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Sample records for collateral branches preliminary

  1. It takes a village to raise a branch: Cellular mechanisms of the initiation of axon collateral branches.

    Science.gov (United States)

    Armijo-Weingart, Lorena; Gallo, Gianluca

    2017-10-01

    The formation of axon collateral branches from the pre-existing shafts of axons is an important aspect of neurodevelopment and the response of the nervous system to injury. This article provides an overview of the role of the cytoskeleton and signaling mechanisms in the formation of axon collateral branches. Both the actin filament and microtubule components of the cytoskeleton are required for the formation of axon branches. Recent work has begun to shed light on how these two elements of the cytoskeleton are integrated by proteins that functionally or physically link the cytoskeleton. While a number of signaling pathways have been determined as having a role in the formation of axon branches, the complexity of the downstream mechanisms and links to specific signaling pathways remain to be fully determined. The regulation of intra-axonal protein synthesis and organelle function are also emerging as components of signal-induced axon branching. Although much has been learned in the last couple of decades about the mechanistic basis of axon branching we can look forward to continue elucidating this complex biological phenomenon with the aim of understanding how multiple signaling pathways, cytoskeletal regulators and organelles are coordinated locally along the axon to give rise to a branch. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Preliminary (Collateral Question in the International Private Law: Concept and Legal Nature

    Directory of Open Access Journals (Sweden)

    Victoria A. Kosovskaya

    2016-03-01

    Full Text Available One of the most difficult problems of application of conflict-of-laws rules in the international private law is the problem of statement and permission of a preliminary (collateral question. This results from the fact that in the scientific doctrine there was no uniform understanding of the legal nature and ways of permission of a preliminary question, and lack of his fixing at the legislative level. In article the concept of a preliminary (collateral question as legal treatment of the actual circumstances accompanying consideration of the main legal relationship reveals and also examples of those actions which need to be executed before definition of applicable law to the main legal relationship or in the course of its application are given. Permission of a preliminary question is necessary for the correct and complete idea of all actual facts of the case arising by consideration of the civil dispute complicated by a foreign element. The author reveals possible solutions of various options of a preliminary (collateral question, in particular, by means of use of the right of the country of court (lex fori, the right of the country with which legal relationship in general (lex causae, and also the legal procedure of the national right is connected.

  3. Variations of the origin of collateral branches emerging from the posterior aspect of the brachial plexus

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    Ramirez Luis

    2007-06-01

    Full Text Available Abstract Background The frequency of variation found in the arrangement and distribution of the branches in the brachial plexus, make this anatomical region extremely complicated. The medical concerns involved with these variations include anesthetic blocks, surgical approaches, interpreting tumor or traumatic nervous compressions having unexplained clinical symptoms (sensory loss, pain, wakefulness and paresis, and the possibility of these structures becoming compromised. The clinical importance of these variations is discussed in the light of their differential origins. Methods The anatomy of brachial plexus structures from 46 male and 11 female cadaverous specimens were studied. The 40–80 year-old specimens were obtained from the Universidad Industrial de Santander's Medical Faculty's Anatomy Department (dissection laboratory. Parametric measures were used for calculating results. Results Almost half (47.1% of the evaluated plexuses had collateral variations. Subscapular nerves were the most varied structure, including the presence of a novel accessory nerve. Long thoracic nerve variations were present, as were the absence of C5 or C7 involvement, and late C7 union with C5–C6. Conclusion Further studies are needed to confirm the existence of these variations in a larger sample of cadaver specimens.

  4. Visualization of Periventricular Collaterals in Moyamoya Disease with Flow-sensitive Black-blood Magnetic Resonance Angiography: Preliminary Experience

    Science.gov (United States)

    FUNAKI, Takeshi; FUSHIMI, Yasutaka; TAKAHASHI, Jun C.; TAKAGI, Yasushi; ARAKI, Yoshio; YOSHIDA, Kazumichi; KIKUCHI, Takayuki; MIYAMOTO, Susumu

    2015-01-01

    Fragile abnormal collaterals in moyamoya disease, known as “moyamoya vessels,” have rarely been defined. While flow-sensitive black-blood magnetic resonance angiography (FSBB-MRA) is a promising technique for visualizing perforating arteries, as of this writing no other reports exist regarding its application to moyamoya disease. Six adults with moyamoya disease underwent FSBB-MRA. It depicted abnormal collaterals as extended lenticulostriate, thalamic perforating, or choroidal arteries, which were all connected to the medullary or insular artery in the periventricular area and supplied the cortex. This preliminary case series illustrates the potential for FSBB-MRA to reveal abnormal moyamoya vessels, which could be reasonably defined as periventricular collaterals. PMID:25739429

  5. Comparative analysis of the development of collateral vessels in macular edema due to branch retinal vein occlusion following grid laser or ranibizumab treatment

    Directory of Open Access Journals (Sweden)

    Kokolaki AE

    2015-09-01

    Full Text Available Afroditi Eleni Kokolaki, Ilias Georgalas, Chryssanthi Koutsandrea, Athanasios Kotsolis, Maria Niskopoulou, Ioannis LadasDepartment of Ophthalmology, University of Athens, Athens, Greece Purpose: To evaluate the differences in the development of collateral vessels in patients with macular edema due to branch retinal vein occlusion (BRVO after treatment with either grid laser or ranibizumab (RNB.Methods: Comparative study including patients with macular edema due to acute BRVO and best-corrected visual acuity (BCVA between 20/40 and 20/200. The sample was divided into two groups according to the treatment applied: laser group, including eyes treated with Argon laser when retinal hemorrhages were sufficiently absorbed to perform the treatment, and RNB group,  including patients treated initially with one monthly intravitreal injection for a period of 3 months of RNB and more injections according to need thereafter.. Before treatment patients in both groups, received a complete ophthalmic examination, including BCVA, fundus examination, optical coherence tomography, fundus color photography, and fundus fluorescein angiography (FA. This same protocol of examination was repeated in every visit after treatment, except FA that was only repeated every 3 months. The detection of the collateral vessels was done by two experienced examiners based on the analysis of the early phase of the FA. If there was a discrepancy in their judgment, the criterion of a third examiner evaluating the FA was considered.Results: Mean baseline BCVA was 0.86±0.26 and 0.82±0.25 (logMAR [logarithm of the minimum angle of resolution] in the RNB and laser groups, respectively (P=0.83. At the end of the follow-up, mean BCVA was 0.38±0.18 and 0.64±0.33 (logMAR in the RNB and laser groups, respectively. The difference in the final BCVA between both groups was statistically significant (P=0.002. Collaterals developed in both groups; 66.67% of patients (14 out of 21

  6. Lateral collateral ligament (image)

    Science.gov (United States)

    The lateral collateral ligament connects the end of the femur (thigh) to the top of the fibula (the thin bone that runs next to the shin bone). The lateral collateral ligament provides stability against varus stress. Varus stress is ...

  7. Pathophysiology of Coronary Collaterals#

    Science.gov (United States)

    Stoller, Michael; Seiler, Christian

    2014-01-01

    While the existence of structural adaptation of coronary anastomoses is undisputed, the potential of coronary collaterals to be capable of functional adaptation has been questioned. For many years, collateral vessels were thought to be rigid tubes allowing only limited blood flow governed by the pressure gradient across them. This concept was consistent with the notion that although collaterals could provide adequate blood flow to maintain resting levels, they would be unable to increase blood flow sufficiently in situations of increased myocardial oxygen demand. However, more recent studies have demonstrated the capability of the collateral circulation to deliver sufficient blood flow even during exertion or pharmacologic stress. Moreover, it has been shown that increases in collateral flow could be attributed directly to collateral vasomotion. This review summarizes the pathophysiology of the coronary collateral circulation, ie the functional adapation of coronary collaterals to acute alterations in the coronary circulation. PMID:23701025

  8. Loan collaterals and collateral substitutes in rural finance: a review ...

    African Journals Online (AJOL)

    The limited availability of conventional collaterals in rural financial markets has led to the acceptance of non-traditional methods of loan security referred to as collateral substitutes. This paper reviews loan collaterals and collateral substitutes in the rural financial markets of developing countries. Keywords:: Collaterals ...

  9. A QUANTITATIVE METHOD FOR ANALYSING 3-D BRANCHING IN EMBRYONIC KIDNEYS: DEVELOPMENT OF A TECHNIQUE AND PRELIMINARY DATA

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    Gabriel Fricout

    2011-05-01

    Full Text Available The normal human adult kidney contains between 300,000 and 1 million nephrons (the functional units of the kidney. Nephrons develop at the tips of the branching ureteric duct, and therefore ureteric duct branching morphogenesis is critical for normal kidney development. Current methods for analysing ureteric branching are mostly qualitative and those quantitative methods that do exist do not account for the 3- dimensional (3D shape of the ureteric "tree". We have developed a method for measuring the total length of the ureteric tree in 3D. This method is described and preliminary data are presented. The algorithm allows for performing a semi-automatic segmentation of a set of grey level confocal images and an automatic skeletonisation of the resulting binary object. Measurements of length are automatically obtained, and numbers of branch points are manually counted. The final representation can be reconstructed by means of 3D volume rendering software, providing a fully rotating 3D perspective of the skeletonised tree, making it possible to identify and accurately measure branch lengths. Preliminary data shows the total length estimates obtained with the technique to be highly reproducible. Repeat estimates of total tree length vary by just 1-2%. We will now use this technique to further define the growth of the ureteric tree in vitro, under both normal culture conditions, and in the presence of various levels of specific molecules suspected of regulating ureteric growth. The data obtained will provide fundamental information on the development of renal architecture, as well as the regulation of nephron number.

  10. Collateral Intimate Partner Homicide

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    Emily Meyer

    2013-04-01

    Full Text Available Collateral intimate partner homicide (CIPH is an underinvestigated genre of intimate partner violence (IPV where an individual(s connected to the IPV victim is murdered. We conducted a content analysis of a statewide database of CIPH newspaper articles (1990-2007. Out of 111 collateral murder victims, there were 84 IPV female focal victims and 84 male perpetrators. The most frequently reported CIPH decedent was the focal victim’s new partner (30%; 45% of focal victims were themselves killed. News reports framed CIPH as the unexpected result of interpersonal conflict, despite evidence of a systematic pattern of coercion and violence that capitulated in murder.

  11. [Senile dementia: differentiation of syndromes according to meridians based on the theory of "cerebral collaterals injury by toxin"].

    Science.gov (United States)

    Zhou, Li; Zhang, Yun-Ling; Hou, Xiao-Bing; Hu, Hui

    2012-11-01

    The pathogenesis and treatments based on meridian differentiation of senile dementia are discussed through analyses and researches on the theory of "cerebral collaterals injury by toxins" and "collateral diseases". The symptoms of "Cerebral collaterals injury by toxins" are preliminary characterized by toxins and blood stasis occluding brain collaterals. "Cerebral collateral injury by toxins" and "Governor Vessel occlusion by blood stasis" are taken as the major pathogeneses of senile dementia. And the treatment should be focused on clearing the collaterals. Clearance acting as reinforcing as well as to clear and modify the Governor Vessel are taken as crucial sections in the treatment of senile dementia based on meridian differentiation. It is also the application of acupuncture-moxibustion intervention in senile dementia based on the theory of "cerebral collateral injury by toxins", which expands the application of the theory concerning "collateral diseases" in disease prevention and treatment with acupuncture-moxibustion.

  12. Thumb ulnar collateral and radial collateral ligament injuries.

    Science.gov (United States)

    Schroeder, Nicole S; Goldfarb, Charles A

    2015-01-01

    Thumb metacarpophalangeal ulnar and radial collateral ligament injuries occur frequently in the competitive athlete. Collateral ligament integrity is essential to joint stability, pinch strength, and pain-free motion. Acute rupture of the ulnar collateral ligament is due to a sudden radial deviation force on the abducted thumb and is referred to as skier's thumb. An ulnar-directed force causes injury to the radial collateral ligament. The degree of joint instability on clinical examination allows classification of these injuries and guides management. Surgical repair of acute, complete tears results in good outcomes and allows for return to sporting activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Preliminary Experience with the GORE(®) EXCLUDER(®) Iliac Branch Endoprosthesis for Common Iliac Aneurysm Endovascular Treatment.

    Science.gov (United States)

    Millon, Antoine; Della Schiava, Nellie; Arsicot, Matthieu; De Lambert, Alberic; Feugier, Patrick; Magne, Jean Luc; Lermusiaux, Patrick

    2016-05-01

    The aim of this study is to assess the safety and the short-term results of endovascular treatment of common iliac artery (CIA) aneurysms using the new GORE EXCLUDER iliac branch endoprosthesis (IBE) device. The study is a retrospective with prospective follow-up nonrandomized, single-arm evaluation. Patients with a CIA aneurysm (diameter >30 mm) extending to the iliac bifurcation underwent endovascular treatment with the Gore IBE. Anatomic and procedural data were collected. Computed tomography angiography (CTA) was performed within the 30 days after the procedure and every 6 month. Thirty-day and at least 6-months outcomes were investigated. From February 2014 to December 2014, 10 male patients with aneurysmal CIA (mean age 75 years old) underwent consecutive endovascular treatment with the Gore IBE. The CIA aneurysm (mean diameter 43.2 mm, range 32-49) treated with the Gore IBE was associated with an abdominal aortic aneurysm (AAA) in 5 patients. One patient had a previous AAA open repair. CIA aneurysm was bilateral in 5 patients. Preliminary procedure of internal iliac artery embolization was performed in 3 patients. Technical success rate of the Gore IBE implantation was 100% with a median fluoroscopy time of 35 min (range 12-64, ±16) and median contrast load of 150 mL (range 100-250, ±45). No perioperative complications were observed. Median length of stay was 4 days (range 3-7, ±2). One aortic type Ia endoleak was observed on the postoperative CT scan requiring an aortic extension at day 3. Branch patency was observed in all 10 patients at 1 month and 9 patients at 6 month. All CIA aneurysms were excluded without type Ib or type III endoleak. The technical success and short-term results demonstrate encouraging results and clinical benefits of the new GORE EXCLUDER IBE. A longer follow-up is needed to assess midterm and long-term results. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Collateralized debt obligations (CDOs

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    Dragosavac Miloš

    2012-01-01

    Full Text Available Collateralized debt obligations (CDOs were issued in 1987 by bankers at Drexel Burnham Lambert Inc. A decade later, CDOs became the leading power on the credit derivative markets, on which the value of derivative assets was derived from the value of other assets. However, unlike options and credit swamps, CDOs are not real, which means that they are constructed, and sometimes even the construction of their construction. CDOs were made to satisfy different types of investors, at one end, there is low-risk with low-income, and at the other, high-risk with high-income. By 2007, following the bubble burst on the US real estate market, losses on the CDO market started to expand. By 2008, the crisis on the CDO market turned into what we call today 'the global financial crisis.' CDOs are 'in the heart' of the crisis, and even wider. Our attempt is to reveal the mechanism of collateralized debt obligations (CDOs and the way in which CDOs expanded the negative effects of the present global financial crisis.

  15. Demonstrating the fibular collateral ligament.

    OpenAIRE

    Pridmore, S A

    1980-01-01

    A posture is described which allows palpation of the fibular collateral ligament of the knee as an isolated structure. Visual identification is also possible. This is of interest to the clinician and student of surface anatomy.

  16. Torn lateral collateral ligament (image)

    Science.gov (United States)

    ... LCL), is an injury to the lateral collateral ligament, a ligament extending from the top-outside surface of the ... the bottom-outside surface of the femur. The ligament prevents the knee joint from side-to-side ( ...

  17. Torn medial collateral ligament (image)

    Science.gov (United States)

    ... MCL), is an injury to the medial collateral ligament. This ligament extends from the upper-inside surface of the ... the bottom-inside surface of the femur. The ligament prevents the knee joint from medial instability, that ...

  18. A novel method for selectively labelling olivocochlear collaterals in the rat.

    Science.gov (United States)

    Baashar, Ahmaed; Robertson, Donald; Mulders, Wilhelmina H A M

    2015-07-01

    Axons of olivocochlear neurons originate from the brainstem and project to the cochlea. A subpopulation, medial olivocochlear (MOC) neurons, also projects collateral branches to the cochlear nucleus. The precise targets of these collaterals are as yet unknown. Previous methods for labelling these collaterals include firstly, cochlear injections of retrograde tracers, but this is technically demanding and can also label afferent projections or secondly, labelling by injecting tracers into the nuclei of origin of MOC neurons. However, this latter method is non-specific because it also labels non-MOC projections. A technique was used to specifically label MOC collaterals, which involved injections of the tracer biocytin at the floor of the fourth ventricle and fixation 3 hours later. Biocytin injections resulted in labelled neurons in the ventral nucleus of the trapezoid body and rostral periolivary nucleus, confirming MOC axonal labelling. Labelled neurons in dorsal cochlear nucleus indicated labelling of the dorsal acoustic stria and these injections were discarded. After selective MOC labelling, collateral branches were found to innervate granule cell regions, medial edge and core of the ventral cochlear nucleus, as well as the dorsal cochlear nucleus, in agreement with previous data. Therefore we conclude that injections at the floor of the fourth ventricle provide a simple, rapid and specific technique for labelling the majority of MOC axons and their collaterals and this technique may assist in defining the precise neuronal targets of olivocochlear collaterals in cochlear nucleus. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Dynamics of the Collateral Encyclopedia

    DEFF Research Database (Denmark)

    Thellefsen, Torkild Leo; Sørensen, Bent; Thellefsen, Martin Muderspach

    2015-01-01

    Both Umberto Eco and Charles S. Peirce have been concerned with the notion of background knowledge. Eco refers to background knowledge as the encyclopedia; Peirce’s term of reference is collateral experience. The aim of this article is to investigate the degree to which these two concepts...... are comparable. We focus on one major metaphysical issue, viz. the fact that Eco defines collateral experience, which is the first step in any process of cognition, as private, whereas Peirce, as a realist, would never accept the concept of private thoughts, feelings, etc. We suggest that freeing collateral...... experience from its nominalistic nomenclature makes possible a comparison and synthesis of Eco’s and Peirce’s conceptions when seen from the perspectives of their cognitive type, nuclear type, and molar content....

  20. Sovereign collateral as a Trojan Horse

    DEFF Research Database (Denmark)

    Buschmann, Christian; Schmaltz, Christian

    2017-01-01

    Sovereign bonds are widely used as collateral in banks' funding and trading operations. If a sovereign becomes distressed, the collateral mechanism impairs and banks are suddenly facing significant liquidity calls. Basel III's Liquidity Coverage Ratio (LCR) protects banks against unexpected...

  1. 7 CFR 1779.48 - Collateral.

    Science.gov (United States)

    2010-01-01

    ... (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.48 Collateral. (a) Lender responsibility. The lender is responsible for obtaining and maintaining proper and adequate collateral to protect...

  2. Comparison of Different 3.0 T Magnetic Resonance Sequences for Lumbosacral Plexus and Its Branches: Preliminary Study

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyuk Joon; Lee, Joon Woo; Lee, Jee Hye; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2013-01-15

    To prospectively evaluate four magnetic resonance sequences [ProSet, fluid attenuation inversion recovery (FLAIR), balanced turbo field echo (B-TFE), T2 Drive] for the lumbosacral plexus and its branches. Ten healthy volunteers who underwent four MRI sequences on lumbosacral area were evaluated for image quality (1 to 5; 1 = poor, 5 = excellent), the number of visualized bilateral spinal nerves from L2 to S1, the overlapping vessels obscuring the plexus (1 = many, 2 = some, 3 = few), and image quality defining spinal nerves (0 = nonvisualized, 1 = poor, 2 = moderate, 3 = good). The ProSet (mean = 4.2, range 3-5) and B-TFE (mean = 3.7, range 3-5) showed better image quality than others. The number of visualized spinal nerves was the largest on ProSet image (mean = 9.2, range 8-10). FLAIR (mean = 2.1, range 1-3) and T2 Drive sequences (mean = 2.1, range 1-3) discriminated the nerves well from the vessels. The main branches of the lumbosacral plexus were well visualized on both ProSet (mean = 2.9, range 2-3) and FLAIR images (mean = 2.6, range 1-3). All of these were statistically significant. ProSet is the best sequence in the evaluation of the lumbosacral plexus and its major branches while FLAIR can be a complementary sequence for the evaluation of nerves overlapping vascular structures.

  3. 30 CFR 800.21 - Collateral bonds.

    Science.gov (United States)

    2010-07-01

    ... a margin which is the ratio of bond value to market value, as determined by the regulatory authority... value of collateral exceed the market value. (f) Persons with an interest in collateral posted as a bond... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Collateral bonds. 800.21 Section 800.21 Mineral...

  4. Lateral collateral ligament of the elbow joint

    DEFF Research Database (Denmark)

    Olsen, Bo Sanderhoff; Vaesel, M T; Søjbjerg, Jens Ole

    1996-01-01

    The structure and kinematics of the lateral collateral ligament of the elbow joint were investigated in 10 cadaveric specimens. The lateral collateral ligament was observed to be a distinct part of the lateral collateral ligament complex. It contains posterior fibers that pass through the annular...

  5. A brief etymology of the collateral circulation.

    Science.gov (United States)

    Faber, James E; Chilian, William M; Deindl, Elisabeth; van Royen, Niels; Simons, Michael

    2014-09-01

    It is well known that the protective capacity of the collateral circulation falls short in many individuals with ischemic disease of the heart, brain, and lower extremities. In the past 15 years, opportunities created by molecular and genetic tools, together with disappointing outcomes in many angiogenic trials, have led to a significant increase in the number of studies that focus on: understanding the basic biology of the collateral circulation; identifying the mechanisms that limit the collateral circulation's capacity in many individuals; devising methods to measure collateral extent, which has been found to vary widely among individuals; and developing treatments to increase collateral blood flow in obstructive disease. Unfortunately, accompanying this increase in reports has been a proliferation of vague terms used to describe the disposition and behavior of this unique circulation, as well as the increasing misuse of well-ensconced ones by new (and old) students of collateral circulation. With this in mind, we provide a brief glossary of readily understandable terms to denote the formation, adaptive growth, and maladaptive rarefaction of collateral circulation. We also propose terminology for several newly discovered processes that occur in the collateral circulation. Finally, we include terms used to describe vessels that are sometimes confused with collaterals, as well as terms describing processes active in the general arterial-venous circulation when ischemic conditions engage the collateral circulation. We hope this brief review will help unify the terminology used in collateral research. © 2014 American Heart Association, Inc.

  6. The dynamics of the coronary collateral circulation.

    Science.gov (United States)

    Zimarino, Marco; D'Andreamatteo, Mariangela; Waksman, Ron; Epstein, Stephen E; De Caterina, Raffaele

    2014-04-01

    Coronary collaterals are present at birth, with wide interindividual variation in their functional capacity. These vessels protect jeopardized myocardium, and the number of collaterals and the extent of their coverage are associated with improved survival in patients with coronary heart disease. The collateral circulation is not a permanent set of structures, but undergoes dynamic changes with important consequences for cardioprotection. If a severe atherosclerotic lesion develops in an artery supplying tissue downstream of a total occlusion through collateral blood flow, pressure gradients across the collateral bed change. The result is that some of the collateral flow previously supplying the perfusion territory of the totally occluded artery is redirected to the perfusion territory of the donor artery, thus producing a 'collateral steal'. The collateral circulation can regress once antegrade flow in the main dependent artery is re-established, as occurs following the recanalization of a chronic total occlusion. The clinical benefits of coronary revascularization must be cautiously weighed against the risk of reducing the protective support derived from coronary collaterals. Consequently, pharmacological, gene-based, and cell-based therapeutic attempts have been made to enhance collateral function. Although such approaches have so far yielded no, or modest, beneficial results, the rapidly accruing data on coronary collateral circulation will hopefully lead to new effective therapeutic strategies.

  7. [Observation and analysis on the meridian-collateral running track-related anatomical structure in the human body].

    Science.gov (United States)

    Xie, Hao-ran; Li, Fang-chun; Zhang, Wei-bo

    2009-06-01

    In the present paper the authors analyze the anatomical structure of the meridian running track by using the dialectical thought and comprehensive analysis of the integrated Chinese and western medicine. It has been observed that the "Qi-passages" of the 14 meridians of Chinese medicine are located in the connective tissue among the interspace of the muscles, etc. distributing longitudinally. The "Qi-passages" of the 15 Luomai (collaterals of the meridians) are located in the connective tissue among the interspace of the muscles, etc. distributing transversally, while those of the small branches of the meridian collaterals are located in the interspace mesenchyme of the muscle bundles distributing in the whole body. The "Qi-passages" of the tiny branches of the meridian collaterals are located in the mesenchyme of the intracellular space, such as the muscle fibers in the whole body. The authors hold that the so-called "Mai Qi" of the meridian-collaterals is the liquid-Qi flowing in the vertical and horizontal tissue interspaces. The "Qi-passage" of the meridian-collaterals of Chinese medicine is the pathway of the liquid-Qi of the tissue interspaces. The structure of the meridian-collaterals is the tissue interspace. The meridian-collateral system is a regulation-control system in the human body where the Qi-passages communicate with each other, and is, in fact, the protoplasm, the liquid-Qi circulating in the tissue interspaces.

  8. Asymmetric dimethylarginine and coronary collateral vessel development.

    Science.gov (United States)

    Kocaman, Sinan Altan; Sahinarslan, Asife; Biberoglu, Gursel; Hasanoglu, Alev; Akyel, Ahmet; Timurkaynak, Timur; Cengel, Atiye

    2008-11-01

    Nitric oxide (NO) plays a major role in collateral vessel development. Asymmetric dimethylarginine (ADMA) that is an endogenous inhibitor of NO synthesis may impair the effective coronary collateral vessel development. The aim of this study was to evaluate the relationship between plasma ADMA level and coronary collateral vessel development. The patients with a greater than or equal to 95% obstruction in at least one epicardial coronary artery were included in the study. Degree of coronary collateral development was determined according to Rentrop method. Patients with grade 2-3 collateral development were regarded as good collateral group and formed group I. The patients with grade 0-1 collateral development were regarded as poor collateral group and were included in group II. Group III that had been formed as a control group included the patients with a normal coronary angiogram. We compared the plasma ADMA, symmetric dimethylarginine, L-arginine/ADMA ratio among three groups. Seventy-four patients have been included in the study. Patients with good collateral development had lower plasma ADMA level in comparison with patients with poor collateral development (0.41+/-0.25 micromol/l vs. 0.70+/-0.23 micromol/l, P=0.001) and had similar plasma ADMA levels with the patients who have normal coronary arteries. When we compared L-arginine/ADMA ratio between good and poor collateral groups, we found that the patients with higher L-arginine/ADMA ratio have significantly better collateral development (270.8+/-168.0 vs. 120.9+/-92.1, P<0.001). In the analyses comparing Rentrop score with ADMA level and L-arginine/ADMA ratio, there were significant correlations (r=-0.444, P=0.008 and r=0.553, P=0.001, respectively). In multivariate analysis, ADMA level (odds ratio, 0.009; 95% confidence interval, 0.000-0.466, P=0.020) and L-arginine/ADMA ratio (odds ratio, 1.010; 95% confidence interval, 1.001-1.020, P=0.032) were independent predictors of collateral development. Increased

  9. Multiple coil closure of isolated aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Padhi Sumanta

    2010-01-01

    Full Text Available A 7-month-old girl was diagnosed to have large aortopulmonary collateral during evaluation for congestive heart failure. There was no other evidence of cardiopulmonary disease. The collateral was successfully closed with multiple coils delivered sequentially. We describe the issues associated during closure of the aortopulmonary collateral in this case. To the best of our knowledge, this is the first reported case of large aortopulmonary collateral presenting with heart failure in an otherwise structurally normal heart that was closed successfully with multiple coils delivered sequentially.

  10. Mesenteric stenosis, collaterals, and compensatory blood flow

    NARCIS (Netherlands)

    van Petersen, Andre S.; Kolkman, Jeroen J.; Meerwaldt, Robbert; Huisman, Ad B.; van der Palen, Jacobus Adrianus Maria; Zeebregts, Clark J.; Geelkerken, Robert H.

    2014-01-01

    Background The mesenteric circulation has an extensive collateral network. Therefore, stenosis in one or more mesenteric arteries does not necessarily lead to symptoms. The objective of this study was to determine the effect of collateral flow on celiac artery (CA) and superior mesenteric artery

  11. 13 CFR 120.343 - Collateral.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Collateral. 120.343 Section 120.343 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION BUSINESS LOANS Special Purpose Loans... letters of credit). Collateral must be located in the United States, its territories or possessions. ...

  12. Mesenteric stenosis, collaterals, and compensatory blood flow

    NARCIS (Netherlands)

    van Petersen, Andre S.; Kolkman, Jeroen J.; Meerwaldt, Robbert; Huisman, Ad B.; van der Palen, Job; Zeebregts, Clark J.; Geelkerken, Robert H.

    Background: The mesenteric circulation has an extensive collateral network. Therefore, stenosis in one or more mesenteric arteries does not necessarily lead to symptoms. The objective of this study was to determine the effect of collateral flow on celiac artery (CA) and superior mesenteric artery

  13. ISOLATED MAJOR AORTOPULMONARY COLLATERAL ARTERY CAUSING CCF IN A NEWBORN: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Mohammed Ashfaque Tinmaswala, Pallavi P Saple, Arpita Gupta, Prachi N, Nitinkumar A, Kaba Amin

    2015-04-01

    Full Text Available ABSTRACT Major Aortopulmonary collateral artery (MAPCA is an anamolous vascular connection in between aorta or one of its main branches and pulmonary artery. It is single or multiple in which case it’s called multiple anamolousaortopulmonary collaterals (MAPCAs. These are usually seen in association with congenital heart diseases with decreased pulmonary blood flow but rarely may it be present as an isolated anamoly without evidence of any structural heart disease. The infant may present with pulmonary hypertension, bronchopulmonary dysplasia, recurrent lower respiratory tract infections or Congestive cardiac failure (CCF. We describe here a case of isolated Aortopulmonary collateral artery causing congestive cardiac failure in a late preterm baby. The congestive cardiac failure in this infant was successfully managed by obliteration of MAPCA by a single coil.

  14. The Effect of Placing Flow-Diverting Stents in Intracranial Collateral Arteries of Miniature Pig.

    Science.gov (United States)

    Wang, Jiwei; Ding, Yanan; Wang, Qiuxia; Wang, Yanan; Mu, Shiqing; Bi, Lixin; Li, Youxiang

    2017-03-23

    BACKGROUND Flow-diverting stent (FDS) has been suggested as an effective intracranial aneurysm treatment. However, the effects of FDS on collateral branches of an aneurysm parent artery still remain unknown. Thus, the present study aimed to comprehensively evaluate the effects of placing a FDS in the intracranial collateral artery, using a miniature pig animal model. MATERIAL AND METHODS Ten healthy miniature pigs were included in the study: one pig was reserved as a control and the remaining nine pigs were placed in three experimental groups: FDS (i.e., Pipeline), LVIS, and Solitaier-AB stent groups. Pigs in the experimental groups were examined by cerebral angiography immediately after stent placement, followed by hemodynamic analyses. In addition, magnetic resonance imaging (MRI) of the brain of pigs in the experimental groups was performed to inspect the brain for obstruction and blood flow. Stents were examined for the growth of neointimas. RESULTS The results showed that neointimas, consisting of smooth muscle cells, collagenous fibers, and macrophages, were 0.67 mm thick on average and partially covered the stent wires. The thickness of neointimas in the FDS group was significantly higher than in the two conventional intracranial stent groups. There was no obvious obstruction identified in collateral arteries where the FDS was placed. CONCLUSIONS These results indicated that neointimas in collateral arteries of a miniature pig would be slightly thickened after one month of FDS placement; and FDS was shown to be safe for collateral arteries.

  15. Understanding Collateral Evolution in Linux Device Drivers

    DEFF Research Database (Denmark)

    Padioleau, Yoann; Lawall, Julia Laetitia; Muller, Gilles

    2006-01-01

    In a modern operating system (OS), device drivers can make up over 70% of the source code. Driver code is also heavily dependent on the rest of the OS, for functions and data structures defined in the kernel and driver support libraries. These properties pose a significant problem for OS evolution......, as any changes in the interfaces exported by the kernel and driver support libraries can trigger a large number of adjustments in dependent drivers. These adjustments, which we refer to as collateral evolutions, may be complex, entailing substantial code reorganizations. As to our knowledge there exist...... no tools to help in this process, collateral evolution is thus time consuming and error prone.In this paper, we present a qualitative and quantitative assessment of collateral evolution in Linux device driver code. We provide a taxonomy of evolutions and collateral evolutions, and use an automated patch...

  16. The collateral circulation of the heart

    Science.gov (United States)

    2013-01-01

    The coronary arteries have been regarded as end arteries for decades. However, there are functionally relevant anastomotic vessels, known as collateral arteries, which interconnect epicardial coronary arteries. These vessels provide an alternative source of blood supply to the myocardium in cases of occlusive coronary artery disease. The relevance of these collateral arteries is a matter of ongoing debate, but increasing evidence indicates a relevant protective role in patients with coronary artery disease. The collateral circulation can be assessed by different methods; the gold standard involves intracoronary pressure measurements. While the first clinical trials to therapeutically induce growth of collateral arteries have been unavailing, recent pilot studies using external counterpulsation or growth factors such as granulocyte colony stimulating factor (G-CSF) have shown promising results. PMID:23735225

  17. Effect of dehydration on the development of collaterals in acute middle cerebral artery occlusion.

    Science.gov (United States)

    Chang, S-W; Huang, Y-C; Lin, L-C; Yang, J-T; Weng, H-H; Tsai, Y-H; Lee, T-H

    2016-03-01

    Recent large series studies have demonstrated that dehydration is common amongst stroke subjects and is associated with poor outcome. However, the effects of hydration status on the development of collaterals have never been discussed. In this study, the hypothesis that hydration status is an important factor for developing collaterals after acute middle cerebral artery (MCA) infarction was tested. Eighty-seven patients with acute infarction due to occlusion of the MCA were enrolled. Two collateral markers, posterior cerebral artery (PCA) laterality and fluid-attenuated inversion recovery hyperintense vessels (HVs) were assessed from magnetic resonance imaging. Dehydration status was defined by a nitrogen to creatinine ratio ≧ of 15. The associations between dehydration status and the development of collaterals were estimated. Sixty-one of 87 patients (70.1%) were identified as dehydrated. The development of PCA laterality and HVs shows a significant difference between dehydrated and euhydrated patients. A serum nitrogen to creatinine ratio Dehydration remained an independent negative predictor for the development of PCA laterality and HVs in the multivariate analysis. Hydration status is associated with the development of collateral flow after acute MCA occlusion. This preliminary study provides an imaging clue that hydration status and early hydration therapy could be important for acute stroke management. © 2016 EAN.

  18. Plexin A3 and turnout regulate motor axonal branch morphogenesis in zebrafish.

    Directory of Open Access Journals (Sweden)

    Rajiv Sainath

    Full Text Available During embryogenesis motor axons navigate to their target muscles, where individual motor axons develop complex branch morphologies. The mechanisms that control axonal branching morphogenesis have been studied intensively, yet it still remains unclear when branches begin to form or how branch locations are determined. Live cell imaging of individual zebrafish motor axons reveals that the first axonal branches are generated at the ventral extent of the myotome via bifurcation of the growth cone. Subsequent branches are generated by collateral branching restricted to their synaptic target field along the distal portion of the axon. This precisely timed and spatially restricted branching process is disrupted in turnout mutants we identified in a forward genetic screen. Molecular genetic mapping positioned the turnout mutation within a 300 kb region encompassing eight annotated genes, however sequence analysis of all eight open reading frames failed to unambiguously identify the turnout mutation. Chimeric analysis and single cell labeling reveal that turnout function is required cell non-autonomously for intraspinal motor axon guidance and peripheral branch formation. turnout mutant motor axons form the first branch on time via growth cone bifurcation, but unlike wild-type they form collateral branches precociously, when the growth cone is still navigating towards the ventral myotome. These precocious collateral branches emerge along the proximal region of the axon shaft typically devoid of branches, and they develop into stable, permanent branches. Furthermore, we find that null mutants of the guidance receptor plexin A3 display identical motor axon branching defects, and time lapse analysis reveals that precocious branch formation in turnout and plexin A3 mutants is due to increased stability of otherwise short-lived axonal protrusions. Thus, plexin A3 dependent intrinsic and turnout dependent extrinsic mechanisms suppress collateral branch

  19. How isometric are the medial patellofemoral, superficial medial collateral, and lateral collateral ligaments of the knee?

    Science.gov (United States)

    Victor, Jan; Wong, Pius; Witvrouw, Eric; Sloten, Jos Vander; Bellemans, Johan

    2009-10-01

    Ligament isometry is a cornerstone in the description of normal knee function and thorough knowledge is mandatory for successful repair of torn ligaments. This study was undertaken to validate a novel experimental model for the study of ligament strains and to determine the length changes in the superficial medial collateral, lateral collateral, and medial patellofemoral ligaments. Descriptive laboratory study. Passive motions and loaded squats of 12 cadaveric specimens were performed while controlling ankle load and optically tracking the motion of the bones. Preexperiment and postexperiment computed axial tomography scans allow the transformation of rigid body motion to relative motion of relevant anatomic landmarks on the femur, tibia, and patella. The superficial medial collateral ligament is a near-isometric ligament with a strain of less than 2%. The ligament is a little more slack in midflexion (30 degrees to 50 degrees ) and in deep flexion, but length changes are not significant (P > .05). The lateral collateral ligament behaves near isometric (tension from the collateral ligaments (P superficial medial collateral ligament is a near-isometric ligament with no significant length changes. The medial patellofemoral ligament behaves differently in its cranial and caudal parts. In knees with chronic medial collateral ligament insufficiency, isometric repair of the superficial medial collateral ligament can be attempted. A medial patellofemoral ligament reconstruction with a double fixation on the medial patellar border is supported. The cranial bundle should be tightened at full extension and the caudal bundle at 30 degrees of knee flexion.

  20. Preliminary analysis of the hydrologic effects of temporary shutdowns of the Rondout-West Branch Water Tunnel on the groundwater-flow system in Wawarsing, New York

    Science.gov (United States)

    Stumm, Frederick; Chu, Anthony; Como, Michael D.; Noll, Michael L.

    2012-01-01

    Flooding of streets and residential basements, and bacterial contamination of private-supply wells with Escherichia coli (E. coli) are recurring problems in the Rondout Valley near the Town of Wawarsing, Ulster County, New York. Leakage from the Rondout-West Branch (RWB) Water Tunnel and above-normal precipitation have been suspected of causing elevated groundwater levels and basement flooding. The hydrology of a 12-square-mile study area within the Town of Wawarsing was studied during 2008-10. A network of 41 wells (23 unconsolidated-aquifer and 18 bedrock wells) and 2 surface-water sites was used to monitor the hydrologic effects of four RWB Water Tunnel shutdowns. The study area is underlain by a sequence of northeast-trending sedimentary rocks that include limestone, shale, and sandstone. The bedrock contains dissolution features, fractures, and faults. Inflows that ranged from less than 1 to more than 9,000 gallons per minute from the fractured bedrock were documented during construction of the 13.5-foot-diameter RWB Water Tunnel through the sedimentary-rock sequence 710 feet (ft) beneath the study-area valley. Glacial sediments infill the valley above the bedrock sequence and consist of clay, silt, sand, and gravel. The groundwater-flow system in the valley consists of both fractured-rock and unconsolidated aquifers. Water levels in both the bedrock and unconsolidated aquifers respond to variations in seasonal precipitation. During the past 9 years (2002-10), annual precipitation at Central Park, N.Y., has exceeded the 141-year mean. Potentiometric-surface maps indicate that groundwater in the bedrock flows from the surrounding hills on the east and west sides of the valley toward the center of the valley, and ultimately toward the northeast. On average, water levels in the bedrock aquifer had seasonal differences of 5.3 ft. Analysis of hydrographs of bedrock wells indicates that many of these wells are affected by the RWB Tunnel leakage. Tunnel

  1. [Surgical treatment of ulnar collateral ligament injuries of the thumb metacarpophalangeal joint].

    Science.gov (United States)

    Ziegler, C; Neshkova, I; Schmidt, K; Meffert, R; Jakubietz, M; Jakubietz, R

    2016-04-01

    Reconstruction of the ruptured ulnar collateral ligament of the metacarpophalangeal (MP) joint of the thumb. Ruptured ulnar collateral ligament of the thumb MP joint with instability: joint opening of more than 30° in flexion and more than 20° in extension, Stener lesion, displaced avulsion fractures. Abrasions, wound-healing disturbance, skin disease, osteoarthritis. Curved skin incision dorsoulnar above the thumb MP joint. Protection of the branches of the superficial radial nerve. Incision of the adductor aponeurosis. Exposing the ulnar collateral ligament; opening and examination of the joint. Depending on the injury, primary suture repair, transosseous suture, repair with a bone anchor, osteosynthesis with K-wires or small screws in avulsion fracture, ligament reconstruction in chronic instability or older injury. Cast splint of the MP joint until swelling subsides; cast immobilization for 6 weeks; range-of-motion exercises, avoiding forced radial deviation of the MP joint for 3 months. Complete joint stability 3 months postoperatively in all 34 patients with rupture of the ulnar collateral ligament.

  2. Existence of collateral Equilibrium without survival assumption

    Directory of Open Access Journals (Sweden)

    Jaime Orrillo

    2011-03-01

    Full Text Available This paper shows the existence of a collateral equilibrium without assuming any hypotheses on the strict positivity, be they individual initial endowments, including the ex post initial endowments, or aggregated initial endowments. Because of dropping the strict positivity of social initial endowment we fail to get an equilibrium. Instead, we get a quasi-equilibrium. Then, appealing to the concept of irreducibility (introduced by McKenzie in 1959 which is adapted to the collateral model, we show that the quasi-equilibrium is indeed a legitime equilibrium.

  3. Distribution of collateral fibers in the monkey cervical spinal cord detected with diffusion-weighted magnetic resonance imaging

    DEFF Research Database (Denmark)

    Lundell, Henrik; Nielsen, Jens Bo; Ptito, Maurice

    2011-01-01

    techniques. We calculate the diffusion tensor and the persistent angular structure (PAS), a multi-fiber reconstruction technique, from high quality post mortem data of a perfusion-fixed vervet monkey cervical spinal cord sample and simulated crossing fiber data. Our results show that (i) cylindrical geometry......Diffusion anisotropy monitored with diffusion-weighted magnetic resonance imaging (DWMRI) is a sensitive marker to monitor developmental or pathological microstructural changes in spinal cord. The white matter is often treated as a unidirectional axonal bundle but collateral fibers branching off...... in the white matter of the spinal cord is an invalid assumption due to collateral fibers. We also demonstrate that (ii) collateral fibers can be resolved as distinct peaks in the water diffusion propagator in white matter using multi-fiber models. Finally, we show that (iii) crossing fibers are mainly located...

  4. 26 CFR 403.29 - Deposit of collateral.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Deposit of collateral. 403.29 Section 403.29... ADMINISTRATION DISPOSITION OF SEIZED PERSONAL PROPERTY Seizures and Forfeitures § 403.29 Deposit of collateral... principal by the United States, may be pledged and deposited by claimants as collateral security in lieu of...

  5. 27 CFR 24.151 - Deposit of collateral security.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Deposit of collateral... § 24.151 Deposit of collateral security. (a) Bonds or notes of the United States, or other obligations... pledged and deposited as collateral security in lieu of corporate sureties in accordance with the...

  6. 46 CFR 308.509 - Collateral deposit fund.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Collateral deposit fund. 308.509 Section 308.509... Risk Cargo Insurance Ii-Open Policy War Risk Cargo Insurance § 308.509 Collateral deposit fund. (a) Requirements. An assured electing to use a cash collateral deposit fund pursuant to § 308.507 shall comply with...

  7. 27 CFR 72.25 - Deposit of collateral.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 2 2010-04-01 2010-04-01 false Deposit of collateral. 72... Seizures and Forfeitures § 72.25 Deposit of collateral. (a) Bonds or notes of the United States, or other... be pledged and deposited by claimants as collateral security in lieu of corporate sureties in...

  8. Trade credit, collateral liquidation and borrowing constraints

    NARCIS (Netherlands)

    Fabbri, D.; Menichini, A.M.C.

    2009-01-01

    The paper proposes a model of collateralized bank and trade credit. Firms use a two-input technology. Assuming that the supplier is better able to extract value from existing assets and has an information advantage over other creditors, the paper derives a series of predictions. (1) Financially

  9. 28 CFR 104.47 - Collateral sources.

    Science.gov (United States)

    2010-07-01

    ... compensation, including life insurance, pension funds, death benefits programs, and payments by Federal, State... determining the appropriate value of offsets for pension funds, life insurance and similar collateral sources... Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) SEPTEMBER 11TH VICTIM COMPENSATION FUND OF 2001...

  10. Debt capacity of real estate collateral

    NARCIS (Netherlands)

    Giambona, E.; Golec, J.; Schwienbacher, A.

    2014-01-01

    We study whether real estate assets have a greater positive influence on firm leverage than other tangible assets. Using a large sample of COMPUSTAT firms, we find a significant positive relation between tangibility and leverage in general, and the relation is strongest for real estate collateral.

  11. Collateral Learning and Mathematical Education of Teachers

    Science.gov (United States)

    Abramovich, Sergei

    2012-01-01

    This article explores the notion of collateral learning in the context of classic ideas about the summation of powers of the first "n" counting numbers. Proceeding from the well-known legend about young Gauss, this article demonstrates the value of reflection under the guidance of "the more knowledgeable other" as a pedagogical method of making…

  12. 31 CFR 202.6 - Collateral security.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Collateral security. 202.6 Section 202.6 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE... section to the Federal Reserve Bank of the district, as fiscal agent of the United States, and in any...

  13. Branched polymers on branched polymers

    OpenAIRE

    Durhuus, Bergfinnur; Jonsson, Thordur

    1996-01-01

    We study an ensemble of branched polymers which are embedded on other branched polymers. This is a toy model which allows us to study explicitly the reaction of a statistical system on an underlying geometrical structure, a problem of interest in the study of the interaction of matter and quantized gravity. We find a phase transition at which the embedded polymers begin to cover the basis polymers. At the phase transition point the susceptibility exponent $\\gamma$ takes the value 3/4 and the ...

  14. Collateral effects of antiarrhythmics in pediatric age.

    Science.gov (United States)

    Ali, K M Sulafa

    2008-01-01

    Although there are numerous reports of antiarrhythmic use in children, controlled, comparison trials of antiarrhythmic agents in children are virtually nonexistent and most data are obtained from case series of children treated. Effective and safe pharmacological therapy requires that the physicians attempt to identify a drug with the most appropriate profile to attack the most vulnerable parameter of the mechanisms of the cardiac arrhythmia with the least pro arrhythmic/collateral effects. Digoxin in patients with Wolf-Parkinson -White syndrome, verapamil in infants and intravenous quinidine should be avoided as there is clear evidence that they can cause serious side effects. Collateral effects of other antiarrhythmic drugs are discussed in details in this review. Well-designed, controlled trials are needed to further evaluate the comparative efficacy of antiarrhythmics in children, as well as to evaluate dosing and toxicity in various age groups.

  15. Acquired portosystemic collaterals: anatomy and imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Andrea Farias de Melo; Mota Junior, Americo, E-mail: andreafariasm@gmail.com [Instituto de Medicina Integral Professor Fernando Figueira de Pernambuco (IMIP), Recife, PE (Brazil); Chagas-Neto, Francisco Abaete [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    2016-07-15

    Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common - increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. (author)

  16. Collateral artery pathways of the femoral and popliteal artery.

    Science.gov (United States)

    Kruse, Rombout R; Doomernik, Denise E; Maltha, Kasper V; Kooloos, Jan G M; Kozicz, Tamas L; Reijnen, Michel M P J

    2017-05-01

    The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. Ten fresh frozen cadaver legs were selected. The SFA and DFA were separately cannulated and injected with a different colored latex mixture simultaneously. After curing of the latex, the circulation was dissected thus visualizing the main arteries and their collateral vessels. The process was photographed and recorded, and collateral pathways were analyzed using a standardized vessel segmentation. The upper leg was divided in three regions, that is, the femoral triangle (F), the adductor canal (H), and the popliteal fossa (P) that, in turn, were split in three segments (1, 2, and 3, from proximal to distal). Overall, 113 collateral vessels were found; 69 originated from the DFA, 34 from the SFA, and 10 from the PA. The majority of collaterals originating from the DFA terminated in the SFA (57%). Fifty-six of 113 collaterals (50%) ended in either the distal adductor channel (H3) or the proximal PA (P1). Another 28 collateral arteries (25%) had their origin in this segment (H3, P1) and mostly connected to the P2 and P3 segments. Forty-three collaterals of the DFA and H3 segment had a direct or indirect connection to below the knee muscles. The majority of collaterals originate from the DFA, and the greater part of all collaterals has a connection with the H3-P1 segment. This observation may have clinical implications in the planning of endovascular procedures. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The human coronary collateral circulation: development and clinical importance.

    Science.gov (United States)

    Seiler, Christian; Stoller, Michael; Pitt, Bertram; Meier, Pascal

    2013-09-01

    Coronary collaterals are an alternative source of blood supply to myocardium jeopardized by ischaemia. In comparison with other species, the human coronary collateral circulation is very well developed. Among individuals without coronary artery disease (CAD), there are preformed collateral arteries preventing myocardial ischaemia during a brief vascular occlusion in 20-25%. Determinants of such anastomoses are low heart rate and the absence of systemic arterial hypertension. In patients with CAD, collateral arteries preventing myocardial ischaemia during a brief occlusion are present in every third individual. Collateral flow sufficient to prevent myocardial ischaemia during coronary occlusion amounts to one-fifth to one-fourth the normal flow through the open vessel. Myocardial infarct size, the most important prognostic determinant after such an event, is the product of coronary artery occlusion time, area at risk for infarction, and the inverse of collateral supply. Well-developed coronary collateral arteries in patients with CAD mitigate myocardial infarcts and improve survival. Approximately one-fifth of patients with CAD cannot be revascularized by percutaneous coronary intervention or coronary artery bypass grafting. Therapeutic promotion of collateral growth is a valuable treatment strategy in those patients. It should aim at growth of large conductive collateral arteries (arteriogenesis). Potential arteriogenic approaches include the treatment with granulocyte colony-stimulating factor, physical exercise training, and external counterpulsation.

  18. Mortgage Finance and Security of Collateral

    DEFF Research Database (Denmark)

    Haldrup, Karin

    2011-01-01

    Developing economies face a gigantic lack of financing for urbanization due to the absence of formal and transparent property markets. The paper discuss the interference between mortgage finance and collateral security by using the Danish mortgage financing model as an example, because of its 200...... years long history, and because the system is recommended as an option in emerging markets and as a possible model for remedying failures in mature housing finance markets. It is suggested that development policies in land administration need to be revised in order to support a widening of credit...

  19. Transvenous closure of large aortopulmonary collateral

    Directory of Open Access Journals (Sweden)

    Parag W Barwad

    2014-01-01

    Full Text Available Aortopulmonary collaterals (APCs are occluded either preoperatively or at the time of cardiac surgery in patients with pulmonary atresia and ventricular septal defect (PAVSD. If left untreated, APCs are an important cause of deterioration in the early postoperative period. We present here an unusual case with a large residual APC causing refractory low-output state in the early postoperative period. Usual arterial approach failed due to extensive angulation with ostial narrowing. The large residual APC was successfully closed with an Amplatzer duct occluder (ADO device delivered through the transvenous route.

  20. The relationship of serum erythropoietin level with coronary collateral grade.

    Science.gov (United States)

    Sahinarslan, Asife; Yalcin, Ridvan; Kocaman, Sinan Altan; Ercin, Ugur; Tanalp, Ali Cevat; Topal, Salih; Bukan, Neslihan; Boyaci, Bulent; Cengel, Atiye

    2011-01-01

    Erythropoietin has been shown to induce neovascularization and protect against ischemic vascular injury. We investigated whether a higher serum erythropoietin (EPO) level is related to better coronary collateral vessel grade. Ninety-nine patients with stable angina pectoris who have at least 1 coronary stenosis of equal to or greater than 70% at coronary angiography were prospectively enrolled. Serum EPO and vascular endothelial growth factor (VEGF) levels were studied. Coronary collateral degree was graded according to the Rentrop method. Patients with grade 2-3 collateral degree were included in the good collateral group and formed Group I. The patients with grade 0-1 collateral degree were included in the poor collateral group and formed Group II. The serum EPO level was significantly higher in the good collateral group (17.3 ± 9.3 mU/mL vs 11.7 ± 5.0 mU/mL; P < 0.001). There was also a positive correlation between serum EPO level and Rentrop score (r = 0.39; P < 0.001). In multivariate analysis, serum EPO level (odds ratio [OR] 1.336; 95% confidence interval [CI], 1.120-1.593; P = 0.001), oxygen saturation (OR 0.638; 95% CI, 0.422-0.963; P = 0.033) and presence of chronic total occlusion (CTO) (OR 26.7; 95% CI, 3.874-184.6; P = 0.001) were independently related to well-developed coronary collaterals. Higher serum EPO level is related to better coronary collateral development. Erythropoietin may have a positive effect on the development of collaterals and may provide a new agent for the treatment strategies to enhance coronary collateral vessel development. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  1. Factors affecting agreement between alcohol abusers' and their collaterals' reports.

    Science.gov (United States)

    Sobell, L C; Agrawal, S; Sobell, M B

    1997-07-01

    Because of their low cost and ease of use, collaterals' reports are the most frequent source of independent corroboration with alcohol abusers' self-reports of drinking and related events. Although several reviews have shown that we can have confidence in the accuracy of alcohol abusers' reports of their drinking and in the use of collateral reports as an independent validity criterion, neither data source is error free. This study examined factors that influence the level of agreement between collaterals' and alcohol abusers' reports. Using data from a study of natural recoveries from alcohol-related problems, this study examined how agreement between 120 alcohol abusers' (79.2% male) and their collaterals' reports varied as a function of collateral type and of the collaterals' ratings of their confidence in the accuracy of their reports of the subjects' drinking and related behaviors. Collaterals' awareness of nonalcohol-related levels was also examined. The best agreement occurred for reports from alcohol abusers' spouses who were fairly confident about the information provided. For all variables, some proportion of collaterals respond to demand characteristics of the interview by providing very specific information about subjects' behavior yet admit to being unsure of this information. Collaterals who are fairly sure of the information they provide are the preferred informants to corroborate alcohol abusers' reports of drinking and related behaviors. In some cases the best collaterals are spouses who are fairly sue of the information they reported. It is also recommended that treatment outcome studies should accept reports only from collaterals who are confident about the information they report.

  2. Interaction between axons and specific populations of surrounding cells is indispensable for collateral formation in the mammillary system.

    Directory of Open Access Journals (Sweden)

    Nora-Emöke Szabó

    Full Text Available An essential phenomenon during brain development is the extension of long collateral branches by axons. How the local cellular environment contributes to the initial sprouting of these branches in specific points of an axonal shaft remains unclear.The principal mammillary tract (pm is a landmark axonal bundle connecting ventral diencephalon to brainstem (through the mammillotegmental tract, mtg. Late in development, the axons of the principal mammillary tract sprout collateral branches at a very specific point forming a large bundle whose target is the thalamus. Inspection of this model showed a number of distinct, identified cell populations originated in the dorsal and the ventral diencephalon and migrating during development to arrange themselves into several discrete groups around the branching point. Further analysis of this system in several mouse lines carrying mutant alleles of genes expressed in defined subpopulations (including Pax6, Foxb1, Lrp6 and Gbx2 together with the use of an unambiguous genetic marker of mammillary axons revealed: 1 a specific group of Pax6-expressing cells in close apposition with the prospective branching point is indispensable to elicit axonal branching in this system; and 2 cooperation of transcription factors Foxb1 and Pax6 to differentially regulate navigation and fasciculation of distinct branches of the principal mammillary tract.Our results define for the first time a model system where interaction of the axonal shaft with a specific group of surrounding cells is essential to promote branching. Additionally, we provide insight on the cooperative transcriptional regulation necessary to promote and organize an intricate axonal tree.

  3. Collateral artery pathways of the femoral and popliteal artery

    NARCIS (Netherlands)

    Kruse, R.R.; Doomernik, D.E.; Maltha, K.V.; Kooloos, J.G.M.; Kozicz, T.; Reijnen, M.

    2017-01-01

    BACKGROUND: The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute

  4. Exercise promotes collateral artery growth mediated by monocytic nitric oxide.

    Science.gov (United States)

    Schirmer, Stephan H; Millenaar, Dominic N; Werner, Christian; Schuh, Lisa; Degen, Achim; Bettink, Stephanie I; Lipp, Peter; van Rooijen, Nico; Meyer, Tim; Böhm, Michael; Laufs, Ulrich

    2015-08-01

    Collateral artery growth (arteriogenesis) is an important adaptive response to hampered arterial perfusion. It is unknown whether preventive physical exercise before limb ischemia can improve arteriogenesis and modulate mononuclear cell function. This study aimed at investigating the effects of endurance exercise before arterial occlusion on MNC function and collateral artery growth. After 3 weeks of voluntary treadmill exercise, ligation of the right femoral artery was performed in mice. Hindlimb perfusion immediately after surgery did not differ from sedentary mice. However, previous exercise improved perfusion restoration ≤7 days after femoral artery ligation, also when exercise was stopped at ligation. This was accompanied by an accumulation of peri-collateral macrophages and increased expression of endothelial nitric oxide synthase and inducible nitric oxide synthase (iNOS) in hindlimb collateral and in MNC of blood and spleen. Systemic monocyte and macrophage depletion by liposomal clodronate but not splenectomy attenuated exercise-induced perfusion restoration, collateral artery growth, peri-collateral macrophage accumulation, and upregulation of iNOS. iNOS-deficient mice did not show exercise-induced perfusion restoration. Transplantation of bone marrow-derived MNC from iNOS-deficient mice into wild-type animals inhibited exercise-induced collateral artery growth. In contrast to sedentary controls, thrice weekly aerobic exercise training for 6 months in humans increased peripheral blood MNC iNOS expression. Circulating mononuclear cell-derived inducible nitric oxide is an important mediator of exercise-induced collateral artery growth. © 2015 American Heart Association, Inc.

  5. 27 CFR 17.104 - Deposit of collateral.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Deposit of collateral. 17... PRODUCTS Bonds and Consents of Sureties § 17.104 Deposit of collateral. Except as otherwise provided by law... guaranteed as to both interest and principal by the United States, may be pledged and deposited by principals...

  6. Collateral Informant Assessment in Alcohol Use Research Involving College Students

    Science.gov (United States)

    Hagman, Brett T.; Cohn, Amy M.; Noel, Nora E.; Clifford, Patrick R.

    2010-01-01

    Objective: This study examined the associations between college students' self-reported alcohol use and corresponding collateral reports and identified factors that influence agreement between both sets of reports. Participants/Methods: Subject-collateral pairs (N = 300) were recruited from undergraduate psychology courses. Results: Data yielded…

  7. Radiologic analysis of the medical collateral ligament rupture

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Chung Che; Lee, Chang Jun; Kim, Kun Sang; Park, Soo Soung [Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    The medical collateral ligament rupture is the most common injury involving the knee joint ligaments. The ruptured medical collateral ligaments of 73 cases with clinical and surgical confirmations were radiologically analyzed. The results were obtained as follows: 1. The most risky age for tearing of the medical collateral ligament was third to fifth decades (50 cases of male and 23 of females). 2. The most common cause of the medical collateral ligament rupture was traffic accident (82.2%). 3. The mean distance of medial knee joint space was 7.9 {+-} 2.0 mm on the normal side and 13.7 {+-} 4.2 mm on the affected side. 4. The mean degree of knee joint space was 10.1 {+-} 2.5 on the normal side and 14.7 {+-} 3.8 on the affected side. 5. The fibula was the bone fractured most frequently in association with the medial collateral ligament rupture (30.6%)

  8. Documenting and automating collateral evolutions in Linux device drivers

    DEFF Research Database (Denmark)

    Padioleau, Yoann; Hansen, René Rydhof; Lawall, Julia

    2008-01-01

    The internal libraries of Linux are evolving rapidly, to address new requirements and improve performance. These evolutions, however, entail a massive problem of collateral evolution in Linux device drivers: for every change that affects an API, all dependent drivers must be updated accordingly....... Manually performing such collateral evolutions is time-consuming and unreliable, and has lead to errors when modifications have not been done consistently. In this paper, we present an automatic program transformation tool, Coccinelle, for documenting and automating device driver collateral evolutions...

  9. Pricing a Collateralized Derivative Trade with a Funding Value Adjustment

    Directory of Open Access Journals (Sweden)

    Chadd B. Hunzinger

    2015-01-01

    Full Text Available The 2008 credit crisis changed the manner in which derivative trades are conducted. One of these changes is the posting of collateral in a trade to mitigate the counterparty credit risk. Another is the realization that banks are not risk-free and, as a result, cannot borrow at the risk-free rate any longer. The latter led banks to introduced the controversial adjustment to derivative prices, known as a funding value adjustment (FVA, which is interlinked with the posting of collateral. In this paper, we extend the Cox, Ross and Rubinstein (CRR discrete-time model to include collateral and FVA. We prove that this derived model is a discrete analogue of Piterbarg’s partial differential equation (PDE, which describes the price of a collateralized derivative. The fact that the two models coincide is also verified by numerical implementation of the results that we obtain.

  10. Atraumatic medial collateral ligament oedema in medial compartment knee osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Bergin, D.; Keogh, C.; O' Connell, M.; Zoga, A. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); Rowe, D.; Shah, B. [Boston Univ., MA (United States). Medical Center; Fitzpatrick, P. [Department of Public Health and Epidemiology, University College Dublin (Ireland); Eustace, S. [Department of Radiology, Mater Misericordiae Hospital, Dublin (Ireland); X-Ray Department, Cappagh National Orthopedic Hospital, Dublin (Ireland)

    2002-01-01

    Objective: To describe and determine the prevalence of atraumatic medial collateral oedema identified in patients with medial compartment osteoarthritis. Design and patients: Sixty patients, 30 patients with medial compartment knee osteoarthritis (Kellgren and Lawrence grade 2 to 4) and 30 age-matched patients with atraumatic knee pain without osteoarthritis, referred for MR imaging over a 2 year period were included in the study. In each case, severity of osteoarthritis was recorded on radiographs and correlated with the presence or absence of medial collateral ligament oedema at MR imaging. Results: Medial collateral oedema was identified in 27 of the 30 patients with osteoarthritis, of whom 14 had grade 1 oedema and 13 had grade 2 oedema compared with the presence of medial collateral ligament oedema (grade 1) in only two of the 30 control patients without osteoarthritis (P<<0.0001). Conclusion: Medial collateral oedema is common in patients with osteoarthritis in the absence of trauma. When identified, medial collateral ligament oedema should be considered to be a feature of osteoarthritis and should not be incorrectly attributed to an acute traumatic injury. (orig.)

  11. [Collateral ligament injuries of the metacarpophalangeal joints].

    Science.gov (United States)

    Pillukat, T; Schädel-Höpfner, M; Windolf, J; Prommersberger, K-J

    2012-07-01

    Collateral ligament injuries of the metacarpal joints of the fingers are rare conditions. The injury should be diagnosed by clinical investigation and standard radiographs. Leading symptoms are local tenderness and joint instability. Instability is verified by clinical stress testing of the metacarpophalangeal joint in 90° of flexion. In Grade I injuries stability is preserved due to ligament attenuation or small partial tears. Grade II injuries show laxity with firm endpoint according to incomplete tear. In Grade III injuries instability without endpoint can be found as a result of complete tears. Radiographs may show avulsed bone fragments.In Grade I and II tears or non- displaced avulsion fragments treatment is conservative with buddy taping for 6 weeks. In case of persistent instability or grade III tears suturing or refixation of the ligament are performed. Small avulsion fragments are removed and the ligament is fixed to the bone. Greater avulsion fragments are fixed by suitable small implants. Adequate treatment will lead to reliable good results. Even in chronic tears reconstruction with local material or tendon transplants is usually successful.

  12. Recruitment of dorsal columm fibers in spinal cord stimulation: influence of collateral branching

    NARCIS (Netherlands)

    Struijk, J.J.; Struijk, Johannes J.; Holsheimer, J.; van der Heide, Gerlof G.; van der Heide, G.G.; Boom, H.B.K.

    1992-01-01

    An electrical network model of myelinated dorsal column nerve fibers is presented. The effect of electrical simulation was investigated using both a homogeneous volume conductor and a more realistic model of the spinal cord. An important feature of dorsal column nerve fibers is the presence of

  13. Organization and collateralization of a subendocardial plexus in end-stage human heart failure.

    Science.gov (United States)

    van den Wijngaard, Jeroen P H M; van Horssen, Pepijn; ter Wee, Rene; Coronel, Ruben; de Bakker, Jacques Mt; de Jonge, Nicolaas; Siebes, Maria; Spaan, Jos A E

    2010-01-01

    In the failing myocardium a subendocardial plexus can develop. Detection of the presence or function, however, of such a plexus does not form part of the present diagnostic spectrum for heart failure. This may now change as new methods for high-resolution imaging of myocardial perfusion distribution are being developed. A severely hypertrophic heart was harvested during transplantation and analyzed for morphology of the intramural coronary arterial vasculature. The heart only had one coronary ostium, and the main branches of the coronary artery were cannulated. A fluorescent casting material was infused that was allowed to harden under physiological pressure. The entire heart was frozen and placed in a novel imaging cryomicrotome and sequentially cut in 25-microm slices. High-resolution images of each cutting plane were acquired, allowing a detailed three-dimensional reconstruction of the arterial vasculature. The epicardial layer of the free wall demonstrated a normal vasculature with penetrating branching arteries. The endocardial layer and the septum revealed a highly interconnected vascular plexus with large vessels oriented parallel to the apicobasal axis. An extensive endocardial network with collaterals was detected, forming connections between the main epicardial branches. We conclude that an outward remodeling of transmural vessels did not prevent the generation and growth of subendocardial conduit arteries. The orientation and vascular volume in the plexus provides an opportunity for detection by novel techniques of MRI contrast imaging currently developed. Knowledge of the effect on perfusion studies is required to prevent a misinterpretation of subendocardial perfusion images in heart failure.

  14. Ulnar collateral ligament reconstruction in major league baseball pitchers.

    Science.gov (United States)

    Gibson, Brett W; Webner, David; Huffman, G Russell; Sennett, Brian J

    2007-04-01

    Ulnar collateral ligament reconstruction is commonly performed in major league pitchers, but little is known about pitching performance after a return to major league play. Pitching performance after ulnar collateral ligament reconstruction returns to baseline by the second season after surgery. Cohort study (prognosis); Level of evidence, 2. Data were reviewed for 68 major league pitchers who pitched in at least 1 major league game before undergoing ulnar collateral ligament reconstruction between 1998 and 2003. Mean innings pitched per season, earned run average, and walks and hits per inning pitched were compared for each major league pitcher before and after surgery. All demographic and performance variables were analyzed for an association with ulnar collateral ligament insufficiency and a successful return to major league play. Fifty-six (82%) pitchers returned to major league play at a mean of 18.5 months after surgery with no significant change in mean earned run average or walks and hits per inning pitched. The mean innings pitched per season was not statistically different from controls by the second season after surgery. Starting pitchers demonstrated a higher risk of ulnar collateral ligament injury requiring reconstruction. More experienced pitchers and those with a higher earned run average were less likely to require ulnar collateral ligament reconstruction. No factors predictive of a successful return to play were identified. Most major league pitchers return from ulnar collateral ligament reconstruction by the second season after surgery with no statistical change in mean innings pitched, earned run average, or walks and hits per inning pitched from preinjury levels.

  15. 'Wellbeing': a collateral casualty of modernity?

    Science.gov (United States)

    Carlisle, Sandra; Henderson, Gregor; Hanlon, Phil W

    2009-11-01

    In the now vast empirical and theoretical literature on wellbeing knowledge of the subject is provided mainly by psychology and economics, where understanding of the concept are framed in very different ways. We briefly rehearse these, before turning to some important critical points which can be made about this burgeoning research industry, including the tight connections between the meanings of the concept with the moral value systems of particular 'modern' societies. We then argue that both the 'science' of wellbeing and its critique are, despite their diversity, re-connected by and subsumed within the emerging environmental critique of modern consumer society. This places concerns for individual and social wellbeing within the broader context of global human problems and planetary wellbeing. A growing number of thinkers now suggest that Western society and culture are dominated by materialistic and individualistic values, made manifest at the political and social levels through the unending pursuit of economic growth, and at the individual level by the seemingly endless quest for consumer goods, regardless of global implications such as broader environmental harms. The escalating growth of such values is associated with a growing sense of individual alienation, social fragmentation and civic disengagement and with the decline of more spiritual, moral and ethical aspects of life. Taken together, these multiple discourses suggest that wellbeing can be understood as a collateral casualty of the economic, social and cultural changes associated with late modernity. However, increasing concerns for the environment have the potential to counter some of these trends, and in so doing could also contribute to our wellbeing as individuals and as social beings in a finite world.

  16. Middle cerebral artery stenosis associated with moyamoya pattern collateralization

    Directory of Open Access Journals (Sweden)

    Randall Edgell

    2010-11-01

    Full Text Available Background and Purpose: Moyamoya disease is a well described phenomenon presenting with terminal internal carotid artery occlusion and rete pattern of collateralization around the occlusion. The development of moyamoya-like collaterals secondary to isolated middle cerebral artery stenosis or occlusion and the natural history of this entity in Caucasians have not been well described. Methods: Cerebral angiograms and CT angiograms performed between August 2004 and August of 2006 demonstrating moyamoya collateralization at a single US center were retrospectively reviewed. All cases of middle cerebral artery stenosis associated with a rete pattern of collateralization were included in this series. Demographic, clinical, and angiographic data were obtained. Results: There were 3 cases of middle cerebral artery stenosis associated with a moyamoya pattern of collateralization. The average age of the patients was 36 years old, 2 were male, and all were Caucasian. All patients presented with ischemic symptoms. The average degree of stenosis was 91%. No stenosis was seen in the supraclinoid internal carotid arteries or elsewhere in the intracranial vasculature. Conclusion: We describe a moyamoya-like pattern of anastomosis associated with isolated severe middle cerebral artery stenosis or occlusion in Caucasians.

  17. Neuro-Oncology Branch

    Science.gov (United States)

    ... BTTC are experts in their respective fields. Neuro-Oncology Clinical Fellowship This is a joint program with ... can increase survival rates. Learn more... The Neuro-Oncology Branch welcomes Dr. Mark Gilbert as new Branch ...

  18. Branched polynomial covering maps

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    1999-01-01

    A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch...... set. Particular studies are made of branched polynomial covering maps arising from Riemann surfaces and from knots in the 3-sphere....

  19. Branched polynomial covering maps

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard

    2002-01-01

    A Weierstrass polynomial with multiple roots in certain points leads to a branched covering map. With this as the guiding example, we formally define and study the notion of a branched polynomial covering map. We shall prove that many finite covering maps are polynomial outside a discrete branch...... set. Particular studies are made of branched polynomial covering maps arising from Riemann surfaces and from knots in the 3-sphere. (C) 2001 Elsevier Science B.V. All rights reserved....

  20. Collateral vessels in moyamoya disease : comparison of MR and MRA with conventional angiography

    Energy Technology Data Exchange (ETDEWEB)

    Shim, Joo Eun; Yoon, Dae Young; Yi, Jeong Geun; Kim, Ho Chul; Choi, Chul Sun; Bae, Sang Hoon [Hallym University College of Medicine, Choonchun (Korea, Republic of)

    1998-01-01

    To determine the value of magnetic resonance imaging (MR) and magnetic resonance angiography (MRA) in assessing collateral vessels of moyamoya disease. Twenty-four patients with moyamoya disease who underwent MR, 3D TOF MRA, and conventional angiography participated in this study. Two radiologists working independently and with no knowledge of the angiographic findings, interpreted the MR and MRA images. To determine the presence of parenchymal and leptomeningeal collaterals (48 hemispheres) and transdural collaterals (38 hemispheres in 19 patients were depicted by angiography of the external carotid), the findings were compared with those of angiography. Parenchymal, leptomeningeal, and transdural collaterals were depicted by conventional angiography in 34 (71%), 32 (67%), and 11 (29%) hemispheres respectively. The sensitivity and specificity of MR/MRA for collateral vessels were 79.1/88.1 % for parenchymal collaterals, 72.1/88.1 % for leptomeningeal collaterals, and 0.1/18.1 % for transdural collaterals, respectively. Respective sensitivity and specificity of MR/MRA were 88.94/94.1% for leptomeningeal collaterals, and 18.93/55.1 % for transdural collaterals, when the prominent posterior cerebral and external carotid artery were regarded as secondary signs of leptomeningeal and transdural collateral vessels. In moyamoya disease, MR and MRA are useful imaging modalities for the assessment of collateral vessels. The prominent posterior cerebral artery and external carotid artery can be useful secondary signs of leptomeningeal and transdural collateral vessels. (author). 18 refs., 2 figs.

  1. [Exploration and practice on teaching Meridian, collateral and acupoints to international students in China].

