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Sample records for deep hypothermic cardiac

  1. Selective cerebral perfusion prevents abnormalities in glutamate cycling and neuronal apoptosis in a model of infant deep hypothermic circulatory arrest and reperfusion.

    Science.gov (United States)

    Kajimoto, Masaki; Ledee, Dolena R; Olson, Aaron K; Isern, Nancy G; Robillard-Frayne, Isabelle; Des Rosiers, Christine; Portman, Michael A

    2016-11-01

    Deep hypothermic circulatory arrest is often required for the repair of complex congenital cardiac defects in infants. However, deep hypothermic circulatory arrest induces neuroapoptosis associated with later development of neurocognitive abnormalities. Selective cerebral perfusion theoretically provides superior neural protection possibly through modifications in cerebral substrate oxidation and closely integrated glutamate cycling. We tested the hypothesis that selective cerebral perfusion modulates glucose utilization, and ameliorates abnormalities in glutamate flux, which occur in association with neuroapoptosis during deep hypothermic circulatory arrest. Eighteen infant male Yorkshire piglets were assigned randomly to two groups of seven (deep hypothermic circulatory arrest or deep hypothermic circulatory arrest with selective cerebral perfusion for 60 minutes at 18℃) and four control pigs without cardiopulmonary bypass support. Carbon-13-labeled glucose as a metabolic tracer was infused, and gas chromatography-mass spectrometry and nuclear magnetic resonance were used for metabolic analysis in the frontal cortex. Following 2.5 h of cerebral reperfusion, we observed similar cerebral adenosine triphosphate levels, absolute levels of lactate and citric acid cycle intermediates, and carbon-13 enrichment among three groups. However, deep hypothermic circulatory arrest induced significant abnormalities in glutamate cycling resulting in reduced glutamate/glutamine and elevated γ-aminobutyric acid/glutamate along with neuroapoptosis, which were all prevented by selective cerebral perfusion. The data suggest that selective cerebral perfusion prevents these modifications in glutamate/glutamine/γ-aminobutyric acid cycling and protects the cerebral cortex from apoptosis. © The Author(s) 2016.

  2. Histological changes in neonatal kidneys after cardiopulmonary bypass and deep hypothermic circulatory arrest.

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    Tirilomis, T; Tempes, T; Waldmann-Beushausen, R; Ballat, C; Bensch, M; Schoendube, F A

    2009-02-01

    Renal failure after open-heart surgery is a serious complication resulting in increased mortality and morbidity. The aim of the study was to find out whether different strategies for open-heart surgery would result in renal histological differences in a neonatal animal model. The renal tissue of newborn piglets was examined after mild hypothermic cardiopulmonary bypass (CPB group; n = 10), deep hypothermic circulatory arrest (DHCA group; n = 8), instrumentation without extracorporeal circulation (sham; n = 3), and the data were compared with those of normal porcine neonatal kidneys (control; n = 6). The severity of tissue damage was graded using a 4-point scoring system (0: normal morphology, 3: severe damage). Apoptotic cells and granulocytes were counted. The histological score was higher in all groups compared with controls ( P < 0.05) and higher in the CPB group compared with the DHCA group ( P < 0.05). More apoptotic cells and granulocytes were found in the CPB group compared with controls and the DHCA group ( P < 0.05). Although changes in the kidney tissue of newborn piglets are detectable after any cardiac procedure, changes are more profound after cardiopulmonary bypass with mild hypothermia.

  3. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E

    2013-12-01

    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention.

  4. Post-hypothermic cardiac left ventricular systolic dysfunction after rewarming in an intact pig model.

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    Filseth, Ole Magnus; How, Ole-Jakob; Kondratiev, Timofei; Gamst, Tor Magne; Tveita, Torkjel

    2010-01-01

    We developed a minimally invasive, closed chest pig model with the main aim to describe hemodynamic function during surface cooling, steady state severe hypothermia (one hour at 25°C) and surface rewarming. Twelve anesthetized juvenile pigs were acutely catheterized for measurement of left ventricular (LV) pressure-volume loops (conductance catheter), cardiac output (Swan-Ganz), and for vena cava inferior occlusion. Eight animals were surface cooled to 25°C, while four animals were kept as normothermic time-matched controls. During progressive cooling and steady state severe hypothermia (25°C) cardiac output (CO), stroke volume (SV), mean arterial pressure (MAP), maximal deceleration of pressure in the cardiac cycle (dP/dt(min)), indexes of LV contractility (preload recruitable stroke work, PRSW, and maximal acceleration of pressure in the cardiac cycle, dP/dt(max)) and LV end diastolic and systolic volumes (EDV and ESV) were significantly reduced. Systemic vascular resistance (SVR), isovolumetric relaxation time (Tau), and oxygen content in arterial and mixed venous blood increased significantly. LV end diastolic pressure (EDP) remained constant. After rewarming all the above mentioned hemodynamic variables that were depressed during 25°C remained reduced, except for CO that returned to pre-hypothermic values due to an increase in heart rate. Likewise, SVR and EDP were significantly reduced after rewarming, while Tau, EDV, ESV and blood oxygen content normalized. Serum levels of cardiac troponin T (TnT) and tumor necrosis factor-alpha (TNF-α) were significantly increased. Progressive cooling to 25°C followed by rewarming resulted in a reduced systolic, but not diastolic left ventricular function. The post-hypothermic increase in heart rate and the reduced systemic vascular resistance are interpreted as adaptive measures by the organism to compensate for a hypothermia-induced mild left ventricular cardiac failure. A post-hypothermic increase in TnT indicates

  5. Leukocyte filtration to decrease the number of adherent leukocytes in the cerebral microcirculation after a period of deep hypothermic circulatory arrest.

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    Alaoja, Hanna; Niemelä, Eija; Anttila, Vesa; Dahlbacka, Sebastian; Mäkelä, Jussi; Kiviluoma, Kai; Laurila, Päivi; Kaakinen, Timo; Juvonen, Tatu

    2006-12-01

    Cardiopulmonary bypass and hypothermic circulatory arrest induce a systemic inflammatory response, including a cascade of leukocyte and endothelial cell activity, during the postischemic reperfusion phase. Accumulation of leukocytes in the brain can lead to neurologic problems after cardiac surgery. The beneficial effects of a leukocyte-depleting filter have been documented, but because of contradictory results the underlying function of the filter remains unclear. Twenty-two juvenile piglets (6 to 8 weeks) were randomly assigned to undergo cardiopulmonary bypass with or without a leukocyte-depleting filter 60 minutes before and 60 minutes after a 75-minute hypothermic circulatory arrest at 18 degrees C. The cerebral vessels were visualized with intravital microscopy through a cranial window placed over the parietal cortex. Rhodamine staining was used to observe adherent and rolling leukocytes in the cerebral postcapillary venules. The animals were electively killed 1 hour after weaning from cardiopulmonary bypass. There were no significant differences between the study groups regarding hemodynamic data. Numbers of adherent activated leukocytes were lower in the leukocyte filtration group, reaching borderline statistical significance when assessed throughout the experiment (between-groups P = .069) and actual statistical significance when assessed during the rewarming period (between-groups P = .029). The leukocyte-depleting filter succeeded in reducing the number of adherent leukocytes during the reperfusion period in an experimental operation with deep hypothermic circulatory arrest. Such a filter thus could mitigate cerebral reperfusion injury after cardiac surgery.

  6. Functional outcome in female rats after 45 minutes of deep hypothermic circulatory arrest: gender matters.

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    Kellermann, Kristine; Gordan, Lucia M; Blobner, Manfred; Luppa, Peter; Kochs, Eberhard F; Jungwirth, Bettina

    2013-01-01

    After adjusting for cofactors, female gender remains an independent risk factor. The aim of our study was to investigate the role of gender on functional outcome 14 days after 45 minutes of deep hypothermic circulatory arrest (DHCA) in rats. After institutional animal care committee Institutional Review Board approval, 40 male and 40 female rats were randomly divided into two groups (40 DHCA, 40 controls). The rats were neutered or sham-neutered and 40 of them were subjected to DHCA with 40 controls remaining naïve. Postoperative functional performance was assessed with modified hole-board test. Brain morphology was assessed using hematoxylin and eosin (HE) staining and cerebral inflammation/apoptosis determined immunohistochemically. Data were analyzed using general linear models (post hoc analysis of variance [ANOVA] and Bonferroni t tests) and Kruskal-Wallis (post hoc Mann-Whitney U test) (p intestine with regard to its rate. Georg Thieme Verlag KG Stuttgart · New York.

  7. Modified ultrafiltration may not improve neurologic outcome following deep hypothermic circulatory arrest.

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    Myung, Richard J; Kirshbom, Paul M; Petko, Matus; Golden, Jeffrey A; Judkins, Alexander R; Ittenbach, Richard F; Spray, Thomas L; Gaynor, J William

    2003-08-01

    Modified ultrafiltration (MUF) improves systolic blood pressure and left ventricular performance, as well as lowering transfusion requirements, after cardiopulmonary bypass (CPB). MUF has also been shown to enhance acute cerebral metabolic recovery after deep hypothermic circulatory arrest (DHCA), but whether this improves neurologic outcome is unknown. Sixteen neonatal piglets underwent CPB and 90 min of DHCA. The hematocrit was maintained between 25 and 30%. Alpha-stat blood gas management was used. After separation from CPB, animals were randomized to 15 min of MUF (n = 8) or no intervention (n = 8). Neurologic injury was assessed with behavior scores and histologic examination. Standardized behavior scores were obtained on post-operative days 1, 3, and 6 (0 = no deficit to 95 = brain death). The percentage of injured neurons by hematoxylin and eosin staining and the degree of reactive astrocytosis by glial filbrillary acidic protein (GFAP) immunohistochemistry were assessed to determine histologic scores in the neocortex and hippocampus (0 = no injury to 4 = diffuse injury). There were no statistically significant differences between groups during CPB. After MUF, the hematocrit was significantly higher (40% +/- 5.7 vs. 28% +/- 3.9, P 0.1). There was resolution of deficits by day 6 in all animals. Neuronal injury was present in 81% (13/16) of the animals with no statistically significant differences between groups in incidence or severity. Use of MUF after DHCA does not prevent neuronal injury or improve neurologic outcome in this neonatal swine model.

  8. Neuroprotective effect of intracarotid cold saline infusion following cardiopulmonary resuscitation in a hypothermic cardiac arrest canine model

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    Wei-zheng SHUAI

    2017-11-01

    Full Text Available Objective To evaluate the effect of intracarotid cold saline infusion (ICSI on neurological outcomes in canines with cardiac arrest (CA introduced by severe hypothermia. Methods Restoration of spontaneous circulation (ROSC after hypothermic CA was induced in 10 Beagle dogs. These 10 dogs were randomly divided into 2 groups (5 each. Dogs in control group were rewarmed using warn water bath, and dogs in experimental group received the bath rewarming plus ICSI for 6 hours to maintain the brain temperature <36℃. In both groups, the Neurologic Disability Scores (NDS were recorded at 24h after the ROSC, and their brains were removed for pathologic analysis using hematoxylin and eosin stain. The brain water content and s100β of serum level were also measured. Results The water content (79.43%±0.72% vs. 80.79%±1.06%, P<0.05 and serum level of s100β (119.83±42.93pg/ml vs. 329.82±190.39pg/ml, P<0.05 were significantly lower in experimental group than in the control group. Control group presented obvious pathological damage of the hippocampal pyramidal cells. There was no significant difference in NDS between the two groups. Conclusion ICSI could reduce the production of s100β and pathological brain damage in post-arrest hypothermic canines. DOI: 10.11855/j.issn.0577-7402.2017.10.08

  9. The effects of aprotinin on blood product transfusion associated with thoracic aortic surgery requiring deep hypothermic circulatory arrest.

    LENUS (Irish Health Repository)

    Seigne, P W

    2012-02-03

    OBJECTIVE: To compare the effects of aprotinin on blood product use and postoperative complications in patients undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest. DESIGN: A retrospective study. SETTING: A university hospital. PARTICIPANTS: Nineteen patients who underwent elective or urgent thoracic aortic surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The total number of units of packed red blood cells, fresh frozen plasma, and platelets was significantly less in the group that received aprotinin (p = 0.01, 0.04, and 0.01). The intraoperative transfusion of packed red blood cells and platelets, collection and retransfusion of cell saver, and postoperative transfusion of fresh frozen plasma were also significantly less in the aprotinin group (p = 0.01, 0.02, 0.01, and 0.05). No patient in either group sustained renal dysfunction or a myocardial infarction. Two patients who had not received aprotinin suffered from chronic postoperative seizures, and one patient who had received aprotinin sustained a perioperative stroke. CONCLUSIONS: Low-dose aprotinin administration significantly decreases blood product transfusion requirements in the setting of thoracic aortic surgery requiring deep hypothermic circulatory arrest, and it does not appear to be associated with renal or myocardial dysfunction.

  10. Alkaline Phosphatase for the Prevention of Intestinal and Renal Injury in a Rat Model of Cardiopulmonary Bypass with Deep Hypothermic Circulatory Arrest

    Science.gov (United States)

    2017-09-01

    AWARD NUMBER: W81XWH-16-1-0090 TITLE: Alkaline Phosphatase for the Prevention of Intestinal and Renal Injury in a Rat Model of Cardiopulmonary...TYPE Annual 3. DATES COVERED 8/15/2016—8/14/2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Alkaline Phosphatase for the Prevention of Intestinal... prevention of intestinal and kidney injury after pediatric cardiopulmonary bypass with deep hypothermic circulatory arrest. In this model, we place 5-10kg

  11. The effect of hypothermic cardiopulmonary bypass and total circulatory arrest on cerebral metabolism in neonates, infants, and children.

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    Greeley, W J; Kern, F H; Ungerleider, R M; Boyd, J L; Quill, T; Smith, L R; Baldwin, B; Reves, J G

    1991-05-01

    Cardiopulmonary bypass management in neonates, infants, and children often requires the use of deep hypothermia at 18 degrees C with occasional periods of circulatory arrest and represents marked physiologic extremes of temperature and perfusion. The safety of these techniques is largely dependent on the reduction of metabolism, particularly cerebral metabolism. We studied the effect of hypothermia on cerebral metabolism during cardiac surgery and quantified the changes. Cerebral metabolism was measured before, during, and after hypothermic cardiopulmonary bypass in 46 pediatric patients, aged 1 day to 14 years. Patients were grouped on the basis of the different bypass techniques commonly used in children: group A--moderate hypothermic bypass at 28 degrees C; group B--deep hypothermic bypass at 18 degrees to 20 degrees C with maintenance of continuous flow; and group C--deep hypothermic circulatory arrest at 18 degrees C. Cerebral metabolism significantly decreased under hypothermic conditions in all groups compared with control levels at normothermia, the data demonstrating an exponential relationship between temperature and cerebral metabolism and an average temperature coefficient of 3.65. There was no significant difference in the rate of metabolism reduction (temperature coefficient) in patients cooled to 28 degrees and 18 degrees C. From these data we were able to derive an equation that numerically expresses a hypothermic metabolic index, which quantitates duration of brain protection provided by reduction of cerebral metabolism owing to hypothermic bypass over any temperature range. Based on this index, patients cooled to 28 degrees C have a predicted ischemic tolerance of 11 to 19 minutes. The predicted duration that the brain can tolerate ischemia ("safe" period of deep hypothermic circulatory arrest) in patients cooled to 18 degrees C, based on our metabolic index, is 39 to 65 minutes, similar to the safe period of deep hypothermic circulatory arrest

  12. Selective cerebral perfusion prevents abnormalities in glutamate cycling and neuronal apoptosis in a model of infant deep hypothermic circulatory arrest and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Kajimoto, Masaki; Ledee, Dolena R.; Olson, Aaron K.; Isern, Nancy G.; Robillard-Frayne, Isabelle; Des Rosiers, Christine; Portman, Michael A.

    2016-10-01

    Rationale: Deep hypothermic circulatory arrest (DHCA) is often required for the repair of complex congenital cardiac defects in infants. However, DHCA induces neuroapoptosis associated with later development of neurocognitive abnormalities. Selective cerebral perfusion (SCP) theoretically provides superior neural protection possibly through modifications in cerebral substrate oxidation and closely integrated glutamate cycling. Objectives: We tested the hypothesis that SCP modulates glucose entry into the citric acid cycle, and ameliorates abnormalities in glutamate flux which occur in association neuroapoptosis during DHCA. Methods and Results: Eighteen male Yorkshire piglets (age 34-44 days) were assigned randomly to 2 groups of 7 (DHCA or DHCA with SCP for 60 minutes at 18 °C) and 4 control pigs without cardiopulmonary bypass support. After the completion of rewarming from DHCA, 13-Carbon-labeled (13C) glucose as a metabolic tracer was infused. We used gas chromatography-mass spectrometry (GCMS) and nuclear magnetic resonance for metabolic analysis in the frontal cortex. Following 2.5 hours of cerebral reperfusion, we observed similar cerebral ATP levels, absolute levels of lactate and citric acid cycle intermediates, and 13C-enrichment. However, DHCA induced significant abnormalities in glutamate cycling resulting in reduced glutamate/glutamine and elevated γ-aminobutyric acid (GABA)/glutamate along with neuroapoptosis (TUNEL), which were all prevented by SCP. Conclusions: DHCA alone induces abnormalities in cycling of the major neurotransmitters in association with neuroapoptosis, but does not alter cerebral glucose utilization during reperfusion. The data suggest that SCP prevents these modifications in glutamate/glutamine/GABA cycling and protects the cerebral cortex from neuroapoptosis.

