WorldWideScience

Sample records for clip goldblatt hypertension

  1. Right ventricular pressure elevated in one-kidney, one clip Goldblatt hypertensive rats.

    Science.gov (United States)

    Ketabchi, Farzaneh; Bajoovand, Shirin; Adlband, Mojtaba; Naseh, Maryam; Nekooeian, Ali A; Mashghoolozekr, Elaheh

    2017-01-01

    Both renal and respiratory diseases are common with high mortality rate around the world. This study was the first to compare effects of two kidneys, one clip (2K1C) and one-kidney, one clip (1K1C) Goldblatt hypertension on right ventricular pressure during normal condition and mechanical ventilation with hypoxia gas. Male Sprague-Dawley rats were subjected to control, 2K1C, or 1K1C groups. Twenty-eight days after the first surgery, animals were anesthetized, and femoral artery and vein, and right ventricle cannulated. Systemic arterial pressure and right ventricular systolic pressures (RVSP) were recorded during ventilation the animals with normoxic or hypoxic gas. RVSP in the 1K1C group was significantly more than the control and 2K1C groups during baseline conditions and ventilation the animals with hypoxic gas. Administration of antioxidant Trolox increased RVSP in the 1K1C and control groups compared with their baselines. Furthermore, there was no alteration in RVSP during hypoxia in the presence of Trolox. This study indicated that RVSP only increased after 28 days induction of 1K1C but not 2K1C model. In addition, it seems that the response to hypoxic gas and antioxidants in 1K1C is more than 2K1C. These data also suggest that effects of 1K1C may partially be related to reactive oxygen species (ROS) pathways.

  2. Angiotensin converting enzyme inhibition induces alterations to hippuran renography despite unchanged ipsilateral renal blood flow in conscious two-kidney, one clip Goldblatt hypertensive dogs

    NARCIS (Netherlands)

    Jonker, G J; de Zeeuw, D; Huisman, R M; van der Hem, G K

    1988-01-01

    We performed experiments in the two-kidney, one clip Goldblatt hypertensive dog to see whether angiotensin converting enzyme (ACE) inhibition could improve the sensitivity of hippurate renography in detecting renal artery stenosis. Ten dogs on a sodium-restricted diet were studied before and after

  3. CHANGES IN RENAL-FUNCTION INDUCED BY ACE-INHIBITION IN THE CONSCIOUS 2-KIDNEY, ONE-CLIP GOLDBLATT HYPERTENSIVE DOG

    NARCIS (Netherlands)

    JONKER, GJ; VISSCHER, CA; DEZEEUW, D; HUISMAN, RM; PIERS, DA; BEEKHUIS, H; VANDERHEM, GK

    In order to study why the diagnostic sensitivity of I-123-hippurate renography for a renal artery stenosis is improved by angiotensin converting enzyme (ACE-) inhibition we used the model of the conscious chronically instrumented two-kidney, one-clip Goldblatt hypertensive dog. Urine flow (UV),

  4. Water and exchangeable sodium in Goldblatt two-kidney, two-clip hypertensive rats

    International Nuclear Information System (INIS)

    Mac Cormack, W.P.; Roson, M.I.; Maquieira, M.K.; Mendez, M.A.; Santoro, F.M.; Morera, S.; de la Riva, I.J.

    1986-01-01

    Exchangeable 22 Na (ExNa), total body water (TBW) and the inulin space (InSp) were determined in two-kidney, two-clip (2K-2C) hypertensive and sham operated (normotensive) control rats 6-8 weeks after surgery. TBW (ml/kg lean body weight) was the same in hypertensive and sham rats. In contrast, ExNa (mEq/kglbw) and InSp (ml/kglbw) significantly increased (p less than 0.01) in rats whose hypertension did not exceed 170 mmHg. Consequently, sham, moderate hypertensive (less than 170 mmHg) and severe hypertensive (less than 170 mmHg) animals showed equal TBW but differed in body water distribution in that moderately hypertensive animals displayed a redistribution of water in favor of the extracellular space

  5. The role of vascular protein and renin in chronic two-kidney, one clip Goldblatt hypertension

    International Nuclear Information System (INIS)

    Nakada, T.; Yamori, Y.

    1982-01-01

    Chronic hypertension was induced in rats by application of a clip for 17 or 20 weeks to the unilateral renal artery and leaving the contrarenal vessel intact. Some of the rats received antihypertensive treatment with phenoxybenzamine (POB). 3 H-proline was injected into all rats in the 17th experimental week to observe the in vivo incorporation rates of 3 H-proline into vascular non-collagenous protein and vascular collagen. Plasma renin activity (PRA) of decapitated rats was assayed in the terminal stage of the experiment. Significant differences were noted between 2K-1C hypertensive rats and sham-operated normotensive rats, the former rats having significantly higher incorporation rates of 3 H-proline into non-collagenous protein and collagen of testicular or mesenteric artery. These results indicate that increased synthesis of vascular non-collagenous protein as well as collagen, especially of small arteries, plays a major role for the pathogenesis of chronic hypertension in 2K-1C rats, and renin does not contribute to elevation of the blood pressure in the maintenance phase of this type of experimental hypertension

  6. Antihypertensive therapy induces compartment-specific chemokine expression and a Th1 immune response in the clipped kidney of Goldblatt hypertensive rats

    NARCIS (Netherlands)

    Steinmetz, O. M.; Sadaghiani, S.; Panzer, U.; Krebs, C.; Meyer-Schwesinger, C.; Streichert, T.; Fehr, S.; Hamming, I.; van Goor, H.; Stahl, R. A. K.; Wenzel, U.

    The present study examined the pathogenesis of interstitial inflammation and fibrosis in antihypertensively treated rats with two-kidney, one-clip hypertension. Hypertensive rats were randomized into four groups: no treatment and moderate, intermediate, and intensified lowering of blood pressure

  7. Orally active epoxyeicosatrienoic acid analog does not exhibit antihypertensive and reno- or cardioprotective actions in two-kidney, one-clip Goldblatt hypertensive rats

    Czech Academy of Sciences Publication Activity Database

    Alánová, Petra; Husková, Z.; Kopkan, L.; Sporková, A.; Jíchová, Š.; Neckář, Jan; Imig, J. D.; Klevstig, Martina; Kolář, František; Reddy, N. R.; Falck, J. R.; Sadowski, J.; Nishiyama, A.; Kramer, H. J.; Melenovský, V.; Červenková, L.; Kujal, P.; Vernerová, Z.; Červenka, L.

    2015-01-01

    Roč. 73, Oct 2015 (2015), s. 45-56 ISSN 1537-1891 R&D Projects: GA ČR(CZ) GA15-08066S; GA ČR(CZ) GAP303/12/1162 Institutional support: RVO:67985823 Keywords : renovascular hypertension * myocardial ischemia/reperfusion injury * 14,15-epoxyeicosatrienoic acid analog * renin-angiotensin system Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 2.500, year: 2015

  8. Anti-hypertensive effect of Gastrodia elata Bl leaf extract in rats

    African Journals Online (AJOL)

    Methods: The two-kidney one-clip (2K1C) Goldblatt model of renovascular hypertension was used in. Wistar rats. ... urea levels of the rats were measured by enzyme-linked immunosorbent assay (ELISA). Superoxide ... Hypertension is the most common risk factor for .... (BP-6 noninvasive Electro-Sphygmomanometer,.

  9. A novel vascular clip design for the reliable induction of 2-kidney, 1-clip hypertension in the rat

    OpenAIRE

    Chelko, Stephen P.; Schmiedt, Chad W.; Lewis, Tristan H.; Lewis, Stephen J.; Robertson, Tom P.

    2011-01-01

    The 2-kidney, 1-clip (2K1C) model has provided many insights into the pathogenesis of renovascular hypertension. However, studies using the 2K1C model often report low success rates of hypertension, with typical success rates of just 40–60%. We hypothesized that these low success rates are due to fundamental design flaws in the clips traditionally used in 2K1C models. Specifically, the gap widths of traditional silver clips may not be maintained during investigator handling and these clips ma...

  10. Computer assisted nuclear assessment of renal perfusion in a two kidney, one clip canine model of Goldblatt hypertension

    International Nuclear Information System (INIS)

    Clarke, H.St.C. Jr.

    1984-01-01

    This study was designed to evaluate ninety-second and fifteen-minute Technetium-DTPA (/sup 99m/Tc-DTPA) time-activity curves in acute unilateral renal artery stenosis (RAS). The /sup 99m/Tc-DTPA studies were compared to angiograms, PAH clearances (C/sup PAH/), and thirty-minute 131 I-Hippuran renograms in eight dogs prior to and after RAS. Renal artery stenosis resulted in a reduction of the renal blood flow ranging from 32% to 68%, as measured by electromagnetic flow probe and C/sub PAH/. The mean arterial pressure increased 21 mmHg. Changes in the ninety-second /sup 99m/Tc-DTPA curve were identified by eight computer isolated curve parameters. The fifteen minute /sup 99m/Tc-DTPA curves were interpreted according to the same criteria used in analyzing the 131 I-Hippuran renograms, specifically the time to maximum activity, ratios of peak activity, and time to return to baseline activity. Both the ninety-second and the fifteen-minute /sup 99m/Tc-DTPA studies were superior to the 131 I-Hippuran renogram in assessing RAS. It is concluded that (1) /sup 99m/Tc-DTPA studies are superior to 131 I-Hippuran renograms for detecting unilateral experimental RAS, and (2) /sup 99m/Tc-DTPA may be the radioisotope of choice for detection and follow-up of RAS

  11. A novel vascular clip design for the reliable induction of 2-kidney, 1-clip hypertension in the rat.

    Science.gov (United States)

    Chelko, Stephen P; Schmiedt, Chad W; Lewis, Tristan H; Lewis, Stephen J; Robertson, Tom P

    2012-02-01

    The 2-kidney, 1-clip (2K1C) model has provided many insights into the pathogenesis of renovascular hypertension. However, studies using the 2K1C model often report low success rates of hypertension, with typical success rates of just 40-60%. We hypothesized that these low success rates are due to fundamental design flaws in the clips traditionally used in 2K1C models. Specifically, the gap widths of traditional silver clips may not be maintained during investigator handling and these clips may also be easily dislodged from the renal artery following placement. Therefore, we designed and tested a novel vascular clip possessing design features to maintain both gap width and position around the renal artery. In this initial study, application of these new clips to the left renal artery produced reliable and consistent levels of hypertension in rats. Nine-day application of clips with gap widths of 0.27, 0.25, and 0.23 mm elicited higher mean arterial blood pressures of 112 ± 4, 121 ± 6, and 135 ± 7 mmHg, respectively (n = 8 for each group), than those of sham-operated controls (95 ± 2 mmHg, n = 8). Moreover, 8 out of 8 rats in each of the 0.23 and 0.25 mm 2K1C groups were hypertensive, whereas 7 out of 8 rats in the 0.27 mm 2K1C group were hypertensive. Plasma renin concentrations were also increased in all 2K1C groups compared with sham-operated controls. In summary, this novel clip design may help eliminate the large degree of unreliability commonly encountered with the 2K1C model.

  12. Flax lignan concentrate attenuate hypertension and abnormal left ventricular contractility via modulation of endogenous biomarkers in two-kidney-one-clip (2K1C hypertensive rats

    Directory of Open Access Journals (Sweden)

    Sameer Hanmantrao Sawant

    Full Text Available ABSTRACT The present investigation was designed to study the effect of flax lignan concentrate obtained from Linum usitatissimum L., Linaceae, in two-kidney, one clip (2K1C hypertension model in Wistar rats. 2K1C Goldblatt model rats were divided randomly into six groups: sham, 2K1C control, captopril (30 mg/kg, flax lignan concentrate (200, 400 and 800 mg/kg. Flax lignan concentrate and captopril were administered daily for eight consecutive weeks. Sham-operated, and 2K1C control rats received the vehicle. Treatment with flax lignan concentrate (400 and 800 mg/kg significantly and dose-dependently restored the hemodynamic parameters systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and left ventricular functions. The flax lignan concentrate significantly restored the elevated hepatic, renal and cardiac marker enzymes in the serum. It also restored the organs weights (kidney and heart, serum electrolyte level and histological abnormalities. Furthermore, flax lignan concentrate significantly elevated the level of biochemical markers that is enzymatic antioxidants superoxide dismutase, glutathione and decreased malondialdehyde in the heart and kidney tissues. Meanwhile, we found that plasma nitric oxide and plasma nitric oxide synthase contents were significantly increased in the flax lignan concentrate-treated group, and plasma endothelin-1 and renal angiotensin-II levels were significantly lower than 2K1C hypertensive group. In conclusion, the antihypertensive and antioxidant effect of flax lignan concentrate were dose-dependent and at the highest dose (i.e. 800 mg/kg similar to those of captopril (30 mg/kg. It is suggested that flax lignan concentrate reduced blood pressure by reduction of renal angiotensin-II level, inhibition of plasma endothelin-1 production, induction of the nitric oxide, nitric oxide synthase and in vivo antioxidant defense system.

  13. Hemodynamic control of in patients with concomitant hypertensive disease during brain aneurysm clipping

    OpenAIRE

    Dzyuba, D.O.; Melnik, A.F.; Yavorsky, F.A.

    2018-01-01

    The article describes the state of the problem of hemodynamic control during brain aneurysm clipping in concomitant hypertensive disease. Author studies hemodynamic control by using magnesia therapy with the addition of clonidine solution and infusion of urapidil solution. Based on the results of the study, the advantages of urapidil infusion are given.

  14. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats

    OpenAIRE

    Stephen P. Chelko; Chad W. Schmiedt; Tristan H. Lewis; Tom P. Robertson; Stephen J. Lewis

    2014-01-01

    This study compared the contractile responses elicited by angiotensin II (AII), arginine vasopressin (AVP), and 5-hydroxytryptamine (5-HT) in isolated occipital arteries (OAs) from sham-operated (SHAM) and 2-kidney, 1-clip (2K-1C) hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery) and distal segments (closer to the nodose ganglion) and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, hea...

  15. Renovascular hypertension in spontaneous hypertensive rats: an experimental model of renal artery stenosis superimposed on essential hypertension.

    Science.gov (United States)

    Rosenthal, T; Bass, A; Grossman, E; Shani, M; Griffel, B; Adar, R

    1987-09-01

    Renovascular hypertension superimposed on essential hypertension, a condition encountered in the elderly, was studied. An experimental animal model consisting of a two-kidney one-clip Goldblatt preparation in the spontaneous hypertensive (SHR) rat, that would simulate this condition, was designed. A 0.25 mm silver clip was placed on the left renal artery of SHR male rats. The same procedure performed on WKY rats served as control. All experiments were performed on low, normal, and rich sodium diet. Systolic blood pressure (BP) was measured by tail-cuff method. Plasma renin concentration (PRC) was determined before and after clipping of the renal artery. Results were as follows: Mean systolic BP increased significantly in clipped rats fed with normal and rich sodium diets. SHR showed an increase from 144 +/- 3 (mean + s.e.m.) to 168 +/- 3 mmHg, and WKY rats showed an increase from 120 +/- 2 to 139 +/- 5 mmHg. There was a two- to threefold rise in PRC. A low-salt diet given prior to clipping prevented the appearance of renovascular hypertension despite a significant rise in PRC. We concluded that renal artery narrowing plays a significant role in the rise of BP in the basically essential type of hypertension.

  16. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats.

    Science.gov (United States)

    Chelko, Stephen P; Schmiedt, Chad W; Lewis, Tristan H; Robertson, Tom P; Lewis, Stephen J

    2014-01-01

    This study compared the contractile responses elicited by angiotensin II (AII), arginine vasopressin (AVP), and 5-hydroxytryptamine (5-HT) in isolated occipital arteries (OAs) from sham-operated (SHAM) and 2-kidney, 1-clip (2K-1C) hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery) and distal segments (closer to the nodose ganglion) and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, heart rates, and plasma renin concentrations than SHAM rats. The contractile responses to AII were markedly diminished in both proximal and distal segments of OAs from 2K-1C rats as compared to those from SHAM rats. The responses elicited by AVP were substantially greater in distal than in proximal segments of OAs from SHAM rats and that AVP elicited similar responses in OA segments from 2K-1C rats. The responses elicited by 5-HT were similar in proximal and distal segments from SHAM and 2K-1C rats. These results demonstrate that continued exposure to circulating AII and AVP in 2K-1C rats reduces the contractile efficacy of AII but not AVP or 5-HT. The diminished responsiveness to AII may alter the physiological status of OAs in vivo.

  17. Occipital Artery Function during the Development of 2-Kidney, 1-Clip Hypertension in Rats

    Directory of Open Access Journals (Sweden)

    Stephen P. Chelko

    2014-01-01

    Full Text Available This study compared the contractile responses elicited by angiotensin II (AII, arginine vasopressin (AVP, and 5-hydroxytryptamine (5-HT in isolated occipital arteries (OAs from sham-operated (SHAM and 2-kidney, 1-clip (2K-1C hypertensive rats. OAs were isolated and bisected into proximal segments (closer to the common carotid artery and distal segments (closer to the nodose ganglion and mounted separately on myographs. On day 9, 2K-1C rats had higher mean arterial blood pressures, heart rates, and plasma renin concentrations than SHAM rats. The contractile responses to AII were markedly diminished in both proximal and distal segments of OAs from 2K-1C rats as compared to those from SHAM rats. The responses elicited by AVP were substantially greater in distal than in proximal segments of OAs from SHAM rats and that AVP elicited similar responses in OA segments from 2K-1C rats. The responses elicited by 5-HT were similar in proximal and distal segments from SHAM and 2K-1C rats. These results demonstrate that continued exposure to circulating AII and AVP in 2K-1C rats reduces the contractile efficacy of AII but not AVP or 5-HT. The diminished responsiveness to AII may alter the physiological status of OAs in vivo.

  18. Technetium-99m DTPA renal flow studies in Goldblatt hypertension

    International Nuclear Information System (INIS)

    Nally, J.V.; Clarke, H.S.; Windham, J.P.; Grecos, G.P.; Gross, M.L.; Potvin, W.J.

    1985-01-01

    Computer-assisted dynamic renal studies were performed on a group of 14 mongrel dogs before and after the induction of unilateral renal artery stenosis. Ninety-second technetium-99m diethylenetriaminepentaacetic acid ([/sup 99m/Tc]DTPA), 15-min [/sup 99m/Tc]DTPA, and 30-min iodine-131 orthoiodohippurate ([ 131 I]hippuran) time-activity curves were analyzed and correlated with reduction of renal blood flow as measured by electromagnetic flow probe and PAH clearance techniques. For blood flow reductions greater than 33%, the [/sup 99m/Tc]DTPA studies were judged diagnostic of unilateral renal artery stenosis in all cases, whereas the [ 131 I]hippuran time-activity curves were indicative of stenosis in only six of ten studies. Thus, in this model we find the computer-assisted 90-sec [/sup 99m/Tc]DTPA renal flow study to be superior to conventional [ 131 I]hippuran renography in the diagnosis of moderate-to-serve unilateral renal artery stenosis

  19. MiR-139-3p is related to left ventricular hypertrophy and cardiomyocyte apoptosis in two-kidney one-clip hypertensive rats

    Directory of Open Access Journals (Sweden)

    Yang Xiaomin

    2015-01-01

    Full Text Available MicroRNAs (miRNAs are important post-transcriptional regulators of gene expression in many physiological and pathological processes. Previous studies have reported the role of miR-139-3p in cancer. However, its specific roles and functions in the heart undergoing hypertrophy have yet to be fully elucidated. In the present study, a significant upregulation of miR-139-3p expression was demonstrated in the left ventricular myocardium of two-kidney one-clip (2K1C hypertensive rats using microarray and quantitative real-time PCR (qRT-PCR. Based on computational analysis, we observed that miR-139-3p can control the expression of mitogen-activated protein kinase 1 (MAPK1 as a target gene, which is essential for the induction of cardiac hypertrophy and cardiomyocyte apoptosis. This study provides first information that the highly expressed miR-139-3p might be closely involved in MAPK1-mediated cardiac hypertrophy and cardiomyocyte apoptotic processes in 2K1C rat.

  20. Quantitative evaluation of CART-containing cells in urinary bladder of rats with renovascular hypertension

    Directory of Open Access Journals (Sweden)

    I. Janiuk

    2015-04-01

    Full Text Available Recent biological advances make it possible to discover new peptides associated with hypertension. The cocaine- and amphetamine-regulated transcript (CART is a known factor in appetite and feeding behaviour. Various lines of evidence suggest that this peptide participates not only in control of feeding behaviour but also in the regulation of the cardiovascular and sympathetic systems and blood pressure. The role of CART in blood pressure regulation led us to undertake a study aimed at analysing quantitative changes in CART-containing cells in urinary bladders (UB of rats with renovascular hypertension. We used the Goldblatt model of arterial hypertension (two-kidney, one clip to evaluate quantitative changes. This model provides researchers with a commonly used tool to analyse the renin-angiotensin system of blood pressure control and, eventually, to develop drugs for the treatment of chronic hypertension. The study was performed on sections of urinary bladders of rats after 3-, 14-, 28-, 42 and 91 days from hypertension induction. Immunohistochemical identification of CART cells was performed on paraffin for the UBs of all the study animals. CART was detected in the endocrine cells, especially numerous in the submucosa and muscularis layers, with a few found in the transitional epithelium and only occasionally in serosa. Hypertension significantly increased the number of CART-positive cells in the rat UBs. After 3 and 42 days following the procedure, statistically significantly higher numbers of CART-positive cells were identified in comparison with the control animals. The differences between the hypertensive rats and the control animals concerned not only the number density of CART-immunoreactive cells but also their localization. After a 6-week period, each of the rats subjected to the renal artery clipping procedure developed stable hypertension. CART appeared in numerous transitional epithelium cells. As this study provides novel findings

  1. Noradrenaline concentration and turnover in nuclei of the hypothalamus and the medulla oblongata at two stages in the development of renal hypertension in the rat

    NARCIS (Netherlands)

    Wijnen, H.J.L.M.; Kloet, E.R. de; Versteeg, D.H.G.; Jong, Wybren de

    1980-01-01

    The noradrenaline concentration and the α-methyl-para-tyrosine (α-MPT)-induced disappearance of noradrenaline were determined in several nuclei of the hypothalamus and the medulla oblongata of renal hypertensive rats (two-kidney Goldblatt hypertension). A decreased α-MPT-induced disappearance of

  2. Hypertension

    Science.gov (United States)

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Obstructive sleep apnea is a potentially serious sleep ...

  3. hypertension

    Directory of Open Access Journals (Sweden)

    Emine Hatipoglu

    2013-05-01

    Full Text Available Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.

  4. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  5. Hypertension

    OpenAIRE

    Farrugia, Emanuel

    2004-01-01

    Hypertension is a rapidly moving clinical field with frequent developments in new pharmacologic agents and management strategies. Perhaps more importantly, there have been substantial improvements in our understanding of how best to use the drugs available to us. In this article, I will review some of the more important advances in our understanding of hypertension over the past two years, specifically by reviewing six important trials, one survey and two sets of guidelines, all published bet...

  6. Comment on "Clouds and the Faint Young Sun Paradox" by Goldblatt and Zahnle (2011

    Directory of Open Access Journals (Sweden)

    R. Rondanelli

    2012-03-01

    Full Text Available Goldblatt and Zahnle (2011 raise a number of issues related to the possibility that cirrus clouds can provide a solution to the faint young sun paradox. Here, we argue that: (1 climates having a lower than present mean surface temperature cannot be discarded as solutions to the faint young sun paradox, (2 the detrainment from deep convective clouds in the tropics is a well-established physical mechanism for the formation of high clouds that have a positive radiative forcing (even if the possible role of these clouds as a negative climate feedback remains controversial and (3 even if some cloud properties are not mutually consistent with observations in radiative transfer parameterizations, the most relevant consistency (for the purpose of hypothesis testing is with observations of the cloud radiative forcing. Therefore, we maintain that cirrus clouds, as observed in the current climate and covering a large region of the tropics, can provide a solution to the faint young sun paradox, or at least ease the amount of CO2 or other greenhouse substances needed to provide temperatures above freezing during the Archean.

  7. Modified Clipped LMS Algorithm

    Directory of Open Access Journals (Sweden)

    Lotfizad Mojtaba

    2005-01-01

    Full Text Available Abstract A new algorithm is proposed for updating the weights of an adaptive filter. The proposed algorithm is a modification of an existing method, namely, the clipped LMS, and uses a three-level quantization ( scheme that involves the threshold clipping of the input signals in the filter weight update formula. Mathematical analysis shows the convergence of the filter weights to the optimum Wiener filter weights. Also, it can be proved that the proposed modified clipped LMS (MCLMS algorithm has better tracking than the LMS algorithm. In addition, this algorithm has reduced computational complexity relative to the unmodified one. By using a suitable threshold, it is possible to increase the tracking capability of the MCLMS algorithm compared to the LMS algorithm, but this causes slower convergence. Computer simulations confirm the mathematical analysis presented.

  8. Clip, connect, clone

    DEFF Research Database (Denmark)

    Fujima, Jun; Lunzer, Aran; Hornbæk, Kasper

    2010-01-01

    using three mechanisms: clipping of input and result elements from existing applications to form cells on a spreadsheet; connecting these cells using formulas, thus enabling result transfer between applications; and cloning cells so that multiple requests can be handled side by side. We demonstrate...

  9. Fuzzy expert systems using CLIPS

    Science.gov (United States)

    Le, Thach C.

    1994-01-01

    This paper describes a CLIPS-based fuzzy expert system development environment called FCLIPS and illustrates its application to the simulated cart-pole balancing problem. FCLIPS is a straightforward extension of CLIPS without any alteration to the CLIPS internal structures. It makes use of the object-oriented and module features in CLIPS version 6.0 for the implementation of fuzzy logic concepts. Systems of varying degrees of mixed Boolean and fuzzy rules can be implemented in CLIPS. Design and implementation issues of FCLIPS will also be discussed.

  10. Seismic signals hard clipping overcoming

    Science.gov (United States)

    Olszowa, Paula; Sokolowski, Jakub

    2018-01-01

    In signal processing the clipping is understand as the phenomenon of limiting the signal beyond certain threshold. It is often related to overloading of a sensor. Two particular types of clipping are being recognized: soft and hard. Beyond the limiting value soft clipping reduces the signal real gain while the hard clipping stiffly sets the signal values at the limit. In both cases certain amount of signal information is lost. Obviously if one possess the model which describes the considered signal and the threshold value (which might be slightly more difficult to obtain in the soft clipping case), the attempt of restoring the signal can be made. Commonly it is assumed that the seismic signals take form of an impulse response of some specific system. This may lead to belief that the sine wave may be the most appropriate to fit in the clipping period. However, this should be tested. In this paper the possibility of overcoming the hard clipping in seismic signals originating from a geoseismic station belonging to an underground mine is considered. A set of raw signals will be hard-clipped manually and then couple different functions will be fitted and compared in terms of least squares. The results will be then analysed.

  11. Mounting clips for panel installation

    Science.gov (United States)

    Cavieres, Andres; Al-Haddad, Tristan; Goodman, Joseph; Valdes, Francisco

    2017-02-14

    An exemplary mounting clip for removably attaching panels to a supporting structure comprises a base, spring locking clips, a lateral flange, a lever flange, and a spring bonding pad. The spring locking clips extend upwardly from the base. The lateral flange extends upwardly from a first side of the base. The lateral flange comprises a slot having an opening configured to receive at least a portion of one of the one or more panels. The lever flange extends outwardly from the lateral flange. The spring bonding flange extends downwardly from the lever flange. At least a portion of the first spring bonding flange comprises a serrated edge for gouging at least a portion of the one or more panels when the one or more panels are attached to the mounting clip to electrically and mechanically couple the one or more panels to the mounting clip.

  12. Concept of the central clip

    DEFF Research Database (Denmark)

    Alegria-Barrero, Eduardo; Chan, Pak Hei; Foin, Nicolas

    2014-01-01

    AIMS: Percutaneous edge-to-edge mitral valve repair with the MitraClip(®) was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. We analyse the concept of the central clip and the predictors for the need of more than one MitraClip(®) in our high.......8±10.7 years (30 males, 13 females; mean logistic EuroSCORE 24.1±11, mean LVEF 47.5±18.5%; mean±SD) were treated. Median follow-up was 385 days (104-630; Q1-Q3). Device implantation success was 93%. All patients were treated following the central clip concept: 52.5% of MR was degenerative in aetiology and 47....... The presence of a restricted posterior mitral valve leaflet (PML) was inversely correlated with the need for more than one clip (p=0.02). A cut-off value of ≥7.5 mm for vena contracta predicted the need for a second clip (sensitivity 83%, specificity 90%, p=0.01). CONCLUSIONS: The central MitraClip(®) concept...

  13. Antarctic news clips - 1992

    Science.gov (United States)

    1992-07-01

    The newspaper and magazine stories selected for this book present only a sampling of one year's (July 1991 to July 1992) news coverage of Antarctica. The only requirement for inclusion in this publication is that the article's subject matter pertains or refers to Antarctica in some way - whether it is focused on the science done there, or on the people who play such a large part in the work accomplished, or on the issues related to it. No attempt has been made to correlate the number of articles, or their length, with the importance of the subjects treated. Clippings are provided to the Foundation by a service that searches for items containing the phrase 'National Science Foundation'. Identical versions of many stories, especially those written and distributed by wire services such as the Associated Press and United Press International, and by syndicated columnists, are published in numerous papers across the United States. Other articles are submitted from a variety of sources, including interested readers across the United States and in New Zealand.

  14. Mounting clips for panel installation

    Science.gov (United States)

    Cavieres, Andres; Al-Haddad, Tristan; Goodman, Joseph

    2017-07-11

    A photovoltaic panel mounting clip comprising a base, central indexing tabs, flanges, lateral indexing tabs, and vertical indexing tabs. The mounting clip removably attaches one or more panels to a beam or the like structure, both mechanically and electrically. It provides secure locking of the panels in all directions, while providing guidance in all directions for accurate installation of the panels to the beam or the like structure.

  15. Post-Vacuum-Assisted Stereotactic Core Biopsy Clip Displacement: A Comparison Between Commercially Available Clips and Surgical Clip.

    Science.gov (United States)

    Yen, Peggy; Dumas, Sandra; Albert, Arianne; Gordon, Paula

    2018-02-01

    The placement of localization clips following percutaneous biopsy is a standard practice for a variety of situations. Subsequent clip displacement creates challenges for imaging surveillance and surgical planning, and may cause confusion amongst radiologists and between surgeons and radiologists. Many causes have been attributed for this phenomenon including the commonly accepted "accordion effect." Herein, we investigate the performance of a low cost surgical clip system against 4 commercially available clips. We retrospectively reviewed 2112 patients who underwent stereotactic vacuum-assisted core biopsy followed by clip placement between January 2013 and June 2016. The primary performance parameter compared was displacement >10 mm following vacuum-assisted stereotactic core biopsy. Within the group of clips that had displaced, the magnitude of displacement was compared. There was a significant difference in displacement among the clip types (P < .0001) with significant pairwise comparisons between pediatric surgical clips and SecureMark (38% vs 28%; P = .001) and SenoMark (38% vs 27%; P = .0001) in the proportion displaced. The surgical clips showed a significant magnitude of displacement of approximately 25% greater average distance displaced. As a whole, the commercial clips performed better than the surgical clip after stereotactic vacuum-assisted core biopsy suggesting the surrounding outer component acts to anchor the central clip and minimizes clip displacement. The same should apply to tomosynthesis-guided biopsy. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  16. Diagnostic applications of nail clippings.

    Science.gov (United States)

    Stephen, Sasha; Tosti, Antonella; Rubin, Adam I

    2015-04-01

    "Nail clipping is a simple technique for diagnosis of several nail unit dermatoses. This article summarizes the practical approach, utility, and histologic findings of a nail clipping in evaluation of onychomycosis, nail unit psoriasis, onychomatricoma, subungual hematoma, melanonychia, and nail cosmetics, and the forensic applications of this easily obtained specimen. It reviews important considerations in optimizing specimen collection, processing methods, and efficacy of special stains in several clinical contexts. Readers will develop a greater understanding and ease of application of this indispensable procedure in assessing nail unit dermatoses." Copyright © 2015 Elsevier Inc. All rights reserved.

  17. 21 CFR 882.4215 - Clip rack.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Clip rack. 882.4215 Section 882.4215 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4215 Clip rack. (a) Identification. A clip rack is a...

  18. Preserving Sharp Edges with Volume Clipping

    NARCIS (Netherlands)

    Termeer, M.A.; Oliván Bescós, J.; Telea, A.C.

    2006-01-01

    Volume clipping is a useful aid for exploring volumetric datasets. To maximize the effectiveness of this technique, the clipping geometry should be flexibly specified and the resulting images should not contain artifacts due to the clipping techniques. We present an improvement to an existing

  19. Author Details

    African Journals Online (AJOL)

    Odigie, IP. Vol 10, No 4 (2000) - Articles High dose vitamin E administration attenuates hypertensin in 2-Kidney 1 Clip Goldblatt hypertensive rats. Details. ISSN: 0189-2657. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms ...

  20. Adding run history to CLIPS

    Science.gov (United States)

    Tuttle, Sharon M.; Eick, Christoph F.

    1991-01-01

    To debug a C Language Integrated Production System (CLIPS) program, certain 'historical' information about a run is needed. It would be convenient for system builders to have the capability to request such information. We will discuss how historical Rete networks can be used for answering questions that help a system builder detect the cause of an error in a CLIPS program. Moreover, the cost of maintaining a historical Rete network is compared with that for a classical Rete network. We will demonstrate that the cost for assertions is only slightly higher for a historical Rete network. The cost for handling retraction could be significantly higher; however, we will show that by using special data structures that rely on hashing, it is also possible to implement retractions efficiently.

  1. Hipertensão Arterial Experimental e Prenhez em Ratas: Repercussões sobre o Peso, Comprimento e Órgãos dos Recém-nascidos Experimental Arterial Hypertension and Pregnancy in Rats: Repercussion Regarding Body Weight Gain, Body Length and Organs of Offspring

    Directory of Open Access Journals (Sweden)

    Rogério Dias

    2000-10-01

    controlled constriction of the main left renal artery and contralateral nephrectomy, according to the technique described by Goldblatt (Goldblatt I: one kidney - one clip hypertension. Afterwards, they were distributed among nonpregnant and pregnant groups. The following newborn groups resulted from the pregnant groups: RN-C (control-newborn group of pregnant rats without surgical treatment, RN-M (manipulation-newborn group of the pregnant rats with surgical manipulation, RN-N (nephrectomized-newborn group of pregnant rats with nephrectomy and Rn-H (hypertensive-newborn group of pregnant rats with hypertension. Results: the RN-N and RN-H groups showed body weight gain ( = 3,64 ± 0,50; or = 3,37 ± 0,44, body length ( = 3,89 ± 0,36; or = 3,68 ± 0,32 and brain weight ( = 0,16 ± 0,01; or = 0,16 ± 0,05, respectively, smaller than the control group ( = 5,40 ± 0,51; or = 4,95 ± 0,23 and or = 0,22 ± 0,04, respectively. In addition, the RN-H group showed the lowest liver weight ( = 0,22 ± 0,03 compared with the other three groups. Conclusion: after statistical analysis, the results obtained showed that the arterial hypertension determined a reduction in body weight, body length, and liver and brain weight of the offspring.

  2. 21 CFR 868.6225 - Nose clip.

    Science.gov (United States)

    2010-04-01

    ... ANESTHESIOLOGY DEVICES Miscellaneous § 868.6225 Nose clip. (a) Identification. A nose clip is a device intended to close a patient's external nares (nostrils) during diagnostic or therapeutic procedures. (b... from the current good manufacturing practice requirements of the quality system regulation in part 820...

  3. Chinese Language Video Clips. [CD-ROM].

    Science.gov (United States)

    Fleming, Stephen; Hipley, David; Ning, Cynthia

    This compact disc includes video clips covering six topics for the learner of Chinese: personal information, commercial transactions, travel and leisure, health and sports, food and school. Filmed on location in Beijing, these naturalistic video clips consist mainly of unrehearsed interviews of ordinary people. The learner is lead through a series…

  4. Sepsis from dropped clips at laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Hussain, Sarwat

    2001-01-01

    We report seven patients in whom five dropped surgical clips and two gallstones were visualized in the peritoneal cavity, on radiological studies. In two, subphrenic abscesses and empyemas developed as a result of dropped clips into the peritoneal cavity during or following laparoscopic cholecystectomy. In one of these two, a clip was removed surgically from the site of an abscess. In two other patients dropped gallstones, and in three, dropped clips led to no complications. These were seen incidentally on studies done for other indications. Abdominal abscess secondary to dropped gallstones is a well-recognized complication of laparoscopic cholecystectomy (LC). We conclude that even though dropped surgical clips usually do not cause problems, they should be considered as a risk additional to other well-known causes of post-LC abdominal sepsis

  5. Automated information retrieval using CLIPS

    Science.gov (United States)

    Raines, Rodney Doyle, III; Beug, James Lewis

    1991-01-01

    Expert systems have considerable potential to assist computer users in managing the large volume of information available to them. One possible use of an expert system is to model the information retrieval interests of a human user and then make recommendations to the user as to articles of interest. At Cal Poly, a prototype expert system written in the C Language Integrated Production System (CLIPS) serves as an Automated Information Retrieval System (AIRS). AIRS monitors a user's reading preferences, develops a profile of the user, and then evaluates items returned from the information base. When prompted by the user, AIRS returns a list of items of interest to the user. In order to minimize the impact on system resources, AIRS is designed to run in the background during periods of light system use.

  6. Intelligent tutoring using HyperCLIPS

    Science.gov (United States)

    Hill, Randall W., Jr.; Pickering, Brad

    1990-01-01

    HyperCard is a popular hypertext-like system used for building user interfaces to databases and other applications, and CLIPS is a highly portable government-owned expert system shell. We developed HyperCLIPS in order to fill a gap in the U.S. Army's computer-based instruction tool set; it was conceived as a development environment for building adaptive practical exercises for subject-matter problem-solving, though it is not limited to this approach to tutoring. Once HyperCLIPS was developed, we set out to implement a practical exercise prototype using HyperCLIPS in order to demonstrate the following concepts: learning can be facilitated by doing; student performance evaluation can be done in real-time; and the problems in a practical exercise can be adapted to the individual student's knowledge.

  7. SOCIOLINGUISTIC IMPORT OF NAME-CLIPPING AMONG ...

    African Journals Online (AJOL)

    NGOZI

    2013-02-27

    Feb 27, 2013 ... experiences which, most of the times, encompass cultural and philosophical ... The art of name clipping goes way back in language history ... describes Akan names as “iconic representation of complete social variables that ...

  8. Integrating CLIPS applications into heterogeneous distributed systems

    Science.gov (United States)

    Adler, Richard M.

    1991-01-01

    SOCIAL is an advanced, object-oriented development tool for integrating intelligent and conventional applications across heterogeneous hardware and software platforms. SOCIAL defines a family of 'wrapper' objects called agents, which incorporate predefined capabilities for distributed communication and control. Developers embed applications within agents and establish interactions between distributed agents via non-intrusive message-based interfaces. This paper describes a predefined SOCIAL agent that is specialized for integrating C Language Integrated Production System (CLIPS)-based applications. The agent's high-level Application Programming Interface supports bidirectional flow of data, knowledge, and commands to other agents, enabling CLIPS applications to initiate interactions autonomously, and respond to requests and results from heterogeneous remote systems. The design and operation of CLIPS agents are illustrated with two distributed applications that integrate CLIPS-based expert systems with other intelligent systems for isolating and mapping problems in the Space Shuttle Launch Processing System at the NASA Kennedy Space Center.

  9. Ocular Hypertension

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué es la hipertensión ocular? ...

  10. Content-based video retrieval by example video clip

    Science.gov (United States)

    Dimitrova, Nevenka; Abdel-Mottaleb, Mohamed

    1997-01-01

    This paper presents a novel approach for video retrieval from a large archive of MPEG or Motion JPEG compressed video clips. We introduce a retrieval algorithm that takes a video clip as a query and searches the database for clips with similar contents. Video clips are characterized by a sequence of representative frame signatures, which are constructed from DC coefficients and motion information (`DC+M' signatures). The similarity between two video clips is determined by using their respective signatures. This method facilitates retrieval of clips for the purpose of video editing, broadcast news retrieval, or copyright violation detection.

  11. Photovoltaic module mounting clip with integral grounding

    Science.gov (United States)

    Lenox, Carl J.

    2010-08-24

    An electrically conductive mounting/grounding clip, usable with a photovoltaic (PV) assembly of the type having an electrically conductive frame, comprises an electrically conductive body. The body has a central portion and first and second spaced-apart arms extending from the central portion. Each arm has first and second outer portions with frame surface-disrupting element at the outer portions.

  12. 76 FR 42730 - Paper Clips From China

    Science.gov (United States)

    2011-07-19

    ... China Determination On the basis of the record \\1\\ developed in the subject five-year review, the United... China would be likely to lead to continuation or recurrence of material injury to an industry in the...), entitled Paper Clips from China: Investigation No. 731-TA-663 (Third Review). By order of the Commission...

  13. Semantic Labeling of Nonspeech Audio Clips

    Directory of Open Access Journals (Sweden)

    Xiaojuan Ma

    2010-01-01

    Full Text Available Human communication about entities and events is primarily linguistic in nature. While visual representations of information are shown to be highly effective as well, relatively little is known about the communicative power of auditory nonlinguistic representations. We created a collection of short nonlinguistic auditory clips encoding familiar human activities, objects, animals, natural phenomena, machinery, and social scenes. We presented these sounds to a broad spectrum of anonymous human workers using Amazon Mechanical Turk and collected verbal sound labels. We analyzed the human labels in terms of their lexical and semantic properties to ascertain that the audio clips do evoke the information suggested by their pre-defined captions. We then measured the agreement with the semantically compatible labels for each sound clip. Finally, we examined which kinds of entities and events, when captured by nonlinguistic acoustic clips, appear to be well-suited to elicit information for communication, and which ones are less discriminable. Our work is set against the broader goal of creating resources that facilitate communication for people with some types of language loss. Furthermore, our data should prove useful for future research in machine analysis/synthesis of audio, such as computational auditory scene analysis, and annotating/querying large collections of sound effects.

  14. A defect in the CLIP1 gene (CLIP-170) can cause autosomal recessive intellectual disability

    OpenAIRE

    Larti, Farzaneh; Kahrizi, Kimia; Musante, Luciana; Hu, Hao; Papari, Elahe; Fattahi, Zohreh; Bazazzadegan, Niloofar; Liu, Zhe; Banan, Mehdi; Garshasbi, Masoud; Wienker, Thomas F; Hilger Ropers, H; Galjart, Niels; Najmabadi, Hossein

    2015-01-01

    In the context of a comprehensive research project, investigating novel autosomal recessive intellectual disability (ARID) genes, linkage analysis based on autozygosity mapping helped identify an intellectual disability locus on Chr.12q24, in an Iranian family (LOD score=3.7). Next-generation sequencing (NGS) following exon enrichment in this novel interval, detected a nonsense mutation (p.Q1010*) in the CLIP1 gene. CLIP1 encodes a member of microtubule (MT) plus-end tracking proteins, which ...

  15. Portal Hypertension

    Science.gov (United States)

    ... Overview of Gallbladder Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Professor of Medicine, ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

  16. [Secondary hypertension].

    Science.gov (United States)

    Yoshida, Yuichi; Shibata, Hirotaka

    2015-11-01

    Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice.

  17. Secondary Hypertension

    Science.gov (United States)

    Secondary hypertension Overview Secondary hypertension (secondary high blood pressure) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, ...

  18. Biocompatibility of Plastic Clip in Neurocranium - Experimental Study on Dogs.

    Science.gov (United States)

    Delibegovic, Samir; Dizdarevic, Kemal; Cickusic, Elmir; Katica, Muhamed; Obhodjas, Muamer; Ocus, Muhamed

    2016-01-01

    A potential advantage of the use of the plastic clips in neurosurgery is their property of causing fewer artifacts than titanium clips as assessed by computed tomography and magnetic resonance scans. The biocompatibility of plastic clips was demonstrated in the peritoneal cavity, but their behavior in the neurocranium is not known. Twelve aggressive stray dogs designated for euthanasia were taken for this experimental study. The animals were divided into two groups. In all cases, after anesthesia, a craniotomy was performed, and after opening the dura, a proximal part titanium clip was placed on the isolated superficial Sylvian vein (a permanent Yasargil FT 746 T clip at a 90° angle, while a plastic Hem-o-lok clip ML was placed on another part of the vein). The first group of animals was sacrificed on the 7 th postoperative day and the second group on the 60 th postoperative day. Samples of tissue around the clips were taken for a histopathological evaluation. The plastic clip caused a more intensive tissue reaction than the titanium clip on the 7 th postoperative day, but there was no statistical difference. Even on the 60 th postoperative day there was no significant difference in tissue reaction between the titanium and plastic clips. These preliminary results confirm the possibility for the use of plastic clips in neurosurgery. Before their use in human neurosurgery, further studies are needed to investigate the long-term effects of the presence of plastic clips in the neurocranium, as well as studies of the aneurysmal model.

  19. 21 CFR 886.1410 - Ophthalmic trial lens clip.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ophthalmic trial lens clip. 886.1410 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Diagnostic Devices § 886.1410 Ophthalmic trial lens clip. (a) Identification. An ophthalmic trial lens clip is a device intended to hold prisms, spheres, cylinders, or...

  20. A defect in the CLIP1 gene (CLIP-170) can cause autosomal recessive intellectual disability.

    Science.gov (United States)

    Larti, Farzaneh; Kahrizi, Kimia; Musante, Luciana; Hu, Hao; Papari, Elahe; Fattahi, Zohreh; Bazazzadegan, Niloofar; Liu, Zhe; Banan, Mehdi; Garshasbi, Masoud; Wienker, Thomas F; Ropers, H Hilger; Galjart, Niels; Najmabadi, Hossein

    2015-03-01

    In the context of a comprehensive research project, investigating novel autosomal recessive intellectual disability (ARID) genes, linkage analysis based on autozygosity mapping helped identify an intellectual disability locus on Chr.12q24, in an Iranian family (LOD score = 3.7). Next-generation sequencing (NGS) following exon enrichment in this novel interval, detected a nonsense mutation (p.Q1010*) in the CLIP1 gene. CLIP1 encodes a member of microtubule (MT) plus-end tracking proteins, which specifically associates with the ends of growing MTs. These proteins regulate MT dynamic behavior and are important for MT-mediated transport over the length of axons and dendrites. As such, CLIP1 may have a role in neuronal development. We studied lymphoblastoid and skin fibroblast cell lines established from healthy and affected patients. RT-PCR and western blot analyses showed the absence of CLIP1 transcript and protein in lymphoblastoid cells derived from affected patients. Furthermore, immunofluorescence analyses showed MT plus-end staining only in fibroblasts containing the wild-type (and not the mutant) CLIP1 protein. Collectively, our data suggest that defects in CLIP1 may lead to ARID.

  1. EFFECT OF CHRONIC ACE-INHIBITION ON THE DIAGNOSTIC-VALUE OF RENOGRAPHY FOR RENOVASCULAR HYPERTENSION - A PRELIMINARY-REPORT

    NARCIS (Netherlands)

    VISSCHER, CA; DEZEEUW, D; HUISMAN, RM

    1995-01-01

    We compared the effects of acute and chronic ACE inhibition (ACEi) on the I-123-hippurate in the stenotic kidney of two 2-kidney, 1-clip hypertensive dogs. In the period after clip implantation poststenotic renograms without ACEi of both dogs were normal. Acute ACEi always resulted in delayed

  2. Morphologic changes of cerebral veins in hypertensive rats: venous collagenosis is associated with hypertension.

    Science.gov (United States)

    Zhou, Min; Mao, Lijuan; Wang, Ying; Wang, Qian; Yang, Zhiyun; Li, Shurong; Li, Ling

    2015-03-01

    The aims of this study were to determine whether arterial hypertension could affect the venous system of brain and to find out the consequent pathologic changes of cerebral veins. Thirty male Sprague-Dawley rats were divided into 2 groups: a sham-clipped group and a stroke-prone renovascular hypertensive rat group. A 2-kidney 2-clip rat model was used to induce renovascular hypertension in the hypertensive group. Systolic blood pressure was measured by tail cuff once each week. Susceptibility-weighted imaging (SWI) was performed at 12, 16, and 20 weeks after surgery. All the rats were sacrificed after the SWI examination at 20 weeks after surgery. The brains were extracted and embedded in paraffin for histologic examination. Masson trichrome staining was performed to identify venous collagenosis. The sham group demonstrated less prominence of cerebral veins compared with hypertensive groups (P veins on SWI as a sign of venous hypertension and the thickened cerebral venous walls (venous collagenosis), which may play a role in cerebral ischemia and/or infarction, are both consequences of long-term hypertension in hypertensive rats. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Cortical Response Similarities Predict which Audiovisual Clips Individuals Viewed, but Are Unrelated to Clip Preference.

    Directory of Open Access Journals (Sweden)

    David A Bridwell

    Full Text Available Cortical responses to complex natural stimuli can be isolated by examining the relationship between neural measures obtained while multiple individuals view the same stimuli. These inter-subject correlation's (ISC's emerge from similarities in individual's cortical response to the shared audiovisual inputs, which may be related to their emergent cognitive and perceptual experience. Within the present study, our goal is to examine the utility of using ISC's for predicting which audiovisual clips individuals viewed, and to examine the relationship between neural responses to natural stimuli and subjective reports. The ability to predict which clips individuals viewed depends on the relationship of the EEG response across subjects and the nature in which this information is aggregated. We conceived of three approaches for aggregating responses, i.e. three assignment algorithms, which we evaluated in Experiment 1A. The aggregate correlations algorithm generated the highest assignment accuracy (70.83% chance = 33.33% and was selected as the assignment algorithm for the larger sample of individuals and clips within Experiment 1B. The overall assignment accuracy was 33.46% within Experiment 1B (chance = 06.25%, with accuracies ranging from 52.9% (Silver Linings Playbook to 11.75% (Seinfeld within individual clips. ISC's were significantly greater than zero for 15 out of 16 clips, and fluctuations within the delta frequency band (i.e. 0-4 Hz primarily contributed to response similarities across subjects. Interestingly, there was insufficient evidence to indicate that individuals with greater similarities in clip preference demonstrate greater similarities in cortical responses, suggesting a lack of association between ISC and clip preference. Overall these results demonstrate the utility of using ISC's for prediction, and further characterize the relationship between ISC magnitudes and subjective reports.

  4. Cortical Response Similarities Predict which Audiovisual Clips Individuals Viewed, but Are Unrelated to Clip Preference.

    Science.gov (United States)

    Bridwell, David A; Roth, Cullen; Gupta, Cota Navin; Calhoun, Vince D

    2015-01-01

    Cortical responses to complex natural stimuli can be isolated by examining the relationship between neural measures obtained while multiple individuals view the same stimuli. These inter-subject correlation's (ISC's) emerge from similarities in individual's cortical response to the shared audiovisual inputs, which may be related to their emergent cognitive and perceptual experience. Within the present study, our goal is to examine the utility of using ISC's for predicting which audiovisual clips individuals viewed, and to examine the relationship between neural responses to natural stimuli and subjective reports. The ability to predict which clips individuals viewed depends on the relationship of the EEG response across subjects and the nature in which this information is aggregated. We conceived of three approaches for aggregating responses, i.e. three assignment algorithms, which we evaluated in Experiment 1A. The aggregate correlations algorithm generated the highest assignment accuracy (70.83% chance = 33.33%) and was selected as the assignment algorithm for the larger sample of individuals and clips within Experiment 1B. The overall assignment accuracy was 33.46% within Experiment 1B (chance = 06.25%), with accuracies ranging from 52.9% (Silver Linings Playbook) to 11.75% (Seinfeld) within individual clips. ISC's were significantly greater than zero for 15 out of 16 clips, and fluctuations within the delta frequency band (i.e. 0-4 Hz) primarily contributed to response similarities across subjects. Interestingly, there was insufficient evidence to indicate that individuals with greater similarities in clip preference demonstrate greater similarities in cortical responses, suggesting a lack of association between ISC and clip preference. Overall these results demonstrate the utility of using ISC's for prediction, and further characterize the relationship between ISC magnitudes and subjective reports.

  5. Training model for cerebral aneurysm clipping

    Directory of Open Access Journals (Sweden)

    Hiroshi Tenjin, M.D., Ph.D.

    2017-12-01

    Full Text Available Clipping of cerebral aneurysms is still an important skill in neurosurgery. We have made a training model for the clipping of cerebral aneurysms. The concepts for the model were 1: training model for beginners, 2: three dimensional manipulation using an operating microscope, 3: the aneurysm model is to be perfused by simulated blood causing premature rupture. The correct relationship between each tissue, and softness of the brain and vessels were characteristics of the model. The skull, brain, arteries, and veins were made using a 3D printer with data from DICOM. The brain and vessels were made from polyvinyl alcohol (PVA. One training course was held and this model was useful for training of cerebral aneurysm surgery for young neurosurgeons.

  6. Modeling Timbre Similarity of Short Music Clips.

    Science.gov (United States)

    Siedenburg, Kai; Müllensiefen, Daniel

    2017-01-01

    There is evidence from a number of recent studies that most listeners are able to extract information related to song identity, emotion, or genre from music excerpts with durations in the range of tenths of seconds. Because of these very short durations, timbre as a multifaceted auditory attribute appears as a plausible candidate for the type of features that listeners make use of when processing short music excerpts. However, the importance of timbre in listening tasks that involve short excerpts has not yet been demonstrated empirically. Hence, the goal of this study was to develop a method that allows to explore to what degree similarity judgments of short music clips can be modeled with low-level acoustic features related to timbre. We utilized the similarity data from two large samples of participants: Sample I was obtained via an online survey, used 16 clips of 400 ms length, and contained responses of 137,339 participants. Sample II was collected in a lab environment, used 16 clips of 800 ms length, and contained responses from 648 participants. Our model used two sets of audio features which included commonly used timbre descriptors and the well-known Mel-frequency cepstral coefficients as well as their temporal derivates. In order to predict pairwise similarities, the resulting distances between clips in terms of their audio features were used as predictor variables with partial least-squares regression. We found that a sparse selection of three to seven features from both descriptor sets-mainly encoding the coarse shape of the spectrum as well as spectrotemporal variability-best predicted similarities across the two sets of sounds. Notably, the inclusion of non-acoustic predictors of musical genre and record release date allowed much better generalization performance and explained up to 50% of shared variance ( R 2 ) between observations and model predictions. Overall, the results of this study empirically demonstrate that both acoustic features related

  7. CLIP Tool Kit (CTK): a flexible and robust pipeline to analyze CLIP sequencing data.

    Science.gov (United States)

    Shah, Ankeeta; Qian, Yingzhi; Weyn-Vanhentenryck, Sebastien M; Zhang, Chaolin

    2017-02-15

    UV cross-linking and immunoprecipitation (CLIP), followed by high-throughput sequencing, is a powerful biochemical assay that maps in vivo protein-RNA interactions on a genome-wide scale. The CLIP Tool Kit (CTK) aims at providing a set of tools for flexible, streamlined and comprehensive CLIP data analysis. This software package extends the scope of our original CIMS package. The software is implemented in Perl. The source code and detailed documentation are available at http://zhanglab.c2b2.columbia.edu/index.php/CTK . cz2294@columbia.edu. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  8. Hardware Implementation Of Line Clipping A lgorithm By Using FPGA

    Directory of Open Access Journals (Sweden)

    Amar Dawod

    2013-04-01

    Full Text Available The computer graphics system performance is increasing faster than any other computing application. Algorithms for line clipping against convex polygons and lines have been studied for a long time and many research papers have been published so far. In spite of the latest graphical hardware development and significant increase of performance the clipping is still a bottleneck of any graphical system. So its implementation in hardware is essential for real time applications. In this paper clipping operation is discussed and a hardware implementation of the line clipping algorithm is presented and finally formulated and tested using Field Programmable Gate Arrays (FPGA. The designed hardware unit consists of two parts : the first is positional code generator unit and the second is the clipping unit. Finally it is worth mentioning that the  designed unit is capable of clipping (232524 line segments per second.       

  9. A CLIPS expert system for clinical flow cytometry data analysis

    Science.gov (United States)

    Salzman, G. C.; Duque, R. E.; Braylan, R. C.; Stewart, C. C.

    1990-01-01

    An expert system is being developed using CLIPS to assist clinicians in the analysis of multivariate flow cytometry data from cancer patients. Cluster analysis is used to find subpopulations representing various cell types in multiple datasets each consisting of four to five measurements on each of 5000 cells. CLIPS facts are derived from results of the clustering. CLIPS rules are based on the expertise of Drs. Stewart, Duque, and Braylan. The rules incorporate certainty factors based on case histories.

  10. Journal of Clipped Words in Reader's Digest Magazine

    OpenAIRE

    Simanjuntak, Lestari

    2012-01-01

    This study deals with Clipped Words in the “Laughter, the Best Medicine” of Reader's Digest. The objectives of the study are to find out the types of clipped words which are used in the “Laughter, the Best Medicine” of Reader's Digest, to find out sthe dominantly used in the whole story and to reason the dominant clipped word use in the text. The study use descriptive qualitative method. The data were collected from seventeen selected Reader's Digest which contains the clipped word by applie...

  11. Authoring Data-Driven Videos with DataClips.

    Science.gov (United States)

    Amini, Fereshteh; Riche, Nathalie Henry; Lee, Bongshin; Monroy-Hernandez, Andres; Irani, Pourang

    2017-01-01

    Data videos, or short data-driven motion graphics, are an increasingly popular medium for storytelling. However, creating data videos is difficult as it involves pulling together a unique combination of skills. We introduce DataClips, an authoring tool aimed at lowering the barriers to crafting data videos. DataClips allows non-experts to assemble data-driven "clips" together to form longer sequences. We constructed the library of data clips by analyzing the composition of over 70 data videos produced by reputable sources such as The New York Times and The Guardian. We demonstrate that DataClips can reproduce over 90% of our data videos corpus. We also report on a qualitative study comparing the authoring process and outcome achieved by (1) non-experts using DataClips, and (2) experts using Adobe Illustrator and After Effects to create data-driven clips. Results indicated that non-experts are able to learn and use DataClips with a short training period. In the span of one hour, they were able to produce more videos than experts using a professional editing tool, and their clips were rated similarly by an independent audience.