    Science.gov (United States)

    Li, Mingyue; Xu, Yilan; Guo, Yi; Xu, Li

    2015-11-01

    Meridian, collateral and acupoints is the basic course of acupuncture and moxibustion and even is the core for training excellent acupuncture physician. Associated with the characters of international students, the writers had the preliminary exploration and practice on teaching this course. For the acupoint names, the international codes of acupoints and Chinese pinyin were applied in combination and the meanings of acupoint were explained to deepen the understanding of acupoints. For acupoint location, the international standards and classical medical works were combined and the experiences in acupoint location were introduced additionally to open the approach to acupoint location. For acupoint effect, the major functions and ancient medical cases were combined to improve the learning interests. For acupoint location practice, the demonstration by teachers was combined with practice and drawing of acupoints and meridians was supplemented to consolidate the foundational knowledge.

  2. Collateral Development in Thrombosis of the Hepatic Artery After Transplantation.

    Science.gov (United States)

    García Bernardo, C M; Argüelles García, B; Redondo Buil, P; Miyar de León, A; González Dieguez, L; Cadahía Rodrigo, V; González-Pinto Arrillaga, I; Vázquez Velasco, L

    2016-11-01

    The authors sought to identify strictures or hepatic artery obstruction with posterior collateral transformation in our series of liver transplantation, treatment, and evolution. The thrombosis or severe hepatic artery stenosis sometimes presents a compensation mechanism, the collateral transformation of the artery. From April 2002 to December 2011 we collected 18 cases of collateral transformation. We analyzed data regarding the transplantation, diagnosis, treatment, clinical evolution, liver function, and Doppler-ultrasound. The main indication was alcoholic cirrhosis, followed by hepatocellular carcinoma - hepatitis C virus. The mean cold ischemia time was 292.2 minutes mean hot ischemia was 48.8. The anastomosis was performed on the gastroduodenal-splenic patch donor in 14 cases, the celiac trunk in 2 cases, and on grafts to the aorta in another 2. Doppler ultrasound showed 8 cases without complications, 8 with low flows, and 2 cases with alterations of the right hepatic artery. Computed tomographic (CT) angiography was performed in patients with impaired eco-Doppler and found 4 obstructions, 2 cases with kinking, 1 stenosis, and 3 normal cases. Three patients with low flows were re-operated and another re-transplanted. After diagnosis of collateral transformation, all were treated with antiplatelet agents. Two cases of angioplasty were associated. The collaterals were diagnosed 1 month to 44.8 months after transplantation. Five patients died. In the latest data, 10 patients do not have analytical alteration. The Doppler ultrasound shows 7 cases being normal and 6 with flow but low resistances. In our series, all patients with collateral transformation, except one who was transplanted, maintain good liver function with permeable vessels. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Historical Aspects and Relevance of the Human Coronary Collateral Circulation

    Science.gov (United States)

    Seiler, Christian; Meier, Pascal

    2014-01-01

    In 1669, anastomoses between the right and left coronary artery were first documented by Richard Lower of Amsterdam. Using post-mortem imaging, a debate followed on the existence of structural inter-coronary anastomoses, which was not resolved before the first half of the 20ieth century in case of the presence of coronary artery disease (CAD), and not before the early 1960ies in case of the normal human coronary circulation by William Fulton. Functional coronary collateral measurements during coronary interventions were first performed only in the 1970ies, respectively in the early 1980ies. In humans, the existence of functional coronary collaterals in the absence of CAD has not been documented before 2003. Though the coronary collateral circulation has been recognized as an alternative source of blood supply to ischemic myocardium, its prognostic significance for the CAD population as a whole has been controversial until recently. The debate was due to different populations examined (acute versus chronic CAD, varying severity of CAD), to variable definitions of the term “prognosis”, to insufficient statistical power of the investigation with rare occurrence of prognostic endpoints, to short duration of follow-up and to blunt instruments employed for collateral assessment. Individually, it has been acknowledged that a well functioning collateral supply to a myocardial area at risk for necrosis reduces infarct size, preserves ventricular function, prevents ventricular remodelling and aneurysm formation. Collectively, evidence has accumulated only recently that an extensive coronary collateral circulation is a beneficial prognosticator quoad vitam. In a recent meta-analysis on the topic, the risk ratio to die from any cause for high vs low or absent collateralization in patients with subacute myocardial infarction was 0.53 (95% confidence interval 0.15–1.92; p=0.335), and for patients with acute myocardial infarction, it was 0.63 (95% confidence interval 0.29

  4. Leptomeningeal collateral status predicts outcome after middle cerebral artery occlusion

    DEFF Research Database (Denmark)

    Madelung, Christopher Fugl; Ovesen, C; Trampedach, C

    2017-01-01

    reperfusion therapy. MATERIALS AND METHODS: This retrospectively planned analysis was passed on prospectively collected data from 187 consecutive patients with middle cerebral artery occlusion admitted within 4.5 hours to one center and treated with intravenous thrombolysis alone (N = 126), mechanical...... thrombectomy alone (N = 5), or both (N = 56) from May 2009 to April 2014. Non-contrast CT (NCCT) and computed tomography angiography (CTA) were provided on admission and NCCT repeated at 24 hours. Collateral status was assessed based on the initial CTA. Hemorrhagic transformation was evaluated on the 24-hour...... population (P = .001). CONCLUSIONS: Leptomeningeal collateral status predicts functional outcome, mortality, and hemorrhagic transformation following middle cerebral artery occlusion....

  5. 13 CFR 120.1850 - Will the Collateral be held by SBA?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Will the Collateral be held by SBA... Loan Program) § 120.1850 Will the Collateral be held by SBA? Yes, SBA or its expressly authorized agent will take physical possession of all Collateral. SBA or its expressly authorized agent shall maintain...

  6. Timing-Invariant Imaging of Collateral Vessels in Acute Ischemic Stroke

    NARCIS (Netherlands)

    Smit, E.J.; Vonken, E.J.; Seeters, T. van; Dankbaar, J.W.; Schaaf, I.C. van der; Kappelle, L.J.; Ginneken, B. van; Velthuis, B.K.; Prokop, M.

    2013-01-01

    BACKGROUND AND PURPOSE: Although collateral vessels have been shown to be an important prognostic factor in acute ischemic stroke, patients with lack of collaterals on standard imaging techniques may still have good clinical outcome. We postulate that in these cases collateral vessels are present

  7. 76 FR 33817 - Protection of Cleared Swaps Customer Contracts and Collateral; Conforming Amendments to the...

    Science.gov (United States)

    2011-06-09

    ... another customer by making certain that the value of the cleared swaps collateral that the DCO holds... value of FCM or DCO investments of cleared swaps customer collateral. Section 4d(f) of the CEA permits... Swaps Customer Contracts and Collateral; Conforming Amendments to the Commodity Broker Bankruptcy...

  8. The Collateral Circulation in Moyamoya Disease: A Single-Center Experience in 140 Pediatric Patients.

    Science.gov (United States)

    Zhao, Meng; Zhang, Dong; Wang, Shuo; Zhang, Yan; Deng, Xiaofeng; Zhao, Jizong

    2017-12-01

    The patterns and clinical significance of the presence of collaterals in moyamoya disease has not been elucidated thoroughly. We aimed to summarize the clinical features of collaterals in pediatric moyamoya disease. We reviewed consecutive pediatric patients with moyamoya vasculopathy who were admitted to our hospital from 2009 to 2015. Only pediatric moyamoya patients with digital subtraction angiography examinations were included in this study. We classified spontaneous collaterals into two groups by their origins, the internal carotid artery and vertebral artery (ICA-VA)-originated collaterals and the external carotid artery (ECA)-originated collaterals. A total of 140 pediatric patients with moyamoya disease (mean age, 10.1 ± 3.7 years) were included in this study. We identified collaterals originated from ICA-VA in 122 (87.1%) pediatric patients (222 hemispheres). Patients in the ICA-VA collaterals group had similar Suzuki stages with patients without collaterals originated from ICA-VA (mean, 3.86 vs 3.50; P = 0.157). We identified collaterals originated from ECAs in 70 (50.0%) pediatric patients (106 hemispheres) with moyamoya disease. The infarctions were more common in patients with ECA-originated collaterals than in patients without ECA-originated collaterals (25 versus 12; P = 0.021). Our results demonstrate that collaterals originating from ECAs are associated with advanced Suzuki stages and infarction presentations in children with moyamoya disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Coronary collateral circulation: clinical significance and influence on survival in patients with coronary artery occlusion

    DEFF Research Database (Denmark)

    Hansen, J F

    1989-01-01

    In a consecutive series of 96 patients with coronary artery occlusion, 67 had good and 29 had no or poor collateral circulation. Patients with good collaterals had the severest degree of coronary artery disease. Good collaterals are associated with a higher incidence of angina pectoris and normal...

  10. 12 CFR 614.4250 - Collateral evaluation standards.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Collateral evaluation standards. 614.4250 Section 614.4250 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM LOAN POLICIES AND... marketing period for the property; (iii) The current market conditions and trends that will affect projected...

  11. Stiffness of the healing medial collateral ligament of the mouse.

    NARCIS (Netherlands)

    Gijssen, Y.; Sierevelt, I.N.; Kooloos, J.G.M.; Blankevoort, L.

    2004-01-01

    The knee joints of mice can serve as a model for studying knee ligament properties. The goal of our study was to measure the structural stiffness of the medial collateral ligament (MCL) of the murine knee. A tensile test was developed for this purpose. First 84 femur-MCL-tibia complexes of

  12. Targeting pathogen metabolism without collateral damage to the host

    NARCIS (Netherlands)

    Haanstra, Jurgen R.; Gerding, Albert; Dolga, Amalia M.; Sorgdrager, Freek J. H.; Buist-Homan, Manon; du Toit, Francois; Faber, Klaas Nico; Holzhuetter, Hermann-Georg; Szoor, Balazs; Matthews, Keith R.; Snoep, Jacky L.; Westerhoff, Hans V.; Bakker, Barbara M.

    2017-01-01

    The development of drugs that can inactivate disease-causing cells (e.g. cancer cells or parasites) without causing collateral damage to healthy or to host cells is complicated by the fact that many proteins are very similar between organisms. Nevertheless, due to subtle, quantitative differences

  13. SPECT bone scintigraphy of medial collateral ligament/meniscus injury

    Energy Technology Data Exchange (ETDEWEB)

    Micallef, L.; Larcos, G. [Westmead Medical Imaging, Westmead, NSW (Australia)

    1998-06-01

    Full text: Acute or chronic knee pain is common amongst athletic persons. MRI is generally regarded as the best test, but is not widely available and may lack specificity in meniscal tears and cruciate injury. Bone scan with SPECT is an appealing alternative since it is relatively cheap and easily obtained. Further, a number of investigators have published data indicating sensitivity and specificity exceeding 85%. The purpose of the study is to determine typical scintigraphic findings in medial collateral ligament or medial meniscus injury. We present a small group of patients with acute knee trauma in whom arthroscopy and/or clinical follow-up indicated medial collateral ligament injury. Bone scans were undertaken after 900-1000 MBq of {sup 99m}Tc-MDP with immediate blood pool, delayed planar images and SPECT acquired on a Picker Prism 2000. SPECT was obtained with high resolution collimators and 20 sec/stop for 180 deg each. SPECT images showed focal radiopharmaceutical accumulation in the medial proximal tibial shaft and medial femoral condyle, corresponding to the superficial layer of the medial collateral ligament (best seen on coronal images). Disruption of the deep layer and/or medial meniscus can be suspected with abnormal uptake in part or all of the meniscus (best seen on transverse images). We conclude that acute/chronic medial collateral ligament injury can be detected on bone scintigraphy with abnormal uptake at the predicted anatomic site of attachment

  14. Status of systemic to pulmonary arterial collateral flow after the fontan procedure.

    Science.gov (United States)

    Whitehead, Kevin K; Harris, Matthew A; Glatz, Andrew C; Gillespie, Matthew J; DiMaria, Michael V; Harrison, Neil E; Dori, Yoav; Keller, Marc S; Rome, Jonathan J; Fogel, Mark A

    2015-06-15

    The investigators recently validated a method of quantifying systemic-to-pulmonary arterial collateral flow using phase-contrast magnetic resonance imaging velocity mapping. Cross-sectional data suggest decreased collateral flow in patients with total cavopulmonary connections (TCPCs) compared with those with superior cavopulmonary connections (SCPCs). However, no studies have examined serial changes in collateral flow from SCPCs to TCPCs in the same patients. The aim of this study was to examine differences in collateral flow between patients with SCPCs and those with TCPCs. Collateral flow was quantified by 2 independent measures from 250 single-ventricle studies in 219 different patients (115 SCPC and 135 TCPC studies, 31 patients with both) and 18 controls, during routine studies using through-plane phase-contrast magnetic resonance imaging. Collateral flow was indexed to body surface area, aortic flow, and pulmonary venous flow. Regardless of indexing method, SCPC patients had significantly higher collateral flow than TCPC patients (1.64 ± 0.8 vs 1.03 ± 0.8 L/min/m(2), p SCPC and TCPC patients demonstrate substantial collateral flow, with SCPC patients having higher collateral flow than TCPC patients overall. On the basis of the paired subset analysis, collateral flow does not decrease in the short term after TCPC completion and trends toward an increase. In the long term, however, collateral flow decreases over time after TCPC completion. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Determinants of leptomeningeal collateral flow in stroke patients with a middle cerebral artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Seeters, Tom van; Velthuis, Birgitta K. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Biessels, Geert Jan; Kappelle, L.J. [University Medical Center Utrecht, Department of Neurology, Brain Center Rudolf Magnus, Utrecht (Netherlands); Graaf, Yolanda van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Collaboration: on behalf of the Dutch acute stroke study (DUST) investigators

    2016-10-15

    Poor leptomeningeal collateral flow is related to worse clinical outcome in acute ischemic stroke, but the factors that determine leptomeningeal collateral patency are largely unknown. We explored the determinants of leptomeningeal collateral flow and assessed their effect on the relation between leptomeningeal collateral flow and clinical outcome. We included 484 patients from the Dutch acute stroke study (DUST) with a middle cerebral artery (MCA) occlusion. The determinants of poor leptomeningeal collateral flow (≤50 % collateral filling) were identified with logistic regression. We calculated the relative risk (RR) of poor leptomeningeal collateral flow in relation to poor clinical outcome (90-day modified Rankin Scale 3-6) using Poisson regression and assessed whether the determinants of leptomeningeal collateral flow affected this relation. Leptomeningeal collateral flow was poor in 142 patients (29 %). In multivariable analyses, higher admission glucose level (odds ratio (OR) 1.1 per mmol/L increase (95 % CI 1.0-1.2)), a proximal MCA occlusion (OR 1.9 (95 % CI 1.3-3.0)), and an incomplete posterior circle of Willis (OR 1.7 (95 % CI 1.1-2.6)) were independently related to poor leptomeningeal collateral flow. Poor leptomeningeal collateral flow was related to poor clinical outcome (unadjusted RR 1.7 (95 % CI 1.4-2.0)), and this relation was not affected by the determinants of leptomeningeal collateral flow. Our study shows that admission glucose level, a proximal MCA occlusion, and an incomplete ipsilateral posterior circle of Willis are determinants of leptomeningeal collateral flow that represent a combination of congenital, acquired, and acute factors. After adjustment for these determinants, leptomeningeal collateral flow remains related to clinical outcome. (orig.)

  16. Coherent branching feature bisimulation

    Directory of Open Access Journals (Sweden)

    Tessa Belder

    2015-04-01

    Full Text Available Progress in the behavioral analysis of software product lines at the family level benefits from further development of the underlying semantical theory. Here, we propose a behavioral equivalence for feature transition systems (FTS generalizing branching bisimulation for labeled transition systems (LTS. We prove that branching feature bisimulation for an FTS of a family of products coincides with branching bisimulation for the LTS projection of each the individual products. For a restricted notion of coherent branching feature bisimulation we furthermore present a minimization algorithm and show its correctness. Although the minimization problem for coherent branching feature bisimulation is shown to be intractable, application of the algorithm in the setting of a small case study results in a significant speed-up of model checking of behavioral properties.

  17. Significance of good collateral compensation in symptomatic intracranial atherosclerosis.

    Science.gov (United States)

    Lau, Alexander Y L; Wong, Edward H C; Wong, Adrian; Mok, Vincent C T; Leung, Thomas W; Wong, Ka-sing Lawrence

    2012-01-01

    Collateral circulation stabilizes cerebral blood flow in patients with acute occlusion, but its prognostic role is less studied in intracranial atherosclerosis and appears different in moderate to severe stenosis. We aimed to study the associations between antegrade flow across stenosis, collateral flow via leptomeningeal anastomosis, and the neurological outcome and recurrence risk in patients with symptomatic intracranial stenosis. We examined a cohort of consecutive patients admitted for stroke or transient ischemic attack (TIA) with symptomatic intracranial stenosis confirmed by digital subtraction angiography in a single-center retrospective study. Angiograms were graded systematically in a blinded fashion for antegrade and collateral flow, using Thrombolysis in Cerebral Infarction (TICI) and American Society of Intervention and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) grading, respectively, and integrated to a simple composite circulation score. Demographic and clinical variables, modified Rankin Scale (mRS) scores at 3 months, recurrent stroke or TIA in 12 months were collected. Uni- and multivariate analyses were performed to identify independent predictors of good outcome (mRS 0-2) and recurrence in a logistic regression model. Among 69 patients with pure intracranial atherosclerosis ≥ 50%, compromised antegrade flow (TICI 0-2a) was observed in 26 (36%) patients and was associated with more severe arterial stenosis (mean 86 vs. 74%, p = 0.001). Poor collateral compensation resulting in a poor composite circulation score was observed in 8 (12%) patients. Patients with a good circulation score (n = 61, 88%) had preserved flow, which was associated with more favorable outcome (OR 7.50, 95% CI 1.11-50.7, p = 0.04) and less recurrent TIA or stroke (OR 0.18, 95% CI 0.04-0.96, p = 0.04). Prognosis was not significantly associated with antegrade or collateral grade per se. Good collateral compensations are more important in

  18. Collateral circulation formation determines the characteristic profiles of contrast-enhanced MRI in the infarcted myocardium of pigs

    Science.gov (United States)

    Wang, Jian; Xiang, Bo; Lin, Hung-yu; Liu, Hong-yu; Freed, Darren; Arora, Rakesh C; Tian, Gang-hong

    2015-01-01

    Aim: To investigate the relationship between the collateral circulation and contrast-enhanced MR signal change for myocardial infarction (MI) in pigs. Methods: Pigs underwent permanent ligation of two diagonal branches of the left anterior descending artery. First-pass perfusion (FPP) MRI (for detecting myocardial perfusion abnormalities) and delayed enhancement (DE) MRI (for estimating myocardial infarction) using Gd-DTPA were performed at 2 h, 7 d and 4 weeks after the coronary occlusion. Myocardial blood flow (MBF) was evaluated using nonradioactive red-colored microspheres. Histological examination was performed to characterize the infarcts. Results: Acute MI performed at 2 h afterwards was characterized by hypoenhancement in both FPP- and DE-MRI, with small and almost unchanged FPP-signal intensity (SI) and DE-SI due to negligible MBF. Subacute MI detected 7 d afterwards showed small but significantly increaseing FPP-SI, and was visible as a sluggish hyperenhancement in DE-MRI with considerably higher DE-SI compared to the normal myocardium; the MBF approached the half-normal value. Chronic MI detected at 4 weeks afterwards showed increasing FPP-SI comparable to the normal myocardium, and a rapid hyperenhancement in DE-MRI with even higher DE-SI; the MBF was close to the normal value. The MBF was correlated with FPP-SI (r=+0.94, P<0.01) and with the peak DE-SI (r=+0.92, P<0.01) at the three MI stages. Remodeled vessels were observed at intra-infarction and peri-infarction zones during the subacute and chronic periods. Conclusion: Progressive collateral recovery determines the characteristic profiles of contrast-enhanced MRI in acute, subacute and chronic myocardial infarction in pigs. The FPP- and DE-MRI signal profiles not only depend on the loss of tissue viability and enlarged interstitial space, but also on establishing a collateral circulation. PMID:25832427

  19. Predictors of Collateral Learning Transfer in Continuing Vocational Training

    Directory of Open Access Journals (Sweden)

    Anja-Christina Hinrichs

    2014-08-01

    Full Text Available Against the background of demographic change and skill shortages continuing vocational training is of great significance in Germany. However, the training effectiveness is mostly assessed only at the end of a training program or several months after the training. Since in continuing vocational training the two contexts learning field (training and performance field (work context act simultaneously, the presented study investigated whether there are already situations in the work context which allow the application of newly acquired knowledge in parallel with the training. The main focus lies in the identification of predictors of learning transfer that takes place alongside the training participation and in the investigation of their causal relationships. Using structural equation modelling five latent variables were identified which have a significant effect on learning transfer parallel to the training – the so called collateral learning transfer. These five predictors explain together 62% of the variance of collateral learning transfer (gathered as performance improvement at work.

  20. Renal Branch Artery Stenosis

    DEFF Research Database (Denmark)

    Andersson, Zarah; Thisted, Ebbe; Andersen, Ulrik Bjørn

    2017-01-01

    Renovascular hypertension is a common cause of pediatric hypertension. In the fraction of cases that are unrelated to syndromes such as neurofibromatosis, patients with a solitary stenosis on a branch of the renal artery are common and can be diagnostically challenging. Imaging techniques...... that perform well in the diagnosis of main renal artery stenosis may fall short when it comes to branch artery stenosis. We report 2 cases that illustrate these difficulties and show that a branch artery stenosis may be overlooked even by the gold standard method, renal angiography....

  1. Materials Test Branch

    Science.gov (United States)

    Gordon, Gail

    2012-01-01

    The Materials Test Branch resides at Marshall Space Flight Center's Materials and Processing laboratory and has a long history of supporting NASA programs from Mercury to the recently retired Space Shuttle. The Materials Test Branch supports its customers by supplying materials testing expertise in a wide range of applications. The Materials Test Branch is divided into three Teams, The Chemistry Team, The Tribology Team and the Mechanical Test Team. Our mission and goal is to provide world-class engineering excellence in materials testing with a special emphasis on customer service.

  2. [MRI of the thumb collateral ligament at the metacarpophalangeal joint: anatomy and injuries].

    Science.gov (United States)

    Ye, Wei; Zhan, Huili; Bai, Rongjie; Qian, Zhanhua; Li, Yaxiong; Wu, Bodong

    2015-05-05

    To explore the anatomy and injuries features of the thumb collateral ligamentat the metacarpophalangeal (MCP) joints. The study was reviewed and approved by an institutional review board of hospital. Clinical imaging data of 7 healthy volunteers who without injuries and 20 patients with thumb collateral ligament injuries were retrospectively analyzed. All subjects underwent magnetic resonance examination, then comparative analysis of the normal anatomy and the thumb collateral ligament injury at MCP joints of MRI features in healthy volunteers and patients with injury. Imaging findings were compared with the surgical results and confirmed by followed up in patients. Seven volunteers without ligament injures showed homogeneous low-signal-intensity on T1-weighted and proton fat saturation sequence (PD-FS) images. The average thickness of the ulnarcollateral ligament is about 2.0 to 2.3 mm, however, the normal radial collateral ligament is thinner, the average thickness is about 1.4-1.5 mm. There were 20 patients with thumb collateral ligament injuresat MCP joints, including 12 cases of ulnar collateral ligament injury and 8 cases of radial collateral ligament injury, which demonstrated poor definition, discontinuity and heterogeneously increased signal intensity in proton fat saturation sequence (PD-FS) of the involved collateral ligament. There was edema in the soft tissues surrounding the injured sites. MRI is an accurate method for evaluation of the anatomy and pathologic conditions of the thumb collateral ligamentsat MCP joints, and it is a useful tool for early diagnosis and treatment of the thumb collateral ligaments injuries.

  3. The relationship between gamma-glutamyltransferase and coronary collateral circulation in patients with chronic total occlusion.

    Science.gov (United States)

    Şahin, Müslüm; Demir, Serdar; Kalkan, Mehmet Emin; Özkan, Birol; Alıcı, Gökhan; Çakalağaoğlu, Kamil Cantürk; Yazıcıoğlu, Mehmet Vefik; Sarıkaya, Sabit; Biteker, Murat; Türkmen, Mehmet Muhsin

    2014-02-01

    The aim of this study was to evaluate the relation between blood gamma-glutamyltransferase (GGT) levels and coronary collateral circulation in patients with chronic total occlusion (CTO). Two hundred twenty-two patients with chronic stable coronary artery disease (CAD) and CTO were included in this cross-sectional, observational study. Coronary collaterals were graded from 0 to 3 according to the Rentrop method. Patients with grade 0-1 collateral development were regarded as poor collateral group (n=66) while patients with grade 2-3 collateral development were regarded as good collateral group (n=156). Statistical analysis was performed using independent samples t, Mann-Whitney U and Chi-square tests, logistic regression and receiver operator curve analysis. The poor coronary collateral group had significantly higher levels of serum GGT compared to the good collateral group (pcirculation (OR-0.946, 95% CI=0.918-0.9719, pcoronary collateral circulation in patients with CTO. GGT may be used to predict the grade of coronary collateral circulation in CTO patients with chronic stable CAD.

  4. Bundle Branch Block

    Science.gov (United States)

    ... 2015. Bundle branch block Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  5. Branching processes in biology

    CERN Document Server

    Kimmel, Marek

    2015-01-01

    This book provides a theoretical background of branching processes and discusses their biological applications. Branching processes are a well-developed and powerful set of tools in the field of applied probability. The range of applications considered includes molecular biology, cellular biology, human evolution and medicine. The branching processes discussed include Galton-Watson, Markov, Bellman-Harris, Multitype, and General Processes. As an aid to understanding specific examples, two introductory chapters, and two glossaries are included that provide background material in mathematics and in biology. The book will be of interest to scientists who work in quantitative modeling of biological systems, particularly probabilists, mathematical biologists, biostatisticians, cell biologists, molecular biologists, and bioinformaticians. The authors are a mathematician and cell biologist who have collaborated for more than a decade in the field of branching processes in biology for this new edition. This second ex...

  6. Salient features of the coronary collateral circulation and its clinical relevance.

    Science.gov (United States)

    Stoller, Michael; Seiler, Christian

    2015-01-01

    The coronary collateral circulation provides an alternative source of blood supply to myocardium jeopardised by ischaemia. Collaterals enlarge with obstructive coronary artery disease to allow bulk flow, but blood flow deliverable by the native, pre-formed collateral extent can already be sizeable. Genetic determinants contribute significantly to the wide variability observed in both native collateral extent and its capacity to enlarge, and the severity of the coronary stenosis is the most significant environmental determinant for collateral enlargement. The protective effect of a well-developed coronary collateral circulation translates into relevant improvements in all-cause and cardiac mortality in the acute and chronic phases of coronary artery disease, as well as into a reduction of future adverse cardiovascular events.

  7. Morphological study of mechanoreceptors in collateral ligaments of the ankle joint

    OpenAIRE

    Wu, Xiaochuan; Song, Weidong; Zheng, Cuihuan; Zhou, Shixiong; Bai, Shengbin

    2015-01-01

    Background The aim of this study was to analyze the pattern and types of sensory nerve endings in ankle collateral ligaments using histological techniques, in order to observe the morphology and distribution of mechanoreceptors in the collateral ligaments of cadaver ankle joint, and to provide the morphological evidence for the role of the ligament in joint sensory function. Methods Twelve lateral collateral ligaments including anterior talofibular ligament (ATFL; n?=?6), posterior talofibula...

  8. Coronary collateralization shows sex and racial-ethnic differences in obstructive artery disease patients.

    Directory of Open Access Journals (Sweden)

    Zhi Liu

    Full Text Available Coronary collateral circulation protects cardiac tissues from myocardial infarction damage and decreases sudden cardiac death. So far, it is unclear how coronary collateralization varies by race-ethnicity groups and by sex.We assessed 868 patients with obstructive CAD. Patients were assessed for collateral grades based on Rentrop grading system, as well as other covariates. DNA samples were genotyped using the Affymetrix 6.0 genotyping array. To evaluate genetic contributions to collaterals, we performed admixture mapping using logistic regression with estimated local and global ancestry.Overall, 53% of participants had collaterals. We found difference between sex and racial-ethnic groups. Men had higher rates of collaterals than women (P-value = 0.000175. White Hispanics/Latinos showed overall higher rates of collaterals than African Americans and non-Hispanic Whites (59%, 50% and 48%, respectively, P-value = 0.017, and especially higher rates in grade 1 and grade 3 collateralization than the other two populations (P-value = 0.0257. Admixture mapping showed Native American ancestry was associated with the presence of collaterals at a region on chromosome 17 (chr17:35,243,142-41,251,931, β = 0.55, P-value = 0.000127. African ancestry also showed association with collaterals at a different region on chromosome 17 (chr17: 32,266,966-34,463,323, β = 0.38, P-value = 0.00072.In our study, collateralization showed sex and racial-ethnic differences in obstructive CAD patients. We identified two regions on chromosome 17 that were likely to harbor genetic variations that influenced collateralization.

  9. Status of Systemic To Pulmonary Arterial Collateral Flow After the Fontan Procedure

    OpenAIRE

    Whitehead, Kevin K.; Harris, Matthew A.; Glatz, Andrew C.; Gillespie, Matthew J.; DiMaria, Michael V.; Harrison, Neil E.; Dori, Yoav; Keller, Marc S.; Rome, Jonathan J.; Fogel, Mark A.

    2015-01-01

    We recently validated a method of quantifying systemic to pulmonary arterial collateral flow using phase-contrast magnetic resonance imaging velocity mapping (PC-MRI). Cross-sectional data suggest decreased collateral flow in patients with total cavopulmonary connections (TCPC) compared to those with superior cavopulmonary connections (SCPC). However, no studies have examined serial changes in collateral flow from SCPC to TCPC in the same patients. We sought to examine differences in collater...

  10. Associations Between Collateral Status and Thrombus Characteristics and Their Impact in Anterior Circulation Stroke.

    Science.gov (United States)

    Alves, Heitor C; Treurniet, Kilian M; Dutra, Bruna G; Jansen, Ivo G H; Boers, Anna M M; Santos, Emilie M M; Berkhemer, Olvert A; Dippel, Diederik W J; van der Lugt, Aad; van Zwam, Wim H; van Oostenbrugge, Robert J; Lingsma, Hester F; Roos, Yvo B W E M; Yoo, Albert J; Marquering, Henk A; Majoie, Charles B L M

    2018-02-01

    Thrombus characteristics and collateral score are associated with functional outcome in patients with acute ischemic stroke. It has been suggested that they affect each other. The aim of this study is to evaluate the association between clot burden score, thrombus perviousness, and collateral score and to determine whether collateral score influences the association of thrombus characteristics with functional outcome. Patients with baseline thin-slice noncontrast computed tomography and computed tomographic angiography images from the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands) were included (n=195). Collateral score and clot burden scores were determined on baseline computed tomographic angiography. Thrombus attenuation increase was determined by comparing thrombus density on noncontrast computed tomography and computed tomographic angiography using a semiautomated method. The association of collateral score with clot burden score and thrombus attenuation increase was evaluated with linear regression. Mediation and effect modification analyses were used to assess the influence of collateral score on the association of clot burden score and thrombus attenuation increase with functional outcome. A higher clot burden score (B=0.063; 95% confidence interval, 0.008-0.118) and a higher thrombus attenuation increase (B=0.014; 95% confidence interval, 0.003-0.026) were associated with higher collateral score. Collateral score mediated the association of clot burden score with functional outcome. The association between thrombus attenuation increase and functional outcome was modified by the collateral score, and this association was stronger in patients with moderate and good collaterals. Patients with lower thrombus burden and higher thrombus perviousness scores had higher collateral score. The positive effect of thrombus perviousness on clinical outcome was only present in patients with

  11. Synthesis of branched polysaccharides with tunable degree of branching

    NARCIS (Netherlands)

    Ciric, Jelena; Loos, Katja

    2013-01-01

    An in vitro enzyme-catalyzed tandem reaction using the enzymes phosphorylase b from rabbit muscle and Deinococcus geothermalis glycogen branching enzyme (Dg GBE) to obtain branched polyglucans with tunable degree of branching (2% divided by 13%) is presented. The tunable degree of branching is

  12. Detection of human collateral circulation by vasodilation-thallium-201 tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nienaber, C.A.; Salge, D.; Spielmann, R.P.; Montz, R.; Bleifeld, W. (University Hospital Eppendorf, Hamburg (Germany, F.R.))

    1990-04-15

    Coronary arteriolar vasodilation may provoke redistribution of flow to collateral-dependent jeopardized myocardium. To assess the physiologic significance of collaterals, 80 consecutive post-infarction patients (age 58 +/- 8 years) underwent vasodilation-redistribution thallium-201 tomographic imaging after administration of 0.56 mg of intravenous dipyridamole/kg body weight. Circumferential profile analysis of thallium-201 uptake and redistribution in representative left ventricular tomograms provided quantitative assessment of transient and fixed defects and separation between periinfarctional and distant inducible hypoperfusion. Tomographic perfusion data were correlated to wall motion and collateral circulation between distinct anatomic perfusion territories. Patients were grouped according to presence (59%) or absence (41%) of angiographically visible collateral channels to jeopardized myocardium. In the presence of collaterals, distant reversible defects were larger than in absence of collaterals (p less than 0.05); the extent of combined periinfarctional and distant redistribution was also larger in collateralized patients (p less than 0.025), whereas the size of the persistent perfusion defect was similar in both groups. By prospective analysis the tomographic perfusion pattern of combined periinfarctional and distant redistribution revealed a sensitivity of 85% and a specificity of 78% for the detection of significant collateral circulation in this group of patients. Thus, using the exhausted flow reserve as a diagnostic tool, vasodilation-thallium-201 tomography has the potential to identify and quantitate collateralized myocardium in post-infarction patients and may guide diagnostic and therapeutic decision-making.

  13. Right bundle branch block

    DEFF Research Database (Denmark)

    Bussink, Barbara E; Holst, Anders Gaarsdal; Jespersen, Lasse

    2013-01-01

    AimsTo determine the prevalence, predictors of newly acquired, and the prognostic value of right bundle branch block (RBBB) and incomplete RBBB (IRBBB) on a resting 12-lead electrocardiogram in men and women from the general population.Methods and resultsWe followed 18 441 participants included.......5%/2.3% in women, P Right bundle branch block was associated with significantly...... increased all-cause and cardiovascular mortality in both genders with age-adjusted hazard ratios (HR) of 1.31 [95% confidence interval (CI), 1.11-1.54] and 1.87 (95% CI, 1.48-2.36) in the gender pooled analysis with little attenuation after multiple adjustment. Right bundle branch block was associated...

  14. Isolated Unilateral Absent Branch Pulmonary Artery with Peripheral Pulmonary Stenosis and Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Sunil Abhishek B

    2017-09-01

    Full Text Available Isolated Unilateral Absent Pulmonary Artery (UAPA is a rare congenital anomaly. It is usually associated with congenital heart defects. A 45 year old male patient presented with complaints of fever with cough and expectoration for 15 days and retrosternal chest discomfort for the previous 2 days. ECG showed diffuse ST segment depression with T wave inversion in the inferior and lateral leads. Coronary Angiogram done through the right femoral approach revealed diffusely diseased Left Anterior Descending (LAD artery that was totally cut off at the mid segment. The Left Circumflex (LCx artery was providing blood supply to the right middle and lower lung areas. There was another collateral arising from the Left Subclavian Artery supplying the right middle and lower lung areas. The left pulmonary artery was normal, but branches supplying the middle and lower lobes of the right lung were absent and the upper lobe branch had pulmonary stenosis. UAPA is a rare clinical entity; collaterals from coronaries are extremely rare in this condition and till now there has not been any case report of unilateral absent branch pulmonary artery with peripheral stenosis of other branches, on the affected side and associated coronary artery disease.

  15. The fibular collateral ligament of the knee: a detailed review.

    Science.gov (United States)

    Song, Young-Bin; Watanabe, Koichi; Hogan, Elizabeth; D'Antoni, Anthony V; Dilandro, Anthony C; Apaydin, Nihal; Loukas, Marios; Shoja, Mohammadali M; Tubbs, R Shane

    2014-07-01

    The fibular collateral ligament (FCL) is one of the larger ligaments of the knee. The FCL, along with the popliteus tendon, arcuate popliteal ligament, and joint capsule, make up the posterolateral corner of the knee. Recently, there has there been an increased awareness and research on the structures of the posterolateral corner of the knee, particularly the FCL. Studying the detailed structure of the FCL may provide a better understanding that can lead to better diagnosis and treatments following injury. Therefore, this article reviews the FCL, which appears to be the primary restraint to varus rotation but is poorly oriented to resist external rotation of the knee. © 2013 Wiley Periodicals, Inc.

  16. State-set branching

    DEFF Research Database (Denmark)

    Jensen, Rune Møller; Veloso, Manuela M.; Bryant, Randal E.

    2008-01-01

    In this article, we present a framework called state-set branching that combines symbolic search based on reduced ordered Binary Decision Diagrams (BDDs) with best-first search, such as A* and greedy best-first search. The framework relies on an extension of these algorithms from expanding a sing...

  17. Tracheobronchial Branching Anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Min Ji; Kim, Young Tong; Jou, Sung Shick [Soonchunhyang University, Cheonan Hospital, Cheonan (Korea, Republic of); Park, A Young [Soonchunhyang University College of Medicine, Asan (Korea, Republic of)

    2010-04-15

    There are various congenital anomalies with respect to the number, length, diameter, and location of tracheobronchial branching patterns. The tracheobronchial anomalies are classified into two groups. The first one, anomalies of division, includes tracheal bronchus, cardiac bronchus, tracheal diverticulum, pulmonary isomerism, and minor variations. The second one, dysmorphic lung, includes lung agenesis-hypoplasia complex and lobar agenesis-aplasia complex

  18. Collateral methotrexate resistance in cisplatin-selected murine leukemia cells

    Directory of Open Access Journals (Sweden)

    Bhushan A.

    1999-01-01

    Full Text Available Resistance to anticancer drugs is a major cause of failure of many therapeutic protocols. A variety of mechanisms have been proposed to explain this phenomenon. The exact mechanism depends upon the drug of interest as well as the tumor type treated. While studying a cell line selected for its resistance to cisplatin we noted that the cells expressed a >25,000-fold collateral resistance to methotrexate. Given the magnitude of this resistance we elected to investigate this intriguing collateral resistance. From a series of investigations we have identified an alteration in a membrane protein of the resistant cell as compared to the sensitive cells that could be the primary mechanism of resistance. Our studies reviewed here indicate decreased tyrosine phosphorylation of a protein (molecular mass = 66 in the resistant cells, which results in little or no transfer of methotrexate from the medium into the cell. Since this is a relatively novel function for tyrosine phosphorylation, this information may provide insight into possible pharmacological approaches to modify therapeutic regimens by analyzing the status of this protein in tumor samples for a better survival of the cancer patients.

  19. 13 CFR 123.513 - Does SBA require collateral on its Military Reservist EIDL?

    Science.gov (United States)

    2010-01-01

    ... Military Reservist EIDL? 123.513 Section 123.513 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION DISASTER LOAN PROGRAM Military Reservist Economic Injury Disaster Loans § 123.513 Does SBA require collateral on its Military Reservist EIDL? SBA will not generally require you to pledge collateral to secure...

  20. 7 CFR 1421.106 - Warehouse-stored marketing assistance loan collateral.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Warehouse-stored marketing assistance loan collateral...) COMMODITY CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS GRAINS AND... Marketing Assistance Loans § 1421.106 Warehouse-stored marketing assistance loan collateral. (a) A commodity...

  1. Collateralization, Bank Loan Rates and Monitoring : Evidence from a Natural Experiment

    NARCIS (Netherlands)

    Cerqueiro, G.M.; Ongena, S.; Roszbach, K.

    2011-01-01

    Collateral is one of the most important features of a debt contract. A substantial theoretical literature motivates the use of collateral as a means to alleviate ex-ante and ex-post information asymmetries between borrowers and lenders and the incidence of credit rationing. Through its seniority

  2. Validation of ultrasound parameters to assess collateral flow via ophthalmic artery in internal carotid artery occlusion.

    Science.gov (United States)

    Tanaka, Tomotaka; Doijiri, Ryosuke; Saito, Kozue; Kajimoto, Katsufumi; Ihara, Masafumi; Yamagami, Hiroshi; Miyashita, Kotaro; Nagatsuka, Kazuyuki

    2014-01-01

    This study aimed to characterize the flow patterns using ultrasound (US) in the external carotid artery (ECA) in patients with total occlusion of internal carotid artery (ICA) and characterize collateral retrograde flow through the ophthalmic artery (OA, secondary collateral, internalization). This study was performed on 45 patients who were retrospectively selected with total occlusion of the ICA, who underwent digital subtraction angiography (DSA), magnetic resonance angiography (MRA), and US (43 men; mean age 68.1 ± 7.9 years). Collateral retrograde flow and collateral flow through the circle of Willis (primary collateral) were determined by DSA and MRA. We compared several US parameters such as ECA peak systolic velocity, mean velocity, end-diastolic (ED) velocity, pulsatility index (PI), and pulsatility transmission index (PTI). PTI was defined as the ratio of ipsilateral ECA PI to the ipsilateral common carotid artery (CCA). In this patient group, 27 patients showed retrograde flow through OA as assessed by DSA. The presence of primary collateral flow was significantly lower in patients with retrograde flow than without (P ECA ED velocity was significantly higher, and PI and PTI were significantly lower with retrograde flow through OA than without (P ECA because a collateral pathway through OA in cases of ICA occlusion had less primary collateral pathways. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  3. Selective cyclooxygenase-1 inhibition improves collateral vascular reactivity in biliary cirrhotic rats

    Directory of Open Access Journals (Sweden)

    Ching-Chih Chang

    2013-10-01

    Conclusion: There was no significant hemodynamic change and renal toxicity after acute administration of COX inhibitor in the FBDL-induced cirrhotic rats. Preincubation of selective COX-1, but not COX-2, inhibitor could enhance collateral vascular response to AVP, indicating that COX-1 plays a major role in the collateral vascular reactivity.

  4. Laparoscopic umbilical hernia repair in the presence of extensive paraumbilical collateral veins: A case report

    NARCIS (Netherlands)

    S.S. Lases (Seilenna); H.H. Eker (Hasan); E.G.J.M. Pierik; P.J. Klitsie (Pieter); B. de Goede (Barry); M.P.F.V. Peeters; G. Kazemier (Geert); J.F. Lange (Johan)

    2011-01-01

    textabstractA patient with an umbilical hernia presenting with collateral veins in the abdominal wall and umbilicus is a case that every hernia surgeon has to deal with occasionally. Several underlying diseases have been described to provoke collateral veins in the abdominal wall. However, the

  5. Role of coronary collaterals in off-pump and on-pump coronary bypass surgery

    NARCIS (Netherlands)

    Nathoe, H.M.|info:eu-repo/dai/nl/267961472; Buskens, Erik; Jansen, E.W.L.; Suyker, W.J.L.|info:eu-repo/dai/nl/321847024; Stella, P.R.|info:eu-repo/dai/nl/304814717; Lahpor, J.R.; van Boven, W.J.; van Dijk, D.|info:eu-repo/dai/nl/241616301; Diephuis, J.C.; Borst, C.; Moons, K.G.M.|info:eu-repo/dai/nl/152483519; Grobbee, D.E.|info:eu-repo/dai/nl/071889256; de Jaegere, P.P.T.

    2004-01-01

    BACKGROUND: Collaterals limit infarct size, preserve viability, and reduce mortality in patients with acute myocardial infarction. In patients with stable coronary disease, collaterals are associated with less angina and ischemia during angioplasty and fewer ischemic events during follow-up. The

  6. CSPGs inhibit axon branching by impairing mitochondria-dependent regulation of actin dynamics and axonal translation.

    Science.gov (United States)

    Sainath, Rajiv; Ketschek, Andrea; Grandi, Leah; Gallo, Gianluca

    2017-04-01

    Chondroitin sulfate proteoglycans (CSPGs) inhibit the formation of axon collateral branches. The regulation of the axonal cytoskeleton and mitochondria are important components of the mechanism of branching. Actin-dependent axonal plasticity, reflected in the dynamics of axonal actin patches and filopodia, is greatest along segments of the axon populated by mitochondria. It is reported that CSPGs partially depolarize the membrane potential of axonal mitochondria, which impairs the dynamics of the axonal actin cytoskeleton and decreases the formation and duration of axonal filopodia, the first steps in the mechanism of branching. The effects of CSPGs on actin cytoskeletal dynamics are specific to axon segments populated by mitochondria. In contrast, CSPGs do not affect the microtubule content of axons, or the localization of microtubules into axonal filopodia, a required step in the mechanism of branch formation. It is also reported that CSPGs decrease the mitochondria-dependent axonal translation of cortactin, an actin associated protein involved in branching. Finally, the inhibitory effects of CSPGs on axon branching, actin cytoskeletal dynamics and the axonal translation of cortactin are reversed by culturing neurons with acetyl-l-carnitine, which promotes mitochondrial respiration. Collectively these data indicate that CSPGs impair mitochondrial function in axons, an effect which contributes to the inhibition of axon branching. © 2016 Wiley Periodicals, Inc. Develop Neurobiol 77: 419-437, 2017. © 2016 Wiley Periodicals, Inc.

  7. The association of circulating monocyte count with coronary collateral growth in patients with diabetes mellitus.

    Science.gov (United States)

    Kocaman, Sinan Altan; Sahinarslan, Asife; Akyel, Ahmet; Timurkaynak, Timur; Boyaci, Bulent; Cengel, Atiye

    2010-03-01

    The status of inflammation may affect the collateral development in patients with diabetes mellitus (DM). Monocytes were found to have an important role in collateral growth in animal studies. We aimed to investigate the possible association of circulating monocyte count with collateral development in patients with DM and severe coronary artery disease (CAD). We enrolled 134 consecutive patients with DM who had > or =95 stenosis in at least one major coronary artery and investigated the relationship between circulating monocyte count and collateral growth. When we analyzed the coronary angiograms of eligible patients, we found that 64 of them had good collateral growth and 70 had poor collateral growth according to the Cohen-Rentrop method. The monocyte count was significantly different between good and poor collateral growth groups (643 +/- 184 vs. 479 +/- 143 per mm(3), P < 0.001). In the analysis comparing the Rentrop score with the Gensini score and circulating monocyte count, we found significant correlations (r = 0.293, P = 0.001 and r = 0.455, P < 0.001, respectively). The duration of ischemic symptoms tended to be longer in the good collateral group (1.9 +/- 4.1 vs. 0.8 +/- 1.3 years, P = 0.079). The Gensini score was also correlated with the duration of myocardial ischemic symptoms (r = 0.299, P = 0.004). Multivariate analysis revealed an increased monocyte count in the good collateral group [odds ratio (OR), 5.726; 95% confidence interval (CI), 1.817-18.040, P = 0.003, the cut-off value for monocyte was defined as 550 cell/mm(3)]. The increased circulating monocyte count in diabetic patients was evidently related to good coronary collateral growth. This finding may be potentially important in clinical and basic cardiovascular medicine.

  8. [Synopsis about the hypothesis of "information channel" of channel-collateral system].

    Science.gov (United States)

    Chang, Xi-Lang

    2008-10-01

    The author of the present paper founded a theorem about the "incompleteness of single channel structure" (nerve, blood vessel, lymphatic, interspace, aperture, etc.) through quantitative and qualitative analysis about the economic information channel in the human body, which eliminates the probability of single channel structure in the information channel of channel (meridian)-collateral system. After comprehensive analysis on the current researches, the author puts forward a neodoxy, i.e., the body "information channel" structure of the channel-collateral system, mainly follows the distribution regularity of systemic statistics, and is not a single specific entity; various layers of the information channel in the main stems of the channel-collaterals are composed of optimized structure tissues. Hence, the structure of this information channel of channel-collateral system is an overall-optimized, sequential and compatible systemic structure. From this neodoxy, the author brings forward a working principle of channel-collaterals, which is supported theoretically by bio-auxology. The longitudinal distribution of the main stems of meridian-collaterals is considered to result from that in the process of the animal evolution, in the animals moving forward, the microscopic complicated movement of intracorporeal information and energy molecules is related to the forward macroscopic and non-uniform movement of organism in trans-measure. Its impulse and kinetic momentum forms a main vector in the longitudinal direction of the body (the direction of the main stem of channel-collaterals). In order to adapt to and utilize natural regularities, the main stems of the channel-collaterals gradually differentiate and evolve in the living organism, forming a whole system. The "hypothesis of biological origin of channel-collateral system" and "that of information channel of the channel-collaterals in the body" constitute a relatively complete theoretical system framework.

  9. Tau leptonic branching ratios

    CERN Document Server

    Buskulic, Damir; De Bonis, I; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Odier, P; Pietrzyk, B; Ariztizabal, F; Chmeissani, M; Crespo, J M; Efthymiopoulos, I; Fernández, E; Fernández-Bosman, M; Gaitan, V; Garrido, L; Martínez, M; Orteu, S; Pacheco, A; Padilla, C; Palla, Fabrizio; Pascual, A; Perlas, J A; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Farilla, A; Gelao, G; Girone, M; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Natali, S; Nuzzo, S; Ranieri, A; Raso, G; Romano, F; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Bonvicini, G; Cattaneo, M; Comas, P; Coyle, P; Drevermann, H; Engelhardt, A; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Jacobsen, R; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Markou, C; Martin, E B; Mato, P; Minten, Adolf G; Miquel, R; Oest, T; Palazzi, P; Pater, J R; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schneider, O; Tejessy, W; Tomalin, I R; Venturi, A; Wachsmuth, H W; Wiedenmann, W; Wildish, T; Witzeling, W; Wotschack, J; Ajaltouni, Ziad J; Bardadin-Otwinowska, Maria; Barrès, A; Boyer, C; Falvard, A; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Montret, J C; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rossignol, J M; Saadi, F; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Kyriakis, A; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Passalacqua, L; Rougé, A; Rumpf, M; Tanaka, R; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Delfino, M C; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Pepé-Altarelli, M; Dorris, S J; Halley, A W; ten Have, I; Knowles, I G; Lynch, J G; Morton, W T; O'Shea, V; Raine, C; Reeves, P; Scarr, J M; Smith, K; Smith, M G; Thompson, A S; Thomson, F; Thorn, S; Turnbull, R M; Becker, U; Braun, O; Geweniger, C; Graefe, G; Hanke, P; Hepp, V; Kluge, E E; Putzer, A; Rensch, B; Schmidt, M; Sommer, J; Stenzel, H; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Colling, D J; Dornan, Peter J; Konstantinidis, N P; Moneta, L; Moutoussi, A; Nash, J; San Martin, G; Sedgbeer, J K; Stacey, A M; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Bowdery, C K; Brodbeck, T J; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Whelan, E P; Williams, M I; Galla, A; Greene, A M; Kleinknecht, K; Quast, G; Raab, J; Renk, B; Sander, H G; Wanke, R; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Bencheikh, A M; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Diaconu, C A; Etienne, F; Thulasidas, M; Nicod, D; Payre, P; Rousseau, D; Talby, M; Abt, I; Assmann, R W; Bauer, C; Blum, Walter; Brown, D; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Jakobs, K; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Wolf, G; Alemany, R; Boucrot, J; Callot, O; Cordier, A; Courault, F; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Musolino, G; Nikolic, I A; Park, H J; Park, I C; Schune, M H; Simion, S; Veillet, J J; Videau, I; Abbaneo, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Rizzo, G; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Triggiani, G; Vannini, C; Verdini, P G; Walsh, J; Betteridge, A P; Blair, G A; Bryant, L M; Cerutti, F; Gao, Y; Green, M G; Johnson, D L; Medcalf, T; Mir, L M; Perrodo, P; Strong, J A; Bertin, V; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Edwards, M; Maley, P; Norton, P R; Thompson, J C; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Marx, B; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Beddall, A; Booth, C N; Boswell, R; Cartwright, S L; Combley, F; Dawson, I; Köksal, A; Letho, M; Newton, W M; Rankin, C; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Feigl, E; Grupen, Claus; Lutters, G; Minguet-Rodríguez, J A; Rivera, F; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Ragusa, F; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Bellantoni, L; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Harton, J L; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Schmitt, M; Scott, I J; Sharma, V; Turk, J; Walsh, A M; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1996-01-01

    A sample of 62249 \\tau-pair events is selected from data taken with the ALEPH detector in 1991, 1992 and 1993. The measurement of the branching fractions for \\tau decays into electrons and muons is presented with emphasis on the study of systematic effects from selection, particle identification and decay classification. Combined with the most recent ALEPH determination of the \\tau lifetime, these results provide a relative measurement of the leptonic couplings in the weak charged current for transverse W bosons.

  10. On Security of Collateral in Danish Mortgage Finance

    DEFF Research Database (Denmark)

    Haldrup, Karin

    2017-01-01

    on the balance principle that assigns risks and responsibility to market players in a self-disciplinary manner and protected the mortgage banks against cash flow mismatches even during deep crisis, as history attests. It is shown how property registers and effective enforcement have created transparent property......Specialized mortgage intermediaries in Denmark have for over two hundred years provided owners and buyers of real property wide access to credit. The present paper sets out to explore the safeguards that nurtured development of a robust, market based financing system and a deep mortgage market....... Observations are made on the nature of collateral performance in respect to property rights, mortgage law and market development in search of general features of required institutional arrangements. The robustness of the Danish mortgage finance system is largely accredited to the securitization model based...

  11. Medial collateral ligament recession for chronic medial knee laxity.

    Science.gov (United States)

    Backes, Jeffrey R; Wiltfong, Roger E; Steensen, Robert N

    2013-06-01

    The medial collateral ligament (MCL) is the primary restraint to valgus stress of the knee. Although the MCL has demonstrated an ability to reliably heal with conservative management, chronic medial instability has been well described following an isolated MCL injury or in combination with an anterior cruciate ligament (ACL) tear. When the MCL heals with persistent medial laxity surgical treatment may be necessary to prevent chronic medial instability and valgus overload of a reconstructed cruciate ligament. We present a simple technique for MCL recession that can be used for isolated MCL laxity as well as in chronic ACL/MCL knee injuries. This technique allows for secure fixation with bone-to-bone healing, avoids donor-site morbidity, maintains relative MCL isometry, and can be performed through a modest incision. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Stress changes of lateral collateral ligament at different

    Directory of Open Access Journals (Sweden)

    ZHONG Yan-lin

    2011-04-01

    Full Text Available 【Abstract】 Objective: To create a 3-dimensional finite element model of knee ligaments and to analyse the stress changes of lateral collateral ligament (LCL with or without displaced movements at different knee flexion conditions. Methods: A four-major-ligament contained knee specimen from an adult died of skull injury was prepared for CT scanning with the detectable ligament insertion footprints, locations and orientations precisely marked in advance. The CT scanning images were converted to a 3-dimensional model of the knee with the 3-dimensional reconstruction technique and transformed into finite element model by the software of ANSYS. The model was validated using experimental and numerical results obtained by other scientists. The natural stress changes of LCL at five different knee flexion angles (0°, 30°, 60°, 90°, 120° and under various motions of anterior-posterior tibial translation, tibial varus rotation and internal-external tibial rotation were measured. Results: The maximum stress reached to 87%-113% versus natural stress in varus motion at early 30° of knee flexions. The stress values were smaller than the peak value of natural stress at 0° (knee full extension when knee bending was over 60° of flexion in anterior-posterior tibial translation and internal-external rotation. Conclusion: LCL is vulnerable to varus motion in almost all knee bending positions and susceptible to anterior- posterior tibial translation or internal-external rotation at early 30° of knee flexions. Key words: Knee joint; Collateral ligaments; Finite element analysis

  13. Surgical treatment of grade Ⅲ collateral ligament injury of knee joint caused by military training

    Directory of Open Access Journals (Sweden)

    Qiang ZHANG

    2011-08-01

    Full Text Available Objective To explore the method and effect of surgical treatment on grade Ⅲ collateral ligament injuries caused by military training.Methods Sixteen cases of grade Ⅲ collateral ligament injuries caused by military training were involved in the present study.Injuries to insertion of collateral ligament was repaired with suture anchor,fresh rupture of medial collateral ligament parenchyma was sutured directly,old rupture of medial collateral ligament parenchyma was repaired by direct suture and strengthening with autologous semitendinosus-gracilis tendon graft,while both fresh and old rupture of lateral collateral ligament parenchyma was reconstructed with autologous semitendinosus-gracilis tendon graft.Knee function was assessed 1 year after operation by Lysholm scores and compared with that before the operation.Results All the 16 patients were followed-up for 12 to 33 months with a mean of 20.5 months.The Lysholm knee scores of 1 year after peration(92.45±4.03 was significantly higher than that before operation(56.45±11.03,P < 0.05.Conclusions For the grade Ⅲ collateral ligament injuries caused by military training,the treatment principle was early diagnosis and early operation,and different surgical methods should be used according to the injury types for the sake of obtaining best therapeutic effects.

  14. Effective collateral circulation may indicate improved perfusion territory restoration after carotid endarterectomy.

    Science.gov (United States)

    Lin, Tianye; Lai, Zhichao; Lv, Yuelei; Qu, Jianxun; Zuo, Zhentao; You, Hui; Wu, Bing; Hou, Bo; Liu, Changwei; Feng, Feng

    2018-02-01

    To investigate the relationship between the level of collateral circulation and perfusion territory normalisation after carotid endarterectomy (CEA). This study enrolled 22 patients with severe carotid stenosis that underwent CEA and 54 volunteers without significant carotid stenosis. All patients were scanned with ASL and t-ASL within 1 month before and 1 week after CEA. Collateral circulation was assessed on preoperative ASL images based on the presence of ATA. The postoperative flow territories were considered as back to normal if they conformed to the perfusion territory map in a healthy population. Neuropsychological tests were performed on patients before and within 7 days after surgery. ATA-based collateral score assessed on preoperative ASL was significantly higher in the flow territory normalisation group (n=11, 50 %) after CEA (P territory normalisation group [>mean differences+2SD among control (MMSE=1.35, MOCA=1.02)]. This study demonstrated that effective collateral flow in carotid stenosis patients was associated with normalisation of t-ASL perfusion territory after CEA. The perfusion territory normalisation group tends to have more cognitive improvement after CEA. • Evaluation of collaterals before CEA is helpful for avoiding ischaemia during clamping. • There was good agreement on ATA-based ASL collateral grading. • Perfusion territories in carotid stenosis patients are altered. • Patients have better collateral circulation with perfusion territory back to normal. • MMSE and MOCA test scores improved more in the territory normalisation group.

  15. Infarct Pattern and Collateral Status in Adult Moyamoya Disease: A Multimodal Magnetic Resonance Imaging Study.

    Science.gov (United States)

    Kim, Dong Yeop; Son, Jeong Pyo; Yeon, Je Young; Kim, Gyeong-Moon; Kim, Jong-Soo; Hong, Seung-Chyul; Bang, Oh Young

    2017-01-01

    Moyamoya disease (MMD) is a unique cerebrovascular disease characterized by the progressive stenosis of large intracranial arteries and a hazy network of basal collaterals, called moyamoya vessels. Although hemodynamic studies have been applied in MMD patients, the mechanisms of stroke in MMD are still unclear. The present study evaluated the infarct pattern and collateral status using multimodal magnetic resonance imaging in MMD patients. Adult MMD patients with acute ischemic stroke were prospectively recruited, and infarct pattern on diffusion-weighted imaging was evaluated. A collateral flow map, derived from magnetic resonance perfusion-weighted imaging data, was generated through automatic postprocessing, and collateral status was assigned into 3 grades. Transcranial Doppler monitoring was performed to detect microembolic signals in selected patients. A total of 67 hemispheres (31 patients with bilateral and 5 patients with unilateral MMD) were analyzed. Most patients (83.7%) showed embolic pattern and rarely deep (9.3%) or hemodynamic infarct pattern (7.0%) on diffusion-weighted imaging. Most cases (86%) showed good collateral status, and few patients with acute infarcts of embolic pattern showed poor collateral status (n=7). One third (31.6%) of patients who underwent transcranial Doppler monitoring showed microembolic signals. In the studied population of adult MMD patients, embolic phenomenon played an important role in ischemic stroke. Therapeutic strategies against thromboembolism, as well as collateral enhancing strategies targeting improvement of hemodynamic status or increased washout of emboli, are warranted. © 2016 American Heart Association, Inc.

  16. The fissure: interlobar collateral ventilation and implications for endoscopic therapy in emphysema.

    Science.gov (United States)

    Koster, Theodoor David; Slebos, Dirk-Jan

    2016-01-01

    In patients with severe emphysema, bronchoscopic lung volume reduction using one-way valves is a promising therapeutic option to improve lung function and quality of life. The goal of this treatment is to achieve a complete lobar atelectasis. In a significant proportion of patients, this atelectasis cannot be achieved due to interlobar collateral ventilation. This collateral ventilation is generated through incomplete lobar fissures. Therefore, only patients with complete fissures and no collateral ventilation can be selected for endobronchial therapy with one-way valves. Incomplete fissures are very common and exhibit a great variation in anatomy. The reported prevalence is 17%-85% for the right major fissure, 19%-74% for the left major fissure, and 20%-90% for the minor fissure. There are several methods of measuring or predicting the presence of collateral ventilation, with computed tomography (CT)-fissure analysis and the Chartis measurement being the most important. CT-fissure analysis is an indirect method to measure the completeness of fissures as a surrogate for collateral ventilation. The Chartis system is an endobronchial method to directly measure the presence of collateral ventilation. Both methods have unique value, and the combination of both can accurately predict the treatment response to the bronchoscopic placement of endobronchial valves. This review provides an in-depth view of lung fissure and collateral ventilation to help understand its importance in selecting the appropriate patients for new emphysema treatments and thus avoid useless treatment in unsuitable patients.

  17. Impact of obstructive sleep apnea in recruitment of coronary collaterality during inaugural acute myocardial infarction.

    Science.gov (United States)

    Ben Ahmed, H; Boussaid, H; Longo, S; Tlili, R; Fazaa, S; Baccar, H; Boujnah, M R

    2015-09-01

    Obstructive sleep apnea (OSA) may lead to myocardial preconditioning by increasing coronary collateral vessel recruitment in patients with acute coronary occlusion. To determine the relationship between the severity of obstructive sleep apnea and coronary collaterality during acute myocardial infarction. This study prospectively included 71 patients with an inaugural myocardial infarction who had undergone a coronary angiography within 24h of onset. All patients underwent an overnight polygraph before discharge and were classified according to the apnea-hypopnea index (AHI). Coronary collaterals were scored by visual analyses and according to the Rentrop grading system. Mean age was 59±11years and 83% of patients were men. All patients had complete or subtotal occlusion of the infarct-related artery. After the sleep study, patients were divided into two groups: 25 were suffering from OSA (AHI>15/h). Patients with OSA showed better collateral vessel development (Rentrop score≥1) compared to non-OSA patients (68 vs. 41%, P=0.032). AHI was significantly higher in patients with developed coronary collaterals (Rentrop≥1) compared to those without collaterality (17.74±13.2 vs. 12.24±10.9, P=0.025). Coronary collateral development may be increased in OSA patients who are presenting with a first myocardial infarction. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Severe Degeneration of the Medial Collateral Ligament in Hallux Valgus: A Histopathologic Study in 12 Consecutive Patients

    Science.gov (United States)

    Prasitdumrong, Ittipol; Rungprai, Chamnanni; Reeboonlarb, Nitit; Poonpracha, Tara; Phisitkul, Phinit

    2013-01-01

    Objective To determine the degree and location of degenerative changes of the medial collateral ligament of the first metatarsophalangeal joint, using the lateral collateral ligament as a control, in patients undergoing hallux valgus correction. Materials and Methods A strip of medial and lateral collateral ligaments were biopsied from 12 consecutive patients (age 45 ± 4.8 years) with symptomatic hallux valgus. A blinded analysis of histopathology was performed by an experienced pathologist. Results The medial collateral ligament was significantly more degenerated compared to the lateral collateral ligament (x2 = 23.41, DF = 2, p hallux valgus correction. The Authors received no financial support for this study. PMID:24027461

  19. Alternative Evolutionary Paths to Bacterial Antibiotic Resistance Cause Distinct Collateral Effects.

    Science.gov (United States)

    Barbosa, Camilo; Trebosc, Vincent; Kemmer, Christian; Rosenstiel, Philip; Beardmore, Robert; Schulenburg, Hinrich; Jansen, Gunther

    2017-09-01

    When bacteria evolve resistance against a particular antibiotic, they may simultaneously gain increased sensitivity against a second one. Such collateral sensitivity may be exploited to develop novel, sustainable antibiotic treatment strategies aimed at containing the current, dramatic spread of drug resistance. To date, the presence and molecular basis of collateral sensitivity has only been studied in few bacterial species and is unknown for opportunistic human pathogens such as Pseudomonas aeruginosa. In the present study, we assessed patterns of collateral effects by experimentally evolving 160 independent populations of P. aeruginosa to high levels of resistance against eight commonly used antibiotics. The bacteria evolved resistance rapidly and expressed both collateral sensitivity and cross-resistance. The pattern of such collateral effects differed to those previously reported for other bacterial species, suggesting interspecific differences in the underlying evolutionary trade-offs. Intriguingly, we also identified contrasting patterns of collateral sensitivity and cross-resistance among the replicate populations adapted to the same drug. Whole-genome sequencing of 81 independently evolved populations revealed distinct evolutionary paths of resistance to the selective drug, which determined whether bacteria became cross-resistant or collaterally sensitive towards others. Based on genomic and functional genetic analysis, we demonstrate that collateral sensitivity can result from resistance mutations in regulatory genes such as nalC or mexZ, which mediate aminoglycoside sensitivity in β-lactam-adapted populations, or the two-component regulatory system gene pmrB, which enhances penicillin sensitivity in gentamicin-resistant populations. Our findings highlight substantial variation in the evolved collateral effects among replicates, which in turn determine their potential in antibiotic therapy. © The Author 2017. Published by Oxford University Press on

  20. Collateral blood flow in different cerebrovascular hierarchy provides endogenous protection in cerebral ischemia.

    Science.gov (United States)

    Luo, Chuanming; Liang, Fengyin; Ren, Huixia; Yao, Xiaoli; Liu, Qiang; Li, Mingyue; Qin, Dajiang; Yuan, Ti-Fei; Pei, Zhong; Su, Huanxing

    2017-11-01

    Collateral blood flow as vascular adaptions to focal cerebral ischemia is well recognized. However, few studies directly investigate the dynamics of collateral vessel recruitment in vivo and little is known about the effect of collateral blood flow in different cerebrovascular hierarchy on the neuropathology after focal ischemic stroke. Here, we report that collateral blood flow is critically involved in blood vessel compensations following regional ischemia. We occluded a pial arteriole using femtosecond laser ablating under the intact thinned skull and documented the changes of collateral flow around the surface communication network and between the surface communication network and subsurface microcirculation network using in vivo two photon microscopy imaging. Occlusion of the pial arteriole apparently increased the diameter and collateral blood flow of its leptomeningeal anastomoses, which significantly reduced the cortical infarction size. This result suggests that the collateral flow via surface communicating network connected with leptomeningeal anastomoses could greatly impact on the extent of infarction. We then further occluded the target pial arteriole and all of its leptomeningeal anastomoses. Notably, this type of occlusion led to reversals of blood flow in the penetrating arterioles mainly proximal to the occluded pial arteriole in a direction from the subsurface microcirculation network to surface arterioles. Interesting, the cell death in the area of ischemic penumbra was accelerated when we performed occlusion to cease the reversed blood flow in those penetrating arterioles, suggesting that the collateral blood flow from subsurface microcirculation network exerts protective roles in delaying cell death in the ischemic penumbra. In conclusion, we provide the first experimental evidence that collateral blood vessels at different cerebrovascular hierarchy are endogenously compensatory mechanisms in brain ischemia. © 2016 International Society of

  1. Mapping of contributions from collateral ligaments to overall knee joint constraint: an experimental cadaveric study.

    Science.gov (United States)

    Cyr, Adam J; Shalhoub, Sami S; Fitzwater, Fallon G; Ferris, Lauren A; Maletsky, Lorin P

    2015-06-01

    Understanding the contribution of the soft-tissues to total joint constraint (TJC) is important for predicting joint kinematics, developing surgical procedures, and increasing accuracy of computational models. Previous studies on the collateral ligaments have focused on quantifying strain and tension properties under discrete loads or kinematic paths; however, there has been little work to quantify collateral ligament contribution over a broad range of applied loads and range of motion (ROM) in passive constraint. To accomplish this, passive envelopes were collected from nine cadaveric knees instrumented with implantable pressure transducers (IPT) in the collateral ligaments. The contributions from medial and lateral collateral ligaments (LCL) were quantified by the relative contribution of each structure at various flexion angles (0-120 deg) and compound external loads (±10 N m valgus, ±8 N m external, and ±40 N anterior). Average medial collateral ligament (MCL) contributions were highest under external and valgus torques from 60 deg to 120 deg flexion. The MCL showed significant contributions to TJC under external torques throughout the flexion range. Average LCL contributions were highest from 0 deg to 60 deg flexion under external and varus torques, as well as internal torques from 60 deg to 110 deg flexion. Similarly, these regions were found to have statistically significant LCL contributions. Anterior and posterior loads generally reduced collateral contribution to TJC; however, posterior loads further reduced MCL contribution, while anterior loads further reduced LCL contribution. These results provide insight to the functional role of the collaterals over a broad range of passive constraint. Developing a map of collateral ligament contribution to TJC may be used to identify the effects of injury or surgical intervention on soft-tissue, and how collateral ligament contributions to constraint correlate with activities of daily living.

  2. Leptomeningeal collateralization in acute ischemic stroke: Impact on prominent cortical veins in susceptibility-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Verma, Rajeev K., E-mail: rajeev.verma@insel.ch [University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern (Switzerland); Hsieh, Kety; Gratz, Pascal P.; Schankath, Adrian C.; Mordasini, Pasquale; Zubler, Christoph; Kellner-Weldon, Frauke [University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern (Switzerland); Jung, Simon [Department of Neurology, Inselspital, University of Bern, Bern (Switzerland); Schroth, Gerhard; Gralla, Jan; El-Koussy, Marwan [University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, University of Bern, Bern (Switzerland)

    2014-08-15

    Background: The extent of hypoperfusion is an important prognostic factor in acute ischemic stroke. Previous studies have postulated that the extent of prominent cortical veins (PCV) on susceptibility-weighted imaging (SWI) reflects the extent of hypoperfusion. Our aim was to investigate, whether there is an association between PCV and the grade of leptomeningeal arterial collateralization in acute ischemic stroke. In addition, we analyzed the correlation between SWI and perfusion-MRI findings. Methods: 33 patients with acute ischemic stroke due to a thromboembolic M1-segment occlusion underwent MRI followed by digital subtraction angiography (DSA) and were subdivided into two groups with very good to good and moderate to no leptomeningeal collaterals according to the DSA. The extent of PCV on SWI, diffusion restriction (DR) on diffusion-weighted imaging (DWI) and prolonged mean transit time (MTT) on perfusion-imaging were graded according to the Alberta Stroke Program Early CT Score (ASPECTS). The National Institutes of Health Stroke Scale (NIHSS) scores at admission and the time between symptom onset and MRI were documented. Results: 20 patients showed very good to good and 13 patients poor to no collateralization. PCV-ASPECTS was significantly higher for cases with good leptomeningeal collaterals versus those with poor leptomeningeal collaterals (mean 4.1 versus 2.69; p = 0.039). MTT-ASPECTS was significantly lower than PCV-ASPECTS in all 33 patients (mean 1.0 versus 3.5; p < 0.00). Conclusions: In our small study the grade of leptomeningeal collateralization correlates with the extent of PCV in SWI in acute ischemic stroke, due to the deoxyhemoglobin to oxyhemoglobin ratio. Consequently, extensive PCV correlate with poor leptomeningeal collateralization while less pronounced PCV correlate with good leptomeningeal collateralization. Further SWI is a very helpful tool in detecting tissue at risk but cannot replace PWI since MTT detects significantly more ill

  3. Thermal Energy Conversion Branch

    Science.gov (United States)

    Bielozer, Matthew C.; Schreiber, Jeffrey, G.; Wilson, Scott D.

    2004-01-01

    The Thermal Energy Conversion Branch (5490) leads the way in designing, conducting, and implementing research for the newest thermal systems used in space applications at the NASA Glenn Research Center. Specifically some of the most advanced technologies developed in this branch can be broken down into four main areas: Dynamic Power Systems, Primary Solar Concentrators, Secondary Solar Concentrators, and Thermal Management. Work was performed in the Dynamic Power Systems area, specifically the Stirling Engine subdivision. Today, the main focus of the 5490 branch is free-piston Stirling cycle converters, Brayton cycle nuclear reactors, and heat rejection systems for long duration mission spacecraft. All space exploring devices need electricity to operate. In most space applications, heat energy from radioisotopes is converted to electrical power. The Radioisotope Thermoelectric Generator (RTG) already supplies electricity for missions such as the Cassini Spacecraft. The focus of today's Stirling research at GRC is aimed at creating an engine that can replace the RTG. The primary appeal of the Stirling engine is its high system efficiency. Because it is so efficient, the Stirling engine will significantly reduce the plutonium fuel mission requirements compared to the RTG. Stirling is also being considered for missions such as the lunar/Mars bases and rovers. This project has focused largely on Stirling Engines of all types, particularly the fluidyne liquid piston engine. The fluidyne was developed by Colin D. West. This engine uses the same concepts found in any type of Stirling engine, with the exception of missing mechanical components. All the working components are fluid. One goal was to develop and demonstrate a working Stirling Fluidyne Engine at the 2nd Annual International Energy Conversion Engineering Conference in Providence, Rhode Island.