  13. Forbidden word entropy of cerebral oximetric values predicts postoperative neurocognitive decline in patients undergoing aortic arch surgery under deep hypothermic circulatory arrest

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    Anna Dubovoy

    2017-01-01

    Full Text Available Purpose: Up to 53% of cardiac surgery patients experience postoperative neurocognitive decline. Cerebral oximetry is designed to detect changes in cerebral tissue saturation and therefore may be useful to predict which patients are at risk of developing neurocognitive decline. Methods: This is a retrospective analysis of a prospective study originally designed to determine if treatment of cerebral oximetry desaturation is associated with improvement in postoperative cognitive dysfunction in patients undergoing aortic reconstruction under deep hypothermic circulatory arrest. Cognitive function was measured, preoperatively and 3 months postoperatively, with 15 neuropsychologic tests administered by a psychologist; the individual test scores were summed and normalized. Bilateral cerebral oximetry data were stored and analyzed using measures of entropy. Cognitive decline was defined as any decrease in the summed normalized score from baseline to 3 months. Results: Seven of 17 (41% patients suffered cognitive decline. There was no association between baseline cerebral oximetry and postoperative cognitive dysfunction. Nor were changes in oximetry values associated with cognitive decline. However, cognitive decline was associated with loss of forbidden word entropy (FwEn (correlation: Rho ρ = 0.51, P = 0.037 for left cerebral oximetry FwEn and ρ = 0.54, P = 0.025 for right cerebral oximetry FwEn. Conclusion: Postoperative cognitive decline was associated with loss of complexity of the time series as shown by a decrease in FwEn from beginning to end of the case. This suggests that regulation of cerebral oximetry is different between those who do and those who do not develop cognitive decline.

  14. Removal of infected pacemaker leads with deep hypothermic circulatory arrest and open surgical exploration of the superior vena cava and innominate veins.

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    Feldbaum, D M; Brodman, R F; Frame, R; Camacho, M T; Gross, J; Ferrick, K

    1999-06-01

    Despite the use of transvenous methods for extraction of infected leads, failed attempts may result in retained lead fragments. Retained lead fragments may be a focus of continued infection leading to sepsis. We present two patients in which conversion from cardiopulmonary bypass to hypothermic circulatory arrest allowed direct visualization, using venotomies in the superior vena cava and innominate vein to achieve complete removal of retained pacemaker lead fragments. Use of venotomies in the extracardiac venous system is a technical addition to prior descriptions of lead extraction using deep hypothermia and circulatory arrest.

  15. Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery: A Prospective Study

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    Hu, Zhiyong; Xu, Lili; Zhu, Zhirui; Seal, Robert; McQuillan, Patrick M.

    2016-01-01

    Abstract The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients. Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded. Internal jugular bulb venous oxygen saturation and SvO2 were obtained from blood gas analysis at the time points: after induction of anesthesia (T0), beginning of CPB (T1), ascending aortic occlusion (T2), 20 minutes after initiating CPB (T3), coronary reperfusion (T4), separation from CPB (T5), and at the end of operation (T6). The effect of hypothermia or changes in CPP on rSO2, SjvO2, SvO2, and BIS were analyzed. Compared with postinduction baseline values, rSO2 significantly decreased at all-time points: onset of extracorporeal circulation, ascending aortic occlusion, 20 minutes after CPB initiation, coronary reperfusion, and separation from CPB (P  0.05). Correlation analysis demonstrated that rSO2 was positively related to CPP (r = 0.687, P = 0.000), with a low linear correlation to temperature (r = 0.453, P = 0.000). Internal jugular bulb venous oxygen saturation was negatively related to temperature (r = −0.689, P = 0.000). Bispectral index was positively related to both temperature (r = 0.824, P = 0.000) and CPP (r = 0.782, P = 0.000). Cerebral oxygen saturation had a positive linear correlation with CPP and a low linear correlation to temperature. Internal jugular bulb venous oxygen saturation had a negative linear correlation to temperature. Pre-and and early

  16. Sodium bicarbonate use and the risk of hypernatremia in thoracic aortic surgical patients with metabolic acidosis following deep hypothermic circulatory arrest

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    Kamrouz Ghadimi

    2016-01-01

    Full Text Available Objective: Metabolic acidosis after deep hypothermic circulatory arrest (DHCA for thoracic aortic operations is commonly managed with sodium bicarbonate (NaHCO 3 . The purpose of this study was to determine the relationships between total NaHCO 3 dose and the severity of metabolic acidosis, duration of mechanical ventilation, duration of vasoactive infusions, and Intensive Care Unit (ICU or hospital length of stay (LOS. Methods: In a single center, retrospective study, 87 consecutive elective thoracic aortic operations utilizing DHCA, were studied. Linear regression analysis was used to test for the relationships between the total NaHCO 3 dose administered through postoperative day 2, clinical variables, arterial blood gas values, and short-term clinical outcomes. Results: Seventy-five patients (86% received NaHCO 3 . Total NaHCO 3 dose averaged 136 ± 112 mEq (range: 0.0-535 mEq per patient. Total NaHCO 3 dose correlated with minimum pH (r = 0.41, P < 0.0001, minimum serum bicarbonate (r = −0.40, P < 0.001, maximum serum lactate (r = 0.46, P = 0.007, duration of metabolic acidosis (r = 0.33, P = 0.002, and maximum serum sodium concentrations (r = 0.29, P = 0.007. Postoperative hypernatremia was present in 67% of patients and peaked at 12 h following DHCA. Eight percent of patients had a serum sodium ≥ 150 mEq/L. Total NaHCO 3 dose did not correlate with anion gap, serum chloride, not the duration of mechanical ventilator support, vasoactive infusions, ICU or hospital LOS. Conclusion: Routine administration of NaHCO 3 was common for the management of metabolic acidosis after DHCA. Total dose of NaHCO 3 was a function of the severity and duration of metabolic acidosis. NaHCO 3 administration contributed to postoperative hypernatremia that was often severe. The total NaHCO 3 dose administered was unrelated to short-term clinical outcomes.

  17. Current perspectives in transplant medicine: hypothermic oxygenated perfusion

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    Michel SG

    2016-11-01

    Full Text Available Sebastian G Michel,1 Joren C Madsen2,3 1Department of Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany; 2Department of Surgery, Center for Transplantation Sciences, 3Division of Cardiac Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA Abstract: The purpose of this review was to provide an update on hypothermic oxygenated perfusion as a preservation technique for whole organ allografts. Clinical and experimental data in heart, lung, liver, kidney, and pancreas/islet transplantation are summarized with a special emphasis on marginal donors and donation after circulatory death. The rationale behind hypothermic machine perfusion as well as its advantages and disadvantages compared to conventional cold storage and the competing technique, normothermic machine perfusion, are reviewed. Keywords: organ transplantation, organ preservation, hypothermic perfusion

  18. Granite-related hypothermal uranium mineralization in South China

    International Nuclear Information System (INIS)

    Liu, X.; Wu, J.; Pan, J.; Zhu, M.

    2014-01-01

    As one of the important geological types, granite-related uranium deposits account for about 29% of the total discovered natural uranium resources in China. Most of the granite-related uranium deposits located in Taoshan - Zhuguang uranium metallogenic belt, South China. In addition to the typical pitchblende vein-type uranium mineralization of epithermal metallogenic system, a new type of granite-related uranium mineralization with characteristics of hypothermal matallogenic system was discovered in South China by current studies. However, hypothermal is contact thermal to epithermal mineralization, and not the conventional intrusive high temperature mineralization. Hypothermal uranium mineralization is presented by disseminated uraninite or pitchblende stockwork in fissures in granites normally with extensive alkaline alteration. The high temperature mineral assemblage of uraninite associate with scheelite and tourmaline was identified in hypothermal uranium mineralization. Fluid inclusion studies on this type mineralization indicated the middle to high temperature (>250℃) mineralization with the mixing evidence of ore forming solution derived from deep level, and the boiling and mixing of ore forming solution are regarded as the dominant mineralization mechanism for the precipitating of uranium. In contrast to the mineralization ages of 67 Ma to 87 Ma for typical pitchblende vein mineralization of epithermal metallogenic system, the mineralization age is older than 100 Ma for hypothermal uranium mineralization in granite. In the Shituling deposit, Xiazhuang uranium ore field, uraninite and pitchblende micro veins with extensive potassic alteration, chloritization and sericitization are hosted in fissures of Indo-Chinese epoch granites with the uranium mineralization age of 130 Ma to 138 Ma with a mineralization temperature of 290℃ to 330℃ indicated. Other examples sharing the similar characters of hypothermal uranium mineralization have been recognized in

  19. Is extracorporeal rewarming indicated in avalanche victims with unwitnessed hypothermic cardiorespiratory arrest?

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    Mair, Peter; Brugger, Hermann; Mair, Birgit; Moroder, Luca; Ruttmann, Elfriede

    2014-12-01

    International guidelines recommend using extracorporeal rewarming in all hypothermic avalanche victims with prolonged cardiac arrest if they have patent airways and a plasma potassium level≤12 mmol/L. The aim of this study was to evaluate outcome data to determine if available experience with extracorporeal rewarming of avalanche victims supports this recommendation. At Innsbruck Medical University Hospital, 28 patients with hypothermic cardiac arrest following an avalanche accident were resuscitated using extracorporeal circulation. Of these patients, 25 were extricated from the snow masses with no vital signs and did not survive to hospital discharge. Three patients had witnessed cardiac arrest after extrication and a core temperature of 21.7°C, 22°C, and 24.0°C, two of whom survived long-term with full neurological recovery. A search of the literature revealed only one asystolic avalanche victim with unwitnessed hypothermic cardiac arrest (core temperature 19°C) surviving long-term. All other avalanche victims in the medical literature surviving prolonged hypothermic cardiac arrest suffered witnessed arrest after extrication with a core temperature below 24°C. Our results suggest that prognosis of hypothermic avalanche victims with unwitnessed asystolic cardiac arrest and a core temperature>24°C is extremely poor. Available outcome data do not support the use of extracorporeal rewarming in these patients.

  20. Deep sternal wound infections: a severe complication after cardiac surgery.

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    Morgante, A; Romeo, F

    2017-01-01

    Sternal Wound Infections (SWI) represent a dangerous complication after cardiac surgery entailing significantly longer hospital stays and worse short-term survival, especially in case of deep infections (DSWI) with the onset of osteomielitis or mediastinitis. The real incidence of SWI can be estimated between 0.25% and 10%; among the risk factors for sternal dehiscences after a longitudinal median sternotomy, several experiences underline the role of diabetes as an independent risk factor for post-operative infections, especially in patients affected by COPD with higher BMI. The application of a negative-pressure therapy, through instill modality too, assures a wound cleansing through periodic irrigation of topical solutions with particulate secretion removal; moreover it improves the granulation process owing to the increased blood flow and makes the size wound reduction easier, representing very often the treatment of first-line in DSWI and an optimal bridge for another reconstructive procedure of the sternal defect. The following case report shows how a plastic surgical approach associated to the adoption of a VAC-therapy instill after specific antibiotictherapy has integrated and optimized the trend of a very complex clinical circumstance.

  1. Obesity Does Not Affect Propofol Pharmacokinetics During Hypothermic Cardiopulmonary Bypass.

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    El-Baraky, Iman A; Abbassi, Maggie M; Marei, Tarek A; Sabry, Nirmeen A

    2016-08-01

    Because of the lack of data regarding the impact of obesity on propofol pharmacokinetics in patients undergoing cardiac surgery using hypothermic cardiopulmonary bypass (CPB), the authors sought to explore propofol pharmacokinetics and develop a predictive pharmacokinetic model that characterizes and predicts propofol pharmacokinetics in this population. A prospective, observational study. A teaching hospital. The study comprised 17 obese and 17 control (nonobese) patients undergoing hypothermic CPB. None. Patients mainly underwent valve surgery. On initiation of hypothermic CPB (28°C-32°C), patients received a propofol (1%) bolus (1 mg/kg) immediately followed by a 2 mg/kg/h infusion. Blood samples were withdrawn at the following times: before dosing; 1, 3, 5, and 7 minutes after the propofol bolus dose; every 20 minutes during infusion; just before discontinuation of the infusion; and at 1, 3, 5, 7, 10, 20, 30, and 60 minutes after discontinuation of the infusion. The plasma propofol concentration was determined using high-performance liquid chromatography, and then data were imported into Monolix (Lixoft, Antony, France) for population pharmacokinetic modeling and pharmacokinetic parameters estimation. A 2-compartment pharmacokinetic model with age as a covariate on the peripheral volume of distribution (V2) best described the pooled data. The pooled data was internally evaluated successfully to describe and predict propofol pharmacokinetics in the addressed population. Propofol clearance, intercompartmental clearance, and central volume of distribution were 805 mL/min, 1140 mL/min and 18.8 L, respectively. V2 was calculated as 9.86×exp.(1.88×[age/40]) L. Propofol pharmacokinetic parameters were similar in obese and nonobese patients undergoing hypothermic CPB. Age was the major determinant of propofol V2 in the obese population. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Development of regional cerebral sub-hypothermia with perfusion of hypothermic liquids

    International Nuclear Information System (INIS)

    Wang Peng; Ji Xunming

    2007-01-01

    The neuroprotection of induced hypothermia has been investigated intensively and confirmed in animal models and it has been used clinically in many fields since the finding of sub-hypothermia can also reduce cerebral injury. However the use of hypothermia in clinics is limited by the simultaneously induced systemic complications. Recently the sub-hypothermia induced by hypothermic regional arterial perfusion is proved to be the most effective method to reach the goal, including hypothermic normal saline with no influences on whole body temperature, cardiac rhythm and blood coagulation. According to the well development, fruitful achievement in the present status of this field, the authors are surely to have the inspiration for the further investigation and development of regional cerebral sub-hypothermia with perfusion of hypothermic liquids. (authors)

  3. Automatic localization of the left ventricle in cardiac MRI images using deep learning.

    Science.gov (United States)

    Emad, Omar; Yassine, Inas A; Fahmy, Ahmed S

    2015-08-01

    Automatic localization of the left ventricle (LV) in cardiac MRI images is an essential step for automatic segmentation, functional analysis, and content based retrieval of cardiac images. In this paper, we introduce a new approach based on deep Convolutional Neural Network (CNN) to localize the LV in cardiac MRI in short axis views. A six-layer CNN with different kernel sizes was employed for feature extraction, followed by Softmax fully connected layer for classification. The pyramids of scales analysis was introduced in order to take account of the different sizes of the heart. A publically-available database of 33 patients was used for learning and testing. The proposed method was able it localize the LV with 98.66%, 83.91% and 99.07% for accuracy, sensitivity and specificity respectively.

  4. Exercise at depth alters bradycardia and incidence of cardiac anomalies in deep-diving marine mammals.

    Science.gov (United States)

    Williams, Terrie M; Fuiman, Lee A; Kendall, Traci; Berry, Patrick; Richter, Beau; Noren, Shawn R; Thometz, Nicole; Shattock, Michael J; Farrell, Edward; Stamper, Andy M; Davis, Randall W

    2015-01-16

    Unlike their terrestrial ancestors, marine mammals routinely confront extreme physiological and physical challenges while breath-holding and pursuing prey at depth. To determine how cetaceans and pinnipeds accomplish deep-sea chases, we deployed animal-borne instruments that recorded high-resolution electrocardiograms, behaviour and flipper accelerations of bottlenose dolphins (Tursiops truncatus) and Weddell seals (Leptonychotes weddellii) diving from the surface to >200 m. Here we report that both exercise and depth alter the bradycardia associated with the dive response, with the greatest impacts at depths inducing lung collapse. Unexpectedly, cardiac arrhythmias occurred in >73% of deep, aerobic dives, which we attribute to the interplay between sympathetic and parasympathetic drivers for exercise and diving, respectively. Such marked cardiac variability alters the common view of a stereotypic 'dive reflex' in diving mammals. It also suggests the persistence of ancestral terrestrial traits in cardiac function that may help explain the unique sensitivity of some deep-diving marine mammals to anthropogenic disturbances.