  12. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

  13. An anthropomorphic phantom study of visualisation of surgical clips for partial breast irradiation (PBI) setup verification

    International Nuclear Information System (INIS)

    Thomas, Carys W.; Nichol, Alan M.; Park, Julie E.; Hui, Jason F.; Giddings, Alison A.; Grahame, Sheri; Otto, Karl

    2009-01-01

    Surgical clips were investigated for partial breast image-guided radiotherapy (IGRT). Small titanium clips were insufficiently well visualised. Medium tantalum clips were best for megavoltage IGRT and small tantalum clips were best for floor mounted kilovoltage IGRT (ExacTrac TM ). Both small tantalum and medium titanium clips were suitable for isocentric kilovoltage IGRT

  14. An anthropomorphic phantom study of visualisation of surgical clips for partial breast irradiation (PBI) setup verification.

    Science.gov (United States)

    Thomas, Carys W; Nichol, Alan M; Park, Julie E; Hui, Jason F; Giddings, Alison A; Grahame, Sheri; Otto, Karl

    2009-01-01

    Surgical clips were investigated for partial breast image-guided radiotherapy (IGRT). Small titanium clips were insufficiently well visualised. Medium tantalum clips were best for megavoltage IGRT and small tantalum clips were best for floor mounted kilovoltage IGRT (ExacTrac). Both small tantalum and medium titanium clips were suitable for isocentric kilovoltage IGRT.

  15. Recurrence of ICA-PCoA aneurysms after neck clipping.

    Science.gov (United States)

    Sakaki, T; Takeshima, T; Tominaga, M; Hashimoto, H; Kawaguchi, S

    1994-01-01

    Between 1975 and 1992, 2211 patients underwent aneurysmal neck clipping at the Nara Medical University clinic and associated hospitals. The aneurysm in 931 of these patients was situated at the junction of the internal carotid artery (ICA) and posterior communicating artery (PCoA). Seven patients were readmitted 4 to 17 years after the first surgery because of regrowth and rupture of an ICA-PCoA aneurysmal sac that had arisen from the residual neck. On angiograms obtained following aneurysmal neck clipping, a large primitive type of PCoA was demonstrated in six patients and a small PCoA in one. A small residual aneurysm was confirmed in only two patients and angiographically complete neck clipping in five. Recurrent ICA-PCoA aneurysms were separated into two types based on the position of the old clip in relation to the new growth. Type 1 aneurysms regrow from the entire neck and balloon eccentrically. In this type, it is possible to apply the clip at the neck as in conventional clipping for a ruptured aneurysm. Type 2 includes aneurysms in which the proximal portion of a previous clip is situated at the corner of the ICA and aneurysmal neck and the distal portion on the enlarged dome of the aneurysm, because the sac is regrowing from a portion of the residual neck. In this type of aneurysm, a Sugita fenestrated clip can occlude the residual neck, overriding the old clip. Classifying these aneurysms into two groups is very useful from a surgical point of view because it is possible to apply a new clip without removing the old clip, which was found to be adherent to surrounding tissue.

  16. Molecular clips based on propanediurea : synthesis and physical properties

    NARCIS (Netherlands)

    Jansen, Robertus Johannes

    2002-01-01

    This thesis describes the synthesis and physical properties of a series of molecular clips derived from the concave molecule propanediurea. These molecular clips are cavity-containing receptors that can bind a variety of aromatic guests. This binding is a result of hydrogen bonding and pi-pi

  17. The influence of clipping frequency on reserve carbohydrates and ...

    African Journals Online (AJOL)

    Increasing the frequency of clipping over a 12 week period resulted in decreasing root and stubble weight at the end of the 12 week period. During the regrowth period, following the clipping treatment, the aerial dry matter production was found to increase with the more lenient treatments. Keywords: weights|dry ...

  18. 21 CFR 886.3100 - Ophthalmic tantalum clip.

    Science.gov (United States)

    2010-04-01

    ... blood vessels in the eye. (b) Classification. Class II (special controls). The device is exempt from the...) MEDICAL DEVICES OPHTHALMIC DEVICES Prosthetic Devices § 886.3100 Ophthalmic tantalum clip. (a) Identification. An ophthalmic tantalum clip is a malleable metallic device intended to be implanted permanently...

  19. Understanding and Applying Psychology through Use of News Clippings.

    Science.gov (United States)

    Rider, Elizabeth A.

    1992-01-01

    Discusses a student project for psychology courses in which students collect newspaper clippings that illustrate psychological concepts. Explains that the students record the source and write a brief description of the clipping, explaining how it relates to a psychological concept or theory. Includes results of student evaluations of the…

  20. 21 CFR 882.4190 - Clip forming/cutting instrument.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Clip forming/cutting instrument. 882.4190 Section 882.4190 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES.../cutting instrument. (a) Identification. A clip forming/cutting instrument is a device used by the...

  1. Film clips and narrative text as subjective emotion elicitation techniques.

    Science.gov (United States)

    Zupan, Barbra; Babbage, Duncan R

    2017-01-01

    Film clips and narrative text are useful techniques in eliciting emotion in a laboratory setting but have not been examined side-by-side using the same methodology. This study examined the self-identification of emotions elicited by film clip and narrative text stimuli to confirm that selected stimuli appropriately target the intended emotions. Seventy participants viewed 30 film clips, and 40 additional participants read 30 narrative texts. Participants identified the emotion experienced (happy, sad, angry, fearful, neutral-six stimuli each). Eighty-five percent of participants self-identified the target emotion for at least two stimuli for all emotion categories of film clips, except angry (only one) and for all categories of narrative text, except fearful (only one). The most effective angry text was correctly identified 74% of the time. Film clips were more effective in eliciting all target emotions in participants for eliciting the correct emotion (angry), intensity rating (happy, sad), or both (fearful).

  2. Large window median filtering on Clip7

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, K N

    1983-07-01

    Median filtering has been found to be a useful operation to perform on images in order to reduce random noise while preserving edges of objects. However, in some cases, as the resolution of the image increases, so too does the required window size of the filter. For parallel array processors, this leads to problems when dealing with the large amount of data involved. That is to say that there tend to be problems over slow access of data from pixels over a large neighbourhood, lack of available storage of this data during the operation and long computational times for finding the median. An algorithm for finding the median, designed for use on byte wide architecture parallel array processors is presented together with its implementation on Clip7, a scanning array of such processors. 6 references.

  3. Laparoscopic cholecystectomy without clips: 50 cases

    International Nuclear Information System (INIS)

    Morales Gonzalez, Raul A.; Goderich Lalan, Jose M.; Gonzalez Constanten, Juan

    2001-01-01

    A prospective and descriptive study that included 50 patients operated on of vesicular lithiasis by minimally invasive surgery and in whom the clips Were substituted by intra corporeal knots was conducted aimed at knowing the results of this procedure. These patients received attention at Celia Sanchez Manduley, Provincial Clinical and Surgical Teaching Hospital from April 12 to May 3, 2000. Aspects such as age, sex, surgical time, complications and hospital costs Were analyzed. The surgical time was 20 min higher than the one used in a by the usual technique. There Were no surgical complications. It was possible to reduce the cost of surgery. It is considered that this variable is safe, more economic and may be performed in a time similar to the one used in the usual technique

  4. Resistant Hypertension.

    Science.gov (United States)

    Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

    2016-01-01

    Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.

  5. The activation of the kynurenine pathway in a rat model with renovascular hypertension.

    Science.gov (United States)

    Bartosiewicz, Jacek; Kaminski, Tomasz; Pawlak, Krystyna; Karbowska, Malgorzata; Tankiewicz-Kwedlo, Anna; Pawlak, Dariusz

    2017-04-01

    Hypertension is a serious condition that can lead to many health problems. The mechanisms underlying this process are still not fully understood. The kynurenine pathway may be involved in the occurrence and progression of hypertension. The purpose of this study was to examine the activity of peripheral kynurenine pathway in rats with renovascular hypertension in Goldblatt 2K1C model. Hypertension was induced in the experimental groups by constricting the renal artery of the left kidney of the rats. Determination of tryptophan (Trp) and kynurenine pathway metabolites was assessed by high-performance liquid chromatography in plasma and tissues obtained at 4, 8, and 16 weeks after the surgical intervention or sham surgery. Levels of Ang II were evaluated using commercial immuno-enzymatic ELISA kits. Surgical treatment led to increased values of mean blood pressure and systolic blood pressure, whereas Trp concentrations were decreased in experimental animals compared to appropriate controls. Simultaneously, the considerable increment of kynurenine pathway components and a significant increase in the activity of tryptophan 2,3-dioxygenase were observed in rats with developed hypertension in comparison with controls. There were no differences between Ang II levels in controls and experimental groups. The inverse relationship was between plasma Trp and both SBP and Ang II values, and Trp independently affected Ang II concentrations in hypertensive rats. In contrast, tryptophan 2,3-dioxygenase activity and plasma kynurenine metabolites positively correlated with blood pressure values as well as with Ang II levels in these animals. Moreover, kynurenine was independently connected with MBP. Renovascular hypertension influences kynurenine pathway and leads to an imbalance in Trp and its metabolite levels. Tryptophan 2,3-dioxygenase and part of the kynurenine metabolites in plasma and tissues positively correlated with blood pressure values and Ang II levels. Although the

  6. CLIPS - C LANGUAGE INTEGRATED PRODUCTION SYSTEM (IBM PC VERSION)

    Science.gov (United States)

    Riley, G.

    1994-01-01

    The C Language Integrated Production System, CLIPS, is a shell for developing expert systems. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. The primary design goals for CLIPS are portability, efficiency, and functionality. For these reasons, the program is written in C. CLIPS meets or outperforms most micro- and minicomputer based artificial intelligence tools. CLIPS is a forward chaining rule-based language. The program contains an inference engine and a language syntax that provide a framework for the construction of an expert system. It also includes tools for debugging an application. CLIPS is based on the Rete algorithm, which enables very efficient pattern matching. The collection of conditions and actions to be taken if the conditions are met is constructed into a rule network. As facts are asserted either prior to or during a session, CLIPS pattern-matches the number of fields. Wildcards and variables are supported for both single and multiple fields. CLIPS syntax allows the inclusion of externally defined functions (outside functions which are written in a language other than CLIPS). CLIPS itself can be embedded in a program such that the expert system is available as a simple subroutine call. Advanced features found in CLIPS version 4.3 include an integrated microEMACS editor, the ability to generate C source code from a CLIPS rule base to produce a dedicated executable, binary load and save capabilities for CLIPS rule bases, and the utility program CRSV (Cross-Reference, Style, and Verification) designed to facilitate the development and maintenance of large rule bases. Five machine versions are available. Each machine version includes the source and the executable for that machine. The UNIX version includes the source and binaries for IBM RS/6000, Sun3 series, and Sun4 series computers. The UNIX, DEC VAX, and DEC RISC Workstation versions are line oriented. The PC version and the Macintosh

  7. CLIPS - C LANGUAGE INTEGRATED PRODUCTION SYSTEM (MACINTOSH VERSION)

    Science.gov (United States)

    Culbert, C.

    1994-01-01

    The C Language Integrated Production System, CLIPS, is a shell for developing expert systems. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. The primary design goals for CLIPS are portability, efficiency, and functionality. For these reasons, the program is written in C. CLIPS meets or outperforms most micro- and minicomputer based artificial intelligence tools. CLIPS is a forward chaining rule-based language. The program contains an inference engine and a language syntax that provide a framework for the construction of an expert system. It also includes tools for debugging an application. CLIPS is based on the Rete algorithm, which enables very efficient pattern matching. The collection of conditions and actions to be taken if the conditions are met is constructed into a rule network. As facts are asserted either prior to or during a session, CLIPS pattern-matches the number of fields. Wildcards and variables are supported for both single and multiple fields. CLIPS syntax allows the inclusion of externally defined functions (outside functions which are written in a language other than CLIPS). CLIPS itself can be embedded in a program such that the expert system is available as a simple subroutine call. Advanced features found in CLIPS version 4.3 include an integrated microEMACS editor, the ability to generate C source code from a CLIPS rule base to produce a dedicated executable, binary load and save capabilities for CLIPS rule bases, and the utility program CRSV (Cross-Reference, Style, and Verification) designed to facilitate the development and maintenance of large rule bases. Five machine versions are available. Each machine version includes the source and the executable for that machine. The UNIX version includes the source and binaries for IBM RS/6000, Sun3 series, and Sun4 series computers. The UNIX, DEC VAX, and DEC RISC Workstation versions are line oriented. The PC version and the Macintosh

  8. Mineralocorticoid hypertension

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2011-01-01

    Full Text Available Hypertension affects about 10 - 25% of the population and is an important risk factor for cardiovascular and renal disease. The renin-angiotensin system is frequently implicated in the pathophysiology of hypertension, be it primary or secondary. The prevalence of primary aldosteronism increases with the severity of hypertension, from 2% in patients with grade 1 hypertension to 20% among resistant hypertensives. Mineralcorticoid hypertension includes a spectrum of disorders ranging from renin-producing pathologies (renin-secreting tumors, malignant hypertension, coarctation of aorta, aldosterone-producing pathologies (primary aldosteronism - Conns syndrome, familial hyperaldosteronism 1, 2, and 3, non-aldosterone mineralocorticoid producing pathologies (apparent mineralocorticoid excess syndrome, Liddle syndrome, deoxycorticosterone-secreting tumors, ectopic adrenocorticotropic hormones (ACTH syndrome, congenitalvadrenal hyperplasia, and drugs with mineraocorticoid activity (locorice, carbenoxole therapy to glucocorticoid receptor resistance syndromes. Clinical presentation includes hypertension with varying severity, hypokalemia, and alkalosis. Ratio of plasma aldosterone concentraion to plasma renin activity remains the best screening tool. Bilateral adrenal venous sampling is the best diagnostic test coupled with a CT scan. Treatment is either surgical (adrenelectomy for unilateral adrenal disease versus medical therapy for idiopathic, ambiguous, or bilateral disease. Medical therapy focuses on blood pressure control and correction of hypokalemia using a combination of anti-hypertensives (calcium channel blockers, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers and potassium-raising therapies (mineralcorticoid receptor antagonist or potassium sparing diuretics. Direct aldosterone synthetase antagonists represent a promising future therapy.

  9. Development of an artifact-free aneurysm clip

    Directory of Open Access Journals (Sweden)

    Brack Alexander

    2016-09-01

    Full Text Available For the treatment of intracranial aneurysms with aneurysm clips, usually a follow-up inspection in MRI is required. To avoid any artifacts, which can make a proper diagnosis difficult, a new approach for the manufacturing of an aneurysm clip entirely made from fiber-reinforced plastics has been developed. In this paper the concept for the design of the clip, the development of a new manufacturing technology for the fiber-reinforced components as well as first results from the examination of the components in phantom MRI testing is shown.

  10. Hypertension hos gravide

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

  11. Sympathetic block by metal clips may be a reversible operation

    DEFF Research Database (Denmark)

    Thomsen, Lars L; Mikkelsen, Rasmus T; Derejko, Miroslawa

    2014-01-01

    , but the question of reversibility remains controversial. Two recent experimental studies found severe histological signs of nerve damage 4-6 weeks after clip removal, but they only used conventional histopathological staining methods. METHODS: Thoracoscopic clipping of the sympathetic trunk was performed in adult...... the sympathetic chain vary tremendously. Most surgeons transect or resect the sympathetic chain, but application of a metal clip that blocks transmission of nerve impulses in the sympathetic chain is used increasingly worldwide. This approach offers potential reversibility if patients regret surgery...... suggests in theory that application of metal clips to the sympathetic chain is a reversible procedure if only the observation period is prolonged. Further studies with longer periods between application and removal as well as investigations of nerve conduction should be encouraged, because we do not know...

  12. Remission of migraine after clipping of saccular intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, E R; Busygina, A V; Kolotvinov, V S

    2015-01-01

    interview. The remission rates of migraine and tension-type headache (TTH) in these patients were compared to 92 patients from a headache center. Diagnoses were made according to the ICHD-2. RESULTS: During 1 year preceding rupture 51 patients with SIA had migraine. During the year after clipping......BACKGROUND: Unruptured saccular intracranial aneurysm (SIA) is associated with an increased prevalence of migraine, but it is unclear whether this is altered by clipping of the aneurysm. The aim of our study was to determine whether remission rate of migraine and other recurrent headaches...... was greater in patients with SIA after clipping than in controls. METHODS: We prospectively studied 87 SIA patients with migraine or other recurrent headaches. They were interviewed about headaches in the preceding year before and 1 year after clipping using a validated semi-structured neurologist conducted...

  13. Ingested bread clip as an unexpected diagnostic tool.

    Science.gov (United States)

    Jay, Sharon M; Russell, Michael J; Lau, Yee C; Dunn, Joel W; Roberts, Ross

    2018-03-23

    We describe a case where a bread clip has in fact became lodged adjacent to a portion of small bowel affected by a deposit of previously undiagnosed metastatic serous carcinoma of likely ovarian origin.

  14. Clips supporting and spacing flanged sheets of reflective insulation

    International Nuclear Information System (INIS)

    Carr, R.W.

    1980-01-01

    This invention relates to clips, spacing and supporting flanged sheets of reflective insulation used to encase the main body and associated piping of nuclear reactors to minimize heat and radiation losses. (UK)

  15. Anesthesia management for MitraClip device implantation

    Directory of Open Access Journals (Sweden)

    Harikrishnan Kothandan

    2014-01-01

    Full Text Available Aims and Objectives: Percutaneous MitraClip implantation has been demonstrated as an alternative procedure in high-risk patients with symptomatic severe mitral regurgitation (MR who are not suitable (or denied mitral valve repair/replacement due to excessive co morbidity. The MitraClip implantation was performed under general anesthesia and with 3-dimensional transesophageal echocardiography (TEE and fluoroscopic guidance. Materials and Methods: Peri-operative patient data were extracted from the electronic and paper medical records of 21 patients who underwent MitraClip implantations. Results: Four MitraClip implantation were performed in the catheterization laboratory; remaining 17 were performed in the hybrid operating theatre. In 2 patients, procedure was aborted, in one due to migration of the Chiari network into the left atrium and in second one, the leaflets and chords of the mitral valve torn during clipping resulting in consideration for open surgery. In the remaining 19 patients, MitraClip was implanted and the patients showed acute reduction of severe MR to mild-moderate MR. All the patients had invasive blood pressure monitoring and the initial six patients had central venous catheterization prior to the procedure. Intravenous heparin was administered after the guiding catheter was introduced through the inter-atrial septum and activated clotting time was maintained beyond 250 s throughout the procedure. Protamine was administered at the end of the procedure. All the patients were monitored in the intensive care unit after the procedure. Conclusions: Percutaneous MitraClip implantation is a feasible alternative in high-risk patients with symptomatic severe MR. Anesthesia management requirements are similar to open surgical mitral valve repair or replacement. TEE plays a vital role during the MitraClip implantation.

  16. Como o clipping pode auxiliar o dermatologista How the Nail clipping helps the dermatologist

    Directory of Open Access Journals (Sweden)

    José Fillus Neto

    2009-04-01

    Full Text Available Alterações ungueais são queixas muito frequentes nos consultórios dermatológicos. Onicomicoses representam cerca de 50% das onicopatias, daí a importância de se estabelecer o diagnóstico correto antes de se iniciar o tratamento. Neste artigo, relataremos a utilidade de um exame que é de fácil execução pelo clínico, de baixo custo e sensível: esse exame consiste na análise histopatológica da queratina ungueal distal, atualmente já consagrado com o termo clipping.Onycodystrophies are common problems in dermatologic practice. About 50% of dystrophic nails have a fungal cause, so it is very important to establish a correct diagnosis before treatment. In this article we relate the usefulness of an easydoing exam, free from pain, cheap and sensible. This exam is the histopathology of the nail keratin or nail clipping.

  17. Dynamics of cocaine- and amphetamine-regulated transcript containing cell changes in the adrenal glands of two kidney, one clip rats.

    Science.gov (United States)

    Kasacka, Irena; Piotrowska, Zaneta; Janiuk, Izabela; Zbucki, Robert

    2014-10-01

    Taking into consideration the homeostatic disorders resulting from renal hypertension and the essential role of cocaine- and amphetamine-regulated transcript (CART) in maintaining homeostasis by regulating many functions of the body, the question arises as to what extent the renovascular hypertension affects the morphology and dynamics of changes of CART-containing cells in the adrenal glands. The aim of the present study was to examine the distribution, morphology, and dynamics of changes of CART-containing cells in the adrenal glands of "two kidney, one clip" (2K1C) renovascular hypertension model in rats. The studies were carried out on the adrenal glands of rats after 3, 14, 28, 42, and 91 days from the renal artery clipping procedure. To identify neuroendocrine cells, immunohistochemical reaction was performed with the use of a specific antibody against CART. It was revealed that renovascular hypertension causes changes in the endocrine cells containing CART in the adrenal glands of rats. The changes observed in the endocrine cells depend on the time when the rats with experimentally induced hypertension were examined. In the first period of hypertension, the number and immunoreactivity of CART-containing cells were decreased, while from the 28-day test, it significantly increased, as compared to the control rats. CART is relevant to the regulation of homeostasis in the cardiovascular system and seems to be involved in renovascular hypertension. The results of the present work open the possibility of new therapeutic perspectives for the treatment of arterial hypertension, since CART function is involved in their pathophysiology. © 2014 by the Society for Experimental Biology and Medicine.

  18. Knowledge base rule partitioning design for CLIPS

    Science.gov (United States)

    Mainardi, Joseph D.; Szatkowski, G. P.

    1990-01-01

    This describes a knowledge base (KB) partitioning approach to solve the problem of real-time performance using the CLIPS AI shell when containing large numbers of rules and facts. This work is funded under the joint USAF/NASA Advanced Launch System (ALS) Program as applied research in expert systems to perform vehicle checkout for real-time controller and diagnostic monitoring tasks. The Expert System advanced development project (ADP-2302) main objective is to provide robust systems responding to new data frames of 0.1 to 1.0 second intervals. The intelligent system control must be performed within the specified real-time window, in order to meet the demands of the given application. Partitioning the KB reduces the complexity of the inferencing Rete net at any given time. This reduced complexity improves performance but without undo impacts during load and unload cycles. The second objective is to produce highly reliable intelligent systems. This requires simple and automated approaches to the KB verification & validation task. Partitioning the KB reduces rule interaction complexity overall. Reduced interaction simplifies the V&V testing necessary by focusing attention only on individual areas of interest. Many systems require a robustness that involves a large number of rules, most of which are mutually exclusive under different phases or conditions. The ideal solution is to control the knowledge base by loading rules that directly apply for that condition, while stripping out all rules and facts that are not used during that cycle. The practical approach is to cluster rules and facts into associated 'blocks'. A simple approach has been designed to control the addition and deletion of 'blocks' of rules and facts, while allowing real-time operations to run freely. Timing tests for real-time performance for specific machines under R/T operating systems have not been completed but are planned as part of the analysis process to validate the design.

  19. Digital video clips for improved pedagogy and illustration of scientific research — with illustrative video clips on atomic spectrometry

    Science.gov (United States)

    Michel, Robert G.; Cavallari, Jennifer M.; Znamenskaia, Elena; Yang, Karl X.; Sun, Tao; Bent, Gary

    1999-12-01

    This article is an electronic publication in Spectrochimica Acta Electronica (SAE), a section of Spectrochimica Acta Part B (SAB). The hardcopy text is accompanied by an electronic archive, stored on the CD-ROM accompanying this issue. The archive contains video clips. The main article discusses the scientific aspects of the subject and explains the purpose of the video files. Short, 15-30 s, digital video clips are easily controllable at the computer keyboard, which gives a speaker the ability to show fine details through the use of slow motion. Also, they are easily accessed from the computer hard drive for rapid extemporaneous presentation. In addition, they are easily transferred to the Internet for dissemination. From a pedagogical point of view, the act of making a video clip by a student allows for development of powers of observation, while the availability of the technology to make digital video clips gives a teacher the flexibility to demonstrate scientific concepts that would otherwise have to be done as 'live' demonstrations, with all the likely attendant misadventures. Our experience with digital video clips has been through their use in computer-based presentations by undergraduate and graduate students in analytical chemistry classes, and by high school and middle school teachers and their students in a variety of science and non-science classes. In physics teaching laboratories, we have used the hardware to capture digital video clips of dynamic processes, such as projectiles and pendulums, for later mathematical analysis.

  20. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  1. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  2. Resistant hypertension.

    Science.gov (United States)

    Wei, Fang-Fei; Zhang, Zhen-Yu; Huang, Qi-Fang; Yang, Wen-Yi; Staessen, Jan A

    2018-06-15

    The publication of the first non-randomised proof-of-concept trial of renal denervation as a treatment modality in treatment-resistant hypertension set the stage for a search for novel devices with the expectation that technology would reduce the burden of hypertension by reducing or eliminating the costly and lifelong use of blood pressure lowering medications. As we demonstrate in this review, this idea so attractive to manufacturers and invasive cardiologists and radiologists overlooked decades of careful pathophysiological research in a disease, which still remains enigmatic but remains the major cause of cardiovascular mortality worldwide. To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension. Next, we highlighted the key points required for the diagnosis of treatment-resistant hypertension, including the recording of the ambulatory blood pressure and the assessment of adherence to medication. Finally, we summarised new insights in the management of treatment-resistant hypertension by medication and devices and in the future research. Throughout our review, we focused on new evidence became available since 2013. Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.

  3. ART/Ada and CLIPS/Ada

    Science.gov (United States)

    Culbert, Chris

    1990-01-01

    Although they have reached a point of commercial viability, expert systems were originally developed in artificial intelligence (AI) research environments. Many of the available tools still work best in such environments. These environments typically utilize special hardware such as LISP machines and relatively unfamiliar languages such as LISP or Prolog. Space Station applications will require deep integration of expert system technology with applications developed in conventional languages, specifically Ada. The ability to apply automation to Space Station functions could be greatly enhanced by widespread availability of state-of-the-art expert system tools based on Ada. Although there have been some efforts to examine the use of Ada for AI applications, there are few, if any, existing products which provide state-of-the-art AI capabilities in an Ada tool. The goal of the ART/Ada Design Project is to conduct research into the implementation in Ada of state-of-the-art hybrid expert systems building tools (ESBT's). This project takes the following approach: using the existing design of the ART-IM ESBT as a starting point, analyze the impact of the Ada language and Ada development methodologies on that design; redesign the system in Ada; and analyze its performance. The research project will attempt to achieve a comprehensive understanding of the potential for embedding expert systems in Ada systems for eventual application in future Space Station Freedom projects. During Phase 1 of the project, initial requirements analysis, design, and implementation of the kernel subset of ART-IM functionality was completed. During Phase 2, the effort has been focused on the implementation and performance analysis of several versions with increasing functionality. Since production quality ART/Ada tools will not be available for a considerable time, and additional subtask of this project will be the completion of an Ada version of the CLIPS expert system shell developed by NASA

  4. Hemodynamic response during aneurysm clipping surgery among experienced neurosurgeons.

    Science.gov (United States)

    Bunevicius, Adomas; Bilskiene, Diana; Macas, Andrius; Tamasauskas, Arimantas

    2016-02-01

    Neurosurgery is a challenging field associated with high levels of mental stress. The goal of this study was to investigate the hemodynamic response of experienced neurosurgeons during aneurysm clipping surgery and to evaluate whether neurosurgeons' hemodynamic responses are associated with patients' clinical statuses. Four vascular neurosurgeons (all male; mean age 51 ± 10 years; post-residency experience ≥7 years) were studied during 42 aneurysm clipping procedures. Blood pressure (BP) and heart rate (HR) were assessed at rest and during seven phases of surgery: before the skin incision, after craniotomy, after dural opening, after aneurysm neck dissection, after aneurysm clipping, after dural closure and after skin closure. HR and BP were significantly greater during surgery relative to the rest situation (p ≤ 0.03). There was a statistically significant increase in neurosurgeons' HR (F [6, 41] = 10.88, p neurosurgeon experience, the difference in BP as a function of aneurysm rupture was not significant (p > 0.08). Aneurysm location, intraoperative aneurysm rupture, admission WFNS score, admission Glasgow Coma Scale scores and Fisher grade were not associated with neurosurgeons' intraoperative HR and BP (all p > 0.07). Aneurysm clipping surgery is associated with significant hemodynamic system activation among experienced neurosurgeons. The greatest HR and BP were after aneurysm neck dissection and clipping. Aneurysm location and patient clinical status were not associated with intraoperative changes of neurosurgeons' HR and BP.

  5. Speed Biases With Real-Life Video Clips

    Directory of Open Access Journals (Sweden)

    Federica Rossi

    2018-03-01

    Full Text Available We live almost literally immersed in an artificial visual world, especially motion pictures. In this exploratory study, we asked whether the best speed for reproducing a video is its original, shooting speed. By using adjustment and double staircase methods, we examined speed biases in viewing real-life video clips in three experiments, and assessed their robustness by manipulating visual and auditory factors. With the tested stimuli (short clips of human motion, mixed human-physical motion, physical motion and ego-motion, speed underestimation was the rule rather than the exception, although it depended largely on clip content, ranging on average from 2% (ego-motion to 32% (physical motion. Manipulating display size or adding arbitrary soundtracks did not modify these speed biases. Estimated speed was not correlated with estimated duration of these same video clips. These results indicate that the sense of speed for real-life video clips can be systematically biased, independently of the impression of elapsed time. Measuring subjective visual tempo may integrate traditional methods that assess time perception: speed biases may be exploited to develop a simple, objective test of reality flow, to be used for example in clinical and developmental contexts. From the perspective of video media, measuring speed biases may help to optimize video reproduction speed and validate “natural” video compression techniques based on sub-threshold temporal squeezing.

  6. Clinical experience of titanium cerebral aneurysm clips. Evaluation of artifact of CT and MRI

    International Nuclear Information System (INIS)

    Ninomiya, Takashi; Kato, Yoko; Sano, Hirotoshi

    1996-01-01

    The titanium aneurysm clips manufactured by AESCULAP Company are expected to be useful, not only for clinical applications, but also for reducing artifacts in post-operative CT and MRI. We carried out an investigation of the behavior of the new Yasargil titanium clips in a 1.5T MR imager. The new titanium clips showed considerably smaller clip-induced MR and CT artifacts than phynox and elgiloy clips. No movement of the titanium clips was seen by introducing them to the MR imager. Subsequent to these experimental studies, we applied titanium clips to 25 cerebral aneurysms. Post-operative CT, especially helical scanning CT and MR showed minimal artifacts, leading to the conclusion that the titanium clips are better than the other types of clips for the evaluation of post-operative neuroradiological images. (author)

  7. Renovascular hypertension

    International Nuclear Information System (INIS)

    Thomsen, H.S.; Sos, T.A.; Nielsen, S.L.; Koebenhavns Amts Sygehus, Herlev; Cornell Univ., New York

    1989-01-01

    Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

  8. Delay line clipping in a scintillation camera system

    International Nuclear Information System (INIS)

    Hatch, K.F.

    1979-01-01

    The present invention provides a novel base line restoring circuit and a novel delay line clipping circuit in a scintillation camera system. Single and double delay line clipped signal waveforms are generated for increasing the operational frequency and fidelity of data detection of the camera system by base line distortion such as undershooting, overshooting, and capacitive build-up. The camera system includes a set of photomultiplier tubes and associated amplifiers which generate sequences of pulses. These pulses are pulse-height analyzed for detecting a scintillation having an energy level which falls within a predetermined energy range. Data pulses are combined to provide coordinates and energy of photopeak events. The amplifiers are biassed out of saturation over all ranges of pulse energy level and count rate. Single delay line clipping circuitry is provided for narrowing the pulse width of the decaying electrical data pulses which increase operating speed without the occurrence of data loss. (JTA)

  9. Low Proteolytic Clipping of Histone H3 in Cervical Cancer

    Science.gov (United States)

    Sandoval-Basilio, Jorge; Serafín-Higuera, Nicolás; Reyes-Hernandez, Octavio D.; Serafín-Higuera, Idanya; Leija-Montoya, Gabriela; Blanco-Morales, Magali; Sierra-Martínez, Monica; Ramos-Mondragon, Roberto; García, Silvia; López-Hernández, Luz Berenice; Yocupicio-Monroy, Martha; Alcaraz-Estrada, Sofia L.

    2016-01-01

    Chromatin in cervical cancer (CC) undergoes chemical and structural changes that alter the expression pattern of genes. Recently, a potential mechanism, which regulates gene expression at transcriptional levels is the proteolytic clipping of histone H3. However, until now this process in CC has not been reported. Using HeLa cells as a model of CC and human samples from patients with CC, we identify that the H3 cleavage was lower in CC compared with control tissue. Additionally, the histone H3 clipping was performed by serine and aspartyl proteases in HeLa cells. These results suggest that histone H3 clipping operates as part of post-translational modification system in CC. PMID:27698925

  10. PAPR Reduction of FBMC by Clipping and Its Iterative Compensation

    Directory of Open Access Journals (Sweden)

    Zsolt Kollár

    2012-01-01

    Full Text Available Physical layers of communication systems using Filter Bank Multicarrier (FBMC as a modulation scheme provide low out-of-band leakage but suffer from the large Peak-to-Average Power Ratio (PAPR of the transmitted signal. Two special FBMC schemes are investigated in this paper: the Orthogonal Frequency Division Multiplexing (OFDM and the Staggered Multitone (SMT. To reduce the PAPR of the signal, time domain clipping is applied in both schemes. If the clipping is not compensated, the system performance is severely affected. To avoid this degradation, an iterative noise cancelation technique, Bussgang Noise Cancelation (BNC, is applied in the receiver. It is shown that clipping can be a good means for reducing the PAPR, especially for the SMT scheme. A novel modified BNC receiver is presented for SMT. It is shown how this technique can be implemented in real-life applications where special requirements must be met regarding the spectral characteristics of the transmitted signal.

  11. Clip reconstruction of a large right MCA bifurcation aneurysm. Case report

    Directory of Open Access Journals (Sweden)

    Giovani A.

    2014-06-01

    Full Text Available We report a case of complex large middle cerebral artery (MCA bifurcation aneurysm that ruptured during dissection from the very adherent MCA branches but was successfully clipped and the MCA bifurcation reconstructed using 4 Yasargill clips. Through a right pterional craniotomy the sylvian fissure was largely opened as to allow enough workspace for clipping the aneurysm and placing a temporary clip on M1. The pacient recovered very well after surgery and was discharged after 1 week with no neurological deficit. Complex MCA bifurcation aneurysms can be safely reconstructed using regular clips, without the need of using fenestrated clips or complex by-pass procedures.

  12. Exercise Hypertension.

    Science.gov (United States)

    Schultz, Martin G; Sharman, James E

    2014-05-01

    Irrespective of apparent 'normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥210 mm Hg in men or ≥190 mm Hg in women or diastolic BP ≥110 mm Hg in men or women), a condition termed exercise hypertension or a 'hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory 'masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

  13. YUCSA: A CLIPS expert database system to monitor academic performance

    Science.gov (United States)

    Toptsis, Anestis A.; Ho, Frankie; Leindekar, Milton; Foon, Debra Low; Carbonaro, Mike

    1991-01-01

    The York University CLIPS Student Administrator (YUCSA), an expert database system implemented in C Language Integrated Processing System (CLIPS), for monitoring the academic performance of undergraduate students at York University, is discussed. The expert system component in the system has already been implemented for two major departments, and it is under testing and enhancement for more departments. Also, more elaborate user interfaces are under development. We describe the design and implementation of the system, problems encountered, and immediate future plans. The system has excellent maintainability and it is very efficient, taking less than one minute to complete an assessment of one student.

  14. A model-based approach to identify binding sites in CLIP-Seq data.

    Directory of Open Access Journals (Sweden)

    Tao Wang

    Full Text Available Cross-linking immunoprecipitation coupled with high-throughput sequencing (CLIP-Seq has made it possible to identify the targeting sites of RNA-binding proteins in various cell culture systems and tissue types on a genome-wide scale. Here we present a novel model-based approach (MiClip to identify high-confidence protein-RNA binding sites from CLIP-seq datasets. This approach assigns a probability score for each potential binding site to help prioritize subsequent validation experiments. The MiClip algorithm has been tested in both HITS-CLIP and PAR-CLIP datasets. In the HITS-CLIP dataset, the signal/noise ratios of miRNA seed motif enrichment produced by the MiClip approach are between 17% and 301% higher than those by the ad hoc method for the top 10 most enriched miRNAs. In the PAR-CLIP dataset, the MiClip approach can identify ∼50% more validated binding targets than the original ad hoc method and two recently published methods. To facilitate the application of the algorithm, we have released an R package, MiClip (http://cran.r-project.org/web/packages/MiClip/index.html, and a public web-based graphical user interface software (http://galaxy.qbrc.org/tool_runner?tool_id=mi_clip for customized analysis.

  15. Essential hypertension vs. secondary hypertension among children.

    Science.gov (United States)

    Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay; Hashmi, Syed Sharukh; Tyson, John E; Barratt, Michelle S; Hecht, Jacqueline T; Milewicz, Diane M; Boerwinkle, Eric

    2015-01-01

    The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P secondary hypertension. The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. 76 FR 26242 - Paper Clips From the People's Republic of China: Final Results of Expedited Sunset Review of...

    Science.gov (United States)

    2011-05-06

    ... order are plastic and vinyl covered paper clips, butterfly clips, binder clips, or other paper fasteners... order is revoked. Parties can obtain a public copy of the I&D Memo from the Central Records Unit, room...

  17. Receiver-based recovery of clipped ofdm signals for papr reduction: A bayesian approach

    KAUST Repository

    Ali, Anum; Al-Rabah, Abdullatif R.; Masood, Mudassir; Al-Naffouri, Tareq Y.

    2014-01-01

    at the receiver for information restoration. In this paper, we acknowledge the sparse nature of the clipping signal and propose a low-complexity Bayesian clipping estimation scheme. The proposed scheme utilizes a priori information about the sparsity rate

  18. Direct mounted photovoltaic device with improved front clip

    Science.gov (United States)

    Keenihan, James R; Boven, Michelle; Brown, Jr., Claude; Gaston, Ryan S; Hus, Michael; Langmaid, Joe A; Lesniak, Mike

    2013-11-05

    The present invention is premised upon a photovoltaic assembly system for securing and/or aligning at least a plurality of vertically adjacent (overlapping) photovoltaic device assemblies to one another. The securing function being accomplished by a clip member that may be a separate component or integral to one or more of the photovoltaic device assemblies.

  19. Direct mounted photovoltaic device with improved side clip

    Science.gov (United States)

    Keenihan, James R; Boven, Michelle L; Brown, Jr., Claude; Eurich, Gerald K; Gaston, Ryan S; Hus, Michael

    2013-11-19

    The present invention is premised upon a photovoltaic assembly system for securing and/or aligning at least a plurality of vertically adjacent photovoltaic device assemblies to one another. The securing function being accomplished by a clip member that may be a separate component or integral to one or more of the photovoltaic device assemblies.

  20. ASTP 15th Anniversary Clip-Media Release

    Science.gov (United States)

    1990-01-01

    This release is comprised of 5 separate clips, including the following: CL 762 Astronauts/Cosmonauts Visit to KSC and Walt Disney World; CL 739 ASTP Joint Crew Activities; CL 748 ASTP Astronauts/Cosmonauts Horlock Ranch Visit; CL 758 T-21 ASTP Training - US/USSR; and CL 743 ASTP Joint Crew Training in the Soviet Union.

  1. Improving NAVFAC's total quality management of construction drawings with CLIPS

    Science.gov (United States)

    Antelman, Albert

    1991-01-01

    A diagnostic expert system to improve the quality of Naval Facilities Engineering Command (NAVFAC) construction drawings and specification is described. C Language Integrated Production System (CLIPS) and computer aided design layering standards are used in an expert system to check and coordinate construction drawings and specifications to eliminate errors and omissions.

  2. Sociolinguistic import of name-clipping among Omambala cultural ...

    African Journals Online (AJOL)

    This study examines the perceived but obvious manifestation of name-clipping among Omambala cultural zone of Anambra State. This situation has given rise to distortion of names and most often, to either mis-interpretation or complete loss of the original and full meanings of the names. This situation of misinterpretation is ...

  3. Equation-Method for correcting clipping errors in OFDM signals.

    Science.gov (United States)

    Bibi, Nargis; Kleerekoper, Anthony; Muhammad, Nazeer; Cheetham, Barry

    2016-01-01

    Orthogonal frequency division multiplexing (OFDM) is the digital modulation technique used by 4G and many other wireless communication systems. OFDM signals have significant amplitude fluctuations resulting in high peak to average power ratios which can make an OFDM transmitter susceptible to non-linear distortion produced by its high power amplifiers (HPA). A simple and popular solution to this problem is to clip the peaks before an OFDM signal is applied to the HPA but this causes in-band distortion and introduces bit-errors at the receiver. In this paper we discuss a novel technique, which we call the Equation-Method, for correcting these errors. The Equation-Method uses the Fast Fourier Transform to create a set of simultaneous equations which, when solved, return the amplitudes of the peaks before they were clipped. We show analytically and through simulations that this method can, correct all clipping errors over a wide range of clipping thresholds. We show that numerical instability can be avoided and new techniques are needed to enable the receiver to differentiate between correctly and incorrectly received frequency-domain constellation symbols.

  4. Our History Clips: Collaborating for the Common Good

    Science.gov (United States)

    Bailey, Beatrice N.

    2017-01-01

    This case study reveals how middle school social studies teachers within a professional development program are encouraging their students to use multiple disciplinary literacies to create Our History Clips as they also work toward developing a classroom community of engaged student citizens.

  5. 33 CFR 183.532 - Clips, straps, and hose clamps.

    Science.gov (United States)

    2010-07-01

    ... resistant material; and (2) Not cut or abrade the fuel line. (b) If tested in accordance with the fire test under § 183.590, a hose clamp installed on a fuel line system requiring metallic fuel lines or “USCG... (CONTINUED) BOATING SAFETY BOATS AND ASSOCIATED EQUIPMENT Fuel Systems Equipment Standards § 183.532 Clips...

  6. An Exploration of Gender Bias in Computer Clip Art.

    Science.gov (United States)

    Dyrud, Marilyn A.

    1997-01-01

    Examines over 14,000 clip art images for gender bias. Finds that only 4% of images depicted women and that those images present women in stereotypical roles, such as secretaries, nurses, teachers. Notes the irony that communication instructors expend much effort persuading students that gender-free prose is the new model--while visually still…

  7. Extravasal occlusion of large vessels with titanic clips: efficiency, indications, and contraindications.

    Science.gov (United States)

    Vasilenko, Yu V; Kim, A I; Kotov, S A

    2002-11-01

    The mechanism of extravasal occlusion of blood vessels with titanic clips "Atrauclip" and "Ligaclip extra" was studied in order to reveal indications and contraindications to their use. Occlusion with the clips of both types was ineffective in vessels with a diameter of >7.0 mm. Arteritis or the presence of an intravascular occlusion facility in the vessel were also the contraindications for clip occlusion. In overcases the procedure of occlusion with titanic clips was efficient and atraumatic.

  8. Effect of apical meristem clipping on carbon allocation and morphological development of white oak seedlings

    Science.gov (United States)

    Paul P. Kormanik; Shi-Jean S. Sung; T.L. Kormanik; Stanley J. Zarnoch

    1994-01-01

    Seedlings from three open-pollinated half-sib white oak seedlots were clipped in mid-July and their development was compared to nonclipped controls after one growing season.In general when data were analyzed by family, clipped seedlings were significantly less desirable in three to six of the eight variables tested.Numerically, in all families seedlots, the clipped...

  9. Current MitraClip experience, safety and feasibility in the Netherlands

    NARCIS (Netherlands)

    Rahhab, Z.; Kortlandt, F. A.; Velu, J. F.; Schurer, R. A. J.; Delgado, V.; Tonino, P.; Boven, A. J.; van den Branden, B. J. L.; Kraaijeveld, A. O.; Voskuil, M.; Hoorntje, J.; van Wely, M. [=Marleen; van Houwelingen, K.; Bleeker, G. B.; Rensing, B.; Kardys, I.; Baan, J.; van der Heyden, J. A. S.; van Mieghem, N. M.

    2017-01-01

    Purpose Data on MitraClip procedural safety and efficacy in the Netherlands are scarce. We aim to provide an overview of the Dutch MitraClip experience. Methods We pooled anonymised demographic and procedural data of 1151 consecutive MitraClip patients, from 13 Dutch hospitals. Data was collected by

  10. Hypertension Subtypes among Hypertensive Patients in Ibadan

    OpenAIRE

    Abiodun M. Adeoye; Adewole Adebiyi; Bamidele O. Tayo; Babatunde L. Salako; Adesola Ogunniyi; Richard S. Cooper

    2014-01-01

    Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% fema...

  11. Controlling Hypertension

    Centers for Disease Control (CDC) Podcasts

    Hypertension, or high blood pressure, affects one third of U.S. adults and is a leading cause of heart disease and stroke. A recent study found an increase in self-reported high blood pressure among U.S. adults, and an increase in the use of medications to control high blood pressure. In this podcast, Dr. Fleetwood Loustalot discusses the importance of controlling high blood pressure.

  12. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Directory of Open Access Journals (Sweden)

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  13. Pulmonary Hypertension

    Science.gov (United States)

    Kim, John S.; McSweeney, Julia; Lee, Joanne; Ivy, Dunbar

    2015-01-01

    Objective Review the pharmacologic treatment options for pulmonary arterial hypertension (PAH) in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. Data Sources and Study Selection Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of PAH therapies. Data Extraction Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies. Data Synthesis Specific targeted therapies developed for the treatment of adult patients with PAH have been applied for the benefit of children with PAH. With the exception of inhaled nitric oxide, there are no PAH medications approved for children in the US by the FDA. Unfortunately, data on treatment strategies in children with PAH are limited by the small number of randomized controlled clinical trials evaluating the safety and efficacy of specific treatments. The treatment options for PAH in children focus on endothelial-based pathways. Calcium channel blockers are recommended for use in a very small, select group of children who are responsive to vasoreactivity testing at cardiac catheterization. Phosphodiesterase type 5 inhibitor therapy is the most-commonly recommended oral treatment option in children with PAH. Prostacyclins provide adjunctive therapy for the treatment of PAH as infusions (intravenous and subcutaneous) and inhalation agents. Inhaled nitric oxide is the first line vasodilator therapy in persistent pulmonary hypertension of the newborn, and is commonly used in the treatment of PAH in the Intensive Care Unit (ICU). Endothelin receptor antagonists have been shown to improve exercise tolerance and survival in adult patients with PAH. Soluble Guanylate Cyclase Stimulators are the first drug class to be FDA approved for the treatment of chronic thromboembolic pulmonary hypertension. Conclusions Literature and data supporting the

  14. Hormones and Hypertension

    Science.gov (United States)

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Resources • Find-an-Endocrinologist: www.hormone.org or ...

  15. Pulmonary Hypertension in Scleroderma

    Science.gov (United States)

    PULMONARY HYPERTENSION IN SCLERODERMA PULMONARY HYPERTENSION Pulmonary hypertension (PH) is high blood pressure in the blood vessels of the lungs. If the high ... the right side of the heart. Patients with scleroderma are at increased risk for developing PH from ...

  16. Hypertension and Spina Bifida

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Hypertension A disease that often goes undetected. What is hypertension? Hypertension, also called high blood pressure , is a condition in which the arteries of ...

  17. Intracranial Hypertension Research Foundation

    Science.gov (United States)

    ... PARTNERSHIPS Meet our Fundraising Partners Tweet Welcome Intracranial hypertension (IH) is the general term for the neurological ... high. (Old names for IH include Benign Intracranial Hypertension and Pseudotumor Cerebri). The Intracranial Hypertension Research Foundation ...

  18. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... What do I need to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and ... Should an HIV patient be tested for pulmonary hypertension? HIV patients know that medical supervision is critical ...

  19. Efficient computation of clipped Voronoi diagram for mesh generation

    KAUST Repository

    Yan, Dongming

    2013-04-01

    The Voronoi diagram is a fundamental geometric structure widely used in various fields, especially in computer graphics and geometry computing. For a set of points in a compact domain (i.e. a bounded and closed 2D region or a 3D volume), some Voronoi cells of their Voronoi diagram are infinite or partially outside of the domain, but in practice only the parts of the cells inside the domain are needed, as when computing the centroidal Voronoi tessellation. Such a Voronoi diagram confined to a compact domain is called a clipped Voronoi diagram. We present an efficient algorithm to compute the clipped Voronoi diagram for a set of sites with respect to a compact 2D region or a 3D volume. We also apply the proposed method to optimal mesh generation based on the centroidal Voronoi tessellation. Crown Copyright © 2011 Published by Elsevier Ltd. All rights reserved.

  20. Efficient computation of clipped Voronoi diagram for mesh generation

    KAUST Repository

    Yan, Dongming; Wang, Wen Ping; Lé vy, Bruno L.; Liu, Yang

    2013-01-01

    The Voronoi diagram is a fundamental geometric structure widely used in various fields, especially in computer graphics and geometry computing. For a set of points in a compact domain (i.e. a bounded and closed 2D region or a 3D volume), some Voronoi cells of their Voronoi diagram are infinite or partially outside of the domain, but in practice only the parts of the cells inside the domain are needed, as when computing the centroidal Voronoi tessellation. Such a Voronoi diagram confined to a compact domain is called a clipped Voronoi diagram. We present an efficient algorithm to compute the clipped Voronoi diagram for a set of sites with respect to a compact 2D region or a 3D volume. We also apply the proposed method to optimal mesh generation based on the centroidal Voronoi tessellation. Crown Copyright © 2011 Published by Elsevier Ltd. All rights reserved.

  1. A Sieving ANN for Emotion-Based Movie Clip Classification

    Science.gov (United States)

    Watanapa, Saowaluk C.; Thipakorn, Bundit; Charoenkitkarn, Nipon

    Effective classification and analysis of semantic contents are very important for the content-based indexing and retrieval of video database. Our research attempts to classify movie clips into three groups of commonly elicited emotions, namely excitement, joy and sadness, based on a set of abstract-level semantic features extracted from the film sequence. In particular, these features consist of six visual and audio measures grounded on the artistic film theories. A unique sieving-structured neural network is proposed to be the classifying model due to its robustness. The performance of the proposed model is tested with 101 movie clips excerpted from 24 award-winning and well-known Hollywood feature films. The experimental result of 97.8% correct classification rate, measured against the collected human-judges, indicates the great potential of using abstract-level semantic features as an engineered tool for the application of video-content retrieval/indexing.

  2. Esophageal Perforation due to Transesophageal Echocardiogram: New Endoscopic Clip Treatment

    Directory of Open Access Journals (Sweden)

    John Robotis

    2014-07-01

    Full Text Available Esophageal perforation due to transesophageal echocardiogram (TEE during cardiac surgery is rare. A 72-year-old female underwent TEE during an operation for aortic valve replacement. Further, the patient presented hematemesis. Gastroscopy revealed an esophageal bleeding ulcer. Endoscopic therapy was successful. Although a CT scan excluded perforation, the patient became febrile, and a second gastroscopy revealed a big perforation at the site of ulcer. The patient's clinical condition required endoscopic intervention with a new OTSC® clip (Ovesco Endoscopy, Tübingen, Germany. The perforation was successfully sealed. The patient remained on intravenous antibiotics, proton pump inhibitors and parenteral nutrition for few days, followed by enteral feeding. She was discharged fully recovered 3 months later. We clearly demonstrate an effective, less invasive treatment of an esophageal perforation with a new endoscopic clip.

  3. Functional outcome of microsurgical clipping compared to endovascular coiling.

    Science.gov (United States)

    Premananda, R M; Ramesh, N; Hillol, K P

    2012-12-01

    Endovascular coiling has been used increasingly as an alternative to neurosurgical clipping for treating subarachnoid hemorrhage secondary to aneurysm rupture. In a retrospective cohort review on the treatment methods of aneurysm rupture in Hospital Kuala Lumpur over the period of five years (2005-2009) a total of 268 patients were treated. These patients were broadly categorized into two groups based on their treatment mode for ruptured aneurysms. Statistical analysis was determined using Chi- Square tests to study these associations. In our study, 67.5% of patients presented with Good World Federation of Neurosurgical Societies (WFNS) grade (WFNS1-2) while 32.5% patients presented with Poor WFNS prior to intervention. In our outcome, it was noted that 60.4% had good functional outcome (mRS grade 0-2) as compared to 39.6% patients who had poor mRS(modified rankin scale) outcome (mRS 3-6). In the good WFNS group, 76% of patients in clipping group had a good mRS outcome while, 86.5% patients in coiling group had good mRS outcome (p=0.114). In poor WFNS presentation, it was noted that in 77.3% patients in clipping group, had poor mRS outcome. Similarly with poor WFNS presentation, 83.3% of patient in coiling group had poor outcome. (p=1.00). Hence when we control the WFNS group, there was no significant association between treatment group (clipping and coiling) and mRS outcome at 6 months. The outcome of patient is determined by initial clinical presentation (WFNS grade) and influenced by requirement of Extraventricular drain (EVD) in presence of hydrocephalus, CSF infection and pneumonia. Therefore the decision regarding treatment option needs to be individualized based on the presentation of the patient.

  4. Determination of moulting events in rock lobsters from pleopod clipping.

    Science.gov (United States)

    Gardner, Caleb; Mills, David J

    2013-01-01

    Rock lobster growth is routinely measured for research to optimise management measures such as size limits and quotas. The process of estimating growth is complicated in crustaceans as growth only occurs when the animal moults. As data are typically collected by tag-recapture methods, the timing of moulting events can bias results. For example, if annual moulting events take place within a very short time-at-large after tagging, or if time-at-large is long and no moulting occurs. Classifying data into cases where moulting has / has not occurred during time-at-large can be required and can generally be determined by change in size between release and recapture. However, in old or slow growth individuals the moult increment can be too small to provide surety that moulting has occurred. A method that has been used since the 1970's to determine moulting in rock lobsters involves clipping the distal portion of a pleopod so that any regeneration observed at recapture can be used as evidence of a moult. We examined the use of this method in both tank and long-duration field trials within a marine protected area, which provided access to large animals with smaller growth increments. Our results emphasised that determination of moulting by change in size was unreliable with larger lobsters and that pleopod clipping can assist in identifying moulting events. However, regeneration was an unreliable measure of moulting if clipping occurred less than three months before the moult.

  5. Determination of moulting events in rock lobsters from pleopod clipping.

    Directory of Open Access Journals (Sweden)

    Caleb Gardner

    Full Text Available Rock lobster growth is routinely measured for research to optimise management measures such as size limits and quotas. The process of estimating growth is complicated in crustaceans as growth only occurs when the animal moults. As data are typically collected by tag-recapture methods, the timing of moulting events can bias results. For example, if annual moulting events take place within a very short time-at-large after tagging, or if time-at-large is long and no moulting occurs. Classifying data into cases where moulting has / has not occurred during time-at-large can be required and can generally be determined by change in size between release and recapture. However, in old or slow growth individuals the moult increment can be too small to provide surety that moulting has occurred. A method that has been used since the 1970's to determine moulting in rock lobsters involves clipping the distal portion of a pleopod so that any regeneration observed at recapture can be used as evidence of a moult. We examined the use of this method in both tank and long-duration field trials within a marine protected area, which provided access to large animals with smaller growth increments. Our results emphasised that determination of moulting by change in size was unreliable with larger lobsters and that pleopod clipping can assist in identifying moulting events. However, regeneration was an unreliable measure of moulting if clipping occurred less than three months before the moult.

  6. Object oriented development of engineering software using CLIPS

    Science.gov (United States)

    Yoon, C. John

    1991-01-01

    Engineering applications involve numeric complexity and manipulations of a large amount of data. Traditionally, numeric computation has been the concern in developing an engineering software. As engineering application software became larger and more complex, management of resources such as data, rather than the numeric complexity, has become the major software design problem. Object oriented design and implementation methodologies can improve the reliability, flexibility, and maintainability of the resulting software; however, some tasks are better solved with the traditional procedural paradigm. The C Language Integrated Production System (CLIPS), with deffunction and defgeneric constructs, supports the procedural paradigm. The natural blending of object oriented and procedural paradigms has been cited as the reason for the popularity of the C++ language. The CLIPS Object Oriented Language's (COOL) object oriented features are more versatile than C++'s. A software design methodology based on object oriented and procedural approaches appropriate for engineering software, and to be implemented in CLIPS was outlined. A method for sensor placement for Space Station Freedom is being implemented in COOL as a sample problem.

  7. 76 FR 44575 - Paper Clips From the People's Republic of China: Continuation of the Antidumping Duty Order

    Science.gov (United States)

    2011-07-26

    ..., butterfly clips, binder clips, or other paper fasteners that are not made wholly of wire of base metal and... DEPARTMENT OF COMMERCE International Trade Administration [A-570-826] Paper Clips From the People... the antidumping duty order on paper clips from the People's Republic of China (``PRC'') would likely...

  8. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  9. Sex Differences in Emotional Evaluation of Film Clips: Interaction with Five High Arousal Emotional Categories

    Science.gov (United States)

    Maffei, Antonio; Vencato, Valentina; Angrilli, Alessandro

    2015-01-01

    The present study aimed to investigate gender differences in the emotional evaluation of 18 film clips divided into six categories: Erotic, Scenery, Neutral, Sadness, Compassion, and Fear. 41 female and 40 male students rated all clips for valence-pleasantness, arousal, level of elicited distress, anxiety, jittery feelings, excitation, and embarrassment. Analysis of positive films revealed higher levels of arousal, pleasantness, and excitation to the Scenery clips in both genders, but lower pleasantness and greater embarrassment in women compared to men to Erotic clips. Concerning unpleasant stimuli, unlike men, women reported more unpleasantness to the Compassion, Sadness, and Fear compared to the Neutral clips and rated them also as more arousing than did men. They further differentiated the films by perceiving greater arousal to Fear than to Compassion clips. Women rated the Sadness and Fear clips with greater Distress and Jittery feelings than men did. Correlation analysis between arousal and the other emotional scales revealed that, although men looked less aroused than women to all unpleasant clips, they also showed a larger variance in their emotional responses as indicated by the high number of correlations and their relatively greater extent, an outcome pointing to a masked larger sensitivity of part of male sample to emotional clips. We propose a new perspective in which gender difference in emotional responses can be better evidenced by means of film clips selected and clustered in more homogeneous categories, controlled for arousal levels, as well as evaluated through a number of emotion focused adjectives. PMID:26717488

  10. Receiver-based recovery of clipped ofdm signals for papr reduction: A bayesian approach

    KAUST Repository

    Ali, Anum

    2014-01-01

    Clipping is one of the simplest peak-to-average power ratio reduction schemes for orthogonal frequency division multiplexing (OFDM). Deliberately clipping the transmission signal degrades system performance, and clipping mitigation is required at the receiver for information restoration. In this paper, we acknowledge the sparse nature of the clipping signal and propose a low-complexity Bayesian clipping estimation scheme. The proposed scheme utilizes a priori information about the sparsity rate and noise variance for enhanced recovery. At the same time, the proposed scheme is robust against inaccurate estimates of the clipping signal statistics. The undistorted phase property of the clipped signal, as well as the clipping likelihood, is utilized for enhanced reconstruction. Furthermore, motivated by the nature of modern OFDM-based communication systems, we extend our clipping reconstruction approach to multiple antenna receivers and multi-user OFDM.We also address the problem of channel estimation from pilots contaminated by the clipping distortion. Numerical findings are presented that depict favorable results for the proposed scheme compared to the established sparse reconstruction schemes.