  4. The branch librarians' handbook

    CERN Document Server

    Rivers, Vickie

    2004-01-01

    ""Recommended""--Booklist; ""an excellent addition...highly recommended""--Public Libraries; ""clear...very sound advice...strongly recommend""--Catholic Library World; ""excellent resource...organized...well written""--Against the Grain; ""interesting...thoroughly practical...a very good book...well organized...clearly written""--ARBA. This handbook covers a wide variety of issues that the branch librarian must deal with every day. Chapters are devoted to mission statements (the Dallas Public Library and Dayton Metro Library mission statements are highlighted as examples), library systems,

  5. Flight Dynamics Analysis Branch

    Science.gov (United States)

    Stengle, Tom; Flores-Amaya, Felipe

    2000-01-01

    This report summarizes the major activities and accomplishments carried out by the Flight Dynamics Analysis Branch (FDAB), Code 572, in support of flight projects and technology development initiatives in fiscal year 2000. The report is intended to serve as a summary of the type of support carried out by the FDAB, as well as a concise reference of key accomplishments and mission experience derived from the various mission support roles. The primary focus of the FDAB is to provide expertise in the disciplines of flight dynamics, spacecraft trajectory, attitude analysis, and attitude determination and control. The FDAB currently provides support for missions and technology development projects involving NASA, government, university, and private industry.

  6. Recruitable collateral blood flow index predicts coronary instent restenosis after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Thayssen, Per; Lassen, Jens Flensted

    2007-01-01

    AIMS: Collateral flow may influence long-term results after percutaneous coronary intervention (PCI) because of haemodynamic forces compete with the antegrade flow through the dilated lesion. The aim of the study was to assess the influence of recruitable collateral blood flow on restenosis......-derived collateral flow index (CFI) was determined as (P(w)-P(cvp))/(P(a)-P(cvp)), where P(w) represents coronary wedge pressure, P(cvp) central venous pressure, and P(a) mean aortic blood pressure. Both were measured during transient coronary occlusion by a balloon inflation of 30 s. Pre-interventional FFR (0...

  7. PENGEMBANGAN HAK KEKAYAAN INTELEKTUAL SEBAGAI COLLATERAL (AGUNAN UNTUK MENDAPATKAN KREDIT PERBANKAN DI INDONESIA

    Directory of Open Access Journals (Sweden)

    Sri Mulyani

    2012-09-01

    Full Text Available Intellectual Property Rights is granted the exclusive rights to creators, inventors or designers for the creation or invention that has commercial value, either directly or through the automatic registration of the relevant agencies as awards, recognition should be given the protection of the rights of the community development law. Globally, the IPR will be used as collateral to obtain a bank loan internasional. In this law is necessary to realize the concept of legislation in each country who are willing to apply that regulate substance loading, binding, and registration of intellectual property as collateral. Key words: development of intellectual property rights, collateral, bank credit in Indonesia

  8. Injuries to the Collateral Ligaments of the Metacarpophalangeal Joint of the Thumb, Including Simultaneous Combined Thumb Ulnar and Radial Collateral Ligament Injuries, in National Football League Athletes.

    Science.gov (United States)

    Werner, Brian C; Belkin, Nicole S; Kennelly, Steve; Weiss, Leigh; Barnes, Ronnie P; Rodeo, Scott A; Warren, Russell F; Hotchkiss, Robert N

    2017-01-01

    Thumb collateral ligament injuries occur frequently in the National Football League (NFL). In the general population or in recreational athletes, pure metacarpophalangeal (MCP) abduction or adduction mechanisms yield isolated ulnar collateral ligament (UCL) and radial collateral ligament (RCL) tears, respectively, while NFL athletes may sustain combined mechanism injury patterns. To evaluate the incidence of simultaneous combined thumb UCL and RCL tears among all thumb MCP collateral ligament injuries in NFL athletes on a single team. Case series; Level of evidence, 4. A retrospective review of all thumb injuries on a single NFL team from 1991 to 2014 was performed. All players with a thumb MCP collateral ligament injury were included. Collateral ligament injuries were confirmed by review of both physical examination findings and magnetic resonance imaging. Player demographics, surgical details, and return-to-play data were obtained from the team electronic medical record and surgeons' records. A total of 36 thumbs in 32 NFL players were included in the study, yielding an incidence of 1.6 thumb MCP collateral ligament injuries per year on a single NFL team. Of these, 9 thumbs (25%) had a simultaneous combined UCL and RCL tear injury pattern confirmed on both physical examination and MRI. The remaining 27 thumbs (75%) were isolated UCL injuries. All combined UCL/RCL injuries required surgery due to dysfunction from instability; 63.0% of isolated UCL injuries required surgical repair ( P = .032) due to continued pain and dysfunction from instability. Repair, when required, was delayed until the end of the season. All players with combined UCL/RCL injuries and isolated UCL injuries returned to play professional football the following season. Simultaneous combined thumb UCL and RCL tear is a previously undescribed injury pattern that occurred in 25% of thumb MCP collateral ligament injuries on a single NFL team over a 23-year period. All players with combined thumb UCL

  9. Improved β Decay Branching Ratios

    Science.gov (United States)

    Iacob, V. E.; Hardy, J. C.; Golovko, V.

    2008-04-01

    The work we report here aims at increasing the precision possible in the measurement of branching ratios for superallowed β^+decays. Such highly accurate values are essential in generating precise ft-values for 0^+->0^+decays, which can then be used to test the Standard Model via the unitarity of the Cabibbo-Kobayashi-Maskawa matrix [1]. The required precision is ˜0.1% or better. While this limit was already achieved in the case of ^34Ar [2], it would have been very difficult, if not impossible, to achieve it for other β^+-decays without an upgrade to our acquisition and data-reduction systems. We have thus improved the controls over all the key elements in our experimental set-up: we now have direct control over the dead-time for the singles and coincidence channels and <0.1 mm control over the source-detector distance. In addition, we have extensively studied the efficiency of the β-detector with source-measurements tested against various Monte Carlo programs [3]. We have tested our new acquisition set-up on ^60Co and ^22Na (β^- and β^+ emitters respectively) to validate our new methods. Preliminary results on the two sources are statistically consistent with the expected values. An ^34Ar decay experiment using the new experimental configuration has already been performed and is currently analyzed. [1] J.C. Hardy and I.S. Towner, PRC 71, 055501 (2005) [2] V. Iacob et al., BAPS 52(3)B16; BAPS 52(9)HF3 [3] V. Golovko et al., BAPS 52(9)DH4; this BAPS

  10. Use of collateral sensitivity networks to design drug cycling protocols that avoid resistance development

    DEFF Research Database (Denmark)

    Imamovic, Lejla; Sommer, Morten

    2013-01-01

    and select against drug resistance development. We identified hundreds of such drug sets and demonstrated that the antibiotics gentamicin and cefuroxime can be deployed cyclically such that the treatment regimen selected against resistance to either drug. We then validated our findings with related bacterial......New drug deployment strategies are imperative to address the problem of drug resistance, which is limiting the management of infectious diseases and cancers. We evolved resistance in Escherichia coli toward 23 drugs used clinically for treating bacterial infections and mapped the resulting...... collateral sensitivity and resistance profiles, revealing a complex collateral sensitivity network. On the basis of these data, we propose a new treatment framework-collateral sensitivity cycling-in which drugs with compatible collateral sensitivity profiles are used sequentially to treat infection...

  11. Cerebral collateral therapeutics in acute ischemic stroke: A randomized preclinical trial of four modulation strategies.

    Science.gov (United States)

    Beretta, Simone; Versace, Alessandro; Carone, Davide; Riva, Matteo; Dell'Era, Valentina; Cuccione, Elisa; Cai, Ruiyao; Monza, Laura; Pirovano, Silvia; Padovano, Giada; Stiro, Fabio; Presotto, Luca; Paternò, Giovanni; Rossi, Emanuela; Giussani, Carlo; Sganzerla, Erik P; Ferrarese, Carlo

    2017-10-01

    Cerebral collaterals are dynamically recruited after arterial occlusion and highly affect tissue outcome in acute ischemic stroke. We investigated the efficacy and safety of four pathophysiologically distinct strategies for acute modulation of collateral flow (collateral therapeutics) in the rat stroke model of transient middle cerebral artery (MCA) occlusion. A composed randomization design was used to assign rats (n = 118) to receive phenylephrine (induced hypertension), polygeline (intravascular volume load), acetazolamide (cerebral arteriolar vasodilation), head down tilt (HDT) 15° (cerebral blood flow diversion), or no treatment, starting 30 min after MCA occlusion. Compared to untreated animals, treatment with collateral therapeutics was associated with lower infarct volumes (62% relative mean difference; 51.57 mm3 absolute mean difference; p therapy.

  12. Aspirin, but not clopidogrel, reduces collateral conductance in a rabbit model of femoral artery occlusion

    NARCIS (Netherlands)

    Hoefer, Imo E.; Grundmann, Sebastian; Schirmer, Stephan; van Royen, Niels; Meder, Benjamin; Bode, Christoph; Piek, Jan J.; Buschmann, Ivo R.

    2005-01-01

    OBJECTIVES The objective of this study was to test the potential of aspirin and clopidogrel to influence collateral artery growth (arteriogenesis). BACKGROUND Aspirin and clopidogrel are antiplatelet agents commonly used in the treatment of ischemic cardiovascular disease. Both inhibit platelet

  13. Kinematics of partial and total ruptures of the medial collateral ligament of the elbow

    DEFF Research Database (Denmark)

    Eygendaal, D; Olsen, Bo Sanderhoff; Jensen, Steen Lund

    2000-01-01

    In this study the kinematics of partial and total ruptures of the medial collateral ligament of the elbow are investigated. After selective transection of the medial collateral ligament of 8 osteoligamentous intact elbow preparations was performed, 3-dimensional measurements of angular displacement...... ligament and was maximum between 70 degrees to 90 degrees of flexion. No radial head movement was seen after partial or total transection of the anterior bundle of the medial collateral ligament was performed. In conclusion, this study indicates that valgus or internal rotatory elbow instability should...... be evaluated at 70 degrees to 90 degrees of flexion. Detection of partial ruptures in the anterior bundle of the medial collateral ligament based on medial joint opening and increased valgus movement is impossible....

  14. Management of Medial Collateral Ligament Injury During Primary Total Knee Arthroplasty: A Systematic Review

    National Research Council Canada - National Science Library

    Della Torre, MD, Paul; Stephens, MD, Andrew; Oh, MD, Horng Lii; Kamra, MD, Akshay; Zicat, MD, Bernard; Walker, MD, Peter

    2014-01-01

    Medial collateral ligament injury during primary total knee arthroplasty is a recognised complication potentially resulting in valgus instability, suboptimal patient outcomes and a higher rate of revision or reoperation...

  15. Simulation of aortopulmonary collateral flow in Fontan patients for use in prediction of interventional outcomes.

    Science.gov (United States)

    Frieberg, Petter; Sjöberg, Pia; Revstedt, Johan; Heiberg, Einar; Liuba, Petru; Carlsson, Marcus

    2017-08-07

    Patients with complex congenital heart disease may need to be converted to a Fontan circulation with systemic venous return surgically connected to the pulmonary circulation. These patients frequently form aortopulmonary collaterals (APC), that is arterial inflows to the pulmonary artery vascular tree. The aim of this study was to develop a method to calculate the effect of APC on the pulmonary flow distribution based on magnetic resonance imaging (MRI) measurements and computational fluid dynamics simulations in order to enable prediction of interventional outcomes in Fontan patients. Patient-specific models of 11 patients were constructed in a 3D-design software based on MRI segmentations. APC flow was quantified as the difference between pulmonary venous flow and pulmonary artery flow, measured by MRI. A method was developed to include the modulating effect of the APC flow by calculating the patient-specific relative pulmonary vascular resistance. Simulations, including interventions with a Y-graft replacement and a stent dilatation, were validated against MRI results. The bias between simulated and MRI-measured fraction of blood to the left lung was 2·9 ± 5·3%. Including the effects of the APC flow in the simulation (n = 6) reduced simulation error from 9·8 ± 7·0% to 5·2 ± 6·3%. Preliminary findings in two patients show that the effect of surgical and catheter interventions could be predicted using the demonstrated methods. The work demonstrates a novel method to include APC flow in predictive simulations of Fontan hemodynamics. APC flow was found to have a significant contribution to the pulmonary flow distribution in Fontan patients. © 2017 The Authors. Clinical Physiology and Functional Imaging published by John Wiley & Sons Ltd on behalf of Scandinavian Society of Clinical Physiology and Nuclear Medicine.

  16. Quiver Varieties and Branching

    Directory of Open Access Journals (Sweden)

    Hiraku Nakajima

    2009-01-01

    Full Text Available Braverman and Finkelberg recently proposed the geometric Satake correspondence for the affine Kac-Moody group Gaff [Braverman A., Finkelberg M., arXiv:0711.2083]. They conjecture that intersection cohomology sheaves on the Uhlenbeck compactification of the framed moduli space of Gcpt-instantons on $R^4/Z_r$ correspond to weight spaces of representations of the Langlands dual group $G_{aff}^{vee}$ at level $r$. When $G = SL(l$, the Uhlenbeck compactification is the quiver variety of type $sl(r_{aff}$, and their conjecture follows from the author's earlier result and I. Frenkel's level-rank duality. They further introduce a convolution diagram which conjecturally gives the tensor product multiplicity [Braverman A., Finkelberg M., Private communication, 2008]. In this paper, we develop the theory for the branching in quiver varieties and check this conjecture for $G = SL(l$.

  17. Contrast-Enhanced Sonography for Diagnosing Collateral Transformation of the Hepatic Artery After Liver Transplantation.

    Science.gov (United States)

    Lyu, Su-Qin; Ren, Jie; Zheng, Rong-Qin; Meng, Xiao-Chun; Huang, Ming-Sheng; Wang, Ping

    2015-09-01

    To determine the contrast-enhanced sonographic features of hepatic artery collateral transformation in patients with hepatic artery complications after liver transplantation. Ninety-nine liver transplant recipients who underwent contrast-enhanced sonography were recruited from April 2004 to May 2014. The reference standards were conventional angiography and computed tomographic angiography. The contrast-enhanced sonographic features of the hepatic artery in patients with and without collateral arteries were retrospectively analyzed. All 15 patients with hepatic artery collateral transformation had hepatic artery thrombosis (10 of 15) or hepatic artery stenosis (5 of 15). The collateral artery detection rate on contrast-enhanced sonography was 100%. The peripheral hepatic artery could not be visualized by contrast-enhanced sonography in most of the patients with hepatic artery collateral transformation (14 of 15). Additionally, many small tortuous collateral arteries in the porta hepatis region were visualized during the arterial and early portal phases, showing reticulated/patchy (15 of 15) and striped (3 of 15) enhancement patterns on contrast-enhanced sonography. Collateral transformation of the hepatic artery in patients with hepatic artery complications after liver transplantation appears to have characteristic features on contrast-enhanced sonography, especially a reticulated or patchy enhancement pattern in the porta hepatis region during the arterial and early portal phases combined with the absence of the peripheral hepatic artery. Contrast-enhanced sonography may be a novel method for diagnosing hepatic artery collateral transformation, which may be a highly specific sign of hepatic artery thrombosis or stenosis. © 2015 by the American Institute of Ultrasound in Medicine.

  18. Does information sharing reduce the role of collateral as a screening device?

    OpenAIRE

    Stacescu, Bogdan; Karapetyan, Artashes

    2014-01-01

    This is the authors’ accepted, refereed and final manuscript to the article. Publisher’s version available at http://dx.doi.org/10.1016/j.jbankfin.2014.02.010 Information sharing and collateral are both devices that help banks reduce the cost of adverse selection. We examine whether they are likely to be used as substitutes (information sharing reduces the need for collateral) or complements. We show that information sharing via a credit bureaus and registers may increase, r...

  19. Isolated lateral collateral ligament complex injury in rock climbing and Brazilian Jiu-jitsu.

    Science.gov (United States)

    Davis, Bryan A; Hiller, Lucas P; Imbesi, Steven G; Chang, Eric Y

    2015-08-01

    We report two occurrences of high-grade tears of the lateral collateral ligament complex (LCLC), consisting of the anterolateral ligament (ALL) and fibular collateral ligament (FCL). One injury occurred in a rock climber and the other in a martial artist. Increasing awareness of isolated injuries of the LCLC will allow for appropriate diagnosis and management. We review and discuss the anatomy of the LCLC, the unique mechanism of isolated injury, as well as physical and imaging examination findings.

  20. Retrospective analysis of intravertebral collateral enhancement in patients with central venous obstruction

    Energy Technology Data Exchange (ETDEWEB)

    Simeone, F.J.; Chang, Connie Y.; Huang, Ambrose J.; Kattapuram, Susan V.; Bredella, Miriam A.; Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Bennett, Debbie L. [Saint Louis University School of Medicine, Department of Radiology, Saint Louis, MO (United States)

    2016-02-15

    To compare prevalence and patterns of intravertebral collateral enhancement in patients with and without central venous obstruction (CVO). Chest CTs performed between 1/1/2000 and 12/15/2012 with reports containing terms indicating CVO were identified. All contrast enhanced CTs were examined for the presence of CVO and collateral venous pathways. If intravertebral collateral enhancement was present, the pattern was recorded as nodular, linear, or both. In 209 suspected cases of CVO, 53 (25 %) were confirmed with obstruction and 156 (75 %) were without obstruction. In patients with CVO, 47 % (25/53) demonstrated collateral venous flow through an intravertebral marrow pathway compared to 5 % (8/156) of patients without CVO (P < 0.0001). The most common level of enhancement was the upper thoracic spine, involving only the vertebral body. Nodular, linear, and combined nodular-linear enhancement patterns were seen with similar frequency. Nodular intravertebral collateral enhancement was mistaken for sclerotic metastases in 33 % (3/9) of cases. Intravertebral collateral enhancement was seen in almost half the patients with CVO and when nodular enhancement is present, it is important to differentiate between metastatic lesions and enhancement related to CVO. (orig.)

  1. Acute development of collateral circulation and therapeutic prospects in ischemic stroke

    Directory of Open Access Journals (Sweden)

    Eri Iwasawa

    2016-01-01

    Full Text Available In acute ischemic stroke, collateral circulation plays an important role in maintaining blood flow to the tissue that is at risk of progressing into ischemia, and in increasing the successful recanalization rate without hemorrhagic transformation. We have reported that well-developed collateral circulation is associated with smaller infarct volume and better long-term neurological outcome, and it disappears promptly once the effective recanalization is achieved. Contrary to the belief that collateral vessels develop over time in chronic stenotic condition, there exists a phenomenon that collateral circulation develops immediately in acute stenosis or occlusion of the arteries and it seems to be triggered by fluid shear stress, which occurs between the territories of stenotic/occluded arteries and those fed by surrounding intact arteries. We believe that this acute development of collateral circulation is a target of novel therapeutics in ischemic stroke and refer our recent attempt in enhancing collateral circulation by modulating sphingosine-1-phosphate receptor 1, which is a known shear-stress mechanosensing protein.

  2. Durability of branches in branched and fenestrated endografts.

    Science.gov (United States)

    Mastracci, Tara M; Greenberg, Roy K; Eagleton, Matthew J; Hernandez, Adrian V

    2013-04-01

    Branched and fenestrated repair has been shown to be effective for treatment of complex aortic aneurysms. However, the long-term durability of branches is not well reported. Prospective data collected for all patients enrolled in a physician-sponsored investigational device exemption trial for branched and fenestrated endografts were analyzed. Retrospective review of imaging studies and electronic records was used to supplement the dataset. Incidences of branch stent secondary intervention, stent fracture, migration, branch-related rupture, and death were calculated. A time-to-event analysis was performed for secondary intervention for any branch. Univariable and multivariable analyses were performed to identify related variables. Branch instability, a composite outcome of any branch event, was reported as a function of exponential decay to capture the loss of freedom from complications over time. Between the years 2001 and 2010, 650 patients underwent endovascular aortic repair with branched or fenestrated devices. Over 9 years of follow-up (mean [standard deviation], 3 [2.3] years), secondary procedures were performed for 0.6% of celiac, 4% of superior mesenteric artery (SMA), 6% of right renal artery, and 5% of left renal artery stents. Mean time to reintervention was 237 (354) days. The 30-day, 1-year, and 5-year freedom from branch intervention was 98% (95% confidence interval [CI], 96%-99%), 94% (95% CI, 92%-96%), and 84% (95% CI, 78%-90%), respectively. Death from branch stent complications occurred in three patients, two related to SMA thrombosis and one due to an unstented SMA scallop. Multivariable analysis revealed no factors as independent predictors of need for branch reintervention. Branches, after branched or fenestrated aortic repair, appear to be durable and are rarely the cause of patient death. The absence of long-term data on branch patency in open repair precludes comparison, yet the lower morbidity and mortality risk coupled with longer

  3. 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.

  4. The control of branching morphogenesis

    Science.gov (United States)

    Iber, Dagmar; Menshykau, Denis

    2013-01-01

    Many organs of higher organisms are heavily branched structures and arise by an apparently similar process of branching morphogenesis. Yet the regulatory components and local interactions that have been identified differ greatly in these organs. It is an open question whether the regulatory processes work according to a common principle and how far physical and geometrical constraints determine the branching process. Here, we review the known regulatory factors and physical constraints in lung, kidney, pancreas, prostate, mammary gland and salivary gland branching morphogenesis, and describe the models that have been formulated to analyse their impacts. PMID:24004663

  5. Methods and Technologies Branch (MTB)

    Science.gov (United States)

    The Methods and Technologies Branch focuses on methods to address epidemiologic data collection, study design and analysis, and to modify technological approaches to better understand cancer susceptibility.

  6. Outcomes of Medial Collateral Ligament Injuries during Total Knee Arthroplasty.

    Science.gov (United States)

    Siqueira, Marcelo B P; Haller, Kathryn; Mulder, Andrew; Goldblum, Andrew S; Klika, Alison K; Barsoum, Wael K

    2016-01-01

    Intraoperative medial collateral ligament (MCL) disruption during total knee arthroplasty (TKA) is often managed with either primary repair or use of a constrained implant. A total of 23 patients with an MCL injury during TKA between 2003 and 2009 were compared with 92 matched controls. Of the 23 patients, 10 were treated with an unconstrained implant and primary MCL repair, 8 with constrained implants, 3 with constrained implants and MCL repair, and 2 with unconstrained implants and no MCL repair. After an average 5-year follow-up, patients had lower Knee Society Scores (KSS), 79 versus 87 (p = 0.03), but similar Knee Function Scores (KFS), 68 versus 72 (p = 0.35). The improvement between preoperative and postoperative KSS and KFS did not vary among the two groups (p = 0.88 and p = 0.77, respectively). Postoperative scores did not vary significantly among the four treatment modalities. Conservative treatment can provide satisfactory outcomes and avoid potential complications of increased constraint. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. COLLATERAL'S IMPORTANCE IN SMES FINANCING: WHAT IS THE BANKS RESPONSE? SOME EVIDENCE FOR ROMANIA

    Directory of Open Access Journals (Sweden)

    Petria Nicolae

    2011-07-01

    Full Text Available Searching for funding, SMEs managers face various obstacles arising from information asymmetry, lack of experience, severe market conditions, and insufficient or unsatisfactory collaterals for banks (OECD 2006; Badulescu and Badulescu 2010; OECD 2000 and 2004; Lin and Sun 2006; Toivanen and Cresy, 2000. The collateral issue is extensively discussed in literature preventing moral hazard, the alignment the interests (Stiglitz and Weiss 1981:393-410; Chan and Thakor 1987:345-363; Jimenez and Saurina 2004, a means to discipline the borrowers behaviour (ex post given the existence of a credible threat (Aghion and Bolton 1992:473-494, or even banking behaviour on the market (Manove et al. 2001:726-744, Argentiero 2009. In the same time we find that the perception of firms, revealed by National Bank of Romania (NBR 2010 survey data, show that banks still use the collateral as a measure of pressure, in special in crisis times. For an important part of managers, the bank increased the level of required collateral for existing, renewing or new credits, asking for new covenants, revealing a paradox of crisis time: while the bank loans remained the favourite method of external financing needs of business, the banks often reduce their availability. Although the bank loan remains the favorite mean to support the growth ambitions, the higher level of collateral or lending costs are seen as principal obstacles by the majority of manager in EU. According to NBR survey, the influence of risk factors related to collateral had a climax at the end of 2008 and 2009, when the banks have tightened the requirement for loan guarantee. Using National Bank of Romania (NBR 2010 survey data, we show that the banks still use the collateral as a measure of pressure, in special in crisis times. For an important part of managers, the bank increased the level of required collateral for existing, renewing or new credits, asking for new covenants, revealing a paradox of crisis time

  8. Tau hadronic branching ratios

    CERN Document Server

    Buskulic, Damir; De Bonis, I; Décamp, D; Ghez, P; Goy, C; Lees, J P; Lucotte, A; Minard, M N; Odier, P; Pietrzyk, B; Ariztizabal, F; Chmeissani, M; Crespo, J M; Efthymiopoulos, I; Fernández, E; Fernández-Bosman, M; Gaitan, V; Martínez, M; Orteu, S; Pacheco, A; Padilla, C; Palla, Fabrizio; Pascual, A; Perlas, J A; Sánchez, F; Teubert, F; Colaleo, A; Creanza, D; De Palma, M; Farilla, A; Gelao, G; Girone, M; Iaselli, Giuseppe; Maggi, G; Maggi, M; Marinelli, N; Natali, S; Nuzzo, S; Ranieri, A; Raso, G; Romano, F; Ruggieri, F; Selvaggi, G; Silvestris, L; Tempesta, P; Zito, G; Huang, X; Lin, J; Ouyang, Q; Wang, T; Xie, Y; Xu, R; Xue, S; Zhang, J; Zhang, L; Zhao, W; Bonvicini, G; Cattaneo, M; Comas, P; Coyle, P; Drevermann, H; Engelhardt, A; Forty, Roger W; Frank, M; Hagelberg, R; Harvey, J; Jacobsen, R; Janot, P; Jost, B; Kneringer, E; Knobloch, J; Lehraus, Ivan; Markou, C; Martin, E B; Mato, P; Minten, Adolf G; Miquel, R; Oest, T; Palazzi, P; Pater, J R; Pusztaszeri, J F; Ranjard, F; Rensing, P E; Rolandi, Luigi; Schlatter, W D; Schmelling, M; Schneider, O; Tejessy, W; Tomalin, I R; Venturi, A; Wachsmuth, H W; Wiedenmann, W; Wildish, T; Witzeling, W; Wotschack, J; Ajaltouni, Ziad J; Bardadin-Otwinowska, Maria; Barrès, A; Boyer, C; Falvard, A; Gay, P; Guicheney, C; Henrard, P; Jousset, J; Michel, B; Monteil, S; Pallin, D; Perret, P; Podlyski, F; Proriol, J; Rossignol, J M; Saadi, F; Fearnley, Tom; Hansen, J B; Hansen, J D; Hansen, J R; Hansen, P H; Nilsson, B S; Kyriakis, A; Simopoulou, Errietta; Siotis, I; Vayaki, Anna; Zachariadou, K; Blondel, A; Bonneaud, G R; Brient, J C; Bourdon, P; Passalacqua, L; Rougé, A; Rumpf, M; Tanaka, R; Valassi, Andrea; Verderi, M; Videau, H L; Candlin, D J; Parsons, M I; Focardi, E; Parrini, G; Corden, M; Delfino, M C; Georgiopoulos, C H; Jaffe, D E; Antonelli, A; Bencivenni, G; Bologna, G; Bossi, F; Campana, P; Capon, G; Chiarella, V; Felici, G; Laurelli, P; Mannocchi, G; Murtas, F; Murtas, G P; Pepé-Altarelli, M; Dorris, S J; Halley, A W; ten Have, I; Knowles, I G; Lynch, J G; Morton, W T; O'Shea, V; Raine, C; Reeves, P; Scarr, J M; Smith, K; Smith, M G; Thompson, A S; Thomson, F; Thorn, S; Turnbull, R M; Becker, U; Braun, O; Geweniger, C; Graefe, G; Hanke, P; Hepp, V; Kluge, E E; Putzer, A; Rensch, B; Schmidt, M; Sommer, J; Stenzel, H; Tittel, K; Werner, S; Wunsch, M; Beuselinck, R; Binnie, David M; Cameron, W; Colling, D J; Dornan, Peter J; Konstantinidis, N P; Moneta, L; Moutoussi, A; Nash, J; San Martin, G; Sedgbeer, J K; Stacey, A M; Dissertori, G; Girtler, P; Kuhn, D; Rudolph, G; Bowdery, C K; Brodbeck, T J; Colrain, P; Crawford, G; Finch, A J; Foster, F; Hughes, G; Sloan, Terence; Whelan, E P; Williams, M I; Galla, A; Greene, A M; Kleinknecht, K; Quast, G; Raab, J; Renk, B; Sander, H G; Wanke, R; Van Gemmeren, P; Zeitnitz, C; Aubert, Jean-Jacques; Bencheikh, A M; Benchouk, C; Bonissent, A; Bujosa, G; Calvet, D; Carr, J; Diaconu, C A; Etienne, F; Thulasidas, M; Nicod, D; Payre, P; Rousseau, D; Talby, M; Abt, I; Assmann, R W; Bauer, C; Blum, Walter; Brown, D; Dietl, H; Dydak, Friedrich; Ganis, G; Gotzhein, C; Jakobs, K; Kroha, H; Lütjens, G; Lutz, Gerhard; Männer, W; Moser, H G; Richter, R H; Rosado-Schlosser, A; Schael, S; Settles, Ronald; Seywerd, H C J; Saint-Denis, R; Wolf, G; Alemany, R; Boucrot, J; Callot, O; Cordier, A; Courault, F; Davier, M; Duflot, L; Grivaz, J F; Heusse, P; Jacquet, M; Kim, D W; Le Diberder, F R; Lefrançois, J; Lutz, A M; Musolino, G; Nikolic, I A; Park, H J; Park, I C; Schune, M H; Simion, S; Veillet, J J; Videau, I; Abbaneo, D; Azzurri, P; Bagliesi, G; Batignani, G; Bettarini, S; Bozzi, C; Calderini, G; Carpinelli, M; Ciocci, M A; Ciulli, V; Dell'Orso, R; Fantechi, R; Ferrante, I; Foà, L; Forti, F; Giassi, A; Giorgi, M A; Gregorio, A; Ligabue, F; Lusiani, A; Marrocchesi, P S; Messineo, A; Rizzo, G; Sanguinetti, G; Sciabà, A; Spagnolo, P; Steinberger, Jack; Tenchini, Roberto; Tonelli, G; Triggiani, G; Vannini, C; Verdini, P G; Walsh, J; Betteridge, A P; Blair, G A; Bryant, L M; Cerutti, F; Gao, Y; Green, M G; Johnson, D L; Medcalf, T; Mir, L M; Perrodo, P; Strong, J A; Bertin, V; Botterill, David R; Clifft, R W; Edgecock, T R; Haywood, S; Edwards, M; Maley, P; Norton, P R; Thompson, J C; Bloch-Devaux, B; Colas, P; Emery, S; Kozanecki, Witold; Lançon, E; Lemaire, M C; Locci, E; Marx, B; Pérez, P; Rander, J; Renardy, J F; Roussarie, A; Schuller, J P; Schwindling, J; Trabelsi, A; Vallage, B; Johnson, R P; Kim, H Y; Litke, A M; McNeil, M A; Taylor, G; Beddall, A; Booth, C N; Boswell, R; Cartwright, S L; Combley, F; Dawson, I; Köksal, A; Letho, M; Newton, W M; Rankin, C; Thompson, L F; Böhrer, A; Brandt, S; Cowan, G D; Feigl, E; Grupen, Claus; Lutters, G; Minguet-Rodríguez, J A; Rivera, F; Saraiva, P; Smolik, L; Stephan, F; Apollonio, M; Bosisio, L; Della Marina, R; Giannini, G; Gobbo, B; Ragusa, F; Rothberg, J E; Wasserbaech, S R; Armstrong, S R; Bellantoni, L; Elmer, P; Feng, Z; Ferguson, D P S; Gao, Y S; González, S; Grahl, J; Harton, J L; Hayes, O J; Hu, H; McNamara, P A; Nachtman, J M; Orejudos, W; Pan, Y B; Saadi, Y; Schmitt, M; Scott, I J; Sharma, V; Turk, J; Walsh, A M; Wu Sau Lan; Wu, X; Yamartino, J M; Zheng, M; Zobernig, G

    1996-01-01

    From 64492 selected \\tau-pair events, produced at the Z^0 resonance, the measurement of the tau decays into hadrons from a global analysis using 1991, 1992 and 1993 ALEPH data is presented. Special emphasis is given to the reconstruction of photons and \\pi^0's, and the removal of fake photons. A detailed study of the systematics entering the \\pi^0 reconstruction is also given. A complete and consistent set of tau hadronic branching ratios is presented for 18 exclusive modes. Most measurements are more precise than the present world average. The new level of precision reached allows a stringent test of \\tau-\\mu universality in hadronic decays, g_\\tau/g_\\mu \\ = \\ 1.0013 \\ \\pm \\ 0.0095, and the first measurement of the vector and axial-vector contributions to the non-strange hadronic \\tau decay width: R_{\\tau ,V} \\ = \\ 1.788 \\ \\pm \\ 0.025 and R_{\\tau ,A} \\ = \\ 1.694 \\ \\pm \\ 0.027. The ratio (R_{\\tau ,V} - R_{\\tau ,A}) / (R_{\\tau ,V} + R_{\\tau ,A}), equal to (2.7 \\pm 1.3) \\ \\%, is a measure of the importance of Q...

  9. Coronary artery disease confined to secondary branches of the left coronary system

    Energy Technology Data Exchange (ETDEWEB)

    Iskandrian, A.S.; Klein, B.L.; Segal, B.L.; Kimbiris, D.; Bemis, C.E.

    1981-05-01

    Among 3,000 patients studied by coronary arteriography during a 4-year period, 31 patients (1%) had coronary artery disease limited to a diagonal branch of the left anterior descending (15 patients), marginal branch of the left circumflex (10 patients), or to both branches (6 patients). Ten patients had 50-69% and twenty-one had greater than or equal to 70% diameter narrowing. The suitability for grafting was noted in 20 patients as judged by the caliber and distribution of the diseased branches. Collaterals were noted in seven patients. Disease was present in 28 men and 3 women (age range 38-70 years). At least one major coronary risk factor was present in 27 patients. Angina was noted in 27 patients; prior myocardial infarction was noted in 5 patients by history and in 4 by ECG. The left ventriculogram was normal in 22 patients and showed mild segmental asynergy in 9; ejection fraction was normal in all. Exercise ECGs were positive in 12 of 25 patients; exercise 201thallium scans were positive in 13. All patients responded to medical therapy. In conclusion, among the population of patients who undergo catheterization, coronary branch disease is rare. The clinical findings are indistinguishable from patients with major coronary disease. Prognosis remains benign and patients respond to medical therapy.

  10. Legislative Branch: FY2014 Appropriations

    Science.gov (United States)

    2013-11-25

    Authorizations Since 1999, by Matthew E. Glassman . Legislative Branch: FY2014 Appropriations Congressional Research Service 10 The FY2012 level of...Congresses, by Matthew E. Glassman . Legislative Branch: FY2014 Appropriations Congressional Research Service 11 Members’ Representational...vehicles; communications equipment; security equipment and its installation; dignitary protection; intelligence analysis; hazardous material response

  11. Cognitive assessment of older adults in general practice: the collateral history.

    Science.gov (United States)

    Dyer, Adam H; Foley, Tony; O'Shea, Brendan; Kennelly, Sean P

    2017-12-02

    The collateral (or informant) history is a key component in the assessment of older adults presenting with a memory problem or concern over cognition. Despite this, it rarely features in medical literature and academic curricula. Its role in general practice has never been assessed. The aim of this study is to assess the role of the collateral history in the investigation of cognitive impairment in general practice. An online survey distributed to three nationally representative cohorts of GPs in Ireland (n = 692). Ninety-five (14%; 52.2% male) responded. Nearly all (87%; 83/95) indicate that it is most often a family member who brings possible cognitive impairment to the attention of their GP. The vast majority obtain a collateral history in > 90% of cases (72.6%; 69/95) and rate it very useful in their clinical assessment of cognition. GPs report the collateral history as readily available and rarely refused, with the general practice environment well-suited to obtaining collateral histories. A small minority routinely use the GPCOG informant section (3.2%; 3/95). Nearly all (92.6%; 88/95) report having received no training in obtaining collateral histories with most (79%; 75/95) welcoming of further training in this area. Despite recognition of the utility and importance of the collateral history, the vast majority of GPs report having never received training in obtaining one and do not use structured tools to guide their interview. Further emphasis on the informant history as a distinct clinical entity on medical curricula and increasing emphasis on the availability of structured informant tools are warranted.

  12. Embolization for Thoracic Duct Collateral Leakage in High-Output Chylothorax After Thoracic Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kariya, Shuji, E-mail: kariyas@hirakata.kmu.ac.jp; Nakatani, Miyuki, E-mail: nakatanm@hirakata.kmu.ac.jp; Yoshida, Rie, E-mail: yagir@hirakata.kmu.ac.jp; Ueno, Yutaka, E-mail: uenoyut@hirakata.kmu.ac.jp; Komemushi, Atsushi, E-mail: komemush@takii.kmu.ac.jp; Tanigawa, Noboru, E-mail: tanigano@hirakata.kmu.ac.jp [Kansai Medical University, Department of Radiology (Japan)

    2017-01-15

    PurposeThis study was designed to investigate thoracic duct collateral leakage and the supply route of lymphatic fluid by lymphangiography and transcatheter thoracic ductography and to evaluate the results of embolization for thoracic duct collateral leakage performed to cut off this supply route.MethodsData were retrospectively collected from five patients who underwent embolization for thoracic duct collateral leakage in persistent high-output chylothorax after thoracic surgery. Extravasation of lipiodol at the ruptured thoracic duct collaterals was confirmed in all patients on lymphangiography. Transcatheter thoracic ductography was used to identify extravasation of iodinated contrast agent and to identify communication between the thoracic duct and leakage site. Thoracic duct embolization (TDE) was performed using the percutaneous transabdominal approach to cut off the supply route using N-butyl cyanoacrylate (NBCA) mixed with lipiodol (1:5–1:20).ResultsClinical success (drainage volume ≤10 mL/kg/day within 7 days after TDE) was achieved in all patients. The collateral routes developed as consequence of surgical thoracic duct ligation. In three patients, NBCA-Lipiodol reached the leakage site through direct communication between the thoracic duct and the ruptured lymphatic duct. In the other two patients, direct communication and extravasation was not detected on thoracic ductography, and NBCA-Lipiodol did not reach the leakage site. However, NBCA-Lipiodol did reach the cisterna chyli, lumbar trunks, and some collateral routes via the cisterna chyli or lumbar lymphatics. As a result, leakage was stopped.ConclusionsTDE was effective for the management of leakage of the collaterals in high-output chylothorax after thoracic surgery.

  13. Do Fluid-Attenuated Inversion Recovery Vascular Hyperintensities Represent Good Collaterals before Reperfusion Therapy?

    Science.gov (United States)

    Mahdjoub, E; Turc, G; Legrand, L; Benzakoun, J; Edjlali, M; Seners, P; Charron, S; Hassen, W Ben; Naggara, O; Meder, J-F; Mas, J-L; Baron, J-C; Oppenheim, C

    2017-10-26

    In acute ischemic stroke, whether FLAIR vascular hyperintensities represent good or poor collaterals remains controversial. We hypothesized that extensive FLAIR vascular hyperintensities correspond to good collaterals, as indirectly assessed by the hypoperfusion intensity ratio. We included 244 consecutive patients eligible for reperfusion therapy with MCA stroke and pretreatment MR imaging with both FLAIR and PWI. The FLAIR vascular hyperintensity score was based on ASPECTS, ranging from 0 (no FLAIR vascular hyperintensity) to 7 (FLAIR vascular hyperintensities abutting all ASPECTS cortical areas). The hypoperfusion intensity ratio was defined as the ratio of the time-to-maximum >10-second over time-to-maximum >6-second lesion volumes. The median hypoperfusion intensity ratio was used to dichotomize good (low hypoperfusion intensity ratio) versus poor (high hypoperfusion intensity ratio) collaterals. We then studied the association between FLAIR vascular hyperintensity extent and hypoperfusion intensity ratio. Hypoperfusion was present in all patients, with a median hypoperfusion intensity ratio of 0.35 (interquartile range, 0.19-0.48). The median FLAIR vascular hyperintensity score was 4 (interquartile range, 3-5). The FLAIR vascular hyperintensities were more extensive in patients with good collaterals (hypoperfusion intensity ratio ≤0.35) than with poor collaterals (hypoperfusion intensity ratio >0.35; P for Trend = .016). The FLAIR vascular hyperintensity score was independently associated with good collaterals (P for Trend = .002). In patients eligible for reperfusion therapy, FLAIR vascular hyperintensity extent was associated with good collaterals, as assessed by the pretreatment hypoperfusion intensity ratio. The ASPECTS assessment of FLAIR vascular hyperintensities could be used to rapidly identify patients more likely to benefit from reperfusion therapy. © 2018 by American Journal of Neuroradiology.

  14. The epidemiology of medial collateral ligament sprains in young athletes.

    Science.gov (United States)

    Roach, Christopher J; Haley, Chad A; Cameron, Kenneth L; Pallis, Mark; Svoboda, Steven J; Owens, Brett D

    2014-05-01

    A medial collateral ligament (MCL) knee sprain is a prevalent injury in athletic populations that may result in significant time lost to injury. Remarkably little is known of the epidemiology of this injury. To define the incidence of MCL tears and to determine the demographic and athletic risk factors. Descriptive epidemiological study. A longitudinal cohort study was performed to examine the epidemiology of isolated MCL sprains at the United States Military Academy (USMA) between 2005 and 2009. Charts and radiographic studies were reviewed by an independent orthopaedic surgeon to identify all new isolated MCL sprains resulting in time lost to sport and activity that occurred within the study period. Incidence rates (IRs) with 95% confidence intervals (CIs) were calculated per 1000 person-years at risk and by sex, sport, and level of competition. The IR per 1000 athlete-exposures (AEs) was also determined. Incidence rate ratios (IRRs) and respective 95% CIs were calculated between male and female students, intercollegiate and intramural athletes, and male and female intercollegiate athletes involved in selected sports. Chi-square and Poisson regression analyses were used to examine the relationship between the variables of interest and the incidence of MCL sprains, with statistical significance set at P student person-years from 2005 to 2009. This resulted in an IR of approximately 7.3 per 1000 person-years. Of the 128 injuries, 114 were in male athletes (89%) and 14 were in female athletes (11%). Male cadets had a 44% higher IR than did female cadets (7.60 vs 5.36, respectively), although this was not significant (P = .212). Of 5820 at-risk intercollegiate athletes, 59 (53 male, 6 female) sustained an isolated MCL sprain during 528,523 (407,475 male, 121,048 female) AEs for an overall IR of 10.14 per 1000 person-years and 0.11 per 1000 AEs. The IRR of MCL sprains of men compared with women involved in intercollegiate athletics was 2.87 (95% CI, 1.24-8.18) per

  15. Morphology of the medial collateral ligament of the knee

    Directory of Open Access Journals (Sweden)

    Gill Thomas J

    2010-09-01

    Full Text Available Abstract Background Quantitative knowledge on the anatomy of the medial collateral ligament (MCL is important for treatment of MCL injury and for MCL release during total knee arthroplasty (TKA. The objective of this study was to quantitatively determine the morphology of the MCL of human knees. Methods 10 cadaveric human knees were dissected to investigate the MCL anatomy. The specimens were fixed in full extension and this position was maintained during the dissection and morphometric measurements. The outlines of the insertion sites of the superficial MCL (sMCL and deep MCL (dMCL were digitized using a 3D digitizing system. Results The insertion areas of the superficial MCL (sMCL were 348.6 ± 42.8 mm2 and 79.7 ± 17.6 mm2 on the tibia and femur, respectively. The insertion areas of the deep MCL (dMCL were 63.6 ± 13.4 mm2 and 71.9 ± 14.8 mm2 on the tibia and femur, respectively. The distances from the centroids of the tibial and femoral insertions of the sMCL to the tibial and femoral joint line were 62.4 ± 5.5 mm and 31.1 ± 4.6 mm, respectively. The distances from the centroids of dMCL in the tibial insertion and the femoral insertion to the tibial and femoral joint line were 6.5 ± 1.3 mm and 20.5 ± 4.2 mm, respectively. The distal portion of the dMCL (meniscotibial ligament - MTL was approximately 1.7 times wider than the proximal portion of the dMCL (meniscofemoral ligament - MFL, whereas the MFL was approximately 3 times longer than the MTL. Conclusions The morphologic data on the MCL may provide useful information for improving treatments of MCL-related pathology and performing MCL release during TKA.

  16. Prevalence of Ulnar Collateral Ligament Surgery in Professional Baseball Players.

    Science.gov (United States)

    Conte, Stan A; Fleisig, Glenn S; Dines, Joshua S; Wilk, Kevin E; Aune, Kyle T; Patterson-Flynn, Nancy; ElAttrache, Neal

    2015-07-01

    While the high rate of ulnar collateral ligament (UCL) injuries in professional baseball is widely discussed in the media and medical literature, the actual prevalence of UCL reconstruction has not been documented. The prevalence of UCL reconstruction will be higher among pitchers than nonpitchers, and Major League Baseball (MLB) pitchers will have a higher prevalence than will minor league pitchers. Descriptive epidemiology study. An online questionnaire was distributed to all 30 MLB organizations. Certified athletic trainers from each team administered the questionnaire to all players in the organization, including major league players and 6 levels of minor league players. Demographic data were compared between major and minor league players. Continuous variables (age, years of professional baseball, country of origin, etc) were compared with Student t tests (P baseball players (722 major league and 4366 minor league) participated in the survey. Pitchers represented 53% of all players, and 497 players reported at least 1 UCL reconstruction, demonstrating a prevalence rate of 10% (497 of 5088). Pitchers reported a significantly higher prevalence of UCL reconstruction (16%; 437 of 2706) than nonpitchers (3%; 60 of 2382; P major league pitchers, 25% (96 of 382) had a history of UCL reconstruction, while minor league pitchers showed a 15% (341 of 2324) prevalence (P Major league pitchers were also significantly older (28.8 ± 3.9 years) than minor league pitchers (22.8 ± 3.0; P majority of major leaguers (86%) had their UCL reconstruction as professional pitchers, whereas the majority of minor league pitchers (61%) underwent their UCL reconstruction during high school and college (P major league and minor league pitchers. No difference in prevalence was shown between pitchers born in the United States versus Latin American countries. Pitchers have a high prevalence of UCL reconstruction in professional baseball, with 25% of major league pitchers and 15% of minor

  17. Measurement of Branching Fractions and Spectral Functions in tau Decays

    CERN Document Server

    Davier, Michel

    2005-01-01

    Full LEP-I data collected by the ALEPH detector during 1991-1995 running are analyzed in order to measure the tau decay branching fractions and the hadronic spectral functions. The analysis follows the global method used in the published study based on 1991-1993 data, with several improvements, especially concerning the treatment of photons and pi /sup 0/'s. Extensive systematic studies are performed, in order to match the large statistics of the data sample corresponding to 327148 measured and identified tau decays. Preliminary values for the branching fractions are obtained for the 2 leptonic channels and 11 hadronic channels defined by their respective numbers of charged particles and pi /sup 0/'s. Using previously published ALEPH results on final states with charged and neutral kaons, corrections are applied so that branching ratios for exclusive final states without kaons are derived. Some physics implications of the results are given, in particular concerning universality in the leptonic charged weak cu...

  18. Increased circulating monocyte count is related to good collateral development in coronary artery disease.

    Science.gov (United States)

    Kocaman, Sinan Altan; Arslan, Uğur; Tavil, Yusuf; Okuyan, Hizir; Abaci, Adnan; Cengel, Atiye

    2008-04-01

    Monocytes have been shown to take an important role in collateral growth in animal studies. The aim of the study was to investigate the relation of circulating monocyte count with collateral development in patients with severely stenotic CAD. Patients who had > or =95% stenosis in at least one major coronary artery were included in the study. Coronary angiograms of 210 eligible patients from our database were analyzed again and 103 of them had good and 107 had poor collateral development according to Cohen-Rentrop method. Only the monocyte count was found to be significantly different between two groups (671+/-218 mm(-3) versus 522+/-195 mm(-3), p<0.001) when multivariate analysis was performed and an increased monocyte count was observed in the good collateral group (Odds ration [OR], 2.918; 95% confidence interval [CI], 1.281-6.648, p=0.011). This study in which the relationship between monocyte count in blood and collateral development was disclosed has a potential importance in clinical and basic cardiovascular medicine.

  19. [Repair of collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger].

    Science.gov (United States)

    Ka, S; Guan, Z M; Liu, C

    2000-01-01

    To introduce the surgical procedure and clinical result of microsurgical repair on collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger. From 1987, 23 cases with collateral ligament rupture in the interphalangeal joint were repaired by part of superficial flexor tendon of finger. The initial point of collateral ligament was drilled two holes, 2 to 3 mm in distance, and crossed by steel wire. Then the superficial flexor tendon of finger was crossed under the steel wire and sutured to the terminal point of superficial flexor tendon of finger by 5/0 to 7/0 nontraumatic suture thread to maintain suitable tension, and sutured to collateral ligament by 8/0 nontraumatic suture thread. Extension splint fixation was performed 4 to 6 weeks postoperatively. Followed up 3 to 6 months, 15 cases were excellent, 6 cases were better, 2 cases were moderate, and the excellent rate was 91.34% according to Saetta standard. Microsurgical repair on collateral ligament rupture in the interphalangeal joint using superficial flexor tendon of finger is a convenient and effective surgical method.

  20. The role of VEGF and KDR polymorphisms in moyamoya disease and collateral revascularization.

    Directory of Open Access Journals (Sweden)

    Young Seok Park

    Full Text Available We conducted a case-control study to investigate whether vascular endothelial growth factor (VEGF -2578, -1154, -634, and 936 and kinase insert domain containing receptor (KDR -604, 1192, and 1719 polymorphisms are associated with moyamoya disease. Korean patients with moyamoya disease (n = 107, mean age, 20.9±15.9 years; 66.4% female and 243 healthy control subjects (mean age, 23.0±16.1 years; 56.8% female were included. The subjects were divided into pediatric and adult groups. Among the 64 surgical patients, we evaluated collateral vessel formation after 2 years and divided patients into good (collateral grade A or poor (collateral grade B and C groups. The frequencies and distributions of four VEGF (-2578, -1154, -634, and 936 and KDR (-604, 1192, and 1719 polymorphisms were assessed from patients with moyamoya disease and compared to the control group. No differences were observed in VEGF -2578, -1154, -634, and 936 or KDR -604, 1192, and 1719 polymorphisms between the control group and moyamoya disease group. However, we found the -634CC genotype occurred less frequently in the pediatric moyamoya group (p = 0.040 whereas the KDR -604C/1192A/1719T haplotype increased the risk of pediatric moyamoya (p = 0.024. Patients with the CC genotype of VEGF -634 had better collateral vessel formation after surgery. Our results suggest that the VEGF -634G allele is associated with pediatric moyamoya disease and poor collateral vessel formation.

  1. Injuries to the medial collateral ligament and associated medial structures of the knee.

    Science.gov (United States)

    Wijdicks, Coen A; Griffith, Chad J; Johansen, Steinar; Engebretsen, Lars; LaPrade, Robert F

    2010-05-01

    *The superficial medial collateral ligament and other medial knee stabilizers-i.e., the deep medial collateral ligament and the posterior oblique ligament-are the most commonly injured ligamentous structures of the knee. *The main structures of the medial aspect of the knee are the proximal and distal divisions of the superficial medial collateral ligament, the meniscofemoral and meniscotibial divisions of the deep medial collateral ligament, and the posterior oblique ligament. *Physical examination is the initial method of choice for the diagnosis of medial knee injuries through the application of a valgus load both at full knee extension and between 20 degrees and 30 degrees of knee flexion. *Because nonoperative treatment has a favorable outcome, there is a consensus that it should be the first step in the management of acute isolated grade-III injuries of the medial collateral ligament or such injuries combined with an anterior cruciate ligament tear. *If operative treatment is required, an anatomic repair or reconstruction is recommended.

  2. [EFFICACY COMPARISON BETWEEN DEEP MEDIAL COLLATERAL LIGAMENT REPAIR AND CONSERVATIVE TREATMENT FOR COMPLETE MEDIAL COLLATERAL LIGAMENT RUPTURE].

    Science.gov (United States)

    Zhang, Hangzhou; Bai, Xizhuang; Liang, Qingwei; Wang, Yanfeng; Liu, Xiangnan; You, Fuli

    2016-03-01

    To compare the clinical efficacy between deep medial collateral ligament (dMCL) repair and conservative treatment for complete MCL rupture. Between August 2009 and December 2013, 36 patients with grade 3 MCL rupture underwent superior MCL (sMCL) reconstruction with tibial Inlay technique. Of 36 cases, 19 received dMCL repair (repair group), and 17 received conservative treatment (conservation group) after sMCL reconstruction. There was no significant difference in gender, age, knee sides, type of injury, disease duration and preoperative medial joint opening, knee Lysholm scores, and International Knee Documentation Committee (IKDC) score between 2 groups (P > 0.05). The Lysholm and IKDC scores, medial joint opening, range of motion (ROM), visual analogue scale (VAS) scores, and complications were used to assess the knee joint function. All patients achieved primary incision healing without acute postoperative complications of incision infection and deep vein thrombosis in the lower limb. The patients were followed up 28-65 months (mean, 46.3 months) in the repair group, and 26-69 months (mean, 45.9 months) in the conservation group. No knee stiffness, vascular or nerve injury, and knee joint infection occurred in 2 groups. All the patients recovered medial stability at 2 years postoperatively. At 2 years after operation, no significant difference was shown in knee ROM between 2 groups (t = 0.26, P = 0.80); the VAS score of the repair group was significantly lower than that of the conservation group (t = 5.22, P = 0.00); medial joint opening, IKDC score, and Lysholm score were significantly improved when compared with preoperative ones in 2 groups (P 0.05). Whether or not additional dMCL repair is performed can recover medial stability after sMCL reconstruction. However, the additional dMCL repair is better in relieving medial knee pain than the conservative treatment.

  3. Models of lung branching morphogenesis.

    Science.gov (United States)

    Miura, Takashi

    2015-03-01

    Vertebrate airway has a tree-like-branched structure. This structure is generated by repeated tip splitting, which is called branching morphogenesis. Although this phenomenon is extensively studied in developmental biology, the mechanism of the pattern formation is not well understood. Conversely, there are many tree-like structures in purely physical or chemical systems, and their pattern formation mechanisms are well-understood using mathematical models. Recent studies correlate these biological observations and mathematical models to understand lung branching morphogenesis. These models use slightly different mechanisms. In this article, we will review recent progress in modelling lung branching morphogenesis, and future directions to experimentally verify the models. © The Authors 2015. Published by Oxford University Press on behalf of the Japanese Biochemical Society. All rights reserved.

  4. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

    The relationship between myocardial electrical activation by electrocardiogram (ECG) and mechanical contraction by echocardiography in left bundle-branch block (LBBB) has never been clearly demonstrated. New strict criteria for LBBB based on a fundamental understanding of physiology have recently...

  5. Pulmonary fissure integrity and collateral ventilation in COPD patients.

    Directory of Open Access Journals (Sweden)

    Jiantao Pu

    Full Text Available To investigate whether the integrity (completeness of pulmonary fissures affects pulmonary function in patients with chronic obstructive pulmonary disease (COPD.A dataset consisting of 573 CT exams acquired on different subjects was collected from a COPD study. According to the global initiative for chronic obstructive lung disease (GOLD criteria, these subjects (examinations were classified into five different subgroups, namely non-COPD (222 subjects, GOLD-I (83 subjects, GOLD-II (141 subjects, GOLD-III (63 subjects, and GOLD-IV (64 subjects, in terms of disease severity. An available computer tool was used to aid in an objective and efficient quantification of fissure integrity. The correlations between fissure integrity, and pulmonary functions (e.g., FEV1, and FEV1/FVC and COPD severity were assessed using Pearson and Spearman's correlation coefficients, respectively.For the five sub-groups ranging from non-COPD to GOLD-IV, the average integrities of the right oblique fissure (ROF were 81.8%, 82.4%, 81.8%, 82.8%, and 80.2%, respectively; the average integrities of the right horizontal fissure (RHF were 62.6%, 61.8%, 62.1%, 62.2%, and 62.3%, respectively; the average integrities of the left oblique fissure (LOF were 82.0%, 83.2%, 81.7%, 82.0%, and 78.4%, respectively; and the average integrities of all fissures in the entire lung were 78.0%, 78.6%, 78.1%, 78.5%, and 76.4%, respectively. Their Pearson correlation coefficients with FEV1 and FE1/FVC range from 0.027 to 0.248 with p values larger than 0.05. Their Spearman correlation coefficients with COPD severity except GOLD-IV range from -0.013 to -0.073 with p values larger than 0.08.There is no significant difference in fissure integrity for patients with different levels of disease severity, suggesting that the development of COPD does not change the completeness of pulmonary fissures and incomplete fissures alone may not contribute to the collateral ventilation.

  6. [Dendritic cells and coronary collateral circulation in coronary heart disease].

    Science.gov (United States)

    Li, Chuanchang; Liu, Wei; Yi, Jun; Li, Zhenyu; Pu, Xiaoqun; Yang, Tianlun; Xie, Qiying; Mo, Long; Chen, Xiaobin

    2010-05-01

    To determine the relationship between the number,phenotype and functional status of dendritic cells (DCs) and coronary collateral circulation (CCC) in coronary heart disease (CHD). Forty patients with severe coronary stenosis were recruited and divided into a CCC formation group (Group A, n=22) and a non-CCC formation group (Group B, n=18). Density gradient centrifugation was applied to separate the mononuclear cells (MNCs) from coronary artery blood samples, and MNCs were cultured and proliferated in vitro. The morphology of DCs was observed under converted microscope. The number of harvested cells and DCs was counted by hematocytometer. Flow cytometry was applied to investigate the phenotype and the mean fluorescence intensity (MFI). Mixed lymphocyte reaction was used to test the function of DCs to stimulate the proliferation of T lymphocytes. Stimulation index (SI) was calculated and compared. (1) After in vitro proliferation, DCs were cultured successfully from the mononuclear cells from coronary artery blood samples and the morphology of DCs was not different in the 2 groups. (2) The number of mononuclear cells (MNC no) was (3.95+/-1.41)*10(6), in the CCC group and (2.76+/-0.92)*10(6) in the non-CCC group. The MNC number was significantly increased in the CCC group (P=0.003). (3) The number of DCs was (1.54+/-0.96)*10(6) in the CCC group, and (0.99+/-0.46)*10(6) in the non-CCC group (P=0.033). (4)There was no statistical significance in the percent of CD1a+, CD1a+CD80+, CD1a+CD83+, CD1a+CD86+ cells, and MFI in the 2 groups (P>0.05). (5) SI was 4.96+/-2.30 in the CCC group, whereas 2.66+/-1.04 in the non-CCC group. The SI in the CCC group increased significantly(P=0.0003). In CHD patients with severe coronary stenosis, patients with CCC formation have higher number of DCs and stronger potential of T lymphocyte stimulation.

  7. Penetrating neck injury: Collaterals for another life after ligation of common carotid artery and subclavian artery

    Directory of Open Access Journals (Sweden)

    Annu Babu

    2017-02-01

    Full Text Available Neck, being not protected by skeleton, is vulnerable to external trauma and injury which involves blood vessels, trachea, esophagus and other endocrine and nervous system organs. Vascular injuries can not only cause potentially life-threatening hemorrhage but also need profound surgical expertise in management. Development of collateral circulation in neck is well known; however, there is scarcity of literature on the role of collateral formation in neck trauma. Here, we present a unique case of penetrating gunshot injury to neck with right common carotid and right subclavian artery injury with hemorrhagic shock managed with ligation of these vessels as a life-saving procedure. The patient presented with no neurological or motor deficits in immediate postoperative period owing to the collateral circulation between right vertebral artery and right common carotid and right subclavian artery.

  8. Early mobilization of rabbit medial collateral ligament repairs: biomechanic and histologic study.

    Science.gov (United States)

    Goldstein, W M; Barmada, R

    1984-05-01

    The postoperative management of repaired medial collateral ligaments is controversial. There are proponents for either early mobilization or immobilization. To contribute to an understanding of the issues, 24 adult Dutch rabbits were divided into four groups and a comparative study was made of their incised medial collateral ligaments, contrasting early immobilization with mobilization at three and six weeks. The ligaments were studied histologically and biomechanically. At three weeks, the immobilized ligaments were twice as strong as mobilized ligaments. Histologically, the immobilized ligaments demonstrated more fibroblastic reaction while the mobilized ligaments showed more mature tissue development at the repair site. There were no statistically significant differences between knees mobilized for six weeks and knees immobilized for three weeks and then subsequently mobilized for three weeks. In view of these results, the authors conclude that the deleterious effects of immobilization should be considered when planning postoperative or postinjury treatment of torn medial collateral ligaments.

  9. SmPL: A Domain-Specific Language for Specifying Collateral Evolutions in Linux Device Drivers

    DEFF Research Database (Denmark)

    Padioleau, Yoann; Lawall, Julia Laetitia; Muller, Gilles

    2007-01-01

    identifying the affected files and modifying all of the code fragments in these files that in some way depend on the changed interface. We have studied the collateral evolution problem in the context of Linux device drivers. Currently, collateral evolutions in Linux are mostly done manually using a text...... editor, possibly with the help of tools such as grep. The large number of Linux drivers, however, implies that this approach is time-consuming and unreliable, leading to subtle errors when modifications are not done consistently. In this paper, we propose a transformation language, SmPL, to specify...... collateral evolutions. Because Linux programmers are accustomed to exchanging, reading, and manipulating program modifications in terms of patches, we build our language around the idea and syntax of a patch, extending patches to semantic patches. Udgivelsesdato: January 3...

  10. Hemodynamic contribution of transdural collateral flow in adult patients with moyamoya disease.

    Science.gov (United States)

    Hong, Ji Man; Hong, Yoon Hee; Lee, Seong-Joon; Lee, Sung Eun; Lee, Jin Soo; Shin, Dong Hoon

    2016-12-01

    To evaluate the hemodynamic contributions of collateral flow in adult patients with moyamoya disease, neurological deterioration or fluctuation during admission, Suzuki grade, various collateral routes, lesion volume, cerebral blood flow (CBF), and their associations were analyzed. Thirty patients (60 cerebral hemispheres, mean age 45 ± 25 years, and 73.3 % female) who were diagnosed with moyamoya disease or syndrome were enrolled over 3 years. Moyamoya stages from each hemisphere were stratified according to the Suzuki's criteria through six-vessel angiography into internal carotid arteries (ICAs), external carotid arteries (ECAs), and vertebral arteries (VAs). Collateral routes were categorized into the circle of Willis, leptomeningeal, and transdural. The volume of ipsilateral infarction was analyzed by magnetic resonance imaging. CBF volume was measured using color-coded duplex sonography. Suzuki's grade was inversely correlated with flow volume of the ICAs (p moyamoya disease, suggesting a protector against an impending ischemic attack.

  11. Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease

    DEFF Research Database (Denmark)

    Hartkamp, Nolan S; Petersen, Esben T; Chappell, Michael A

    2018-01-01

    Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment...... is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial...... arterial spin labeling (ASL) imaging. Cerebral blood flow and cerebrovascular reactivity were assessed with ASL before and after acetazolamide. Cerebral haemodynamics were normal in asymptomatic ICA stenosis patients, as opposed to patients with ICA occlusion, in whom the haemodynamics in both hemispheres...

  12. Long chain branching of PLA

    Science.gov (United States)

    Gu, Liangliang; Xu, Yuewen; Fahnhorst, Grant; Macosko, Christopher W.

    2017-05-01

    A trifunctional aziridine linker, trimethylolpropane tris(2-methyl-1-aziridinepropionate) (TTMAP), was melt blended with linear polylactic acid (PLA) to make star branched PLA. Adding pyromellitic dianhydride (PMDA) led to long chain branched (LCB) PLA. Mixing torque evolution during melt processing revealed high reactivity of aziridine with the carboxyl end group on PLA and an incomplete reaction of PMDA with the hydroxyl end group. Star-shaped PLA exhibited higher viscosity but no strain hardening in extensional flow while LCB PLA showed significant extensional hardening. Excess TTMAP in the branching reaction resulted in gel formation, which led to failure at low strain in extension. PMDA conversion was estimated based on gelation theory. The strain rate dependence of extensional hardening indicated that the LCB PLA had a low concentration of long chain branched molecules with an H-shaped topology. Unlike current methods used to branch PLA, free radical chemistry or use of an epoxy functional oligomers, our branching strategy produced strain hardening with less increase in shear viscosity. This study provides guidelines for design of polymers with low shear viscosity, which reduces pressure drop in extrusion, combined with strong extensional hardening, which enhances performance in processes that involve melt stretching.

  13. Structural Mechanics and Dynamics Branch

    Science.gov (United States)

    Stefko, George

    2003-01-01

    The 2002 annual report of the Structural Mechanics and Dynamics Branch reflects the majority of the work performed by the branch staff during the 2002 calendar year. Its purpose is to give a brief review of the branch s technical accomplishments. The Structural Mechanics and Dynamics Branch develops innovative computational tools, benchmark experimental data, and solutions to long-term barrier problems in the areas of propulsion aeroelasticity, active and passive damping, engine vibration control, rotor dynamics, magnetic suspension, structural mechanics, probabilistics, smart structures, engine system dynamics, and engine containment. Furthermore, the branch is developing a compact, nonpolluting, bearingless electric machine with electric power supplied by fuel cells for future "more electric" aircraft. An ultra-high-power-density machine that can generate projected power densities of 50 hp/lb or more, in comparison to conventional electric machines, which generate usually 0.2 hp/lb, is under development for application to electric drives for propulsive fans or propellers. In the future, propulsion and power systems will need to be lighter, to operate at higher temperatures, and to be more reliable in order to achieve higher performance and economic viability. The Structural Mechanics and Dynamics Branch is working to achieve these complex, challenging goals.

  14. Fragrance Release from the Surface of Branched Poly (Amide S

    Directory of Open Access Journals (Sweden)

    T. Youngs

    2005-01-01

    Full Text Available Enzymes are powerful tools in organic synthesis that are able to catalyse a wide variety of selective chemical transformations under mild and environmentally friendly conditions. Enzymes such as the lipases have also found applications in the synthesis and degradation of polymeric materials. However, the use of these natural catalysts in the synthesis and the post-synthetic modification of dendrimers and hyperbranched molecules is an application of chemistry yet to be explored extensively. In this study the use of two hydrolytic enzymes, a lipase from Candida cylindracea and a cutinase from Fusarium solani pisii, were investigated in the selective cleavage of ester groups situated on the peripheral layer of two families of branched polyamides. These branched polyamides were conjugated to simple fragrances citronellol and L-menthol via ester linkages. Hydrolysis of the ester linkage between the fragrances and the branched polyamide support was carried out in aqueous buffered systems at slightly basic pH values under the optimum operative conditions for the enzymes used. These preliminary qualitative investigations revealed that partial cleavage of the ester functionalities from the branched polyamide support had occurred. However, the ability of the enzymes to interact with the substrates decreased considerably as the branching density, the rigidity of the structure and the bulkiness of the polyamide-fragrance conjugates increased.

  15. Dynamic Magnetic Resonance Angiography Provides Collateral Circulation and Hemodynamic Information in Acute Ischemic Stroke.

    Science.gov (United States)

    Hernández-Pérez, María; Puig, Josep; Blasco, Gerard; Pérez de la Ossa, Natalia; Dorado, Laura; Dávalos, Antoni; Munuera, Josep

    2016-02-01

    Contrary to usual static vascular imaging techniques, contrast-enhanced dynamic magnetic resonance angiography (dMRA) enables dynamic study of cerebral vessels. We evaluated dMRA ability to assess arterial occlusion, cerebral hemodynamics, and collateral circulation in acute ischemic stroke. Twenty-five acute ischemic stroke patients with proximal anterior circulation occlusion underwent dMRA on a 3T scanner within 12 hours of symptoms onset. Diffusion weighted imaging, Tmax6 s lesion volumes and hypoperfusion intensity ratio as volume of Tmax>6 s/volume of Tmax>10 s were measured. Site and grade of occlusion (Thrombolysis in Myocardial Infarction criteria) were evaluated on time-of-flight MRA and dMRA. Leptomeningeal collaterality (American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology [ASITN/SIR] Scale) and asymmetries in venous clearance were assessed exclusively on dMRA. Collateral filling was dichotomized into incomplete (ASITN/SIR 0-2) or complete (ASITN/SIR 3-4). On dMRA, site of occlusion was M1 in 21 patients, tandem internal carotid artery/M1 in 2 and tandem internal carotid artery/terminal internal carotid artery in 2 patients. Three tandem occlusions were not detected on time-of-flight-MRA. All patients had Thrombolysis in Myocardial Infarction 0 to 1 on time-of-flight-MRA, but three of them had Thrombolysis in Myocardial Infarction 2 on dMRA. Complete collateral filling (n=12, 48%) was associated with smaller diffusion weighted imaging lesion volume (P=0.039), smaller hypoperfused volume (P=0.018), and lower hypoperfusion intensity ratio (P=0.006). Patients with symmetrical clearance of transverse sinuses (52%) were more likely to have complete collateral filling (P=0.015). As a fast, direct, feasible, noninvasive, and reliable method to assess site of occlusion, collateral circulation and hemodynamic alterations, dMRA provides profound insights in acute stroke. © 2015 American Heart Association, Inc.

  16. Morphological study of mechanoreceptors in collateral ligaments of the ankle joint.

    Science.gov (United States)

    Wu, Xiaochuan; Song, Weidong; Zheng, Cuihuan; Zhou, Shixiong; Bai, Shengbin

    2015-06-12

    The aim of this study was to analyze the pattern and types of sensory nerve endings in ankle collateral ligaments using histological techniques, in order to observe the morphology and distribution of mechanoreceptors in the collateral ligaments of cadaver ankle joint, and to provide the morphological evidence for the role of the ligament in joint sensory function. Twelve lateral collateral ligaments including anterior talofibular ligament (ATFL; n = 6), posterior talofibular ligament (PTFL; n = 6), and calcaneofibular ligament (CFL; n = 6) were harvested from six fresh frozen cadavers. The ligaments were embedded in paraffin, sectioned at 4 μm, and then stained using a modified gold-chloride staining methods. The collateral ligament was divided into three segments: proximal, middle, and distal segments. Fifty-four ATFL slides, 90 PTFL slides, and 108 CFL slides were analyzed. Mechanoreceptors were classified based on Freemen and Wyke's classification. Mechanoreceptor distribution was analyzed statistically. One-way ANOVA (postHoc LSD) was used for statistical analysis. All the four typical types of nerve endings (the Ruffini corpuscles, Pacinian corpuscles, Golgi tendon organs, and free nerve endings) were identified in these ligaments. Pacinian corpuscles were the predominant in all four complexes. More mechanoreceptors were found in synovial membrane near both ends of the ligaments attached to the bone. No statistical differences were found in the amount of mechanoreceptors among distal, middle, and proximal parts of the ligaments. The four typical types of mechanoreceptors were all identified in the collateral ligaments of the human ankle. Pacinian corpuscles were the predominant in all four complexes. This indicates that the main function of ankle collateral ligaments is to sense joint speeds in motions.

  17. Cerebrovascular Collaterals Correlate with Disease Severity in Adult North American Patients with Moyamoya Disease

    Science.gov (United States)

    Strother, M.K.; Anderson, M.D.; Singer, R.J.; Du, L.; Moore, R.D.; Shyr, Y.; Ladner, T.R.; Arteaga, D.; Day, M.A.; Clemmons, P.F.; Donahue, M.J.

