undergoing cardiac surgery. A subanalysis was performed comparing cross-sectional area by TEE with cardiac computed...... tomography (CT) angiography. Sixty-two patients, scheduled for elective heart surgery, were included; 1 was subsequently excluded for logistic reasons. Inclusion criteria were coronary artery bypass surgery (N = 42) and aortic valve replacement (N = 19). Exclusion criteria were chronic atrial fibrillation......, left ventricular ejection fraction below 0.40 and intracardiac shunts. Nineteen randomly selected patients had a cardiac CT the day before surgery. All images were stored for blinded post hoc analyses, and Bland-Altman plots were used to assess agreement between measurement methods, defined as the bias...

  13. Late outcome of right ventricular outflow tract repair using bicuspid pulmonary prosthesis in tetralogy of Fallot surgery repair: case report Resultado tardio da reconstrução da via de saída do ventrículo direito com prótese pulmonar bicúspide na correção da tetralogia de Fallot: relato de caso

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2009-12-01

    Full Text Available We present a case of a 19 year-old female patient, with tetralogy of Fallot and hypoplastic pulmonary ring. Diagnosis was performed by echocardiography and cardiac catheterization. The surgical repair was performed at the age of 2 years old. A right ventricular outflow tract remodeling was performed using a porcine pulmonary bicuspid prosthesis. The patient presented a uneventful follow-up during 17 years. Postoperative assessment has shown: mild pulmonary insufficiency and mild pulmonary ventricle gradient, satisfactory right ventricular performance and prosthesis not presenting calcification. This is an option to correct the tetralogy of Fallot adopted by our Institution in the last two decades.É apresentado o caso de uma paciente de 19 anos de idade, sexo feminino, portadora de tetralogia de Fallot com anel pulmonar hipoplásico. O diagnóstico foi feito com ecoDopplercardiograma e cateterismo cardíaco. A correção cirúrgica foi realizada com 2 anos de idade. Para a reconstrução da valva pulmonar e via de saída do ventrículo foi utilizada prótese bivalvular pulmonar porcina. A paciente teve boa evolução clínica durante 17 anos. A avaliação pós-operatória demonstrou: discreta insuficiência pulmonar, discreto gradiente transvalvar pulmonar, desempenho do ventrículo direito preservado e prótese pulmonar sem calcificação. Esse é o procedimento adotado pela nossa Instituição para a correção da tetralogia de Fallot, nos últimos 20 anos.

  14. Outcomes of pulmonary valve replacement in 170 patients with chronic pulmonary regurgitation after relief of right ventricular outflow tract obstruction: implications for optimal timing of pulmonary valve replacement.

    Science.gov (United States)

    Lee, Cheul; Kim, Yang Min; Lee, Chang-Ha; Kwak, Jae Gun; Park, Chun Soo; Song, Jin Young; Shim, Woo-Sup; Choi, Eun Young; Lee, Sang Yun; Baek, Jae Suk

    2012-09-11

    The objectives of this study were to evaluate outcomes of pulmonary valve replacement (PVR) in patients with chronic pulmonary regurgitation (PR) and to better define the optimal timing of PVR. Although PVR is effective in reducing right ventricular (RV) volume overload in patients with chronic PR, the optimal timing of PVR is not well defined. A total of 170 patients who underwent PVR between January 1998 and March 2011 for chronic PR were retrospectively analyzed. To define the optimal timing of PVR, pre-operative and post-operative cardiac magnetic resonance imaging (MRI) data (n = 67) were analyzed. The median age at the time of PVR was 16.7 years. Follow-up completeness was 95%, and the median follow-up duration was 5.9 years. Overall and event-free survival at 10 years was 98% and 70%, respectively. Post-operative MRI showed significant reduction in RV volumes and significant improvement in biventricular function. Receiver-operating characteristic curve analysis revealed a cutoff value of 168 ml/m(2) for non-normalization of RV end-diastolic volume index (EDVI) and 80 ml/m(2) for RV end-systolic volume index (ESVI). Cutoff values for optimal outcome (normalized RV volumes and function) were 163 ml/m(2) for RV EDVI and 80 ml/m(2) for RV ESVI. Higher pre-operative RV ESVI was identified as a sole independent risk factor for suboptimal outcome. Midterm outcomes of PVR in patients with chronic PR were acceptable. PVR should be considered before RV EDVI exceeds 163 ml/m(2) or RV ESVI exceeds 80 ml/m(2), with more attention to RV ESVI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Efecto de la localización del electrodo ventricular derecho (tracto de salida vs. ápex sobre la sincronía ventricular mecánica, en pacientes sometidos a terapia de implante de marcapaso cardiaco Effect of right ventricular electrode location (outflow tract vs. apex on mechanical ventricular synchrony in patients that underwent pacemaker implant therapy

    Directory of Open Access Journals (Sweden)

    Oscar S Rincón

    2008-12-01

    Full Text Available Objetivo: evaluar a profundidad el efecto de la estimulación ventricular desde el tracto de salida del ventrículo derecho y el ápex, sobre la sincronía ventricular mecánica. Materiales y métodos: estudio analítico de cohorte, en el que se realizó ecocardiograma transtorácico pre y post implante de marcapaso a 20 pacientes (diez por cada grupo con indicación de marcapaso definitivo, con implante del electrodo en el tracto de salida del ventrículo derecho y el ápex, sin cardiopatía estructural, fracción de eyección > 50%; QRS y conducción aurículo-ventricular normal, con el fin de evaluar la asincronía ventricular mecánica (modo M y Doppler tisular y los parámetros de implante y programación del dispositivo. Análisis estadístico: los resultados se presentan como promedios, desviación estándar o porcentajes. Las variables continuas se compararon utilizando prueba Chi cuadrado y ANOVA. Se consideró como estadísticamente significativa una p Objective: to assess in depth the effect of ventricular stimulation from the right ventricular outflow tract and the apex on mechanical ventricular synchrony. Materials and Methods: cohort analytical study. 20 patients with indication of definitive pacemaker indication underwent transthoracic echocardiogram before and after pacemaker implant with electrode implantation in the right ventricular outflow tract and in the apex (10 patients in each group. There was no structural cardiopathy, ejection fraction was > 50%, QRS and AV conduction were normal. Mechanical ventricular asynchrony (M mode and tissue doppler and implant and device parameters were evaluated. Statistical Analysis: results are given as mean values, standard deviation or percentages. Continuous variables were compared using Chi-square test and ANOVA. A p <0.05 value was considered statistically significant. Results: in five patients (25% a pre-implant ventricular asynchrony was found; in seven (70% ventricular asynchrony

  16. A Benign Cardiac Growth but Not So Indolent

    Directory of Open Access Journals (Sweden)

    Adil S. Wani

    2016-01-01

    Full Text Available Cardiac lipomatous hypertrophy is a rare benign condition that usually involves the interatrial septum. Due to its benign nature it rarely requires intervention. Its presence outside the interatrial septum is reported infrequently. We present a case of lipomatous hypertrophy in the intraventricular septum that was complicated by a severe, symptomatic, and disabling dynamic left ventricular outflow tract obstruction. The symptoms significantly improved following the excision of the mass. In our case transthoracic echocardiogram was used to visualize the mass and measure the severity of the obstruction; Cardiac Magnetic Resonance Imaging was used to characterize the mass and histopathology confirmed the diagnosis.

  17. A Benign Cardiac Growth but Not So Indolent

    Science.gov (United States)

    Reddy, Sahadev T.; Biederman, Robert W. W.

    2016-01-01

    Cardiac lipomatous hypertrophy is a rare benign condition that usually involves the interatrial septum. Due to its benign nature it rarely requires intervention. Its presence outside the interatrial septum is reported infrequently. We present a case of lipomatous hypertrophy in the intraventricular septum that was complicated by a severe, symptomatic, and disabling dynamic left ventricular outflow tract obstruction. The symptoms significantly improved following the excision of the mass. In our case transthoracic echocardiogram was used to visualize the mass and measure the severity of the obstruction; Cardiac Magnetic Resonance Imaging was used to characterize the mass and histopathology confirmed the diagnosis. PMID:27293911

  18. 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.

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

    OpenAIRE

    S Leah Etheridge; Saugata Ray; Shuangding Li; Natasha S Hamblet; Nardos Lijam; Michael Tsang; Michael Tsang; Joy Greer; Natalie Kardos; Jianbo Wang; Daniel J Sussman; Ping Chen; Anthony Wynshaw-Boris

    2008-01-01

    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, ...

  20. Anatomical Basis for the Cardiac Interventional Electrophysiologist

    Directory of Open Access Journals (Sweden)

    Damián Sánchez-Quintana

    2015-01-01

    Full Text Available The establishment of radiofrequency catheter ablation techniques as the mainstay in the treatment of tachycardia has renewed new interest in cardiac anatomy. The interventional arrhythmologist has drawn attention not only to the gross anatomic details of the heart but also to architectural and histological characteristics of various cardiac regions that are relevant to the development or recurrence of tachyarrhythmias and procedural related complications of catheter ablation. In this review, therefore, we discuss some anatomic landmarks commonly used in catheter ablations including the terminal crest, sinus node region, Koch’s triangle, cavotricuspid isthmus, Eustachian ridge and valve, pulmonary venous orifices, venoatrial junctions, and ventricular outflow tracts. We also discuss the anatomical features of important structures in the vicinity of the atria and pulmonary veins, such as the esophagus and phrenic nerves. This paper provides basic anatomic information to improve understanding of the mapping and ablative procedures for cardiac interventional electrophysiologists.

  1. 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.

  2. Organizing Thrombus Mimicking a Cardiac Tumor Located at the Mitral-Aortic Intervalvular Fibrosa

    Directory of Open Access Journals (Sweden)

    Ji Seong Lee

    2016-02-01

    Full Text Available Thrombosis at the left ventricular outflow tract occurs without any detectable heart disease or predisposing factors only extremely rarely. A 48-year-old male visited Konkuk University Medical Center with loss of consciousness one month prior to presentation. Before he visited our hospital, he had been diagnosed with a cardiac tumor, which was located between the left atrium and posterior aortic root, and which was adjacent to both the aortic and mitral valves. Cardiac transplantation was recommended at the other hospital because of the high risk of cardiac dysfunction induced by both aortic and mitral valvular dysfunction after surgical resection. Based on preoperative transthoracic echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, and intraoperative transesophageal echocardiography, we considered it to be a benign tumor. Complete resection was achieved and the pathology confirmed organizing thrombus. We report a case of organizing thrombus mimicking a cardiac tumor, which was located at the mitral-aortic intervalvular fibrosa of the left ventricular outflow tract without any heart disease.

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

    OpenAIRE

    Nemani, Lalita; Barik, Ramachandra; Patnaik, Amar Narayana; Mishra, Ramesh C; Rao, Amaresh M; Kapur, Pragati

    2014-01-01

    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 vent...

  4. Five-year results from a prospective multicentre study of percutaneous pulmonary valve implantation demonstrate sustained removal of significant pulmonary regurgitation, improved right ventricular outflow tract obstruction and improved quality of life

    DEFF Research Database (Denmark)

    Hager, Alfred; Schubert, Stephan; Ewert, Peter

    2017-01-01

    . The EQ-5D quality of life utility index and visual analogue scale scores were both significantly improved six months post PPVI and remained so at five years. CONCLUSIONS: Five-year results following PPVI demonstrate resolved moderate or severe pulmonary regurgitation, improved right ventricular outflow...

  5. Studies of Quasar Outflows

    Science.gov (United States)

    Arav, Nahum

    2002-01-01

    The main aim of this research program is to determine the ionization equilibrium and abundances in quasar outflows. Especially in the broad absorption line QSO PG 0946+301. We find that the outflow's metalicity is consistent with being solar, while the abundance ratio of phosphorus to other metals is at least ten times solar. These findings are based on diagnostics that are not sensitive to saturation and partial covering effects in the BALs (Broad Adsorption Lines), which considerably weakened previous claims for enhanced metalicity. Ample evidence for these effects is seen in the spectrum.

  6. 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.

  7. 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.

  8. Relativistic Outflows from ADAFs

    Science.gov (United States)

    Becker, Peter; Subramanian, Prasad; Kazanas, Demosthenes

    2001-04-01

    Advection-dominated accretion flows (ADAFs) have a positive Bernoulli parameter, and are therefore gravitationally bound. The Newtonian ADAF model has been generalized recently to obtain the ADIOS model that includes outflows of energy and angular momentum, thereby allowing accretion to proceed self-consistently. However, the utilization of a Newtonian gravitational potential limits the ability of this model to describe the inner region of the disk, where any relativistic outflows are likely to originate. In this paper we modify the ADIOS scenario to incorporate a seudo - Newtonian potential, which approximates the effects of general relativity. The analysis yields a unique, self - similar solution for the structure of the coupled disk/wind system. Interesting features of the new solution include the relativistic character of the outflow in the vicinity of the radius of marginal stability, which represents the inner edge of the quasi-Keplerian disk in our model. Our self - similar model may therefore help to explain the origin of relativistic jets in active galaxies. At large distances the radial dependence of the accretion rate approachs the unique form dot M ∝ r^1/2, with an associated density variation given by ρ ∝ r-1. This density variation agrees with that implied by the dependence of the X-ray hard time lags on the Fourier frequency for a number of accreting galactic black hole candidates. While intriguing, the results of our self-similar model need to be confirmed in the future by incorporating a detailed physical description of the energization mechanism that drives the outflow, which is likely to be powered by the shear of the underlying accretion disk.

  9. Fibroma (fibrous Hamartoma) of the right ventricle, causing of obstruction of the exit tract: reports of a case

    International Nuclear Information System (INIS)

    Lombardi J, Pier F; Mendez D, Lupo R; Echeverria C, Rafael; Lozano H, Edward C; Montes, David; Perez G, Jesus

    2003-01-01

    Most part of benign cardiac tumors are myxomas, they affect usually adults and are generally located in the atrial cavities. Fibromas, which are the second most common cardiac tumors, are rare. These are considered characteristic tumors during infancy and adolescence. A case of a 16 years old female patient with symptoms of advanced congestive cardiac failure is reported. An echocardiographyc diagnostic of an obstructive mass in the right ventricular outflow tract was made. The tumor was successfully enucleated. The pathologic specimen showed a fibro-myxoid macroscopical aspect; the microscopic study was consistent with a fibroblastic tumor with lax stroma and elongated cells, positive for interstitial collagen bundles (Masson's trichrome). The tumor cells had a positive reactivity to Vimentine and a negative one for factor VIII

  10. The paediatric cardiac centre for Africa--proceedings of the March 2012 symposium.

    Science.gov (United States)

    Kinsley, Robin H; Edwin, Frank; Entsua-Mensah, Kow

    2013-04-01

    The Pediatric Cardiac Centre for Africa (PCCA) was opened by national patron Mr Nelson Mandela on November 7, 2003. In 2008, the Centre's international pediatric cardiac symposium was introduced as a learning forum for pediatric cardiac surgeons and cardiologists in the continent. The symposium has consistently grown in attendance and attracted distinguished leaders in the field. The 2012 symposium featured Dr. Thomas Spray of Children's Hospital of Philadelphia, Dr. David Barron of Birmingham Children's Hospital, and Dr. John Brown of Indiana University School of Medicine as guest speakers. Experience of the Fontan procedure, the small aortic root, hypoplastic left heart syndrome, right ventricular outflow tract reconstruction, transposition of the great arteries, and interrupted aortic arch were the highlights of the symposium. In the "African Corner," centers in South Africa, Ghana, and Angola presented work done from across the African continent.

  11. Measurement method of cardiac computed tomography (CT)

    International Nuclear Information System (INIS)

    Watanabe, Shigeru; Yamamoto, Hironori; Yumura, Yasuo; Yoshida, Hideo; Morooka, Nobuhiro

    1980-01-01

    The CT was carried out in 126 cases consisting of 31 normals, 17 cases of mitral stenosis (MS), 8 cases of mitral regurgitation (MR), 11 cases of aortic stenosis (AS), 9 cases of aortic regurgitation (AR), 20 cases of myocardial infarction (MI), 8 cases of atrial septal defect (ASD) and 22 hypertensives. The 20-second scans were performed every 1.5 cm from the 2nd intercostal space to the 5th or 6th intercostal space. The computed tomograms obtained were classified into 8 levels by cross-sectional anatomy; levels of (1) the aortic arch, (2) just beneath the aortic arch, (3) the pulmonary artery bifurcation, (4) the right atrial appendage or the upper right atrium, (5) the aortic root, (6) the upper left ventricle, (7) the mid left ventricle, and (8) the lower left ventricle. The diameter (anteroposterior and transverse) and cross-sectional area were measured about ascending aorta (Ao), descending aorta (AoD), superior vena cava (SVC), inferoir vena cava (IVC), pulmonary artery branch (PA), main pulmonary artery (mPA), left atrium (LA), right atrium (RA), and right ventricular outflow tract (RVOT) on each level where they were clearly distinguished. However, it was difficult to separate cardiac wall from cardiac cavity because there was little difference of X-ray attenuation coefficient between the myocardium and blood. Therefore, on mid ventricular level, diameter and area about total cardiac shadow were measured, and then cardiac ratios to the thorax were respectively calculated. The normal range of their values was shown in table, and abnormal characteristics in cardiac disease were exhibited in comparison with normal values. In MS, diameter and area in LA were significantly larger than normal. In MS and ASD, all the right cardiac system were larger than normal, especially, RA and SVC in MS, PA and RVOT in ASD. The diameter and area of the aortic root was larger in the order of AR, AS and HT than normal. (author)

  12. 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.

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

    Science.gov (United States)

    Nemani, Lalita; Barik, Ramachandra; Patnaik, Amar Narayana; Mishra, Ramesh C; Rao, Amaresh M; Kapur, Pragati

    2014-09-01

    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.

  14. Molecular outflows in protostellar evolution

    International Nuclear Information System (INIS)

    Fukui, Y.; Iwata, T.; Mizuno, A.; Ogawa, H.; Kawabata, K.; Sugitani, K.

    1989-01-01

    Molecular outflow is an energetic mass-ejection phenomenon associated with very early stage of stellar evolution. The large kinetic energy involved in the phenomenon indicates that outflow may play an essential role in the process of star formation, particularly by extracting angular momentum. Most of the previous searches have been strongly biased toward optical or near-infrared signposts of star formation. They are not able, therefore, to provide the complete database necessary for a statistical study of the evolutionary status of molecular outflow. To overcome this difficulty, it is of vital importance to make an unbiased search of single molecular clouds for molecular outflows; here we report the final result of such a survey of the Lynds 1641 dark cloud. We show that molecular outflows are characterized by a total luminosity significantly greater than that of T Tauri stars. This indicates that molecular outflow corresponds to the main accretion phase of protostellar evolution, in which the luminosity excess is due to the gravitational energy released by dynamical mass accretion onto the protostellar core. (author)

  15. Neonatal outcomes in fetuses with cardiac anomalies and the impact of delivery route.

    Science.gov (United States)

    Parikh, Laura I; Grantz, Katherine L; Iqbal, Sara N; Huang, Chun-Chih; Landy, Helain J; Fries, Melissa H; Reddy, Uma M

    2017-10-01

    Congenital fetal cardiac anomalies compromise the most common group of fetal structural anomalies. Several previous reports analyzed all types of fetal cardiac anomalies together without individualized neonatal morbidity outcomes based on cardiac defect. Mode of delivery in cases of fetal cardiac anomalies varies greatly as optimal mode of delivery in these complex cases is unknown. We sought to determine rates of neonatal outcomes for fetal cardiac anomalies and examine the role of attempted route of delivery on neonatal morbidity. Gravidas with fetal cardiac anomalies and delivery >34 weeks, excluding stillbirths and aneuploidies (n = 2166 neonates, n = 2701 cardiac anomalies), were analyzed from the Consortium on Safe Labor, a retrospective cohort study of electronic medical records. Cardiac anomalies were determined using International Classification of Diseases, Ninth Revision codes and organized based on morphology. Neonates were assigned to each cardiac anomaly classification based on the most severe cardiac defect present. Neonatal outcomes were determined for each fetal cardiac anomaly. Composite neonatal morbidity (serious respiratory morbidity, sepsis, birth trauma, hypoxic ischemic encephalopathy, and neonatal death) was compared between attempted vaginal delivery and planned cesarean delivery for prenatal and postnatal diagnosis. We used multivariate logistic regression to calculate adjusted odds ratio for composite neonatal morbidity controlling for race, parity, body mass index, insurance, gestational age, maternal disease, single or multiple anomalies, and maternal drug use. Most cardiac anomalies were diagnosed postnatally except hypoplastic left heart syndrome, which had a higher prenatal than postnatal detection rate. Neonatal death occurred in 8.4% of 107 neonates with conotruncal defects. Serious respiratory morbidity occurred in 54.2% of 83 neonates with left ventricular outflow tract defects. Overall, 76.3% of pregnancies with fetal

  16. Knowledge Outflows from Foreign Subsidiaries

    DEFF Research Database (Denmark)

    Perri, Alessandra; Andersson, Ulf

    This paper analyzes the MNC subsidiaries’ trade-off between the need for knowledge creation and the need for knowledge protection, and relates it to the extent of knowledge outflows generated within the host location. Combining research in International Business with Social Theory, we find...... 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...... that subsidiaries that extensively draw on external knowledge sources are also more likely to generate knowledge outflows to local firms. We argue that this may be explained by the subsidiaries’ willingness to build the trust that facilitates the establishment of reciprocal knowledge linkages. However, when...

  17. Molecular Outflows: Explosive versus Protostellar

    Energy Technology Data Exchange (ETDEWEB)

    Zapata, Luis A.; Rodríguez, Luis F.; Palau, Aina; Loinard, Laurent [Instituto de Radioastronomía y Astrofísica, UNAM, Apdo. Postal 3-72 (Xangari), 58089 Morelia, Michoacán, México (Mexico); Schmid-Burgk, Johannes [Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, D-53121, Bonn (Germany)

    2017-02-10

    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 {sup 12}CO( 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.

  18. 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

    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...... of depressed conductivity known to be a prerequisite for experimental ventricular ectopy including parasystole....

  19. Qualitative and quantitative analyses of the morphological-dynamics of early cardiac pump action using video densidometry and optical coherence tomography (OCT)

    DEFF Research Database (Denmark)

    Männer, Jörg; Thrane, Lars; Thommes, Jan

    2010-01-01

    a matter of dispute. Uncovering of the pumping mechanism of tubular embryonic hearts requires detailed information about the hemodynamics as well as morphological dynamics of their pump action. We have therefore analyzed the morphological dynamics of cardiac pump action in chick embryos (HH-stages 16...... have recorded striking differences in the contraction behavior (e.g. contraction speed, duration of systolic occlusion of heart lumen) of the embryonic heart segments (common atrium, AV-canal, embryonic ventricles, outflow tract). Moreover, we show, for the first time, the pump action of tubular...

  20. PROTOSTELLAR OUTFLOWS IN L1340

    Energy Technology Data Exchange (ETDEWEB)

    Walawender, Josh [W. M. Keck Observatory, 65-1120 Mamalahoa Hwy, Kamuela, HI 96743 (United States); Wolf-Chase, Grace [Astronomy Department, Adler Planetarium, 1300 South Lake Shore Drive, Chicago, IL 60605 (United States); Smutko, Michael [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and Department of Physics and Astronomy, Northwestern University, 2145 Sheridan Road, Evanston, IL 60208 (United States); OLinger-Luscusk, JoAnn [California Institute of Technology, 1200 E California Blvd, Pasadena, CA 91125 (United States); Moriarty-Schieven, Gerald, E-mail: jmwalawender@keck.hawaii.edu [National Research Council—Herzberg Astronomy and Astrophysics, 5017 West Saanich Road, Victoria, BC, V9E 2E7 (Canada)

    2016-12-01

    We have searched the L1340 A, B, and C clouds for shocks from protostellar outflows using the H{sub 2} 2.122 μ m near-infrared line as a shock tracer. Substantial outflow activity has been found in each of the three regions of the cloud (L1340 A, L1340 B, and 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 into 12 distinct outflows and identify candidate source stars for each. We examine the properties ( A {sub V}, T {sub bol}, and L {sub bol}) of the source protostars and compare them to the properties of the general population of Class 0/I and flat spectral energy distribution 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 {sub V}, higher L {sub bol}, and lower T {sub bol} than the general population of protostars.

  1. Satisfactory visualization rates of standard cardiac views at 18 to 22 weeks' gestation using spatiotemporal image correlation.

    Science.gov (United States)

    Cohen, Leeber; Mangers, Kristie; Grobman, William A; Platt, Lawrence D

    2009-12-01

    The purpose of this study was to determine the frequency with which 3 standard screening views of the fetal heart (4-chamber, left ventricular outflow tract [LVOT], and right ventricular outflow tract [RVOT]) can be obtained satisfactorily with the spatiotemporal image correlation (STIC) technique. A prospective study of 111 patients undergoing anatomic surveys at 18 to 22 weeks was performed. Two ultrasound machines with fetal cardiac settings were used. The best volume set that could be obtained from each patient during a 45-minute examination was graded by 2 sonologists with regard to whether the 4-chamber, LVOT, and RVOT images were satisfactory for screening. All 3 views were judged satisfactory for screening in most patients: 1 sonologist graded the views as satisfactory in 70% of the patients, whereas the other found the views to be satisfactory in 83%. The position of the placenta did not alter the probability of achieving a satisfactory view, but a fetus in the spine anterior position was associated with a significantly lower probability that the views were regarded as satisfactory for screening (odds ratio, 0.28; 95% confidence interval, 0.09-0.70; P < .05). This study suggests that STIC may assist with screening for cardiac anomalies at 18 to 22 weeks' gestation.

  2. Role of imaging in evaluation of sudden cardiac death risk in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Geske, Jeffrey B; Ommen, Steve R

    2015-09-01

    Hypertrophic cardiomyopathy (HCM) is the most common heritable cardiomyopathy and is associated with sudden cardiac death (SCD) - an uncommon but devastating clinical outcome. This review is designed to assess the role of imaging in established risk factor assessment and its role in emerging SCD risk stratification. Recent publications have highlighted the crucial role of imaging in HCM SCD risk stratification. Left ventricular hypertrophy assessment remains the key imaging determinant of risk. Data continue to emerge on the role of systolic dysfunction, apical aneurysms, left atrial enlargement and left ventricular outflow tract obstruction as markers of risk. Quantitative assessment of delayed myocardial enhancement and T1 mapping on cardiac MRI continue to evolve. Recent multicenter trials have allowed multivariate SCD risk assessment in large HCM cohorts. Given aggregate risk with presence of multiple risk factors, a single parameter should not be used in isolation to determine implantable cardiac defibrillator candidacy. Use of all available imaging data, including cardiac magnetic resonance tissue characterization, allows a comprehensive approach to SCD stratification and implantable cardiac defibrillator decision-making.

  3. Massive Outflows Associated with ATLASGAL Clumps

    Science.gov (United States)

    Yang, A. Y.; Thompson, M. A.; Urquhart, J. S.; Tian, W. W.

    2018-03-01

    We have undertaken the largest survey for outflows within the Galactic plane using simultaneously observed {}13{CO} and {{{C}}}18{{O}} data. Out of a total of 919 ATLASGAL clumps, 325 have data suitable to identify outflows, and 225 (69% ± 3%) show high-velocity outflows. The clumps with detected outflows show significantly higher clump masses ({M}clump}), bolometric luminosities ({L}bol}), luminosity-to-mass ratios ({L}bol}/{M}clump}), and peak H2 column densities ({N}{{{H}}2}) compared to those without outflows. Outflow activity has been detected within the youngest quiescent clump (i.e., 70 μ {{m}} weak) in this sample, and we find that the outflow detection rate increases with {M}clump}, {L}bol}, {L}bol}/{M}clump}, and {N}{{{H}}2}, approaching 90% in some cases (UC H II regions = 93% ± 3%; masers = 86% ± 4%; HC H II regions = 100%). This high detection rate suggests that outflows are ubiquitous phenomena of massive star formation (MSF). The mean outflow mass entrainment rate implies a mean accretion rate of ∼ {10}-4 {M}ȯ {yr}}-1, in full agreement with the accretion rate predicted by theoretical models of MSF. Outflow properties are tightly correlated with {M}clump}, {L}bol}, and {L}bol}/{M}clump} and show the strongest relation with the bolometric clump luminosity. This suggests that outflows might be driven by the most massive and luminous source within the clump. The correlations are similar for both low-mass and high-mass outflows over 7 orders of magnitude, indicating that they may share a similar outflow mechanism. Outflow energy is comparable to the turbulent energy within the clump; however, we find no evidence that outflows increase the level of clump turbulence as the clumps evolve. This implies that the origin of turbulence within clumps is fixed before the onset of star formation.

  4. 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...

  5. Investigation of cerebral venous outflow in microgravity.

    Science.gov (United States)

    Taibi, A; Gadda, G; Gambaccini, M; Menegatti, E; Sisini, F; Zamboni, P

    2017-10-31

    The gravitational gradient is the major component to face when considering the physiology of venous return, and there is a growing interest in understanding the mechanisms ensuring the heart filling, in the absence of gravity, for astronauts who perform long-term space missions. The purpose of the Drain Brain project was to monitor the cerebral venous outflow of a crew member during an experiment on the International Space Station (ISS), so as to study the compensatory mechanisms that facilitate this essential physiological action in subjects living in a microgravity environment. Such venous function has been characterized by means of a novel application of strain-gauge plethysmography which uses a capacitive sensor. In this contribution, preliminary results of our investigation have been presented. In particular, comparison of plethysmography data confirmed that long duration spaceflights lead to a redistribution of venous blood volume, and showed interesting differences in the amplitude of cardiac oscillations measured at the level of the neck veins. The success of the experiment has also demonstrated that thanks to its easy portability, non-invasiveness, and non-operator dependence, the proposed device can be considered as a novel tool for use aboard the ISS. Further trials are now under way to complete the investigation on the drainage function of the neck veins in microgravity.

  6. 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

  7. Feasibility of MRI of the fetal heart with balanced steady-state free precession sequence along fetal body and cardiac planes.

    Science.gov (United States)

    Saleem, Sahar N

    2008-10-01

    The purpose of this study was to evaluate the feasibility of imaging the fetal heart with a balanced steady-state free precession MRI sequence along the body and cardiac axes after inadequate echocardiography. After technically inadequate echocardiography, MRI was performed on 20 fetuses (mean gestational age, 24 weeks; range, 18-32 weeks) at risk of congenital heart disease. MRI was attempted along the three fetal body planes (n = 20) and cardiac axes (n = 3) without fetal sedation. The images were analyzed with an anatomic segmental approach. Each feature was classified as well visualized or poorly or not visualized. In each group, the Student's t test was used to assess the relation between visibility of fetal cardiac features and gestational age. Imaging was possible along the fetal body and cardiac axes. In the axial plane, a balanced four-chamber view was obtained in all fetuses, enabling evaluation of heart position, axis, chambers, and interventricular septum. The left and right ventricular outflow tracts were well visualized in 12 (60%) and nine (45%) of the fetuses, respectively; the three-vessel view was obtained in 10 fetuses (50%). With the combination of sagittal and coronal views, both ventricular outflow tracts were assessed in all fetuses. The superior and inferior venae cavae were identified in all fetuses, and at least one pulmonary vein was visualized in 17 fetuses (85%). There were no statistically significant differences between gestational age and lack of visualization of a cardiac feature that was attributed to fetal motion. MRI of the fetal heart with a steady-state free precession sequence in multiple planes and image analysis with an anatomic segmental approach to congenital heart disease are possible in situations that limit echocardiography.

  8. Adverse cardiac events in children with Williams syndrome undergoing cardiovascular surgery: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database.

    Science.gov (United States)

    Hornik, Christoph P; Collins, Ronnie Thomas; Jaquiss, Robert D B; Jacobs, Jeffrey P; Jacobs, Marshall L; Pasquali, Sara K; Wallace, Amelia S; Hill, Kevin D

    2015-06-01

    Patients with Williams syndrome (WS) undergoing cardiac surgery are at risk for major adverse cardiac events (MACE). Prevalence and risk factors for such events have not been well described. We sought to define frequency and risk of MACE in patients with WS using a multicenter clinical registry. We identified cardiac operations performed in patients with WS using the Society of Thoracic Surgeons Congenital Heart Surgery Database (2000-2012). Operations were divided into 4 groups: isolated supravalvular aortic stenosis, complex left ventricular outflow tract (LVOT), isolated right ventricular outflow tract (RVOT), and combined LVOT/RVOT procedures. The proportion of patients with MACE (in-hospital mortality, cardiac arrest, or postoperative mechanical circulatory support) was described and the association with preoperative factors was examined. Of 447 index operations (87 centers), median (interquartile range) age and weight at surgery were 2.4 years (0.6-7.4 years) and 10.6 kg (6.5-21.5 kg), respectively. Mortality occurred in 20 patients (5%). MACE occurred in 41 patients (9%), most commonly after combined LVOT/RVOT (18 out of 87; 21%) and complex LVOT (12 out of 131; 9%) procedures, but not after isolated RVOT procedures. Odds of MACE decreased with age (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98-0.99), weight (OR, 0.97; 95% CI, 0.93-0.99), but increased in the presence of any preoperative risk factor (OR, 2.08; 95% CI, 1.06-4.00), and in procedures involving coronary artery repair (OR, 5.37; 95% CI, 2.05-14.06). In this multicenter analysis, MACE occurred in 9% of patients with WS undergoing cardiac surgery. Demographic and operative characteristics were associated with risk. Further study is needed to elucidate mechanisms of MACE in this high-risk population. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  9. Recent advances in cardiac catheterization for congenital heart disease [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Sok-Leng Kang

    2018-03-01

    Full Text Available The field of pediatric and adult congenital cardiac catheterization has evolved rapidly in recent years. This review will focus on some of the newer endovascular technological and management strategies now being applied in the pediatric interventional laboratory. Emerging imaging techniques such as three-dimensional (3D rotational angiography, multi-modal image fusion, 3D printing, and holographic imaging have the potential to enhance our understanding of complex congenital heart lesions for diagnostic or interventional purposes. While fluoroscopy and standard angiography remain procedural cornerstones, improved equipment design has allowed for effective radiation exposure reduction strategies. Innovations in device design and implantation techniques have enabled the application of percutaneous therapies in a wider range of patients, especially those with prohibitive surgical risk. For example, there is growing experience in transcatheter duct occlusion in symptomatic low-weight or premature infants and stent implantation into the right ventricular outflow tract or arterial duct in cyanotic neonates with duct-dependent pulmonary circulations. The application of percutaneous pulmonary valve implantation has been extended to a broader patient population with dysfunctional ‘native’ right ventricular outflow tracts and has spurred the development of novel techniques and devices to solve associated anatomic challenges. Finally, hybrid strategies, combining cardiosurgical and interventional approaches, have enhanced our capabilities to provide care for those with the most complex of lesions while optimizing efficacy and safety.

  10. Premature Ventricular Contraction Coupling Interval Variability Destabilizes Cardiac Neuronal and Electrophysiological Control: Insights From Simultaneous Cardioneural Mapping.

    Science.gov (United States)

    Hamon, David; Rajendran, Pradeep S; Chui, Ray W; Ajijola, Olujimi A; Irie, Tadanobu; Talebi, Ramin; Salavatian, Siamak; Vaseghi, Marmar; Bradfield, Jason S; Armour, J Andrew; Ardell, Jeffrey L; Shivkumar, Kalyanam

    2017-04-01

    Variability in premature ventricular contraction (PVC) coupling interval (CI) increases the risk of cardiomyopathy and sudden death. The autonomic nervous system regulates cardiac electrical and mechanical indices, and its dysregulation plays an important role in cardiac disease pathogenesis. The impact of PVCs on the intrinsic cardiac nervous system, a neural network on the heart, remains unknown. The objective was to determine the effect of PVCs and CI on intrinsic cardiac nervous system function in generating cardiac neuronal and electric instability using a novel cardioneural mapping approach. In a porcine model (n=8), neuronal activity was recorded from a ventricular ganglion using a microelectrode array, and cardiac electrophysiological mapping was performed. Neurons were functionally classified based on their response to afferent and efferent cardiovascular stimuli, with neurons that responded to both defined as convergent (local reflex processors). Dynamic changes in neuronal activity were then evaluated in response to right ventricular outflow tract PVCs with fixed short, fixed long, and variable CI. PVC delivery elicited a greater neuronal response than all other stimuli ( P <0.001). Compared with fixed short and long CI, PVCs with variable CI had a greater impact on neuronal response ( P <0.05 versus short CI), particularly on convergent neurons ( P <0.05), as well as neurons receiving sympathetic ( P <0.05) and parasympathetic input ( P <0.05). The greatest cardiac electric instability was also observed after variable (short) CI PVCs. Variable CI PVCs affect critical populations of intrinsic cardiac nervous system neurons and alter cardiac repolarization. These changes may be critical for arrhythmogenesis and remodeling, leading to cardiomyopathy. © 2017 American Heart Association, Inc.

  11. Geometry of anisotropic CO outflows

    International Nuclear Information System (INIS)

    Liseau, R.; Sandell, G.; Helsinki Univ., Observatory, Finland)

    1986-01-01

    A simple geometrical model for the space motions of the bipolar high-velocity CO outflows in regions of recent, active star formation is proposed. It is assumed that the velocity field of the neutral gas component can be represented by large-scale uniform motions. From observations of the spatial distribution and from the characteristics of the line shape of the high-velocity molecular gas emission the geometry of the line-emitting regions can be inferred, i.e., the direction in space and the collimating angle of the flow. The model has been applied to regions where a check on presently obtained results is provided by independent optical determinations of the motions of Herbig-Haro objects associated with the CO flows. These two methods are in good agreement and, furthermore, the results obtained provide convincingly strong evidence for the physical association of CO outflows and Herbig-Haro objects. This also supports the common view that a young stellar central source is responsible for the active phenomena observed in its environmental neighborhood. It is noteworthy that within the framework of the model the determination of the flow geometry of the high-velocity gas from CO measurements is independent of the distance to the source and, furthermore, can be done at relatively low spatial resolution. 32 references

  12. Non-invasive cardiac output trending during exercise recovery on a bathroom-scale-based ballistocardiograph

    International Nuclear Information System (INIS)

    Inan, O T; Etemadi, M; Giovangrandi, L; Kovacs, G T A; Paloma, A

    2009-01-01

    Cardiac ejection of blood into the aorta generates a reaction force on the body that can be measured externally via the ballistocardiogram (BCG). In this study, a commercial bathroom scale was modified to measure the BCGs of nine healthy subjects recovering from treadmill exercise. During the recovery, Doppler echocardiogram signals were obtained simultaneously from the left ventricular outflow tract of the heart. The percentage changes in root-mean-square (RMS) power of the BCG were strongly correlated with the percentage changes in cardiac output measured by Doppler echocardiography (R 2 = 0.85, n = 275 data points). The correlation coefficients for individually analyzed data ranged from 0.79 to 0.96. Using Bland–Altman methods for assessing agreement, the mean bias was found to be −0.5% (±24%) in estimating the percentage changes in cardiac output. In contrast to other non-invasive methods for trending cardiac output, the unobtrusive procedure presented here uses inexpensive equipment and could be performed without the aid of a medical professional

  13. Non-invasive cardiac output trending during exercise recovery on a bathroom-scale-based ballistocardiograph.

    Science.gov (United States)

    Inan, O T; Etemadi, M; Paloma, A; Giovangrandi, L; Kovacs, G T A

    2009-03-01

    Cardiac ejection of blood into the aorta generates a reaction force on the body that can be measured externally via the ballistocardiogram (BCG). In this study, a commercial bathroom scale was modified to measure the BCGs of nine healthy subjects recovering from treadmill exercise. During the recovery, Doppler echocardiogram signals were obtained simultaneously from the left ventricular outflow tract of the heart. The percentage changes in root-mean-square (RMS) power of the BCG were strongly correlated with the percentage changes in cardiac output measured by Doppler echocardiography (R(2) = 0.85, n = 275 data points). The correlation coefficients for individually analyzed data ranged from 0.79 to 0.96. Using Bland-Altman methods for assessing agreement, the mean bias was found to be -0.5% (+/-24%) in estimating the percentage changes in cardiac output. In contrast to other non-invasive methods for trending cardiac output, the unobtrusive procedure presented here uses inexpensive equipment and could be performed without the aid of a medical professional.

  14. [Catheter ablation in patients with refractory cardiac arrhythmias with radiofrequency techniques].

    Science.gov (United States)

    de Paola, A A; Balbão, C E; Silva Netto, O; Mendonça, A; Villacorta, H; Vattimo, A C; Souza, I A; Guiguer Júnior, N; Portugal, O P; Martinez Filho, E E

    1993-02-01

    evaluate the efficacy of radiofrequency catheter ablation in patients with refractory cardiac arrhythmias. twenty patients with refractory cardiac arrhythmias were undertaken to electrophysiologic studies for diagnosis and radiofrequency catheter ablation of their reentrant arrhythmias. Ten patients were men and 10 women with ages varying from 13 to 76 years (mean = 42.4 years). Nineteen patients had supraventricular tachyarrhythmias: One patient had atrial tachycardia and 1 atrial fibrillation with rapid ventricular rate, 5 patients had reentrant nodal tachycardia, 12 patients had reentrant atrioventricular tachycardia and 1 patient had right ventricular outflow tract tachycardia. the mean time of the procedure was 4.1 hours. The radiofrequency current energy applied was 40-50 V for 30-40 seconds. Ablation was successful in 18/20 (90%) patients; in 15/18 (83%) of successfully treated patients the same study was done for diagnosis and radiofrequency ablation. One patient had femoral arterial occlusion and was treated with no significant sequelae. During a mean follow-up of 4 months no preexcitation or reentrant tachycardia occurred. the results of our experience with radiofrequency catheter ablation of cardiac arrhythmias suggest that this technique can benefit an important number of patients with cardiac arrhythmias.

  15. 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

  16. Right ventricular involvement in cardiac sarcoidosis demonstrated with cardiac magnetic resonance.

    Science.gov (United States)

    Smedema, Jan-Peter; van Geuns, Robert-Jan; Ainslie, Gillian; Ector, Joris; Heidbuchel, Hein; Crijns, Harry J G M

    2017-11-01

    Cardiac involvement in sarcoidosis is reported in up to 30% of patients. Left ventricular involvement demonstrated by contrast-enhanced cardiac magnetic resonance has been well validated. We sought to determine the prevalence and distribution of right ventricular late gadolinium enhancement in patients diagnosed with pulmonary sarcoidosis. We prospectively evaluated 87 patients diagnosed with pulmonary sarcoidosis with contrast-enhanced cardiac magnetic resonance for right ventricular involvement. Pulmonary artery pressures were non-invasively evaluated with Doppler echocardiography. Patient characteristics were compared between the groups with and without right ventricular involvement, and right ventricular enhancement was correlated with pulmonary hypertension, ventricular mass, volume, and systolic function. Left ventricular late gadolinium enhancement was demonstrated in 30 patients (34%). Fourteen patients (16%) had right ventricular late gadolinium enhancement, with sole right ventricular enhancement in only two patients. The pattern of right ventricular enhancement consisted of right ventricular outflow tract enhancement in 1 patient, free wall enhancement in 8 patients, ventricular insertion point enhancement in 10 patients, and enhancement of the right side of the interventricular septum in 11 patients. Pulmonary arterial hypertension correlated with the presence of right ventricular enhancement (P Right ventricular enhancement correlated with systolic ventricular dysfunction (P Right ventricular enhancement was present in 16% of patients diagnosed with pulmonary sarcoidosis and in 48% of patients with left ventricular enhancement. The presence of right ventricular enhancement correlated with pulmonary arterial hypertension, right ventricular systolic dysfunction, hypertrophy, and dilation. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

  17. 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

  18. Urinary Tract Infection (UTI)

    Science.gov (United States)

    ... Home A-Z Health Topics Urinary tract infections Urinary tract infections > A-Z Health Topics Urinary tract infections (PDF, ... Embed Subscribe To receive Publications email updates Submit Urinary tract infections Urinary tract infections (UTIs) are most often caused ...

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

    Directory of Open Access Journals (Sweden)

    Bjarke Jensen

    Full Text Available 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.

  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. Premature Ventricular Contraction Coupling Interval Variability Destabilizes Cardiac Neuronal and Electrophysiological Control: Insights from Simultaneous Cardio-Neural Mapping

    Science.gov (United States)

    Hamon, David; Rajendran, Pradeep S.; Chui, Ray W.; Ajijola, Olujimi A.; Irie, Tadanobu; Talebi, Ramin; Salavatian, Siamak; Vaseghi, Marmar; Bradfield, Jason S.; Armour, J. Andrew; Ardell, Jeffrey L.; Shivkumar, Kalyanam

    2017-01-01

    Background Variability in premature ventricular contraction (PVC) coupling interval (CI) increases the risk of cardiomyopathy and sudden death. The autonomic nervous system regulates cardiac electrical and mechanical indices, and its dysregulation plays an important role in cardiac disease pathogenesis. The impact of PVCs on the intrinsic cardiac nervous system (ICNS), a neural network on the heart, remains unknown. The objective was to determine the effect of PVCs and CI on ICNS function in generating cardiac neuronal and electrical instability using a novel cardio-neural mapping approach. Methods and Results In a porcine model (n=8) neuronal activity was recorded from a ventricular ganglion using a microelectrode array, and cardiac electrophysiological mapping was performed. Neurons were functionally classified based on their response to afferent and efferent cardiovascular stimuli, with neurons that responded to both defined as convergent (local reflex processors). Dynamic changes in neuronal activity were then evaluated in response to right ventricular outflow tract PVCs with fixed short, fixed long, and variable CI. PVC delivery elicited a greater neuronal response than all other stimuli (P<0.001). Compared to fixed short and long CI, PVCs with variable CI had a greater impact on neuronal response (P<0.05 versus short CI), particularly on convergent neurons (P<0.05), as well as neurons receiving sympathetic (P<0.05) and parasympathetic input (P<0.05). The greatest cardiac electrical instability was also observed following variable (short) CI PVCs. Conclusions Variable CI PVCs affect critical populations of ICNS neurons and alter cardiac repolarization. These changes may be critical for arrhythmogenesis and remodeling leading to cardiomyopathy. PMID:28408652

  2. The evaluation of cardiac tamponade risk in patients with pericardial effusion detected by non-gated chest CT.

    Science.gov (United States)

    Ohta, Yasutoshi; Miyoshi, Fuminori; Kaminou, Toshio; Kaetsu, Yasuhiro; Ogawa, Toshihide

    2016-05-01

    Although pericardial effusion is often identified using non-gated chest computed tomography (CT), findings predictive of cardiac tamponade have not been adequately established. To determine the findings predictive of clinical cardiac tamponade in patients with moderate to large pericardial effusion using non-gated chest CT. We performed a retrospective analysis of 134 patients with moderate to large pericardial effusion who were identified from among 4581 patients who underwent non-gated chest CT. Cardiac structural changes, including right ventricular outflow tract (RVOT), were qualitatively evaluated. The inferior vena cava ratio with hepatic (IVCupp) and renal portions (IVClow) and effusion size were measured. The diagnostic performance of each structural change was calculated, and multivariate analysis was used to determine the predictors of cardiac tamponade. Of the 134 patients (mean age, 70.3 years; 64 men), 37 (28%) had cardiac tamponade. The sensitivity and specificity were 76% and 74% for RVOT compression; 87% and 84% for an IVClow ratio ≥0.77; and 60% and 77% for an effusion size ≥25.5 mm, respectively. Multivariate logistic regression analysis demonstrated that RVOT compression, an IVClow ratio ≥0.77, and an effusion size ≥25.5 mm were independent predictors of cardiac tamponade. The combination of these three CT findings had a sensitivity, specificity, and accuracy of 81%, 95%, and 91%, respectively. In patients with moderate to large pericardial effusion, non-gated chest CT provides additional information for predicting cardiac tamponade. © The Foundation Acta Radiologica 2015.