  11. Sex Differences in Emotional Evaluation of Film Clips: Interaction with Five High Arousal Emotional Categories.

    Directory of Open Access Journals (Sweden)

    Antonio Maffei

    Full Text Available The present study aimed to investigate gender differences in the emotional evaluation of 18 film clips divided into six categories: Erotic, Scenery, Neutral, Sadness, Compassion, and Fear. 41 female and 40 male students rated all clips for valence-pleasantness, arousal, level of elicited distress, anxiety, jittery feelings, excitation, and embarrassment. Analysis of positive films revealed higher levels of arousal, pleasantness, and excitation to the Scenery clips in both genders, but lower pleasantness and greater embarrassment in women compared to men to Erotic clips. Concerning unpleasant stimuli, unlike men, women reported more unpleasantness to the Compassion, Sadness, and Fear compared to the Neutral clips and rated them also as more arousing than did men. They further differentiated the films by perceiving greater arousal to Fear than to Compassion clips. Women rated the Sadness and Fear clips with greater Distress and Jittery feelings than men did. Correlation analysis between arousal and the other emotional scales revealed that, although men looked less aroused than women to all unpleasant clips, they also showed a larger variance in their emotional responses as indicated by the high number of correlations and their relatively greater extent, an outcome pointing to a masked larger sensitivity of part of male sample to emotional clips. We propose a new perspective in which gender difference in emotional responses can be better evidenced by means of film clips selected and clustered in more homogeneous categories, controlled for arousal levels, as well as evaluated through a number of emotion focused adjectives.

  12. Economic evaluation of Community Level Interventions for Pre-eclampsia (CLIP) in South Asian and African countries: a study protocol.

    Science.gov (United States)

    Khowaja, Asif R; Mitton, Craig; Bryan, Stirling; Magee, Laura A; Bhutta, Zulfiqar A; von Dadelszen, Peter

    2015-05-26

    Globally, hypertensive disorders of pregnancy, particularly pre-eclampsia and eclampsia, are the leading cause of maternal and neonatal mortality, and impose substantial burdens on the families of pregnant women, their communities, and healthcare systems. The Community Level Interventions for Pre-eclampsia (CLIP) Trial evaluates a package of care applied at both community and primary health centres to reduce maternal and perinatal disabilities and deaths resulting from the failure to identify and manage pre-eclampsia at the community level. Economic evaluation of health interventions can play a pivotal role in priority setting and inform policy decisions for scale-up. At present, there is a paucity of published literature on the methodology of economic evaluation of large, multi-country, community-based interventions in the area of maternal and perinatal health. This study protocol describes the application of methodology for economic evaluation of the CLIP in South Asia and Africa. A mixed-design approach i.e. cost-effectiveness analysis (CEA) and qualitative thematic analysis will be used alongside the trial to prospectively evaluate the economic impact of CLIP from a societal perspective. Data on health resource utilization, costs, and pregnancy outcomes will be collected through structured questionnaires embedded into the pregnancy surveillance, cross-sectional survey and budgetary reviews. Qualitative data will be collected through focus groups (FGs) with pregnant women, household male-decision makers, care providers, and district level health decision makers. The incremental cost-effectiveness ratio will be calculated for healthcare system and societal perspectives, taking into account the country-specific model inputs (costs and outcome) from the CLIP Trial. Emerging themes from FGs will inform the design of the model, and help to interpret findings of the CEA. The World Health Organization (WHO) strongly recommends cost-effective interventions as a key

  13. Percutaneous interventional mitral regurgitation treatment using the Mitra-Clip system

    DEFF Research Database (Denmark)

    Boekstegers, P; Hausleiter, J; Baldus, S

    2014-01-01

    The interventional treatment of mitral valve regurgitation by the MitraClip procedure has grown rapidly in Germany and Europe during the past years. The MitraClip procedure has the potential to treat high-risk patients with secondary mitral valve regurgitation and poor left ventricular function....... Furthermore, patients with primary mitral valve regurgitation may be treated successfully by the MitraClip procedure in case of high surgical risk or in very old patients. At the same time it has been emphasised that the MitraClip interventional treatment is still at an early stage of clinical development....... The largest clinical experience with the MitraClip procedure so far is probably present in some German cardiovascular centers, which here summarise their recommendations on the current indications and procedural steps of the MitraClip treatment. These recommendations of the AGIK and ALKK may present a basis...

  14. Endogenous angiotensin II modulates nNOS expression in renovascular hypertension

    Directory of Open Access Journals (Sweden)

    T.M.C. Pereira

    2009-07-01

    Full Text Available Nitric oxide (NO influences renal blood flow mainly as a result of neuronal nitric oxide synthase (nNOS. Nevertheless, it is unclear how nNOS expression is modulated by endogenous angiotensin II, an inhibitor of NO function. We tested the hypothesis that the angiotensin II AT1 receptor and oxidative stress mediated by NADPH oxidase contribute to the modulation of renal nNOS expression in two-kidney, one-clip (2K1C hypertensive rats. Experiments were performed on male Wistar rats (150 to 170 g body weight divided into 2K1C (N = 19 and sham-operated (N = 19 groups. nNOS expression in kidneys of 2K1C hypertensive rats (N = 9 was compared by Western blotting to that of 2K1C rats treated with low doses of the AT1 antagonist losartan (10 mg·kg-1·day-1; N = 5 or the superoxide scavenger tempol (0.2 mmol·kg-1·day-1; N = 5, which still remain hypertensive. After 28 days, nNOS expression was significantly increased by 1.7-fold in the clipped kidneys of 2K1C rats and by 3-fold in the non-clipped kidneys of 2K1C rats compared with sham rats, but was normalized by losartan. With tempol treatment, nNOS expression increased 2-fold in the clipped kidneys and 1.4-fold in the non-clipped kidneys compared with sham rats. The changes in nNOS expression were not followed by changes in the enzyme activity, as measured indirectly by the cGMP method. In conclusion, AT1 receptors and oxidative stress seem to be primary stimuli for increased nNOS expression, but this up-regulation does not result in higher enzyme activity.

  15. Hypertension in women

    OpenAIRE

    Hage, Fadi G; Mansur, Sulaf J; Xing, Dongqi; Oparil, Suzanne

    2013-01-01

    Hypertension is the most common modifiable risk factor for cardiovascular disease, the leading cause of death in both men and women. The prevalence and severity of hypertension rise markedly with age, and blood pressure control becomes more difficult with aging in both genders, particularly in women. In addition, there are forms of hypertension that occur exclusively in women, e.g., hypertension related to menopause, oral contraceptive use, or pregnancy (e.g., chronic hypertension, gestationa...

  16. CLIPS based decision support system for water distribution networks

    Directory of Open Access Journals (Sweden)

    K. Sandeep

    2011-10-01

    Full Text Available The difficulty in knowledge representation of a water distribution network (WDN problem has contributed to the limited use of artificial intelligence (AI based expert systems (ES in the management of these networks. This paper presents a design of a Decision Support System (DSS that facilitates "on-demand'' knowledge generation by utilizing results of simulation runs of a suitably calibrated and validated hydraulic model of an existing aged WDN corresponding to emergent or even hypothetical but likely scenarios. The DSS augments the capability of a conventional expert system by integrating together the hydraulic modelling features with heuristics based knowledge of experts under a common, rules based, expert shell named CLIPS (C Language Integrated Production System. In contrast to previous ES, the knowledge base of the DSS has been designed to be dynamic by superimposing CLIPS on Structured Query Language (SQL. The proposed ES has an inbuilt calibration module that enables calibration of an existing (aged WDN for the unknown, and unobservable, Hazen-Williams C-values. In addition, the daily run and simulation modules of the proposed ES further enable the CLIPS inference engine to evaluate the network performance for any emergent or suggested test scenarios. An additional feature of the proposed design is that the DSS integrates computational platforms such as MATLAB, open source Geographical Information System (GIS, and a relational database management system (RDBMS working under the umbrella of the Microsoft Visual Studio based common user interface. The paper also discusses implementation of the proposed framework on a case study and clearly demonstrates the utility of the application as an able aide for effective management of the study network.

  17. Clinical features and nail clippings in 52 children with psoriasis.

    Science.gov (United States)

    Uber, Marjorie; Carvalho, Vânia O; Abagge, Kerstin T; Robl Imoto, Renata; Werner, Betina

    2018-03-01

    Nail clipping, the act of cutting the distal portion of a nail for microscopic analysis, can complement the diagnosis of skin diseases with nail involvement, such as psoriasis. This study aimed to describe histopathologic findings on 81 nails from 52 children and adolescents with skin psoriasis and to determine whether these changes correlated with the severity of skin and nail involvement. Children with psoriasis were enrolled in this cross-sectional study to obtain Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores. The most altered nails were processed using periodic acid-Schiff with diastase staining. Fifty-two patients with a median age of 10.5 years were included. The median Nail Psoriasis Severity Index score of the 20 nails from these patients was 17 (range 3-80). The most common findings were pitting (94.2%), leukonychia (73.0%), and longitudinal ridges (63.5%). Eighty-one nail fragments were collected by clipping. Neutrophils were found in 6 samples (7.6%) and serous lakes in 15 (19%). Median nail plate thickness was 0.3 mm (range 0.1-0.63 mm). Patients whose nails had neutrophils had a higher median PASI score (6.1 vs 2.0, P = .03). Patients whose nails had serous lakes had higher median PASI (5.3 vs 1.9, P = .008) and NAPSI (median 45.0 vs 18.0, P = .006) scores. There seems to be a correlation between some microscopic nail features in children with psoriasis and their PASI and NAPSI scores, so nail clippings from children with suspected psoriasis may help with diagnosis, especially in the presence of neutrophils, and in excluding onychomycosis. © 2018 Wiley Periodicals, Inc.

  18. Current MitraClip experience, safety and feasibility in the Netherlands

    OpenAIRE

    Rahhab, Z.; Kortlandt, F.A.; Velu, J.F.; Schurer, R.A.J.; Delgado, V.; Tonino, P.; Boven, A.J. van; Branden, B.J.L. Van den; Kraaijeveld, A.O.; Voskuil, M.; Hoorntje, J.; Wely, M.H. van; Houwelingen, K. van; Bleeker, G.B.; Rensing, B.

    2017-01-01

    PURPOSE: Data on MitraClip procedural safety and efficacy in the Netherlands are scarce. We aim to provide an overview of the Dutch MitraClip experience. METHODS: We pooled anonymised demographic and procedural data of 1151 consecutive MitraClip patients, from 13 Dutch hospitals. Data was collected by product specialists in collaboration with local operators. Effect on mitral regurgitation was intra-procedurally assessed by transoesophageal echocardiography. Technical success and device succe...

  19. CLIPS/Ada: An Ada-based tool for building expert systems

    Science.gov (United States)

    White, W. A.

    1990-01-01

    Clips/Ada is a production system language and a development environment. It is functionally equivalent to the CLIPS tool. CLIPS/Ada was developed in order to provide a means of incorporating expert system technology into projects where the use of the Ada language had been mandated. A secondary purpose was to glean information about the Ada language and its compilers. Specifically, whether or not the language and compilers were mature enough to support AI applications. The CLIPS/Ada tool is coded entirely in Ada and is designed to be used by Ada systems that require expert reasoning.

  20. A method of handing down surgical clipping technique for cerebral aneurysm

    International Nuclear Information System (INIS)

    Idei, Masaru; Yamane, Kanji; Okita, Shinji; Kumano, Kiyoshi; Nakae, Ryuta

    2009-01-01

    Meticulous clipping techniques are essential to obtain good results. Recently, the introduction of intravascular surgery for cerebral aneurysms has decreased the number of the direct clipping surgeries. And the increasing number of the lawsuits against doctors further discourages young surgeons from attempting clipping. As a result, young neurosurgeons, have less experience performing clipping. Therefore, we must learn clipping techniques from expert neurosurgeons under the limitation of having fewer opportunities to perform clipping surgery. In this paper, I present my experiences and discuss ways to obtain techniques for clipping surgery. I performed surgical clipping in 19 cases, 12 unruptured and 7 ruptured aneurysms, 7 males and 12 females aged from 36 to 79 years old (mean 61.9 years). Postoperatively, there were no symptomatic complications, but there were 2 asymptomatic infarctions that were revealed on CT scan. Intraoperative premature rupture occurred in 1 patient with a ruptured aneurysm. Techniques of manipulation with micro-forceps, suction and spatula are required for successful clipping. Off-the-job training of dissecting chicken wing arteries and rat abdominal aortas and vena cavas is useful. Moreover, actual experiences of surgical operations are essential. Surgical experiences raise the motivation of young neurosurgeons and encourage them to train more. We believe that this benign cycle contributes to meticulous surgical skills. (author)

  1. A systematic review of discomfort due to toe or ear clipping in laboratory rodents

    Science.gov (United States)

    Geessink, Florentine J.; Brouwer, Michelle A. E.; Tillema, Alice; Ritskes-Hoitinga, Merel

    2017-01-01

    Toe clipping and ear clipping (also ear notching or ear punching) are frequently used methods for individual identification of laboratory rodents. These procedures potentially cause severe discomfort, which can reduce animal welfare and distort experimental results. However, no systematic summary of the evidence on this topic currently exists. We conducted a systematic review of the evidence for discomfort due to toe or ear clipping in rodents. The review methodology was pre-specified in a registered review protocol. The population, intervention, control, outcome (PICO) question was: In rodents, what is the effect of toe clipping or ear clipping, compared with no clipping or sham clipping, on welfare-related outcomes? Through a systematic search in PubMed, Embase, Web of Science and grey literature, we identified seven studies on the effect of ear clipping on animal welfare, and five such studies on toe clipping. Studies were included in the review if they contained original data from an in vivo experiment in rodents, assessing the effect of toe clipping or ear clipping on a welfare-related outcome. Case studies and studies applying unsuitable co-interventions were excluded. Study quality was appraised using an extended version of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE)’s risk of bias tool for animal studies. Study characteristics and outcome measures were highly heterogeneous, and there was an unclear or high risk of bias in all studies. We therefore present a narrative synthesis of the evidence identified. None of the studies reported a sample size calculation. Out of over 60 different outcomes, we found evidence of discomfort due to ear clipping in the form of increased respiratory volume, vocalization and blood pressure. For toe clipping, increased vocalization and decreased motor activity in pups were found, as well as long-term effects in the form of reduced grip strength and swimming ability in adults. In conclusion, there

  2. Catheter Entrapment During Posterior Mitral Leaflet Pushing Maneuver for MitraClip Implantation.

    Science.gov (United States)

    Castrodeza, Javier; Amat-Santos, Ignacio J; Tobar, Javier; Varela-Falcón, Luis H

    2016-06-01

    MitraClip (Abbott Vascular) therapy has been reported to be an effective procedure for mitral regurgitation, especially in high-risk patients. Recently, the novel pushing maneuver technique has been described for approaching restricted and short posterior leaflets with a pigtail catheter in order to facilitate grasping of the clip. However, complications or unexpected situations may occur. We report the case of an 84-year-old patient who underwent MitraClip implantation wherein the pushing maneuver was complicated by the clip accidentally gripping the pigtail catheter along with the two leaflets.

  3. Definition of postlumpectomy tumor bed for radiotherapy boost field planning: CT versus surgical clips

    International Nuclear Information System (INIS)

    Goldberg, Hadassah; Prosnitz, Robert G.; Olson, John A.; Marks, Lawrence B.

    2005-01-01

    Purpose: To compare the location and extent of the tumor bed as defined by surgical clips and computed tomography (CT) scans, after lumpectomy, for electron boost planning as part of breast radiotherapy. Methods and Materials: Planning CT images of 31 operated breasts in 30 patients who underwent lumpectomy were reviewed. One or more clips were placed in the lumpectomy cavity. Serial CT images were used to measure the depth and transverse and longitudinal dimensions. The area and geometric center of the tumor bed were defined by the clips and CT. Results: The CT and clip measurements were identical for the maximal tumor depth in 27 of 30 patients. The CT bed extended beyond the clips by 0-7 mm medially in the transverse/longitudinal extent (multiclip patients). The median distance between the geometric centers in the coronal plane for the tumor bed center was larger for patients with single clips than for those with multiple clips (p 2 . The CT bed was more readily visible in patients with a shorter interval between surgery and radiotherapy. Conclusion: The maximal depth of the tumor bed was similar using the two methods. The extent and centers of the clip-and CT-determined beds differed significantly. This may indicate an underestimation of the tumor bed as defined by clips only and justifies integration of CT information in boost field planning

  4. Systolic hypertension in adult nigerians with hypertension

    International Nuclear Information System (INIS)

    Opadijo, O.G.; Salami, T.A.T.; Sanya, E.O.; Omotoso, A.B.O.

    2007-01-01

    To determine the prevalence of both systolic and diastolic hypertensions in relation to age and their impacts on target organ among adult Nigerians with hypertension. Newly diagnosed adult hypertensives, with blood pressure 140/90mm Hg, taken twice with mercury column sphygmomanometer at 3 weeks interval, were studied. The total number of hypertensive patients treated over this period was also taken into consideration. The newly diagnosed hypertensives were classified using JNC VI classification. The frequency of occurrence of target organ damage such as Left Ventricular Hypertrophy (LVH), heart failure, renal impairment etc. was charted according to systolic and or diastolic pressures. The occurrence of systolic or diastolic blood pressure was also related with the age of the patients. Blood metabolic parameters were compared in both systolic and diastolic blood pressures for their possible contributory role. Two thousand seven hundred and ninety-two adult hypertensive patients were managed over the study period. Of them, 218 (7.8%) were newly diagnosed and studied. There were 94 males and 124 females. Seventy-seven (35.3%) were aged 60 years and above with equal frequency in the gender. One hundred and seventy-eight (81.7%) cases had combined systolic and diastolic pressures. Twenty-nine (13.3%) patients had systolic hypertension. Twenty-five (86.2%) of these 29 were aged 50 years and above and 20 (69.0%) were aged 60 years and above. Eleven (5.0%) patients had isolated diastolic hypertension and they were all in the age bracket 40-49 years. Systolic blood pressure was found to be rising with advancing age while diastolic blood pressure peaked at mid 40's and declined. Target organ damage occurred more frequently with systolic hypertension and advancing age than with diastolic hypertension. Systolic hypertension occurred more frequently in this series of adult Nigerians with hypertension. It was higher with advancing age and associated with more target organ

  5. Chaos in blood flow control in genetic and renovascular hypertensive rats

    DEFF Research Database (Denmark)

    Yip, K P; Holstein-Rathlou, N H; Marsh, D J

    1991-01-01

    Hydrostatic pressure and flow in renal proximal tubules oscillate at 30-40 mHz in normotensive rats anesthetized with halothane. The oscillations originate in tubuloglomerular feedback, a mechanism that provides local blood flow regulation. Instead of oscillations, spontaneously hypertensive rats...... (SHR) have aperiodic tubular pressure fluctuations; the pattern is suggestive of deterministic chaos. Normal rats made hypertensive by clipping one renal artery had similar aperiodic tubular pressure fluctuations in the unclipped kidney, and the fraction of rats with irregular fluctuations increased...... with time after the application of the renal artery clip. Statistical measures of deterministic chaos were applied to tubular pressure data. The correlation dimension, a measure of the dimension of the phase space attractor generating the time series, indicated the presence of a low-dimension strange...

  6. [MitraClip® for treatment of tricuspid valve insufficiency].

    Science.gov (United States)

    Pfister, R; Baldus, S

    2017-11-01

    Tricuspid valve regurgitation is frequently found as a result of right ventricular remodeling due to advanced left heart diseases. Drug treatment is limited to diuretics and the cardiac or pulmonary comorbidities. Due to the high risk only a small percentage of patients are amenable to surgical treatment of tricuspid regurgitation in those who undergo left-sided surgery for other reasons. Catheter-based procedures are an attractive treatment alternative, particularly since the strong prognostic impact of tricuspid regurgitation suggests an unmet need of treatment, independent of the underlying heart disease. A vast amount of clinical experience exists for the MitraClip system for treatment of mitral regurgitation. A first case series shows that the application for treatment of tricuspid regurgitation is technically feasible, seems to be safe and the degree of valve regurgitation can be reduced. In this review the background of tricuspid regurgitation treatment is summarized and first experiences and perspectives with the MitraClip system are assessed.

  7. BioClips of symmetric and asymmetric cell division.

    Science.gov (United States)

    Lu, Fong-Mei; Eliceiri, Kevin W; White, John G

    2007-05-01

    Animations have long been used as tools to illustrate complex processes in such diverse fields as mechanical engineering, astronomy, bacteriology and physics. Animations in biology hold particular educational promise for depicting complex dynamic processes, such as photosynthesis, motility, viral replication and cellular respiration, which cannot be easily explained using static two-dimensional images. However, these animations have often been restrictive in scope, having been created for a specific classroom or research audience. In recent years, a new type of animation has emerged called the BioClip (http://www.bioclips.com) that strives to present science in an interactive multimedia format, which is, at once, informative and entertaining, by combining animations, text descriptions and music in one portable cross-platform document. In the present article, we illustrate the educational value of this new electronic resource by reviewing in depth two BioClips our group has created which describe the processes of symmetric and asymmetric cell division (http://www.wormclassroom.org/cb/bioclip).

  8. Renal sympathetic denervation attenuates hypertension and vascular remodeling in renovascular hypertensive rats.

    Science.gov (United States)

    Li, Peng; Huang, Pei-Pei; Yang, Yun; Liu, Chi; Lu, Yan; Wang, Fang; Sun, Wei; Kong, Xiang-Qing

    2017-01-01

    Li P, Huang P, Yang Y, Liu C, Lu Y, Wang F, Sun W, Kong X. Renal sympathetic denervation attenuates hypertension and vascular remodeling in renovascular hypertensive rats. J Appl Physiol 122: 121-129, 2017. First published October 14, 2016; doi:10.1152/japplphysiol.01019.2015-Sympathetic activity is enhanced in patients with essential or secondary hypertension, as well as in various hypertensive animal models. Therapeutic targeting of sympathetic activation is considered an effective antihypertensive strategy. We hypothesized that renal sympathetic denervation (RSD) attenuates hypertension and improves vascular remodeling and renal disease in the 2-kidney, 1-clip (2K1C) rat model. Rats underwent 2K1C modeling or sham surgery; then rats underwent RSD or sham surgery 4 wk later, thus resulting in four groups (normotensive-sham, normotensive-RSD, 2K1C-sham, and 2K1C-RSD). Norepinephrine was measured by ELISA. Echocardiography was used to assess heart function. Fibrosis and apoptosis were assessed by Masson and TUNEL staining. Changes in mean arterial blood pressure in response to hexamethonium and plasma norepinephrine levels were used to evaluate basal sympathetic nerve activity. The 2K1C modeling success rate was 86.8%. RSD reversed the elevated systolic blood pressure induced by 2K1C, but had no effect on body weight. Compared with rats in the 2K1C-sham group, rats in the 2K1C-RSD group showed lower left ventricular mass/body weight ratio, interventricular septal thickness in diastole, left ventricular end-systolic diameter, and left ventricular posterior wall thickness in systole, whereas fractional shortening and ejection fraction were higher. Right kidney apoptosis and left kidney hypertrophy were not changed by RSD. Arterial fibrosis was lower in animals in the 2K1C-RSD group compared with those in the 2K1C-sham group. RSD reduced plasma norepinephrine and basal sympathetic activity in rats in the 2K1C-RSD group compared with rats in the 2K1C-sham group. These

  9. Effects of Japanese beetle (Coleoptera: Scarabaeidae) and silk clipping in field corn.

    Science.gov (United States)

    Steckel, Sandy; Stewart, S D; Tindall, K V

    2013-10-01

    Japanese beetle (Popillia japonica Newman) is an emerging silk-feeding insect found in fields in the lower Corn Belt and Midsouthern United States. Studies were conducted in 2010 and 2011 to evaluate how silk clipping in corn affects pollination and yield parameters. Manually clipping silks once daily had modest effects on yield parameters. Sustained clipping by either manually clipping silks three times per day or by caging Japanese beetles onto ears affected total kernel weight if it occurred during early silking (R1 growth stage). Manually clipping silks three times per day for the first 5 d of silking affected the number of kernels per ear, total kernel weight, and the weight of individual kernels. Caged beetles fed on silks and, depending on the number of beetles caged per ear, reduced the number of kernels per ear. Caging eight beetles per ear significantly reduced total kernel weight compared with noninfested ears. Drought stress before anthesis appeared to magnify the impact of silk clipping by Japanese beetles. There was evidence of some compensation for reduced pollination by increasing the size of pollinated kernels within the ear. Our results showed that it requires sustained silk clipping during the first week of silking to have substantial impacts on pollination and yield parameters, at least under good growing conditions. Some states recommend treating for Japanese beetle when three Japanese beetles per ear are found, silks are clipped to < 13 mm, and pollination is < 50% complete, and that recommendation appears to be adequate.

  10. The "Isms" of Art. Introduction to the 2001-2002 Clip and Save Art Prints.

    Science.gov (United States)

    Hubbard, Guy

    2001-01-01

    Provides an introduction to the 2001-2002 Clip and Save Art Prints that will focus on ten art movements from the past 150 years. Includes information on three art movements, or "isms": Classicism, Romanticism, and Realism. Discusses the Clip and Save Art Print format and provides information on three artists. (CMK)

  11. Suture retraction technique to prevent parent vessel obstruction following aneurysm tandem clipping.

    Science.gov (United States)

    Rayan, Tarek; Amin-Hanjani, Sepideh

    2015-08-01

    With large or giant aneurysms, the use of multiple tandem clips can be essential for complete obliteration of the aneurysm. One potential disadvantage, however, is the considerable cumulative weight of these clips, which may lead to kinking of the underlying parent vessels and obstruction of flow. The authors describe a simple technique to address this problem, guided by intraoperative blood flow measurements, in a patient with a ruptured near-giant 2.2 × 1.7-cm middle cerebral artery bifurcation aneurysm that was treated with the tandem clipping technique. A total of 11 clips were applied in a vertical stacked fashion. The cumulative weight of the clips caused kinking of the temporal M2 branch of the bifurcation with reduction of flow. A 4-0 Nurolon suture tie was applied to the hub of one of the clips and was tethered to the dura of the sphenoid ridge by a small mini-clip and reinforced by application of tissue sealant. The patient underwent intraoperative indocyanine green videoangiography as well as catheter angiography, which demonstrated complete aneurysmal obliteration and preservation of vessel branches. Postoperative angiography confirmed patency of the bifurcation vessels with mild vasospasm. The patient had a full recovery with no postoperative complications and was neurologically intact at her 6-month follow-up. The suture retraction technique allows a simple solution to parent vessel obstruction following aneurysm tandem clipping, in conjunction with the essential guidance provided by intraoperative flow measurements.

  12. Establishment of an easy Ic measurement method of HTS superconducting tapes using clipped voltage taps

    International Nuclear Information System (INIS)

    Shin, Hyung Seop; Nisay, Arman; Dedicatoria, Marlon; Sim, Ki Deok

    2014-01-01

    The critical current, I c of HTS superconducting tapes can be measured by transport or contactless method. Practically, the transport method using the four-probe method is the most common. In this study, a simple test procedure by clipping the voltage lead taps have been introduced instead of soldering which reduces time and effort and thereby achieving a much faster measurement of I c . When using a pair of iron clips, I c value decreased as compared with the measured one by standard method using soldered voltage taps and varies with the width of the clipped specimen part. However, when using a pure Cu clip, both by clipping and by soldering voltage taps give a comparable result and I c measured are equal and close to the samples specification. As a result, material to be used as voltage clip should be considered and should not influence the potential voltage between the leads during I c measurement. Furthermore, the simulation result of magnetic flux during I c measurement test showed that the decrease of I c observed in the experiment is due to the magnetic flux density, By produced at the clipped part of the sample by the operating current with iron clips attached to the sample.

  13. Capturing Students' Attention: Movie Clips Set the Stage for Learning in Abnormal Psychology.

    Science.gov (United States)

    Badura, Amy S.

    2002-01-01

    Presents results of a study that evaluated using popular movie clips, shown in the first class meeting of an abnormal psychology course, in relation to student enthusiasm. Compares two classes of female juniors, one using clips and one class not using them. States that the films portrayed psychological disorders. (CMK)

  14. Using Film Clips to Teach Teen Pregnancy Prevention: "The Gloucester 18" at a Teen Summit

    Science.gov (United States)

    Herrman, Judith W.; Moore, Christopher C.; Anthony, Becky

    2012-01-01

    Teaching pregnancy prevention to large groups offers many challenges. This article describes the use of film clips, with guided discussion, to teach pregnancy prevention. In order to analyze the costs associated with teen pregnancy, a film clip discussion session based with the film "The Gloucester 18" was the keynote of a youth summit. The lesson…

  15. A systematic review of discomfort due to toe or ear clipping in laboratory rodents

    NARCIS (Netherlands)

    Wever, K.E.; Geessink, F.J.; Brouwer, M.A.E.; Tillema, A.; Ritskes-Hoitinga, M.

    2017-01-01

    Toe clipping and ear clipping (also ear notching or ear punching) are frequently used methods for individual identification of laboratory rodents. These procedures potentially cause severe discomfort, which can reduce animal welfare and distort experimental results. However, no systematic summary of

  16. Real-world experience of MitraClip for treatment of severe mitral regurgitation

    DEFF Research Database (Denmark)

    Chan, Pak Hei; She, Hoi Lam; Alegria-Barrero, Eduardo

    2012-01-01

     Percutaneous edge-to-edge mitral valve repair with the MitraClip(®) was shown to be a safe and feasible alternative compared to conventional surgical mitral valve repair. Herein is reported our experience on MitraClip(®) for high-risk surgical candidates with severe mitral regurgitation (MR)....

  17. [Clip Sheets from BOCES. Opportunities. Health. Careers. = Oportunidades. Salud. Una Camera En...

    Science.gov (United States)

    State Univ. of New York, Geneseo. Coll. at Geneseo. Migrant Center.

    This collection of 83 clip sheets, or classroom handouts, was created to help U.S. migrants learn more about health, careers, and general "opportunities" including education programs. They are written in both English and Spanish and are presented in an easily understandable format. Health clip-sheet topics include the following: Abuse; AIDS;…

  18. Bayesian Recovery of Clipped OFDM Signals: A Receiver-based Approach

    KAUST Repository

    Al-Rabah, Abdullatif R.

    2013-01-01

    recovery algorithm to reconstruct the clipping signal at the receiver side by measuring part of subcarriers, iii) perform well in the absence of statistical information about the signal (e.g. clipping level) and the noise (e.g. noise variance

  19. Using Short Movie and Television Clips in the Economics Principles Class

    Science.gov (United States)

    Sexton, Robert L.

    2006-01-01

    The author describes a teaching method that uses powerful contemporary media, movie and television clips, to demonstrate the enormous breadth and depth of economic concepts. Many different movie and television clips can be used to show the power of economic analysis. The author describes the scenes and the economic concepts within those scenes for…

  20. Hypertensive retinopathy (image)

    Science.gov (United States)

    ... retina from high blood pressure is called hypertensive retinopathy. It occurs as the existing high blood pressure ... flame hemorrhages and cotton wool spots. As hypertensive retinopathy progresses, hard exudates can appear around the macula ...

  1. Hypertensive heart disease

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000163.htm Hypertensive heart disease To use the sharing features on this page, please enable JavaScript. Hypertensive heart disease refers to heart problems that occur because of ...

  2. Chronic Hypertension in Pregnancy

    Science.gov (United States)

    ... org/ by guest on June 19, 2018 Chronic Hypertension in Pregnancy Ellen W. Seely, MD; Cynthia Maxwell, ... M any women have been diag- nosed with hypertension (blood pressure Ͼ 140/ 90 mm Hg) when ...

  3. Molecular Recognition Involving Anthraquinone Derivatives and Molecular Clips

    Science.gov (United States)

    Alaparthi, Madhubabu

    In the past, we have demonstrated that 1,8-anthraquinone-18-crown-5 (1) and its heterocyclic derivatives act as luminescent hosts for a variety of cations of environmental and clinical concern. We report here a series of heteroatom-substituted macrocycles containing an anthraquinone moiety as a fluorescent signaling unit and a cyclic polyheteroether chain as the receptor. Sulfur, selenium, and tellurium derivatives of 1,8-anthraquinone-18-crown-5 (1) were synthesized by reacting sodium sulfide (Na2S), sodium selenide (Na2Se) and sodium telluride (Na2Te) with 1,8-bis(2-bromoethylethyleneoxy)anthracene - 9,10-dione in a 1:1 ratio (2,3, and 6). These sensors bind metal ions in a 1:1 ratio (7 and 8), and the optical properties of the new complexes were examined and the sulfur and selenium analogues show that selectivity for Pb(II) is markedly improved as compared to the oxygen analogue 1 which was competitive for Ca(II) ion. Selective reduction of 1 yields secondary alcohols where either one or both of the anthraquinone carbonyl groups has been reduced ( 15 and 9). A new mechanism for the fluorescence detection of metal cations in solution is introduced involving a unique keto-enol tautomerization. Reduction of 1 yields the doubly reduced secondary alcohol, 9. 9 acts as a chemodosimeter for Al(III) ion producing a strong blue emission due to the formation of the anthracene fluorophore, 10, via dehydration of the internal secondary alcohol in DMSO/aqueous solution. The enol form is not the most thermodynamically stable form under these conditions however, and slowly converts to the keto form 11.. Currently we are focusing on cucurbituril derivatives, also described as molecular clips due to their folded geometry used as molecular recognition hosts. We first investigated the synthesis and characterization of aromatic methoxy/catechol terminated cucurbituril units that act as hosts for small solvent molecules, such as CH2Cl2, CH3CN, DMF, and MeOH, through dual pi...H-C T

  4. Maskeret hypertension i graviditeten

    DEFF Research Database (Denmark)

    Fischer, Margit Bistrup; Thingaard, Ebbe; Andersen, Anita Sylvest

    2018-01-01

    Hypertension during pregnancy is one of the leading causes of maternal and foetal morbidity and mortality. Monitoring of blood pressure is therefore an essential part of prenatal care. Masked hypertension, where blood pressure levels are elevated at home despite normal blood pressure levels...... monitored in a clinical setting, may lead to cardiovascular and obstetric complications equal to those of sustained hypertension. This article discusses masked hypertension and the need for further investigation of blood pressure monitoring during pregnancy....

  5. Maskeret hypertension i graviditeten

    DEFF Research Database (Denmark)

    Fischer, Margit Bistrup; Thingaard, Ebbe; Andersen, Anita Sylvest

    2018-01-01

    Hypertension during pregnancy is one of the leading causes of maternal and foetal morbidity and mortality. Monitoring of blood pressure is therefore an essential part of prenatal care. Masked hypertension, where blood pressure levels are elevated at home despite normal blood pressure levels monit...... monitored in a clinical setting, may lead to cardiovascular and obstetric complications equal to those of sustained hypertension. This article discusses masked hypertension and the need for further investigation of blood pressure monitoring during pregnancy....

  6. Biochemical Analysis Reveals the Multifactorial Mechanism of Histone H3 Clipping by Chicken Liver Histone H3 Protease

    KAUST Repository

    Chauhan, Sakshi; Mandal, Papita; Tomar, Raghuvir S.

    2016-01-01

    Proteolytic clipping of histone H3 has been identified in many organisms. Despite several studies, the mechanism of clipping, the substrate specificity, and the significance of this poorly understood epigenetic mechanism are not clear. We have

  7. Hypertension after kidney transplantation

    NARCIS (Netherlands)

    Dobrowolski, L.C.

    2016-01-01

    Hypertension increases the cardiovascular risk in kidney transplant recipients (KTRs). In chapter 2 we found that hypertension was highly prevalent in adult (77.2%), paediatric (62.7%) and young adult (86.4%) KTRs. Transition from the paediatric to adult care did not affect hypertension and there

  8. Hypertension in pregnancy

    Directory of Open Access Journals (Sweden)

    Andrea Ungar

    2007-03-01

    Full Text Available Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Hypertensive disorders during pregnancy are classified into 4 categories: chronic hypertension, pre-eclampsia/eclampsia, pre-eclampsia superimposed on chronic hypertension, and gestational hypertension. A relative paucity of investigative data, as well as the frequent difficulty in making an etiological diagnosis, may lead to problems in its management. This case report analyses current concepts regarding the hypertensive disorders of gestation, focusing on chronic hypertension. Chronic hypertension is defined as blood pressure exceeding 140/90 mmHg before pregnancy or before 20 weeks gestation. Hypertensive disorders in pregnancy may cause maternal and fetal morbidity and remain a leading source of maternal mortality. A prompt diagnosis is needed also because hypertension may be an indicator of pre-eclampsia, a condition which can evolve into serious complications. Maintaining blood pressure below 140/90 mmHg is recommended, although treatment should be determined on an individual basis. Many anti-hypertensive agents appear to be safe for use during pregnancy: methildopa has been the most studied of the anti-hypertensive drugs and has the best safety record. Labetalol, idralazine and nifedipine also have been found to be safe; ACE-inhibitors are absolutely contraindicated, because they are associated with intrauterine growth retardation.

  9. Genetik og hypertension

    DEFF Research Database (Denmark)

    Ellervik, Christina; Tarnow, Lisa; Pedersen, Erling Bjerregaard

    2009-01-01

    Monogenic forms of hypertension are very rare, but have a well-characterized heredity. Primary hypertension is very common with a complex and polygenic heredity. Primary hypertension arises due to an interaction between multiple genetic and environmental factors. Its heredity is unknown, although...

  10. Assessing arsenic and selenium in a single nail clipping using portable X-ray fluorescence

    International Nuclear Information System (INIS)

    Fleming, David E.B.; Nader, Michel N.; Foran, Kelly A.; Groskopf, Craig; Reno, Michael C.; Ware, Chris S.; Tehrani, Mina; Guimarães, Diana; Parsons, Patrick J.

    2017-01-01

    The feasibility of measuring arsenic and selenium contents in a single nail clipping was investigated using a small-focus portable X-ray fluorescence (XRF) instrument with monochromatic excitation beams. Nail clipping phantoms supplemented with arsenic and selenium to produce materials with 0, 5, 10, 15, and 20 µg/g were used for calibration purposes. In total, 10 different clippings were analyzed at two different measurement positions. Energy spectra were fit with detection peaks for arsenic K_α, selenium K_α, arsenic K_β, selenium K_β, and bromine K_α characteristic X-rays. Data analysis was performed under two distinct conditions of fitting constraint. Calibration lines were established from the amplitude of each of the arsenic and selenium peaks as a function of the elemental contents in the clippings. The slopes of the four calibration lines were consistent between the two conditions of analysis. The calculated minimum detection limit (MDL) of the method, when considering the K_α peak only, ranged from 0.210±0.002 µg/g selenium under one condition of analysis to 0.777±0.009 µg/g selenium under another. Compared with previous portable XRF nail clipping studies, MDLs were substantially improved for both arsenic and selenium. The new measurement technique had the additional benefits of being short in duration (~3 min) and requiring only a single nail clipping. The mass of the individual clipping used did not appear to play a major role in signal strength, but positioning of the clipping is important. - Highlights: • Portable X-ray fluorescence was used to assess As and Se in nail clipping phantoms. • Calibration lines were consistent between two different conditions of data analysis. • This new XRF approach was sensitive and required only a single nail clipping.

  11. Multivariate Cryptography Based on Clipped Hopfield Neural Network.

    Science.gov (United States)

    Wang, Jia; Cheng, Lee-Ming; Su, Tong

    2018-02-01

    Designing secure and efficient multivariate public key cryptosystems [multivariate cryptography (MVC)] to strengthen the security of RSA and ECC in conventional and quantum computational environment continues to be a challenging research in recent years. In this paper, we will describe multivariate public key cryptosystems based on extended Clipped Hopfield Neural Network (CHNN) and implement it using the MVC (CHNN-MVC) framework operated in space. The Diffie-Hellman key exchange algorithm is extended into the matrix field, which illustrates the feasibility of its new applications in both classic and postquantum cryptography. The efficiency and security of our proposed new public key cryptosystem CHNN-MVC are simulated and found to be NP-hard. The proposed algorithm will strengthen multivariate public key cryptosystems and allows hardware realization practicality.

  12. Pull-off characteristics of double-shanked compared to single-shanked ligation clips: an animal study

    Directory of Open Access Journals (Sweden)

    Schenk Martin

    2016-09-01

    Full Text Available The use of surgical ligation clips is considered as the gold standard for the closure of vessels, particularly in laparoscopic surgery. The safety of clips is mainly achieved by the deep indentation of the metal bar with a high retention force. A novel double-shanked (DS titanium clip was compared to two single-shanked clips with respect to axial and radial pull-off forces.

  13. Survival Prediction in Patients Undergoing Open-Heart Mitral Valve Operation After Previous Failed MitraClip Procedures.

    Science.gov (United States)

    Geidel, Stephan; Wohlmuth, Peter; Schmoeckel, Michael

    2016-03-01

    The objective of this study was to analyze the results of open heart mitral valve operations for survival prediction in patients with previously unsuccessful MitraClip procedures. Thirty-three consecutive patients who underwent mitral valve surgery in our institution were studied. At a median of 41 days, they had previously undergone one to five futile MitraClip implantations. At the time of their operations, patients were 72.6 ± 10.3 years old, and the calculated risk, using the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II, was a median of 26.5%. Individual outcomes were recorded, and all patients were monitored postoperatively. Thirty-day mortality was 9.1%, and the overall survival at 2.2 years was 60.6%. Seven cardiac-related and six noncardiac deaths occurred. Univariate survival regression models demonstrated a significant influence of the following variables on survival: EuroSCORE II (p = 0.0022), preoperative left ventricular end-diastolic dimension (p = 0.0052), left ventricular ejection fraction (p = 0.0249), coronary artery disease (p = 0.0385), and severe pulmonary hypertension (p = 0.0431). Survivors showed considerable improvements in their New York Heart Association class (p < 0.0001), left ventricular ejection fraction (p = 0.0080), grade of mitral regurgitation (p = 0.0350), and mitral valve area (p = 0.0486). Survival after mitral repair was not superior to survival after replacement. Indications for surgery after failed MitraClip procedures must be considered with the greatest of care. Variables predicting postoperative survival should be taken into account regarding the difficult decision as to whether to operate or not. Our data suggest that replacement of the pretreated mitral valve is probably the more reasonable concept rather than complex repairs. When the EuroSCORE II at the time of surgery exceeds 30%, conservative therapy is advisable. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc

  14. Characteristics and Outcomes of Patients with Anterior Circulation Intracranial Aneurysm Managed with Clipping in Hospital Sungai Buloh.

    Science.gov (United States)

    Ab Ghani, Ailani; Nayan, Saiful Azli Mat; Kandasamy, Regunath; Rosman, Azmin Kas; Ghani, Abdul Rahman Izani

    2016-11-01

    The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1-1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon's preference. This study aims to report the characteristics and outcomes of patients with a clipped anterior circulation aneurysm in Hospital Sungai Buloh. We retrospectively collected the data of patients with anterior circulation aneurysms who underwent clipping from 1 January 2013 until 30 June 2014 in Hospital Sungai Buloh. The mean age of the patients was 48.9 years old, and 56.7% of the study population were male and 63.3% were Malay. There were almost equal numbers of patients with (46.7%) and without (53.3%) co-morbidities such as hypertension and ischaemic heart disease. Half of the study population fell under Fisher grade 3 (50.0%), whereas 46.7% were Fisher grade 4. With respect to the Navarro score, 20% of patients scored 10, 16.7% scored 5 or 7, 13.3% scored 11, 10% scored 9, 6.7% scored 1 and 3.3% scored 2, 3 or 8. Most of the patients fell under grade I (33.3%) of the World Federation of Neurological Societies grading (WFNS), and the fewest number of patients were grade III (3.3%). Most (56.7%) patients had an intracranial aneurysm located at the anterior communicating artery (ACOM), followed by the anterior cerebral artery (ACA) and the middle cerebral artery (MCA) (16.7% each), the posterior communicating artery (PCOM) (6.7%) and, finally, the internal carotid artery (ICA) (3.3%). Neurological outcomes at three and six months were assessed using the Modified Rankin Scale (mRS). At three months follow-up, the majority of the participants (33.3%) scored 0 or 6, whereas at six months

  15. CLIPS - C LANGUAGE INTEGRATED PRODUCTION SYSTEM (IBM PC VERSION WITH CLIPSITS)

    Science.gov (United States)

    Riley, , .

    1994-01-01

    The C Language Integrated Production System, CLIPS, is a shell for developing expert systems. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. The primary design goals for CLIPS are portability, efficiency, and functionality. For these reasons, the program is written in C. CLIPS meets or outperforms most micro- and minicomputer based artificial intelligence tools. CLIPS is a forward chaining rule-based language. The program contains an inference engine and a language syntax that provide a framework for the construction of an expert system. It also includes tools for debugging an application. CLIPS is based on the Rete algorithm, which enables very efficient pattern matching. The collection of conditions and actions to be taken if the conditions are met is constructed into a rule network. As facts are asserted either prior to or during a session, CLIPS pattern-matches the number of fields. Wildcards and variables are supported for both single and multiple fields. CLIPS syntax allows the inclusion of externally defined functions (outside functions which are written in a language other than CLIPS). CLIPS itself can be embedded in a program such that the expert system is available as a simple subroutine call. Advanced features found in CLIPS version 4.3 include an integrated microEMACS editor, the ability to generate C source code from a CLIPS rule base to produce a dedicated executable, binary load and save capabilities for CLIPS rule bases, and the utility program CRSV (Cross-Reference, Style, and Verification) designed to facilitate the development and maintenance of large rule bases. Five machine versions are available. Each machine version includes the source and the executable for that machine. The UNIX version includes the source and binaries for IBM RS/6000, Sun3 series, and Sun4 series computers. The UNIX, DEC VAX, and DEC RISC Workstation versions are line oriented. The PC version and the Macintosh

  16. Idiopathic portal hypertension

    International Nuclear Information System (INIS)

    Han, Tae Kyun; Ryu, Dae Sik; Kim, Heung Chul; Hur, Hun; Eom, Kyeung Tae; Namkung, Sook; Park, Man Soo; Hwang, Woo Chul; Lee, Kwan Seop

    1996-01-01

    To describe the radiologic findings of idiopathic portal hypertension and to find the points of differentiation between idiopathic portal hypertension and liver cirrhosis. Four portograms in five patients who for four years had suffered from pathologically confirmed idiopathic portal hypertension were retrospectively analyzed and compared with a portogram obtained from a control subject with liver cirrhosis. Portographic finding s of idiopathic portal hypertension were paucity of medium-sized portal branches, irregular and obtuse-angled division of peripheral branches, abrupt interruption and an avascular area beneath the liver margin. A portogram of idiopathic portal hypertension may be useful in differentiation this and liver cirrhosis

  17. SECONDARY (ENDOCRINE HYPERTENSION: LECTURE

    Directory of Open Access Journals (Sweden)

    M. Yu. Yukina

    2016-01-01

    Full Text Available Hypertension is a  very common disease with high morbidity and reduction in quality of life. Endocrine disorders are the most common cause of secondary hypertension affecting ~3% of the population. Primary aldosteronism can be the cause of endocrine hypertension more often than other endocrine disorders. Other less common causes of endocrine hypertension include Cushing syndrome, pheochromocytoma, thyroid disorders, and hyperparathyroidism. Endocrine hypertension is potentially curable if the underlying cause is identified and treated accordingly. Younger age at manifestation of resistance to multiple antihypertensive drugs, together with other clinical signs of an endocrine disorder, should raise the suspicion and prompt the appropriate evaluation.

  18. 76 FR 31360 - Paper Clips From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping...

    Science.gov (United States)

    2011-05-31

    ... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-663 Third Review] Paper Clips From China; Scheduling of an Expedited Five-Year Review Concerning the Antidumping Duty Order on Paper Clips From China... paper clips from China would be likely to lead to continuation or recurrence of material injury within a...

  19. Structural changes in the human vas deferens after tantalum clip occlusion and conventional vasectomy.

    Science.gov (United States)

    Kothari, L K; Gupta, A S

    1978-02-01

    In 15 human subjects, the vasa deferentia were occluded by applying two tantalum clips on one side and by conventional vasectomy with silk ligatures on the other. After 2 weeks, the occluded segments were recovered for histopathologic examination of serial sections. Obstructing the seminal tract did not, as such, produce any significant change in the vas: the distal and proximal segments appeared to be essentially similar and normal. At the actual site of occlusion, however, tantalum clips produced marked flattening of the tube, complete loss of lining epithelium, distortion of the muscular lamellae, and areas of hemorrhage. The lumen was converted into a narrow slit. Under the ligatures, the damage was largely confined to denudation of the mucosal epithelium. The mucosa of the intersegment left unexcised between two clips showed hyalinization, invasion by macrophages, and degeneration of the epithelium. The changes under the clips suggest that, although clip occlusion may offer several advantages, sterility cannot be reversed merely by removing the clips. The mechanisms of these changes, different in the case of clips and ligatures, are discussed and some possible long-term consequences are considered.

  20. Comparison of Sonography versus Digital Breast Tomosynthesis to Locate Intramammary Marker Clips.

    Science.gov (United States)

    Schulz-Wendtland, R; Dankerl, P; Dilbat, G; Bani, M; Fasching, P A; Heusinger, K; Lux, M P; Loehberg, C R; Jud, S M; Rauh, C; Bayer, C M; Beckmann, M W; Wachter, D L; Uder, M; Meier-Meitinger, M; Brehm, B

    2015-01-01

    Introduction: This study aimed to compare the accuracy of sonography versus digital breast tomosynthesis to locate intramammary marker clips placed under ultrasound guidance. Patients and Methods: Fifty patients with suspicion of breast cancer (lesion diameter less than 2 cm [cT1]) had ultrasound-guided core needle biopsy with placement of a marker clip in the center of the tumor. Intramammary marker clips were subsequently located with both sonography and digital breast tomosynthesis. Results: Sonography detected no dislocation of intrammammary marker clips in 42 of 50 patients (84 %); dislocation was reported in 8 patients (16 %) with a maximum dislocation of 7 mm along the x-, y- or z-axis. Digital breast tomosynthesis showed accurate placement without dislocation of the intramammary marker clip in 48 patients (96 %); 2 patients (4 %) had a maximum clip dislocation of 3 mm along the x-, y- or z-axis (p tomosynthesis could improve the accuracy when locating intramammary marker clips compared to sonography and could, in future, be used to complement or even completely replace sonography.

  1. Simple device to determine the pressure applied by pressure clips for the treatment of earlobe keloids

    Directory of Open Access Journals (Sweden)

    Aashish Sasidharan

    2015-01-01

    Full Text Available Background: Keloids of the ear are common problems. Various treatment modalities are available for the treatment of ear keloids. Surgical excision with intralesional steroid injection along with compression therapy has the least recurrence rate. Various types of devices are available for pressure therapy. Pressure applied by these devices is uncontrolled and is associated with the risk of pressure necrosis. We describe here a simple and easy to use device to measure pressure applied by these clips for better outcome. Objectives: To devise a simple method to measure the pressure applied by various pressure clips used in ear keloid pressure therapy. Materials and Methods: By using a force sensitive resistor (FSR, the pressure applied gets converted into voltage using electrical wires, resistors, capacitors, converter, amplifier, diode, nine-volt (9V cadmium battery and the voltage is measured using a multimeter. The measured voltage is then converted into pressure using pressure voltage graph that depicts the actual pressure applied by the pressure clip. Results: The pressure applied by different clips was variable. The spring clips were adjustable by slight variation in the design whereas the pressure applied by binder clips and magnet discs was not adjustable. Conclusion: The uncontrolled/suboptimal pressure applied by certain pressure clips can be monitored to provide optimal pressure therapy in ear keloid for better outcome.

  2. What kind of erotic film clips should we use in female sex research? An exploratory study.

    Science.gov (United States)

    Woodard, Terri L; Collins, Karen; Perez, Mindy; Balon, Richard; Tancer, Manuel E; Kruger, Michael; Moffat, Scott; Diamond, Michael P

    2008-01-01

    Erotic film clips are used in sex research, including studies of female sexual dysfunction and arousal. However, little is known about which clips optimize female sexual response. Furthermore, their use is not well standardized. To identify the types of film clips that are most mentally appealing and physically arousing to women for use in future sexual function and dysfunction studies; to explore the relationship between mental appeal and reported physical arousal; to characterize the content of the films that were found to be the most and least appealing and arousing. Twenty-one women viewed 90 segments of erotic film clips. They rated how (i) mentally appealing and (ii) how physically aroused they were by each clip. The data were analyzed by descriptive statistics. The means of the mental and self-reported physical responses were calculated to determine the most and least appealing/arousing film clips. Pearson correlations were calculated to assess the relationship between mental appeal and reported physical arousal. Self-reported mental and physical arousal. Of 90 film clips, 18 were identified as the most mentally appealing and physically arousing while nine were identified as the least mentally appealing and physically arousing. The level of mental appeal positively correlated with the level of perceived physical arousal in both categories (r = 0.61, P Erotic film clips reliably produced a state of self-reported arousal in women. The most appealing and arousing films tended to depict heterosexual vaginal intercourse. Film clips with these attributes should be used in future research of sexual function and response of women.

  3. Virtual Cerebral Aneurysm Clipping with Real-Time Haptic Force Feedback in Neurosurgical Education.

    Science.gov (United States)

    Gmeiner, Matthias; Dirnberger, Johannes; Fenz, Wolfgang; Gollwitzer, Maria; Wurm, Gabriele; Trenkler, Johannes; Gruber, Andreas

    2018-04-01

    Realistic, safe, and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education, and they should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force feedback and real-time deformation of the aneurysm and vessels. A prototype simulator was developed from 2012 to 2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software, and the prototype was evaluated by 18 neurosurgeons. In 4 patients with different medial cerebral artery aneurysms, virtual clipping was performed after real-life surgery, and surgical results were compared regarding clip application, surgical trajectory, and blood flow. After head positioning and craniotomy, bimanual virtual aneurysm clipping with an original forceps was performed. Blood flow simulation demonstrated residual aneurysm filling or branch stenosis. The simulator improved anatomic understanding for 89% of neurosurgeons. Simulation of head positioning and craniotomy was considered realistic by 89% and 94% of users, respectively. Most participants agreed that this simulator should be integrated into neurosurgical education (94%). Our illustrative cases demonstrated that virtual aneurysm surgery was possible using the same trajectory as in real-life cases. Both virtual clipping and blood flow simulation were realistic in broad-based but not calcified aneurysms. Virtual clipping of a calcified aneurysm could be performed using the same surgical trajectory, but not the same clip type. We have successfully developed a virtual aneurysm-clipping simulator. Next, we will prospectively evaluate this device for surgical procedure planning and education. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Portable x-ray fluorescence for the analysis of chromium in nail and nail clippings

    International Nuclear Information System (INIS)

    Fleming, David E.B.; Ware, Chris S.

    2017-01-01

    Assessment of chromium content in human nail or nail clippings could serve as an effective biomarker of chromium status. The feasibility of a new portable x-ray fluorescence (XRF) approach to chromium measurement was investigated through analysis of nail and nail clipping phantoms. Five measurements of 180 s (real time) duration were first performed on six whole nail phantoms having chromium concentrations of 0, 2, 5, 10, 15, and 20 µg/g. Using nail clippers, these phantoms were then converted to nail clippings, and assembled into different mass groups of 20, 40, 60, 80, and 100 mg for additional measurements. The amplitude of the chromium Kα characteristic x-ray energy peak was examined as a function of phantom concentration for all measurement conditions to create a series of calibration lines. The minimum detection limit (MDL) for chromium was also calculated for each case. The chromium MDL determined from the whole nail intact phantoms was 0.88±0.03 µg/g. For the clipping phantoms, the MDL ranged from 1.2 to 3.3 µg/g, depending on the mass group analyzed. For the 40 mg clipping group, the MDL was 1.2±0.1 µg/g, and higher mass collections did not improve upon this result. This MDL is comparable to chromium concentration levels seen in various studies involving human nail clippings. Further improvements to the portable XRF technique would be required to detect chromium levels expected from the lower end of a typical population. - Highlights: • Portable x-ray fluorescence (XRF) was explored as a technique to assess levels of chromium in human nails or nail clippings. • Results were found to depend on the mass of clipping sample provided. • Minimum detection limits for chromium were similar to concentration levels found in previous studies of human nail clippings.

  5. Successful Removal of Football Helmet Face-Mask Clips After 1 Season of Use

    Science.gov (United States)

    Scibek, Jason S.; Gatti, Joseph M.; McKenzie, Jennifer I.