  5. Novel Zero-Heat-Flux Deep Body Temperature Measurement in Lower Extremity Vascular and Cardiac Surgery.

    Science.gov (United States)

    Mäkinen, Marja-Tellervo; Pesonen, Anne; Jousela, Irma; Päivärinta, Janne; Poikajärvi, Satu; Albäck, Anders; Salminen, Ulla-Stina; Pesonen, Eero

    2016-08-01

    The aim of this study was to compare deep body temperature obtained using a novel noninvasive continuous zero-heat-flux temperature measurement system with core temperatures obtained using conventional methods. A prospective, observational study. Operating room of a university hospital. The study comprised 15 patients undergoing vascular surgery of the lower extremities and 15 patients undergoing cardiac surgery with cardiopulmonary bypass. Zero-heat-flux thermometry on the forehead and standard core temperature measurements. Body temperature was measured using a new thermometry system (SpotOn; 3M, St. Paul, MN) on the forehead and with conventional methods in the esophagus during vascular surgery (n = 15), and in the nasopharynx and pulmonary artery during cardiac surgery (n = 15). The agreement between SpotOn and the conventional methods was assessed using the Bland-Altman random-effects approach for repeated measures. The mean difference between SpotOn and the esophageal temperature during vascular surgery was+0.08°C (95% limit of agreement -0.25 to+0.40°C). During cardiac surgery, during off CPB, the mean difference between SpotOn and the pulmonary arterial temperature was -0.05°C (95% limits of agreement -0.56 to+0.47°C). Throughout cardiac surgery (on and off CPB), the mean difference between SpotOn and the nasopharyngeal temperature was -0.12°C (95% limits of agreement -0.94 to+0.71°C). Poor agreement between the SpotOn and nasopharyngeal temperatures was detected in hypothermia below approximately 32°C. According to this preliminary study, the deep body temperature measured using the zero-heat-flux system was in good agreement with standard core temperatures during lower extremity vascular and cardiac surgery. However, agreement was questionable during hypothermia below 32°C. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Hypothermic machine perfusion in kidney transplantation

    NARCIS (Netherlands)

    De Deken, Julie; Kocabayoglu, Peri; Moers, Cyril

    Purpose of reviewThis article summarizes novel developments in hypothermic machine perfusion (HMP) as an organ preservation modality for kidneys recovered from deceased donors.Recent findingsHMP has undergone a renaissance in recent years. This renewed interest has arisen parallel to a shift in

  7. Cardiac motion during deep-inspiration breath-hold: implications for breast cancer radiotherapy.

    Science.gov (United States)

    Wang, Xiaochun; Pan, Tinsu; Pinnix, Chelsea; Zhang, Sean X; Salehpour, Mohammad; Sun, Tzouh Liang; Gladish, Gregory; Strom, Eric A; Perkins, George H; Tereffe, Welela; Woodward, Wendy; Hoffman, Karen E; Buchholz, Thomas A; Yu, T Kuan

    2012-02-01

    Many patients with left-sided breast cancer receive adjuvant radiotherapy during deep-inspiration breath hold (DIBH) to minimize radiation exposure to the heart. We measured the displacement of the left anterior descending artery (LAD) and heart owing to cardiac motion during DIBH, relative to the standard tangential fields for left breast cancer radiotherapy. A total of 20 patients who had undergone computed tomography-based coronary angiography with retrospective electrocardiographic gating were randomly selected for the present study. The patients underwent scanning during DIBH to control the influence of respiration on cardiac motion. Standard medial and lateral tangential fields were placed, and the LADs were contoured on the systolic- and diastolic-phase computed tomography data sets by the clinicians. Displacement of the LAD during cardiac contractions was calculated in three directions: toward the posterior edge of the treatment fields, left-right, and anteroposterior. Displacement of the entire heart was measured on the maximal and minimal intensity projection computed tomography images. The mean displacement of the LAD from cardiac contraction without the influence of respiration for 20 patients was 2.3 mm (range, 0.7-3.8) toward the posterior edge of the treatment fields, 2.6 mm (range, 1.0-6.8) in the left-right direction, and 2.3 mm (range, 0.6-6.5) in the anteroposterior direction. At least 30% of the LAD volume was displaced >5 mm in any direction in 2 patients (10%), and 5 mm in 10 patients (50%). The extent of displacement of the heart periphery during cardiac motion was negligible near the treatment fields. Displacement of the heart periphery near the treatment fields was negligible during DIBH; however, displacement of the LAD from cardiac contraction varied substantially between and within patients. We recommend maintaining ≥ 5 mm of distance between the LAD and the field edge for patients undergoing breast cancer radiotherapy during DIBH

  8. Vancomycin Paste Does Not Reduce the Incidence of Deep Sternal Wound Infection After Cardiac Operations.

    Science.gov (United States)

    Lander, Heather L; Ejiofor, Julius I; McGurk, Siobhan; Tsuyoshi, Kaneko; Shekar, Prem; Body, Simon C

    2017-02-01

    Deep sternal wound infection (DSWI) is a devastating complication that increases morbidity and death in cardiac surgical patients. Vancomycin is often administered intravenously for antibiotic prophylaxis in cardiac operations. Many cardiac surgeons also apply vancomycin paste topically to the sternal edges. We examined the effect of vancomycin paste on the incidence of DSWI in patients undergoing elective cardiac operations. We retrospectively reviewed the medical records of all patients from 2003 to 2015 who underwent coronary artery bypass grafting, valve, or combined coronary artery bypass grafting and valve operations at a single institution. We derived The Society for Thoracic Surgeons (STS) DSWI risk index for each patient and systematically reviewed operative, pharmacy, microbiology, and discharge records to document DSWI in these patients. Multivariate analyses were used to identify predictors of DSWI in this cohort and to quantify the effect of vancomycin paste. Of the 14,492 patients whose records we examined, DSWI developed in 136 patients, resulting in an overall incidence of 0.9%. After multivariate analysis, body mass index, New York Heart Association Functional Classification, and the STS DSWI risk index remained statistically significant and associated with DSWI. Although the incidence of DSWI decreased over time, the use of vancomycin paste was not associated with a reduced incidence of DSWI. There was a marked decrease in the incidence of DSWI during the study period, concurrent with institutional implementation of revised STS antibiotic dosing guidelines in 2007 and other strategies. However, the application of vancomycin paste to the sternal edges of patients undergoing cardiac operations was not associated with a reduced risk of DSWI. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Effect of physostigmine on ventricular fibrillation and myocardial glycogen in hypothermic dogs.

    Science.gov (United States)

    Das, P K; Sinha, P S

    1972-03-01

    1. Physostigmine (0.1 mg/kg i.v.) given at 37 degrees C and 25 degrees C rectal temperatures, completely protected the hypothermic dog heart against ventricular fibrillation.2. Pentolinium, atropine, vagotomy and reserpine did not significantly alter the incidence of ventricular fibrillation.3. The incidence of ventricular fibrillation under hypothermia could be significantly increased by ligating the anterior descending branch of the left coronary artery. The incidence of ventricular fibrillation in coronary ligated hypothermic dogs was reduced to half by physostigmine pretreatment.4. Hypothermia produced ventricular glycogen depletion and physostigmine prevented ventricular glycogenolysis under hypothermia. However, in the normothermic state physostigmine itself produced a significant decrease in cardiac glycogen.5. The relation between the antifibrillatory and antiglycogenolytic effects of physostigmine under hypothermia are discussed.

  10. Hypothermic overdose, not all bad?

    Directory of Open Access Journals (Sweden)

    Timothy Petterson

    2013-01-01

    Full Text Available A 51-year-old woman was brought into the Emergency Department (ED following an intentional overdose of alcohol and her medication. Along with two bottles of wine it was estimated that she had taken 5800 mg of Quetiapine and 240 mg of Citalopram along with the wine. The ambient temperature in her flat was thought to be 10°C. On arrival to the ED her GCS was 8. She had agonal respirations with a pulse of 56/min, hypotensive 55/35 mmHg and a temperature 24°C. The patient was intubated and was given sodium bicarbonate, magnesium sulphate, calcium gluconate and an adrenaline infusion. She received active and passive rewarming measures. She had significant ECG findings related to her hypothermia and polypharmacy overdose which seemed to have been cumulative. The patient recovered and the only neurological deficit was numbness in her left leg which was thought to be related to prolonged immobility. Hypothermia may have contributed to her good outcome as hypothermia has been shown to improve both cardiac and neurological outcome.

  11. Role of blood transfusion product type and amount in deep vein thrombosis after cardiac surgery.

    Science.gov (United States)

    Ghazi, Lama; Schwann, Thomas A; Engoren, Milo C; Habib, Robert H

    2015-12-01

    Postoperative deep vein thrombosis (DVT) is associated with significant morbidity. Even with maximal thromboprophylaxis, postoperative DVT is present in 10% of cardiac surgery patients, and is linked to receiving transfusion. We hypothesized that the incidence of DVT varies with the transfused blood product type, and increases with transfusion dose. 139/1070 cardiac surgery patients have DVT despite maximal chemo and mechanical prophylaxis. DVTs were detected via serial perioperative duplex venous scans (DVS). Red blood cells (RBC), platelets (PLT), plasma (FFP) and cryoprecipitate transfusion data were collected. Transfusion was used in 506(47%) patients: RBC [468(44%); 4.0 ± 4.2u]; FFP [155(14.5%); 3.5 ± 2.3 u]; PLT [185(17.3%); 2.2 ± 1.3 u] and Cryoprecipitate [51(4.8%); 1.3 ± 0.6 u]. Isolated RBC transfusion accounted for 92.6% patients receiving one product, and their DVT rate was increased considerably compared to no transfusion (16.7% versus 7.3%; Pproduct transfusions; particularly when both RBC and FFP are used (25%-40%). Relative to no RBC (n=602), multivariate logistic regression analysis identified a significant RBC-DVT dose dependent relation (Pfashion that is exacerbated when accompanied with FFP. Postoperative screening diagnostic DVS are warranted in this transfused, high risk for DVT population to facilitate timely therapeutic intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Treatment of gram-positive deep sternal wound infections in cardiac surgery -experiences with daptomycin-

    Directory of Open Access Journals (Sweden)

    Coskun Kasim O

    2011-09-01

    Full Text Available Abstract The reported incidence of deep sternal wound infection (DSWI after cardiac surgery is 0.4-5% with Staphylococcus aureus being the most common pathogen isolated from infected wound sternotomies and bacteraemic blood cultures. This infection is associated with a higher morbidity and mortality than other known aetiologies. Little is reported about the optimal antibiotic management. The aim of the study is to quantify the application of daptomycin treatment of DSWI due to gram-positive organisms post cardiac surgery. We performed an observational analysis in 23 cases of post sternotomy DSWI with gram-positive organisms February 2009 and September 2010. When the wound appeared viable and the microbiological cultures were negative, the technique of chest closure was individualised to the patient. The incidence of DSWI was 1.46%. The mean dose of daptomycin application was 4.4 ± 0.9 mg/kg/d and the average duration of the daptomycin application was 14.47 ± 7.33 days. In 89% of the patients VAC therapy was used. The duration from daptomycin application to sternal closure was 18 ± 13.9 days. The parameters of infection including, fibrinogen (p = 0.03, white blood cell count (p = 0.001 and C-reactive protein (p = 0.0001 were significantly reduced after daptomycin application. We had no mortality and wound healing was successfully achieved in all patients. Treatment of DSWI due to gram-positive organisms with a daptomycin-containing antibiotic regimen is safe, effective and promotes immediate improvement of local wound conditions. Based on these observations, daptomycin may offer a new treatment option for expediting surgical management of DSWI after cardiac surgery.

  13. Enhanced preservation of the rat heart after prolonged hypothermic ischemia with erythropoietin-supplemented Celsior solution.

    Science.gov (United States)

    Watson, Alasdair J; Gao, Ling; Sun, Lin; Tsun, Jireh; Jabbour, Andrew; Ru Qiu, Min; Jansz, Paul C; Hicks, Mark; Macdonald, Peter S

    2013-06-01

    The cardioprotective efficacy of erythropoietin (EPO) has been widely documented in rodent models of acute coronary syndrome. We sought to evaluate its cardioprotective potential as an adjunct to Celsior cardioplegia in a rodent model of prolonged hypothermic global ischemia-reperfusion injury. Isolated working rat hearts were subjected to 6 or 10 hours of hypothermic ischemic storage in Celsior cardioplegic solution. Celsior was supplemented with EPO over a dose range of 0 to 5 units/ml, as well as with glyceryl trinitrate (0.1 mg/ml) and zoniporide (1 µmol/liter). Myocardial functional recovery was determined after 45 minutes of reperfusion, then left ventricular tissue was prepared for Western blotting. The presence of EPO in Celsior dose-dependently improved recovery of myocardial function after 6 hours ischemic storage time (cardiac output recovery: 52.5 ± 11.3% vs 2.5 ± 0.4%; EPO: 5 units/ml vs 0 units/ml; p zoniporide. EPO has demonstrated cardioprotective efficacy in a rodent model of ischemia-reperfusion injury simulating cardiac allograft preservation, which appears to be mediated via activation of the SAFE cytoprotective signaling pathway. Copyright © 2013 International Society for Heart and Lung Transplantation. All rights reserved.

  14. The cardiac dose-sparing benefits of deep inspiration breath-hold in left breast irradiation: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Smyth, Lloyd M, E-mail: lloyd.smyth@epworth.org.au [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia); Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Knight, Kellie A [Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, School of Biomedical Sciences, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia); Aarons, Yolanda K; Wasiak, Jason [Epworth Radiation Oncology, Level 4, The Epworth Centre, Richmond, Victoria (Australia)

    2015-03-15

    Despite technical advancements in breast radiation therapy, cardiac structures are still subject to significant levels of irradiation. As the use of adjuvant radiation therapy after breast-conserving surgery continues to improve survival for early breast cancer patients, the associated radiation-induced cardiac toxicities become increasingly relevant. Our primary aim was to evaluate the cardiac-sparing benefits of the deep inspiration breath-hold (DIBH) technique. An electronic literature search of the PubMed database from 1966 to July 2014 was used to identify articles published in English relating to the dosimetric benefits of DIBH. Studies comparing the mean heart dose of DIBH and free breathing treatment plans for left breast cancer patients were eligible to be included in the review. Studies evaluating the reproducibility and stability of the DIBH technique were also reviewed. Ten studies provided data on the benefits of DIBH during left breast irradiation. From these studies, DIBH reduced the mean heart dose by up to 3.4 Gy when compared to a free breathing approach. Four studies reported that the DIBH technique was stable and reproducible on a daily basis. According to current estimates of the excess cardiac toxicity associated with radiation therapy, a 3.4 Gy reduction in mean heart dose is equivalent to a 13.6% reduction in the projected increase in risk of heart disease. DIBH is a reproducible and stable technique for left breast irradiation showing significant promise in reducing the late cardiac toxicities associated with radiation therapy.

  15. Secondary omental and pectoralis major double flap reconstruction following aggressive sternectomy for deep sternal wound infections after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Shirasawa Bungo

    2011-04-01

    Full Text Available Abstract Background Deep sternal wound infection after cardiac surgery carries high morbidity and mortality. Our strategy for deep sternal wound infection is aggressive strenal debridement followed by vacuum-assisted closure (VAC therapy and omental-muscle flap reconstrucion. We describe this strategy and examine the outcome and long-term quality of life (QOL it achieves. Methods We retrospectively examined 16 patients treated for deep sternal wound infection between 2001 and 2007. The most recent nine patients were treated with total sternal resection followed by VAC therapy and secondary closure with omental-muscle flap reconstruction (recent group; whereas the former seven patients were treated with sternal preservation if possible, without VAC therapy, and four of these patients underwent primary closure (former group. We assessed long-term quality of life after DSWI by using the Short Form 36-Item Health Survey, Version 2 (SF36v2. Results One patient died and four required further surgery for recurrence of deep sternal wound infection in the former group. The duration of treatment for deep sternal wound infection in the recent group was significantly shorter than that in previous group (63.4 ± 54.1 days vs. 120.0 ± 31.8 days, respectively; p = 0.039. Despite aggressive sternal resection, the QOL of patients treated for DSWI was only minimally compromised compared with age-, sex-, surgical procedures-matched patients without deep sternal wound infection. Conclusions Aggressive sternal debridement followed by VAC therapy and secondary closure with an omental-muscle flap is effective for deep sternal wound infection. In this series, it resulted in a lower incidence of recurrent infection, shorter hospitalization, and it did not compromise long-term QOL greatly.

  16. Hypothermic organ preservation by static storage methods: Current status and a view to the future.

    Science.gov (United States)

    McAnulty, Jonathan F

    2010-07-01

    The donor organ shortage is the largest problem in transplantation today and is one where organ preservation technology has an important role to play. Static storage of solid organs, especially of the kidney, continues to be the most common method employed for storage and transport of organs from deceased donors. However, the increase in organs obtained from expanded criteria donors and donors with cardiac death provide new challenges in crafting effective preservation methods for the future. This article reviews the current status of static hypothermic storage methods and discusses potential avenues for future exploitation of this technology as the available organ pool is expanded into the more marginal donor categories. Copyright 2009 Elsevier Inc. All rights reserved.

  17. Divine Love and Deep Connections: A Long-Term Followup of Patients Surviving Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Amy L. Ai

    2011-01-01

    Full Text Available We examined experiencing divine love as an indicator of affective spiritual growth in a prospective cohort of 200 patients surviving cardiac surgery. These patients previously completed two-wave preoperative interviews when standardized cardiac surgery data were also collected. The information included left ventricular ejection fraction, New York Heart Association Classification, baseline health (physical and mental, optimism, hope, religiousness, prayer coping, religious/spiritual coping, and demographics. We then measured divine love at 900 days postoperatively. Hierarchical linear regression indicated the direct effect of positive religious coping on experiences of divine love, controlling for other key variables. Postoperatively perceived spiritual support was entered at the final step as an explanatory factor, which appeared to mediate the coping effect. None of the other faith factors predicted divine love. Further research regarding divine love and spiritual support may eventually guide clinical attempts to support patients' spiritual growth as an independently relevant outcome of cardiac surgery.

  18. Sedative, hypothermic and muscle relaxant effects of the essential ...

    African Journals Online (AJOL)

    The sedative effect was assessed by sodium pentobarbitone (50 mg/kg, i.p.) - induced sleeping time, while hypothermic effect was evaluated by estimating rectal temperature variation after administration of various doses of the oil using digital thermometer. The muscle relaxant effect was determined using the hind limb-grip ...

  19. SU-E-J-33: Cardiac Movement in Deep Inspiration Breath-Hold for Left-Breast Cancer Radiotherapy

    International Nuclear Information System (INIS)

    Kim, M; Lee, S; Suh, T

    2014-01-01

    Purpose: The present study was designed to investigate the displacement of heart using Deep Inspiration Breath Hold (DIBH) CT data compared to free-breathing (FB) CT data and radiation exposure to heart. Methods: Treatment planning was performed on the computed tomography (CT) datasets of 20 patients who had received lumpectomy treatments. Heart, lung and both breasts were outlined. The prescribed dose was 50 Gy divided into 28 fractions. The dose distributions in all the plans were required to fulfill the International Commission on Radiation Units and Measurement specifications that include 100% coverage of the CTV with ≥ 95% of the prescribed dose and that the volume inside the CTV receiving > 107% of the prescribed dose should be minimized. Displacement of heart was measured by calculating the distance between center of heart and left breast. For the evaluation of radiation dose to heart, minimum, maximum and mean dose to heart were calculated. Results: The maximum and minimum left-right (LR) displacements of heart were 8.9 mm and 3 mm, respectively. The heart moved > 4 mm in the LR direction in 17 of the 20 patients. The distances between the heart and left breast ranged from 8.02–17.68 mm (mean, 12.23 mm) and 7.85–12.98 mm (mean, 8.97 mm) with DIBH CT and FB CT, respectively. The maximum doses to the heart were 3115 cGy and 4652 cGy for the DIBH and FB CT dataset, respectively. Conclusion: The present study has demonstrated that the DIBH technique could help to reduce the risk of radiation dose-induced cardiac toxicity by using movement of cardiac; away from radiation field. The DIBH technique could be used in an actual treatment room for a few minutes and could effectively reduce the cardiac dose when used with a sub-device or image acquisition standard to maintain consistent respiratory motion

  20. Prolonged extracorporeal membrane oxygenation-assisted support provides improved survival in hypothermic patients with cardiocirculatory arrest.