  3. Comparing Methods for Cardiac Output: Intraoperatively Doppler-Derived Cardiac Output Measured With 3-Dimensional Echocardiography Is Not Interchangeable With Cardiac Output by Pulmonary Catheter Thermodilution.

    Science.gov (United States)

    Graeser, Karin; Zemtsovski, Mikhail; Kofoed, Klaus F; Winther-Jensen, Matilde; Nilsson, Jens C; Kjaergaard, Jesper; Møller-Sørensen, Hasse

    2018-01-09

    Estimation of cardiac output (CO) is essential in the treatment of circulatory unstable patients. CO measured by pulmonary artery catheter thermodilution is considered the gold standard but carries a small risk of severe complications. Stroke volume and CO can be measured by transesophageal echocardiography (TEE), which is widely used during cardiac surgery. We hypothesized that Doppler-derived CO by 3-dimensional (3D) TEE would agree well with CO measured with pulmonary artery catheter thermodilution as a reference method based on accurate measurements of the cross-sectional area of the left ventricular outflow tract. The primary aim was a systematic comparison of CO with Doppler-derived 3D TEE and CO by thermodilution in a broad population of patients undergoing cardiac surgery. A subanalysis was performed comparing cross-sectional area by TEE with cardiac computed tomography (CT) angiography. Sixty-two patients, scheduled for elective heart surgery, were included; 1 was subsequently excluded for logistic reasons. Inclusion criteria were coronary artery bypass surgery (N = 42) and aortic valve replacement (N = 19). Exclusion criteria were chronic atrial fibrillation, left ventricular ejection fraction below 0.40 and intracardiac shunts. Nineteen randomly selected patients had a cardiac CT the day before surgery. All images were stored for blinded post hoc analyses, and Bland-Altman plots were used to assess agreement between measurement methods, defined as the bias (mean difference between methods), limits of agreement (equal to bias ± 2 standard deviations of the bias), and percentage error (limits of agreement divided by the mean of the 2 methods). Precision was determined for the individual methods (equal to 2 standard deviations of the bias between replicate measurements) to determine the acceptable limits of agreement. We found a good precision for Doppler-derived CO measured by 3D TEE, but although the bias for Doppler-derived CO by 3D compared to

  4. Large-Scale Outflows in Seyfert Galaxies

    Science.gov (United States)

    Colbert, E. J. M.; Baum, S. A.

    1995-12-01

    \\catcode`\\@=11 \\ialign{m @th#1hfil ##hfil \\crcr#2\\crcr\\sim\\crcr}}} \\catcode`\\@=12 Highly collimated outflows extend out to Mpc scales in many radio-loud active galaxies. In Seyfert galaxies, which are radio-quiet, the outflows extend out to kpc scales and do not appear to be as highly collimated. In order to study the nature of large-scale (>~1 kpc) outflows in Seyferts, we have conducted optical, radio and X-ray surveys of a distance-limited sample of 22 edge-on Seyfert galaxies. Results of the optical emission-line imaging and spectroscopic survey imply that large-scale outflows are present in >~{{1} /{4}} of all Seyferts. The radio (VLA) and X-ray (ROSAT) surveys show that large-scale radio and X-ray emission is present at about the same frequency. Kinetic luminosities of the outflows in Seyferts are comparable to those in starburst-driven superwinds. Large-scale radio sources in Seyferts appear diffuse, but do not resemble radio halos found in some edge-on starburst galaxies (e.g. M82). We discuss the feasibility of the outflows being powered by the active nucleus (e.g. a jet) or a circumnuclear starburst.

  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. OH outflows in star-forming regions

    International Nuclear Information System (INIS)

    Mirabel, I.F.; Ruiz, A.; Rodriguez, L.F.; Canto, J.; Universidad de Puer; Universidad de Puerto Rico, Rio Piedras; Universidad Nacional Autonoma de Mexico, Mexico City)

    1987-01-01

    The results from a survey for high-velocity OH in molecular outflows in star-forming regions are reported. High-velocity OH was detected in absorption in nine of these regions. When the telescope beam can resolve the outflows, they show similar anisotropic angular distribution as the redshifted and blueshifted CO. The OH transitions are markedly subthermal since for several sources it is found that the radiation that is being absorbed is a background continuum constituted by the cosmic component plus a small Galactic contribution. The absorbing OH appears to trace gas with higher velocities and lower densities than does the CO and, in some cases, provides information on the structure of the outflows at larger distances from the central source. At scales of 0.1 pc, the outflows are elongated in the direction of the steepest density gradient of the ambient cloud, suggesting that the large-scale collimation of the outflow is produced by the density structure of the ambient cloud. 29 references

  7. Active galactic nucleus outflows in galaxy discs

    Science.gov (United States)

    Hartwig, Tilman; Volonteri, Marta; Dashyan, Gohar

    2018-05-01

    Galactic outflows, driven by active galactic nuclei (AGNs), play a crucial role in galaxy formation and in the self-regulated growth of supermassive black holes (BHs). AGN feedback couples to and affects gas, rather than stars, and in many, if not most, gas-rich galaxies cold gas is rotationally supported and settles in a disc. We present a 2D analytical model for AGN-driven outflows in a gaseous disc and demonstrate the main improvements, compared to existing 1D solutions. We find significant differences for the outflow dynamics and wind efficiency. The outflow is energy-driven due to inefficient cooling up to a certain AGN luminosity (˜1043 erg s-1 in our fiducial model), above which the outflow remains momentum-driven in the disc up to galactic scales. We reproduce results of 3D simulations that gas is preferentially ejected perpendicular to the disc and find that the fraction of ejected interstellar medium is lower than in 1D models. The recovery time of gas in the disc, defined as the free-fall time from the radius to which the AGN pushes the ISM at most, is remarkably short, of the order 1 Myr. This indicates that AGN-driven winds cannot suppress BH growth for long. Without the inclusion of supernova feedback, we find a scaling of the BH mass with the halo velocity dispersion of MBH ∝ σ4.8.

  8. Zooplankton in the Arctic outflow

    Science.gov (United States)

    Soloviev, K. A.; Dritz, A. V.; Nikishina, A. B.

    2009-04-01

    Climate changes in the Arctic cause the changes in the current system that may have cascading effect on the structure of plankton community and consequently on the interlinked and delicately balanced food web. Zooplankton species are by definition incapable to perform horizontal moving. Their transport is connected with flowing water. There are zooplankton species specific for the definite water masses and they can be used as markers for the different currents. That allows us to consider zooplankton community composition as a result of water mixing in the studied area. Little is known however about the mechanisms by which spatial and temporal variability in advection affect dynamics of local populations. Ice conditions are also very important in the function of pelagic communities. Melting time is the trigger to all "plankton blooming" processes, and the duration of ice-free conditions determines the food web development in the future. Fram Strait is one of the key regions for the Arctic: the cold water outflow comes through it with the East Greenland Current and meets warm Atlantic water, the West Spitsbergen Current, producing complicated hydrological situation. During 2007 and 2008 we investigated the structure functional characteristics of zooplankton community in the Fram Strait region onboard KV "Svalbard" (April 2007, April and May 2008) and RV "Jan Mayen" (May 2007, August 2008). This study was conducted in frame of iAOOS Norway project "Closing the loop", which, in turn, was a part of IPY. During this cruises multidisciplinary investigations were performed, including sea-ice observations, CTD and ADCP profiling, carbon flux, nutrients and primary production measurements, phytoplankton sampling. Zooplankton was collected with the Hydro-Bios WP2 net and MultiNet Zooplankton Sampler, (mouth area 0.25 m2, mesh size 180 um).Samples were taken from the depth strata of 2000-1500, 1500-1000, 1000-500,500-200, 200-100, 100-60, 60-30, 30-0 m. Gut fluorescence

  9. Evolution of the outflow activity of protostars

    International Nuclear Information System (INIS)

    Bontemps, Sylvain

    1996-01-01

    After a first part describing the formation of low-mass stars (sites of stellar formation, protostellar evolution) and matter outflows from young objects (molecular flows and their origin, optical and radio jets, outflow mechanisms), this research thesis discusses the evolution of molecular flows by reprinting a published article (Evolution of outflow activity around low-mass embedded young stellar objects), and by outlining some remaining issues (differences between clouds of stellar formation, morphological evolution of molecular flows). The author then discusses the continuous radio centimetre emission: origin, systematic search for Class 0 objects by using the VLA (Very Large Array radio interferometer), presentation of a new Class 0 protostar (HH24MMS). The author reports the study of H_2 emission in the infrared: generalities on protostellar shocks, infrared jet by HH24MMS, H_2 emission at 10 microns by using the ISOCAM camera [fr

  10. Wind influence on a coastal buoyant outflow

    Science.gov (United States)

    Whitney, Michael M.; Garvine, Richard W.

    2005-03-01

    This paper investigates the interplay between river discharge and winds in forcing coastal buoyant outflows. During light winds a plume influenced by the Earth's rotation will flow down shelf (in the direction of Kelvin wave propagation) as a slender buoyancy-driven coastal current. Downwelling favorable winds augment this down-shelf flow, narrow the plume, and mix the water column. Upwelling favorable winds drive currents that counter the buoyancy-driven flow, spread plume waters offshore, and rapidly mix buoyant waters. Two criteria are developed to assess the wind influence on a buoyant outflow. The wind strength index (Ws) determines whether a plume's along-shelf flow is in a wind-driven or buoyancy-driven state. Ws is the ratio of the wind-driven and buoyancy-driven along-shelf velocities. Wind influence on across-shelf plume structure is rated with a timescale (ttilt) for the isopycnal tilting caused by wind-driven Ekman circulation. These criteria are used to characterize wind influence on the Delaware Coastal Current and can be applied to other coastal buoyant outflows. The Delaware buoyant outflow is simulated for springtime high-river discharge conditions. Simulation results and Ws values reveal that the coastal current is buoyancy-driven most of the time (∣Ws∣ Wind events, however, overwhelm the buoyancy-driven flow (∣Ws∣ > 1) several times during the high-discharge period. Strong upwelling events reverse the buoyant outflow; they constitute an important mechanism for transporting fresh water up shelf. Across-shelf plume structure is more sensitive to wind influence than the along-shelf flow. Values of ttilt indicate that moderate or strong winds persisting throughout a day can modify plume width significantly. Plume widening during upwelling events is accompanied by mixing that can erase the buoyant outflow.

  11. gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Rolandas Vaicekauskas

    2016-07-01

    Full Text Available Introduction : Accurate diagnosis of subepithelial lesions (SELs in the gastrointestinal tract depends on a variety of methods: endoscopy, endoscopic ultrasound and different types of biopsy. Making an error-free diagnosis is vital for the subsequent application of an appropriate treatment. Aim: To evaluate the efficacy of deep biopsy via the endoscopic submucosal dissection (ESD technique for SELs in the upper gastrointestinal tract. Material and methods: It was a case series study. Deep biopsy via the ESD technique was completed in 38 patients between November 2012 and October 2014. Thirty-eight SELs in the upper gastrointestinal tract of varying size (very small ≤ 1 cm, small 1–2 cm and large ≥ 2 cm by means of the ESD technique after an incision with an electrosurgical knife of the overlying layers and revealing a small part of the lesion were biopsied under direct endoscopic view. Results: Deep biopsy via the ESD technique was diagnostic in 28 of 38 patients (73.3%; 95% CI: 59.7–89.7%. The diagnostic yield for SELs with a clear endophytic shape increased to 91.3%. An evident endophytic appearance of a subepithelial lesion, the mean number of biopsied samples (6.65 ±1.36 and the total size in length of all samples per case (19.88 ±8.07 mm were the main criteria influencing the positiveness of deep biopsy in the diagnostic group compared to the nondiagnostic one (p = 0.001; p = 0.025; p = 0.008. Conclusions : Deep biopsy via the ESD technique is an effective and safe method for the diagnosis of SELs especially with a clear endophytic appearance in a large number of biopsied samples.

  12. Explosive Outflows from Forming Massive Stars

    OpenAIRE

    Bally, J.; Ginsburg, A.; Kasliwal, M. M.

    2016-01-01

    AO imaging of the near IR [Fe ii] and H_2 lines and ALMA CO J = 2 − 1 data confirms the explosive nature of the BN/KL outflow in Orion. N-body interactions in compact groups may be responsible for the production of powerful, explosive protostellar outflows and luminous infrared flares. The Orion event may have been triggered by a protostellar merger. First results of a search for Orion-like events in 200 nearby galaxies with the SPitzer InfraRed Intensive Transients Survey (SPIRITS) are brief...

  13. Digestive tract

    International Nuclear Information System (INIS)

    Rocha, A.F.G. da

    1976-01-01

    Scintiscanning of salivary glands with (sup 99m)Tc is commented. The uses of triolein - and oleic acid labelled with 131 I, 125 I or 82 Br are discussed in the study of fat absorption, as well as 14 C and 191 Y. The use of 57 Co as a radiotracer in the intestinal absorption of vitamin B 12 is analysed. Orientation is given about 51 Cr - albumin clearance in the study of plasmatic protein loss by digestive tract. The radiotracers 131 I, 125 I and 51 Cr are pointed out in the investigation of immunoglobulins. Consideration is given to the quantification of digestive bleedings by the use of 51 Cr [pt

  14. PROTOSTELLAR OUTFLOW EVOLUTION IN TURBULENT ENVIRONMENTS

    International Nuclear Information System (INIS)

    Cunningham, Andrew J.; Frank, Adam; Carroll, Jonathan; Blackman, Eric G.; Quillen, Alice C.

    2009-01-01

    The link between turbulence in star-forming 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 cannot be the source of turbulence.

  15. Alignment between Protostellar Outflows and Filamentary Structure

    Energy Technology Data Exchange (ETDEWEB)

    Stephens, Ian W.; Dunham, Michael M.; Myers, Philip C.; Pokhrel, Riwaj; Sadavoy, Sarah I.; Lee, Katherine I.; Goodman, Alyssa A. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA (United States); Vorobyov, Eduard I. [Institute of Fluid Mechanics and Heat Transfer, TU Wien, Vienna, A-1060 (Austria); Tobin, John J. [Homer L. Dodge Department of Physics and Astronomy, University of Oklahoma, 440 W. Brooks Street, Norman, OK 73019 (United States); Pineda, Jaime E. [Max-Planck-Institut für extraterrestrische Physik, Giessenbachstrasse 1, 85748 Garching (Germany); Offner, Stella S. R. [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Kristensen, Lars E. [Centre for Star and Planet Formation, Niels Bohr Institute and Natural History Museum of Denmark, University of Copenhagen, Øster Voldgade 5-7, DK-1350 Copenhagen K (Denmark); Jørgensen, Jes K. [Niels Bohr Institute and Center for Star and Planet Formation, Copenhagen University, DK-1350 Copenhagen K. (Denmark); Bourke, Tyler L. [SKA Organization, Jodrell Bank Observatory, Lower Withington, Macclesfield, Cheshire SK11 9DL (United Kingdom); Arce, Héctor G. [Department of Astronomy, Yale University, New Haven, CT 06520 (United States); Plunkett, Adele L., E-mail: ian.stephens@cfa.harvard.edu [European Southern Observatory, Av. Alonso de Cordova 3107, Vitacura, Santiago de Chile (Chile)

    2017-09-01

    We present new Submillimeter Array (SMA) observations of CO(2–1) outflows toward young, embedded protostars in the Perseus molecular cloud as part of the Mass Assembly of Stellar Systems and their Evolution with the SMA (MASSES) survey. For 57 Perseus protostars, we characterize the orientation of the outflow angles and compare them with the orientation of the local filaments as derived from Herschel observations. We find that the relative angles between outflows and filaments are inconsistent with purely parallel or purely perpendicular distributions. Instead, the observed distribution of outflow-filament angles are more consistent with either randomly aligned angles or a mix of projected parallel and perpendicular angles. A mix of parallel and perpendicular angles requires perpendicular alignment to be more common by a factor of ∼3. Our results show that the observed distributions probably hold regardless of the protostar’s multiplicity, age, or the host core’s opacity. These observations indicate that the angular momentum axis of a protostar may be independent of the large-scale structure. We discuss the significance of independent protostellar rotation axes in the general picture of filament-based star formation.

  16. Cardiac tumours: non invasive detection and assessment by gated cardiac blood pool radionuclide imaging

    International Nuclear Information System (INIS)

    Pitcher, D.; Wainwright, R.; Brennand-Roper, D.; Deverall, P.; Sowton, E.; Maisey, M.

    1980-01-01

    Four patients with cardiac tumours were investigated by gated cardiac blood pool radionuclide imaging and echocardiography. Contrast angiocardiography was performed in three of the cases. Two left atrial tumours were detected by all three techniques. In one of these cases echocardiography alone showed additional mitral valve stenosis, but isotope imaging indicated tumour size more accurately. A large septal mass was detected by all three methods. In this patient echocardiography showed evidence of left ventricular outflow obstruction, confirmed at cardiac catheterisation, but gated isotope imaging provided a more detailed assessment of the abnormal cardiac anatomy. In the fourth case gated isotope imaging detected a large right ventricular tumour which had not been identified by echocardiography. Gated cardiac blood pool isotope imaging is a complementary technique to echocardiography for the non-invasive detection and assessment of cardiac tumours. (author)

  17. 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

  18. Twist1 Controls a Cell-Specification Switch Governing Cell Fate Decisions within the Cardiac Neural Crest

    Science.gov (United States)

    Vincentz, Joshua W.; Firulli, Beth A.; Lin, Andrea; Spicer, Douglas B.; Howard, Marthe J.; Firulli, Anthony B.

    2013-01-01

    Neural crest cells are multipotent progenitor cells that can generate both ectodermal cell types, such as neurons, and mesodermal cell types, such as smooth muscle. The mechanisms controlling this cell fate choice are not known. The basic Helix-loop-Helix (bHLH) transcription factor Twist1 is expressed throughout the migratory and post-migratory cardiac neural crest. Twist1 ablation or mutation of the Twist-box causes differentiation of ectopic neuronal cells, which molecularly resemble sympathetic ganglia, in the cardiac outflow tract. Twist1 interacts with the pro-neural factor Sox10 via its Twist-box domain and binds to the Phox2b promoter to repress transcriptional activity. Mesodermal cardiac neural crest trans-differentiation into ectodermal sympathetic ganglia-like neurons is dependent upon Phox2b function. Ectopic Twist1 expression in neural crest precursors disrupts sympathetic neurogenesis. These data demonstrate that Twist1 functions in post-migratory neural crest cells to repress pro-neural factors and thereby regulate cell fate determination between ectodermal and mesodermal lineages. PMID:23555309

  19. Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot.

    Science.gov (United States)

    Soslow, Jonathan H; Usoro, Emem; Wang, Li; Parra, David A

    2016-04-01

    Aneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores. Tricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function. Tricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.

  20. Mitral valve prolapse: an underestimated cause of sudden cardiac death-a current review of the literature.

    Science.gov (United States)

    Spartalis, Michael; Tzatzaki, Eleni; Spartalis, Eleftherios; Athanasiou, Antonios; Moris, Demetrios; Damaskos, Christos; Garmpis, Nikolaos; Voudris, Vassilis

    2017-12-01

    Mitral valve prolapse (MVP) is a common valve abnormality in general population. Despite the general belief of a benign disorder, several articles since the 1980s report sudden cardiac death (SCD) in MVP patients, with a substantial percentage of asymptomatic young individuals. The problem is to detect those patients at increased risk and implement methods that are suitable to prevent cardiac arrest. This review investigates the correlation between MVP and SCD, the understanding of the pathophysiology, the strategies for detecting those at risk and treatment options. A complete literature survey was performed using PubMed database search to gather available information regarding MVP and SCD. A total of 33 studies met selection criteria for inclusion in the review. MVP is an underrated cause of arrhythmic SCD. The subset of patients with malignant MVP who may be at greater risk for SCD is characterized by young women with bileaflet MVP, biphasic or inverted T waves in the inferior leads, and frequent complex ventricular ectopic activity with documented ventricular bigeminy or ventricular tachycardia (VT) and premature ventricular contractions (PVCs) configurations of outflow tract alternating with fascicular origin or papillary muscle. MVP is a common condition in the general population and is often encountered in asymptomatic individuals. The existing literature continues to generate significant controversy regarding the association of MVP with ventricular arrhythmias and SCD. Early echocardiography and cardiac magnetic resonance (CMR) are essential, as is a greater understanding of the potential electrophysiological processes of primary arrhythmogenesis and the evaluation of the genetic substrate.

  1. Human cardiac stem cells exhibit mesenchymal features and are maintained through Akt/GSK-3β signaling

    International Nuclear Information System (INIS)

    Tateishi, Kento; Ashihara, Eishi; Honsho, Shoken; Takehara, Naofumi; Nomura, Tetsuya; Takahashi, Tomosaburo; Ueyama, Tomomi; Yamagishi, Masaaki; Yaku, Hitoshi; Matsubara, Hiroaki; Oh, Hidemasa

    2007-01-01

    Recent evidence suggested that human cardiac stem cells (hCSCs) may have the clinical application for cardiac repair; however, their characteristics and the regulatory mechanisms of their growth have not been fully investigated. Here, we show the novel property of hCSCs with respect to their origin and tissue distribution in human heart, and demonstrate the signaling pathway that regulates their growth and survival. Telomerase-active hCSCs were predominantly present in the right atrium and outflow tract of the heart (infant > adult) and had a mesenchymal cell-like phenotype. These hCSCs expressed the embryonic stem cell markers and differentiated into cardiomyocytes to support cardiac function when transplanted them into ischemic myocardium. Inhibition of Akt pathway impaired the hCSC proliferation and induced apoptosis, whereas inhibition of glycogen synthase kinase-3 (GSK-3) enhanced their growth and survival. We conclude that hCSCs exhibit mesenchymal features and that Akt/GSK-3β may be crucial modulators for hCSC maintenance in human heart

  2. [Influence of detomidine on echocardiographic function parameters and cardiac hemodynamics in horses with and without heart murmur].

    Science.gov (United States)

    Gehlen, H; Kroker, K; Deegen, E; Stadler, P

    2004-03-01

    30 warmblood horses were examined before and after sedation with 20 micrograms/kg BW detomidine, to determine changes of cardiac function parameters, using B-mode, M-mode and Doppler echocardiography. 15 horses showed a heart murmur, but no clinical signs of cardiac heart failure, 15 horses had neither a heart murmur nor other signs of cardiac disease. After sedation with detomidine we could recognise a significant increase of end-diastolic left atrium diameter, an increase of end-systolic left ventricular diameter and aortic root diameter. The end-systolic thickness of papillary muscle and interventricular septum showed a decrease. Fractional shortening and amplitude of left ventricular wall motion was decreased after sedation. The mitral valve echogram revealed a presystolic valve closure and an inflection in the Ac slope (B-notch) in xy horses before sedation. Both increased after sedation with detomidine. Doppler echocardiography showed a decrease of blood flow velocity and velocity time integral (VTI) in the left and right ventricular outflow tract after sedation. Regurgitant flow signals were intensified following sedation in xy horses, especially at the mitral valve.

  3. Pulmonary damage following right ventricular outflow tachycardia ablation in a child: When electroanatomical mapping isn't good enough.

    Science.gov (United States)

    Bansal, Neha; Kobayashi, Daisuke; Karpawich, Peter P

    2017-11-11

    A 14-year-old female was referred for severe pulmonary valve insufficiency after undergoing radiofrequency ablation for a right ventricular outflow tract tachycardia that originated in the proximal pulmonary artery at 10 years of age. Clinical records indicated that ablation was guided solely by electrograms and electroanatomical mapping. Due to myocardial tissue extensions, mapping failed to identify the level of the pulmonary valve annulus, which resulted in delivery of energy on the valve proper and into the pulmonary artery. She developed severe pulmonary valve insufficiency and moderate proximal pulmonary artery stenosis necessitating intravascular stent placement 4 years later with an associated transcatheter valve. Although the nonfluoroscopic approach during ablation has gained wide acceptance for use in children, this report highlights the benefits of adjunctive imaging to identify the precise location of the pulmonary valve when ablation therapy is contemplated in the right ventricle outflow tract. © 2017 Wiley Periodicals, Inc.

  4. Effect of amiodarone-induced hyperthyroidism on left ventricular outflow obstruction after septal myectomy for hypertrophic cardiomyopathy.

    Science.gov (United States)

    Pokorney, Sean D; Stone, Neil J; Passman, Rod; Oyer, David; Rigolin, Vera H; Bonow, Robert O

    2010-12-01

    Patients with obstructive hypertrophic cardiomyopathy who undergo septal myectomy are at risk for developing postoperative atrial fibrillation. Amiodarone is effective in treating this arrhythmia but is associated with multiple adverse effects, often with delayed onset. A novel case is described of a patient who developed type 2 amiodarone-induced hyperthyroidism that presented as recurrence of outflow obstruction after septal myectomy. The patient's symptoms and echocardiographic findings of outflow obstruction resolved substantially with the treatment of the amiodarone-induced hyperthyroidism. Amiodarone-induced hyperthyroidism of delayed onset can be a subtle diagnosis, requiring a high index of suspicion. In conclusion, recognition of this diagnosis in patients with recurrence of outflow obstruction by symptoms and cardiac imaging after septal myectomy may avoid unnecessary repeat surgical intervention. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Urinary Tract Health

    Science.gov (United States)

    ... related to the urinary tract health of women: Urinary Tract Infections (UTIs) and Urinary Incontinence (UI). For information on a range of urinary tract health issues for women, men, and children, visit the National Kidney and Urologic Diseases Information ...

  6. Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

    Energy Technology Data Exchange (ETDEWEB)

    Mou, Guobin; Wang, Tinggui; Yang, Chenwei, E-mail: gbmou@ustc.edu.cn [CAS Key Laboratory for Research in Galaxies and Cosmology, Department of Astronomy, University of Science and Technology of China, Hefei 230026 (China)

    2017-07-20

    The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

  7. Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

    International Nuclear Information System (INIS)

    Mou, Guobin; Wang, Tinggui; Yang, Chenwei

    2017-01-01

    The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

  8. Numerical Study on Outflows in Seyfert Galaxies I: Narrow Line Region Outflows in NGC 4151

    Science.gov (United States)

    Mou, Guobin; Wang, Tinggui; Yang, Chenwei

    2017-07-01

    The origin of narrow line region (NLR) outflows remains unknown. In this paper, we explore the scenario in which these outflows are circumnuclear clouds driven by energetic accretion disk winds. We choose the well-studied nearby Seyfert galaxy NGC 4151 as an example. By performing 3D hydrodynamical simulations, we are able to reproduce the radial distributions of velocity, mass outflow rate, and kinetic luminosity of NLR outflows in the inner 100 pc deduced from spatial resolved spectroscopic observations. The demanded kinetic luminosity of disk winds is about two orders of magnitude higher than that inferred from the NLR outflows, but is close to the ultrafast outflows (UFO) detected in the X-ray spectrum and a few times lower than the bolometric luminosity of the Seyfert. Our simulations imply that the scenario is viable for NGC 4151. The existence of the underlying disk winds can be confirmed by their impacts on higher density ISM, e.g., shock excitation signs, and the pressure in NLR.

  9. A New Look at Speeding Outflows

    Science.gov (United States)

    Kohler, Susanna

    2018-02-01

    The compact centers of active galaxies known as active galactic nuclei, or AGN are known for the dynamic behavior they exhibit as the supermassive black holes at their centers accrete matter. New observations of outflows from a nearby AGN provide a more detailed look at what happens in these extreme environments.Outflows from GiantsThe powerful radio jets of Cygnus A, which extend far beyond the galaxy. [NRAO/AUI]AGN consist of a supermassive black hole of millions to tens of billions of solar masses surrounded by an accretion disk of in-falling matter. But not all the material falling toward the black hole accretes! Some of it is flung from the AGN via various types of outflows.The most well-known of these outflows are powerful radio jets collimated and incredibly fast-moving streams of particles that blast their way out of the host galaxy and into space. Only around 10% of AGN are observed to host such jets, however and theres another outflow thats more ubiquitous.Fast-Moving AbsorbersPerhaps 30% of AGN both those with and without observed radio jets host wider-angle, highly ionized gaseous outflows known as ultra-fast outflows (UFOs). Ultraviolet and X-ray radiation emitted from the AGN is absorbed by the UFO, revealing the outflows presence: absorption lines appear in the ultraviolet and X-ray spectra of the AGN, blue-shifted due to the high speeds of the absorbing gas in the outflow.Quasar PG 1211+143, indicated by the crosshairs at the center of the image, in the color context of its surroundings. [SDSS/S. Karge]But what is the nature of UFOs? Are they disk winds? Or are they somehow related to the radio jets? And what impact do they have on the AGNs host galaxy?X-ray and Ultraviolet CooperationNew observations are now providing fresh information about one particular UFO. A team of scientists led by Ashkbiz Danehkar (Harvard-Smithsonian Center for Astrophysics) recently used the Chandra and Hubble space telescopes to make the first simultaneous observations

  10. Qualitative and quantitative analyses of the morphological-dynamics of early cardiac pumping function using video densitometry and optical coherence tomography (OCT)

    DEFF Research Database (Denmark)

    Happel, C.; Männer, J.; Thommes, J.

    has become a matter of dispute. Uncovering of the pumping mechanism of tubular embryonic hearts requires detailed information about the hemodynamics as well as morphological dynamics of the pump action. We have analyzed the morphological dynamics of cardiac pump action in chick embryos (HH-stage 16......) of the embryonic heart segments (common atrium, AV-canal, embryonic ventricles, outflow tract). Video densitometric M-mode curves show remarkable similarities to OCT M-mode recordings. OCT M-mode recordings can only be taken at one site at a time whereas video densitometry allows simultaneous recordings at any...... striking differences in contraction behavior of different heart segments of the tubular embryonic heart. These findings are important for the understanding of the pumping mechanism of the developing valveless embryonic heart....

  11. Procedimento de Lecompte para a correção de transposição das grandes artérias, associada à comunicação interventricular e obstrução de via de saída do ventrículo esquerdo Lecompte procedure for correction of the transposition of the great arteries associated with ventricular septal defect and left ventricle outflow tract obstruction

    Directory of Open Access Journals (Sweden)

    Miguel Angel Maluf

    2006-12-01

    Full Text Available OBJETIVO: Avaliar o procedimento de Lecompte para a correção da transposição das grandes artérias associada à comunicação interventricular e obstrução da via de saída do ventrículo esquerdo (TGA, CIV e OVSVE e apresentar os resultados no período pós-operatório intermediário e tardio. MÉTODO: Entre fevereiro de 1994 e julho de 2005, sete pacientes, com idade de 2 a 8 anos (mediana -M-: 3,0, portadores de TGA, CIV e OVSVE, foram submetidos a tratamento cirúrgico corretivo. Em seis casos, foi utilizado o procedimento de Lecompte. Esta técnica consiste na abordagem por ventriculotomia direita, ressecção ampla do septo conal e construção de um túnel ventricular conectando o ventrículo esquerdo à aorta; o caso restante apresentava obstrução da prótese valvulada implantada entre o ventrículo direito e a artéria pulmonar (VD-AP e falência do VD e foi submetido à conversão no procedimento de Lecompte. RESULTADOS: Os tempos de CEC variaram entre 105 e 194 min (M: 130 e os tempos de anoxia entre 65 e 90 min (M: 78. Houve um óbito no pós-operatório imediato devido a coagulopatia, seguido de insuficiência ventricular direita. Os seis pacientes sobreviventes receberam alta hospitalar no período de 5 a 30 dias (M: 11 e permaneceram em acompanhamento entre 12 a 144 meses (M: 73,6. CONCLUSÃO: O procedimento de Lecompte teve como vantagens: 1 - Indicação cirúrgica em pacientes com menor faixa etária; 2 - Baixa morbi-mortalidade; 3 - Expectativa de acompanhamento a longo prazo, sem reoperação; 4 - Possibilidade de converter o procedimento de Rastelli em Lecompte.OBJECTIVE: To evaluate the Lecompte procedure used for the correction of transposition of the great arteries (TGA associated with ventricular septal defect (VSD and left ventricle outflow tract obstruction (LVOTO and to present the intermediate and long-term results of the surgery. METHODS: Between February 1994 and July 2005, seven patients with ages between 2

  12. Evaluation of concordance among three cardiac output measurement techniques in adult patients during cardiovascular surgery postoperative care.

    Science.gov (United States)

    Muñoz, L; Velandia, A; Reyes, L E; Arevalo-Rodríguez, I; Mejía, C; Asprilla, D; Uribe, D V; Arevalo, J J

    2017-12-01

    The standard method for cardiac output measuring is thermodilution although it is an invasive technique. Transesophageal Echocardiography (TEE) offers a dynamic and functional alternative to thermodilution. Analyze concordance between two TEE methods and thermodilution for cardiac output assessment. Observational concordance study in cardiovascular surgery patients that required pulmonary artery catheter. TEE cardiac output measurement at both mitral annulus (MA) and left ventricle outflow tract (LVOT) were performed. Results were compared with thermodilution. Correlation was evaluated by Lin's concordance correlation coefficient and Bland-Altman analysis. Statistical analysis was undertaken in STATA 13.0. Twenty-five patients were enrolled. Fifty two percent of patients were male, median age and ejection fraction was 63 years and 35% respectively. Median thermodilution, LVOT and MA -measured cardiac output was 3.25 L/min, 3.46 L/min and 8.4 L/min respectively. Different values between thermodilution and MA measurements were found (Lin concordance=0.071; Confidence Interval 95%=-0.009 to 0.151; Spearman's correlation=0.22) as values between thermodilution and LVOT (Lin concordance=0.232; Confidence Interval 95%=-0.12 a 0.537; Spearman's correlation 0.28). Bland-Altman analysis showed greater difference between MA measurements and thermodilution (DM=-0.408; Bland-Altman Limits=-0.809 to -0.007), than the other echocardiographic findings (DM=0.007; Bland-Altman Limits=-0.441 to 0.428). Results from cardiac output measurement by doppler and 2D-TEE on both MA and LVOT do not correlate with those obtained by thermodilution. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  13. Cardiac rehabilitation

    Science.gov (United States)

    ... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...

  14. Silo outflow of soft frictionless spheres

    Science.gov (United States)

    Ashour, Ahmed; Trittel, Torsten; Börzsönyi, Tamás; Stannarius, Ralf

    2017-12-01

    Outflow of granular materials from silos is a remarkably complex physical phenomenon that has been extensively studied with simple objects like monodisperse hard disks in two dimensions (2D) and hard spheres in 2D and 3D. For those materials, empirical equations were found that describe the discharge characteristics. Softness adds qualitatively new features to the dynamics and to the character of the flow. We report a study of the outflow of soft, practically frictionless hydrogel spheres from a quasi-2D bin. Prominent features are intermittent clogs, peculiar flow fields in the container, and a pronounced dependence of the flow rate and clogging statistics on the container fill height. The latter is a consequence of the ineffectiveness of Janssen's law: the pressure at the bottom of a bin containing hydrogel spheres grows linearly with the fill height.

  15. Hot Accretion onto Black Holes with Outflow

    Directory of Open Access Journals (Sweden)

    Park Myeong-Gu

    2018-01-01

    Full Text Available Classic Bondi accretion flow can be generalized to rotating viscous accretion flow. Study of hot accretion flow onto black holes show that its physical charateristics change from Bondi-like for small gas angular momentum to disk-like for Keperian gas angular momentum. Especially, the mass accretion rate divided by the Bondi accretion rate is proportional to the viscosity parameter alpha and inversely proportional to the gas angular momentum divided by the Keplerian angular momentum at the Bondi radius for gas angular momentum comparable to the Keplerian value. The possible presence of outflow will increase the mass inflow rate at the Bondi radius but decrease the mass accretion rate across the black hole horizon by many orders of magnitude. This implies that the growth history of supermassive black holes and their coevolution with host galaxies will be dramatically changed when the accreted gas has angular momentum or develops an outflow.

  16. Gastrointestinal tract

    International Nuclear Information System (INIS)

    James, R.D.; Pointon, R.C.S.

    1985-01-01

    At the time of writing, radiotherapy is of only minor use in the management of adenocarcinoma of the gastrointestinal tract, for a number of reasons. First, an exploratory laparotomy is generally needed for diagnosis, and if possible the tumour is resected or by-passed. Second, radiotherapy planning in the upper abdomen is complicated by the proximity of small bowel, kidneys, and spinal cord. Third, it has been assumed that these tumours cause death largely as a result of distant metastases, so that local radiotherapy, even if effective, would contribute little to survival. The continued interest in radiotherapy for this group of tumours arises out of the poor survival rates following surgery, which have not changed for many years, and the morbidity associated with their resection. It was hoped that the addition of cytotoxic agents to radical surgery would improve survival rates in carcinoma of the stomach and intraperitoneal colon. Despite a large number of well-organised prospective trials, using a variety of cytotoxic drugs, there is so far no evidence that the addition of chemotherapy to radical surgery improves survival for either tumour site. The authors are therefore faced with a group of tumours which are not only common, but commonly fatal and many surgeons would accept that a new approach using modern radiotherapy techniques may well be justified. There is evidence that this movement is already taking place for carcinoma of the rectum, and the indications for radiotherapy in this condition will be dealt with below. Before considering these it is worth dwelling briefly on recent changes in surgical and radiological practices which, if they fulfil expectations, might allow radiotherapy to be used for carcinoma of the colon, stomach, and pancreas as it is now used for rectal cancer

  17. Outflow Kinematics Manifested by the Hα Line: Gas Outflows in Type 2 AGNs. IV

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Daeun; Woo, Jong-Hak; Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of)

    2017-08-20

    Energetic ionized gas outflows driven by active galactic nuclei (AGNs) have been studied as a key phenomenon related to AGN feedback. To probe the kinematics of the gas in the narrow-line region, [O iii] λ 5007 has been utilized in a number of studies showing nonvirial kinematic properties due to AGN outflows. In this paper, we statistically investigate whether the H α emission line is influenced by AGN-driven outflows by measuring the kinematic properties based on the H α line profile and comparing them with those of [O iii]. Using the spatially integrated spectra of ∼37,000 Type 2 AGNs at z < 0.3 selected from the Sloan Digital Sky Survey DR7, we find a nonlinear correlation between H α velocity dispersion and stellar velocity dispersion that reveals the presence of the nongravitational component, especially for AGNs with a wing component in H α . The large H α velocity dispersion and velocity shift of luminous AGNs are clear evidence of AGN outflow impacts on hydrogen gas, while relatively smaller kinematic properties compared to those of [O iii] imply that the observed outflow effect on the H α line is weaker than the case of [O iii].

  18. 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.

  19. Iodine-131 monitoring in sewage plant outflow

    International Nuclear Information System (INIS)

    McGowan, D R; Crawley, M T; Pratt, B E; Hinton, P J; Peet, D J

    2014-01-01

    Three different hospital sites (Oxford, Sutton and Guildford) have performed sampling of their local sewage plant outflow to determine levels of radioactivity resulting from iodine-131 patients undergoing radionuclide therapies. It was found that a maximum of 20% of activity discharged from the hospitals was present in the sewage plant final effluent channel. This is significantly below the level predicted by mathematical models in current use. The results further show that abatement systems to reduce public exposure are unlikely to be warranted at hospital sites. (paper)

  20. New noninvasive treatment for prostate outflow obstruction

    International Nuclear Information System (INIS)

    Richards, D.; Milroy, E.; Chapple, C.; Eldin, A.; Wallstein, H.

    1989-01-01

    Sixteen patients with prostatic outflow obstruction underwent implantation of the Wallstent endoprothesis, a woven mesh of fine stainless steel, mounted on a 9-F delivery system with an unconstrained diameter of 14 mm. The stent was inserted under local anesthesia, and placement was guided by linear transrectal US and flexible urethroscopy. In no patient was the distal sphincter mechanism compromised. In four, stent balloon dilation was needed. Urodynamic parameters (especially flow rate, voiding detrusor pressure, and postvoid residual) improved in all patients. Our experience showed the Wallstent endoprosthesis to be a safe, clinically acceptable, and minimally invasive alternative to prostatectomy

  1. 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.

  2. ATOMIC HYDROGEN IN A GALACTIC CENTER OUTFLOW

    International Nuclear Information System (INIS)

    McClure-Griffiths, N. M.; Green, J. A.; Hill, A. S.; Lockman, F. J.; Dickey, J. M.; Gaensler, B. M.; Green, A. J.

    2013-01-01

    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 ∼14 km s –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 ∼200 km s –1 in a Galactic wind.

  3. Inferring Polar Ion Outflows from Topside Ionograms

    Science.gov (United States)

    Sojka, J. J.; Rice, D. D.; Eccles, V.; Schunk, R. W.; David, M.; Benson, R. F.; James, H. G.

    2017-12-01

    The high-latitude topside ionosphere is dominated by O+ ions from the F-region peak around 300 km to over 1000 km altitude. The O+ profile shape provides information on the thermal structure, field aligned plasma dynamics, and outflows into the magnetosphere. Topside electron density profiles (EDP) are either obtained from topside sounders or Incoherent Scatter Radars. There is a large archive of topside sounder ionograms and hand scaled EDPs from the Alouette and ISIS satellites between 1962 and 1990. Recent NASA data enhancement efforts have augmented these EDP archives by producing digital topside ionograms both from the 7-track analog telemetry tapes and from 35 mm topside film ionograms. Rice et al [2017] in their 35 mm ionogram recovery emphasized high latitude ionograms taken during disturbed conditions. The figure below contrasts ISIS-II EDPs extracted from 35 mm films before and during a major storm (Dst -200nT) on 9 April 1972 (left panel: quiet period before the storm; right panel: during the peak of the storm). Both satellite passes used for these EDPs were centered on the Resolute Bay location that in 1972 was close to the magnetic pole. They begin at auroral latitudes around 2100 MLT and end on the dayside around 0900MLT. We will present results of how ionospheric models replicate both the quiet and disturbed conditions shown in the figure. Three types of models will be contrasted: an empirical ionosphere (IRI), a physics based ionospheric model (TDIM), and a fluid-based polar-wind model (PW). During the storm pass, when it is expected that substantial heating is present, the ISIS-II topside EDPs provide severe constraints on the usage of these models. These constraints enable estimates of the outflow fluxes as well as the heating that has occurred. The comparisons with the empirical model establish how well the pre-storm topside is modeled and identifies the challenges as the storm magnitude increases. The physics-based TDIM does have storm drivers

  4. GGD 37: AN EXTREME PROTOSTELLAR OUTFLOW

    International Nuclear Information System (INIS)

    Green, J. D.; Watson, D. M.; Forrest, W. J.; Kim, K. H.; Bergin, E.; Maret, S.; Melnick, G.; Tolls, V.; Sonnentrucker, P.; Sargent, B. A.; Raines, S. N.

    2011-01-01

    We present the first Spitzer-IRS spectral maps of the Herbig-Haro flow GGD 37 detected in lines of [Ne III], [O IV], [Ar III], and [Ne V]. The detection of extended [O IV] (55 eV) and some extended emission in [Ne V] (97 eV) indicates a shock temperature in excess of 100,000 K, in agreement with X-ray observations, and a shock speed in excess of 200 km s -1 . The presence of an extended photoionization or collisional ionization region indicates that GGD 37 is a highly unusual protostellar outflow.

  5. Fetal Primary Cardiac Tumors During Perinatal Period

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2017-06-01

    Full Text Available Fetal primary cardiac tumors are rare, but they may cause complications, which are sometimes life threatening, including arrhythmias, hydrops fetalis, ventricular outflow/inflow obstruction, cardiac failure, and even sudden death. Among fetal primary cardiac tumors, rhabdomyomas are most common, followed by teratomas, fibromas, hemangiomas, and myxomas. Everolimus, a mammalian target of rapamycin inhibitor, has been reported to be an effective drug to cause tumor remission in three neonates with multiple cardiac rhabdomyomas. Neonatal cardiac surgery for the resection of primary cardiac tumors found by fetal echocardiography has been reported sporadically. However, open fetal surgery for pericardial teratoma resection, which was performed successfully via a fetal median sternotomy in one case report, could be a promising intervention to rescue these patients with large pericardial effusions. These recent achievements undoubtedly encourage further development in early management of fetal cardiac tumors. Owing to the rarity of fetal primary cardiac tumors, relevant information in terms of prenatal diagnosis, treatment, and prognosis remains to be clarified.

  6. Compact binary merger and kilonova: outflows from remnant disc

    Science.gov (United States)

    Yi, Tuan; Gu, Wei-Min; Liu, Tong; Kumar, Rajiv; Mu, Hui-Jun; Song, Cui-Ying

    2018-05-01

    Outflows launched from a remnant disc of compact binary merger may have essential contribution to the kilonova emission. Numerical calculations are conducted in this work to study the structure of accretion flows and outflows. By the incorporation of limited-energy advection in the hyper-accretion discs, outflows occur naturally from accretion flows due to imbalance between the viscous heating and the sum of the advective and radiative cooling. Following this spirit, we revisit the properties of the merger outflow ejecta. Our results show that around 10-3 ˜ 10-1 M⊙ of the disc mass can be launched as powerful outflows. The amount of unbound mass varies with the disc mass and the viscosity. The outflow-contributed peak luminosity is around 1040 ˜ 1041 erg s-1. Such a scenario can account for the observed kilonovae associated with short gamma-ray bursts, including the recent event AT2017gfo (GW170817).

  7. 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, Erika; Hakobian, Nicholas S.; Heiles, Carl; Houde, Martin; Hughes, A. Meredith; Jameson, Katherine; Kwon, Woojin; Lamb, James W.

    2013-01-01

    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...

  8. Molecular outflows in the L1641 region of Orion

    International Nuclear Information System (INIS)

    Morgan, J.A.