    2015-01-01

    BACKGROUND AND PURPOSE Cerebrovascular collaterals have been increasingly recognized as predictive of clinical outcomes in Moyamoya disease in Asia. The aim of this study was to characterize collaterals in North American adult patients with Moyamoya disease and to assess whether similar correlations are valid. MATERIALS AND METHODS Patients with Moyamoya disease (n = 39; mean age, 43.5±10.6 years) and age- and sex-matched control subjects (n = 33; mean age, 44.3±12.0 years) were graded via angiography. Clinical symptoms of stroke or hemorrhage were graded separately by imaging. Correlations between collateralization and disease severity, measured by the modified Suzuki score, were evaluated in patients with Moyamoya disease by fitting a regression model with clustered ordinal multinomial responses. RESULTS The presence of leptomeningeal collaterals (P = .008), dilation of the anterior choroidal artery (P = .01), and the posterior communicating artery/ICA ratio (P = .004) all correlated significantly with disease severity. The presence of infarct or hemorrhage and posterior steno-occlusive disease did not correlate significantly with the modified Suzuki score (P=.1). Anterior choroidal artery changes were not specific for hemorrhage. Patients with Moyamoya disease were statistically more likely than controls to have higher posterior communicating artery/ICA ratios and a greater incidence of leptomeningeal collaterals. CONCLUSIONS As with Moyamoya disease in Asian patients, the presence of cerebrovascular collaterals correlated with the modified Suzuki score for disease severity in North American patients with Moyamoya disease. However, anterior choroidal artery changes, which correlated with increased rates of hemorrhage in Asian studies, were not specific to hemorrhage in North Americans. PMID:24651814

  18. Evaluation and treatment of medial collateral ligament and medial-sided injuries of the knee.

    Science.gov (United States)

    Jacobson, Kurt E; Chi, Frederic S

    2006-06-01

    Injuries to the medial side of the knee are not always isolated injuries of the superficial medial collateral ligament. Medial-sided injuries can also involve the deep medial collateral ligament, the posteromedial corner, or the medial meniscus. Magnetic resonance imaging is a useful adjunct to the physical examination; however, the extent of medial-sided injuries is frequently underappreciated on these images. An understanding of the anatomy and biomechanics of the medial side of the knee and a thorough physical examination aids the physician in determining the full extent of injury and helping the physician to treat each unique injury pattern.

  19. Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Joon Ho; Kim, Man Deuk, E-mail: mdkim@yuhs.ac; Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun [Yonsei University College of Medicine, Department of Radiology, Research Institute of Radiological Science, Severance Hospital (Korea, Republic of)

    2013-02-15

    We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

  20. Incidence and angiographic predictors of collateral function in patients with stable coronary artery disease scheduled for percutaneous coronary intervention

    NARCIS (Netherlands)

    de Vries, Jessica; Anthonio, Rutger L.; van den Heuvel, Ad F. M.; Tan, Eng-Shiong; Jessurun, Gillian A.; de Smet, Bart J. G. L.; DeJongste, Mike J. L.; Zijlstra, Felix

    2007-01-01

    Objectives: To investigate the incidence and angiographic predictors of functional collateral perfusion in patients with stable coronary artery disease, scheduled for elective PCI. Background: Functional collateral perfusion is defined as a Pw/Pa ratio >= 0.24. Since this can only be measured

  1. Impact of Collateral Status Evaluated by Dynamic Computed Tomographic Angiography on Clinical Outcome in Patients With Ischemic Stroke

    NARCIS (Netherlands)

    van den Wijngaard, Ido R.; Boiten, Jelis; Holswilder, Ghislaine; Algra, Ale|info:eu-repo/dai/nl/07483472X; Dippel, Diederik W J; Velthuis, Birgitta K.|info:eu-repo/dai/nl/176956301; Wermer, Marieke J H; van Walderveen, Marianne A A

    2015-01-01

    BACKGROUND AND PURPOSE—: Status of collateral circulation is a strong predictor of outcome after acute ischemic stroke. Our aim was to compare the predictive value of strategies for collateral blood flow assessment with dynamic computed tomographic angiography (CTA) and conventional single-phase CT

  2. Coronary Collateral Growth Induced by Physical Exercise: Results of the Impact of Intensive Exercise Training on Coronary Collateral Circulation in Patients With Stable Coronary Artery Disease (EXCITE) Trial.

    Science.gov (United States)

    Möbius-Winkler, Sven; Uhlemann, Madlen; Adams, Volker; Sandri, Marcus; Erbs, Sandra; Lenk, Karsten; Mangner, Norman; Mueller, Ulrike; Adam, Jennifer; Grunze, Martin; Brunner, Susanne; Hilberg, Thomas; Mende, Meinhard; Linke, Axel P; Schuler, Gerhard

    2016-04-12

    A well-developed coronary collateral circulation provides a potential source of blood supply in coronary artery disease. However, the prognostic importance and functional relevance of coronary collaterals is controversial with the association between exercise training and collateral growth still unclear. This prospective, open-label study randomly assigned 60 patients with significant coronary artery disease (fractional flow reserve ≤0.75) to high-intensity exercise (group A, 20 patients) or moderate-intensity exercise (group B, 20 patients) for 4 weeks or to a control group (group C, 20 patients). The primary end point was the change of the coronary collateral flow index (CFI) after 4 weeks. Analysis was based on the intention to treat. After 4 weeks, baseline CFI increased significantly by 39.4% in group A (from 0.142±0.07 at beginning to 0.198±0.09 at 4 weeks) in comparison with 41.3% in group B (from 0.143±0.06 to 0.202±0.09), whereas CFI in the control group remained unchanged (0.7%, from 0.149±0.09 to 0.150±0.08). High-intensity exercise did not lead to a greater CFI than moderate-intensity training. After 4 weeks, exercise capacity, Vo2 peak and ischemic threshold increased significantly in group A and group B in comparison with group C with no difference between group A and group B. A significant improvement in CFI was demonstrated in response to moderate- and high-intensity exercise performed for 10 hours per week. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01209637. © 2016 American Heart Association, Inc.

  3. Plasma chemokine levels are associated with the presence and extent of angiographic coronary collaterals in chronic ischemic heart disease.

    Directory of Open Access Journals (Sweden)

    Ellen C Keeley

    Full Text Available In patients with chronic ischemic heart disease (IHD, the presence and extent of spontaneously visible coronary collaterals are powerful determinants of clinical outcome. There is marked heterogeneity in the recruitment of coronary collaterals amongst patients with similar degrees of coronary artery stenoses, but the biological basis of this heterogeneity is not known. Chemokines are potent mediators of vascular remodeling in diverse biological settings. Their role in coronary collateralization has not been investigated. We sought to determine whether plasma levels of angiogenic and angiostatic chemokines are associated with of the presence and extent of coronary collaterals in patients with chronic IHD.We measured plasma concentrations of angiogenic and angiostatic chemokine ligands in 156 consecutive subjects undergoing coronary angiography with at least one ≥90% coronary stenosis and determined the presence and extent of spontaneously visible coronary collaterals using the Rentrop scoring system. Eighty-eight subjects (56% had evidence of coronary collaterals. In a multivariable regression model, the concentration of the angiogenic ligands CXCL5, CXCL8 and CXCL12, hyperlipidemia, and an occluded artery were associated with the presence of collaterals; conversely, the concentration of the angiostatic ligand CXCL11, interferon-γ, hypertension and diabetes were associated with the absence of collaterals (ROC area 0.91. When analyzed according to extent of collateralization, higher Rentrop scores were significantly associated with increased concentration of the angiogenic ligand CXCL1 (p<0.0001, and decreased concentrations of angiostatic ligands CXCL9 (p<0.0001, CXCL10 (p = 0.002, and CXCL11 (p = 0.0002, and interferon-γ (p = 0.0004.Plasma chemokine concentrations are associated with the presence and extent of spontaneously visible coronary artery collaterals and may be mechanistically involved in their recruitment.

  4. The PLAU P141L single nucleotide polymorphism is associated with collateral circulation in patients with coronary artery disease.

    Science.gov (United States)

    Duran, Joan; Sánchez-Olavarría, Pilar; Mola, Marina; Götzens, Víctor; Carballo, Julio; Martín-Pelegrina, Eva; Petit, Màrius; García Del Blanco, Bruno; García-Dorado, David; de Anta, Josep M

    2014-07-01

    Urokinase-type plasminogen activator, which is encoded by the PLAU gene, plays a prominent role during collateral arterial growth. We investigated whether the PLAU P141L (C > T) polymorphism, which causes a mutation in the kringle domain of the protein, is associated with coronary collateral circulation in a cohort of 676 patients with coronary artery disease. The polymorphism was genotyped in blood samples using a TaqMan-based genotyping assay, and collateral circulation was assessed by the Rentrop method. Multivariate logistic regression models adjusted by clinically relevant variables to estimate odds ratios were used to examine associations of PLAU P141L allelic variants and genotypes with collateral circulation. Patients with poor collateral circulation (Rentrop 0-1; n = 547) showed a higher frequency of the TT genotype than those with good collateral circulation (Rentrop 2-3; n = 129; P = .020). The T allele variant was also more common in patients with poor collateral circulation (P = .006). The odds ratio of having poorly developed collaterals in patients bearing the T allele (adjusted for clinically relevant variables) was statistically significant under the dominant model (odds ratio = 1.83 [95% confidence interval, 1.16-2.90]; P = .010) and the additive model (odds ratio = 1.73 [95% confidence interval, 1.14-2.62]; P = .009). An association was found between coronary collateral circulation and the PLAU P141L polymorphism. Patients with the 141L variant are at greater risk of developing poor coronary collateral circulation. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  5. Multiple pathways regulate shoot branching

    Directory of Open Access Journals (Sweden)

    Catherine eRameau

    2015-01-01

    Full Text Available Shoot branching patterns result from the spatio-temporal regulation of axillary bud outgrowth. Numerous endogenous, developmental and environmental factors are integrated at the bud and plant levels to determine numbers of growing shoots. Multiple pathways that converge to common integrators are most probably involved. We propose several pathways involving not only the classical hormones auxin, cytokinins and strigolactones, but also other signals with a strong influence on shoot branching such as gibberellins, sugars or molecular actors of plant phase transition. We also deal with recent findings about the molecular mechanisms and the pathway involved in the response to shade as an example of an environmental signal controlling branching. We propose the TCP transcription factor TB1/BRC1 and the polar auxin transport stream in the stem as possible integrators of these pathways. We finally discuss how modeling can help to represent this highly dynamic system by articulating knowledges and hypothesis and calculating the phenotype properties they imply.

  6. CUDA-based acceleration of collateral filtering in brain MR images

    Science.gov (United States)

    Li, Cheng-Yuan; Chang, Herng-Hua

    2017-02-01

    Image denoising is one of the fundamental and essential tasks within image processing. In medical imaging, finding an effective algorithm that can remove random noise in MR images is important. This paper proposes an effective noise reduction method for brain magnetic resonance (MR) images. Our approach is based on the collateral filter which is a more powerful method than the bilateral filter in many cases. However, the computation of the collateral filter algorithm is quite time-consuming. To solve this problem, we improved the collateral filter algorithm with parallel computing using GPU. We adopted CUDA, an application programming interface for GPU by NVIDIA, to accelerate the computation. Our experimental evaluation on an Intel Xeon CPU E5-2620 v3 2.40GHz with a NVIDIA Tesla K40c GPU indicated that the proposed implementation runs dramatically faster than the traditional collateral filter. We believe that the proposed framework has established a general blueprint for achieving fast and robust filtering in a wide variety of medical image denoising applications.

  7. Collateral damage: Spread of repeat-induced point mutation from a ...

    Indian Academy of Sciences (India)

    Unknown

    of the erg-3 gene, present in single copy, to the spread of RIP from duplications of adjoining sequences. Ge- nomic segments ... [Vyas M and Kasbekar D P 2005 Collateral damage: Spread of repeat-induced point mutation from a duplicated DNA sequence into an ad- .... was essentially as described by Davis and De Serres.

  8. Collateral Damage Related to Rape and Interpersonal Violence in Higher Education

    Science.gov (United States)

    Jones, Dan L.

    2014-01-01

    Collegiate communities are often faced with difficult situations from sexual assault, rape, and other forms of interpersonal violence. These events are not only tragic or traumatic for the individuals involved but also have ripple effects and create collateral damage within the campus community. Many universities are instituting bystander training…

  9. Light scattering changes follow evoked potentials from hippocampal Schaeffer collateral stimulation

    DEFF Research Database (Denmark)

    Rector, D M; Poe, G R; Kristensen, Morten Pilgaard

    1997-01-01

    We assessed relationships of evoked electrical and light scattering changes from cat dorsal hippocampus following Schaeffer collateral stimulation. Under anesthesia, eight stimulating electrodes were placed in the left hippocampal CA field and an optic probe, coupled to a photodiode or a charge-c...

  10. Clinical study of the hypothesis of “endogenous collateral wind” on ...

    African Journals Online (AJOL)

    Background: Acute Coronary Syndrome (ACS), is a serious threat to people's health, and life, and in recent years, the incidence has increased yearly. This study was to propose the hypothesis of “endogenous collateral wind” based on the patho-mechanism of thrombogenesis complicated by ruptured plaque on ACS, and ...

  11. Natural killer cells and CD4+ T-cells modulate collateral artery development

    NARCIS (Netherlands)

    Weel, V. van; Toes, R.E.M.; Seghers, L.; Deckers, M.M.L.; Vries, M.R. de; Eilers, P.H.; Sipkens, J.; Schepers, A.; Eefting, D.; Hinsbergh, V.W.M. van; Bockel, J.H. van; Quax, P.H.A.

    2007-01-01

    OBJECTIVE - The immune system is thought to play a crucial role in regulating collateral circulation (arteriogenesis), a vital compensatory mechanism in patients with arterial obstructive disease. Here, we studied the role of lymphocytes in a murine model of hindlimb ischemia. METHODS AND RESULTS -

  12. Collateral sensitivity to cisplatin in KB-8-5-11 drug-resistant cancer cells.

    LENUS (Irish Health Repository)

    Doherty, Ben

    2014-01-01

    KB-8-5-11 cells are a drug-resistant cervical cell model that overexpresses ABCB1 (P-glycoprotein). KB-8-5-11 has become sensitive to non-ABCB1 substrate cisplatin. Understanding the mechanism of collateral sensitivity to cisplatin may lead to biomarker discovery for platinum sensitivity in patients with cancer.

  13. 12 CFR 221.7 - Supplement: Maximum loan value of margin stock and other collateral.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Supplement: Maximum loan value of margin stock... FOR THE PURPOSE OF PURCHASING OR CARRYING MARGIN STOCK (REGULATION U) § 221.7 Supplement: Maximum loan value of margin stock and other collateral. (a) Maximum loan value of margin stock. The maximum loan...

  14. Functional Enabling and Physiotherapeutic Treatment of Sportsmen after Injuring Collateral Ligaments of Knee Joint

    Directory of Open Access Journals (Sweden)

    Vukosav Joksimović

    2007-05-01

    Full Text Available Ligamental compound of knee joint represents in mechanical terms, the most complex joint ligamental concatenation. According to seriousness and occurrence of damage, injuries of collateral ligaments can be divided into three degrees. Aim of paper was monitoring and evaluation of results of physiotherapeutic treatment in sportsmen with collateral ligaments injury (CLs of knee joint. The paper comprises 54 sportsmen over the period of four years aged from 16 to 32. Results of paper: 40% (74% injured collateral ligaments while playing game, during football game and 14 (26% while training, 43 (79,6% had collateral ligament injuries of right leg and 11 (20,4% of left leg. In 20( 37% it was a fi rst (1 st degree injury, in 26(48,1 % - second (2nd degree and in 8 (14% third (3rd degree injury. Treatment was conducted over three phases: fi rst - the phase of immobilization ( 2- 6 weeks with K.T.H. of free extremities. Second - the phase of removing immobilization, cryo T.h in combination with available electro- procedures. Third phase was enabling for high- risk physical activities. Results of paper have been classifi ed into four groups: excellent result was observed in 41 ( 76% sportsmen, good in 6 (11 % and satisfactory in 2( 3,8%. Conclusion: Illustrated results obtained on the basis of functional research and after completed rehabilitation allow us to recommend this rehabilitation program as on of the most effi cient ways in treatment of such serious injuries.

  15. Clinical significance of mesenteric arterial collateral circulation in patients with celiac artery compression syndrome.

    NARCIS (Netherlands)

    van Petersen, Andre S.; Kolkman, Jeroen; Gerrits, Dick G; van der Palen, Job; Zeebregts, Clark J.; Geelkerken, Robert H

    OBJECTIVE: Although extensive collateral arterial circulation will prevent ischemia in most patients with stenosis of a single mesenteric artery, mesenteric ischemia may occur in these patients, for example, in patients with celiac artery compression syndrome (CACS). Variation in the extent of

  16. Clinical significance of mesenteric arterial collateral circulation in patients with celiac artery compression syndrome

    NARCIS (Netherlands)

    van Petersen, Andre S.; Kolkman, Jeroen J.; Gerrits, Dick G.; van der Palen, Job; Zeebregts, Clark J.; Geelkerken, Robert H.

    Objective: Although extensive collateral arterial circulation will prevent ischemia in most patients with stenosis of a single mesenteric artery, mesenteric ischemia may occur in these patients, for example, in patients with celiac artery compression syndrome (CACS). Variation in the extent of

  17. PRINSIP 6C (CHARACTER, CAPACITY, CAPITAL, CONDITION OF ECONOMY, COLLATERAL DAN CONSTRAINT DALAM WIRAUSAHA MAHASISWA

    Directory of Open Access Journals (Sweden)

    Henny Sri Astuty

    2015-04-01

    Full Text Available Abstrak: Prinsip 6C (Character, Capacity, Capital, Condition of Economy, Collateral dan Constraint dalam Wirausaha Mahasiswa. Kegiatan wirausaha yang sekarang banyak dilakukan oleh mahasiswa memiliki sisi positif maupun negatif, dari yang berhasil kuliah dan wirausahanya hingga yang gagal semuanya. Untuk ini diperlukan pemahaman tentang prinsip enam C (character, capacity, capital, condition of economy, collateral and constraint yang akan membantu mahasiswa sebagai bekal dalam melakukan kegiatan usahanya. Banyak faktor yang diperoleh dalam prinsip ini yaitu aspek manajemen, pemasaran, produksi, dan keuangan. Kata Kunci: prinsip 6c, wirausaha, mahasiswa Abstract: 6C Principles (Character, Capacity, Capital, Condition of Economy, Collateral and Constraint in Entrepreneurial Students. Entrepreneurial activity that is widely performed by students has two different stories. Some of them are successful on the other hand, the rest of them are fail. Accordingly, it is required an understanding of the 6C principles of the six C (character, capacity, capital, condition of economy, collateral and constraints which will help the students as a preparation in conducting their business activities. Many factors obtained in this principle namely: management, marketing, production, and financial aspects. Keywords: 6C principles, entrepreneurs, students

  18. Dynamic knee alignment and collateral knee laxity and its variations in normal humans

    Directory of Open Access Journals (Sweden)

    Kamal eDeep

    2015-11-01

    Full Text Available Alignment of normal, arthritic and replaced human knees is a much debated subject as is the collateral ligamentous laxity. Traditional quantitative values have been challenged. Methods used to measure these are also not without flaws. Authors review the recent literature and a novel method of measurement of these values has been included. This method includes use of computer navigation technique in clinic setting for assessment of the normal or affected knee before the surgery. Computer navigation has been known for achievement of alignment accuracy during knee surgery. Now its use in clinic setting has added to the inventory of measurement methods. Authors dispel the common myth of straight mechanical axis in normal knees and also look at quantification of amount of collateral knee laxity. Based on the scientific studies it has been shown that the mean alignment is in varus in normal knees. It changes from lying non weight bearing position to standing weight bearing position in both coronal and the sagittal planes. It also varies with gender and race. The collateral laxity is also different for males and females. Further studies are needed to define the ideal alignment and collateral laxity which the surgeon should aim for individual knees.

  19. Assessment of collateral artery function and growth in a pig model of stepwise coronary occlusion

    NARCIS (Netherlands)

    de Groot, Daphne; Grundmann, Sebastian; Timmers, Leo; Pasterkamp, Gerard; Hoefer, Imo E.

    de Groot D, Grundmann S, Timmers L, Pasterkamp G, Hoefer IE. Assessment of collateral artery function and growth in a pig model of stepwise coronary occlusion. Am J Physiol Heart Circ Physiol 300: H408-H414, 2011. First published October 15, 2010; doi: 10.1152/ajpheart.00070.2010.-Therapeutic

  20. Branch prediction in the pentium family

    DEFF Research Database (Denmark)

    Fog, Agner

    1998-01-01

    How the branch prediction mechanism in the Pentium has been uncovered with all its quirks, and the incredibly more effective branch prediction in the later versions.......How the branch prediction mechanism in the Pentium has been uncovered with all its quirks, and the incredibly more effective branch prediction in the later versions....

  1. Evaluation of portosystemic collaterals by MDCT-MPR imaging for management of hemorrhagic esophageal varices

    Energy Technology Data Exchange (ETDEWEB)

    Kodama, Hideaki [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Aikata, Hiroshi, E-mail: aikata@hiroshima-u.ac.jp [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Takaki, Shintaro; Azakami, Takahiro; Katamura, Yoshio; Kawaoka, Tomokazu; Hiramatsu, Akira; Waki, Koji; Imamura, Michio; Kawakami, Yoshiiku; Takahashi, Shoichi [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Toyota, Naoyuki; Ito, Katsuhide [Department of Radiology, Division of Medical Intelligence and Informatics, Programs for Applied Biomedicine, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan); Chayama, Kazuaki [Department of Medicine and Molecular Science, Division of Frontier Medical Science, Graduate School of Biomedical Science, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551 (Japan)

    2010-11-15

    Objective: To study the correlation between changes in portosystemic collaterals, evaluated by multidetector-row computed tomography imaging using multiplanar reconstruction (MDCT-MPR), and prognosis in patients with hemorrhagic esophageal varices (EV) after endoscopic treatment. Methods: Forty-nine patients with primary hemostasis for variceal bleeding received radical endoscopic treatment: endoscopic injection sclerotherapy (EIS) or endoscopic variceal ligation (EVL). Patients were classified according to the rate of reduction in feeding vessel diameter on MDCT-MPR images, into the narrowing (n = 24) and no-change (n = 25) groups. We evaluated changes in portosystemic collaterals by MDCT-MPR before and after treatment, and determined rebleeding and survival rates. Results: The left gastric and paraesophageal (PEV) veins were recognized as portosystemic collaterals in 100 and 80%, respectively, of patients with EV on MDCT-MPR images. The rebleeding rates at 1, 2, 3, and 5 years after endoscopic treatment were 10, 15, 23, and 23%, respectively, for the narrowing group, and 17, 24, 35, and 67%, respectively, for the no-change group (P = 0.068). Among no-change group, the rebleeding rate in patients with large PEV was significantly lower than that with small PEV (P = 0.027). The rebleeding rate in patients with small PEV of the no-change group was significantly higher than that in the narrowing group (P = 0.018). There was no significant difference in rebleeding rates between the no-change group with a large PEV and narrowing group (P = 0.435). Conclusion: Changes in portosystemic collaterals evaluated by MDCT-MPR imaging correlate with rebleeding rate. Evaluation of portosystemic collaterals in this manner would provide useful information for the management of hemorrhagic EV.

  2. The Role of VEGF and KDR Polymorphisms in Moyamoya Disease and Collateral Revascularization

    Science.gov (United States)

    Park, Young Seok; Jeon, Young Joo; Kim, Hyun Seok; Chae, Kyu Young; Oh, Seung-Hun; Han, In Bo; Kim, Hyun Sook; Kim, Won-Chan; Kim, Ok-Joon; Kim, Tae Gon; Choi, Joong-Uhn; Kim, Dong-Seok; Kim, Nam Keun

    2012-01-01

    We conducted a case-control study to investigate whether vascular endothelial growth factor (VEGF −2578, −1154, −634, and 936) and kinase insert domain containing receptor (KDR −604, 1192, and 1719) polymorphisms are associated with moyamoya disease. Korean patients with moyamoya disease (n = 107, mean age, 20.9±15.9 years; 66.4% female) and 243 healthy control subjects (mean age, 23.0±16.1 years; 56.8% female) were included. The subjects were divided into pediatric and adult groups. Among the 64 surgical patients, we evaluated collateral vessel formation after 2 years and divided patients into good (collateral grade A) or poor (collateral grade B and C) groups. The frequencies and distributions of four VEGF (−2578, −1154, −634, and 936) and KDR (−604, 1192, and 1719) polymorphisms were assessed from patients with moyamoya disease and compared to the control group. No differences were observed in VEGF −2578, −1154, −634, and 936 or KDR −604, 1192, and 1719 polymorphisms between the control group and moyamoya disease group. However, we found the −634CC genotype occurred less frequently in the pediatric moyamoya group (p = 0.040) whereas the KDR −604C/1192A/1719T haplotype increased the risk of pediatric moyamoya (p = 0.024). Patients with the CC genotype of VEGF −634 had better collateral vessel formation after surgery. Our results suggest that the VEGF −634G allele is associated with pediatric moyamoya disease and poor collateral vessel formation. PMID:23077562

  3. Dopamine D2 Receptors Regulate Collateral Inhibition between Striatal Medium Spiny Neurons

    Science.gov (United States)

    van der Goes, Marie-Sophie; Partridge, John G.; Vicini, Stefano

    2013-01-01

    The principle neurons of the striatum are GABAergic medium spiny neurons (MSNs), whose collateral synapses onto neighboring neurons play critical roles in striatal function. MSNs can be divided by dopamine receptor expression into D1-class and D2-class MSNs, and alterations in D2 MSNs are associated with various pathological states. Despite overwhelming evidence for D2 receptors (D2Rs) in maintaining proper striatal function, it remains unclear how MSN collaterals are specifically altered by D2R activation. Here, we report that chronic D2R stimulation regulates MSN collaterals in vitro by presynaptic and postsynaptic mechanisms. We used corticostriatal cultures from mice in which MSN subtypes were distinguished by fluorophore expression. Quinpirole, an agonist for D2/3 receptors, was used to chronically activate D2Rs. Quinpirole increased the rate and strength of collateral formation onto D2R-containing MSNs as measured by dual whole-cell patch-clamp recordings. Additionally, these neurons were more sensitive to low concentrations of GABA and exhibited an increase in gephyrin puncta density, suggesting increased postsynaptic GABAA receptors. Last, quinpirole treatment increased presynaptic GABA release sites, as shown by increased frequency of sIPSCs and mIPSCs, correlating with increased VGAT (vesicular GABA transporter) puncta. Combined with the observation that there were no detectable differences in sensitivity to specific GABAA receptor modulators, we provide evidence that D2R activation powerfully transforms MSN collaterals via coordinated presynaptic and postsynaptic alterations. As the D2 class of MSNs is highly implicated in Parkinson's disease and other neurological disorders, our findings may contribute to understanding and treating the changes that occur in these pathological states. PMID:23986243

  4. Rapid Liver Hypertrophy After Portal Vein Occlusion Correlates with the Degree of Collateralization Between Lobes-a Study in Pigs.

    Science.gov (United States)

    Deal, Rebecca; Frederiks, Charles; Williams, Lauren; Olthof, Pim B; Dirscherl, Konstantin; Keutgen, Xavier; Chan, Edie; Deziel, Daniel; Hertl, Martin; Schadde, Erik

    2017-08-01

    Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) induces more rapid liver growth than portal vein ligation (PVL). Transection of parenchyma in ALPPS may prevent the formation of collaterals between lobes. The aim of this study was to determine if abrogating the formation of collaterals through parenchymal transection impacted growth rate. Twelve Yorkshire Landrace pigs were randomized to undergo ALPPS, PVL, or "partial ALPPS" by varying degrees of parenchymal transection. Hepatic volume was measured after 7 days. Portal blood flow and pressure were measured. Portal vein collaterals were examined from epoxy casts. PVL, ALPPS, and partial ALPPS led to volume increases of the RLL by 15.5% (range 3-22), 64% (range 45-76), and 32% (range 18-77), respectively, with significant differences between PVL and ALPPS/partial ALPPS (p portal vein collaterals were found. The number of collaterals correlated inversely with the growth rate (p = 0.039). Portal vein pressure was elevated in all models after ligation suggesting hyperflow to the portal vein-supplied lobe (p < 0.05). These data suggest that liver hypertrophy following PVL is inversely proportional to the development of collaterals. Hypertrophy after ALPPS is likely more rapid due to reduction of collaterals through transection.

  5. National Zoological Park Branch Library.

    Science.gov (United States)

    Kenyon, Kay A.

    1988-01-01

    Describes the functions of the National Zoological Park Branch of the Smithsonian Institution Libraries, which is dedicated to supporting the special information needs of the zoo. Topics covered include the library's history, collection, programs, services, future plans, and relations with other zoo libraries. (two references) (Author/CLB)

  6. Branching diffusion with particle interactions

    OpenAIRE

    Engländer, János; Zhang, Liang

    2016-01-01

    A $d$-dimensional branching diffusion, $Z$, is investigated, where the linear attraction or repulsion between particles is competing with an Ornstein-Uhlenbeck drift, with parameter $b$ (we take $b>0$ for inward O-U and $b0$) or repulsion ($\\gamma 0$, while escapes to infinity exponentially fast (rate $|b|$) when $b

  7. Risk Factor Assessment Branch (RFAB)

    Science.gov (United States)

    The Risk Factor Assessment Branch (RFAB) focuses on the development, evaluation, and dissemination of high-quality risk factor metrics, methods, tools, technologies, and resources for use across the cancer research continuum, and the assessment of cancer-related risk factors in the population.

  8. Admission hyperglycemia causes infarct volume expansion in patients with ICA or MCA occlusion: association of collateral grade on conventional angiography.

    Science.gov (United States)

    Shimoyama, T; Shibazaki, K; Kimura, K; Uemura, J; Shiromoto, T; Watanabe, M; Inoue, T; Iguchi, Y; Mochio, S

    2013-01-01

    Hyperglycemia (HG) is associated with infarct volume expansion in acute ischaemic stroke patients. However, collateral circulation can sustain the ischaemic penumbra and limit the growth of infarct volume. The aim of this study was to determine whether the association between HG and infarct volume expansion is dependent on collateral circulation. We performed a retrospective analysis of 93 acute ischaemic stroke patients with internal carotid artery or middle cerebral artery occlusion within 24 h of onset were retrospectively studied. HG was diagnosed in patients with an admitting blood glucose value ≥140 mg/dl. Angiographic collateral grade 0-1 was designated as poor collateral circulation and grade 2-4 as good collateral circulation. Infarct volume was measured at admission and at again within 7 days using diffusion-weighted magnetic resonance images. Among 34 patients with poor collateral grade, the change in infarct volume was significantly greater in the HG group than in the non-HG group (106.0 ml vs. 22.7 ml, P = 0.002). Among the 59 patients with good collateral circulation, the change in infarct volume was greater in the HG group than in the non-HG group (53.3 ml vs. 10.9 ml, P = 0.047). Multiple regression analysis indicated that admission HG (P = 0.004), baseline National Institutes of Health Stroke Scale score (P = 0.018), and poor collateral circulation (P = 0.040) were independently associated with infarct volume expansion. Infarct volume expansion was greater in individuals with HG on admission regardless of collateral circulation status. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  9. Synaptic excitation by climbing fibre collaterals in the cerebellar nuclei of juvenile and adult mice.

    Science.gov (United States)

    Najac, Marion; Raman, Indira M

    2017-11-01

    The inferior olive sends instructive motor signals to the cerebellum via the climbing fibre projection, which sends collaterals directly to large premotor neurons of the mouse cerebellar nuclei (CbN cells). Optogenetic activation of inferior olivary axons in vitro evokes EPSCs in CbN cells of several hundred pA to more than 1 nA. The inputs are three-fold larger at younger ages, 12 to 14 days old, than at 2 months old, suggesting a strong functional role for this pathway earlier in development. The EPSCs are multipeaked, owing to burst firing in several olivary afferents that fire asynchronously. The convergence of climbing fibre collaterals onto CbN cells decreases from ∼40 to ∼8, which is consistent with the formation of closed-loop circuits in which each CbN neuron receives input from 4-7 collaterals from inferior olivary neurons as well as from all 30-50 Purkinje cells that are innervated by those olivary neurons. The inferior olive conveys instructive signals to the cerebellum that drive sensorimotor learning. Inferior olivary neurons transmit their signals via climbing fibres, which powerfully excite Purkinje cells, evoking complex spikes and depressing parallel fibre synapses. Additionally, however, these climbing fibres send collaterals to the cerebellar nuclei (CbN). In vivo and in vitro data suggest that climbing fibre collateral excitation is weak in adult mice, raising the question of whether the primary role of this pathway may be developmental. We therefore examined climbing fibre collateral input to large premotor CbN cells over development by virally expressing channelrhodopsin in the inferior olive. In acute cerebellar slices from postnatal day (P)12-14 mice, light-evoked EPSCs were large (> 1 nA at -70 mV). The amplitude of these EPSCs decreased over development, reaching a plateau of ∼350 pA at P20-60. Trains of EPSCs (5 Hz) depressed strongly throughout development, whereas convergence estimates indicated that the total number of

  10. Branching processes in disease epidemics

    Science.gov (United States)

    Singh, Sarabjeet

    Branching processes have served as a model for chemical reactions, biological growth processes and contagion (of disease, information or fads). Through this connection, these seemingly different physical processes share some common universalities that can be elucidated by analyzing the underlying branching process. In this thesis, we focus on branching processes as a model for infectious diseases spreading between individuals belonging to different populations. The distinction between populations can arise from species separation (as in the case of diseases which jump across species) or spatial separation (as in the case of disease spreading between farms, cities, urban centers, etc). A prominent example of the former is zoonoses -- infectious diseases that spill from animals to humans -- whose specific examples include Nipah virus, monkeypox, HIV and avian influenza. A prominent example of the latter is infectious diseases of animals such as foot and mouth disease and bovine tuberculosis that spread between farms or cattle herds. Another example of the latter is infectious diseases of humans such as H1N1 that spread from one city to another through migration of infectious hosts. This thesis consists of three main chapters, an introduction and an appendix. The introduction gives a brief history of mathematics in modeling the spread of infectious diseases along with a detailed description of the most commonly used disease model -- the Susceptible-Infectious-Recovered (SIR) model. The introduction also describes how the stochastic formulation of the model reduces to a branching process in the limit of large population which is analyzed in detail. The second chapter describes a two species model of zoonoses with coupled SIR processes and proceeds into the calculation of statistics pertinent to cross species infection using multitype branching processes. The third chapter describes an SIR process driven by a Poisson process of infection spillovers. This is posed as a

  11. Management of Medial Collateral Ligament Injury During Primary Total Knee Arthroplasty: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Paul Della Torre, MD

    2014-07-01

    Full Text Available Medial collateral ligament injury during primary total knee arthroplasty is a recognised complication potentially resulting in valgus instability, suboptimal patient outcomes and a higher rate of revision or reoperation. Options for management include primary repair with or without augmentation, reconstruction or immediate conversion to prosthesis with greater constraint, in conjunction with various postoperative rehabilitation protocols. Inconsistent recommendations throughout the orthopaedic literature have made the approach to managing this complication problematic. The objective of this study was to review the available literature to date comparing intraoperative and postoperative management options for primary total knee arthroplasty complicated by recognised injury to the medial collateral ligament. This systematic literature review was prospectively registered with PROSPERO (#CRD42014008866 and performed in accordance with PRISMA guidelines including a PRISMA flow diagram. Five articles satisfied the inclusion criteria. Each was a retrospective, observational cohort or case series with small numbers reported, inconsistent methodology and incompletely reported outcomes. Four of the five studies managing medial collateral ligament injury during total knee arthroplasty (47/84 patients with direct repair with or without autograft augmentation reported good outcomes with no revision or reoperation required for symptomatic instability over a follow-up period of 16 months to almost 8 years. The fifth study with a follow-up to 10 years and a high rate of conversion to unlinked semi constrained total knee arthroplasty implant (30/37 patients reported a greater incidence of revision due to instability, in patients in whom the medial collateral ligament injury was directly repaired without added constraint. Overall balance of evidence is in favour of satisfactory outcomes without symptomatic instability following direct repair with or without

  12. Branched endografts for thoracoabdominal aneurysms.

    Science.gov (United States)

    Greenberg, Roy; Eagleton, Matthew; Mastracci, Tara

    2010-12-01

    Endovascular management of thoracoabdominal aneurysms has been studied since 2001, with marked advances allowing for the treatment of complex anatomic situations including chronic aortic dissections, tortuous anatomy, and extensive aneurysms that involve the visceral segment, aortic arch, and iliacs as well. However, the technology is not widely disseminated, and a thorough understanding of the engineering principles, imaging techniques, and devices available is required. Reinforced fenestrated branches coupled with balloon expandable stent grafts, and side-arm branch designs mated with self-expanding stent grafts have been used. Pure fenestrated designs were used for juxtarenal aneurysms, whereas thoracoabdominal aneurysms were treated with reinforced fenestrated branches or hybrid devices including side-arm branches and reinforced fenestrated branches. Intraoperative fusion techniques have been used since 2009, whereby preoperative computed tomographic data are fused with intraoperative fluoroscopy. Long-term survival in accordance with extent of disease was assessed with life table analysis techniques, and differences were analyzed using the log rank test. Intermediate-term data pertaining to patency related to both types of branches and paraplegia have been evaluated and previously published. A total of 406 patients with thoracoabdominal aneurysms and 227 patients with juxtarenal aneurysms have been enrolled in a prospective study. Perioperative and 2-year survival were most closely related to extent of initial disease and were estimated to be 1.8% and 82% for juxtarenal aneurysms, 2.3% and 82% for type IV, and 5.2% and 74% for type II and III thoracoabdominal aneurysms at 24 months, respectively. When patients undergoing endovascular repair (ER group) were matched with those having contemporary surgical repair (SR group) for anatomic disease extent, mortality was similar at 30 days (5.7% ER vs 8.3% SR; P = .2) and at 12 months (15.6% ER vs 15.9% SR; P = .9

  13. Solid State Photovoltaic Research Branch

    Energy Technology Data Exchange (ETDEWEB)

    1990-09-01

    This report summarizes the progress of the Solid State Photovoltaic Research Branch of the Solar Energy Research Institute (SERI) from October 1, 1988, through September 30,l 1989. Six technical sections of the report cover these main areas of SERIs in-house research: Semiconductor Crystal Growth, Amorphous Silicon Research, Polycrystalline Thin Films, III-V High-Efficiency Photovoltaic Cells, Solid-State Theory, and Laser Raman and Luminescence Spectroscopy. Sections have been indexed separately for inclusion on the data base.

  14. Anterior Rectal Resection in a Patient with Aortoiliac Occlusive Disease and Coexisting Collateral Pathways: Management and Pitfalls

    Directory of Open Access Journals (Sweden)

    Floryn Cherbanyk

    2016-01-01

    Full Text Available Chronic aortoiliac occlusive disease most often affects the common iliac arteries and distal aorta but can progress all the way to the renal arteries, occluding the inferior mesenteric artery. A compensatory collateral network typically develops to preserve lower body perfusion. Inadvertent compression or ligation of such collaterals during surgery can have catastrophic consequences. In this article, we present the case of a 63-year-old patient with aortoiliac occlusive disease, requiring surgery for an adenocarcinoma of the rectosigmoid junction. A CT angiography was performed in order to map out the collateral pathways that had developed and Doppler ultrasound was used to mark their positions. The surgical procedure was adapted to his specific anatomy. A successful anterior resection was performed, and the patient made an uneventful recovery. In cases of aortoiliac obliteration, the existence of collaterals must be kept in mind and investigated with a multidisciplinary approach before any surgery is considered.

  15. Branching processes and neutral evolution

    CERN Document Server

    Taïb, Ziad

    1992-01-01

    The Galton-Watson branching process has its roots in the problem of extinction of family names which was given a precise formulation by F. Galton as problem 4001 in the Educational Times (17, 1873). In 1875, an attempt to solve this problem was made by H. W. Watson but as it turned out, his conclusion was incorrect. Half a century later, R. A. Fisher made use of the Galton-Watson process to determine the extinction probability of the progeny of a mutant gene. However, it was J. B. S. Haldane who finally gave the first sketch of the correct conclusion. J. B. S. Haldane also predicted that mathematical genetics might some day develop into a "respectable branch of applied mathematics" (quoted in M. Kimura & T. Ohta, Theoretical Aspects of Population Genetics. Princeton, 1971). Since the time of Fisher and Haldane, the two fields of branching processes and mathematical genetics have attained a high degree of sophistication but in different directions. This monograph is a first attempt to apply the current sta...

  16. Electrostatically anchored branched brush layers.

    Science.gov (United States)

    Liu, Xiaoyan; Dedinaite, Andra; Rutland, Mark; Thormann, Esben; Visnevskij, Ceslav; Makuska, Ricardas; Claesson, Per M

    2012-11-06

    A novel type of block copolymer has been synthesized. It consists of a linear cationic block and an uncharged bottle-brush block. The nonionic bottle-brush block contains 45 units long poly(ethylene oxide) side chains. This polymer was synthesized with the intention of creating branched brush layers firmly physisorbed to negatively charged surfaces via the cationic block, mimicking the architecture (but not the chemistry) of bottle-brush molecules suggested to be present on the cartilage surface, and contributing to the efficient lubrication of synovial joints. The adsorption properties of the diblock copolymer as well as of the two blocks separately were studied on silica surfaces using quartz crystal microbalance with dissipation monitoring (QCM-D) and optical reflectometry. The adsorption kinetics data highlight that the diblock copolymers initially adsorb preferentially parallel to the surface with both the cationic block and the uncharged bottle-brush block in contact with the surface. However, as the adsorption proceeds, a structural change occurs within the layer, and the PEO bottle-brush block extends toward solution, forming a surface-anchored branched brush layer. As the adsorption plateau is reached, the diblock copolymer layer is 46-48 nm thick, and the water content in the layer is above 90 wt %. The combination of strong electrostatic anchoring and highly hydrated branched brush structures provide strong steric repulsion, low friction forces, and high load bearing capacity. The strong electrostatic anchoring also provides high stability of preadsorbed layers under different ionic strength conditions.

  17. Intensity-based 3D/2D registration for percutaneous intervention of major aorto-pulmonary collateral arteries

    Science.gov (United States)

    Couet, Julien; Rivest-Henault, David; Miro, Joaquim; Lapierre, Chantal; Duong, Luc; Cheriet, Mohamed

    2012-02-01

    Percutaneous cardiac interventions rely mainly on the experience of the cardiologist to safely navigate inside soft tissues vessels under X-ray angiography guidance. Additional navigation guidance tool might contribute to improve reliability and safety of percutaneous procedures. This study focus on major aorta-pulmonary collateral arteries (MAPCAs) which are pediatric structures. We present a fully automatic intensity-based 3D/2D registration method that accurately maps pre-operatively acquired 3D tomographic vascular data of a newborn patient over intra-operatively acquired angiograms. The tomographic dataset 3D pose is evaluated by comparing the angiograms with simulated X-ray projections, computed from the pre-operative dataset with a proposed splatting-based projection technique. The rigid 3D pose is updated via a transformation matrix usually defined in respect of the C-Arm acquisition system reference frame, but it can also be defined in respect of the projection plane local reference frame. The optimization of the transformation is driven by two algorithms. First the hill climbing local search and secondly a proposed variant, the dense hill climbing. The latter makes the search space denser by considering the combinations of the registration parameters instead of neighboring solutions only. Although this study focused on the registration of pediatric structures, the same procedure could be applied for any cardiovascular structures involving CT-scan and X-ray angiography. Our preliminary results are promising that an accurate (3D TRE 0.265 +/- 0.647mm) and robust (99% success rate) bi-planes registration of the aorta and MAPCAs from a initial displacement up to 20mm and 20° can be obtained within a reasonable amount of time (13.7 seconds).

  18. Collateral management a jeho zachycení a podpora v informačních systémech peněžního ústavu

    OpenAIRE

    Dudek, Tomáš

    2011-01-01

    The main objective of this thesis is to capture and support for Collateral Management in the environment of financial institution. The thesis deals with general and practical description Collateral Management, realizaction collateral management, trouble banking institucion implemented through the parent banking institution, and aplicaton design Collateral Management. The main benefits of this thesis I find the introduction of Collateral Management and submitting information on IT application ...

  19. Portal hypertension: Imaging of portosystemic collateral pathways and associated image-guided therapy.

    Science.gov (United States)

    Bandali, Murad Feroz; Mirakhur, Anirudh; Lee, Edward Wolfgang; Ferris, Mollie Clarke; Sadler, David James; Gray, Robin Ritchie; Wong, Jason Kam

    2017-03-14

    Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.

  20. Posttraumatic incarceration of medial collateral ligament into knee joint with anterior cruciate ligament injury.

    Science.gov (United States)

    Kini, Sunil-Gurpur; du Pre, Karel; Bruce, Warwick

    2015-01-01

    Medial collateral ligament of the knee is an important coronal stabiliser and often injured in isolation or as combination of injuries. The article reports a case of incarcerated medial collateral ligament (MCL) injury in combination with anterior cruciate ligament (ACL) injury in 20 year old male who presented to us 4 weeks after injury. Clinical examination and MRI was correlated to complete ACL tear with torn distal MCL and incarceration into the joint. Patient was taken up for ACL hamstring graft reconstruction with mini-arthrotomy and repair of the torn MCL. Patient was followed up with dedicated rehabilitation protocol with good functional results. At one year follow-up, patient exhibited full range of motion with negative Lachman, Pivot shift and valgus stress tests. This article highlights the rare pattern of MCL tear and also reviews the literature on this pattern of injury.

  1. The association of plasma miR-155 and VCAM-1 levels with coronary collateral circulation.

    Science.gov (United States)

    Wang, Junnan; Yan, Youyou; Song, Dandan; Liu, Lulu; Liu, Bin

    2017-02-01

    Inflammation plays an important role in development of coronary collateral circulation (CCC). The aim of this study is to determine whether the inflammation-related miRNA miR-155 and the inflammation marker VCAM-1 could be a biomarker for CCC. We measured levels of plasma VCAM-1 and miR-155 in patients with CCC according to Rentrop grade by ELISA or real-time polymerase chain reaction, respectively (n = 112). Plasma miR-155 was negatively correlated with VCAM-1 in the poor CCC group and with Rentrop grade in all patients with CCC. In addition, plasma VCAM-1 was significantly decreased in CAD patients with CCC. Plasma miR-155 might be a potent independent predictor of collateral formation.

  2. Sphingosine-1-Phosphate Receptor-1 Selective Agonist Enhances Collateral Growth and Protects against Subsequent Stroke.

    Directory of Open Access Journals (Sweden)

    Masahiko Ichijo

    Full Text Available Collateral growth after acute occlusion of an intracranial artery is triggered by increasing shear stress in preexisting collateral pathways. Recently, sphingosine-1-phosphate receptor-1 (S1PR1 on endothelial cells was reported to be essential in sensing fluid shear stress. Here, we evaluated the expression of S1PR1 in the hypoperfused mouse brain and investigated the effect of a selective S1PR1 agonist on leptomeningeal collateral growth and subsequent ischemic damage after focal ischemia.In C57Bl/6 mice (n = 133 subjected to unilateral common carotid occlusion (CCAO and sham surgery. The first series examined the time course of collateral growth, cell proliferation, and S1PR1 expression in the leptomeningeal arteries after CCAO. The second series examined the relationship between pharmacological regulation of S1PR1 and collateral growth of leptomeningeal anastomoses. Animals were randomly assigned to one of the following groups: LtCCAO and daily intraperitoneal (i.p. injection for 7 days of an S1PR1 selective agonist (SEW2871, 5 mg/kg/day; sham surgery and daily i.p. injection for 7 days of SEW2871 after surgery; LtCCAO and daily i.p. injection for 7 days of SEW2871 and an S1PR1 inverse agonist (VPC23019, 0.5 mg/kg; LtCCAO and daily i.p. injection of DMSO for 7 days after surgery; and sham surgery and daily i.p. injection of DMSO for 7 days. Leptomeningeal anastomoses were visualized 14 days after LtCCAO by latex perfusion method, and a set of animals underwent subsequent permanent middle cerebral artery occlusion (pMCAO 7 days after the treatment termination. Neurological functions 1 hour, 1, 4, and 7 days and infarction volume 7 days after pMCAO were evaluated.In parallel with the increase in S1PR1 mRNA levels, S1PR1 expression colocalized with endothelial cell markers in the leptomeningeal arteries, increased markedly on the side of the CCAO, and peaked 7 days after CCAO. Mitotic cell numbers in the leptomeningeal arteries increased after

  3. IMATERALISASI JAMINAN BENDA DALAM BENTUK CASH COLLATERAL SEBAGAI JAMINAN PROYEK INFRA STRUKTUR MELALUI MEKANISME SWIFT

    Directory of Open Access Journals (Sweden)

    Tarsisius Murwaji

    2013-10-01

    Full Text Available The construction of infrastructure projects require large expenses. The cost for the project loan is usually derived from international banks. Legal issues, among others: we do not guarantee the legal system conducive to use in large financing; corporate body and banking institutions we considered to be of international standard, and our le-gal system is regarded as the country risk. The other hand many people of Indonesia who have collateral material, usually pure gold (precious metals that have been diimaterialization and included in the accounts of foreign banks. Such guarantees may be used as the basis of the issuance of bank guarantees and through the mechanism of Society Worldwide Interbank Financial Telecommunications (SWIFT can be used as loan collateral banks in Indonesia. Key words: bank guaranty, SWIFT, security law, international banking system

  4. Endovascular therapy of ruptured distal anterior choroidal artery aneurysm associated with moyamoya pattern collateralization secondary to middle cerebral artery occlusion

    Directory of Open Access Journals (Sweden)

    Hidenori Oishi

    2013-01-01

    Full Text Available We report a case of a ruptured distal anterior choroidal artery (AChoA aneurysm associated with moyamoya pattern collateralization secondary to the middle cerebral artery occlusion. Patient was successfully treated with the coil embolization of the distal AChoA. This case supports the feasibility and efficacy of the endovascular therapy for the distal AChoA aneurysms in patients with MCA occlusion with moyamoya pattern collateralization.

  5. Impact on left ventricular function of the exercise response of coronary collateral flow in coronary heart disease

    Energy Technology Data Exchange (ETDEWEB)

    Tweddel, A.C.; Martin, W.; McGhie, I.; Hutton, I.

    1985-05-01

    This study was designed to determine the effect of physiological stress on regional myocardial flow, and the effect of collateral circulation on left ventricular function. Myocardial flow was measured by the Xenon clearance technique in 25 patients with stable angina, studied at routine coronary angiography, with normal distribution of flow obtained from 10 patients. Regional wall motion was quantified from the contrast ventriculogram by percentage shortening of radial chords. Twenty collateral distributions were identified angiographically and a further 14 with intracoronary Xenon. Scans were performed at rest and immediately post maximal supine exercise. Collateral flows in response to dynamic exercise were differentiated as follows: in 8 regions identified arteriographically, mean flow fell from 46.3 +- 5.1 to 40 +- 5.1 ml/100g/min (p<0.02) and from 28.9 +- 3.6 to 21.1 +- 1.4 ml/100g/min (p<0.05) in regions of collateral flow seen with Xenon. In these regions, mean left ventricular percentage shortening was 22 +- 6.0% and 35.5 +- 5.0% respectively. In contrast, in 12 regions demonstrated angiographically, collateral flow increased 41.2 +- 4.6 to 63.4 +- 5.8 ml/100g/min (p<0.005), and 6 Xenon collateral distributions where flow increased post exercise from 19.5 +- 7.8 to 37.8 +- 5.1 ml/100g/min (p<0.05). The mean left ventricular percentage shortening was 43.2 +- 7.3% (p<0.02) in these collateral distributions identified arteriographically and 44 +- 4.5% (p<0.05) with Xenon. The authors conclude that collateral flow, which increased in response to stress, appears to be beneficial in the preservation of regional left ventricular function.

  6. FLAIR vascular hyperintensities and dynamic 4D angiograms for the estimation of collateral blood flow in posterior circulation occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Foerster, Alex; Wenz, Holger; Kerl, Hans Ulrich; Al-Zghloul, Mansour; Habich, Sonia; Groden, Christoph [University of Heidelberg, Department of Neuroradiology, Universitaetsmedizin Mannheim, Mannheim (Germany)

    2014-09-15

    The objectives of this paper are to assess collateral blood flow in posterior circulation occlusion by MRI-based approaches (fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVHs), collateralization on dynamic 4D angiograms) and investigate its relation to ischemic lesion size and growth. In 28 patients with posterior cerebral artery (PCA) and 10 patients with basilar artery (BA) occlusion, MRI findings were analyzed, with emphasis on distal FVH and collateralization on dynamic 4D angiograms. In PCA occlusion, distal FVH was observed in 18/29 (62.1 %), in BA occlusion, in 8/10 (80 %) cases. Collateralization on dynamic 4D angiograms was graded 1 in 8 (27.6 %) patients, 2 in 1 (3.4 %) patient, 3 in 12 (41.4 %) patients, and 4 in 8 (27.6 %) patients with PCA occlusion and 0 in 1 (10 %) patient, 2 in 3 (30 %) patients, 3 in 1 (10 %) patient, and 4 in 5 (50 %) patients with BA occlusion. FVH grade showed neither correlation with initial or follow-up diffusion-weighted image (DWI) lesion size nor DWI-perfusion-weighted imaging (PWI) mismatch ratio. Collateralization on dynamic 4D angiograms correlated inversely with initial DWI lesion size and moderately with the DWI-(PWI) mismatch ratio. The combination of distal FVH and collateralization grade on dynamic 4D angiograms correlated inversely with initial as well as follow-up DWI lesion size and highly with the DWI-PWI mismatch ratio. In posterior circulation occlusion, FVH is a frequent finding, but its prognostic value is limited. Dynamic 4D angiograms are advantageous to examine and graduate collateral blood flow. The combination of both parameters results in an improved characterization of collateral blood flow and might have prognostic relevance. (orig.)

  7. Workshop on Branching Processes and Their Applications

    CERN Document Server

    Gonzalez Velasco, Miguel; Martinez, Rodrigo; Molina, Manuel

    2010-01-01

    Contains papers presented at the Workshop on Branching Processes and Their Applications (WBPA09), held in Badajoz, Spain, April 20-23, 2009, which deal with theoretical and practical aspects of branching process theory

  8. Coulomb branch localization in quiver quantum mechanics

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Kazutoshi; Sasai, Yuya [Institute of Physics, Meiji Gakuin University,1518 Kamikurata-cho, Yokohama, 244-8539 (Japan)

    2016-02-16

    We show how to exactly calculate the refined indices of N=4U(1)×U(N) supersymmetric quiver quantum mechanics in the Coulomb branch by using the localization technique. The Coulomb branch localization is discussed from the viewpoint of both non-linear and gauged linear sigma models. A classification of fixed points in the Coulomb branch differs from one in the Higgs branch, but the derived indices completely agree with the results which were obtained by the localization in the Higgs branch. In the Coulomb branch localization, the refined indices can be written as a summation over different sets of the Coulomb branch fixed points. We also discuss a space-time picture of the fixed points in the Coulomb branch.

  9. The Effect of Ulnar Collateral Ligament Reconstruction on Pitch Velocity in Major League Baseball Pitchers

    OpenAIRE

    Lansdown, Drew A.; Feeley, Brian T.

    2014-01-01

    Background: The medial ulnar collateral ligament (UCL) is the primary restraint to valgus load, and injury is commonly encountered as a result of overuse in throwing athletes. Reconstruction of this ligament has allowed for a high rate of return to sport for elite pitchers. Public perception of this procedure has resulted in a commonly held belief of increased throwing velocity following UCL reconstruction. Hypothesis: Fastball velocity for Major League Baseball (MLB) pitchers is significantl...

  10. Circle of Willis Collateral During Temporary Internal Carotid Artery Occlusion II: Observations From Computed Tomography Angiography.

    Science.gov (United States)

    Wang, Bill Hao; Leung, Andrew; Lownie, Stephen P

    2016-07-01

    The Circle of Willis (CoW) is the most effective collateral circulation to the brain during internal carotid artery (ICA) occlusion. Carotid stump pressure (CSP) is an established surrogate measure of the cerebral collateral circulation. This study aims to use hemodynamic and computed tomography angiography measurements to determine the strongest influences upon the dependent variable, CSP. These findings could help clinicians noninvasively assess the adequacy of the collateral circulation and facilitate surgical risk assessment in an outpatient setting. CSP and mean arterial pressure were measured during carotid endarterectomy or during carotid balloon test occlusion in 92 patients. Intracranial arterial diameters were measured on computed tomography angiography at 16 different locations. Univariate and multivariate analyses were used to determine the key factors associated with CSP. In a subgroup of individuals (n=27) with severe (>70% North American Symptomatic Carotid Endarterectomy Trial) contralateral stenosis or occlusion, the same analysis was performed. The contralateral anterior cerebral artery proximal to anterior communicating artery (A1) of the CoW had the strongest influence upon CSP, followed by the mean arterial pressure, the contralateral ICA diameter, and the anterior communicating artery diameter (R 2=0.364). In the subgroup with high-grade contralateral ICA stenosis, the ipsilateral posterior communicating artery exerted the strongest influence (R 2=0.620). During ICA occlusion, the anterior CoW dominates in preserving collateral flow, especially the contralateral A1 segment. In individuals with high-grade contralateral carotid stenosis, the posterior communicating artery calibre becomes a dominant influence. The most favourable anatomy consists of large contralateral A1 and anterior communicating arteries, and no contralateral carotid stenosis.

  11. Return to Play after Nonsurgical Treatment of Elbow Ulnar Collateral Ligament Injuries in Professional Baseball Players

    OpenAIRE

    Ford, Gregory M.; Genuario, James; Noonan, Thomas J.; Kinkartz, Jason D.; Githens, Thomas; Murayama, Scott

    2014-01-01

    Objectives: Injury to the elbow ulnar collateral ligament (UCL) is relatively common in pitchers. In the 70's reconstructive surgery was developed as a viable option to a potentially career ending injury. Multiple studies have demonstrated return to play (RTP) rates of 74-83% after reconstruction. Studies of RTP after nonoperative treatment in throwing athletes are limited, reporting 42%. There are no studies reporting RTP rates with nonoperative treatment of professional baseball players. Th...

  12. Blood ammonia levels in liver cirrhosis: a clue for the presence of portosystemic collateral veins

    Directory of Open Access Journals (Sweden)

    Tripodi Francesca

    2009-03-01

    Full Text Available Abstract Background Portal hypertension leads to the formation of portosystemic collateral veins in liver cirrhosis. The resulting shunting is responsible for the development of portosystemic encephalopathy. Although ammonia plays a certain role in determining portosystemic encephalopathy, the venous ammonia level has not been found to correlate with the presence or severity of this entity. So, it has become partially obsolete. Realizing the need for non-invasive markers mirroring the presence of esophageal varices in order to reduce the number of endoscopy screening, we came back to determine whether there was a correlation between blood ammonia concentrations and the detection of portosystemic collateral veins, also evaluating splenomegaly, hypersplenism (thrombocytopenia and the severity of liver cirrhosis. Methods One hundred and fifty three consecutive patients with hepatic cirrhosis of various etiologies were recruited to participate in endoscopic and ultrasonography screening for the presence of portosystemic collaterals mostly esophageal varices, but also portal hypertensive gastropathy and large spontaneous shunts. Results Based on Child-Pugh classification, the median level of blood ammonia was 45 mcM/L in 64 patients belonging to class A, 66 mcM/L in 66 patients of class B and 108 mcM/L in 23 patients of class C respectively (p The grade of esophageal varices was concordant with venous ammonia levels (rho 0.43, p Conclusion Identifying cirrhotic patients with high blood ammonia concentrations could be clinically useful, as high levels would lead to suspicion of being in presence of collaterals, in clinical practice of esophageal varices, and pinpoint those patients requiring closer follow-up and endoscopic screening.

  13. Repo collateral fire sales: the effects of exemption from automatic stay

    OpenAIRE

    Sebastian Infante

    2013-01-01

    What are the consequences of a potential fire sale stemming from the exemption of repurchase agreements (repos) from automatic stay? This paper shows that repo's exemption from stay alters firms' financing and investment decisions ex ante. Specifically, a stay exemption changes firms' investment opportunity set, enabling them to purchase assets of defaulted firms at fire sale prices. Fire sales arise endogenously because of limited capital available to purchase collateral posted by insolvent ...

  14. Intra-articular entrapment of the medial collateral ligament: radiographic and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Patel, J.J. [Dept. of Radiology, Baystate Medical Center, Springfield, MA (United States)

    1999-11-01

    Displacement of the medial collateral ligament (MCL) into the medial knee joint is an extremely rare finding associated with MCL tears, and is easily diagnosed on magnetic resonance imaging. A case of intra-articular interposition of the MCL during a severe knee injury is presented. A radiolucent ''fat stripe'' sign and adjacent skin dimpling on radiographs may be relatively specific indicators of this injury. (orig.)

  15. Relation between prognosis and collateral circulation or recanalization in occlusive cerebral vascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Yuko (Tokyo Women' s Medical Coll. (Japan))

    1982-09-01

    CT images and angiograms were compared, in occlusive cerebral vascular diseases with complete stroke in the region of internal carotid artery, and following subjects were discussed. 1) Relation between size of final low density area on CT and prognosis. 2) Effectiveness of collateral circulation and recanalization to the low density area on CT in the territory of occluded artery. For the subject 1,100 cases of infarction of the region of middle cerebral artery were chosen at random, and the prognosis was compared with the size of low density area on CT. For the subject 2,186 cases of infarction in the region on internal carotid artery were selected, and CT images and angiograms were compared, considering the duration between stroke and angiography. With these studies, following conclusions were obtained. There is tendency that cases with the smaller low density areas on CT have the better prognosis. The low density on CT appears inside of the territory of the occluded artery. When there is neither collateral circulation nor recanalization, appearance of the low density on CT is not avoided. Collateral circulation or recanalization is able to rescue the affected area from appearance of low density on CT, even if it is formed later than 6 hours after ictus. The critical period when collateral circulation or recanalization effects on the involved area is variable depending on each cases, but it is suspected to be 24 or 72 hours after onset. Blood supply which begins later than 73 hours after occlusion of artery does not effect on the involved area.

  16. Endocan: a novel biomarker associated with well-developed coronary collateral circulation in patients with stable angina and chronic total occlusion.

    Science.gov (United States)

    Emet, Samim; Elitok, Ali; Onur, Imran; Kocaaga, Mehmet; Bilge, Ahmet Kaya; Oflaz, Huseyin; Umman, Berrin; Oncul, Aytac; Bugra, Zehra; Adalet, Kamil; Mercanoglu, Fehmi

    2017-01-01

    Angiogenesis and arteriogenesis have a crucial role in the formation of coronary collateral vessels. It has been shown that endocan and vascular cell adhesion molecule-1 (VCAM-1) are potential angiogenetic factors. We investigated the relationship between serum endocan levels and grade of coronary collaterals, and also the correlation of endocan levels with serum VCAM-1 levels. Patients with stable angina and at least one total coronary occlusion at invasive coronary angiography were included in our study. Collateral degree was graded according to Rentrop and Cohen's classification. Patients who had grade 0 or 1 collateral vessels were included in the poorly-developed collateral group, and those with grade 2 or 3 coronary collateral vessels were included in the well-developed collateral group. Serum endocan and VCAM-1 levels were significantly higher in the well-developed collateral group (436.6 ± 213.3 ng/mL vs. 216.1 ± 78.5 ng/mL, p coronary collateral development. In the event that these results are confirmed in further studies, endocan may be considered as an anti-ischemic treatment strategy in order to improve collateral development.

  17. The sword of Damocles: an illustrative example of the life-saving effect of the collateral circulation.

    Science.gov (United States)

    Meier, Pascal

    2011-03-01

    There is an ongoing debate on the effective importance of the collateral network, especially in the current era, where most patients with significant coronary artery disease are revascularized, be it percutaneously or surgically; thus, people may question a significant benefit of the coronary collateral circulation. However, the presented 61-year-old male patient demonstrates an unambiguous situation of a life-saving effect of the collateral circulation. The patient presented without any angina symptoms and with only mild shortness of breath on moderate to severe exertion. A subsequent angiography revealed a complete chronic occlusion of the main coronary artery. The entire left coronary system was provided by well-developed right to left collaterals. Additionally, the patient had an 80-90% stenosis of his mid-right coronary artery (RCA). The entire blood supply to the heart had to pass this lesion to provide the RCA area and also the left anterior descending and left circumflex areas via collaterals. This extreme example illustrates the potentially lifesaving effect of the coronary collateral circulation. Obviously, the entire myocardium can in some cases be perfused entirely via one critically stenosed vessel.

  18. Evaluation of the thickness of the medial ulnar collateral ligament in junior high and high school baseball players.

    Science.gov (United States)

    Nagamoto, Hideaki; Yamamoto, Nobuyuki; Kurokawa, Daisuke; Takahashi, Hiroyuki; Muraki, Takayuki; Tanaka, Minoru; Koike, Yoichi; Sano, Hirotaka; Itoi, Eiji

    2015-07-01

    Thickening of the medial ulnar collateral ligament in the throwing arm of adult baseball players is a well-known phenomenon. However, onset of the thickening is unclear among young baseball players. The purpose of this study was to evaluate the thickness of the medial ulnar collateral ligament in junior high and high school baseball players. Seventy-one uninjured and asymptomatic junior high and high school baseball players were included in the study. Participants underwent physical examination after completing a questionnaire, followed by ultrasonographic evaluation. The thickness of the medial ulnar collateral ligament was measured bilaterally. The thickness of the throwing and non-throwing sides in high school and junior high school baseball players, and within each group, was compared and statistically analyzed. The medial ulnar collateral ligament in the throwing arm of high school baseball players was thicker than that in the non-throwing arm (5.5 vs. 4.4 mm), although no significant difference was seen in junior high school baseball players. High school baseball players showed a significantly thicker medial ulnar collateral ligament in the throwing arm than junior high school baseball players. Thickening of the medial ulnar collateral ligament in the throwing arm of asymptomatic and uninjured baseball players may begin by the time the players reach high school.

  19. The association between prolongation in QRS duration and presence of coronary collateral circulation in patients with acute myocardial infarction.

    Science.gov (United States)

    Karahan, Zülküf; Altıntaş, Bernas; Uğurlu, Murat; Kaya, İlyas; Uçaman, Berzal; Uluğ, Ali Veysel; Altındağ, Rojhat; Altaş, Yakup; Adıyaman, Mehmet Şahin; Öztürk, Önder

    2016-01-01

    It is known that QRS duration is related to prognosis in acute myocardial infarction. The relation between QRS duration and coronary collateral circulation is uncertain. In the present study, we aimed to determine the relation between QRS duration and coronary collateral circulation in patients admitted with acute myocardial infarction. The present study was composed of 109 consecutive patients with acute myocardial infarction. All patients had total occlusion in the left anterior descending coronary artery. Electrocardiographic recordings on admission were obtained for the assessment of QRS duration. The Rentrop classification was used to define coronary collateral circulation on coronary angiography. Patients were divided into two groups as follows: Group 1 with poor coronary collateral circulation (Rentrop 0-1) and Group 2 with good coronary collateral circulation (Rentrop 2-3). Of all patients, 62 patients were included in group 1 and 47 patients in group 2, respectively. In the present study, patients in the group 1 had longer QRS duration than patients in the group 2 (p coronary collateral circulation in patients with acute myocardial infarction.

  20. Impact of Collateral Status Evaluated by Dynamic Computed Tomographic Angiography on Clinical Outcome in Patients With Ischemic Stroke.

    Science.gov (United States)

    van den Wijngaard, Ido R; Boiten, Jelis; Holswilder, Ghislaine; Algra, Ale; Dippel, Diederik W J; Velthuis, Birgitta K; Wermer, Marieke J H; van Walderveen, Marianne A A

    2015-12-01

    Status of collateral circulation is a strong predictor of outcome after acute ischemic stroke. Our aim was to compare the predictive value of strategies for collateral blood flow assessment with dynamic computed tomographic angiography (CTA) and conventional single-phase CT angiography. Patients with a proximal middle cerebral artery occlusion underwent noncontrast CT, single-phase CTA and whole brain CT perfusion/dynamic CTA within 9 hours after stroke onset. We defined poor outcome as a score on the modified Rankin Scale score of ≥3. The association between collateral score and clinical outcome at 3 months was analyzed with Poisson regression. The prognostic value of collateral scoring with dynamic CTA and single-phase CTA in addition to age, stroke severity, and noncontrast CT was assessed with logistic regression and summarized with the area under the curve. Seventy patients were included, with a mean age of 68 years. We observed an increased risk of poor outcome in patients with poor collaterals on single-phase CTA (risk ratio, 1.8; 95% confidence interval, 1.0-3.1) and on dynamic CTA (risk ratio, 2.0; 95% confidence interval, 1.5-2.7). The prediction of poor clinical outcome by means of collateral adjustment was better with dynamic CTA (area under the curve, 0.84; likelihood ratio test PURL: http://www.trialregister.nl/trialreg. Unique identifier: NTR1804. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00880113. © 2015 American Heart Association, Inc.

  1. Novel Suture Anchor Technique with Continuous Locking Stitch for Collateral Ligament Repair.

    Science.gov (United States)

    Tokunaga, Susumu; Abe, Yoshihiro

    2016-06-01

    Collateral ligaments are difficult to repair due to large amount of fraying in detached ligaments and attenuated stumps that may not provide enough strength after the repair. Although strong locking sutures are used to repair the ligament with proper tension, these damages can cause pull-out failure or relaxation of the repaired ligaments even from undersized load that may extend postoperative splinting or casting time. Furthermore, current suture techniques can repair varus or valgus instability of the elbow and radial or ulnar instability of the fingers, but these techniques do not offer rotatory stability of these areas. We have developed a novel suture anchor technique that has overcome this problem of current suture techniques, and this can be used to correct rotatory instability in the elbow and fingers. We used this procedure in seven cases with injury of collateral ligament in the elbow and eight cases with detached collateral ligaments of finger joint. No patient experienced rerupture or any kind of residual instability. We believe that the proposed method can produce much stronger repair and may shorten the postoperative immobilization period.

  2. [Restoration of ulnar collateral ligament stability of the metacarpophalangeal joint of the thumb].

    Science.gov (United States)

    Langer, M F; Hermann, K; Oeckenpöhler, S; Wieskötter, B

    2015-10-01

    Restoration of ulnar collateral ligament stability of the metacarpophalangeal (MP) joint of the thumb with elimination of palmar subluxation while retaining mobility for chronic instability without osteoarthritis. Acquired or congenital chronic instability of the MP joint of the thumb with compelling reasons for joint preservation and against arthrodesis, e.g., an arthrodesis or arthritis of adjacent joints. Arthritis of the thumb MP joint. Contractures of the MP joint. Low natural range of motion of the joint (compared to the contralateral hand). Additional palmar instability with significant hyperextensibility. Infections. Lesions to the median and/or ulnar nerve with impaired active mobility. Anatomical reconstruction of the ulnar collateral ligament and the accessory collateral ligament using a tendon graft (palmaris longus tendon). Ulnar approach, transosseous course of the tendon graft and elimination of subluxation. Splint for 5 weeks and hand therapy. Of 12 patients undergoing this type of ligament reconstruction, all achieved good stability and pain-free range of motion, which was 60-95% of the contralateral hand. This surgical procedure has few complications and is considered reliable.

  3. The relationship between ischemia modified albumin and good coronary collateral circulation.

    Science.gov (United States)

    Gök, Murat; Kundi, Harun; Kızıltunç, Emrullah; Topcuoglu, Canan; Örnek, Ender

    2017-11-13

    It is important to determine the grade of the coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD). In this study, we aimed to investigate the relationship between the ischemia modified albumin (IMA) level and good CCC. A total of 95 patients with coronary angiography and at least one epicardial coronary artery obstruction were included in the study. The Rentrop classification was used with CCC grading, where 0 and 1 were defined as poor collateral, and 2 and 3 were defined as good collateral. The IMA level of the patients was measured using an enzyme-linked immunosorbent assay (ELISA). The receiver-operating characteristic curve was used to show the sensitivity and specificity of IMA levels and the optimal cut-off value for predicting good CCC. The multiple logistic regression analysis revealed that the IMA level in the good CCC group was higher (p good CCC group (p good CCC level, and this shows good CCC with 70.2% sensitivity and 60.3% specificity. The IMA level could serve as a simple and useful predictor of well-developed CCC.

  4. Mechanistic, technical, and clinical perspectives in therapeutic stimulation of coronary collateral development by angiogenic growth factors.

    Science.gov (United States)

    Rubanyi, Gabor M

    2013-04-01

    Stimulation of collateral vessel development in the heart by angiogenic growth factor therapy has been tested in animals and humans for almost two decades. Discordance between the outcome of preclinical studies and clinical trials pointed to the difficulties of translation from animal models to patients. Lessons learned in this process identified specific mechanistic, technical, and clinical hurdles, which need to be overcome. This review summarizes current understanding of the mechanisms leading to the establishment of a functional coronary collateral network and the biological processes growth factor therapies should stimulate even under conditions of impaired natural adaptive vascular response. Vector delivery methods are recommended to maximize angiogenic gene therapy efficiency and reduce side effects. Optimization of clinical trial design should include the choice of clinical end points which provide mechanistic proof-of-concept and also reflect clinical benefits (e.g., surrogates to assess increased collateral flow reserve, such as myocardial perfusion imaging). Guidelines are proposed to select patients who may respond to the therapy with high(er) probability. Both short and longer term strategies are outlined which may help to make therapeutic angiogenesis (TA) work in the future.