    2012-01-01

    Context Whereas many researchers have assessed the ability to remove loop straps in traditional face-mask attachment systems after at least 1 season of use, research in which the effectiveness of the Riddell Quick Release (QR) Face Guard Attachment System clip after 1 season has been assessed is limited. Objective To examine the success rate of removing the QR clips after 1 season of use at the Football Championship Subdivision level. We hypothesized that 1 season of use would negatively affect the removal rate of the QR clip but repeated clip-removal trials would improve the removal rate. Design Retrospective, quasi-experimental design. Setting Controlled laboratory study. Patients or Other Participants Sixty-three football helmets from a National Collegiate Athletic Association Division I university located in western Pennsylvania used during the 2008 season were tested. Intervention(s) Three certified athletic trainers (2 men, 1 woman; age = 31.3 ± 3.06 years, time certified = 9.42 ± 2.65 years) attempted to remove the QR clips from each helmet with the tool provided by the manufacturer. Helmets then were reassembled to allow each athletic trainer to attempt clip removal. Main Outcome Measure(s) The dependent variables were total left clips removed (TCR-L), total right clips removed (TCR-R), and total clips removed (TCR). Success rate of clip removal (SRCR) also was assessed. Results Percentages for TCR-L, TCR-R, and TCR were 100% (189 of 189), 96.30% (182 of 189), and 98.15% (371 of 378), respectively. A paired-samples t test revealed a difference between TCR-R and TCR-L (t188 = −2.689, P = .008, μd = 0.037, 95% confidence interval [CI] = −0.064, −0.010). The percentage for SRCR was 96.30% (n = 182), whereas SRCR percentages for trials 1, 2, and 3 were 95.24% (n = 60), 98.41% (n = 62), and 95.24% (n = 60), respectively, and did not represent a difference (F2,186 = 0.588, P = .56, 95% CI = 0.94, 0.99). Conclusions Our results indicated favorable and

  6. Multichannel infinite clipping as a form of sampling of speech signals

    International Nuclear Information System (INIS)

    Guidarelli, G.

    1985-01-01

    A remarkable improvement of both intelligibility and naturalness of infinitely clipped speech can be achieved by means of a multichannel system in which the speech signal is splitted into several band-pass channels before the clipping and successively reconstructed by summing up the clipped outputs of each channel. A possible explanation of such an improvement is given, founded on the so-called zero-based representation of band limited signals where the zero-crossings sequence is considered as a set of samples of the signal

  7. Advantages in imaging results with titanium aneurysm clips (TiAl6V4)

    International Nuclear Information System (INIS)

    Piepgras, A.; Gueckel, F.; Weik, T.; Schmiedek, P.

    1995-01-01

    Aneurysm clips made of a titanium alloy (TiAl6V4) were used in clinical practice for the first time. The design of the clips is identical to the routinely used Yasargil series. In 30 patients, 38 symptomatic and asymptomatic aneurysms were fixed with 45 clips. Metallurgical advantages of the new alloy are better biocompatibility, less magnetic susceptibility, and lower X-ray density. The postoperative imaging results are superior to the conventionally used alloys with respect to artifact reduction in computed tomography, angiography, and magnetic resonance imaging. With a follow-up period of 7 months, a statement on biocompatibility cannot yet be given. (orig.) [de

  8. CLIPS 6.0 - C LANGUAGE INTEGRATED PRODUCTION SYSTEM, VERSION 6.0 (IBM PC VERSION)

    Science.gov (United States)

    Donnell, B.

    1994-01-01

    CLIPS, the C Language Integrated Production System, is a complete environment for developing expert systems -- programs which are specifically intended to model human expertise or knowledge. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. CLIPS 6.0 provides a cohesive tool for handling a wide variety of knowledge with support for three different programming paradigms: rule-based, object-oriented, and procedural. Rule-based programming allows knowledge to be represented as heuristics, or "rules-of-thumb" which specify a set of actions to be performed for a given situation. Object-oriented programming allows complex systems to be modeled as modular components (which can be easily reused to model other systems or create new components). The procedural programming capabilities provided by CLIPS 6.0 allow CLIPS to represent knowledge in ways similar to those allowed in languages such as C, Pascal, Ada, and LISP. Using CLIPS 6.0, one can develop expert system software using only rule-based programming, only object-oriented programming, only procedural programming, or combinations of the three. CLIPS provides extensive features to support the rule-based programming paradigm including seven conflict resolution strategies, dynamic rule priorities, and truth maintenance. CLIPS 6.0 supports more complex nesting of conditional elements in the if portion of a rule ("and", "or", and "not" conditional elements can be placed within a "not" conditional element). In addition, there is no longer a limitation on the number of multifield slots that a deftemplate can contain. The CLIPS Object-Oriented Language (COOL) provides object-oriented programming capabilities. Features supported by COOL include classes with multiple inheritance, abstraction, encapsulation, polymorphism, dynamic binding, and message passing with message-handlers. CLIPS 6.0 supports tight integration of the rule-based programming features of CLIPS with

  9. CLIPS 6.0 - C LANGUAGE INTEGRATED PRODUCTION SYSTEM, VERSION 6.0 (UNIX VERSION)

    Science.gov (United States)

    Donnell, B.

    1994-01-01

    CLIPS, the C Language Integrated Production System, is a complete environment for developing expert systems -- programs which are specifically intended to model human expertise or knowledge. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. CLIPS 6.0 provides a cohesive tool for handling a wide variety of knowledge with support for three different programming paradigms: rule-based, object-oriented, and procedural. Rule-based programming allows knowledge to be represented as heuristics, or "rules-of-thumb" which specify a set of actions to be performed for a given situation. Object-oriented programming allows complex systems to be modeled as modular components (which can be easily reused to model other systems or create new components). The procedural programming capabilities provided by CLIPS 6.0 allow CLIPS to represent knowledge in ways similar to those allowed in languages such as C, Pascal, Ada, and LISP. Using CLIPS 6.0, one can develop expert system software using only rule-based programming, only object-oriented programming, only procedural programming, or combinations of the three. CLIPS provides extensive features to support the rule-based programming paradigm including seven conflict resolution strategies, dynamic rule priorities, and truth maintenance. CLIPS 6.0 supports more complex nesting of conditional elements in the if portion of a rule ("and", "or", and "not" conditional elements can be placed within a "not" conditional element). In addition, there is no longer a limitation on the number of multifield slots that a deftemplate can contain. The CLIPS Object-Oriented Language (COOL) provides object-oriented programming capabilities. Features supported by COOL include classes with multiple inheritance, abstraction, encapsulation, polymorphism, dynamic binding, and message passing with message-handlers. CLIPS 6.0 supports tight integration of the rule-based programming features of CLIPS with

  10. CLIPS 6.0 - C LANGUAGE INTEGRATED PRODUCTION SYSTEM, VERSION 6.0 (MACINTOSH VERSION)

    Science.gov (United States)

    Riley, G.

    1994-01-01

    CLIPS, the C Language Integrated Production System, is a complete environment for developing expert systems -- programs which are specifically intended to model human expertise or knowledge. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. CLIPS 6.0 provides a cohesive tool for handling a wide variety of knowledge with support for three different programming paradigms: rule-based, object-oriented, and procedural. Rule-based programming allows knowledge to be represented as heuristics, or "rules-of-thumb" which specify a set of actions to be performed for a given situation. Object-oriented programming allows complex systems to be modeled as modular components (which can be easily reused to model other systems or create new components). The procedural programming capabilities provided by CLIPS 6.0 allow CLIPS to represent knowledge in ways similar to those allowed in languages such as C, Pascal, Ada, and LISP. Using CLIPS 6.0, one can develop expert system software using only rule-based programming, only object-oriented programming, only procedural programming, or combinations of the three. CLIPS provides extensive features to support the rule-based programming paradigm including seven conflict resolution strategies, dynamic rule priorities, and truth maintenance. CLIPS 6.0 supports more complex nesting of conditional elements in the if portion of a rule ("and", "or", and "not" conditional elements can be placed within a "not" conditional element). In addition, there is no longer a limitation on the number of multifield slots that a deftemplate can contain. The CLIPS Object-Oriented Language (COOL) provides object-oriented programming capabilities. Features supported by COOL include classes with multiple inheritance, abstraction, encapsulation, polymorphism, dynamic binding, and message passing with message-handlers. CLIPS 6.0 supports tight integration of the rule-based programming features of CLIPS with

  11. Chronic hypertension alters the expression of Cx43 in cardiovascular muscle cells

    Directory of Open Access Journals (Sweden)

    Haefliger J.-A.

    2000-01-01

    Full Text Available Connexin43 (Cx43, the predominant gap junction protein of muscle cells in vessels and heart, is involved in the control of cell-to-cell communication and is thought to modulate the contractility of the vascular wall and the electrical coupling of cardiac myocytes. We have investigated the effects of arterial hypertension on the expression of Cx43 in aorta and heart in three different models of experimental hypertension. Rats were made hypertensive either by clipping one renal artery (two kidney, one-clip renal (2K,1C model by administration of deoxycorticosterone and salt (DOCA-salt model or by inhibiting nitric oxide synthase with NG-nitro-L-arginine methyl ester (L-NAME model. After 4 weeks, rats of the three models showed a similar increase in intra-arterial mean blood pressure and in the thickness of the walls of both aorta and heart. Analysis of heart mRNA demonstrated no change in Cx43 expression in the three models compared to their respective controls. The same 2K,1C and DOCA-salt hypertensive animals expressed twice more Cx43 in aorta, and the 2K,1C rats showed an increase in arterial distensibility. In contrast, the aortae of L-NAME hypertensive rats were characterized by a 50% decrease in Cx43 and the carotid arteries did not show increased distensibility. Western blot analysis indicated that Cx43 was more phosphorylated in the aortae of 2K,1C rats than in those of L-NAME or control rats, indicating a differential regulation of aortic Cx43 in different models of hypertension. The data suggest that localized mechanical forces induced by hypertension affect Cx43 expression and that the cell-to-cell communication mediated by Cx43 channels may contribute to regulating the elasticity of the vascular wall.

  12. Noncirrhotic portal hypertension.

    Science.gov (United States)

    Da, Ben L; Koh, Christopher; Heller, Theo

    2018-05-01

    Noncirrhotic portal hypertension represents a heterogeneous group of liver disorders that is characterized by portal hypertension in the absence of cirrhosis. The purpose of this review is to serve as a guide on how to approach a patient with noncirrhotic portal hypertension with a focus on recent developments. Recent studies pertaining to noncirrhotic portal hypertension have investigated aetiological causes, mechanisms of disease, noninvasive diagnostic modalities, clinical characteristics in the paediatric population and novel treatment targets. Noncirrhotic portal hypertension is an underappreciated clinical entity that can be difficult to diagnosis without a healthy suspicion. Diagnosis then relies on a comprehensive understanding of the causes and clinical manifestations of this disease, as well as a careful interpretation of the liver biopsy. Noninvasive approaches to diagnosis may play a significant role moving forward in this disease. Treatment in NCPH remains largely targeted at the individual sequalae of portal hypertension.

  13. Hypertension in Danish seafarers

    DEFF Research Database (Denmark)

    Tu, Mingshan; Jepsen, Jørgen Riis

    2016-01-01

    Background: Due to the high prevalence of arterial hypertension and its role in the development of athe- rosclerosis, myocardial infarction and stroke, hypertension is a major public health challenge worldwide. There is limited knowledge of the prevalence of hypertension among seafarers who......, however, are known to have an excess morbidity and mortality from these disorders. This article addresses the prevalence of hypertension among Danish seafarers and discusses potential risk factors for hypertension in maritime settings. Materials and methods: A representative sample of 629 Danish seafarers...... who had statutory medical examinations was studied from the beginning of October 2011 to the end of June 2012. The medical examination included measurements of blood pressure. The prevalence of hypertension in the study po- pulation was stratified by age, work place on board, smoking status, alcohol...

  14. Supplemental knowledge acquisition through external product interface for CLIPS

    Science.gov (United States)

    Saito, Tim; Ebaud, Stephen; Loftin, Bowen R.

    1990-01-01

    Traditionally, the acquisition of knowledge for expert systems consisted of the interview process with the domain or subject matter expert (SME), observation of domain environment, and information gathering and research which constituted a direct form of knowledge acquisition (KA). The knowledge engineer would be responsible for accumulating pertinent information and/or knowledge from the SME(s) for input into the appropriate expert system development tool. The direct KA process may (or may not) have included forms of data or documentation to incorporate from the SME's surroundings. The differentiation between direct KA and supplemental KA (indirect) would be the difference in the use of data. In acquiring supplemental knowledge, the knowledge engineer would access other types of evidence (manuals, documents, data files, spreadsheets, etc.) that would support the reasoning or premises of the SME. When an expert makes a decision in a particular task, one tool that may have been used to justify a recommendation, would have been a spreadsheet total or column figure. Locating specific decision points from that data within the SME's framework would constitute supplemental KA. Data used for a specific purpose in one system or environment would be used as supplemental knowledge for another, specifically a CLIPS project.

  15. Neighbour effects on Erica multiflora (Ericaceae) reproductive performance after clipping

    Science.gov (United States)

    Vilà, Montserrat; Terradas, Jaume

    1998-04-01

    The effect of interspecific competition on resprouting and reproductive success and the relationship between above-ground vegetative biomass variability and reproductive biomass variability were analysed during resprouting after clipping. For this purpose, a field experiment was performed by removing neighbours around individuals of Erica multiflora in a Mediterranean shrub community. Removal of neighbours increased the number of sprouts and the above-ground vegetative biomass of target plants. However, it did not decrease plant size variability. Neighbours decreased the likelihood of fruiting and the biomass of fruits. In target plants that had set fruits a simple allometric relationship between above-ground vegetative biomass and the biomass of fruits explained 42% of the variation in fruit biomass. The probability to set fruits at a given plant size was smaller in plants with neighbours than without neighbours. Presence of neighbours also increased the variability of fruit biomass within the population, because 50% of target plants with neighbours did not set fruits. This failure to set fruits may be related to shading, the small size of plants with neighbours, as well as a delay in development.

  16. Fault Diagnosis of Motor Bearing by Analyzing a Video Clip

    Directory of Open Access Journals (Sweden)

    Siliang Lu

    2016-01-01

    Full Text Available Conventional bearing fault diagnosis methods require specialized instruments to acquire signals that can reflect the health condition of the bearing. For instance, an accelerometer is used to acquire vibration signals, whereas an encoder is used to measure motor shaft speed. This study proposes a new method for simplifying the instruments for motor bearing fault diagnosis. Specifically, a video clip recording of a running bearing system is captured using a cellphone that is equipped with a camera and a microphone. The recorded video is subsequently analyzed to obtain the instantaneous frequency of rotation (IFR. The instantaneous fault characteristic frequency (IFCF of the defective bearing is obtained by analyzing the sound signal that is recorded by the microphone. The fault characteristic order is calculated by dividing IFCF by IFR to identify the fault type of the bearing. The effectiveness and robustness of the proposed method are verified by a series of experiments. This study provides a simple, flexible, and effective solution for motor bearing fault diagnosis. Given that the signals are gathered using an affordable and accessible cellphone, the proposed method is proven suitable for diagnosing the health conditions of bearing systems that are located in remote areas where specialized instruments are unavailable or limited.

  17. Primitive experience of three dimensional multi-slice spiral CT angiography for the follow-up of intracranial aneurysm clipping

    International Nuclear Information System (INIS)

    Yang Yunjun; Chen Weijian; Hu Zhangyong; Wu Enfu; Wang Meihao; Zhuge Qichuan; Zhongming; Cheng Jingliang; Ren Cuiping; Zhang Yong

    2008-01-01

    Objective To evaluate multi-slice three-dimensional CT angiography (MS 3D-CTA) for the follow-up of intracranial aneurysm clipping. Methods: MS 3D-CTA of 16 patients with intracranial aneurysm clipping were retrospectively analyzed. The patients were scanned on a 16-slice spiral CT (GE Lightspeed pro). Volume rendering(VR), thin maximum intensity projection(thin MIP) and multi-planar reconstruction (MPR) were employed in image postprocessing in all cases. Results: There were 17 clips in the 16 patients with aneurysm clipping. Six clips were located at the posterior communicating artery, 5 at the anterior communicating artery, 4 at the middle cerebral artery, and the remaining 2 clips were located at the pericallosal artery, in 1 patient. There were no abnormalities found in the aneurysm clipping region in 7 cases by MS 3D- CTA. There were residual aneurysm in 2 cases, parent artery stenosis in 4 cases, and artery spasm in 3 eases. There was no parent artery occlusion and clip displacement in all cases. VR showed excellent 3D spacial relations between the clip and parent artery in 12 cases, and showed good relations in 3 cases. The 1 case with 2 clips in the pericallosal artery showed heavy beam-hardening artifacts. The size and shape of aneurysm clips were clearly depicted by MPR and thin MIP, while 3D spacial relation of aneurysm clip and parent artery were poorly showed. Conclusion: MS 3D-CTA is a safe and efficient method for the follow-up of intracranialaneurysm clipping. Combined VR with MPR or thin MIP can well reveal postoperative changes after aneurysm clipping. (authors)

  18. Pediatric portal hypertension

    Science.gov (United States)

    Vogel, Clarissa Barbon

    2017-01-01

    Abstract: Pediatric portal hypertension management is a team approach between the patient, the patient's family, the primary caregiver, and specialty providers. Evidence-based practice guidelines have not been established in pediatrics. This article serves as a review for the primary care NP in the management of pediatric portal hypertension, discussing the etiology, pathophysiology, and clinical presentation of pediatric portal hypertension, diagnostic tests, and treatment and management options. PMID:28406835

  19. Hypertension og hyperlipidaemi

    DEFF Research Database (Denmark)

    Hansen, Henrik Steen; Larsen, Mogens Lytken

    2009-01-01

    Hypertension and hyperlipidemia are well-established and partially overlapping risk factors for cardiovascular disease. Analyses of cardiovascular morbidity in relationship to changes in blood pressure and in serum cholesterol levels have shown that combined reduction of both risk factors...... are important to achieve a reduction in morbidity. Statins have been shown to be effective in preventing both coronary and cerebrovascular events in both hypertensive and normotensive cases. Consequently, most recent guidelines recommend that statin treatment be considered in hypertensive patients aged less...

  20. Optimizing assessment of sexual arousal in postmenopausal women using erotic film clips.

    Science.gov (United States)

    Ramos Alarcon, Lauren G; Dai, Jing; Collins, Karen; Perez, Mindy; Woodard, Terri; Diamond, Michael P

    2017-10-01

    This study sought to assess sexual arousal in a subgroup of women by identifying erotic film clips that would be most mentally appealing and physically arousing to postmenopausal women. By measuring levels of mental appeal and self-reported physical arousal using a bidirectional scale, we aimed to elucidate the clips that would best be utilized for sexual health research in the postmenopausal or over 50-year-old subpopulation. Our results showed that postmenopausal women did not rate clips with older versus younger actors differently (p>0.05). The mean mental and mean physical scores were significantly correlated for both premenopausal subject ratings (r=0.69, perotic film clips; this knowledge is relevant for design of future sexual function research. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Acute Cholangitis following Intraductal Migration of Surgical Clips 10 Years after Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Natalie E. Cookson

    2015-01-01

    Full Text Available Background. Laparoscopic cholecystectomy represents the gold standard approach for treatment of symptomatic gallstones. Surgery-associated complications include bleeding, bile duct injury, and retained stones. Migration of surgical clips after cholecystectomy is a rare complication and may result in gallstone formation “clip cholelithiasis”. Case Report. We report a case of a 55-year-old female patient who presented with right upper quadrant pain and severe sepsis having undergone an uncomplicated laparoscopic cholecystectomy 10 years earlier. Computed tomography (CT imaging revealed hyperdense material in the common bile duct (CBD compatible with retained calculus. Endoscopic retrograde cholangiopancreatography (ERCP revealed appearances in keeping with a migrated surgical clip within the CBD. Balloon trawl successfully extracted this, alleviating the patient’s jaundice and sepsis. Conclusion. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy which may lead to choledocholithiasis. Appropriate management requires timely identification and ERCP.

  2. Longline Observer (HI & Am. Samoa) Opah Fin Clip Collection for Lampris spp. Distribution Study

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Data set containing information collected from the 1000+ fin clips collected by Hawaii & American Samoa Longline Observers that will be used to analyze the...

  3. Surgical clipping is still a good choice for the treatment of paraclinoid aneurysms

    Directory of Open Access Journals (Sweden)

    Felix Hendrik Pahl

    2016-04-01

    Full Text Available ABSTRACT Paraclinoid aneurysms are lesions located adjacent to the clinoid and ophthalmic segments of the internal carotid artery. In recent years, flow diverter stents have been introduced as a better endovascular technique for treatment of these aneurysms. Method From 2009 to 2014, a total of 43 paraclinoid aneurysms in 43 patients were surgically clipped. We retrospectively reviewed the records of these patients to analyze clinical outcomes. Results Twenty-six aneurysms (60.5% were ophthalmic artery aneurysms, while 17 were superior hypophyseal artery aneurysms (39.5%. The extradural approach to the clinoid process was used to clip these aneurysms. One hundred percent of aneurysms were clipped (complete exclusion in 100% on follow-up angiography. The length of follow-up ranged from 1 to 60 months (mean, 29.82 months. Conclusion Surgical clipping continues to be a good option for the treatment of paraclinoid aneurysms.

  4. 21 CFR 884.2685 - Fetal scalp clip electrode and applicator.

    Science.gov (United States)

    2010-04-01

    ... and an external monitoring device by means of pinching skin tissue with a nonreusable clip. This... shall have an approved PMA or a declared completed PDP in effect before being placed in commercial...

  5. Laparoscopic Filshie clip sterilization and selective use of the methylene blue dye test.

    Science.gov (United States)

    Karoshi, Mahantesh; Yoong, Wai

    2004-01-01

    In laparoscopic Filshie clip sterilization, difficulties may arise in identifying the length of the fallopian tube, with the possibility of failure of sterilization. This article describes a novel intraoperative method of demonstrating adequate tubal closure.

  6. 42. Hypertension: Morbidity review

    Directory of Open Access Journals (Sweden)

    Hamzullah khan

    2015-10-01

    Conclusions: hypertension is a major modifiable risk factor for coronary artery disease, stroke, eye abnormalities and end stage renal disease, which require proper counseling and management of patients.

  7. The new hypertension guidelines.

    Science.gov (United States)

    Stern, Ralph H

    2013-10-01

    The Canadian Hypertension Education Program (CHEP) has published guidelines annually since 2000. The CHEP guidelines are a model of concise, comprehensive, up-to-date, evidence-rated guidelines for physicians who diagnose and treat hypertension. The guidelines address measurement of blood pressure and the definition of hypertension, secondary hypertension evaluation and treatment, and blood pressure targets and medication choices in patients with and without compelling indications. This review describes CHEP's process for developing guidelines and provides an overview of the 2013 recommendations. ©2013 Wiley Periodicals, Inc.

  8. [Hypertension in women].

    Science.gov (United States)

    Tagle, Rodrigo; Tagle V, Rodrigo; Acevedo, Mónica; Valdés, Gloria

    2013-02-01

    The present review examines the types of hypertension that women may suffer throughout life, their physiopathological characteristics and management. In early life, the currently used low-dose oral contraceptives seldom cause hypertension. Pregnancy provokes preeclampsia, its main medical complication, secondary to inadequate transformation of the spiral arteries and the subsequent multisystem endothelial damage caused by deportation of placental factors and microparticles. Hypertension in preeclampsia is an epiphenomenon which needs to be controlled at levels that reduce maternal risk without impairing placental perfusion. The hemodynamic changes of pregnancy may unmask a hypertensive phenotype, may exacerbate a chronic hypertension, or may complicate hypertension secondary to lupus, renovascular lesions, and pheochromocytoma. On the other hand a primary aldosteronism may benefit from the effect of progesterone and present as a postpartum hypertension. A hypertensive pregnancy, especially preeclampsia, represents a risk for cardiac, vascular and renal disease in later life. Menopause may mimic a pheochromocytoma, and is associated to endothelial dysfunction and salt-sensitivity. Among women, non-pharmacological treatment should be forcefully advocated, except for sodium restriction during pregnancy. The blockade of the renin-angiotensin system should be avoided in women at risk of pregnancy; betablockers could be used with precautions during pregnancy; diuretics, ACE inhibitors and angiotensin receptor antagonists should not be used during breast feeding. Collateral effects of antihypertensives, such as hyponatremia, cough and edema are more common in women. Thus, hypertension in women should be managed according to the different life stages.

  9. Hypertension impairs hippocampus-related adult neurogenesis, CA1 neuron dendritic arborization and long-term memory.

    Science.gov (United States)

    Shih, Y-H; Tsai, S-F; Huang, S-H; Chiang, Y-T; Hughes, M W; Wu, S-Y; Lee, C-W; Yang, T-T; Kuo, Y-M

    2016-05-13

    Hypertension is associated with neurodegenerative diseases and cognitive impairment. Several studies using spontaneous hypertensive rats to study the effect of hypertension on memory performance and adult hippocampal neurogenesis have reached inconsistent conclusions. The contradictory findings may be related to the genetic variability of spontaneous hypertensive rats due to the conventional breeding practices. The objective of this study is to examine the effect of hypertension on hippocampal structure and function in isogenic mice. Hypertension was induced by the '2 kidneys, 1 clip' method (2K1C) which constricted one of the two renal arteries. The blood pressures of 2K1C mice were higher than the sham group on post-operation day 7 and remained high up to day 28. Mice with 2K1C-induced hypertension had impaired long-term, but not short-term, memory. Dendritic complexity of CA1 neurons and hippocampal neurogenesis were reduced by 2K1C-induced hypertension on post-operation day 28. Furthermore, 2K1C decreased the levels of hippocampal brain-derived neurotrophic factor, while blood vessel density and activation status of astrocytes and microglia were not affected. In conclusion, hypertension impairs hippocampus-associated long-term memory, dendritic arborization and neurogenesis, which may be caused by down-regulation of brain-derived neurotrophic factor signaling pathways. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  10. [Choledochal lithiasis and stenosis secondary to the migration of a surgical clip].

    Science.gov (United States)

    Baldomà España, M; Pernas Canadell, J C; González Ceballos, S

    2014-01-01

    The migration of a clip to the common bile duct after cholecystectomy is an uncommon, usually late, complication that can lead to diverse complications like stone formation, stenosis, and obstruction in the bile duct. We present the case of a patient who presented with signs and symptoms of cholangitis due to clip migration one year after laparoscopic cholecystectomy; endoscopic retrograde cholangiopancreatography and biliary tract stent placement resolved the problem. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  11. Origin of fin-clipped salmonids collected at two thermal discharges on Lake Michigan

    International Nuclear Information System (INIS)

    Romberg, G.P.; Thommes, M.M.; Spigarelli, S.A.

    1974-01-01

    Fin clips observed on fish collected during tagging studies at the Point Beach and Waukegan thermal discharges were recorded and the data were tabulated by species. Using fin clip and fish size, attempts were made to identify probable stocking locations and dates from agency records. Data are presented for lake trout, rainbow trout, brown trout, and Coho salmon. Tables are presented to show probable stocking locations and dates

  12. The OTSC®-clip in revisional endoscopy against weight gain after bariatric gastric bypass surgery.

    Science.gov (United States)

    Heylen, Alex Marie Florent; Jacobs, Anja; Lybeer, Monika; Prosst, Ruediger L

    2011-10-01

    The maintenance of the restrictive component of the Fobi pouch gastric bypass is essential for permanent weight control. Dilatation of the pouch-outlet and of the pouch itself is responsible for substantial weight gain by an increased volume per meal and binge-eating due to the rapid emptying. An endoscopic over-the-scope clip (OTSC®; Ovesco AG, Tübingen, Germany) was applied in 94 patients following gastric bypass and unintended weight gain by dilated gastro-jejunostomy to narrow the pouch-outlet. The OTSC®-clip application was safe and efficient to reduce the pouch-outlet in all cases. Best clinical results were obtained by narrowing the gastro-jejunostomy by placing two clips at opposite sites, hence reducing the outlet of more than 80%. Preferably, the clip approximated the whole thickness of the wall to avoid further dilatation of the anastomosis. Between surgery and OTSC®-clip application the mean BMI dropped from 45.8 (±3.6) to 32.8 (±1.9). At the first follow-up about 3 months (mean 118 days, ±46 days) after OTSC®-clip application the mean BMI was 29.7 (±1.8). At the second follow-up about 1 year (mean 352 days, ±66 days) after OTSC®-clip application the mean BMI was 27.4 (±3.8). The OTSC®-clip for revisional endoscopy after gastric bypass is reliable and effective in treating weight gain due to a dilated pouch-outlet with favorable short- and midterm results.

  13. Preoperative simulation for the planning of microsurgical clipping of intracranial aneurysms.

    Science.gov (United States)

    Marinho, Paulo; Vermandel, Maximilien; Bourgeois, Philippe; Lejeune, Jean-Paul; Mordon, Serge; Thines, Laurent

    2014-12-01

    The safety and success of intracranial aneurysm (IA) surgery could be improved through the dedicated application of simulation covering the procedure from the 3-dimensional (3D) description of the surgical scene to the visual representation of the clip application. We aimed in this study to validate the technical feasibility and clinical relevance of such a protocol. All patients preoperatively underwent 3D magnetic resonance imaging and 3D computed tomography angiography to build 3D reconstructions of the brain, cerebral arteries, and surrounding cranial bone. These 3D models were segmented and merged using Osirix, a DICOM image processing application. This provided the surgical scene that was subsequently imported into Blender, a modeling platform for 3D animation. Digitized clips and appliers could then be manipulated in the virtual operative environment, allowing the visual simulation of clipping. This simulation protocol was assessed in a series of 10 IAs by 2 neurosurgeons. The protocol was feasible in all patients. The visual similarity between the surgical scene and the operative view was excellent in 100% of the cases, and the identification of the vascular structures was accurate in 90% of the cases. The neurosurgeons found the simulation helpful for planning the surgical approach (ie, the bone flap, cisternal opening, and arterial tree exposure) in 100% of the cases. The correct number of final clip(s) needed was predicted from the simulation in 90% of the cases. The preoperatively expected characteristics of the optimal clip(s) (ie, their number, shape, size, and orientation) were validated during surgery in 80% of the cases. This study confirmed that visual simulation of IA clipping based on the processing of high-resolution 3D imaging can be effective. This is a new and important step toward the development of a more sophisticated integrated simulation platform dedicated to cerebrovascular surgery.

  14. Endoscopic clipping for gastrointestinal tumors. A method to define the target volume more precisely

    International Nuclear Information System (INIS)

    Riepl, M.; Klautke, G.; Fehr, R.; Fietkau, R.; Pietsch, A.

    2000-01-01

    Background: In many cases it is not possible to exactly define the extension of carcinoma of the gastrointestinal tract with the help of computertomography scans made for 3-D-radiation treatment planning. Consequently, the planning of external beam radiotherapy is made more difficult for the gross tumor volume as well as, in some cases, also for the clinical target volume. Patients and Methods: Eleven patients with macrosocpic tumors (rectal cancer n = 5, cardiac cancer n = 6) were included. Just before 3-D planning, the oral and aboral border of the tumor was marked endoscopically with hemoclips. Subsequently, CT scans for radiotherapy planning were made and the clinical target volume was defined. Five to 6 weeks thereafter, new CT scans were done to define the gross tumor volume for boost planning. Two investigators independently assessed the influence of the hemoclips on the different planning volumes, and whether the number of clips was sufficient to define the gross tumor volume. Results: In all patients, the implantation of the clips was done without complications. Start of radiotherapy was not delayed. With the help of the clips it was possible to exactly define the position and the extension of the primary tumor. The clinical target volume was modified according to the position of the clips in 5/11 patients; the gross tumor volume was modified in 7/11 patients. The use of the clips made the documentation and verification of the treatment portals by the simulator easier. Moreover, the clips helped the surgeon to define the primary tumor region following marked regression after neoadjuvant therapy in 3 patients. Conclusions: Endoscopic clipping of gastrointestinal tumors helps to define the tumor volumes more precisely in radiation therapy. The clips are easily recognized on the portal films and, thus, contribute to quality control. (orig.) [de

  15. Inducing negative affect using film clips with general and eating disorder-related content.

    Science.gov (United States)

    Koushiou, Maria; Nicolaou, Kalia; Karekla, Maria

    2018-02-09

    The aim of the present study was to select appropriate film clips with a general vs. eating disorder (ED)-related content to induce negative affect. More specifically, the study examined the subjective emotional experience (valence, arousal, anxiety, induction of somatic symptoms, and ability to control reactions during film clips) of Greek-Cypriot university students (N = 79) in response to three types of film clips: general unpleasant, ED-specific unpleasant, and emotionally neutral. In addition, the study aimed to compare the emotional reactions to the aforementioned clips between two groups of participants differing on their risk for ED (high vs. low). Preliminary results indicate the clips with general content ("The Champ") and with ED-specific content ("Binge eating") that are most effective in inducing negative affect and differentiating between risk groups. These clips provide an effective method for emotion induction that can be used for assessing the emotional experience of individuals with ED symptoms, since their emotional experience is significantly implicated in the development and maintenance of their symptoms (Merwin, Clin Psychol Sci Pract 18(3):208-214, 2011).Level of evidence No level of evidence, Experimental Study.

  16. The Use of Film Clips in a Viewing Time Task of Sexual Interests.

    Science.gov (United States)

    Lalumière, Martin L; Babchishin, Kelly M; Ebsworth, Megan

    2018-04-01

    Viewing time tasks using still pictures to assess age and gender sexual interests have been well validated and are commonly used. The use of film clips in a viewing time task would open up interesting possibilities for the study of sexual interest toward sexual targets or activities that are not easily captured in still pictures. We examined the validity of a viewing time task using film clips to assess sexual interest toward male and female targets, in a sample of 52 young adults. Film clips produced longer viewing times than still pictures. For both men and women, the indices derived from the film viewing time task were able to distinguish individuals who identified as homosexual (14 men, 8 women) from those who identified as heterosexual (15 men, 15 women), and provided comparable group differentiation as indices derived from a viewing time task using still pictures. Men's viewing times were more gender-specific than those of women. Viewing times to film clips were correlated with participants' ratings of sexual appeal of the same clips, and with viewing times to pictures. The results support the feasibility of a viewing time measure of sexual interest that utilizes film clips and, thus, expand the types of sexual interests that could be investigated (e.g., sadism, biastophilia).

  17. Anterior petroclinoid fold fenestration: an adjunct to clipping of postero-laterally projecting posterior communicating aneurysms.

    Science.gov (United States)

    Nossek, Erez; Setton, Avi; Dehdashti, Amir R; Chalif, David J

    2014-10-01

    Proximally located posterior communicating artery (PCoA) aneurysms, projecting postero-laterally in proximity to the tentorium, may pose a technical challenge for microsurgical clipping due to obscuration of the proximal aneurysmal neck by the anterior petroclinoid fold. We describe an efficacious technique utilizing fenestration of the anterior petroclinoid fold to facilitate visualization and clipping of PCoA aneurysms abutting this aspect of the tentorium. Of 86 cases of PCoA aneurysms treated between 2003 and 2013, the technique was used in nine (10.5 %) patients to allow for adequate clipping. A 3 mm fenestration in the anterior petroclinoid ligament is created adjacent and lateral to the anterior clinoid process. This fenestration is then widened into a small wedge corridor by bipolar coagulation. In all cases, the proximal aneurysm neck was visualized after the wedge fenestration. Additionally, an adequate corridor for placement of the proximal clip blade was uniformly established. All cases were adequately clipped, with complete occlusion of the aneurysm neck and fundus with preservation of the PCoA. There were two intraoperative ruptures not related to creation of the wedge fenestration. One patient experienced post-operative partial third nerve palsy, which resolved during follow-up. We describe a technique of fenestration of the anterior petroclinoid fold to establish a critical and safe corridor for both visualization and clipping of PCoA aneurysms.

  18. The effect of music video clips on adolescent boys' body image, mood, and schema activation.

    Science.gov (United States)

    Mulgrew, Kate E; Volcevski-Kostas, Diana; Rendell, Peter G

    2014-01-01

    There is limited research that has examined experimentally the effects of muscular images on adolescent boys' body image, with no research specifically examining the effects of music television. The aim of the current study was to examine the effects of viewing muscular and attractive singers in music video clips on early, mid, and late adolescent boys' body image, mood, and schema activation. Participants were 180 boys in grade 7 (mean age = 12.73 years), grade 9 (mean age = 14.40 years) or grade 11 (mean age = 16.15 years) who completed pre- and post-test measures of mood and body satisfaction after viewing music videos containing male singers of muscular or average appearance. They also completed measures of schema activation and social comparison after viewing the clips. The results showed that the boys who viewed the muscular clips reported poorer upper body satisfaction, lower appearance satisfaction, lower happiness, and more depressive feelings compared to boys who viewed the clips depicting singers of average appearance. There was no evidence of increased appearance schema activation but the boys who viewed the muscular clips did report higher levels of social comparison to the singers. The results suggest that music video clips are a powerful form of media in conveying information about the male ideal body shape and that negative effects are found in boys as young as 12 years.

  19. Impact of Clipping versus Coiling on Postoperative Hemodynamics and Pulmonary Edema after Subarachnoid Hemorrhage

    Directory of Open Access Journals (Sweden)

    Nobutaka Horie

    2014-01-01

    Full Text Available Volume management is critical for assessment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH. This multicenter prospective cohort study compared the impact of surgical clipping versus endovascular coiling on postoperative hemodynamics and pulmonary edema in patients with SAH. Hemodynamic parameters were measured for 14 days using a transpulmonary thermodilution system. The study included 202 patients, including 160 who underwent clipping and 42 who underwent coiling. There were no differences in global ejection fraction (GEF, cardiac index, systemic vascular resistance index, or global end-diastolic volume index between the clipping and coiling groups in the early period. However, extravascular lung water index (EVLWI and pulmonary vascular permeability index (PVPI were significantly higher in the clipping group in the vasospasm period. Postoperative C-reactive protein (CRP level was higher in the clipping group and was significantly correlated with postoperative brain natriuretic peptide level. Multivariate analysis found that PVPI and GEF were independently associated with high EVLWI in the early period, suggesting cardiogenic edema, and that CRP and PVPI, but not GEF, were independently associated with high EVLWI in the vasospasm period, suggesting noncardiogenic edema. In conclusion, clipping affects postoperative CRP level and may thereby increase noncardiogenic pulmonary edema in the vasospasm period. His trial is registered with University Hospital Medical Information Network UMIN000003794.

  20. Anticipation of high arousal aversive and positive movie clips engages common and distinct neural substrates.

    Science.gov (United States)

    Greenberg, Tsafrir; Carlson, Joshua M; Rubin, Denis; Cha, Jiook; Mujica-Parodi, Lilianne

    2015-04-01

    The neural correlates of anxious anticipation have been primarily studied with aversive and neutral stimuli. In this study, we examined the effect of valence on anticipation by using high arousal aversive and positive stimuli and a condition of uncertainty (i.e. either positive or aversive). The task consisted of predetermined cues warning participants of upcoming aversive, positive, 'uncertain' (either aversive or positive) and neutral movie clips. Anticipation of all affective clips engaged common regions including the anterior insula, dorsal anterior cingulate cortex, thalamus, caudate, inferior parietal and prefrontal cortex that are associated with emotional experience, sustained attention and appraisal. In contrast, the nucleus accumbens and medial prefrontal cortex, regions implicated in reward processing, were selectively engaged during anticipation of positive clips (depicting sexually explicit content) and the mid-insula, which has been linked to processing aversive stimuli, was selectively engaged during anticipation of aversive clips (depicting graphic medical procedures); these three areas were also activated during anticipation of 'uncertain' clips reflecting a broad preparatory response for both aversive and positive stimuli. These results suggest that a common circuitry is recruited in anticipation of affective clips regardless of valence, with additional areas preferentially engaged depending on whether expected stimuli are negative or positive. © The Author (2014). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

  1. Microsurgery Simulator of Cerebral Aneurysm Clipping with Interactive Cerebral Deformation Featuring a Virtual Arachnoid.

    Science.gov (United States)

    Shono, Naoyuki; Kin, Taichi; Nomura, Seiji; Miyawaki, Satoru; Saito, Toki; Imai, Hideaki; Nakatomi, Hirofumi; Oyama, Hiroshi; Saito, Nobuhito

    2018-05-01

    A virtual reality simulator for aneurysmal clipping surgery is an attractive research target for neurosurgeons. Brain deformation is one of the most important functionalities necessary for an accurate clipping simulator and is vastly affected by the status of the supporting tissue, such as the arachnoid membrane. However, no virtual reality simulator implementing the supporting tissue of the brain has yet been developed. To develop a virtual reality clipping simulator possessing interactive brain deforming capability closely dependent on arachnoid dissection and apply it to clinical cases. Three-dimensional computer graphics models of cerebral tissue and surrounding structures were extracted from medical images. We developed a new method for modifiable cerebral tissue complex deformation by incorporating a nonmedical image-derived virtual arachnoid/trabecula in a process called multitissue integrated interactive deformation (MTIID). MTIID made it possible for cerebral tissue complexes to selectively deform at the site of dissection. Simulations for 8 cases of actual clipping surgery were performed before surgery and evaluated for their usefulness in surgical approach planning. Preoperatively, each operative field was precisely reproduced and visualized with the virtual brain retraction defined by users. The clear visualization of the optimal approach to treating the aneurysm via an appropriate arachnoid incision was possible with MTIID. A virtual clipping simulator mainly focusing on supporting tissues and less on physical properties seemed to be useful in the surgical simulation of cerebral aneurysm clipping. To our knowledge, this article is the first to report brain deformation based on supporting tissues.

  2. Heavy metal phytoextraction by Sedum alfredii is affected by continual clipping and phosphorus fertilization amendment.

    Science.gov (United States)

    Huang, Huagang; Li, Tingqiang; Gupta, D K; He, Zhenli; Yang, Xiao-E; Ni, Bingnan; Li, Mao

    2012-01-01

    Improving the efficacy of phytoextraction is critical for its successful application in metal contaminated soils. Mineral nutrition affects plant growth and metal absorption and subsequently the accumulation of heavy metal through hyper-accumulator plants. This study assessed the effects of di-hydrogen phosphates (KH2PO4, Ca(H2PO4)2, NaH2PO4 and NH4H2PO4) application at three levels (22, 88 and 352 mg P/kg soil) on Sedum alfredii growth and metal uptake by three consecutive harvests on aged and Zn/Cd combined contaminated paddy soil. The addition of phosphates (P) significantly increased the amount of Zn taken up by S. alfredii due to increased shoot Zn concentration and dry matter yield (DMY) (P phytoextraction of Zn and Cd was observed in KH2PO4 and NH4H2PO4 treatment at 352 mg P/kg soil. The amount of Zn removed by phytoextraction increased in the order of 1st clipping < 2nd clipping < 3rd clipping, and for Cd extraction the order was 2nd clipping < 1st clipping < 3rd clipping. These results indicate that the application of P fertilizers coupled with multiple cuttings can enhance the removal of Zn and Cd from contaminated soils by S. alfredii, thus shortening the time needed for accomplishing remediation goals.

  3. Magnetic resonance angiography with ultrashort echo times reduces the artefact of aneurysm clips

    International Nuclear Information System (INIS)

    Goenner, F.; Heid, O.; Remonda, L.; Schroth, G.; Loevblad, K.O.; Guzman, R.; Barth, A.

    2002-01-01

    We evaluated the ability of an ultrashort echo time (TE) three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA) sequence to reduce the metal artefact of intracranial aneurysm clips and to display adjacent cerebral arteries. In five patients (aged 8-72 years) treated with Elgiloy or Phynox aneurysm clips we prospectively performed a conventional (TE 6.0 ms) and a new ultrashort TE (TE 2.4 ms) 3D TOF MRA. We compared the diameter of the clip-induced susceptibility artefact and the detectability of flow in adjacent vessels. The mean artefact diameter was 22.3±6.4 mm (range 14-38 mm) with the ultrashort TE and 27.7±6.4 mm (range 19-45 mm) with the conventional MRA (P<0.0001). This corresponded to a diameter reduction of 19.5±9.2%. More parts of adjacent vessels were detected, but with less intense flow signal. The aneurysm dome and neck remained within the area of signal loss and were therefore not displayed. Ultrashort TE MRA is a noninvasive and fast method for improving detection of vessels adjacent to clipped intracranial aneurysms, by reducing clip-induced susceptibility artefact. The method cannot, however, be used to show remnants of the aneurysm neck or sac as a result of imperfect clipping. (orig.)

  4. Biochemical Analysis Reveals the Multifactorial Mechanism of Histone H3 Clipping by Chicken Liver Histone H3 Protease

    KAUST Repository

    Chauhan, Sakshi

    2016-09-02

    Proteolytic clipping of histone H3 has been identified in many organisms. Despite several studies, the mechanism of clipping, the substrate specificity, and the significance of this poorly understood epigenetic mechanism are not clear. We have previously reported histone H3 specific proteolytic clipping and a protein inhibitor in chicken liver. However, the sites of clipping are still not known very well. In this study, we attempt to identify clipping sites in histone H3 and to determine the mechanism of inhibition by stefin B protein, a cysteine protease inhibitor. By employing site-directed mutagenesis and in vitro biochemical assays, we have identified three distinct clipping sites in recombinant human histone H3 and its variants (H3.1, H3.3, and H3t). However, post-translationally modified histones isolated from chicken liver and Saccharomyces cerevisiae wild-type cells showed different clipping patterns. Clipping of histone H3 N-terminal tail at three sites occurs in a sequential manner. We have further observed that clipping sites are regulated by the structure of the N-terminal tail as well as the globular domain of histone H3. We also have identified the QVVAG region of stefin B protein to be very crucial for inhibition of the protease activity. Altogether, our comprehensive biochemical studies have revealed three distinct clipping sites in histone H3 and their regulation by the structure of histone H3, histone modifications marks, and stefin B.

  5. Therapeutic Exercise and Hypertension

    African Journals Online (AJOL)

    Nekky Umera

    patients but may not reduce the BP of normotensive individual. Exercise function ... and mortality in all age groups; it also creates major social, personal and financial ... drug therapy by as symptomatic hypertensive and high cost of drugs particularly in a ..... Events in hypertensive patients randomized to doxagosin versus.

  6. Noncirrotisk intrahepatisk portal hypertension

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Havelund, Troels

    2007-01-01

    Non-cirrhotic intrahepatic portal hypertension is characterized by portal hypertension in the absence of liver cirrhosis or portal vein thrombosis. The disease is common in the East and rarely seen in the West. Two cases with oesophageal varices are described. The histopathology is heterogeneous...... but includes vascular lesions and portal fibrosis. Patient management follows the current recommendations for variceal bleeding....

  7. Pulmonary Arterial Hypertension

    Science.gov (United States)

    ... heart). This type of pulmonary hypertension was called “secondary pulmonary hypertension” but is now referred to as PH, because the cause is known to be from lung disease, heart disease, or chronic thromboemboli (blood clots). Pulmonary Arterial Hypertension (PAH) used to be ...

  8. Hypertension (High Blood Pressure)

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Hypertension (High Blood Pressure) KidsHealth / For Teens / Hypertension (High Blood Pressure) What's ... rest temperature diet emotions posture medicines Why Is High Blood Pressure Bad? High blood pressure means a person's heart ...

  9. Cervical Spondylosis and Hypertension

    Science.gov (United States)

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully with anterior cervical discectomy and fusion. Stimulation of sympathetic nerve fibers in pathologically degenerative disc could produce sympathetic excitation, and induce a sympathetic reflex to cause cervical vertigo and hypertension. In addition, chronic neck pain could contribute to hypertension development through sympathetic arousal and failure of normal homeostatic pain regulatory mechanisms. Cervical spondylosis may be one of the causes of secondary hypertension. Early treatment for resolution of symptoms of cervical spondylosis may have a beneficial impact on cardiovascular disease risk in patients with cervical spondylosis. PMID:25761188

  10. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    OBJECTIVE:: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS:: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS:: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION:: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  11. Hypertension in women.

    Science.gov (United States)

    Pimenta, Eduardo

    2012-02-01

    Hypertension is an important modifiable risk factor for cardiovascular (CV) morbidity and mortality, and a highly prevalent condition in both men and women. However, the prevalence of hypertension is predicted to increase more among women than men. Combined oral contraceptives (COCs) can induce hypertension in a small group of women and, increase CV risk especially among those with hypertension. Both COC-related increased CV risk and blood pressure (BP) returns to pretreatment levels by 3 months of its discontinuation. The effects of menopause and hormone replacement therapy (HRT) on BP are controversial, and COCs and HRT containing the new generation progestin drospirenone are preferred in women with established hypertension. Despite the high incidence of cancer in women, CV disease remains the major cause of death in women and comparable benefit of antihypertensive treatment have been demonstrated in both women and men.

  12. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    OBJECTIVE: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  13. A comparison of two endoscopic closures: over-the-scope clip (OTSC) versus KING closure (endoloop plus clips) in a randomized long-term experimental study

    Czech Academy of Sciences Publication Activity Database

    Doležel, R.; Ryska, O.; Kollár, M.; Juhásová, Jana; Kalvach, J.; Ryska, M.; Martínek, J.

    2016-01-01

    Roč. 30, č. 11 (2016), s. 4910-4916 ISSN 0930-2794 R&D Projects: GA MZd(CZ) NT13634; GA MŠk ED2.1.00/03.0124 Institutional support: RVO:67985904 Keywords : NOTES * endoscopic closure * KING closure * over-the-scope clip Subject RIV: FJ - Surgery incl. Transplants Impact factor: 3.747, year: 2016

  14. Fabrication and Characterization of ZnO Nano-Clips by the Polyol-Mediated Process.

    Science.gov (United States)

    Wang, Mei; Li, Ai-Dong; Kong, Ji-Zhou; Gong, You-Pin; Zhao, Chao; Tang, Yue-Feng; Wu, Di

    2018-02-09

    ZnO nano-clips with better monodispersion were prepared successfully using zinc acetate hydrate (Zn(OAc) 2 ·nH 2 O) as Zn source and ethylene glycol (EG) as solvent by a simple solution-based route-polyol process. The effect of solution concentration on the formation of ZnO nano-clips has been investigated deeply. We first prove that the 0.01 M Zn(OAc) 2 ·nH 2 O can react with EG without added water or alkaline, producing ZnO nano-clips with polycrystalline wurtzite structure at 170 °C. As-synthesized ZnO nano-clips contain a lot of aggregated nanocrystals (~ 5 to 15 nm) with high specific surface area of 88 m 2 /g. The shapes of ZnO nano-clips basically keep constant with improved crystallinity after annealing at 400-600 °C. The lower solution concentration and slight amount of H 2 O play a decisive role in ZnO nano-clip formation. When the solution concentration is ≤ 0.0125 M, the complexing and polymerization reactions between Zn(OAc) 2 ·nH 2 O and EG predominate, mainly elaborating ZnO nano-clips. When the solution concentration is ≥ 0.015 M, the alcoholysis and polycondensation reactions of Zn(OAc) 2 ·nH 2 O and EG become dominant, leading to ZnO particle formation with spherical and elliptical shapes. The possible growth mechanism based on a competition between complexing and alcoholysis of Zn(OAc) 2 ·nH 2 O and EG has been proposed.

  15. Fabrication and Characterization of ZnO Nano-Clips by the Polyol-Mediated Process

    Science.gov (United States)

    Wang, Mei; Li, Ai-Dong; Kong, Ji-Zhou; Gong, You-Pin; Zhao, Chao; Tang, Yue-Feng; Wu, Di

    2018-02-01

    ZnO nano-clips with better monodispersion were prepared successfully using zinc acetate hydrate (Zn(OAc)2·nH2O) as Zn source and ethylene glycol (EG) as solvent by a simple solution-based route-polyol process. The effect of solution concentration on the formation of ZnO nano-clips has been investigated deeply. We first prove that the 0.01 M Zn(OAc)2·nH2O can react with EG without added water or alkaline, producing ZnO nano-clips with polycrystalline wurtzite structure at 170 °C. As-synthesized ZnO nano-clips contain a lot of aggregated nanocrystals ( 5 to 15 nm) with high specific surface area of 88 m2/g. The shapes of ZnO nano-clips basically keep constant with improved crystallinity after annealing at 400-600 °C. The lower solution concentration and slight amount of H2O play a decisive role in ZnO nano-clip formation. When the solution concentration is ≤ 0.0125 M, the complexing and polymerization reactions between Zn(OAc)2·nH2O and EG predominate, mainly elaborating ZnO nano-clips. When the solution concentration is ≥ 0.015 M, the alcoholysis and polycondensation reactions of Zn(OAc)2·nH2O and EG become dominant, leading to ZnO particle formation with spherical and elliptical shapes. The possible growth mechanism based on a competition between complexing and alcoholysis of Zn(OAc)2·nH2O and EG has been proposed.

  16. Nonvariceal Upper Gastrointestinal Bleeding: the Usefulness of Rotational Angiography after Endoscopic Marking with a Metallic Clip

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Soo; Kwak, Hyo Sung; Chung, Gyung Ho [Chonbuk National University Medical School, Chonju (Korea, Republic of)

    2011-08-15

    We wanted to assess the usefulness of rotational angiography after endoscopic marking with a metallic clip in upper gastrointestinal bleeding patients with no extravasation of contrast medium on conventional angiography. In 16 patients (mean age, 59.4 years) with acute bleeding ulcers (13 gastric ulcers, 2 duodenal ulcers, 1 malignant ulcer), a metallic clip was placed via gastroscopy and this had been preceded by routine endoscopic treatment. The metallic clip was placed in the fibrous edge of the ulcer adjacent to the bleeding point. All patients had negative results from their angiographic studies. To localize the bleeding focus, rotational angiography and high pressure angiography as close as possible to the clip were used. Of the 16 patients, seven (44%) had positive results after high pressure angiography as close as possible to the clip and they underwent transcatheter arterial embolization (TAE) with microcoils. Nine patients without extravasation of contrast medium underwent TAE with microcoils as close as possible to the clip. The bleeding was stopped initially in all patients after treatment of the feeding artery. Two patients experienced a repeat episode of bleeding two days later. Of the two patients, one had subtle oozing from the ulcer margin and that patient underwent endoscopic treatment. One patient with malignant ulcer died due to disseminated intravascular coagulation one month after embolization. Complete clinical success was achieved in 14 of 16 (88%) patients. Delayed bleeding or major/minor complications were not noted. Rotational angiography after marking with a metallic clip helps to localize accurately the bleeding focus and thus to embolize the vessel correctly.

  17. Nonvariceal Upper Gastrointestinal Bleeding: the Usefulness of Rotational Angiography after Endoscopic Marking with a Metallic Clip

    International Nuclear Information System (INIS)

    Song, Ji Soo; Kwak, Hyo Sung; Chung, Gyung Ho

    2011-01-01

    We wanted to assess the usefulness of rotational angiography after endoscopic marking with a metallic clip in upper gastrointestinal bleeding patients with no extravasation of contrast medium on conventional angiography. In 16 patients (mean age, 59.4 years) with acute bleeding ulcers (13 gastric ulcers, 2 duodenal ulcers, 1 malignant ulcer), a metallic clip was placed via gastroscopy and this had been preceded by routine endoscopic treatment. The metallic clip was placed in the fibrous edge of the ulcer adjacent to the bleeding point. All patients had negative results from their angiographic studies. To localize the bleeding focus, rotational angiography and high pressure angiography as close as possible to the clip were used. Of the 16 patients, seven (44%) had positive results after high pressure angiography as close as possible to the clip and they underwent transcatheter arterial embolization (TAE) with microcoils. Nine patients without extravasation of contrast medium underwent TAE with microcoils as close as possible to the clip. The bleeding was stopped initially in all patients after treatment of the feeding artery. Two patients experienced a repeat episode of bleeding two days later. Of the two patients, one had subtle oozing from the ulcer margin and that patient underwent endoscopic treatment. One patient with malignant ulcer died due to disseminated intravascular coagulation one month after embolization. Complete clinical success was achieved in 14 of 16 (88%) patients. Delayed bleeding or major/minor complications were not noted. Rotational angiography after marking with a metallic clip helps to localize accurately the bleeding focus and thus to embolize the vessel correctly.

  18. Iterative Signal Processing for Mitigation of Analog-to-Digital Converter Clipping Distortion in Multiband OFDMA Receivers

    Directory of Open Access Journals (Sweden)

    Markus Allén

    2012-01-01

    Full Text Available In modern wideband communication receivers, the large input-signal dynamics is a fundamental problem. Unintentional signal clipping occurs, if the receiver front-end with the analog-to-digital interface cannot respond to rapidly varying conditions. This paper discusses digital postprocessing compensation of such unintentional clipping in multiband OFDMA receivers. The proposed method iteratively mitigates the clipping distortion by exploiting the symbol decisions. The performance of the proposed method is illustrated with various computer simulations and also verified by concrete laboratory measurements with commercially available analog-to-digital hardware. It is shown that the clipping compensation algorithm implemented in a turbo decoding OFDM receiver is able to remove almost all the clipping distortion even under significant clipping in fading channel circumstances. That is to say, it is possible to nearly recover the receiver performance to the level, which would be achieved in the equivalent nonclipped situation.

  19. Pulmonary hypertension CT imaging

    International Nuclear Information System (INIS)

    Nedevska, A.