    1990-01-01

    Little is known about the interaction between molecular outflows associated with young stellar objects and the parent molecular cloud that produced them. This is because molecular outflows are a recently discovered phenomenon and, so, have not had their global properties studied in great detail and molecular clouds were not mapped to sufficiently high spatial resolution to resolve the interaction. The interaction between molecular outflows and the L1641 molecular cloud is addressed by both identifying and mapping all the molecular outflows as well as the detailed structure of the cloud. Candidate molecular outflows were found from single point 12-CO observations of young stellar objects identified from the IRAS survey data. The candidate sources were then mapped to confirm their molecular outflow nature. From these maps, molecular outflow characteristics such as their morphology, orientation, and energetics were determined. In addition, the Orion molecular cloud was mapped to compare directly with the molecular outflows. The molecular outflows identified were found to have rising infrared spectra, radio continuum emission that suggests a stellar wind or optically thick H II region, and molecular line strengths that indicate that they are embedded within a very dense environment. The lack of an optical counterpart for many molecular outflows suggests that they occur at the earliest stages of stellar evolution. The lack of an optical counterpart for many molecular outflows suggest that they occur at the earliest stages of stellar evolution. The orientations of the molecular outflows appear to lie in no preferred direction and they have shapes that indicate that the molecular cloud is responsible for determining their direction and collimation

  9. Studying the outflow-core interaction with ALMA Cycle 1 observations of the HH 46/47 molecular outflow

    Science.gov (United States)

    Zhang, Yichen; Arce, Hector G.; Mardones, Diego; Dunham, Michael; Garay, Guido; Noriega-Crespo, Alberto; Corder, Stuartt; Offner, Stella; Cabrit, Sylvie

    2016-01-01

    We present ALMA Cycle 1 observations of the HH 46/47 molecular outflow which is driven by a low-mass Class 0/I protostar. Previous ALMA Cycle 0 12CO observation showed outflow cavities produced by the entrainment of ambient gas by the protostellar jet and wide-angle wind. Here we present analysis of observation of 12CO, 13CO, C18O and other species using combined 12m array and ACA observations. The improved angular resolution and sensitivity allow us to detect details of the outflow structure. Specially, we see that the outflow cavity wall is composed of two or more layers of outflowing gas, which separately connect to different shocked regions along the outflow axis inside the cavity, suggesting the outflow cavity wall is composed of multiple shells entrained by a series of jet bow-shock events. The new 13CO and C18O data also allow us to trace relatively denser and slower outflow material than that traced by the 12CO. These species are only detected within about 1 to 2 km/s from the cloud velocity, tracing the outflow to lower velocities than what is possible using only the 12CO emission. Interestingly, the cavity wall of the red lobe appears at very low outflow velocities (as low as ~0.2 km/s). In addition, 13CO and C18O allow us to correct for the CO optical depth, allowing us to obtain more accurate estimates of the outflow mass, momentum and kinetic energy. Applying the optical depth correction significantly increases the previous mass estimate by a factor of 14. The outflow kinetic energy distribution shows that even though the red lobe is mainly entrained by jet bow-shocks, most of the outflow energy is being deposited into the cloud at the base of the outflow cavity rather than around the heads of the bow shocks. The estimated total mass, momentum, and energy of the outflow indicate that the outflow has the ability to disperse the parent core. We found possible evidence for a slowly moving rotating outflow in CS. Our 13CO and C18O observations also trace a

  10. DISCOVERY OF RELATIVISTIC OUTFLOW IN THE SEYFERT GALAXY Ark 564

    International Nuclear Information System (INIS)

    Gupta, A.; Mathur, S.; 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. 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 Kα transitions of O VII (two lines) and O VI at outflow velocities of ∼0.1c. These lines are detected at 6.9σ, 6.2σ, and 4.7σ, respectively, and cannot be due to chance statistical fluctuations. Photoionization models with ultra-high velocity components improve 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 (outflow)/L bol lower limit of ≥0.006% assuming a bi-conical wind geometry. This is the first time that absorption lines with ultra-high velocities are unambiguously detected in the soft X-ray band. The presence of outflows with relativistic velocities in active galactic nuclei (AGNs) with Seyfert-type luminosities is hard to understand and provides valuable constraints to models of AGN outflows. Radiation pressure is unlikely to be the driving mechanism for such outflows and magnetohydrodynamic may be involved

  11. The energetics of AGN radiation pressure-driven outflows

    Science.gov (United States)

    Ishibashi, W.; Fabian, A. C.; Maiolino, R.

    2018-05-01

    The increasing observational evidence of galactic outflows is considered as a sign of active galactic nucleus (AGN) feedback in action. However, the physical mechanism responsible for driving the observed outflows remains unclear, and whether it is due to momentum, energy, or radiation is still a matter of debate. The observed outflow energetics, in particular the large measured values of the momentum ratio (\\dot{p}/(L/c) ˜ 10) and energy ratio (\\dot{E}_k/L ˜ 0.05), seems to favour the energy-driving mechanism; and most observational works have focused their comparison with wind energy-driven models. Here, we show that AGN radiation pressure on dust can adequately reproduce the observed outflow energetics (mass outflow rate, momentum flux, and kinetic power), as well as the scalings with luminosity, provided that the effects of radiation trapping are properly taken into account. In particular, we predict a sublinear scaling for the mass outflow rate (\\dot{M} ∝ L^{1/2}) and a superlinear scaling for the kinetic power (\\dot{E}_k ∝ L^{3/2}), in agreement with the observational scaling relations reported in the most recent compilation of AGN outflow data. We conclude that AGN radiative feedback can account for the global outflow energetics, at least equally well as the wind energy-driving mechanism, and therefore both physical models should be considered in the interpretation of future AGN outflow observations.

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

    International Nuclear Information System (INIS)

    Arce, Héctor G.; Mardones, Diego; Garay, Guido; Corder, Stuartt A.; Noriega-Crespo, Alberto; Raga, Alejandro C.

    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 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

  13. Tetralogy of fallot (cyanotic cardiac malformation), trends and variation in a population based study

    International Nuclear Information System (INIS)

    Arif, A.; Zehra, S.; Qamarunnisa, S.; Azhar, A.

    2012-01-01

    Congenital heart diseases (CHDs) are a major threat worldwide for children below the age of five. It has high mortality and morbidity ratio. CHDs can be classified as cyanotic and acyanotic. Cyanotic cardiac malformation accounts 25% of all congenital heart diseases and Tetralogy of Fallot (TOF) is .the most common form of cyanotic CHD. Tetralogy of Fallot is a combination of four anatomical abnormalities. These include a large ventricular septal defect (VSD), right ventricular outflow tract and pulmonary valve obstruction, right ventricular hypertrophy, and over-riding of the aorta. The current investigation was conducted over the span of 2.5 years on the patients presented in OPD and hospitalized at various pediatric cardiology centers. A detailed family history was taken to elucidate the genetic and environmental factors. Diagnosis was confirmed by the cardiologist based on examination of cardiac murmur, chest X-ray, fetal echocardiography (ECG), complete blood count (CBC), echocardiograms and/or echocardiogram (ECHO) reports, cardiac catherization reports, operative notes and MRI of heart, if applicable. This study recruited a cohort of 268 patients and 140 controls, healthy unrelated individuals. The mean age for patients was 2.97+-1.21 and that for controls was 3.14+-2.44 years. Males were shown to have a higher rate of incidence than females (1.26:1) in our population. The genes that are mainly involved are NKX 2.5, GAT A 4, TBX5, JAGI, ZFPM2 and VEGF. The present study focuses on NKX 2.5 and its mutations in our population. (author)

  14. Imaging cardiac activation sequence during ventricular tachycardia in a canine model of nonischemic heart failure.

    Science.gov (United States)

    Han, Chengzong; Pogwizd, Steven M; Yu, Long; Zhou, Zhaoye; Killingsworth, Cheryl R; He, Bin

    2015-01-15

    Noninvasive cardiac activation imaging of ventricular tachycardia (VT) is important in the clinical diagnosis and treatment of arrhythmias in heart failure (HF) patients. This study investigated the ability of the three-dimensional cardiac electrical imaging (3DCEI) technique for characterizing the activation patterns of spontaneously occurring and norepinephrine (NE)-induced VTs in a newly developed arrhythmogenic canine model of nonischemic HF. HF was induced by aortic insufficiency followed by aortic constriction in three canines. Up to 128 body-surface ECGs were measured simultaneously with bipolar recordings from up to 232 intramural sites in a closed-chest condition. Data analysis was performed on the spontaneously occurring VTs (n=4) and the NE-induced nonsustained VTs (n=8) in HF canines. Both spontaneously occurring and NE-induced nonsustained VTs initiated by a focal mechanism primarily from the subendocardium, but occasionally from the subepicardium of left ventricle. Most focal initiation sites were located at apex, right ventricular outflow tract, and left lateral wall. The NE-induced VTs were longer, more rapid, and had more focal sites than the spontaneously occurring VTs. Good correlation was obtained between imaged activation sequence and direct measurements (averaged correlation coefficient of ∼0.70 over 135 VT beats). The reconstructed initiation sites were ∼10 mm from measured initiation sites, suggesting good localization in such a large animal model with cardiac size similar to a human. Both spontaneously occurring and NE-induced nonsustained VTs had focal initiation in this canine model of nonischemic HF. 3DCEI is feasible to image the activation sequence and help define arrhythmia mechanism of nonischemic HF-associated VTs. Copyright © 2015 the American Physiological Society.

  15. 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...

  16. Kidneys and Urinary Tract

    Science.gov (United States)

    ... Videos for Educators Search English Español Kidneys and Urinary Tract KidsHealth / For Teens / Kidneys and Urinary Tract What's ... a sign of diabetes . What the Kidneys and Urinary Tract Do Although the two kidneys work together to ...

  17. 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

  18. Genital and Urinary Tract Defects

    Science.gov (United States)

    ... conditions > Genital and urinary tract defects Genital and urinary tract defects E-mail to a friend Please fill ... and extra fluids. What problems can genital and urinary tract defects cause? Genital and urinary tract defects affect ...

  19. Simulation of Breach Outflow for Earthfill Dam

    International Nuclear Information System (INIS)

    Razad, Azwin Zailti Abdul; Muda, Rahsidi Sabri; Sidek, Lariyah Mohd; Azia, Intan Shafilah Abdul; Mansor, Faezah Hanum; Yalit, Ruzaimei

    2013-01-01

    Dams have been built for many reasons such as irrigation, hydropower, flood mitigation, and water supply to support development for the benefit of human. However, the huge amount of water stored behind the dam can seriously pose adverse impacts to the downstream community should it be released due to unwanted dam break event. To minimise the potential loss of lives and property damages, a workable Emergency Response Plan is required to be developed. As part of a responsible dam owner and operator, TNB initiated a study on dam breach modelling for Cameron Highlands Hydroelectric Scheme to simulate the potential dam breach for Jor Dam. Prediction of dam breach parameters using the empirical equations of Froehlich and Macdonal-Langridge-Monopolis formed the basis of the modelling, coupled with MIKE 11 software to obtain the breach outflow due to Probable Maximum Flood (PMF). This paper will therefore discuss the model setup, simulation procedure and comparison of the prediction with existing equations.

  20. Enhanced ion acoustic fluctuations and ion outflows

    Directory of Open Access Journals (Sweden)

    F. R. E. Forme

    1999-02-01

    Full Text Available A number of observations showing enhanced ion acoustic echoes observed by means of incoherent scatter radars have been reported in the literature. The received power is extremely enhanced by up to 1 or 2 orders of magnitude above usual values, and it is mostly contained in one of the two ion acoustic lines. This spectral asymmetry and the intensity of the received signal cannot be resolved by the standard analysis procedure and often causes its failure. As a result, and in spite of a very clear spectral signature, the analysis is unable to fit the plasma parameters inside the regions of ion acoustic turbulence. We present European Incoherent Scatter radar (EISCAT observations of large ion outflows associated with the simultaneous occurrence of enhanced ion acoustic echoes. The ion fluxes can reach 1014 m-2 s-1 at 800 km altitude. From the very clear spectral signatures of these echoes, a method is presented to extract estimates of the electron temperature and the ion drift within the turbulent regions. It is shown that the electron gas is strongly heated up to 11 000 K. Also electron temperature gradients of about 0.02 K/m exist. Finally, the estimates of the electron temperature and of the ion drift are used to study the possible implications for the plasma transport inside turbulent regions. It is shown that strong electron temperature gradients cause enhancement of the ambipolar electric field and can account for the observed ion outflows.Key words. Ionosphere (auroral ionosphere; ionosphere · magnetosphere interactions; plasma waves and instabilities.

  1. The impact of remittances outflows on the economy of Poland

    OpenAIRE

    LASTOVETSKA ROKSOLANA ORESTIVNA

    2015-01-01

    The impact of remittances outflows on the economy of Poland is analyzed in the article. Based on historical data the vector autoregression model (VAR) was built to examine the effects of the sharp rise in the volume of remittances outflows. The model results are presented for the next macroeconomic indicators: GDP, inflation, interest rate and exchange rate.

  2. Assessment of infective urinary tract disorders

    International Nuclear Information System (INIS)

    Sixt, R.; Stokland, E.

    1998-01-01

    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 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

  3. Myocardial ischaemia and the cardiac nervous system.

    Science.gov (United States)

    Armour, J A

    1999-01-01

    The intrinsic cardiac nervous system has been classically considered to contain only parasympathetic efferent postganglionic neurones which receive inputs from medullary parasympathetic efferent preganglionic neurones. In such a view, intrinsic cardiac ganglia act as simple relay stations of parasympathetic efferent neuronal input to the heart, the major autonomic control of the heart purported to reside solely in the brainstem and spinal cord. Data collected over the past two decades indicate that processing occurs within the mammalian intrinsic cardiac nervous system which involves afferent neurones, local circuit neurones (interconnecting neurones) as well as both sympathetic and parasympathetic efferent postganglionic neurones. As such, intrinsic cardiac ganglionic interactions represent the organ component of the hierarchy of intrathoracic nested feedback control loops which provide rapid and appropriate reflex coordination of efferent autonomic neuronal outflow to the heart. In such a concept, the intrinsic cardiac nervous system acts as a distributive processor, integrating parasympathetic and sympathetic efferent centrifugal information to the heart in addition to centripetal information arising from cardiac sensory neurites. A number of neurochemicals have been shown to influence the interneuronal interactions which occur within the intrathoracic cardiac nervous system. For instance, pharmacological interventions that modify beta-adrenergic or angiotensin II receptors affect cardiomyocyte function not only directly, but indirectly by influencing the capacity of intrathoracic neurones to regulate cardiomyocytes. Thus, current pharmacological management of heart disease may influence cardiomyocyte function directly as well as indirectly secondary to modifying the cardiac nervous system. This review presents a brief summary of developing concepts about the role of the cardiac nervous system in regulating the normal heart. In addition, it provides some

  4. Cardiac arrest

    Science.gov (United States)

    ... magnesium. These minerals help your heart's electrical system work. Abnormally high or low levels can cause cardiac arrest. Severe physical stress. Anything that causes a severe stress on your ...

  5. Cardiac Ochronosis

    Science.gov (United States)

    Erek, Ersin; Casselman, Filip P.A.; Vanermen, Hugo

    2004-01-01

    We report the case of 67-year-old woman who underwent aortic valve replacement and mitral valve repair due to ochronotic valvular disease (alkaptonuria), which was diagnosed incidentally during cardiac surgery. PMID:15745303

  6. Cardiac catheterization

    Science.gov (United States)

    ... tests. However, it is very safe when done by an experienced team. The risks include: Cardiac tamponade Heart attack Injury to a coronary artery Irregular heartbeat Low blood pressure Reaction to the contrast dye Stroke Possible complications ...

  7. Nuclear cardiac

    International Nuclear Information System (INIS)

    Slutsky, R.; Ashburn, W.L.

    1982-01-01

    The relationship between nuclear medicine and cardiology has continued to produce a surfeit of interesting, illuminating, and important reports involving the analysis of cardiac function, perfusion, and metabolism. To simplify the presentation, this review is broken down into three major subheadings: analysis of myocardial perfusion; imaging of the recent myocardial infarction; and the evaluation of myocardial function. There appears to be an increasingly important relationship between cardiology, particularly cardiac physiology, and nuclear imaging techniques

  8. Molecular outflows driven by low-mass protostars. I. Correcting for underestimates when measuring outflow masses and dynamical properties

    Energy Technology Data Exchange (ETDEWEB)

    Dunham, Michael M. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, MS 78, Cambridge, MA 02138 (United States); Arce, Héctor G. [Department of Astronomy, Yale University, P.O. Box 208101, New Haven, CT 06520 (United States); Mardones, Diego [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile); Lee, Jeong-Eun [Department of Astronomy and Space Science, Kyung Hee University, Yongin, Gyeonggi 446-701 (Korea, Republic of); Matthews, Brenda C. [National Research Council of Canada, Herzberg Astronomy and Astrophysics, 5071 W. Saanich Road, Victoria, BC V9E 2E7 (Canada); Stutz, Amelia M. [Max-Planck-Institut für Astronomie, Königstuhl 17, D-69117, Heidelberg (Germany); Williams, Jonathan P., E-mail: mdunham@cfa.harvard.edu [Institute for Astronomy, University of Hawaii, Honolulu, HI 96822 (United States)

    2014-03-01

    We present a survey of 28 molecular outflows driven by low-mass protostars, all of which are sufficiently isolated spatially and/or kinematically to fully separate into individual outflows. Using a combination of new and archival data from several single-dish telescopes, 17 outflows are mapped in {sup 12}CO (2-1) and 17 are mapped in {sup 12}CO (3-2), with 6 mapped in both transitions. For each outflow, we calculate and tabulate the mass (M {sub flow}), momentum (P {sub flow}), kinetic energy (E {sub flow}), mechanical luminosity (L {sub flow}), and force (F {sub flow}) assuming optically thin emission in LTE at an excitation temperature, T {sub ex}, of 50 K. We show that all of the calculated properties are underestimated when calculated under these assumptions. Taken together, the effects of opacity, outflow emission at low velocities confused with ambient cloud emission, and emission below the sensitivities of the observations increase outflow masses and dynamical properties by an order of magnitude, on average, and factors of 50-90 in the most extreme cases. Different (and non-uniform) excitation temperatures, inclination effects, and dissociation of molecular gas will all work to further increase outflow properties. Molecular outflows are thus almost certainly more massive and energetic than commonly reported. Additionally, outflow properties are lower, on average, by almost an order of magnitude when calculated from the {sup 12}CO (3-2) maps compared to the {sup 12}CO (2-1) maps, even after accounting for different opacities, map sensitivities, and possible excitation temperature variations. It has recently been argued in the literature that the {sup 12}CO (3-2) line is subthermally excited in outflows, and our results support this finding.

  9. Right ventricular outflow tract strategies for repair of tetralogy of Fallot: effect of monocusp valve reconstruction.

    NARCIS (Netherlands)

    Sasson, L.; Houri, S.; Raucher Sternfeld, A.; Cohen, I.; Lenczner, O.; Bove, E.L.; Kapusta, L.; Tamir, A.

    2013-01-01

    OBJECTIVES: The absence of a pulmonary valve (PV) after tetralogy of Fallot (TOF) repair has been shown to impact postoperative right ventricular (RV) function. The purposes of this study were to (i) compare early outcomes after PV-sparing vs transannular patching (TAP) with monocusp valve

  10. AGN outflows as neutrino sources: an observational test

    Science.gov (United States)

    Padovani, P.; Turcati, A.; Resconi, E.

    2018-04-01

    We test the recently proposed idea that outflows associated with Active Galactic Nuclei (AGN) could be neutrino emitters in two complementary ways. First, we cross-correlate a list of 94 "bona fide" AGN outflows with the most complete and updated repository of IceCube neutrinos currently publicly available, assembled by us for this purpose. It turns out that AGN with outflows matched to an IceCube neutrino have outflow and kinetic energy rates, and bolometric powers larger than those of AGN with outflows not matched to neutrinos. Second, we carry out a statistical analysis on a catalogue of [O III] λ5007 line profiles using a sample of 23,264 AGN at z values (˜6 and 18 per cent respectively, pre-trial) for relatively high velocities and luminosities. Our results are consistent with a scenario where AGN outflows are neutrino emitters but at present do not provide a significant signal. This can be tested with better statistics and source stacking. A predominant role of AGN outflows in explaining the IceCube data appears in any case to be ruled out.

  11. 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.

  12. Formation and spatial distribution of hypervelocity stars in AGN outflows

    Science.gov (United States)

    Wang, Xiawei; Loeb, Abraham

    2018-05-01

    We study star formation within outflows driven by active galactic nuclei (AGN) as a new source of hypervelocity stars (HVSs). Recent observations revealed active star formation inside a galactic outflow at a rate of ∼ 15M⊙yr-1 . We verify that the shells swept up by an AGN outflow are capable of cooling and fragmentation into cold clumps embedded in a hot tenuous gas via thermal instabilities. We show that cold clumps of ∼ 103 M⊙ are formed within ∼ 105 yrs. As a result, stars are produced along outflow's path, endowed with the outflow speed at their formation site. These HVSs travel through the galactic halo and eventually escape into the intergalactic medium. The expected instantaneous rate of star formation inside the outflow is ∼ 4 - 5 orders of magnitude greater than the average rate associated with previously proposed mechanisms for producing HVSs, such as the Hills mechanism and three-body interaction between a star and a black hole binary. We predict the spatial distribution of HVSs formed in AGN outflows for future observational probe.

  13. Density diagnostics of ionized outflows in active galacitc nuclei

    Science.gov (United States)

    Mao, J.; Kaastra, J.; Mehdipour, M.; Raassen, T.; Gu, L.

    2017-10-01

    Ionized outflows in Active Galactic Nuclei are thought to influence their nuclear and local galactic environment. However, the distance of outflows with respect to the central engine is poorly constrained, which limits our understanding of the kinetic power by the outflows. Therefore, the impact of AGN outflows on their host galaxies is uncertain. Given the density of the outflows, their distance can be immediately obtained by the definition of the ionization parameter. Here we carry out a theoretical study of density diagnostics of AGN outflows using absorption lines from metastable levels in Be-like to F-like ions. With the new self-consistent photoionization model (PION) in the SPEX code, we are able to calculate ground and metastable level populations. This enable us to determine under what physical conditions these levels are significantly populated. We then identify characteristic transitions from these metastable levels in the X-ray band. Firm detections of absorption lines from such metastable levels are challenging for current grating instruments. The next generation of spectrometers like X-IFU onboard Athena will certainly identify the presence/absence of these density- sensitive absorption lines, thus tightly constraining the location and the kinetic power of AGN outflows.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-05-01

    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 is refined by our new algorithm. Correlations of outflow velocity and strength with a hot dust indicator (β{sub NIR}) and other quasar physical parameters—such as an Eddington ratio, luminosity, and a UV continuum slope—are explored in order to figure out which parameters drive outflows. Here β{sub NIR} is the near-infrared continuum slope, which is a good indicator of the amount of hot dust emission relative to the accretion disk emission. We confirm previous findings that outflow properties moderately or weakly depend on the Eddington ratio, UV slope, and luminosity. For the first time, we report moderate and significant correlations of outflow strength and velocity with β{sub NIR} in BAL quasars. It is consistent with the behavior of blueshifted broad emission lines in non-BAL quasars. The statistical analysis and composite spectra study both reveal that outflow strength and velocity are more strongly correlated with β{sub NIR} than the Eddington ratio, luminosity, and UV slope. In particular, the composites show that the entire C IV absorption profile shifts blueward and broadens as β{sub NIR} increases, while the Eddington ratio and UV slope only affect the high and low velocity part of outflows, respectively. We discuss several potential processes and suggest that the dusty outflow scenario, i.e., that dust is intrinsic to outflows and may contribute to the outflow acceleration, is most likely.

  15. Universal algorithm for diagnosis of biventricular capture in patients with cardiac resynchronization therapy.

    Science.gov (United States)

    Jastrzebski, Marek; Kukla, Piotr; Fijorek, Kamil; Czarnecka, Danuta

    2014-08-01

    An accurate and universal method for diagnosis of biventricular (BiV) capture using a standard 12-lead electrocardiogram (ECG) would be useful for assessment of cardiac resynchronization therapy (CRT) patients. Our objective was to develop and validate such an ECG method for BiV capture diagnosis that would be independent of pacing lead positions-a major confounder that significantly influences the morphologies of paced QRS complexes. On the basis of an evaluation of 789 ECGs of 443 patients with heart failure and various right ventricular (RV) and left ventricular (LV) lead positions, the following algorithm was constructed and validated. BiV capture was diagnosed if the QRS in lead I was predominantly negative and either V1 QRS was predominantly positive or V6 QRS was of negative onset and predominantly negative (step 1), or if QRS complex duration was capture. The algorithm showed good accuracy (93%), sensitivity (97%), and specificity (90%) for detection of loss of LV capture. The performance of the algorithm did not differ among apical, midseptal, and outflow tract RV lead positions and various LV lead positions. LV capture leaves diagnostic hallmarks in the fused BiV QRS related to different vectors of depolarization and more rapid depolarization of the ventricles. An accurate two-step ECG algorithm for BiV capture diagnosis was developed and validated. This algorithm is universally applicable to all CRT patients, regardless of the positions of the pacing leads. ©2014 Wiley Periodicals, Inc.

  16. 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.

  17. An Unusual Left Ventricular Outflow Pseudoaneurysm: Usefulness of Echocardiography and Multidetector Computed Tomography for Surgical Repair

    International Nuclear Information System (INIS)

    Da Col, Uberto; Ramoni, Enrico; Di Bella, Isidoro; Ragni, Temistocle

    2009-01-01

    Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures. An unusual case of LVOT pseudoaneurysm is described. It was detected by transthoracic ecocardiography 7 months after aortic root replacement for acute endocarditis. Multidetector computed tomography (MDCT) confirmed the presence of a pouch located between the aortic root and the right atrium. Computed tomography also detected the origin of the pseudoaneurysm from the muscular interventricular septum of the LVOT, rather below the aortic valve plane. It was repaired with an extracardiac surgical approach, sparing the aortic root bioprosthesis previously implanted. The high-resolution three-dimensional details provided by the preoperative MDCT allowed us to plan a simple and effective surgical strategy.

  18. ALMA Studies of the Disk-Jet-Outflow Connection

    Science.gov (United States)

    Dougados, Catherine; Louvet, F.; Mardones, D.; Cabrit, S.

    2017-06-01

    I will describe in this contribution recent results obtained with ALMA on the origin of the disk/jet/outflow connexion in T Tauri stars. I will first present ALMA observations of the disk associated with the jet source Th 28, which question previous jet rotation measurements in this source and the implications drawn from them. I will then discuss Cycle 2 ALMA observations of the disk and small scale CO outflow associated with the prototypical edge-on HH 30 source. The unprecedented angular resolution of this dataset brings new constraints on the origin of the CO outflows in young stars.

  19. Evaluation of Tricuspid Annular Plane Systolic Excursion Measured with Cardiac Magnetic Resonance Imaging in Pediatric Patients with Tetralogy of Fallot

    Science.gov (United States)

    Soslow, Jonathan H.; Usoro, Emem; Wang, Li; Parra, David A.

    2015-01-01

    Background Aneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesized that tricuspid annular plane systolic excursion measured by cardiac magnetic resonance imaging approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in pediatric patients with repaired tetralogy of Fallot. Methods Tricuspid annular plane systolic excursion was measured retrospectively on cardiac magnetic resonance images in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was: 1) indexed to body surface area, 2) converted into a fractional value, and 3) converted into published pediatric Z-scores. Results Tricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Pediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function. Conclusions Tricuspid annular plane systolic excursion measured on cardiac magnetic resonance imaging correlates poorly with global and segmental right ventricular ejection fraction in pediatric patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population. PMID:26279488

  20. A man with multiple cardiac masses.

    Science.gov (United States)

    Indrabhinduwat, Manasawee; Arciniegas Calle, Maria C; Colgan, Joseph P; Villarraga, Benoy N

    2018-06-12

    A 37-year-old male presented with cough, dyspnea, significant weight loss (45 pounds) and subacute fever for the past two months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high grade B cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function. The masses in the RV outflow track caused partial obstruction (Pulmonary Valve peak velocity 2.3 m/s) with a RV systolic pressure of 43 mmHg. The infiltrative mass in the interatrial septum extended into both the right and left atrial cavities. The right superior pulmonary vein was occluded. This patient was treated with aggressive chemotherapy and had a good clinical response that resulted in mass size reduction after the first course of chemotherapy. Multimodality imaging techniques such as echocardiography, cardiac CT and PET scan can provide complementary information to better evaluate, stage and manage these patients. © 2018 The authors.

  1. Cumulative neutrino background from quasar-driven outflows

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Xiawei; Loeb, Abraham, E-mail: xiawei.wang@cfa.harvard.edu, E-mail: aloeb@cfa.harvard.edu [Department of Astronomy, Harvard University, 60 Garden Street, Cambridge, MA 02138 (United States)

    2016-12-01

    Quasar-driven outflows naturally account for the missing component of the extragalactic γ-ray background through neutral pion production in interactions between protons accelerated by the forward outflow shock and interstellar protons. We study the simultaneous neutrino emission by the same protons. We adopt outflow parameters that best fit the extragalactic γ-ray background data and derive a cumulative neutrino background of ∼ 10{sup −7} GeV cm{sup −2} s{sup −1} sr{sup −1} at neutrino energies E {sub ν} ∼> 10 TeV, which naturally explains the most recent IceCube data without tuning any free parameters. The link between the γ-ray and neutrino emission from quasar outflows can be used to constrain the high-energy physics of strong shocks at cosmological distances.

  2. Cardiac CT

    International Nuclear Information System (INIS)

    Dewey, Marc

    2011-01-01

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

  3. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  4. 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.

  5. Characterization of molecular outflows in the substellar domain

    International Nuclear Information System (INIS)

    Phan-Bao, Ngoc; Dang-Duc, Cuong; Lee, Chin-Fei; Ho, Paul T. P.; 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°. 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 –6 M ☉ to 2.9 × 10 –5 M ☉ and an outflow mass-loss rate from 2.7 × 10 –9 M ☉ yr –1 to 4.1 × 10 –8 M ☉ yr –1 . These values are comparable to those we have observed in the young brown dwarf ISO-Oph 102 of 60 M J in ρ Ophiuchi and the very low-mass star MHO 5 of 90 M 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. 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.

  7. Topographic control on the nascent Mediterranean outflow

    Science.gov (United States)

    Gasser, M.; Pelegrí, J. L.; Nash, J. D.; Peters, H.; García-Lafuente, J.

    2011-12-01

    Data collected during a 12-day cruise in July 2009 served to examine the structure of the nascent Mediterranean Outflow Water (MOW) immediately west of the Espartel Sill, the westernmost sill in the Strait of Gibraltar. The MOW is characterized by high salinities (>37.0 and reaching 38.3) and high velocities (exceeding 1 m s-1 at 100 m above the seafloor), and follows a submerged valley along a 30 km stretch, the natural western extension of the strait. It is approx. 150 m thick and 10 km wide, and experiences a substantial drop from 420 to 530 m over a distance of some 3 km between two relatively flat regions. Measurements indicate that the nascent MOW behaves as a gravity current with nearly maximal traveling speed; if this condition is maintained, then the maximum MOW velocity would decrease slowly with distance from the Espartel Sill, remaining significantly high until the gravity current excess density is only a small fraction of its original value. The sharp pycnocline between the Mediterranean and the overlying North Atlantic Central waters is dynamically unstable, particularly where the flow interacts with the 100 m decrease in bottom depth. Here, subcritical gradient Richardson numbers coincide with the development of large interfacial undulations and billows. The very energetic downslope flow is likely responsible for the development of a narrow V-shaped channel downstream of the seafloor drop along the axis of the submerged valley, this probably being the very first erosional scour produced by the nascent MOW. The coincidence of subcritical gradient Richardson numbers with relatively high turbidity values above the channel flanks suggests it may be undergoing upstream erosion.

  8. Quasar outflow energetics from broad absorption line variability

    Science.gov (United States)

    McGraw, S. M.; Shields, J. C.; Hamann, F. W.; Capellupo, D. M.; Herbst, H.

    2018-03-01

    Quasar outflows have long been recognized as potential contributors to the co-evolution between supermassive black holes (SMBHs) and their host galaxies. The role of outflows in active galactic nucleus (AGN) feedback processes can be better understood by placing observational constraints on wind locations and kinetic energies. We utilize broad absorption line (BAL) variability to investigate the properties of a sample of 71 BAL quasars with P V broad absorption. The presence of P V BALs indicates that other BALs like C IV are saturated, such that variability in those lines favours clouds crossing the line of sight. We use these constraints with measurements of BAL variability to estimate outflow locations and energetics. Our data set consists of multiple-epoch spectra from the Sloan Digital Sky Survey and MDM Observatory. We detect significant (4σ) BAL variations from 10 quasars in our sample over rest-frame time-scales between ≤0.2-3.8 yr. Our derived distances for the 10 variable outflows are nominally ≲ 1-10 pc from the SMBH using the transverse-motion scenario, and ≲ 100-1000 pc from the central source using ionization-change considerations. These distances, in combination with the estimated high outflow column densities (i.e. NH ≳ 1022 cm-2), yield outflow kinetic luminosities between ˜ 0.001 and 1 times the bolometric luminosity of the quasar, indicating that many absorber energies within our sample are viable for AGN feedback.

  9. The Mass Outflow Rate of the Milky Way

    Science.gov (United States)

    Fox, Andrew

    2017-08-01

    The balance between gaseous inflow and outflow regulates star formation in spiral galaxies. This paradigm can be tested in the Milky Way, but whereas the star formation rate and inflow rate have both been measured, the outflow rate has not. We propose an archival COS program to determine the Galactic outflow rate in cool gas ( 10^4 K) by surveying UV absorption line high-velocity clouds (HVCs). This project will make use of the newly updated Hubble Spectroscopic Legacy Archive, which contains a uniformly reduced sample of 233 COS G130M spectra of background AGN. The outflow rate will be determined by (1) searching for redshifted HVCs; (2) modeling the clouds with photoionization simulations to determine their masses and physical properties; (3) combining the cloud masses with their velocities and distances. We will measure how the outflow is distributed spatially across the sky, calculate its mass loading factor, and compare the line profiles to synthetic spectra extracted from new hydrodynamic simulations. The distribution of HVC velocities will inform us what fraction of the outflowing clouds will escape the halo and what fraction will circulate back to the disk, to better understand how and where gas enters and exits the Milky Way.

  10. Pilot Study: Estimation of Stroke Volume and Cardiac Output from Pulse Wave Velocity.

    Directory of Open Access Journals (Sweden)

    Yurie Obata

    Full Text Available Transesophageal echocardiography (TEE is increasingly replacing thermodilution pulmonary artery catheters to assess hemodynamics in patients at high risk for cardiovascular morbidity. However, one of the drawbacks of TEE compared to pulmonary artery catheters is the inability to measure real time stroke volume (SV and cardiac output (CO continuously. The aim of the present proof of concept study was to validate a novel method of SV estimation, based on pulse wave velocity (PWV in patients undergoing cardiac surgery.This is a retrospective observational study. We measured pulse transit time by superimposing the radial arterial waveform onto the continuous wave Doppler waveform of the left ventricular outflow tract, and calculated SV (SVPWV using the transformed Bramwell-Hill equation. The SV measured by TEE (SVTEE was used as a reference.A total of 190 paired SV were measured from 28 patients. A strong correlation was observed between SVPWV and SVTEE with the coefficient of determination (R2 of 0.71. A mean difference between the two (bias was 3.70 ml with the limits of agreement ranging from -20.33 to 27.73 ml and a percentage error of 27.4% based on a Bland-Altman analysis. The concordance rate of two methods was 85.0% based on a four-quadrant plot. The angular concordance rate was 85.9% with radial limits of agreement (the radial sector that contained 95% of the data points of ± 41.5 degrees based on a polar plot.PWV based SV estimation yields reasonable agreement with SV measured by TEE. Further studies are required to assess its utility in different clinical situations.

  11. 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

  12. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... urinary tract infection, or UTI, you're probably thinking about peeing quite a lot. Why? Because it ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ...

  13. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals ... Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary Tract? Urinary Tract ...

  14. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Health Growth & Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & ... Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary Tract? Urinary Tract ...

  15. [Cardiac cachexia].

    Science.gov (United States)

    Miján, Alberto; Martín, Elvira; de Mateo, Beatriz

    2006-05-01

    Chronic heart failure (CHF), especially affecting the right heart, frequently leads to malnutrition. If the latter is severe and is combined to other factors, it may lead to cardiac cachexia. This one is associated to increased mortality and lower survival of patients suffering from it. The causes of cardiac cachexia are diverse, generally associated to maintenance of a negative energy balance, with increasing evidence of its multifactorial origin. Neurohumoral, inflammatory, immunological, and metabolic factors, among others, are superimposed in the patient with CHF, leading to involvement and deterioration of several organs and systems, since this condition affects both lean (or active cellular) mass and adipose and bone tissue osteoporosis. Among all, the most pronounced deterioration may be seen at skeletal muscle tissue, at both structural and functional levels, the heart not being spared. As for treatment, it should be based on available scientific evidence. Assessment of nutritional status of any patient with CHF is a must, with the requirement of nutritional intervention in case of malnutrition. In this situation, especially if accompanied by cardiac cachexia, it is required to modify energy intake and oral diet quality, and to consider the indication of specific complementary or alternative artificial nutrition. Besides, the causal relationship of the beneficial role of moderate physical exertion is increasing, as well as modulation of metabolic and inflammatory impairments observed in cardiac cachexia with several drugs, leading to a favorable functional and structural response in CHF patients.

  16. Cardiac Pacemakers

    International Nuclear Information System (INIS)

    Fiandra, O.; Espasandin, W.; Fiandra, H.

    1984-01-01

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

  17. Aortic valve bypass surgery in severe aortic valve stenosis: Insights from cardiac and brain magnetic resonance imaging.

    Science.gov (United States)

    Mantini, Cesare; Caulo, Massimo; Marinelli, Daniele; Chiacchiaretta, Piero; Tartaro, Armando; Cotroneo, Antonio Raffaele; Di Giammarco, Gabriele

    2018-04-13

    To investigate and describe the distribution of aortic and cerebral blood flow (CBF) in patients with severe valvular aortic stenosis (AS) before and after aortic valve bypass (AVB) surgery. We enrolled 10 consecutive patients who underwent AVB surgery for severe AS. Cardiovascular magnetic resonance imaging (CMR) and brain magnetic resonance imaging were performed as baseline before surgery and twice after surgery. Quantitative flow measurements were obtained using 1.5-T magnetic resonance imaging (MRI) scanner phase-contrast images of the ascending aorta, descending thoracic aorta (3 cm proximally and distally from the conduit-to-aorta anastomosis), and ventricular outflow portion of the conduit. The evaluation of CBF was performed using 3.0-T MRI scanner arterial spin labeling (ASL) through sequences acquired at the gray matter, dorsal default-mode network, and sensorimotor levels. Conduit flow, expressed as the percentage of total antegrade flow through the conduit, was 63.5 ± 8% and 67.8 ± 7% on early and mid-term postoperative CMR, respectively (P surgery in patients with severe AS, cardiac output is split between the native left ventricular outflow tract and the apico-aortic bypass, with two-thirds of the total antegrade flow passing through the latter and one-third passing through the former. In our experience, CBF assessment confirms that the flow redistribution does not jeopardize cerebral blood supply. Copyright © 2018 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  18. Modeling jet and outflow feedback during star cluster formation

    Energy Technology Data Exchange (ETDEWEB)

    Federrath, Christoph [Monash Centre for Astrophysics, School of Mathematical Sciences, Monash University, VIC 3800 (Australia); Schrön, Martin [Department of Computational Hydrosystems, Helmholtz Centre for Environmental Research-UFZ, Permoserstr. 15, D-04318 Leipzig (Germany); Banerjee, Robi [Hamburger Sternwarte, Gojenbergsweg 112, D-21029 Hamburg (Germany); Klessen, Ralf S., E-mail: christoph.federrath@monash.edu [Universität Heidelberg, Zentrum für Astronomie, Institut für Theoretische Astrophysik, Albert-Ueberle-Strasse 2, D-69120 Heidelberg (Germany)

    2014-08-01

    Powerful jets and outflows are launched from the protostellar disks around newborn stars. These outflows carry enough mass and momentum to transform the structure of their parent molecular cloud and to potentially control star formation itself. Despite their importance, we have not been able to fully quantify the impact of jets and outflows during the formation of a star cluster. The main problem lies in limited computing power. We would have to resolve the magnetic jet-launching mechanism close to the protostar and at the same time follow the evolution of a parsec-size cloud for a million years. Current computer power and codes fall orders of magnitude short of achieving this. In order to overcome this problem, we implement a subgrid-scale (SGS) model for launching jets and outflows, which demonstrably converges and reproduces the mass, linear and angular momentum transfer, and the speed of real jets, with ∼1000 times lower resolution than would be required without the SGS model. We apply the new SGS model to turbulent, magnetized star cluster formation and show that jets and outflows (1) eject about one-fourth of their parent molecular clump in high-speed jets, quickly reaching distances of more than a parsec, (2) reduce the star formation rate by about a factor of two, and (3) lead to the formation of ∼1.5 times as many stars compared to the no-outflow case. Most importantly, we find that jets and outflows reduce the average star mass by a factor of ∼ three and may thus be essential for understanding the characteristic mass of the stellar initial mass function.

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

    International Nuclear Information System (INIS)

    Wang, Huiyuan; Xing, Feijun; Wang, Tinggui; Zhou, Hongyan; Zhang, Kai; Zhang, Shaohua

    2013-01-01

    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

  20. [Evaluation of upper urinary tract function in patients undergoing autoplastic surgery for hydronphrosis of the intrarenal pelvis].

    Science.gov (United States)

    Kurbanaliev, R M; Usupbaev, A Ch; Kolesnichenko, I V; Sadyrbekov, N Zh; Sultanov, B M

    2018-05-01

    To investigate the functional state of the upper urinary tract in patients undergoing autoplastic surgery for a hydronophrosis of the intrarenal pelvis. The study comprised 78 patients with the intrarenal pelvis and impaired urinary outflow due to stricture of the ureteropelvic junction and vascular conflict (interatrial and arteriovenous narrowing), who underwent pyeloplasty using autologous tunica vaginalis. All patients underwent an incision of ureteropelvic stricture and resection of the parietal layer of the tunica vaginalis which was used to repair the obstruction site and internal stenting of the upper urinary tract. The patients were examined at baseline and during follow-up ranging from 3 months to 3 years. At three months after surgery, there was a decrease in the size of the renal pelvis and calyces with an improvement of all parameters of uro- and hemodynamics. At three years after surgery, the structural and functional parameters of the upper urinary tract were completely restored. Obstructive uropathy, resulting from the intrarenal pelvis, leads to persistently impaired urinary outflow from the upper urinary tract. Surgical intervention is the only curative treatment able to restore the urinary flow. In men with the intrarenal pelvis, the autoplastic surgery of the ureteropelvic junction obstruction using a parietal layer of the tunica vaginalis is an effective surgical modality improving renal pelvis capacity and contributing to the recovery of urinary outflow from the upper urinary tract.

  1. 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 Bowel Why is it important to begin urologic care in infancy and ...

  2. Urinary tract infection - children

    Science.gov (United States)

    UTI - children; Cystitis - children; Bladder infection - children; Kidney infection - children; Pyelonephritis - children ... Craig JC. Long-term antibiotics for preventing recurrent urinary tract infection in children. Cochrane Database Syst Rev . 2011;(3):CD001534. PMID: ...

  3. Upper respiratory tract (image)

    Science.gov (United States)

    The major passages and structures of the upper respiratory tract include the nose or nostrils, nasal cavity, mouth, throat (pharynx), and voice box (larynx). The respiratory system is lined with a mucous membrane that ...

  4. Cardiac ablation

    Directory of Open Access Journals (Sweden)

    Kelly Ratheal

    2016-01-01

    Full Text Available Cardiac ablation is a procedure that uses either radiofrequency or cryothermal energy to destroy cells in the heart to terminate and/or prevent arrhythmias. The indications for cardiac catheter ablation include refractory, symptomatic arrhythmias, with more specific guidelines for atrial fibrillation in particular. The ablation procedure itself involves mapping the arrhythmia and destruction of the aberrant pathway in an effort to permanently prevent the arrhythmia. There are many types of arrhythmias, and they require individualized approaches to ablation based on their innately different electrical pathways. Ablation of arrhythmias, such as Wolff-Parkinson-White syndrome, AV nodal reentrant tachycardia, and atrial-fibrillation, is discussed in this review. Ablation has a high success rate overall and minimal complication rates, leading to improved quality of life in many patients.

  5. 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.

  6. Cosmic ray driven outflows in an ultraluminous galaxy

    Science.gov (United States)

    Fujita, Akimi; Mac Low, Mordecai-Mark

    2018-06-01

    In models of galaxy formation, feedback driven both by supernova (SN) and active galactic nucleus is not efficient enough to quench star formation in massive galaxies. Models of smaller galaxies have suggested that cosmic rays (CRs) play a major role in expelling material from the star-forming regions by diffusing SN energy to the lower density outskirts. We therefore run gas dynamical simulations of galactic outflows from a galaxy contained in a halo with 5 × 1012 M⊙ that resembles a local ultraluminous galaxy, including both SN thermal energy and a treatment of CRs using the same diffusion approximation as Salem & Bryan. We find that CR pressure drives a low-density bubble beyond the edge of the shell swept up by thermal pressure, but the main bubble driven by SN thermal pressure overtakes it later, which creates a large-scale biconical outflow. CRs diffusing into the disc are unable to entrain its gas in the outflows, yielding a mass-loading rate of only ˜ 0.1 per cent with varied CR diffusion coefficients. We find no significant difference in mass-loading rates in SN-driven outflows with or without CR pressure. Our simulations strongly suggest that it is hard to drive a heavily mass-loaded outflow with CRs from a massive halo potential, although more distributed star formation could lead to a different result.

  7. Urinary Tract Infections (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections KidsHealth / For Teens / Urinary Tract Infections What's ... especially girls — visit a doctor. What Is a Urinary Tract Infection? A bacterial urinary tract infection (UTI) is ...

  8. Urinary Tract Infections (For Kids)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections ( ... Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system made ...

  9. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections ( ... Let's find out more. What Exactly Is a Urinary Tract? Your urinary tract is actually a system made ...

  10. Plasma Outflows: Known Knowns, Known Unknowns, and The Unknown

    Science.gov (United States)

    Moore, T. E.