  5. The relationship between mean platelet volume and coronary collateral vessels in patients with acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Gaurav Singhal

    2016-01-01

    Full Text Available Background: Elevated mean platelet volume (MPV has been proposed as a risk factor for coronary artery disease (CAD and is associated with poor clinical outcome in acute coronary syndrome (ACS. However, some studies have contradictory findings. Hence, we aimed to evaluate the association of MPV with the presence of coronary collateral vessel (CCV in patients with ACS. Objective: To find MPV value in ACS patients and to find the predictive value of MPV in the spectrum of CAD and to examine whether levels of MPV predict the presence of CCVs. Methods: A total of 180 patients with first ACS were included in the study. MPV was measured. All patients underwent coronary angiography to know disease severity and CCVs. The CCVs are graded according to the Rentrop scoring system and according to coronary angiography results; patients were divided into two groups as Group 1 (poor CCV and Group 2 (good CCV. Results: The MPV was 10.74 ± 2 fl in poor collateral group patients and 11.01 ± 1.7 fl in good collateral group (P = 0.421. The presence of CCV was not significantly associated with high levels of MPV. MPV value did not show any prediction of the spectrum of CAD. Conclusion: MPV on admission was not associated with the development of CCV positively in patients with ACS. Furthermore, it is not associated with a number of vessel involvements.

  6. Biomechanical model of knee collateral ligament injury with six degrees of freedom.

    Science.gov (United States)

    Ozada, Neriman

    2016-05-01

    Knee ligament injuries cannot be fully described using simplified joint models or by experimentation alone. The study objective was to model the contributions of the collateral ligaments over six degrees of freedom (DOF) of knee joint articulation to aid the diagnosis of knee ligament injuries. A kinematic model of the knee joint with six DOF was developed using the Musculoskeletal Joint Modeller software, and the effects of medial collateral ligament (MCL) and lateral collateral ligament (LCL) rupture were evaluated. The centres of mass of the tibia and femur were determined from their surface geometry, and the displacement of the moving tibia was determined by measuring the displacements of the attached ligaments with respect to its centre of mass. Compared to an intact knee, a tibia without the LCL had higher medial translation and lower valgus rotation, while a tibia without the MCL had higher lateral translation and higher valgus rotation. At 0°, 30° and 60° of flexion, the tibia without the LCL had more internal rotation than an intact knee. Understanding the complete kinematics of knee joints may improve the diagnosis of ligament injuries and guide tissue replacement surgery. Predicting joint behaviour in the clinic after treatment might benefit from a combined modelling approach that includes both clinicians and basic researchers.

  7. The Effects of a Branch Campus

    Science.gov (United States)

    Lien, Donald; Wang, Yaqin

    2012-01-01

    We examine the effects of a branch campus on the social welfare of the host country and the foreign university. Overall, we find that a branch campus increases both the domestic social welfare (measured by the aggregate student utility) and the tuition revenue of the foreign university. The effect of a branch campus on the brain drain is…

  8. Introduction of Branching Degrees of Octane Isomers.

    Science.gov (United States)

    Perdih, Anton

    2016-01-01

    The concept of branching degrees is introduced. In the case of octane isomers it is derived from the values of a set of their physicochemical properties, calculating for each isomer the average of the normalized values and these averages are defined as branching degrees of octane isomers. The sequence of these branching degrees of octane isomers does not differ much from the »regular« one defined earlier. 2,2-Dimethylhexane appears to be less branched than 3,4-dimethylhexane and 3-ethyl, 2-methylpentane, whereas 2,3,4-trimethylpentane appears to be less branched than 3-ethyl, 3-methylpentane. While the increasing number of branches gives rise to increasing branching degrees, the peripheral position of branches and the separation between branches decreases the value of the branching degree. The central position of branches increases it. A bigger branch increases it more than a smaller one. The quantification of these structural features and their correlations with few indices is given as well.

  9. Structural dynamics branch research and accomplishments

    Science.gov (United States)

    1990-01-01

    Summaries are presented of fiscal year 1989 research highlights from the Structural Dynamics Branch at NASA Lewis Research Center. Highlights from the branch's major work areas include aeroelasticity, vibration control, dynamic systems, and computation structural methods. A listing of the fiscal year 1989 branch publications is given.

  10. An investigation of cognitive 'branching' processes in major depression

    Directory of Open Access Journals (Sweden)

    Williams Steven CR

    2009-11-01

    Full Text Available Abstract Background Patients with depression demonstrate cognitive impairment on a wide range of cognitive tasks, particularly putative tasks of frontal lobe function. Recent models of frontal lobe function have argued that the frontal pole region is involved in cognitive branching, a process requiring holding in mind one goal while performing sub-goal processes. Evidence for this model comes from functional neuroimaging and frontal-pole lesion patients. We have utilised these new concepts to investigate the possibility that patients with depression are impaired at cognitive 'branching'. Methods 11 non-medicated patients with major depression were compared to 11 matched controls in a behavioural study on a task of cognitive 'branching'. In the version employed here, we recorded participant's performance as they learnt to perform the task. This involved participants completing a control condition, followed by a working memory condition, a dual-task condition and finally the branching condition, which integrates processes in the working memory and dual-task conditions. We also measured participants on a number of other cognitive tasks as well as mood-state before and after the branching experiment. Results Patients took longer to learn the first condition, but performed comparably to controls after six runs of the task. Overall, reaction times decreased with repeated exposure on the task conditions in controls, with this effect attenuated in patients. Importantly, no differences were found between patients and controls on the branching condition. There was, however, a significant change in mood-state with patients increasing in positive affect and decreasing in negative affect after the experiment. Conclusion We found no clear evidence of a fundamental impairment in anterior prefrontal 'branching processes' in patients with depression. Rather our data argue for a contextual learning impairment underlying cognitive dysfunction in this disorder. Our

  11. Chiral methyl-branched pheromones.

    Science.gov (United States)

    Ando, Tetsu; Yamakawa, Rei

    2015-07-01

    Insect pheromones are some of the most interesting natural products because they are utilized for interspecific communication between various insects, such as beetles, moths, ants, and cockroaches. A large number of compounds of many kinds have been identified as pheromone components, reflecting the diversity of insect species. While this review deals only with chiral methyl-branched pheromones, the chemical structures of more than one hundred non-terpene compounds have been determined by applying excellent analytical techniques. Furthermore, their stereoselective syntheses have been achieved by employing trustworthy chiral sources and ingenious enantioselective reactions. The information has been reviewed here not only to make them available for new research but also to understand the characteristic chemical structures of the chiral pheromones. Since biosynthetic studies are still limited, it might be meaningful to examine whether the structures, particularly the positions and configurations of the branched methyl groups, are correlated with the taxonomy of the pheromone producers and also with the function of the pheromones in communication systems.

  12. Branched-Chain Amino Acids.

    Science.gov (United States)

    Yamamoto, Keisuke; Tsuchisaka, Atsunari; Yukawa, Hideaki

    Branched-chain amino acids (BCAAs), viz., L-isoleucine, L-leucine, and L-valine, are essential amino acids that cannot be synthesized in higher organisms and are important nutrition for humans as well as livestock. They are also valued as synthetic intermediates for pharmaceuticals. Therefore, the demand for BCAAs in the feed and pharmaceutical industries is increasing continuously. Traditional industrial fermentative production of BCAAs was performed using microorganisms isolated by random mutagenesis. A collection of these classical strains was also scientifically useful to clarify the details of the BCAA biosynthetic pathways, which are tightly regulated by feedback inhibition and transcriptional attenuation. Based on this understanding of the metabolism of BCAAs, it is now possible for us to pursue strains with higher BCAA productivity using rational design and advanced molecular biology techniques. Additionally, systems biology approaches using augmented omics information help us to optimize carbon flux toward BCAA production. Here, we describe the biosynthetic pathways of BCAAs and their regulation and then overview the microorganisms developed for BCAA production. Other chemicals, including isobutanol, i.e., a second-generation biofuel, can be synthesized by branching the BCAA biosynthetic pathways, which are also outlined.

  13. Studies on intracranial collateral circulation with multi-slice CT angiography in patients with symptomatic cerebral artery stenosis

    Directory of Open Access Journals (Sweden)

    Shu-qing ZHOU

    2011-06-01

    Full Text Available Objective To explore the features of intracranial collateral circulation in patients with symptomatic cerebral artery stenosis.Method Ninety-four patients with ischemic cerebrovascular disease admitted from Apr.2004 to Jun.2009 were involved in present study.All the patients were examined with cerebral multi-slice CT angiography,and the features of cerebral artery stenosis and intracranial collateral circulation were evaluated using maximum intensity projection(MIP and volume rendering(VR images of CT angiography.Result Of the 94 patients involved,48 were diagnosed as cerebral artery stenosis,including 29 cases of cerebral infarction,18 of transient ischemic attack(TIA and 1 of moyamoya disease(MMD.Among the 14 cases of severe cerebral artery stenosis or occlusion,cerebral infarction was found in 6 cases with lesser intracranial collateral vessels(including massive cerebral infarction in 4 cases and watershed infarction in 2 cases,and focal infarction of central semi-ovale in 1 case and TIA in 7 cases were found with abundant intracranial collateral vessels.Multiple lacunar infarction was found in 22 cases of mild or moderate cerebral artery stenosis,but there was no significant correlation between the stenosed arteries and infarction sites.Abundant intracranial collateral vessels were found in one patient with Moyamoya disease but no infarction was observed.Conclusions Intracranial collateral circulation plays an important role of compensation in patients with severe cerebral artery stenosis or occlusion.Cerebral angiography with multi-slice CT is of great significance in evaluation of cerebral artery stenosis and intracranial collateral circulation.

  14. Clinical features and injury patterns of medial collateral ligament tibial side avulsions: "wave sign" on magnetic resonance imaging is essential for diagnosis.

    Science.gov (United States)

    Taketomi, Shuji; Uchiyama, Eiji; Nakagawa, Takumi; Takeda, Hideki; Nakayama, Shuichi; Fukai, Atsushi; Sanada, Takaki; Iwaso, Hiroshi

    2014-12-01

    Medial collateral ligament tibial avulsion is rare. Consequently, diagnostic criteria and a treatment regimen for medial collateral ligament tibial side avulsions remain to be established. The purpose of this study is to clarify the clinical features of medial collateral ligament tibial side avulsions. We performed a retrospective clinical and magnetic resonance imaging review of a consecutive series of 12 medial collateral ligament tibial side avulsions. All patients were treated operatively and the final diagnosis was made based on the intraoperative findings. Post-injury magnetic resonance imaging studies were reviewed to assess injury patterns with respect to the intraoperative findings. Eleven of 12 cases (92%) had grade III valgus laxity (unstable to valgus stress at both 0° and 30° of flexion) on an examination under anesthesia. Concomitant anterior cruciate ligament tear was noticed in all cases. Intraoperative findings were classified into 3 types depending on the location of the ruptured end of the superficial medial collateral ligament with respect to the pes anserinus tendons. Magnetic resonance imaging depicted characteristic waving ("wave sign") of the superficial layer of medial collateral ligament in all cases. "Wave sign" of the superficial layer of medial collateral ligament on magnetic resonance imaging is essential for diagnosing medial collateral ligament tibial side avulsions. Based on the clinical features and injury patterns, operative treatment is primarily recommended for medial collateral ligament tibial side avulsions. Case series, Level IV. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Preliminary Study of the Confined, Collateral, and Combined Effects of Reading and Behavioral Interventions: Evidence for a Transactional Relationship

    Science.gov (United States)

    Cook, Clayton R.; Dart, Evan; Collins, Tai; Restori, Alberto; Daikos, Chris; Delport, John

    2012-01-01

    Recent correlational studies provide support for a transactional relationship between reading and behavior problems. A transactional relationship implies that reading problems cause behavior problems, and vice versa. This study took this basic finding and examined its implications for intervention. Specifically, this study employed single-case…

  16. Branching process models of cancer

    CERN Document Server

    Durrett, Richard

    2015-01-01

    This volume develops results on continuous time branching processes and applies them to study rate of tumor growth, extending classic work on the Luria-Delbruck distribution. As a consequence, the authors calculate the probability that mutations that confer resistance to treatment are present at detection and quantify the extent of tumor heterogeneity. As applications, the authors evaluate ovarian cancer screening strategies and give rigorous proofs for results of Heano and Michor concerning tumor metastasis. These notes should be accessible to students who are familiar with Poisson processes and continuous time. Richard Durrett is mathematics professor at Duke University, USA. He is the author of 8 books, over 200 journal articles, and has supervised more than 40 Ph.D. students. Most of his current research concerns the applications of probability to biology: ecology, genetics, and most recently cancer.

  17. The "Open Branch" Technique: A New Way to Prevent Paraplegia After Total Endovascular Repair of Thoracoabdominal Aneurysm.

    Science.gov (United States)

    Mangialardi, Nicola; Lachat, Mario; Esposito, Andrea; Puippe, Gilberte; Orrico, Matteo; Alberti, Vittorio; Fazzini, Stefano; Ronchey, Sonia

    2016-03-01

    Staged endovascular treatment of thoracoabdominal aortic aneurysms (TAAA) has been proved to be an effective strategy to reduce the risk of spinal cord ischemia (SCI). Several techniques have been described: some imply the staged coverage of the aorta, other the temporarily perfusion of the sac through a branch left unstented or a dedicated branch that will be occluded later. The aim of those is to facilitate the expansion of the collateral network that perfuses the spinal cord. However, each of them, have some disadvantages such as the need of two interventions of big magnitude and the risk of target vessel occlusion or endograft displacement. We describe a new technique to treat TAAA in a staged manner. The first step of our technique is the thoracoabdominal endograft deployment with the branching of all target vessels; one of these is branched with a bare stent inside which a covered stent will be placed in a second step, which can be perfomed under local anesthesia. We named this technique "open branch" (OB). Before insertion of the covered stent, a balloon is inflated inside the bare stent to simulate the complete sac exclusion to evaluate eventual neurological complication. Two patients with Crawford type II TAAA and one with a suprarenal aneurysm following the open repair of an infrarenal aortic aneurysm were treated. No cases of SCI were observed after the two procedures. Median interval time between the two procedures was 8, 6 weeks (4-16). Between the two steps, no aneurysm growth or rupture and no branch occlusion or endograft displacement was observed. These three cases of "OB" technique show that this is a safe and feasible alternative strategy to treat TAAA in a staged manner. © 2015 Wiley Periodicals, Inc.

  18. Pathogenesis of Portal Cavernoma Cholangiopathy: Is it Compression by Collaterals or Ischemic Injury to Bile Ducts During Portal Vein Thrombosis?

    Science.gov (United States)

    Puri, Pankaj

    2014-01-01

    The pathogenesis of portal cavernoma cholangiopathy (PCC) is important as it can impact the choice of treatment modalities. PCC consists of a reversible component, which resolves by decompression of collaterals as well as a fixed component, which persists despite the decompression of collaterals. The reversible component is due to compression by large collaterals located adjacent to the bile duct as well as possibly intracholedochal varices. The fixed component is likely to be due to ischemia at the time of portal vein thrombosis, local ischemia by compression as well as encasement by a solid tumor-like cavernoma comprising of fibrous hilar mass containing multiple tiny collateral veins rather than markedly enlarged portal collaterals. Although cholangiographic abnormalities in portal hypertension are common, the prevalence of symptomatic PCC is low. This is likely to be related to the cause of portal hypertension, the duration of portal hypertension and possibly the pattern of occlusion of the splenoportal axis. There may possibly be higher prevalence of symptomatic PCC in extension of the thrombosis to the splenomesentric veins. PMID:25755592

  19. Noninvasive evaluation of collateral blood flow through circle of Willis in cervical carotid stenosis using selective magnetic resonance angiography.

    Science.gov (United States)

    Ito, Kenji; Sasaki, Makoto; Kobayashi, Masakazu; Ogasawara, Kuniaki; Nishihara, Takashi; Takahashi, Tetsuhiko; Natori, Tatsunori; Uwano, Ikuko; Yamashita, Fumio; Kudo, Kohsuke

    2014-01-01

    Preoperative assessment of intracranial collateral circulation is helpful in predicting cerebral ischemia during surgical procedures for cervical internal carotid artery (ICA) stenosis. However, magnetic resonance angiography (MRA) and other less-invasive techniques cannot evaluate collateral blood flow because these techniques are nonselective. Hence, by using a newly developed selective MRA technique, we attempted to visualize collaterals via the circle of Willis in patients with ICA stenosis. Twelve patients who underwent carotid endarterectomy were prospectively examined with a 1.5-T MR scanner. Both selective and nonselective MRA were obtained using a 3-dimensional time-of-flight technique, with or without a cylindrical saturation pulse that suppresses the flow signal from the region of the target ICA. Maximum intensity projection MRA images were generated and compared with digital subtraction angiography (DSA) images. In all patients, the distal flow signal of the ipsilateral ICA was completely suppressed on selective MRA compared with nonselective MRA. In addition, collateral blood flow through the anterior and posterior communicating arteries was visualized in 5 and 2 patients, respectively. These findings corresponded well with the DSA imaging. Selective MRA techniques can readily suppress signals from the distal blood flow of the target artery and visualize the presence of collateral flows through the circle of Willis in patients with cervical ICA stenosis. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. A novel method to assess pial collateralization from stroke perfusion MRI: subdividing T{sub max} into anatomical compartments

    Energy Technology Data Exchange (ETDEWEB)

    Potreck, Arne; Seker, Fatih; Hoffmann, Angelika; Pfaff, Johannes; Bendszus, Martin; Heiland, Sabine; Pham, Mirko [Heidelberg University Hospital, Department of Neuroradiology, Heidelberg (Germany); Nagel, Simon [Heidelberg University Hospital, Department of Neurology, Heidelberg (Germany)

    2017-02-15

    To develop and validate a quantitative and observer-independent method to evaluate pial collateral circulation by DSC-perfusion MRI and test whether this novel method delivers diagnostic information which is redundant to or independent from conventional penumbra imaging by the mismatch approach. We retrospectively identified 47 patients with M1 occlusion who underwent MR diffusion/perfusion imaging and mechanical thrombectomy at our facility. By automated registration and segmentation, T{sub max} delays were attributed specifically to the pial, cortical and parenchymal compartments. The resulting pial volumes at delay were defined as the pial T{sub max} map-assessed collateral score (TMACS) and correlated with gold standard digital subtraction angiography (DSA). Mismatch ratio was assessed by conventional penumbra defining MRI criteria. Strong correlation was found between TMACS and angiographically assessed collateral score (Pearson ρ = -0.74, p < 0.001). In multiple logistic regression, both good collaterals according to TMACS [OR 4.3 (1.1-19, p = 0.04)] and mismatch ratio ≥ 3.5 [OR 12.3 (1.88-249, p = 0.03)] were independent predictors of favourable clinical outcome. Perfusion delay in the pial compartment, as evaluated by TMACS, closely reflects the extent of pial collaterals in gold-standard DSA. TMACS and mismatch ratio were found to be complementary predictors of a favourable clinical outcome, each adding independent predictive information. (orig.)

  1. The relationship between diastolic pressure and coronary collateral circulation in patients with stable angina pectoris and chronic total occlusion.

    Science.gov (United States)

    Shu, Wang; jing, Jing; Fu, Liu Chang; Min, Jiang Tie; Bo, Yang Xiao; Ying, Zhou; Dai, Chen Yun

    2013-05-01

    The most important biomechanical source of activation of the coronary collateral circulation (CCC) is increased tangential fluid shear stress at the arterial endothelial surface. The coronary circulation is unique in that most coronary blood flow occurs in diastole. Consequently, the diastolic blood pressure (DBP) may influence the tangential fluid shear stress on the arterial endothelial surface in diastole, therebyaffecting development of the CCC. To investigate this, we conducted a study of 222 patients with stable angina pectoris and chronic total occlusion of coronary arteries. All of the patients had no history of coronary artery interventional therapy, coronary artery bypass surgery, cardiomyopathy, or congenital heart disease. The extent of the collateral vasculature of the area perfused by the artery affected by chronic total occlusion was graded as poor or well-developed according to Rentrop's classification. Univariate analysis showed a significant difference between the study subgroup with poorly developed collaterals and that with well-developed collaterals in terms of high diastolic blood pressure (DBP) and mean DBP. Multivariate analysis revealed high DBP as the only independent positive predictor of a well-developed collateral circulation. High DBP is positively related to a well-developed CCC. Differences in development of the CCC may be one of the pathophysiologic mechanisms responsible for the J-curve phenomenon in the relationship between DBP and cardiovascular risk.

  2. Vegetation survey of PEN Branch wetlands

    Energy Technology Data Exchange (ETDEWEB)

    1991-01-01

    A survey was conducted of vegetation along Pen Branch Creek at Savannah River Site (SRS) in support of K-Reactor restart. Plants were identified to species by overstory, understory, shrub, and groundcover strata. Abundance was also characterized and richness and diversity calculated. Based on woody species basal area, the Pen Branch delta was the most impacted, followed by the sections between the reactor and the delta. Species richness for shrub and groundcover strata were also lowest in the delta. No endangered plant species were found. Three upland pine areas were also sampled. In support of K Reactor restart, this report summarizes a study of the wetland vegetation along Pen Branch. Reactor effluent enters Indian Grove Branch and then flows into Pen Branch and the Pen Branch Delta.

  3. MEASUREMENT OF THE B0 ---> D*- A+(1) BRANCHING FRACTION WITH PARTIALLY RECONSTRUCTED D*

    Energy Technology Data Exchange (ETDEWEB)

    Salvatore, Pasquale F

    2002-07-26

    The B{sup 0} {yields} D*{sup -} a{sub 1}{sup +} branching fraction has been measured with data collected by the BaBar experiment in 1999 and 2000 corresponding to a total integrated luminosity of 20.6 fb{sup -1}. Signal events have been selected using a partial reconstruction technique, in which only the a{sub 1}{sup +} and the slow pion ({pi}{sub s}) from the D*{sup -} decay are identified. A signal yield of 18400 {+-} 1200 events has been found, corresponding to a preliminary branching fraction of (1.20 {+-} 0.07(stat) {+-} 0.14(syst))%.

  4. Mathematical Modeling of the Process for Microbial Production of Branched Chained Amino Acids

    Directory of Open Access Journals (Sweden)

    Todorov K.

    2009-12-01

    Full Text Available This article deals with modelling of branched chained amino acids production. One of important branched chained amino acid is L-valine. The aim of the article is synthesis of dynamic unstructured model of fed-batch fermentation process with intensive droppings for L-valine production. The presented approach of the investigation includes the following main procedures: description of the process by generalized stoichiometric equations; preliminary data processing and calculation of specific rates for main kinetic variables; identification of the specific rates takes into account the dissolved oxygen tension; establishment and optimisation of dynamic model of the process; simulation researches. MATLAB is used as a research environment.

  5. Sonography of injury of the ulnar collateral ligament of the elbow - initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 825 Northern Boulevard, 11021, Great Neck, NY (United States); Adler, Ronald S. [Department of Imaging and Nuclear Medicine, Hospital for Special Surgery, 535 East 70th Street, 10021, New York, NY (United States); Friedman, Lawrence [Department of Radiology, Hamilton Health Sciences - Henderson Division, 711 Concession Street, L8V 1C3, Hamilton, Ontario (Canada)

    2004-07-01

    The purpose of this study is to describe the sonographic appearance of injuries of the ulnar collateral ligament (UCL) of the elbow. Eight non-professional male baseball pitchers, ages 13-35 years, with medial elbow pain and clinical suspicion of ulnar collateral ligament injury, were referred for imaging. All eight underwent sonography of the affected and contralateral asymptomatic elbow, and six also underwent MR imaging. Neither valgus stress nor power Doppler was used during the sonographic examinations. Time from onset of symptoms to imaging was 1.5 weeks to 6 months. Three patients had surgical confirmation of their injuries, with time from imaging to surgery of 2 days to 9 months. In four patients, the UCL was ruptured, manifest sonographically in three cases as discontinuity of the normally hyperechoic ligament with anechoic fluid in the gap and in one case as non-visualization of the ligament with heterogeneous echogenicity in the expected location of the ligament. Two adolescent patients had avulsions of the UCL from the medial epicondyle, with sonographic demonstration of the avulsed echogenic bony fragment in both cases. One patient had a mild sprain, manifest as mild thickening and decreased echogenicity of the ligament sonographically compared with the contralateral normal elbow, with mild surrounding hypoechoic edema. The eighth patient had a small partial tear of the deep surface of the distal aspect of the ligament, visualized as a hypoechoic focus between the deep surface of the ligament and its ulnar attachment. Tears of the ulnar collateral ligament are manifested sonographically as non-visualization of the ligament or alteration of the normal morphology. (orig.)

  6. High-resolution MRI of the ulnar and radial collateral ligaments of the wrist.

    Science.gov (United States)

    Nozaki, Taiki; Wu, Wei Der; Kaneko, Yasuhito; Rafijah, Gregory; Yang, Lily; Hitt, Dave; Yoshioka, Hiroshi

    2017-12-01

    Background Accurate diagnosis of injuries to the collateral ligaments of the wrist is technically challenging on MRI. Purpose To investigate usefulness of high-resolution two-dimensional (2D) and isotropic three-dimensional (3D) magnetic resonance imaging (MRI) for identifying and classifying the morphology of the ulnar and radial collateral ligaments (UCL and RCL) of the wrist. Material and Methods Thirty-seven participants were evaluated using 3T coronal 2D and isotropic 3D images by two radiologists independently. The UCL was classified into four types: 1a, narrow attachment to the tip of the ulnar styloid (Tip); 1b, broad attachment to the Tip; 2a, narrow attachment to the medial base of the ulnar styloid (Base); and 2b, broad attachment to the Base. The RCL was also classified into four types: 1a, separate radioscaphoid and scaphotrapezial ligaments (RS + ST) with narrow scaphoid attachment; 1b, RS + ST with broad scaphoid attachment; 2a, continuous radio-scapho-trapezial ligaments (RST) with narrow scaphoid attachment; and 2b, RST with broad scaphoid attachment. The inter-observer reliability of these classifications was calculated. Results Type 1a was the most common of both collateral ligaments. Of UCL classifications, 31.4% were revised after additional review of multiplanar reconstruction (MPR) images from isotropic data. The inter-observer reliability of UCL classification was substantial (k = 0.62) without MPR, and almost perfect (k = 0.84) with MPR. The inter-observer reliability of RCL classification was almost perfect (k = 0.89). Anatomic delineation between the two sequences was not statistically different. Conclusion The UCL and RCL were each identified on high-resolution 2D and isotropic 3D MRI equally well. MPR allows accurate identification of the UCL attachment to the ulnar styloid.

  7. Radial collateral ligament injury of the little finger proximal interphalangeal joint in young pianists.

    Science.gov (United States)

    Gong, Hyun Sik; Cho, Hoyune Esther; Rhee, Seung Hwan; Kim, Jihyeong; Lee, Young Ho; Baek, Goo Hyun

    2014-08-01

    To report the features of radial collateral ligament injury of the little finger proximal interphalangeal joint in young piano players. Between 2005 and 2012, we treated 6 cases of radial collateral ligament injury of the little finger proximal interphalangeal joint in young piano players at a single referral center. We conducted a retrospective review of charts and radiographs and telephone-interviewed all patients at a mean follow-up of 33 months (range, 12-66 mo) to evaluate features of this injury. All patients were girls with a mean age of 10 years (range, 8-12 y), and all had injuries in their right hands. Patients had been playing piano for a mean 3.8 years (range, 3-5 y) and practicing for a mean 1.8 hours per day (range, 1-3 h). Pain was commonly aggravated when they played octaves or advanced pieces requiring extensive finger movements. All patients were playing on standard-size piano keyboards and had generalized hypermobility with a mean Beighton and Horan score of 6.3 (range, 5-9). Two patients had an ulnar deviation deformity of 10° and 15° each at the proximal interphalangeal joint whereas the others had no fixed joint deformity. Five patients showed improvement with conservative treatment, but 1 patient underwent surgery. In our practice, all piano-related radial collateral ligament injuries were in female preadolescents with evidence of generalized hypermobility; patients had been playing piano extensively, suggesting that the injury could have resulted from stress on the joint during piano playing. Future studies should further evaluate the efficacy of modifying keyboard size, techniques, and repertoires for piano lessons and of patient education for this type of injury. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  8. Infrared Thermal Imaging in Patients with Medial Collateral Ligament Injury of the Knee - A Retrospective Study

    Directory of Open Access Journals (Sweden)

    HyunJung Yang

    2014-12-01

    Full Text Available Objectives: Digital infrared thermographic imaging (DITI has been used widely for various inflammatory diseases, circulatory diseases, skin diseases, musculoskeletal diseases and cancers. In cases of ligament injury, obviously the temperature of the damaged area increases due to local inflammation; however, whether the temperature also increases due to DITI has not been determined. The purpose of the present study was to identify whether or not the changes of temperature in patient’s with medial collateral ligament injury were really due to infrared thermography and to determine the applicability of DITI for assessing ligament injuries. Methods: Twenty patient’s who underwent DITI for a medial collateral ligament injury from September 2012 to June 2014 were included in the current study. The thermographic images from the patient’s knees were divided to cover seven sub-areas: the middle of the patella, and the inferomedial, the inferolateral, the superomedial, the superolateral, the medial, and the lateral regions of patella. The temperatures of the seven regions were measured, and the temperature differences between affected and unaffected regions were analyzed by using the Wilcoxon signed rank test. Results: The 20 patient’s were composed of 14 women (70% and 6 men (30%, with a mean age of 62.15 ± 15.71 (mean ± standard deviation (SD years. The temperature of the affected side, which included the middle of the patella, and the inferomedial, the superomedial, the superolateral, and the medial regions, showed a significant increase compared to that of the unaffected side (P < 0.05. The inferolateral and the lateral regions showed no significant changes. Conclusion: Our study results suggest that DITI can show temperature changes if a patient has a ligament injury and that it can be applied in the evaluation of a medial collateral ligament injury.

  9. The association of plasma vitamin A and E levels with coronary collateral circulation.

    Science.gov (United States)

    Söğüt, Erkan; Kadı, Hasan; Karayakalı, Metin; Mertoğlu, Cuma

    2015-04-01

    To investigate if plasma levels of vitamin A and E have an association with coronary collateral development. A total of 189 patients who underwent coronary angiography and had total occlusion in at least one major epicardial coronary artery were enrolled in the study. To classify coronary collateral circulation (CCC), the Rentrop scoring system was used. Patients were classified as having poor CCC (Rentrop grades 0-1) or good CCC (Rentrop grades 2-3), and all patients were also screened for hypertension, hypercholesterolemia, diabetes, and smoking history. There were no differences in plasma vitamin A and E levels between the two groups (vitamin A: 2.37 ± 0.65 vs. 2.35 ± 0.78, p = 0.253; vitamin E: 47.1 ± 12.8 vs. 44.6 ± 15.1, p = 0.082), and plasma vitamin A and E levels were not associated with CCC. Serum high-sensitivity C-reactive protein (hs-CRP) levels were significantly higher in patients with poor CCC (4.68 ± 2.52 vs. 3.89 ± 1.78, p = 0.001). The higher frequency of diabetes and higher serum hs-CRP levels were found to be an independent predictor for poor CCC (odds ratio = 2.44, p = 0.006; odds ratio = 1.24, p = 0.007, respectively). And a higher frequency of total occluded RCA was found to be a positive predictor for good CCC (odds ratio = 2.36, p = 0.06) in a multivariate logistic regression analysis. We found that serum hs-CRP levels, presence of diabetes, and total occlusion of RCA have an effect on coronary collateral development. We found no correlation between plasma vitamin A and E levels and CCC. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. A Technique of Superficial Medial Collateral Ligament Reconstruction Using an Adjustable-Loop Suspensory Fixation Device.

    Science.gov (United States)

    Deo, Shaneel; Getgood, Alan

    2015-06-01

    This report describes superficial medial collateral ligament reconstruction of the knee using a novel method of graft fixation with the ACL Tightrope RT (Arthrex, Naples, FL). After tibial fixation with either a standard interference screw or staple, femoral fixation of the semitendinosus tendon is performed with the adjustable-loop suspensory fixation device, which allows for both initial graft tensioning and re-tensioning after cyclical knee range of motion. This provides the ability for the graft to accommodate for resultant soft-tissue creep and stress relaxation, thereby allowing for optimal soft-tissue tension and reduction in laxity at the end of the procedure.

  11. Prediction of resistance development against drug combinations by collateral responses to component drugs

    DEFF Research Database (Denmark)

    Munck, Christian; Gumpert, Heidi; Nilsson Wallin, Annika

    2014-01-01

    to do so. Thus, predictive models are needed to rationally design resistance-limiting therapeutic regimens. Using adaptive evolution, we studied the resistance response of the common pathogen Escherichia coli to 5 different single antibiotics and all 10 different antibiotic drug pairs. By analyzing...... adaptation to the component drugs. Then, using engineered E. coli strains, we confirmed that drug resistance mutations that imposed collateral sensitivity were suppressed in a drug pair growth environment. These results provide a framework for rationally selecting drug combinations that limit resistance...

  12. Surgical Management and Treatment of the Anterior Cruciate Ligament/Medial Collateral Ligament Injured Knee.

    Science.gov (United States)

    Dale, Kevin M; Bailey, James R; Moorman, Claude T

    2017-01-01

    The medial collateral ligament (MCL) is the most commonly injured ligament of the knee. The anterior cruciate ligament (ACL) is the most commonly injured ligament in conjunction with the MCL. Most MCL injuries can be treated nonoperatively, whereas the ACL often requires reconstruction. A good physical examination is essential for diagnosis, whereas radiographs and MRI of the knee confirm diagnosis and help guide treatment planning. Preoperative physical therapy should be completed before surgical management to allow for return of knee range of motion and an attempt at MCL healing. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Collateral ligament reconstruction of the chronic thumb injury with bio-tenodesis screw fixation

    DEFF Research Database (Denmark)

    Gvozdenovic, Robert; Boeckstyns, Michel

    2014-01-01

    We describe a new technique for the reconstruction of chronic lesions of the collateral ligaments of the metacarpophalangeal ligaments of the thumb, using a Bio-Tenodesis screw for the fixation of a tendon graft in a triangular manner with proximal apex and allowing early mobilization, starting 2...... weeks after operation. Short-term results after 12 to 43 months (mean, 26 mo), showed no significant differences in grip and pinch strength compared with the opposite thumb and restricted loss of motion in the metacarpophalangeal joints (10%) and the interphalangeal joints (4%). We conclude...

  14. Wikileaks: costruire la trasparenza - Analisi del video “Collateral Murder”

    Directory of Open Access Journals (Sweden)

    Isabella Pezzini

    2014-12-01

    Full Text Available L’articolo esamina la strategia comunicativa adottata da Wikileaks in occasione della diffusione del video “Collateral murder” (3 aprile 2010, in cui denunciava il comportamento dell’aviazione americana nella guerra in Iraq e si proponeva come un nuovo soggetto della controcomunicazione globale. Analizzando i modi in cui il video fu costruito a partire dalle registrazioni delle azioni militari sottratte agli stessi USA, emerge il rovesciamento narrativo che Wikileaks riuscì a ottenere, presentando la propria struttura come il vero Destinante custode dei valori condivisi dall’opinione pubblica mondiale, smascherando viceversa gli USA come Antidestinante.

  15. [Diagnosis of medial collateral ligament injury by stress X-ray and MRI of knee joint].

    Science.gov (United States)

    Zhang, Long-Jun; Chen, Jian-Liang; Xu, Yong; Zhu, Shao-Bing

    2012-11-01

    To study the application of stress X-ray of knee joint for the diagnosis ot medial collateral ligament injury. From January 2008 to June 2011, 46 patients with medial collateral ligament injury were reviewed. Among the patients, 32 patients were male and 14 patients were female, ranging in age from 28 to 72 years, with an average of (49.46 +/- 22.54) years. Left knee joint injuries occurred in 22 patients, and 24 patients had injuries in right knee joint. Thirty-one patients were treated with surgical method, and 15 patients were treated with conservative method including 1 patient finally received operation after 3 months treatment with conservative method without effect. The injury side and normal side were observed by X-ray under stress and non-stress, as well as MRI. Operation was used to treat patients with medial gap markedly widen and the deep layer of medial collateral ligament injury in MRI. A line (line A) was drawn from medial condyle to lateral condyle of tibia platform. The line A was translated to the inner margin of condylus medialis femoris, which was line B. The perpendicular distance was measured, which was line C. The ration of space difference (R) was calculated by (space at stress force of injured side-space at non-stress force of injured side)/(space at stress force of normal side-space at non-stress force of normal side). The relationship between R and ligament injury type were investigated. There were 17 patients with injuries of superficial lamella, 21 patients with injuries of deep lamella. Eight patients had associated injuries of articular capsule and posterior cruciate ligament. When R value was between 1.51 to 5.24, the injury of superficial ligament was found in 15 patients, actual injuries were found in 17 patients. When R value between 5.28 and 13.85, the injuries of bathypelagic ligament were found in 19 patients, actual injuries were found in 21 patients. When R value was between 15.61 and 26.25, the associated injuries of

  16. Repair of collateral ligament ruptures in the metacarpophalangeal joints of the long fingers.

    Science.gov (United States)

    Vigasio, Adolfo; Marcoccio, Ignazio

    2012-03-01

    Isolated collateral ligament ruptures in the metacarpophalangeal joints of the fingers seem to be more frequent than described. For ligament repair, dorsal access is generally described, but the proper method by which to proceed inside the joint is unclear and left to the surgeon's discretion and experience. With the technique we propose, it is possible to explore the interior of the joint from the top, allowing an easy and complete examination of the entire length of the ligament. This proposed method allows for a better identification of the lesion and the area of ligament reinsertion, facilitating technical decision-making, and reducing the operating time.

  17. Molecular Analysis of Salivary Gland Branching Morphogenesis

    National Research Council Canada - National Science Library

    Sakai, Takayoshi; Larsen, Melinda; Kogo, Mikihiko; Yamada, Kenneth M

    2004-01-01

    .... This mini-review describes a recently developed and tested set of approaches for identifying and characterizing molecules essential for branching morphogenesis and other developmental processes...

  18. Axis deviation without left bundle branch block.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo; Mancuso, Antonia

    2010-04-15

    It has been rarely reported changing axis deviation in the presence of left bundle branch block also during atrial fibrillation and with acute myocardial infarction too. It has also been rarely reported changing axis deviation with changing bundle branch block with onset of atrial fibrillation during acute myocardial infarction. We present a case of axis deviation without left bundle branch block and without atrial fibrillation and acute myocardial infarction in a 65-year-old Italian man. To our knowledge, this is the first report of axis deviation without left bundle branch block and without atrial fibrillation and acute myocardial infarction. Copyright 2008 Elsevier Ireland Ltd. All rights reserved.

  19. Clinical and Translational Epidemiology Branch (CTEB)

    Science.gov (United States)

    The Clinical and Translational Epidemiology Branch focuses on factors that influence cancer progression, recurrence, survival, and other treatment outcomes, and factors associated with cancer development.

  20. Toward improved branch prediction through data mining.

    Energy Technology Data Exchange (ETDEWEB)

    Hemmert, K. Scott; Johnson, D. Eric (University of Texas at Austin)

    2009-09-01

    Data mining and machine learning techniques can be applied to computer system design to aid in optimizing design decisions, improving system runtime performance. Data mining techniques have been investigated in the context of branch prediction. Specifically, a comparison of traditional branch predictor performance has been made to data mining algorithms. Additionally, the possiblity of whether additional features available within the architectural state might serve to further improve branch prediction has been evaluated. Results show that data mining techniques indicate potential for improved branch prediction, especially when register file contents are included as a feature set.

  1. Temporal expression of extracellular matrix metalloproteinases and tissue plasminogen activator in the development of collateral vessels in the canine model of coronary occlusion.

    Science.gov (United States)

    Tyagi, S C; Kumar, S; Cassatt, S; Parker, J L

    1996-08-01

    Although heart attack is caused by occlusion of a major coronary artery, some patients have occlusion without heart attack because these patients have sufficient collateral circulation to provide an alternate pathway for blood supply to the myocardium at ischemic risk. The growth of new capillary vessels (angiogenesis) and enlargement of preexisting vessels play an important role in the collateral development. We evaluated the hypothesis that extracellular matrix metalloproteinase (MMP) expression is altered in coronary collateral arteries (0.5-1 mm o.d.) isolated from canine hearts 2-4 months after surgical placement of an ameroid occluder around the proximal left circumflex artery (n = 4), during the development of collateral vessels and restructuring new vessels. Histologic studies (hematoxylin and eosin, trichrome, and van Gieson stains) indicated cellular proliferation and increased collagen and elastin content in collateral vessels compared with comparable-sized unoccluded arterial segments of the left anterior descending (LAD) artery. In situ MMP activity of collateral vessels, measured using denatured collagen in the gel matrix, indicated an increase in total MMP activity in the intima of collateral vessels compared with normal LAD vessels. To further identify the type of MMP, tissue homogenates were prepared from collateral and LAD vessels and analyzed by SDS-PAGE zymography. The results suggest induction of gelatinase A and gelatinase B expression in collateral vessels compared with normal LAD tissue, when identical amounts of total protein were loaded onto each lane in the gel. Based on plasminogen-casein zymography, we observed the tissue plasminogen activator level to be increased in collateral vessels. On the basis of immunoblot and mRNA (Northern blot) analyses, we determined that the MMP-1 level was induced in collateral vessels 2 and 4 months after ameroid occlusion. In contrast with MMP-1, the level of TIMP-1 (tissue inhibitor of

  2. Biliary collateral veins and associated biliary abnormalities of portal hypertensive biliopathy in patients with cavernous transformation of portal vein.

    Science.gov (United States)

    Liu, Yubao; Hou, Baohua; Chen, Ren; Jin, Haosheng; Zhong, Xiaomei; Ye, Weitao; Liang, Changhong

    2015-01-01

    The purpose was to investigate magnetic resonance imaging (MRI) features of biliary collateral veins and associated biliary abnormalities of portal hypertensive biliopathy (PHB). Thirty-six patients including 18 patients with abnormal biliary changes and 18 patients as control group were involved in this study. MRI features of biliary collateral veins were analyzed. Stenosis with dilated proximal bile ducts occurred in 33.3% of patients, 27.8% of patients had irregular ductal walls, 22.2% of patients had thickened ductal walls, 16.7% of patients had angulated ductal walls, and 44.4% of patients had thickened gallbladder walls. Biliary collateral veins and associated biliary abnormalities of PHB can be detected by MRI. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. A new risk scoring model for prediction of poor coronary collateral circulation in acute non-ST-elevation myocardial infarction.

    Science.gov (United States)

    İleri, Mehmet; Güray, Ümit; Yetkin, Ertan; Gürsoy, Havva Tuğba; Bayır, Pınar Türker; Şahin, Deniz; Elalmış, Özgül Uçar; Büyükaşık, Yahya

    2016-01-01

    We aimed to investigate the clinical features associated with development of coronary collateral circulation (CCC) in patients with acute non-ST-elevation myocardial infarction (NSTEMI) and to develop a scoring model for predicting poor collateralization at hospital admission. The study enrolled 224 consecutive patients with NSTEMI admitted to our coronary care unit. Patients were divided into poor (grade 0 and 1) and good (grade 2 and 3) CCC groups. In logistic regression analysis, presence of diabetes mellitus, total white blood cell (WBC) and neutrophil counts and neutrophil to lymphocyte ratio (NLR) were found as independent positive predictors of poor CCC, whereas older age (≥ 70 years) emerged as a negative indicator. The final scoring model was based on 5 variables which were significant at p coronary collateralization in patients with acute NSTEMI.

  4. Quantification of Structural Topology in Branched Polymers

    Science.gov (United States)

    Ramachandran, Ramnath

    Complex molecular structures occur in various natural and synthetic materials. From common plastics like polyethylene to proteins like hemoglobin, the significant effect of the molecular structure of these materials on their properties cannot be understated. Hence, it is fundamental to comprehensively characterize these complex structures. In the case of polyethylene, branching plays a significant role in determining its structure-property relationships. Various characterization techniques are available to measure the branch content in polyethylene. Qualitative techniques based on gel permeation chromatography and rheology; and absolute measurements from nuclear magnetic resonance spectroscopy are commonly used to estimate branch content. Drawbacks posed by these common techniques have been well documented in literature. Further, these techniques are unable to provide a comprehensive picture of the structural topology of polyethylene which is crucial to understanding the structure-property relationships of these systems. In this dissertation, a novel scaling approach is described to quantify branching in polyethylene. The approach is useful in quantifying both short-chain and long-chain branch contents in polyethylene. Additionally, unique measurements such as average long-chain branch length and hyperbranch (branch-on-branch) content are available through this approach. Such enhanced topological information can help us better understand the effect of catalyst systems on the structure of polyethylene as well as the effect of branching on the polymer's physical properties. The scaling approach was successful in quantifying the structure of variety of model and commercial branched polyethylene systems. Specific examples of high-density and linear low-density polyethylene as well as hydrogenated polybutadienes are discussed here. The dissertation is intended to standardize and corroborate the scaling approach in quantifying the structure of branched polymers. The

  5. Branched-Chain Amino Acids

    Directory of Open Access Journals (Sweden)

    Matteo Ghiringhelli

    2015-07-01

    Full Text Available Our study is focused on evaluation and use of the most effective and correct nutrients. In particular, our attention is directed to the role of certain amino acids in cachectic patients. During parenteral nutrition in humans, physician already associates in the PN-bags different formulations including amino acids, lipids and glucose solutions or essential amino acids solution alone or exclusively branched-chain amino acids (BCAA. Studies investigated the effects of dietary BCAA ingestion on different diseases and conditions such as obesity and metabolic disorders, liver disease, muscle atrophy, cancer, impaired immunity or injuries (surgery, trauma, burns, and sepsis. BCAAs have been shown to affect gene expression, protein metabolism, apoptosis and regeneration of hepatocytes, and insulin resistance. They have also been shown to inhibit the proliferation of liver cancer cells in vitro, and are essential for lymphocyte proliferation and dendritic cell maturation. Oral or parenteral administration of these three amino acids will allow us to evaluate the real efficacy of these compounds during a therapy to treat malnutrition in subjects unable to feed themselves.

  6. Collateral Damage

    Science.gov (United States)

    1978-10-01

    Revised, October 1971. 3.13 Cockayne , Z.E., and E.V. Lofgren, "Tactical Implictions of Air B6a=1 ,ariations from Nuclear Weapon Tests," SAIReport SAI...radiation lethality is characterized by three syndromes depending upon dose (Ref. 5.34): * Hematopoietic syndrome - whole-body doses of less than 500 rads...Gastrointestinal syndrome - whole-body doses between about 500 and 2000 rads 5-16 ,ew.tologic oep.$$ion 14:5 Ot~er/ .BD so(%.CRP) Tissue Kermin (free

  7. Coronary collaterals

    NARCIS (Netherlands)

    Koerselman, Jeroen

    2004-01-01

    Cardiovascular diseases, in particular coronary artery disease, are the leading cause of death and disease in industrialized countries. Atherosclerotic changes of the arterial vessel wall constitute one of the major causes for the occurrence of cardiovascular disease. Important risk factors for

  8. Magnetic resonance imaging guided treatment of equine distal interphalangeal joint collateral ligaments: 2009-2014

    Directory of Open Access Journals (Sweden)

    Nathaniel A. White

    2016-09-01

    Full Text Available Objectives: To determine the success of treating distal interphalangeal joint collateral ligament (DIJCL desmopathy using magnetic resonance imaging (MRI guided ligament injection. Methods: Medical records of 13 adult horses diagnosed with DIJCL desmopathy using low field MRI and treated by MRI guided ligament injection of mesenchymal stem cells and/or platelet rich plasma were reviewed. Information collected included signalment, MRI diagnosis, treatment type, time to resolution of lameness and level of exercise after treatment. Results: Collateral ligament inflammation was diagnosed as a cause of lameness in 13 horses. MRI was used to guide the injection of the injured DIJCL. All lameness attributed to DIJCL desmopathy resolved with the resulting level of performance at expected (10 or less than expected (3. Conclusions and Clinical Relevance: Injection of the DIJCL can be completed in horses standing in a low field magnet guided by MRI as previously demonstrated in cadaver specimens. Administration of stem cells or PRP appears useful as a treatment for DIJCL desmopathy.

  9. Homeless Shelters' Policies on Sex Offenders: Is This Another Collateral Consequence?

    Science.gov (United States)

    Rolfe, Shawn M; Tewksbury, Richard; Schroeder, Ryan D

    2017-12-01

    The primary focus of sex offender research has been on the efficacy and collateral consequences of sex offender registration and notification (SORN) and residence restrictions. Past scholarship has found these laws to cause numerous re-entry barriers for sex offenders. Such barriers have affected sex offenders' ability to find and maintain housing, employment, and social support. Moreover, registered sex offenders (RSOs) have become homeless due to such laws. Although previous scholarship has highlighted the collateral consequences of SORN, there is a lack of scholarship addressing homeless sex offenders. Specifically, the current study assesses policies regarding RSO access to homeless shelters in a four-state region, focusing on the effect of structural, procedural, and geographic factors, as well as a shelter's proximity to children. Drawing on the loose coupling organizational framework, the findings suggest that a small maximum occupancy, unwritten policies for RSOs, being in Kentucky or Tennessee, being located near a school, and being near a higher proportion of homes with children all decrease the odds that a homeless shelter allows RSOs. Furthermore, although unwilling to make exceptions to the policies regarding RSOs, shelters were generally willing to make exceptions to other policies governing shelter accessibility.

  10. Trans-collateral angioplasty in vascular access intervention therapy for subacute occluded vessel.

    Science.gov (United States)

    Higuchi, Yusuke; Nomura, Tetsuya; Ikeda, Kisho; Kubota, Hiroshi; Miyawaki, Daisuke; Urata, Ryota; Sugimoto, Takeshi; Kato, Taku; Keira, Natsuya; Tatsumi, Tetsuya

    2016-05-07

    We describe the first reported case of successful trans-collateral angioplasty (TCA) in vascular access intervention therapy (VAIVT) for a subacute occluded lesion in the vascular access route. TCA is a technique which has been developed in the field of endovascular therapy for peripheral arterial disease and is usually applied for a long chronic total occluded lesion with no available distal puncture site. Because such lesion characteristics suitable for being applied with TCA are not usually seen in the patients who receive VAIVT, there is little opportunity when TCA is performed in VAIVT. The present patient showed subacute occlusion in the vascular access route with well-developed collateral blood vessels. Because antegrade wiring resulted in subintimal tracking, we failed to antegradely introduce the guidewire to the vascular true lumen. Moreover, no puncture site in the venous side was anatomically available. Therefore, we adopted the strategy of TCA and successfully completed the procedure. Although we rarely encounter the situation in which TCA is necessary for VAIVT, the strategy of TCA is a promising procedure if the condition permits.

  11. Comparative analysis of the structural properties of the collateral ligaments of the human knee.

    Science.gov (United States)

    Wilson, William T; Deakin, Angela H; Payne, Anthony P; Picard, Frederic; Wearing, Scott C

    2012-04-01

    Controlled laboratory study. Varus knee instability arising from lateral collateral ligament (LCL) injury increases stress on cruciate ligament grafts, potentially leading to failure of reconstructed ligaments. In contrast to the medial collateral ligament (MCL), little is known about the structural properties of the LCL. To compare the tensile properties of the LCL and MCL complex of the human knee joint. Ten fresh-frozen cadaveric knees (mean ± SD age, 81 ± 11 years), free of gross musculoskeletal pathology, were obtained. Following dissection, the length, width, and thickness of the ligaments were measured using calipers, and bone-ligament-bone preparations were mounted in a uniaxial load frame. After preconditioning, specimens were extended to failure at a rate of 500 mm/min (approximately 20%/s). Force and crosshead displacement were used to calculate structural properties, including stiffness, yield strength, ultimate tensile strength, and failure energy. The fan-shaped MCL was significantly longer (60%; Pligaments (MCL, 63 ± 14 N/mm; LCL, 59 ± 12 N/mm). Despite differences in geometry and strength, there was no significant difference in stiffness of the MCL and LCL when tested in vitro.

  12. [Resveratrol improves coronary collateral circulation in pigs with experimental acute coronary occlusion].

    Science.gov (United States)

    Wang, Zhi-rong; Xu, Wu; Zhang, Chao-qun; Xie, Wei; Zhou, Zhao-feng; Zhou, Xiao-feng; Zhang, Zhuo-qi

    2011-10-01

    To evaluate the impact of resveratrol on coronary collateral circulation in pigs suffered from experimental acute coronary occlusion. Eighteen healthy pigs were randomly divided into 3 groups: resveratrol group, nitroglycerin group and control group. Animal model of acute coronary occlusion was established through PTCA method, and the blood flow spectrum in the left circumflex artery (LCX) was detected using intracoronary Doppler ultrasound. The average peak velocity (APV) in infarction correlation artery (IRA) was significantly decreased immediately after coronary occlusion [(0.85 ± 0.25) cm/s vs. (24.83 ± 3.43) cm/s, P coronary injection of resveratrol (2 mg) or nitroglycerin (0.3 mg). There was no significant difference in peak APV between the resveratrol and nitroglycerin groups. The duration of increased APV was significantly longer in resveratrol group than that in nitroglycerin group [(58.83 ± 6.15) min vs. (21.80 ± 5.79) min, P circulation after acute coronary occlusion was obviously insufficient in pigs. Resveratrol could significantly improve the blood flow in coronary collateral circulation after acute occlusion in this model.

  13. CFD simulation of blood flow inside the corkscrew collaterals of the Buerger's disease.

    Science.gov (United States)

    Sharifi, Alireza; Charjouei Moghadam, Mohammad

    2016-01-01

    Buerger's disease is an occlusive arterial disease that occurs mainly in medium and small vessels. This disease is associated with Tobacco usage. The existence of corkscrew collateral is one of the established characteristics of the Buerger's disease. In this study, the computational fluid dynamics (CFD) simulation of blood flow within the corkscrew artery of the Buerger's disease is conducted. The geometry of the artery is constructed based on the actual corkscrew artery of a patient diagnosed with the Buerger's disease. The blood properties are the same as the actual blood properties of the patient. The blood flow rate is taken from the available experimental data in the literature. The local velocity patterns, pressure and kinematic viscosity distributions in different segments of the corkscrew collateral artery was demonstrated and discussed for the first time for this kind of artery. The effects of non-Newtonian consideration for the blood viscosity behavior were investigated in different segments of the artery. Moreover, the variations of the blood flow patterns along the artery were investigated in details for each segment. It was found that the flow patterns were affected by the complex geometry of this artery in such a way that it could lead to the presence of sites that were prone to the accumulation of the flowing particles in blood like nicotine. Furthermore, due to the existence of many successive bends in this artery, the variations of kinematic viscosity along this artery were significant, therefore the non-Newtonian behavior of the blood viscosity must be considered.

  14. Does rich coronary collateral circulation distal to chronically occluded left anterior descending artery compete with graft flow?

    Science.gov (United States)

    Kaku, Daisuke; Nakahira, Atsushi; Hirai, Hidekazu; Sasaki, Yasuyuki; Hosono, Mitsuharu; Bito, Yasuyuki; Suehiro, Yasuo; Suehiro, Shigefumi

    2013-12-01

    In coronary artery bypass grafting (CABG), graft flow distal to a mild stenosis can compete with relatively preserved native flow through the stenosis and the competition can result in graft stenosis. In chronic total occlusion (CTO), coronary collateral circulation, which is essential to maintain myocardial viability distal to CTO, varies in extent among patients and the extent can be scored by Rentrop grade in coronary angiography. We investigated whether rich collateral circulation distal to CTO competes with distally anastomosed graft flow in association with Rentrop grade. Of 666 patients who underwent CABG from January 2001 to December 2012, 70 patients whose left internal thoracic artery (ITA) was grafted distal to CTO in the left anterior descending artery (LAD) were divided into three groups: Poor collaterals (Rentrop grades 0 and 1, Group P, n = 22), Moderate collaterals (grade 2, Group M, n = 23) and Rich collaterals (grade 3, Group R, n = 25). The intraoperative measurements of mean graft flow (MGF) and pulsatility index (PI) of left ITA grafts, early graft patency and long-term clinical outcomes were compared. The MGF and PI of left ITA grafts differed significantly among the three groups (P = 0.025 and P = 0.046, respectively). Lower Rentrop grade was associated with preferable results of higher MGF and lower PI. The graft flow pattern in Group P showed a significantly higher MGF (P = 0.020) and lower PI (P = 0.041) than those in Group R. All early postoperative coronary angiograms showed patent left ITA grafts. Serial echocardiographic evaluations, survival rates and cardiac event-free rates were comparable with the follow-up of 5.00 ± 3.11 years. Rich collateral circulation distal to CTO in LADs can potentially compete with graft flow, although the competition seems not to affect clinical outcomes probably due to the regression of collaterals surmounted by the graft flow. Rentrop grade is shown to certainly reflect the degree of collateral

  15. Association of Collateral Blood Vessels Detected by Arterial Spin Labeling Magnetic Resonance Imaging With Neurological Outcome After Ischemic Stroke.

    Science.gov (United States)

    de Havenon, Adam; Haynor, David R; Tirschwell, David L; Majersik, Jennifer J; Smith, Gordon; Cohen, Wendy; Andre, Jalal B

    2017-04-01

    Robust collateral blood vessels have been associated with better neurologic outcome following acute ischemic stroke (AIS). The most commonly used methods for identifying collaterals are contrast-based angiographic imaging techniques, which are not possible in all patients after AIS. To assess the association between the presence of collateral vessels identified using arterial spin labeling (ASL) magnetic resonance imaging, a technique that does not require exogenous administration of contrast, and neurologic outcome in patients after AIS. This retrospective cohort study examined 38 patients after AIS admitted to a tertiary academic medical center between 2012 and 2014 who underwent MRI with ASL. According to a prespecified hypothesis, ASL images were graded for the presence of collaterals by 2 neuroradiologists. Modified Rankin Scale (mRS) scores at discharge and other composite data were abstracted from the medical record by a neurologist blinded to radiologic data. Of the 38 patients, 19 (50.0%) were male, and the mean (SD) age was 61 (20) years. In 25 of 38 patients (65.8%), collaterals were detected using ASL, which were significantly associated with both a good outcome (mRS score of 0-2 at discharge; P = .02) and a 1-point decrease in mRS score at discharge (odds ratio, 6.4; 95% CI, 1.7-23.4; P = .005). In a multivariable ordinal logistic regression model, controlling for admission National Institutes of Health Stroke Scale score, history of atrial fibrillation, premorbid mRS score, and stroke parent artery status, there was a strong association between the presence of ASL collaterals and a 1-point decrease in the mRS score at discharge (odds ratio, 5.1; 95% CI, 1.2-22.1; P = .03). Following AIS, the presence of ASL collaterals is strongly associated with better neurological outcome at hospital discharge. This novel association between ASL collaterals and improved neurologic outcome may help guide prognosis and management, particularly in patients

  16. 3D modelling of branching in plants

    NARCIS (Netherlands)

    Evers, J.B.

    2011-01-01

    Shoot branching is a key determinant of overall aboveground plant form. During plant development, the number of branches formed strongly influences the amount of light absorbed by the plant, and thus the plant’s competitive strength in terms of light capture in relation to neighbouring plants.

  17. A Unifying Theory of Branching Morphogenesis

    NARCIS (Netherlands)

    Hannezo, Edouard; Scheele, Colinda L G J; Moad, Mohammad; Drogo, Nicholas; Heer, Rakesh; Sampogna, Rosemary V; van Rheenen, Jacco; Simons, Benjamin D

    2017-01-01

    The morphogenesis of branched organs remains a subject of abiding interest. Although much is known about the underlying signaling pathways, it remains unclear how macroscopic features of branched organs, including their size, network topology, and spatial patterning, are encoded. Here, we show that,

  18. Variants of the left aortic arch branches

    African Journals Online (AJOL)

    ORIGINAL ARTICLE. Variants of the left aortic arch branches. N Z Makhanya. MB ChB. R T Mamogale. MB 0113. N Khan. FCRaD (0). Department of Diagnostic Radiology. Medical University of Southern Africa. Abstract. The normal aorta has three branches from its arch, but variations in this pattern are not uncommon. Our.

  19. [Value of evaluating the coronary collateral circulation by transluminal attenuation gradient in patients with chronic total occlusion and related influencing factors].

    Science.gov (United States)

    Chen, Y L; Wang, R; He, Y; Li, J N; Yuan, F; Tian, R; Ge, C J; Zhou, Y; Huang, R C; Cui, S; Song, X T

    2017-10-24

    Objective: To observe the value of evaluating the coronary collateral circulation of chronic total occlusion (CTO) by transluminal attenuation gradient (TAG) and Rentrop grading, and analyze the influencing factors for coronary collateral circulation. Methods: A total of 179 CTO patients admitted to Beijing Anzhen hospital during June 2013 to August 2016 were included in this study.All patients received coronary computed tomographic angiography (CCTA) examination before coronary angiography.Finally, 75 patients (79 vessels) were enrolled.Patients were divided into two groups on the basis of Rentrop classification.The Rentrop 3 was defined as a well-developed coronary collateral circulation group, including 50 CTO vessels, Rentrop 2 or below was defined as poorly-developed collateral circulation group, including 29 vessels.TAG values in patients with various Rentrop grades were analyzed.Univariate and multivariate analysis were used to determine the predictors of collateral circulation. Results: TAG increased consistently in proportion to the angiographic extent of collateral flow (TAG was (-33.6±24.4), (-16.5±15.7) and (-12.8±15.8) HU/10 mm in patients with Rentrop grade 0 or 1, 2 and 3, respectively, P=0.007). Number of good collateral circulation vessels predicted by TAG≥15.6 HU/10 mm was 45(57.0%, 45/79), and 50 (63.3%, 50/79) by Rentrop grade (P=0.383). Prevalence of diabetes was significantly lower (20.8%(10/48) vs. 48.1%(13/27), P=0.01), while history of previous myocardial infarction (MI) was significantly higher (35.4%(17/48) vs. 11.1%(3/27), P=0.02) in patients with good collateral circulation than in patients with poor collateral circulation.The TAG of the good collateral circulation group was significantly higher than in poorly collateral circulation group ((-12.8±15.8) HU/10 mm vs. (-21.2±19.6) HU/10mm, P=0.041). Multiple logistic regression analysis revealed that history of MI (OR=0.196, 95%CI 0.041-0.936, P=0.041) and diabetes(OR=6.604, 95%CI 1

  20. The influence of genotype on vascular endothelial growth factor and regulation of myocardial collateral blood flow in patients with acute and chronic coronary heart disease

    DEFF Research Database (Denmark)

    Ripa, R.S.; Jorgensen, E.; Baldazzi, F.

    2009-01-01

    OBJECTIVE: To test the hypothesis that mutations in the vascular endothelial growth factor (VEGF) gene are associated with plasma concentration of VEGF and subsequently the ability to influence coronary collateral arteries in patients with coronary heart disease (CHD). METHODS: Blood samples from...... patients with chronic ischemic heart disease (n=53) and acute coronary syndrome (n=61) were analysed. Coronary collaterals were scored from diagnostic biplane coronary angiograms. RESULTS: The plasma concentration of VEGF was increased in patients with acute compared to chronic CHD (p=0.01). The genotype......-1154 and coronary collateral size (p=0.03) and a significant association between the VEGF plasma concentration and the collateral size (p=0.03). CONCLUSION: VEGF plasma concentration seems related to coronary collateral function in patients with CHD. The results did not support the hypothesis...

  1. [Coronary collateral circulation in infarction-related artery in patients with acute myocardial infarction with rise and without rise of ST segment].

    Science.gov (United States)

    Iaitskiĭ, N A; Zverev, O G; Volkov, A B; Voĭnov, A V; Abdulragimov, R I

    2014-01-01

    The authors analyzed a condition of coronary collateral circulation in infarction-related artery in patients with acute myocardial infarction with rise and without rise of ST segment. The assessment of collateral circulation was made by coronary angiography using Rentop scale. Results of the research showed, that collateral circulation wasn't visualized by angiography in the first hours after acute myocardial infarction with the rise of ST segment. Apparently, this circulation didn't significantly assisted in maintenance of vital capacity of the myocardium in the pool of infarction-related occlusive coronary artery. Visualization of collateral circulation was noted in majority of patients with acute myocardial infarction without the rise of ST segment. Collateral flow was an important alternative source of blood supply of the heart in patients without rise of ST segment in the period of critical reduction of the antegrade blood flow.

  2. Measurement of CP Asymmetries and Branching Fractions in B to pi pi and B to K pi Decays.

    Energy Technology Data Exchange (ETDEWEB)

    Aubert, B

    2006-09-26

    The authors present preliminary measurements of the Cp asymmetries and branching fractions for B {yields} {pi}{pi} and B {yields} K{pi} decays. A total of 347 million B{bar B} events collected by the BABAR detector at the PEP-II asymmetric-energy e{sup +}e{sup -} collider at SLAC are used for these results.

  3. Importance of anatomically locating the infrapatellar branch of the saphenous nerve in reconstructing the anterior cruciate ligament using flexor tendons,

    Directory of Open Access Journals (Sweden)

    Julio Cesar Gali

    2014-12-01

    Full Text Available Objective:To describe the path of the infrapatellar branch of the saphenous nerve (IBSN using the medial joint line, anterior tibial tuberosity (ATT, tibial collateral ligament and a horizontal line parallel to the medial joint line that passes over the ATT, as reference points, in order to help surgeons to diminish the likelihood of injuring this nerve branch during reconstruction of the anterior cruciate ligament (ACL using flexor tendons.Methods:Ten frozen knees that originated from amputations were examined. Through anatomical dissection performed with the specimens flexed, we sought to find the IBSN, from its most medial and proximal portion to its most lateral and distal portion. Following this, the anatomical specimens were photographed and, using the ImageJ software, we determined the distance from the IBSN to the medial joint line and to a lower horizontal line going through the ATT and parallel to the first line. We also measured the angle of the direction of the path of the nerve branch in relation to this lower line.Results:The mean angle of the path of the nerve branch in relation to the lower horizontal line was 17.50 ±6.17°. The mean distance from the IBSN to the medial joint line was 2.61 ± 0.59 cm and from the IBSN to the lower horizontal line, 1.44 ±0.51 cm.Conclusion:The IBSN was found in all the knees studied. In three knees, we found a second branch proximal to the first one. The direction of its path was always from proximal and medial to distal and lateral. The IBSN was always proximal and medial to the ATT and distal to the medial joint line. The medial angle between its direction and a horizontal line going through the ATT was 17.50 ± 6.17°.

  4. Thermal Neutron Capture Branching Ratio of 209BI Using a Gamma-Ray Technique

    Science.gov (United States)

    Letourneau, A.; Berthoumieux, E.; Deruelle, O.; Fadil, M.; Fioni, G.; Gunsing, F.; Marie, F.; Perrot, L.; Ridikas, D.; Boerner, H.; Faust, H.; Mutti, P.; Simpson, G.; Schillebeeckx, P.

    2003-06-01

    A new experimental program concerning the measurement of the neutron capture branching ratio of 209Bi as a function of neutron energy has been proposed recently. The preliminary results obtained at the high neutron flux reactor of ILL with a thermal neutron flux are presented in this paper. The neutron capture cross section and the corresponding branching ratio are measured with an on-line gamma-ray spectroscopy method. We find for the capture cross section 35±1.75 mb, what is in a good agreement with existing results. For the partial cross sections we get σ210gs = 17.9±2 mb and σ210m =17.1±2 mb giving a branching ratio of 51%±5%. This value is by 25% smaller than values from evaluated libraries.

  5. [Croatian Medical Association--Branch Zagreb].

    Science.gov (United States)

    Kaić, Zvonimir; Sain, Snjezana; Gulić, Mirjana; Mahovlić, Vjekoslav; Krznarić, Zeljko

    2014-01-01

    The available literature shows us that "Druztvo ljeciteljah u Zagrebus (the Society of Healers in Zagreb) was founded as far back as the year 1845 by a total of thirteen members. This data allows us to follow the role of doctors and health workers in Zagreb through their everyday profession, research, organizational and social work as well as management through a period of over one hundred to seventy years. The Branch Zagreb was active before the official establishment of subsidiaries of CMA which is evident from the minutes of the regular annual assembly of the Croatian Medical Association on 21 March 1948. Until the end of 1956, there was no clear division of labor, functions and competencies between the Branch and the Main Board. Their actions were instead consolidated and the Branch operated within and under the name of Croatian Medical Association. In that year the Branch became independent. The Branch Zagreb is the largest and one of the most active branches of the Croatian Medical Association. At the moment, the Branch brings together 3621 members, regular members--doctors of medicine (2497), doctors of dental medicine (384), retired physicians (710), and associate members (30 specialists with higher education who are not doctors). The Branch is especially accomplished in its activities in the area of professional development of its members and therefore organizes a series of scientific conferences in the framework of continuous education of physicians, allowing its members to acquire necessary points for the extension of their operating license. The choir "Zagrebacki lijecnici pjevaci" (Zagreb Physicians' Choir) of the Croatian Medical Music Society of the CMA and its activities are inseparable from the Branch Zagreb. The Branch is firmly linked to the parent body, the CMA, and thus has a visible impact on the strategy and the activities of the Association as a whole. Most professional societies of the CMA have their headquarters in Zagreb and this is

  6. WW cross section and branching fraction measurements at LEP

    CERN Document Server

    Malgeri, L

    1999-01-01

    In two years of running at energies above WW production threshold, LEP-II provided each experiment an integrated luminosity of ~80 pb /sup -1/ until the end of 1997. The amount of collected events, ~1000 /experiment, allows to measure with high precision the total e/sup + /e/sup -/ to WW cross section: sigma /sub WW/( square root s=182.7 Ge V)=15.89+or-0.40 pb and the W-boson decay branching fractions: BR(W to qq)=68.79+or-0.77% and BR(W to l nu /sub l/)=10.40+or-0.26%, both in good agreement with Standard Model expectations. The W decay branching fractions and the total WW cross section are also used to extract a value for the Cabibbo-Kobayashi-Mas kawa matrix element V /sub cs/ and to put stringent limits on the invisible W width, Gamma /sub W//sup in upsilon /. A preliminary and incomplete look at the first data of this year, which is foreseen to increase the available statistics by four times, is also herein presented. (14 refs).

  7. Mechanisms of Side Branching and Tip Splitting in a Model of Branching Morphogenesis

    Science.gov (United States)

    Guo, Yina; Sun, Mingzhu; Garfinkel, Alan; Zhao, Xin

    2014-01-01

    Recent experimental work in lung morphogenesis has described an elegant pattern of branching phenomena. Two primary forms of branching have been identified: side branching and tip splitting. In our previous study of lung branching morphogenesis, we used a 4 variable partial differential equation (PDE), due to Meinhardt, as our mathematical model to describe the reaction and diffusion of morphogens creating those branched patterns. By altering key parameters in the model, we were able to reproduce all the branching styles and the switch between branching modes. Here, we attempt to explain the branching phenomena described above, as growing out of two fundamental instabilities, one in the longitudinal (growth) direction and the other in the transverse direction. We begin by decoupling the original branching process into two semi-independent sub-processes, 1) a classic activator/inhibitor system along the growing stalk, and 2) the spatial growth of the stalk. We then reduced the full branching model into an activator/inhibitor model that embeds growth of the stalk as a controllable parameter, to explore the mechanisms that determine different branching patterns. We found that, in this model, 1) side branching results from a pattern-formation instability of the activator/inhibitor subsystem in the longitudinal direction. This instability is far from equilibrium, requiring a large inhomogeneity in the initial conditions. It successively creates periodic activator peaks along the growing stalk, each of which later on migrates out and forms a side branch; 2) tip splitting is due to a Turing-style instability along the transversal direction, that creates the spatial splitting of the activator peak into 2 simultaneously-formed peaks at the growing tip, the occurrence of which requires the widening of the growing stalk. Tip splitting is abolished when transversal stalk widening is prevented; 3) when both instabilities are satisfied, tip bifurcation occurs together with side

  8. Mechanisms of side branching and tip splitting in a model of branching morphogenesis.

    Directory of Open Access Journals (Sweden)

    Yina Guo

    Full Text Available Recent experimental work in lung morphogenesis has described an elegant pattern of branching phenomena. Two primary forms of branching have been identified: side branching and tip splitting. In our previous study of lung branching morphogenesis, we used a 4 variable partial differential equation (PDE, due to Meinhardt, as our mathematical model to describe the reaction and diffusion of morphogens creating those branched patterns. By altering key parameters in the model, we were able to reproduce all the branching styles and the switch between branching modes. Here, we attempt to explain the branching phenomena described above, as growing out of two fundamental instabilities, one in the longitudinal (growth direction and the other in the transverse direction. We begin by decoupling the original branching process into two semi-independent sub-processes, 1 a classic activator/inhibitor system along the growing stalk, and 2 the spatial growth of the stalk. We then reduced the full branching model into an activator/inhibitor model that embeds growth of the stalk as a controllable parameter, to explore the mechanisms that determine different branching patterns. We found that, in this model, 1 side branching results from a pattern-formation instability of the activator/inhibitor subsystem in the longitudinal direction. This instability is far from equilibrium, requiring a large inhomogeneity in the initial conditions. It successively creates periodic activator peaks along the growing stalk, each of which later on migrates out and forms a side branch; 2 tip splitting is due to a Turing-style instability along the transversal direction, that creates the spatial splitting of the activator peak into 2 simultaneously-formed peaks at the growing tip, the occurrence of which requires the widening of the growing stalk. Tip splitting is abolished when transversal stalk widening is prevented; 3 when both instabilities are satisfied, tip bifurcation occurs

  9. Surgical strategy to minimize ischemia during trapping/resection of giant extracranial carotid artery aneurysm stratified by collateral evaluation.