    2013-01-01

    Full text: The right heart catheterization is the gold standard in the diagnosis and determines the severity of pulmonary hypertension. The significant technical progress of noninvasive diagnostic imaging methods significantly improves the pixel density and spatial resolution in the study of cardiovascular structures, thus changes their role and place in the overall diagnostic plan. Learning points: What is the etiology, clinical manifestation and general pathophysiological disorders in pulmonary hypertension. What are the established diagnostic methods in the diagnosis and follow-up of patients with pulmonary hypertension. What is the recommended protocol for CT scanning for patients with clinically suspected or documented pulmonary hypertension. What are the important diagnostic findings in CT scan of a patient with pulmonary hypertension. Discussion: The prospect of instantaneous complex - anatomical and functional cardiopulmonary and vascular diagnostics seems extremely attractive. The contrast enhanced multislice computed (CT ) and magnetic resonance imaging are very suitable methods for imaging the structures of the right heart, with the possibility of obtaining multiple projections and three-dimensional imaging reconstructions . There are specific morphological features that, if carefully analyzed, provide diagnostic information. Thus, it is possible to avoid or at least reduce the frequency of use of invasive diagnostic cardiac catheterization in patients with pulmonary hypertension. Conclusion: This review focuses on the use of contrast-enhanced CT for comprehensive evaluation of patients with pulmonary hypertension and presents the observed characteristic changes in the chest, lung parenchyma , the structures of the right half of the heart and pulmonary vessels

  20. Chronic infusion of lisinopril into hypothalamic paraventricular nucleus modulates cytokines and attenuates oxidative stress in rostral ventrolateral medulla in hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Li, Hong-Bao [Department of Physiology and Pathophysiology, Xi' an Jiaotong University Cardiovascular Research Center, Xi' an Jiaotong University School of Medicine, Xi' an 710061 (China); Qin, Da-Nian, E-mail: dnqin@stu.edu.cn [Department of Physiology, Shantou University Medical College, Shantou 515041 (China); Ma, Le [Department of Public Health, Xi' an Jiaotong University School of Medicine, Xi' an 710061 (China); Miao, Yu-Wang [Department of Physiology and Pathophysiology, Xi' an Jiaotong University Cardiovascular Research Center, Xi' an Jiaotong University School of Medicine, Xi' an 710061 (China); Zhang, Dong-Mei [Department of Physiology, Dalian Medical University, Dalian 116044 (China); Lu, Yan [Department of Clinical Laboratory, Sanaitang Hospital, Lanzhou 730030 (China); Song, Xin-Ai [Department of Physiology and Pathophysiology, Xi' an Jiaotong University Cardiovascular Research Center, Xi' an Jiaotong University School of Medicine, Xi' an 710061 (China); Zhu, Guo-Qing [Key Laboratory of Cardiovascular Disease and Molecular Intervention, Department of Physiology, Nanjing Medical University, Nanjing 210029 (China); Kang, Yu-Ming, E-mail: ykang@mail.xjtu.edu.cn [Department of Physiology and Pathophysiology, Xi' an Jiaotong University Cardiovascular Research Center, Xi' an Jiaotong University School of Medicine, Xi' an 710061 (China)

    2014-09-01

    The hypothalamic paraventricular nucleus (PVN) and rostral ventrolateral medulla (RVLM) play a critical role in the generation and maintenance of sympathetic nerve activity. The renin–angiotensin system (RAS) in the brain is involved in the pathogenesis of hypertension. This study was designed to determine whether inhibition of the angiotensin-converting enzyme (ACE) in the PVN modulates cytokines and attenuates oxidative stress (ROS) in the RVLM, and decreases the blood pressure and sympathetic activity in renovascular hypertensive rats. Renovascular hypertension was induced in male Sprague–Dawley rats by the two-kidney one-clip (2K1C) method. Renovascular hypertensive rats received bilateral PVN infusion with ACE inhibitor lisinopril (LSP, 10 μg/h) or vehicle via osmotic minipump for 4 weeks. Mean arterial pressure (MAP), renal sympathetic nerve activity (RSNA), and plasma proinflammatory cytokines (PICs) were significantly increased in renovascular hypertensive rats. The renovascular hypertensive rats also had higher levels of ACE in the PVN, and lower level of interleukin-10 (IL-10) in the RVLM. In addition, the levels of PICs, the chemokine MCP-1, the subunit of NAD(P)H oxidase (gp91{sup phox}) and ROS in the RVLM were increased in hypertensive rats. PVN treatment with LSP attenuated those changes occurring in renovascular hypertensive rats. Our findings suggest that the beneficial effects of ACE inhibition in the PVN in renovascular hypertension are partly due to modulation cytokines and attenuation oxidative stress in the RVLM. - Highlights: • Chronic ACE inhibition in PVN on renovascular hypertension was investigated. • 2K1C resulted in sympathoexcitation, increased plasma PICs and hypertension. • 2K1C rats had higher levels of cytokines and reactive oxygen species (ROS) in RVLM. • Chronic inhibiting PVN ACE attenuates cytokines and ROS in RVLM in hypertension.

  1. Chronic infusion of lisinopril into hypothalamic paraventricular nucleus modulates cytokines and attenuates oxidative stress in rostral ventrolateral medulla in hypertension

    International Nuclear Information System (INIS)

    Li, Hong-Bao; Qin, Da-Nian; Ma, Le; Miao, Yu-Wang; Zhang, Dong-Mei; Lu, Yan; Song, Xin-Ai; Zhu, Guo-Qing; Kang, Yu-Ming

    2014-01-01

    The hypothalamic paraventricular nucleus (PVN) and rostral ventrolateral medulla (RVLM) play a critical role in the generation and maintenance of sympathetic nerve activity. The renin–angiotensin system (RAS) in the brain is involved in the pathogenesis of hypertension. This study was designed to determine whether inhibition of the angiotensin-converting enzyme (ACE) in the PVN modulates cytokines and attenuates oxidative stress (ROS) in the RVLM, and decreases the blood pressure and sympathetic activity in renovascular hypertensive rats. Renovascular hypertension was induced in male Sprague–Dawley rats by the two-kidney one-clip (2K1C) method. Renovascular hypertensive rats received bilateral PVN infusion with ACE inhibitor lisinopril (LSP, 10 μg/h) or vehicle via osmotic minipump for 4 weeks. Mean arterial pressure (MAP), renal sympathetic nerve activity (RSNA), and plasma proinflammatory cytokines (PICs) were significantly increased in renovascular hypertensive rats. The renovascular hypertensive rats also had higher levels of ACE in the PVN, and lower level of interleukin-10 (IL-10) in the RVLM. In addition, the levels of PICs, the chemokine MCP-1, the subunit of NAD(P)H oxidase (gp91 phox ) and ROS in the RVLM were increased in hypertensive rats. PVN treatment with LSP attenuated those changes occurring in renovascular hypertensive rats. Our findings suggest that the beneficial effects of ACE inhibition in the PVN in renovascular hypertension are partly due to modulation cytokines and attenuation oxidative stress in the RVLM. - Highlights: • Chronic ACE inhibition in PVN on renovascular hypertension was investigated. • 2K1C resulted in sympathoexcitation, increased plasma PICs and hypertension. • 2K1C rats had higher levels of cytokines and reactive oxygen species (ROS) in RVLM. • Chronic inhibiting PVN ACE attenuates cytokines and ROS in RVLM in hypertension

  2. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...

  3. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice....

  4. Hypertension and Cardiac Arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension (HTN) is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease (CAD), stroke, peripheral artery disease and chronic renal failure. Hypertensive heart disease can manifest as many types of cardiac arrhythmias, most commonly being atrial fibrillation......) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit of comprehensively reviewing the available evidence...

  5. Effect of hypertensive rat plasma on ion transport of cultured vascular smooth muscle

    International Nuclear Information System (INIS)

    Magargal, W.W.; Overbeck, H.W.

    1986-01-01

    We layered fresh, unprocessed plasma from healthy rats with early (less than or equal to 7 days) or benign, chronic (greater than 3 wk) one-kidney, one-clip hypertension and from paired one-kidney normotensive control rats over confluent primary-cultured rat aortic smooth muscle cells. Plasma from all rats increased cellular ouabain-sensitive 86 Rb + uptake and sodium content and decreased ouabain-insensitive 86 Rb + uptake compared with uptakes and content in the presence of balanced salt solution (P less than 0.01). Cells incubated in the presence of plasma from rats with early (P less than 0.02) or chronic hypertension (P less than 0.01) had significantly reduced ouabain-sensitive 86 Rb + uptake when compared with cells incubated in normotensive plasma, but their intracellular Na+ contents were not lower. We no longer detected this uptake difference when chronic hypertensives drank 0.9% NaCl instead of water. Plasma from hypertensive rats also altered ouabain-insensitive 86 Rb + uptake by the cultured cells. These findings of this new, reproducible, and specific assay system support the hypothesis that plasma factors inhibit the membrane sodium-potassium pump in vascular smooth muscle cells in this form of hypertension. The abnormality occurs in both early and chronic stages, but may not be related to sodium intake. The data also provide evidence for plasma factors in hypertension altering membrane K+ permeability

  6. Increased proteoglycan synthesis by the cardiovascular system of coarctation hypertensive rats

    International Nuclear Information System (INIS)

    Lipke, D.W.; Couchman, J.R.

    1991-01-01

    Proteoglycan (PG) synthesis in the cardiovascular system of coarctation hypertensive rats was examined by in vivo and in vitro labeling of glycosaminoglycans with 35SO4 in rats made hypertensive for short (4 days) and longer (14 days) durations. With in vivo labeling, only tissues directly exposed to elevated pressure (left ventricle, LV and aorta above the clip, AOR increases) exhibited elevated PG synthesis after 4 days of hypertension. By 14 days, tissues both exposed to (LV and AOR increases) and protected from elevated pressure (right ventricle and kidney) exhibited elevated PG synthetic rates. Slight elevations in the proportion of galactosaminoglycans were observed with a concurrent proportional decrease in heparan sulfate PGs. Using the in vitro labeling procedure, no significant increases in PG synthesis were observed in any tissue at either 4 days or 14 days of hypertension. These data indicate that: (1) coarctation hypertension stimulates PG production that is dependent initially on increased pressure and later, on additional non-pressure related factors, (2) these other factors are responsible for enhanced PG production in tissues not directly exposed to pressure overload, (3) pressure and/or these other factors are essential for enhanced PG production in coarctation hypertension, and (4) synthesis of all GAG types appears to be affected

  7. Psychiatric disorder associated with vacuum-assisted breast biopsy clip placement: a case report

    Directory of Open Access Journals (Sweden)

    Zografos George C

    2008-10-01

    Full Text Available Abstract Introduction Vacuum-assisted breast biopsy is a minimally invasive technique that has been used increasingly in the treatment of mammographically detected, non-palpable breast lesions. Clip placement at the biopsy site is standard practice after vacuum-assisted breast biopsy. Case presentation We present the case of a 62-year-old woman with suspicious microcalcifications in her left breast. The patient was informed about vacuum-assisted breast biopsy, including clip placement. During the course of taking the patient's history, she communicated excellently, her demeanor was normal, she disclosed no intake of psychiatric medication and had not been diagnosed with any psychiatric disorders. Subsequently, the patient underwent vacuum-assisted breast biopsy (11 G under local anesthesia. A clip was placed at the biopsy site. The pathological diagnosis was of sclerosing adenosis. At the 6-month mammographic follow-up, the radiologist mentioned the existence of the metallic clip in her breast. Subsequently, the woman presented complaining about "being spied [upon] by an implanted clip in [her] breast" and repeatedly requested the removal of the clip. The patient was referred to the specialized psychiatrist of our breast unit for evaluation. The Mental State Examination found that systematized paranoid ideas of persecutory type dominated her daily routines. At the time, she believed that the implanted clip was one of several pieces of equipment being used to keep her under surveillance, the other equipment being her telephone, cameras and television. Quite surprisingly, she had never had a consultation with a mental health professional. The patient appeared depressed and her insight into her condition was impaired. The prevalent diagnosis was schizotypal disorder, whereas the differential diagnosis comprised delusional disorder of persecutory type, affective disorder with psychotic features or comorbid delusional disorder with major depression

  8. Effects of Milrinone continuous intravenous infusion on global cerebral oxygenation and cerebral vasospasm after cerebral aneurysm surgical clipping

    Directory of Open Access Journals (Sweden)

    Mohamed A. Ghanem

    2014-01-01

    Conclusions: Milrinone improved significantly the global cerebral oxygenation and reduced the incidence of cerebral vasospasm during the dangerous period of cerebral spasm after cerebral aneurysm clipping.

  9. It is time for a better clip applier - 3 mm, percutaneous, non-crushing and locking.

    Science.gov (United States)

    Yuval, Jonathan B; Weiss, Daniel J; Paz, Adrian; Bachar, Yehuda; Brodie, Ronit; Shapira, Yinon; Mintz, Yoav

    2017-10-06

    Since the advent of laparoscopy there have been attempts to minimize abdominal wall incisions. For this purpose smaller instruments have been produced. Our aim was to develop the first 3 mm percutaneous clip applier and to make it better than the standard clips of today. The ClipTip clip is made of Nitinol and has a crocodile shaped jaws, which when apposed effectively seal vessels. The shaft operates as a retractable needle permitting percutaneous insertion. Closing, reopening and reclosing is possible. The physical properties of the device were compared to three commercially available clip appliers. Surgeries were performed on porcine animals by experienced surgeons. In comparison to available clips, the superiority of the ClipTip is a combination of wide effective length alongside the ability to withstand strong forces. In live animal studies the Cliptip was inserted into the peritoneal cavity without any injuries. Vessels were ligated successfully and no clip dislodgement or leakage occurred. We developed the next generation clip applier with better properties. Advantages include its length, the needleoscopic caliber, non-crushing effect, locking mechanism and wide aperture. The device has performed safely and effectively in pre-clinical tests. Further studies are planned in humans.

  10. Peak reduction and clipping mitigation in OFDM by augmented compressive sensing

    KAUST Repository

    Al-Safadi, Ebrahim B.

    2012-07-01

    This work establishes the design, analysis, and fine-tuning of a peak-to-average-power-ratio (PAPR) reducing system, based on compressed sensing (CS) at the receiver of a peak-reducing sparse clipper applied to an orthogonal frequency-division multiplexing (OFDM) signal at the transmitter. By exploiting the sparsity of clipping events in the time domain relative to a predefined clipping threshold, the method depends on partially observing the frequency content of the clipping distortion over reserved tones to estimate the remaining distortion. The approach has the advantage of eliminating the computational complexity at the transmitter and reducing the overall complexity of the system compared to previous methods which incorporate pilots to cancel nonlinear distortion. Data-based augmented CS methods are also proposed that draw upon available phase and support information from data tones for enhanced estimation and cancelation of clipping noise. This enables signal recovery under more severe clipping scenarios and hence lower PAPR can be achieved compared to conventional CS techniques. © 2012 IEEE.

  11. Peak reduction and clipping mitigation in OFDM by augmented compressive sensing

    KAUST Repository

    Al-Safadi, Ebrahim B.; Al-Naffouri, Tareq Y.

    2012-01-01

    This work establishes the design, analysis, and fine-tuning of a peak-to-average-power-ratio (PAPR) reducing system, based on compressed sensing (CS) at the receiver of a peak-reducing sparse clipper applied to an orthogonal frequency-division multiplexing (OFDM) signal at the transmitter. By exploiting the sparsity of clipping events in the time domain relative to a predefined clipping threshold, the method depends on partially observing the frequency content of the clipping distortion over reserved tones to estimate the remaining distortion. The approach has the advantage of eliminating the computational complexity at the transmitter and reducing the overall complexity of the system compared to previous methods which incorporate pilots to cancel nonlinear distortion. Data-based augmented CS methods are also proposed that draw upon available phase and support information from data tones for enhanced estimation and cancelation of clipping noise. This enables signal recovery under more severe clipping scenarios and hence lower PAPR can be achieved compared to conventional CS techniques. © 2012 IEEE.

  12. Harmonic Scalpel versus electrocautery and surgical clips in head and neck free-flap harvesting.

    Science.gov (United States)

    Dean, Nichole R; Rosenthal, Eben L; Morgan, Bruce A; Magnuson, J Scott; Carroll, William R

    2014-06-01

    We sought to determine the safety and utility of Harmonic Scalpel-assisted free-flap harvesting as an alternative to a combined electrocautery and surgical clip technique. The medical records of 103 patients undergoing radial forearm free-flap reconstruction (105 free flaps) for head and neck surgical defects between 2006 and 2008 were reviewed. The use of bipolar electrocautery and surgical clips for division of small perforating vessels (n = 53) was compared to ultrasonic energy (Harmonic Scalpel; Ethicon Endo-Surgery, Inc., Cincinnati, Ohio) (n = 52) free-tissue harvesting techniques. Flap-harvesting time was reduced with the use of the Harmonic Scalpel when compared with electrocautery and surgical clip harvest (31.4 vs. 36.9 minutes, respectively; p = 0.06). Two patients who underwent flap harvest with electrocautery and surgical clips developed postoperative donor site hematomas, whereas no donor site complications were noted in the Harmonic Scalpel group. Recipient site complication rates for infection, fistula, and hematoma were similar for both harvesting techniques (p = 0.77). Two flap failures occurred in the clip-assisted radial forearm free-flap harvest group, and none in the Harmonic Scalpel group. Median length of hospitalization was significantly reduced for patients who underwent free-flap harvest with the Harmonic Scalpel when compared with the other technique (7 vs. 8 days; p = 0.01). The Harmonic Scalpel is safe, and its use is feasible for radial forearm free-flap harvest.

  13. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  14. Hypertension and liver disease

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Møller, Søren

    2004-01-01

    to increased arterial blood pressure. Subjects with established arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin......Arterial hypertension is a common disorder with a frequency of 10% to 15% in subjects in the 40- to 60-year age group. Yet most reports find the prevalence of arterial hypertension in patients with chronic liver disease (cirrhosis) much lower. In this review, we consider the alterations in systemic...... hemodynamics in cirrhosis. The most characteristic findings in cirrhotic patients are vasodilatation with low systemic vascular resistance, increased cardiac output, high arterial compliance, secondary activation of counterregulatory systems (sympathetic nervous system, renin-angiotensin-aldosterone system...

  15. Secondary hypertension in adults.

    Science.gov (United States)

    Puar, Troy Hai Kiat; Mok, Yingjuan; Debajyoti, Roy; Khoo, Joan; How, Choon How; Ng, Alvin Kok Heong

    2016-05-01

    Secondary hypertension occurs in a significant proportion of adult patients (~10%). In young patients, renal causes (glomerulonephritis) and coarctation of the aorta should be considered. In older patients, primary aldosteronism, obstructive sleep apnoea and renal artery stenosis are more prevalent than previously thought. Primary aldosteronism can be screened by taking morning aldosterone and renin levels, and should be considered in patients with severe, resistant or hypokalaemia-associated hypertension. Symptoms of obstructive sleep apnoea should be sought. Worsening of renal function after starting an angiotensin-converting enzyme inhibitor suggests the possibility of renal artery stenosis. Recognition, diagnosis and treatment of secondary causes of hypertension lead to good clinical outcomes and the possible reversal of end-organ damage, in addition to blood pressure control. As most patients with hypertension are managed at the primary care level, it is important for primary care physicians to recognise these conditions and refer patients appropriately. Copyright: © Singapore Medical Association.

  16. Pulmonary Hypertension Overview

    Science.gov (United States)

    ... well as sleep apnea, are common causes of secondary pulmonary hypertension. Other causes include the following: Congestive heart failure Birth defects in the heart Chronic pulmonary thromboembolism (blood clots in the pulmonary arteries) Acquired immunodeficiency syndrome ( ...

  17. Hypertension and Anaesthesia

    African Journals Online (AJOL)

    worldwide, and is a major risk factor for coronary artery disease, myocardial ... pressure falls in different categories of systolic and diastolic pressure the higher ... Without this consensus, the management of the elderly hypertensive patient.

  18. Diabetes + Hypertension (comorbidity)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data set provides de-identified population data for diabetes and hypertension comorbidity prevalence in Allegheny County.

  19. Understanding idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Markey, Keira A; Mollan, Susan P; Jensen, Rigmor H

    2016-01-01

    Idiopathic intracranial hypertension is a disorder characterised by raised intracranial pressure that predominantly affects young, obese women. Pathogenesis has not been fully elucidated, but several causal factors have been proposed. Symptoms can include headaches, visual loss, pulsatile tinnitus...

  20. High Blood Pressure (Hypertension)

    Science.gov (United States)

    ... Print Page Text Size: A A A Listen High Blood Pressure (Hypertension) Nearly 1 in 3 American adults has ... weight. How Will I Know if I Have High Blood Pressure? High blood pressure is a silent problem — you ...

  1. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both...... supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia......, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society...

  2. Diabetes Mellitus and Hypertension

    OpenAIRE

    Tuğrul, Armağan

    2014-01-01

    Hypertension is a major worldwide health problem. Its prevalence is 1.5-2 times higher in diabetic population than that in non-diabetic individuals. Its pathogenesis depends on diabetic nephropathy in type 1, whereas may be multifactorial in type 2 diabetes mellitus. In diabetics, angiotensin converting enzyme inhibitors are most widely preferred in the treatment of hypertension because of their numerous desirable effects. In this article, the most recent data are presented on the relationshi...

  3. Hypertension og hjernen

    DEFF Research Database (Denmark)

    Christensen, Hanne; Strandgaard, Svend

    2009-01-01

    Hypertension is a major and modifiable risk factor of stroke and dementia. Hypertension causes remodelling of the cerebral resistance vessels, impairing their tolerance to very low blood pressure. In primary prevention of stroke, the effect of beta-blockers is inferior to other classes...... of antihypertensives. In secondary prevention of stroke, ACE-inhibitors and angiotensin blockers may be recommended as first choice drugs. Lowering of the blood pressure is, however, more important than the choice of drug. Udgivelsesdato: 2009-Jun-8...

  4. Cervical Spondylosis and Hypertension

    OpenAIRE

    Peng, Baogan; Pang, Xiaodong; Li, Duanming; Yang, Hong

    2015-01-01

    Abstract Cervical spondylosis and hypertension are all common diseases, but the relationship between them has never been studied. Patients with cervical spondylosis are often accompanied with vertigo. Anterior cervical discectomy and fusion is an effective method of treatment for cervical spondylosis with cervical vertigo that is unresponsive to conservative therapy. We report 2 patients of cervical spondylosis with concomitant cervical vertigo and hypertension who were treated successfully w...

  5. Thromboembolic chronicle pulmonary Hypertension

    International Nuclear Information System (INIS)

    Ovalle, Amador

    2003-01-01

    The thromboembolic chronicle pulmonary Hypertension, also well known as chronic lung thromboembolism not resolved; it is a form not very common of lung thromboembolism. Until very recently was considered a rare curiosity of autopsy, but as the methods of diagnoses have improved and our attitude has changed, the incidence of this nosological entity has experienced a notable increment, but the most excellent in this illness is maybe that it is a form of lung hypertension, potentially recoverable

  6. Renovascular hypertension: bibliographic review

    International Nuclear Information System (INIS)

    Cruz Guzman, Luis Fernando

    2011-01-01

    A review of the literature on the management of the renovascular disease is performed to provide better attention to patients. Renovascular hypertension is defined. The clinical implications and complications of the disease are determined. Pharmacological and surgical management are specified. Endovascular therapy has allowed to determine some indication in the management of hypertension renovascular. Instances where endovascular therapy has been beneficial are detailed. The new interventions for the management of renovascular disease are exposed [es

  7. Adaptive quantization-parameter clip scheme for smooth quality in H.264/AVC.

    Science.gov (United States)

    Hu, Sudeng; Wang, Hanli; Kwong, Sam

    2012-04-01

    In this paper, we investigate the issues over the smooth quality and the smooth bit rate during rate control (RC) in H.264/AVC. An adaptive quantization-parameter (Q(p)) clip scheme is proposed to optimize the quality smoothness while keeping the bit-rate fluctuation at an acceptable level. First, the frame complexity variation is studied by defining a complexity ratio between two nearby frames. Second, the range of the generated bits is analyzed to prevent the encoder buffer from overflow and underflow. Third, based on the safe range of the generated bits, an optimal Q(p) clip range is developed to reduce the quality fluctuation. Experimental results demonstrate that the proposed Q(p) clip scheme can achieve excellent performance in quality smoothness and buffer regulation.

  8. Biology of portal hypertension.

    Science.gov (United States)

    McConnell, Matthew; Iwakiri, Yasuko

    2018-02-01

    Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized. As a secondary event, portal hypertension results in splanchnic and systemic arterial vasodilation, leading to the development of a hyperdynamic circulatory syndrome and subsequently to clinically devastating complications including gastroesophageal varices and variceal hemorrhage, hepatic encephalopathy from the formation of portosystemic shunts, ascites, and renal failure due to the hepatorenal syndrome. This review article discusses: (1) mechanisms of sinusoidal portal hypertension, focusing on HSC and LSEC biology, pathological angiogenesis, and the role of microvascular thrombosis and platelets, (2) the mesenteric vasculature in portal hypertension, and (3) future directions for vascular biology research in portal hypertension.

  9. New concept of 3D printed bone clip (polylactic acid/hydroxyapatite/silk composite) for internal fixation of bone fractures.

    Science.gov (United States)

    Yeon, Yeung Kyu; Park, Hae Sang; Lee, Jung Min; Lee, Ji Seung; Lee, Young Jin; Sultan, Md Tipu; Seo, Ye Bin; Lee, Ok Joo; Kim, Soon Hee; Park, Chan Hum

    Open reduction with internal fixation is commonly used for the treatment of bone fractures. However, postoperative infection associated with internal fixation devices (intramedullary nails, plates, and screws) remains a significant complication, and it is technically difficult to fix multiple fragmented bony fractures using internal fixation devices. In addition, drilling in the bone to install devices can lead to secondary fracture, bone necrosis associated with postoperative infection. In this study, we developed bone clip type internal fixation device using three- dimensional (3D) printing technology. Standard 3D model of the bone clip was generated based on computed tomography (CT) scan of the femur in the rat. Polylacticacid (PLA), hydroxyapatite (HA), and silk were used for bone clip material. The purpose of this study was to characterize 3D printed PLA, PLA/HA, and PLA/HA/Silk composite bone clip and evaluate the feasibility of these bone clips as an internal fixation device. Based on the results, PLA/HA/Silk composite bone clip showed similar mechanical property, and superior biocompatibility compared to other types of the bone clip. PLA/HA/Silk composite bone clip demonstrated excellent alignment of the bony segments across the femur fracture site with well-positioned bone clip in an animal study. Our 3D printed bone clips have several advantages: (1) relatively noninvasive (drilling in the bone is not necessary), (2) patient-specific design (3) mechanically stable device, and (4) it provides high biocompatibility. Therefore, we suggest that our 3D printed PLA/HA/Silk composite bone clip is a possible internal fixation device.

  10. Impact of Aneurysm Projection on Intraoperative Complications During Surgical Clipping of Ruptured Posterior Communicating Artery Aneurysms.

    Science.gov (United States)

    Fukuda, Hitoshi; Hayashi, Kosuke; Yoshino, Kumiko; Koyama, Takashi; Lo, Benjamin; Kurosaki, Yoshitaka; Yamagata, Sen

    2016-03-01

    Surgical clipping of ruptured posterior communicating artery (PCoA) aneurysms is a well-established procedure to date. However, preoperative factors associated with procedure-related risk require further elucidation. To investigate the impact of the direction of aneurysm projection on the incidence of procedure-related complications during surgical clipping of ruptured PCoA aneurysms. A total of 65 patients with ruptured PCoA aneurysms who underwent surgical clipping were retrospectively analyzed from a single-center, prospective, observational cohort database in this study. The aneurysms were categorized into lateral and posterior projection groups, depending on direction of the dome. Characteristics and operative findings of each projection group were identified. We also evaluated any correlation of aneurysm projection with the incidence of procedure-related complications. Patients with ruptured PCoA aneurysms with posterior projection more likely presented with good-admission-grade subarachnoid hemorrhage (P = .01, χ test) and were less to also have intracerebral hematoma (P = .01). These aneurysms were found to be associated with higher incidence of intraoperative rupture (P = .02), complex clipping with fenestrated clips (P = .02), and dense adherence to PCoA or its perforators (P = .04) by univariate analysis. Aneurysms with posterior projection were also correlated with procedure-related complications, including postoperative cerebral infarction or hematoma formation (odds ratio, 5.87; 95% confidence interval, 1.11-31.1; P = .04) by multivariable analysis. Ruptured PCoA aneurysms with posterior projection carried a higher risk of procedure-related complications of surgical clipping than those with lateral projection.

  11. Fundamental Frequency Extraction Method using Central Clipping and its Importance for the Classification of Emotional State

    Directory of Open Access Journals (Sweden)

    Pavol Partila

    2012-01-01

    Full Text Available The paper deals with a classification of emotional state. We implemented a method for extracting the fundamental speech signal frequency by means of a central clipping and examined a correlation between emotional state and fundamental speech frequency. For this purpose, we applied an approach of exploratory data analysis. The ANOVA (Analysis of variance test confirmed that a modification in the speaker's emotional state changes the fundamental frequency of human vocal tract. The main contribution of the paper lies in investigation, of central clipping method by the ANOVA.

  12. Future of clip-on weapon sights: pros and cons from an applications perspective

    Science.gov (United States)

    Knight, C. Reed; Greenslade, Ken; Francisco, Glen

    2015-05-01

    US Domestic, International, allied Foreign National Warfighters and Para-Military First Responders (Police, SWAT, Special Operations, Law Enforcement, Government, Security and more) are put in harm's way all the time. To successfully complete their missions and return home safely are the primary goals of these professionals. Tactical product improvements that affect mission effectiveness and solider survivability are pivotal to understanding the past, present and future of Clip-On in-line weapon sights. Clip-On Weapon Sight (WS) technology was deemed an interim solution by the US Government for use until integrated and fused (day/night multi-sensor) Weapon Sights (WSs) were developed/fielded. Clip-On has now become the solution of choice by Users, Warriors, Soldiers and the US Government. SWaP-C (size, weight and power -cost) has been improved through progressive advances in Clip-On Image Intensified (I2), passive thermal, LL-CMOS and fused technology. Clip-On Weapon Sights are now no longer mounting position sensitive. Now they maintain aim point boresight, so they can be used for longer ranges with increased capabilities while utilizing the existing zeroed weapon and daysight optic. Active illuminated low-light level (both analog I2 and digital LL-CMOS) imaging is rightfully a real-world technology, proven to deliver daytime and low-light level identification confidence. Passive thermal imaging is also a real-world technology, proven to deliver daytime, nighttime and all-weather (including dirty battlefield) target detection confidence. Image processing detection algorithms with intelligent analytics provide documented promise to improve confidence by reducing Users, Warriors and Soldiers' work-loads and improving overall system engagement solution outcomes. In order to understand the future of Clip-On in-line weapon sights, addressing pros and cons, this paper starts with an overview of historical weapon sight applications, technologies and stakeholder decisions

  13. The use of shape memory compression anastomosis clips in cholecystojejunostomy in pigs – a preliminary study

    Directory of Open Access Journals (Sweden)

    Piotr Holak

    2015-01-01

    Full Text Available This paper reports on the use of compression anastomosis clips (CAC in cholecystoenterostomy in an animal model. Cholecystojejunostomy was performed in 6 pigs using implants made of nickel-titanium alloy in the form of elliptical springs with two-way shape memory. The applied procedure led to the achievement of tight anastomosis with a minimal number of complications and positive results of histopathological evaluations of the anastomotic site. The results of the study indicate that shape memory NiTi clips are a promising surgical tool for cholecystoenterostomy in cats and dogs.

  14. Emotion Index of Cover Song Music Video Clips based on Facial Expression Recognition

    DEFF Research Database (Denmark)

    Kavallakis, George; Vidakis, Nikolaos; Triantafyllidis, Georgios

    2017-01-01

    This paper presents a scheme of creating an emotion index of cover song music video clips by recognizing and classifying facial expressions of the artist in the video. More specifically, it fuses effective and robust algorithms which are employed for expression recognition, along with the use...... of a neural network system using the features extracted by the SIFT algorithm. Also we support the need of this fusion of different expression recognition algorithms, because of the way that emotions are linked to facial expressions in music video clips....

  15. Bayesian Recovery of Clipped OFDM Signals: A Receiver-based Approach

    KAUST Repository

    Al-Rabah, Abdullatif R.

    2013-05-01

    Recently, orthogonal frequency-division multiplexing (OFDM) has been adopted for high-speed wireless communications due to its robustness against multipath fading. However, one of the main fundamental drawbacks of OFDM systems is the high peak-to-average-power ratio (PAPR). Several techniques have been proposed for PAPR reduction. Most of these techniques require transmitter-based (pre-compensated) processing. On the other hand, receiver-based alternatives would save the power and reduce the transmitter complexity. By keeping this in mind, a possible approach is to limit the amplitude of the OFDM signal to a predetermined threshold and equivalently a sparse clipping signal is added. Then, estimating this clipping signal at the receiver to recover the original signal. In this work, we propose a Bayesian receiver-based low-complexity clipping signal recovery method for PAPR reduction. The method is able to i) effectively reduce the PAPR via simple clipping scheme at the transmitter side, ii) use Bayesian recovery algorithm to reconstruct the clipping signal at the receiver side by measuring part of subcarriers, iii) perform well in the absence of statistical information about the signal (e.g. clipping level) and the noise (e.g. noise variance), and at the same time iv is energy efficient due to its low complexity. Specifically, the proposed recovery technique is implemented in data-aided based. The data-aided method collects clipping information by measuring reliable 
data subcarriers, thus makes full use of spectrum for data transmission without the need for tone reservation. The study is extended further to discuss how to improve the recovery of the clipping signal utilizing some features of practical OFDM systems i.e., the oversampling and the presence of multiple receivers. Simulation results demonstrate the superiority of the proposed technique over other recovery algorithms. The overall objective is to show that the receiver-based Bayesian technique is highly

  16. Clinical outcome of critically ill, not fully recompensated, patients undergoing MitraClip therapy

    DEFF Research Database (Denmark)

    Rudolph, Volker; Huntgeburth, Michael; von Bardeleben, Ralph Stephan

    2014-01-01

    AIMS: As periprocedural risk is low, MitraClip implantation is often performed in critically ill, not fully recompensated patients, who are in NYHA functional class IV at the time of the procedure, to accelerate convalescence. We herein sought to evaluate the procedural and 30-day outcome.......3%. CONCLUSION: MitraClip therapy is feasible and safe even in critically ill, not fully recompensated patients and leads to symptomatic improvement in over two-thirds of these patients; however, it is associated with an elevated 30-day mortality....

  17. From benchmarking HITS-CLIP peak detection programs to a new method for identification of miRNA-binding sites from Ago2-CLIP data.

    Science.gov (United States)

    Bottini, Silvia; Hamouda-Tekaya, Nedra; Tanasa, Bogdan; Zaragosi, Laure-Emmanuelle; Grandjean, Valerie; Repetto, Emanuela; Trabucchi, Michele

    2017-05-19

    Experimental evidence indicates that about 60% of miRNA-binding activity does not follow the canonical rule about the seed matching between miRNA and target mRNAs, but rather a non-canonical miRNA targeting activity outside the seed or with a seed-like motifs. Here, we propose a new unbiased method to identify canonical and non-canonical miRNA-binding sites from peaks identified by Ago2 Cross-Linked ImmunoPrecipitation associated to high-throughput sequencing (CLIP-seq). Since the quality of peaks is of pivotal importance for the final output of the proposed method, we provide a comprehensive benchmarking of four peak detection programs, namely CIMS, PIPE-CLIP, Piranha and Pyicoclip, on four publicly available Ago2-HITS-CLIP datasets and one unpublished in-house Ago2-dataset in stem cells. We measured the sensitivity, the specificity and the position accuracy toward miRNA binding sites identification, and the agreement with TargetScan. Secondly, we developed a new pipeline, called miRBShunter, to identify canonical and non-canonical miRNA-binding sites based on de novo motif identification from Ago2 peaks and prediction of miRNA::RNA heteroduplexes. miRBShunter was tested and experimentally validated on the in-house Ago2-dataset and on an Ago2-PAR-CLIP dataset in human stem cells. Overall, we provide guidelines to choose a suitable peak detection program and a new method for miRNA-target identification. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  18. 78 FR 78319 - Media Bureau Seeks Comment on Application of the IP Closed Captioning Rules to Video Clips

    Science.gov (United States)

    2013-12-26

    ... Video Programming: Implementation of the Twenty-First Century Communications and Video Accessibility Act..., pursuant to the Twenty-First Century Communications and Video Accessibility Act of 2010 (``CVAA''),\\2\\ the... clips, especially news clips.\\8\\ The Commission stated that if it finds that consumers who are deaf or...

  19. Effect of advanced chronic kidney disease in clinical and echocardiographic outcomes of patients treated with MitraClip system

    DEFF Research Database (Denmark)

    Estévez-Loureiro, Rodrigo; Settergren, Magnus; Pighi, Michele

    2015-01-01

    BACKGROUND: Data regarding the influence of different levels of renal dysfunction on clinical and echocardiographic results of MitraClip therapy are scarce. We aimed to evaluate the impact of baseline advance renal failure in the outcomes of a cohort of patients treated with MitraClip. METHODS AN...

  20. Comparison of Outcome After Percutaneous Mitral Valve Repair With the MitraClip in Patients With Versus Without Atrial Fibrillation

    NARCIS (Netherlands)

    Velu, Juliëtte F.; Kortlandt, Friso A.; Hendriks, Tom; Schurer, Remco A. J.; van Boven, Ad J.; Koch, Karel T.; Vis, M. Marije; Henriques, Jose P.; Piek, Jan J.; van den Branden, Ben J. L.; Schaap, Jeroen; Rensing, Benno J.; Swaans, Martin J.; Bouma, Berto J.; van der Heyden, Jan A. S.; Baan, Jan

    2017-01-01

    Percutaneous mitral valve repair with the MitraClip is an established treatment for patients with mitral regurgitation (MR) who are inoperable or at high risk for surgery. Atrial Fibrillation (AF) frequently coincides with MR, but only scarce data of the influence of AF on outcome after MitraClip is

  1. Current opinion on clip placement after breast biopsy: A survey of practising radiologists in France and Quebec

    International Nuclear Information System (INIS)

    Thomassin-Naggara, I.; Jalaguier-Coudray, A.; Chopier, J.; Tardivon, A.; Trop, I.

    2013-01-01

    Aim: To investigate current practice regarding clip placement after breast biopsy. Materials and methods: In June 2011, an online survey instrument was designed using an Internet-based survey site ( (www.surveymonkey.com)) to assess practices and opinions of breast radiologists regarding clip placement after breast biopsy. Radiologists were asked to give personal practice data, describe their current practice regarding clip deployment under stereotactic, ultrasonographic, and magnetic resonance imaging (MRI) guidance, and describe what steps are taken to ensure quality control with regards to clip deployment. Results: The response rate was 29.9% in France (131 respondents) and 46.7% in Quebec (50 respondents). The great majority of respondents used breast markers in their practice (92.1% in France and 96% in Quebec). In both countries, most reported deploying a clip after percutaneous biopsy under stereotactic or MRI guidance. Regarding clip deployment under ultrasonography, 38% of Quebec radiologists systematically placed a marker after each biopsy, whereas 30% of French radiologists never placed a marker in this situation, mainly due to its cost. Finally, 56.4% of radiologists in France and 54% in Quebec considered that their practice regarding clip deployment after breast percutaneous biopsy had changed in the last 5 years. Conclusion: There continues to be variations in the use of biopsy clips after imaging-guided biopsies, particularly with regards to sonographic techniques. These variations are likely to decrease over time, with the standardization of relatively new investigation protocols

  2. Pregnancy with Portal Hypertension

    Science.gov (United States)

    Aggarwal, Neelam; Negi, Neha; Aggarwal, Aakash; Bodh, Vijay; Dhiman, Radha K.

    2014-01-01

    Even though pregnancy is rare with cirrhosis and advanced liver disease, but it may co-exist in the setting of non-cirrhotic portal hypertension as liver function is preserved but whenever encountered together is a complex clinical dilemma. Pregnancy in a patient with portal hypertension presents a special challenge to the obstetrician as so-called physiological hemodynamic changes associated with pregnancy, needed for meeting demands of the growing fetus, worsen the portal hypertension thereby putting mother at risk of potentially life-threatening complications like variceal hemorrhage. Risks of variceal bleed and hepatic decompensation increase many fold during pregnancy. Optimal management revolves round managing the portal hypertension and its complications. Thus management of such cases requires multi-speciality approach involving obstetricians experienced in dealing with high risk cases, hepatologists, anesthetists and neonatologists. With advancement in medical field, pregnancy is not contra-indicated in these women, as was previously believed. This article focuses on the different aspects of pregnancy with portal hypertension with special emphasis on specific cause wise treatment options to decrease the variceal bleed and hepatic decompensation. Based on extensive review of literature, management from pre-conceptional period to postpartum is outlined in order to have optimal maternal and perinatal outcomes. PMID:25755552

  3. Management of diabetic hypertensives

    Science.gov (United States)

    Ganesh, Jai; Viswanathan, Vijay

    2011-01-01

    Hypertension occurs twice as commonly in diabetics than in comparable nondiabetics. Patients with both disorders have a markedly higher risk for premature microvascular and macrovascular complications. Aggressive control of blood pressure (BP) reduces both micro- and macrovascular complications. In diabetic hypertensives, angiotensin converting enzyme inhibitors (ACEIs) are the first line in management of hypertension, and can be replaced by angiotensin II receptor blockers (ARBs) if patients are intolerant of them. Recent studies suggest ARBs to be on par with ACEI in reducing both macro- and microvascular risks. Adding both these agents may have a beneficial effect on proteinuria, but no extra macrovascular risk reduction. Thiazides can also be used as first line drugs, but are better used along with ACEI/ARBs. Beta-blockers [especially if the patient has coronary artery disease] and calcium channel blockers are used as second line add-on drugs. Multidrug regimens are commonly needed in diabetic hypertensives. Achieving the target BP of <130/80 is the priority rather than the drug combination used in order to arrest and prevent the progression of macro- and microvascular complications in diabetic hypertensives. PMID:22145142

  4. Adaptation, allometry, and hypertension.

    Science.gov (United States)

    Weder, A B; Schork, N J

    1994-08-01

    Essential hypertension is a "disease of civilization" but has a clear genetic component. From an evolutionary perspective, persistence in the human genome of elements capable of raising blood pressure presupposes their adaptive significance. Recently, two hypotheses that explicitly appeal to selectionist arguments, the "slavery" and "thrifty gene" theories, have been forwarded. We find neither completely successful, and we advance an alternative explanation of the adaptive importance of genes responsible for hypertension. We propose that blood pressure rises during childhood and adolescence to subserve homeostatic needs of the organism. Specifically, we contend that blood pressure is a flexible element in the repertoire of renal homeostatic mechanisms serving to match renal function to growth. The effect of modern diet and lifestyle on human growth stimulates earlier and more vigorous development, straining biologically necessary relationships between renal and general somatic growth and requiring compensation via homeostatic mechanisms preserved during evolution. Prime among such mechanisms is blood pressure, which rises as a compensation to maintain renal function in the face of greater growth. Since virtually all members of acculturated societies share in the modern lifestyle, the demands imposed by accelerated growth and development result in a populational shift to higher blood pressures, with a consequent increase in the prevalence of hypertension. We propose that hypertension is the product of maladaptation of highly genetically conserved mechanisms subserving important biological homeostatic needs. Elucidation of the mechanisms underlying hypertension will require approaches that examine the developmental processes linking growth to blood pressure.

  5. Reduction of transmural 125I-albumin concentration in rat aortic media by chronic hypertension

    International Nuclear Information System (INIS)

    Belmin, J.; Michel, J.B.; Curmi, P.A.; Salzmann, J.L.; Juan, L.; Tedgui, A.

    1991-01-01

    Relative 125I-albumin concentration was measured in vivo in the aortic media of sham-operated (n = 10) and hypertensive (two-kidney, one clip) rats, untreated (n = 8) or treated (n = 10) by an angiotensin converting enzyme inhibitor (CEI, Trandolapril). Blood pressure was acutely lowered to a normal level at the time of the experiment in hypertensive rats (n = 7) to separate the direct effect of increased pressure from the effect of pressure-induced structural changes. Relative tissue concentration profiles of labeled albumin across the media were obtained using a serial frozen-sectioning technique. In hypertensive rats, the mean medial albumin concentration decreased by 35% in the ascending arch and 32% in the descending arch (p less than 0.01). When blood pressure was acutely lowered in hypertensive animals, this value decreased further by 56% in the ascending arch, 48% in the descending arch (p less than 0.01), and 22% in the thoracic aorta (p less than 0.05) as compared with controls. The medial thickness in hypertensive rats was significantly increased (more in the ascending arch than in the rest of the aorta). Four-week CEI treatment reversed hypertension and medial thickening, but the mean medial albumin concentration remained significantly lower in the arch (by 36% in the ascending part and 40% in the descending part, p less than 0.01). The collagen content in the thoracic aorta was significantly increased in hypertensive rats (by 40%, p less than 0.01) and remained increased (by 29%, p less than 0.01) after CEI treatment. These results suggested that the hypertension-induced structural changes might reduce the medial distribution volume for albumin, whereas elevated blood pressure per se tended to enhance albumin concentration within the media

  6. Hypertension in postmenopausal women: how to approach hypertension in menopause.

    Science.gov (United States)

    Modena, Maria Grazia

    2014-09-01

    During fertile life women are usually normo or hypotensive. Hypertension may appear during pregnancy and this represents a peculiar phenomenon increasing nowadays for delay time of pregnancy. Gestational hypertension appears partially similar to hypertension in the context of metabolic syndrome for a similar condition of increased waste circumference. Parity, for the same pathogenesis, has been reported to be associated to peri and postmenopausal hypertension, not confirmed by our study of parous women with transitional non persistent perimenopausal hypertension. Estrogen's deficiency inducing endothelial dysfunction and increased body mass index are the main cause for hypertension in this phase of life. For these reasons lifestyle modification, diet and endothelial active drugs represent the ideal treatment. Antioxidant agents may have a role in prevention and treatment of hypertension. In conclusion, hypertension in women represents a peculiar constellation of different biological and pathogenic factors, which need a specific gender related approach, independent from the male model.

  7. Knowledge and awareness of hypertension among patients with systemic hypertension.

    Science.gov (United States)

    Familoni, B. Oluranti; Ogun, S. Abayomi; Aina, A. Olutoyin

    2004-01-01

    BACKGROUND: In Nigeria, systemic hypertension is the commonest noncommunicable disease, and public awareness about hypertension and its determinants is poor. This study aims to assess the knowledge and level of awareness of the disease among hypertensive patients attending the medical outpatient clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH). METHODOLOGY: Hypertensive patients who attended the medical outpatient clinic during the one-year study period and gave their consent were recruited into the study. Response to a questionnaire on various aspects of hypertension was analyzed using the STATA for Windows software. RESULTS: There were 254 hypertensive patients, of which 111 were males and 143 were females, giving a male: female ratio of 1:1.3. The mean age (SD) of the patients was 51 years +/- 12.2; 52.4% of the participants were aware that hypertension was the commonest noncommunicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure. Only about one-third (35.4%) of the patients knew that hypertension should ideally be treated for life, while 58.3% believed that antihypertensive drugs should be used only when there are symptoms. The remaining 6.3% believed that the treatment of hypertension should be for periods ranging from two weeks to five years but not for life. CONCLUSION: This study has demonstrated inadequate knowledge of hypertension in patients with hypertension in our study population. Conscious efforts should be made and time set aside to health educate hypertensive patients. Organization of "hypertensive club or society" could be encouraged. These will reduce dissemination of false or inaccurate information by hypertensive patients to the public and its attendant dangers. PMID:15160976

  8. The Diterpene Sclareol Vascular Effect in Normotensive and Hypertensive Rats

    Science.gov (United States)

    Campos, Debora Ribeiro; Celotto, Andrea Carla; Albuquerque, Agnes Afrodite S.; Ferreira, Luciana Garros; Monteiro, Ariadne Santana e Neves; Coelho, Eduardo Barbosa; Evora, Paulo Roberto Barbosa

    2017-01-01

    Background The diterpene Sclareol has antimicrobial action, cytotoxic and cytostatic effects and anti-tumor activities. However, researches on the cardiovascular system are scarce. Objective This study was designed to investigate the mechanisms involved in the Sclareol cardiovascular effect in normotensive and hypertensive rats. Methods The arterial hypertension was promoted using 2-kidneys 1-clip model in rats. The effect of sclareol on blood pressure was performed by using three dose (10, 20 and 40 mg/kg). Cumulative dose-response curves for Sclareol were determined for endothelium-intact and endothelium-denuded aortic rings in presence or absence of L-NAME and ODQ. The NOx levels were measure in the plasma sample. Results The Sclareol administration in vivo caused a significant reduction in blood pressure in both groups. In vitro the sclareol promoted relaxation in aorta, with endothelium, pre-contracted to Phe. The inhibitors of the nitric oxide synthase and soluble guanylate cyclase were as efficient as the removal of endothelium, in inhibiting the Sclareol-induced relaxation. Otherwise, it was no change of NOx. Also, for unknown reasons, the Sclareol is not selective for hypertensive animals. Conclusion The diterpene Sclareol showed in vivo hypotensive and in-vitro vasodilator effects;The chemiluminescence plasmatic NO analysis showed no significant difference between groups andThe Sclareol exhibit better effect on normotensive than hypertensive animals to reduce blood pressure. It is concluded that the diterpenes metabolites would be a promising source prototype for the development of new agents in the cardiovascular therapy. PMID:28678928

  9. MRI-validation of SEP monitoring for ischemic events during microsurgical clipping of intracranial aneurysms.

    Science.gov (United States)

    Krayenbühl, Niklaus; Sarnthein, Johannes; Oinas, Minna; Erdem, Eren; Krisht, Ali F

    2011-09-01

    During surgical clipping of intracranial aneurysms, reduction in SEP amplitude is thought to indicate cortical ischemia and subsequent neurological deficits. Since the sensitivity of SEP is questioned, we investigated SEP with respect to post-operative ischemia. In 36 patients with 51 intracranial aneurysms, clinical evaluation and diffusion-weighted MRI (DWI) was performed before and within 24h after surgery. During surgery, time of temporary occlusion was recorded. MRI images were reviewed for signs of ischemia. For 43 clip applications (84%), we observed neither pathologic SEP events nor ischemia in MRI. In two cases where reduction lasted >10 min after clip release, SEP events correlated with ischemia in the MRI. Only one of the ischemic patients was symptomatic and developed a transient hemiparesis. While pathologic SEP events correlated with visible ischemia in MRI only in two cases with late SEP recovery, ischemia in MRI may have been transient or may not have reached detection threshold in the other cases, in agreement with the absence of permanent neurological deficits. In complex aneurysm cases, where prolonged temporary occlusion is expected, SEP should be used to detect ischemia at a reversible stage to improve the safety of aneurysm clipping. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  10. Exploring the Use of Video-Clips for Motivation Building in a Secondary School EFL Setting

    Science.gov (United States)

    Park, Yujong; Jung, Eunsu

    2016-01-01

    By employing an action research framework, this study evaluated the effectiveness of a video-based curriculum in motivating EFL learners to learn English. Fifteen Korean EFL students at the secondary school context participated in an 8-week English program, which employed video clips including TED talk replays, sitcoms, TV news reports and movies…

  11. Endoscopic Management of Gastrocutaneous Fistula Using Clipping, Suturing, and Plugging Methods

    Directory of Open Access Journals (Sweden)

    Shou-jiang Tang

    2014-09-01

    Conclusions: Health care providers need to be aware of this uncommon complication after PEG tube removal and management it with appropriate minimally invasive options where expertise and devices are available. Currently, tissue approximation with clips, intra-gastric and/or trans-abdominal suture placement is the preferred endoscopic options for fistula closure.

  12. Cerebral Aneurysm Clipping Surgery Simulation Using Patient-Specific 3D Printing and Silicone Casting.

    Science.gov (United States)

    Ryan, Justin R; Almefty, Kaith K; Nakaji, Peter; Frakes, David H

    2016-04-01

    Neurosurgery simulator development is growing as practitioners recognize the need for improved instructional and rehearsal platforms to improve procedural skills and patient care. In addition, changes in practice patterns have decreased the volume of specific cases, such as aneurysm clippings, which reduces the opportunity for operating room experience. The authors developed a hands-on, dimensionally accurate model for aneurysm clipping using patient-derived anatomic data and three-dimensional (3D) printing. Design of the model focused on reproducibility as well as adaptability to new patient geometry. A modular, reproducible, and patient-derived medical simulacrum was developed for medical learners to practice aneurysmal clipping procedures. Various forms of 3D printing were used to develop a geometrically accurate cranium and vascular tree featuring 9 patient-derived aneurysms. 3D printing in conjunction with elastomeric casting was leveraged to achieve a patient-derived brain model with tactile properties not yet available from commercial 3D printing technology. An educational pilot study was performed to gauge simulation efficacy. Through the novel manufacturing process, a patient-derived simulacrum was developed for neurovascular surgical simulation. A follow-up qualitative study suggests potential to enhance current educational programs; assessments support the efficacy of the simulacrum. The proposed aneurysm clipping simulator has the potential to improve learning experiences in surgical environment. 3D printing and elastomeric casting can produce patient-derived models for a dynamic learning environment that add value to surgical training and preparation. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Response of Advance Cherrybark Oak Reproduction to Midstory Removal and Shoot Clipping

    Science.gov (United States)

    Brian R. Lockhart; John D. Hodges; Emile S. Gardiner

    2000-01-01

    A Midstory competition control and shoot clipping have been proposed to increase the vigor and height of advance bottomland oak reproduction. Results from a study in east-central Mississippi showed that advance cherrybark oak (Quercus pagoda Raf) released from midstory competition had greater survival than nonreleased seedlings, 64% and 48%,...

  14. Coiling and clipping of middle cerebral artery aneurysms: a systematic review on clinical and imaging outcome

    NARCIS (Netherlands)

    Zijlstra, Ijsbrand A.; Verbaan, Dagmar; Majoie, Charles B.; Vandertop, Peter; van den Berg, Rene

    2016-01-01

    There is an ongoing debate on the preferred treatment of middle cerebral artery (MCA) aneurysms. The purpose of this study was to assess the clinical and imaging outcomes comparing conventional coiling and clipping of unruptured and ruptured MCA aneurysms. We searched the electronic databases

  15. Tailfin clipping, a painful procedure: Studies on Nile tilapia and common carp

    NARCIS (Netherlands)

    Roques, J.A.C.; Abbink, W.; Geurds, F.; Vis, van de J.W.; Flik, G.

    2010-01-01

    The fish welfare debate is intensifying. Consequently, more research is carried out to further our knowledge on fish welfare in aquaculture. We define here a series of key parameters to substantiate an acute response to a supposedly painful stimulus: a standardized tailfin clip. Ultrastructural

  16. Drosophila Imp iCLIP identifies an RNA assemblage coordinating F-actin formation

    DEFF Research Database (Denmark)

    Hansen, Heidi Theil; Rasmussen, Simon Horskjær; Adolph, Sidsel Kramshøj

    2015-01-01

    BACKGROUND: Post-transcriptional RNA regulons ensure co-ordinated expression of monocistronic mRNAs encoding functionally related proteins. In this study, we employ a combination of RIP-seq and short- and long-wave individual-nucleotide resolution crosslinking and immunoprecipitation (iCLIP...

  17. Anterior communicating artery aneurysm clipping versus coiling: a comparative study of 50 cases

    Directory of Open Access Journals (Sweden)

    Kumar Pradeep

    2017-09-01

    Full Text Available Introduction: Aneurysmal Subarachnoid Hemorrhage (aSAH remains a devastating and often fatal form of stroke. The aneurysm is targeted for obliteration to prevent re-bleeding and to manage the possible complications from the event. Endovascular coiling has emerged as a less invasive alternative to conventional surgical clipping to treat aneurysms.

  18. Real-time video streaming of sonographic clips using domestic internet networks and free videoconferencing software.

    Science.gov (United States)

    Liteplo, Andrew S; Noble, Vicki E; Attwood, Ben H C

    2011-11-01

    As the use of point-of-care sonography spreads, so too does the need for remote expert over-reading via telesonogrpahy. We sought to assess the feasibility of using familiar, widespread, and cost-effective existent technology to allow remote over-reading of sonograms in real time and to compare 4 different methods of transmission and communication for both the feasibility of transmission and image quality. Sonographic video clips were transmitted using 2 different connections (WiFi and 3G) and via 2 different videoconferencing modalities (iChat [Apple Inc, Cupertino, CA] and Skype [Skype Software Sàrl, Luxembourg]), for a total of 4 different permutations. The clips were received at a remote location and recorded and then scored by expert reviewers for image quality, resolution, and detail. Wireless transmission of sonographic clips was feasible in all cases when WiFi was used and when Skype was used over a 3G connection. Images transmitted via a WiFi connection were statistically superior to those transmitted via 3G in all parameters of quality (average P = .031), and those sent by iChat were superior to those sent by Skype but not statistically so (average P = .057). Wireless transmission of sonographic video clips using inexpensive hardware, free videoconferencing software, and domestic Internet networks is feasible with retention of image quality sufficient for interpretation. WiFi transmission results in greater image quality than transmission by a 3G network.

  19. Custom-made different designs of pressure clips for the management of ear lobe keloids

    Directory of Open Access Journals (Sweden)

    Anshul Chugh

    2013-01-01

    Full Text Available Introduction : Keloids are frequent finding after physical trauma. Keloids of ear lobe are common complication of ear piercing, although its incidence remains unknown. The use of intrakeloid resection and a form pressure device to treat pinna keloids. The recommendation of this therapy is to maintain constant pressure and duration of pressure therapy was about 25 weeks. Clinical innovation : This article will present inexpensive custom made pressure clips of various designs. The dimensions of polymethylmethacrylate (PMMA plates in ear lobe clip presented by us though they esthetically not so good, but colored PMMA has been used to make it decorative and acceptable by most of the patients. This has been an encouraging experience to use the different designs. Discussion : Ear clip prosthesis has been developed for maintaining pressure on ear lobe keloids before and after surgical removal. The prosthesis includes an ear clip to which heat-polymerized acrylic resin is attached, which covers the keloid area. Pressure therapy is widely used to help in the early maturation of scar tissue and to prevent the recurrence of keloid. The preliminary report by Brent revealed that constant light pressure was an effective means of preventing post excision recurrence of ear lobe keloids using a decorative, spring-pressure earring.

  20. Portable inference engine: An extended CLIPS for real-time production systems

    Science.gov (United States)

    Le, Thach; Homeier, Peter

    1988-01-01

    The present C-Language Integrated Production System (CLIPS) architecture has not been optimized to deal with the constraints of real-time production systems. Matching in CLIPS is based on the Rete Net algorithm, whose assumption of working memory stability might fail to be satisfied in a system subject to real-time dataflow. Further, the CLIPS forward-chaining control mechanism with a predefined conflict resultion strategy may not effectively focus the system's attention on situation-dependent current priorties, or appropriately address different kinds of knowledge which might appear in a given application. Portable Inference Engine (PIE) is a production system architecture based on CLIPS which attempts to create a more general tool while addressing the problems of real-time expert systems. Features of the PIE design include a modular knowledge base, a modified Rete Net algorithm, a bi-directional control strategy, and multiple user-defined conflict resolution strategies. Problems associated with real-time applications are analyzed and an explanation is given for how the PIE architecture addresses these problems.

  1. Physiological remodeling of bifurcation aneurysms: preclinical results of the eCLIPs device.

    Science.gov (United States)

    Marotta, Thomas R; Riina, Howard A; McDougall, Ian; Ricci, Donald R; Killer-Oberpfalzer, Monika

    2018-02-01

    OBJECTIVE Intracranial bifurcation aneurysms are complex lesions for which current therapy, including simple coiling, balloon- or stent-assisted coiling, coil retention, or intrasaccular devices, is inadequate. Thromboembolic complications due to a large burden of intraluminal metal, impedance of access to side branches, and a high recurrence rate, due largely to the unmitigated high-pressure flow into the aneurysm (water hammer effect), are among the limitations imposed by current therapy. The authors describe herein a novel device, eCLIPs, and its use in a preclinical laboratory study that suggests the device's design and functional features may overcome many of these limitations. METHODS A preclinical model of wide-necked bifurcation aneurysms in rabbits was used to assess functional features and efficacy of aneurysm occlusion by the eCLIPs device. RESULTS The eCLIPs device, in bridging the aneurysm neck, allows coil retention, disrupts flow away from the aneurysm, leaves the main vessel and side branches unencumbered by intraluminal metal, and serves as a platform for endothelial growth across the neck, excluding the aneurysm from the circulation. CONCLUSIONS The eCLIPs device permits physiological remodeling of the bifurcation.