    2012-01-01

    A brief summary is given of i) what we know from observing ionospheric outflows and ii) how outflow parameterizations are being used in global simulations to evaluate their effects on magnetospheric dynamics. Then, a list of unanswered questions and issues to be resolved is given, followed by a description of the known future mission plans expressed in the Heliophysics Roadmap, such as Origin of Near-Earth Plasmas (ONEP), and Ion-Neutral Coupling in the Atmosphere (INCA). Finally, a set of requirements for definitive plasma outflow observations are identified, along with possible methods for fulfilling them in future missions. Since results of the current Heliophysics Decadal Survey are expected soon, it is hoped that future plans can be summarized and discussed without speculation at the GEM 2012 meeting.

  11. Multi-phase outflows as probes of AGN accretion history

    Science.gov (United States)

    Nardini, Emanuele; Zubovas, Kastytis

    2018-05-01

    Powerful outflows with a broad range of properties (such as velocity, ionization, radial scale and mass loss rate) represent a key feature of active galactic nuclei (AGN), even more so since they have been simultaneously revealed also in individual objects. Here we revisit in a simple analytical framework the recent remarkable cases of two ultraluminous infrared quasars, IRAS F11119+3257 and Mrk 231, which allow us to investigate the physical connection between multi-phase AGN outflows across the ladder of distance from the central supermassive black hole (SMBH). We argue that any major deviations from the standard outflow propagation models might encode unique information on the past SMBH accretion history, and briefly discuss how this could help address some controversial aspects of the current picture of AGN feedback.

  12. The outflow speed of the coma of Halley's comet

    International Nuclear Information System (INIS)

    Combi, M.R.

    1989-01-01

    Data concerning the outflow speed of the coma of Comet Halley are studied in relation to a generalization of the coupled pure-gas-dynamic/Monte Carlo model of Combi and Smyth (1988) to include the dusty-gas dynamics of the inner coma. Measurements made by the Giotto neutral-gas spectrometer, IR water observations from the Kuiper Airborne Observatory, and Doppler radio line profiles of HCN and OH are used to examine the radial dependence of the outflow speed, the asymmetry in the outflow speed, and the overall heliocentric distance dependence of the Doppler profiles, respectively. The results suggest that the model makes it possible to understand the gross long-term behavior and radial structure of the dynamics of the cometary coma. 23 refs

  13. CORONAL MASS EJECTION INDUCED OUTFLOWS OBSERVED WITH HINODE/EIS

    International Nuclear Information System (INIS)

    Jin, M.; Ding, M. D.; Chen, P. F.; Fang, C.; Imada, S.

    2009-01-01

    We investigate the outflows associated with two halo coronal mass ejections (CMEs) that occurred on 2006 December 13 and 14 in NOAA 10930, using the Hinode/EIS observations. Each CME was accompanied by an EIT wave and coronal dimmings. Dopplergrams in the dimming regions are obtained from the spectra of seven EIS lines. The results show that strong outflows are visible in the dimming regions during the CME eruption at different heights from the lower transition region to the corona. It is found that the velocity is positively correlated with the photospheric magnetic field, as well as the magnitude of the dimming. We estimate the mass loss based on height-dependent EUV dimmings and find it to be smaller than the CME mass derived from white-light observations. The mass difference is attributed partly to the uncertain atmospheric model, and partly to the transition region outflows, which refill the coronal dimmings.

  14. Relative outflow enhancements during major geomagnetic storms – Cluster observations

    Directory of Open Access Journals (Sweden)

    A. Schillings

    2017-12-01

    Full Text Available The rate of ion outflow from the polar ionosphere is known to vary by orders of magnitude, depending on the geomagnetic activity. However, the upper limit of the outflow rate during the largest geomagnetic storms is not well constrained due to poor spatial coverage during storm events. In this paper, we analyse six major geomagnetic storms between 2001 and 2004 using Cluster data. The six major storms fulfil the criteria of Dst  < −100 nT or Kp  > 7+. Since the shape of the magnetospheric regions (plasma mantle, lobe and inner magnetosphere are distorted during large magnetic storms, we use both plasma beta (β and ion characteristics to define a spatial box where the upward O+ flux scaled to an ionospheric reference altitude for the extreme event is observed. The relative enhancement of the scaled outflow in the spatial boxes as compared to the data from the full year when the storm occurred is estimated. Only O+ data were used because H+ may have a solar wind origin. The storm time data for most cases showed up as a clearly distinguishable separate peak in the distribution toward the largest fluxes observed. The relative enhancement in the outflow region during storm time is 1 to 2 orders of magnitude higher compared to less disturbed time. The largest relative scaled outflow enhancement is 83 (7 November 2004 and the highest scaled O+ outflow observed is 2  ×  1014 m−2 s−1 (29 October 2003.

  15. Pediatric urinary tract infection

    Energy Technology Data Exchange (ETDEWEB)

    Blickman, J.G.

    1991-02-06

    Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs.

  16. Pediatric urinary tract infection

    International Nuclear Information System (INIS)

    Blickman, J.G.

    1991-01-01

    Acute urinary tract infection (UTI) is an important cause of morbidity in children and may be complicated by congenital urinary tract abnormalities of a functional or anatomic nature which, predispose to recurrent UTI's that in turn may lead to renal failure and hypertension. Early radiologic and ultrasonographic investigations may reveal these anatomic anomalies in particular because the urinary tract, specifically in children, is not readily accessible to adequate clinical examinations Excretory urography (EU) has been considered as the 'gold standard' of upper urinary tract visualization, while the voiding cystourethrogram (VCUG) was thought to be the preferential method of imaging of the lower urinary tract. Recently, major technical advances have altered this commonly accepted diagnostic workup. Although ultrasonography, radio-nuclide scanning and urodynamics have become important contributors to the understanding of pathophysiology of UTI's their value and place in assessment of the sequence of imaging has not been comprehensively studied. This thesis deals about the optimization of the choice and the order of the different imaging techniques used in the evaluation of children, younger than six year with UTI. (author). 243 refs.; 23 figs.; 8 tabs

  17. Does the X-ray outflow quasar PDS 456 have a UV outflow at 0.3c?

    Science.gov (United States)

    Hamann, Fred; Chartas, George; Reeves, James; Nardini, Emanuele

    2018-05-01

    The quasar PDS 456 (at redshift ˜0.184) has a prototype ultra-fast outflow (UFO) measured in X-rays. This outflow is highly ionized with relativistic speeds, large total column densities log NH(cm-2) > 23, and large kinetic energies that could be important for feedback to the host galaxy. A UV spectrum of PDS 456 obtained with the Hubble Space Telescope in 2000 contains one well-measured broad absorption line (BAL) at ˜1346 Å (observed) that might be Ly α at v ≈ 0.06c or N V λ1240 at v ≈ 0.08c. However, we use photoionization models and comparisons to other outflow quasars to show that these BAL identifications are problematic because other lines that should accompany them are not detected. We argue that the UV BAL is probably C IV at v ≈ 0.30c. This would be the fastest UV outflow ever reported, but its speed is similar to the X-ray outflow and its appearance overall is similar to relativistic UV BALs observed in other quasars. The C IV BAL identification is also supported indirectly by the tentative detection of another broad C IV line at v ≈ 0.19c. The high speeds suggest that the UV outflow originates with the X-ray UFO crudely 20-30 rg from the central black hole. We speculate that the C IV BAL might form in dense clumps embedded in the X-ray UFO, requiring density enhancements of only ≳0.4 dex compared to clumpy structures already inferred for the soft X-ray absorber in PDS 456. The C IV BAL might therefore be the first detection of low-ionization clumps proposed previously to boost the opacities in UFOs for radiative driving.

  18. 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...

  19. 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

  20. Atmospheric transport and outflow of polycyclic aromatic hydrocarbons from China

    Energy Technology Data Exchange (ETDEWEB)

    Chang Lang; Shu Tao; Wenxin Liu; Yanxu Zhang; Staci Simonich [Peking University, Beijing (China). Laboratory for Earth Surface Processes, College of Environmental Sciences

    2008-07-15

    A potential receptor influence function (PRIF) model, based on air mass forward trajectory calculations, was applied to simulate the atmospheric transport and outflow of polycyclic aromatic hydrocarbons (PAHs) emitted from China. With a 10 day atmospheric transport time, most neighboring countries and regions, as well as remote regions, were influenced by PAH emissions from China. Of the total annual PAH emission of 114 Gg, 92.7% remained within the boundary of mainland China. The geographic distribution of PRIFs within China was similar to the geographic distribution of the source regions, with high values in the North China Plain, Sichuan Basin, Shanxi, and Guizhou province. The Tarim basin and Sichuan basin had unfavorable meteorological conditions for PAH outflow. Of the PAH outflow from China (8092 tons or 7.1% of the total annual PAH emission), approximately 69.9% (5655 tons) reached no further than the offshore environment of mainland China and the South China Sea. Approximate 227, 71, 746, and 131 tons PAHs reached North Korea, South Korea, Russia-Mongolia region, and Japan, respectively, 2-4 days after the emission. Only 1.4 tons PAHs reached North America after more than 9 days. Interannual variation in the eastward PAH outflow was positively correlated to cold episodes of El Nino/Southern Oscillation. However, trans-Pacific atmospheric transport of PAHs from China was correlated to Pacific North America index (PNA) which is associated with the strength and position of westerly winds. 38 refs., 4 figs.

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

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    Abstract. 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 outflow rates when the inflow parameters are known. Since temperature of the CENBOL decides the spectral states of the black hole, ...

  2. 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.

  3. PROTOSTELLAR OUTFLOW HEATING IN A GROWING MASSIVE PROTOCLUSTER

    International Nuclear Information System (INIS)

    Wang Ke; Wu Yuefang; Zhang Huawei; Zhang Qizhou; Li Huabai

    2012-01-01

    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 3 (J,K) = (1,1), (2,2), (3,3) lines, as well as H 2 O and class I CH 3 OH masers. Multiple NH 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 3 (3,3) emission features are also found coincident with the outflows. A weak NH 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.

  4. Quenching of Star Formation in Molecular Outflow Host NGC 1266

    NARCIS (Netherlands)

    Alatalo, K.; Nyland, K. E.; Graves, G.; Deustua, S.; Young, L. M.; Davis, T. A.; Crocker, A. F.; 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.; McDermid, R. M.; Morganti, R.; Naab, T.; Oosterloo, T.; Sarzi, M.; Scott, N.; Serra, P.; Weijmans, A.; Wong, Tony; Ott, Jürgen

    We detail the rich molecular story of NGC 1266, its serendipitous discovery within the ATLAS3D survey (Cappellari et al. 2011) and how it plays host to an AGN-driven molecular outflow, potentially quenching all of its star formation (SF) within the next 100 Myr. While major mergers appear to play a

  5. Reconstructing Global-scale Ionospheric Outflow With a Satellite Constellation

    Science.gov (United States)

    Liemohn, M. W.; Welling, D. T.; Jahn, J. M.; Valek, P. W.; Elliott, H. A.; Ilie, R.; Khazanov, G. V.; Glocer, A.; Ganushkina, N. Y.; Zou, S.

    2017-12-01

    The question of how many satellites it would take to accurately map the spatial distribution of ionospheric outflow is addressed in this study. Given an outflow spatial map, this image is then reconstructed from a limited number virtual satellite pass extractions from the original values. An assessment is conducted of the goodness of fit as a function of number of satellites in the reconstruction, placement of the satellite trajectories relative to the polar cap and auroral oval, season and universal time (i.e., dipole tilt relative to the Sun), geomagnetic activity level, and interpolation technique. It is found that the accuracy of the reconstructions increases sharply from one to a few satellites, but then improves only marginally with additional spacecraft beyond 4. Increased dwell time of the satellite trajectories in the auroral zone improves the reconstruction, therefore a high-but-not-exactly-polar orbit is most effective for this task. Local time coverage is also an important factor, shifting the auroral zone to different locations relative to the virtual satellite orbit paths. The expansion and contraction of the polar cap and auroral zone with geomagnetic activity influences the coverage of the key outflow regions, with different optimal orbit configurations for each level of activity. Finally, it is found that reconstructing each magnetic latitude band individually produces a better fit to the original image than 2-D image reconstruction method (e.g., triangulation). A high-latitude, high-altitude constellation mission concept is presented that achieves acceptably accurate outflow reconstructions.

  6. Outflow and Accretion Physics in Active Galactic Nuclei

    Science.gov (United States)

    McGraw, Sean Michael

    2016-09-01

    This dissertation focuses on placing observational constraints on outflows and accretion disks in active galactic nuclei (AGN) for the purpose of better understanding the physics of super-massive black holes (SMBHs) and their evolution with the host galaxy over cosmic time. Quasar outflows and their importance in SMBH-host galaxy co-evolution can be further understood by analyzing broad absorption lines (BALs) in rest-frame UV spectra that trace a range of wind conditions. We quantify the properties of the flows by conducting BAL variability studies using multiple-epoch spectra acquired primarily from MDM Observatory and from the Sloan Digital Sky Survey. Iron low-ionization BALs (FeLoBALs) are a rare type of outflow that may represent a transient phase in galaxy evolution, and we analyze the variations in 12 FeLoBAL quasars with redshifts between 0.7 ≤ z ≤ 1.9 and rest frame timescales between ˜10 d to 7.6 yr. We investigate BAL variability in 71 quasar outflows that exhibit P V absorption, a tracer of high column density gas (i.e. NH ≥ 1022 cm -2), in order to quantify the energies and momenta of the flows. We also characterize the variability patterns of 26 quasars with mini-BALs, an interesting class of absorbers that may represent a distinct phase in the evolution of outflows. Low-luminosity AGN (LLAGN) are important objects to study since their prominence in the local Universe suggest a possible evolution from the quasar era, and their low radiative outputs likely indicate a distinct mode of accretion onto the SMBH. We probe the accretion conditions in the LLAGN NGC 4203 by estimating the SMBH mass, which is obtained by modeling the 2-dimensional velocity field of the nebular gas using spectra from the Hubble Space Telescope. We detect significant BAL and mini-BAL variability in a subset of quasars from each of our samples, with measured rest-frame variability time-scales from days to years and over multiple years on average. Variable wavelength

  7. Ionized and Neutral Outflows in the QUEST QSOs

    Science.gov (United States)

    Veilleux, Sylvain

    2011-10-01

    The role of galactic winds in gas-rich mergers is of crucial importance to understand galaxy and SMBH evolution. In recent months, our group has had three major scientific breakthroughs in this area: {1} The discovery with Herschel of massive molecular {OH-absorbing} outflows in several ULIRGs, including the nearest quasar, Mrk 231. {2} The independent discovery from mm-wave interferometric observations in the same object of a spatially resolved molecular {CO-emitting} wind with estimated mass outflow rate 3x larger than the star formation rate and spatially coincident with blueshifted neutral {Na ID-absorbing} gas in optical long-slit spectra. {3} The unambiguous determination from recent Gemini/IFU observations that the Na ID outflow in this object is wide-angle, thus driven by a QSO wind rather than a jet. This powerful outflow may be the long-sought "smoking gun" of quasar mechanical feedback purported to transform gas-rich mergers. However, our Herschel survey excludes all FIR-faint {UV-bright} "classic" QSOs by necessity. So here we propose a complementary FUV absorption-line survey of all FIR-bright -and- FIR-faint QSOs from the same parent sample. New {19 targets} and archival {11} spectra will be used to study, for the first time, the gaseous environments of QSOs as a function of host properties and age across the merger sequence ULIRG -> QSO. These data will allow us to distinguish between ionized & neutral quasar-driven outflows, starburst-driven winds, and tidal debris around the mergers. They will also be uniquely suited for a shallow but broad study of the warm & warm-hot intergalactic media, complementary to on-going surveys that are deeper but narrower.

  8. 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.

  9. Atmospheric outflow of nutrients to the Bay of Bengal: Impact of anthropogenic sources..

    Digital Repository Service at National Institute of Oceanography (India)

    Srinivas, B.; Sarin, M.M.; Sarma, V.V.S.S.

    outflow show pronounced temporal variability. The inorganic nitrogen (NH4 + -N: ~90% of NInorg) dominates the total soluble nitrogen (NTot). Although the contribution of organic nitrogen is not significant, the mass ratio of NOrg/NTotin the outflow varied...

  10. 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…

  11. Cardiac pacemaker

    International Nuclear Information System (INIS)

    Kolenik, S.A.

    1976-01-01

    The construction of a cardiac pacemaker is described which is characterized by particularly small dimensions, small weight and long life duration. The weight is under 100g, the specific weight under 1.7. Mass inertia forces which occur through acceleration and retardation processes, thus remain below the threshold values, above which one would have to reckon with considerable damaging of the surrounding body tissue. The maintaining of small size and slight weight is achieved by using an oscillator on COSMOS basis, where by considerably lower energy consumption, amongst others the lifetimes of the batteries used - a lithium anode with thionyl chloride electrolyte - is extended to over 5 years. The reliability can be increased by the use of 2 or more batteries. The designed dimension are 20x60x60 mm 3 . (ORU/LH) [de

  12. Cardiac ventriculography

    International Nuclear Information System (INIS)

    Hillis, L.D.; Grossman, W.

    1986-01-01

    Cardiac ventriculography has been used extensively to define the anatomy of the ventricles and related structures in patients with congenital, valvular, coronary, and cardiomyopathic heart disease. Specifically, left ventriculography may provide valuable information about global and segmental left ventricular function, mitral valvular incompetence, and the presence, location, and severity of a number of other abnormalities, including ventricular septal defect and hypertrophic cardiomyopathy. As a result, it should be a routine part of catheterization in patients being evaluated for coronary artery disease, aortic or mitral valvular disease, unexplained left ventricular failure, or congenital heart disease. Similarly, right ventriculography may provide information about global and segmental right ventricular function and can be especially helpful in patients with congenital heart disease

  13. 4D display of the outflow track of embryonic-chick hearts (HH 14-19) using a high speed streak mode OCT

    Science.gov (United States)

    Ma, Siyu; Wang, Rui; Goodwin, Richard L.; Markwald, Roger R.; Borg, Thomas K.; Runyan, Raymond B.; Gao, Zhi

    2013-02-01

    Congenital Heart Disease (CHD) is the most common congenital malformation in newborns in the US. Although knowledge of CHD is limited, altered hemodynamic conditions are suspected as the factor that stimulates cardiovascular cell response, resulting in the heart morphology remodeling that ultimately causes CHDs. Therefore, one of recent efforts in CHD study is to develop high-speed imaging tools to correlate the rapidly changing hemodynamic condition and the morphological adaptations of an embryonic heart in vivo. We have developed a high-speed streak mode OCT that works at the center wavelength of 830 nm and is capable of providing images (292x220 μm2) of the outflow tract of an embryonic chick heart at the rate of 1000 Hz. The modality can provide a voxel resolution in the range of 10 μm3, and the spectral resolution allows a depth range of 1.63 mm. In the study reported here, each of the 4D images of an outflow tract was recorded for 2 seconds. The recording was conducted every 2 hours (HH17 to HH18), 3 hours (HH14 to HH17), and 4 hours (HH18 to HH19). Because of the fast scan speed, there is no need for postacquisition processing such as use of gating techniques to provide a fine 3D structure. In addition, more details of the outflow tract are preserved in the recorded images. The 4D images can be used in the future to determine the role of blood flow in CHD development.

  14. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ... topic for: Kids Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more Partner Message ...

  15. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys ... topic for: Kids Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more About Us ...

  16. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... an infection somewhere in your urinary tract. Let's find out more. What Exactly Is a Urinary Tract? ... bladder, your brain tells you it's time to find a bathroom. Once you're ready to pee, ...

  17. 500 Cities: Census Tract Boundaries

    Data.gov (United States)

    U.S. Department of Health & Human Services — This census tract shapefile for the 500 Cities project was extracted from the Census 2010 Tiger/Line database and modified to remove portions of census tracts that...

  18. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is ...

  19. Generation of shockwave and vortex structures at the outflow of a boiling water jet

    Science.gov (United States)

    Alekseev, M. V.; Lezhnin, S. I.; Pribaturin, N. A.; Sorokin, A. L.

    2014-12-01

    Results of numerical simulation for shock waves and generation of vortex structures during unsteady outflow of boiling liquid jet are presented. The features of evolution of shock waves and vortex structures formation during unsteady outflow of boiling water are compared with corresponding structures during unsteady gas outflow.

  20. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) ... How Do I Know if I Have a UTI? You may notice signs of a urinary tract ...

  1. A young bipolar outflow from IRAS 15398-3359

    Science.gov (United States)

    Bjerkeli, P.; Jørgensen, J. K.; Brinch, C.

    2016-03-01

    Context. 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. Aims: We aim to determine the spatial distribution of different species that are 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 to determine the nature of the infalling and outflowing gas in the system. We also aim to determine the physical properties of the outflow. Methods: Maps from the Submillimeter Array (SMA) reveal the spatial distribution of the gaseous emission towards IRAS 15398-3359. The line radiative transfer code LIME is used to construct a full 3D model of the system taking all relevant components and scales into account. Results: CO, HCO+, and N2H+ are detected and shown to trace the motions of the outflow. For CO, the circumstellar envelope and the surrounding cloud also have a profound impact on the observed line profiles. N2H+ is detected in the outflow, but is suppressed towards the central region, perhaps because of the competing reaction between CO and H3+ in the densest regions as well as the destruction of N2H+ by CO. N2D+ is detected in a ridge south-west of the protostellar condensation and is not associated with the outflow. The morphology and kinematics of the CO emission suggests that the source is younger than ~1000 years. The mass, momentum, momentum rate, mechanical luminosity, kinetic energy, and mass-loss rate are also all estimated to be low. A full 3D radiative transfer model of the system can explain all the kinematical and morphological features in the system.

  2. The Gaseous Environments of Quasars: Outflows, Feedback & Cold Mode Accretion

    Science.gov (United States)

    Chen, Chen; Hamann, Fred

    2018-06-01

    The early stages of massive galaxy evolution can involve galaxy-scale outflows driven by a starburst or a central quasar and cold-mode accretion (infall) that adds to the mass buildup in the galaxies. I will describe three related studies that use quasar absorption lines to measure outflows, infall, and the general gaseous environments of quasars across a range of spatial scales. The three studies are: 1) High-resolution spectroscopy with Keck-HIRES and VLT-UVES to study associated absorption lines (AALs) that have redshifts greater than the emission redshifts indicating infall and/or rich multi-component AAL complexes that might be interstellar clouds in the host galaxies that have been shredded and dispersed by a fast unseen quasar-driven wind. The data provide strong constraints on the gas kinematics, spatial structure, column densities, metallicities, and energetics. 2) A complete inventory of high-velocity CIV 1548,1550 mini-BAL outflows in quasars using high-resolution high signal-to-noise spectra in the public VLT-UVES and Keck-HIRES archives. This sensitive mini-BAL survey fills an important niche between previous work on narrow absorption lines (NALs) and the much-studied broad absorption lines (BALs) to build a more complete picture of quasar outflows. I will report of the mini-BAL statistics, the diversity of lines detected, and some tests for correlations with the quasar properties. We find, for example, that mini-BALs at v > 4000 km/s in at least 10% of 511 quasars studied, including 1% at v > 0.1 c. Finally, 3) Use the much larger database of NALs measured in 262,449 BOSS quasars by York et al. (in prep.) to study their potential relationships to the quasars and, specifically, their origins in quasar outflows. This involves primarily comparisons of the incidence and properties of NALs at different velocity shifts to other measured properties of the quasars such as BAL outflows, emission line characteristics, radio-loudness, and red colors. We find

  3. Urinary Tract and How It Works

    Science.gov (United States)

    ... VUR) The Urinary Tract & How It Works The Urinary Tract & How It Works On this page: What is ... a person produces? Clinical Trials What is the urinary tract and how does it work? The urinary tract ...

  4. Mitral valve replacement complicated by iatrogenic left ventricular outflow obstruction and paravalvular leak: case report and review of literature.

    Science.gov (United States)

    Lee, Justin Z; Tey, Kai R; Mizyed, Ahmad; Hennemeyer, Charles T; Janardhanan, Rajesh; Lotun, Kapildeo

    2015-10-09

    Left ventricular outflow tract (LVOT) obstruction and paravalvular leak (PVL) are relatively uncommon, but are serious complications of prosthetic valve replacement. We present a case that displays the unique therapeutic challenges of treating a patient who developed both LVOT obstruction and mitral PVL after undergoing surgical aortic and mitral valve replacement (MVR). We also describe the use of alcohol septal ablation and albumin-glutaraldehyde (BioGlue) for septal ablation to percutaneously treat the patient's LVOT obstruction, followed by use of an Amplatzer vascular plug for percutaneous closure of an antero-medial mitral PVL associated with severe regurgitation. Percutaneous interventional management of these entities may be considered as an initial therapeutic option, especially in high-risk patients with significant morbidity and mortality of repeat surgical operations.

  5. Character and dynamics of the Red Sea and Persian Gulf outflows

    Science.gov (United States)

    Bower, Amy S.; Hunt, Heather D.; Price, James F.

    2000-03-01

    Historical hydrographic data and a numerical plume model are used to investigate the initial transformation, dynamics, and spreading pathways of Red Sea and Persian Gulf outflow waters where they enter the Indian Ocean. The annual mean transport of these outflows is relatively small (outflows in that they flow over very shallow sills (depth Red Sea outflow exhibits strong seasonal variability in transport. The four main results of this study are as follows. First, on the basis of observed temperature-salinity (T-S) characteristics of the outflow source and product waters we estimate that the Red Sea and Persian Gulf outflows are diluted by factors of ˜2.5 and 4, respectively, as they descend from sill depth to their depth of neutral buoyancy. The high-dilution factor for the Persian Gulf outflow results from the combined effects of large initial density difference between the outflow source water and oceanic water and low outflow transport. Second, the combination of low latitude and low outflow transport (and associated low outflow thickness) results in Ekman numbers for both outflows that are O(1). This indicates that they should be thought of as frictional density currents modified by rotation rather than geostrophic density currents modified by friction. Third, different mixing histories along the two channels that direct Red Sea outflow water into the open ocean result in product waters with significantly different densities, which probably contributes to the multilayered structure of the Red Sea product waters. In both outflows, seasonal variations in source water and oceanic properties have some effect on the T-S of the product waters, but they have only a minor impact on equilibrium depth. Fourth, product waters from both outflows are advected away from the sill region in narrow boundary currents, at least during part of the year. At other times, the product water appears more in isolated patches.

  6. A young bipolar outflow from IRAS 15398-3359

    DEFF Research Database (Denmark)

    Bjerkeli, Per; Jørgensen, Jes Kristian; Brinch, Christian

    2016-01-01

    emission towards IRAS 15398-3359. The lineradiative transfer code LIME is used to construct a full 3D model of thesystem taking all relevant components and scales into account. Results: CO, HCO+, and N2H+ aredetected and shown to trace the motions of the outflow. For CO, thecircumstellar envelope...... and the surrounding cloud also have a profoundimpact on the observed line profiles. N2H+ isdetected in the outflow, but is suppressed towards the central region,perhaps because of the competing reaction between CO andH3+ in the densest regions as well as thedestruction of N2H+ by CO.N2D+ is detected in a ridge south...

  7. The genitourinary tract

    International Nuclear Information System (INIS)

    Currarino, G.

    1985-01-01

    Considerable progress has been made in the field of pediatric uroradiology, as in most other aspects of radiology, since the last edition of this text was published in 1978. To a large extent, this progress was due to the remarkable advances in, and an increased application of, ultrasound, computed tomography, and nuclear imaging. In this section, an attempt has been made to incorporate and illustrate some of the applications of these diagnostic modalities to pediatric urology. The subjects discussed in this section include a brief account of the major radiologic procedures used in pediatric urology, followed by a review of the most common congenital and acquired diseases of the urinary tract and of the male and female genital tract, precocious puberty and intersex conditions, and disorders of the adrenal glands and related structures

  8. Radiology illustrated. Gastrointestinal tract

    International Nuclear Information System (INIS)

    Choi, Byung Ihn

    2015-01-01

    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.

  9. 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.

  10. Cardiac regeneration therapy: connections to cardiac physiology.

    Science.gov (United States)

    Takehara, Naofumi; Matsubara, Hiroaki

    2011-12-01

    Without heart transplantation, a large number of patients with failing hearts worldwide face poor outcomes. By means of cardiomyocyte regeneration, cardiac regeneration therapy is emerging with great promise as a means for restoring loss of cardiac function. However, the limited success of clinical trials using bone marrow-derived cells and myoblasts with heterogeneous constituents, transplanted at a wide range of cell doses, has led to disagreement on the efficacy of cell therapy. It is therefore essential to reevaluate the evidence for the efficacy of cell-based cardiac regeneration therapy, focusing on targets, materials, and methodologies. Meanwhile, the revolutionary innovation of cardiac regeneration therapy is sorely needed to help the millions of people who suffer heart failure from acquired loss of cardiomyocytes. Cardiac regeneration has been used only in limited species or as a developing process in the rodent heart; now, the possibility of cardiomyocyte turnover in the human heart is being revisited. In the pursuit of this concept, the use of cardiac stem/progenitor stem cells in the cardiac niche must be focused to usher in a second era of cardiac regeneration therapy for the severely injured heart. In addition, tissue engineering and cellular reprogramming will advance the next era of treatment that will enable current cell-based therapy to progress to "real" cardiac regeneration therapy. Although many barriers remain, the prevention of refractory heart failure through cardiac regeneration is now becoming a realistic possibility.

  11. A null mutation of Hhex results in abnormal cardiac development, defective vasculogenesis and elevated Vegfa levels.

    Science.gov (United States)

    Hallaq, Haifa; Pinter, Emese; Enciso, Josephine; McGrath, James; Zeiss, Caroline; Brueckner, Martina; Madri, Joseph; Jacobs, Harris C; Wilson, Christine M; Vasavada, Hemaxi; Jiang, Xiaobing; Bogue, Clifford W

    2004-10-01

    The homeobox gene Hhex has recently been shown to be essential for normal liver, thyroid and forebrain development. Hhex(-/-) mice die by mid-gestation (E14.5) and the cause of their early demise remains unclear. Because Hhex is expressed in the developing blood islands at E7.0 in the endothelium of the developing vasculature and heart at E9.0-9.5, and in the ventral foregut endoderm at E8.5-9.0, it has been postulated to play a critical role in heart and vascular development. We show here, for the first time, that a null mutation of Hhex results in striking abnormalities of cardiac and vascular development which include: (1) defective vasculogenesis, (2) hypoplasia of the right ventricle, (3) overabundant endocardial cushions accompanied by ventricular septal defects, outflow tract abnormalities and atrio-ventricular (AV) valve dysplasia and (4) aberrant development of the compact myocardium. The dramatic enlargement of the endocardial cushions in the absence of Hhex is due to decreased apoptosis and dysregulated epithelial-mesenchymal transformation (EMT). Interestingly, vascular endothelial growth factor A (Vegfa) levels in the hearts of Hhex(-/-) mice were elevated as much as three-fold between E9.5 and E11.5, and treatment of cultured Hhex(-/-) AV explants with truncated soluble Vegfa receptor 1, sFlt-1, an inhibitor of Vegf signaling, completely abolished the excessive epithelial-mesenchymal transformation seen in the absence of Hhex. Therefore, Hhex expression in the ventral foregut endoderm and/or the endothelium is necessary for normal cardiovascular development in vivo, and one function of Hhex is to repress Vegfa levels during development.

  12. FOREIGN DIRECT INVESTMENT OUTFLOWS FROM CHINA AND INDIA

    OpenAIRE

    K. C. FUNG; ALICIA GARCIA-HERRERO

    2012-01-01

    In this paper, we examine the determinants of Indian and Chinese FDI outflows. There are three sets of results. First, Chinese investment is attracted to more corrupt countries, while India is attracted to economies with better rule of law. Further analysis suggests that our result of China investing in more corrupt destinations is mostly driven by Chinese investment in the sub-sample of African countries. While we do not conduct economic welfare analysis, several studies in the literature re...

  13. Effects of Energetic Ion Outflow on Magnetospheric Dynamics

    Science.gov (United States)

    Kistler, L. M.; Mouikis, C.; Lund, E. J.; Menz, A.; Nowrouzi, N.

    2016-12-01

    There are two dominant regions of energetic ion outflow: the nightside auroral region and the dayside cusp. Processes in these regions can accelerate ions up to keV energies. Outflow from the nightside has direct access to the plasma sheet, while outflow from the cusp is convected over the polar cap and into the lobes. The cusp population can enter the plasma sheet from the lobe, with higher energy ions entering further down the tail than lower energy ions. During storm times, the O+ enhanced plasma sheet population is convected into the inner magnetosphere. The plasma that does not get trapped in the inner magnetosphere convects to the magnetopause where reconnection is taking place. An enhanced O+ population can change the plasma mass density, which may have the effect of decreasing the reconnection rate. In addition O+ has a larger gyroradius than H+ at the same velocity or energy. Because of this, there are larger regions where the O+ is demagnetized, which can lead to larger acceleration because the O+ can move farther in the direction of the electric field. In this talk we will review results from Cluster, Van Allen Probes, and MMS, on how outflow from the two locations affects magnetospheric dynamics. We will discuss whether enhanced O+ from either population has an effect on the reconnection rate in the tail or at the magnetopause. We will discuss how the two populations impact the inner magnetosphere during storm times. And finally, we will discuss whether either population plays a role in triggering substorms, particularly during sawtooth events.

  14. The Role of Ionospheric Outflow Preconditioning in Determining Storm Geoeffectiveness

    Science.gov (United States)

    Welling, D. T.; Liemohn, M. W.; Ridley, A. J.

    2012-12-01

    It is now well accepted that ionospheric outflow plays an important role in the development of the plasma sheet and ring current during geomagnetic storms. Furthermore, even during quiet times, ionospheric plasma populates the magnetospheric lobes, producing a reservoir of hydrogen and oxygen ions. When the Interplanetary Magnetic Field (IMF) turns southward, this reservoir is connected to the plasma sheet and ring current through magnetospheric convection. Hence, the conditions of the ionosphere and magnetospheric lobes leading up to magnetospheric storm onset have important implications for storm development. Despite this, there has been little research on this preconditioning; most global simulations begin just before storm onset, neglecting preconditioning altogether. This work explores the role of preconditioning in determining the geoeffectiveness of storms using a coupled global model system. A model of ionospheric outflow (the Polar Wind Outflow Model, PWOM) is two-way coupled to a global magnetohydrodynamic model (the Block-Adaptive Tree Solar wind Roe-type Upwind Scheme, BATS-R-US), which in turn drives a ring current model (the Ring current Atmosphere interactions Model, RAM). This unique setup is used to simulate an idealized storm. The model is started at many different times, from 1 hour before storm onset to 12 hours before. The effects of storm preconditioning are examined by investigating the total ionospheric plasma content in the lobes just before onset, the total ionospheric contribution in the ring current just after onset, and the effects on Dst, magnetic elevation angle at geosynchronous, and total ring current energy density. This experiment is repeated for different solar activity levels as set by F10.7 flux. Finally, a synthetic double-dip storm is constructed to see how two closely spaced storms affect each other by changing the preconditioning environment. It is found that preconditioning of the magnetospheric lobes via ionospheric

  15. 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...

  16. Female genital tract

    International Nuclear Information System (INIS)

    Cole, M.P.; Hunter, R.D.

    1985-01-01

    This chapter is concerned with cancers of the cervix uteri, the corpus uteri, the ovary, vulva, and vagina. Radiotherapy has an important place in the management of patients with cancers of the genital tract but the radiotherapist must collaborate closely with surgical colleagues, both gynaecological and urological. Each must appreciate the merits and limitations of surgery and radiation therapy, whether used alone or in combination, with curative intent or in a supportive role

  17. MULTIPLE OUTFLOWS IN THE GIANT ERUPTION OF A MASSIVE STAR

    Energy Technology Data Exchange (ETDEWEB)

    Humphreys, Roberta M.; Gordon, Michael S.; Jones, Terry J. [Minnesota Institute for Astrophysics, 116 Church St. SE, University of Minnesota, Minneapolis, MN 55455 (United States); Martin, John C., E-mail: roberta@umn.edu [University of Illinois Springfield, Springfield, IL 62703 (United States)

    2016-08-01

    The supernova impostor PSN J09132750+7627410 in NGC 2748 reached a maximum luminosity of ≈−14 mag. It was quickly realized that it was not a true supernova, but another example of a nonterminal giant eruption. PSN J09132750+7627410 is distinguished by multiple P Cygni absorption minima in the Balmer emission lines that correspond to outflow velocities of −400, −1100, and −1600 km s{sup −1}. Multiple outflows have been observed in only a few other objects. In this paper we describe the evolution of the spectrum and the P Cygni profiles for 3 months past maximum, the post-maximum formation of a cool, dense wind, and the identification of a possible progenitor. One of the possible progenitors is an infrared source. Its pre-eruption spectral energy distribution suggests a bolometric luminosity of −8.3 mag and a dust temperature of 780 K. If it is the progenitor, it is above the AGB limit, unlike the intermediate-luminosity red transients. The three P Cygni profiles could be due to ejecta from the current eruption, the wind of the progenitor, or previous mass-loss events. We suggest that they were all formed as part of the same high-mass-loss event and are due to material ejected at different velocities or energies. We also suggest that multiple outflows during giant eruptions may be more common than reported.

  18. CLUSTERED STAR FORMATION AND OUTFLOWS IN AFGL 2591

    International Nuclear Information System (INIS)

    Sanna, A.; Carrasco-González, C.; Menten, K. M.; Brunthaler, A.; Reid, M. J.; Moscadelli, L.; Rygl, K. L. J.

    2012-01-01

    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 M ☉ . 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 –1 ) and perhaps a lower-velocity (∼10 km s –1 ) wind with an opening angle of about 20° from the jet axis.

  19. CLUSTERED STAR FORMATION AND OUTFLOWS IN AFGL 2591

    Energy Technology Data Exchange (ETDEWEB)

    Sanna, A.; Carrasco-Gonzalez, C.; Menten, K. M.; Brunthaler, A. [Max-Planck-Institut fuer Radioastronomie, Auf dem Huegel 69, 53121 Bonn (Germany); Reid, M. J. [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Moscadelli, L. [INAF, Osservatorio Astrofisico di Arcetri, Largo E. Fermi 5, 50125 Firenze (Italy); Rygl, K. L. J., E-mail: asanna@mpifr-bonn.mpg.de [IFSI-INAF, Istituto di Fisica dello Spazio Interplanetario, Via del Fosso del Cavaliere 100, 00133 Roma (Italy)

    2012-02-01

    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 M{sub Sun }. 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{sup -1}) and perhaps a lower-velocity ({approx}10 km s{sup -1}) wind with an opening angle of about 20 Degree-Sign from the jet axis.

  20. Physical Processes for Driving Ionospheric Outflows in Global Simulations

    Science.gov (United States)

    Moore, Thomas Earle; Strangeway, Robert J.

    2009-01-01

    We review and assess the importance of processes thought to drive ionospheric outflows, linking them as appropriate to the solar wind and interplanetary magnetic field, and to the spatial and temporal distribution of their magnetospheric internal responses. These begin with the diffuse effects of photoionization and thermal equilibrium of the ionospheric topside, enhancing Jeans' escape, with ambipolar diffusion and acceleration. Auroral outflows begin with dayside reconnexion and resultant field-aligned currents and driven convection. These produce plasmaspheric plumes, collisional heating and wave-particle interactions, centrifugal acceleration, and auroral acceleration by parallel electric fields, including enhanced ambipolar fields from electron heating by precipitating particles. Observations and simulations show that solar wind energy dissipation into the atmosphere is concentrated by the geomagnetic field into auroral regions with an amplification factor of 10-100, enhancing heavy species plasma and gas escape from gravity, and providing more current carrying capacity. Internal plasmas thus enable electromagnetic driving via coupling to the plasma, neutral gas and by extension, the entire body " We assess the Importance of each of these processes in terms of local escape flux production as well as global outflow, and suggest methods for their implementation within multispecies global simulation codes. We complete 'he survey with an assessment of outstanding obstacles to this objective.

  1. VY Canis Majoris: Observational Studies of the Outflow

    Science.gov (United States)

    Harwit, M.

    2001-12-01

    A number of recent studies carried out with the Infrared Space Observatory, ISO, and the Submillimeter Wave Astronomy Satellite, SWAS, provide new information on the chemical composition of the dust and the geometry of the outflow. With ISO, we have obtained a near-, mid-, and far-infrared spectrum of VY CMa that shows the strong preponderance of amorphous, as contrasted to crystalline, silicates. The sharp spectral slope in the near-infrared suggests the presence also of iron grains. While an excellent theoretical fit to the data is obtained, we emphasize that this is far from unique. A resolution of ambiguities will require a self-consistent model that considers not only radiative transfer, but also plausible elemental abundances, laboratory studies of chemical condensation sequences, and gas dynamics. With SWAS we have obtained a high-resolution spectrum of the 557GHz ground state transition of ortho-water. The spectral profile enables us to rule out a number of outflow geometries proposed in the literature. With ISO we also obtained the intensities and velocity structure of several other spectral lines of water. Most of these lines must be optically thick but effectively thin, a circumstance that permits us to make use of recent gas-dynamic models to locate the radial position in the outflow where individual lines are emitted.

  2. Large sea ice outflow into the Nares Strait in 2007

    DEFF Research Database (Denmark)

    Kwok, R.; Pedersen, L.T.; Gudmandsen, Preben

    2010-01-01

    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...... 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...

  3. Ultrafast outflows disappear in high-radiation fields

    Science.gov (United States)

    Pinto, C.; Alston, W.; Parker, M. L.; Fabian, A. C.; Gallo, L. C.; Buisson, D. J. K.; Walton, D. J.; Kara, E.; Jiang, J.; Lohfink, A.; Reynolds, C. S.

    2018-05-01

    Ultrafast outflows (UFOs) are the most extreme winds launched by active galactic nuclei (AGN) due to their mildly relativistic speeds (˜0.1-0.3c) and are thought to significantly contribute to galactic evolution via AGN feedback. Their nature and launching mechanism are however not well understood. Recently, we have discovered the presence of a variable UFO in the narrow-line Seyfert 1 IRAS 13224-3809. The UFO varies in response to the brightness of the source. In this work we perform flux-resolved X-ray spectroscopy to study the variability of the UFO and found that the ionization parameter is correlated with the luminosity. In the brightest states the gas is almost completely ionized by the powerful radiation field and the UFO is hardly detected. This agrees with our recent results obtained with principal component analysis. We might have found the tip of the iceberg: the high ionization of the outflowing gas may explain why it is commonly difficult to detect UFOs in AGN and possibly suggest that we may underestimate their actual feedback. We have also found a tentative correlation between the outflow velocity and the luminosity, which is expected from theoretical predictions of radiation-pressure-driven winds. This trend is rather marginal due to the Fe XXV-XXVI degeneracy. Further work is needed to break such degeneracy through time-resolved spectroscopy.

  4. Fluid outflows from Venus impact craters - Analysis from Magellan data

    Science.gov (United States)

    Asimow, Paul D.; Wood, John A.

    1992-01-01

    Many impact craters on Venus have unusual outflow features originating in or under the continuous ejecta blankets and continuing downhill into the surrounding terrain. These features clearly resulted from flow of low-viscosity fluids, but the identity of those fluids is not clear. In particular, it should not be assumed a priori that the fluid is an impact melt. A number of candidate processes by which impact events might generate the observed features are considered, and predictions are made concerning the rheological character of flows produce by each mechanism. A sample of outflows was analyzed using Magellan images and a model of unconstrained Bingham plastic flow on inclined planes, leading to estimates of viscosity and yield strength for the flow materials. It is argued that at least two different mechanisms have produced outflows on Venus: an erosive, channel-forming process and a depositional process. The erosive fluid is probably an impact melt, but the depositional fluid may consist of fluidized solid debris, vaporized material, and/or melt.

  5. Cross-talk between cardiac muscle and coronary vasculature.

    Science.gov (United States)

    Westerhof, Nico; Boer, Christa; Lamberts, Regis R; Sipkema, Pieter

    2006-10-01

    The cardiac muscle and the coronary vasculature are in close proximity to each other, and a two-way interaction, called cross-talk, exists. Here we focus on the mechanical aspects of cross-talk including the role of the extracellular matrix. Cardiac muscle affects the coronary vasculature. In diastole, the effect of the cardiac muscle on the coronary vasculature depends on the (changes in) muscle length but appears to be small. In systole, coronary artery inflow is impeded, or even reversed, and venous outflow is augmented. These systolic effects are explained by two mechanisms. The waterfall model and the intramyocardial pump model are based on an intramyocardial pressure, assumed to be proportional to ventricular pressure. They explain the global effects of contraction on coronary flow and the effects of contraction in the layers of the heart wall. The varying elastance model, the muscle shortening and thickening model, and the vascular deformation model are based on direct contact between muscles and vessels. They predict global effects as well as differences on flow in layers and flow heterogeneity due to contraction. The relative contributions of these two mechanisms depend on the wall layer (epi- or endocardial) and type of contraction (isovolumic or shortening). Intramyocardial pressure results from (local) muscle contraction and to what extent the interstitial cavity contracts isovolumically. This explains why small arterioles and venules do not collapse in systole. Coronary vasculature affects the cardiac muscle. In diastole, at physiological ventricular volumes, an increase in coronary perfusion pressure increases ventricular stiffness, but the effect is small. In systole, there are two mechanisms by which coronary perfusion affects cardiac contractility. Increased perfusion pressure increases microvascular volume, thereby opening stretch-activated ion channels, resulting in an increased intracellular Ca2+ transient, which is followed by an increase in Ca

  6. 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.