    Science.gov (United States)

    Ruttmann, Elfriede; Weissenbacher, Annemarie; Ulmer, Hanno; Müller, Ludwig; Höfer, Daniel; Kilo, Juliane; Rabl, Walter; Schwarz, Birgit; Laufer, Günther; Antretter, Herwig; Mair, Peter

    2007-09-01

    Extracorporeal circulation is considered the gold standard in the treatment of hypothermic cardiocirculatory arrest; however, few centers use extracorporeal membrane oxygenation instead of standard extracorporeal circulation for this indication. The aim of this study was to evaluate whether extracorporeal membrane oxygenation-assisted resuscitation improves survival in patients with hypothermic cardiac arrest. A consecutive series of 59 patients with accidental hypothermia in cardiocirculatory arrest between 1987 and 2006 were included. Thirty-four patients (57.6%) were resuscitated by standard extracorporeal circulation, and 25 patients (42.4%) were resuscitated by extracorporeal membrane oxygenation. Accidental hypothermia was caused by avalanche in 22 patients (37.3%), drowning in 22 patients (37.3%), exposure to cold in 8 patients (13.5%), and falling into a crevasse in 7 patients (11.9%). Multivariate logistic regression analysis was used to compare extracorporeal membrane oxygenation with extracorporeal circulation resuscitation, with adjustment for relevant parameters. Restoration of spontaneous circulation was achieved in 32 patients (54.2%). A total of 12 patients (20.3%) survived hypothermia. In the extracorporeal circulation group, 64% of the nonsurviving patients who underwent restoration of spontaneous circulation died of severe pulmonary edema, but none died in the extracorporeal membrane oxygenation group. In multivariate analysis, extracorporeal membrane oxygenation-assisted resuscitation showed a 6.6-fold higher chance for survival (relative risk: 6.6, 95% confidence interval: 1.2-49.3, P = .042). Asphyxia-related hypothermia (avalanche or drowning) was the most predictive adverse factor for survival (relative risk: 0.09, 95% confidence interval: 0.01-0.60, P = .013). Potassium and pH failed to show statistical significance in the multivariate analysis. Extracorporeal rewarming with an extracorporeal membrane oxygenation system allows prolonged

  1. Deep learning for cardiac computer-aided diagnosis: benefits, issues & solutions.

    Science.gov (United States)

    Loh, Brian C S; Then, Patrick H H

    2017-01-01

    Cardiovascular diseases are one of the top causes of deaths worldwide. In developing nations and rural areas, difficulties with diagnosis and treatment are made worse due to the deficiency of healthcare facilities. A viable solution to this issue is telemedicine, which involves delivering health care and sharing medical knowledge at a distance. Additionally, mHealth, the utilization of mobile devices for medical care, has also proven to be a feasible choice. The integration of telemedicine, mHealth and computer-aided diagnosis systems with the fields of machine and deep learning has enabled the creation of effective services that are adaptable to a multitude of scenarios. The objective of this review is to provide an overview of heart disease diagnosis and management, especially within the context of rural healthcare, as well as discuss the benefits, issues and solutions of implementing deep learning algorithms to improve the efficacy of relevant medical applications.

  2. Automatic segmentation of left ventricle in cardiac cine MRI images based on deep learning

    Science.gov (United States)

    Zhou, Tian; Icke, Ilknur; Dogdas, Belma; Parimal, Sarayu; Sampath, Smita; Forbes, Joseph; Bagchi, Ansuman; Chin, Chih-Liang; Chen, Antong

    2017-02-01

    In developing treatment of cardiovascular diseases, short axis cine MRI has been used as a standard technique for understanding the global structural and functional characteristics of the heart, e.g. ventricle dimensions, stroke volume and ejection fraction. To conduct an accurate assessment, heart structures need to be segmented from the cine MRI images with high precision, which could be a laborious task when performed manually. Herein a fully automatic framework is proposed for the segmentation of the left ventricle from the slices of short axis cine MRI scans of porcine subjects using a deep learning approach. For training the deep learning models, which generally requires a large set of data, a public database of human cine MRI scans is used. Experiments on the 3150 cine slices of 7 porcine subjects have shown that when comparing the automatic and manual segmentations the mean slice-wise Dice coefficient is about 0.930, the point-to-curve error is 1.07 mm, and the mean slice-wise Hausdorff distance is around 3.70 mm, which demonstrates the accuracy and robustness of the proposed inter-species translational approach.

  3. Hypothermic stunning of green sea turtles in a western Gulf of Mexico foraging habitat.

    Directory of Open Access Journals (Sweden)

    Donna J Shaver

    Full Text Available Texas waters provide one of the most important developmental and foraging habitats for juvenile green turtles (Chelonia mydas in the western Gulf of Mexico, but hypothermic stunning is a significant threat and was the largest cause of green turtle strandings in Texas from 1980 through 2015; of the 8,107 green turtles found stranded, 4,529 (55.9% were victims of hypothermic stunning. Additionally, during this time, 203 hypothermic stunned green turtles were found incidentally captured due to power plant water intake entrapment. Overall, 63.9% of 4,529 hypothermic stunned turtles were found alive, and 92.0% of those survived rehabilitation and were released. Numbers of green turtles recorded as stranded and as affected by hypothermic stunning increased over time, and were most numerous from 2007 through 2015. Large hypothermic stunning events (with more than 450 turtles documented occurred during the winters of 2009-2010, 2010-2011, 2013-2014, and 2014-2015. Hypothermic stunning was documented between November and March, but peaked at various times depending on passage of severe weather systems. Hypothermic stunning occurred state-wide, but was most prevalent in South Texas, particularly the Laguna Madre. In the Laguna Madre, hypothermic stunning was associated with an abrupt drop in water temperatures strong northerly winds, and a threshold mean water temperature of 8.0°C predicted large turtle hypothermic stunning events. Knowledge of environmental parameters contributing to hypothermic stunning and the temporal and spatial distribution of turtles affected in the past, can aid with formulation of proactive, targeted search and rescue efforts that can ultimately save the lives of many affected individuals, and aid with recovery efforts for this bi-national stock. Such rescue efforts are required under the U.S. Endangered Species Act and respond to humanitarian concerns of the public.

  4. Factors associated with methicillin-resistant coagulase-negative staphylococci as causing organisms in deep sternal wound infections after cardiac surgery

    Directory of Open Access Journals (Sweden)

    R. Sommerstein

    2015-07-01

    Full Text Available Established preoperative antibiotic prophylaxis in cardiac surgery is ineffective against methicillin-resistant coagulase-negative staphylococci (CoNS. This case–control study aimed to determine factors predicting deep sternal wound infections due to methicillin-resistant CoNS. All cardiac surgery patients undergoing sternotomy between June 2009 and March 2013 prospectively documented in a Swiss tertiary care center were included. Among 1999 patients, 82 (4.1% developed deep sternal wound infection. CoNS were causal in 36 (44% patients, with 25/36 (69% being methicillin resistant. Early reintervention for noninfectious causes (odds ratio (OR 4.3; 95% confidence interval (CI 1.9–9.5 was associated with methicillin-resistant CoNS deep sternal wound infection. Among CoNS deep sternal wound infection, perioperative antimicrobial therapy (p 0.002, early reintervention for noninfectious causes (OR 7.9; 95% CI 0.9–71.1 and time between surgery and diagnosis of infection over 21 days (OR 10.8; 95% CI 1.2–97.8 were associated with methicillin resistance. These findings may help to better tailor preoperative antimicrobial prophylaxis.

  5. Factors associated with methicillin-resistant coagulase-negative staphylococci as causing organisms in deep sternal wound infections after cardiac surgery

    Science.gov (United States)

    Sommerstein, R.; Kohler, P.; Wilhelm, M.J.; Kuster, S.P.; Sax, H.

    2015-01-01

    Established preoperative antibiotic prophylaxis in cardiac surgery is ineffective against methicillin-resistant coagulase-negative staphylococci (CoNS). This case–control study aimed to determine factors predicting deep sternal wound infections due to methicillin-resistant CoNS. All cardiac surgery patients undergoing sternotomy between June 2009 and March 2013 prospectively documented in a Swiss tertiary care center were included. Among 1999 patients, 82 (4.1%) developed deep sternal wound infection. CoNS were causal in 36 (44%) patients, with 25/36 (69%) being methicillin resistant. Early reintervention for noninfectious causes (odds ratio (OR) 4.3; 95% confidence interval (CI) 1.9–9.5) was associated with methicillin-resistant CoNS deep sternal wound infection. Among CoNS deep sternal wound infection, perioperative antimicrobial therapy (p 0.002), early reintervention for noninfectious causes (OR 7.9; 95% CI 0.9–71.1) and time between surgery and diagnosis of infection over 21 days (OR 10.8; 95% CI 1.2–97.8) were associated with methicillin resistance. These findings may help to better tailor preoperative antimicrobial prophylaxis. PMID:26042188

  6. Factors associated with methicillin-resistant coagulase-negative staphylococci as causing organisms in deep sternal wound infections after cardiac surgery.

    Science.gov (United States)

    Sommerstein, R; Kohler, P; Wilhelm, M J; Kuster, S P; Sax, H

    2015-07-01

    Established preoperative antibiotic prophylaxis in cardiac surgery is ineffective against methicillin-resistant coagulase-negative staphylococci (CoNS). This case-control study aimed to determine factors predicting deep sternal wound infections due to methicillin-resistant CoNS. All cardiac surgery patients undergoing sternotomy between June 2009 and March 2013 prospectively documented in a Swiss tertiary care center were included. Among 1999 patients, 82 (4.1%) developed deep sternal wound infection. CoNS were causal in 36 (44%) patients, with 25/36 (69%) being methicillin resistant. Early reintervention for noninfectious causes (odds ratio (OR) 4.3; 95% confidence interval (CI) 1.9-9.5) was associated with methicillin-resistant CoNS deep sternal wound infection. Among CoNS deep sternal wound infection, perioperative antimicrobial therapy (p 0.002), early reintervention for noninfectious causes (OR 7.9; 95% CI 0.9-71.1) and time between surgery and diagnosis of infection over 21 days (OR 10.8; 95% CI 1.2-97.8) were associated with methicillin resistance. These findings may help to better tailor preoperative antimicrobial prophylaxis.

  7. The deep inspiration breath hold technique using Abches reduces cardiac dose in patients undergoing left-sided breast irradiation

    International Nuclear Information System (INIS)

    Lee, Ha Yoon; Chang, Jee Suk; Lee, Ik Jae; Park, Kwang Woo; Kim, Yong Bae; Suh, Chang Ok; Kim, Jun Won; Keum, Ki Chang

    2013-01-01

    We explored whether the deep inspiration breath hold (DIBH) technique using Abches during left-sided breast irradiation was effective for minimizing the amount of radiation to the heart and lung compared to free breathing (FB). Between February and July 2012, a total of 25 patients with left-sided breast cancer underwent two computed tomography scans each with the DIBH using Abches and using FB after breast-conserving surgery. The scans were retrospectively replanned using standardized criteria for the purpose of this study. The DIBH plans for each patient were compared with FB plans using dosimetric parameters. All patients were successfully treated with the DIBH technique using Abches. Significant differences were found between the DIBH and FB plans for mean heart dose (2.52 vs. 4.53 Gy), heart V30 (16.48 vs. 45.13 cm 3 ), V20 (21.35 vs. 54.55 cm 3 ), mean left anterior descending coronary artery (LAD) dose (16.01 vs. 26.26 Gy, all p 3 of the LAD (41.65 vs. 47.27 Gy, p = 0.017). The mean left lung dose (7.53 vs. 8.03 Gy, p = 0.073) and lung V20 (14.63% vs. 15.72%, p 0.060) of DIBH using Abches were not different significantly compared with FB. We report that the use of a DIBH technique using Abches in breathing adapted radiotherapy for left-sided breast cancer is easily feasible in daily practice and significantly reduces the radiation doses to the heart and LAD, therefore potentially reducing cardiac risk.

  8. Enhanced preservation of the isolated rat heart after hypothermic storage by pinacidil pretreatment and storage in lazaroid U74500A

    Energy Technology Data Exchange (ETDEWEB)

    Hicks, M. [St Vincent`s Hospital, Darlinghurst, NSW (Australia). Division of Clinical Pharmacology and Toxicology; Du, Z.Y.; Spratt, P.; Macdonald, P. [St Vincent`s Hospital, Darlinghurst, NSW (Australia). Cardiopulmonary Transplant Unit

    1998-12-31

    The aim of the present study was to compare 3 protocols incorporating these approaches on the preservation of haemodynamic function in the isolated working rat heart after hypothermic storage. These protocols were: 1) pretreatment of the heart with 200 {mu}M pinacidil, an ATP-sensitive potassium channel opener; 2) storage in cardioplegic solution containing the lipid soluble lazaroid antioxidant U74500A (30 {mu}M); 3) A combination of protocols 1 and 2. Methods: Hearts from Wistar rats (250 to 330g body weight) were perfused on a Langendorff apparatus. Each heart was ligated to an aortic cannula and perfused retrogradely, with oxygenated Krebs solution at a hydrostatic pressure of 100 cm H{sub 2}O. The system was then converted to `working mode` by switching the perfusate from aorta to a left atrial cannula (filling pressure 15 cm H{sub 2}O). After stabilisation, the following pre-arrest indices of cardiac function were recorded: heart rate (HR), coronary flow (CF), aortic flow (AF) and cardiac output (CO). Hearts were then randomised to protocols 1-3, untreated controls or vehicle treated controls (n=6 animals/ group). Hearts were stored in an extracellular-based preservation solution for 12 hours at 2-3degC, remounted on the perfusion apparatus and stabilised as before. Haemodynamic measurements were then repeated. Conclusions: Combined pharmacological activation of ATP-sensitive potassium channels before cardioplegia and the addition of U74500A to the preservation solution is associated with a significantly enhanced haemodynamic function in the rat heart after 12 hours of hypothermic storage. These data suggest a novel use for these agents in the transplantation context Truncated abstract. 1 tab.

  9. Enhanced preservation of the isolated rat heart after hypothermic storage by pinacidil pretreatment and storage in lazaroid U74500A

    International Nuclear Information System (INIS)

    Hicks, M.; Du, Z.Y.; Spratt, P.; Macdonald, P.

    1998-01-01

    The aim of the present study was to compare 3 protocols incorporating these approaches on the preservation of haemodynamic function in the isolated working rat heart after hypothermic storage. These protocols were: 1) pretreatment of the heart with 200 μM pinacidil, an ATP-sensitive potassium channel opener; 2) storage in cardioplegic solution containing the lipid soluble lazaroid antioxidant U74500A (30 μM); 3) A combination of protocols 1 and 2. Methods: Hearts from Wistar rats (250 to 330g body weight) were perfused on a Langendorff apparatus. Each heart was ligated to an aortic cannula and perfused retrogradely, with oxygenated Krebs solution at a hydrostatic pressure of 100 cm H 2 O. The system was then converted to 'working mode' by switching the perfusate from aorta to a left atrial cannula (filling pressure 15 cm H 2 O). After stabilisation, the following pre-arrest indices of cardiac function were recorded: heart rate (HR), coronary flow (CF), aortic flow (AF) and cardiac output (CO). Hearts were then randomised to protocols 1-3, untreated controls or vehicle treated controls (n=6 animals/ group). Hearts were stored in an extracellular-based preservation solution for 12 hours at 2-3degC, remounted on the perfusion apparatus and stabilised as before. Haemodynamic measurements were then repeated. Conclusions: Combined pharmacological activation of ATP-sensitive potassium channels before cardioplegia and the addition of U74500A to the preservation solution is associated with a significantly enhanced haemodynamic function in the rat heart after 12 hours of hypothermic storage. These data suggest a novel use for these agents in the transplantation context

  10. Normothermic Versus Hypothermic Heart Surgery: Evaluation of Post-Operative Complications

    Directory of Open Access Journals (Sweden)

    H Akhlagh

    2012-04-01

    Full Text Available Introduction: The recently introduced technique of warm heart surgery may be a very effective method of myocardial protection. Although the systemic effects of hypothermic cardiopulmonary bypass are well known, the effects of warm heart surgery are not. Methods: In a prospective trial, 60 patients undergoing an elective coronary artery bypass grafting were randomly allocated to normothermic(30 patients and hypothermic(30 patients group and assessments regarding renal, respiratory and neurologic complications and bleeding volume was done. Resulst: Eighty percent of hypothermic group and 86% of normothermic group were males (p=0/36. Mean age was 56.4 and 56.1 years in hypothermic and normothermic groups, respectively. Groups had similar central temperature, shivering, nipride usage, intake and output, bleeding volume, neurologic complications and ICU staying(p>0/05 but inotrop usage and incidence of phrenic nerve palsy were higher in hypothermic group(p<0/05. Conclusion: Hypothermic procedure leads to a lower rate of respiratory complications, therefore we recommend replacing hypothermic procedure by normothermic one.