  2. Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.

    Science.gov (United States)

    Alaraj, Ali; Luciano, Cristian J; Bailey, Daniel P; Elsenousi, Abdussalam; Roitberg, Ben Z; Bernardo, Antonio; Banerjee, P Pat; Charbel, Fady T

    2015-03-01

    With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents. A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomographic angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-dimensional immersive virtual reality environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from 3 residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery. Residents thought that the simulation would be useful in preparing for real-life surgery. About two-thirds of the residents thought that the 3-dimensional immersive anatomic details provided a close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They thought the simulation was useful for preoperative surgical rehearsal and neurosurgical training. A third of the residents thought that the technology in its current form provided realistic haptic feedback for aneurysm surgery. Neurosurgical residents thought that the novel immersive VR simulator is helpful in their training, especially because they do not get a chance to perform aneurysm clippings until late in their residency programs.

  3. [Rapid 3-Dimensional Models of Cerebral Aneurysm for Emergency Surgical Clipping].

    Science.gov (United States)

    Konno, Takehiko; Mashiko, Toshihiro; Oguma, Hirofumi; Kaneko, Naoki; Otani, Keisuke; Watanabe, Eiju

    2016-08-01

    We developed a method for manufacturing solid models of cerebral aneurysms, with a shorter printing time than that involved in conventional methods, using a compact 3D printer with acrylonitrile-butadiene-styrene(ABS)resin. We further investigated the application and utility of this printing system in emergency clipping surgery. A total of 16 patients diagnosed with acute subarachnoid hemorrhage resulting from cerebral aneurysm rupture were enrolled in the present study. Emergency clipping was performed on the day of hospitalization. Digital Imaging and Communication in Medicine(DICOM)data obtained from computed tomography angiography(CTA)scans were edited and converted to stereolithography(STL)file formats, followed by the production of 3D models of the cerebral aneurysm by using the 3D printer. The mean time from hospitalization to the commencement of surgery was 242 min, whereas the mean time required for manufacturing the 3D model was 67 min. The average cost of each 3D model was 194 Japanese Yen. The time required for manufacturing the 3D models shortened to approximately 1 hour with increasing experience of producing 3D models. Favorable impressions for the use of the 3D models in clipping were reported by almost all neurosurgeons included in this study. Although 3D printing is often considered to involve huge costs and long manufacturing time, the method used in the present study requires shorter time and lower costs than conventional methods for manufacturing 3D cerebral aneurysm models, thus making it suitable for use in emergency clipping.

  4. Polymer Basics: Classroom Activities Manipulating Paper Clips to Introduce the Structures and Properties of Polymers

    Science.gov (United States)

    Umar, Yunusa

    2014-01-01

    A simple and effective hands-on classroom activity designed to illustrate basic polymer concepts is presented. In this activity, students build primary structures of homopolymers and different arrangements of monomers in copolymer using paper clips as monomers. The activity supports formation of a basic understanding of polymer structures,…

  5. A calibration method for proposed XRF measurements of arsenic and selenium in nail clippings

    International Nuclear Information System (INIS)

    Gherase, Mihai R; Fleming, David E B

    2011-01-01

    A calibration method for proposed x-ray fluorescence (XRF) measurements of arsenic and selenium in nail clippings is demonstrated. Phantom nail clippings were produced from a whole nail phantom (0.7 mm thickness, 25 x 25 mm 2 area) and contained equal concentrations of arsenic and selenium ranging from 0 to 20 μg g -1 in increments of 5 μg g -1 . The phantom nail clippings were then grouped in samples of five different masses: 20, 40, 60, 80 and 100 mg for each concentration. Experimental x-ray spectra were acquired for each of the sample masses using a portable x-ray tube and a detector unit. Calibration lines (XRF signal in a number of counts versus stoichiometric elemental concentration) were produced for each of the two elements. A semi-empirical relationship between the mass of the nail phantoms (m) and the slope of the calibration line (s) was determined separately for arsenic and selenium. Using this calibration method, one can estimate elemental concentrations and their uncertainties from the XRF spectra of human nail clippings. (note)

  6. Metallic clip migration to the common bile duct after laparoscopic surgery of the gallbladder

    International Nuclear Information System (INIS)

    Mendoza, Monica E.; Bauni, Carlos E.; Vives, Daniel A.

    2001-01-01

    We report a case of a 65 years old man with jaundice and cholangitis, appeared 8 month after laparoscopic cholecystectomy. CT demonstrated a surgical endo-clip migrated into the common bile duct. CT diagnosis was accurate. The patient had a good clinical evolution after successful endoscopic therapy. (author)

  7. Hypertension og nyresygdom

    DEFF Research Database (Denmark)

    Kamper, Anne-Lise; Pedersen, Erling B; Strandgaard, Svend

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice. Udgivelsesdato: 2009-Jun-15...

  8. [Hypertension and renal disease

    DEFF Research Database (Denmark)

    Kamper, A.L.; Pedersen, E.B.; Strandgaard, S.

    2009-01-01

    Renal mechanisms, in particular the renin-angiotensin system and renal salt handling, are of major importance in blood pressure regulation. Co-existence of hypertension and decreased renal function may be due to nephrosclerosis secondary to hypertension, or primary renal disease with secondary...... hypertension. Mild degrees of chronic kidney disease (CKD) can be detected in around 10% of the population, and detection is important as CKD is an important risk factor for atherosclerotic cardiovascular disease. Conversely, heart failure may cause an impairment of renal function. In chronic progressive...... nephropathy, effective blood pressure lowering is of paramount importance, and angiotensin converting enzyme inhibitors and angiotensin receptor blockers are agents of choice Udgivelsesdato: 2009/6/15...

  9. Echocardiography in Arterial Hypertension.

    Science.gov (United States)

    de Simone, Giovanni; Mancusi, Costantino; Esposito, Roberta; De Luca, Nicola; Galderisi, Maurizio

    2018-05-02

    Hypertension is a condition characterized by pressure and/or volume overloads and echocardiography is helpful and feasible to understand hemodynamic mechanisms. Echocardiographic information is sometimes critical and susceptible of modifying decision making. In this review, we provide detailed descriptions of the parameters that can be derived from a standard transthoracic echocardiogram, including some more recent techniques. We will also explain how each parameter might have impact in the evaluation of the hypertensive patient and give indications on when to refer patients to echo-labs, which parameters are critical and which ones might be redundant, and how to use the information obtained in the report. Cardiac geometry, LV systolic and diastolic function, LV pump performance, output impedance and left atrial function are parameters that might be altered in arterial hypertension, but not necessarily doctors need the whole information for decision making. The critical measures are provided.

  10. [Hypertension in females].

    Science.gov (United States)

    Cífková, Renata

    2015-05-01

    Hypertension is the most common cardiovascular disorder affecting more males in younger age groups; in the age group of 45-64, it is equally frequent in both genders, it is more common in elderly females. Blood pressure increases more in females around the menopause. Use of hormonal replacement therapy is not associated with an BP increase but, because of increased risk of coronary events, stroke, and thromboembolic events, HRT is not re-commended in CVD prevention. There is a similar decrease in BP by antihypertensive drugs in both genders as well as benefit from antihypertensive treatment. Women report about a double rate of adverse events of antihypertensive drugs. Oral contraception use is associated with a mild BP increase in most women and development of overt hypertension in about 5 %. Pre-eclampsia is associated with increased risk of developing CVD later in life (more frequent development of hypertension, myocardial infarction, and stroke).

  11. Peripheral adrenergic receptors in hypertension

    NARCIS (Netherlands)

    Michel, M. C.; Brodde, O. E.; Insel, P. A.

    1990-01-01

    Increased sympathoadrenal activity appears to play an important role in the development or maintenance of elevated blood pressure in hypertensive patients and various animal models of hypertension. Alterations of adrenergic receptor number or responsiveness might contribute to this increased

  12. Radiation-induced renovascular hypertension

    International Nuclear Information System (INIS)

    Staab, G.E.; Tegtmeyer, C.J.; Constable, W.C.

    1976-01-01

    Radiation is known to produce changes in the small vessels and interstitium of the kidneys resulting in hypertension. Two cases of renal artery stenosis and resultant hypertension secondary to abdominal irradiation are reported and the literature is reviewed

  13. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.

    2011-01-01

    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance

  14. Knowing hypertension and diabetes

    DEFF Research Database (Denmark)

    Whyte, Susan Reynolds

    2015-01-01

    In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology...... for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy...

  15. Idiopathic intracranial hypertension

    DEFF Research Database (Denmark)

    Yri, Hanne M; Jensen, Rigmor H

    2015-01-01

    AIMS: The aims of this article are to characterize the headache in idiopathic intracranial hypertension (IIH) and to field-test the ICHD diagnostic criteria for headache attributed to IIH. MATERIALS AND METHODS: We included 44 patients with new-onset IIH. Thirty-four patients with suspected but u...... tinnitus may suggest intracranial hypertension. Based on data from a well-defined IIH cohort, we propose a revision of the ICDH-3 beta diagnostic criteria with improved clinical applicability and increased sensitivity and specificity....

  16. Hypertension and renovascular disease

    DEFF Research Database (Denmark)

    Hasbak, P; Ibsen, H; Jensen, Lars Thorbjørn

    2002-01-01

    The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21%), nephr......The clinical value of renal vein renin sampling (RVRS) as a prognostic tool in the treatment of renovascular hypertension was evaluated. One hundred consecutive patients were included over a 4-year period of time. About half of the patients (49%) were treated interventionally by PTRA (21...

  17. Phosphorus runoff from turfgrass as affected by phosphorus fertilization and clipping management.

    Science.gov (United States)

    Bierman, Peter M; Horgan, Brian P; Rosen, Carl J; Hollman, Andrew B; Pagliari, Paulo H

    2010-01-01

    Phosphorus enrichment of surface water is a concern in many urban watersheds. A 3-yr study on a silt loam soil with 5% slope and high soil test P (27 mg kg(-1) Bray P1) was conducted to evaluate P fertilization and clipping management effects on P runoff from turfgrass (Poa pratensis L.) under frozen and nonfrozen conditions. Four fertilizer treatments were compared: (i) no fertilizer, (ii) nitrogen (N)+potassium (K)+0xP, (iii) N+K+1xP, and (iv) N+K+3xP. Phosphorus rates were 21.3 and 63.9 kg ha(-1) yr(-1) the first year and 7.1 and 21.3 kg ha(-1) yr(-1) the following 2 yr. Each fertilizer treatment was evaluated with clippings removed or clippings recycled back to the turf. In the first year, P runoff increased with increasing P rate and P losses were greater in runoff from frozen than nonfrozen soil. In year 2, total P runoff from the no fertilizer treatment was greater than from treatments receiving fertilizer. This was because reduced turf quality resulted in greater runoff depth from the no fertilizer treatment. In year 3, total P runoff from frozen soil and cumulative total P runoff increased with increasing P rate. Clipping management was not an important factor in any year, indicating that returning clippings does not significantly increase P runoff from turf. In the presence of N and K, P fertilization did not improve turf growth or quality in any year. Phosphorus runoff can be reduced by not applying P to high testing soils and avoiding fall applications when P is needed.

  18. Surgical Clipping versus Endovascular Intervention for the Treatment of Subarachnoid Hemorrhage Patients in New York State.

    Directory of Open Access Journals (Sweden)

    Kimon Bekelis

    Full Text Available Randomized trials have demonstrated a survival benefit for endovascular treatment of ruptured cerebral aneurysms. We investigated the association of surgical clipping and endovascular coiling with outcomes in subarachnoid hemorrhage (SAH patients in a real-world regional cohort.We performed a cohort study involving patients with ruptured cerebral aneurysms, who underwent surgical clipping, or endovascular coiling from 2009-2013 and were registered in the Statewide Planning and Research Cooperative System (SPARCS database. An instrumental variable analysis was used to investigate the association of treatment technique with outcomes.Of the 4,098 patients undergoing treatment, 2,585 (63.1% underwent coiling, and 1,513 (36.9% underwent clipping. Using an instrumental variable analysis, we did not identify a difference in inpatient mortality [marginal effect (ME, -0.56; 95% CI, -1.03 to 0.02], length of stay (LOS (ME, 1.72; 95% CI, -3.39 to 6.84, or the rate of 30-day readmissions (ME, -0.30; 95% CI, -0.82 to 0.22 between the two treatment techniques for patients with SAH. Clipping was associated with a higher rate of discharge to rehabilitation (ME, 0.63; 95% CI, 0.24 to 1.01. In sensitivity analysis, mixed effect regression, and propensity score adjusted regression models demonstrated identical results.Using a comprehensive all-payer cohort of patients in New York State presenting with aneurysmal SAH we did not identify an association of treatment method with mortality, LOS or 30-day readmission. Clipping was associated with a higher rate of discharge to rehabilitation.

  19. Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling.

    Science.gov (United States)

    Shen, Guangping; Zhang, Songning; Bennett, Hunter J; Martin, James C; Crouter, Scott E; Fitzhugh, Eugene C

    2018-06-01

    Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling.

  20. Hyperuricemia in Childhood Primary Hypertension

    OpenAIRE

    Feig, Daniel I.; Johnson, Richard J.

    2003-01-01

    Experimental animal models suggest that uric acid might have a pathogenic role in the early development of primary hypertension. We hypothesized that serum uric acid is correlated with blood pressure in children with new-onset, untreated, primary hypertension. We evaluated 125 consecutive children referred to the Baylor Pediatric Renal Program for evaluation of hypertension. None of the subjects had previously been evaluated or treated for hypertension. The children ranged in age from 6 to 18...

  1. Hypertension and experimental stroke therapies

    OpenAIRE

    O'Collins, Victoria E; Donnan, Geoffrey A; Macleod, Malcolm R; Howells, David W

    2013-01-01

    Hypertension is an established target for long-term stroke prevention but procedures for management of hypertension in acute stroke are less certain. Here, we analyze basic science data to examine the impact of hypertension on candidate stroke therapies and of anti-hypertensive treatments on stroke outcome. Methods: Data were pooled from 3,288 acute ischemic stroke experiments (47,899 animals) testing the effect of therapies on infarct size (published 1978–2010). Data were combined using meta...

  2. EMERGENCY STATES IN ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. A. Gurevich

    2014-01-01

    Full Text Available The article describes in detail potential emergency states in patients with different stages of arterial hypertension with special attention to diagnosis and rational management of hypertensive crisis. Differentiated approach to management of different forms of hypertensive crisis is specified.

  3. Primary lung hypertension in-patient with hypertension portal

    International Nuclear Information System (INIS)

    Restrepo Uribe; Villa Restrepo, Alfredo

    1990-01-01

    Thorax x-rays were reviewed in 18 patients with portal hypertension. In 28% of these we found radiologic signs of pulmonary hypertension of the precapillary type. The existing relation between primary pulmonary hypertension and portal hypertension has been established in different scientific papers. In the published series the incidence of primary pulmonary hypertension is less than the one of found in these patients the physiopathology of this association is reviewed, and as a hypothetic manner it is postulated the possible roll of the hypoxaemia of the residents, at the altitude of the Bogota city. (2.640 mts) as a helping factor in this phenomenon

  4. Decoding white coat hypertension

    Science.gov (United States)

    Bloomfield, Dennis A; Park, Alex

    2017-01-01

    There is arguably no less understood or more intriguing problem in hypertension that the “white coat” condition, the standard concept of which is significantly blood pressure reading obtained by medical personnel of authoritative standing than that obtained by more junior and less authoritative personnel and by the patients themselves. Using hospital-initiated ambulatory blood pressure monitoring, the while effect manifests as initial and ending pressure elevations, and, in treated patients, a low daytime profile. The effect is essentially systolic. Pure diastolic white coat hypertension appears to be exceedingly rare. On the basis of the studies, we believe that the white coat phenomenon is a common, periodic, neuro-endocrine reflex conditioned by anticipation of having the blood pressure taken and the fear of what this measurement may indicate concerning future illness. It does not change with time, or with prolonged association with the physician, particularly with advancing years, it may be superimposed upon essential hypertension, and in patients receiving hypertensive medication, blunting of the nighttime dip, which occurs in about half the patients, may be a compensatory mechanisms, rather than an indication of cardiovascular risk. Rather than the blunted dip, the morning surge or the widened pulse pressure, cardiovascular risk appears to be related to elevation of the average night time pressure. PMID:28352632

  5. Angiography for renal hypertension

    International Nuclear Information System (INIS)

    Chuang, V.P.; Ernst, C.B.

    1985-01-01

    As angioplasty and operative techniques have become more precise and successful, so have evaluation techniques. Preoperative arteriography is indispensible for deciding on the appropriate treatment modality and the specifics of the procedure. Arteriography, therefore, remains the cornerstone in managing renovascular hypertension and renal arterial disease

  6. Children and Hypertension.

    Science.gov (United States)

    Carter, Denise

    1983-01-01

    Since children as young as seven years old can suffer from hypertension, all children should have blood pressure checked during physical examinations. Guidelines for testing children's blood pressure are presented along with suggestions about what schools and parents can do to help deal with the problem. (PP)

  7. Project "Hypertension Alert."

    Science.gov (United States)

    Sailors, Emma Lou

    1983-01-01

    "Hypertension Alert," a 1979-80 blood pressure screening-awareness project of the Yonkers, New York Public Schools, is described. Data is analyzed in tables for ethnic composition, and range of blood pressure readings for the high school, junior high school, and elementary school students tested. (Author/JMK)

  8. Hypertensive Heart Disease

    DEFF Research Database (Denmark)

    Wachtell, Kristian

    2011-01-01

    Abstract Hypertensive heart disease is prevalent and during the last decade it has been determined that patients with left ventricular (LV) hypertrophy have increased cardiovascular morbidity and mortality. However, many have doubted the effectiveness of LV mass assessment because it is difficult...

  9. What Is Pulmonary Hypertension?

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Pulmonary Hypertension - High Blood Pressure in the Heart-to-Lung System Updated:Jan ... Pressure" This content was last reviewed October 2016. High Blood Pressure • Home • Get the Facts About HBP Introduction What ...

  10. Hypertension og hjertet

    DEFF Research Database (Denmark)

    Wachtell, Kristian; Andersen, Niels Holmark; Svendsen, Tage Lysbo

    2009-01-01

    of left ventricular mass is associated with substantial and significant reduction of cardiovascular morbidity and mortality. Hypertension is strongly associated with increased risk of subsequent heart failure. Meta analysis data suggests that reduction in blood pressure is also associated with very...

  11. Fermented milk for hypertension

    DEFF Research Database (Denmark)

    Usinger, Lotte; Reimer, Christina; Ibsen, Hans

    2012-01-01

    Fermented milk has been suggested to have a blood pressure lowering effect through increased content of proteins and peptides produced during the bacterial fermentation. Hypertension is one of the major risk factors for cardiovascular disease world wide and new blood pressure reducing lifestyle...

  12. Nitroglycerin kan give hypertension

    DEFF Research Database (Denmark)

    Mørup, Peter; Levinsen, Tine Holbæk; Hovind, Peter

    2011-01-01

    Hg. The conclusion was that her response was a paradoxical response to glycerylnitrate, orthostatism and a pathological response to massage of the carotid artery. This is the third reported case on paradoxical hypertension induced by glyceryl nitrates. It is speculated that dysfunction of the cerebral bloodflow...

  13. Evaluation of stiffness and plastic deformation of active ceramic self-ligating bracket clips after repetitive opening and closure movements.

    Science.gov (United States)

    Carneiro, Grace Kelly Martins; Roque, Juliano Alves; Segundo, Aguinaldo Silva Garcez; Suzuki, Hideo

    2015-01-01

    The aim of this study was to assess whether repetitive opening and closure of self-ligating bracket clips can cause plastic deformation of the clip. Three types of active/interactive ceramic self-ligating brackets (n = 20) were tested: In-Ovation C, Quicklear and WOW. A standardized controlled device performed 500 cycles of opening and closure movements of the bracket clip with proper instruments and techniques adapted as recommended by the manufacturer of each bracket type. Two tensile tests, one before and one after the repetitive cycles, were performed to assess the stiffness of the clips. To this end, a custom-made stainless steel 0.40 x 0.40 mm wire was inserted into the bracket slot and adapted to the universal testing machine (EMIC DL2000), after which measurements were recorded. On the loading portion of the loading-unloading curve of clips, the slope fitted a first-degree equation curve to determine the stiffness/deflection rate of the clip. The results of plastic deformation showed no significant difference among bracket types before and after the 500 cycles of opening and closure (p = 0.811). There were significant differences on stiffness among the three types of brackets (p = 0.005). The WOW bracket had higher mean values, whereas Quicklear bracket had lower values, regardless of the opening/closure cycle. Repetitive controlled opening and closure movements of the clip did not alter stiffness or cause plastic deformation.

  14. Effects of Tail Clipping on Larval Performance and Tail Regeneration Rates in the Near Eastern Fire Salamander, Salamandra infraimmaculata.

    Directory of Open Access Journals (Sweden)

    Ori Segev

    Full Text Available Tail-tip clipping is a common technique for collecting tissue samples from amphibian larvae and adults. Surprisingly, studies of this invasive sampling procedure or of natural tail clipping--i.e., bites inflicted by predators including conspecifics--on the performance and fitness of aquatic larval stages of urodeles are scarce. We conducted two studies in which we assessed the effects of posterior tail clipping (~30 percent of tail on Near Eastern fire salamander (Salamandra infraimmaculata larvae. In a laboratory study, we checked regeneration rates of posterior tail-tip clipping at different ages. Regeneration rates were hump-shaped, peaking at the age of ~30 days and then decreasing. This variation in tail regeneration rates suggests tradeoffs in resource allocation between regeneration and somatic growth during early and advanced development. In an outdoor artificial pond experiment, under constant larval densities, we assessed how tail clipping of newborn larvae affects survival to, time to, and size at metamorphosis. Repeated measures ANOVA on mean larval survival per pond revealed no effect of tail clipping. Tail clipping had correspondingly no effect on larval growth and development expressed in size (mass and snout-vent length at, and time to, metamorphosis. We conclude that despite the given variation in tail regeneration rates throughout larval ontogeny, clipping of 30% percent of the posterior tail area seems to have no adverse effects on larval fitness and survival. We suggest that future use of this imperative tool for the study of amphibian should take into account larval developmental stage during the time of application and not just the relative size of the clipped tail sample.

  15. Hypertension, a health economics perspective.

    Science.gov (United States)

    Alcocer, Luis; Cueto, Liliana

    2008-06-01

    The economic aspects of hypertension are critical to modern medicine. The medical, economic, and human costs of untreated and inadequately controlled hypertension are enormous. Hypertension is distributed unequally and with iniquity in different countries and regions of the world. Treatment of hypertension requires an investment over many years to prolong disease-free quality years of life. The high prevalence and high cost of the disease impacts on the microeconomics and macroeconomics of countries and regions. The criteria used for inclusion in clinical guidelines for hypertension impact on the cost and cost/utility of diagnosis or treatment.

  16. Pulmonary Hypertension and Pulmonary Vasodilators.

    Science.gov (United States)

    Keller, Roberta L

    2016-03-01

    Pulmonary hypertension in the perinatal period can present acutely (persistent pulmonary hypertension of the newborn) or chronically. Clinical and echocardiographic diagnosis of acute pulmonary hypertension is well accepted but there are no broadly validated criteria for echocardiographic diagnosis of pulmonary hypertension later in the clinical course, although there are significant populations of infants with lung disease at risk for this diagnosis. Contributing cardiovascular comorbidities are common in infants with pulmonary hypertension and lung disease. It is not clear who should be treated without confirmation of pulmonary vascular disease by cardiac catheterization, with concurrent evaluation of any contributing cardiovascular comorbidities. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Use of a surgical rehearsal platform and improvement in aneurysm clipping measures: results of a prospective, randomized trial.

    Science.gov (United States)

    Chugh, A Jessey; Pace, Jonathan R; Singer, Justin; Tatsuoka, Curtis; Hoffer, Alan; Selman, Warren R; Bambakidis, Nicholas C

    2017-03-01

    OBJECTIVE The field of neurosurgery is constantly undergoing improvements and advances, both in technique and technology. Cerebrovascular neurosurgery is no exception, with endovascular treatments changing the treatment paradigm. Clipping of aneurysms is still necessary, however, and advances are still being made to improve patient outcomes within the microsurgical treatment of aneurysms. Surgical rehearsal platforms are surgical simulators that offer the opportunity to rehearse a procedure prior to entering the operative suite. This study is designed to determine whether use of a surgical rehearsal platform in aneurysm surgery is helpful in decreasing aneurysm dissection time and clip manipulation of the aneurysm. METHODS The authors conducted a blinded, prospective, randomized study comparing key effort and time variables in aneurysm clip ligation surgery with and without preoperative use of the SuRgical Planner (SRP) surgical rehearsal platform. Initially, 40 patients were randomly assigned to either of two groups: one in which surgery was performed after use of the SRP (SRP group) and one in which surgery was performed without use of the SRP (control group). All operations were videotaped. After exclusion of 6 patients from the SRP group and 9 from the control group, a total of 25 surgical cases were analyzed by a reviewer blinded to group assignment. The videos were analyzed for total microsurgical time, number of clips used, and number of clip placement attempts. Means and standard deviations (SDs) were calculated and compared between groups. RESULTS The mean (± SD) amount of operative time per clip used was 920 ± 770 seconds in the SRP group and 1294 ± 678 seconds in the control group (p = 0.05). In addition, the mean values for the number of clip attempts, total operative time, ratio of clip attempts to clips used, and time per clip attempt were all lower in the SRP group, although the between-group differences were not statistically significant

  18. Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling

    Science.gov (United States)

    Shen, Guangping; Zhang, Songning; Bennett, Hunter J.; Martin, James C.; Crouter, Scott E.; Fitzhugh, Eugene C.

    2018-01-01

    Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling. Key points Varus or valgus alignment did not cause increased frontal-plane knee joint loading, suggesting stationary cycling is a safe exercise. This study supports that using a toe clip did not lead to abnormal frontal-plane knee loading during stationary cycling. Two different knee frontal plane loading patterns, knee abduction and adduction moment, were observed during stationary cycling, which are likely affected by

  19. Aneurysmal subarachnoid hemorrhage: outcome of aneurysm clipping versus coiling in anterior circulation aneurysm

    International Nuclear Information System (INIS)

    Wadd, I.H.; Haroon, A.; Ansari, S.

    2015-01-01

    To compare the neurological outcome of microsurgical clipping versus coiling in patients with anterior circulation aneurysm. Study Design: Comparative study. Place and Duration of Study: Department of Neurosurgery, Lahore General Hospital, Lahore, from January 2010 to December 2013. Methodology: Patients aged 14 - 60 years, with ruptured cerebral aneurysm of anterior circulation and World Federation of Neurosurgical Society (WFNS) grades 1, 2 and 3 were included. Patients more than 60 years, medically unfit patient and posterior circulation aneurysms and WFNS grades 4 and 5 were excluded. Aneurysm sac obliteration was done in randomized manner with microsurgical clipping or coiling. Postoperatively, the patients were assessed and followed-up upto one year for outcome parameters on the bases of WFNS grade and Modified Ranking Scale (mRS) as favourable (mRS =2 ) and unfavourable (mRS > 2). Results: Among 140 subjects selected for study, 70 were included in group A, i.e. coiling and other 70 were in group B, i.e. clipping. The median age of patients in group A was 52.5 ± 10 years and in group B was 51.00 ± years. Overall, 56 (40%) males, 28 (60%) males in each group; and 84 (60%) females, 42 (60%) in each group were included. The male to female ratio in this study was 1:1.5. In group A, i.e. coiling, 27 (38.6%) patients had no disability (grades 1 and 2), 25 (35.7%) were slightly disabled (grade 3) and 18 (25.7%) had moderate disability (grade 4); whereas in group B, i.e. clipping group 23 (32.9%) patients had no disability (grades 1 and 2), 23 (32.9%) were slightly disabled (grade 3) and 24 (34.3%) had moderate disability (grade 4). At one year follow-up, in group A, favourable outcome was achieved in 56 (80%) of patients compared to 48 (68.6%) in group B; whilst, 14 (20%) patients in group A and 22 (33.1%) in group B showed unfavourable outcome. Although mortality rate was higher in clipping (n=3, 4.3%) as compared to coiling (n=1, 1.4%), but was not statistically

  20. CLIPS 6.0 - C LANGUAGE INTEGRATED PRODUCTION SYSTEM, VERSION 6.0 (DEC VAX VMS VERSION)

    Science.gov (United States)

    Donnell, B.

    1994-01-01

    CLIPS, the C Language Integrated Production System, is a complete environment for developing expert systems -- programs which are specifically intended to model human expertise or knowledge. It is designed to allow artificial intelligence research, development, and delivery on conventional computers. CLIPS 6.0 provides a cohesive tool for handling a wide variety of knowledge with support for three different programming paradigms: rule-based, object-oriented, and procedural. Rule-based programming allows knowledge to be represented as heuristics, or "rules-of-thumb" which specify a set of actions to be performed for a given situation. Object-oriented programming allows complex systems to be modeled as modular components (which can be easily reused to model other systems or create new components). The procedural programming capabilities provided by CLIPS 6.0 allow CLIPS to represent knowledge in ways similar to those allowed in languages such as C, Pascal, Ada, and LISP. Using CLIPS 6.0, one can develop expert system software using only rule-based programming, only object-oriented programming, only procedural programming, or combinations of the three. CLIPS provides extensive features to support the rule-based programming paradigm including seven conflict resolution strategies, dynamic rule priorities, and truth maintenance. CLIPS 6.0 supports more complex nesting of conditional elements in the if portion of a rule ("and", "or", and "not" conditional elements can be placed within a "not" conditional element). In addition, there is no longer a limitation on the number of multifield slots that a deftemplate can contain. The CLIPS Object-Oriented Language (COOL) provides object-oriented programming capabilities. Features supported by COOL include classes with multiple inheritance, abstraction, encapsulation, polymorphism, dynamic binding, and message passing with message-handlers. CLIPS 6.0 supports tight integration of the rule-based programming features of CLIPS with

  1. [Hypertension in polycystic ovary syndrome].

    Science.gov (United States)

    Ben Salem Hachmi, L; Ben Salem Hachmi, S; Bouzid, C; Younsi, N; Smida, H; Bouguerra, R; Ben Slama, C

    2006-01-01

    Polycystic ovary syndrome (PCOS) is associated with multiple cardiovascular risk factors. The aims of this study are to investigate the prevalence of hypertension in a female population with PCOS and to correlate hypertension with her clinical and hormonal profile. it is a transversal study of 79 PCOS patients with mean age of 25 +/- 7 years (range 13-44). PCOS diagnosis is made by Rotterdam consensus criteria's (2003). WHO definition of hypertension is used (BP 140/90 mmHg). Blood pressure is measured three times in each patient. Ovarian echography and biochemical assays (GnRH test, androgens, cholesterol, triglycerides, and oral glucose tolerance test) are made before the 5th day of the menstrual cycle. 12% of PCOS women have hypertension. Family history of hypertension is not a predictive factor of hypertension in our study. PCOS patients with hypertension are not significantly older than those without hypertension (28.4 +/- 6.5 vs. 25.2 +/- 7; p = 0.12). If compared to PCOS women without hypertension, those with hypertension have a significantly higher BMI (39.2 +/- 7 vs. 29.6; p = 0.0004). PCOS patients with and without hypertension do not differ significantly in their level of androgens and total cholesterol. Triglycerides level is higher in PCOS patients with hypertension (p = 0.06). In oral glucose tolerance test, areas under the curve of insulin and glucose are significantly higher in PCOS patients with hypertension (respectively p = 0.06 and 0.02). The area under the curve of LH during GnRH test is lower in PCOS patients with hypertension (p = 0.04).

  2. Postoperative three-dimensional CT angiography after cerebral aneurysm clipping with titanium clips: detection with single detector CT. Comparison with intra-arterial digital subtraction angiography

    International Nuclear Information System (INIS)

    Sakuma, I.; Tomura, N.; Kinouchi, H.; Takahashi, S.; Otani, T.; Watarai, J.; Mizoi, K.

    2006-01-01

    AIM: To assess the significance of three-dimensional computed tomography angiography (3D-CTA) in detecting remnant necks after cerebral aneurysm clipping. MATERIALS AND METHODS: A total of 59 patients (77 aneurysms) underwent surgery using titanium clips. Two blinded observers independently evaluated the presence of neck remnants on shaded-surface display (SSD) imaging, volume rendered (VR) imaging, and intra-arterial digital subtraction angiography (IADSA). RESULTS: Mean sensitivity and specificity for detecting neck remnants were 50.0 and 74.2% for SSD imaging, 61.5 and 82.8% for VR imaging, and 92.3 and 92.2% for IADSA, respectively. Receiver operating characteristic (ROC) analysis revealed excellent diagnostic performance for IADSA [mean area under ROC curve (Az)=0.97], and good diagnostic performance for 3D-CTA (Az=0.70 and 0.76 for SSD and VR, respectively). Specificity of VR was better than that SSD (p=0.082), however, there was no significant difference between them. CONCLUSION: Use of 3D-CTA techniques can facilitate postoperative evaluation

  3. The evolving definition of systemic arterial hypertension.

    Science.gov (United States)

    Ram, C Venkata S; Giles, Thomas D

    2010-05-01

    Systemic hypertension is an important risk factor for premature cardiovascular disease. Hypertension also contributes to excessive morbidity and mortality. Whereas excellent therapeutic options are available to treat hypertension, there is an unsettled issue about the very definition of hypertension. At what level of blood pressure should we treat hypertension? Does the definition of hypertension change in the presence of co-morbid conditions? This article covers in detail the evolving concepts in the diagnosis and management of hypertension.

  4. Integrating knowledge and control into hypermedia-based training environments: Experiments with HyperCLIPS

    Science.gov (United States)

    Hill, Randall W., Jr.

    1990-01-01

    The issues of knowledge representation and control in hypermedia-based training environments are discussed. The main objective is to integrate the flexible presentation capability of hypermedia with a knowledge-based approach to lesson discourse management. The instructional goals and their associated concepts are represented in a knowledge representation structure called a 'concept network'. Its functional usages are many: it is used to control the navigation through a presentation space, generate tests for student evaluation, and model the student. This architecture was implemented in HyperCLIPS, a hybrid system that creates a bridge between HyperCard, a popular hypertext-like system used for building user interfaces to data bases and other applications, and CLIPS, a highly portable government-owned expert system shell.

  5. Microanalysis on selected video clips with focus on communicative response in music therapy

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner

    2007-01-01

    This chapter describes a five-step procedure for video analysis where the topic of investigation is the communicative response of clients in music therapy. In this microanalysis procedure only very short video clips are used, and in order to select these clips an overview of each music therapy...... session is obtained with the help of a session-graph that is a systematic way of collecting video observations from one music therapy session and combining the data in one figure. The systematic procedures do not demand sophisticated computer equipment; only standard programmes such as Excel and a media...... player. They are based on individual music therapy work with a population who are difficult to engage in joint activities and who show little response (e.g. persons suffering from severe dementia). The video analysis tools might be relevant to other groups of clients where it is important to form a clear...

  6. A combination of selected mapping and clipping to increase energy efficiency of OFDM systems

    Science.gov (United States)

    Lee, Byung Moo; Rim, You Seung

    2017-01-01

    We propose an energy efficient combination design for OFDM systems based on selected mapping (SLM) and clipping peak-to-average power ratio (PAPR) reduction techniques, and show the related energy efficiency (EE) performance analysis. The combination of two different PAPR reduction techniques can provide a significant benefit in increasing EE, because it can take advantages of both techniques. For the combination, we choose the clipping and SLM techniques, since the former technique is quite simple and effective, and the latter technique does not cause any signal distortion. We provide the structure and the systematic operating method, and show the various analyzes to derive the EE gain based on the combined technique. Our analysis show that the combined technique increases the EE by 69% compared to no PAPR reduction, and by 19.34% compared to only using SLM technique. PMID:29023591

  7. Three-port laparoscopic cholecystectomy by harmonic dissection without cystic duct and artery clipping.

    Science.gov (United States)

    Tebala, Giovanni D

    2006-05-01

    The technique of laparoscopic cholecystectomy (LC) still has areas of refinements. To decrease the number of ports, a cannula may be replaced by a percutaneous suture suspension of the gallbladder. The risk of tissue injury caused by repeat blind extraction and insertion of various instruments in and out of the abdomen may be decreased by the use of the multipurpose harmonic dissector. One hundred consecutive patients with symptomatic cholelithiasis underwent 3-port LC entirely performed by harmonic dissector without cystic duct and artery clipping. In 8 cases, a fourth trocar was necessary. In 2 cases, the cystic duct was clipped after an unsafe ultrasound sealing. In 1 case, continuous bleeding from the liver required the use of diathermy. No common bile duct injury was registered. The 3-port harmonic LC is a feasible, effective, and safe technique.

  8. Use of activation analysis method for determining trace elements in human nail clippings

    International Nuclear Information System (INIS)

    Aguiar, Amilton Reinaldo; Saiki, Mitiko

    1999-01-01

    This work presents results obtained in nail clipping samples analyses. These nail samples were collected from healthy group of individuals and from patients with cystic fibrosis disease. Irradiation of nail clippings was carried out with a thermal neutron flux from 10 11 to 10 13 n.cm -2 .s -1 at the IEA-R1m nuclear research reactor and the elements Al, As, Br, Ca, cd, Cl, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Se and Zn were determined. The results obtained for healthy group were within the range of concentrations published, for normal population. However for several elements, the group of patients presented higher concentrations than those presented for healthy individuals. The precision and the accuracy of the results were evaluated by analyzing reference materials NIST 1577b Bovine Liver and 1566a Oyster Tissue. (author)

  9. Cryoablation of lung malignancies recurring close to surgical clips following surgery: Report of three cases

    International Nuclear Information System (INIS)

    Grasso, Rosario F; Luppi, Giacomo; Cazzato, Roberto L; Vescovo, Riccardo Del; Giurazza, Francesco; Mercurio, Simona; Faiella, Eliodoro; Zobel, Bruno Beomonte

    2015-01-01

    Minimally ablative therapies are now available for the treatment of lung malignancies. However, selection of the appropriate technique is not always easy and requires accurate preoperative planning. To describe the treatment of lung tumors with cryoablation. We report three cases of lung malignancies that recurred close to surgical clips after surgical treatment, successfully treated by cryoablation. An initial freezing cycle was performed for 10 min, followed by a 5-min thawing cycle, and an additional 10-min freezing cycle. A final 5-min thaw was necessary to remove the needle from the iceball formed during the freezing cycle. The procedures were completed successfully with no signs of surgical-clip misplacement, and excellent ablation of the lesions. Cryoablation is a relatively new procedure that potentially permits the local treatment of lung tumors with minimal loss of lung parenchyma

  10. Results from extrapleural clipping of a patent ductus arteriosus in seriously ill preterm infants.

    Science.gov (United States)

    Demirturk, Orhan; Güvener, Murat; Coşkun, Isa; Tünel, Hüseyin Ali

    2011-12-01

    Minithoracotomy for extrapleural closure of the patent ductus arteriosus (PDA) in seriously ill patients offers a fast and less invasive alternative to conventional transpleural ductal closure. This study reports the immediate postoperative clinical outcomes for 24 extrapleurally clipped premature infants presenting with congestive heart failure in high-risk comorbidity status between March 2007 and November 2010. The demographics, preoperative clinical characteristics, and postoperative outcomes of the patients, including echocardiographic assessments, were evaluated. No surgery-related mortalities occurred. Four mortalities occurred after surgery due to sepsis and bleeding diathesis. All 20 surviving patients exhibited normal left ventricular dimensions and systolic function in the immediate follow-up period. The study shows that extrapleural clip closure in seriously ill premature infants has an acceptable overall short-term mortality and complication rate with a high rate of ductal closure.

  11. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    International Nuclear Information System (INIS)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan

    2017-01-01

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip_p, ≤2 cm) and 3 distal clips (clip_d, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy

  12. The role of surgical clips in the evaluation of interfractional uncertainty for treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Bae, Jin Suk; Kim, Dong Hyun; Kim, Won Taek; Kim, Yong Ho; Park, Dahl; Ki, Yong Kan [Pusan National University Hospital, Pusan National University School of Medicine, Busan (Korea, Republic of)

    2017-03-15

    To evaluate the utility of implanted surgical clips for detecting interfractional errors in the treatment of hepatobiliary and pancreatic cancer with postoperative radiotherapy (PORT). Twenty patients had been treated with PORT for locally advanced hepatobiliary or pancreatic cancer, from November 2014 to April 2016. Patients underwent computed tomography simulation and were treated in expiratory breathing phase. During treatment, orthogonal kilovoltage (kV) imaging was taken twice a week, and isocenter shifts were made to match bony anatomy. The difference in position of clips between kV images and digitally reconstructed radiographs was determined. Clips were consist of 3 proximal clips (clip{sub p}, ≤2 cm) and 3 distal clips (clip{sub d}, >2 cm), which were classified according to distance from treatment center. The interfractional displacements of clips were measured in the superior-inferior (SI), anterior-posterior (AP), and right-left (RL) directions. The translocation of clip was well correlated with diaphragm movement in 90.4% (190/210) of all images. The clip position errors greater than 5 mm were observed in 26.0% in SI, 1.8% in AP, and 5.4% in RL directions, respectively. Moreover, the clip position errors greater than 10 mm were observed in 1.9% in SI, 0.2% in AP, and 0.2% in RL directions, despite respiratory control. Quantitative analysis of surgical clip displacement reflect respiratory motion, setup errors and postoperative change of intraabdominal organ position. Furthermore, position of clips is distinguished easily in verification images. The identification of the surgical clip position may lead to a significant improvement in the accuracy of upper abdominal radiation therapy.

  13. Hepatic angiography: Portal hypertension

    International Nuclear Information System (INIS)

    Oliver, T.W. Jr.; Sones, P.J. Jr.

    1985-01-01

    Portal hypertension is usually a manifestation of underlying hepatic parenchymal disease, although it may be secondary to portal or hepatic venous thrombosis and rarely to hyperdynamic portal states. Portal hypertension may present as encephalopathy, ascites, jaundice, hepatic failure, or catastrophic upper gastrointestinal hemorrhage. Radiologic investigation should include indirect or direct measurements of portal pressure, assessment of portal venous perfusion, visualization of collaterals, and demonstration of arterial and venous anatomy for potential shunt procedure. Following survival of initial variceal bleeding, the most effective procedure to prevent recurrent hemorrhage is a shunt to decompress the varices. The decision whether to intervene medically or surgically during the acute hemorrhagic episode as well as the type of shunt used to prevent future hemorrhage is the subject of continuing controversy

  14. [Exercise in arterial hypertension].

    Science.gov (United States)

    Predel, Hans-Georg; Schramm, Thomas

    2006-09-01

    Regular endurance training has established itself as a major therapeutic principle in the specter of nonpharmacological measures in arterial hypertension. An initial medical check as well as an adequate technique, dosage and intensity of the prescribed exercise training are mandatory. With respect to the concomitant pharmacological treatment, it should be considered that the beneficial effects of lifestyle modification will not be counteracted by the chosen antihypertensive drug but, ideally, synergistically supported. Based on the individual clinical situation, principally all antihypertensive drugs recommended by the current European guidelines, may be prescribed as mono- or combination therapy.beta-receptor blockers are especially capable of controlling excessive exercise-induced blood pressure increase; however, they have metabolic and exercise physiological limitations. The neutrality concerning metabolic and exercise physiological parameters as well as the positive profile of side effects favor ACE inhibitors, long-acting calcium channel blockers and especially AT(1) antagonists in physically active hypertensive patients with concomitant metabolic syndrome.

  15. [Chronic hypertension and pregnancy].

    Science.gov (United States)

    Lecarpentier, Edouard; Tsatsaris, Vassili

    2012-09-01

    Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal mortality and morbidity. The management of patients with chronic hypertension requires a multidisciplinary approach prior to conception, during pregnancy and post-partum. In the preconception period, fetotoxic agents should be discontinued. It is also essential to undertake a full cardiovascular examination which may, in some cases, question the possibility of pregnancy. During pregnancy, blood pressure should be monitored and controlled, but not necessarily returned to a normal value. Low blood pressure levels could indeed lead to placental hypoperfusion and fetal growth restriction. Close clinical, biological and ultrasound monitoring is recommended, even postpartum, since those patients are at higher risk for preeclampsia.

  16. Virtual Reality Cerebral Aneurysm Clipping Simulation With Real-time Haptic Feedback

    Science.gov (United States)

    Alaraj, Ali; Luciano, Cristian J.; Bailey, Daniel P.; Elsenousi, Abdussalam; Roitberg, Ben Z.; Bernardo, Antonio; Banerjee, P. Pat; Charbel, Fady T.

    2014-01-01

    Background With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. Objective To develop and evaluate the usefulness of a new haptic-based virtual reality (VR) simulator in the training of neurosurgical residents. Methods A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the Immersive Touch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomography angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-D immersive VR environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from three residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery. Results Residents felt that the simulation would be useful in preparing for real-life surgery. About two thirds of the residents felt that the 3-D immersive anatomical details provided a very close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They believed the simulation is useful for preoperative surgical rehearsal and neurosurgical training. One third of the residents felt that the technology in its current form provided very realistic haptic feedback for aneurysm surgery. Conclusion Neurosurgical residents felt that the novel immersive VR simulator is helpful in their training especially since they do not get a chance to perform aneurysm clippings until very late in their residency programs. PMID:25599200

  17. Resolution of Oculomotor Nerve Palsy Secondary to Posterior Communicating Artery Aneurysms: Comparison of Clipping and Coiling.

    Science.gov (United States)

    McCracken, D Jay; Lovasik, Brendan P; McCracken, Courtney E; Caplan, Justin M; Turan, Nefize; Nogueira, Raul G; Cawley, C Michael; Dion, Jacques E; Tamargo, Rafael J; Barrow, Daniel L; Pradilla, Gustavo

    2015-12-01

    Previous studies have attempted to determine the best treatment for oculomotor nerve palsy (ONP) secondary to posterior communicating artery (PCoA) aneurysms, but have been limited by small sample sizes and limited treatment. To analyze the treatment of ONP secondary to PCoA with both coiling and clipping in ruptured and unruptured aneurysms. Data from 2 large academic centers was retrospectively collected over 22 years, yielding a total of 93 patients with ONP secondary to PCoA aneurysms. These patients were combined with 321 patients from the literature review for large data analyses. Onset symptoms, recovery, and time to resolution were evaluated with respect to treatment and aneurysm rupture status. For all patients presenting with ONP (n = 414) 56.6% of those treated with microsurgical clipping made a full recovery vs 41.5% of those treated with endovascular coil embolization (P = .02). Of patients with a complete ONP (n = 229), full recovery occurred in 47.3% of those treated with clipping but in only 20% of those undergoing coiling (P = .01). For patients presenting with ruptured aneurysms (n = 130), full recovery occurred in 70.9% compared with 49.3% coiled patients (P = .01). Additionally, although patients with full ONP recovery had a median time to treatment of 4 days, those without full ONP recovery had a median time to treatment of 7 days (P = .01). Patients with ONP secondary to PCoA aneurysms treated with clipping showed higher rates of full ONP resolution than patients treated with coil embolization. Larger prospective studies are needed to determine the true potential of recovery associated with each treatment. EUH, Emory University HospitalIQR, interquartile rangeJHU, Johns Hopkins UniversitymRS, modified Rankin ScaleONP, oculomotor nerve palsyPCoA, posterior communicating arterySAH, subarachnoid hemorrhage.

  18. The contribution of CLIP2 haploinsufficiency to the clinical manifestations of the Williams-Beuren syndrome.

    Science.gov (United States)

    Vandeweyer, Geert; Van der Aa, Nathalie; Reyniers, Edwin; Kooy, R Frank

    2012-06-08

    Williams-Beuren syndrome is a rare contiguous gene syndrome, characterized by intellectual disability, facial dysmorphisms, connective-tissue abnormalities, cardiac defects, structural brain abnormalities, and transient infantile hypercalcemia. Genes lying telomeric to RFC2, including CLIP2, GTF2I and GTF2IRD1, are currently thought to be the most likely major contributors to the typical Williams syndrome cognitive profile, characterized by a better-than-expected auditory rote-memory ability, a relative sparing of language capabilities, and a severe visual-spatial constructive impairment. Atypical deletions in the region have helped to establish genotype-phenotype correlations. So far, however, hardly any deletions affecting only a single gene in the disease region have been described. We present here two healthy siblings with a pure, hemizygous deletion of CLIP2. A putative role in the cognitive and behavioral abnormalities seen in Williams-Beuren patients has been suggested for this gene on the basis of observations in a knock-out mouse model. The presented siblings did not show any of the clinical features associated with the syndrome. Cognitive testing showed an average IQ for both and no indication of the Williams syndrome cognitive profile. This shows that CLIP2 haploinsufficiency by itself does not lead to the physical or cognitive characteristics of the Williams-Beuren syndrome, nor does it lead to the Williams syndrome cognitive profile. Although contribution of CLIP2 to the phenotype cannot be excluded when it is deleted in combination with other genes, our results support the hypothesis that GTF2IRD1 and GTF2I are the main genes causing the cognitive defects associated with Williams-Beuren syndrome. Copyright © 2012 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  19. Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Tabani, Halima; Safaee, Michael M; Burkhardt, Jan-Karl; Lawton, Michael T

    2018-01-26

    OBJECTIVE While most paraclinoid aneurysms can be clipped with excellent results, new postoperative visual deficits are a concern. New technology, including flow diverters, has increased the popularity of endovascular therapy. However, endovascular treatment of paraclinoid aneurysms is not without procedural risks, is associated with higher rates of incomplete aneurysm occlusion and recurrence, and may not address optic nerve compression symptoms that surgical debulking can. The increasing endovascular management of paraclinoid aneurysms should be justified by comparisons to surgical benchmarks. The authors, therefore, undertook this study to define patient, visual, and aneurysm outcomes in the most common type of paraclinoid aneurysm: ophthalmic artery (OphA) aneurysms. METHODS Results from microsurgical clipping of 208 OphA aneurysms in 198 patients were retrospectively reviewed. Patient demographics, aneurysm morphology (size, calcification, etc.), clinical characteristics, and patient outcomes were recorded and analyzed. RESULTS Despite 20% of these aneurysms being large or giant in size, complete aneurysm occlusion was accomplished in 91% of 208 cases, with OphA patency preserved in 99.5%. The aneurysm recurrence rate was 3.1% and the retreatment rate was 0%. Good outcomes (modified Rankin Scale score 0-2) were observed in 96.2% of patients overall and in all 156 patients with unruptured aneurysms. New visual field defects (hemianopsia or quadrantanopsia) were observed in 8 patients (3.8%), decreased visual acuity in 5 (2.4%), and monocular blindness in 9 (4.3%). Vision improved in 9 (52.9%) of the 17 patients with preoperative visual deficits. CONCLUSIONS The most important risk associated with clipping OphA aneurysms is a new visual deficit. Meticulous microsurgical technique is necessary during anterior clinoidectomy, aneurysm dissection, and clip application to optimize visual outcomes, and aggressive medical management postoperatively might potentially

  20. Adrenal Mass Causing Secondary Hypertension.

    Science.gov (United States)

    Robinson, Darlene Y

    2015-11-01

    Most hypertensive patients have essential (primary) hypertension; only 5% to 10% have a secondary cause. Two clinical characteristics suggestive of secondary hypertension are early onset (hypertension (>180/110 mm Hg). When faced with these findings, clinicians should consider a secondary cause of hypertension. A 22-year-old woman being evaluated for asthma exacerbation in the emergency department was noted to have severe persistent hypertension. Additional evaluation revealed severe hypokalemia, metabolic alkalosis, and hypernatremia. The patient was admitted to the hospital for blood pressure management, electrolyte replacement, and further evaluation of presumed hyperaldosteronism. Diagnostic imaging revealed a large adrenal mass. Surgical resection was performed, leading to a diagnosis of hyperaldosteronism caused by adrenal carcinoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Secondary hypertension is far less common than essential hypertension; however, considering the large volume of patients seen in emergency departments, it is likely that some will have secondary hypertension. Emergency physicians should be aware of the clinical characteristics that suggest secondary hypertension so that the appropriate diagnostic and treatment pathways can be pursued. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina

    2015-01-01

    Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.

  2. Epidemiology of hypertensive kidney disease.

    Science.gov (United States)

    Udani, Suneel; Lazich, Ivana; Bakris, George L

    2011-01-01

    The prevalence of hypertension, chronic kidney disease (CKD) and end-stage renal disease (ESRD) attributable to hypertension continues to rise worldwide. Identifying the precise prevalence of CKD attributable to hypertension is difficult owing to the absence of uniform criteria to establish a diagnosis of hypertensive nephropathy. Despite the increasing prevalence of CKD-associated hypertension, awareness of hypertension among individuals with CKD remains suboptimal and rates of blood-pressure control remain poor. Targeted subgroups involved in studies of CKD seem to reach better rates of blood-pressure control, suggesting that this therapeutic goal can be achieved in patients with CKD. Elevated blood-pressure levels are associated with CKD progression. However, the optimal blood-pressure level and pharmacological agent remains unclear. Physicians treating patients with CKD must recognize the importance of maintaining optimal salt and volume balance to achieve blood-pressure goals. Furthermore, agents that modify the renin-angiotensin-aldosterone axis can be an important adjunct to therapy and physicians must monitor expected changes in serum creatinine and electrolyte levels after their administration. Hypertension remains a common factor complicating CKD. Future investigations identifying early signs of hypertension-related CKD, increasing awareness of the effects of hypertension in CKD and determining optimal therapeutic interventions might help reduce the incidence of hypertensive nephropathy.

  3. Angiography in portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Zeitler, E

    1982-04-05

    We report on the cooperative possibilities the radiologist has as to diagnosis and therapy of portal hypertension. The catheter angiography allows to make a differentiation between pre- and intrahepatic bloc and the localization of bleeding esophagus varices. Only after all endoscopic measures with sclerotherapy and Laser coagulation have failed, catheter angiography will be carried out as a therapeutic measure. The future development, however, will give the opportunity to a series of therapeutic attempts on the field of interventional radiology.

  4. Renal denervation and hypertension.

    Science.gov (United States)

    Schlaich, Markus P; Krum, Henry; Sobotka, Paul A; Esler, Murray D

    2011-06-01

    Essential hypertension remains one of the biggest challenges in medicine with an enormous impact on both individual and society levels. With the exception of relatively rare monogenetic forms of hypertension, there is now general agreement that the condition is multifactorial in nature and hence requires therapeutic approaches targeting several aspects of the underlying pathophysiology. Accordingly, all major guidelines promote a combination of lifestyle interventions and combination pharmacotherapy to reach target blood pressure (BP) levels in order to reduce overall cardiovascular risk in affected patients. Although this approach works for many, it fails in a considerable number of patients for various reasons including drug-intolerance, noncompliance, physician inertia, and others, leaving them at unacceptably high cardiovascular risk. The quest for additional therapeutic approaches to safely and effectively manage hypertension continues and expands to the reappraisal of older concepts such as renal denervation. Based on the robust preclinical and clinical data surrounding the role of renal sympathetic nerves in various aspects of BP control very recent efforts have led to the development of a novel catheter-based approach using radiofrequency (RF) energy to selectively target and disrupt the renal nerves. The available evidence from the limited number of uncontrolled hypertensive patients in whom renal denervation has been performed are auspicious and indicate that the procedure has a favorable safety profile and is associated with a substantial and presumably sustained BP reduction. Although promising, a myriad of questions are far from being conclusively answered and require our concerted research efforts to explore the full potential and possible risks of this approach. Here we briefly review the science surrounding renal denervation, summarize the current data on safety and efficacy of renal nerve ablation, and discuss some of the open questions that need

  5. Angiography in portal hypertension

    International Nuclear Information System (INIS)

    Zeitler, E.

    1982-01-01

    We report on the cooperative possibilities the radiologist has as to diagnosis and therapy of portal hypertension. The catheter angiography allows to make a differentiation between pre- and intrahepatic bloc and the localization of bleeding esophagus varices. Only after all endoscopic measures with sclerotherapy and Laser coagulation have failed, catheter angiography will be carried out as a therapeutic measure. The future development, however, will give the opportunity to a series of therapeutic attempts on the field of interventional radiology. (orig.) [de

  6. Managing hypertension by polyphenols.

    Science.gov (United States)

    Fernández-Arroyo, Salvador; Camps, Jordi; Menendez, Javier A; Joven, Jorge

    2015-06-01

    Some polyphenols, obtained from plants of broad use, induce a favorable endothelial response in hypertension and beneficial effects in the management of other metabolic cardiovascular risks. Previous studies in our laboratories using the calyces of Hibiscus sabdariffa as a source of polyphenols show that significant effects on hypertension are noticeable in humans only when provided in high amounts. Available data are suggestive in animal models and ex vivo experiments, but data in humans are difficult to acquire. Additionally, and despite the low bioavailability of polyphenols, intervention studies provide evidence for the protective effects of secondary plant metabolites. Assumptions on public health benefits are limited by the lack of scientific knowledge, robust data derived from large randomized clinical trials, and an accurate assessment of the bioactive components provided by common foodstuff. Because it is likely that clinical effects are the result of multiple interactions among different polyphenols rather than the isolated action of unique compounds, to provide polyphenol-rich botanical extracts as dietary supplements is a suggestive option. Unfortunately, the lack of patent perspectives for the pharmaceutical industries and the high cost of production and release for alimentary industries will hamper the performance of the necessary clinical trials. Here we briefly discuss whether and how such limitations may complicate the extensive use of plant-derived products in the management of hypertension and which steps are the necessary to deal with the predictable complexity in a possible clinical practice. Georg Thieme Verlag KG Stuttgart · New York.

  7. [Resistant hypertension: An update].