  7. Disruption of Smad4 in neural crest cells leads to mid-gestation death with pharyngeal arch, craniofacial and cardiac defects

    Science.gov (United States)

    Nie, Xuguang; Deng, Chu-xia; Wang, Qin; Jiao, Kai

    2008-01-01

    TGFβ/BMP signaling pathways are essential for normal development of neural crest cells (NCCs). Smad4 encodes the only common Smad protein in mammals, which is a critical nuclear mediator of TGFβ/BMP signaling. In this work, we sought to investigate the roles of Smad4 for development of NCCs. To overcome the early embryonic lethality of Smad4 null mice, we specifically disrupted Smad4 in NCCs using a Cre/loxP system. The mutant mice died at mid-gestation with defects in facial primordia, pharyngeal arches, outflow tract and cardiac ventricles. Further examination revealed that mutant embryos displayed severe molecular defects starting from E9.5. Expression of multiple genes, including Msx1, 2, Ap-2α, Pax3, and Sox9, which play critical roles for NCC development, was downregulated by NCC disruption of Smad4. Moreover, increased cell death was observed in pharyngeal arches from E10.5. However, the cell proliferation rate in these areas was not substantially altered. Taken together, these findings provide compelling genetic evidence that Smad4-mediated activities of TGFβ/BMP signals are essential for appropriate NCC development. PMID:18334251

  8. Fading AGN Candidates: AGN Histories and Outflow Signatures

    Energy Technology Data Exchange (ETDEWEB)

    Keel, William C.; Maksym, W. Peter [Department of Physics and Astronomy, University of Alabama, Box 870324, Tuscaloosa, AL 35487 (United States); Lintott, Chris J. [Astrophysics, Oxford University and Adler Planetarium, 1300 S. Lakeshore Drive, Chicago, IL 60605 (United States); Bennert, Vardha N.; Scott, Bryan; Showley, Charles; Flatland, Kelsi [Physics Department, California Polytechnic State University, San Luis Obispo, CA 93407 (United States); Chojnowski, S. Drew [Department of Astronomy, New Mexico State University, P.O. Box 30001, MSC 4500, Las Cruces, NM 88003-8001 (United States); Moiseev, Alexei; Smirnova, Aleksandrina [Special Astrophysical Observatory, Russian Academy of Sciences, Nizhny Arkhyz, 369167 (Russian Federation); Schawinski, Kevin; Sartori, Lia F. [Institute for Astronomy, ETH Zürich, Wolfgang-Pauli-Straße 27, CH-8093 Zurich (Switzerland); Urry, C. Megan [Department of Physics, Yale University, P.O. Box 208120, New Haven, CT 06520-8120 (United States); Pancoast, Anna [Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Schirmer, Mischa, E-mail: wkeel@ua.edu [Gemini Observatory, La Serena (Chile)

    2017-02-01

    We consider the energy budgets and radiative history of eight fading active galactic nuclei (AGNs), identified from an energy shortfall between the requirements to ionize very extended (radius > 10 kpc) ionized clouds and the luminosity of the nucleus as we view it directly. All show evidence of significant fading on timescales of ≈50,000 yr. We explore the use of minimum ionizing luminosity Q {sub ion} derived from photoionization balance in the brightest pixels in H α at each projected radius. Tests using presumably constant Palomar–Green QSOs, and one of our targets with detailed photoionization modeling, suggest that we can derive useful histories of individual AGNs, with the caveat that the minimum ionizing luminosity is always an underestimate and subject to uncertainties about fine structure in the ionized material. These consistency tests suggest that the degree of underestimation from the upper envelope of reconstructed Q {sub ion} values is roughly constant for a given object and therefore does not prevent such derivation. The AGNs in our sample show a range of behaviors, with rapid drops and standstills; the common feature is a rapid drop in the last ≈2×10{sup 4} yr before the direct view of the nucleus. The e -folding timescales for ionizing luminosity are mostly in the thousands of years, with a few episodes as short as 400 yr. In the limit of largely obscured AGNs, we find additional evidence for fading from the shortfall between even the lower limits from recombination balance and the maximum luminosities derived from far-infrared fluxes. We compare these long-term light curves, and the occurrence of these fading objects among all optically identified AGNs, to simulations of AGN accretion; the strongest variations over these timespans are seen in models with strong and local (parsec-scale) feedback. We present Gemini integral-field optical spectroscopy, which shows a very limited role for outflows in these ionized structures. While rings and

  9. Fading AGN Candidates: AGN Histories and Outflow Signatures

    International Nuclear Information System (INIS)

    Keel, William C.; Maksym, W. Peter; Lintott, Chris J.; Bennert, Vardha N.; Scott, Bryan; Showley, Charles; Flatland, Kelsi; Chojnowski, S. Drew; Moiseev, Alexei; Smirnova, Aleksandrina; Schawinski, Kevin; Sartori, Lia F.; Urry, C. Megan; Pancoast, Anna; Schirmer, Mischa

    2017-01-01

    We consider the energy budgets and radiative history of eight fading active galactic nuclei (AGNs), identified from an energy shortfall between the requirements to ionize very extended (radius > 10 kpc) ionized clouds and the luminosity of the nucleus as we view it directly. All show evidence of significant fading on timescales of ≈50,000 yr. We explore the use of minimum ionizing luminosity Q ion derived from photoionization balance in the brightest pixels in H α at each projected radius. Tests using presumably constant Palomar–Green QSOs, and one of our targets with detailed photoionization modeling, suggest that we can derive useful histories of individual AGNs, with the caveat that the minimum ionizing luminosity is always an underestimate and subject to uncertainties about fine structure in the ionized material. These consistency tests suggest that the degree of underestimation from the upper envelope of reconstructed Q ion values is roughly constant for a given object and therefore does not prevent such derivation. The AGNs in our sample show a range of behaviors, with rapid drops and standstills; the common feature is a rapid drop in the last ≈2×10 4 yr before the direct view of the nucleus. The e -folding timescales for ionizing luminosity are mostly in the thousands of years, with a few episodes as short as 400 yr. In the limit of largely obscured AGNs, we find additional evidence for fading from the shortfall between even the lower limits from recombination balance and the maximum luminosities derived from far-infrared fluxes. We compare these long-term light curves, and the occurrence of these fading objects among all optically identified AGNs, to simulations of AGN accretion; the strongest variations over these timespans are seen in models with strong and local (parsec-scale) feedback. We present Gemini integral-field optical spectroscopy, which shows a very limited role for outflows in these ionized structures. While rings and loops of emission

  10. Magnetic Topology and Ion Outflow in Mars' Magnetotail

    Science.gov (United States)

    Mitchell, D. L.; Xu, S.; McFadden, J. P.; Hara, T.; Luhmann, J. G.; Mazelle, C. X.; Andersson, L.; DiBraccio, G. A.; Connerney, J. E. P.

    2017-12-01

    Planetary ion outflow down the Martian magnetotail could be an important atmospheric loss mechanism. This process depends on magnetic connectivity to the day-side ionosphere and on acceleration of ions to escape velocity. The Mars Atmosphere and Volatile Evolution (MAVEN) mission has obtained comprehensive ion, electron, and magnetic field data in Mars' magnetotail. The spacecraft is in a 75°-inclination, elliptical orbit that samples altitudes from 150 to 6200 km. As the orbit precesses, it sweeps through the tail at a variety of altitudes in this range. Data from the Solar Wind Electron Analyzer (SWEA) and Magnetometer (MAG) are used to determine the magnetic field topology in the tail at high cadence (every 2-4 seconds), and in particular whether field lines are open, closed, or draped, and if open whether they have access to the day-side or night-side ionosphere. Simultaneous observations by the Supra-Thermal and Thermal Ion Composition (STATIC) instrument and the Langmuir Probe and Waves (LPW) experiment are used to measure the density, composition, and velocity of planetary plasma on these field lines. We find that magnetic topology in the tail is complex and variable, and is influenced by the IMF polarity and the orientation of Mars' crustal magnetic fields with respect to the Sun. We find that planetary ion outflow occurs on both open and draped field lines. On open field lines, outflow tends to occur parallel to the field line, with colder, denser, and slower outflow on field lines connected to the day-side ionosphere (Fig. 1). On these same field lines (after correction for the spacecraft potential) a shift in the position of the He-II photoelectron feature indicates a 1-Volt parallel electric potential directed away from the planet. Except for H+ and occasionally O+, this potential is insufficient by itself to accelerate planetary ions to escape velocity. Outflow is warmer, less dense, and faster moving on draped field lines. In this case, the ion bulk

  11. Acute respiratory tract infections: a potential trigger for the acute coronary syndrome

    NARCIS (Netherlands)

    Harskamp, Ralf E.; van Ginkel, Margreet W.

    2008-01-01

    Clinical studies suggest that acute respiratory tract infection (ARTI) may be a risk factor for the acute coronary syndrome (ACS). ARTI is associated with an increased risk for ACS up to 2 weeks prior to a cardiac event. The mechanism that may underlie this association is unclear. Infections are

  12. 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.

  13. 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.

  14. Urinary tract trauma

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, J.E. (Sunnybrook Medical Centre, Toronto, Ontario (Canada))

    1983-09-01

    From a practical point of view, a woman who has blunt injury to the pelvic area with hematuria from the lower urinary tract, has a contused or ruptured bladder. In a man, such a situation calls for retrograde urethrography to determine if the injury is in the urethra or the bladder because the two organs are investigated differently. In both sexes, such injuries are usually associated with pelvic fractures. Massive bladder displacement and severe hemorrhage should alert one to the need for pelvic angiography to find and embolize the bleeding site within the first 24 hours after injury. For blunt trauma to the upper urinary tract an intravenous urogram with tomography is still the main examination. However, a normal intravenous urogram does not exclude serious injury. Therefore, if signs or symptoms persist, a computerized tomographic (CT) examination should be performed if available. Otherwise, a radionuclide study is advisable. Non-excretion on intravenous urography with tomography calls for selective renal arteriography to delineate the etiology. There can be serious renal trauma in the absence of hematuria, which may occur with renal pedicle injury or avulsion of the ureter. Minor forniceal ruptures may occasionally mask severe posterior renal lacerations.

  15. ERUPTIVE VARIABLE STARS AND OUTFLOWS IN SERPENS NW

    Energy Technology Data Exchange (ETDEWEB)

    Hodapp, Klaus W. [Institute for Astronomy, University of Hawaii, 640 N. Aohoku Place, Hilo, HI 96720 (United States); Chini, Rolf; Watermann, Ramon; Lemke, Roland, E-mail: hodapp@ifa.hawaii.edu [Ruhr Universitaet Bochum, Astronomisches Institut, Universitaetsstrasse 150, D-44801 Bochum (Germany)

    2012-01-01

    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 broadband K and in a narrowband filter centered on the 1-0 S(1) emission line of H{sub 2} 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 an H{sub 2} jet emerging from the cometary nebula EC 53. The star illuminating EC 53 is periodically variable with a period of 543 days and has a close-by, non-variable companion at a projected distance of 92 AU. We argue that the periodic variability is the result of accretion instabilities triggered by another very close, not directly observable, binary companion and that EC 53 can be understood in the model of a multiple system developing into a hierarchical configuration.

  16. 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.

  17. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    Gulati, Gurpreet S; Kothari, Shyam S

    2011-01-01

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

  18. Atmospheric pollutant outflow from southern Asia: a review

    Directory of Open Access Journals (Sweden)

    M. G. Lawrence

    2010-11-01

    Full Text Available 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

  19. 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

  20. 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

  1. Cardiac systolic function in cirrhotic patients’ candidate of liver trans-plantation compared with control group

    Directory of Open Access Journals (Sweden)

    Roya Sattarzadeh-Badkoubeh

    2017-02-01

    Full Text Available Background: We assessed different systolic cardiac indices to describe left and right ventricular dysfunction in cirrhotic patients before liver transplantation. Methods: In this case-control study, eighty-one consecutive individuals with the confirmed hepatic cirrhosis and candidate for liver transplantation in the Imam Khomeini Hospital between March 2008 and March 2010 were selected. Thirty-two age and gender cross-matched healthy volunteers were also selected as the control group. A detailed two-dimensional and Doppler echocardiography was obtained in all patients and controls performed by the same operator on the day of admission. Results: Dimensions of both left and right atriums as well as left ventricular end-diastolic volume and basal right ventricular dimension in the cirrhotic group were significantly higher than control group. Left ventricular end-systolic dimensions as well as aortic annulus diameter were not different between the two study groups. Left ventricular outflow tract velocity time integral, isovolumic pre-ejection time, isovolumic relaxation time, stroke volume, left ventricular ejection fraction, IVCT+IVRT+ET, systolic velocity of tricuspid annulus, systolic velocity of basal segment of RV free wall, systolic velocity of basal segment of septal wall, peak strain of septal margin (base, peak strain of septal margin (midpoint, peak strain of lateral margin (midpoint, strain rate of septal margin (base, strain rate of septal margin (midpoint, strain rate of lateral margin (base, strain rate of lateral margin (midpoint, Tei index (left and right ventricles, systolic time interval and tricuspid annular plane systolic excursion were higher in cirrhotic group, significantly, (P< 0.05. Left ventricular ejection time and systolic velocity of mid segment of lateral wall were lower in cirrhotic group, significantly, (P< 0.05. Conclusion: In this study, the effects of liver on heart were volume overload, hyperdynamic state and

  2. Negative and Positive Outflow-Feedback in Nearby (U)LIRGs

    Energy Technology Data Exchange (ETDEWEB)

    Cazzoli, Sara, E-mail: sara@iaa.es [Instituto de Astrofisica de Andalucia (CSIC), Granada (Spain)

    2017-12-15

    The starburst-AGN coexistence in local (U)LIRGs makes these galaxies excellent laboratories for the study of stellar and AGN outflows and feedback. Outflows regulate star formation and AGN activity, redistributing gas, dust and metals over large scales in the interstellar and intergalactic media (negative feedback) being also considered to be able to undergo vigorous star formation (positive feedback). In this contribution, I will summarize the results from a search for outflows in a sample of nearby 38 local (U)LIRG systems observed with VIMOS/VLT integral field unit. For two galaxies of the sample I will detail the outflow properties and discuss the observational evidence for negative and positive outflow-feedback. The assessment of both negative and positive feedback effects represent a novel approach toward a comprehensive understanding of the impact of outflow feedback in the galaxy evolution.

  3. THE TURBULENT ORIGIN OF OUTFLOW AND SPIN MISALIGNMENT IN MULTIPLE STAR SYSTEMS

    Energy Technology Data Exchange (ETDEWEB)

    Offner, Stella S. R.; Lee, Katherine I.; Arce, Héctor G.; Fielding, Drummond B. [Department of Astronomy, University of Massachusetts, Amherst, MA 01003 (United States); Dunham, Michael M., E-mail: soffner@astro.umass.edu [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138 (United States)

    2016-08-10

    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 {sup 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 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.

  4. THE TURBULENT ORIGIN OF OUTFLOW AND SPIN MISALIGNMENT IN MULTIPLE STAR SYSTEMS

    International Nuclear Information System (INIS)

    Offner, Stella S. R.; Lee, Katherine I.; Arce, Héctor G.; Fielding, Drummond B.; Dunham, Michael M.

    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 momentum. 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 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.

  5. 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. © 2015 Japan Pediatric Society.

  6. 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

  7. The digital aqueous humor outflow meter: an alternative tool for screening of the human eye outflow facility

    Directory of Open Access Journals (Sweden)

    Vassilios P Kozobolis

    2010-08-01

    Full Text Available Vassilios P Kozobolis, Eleftherios I Paschalis, Nikitas C Foudoulakis, Stavrenia C Koukoula, Georgios LabirisDepartment of Ophthalmology and Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, GreecePurpose: To develop, characterize, and validate a prototype digital aqueous humor outflow tonographer (DAHOM.Material and methods: The DAHOM was developed, characterized, and validated in three phases. Phase 1 involved construction of the sensor. This was broadly based on the fundamental design of a typical Schiotz tonographer with a series of improvements, including corneal indentation, which was converted to an electrical signal via a linear variable differential transducer, an analog signal which was converted to digital via ADC circuitry, and digital data acquisition and processing which was made possible by a serial port interface. Phase 2 comprised development of software for automated assessment of the outflow facility. Automated outflow facility assessment incorporated a series of fundamental improvements in comparison with traditional techniques, including software-based filtering of ripple noise and extreme variations, rigidity impact analysis, and evaluation of the impact of patient age, central corneal thickness, and ocular axial length. Phase 3 comprised characterization and validation of DAHOM, for which we developed an experimental setup using porcine cadaver eyes. DAHOM’s repeatability was evaluated by means of Cronbach’s alpha and intraclass correlation coefficient. The level of agreement with a standard Schiotz tonographer was evaluated by means of paired t-tests and Bland-Altman analysis in human eyes.Results: The experimental setup provided the necessary data for the characterization of DAHOM. A fourth order polynomial equation provided excellent fit (R square >0.999. DAHOM demonstrated high repeatability (Cronbach’s alpha ≥0.997; intraclass correlation coefficient ≥0.987 and an adequate level of

  8. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract? Your urinary tract is actually a system made up of these main parts: two kidneys two ureters (say: ... Chronic Kidney Diseases Movie: Urinary System Your Urinary System Bedwetting View more ... & Terms of Use Notice of Nondiscrimination Visit the Nemours Web ...

  9. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... English Español Urinary Tract Infections (UTIs) KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? ...

  10. The Red Sea outflow regulated by the Indian monsoon

    Science.gov (United States)

    Aiki, Hidenori; Takahashi, Keiko; Yamagata, Toshio

    2006-08-01

    To investigate why the Red Sea water overflows less in summer and more in winter, we have developed a locally high-resolution global OGCM with transposed poles in the Arabian peninsula and India. Based on a series of sensitivity experiments with different sets of idealized atmospheric forcing, the present study shows that the summer cessation of the strait outflow is remotely induced by the monsoonal wind over the Indian Ocean, in particular that over the western Arabian Sea. During the southwest monsoon (May-September), thermocline in the Gulf of Aden shoals as a result of coastal Ekman upwelling induced by the predominantly northeastward wind in the Gulf of Aden and the Arabian Sea. Because this shoaling is maximum during the southwest summer monsoon, the Red Sea water is blocked at the Bab el Mandeb Strait by upwelling of the intermediate water of the Gulf of Aden in late summer. The simulation also shows the three-dimensional evolution of the Red Sea water tongue at the mid-depths in the Gulf of Aden. While the tongue meanders, the discharged Red Sea outflow water (RSOW) (incoming Indian Ocean intermediate water (IOIW)) is always characterized by anticyclonic (cyclonic) vorticity, as suggested from the potential vorticity difference.

  11. Ultrafast Outflows: Galaxy-scale Active Galactic Nucleus Feedback

    Science.gov (United States)

    Wagner, A. Y.; Umemura, M.; Bicknell, G. V.

    2013-01-01

    We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves in the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.

  12. Device for preventing coolant outflow in a reactor

    International Nuclear Information System (INIS)

    Nemoto, Kiyomitsu; Mochizuki, Keiichi.

    1975-01-01

    Object: To prevent outflow of coolant from a reactor vessel even in an occurrence of leaking trouble at a low position in a primary cooling system or the like in the reactor vessel. Structure: An inlet at the foremost end of a coolant inlet pipe inserted into a reactor vessel is arranged at a level lower than a core, and a check valve is positioned at a level higher than the core in a rising portion of the inlet. In normal condition, the check valve is pushed up by discharge pressure of a main circulating pump and remains closed, and hence, producing no flow loss of coolant, sodium. However, when a trouble such as rupture occurs at the lower position in the primary cooling system, the attractive force for allowing the coolant to back-flow outside the reactor vessel and the load force of the coolant within the reactor vessel cause the check valve to actuate, as a consequence of which a liquid level of the coolant downwardly moves to the position of the check valve to intake the cover gases into a gas intake, thereby cutting off a flow passage of the coolant to stop outflow thereof. (Kamimura, M.)

  13. ULTRAFAST OUTFLOWS: GALAXY-SCALE ACTIVE GALACTIC NUCLEUS FEEDBACK

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, A. Y.; Umemura, M. [Center for Computational Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8577 (Japan); Bicknell, G. V., E-mail: ayw@ccs.tsukuba.ac.jp [Research School of Astronomy and Astrophysics, Australian National University, ACT 2611 (Australia)

    2013-01-20

    We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves in the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.

  14. ULTRAFAST OUTFLOWS: GALAXY-SCALE ACTIVE GALACTIC NUCLEUS FEEDBACK

    International Nuclear Information System (INIS)

    Wagner, A. Y.; Umemura, M.; Bicknell, G. V.

    2013-01-01

    We show, using global three-dimensional grid-based hydrodynamical simulations, that ultrafast outflows (UFOs) from active galactic nuclei (AGNs) result in considerable feedback of energy and momentum into the interstellar medium (ISM) of the host galaxy. The AGN wind interacts strongly with the inhomogeneous, two-phase ISM consisting of dense clouds embedded in a tenuous, hot, hydrostatic medium. The outflow floods through the intercloud channels, sweeps up the hot ISM, and ablates and disperses the dense clouds. The momentum of the UFO is primarily transferred to the dense clouds via the ram pressure in the channel flow, and the wind-blown bubble evolves in the energy-driven regime. Any dependence on UFO opening angle disappears after the first interaction with obstructing clouds. On kpc scales, therefore, feedback by UFOs operates similarly to feedback by relativistic AGN jets. Negative feedback is significantly stronger if clouds are distributed spherically rather than in a disk. In the latter case, the turbulent backflow of the wind drives mass inflow toward the central black hole. Considering the common occurrence of UFOs in AGNs, they are likely to be important in the cosmological feedback cycles of galaxy formation.

  15. Screen Channel Liquid Acquisition Device Outflow Tests in Liquid Hydrogen

    Science.gov (United States)

    Hartwig, Jason W.; Chato, David J.; McQuillen, J. B.; Vera, J.; Kudlac, M. T.; Quinn, F. D.

    2013-01-01

    This paper presents experimental design and test results of the recently concluded 1-g inverted vertical outflow testing of two 325x2300 full scale liquid acquisition device (LAD) channels in liquid hydrogen (LH2). One of the channels had a perforated plate and internal cooling from a thermodynamic vent system (TVS) to enhance performance. The LADs were mounted in a tank to simulate 1-g outflow over a wide range of LH2 temperatures (20.3 - 24.2 K), pressures (100 - 350 kPa), and flow rates (0.010 - 0.055 kg/s). Results indicate that the breakdown point is dominated by liquid temperature, with a second order dependence on mass flow rate through the LAD. The best performance is always achieved in the coldest liquid states for both channels, consistent with bubble point theory. Higher flow rates cause the standard channel to break down relatively earlier than the TVS cooled channel. Both the internal TVS heat exchanger and subcooling the liquid in the propellant tank are shown to significantly improve LAD performance.

  16. The sacral autonomic outflow is parasympathetic: Langley got it right.

    Science.gov (United States)

    Horn, John P

    2018-04-01

    A recent developmental study of gene expression by Espinosa-Medina, Brunet and colleagues sparked controversy by asserting a revised nomenclature for divisions of the autonomic motor system. Should we re-classify the sacral autonomic outflow as sympathetic, as now suggested, or does it rightly belong to the parasympathetic system, as defined by Langley nearly 100 years ago? Arguments for rejecting Espinosa-Medina, Brunet et al.'s scheme subsequently appeared in e-letters and brief reviews. A more recent commentary in this journal by Brunet and colleagues responded to these criticisms by labeling Langley's scheme as a historical myth perpetuated by ignorance. In reaction to this heated exchange, I now examine both sides to the controversy, together with purported errors by the pioneers in the field. I then explain, once more, why the sacral outflow should remain known as parasympathetic, and outline suggestions for future experimentation to advance the understanding of cellular identity in the autonomic motor system.

  17. Advection-dominated Inflow/Outflows from Evaporating Accretion Disks.

    Science.gov (United States)

    Turolla; Dullemond

    2000-03-01

    In this Letter we investigate the properties of advection-dominated accretion flows (ADAFs) fed by the evaporation of a Shakura-Sunyaev accretion disk (SSD). In our picture, the ADAF fills the central cavity evacuated by the SSD and extends beyond the transition radius into a coronal region. We find that, because of global angular momentum conservation, a significant fraction of the hot gas flows away from the black hole, forming a transsonic wind, unless the injection rate depends only weakly on radius (if r2sigma&d2;~r-xi, xiBernoulli number of the inflowing gas is negative if the transition radius is less, similar100 Schwarzschild radii, so matter falling into the hole is gravitationally bound. The ratio of inflowing to outflowing mass is approximately 1/2, so in these solutions the accretion rate is of the same order as in standard ADAFs and much larger than in advection-dominated inflow/outflow models. The possible relevance of evaporation-fed solutions to accretion flows in black hole X-ray binaries is briefly discussed.

  18. Intestinal tract diseases

    International Nuclear Information System (INIS)

    Rozenshtraukh, L.S.

    1985-01-01

    Roentgenoanatomy and physiology of the small intestine are described. Indications for radiological examinations and their possibilities in the diagnosis of the small intestine diseases are considered.Congenital anomalies and failures in the small intestine development, clinical indications and diagnosis methods for the detection of different aetiology enteritis are described. Characteristics of primary malabsorption due to congenital or acquired inferiority of the small intestine, is provided. Radiological picture of intestinal allergies is described. Clinical, morphological, radiological pictures of Crohn's disease are considered in detail. Special attention is paid to the frequency of primary and secondary tuberculosis of intestinal tract. The description of clinical indications and frequency of benign and malignant tumours of the small intestine, methods for their diagnosis are given. Radiological pictures of parasitogenic and rare diseases of the small intestine are presented. Changes in the small intestine as a result of its reaction to pathological processes, developing in other organs and systems of the organism, are described

  19. 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......-related GIT damage and dysfunction. New and novel aspects of drug delivery and drug-dietary supplement interactions are discusses and much needed areas of focus in terms of drug GIT testing are identified....... is not one of the core battery of tests that pharmaceutical companies are obliged to investigate as part of drug development. This review aims to cover the basics of GIT function before highlighting aspects of relevance for safety pharmacology in terms of age, cancerogenesis, and noth drug and diet...

  20. The urinary tract

    International Nuclear Information System (INIS)

    Thornbury, J.R.; Weiss, S.L.

    1987-01-01

    Introduction of new methods and enhancement of traditional radiologic methods have greatly influenced the use of imaging to diagnose and treat patients who have urinary tract disease. In the past, plain films of the abdomen and excretory urography were the starting point in the diagnostic imaging process. Today, either computed tomography (CT) or ultrasonography may be requested initially. Choosing the appropriate method has become more complex because of the variety that confronts the physician. If physicians think critically about the selection of patients before requesting an imaging examination, they can improve their use of such examinations. First, the physician must hypothesize a differential diagnosis. Particularly important is the action of linking the use of the diagnostic test to the choice of treatment. The following paragraphs present the most frequently used (or most useful) examinations for the specific diagnostic problem situations that are discussed subsequently

  1. Two separate outflows in the dual supermassive black hole system NGC 6240.

    Science.gov (United States)

    Müller-Sánchez, F; Nevin, R; Comerford, J M; Davies, R I; Privon, G C; Treister, E

    2018-04-01

    Theoretical models and numerical simulations have established a framework of galaxy evolution in which galaxies merge and create dual supermassive black holes (with separations of one to ten kiloparsecs), which eventually sink into the centre of the merger remnant, emit gravitational waves and coalesce. The merger also triggers star formation and supermassive black hole growth, and gas outflows regulate the stellar content 1-3 . Although this theoretical picture is supported by recent observations of starburst-driven and supermassive black hole-driven outflows 4-6 , it remains unclear how these outflows interact with the interstellar medium. Furthermore, the relative contributions of star formation and black hole activity to galactic feedback remain unknown 7-9 . Here we report observations of dual outflows in the central region of the prototypical merger NGC 6240. We find a black-hole-driven outflow of [O III] to the northeast and a starburst-driven outflow of Hα to the northwest. The orientations and positions of the outflows allow us to isolate them spatially and study their properties independently. We estimate mass outflow rates of 10 and 75 solar masses per year for the Hα bubble and the [O III] cone, respectively. Their combined mass outflow is comparable to the star formation rate 10 , suggesting that negative feedback on star formation is occurring.

  2. Burst Activity and Heart Rhythm Modulation in the Sympathetic Outflow to the Heart

    National Research Council Canada - National Science Library

    Baselli, G

    2001-01-01

    In 13 decerebrate, artificially ventilated cats preganglionic sympathetic outflow to the heart was recorded with ECG and ventilation signal, A novel algorithm was implemented that extracts weighted...

  3. Cardiac gated ventilation

    International Nuclear Information System (INIS)

    Hanson, C.W. III; Hoffman, E.A.

    1995-01-01

    There are several theoretic advantages to synchronizing positive pressure breaths with the cardiac cycle, including the potential for improving distribution of pulmonary and myocardial blood flow and enhancing cardiac output. The authors evaluated the effects of synchronizing respiration to the cardiac cycle using a programmable ventilator and electron beam CT (EBCT) scanning. The hearts of anesthetized dogs were imaged during cardiac gated respiration with a 50 msec scan aperture. Multi slice, short axis, dynamic image data sets spanning the apex to base of the left ventricle were evaluated to determine the volume of the left ventricular chamber at end-diastole and end-systole during apnea, systolic and diastolic cardiac gating. The authors observed an increase in cardiac output of up to 30% with inspiration gated to the systolic phase of the cardiac cycle in a non-failing model of the heart

  4. Coffin-Siris syndrome and cardiac anomaly with a novel SOX11 mutation.

    Science.gov (United States)

    Okamoto, Nobuhiko; Ehara, Eiji; Tsurusaki, Yoshinori; Miyake, Noriko; Matsumoto, Naomichi

    2017-08-08

    Coffin-Siris syndrome (CSS) is characterized by growth deficiency, intellectual disability, microcephaly, dysmorphic features, and hypoplastic nails of the fifth fingers and/or toes. Variants in the genes encoding subunits of the BAF complex as well as in SOX11 encoding the transcriptional factor under the control of BAF complex are associated with CSS. We report a new patient with a novel SOX11 mutation. He showed the CSS phenotype and coarctation of the aorta. Sox11 is known to be associated with cardiac outflow development in mouse studies. Therefore, cardiac anomalies might be an important complication in patients with SOX11 mutations. © 2017 Japanese Teratology Society.

  5. 10-year follow-up after radiofrequency ablation of idiopathic ventricular arrhythmias from right ventricular outflow tract

    Directory of Open Access Journals (Sweden)

    Synne Dragesund Rørvik

    2016-05-01

    Conclusions: A reduction of symptoms and use of antiarrhythmic medication, as well as an improvement in the general health perception and fitness to work after RFA of idiopathic ventricular arrhythmias can be demonstrated at ten-year follow-up.

  6. Unique developmental trajectories and genetic regulation of ventricular and outflow tract progenitors in the zebrafish second heart field

    DEFF Research Database (Denmark)

    Paffett-Lugassy, Noelle; Novikov, Natasha; Jeffrey, Spencer

    2017-01-01

    temporarily sequestered in the mesodermal cores of pharyngeal arch 2 (PA2), where they downregulate nkx2.5 expression. While there, they intermingle with precursors for PA2-derived head muscles (HMs) and hypobranchial artery endothelium, which we demonstrate are co-specified with SHF progenitors in the nkx2...

  7. 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.

  8. The launch region of the SVS 13 outflow and jet

    Energy Technology Data Exchange (ETDEWEB)

    Hodapp, Klaus W. [Institute for Astronomy, University of Hawaii, 640 North Aohoku Place, Hilo, HI 96720 (United States); Chini, Rolf, E-mail: hodapp@ifa.hawaii.edu, E-mail: rolf.chini@astro.ruhr-uni-bochum.de [Astronomisches Institut, Ruhr-Universität Bochum, Universitätsstraße 150, D-44801 Bochum (Germany)

    2014-10-20

    We present the results of Keck telescope laser adaptive-optics integral field spectroscopy with OSIRIS of the innermost regions of the NGC 1333 SVS 13 outflow that forms the system of Herbig-Haro objects 7-11. We find a bright 0.''2 long microjet traced by the emission of shock-excited [Fe II]. Beyond the extent of this jet, we find a series of bubbles and fragments of bubbles that are traced in the lower excitation H{sub 2} 1-0 S(1) line. While the most recent outflow activity is directed almost precisely (P.A. ≈ 145°) to the southeast of SVS 13, there is clear indication that prior bubble ejections were pointed in different directions. Within these variations, a clear connection between the newly observed bubble ejection events and the well-known, poorly collimated HH 7-11 system of Herbig-Haro objects is established. The astrometry of the youngest of the expanding shock fronts at three epochs, covering a timespan of over 2 yr, gives kinematic ages for two of these bubbles. The kinematic age of the youngest bubble is slightly older than the historically observed last photometric outburst of SVS 13 in 1990, consistent with that event, launching the bubble and some deceleration of its expansion. A re-evaluation of historic infrared photometry and new data show that SVS 13 has not yet returned to its brightness before that outburst and thus reveal behavior similar to FUor outbursts, albeit with a smaller amplitude. We postulate that the creation of a series of bubbles and the changes in outflow direction are indicative of a precessing disk and accretion events triggered by a repetitive phenomenon possibly linked to the orbit of a close binary companion. However, our high-resolution images in the H and K bands do not directly detect any companion object. We have tried, but failed, to detect the kinematic rotation signature of the microjet in the [Fe II] emission line at 1.644 μm.

  9. The Launch Region of the SVS 13 Outflow and Jet

    Science.gov (United States)

    Hodapp, Klaus W.; Chini, Rolf

    2014-10-01

    We present the results of Keck telescope laser adaptive-optics integral field spectroscopy with OSIRIS of the innermost regions of the NGC 1333 SVS 13 outflow that forms the system of Herbig-Haro objects 7-11. We find a bright 0.''2 long microjet traced by the emission of shock-excited [Fe II]. Beyond the extent of this jet, we find a series of bubbles and fragments of bubbles that are traced in the lower excitation H2 1-0 S(1) line. While the most recent outflow activity is directed almost precisely (P.A. ≈ 145°) to the southeast of SVS 13, there is clear indication that prior bubble ejections were pointed in different directions. Within these variations, a clear connection between the newly observed bubble ejection events and the well-known, poorly collimated HH 7-11 system of Herbig-Haro objects is established. The astrometry of the youngest of the expanding shock fronts at three epochs, covering a timespan of over 2 yr, gives kinematic ages for two of these bubbles. The kinematic age of the youngest bubble is slightly older than the historically observed last photometric outburst of SVS 13 in 1990, consistent with that event, launching the bubble and some deceleration of its expansion. A re-evaluation of historic infrared photometry and new data show that SVS 13 has not yet returned to its brightness before that outburst and thus reveal behavior similar to FUor outbursts, albeit with a smaller amplitude. We postulate that the creation of a series of bubbles and the changes in outflow direction are indicative of a precessing disk and accretion events triggered by a repetitive phenomenon possibly linked to the orbit of a close binary companion. However, our high-resolution images in the H and K bands do not directly detect any companion object. We have tried, but failed, to detect the kinematic rotation signature of the microjet in the [Fe II] emission line at 1.644 μm.

  10. The launch region of the SVS 13 outflow and jet

    International Nuclear Information System (INIS)

    Hodapp, Klaus W.; Chini, Rolf

    2014-01-01

    We present the results of Keck telescope laser adaptive-optics integral field spectroscopy with OSIRIS of the innermost regions of the NGC 1333 SVS 13 outflow that forms the system of Herbig-Haro objects 7-11. We find a bright 0.''2 long microjet traced by the emission of shock-excited [Fe II]. Beyond the extent of this jet, we find a series of bubbles and fragments of bubbles that are traced in the lower excitation H 2 1-0 S(1) line. While the most recent outflow activity is directed almost precisely (P.A. ≈ 145°) to the southeast of SVS 13, there is clear indication that prior bubble ejections were pointed in different directions. Within these variations, a clear connection between the newly observed bubble ejection events and the well-known, poorly collimated HH 7-11 system of Herbig-Haro objects is established. The astrometry of the youngest of the expanding shock fronts at three epochs, covering a timespan of over 2 yr, gives kinematic ages for two of these bubbles. The kinematic age of the youngest bubble is slightly older than the historically observed last photometric outburst of SVS 13 in 1990, consistent with that event, launching the bubble and some deceleration of its expansion. A re-evaluation of historic infrared photometry and new data show that SVS 13 has not yet returned to its brightness before that outburst and thus reveal behavior similar to FUor outbursts, albeit with a smaller amplitude. We postulate that the creation of a series of bubbles and the changes in outflow direction are indicative of a precessing disk and accretion events triggered by a repetitive phenomenon possibly linked to the orbit of a close binary companion. However, our high-resolution images in the H and K bands do not directly detect any companion object. We have tried, but failed, to detect the kinematic rotation signature of the microjet in the [Fe II] emission line at 1.644 μm.

  11. Supernova blast wave within a stellar cluster outflow

    Science.gov (United States)

    Rodríguez-Ramírez, J. C.; Raga, A. C.; Velázquez, P. F.; Rodríguez-González, A.; Toledo-Roy, J. C.

    2014-11-01

    In this paper, we develop a semi-analytic model of a supernova which goes off in the centre of a stellar cluster. The supernova remnant interacts with a stratified, pre-existent outflow produced by the winds of the cluster stars. We compare our semi-analytic model with numerical simulations using the spherically symmetric Euler equations with appropriate mass and energy source terms. We find good agreement between these two approaches, and we find that for typical parameters the blast wave is likely to reach the Taylor-Sedov regime outside the cluster radius. We also calculate the predicted X-ray luminosity of the flow as a function of time, and we obtain its dependence on the outer radius and the number of stars of the cluster.

  12. SPITZER OBSERVATIONS OF BOW SHOCKS AND OUTFLOWS IN RCW 38

    Energy Technology Data Exchange (ETDEWEB)

    Winston, E. [ESA-ESTEC (SRE-SA), Keplerlaan 1, 2201 AZ Noordwijk ZH (Netherlands); Wolk, S. J.; Bourke, T. L.; Spitzbart, B. [Harvard Smithsonian Center for Astrophysics, 60 Garden St., Cambridge, MA 02138 (United States); Megeath, S. T. [Ritter Observatory, Department of Physics and Astronomy, University of Toledo, 2801 W. Bancroft Ave., Toledo, OH 43606 (United States); Gutermuth, R., E-mail: ewinston@rssd.esa.int [Five Colleges Astronomy Department, Smith College, Northampton, MA 01027 (United States)

    2012-01-10

    We report Spitzer observations of five newly identified bow shocks in the massive star-forming region RCW 38. Four are visible at Infrared Array Camera (IRAC) wavelengths, the fifth is only visible at 24 {mu}m. Chandra X-ray emission indicates that winds from the central O5.5 binary, IRS 2, have caused an outflow to the northeast and southwest of the central subcluster. The southern lobe of hot ionized gas is detected in X-rays; shocked gas and heated dust from the shock front are detected with Spitzer at 4.5 and 24 {mu}m. The northern outflow may have initiated the present generation of star formation, based on the filamentary distribution of the protostars in the central subcluster. Further, the bow-shock driving star, YSO 129, is photo-evaporating a pillar of gas and dust. No point sources are identified within this pillar at near- to mid-IR wavelengths. We also report on IRAC 3.6 and 5.8 {mu}m observations of the cluster DBS2003-124, northeast of RCW 38, where 33 candidate young stellar objects (YSOs) are identified. One star associated with the cluster drives a parsec-scale jet. Two Herbig-Haro objects associated with the jet are visible at IRAC and Multiband Imaging Photometer for Spitzer (MIPS) wavelengths. The jet extends over a distance of {approx}3 pc. Assuming a velocity of 100 km s{sup -1} for the jet material gives an age of 3 Multiplication-Sign 10{sup 4} yr, indicating that the star (and cluster) are likely to be very young, with a similar or possibly younger age than RCW 38, and that star formation is ongoing in the extended RCW 38 region.

  13. SPITZER OBSERVATIONS OF BOW SHOCKS AND OUTFLOWS IN RCW 38

    International Nuclear Information System (INIS)

    Winston, E.; Wolk, S. J.; Bourke, T. L.; Spitzbart, B.; Megeath, S. T.; Gutermuth, R.

    2012-01-01

    We report Spitzer observations of five newly identified bow shocks in the massive star-forming region RCW 38. Four are visible at Infrared Array Camera (IRAC) wavelengths, the fifth is only visible at 24 μm. Chandra X-ray emission indicates that winds from the central O5.5 binary, IRS 2, have caused an outflow to the northeast and southwest of the central subcluster. The southern lobe of hot ionized gas is detected in X-rays; shocked gas and heated dust from the shock front are detected with Spitzer at 4.5 and 24 μm. The northern outflow may have initiated the present generation of star formation, based on the filamentary distribution of the protostars in the central subcluster. Further, the bow-shock driving star, YSO 129, is photo-evaporating a pillar of gas and dust. No point sources are identified within this pillar at near- to mid-IR wavelengths. We also report on IRAC 3.6 and 5.8 μm observations of the cluster DBS2003-124, northeast of RCW 38, where 33 candidate young stellar objects (YSOs) are identified. One star associated with the cluster drives a parsec-scale jet. Two Herbig-Haro objects associated with the jet are visible at IRAC and Multiband Imaging Photometer for Spitzer (MIPS) wavelengths. The jet extends over a distance of ∼3 pc. Assuming a velocity of 100 km s –1 for the jet material gives an age of 3 × 10 4 yr, indicating that the star (and cluster) are likely to be very young, with a similar or possibly younger age than RCW 38, and that star formation is ongoing in the extended RCW 38 region.

  14. Modeling the outflow of liquid with initial supercritical parameters using the relaxation model for condensation

    Directory of Open Access Journals (Sweden)

    Lezhnin Sergey

    2017-01-01

    Full Text Available The two-temperature model of the outflow from a vessel with initial supercritical parameters of medium has been realized. The model uses thermodynamic non-equilibrium relaxation approach to describe phase transitions. Based on a new asymptotic model for computing the relaxation time, the outflow of water with supercritical initial pressure and super- and subcritical temperatures has been calculated.

  15. Coastal circulations driven by river outflow in a variable-density 1.5-layer model

    Digital Repository Service at National Institute of Oceanography (India)

    McCreary, J.P.; Zhang, S.; Shetye, S.R.

    A variable-density, 1.5-layer model is used to investigate the dynamics of the fresher-water plumes generated by river outflow. Solutions are found in a north-south channel, and the transport M sub(tau) and salinity S sub(tau) of the outflow...

  16. The effect of outflowing water coolant with supercritical parameters on a barrier

    Directory of Open Access Journals (Sweden)

    Alekseev Maksim

    2017-01-01

    Full Text Available The outflow of supercritical coolant with different initial parameters and its impact on the barrier have been numerically simulated. Spatial and axial distributions of pressure and steam quality are presented. The force acting on the barrier at different parameters of the outflow has been calculated.

  17. Superposed epoch analysis of O+ auroral outflow during sawtooth events and substorms

    Science.gov (United States)

    Nowrouzi, N.; Kistler, L. M.; Lund, E. J.; Cai, X.

    2017-12-01

    Sawtooth events are repeated injection of energetic particles at geosynchronous orbit. Studies have shown that 94% of sawtooth events occurred during magnetic storm times. The main factor that causes a sawtooth event is still an open question. Simulations have suggested that heavy ions like O+ may play a role in triggering the injections. One of the sources of the O+ in the Earth's magnetosphere is the nightside aurora. O+ ions coming from the nightside auroral region have direct access to the near-earth magnetotail. A model (Brambles et al. 2013) for interplanetary coronal mass ejection driven sawtooth events found that nightside O+ outflow caused the subsequent teeth of the sawtooth event through a feedback mechanism. This work is a superposed epoch analysis to test whether the observed auroral outflow supports this model. Using FAST spacecraft data from 1997-2007, we examine the auroral O+ outflow as a function of time relative to an injection onset. Then we determine whether the profile of outflow flux of O+ during sawtooth events is different from the outflow observed during isolated substorms. The auroral region boundaries are estimated using the method of (Andersson et al. 2004). Subsequently the O+ outflow flux inside these boundaries are calculated and binned as a function of superposed epoch time for substorms and sawtooth "teeth". In this way, we will determine if sawtooth events do in fact have greater O+ outflow, and if that outflow is predominantly from the nightside, as suggested by the model results.

  18. Radio Jets as Driving Mechanism of Fast Outflows: The HI View

    NARCIS (Netherlands)

    Morganti, Raffaella; Maccagni, Filippo; Oosterloo, Tom; Schulz, Robert; Santoro, Francesco

    2017-01-01

    The complex and multi-phase nature of gas outflows is one of the properties highlighted by the work in recent years on AGN-driven outflows. In particular, the cold gas is found to play a more important role than previously expected. Surprisingly, HI has been shown to be a good tracer of fast

  19. Financial Crisis, Capital Outflows, and Policy Responses: Examples from East Asia

    Science.gov (United States)

    Rajan, Ramkishen S.

    2007-01-01

    Financial crises seem to have become the norm rather than the exception since 1992. The author examines the impact of a crisis of confidence and resultant capital outflows from a small and open economy and the possible policy options in response to such outflows, using simple tools and definitions that will be familiar to any money and banking or…

  20. Misalignment of outflow axes in the proto-multiple systems in Perseus

    DEFF Research Database (Denmark)

    Lee, Katherine I.; Dunham, Michael M.; Myers, Philip C.

    2016-01-01

    We investigate the alignment between outflow axes in nine of the youngest binary/multiple systems in the Perseus Molecular Cloud. These systems have typical member spacing larger than 1000 au. For outflow identification, we use 12CO(2-1) and 12CO(3-2) data from a large survey with the Submillimet...

  1. 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.

  2. 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.

  3. Unveiling the molecular bipolar outflow of the peculiar red supergiant VY Canis Majoris

    Science.gov (United States)

    Shinnaga, Hiroko; Claussen, Mark J.; Lim, Jeremy; Dinh-van-Trung; Tsuboi, Masato

    2003-04-01

    We carried out polarimetric spectral-line imaging of the molecular outflow of the peculiar red supergiant VY Canis Majoris in SiO J=1-0 line in the ground vibrational state, which contains highly linearly-polarized velocity components, using the Very Large Array. We succeeded in unveiling the highly linearly polarized bipolar outflow for the first time at subarcsecond spatial resolution. The results clearly show that the direction of linear polarization of the brightest maser components is parallel to the outflow axis. The results strongly suggest that the linear polarization of the SiO maser is closely related to the outflow phenomena of the star. Furthermore, the results indicate that the linear polarization observed in the optical and infrared also occur due to the outflow phenomena.

  4. The Simbol-X Perspective on the Physics of Quasar Outflows

    Science.gov (United States)

    Giustini, M.; Cappi, M.; Vignali, C.; Palumbo, G. G. C.; Fiore, F.; Malaguti, G.

    2009-05-01

    There is increasing evidence that quasar outflows may play a key role in providing the feedback between AGN/QSOs and their surrounding (and feeding) media, in regulating the central supermassive black hole growth and the galaxy formation and, on larger scales, in shaping the growth of cosmic structures (see e.g. [1]). X-ray observations of quasar outflows are crucial to probe their innermost parts and assess the global energetics entrained in the outflow by studying its most extreme (in terms of velocity, ionization state, mass outflow rate) phases. Simbol-X-with its high effective area in the Fe K energy band and above-will allow the detection and the characterization of powerful outflows in bright, nearby AGN and notably also in moderately faint AGN, thus shedding light on feedback processes in these objects.

  5. Quantitation of uveoscleral outflow in normotensive and glaucomatous Beagles by 3H-labeled dextran

    International Nuclear Information System (INIS)

    Barrie, K.P.; Gum, G.G.; Samuelson, D.A.; Gelatt, K.N.