    Science.gov (United States)

    Hongo, Hiroki; Inoue, Tomohiro; Tamura, Akira; Saito, Isamu

    2017-01-01

    Extracranial carotid artery aneurysm (ECAA) is a rare clinical entity, and no standard treatment strategy has been established for this condition. Data from three patients who underwent surgical treatment of enlarging giant ECAAs were retrospectively reviewed. Based on the collateral status, as evaluated by preoperative digital subtraction angiography (DSA), surgical strategy was stratified into (1) high flow bypass followed by cervical ICA (internal carotid artery) ligation, when the collateral status was judged as poor/fair or (2) direct cervical repair with patch application after aneurysmal wall resection when the collateral status was judged as robust. Postoperative results were evaluated by magnetic resonance imaging (MRI). Postoperative follow-up (day 0 to 1, as well as midterm at approximately 6 months) confirmed completely trapped aneurysm with successful robust bypass and robust anterograde flow of the reconstructed cervical carotid artery on magnetic resonance angiography with no additional ischemic lesions on diffusion weighted imaging and T2-weighted imaging when compared with preoperative imaging in all three patients. Postoperatively, there was no stroke event during the midterm follow-up at 6 months. Clinical results of ECAAs treated by a surgical strategy stratified based on collateral status, as evaluated by preoperative DSA, were favorable, without postoperative ischemic event, and with satisfactory mid-term MRI results.

  10. Does high-quality auditing decrease the use of collateral? Analysis from the perspective of lenders’ self-protection

    Directory of Open Access Journals (Sweden)

    Yang Yang

    2014-09-01

    Full Text Available We examine the association between audit quality and the use of collateral in a sample of Chinese firms from 2005 to 2011. Using the full sample, we document a negative relationship between audit quality and the use of collateral that is consistent with lenders’ interests. We also show that audit quality and collateral are regarded as alternative means of reducing debt credit risk. Our conclusions are robust after using an auditor-switching test, the Heckman two-stage model and a propensity-score matching model to address endogeneity issues. China’s institutional background is also considered. First, we find that in the group of firms in which large shareholders are able to control borrowers’ activities, the substitution effects between collateral and audit quality are reduced when the degree of separation between large shareholders’ control and ownership is high. Second, these substitution effects are greater when the borrowers’ ultimate controller is a state-owned enterprise (SOE rather than a non-state-owned enterprise (NSOE. Third, the differences in substitution effects between NSOEs and SOEs are smaller in areas with a high market-development index. We conclude that the substitution effects are smaller in high credit risk firms than in low credit risk firms.

  11. The Dual Role of Cerebral Autoregulation and Collateral Flow in the Circle of Willis After Major Vessel Occlusion.

    Science.gov (United States)

    Kennedy McConnell, Flora; Payne, Stephen

    2017-08-01

    Ischaemic stroke is a leading cause of death and disability. Autoregulation and collateral blood flow through the circle of Willis both play a role in preventing tissue infarction. To investigate the interaction of these mechanisms a one-dimensional steady-state model of the cerebral arterial network was created. Structural variants of the circle of Willis that present particular risk of stroke were recreated by using a network model coupled with: 1) a steady-state physiological model of cerebral autoregulation; and 2) one wherein the cerebral vascular bed was modeled as a passive resistance. Simulations were performed in various conditions of internal carotid and vertebral artery occlusion. Collateral flow alone is unable to ensure adequate blood flow ([Formula: see text] normal flow) to the cerebral arteries in several common variants during internal carotid artery occlusion. However, compared to a passive model, cerebral autoregulation is better able to exploit available collateral flow and maintain flows within [Formula: see text] of baseline. This is true for nearly all configurations. Hence, autoregulation is a crucial facilitator of collateral flow through the circle of Willis. Impairment of this response during ischemia will severely impact cerebral blood flows and tissue survival, and hence, autoregulation should be monitored in this situation.

  12. The Effects of a Peer-Yoked Contingency on Observational Learning and the Collateral Emergence of Naming

    Science.gov (United States)

    Rothstein, Mindy Bunya; Gautreaux, Grant Gerard

    2007-01-01

    We tested the effects of a Peer-Yoked Contingency on students' acquisition of observational learning repertoires and collateral effects on naming. Three male middle school participants, diagnosed with emotional and behavioral disabilities, were selected for this study. The three participants did not have naming repertoires, and two of the three…

  13. Blood flow and vascular reactivity in collaterally perfused brain tissue. Evidence of an ischemic penumbra in patients with acute stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Larsen, B; Herning, M

    1983-01-01

    In a group of 48 patients with completed stroke, 8 patients had viable collaterally perfused brain tissue which was accessible for rCBF recordings with a two dimensional technique. All 8 had deep subcortical infarcts on CT-scan, and angiographic occlusion of the arteries normally supplying...

  14. 12 CFR 221.120 - Allocation of stock collateral to purpose and nonpurpose credits to same customer.

    Science.gov (United States)

    2010-01-01

    ... nonpurpose credits to same customer. 221.120 Section 221.120 Banks and Banking FEDERAL RESERVE SYSTEM... § 221.120 Allocation of stock collateral to purpose and nonpurpose credits to same customer. (a) A bank... be extended at the same time, each would be evidenced by a separate agreement. Credit A would be...

  15. Female CFOs and loan contracting: Financial conservatism or gender discrimination? – An empirical test based on collateral clauses

    Directory of Open Access Journals (Sweden)

    Xixiong Xu

    2016-06-01

    Full Text Available Based on signaling and gender discrimination theory, we examine whether chief financial officer (CFO gender matters to bank–firm relationships and the designing of collateral clauses in bank loan contracting, and explore the potential path of influence. Data taken from Chinese listed companies between 2009 and 2012 indicate that (1 female-CFO-led firms are less likely to obtain credit loans than male-CFO-led firms; (2 female-CFO-led borrowers are more likely to be required to provide collateral for loans than male-CFO-led borrowers; and (3 banks are more inclined to claim mortgaging collateral when lending to female-CFO-led firms and prefer to guarantee collateral when lending to male-CFO-led firms. Female-CFO-led borrowers seem to be granted more unfavorable loan terms than male-CFO-led borrowers, supporting the hypothesis that female CFOs experience credit discrimination. Further analysis reveals that regional financial development helps to alleviate lending discrimination against female CFOs. Furthermore, female CFOs in SOEs are less likely than their non-SOE counterparts to experience gender discrimination in the credit market.

  16. The relationship of plasma decoy receptor 3 and coronary collateral circulation in patients with coronary artery disease.

    Science.gov (United States)

    Yan, Youyou; Song, Dandan; Liu, Lulu; Meng, Xiuping; Qi, Chao; Wang, Junnan

    2017-11-15

    Previously, decoy receptor 3 (DcR3) was found to be a potential angiogenetic factor, while the relationship of DcR3 with coronary collateral circulation formation has not been investigated. In this study, we aimed to investigate whether plasma decoy receptor 3 levels was associated with CCC formation and evaluate its predictive power for CCC status in patients with coronary artery disease. Among patients who underwent coronary angiography with coronary artery disease and had a stenosis of ≥90% were included in our study. Collateral degree was graded according to Rentrope Cohen classification. Patients with grade 2 or 3 collateral degree were enrolled in good CCC group and patients with grade 0 or 1 collateral degree were enrolled in poor CCC group. Plasma DcR3 level was significantly higher in good CCC group (328.00±230.82 vs 194.84±130.63ng/l, p<0.01) and positively correlated with Rentrope grade (p<0.01). In addition, plasma DcR3 was also positively correlated with VEGF-A. Both ROC (receiver operating characteristic curve) and multinomial logistical regression analysis showed that plasma DcR3 displayed potent predictive power for CCC status. Higher plasma DcR3 level was related to better CCC formation and displayed potent predictive power for CCC status. Copyright © 2017. Published by Elsevier Inc.

  17. Cellular and physical mechanisms of branching morphogenesis

    Science.gov (United States)

    Varner, Victor D.; Nelson, Celeste M.

    2014-01-01

    Branching morphogenesis is the developmental program that builds the ramified epithelial trees of various organs, including the airways of the lung, the collecting ducts of the kidney, and the ducts of the mammary and salivary glands. Even though the final geometries of epithelial trees are distinct, the molecular signaling pathways that control branching morphogenesis appear to be conserved across organs and species. However, despite this molecular homology, recent advances in cell lineage analysis and real-time imaging have uncovered surprising differences in the mechanisms that build these diverse tissues. Here, we review these studies and discuss the cellular and physical mechanisms that can contribute to branching morphogenesis. PMID:25005470

  18. A new site for venous access: superficial veins of portal collateral circulation.

    Science.gov (United States)

    Turc, Jean; Gergelé, Laurent; Attof, Rachid; Mottard, Nicolas; Bérend, Michel; David, Jean-Stéphane

    2012-01-01

    In case of failure of peripheral vascular access, classical alternatives are central venous or intraosseous access. We report a new site of vascular access necessitating no specific material. A 53-year-old patient with cirrhosis-induced coagulopathy, portal hypertension, and collateral abdominal portosystemic circulation required parenteral antibiotherapy. After failure of peripheral vein catheterization, he was addressed to our resuscitation room for central venous access. To avoid the risks associated with this invasive procedure, we chose an alternative approach. After skin preparation, a 20-gauge peripheral venous catheter was inserted in a dilated subcutaneous vein of abdominal wall. To our knowledge, it is the first human report of insertion of a catheter in a superficial vein of abdominal wall. It could be an alternative approach for vascular access after failure of peripheral venipuncture in patients with portal hypertension.

  19. An Unusual Knee Trauma: Combined Rupture of Medial Collateral Ligament and Patellar Tendon

    Directory of Open Access Journals (Sweden)

    T. De Baere

    2014-01-01

    Full Text Available We present the case of a combined lesion of the medial collateral ligament (MCL and patellar tendon of the knee in a 45-year-old man, after a fall while skiing. Although there are numerous publications concerning associated tears of MCL and other knee ligaments, a combination of MCL tear with a rupture of the patellar tendon is very rare. After a review of the literature and treatment guidelines about these lesions, the clinical case is described and discussed. This knee trauma was treated with a transosseous reinsertion of the patellar tendon, which was reinforced by an allograft of fascia lata, followed by a direct suture of the MCL, which was reinforced with the lateral semitendinosus tendon.

  20. Effects of collateral peer supportive behaviors within the classwide peer tutoring program.

    Science.gov (United States)

    Kohler, F W; Greenwood, C R

    1990-01-01

    A classwide peer tutoring procedure was implemented in an urban elementary school classroom to improve students' spelling performance. Three students combined untrained or collateral tutoring behaviors with the core behaviors initially taught. To explore the function of these natural and spontaneous behaviors, a multielement single-subject experiment with replications was conducted. Results indicated that the additional tutoring behaviors increased (a) the academic response frequencies of 3 tutees and (b) the weekly spelling achievement of 1 target tutee. The remaining class members were successfully taught and continued to use these behaviors over the final 3 weeks of the school year. These findings are discussed with regard to academic instruction, natural communities of peer reinforcement, and the social validation of intervention procedures.

  1. Arthroscopic trans-portal deep medial collateral ligament pie-crusting release.

    Science.gov (United States)

    Atoun, Ehud; Debbi, Ronen; Lubovsky, Omri; Weiler, Andreas; Debbi, Eytan; Rath, Ehud

    2013-02-01

    Arthroscopic treatments of meniscal injuries of the knee are among the most common orthopaedic procedures performed. Adequate visualization of the posterior horn of the medial meniscus might be challenging, especially in patients with tight medial compartments. In these cases instrument manipulation in an attempt to reach the posterior horn of the meniscus can cause an iatrogenic chondral injury because of the narrow medial joint space. A transcutaneous medial collateral ligament (MCL) pie-crusting release facilitates expansion of the medial joint space in a case of a tight medial compartment. Nevertheless, it might cause injury to the superficial MCL, infection, and pain and injury to the saphenous nerve because of multiple needle punctures of the skin. We describe an inside-out, arthroscopic deep MCL pie-crusting release, which allows access to the medial meniscus through the anterior approach to provide good visualization of the footprint and sufficient working space.

  2. Primary Repair of Iatrogenic Medial Collateral Ligament Injury During TKA: A Modified Technique.

    Science.gov (United States)

    Shahi, Alisina; Tan, Timothy L; Tarabichi, Samih; Maher, Ahmed; Della Valle, Craig; Saleh, Usama Hassan

    2015-05-01

    Intraoperative injury to the medial collateral ligament (MCL) is a rare but important complication of total knee arthroplasty (TKA). While described treatment methods are mainly primary repair and revision with a more constrained implant, a few studies have investigated the outcomes of primary repair without constrained implants. A retrospective study was performed to evaluate the prevalence of iatrogenic injury to the MCL during primary TKA and determine the clinical outcomes of MCL repair augmented with synthetic material without the use of a constrained device. The incidence of intraoperative tear of the MCL was 0.43% (15/3432). No patient demonstrated instability during the follow-up period. Primary repair of iatrogenic MCL injury without the use of constrained implants appears to be a potential alternative that warrants further investigation. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Association between uric acid and coronary collateral circulation in patients with stable coronary artery disease.

    Science.gov (United States)

    Uysal, Onur Kadir; Sahin, Durmus Yildiray; Duran, Mustafa; Turkoglu, Caner; Yildirim, Arafat; Elbasan, Zafer; Ozkan, Bugra; Tekin, Kamuran; Kunak, Aysegul Ulgen; Yilmaz, Yucel; Kaya, Mehmet Gungor; Gur, Mustafa; Cayli, Murat

    2014-03-01

    Serum uric acid (SUA) levels have been proposed as a biomarker of coronary artery disease (CAD) and coronary collateral circulation (CCC). We investigated the association between SUA levels and development of CCC in patients with stable CAD. Consecutive patients (n = 480) with stable CAD who underwent coronary angiography and documented total occlusion in 1 of the major coronary arteries were included in this study. Levels of fasting blood glucose, white blood cell (WBC), creatinine, platelet count, and SUA were significantly higher in patients with poor CCC than in those with good CCC. After multivariate analysis, high levels of SUA were an independent predictor of CCC together with levels of fasting blood glucose and WBC. The receiver-operating characteristic analysis provided a cutoff value of 5.65 mg/dL for SUA to predict poor CCC with 60% sensitivity and 66% specificity. High levels of SUA may be associated with poor CCC in patients with stable CAD.

  4. Collaterals: an Important Determinant of Prolonged Ischemic Penumbra versus Rapid Cerebral Infarction?

    Directory of Open Access Journals (Sweden)

    Elisabeth Breese Marsh

    2014-10-01

    Full Text Available Intravenous tissue plasminogen activator is the mainstay for the treatment of acute ischemic stroke in patients presenting within 4.5 hours of symptom onset. Studies have demonstrated that treating patients early leads to improved long term outcomes. MR imaging currently allows quantification of the ischemic penumbra in order to better identify individuals most likely to benefit from intervention, irrespective of time last seen normal. Its increasing use in clinical practice has demonstrated individual differences in rate of infarction. One explanation for this variability is a difference in collateral blood flow. We report two cases that highlight the individual variability of infarction rate, and discuss potential underlying mechanisms that may influence treatment decisions and outcomes.

  5. Functional Significance of Angiographic Collaterals in Patients with Totally Occluded Right Coronary Artery: Intracoronary Thallium-201 Scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Do Yun; Lee, Jong Doo; Cho, Seung Yun; Shim, Won Heum; Ha, Jong Won; Kim, Han Soo; Kwon, Hyuk Moon; Jang, Yang Soo; Chung, Nam Sik; Kim, Sung Soon [Yonsei University College of Medicine, Seoul (Korea, Republic of); Park, Chang Yun; Kim, Young Soo [Inje University College of Medicine, Seoul (Korea, Republic of)

    1993-07-15

    To compare the myocardial viability in patients suffering from total occlusion of the right coronary artery (RCA) with the angiographic collaterals, intracoronary injection of Thallium-201 (T1-201) was done to 14 coronary artery disease (CAD) patients (pts) with total occlusion of RCA and into four normal subjects for control. All 14 CAD pts had Grade 2 or 3 collateral circulations. There were 14 male and 4 females, and their ages ranged from 31 to 70 years. In nine pts, T1-201 was injected into left main coronary artery (LCA) (300 approx 350 mu Ci) to evaluate the myocardial viability of RCA territory through collateral circulations. The remaining five pts received T1-201 into RCA (200-250 mu Ci) because two had intraarterial bridging collaterals and three had previous successful PTCA. Planar and SPECT myocardial perfusion images were obtained 30 minutes, and four to five hours after T1-201 reinjection. Intravenous T1-201 reinjection (six pts) or {sup 99m}Tc-MIBI (two pts) were also performed in eight CAD pts. Intracoronary myocardial perfusion images were compared with intravenous T1-201(IV T1-201) images, EGG, and ventriculography. Intracoronary TI-201 images proved to be superior to that of IV T1-201 due to better myocardial to background uptake ratio and more effective in the detection of viable tissue. We also found that perfusion defects were smaller on intracoronary T1-201 images than those on the IV T1-201. All of the 14 CAD pts had either mostly viable myocardium (seven pts) or large area of T1-201 perfusion (seven pts) in RCA territory, however ventriculographic wall motion and ECG did not correlate well with intracoronary myocardial perfusion images. In conclusion, total RCA occlusion patients with well developed collateral circulation had large area of viable myocardial in the corresponding territory.

  6. Early CT perfusion mismatch in acute stroke is not time-dependent but relies on collateralization grade

    Energy Technology Data Exchange (ETDEWEB)

    Baumgarten, Louisa von; Straube, Andreas [University of Munich Hospitals, Department of Neurology, Munich (Germany); Thierfelder, Kolja M.; Beyer, Sebastian E.; Baumann, Alena B.; Bollwein, Christine; Reiser, Maximilian F.; Sommer, Wieland H. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany); Janssen, Hendrik [Ludwig-Maximilians-University Hospital Munich, Department of Neuroradiology, Munich (Germany)

    2016-04-15

    Factors that determine the extent of the penumbra in the initial diagnostic workup using whole brain CT Perfusion (WB-CTP) remain unclear. The purpose of the current study was to determine a possible dependency of the initial mismatch size between cerebral blood flow (CBF) and cerebral blood volume (CBV) from time after symptom onset, leptomeningeal collateralization, and occlusion localization in acute middle cerebral artery (MCA) infarctions. Out of an existing cohort of 992 consecutive patients receiving multiparametric CT scans including WB-CTP due to suspected stroke, we included patients who had (1) a witnessed time of symptom onset, (2) an infarction of the MCA territory as documented by follow-up imaging, and (3) an initial CBF volume of >10 ml. CBF and CBV lesion sizes, collateralization grade, and the site of occlusion were determined. We included 103 patients. Univariate analysis showed that time from symptom onset (168 +/- 91.2 min) did not correlate with relative or absolute mismatch volumes (p = 0.458 and p = 0.921). Higher collateralization gradings were associated with small absolute mismatch volumes (p = 0.004 and p < 0.001). Internal carotid artery (ICA) occlusions were associated with large absolute mismatch volumes (p = 0.004). Multivariate analysis confirmed that ICA occlusion was associated with large absolute mismatch volumes (p = 0.005), and high collateral grade was associated with small absolute mismatch volumes (p = 0.017). There is no significant correlation between initial CTP mismatch and time after symptom onset. Predictors of mismatch size include the extent of the collaterals and a proximal location of the occlusion. (orig.)

  7. Expression of Proinflammatory Factors, Proangiogenic Factors and Endostatin in Patients with Heart Failure and Different Grades of Collateral Circulation Development.

    Science.gov (United States)

    Kobusiak-Prokopowicz, Małgorzata; Jołda-Mydłowska, Beata; Grzebieniak, Tomasz; Początek, Karol; Mysiak, Andrzej

    2015-01-01

    The process of collateral vessel maturation is stimulated by numerous factors affecting the endothelium and smooth muscle cells building the vessel wall. Looking for arteriogenesis stimulating factors means looking for a potential innovative heart failure treatment method in the patients unresponsive to traditional therapies. The purpose of this study was to assess the changes in serum concentrations of pro-inflammatory factor IL-6, growth factors FGF (FGFa, FGFb, FGFbH), HGF, VEGF and endostatin in heart failure patients in relation to the coronary collaterals development stage. This study included 22 patients with chronic heart failure NYHA II or III (mean age 62.5 ± 11.6 years) and 8 control patients (mean age 58.4 ± 10.7 years). Coronary angiography was performed and the presence and grade of collateral circulation was assessed by a four-level scale proposed by Rentrop and Cohen. The level of the studied factors was determined in the blood samples collected during the angiographic procedure. The concentration of IL-6 was significantly higher in the heart failure patients than in the control group (p < 0.001) and in NYHA III vs. NYHA II patients (p < 0.02). Patients with heart failure and collaterals grade 1 or 2 exhibited higher serum concentrations of FGFbH (from p < 0.03 to p < 0.01). The serum VEGF level in NYHA III patients was significantly higher than in NYHA II individuals (from p < 0.03 to p < 0.01). Higher levels of IL-6 and FGFbH were observed in patients with heart failure. Collaterals formation seems to be associated with the activation of pro-inflammatory factors, growth factors and endostatin.

  8. Quantitative analysis of axon collaterals of single pyramidal cells of the anterior piriform cortex of the guinea pig.

    Science.gov (United States)

    Yang, Junli; Litscher, Gerhard; Sun, Zhongren; Tang, Qiang; Kishi, Kiyoshi; Oda, Satoko; Takayanagi, Masaaki; Sheng, Zemin; Liu, Yang; Guo, Wenhai; Zhang, Ting; Wang, Lu; Gaischek, Ingrid; Litscher, Daniela; Lippe, Irmgard Th; Kuroda, Masaru

    2017-02-08

    The role of the piriform cortex (PC) in olfactory information processing remains largely unknown. The anterior part of the piriform cortex (APC) has been the focus of cortical-level studies of olfactory coding, and associative processes have attracted considerable attention as an important part in odor discrimination and olfactory information processing. Associational connections of pyramidal cells in the guinea pig APC were studied by direct visualization of axons stained and quantitatively analyzed by intracellular biocytin injection in vivo. The observations illustrated that axon collaterals of the individual cells were widely and spatially distributed within the PC, and sometimes also showed a long associational projection to the olfactory bulb (OB). The data showed that long associational axons were both rostrally and caudally directed throughout the PC, and the intrinsic associational fibers of pyramidal cells in the APC are omnidirectional connections in the PC. Within the PC, associational axons typically followed rather linear trajectories and irregular bouton distributions. Quantitative data of the axon collaterals of two pyramidal cells in the APC showed that the average length of axonal collaterals was 101 mm, out of which 79 mm (78% of total length) were distributed in the PC. The average number of boutons was 8926 and 7101, respectively, with 79% of the total number of boutons being distributed in the PC. The percentage of the total area of the APC and the posterior piriform cortex occupied by the average distribution region of the axon collaterals of two superficial pyramidal (SP) cells was about 18 and 5%, respectively. Our results demonstrate that omnidirectional connection of pyramidal cells in the APC provides a substrate for recurrent processes. These findings indicate that the axon collaterals of SP cells in the PC could make synaptic contacts with all granule cells in the OB. This study provides the morphological evidence for understanding

  9. Injuries of the lateral collateral ligaments of the ankle: assessment with MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kreitner, K.F.; Ferber, A.; Grebe, P.; Thelen, M. [Department of Radiology, Johannes Gutenberg University Mainz (Germany); Runkel, M. [Department of Traumatologic and Reconstructive Surgery, Johannes Gutenberg University Mainz (Germany); Berger, S. [Department of Pediatric Surgery, Johannes Gutenberg University Mainz (Germany)

    1999-04-01

    The aim of this study was to evaluate the ability of MRI to display injuries of the lateral collateral ligamentous complex in patients with an acute ankle distorsion trauma. The MR examinations of 36 patients with ankle pain after ankle distorsion were evaluated retrospectively without knowledge of clinical history, outcome and/or operative findings. The examinations were performed on a 1.5-T whole-body imager using a flexible surface coil. The signs for ligamentous abnormality were as follows: complete or partial discontinuity, increased signal within, and irregularity and waviness of the ligament. The results were compared with operative findings in 18 patients with subsequent surgical repair. Eighteen patients with conservative therapy had a follow-up MR examination after 3 months. There was 1 sprain, 3 partial and 32 complete tears of the anterior talofibular ligament, and 5 sprains, 5 partial, and 7 complete tears of the calcaneofibular ligament. There were no lesions of the posterior talofibular ligament. Compared with surgery, MRI demonstrated in 18 of 18 cases the exact extent of anterior talofibular ligament injuries and underestimated the extent in 2 of 8 cases of calcaneofibular ligament injury. In patients with follow-up MRI after conservative therapy, a thickened band-like structure was found along the course of the injured ligament in 17 of 18 cases. The absence of ligament repair after conservative treatment was confirmed during operative revision in one case. The MRI technique allows for grading of the extent of injury of the lateral collateral ligamentous complex after acute ankle strain. It seems to be suitable for monitoring the healing process after conservative-functional treatment of ligament tears. (orig.) With 5 figs., 2 tabs., 26 refs.

  10. Ethical responsibilities toward indirect and collateral participants in pragmatic clinical trials.

    Science.gov (United States)

    Smalley, Jaye Bea; Merritt, Maria W; Al-Khatib, Sana M; McCall, Debbe; Staman, Karen L; Stepnowsky, Carl

    2015-10-01

    Pragmatic clinical trials are designed to inform decision makers about the benefits, burdens, and risks of health interventions in real-world settings. Pragmatic clinical trials often use for research purposes data collected in the course of clinical practice. The distinctive features of pragmatic clinical trials demand fresh thinking about what is required to act properly toward people affected by their conduct, in ways that go beyond ensuring the protection of rights and welfare for "human research subjects" under conventional research ethics regulations. To stimulate such work, we propose to distinguish among categories of research participants in pragmatic clinical trials as follows: Direct participants: (1) individuals being directly intervened upon and/or (2) individuals from whom personal identifiable data are being collected for the purposes of the pragmatic clinical trial. Indirect participants: individuals who are (1) not identified as direct participants and (2) whose rights and welfare may be affected by the intervention through their routine exposure to the environment in which the intervention is being deployed. Collateral participants: patient groups and other stakeholder communities who may be otherwise affected by the occurrence and findings of the pragmatic clinical trial. We illustrate these distinctions with case examples and discuss the distinctive responsibilities of researchers and pragmatic clinical trial leadership toward each type of participant. We suggest that pragmatic clinical trial investigators, institutional review boards, health systems leaders, and others engaged in the research enterprise work together to identify these participants. For indirect participants, risks and benefits to which they are exposed should be weighed to ensure that their rights and welfare are protected accordingly, and communication strategies should be considered to help them make well-informed decisions. Collateral participants could provide input on the

  11. MR imaging of medial collateral ligament injury and associated internal knee joint injury

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Chae Ha; Lee, Sun Kyoung; Lim, Dong Hun; Kim, Young Sook; Byun, Ju Nam; Kim, Young Chul; Oh, Jae Hee [Chosun Univ. College of Medicine, GwangJu (Korea, Republic of)

    1996-11-01

    To assess the value of MR imaging in the diagnosis of medial collateral ligament injury of the knee, we used MR imaging to evaluate the characteristic findings in MCL tears and the frequency of associated knee joint injury. We retrospectively reviewed 26 patients within four weeks of MCL injury, analysed MR findings and correlated them with surgical findings. We evaluated discontinuity, heterogeneous signal intensity of MCL, thin band- like low signal intensity at MCL, facial edema, loss of clear demarcation of adjacent fat also combined bone injury, meniscus injury and other ligament injury. Complete MCL tears were present in 14 patients and partial tears in 12. Complete tears showed discontinuity of MCL, fascial edema and loss of clear demarcation from adjacent fat in 11 patients(79%);proximal MCL tears are more common than distal tears. Partial tears showed thin band-like low signal intensity within MCL, fascial edema and loss of clear demarcation from adjacent fat in seven patients (58%);all patient s with MCL injury showed fascial edema;in 12 patients there was loss of clear demarcation from adjacent fat. We could not, however, distinguish between complete tears and partial tears when MCL showed heterogeneous high signal intensity. Combined bone injury in MCL tears was found in eight patients(62%);the most common sites of this were the lateral femoral condyle and lateral tibial plateau. There was associated injury involving other ligaments(ACL:50%;PCL:27%). Combined meniscus injury in MCL tears was present in 17 patients and the most common meniscus site(50%) is the posterior horn of the medial meniscus. Complete MCL tears showed discontinuity of MCL and partial tears showed a thin band-like low signal intensity within MCL. All patients with MCL injury showed fascial edema, and loss of clear demarcation from adjacent fat. Various other injuries combine with MCL tears. MR imaging is therefore useful in the evaluation of medial collateral ligament injury and

  12. Arkansas State University Beebe Branch Faculty Handbook.

    Science.gov (United States)

    Arkansas State Univ., Beebe.

    Arkansas State University Beebe Branch provides a liberal arts oriented program for traditional and nontraditional students. Its faculty handbook contains institutional goals, description of responsibilities of administrative officers and faculty committees, faculty employment policies, and administrative and instructional policies. The…

  13. 77 FR 39143 - Executive Branch Qualified Trusts

    Science.gov (United States)

    2012-07-02

    ... executive branch qualified trust, an entity must meet the strict requirements for independence set forth in... this subpart. A parent or guardian may execute the umbrella trust agreement on behalf of a required...

  14. FY 1990 Applied Sciences Branch annual report

    Energy Technology Data Exchange (ETDEWEB)

    Keyes, B.M.; Dippo, P.C. (eds.)

    1991-11-01

    The Applied Sciences Branch actively supports the advancement of DOE/SERI goals for the development and implementation of the solar photovoltaic technology. The primary focus of the laboratories is to provide state-of-the-art analytical capabilities for materials and device characterization and fabrication. The branch houses a comprehensive facility which is capable of providing information on the full range of photovoltaic components. A major objective of the branch is to aggressively pursue collaborative research with other government laboratories, universities, and industrial firms for the advancement of photovoltaic technologies. Members of the branch disseminate research findings to the technical community in publications and presentations. This report contains information on surface and interface analysis, materials characterization, development, electro-optical characterization module testing and performance, surface interactions and FTIR spectroscopy.

  15. Overview of the Advanced High Frequency Branch

    Science.gov (United States)

    Miranda, Felix A.

    2015-01-01

    This presentation provides an overview of the competencies, selected areas of research and technology development activities, and current external collaborative efforts of the NASA Glenn Research Center's Advanced High Frequency Branch.

  16. How Banks Go Abroad : Branches or Subsidiaries?

    OpenAIRE

    Cerutti, Eugenio; Dell'Ariccia, Giovanni; Martínez Pería, Maria Soledad

    2005-01-01

    The authors examine the factors that influence banks' type of organizational form when operating in foreign markets using an original database of the branches and subsidiaries in Latin America and Eastern Europe of the top 100 international banks. They find that regulation, taxation, the degree of desired penetration in the local market, and host-country economic and political risks matter. Banks are more likely to operate as branches in countries that have higher corporate taxes and when the...

  17. Branch retinal artery occlusion in Susac's syndrome

    Directory of Open Access Journals (Sweden)

    Ricardo Evangelista Marrocos de Aragão

    2015-02-01

    Full Text Available Susac's syndrome is a rare disease attribuited to a microangiopathy involving the arterioles of the cochlea, retina and brain. Encefalopathy, hearing loss, and visual deficits are the hallmarks of the disease. Visual loss is due to multiple, recurrent branch arterial retinal occlusions. We report a case of a 20-year-old women with Susac syndrome presented with peripheral vestibular syndrome, hearing loss, ataxia, vertigo, and vision loss due occlusion of the retinal branch artery.

  18. All change at the CERN UBS branch

    CERN Multimedia

    Antonella Del Rosso

    2012-01-01

    UBS branches across the country are being modernised, and the CERN branch is no exception. The Bulletin brings you a preview of the project, which will get under way in January 2013.   Mock-up of the renovated UBS branch. The changes at the UBS branch in CERN's Main Building will be no simple facelift. The entire bank will be renovated, transforming the present relatively confined premises into an open and attractive area. "The renovation of the UBS branches is part of a wider campaign designed to further enhance our customer relations," explains Ezio Mangia, the head of the CERN branch.  The UBS bank currently occupies three sets of premises in CERN's Main Building (two on the ground floor and one in the basement). "By the end of the work, which is scheduled to be completed by the middle of next year, CERN customers will benefit from a new area with open-plan counters and "hole-in-the-wall" machines accessible to...

  19. A multi-queue branch-and-bound algorithm for anytime optimal search with biological applications.

    Science.gov (United States)

    Lathrop, R H; Sazhin, A; Sun, Y; Steffin, N; Irani, S S

    2001-01-01

    Many practical biological problems involve an intractable (NP-hard) search through a large space of possibilities. This paper describes preliminary results from a multi-queue variant of branch-and-bound search that combines anytime and optimal search behavior. The algorithm applies to problems whose solutions may be described by an N-dimensional vector. It produces an approximate solution quickly, then iteratively improves the result over time until a global optimum is produced. A global optimum may be produced before producing its proof of global optimality. Local minima are never revisited. We describe preliminary applications to ab initio protein backbone prediction, small drug-like molecule conformations, and protein-DNA binding motif discovery. The results are encouraging, although still quite preliminary.

  20. Better branch prediction through prophet/critic hybrids

    OpenAIRE

    Falcón Samper, Ayose Jesús; Stark, Jared; Ramírez Bellido, Alejandro; Lai, Konrad; Valero Cortés, Mateo

    2005-01-01

    The prophet/critic hybrid conditional branch predictor has two component predictors. The prophet uses a branch's history to predict its direction. We call this prediction and the ones for branches following it the branch future. The critic uses the branch's history and future to critique the prophet's prediction. The hybrid combines the prophet's prediction with the critique, either agrees or disagree, forming the branch's overall prediction. Results shows these hybrids can reduce mispredicts...

  1. A Comparative Analysis of Schemes for Correlated Branch Prediction

    OpenAIRE

    Young, Cliff; Gloy, Nicolas; Smith, Michael D.

    1995-01-01

    Modern high-performance architectures require extremely accurate branch prediction to overcome the performance limitations of conditional branches. We present a framework that categorizes branch prediction schemes by the way in which they partition dynamic branches and by the kind of predictor that they use. The framework allows us to compare and contrast branch prediction schemes, and to analyze why they work. We use the framework to show how a static correlated branch prediction scheme incr...

  2. Combining living anionic polymerization with branching reactions in an iterative fashion to design branched polymers.

    Science.gov (United States)

    Higashihara, Tomoya; Sugiyama, Kenji; Yoo, Hee-Soo; Hayashi, Mayumi; Hirao, Akira

    2010-06-16

    This paper reviews the precise synthesis of many-armed and multi-compositional star-branched polymers, exact graft (co)polymers, and structurally well-defined dendrimer-like star-branched polymers, which are synthetically difficult, by a commonly-featured iterative methodology combining living anionic polymerization with branched reactions to design branched polymers. The methodology basically involves only two synthetic steps; (a) preparation of a polymeric building block corresponding to each branched polymer and (b) connection of the resulting building unit to another unit. The synthetic steps were repeated in a stepwise fashion several times to successively synthesize a series of well-defined target branched polymers. Copyright © 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Effect of a collateral ligament sparing surgical approach on mechanical properties of equine proximal interphalangeal joint arthrodesis constructs.

    Science.gov (United States)

    Bras, Jose J; Lillich, James D; Beard, Warren L; Anderson, David E; Armbrust, Laura J; Frink, Elizabeth; Lease, Kevin

    2011-01-01

    To (1) compare the effect of a collateral ligament sparing surgical approach with an open surgical approach on mechanical properties of proximal interphalangeal joint (PIPJ) arthrodesis, and (2) to determine the percentage of articular cartilage surface removed by transarticular (TA) drilling with different diameter drill bits. Randomized paired limb design. Cadaveric equine limbs (n=76). Cadaveric PIPJ were drilled using a 3.5, 4.5, or 5.5 mm drill bit at 80-84° to the dorsal plane to remove articular cartilage and subchondral bone from the distal articular surface of the proximal phalanx (P1) and the proximal articular surface of the middle phalanx (P2). Bone ends were photographed and the percentage of the projected surface area that was denuded of cartilage was measured. PIPJ arthrodesis constructs (3-hole dynamic compression plate [DCP], two 5.5 mm TA screws inserted in lag fashion, medial and lateral to the DCP; DCP-TA) were created using 2 surgical approaches in paired limbs. A conventional open approach was used in 1 limb and a collateral ligament sparing approach used in the other limb. Constructs were tested to failure in single-cycle 3-point dorsopalmar/plantar or lateromedial bending. Maximum load, yield load, and composite stiffness were compared between techniques. The 3.5, 4.5, and 5.5 mm drill bits removed 24±4%, 35±5%, and 45±7% of total PIPJ articular cartilage surface, respectively. Constructs with the collateral ligament sparing approach had significantly greater mean yield load (11.3±2.8 versus 7.68±1.1 kN, P=.008) and mean maximum load (13.5±3.1 versus 10.1±1.94 kN, P=.02) under lateromedial bending. Under dorsopalmar/plantar bending there was no significant difference between surgical approaches. The collateral ligament sparing arthrodesis technique had a shorter surgical time (19±3 minutes) compared with the open technique (31±3 minutes). A collateral ligament sparing surgical approach to the PIPJ with removal of articular

  4. Cadaveric Evaluation of Dorsal Intermetatarsal Approach for Plantar Plate and Lateral Collateral Ligament Repair of the Lesser Metatarsophalangeal Joints.

    Science.gov (United States)

    Phisitkul, Phinit; Hosuru Siddappa, Vinay; Sittapairoj, Tinnart; Goetz, Jessica E; Den Hartog, Bryan D; Femino, John E

    2017-07-01

    Access to the plantar plate has been described using either a plantar approach or an extensive dorsal approach that required complete joint destabilization and often a metatarsal osteotomy. Clinical scenarios related to plantar plate tear vary and the pathologies in early stages are frequently limited to unilateral soft tissue structures; a less invasive operative approach may be possible. A novel approach requiring a release of only the lateral collateral ligament and the lateral half of the plantar plate is presented in this cadaver model; the extent of joint exposure possible is described. The ability to place a secure suture through the lateral collateral ligament and the plantar plate was analyzed. Nine fresh-frozen cadaveric specimens were dissected in a randomized fashion across the second to fourth metatarsophalangeal joints through the intermetatarsal space dorsally. Under distraction, soft tissue was sequentially released, including dorsal capsule, lateral collateral ligament, and the lateral half of the plantar plate. Integrity of the extensor tendons, deep transverse intermetatarsal ligament, proximal attachment of the plantar plate, and osseous structures was carefully preserved. The joint exposure was quantified after each step with sizing rods. Using a suture passer, 2-0 nonabsorbable braided sutures were passed into the lateral collateral ligament and the plantar plate, and the construct strength was measured using a tensiometer. Progressive increase in mean joint exposure was noted after each step of soft tissue release with the final exposure of 6 mm after release of the lateral half of the plantar plate. Joint exposures after a capsulotomy and a lateral collateral release were 3 mm and 4 mm, respectively. Under distraction, the unilateral release of soft tissue created a lateral opening of the joint while the proximal phalangeal base adducted and medially deviated. Successful suture passage was noted in all specimens that could sustain a minimum

  5. Airway branching morphogenesis in three dimensional culture

    Directory of Open Access Journals (Sweden)

    Gudjonsson Thorarinn

    2010-11-01

    Full Text Available Abstract Background Lungs develop from the fetal digestive tract where epithelium invades the vascular rich stroma in a process called branching morphogenesis. In organogenesis, endothelial cells have been shown to be important for morphogenesis and the maintenance of organ structure. The aim of this study was to recapitulate human lung morphogenesis in vitro by establishing a three dimensional (3D co-culture model where lung epithelial cells were cultured in endothelial-rich stroma. Methods We used a human bronchial epithelial cell line (VA10 recently developed in our laboratory. This cell line cell line maintains a predominant basal cell phenotype, expressing p63 and other basal markers such as cytokeratin-5 and -14. Here, we cultured VA10 with human umbilical vein endothelial cells (HUVECs, to mimic the close interaction between these cell types during lung development. Morphogenesis and differentiation was monitored by phase contrast microscopy, immunostainings and confocal imaging. Results We found that in co-culture with endothelial cells, the VA10 cells generated bronchioalveolar like structures, suggesting that lung epithelial branching is facilitated by the presence of endothelial cells. The VA10 derived epithelial structures display various complex patterns of branching and show partial alveolar type-II differentiation with pro-Surfactant-C expression. The epithelial origin of the branching VA10 colonies was confirmed by immunostaining. These bronchioalveolar-like structures were polarized with respect to integrin expression at the cell-matrix interface. The endothelial-induced branching was mediated by soluble factors. Furthermore, fibroblast growth factor receptor-2 (FGFR-2 and sprouty-2 were expressed at the growing tips of the branching structures and the branching was inhibited by the FGFR-small molecule inhibitor SU5402. Discussion In this study we show that a human lung epithelial cell line can be induced by endothelial cells to

  6. Preliminary pharmacognostic screening of Achyranthes coynei stem

    Directory of Open Access Journals (Sweden)

    Vinayak Upadhya

    2015-01-01

    Full Text Available Achyranthes coynei is a rare, endemic perennial shrub reported from Karnataka and Maharashtra states of India. The plant is used to treat various disorders by folk healers and was proven to have antimicrobial and antioxidant properties. The present study was undertaken to evaluate microscopic and macroscopic characters of A. coynei stem, along with its physicochemical parameters. ProgRes ® CapturePro and Microsoft Excel were used for statistical analysis. Perennial, shrubby nature and woody stem were the distinguishing morphological characters observed. Transverse section (TS illustrated quadrangular outline of the stem and showed the presence of two types of trichomes on the thick-walled epidermis. TS also showed number of rosette calcium oxalates crystals; prismatic and microsphenoid crystals; conjoint, collateral open secondary vascular bundles; and two amphixylic medullary bundles in the pith. Ash and extractive values, micro and macro elements and nutritive factors were estimated in the present study. The presence of alkaloids, saponins and triterpenoids were observed in preliminary phytochemical screening. High-performance thin layer chromatographic analysis yielded different bands and also indicated the presence of oleanolic acid. The studied parameters for A. coynei stem will be useful for identification and authentication of the plant material.

  7. Preliminary pharmacognostic screening of Achyranthes coynei stem.

    Science.gov (United States)

    Upadhya, Vinayak; Ankad, Gireesh M; Pai, Sandeep R; Hegde, Shruti V; Hegde, Harsha V

    2015-01-01

    Achyranthes coynei is a rare, endemic perennial shrub reported from Karnataka and Maharashtra states of India. The plant is used to treat various disorders by folk healers and was proven to have antimicrobial and antioxidant properties. The present study was undertaken to evaluate microscopic and macroscopic characters of A. coynei stem, along with its physicochemical parameters. ProgRes(®) CapturePro and Microsoft Excel were used for statistical analysis. Perennial, shrubby nature and woody stem were the distinguishing morphological characters observed. Transverse section (TS) illustrated quadrangular outline of the stem and showed the presence of two types of trichomes on the thick-walled epidermis. TS also showed number of rosette calcium oxalates crystals; prismatic and microsphenoid crystals; conjoint, collateral open secondary vascular bundles; and two amphixylic medullary bundles in the pith. Ash and extractive values, micro and macro elements and nutritive factors were estimated in the present study. The presence of alkaloids, saponins and triterpenoids were observed in preliminary phytochemical screening. High-performance thin layer chromatographic analysis yielded different bands and also indicated the presence of oleanolic acid. The studied parameters for A. coynei stem will be useful for identification and authentication of the plant material.

  8. A Unifying Theory of Branching Morphogenesis.

    Science.gov (United States)

    Hannezo, Edouard; Scheele, Colinda L G J; Moad, Mohammad; Drogo, Nicholas; Heer, Rakesh; Sampogna, Rosemary V; van Rheenen, Jacco; Simons, Benjamin D

    2017-09-21

    The morphogenesis of branched organs remains a subject of abiding interest. Although much is known about the underlying signaling pathways, it remains unclear how macroscopic features of branched organs, including their size, network topology, and spatial patterning, are encoded. Here, we show that, in mouse mammary gland, kidney, and human prostate, these features can be explained quantitatively within a single unifying framework of branching and annihilating random walks. Based on quantitative analyses of large-scale organ reconstructions and proliferation kinetics measurements, we propose that morphogenesis follows from the proliferative activity of equipotent tips that stochastically branch and randomly explore their environment but compete neutrally for space, becoming proliferatively inactive when in proximity with neighboring ducts. These results show that complex branched epithelial structures develop as a self-organized process, reliant upon a strikingly simple but generic rule, without recourse to a rigid and deterministic sequence of genetically programmed events. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  9. CT angiography collateral scoring: Correlation with DWI infarct size in proximal middle cerebral artery occlusion stroke within 12 h onset

    Directory of Open Access Journals (Sweden)

    Mahmoud M. Higazi

    2016-09-01

    Conclusions: In patients with major acute MCA occlusion strokes, CTA collateral grading is significantly correlated with admission DWI size. This finding may be relevant for clinical practice and helpful for guiding treatment decision and predicting clinical outcome.

  10. Preliminary Monthly Climatological Summaries

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Preliminary Local Climatological Data, recorded since 1970 on Weather Burean Form 1030 and then National Weather Service Form F-6. The preliminary climate data pages...

  11. Measurement of Tau Lepton Branching Fractions

    Energy Technology Data Exchange (ETDEWEB)

    Nicol, N.

    2003-12-19

    We present {tau}{sup -} lepton branching fraction measurements based on data from the TPC/Two-Gamma detector at PEP. Using a sample of {tau}{sup -} {yields} {nu}{sub {tau}}K{sup -}{pi}{sup +}{pi}{sup -} events, we examine the resonance structure of the K{sup -}{pi}{sup +}{pi}{sup -} system and obtain the first measurements of branching fractions for {tau}{sup -} {yields} {nu}{sub {tau}}K{sub 1}{sup -}(1270) and {tau}{sup -} {yields} {nu}{sub {tau}}K{sub 1}{sup -}(1400). We also describe a complete set of branching fraction measurements in which all the decays of the {tau}{sup -} lepton are separated into classes defined by the identities of the charged particles and an estimate of the number of neutrals. This is the first such global measurement with decay classes defined by the four possible charged particle species, e, {mu}, {pi}, and K.

  12. Fastball Pitch Velocity Helps Predict Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers.

    Science.gov (United States)

    Chalmers, Peter N; Erickson, Brandon J; Ball, Brian; Romeo, Anthony A; Verma, Nikhil N

    2016-08-01

    Ulnar collateral ligament injury and its subsequent surgical reconstruction are some of the most common issues among Major League Baseball (MLB) players. The purpose of this study was to determine factors predictive of ulnar collateral ligament reconstruction (UCLR) among MLB pitchers. The hypothesis was that pitchers who underwent UCLR would have higher preinjury peak fastball pitch velocity. Case-control study; Level of evidence, 3. Data on pitch velocity, number, and type (fastball, curveball, etc) for every pitcher and game within MLB from April 2, 2007 to April 14, 2015 were gathered from the publically available PitchFx database. Pitcher demographic information was also recorded. Data from after 2012 were excluded to avoid lead-time bias. Using publically available information, the names and approximate dates of surgery for every MLB pitcher who ever underwent UCLR, including those before 2007 and after 2012, were collected. Each pitcher-game was then classified as "control," "preinjury," or "postoperative." Control and preinjury pitchers were then compared to determine risk factors for UCLR. Overall, 1327 pitchers were included, of whom 309 (26.8%) had undergone UCLR. Of these, 145 had preinjury velocity data. Peak pitch velocity was significantly higher among preinjury pitchers than control pitchers (mean [95% CI], 93.3 mph [92.8-93.8] vs 92.1 mph [91.9-92.3]; P < .001), as was mean pitch velocity (87.8 mph [87.3-88.3] vs 86.9 mph [86.7-87.1]; P = .001). Both demonstrated a dose-response relationship. Although height did not differ (P = .934), weight was significantly higher for preinjury pitchers than controls (P = .005). Pitch counts per year were significantly lower for preinjury pitchers compared with control pitchers, although preinjury pitchers threw more breaking pitches (P = .003). On multivariate regression, peak pitch velocity was the primary independent predictor of whether a pitcher underwent UCLR (P < .001), with mean velocity (P = .013), body

  13. Heterotrophic denitrification vs. autotrophic anammox – quantifying collateral effects on the oceanic carbon cycle

    Directory of Open Access Journals (Sweden)

    W. Koeve

    2010-08-01

    Full Text Available The conversion of fixed nitrogen to N2 in suboxic waters is estimated to contribute roughly a third to total oceanic losses of fixed nitrogen and is hence understood to be of major importance to global oceanic production and, therefore, to the role of the ocean as a sink of atmospheric CO2. At present heterotrophic denitrification and autotrophic anammox are considered the dominant sinks of fixed nitrogen. Recently, it has been suggested that the trophic nature of pelagic N2-production may have additional, "collateral" effects on the carbon cycle, where heterotrophic denitrification provides a shallow source of CO2 and autotrophic anammox a shallow sink. Here, we analyse the stoichiometries of nitrogen and associated carbon conversions in marine oxygen minimum zones (OMZ focusing on heterotrophic denitrification, autotrophic anammox, and dissimilatory nitrate reduction to nitrite and ammonium in order to test this hypothesis quantitatively. For open ocean OMZs the combined effects of these processes turn out to be clearly heterotrophic, even with high shares of the autotrophic anammox reaction in total N2-production and including various combinations of dissimilatory processes which provide the substrates to anammox. In such systems, the degree of heterotrophy (ΔCO2:ΔN2, varying between 1.7 and 6.5, is a function of the efficiency of nitrogen conversion. On the contrary, in systems like the Black Sea, where suboxic N-conversions are supported by diffusive fluxes of NH4+ originating from neighbouring waters with sulphate reduction, much lower values of ΔCO2:ΔN2 can be found. However, accounting for concomitant diffusive fluxes of CO2, the ratio approaches higher values similar to those computed for open ocean OMZs. Based on this analysis, we question the significance of collateral effects concerning the trophic

  14. Crack branching in cross-ply composites

    Science.gov (United States)

    La Saponara, Valeria

    2001-10-01

    The purpose of this research work is to examine the behavior of an interface crack in a cross-ply laminate which is subject to static and fatigue loading. The failure mechanism analyzed here is crack branching (or crack kinking or intra-layer crack): the delamination located between two different plies starts growing as an interface crack and then may branch into the less tough ply. The specimens were manufactured from different types of Glass/Epoxy and Graphite/Epoxy, by hand lay-up, vacuum bagging and cure in autoclave. Each specimen had a delamination starter. Static mixed mode tests and compressive fatigue tests were performed. Experiments showed the scale of the problem, one ply thickness, and some significant features, like contact in the branched crack. The amount of scatter in the experiments required use of statistics. Exploratory Data Analysis and a factorial design of experiments based on a 8 x 8 Hadamard matrix were used. Experiments and statistics show that there is a critical branching angle above which crack growth is greatly accelerated. This angle seems: (1) not to be affected by the specimens' life; (2) not to depend on the specimen geometry and loading conditions; (3) to strongly depend on the amount of contact in the branched crack. Numerical analysis was conducted to predict crack propagation based on the actual displacement/load curves for static tests. This method allows us to predict the total crack propagation in 2D conditions, while neglecting branching. Finally, the existence of a solution based on analytic continuation is discussed.

  15. The branching channel network in the Yangtze Estuary

    NARCIS (Netherlands)

    Wang, Z.B.; Ding, P.X.

    2012-01-01

    The channels in the Yangtze Estuary have an ordered-branching structure: The estuary is first divided by the Chongming Island into the North Branch and the South Branch. Then the South Branch is divided into the North Channel and South Channel by the Islands Changxing and Hengsha. The South Channel

  16. Branching ratio for the superallowed beta-decay of 10C

    Science.gov (United States)

    Eronen, Tommi; Bencomo, M.; Chen, L.; Hardy, J. C.; Horvat, V.; Iacob, V.; Nica, N.; Park, H. I.; Roeder, B.; Saastamoinen, A.

    2016-03-01

    Superallowed β decays play a key role in testing the Standard Model of Particle Physics. These decays occur between nuclear analog states having spin-parity of 0+ and isospin T = 1 . Currently, and in the foreseeable future, they offer the most accurate value for the Vud matrix element of the Cabibbo-Kobayashi-Maskawa quark mixing matrix. Each superallowed transition is characterized with an Ft value combining both experimental and theoretical quantities. We have just made a preliminary new measurement of the 10C branching ratio, which currently is the least precisely known quantity for any of the ``traditional nine'' superallowed transitions. Furthermore, 10C is the only case that appears to have its corrected Ft value outside the world average value, which could be explained with the existence of a scalar current. We performed the branching-ratio measurement with a β- γ coincidence setup using a scintillator for β and an HPGe with +/-0.15% calibrated relative efficiency for γ detection. Since the branching ratio is obtained from the ratio of intensities of 718 keV and 1022 keV γ lines, most systematic uncertainties cancel out. I will show an overview of the experiment and preliminary results.

  17. Nature of branching in disordered materials

    Science.gov (United States)

    Kulkarni, Amit S.

    The phenomenon of structural branching is ubiquitous in a wide array of materials such as polymers, ceramic aggregates, networks and gels. These materials with structural branching are a unique class of disordered materials and often display complex architectures. Branching has a strong influence over the structure-property relationships of these materials. Despite the generic importance across a wide spectrum of materials, our physical understanding of the scientific nature of branching and the analytic description and quantification of branching is at an early stage, though many decades of effort have been made. For polymers, branching is conventionally characterized by hydrodynamic radius (size exclusion chromatography, SEC, rheology) or by counting branch sites (nuclear magnetic resonance spectroscopy, NMR). SEC and rheology are, at best, qualitative; and quantitative characterization techniques like NMR and transmission electron microscopy (TEM) (for ceramic nanoparticulate aggregates) have limitations in providing routine quantification. Effective structure characterization, though an important step in understanding these materials, remains elusive. For ceramic aggregates, theoretical work has dominated and only a few publications on analytic studies exist to support theory. A new generic scaling model is proposed in Chapter I, which encompasses the critical structural features associated with these complex architectures. The central theme of this work is the application of this model to describe a variety of disordered structures like aggregated nano-particulates, long chain branched polymers like polyethylene, hyperbranched polymers, multi-arm star polymers, and cyclic macromolecules. The application of the proposed model to these materials results in a number of fundamental structural parameters, like the mass-fractal dimension, df, the minimum path dimension, dmin, connectivity dimension, c, and the mole fraction branch content, φbr. These dimensions

  18. Incidental right Bochdalek hernia with interruption of the inferior vena cava and hepatic venous collateral continuation: A case report

    Directory of Open Access Journals (Sweden)

    Farzanah I. Ismail

    2014-04-01

    Full Text Available A 36-year-old asymptomatic female had a routine chest radiograph to exclude pulmonary tuberculosis, as part of an employee wellness programme. There was opacification of the right lower thorax. Computed tomography and venography demonstrated an incidental right Bochdalek hernia with interruption of the inferior vena cava (IVC and hepatic venous collateral continuation. The association of a Bochdalek hernia with an anomaly of the IVC is rare, with only one case described in the literature.

  19. Myocardial extracellular volume fraction measurement in chronic total coronary occlusion: Association with myocardial injury, angiographic collateral flow, and functional recovery.

    Science.gov (United States)

    Chen, Yin-Yin; Ren, Dao-Yuan; Zeng, Meng-Su; Yang, Shan; Yun, Hong; Fu, Cai-Xia; Ge, Jun-Bo; Jin, Hang; Qian, Ju-Ying; Zhang, Wei-Guo

    2016-10-01

    To investigate whether myocardial extracellular volume fraction (ECV) measurement by cardiac MR is indicative of myocardial injury, angiographic collateral flow, and functional recovery in patients with chronic total coronary occlusion (CTO). A total of 50 CTO patients undergoing 1.5 Tesla MR were prospectively enrolled, and 28 underwent a second MR 6 months after revascularization. T1-mapping based indices, including pre- and postcontrast T1 values and ECV, were obtained from infarcted and non-infarcted myocardium, myocardial segments, and coronary territory. The severity of myocardial injury was rated by transmurality extent of infarction (TEI) and regional wall motion abnormalities (RWMA) score. Angiographic collateral flow was evaluated using Rentrop classification. Improvement in segmental wall motion at 6 months was also assessed. ECV and postcontrast T1 value significantly outperformed precontrast T1 value for identifying myocardial infarction (area under the receiver operating characteristic curve [AUC]: 0.998 and 0.953 versus 0.824, all P < 0.02). Myocardial ECV was strongly correlated with TEI (P = 0.000), RWMA score (P = 0.000), and collateral classification (P = 0.007 for left anterior descending artery [LAD] territory, P = 0.001 for non-LAD territory). Furthermore, the likelihood of functional recovery was better predicted by ECV than by late gadolinium enhancement (LGE) (AUC: 0.76 versus 0.68, P < 0.02). Myocardial ECV may be a useful surrogate to assess myocardial injury and angiographic collateral flow in CTO, and ECV provides incremental value to LGE in assessing functional recovery after revascularization. J. MAGN. RESON. IMAGING 2016;44:972-982. © 2016 International Society for Magnetic Resonance in Medicine.

  20. Case report - calcification of the medial collateral ligament of the knee with simultaneous calcifying tendinitis of the rotator cuff

    OpenAIRE

    Kamawal, Yama; Steinert, Andre F; Boris M. Holzapfel; Rudert, Maximilian; Barthel, Thomas

    2016-01-01

    Background Calcification of the medial collateral ligament (MCL) of the knee is a very rare disease. We report on a case of a patient with a calcifying lesion within the MCL and simultaneous calcifying tendinitis of the rotator cuff in both shoulders. Case presentation Calcification of the MCL was diagnosed both via x-ray and magnetic resonance imaging (MRI) and was successfully treated surgically. Calcifying tendinitis of the rotator cuff was successfully treated applying conservative method...

  1. Cutaneous collateral axonal sprouting re-innervates the skin component and restores sensation of denervated Swine osteomyocutaneous alloflaps.

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    Zuhaib Ibrahim

    Full Text Available Reconstructive transplantation such as extremity and face transplantation is a viable treatment option for select patients with devastating tissue loss. Sensorimotor recovery is a critical determinant of overall success of such transplants. Although motor function recovery has been extensively studied, mechanisms of sensory re-innervation are not well established. Recent clinical reports of face transplants confirm progressive sensory improvement even in cases where optimal repair of sensory nerves was not achieved. Two forms of sensory nerve regeneration are known. In regenerative sprouting, axonal outgrowth occurs from the transected nerve stump while in collateral sprouting, reinnervation of denervated tissue occurs through growth of uninjured axons into the denervated tissue. The latter mechanism may be more important in settings where transected sensory nerves cannot be re-apposed. In this study, denervated osteomyocutaneous alloflaps (hind- limb transplants from Major Histocompatibility Complex (MHC-defined MGH miniature swine were performed to specifically evaluate collateral axonal sprouting for cutaneous sensory re-innervation. The skin component of the flap was externalized and serial skin sections extending from native skin to the grafted flap were biopsied. In order to visualize regenerating axonal structures in the dermis and epidermis, 50 um frozen sections were immunostained against axonal and Schwann cell markers. In all alloflaps, collateral axonal sprouts from adjacent recipient skin extended into the denervated skin component along the dermal-epidermal junction from the periphery towards the center. On day 100 post-transplant, regenerating sprouts reached 0.5 cm into the flap centripetally. Eight months following transplant, epidermal fibers were visualized 1.5 cm from the margin (rate of regeneration 0.06 mm per day. All animals had pinprick sensation in the periphery of the transplanted skin within 3 months post

  2. An examination of the collateral psychological and political damage of drone warfare in the FATA region of Pakistan

    OpenAIRE

    Dengler, Judson J.

    2013-01-01

    CHDS State/Local This research will examine the collateral psychological and political damage of the United States drone warfare program on Pakistani society in the Federally Administered Tribal Areas (FATA), to determine if this is an effective, proactive homeland defense tactic. The use of drone aircraft by the United States government has increased worldwide since this evolving technology was first utilized in 2001. Each drone strike impacts militants, noncombatants, and ordinary civili...

  3. Angiotensin-converting enzyme DD polymorphism is associated with poor coronary collateral circulation in patients with coronary artery disease.

    Science.gov (United States)

    Ceyhan, Koksal; Kadi, Hasan; Celik, Atac; Burucu, Turgay; Koc, Fatih; Sogut, Erkan; Sahin, Semsettin; Onalan, Orhan

    2012-01-01

    Although association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and cardiovascular diseases was reported by many studies, the relation between ACE I/D polymorphism and coronary collateral circulation (CCC) has not been studied yet. The aim of the present study was to investigate a possible relationship between ACE I/D polymorphism and CCC. Patients who were subjected to coronary angiography in the 2006 to 2009 period and had at least a completely occluded major artery were included in this study. To classify collateral circulation, we used the Rentrop classification. Patients were classified as having poor CCC (Rentrop grades 0 to 1) or good CCC (Rentrop grades 2 to 3). Gene polymorphism was detected through the detailed melting curve analysis of polymerase chain reaction products after amplification using real-time polymerase chain reaction method and LightCycler 1.5 apparatus. We prospectively studied 113 patients who had at least 1 totally occluded major epicardial coronary artery. Forty-seven patients had poor CCC and 67 patients had good CCC. There were no differences among groups in age, sex, risk factors, lipid profile, uses of cardiovascular drugs, and number of diseased vessels. Plasma ACE levels were significantly higher in poor CCC group (P DD polymorphism was higher in the poor CCC group (P DD genotype (95% CI, 2.55-12.79; P = 0.001), presence of diabetes (95% CI, 1.03-3.16; P = 0.005), and pulse pressure (95% CI, 1.04-1.56; P = 0.045) were independent determinants of poor coronary collateral development. This study showed that ACE DD polymorphism is associated with poor CCC. Poor collateral circulation in patients carrying the D allele may be associated with endothelial dysfunction and elevated blood ACE levels in these patients.

  4. The evaluation of the role of medial collateral ligament maintaining knee stability by a finite element analysis.

    Science.gov (United States)

    Ren, Dong; Liu, Yueju; Zhang, Xianchao; Song, Zhaohui; Lu, Jian; Wang, Pengcheng

    2017-04-21

    A three-dimensional finite element model (FEM) of the knee joint was established to analyze the biomechanical functions of the superficial and deep medial collateral ligaments (MCLs) of knee joints and to investigate the treatment of the knee medial collateral ligament injury. The right knee joint of a healthy male volunteer was subjected to CT and MRI scans in the extended position. The scanned data were imported into MIMICS, Geomagic, and ANSYS software to establish a three-dimensional FEM of the human knee joint. The anterior-posterior translation, valgus-varus rotation, and internal-external rotation of knee joints were simulated to observe tibial displacement or valgus angle. In addition, the magnitude and distribution of valgus stress in the superficial and deep layers of the intact MCL as well as the superficial, deep, and overall deficiencies of the MCL were investigated. In the extended position, the superficial medial collateral ligament (SMCL) would withstand maximum stresses of 48.63, 16.08, 17.23, and 16.08 MPa in resisting the valgus of knee joints, tibial forward displacement, internal rotation, and external rotation, respectively. Meanwhile, the maximum stress tolerated by the SMCL in various ranges of motion mainly focused on the femoral end point, which was located at the anterior and posterior parts of the femur in resisting valgus motion and external rotation, respectively. However, the deep medial collateral ligament could tolerate only minimum stress, which was mainly focused at the femoral start and end points. This model can effectively analyze the biomechanical functions of the superficial and deep layers of the MCLs of knee joints. The results show that the knee MCL II° injury is the indication of surgical repair.

  5. Prevention of the Rerupture of Collateral Artery Aneurysms on the Ventricular Wall by Early Surgical Revascularization in Moyamoya Disease: Report of Two Cases and Review of the Literature.

    Science.gov (United States)

    Kanamori, Fumiaki; Takasu, Syuntaro; Ota, Shinji; Seki, Yukio

    2018-01-01

    Collateral artery aneurysms are a source of intracranial hemorrhage in moyamoya disease. Several reports have shown that surgical revascularization leads to the obliteration of collateral artery aneurysms. However, its effect on the prevention of rebleeding has not been established, and the optimal timing of the operation remains unclear. The purpose of the present study is to evaluate the effects of surgical revascularization and to investigate the optimal operation timing in patients with moyamoya disease who have ruptured collateral artery aneurysms on the ventricular wall. Two patients with moyamoya disease who presented with intraventricular hemorrhage caused by rupture of collateral artery aneurysms on the wall of the lateral ventricle are presented here. In both cases, the aneurysms reruptured approximately 1 month after the initial hemorrhage. Both patients successfully underwent superficial temporal artery-middle cerebral artery anastomosis combined with indirect bypass in the subacute stage. The aneurysms decreased with the development of collateral circulation through the direct bypasses, and rebleeding did not occur after the surgery. Because ruptured collateral artery aneurysms on the wall of the lateral ventricle in moyamoya disease are prone to rerupture within 1 month, surgical revascularization may be recommended as soon as the patients are stable and able to withstand the operation. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Angiopoietin-2 impairs collateral artery growth associated with the suppression of the infiltration of macrophages in mouse hindlimb ischaemia

    Directory of Open Access Journals (Sweden)

    Xiaoyong Tan

    2016-10-01

    Full Text Available Abstract Background Angiopoietin-2 (Ang-2, a ligand of the Tie-2 receptor, plays an important role in maintaining endothelial cells and in destabilizing blood vessels. Collateral artery growth (arteriogenesis is a key adaptive response to arterial occlusion. It is unknown whether the destabilization of blood vessels by Ang-2 can affect arteriogenesis and modulate mononuclear cell function. This study aimed to investigate the effects of Ang-2 on collateral artery growth. Methods Hindlimb ischaemia model was produced in C57BL/6 mice by femoral artery ligation. Blood flow perfusion was measured using a laser Doppler perfusion imager quantitative RT-PCR analysis was applied to identify the level of angiogenic factors. Results After the induction of hindlimb ischaemia, blood flow recovery was impaired in mice treated with recombinant Ang-2 protein; this was accompanied by a reduction of peri-collateral macrophage infiltration. In addition, quantitative RT-PCR analysis revealed that Ang-2 treatment decreased monocyte chemotactic protein-1 (MCP-1, platelet-derived growth factor-BB (PDGF-BB mRNA levels in ischaemic adductor muscles. Ang-2 can lead to macrophage M1/M2 polarization shift inhibition in the ischaemic muscles. Furthermore, Ang-2 reduced the in vitro inflammatory response in macrophages and vascular cells involved in arteriogenesis. Conclusions Our results demonstrate that Ang-2 is essential for efficient arteriogenesis, which controls macrophage infiltration.

  7. Arthroscopic Reinsertion of Lateral Collateral Ligament, Anterior Capsular Plication, and Coronoid Tunneling Technique for Chronic Elbow Posterolateral Rotatory Instability.

    Science.gov (United States)

    Arrigoni, Paolo; D'Ambrosi, Riccardo; Nicoletti, Simone; Randelli, Pietro

    2016-06-01

    Posterolateral rotatory instability (PLRI) of the elbow is a chronic condition that results from lateral collateral ligament complex injury and presents with pain, clicking, and subluxation within the flexion and extension arcs of elbow motion. The primary cause involves a lesion of the lateral collateral ligament complex and its avulsion from the lateral epicondyle. In most cases, it is the result of trauma such as a fall on an outstretched hand or any other mechanism that imparts axial compression, valgus force, and supination. Several surgical techniques have been described for the treatment of PLRI, but there is no consensus regarding the ideal surgical treatment. The advantages of an arthroscopic approach for the treatment of PLRI are first diagnostic. Arthroscopy allows for visualization and diagnosis of every compartment of the elbow. The main steps of the surgical procedure consist of reinsertion of the lateral collateral ligament, anterior capsular plication, and coronoid tunneling. By use of this technique, it is possible to perform an anatomic repair and provide stability of the elbow.

  8. Formation of Collateral Veins in a Graft Pancreas After a Simultaneous Pancreas and Kidney Transplantation: A Case Report.

    Science.gov (United States)

    Choi, B H; Lee, H Y; Park, Y M; Yang, K H; Ryu, J H; Chu, C W

    2015-09-01

    A graft vein thrombosis is the main cause of early graft failure after pancreas transplantation. We report a case of formation of collateral veins in a graft pancreas after transplant. A 30-year-old woman underwent simultaneous pancreas and kidney transplantation. She was discharged 16 days after the operation with good pancreas and kidney function. A total occlusion of the portal vein was discovered on computed tomography (CT) performed at an outpatient clinic. She had no symptoms or signs of hyperglycemia. Venography was attempted for vein thrombectomy but failed. After 2 weeks of heparinization therapy, the edema disappeared and perfusion of the graft pancreas improved. However, the thrombotic occlusion was not resolved on CT. Arteriography of the Y-graft revealed collateral veins. She was discharged with warfarin. She is currently doing well without any symptoms or signs. This is the first reported case of collateral vein formation in a grafted pancreas after pancreas transplantation. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Biomechanical study of the effect of platelet rich plasma on the treatment of medial collateral ligament lesion in rabbits.

    Science.gov (United States)

    Costa, Eduardo Louzada da; Teixeira, Luiz Eduardo Moreira; Pádua, Bruno Jannotti; Araújo, Ivana Duval de; Vasconcellos, Leonardo de Souza; Dias, Luide Scalioni Borges

    2017-10-01

    To evaluate the use of platelet-rich plasma in the early stages of healing of traumatic injury of the medial collateral ligament in the knee of rabbits. Thirty rabbits were subjected to surgical lesion of the medial collateral ligament. Of these, 16 were treated with platelet-rich plasma and 14 with saline (control). After 3 and 6 weeks of treatment, 50% of the animals from each group were sacrificed, and biomechanical tests were performed on the injured ligament to compare the tensile strength between the two groups. Platelet-rich plasma significantly increased the tensile strength of the ligament in the groups treated after3 and 6 weeks. In the group treated with platelet-rich plasma vs. saline, the tensile strength values were 3192.5 ± 189.7 g/f vs. 2851.1 ± 193.1 g/f at3 weeks (p = 0.005) and 5915.6 ± 832.0 g/f vs. 4187.6 ± 512.9 g/f at 6 weeks (p = 0.0001). The use of platelet-rich plasma at the injury site accelerated ligament healing in an animal model, demonstrated by an increase in the tensile strength of the medial collateral ligament.

  10. Firm age, collateral value, and access to debt financing in an emerging economy: evidence from South Africa

    Directory of Open Access Journals (Sweden)

    Abel Ezeoha

    2012-03-01

    Full Text Available This paper applies the Blundell and Bond system generalised method of moments (GMM two-step estimator to examine the impact of age and collateral value on debt financing, using a panel of 177 non-financial companies listed on the Johannesburg Stock Exchange over the period 1999 to 2009. The results show that South African firms have target leverage ratios and adjust their capital structures from time to time to achieve their respective targets, that the relationship between firm age and debt financing is non-monotonic, and that firms with higher collateral value are likely to face fewer constraints on borrowing and therefore have greater access to medium-term and long-term debts. Robustness tests also reveal that during start-up and maturity stages, a firm’s access to debt markets is significantly influenced by investments in assets that are acceptable to external creditors as collateral. These findings suggest that debt financing policies could be more critical for firms in the start-up and maturity stages.

  11. The unique branching patterns of Deinococcus glycogen branching enzymes are determined by their N-terminal domains.

    NARCIS (Netherlands)

    Palomo, M.; Kralj, S.; van der Maarel, M. J. E. C.; Dijkhuizen, L.

    2009-01-01

    Glycogen branching enzymes (GBE) or 1,4-alpha-glucan branching enzymes (EC 2.4.1.18) introduce alpha-1,6 branching points in alpha-glucans, e.g., glycogen. To identify structural features in GBEs that determine their branching pattern specificity, the Deinococcus geothermalis and Deinococcus

  12. Incarceration of the medial collateral ligament in the intercondylar notch following proximal avulsion

    Energy Technology Data Exchange (ETDEWEB)

    Walton, Edward [Fiona Stanley Hospital, Department of Radiology, Perth, Western Australia (Australia); Williams, Martin [North Bristol NHS Trust, Department of Radiology, Bristol (United Kingdom); Robinson, James R. [Bristol Knee Group, Avon Orthopaedic Centre, Bristol (United Kingdom)

    2017-11-15

    Intra-articular entrapment of the medial collateral ligament (MCL) is a rare but recognised complication of traumatic injury to the posteromedial corner (PMC) of the knee. Considering the MCL is the most commonly injured ligament of the knee this complication is extremely rare with only a handful of cases describing MCL entrapment following distal avulsion of the MCL. We present the first known case of MCL entrapment following proximal avulsion of the MCL and posterior oblique ligament (POL) with the mid-substance of the MCL becoming entrapped in the joint, lying on the superior surface of the medial meniscus and extending up into the intercondylar notch. In addition, the medial patellar retinaculum was also entrapped in the medial aspect of the medial patellofemoral joint. MCL entrapment is best treated with expeditious surgical intervention and it is therefore crucial that the MRI findings are not overlooked. Details of the clinical assessment, MRI and operative findings are presented with a literature review of MCL entrapment. (orig.)