  11. A combined deep-learning and deformable-model approach to fully automatic segmentation of the left ventricle in cardiac MRI.

    Science.gov (United States)

    Avendi, M R; Kheradvar, Arash; Jafarkhani, Hamid

    2016-05-01

    Segmentation of the left ventricle (LV) from cardiac magnetic resonance imaging (MRI) datasets is an essential step for calculation of clinical indices such as ventricular volume and ejection fraction. In this work, we employ deep learning algorithms combined with deformable models to develop and evaluate a fully automatic LV segmentation tool from short-axis cardiac MRI datasets. The method employs deep learning algorithms to learn the segmentation task from the ground true data. Convolutional networks are employed to automatically detect the LV chamber in MRI dataset. Stacked autoencoders are used to infer the LV shape. The inferred shape is incorporated into deformable models to improve the accuracy and robustness of the segmentation. We validated our method using 45 cardiac MR datasets from the MICCAI 2009 LV segmentation challenge and showed that it outperforms the state-of-the art methods. Excellent agreement with the ground truth was achieved. Validation metrics, percentage of good contours, Dice metric, average perpendicular distance and conformity, were computed as 96.69%, 0.94, 1.81 mm and 0.86, versus those of 79.2-95.62%, 0.87-0.9, 1.76-2.97 mm and 0.67-0.78, obtained by other methods, respectively. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. [Neonatal asphyxia: a care experience using hypothermic therapy].

    Science.gov (United States)

    Wang, Mo-Mei; Wang, Mei-Hua

    2013-12-01

    Hypothermia therapy, used to treat hypoxic-ischemic encephalopathy in neonates, has been shown to effectively decrease asphyxia complications and mortality. This article reports on an experience using this therapy approach to care for a neonatal asphyxic patient. Due to our lack of an appropriate cooling device, we adjusted the number of cool water bags to successfully perform hypothermic therapy. Despite this added procedural complication, we succeeded in saving the patient's life. The holistic care process for this type of case requires family-centered care to help family members deal with the critical condition and assist parents to face depression and guilt, reduce anxiety, and reaffirm the parent-child relationship. We used hypothermia in the initial stage. Relevant standards of critical care for this condition should be established to ensure adequate nursing care safety and quality.

  13. Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs.

    Science.gov (United States)

    Halsøy, Kathrine; Kondratiev, Timofey; Tveita, Torkjel; Bjertnaes, Lars J

    2016-01-01

    Victims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic-isolated blood-perfused rat lungs whether perfusion at constant pressure influences fluid filtration differently from perfusion at constant flow. Isolated blood-perfused rat lungs were hanging freely in a weight transducer for measuring weight changes (ΔW). Fluid filtration coefficient (Kfc), was determined by transiently elevating left atrial pressure (Pla) by 5.8 mmHg two times each during normothermia (37°C) and during hypothermia (15°C). The lung preparations were randomized to two groups. One group was perfused with constant flow (Constant flow group) and the other group with constant pulmonary artery pressure (Constant PPA group). Microvascular pressure (Pmv) was determined before and during elevation of Pla (ΔPmv) by means of the double occlusion technique. Kfc was calculated with the formula Kfc = ΔW/ΔPmv/min. All Kfc values were normalized to predicted lung weight (P LW ), which was based on body weight (BW) according to the formula: P LW  = 0.0053 BW - 0.48 and presented as Kfc PLW in mg/min/mmHg/g. At cessation, bronchoalveolar lavage (BAL) fluid/perfusate protein concentration (B/P) ratio was determined photometrically. Data were analyzed with parametric or non-parametric tests as appropriate. p  < 0.05 considered as significant. Perfusate flow remained constant in the Constant flow group, but was more than halved during hypothermia in the Constant PPA group concomitant with a more fold increase in PVR. In the Constant flow group, Kfc PLW and B/P ratio increased significantly by more than 10-fold during hypothermia concerted by visible signs of edema in the trachea. Hemoglobin and hematocrit increased within

  14. Transition of intestinal fatty acid-binding protein on hypothermic circulatory arrest with cardiopulmonary bypass.

    Science.gov (United States)

    Kano, Hiroya; Takahashi, Hiroaki; Inoue, Takeshi; Tanaka, Hiroshi; Okita, Yutaka

    2017-04-01

    Intestinal fatty acid-binding protein (I-FABP) is increasingly employed as a highly specific marker of intestinal necrosis. However, the value of this marker associated with cardiovascular surgery with hypothermic circulatory arrest is unclear. The aim of this study was to measure serum I-FABP levels and provide the transition of I-FABP levels with hypothermic circulatory arrest to help in the management of intestinal perfusion. From August 2011 to September 2013, 33 consecutive patients who had aortic arch surgery with hypothermic circulatory arrest or heart valve surgery performed were enrolled in the study. Twenty patients had aortic surgery with hypothermic (23-29°C) circulatory arrest and 13 patients had heart valve surgery with cardiopulmonary bypass (33°C). I-FABP levels increased, both in patients undergoing aortic surgery with hypothermic circulatory arrest and heart valve surgery with cardiopulmonary bypass, reaching peak levels shortly after the administration of protamine. I-FABP levels in patients with aortic surgery were significantly higher with circulatory arrest. They reached peak levels immediately after recirculation and there was a significant drop at the end of surgery (parrest than in patients with heart valve surgery. However, no postoperative reperfusion injury occurred in the intestinal tract due to the use of hypothermic organ protection. Plasma I-FABP monitoring could be a valuable method for finding an intestinal ischemia in patients with cardiovascular surgery.

  15. Utility of Deep Inspiration Breath Hold for Left-Sided Breast Radiation Therapy in Preventing Early Cardiac Perfusion Defects: A Prospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Zagar, Timothy M., E-mail: zagar@med.unc.edu [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Kaidar-Person, Orit [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Tang, Xiaoli [Memorial Sloan Kettering Cancer Center, West Harrison, New York (United States); Jones, Ellen E.; Matney, Jason; Das, Shiva K.; Green, Rebecca L. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States); Sheikh, Arif [Department of Radiology, Columbia University, New York, New York (United States); Khandani, Amir H.; McCartney, William H.; Oldan, Jorge Daniel; Wong, Terence Z. [Department of Radiology, University of North Carolina, Chapel Hill, North Carolina (United States); Marks, Lawrence B. [Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina (United States)

    2017-04-01

    Purpose: To evaluate early cardiac single photon computed tomography (SPECT) findings after left breast/chest wall postoperative radiation therapy (RT) in the setting of deep inspiration breath hold (DIBH). Methods and Materials: We performed a prospective single-institution single-arm study of patients who were planned for tangential RT with DIBH to the left breast/chest wall (± internal mammary nodes). The DIBH was done by use of a controlled surface monitoring technique (AlignRT, Vision RT Ltd, London, UK). The RT was given with tangential fields and a heart block. Radiation-induced cardiac perfusion and wall motion changes were assessed by pre-RT and 6-month post-RT SPECT scans. A cumulative SPECT summed-rest score was used to quantify perfusion in predefined left ventricle segments. The incidence of wall motion abnormalities was assessed in each of these same segments. Results: A total of 20 patients with normal pre-RT scans were studied; their median age was 56 years (range, 39-72 years). Seven (35%) patients also received irradiation to the left internal mammary chain, and 5 (25%) received an additional RT field to supraclavicular nodes. The median heart dose was 94 cGy (range, 56-200 cGy), and the median V25{sub Gy} was zero (range, 0-0.1). None of the patients had post-RT perfusion or wall motion abnormalities. Conclusions: Our results suggest that DIBH and conformal cardiac blocking for patients receiving tangential RT for left-sided breast cancer is an effective means to avoid early RT-associated cardiac perfusion defects.

  16. Independence of brain and trunk temperature during hypothermic preconditioning in rats.

    Science.gov (United States)

    Katz, Laurence M; Frank, Jonathan E; Dvorak, Anne; Finch, Alex; Szymanowski, Adam; Gordon, Christopher J

    2009-05-15

    Hypothermic preconditioning is rapid cooling and warming to induce tolerance to ischemia. The purpose of the study was to examine differences in brain and trunk temperature during hypothermic preconditioning. Rats (n=18) were implanted with telemetric probes for simultaneous measure of brain and trunk temperature. Hypothermic preconditioning was produced by exposing rats to cool and warm environments that produced rapid cooling to 30 degrees C and warming to 35 degrees C. Brain temperature was warmer (37.56+/-0.45 degrees C) than trunk (37.17+/-0.29 degrees C) temperature in unanesthetized, free roaming rats at room temperature (t-test p=0.04). The brain cooled (0.59+/-0.1 degrees C/min) quicker than the trunk (0.44+/-0.19 degrees C/min) during cooling cycles of hypothermic preconditioning and the brain (0.28+/-0.04 degrees C/min) warmed quicker than the trunk (0.18+/-0.07 degrees C/min) during the warming cycle of hypothermic preconditioning (t-test ptrunk temperature probe was designated to reach the target temperature of 35 degrees C during warming, the brain temperature (38.1+/-0.44 degrees C) was warmer than trunk temperature (34.95+/-0.16 degrees C) during the peak of warming (t-test pbrain cools and warms quicker than the trunk during hypothermic preconditioning. Failure to anticipate these differences could lead to unrecognized brain hyperthermia during warming. Appreciation of differences in rates of change between brain and trunk temperature may be important when designing hypothermic preconditioning experiments.

  17. Hypothermic circulatory arrest for acute traumatic aortic rupture associated with shock.

    Science.gov (United States)

    Kawahito, Koji; Adachi, Hideo

    2011-07-01

    Hypothermic circulatory arrest is considered to be a contraindication in acute traumatic aortic rupture (TAR) because full heparinization and hypothermia may lead to fatal bleeding if concomitant hemorrhagic injuries are present. However, in extremely emergent situations, rapid volume infusion via cardiotomy vacuums and the institution of hypothermic circulatory arrest appears to be the only method for saving patients with uncontrollable bleeding. In this study, we evaluate the feasibility of hypothermic circulatory arrest for treating patients with TAR with hemorrhagic shock. Ten patients (nine men and one woman; mean age, 35 ± 18 years), with acute TAR caused by blunt chest trauma and in a shock state, underwent surgery between 1999 and 2007. All ten patients exhibited rupture of the isthmus, and polytraumatism was frequent. Any life-threatening blood loss from other injuries was surgically treated before aortic surgery. All patients were operated on with standard cardiopulmonary bypass under hypothermic circulatory arrest. All patients received prosthetic graft replacement. The overall hospital mortality was 10.0% (1/10). One patient died of intraabdominal and pulmonary bleeding during surgery, and the other nine were discharged without complications. There was no evidence of any new or increased hemorrhagic complications during heparinization in the nine surviving patients. Mean operation and circulatory arrest times were 305 ± 44 min and 27 ± 7 min, respectively. Hypothermic circulatory arrest is feasible for saving TAR patients with unstable hemodynamics resulting from rupture, provided associated injuries are properly treated in advance.

  18. Combined in situ hypothermic liver preservation and cardioplegia for resection of hepatoblastoma with intra-atrial extension in a 3 year old child

    Directory of Open Access Journals (Sweden)

    Julian Thalhammer

    2016-09-01

    Full Text Available Cure of hepatoblastoma requires complete macro- and microscopic resection of the tumor, without tumor rupture. In case of hepatoblastoma with intra-atrial tumor extension (ITE, “en bloc” resection of the hepatic tumor and ITE, with minimal risk of postoperative liver failure, constitutes a surgical challenge. We report on a 3 year old child with hepatoblastoma of the right liver lobe, and ITE through the upper Inferior Vena Cava. Initial chemotherapy (SIOPEL IV HR induced good response, but tumor persisted inside the right atrium with tight adhesions to the cardiac wall. “En bloc” right extended hepatectomy and removal of the ITE with reconstruction of the atrial and caval wall with autologous pericardial patch was performed under normothermic extracorporeal circulation and cardioplegia, combined with in situ hypothermic liver preservation of the remaining left liver. Complete tumor resection was achieved without tumor rupture. Postoperative liver function was immediately good and adjuvant chemotherapy was resumed per protocol. Eleven months after the end of treatment the child is in complete tumor remission. In children with hepatic tumor and ITE, combination of normothermic extracorporeal circulation with cardioplegia and in situ hypothermic liver preservation allows “en bloc” extended hepatectomy and removal of ITE, with limited risk of postoperative liver failure.

  19. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.

    Science.gov (United States)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-09-22

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of Dmean irradiation.

  20. Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage

    International Nuclear Information System (INIS)

    Vikstroem, Johan; Hjelstuen, Mari H.B.; Mjaaland, Ingvil; Dybvik, Kjell Ivar

    2011-01-01

    Background and purpose. Cardiac disease and pulmonary complications are documented risk factors in tangential breast irradiation. Respiratory gating radiotherapy provides a possibility to substantially reduce cardiopulmonary doses. This CT planning study quantifies the reduction of radiation doses to the heart and lung, using deep inspiration breath-hold (DIBH). Patients and methods. Seventeen patients with early breast cancer, referred for adjuvant radiotherapy, were included. For each patient two CT scans were acquired; the first during free breathing (FB) and the second during DIBH. The scans were monitored by the Varian RPM respiratory gating system. Audio coaching and visual feedback (audio-visual guidance) were used. The treatment planning of the two CT studies was performed with conformal tangential fields, focusing on good coverage (V95>98%) of the planning target volume (PTV). Dose-volume histograms were calculated and compared. Doses to the heart, left anterior descending (LAD) coronary artery, ipsilateral lung and the contralateral breast were assessed. Results. Compared to FB, the DIBH-plans obtained lower cardiac and pulmonary doses, with equal coverage of PTV. The average mean heart dose was reduced from 3.7 to 1.7 Gy and the number of patients with >5% heart volume receiving 25 Gy or more was reduced from four to one of the 17 patients. With DIBH the heart was completely out of the beam portals for ten patients, with FB this could not be achieved for any of the 17 patients. The average mean dose to the LAD coronary artery was reduced from 18.1 to 6.4 Gy. The average ipsilateral lung volume receiving more than 20 Gy was reduced from 12.2 to 10.0%. Conclusion. Respiratory gating with DIBH, utilizing audio-visual guidance, reduces cardiac and pulmonary doses for tangentially treated left sided breast cancer patients without compromising the target coverage

  1. Static cerebrovascular pressure autoregulation remains intact during deep hypothermia.

    Science.gov (United States)

    Goswami, Dheeraj; McLeod, Katherine; Leonard, Samantha; Kibler, Kathleen; Easley, Ronald Blaine; Fraser, Charles D; Andropoulos, Dean; Brady, Ken

    2017-09-01

    Clinical studies measuring cerebral blood flow in infants during deep hypothermia have demonstrated diminished cerebrovascular pressure autoregulation. The coexistence of hypotension in these cohorts confounds the conclusion that deep hypothermia impairs cerebrovascular pressure autoregulation. We sought to compare the lower limit of autoregulation and the static rate of autoregulation between normothermic and hypothermic piglets. Twenty anesthetized neonatal piglets (5-7 days old; 10 normothermic and 10 hypothermic to 20°C) had continuous measurements of cortical red cell flux using laser Doppler flowmetry, while hemorrhagic hypotension was induced without cardiopulmonary bypass. Lower limit of autoregulation was determined for each subject using piecewise regression and SRoR was determined above and below each lower limit of autoregulation as (%change cerebrovascular resistance/%change cerebral perfusion pressure). The estimated difference in lower limit of autoregulation was 1.4 mm Hg (lower in the hypothermic piglets; 95% C.I. -10 to 14 mm Hg; P=0.6). The median lower limit of autoregulation in the normothermic group was 39 mm Hg [IQR 38-51] vs 35 mm Hg [31-50] in the hypothermic group. Intact steady-state pressure autoregulation was defined as static rate of autoregulation >0.5 and was demonstrated in all normothermic subjects (static rate of autoregulation=0.72 [0.65-0.87]) and in 9/10 of the hypothermic subjects (static rate of autoregulation=0.65 [0.52-0.87]). This difference in static rate of autoregulation of 0.06 (95% C.I. -0.3 to 0.1) was not significant (P=0.4). Intact steady-state cerebrovascular pressure autoregulation is demonstrated in a swine model of profound hypothermia. Lower limit of autoregulation and static rate of autoregulation were similar in hypothermic and normothermic subjects. © 2017 John Wiley & Sons Ltd.

  2. The Role of Hypothermia Coordinator: A Case of Hypothermic Cardiac Arrest Treated with ECMO.

    Science.gov (United States)

    Darocha, Tomasz; Kosinski, Sylweriusz; Moskwa, Maciej; Jarosz, Anna; Sobczyk, Dorota; Galazkowski, Robert; Slowik, Marcin; Drwila, Rafal

    2015-12-01

    We present a description of emergency medical rescue procedures in a patient suffering from severe hypothermia who was found in the Babia Gora mountain range (Poland). After diagnosing the symptoms of II/III stage hypothermia according to the Swiss Staging System, the Mountain Rescue Service notified the coordinator from the Severe Accidental Hypothermia Center (CLHG) Coordinator in Krakow and then kept in constant touch with him. In accordance with the protocol for managing such situations, the coordinator started the procedure for patients in severe hypothermia with the option of extracorporeal warming and secured access to a device for continuous mechanical chest compression. After reaching the hospital, extracorporeal warming with ECMO support in the arteriovenuous configuration was started. The total duration of circulatory arrest was 150 minutes. The rescue procedures were supervised by the coordinator, who was on 24-hour duty and was reached by means of an alarm phone. The task of the coordinator is to consult the management of hypothermia cases, use his knowledge and experience to help in the diagnosis and treatment. and if the need arises refer the patient for ECMO at CLHG. Good coordination, planning, predicting possible problems, and acting in accordance with the agreed procedures in the scheme, make it possible to shorten the time of reaching the destination hospital and implement effective treatment.