    1985-01-01

    In uveoscleral outflow, aqueous humor leaves the anterior chamber and passes caudally through the trabecular meshwork and the sclerociliary cleft to enter the supraciliary and suprachoroidal spaces. The fluid is then absorbed by choroidal and scleral circulations. Using 3 H-labeled dextran, uveoscleral outflow was quantitated in normotensive and glaucomatous Beagles under general anesthesia. The intrascleral plexus was isolated and 3 H-labeled dextran was injected into the anterior chamber. Intrascleral plexus contents were sampled every 5 minutes over a 30- to 60-minute period. The eyes were enucleated, sectioned, and prepared for scintillation counting. Uveoscleral outflow accounted for 15% and 3% of the total aqueous humor outflow in the normotensive dogs and in the advanced glaucomatous dogs, respectively. In the advanced glaucomatous Beagle, conventional and uveoscleral outflow pathways were reduced and contributed to the etiopathogenesis of glaucoma

  6. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... urinary tract infection, or UTI, you're probably thinking about peeing quite a lot. Why? Because it ... you have a bladder infection, your doctor will order some medicine for you to take to kill ...

  7. URINARY TRACT INFECTION IN ADULTS

    African Journals Online (AJOL)

    Enrique

    Infection of the urinary tract (UTI) is frequently encountered in clinical practice — in the USA these ... Asymptomatic UTI is identified when organisms can be isolated in appropriate numbers .... Pregnancy ... men, so pre-treatment urine culture is.

  8. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Illnesses & Injuries Relax & Unwind People, Places & Things That Help Feelings Expert Answers Q&A Movies & More for ... ll never want to have one again! To help keep those bacteria out of your urinary tract, ...

  9. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Urinary Tract Troubles Girls are more likely than boys to get a UTI. That's because their urethras are much shorter than boys' urethras. The shorter urethra means bacteria can get ...

  10. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... when you do, phew! Your pee smells bad. These things happen because bacteria have caused an infection ... tract is actually a system made up of these main parts: two kidneys two ureters (say: YUR- ...

  11. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... body. Ahhh! That feels better. Urinary Tract Troubles Girls are more likely than boys to get a ... away properly, they stay on your skin. In girls, this means they can grow near the opening ...

  12. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... site Sitio para adolescentes Body Mind Sexual Health Food & Fitness Diseases & ... KidsHealth / For Kids / Urinary Tract Infections (UTIs) What's in this article? What Exactly Is a Urinary ...

  13. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... five to six times a day but never think twice about? Answer: Pee! But if you have ... urinary tract infection, or UTI, you're probably thinking about peeing quite a lot. Why? Because it ...

  14. 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

  15. Urinary tract infections in children.

    Science.gov (United States)

    Sedberry-Ross, Sherry; Pohl, Hans G

    2008-03-01

    Urinary tract infections can be a significant source of morbidity in the pediatric population. The mainstay of evaluating urinary tract infections in children has been physical examination, urinalysis and culture, and renal and bladder sonography and contrast cystography. However, novel clinical paradigms now consider the importance of various risk factors, such as bacterial virulence and antibiotic-resistance patterns, elimination disorders, and the role of innate immunity and inflammation in determining the likelihood of renal cortical scarring.

  16. [Urinary tract infections in adults].

    Science.gov (United States)

    Michno, Mikolaj; Sydor, Antoni

    Review of urinary tract infections in adults including etiology, pathogenesis, classification and the most important therapeutic recommendations. Urinary tract infections are still a common clinical problem occurring more often in sexually active women, pregnancy, elderly , after catherization of a urinary bladder and urological surgery as well as in the co-existence of diabetes or nephrolithiasis. Due to the anatomical differences, women suffer more often than men. The main etiological factor is Escherichia coli, even though it plays a lesser role in the complicated infections, than in non-complicated ones. Apart from that, the infections may also be caused by atypical microbes, viruses and fungi. Relapses as well as reinfections are typical features of urinary tract infections and in some cases prolonged infections can spread from lower to upper urinary tract contributing to pyelonephritis, urosepsis or even death. These long-term infections can progress in a hidden, insidious, oligosymptomatic or asymptomatic manner leading to irreversible, progressive deterioration of renal function. They can also mask other diseases such as tuberculosis or neoplasms of the urinary tract, which leads to the delayed diagnosis and treatment. Diagnosis and treatment of urinary tract infections is a complex problem, often requiring specialized procedures as well as hospitalization. The choice of a therapy is determined by the type of infection, general condition, age and coexisting diseases. Rapid diagnosis and implementation of proper pharmacotherapy may shorten the time of treatment and hospitalization, preventing serious complications and reinfections.

  17. Poisson cluster analysis of cardiac arrest incidence in Columbus, Ohio.

    Science.gov (United States)

    Warden, Craig; Cudnik, Michael T; Sasson, Comilla; Schwartz, Greg; Semple, Hugh

    2012-01-01

    Scarce resources in disease prevention and emergency medical services (EMS) need to be focused on high-risk areas of out-of-hospital cardiac arrest (OHCA). Cluster analysis using geographic information systems (GISs) was used to find these high-risk areas and test potential predictive variables. This was a retrospective cohort analysis of EMS-treated adults with OHCAs occurring in Columbus, Ohio, from April 1, 2004, through March 31, 2009. The OHCAs were aggregated to census tracts and incidence rates were calculated based on their adult populations. Poisson cluster analysis determined significant clusters of high-risk census tracts. Both census tract-level and case-level characteristics were tested for association with high-risk areas by multivariate logistic regression. A total of 2,037 eligible OHCAs occurred within the city limits during the study period. The mean incidence rate was 0.85 OHCAs/1,000 population/year. There were five significant geographic clusters with 76 high-risk census tracts out of the total of 245 census tracts. In the case-level analysis, being in a high-risk cluster was associated with a slightly younger age (-3 years, adjusted odds ratio [OR] 0.99, 95% confidence interval [CI] 0.99-1.00), not being white, non-Hispanic (OR 0.54, 95% CI 0.45-0.64), cardiac arrest occurring at home (OR 1.53, 95% CI 1.23-1.71), and not receiving bystander cardiopulmonary resuscitation (CPR) (OR 0.77, 95% CI 0.62-0.96), but with higher survival to hospital discharge (OR 1.78, 95% CI 1.30-2.46). In the census tract-level analysis, high-risk census tracts were also associated with a slightly lower average age (-0.1 years, OR 1.14, 95% CI 1.06-1.22) and a lower proportion of white, non-Hispanic patients (-0.298, OR 0.04, 95% CI 0.01-0.19), but also a lower proportion of high-school graduates (-0.184, OR 0.00, 95% CI 0.00-0.00). This analysis identified high-risk census tracts and associated census tract-level and case-level characteristics that can be used to

  18. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.

    2013-01-01

    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for

  19. Cardiac Catheterization (For Kids)

    Science.gov (United States)

    ... First Aid & Safety Doctors & Hospitals Videos Recipes for Kids Kids site Sitio para niños How the Body Works ... Educators Search English Español Cardiac Catheterization KidsHealth / For Kids / Cardiac Catheterization What's in this article? What Is ...

  20. Survey of risk factors urinary tract infection

    OpenAIRE

    A Dehghani; M zahedi; M moezzi; M dafei; H Falahzadeh

    2016-01-01

    Introduction: Women are very susceptible to urinary tract infections and pregnancy raises the risk of urinary tract infection. In general, little information on the risk factors of urinary tract infection in pregnancy is underway. Urinary tract infection in pregnancy is an important risk factor for pregnancy dire consequences. The purpose of this study is to find risk factors associated with urinary tract infection in pregnant women. Methods: The study was observational and retrospective ...

  1. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

    Full Text Available Sudden cardiac death is one of the most common cause of mortality worldwide. Despite significant advances in the medical science, there is little improvement in the sudden cardiac death related mortality. Coronary artery disease is the most common etiology behind sudden cardiac death, in the above 40 years population. Even in the apparently healthy population, there is a small percentage of patients dying from sudden cardiac death. Given the large denominator, this small percentage contributes to the largest burden of sudden cardiac death. Identification of this at risk group among the apparently healthy individual is a great challenge for the medical fraternity. This article looks into the causes and methods of preventing SCD and at some of the Indian data. Details of Brugada syndrome, Long QT syndrome, Genetics of SCD are discussed. Recent guidelines on many of these causes are summarised.

  2. CARDIAC LYMPHOMA IN DOG

    Directory of Open Access Journals (Sweden)

    G. D. Cruz

    2016-11-01

    Full Text Available Lymphoma is a lymphoid tumor that originates in hematopoietic organs such as lymph node, spleen or liver. In dogs, the overall prevalence of cardiac tumors was estimated to be only 0.19% based on the results of the survey of a large database, and lymphomas accounts for approximately 2% of all cardiac tumors. In general, the involvement of the myocardium is rarely described in canine lymphoma. Currently, there is no evidence of a viral association with primary cardiac lymphoma in dogs, but other types of immunosuppression may contribute to abnormal events, such as involvement primary cardiac. The aim of this study was to analyze a case of sudden death of a bitch, SRD, aged 10, who had the final diagnosis of cardiac lymphoma.

  3. 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...

  4. 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 ...

  5. THE ROLE OF COSMIC-RAY PRESSURE IN ACCELERATING GALACTIC OUTFLOWS

    Energy Technology Data Exchange (ETDEWEB)

    Simpson, Christine M.; Pakmor, Rüdiger; Pfrommer, Christoph; Springel, Volker [Heidelberger Institut für Theoretische Studien, Schloss-Wolfsbrunnenweg 35, D-69118 Heidelberg (Germany); Marinacci, Federico [Kavli Institute for Astrophysics and Space Research, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Glover, Simon C. O. [Zentrum für Astronomie der Universität Heidelberg, ITA, Albert-Ueberle-Str. 2, D-69120 Heidelberg (Germany); Clark, Paul C. [School of Physics and Astronomy, Queen’s Buildings, The Parade, Cardiff University, Cardiff CF24 3AA (United Kingdom); Smith, Rowan J., E-mail: Christine.Simpson@h-its.org [Jodrell Bank Centre for Astrophysics, University of Manchester, Oxford Road, Manchester M13 9PL (United Kingdom)

    2016-08-20

    We study the formation of galactic outflows from supernova (SN) explosions 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 SN placement and energy feedback, including cosmic rays (CRs), 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 from the interstellar medium.

  6. THE ORION FINGERS: NEAR-IR SPECTRAL IMAGING OF AN EXPLOSIVE OUTFLOW

    Energy Technology Data Exchange (ETDEWEB)

    Youngblood, Allison; Bally, John [Department of Astrophysical and Planetary Sciences, University of Colorado, UCB 389, Boulder, CO 80309 (United States); Ginsburg, Adam, E-mail: allison.youngblood@colorado.edu [ESO Headquarters, Karl-Schwarzschild-Strasse 2, D-85748 Garching bei München (Germany)

    2016-06-01

    We present near-IR (1.1–2.4 μ m) position–position–velocity cubes of the 500 year old Orion BN/KL explosive outflow with spatial resolution 1″ and spectral resolution 86 km s{sup −1}. We construct integrated intensity maps free of continuum sources of 15 H{sub 2} and [Fe ii] lines while preserving kinematic information of individual outflow features. Included in the detected H{sub 2} lines are the 1-0 S(1) and 1-0 Q(3) transitions, allowing extinction measurements across the outflow. Additionally, we present dereddened flux ratios for over two dozen outflow features to allow for the characterization of the true excitation conditions of the BN/KL outflow. All of the ratios show the dominance of the shock excitation of the H{sub 2} emission, although some features exhibit signs of fluorescent excitation from stellar radiation or J-type shocks. We also detect tracers of the PDR/ionization front north of the Trapezium stars in [O i] and [Fe ii] and analyze other observed outflows not associated with the BN/KL outflow.

  7. UNRAVELLING THE COMPLEX STRUCTURE OF AGN-DRIVEN OUTFLOWS. II. PHOTOIONIZATION AND ENERGETICS

    Energy Technology Data Exchange (ETDEWEB)

    Karouzos, Marios; Woo, Jong-Hak [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of); Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr [Department of Astronomy and Center for Galaxy EVolution Research, Yonsei University, Seoul 120-749 (Korea, Republic of)

    2016-12-20

    Outflows have been shown to be prevalent in galaxies hosting luminous active galactic nuclei (AGNs); they present a physically plausible way to couple the AGN energy output with the interstellar medium of their hosts. Despite their prevalence, accurate characterization of these outflows has been challenging. In the second of a series of papers, we use Gemini Multi-Object Spectrograph integral field unit (IFU) data of six local ( z  < 0.1) and moderate-luminosity Type 2 AGNs to study the ionization properties and energetics of AGN-driven outflows. We find strong evidence connecting the extreme kinematics of the ionized gas to the AGN photoionization. The kinematic component related to the AGN-driven outflow is clearly separated from other kinematic components, such as virial motions or rotation, on the velocity and velocity dispersion diagram. Our spatially resolved kinematic analysis reveals that 30 to 90% of the total mass and kinetic energy of the outflow is contained within the central kpc of the galaxy. The spatially integrated mass and kinetic energy of the gas entrained in the outflow correlate well with the AGN bolometric luminosity and results in energy conversion efficiencies between 0.01% and 1%. Intriguingly, we detect ubiquitous signs of ongoing circumnuclear star formation. Their small size, the centrally contained mass and energy, and the universally detected circumnuclear star formation cast doubts on the potency of these AGN-driven outflows as agents of galaxy-scale negative feedback.

  8. Multipoint analysis of the spatio-temporal coherence of dayside O+ outflows with Cluster

    Directory of Open Access Journals (Sweden)

    P. Puhl-Quinn

    2004-07-01

    Full Text Available The spatial distribution of ionospheric ion outflow from the dayside cusp/cleft has previously been studied in great detail with numerous satellite missions, but only statistically. Between July and November 2001, the orbit configuration of the Cluster multi-satellite system close to its perigee (4 Earth radii allows for delay times between spacecraft of about 4 and 35min in crossing the cusp/cleft. This enables for the first time to assess the spatial and temporal coherence of O+ ion outflow on time scales of the order of the satellite time lag. After presenting two contrasting events in detail, O+ velocities and outflow intensities from three spacecraft, available on 18 events, all with a similar orbit, have been cross-correlated to quantify the degree of coherence in the outflow. The main result from the analysis is that, although dayside outflows are a permanent feature, steady-state conditions are surprisingly never achieved. In particular, a significant variability is found for convection drift and local outflow intensities on small time scales. This variability of local intensities is not found to depend on the total strenghth of the outflow, which is much more stable and increases with the dynamic solar wind pressure.

  9. AGN feedback in action? - outflows and star formation in type 2 AGNs

    Science.gov (United States)

    Woo, Jong-Hak

    2017-01-01

    We present the statistical constraints on the ionized gas outflows and their connection to star formation, using a large sample of ~110,000 AGNs and star-forming galaxies at z dispersion of star forming galaxies can be entirely accounted by the gravitational potential of host galaxies, AGNs clearly show non-gravitational kinematics, which is comparable to or stronger than the virial motion caused by the gravitational potential. Second, the distribution in the [OIII] velocity - velocity dispersion diagram dramatically expands toward large values with increasing AGN luminosity, implying that the outflows are AGN-driven. Third, the fraction of AGNs with a signature of outflow kinematics, steeply increases with AGN luminosity and Eddington ratio. In particular, the majority of luminous AGNs presents strong non-gravitational kinematics in the [OIII] profile. Interestingly, we find that the specific star formation of non-outflow AGNs is much lower than that of strong outflow AGNs, while the star formation rate of strong outflow AGNs is comparable to that of star forming galaxies. We interpret this trend as a delayed AGN feedback as it takes dynamical time for the outflows to suppress star formation in galactic scales.

  10. MULTIPLE FAST MOLECULAR OUTFLOWS IN THE PRE-PLANETARY NEBULA CRL 618

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chin-Fei; Huang, Po-Sheng [Academia Sinica Institute of Astronomy and Astrophysics, P.O. Box 23-141, Taipei 106, Taiwan (China); Sahai, Raghvendra [Jet Propulsion Laboratory, MS 183-900, California Institute of Technology, Pasadena, CA 91109 (United States); Sánchez Contreras, Carmen [Astrobiology Center (CSIC-INTA), ESAC Campus, E-28691 Villanueva de la Canada, Madrid (Spain); Tay, Jeremy Jian Hao [Department of Physics, National University of Singapore, 2 Science Drive 3, Singapore 117542 (Singapore)

    2013-11-01

    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 extended optical lobes. One possibility to launch these bullets is a magneto-rotational explosion of the stellar envelope.

  11. Transport pathways for Asian pollution outflow over the Pacific: Interannual and seasonal variations

    Science.gov (United States)

    Liu, Hongyu; Jacob, Daniel J.; Bey, Isabelle; Yantosca, Robert M.; Duncan, Bryan N.; Sachse, Glen W.

    2003-10-01

    The meteorological pathways contributing to Asian pollution outflow over the Pacific are examined with a global three-dimensional model analysis of CO observations from the Transport and Chemical Evolution over the Pacific (TRACE-P) aircraft mission (February-April 2001). The model is used also to place the TRACE-P observations in an interannual (1994-2001) and seasonal context. The major process driving Asian pollution outflow in spring is frontal lifting ahead of southeastward-moving cold fronts (the leading edge of cold surges) and transport in the boundary layer behind the cold fronts. Orographic lifting over central and eastern China combines with the cold fronts to promote the transport of Chinese pollution to the free troposphere. Outflow of seasonal biomass burning in Southeast Asia during spring takes place mostly by deep convection but also by northeastward transport and frontal lifting, mixing with the anthropogenic outflow. Boundary layer outflow over the western Pacific is largely devoid of biomass burning influence. European and African (biomass burning) plumes in Asian outflow during TRACE-P were weak (pollution signal. Spring 2001 (La Niña) was characterized by unusually frequent cold surge events in the Asian Pacific rim and strong convection in Southeast Asia, leading to unusually strong boundary layer outflow of anthropogenic emissions and convective outflow of biomass burning emissions in the upper troposphere. The Asian outflow flux of CO to the Pacific is found to vary seasonally by a factor of 3-4 (maximum in March and minimum in summer). The March maximum results from frequent cold surge events and seasonal biomass burning emissions.

  12. A SEARCH FOR 95 GHz CLASS I METHANOL MASERS IN MOLECULAR OUTFLOWS

    Energy Technology Data Exchange (ETDEWEB)

    Gan, Cong-Gui; Chen, Xi; Shen, Zhi-Qiang [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan RD, Shanghai 200030 (China); Xu, Ye; Ju, Bing-Gang, E-mail: cggan@shao.ac.cn [Key Laboratory of Radio Astronomy, Chinese Academy of Sciences (China)

    2013-01-20

    We have observed a sample of 288 molecular outflow sources including 123 high-mass and 165 low-mass sources in order to search for class I methanol masers at the 95 GHz transition and to investigate the relationship between outflow characteristics and class I methanol maser emission with the Purple Mountain Observatory 13.7 m radio telescope. Our survey detected 62 sources with 95 GHz methanol masers above a 3{sigma} detection limit, which includes 47 high-mass sources and 15 low-mass sources. Therefore, the detection rate is 38% for high-mass outflow sources and 9% for low-mass outflow sources, suggesting that class I methanol masers are relatively easily excited in high-mass sources. There are 37 newly detected 95 GHz methanol masers (including 27 high-mass and 10 low-mass sources), 19 of which are newly identified (i.e., first identification) class I methanol masers (including 13 high-mass and 6 low-mass sources). A statistical analysis of the distributions of maser detections with the outflow parameters reveals that the maser detection efficiency increases with the outflow properties (e.g., mass, momentum, kinetic energy, mechanical luminosity of outflows, etc.). Systematic investigations of the relationships between the intrinsic luminosity of methanol masers and the outflow properties (including mass, momentum, kinetic energy, bolometric luminosity, and mass-loss rate of the central stellar sources) indicate a positive correlation. This further supports the theory that class I methanol masers are collisionally pumped and associated with shocks when outflows interact with the surrounding ambient medium.

  13. Fast Molecular Outflows in Luminous Galaxy Mergers: Evidence for Quasar Feedback from Herschel

    Science.gov (United States)

    Veilleux, S.; Melendez, M.; Sturm, E.; Garcia-Carpio, J.; Fischer, J.; Gonzalez-Alfonso, E.; Contursi, A.; Lutz, D.; Poglitsch, A.; Davies, R.; hide

    2013-01-01

    We report the results from a systematic search for molecular (OH 119 micron) outflows with Herschel/PACS in a sample of 43 nearby (z 11.8 +/- 0.3]. The quasars in these systems play a dominant role in driving the molecular outflows. However, the most AGN dominated systems, where OH is seen purely in emission, show relatively modest OH line widths, despite their large AGN luminosities, perhaps indicating that molecular outflows subside once the quasar has cleared a path through the obscuring material.

  14. Modeling the Quiet Time Outflow Solution in the Polar Cap

    Science.gov (United States)

    Glocer, Alex

    2011-01-01

    We use the Polar Wind Outflow Model (PWOM) to study the geomagnetically quiet conditions in the polar cap during solar maximum, The PWOM solves the gyrotropic transport equations for O(+), H(+), and He(+) along several magnetic field lines in the polar region in order to reconstruct the full 3D solution. We directly compare our simulation results to the data based empirical model of Kitamura et al. [2011] of electron density, which is based on 63 months of Akebono satellite observations. The modeled ion and electron temperatures are also compared with a statistical compilation of quiet time data obtained by the EISCAT Svalbard Radar (ESR) and Intercosmos Satellites (Kitamura et al. [2011]). The data and model agree reasonably well. This study shows that photoelectrons play an important role in explaining the differences between sunlit and dark results, ion composition, as well as ion and electron temperatures of the quiet time polar wind solution. Moreover, these results provide validation of the PWOM's ability to model the quiet time ((background" solution.

  15. Estimation of future outflows of e-waste in India

    International Nuclear Information System (INIS)

    Dwivedy, Maheshwar; Mittal, R.K.

    2010-01-01

    The purpose of this study is to construct an approach and a methodology to estimate the future outflows of electronic waste (e-waste) in India. Consequently, the study utilizes a time-series multiple lifespan end-of-life model proposed by Peralta and Fontanos for estimating the current and future quantities of e-waste in India. The model estimates future e-waste generation quantities by modeling their usage and disposal. The present work considers two scenarios for the approximation of e-waste generation based on user preferences to store or to recycle the e-waste. This model will help formal recyclers in India to make strategic decisions in planning for appropriate recycling infrastructure and institutional capacity building. Also an extension of the model proposed by Peralta and Fontanos is developed with the objective of helping decision makers to conduct WEEE estimates under a variety of assumptions to suit their region of study. During 2007-2011, the total WEEE estimates will be around 2.5 million metric tons which include waste from personal computers (PC), television, refrigerators and washing machines. During the said period, the waste from PC will account for 30% of total units of WEEE generated.

  16. AGN Outflow Shocks on Bonnor–Ebert Spheres

    Energy Technology Data Exchange (ETDEWEB)

    Dugan, Zachary; Silk, Joseph; Rahman, Mubdi [The Johns Hopkins University Department of Physics and Astronomy, Bloomberg Center for Physics and Astronomy, Room 366, 3400 N. Charles Street, Baltimore, MD 21218 (United States); Gaibler, Volker [Universität Heidelberg, Zentrum für Astronomie, Institut für Theoretische Astrophysik, Albert-Ueberle-Str. 2, D-69120 Heidelberg (Germany); Bieri, Rebekka [Institut d’Astrophysique de Paris, UMR 7095, CNRS, UPMC Univ. Paris VI, 98 bis Boulevard Arago, F-75014 Paris (France)

    2017-04-20

    Feedback from active galactic nuclei (AGNs) and subsequent jet cocoons and outflow bubbles can have a significant impact on star formation in the host galaxy. To investigate feedback physics on small scales, we perform hydrodynamic simulations of realistically fast AGN winds striking Bonnor–Ebert spheres and examine gravitational collapse and ablation. We test AGN wind velocities ranging from 300 to 3000 km s{sup −1} and wind densities ranging from 0.5 to 10 m {sub p} cm{sup −3}. We include heating and cooling of low- and high-temperature gas, self-gravity, and spatially correlated perturbations in the shock, with a maximum resolution of 0.01 pc. We find that the ram pressure is the most important factor that determines the fate of the cloud. High ram pressure winds increase fragmentation and decrease the star formation rate, but they also cause star formation to occur on a much shorter timescale and with increased velocities of the newly formed stars. We find a threshold ram pressure of ∼2 × 10{sup −8} dyn cm{sup −2} above which stars are not formed because the resulting clumps have internal velocities large enough to prevent collapse. Our results indicate that simultaneous positive and negative feedback will be possible in a single galaxy, as AGN wind parameters will vary with location within a galaxy.

  17. Physical Conditions in Ultra-fast Outflows in AGN

    Science.gov (United States)

    Kraemer, S. B.; Tombesi, F.; Bottorff, M. C.

    2018-01-01

    XMM-Newton and Suzaku spectra of Active Galactic Nuclei (AGN) have revealed highly ionized gas, in the form of absorption lines from H-like and He-like Fe. Some of these absorbers, ultra-fast outflows (UFOs), have radial velocities of up to 0.25c. We have undertaken a detailed photoionization study of high-ionization Fe absorbers, both UFOs and non-UFOs, in a sample of AGN observed by XMM-Newton. We find that the heating and cooling processes in UFOs are Compton-dominated, unlike the non-UFOs. Both types are characterized by force multipliers on the order of unity, which suggest that they cannot be radiatively accelerated in sub-Eddington AGN, unless they were much less ionized at their point of origin. However, such highly ionized gas can be accelerated via a magneto-hydrodynamic (MHD) wind. We explore this possibility by applying a cold MHD flow model to the UFO in the well-studied Seyfert galaxy, NGC 4151. We find that the UFO can be accelerated along magnetic streamlines anchored in the accretion disk. In the process, we have been able to constrain the magnetic field strength and the magnetic pressure in the UFO and have determined that the system is not in magnetic/gravitational equipartition. Open questions include the variability of the UFOs and the apparent lack of non-UFOs in UFO sources.

  18. 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...... 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....

  19. Dual energy cardiac CT.

    Science.gov (United States)

    Carrascosa, Patricia; Deviggiano, Alejandro; Rodriguez-Granillo, Gastón

    2017-06-01

    Conventional single energy CT suffers from technical limitations related to the polychromatic nature of X-rays. Dual energy cardiac CT (DECT) shows promise to attenuate and even overcome some of these limitations, and might broaden the scope of patients eligible for cardiac CT towards the inclusion of higher risk patients. This might be achieved as a result of both safety (contrast reduction) and physiopathological (myocardial perfusion and characterization) issues. In this article, we will review the main clinical cardiac applications of DECT, that can be summarized in two core aspects: coronary artery evaluation, and myocardial evaluation.

  20. Respiratory tract infection during Hajj

    Directory of Open Access Journals (Sweden)

    Alzeer Abdulaziz

    2009-01-01

    Full Text Available Respiratory tract infection during Hajj (pilgrimage to Mecca is a common illness, and it is responsible for most of the hospital admissions. Influenza virus is the leading cause of upper respiratory tract infection during Hajj, and pneumonia can be serious. Taking into account the close contacts among the pilgrims, as well as the crowding, the potential for transmission of M. tuberculosis is expected to be high. These pilgrims can be a source for spreading infection on their return home. Although vaccination program for influenza is implemented, its efficacy is uncertain in this religious season. Future studies should concentrate on prevention and mitigation of these infections.

  1. Application of cine cardiac MR imaging in normal subjects and patients with valvular, coronary artery, and aortic disease

    International Nuclear Information System (INIS)

    Maddahi, J.; Ostrzega, E.; Crues, J.; Honma, H.; Siegel, R.; Charuzi, Y.; Berman, D.

    1987-01-01

    Cine MR imaging was performed on 15 normal subjects and 27 patients with cardiac disease. In normal subjects, high signal intensity of flowing blood contrasted with that of the myocardium. In 16 patients with valvular regurgitation, signal void jet due to turbulence was visualized across the diseased valves. In three IHSS patients, thickened LV myocardium, mitral regurgitant jets, and systolic LV outflow jets were noted. Five patients with myocardial infarction (MI) showed thinning and/or hypokinesis of MI regions. In three patients with Marfan syndrome, aortic dilatation, insufficiency, and flap (one pt) were identified. Cine MR imaging is potentially useful for evaluation of a variety of cardiac diseases

  2. Low-energy ion outflow modulated by the solar wind energy input

    Science.gov (United States)

    Li, Kun; Wei, Yong; Andre, Mats; Eriksson, Anders; Haaland, Stein; Kronberg, Elena; Nilsson, Hans; Maes, Lukas

    2017-04-01

    Due to the spacecraft charging issue, it has been difficult to measure low-energy ions of ionospheric origin in the magnetosphere. A recent study taking advantage of the spacecraft electric potential has found that the previously 'hidden' low-energy ions is dominant in the magnetosphere. This comprehensive dataset of low-energy ions allows us to study the relationship between the ionospheric outflow and energy input from the solar wind (ɛ). In this study, we discuss the ratios of the solar wind energy input to the energy of the ionospheric outflow. We show that the ɛ controls the ionospheric outflow when the ɛ is high, while the ionospheric outflow does not systematically change with the ɛ when the ɛ is low.

  3. A 3D view of the outflow in the Orion Molecular Cloud 1 (OMC-1)

    DEFF Research Database (Denmark)

    Nissen, H.D.; Cunningham, N.J.; Sherson, Maiken Gustafsson

    2012-01-01

    and proper motion data for near-IR emission of molecular hydrogen to obtain the first 3-dimensional (3D) structure of the OMC-1 outflow. Our work illustrates a new diagnostic tool for studies of star formation that will be exploited in the near future with the advent of high spatial resolution spectro...... Observatory, the Anglo-Australian Observatory and the Subaru Telescope. These data give the 3D velocity of ejecta yielding a 3D reconstruction of the outflows. This allows one to view the material from different vantage points in space giving considerable insight into the geometry. Our analysis indicates......The fast outflow emerging from a region associated with massive star formation in the Orion Molecular Cloud 1 (OMC-1), located behind the Orion Nebula, appears to have been set in motion by an explosive event. Here we study the structure and dynamics of outflows in OMC-1. We combine radial velocity...

  4. Cardiac Catheterization (For Parents)

    Science.gov (United States)

    ... cases, the doctor might call for a cardiac magnetic resonance imaging (MRI) scan or a CAT scan . ... first couple of days. This means no heavy lifting (more than 10 pounds) and no sports. After ...

  5. Cardiac Catheterization (For Teens)

    Science.gov (United States)

    ... doctor may also call for a cardiac MRI (magnetic resonance imaging) scan or a CT (computerized tomography) ... first couple of days. This means no heavy lifting (nothing over 10 pounds) and no sports. After ...

  6. ON THE ORIGIN OF THE MOLECULAR OUTFLOWS IN IRAS 16293–2422

    Energy Technology Data Exchange (ETDEWEB)

    Girart, Josep M.; Palau, Aina; Torrelles, José M. [Institut de Ciències de l' Espai, (CSIC-IEEC), Campus UAB, Facultat de Ciències, C5p 2, E-08193 Bellaterra, Catalonia (Spain); Estalella, Robert [Departament d' Astronomia i Meteorologia, Institut de Ciències del Cosmos (UB-IEEC), Martí i Franquès, Universitat de Barcelona, E-08028 Barcelona, Catalonia (Spain); Rao, Ramprasad, E-mail: girart@ice.cat [Institute of Astronomy and Astrophysics, Academia Sinica, 645 N. Aohoku Pl., Hilo, HI 96720 (United States)

    2014-01-01

    We present CO 3-2, SiO 8-7, C{sup 34}S 7-6, and 878 μm dust continuum subarcsecond angular resolution observations with the Submillimeter Array (SMA) toward the IRAS 16293–2422 (I16293) multiple low-mass protostellar system. The C{sup 34}S emission traces the 878 μm dust continuum well, and in addition clearly shows a smooth velocity gradient along the major axis of component I16293A. CO shows emission at moderate high velocities arising from two bipolar outflows, which appear to be perpendicular with respect to each other. The high sensitivity and higher angular resolution of these observations allows us to pinpoint well the origin of these two outflows at the center of component I16293A. Interestingly, the most compact outflow appears to point toward I16293B. Our data show that the previously reported monopolar blueshifted CO outflow associated with component I16293B seems to be part of the compact outflow arising from component I16293A. In addition, the SiO emission is also tracing this compact outflow: on the one hand, the SiO emission appears to have a jet-like morphology along the southern redshifted lobe; on the other hand, the SiO emission associated with the blueshifted northern lobe traces a well-defined arc on the border of component I16293B facing I16293A. The blueshifted CO lobe of the compact outflow splits into two lobes around the position of this SiO arc. All these results lead us to propose that the compact outflow from component I16293A is impacting on the circumstellar gas around component I16293B, possibly being diverged as a consequence of the interaction.

  7. FEATURES OF OUTFLOW OF INTRAOCULAR LIQUID AFTER AN EKSIMERLAZER SKLEREKTOMY (PILOT STUDY)

    OpenAIRE

    E. A. Korchuganova; O. A. Rumyantseva; S. B. Gudkova

    2017-01-01

    Modern approaches to surgical glaucoma treatment is based on the safe and effective methods. In recent years, great attention is paid to the techniques of stimulating uveoscleral path outtake aqueous humor from the eye. Uveoscleral space in the extended outflow pathways is dominant and constitutes about 72%. Sclera is a field of the greatest interest, as the end stages of the outflow of aqueous humor via the uveoscleral path. The aim of the study was to investigate the influence of excimer la...

  8. Dissecting the Butterfly: Dual Outflows in the Dual AGN NGC 6240

    Science.gov (United States)

    Mueller Sanchez, Francisco; Comerford, Julie; Nevin, Rebecca; Davies, Richard; Treister, Ezequiel; Privon, George

    2018-01-01

    Current theories of galaxy evolution invoke some kind of feedback (from the stars or the supermassive black hole) to explain the properties of galaxies. However, numerical simulations and observations have not been able to evaluate the real impact of feedback in galaxies. This is largely because most studies have focused on studying stellar feedback or AGN feedback alone, instead of considering the combined effect of both. In fact, this is an unexplored territory for observations due to the difficulty of separating the contribution from the two sources.In this contribution I present the discovery of a dual outflow of different species of gas in the prototypical merging galaxy NGC 6240 using HST imaging, long-slit and integral-eld spectroscopy: an AGN-driven outflow of highly-ionized gas to the northeast and a starburst-driven outflow of ionized hydrogen to the northwest. The AGN outflow extends up to 4 kpc along a position angle of 56 degrees, has a conical shape with an opening angle of 52 degrees and a maximum line-of-sight velocity of 350 km/s. The WFC3 images also reveal a bubble of Halpha emission in the northwest, which has no counterpart in [O III], consistent with a scenario in which the starburst is ionizing and driving outflowing winds which inflate the bubble at an expansion velocity of 380 km/s. Assuming a spherical geometry for the starburst-driven bubble and a conical geometry for the AGN-driven outflow, we estimate mass outflow rates of 26 Msun/yr and 62 Msun/yr, respectively. We conclude that the AGN contribution to the evolution of the merger remnant and the formation of outflowing winds is signicant in the central 5 kpc of NGC 6240.

  9. THE SINS/zC-SINF SURVEY of z {approx} 2 GALAXY KINEMATICS: OUTFLOW PROPERTIES

    Energy Technology Data Exchange (ETDEWEB)

    Newman, Sarah F.; Genzel, Reinhard [Department of Astronomy, Campbell Hall, University of California, Berkeley, CA 94720 (United States); Foerster-Schreiber, Natascha M.; Buschkamp, Peter; Davies, Ric; Eisenhauer, Frank; Kurk, Jaron; Lutz, Dieter [Max-Planck-Institut fuer extraterrestrische Physik (MPE), Giessenbachstr.1, D-85748 Garching (Germany); Griffin, Kristen Shapiro [Space Sciences Research Group, Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 (United States); Mancini, Chiara; Renzini, Alvio [Osservatorio Astronomico di Padova, Vicolo dellOsservatorio 5, Padova, I-35122 (Italy); Lilly, Simon J.; Carollo, C. Marcella; Peng, Yingjie [Institute of Astronomy, Department of Physics, Eidgenoessische Technische Hochschule, ETH Zuerich, CH-8093 (Switzerland); Bouche, Nicolas [Institut de Recherche en Astrophysique et Planetologie (IRAP), Universite de Toulouse, UPS-OMP, IRAP, 14, avenue Edouard Berlin, F-31400 Toulouse (France); Burkert, Andreas [Department fuer Physik, Universitaets-Sternwarte Ludwig-Maximilians-Universitaet (USM), Scheinerstr. 1, Muenchen, D-81679 (Germany); Cresci, Giovanni [Istituto Nazionale di AstrofisicaOsservatorio Astronomico di Arcetri, Largo Enrico Fermi 5, I-50125 Firenze (Italy); Genel, Shy [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Hicks, Erin K. S. [Department of Astronomy, University of Washington, Box 351580, U.W., Seattle, WA 98195-1580 (United States); Naab, Thorsten, E-mail: sfnewman@berkeley.edu [Max-Planck Institute for Astrophysics, Karl Schwarzschildstrasse 1, D-85748 Garching (Germany); and others

    2012-12-10

    Using SINFONI H{alpha}, [N II], and [S II] AO data of 27 z {approx} 2 star-forming galaxies (SFGs) from the SINS and zC-SINF surveys, we explore the dependence of outflow strength (via the broad flux fraction) on various galaxy parameters. For galaxies that have evidence for strong outflows, we find that the broad emission is spatially extended to at least the half-light radius ({approx}a few kpc). Decomposition of the [S II] doublet into broad and narrow components suggests that this outflowing gas probably has a density of {approx}10-100 cm{sup -3}, less than that of the star-forming gas (600 cm{sup -3}). There is a strong correlation of the H{alpha} broad flux fraction with the star formation surface density of the galaxy, with an apparent threshold for strong outflows occurring at 1 M{sub Sun} yr{sup -1} kpc{sup -2}. Above this threshold, we find that SFGs with log m{sub *} > 10 have similar or perhaps greater wind mass-loading factors ({eta} = M-dot{sub out}/SFR) and faster outflow velocities than lower mass SFGs, suggesting that the majority of outflowing gas at z {approx} 2 may derive from high-mass SFGs. The mass-loading factor is also correlated with the star formation rate (SFR), galaxy size, and inclination, such that smaller, more star-forming, and face-on galaxies launch more powerful outflows. We propose that the observed threshold for strong outflows and the observed mass loading of these winds can be explained by a simple model wherein break-out of winds is governed by pressure balance in the disk.

  10. Autonomic cardiac innervation

    Science.gov (United States)

    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 targets, upon which target-derived trophic factors take over final maturation, synaptic strength and postnatal survival. Although target-derived neurotrophins have a central role to play in development, alternative sources of neurotrophins may also modulate innervation. Both developing and adult sympathetic neurons express proNGF, and adult parasympathetic cardiac ganglion neurons also synthesize and release NGF. The physiological function of these “non-classical” cardiac sources of neurotrophins remains to be determined, especially in relation to autocrine/paracrine sustenance during development.   Cardiac autonomic nerves are closely spatially associated in cardiac plexuses, ganglia and pacemaker regions and so are sensitive to release of neurotransmitter, neuropeptides and trophic factors from adjacent nerves. As such, in many cardiac pathologies, it is an imbalance within the two arms of the autonomic system that is critical for disease progression. Although this crosstalk between sympathetic and parasympathetic nerves has been well established for adult nerves, it is unclear whether a degree of paracrine regulation occurs across the autonomic limbs during development. Aberrant nerve remodeling is a common occurrence in many adult cardiovascular pathologies, and the mechanisms regulating outgrowth or denervation are disparate. However, autonomic neurons display considerable plasticity in this regard with neurotrophins and inflammatory cytokines having a central regulatory

  11. Cardiac imaging in adults

    International Nuclear Information System (INIS)

    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

  12. 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.

  13. Cardiac biomarkers in Neonatology

    OpenAIRE

    Vijlbrief, D.C.

    2015-01-01

    In this thesis, the role for cardiac biomarkers in neonatology was investigated. Several clinically relevant results were reported. In term and preterm infants, hypoxia and subsequent adaptation play an important role in cardiac biomarker elevation. The elevated natriuretic peptides are indicative of abnormal function; elevated troponins are suggestive for cardiomyocyte damage. This methodology makes these biomarkers of additional value in the treatment of newborn infants, separate or as a co...

  14. 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....

  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. MASS OUTFLOW IN THE SEYFERT 1 GALAXY NGC 5548

    International Nuclear Information System (INIS)

    Crenshaw, D. M.; Kraemer, S. B.; Schmitt, H. R.; Kaastra, J. S.; Arav, N.; Gabel, J. R.; Korista, K. T.

    2009-01-01

    We present a study of the intrinsic UV absorption and emission lines in an historically low-state spectrum of the Seyfert 1 galaxy NGC 5548, which we obtained in 2004 February at high spatial and spectral resolution with the Space Telescope Imaging Spectrograph on the Hubble Space Telescope. We isolate a component of emission with a width of 680 km s -1 that arises from an 'intermediate-line region' (ILR), similar to that we discovered in NGC 4151, at a distance of ∼1 pc from the central continuum source. From a detailed analysis of the five intrinsic absorption components in NGC 5548 and their behavior over a span of eight years, we present evidence that most of the UV absorbers only partially cover the ILR and do not cover an extended region of UV continuum emission, most likely from hot stars in the circumnuclear region. We also find that four of the UV absorbers are at much greater distances (greater than 70 pc) than the ILR, and none have sufficient N V or C IV column densities to be the ILR in absorption. At least a portion of the UV absorption component 3, at a radial velocity of -530 km s -1 , is likely responsible for most of the X-ray absorption, at a distance less than 7 pc from the central source. The fact that we see the ILR in absorption in NGC 4151 and not in NGC 5548 suggests that the ILR is located at a relatively large polar angle (∼45 deg.) with respect to the narrow-line region outflow axis.

  17. Monte Carlo Simulations of Photospheric Emission in Relativistic Outflows

    Science.gov (United States)

    Bhattacharya, Mukul; Lu, Wenbin; Kumar, Pawan; Santana, Rodolfo

    2018-01-01

    We study the spectra of photospheric emission from highly relativistic gamma-ray burst outflows using a Monte Carlo code. We consider the Comptonization of photons with a fast-cooled synchrotron spectrum in a relativistic jet with a realistic photon-to-electron number ratio {N}γ /{N}{{e}}={10}5, using mono-energetic protons that interact with thermalized electrons through Coulomb interaction. The photons, electrons, and protons are cooled adiabatically as the jet expands outward. We find that the initial energy distributions of the protons and electrons do not have any appreciable effect on the photon peak energy {E}γ ,{peak} and the power-law spectrum above {E}γ ,{peak}. The Coulomb interaction between the electrons and the protons does not affect the output photon spectrum significantly as the energy of the electrons is elevated only marginally. {E}γ ,{peak} and the spectral indices for the low- and high-energy power-law tails of the photon spectrum remain practically unchanged even with electron-proton coupling. Increasing the initial optical depth {τ }{in} results in a slightly shallower photon spectrum below {E}γ ,{peak} and fewer photons at the high-energy tail, although {f}ν \\propto {ν }-0.5 above {E}γ ,{peak} and up to ∼1 MeV, independent of {τ }{in}. We find that {E}γ ,{peak} determines the peak energy and the shape of the output photon spectrum. Finally, we find that our simulation results are quite sensitive to {N}γ /{N}{{e}}, for {N}{{e}}=3× {10}3. For almost all our simulations, we obtain an output photon spectrum with a power-law tail above {E}γ ,{peak} extending up to ∼1 MeV.

  18. Regulation of Breathing and Autonomic Outflows by Chemoreceptors

    Science.gov (United States)

    Guyenet, Patrice G.

    2016-01-01

    Lung ventilation fluctuates widely with behavior but arterial PCO2 remains stable. Under normal conditions, the chemoreflexes contribute to PaCO2 stability by producing small corrective cardiorespiratory adjustments mediated by lower brainstem circuits. Carotid body (CB) information reaches the respiratory pattern generator (RPG) via nucleus solitarius (NTS) glutamatergic neurons which also target rostral ventrolateral medulla (RVLM) presympathetic neurons thereby raising sympathetic nerve activity (SNA). Chemoreceptors also regulate presympathetic neurons and cardiovagal preganglionic neurons indirectly via inputs from the RPG. Secondary effects of chemoreceptors on the autonomic outflows result from changes in lung stretch afferent and baroreceptor activity. Central respiratory chemosensitivity is caused by direct effects of acid on neurons and indirect effects of CO2 via astrocytes. Central respiratory chemoreceptors are not definitively identified but the retrotrapezoid nucleus (RTN) is a particularly strong candidate. The absence of RTN likely causes severe central apneas in congenital central hypoventilation syndrome. Like other stressors, intense chemosensory stimuli produce arousal and activate circuits that are wake- or attention-promoting. Such pathways (e.g., locus coeruleus, raphe, and orexin system) modulate the chemoreflexes in a state-dependent manner and their activation by strong chemosensory stimuli intensifies these reflexes. In essential hypertension, obstructive sleep apnea and congestive heart failure, chronically elevated CB afferent activity contributes to raising SNA but breathing is unchanged or becomes periodic (severe CHF). Extreme CNS hypoxia produces a stereotyped cardiorespiratory response (gasping, increased SNA). The effects of these various pathologies on brainstem cardiorespiratory networks are discussed, special consideration being given to the interactions between central and peripheral chemoreflexes. PMID:25428853

  19. Saturated Pool Boiling in Vertical Annulus with Reduced Outflow Area

    International Nuclear Information System (INIS)

    Kang, Myeong Gie

    2012-01-01

    The mechanisms of pool boiling heat transfer have been studied extensively to design efficient heat transfer devices or to assure the integrity of safety related systems. However, knowledge on pool boiling heat transfer in a confined space is still quite limited. The confined nucleate boiling is an effective technique to enhance heat transfer. Improved heat transfer might be attributed to an increase in the heat transfer coefficient due to vaporization from the thin liquid film on the heating surface or increased bubble activity. According to Cornwell and Houston, the bubbles sliding on the heated surface agitate environmental liquid. In a confined space a kind of pulsating flow due to the bubbles is created and, as a result very active liquid agitation is generated. The increase in the intensity of liquid agitation results in heat transfer enhancement. Sometimes a deterioration of heat transfer appears at high heat fluxes for confined boiling. The cause of the deterioration is suggested as active bubble coalescence. Recently, Kang published inflow effects on pool boiling heat transfer in a vertical annulus with closed bottoms. Kang regulated the gap size at the upper regions of the annulus and identified that effects of the reduced gaps on heat transfer become evident as the heat flux increases. This kind of geometry is found in an in-pile test section. Since more detailed analysis is necessary, effects of the outflow area on nucleate pool boiling heat transfer are investigated in this study. Up to the author's knowledge, no previous results concerning to this effect have been published yet

  20. Martian outflow channels: How did their source aquifers form, and why did they drain so rapidly?

    Science.gov (United States)

    Rodriguez, J Alexis P; Kargel, Jeffrey S; Baker, Victor R; Gulick, Virginia C; Berman, Daniel C; Fairén, Alberto G; Linares, Rogelio; Zarroca, Mario; Yan, Jianguo; Miyamoto, Hideaki; Glines, Natalie

    2015-09-08

    Catastrophic floods generated ~3.2 Ga by rapid groundwater evacuation scoured the Solar System's most voluminous channels, the southern circum-Chryse outflow channels. Based on Viking Orbiter data analysis, it was hypothesized that these outflows emanated from a global Hesperian cryosphere-confined aquifer that was infused by south polar meltwater infiltration into the planet's upper crust. In this model, the outflow channels formed along zones of superlithostatic pressure generated by pronounced elevation differences around the Highland-Lowland Dichotomy Boundary. However, the restricted geographic location of the channels indicates that these conditions were not uniform. Furthermore, some outflow channel sources are too high to have been fed by south polar basal melting. Using more recent mission data, we argue that during the Late Noachian fluvial and glacial sediments were deposited into a clastic wedge within a paleo-basin located in the southern circum-Chryse region, which at the time was completely submerged under a primordial northern plains ocean [corrected]. Subsequent Late Hesperian outflow channels were sourced from within these geologic materials and formed by gigantic groundwater outbursts driven by an elevated hydraulic head from the Valles Marineris region. Thus, our findings link the formation of the southern circum-Chryse outflow channels to ancient marine, glacial, and fluvial erosion and sedimentation.