    Science.gov (United States)

    Renna, N F

    2018-02-04

    An estimated 10% to 20% of hypertensive patients could be considered resistant to treatment (RH). These are patients who are not controlled using three drugs, at the maximum tolerated doses, including a diuretic, as well as those with high blood pressure controlled using four or more drugs. The term is used to identify patients that might benefit from special diagnostic and/or therapeutic consideration. The term 'refractory hypertension' has recently been proposed as a novel phenotype of antihypertensive failure. It refers to patients whose blood pressure cannot be controlled with maximum treatment. The first studies of this phenotype indicate that it is rare and affects less than 5% of patients with RH. Adherence to or compliance with medical treatment is key to defining resistant hypertension. Closer attention has been paid to clinical and experimental research since the first scientific statement for the diagnosis, assessment and treatment of RH from the American Heart Association, and in the European guidelines, was published in 2008. This review will set out the concepts relating to prevalence, prognosis and compliance and cover the latest developments on this subject. Copyright © 2018 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Predicting Factors of Chronic Subdural Hematoma Following Surgical Clipping in Unruptured and Ruptured Intracranial Aneurysm.

    Science.gov (United States)

    Kwon, Min-Yong; Kim, Chang-Hyun; Lee, Chang-Young

    2016-09-01

    The aim of this study is to analyze the differences in the incidence, predicting factors, and clinical course of chronic subdural hematoma (CSDH) following surgical clipping between unruptured (UIA) and ruptured intracranial aneurysm (RIA). We conducted a retrospective analysis of 752 patients (UIA : 368 and RIA : 384) who underwent surgical clipping during 8 years. The incidence and predicting factors of CSDH development in the UIA and RIA were compared according to medical records and radiological data. The incidence of postoperative CSDH was higher in the UIA (10.9%) than in the RIA (3.1%) (p=0.000). In multivariate analysis, a high Hounsfield (HF) unit (blood clots) for subdural fluid collection (SFC), persistence of SFC ≥5 mm and male sex in the UIA and A high HF unit for SFC and SFC ≥5 mm without progression to hydrocephalus in the RIA were identified as the independent predicting factors for CSDH development (psubdural space and persistence of SFC ≥5 mm were predicting factors in both UIA and RIA. However, progression to hydrocephalus may have in part contributed to low CSDH development in the RIA. We suggest that cleaning of blood clots in the subdural space and efforts to minimize SFC ≥5 mm at the end of surgery is helpful to prevent CSDH following aneurysmal clipping.

  9. Establishing a protocol for element determination in human nail clippings by neutron activation analysis

    International Nuclear Information System (INIS)

    Sanches, Thalita Pinheiro; Saiki, Mitiko

    2011-01-01

    Human nail samples have been analyzed to evaluate occupational exposure, nutritional status and to diagnose certain diseases. However, sampling and washing protocols for nail analyses vary from study to study not allowing comparisons between studies. One of the difficulties in analyzing nail samples is to eliminate only surface contamination without removing elements of interest in this tissue. In the present study, a protocol was defined in order to obtain reliable results of element concentrations in human nail clippings. Nail clippings collected from all 10 fingers or toes were previously pre cleaned using an ethyl alcohol solution to eliminate microbes. Then, the clippings were cut in small pieces and submitted to different reagents for washing by shaking. Neutron activation analysis (NAA) was applied for nail samples analysis which consisted of irradiating aliquots of samples together with synthetic elemental standards in the IEA-R1 nuclear research reactor followed by gamma ray spectrometry. Comparisons made between the results obtained for nails submitted to different reagents for cleaning indicated that the procedure using acetone and Triton X100 solution is more effective than that of nitric acid solution. Analyses in triplicates of a nail sample indicated results with relative standard deviations lower than 15% for most of elements, showing the homogeneity of the prepared sample. Qualitative analyses of different nail polishes showed that the presence of elements determined in the present study is negligible in these products. Quality control of the analytical results indicated that the applied NAA procedure is adequate for human nail analysis. (author)

  10. Turbo Decision Aided Receivers for Clipping Noise Mitigation in Coded OFDM

    Directory of Open Access Journals (Sweden)

    Declercq David

    2008-01-01

    Full Text Available Abstract Orthogonal frequency division multiplexing (OFDM is the modulation technique used in most of the high-rate communication standards. However, OFDM signals exhibit high peak average to power ratio (PAPR that makes them particularly sensitive to nonlinear distortions caused by high-power amplifiers. Hence, the amplifier needs to operate at large output backoff, thereby decreasing the average efficiency of the transmitter. One way to reduce PAPR consists in clipping the amplitude of the OFDM signal introducing an additional noise that degrades the overall system performance. In that case, the receiver needs to set up an algorithm that compensates this clipping noise. In this paper, we propose three new iterative receivers with growing complexity and performance that operate at severe clipping: the first and simplest receiver uses a Viterbi algorithm as channel decoder whereas the other two implement a soft-input soft-output (SISO decoder. Each soft receiver is analyzed through EXIT charts for different mappings. Finally, the performances of the receivers are simulated on both short time-varying channel and AWGN channel.

  11. Turbo Decision Aided Receivers for Clipping Noise Mitigation in Coded OFDM

    Directory of Open Access Journals (Sweden)

    Maxime Colas

    2008-02-01

    Full Text Available Orthogonal frequency division multiplexing (OFDM is the modulation technique used in most of the high-rate communication standards. However, OFDM signals exhibit high peak average to power ratio (PAPR that makes them particularly sensitive to nonlinear distortions caused by high-power amplifiers. Hence, the amplifier needs to operate at large output backoff, thereby decreasing the average efficiency of the transmitter. One way to reduce PAPR consists in clipping the amplitude of the OFDM signal introducing an additional noise that degrades the overall system performance. In that case, the receiver needs to set up an algorithm that compensates this clipping noise. In this paper, we propose three new iterative receivers with growing complexity and performance that operate at severe clipping: the first and simplest receiver uses a Viterbi algorithm as channel decoder whereas the other two implement a soft-input soft-output (SISO decoder. Each soft receiver is analyzed through EXIT charts for different mappings. Finally, the performances of the receivers are simulated on both short time-varying channel and AWGN channel.

  12. Do medical students watch video clips in eLearning and do these facilitate learning?

    Science.gov (United States)

    Romanov, Kalle; Nevgi, Anne

    2007-06-01

    There is controversial evidence of the impact of individual learning style on students' performance in computer-aided learning. We assessed the association between the use of multimedia materials, such as video clips, and collaborative communication tools with learning outcome among medical students. One hundred and twenty-one third-year medical students attended a course in medical informatics (0.7 credits) consisting of lectures, small group sessions and eLearning material. The eLearning material contained six learning modules with integrated video clips and collaborative learning tools in WebCT. Learning outcome was measured with a course exam. Approximately two-thirds of students (68.6%) viewed two or more videos. Female students were significantly more active video-watchers. No significant associations were found between video-watching and self-test scores or the time used in eLearning. Video-watchers were more active in WebCT; they loaded more pages and more actively participated in discussion forums. Video-watching was associated with a better course grade. Students who watched video clips were more active in using collaborative eLearning tools and achieved higher course grades.

  13. Clinical observation of Artisan iris-clip intraocular lens implantation at stage Ⅰ

    Directory of Open Access Journals (Sweden)

    Qing Zhou

    2014-09-01

    Full Text Available AIM: To observe the clinical efficacy of Artisan iris-clip intraocular lens(IOLimplantation on cataract with a wide range of lens dislocation.METHODS: Twenty-four hospital patients(28 eyesof cataract with lens subluxation by trauma(20 patients, 20 eyesand Marfan's syndrome(4 patients, 8 eyesduring May 2007 to December 2011 were selected. All of them underwent phacoemulsification or an anterior vitrectomy and Artisan iris-clip IOL implantation at stage Ⅰ. Postoperative visual acuity, corneal endothelial cell count, intraocular lens position and postoperative complications were observed. Follow-up time was 6mo.RESULTS:Compared with the preoperative, postoperative best corrected visual acuity improved to varying degrees, visual acuity of 0.1-0.5 was in 20 eyes, 0.5-1.0 in 8 eyes. After followed up 1-6mo, no artificial lens shift, iris inflammation, iris atrophy and corneal decompensation and other complications were observed.CONCLUSION: Cataract surgery with a wide range of lens dislocation is difficult, but as long as surgeons who have a wealth of clinical experience and superb skills, still can carry out phacoemulsification surgery or anterior vitrectomy and Artisan iris-clip IOL implantation and obtain a better outcome.

  14. Level of headaches after surgical aneurysm clipping decreases significantly faster compared to endovascular coiled patients

    Directory of Open Access Journals (Sweden)

    Athanasios K. Petridis

    2017-04-01

    Full Text Available In incidental aneurysms, endovascular treatment can lead to post-procedural headaches. We studied the difference of surgical clipping vs. endovascular coiling in concern to post-procedural headaches in patients with ruptured aneurysms. Sixtyseven patients with aneurysmal subarachnoidal haemorrhage were treated in our department from September 1st 2015 - September 1st 2016. 43 Patients were included in the study and the rest was excluded because of late recovery or highgrade subarachnoid bleedings. Twenty-two were surgical treated and twenty-one were interventionally treated. We compared the post-procedural headaches at the time points of 24 h, 21 days, and 3 months after treatment using the visual analog scale (VAS for pain. After surgical clipping the headache score decreased for 8.8 points in the VAS, whereas the endovascular treated population showed a decrease of headaches of 3.3 points. This difference was highly statistical significant and remained significant even after 3 weeks where the pain score for the surgically treated patients was 0.68 and for the endovascular treated 1.8. After 3 months the pain was less than 1 for both groups with surgically treated patients scoring 0.1 and endovascular treated patients 0.9 (not significant. Clipping is relieving the headaches of patients with aneurysm rupture faster and more effective than endovascular coiling. This effect stays significant for at least 3 weeks and plays a crucial role in stress relieve during the acute and subacute ICU care of such patients.

  15. Effect of hair coat clipping on some physiological changes of dairy bulls

    Directory of Open Access Journals (Sweden)

    Prasanpanich, S.

    2006-03-01

    Full Text Available Some physiological responses of 6 Friesian crossbred (87.5% bull yearling with 2.5 years old, averaging 235 kg. bodyweight were investigated under hot humid conditions. All animals were raised in a house (4 × 15 × 5; w × l × h meters, respectively with concrete floor and were assigned to the Pair Comparison Design according to their weight and age into 2 groups. Animals in group 1 were maintained with their natural hair coat while their counterparts in group 2 were coat clipped fortnightly through a 70-day experimental period. The results indicated that the clipped animals had a significantly (P<0.05 lower sweating rate than did the unclipped ones (102.7±15.48 and 48.3±15.48 g/m2/hour, respectively. However, there were no significant differences in rectal temperature, skin temperature and respiratory rate between the two groups of animals. Further study should be done to clarify the consequences of lower sweating rate in clipped animals under hot humid conditions.

  16. Analyzing Behaviour of the Utilization of the Online News Clipping Database: Experience in Suan Sunandha Rajabhat University

    OpenAIRE

    Siriporn Poolsuwan; Kanyarat Bussaban

    2014-01-01

    This research aims to investigate and analyze user’s behaviour towards the utilization of the online news clipping database at Suan Sunandha Rajabhat University, Thailand. Data is gathered from 214 lecturers and 380 undergraduate students by using questionnaires. Findings show that most users knew the online news clipping service from their friends, library’s website and their teachers. The users learned how to use it by themselves and others learned by training of SSRU library. Most users us...

  17. Hypertensive target organ damage in Ghanaian civil servants with hypertension.

    Directory of Open Access Journals (Sweden)

    Juliet Addo

    2009-08-01

    Full Text Available Low levels of detection, treatment and control of hypertension have repeatedly been reported from sub Saharan Africa, potentially increasing the likelihood of target organ damage.A cross-sectional study was conducted on 1015 urban civil servants aged > or = 25 years from seven central government ministries in Accra, Ghana. Participants diagnosed to have hypertension were examined for target organ involvement. Hypertensive target organ damage was defined as the detection of any of the following: left ventricular hypertrophy diagnosed by electrocardiogram, reduction in glomerular filtration rate, the presence of hypertensive retinopathy or a history of a stroke.Of the 219 hypertensive participants examined, 104 (47.5% had evidence of target organ damage. The presence of target organ damage was associated with higher systolic and diastolic blood pressure levels. The odds of developing hypertensive target organ damage was five to six times higher in participants with blood pressure (BP > or = 180/110 mmHg compared to those with BP < 140/90 mmHg, and there was a trend to higher odds of target organ damage with increasing BP (p = 0.001. Women had about lower odds of developing target organ damage compared to men.The high prevalence of target organ damage in this working population associated with increasing blood pressure, emphasises the need for hypertension control programs aimed at improving the detection of hypertension, and importantly addressing the issues inhibiting the effective treatment and control of people with hypertension in the population.

  18. Efficacy of electrocoagulation in sealing the cystic artery and cystic duct occluded with only one absorbable clip during laparoscopic cholecystectomy.

    Science.gov (United States)

    Yang, Chang-Ping; Cao, Jin-Lin; Yang, Ren-Rong; Guo, Hong-Rong; Li, Zhao-Hui; Guo, Hai-Ying; Shao, Yin-Can; Liu, Gui-Bao

    2014-02-01

    Even though laparoscopic cholecystectomy (LC) emerged over 20 years ago, controversies persist with regard to the best method to ligate the cystic duct and artery. We proposed to assess the effectiveness and safety of electrocoagulation to seal the cystic artery and cystic duct after their occlusion with only one absorbable clip. We retrospectively compared the clinical data for 635 patients undergoing LC using electrocoagulation to seal the cystic artery and cystic duct that were occluded with only one absorbable clip (Group 1) and 728 patients undergoing LC using titanium clips (Group 2). In parallel, 30 rabbits randomized into six groups underwent cholecystectomy. After cystic duct ligation with absorbable or titanium clips, the animals were sacrificed 1, 3, or 6 months later, and intraabdominal adhesions were assessed after celiotomy. The mean operative time was significantly shorter (41.6 versus 58.9 minutes, PElectrocoagulation of the cystic artery and cystic duct that were occluded with only one absorbable clip is safe and effective during LC. This approach is associated with shortened operative times and reduced leakage, compared with the standard method using metal clips.

  19. O MONITORAMENTO DE NOTÍCIAS COMO FERRAMENTA PARA A INTELIGÊNCIA COMPETITIVATHE CLIPPING AS TOLL FOR COMPETITIVE INTELLIGENCE

    Directory of Open Access Journals (Sweden)

    Ariane Barbosa Lemos

    2011-07-01

    Full Text Available O artigo apresenta um diagnóstico do serviço de monitoramento de notícias (clipping. No estudo, foram investigados os processos de elaboração desse serviço por uma empresa especializada e sua utilização por parte de organizações dos setores de educação executiva, jurídico e entretenimento. Conclui que tanto a empresa clipadora quanto seus clientes consideram o clipping útil para o processo decisório e o serviço é visto de forma complementar a ação geral de inteligência competitiva das organizações. Palavras-chave inteligência competitiva, monitoramento ambiental, fontes de informação e monitoramento de notícias. Abstract The paper presents a diagnostic study about a clipping service. This study focused the development of the service provided by a specialized firm and its use by organizations operating in the executive education, legal and entertainment areas. It concludes that both the company and your customers consider clipping useful for decision making and the clipping is seen as complementary to general action of competitive intelligence organizations. Keywords competitive intelligence, environmental scanning, information source and clipping.

  20. Development of a new detection device using a glass clip emitting infrared fluorescence for laparoscopic surgery of gastric cancer

    International Nuclear Information System (INIS)

    Inada, Shunko Albano; Mori, Kensaku; Fuchi, Shingo; Hasegawa, Junichi; Misawa, Kazunari; Nakanishi, Hayao

    2015-01-01

    In conventional method, to identify location of the tumor intraperitoneally for extirpation of the gastric cancer, charcoal ink is injected around the primary tumor. However, in the time of laparoscopic operation, it is difficult to estimate specific site of primary tumor. In this study we developed a glass phosphors was realized with Yb 3+ , Nd 3+ doped to Bi 2 O 3 -B 2 O 3 based glasses, which have central emission wavelength of 1020 nm and 100 nm of FWHM. Using this glass phosphor, we developed a fluorescent clip and the laparoscopic fluorescent detection system for clip-derived near-infrared light. To evaluated clinical performance of a fluorescent clip and the laparoscopic detection system, we used resected stomach from the patients. Fluorescent clip was fixed on the gastric mucosa, and an excitation light (wavelength: 808nm) was irradiated from outside of stomach for detection of fluorescent through stomach wall. As a result, fluorescent emission from the clip was successfully detected. These results indicate that the glass fluorescent clip in combination with laparoscopic detection system is a very useful method to identify the exact location of the primary gastric cancer. (paper)

  1. [Control of hypertension in nursing homes].

    Science.gov (United States)

    Thomas, J M; Alvarez, W; Mulaj, M; De Breucker, S; Leeman, M; Pepersack, T

    2006-09-01

    In a cross sectional study we determined prevalence of hypertension among institutionalized old subjects. Prevalence of hypertension was 69%. Among detected hypertensive patients, 76% received an antihypertensive drug treatment. 61% of the declared hypertensive patients and 80% of the treated hypertensive patients had their blood pressure controlled. The general practitioners should better detect and treat this common geriatric problem associated with a high comorbidity.

  2. Taste and hypertension in humans

    DEFF Research Database (Denmark)

    Roura, Eugeni; Foster, Simon; Winklebach, Anja

    2016-01-01

    The association between salty taste and NaCl intake with hypertension is well-established, although it is far from completely understood. Other taste types such as sweet, umami or bitter have also been related to alterations in blood pressure. Here, we review the mutual relationship between taste...... and hypertension to identify potential avenues to better control blood pressure. This review focuses on published data involving humans, with the exception of a section on molecular mechanisms. There is compelling evidence to suggest that changes in salty taste sensitivity can be used to predict the onset...... of hypertension. This goes hand in hand with the medical concept of sodium sensitivity, which also increases with age, particularly in hypertensive patients. The association of hypertension with the loss of taste acuity less definitive with some data/conclusions masked by the use of anti-hypertensive drugs...

  3. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over ...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates....

  4. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates....

  5. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael Hecht; Jeppesen, Jørgen; Larsen, Mogens Lytken

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun...

  6. Hypertension og det metaboliske syndrom

    DEFF Research Database (Denmark)

    Olsen, Michael; Jeppesen, Jørgen; Larsen, Mogens

    2009-01-01

    The metabolic syndrome is a relatively prevalent condition characterized by co-existence of several metabolic and cardiovascular risk factors including hypertension. Patients with hypertension have an increased risk of developing the metabolic syndrome which, in turn, increases the cardiovascular...... syndrome is of clinical importance as it makes the treating physician test for other elements of the syndrome in patients with one of the elements, e.g. hypertension. Udgivelsesdato: 2009-Jun-15...

  7. [Hepatopulmonary syndrome and portopulmonary hypertension].

    Science.gov (United States)

    Marcu, Cristina; Schiffer, Eduardo; Aubert, John-David; Vionnet, Julien; Yerly, Patrick; Deltenre, Pierre; Marot, Astrid

    2017-08-30

    Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are two frequent pulmonary complications of liver disease. Portal hypertension is a key element in the pathogenesis of both disorders, which are however distinct in terms of pathogenesis, diagnosis and treatment. HPS corresponds to an abnormal arterial oxygenation in relation with the development of intrapulmonary vascular dilatations. POPH is a pulmonary arterial hypertension in the setting of portal hypertension and elevated pulmonary vascular resistance. As both diseases are associated with an increased risk of morbidity and mortality, it is important to screen and evaluate the severity of these two disorders particularly in liver transplant candidates.

  8. Vascular inflammatory cells in hypertension

    Directory of Open Access Journals (Sweden)

    David G. Harrison

    2012-05-01

    Full Text Available Hypertension is a common disorder with uncertain etiology. In the last several years, it has become evident that components of both the innate and adaptive immune system play an essential role in hypertension. Macrophages and T cells accumulate in the perivascular fat, the heart and the kidney of hypertensive patients and in animals with experimental hypertension. Various immunosuppressive agents lower blood pressure and prevent end-organ damage. Mice lacking lymphocytes are protected against hypertension, and adoptive transfer of T cells, but not B cells in the animals restores their blood pressure response to stimuli such as angiotensin II or high salt. Recent studies have shown that mice lacking macrophages have blunted hypertension in response to angiotensin II and that genetic deletion of macrophages markedly reduces experimental hypertension. Dendritic cells have also been implicated in this disease. Many hypertensive stimuli have triggering effects on the central nervous system and signals arising from the circumventricular organ seem to promote inflammation. Studies have suggested that central signals activate macrophages and T cells, which home to the kidney and vasculature and release cytokines, including IL-6 and IL-17, which in turn cause renal and vascular dysfunction and lead to blood pressure elevation. These recent discoveries provide a new understanding of hypertension and provide novel therapeutic opportunities for treatment of this serious disease.

  9. Pulmonary hypertension in older adults.

    Science.gov (United States)

    McArdle, John R; Trow, Terence K; Lerz, Kathryn

    2007-12-01

    Pulmonary hypertension is a frequently encountered problem in older patients. True idiopathic pulmonary arterial hypertension can also be seen and requires careful exclusion in older patients. Institution of therapies must be tempered with an appreciation of individual comorbidities and functional limitations that may affect patients' ability to comply and benefit from the complex treatments available for pulmonary arterial hypertension. This article reviews the existing data on the various forms of pulmonary hypertension presenting in older patients and on appropriate therapy in this challenging population.

  10. Development of a new biodegradable operative clip made of a magnesium alloy: Evaluation of its safety and tolerability for canine cholecystectomy.

    Science.gov (United States)

    Yoshida, Toshihiko; Fukumoto, Takumi; Urade, Takeshi; Kido, Masahiro; Toyama, Hirochika; Asari, Sadaki; Ajiki, Tetsuo; Ikeo, Naoko; Mukai, Toshiji; Ku, Yonson

    2017-06-01

    Operative clips used to ligate vessels in abdominal operation usually are made of titanium. They remain in the body permanently and form metallic artifacts in computed tomography images, which impair accurate diagnosis. Although biodegradable magnesium instruments have been developed in other fields, the physical properties necessary for operative clips differ from those of other instruments. We developed a biodegradable magnesium-zinc-calcium alloy clip with good biologic compatibility and enough clamping capability as an operative clip. In this study, we verified the safety and tolerability of this clip for use in canine cholecystectomy. Nine female beagles were used. We performed cholecystectomy and ligated the cystic duct by magnesium alloy or titanium clips. The chronologic change of clips and artifact formation were compared at 1, 4, 12, 18, and 24 weeks postoperative by computed tomography. The animals were killed at the end of the observation period, and the clips were removed to evaluate their biodegradability. We also evaluated their effect on the living body by blood biochemistry data. The magnesium alloy clip formed much fewer artifacts than the titanium clip, and it was almost absorbed at 6 months postoperative. There were no postoperative complications and no elevation of constituent elements such as magnesium, calcium, and zinc during the observation period in both groups. The novel magnesium alloy clip demonstrated sufficient sealing capability for the cystic duct and proper biodegradability in canine models. The magnesium alloy clip revealed much fewer metallic artifacts in CT than the conventional titanium clip. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. ESSENTIAL ARTERIAL HYPERTENSION AND RISK FACTORS ASSOCIATED WITH HYPERTENSIVE NEPHROPATHY

    Directory of Open Access Journals (Sweden)

    Boban Milojković

    2014-12-01

    Full Text Available Arterial hypertension is a major risk factor that predisposes to cardiovascular disorders and is responsible for most of the morbidity and mortality in patients. Hypertension is closely associated with the kidney, because kidney disease can be both the cause and consequence of increased blood pressure. Elevation of blood pressure is a strong independent risk factor for hypertensive nephropathy and development of ESRD. The pathogenesis of ischemic hypertensive nephropathy (IHN is multifactoral, and in addition to blood pressure other factors contribute to the development of this renal pathology and its progression to end-stage renal disease. These include obesity, smoking, male gender and other still unknown risk factors. The aim of this paper was to analyse the association between essential arterial hypertension and renal hypertensive disease and prevalence of other atherosclerotic risk factors in patients with developed hypertensive renal disease. In this prospective cross sectional study 283 patients of both genders with diagnosed essential hypertension and hypertensive renal disease were analysed. The anamnestic data related to age, duration of hypertension, history of smoking, presence of hypertensive retinopathy, hypertrophy of the left chamber and data about previous renal diseases were collected through conversation and medical documentation. The clinical examination comprise determination of blood pressure, body mass index (BMI, lipid parameters (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides, serum urea and creatinine, urine, albumin and protein concentration. The total number of 283 patients (185 males and 98 females with HN was analyzed. The analysis revealed significantly higher proportion of males aged over 60 years with IHN. The mean age of examined hypertensive patients with IHN is 62.6±8.8 years with duration of hypertension 19.8±5.9 years. All examined patients had hypertensive retinopathy and

  12. Ovarian cryopreservation after laparoscopic ovariectomy using the Endo-GIA stapling device and LAPRO-clip absorbable ligating clip in a woman: a case report

    Directory of Open Access Journals (Sweden)

    Messner Alexandra

    2011-02-01

    Full Text Available Abstract Introduction Several options are available for preserving fertility before cytotoxic treatment, including ovarian tissue cryopreservation. Most reported surgical techniques include electrocoagulation. Our hypothesis is that avoidance of electrocoagulation may decrease ovarian cortex injury during cryopreservation procedures. Case presentation We report a laparoscopic technique of whole-ovary removal without coagulation using Endo-GIA forceps and clips. Laparoscopic ovariectomy was performed for cryopreservation in a 37-year-old Caucasian woman with breast cancer and for whom chemotherapy was planned. The procedure was completed quickly and without complication. This Endo-GIA procedure was of short duration with a short period of ischemia before freezing. Conclusion Laparoscopic ovariectomy using the Endo-GIA stapling device procedure without coagulation may diminish ovary injury before ovarian cryopreservation.

  13. Ovarian cryopreservation after laparoscopic ovariectomy using the Endo-GIA stapling device and LAPRO-clip absorbable ligating clip in a woman: a case report

    Science.gov (United States)

    2011-01-01

    Introduction Several options are available for preserving fertility before cytotoxic treatment, including ovarian tissue cryopreservation. Most reported surgical techniques include electrocoagulation. Our hypothesis is that avoidance of electrocoagulation may decrease ovarian cortex injury during cryopreservation procedures. Case presentation We report a laparoscopic technique of whole-ovary removal without coagulation using Endo-GIA forceps and clips. Laparoscopic ovariectomy was performed for cryopreservation in a 37-year-old Caucasian woman with breast cancer and for whom chemotherapy was planned. The procedure was completed quickly and without complication. This Endo-GIA procedure was of short duration with a short period of ischemia before freezing. Conclusion Laparoscopic ovariectomy using the Endo-GIA stapling device procedure without coagulation may diminish ovary injury before ovarian cryopreservation. PMID:21291518

  14. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  15. Prevalence and persistence of masked hypertension in treated hypertensive patients

    NARCIS (Netherlands)

    Verberk, Willem J.; Thien, Theo; Kroon, Abraham A.; Lenders, Jacques W. M.; van Montfrans, Gert A.; Smit, Andries J.; de Leeuw, Peter W.

    2007-01-01

    Background: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the

  16. Prevalence and persistence of masked hypertension in treated hypertensive patients.

    NARCIS (Netherlands)

    Verberk, W.J.; Thien, Th.; Kroon, A.A.; Lenders, J.W.M.; Montfrans, G.A. van; Smit, A.J.; Leeuw, P.W. de

    2007-01-01

    BACKGROUND: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the

  17. Prevalence and persistence of masked hypertension in treated hypertensive patients

    NARCIS (Netherlands)

    Verberk, Willem J.; Thien, Theo; Kroon, Abraham A.; Lenders, Jacques W. M.; van Montfrans, Gert A.; Smit, Andries J.; de Leeuw, Peter W.

    2007-01-01

    BACKGROUND: Masked hypertension (MH) is defined as a normal blood pressure in the physician's office and an elevated blood pressure when measured out-of-office. The cause of MH may be termed the masked hypertension effect (MHE), and is not restricted to blood-pressure (BP) values around the

  18. Dietary habits of hypertensive patients in a tertiary hypertension ...

    African Journals Online (AJOL)

    Introduction: The prescriptions regarding non-pharmacological care in the management of hypertension has been carefully defined by the various practice guidelines. However, there is paucity of data on dietary practices in our environment, therefore this study set out to determine the dietary practices of hypertensive ...

  19. Drug induced hypertension--An unappreciated cause of secondary hypertension.

    Science.gov (United States)

    Grossman, Alon; Messerli, Franz H; Grossman, Ehud

    2015-09-15

    Most patients with hypertension have essential hypertension or well-known forms of secondary hypertension, such as renal disease, renal artery stenosis, or common endocrine diseases (hyperaldosteronism or pheochromocytoma). Physicians are less aware of drug induced hypertension. A variety of therapeutic agents or chemical substances may increase blood pressure. When a patient with well controlled hypertension is presented with acute blood pressure elevation, use of drug or chemical substance which increases blood pressure should be suspected. Drug-induced blood pressure increases are usually minor and short-lived, although rare hypertensive emergencies associated with use of certain drugs have been reported. Careful evaluation of prescription and non-prescription medications is crucial in the evaluation of the hypertensive individual and may obviate the need for expensive and unnecessary evaluations. Discontinuation of the offending agent will usually achieve adequate blood pressure control. When use of a chemical agent which increases blood pressure is mandatory, anti-hypertensive therapy may facilitate continued use of this agent. We summarize the therapeutic agents or chemical substances that elevate blood pressure and their mechanisms of action. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Pre-Hypertension and Hypertension in Adolescence: How much ...

    African Journals Online (AJOL)

    Background: Hypertension is an important worldwide public-health challenge because of its high frequency and concomitant risks of cardiovascular and kidney disease. Previous studies have documented that hypertension may begin in adolescence, perhaps even in childhood. Objectives: This study set out to determine ...

  1. Liquorice: a root cause of secondary hypertension

    OpenAIRE

    Varma, Ravi; Ross, Calum N.

    2017-01-01

    We describe a patient presenting with hypertension and hypokalaemia who was ultimately diagnosed with liquorice- induced pseudohyperaldosteronism. This rare cause of secondary hypertension illustrates the importance of a methodical approach to the assessment of hypertension.

  2. ORIGINAL ARTICLES Hypertension Guideline 2003 Update

    African Journals Online (AJOL)

    reduction of BP in the elderly and in those with severe hypertension should .... management of hypertension in adults by health care .... They may demonstrate postural and post- ..... Persons with severe hypertension fall into three categories.

  3. Genetics Home Reference: pulmonary arterial hypertension

    Science.gov (United States)

    ... Home Health Conditions Pulmonary arterial hypertension Pulmonary arterial hypertension Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  4. Isolated Systolic Hypertension: A Health Concern?

    Science.gov (United States)

    Isolated systolic hypertension: A health concern? Is having a high top number (systolic) blood pressure, but a normal bottom number (diastolic) ... mm Hg, you have a common type of high blood pressure called isolated systolic hypertension. Isolated systolic hypertension can ...

  5. Pharmacotherapy for mild hypertension

    Directory of Open Access Journals (Sweden)

    Diana Diao

    2012-01-01

    Full Text Available BACKGROUND: People with no previous cardiovascular events or cardiovascular disease represent a primary prevention population. The benefits and harms of treating mild hypertension in primary prevention patients are not known at present. This review examines the existing randomized controlled trial (RCT evidence. OBJECTIVE: Primary objective: To quantify the effects of antihypertensive drug therapy on mortality and morbidity in adults with mild hypertension (systolic blood pressure (BP 140-159 mmHg and/or diastolic BP 90-99 mmHg and without cardiovascular disease. METHODS: Search: We searched CENTRAL (2011, Issue 1, MEDLINE (1948 to May 2011, EMBASE (1980 to May 2011 and reference lists of articles. The Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness (DARE were searched for previous reviews and meta-analyses of anti-hypertensive drug treatment compared to placebo or no treatment trials up until the end of 2011. Selection criteria: RCTs of at least 1 year duration. Data collection and analysis: The outcomes assessed were mortality, stroke, coronary heart disease (CHD, total cardiovascular events (CVS, and withdrawals due to adverse effects. MAIN RESULTS: Of 11 RCTs identified 4 were included in this review, with 8,912 participants. Treatment for 4 to 5 years with antihypertensive drugs as compared to placebo did not reduce total mortality (RR 0.85, 95% CI 0.63, 1.15. In 7,080 participants treatment with antihypertensive drugs as compared to placebo did not reduce coronary heart disease (RR 1.12, 95% CI 0.80, 1.57, stroke (RR 0.51, 95% CI 0.24, 1.08, or total cardiovascular events (RR 0.97, 95% CI 0.72, 1.32. Withdrawals due to adverse effects were increased by drug therapy (RR 4.80, 95% CI 4.14, 5.57, ARR 9%. AUTHORS' CONCLUSIONS: Antihypertensive drugs used in the treatment of adults (primary prevention with mild hypertension (systolic BP 140-159 mmHg and/or diastolic BP 90-99 mmHg have not been

  6. Nocturnal Hypertension: Neglected Issue in Comprehensive Hypertension Management

    Directory of Open Access Journals (Sweden)

    Andi Kristanto

    2016-09-01

    Full Text Available The body circardian rhythm affects blood pressure variability at day and night, therefore blood pressure at day and night might be different. Nocturnal hypertension is defined as increase of blood pressure >120/70mmHg at night, which is caused by disturbed circadian rhythm, and associated with higher cardiovascular and cerebrovascular events also mortality in hypertensive patients. Nocturnal hypertension and declining blood pressure pattern, can only be detected by continuous examination for 24 hours, also known as ambulatory blood pressure measurement (ABPM. Chronotherapy, has become a strategy for managing the hypertensive nocturnal patients, by taking hypertensive medication at night to obtain normal blood pressure decrease in accordance with the normal circadian rhythm and, improving blood pressure control.

  7. Clipping treatment of posterior communicating artery aneurysms associated with arteriosclerosis and calcification: A single center study of 136 cases.

    Science.gov (United States)

    Shi, Lei; Yu, Jing; Zhao, Ying; Xu, Kan; Yu, Jinlu

    2018-02-01

    It is widely acknowledged that arteriosclerosis and calcification of the parent artery and aneurysm neck make it difficult to clip posterior communicating artery (PCoA) aneurysms. A total of 136 cases of PCoA aneurysms accompanied by arteriosclerosis and calcification were collected and treated with clipping in the present study. Of the 136 patients, 112 were females (82.4%) and 24 were males (17.6%), with ages ranging from 37 to 76 years (mean age, 60.2 years). Rupture of a PCoA aneurysm was identified in 132 cases (97.1%), and there were 4 cases of unruptured PCoA aneurysms (2.9%). According to the severity of arteriosclerosis and calcification, the aneurysms were divided into type I, II or III. The treatment of type I aneurysms achieved the best curative effect. It is difficult to temporarily occlude type II and III aneurysms during surgery, and temporary occlusion failed in almost 50% of cases. Types II and III were prone to intraoperative aneurysm ruptures. A significantly higher rate of intraoperative aneurysm rupture was seen in type III compared with type II cases. Type II and III cases were more likely to be treated using a fenestrated clip for aneurysm clipping compared with type I cases, and fenestrated clips were used significantly more frequently in type III cases compared with type II cases. Arteriosclerosis and calcification were likely to affect the prognosis of patients, particularly in cases with type III arteriosclerosis and calcification of the parent artery and aneurysm neck. Therefore, the stratification of the arteriosclerosis and calcification of the parent artery and aneurysm neck into types I-III can guide the intraoperative aneurysm clipping strategy, aid in choosing the correct clips, and inform predictions of the occurrence of rupture and hemorrhage, as well as the prognosis for aneurysms.

  8. A Systematic Review and Meta-Analysis on Economic Comparison Between Endovascular Coiling Versus Neurosurgical Clipping for Ruptured Intracranial Aneurysms.

    Science.gov (United States)

    Zhang, Xiaoxi; Li, Li; Hong, Bo; Xu, Yi; Liu, Yuan; Huang, Qinghai; Liu, Jianmin

    2018-05-01

    Healthcare expenditures and cost reduction have been under critical surveillance in all countries and are critical for policymakers. This review aims at qualitatively and quantitatively analyzing the difference of hospital costs and length of stay between endovascular coiling versus neurosurgical clipping in ruptured intracranial aneurysms (RAs). MEDLINE, the Cochrane database, Embase, and the Web of Science database were searched and evaluated independently by 2 authors according to the Newcastle-Ottawa Scale for cohort studies describing economic hospital cost or length of stay in patients with RAs. A total of 8 studies were included, describing 24,219 RAs treated with neurosurgical clipping and 24,962 RAs with endovascular coiling. Meta-analysis revealed that the total hospital costs (THCs) were similar between coiling versus clipping in RAs (standard mean difference [SMD], -0.05; 95% confidence interval [CI], -0.12 to 0.22; I 2  = 99%; P = 0.50). Subgroup analysis showed that THCs of clipping and coiling were similar in ruptured aneurysms in the United States. However, in South Korea, the THCs of coiling were significantly higher than clipping. In the long run, 1-year medical costs of endovascular treatment were significantly lower than that of clipping in RAs (SMD, 0.15; 95% CI, 0.05-0.25; I 2  = 66%; P = 0.005). In addition, the length of stay of coiled patients was significantly shorter than clipped patients (SMD, 0.29; 95% CI, 0.13-0.45; I 2  = 96%; P China, coiling was more expensive. The length of stay was much shorter in coiled patients in all countries. Copyright © 2018. Published by Elsevier Inc.

  9. Epicardial clip occlusion of the left atrial appendage during cardiac surgery provides optimal surgical results and long-term stability.

    Science.gov (United States)

    Kurfirst, Vojtech; Mokrácek, Aleš; Canádyová, Júlia; Frána, Radim; Zeman, Petr

    2017-07-01

    Occlusion of the left atrial appendage (LAA) has become an integral and important part of the surgical treatment of atrial fibrillation. Different methods of surgical occlusion of the LAA have been associated with varying levels of short- and long-term success for closure. The purpose of this study was to evaluate long-term results of epicardial placement and endocardial occlusion in patients undergoing cardiac operative procedures. A total of 101 patients (average age 65.7 years) undergoing cardiac operative procedures with the epicardial AtriClip Exclusion System of the LAA were enrolled in the study. The AtriClip was placed via a sternotomy or a thoracotomy or from a thoracoscopic approach. Postoperative variables, such as thromboembolic events, clip stability and endocardial leakage around the device, were examined by transoesophageal echocardiography (TEE) and/or computed tomography. Perioperative clip implantation was achieved in 98% of patients. TEE and/or computed tomography conducted during the follow-up period, comprising 1873 patient-months with a mean duration of 18 ± 11 months, revealed no clip migration, no leakage around the device and no clot formation near the remnant cul-de-sac. During the follow-up period, 4 of the cardiac patients experienced transitory ischaemic attacks, whereas no patient experienced a cerebrovascular attack. The Epicardial AtriClip Exclusion System of the LAA appears to be a feasable and safe operative method with a high success rate. Long-term follow-up confirmed clip stability, complete occlussion of the LAA and absence of any atrial fibrilation-related thromboembolic events. These results need to be confirmed by a larger, multicentre study. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  10. A clip domain serine protease involved in moulting in the silkworm, Bombyx mori: cloning, characterization, expression patterns and functional analysis.

    Science.gov (United States)

    Liu, H-W; Wang, L-L; Meng, Z; Tang, X; Li, Y-S; Xia, Q-Y; Zhao, P

    2017-10-01

    Clip domain serine proteases (CLIPs), characterized by one or more conserved clip domains, are essential components of extracellular signalling cascades in various biological processes, especially in innate immunity and the embryonic development of insects. Additionally, CLIPs may have additional non-immune functions in insect development. In the present study, the clip domain serine protease gene Bombyx mori serine protease 95 (BmSP95), which encodes a 527-residue protein, was cloned from the integument of B. mori. Bioinformatics analysis indicated that BmSP95 is a typical CLIP of the subfamily D and possesses a clip domain at the N terminus, a trypsin-like serine protease (tryp_spc) domain at the C terminus and a conserved proline-rich motif between these two domains. At the transcriptional level, BmSP95 is expressed in the integument during moulting and metamorphosis, and the expression pattern is consistent with the fluctuating 20-hydroxyecdysone (20E) titre in B. mori. At the translational level, BmSP95 protein is synthesized in the epidermal cells, secreted as a zymogen and activated in the moulting fluid. Immunofluorescence revealed that BmSP95 is distributed into the old endocuticle in the moulting stage. The expression of BmSP95 was upregulated by 20E. Moreover, expression of BmSP95 was downregulated by pathogen infection. RNA interference-mediated silencing of BmSP95 led to delayed moulting from pupa to moth. These results suggest that BmSP95 is involved in integument remodelling during moulting and metamorphosis. © 2017 The Royal Entomological Society.

  11. Evaluation of stiffness and plastic deformation of active ceramic self-ligating bracket clips after repetitive opening and closure movements

    Directory of Open Access Journals (Sweden)

    Grace Kelly Martins Carneiro

    2015-08-01

    Full Text Available OBJECTIVE: The aim of this study was to assess whether repetitive opening and closure of self-ligating bracket clips can cause plastic deformation of the clip.METHODS: Three types of active/interactive ceramic self-ligating brackets (n = 20 were tested: In-Ovation C, Quicklear and WOW. A standardized controlled device performed 500 cycles of opening and closure movements of the bracket clip with proper instruments and techniques adapted as recommended by the manufacturer of each bracket type. Two tensile tests, one before and one after the repetitive cycles, were performed to assess the stiffness of the clips. To this end, a custom-made stainless steel 0.40 x 0.40 mm wire was inserted into the bracket slot and adapted to the universal testing machine (EMIC DL2000, after which measurements were recorded. On the loading portion of the loading-unloading curve of clips, the slope fitted a first-degree equation curve to determine the stiffness/deflection rate of the clip.RESULTS: The results of plastic deformation showed no significant difference among bracket types before and after the 500 cycles of opening and closure (p = 0.811. There were significant differences on stiffness among the three types of brackets (p = 0.005. The WOW bracket had higher mean values, whereas Quicklear bracket had lower values, regardless of the opening/closure cycle.CONCLUSION: Repetitive controlled opening and closure movements of the clip did not alter stiffness or cause plastic deformation.

  12. Psychophysiological correlates of sexually and non-sexually motivated attention to film clips in a workload task.

    Science.gov (United States)

    Carvalho, Sandra; Leite, Jorge; Galdo-Álvarez, Santiago; Gonçalves, Oscar F

    2011-01-01

    Some authors have speculated that the cognitive component (P3) of the Event-Related Potential (ERP) can function as a psychophysiological measure of sexual interest. The aim of this study was to determine if the P3 ERP component in a workload task can be used as a specific and objective measure of sexual motivation by comparing the neurophysiologic response to stimuli of motivational relevance with different levels of valence and arousal. A total of 30 healthy volunteers watched different films clips with erotic, horror, social-positive and social-negative content, while answering an auditory oddball paradigm. Erotic film clips resulted in larger interference when compared to both the social-positive and auditory alone conditions. Horror film clips resulted in the highest levels of interference with smaller P3 amplitudes than erotic and also than social-positive, social-negative and auditory alone condition. No gender differences were found. Both horror and erotic film clips significantly decreased heart rate (HR) when compared to both social-positive and social-negative films. The erotic film clips significantly increased the skin conductance level (SCL) compared to the social-negative films. The horror film clips significantly increased the SCL compared to both social-positive and social-negative films. Both the highly arousing erotic and non-erotic (horror) movies produced the largest decrease in the P3 amplitude, a decrease in the HR and an increase in the SCL. These data support the notion that this workload task is very sensitive to the attentional resources allocated to the film clip, although they do not act as a specific index of sexual interest. Therefore, the use of this methodology seems to be of questionable utility as a specific measure of sexual interest or as an objective measure of the severity of Hypoactive Sexual Desire Disorder. © 2011 Carvalho et al.

  13. Psychophysiological correlates of sexually and non-sexually motivated attention to film clips in a workload task.

    Directory of Open Access Journals (Sweden)

    Sandra Carvalho

    Full Text Available Some authors have speculated that the cognitive component (P3 of the Event-Related Potential (ERP can function as a psychophysiological measure of sexual interest. The aim of this study was to determine if the P3 ERP component in a workload task can be used as a specific and objective measure of sexual motivation by comparing the neurophysiologic response to stimuli of motivational relevance with different levels of valence and arousal. A total of 30 healthy volunteers watched different films clips with erotic, horror, social-positive and social-negative content, while answering an auditory oddball paradigm. Erotic film clips resulted in larger interference when compared to both the social-positive and auditory alone conditions. Horror film clips resulted in the highest levels of interference with smaller P3 amplitudes than erotic and also than social-positive, social-negative and auditory alone condition. No gender differences were found. Both horror and erotic film clips significantly decreased heart rate (HR when compared to both social-positive and social-negative films. The erotic film clips significantly increased the skin conductance level (SCL compared to the social-negative films. The horror film clips significantly increased the SCL compared to both social-positive and social-negative films. Both the highly arousing erotic and non-erotic (horror movies produced the largest decrease in the P3 amplitude, a decrease in the HR and an increase in the SCL. These data support the notion that this workload task is very sensitive to the attentional resources allocated to the film clip, although they do not act as a specific index of sexual interest. Therefore, the use of this methodology seems to be of questionable utility as a specific measure of sexual interest or as an objective measure of the severity of Hypoactive Sexual Desire Disorder.

  14. Assessment of knowledge about hypertension

    Directory of Open Access Journals (Sweden)

    Paweł Węgorowski

    2017-07-01

    Patient knowledge about hypertension and its effects can affect the effectiveness of treatment. Medical education should be of paramount importance for medical staff, with particular attention to the self-control of blood pressure by patients. In summary, it is important to note that due to the high risk of complications, both treatment and prevention of hypertension are important.

  15. Resistant Hypertension and Cardiorenovascular Risk

    Directory of Open Access Journals (Sweden)

    Prkacin Ingrid

    2017-06-01

    Full Text Available Studies have documented independent contribution of sympathetic activation to the cardiovascular disease continuum. Hypertension is one of the leading modifiable factors. Most if not all the benefit of antihypertensive treatment depends on blood pressure lowering, regardless how it is obtained. Resistant hypertension is defined as blood pressure that remains uncontrolled in spite of the concurrent use of three antihypertensive drugs of different classes. Ideally, one of the three drugs should be a diuretic, and all drugs should be prescribed at optimal dose amounts. Poor adherence to antihypertensive therapy, undiscovered secondary causes (e.g. obstructive sleep apnea, primary aldosteronism, renal artery stenosis, and lifestyle factors (e.g. obesity, excessive sodium intake, heavy alcohol intake, various drug interactions are the most common causes of resistant hypertension. Cardio(renovascular morbidity and mortality are significantly higher in resistant hypertensive than in general hypertensive population, as such patients are typically presented with a long-standing history of poorly controlled hypertension. Early diagnosis and treatment is needed to avoid further end-organ damage to prevent cardiorenovascular remodeling. Treatment strategy includes lifestyle changes, adding a mineralocorticoid receptor antagonist, treatment adherence in cardiovascular prevention and, in case of failure to control blood pressure, renal sympathetic denervation or baroreceptor activation therapy. The comparative outcomes in resistant hypertension deserve better understanding. In this review, the most current approaches to resistant hypertension and cardiovascular risk based on the available literature evidence will be discussed.

  16. Endocrine hypertension – Cushing's syndrome

    Science.gov (United States)

    Singh, Yashpal; Kotwal, Narendra; Menon, A. S.

    2011-01-01

    Hypertension is a major and frequent comorbid finding of Cushing's syndrome. This review discusses the etiology and pathophysiology of hypertension in Cushing's syndrome, while suggesting methods of management of this condition. It also provides an overview of diagnosis and management strategies in this disease. PMID:22145133

  17. The Immune System in Hypertension

    Science.gov (United States)

    Trott, Daniel W.; Harrison, David G.

    2014-01-01

    While hypertension has predominantly been attributed to perturbations of the vasculature, kidney, and central nervous system, research for almost 50 yr has shown that the immune system also contributes to this disease. Inflammatory cells accumulate in the kidneys and vasculature of humans and experimental animals with hypertension and likely…

  18. Virus-Clip: a fast and memory-efficient viral integration site detection tool at single-base resolution with annotation capability.

    Science.gov (United States)

    Ho, Daniel W H; Sze, Karen M F; Ng, Irene O L

    2015-08-28

    Viral integration into the human genome upon infection is an important risk factor for various human malignancies. We developed viral integration site detection tool called Virus-Clip, which makes use of information extracted from soft-clipped sequencing reads to identify exact positions of human and virus breakpoints of integration events. With initial read alignment to virus reference genome and streamlined procedures, Virus-Clip delivers a simple, fast and memory-efficient solution to viral integration site detection. Moreover, it can also automatically annotate the integration events with the corresponding affected human genes. Virus-Clip has been verified using whole-transcriptome sequencing data and its detection was validated to have satisfactory sensitivity and specificity. Marked advancement in performance was detected, compared to existing tools. It is applicable to versatile types of data including whole-genome sequencing, whole-transcriptome sequencing, and targeted sequencing. Virus-Clip is available at http://web.hku.hk/~dwhho/Virus-Clip.zip.

  19. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

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

  20. Effect of Percutaneous Edge-to-Edge Repair on Mitral Valve Area and Its Association With Pulmonary Hypertension and Outcomes.

    Science.gov (United States)

    Utsunomiya, Hiroto; Itabashi, Yuji; Kobayashi, Sayuki; Rader, Florian; Hussaini, Asma; Makar, Moody; Trento, Alfredo; Siegel, Robert J; Kar, Saibal; Shiota, Takahiro

    2017-08-15

    Percutaneous edge-to-edge repair using the MitraClip system causes reduction in mitral valve area (MVA). However, its clinical impact is not fully elucidated. This study assessed the impact of postprocedural MVA reduction on pulmonary hypertension and outcomes. A total of 92 patients with grades 3 to 4 + mitral regurgitation (MR) who underwent MitraClip therapy were retrospectively reviewed. Using intraprocedural, 3-dimensional transesophageal echocardiography, postprocedural MVA was obtained by 2 optimized planes through the medial and lateral orifices of the repaired valve. MVA was reduced by 60.1% immediately after MitraClip procedure (p <0.001). Postprocedural MVA correlated moderately with mean transmitral pressure gradient (TMPG) in the majority of patients (r = -0.56, p <0.001), but discordance of MVA and TMPG was observed in 40% of patients. In multivariable linear regression analysis, postprocedural MVA ≤1.94 cm 2 was independently associated with a blunted decrease in systolic pulmonary artery pressure at 1-month follow-up (β-estimate -4.63, 95% confidence interval -9.71 to -0.15, p = 0.042). Postprocedural MVA ≤1.94 cm 2 was an independent predictor of all-cause mortality and heart failure hospitalization after MitraClip (hazard ratio 4.28, 95% confidence interval 1.56 to 11.7, p = 0.005) even after adjustment for age, gender, atrial fibrillation, cause of MR, left ventricular systolic function, pre-existing pulmonary hypertension, and residual MR. After further adjustment for TMPG ≥5 mm Hg, postprocedural MVA ≤1.94 cm 2 remained predictive for adverse outcomes (p = 0.048). In conclusion, the intraprocedural assessment of MVA by 3-dimensional transesophageal echocardiography can predict hemodynamic response and postprocedural prognosis after MitraClip therapy. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Media Clips.

    Science.gov (United States)

    Lancaster, Ron; Marion, Charlie

    1996-01-01

    Two lessons, 1 dealing with Social Security taxes and the other with the Dow Jones industrial average, are presented along with 10 questions and answers designed to demonstrate to students that mathematics is useful, current, and newsworthy. (AIM)

  2. Clip & Save.

    Science.gov (United States)

    Hubbard, Guy

    2001-01-01

    Provides historical information on the art movement called Cubism that began with two artists, Georges Braque and Pablo Picasso. Discusses possible activities for students and discusses the life of Max Weber. Focuses on Weber's painting, "Rush Hour, New York." (CMK)

  3. Electroencephalography Amplitude Modulation Analysis for Automated Affective Tagging of Music Video Clips

    Directory of Open Access Journals (Sweden)

    Andrea Clerico

    2018-01-01

    Full Text Available The quantity of music content is rapidly increasing and automated affective tagging of music video clips can enable the development of intelligent retrieval, music recommendation, automatic playlist generators, and music browsing interfaces tuned to the users' current desires, preferences, or affective states. To achieve this goal, the field of affective computing has emerged, in particular the development of so-called affective brain-computer interfaces, which measure the user's affective state directly from measured brain waves using non-invasive tools, such as electroencephalography (EEG. Typically, conventional features extracted from the EEG signal have been used, such as frequency subband powers and/or inter-hemispheric power asymmetry indices. More recently, the coupling between EEG and peripheral physiological signals, such as the galvanic skin response (GSR, have also been proposed. Here, we show the importance of EEG amplitude modulations and propose several new features that measure the amplitude-amplitude cross-frequency coupling per EEG electrode, as well as linear and non-linear connections between multiple electrode pairs. When tested on a publicly available dataset of music video clips tagged with subjective affective ratings, support vector classifiers trained on the proposed features were shown to outperform those trained on conventional benchmark EEG features by as much as 6, 20, 8, and 7% for arousal, valence, dominance and liking, respectively. Moreover, fusion of the proposed features with EEG-GSR coupling features showed to be particularly useful for arousal (feature-level fusion and liking (decision-level fusion prediction. Together, these findings show the importance of the proposed features to characterize human affective states during music clip watching.

  4. Initial experience of percutaneous treatment of mitral regurgitation with MitraClip® therapy in Spain.

    Science.gov (United States)

    Carrasco-Chinchilla, Fernando; Arzamendi, Dabit; Romero, Miguel; Gimeno de Carlos, Federico; Alonso-Briales, Juan Horacio; Li, Chi-Hion; Mesa, Maria Dolores; Arnold, Roman; Serrador Frutos, Ana María; Pan, Manuel; Roig, Eulalia; Rodríguez-Bailón, Isabel; de la Fuente Galán, Luis; Hernández, José María; Serra, Antonio; Suárez de Lezo, José

    2014-12-01

    Symptomatic mitral regurgitation has an unfavorable prognosis unless treated by surgery. However, the European registry of valvular heart disease reports that 49% of patients with this condition do not undergo surgery. Percutaneous treatment of mitral regurgitation with MitraClip® has been proved a safe, efficient adjunct to medical treatment in patients with this profile. The objective of the present study is to describe initial experience of MitraClip® therapy in Spain. Retrospective observational study including all patients treated between November 2011 and July 2013 at the 4 Spanish hospitals recording the highest numbers of implantations. A total of 62 patients (77.4% men) were treated, mainly for restrictive functional mitral regurgitation (85.4%) of grade III (37%) or grade IV (63%), mean (standard deviation) ejection fraction 36% (14%), and New York Heart Association functional class III (37%) or IV (63%). Device implantation was successful in 98% of the patients. At 1 year, 81.2% had mitral regurgitation ≤ 2 and 90.9% were in New York Heart Association functional class ≤ II. One periprocedural death occurred (sepsis at 20 days post-implantation) and another 3 patients died during follow-up (mean, 9.1 months). Two patients needed a second implantation due to partial dehiscence of the first device and 2 others underwent heart transplantation. In Spain, MitraClip® therapy has principally been aimed at patients with functional mitral regurgitation, significant systolic ventricular dysfunction, and high surgical risk. It is considered a safe alternative treatment, which can reduce mitral regurgitation and improve functional capacity. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. Effects of Mitral Annulus Remodeling Following MitraClip Procedure on Reduction of Functional Mitral Regurgitation.

    Science.gov (United States)

    Hidalgo, Francisco; Mesa, Dolores; Ruiz, Martín; Delgado, Mónica; Rodríguez, Sara; Pardo, Laura; Pan, Manuel; López, Amador; Romero, Miguel A; Suárez de Lezo, José

    2016-11-01

    The percutaneous mitral valve repair procedure (MitraClip) appears to reduce mitral annulus diameter in patients with functional mitral regurgitation, but the relationship between this and regurgitation severity has not been demonstrated. The aim of this study was to determine the effect of mitral annulus remodeling on the reduction of mitral regurgitation in patients with functional etiology. The study included all patients with functional mitral regurgitation treated with MitraClip at our hospital until January 2015. Echocardiogram (iE33 model, Philips) was performed in all patients immediately after device positioning. Changes in the mitral annulus correlated with mitral regurgitation severity, as assessed using the effective regurgitant orifice area. The study included 23 patients (age, 65±14 years; 74% men; left ventricular ejection fraction, 31%±13%; systolic pulmonary artery pressure, 47±10 mmHg). After the procedure, the regurgitant orifice area decreased by 0.30 cm 2 ±0.04 cm 2 (P<.0005), from a baseline of 0.49 cm 2 ±0.09 cm 2 . Anteroposterior diameter decreased by 3.14 mm±1.01 mm (P<.0005) from a baseline of 28.27 mm±4.9 mm, with no changes in the intercommissural diameter (0.50 mm±0.91 mm vs 40.68 mm±4.7 mm; P=.26). A significant association was seen between anteroposterior diameter reduction and regurgitant orifice area reduction (r=.49; P=.020). In patients with functional mitral regurgitation, the MitraClip device produces an immediate reduction in the anteroposterior diameter. This remodeling may be related to the reduction in mitral regurgitation. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  6. Dutch guideline for the management of hypertensive crisis -- 2010 revision

    NARCIS (Netherlands)

    van den Born, B. J. H.; Beutler, J. J.; Gaillard, C. A. J. M.; de Gooijer, A.; van den Meiracker, A. H.; Kroon, A. A.

    2011-01-01

    Hypertensive crises are divided into hypertensive urgencies and emergencies. Together they form a heterogeneous group of acute hypertensive disorders depending on the presence or type of target organs involved. Despite better treatment options for hypertension, hypertensive crisis and its associated

  7. Management of hypertension in pregnancy.

    Science.gov (United States)

    Chung, N A; Beevers, D G; Lip, G Y

    2001-01-01

    Hypertension is an important cause of both maternal and fetal morbidity and mortality in pregnant women. There are still no definitive guidelines as to when and how patients should be treated, but it is important that appropriate treatment is initiated early in patients at highest risk and they are closely monitored. Hypertension in pregnancy can be a difficult condition to diagnose and treat because of the numerous and differing classification systems that have been used in the past. One classification system, which accounts for the multisystem involvement which can occur in pre-eclampsia and eclampsia, divides hypertension in pregnancy into 3 main groups: pre-eclampsia, gestational hypertension and chronic hypertension. Little benefit to the fetus has been shown from treating gestational and chronic hypertension, but studies in this area have been small and would not have had the power to show a difference in outcome between treated and untreated groups. However, the reduction in morbidity and mortality in the treatment of pre-eclampsia is significant. Therefore, all pregnancies complicated by hypertension require monitoring to detect the possible onset of superimposed pre-eclampsia/eclampsia. Institutions should have a management strategy for those mothers with severe hypertension including a multidisciplinary approach, where the patient is to be monitored and which antihypertensive agents are to be used. It should not be forgotten that the definitive treatment for severe hypertension is delivery of the fetus despite risks to fetal morbidity and mortality. This will reduce blood pressure, but hypertension per se may still persist post partum requiring short term therapy.