  3. Hypothermic activity of acetaminophen; Involvement of GABAA receptor, theoretical and experimental studies

    Directory of Open Access Journals (Sweden)

    Nematollah Ahangar

    2016-05-01

    Results:Diazepam induced hypothermia was reversed by flumazenil or picrotoxin. Rats injected with APAP displayed dose- and time-related hypothermia. For combined administration, the hypothermic effect of APAP (200 mg/kg was strongly reduced by pretreatment with picrotoxin or flumazenil P

  4. Effect of hypothermic renal ischaemia on renin secretion rate in man

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Petersen, H K; Giese, J

    1985-01-01

    Plasma renin concentration (PRC), renal blood flow (RBF) and renin secretion rate (RSR = renal veno-arterial PRC difference multiplied by renal plasma flow) were measured before and after a period of hypothermic renal ischaemia in seven patients undergoing surgery for renal calculi. After...

  5. Mild hypothermic preservation for transport purposes of the AMC bioartificial liver charged with porcine hepatocytes

    NARCIS (Netherlands)

    Poyck, Paul P. C.; Hoekstra, Ruurdtje; van Wijk, Albert C. W. A.; ten Bloemendaal, Lysbeth; Chamuleau, Robert A. F. M.; van Gulik, Thomas M.

    2005-01-01

    Background. Preservation conditions play a crucial role during transport of a bioartificial liver (BAL) from the laboratory to the hospital. We assessed the possibility to preserve the AMC-BAL loaded with freshly isolated porcine hepatocytes at mild hypothermic temperatures. Methods. Two

  6. Hypothermic machine preservation in liver transplantation revisited : Concepts and criteria in the new millennium

    NARCIS (Netherlands)

    van der Plaats, A; t'Hart, NA; Verkerke, GJ; Leuvenink, HGD; Ploeg, RJ; Rakhorst, G

    To overcome the present shortage of liver donors by expansion of the existing donor pool and possibly lengthening of the storage time, hypothermic machine perfusion of the liver as a dynamic preservation method is revisited. The three most important aspects are defined to be the type of preservation

  7. Postoperative irradiation of left-sided breast cancer patients and cardiac toxicity. Does deep inspiration breath-hold (DIBH) technique protect the heart?

    International Nuclear Information System (INIS)

    Stranzl, H.; Zurl, B.

    2008-01-01

    Purpose: to evaluate the impact of deep inspiration breath-hold (DIBH) technique during postoperative left-sided tangential breast irradiation on minimizing irradiated heart amount compared to normal breathing. Patients and methods: in 22 patients with left-sided breast cancer, postoperative CT scanning was performed in different respiratory phases using the Varian Real-time Position Management System trademark for monitoring of respiratory chest wall motion. Each patient underwent two CT scans: during normal breathing and DIBH. For each scan, an optimized plan was designed with tangential photon fields encompassing the clinical target volume after breast-conserving surgery or modified radical mastectomy. The resulting dose-volume histograms were compared between both breathing techniques for irradiated volume and dose to the heart. Results: the mean patient age was 51 years (range: 34-77 years). The DIBH-gated technique was well accepted by all patients. The significant reduction in dose to the irradiated heart volume for the DIBH technique compared to the normal breathing was 56% (mean heart dose: 2.3 Gy vs. 1.3 Gy; p = 0.01). Conclusion: this study demonstrates that irradiated cardiac volumes can significantly be reduced in left-sided breast cancer patients using DIBH technique for postoperative tangential radiotherapy. Moreover, the technique is safe and feasible in daily routine. (orig.)

  8. Novel approach for independent control of brain hypothermia and systemic normothermia: cerebral selective deep hypothermia for refractory cardiac arrest.

    Science.gov (United States)

    Wang, Chih-Hsien; Lin, Yu-Ting; Chou, Heng-Wen; Wang, Yi-Chih; Hwang, Joey-Jen; Gilbert, John R; Chen, Yih-Sharng

    2017-08-01

    A 38-year-old man was found unconscious, alone in the driver's seat of his car. The emergency medical team identified his condition as pulseless ventricular tachycardia. Defibrillation was attempted but failed. Extracorporeal membrane oxygenation (ECMO) was started in the emergency room 52 min after the estimated arrest following the extracorporeal cardiopulmonary resuscitation (ECPR) protocol in our center. The initial prognosis under the standard protocol was <25% chance of survival. A novel adjunctive to our ECPR protocol, cerebral selective deep (<30°C) hypothermia (CSDH), was applied. CSDH adds a second independent femoral access extracorporeal circuit, perfusing cold blood into the patient's common carotid artery. The ECMO and CSDH circuits demonstrated independent control of cerebral and core temperatures. Nasal temperature was lowered to below 30°C for 12 hours while core was maintained at normothermia. The patient was discharged without significant neurological deficit 32 days after the initial arrest. 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/.

  9. Comparison of cardiac and lung doses for breast cancer patients with free breathing and deep inspiration breath hold technique in 3 dimensional conformal radiotherapy - a dosimetric study

    Science.gov (United States)

    Raj Mani, Karthick; Poudel, Suresh; Maria Das, K. J.

    2017-12-01

    Purpose: To investigate the cardio-pulmonary doses between Deep Inspiration Breath Hold (DIBH) and Free Breathing (FB) technique in left sided breast irradiation. Materials & Methods: DIBH CT and FB CT were acquired for 10 left sided breast patients who underwent whole breast irradiation with or without nodal irradiation. Three fields single isocenter technique were used for patients with node positive patients along with two tangential conformal fields whereas only two tangential fields were used in node negative patients. All the critical structures like lungs, heart, esophagus, thyroid, etc., were delineated in both DIBH and FB scan. Both DIBH and FB scans were fused with the Dicom origin as they were acquired with the same Dicom coordinates. Plans were created in the DIBH scan for a dose range between 50 Gy in 25 fractions. Critical structures doses were recorded from the Dose Volume Histogram for both the DIBH and FB data set for evaluation. Results: The average mean heart dose in DIBH vs FB was 13.18 Gy vs 6.97 Gy, (p = 0.0063) significantly with DIBH as compared to FB technique. The relative reduction in average mean heart dose was 47.12%. The relative V5 reduced by 14.70% (i.e. 34.42% vs 19.72%, p = 0.0080), V10 reduced by 13.83% (i.e. 27.79 % vs 13.96%, p = 0.0073). V20 reduced by 13.19% (i.e. 24.54 % vs 11.35%, p = 0.0069), V30 reduced by 12.38% (i.e. 22.27 % vs 9.89 %, p = 0.0073) significantly with DIBH as compared to FB. The average mean left lung dose reduced marginally by 1.43 Gy (13.73 Gy vs 12.30 Gy, p = 0.4599) but insignificantly with DIBH as compared to FB. Other left lung parameters (V5, V10, V20 and V30) shows marginal decreases in DIBH plans compare to FB plans. Conclusion: DIBH shows a substantial reduction of cardiac doses but slight and insignificant reduction of pulmonary doses as compared with FB technique. Using the simple DIBH technique, we can effectively reduce the cardiac morbidity and at the same time radiation induced lung

  10. Alterations in the perfusion and distribution after normo- and hypothermic ischemia of the kidneys

    International Nuclear Information System (INIS)

    Pfeifer, K.J.; Heinze, H.G.; Eisenberger, F.; Chaussy, C.; Wirth, H.; Muenchen Univ.; Muenchen Univ.

    1976-01-01

    Experimental examinations were performed in 22 dogs to find out the mechanism which leads to a permanent or a reversible damage of the renal parenchyma after normo- and hypothermic ischemia. For this reason the perfusion and the distribution were examined with 133 Xe, the vasculat changes by angiography, and the parenchymal function with 131 I-Hippuran. After normothermic ischemia a short-term reactive hyperemia appeared, which however could not compensate the damage of the renal tubular cells and the resulting excretory insufficiency. After hypothermic ischemia the perfusion was reduced, probably as a consequence of a vasoconstriction by cold, however, the function of the tubular cells remained intact, because of the protective mechanism of the hypothermia. The importance of these findings for the development of the so called 'shock-kidney' (acute tubular necrosis) and for the conservative renal surgery in hypothermia is discussed and the application of measures beneficial to perfusion, are suggested. (orig.) [de

  11. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation : Is IMRT more beneficial than VMAT?

    Science.gov (United States)

    Sakka, Mazen; Kunzelmann, Leonie; Metzger, Martin; Grabenbauer, Gerhard G

    2017-10-01

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  12. Hypothermic oxygenated machine perfusion prevents arteriolonecrosis of the peribiliary plexus in pig livers donated after circulatory death.

    Directory of Open Access Journals (Sweden)

    Sanna Op den Dries

    Full Text Available BACKGROUND: Livers derived from donation after circulatory death (DCD are increasingly accepted for transplantation. However, DCD livers suffer additional donor warm ischemia, leading to biliary injury and more biliary complications after transplantation. It is unknown whether oxygenated machine perfusion results in better preservation of biliary epithelium and the peribiliary vasculature. We compared oxygenated hypothermic machine perfusion (HMP with static cold storage (SCS in a porcine DCD model. METHODS: After 30 min of cardiac arrest, livers were perfused in situ with HTK solution (4°C and preserved for 4 h by either SCS (n = 9 or oxygenated HMP (10°C; n = 9, using pressure-controlled arterial and portal venous perfusion. To simulate transplantation, livers were reperfused ex vivo at 37°C with oxygenated autologous blood. Bile duct injury and function were determined by biochemical and molecular markers, and a systematic histological scoring system. RESULTS: After reperfusion, arterial flow was higher in the HMP group, compared to SCS (251±28 vs 166±28 mL/min, respectively, after 1 hour of reperfusion; p = 0.003. Release of hepatocellular enzymes was significantly higher in the SCS group. Markers of biliary epithelial injury (biliary LDH, gamma-GT and function (biliary pH and bicarbonate, and biliary transporter expression were similar in the two groups. However, histology of bile ducts revealed significantly less arteriolonecrosis of the peribiliary vascular plexus in HMP preserved livers (>50% arteriolonecrosis was observed in 7 bile ducts of the SCS preserved livers versus only 1 bile duct of the HMP preserved livers; p = 0.024. CONCLUSIONS: Oxygenated HMP prevents arteriolonecrosis of the peribiliary vascular plexus of the bile ducts of DCD pig livers and results in higher arterial flow after reperfusion. Together this may contribute to better perfusion of the bile ducts, providing a potential advantage in the post

  13. Petrographic study of hypo-thermal and pyro-metasomatic deposits on the oriental border of Tichka mountain (Occidental High Atlas, Morocco)

    International Nuclear Information System (INIS)

    Bizard, C.; Ziegler, V.

    1956-01-01

    It describes the petrographic and metallogenic study of the oriental side of Tichka mountain (Occidental High Atlas, Morocco) which is the center of an anticlinal system, strongly folded, and approximately SW-NE oriented. The main object of this study is the description of its metallogenic activity and in particular the large variety of paragenesis which have been observed in the oriental part of Tichka mountain where the metamorphism is intense. This area presents a large abundance and diversity of deposits. The structural aspect of the oriental part of the Tichka mountain is described. The petrographic study of the complex structure of the oriental border, in particular the studies of the leucocratic complex of veins and apophyses and of the schistous and calcareous metamorphic complex, leads to make assumptions on the relationship between terminal phase of the metamorphism and the hypo-thermal paragenesis. The abundance of facies and the intensity of metamorphism also give the possibility to establish relationships between the different minerals deposits. The metallogenic study shows that mineralization are all peripheral on the Tichka mountain and increase with the number and size of the apophysis which is observed on the east side. The various hypo-thermal paragenesis are studied in the same order of the associated apophysis. The peripheral meso-thermal deposits of the north area are briefly described to complete the metallogenic aspects of the oriental border of the Tichka mountain. This study shows the nature of the two main factors which originate different types of paragenesis: one is the intrusion deep of the mineralizer, the second is the physical and chemical nature of the medium where the paragenesis occurred. (M.P.)

  14. Cardiac dosimetric evaluation of deep inspiration breath-hold level variances using computed tomography scans generated from deformable image registration displacement vectors

    International Nuclear Information System (INIS)

    Harry, Taylor; Rahn, Doug; Semenov, Denis; Gu, Xuejun; Yashar, Catheryn; Einck, John; Jiang, Steve; Cerviño, Laura

    2016-01-01

    There is a reduction in cardiac dose for left-sided breast radiotherapy during treatment with deep inspiration breath-hold (DIBH) when compared with treatment with free breathing (FB). Various levels of DIBH may occur for different treatment fractions. Dosimetric effects due to this and other motions are a major component of uncertainty in radiotherapy in this setting. Recent developments in deformable registration techniques allow displacement vectors between various temporal and spatial patient representations to be digitally quantified. We propose a method to evaluate the dosimetric effect to the heart from variable reproducibility of DIBH by using deformable registration to create new anatomical computed tomography (CT) scans. From deformable registration, 3-dimensional deformation vectors are generated with FB and DIBH. The obtained deformation vectors are scaled to 75%, 90%, and 110% and are applied to the reference image to create new CT scans at these inspirational levels. The scans are then imported into the treatment planning system and dose calculations are performed. The average mean dose to the heart was 2.5 Gy (0.7 to 9.6 Gy) at FB, 1.2 Gy (0.6 to 3.8 Gy, p < 0.001) at 75% inspiration, 1.1 Gy (0.6 to 3.1 Gy, p = 0.004) at 90% inspiration, 1.0 Gy (0.6 to 3.0 Gy) at 100% inspiration or DIBH, and 1.0 Gy (0.6 to 2.8 Gy, p = 0.019) at 110% inspiration. The average mean dose to the left anterior descending artery (LAD) was 19.9 Gy (2.4 to 46.4 Gy), 8.6 Gy (2.0 to 43.8 Gy, p < 0.001), 7.2 Gy (1.9 to 40.1 Gy, p = 0.035), 6.5 Gy (1.8 to 34.7 Gy), and 5.3 Gy (1.5 to 31.5 Gy, p < 0.001), correspondingly. This novel method enables numerous anatomical situations to be mimicked and quantifies the dosimetric effect they have on a treatment plan.

  15. Cardiac dosimetric evaluation of deep inspiration breath-hold level variances using computed tomography scans generated from deformable image registration displacement vectors.

    Science.gov (United States)

    Harry, Taylor; Rahn, Doug; Semenov, Denis; Gu, Xuejun; Yashar, Catheryn; Einck, John; Jiang, Steve; Cerviño, Laura

    2016-01-01

    There is a reduction in cardiac dose for left-sided breast radiotherapy during treatment with deep inspiration breath-hold (DIBH) when compared with treatment with free breathing (FB). Various levels of DIBH may occur for different treatment fractions. Dosimetric effects due to this and other motions are a major component of uncertainty in radiotherapy in this setting. Recent developments in deformable registration techniques allow displacement vectors between various temporal and spatial patient representations to be digitally quantified. We propose a method to evaluate the dosimetric effect to the heart from variable reproducibility of DIBH by using deformable registration to create new anatomical computed tomography (CT) scans. From deformable registration, 3-dimensional deformation vectors are generated with FB and DIBH. The obtained deformation vectors are scaled to 75%, 90%, and 110% and are applied to the reference image to create new CT scans at these inspirational levels. The scans are then imported into the treatment planning system and dose calculations are performed. The average mean dose to the heart was 2.5Gy (0.7 to 9.6Gy) at FB, 1.2Gy (0.6 to 3.8Gy, p inspiration, 1.1Gy (0.6 to 3.1Gy, p = 0.004) at 90% inspiration, 1.0Gy (0.6 to 3.0Gy) at 100% inspiration or DIBH, and 1.0Gy (0.6 to 2.8Gy, p = 0.019) at 110% inspiration. The average mean dose to the left anterior descending artery (LAD) was 19.9Gy (2.4 to 46.4Gy), 8.6Gy (2.0 to 43.8Gy, p < 0.001), 7.2Gy (1.9 to 40.1Gy, p = 0.035), 6.5Gy (1.8 to 34.7Gy), and 5.3Gy (1.5 to 31.5Gy, p < 0.001), correspondingly. This novel method enables numerous anatomical situations to be mimicked and quantifies the dosimetric effect they have on a treatment plan. Copyright © 2016 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  16. Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation

    International Nuclear Information System (INIS)

    Yeung, Rosanna; Conroy, Leigh; Long, Karen; Walrath, Daphne; Li, Haocheng; Smith, Wendy; Hudson, Alana; Phan, Tien

    2015-01-01

    Deep inspiration breath hold (DIBH) reduces heart and left anterior descending artery (LAD) dose during left-sided breast radiation therapy (RT); however there is limited information about which patients derive the most benefit from DIBH. The primary objective of this study was to determine which patients benefit the most from DIBH by comparing percent reduction in mean cardiac dose conferred by DIBH for patients treated with whole breast RT ± boost (WBRT) versus those receiving breast/chest wall plus regional nodal irradiation, including internal mammary chain (IMC) nodes (B/CWRT + RNI) using a modified wide tangent technique. A secondary objective was to determine if DIBH was required to meet a proposed heart dose constraint of D mean < 4 Gy in these two cohorts. Twenty consecutive patients underwent CT simulation both free breathing (FB) and DIBH. Patients were grouped into two cohorts: WBRT (n = 11) and B/CWRT + RNI (n = 9). 3D-conformal plans were developed and FB was compared to DIBH for each cohort using Wilcoxon signed-rank tests for continuous variables and McNemar’s test for discrete variables. The percent relative reduction conferred by DIBH in mean heart and LAD dose, as well as lung V 20 were compared between the two cohorts using Wilcox rank-sum testing. The significance level was set at 0.05 with Bonferroni correction for multiple testing. All patients had comparable target coverage on DIBH and FB. DIBH statistically significantly reduced mean heart and LAD dose for both cohorts. Percent reduction in mean heart and LAD dose with DIBH was significantly larger in the B/CWRT + RNI cohort compared to WBRT group (relative reduction in mean heart and LAD dose: 55.9 % and 72.1 % versus 29.2 % and 43.5 %, p < 0.02). All patients in the WBRT group and five patients (56 %) in the B/CWBRT + RNI group met heart D mean <4 Gy with FB. All patients met this constraint with DIBH. All patients receiving WBRT met D mean Heart < 4 Gy on FB, while only slightly over

  17. Viability of postmortal epididymal mouse spermatozoa during long-term hypothermic storage and cryopreservation.

    Science.gov (United States)

    Shishova, N V; Gakhova, E N; Mel'nikova, E V

    2011-08-01

    The study examined the effect of long-term hypothermic (4°C) storage of mouse carcasses on motility, cell membrane damage, in vitro survival and capacitation of epididymal spermatozoa before and after cryopreservation. It was shown that the number of spermatozoa with rectilinear forward motion decreased with increasing storage time. There were no significant changes in the total sperm motility and integrity of their plasmalemma. Pronounced effects of hypothermia and long-term storage of the mouse carcasses on cryocapacitation of spermatozoa during cryoconservation were demonstrated.