  1. Multiple monopolar outflows driven by massive protostars in IRAS 18162-2048

    Energy Technology Data Exchange (ETDEWEB)

    Fernández-López, M. [Department of Astronomy, University of Illinois at Urbana-Champaign, 1002 West Green Street, Urbana, IL 61801 (United States); Girart, J. M. [Institut de Ciencies de l' Espai (CSIC-IEEC), Campus UAB, Facultat de Ciencies, Torre C5-parell 2, E-08193 Bellaterra, Catalunya (Spain); Curiel, S.; Fonfría, J. P. [Instituto de Astronomía, Universidad Nacional Autónoma de México (UNAM), Apartado Postal 70-264, 04510 México, DF (Mexico); Zapata, L. A. [Centro de Radioastronomía y Astrofísica, UNAM, Apartado Postal 3-72, Morelia, Michoacán 58089 (Mexico); Qiu, K., E-mail: manferna@illinois.edu, E-mail: girart@ieec.cat [School of Astronomy and Space Science, Nanjing University, Nanjing 210093 (China)

    2013-11-20

    In this article, we present Combined Array for Research in Millimeter-wave Astronomy (CARMA) 3.5 mm observations and SubMillimeter Array (SMA) 870 μm observations toward the high-mass star-forming region IRAS 18162-2048, which is the core of the HH 80/81/80N system. Molecular emission from HCN, HCO{sup +}, and SiO traces two molecular outflows (the so-called northeast and northwest outflows). These outflows have their origin in a region close to the position of MM2, a millimeter source known to harbor two protostars. For the first time we estimate the physical characteristics of these molecular outflows, which are similar to those of 10{sup 3}-5 × 10{sup 3} L {sub ☉} protostars, and suggest that MM2 harbors high-mass protostars. High-angular resolution CO observations show an additional outflow due southeast. Also for the first time, we identify its driving source, MM2(E), and see evidence of precession. All three outflows have a monopolar appearance, but we link the NW and SE lobes, and explain their asymmetric shape as being a consequence of possible deflection.

  2. GASTROINTESTINAL TRACT OF CLARIAS GARIEPINUS ...

    African Journals Online (AJOL)

    DR. AMINU

    one hundred and ninety nine (199) were infested fish samples from gills and gastrointestinal tract .... Body cavity of fish were dissected using a pair of scissors and different portion of the gut (Oesophagus, stomach, intestine and rectum) were isolated and kept in .... Arme, C. and Wakey, M. (1970): The physiology of fishes.

  3. Urinary tract infections in pregnancy.

    Science.gov (United States)

    Ovalle, A; Levancini, M

    2001-01-01

    Urinary tract infections are very common during pregnancy. Escherichia coli is the most common pathogen isolated from pregnant women. Ampicillin should not be used because of its high resistance to Escherichia coli. Pyelonephritis can cause morbidity and can be life-threatening to both mother and fetus. Second and third-generation cephalosporins are recommended for treatment, administered initially intravenously during hospitalization. Cultures and the study of virulence factors of uropathogenic Escherichia coli are recommended for the adequate management of pyelonephritis. The lower genital tract infection associated with pyelonephritis is responsible for the failure of antibiotic treatment. Asymptomatic bacteriuria can evolve into cystitis or pyelonephritis. All pregnant women should be routinely screened for bacteriuria using urine culture, and should be treated with nitrofurantoin, sulfixosazole or first-generation cephalosporins. Recurrent urinary infection should be treated with prophylactic antibiotics. Pregnant women who develop urinary tract infections with group B streptococcal infection should be treated with prophylactic antibiotics during labour to prevent neonatal sepsis. Preterm delivery is frequent. Evidence suggests that infection plays a role in the pathogenesis of preterm labour. Experimental models in pregnant mice support the theory that Escherichia coli propagated by the transplacental route, involving bacterial adhesins, induces preterm delivery, but this has not been demonstrated in humans. Ascending lower genital tract infections are the most probable cause of preterm delivery, but this remains to be proved.

  4. Urinary tract infections in women

    African Journals Online (AJOL)

    Urinary tract infections (UTIs) are common bacterial infections in women, with ... Acute cystitis refers to symptomatic infection of the bladder in the lower ... lungs in a patient with pneumonia.4. Risk factors ... use of antimicrobial agents for community-acquired UTIs has resulted in the emergence of antimicrobial resistance.

  5. Urinary Tract Infections (For Kids)

    Medline Plus

    Full Text Available ... Answers (Q&A) Staying Safe Videos for Educators Search English Español Urinary Tract Infections (UTIs) KidsHealth / For ... Nondiscrimination Visit the Nemours Web site. Note: All information on KidsHealth® is for educational purposes only. For ...

  6. Imaging of the Urinary Tract

    Science.gov (United States)

    ... day urinary urgency—the inability to delay urination urinary incontinence—the accidental loss of urine blockage of urine ... can use several different imaging techniques depending on factors such as the ... urinary tract symptoms. Conventional Radiology X-ray machines have ...

  7. Gas in the urinary tract

    International Nuclear Information System (INIS)

    Trueba, F.J.; Peka, J. de la; Perez, S.; Rodriguez, M.; Sahagun, E.

    1996-01-01

    The causes of gas in the urinary tract and the radiologic procedures employed to detect it are reviewed. The value of each in determining the diagnosis and extension of the pathological process is discussed. The characteristic images of this disorder as represented by the different techniques, are presented. (Author) 18 refs,

  8. Treatment ofurinary tract infection inchildren

    Directory of Open Access Journals (Sweden)

    Danuta Zwolińska

    2016-09-01

    Full Text Available Urinary tract infection is the most frequent bacterial infection in children. Its prevalence in the population younger than 14 years of age has been estimated at 5–10%. Its high recurrence, especially in patients with risk factors, poses a significant problem. The risk factors most common in the group of children ≤3 years are congenital defects blocking the flow of urine to the bladder, whereas in older children they most typically include a tendency for constipation and dysfunction of the lower urinary tract. The clinical picture is variable and depends on the child’s age, immunity status, pathogen virulence and localisation of infection. The mildest form of urinary tract infection is asymptomatic bacteriuria, whereas more severe presentations include acute pyelonephritis, acute focal bacterial nephritis and urosepsis. Prognosis is usually good, but under certain circumstances hypertension, proteinuria and chronic kidney disease may develop. Therefore, early introduced appropriate treatment is essential. According to the Polish Society for Paediatric Nephrology guidelines, asymptomatic bacteriuria does not warrant treatment, whereas febrile patients (>38°C under 24 months old with a suspicion for urinary tract infection must be promptly administered antibiotic therapy, after a urine specimen has been obtained for culture. For many years, urinary tract infection has remained a topic of controversy in terms of therapy duration and administration route. Inpatient treatment of children under 3 months of age is an accepted rule. Acute pyelonephritis necessitates a longer therapy, lasting from 7 to 10 days, whereas the duration of treatment of lower urinary tract infection has been cut down to 3 up to 5 days. Routine prophylactic antimicrobial therapy is not recommended following the initial urinary tract infection episode, yet should be considered in special circumstances. Alternative

  9. Direct Cardiac Reprogramming: Advances in Cardiac Regeneration

    Directory of Open Access Journals (Sweden)

    Olivia Chen

    2015-01-01

    Full Text Available Heart disease is one of the lead causes of death worldwide. Many forms of heart disease, including myocardial infarction and pressure-loading cardiomyopathies, result in irreversible cardiomyocyte death. Activated fibroblasts respond to cardiac injury by forming scar tissue, but ultimately this response fails to restore cardiac function. Unfortunately, the human heart has little regenerative ability and long-term outcomes following acute coronary events often include chronic and end-stage heart failure. Building upon years of research aimed at restoring functional cardiomyocytes, recent advances have been made in the direct reprogramming of fibroblasts toward a cardiomyocyte cell fate both in vitro and in vivo. Several experiments show functional improvements in mouse models of myocardial infarction following in situ generation of cardiomyocyte-like cells from endogenous fibroblasts. Though many of these studies are in an early stage, this nascent technology holds promise for future applications in regenerative medicine. In this review, we discuss the history, progress, methods, challenges, and future directions of direct cardiac reprogramming.

  10. Dosimetry of the respiratory tract

    International Nuclear Information System (INIS)

    Roy, M.

    1996-01-01

    A new dosimetric model of the human respiratory tract has been recently recommended by the International Commission on Radiological Protection, in ICRP Publication 66. This model was intended to update the previous lung model of the Task Group on Lung Dynamics that was adopted by ICRP in Publication 30. With this aim, extensive reviews of the available knowledge were made for anatomy and physiology of the respiratory tract and for deposition, clearance and biological effects of inhaled radionuclides. Finally, expanded dosimetry requirements resulted in a widely different approach from the former model. The main features of the new model are the followings: instead of calculating the average dose to the total mass of blood filled lung, the model takes account of differences in radiosensitivity of the venous respiratory tract tissues. It applies not only to adult workers but also to all members of the population, and provides reference values for children aged 3 months, 1, 5, 10, and 15 years, and adults. Deposition modelling of airborne gases and aerosols associates age dependent breathing rates, airway dimensions and physical activity, to particle size, density and chemical form of inhaled material. Clearance results of competition between mechanical transport clearance and absorption to blood. At each step of the calculation, adjustment guidance is provided to account for use of exact values of particle sizes and specific dissolution rates of inhaled material in order to calculate their own parameter of retention in the airways, and to assess accurately doses to the respiratory tract. Possible influence of smoking, of respiratory tract diseases and of eventual exposure to airborne toxicants is also addressed. (author)

  11. CORTICOTROPIN-RELEASING HORMONE MICROINFUSION IN THE CENTRAL AMYGDALA DIMINISHES A CARDIAC PARASYMPATHETIC OUTFLOW UNDER STRESS-FREE CONDITIONS

    NARCIS (Netherlands)

    WIERSMA, A; BOHUS, B; KOOLHAAS, JM

    1993-01-01

    The central nucleus of the amygdala (CeA) is known to be involved in the regulation of autonomic, neuroendocrine and behavioural responses in stress situations. The CeA contains large numbers of corticotropin-releasing hormone (CRH) cell bodies. Neuroanatomical studies revealed that the majority of

  12. Intrahepatic biliary tract adenocarcinoma. Review of literature

    International Nuclear Information System (INIS)

    Encalada, Edmundo; Engracia, Ruth; Calle, Carlos; Rivera, Tania; Marengo, Carlos

    2002-01-01

    A seven years old patient, with a biliary tract tumoration, diagnosed by computerized tomography and eco, which had practice an exploratory laparotomy, finding an intrahepatic tumor at the left hepatic tract level, with a pathological diagnosis of papillary adenocarcinoma moderately differentiated the biliary tract. The surgery is the main treatment, auxiliary treatments with chemotherapy and radiotherapy. (The author)

  13. Kidneys and Urinary Tract (For Parents)

    Science.gov (United States)

    ... Videos for Educators Search English Español Kidneys and Urinary Tract KidsHealth / For Parents / Kidneys and Urinary Tract What's ... Los riñones y las vías urinarias Kidneys and Urinary Tract Basics Our bodies produce several kinds of wastes, ...

  14. The dependence of galactic outflows on the properties and orientation of zCOSMOS galaxies at z ∼ 1

    International Nuclear Information System (INIS)

    Bordoloi, R.; Lilly, S. J.; Hardmeier, E.; Carollo, C. M.; Contini, T.; Kneib, J.-P.; Fevre, O. Le; Garilli, B.; Mainieri, V.; Renzini, A.; Scodeggio, M.; Zamorani, G.; Bardelli, S.; Bolzonella, M.; Bongiorno, A.; Caputi, K.; Cucciati, O.; De la Torre, S.; De Ravel, L.; Iovino, A.

    2014-01-01

    We present an analysis of cool outflowing gas around galaxies, traced by Mg II absorption lines in the coadded spectra of a sample of 486 zCOSMOS galaxies at 1 ≤ z ≤ 1.5. These galaxies span a range of stellar masses (9.45 ≤ log 10 [M * /M ☉ ] ≤ 10.7) and star formation rates (0.14 ≤ log 10 [SFR/M ☉ yr –1 ] ≤ 2.35). We identify the cool outflowing component in the Mg II absorption and find that the equivalent width of the outflowing component increases with stellar mass. The outflow equivalent width also increases steadily with the increasing star formation rate of the galaxies. At similar stellar masses, the blue galaxies exhibit a significantly higher outflow equivalent width as compared to red galaxies. The outflow equivalent width shows strong correlation with the star formation surface density (Σ SFR ) of the sample. For the disk galaxies, the outflow equivalent width is higher for the face-on systems as compared to the edge-on ones, indicating that for the disk galaxies, the outflowing gas is primarily bipolar in geometry. Galaxies typically exhibit outflow velocities ranging from –150 km s –1 ∼–200 km s –1 and, on average, the face-on galaxies exhibit higher outflow velocity as compared to the edge-on ones. Galaxies with irregular morphologies exhibit outflow equivalent width as well as outflow velocities comparable to face on disk galaxies. These galaxies exhibit mass outflow rates >5-7 M ☉ yr –1 and a mass loading factor (η = M-dot out /SFR) comparable to the star formation rates of the galaxies.

  15. Outflow occlusion for circulatory arrest in dogs "Outfow occlusion" para parada circulatória em cães

    Directory of Open Access Journals (Sweden)

    James N.B.M. de Andrade

    2009-02-01

    Full Text Available The purpose of this study was to evaluate the possibility of producing circulatory arrest by occlusion of the pulmonary trunk as an alternative to the venous inflow occlusion through the left hemithorax. Eight healthy mongrel dogs were divided in two groups. Group I underwent 4 minutes of outflow occlusion and Group II was submitted to 8 minutes of circulatory arrest. Outflow occlusion was performed through left thoracotomy and pericardiotomy by passing a Rumel tourniquet around the pulmonary trunk. Physical examination, electrocardiography, echocardiography, blood gas analyses, hemodynamic, and oxygen transport variables were obtained before and after the procedure. The dogs from Group I did not have any clinical, electrocardiographic, echocardiographic, or hemo-dynamic abnormalities after anesthetic recover. In the Group II, only one dog survived, which had no clinical, electrocardiographic, or echocardiographic abnormalities. In this last dog, just after releasing the occlusion, it was detected increases in the following parameters: heart rate (HR, systolic, diastolic and mean arterial blood pressure (SAP; DAP; MAP, pulmonary artery pressure (PAP, pulmonary wedge pressure (PWP, central venous pressure (CVP, cardiac output (CO, systolic index (SI, cardiac index (CI, left and right ventricular stroke work (LVSW; RVSW, oxygen delivery index (DO2, oxygen consumption index (VO2, and oxygen extraction (O2 ext. Moreover, the oxygen content of arterial and mixed venous blood (CaO2; CvO2, and the arterial and mixed venous partial pressure of oxygen (PaO2; PvO2 were decreased 5 minutes after circulatory arrest. Outflow occlusion is a feasible surgical procedure for period of 4 minutes of circulatory arrest.O objetivo deste estudo foi avaliar a possibilidade de se produzir uma parada circulatória pela oclusão do tronco pulmonar, como alternativa ao "inflow occlusion", pelo hemitórax esquerdo. Oito cães sem raça definida foram divididos em dois

  16. Structure of Ion Outflow in the Martian Magnetotail

    Science.gov (United States)

    McFadden, J. P.; Mitchell, D.; Luhmann, J. G.; Connerney, J. E. P.; Jakosky, B. M.

    2017-12-01

    The Suprathermal And Thermal Ion Composition (STATIC) sensor on the MAVEN spacecraft provides a detailed look at the structure of ion outflow in the Martian magnetotail including ion composition, energization, and flow. Mars' magnetotail contains a mixture of cold (multi-species ions, tailward-moving cold multi-species ions, suprathermal ions of a few tens of eV, warm (about 100 eV) proton populations, and heavy (primarily O+) pickup ions at energies from 1 to 10 keV which may display several simultaneous peaks in energy flux. The cold tailward-moving ions represent a significant fraction of the Martian ion loss, perhaps comparable to loses from molecular oxygen dissociation. The suprathermal tail that accompanies the cold ions varies greatly and provides clues to ion escape. The warm protons, on first examination, appear to be of sheath origin, displaying a similar energy distribution and accompanied by a tenuous warm population at M/Q=2 (which could be either solar wind alphas or molecular hydrogen ions of ionospheric origin). STATIC produces a weak ghost peak at M/Q=11-12 when observing molecular hydrogen ions, but not alphas, often allowing the instrument to distinguish the source of protons. Measurements show the warm protons are of ionospheric origin in the central tail and transition to sheath plasma in the umbra. Energetic (1-10 keV) pickup oxygen in the magnetotail is produced on the nightside, near the pole where the IMF convection electric field points toward the planet, the same hemisphere where sputtering occurs. When two spectral peaks are observed, these tailward-moving ions differ in direction by relatively small angles (about 20 degrees). These peaks can persist for tens of minutes indicating approximately time-stationary acceleration, and therefore acceleration in potential fields. Magnetotail structure and geometry can be inferred not only from the local magnetic field, but also from the measured electron distributions which indicate source

  17. Maximal venous outflow velocity: an index for iliac vein obstruction.

    Science.gov (United States)

    Jones, T Matthew; Cassada, David C; Heidel, R Eric; Grandas, Oscar G; Stevens, Scott L; Freeman, Michael B; Edmondson, James D; Goldman, Mitchell H

    2012-11-01

    Leg swelling is a common cause for vascular surgical evaluation, and iliocaval obstruction due to May-Thurner syndrome (MTS) can be difficult to diagnose. Physical examination and planar radiographic imaging give anatomic information but may miss the fundamental pathophysiology of MTS. Similarly, duplex ultrasonographic examination of the legs gives little information about central impedance of venous return above the inguinal ligament. We have modified the technique of duplex ultrasonography to evaluate the flow characteristics of the leg after tourniquet-induced venous engorgement, with the objective of revealing iliocaval obstruction characteristic of MTS. Twelve patients with signs and symptoms of MTS were compared with healthy control subjects for duplex-derived maximal venous outflow velocity (MVOV) after tourniquet-induced venous engorgement of the leg. The data for healthy control subjects were obtained from a previous study of asymptomatic volunteers using the same MVOV maneuvers. The tourniquet-induced venous engorgement mimics that caused during vigorous exercise. A right-to-left ratio of MVOV was generated for patient comparisons. Patients with clinical evidence of MTS had a mean right-to-left MVOV ratio of 2.0, asymptomatic control subjects had a mean ratio of 1.3, and MTS patients who had undergone endovascular treatment had a poststent mean ratio of 1.2 (P = 0.011). Interestingly, computed tomography and magnetic resonance imaging results, when available, were interpreted as positive in only 53% of the patients with MTS according to both our MVOV criteria and confirmatory venography. After intervention, the right-to-left MVOV ratio in the MTS patients was found to be reduced similar to asymptomatic control subjects, indicating a relief of central venous obstruction by stenting the compressive MTS anatomy. Duplex-derived MVOV measurements are helpful for detection of iliocaval venous obstruction, such as MTS. Right-to-left MVOV ratios and

  18. CLASSICAL T TAURI-LIKE OUTFLOW ACTIVITY IN THE BROWN DWARF MASS REGIME

    International Nuclear Information System (INIS)

    Whelan, E. T.; Ray, T. P.; Podio, L.; Bacciotti, F.; Randich, S.

    2009-01-01

    Over the last number of years, spectroscopic studies have strongly supported the assertion that protostellar accretion and outflow activity persist to the lowest masses. Indeed, previous to this work, the existence of three brown dwarf (BD) outflows had been confirmed by us. In this paper, we present the results of our latest investigation of BD outflow activity and report on the discovery of two new outflows. Observations to date have concentrated on studying the forbidden emission line (FEL) regions of young BDs and in all cases data have been collected using the UV-Visual Echelle Spectrometer (UVES) on the ESO Very Large Telescope. Offsets in the FEL regions are recovered using spectro-astrometry. Here, ISO-Oph 32 is shown to drive a blueshifted outflow with a radial velocity of 10-20 km s -1 and spectro-astrometric analysis constrains the position angle of this outflow to 240 0 ± 7 0 . The BD candidate, ISO-ChaI 217 is found to have a bipolar outflow bright in several key forbidden lines (V RAD = -20 km s -1 , +40 km s -1 ) and with a P.A. of 193 0 -209 0 . A striking feature of the ISO-ChaI 217 outflow is the strong asymmetry between the red- and blueshifted lobes. This asymmetry is revealed in the relative brightness of the two lobes (redshifted lobe is brighter), the factor of 2 difference in radial velocity (the redshifted lobe is faster) and the difference in the electron density (again higher in the red lobe). Such asymmetries are common in jets from low-mass protostars and the observation of a marked asymmetry at such a low mass ( sun ) supports the idea that BD outflow activity is scaled down from low-mass protostellar activity. Also note that although asymmetries are unexceptional, it is uncommon for the redshifted lobe to be the brightest as some obscuration by the accretion disk is assumed. This phenomenon has only been observed in one other source, the classical T Tauri (CTTS) star RW Aur. The physical mechanism responsible for the brightening of

  19. 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.

  20. Outflows, dusty cores, and a burst of star formation in the North America and Pelican nebulae

    Energy Technology Data Exchange (ETDEWEB)

    Bally, John [Department of Astrophysical and Planetary Sciences, University of Colorado, UCB 389, Boulder, CO 80309 (United States); Ginsburg, Adam [European Southern Observatory, Karl-Schwarzschild-Str. 2, D-85748 Garching bei Munchen (Germany); Probst, Ron [National Optical Astronomy Observatory, 950 North Cherry Avenue, Tucson, AZ 85719 (United States); Reipurth, Bo [Institute for Astronomy and NASA Astrobiology Institute, University of Hawaii at Manoa, 640 North A' ohoku Place, Hilo, HI 96720 (United States); Shirley, Yancy L. [Steward Observatory, University of Arizona, 933 North Cherry Avenue, Tucson, AZ 85721 (United States); Stringfellow, Guy S., E-mail: John.Bally@colorado.edu, E-mail: aginsburg@eso.org, E-mail: probst@noao.edu, E-mail: reipurth@ifa.hawaii.edu, E-mail: yshirley@as.arizona.edu, E-mail: Guy.Stringfellow@colorado.edu [Center for Astrophysics and Space Astronomy, University of Colorado, UCB 389, Boulder, CO 80309 (United States)

    2014-12-01

    We present observations of near-infrared 2.12 μm molecular hydrogen outflows emerging from 1.1 mm dust continuum clumps in the North America and Pelican Nebula (NAP) complex selected from the Bolocam Galactic Plane Survey (BGPS). Hundreds of individual shocks powered by over 50 outflows from young stars are identified, indicating that the dusty molecular clumps surrounding the NGC 7000/IC 5070/W80 H II region are among the most active sites of ongoing star formation in the solar vicinity. A spectacular X-shaped outflow, MHO 3400, emerges from a young star system embedded in a dense clump more than a parsec from the ionization front associated with the Pelican Nebula (IC 5070). Suspected to be a binary, the source drives a pair of outflows with orientations differing by 80°. Each flow exhibits S-shaped symmetry and multiple shocks indicating a pulsed and precessing jet. The 'Gulf of Mexico', located south of the North America Nebula (NGC 7000), contains a dense cluster of molecular hydrogen objects (MHOs), Herbig-Haro (HH) objects, and over 300 young stellar objects (YSOs), indicating a recent burst of star formation. The largest outflow detected thus far in the North America and Pelican Nebula complex, the 1.6 parsec long MHO 3417 flow, emerges from a 500 M {sub ☉} BGPS clump and may be powered by a forming massive star. Several prominent outflows such as MHO 3427 appear to be powered by highly embedded YSOs only visible at λ > 70 μm. An 'activity index' formed by dividing the number of shocks by the mass of the cloud containing their source stars is used to estimate the relative evolutionary states of Bolocam clumps. Outflows can be used as indicators of the evolutionary state of clumps detected in millimeter and submillimeter dust continuum surveys.

  1. An X-Ray/SDSS Sample: Observational Characterization of The Outflowing Gas

    Science.gov (United States)

    Perna, Michele; Brusa, M.; Lanzuisi, G.; Mignoli, M.

    2016-10-01

    Powerful ionised AGN-driven outflows, commonly detected both locally and at high redshift, are invoked to contribute to the co-evolution of SMBH and galaxies through feedback phenomena. Our recent works (Brusa+2015; 2016; Perna+2015a,b) have shown that the XMM-COSMOS targets with evidence of outflows collected so far ( 10 sources) appear to be associated with low X-ray kbol corrections (Lbol /LX ˜ 18), in spite of their spread in obscuration, in the locations on the SFR-Mstar diagram, in their radio emission. A higher statistical significance is required to validate a connection between outflow phenomena and a X-ray loudness. Moreover, in order to validate their binding nature to the galaxy fate, it is crucial to correctly determine the outflow energetics. This requires time consuming integral field spectroscopic (IFS) observations, which are, at present, mostly limited to high luminosity objectsThe study of SDSS data offers a complementary strategy to IFS efforts. I will present physical and demographic characterization of the AGN-galaxy system during the feedback phase obtained studying a sample of 500 X-ray/SDSS AGNs, at zdispersion) and X-ray properties (intrinsic X-ray luminosity, obscuration and X-ray kbol correction), to determine what drives ionised winds. Several diagnostic line ratios have been used to infer the physical properties of the ionised outflowing gas. The knowledge of these properties can reduce the actual uncertainties in the outflow energetics by a factor of ten, pointing to improve our understanding of the AGN outflow phenomenon and its impact on galaxy evolution.

  2. [Urinary tract infection in pregnancy].

    Science.gov (United States)

    Herráiz, Miguel Angel; Hernández, Antonio; Asenjo, Eloy; Herráiz, Ignacio

    2005-12-01

    Urinary tract infections, asymptomatic bacteriuria (AB), acute cystitis (AC) and acute pyelonephritis (AP), are favored by the morphological and functional changes involved in pregnancy. AB increases the risk of preterm labor, low birth weight and AP. AB should be detected by uroculture (other methods are not sufficiently effective) and treated early. Approximately 80% of cases are caused by Escherichia coli. The risks and effectiveness of the distinct antibiotic regimens should be evaluated: fosfomycin trometamol in monotherapy or as short course therapy is safe and effective for the treatment of AB and AC. AP is the most frequent cause of hospital admission for medical reasons in pregnant women and can lead to complications in 10% of cases, putting the lives of the mother and fetus at risk. Currently outpatient treatment of AP is recommended in selected cases. Adequate follow-up of pregnant women with urinary tract infections is required due to frequent recurrence.

  3. Extensive upper respiratory tract sarcoidosis

    Science.gov (United States)

    Soares, Mafalda Trindade; Sousa, Carolina; Garanito, Luísa; Freire, Filipe

    2016-01-01

    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. PMID:27090537

  4. Isolated Cardiac Hydatid Cyst

    International Nuclear Information System (INIS)

    Shakil, U.; Rehman, A. U.; Shahid, R.

    2015-01-01

    Hydatid cyst disease is common in our part of the world. Cardiac hydatid cyst is its rare manifestation. We report this case of 48-year male having isolated cardiac hydatid cyst, incidentally found on computed tomography. This patient presented in medical OPD of Combined Military Hospital, Lahore with one month history of mild retrosternal discomfort. His general physical and systemic examinations as well as ECG were unremarkable. Chest X-ray showed an enlarged cardiac shadow with mildly irregular left heart border. Contrast enhanced CT scan of the chest showed a large well defined multiloculated non-enhancing cystic lesion with multiple daughter cysts involving wall of left ventricle and overlying pericardium. Serology for echinococcus confirmed the diagnosis of hydatid cyst. Patient was offered the surgical treatment but he opted for medical treatment only. Albendezol was prescribed. His follow-up echocardiography after one month showed no significant decrease in size of the cyst. (author)

  5. 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.

  6. PROPER MOTIONS OF YOUNG STELLAR OUTFLOWS IN THE MID-INFRARED WITH SPITZER (IRAC). I. THE NGC 1333 REGION

    International Nuclear Information System (INIS)

    Raga, A. C.; Noriega-Crespo, A.; Carey, S. J.; Arce, H. G.

    2013-01-01

    We use two 4.5 μm Spitzer (IRAC) maps of the NGC 1333 region taken over a ∼7 yr interval to determine proper motions of its associated outflows. This is a first successful attempt at obtaining proper motions of stellars' outflow from Spitzer observations. For the outflow formed by the Herbig-Haro objects HH7, 8, and 10, we find proper motions of ∼9-13 km s –1 , which are consistent with previously determined optical proper motions of these objects. We determine proper motions for a total of eight outflows, ranging from ∼10 to 100 km s –1 . The derived proper motions show that out of these eight outflows, three have tangential velocities ≤20 km s –1 . This result shows that a large fraction of the observed outflows have low intrinsic velocities and that the low proper motions are not merely a projection effect.

  7. Urinary tract infections during pregnancy.

    Science.gov (United States)

    Le, Jennifer; Briggs, Gerald G; McKeown, Anna; Bustillo, Gerardo

    2004-10-01

    To provide a comprehensive review of urinary tract infections (UTIs) during pregnancy. All aspects of UTIs, including epidemiology, pathogenesis, resistance, clinical features, diagnosis, treatment, and prevention, were reviewed. MEDLINE (1966-August 2003) and Cochrane Library searches were performed using the key search terms urinary tract infection, pyelonephritis, cystitis, asymptomatic bacteriuria, and resistance. All article abstracts were evaluated for relevance. Only articles pertaining to pregnancy were included. The majority of published literature were review articles; the number of original clinical studies was limited. UTIs are the most common bacterial infections during pregnancy. They are characterized by the presence of significant bacteria anywhere along the urinary tract. Pyelonephritis is the most common severe bacterial infection that can lead to perinatal and maternal complications including premature delivery, infants with low birth weight, fetal mortality, preeclampsia, pregnancy-induced hypertension, anemia, thrombocytopenia, and transient renal insufficiency. Enterobacteriaceae account for 90% of UTIs. The common antibiotics used are nitrofurantoin, cefazolin, cephalexin, ceftriaxone, and gentamicin. Therapeutic management of UTIs in pregnancy requires proper diagnostic workup and thorough understanding of antimicrobial agents to optimize maternal outcome, ensure safety to the fetus, and prevent complications that lead to significant morbidity and mortality in both the fetus and the mother.

  8. URINARY TRACT INFECTION IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T. V. Margieva

    2014-01-01

    Full Text Available The issues of diagnosing and treating urinary tract infections and their role in development of renal injury are being actively discussed by scientists and practicing pediatricians. The article presents the most recent data on etiological factors, pathogenesis and clinical manifestations of this disease. It provides recommendations on diagnosis and management of patients depending on their age. The article presents a discussion of antibacterial therapy course duration and indications for anti-relapse treatment. The study demonstrates that intravenous antibacterial therapy must be launched immediately in neonates in the event of pyretic fever; empirical antibacterial therapy must be launched immediately in older children after diagnosis of the urinary tract infection has been confirmed; subsequently, treatment ought to be corrected depending on the results of a bacteriological trial, sensitivity to antibiotics and effectiveness of the prescribed antibiotic. Along with normalization of urination rhythm and water intake schedule, antibacterial preventive therapy might be considered, if effective, in the event of recurrent nature of the urinary tract infection. 

  9. Influence of vesicoureteral reflux and urinary tract infection on renal growth in children with upper urinary tract duplication

    International Nuclear Information System (INIS)

    Hannerz, L.; Wikstad, I.; Celsi, G.; Aperia, A.; St. Goeran's Children's Hospital, Stockholm

    1989-01-01

    The growth of the renal parenchyma was examined in children with duplicated outflow systems, vesicoureteral reflux (VUR), urinary tract infection (UTI) and no sign of obstruction. Ten patients with reflux occurring only in the caudal system (group A) and 4 patients with reflux both to the caudal and the apical system (group B) were studied shortly after their first UTI (study 1) and then 1.5 to 9 years later (study 2). The frequency of UTI was relatively high during the follow-up period. At urography, renal length and renal area were normal in group A in studies 1 and 2. Parenchymal thickness of the apical pole (APT/L) did not differ from normal values in any of the studies. Parenchymal thickness of the caudal pole (CPT/L) was significantly smaller than normal in both studies. There was also a significant decrease in CPT/L between study 1 and 2. UTI during the first year of life was associated with a greater reduction in CPT/L. The determination of renal length and renal area in children with a duplicated ureter, VUR and UTI, does not identify subjects at risk of developing renal growth retardation while serial determinations of parenchymal thickness appear to be an appropriate method. (orig.)

  10. Another piece of the puzzle: The fast H I outflow in Mrk 231

    Science.gov (United States)

    Morganti, Raffaella; Veilleux, Sylvain; Oosterloo, Tom; Teng, Stacy H.; Rupke, David

    2016-09-01

    We present the detection, performed with the Westerbork Synthesis Radio Telescope (WSRT) and the Karl Jansky Very Large Array (VLA), of a fast H I 21 cm outflow in the ultra-luminous infrared galaxy Mrk 231. The outflow is observed as shallow H I absorption blueshifted ~1300 km s-1 with respect to the systemic velocity and located against the inner kpc of the radio source. The outflowing gas has an estimated column density between 5 and 15 × 1018Tspin cm-2. We derive the Tspin to lie in the range 400-2000 K and the corresponding H I densities are nHI ~ 10-100 cm-3. Our results complement previous findings and confirm the multiphase nature of the outflow in Mrk 231. Although effects of the interaction between the radio plasma and the surrounding medium cannot be ruled out, the energetics and the lack of a clear kpc-scale jet suggest that the most likely origin of the H I outflow is a wide-angle nuclear wind, as earlier proposed to explain the neutral outflow traced by Na I and molecular gas in this source. Our results suggest that an H I component is present in fast outflows regardless of the acceleration mechanism (wind vs. jet driven) and that it must be connected with common properties of the pre-interaction gas involved. Considering the observed similarity of their column densities, the H I outflow likely represents the inner part of the broad wind identified on larger scales in atomic Na I. The mass outflow rate of the H I outflow (between 8 and 18 M⊙ yr-1) does not appear to be as large as that observed in molecular gas, partly owing to the smaller sizes of the outflowing region sampled by the H I absorption. These characteristics are commonly seen in other cases of outflows driven by the active galactic nucleus (AGN) suggesting that the H I may represent a short intermediate phase in the rapid cooling of the gas. The results further confirm H I as a good tracer for AGN-driven outflows not only in powerful radio sources. We also obtained deeper continuum

  11. Quantitative cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, M.; Dueber, C.; Wolff, P.; Erbel, R.; Hoffmann, T.

    1985-06-01

    The scope and limitations of quantitative cardiac CT have been evaluated in a series of experimental and clinical studies. The left ventricular muscle mass was estimated by computed tomography in 19 dogs (using volumetric methods, measurements in two axes and planes and reference volume). There was good correlation with anatomical findings. The enddiastolic volume of the left ventricle was estimated in 22 patients with cardiomyopathies; using angiography as a reference, CT led to systematic under-estimation. It is also shown that ECG-triggered magnetic resonance tomography results in improved visualisation and may be expected to improve measurements of cardiac morphology.

  12. Cardiac output measurement

    Directory of Open Access Journals (Sweden)

    Andreja Möller Petrun

    2014-02-01

    Full Text Available In recent years, developments in the measuring of cardiac output and other haemodynamic variables are focused on the so-called minimally invasive methods. The aim of these methods is to simplify the management of high-risk and haemodynamically unstable patients. Due to the need of invasive approach and the possibility of serious complications the use of pulmonary artery catheter has decreased. This article describes the methods for measuring cardiac output, which are based on volume measurement (Fick method, indicator dilution method, pulse wave analysis, Doppler effect, and electrical bioimpedance.

  13. Evidence for ultrafast outflows in radio-quiet AGNs - III. Location and energetics

    Science.gov (United States)

    Tombesi, F.; Cappi, M.; Reeves, J. N.; Braito, V.

    2012-05-01

    Using the results of a previous X-ray photoionization modelling of blueshifted Fe K absorption lines on a sample of 42 local radio-quiet AGNs observed with XMM-Newton, in this Letter we estimate the location and energetics of the associated ultrafast outflows (UFOs). Due to significant uncertainties, we are essentially able to place only lower/upper limits. On average, their location is in the interval ˜0.0003-0.03 pc (˜ 102-104rs) from the central black hole, consistent with what is expected for accretion disc winds/outflows. The mass outflow rates are constrained between ˜0.01 and 1 M⊙ yr-1, corresponding to >rsim5-10 per cent of the accretion rates. The average lower/upper limits on the mechanical power are log? 42.6-44.6 erg s-1. However, the minimum possible value of the ratio between the mechanical power and bolometric luminosity is constrained to be comparable or higher than the minimum required by simulations of feedback induced by winds/outflows. Therefore, this work demonstrates that UFOs are indeed capable to provide a significant contribution to the AGN cosmological feedback, in agreement with theoretical expectations and the recent observation of interactions between AGN outflows and the interstellar medium in several Seyfert galaxies.

  14. Evidence for Ultra-Fast Outflows in Radio-Quiet AGNs: III - Location and Energetics

    Science.gov (United States)

    Tombesi, F.; Cappi, M.; Reeves, J. N.; Braito, V.

    2012-01-01

    Using the results of a previous X-ray photo-ionization modelling of blue-shifted Fe K absorption lines on a sample of 42 local radio-quiet AGNs observed with XMM-Newton, in this letter we estimate the location and energetics of the associated ultrafast outflows (UFOs). Due to significant uncertainties, we are essentially able to place only lower/upper limits. On average, their location is in the interval approx.0.0003-0.03pc (approx.10(exp 2)-10(exp 4)tau(sub s) from the central black hole, consistent with what is expected for accretion disk winds/outflows. The mass outflow rates are constrained between approx.0.01- 1 Stellar Mass/y, corresponding to approx. or >5-10% of the accretion rates. The average lower-upper limits on the mechanical power are logE(sub K) approx. or = 42.6-44.6 erg/s. However, the minimum possible value of the ratio between the mechanical power and bolometric luminosity is constrained to be comparable or higher than the minimum required by simulations of feedback induced by winds/outflows. Therefore, this work demonstrates that UFOs are indeed capable to provide a significant contribution to the AGN r.osmological feedback, in agreement with theoretical expectations and the recent observation of interactions between AGN outflows and the interstellar medium in several Seyferts galaxies .

  15. Ionized Gas Outflows from the MAGNUM Survey: NGC 1365 and NGC 4945

    Energy Technology Data Exchange (ETDEWEB)

    Venturi, Giacomo; Marconi, Alessandro [Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, Sesto Fiorentino (Italy); Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Mingozzi, Matilde [Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Dipartimento di Fisica e Astronomia, Università di Bologna, Bologna (Italy); Carniani, Stefano [Cavendish Laboratory, Department of Physics, University of Cambridge, Cambridge (United Kingdom); Kavli Institute for Cosmology, University of Cambridge, Cambridge (United Kingdom); Cresci, Giovanni [Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Risaliti, Guido [Dipartimento di Fisica e Astronomia, Università degli Studi di Firenze, Sesto Fiorentino (Italy); Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy); Mannucci, Filippo, E-mail: gventuri@arcetri.astro.it [Osservatorio Astrofisico di Arcetri (INAF), Firenze (Italy)

    2017-11-24

    AGN feedback, acting through strong outflows accelerated in the nuclear region of AGN hosts, is invoked as a key ingredient for galaxy evolution by many models to explain the observed BH-galaxy scaling relations. Recently, some direct observational evidence of radiative mode feedback in action has been finally found in quasars at z >1.5. However, it is not possible to study outflows in quasars at those redshifts on small scales (≲100 pc), as spatial information is limited by angular resolution. This is instead feasible in nearby active galaxies, which are ideal laboratories to explore outflow structure and properties, as well as the effects of AGN on their host galaxies. In this proceeding we present preliminary results from the MAGNUM survey, which comprises nearby Seyfert galaxies observed with the integral field spectrograph VLT/MUSE. We focus on two sources, NGC 1365 and NGC 4945, that exhibit double conical outflows extending on distances >1 kpc. We disentangle the dominant contributions to ionization of the various gas components observed in the central ~5.3 kpc of NGC 1365. An attempt to infer outflow 3D structure in NGC 4945 is made via simple kinematic modeling, suggesting a hollow cone geometry.

  16. Differential Canalograms Detect Outflow Changes from Trabecular Micro-Bypass Stents and Ab Interno Trabeculectomy.

    Science.gov (United States)

    Parikh, Hardik A; Loewen, Ralitsa T; Roy, Pritha; Schuman, Joel S; Lathrop, Kira L; Loewen, Nils A

    2016-11-04

    Recently introduced microincisional glaucoma surgeries that enhance conventional outflow offer a favorable risk profile over traditional surgeries, but can be unpredictable. Two paramount challenges are the lack of an adequate training model for angle surgeries and the absence of an intraoperative quantification of surgical success. To address both, we developed an ex vivo training system and a differential, quantitative canalography method that uses slope-adjusted fluorescence intensities of two different chromophores to avoid quenching. We assessed outflow enhancement by trabecular micro-bypass (TMB) implantation or by ab interno trabeculectomy (AIT). In this porcine model, TMB resulted in an insignificant (p > 0.05) outflow increase of 13 ± 5%, 14 ± 8%, 9 ± 3%, and 24 ± 9% in the inferonasal, superonasal, superotemporal, and inferotemporal quadrant, respectively. AIT caused a 100 ± 50% (p = 0.002), 75 ± 28% (p = 0.002), 19 ± 8%, and 40 ± 21% increase in those quadrants. The direct gonioscopy and tactile feedback provided a surgical experience that was very similar to that in human patients. Despite the more narrow and discontinuous circumferential drainage elements in the pig with potential for underperformance or partial stent obstruction, unequivocal patterns of focal outflow enhancement by TMB were seen in this training model. AIT achieved extensive access to outflow pathways beyond the surgical site itself.

  17. Delayed or No Feedback? Gas Outflows in Type 2 AGNs. III

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Jong-Hak; Son, Donghoon; Bae, Hyun-Jin, E-mail: woo@astro.snu.ac.kr, E-mail: hjbae@galaxy.yonsei.ac.kr [Astronomy Program, Department of Physics and Astronomy, Seoul National University, Seoul 151-742 (Korea, Republic of)

    2017-04-20

    We present gas kinematics based on the [O iii] λ 5007 line and their connection to galaxy gravitational potential, active galactic nucleus (AGN) energetics, and star formation, using a large sample of ∼110,000 AGNs and star-forming (SF) galaxies at z < 0.3. Gas and stellar velocity dispersions are comparable to each other in SF galaxies, indicating that the ionized gas kinematics can be accounted by the gravitational potential of host galaxies. In contrast, AGNs clearly show non-gravitational kinematics, which is comparable to or stronger than the virial motion caused by the gravitational potential. The [O iii] velocity–velocity dispersion (VVD) diagram dramatically expands toward high values as a function of AGN luminosity, implying that the outflows are AGN-driven, while SF galaxies do not show such a trend. We find that the fraction of AGNs with a signature of outflow kinematics, steeply increases with AGN luminosity and Eddington ratio. In particular, the majority of luminous AGNs presents strong non-gravitational kinematics in the [O iii] profile. AGNs with strong outflow signatures show on average similar specific star formation rates (sSFRs) to those of star-forming galaxies. In contrast, AGNs with weak or no outflows have an order of magnitude lower sSFRs, suggesting that AGNs with current strong outflows do now show any negative AGN feedback and that it may take dynamical time to impact on star formation over galactic scales.

  18. Characterizing the origin and impact of the most extreme molecular outflows in the nearby universe

    Science.gov (United States)

    Gowardhan, Avani; Riechers, Dominik A.; Spoon, Henrik; Farrah, Duncan

    2018-01-01

    Observations over the last decade have revealed that feedback in the form of molecular gas outflows is ubiquitous in local ultra luminous infrared galaxies (ULIRGs). Such outflows can clear the nuclear environments of gas and dust, quench star formation and active galactic nuclei (AGN) growth, and they are a key step in the evolution of dust-obscured AGN to optically luminous quasars. We here present multi-spectral line observations of feedback in the two most powerful molecular gas outflows in the local universe. We spatially resolve the outflows to determine their kinematics and structure and find that they can drive out the molecular gas and quench star formation within ~ few Myr. Applying mid-IR diagnostics to constrain the relative contributions of AGN and nuclear starburst activity, we find that starburst activity plays a significant role in driving the outflow. We discuss the implications for future studies of feedback in the local universe and obscured AGN at high redshift, which is a key target population for JWST and ALMA over the next decade.