  13. Collateral ventilation of obstructed lung during high-frequency oscillation in dogs and pigs.

    Science.gov (United States)

    Takeda, J; Mackenzie, C F; Watson, R; Roberts, H G; Moorman, R; Hoff, B H; Wilson, D; Johnston, G S; Hill, J L

    1987-09-01

    To determine if collateral ventilation (CV) occurs in pigs and dogs during intermittent positive-pressure ventilation (IPPV) and high-frequency oscillation (HFO), seven pigs and seven dogs were studied by measuring Xenon 133 washout (XeW) from an occluded subsegmental bronchus. The rate constant/min (K) for Xe blood uptake (KXeb) was derived, and when subtracted from K for XeW (KXeW) gave K for removal of Xe by CV (KXecv). Pig XeW were single exponentials with mean KXew = 0.25/min during IPPV and 0.12/min with HFO. In pigs, mean K of XeW was no different from KXeb so that all XeW occurred by blood uptake and none by CV. XeW in dogs had two exponentials. Dogs had over 11 times greater mean KXeW than pigs during IPPV and over 24 times greater during HFO. In dogs, on average, 79% (IPPV) and 87% (HFO) of XeW occurred by CV. CV is a means of gas exchange during HFO and IPPV in dogs but not in pigs.

  14. Physical examination and imaging of medial collateral ligament and posteromedial corner of the knee.

    Science.gov (United States)

    Craft, Jason A; Kurzweil, Peter R

    2015-06-01

    The medial collateral ligament (MCL) is the most commonly injured knee ligament. Most will heal well with nonoperative treatment. However, not all medial knee injuries are the same. A detailed physical examination can help determine the severity of the medial-sided injury. When combined with advanced imaging, the examination will delineate damage to associated medial knee structures, including the location of MCL damage, posteromedial capsule injuries, and combined cruciate injuries. Failure to recognize MCL injuries that may be prone to chronic laxity can lead to significant disability, joint damage, and failure of concomitant cruciate ligament reconstructions. Magnetic resonance imaging is the mainstay of diagnostic imaging, with coronal sequences allowing full assessment of the MCL complex. Tangential views aid in the diagnosis of concomitant injuries. Stress radiography can play a role in evaluating MCL healing and subtle chronic laxity. Ultrasonography is also gaining acceptance as a means to assess MCL injuries. Use of a detailed examination and advanced imaging will allow optimal treatment of medial knee injuries and improve clinical outcomes.

  15. Changes in pitching mechanics after ulnar collateral ligament reconstruction in major league baseball pitchers.

    Science.gov (United States)

    Portney, Daniel A; Lazaroff, Jake M; Buchler, Lucas T; Gryzlo, Stephen M; Saltzman, Matthew D

    2017-08-01

    Medial ulnar collateral ligament (UCL) reconstruction is a common procedure performed on Major League Baseball pitchers. Variations in pitching mechanics before and after UCL reconstructive surgery are not well understood. Publicly available pitch tracking data (PITCHf/x) were compared for all Major League Baseball pitchers who underwent UCL reconstruction between 2008 and 2013. Specific parameters analyzed were fastball percentage, release location, velocity, and movement of each pitch type. These data were compared before and after UCL reconstructive surgery and compared with a randomly selected control cohort. There were no statistically significant changes in pitch selection or pitch accuracy after UCL reconstruction, nor was there a decrease in pitch velocity. The average pitch release location for 4-seam and 2-seam fastballs, curveballs, and changeups is more medial after UCL reconstruction (P < .01). Four-seam fastballs and sliders showed decreased horizontal breaking movement after surgery (P < .05), whereas curveballs showed increased downward breaking movement after surgery (P < .05). Pitch selection, pitch velocity, and pitch accuracy do not significantly change after UCL reconstruction, nor do players who require UCL reconstruction have significantly different pitch selection, velocity, or accuracy than a randomly selected control cohort. Pitch release location is more medial after UCL reconstruction for all pitch types except sliders. Breaking movement of fastballs, sliders, and curveballs changes after UCL reconstruction. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  16. The effects of medial ulnar collateral ligament reconstruction on Major League pitching performance.

    Science.gov (United States)

    Keller, Robert A; Steffes, Matthew J; Zhuo, David; Bey, Michael J; Moutzouros, Vasilios

    2014-11-01

    Medial ulnar collateral ligament (MUCL) reconstruction is commonly performed on Major League Baseball (MLB) pitchers. Previous studies have reported that most pitchers return to presurgical statistical performance levels after MUCL reconstruction. Pitching performance data--specifically, earned run average (ERA), walks and hits per inning pitched (WHIP), winning percentage, and innings pitched--were acquired for 168 MLB pitchers who had undergone MUCL reconstruction. These data were averaged over the 3 years before surgery and the 3 years after surgery and also acquired from 178 age-matched, uninjured MLB pitchers. Of the pitchers who had MUCL reconstruction surgery, 87% returned to MLB pitching. However, compared with presurgical data, pitching performance declined in terms of ERA (P = .001), WHIP (P = .011), and innings pitched (P = .026). Pitching performance also declined in the season before the surgery compared with previous years (ERA, P = .014; WHIP, P = .036; innings pitched, P major league experience at the same age (P major league level. However, after MUCL reconstruction, there is a statistically significant decline in pitching performance. There appears to be a statistically significant decline in pitching performance the year before reconstructive surgery, and this decline is also a risk factor for requiring surgery. In addition, there is an increased risk of MUCL reconstruction for pitchers who enter the major leagues at a younger age. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  17. Periventricular anastomosis in moyamoya disease: detecting fragile collateral vessels with MR angiography.

    Science.gov (United States)

    Funaki, Takeshi; Takahashi, Jun C; Yoshida, Kazumichi; Takagi, Yasushi; Fushimi, Yasutaka; Kikuchi, Takayuki; Mineharu, Yohei; Okada, Tomohisa; Morimoto, Takaaki; Miyamoto, Susumu

    2016-06-01

    OBJECT The authors' aim in this paper was to determine whether periventricular anastomosis, a novel term for the abnormal collateral vessels typical of moyamoya disease, is reliably measured with MR angiography and is associated with intracranial hemorrhage. METHODS This cross-sectional study sampled consecutive patients with moyamoya disease or moyamoya syndrome at a single institution. Periventricular anastomoses were detected using MR angiography images reformatted as sliding-thin-slab maximum-intensity-projection coronal images and were scored according to 3 subtypes: lenticulostriate, thalamic, and choroidal types. The association between periventricular anastomosis and hemorrhagic presentation at onset was evaluated using multivariate analyses. RESULTS Of 136 eligible patients, 122 were analyzed. Eighteen (14.8%) patients presented with intracranial hemorrhage with neurological symptoms at onset. Intra- and interrater agreement for rating of the periventricular anastomosis score was good (κw = 0.65 and 0.70, respectively). The prevalence of hemorrhagic presentation increased with the periventricular anastomosis score: 2.8% for Score 0, 8.8% for Score 1, 18.9% for Score 2, and 46.7% for Score 3 (p moyamoya disease. The clinical utility of periventricular anastomosis as a predictor for hemorrhage should be validated in further prospective studies.

  18. Mexico’s northern border conflict: collateral damage to health and human rights of vulnerable groups

    Science.gov (United States)

    Beletsky, Leo; Martinez, Gustavo; Gaines, Tommi; Nguyen, Lucie; Lozada, Remedios; Rangel, Gudelia; Vera, Alicia; McCauley, Heather L.; Sorensen, Andrea; Strathdee, Steffanie A.

    2013-01-01

    Objective To compare distributions of human rights violations and disease risk; to juxtapose these patterns against demographic and structural environmental variables, and to formulate implications for structural interventions. Methods Female sex workers who inject drugs were surveyed in Tijuana and Ciudad Juarez, Mexico. Structured interviews and testing for sexually transmitted infections (STIs) were conducted (October 2008 to October 2009). Frequencies of individual and environmental factors, including police abuse, risk of HIV infection, and protective behaviors, were compared between sites using univariate logistic regression. Results Of 624 women, almost half reported police syringe confiscation despite syringes being legal; 55.6% reported extortion (past 6 months), with significantly higher proportions in Ciudad Juarez (P Ciudad Juarez, P = 0.04) and sexual abuse (15.7% in Tijuana, 18.3% in Ciudad Juarez) by police were commonplace. Prevalence of STIs was significantly lower in Tijuana than in Ciudad Juarez (64.2% and 83.4%, P Ciudad Juarez respondents reported significantly higher median number of monthly clients (6.8 versus 1.5, P Ciudad Juarez in the past year (72.1% versus 59.2%, P = 0.001). Conclusions Collateral damage from police practices in the context of Mexico’s drug conflict may affect public health in the Northern Border Region. Itinerant officers may facilitate disease spread beyond the region. The urgency for mounting structural interventions is discussed. PMID:22767041

  19. Biologic Augmentation of the Ulnar Collateral Ligament in the Elbow of a Professional Baseball Pitcher

    Directory of Open Access Journals (Sweden)

    James K. Hoffman

    2015-01-01

    Full Text Available Tears of the ulnar collateral ligament (UCL of the elbow are common injuries in overhead athletes. Although surgical reconstruction of the UCL has improved outcomes, not all athletes return to their previous level of competition and when this goal is achieved, the time required averages one to two years. Therefore, additional techniques are needed to further improve return to play and the rate of return to play in overhead athletes. A construct comprising a dermal allograft, platelet rich plasma (PRP, and mesenchymal stem cells (MSCs has been shown to successfully improve healing in the rotator cuff. Given the promising provisional findings, we postulated that this construct could also improve healing if applied to the UCL. Therefore, the purpose of the present report was to examine the feasibility of utilizing a dermal allograft, PRP, and MSC construct to augment UCL reconstruction in a professional baseball pitcher. No complications were encountered. Although limited to minimal follow-up, the patient has demonstrated excellent progress and has returned to activity.

  20. [SEMITENDINOUS AND GRACILIS TRANSFER FOR TREATMENT OF MEDIAL COLLATERAL LIGAMENT INJURY CAUSED BY TOTAL KNEE ARTHROPLASTY].

    Science.gov (United States)

    Cao Jiangang; Wang, Lei; Zhao, Huiwen; Liu, Jun

    2016-02-01

    To evaluate the effectiveness of semitendinous and gracilis transfer for the treatment of medial collateral ligament (MCL) injury caused by total knee arthroplasty (TKA). Between March 2009 and May 2014, 11 patients (11 knees) with MCL injuries caused by primary TKA were treated by semitendinous and gracilis transfer in primary TKA (injury group). Another 18 patients (21 knees) without MCL injury were included as the control group. There was no significant difference in gender, age, injury sides, disease duration, body mass index, knee varus deformity, and preoperative Knee Society Score (KSS) between 2 groups (P>0.05), with comparability. KSS score was used to evaluate the function after operation. Primary healing of incision was obtained in all patients, and no complications of joint instability and pain occurred. The follow-up time was-6-29 months in injury group and was 7-34 months in control group. At last follow-up, the KSS clinical score and ftinctional score were significantly increased to 89.82 +/- 3.76 and 89.54 +/- 3.50 in the injury group (Pinjury caused by TKA. The insertions of semitendinous tendon and gracilis are close to that of the knee MCL, which can effectively improve knee function.

  1. Semitendinosus and gracilis transfer for treatment of medial collateral ligament injury of total knee arthroplasty.

    Science.gov (United States)

    Cao, J-G; Wang, L; Zhao, H-W; Liu, J

    2016-09-01

    The objective of the study is to evaluate the clinic effectiveness of semitendinosus and gracilis transfer for the treatment of medial collateral ligament (MCL) injury of total knee arthroplasty (TKA). From March 2009 to May 2014, a series of 11 patients with MCL injuries of primary TKA were treated by semitendinosus and gracilis transfer. Another 18 patients (21 knees) were recruited as control group. The two groups of patients were comparable for gender, age, body mass index, varus knee deformity, KSS score, joint activity degree and type of prosthesis comparison without significant difference (p > 0.05). All the patients were regularly followed-up using the American Knee Society Scoring System (KSS). No patient of either group reported impaired wound healing, joint instability, pain, prosthesis loosening and other complications. At the final follow-up, the mean knee objective score and the functional score of the injury group include (89.82 ± 3.76) points and (89.54 ± 3.50) points, respectively. The control group includes (90.19 ± 3.39) and (90 ± 3.53) points. They were significantly higher than the preoperative conditions. The difference was not statistically significant. The difference of KSS score was not statistically significant (t = 0.158, p = 0.877; t = 0.820, p = 0.432). The semitendinosus and gracilis transfer are reliable for the treatment of MCL injury of TKA. The semitendinosus and gracilis are close to the knee MCL, which can effectively improve knee function.

  2. MR imaging of tibial collateral ligament injury: comparison with clinical examination

    Energy Technology Data Exchange (ETDEWEB)

    Yao, L. [Dept. of Radiological Sciences, UCLA Center for the Health Sciences, Los Angeles, CA (United States); Dungan, D. [Dept. of Radiological Sciences, UCLA Center for the Health Sciences, Los Angeles, CA (United States); Seeger, L.L. [Dept. of Radiological Sciences, UCLA Center for the Health Sciences, Los Angeles, CA (United States)

    1994-10-01

    We sought to clarify the capability of routine magnetic resonance (MR) imaging of the knee to detect and grade tibial collateral ligament (TCL) injury. We also wanted to define the exact MR findings that were the most important for diagnosis. Sixty-three patients were clinically evaluated for TCL injury prior to MR imaging of the knee on a 1.5-tesla system. MR studies were scored with respect to multiple direct and indirect findings. By discriminant analysis, the overall accuracy of classification (into clinical grades 1, 2, 3 and normal) on the basis of MR was 65%. Accuracy for detection of abnormal TCLs was 87%. The most useful MR findings for detection and grading of TCL injury were direct signs: subcutaneous edema over the TCL, focal disruption of the TCL, increased signal in the TCL on T2-weighted images, and longitudinal striations within the TCL. Indirect signs such as trabecular trauma were less useful for TCL evaluation. The presence of a tear of the anterior cruciate ligament, however, correlated with TCL injury of a higher grade. T2-weighted coronal images, by better depicting intraligamentous edema and fiber disruption, improved the MR assessment of the TCL. (orig.)

  3. Distribution of Force in the Medial Collateral Ligament Complex During Simulated Clinical Tests of Knee Stability.

    Science.gov (United States)

    Schafer, Kevin A; Tucker, Scott; Griffith, Timothy; Sheikh, Saad; Wickiewicz, Thomas L; Nawabi, Danyal H; Imhauser, Carl W; Pearle, Andrew D

    2016-05-01

    Pivot-shift injury commonly results in combined anterior cruciate ligament (ACL)/medial collateral ligament (MCL) injury, yet the contribution of the components of the MCL complex to restraining multiplanar rotatory loads forming critical subcomponents of the pivot shift is not well understood. To quantify the role of the MCL complex in restraining multiplanar rotatory loads. Controlled laboratory study. A robotic manipulator was used to apply combined valgus and internal rotation torques in a simplified model of the pivot-shift examination in 12 cadaveric knees (49 ± 11 years). Tibiofemoral kinematics were recorded with the ACL intact. Loads borne by the superficial MCL (sMCL), posterior oblique ligament (POL), deep MCL (dMCL), and ACL were determined via the principle of superposition. The POL bore about 50% of the load carried by the ACL in response to the combined torques at 5° and 15° of flexion. The POL bore load during the internal rotation component of the combined torques, while the sMCL carried load during the valgus and internal rotation phases of the simulated pivot. Load in the dMCL was always knee stability in the ACL-competent knee. Both the sMCL and POL work together with the ACL to resist combined moments, which form key components of the pivot-shift examination. © 2016 The Author(s).

  4. [Control observation between mild moxibustion and TDP for obsolete collateral ligament injury of interphalangeal joints].

    Science.gov (United States)

    Liang, Yulei; Li, Weihua; Xu, Xiaokang; Ding, Chenguang; Tian, Ling; Duan, Jiaqiang; Zhang, Zhifang; Sun, Lihong

    2016-01-01

    To compare the effects between mild moxibustion and specific electromagnetic spectrum therapy apparatus (TDP) for obsolete collateral ligament injury of interphalangeal joints. Sixty patients were randomly divided into a mild moxibustion group and a TDP group, 30 cases in each one. In the mild moxibustion group, pure moxa sticks were used at the affected digital joints locally for 20-30 min a time. In the TDP group, TDP was applied at the affected digital joints locally for 20-30 min a time. The treatment was given once a day for two courses, and 10-day treatment was made into a course. Visual analogue scale (VAS) for pain, swelling degree of the affected digital joints before and after treatment were observed and the clinical efficacy and safety were evaluated in the two groups. The excellent rate was 56.7% (17/30) and the excellent and, good rate was 83.4% (25/30) in the mild moxibustion group,which were better than 36.7% (11/30) and 76.7% (23/30) in the TDP group respectively (both P ligament injury of interphalangeal joints, which is superior to TDP.

  5. Development of Tissue-Engineered Ligaments: Elastin Promotes Regeneration of the Rabbit Medial Collateral Ligament.

    Science.gov (United States)

    Hirukawa, Masaki; Katayama, Shingo; Sato, Tatsuya; Yamada, Masayoshi; Kageyama, Satoshi; Unno, Hironori; Suzuki, Yoshiaki; Miura, Yoshihiro; Shiratsuchi, Eri; Hasegawa, Masahiro; Miyamoto, Keiichi; Horiuchi, Takashi

    2017-12-21

    When ligaments are injured, reconstructive surgery is sometimes required to restore function. Methods of reconstructive surgery include transplantation of an artificial ligament and autotransplantation of a tendon. However, these methods have limitations related to the strength of the bone-ligament insertion and biocompatibility of the transplanted tissue after surgery. Therefore, it is necessary to develop new reconstruction methods and pursue the development of artificial ligaments. Elastin is a major component of elastic fibers and ligaments. However, the role of elastin in ligament regeneration has not been described. Here, we developed a rabbit model of a medial collateral ligament (MCL) rupture and treated animal knees with exogenous elastin [100 µg/(0.5 mL·week)] for 6 or 12 weeks. Elastin treatment increased gene expression and protein content of collagen and elastin (gene expression, 6-fold and 42-fold, respectively; protein content, 1.6-fold and 1.9-fold, respectively), and also increased the elastic modulus of MCL increased with elastin treatment (2-fold) compared with the controls. Our data suggest that elastin is involved in the regeneration of damaged ligaments. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  6. Relationship of coronary collateral circulation with eosinophils in patients with unstable angina pectoris.

    Science.gov (United States)

    Wang, Jun; Li, Qun; Li, Shi-jing; Wang, De-zhao; Chen, Bu-xing

    2016-01-01

    Eosinophils (EOS) have been associated with prognosis of patients with coronary artery disease, and those who showed plenitudinous coronary collateral circulation (CCC) often have good clinical consequences. However, the relationship between EOS and CCC was seldom reported. To investigate the relationship between EOS and CCC development in patients with unstable angina pectoris (UAP). The study population consisted of 502 consecutive patients with UAP who underwent coronary angiography and coronary stenosis ≥80%. CCC was graded according to the Rentrop grading system of 0-3. Rentrop grades of 0 and 1 indicated low-grade CCC group, whereas grades 2 and 3 indicated high-grade CCC group. The EOS was significantly higher in the high-grade CCC group compared with the low-grade CCC group. In multiple logistic regression analysis, EOS (odds ratio: 1.969; 95% confidence interval [CI]: 1.210-3.3205; P=0.006) and neutrophil count (odds ratio: 0.757; 95% CI: 0.584-0.981; P=0.035) were predictors of high-grade CCC development. EOS of >0.12×10(9)/L could independently predict high-grade CCC with 72.5% sensitivity and 58.4% specificity (area under the curve: 0.681; 95% CI: 0.632-0.729). EOS were associated with high-grade CCC in patients with UAP with coronary stenosis ≥80%. Increased EOS count may play an important role in the development of CCC in patients with UAP.

  7. Sigma-2 receptor agonists as possible antitumor agents in resistant tumors: hints for collateral sensitivity.

    Science.gov (United States)

    Niso, Mauro; Abate, Carmen; Contino, Marialessandra; Ferorelli, Savina; Azzariti, Amalia; Perrone, Roberto; Colabufo, Nicola Antonio; Berardi, Francesco

    2013-12-01

    With the aim of contributing to the development of novel antitumor agents, high-affinity σ2 receptor agonists were developed, with 6,7-dimethoxy-2-[4-[1-(4-fluorophenyl)-1H-indol-3-yl]butyl]-1,2,3,4-tetrahydroisoquinoline (15) and 9-[4-(6,7-dimethoxy-1,2,3,4-tetrahydroisoquinolin-2-yl)butyl]-9H-carbazole (25) showing exceptional selectivity for the σ2 subtype. Most of the compounds displayed notable antiproliferative activity in human MCF7 breast adenocarcinoma cells, with similar activity in the corresponding doxorubicin-resistant MCF7adr cell line. Surprisingly, a few compounds, including 25, displayed enhanced activity in MCF7adr cells over parent cells, recalling the phenomenon of collateral sensitivity, which is under study for the treatment of drug-resistant tumors. All of the compounds showed interaction with P-glycoprotein (P-gp), and 15 and 25, with the greatest activity, were able to revert P-gp-mediated resistance and reestablish the antitumor effect of doxorubicin in MCF7adr cells. We therefore identified a series of σ2 receptor agonists endowed with intriguing antitumor properties; these compounds deserve further investigation for the development of alternate strategies against multidrug- resistant cancers. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Isometric Tunnel Placement in Ulnar Collateral Ligament Reconstruction with Single CT Scan

    Directory of Open Access Journals (Sweden)

    Erica Kholinne

    2017-01-01

    Full Text Available Background. Isometric tunnel placement for anterior bundle of the medial collateral ligament (MCL reconstruction is mandatory for successful surgery. Purpose. This study aimed to demonstrate a useful method for identifying isometric tunnel placement using a single computed tomography (CT scan. Study Design. Descriptive Laboratory Study. Methods. Five normal elbows were scanned at 4 different flexion angles at 45° increment. Three-dimensional models were analyzed using 2 different approaches: single and multiple CT scans methods. Ligament footprints in the humerus and the ulna were registered. Ligament length and isometric points were defined. The locations of the isometric points were imported into both methods to be compared. Results. There was no significant difference between 2 methods in calculating the length in every zone. There was also no significant difference in determining isometric ligament’s origin point, which is located approximately 18.2±4.0 mm and 18.4±2.9 mm for single and multiple CT, respectively, measured inferolaterally from medial epicondyle. Conclusions. A solid preoperative plan is critical when predicting tunnel locations due to the difficulty in finding isometric points and the individuality of optimal bone tunnel locations. Using single CT scan, optimal locations can be predicted with the same accuracy as a multiple CT scans with less radiation exposure.

  9. Global experience with an inner branched arch endograft.

    Science.gov (United States)

    Haulon, Stéphan; Greenberg, Roy K; Spear, Rafaëlle; Eagleton, Matt; Abraham, Cherrie; Lioupis, Christos; Verhoeven, Eric; Ivancev, Krassi; Kölbel, Tilo; Stanley, Brendan; Resch, Timothy; Desgranges, Pascal; Maurel, Blandine; Roeder, Blayne; Chuter, Timothy; Mastracci, Tara

    2014-10-01

    Branched endografts are a new option to treat arch aneurysm in high-risk patients. We performed a retrospective multicenter analysis of all patients with arch aneurysms treated with a new branched endograft designed with 2 inner branches to perfuse the supra aortic trunks. Thirty-eight patients were included. The median age was 71 years (range, 64-74 years). An American Society of Anesthesiologists score of 3 or 4 was reported in 89.5% (95% confidence interval [CI], 79.7-99.3) of patients. The 30-day mortality rate was 13.2% (95% CI, 2.2-24.2). Technical success was obtained in 32 patients (84.2% [95% CI, 72.4-95.9]). Early secondary procedures were performed in 4 patients (10.5% [95% CI, 0.7-20.3]). Early cerebrovascular complications were diagnosed in 6 patients (15.8% [95% CI, 4.0-27.6]), including 4 transient ischemic attacks, 1 stroke, and 1 subarachnoid hemorrhage. The median follow-up was 12 months (range, 6-12 months). During follow-up, no aneurysm-related death was detected. Secondary procedures during follow-up were performed in 3 patients (9.1% [95% CI, 0.0-19.1]), including 1 conversion to open surgery. We compared the first 10 patients (early experience group) with the subsequent 28 patients. Intraoperative complications and secondary procedures were significantly higher in the early experience group. Although not statistically significant, the early mortality was higher in the early experience group (30% [95% CI, 0.0-60.0]) versus the remainder (7.1% [95% CI, 0.0-16.9]; P=.066). Being part of the early experience group and ascending aortic diameter≥38 mm were found to be associated to higher rates of combined early mortality and neurologic complications. Our preliminary study confirms the feasibility and safety of the endovascular repair of arch aneurysms in selected patients who may not have other conventional options. Thoracic IDE NCT00583817, FDA IDE# 000101. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier

  10. Partial Order Reduction for Probabilistic Branching Time

    NARCIS (Netherlands)

    Baier, Christel; d' Argenio, P.R.; Größer, Marcus

    2005-01-01

    In the past, partial order reduction has been used successfully to combat the state explosion problem in the context of model checking for non-probabilistic systems. For both linear time and branching time specifications, methods have been developed to apply partial order reduction in the context of

  11. Simple statistical model for branched aggregates

    DEFF Research Database (Denmark)

    Lemarchand, Claire; Hansen, Jesper Schmidt

    2015-01-01

    We propose a statistical model that can reproduce the size distribution of any branched aggregate, including amylopectin, dendrimers, molecular clusters of monoalcohols, and asphaltene nanoaggregates. It is based on the conditional probability for one molecule to form a new bond with a molecule...

  12. Medial branch neurotomy in low back pain

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore; Mammucari, Matteo; Simonetti, Giovanni [Interventional Radiology and Radiotherapy University ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Rome (Italy); Nano, Giovanni [Interventional Radiology and Radiotherapy University ' ' Tor Vergata' ' , Department of Diagnostic and Molecular Imaging, Rome (Italy); University ' ' Tor Vergata' ' , Department of Radiology, Rome (Italy); Marcia, Stefano [S. Giovanni di Dio Hospital, Department of Diagnostic and Molecular Imaging, Cagliari (Italy)

    2012-07-15

    This study aimed to assess the effectiveness of pulsed radiofrequency medial branch dorsal ramus neurotomy in patients with facet joint syndrome. From January 2008 to April 2010, 92 patients with facet joint syndrome diagnosed by strict inclusion criteria and controlled diagnostic blocks undergone medial branch neurotomy. We did not exclude patients with failed back surgery syndrome (FBSS). Electrodes (20G) with 5-mm active tip were placed under fluoroscopy guide parallel to medial branch. Patients were followed up by physical examination and by Visual Analog Scale and Oswestry Disability Index at 1, 6, and 12 months. In all cases, pain improvement was statistically significant and so quality of life. Three non-FBSS patients had to undergo a second neurotomy because of non-satisfactory pain decrease. Complications were reported in no case. Medial branch radiofrequency neurotomy has confirmed its well-established effectiveness in pain and quality of life improvement as long as strict inclusion criteria be fulfilled and nerve ablation be accomplished by parallel electrode positioning. This statement can be extended also to FBSS patients. (orig.)

  13. Origin of buds, branches, and sprouts

    Science.gov (United States)

    Kevin T. Smith

    2014-01-01

    Recent research shows that survivor trees in rural, managed forests rebuild broken crowns with new branches and foliage after ice storm injury (Shortle et al. 2014). Veteran trees in historic parks and landscapes show repeated cycles of crown loss and recovery (Fay 2002). Crown rebuilding or reiteration from sprouts is a physiological response with architectural...

  14. Academic Branch Libraries: Assessment and Collection Development

    Science.gov (United States)

    Poole, Julie

    2009-01-01

    An ongoing project at Mercer University's Regional Academic Center Libraries illustrates how utilizing established assessment guidelines, stakeholder input, and a clear understanding of audience and curriculum needs may all be used to optimize a collection. Academic branch libraries often have clear collection development limitations in terms of…

  15. Headward growth and branching in subterranean channels

    Science.gov (United States)

    Kudrolli, Arshad; Ionkin, Nikolay; Panaitescu, Andreea

    2017-11-01

    We investigate the erosive growth of channels in a thin subsurface sedimentary layer driven by hydrodynamic drag toward understanding subterranean networks and their relation to river networks charged by ground water. Building on a model based on experimental observations of fluid-driven evolution of bed porosity, we focus on the characteristics of the channel growth and their bifurcations in a horizontal rectangular domain subject to various fluid source and sink distributions. We find that the erosion front between low- and high-porosity regions becomes unstable, giving rise to branched channel networks, depending on the spatial fluctuations of the fluid flow near the front and the degree to which the flow is above the erodibility threshold of the medium. Focusing on the growth of a network starting from a single channel, and by identifying the channel heads and their branch points, we find that the number of branches increases sublinearly and is affected by the source distribution. The mean angles between branches are found to be systematically lower than river networks in humid climates and depend on the domain geometry.

  16. Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition

    Directory of Open Access Journals (Sweden)

    Valverde Israel

    2012-04-01

    velocity acquisition is reliable, operator-independent and more time-efficient than 2D flow acquisition to quantify SPCF. There is considerable SPCF in BCPC and Fontan patients. SPCF was more pronounced towards the respective lung with less pulmonary arterial flow suggesting more collateral flow where less anterograde branch pulmonary artery perfusion.

  17. The AFCRL Lunar amd Planetary Research Branch

    Science.gov (United States)

    Price, Stephan D.

    2011-07-01

    The Lunar and Planetary research program led by Dr John (Jack) Salisbury in the 1960s at the United States Air Force Cambridge Research Laboratories (AFCRL) investigated the surface characteristics of Solar System bodies. The Branch was one of the first groups to measure the infrared spectra of likely surface materials in the laboratory under appropriate vacuum and temperature conditions. The spectral atlases created from the results were then compared to photometric and spectral measurements obtained from ground- and balloon-based telescopes to infer the mineral compositions and physical conditions of the regoliths of the Moon, Mars and asteroids. Starting from scratch, the Branch initially sponsored observations of other groups while its in-house facilities were being constructed. The earliest contracted efforts include the spatially-resolved mapping of the Moon in the first half of the 1960s by Richard W. Shorthill and John W. Saari of the Boeing Scientific Research Laboratories in Seattle. This effort ultimately produced isophotal and isothermal contour maps of the Moon during a lunation and time-resolved thermal images of the eclipsed Moon. The Branch also sponsored probe rocket-based experiments flown by Riccardo Giacconi and his group at American Science and Engineering Inc. that produced the first observations of X-ray stars in 1962 and later the first interferometric measurement of the ozone and C02 emission in the upper atmosphere. The Branch also made early use of balloon-based measurements. This was a singular set of experiments, as these observations are among the very few mid-infrared astronomical measurements obtained from a balloon platform. Notable results of the AFCRL balloon flights were the mid-infrared spectra of the spatially-resolved Moon obtained with the University of Denver mid-infrared spectrometer on the Branch's balloon-borne 61-cm telescope during a 1968 flight. These observations remain among the best available. Salisbury also funded

  18. Tree Branching: Leonardo da Vinci's Rule versus Biomechanical Models

    Science.gov (United States)

    Minamino, Ryoko; Tateno, Masaki

    2014-01-01

    This study examined Leonardo da Vinci's rule (i.e., the sum of the cross-sectional area of all tree branches above a branching point at any height is equal to the cross-sectional area of the trunk or the branch immediately below the branching point) using simulations based on two biomechanical models: the uniform stress and elastic similarity models. Model calculations of the daughter/mother ratio (i.e., the ratio of the total cross-sectional area of the daughter branches to the cross-sectional area of the mother branch at the branching point) showed that both biomechanical models agreed with da Vinci's rule when the branching angles of daughter branches and the weights of lateral daughter branches were small; however, the models deviated from da Vinci's rule as the weights and/or the branching angles of lateral daughter branches increased. The calculated values of the two models were largely similar but differed in some ways. Field measurements of Fagus crenata and Abies homolepis also fit this trend, wherein models deviated from da Vinci's rule with increasing relative weights of lateral daughter branches. However, this deviation was small for a branching pattern in nature, where empirical measurements were taken under realistic measurement conditions; thus, da Vinci's rule did not critically contradict the biomechanical models in the case of real branching patterns, though the model calculations described the contradiction between da Vinci's rule and the biomechanical models. The field data for Fagus crenata fit the uniform stress model best, indicating that stress uniformity is the key constraint of branch morphology in Fagus crenata rather than elastic similarity or da Vinci's rule. On the other hand, mechanical constraints are not necessarily significant in the morphology of Abies homolepis branches, depending on the number of daughter branches. Rather, these branches were often in agreement with da Vinci's rule. PMID:24714065

  19. 3rd Workshop on Branching Processes and their Applications

    CERN Document Server

    González, Miguel; Gutiérrez, Cristina; Martínez, Rodrigo; Minuesa, Carmen; Molina, Manuel; Mota, Manuel; Ramos, Alfonso; WBPA15

    2016-01-01

    This volume gathers papers originally presented at the 3rd Workshop on Branching Processes and their Applications (WBPA15), which was held from 7 to 10 April 2015 in Badajoz, Spain (http://branching.unex.es/wbpa15/index.htm). The papers address a broad range of theoretical and practical aspects of branching process theory. Further, they amply demonstrate that the theoretical research in this area remains vital and topical, as well as the relevance of branching concepts in the development of theoretical approaches to solving new problems in applied fields such as Epidemiology, Biology, Genetics, and, of course, Population Dynamics. The topics covered can broadly be classified into the following areas: 1. Coalescent Branching Processes 2. Branching Random Walks 3. Population Growth Models in Varying and Random Environments 4. Size/Density/Resource-Dependent Branching Models 5. Age-Dependent Branching Models 6. Special Branching Models 7. Applications in Epidemiology 8. Applications in Biology and Genetics Offer...

  20. Clinical considerations of the glandular branch of the lacrimal artery.

    Science.gov (United States)

    Kluckman, Matthew; Fan, Jerry; Balsiger, Heather; Scott, Gabriel; Gest, Thomas

    2015-10-01

    The lacrimal artery is classically described as a branch of the ophthalmic artery supplied by the internal carotid. In this study, 25 orbits were dissected to identify variations in glandular branching and to compare them to previously published accounts. The glandular branching patterns of the lacrimal artery fall into two categories, those that branch (56%) and those that do not branch (44%). We found the medial and lateral glandular branches to be equal in diameter with a divergence of 2.67-40.58 mm proximal to the gland parenchyma. The long glandular branches run alongside the superolateral aspect of the orbit. The lateral branch runs lateral to the lateral rectus muscle. The medial branch runs superomedial to the lateral rectus muscle and lateral to the superior rectus muscle. In relation to the lacrimal gland, the medial branch enters the superior aspect of the gland parenchyma and the lateral branch enters its inferior aspect. The average branch lengths were 17.88 mm (medial) and 13.51 mm (lateral) as measured with a Mitutoyo Absolute 1/100 mm caliper. We could not confirm the existence of a third branch supplying the lacrimal gland, as posited by other authors. The key finding in this study is that the lacrimal gland is predominantly supplied by two significant arterial branches, both of which must be identified during procedures involving the lateral orbit. © 2015 Wiley Periodicals, Inc.

  1. A clinical review of early outcomes from contemporary flow modulation versus open, fenestrated and branch technologies in the management of thoracoabdominal aortic aneurysm.

    Science.gov (United States)

    Sultan, Sherif; Kavanagh, Edel P; Diethrich, Edward; Costache, Victor; Sultan, Mohamed; Jordan, Fionnuala; Hynes, Niamh

    2017-01-01

    Traditional therapeutic options for complex thoracoabdominal aneurysm include open repair, hybrid repair or endovascular repair (involving fenestrated or branched endografts). The Streamliner Multilayer Flow Modulator has been available for treatment of thoracoabdominal aneurysms since 2010. Its design permits blood flow to perfuse through the mesh in a modus that preserves collateral branch patency, while modulating turbulent to laminar flow within the device. The flow then stagnates over time within the surrounding aneurysm sac. Significant complications, including paraplegia, renal failure and cerebrovascular accident, are much lower with Streamliner Multilayer Flow Modulator treatment. Application of the Streamliner Multilayer Flow Modulator to complex aortic pathologies presents a novel solution to an, as of yet, unmet clinical need, and has resulted in promising clinical outcomes when compared to existing solutions. The Streamliner Multilayer Flow Modulator offers potential for treatment of thoracoabdominal aortic pathologies in patients and is not just confined to those with complexity that dictates no other management options. While current literature illustrates that there is a decreased risk of mortality and associated complications when this new disruptive technology is utilised, there is still a need for prospective, long-term clinical trials, as well as comparative trials to accurately assess outcomes of Streamliner Multilayer Flow Modulator treatment that are both precise and reproducible. This article is a review of current clinical literature regarding contemporary flow modulating technology compared with open, branched and fenestrated managements, presenting early outcomes.

  2. Measurement of the Branching Fraction of the Exclusive Decay B0 --> K*0gamma

    Energy Technology Data Exchange (ETDEWEB)

    Barrera, Barbara

    2000-10-16

    The b {yields} s{gamma} transition proceeds by a loop penguin diagram. It may be used to measure precisely the couplings of the top quark and to search for the effects of any new particles appearing in the loop. We present a preliminary measurement of the branching fraction of the exclusive decay, B{sup 0} {yields} K*{sup 0}{gamma}. They use 8.6 x 10{sup 6} B{bar B} decays to measure B(B{sup 0} {yields} K*{sup 0}{gamma}) = (5.4 {+-} 0.8 {+-} 0.5) x 10{sup -5}.

  3. Masquerading bundle branch block: a variety of right bundle branch block with left anterior fascicular block.

    Science.gov (United States)

    Elizari, Marcelo V; Baranchuk, Adrian; Chiale, Pablo A

    2013-01-01

    The so-called 'masquerading' type of right bundle branch block is caused by the simultaneous presence of a high-degree left anterior fascicular block often accompanied with severe left ventricular enlargement and/or fibrotic block in the anterolateral wall of the left ventricle. These conditions tend to reorient the terminal electrical forces of the QRS complex towards the left and upwards, in such a way that the characteristic slurred S wave in lead I becomes smaller or even disappears. In many cases of standard masquerading right bundle branch block, a small Q wave in lead I is present due to the initial forces of the left anterior fascicular block, which are oriented rightwards and inferiorly. However, in some cases, the Q wave in lead I also vanishes, and the mimicking of a left bundle branch block becomes perfect in standard leads. This is commonly associated with an inferior myocardial infarction or severe inferior fibrosis in cardiomyopathies. The typical QRS changes of right bundle branch block may eventually be concealed even in the right precordial leads; under such circumstances, the ECG diagnosis may be mistaken and the right bundle branch block totally missed. The masquerading right bundle branch block carries a poor prognosis, since it always implies the presence of a severe underlying heart disease.

  4. Collateral Channel Size and Tortuosity Predict Retrograde Percutaneous Coronary Intervention Success for Chronic Total Occlusion.

    Science.gov (United States)

    Huang, Ching-Chang; Lee, Chih-Kuo; Meng, Shih-Wei; Hung, Chi-Sheng; Chen, Ying-Hsien; Lin, Mao-Shin; Yeh, Chih-Fan; Kao, Hsien-Li

    2018-01-01

    There is little evidence on how to select an interventional collateral channel (CC) in retrograde chronic total occlusion (CTO) percutaneous coronary intervention. We aimed to identify independent angiographic predictors of CC tracking and technical success in retrograde CTO percutaneous coronary intervention. From January 2012 to December 2015, a total of 216 consecutive retrograde CTO percutaneous coronary intervention attempts by a high-volume operator in a tertiary university-affiliated hospital were enrolled. The clinical, angiographic, and procedural details were collected. The characteristics analyzed included channel type, size, tortuosity, angle of attack, length to emerging point, and the Multicenter CTO Registry of Japan score. The Multicenter CTO Registry of Japan score was 4.2±0.8. A total of 242 CCs were attempted for intervention. CC tracking success rate was 83.5%, and the technical success rate (per CC) was 81.4%. The per-patient technical success rate was 91.2%, and the major procedural complication rate was 4.6%. The atrioventricular groove, epicardial, and septal CCs were used in 36 (14.9%), 84 (34.7%), and 122 (50.4%) tracking attempts, respectively. In multivariable analysis, only large channel size and lack of tortuosity were significant independent predictors of CC tracking and technical success. A new scoring system was developed, while large size was given 1 point and lack of tortuosity was given 2 points. The receiver-operating characteristic area by the new model to predict CC tracking and technical success were 0.800 and 0.752, respectively. In retrograde CTO percutaneous coronary intervention, only size and tortuosity of a CC are independent angiographic predictors of CC tracking and technical success. © 2018 American Heart Association, Inc.

  5. The Effect of Ulnar Collateral Ligament Reconstruction on Pitch Velocity in Major League Baseball Pitchers.

    Science.gov (United States)

    Lansdown, Drew A; Feeley, Brian T

    2014-02-01

    The medial ulnar collateral ligament (UCL) is the primary restraint to valgus load, and injury is commonly encountered as a result of overuse in throwing athletes. Reconstruction of this ligament has allowed for a high rate of return to sport for elite pitchers. Public perception of this procedure has resulted in a commonly held belief of increased throwing velocity following UCL reconstruction. Fastball velocity for Major League Baseball (MLB) pitchers is significantly decreased following UCL reconstruction. Case series; Level of evidence, 4. A total of 129 pitchers were identified as undergoing UCL reconstruction from publicly available reports, and a final group of 80 MLB pitchers were included for analysis. Statistics were collected, including pitch velocity, pitch selection, and performance outcomes. Pre- and postoperative statistics were compared using paired t tests to allow for evaluation of each pitcher relative to his baseline velocity and performance. Mean fastball velocity was significantly decreased following UCL reconstruction, with a presurgical mean velocity of 91.3 mph and postoperative velocity of 90.6 mph (P = .003). The greatest observed difference was in pitchers older than 35 years, with fastball velocity decreasing from 91.7 to 88.8 mph (P = .0048). Pitchers threw fewer fastballs after reconstruction. Pitch velocity for curveballs, changeups, and sliders did not change significantly after UCL reconstruction. Additionally, pitchers threw fewer innings and pitches following reconstruction and produced fewer wins above replacement relative to their preinjury state. Contrary to popular opinion, fastball velocity for MLB pitchers is significantly decreased following UCL reconstruction, which should reinforce the importance of preventing overuse injuries.

  6. Collateral damage to the ureter and Nitinol stone baskets during thulium fiber laser lithotripsy.

    Science.gov (United States)

    Wilson, Christopher R; Hardy, Luke A; Irby, Pierce B; Fried, Nathaniel M

    2015-07-01

    The experimental Thulium fiber laser (TFL) is currently being studied as a potential alternative lithotripter to the clinical gold standard Holmium:YAG laser. Safety studies characterizing undesirable Holmium:YAG laser-induced damage to ureter tissue and stone baskets have been previously reported. Similarly, this study characterizes TFL induced ureter and stone basket damage. A TFL beam with energy of 35 mJ per pulse, pulse duration of 500 µs, and variable pulse rates of 50-500 Hz, was delivered through 100-µm-core optical fibers, to either porcine ureter wall, in vitro, or a standard 1.9-Fr Nitinol stone basket wire. Ureter perforation times were measured and gross, histological, and optical coherence tomography images of the ablation area were acquired. Stone basket damage was graded as a function of pulse rate, number of pulses, and working distance. TFL operation at 150, 300, and 500 Hz produced mean ureter perforation times of 7.9, 3.8, and 1.8 seconds, respectively. Collateral damage widths averaged 510, 370, and 310 µm. Nitinol wire damage decreased with working distance and was non-existent at distances greater than 1.0 mm. In contact mode, 500 pulses delivered at pulse rates ≥300 Hz (≤1.5 seconds) were sufficient to cut Nitinol wires. The TFL, operated in low pulse energy and high pulse rate mode, may provide a greater safety margin than the standard Holmium:YAG laser for lithotripsy, as evidenced by longer TFL ureter perforation times and shorter non-contact working distances for stone basket damage than previously reported with Holmium:YAG laser. © 2015 Wiley Periodicals, Inc.

  7. Should We Limit Innings Pitched After Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers?

    Science.gov (United States)

    Erickson, Brandon J; Cvetanovich, Gregory L; Bach, Bernard R; Bush-Joseph, Charles A; Verma, Nikhil N; Romeo, Anthony A

    2016-09-01

    Ulnar collateral ligament reconstruction (UCLR) has become a common procedure among Major League Baseball (MLB) pitchers. It is unclear if a limit on innings pitched after UCLR should be instituted to prevent revision UCLR. Number of innings pitched and number of pitches thrown after UCLR will not affect whether a pitcher requires a revision UCLR. Descriptive laboratory study. All MLB pitchers between 1974 and 2015 who pitched at least 1 full season after UCLR were included in this study. Pitch counts and innings pitched for the first full season after UCLR as well as total pitch count and total innings pitched were recorded. Pitch counts and innings pitched were compared among players who required revision UCLR and those who did not. Overall, 154 pitchers were included. Of these, 135 pitchers did not require revision UCLR while 19 underwent revision UCLR. No significant difference existed between pitchers who underwent revision UCLR and those who did not when comparing number of innings pitched in the season after UCLR (79.4 ± 46.7 vs 90.1 ± 58.6; P = .9016), number of pitches thrown in the season after UCLR (1233.2 ± 710.4 vs 1449.2 ± 904.1; P = .7337), number of innings pitched in the pitcher's career after UCLR (357.4 ± 312.0 vs 399.3 ± 446.4; P = .6945), and number of pitches thrown in the pitcher's career after UCLR (5632.7 ± 4583.9 vs 5674.7 ± 5755.4; P = .4789), respectively. Furthermore, no difference existed in revision rate between pitchers who pitched more or less than 180 innings in the first full season after UCLR (P = .6678). The number of innings pitched and number of pitches thrown in the first full season as well as over a player's career after UCLR are not associated with an increased risk of a pitcher requiring revision UCLR. © 2016 The Author(s).

  8. Major League Baseball pitch velocity and pitch type associated with risk of ulnar collateral ligament injury.

    Science.gov (United States)

    Keller, Robert A; Marshall, Nathan E; Guest, John-Michael; Okoroha, Kelechi R; Jung, Edward K; Moutzouros, Vasilios

    2016-04-01

    The number of Major League Baseball (MLB) pitchers requiring ulnar collateral ligament (UCL) reconstructions is increasing. Recent literature has attempted to correlate specific stresses placed on the throwing arm to risk for UCL injury, with limited results. Eighty-three MLB pitchers who underwent primary UCL reconstruction were evaluated. Pitching velocity and percent of pitch type thrown (fastball, curve ball, slider, and change-up) were evaluated 2 years before and after surgery. Data were compared with control pitchers matched for age, position, size, innings pitched, and experience. The evaluation of pitch velocity compared with matched controls found no differences in pre-UCL reconstruction pitch velocities for fastballs (91.5 vs. 91.2 miles per hour [mph], P = .69), curveballs (78.2 vs. 77.9 mph, P = .92), sliders (83.3 vs. 83.5 mph, P = .88), or change-ups (83.9 vs. 83.8 mph, P = .96). When the percentage of pitches thrown was evaluated, UCL reconstructed pitchers pitch significantly more fastballs than controls (46.7% vs. 39.4%, P = .035). This correlated to a 2% increase in risk for UCL injury for every 1% increase in fastballs thrown. Pitching more than 48% fastballs was a significant predictor of UCL injury, because pitchers over this threshold required reconstruction (P = .006). MLB pitchers requiring UCL reconstruction do not pitch at higher velocities than matched controls, and pitch velocity does not appear to be a risk factor for UCL reconstruction. However, MLB pitchers who pitch a high percentage of fastballs may be at increased risk for UCL injury because pitching a higher percent of fastballs appears to be a risk factor for UCL reconstruction. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Functional outcomes following revision ulnar collateral ligament reconstruction in Major League Baseball pitchers.

    Science.gov (United States)

    Jones, Kristofer J; Conte, Stan; Patterson, Nancy; ElAttrache, Neal S; Dines, Joshua S

    2013-05-01

    There is a paucity of data regarding outcomes following revision ulnar collateral ligament (UCL) reconstruction in Major League Baseball (MLB) pitchers. A single case series comprised of 4 MLB pitchers has reviewed outcomes in this cohort and reported a 75% rate of return to pitching. We hypothesize that MLB pitchers demonstrate a low rate of return to their pre-injury pitch workload following revision surgery. Clinical outcomes were reviewed with an emphasis on return to pre-injury pitch workload. Utilizing MLB player performance statistics, the postoperative pitch workload (appearances for relief pitchers and games started/innings pitched for starting pitchers) was calculated to determine if players were able to resume pre-injury throwing activity. Position-specific analyses for pitchers (starter vs relief) were also performed utilizing objective pitching statistics. Overall, 78% (14/18) of pitchers were able to return to MLB play within 2 full seasons. Relief pitchers were able to resume 50% of their pre-injury pitch workload, while starting pitchers only reached 35% of their prior workload (P = .52). Relievers demonstrated better pitching statistics (ERA [earned run average], K/9 [strikeouts per 9 innings], and BB/9 [walks per 9 innings]) when compared to starters. Two starting pitchers were reassigned to relief roles by their teams, resulting in improvement in their postoperative pitch workload (mean 94%). The overall rate of return to pre-injury pitch workload following revision UCL reconstruction is low among professional pitchers. Starting pitchers may be at higher risk for treatment failure in the revision setting, given the increased demands of the position, and may benefit from reassignment to a relief role. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  10. Biomechanical performance of baseball pitchers with a history of ulnar collateral ligament reconstruction.

    Science.gov (United States)

    Fleisig, Glenn S; Leddon, Charles E; Laughlin, Walter A; Ciccotti, Michael G; Mandelbaum, Bert R; Aune, Kyle T; Escamilla, Rafael F; MacLeod, Toran D; Andrews, James R

    2015-05-01

    A relatively high number of active professional baseball pitchers have a history of ulnar collateral ligament reconstruction (UCLr) on their throwing elbow. Controversy exists in the literature about whether professional baseball pitchers regain optimal performance after return from UCLr. It has been suggested that pitchers may have different biomechanics after UCLr, but this has not been previously tested. It was hypothesized that, compared with a control group without a history of UCLr, professional pitchers with a history of UCLr would have (1) significantly different throwing elbow and shoulder biomechanics; (2) a shortened stride, insufficient trunk forward tilt, and excessive shoulder horizontal adduction, characteristics associated with "holding back" or being tentative; (3) late shoulder rotation; and (4) improper shoulder abduction and trunk lateral tilt. Controlled laboratory study. A total of 80 active minor league baseball pitchers (and their 8 Major League Baseball organizations) agreed to participate in this study. Participants included 40 pitchers with a history of UCLr and a matched control group of 40 pitchers with no history of elbow or shoulder surgery. Passive ranges of motion were measured for each pitcher's elbows and shoulders, and then 23 reflective markers were attached to his body. The pitcher took as many warm-up pitches as desired and then threw 10 full-effort fastballs for data collection. Ball speed was recorded with a radar gun. The reflective markers were tracked with a 10-camera, 240-Hz automated motion analysis system. Eleven biomechanical parameters were computed for each pitch and then averaged for each participant. Demographic, range of motion, and biomechanical parameters were compared between the UCLr group and the control group by use of Student t tests (significance set at Pbaseball after UCLr pitch with biomechanics similar to that of noninjured professionals. © 2015 The Author(s).

  11. Major League pitching workload after primary ulnar collateral ligament reconstruction and risk for revision surgery.

    Science.gov (United States)

    Keller, Robert A; Mehran, Nima; Marshall, Nathan E; Okoroha, Kelechi R; Khalil, Lafi; Tibone, James E; Moutzouros, Vasilios

    2017-02-01

    Literature has attempted to correlate pitching workload with risk of ulnar collateral ligament (UCL) injury; however, limited data are available in evaluating workload and its relationship with the need for revision reconstruction in Major League Baseball (MLB) pitchers. We identified 29 MLB pitchers who underwent primary UCL reconstruction surgery and subsequently required revision reconstruction and compared them with 121 MLB pitchers who underwent primary reconstruction but did not later require revision surgery. Games pitched, pitch counts, and innings pitched were evaluated and compared for the seasons after returning from primary reconstruction and for the last season pitched before undergoing revision surgery. The difference in workload between pitchers who did and did not require revision reconstruction was not statistically significant in games pitched, innings pitched, and MLB-only pitch counts. The one significant difference in workload was in total pitch counts (combined MLB and minor league), with the pitchers who required revision surgery pitching less than those who did not (primary: 1413.6 pitches vs. revision: 959.0 pitches, P = .04). In addition, pitchers who required revision surgery underwent primary reconstruction at an early age (22.9 years vs. 27.3 years, P < .001) and had less MLB experience (1.5 years vs. 5.0 years, P < .001). There is no specific number of pitches, innings, or games that place a pitcher at an increase risk for injury after primary UCL reconstruction. However, correlations of risk may be younger age and less MLB experience at the time of the primary reconstruction. Copyright © 2017. Published by Elsevier Inc.

  12. Analysis of pitching velocity in major league baseball players before and after ulnar collateral ligament reconstruction.

    Science.gov (United States)

    Jiang, Jimmy J; Leland, J Martin

    2014-04-01

    Ulnar collateral ligament (UCL) reconstructions are relatively common among professional pitchers in Major League Baseball (MLB). To the authors' knowledge, there has not been a study specifically analyzing pitching velocity after UCL surgery. These measurements were examined in a cohort of MLB pitchers before and after UCL reconstruction. There is no significant loss in pitch velocity after UCL reconstruction in MLB pitchers. Cohort study; Level of evidence, 3. Between the years 2008 to 2010, a total of 41 MLB pitchers were identified as players who underwent UCL reconstruction. Inclusion criteria for this study consisted of a minimum of 1 year of preinjury and 2 years of postinjury pitch velocity data. After implementing exclusion criteria, performance data were analyzed from 28 of the 41 pitchers over a minimum of 4 MLB seasons for each player. A pair-matched control group of pitchers who did not have a known UCL injury were analyzed for comparison. Of the initial 41 players, 3 were excluded for revision UCL reconstruction. Eight of the 38 players who underwent primary UCL reconstruction did not return to pitching at the major league level, and 2 players who met the exclusion criteria were omitted, leaving data on 28 players available for final velocity analysis. The mean percentage change in the velocity of pitches thrown by players who underwent UCL reconstruction was not significantly different compared with that of players in the control group. The mean innings pitched was statistically different only for the year of injury and the first postinjury year. There were also no statistically significant differences between the 2 groups with regard to commonly used statistical performance measurements, including earned run average, batting average against, walks per 9 innings, strikeouts per 9 innings, and walks plus hits per inning pitched. There were no significant differences in pitch velocity and common performance measurements between players who returned to

  13. Medial collateral ligament lengthening by standardized pie-crusting technique: A cadaver study.

    Science.gov (United States)

    Dubois de Mont-Marin, G; Babusiaux, D; Brilhault, J

    2016-06-01

    Pie-crusting (PC) is a tissue expansion technique using multiple perforation to lengthen the medial collateral ligament (MCL), but has still to be codified. Standardized MCL PC allows measured opening of the medial femorotibial (MFT) joint line, without risk of MCL tear. Thirty-one knees were dissected, with medial parapatellar arthrotomy and resection of the cruciate ligaments and menisci. The deep MCL bundle was sectioned, and the thick anterior bundle (AB) of the MCL was observed in each knee. Knees were randomly allocated between AB sparing (AB+; n=15) or sectioning (AB-; n=16). A graduated dynometric tensor applied constant 80N distraction on the MFT joint line. MCL PC used a 19-G needle at the joint line, with a horizontal series of perforations every 2mm over the width of the MCL. MFT compartment opening was measured after each PC series. Mean MFT space after sectioning the cruciate ligaments was 5.52±0.37mm, increasing by 1.64±1.28mm with AB sectioning. Twenty-five perforations were made in the AB+ and 16 in the AB- group. Final mean joint-line increase was 0.18±0.18mm in AB+ and 3.16±2.70mm in AB-. There were no MCL tears. MCL pie-crusting was reliable and reproducible, achieving progressive MFT joint-line lengthening to a mean 8.71±2.62mm when associated to sectioning of the cruciate ligaments and MCL AB. Cadaver. IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Surgical technique: medial collateral ligament reconstruction using Achilles allograft for combined knee ligament injury.

    Science.gov (United States)

    Marx, Robert G; Hetsroni, Iftach

    2012-03-01

    Previous approaches for medial collateral ligament (MCL) reconstruction have been associated with extensive exposure, risk of donor site morbidity with autografts, loss of motion, nonanatomic graft placement, and technical complexity with double-bundle constructs. Therefore, we implemented a technique that uses Achilles allograft, small incisions, and anatomic insertions to reconstruct the MCL. The MCL femoral insertion was identified, and a socket reamed over a guide pin. The Achilles bone plug was fixed in the socket and the tendon passed distally under the skin and fixed on the tibia, creating isometric reconstruction. We evaluated 14 patients who had this MCL reconstruction. We determined range of knee motion, knee ligament laxity, functional outcome scores (International Knee Documentation Committee [IKDC]-subjective, Lysholm, Knee injury and Osteoarthritis Outcome Score [KOOS]), and activity level scores (Tegner, Marx). Followup range was 24 to 61 months. Knee motion was maintained in 12 cases. Grade 0-1 + valgus stability was obtained in all 14 cases. In cases of MCL with primary ACL reconstruction, IKDC-subjective, Lysholm, and KOOS-sports scores were 91 ± 6, 92 ± 6, and 93 ± 12, respectively, and return to preinjury activity levels was achieved. In cases of MCL with revision ACL reconstruction, function was inferior, and patients did not return to their preinjury activity levels. This technique uses allograft that provides bone-to-bone healing on the femur, requires small incisions, and creates isometric reconstruction. When performed with a cruciate reconstruction, knee stability can be restored at 2 to 5 years followup. In patients with MCL with primary ACL reconstruction, return to preinjury activity level in recreational athletes can be achieved.

  15. Dielectric response of branched copper phthalocyanine

    Science.gov (United States)

    Hamam, Khalil J.; Al-Amar, Mohammad M.; Mezei, Gellert; Guda, Ramakrishna; Burns, Clement A.

    2017-09-01

    The dielectric constant of pressed pellets and thin films of branched copper phthalocyanine (CuPc) was investigated as a function of frequency from 0.1 kHz to 1 MHz and temperature from 20 °C to 100 °C. Surface morphology was studied using a scanning electron microscope. The high-frequency values of the dielectric constant of pellets and thin films are ~3.5 and ~5.8, respectively. The response was only weakly dependent on frequency and temperature. The branched structure of the CuPc molecules helped to cancel out the effects of low-frequency polarization mechanisms. A planar delocalized charge system with two-dimensional localization was found using time-resolved photoluminescence measurements.

  16. Branching time, indeterminism and tense logic

    DEFF Research Database (Denmark)

    Ploug, Thomas; Øhrstrøm, Peter

    2012-01-01

    This paper deals with the historical and philosophical background of the introduction of the notion of branching time in philosophical logic as it is revealed in the hitherto unpublished mail-correspondence between Saul Kripke and A.N. Prior in the late 1950s. The paper reveals that the idea...... was first suggested by Saul Kripke in a letter to A.N. Prior, dated September 3, 1958, and it is shown how the elaboration of the idea in the course of the correspondence was intimately intervowen with considerations of how to represent indeterminism and of the adequacy of tensed logic in light of special...... relativity. The correspondence underpins the point that Prior’s later development of branching time may be understood as a crucial part of his attempt at the formulating a conceptual framework integrating basic human notions of time and free choice....

  17. Branched standard spines of 3-manifolds

    CERN Document Server

    Benedetti, Riccardo

    1997-01-01

    This book provides a unified combinatorial realization of the categroies of (closed, oriented) 3-manifolds, combed 3-manifolds, framed 3-manifolds and spin 3-manifolds. In all four cases the objects of the realization are finite enhanced graphs, and only finitely many local moves have to be taken into account. These realizations are based on the notion of branched standard spine, introduced in the book as a combination of the notion of branched surface with that of standard spine. The book is intended for readers interested in low-dimensional topology, and some familiarity with the basics is assumed. A list of questions, some of which concerning relations with the theory of quantum invariants, is enclosed.

  18. Photovoltaic Program Branch annual report, FY 1989

    Energy Technology Data Exchange (ETDEWEB)

    Summers, K A [ed.

    1990-03-01

    This report summarizes the progress of the Photovoltaic (PV) Program Branch of the Solar Energy Research Institute (SERI) from October 1, 1988, through September 30, 1989. The branch is responsible for managing the subcontracted portion of SERI's PV Advanced Research and Development Project. In fiscal year (FY) 1989, this included nearly 50 subcontracts, with a total annualized funding of approximately $13.1 million. Approximately two-thirds of the subcontracts were with universities, at a total funding of nearly $4 million. The six technical sections of the report cover the main areas of the subcontracted program: Amorphous Silicon Research, Polycrystalline Thin Films, Crystalline Silicon Materials Research, High-Efficiency Concepts, New Ideas, and University Participation. Technical summaries of each of the subcontracted programs provide a discussion of approaches, major accomplishments in FY 1989, and future research directions. Each report will be cataloged individually.

  19. COELIAC TRUNK BRANCHING PATTERN AND VARIATION

    Directory of Open Access Journals (Sweden)

    Jude Jose Thomson

    2017-01-01

    Full Text Available BACKGROUND Anatomical variations involving the visceral arteries are common. However, variations in coeliac trunk are usually asymptomatic, they may become important in patients undergoing diagnostic angiography for gastrointestinal bleeding or prior to an operative procedure. This study was useful for knowing the possible morphological variations before an upper abdominal surgery. MATERIALS AND METHODS This was a descriptive study done by cadaveric dissection, conducted on thirty cadavers. The coeliac trunk being examined for its origin, branching pattern, distribution, and variations. Results were statistically analysed and compared with the previous studies. RESULTS In our study, 60% of the coeliac trunk shows variations and 40% have normal branching pattern. A complete absence of coeliac trunk was observed in one case. In the present study the Right inferior phrenic artery arising from coeliac trunk in 2 cases (6.6% and left inferior phrenic artery arising from coeliac trunk in 3 cases (9.9%. Both inferior phrenic arteries are arising from coeliac trunk in 2 cases (6.6%. The common hepatomesenteric trunk and gastro splenic trunk was found in 1 case (3.3%. Hepatosplenic trunk was found in 2 cases (6.6%. In another 2 cases (6.6% gastric and hepatic artery originate from coeliac trunk but splenic artery has a separate origin from abdominal aorta. An absent trunk was also found in 1 case (3.3%. In 5 cases (16.7% showed trifurcation with variation in the branching pattern. CONCLUSION The branching pattern and extreme degree variability in coeliac trunk as brought out in the observations of the present study make it obvious that the present study almost falls in description with previous studies.

  20. Multiple-Block Ahead Branch Predictors

    OpenAIRE

    Seznec, André; Jourdan, Stéphan; Sainrat, Pascal; Michaud, Pierre

    1996-01-01

    A basic rule in computer architecture is that a processor cannot execute an application faster than it fetches its instructions. To overcome the instruction fetch bottleneck shown in wide-dispatch «brainiac» processors, this paper presents a novel cost-effective mechanism called the multiple-block ahead branch predictor that predicts in an efficient way addresses of multiple basic blocks in a single cycle. Moreover and unlike the previous multiple predictor schemes, the multiple-block ahead b...

  1. Fabrication and characterization of branched carbon nanostructures

    Directory of Open Access Journals (Sweden)

    Sharali Malik

    2016-09-01

    Full Text Available Carbon nanotubes (CNTs have atomically smooth surfaces and tend not to form covalent bonds with composite matrix materials. Thus, it is the magnitude of the CNT/fiber interfacial strength that limits the amount of nanomechanical interlocking when using conventional CNTs to improve the structural behavior of composite materials through reinforcement. This arises from two well-known, long standing problems in this research field: (a inhomogeneous dispersion of the filler, which can lead to aggregation and (b insufficient reinforcement arising from bonding interactions between the filler and the matrix. These dispersion and reinforcement issues could be addressed by using branched multiwalled carbon nanotubes (b-MWCNTs as it is known that branched fibers can greatly enhance interfacial bonding and dispersability. Therefore, the use of b-MWCNTs would lead to improved mechanical performance and, in the case of conductive composites, improved electrical performance if the CNT filler was better dispersed and connected. This will provide major benefits to the existing commercial application of CNT-reinforced composites in electrostatic discharge materials (ESD: There would be also potential usage for energy conversion, e.g., in supercapacitors, solar cells and Li-ion batteries. However, the limited availability of b-MWCNTs has, to date, restricted their use in such technological applications. Herein, we report an inexpensive and simple method to fabricate large amounts of branched-MWCNTs, which opens the door to a multitude of possible applications.

  2. Preserving the pulmonary vagus nerve branches during thoracoscopic esophagectomy

    NARCIS (Netherlands)

    Weijs, Teus J.; Ruurda, Jelle P.|info:eu-repo/dai/nl/257561021; Luyer, Misha D P; Nieuwenhuijzen, Grard A P; van der Horst, Sylvia; Bleys, Ronald L A W|info:eu-repo/dai/nl/134440455; van Hillegersberg, Richard|info:eu-repo/dai/nl/110706242

    Background: Pulmonary vagus branches are transected as part of a transthoracic esophagectomy and lymphadenectomy for cancer. This may contribute to the development of postoperative pulmonary complications. Studies in which sparing of the pulmonary vagus nerve branches during thoracoscopic

  3. Asymmetric Branching in Biological Resource Distribution Networks

    Science.gov (United States)

    Brummer, Alexander Byers

    There is a remarkable relationship between an organism's metabolic rate (resting power consumption) and the organism's mass. It may be a universal law of nature that an organism's resting metabolic rate is proportional to its mass to the power of 3/4. This relationship, known as Kleiber's Law, appears to be valid for both plants and animals. This law is important because it implies that larger organisms are more efficient than smaller organisms, and knowledge regarding metabolic rates are essential to a multitude of other fields in ecology and biology. This includes modeling the interactions of many species across multiple trophic levels, distributions of species abundances across large spatial landscapes, and even medical diagnostics for respiratory and cardiovascular pathologies. Previous models of vascular networks that seek to identify the origin of metabolic scaling have all been based on the unrealistic assumption of perfectly symmetric branching. In this dissertation I will present a theory of asymmetric branching in self-similar vascular networks (published by Brummer et al. in [9]). The theory shows that there can exist a suite of vascular forms that result in the often observed 3/4 metabolic scaling exponent of Kleiber's Law. Furthermore, the theory makes predictions regarding major morphological features related to vascular branching patterns and their relationships to metabolic scaling. These predictions are suggestive of evolutionary convergence in vascular branching. To test these predictions, I will present an analysis of real mammalian and plant vascular data that shows: (i) broad patterns in vascular networks across entire animal kingdoms and (ii) within these patterns, plant and mammalian vascular networks can be uniquely distinguished from one another (publication in preparation by Brummer et al.). I will also present results from a computational study in support of point (i). Namely, that asymmetric branching may be the optimal strategy to

  4. Effects of tibial plateau angle and spacer thickness applied during in vitro canine total knee replacement on three-dimensional kinematics and collateral ligament strain.

    Science.gov (United States)

    Baker, Katherine M; Foutz, Timothy L; Johnsen, Kyle J; Budsberg, Steven C

    2014-09-01

    To quantify the 3-D kinematics and collateral ligament strain of stifle joints in cadaveric canine limbs before and after cranial cruciate ligament transection followed by total knee replacement (TKR) involving various tibial plateau angles and spacer thicknesses. 6 hemi-pelvises collected from clinically normal nonchondrodystrophic dogs (weight range, 25 to 35 kg). Hemi-pelvises were mounted on a modified Oxford knee rig that allowed 6 degrees of freedom of the stifle joint but prevented mechanical movement of the hip and tarsal joints. Kinematics and collateral ligament strain were measured continuously while stifle joints were flexed. Data were again collected after cranial cruciate ligament transection and TKR with combinations of 3 plateau angles (0°, 4°, and 8°) and spacer thicknesses (5, 7, and 9 mm). Presurgical (ie, normal) stifle joint rotations were comparable to those previously documented for live dogs. After TKR, kinematics recorded for the 8°, 5-mm implant most closely resembled those of unaltered stifle joints. Decreasing the plateau angle and increasing spacer thickness altered stifle joint adduction, internal rotation, and medial translation. Medial collateral ligament strain was minimal in unaltered stifle joints and was unaffected by TKR. Lateral collateral ligament strain decreased with steeper plateau angles but returned to a presurgical level at the flattest plateau angle. Among the constructs tested, greatest normalization of canine stifle joint kinematics in vitro was achieved with the steepest plateau angle paired with the thinnest spacer. Furthermore, results indicated that strain to the collateral ligaments was not negatively affected by TKR.

  5. A 3D numerical study of the collateral capacity of the Circle of Willis with anatomical variation in the posterior circulation.

    Science.gov (United States)

    Ren, Yuan; Chen, Qiang; Li, Zhi-Yong

    2015-01-01

    The Circle of Willis (CoW) is the most important collateral pathway of the cerebral artery. The present study aims to investigate the collateral capacity of CoW with anatomical variation when unilateral internalcarotid artery (ICA) is occluded. Basing on MRI data, we have reconstructed eight 3D models with variations in the posterior circulation of the CoW and set four different degrees of stenosis in the right ICA, namely 24%, 43%, 64% and 79%, respectively. Finally, a total of 40 models are performed with computational fluid dynamics simulations. All of the simulations share the same boundary condition with static pressure and the volume flow rate (VFR) are obtained to evaluate their collateral capacity. As for the middle cerebral artery (MCA) and the anterior cerebral artery (ACA), the transitional-type model possesses the best collateral capacity. But for the posterior cerebral artery (PCA), unilateral stenosis of ICA has the weakest influence on the unilateral posterior communicating artery (PCoA) absent model. We also find that the full fetal-type posterior circle of Willis is an utmost dangerous variation which must be paid more attention. The results demonstrate that different models have different collateral capacities in coping stenosis of unilateral ICA and these differences can be reflected by different outlets. The study could be used as a reference for neurosurgeon in choosing the best treatment strategy.

  6. Differentiation of chronic total occlusion and subtotal occlusion of the femoropopliteal artery-role of retrograde flow sign and collateral circulation on CT angiography images.

    Science.gov (United States)

    Zhang, Shujun; Su, Yanfei; Chen, Haisong

    2017-08-01

    To study the value of a retrograde flow sign and the collateral circulation on CT angiography (CTA) for the differential diagnosis of chronic total occlusion from subtotal occlusion of the femoropopliteal artery (FPA). 50 patients with obstruction of the FPA underwent CTA and digital subtraction angiography examinations of the lower limbs. The frequency of a retrograde flow sign and collateral circulation on CTA in chronic total and subtotal occlusion was noted and analyzed, with the results of digital subtraction angiography as a standard to judge total or subtotal occlusion. The decreasing CT value from the distal to proximal direction on CTA suggests the existence of retrograde flow. There were significant differences in the occurrence rates of a retrograde flow sign on CTA in the chronic total and subtotal obstruction groups (X2 = 13.1, p sign (X2 = 13.5, p sign and the collateral circulation sign to diagnose chronic total obstruction of the FPA had a sensitivity of 92.3% and specificity of 89.8%. The retrograde flow sign combined with a collateral circulation sign is of great clinical value for differentiation of chronic total stenosis from severe stenosis (subtotal occlusion) of the FPA. Advances in knowledge: A retrograde flow sign combined with a collateral circulation sign is of great clinical value to differentiate between chronic total stenosis and severe stenosis (subtotal occlusion) of the FPA.