  18. Cardiac dose-sparing effects of deep-inspiration breath-hold in left breast irradiation. Is IMRT more beneficial than VMAT

    Energy Technology Data Exchange (ETDEWEB)

    Sakka, Mazen; Grabenbauer, Gerhard G. [Coburg Cancer Center, Department of Radiation Oncology, Coburg (Germany); Friedrich-Alexander University of Erlangen-Nuernberg, Faculty of Medicine, Erlangen (Germany); Kunzelmann, Leonie; Metzger, Martin [Coburg Cancer Center, Department of Radiation Oncology, Coburg (Germany)

    2017-10-15

    Given the reduction in death from breast cancer, as well as improvements in overall survival, adjuvant radiotherapy is considered the standard treatment for breast cancer. However, left-sided breast irradiation was associated with an increased rate of fatal cardiovascular events due to incidental irradiation of the heart. Recently, considerable efforts have been made to minimize cardiac toxicity of left-sided breast irradiation by new treatment methods such as deep-inspiration breath-hold (DIBH) and new radiation techniques, particularly intensity modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT). The primary aim of this study was to evaluate the effect of DIBH irradiation on cardiac dose compared with free-breathing (FB) irradiation, while the secondary objective was to compare the advantages of IMRT versus VMAT plans in both the FB and the DIBH position for left-sided breast cancer. In all, 25 consecutive left-sided breast cancer patients underwent CT simulation in the FB and DIBH position. Five patients were excluded with no cardiac displacement following DIBH-CT simulation. The other 20 patients were irradiated in the DIBH position using respiratory gating. Four different treatment plans were generated for each patient, an IMRT and a VMAT plan in the DIBH and in the FB position, respectively. The following parameters were used for plan comparison: dose to the heart, left anterior descending coronary artery (mean dose, maximum dose, D25% and D45%), ipsilateral, contralateral lung (mean dose, D20%, D30%) and contralateral breast (mean dose). The percentage in dose reduction for organs at risk achieved by DIBH for both IMRT and VMAT plans was calculated and compared for each patient by each treatment plan. DIBH irradiation significantly reduced mean dose to the heart and left anterior descending coronary artery (LADCA) using both IMRT (heart -20%; p = 0.0002, LADCA -9%; p = 0.001) and VMAT (heart -23%; p = 0.00003, LADCA -16%; p = 0

  19. Clinical implications of hypothermic ventricular fibrillation versus beating-heart technique during cardiopulmonary bypass for pulmonary valve replacement in patients with repaired tetralogy of Fallot.

    Science.gov (United States)

    Lee, Ji-Hyun; Lee, Ji-Eun; Shin, Jungho; Song, In-Kyung; Kim, Hee-Soo; Kim, Chong-Sung; Kim, Woong-Han; Kim, Jin-Tae

    2017-09-01

    This study aimed to compare the effects of hypothermic ventricular fibrillation and beating-heart techniques during cardiopulmonary bypass (CPB) on postoperative outcomes after simple pulmonary valve replacement in patients with repaired tetralogy of Fallot (TOF). We retrospectively reviewed the data of 47 patients with repaired tetralogy of Fallot at a single institution, who received pulmonary valve replacement under the ventricular fibrillation or beating-heart technique without cardioplegic cardiac arrest during CPB between January 2005 and April 2015. The patients were divided into fibrillation (n = 32) and beating-heart (n = 15) groups. On comparing these groups, the fibrillation group had a larger sinotubular junction (27.1 ± 4.6 vs 22.1 ± 2.4 mm), had a longer operation duration (396 ± 108 vs 345 ± 57 min), required more postoperative transfusions (2.1 ± 2.6 vs 5.0 ± 6.3 units) and had a higher vasoactive-inotropic score at intensive care unit admission (8.0 vs 10, all P tetralogy of Fallot. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  20. The 6-chromanol derivate SUL-109 enables prolonged hypothermic storage of adipose tissue-derived stem cells

    NARCIS (Netherlands)

    Hajmousa, Ghazaleh; Vogelaar, Pieter; Brouwer, Linda A.; Graaf, Adrianus Cornelis van der; Henning, Robert H.; Krenning, Guido

    Encouraging advances in cell therapy research with adipose derived stem cells (ASC) require an effective short-term preservation method that provides time for quality control and transport of cells from their manufacturing facility to their clinical destination. Hypothermic storage of cells in their

  1. Determination of an adequate perfusion pressure for continuous dual vessel hypothermic machine perfusion of the rat liver

    NARCIS (Netherlands)

    't Hart, Nils A.; der van Plaats, Arjan; Leuvenink, Henri G. D.; van Goor, Harry; Wiersema-Buist, Janneke; Verkerke, Gijsbertus J.; Rakhorst, Gerhard; Ploeg, Rutger J.

    Hypothermic machine perfusion (HMP) provides better protection against ischemic damage of the kidney compared to cold-storage. The required perfusion pressures needed for optimal HMP of the liver are, however, unknown. Rat livers were preserved in University of Wisconsin organ preservation solution

  2. Effects of hypothermically reduced plantar skin inputs on anticipatory and compensatory balance responses.

    Science.gov (United States)

    Germano, Andresa M C; Schmidt, Daniel; Milani, Thomas L

    2016-06-29

    Anticipatory and compensatory balance responses are used by the central nervous system (CNS) to preserve balance, hence they significantly contribute to the understanding of physiological mechanisms of postural control. It is well established that various sensory systems contribute to the regulation of balance. However, it is still unclear which role each individual sensory system (e.g. plantar mechanoreceptors) plays in balance regulation. This becomes also evident in various patient populations, for instance in diabetics with reduced plantar sensitivity. To investigate these sensory mechanisms, approaches like hypothermia to deliberately reduce plantar afferent input have been applied. But there are some limitations regarding hypothermic procedures in previous studies: Not only plantar aspects of the feet might be affected and maintaining the hypothermic effect during data collection. Therefore, the aim of the present study was to induce a permanent and controlled plantar hypothermia and to examine its effects on anticipatory and compensatory balance responses. We hypothesized deteriorations in anticipatory and compensatory balance responses as increased center of pressure excursions (COP) and electromyographic activity (EMG) in response to the hypothermic plantar procedure. 52 healthy and young subjects (23.6 ± 3.0 years) performed balance tests (unexpected perturbations). Subjects' foot soles were exposed to three temperatures while standing upright: 25, 12 and 0 °C. COP and EMG were analyzed during two intervals of anticipatory and one interval of compensatory balance responses (intervals 0, 1 and 2, respectively). Similar plantar temperatures confirmed the successful implementation of the thermal platform. No significant COP and EMG differences were found for the anticipatory responses (intervals 0 and 1) under the hyperthermia procedure. Parameters in interval 2 showed generally decreased values in response to cooling. No changes in anticipatory

  3. Design and Implementation of a Hypothermic Machine Perfusion Device for Clinical Preservation of Isolated Organs

    Directory of Open Access Journals (Sweden)

    Fei Shen

    2017-06-01

    Full Text Available The imbalance between limited organ supply and huge potential need has hindered the development of organ-graft techniques. In this paper a low-cost hypothermic machine perfusion (HMP device is designed and implemented to maintain suitable preservation surroundings and extend the survival life of isolated organs. Four necessary elements (the machine perfusion, the physiological parameter monitoring, the thermostatic control and the oxygenation apparatus involved in this HMP device are introduced. Especially during the thermostatic control process, a modified Bayes estimation, which introduces the concept of improvement factor, is realized to recognize and reduce the possible measurement errors resulting from sensor faults and noise interference. Also, a fuzzy-PID controller contributes to improve the accuracy and reduces the computational load using the DSP. Our experiments indicate that the reliability of the instrument meets the design requirements, thus being appealing for potential clinical preservation applications.

  4. Pharmacology of the hypothermic response to 5-HT1A receptor activation in humans.

    Science.gov (United States)

    Lesch, K P; Poten, B; Söhnle, K; Schulte, H M

    1990-01-01

    The selective 5-HT1A receptor ligand ipsapirone (IPS) caused dose-related hypothermia in humans. The response was attenuated by the nonselective 5-HT1/2 receptor antagonist metergoline and was completely antagonized by the nonselective beta-adrenoceptor antagonist pindolol, which interacts stereoselectively with the 5-HT1A receptor. The selective beta 1-adrenergic antagonist betaxolol had no effect. The findings indicate that IPS-induced hypothermia specifically involves activation of (presynaptic) 5-HT1A receptors. Therefore, the hypothermic response to IPS may provide a convenient in vivo paradigma to assess the function of the presynaptic 5-HT receptor in affective disorders and its involvement in the effects of psychotropic drugs.

  5. Portable Prehospital Methods to Treat Near-Hypothermic Shivering Cold Casualties.

    Science.gov (United States)

    Oliver, Samuel J; Brierley, Jennifer L; Raymond-Barker, Philippa C; Dolci, Alberto; Walsh, Neil P

    2016-03-01

    To compare the effectiveness of a single-layered polyethylene survival bag (P), a single-layered polyethylene survival bag with a hot drink (P+HD), a multi-layered metalized plastic sheeting survival bag (MPS: Blizzard Survival), and a multi-layered MPS survival bag with 4 large chemical heat pads (MPS+HP: Blizzard Heat) to treat cold casualties. Portable cold casualty treatment methods were compared by examining core and skin temperature, metabolic heat production, and thermal comfort during a 3-hour, 0°C cold air exposure in 7 shivering, near-hypothermic men (35.4°C). The hot drink (70°C, ~400 ml, ~28 kJ) was consumed at 0, 1, and 2 hours during the cold air exposure. During the cold air exposure, core rewarming and thermal comfort were similar on all trials (P = .45 and P = .36, respectively). However, skin temperature was higher (10%-13%; P 2.7) and metabolic heat production lower (15%-39%; P .9) on MPS and MPS+HP than P and P+HD. The addition of heat pads further lowered metabolic heat production by 15% (MPS+HP vs MPS; P = .05; large effect size d = .9). The addition of the hot drink to polyethylene survival bag did not increase skin temperature or lower metabolic heat production. Near-hypothermic cold casualties are rewarmed with less peripheral cold stress and shivering thermogenesis using a multi-layered MPS survival bag compared with a polyethylene survival bag. Prehospital rewarming is further aided by large chemical heat pads but not by hot drinks. Copyright © 2016 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  6. Application of a pharmacokinetics-pharmacodynamics approach to the free propofol plasma levels during coronary artery bypass grafting surgery with hypothermic cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Carlos R. Silva-Filho

    2018-02-01

    Full Text Available OBJECTIVES: The objective of this study was to apply a pharmacokinetics-pharmacodynamics approach to investigate the free propofol plasma levels in patients undergoing coronary artery bypass grafting under hypothermic conditions compared with the off-pump procedure. METHODS: Nineteen patients scheduled for on-pump coronary artery bypass grafting under hypothermic conditions (n=10 or the equivalent off-pump surgery (n=9 were anesthetized with sufentanil and propofol target-controlled infusion (2 μg/mL during surgery. The propofol concentration was then reduced to 1 μg/mL, and a pharmacokinetics-pharmacodynamics analysis using the maximum-effect-sigmoid model obtained by plotting the bispectral index values against the free propofol plasma levels was performed. RESULTS: Significant increases (two- to five-fold in the free propofol plasma levels were observed in the patients subjected to coronary artery bypass grafting under hypothermic conditions. The pharmacokinetics of propofol varied according to the free drug levels in the hypothermic on-pump group versus the off-pump group. After hypothermic coronary artery bypass was initiated, the distribution volume increased, and the distribution half-life was prolonged. Propofol target-controlled infusion was discontinued when orotracheal extubation was indicated, and the time to patient extubation was significantly higher in the hypothermic on-pump group than in the off-pump group (459 versus 273 min, p=0.0048. CONCLUSIONS: The orotracheal intubation time was significantly longer in the hypothermic on-pump group than in the off-pump group. Additionally, residual hypnosis was identified through the pharmacokinetics-pharmacodynamics approach based on decreases in drug plasma protein binding in the hypothermic on-pump group, which could explain the increased hypnosis observed with this drug in this group of patients.

  7. Reproducible deep-inspiration breath-hold irradiation with forward intensity-modulated radiotherapy for left-sided breast cancer significantly reduces cardiac radiation exposure compared to inverse intensity-modulated radiotherapy.

    Science.gov (United States)

    Bolukbasi, Yasemin; Saglam, Yucel; Selek, Ugur; Topkan, Erkan; Kataria, Anglina; Unal, Zeynep; Alpan, Vildan

    2014-01-01

    To investigate the objective utility of our clinical routine of reproducible deep-inspiration breath-hold irradiation for left-sided breast cancer patients on reducing cardiac exposure. Free-breathing and reproducible deep-inspiration breath-hold scans were evaluated for our 10 consecutive left-sided breast cancer patients treated with reproducible deep-inspiration breath-hold. The study was based on the adjuvant dose of 50 Gy in 25 fractions of 2 Gy/fraction. Both inverse and forward intensity-modulated radiotherapy plans were generated for each computed tomography dataset. Reproducible deep-inspiration breath-hold plans with forward intensity-modulated radiotherapy significantly spared the heart and left anterior descending artery compared to generated free-breathing plans based on mean doses - free-breathing vs reproducible deep-inspiration breath-hold, left ventricle (296.1 vs 94.5 cGy, P = 0.005), right ventricle (158.3 vs 59.2 cGy, P = 0.005), left anterior descending artery (171.1 vs 78.1 cGy, P = 0.005), and whole heart (173.9 vs 66 cGy, P = 0.005), heart V20 (2.2% vs 0%, P = 0.007) and heart V10 (4.2% vs 0.3%, P = 0.007) - whereas they revealed no additional burden on the ipsilateral lung. Reproducible deep-inspiration breath-hold and free-breathing plans with inverse intensity-modulated radiotherapy provided similar organ at risk sparing by reducing the mean doses to the left ventricle, left anterior descending artery, heart, V10-V20 of the heart and right ventricle. However, forward intensity-modulated radiotherapy showed significant reduction in doses to the left ventricle, left anterior descending artery, heart, right ventricle, and contralateral breast (mean dose, 248.9 to 12.3 cGy, P = 0.005). The mean doses for free-breathing vs reproducible deep-inspiration breath-hold of the proximal left anterior descending artery were 1.78 vs 1.08 Gy and of the distal left anterior descending artery were 8.11 vs 3.89 Gy, whereas mean distances to the 50 Gy

  8. Milrinone ameliorates cardiac mechanical dysfunction after hypothermia in an intact rat model.

    Science.gov (United States)

    Dietrichs, Erik Sveberg; Kondratiev, Timofei; Tveita, Torkjel

    2014-12-01

    Rewarming from hypothermia is often complicated by cardiac dysfunction, characterized by substantial reduction in stroke volume. Previously we have reported that inotropic agents, working via cardiac β-receptor agonism may exert serious side effects when applied to treat cardiac contractile dysfunction during rewarming. In this study we tested whether Milrinone, a phosphodiesterase III inhibitor, is able to ameliorate such dysfunction when given during rewarming. A rat model designed for circulatory studies during experimental hypothermia with cooling to a core temperature of 15°C, stable hypothermia at this temperature for 3h and subsequent rewarming was used, with a total of 3 groups: (1) a normothermic group receiving Milrinone, (2) a hypothermic group receiving Milrinone the last hour of hypothermia and during rewarming, and (3) a hypothermic saline control group. Hemodynamic function was monitored using a conductance catheter introduced to the left ventricle. After rewarming from 15°C, stroke volume and cardiac output returned to within baseline values in Milrinone treated animals, while these variables were significantly reduced in saline controls. Milrinone ameliorated cardiac dysfunction during rewarming from 15°C. The present results suggest that at low core temperatures and during rewarming from such temperatures, pharmacologic efforts to support cardiovascular function is better achieved by substances preventing cyclic AMP breakdown rather than increasing its formation via β-receptor stimulation. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. The Hypothermic Influence on CHOP and Ero1-α in an Endoplasmic Reticulum Stress Model of Cerebral Ischemia

    DEFF Research Database (Denmark)

    Poone, Gagandip K.; Hasseldam, Henrik; Munkholm, Nina

    2015-01-01

    globalischemia. A stable increase in CHOP expression was observed throughout the time course (p PC12 cells resulted in a decreased expression of CHOP after three, six and twelve hours...... hippocampi following global cerebral ischemia, and inhypoxic pheochromocytoma cells during normothermic (37 °C) and hypothermic (31 °C)conditions. As a result of ischemia, a significant increase in expression of CHOP andEro1-α was observed after three, six and twelve hours of reperfusion following...