  19. Mass outflow in the nearby proto-planetary system, Beta Pictoris

    International Nuclear Information System (INIS)

    Bruhweiler, F.C.; Grady, C.A.; Kondo, Yoji

    1991-01-01

    Previous spectral studies of circumstallar dust around the nearby, candidate proto-planetary system, Beta Pictoris, has detected only infalling gas. The lack of detectable mass outflow has been critical in the interpretation of the origin of the circumstellar gas and in our understanding of the evolutionary status of the Beta Pictoris system. IUE high-dispersion spectra are presented which show, in addition to infall, the presence of mass outflow, with a maximum observed outflow velocity of -60 km/s, and a corresponding instantaneous outflow rate of 1.1 x 10 to the -14th solar mass/yr, or 1.1 x 10 to the -11th Jupiter mass/yr. This mass outflow rate and terminal velocity are comparable to the magnitudes of mass infall rates and terminal velocities observed from late 1986 through early 1988. The implications of these observations on our understanding of the mechanisms producing infall from the surrounding circumstellar disk are discussed, as are the implications for our understanding of the evolutionary status of the Beta Pic system. 23 refs

  20. GAS OUTFLOWS IN SEYFERT GALAXIES: EFFECTS OF STAR FORMATION VERSUS AGN FEEDBACK

    Energy Technology Data Exchange (ETDEWEB)

    Melioli, C.; Pino, E. M. de Gouveia Dal, E-mail: claudio.melioli@iag.usp.br, E-mail: dalpino@iag.usp.br [Department of Astronomy (IAG-USP), University of Sao Paulo (Brazil)

    2015-10-20

    Large-scale, weakly collimated outflows are very common in galaxies with large infrared luminosities. In complex systems in particular, where intense star formation (SF) coexists with an active galactic nucleus (AGN), it is not clear yet from observations whether the SF, the AGN, or both are driving these outflows. Accreting supermassive black holes are expected to influence their host galaxies through kinetic and radiative feedback processes, but in a Seyfert galaxy, where the energy emitted in the nuclear region is comparable to that of the body of the galaxy, it is possible that stellar activity is also playing a key role in these processes. In order to achieve a better understanding of the mechanisms driving the gas evolution especially at the nuclear regions of these galaxies, we have performed high-resolution three-dimensional hydrodynamical simulations with radiative cooling considering the feedback from both SF regions, including supernova (Type I and II) explosions and an AGN jet emerging from the central region of the active spiral galaxy. We computed the gas mass lost by the system, separating the role of each of these injection energy sources on the galaxy evolution, and found that at scales within 1 kpc an outflow can be generally established considering intense nuclear SF only. The jet alone is unable to drive a massive gas outflow, although it can sporadically drag and accelerate clumps of the underlying outflow to very high velocities.

  1. Turbulent mixing layers in supersonic protostellar outflows, with application to DG Tauri

    Science.gov (United States)

    White, M. C.; Bicknell, G. V.; Sutherland, R. S.; Salmeron, R.; McGregor, P. J.

    2016-01-01

    Turbulent entrainment processes may play an important role in the outflows from young stellar objects at all stages of their evolution. In particular, lateral entrainment of ambient material by high-velocity, well-collimated protostellar jets may be the cause of the multiple emission-line velocity components observed in the microjet-scale outflows driven by classical T Tauri stars. Intermediate-velocity outflow components may be emitted by a turbulent, shock-excited mixing layer along the boundaries of the jet. We present a formalism for describing such a mixing layer based on Reynolds decomposition of quantities measuring fundamental properties of the gas. In this model, the molecular wind from large disc radii provides a continual supply of material for entrainment. We calculate the total stress profile in the mixing layer, which allows us to estimate the dissipation of turbulent energy, and hence the luminosity of the layer. We utilize MAPPINGS IV shock models to determine the fraction of total emission that occurs in [Fe II] 1.644 μm line emission in order to facilitate comparison to previous observations of the young stellar object DG Tauri. Our model accurately estimates the luminosity and changes in mass outflow rate of the intermediate-velocity component of the DG Tau approaching outflow. Therefore, we propose that this component represents a turbulent mixing layer surrounding the well-collimated jet in this object. Finally, we compare and contrast our model to previous work in the field.

  2. Brain Circuitry Supporting Multi-Organ Autonomic Outflow in Response to Nausea.

    Science.gov (United States)

    Sclocco, Roberta; Kim, Jieun; Garcia, Ronald G; Sheehan, James D; Beissner, Florian; Bianchi, Anna M; Cerutti, Sergio; Kuo, Braden; Barbieri, Riccardo; Napadow, Vitaly

    2016-02-01

    While autonomic outflow is an important co-factor of nausea physiology, central control of this outflow is poorly understood. We evaluated sympathetic (skin conductance level) and cardiovagal (high-frequency heart rate variability) modulation, collected synchronously with functional MRI (fMRI) data during nauseogenic visual stimulation aimed to induce vection in susceptible individuals. Autonomic data guided analysis of neuroimaging data, using a stimulus-based (analysis windows set by visual stimulation protocol) and percept-based (windows set by subjects' ratings) approach. Increased sympathetic and decreased parasympathetic modulation was associated with robust and anti-correlated brain activity in response to nausea. Specifically, greater autonomic response was associated with reduced fMRI signal in brain regions such as the insula, suggesting an inhibitory relationship with premotor brainstem nuclei. Interestingly, some sympathetic/parasympathetic specificity was noted. Activity in default mode network and visual motion areas was anti-correlated with parasympathetic outflow at peak nausea. In contrast, lateral prefrontal cortical activity was anti-correlated with sympathetic outflow during recovery, soon after cessation of nauseogenic stimulation. These results suggest divergent central autonomic control for sympathetic and parasympathetic response to nausea. Autonomic outflow and the central autonomic network underlying ANS response to nausea may be an important determinant of overall nausea intensity and, ultimately, a potential therapeutic target. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. Ionized Gas Outflows from the MAGNUM Survey: NGC 1365 and NGC 4945

    Directory of Open Access Journals (Sweden)

    Giacomo Venturi

    2017-11-01

    Full Text Available AGN feedback, acting through strong outflows accelerated in the nuclear region of AGN hosts, is invoked as a key ingredient for galaxy evolution by many models to explain the observed BH-galaxy scaling relations. Recently, some direct observational evidence of radiative mode feedback in action has been finally found in quasars at z >1.5. However, it is not possible to study outflows in quasars at those redshifts on small scales (≲100 pc, as spatial information is limited by angular resolution. This is instead feasible in nearby active galaxies, which are ideal laboratories to explore outflow structure and properties, as well as the effects of AGN on their host galaxies. In this proceeding we present preliminary results from the MAGNUM survey, which comprises nearby Seyfert galaxies observed with the integral field spectrograph VLT/MUSE. We focus on two sources, NGC 1365 and NGC 4945, that exhibit double conical outflows extending on distances >1 kpc. We disentangle the dominant contributions to ionization of the various gas components observed in the central ~5.3 kpc of NGC 1365. An attempt to infer outflow 3D structure in NGC 4945 is made via simple kinematic modeling, suggesting a hollow cone geometry.

  4. Soft X-ray Emission from Large-Scale Galactic Outflows in Seyfert Galaxies

    Science.gov (United States)

    Colbert, E. J. M.; Baum, S.; O'Dea, C.; Veilleux, S.

    1998-01-01

    Kiloparsec-scale soft X-ray nebulae extend along the galaxy minor axes in several Seyfert galaxies, including NGC 2992, NGC 4388 and NGC 5506. In these three galaxies, the extended X-ray emission observed in ROSAT HRI images has 0.2-2.4 keV X-ray luminosities of 0.4-3.5 x 10(40) erg s(-1) . The X-ray nebulae are roughly co-spatial with the large-scale radio emission, suggesting that both are produced by large-scale galactic outflows. Assuming pressure balance between the radio and X-ray plasmas, the X-ray filling factor is >~ 10(4) times as large as the radio plasma filling factor, suggesting that large-scale outflows in Seyfert galaxies are predominantly winds of thermal X-ray emitting gas. We favor an interpretation in which large-scale outflows originate as AGN-driven jets that entrain and heat gas on kpc scales as they make their way out of the galaxy. AGN- and starburst-driven winds are also possible explanations if the winds are oriented along the rotation axis of the galaxy disk. Since large-scale outflows are present in at least 50 percent of Seyfert galaxies, the soft X-ray emission from the outflowing gas may, in many cases, explain the ``soft excess" X-ray feature observed below 2 keV in X-ray spectra of many Seyfert 2 galaxies.

  5. Herbig-haro objects and mid-infrared outflows in the VELA C molecular cloud

    International Nuclear Information System (INIS)

    Zhang, Miaomiao; Wang, Hongchi; Henning, Thomas

    2014-01-01

    We have performed a deep [S II] λλ6717/6731 wide field Herbig-Haro (HH) object survey toward the Vela C molecular cloud with a sky coverage of about 2 deg 2 . In total, 18 new HH objects, HH 1090-1107, are discovered and the two previously known HH objects, HH 73-74, are also detected in our [S II] images. We also present an investigation of mid-infrared outflows in the Vela C molecular cloud using the Wide-field Infrared Survey Explorer images taken from AllWISE data release. Using the method suggested by Zhang and Wang, 11 extended green objects (EGOs) are identified to be the mid-infrared outflows, including 6 new mid-infrared outflows that have not been detected previously at other wavelengths and 5 mid-infrared counterparts of the HH objects detected in this work. Using the AllWISE Source Catalog and the source classification scheme suggested by Koenig et al., we have identified 56 young stellar object (YSO) candidates in the Vela C molecular cloud. The possible driving sources of the HH objects and EGOs are discussed based on the morphology of HH objects and EGOs and the locations of HH objects, EGOs and YSO candidates. Finally we associate 12 HH objects and 5 EGOs with 10 YSOs and YSO candidates. The median length of the outflows in Vela C is 0.35 pc and the outflows seem to be oriented randomly.

  6. Extreme Gaseous Outflows in Radio-Loud Narrow-Line Seyfert 1 Galaxies

    Science.gov (United States)

    Komossa, S.; Xu, D. W.; Wagner, A. Y.

    2018-04-01

    We present four radio-loud NLS1 galaxies with extreme emission-line shifts, indicating radial outflow velocities of the ionized gas of up to 2450 km/s, above the escape velocity of the host galaxies. The forbidden lines show strong broadening, up to 2270 km/s. An ionization stratification (higher line shift at higher ionization potential) implies that we see a large-scale outflow rather than single, localized jet-cloud interactions. Similarly, the paucity of zero-velocity [OIII]λ5007 emitting gas implies the absence of a second narrow-line region (NLR) component at rest, and therefore a large part of the high-ionization NLR is affected by the outflow. Given the radio loudness of these NLS1 galaxies, the observations are consistent with a pole on view onto their central engines, so that the effects of polar outflows are maximized. In addition, a very efficient driving mechanism is required, to reach the high observed velocities. We explore implications from recent hydrodynamic simulations of the interaction between fast winds or jets with the large-scale NLR. Overall, the best agreement with observations (and especially the high outflow speeds of the [NeV] emitting gas) can be reached if the NLS1 galaxies are relatively young sources with lifetimes not much exceeding 1 Myr. These systems represent sites of strong feedback at NLR scales at work, well below redshift one.

  7. A SYSTEMATIC SEARCH FOR MOLECULAR OUTFLOWS TOWARD CANDIDATE LOW-LUMINOSITY PROTOSTARS AND VERY LOW LUMINOSITY OBJECTS

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, Kamber R.; Shirley, Yancy L. [Steward Observatory, 933 N. Cherry Ave., Tucson, AZ 85721 (United States); Dunham, Michael M. [Department of Astronomy, Yale University, P.O. Box 208101, New Haven, CT 06520 (United States)

    2012-10-01

    We present a systematic single-dish search for molecular outflows toward a sample of nine candidate low-luminosity protostars and 30 candidate very low luminosity objects (VeLLOs; L{sub int} {<=} 0.1 L{sub Sun }). The sources are identified using data from the Spitzer Space Telescope cataloged by Dunham et al. toward nearby (D < 400 pc) star-forming regions. Each object was observed in {sup 12}CO and {sup 13}CO J = 2 {yields} 1 simultaneously using the sideband separating ALMA Band-6 prototype receiver on the Heinrich Hertz Telescope at 30'' resolution. Using five-point grid maps, we identify five new potential outflow candidates and make on-the-fly maps of the regions surrounding sources in the dense cores B59, L1148, L1228, and L1165. Of these new outflow candidates, only the map of B59 shows a candidate blue outflow lobe associated with a source in our survey. We also present larger and more sensitive maps of the previously detected L673-7 and the L1251-A-IRS4 outflows and analyze their properties in comparison to other outflows from VeLLOs. The accretion luminosities derived from the outflow properties of the VeLLOs with detected CO outflows are higher than the observed internal luminosity of the protostars, indicating that these sources likely had higher accretion rates in the past. The known L1251-A-IRS3 outflow is detected but not re-mapped. We do not detect clear, unconfused signatures of red and blue molecular wings toward the other 31 sources in the survey indicating that large-scale, distinct outflows are rare toward this sample of candidate protostars. Several potential outflows are confused with the kinematic structure in the surrounding core and cloud. Interferometric imaging is needed to disentangle large-scale molecular cloud kinematics from these potentially weak protostellar outflows.

  8. A SYSTEMATIC SEARCH FOR MOLECULAR OUTFLOWS TOWARD CANDIDATE LOW-LUMINOSITY PROTOSTARS AND VERY LOW LUMINOSITY OBJECTS

    International Nuclear Information System (INIS)

    Schwarz, Kamber R.; Shirley, Yancy L.; Dunham, Michael M.

    2012-01-01

    We present a systematic single-dish search for molecular outflows toward a sample of nine candidate low-luminosity protostars and 30 candidate very low luminosity objects (VeLLOs; L int ≤ 0.1 L ☉ ). The sources are identified using data from the Spitzer Space Telescope cataloged by Dunham et al. toward nearby (D 12 CO and 13 CO J = 2 → 1 simultaneously using the sideband separating ALMA Band-6 prototype receiver on the Heinrich Hertz Telescope at 30'' resolution. Using five-point grid maps, we identify five new potential outflow candidates and make on-the-fly maps of the regions surrounding sources in the dense cores B59, L1148, L1228, and L1165. Of these new outflow candidates, only the map of B59 shows a candidate blue outflow lobe associated with a source in our survey. We also present larger and more sensitive maps of the previously detected L673-7 and the L1251-A-IRS4 outflows and analyze their properties in comparison to other outflows from VeLLOs. The accretion luminosities derived from the outflow properties of the VeLLOs with detected CO outflows are higher than the observed internal luminosity of the protostars, indicating that these sources likely had higher accretion rates in the past. The known L1251-A-IRS3 outflow is detected but not re-mapped. We do not detect clear, unconfused signatures of red and blue molecular wings toward the other 31 sources in the survey indicating that large-scale, distinct outflows are rare toward this sample of candidate protostars. Several potential outflows are confused with the kinematic structure in the surrounding core and cloud. Interferometric imaging is needed to disentangle large-scale molecular cloud kinematics from these potentially weak protostellar outflows.

  9. Impact of respiratory infection in the results of cardiac surgery in a tertiary hospital in Brazil

    Directory of Open Access Journals (Sweden)

    Isaac Newton Guimarães Andrade

    2015-09-01

    Full Text Available AbstractObjective:To assess the impact of respiratory tract infection in the postoperative period of cardiac surgery in relation to mortality and to identify patients at higher risk of developing this complication.Methods:Cross-sectional observational study conducted at the Recovery of Cardiothoracic Surgery, using information from a database consisting of a total of 900 patients operated on in this hospital during the period from 01/07/2008 to 1/07/2009. We included patients whose medical records contained all the information required and undergoing elective surgery, totaling 109 patients with two excluded. Patients were divided into two groups, WITH and WITHOUT respiratory tract infection, as the development or respiratory tract infection in hospital, with patients in the group without respiratory tract infection, the result of randomization, using for the pairing of the groups the type of surgery performed. The outcome variables assessed were mortality, length of hospital stay and length of stay in intensive care unit. The means of quantitative variables were compared using the Wilcoxon and student t-test.Results:The groups were similar (average age P=0.17; sex P=0.94; surgery performed P=0.85-1.00 Mortality in the WITH respiratory tract infection group was significantly higher (P<0.0001. The times of hospitalization and intensive care unit were significantly higher in respiratory tract infection (P<0.0001. The presence of respiratory tract infection was associated with the development of other complications such as renal failure dialysis and stroke P<0.00001 and P=0.002 respectively.Conclusion:The development of respiratory tract infection postoperative cardiac surgery is related to higher mortality, longer periods of hospitalization and intensive care unit stay.

  10. Impact of respiratory infection in the results of cardiac surgery in a tertiary hospital in Brazil

    Science.gov (United States)

    Andrade, Isaac Newton Guimarães; de Araújo, Diego Torres Aladin; de Moraes, Fernando Ribeiro

    2015-01-01

    Objective To assess the impact of respiratory tract infection in the postoperative period of cardiac surgery in relation to mortality and to identify patients at higher risk of developing this complication. Methods Cross-sectional observational study conducted at the Recovery of Cardiothoracic Surgery, using information from a database consisting of a total of 900 patients operated on in this hospital during the period from 01/07/2008 to 1/07/2009. We included patients whose medical records contained all the information required and undergoing elective surgery, totaling 109 patients with two excluded. Patients were divided into two groups, WITH and WITHOUT respiratory tract infection, as the development or respiratory tract infection in hospital, with patients in the group without respiratory tract infection, the result of randomization, using for the pairing of the groups the type of surgery performed. The outcome variables assessed were mortality, length of hospital stay and length of stay in intensive care unit. The means of quantitative variables were compared using the Wilcoxon and student t-test. Results The groups were similar (average age P=0.17; sex P=0.94; surgery performed P=0.85-1.00) Mortality in the WITH respiratory tract infection group was significantly higher (P<0.0001). The times of hospitalization and intensive care unit were significantly higher in respiratory tract infection (P<0.0001). The presence of respiratory tract infection was associated with the development of other complications such as renal failure dialysis and stroke P<0.00001 and P=0.002 respectively. Conclusion The development of respiratory tract infection postoperative cardiac surgery is related to higher mortality, longer periods of hospitalization and intensive care unit stay. PMID:26313727

  11. Neonatal cardiac emergencies

    African Journals Online (AJOL)

    flow) or require intervention (surgical or catheter) within the first ... Cardiac. History. Risk factors, e.g. meconium-stained liquor, prematurity, ... 'snowman' sign for supracardiac total anomalous pulmonary venous drainage (TAPVD), cardiomegaly with plethora for ... central cyanosis and on auscultation you hear no murmurs.

  12. Comparative cardiac imaging

    International Nuclear Information System (INIS)

    Brundage, B.H.

    1990-01-01

    This book is designed to compare all major cardiac imaging techniques. All major imaging techniques - including conventional angiography, digital angiography, echocardiography and Doppler imaging, conventional radioisotope techniques, computed tomography, and magnetic resonance imaging - are covered in this text as they apply to the major cardiovascular disorders. There is brief coverage of positron emission tomography and an extensive presentation of ultrafast computed tomography

  13. Advanced Cardiac Life Support.

    Science.gov (United States)

    Kirkwood Community Coll., Cedar Rapids, IA.

    This document contains materials for an advanced college course in cardiac life support developed for the State of Iowa. The course syllabus lists the course title, hours, number, description, prerequisites, learning activities, instructional units, required text, six references, evaluation criteria, course objectives by units, course…

  14. Cardiac Pacemakers; Marcapasos Cardiacos

    Energy Technology Data Exchange (ETDEWEB)

    Fiandra, O [Universidad de la Republica, Facultad de Maedicina, Departamento de Cardiologia, Montevideo(Uruguay); Espasandin, W [Universidad de la Republica, Facultad de Medicina, Departamento de Cirugia Cardiaca, Montevideo (Uruguay); Fiandra, H [Instituto Nacional de Cirugia Cardiaca, Departamento de Hemodinamia y Marcapasos, Montevideo (Uruguay); and others

    1984-07-01

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

  15. Nonexercise cardiac stress testing

    International Nuclear Information System (INIS)

    Vacek, J.L.; Baldwin, T.

    1989-01-01

    Many patients who require evaluation for coronary artery disease are unable to undergo exercise stress testing because of physiologic or psychological limitations. Drs Vacek and Baldwin describe three alternative methods for assessment of cardiac function in these patients, all of which have high levels of diagnostic sensitivity and specificity. 23 references

  16. Cardiac magnetic resonance imaging

    African Journals Online (AJOL)

    2011-03-06

    Mar 6, 2011 ... Cardiac magnetic resonance imaging. Cardiovascular magnetic resonance imaging is becoming a routine diagnostic technique. BRUCE s sPOTTiswOOdE, PhD. MRC/UCT Medical Imaging Research Unit, University of Cape Town, and Division of Radiology, Stellenbosch University. Bruce Spottiswoode ...

  17. From bipolar to quadrupolar - The collimation processes of the Cepheus A outflow

    Science.gov (United States)

    Torrelles, Jose M.; Verdes-Montenegro, Lourdes; Ho, Paul T. P.; Rodriguez, Luis F.; Canto, Jorge

    1993-01-01

    Results of new K-band observations of the (1, 1) and (2, 2) ammonia lines toward Cepheus A are reported. The lines are mapped with approximately 2 arcsec of angular resolution and 0.3 km/s of velocity resolution. A sensitivity of 10 mJy has been achieved. The observations reveal details of the spatial and kinematics structure of the ambient high-density gas. It is suggested that the interstellar high-density gas is diverting and redirecting the outflow in the sense that the quadrupolar structure of the molecular outflow is produced by the interaction with the ammonia condensationss, with Cep A-1 and Cep A-3 splitting in two halves, respectively the blue- and redshifted lobes of an east-west bipolar molecular outflow.

  18. Centrifuge modeling of one-step outflow tests for unsaturated parameter estimations

    Directory of Open Access Journals (Sweden)

    H. Nakajima

    2006-01-01

    Full Text Available Centrifuge modeling of one-step outflow tests were carried out using a 2-m radius geotechnical centrifuge, and the cumulative outflow and transient pore water pressure were measured during the tests at multiple gravity levels. Based on the scaling laws of centrifuge modeling, the measurements generally showed reasonable agreement with prototype data calculated from forward simulations with input parameters determined from standard laboratory tests. The parameter optimizations were examined for three different combinations of input data sets using the test measurements. Within the gravity level examined in this study up to 40g, the optimized unsaturated parameters compared well when accurate pore water pressure measurements were included along with cumulative outflow as input data. With its capability to implement variety of instrumentations under well controlled initial and boundary conditions and to shorten testing time, the centrifuge modeling technique is attractive as an alternative experimental method that provides more freedom to set inverse problem conditions for the parameter estimation.

  19. Centrifuge modeling of one-step outflow tests for unsaturated parameter estimations

    Science.gov (United States)

    Nakajima, H.; Stadler, A. T.

    2006-10-01

    Centrifuge modeling of one-step outflow tests were carried out using a 2-m radius geotechnical centrifuge, and the cumulative outflow and transient pore water pressure were measured during the tests at multiple gravity levels. Based on the scaling laws of centrifuge modeling, the measurements generally showed reasonable agreement with prototype data calculated from forward simulations with input parameters determined from standard laboratory tests. The parameter optimizations were examined for three different combinations of input data sets using the test measurements. Within the gravity level examined in this study up to 40g, the optimized unsaturated parameters compared well when accurate pore water pressure measurements were included along with cumulative outflow as input data. With its capability to implement variety of instrumentations under well controlled initial and boundary conditions and to shorten testing time, the centrifuge modeling technique is attractive as an alternative experimental method that provides more freedom to set inverse problem conditions for the parameter estimation.

  20. Dependence of Ca outflow and depression of frog myocardium contraction on ryodipine concentration.

    Science.gov (United States)

    Narusevicius, E; Gendviliene, V; Macianskiene, R; Hmelj-Dunai, G; Velena, A; Duburs, G

    1988-02-01

    The effect of ryodipine on calcium outflow from tissues, on contraction force, the duration of action potentials and the relaxation phase time-constant in the contraction cycles of myocardial strips was studied using frog heart preparations. It was found that calcium outflow (delta Ca) as a function on ryodipine concentration can be represented as: (formula; see text) A linear correlation exists between Ca2+, contraction blocking and the shortening of the action potential in the presence of various ryodipine concentrations. Ryodipine (10(-5) mol/l) decreased the relaxation time-constant by about 20% as compared to controls. It was concluded that calcium outflow from myocardial tissues in response to ryodipine is due to blockade of calcium entry into the cells and their output through the Na+--Ca2+ exchange system. Frog heart myocardial contractions are essentially under the control of calcium entry through sarcolemmal calcium channels.

  1. Cloud Formation and Water Transport on Mars after Major Outflow Events

    Science.gov (United States)

    Santiago, D. L.; Colaprete, A.; Kreslavsky, M.; Kahre, M. A.; Asphaug, E.

    2012-01-01

    The triggering of a robust water cycle on Mars might have been caused by the gigantic flooding events evidenced by outflow channels. We use the Ames Mars General Circulation Model (MGCM) to test this hypothesis, studying how these presumably abrupt eruptions of water might have affected the climate of Mars in the past. We model where the water ultimately went as part of a transient atmospheric water cycle, to answer questions including: (1) Can sudden introductions of large amounts of water on the Martian surface lead to a new equilibrated water cycle? (2) What are the roles of water vapor and water ice clouds to sudden changes in the water cycle on Mars? (3) How are radiative feedbacks involved with this? (4) What is the ultimate fate of the outflow water? (5) Can we tie certain geological features to outflow water redistributed by the atmosphere?

  2. The Upshear Environment-Outflow Interface of a Sheared, Rapidly Intensifying Tropical Cyclone

    Science.gov (United States)

    Ryglicki, D.; Doyle, J. D.; Jin, Y.; Hodyss, D.; Viner, K.

    2017-12-01

    An idealized, simulated tropical cyclone (TC) which undergoes rapid intensification in moderate vertical wind shear is shown to exhibit structural similarities to observed TCs of this class. Due to a complex vortex tilt evolution, enhanced convection causes enhanced outflow from the TC which subsequently serves to block and to divert environmental flow around the TC. This allows for the TC to come back into vertical alignment and undergo rapid intensification. A trajectory analysis indicates that blocking is limited to a narrow range of heights, indicating that the vertical profile of environmental winds is a key factor for permitting this evolution. Satellite observations indicate the presence of upper-level arcs extending upshear beyond the TC. Synthetic satellite imagery of the simulated TC indicates this is the termination of the outflow. Using a Helmholtz decomposition, it is found that the divergent component of the outflow extends 1000 km upshear into the environment, potentially explaining the 1000-km clearing seen in satellite observations.

  3. Human cerebral venous outflow pathway depends on posture and central venous pressure

    DEFF Research Database (Denmark)

    Gisolf, J; van Lieshout, J J; van Heusden, K

    2004-01-01

    and central venous pressure (CVP) on the distribution of cerebral outflow over the internal jugular veins and the vertebral plexus, using a mathematical model. Input to the model was a data set of beat-to-beat cerebral blood flow velocity and CVP measurements in 10 healthy subjects, during baseline rest......Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture...... and a Valsalva manoeuvre in the supine and standing position. The model, consisting of 2 jugular veins, each a chain of 10 units containing nonlinear resistances and capacitors, and a vertebral plexus containing a resistance, showed blood flow mainly through the internal jugular veins in the supine position...

  4. The outflows accelerated by the magnetic fields and radiation force of accretion disks

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Xinwu, E-mail: cxw@shao.ac.cn [Key Laboratory for Research in Galaxies and Cosmology, Shanghai Astronomical Observatory, Chinese Academy of Sciences, 80 Nandan Road, Shanghai, 200030 (China)

    2014-03-01

    The inner region of a luminous accretion disk is radiation-pressure-dominated. We estimate the surface temperature of a radiation-pressure-dominated accretion disk, Θ=c{sub s}{sup 2}/r{sup 2}Ω{sub K}{sup 2}≪(H/r){sup 2}, which is significantly lower than that of a gas-pressure-dominated disk, Θ ∼ (H/r){sup 2}. This means that the outflow can be launched magnetically from the photosphere of the radiation-pressure-dominated disk only if the effective potential barrier along the magnetic field line is extremely shallow or no potential barrier is present. For the latter case, the slow sonic point in the outflow will probably be in the disk, which leads to a slow circular dense flow above the disk. This implies that hot gas (probably in the corona) is necessary for launching an outflow from the radiation-pressure-dominated disk, which provides a natural explanation for the observational evidence that the relativistic jets are related to hot plasma in some X-ray binaries and active galactic nuclei. We investigate the outflows accelerated from the hot corona above the disk by the magnetic field and radiation force of the accretion disk. We find that with the help of the radiation force, the mass loss rate in the outflow is high, which leads to a slow outflow. This may be why the jets in radio-loud narrow-line Seyfert galaxies are in general mildly relativistic compared with those in blazars.

  5. DISCOVERY OF AN EXTREMELY WIDE-ANGLE BIPOLAR OUTFLOW IN AFGL 5142

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Tie; Kim, Kee-Tae; Lee, Chang-Won; Cho, Se-Hyung [Korea Astronomy and Space Science Institute 776, Daedeokdae-ro, Yuseong-gu, Daejeon, 305-348 (Korea, Republic of); Zhang, Qizhou [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Wu, Yuefang [Department of Astronomy, Peking University, Beijing 100871 (China); Goldsmith, Paul F. [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Li, Di [National Astronomical Observatories, Chinese Academy of Science, A20 Datun Road, Chaoyang District, Beijing 100012 (China); Liu, Sheng-Yuan; Chen, Huei-Ru [Institute of Astronomy and Astrophysics, Academia Sinica, Taipei, Taiwan (China); Tatematsu, Ken’ichi [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-8588 (Japan); Wang, Ke [European Southern Observatory, Karl-Schwarzschild-Str. 2, D-85748 Garching bei München (Germany); Lee, Jeong-Eun [School of Space Research, Kyung Hee University, Yongin-Si, Gyeonggi-Do 446-701 (Korea, Republic of); Qin, Sheng-Li [Department of Astronomy, Yunnan University, and Key Laboratory of Astroparticle Physics of Yunnan Province, Kunming 650091 (China); Mardones, Diego, E-mail: liutiepku@gmail.com [Departamento de Astronomía, Universidad de Chile, Casilla 36-D, Santiago (Chile)

    2016-06-10

    Most bipolar outflows are associated with individual young stellar objects and have small opening angles. Here we report the discovery of an extremely wide-angle (∼180°) bipolar outflow (“EWBO”) in a cluster forming region AFGL 5142 from low-velocity emission of the HCN (3–2) and HCO{sup +} (3–2) lines. This bipolar outflow is along a north-west to south-east direction with a line of sight flow velocity of about 3 km s{sup −1} and is spatially connected to the high-velocity jet-like outflows. It seems to be a collection of low-velocity material entrained by the high-velocity outflows due to momentum feedback. The total ejected mass and mass loss rate due to both high-velocity jet-like outflows and the “EWBO” are ∼24.5 M {sub ⊙} and ∼1.7 × 10{sup −3} M {sub ⊙} yr{sup −1}, respectively. Global collapse of the clump is revealed by the “blue profile” in the HCO{sup +} (1–0) line. A hierarchical network of filaments was identified in NH{sub 3} (1, 1) emission. Clear velocity gradients of the order of 10 km s{sup −1} pc{sup −1} are found along filaments, indicating gas inflow along the filaments. The sum of the accretion rate along filaments and mass infall rate along the line of sight is ∼3.1 × 10{sup −3} M {sub ⊙} yr{sup −1}, which exceeds the total mass loss rate, indicating that the central cluster is probably still gaining mass. The central cluster is highly fragmented and 22 condensations are identified in 1.1 mm continuum emission. The fragmentation process seems to be determined by thermal pressure and turbulence. The magnetic field may not play an important role in fragmentation.

  6. Investigations of Short-Timescale Outflow Variability in Quasars of the Sloan Digital Sky Survey

    Science.gov (United States)

    Hemler, Zachary; Grier, Catherine; Brandt, William; Hall, Patrick; Schneider, Donald; Shen, Yue; Fernandez-Trincado, Jose; SDSS-RM Collaboration

    2018-01-01

    Quasar outflows are hypothesized to regulate the growth of a quasar's host galaxy and the supermassive black hole (SMBH) itself. Thus, understanding the physics of these outflows is imperative to understanding galactic evolution. The physical properties of these outflows, such as density, radial distance from the SMBH, and kinetic energy can be investigated by measuring both the strength and shape variability of broad absorption lines (BALs) in quasar spectra. However, the accuracy of physical properties calculated using BAL variability methods is limited by the time resolution of the observations. Recent spectral data from the Sloan Digital Sky Survey Reverberation Mapping program (SDSS-RM) provides a novel opportunity to investigate the short-term BAL variability of many quasars at many epochs. The SDSS-RM program took many epochs of spectra for a large sample of quasars over a period of several years, many of which exhibit BALs. The median rest-frame time resolution of these observations is roughly 2 days, in contrast to previous large-sample studies, which typically have time spacing on the order of hundred of days. We are using the SDSS-RM dataset to conduct a BAL variability study that will further constrain outflow properties and provide significant insights into the variability mechanisms of quasar outflows. We are searching for variability in BALs on timescales of less than 2 days among our sample of 22 quasars and determining whether this behavior is common among quasars. We are also investigating the general short-term (less than 10 days) variability characteristics of the entire sample. We will present preliminary results from this study and the possible implications to our understanding of quasar outflows.

  7. Outflows in the narrow-line region of bright Seyfert galaxies - I. GMOS-IFU data

    Science.gov (United States)

    Freitas, I. C.; Riffel, R. A.; Storchi-Bergmann, T.; Elvis, M.; Robinson, A.; Crenshaw, D. M.; Nagar, N. M.; Lena, D.; Schmitt, H. R.; Kraemer, S. B.

    2018-05-01

    We present two-dimensional maps of emission-line fluxes and kinematics, as well as of the stellar kinematics of the central few kpc of five bright nearby Seyfert galaxies - Mrk 6, Mrk 79, Mrk 348, Mrk 607, and Mrk 1058 - obtained from observations with the Gemini Multi-Object Spectrograph Integral Field Unit on the Gemini North Telescope. The data cover the inner 3.5 arcsec × 5.0 arcsec - corresponding to physical scales in the range 0.6 × 0.9-1.5 × 2.2 kpc2 - at a spatial resolution ranging from 110 to 280 pc with a spectral coverage of 4300-7100 Å and velocity resolution of ≈90 km s-1. The gas excitation is Seyfert like everywhere but show excitation gradients that are correlated with the gas kinematics, reddening and/or the gas density. The gas kinematics show in all cases two components: a rotation one similar to that observed in the stellar velocity field, and an outflow component. In the case of Mrk607, the gas is counter-rotating relative to the stars. Enhanced gas velocity dispersion is observed in association with the outflows according to two patterns: at the locations of the highest outflow velocities along the ionization axis or perpendicularly to it in a strip centred at the nucleus that we attribute to an equatorial outflow. Bipolar outflows are observed in Mrk 348 and Mrk 79, while in Mrk 1058 only the blueshifted part is clearly observed, while in cases of Mrk 6 and Mrk 607, the geometry of the outflow needs further constraints from modelling to be presented in a forthcoming study, where the mass flow rate and powers will also be obtained.

  8. Better Than Nothing: A Rational Approach for Minimizing the Impact of Outflow Strategy on Cerebrovascular Simulations.

    Science.gov (United States)

    Chnafa, C; Brina, O; Pereira, V M; Steinman, D A

    2018-02-01

    Computational fluid dynamics simulations of neurovascular diseases are impacted by various modeling assumptions and uncertainties, including outlet boundary conditions. Many studies of intracranial aneurysms, for example, assume zero pressure at all outlets, often the default ("do-nothing") strategy, with no physiological basis. Others divide outflow according to the outlet diameters cubed, nominally based on the more physiological Murray's law but still susceptible to subjective choices about the segmented model extent. Here we demonstrate the limitations and impact of these outflow strategies, against a novel "splitting" method introduced here. With our method, the segmented lumen is split into its constituent bifurcations, where flow divisions are estimated locally using a power law. Together these provide the global outflow rate boundary conditions. The impact of outflow strategy on flow rates was tested for 70 cases of MCA aneurysm with 0D simulations. The impact on hemodynamic indices used for rupture status assessment was tested for 10 cases with 3D simulations. Differences in flow rates among the various strategies were up to 70%, with a non-negligible impact on average and oscillatory wall shear stresses in some cases. Murray-law and splitting methods gave flow rates closest to physiological values reported in the literature; however, only the splitting method was insensitive to arbitrary truncation of the model extent. Cerebrovascular simulations can depend strongly on the outflow strategy. The default zero-pressure method should be avoided in favor of Murray-law or splitting methods, the latter being released as an open-source tool to encourage the standardization of outflow strategies. © 2018 by American Journal of Neuroradiology.

  9. The HST-pNFL program: Mapping the Fluorescent Emission of Galactic Outflows

    Science.gov (United States)

    Heckman, Timothy

    2017-08-01

    Galactic outflows associated with star formation are believed to play a crucial role in the evolution of galaxies and the IGM. Most of our knowledge about outflows has come from down-the-barrel UV absorption spectroscopy of star-forming galaxies. However, absorption-line data alone provide only indirect information about the radial structure of the gas flows, which introduces large systematic uncertainties in some of the most important quantities, such as the outflow rate, the mass loading factor, and the momentum, metal, and energy fluxes. Recent spectroscopic observations of star-forming galaxies with large (projected physical) apertures have revealed non-resonant (fluorescent) emission in the UV, e.g., FeII* and SiII*, that can be naturally produced by spatially extended emission from the same outflowing material traced in absorption. Encouraged by the most recent observations of FeII* emission by the SDSS-IV/eBOSS survey (Zhu et al. 2015), we propose a pilot program to use narrow-band filter UVIS F280N images to map the extended FeII* 2626 and 2613 fluorescent emission in a carefully-chosen sample of 4 starburst galaxies at z=0.065, and COS G130M to obtain down-the- barrel spectra for SiII absorption and SiII* emission. This HST pilot program can provide unique information about the spatial structure of galactic outflows and can potentially lead to a revolution in our understanding of outflow physics and its impact on galaxies and the IGM.

  10. Maternal cardiac metabolism in pregnancy

    Science.gov (United States)

    Liu, Laura X.; Arany, Zolt

    2014-01-01

    Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

  11. Incision of the Jezero Crater Outflow Channel by Fluvial Sediment Transport

    Science.gov (United States)

    Holo, S.; Kite, E. S.

    2017-12-01

    Jezero crater, the top candidate landing site for the Mars 2020 rover, once possessed a lake that over-spilled and eroded a large outflow channel into the Eastern rim. The Western deltaic sediments that would be the primary science target of the rover record a history of lake level, which is modulated by the inflow and outflow channels. While formative discharges for the Western delta exist ( 500 m3/s), little work has been done to see if these flows are the same responsible for outflow channel incision. Other models of the Jezero outflow channel incision assume that a single rapid flood (incision timescales of weeks), with unknown initial hydraulic head and no discharge into the lake (e.g. from the inflow channels or the subsurface), incised an open channel with discharge modulated by flow over a weir. We present an alternate model where, due to an instability at the threshold of sediment motion, the incision of the outflow channel occurs in concert with lake filling. In particular, we assume a simplified lake-channel-valley system geometry and that the channel is hydraulically connected to the filling/draining crater lake. Bed load sediment transport and water discharge through the channel are quantified using the Meyer-Peter and Mueller relation and Manning's law respectively. Mass is conserved for both water and sediment as the lake level rises/falls and the channel incises. This model does not resolve backwater effects or concavity in the alluvial system, but it does capture the non-linear feedbacks between lake draining, erosion rate, channel flow rate, and slope relaxation. We identify controls on incision of the outflow channel and estimate the time scale of outflow channel formation through a simple dynamical model. We find that the observed 300m of channel erosion can be reproduced in decades to centuries of progressive bed load as the delta forming flows fill the lake. This corresponds to time scales on the order of or smaller than the time scale

  12. Human cerebral venous outflow pathway depends on posture and central venous pressure

    DEFF Research Database (Denmark)

    Gisolf, J; van Lieshout, J J; van Heusden, K

    2004-01-01

    Internal jugular veins are the major cerebral venous outflow pathway in supine humans. In upright humans the positioning of these veins above heart level causes them to collapse. An alternative cerebral outflow pathway is the vertebral venous plexus. We set out to determine the effect of posture...... and during a Valsalva manoeuvre in both body positions, correlate highly with model simulation of the jugular cross-sectional area (R(2) = 0.97). The results suggest that the cerebral venous flow distribution depends on posture and CVP: in supine humans the internal jugular veins are the primary pathway...

  13. URINARY TRACT INFECTIONS IN PREGNANCY

    Directory of Open Access Journals (Sweden)

    N Sivalingam

    2007-01-01

    Full Text Available Urinary tract infections frequently affect pregnant mothers. This problem causes significant morbidity and healthcare expenditure. Three common clinical manifestations of UTIs in pregnancy are: asymptomatic bacteriuria, acute cystitis and acute pyelonephritis. Escherichia coli remains the most frequent organism isolated in UTIs. All pregnant mothers should be screened for UTIs in pregnancy and antibiotics should be commenced without delay. Urine culture and sensitivity is the gold standard in diagnosing UTIs. Without treatment, asymptomatic bacteriuria in pregnancy is associated with preterm delivery, intrauterine growth retardation, low birth weight, maternal hypertension, pre-eclampsia and anaemia. Acute pyelonephritis can lead to maternal sepsis. Recurrent UTIs in pregnancy require prophylactic antibiotic treatment.

  14. Biliary tract duplication cyst with gastric heterotopia

    Energy Technology Data Exchange (ETDEWEB)

    Grumbach, K.; Baker, D.H.; Weigert, J.; Altman, R.P.

    1988-05-01

    Cystic duplications of the biliary tract are rare anomalies, easily mistaken for choledochal cysts. Surgical drainage is the preferred therapy for choledochal cyst, but cystic duplication necessitates surgical excision as duplications may contain heterotopic gastric mucosa leading to peptic ulceration of the biliary tract. We report a case of biliary tract duplication cyst containing heterotopic alimentary mucosa which had initially been diagnosed and surgically treated as a choledochal cyst.

  15. Biliary tract duplication cyst with gastric heterotopia

    International Nuclear Information System (INIS)

    Grumbach, K.; Baker, D.H.; Weigert, J.; Altman, R.P.

    1988-01-01

    Cystic duplications of the biliary tract are rare anomalies, easily mistaken for choledochal cysts. Surgical drainage is the preferred therapy for choledochal cyst, but cystic duplication necessitates surgical excision as duplications may contain heterotopic gastric mucosa leading to peptic ulceration of the biliary tract. We report a case of biliary tract duplication cyst containing heterotopic alimentary mucosa which had initially been diagnosed and surgically treated as a choledochal cyst. (orig.)

  16. Study of females genital tract microflora diversity

    OpenAIRE

    Vertelytė, Justina

    2016-01-01

    Study of females genital tract microflora diversity SUMMARY Study of female genital tract microflora diversity Authors of Master’s degree scientific research work: Justina Vertelytė Head of Master’s degree scientific research work: dr Silvija Kiverytė Vilnius, 2016 The aim of research work was to investigate and analyze the composition of the microflora of the female genital tract using the methods of microbiological smear, vaginal wet mount and PCR. The objectives of the work were to evaluat...

  17. Improving early outcomes following hybrid procedure for patients with single ventricle and systemic outflow obstruction: defining risk factors†.

    Science.gov (United States)

    Pizarro, Christian; Davies, Ryan R; Woodford, Edward; Radtke, Wolfgang A

    2015-06-01

    The hybrid procedure has become an accepted management strategy for patients with single ventricle and systemic outflow obstruction (SVSOO), particularly those considered at high risk for mortality following Stage I Norwood. We sought to refine patient selection by identifying clinical variables associated with early mortality. Single-centre review of all patients with SVSOO undergoing a hybrid procedure between January 2003 and December 2012. Demographic, clinical and outcome data were collected from the electronic medical record. The primary outcome was operative mortality (mortality within 30 days of the operation or prior to hospital discharge). Thirty-four patients underwent hybrid palliation at a median age of 5 days (IQR 3-8.5) and a median weight of 2.5 kg (IQR 2.2-2.9). Aortic atresia was present in 13 of 34 patients. Emergency banding for resuscitation was performed in 8 cases. Subsequent procedures included Stage I Norwood in 14, combined Stage I and II Norwood in 8, biventricular repair in 3 and cardiac transplantation in 2. Median cardiac intensive care unit length of stay was 54 days (IQR 27-92). Seven patients had no subsequent procedure. There were 11 operative deaths. Non-modifiable patient-related factors had a significant association with operative mortality, including weight under 2.0 kg (OR 18; 95% CI 1.8-188.3, P = 0.0008) and aortic atresia (OR 6.1; 95% CI 1.2-30.1, P = 0.026). Most significant was the interaction between aortic atresia and weight under 2.0 kg on early mortality (OR 13.1; 95% CI 1.9-92 P = 0.0039). The multivariate analysis demonstrated that the presence of aortic atresia (OR 13.4; 95% CI 1.2-151) and a birthweight of 2.0 kg or less (OR 51; 95% CI 2.4-999) were also significant predictors of operative mortality. Non-modifiable patient-related factors have a profound effect on early survival following a hybrid procedure for SVSOO. Outcomes for patients under 2.0 kg with aortic atresia remain very poor. Risk stratification

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-09-15

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

  19. SPECTROSCOPIC OBSERVATIONS OF CONTINUOUS OUTFLOWS AND PROPAGATING WAVES FROM NOAA 10942 WITH EXTREME ULTRAVIOLET IMAGING SPECTROMETER/HINODE

    International Nuclear Information System (INIS)

    Nishizuka, N.; Hara, H.

    2011-01-01

    We focused on 'sit-and-stare' observations of an outflow region at the edge of active region NOAA 10942 on 2007 February 20 obtained by the Extreme ultraviolet Imaging Spectrometer on board Hinode. We analyzed the data above the base of the outflow and found both continuous outflows and waves, which propagate from the base of the outflow. The spectra at the base of the outflow and at higher locations show different properties. The line profiles show blue-side asymmetry at the base of the outflow where nonthermal broadening becomes large because of fast upflows generated by heating events. On the other hand, at higher locations line profiles are symmetric and the intensity disturbances vary in phase with the velocity disturbances. The correlations between the intensity and velocity disturbances become noticeable at higher locations, so this indicates evidence of (at least locally) upward propagating slow-mode waves along the outflow. We also found a transient oscillation of different period in the wavelet spectrum. This indicates that a different wave is additionally observed during a limited period. High cadence spectroscopic observations revealed intermittent signatures of nonthermal velocities. Each of them seems to correspond to the base of the propagating disturbances. Furthermore, a jet was captured by the sit-and-stare observations across the slit. The similarity of line profiles of the outflow and the jet may indicate that the flows and waves originate in unresolved explosive events in the lower atmosphere of the corona.

  20. Foreign direct investment outflows in the forest products industry: the case of the United States and Japan

    Science.gov (United States)

    R.V. Nagubadi; D. Zhang

    2008-01-01

    This paper investigates the determinants of foreign direct investment (FDI) outflows from two major forest product importing countries: the U.S. and Japan. Exchange rate, per capita income, cost of capital, and cost of labour in host countries have significant impacts on the FDI outflows from these two countries. A complementary relationship is found between forest...