  7. Vascular endothelial growth factor and hypoxia-inducible factor-1α gene polymorphisms and coronary collateral formation in patients with coronary chronic total occlusions

    Directory of Open Access Journals (Sweden)

    Vincent Amoah

    2016-06-01

    Full Text Available Introduction: We evaluated the association between two single nucleotide polymorphisms of the vascular endothelial growth factor gene and one of the hypoxia-inducible factor-1α gene and the degree of coronary collateral formation in patients with a coronary chronic total occlusion. Methods: Totally, 98 patients with symptomatic coronary artery disease and a chronic total occlusion observed during coronary angiography were recruited. Genotyping of two vascular endothelial growth factor promoter single nucleotide polymorphisms (−152G>A and −165C>T and the C1772T single nucleotide polymorphism of hypoxia-inducible factor-1α were performed using polymerase chain reaction and restriction fragment length polymorphism analysis. The presence and extent of collateral vessel filling was scored by blinded observers using the Rentrop grade. Results: We found no association between the vascular endothelial growth factor −152G>A, −165C>T and hypoxia-inducible factor-1α −1772C>T with the presence and filling of coronary collateral vessels. A history of percutaneous coronary intervention and transient ischaemic attack/cerebrovascular accident were associated with the presence of enhanced collateral vessel formation following binary logistic regression analysis. Conclusion: The study findings suggest that coronary collateral formation is not associated with the tested polymorphic variants of vascular endothelial growth factor and hypoxia-inducible factor-1α in patients with symptomatic coronary artery disease and the presence of a chronic total occlusion.

  8. Portosystemic pressure reduction achieved with TIPPS and impact of portosystemic collaterals for the prediction of the portosystemic-pressure gradient in cirrhotic patients

    Energy Technology Data Exchange (ETDEWEB)

    Grözinger, Gerd, E-mail: gerd.groezinger@med.uni-tuebingen.de [Department of Diagnostic Radiology, Department of Radiology, University of Tübingen (Germany); Wiesinger, Benjamin; Schmehl, Jörg; Kramer, Ulrich [Department of Diagnostic Radiology, Department of Radiology, University of Tübingen (Germany); Mehra, Tarun [Department of Dermatology, University of Tübingen (Germany); Grosse, Ulrich; König, Claudius [Department of Diagnostic Radiology, Department of Radiology, University of Tübingen (Germany)

    2013-12-01

    Purpose: The portosystemic pressure gradient is an important factor defining prognosis in hepatic disease. However, noninvasive prediction of the gradient and the possible reduction by establishment of a TIPSS is challenging. A cohort of patients receiving TIPSS was evaluated with regard to imaging features of collaterals in cross-sectional imaging and the achievable reduction of the pressure gradient by establishment of a TIPSS. Methods: In this study 70 consecutive patients with cirrhotic liver disease were retrospectively evaluated. Patients received either CT or MR imaging before invasive pressure measurement during TIPSS procedure. Images were evaluated with regard to esophageal and fundus varices, splenorenal collaterals, short gastric vein and paraumbilical vein. Results were correlated with Child stage, portosystemic pressure gradient and post-TIPSS reduction of the pressure gradient. Results: In 55 of the 70 patients TIPSS reduced the pressure gradient to less than 12 mmHg. The pre-interventional pressure and the pressure reduction were not significantly different between Child stages. Imaging features of varices and portosystemic collaterals did not show significant differences. The only parameter with a significant predictive value for the reduction of the pressure gradient was the pre-TIPSS pressure gradient (r = 0.8, p < 0.001). Conclusions: TIPSS allows a reliable reduction of the pressure gradient even at high pre-interventional pressure levels and a high collateral presence. In patients receiving TIPSS the presence and the characteristics of the collateral vessels seem to be too variable to draw reliable conclusions concerning the portosystemic pressure gradient.

  9. Posterior circulation CT angiography collaterals predict outcome of endovascular acute ischemic stroke therapy for basilar artery occlusion.

    Science.gov (United States)

    Goyal, Nitin; Tsivgoulis, Georgios; Nickele, Chris; Doss, Vinodh T; Hoit, Dan; Alexandrov, Andrei V; Arthur, Adam; Elijovich, Lucas

    2016-08-01

    The natural history of acute ischemic stroke (AIS) due to basilar artery occlusion (BAO) is poor. Endovascular reperfusion therapy (EVT) improves recanalization rates in patients with emergent large vessel intracranial occlusion. To examine the hypothesis that good collateral patterns identified by pretreatment CT angiography (CTA) might be associated with favorable outcomes after EVT. We conducted a retrospective chart review of patients presenting with AIS due to BAO in a tertiary care stroke center during a 4-year period. BAO was diagnosed by CTA in all cases. Admission stroke severity was documented using the National Institute of Health Stroke Scale (NIHSS) score. Pretreatment collateral score for posterior circulation was defined as follows: 0, no posterior communicating artery (PCOM); 1, unilateral PCOM; 2, bilateral PCOM. Favorable outcome was defined as modified Rankin Scale score of 0-2 at 3 months. A total of 21 patients with AIS due to BAO (age range 31-84 years, median admission NIHSS score: 18 points, range 2-38) underwent EVT. Eleven of 21 patients (52.4%) had bilateral PCOMs, while unilateral PCOM was seen in 3 patients (14.3%). Patients with bilateral PCOMs tended (p=0.261) to have less severe stroke at admission than those with absent/unilateral PCOM (median NIHSS score 18 vs 27 points). Neurological improvement during hospitalization (quantified by the median decrease in NIHSS score) and the rate of 3-month functional independence were greater in patients with good collaterals (16 vs 0 points (p=0.016) and 72.7% vs 0% (p=0.001)). The presence of bilateral PCOMs on pretreatment CTA appears to be associated with more favorable outcomes in BAO treated with EVT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  10. Multidetector CT and MRI of ostial atresia of the coronary sinus, associated collateral venous pathways and cardiac anomalies.

    Science.gov (United States)

    Shum, J S F; Kim, S M; Choe, Y H

    2012-12-01

    To analyse the multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) findings in patients with atresia of the coronary sinus orifice (CSA). MDCT findings of 15 consecutive adult patients with CSAs were retrospectively analysed. The patients underwent contrast-enhanced electrocardiography-gated MDCT (n = 13) or both CT and MRI (n = 2). The mean size of the coronary sinus (CS) was 14.2 mm (range 5.5-24 mm) and 11 patients (73.3%) showed CS dilatation (diameter ≥12 mm). The mean length of the atretic CS segment was 2.9 mm (range 0-8 mm). Different forms of venous collateral pathways were observed in the CSA patients. Nine (60%) of the 15 CSA patients had communication between the right atrium (RA; n = 6) or LA (n = 5) and CS via intraseptal veins; six patients (40%) had persistent left superior caval veins; communications were also observed between the CS and RA (n = 4) or LA (n = 4); two patients had collateral venous pathways between dilated cardiac veins with RA; two patients had unroofing of the CS as outlet channels. Nine patients (60%) had cardiac anomalies: coronary artery fistula to the pulmonary artery (n = 6) or left ventricular base and CS (n = 1), atrial septal defects (n = 2), and a ventricular septal defect (n = 1). CSA patients have venous collateral pathways and a high incidence of associated cardiovascular anomalies such as coronary artery fistulae and atrial septal defects. Copyright © 2012 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  11. A case of 'Masquerading' bundle branch block: a forgotten concept.

    Science.gov (United States)

    Choudhary, Dinesh; Namboodiri, Narayanan; Tharakan, Jaganmohan A

    2014-01-01

    'Masquerading' bundle branch block (right bundle branch block in the precordial leads with left bundle branch block in frontal leads and left axis deviation) is seen most commonly with coronary artery disease and hypertension. No definite explanation is available so far for these changes. We are presenting a case of rare congenital intranuclear inclusion myopathy with congestive heart failure and 'Masquerading' bundle branch block in ECG. Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  12. Incidentally diagnosed Takayasu arteritis on thyroid ultrasonography showing prominent collateral vessels of thyroidal arteries and common carotid artery occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Se Jin; Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-10-15

    We report a case of middle-aged woman incidentally diagnosed with Takayasu arteritis during the ultrasonography of a thyroid gland nodule. Prominent collaterals of the thyroidal arteries and a thin common carotid artery with mural thickening and deficient intraluminal flow signals were initially depicted on the ultrasonography with color Doppler. Subsequent magnetic resonance angiography and computed tomography aortography confirmed the diagnosis with the imaging features of a bilateral long segment common carotid artery occlusion and segmental stenosis of the left subclavian artery in addition to the suggestive physical findings.

  13. [Repair of old injury of knee medial collateral ligament by a combination of dynamic and static stability].

    Science.gov (United States)

    Liu, Cheng'en; Li, Renhe; Liu, Yanfen; Li, Yuchun

    2011-01-01

    To observe the effectiveness of the combination of dynamic and static stability in the treatment of old knee medial collateral ligament injury. Between March 2004 and June 2008, 26 cases of old knee medial collateral ligament injury were treated, including 19 males and 7 females with a mean age of 38 years (range, 21-48 years). Injury was caused by traffic accident in 6 cases, by sprains in 12 cases, by falling from height in 8 cases. The location was left knee in 15 cases and right knee in 11 cases. Of them, 24 patients showed the positive result of knee valgus test, 2 cases showed slightly relaxed knee tendon. The knee X-ray films of valgus stress position showed that the medial joint space differences between both knees were 3-5 mm in 2 cases and 5-12 mm in 24 cases. The injuries included avulsion of the medial femoral condyle starting point in 19 cases, central laceration in 6 cases, and tibial point laceration concomitant meniscus injury in 1 case. The time from injury to hospitalization was 3-14 months (mean, 6.4 months). Gracilis muscle was used to repair knee medial collateral ligament and the sartorius muscle transfer to reconstruct the medial rotation of knee stability function. All incisions healed by first intention. No joint infection, deep vein thrombosis, or other postoperative complications occurred. Twenty-six cases were followed up 12-58 months with an average of 30 months. The results of knee valgus stress test were negative with no joint tenderness. At 3 months after operation, the knee X-ray films of valgus stress position showed the medial joint space differences between both knees were less than 1 mm. According to the modified Lysholm-Scale score, the results were excellent in 18 cases, good in 7 cases, and fair in 1 case with an excellent and good rate of 96% at last follow-up. A combination of dynamic and static stability in repairing old knee medial collateral ligament injury is easy-to-operate and has the advantages to perform the

  14. Editor's Choice - Effect of Branch Stent Choice on Branch-related Outcomes in Complex Aortic Repair.

    Science.gov (United States)

    Mastracci, T M; Carrell, T; Constantinou, J; Dias, N; Martin-Gonzalez, T; Katsargyris, A; Modarai, B; Resch, T; Verhoeven, E L G; Burnell, M; Haulon, S

    2016-04-01

    The use of branched stent grafts for the treatment of thoracoabdominal aneurysms [TAAA] is increasing, but mating stent graft choice has not been studied. This study combined experience of five high volume centres to assess a preferred mating stent. Data from five centres were retrospectively combined. Patients were included if they underwent stent graft for treatment of TAAA that used only branches to mate with visceral and renal vessels. All patients with fenestrations in their device were excluded. Perioperative details, reintervention, occlusion, and death were recorded. Outcome of occlusion or reintervention, as well as a composite outcome of any death, occlusion, or reintervention was planned using a per-patient, and per-branch analysis. In 235 included patients, there were 940 vessels available for placement of mating stent. The average age of included patients was 70 years (SD 7.9), and 179 of the 235 were male. Medical comorbidities included diabetes in 29/234 (12.4%), current smoker in 81/233 (34.8%), and COPD in 77/234 (32.9%). The primary stent deployed was self-expanding in 556 branches, balloon expandable in 231 branches, and was unknown in 92 branches. After a mean of 20.7 months (SD 25) follow-up, there have been 44 incidents of occlusion or reintervention, of which 40 culprit stents are known. Where the stent placed is known, the event rate in renal branches (35/437, 8%) is higher than that of visceral branches (8/443, 1.8%). There is no difference in occlusion or reintervention between self-expanding and balloon expandable stents (HR 0.95, p = .91) but there is a statistically significant difference between renal and visceral artery occlusions (HR 3.51, p = 0.001). There appears to be no difference in occlusion or reintervention rate for branch vessels mated with balloon expandable compared with self-expanding stents. Renal events appear to outnumber visceral events in this population. Copyright © 2016 European Society for Vascular Surgery

  15. 46 CFR 111.75-5 - Lighting branch circuits.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 4 2010-10-01 2010-10-01 false Lighting branch circuits. 111.75-5 Section 111.75-5...-GENERAL REQUIREMENTS Lighting Circuits and Protection § 111.75-5 Lighting branch circuits. (a) Loads. A lighting distribution panel must not supply branch circuits rated at over 30 amperes. (b) Connected Load...

  16. 46 CFR 169.690 - Lighting branch circuits.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 7 2010-10-01 2010-10-01 false Lighting branch circuits. 169.690 Section 169.690... Machinery and Electrical Electrical Installations on Vessels of 100 Gross Tons and Over § 169.690 Lighting branch circuits. Each lighting branch circuit must meet the requirements of § 111.75-5 of this chapter...

  17. Dendrimers and methods of preparing same through proportionate branching

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Yihua (Bruce); Yue, Xuyi

    2015-09-15

    The present invention provides for monodispersed dendrimers having a core, branches and periphery ends, wherein the number of branches increases exponentially from the core to the periphery end and the length of the branches increases exponentially from the periphery end to the core, thereby providing for attachment of chemical species at the periphery ends without exhibiting steric hindrance.

  18. Weighted Branching Simulation Distance for Parametric Weighted Kripke Structures

    DEFF Research Database (Denmark)

    Foshammer, Louise; Larsen, Kim Guldstrand; Mariegaard, Anders

    2016-01-01

    This paper concerns branching simulation for weighted Kripke structures with parametric weights. Concretely, we consider a weighted extension of branching simulation where a single transitions can be matched by a sequence of transitions while preserving the branching behavior. We relax this notion...

  19. Structural dynamics branch research and accomplishments to FY 1992

    Science.gov (United States)

    Lawrence, Charles

    1992-01-01

    This publication contains a collection of fiscal year 1992 research highlights from the Structural Dynamics Branch at NASA LeRC. Highlights from the branch's major work areas--Aeroelasticity, Vibration Control, Dynamic Systems, and Computational Structural Methods are included in the report as well as a listing of the fiscal year 1992 branch publications.

  20. Axonal branching patterns of nucleus accumbens neurons in the rat.

    Science.gov (United States)

    Tripathi, Anushree; Prensa, Lucía; Cebrián, Carolina; Mengual, Elisa

    2010-11-15

    The patterns of axonal collateralization of nucleus accumbens (Acb) projection neurons were investigated in the rat by means of single-axon tracing techniques using the anterograde tracer biotinylated dextran amine. Seventy-three axons were fully traced, originating from either the core (AcbC) or shell (AcbSh) compartment, as assessed by differential calbindin D28k-immunoreactivity. Axons from AcbC and AcbSh showed a substantial segregation in their targets; target areas were either exclusively or preferentially innervated from AcbC or AcbSh. Axon collaterals in the subthalamic nucleus were found at higher than expected frequencies; moreover, these originated exclusively in the dorsal AcbC. Intercompartmental collaterals were observed from ventral AcbC axons into AcbSh, and likewise, interconnections at pallidal and mesencephalic levels were also observed, although mostly from AcbC axons toward AcbSh targets, possibly supporting crosstalk between the two subcircuits at several levels. Cell somata giving rise to short-range accumbal axons, projecting to the ventral pallidum (VP), were spatially intermingled with others, giving rise to long-range axons that innervated VP and more caudal targets. This anatomical organization parallels that of the dorsal striatum and provides the basis for possible dual direct and indirect actions from a single axon on either individual or small sets of neurons. Copyright © 2010 Wiley-Liss, Inc.

  1. Baseline left bundle branch block with right bundle branch escape complexes in a patient with coronary artery disease, presents like an alternating bundle branch block: a case report

    Science.gov (United States)

    Bhimaraj, Arvind; Abusin, Salaheldin; Margeta, Bosko

    2008-01-01

    Alternating bundle branch block (ABBB) is a less commonly encountered phenomenon with the advent of re-perfusion therapy for acute myocardial infarction. ECGs simulating the appearance of an ABBB need to be carefully analysed. We present an ECG showing a baseline Left Bundle Branch Block(LBBB) progressing to a high grade AV block with escape complexes having a Right Bundle Branch Block (RBBB) morphology. Such an ECG can be mistaken for an ABBB if not analysed carefully. PMID:19116014

  2. Thinned chimeric radial collateral artery perforator flap in complex distal thumb reconstruction.

    Science.gov (United States)

    Song, Dajiang; Deng, Xiangwu; Chen, Yanmin; Xie, Songlin; Zhou, Xiao

    2015-11-01

    Tissue loss accompanied by bone defects in the thumb is a challenging reconstruction problem. Traditional repair methods are unsatisfactory. Microsurgical thumb reconstruction was performed using 13 thinned chimeric radial collateral artery (RCA) perforator flaps. The flap was created with a thinned skin paddle and humeral bone segments using independent perforators. Primary defatting was completed when the thickness of the perforator entry was approximately similar to that in the periphery. The posterior cutaneous nerve of the arm was carried to make a sensory flap. Defects were 8.5 × 4.5 cm(2) on average (ranging in size from 4.5 × 1.5 to 15.0 × 6.0 cm(2)), and flap size was 9.0 × 5.5 cm(2) on average (ranging in size from 5.0 × 2.0 to 16.0 × 7.0 cm(2)), whereas the humeral fragments were 2.0 × 1.0 cm(2) on average (ranging in size from 1.5 × 0.5 to 4.0 × 1.5 cm(2)). All data were expressed as mean ± SD. The cosmetic appearance of the donor and recipient sites, Kapandji opposition score and static two-point discrimination of the operated thumb were evaluated during a follow-up visit. Follow-up time was 16.6 months (ranging from 14 to 28 months). Flap thickness before defatting, measured immediately after flap elevation was 14.5 mm (ranging from 10.0 to 25.0 mm). Average flap thickness after defatting was 3.5 mm (ranging from 3.0 to 6.0 mm). Venous congestion occurred in two cases. Successful microsurgical revision was achieved in both cases. All flaps survived. Bone components achieved union in all cases at an average period of 4.8 months (ranging from 3 to 6 months). Based on Kapandji opposition score, the mean thumb opposition score was 6. The mean sensation of flap was 7.5 mm (ranging from 6 to 11 mm). No further flap revision or defatting procedures were required in all cases. Cosmetically acceptable results were achieved for all patients. Findings proved that thinned chimeric RCA perforator flap is a beneficial microsurgical alternative for

  3. Impact of Coronary Collaterals on Long-term Prognosis in Patients Treated With Primary Angioplasty.

    Science.gov (United States)

    Hernández-Pérez, Francisco José; Goirigolzarri-Artaza, Josebe; Restrepo-Córdoba, María Alejandra; García-Touchard, Arturo; Oteo-Domínguez, Juan Francisco; Silva-Melchor, Lorenzo; Fernández-Díaz, José Antonio; Domínguez-Puente, José Ramón; Alonso-Pulpón, Luis; Goicolea-Ruigómez, Javier

    2017-03-01

    The beneficial effect of coronary collateral circulation (CC) in patients with ST-segment elevation myocardial infarction is controversial. The aim of this study was to evaluate the impact of CC before reperfusion with primary angioplasty (PA) on the long-term prognosis of these patients. Retrospective observational study of a cohort of 947 patients treated with PA and TIMI grade ≤ 1 flow in a single center from 2005 to 2013. Propensity score matching was used to create 2 groups of 175 patients each, matched by the degree of CC (Rentrop 0-1 vs Rentrop 2-3). In the matched cohort, we determined the impact of CC on total mortality, cardiovascular mortality, and a combined adverse cardiovascular event endpoint for a median follow-up of 864 (interquartile range, 396-1271) days. Of a total of 947 patients included, 735 (78%) had Rentrop 0 to 1 and 212 (22%) had Rentrop 2 to 3. During follow-up, 105 patients died, 71 from cardiovascular causes. In the matched cohort, the total mortality rate was similar between the 2 groups (Rentrop 0-1 [8.8%] vs Rentrop 2-3 [6.3%]; HR = 1.22; 95%CI, 0.50-2.94; P = .654). There were no differences in cardiovascular mortality (Rentrop 0-1 [4.6%] vs Rentrop 2-3 [2.3%]; sHR = 0.49; 95%CI, 0.14-1.62; P = .244) or the composite endpoint including cardiovascular death, reinfarction, target vessel revascularization, and coronary artery bypass surgery (Rentrop 0-1 [18.8%] vs Rentrop 2-3 [13.1%]; sHR = 0.68; 95%CI, 0.40-1.15; P = .157). In this contemporary series, the presence of good CC before PA was not associated with better long-term clinical outcomes. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Treatment of Ulnar Collateral Ligament Injuries and Superior Labral Tears by Major League Baseball Team Physicians.

    Science.gov (United States)

    Erickson, Brandon J; Harris, Joshua D; Fillingham, Yale A; Cvetanovich, Gregory L; Bush-Joseph, Charles A; Bach, Bernard R; Romeo, Anthony A; Verma, Nikhil N

    2016-07-01

    To determine practice patterns of Major League Baseball (MLB) team orthopaedic surgeons in addressing the controversial topics of ulnar collateral ligament (UCL) tears, type II SLAP tears, and partial-thickness rotator cuff tear. Seventy-four MLB team orthopaedic surgeons were surveyed via an online survey system. A 14-question survey was used to assess surgeon experience, technique, and graft choice for UCL reconstruction (UCLR), treatment of type II SLAP tears, and other common pathologic conditions. Thirty team orthopaedic surgeons (41%) responded (mean experience as team physicians: 9.37 ± 6.33 years). Seventeen (56.7%) surgeons use the docking technique for UCLR whereas 20% use the modified Jobe technique. Nineteen (63.3%) use palmaris longus autograft in UCLR. Overall, 28 (93.3%) do not routinely perform elbow arthroscopy or perform an obligatory transposition of the ulnar nerve in patients without preoperative ulnar nerve symptoms. Twenty-eight (93.3%) would repair a type II SLAP tear, whereas only 1 (3.3%) would debride the tear. No surgeon would perform a concomitant biceps tenodesis, either open or arthroscopic. Most MLB team orthopaedic surgeons perform a UCLR using the docking technique with a palmaris longus autograft without concomitant elbow arthroscopy or obligatory transposition of the ulnar nerve. The overwhelming majority of these surgeons would also treat an operative type II SLAP tear with a SLAP repair. The number of UCLRs and SLAP repairs performed on MLB pitchers has significantly increased over the past 10 years. To properly treat these conditions in elite, college, and recreational athletes, it is important to understand how the surgeons who take care of the most elite-level athletes treat them, and how they are able to reproducibly attain excellent outcomes. This study shows how these common shoulder and elbow injuries are treated by those surgeons who care for the most elite overhead-throwing athletes in the world. Copyright © 2016

  5. Risk Stratification for Ulnar Collateral Ligament Injury in Major League Baseball Players

    Science.gov (United States)

    DeFroda, Steven F.; Kriz, Peter K.; Hall, Amber M.; Zurakowski, David; Fadale, Paul D.

    2016-01-01

    Background: Ulnar collateral ligament (UCL) injury has become increasingly common in Major League Baseball (MLB) players in recent years. Hypothesis: There is a significant difference in preinjury fastball velocity between MLB pitchers with tears and matched controls without UCL injury. Pitchers with injuries are throwing harder and getting injured earlier in their MLB careers. Study Design: Cohort study; Level of evidence, 3. Methods: From 2007 to 2014, a total of 170 documented UCL injuries (156 pitchers, 14 position players) occurred in MLB. Inclusion criteria for this study consisted of any player who tore his UCL in MLB during this time frame. There were 130 regular-season tears (April-September). From this group, 118 players who pitched more than 100 innings prior to tear were matched to subjects with no tear and were compared using a logistic regression analysis. A subgroup of “early tear” players who threw less than 100 career innings (n = 37) was also identified and compared with the larger tear group using a logistic regression analysis. Results: Of the 130 tears that occurred during the regular season, a significantly larger number (62%) occurred in the first 3 months (P = .011). The rate of UCL tears per MLB player (P = .001) was statistically significant. In the group of 118 matched tears, the mean fastball velocity was greater in the tear group (91.7 mph) compared with the control group (91.0 mph; P = .014). Furthermore, relief pitchers made up a greater percentage of the early tear group (<100 innings) compared with the later tear group (P = .011). Sixteen of the 170 UCL tears (9.4%) were recurrent tears, with 5 of 16 experiencing both tear and retear within the past 4 years. Conclusion: There is a statistically significant difference in the mean fastball velocity of pitchers who injure their UCL. Small increases in pitcher fastball velocity are a main contribution to the increased rate of tear in MLB. In addition, there has been an increased

  6. Pitching performance and longevity after revision ulnar collateral ligament reconstruction in Major League Baseball pitchers.

    Science.gov (United States)

    Marshall, Nathan E; Keller, Robert A; Lynch, Jonathan R; Bey, Michael J; Moutzouros, Vasilios

    2015-05-01

    Medial ulnar collateral ligament (UCL) reconstruction is a common procedure performed on professional pitchers in Major League Baseball (MLB). Although a great deal is known about primary reconstruction, much less is known about revision reconstruction. The purpose of this study was to evaluate statistical performance, return to play, and career longevity in MLB pitchers after revision UCL surgery, with the hypothesis that pitching performance and career longevity will decline after revision surgery. Cohort study; Level of evidence, 3. A total of 33 MLB pitchers who underwent revision UCL reconstruction surgery (UCL-R group) were identified and compared with 33 age- and position-matched controls (CTL group). Return to play, total years played, and statistical performance were evaluated and compared with controls. After revision surgery, 65.5% of UCL-R pitchers returned to the MLB level. On average, the UCL-R pitchers played 0.8 years less in the majors (P<.01) than did the control pitchers. The UCL-R pitchers who returned to the MLB level had a similar earned run average (UCL-R: 4.88, CTL: 4.76, P=.82) and walks/hits per innings pitched (UCL-R: 1.58, CTL: 1.44, P=.22) compared with the control pitchers. There were significant declines, however, in terms of innings pitched (UCL-R: 36.95, CTL: 75.00, P<.01), walks per 9 innings (UCL-R: 4.75, CTL: 3.49, P<.01), and wins (UCL-R: 1.88, CTL: 4.10, P<.01) as well as nonsignificant declines in wins above replacement (UCL-R: 0.25, CTL: 0.62, P=.06) and runs above replacement (UCL-R: 3.26, CTL: 6.91, P=.07). MLB pitchers who undergo UCL-R have a low rate of return to MLB play and have shortened careers after return. Pitchers who returned to the MLB level maintained performance in several statistics such as earned run average and walks/hits per innings pitched; however, pitchers returned with a significantly decreased workload. © 2015 The Author(s).

  7. Predictors of Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers.

    Science.gov (United States)

    Whiteside, David; Martini, Douglas N; Lepley, Adam S; Zernicke, Ronald F; Goulet, Grant C

    2016-09-01

    Ulnar collateral ligament (UCL) reconstruction surgeries in Major League Baseball (MLB) have increased significantly in recent decades. Although several risk factors have been proposed, a scientific consensus is yet to be reached, providing challenges to those tasked with preventing UCL injuries. To identify significant predictors of UCL reconstruction in MLB pitchers. Case control study; Level of evidence, 3. Demographic and pitching performance data were sourced from public databases for 104 MLB pitchers who underwent UCL reconstruction surgery and 104 age- and position-matched controls. These variables were compared between groups and inserted into a binary logistic regression to identify significant predictors of UCL reconstruction. Two machine learning models (naïve Bayes and support vector machine) were also employed to predict UCL reconstruction in this cohort. The binary linear regression model was statistically significant (χ(2)(12) = 33.592; P = .001), explained 19.9% of the variance in UCL reconstruction surgery, and correctly classified 66.8% of cases. According to this model, (1) fewer days between consecutive games, (2) a smaller repertoire of pitches, (3) a less pronounced horizontal release location, (4) a smaller stature, (5) greater mean pitch speed, and (6) greater mean pitch counts per game were all significant predictors of UCL reconstruction. More specifically, an increase in mean days between consecutive games (odds ratio [OR], 0.685; 95% CI, 0.542-0.865) or number of unique pitch types thrown (OR, 0.672; 95% CI, 0.492-0.917) was associated with a significantly smaller likelihood of UCL reconstruction. In contrast, an increase in mean pitch speed (OR, 1.381; 95% CI, 1.103-1.729) or mean pitches per game (OR, 1.020; 95% CI, 1.007-1.033) was associated with significantly higher odds of UCL reconstruction surgery. The naïve Bayes classifier predicted UCL reconstruction with an accuracy of 72% and the support vector machine classifier with an

  8. Repair of Intraoperative Injury to the Medial Collateral Ligament During Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Bohl, Daniel D; Wetters, Nathan G; Del Gaizo, Daniel J; Jacobs, Joshua J; Rosenberg, Aaron G; Della Valle, Craig J

    2016-01-06

    Optimal treatment for intraoperative injury to the medial collateral ligament (MCL) during primary total knee arthroplasty remains controversial. While some advocate primary ligament repair and a period of bracing, others suggest conversion to a knee prosthesis with increased intrinsic constraint. The purpose of this study was to characterize the outcomes of primary repair followed by bracing. We performed a retrospective review of consecutive primary total knee arthroplasties to identify patients with intraoperative MCL laceration or avulsion treated with primary repair. Midsubstance lacerations were treated with end-to-end suture repair, whereas a screw-and-washer construct, suture, and/or suture anchors were used for reattachment of avulsions. All patients were instructed to wear an unlocked hinged knee brace for six weeks postoperatively. Patients were evaluated at a minimum of two years postoperatively for evidence of instability or other modes of failure and complications. An intraoperative MCL injury occurred during forty-eight (1.2%) of the 3922 total knee arthroplasties that had been performed. One patient died less than two years postoperatively, one was lost to follow-up, and one underwent an intraoperative conversion to a constrained total knee arthroplasty, leaving forty-five total knee arthroplasties available for study. There were twenty-four midsubstance lacerations and twenty-one avulsions; thirty-five of these injuries occurred during a cruciate-retaining total knee arthroplasty and ten, during a posterior-stabilized total knee arthroplasty. At a mean of ninety-nine months (range, twenty-four to 214 months), there were no symptoms or physical examination findings of instability. The mean Hospital for Special Surgery knee score increased from 47 preoperatively to 85 at the time of follow-up (p knees required intervention for stiffness (four manipulations and one revision), and two required revision for aseptic loosening. Our results suggest that

  9. Cyanogen in NGC 1851 Red Giant Branch and Asymptotic Giant Branch Stars: Quadrimodal Distributions

    DEFF Research Database (Denmark)

    Campbell, S. W.; Yong, D.; Wylie-de Boer, E. C.

    2012-01-01

    The Galactic globular cluster NGC 1851 has raised much interest since Hubble Space Telescope photometry revealed that it hosts a double subgiant branch. Here we report on our homogeneous study into the cyanogen (CN) band strengths in the red giant branch (RGB) population (17 stars) and asymptotic...... giant branch (AGB) population (21 stars) using AAOmega/2dF spectra with R ~ 3000. We discover that NGC 1851 hosts a quadrimodal distribution of CN band strengths in its RGB and AGB populations. This result supports the merger formation scenario proposed for this cluster, such that the CN quadrimodality...... found that the four CN peaks may be paired—the two CN-weaker populations being associated with low Ba and the two CN-stronger populations with high Ba. If true, then s-process abundances would be a good diagnostic for disentangling the two original clusters in the merger scenario. More observations...

  10. Branched-chain fatty acid biosynthesis in a branched-chain amino acid aminotransferase mutant of Staphylococcus carnosus

    DEFF Research Database (Denmark)

    Beck, Hans Christian

    2005-01-01

    Fatty acid biosynthesis by a mutant strain of Staphylococcus carnosus deficient in branched-chain amino acid aminotransferase (IlvE) activity was analysed. This mutant was unable to produce the appropriate branched-chain alpha-ketoacid precursors for branched-chain fatty acid biosynthesis from th...

  11. Measurement of the branching fraction and $CP$ asymmetry in radiative $D^0 \\to V \\gamma$ decays

    CERN Document Server

    Abdesselam, A; Adamczyk, K; Aihara, H; Said, S Al; Arinstein, K; Arita, Y; Asner, D M; Aso, T; Atmacan, H; Aulchenko, V; Aushev, T; Ayad, R; Aziz, T; Babu, V; Badhrees, I; Bahinipati, S; Bakich, A M; Bala, A; Ban, Y; Bansal, V; Barberio, E; Barrett, M; Bartel, W; Bay, A; Bedny, I; Behera, P; Belhorn, M; Belous, K; Besson, D; Bhardwaj, V; Bhuyan, B; Bischofberger, M; Biswal, J; Bloomfield, T; Blyth, S; Bobrov, A; Bondar, A; Bonvicini, G; Bookwalter, C; Boulahouache, C; Bozek, A; Bračko, M; Breibeck, F; Brodzicka, J; Browder, T E; Červenkov, D; Chang, M -C; Chang, P; Chao, Y; Chekelian, V; Chen, A; Chen, K -F; Chen, P; Cheon, B G; Chilikin, K; Chistov, R; Cho, K; Chobanova, V; Choi, S -K; Choi, Y; Cinabro, D; Crnkovic, J; Dalseno, J; Danilov, M; Dash, N; Di Carlo, S; Dingfelder, J; Doležal, Z; Drásal, Z; Drutskoy, A; Dubey, S; Dutta, D; Dutta, K; Eidelman, S; Epifanov, D; Esen, S; Farhat, H; Fast, J E; Feindt, M; Ferber, T; Frey, A; Frost, O; Fujikawa, M; Fulsom, B G; Gaur, V; Gabyshev, N; Ganguly, S; Garmash, A; Getzkow, D; Gillard, R; Giordano, F; Glattauer, R; Goh, Y M; Goldenzweig, P; Golob, B; Greenwald, D; Perdekamp, M Grosse; Grygier, J; Grzymkowska, O; Guo, H; Haba, J; Hamer, P; Han, Y L; Hara, K; Hara, T; Hasegawa, Y; Hasenbusch, J; Hayasaka, K; Hayashii, H; He, X H; Heck, M; Hedges, M T; Heffernan, D; Heider, M; Heller, A; Higuchi, T; Himori, S; Hirose, S; Horiguchi, T; Hoshi, Y; Hoshina, K; Hou, W -S; Hsiung, Y B; Hsu, C -L; Huschle, M; Hyun, H J; Igarashi, Y; Iijima, T; Imamura, M; Inami, K; Inguglia, G; Ishikawa, A; Itagaki, K; Itoh, R; Iwabuchi, M; Iwasaki, M; Iwasaki, Y; Iwata, S; Jacobs, W W; Jaegle, I; Jeon, H B; Joffe, D; Jones, M; Joo, K K; Julius, T; Kakuno, H; Kang, J H; Kang, K H; Kapusta, P; Kataoka, S U; Kato, E; Kato, Y; Katrenko, P; Kawai, H; Kawasaki, T; Keck, T; Kichimi, H; Kiesling, C; Kim, B H; Kim, D Y; Kim, H J; Kim, H -J; Kim, J B; Kim, J H; Kim, K T; Kim, M J; Kim, S H; Kim, S K; Kim, Y J; Kinoshita, K; Kleinwort, C; Klucar, J; Ko, B R; Kobayashi, N; Koblitz, S; Kodyš, P; Koga, Y; Korpar, S; Kotchetkov, D; Kouzes, R T; Križan, P; Krokovny, P; Kronenbitter, B; Kuhr, T; Kumar, R; Kumita, T; Kurihara, E; Kuroki, Y; Kuzmin, A; Kvasnička, P; Kwon, Y -J; Lai, Y -T; Lange, J S; Lee, D H; Lee, I S; Lee, S -H; Leitgab, M; Leitner, R; Levit, D; Lewis, P; Li, C H; Li, H; Li, J; Li, L; Li, X; Li, Y; Gioi, L Li; Libby, J; Limosani, A; Liu, C; Liu, Y; Liu, Z Q; Liventsev, D; Loos, A; Louvot, R; Lubej, M; Lukin, P; Luo, T; MacNaughton, J; Masuda, M; Matsuda, T; Matvienko, D; Matyja, A; McOnie, S; Mikami, Y; Miyabayashi, K; Miyachi, Y; Miyake, H; Miyata, H; Miyazaki, Y; Mizuk, R; Mohanty, G B; Mohanty, S; Mohapatra, D; Moll, A; Moon, H K; Mori, T; Morii, T; Moser, H -G; Müller, T; Muramatsu, N; Mussa, R; Nagamine, T; Nagasaka, Y; Nakahama, Y; Nakamura, I; Nakamura, K R; Nakano, E; Nakano, H; Nakano, T; Nakao, M; Nakayama, H; Nakazawa, H; Nanut, T; Nath, K J; Natkaniec, Z; Nayak, M; Nedelkovska, E; Negishi, K; Neichi, K; Ng, C; Niebuhr, C; Niiyama, M; Nisar, N K; Nishida, S; Nishimura, K; Nitoh, O; Nozaki, T; Ogawa, A; Ogawa, S; Ohshima, T; Okuno, S; Olsen, S L; Ono, Y; Onuki, Y; Ostrowicz, W; Oswald, C; Ozaki, H; Pakhlov, P; Pakhlova, G; Pal, B; Palka, H; Panzenböck, E; Park, C -S; Park, C W; Park, H; Park, K S; Paul, S; Peak, L S; Pedlar, T K; Peng, T; Pesántez, L; Pestotnik, R; Peters, M; Petrič, M; Piilonen, L E; Poluektov, A; Prasanth, K; Prim, M; Prothmann, K; Pulvermacher, C; Purohit, M V; Rauch, J; Reisert, B; Ribežl, E; Ritter, M; Röhrken, M; Rorie, J; Rostomyan, A; Rozanska, M; Rummel, S; Ryu, S; Sahoo, H; Saito, T; Sakai, K; Sakai, Y; Sandilya, S; Santel, D; Santelj, L; Sanuki, T; Sasao, N; Sato, Y; Savinov, V; Schlüter, T; Schneider, O; Schnell, G; Schönmeier, P; Schram, M; Schwanda, C; Schwartz, A J; Schwenker, B; Seidl, R; Seino, Y; Sekiya, A; Semmler, D; Senyo, K; Seon, O; Seong, I S; Sevior, M E; Shang, L; Shapkin, M; Shebalin, V; Shen, C P; Shibata, T -A; Shibuya, H; Shinomiya, S; Shiu, J -G; Shwartz, B; Sibidanov, A; Simon, F; Singh, J B; Sinha, R; Smerkol, P; Sohn, Y -S; Sokolov, A; Soloviev, Y; Solovieva, E; Stanič, S; Starič, M; Steder, M; Strube, J F; Stypula, J; Sugihara, S; Sugiyama, A; Sumihama, M; Sumisawa, K; Sumiyoshi, T; Suzuki, K; Suzuki, S; Suzuki, S Y; Suzuki, Z; Takeichi, H; Takizawa, M; Tamponi, U; Tanaka, M; Tanaka, S; Tanida, K; Taniguchi, N; Taylor, G N; Teramoto, Y; Tikhomirov, I; Trabelsi, K; Trusov, V; Tse, Y F; Tsuboyama, T; Uchida, M; Uchida, T; Uehara, S; Ueno, K; Uglov, T; Unno, Y; Uno, S; Uozumi, S; Urquijo, P; Ushiroda, Y; Usov, Y; Vahsen, S E; Van Hulse, C; Vanhoefer, P; Varner, G; Varvell, K E; Vervink, K; Vinokurova, A; Vorobyev, V; Vossen, A; Wagner, M N; Wang, C H; Wang, J; Wang, M -Z; Wang, P; Wang, X L; Watanabe, M; Watanabe, Y; Wedd, R; Wehle, S; White, E; Wiechczynski, J; Williams, K M; Won, E; Yabsley, B D; Yamada, S; Yamamoto, H; Yamaoka, J; Yamashita, Y; Yamauchi, M; Yashchenko, S; Ye, H; Yelton, J; Yook, Y; Yuan, C Z; Yusa, Y; Zhang, C C; Zhang, L M; Zhang, Z P; Zhao, L; Zhilich, V; Zhukova, V; Zhulanov, V; Ziegler, M; Zivko, T; Zupanc, A; Zwahlen, N; Zyukova, O

    2016-01-01

    We report a measurement of the branching fractions of the radiative decays $D^0 \\to V \\gamma$, where $V=\\phi,~\\overline{K}{}^{*0}$ or $\\rho^0$. This is the first observation of the decay $D^0 \\to \\rho^0 \\gamma$. We measure preliminary branching fractions $\\mathcal{B}(D^0 \\to \\phi \\gamma)=(2.76 \\pm 0.20 \\pm 0.08) \\times 10^{-5}$, $\\mathcal{B}(D^0 \\to \\overline{K}{}^{*0} \\gamma)=(4.66 \\pm 0.21 \\pm 0.18) \\times 10^{-4} $ and $\\mathcal{B}(D^0 \\to \\rho^0 \\gamma)=(1.77 \\pm 0.30 \\pm 0.08) \\times 10^{-5}$, where the first uncertainty is statistical and the second systematic. We also present the first measurement of $CP$ asymmetry in these decays. The preliminary values are $\\mathcal{A}_{CP}(D^0 \\to \\phi \\gamma)=-(0.094 \\pm 0.066 \\pm 0.001)$, $\\mathcal{A}_{CP}(D^0 \\to \\overline{K}{}^{*0} \\gamma)=-(0.003 \\pm 0.020 \\pm 0.000)$ and $\\mathcal{A}_{CP}(D^0 \\to \\rho^0 \\gamma)=0.056 \\pm 0.151 \\pm 0.006$. The analysis was conducted using 943 fb$^{-1}$ of data collected by the Belle detector at the KEKB $e^+e^-$ collider.

  12. Annual report, Basic Sciences Branch, FY 1991

    Energy Technology Data Exchange (ETDEWEB)

    1993-04-01

    This report summarizes the progress of the Basic Sciences Branch of the National Renewable Energy Laboratory (NREL) from October 1, 1990, through September 30, 1991. Seven technical sections of the report cover these main areas of NREL's in-house research: Semiconductor Crystal Growth, Amorphous Silicon Research, Polycrystalline Thin Films, III-V High-Efficiency Photovoltaic Cells, Solid-State Theory, Solid-State Spectroscopy, and Superconductivity. Each section explains the purpose and major accomplishments of the work in the context of the US Department of Energy's National Photovoltaic Research Program plans.

  13. Organization and targets of the European Branch

    Energy Technology Data Exchange (ETDEWEB)

    Cataldi, R.

    1997-12-01

    After a short historical review of the formation, objectives and organization of the International Geothermal Association (IGA), this paper describes the functions, goals and activities of the IGA European Branch. In particular, the paper illustrates the plan of action established for the periods 1993-`95 and 1996-`98, and the issues dealt with by the European Forum as of August 1996. The last section of the paper outlines the main problems to be faced in the near future in order to facilitate the aggregation of efforts, the amalgamation of promotional initiatives and the coordination of the basic activities needed for the consolidation and growth of the geothermal community in Europe. (orig.)

  14. Strategy of Irrigation Branch in Russia

    Science.gov (United States)

    Zeyliger, A.; Ermolaeva, O.

    2012-04-01

    At this moment, at the starting time of the program on restoration of a large irrigation in Russia till 2020, the scientific and technical community of irrigation branch does not have clear vision on how to promote a development of irrigated agriculture and without repeating of mistakes having a place in the past. In many respects absence of a vision is connected to serious backlog of a scientific and technical and informational and technological level of development of domestic irrigation branch from advanced one. Namely such level of development is necessary for the resolving of new problems in new conditions of managing, and also for adequate answers to new challenges from climate and degradation of ground & water resources, as well as a rigorous requirement from an environment. In such important situation for irrigation branch when it is necessary quickly generate a scientific and technical politics for the current decade for maintenance of translation of irrigated agriculture in the Russian Federation on a new highly effective level of development, in our opinion, it is required to carry out open discussion of needs and requirements as well as a research for a adequate solutions. From political point of view a framework organized in FP6 DESIRE 037046 project is an example of good practice that can serve as methodical approach how to organize and develop such processes. From technical point of view a technology of operational management of irrigation at large scale presents a prospective alternative to the current type of management based on planning. From point of view ICT operational management demands creation of a new platform for the professional environment of activity. This platform should allow to perceive processes in real time, at their partial predictability on signals of a straight line and a feedback, within the framework of variability of decision making scenarious, at high resolution and the big ex-awning of sensor controls and the gauges

  15. Annual report, Basic Sciences Branch, FY 1991

    Energy Technology Data Exchange (ETDEWEB)

    1993-04-01

    This report summarizes the progress of the Basic Sciences Branch of the National Renewable Energy Laboratory (NREL) from October 1, 1990, through September 30, 1991. Seven technical sections of the report cover these main areas of NREL`s in-house research: Semiconductor Crystal Growth, Amorphous Silicon Research, Polycrystalline Thin Films, III-V High-Efficiency Photovoltaic Cells, Solid-State Theory, Solid-State Spectroscopy, and Superconductivity. Each section explains the purpose and major accomplishments of the work in the context of the US Department of Energy`s National Photovoltaic Research Program plans.

  16. Anomaly matching on the Higgs branch

    Science.gov (United States)

    Shimizu, Hiroyuki; Tachikawa, Yuji; Zafrir, Gabi

    2017-12-01

    We point out that we can almost always determine by the anomaly matching the full anomaly polynomial of a supersymmetric theory in 2d, 4d or 6d if we assume that its Higgs branch is the one-instanton moduli space of some group G. This method not only provides by far the simplest method to compute the central charges of known theories of this class, e.g. 4d E 6,7,8 theories of Minahan and Nemeschansky or the 6d E-string theory, but also gives us new pieces of information about unknown theories of this class.

  17. Branch Retinal Artery Occlusion following Dental Extraction

    OpenAIRE

    Tevfik Oğurel; Zafer Onaran; Reyhan Oğurel; Nurgül Örnek; Nesrin Büyüktortop Gökçınar; Kemal Örnek

    2014-01-01

    Aim. To describe a case of branch retinal artery occlusion following dental extraction and to point out the ophthalmic complications of dental procedures to ophthalmologists and dentists. Case. A 51-year-old woman was referred to our clinic with painless sudden visual loss in her left eye after tooth extraction two days ago. In her left eye the best corrected visual acuity was 6/30 and fundus examination revealed peripapillary flame-shaped hemorrhages and pale retina in the upper temporal arc...

  18. Power system transient stability analysis based on branch potential characteristics

    Science.gov (United States)

    Han, Huan; Wang, Zengping

    2017-09-01

    Branch potential function is proposed based on the power system network preserving model. The concept of thermodynamics-entropy, is introduced to describe spatial distribution characteristics of the branch potential energy. Branch potential energy was analysed in time and space domain., with transient stability index proposed accordingly. The larger disturbance energy line fault injected to grid is, the larger branch energy entropy will be, and the more energy accumulated on key branches is, the more prone to lose stability the system will be. Simulation results on IEEE system proved its feasibility.

  19. [Internal fixation with one-hole microplate for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture].

    Science.gov (United States)

    Wang, Xi-Xun; Sun, De-Tao; Chen, Xu-Hui; Li, Jun; Cui, Yan; Hu, Ji-Chao; Shu, Zheng-Hua; He, Jian; Ding, Chao-Qi; Chen, Bo

    2015-03-01

    To study clinical effects of one-hole microplate internal fixation for the treatment of collateral ligament injuries of the metacarpophalangeal joint of the thumb combined with fracture. Twenty-two patients (16 males, 6 females) with collateral ligament injuries of the metacarpophalangeal joint of the thumb combined fracture were treated with one-hole microplate internal fixation. The age of the patients ranged from 18 to 53 years old with a mean age of 28.5 years old. The duration from injury to surgery ranged from 2 hours to 2 months, and the mean time was 6 days. All the patients had collateral ligament injuries combined with fracture of the metacarpophalangeal joint of the thumb. Thirteen patients had injuries in the right hand and 9 patients had injuries in the left hand. There were 18 cases of closed wound and 4 cases of open wound. Eighteen patients had fresh injuries ( 2 weeks). Sixteen patients had injuries in the ulnar collateral ligament of the thumb combined with fracture, 6 patients had radial collateral ligament injuries of the thumb combined with fracture, 4 cases of which were complicated with injuries of abductor pollicis brevis and the end of the flexor pollicis brevis tender. The size of the avulsed fragment was about 3.0 mm x 4.0 mm to 6.0 mm x 7.0 mm. The incisions of 22 patients healed by first intention. The follow-up periods ranged from 6 months to 5 years old,with an average of 2.5 years old. The thumb function was evaluated by Saetta and other evaluation criteria, and 20 patients got an excellent result and 2 good. The application of one-hole microplate internal fixation in treating collateral ligament injuries with fracture of the metacarpophalangeal joint of the thumb is an effective method.

  20. Case report - calcification of the medial collateral ligament of the knee with simultaneous calcifying tendinitis of the rotator cuff.

    Science.gov (United States)

    Kamawal, Yama; Steinert, Andre F; Holzapfel, Boris M; Rudert, Maximilian; Barthel, Thomas

    2016-07-13

    Calcification of the medial collateral ligament (MCL) of the knee is a very rare disease. We report on a case of a patient with a calcifying lesion within the MCL and simultaneous calcifying tendinitis of the rotator cuff in both shoulders. Calcification of the MCL was diagnosed both via x-ray and magnetic resonance imaging (MRI) and was successfully treated surgically. Calcifying tendinitis of the rotator cuff was successfully treated applying conservative methods. This is the first case report of a patient suffering from both a calcifying lesion within the medial collateral ligament and calcifying tendinitis of the rotator cuff in both shoulders. Clinical symptoms, radio-morphological characteristics and macroscopic features were very similar and therefore it can be postulated that the underlying pathophysiology is the same in both diseases. Our experience suggests that magnetic resonance imaging and x-ray are invaluable tools for the diagnosis of this inflammatory calcifying disease of the ligament, and that surgical repair provides a good outcome if conservative treatment fails. It seems that calcification of the MCL is more likely to require surgery than calcifying tendinitis of the rotator cuff. However, the exact reason for this remains unclear to date.

  1. Coronary collateral circulation in patients with chronic coronary total occlusion; its relationship with cardiac risk markers and SYNTAX score.

    Science.gov (United States)

    Börekçi, A; Gür, M; Şeker, T; Baykan, A O; Özaltun, B; Karakoyun, S; Karakurt, A; Türkoğlu, C; Makça, I; Çaylı, M

    2015-09-01

    Compared to patients without a collateral supply, long-term cardiac mortality is reduced in patients with well-developed coronary collateral circulation (CCC). Cardiovascular risk markers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP) and high-sensitive cardiac troponin T (hs-cTnT) are independent predictors for cardiovascular mortality. The main goal of this study was to examine the relationship between CCC and cardiovascular risk markers. We prospectively enrolled 427 stable coronary artery disease patients with chronic total occlusion (mean age: 57.5±11.1 years). The patients were divided into two groups, according to their Rentrop scores: (a) poorly developed CCC group (Rentrop 0 and 1) and (b) well-developed CCC group (Rentrop 2 and 3). NT-proBNP, hs-CRP, hs-cTnT, uric acid and other biochemical markers were also measured. The SYNTAX score was calculated for all patients. The patients in the poorly developed CCC group had higher frequencies of diabetes and hypertension (pcoronary artery disease with chronic total occlusion. © The Author(s) 2014.

  2. C-reactive protein as a predictor for poor collateral circulation in patients with chronic stable coronary heart disease.

    Science.gov (United States)

    Fan, Ying; Li, Sha; Li, Xiao-Lin; Zhu, Cheng-Gang; Guo, Yuan-Lin; Wu, Na-Qiong; Qing, Ping; Gao, Ying; Dong, Qian; Liu, Geng; Li, Jian-Jun

    2016-01-01

    To investigate the association between serum C-reactive protein (CRP) levels and coronary collateral circulation (CCC) in Chinese patients with angiography-proven ≥95% coronary stenosis. In this study, 1158 patients with angiography-proven ≥95% occlusion in ≥1 major epicardial coronary artery were enrolled, and then classified into two groups: poor CCC (Rentrop grades 0-1) and good CCC (Rentrop grades 2-3). CRP levels were grouped using the following two models: Model 1 discretized CRP group with 33.33% and 66.66% as the critical values and Model 2 with 1.0 and 3.0 mg/L as the cut off values. There were significant differences in serum CRP levels between the two groups (5.76 ± 3.45 vs. 3.49 ± 2.44 mg/L, respectively; p coronary artery disease (CAD) and cardiovascular disorders. In a Chinese cohort of patients with coronary artery occlusion or stenosis of ≥95% TIMI grade 1 anterograde-flow, the relationship between CRP concentrations and angiographically visible coronary collateral (CC) was assessed. Our data indicated that elevated CRP associated with a significant impairment in CC development, and might supply a useful biomarker in clinical applications.

  3. Persistence-Based Branch Misprediction Bounds for WCET Analysis

    DEFF Research Database (Denmark)

    Puffitsch, Wolfgang

    2015-01-01

    Branch prediction is an important feature of pipelined processors to achieve high performance. However, it can lead to overly pessimistic worst-case execution time (WCET) bounds when being modeled too conservatively. This paper presents bounds on the number of branch mispredictions for local...... linear programming formulations of the WCET problem. An evaluation on a number of benchmarks shows that with these bounds, dynamic branch prediction does not necessarily lead to higher WCET bounds than static prediction schemes....... dynamic branch predictors. To handle interferences between branch instructions we use the notion of persistence, a concept that is also found in cache analyses. The bounds apply to branches in general, not only to branches that close a loop. Furthermore, the bounds can be easily integrated into integer...

  4. MR angiography of collateral arteries in a hind limb ischemia model: comparison between blood pool agent Gadomer and small contrast agent Gd-DTPA.

    Directory of Open Access Journals (Sweden)

    Karolien Jaspers

    Full Text Available The objective of this study was to compare the blood pool agent Gadomer with a small contrast agent for the visualization of ultra-small, collateral arteries (diameter0.10. Inter-observer variation was 24% and 18% for Gadomer and Gd-DTPA, respectively. In conclusion, blood pool agent Gadomer improved vessel conspicuity compared to Gd-DTPA. Steady-state MRA can be considered as an excellent non-invasive alternative to intra-arterial XRA for the visualization of ultra-small collateral arteries.

  5. Selective Embolization of Systemic Collaterals for the Treatment of Recurrent Hemoptysis Secondary to the Unilateral Absence of a Pulmonary Artery in a Child

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Yin, E-mail: zhouyin502@163.com [West China Hospital, Sichuan University, Department of Pediatric Surgery (China); Tsauo, Jiaywei, E-mail: 80732059@qq.com [West China Hospital, Sichuan University, Institute of Interventional Radiology (China); Li, Yuan, E-mail: liyuanletters@163.com [West China Hospital, Sichuan University, Department of Pediatric Surgery (China); Li, Xiao, E-mail: simonlixiao@gmail.com [West China Hospital, Sichuan University, Institute of Interventional Radiology (China)

    2015-10-15

    The unilateral absence of the pulmonary artery (UAPA) is a rare anomaly. Hemoptysis due to systemic collaterals is one of the most common complications of UAPA. To the best of the authors’ knowledge, the utility of selective embolization for the treatment of this condition in children has not been reported previously. This report describes a 6-year-old girl with isolated UAPA (IUAPA) admitted for a 10-month history of recurrent hemoptysis that had worsened during the previous 2 months. Selective embolization of the bronchial systemic collaterals was performed. The patient remained asymptomatic with no recurrence of hemoptysis 8 months after the procedure.

  6. Branching dynamics of viral information spreading

    Science.gov (United States)

    Iribarren, José Luis; Moro, Esteban

    2011-10-01

    Despite its importance for rumors or innovations propagation, peer-to-peer collaboration, social networking, or marketing, the dynamics of information spreading is not well understood. Since the diffusion depends on the heterogeneous patterns of human behavior and is driven by the participants’ decisions, its propagation dynamics shows surprising properties not explained by traditional epidemic or contagion models. Here we present a detailed analysis of our study of real viral marketing campaigns where tracking the propagation of a controlled message allowed us to analyze the structure and dynamics of a diffusion graph involving over 31 000 individuals. We found that information spreading displays a non-Markovian branching dynamics that can be modeled by a two-step Bellman-Harris branching process that generalizes the static models known in the literature and incorporates the high variability of human behavior. It explains accurately all the features of information propagation under the “tipping point” and can be used for prediction and management of viral information spreading processes.

  7. Synthesis of branched naphthoquinones from castor oil

    Directory of Open Access Journals (Sweden)

    Adriano Olímpio da Silva

    2012-06-01

    Full Text Available The naphthoquinones are cyclic aromatic α,β-dienonas with a basic framework derived from naphthalene. They are also found in many higher plants, algae, fungi and as the product of the  metabolism  of some  bacteria  having large biologica activity described in the literature such as antibacterial, anti-inflammatory, antitumor, anticancer and trypanocidal [1-3]. Castor oil is an abundant raw material in Brazil of great versatility and, it is present in biodiesel production, surfactants, cosmetics and others. Considering the importance of naphthoquinones and, the availability of the ricinoleic acid from castor oil, the aim of this study was the preparation of new branched naphthoquinones in order to test their trypanocidal activity. Castor oil was submitted to saponification with sodium hydroxide, ethanol and water under reflux for 6 h. We then carried out an acid hydrolysis with hydrochloric acid and the formed ricinoleic acid was extracted with ethyl acetate. Following, through Kochi-Anderson addition reaction it was performed the alkylation of a naphthoquinone 1 and 2, using ammonium persulfate, silver nitrate, acetonitrile and water, under heating at 70-80 ° C during 3 h, to give the branched naphthoquinones 4 and 5 (scheme 1. The naphthoquinone 3 will be similarly submitted to this procedure. The naphthoquinones 4 and 5 were purified by column chromatography on sílica gel using hexane as the eluent. The compounds were characterized by mass spectrometry and 1H and 13CNMR spectroscopy.

  8. Fixman compensating potential for general branched molecules

    Energy Technology Data Exchange (ETDEWEB)

    Jain, Abhinandan, E-mail: Abhi.Jain@jpl.nasa.gov [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, California 91109 (United States); Kandel, Saugat; Wagner, Jeffrey; Larsen, Adrien; Vaidehi, Nagarajan, E-mail: nvaidehi@coh.org [Division of Immunology, Beckman Research Institute of the City of Hope, Duarte, California 91010 (United States)

    2013-12-28

    The technique of constraining high frequency modes of molecular motion is an effective way to increase simulation time scale and improve conformational sampling in molecular dynamics simulations. However, it has been shown that constraints on higher frequency modes such as bond lengths and bond angles stiffen the molecular model, thereby introducing systematic biases in the statistical behavior of the simulations. Fixman proposed a compensating potential to remove such biases in the thermodynamic and kinetic properties calculated from dynamics simulations. Previous implementations of the Fixman potential have been limited to only short serial chain systems. In this paper, we present a spatial operator algebra based algorithm to calculate the Fixman potential and its gradient within constrained dynamics simulations for branched topology molecules of any size. Our numerical studies on molecules of increasing complexity validate our algorithm by demonstrating recovery of the dihedral angle probability distribution function for systems that range in complexity from serial chains to protein molecules. We observe that the Fixman compensating potential recovers the free energy surface of a serial chain polymer, thus annulling the biases caused by constraining the bond lengths and bond angles. The inclusion of Fixman potential entails only a modest increase in the computational cost in these simulations. We believe that this work represents the first instance where the Fixman potential has been used for general branched systems, and establishes the viability for its use in constrained dynamics simulations of proteins and other macromolecules.

  9. Mapping Milky Way Halo Structure with Blue Horizontal Branch Stars

    Science.gov (United States)

    Martin, Charles; Newberg, Heidi Jo; Carlin, Jeffrey L.

    2017-01-01

    The use of blue horizontal brach (BHB) and red giant branch stars as tracers of stellar debris streams is a common practice and has been useful in the confirmation of kinematic properties of previously identified streams. This work explores less common ways of untangling the velocity signatures of streams traveling radially to our line of sight, and to peer toward the higher density region of the Galactic Center using data from the Sloan Digital Sky Survey (SDSS). Using spectra of BHB stars, we are able to kinematically distinguish moving groups in the Milky Way halo. The results of this thesis advance our knowledge of the following stellar halo substructures: the Pisces Stellar Stream, the Hercules-Aquila Cloud, the Hercules Halo Stream, and the Hermus Stream. A study of red giant stars led to the kinematic discovery of the Pisces Stellar Stream. Red giant stars were also examined to determine that the previously identified velocity signature that was suggested for the Hercules-Aquila Cloud was due to disk star contamination and errors in preliminary SDSS velocities. The Hercules Halo Stream is a previously unidentified structure that could be related to the Hercules-Aquila Cloud, and was discovered as a velocity excess of SDSS BHB stars. We identify a group of 10 stars with similar velocities that are spatially coincident with the Hermus Stream. An orbit is fit to the Hermus Stream that rules out a connection with the Phoenix Stream.This work was supported by NSF grants AST 09-37523, 14-09421, 16-15688, the NASA/NY Space Grant fellowship, and contributions made by The Marvin Clan, Babette Josephs, Manit Limlamai, and the 2015 Crowd Funding Campaign to Support Milky Way Research.

  10. Discontinuous conduction in mouse bundle branches is caused by bundle-branch architecture

    NARCIS (Netherlands)

    van Veen, Toon A. B.; van Rijen, Harold V. M.; van Kempen, Marjan J. A.; Miquerol, Lucile; Opthof, Tobias; Gros, Daniel; Vos, Marc A.; Jongsma, Habo J.; de Bakker, Jacques M. T.

    2005-01-01

    Background - Recordings of the electrical activity of mouse bundle branches ( BBs) suggest reduced conduction velocity ( CV) in the midseptal compared with the proximal part of the BB. The present study was performed to elucidate the mechanism responsible for this slowing of conduction. Methods and

  11. Modeling of branching density and branching distribution in low-density polyethylene polymerization

    NARCIS (Netherlands)

    Kim, D.M.; Iedema, P.D.

    2008-01-01

    Low-density polyethylene (ldPE) is a general purpose polymer with various applications. By this reason, many publications can be found on the ldPE polymerization modeling. However, scission reaction and branching distribution are only recently considered in the modeling studies due to difficulties

  12. Additional chain-branching pathways in the low-temperature oxidation of branched alkanes

    KAUST Repository

    Wang, Zhandong

    2015-12-31

    Chain-branching reactions represent a general motif in chemistry, encountered in atmospheric chemistry, combustion, polymerization, and photochemistry; the nature and amount of radicals generated by chain-branching are decisive for the reaction progress, its energy signature, and the time towards its completion. In this study, experimental evidence for two new types of chain-branching reactions is presented, based upon detection of highly oxidized multifunctional molecules (HOM) formed during the gas-phase low-temperature oxidation of a branched alkane under conditions relevant to combustion. The oxidation of 2,5-dimethylhexane (DMH) in a jet-stirred reactor (JSR) was studied using synchrotron vacuum ultra-violet photoionization molecular beam mass spectrometry (SVUV-PI-MBMS). Specifically, species with four and five oxygen atoms were probed, having molecular formulas of C8H14O4 (e.g., diketo-hydroperoxide/keto-hydroperoxy cyclic ether) and C8H16O5 (e.g., keto-dihydroperoxide/dihydroperoxy cyclic ether), respectively. The formation of C8H16O5 species involves alternative isomerization of OOQOOH radicals via intramolecular H-atom migration, followed by third O2 addition, intramolecular isomerization, and OH release; C8H14O4 species are proposed to result from subsequent reactions of C8H16O5 species. The mechanistic pathways involving these species are related to those proposed as a source of low-volatility highly oxygenated species in Earth\\'s troposphere. At the higher temperatures relevant to auto-ignition, they can result in a net increase of hydroxyl radical production, so these are additional radical chain-branching pathways for ignition. The results presented herein extend the conceptual basis of reaction mechanisms used to predict the reaction behavior of ignition, and have implications on atmospheric gas-phase chemistry and the oxidative stability of organic substances. © 2015 The Combustion Institute.

  13. Quantification of branching in model three-arm star polyethylene

    KAUST Repository

    Ramachandran, Ramnath

    2012-01-24

    The versatility of a novel scaling approach in quantifying the structure of model well-defined 3-arm star polyethylene molecules is presented. Many commercial polyethylenes have long side branches, and the nature and quantity of these branches varies widely among the various forms. For instance, low-density polyethylene (LDPE) is typically a highly branched structure with broad distributions in branch content, branch lengths and branch generation (in hyperbranched structures). This makes it difficult to accurately quantify the structure and the inherent structure-property relationships. To overcome this drawback, model well-defined hydrogenated polybutadiene (HPB) structures have been synthesized via anionic polymerization and hydrogenation to serve as model analogues to long-chain branched polyethylene. In this article, model 3-arm star polyethylene molecules are quantified using the scaling approach. Along with the long-chain branch content in polyethylene, the approach also provides unique measurements of long-chain branch length and hyperbranch content. Such detailed description facilitates better understanding of the effect of branching on the physical properties of polyethylene. © 2012 American Chemical Society.

  14. TRI Preliminary Dataset

    Science.gov (United States)

    The TRI preliminary dataset includes the most current TRI data available and reflects toxic chemical releases and pollution prevention activities that occurred at TRI facilities during the each calendar year.

  15. 2016 TRI Preliminary Dataset

    Science.gov (United States)

    The TRI preliminary dataset includes the most current TRI data available and reflects toxic chemical releases and pollution prevention activities that occurred at TRI facilities during the 2016 calendar year.

  16. Repair of the Thumb Ulnar Collateral Ligament With Suture Tape Augmentation.

    Science.gov (United States)

    De Giacomo, Anthony F; Shin, Steven S

    2017-09-08

    One of the most commonly injured structures of the thumb metacarpophalangeal (MCP) joint is the ulnar collateral ligament (UCL). An acute injury of this ligament is often amenable to primary repair. Despite the favorable outcomes of primary repair, the thumb is often restricted during initial healing of the ligament with immobilization and delayed rehabilitation. We present a novel technique to augment the repair of the UCL with suture tape to provide immediate biomechanical support and strength during the critical time of ligament healing. We describe the surgical technique of suture tape augmentation for thumb UCL repair. At the ulnar aspect of the thumb MCP joint, a longitudinal midaxial incision is made. Subsequently, the adductor pollicis aponeurosis and extensor mechanism are identified, incised, and retracted. The UCL is exposed and usually torn off the volar-ulnar base of the proximal phalanx. A 2.5-mm PushLock anchor loaded with 1.3-mm SutureTape and 3-0 FiberWire suture, is placed into a hole at the volar-ulnar base of the proximal phalanx after preparation with a 1.8-mm drill bit. The 3-0 FiberWire is used for direct repair of the ligament. Both tails of the 1.3-mm SutureTape is then brought proximally over the ligament and loaded into a 3.5-mm SwiveLock anchor. A 3.2-mm drill bit is then used to make a hole at the ulnar aspect of the metacarpal head, just proximal to the attachment of the proximal UCL. With the thumb MCP joint held in at least 30 degrees of flexion, the tape-loaded 3.5-mm SwiveLock anchor is inserted into metacarpal head. Reinforcement of the repair is then carried out with fine absorbable suture to surrounding capsular tissue. We present a representative case of a professional basketball player treated with this novel procedure. After the surgical repair, the patient was placed in a plaster splint for 3 days to immobilize the thumb and wrist. At 3 days postsurgery, the splint was removed and therapy initiated. Practice drills were

  17. Return to Play after Nonsurgical Treatment of Elbow Ulnar Collateral Ligament Injuries in Professional Baseball Players

    Science.gov (United States)

    Ford, Gregory M.; Genuario, James; Noonan, Thomas J.; Kinkartz, Jason D.; Githens, Thomas; Murayama, Scott

    2014-01-01

    Objectives: Injury to the elbow ulnar collateral ligament (UCL) is relatively common in pitchers. In the 70's reconstructive surgery was developed as a viable option to a potentially career ending injury. Multiple studies have demonstrated return to play (RTP) rates of 74-83% after reconstruction. Studies of RTP after nonoperative treatment in throwing athletes are limited, reporting 42%. There are no studies reporting RTP rates with nonoperative treatment of professional baseball players. The purpose of this study was to identify professional baseball players' ability to return to play after UCL injuries based on nonoperative vs. operative treatment, MRI grade, and player position. Methods: A retrospective review of a single professional baseball organization (6 minor league teams and 1 Major league team) between 2006 & 2011 revealed 72 medial elbow injuries. MRI was performed on all players. UCL injuries were diagnosed in 45 players by physical exam & MRI. Players were treated with rehabilitation, surgery or both. Success was RTP for >1 season. Rates of RTP and return to the same level of play or higher (RTSP) were calculated and correlated with MRI grade, location, and player position. MRI grading used was: 1 intact ligament +/- edema, 2 partial tearing, 3 complete tear, and 4 chronic healed injury. Results: Overall 91% of 45 players had RTP, and 87% had RTSP. Fifteen were treated surgically and 30 nonoperatively with rehab. Of players treated surgically, 73% had RTSP, whereas 93% of nonoperatively treated players had RTSP (p-value 0.07). All players with grade III tears had surgery. Of surgically treated players, none had grade I injuries, 13% had grade II injuries, 53% had grade III injuries, and 33% had grade IV injuries. Of nonoperatively treated players, 13% had grade I injuries, 23% had grade II injuries, none had grade III injuries, and 60% had grade IV injuries. Of all grade II and grade IV injuries, 78% were treated nonoperatively and all but 1 player

  18. Hierarchical Si/ZnO trunk-branch nanostructure for photocurrent enhancement

    Science.gov (United States)

    Dee, Chang Fu; Chong, Su Kong; Rahman, Saadah Abdul; Omar, Fatin Saiha; Huang, Nay Ming; Majlis, Burhanuddin Yeop; Salleh, Muhamad Mat

    2014-09-01

    Hierarchical Si/ZnO trunk-branch nanostructures (NSs) have been synthesized by hot wire assisted chemical vapor deposition method for trunk Si nanowires (NWs) on indium tin oxide (ITO) substrate and followed by the vapor transport condensation (VTC) method for zinc oxide (ZnO) nanorods (NRs) which was laterally grown from each Si nanowires (NWs). A spin coating method has been used for zinc oxide (ZnO) seeding. This method is better compared with other group where they used sputtering method for the same process. The sputtering method only results in the growth of ZnO NRs on top of the Si trunk. Our method shows improvement by having the growth evenly distributed on the lateral sides and caps of the Si trunks, resulting in pine-leave-like NSs. Field emission scanning electron microscope image shows the hierarchical nanostructures resembling the shape of the leaves of pine trees. Single crystalline structure for the ZnO branch grown laterally from the crystalline Si trunk has been identified by using a lattice-resolved transmission electron microscope. A preliminary photoelectrochemical (PEC) cell testing has been setup to characterize the photocurrent of sole array of ZnO NR growth by both hydrothermal-grown (HTG) method and VTC method on ITO substrates. VTC-grown ZnO NRs showed greater photocurrent effect due to its better structural properties. The measured photocurrent was also compared with the array of hierarchical Si/ZnO trunk-branch NSs. The cell with the array of Si/ZnO trunk-branch NSs revealed four-fold magnitude enhancement in photocurrent density compared with the sole array of ZnO NRs obtain from VTC processes.

  19. Confirmation of Precise Branching Ratio Measurement in the β Decay of ^34Ar

    Science.gov (United States)

    Iacob, V. E.; Hardy, J. C.; Golovko, V.

    2007-10-01

    Precise ft-values for superallowed 0^+->0^+ β^+-decays yield a demanding test of the Standard Model via the unitarity of the Cabibbo-Kobayashi-Maskawa matrix. One of the ingredients of an ft-value is the transition branching ratio which, to be relevant for the unitarity test, must be measured with a precision of ˜0.1% or better. After a preliminary report of such a measurement for ^34Ar [1], we have verified our methods and tested for any possible systematic effects by measuring the decay of ^10C under similar conditions. This nucleus is very well suited for a test of the data reduction method: it has a simple decay scheme without a ground-state branch, and all decay branches generate a 718 keV gamma ray. As with the ^34Ar measurement, an implanted ^10C source was placed between a plastic scintillator for β particles and a HPGe detector that is efficiency calibrated with high precision (0.2% between 50 and 1400 keV). Both β singles and β-γ coincidences were then recorded, and the collect/move/detect cycle was repeated until the desired statistical accuracy was obtained. We determined experimentally that the percentage of ^10C decays leading to a 718 keV gamma ray is statistically consistent with the expected 100%. This result validates our methods and reinforces the branching-ratio value previously obtained for the ^34Ar decay. [1] V. Iacob et al., Bulletin APS 52, (37) Apr-Meeting 2007

  20. Flight Dynamics Analysis Branch 2005 Technical Highlights

    Science.gov (United States)

    2005-01-01

    This report summarizes the major activities and accomplishments carried out by the Flight Dynamics Analysis Branch (FDAB), Code 595, in support of flight projects and technology development initiatives in Fiscal Year (FY) 2005. The report is intended to serve as a summary of the type of support carried out by the FDAB, as well as a concise reference of key accomplishments and mission experience derived from the various mission support roles. The primary focus of the FDAB is to provide expertise in the disciplines of flight dynamics including spacecraft navigation (autonomous and ground based); spacecraft trajectory design and maneuver planning; attitude analysis; attitude determination and sensor calibration; and attitude control subsystem (ACS) analysis and design. The FDAB currently provides support for missions and technology development projects involving NASA, other government agencies, academia, and private industry.