  8. Identification of CELF1 RNA targets by CLIP-seq in human HeLa cells

    Directory of Open Access Journals (Sweden)

    Olivier Le Tonquèze

    2016-06-01

    Full Text Available The specific interactions between RNA-binding proteins and their target RNAs are an essential level to control gene expression. By combining ultra-violet cross-linking and immunoprecipitation (CLIP and massive SoliD sequencing we identified the RNAs bound by the RNA-binding protein CELF1, in human HeLa cells. The CELF1 binding sites deduced from the sequence data allow characterizing specific features of CELF1-RNA association. We present therefore the first map of CELF1 binding sites in human cells.

  9. Dual Selectivity Expressed in [2+2+1] Dynamic Clipping of Unsymmetrical [2]Catenanes

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yi

    2010-06-11

    A {pi}-templated dynamic [2+2+1] clipping protocol is established for the synthesis of [2]catenanes from two parts dialdehyde, two parts diamine and one part tetracationic cyclophane. It is further diversified for the selective formation of an unsymmetrical [2]catenane showing great translational selectivity by employing two different dialdehydes in a one-pot reaction. The dual selectivity and the dynamic nature are verified by {sup 1}H NMR spectroscopy, X-ray single crystal structural studies and exchange experiments.

  10. Treatment of Complex Fistula-in-Ano With a Nitinol Proctology Clip

    DEFF Research Database (Denmark)

    Nordholm-Carstensen, Andreas; Krarup, Peter-Martin; Hagen, Kikke

    2017-01-01

    BACKGROUND: The treatment of complex anocutaneous fistulas remains a major therapeutic challenge balancing the risk of incontinence against the chance of permanent closure. OBJECTIVE: The purpose of this study was to investigate the efficacy of a nitinol proctology clip for closure of complex ano...... with those of other noninvasive, sphincter-sparing techniques for high-complex anocutaneous fistulas, with no risk of incontinence. Predictive parameters for fistula healing using this technique remain uncertain. See Video Abstract at http://links.lww.com/DCR/A347....

  11. Pilotless recovery of clipped OFDM signals by compressive sensing over reliable data carriers

    KAUST Repository

    Al-Safadi, Ebrahim B.

    2012-06-01

    In this paper we propose a novel method of clipping mitigation in OFDM using compressive sensing that completely avoids using reserved tones or channel-estimation pilots. The method builds on selecting the most reliable perturbations from the constellation lattice upon decoding at the receiver (in the frequency domain), and performs compressive sensing over these observations in order to completely recover the sparse nonlinear distortion in the time domain. As such, the method provides a practical solution to the problem of initial erroneous decoding decisions in iterative ML methods, and the ability to recover the distorted signal in one shot. © 2012 IEEE.

  12. The Narrative Analysis of the Discourse on Homosexual BDSM Pornograhic Video Clips of The Manhunt Variety

    Directory of Open Access Journals (Sweden)

    Milica Vasić

    2016-02-01

    Full Text Available In this paper we have analyzed the ideal-type model of the story which represents the basic framework of action in Manhunt category pornographic internet video clips, using narrative analysis methods of Claude Bremond. The results have shown that it is possible to apply the theoretical model to elements of visual and mass culture, with certain modifications and taking into account the wider context of the narrative itself. The narrative analysis indicated the significance of researching categories of pornography on the internet, because it leads to a deep analysis of the distribution of power in relations between the categories of heterosexual and homosexual within a virtual environment.

  13. Acute limb ischemia caused by incorrect deployment of a clip-based arterial closure device

    Directory of Open Access Journals (Sweden)

    Łukasz Dzieciuchowicz

    2016-04-01

    Full Text Available Failure of a vascular closure device most commonly results in a hemorrhage or pseudoaneurysm formation. In this paper a rare case of severe acute limb ischemia following incorrect deployment of a clip-based closure device (Starclose SE, Abbott Vascular in a 31-year-old woman is presented. Symptoms of acute limb ischemia occurred at the start of the ambulation, 6 h after completion of the procedure. Because of the severity of ischemia the patient was treated surgically, and limb perfusion was successfully restored. An attempt of closure of an inadvertently punctured narrow superficial femoral artery was identified as the cause of this complication.

  14. Pilotless recovery of clipped OFDM signals by compressive sensing over reliable data carriers

    KAUST Repository

    Al-Safadi, Ebrahim B.; Al-Naffouri, Tareq Y.

    2012-01-01

    In this paper we propose a novel method of clipping mitigation in OFDM using compressive sensing that completely avoids using reserved tones or channel-estimation pilots. The method builds on selecting the most reliable perturbations from the constellation lattice upon decoding at the receiver (in the frequency domain), and performs compressive sensing over these observations in order to completely recover the sparse nonlinear distortion in the time domain. As such, the method provides a practical solution to the problem of initial erroneous decoding decisions in iterative ML methods, and the ability to recover the distorted signal in one shot. © 2012 IEEE.

  15. Top-down and Middle-down Protein Analysis Reveals that Intact and Clipped Human Histones Differ in Post-translational Modification Patterns

    DEFF Research Database (Denmark)

    Tvardovskiy, Andrey; Wrzesinski, Krzysztof; Sidoli, Simone

    2015-01-01

    Post-translational modifications (PTMs) of histone proteins play a fundamental role in regulation of DNA-templated processes. There is also growing evidence that proteolytic cleavage of histone N-terminal tails, known as histone clipping, influences nucleosome dynamics and functional properties...... hepatocytes and the hepatocellular carcinoma cell line HepG2/C3A when grown in spheroid (3D) culture, but not in a flat (2D) culture. Using tandem mass spectrometry we localized four different clipping sites in H3 and one clipping site in H2B. We show that in spheroid culture clipped H3 proteoforms are mainly...

  16. Real-time surgery simulation of intracranial aneurysm clipping with patient-specific geometries and haptic feedback

    Science.gov (United States)

    Fenz, Wolfgang; Dirnberger, Johannes

    2015-03-01

    Providing suitable training for aspiring neurosurgeons is becoming more and more problematic. The increasing popularity of the endovascular treatment of intracranial aneurysms leads to a lack of simple surgical situations for clipping operations, leaving mainly the complex cases, which present even experienced surgeons with a challenge. To alleviate this situation, we have developed a training simulator with haptic interaction allowing trainees to practice virtual clipping surgeries on real patient-specific vessel geometries. By using specialized finite element (FEM) algorithms (fast finite element method, matrix condensation) combined with GPU acceleration, we can achieve the necessary frame rate for smooth real-time interaction with the detailed models needed for a realistic simulation of the vessel wall deformation caused by the clamping with surgical clips. Vessel wall geometries for typical training scenarios were obtained from 3D-reconstructed medical image data, while for the instruments (clipping forceps, various types of clips, suction tubes) we use models provided by manufacturer Aesculap AG. Collisions between vessel and instruments have to be continuously detected and transformed into corresponding boundary conditions and feedback forces, calculated using a contact plane method. After a training, the achieved result can be assessed based on various criteria, including a simulation of the residual blood flow into the aneurysm. Rigid models of the surgical access and surrounding brain tissue, plus coupling a real forceps to the haptic input device further increase the realism of the simulation.

  17. MR liver imaging and cholangiography in the presence of surgical metallic clips at 1.5 and 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Merkle, Elmar M.; Thomas, John; Paulson, Erik K. [Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC (United States); Dale, Brian M. [Siemens Medical Solutions, Cary, NC (United States)

    2006-10-15

    To evaluate whether clips from prior cholecystectomy impair image quality during magnetic resonance cholangiography (MRC) at 3 Tesla (T) compared with 1.5 T, surgical clips were embedded in a gel phantom and positioned at predefined distances from a fluid-filled tube designed to simulate the bile duct. The maximum clip distance was noted where susceptibility artifacts obscured the fluid-filled tube at 1.5 T and 3 T. Susceptibility artifact size was calculated for each sequence within each magnet class. In vivo analysis included 42 patients postcholecystectomy who underwent MRC at either 1.5 T or 3 T. In vitro, mean area of susceptibility artifacts was 104 mm{sup 2} on 3-T and 75 mm{sup 2} on 1.5-T MR imaging (MRI). While surgical clips within a 2-mm range impaired visualization of the fluid-filled tube on 1.5-T MRI, this range increased to 4 mm on 3-T MRI. In vivo, MRC image quality was impaired by susceptibility artifacts in three of 21 cases at 3 T and in two of 21 cases at 1.5 T. Overall, biliary pseudo-obstructions due to susceptibility artifacts from cholecystectomy surgical clips were not substantially more common on 3-T MRC in clinical practice, and patients with a history of prior cholecystectomy should not be excluded from a 3-T MRC. (orig.)

  18. CLIP-seq analysis of multi-mapped reads discovers novel functional RNA regulatory sites in the human transcriptome.

    Science.gov (United States)

    Zhang, Zijun; Xing, Yi

    2017-09-19

    Crosslinking or RNA immunoprecipitation followed by sequencing (CLIP-seq or RIP-seq) allows transcriptome-wide discovery of RNA regulatory sites. As CLIP-seq/RIP-seq reads are short, existing computational tools focus on uniquely mapped reads, while reads mapped to multiple loci are discarded. We present CLAM (CLIP-seq Analysis of Multi-mapped reads). CLAM uses an expectation-maximization algorithm to assign multi-mapped reads and calls peaks combining uniquely and multi-mapped reads. To demonstrate the utility of CLAM, we applied it to a wide range of public CLIP-seq/RIP-seq datasets involving numerous splicing factors, microRNAs and m6A RNA methylation. CLAM recovered a large number of novel RNA regulatory sites inaccessible by uniquely mapped reads. The functional significance of these sites was demonstrated by consensus motif patterns and association with alternative splicing (splicing factors), transcript abundance (AGO2) and mRNA half-life (m6A). CLAM provides a useful tool to discover novel protein-RNA interactions and RNA modification sites from CLIP-seq and RIP-seq data, and reveals the significant contribution of repetitive elements to the RNA regulatory landscape of the human transcriptome. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  19. Clipping of tumour resection margins allows accurate target volume delineation in head and neck cancer adjuvant radiation therapy

    International Nuclear Information System (INIS)

    Bittermann, Gido; Wiedenmann, Nicole; Bunea, Andrei; Schwarz, Steffen J.; Grosu, Anca-L.; Schmelzeisen, Rainer; Metzger, Marc C.

    2015-01-01

    Background: Accurate tumour bed localisation is a key requirement for adjuvant radiotherapy. A new procedure is described for head and neck cancer treatment that improves tumour bed localisation using titanium clips. Materials and methods: Following complete local excision of the primary tumour, the tumour bed was marked with titanium clips. Preoperative gross target volume (GTV) and postoperative tumour bed were examined and the distances between the centres of gravity were evaluated. Results: 49 patients with squamous cell carcinoma of the oral cavity were prospectively enrolled in this study. All patients underwent tumour resection, neck lymph node dissection and defect reconstruction in one stage. During surgery, 7–49 clips were placed in the resection cavity. Surgical clip insertion was successful in 88% (n = 43). Clip identification and tumour bed delineation was successful in all 43 patients. The overall distance between the centres of gravity of the preoperative tumour extension to the tumour bed was 0.9 cm. A significant relationship between the preoperative tumour extension and the postoperative tumour bed volume could be demonstrated. Conclusion: We demonstrate a precise delineation of the former tumour cavity. Improvements in tumour bed delineation allow an increase of accuracy for adjuvant treatment

  20. Appearance and impact of post-operative intracranial clips and coils on whole-brain CT angiography and perfusion

    International Nuclear Information System (INIS)

    Roach, Cayce J.; Russell, Cheryl L.; Hanson, Eric H.; Bluett, Brent; Orrison, William W.

    2012-01-01

    Background: To evaluate the effect of vascular clips and endovascular coils placed for intracranial aneurysms and arteriovenous malformations on whole-brain computed tomography (CT) angiography and perfusion. Methods: A 320-detector row dynamic volume CT system imaged 11 patients following surgical placement of vascular clips or endovascular coils. The extent of clip and coil subtraction by automated software was evaluated using CT digital subtraction angiography and CT perfusion. Impact on CT perfusion values by retained intracranial devices was compared to age- and gender-matched controls. Results: Clip and coil subtraction on CT angiography was graded as good in 8 and moderate in 3 cases. A residual neck and additional aneurysm were noted in 1 of 11 patients. Post-procedural axial slice level CT perfusion values decreased in reliability with increasing proximity to the metallic devices secondary to beam hardening. However, the intracranial devices did not affect axial slice level CTP values of cerebral blood volume, cerebral blood flow and mean transit time outside of the level of the device. Time to peak values was globally decreased outside of the immediate vascular intervention region. Conclusions: Advances in CT technology have provided clinically useful subtraction of intracranial clips and coils. While CT perfusion values were altered in device subtraction areas and within beam hardening artifact areas; they can provide valuable postoperative information on whole-brain hemodynamics. In selected cases, the combination of CT angiography and whole-brain CT perfusion can offer an alternative to conventional angiography that is a more invasive option.

  1. Endoscopic removal of over-the-scope clips using a novel cutting device: a retrospective case series.

    Science.gov (United States)

    Schmidt, Arthur; Riecken, Bettina; Damm, Michael; Cahyadi, Oscar; Bauder, Markus; Caca, Karel

    2014-09-01

    Over-the-scope clips (OTSCs; Ovesco Endoscopy, Tübingen, Germany) are extensively used for treatment of gastrointestinal perforations, leakages, fistulas, and bleeding. In this report, a new method of removing OTSCs using a prototype bipolar cutting device is described. A total of 11 patients underwent endoscopic removal of an OTSC. The OTSC was cut at two opposing sites by a prototype device (DC ClipCutter; Ovesco Endoscopy). The remaining clip fragments were extracted using a standard forceps. Mean procedure time was 47 minutes (range 35 - 75 minutes). Cutting of the OTSC at two opposing sites was successful in all cases (100 %). Complete retrieval of all clip fragments was possible in 10 patients (91 %). The overall success rate for cutting and complete removal of the clip was 91 %. No major complications were observed. Removal of OTSCs with the prototype device was feasible and effective. The device may be valuable for OTSC removal in emergency as well as elective indications. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Peptides-Derived from Thai Rice Bran Improves Endothelial Function in 2K-1C Renovascular Hypertensive Rats

    Directory of Open Access Journals (Sweden)

    Orachorn Boonla

    2015-07-01

    Full Text Available In recent years, a number of studies have investigated complementary medical approaches to the treatment of hypertension using dietary supplements. Rice bran protein hydrolysates extracted from rice is a rich source of bioactive peptides. The present study aimed to investigate the vasorelaxation and antihypertensive effects of peptides-derived from rice bran protein hydrolysates (RBP in a rat model of two kidney-one clip (2K-1C renovascular hypertension. 2K-1C hypertension was induced in male Sprague-Dawley rats by placing a silver clip around the left renal artery, whereas sham-operated rats were served as controls. 2K-1C and sham-operated rats were intragastrically administered with RBP (50 mg kg−1 or 100 mg kg−1 or distilled water continuously for six weeks. We observed that RBP augmented endothelium-dependent vasorelaxation in all animals. Administration of RBP to 2K-1C rats significantly reduced blood pressure and decreased peripheral vascular resistance compared to the sham operated controls (p < 0.05. Restoration of normal endothelial function and blood pressure was associated with reduced plasma angiotensin converting enzyme (ACE, decreased superoxide formation, reduced plasma malondialdehyde and increased plasma nitrate/nitrite (p < 0.05. Up-regulation of eNOS protein and down-regulation of p47phox protein were found in 2K-1C hypertensive rats-treated with RBP. Our results suggest that RBP possesses antihypertensive properties which are mainly due to the inhibition of ACE, and its vasodilatory and antioxidant activity.

  3. Pulmonary arterial hypertension

    Science.gov (United States)

    2013-01-01

    Pulmonary arterial hypertension (PAH) is a chronic and progressive disease leading to right heart failure and ultimately death if untreated. The first classification of PH was proposed in 1973. In 2008, the fourth World Symposium on PH held in Dana Point (California, USA) revised previous classifications. Currently, PH is devided into five subgroups. Group 1 includes patients suffering from idiopathic or familial PAH with or without germline mutations. Patients with a diagnosis of PAH should systematically been screened regarding to underlying mutations of BMPR2 gene (bone morphogenetic protein receptor type 2) or more rarely of ACVRL1 (activine receptor-like kinase type 1), ENG (endogline) or Smad8 genes. Pulmonary veno occusive disease and pulmonary capillary hemagiomatosis are individualized and designated as clinical group 1'. Group 2 'Pulmonary hypertension due to left heart diseases' is divided into three sub-groups: systolic dysfonction, diastolic dysfonction and valvular dysfonction. Group 3 'Pulmonary hypertension due to respiratory diseases' includes a heterogenous subgroup of respiratory diseases like PH due to pulmonary fibrosis, COPD, lung emphysema or interstitial lung disease for exemple. Group 4 includes chronic thromboembolic pulmonary hypertension without any distinction of proximal or distal forms. Group 5 regroup PH patients with unclear multifactorial mechanisms. Invasive hemodynamic assessment with right heart catheterization is requested to confirm the definite diagnosis of PH showing a resting mean pulmonary artery pressure (mPAP) of ≥ 25 mmHg and a normal pulmonary capillary wedge pressure (PCWP) of ≤ 15 mmHg. The assessment of PCWP may allow the distinction between pre-capillary and post-capillary PH (PCWP > 15 mmHg). Echocardiography is an important tool in the management of patients with underlying suspicion of PH. The European Society of Cardiology and the European Respiratory Society (ESC-ERS) guidelines specify its role

  4. Hypertension in Patients with Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade, E-mail: wolney@cardiol.br [Curso de Pós-Graduação em Ciências Cardiovasculares da Universidade Federal Fluminense, Niterói, RJ (Brazil)

    2015-03-15

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality.

  5. Hypertension in Patients with Cancer

    International Nuclear Information System (INIS)

    Souza, Vinicius Barbosa de; Silva, Eduardo Nani; Ribeiro, Mario Luiz; Martins, Wolney de Andrade

    2015-01-01

    There is a known association between chemotherapy and radiotherapy for treatment of cancer patients and development or worsening of hypertension. The aim of this article is to review this association. A literature search was conducted for articles reporting this association on the databases PubMed, SciELO and LILACS between 1993 and 2013. There was a high coprevalence of hypertension and cancer, since both diseases share the same risk factors, such as sedentary lifestyle, obesity, smoking, unhealthy diet and alcohol abuse. The use of chemotherapy and adjuvant drugs effective in the treatment of cancer increased the survival rate of these patients and, consequently, increased the incidence of hypertension. We described the association between the use of angiogenesis inhibitors (bevacizumab, sorafenib and sunitinib), corticosteroids, erythropoietin and non-steroidal anti-inflammatory drugs with the development of hypertension. We also described the relationship between hypertension and carotid baroreceptor injury secondary to cervical radiotherapy. Morbidity and mortality increased in patients with cancer and hypertension without proper antihypertensive treatment. We concluded that there is need for early diagnosis, effective monitoring and treatment strategies for hypertension in cancer patients in order to reduce cardiovascular morbidity and mortality

  6. Vascular Remodeling in Experimental Hypertension

    Directory of Open Access Journals (Sweden)

    Norma R. Risler

    2005-01-01

    Full Text Available The basic hemodynamic abnormality in hypertension is an increased peripheral resistance that is due mainly to a decreased vascular lumen derived from structural changes in the small arteries wall, named (as a whole vascular remodeling. The vascular wall is an active, flexible, and integrated organ made up of cellular (endothelial cells, smooth muscle cells, adventitia cells, and fibroblasts and noncellular (extracellular matrix components, which in a dynamic way change shape or number, or reorganize in response to physiological and pathological stimuli, maintaining the integrity of the vessel wall in physiological conditions or participating in the vascular changes in cardiovascular diseases such as hypertension. Research focused on new signaling pathways and molecules that can participate in the mechanisms of vascular remodeling has provided evidence showing that vascular structure is not only affected by blood pressure, but also by mechanisms that are independent of the increased pressure. This review will provide an overview of the evidence, explaining some of the pathophysiologic mechanisms participating in the development of the vascular remodeling, in experimental models of hypertension, with special reference to the findings in spontaneously hypertensive rats as a model of essential hypertension, and in fructose-fed rats as a model of secondary hypertension, in the context of the metabolic syndrome. The understanding of the mechanisms producing the vascular alterations will allow the development of novel pharmacological tools for vascular protection in hypertensive disease.

  7. Does exercise pulmonary hypertension exist?

    Science.gov (United States)

    Lau, Edmund M; Chemla, Denis; Whyte, Kenneth; Kovacs, Gabor; Olschewski, Horst; Herve, Philippe

    2016-09-01

    The exercise definition of pulmonary hypertension using a mean pulmonary artery pressure threshold of greater than 30 mmHg was abandoned following the 4th World Pulmonary Hypertension Symposium in 2008, as this definition was not supported by evidence and healthy individuals frequently exceed this threshold. Meanwhile, the clinical value of exercise pulmonary hemodynamic testing has also been questioned. Recent data support the notion that an abnormal pulmonary hemodynamic response during exercise (or exercise pulmonary hypertension) is associated with symptoms and exercise limitation. Pathophysiologic mechanisms accounting for the development of exercise pulmonary hypertension include increased vascular resistance, excessive elevation in left atrial pressure and/or increased volume of trapped air during exercise, resulting in a steep rise in pulmonary artery pressure relative to cardiac output. Recent evidence suggests that exercise pulmonary hypertension may be defined by a mean pulmonary artery pressure surpassing 30 mmHg together with a simultaneous total pulmonary resistance exceeding 3 WU. Exercise pulmonary hypertension is a clinically relevant entity and an improved definition has been suggested based on new evidence. Exercise pulmonary hemodynamics may help unmask early or latent disease, particularly in populations that are at high risk for the development of pulmonary hypertension.

  8. Masked Uncontrolled Hypertension in CKD.

    Science.gov (United States)

    Agarwal, Rajiv; Pappas, Maria K; Sinha, Arjun D

    2016-03-01

    Masked uncontrolled hypertension (MUCH) is diagnosed in patients treated for hypertension who are normotensive in the clinic but hypertensive outside. In this study of 333 veterans with CKD, we prospectively evaluated the prevalence of MUCH as determined by ambulatory BP monitoring using three definitions of hypertension (daytime hypertension ≥135/85 mmHg; either nighttime hypertension ≥120/70 mmHg or daytime hypertension; and 24-hour hypertension ≥130/80 mmHg) or by home BP monitoring (hypertension ≥135/85 mmHg). The prevalence of MUCH was 26.7% by daytime ambulatory BP, 32.8% by 24-hour ambulatory BP, 56.1% by daytime or night-time ambulatory BP, and 50.8% by home BP. To assess the reproducibility of the diagnosis, we repeated these measurements after 4 weeks. Agreement in MUCH diagnosis by ambulatory BP was 75-78% (κ coefficient for agreement, 0.44-0.51), depending on the definition used. In contrast, home BP showed an agreement of only 63% and a κ coefficient of 0.25. Prevalence of MUCH increased with increasing clinic systolic BP: 2% in the 90-110 mmHg group, 17% in the 110-119 mmHg group, 34% in the 120-129 mmHg group, and 66% in the 130-139 mmHg group. Clinic BP was a good determinant of MUCH (receiver operating characteristic area under the curve 0.82; 95% confidence interval 0.76-0.87). In diagnosing MUCH, home BP was not different from clinic BP. In conclusion, among people with CKD, MUCH is common and reproducible, and should be suspected when clinic BP is in the prehypertensive range. Confirmation of MUCH diagnosis should rely on ambulatory BP monitoring. Copyright © 2016 by the American Society of Nephrology.

  9. Differential impact of diabetes mellitus type II and arterial hypertension on collateral artery growth and concomitant macrophage accumulation.

    Science.gov (United States)

    Ito, Wulf D; Lund, Natalie; Sager, Hendrik; Becker, Wiebke; Wenzel, Ulrich

    2015-01-01

    Diabetes mellitus type II and arterial hypertension are major risk factors for peripheral arterial disease and have been considered to reduce collateral growth (arteriogenesis). Collateral growth proceeds through different stages. Vascular proliferation and macrophage accumulation are hallmarks of early collateral growth. We here compare the impact of arterial hypertension and diabetes mellitus type II on collateral proliferation (Brdu incorporation) and macrophage accumulation (ED 2 staining) as well as collateral vessel function (collateral conductance) in a rat model of peripheral vascular disease (femoral artery occlusion), diabetes mellitus type II (Zucker fatty diabetic rats and Zucker lean rat controls) and arterial hypertension (induced via clip placement around the right renal arteriy). We furthermore tested the impact of monocyte chemoattractant protein-1 (MCP‑1) on collateral proliferation and macrophage accumulation in these models Diabetic animals showed reduced vascular proliferation and macrophage accumulation, which however did not translate into a change of collateral conductance. Hypertensive animals on the contrary had reduced collateral conductances without altered macrophage accumulation and only a marginal reduction in collateral proliferation. Infusion of MCP‑1 only enhanced vascular proliferation in diabetic animals. These findings illustrate that impaired monocyte/macrophage recruitment is responsible for reduced collateral growth under diabetic conditions but not in arterial hypertension suggesting that diabetes mellitus in particular affects early stages of collateral growth whereas hypertension has its impact on later remodeling stages. Successful pro-arteriogenic treatment strategies in a patient population that presents with diabetes mellitus and arterial hypertension need to address different stages of collateral growth and thus different molecular and cellular targets simultaneously.

  10. Elevated intracranial pressure and reversible eye-tracking changes detected while viewing a film clip.

    Science.gov (United States)

    Kolecki, Radek; Dammavalam, Vikalpa; Bin Zahid, Abdullah; Hubbard, Molly; Choudhry, Osamah; Reyes, Marleen; Han, ByoungJun; Wang, Tom; Papas, Paraskevi Vivian; Adem, Aylin; North, Emily; Gilbertson, David T; Kondziolka, Douglas; Huang, Jason H; Huang, Paul P; Samadani, Uzma

    2018-03-01

    OBJECTIVE The precise threshold differentiating normal and elevated intracranial pressure (ICP) is variable among individuals. In the context of several pathophysiological conditions, elevated ICP leads to abnormalities in global cerebral functioning and impacts the function of cranial nerves (CNs), either or both of which may contribute to ocular dysmotility. The purpose of this study was to assess the impact of elevated ICP on eye-tracking performed while patients were watching a short film clip. METHODS Awake patients requiring placement of an ICP monitor for clinical purposes underwent eye tracking while watching a 220-second continuously playing video moving around the perimeter of a viewing monitor. Pupil position was recorded at 500 Hz and metrics associated with each eye individually and both eyes together were calculated. Linear regression with generalized estimating equations was performed to test the association of eye-tracking metrics with changes in ICP. RESULTS Eye tracking was performed at ICP levels ranging from -3 to 30 mm Hg in 23 patients (12 women, 11 men, mean age 46.8 years) on 55 separate occasions. Eye-tracking measures correlating with CN function linearly decreased with increasing ICP (p short film clip. These results suggest that eye tracking may be used as a noninvasive, automatable means to quantitate the physiological impact of elevated ICP, which has clinical application for assessment of shunt malfunction, pseudotumor cerebri, concussion, and prevention of second-impact syndrome.

  11. Transcatheter treatment of severe tricuspid regurgitation with the MitraClip system.

    Science.gov (United States)

    Hammerstingl, Christoph; Schueler, Robert; Malasa, Margarita; Werner, Nikos; Nickenig, Georg

    2016-03-07

    The aim of this study was to show technical principles and feasibility of transcatheter tricuspid valve repair by use of the MitraClip system. Three consecutive patients were treated successfully for severe symptomatic Tricuspid regurgitation. Three-dimensional transoesophageal echocardiography confirmed reduction of measured effective regurgitant orifice in all patients [effective regurgitant orifice area-baseline/post-procedure (cm(2)): 0.7/0.3; 1.5/0.8; 0.4/0.1], which was accompanied by an increase in left ventricular stroke volumes [baseline/post-procedure (mL): 42.8/45.4; 38/45; 35.2/45], decrease of measured levels of N terminal pro brain natriuretic peptide (pg/mL: baseline/post-procedure: 548/440; 2526/1702; 1754/623), and significant relief of clinical symptoms for chronic right heart failure in all patients. Transcatheter tricuspid valve repair by use of interventional edge-to-edge repair with the MitraClip system was feasible, and safe in three consecutive patients. Reduction of tricuspid insufficiency associates with relief of clinical symptoms for right heart failure. This strategy seems a promising treatment option for patients at prohibitive surgical risk. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  12. [Surgical fixation of rib fractures with clips and titanium bars (STRATOS System). Preliminary experience].

    Science.gov (United States)

    Moreno De La Santa Barajas, Pablo; Polo Otero, María Dolores; Delgado Sánchez-Gracián, Carlos; Lozano Gómez, Manuel; Toscano Novella, Alberto; Calatayud Moscoso Del Prado, Julia; Leal Ruiloba, Sonsoles; Choren Durán, Maria L

    2010-09-01

    Rib fractures are very common in closed chest injuries. The majority of these patients suffer significant pain with movement and cough. The purpose of this study is to assess the usefulness of titanium rib bars and clips in stabilising rib fractures. Twenty-two patients with rib fractures were treated with open reduction and internal fixation between 2008 and 2009. Indications for treatment were defined as; 1) Patients with unstable chest (13 patients), 2) Patients with pain or instability due to rib fractures (6 patients), and 3) Significant traumatic deformities of the chest wall (3 patients). Age, traumatic mechanism, chest and associated injuries, surgical data, complications and follow-up were prospectively analysed. The surgical technique is described. The majority of patients were extubated immediately after surgery. All patients with pain or instability showed a subjective improvement or disappearance of pain after the surgery. Four patients had a wound infection which had to be drained. After 3 months, 55% of the patients had returned to work or normal life. The results in each group are described. Open reduction with internal fixation of rib fractures is a good alternative. The use of titanium rib bars and clips give good clinical results, are easy to apply and have few complications. Copyright © 2010 AEC. Published by Elsevier Espana. All rights reserved.

  13. Enhanced subcarrier-index modulation-based asymmetrically clipped optical OFDM using even subcarriers

    Science.gov (United States)

    Guan, Rui; Xu, Wei; Yang, Zhaohui; Huang, Nuo; Wang, Jin-Yuan; Chen, Ming

    2017-11-01

    In this paper, we propose a subcarrier-index modulation-based asymmetrically clipped optical orthogonal frequency division multiplexing (SACO-OFDM) scheme for optical wireless communication (OWC) systems, which benefits from the subcarrier-index modulation (SIM) and asymmetrically clipped optical orthogonal frequency division multiplexing (ACO-OFDM) techniques. SACO-OFDM conveys additional information via the subcarrier indexing, and the error rate of the bit transmitted by the subcarrier indexing is much lower than that of the conventional M-ary modulation scheme. On the other hand, as the signal constellation in M-ary modulation is relieved, SACO-OFDM has simple transceiver structure and low detection complexity. Moreover, considering the spectral, an enhanced SACO-OFDM (ESACO-OFDM) using even subcarriers is proposed. In this technique, the odd subcarriers are activated for SACO-OFDM, and the imaginary part of even subcarriers are activated for pulse-amplitude-modulated discrete multitone (PAM-DMT). Clearly, ESACO-OFDM achieves better spectral efficiency than the conventional optical OFDM, since all subcarriers are used for data transmission. Simulation results verify the significant bit error rate (BER) and peak-to-average power ratio (PAPR) improvement by the proposed ESACO-OFDM, especially for the medium-to-high signal-to-noise ratio (SNR) regime.

  14. Integration of object-oriented knowledge representation with the CLIPS rule based system

    Science.gov (United States)

    Logie, David S.; Kamil, Hasan

    1990-01-01

    The paper describes a portion of the work aimed at developing an integrated, knowledge based environment for the development of engineering-oriented applications. An Object Representation Language (ORL) was implemented in C++ which is used to build and modify an object-oriented knowledge base. The ORL was designed in such a way so as to be easily integrated with other representation schemes that could effectively reason with the object base. Specifically, the integration of the ORL with the rule based system C Language Production Systems (CLIPS), developed at the NASA Johnson Space Center, will be discussed. The object-oriented knowledge representation provides a natural means of representing problem data as a collection of related objects. Objects are comprised of descriptive properties and interrelationships. The object-oriented model promotes efficient handling of the problem data by allowing knowledge to be encapsulated in objects. Data is inherited through an object network via the relationship links. Together, the two schemes complement each other in that the object-oriented approach efficiently handles problem data while the rule based knowledge is used to simulate the reasoning process. Alone, the object based knowledge is little more than an object-oriented data storage scheme; however, the CLIPS inference engine adds the mechanism to directly and automatically reason with that knowledge. In this hybrid scheme, the expert system dynamically queries for data and can modify the object base with complete access to all the functionality of the ORL from rules.

  15. Evaluation of Clipping Based Iterative PAPR Reduction Techniques for FBMC Systems

    Directory of Open Access Journals (Sweden)

    Zsolt Kollár

    2014-01-01

    to conventional orthogonal frequency division multiplexing (OFDM technique. The low ACLR of the transmitted FBMC signal makes it especially favorable in cognitive radio applications, where strict requirements are posed on out-of-band radiation. Large dynamic range resulting in high peak-to-average power ratio (PAPR is characteristic of all sorts of multicarrier signals. The advantageous spectral properties of the high-PAPR FBMC signal are significantly degraded if nonlinearities are present in the transceiver chain. Spectral regrowth may appear, causing harmful interference in the neighboring frequency bands. This paper presents novel clipping based PAPR reduction techniques, evaluated and compared by simulations and measurements, with an emphasis on spectral aspects. The paper gives an overall comparison of PAPR reduction techniques, focusing on the reduction of the dynamic range of FBMC signals without increasing out-of-band radiation. An overview is presented on transmitter oriented techniques employing baseband clipping, which can maintain the system performance with a desired bit error rate (BER.

  16. Comparisons of spectrally-enhanced asymmetrically-clipped optical OFDM systems.

    Science.gov (United States)

    Lowery, Arthur James

    2016-02-22

    Asymmetrically clipped optical orthogonal frequency-division multiplexing (ACO-OFDM) is a technique that sacrifices spectral efficiency in order to transmit an orthogonally frequency-division multiplexed signal over a unipolar channel, such as a directly modulated direct-detection fiber or free-space channel. Several methods have been proposed to regain this spectral efficiency, including: asymmetrically clipped DC-biased optical OFDM (ADO-OFDM), enhanced U-OFDM (EU-OFDM), spectral and energy efficient OFDM (SEE-OFDM), Hybrid-ACO-OFDM and Layered-ACO-OFDM. This paper presents simulations up to high-order constellation sizes to show that Layered-ACO-OFDM offers the highest receiver sensitivity for a given optical power at spectral efficiencies above 3 bit/s/Hz. For comparison purposes, white Gaussian noise is added at the receiver, component nonlinearities are not considered, and the fiber is considered to be linear and dispersion-less. The simulations show that LACO-OFDM has a 7-dB sensitivity advantage over DC-biased OFDM (DCO-OFDM) for 1024-QAM at 87.5% of DCO-OFDM's spectral efficiency, at the same bit rate and optical power. This is approximately equivalent to a 4.4-dB advantage at the same spectral efficiency of 87.7% if 896-QAM were to be used for DCO-OFDM.

  17. First- and third-party ground truth for key frame extraction from consumer video clips

    Science.gov (United States)

    Costello, Kathleen; Luo, Jiebo

    2007-02-01

    Extracting key frames (KF) from video is of great interest in many applications, such as video summary, video organization, video compression, and prints from video. KF extraction is not a new problem. However, current literature has been focused mainly on sports or news video. In the consumer video space, the biggest challenges for key frame selection from consumer videos are the unconstrained content and lack of any preimposed structure. In this study, we conduct ground truth collection of key frames from video clips taken by digital cameras (as opposed to camcorders) using both first- and third-party judges. The goals of this study are: (1) to create a reference database of video clips reasonably representative of the consumer video space; (2) to identify associated key frames by which automated algorithms can be compared and judged for effectiveness; and (3) to uncover the criteria used by both first- and thirdparty human judges so these criteria can influence algorithm design. The findings from these ground truths will be discussed.

  18. pre-hypertension and hypertension in apparently healthy ...

    African Journals Online (AJOL)

    user

    hypertension among urban adolescents in Calabar, south eastern Nigeria. This was a ... disease later in life but also to significantly increase .... beam balance is not available (Paynter and ..... keeping with work done among Nigerian School.

  19. Ethical Dilemmas when Diagnosing Hypertension

    Directory of Open Access Journals (Sweden)

    Sandra Santana López

    2012-12-01

    Full Text Available A review on the ethical dilemmas in the diagnosis of hypertension and some elements in the emergence of the bioethics concept was performed. Ethical conflicts that appear at each stage of diagnosis of hypertension: at the time of providing the information, at the point of indication and performance of diagnostic tests, when communicating the diagnosis and during subsequent decision making were identified. We conclude that technological development will introduce new ethical decisions in the diagnosis of hypertension that will increasingly involve the interests of society and create, in one way or another, ethical and moral conflict in the decision making process.

  20. [Hypertension in women after menopause].

    Science.gov (United States)

    Beaufils, Michel

    2006-06-01

    Menopause coincides with an increase in the incidence of hypertension in women. A direct role of estrogen deprivation in this increased blood pressure remains a topic of debate. Menopause probably accelerates the arterial changes related to aging. Hormone replacement therapy does not influence blood pressure significantly and is not contraindicated in hypertensive women. The effect of hormone replacement treatment on cardiovascular risk was recently the object of controversy. It does not increase risk except in cases of late treatment in older women who already have atherosclerosis. Hypertension management in women is otherwise similar to management in men.

  1. Hypertension--forekomst og behandling

    DEFF Research Database (Denmark)

    Ibsen, Hans; Jørgensen, Torben; Jensen, Gorm B

    2009-01-01

    Hypertension is the most important modifiable risk factor for cardiovascular disease. However, less than half of all hypertensives have their blood pressure reduced to relevant goals. The prevalence of hypertension in Denmark was found to be between 26% and 40% of the adult population. Just over...... half were aware of the diagnosis, but less than half were in treatment. Blood pressure control in patients who are undergoing treatment has improved during recent years, but there is still a gap to achievable control rates. Udgivelsesdato: 2009-Jun-8...

  2. [The magnetotherapy of hypertension patients].

    Science.gov (United States)

    Ivanov, S G; Smirnov, V V; Solov'eva, F V; Liashevskaia, S P; Selezneva, L Iu

    1990-01-01

    A study was made of the influence of the constant MKM2-1 magnets on patients suffering from essential hypertension. Continuous action of the magnetic field, created by such magnets, on the patients with stage II essential hypertension was noted to result in a decrease of arterial pressure without the occurrence of any side effects and in a simultaneous reduction of the scope of drug administration. Apart from that fact, magnetotherapy was discovered to produce a beneficial effect on the central hemodynamics and microcirculation. The use of the MKM2-1 magnets may be regarded as a feasible method of the treatment of essential hypertension patients at any medical institution.

  3. Retrieval of Surgical Clip from Common Bile Duct by Endoscopic Retrograde Cholangiopancreatography: A Rare Complication of Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    Shahid Rasool

    2017-04-01

    Full Text Available Laparoscopic cholecystectomy has become the standard procedure for the surgical management of symptomatic cholelithiasis. Laparoscopic cholecystectomy is generally considered a safe procedure although a few complications such as major bleeding, wound infection, bile leakage, biliary and bowel injury are well known. We are reporting a case of a thirty-seven year old male who presented with abdominal pain, three weeks after laparoscopic cholecystectomy. Abdominal ultrasound revealed a filling defect in common bile duct with deranged liver function tests. With an impression of choledocholithiasis, his endoscopic retrograde cholangiopancreatography (ERCP was done which revealed a surgical clip impacted in the ampulla. The surgical clip was retrieved successfully by ERCP. Intraductal clip migration is a rarely encountered complication after laparoscopic cholecystectomy. Appropriate management requires timely identification and retrieval during ERCP.

  4. [Ligation of the retrobulbar vascular-nervous bunch during performance of evisceration and enucleation using titanic clips in ophthalmic surgery].

    Science.gov (United States)

    Rykov, S A; Torchinskaia, N V; Bakbardina, I I; Simchuk, I V

    2011-10-01

    The efficacy of hemostasis achievement during conduction of a retrobulbar vascular-nervous bunch ligation (RVNBL), using titanic clips while evisceroenucleation performance, was studied up. A comparative analysis of clinical and functional results of surgical treatment of 36 patients, suffering terminal dolorous glaucoma and disaster of a sympathetic ophthalmia complication after an eye penetrating wounding occurrence. In 16 patients (the first group) a standard method of a hemostasis achievement was used while doing evisceroenucleation - a deep orbital tamponade for 5 minutes. In 20 patients (the second group) a procedure of RVNBL was conducted, using titanic clips before the bunch transsection doing. There was established, that while doing a RVNPL using titanic clips, a hemorrhage never occurs, a retrobulbar hematoma do not formated, the soft tissues reaction in the early postoperative period is less pronounced, and the patients postoperative rehabilitation period shortens.

  5. Effect of mental challenge induced by movie clips on action potential duration in normal human subjects independent of heart rate.

    Science.gov (United States)

    Child, Nicholas; Hanson, Ben; Bishop, Martin; Rinaldi, Christopher A; Bostock, Julian; Western, David; Cooklin, Michael; O'Neil, Mark; Wright, Matthew; Razavi, Reza; Gill, Jaswinder; Taggart, Peter

    2014-06-01

    Mental stress and emotion have long been associated with ventricular arrhythmias and sudden death in animal models and humans. The effect of mental challenge on ventricular action potential duration (APD) in conscious healthy humans has not been reported. Activation recovery intervals measured from unipolar electrograms as a surrogate for APD (n=19) were recorded from right and left ventricular endocardium during steady-state pacing, whilst subjects watched an emotionally charged film clip. To assess the possible modulating role of altered respiration on APD, the subjects then repeated the same breathing pattern they had during the stress, but without the movie clip. Hemodynamic parameters (mean, systolic, and diastolic blood pressure, and rate of pressure increase) and respiration rate increased during the stressful part of the film clip (P=0.001). APD decreased during the stressful parts of the film clip, for example, for global right ventricular activation recovery interval at end of film clip 193.8 ms (SD, 14) versus 198.0 ms (SD, 13) during the matched breathing control (end film left ventricle 199.8 ms [SD, 16] versus control 201.6 ms [SD, 15]; P=0.004). Respiration rate increased during the stressful part of the film clip (by 2 breaths per minute) and was well matched in the respective control period without any hemodynamic or activation recovery interval changes. Our results document for the first time direct recordings of the effect of a mental challenge protocol on ventricular APD in conscious humans. The effect of mental challenge on APD was not secondary to emotionally induced altered respiration or heart rate. © 2014 American Heart Association, Inc.

  6. SU-E-J-64: Feasibility Study of Surgical Clips for Fiducial Tracking in CyberKnife System

    International Nuclear Information System (INIS)

    Lee, H; Yoon, J; Lee, E; Cho, S; Park, K; Choi, W; Baek, J; Keum, K; Koom, W

    2015-01-01

    Purpose: To investigate the ability of CyberKnife to track surgical clips used as fiducial markers. Methods: The Octavius 1000SRS detector and solid water (RW3) slab phantom were used with motion platform to evaluate the study. The RW3 slab phantom was set up to measure the dose distribution from coronal plane. It consists of 9 plates and the thickness of each plate is 10mm. Among them, one plate was attached with 3 surgical clips, which are orthogonally positioned on outer region of array. The length of attached clip was represented as 1cm on planning CT. The clip plate was placed on the 1000SRS detector and 3 slabs were stacked up on the plate to build the measuring depth. Below the detector, 5 slabs were set. The two-axis motion platform was programmed with 1D sinusoidal movement (20mm peak-to-peak, 3s period) toward superior/inferior and left/right directions to simulate target motion. During delivery, two clips were extracted by two X-ray imagers, which led to translational error correction only. Synchrony was also used for dynamic tracking. After the irradiation, the measured dose distribution of coronal plane was compared with the planar dose distribution calculated by the CyberKnife treatment planning system (Multiplan) for cross verification. The results were assessed by comparing the absolute Gamma (γ) index. Results: The dose distributions measured by the 1000SRS detector were in good agreements with those calculated by Multiplan. In the dosimetric comparison using γ-function criteria based on the distance-to-agreement of 3mm and the local dose difference of 3%, the passing rate with γ- parameter ≤1 was 91% in coronal plane. Conclusion: The surgical clips can be considered as new fiducials for robotic radiosurgery delivery by considering the target margin with less than 5mm

  7. Definition and classification of pulmonary hypertension.

    Science.gov (United States)

    Humbert, Marc; Montani, David; Evgenov, Oleg V; Simonneau, Gérald

    2013-01-01

    Pulmonary hypertension is defined as an increase of mean pulmonary arterial pressure ≥25 mmHg at rest as assessed by right heart catheterization. According to different combinations of values of pulmonary wedge pressure, pulmonary vascular resistance and cardiac output, a hemodynamic classification of pulmonary hypertension has been proposed. Of major importance is the pulmonary wedge pressure which allows to distinguish pre-capillary (pulmonary wedge pressure ≤15 mmHg) and post-capillary (pulmonary wedge pressure >15 mmHg) pulmonary hypertension. Pre-capillary pulmonary hypertension includes the clinical groups 1 (pulmonary arterial hypertension), 3 (pulmonary hypertension due to lung diseases and/or hypoxia), 4 (chronic thrombo-embolic pulmonary hypertension) and 5 (pulmonary hypertension with unclear and/or multifactorial mechanisms). Post-capillary pulmonary hypertension corresponds to the clinical group 2 (pulmonary hypertension due to left heart diseases).

  8. [Diagnostic of secondary hypertension in clinical practice].

    Science.gov (United States)

    Somlóová, Z; Rosa, J; Petrák, O; Strauch, B; Zelinka, T; Holaj, R; Widimský, J

    2011-09-01

    Arterial hypertension is a common worldwide disease with a prevalence of approximately 26%. Secondary cause is known in 5-10% of patients with hypertension. We should think of secondary hypertension in all patients with resistant hypertension, in patients with sudden deterioration in the control of hypertension and in patients with laboratory and clinical signs of diseases associated with secondary hypertension. It is important to distinguish between secondary hypertension and pseudo-resistance (noncompliance to treatment, white coat syndrome). Secondary causes of hypertension can be divided into endocrine (primary aldosteronism, pheochromocytoma, hypercortisolism, hyperparathyreoidism), renal - renovascular and renal parenchymal hypertension, and other causes as sleep apnoe syndrome, hypertension in pregnancy, coarctation of the aorta and intracranial tumors.

  9. The source parameters of 2013 Mw6.6 Lushan earthquake constrained with the restored local clipped seismic waveforms

    Science.gov (United States)

    Hao, J.; Zhang, J. H.; Yao, Z. X.

    2017-12-01

    We developed a method to restore the clipped seismic waveforms near epicenter using projection onto convex sets method (Zhang et al, 2016). This method was applied to rescue the local clipped waveforms of 2013 Mw 6.6 Lushan earthquake. We restored 88 out of 93 clipped waveforms of 38 broadband seismic stations of China Earthquake Networks (CEN). The epicenter distance of the nearest station to the epicenter that we can faithfully restore is only about 32 km. In order to investigate if the source parameters of earthquake could be determined exactly with the restored data, restored waveforms are utilized to get the mechanism of Lushan earthquake. We apply the generalized reflection-transmission coefficient matrix method to calculate the synthetic seismic records and simulated annealing method in inversion (Yao and Harkrider, 1983; Hao et al., 2012). We select 5 stations of CEN with the epicenter distance about 200km whose records aren't clipped and three-component velocity records are used. The result shows the strike, dip and rake angles of Lushan earthquake are 200o, 51o and 87o respectively, hereinafter "standard result". Then the clipped and restored seismic waveforms are applied respectively. The strike, dip and rake angles of clipped seismic waveforms are 184o, 53o and 72o respectively. The largest misfit of angle is 16o. In contrast, the strike, dip and rake angles of restored seismic waveforms are 198o, 51o and 87o respectively. It is very close to the "standard result". We also study the rupture history of Lushan earthquake constrained with the restored local broadband and teleseismic waves based on finite fault method (Hao et al., 2013). The result consists with that constrained with the strong motion and teleseismic waves (Hao et al., 2013), especially the location of the patch with larger slip. In real-time seismology, determining the source parameters as soon as possible is important. This method will help us to determine the mechanism of earthquake

  10. Definition and classification of hypertension: an update.

    Science.gov (United States)

    Giles, Thomas D; Materson, Barry J; Cohn, Jay N; Kostis, John B

    2009-11-01

    Since the publication of a paper by the American Society of Hypertension, Inc. Writing Group in 2003, some refinements have occurred in the definition of hypertension. Blood pressure is now recognized as a biomarker for hypertension, and a distinction is made between the various stages of hypertension and global cardiovascular risk. This paper discusses the logic underlying the refinements in the definition of hypertension. 2009 Wiley Periodical, Inc.

  11. Biomarkers in white-coat hypertension

    OpenAIRE

    Martin, Catherine Ann

    2017-01-01

    The introduction of ambulatory blood pressure monitoring in the 1960s provided new insights into the nature of high blood pressure disorders. Blood pressure is now categorised into four quadrants:normotension, masked hypertension, hypertension and white-coat hypertension. In white-coat hypertension blood pressure is elevated when taken at the doctor’s office but normal if taken outside the doctor’s office. Several controversies are associated with white-coat hypertension, which are discuss...

  12. Sex differences in primary hypertension

    Science.gov (United States)

    2012-01-01

    Men have higher blood pressure than women through much of life regardless of race and ethnicity. This is a robust and highly conserved sex difference that it is also observed across species including dogs, rats, mice and chickens and it is found in induced, genetic and transgenic animal models of hypertension. Not only do the differences between the ovarian and testicular hormonal milieu contribute to this sexual dimorphism in blood pressure, the sex chromosomes also play a role in and of themselves. This review primarily focuses on epidemiological studies of blood pressure in men and women and experimental models of hypertension in both sexes. Gaps in current knowledge regarding what underlie male-female differences in blood pressure control are discussed. Elucidating the mechanisms underlying sex differences in hypertension may lead to the development of anti-hypertensives tailored to one's sex and ultimately to improved therapeutic strategies for treating this disease and preventing its devastating consequences. PMID:22417477

  13. Intracranial Hypertension: Medication and Surgery

    Science.gov (United States)

    ... fallen out of favor, unless there is a secondary inflammatory process caused by an underlying disease like ... have little effect on headaches caused by intracranial hypertension, they may temporarily affect the intensity of a ...

  14. Hypertension presenting early in pregnancy

    OpenAIRE

    Melvin, Audrey; Kinsley, Brendan

    2015-01-01

    Key Clinical Message Paraganglioma in pregnancy is an exceedingly rare and potentially life?threatening diagnosis. It is important that the clinicians consider secondary causes when women present with hypertension in early pregnancy.

  15. Liver Disease and Pulmonary Hypertension

    Science.gov (United States)

    Facebook Twitter Instagram YouTube About PHA Contact Join Careers Store My Account Donate Patients About PH Diagnosis Treatments Newly ... areas © 2017 Pulmonary Hypertension Association. All Rights Reserved. Facebook Twitter Instagram YouTube

  16. Liver Hypertension: Treatment in Infancy !

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Liver Hypertension: Treatment in Infancy ! Liver Disease > Heart. No good non-invasive method. Repeated measurements problematic. Drug efficacy 50% at best. No predictors of response. We Need YOU !!

  17. [Menopause: Hypertension and vascular disease].

    Science.gov (United States)

    Zilberman, J M

    Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Does the placement of surgical clips within the excision cavity influence local control for patients treated with breast conserving surgery and irradiation?

    Energy Technology Data Exchange (ETDEWEB)

    Fein, Douglas A; Fowble, Barbara L; Hanlon, Alexandra L; Hoffman, John P; Sigurdson, Elin R; Eisenberg, Burton L

    1995-07-01

    PURPOSE: A number of authors have demonstrated the importance of using surgical clips to define the tumor bed in the treatment planning of early stage breast cancer. The clips have been useful in delineating the borders of the tangential fields especially for very medial and very lateral lesions as well as the boost volume. If surgical clips better define the tumor bed then a reduction in true or marginal recurrences should be appreciated. We sought to compare the incidence of breast recurrence in women with and without surgical clips controlling for other recognized prognostic factors. METHODS AND MATERIALS: Between 1980 and 1992, 1364 women with clinical Stage I or II invasive breast cancer underwent excisional biopsy, axillary dissection, and definitive irradiation. Median follow-up was 60 months. Median age was 55 years. Seventy-one percent of patients were path N0, 22% had 1-3 nodes and 7% had {>=} 4 nodes. Sixty-one percent were ER positive and 49% PR positive. Margin status was negative in 62%, positive in 10%, close in 9%, and unknown in 19%. Fifty-seven percent of women underwent a reexcision. Adjuvant chemotherapy {+-} tamoxifen was administered in 29%, and tamoxifen alone in 17%. Surgical clips were placed in the excision cavity in 556 patients while the other 808 did not have clips placed. All patients had a boost to the tumor bed. Patients had their boost planned with CT scanning or stereo shift radiographs. No significant differences between the 2 groups were noted for median age, T stage, nodal status, race, ER/PR receptor status, region irradiated, or tumor location. Patients without clips had negative margins less often, a higher rate of unknown or positive margins and more often received no adjuvant therapy compared to patients with surgical clips. RESULTS: Twenty-three and 27 patients with and without surgical clips, respectively developed a true or marginal recurrence in the treated breast. The actuarial probability of a breast recurrence was 2

  19. Does the placement of surgical clips within the excision cavity influence local control for patients treated with breast conserving surgery and irradiation?

    International Nuclear Information System (INIS)

    Fein, Douglas A.; Fowble, Barbara L.; Hanlon, Alexandra L.; Hoffman, John P.; Sigurdson, Elin R.; Eisenberg, Burton L.

    1995-01-01

    PURPOSE: A number of authors have demonstrated the importance of using surgical clips to define the tumor bed in the treatment planning of early stage breast cancer. The clips have been useful in delineating the borders of the tangential fields especially for very medial and very lateral lesions as well as the boost volume. If surgical clips better define the tumor bed then a reduction in true or marginal recurrences should be appreciated. We sought to compare the incidence of breast recurrence in women with and without surgical clips controlling for other recognized prognostic factors. METHODS AND MATERIALS: Between 1980 and 1992, 1364 women with clinical Stage I or II invasive breast cancer underwent excisional biopsy, axillary dissection, and definitive irradiation. Median follow-up was 60 months. Median age was 55 years. Seventy-one percent of patients were path N0, 22% had 1-3 nodes and 7% had ≥ 4 nodes. Sixty-one percent were ER positive and 49% PR positive. Margin status was negative in 62%, positive in 10%, close in 9%, and unknown in 19%. Fifty-seven percent of women underwent a reexcision. Adjuvant chemotherapy ± tamoxifen was administered in 29%, and tamoxifen alone in 17%. Surgical clips were placed in the excision cavity in 556 patients while the other 808 did not have clips placed. All patients had a boost to the tumor bed. Patients had their boost planned with CT scanning or stereo shift radiographs. No significant differences between the 2 groups were noted for median age, T stage, nodal status, race, ER/PR receptor status, region irradiated, or tumor location. Patients without clips had negative margins less often, a higher rate of unknown or positive margins and more often received no adjuvant therapy compared to patients with surgical clips. RESULTS: Twenty-three and 27 patients with and without surgical clips, respectively developed a true or marginal recurrence in the treated breast. The actuarial probability of a breast recurrence was 2% at

  20. Does the placement of surgical clips within the excision cavity influence local control for patients treated with breast-conserving surgery and irradiation?

    International Nuclear Information System (INIS)

    Fein, Douglas A.; Fowble, Barbara L.; Hanlon, Alexandra L.; Hoffman, John P.; Sigurdson, Elin R.; Eisenberg, Burton L.

    1996-01-01

    Purpose: A number of authors have demonstrated the importance of using surgical clips to define the tumor bed in the treatment planning of early-stage breast cancer. The clips have been useful in delineating the borders of the tangential fields, especially for very medial and very lateral lesions as well as the boost volume. If surgical clips better define the tumor bed, then a reduction in true or marginal recurrences should be appreciated. We sought to compare the incidence of breast recurrence in women with and without surgical clips, controlling for other recognized prognostic factors. Methods and Materials: Between 1980 and 1992, 1364 women with clinical Stage I or II invasive breast cancer underwent excisional biopsy, axillary dissection, and definitive irradiation. Median follow-up was 60 months. Median age was 55 years. Seventy-one percent of patients were path N0, 22% had one to three nodes, and 7% had > four nodes. Sixty-one percent were ER positive and 49% PR positive. Margin status was negative in 62%, positive in 10%, close in 9%, and unknown in 19%. Fifty-seven percent of women underwent a reexcision. Adjuvant chemotherapy + tamoxifen was administered in 29%, and tamoxifen alone in 17%. Surgical clips were placed in the excision cavity in 556 patients, while the other 808 did not have clips placed. All patients had a boost to the tumor bed. Patients had their boost planned with CT scanning or stereo shift radiographs. No significant differences between the two groups were noted for median age, T stage, nodal status, race, ER/PR receptor status, region irradiated, or tumor location. Patients without clips had negative margins less often, a higher rate of unknown or positive margins and more often received no adjuvant therapy compared to patients with surgical clips. Results: Twenty-five and 27 patients with and without surgical clips, respectively, developed a true or marginal recurrence in the treated breast. The actuarial probability of a breast