  10. Repair of primary or complicated aortic coarctation in the adult with cardiopulmonary bypass and hypothermic circulatory arrest.

    Science.gov (United States)

    Kouchoukos, Nicholas T; Scharff, James R; Castner, Catherine F

    2015-02-01

    Patients with primary aortic coarctation or complications of a previous coarctation repair may seek treatment as adults. Management options include open, endovascular, hybrid, and extra-anatomic repairs. We evaluated the results of open direct repair with total cardiopulmonary bypass and hypothermic circulatory arrest. Twenty-seven patients with primary coarctation with or without associated aortic abnormalities or with complications of a previous coarctation repair were treated during a 20-year interval. Mean age was 37 years (range, 15-71 years). Thirteen patients had primary coarctation (7 with associated aneurysms), 3 patients had aneurysms of the aorta above or below a noncritical narrowing of the aorta at the isthmus ("pseudocoarctation"), and 11 patients had previous repair of a coarctation. The previous repairs were bypass grafting of the coarctation (n = 5), interposition grafting (n = 3), patch angioplasty (n = 2), and primary repair (n = 1). Mean durations of cardiopulmonary bypass, hypothermic circulatory arrest and hypothermic fibrillation were 104, 36, and 76 minutes, respectively. There were no in-hospital deaths, and no patients sustained stroke, spinal cord ischemic injury, or renal or respiratory failure. Thirteen patients received no blood products. No patient has had evidence of recurrent coarctation or aneurysm formation. Cardiopulmonary bypass with hypothermic circulatory arrest is a safe and suitable technique for treatment of primary and recurrent coarctation. It is associated with low operative risk and absence of major complications. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  11. Effect of age on cerebral blood flow during hypothermic cardiopulmonary bypass

    International Nuclear Information System (INIS)

    Brusino, F.G.; Reves, J.G.; Smith, L.R.; Prough, D.S.; Stump, D.A.; McIntyre, R.W.

    1989-01-01

    Cerebral blood flow was measured in 20 patients by xenon 133 clearance methodology during nonpulsatile hypothermic cardiopulmonary bypass to determine the effect of age on regional cerebral blood flow during these conditions. Measurements of cerebral blood flow at varying perfusion pressures were made in patients arbitrarily divided into two age groups at nearly identical nasopharyngeal temperature, hematocrit value, and carbon dioxide tension and with equal cardiopulmonary bypass flows of 1.6 L/min/m2. The range of mean arterial pressure was 30 to 110 mm Hg for group I (less than or equal to 50 years of age) and 20 to 90 mm Hg for group II (greater than or equal to 65 years of age). There was no significant difference (p = 0.32) between the mean arterial pressure in group I (54 +/- 28 mm Hg) and that in group II (43 +/- 21 mm Hg). The range of cerebral blood flow was 14.8 to 29.2 ml/100 gm/min for group I and 13.8 to 37.5 ml/100 gm/min for group II. There was no significant difference (p = 0.37) between the mean cerebral blood flow in group I (21.5 +/- 4.6 ml/100 gm/min) and group II (24.3 +/- 8.1 ml/100 gm/min). There was a poor correlation between mean arterial pressure and cerebral blood flow in both groups: group I, r = 0.16 (p = 0.67); group II, r = 0.5 (p = 0.12). In 12 patients, a second cerebral blood flow measurements was taken to determine the effect of mean arterial pressure on cerebral blood flow in the individual patient. Changes in mean arterial pressure did not correlate with changes in cerebral blood flow (p less than 0.90). We conclude that age does not alter cerebral blood flow and that cerebral blood flow autoregulation is preserved in elderly patients during nonpulsatile hypothermic cardiopulmonary bypass

  12. MicroRNA profiling of the intestine during hypothermic circulatory arrest in swine.

    Science.gov (United States)

    Lin, Wei-Bin; Liang, Meng-Ya; Chen, Guang-Xian; Yang, Xiao; Qin, Han; Yao, Jian-Ping; Feng, Kang-Ni; Wu, Zhong-Kai

    2015-02-21

    To perform a profiling analysis of changes in intestinal microRNA (miRNA) expression during hypothermic circulatory arrest (HCA). A total of eight piglets were randomly divided into HCA and sham operation (SO) groups. Under general anesthesia, swine in the HCA group were subjected to hypothermic cardiopulmonary bypass at 24 °C followed by 80 min of circulatory arrest, and the reperfusion lasted for 180 min after cross-clamp removal. The counterparts in the SO group were only subjected to median sternotomy. Histopathological analysis was used to detect mucosal injury, and Pick-and-Mix custom miRNA real-time polymerase chain reaction (PCR) panels containing 306 unique primer sets were utilized to assay unpooled intestinal samples harvested from the two groups. The intestinal mucosa of the animals that were subjected to 24 °C HCA exhibited representative ischemic reperfusion injury of grade 2 or 3 according to the Chiu score. Such intestinal mucosal injuries, with the subepithelial space and epithelial layer lifting away from the lamina propria, were accompanied by shortened and irregular villi. On the contrary, the intestinal mucosa remained normal in the sham-operated animals. In total, twenty-five miRNAs were differentially expressed between the two groups (15 upregulated and 10 downregulated in the HCA group). Among these, eight miRNAs (miR-122, miR-221-5p, miR-31, miR-421-5p, miR-4333, miR-499-3p, miR-542 and let-7d-3p) were significantly dysregulated (four higher and four lower). The expression of miR-122 was significantly (5.37-fold) increased in the HCA group vs the SO group, indicating that it may play a key role in HCA-induced mucosal injury. Exposure to HCA caused intestinal miRNA dysregulation and barrier dysfunction in swine. These altered miRNAs might be related to the protection or destruction of the intestinal barrier.

  13. Cardiac rehabilitation

    Science.gov (United States)

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

  14. Moderate Versus Deep Hypothermia With Unilateral Selective Antegrade Cerebral Perfusion for Acute Type A Dissection.

    Science.gov (United States)

    Leshnower, Bradley G; Thourani, Vinod H; Halkos, Michael E; Sarin, Eric L; Keeling, William B; Lamias, Mark J; Guyton, Robert A; Chen, Edward P

    2015-11-01

    Despite improved results with surgical therapy for acute type A aortic dissection (ATAAD), there remains a lack of consensus regarding the optimal method of cerebral protection and circulation management during ATAAD. The purpose of this study is to determine whether in the setting of antegrade cerebral perfusion, moderate hypothermic circulatory arrest (MHCA) provides equivalent cerebral and visceral protection as deep hypothermic circulatory arrest (DHCA) for patients undergoing emergent ATAAD repair. A review of the Emory aortic surgery database from 2004 to 2014 identified 288 patients who underwent ATAAD with right axillary artery cannulation, unilateral selective antegrade cerebral perfusion (uSACP), and hypothermic circulatory arrest (HCA). In all, 88 patients underwent HCA at 24 °C or lower (DHCA), and 206 patients underwent HCA at more than 24 °C (MHCA). Major adverse outcomes of death, stroke, temporary neurologic dysfunction, and dialysis-dependent renal failure were examined. The groups were well matched for age and major comorbidities. The DHCA patients underwent HCA at lower temperatures (DHCA 21.6 ± 3.1 °C vs MHCA 27.4 ± 1.6 °C, p 0.05). Moderate HCA with uSACP is an effective circulation management strategy that provides excellent cerebral and visceral protection during emergent ATAAD repair. In the setting of antegrade cerebral perfusion, deep hypothermia does not provide any additional benefit. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Mild hypothermic culture conditions affect residual host cell protein composition post-Protein A chromatography.

    Science.gov (United States)

    Goey, Cher Hui; Bell, David; Kontoravdi, Cleo

    2018-01-30

    Host cell proteins (HCPs) are endogenous impurities, and their proteolytic and binding properties can compromise the integrity, and, hence, the stability and efficacy of recombinant therapeutic proteins such as monoclonal antibodies (mAbs). Nonetheless, purification of mAbs currently presents a challenge because they often co-elute with certain HCP species during the capture step of protein A affinity chromatography. A Quality-by-Design (QbD) strategy to overcome this challenge involves identifying residual HCPs and tracing their source to the harvested cell culture fluid (HCCF) and the corresponding cell culture operating parameters. Then, problematic HCPs in HCCF may be reduced by cell engineering or culture process optimization. Here, we present experimental results linking cell culture temperature and post-protein A residual HCP profile. We had previously reported that Chinese hamster ovary cell cultures conducted at standard physiological temperature and with a shift to mild hypothermia on day 5 produced HCCF of comparable product titer and HCP concentration, but with considerably different HCP composition. In this study, we show that differences in HCP variety at harvest cascaded to downstream purification where different residual HCPs were present in the two sets of samples post-protein A purification. To detect low-abundant residual HCPs, we designed a looping liquid chromatography-mass spectrometry method with continuous expansion of a preferred, exclude, and targeted peptide list. Mild hypothermic cultures produced 20% more residual HCP species, especially cell membrane proteins, distinct from the control. Critically, we identified that half of the potentially immunogenic residual HCP species were different between the two sets of samples.

  16. Therapeutic hypothermia after cardiac arrest and return of spontaneous circulation: it's complicated.

    Science.gov (United States)

    Beseda, Ryan; Smith, Susan; Veenstra, Amy

    2014-12-01

    Providing evidence-based care to patients with return of spontaneous circulation after a cardiac arrest is a recent complex innovation. Once resuscitated patients must be assessed for appropriateness for therapeutic hypothermia, be cooled in a timely manner, maintained while hypothermic, rewarmed within a specified time frame, and then assessed for whether hypothermia was successful for the patient through neuroprognostication. Nurses caring for therapeutic hypothermia patients must be knowledgeable and prepared to provide care to the patient and family. This article provides an overview of the complexity of therapeutic hypothermia for patients with return of spontaneous circulation in the form of a case study. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Therapeutic Hypothermia Reduces Oxidative Damage and Alters Antioxidant Defenses after Cardiac Arrest

    Science.gov (United States)

    Hackenhaar, Fernanda S.; Medeiros, Tássia M.; Heemann, Fernanda M.; Behling, Camile S.; Putti, Jordana S.; Mahl, Camila D.; Verona, Cleber; da Silva, Ana Carolina A.; Guerra, Maria C.; Gonçalves, Carlos A. S.; Oliveira, Vanessa M.; Riveiro, Diego F. M.; Vieira, Silvia R. R.

    2017-01-01

    After cardiac arrest, organ damage consequent to ischemia-reperfusion has been attributed to oxidative stress. Mild therapeutic hypothermia has been applied to reduce this damage, and it may reduce oxidative damage as well. This study aimed to compare oxidative damage and antioxidant defenses in patients treated with controlled normothermia versus mild therapeutic hypothermia during postcardiac arrest syndrome. The sample consisted of 31 patients under controlled normothermia (36°C) and 11 patients treated with 24 h mild therapeutic hypothermia (33°C), victims of in- or out-of-hospital cardiac arrest. Parameters were assessed at 6, 12, 36, and 72 h after cardiac arrest in the central venous blood samples. Hypothermic and normothermic patients had similar S100B levels, a biomarker of brain injury. Xanthine oxidase activity is similar between hypothermic and normothermic patients; however, it decreases posthypothermia treatment. Xanthine oxidase activity is positively correlated with lactate and S100B and inversely correlated with pH, calcium, and sodium levels. Hypothermia reduces malondialdehyde and protein carbonyl levels, markers of oxidative damage. Concomitantly, hypothermia increases the activity of erythrocyte antioxidant enzymes superoxide dismutase, glutathione peroxidase, and glutathione S-transferase while decreasing the activity of serum paraoxonase-1. These findings suggest that mild therapeutic hypothermia reduces oxidative damage and alters antioxidant defenses in postcardiac arrest patients. PMID:28553435

  18. Preservation of Cell Structure, Metabolism, and Biotransformation Activity of Liver-On-Chip Organ Models by Hypothermic Storage.

    Science.gov (United States)

    Gröger, Marko; Dinger, Julia; Kiehntopf, Michael; Peters, Frank T; Rauen, Ursula; Mosig, Alexander S

    2018-01-01

    The liver is a central organ in the metabolization of nutrition, endogenous and exogenous substances, and xenobiotic drugs. The emerging organ-on-chip technology has paved the way to model essential liver functions as well as certain aspects of liver disease in vitro in liver-on-chip models. However, a broader use of this technology in biomedical research is limited by a lack of protocols that enable the short-term preservation of preassembled liver-on-chip models for stocking or delivery to researchers outside the bioengineering community. For the first time, this study tested the ability of hypothermic storage of liver-on-chip models to preserve cell viability, tissue morphology, metabolism and biotransformation activity. In a systematic study with different preservation solutions, liver-on-chip function can be preserved for up to 2 d using a derivative of the tissue preservation solution TiProtec, containing high chloride ion concentrations and the iron chelators LK614 and deferoxamine, supplemented with polyethylene glycol (PEG). Hypothermic storage in this solution represents a promising method to preserve liver-on-chip function for at least 2 d and allows an easier access to liver-on-chip technology and its versatile and flexible use in biomedical research. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  19. Hypothermic manipulation of bone cement can extend the handling time during vertebroplasty.

    Science.gov (United States)

    Lai, Po-Liang; Tai, Ching-Lung; Chu, I-Ming; Fu, Tsai-Sheng; Chen, Lih-Huei; Chen, Wen-Jer

    2012-10-16

    Polymethylmethacrylate (PMMA) is commonly used for clinical applications. However, the short handling time increases the probability of a surgeon missing the crucial period in which the cement maintains its ideal viscosity for a successful injection. The aim of this article was to illustrate the effects a reduction in temperature would have on the cement handling time during percutaneous vertebroplasty. The injectability of bone cement was assessed using a cement compressor. By twisting the compressor, the piston transmits its axial load to the plunger, which then pumps the bone cement out. The experiments were categorized based on the different types of hypothermic manipulation that were used. In group I (room temperature, sham group), the syringes were kept at 22°C after mixing the bone cement. In group 2 (precooling the bone cement and the container), the PMMA powder and liquid, as well as the beaker, spatula, and syringe, were stored in the refrigerator (4°C) overnight before mixing. In group 3 (ice bath cooling), the syringes were immediately submerged in ice water after mixing the bone cement at room temperature. The average liquid time, paste time, and handling time were 5.1 ± 0.7, 3.4 ± 0.3, and 8.5 ± 0.8 min, respectively, for group 1; 9.4 ± 1.1, 5.8 ± 0.5, and 15.2 ± 1.2 min, respectively, for group 2; and 83.8 ± 5.2, 28.8 ± 6.9, and 112.5 ± 11.3 min, respectively, for group 3. The liquid and paste times could be increased through different cooling methods. In addition, the liquid time (i.e. waiting time) for ice bath cooling was longer than for that of the precooling method (p < 0.05). Both precooling (i.e. lowering the initial temperature) and ice bath cooling (i.e. lowering the surrounding temperature) can effectively slow polymerization. Precooling is easy for clinical applications, while ice bath cooling might be more suitable for multiple-level vertebroplasty. Clinicians can take advantage of the improved injectability without any

  20. Hypothermic manipulation of bone cement can extend the handling time during vertebroplasty

    Directory of Open Access Journals (Sweden)

    Lai Po-Liang

    2012-10-01

    Full Text Available Abstract Background Polymethylmethacrylate (PMMA is commonly used for clinical applications. However, the short handling time increases the probability of a surgeon missing the crucial period in which the cement maintains its ideal viscosity for a successful injection. The aim of this article was to illustrate the effects a reduction in temperature would have on the cement handling time during percutaneous vertebroplasty. Methods The injectability of bone cement was assessed using a cement compressor. By twisting the compressor, the piston transmits its axial load to the plunger, which then pumps the bone cement out. The experiments were categorized based on the different types of hypothermic manipulation that were used. In group I (room temperature, sham group, the syringes were kept at 22°C after mixing the bone cement. In group 2 (precooling the bone cement and the container, the PMMA powder and liquid, as well as the beaker, spatula, and syringe, were stored in the refrigerator (4°C overnight before mixing. In group 3 (ice bath cooling, the syringes were immediately submerged in ice water after mixing the bone cement at room temperature. Results The average liquid time, paste time, and handling time were 5.1 ± 0.7, 3.4 ± 0.3, and 8.5 ± 0.8 min, respectively, for group 1; 9.4 ± 1.1, 5.8 ± 0.5, and 15.2 ± 1.2 min, respectively, for group 2; and 83.8 ± 5.2, 28.8 ± 6.9, and 112.5 ± 11.3 min, respectively, for group 3. The liquid and paste times could be increased through different cooling methods. In addition, the liquid time (i.e. waiting time for ice bath cooling was longer than for that of the precooling method (p Conclusions Both precooling (i.e. lowering the initial temperature and ice bath cooling (i.e. lowering the surrounding temperature can effectively slow polymerization. Precooling is easy for clinical applications, while ice bath cooling might be more suitable for multiple-level vertebroplasty. Clinicians can take

  1. A Decrease in the Density of HLA-DR-Positive Cells Occurs Faster in Corneas Stored in Organ Culture than under Hypothermic Conditions

    Czech Academy of Sciences Publication Activity Database

    Al-Fakih, A.; Faltus, Václav; Jirsová, K.

    2012-01-01

    Roč. 47, č. 1 (2012), s. 39-46 ISSN 0030-3747 Institutional research plan: CEZ:AV0Z10300504 Keywords : antigen-presenting cells * langerhans cells * dendritic cells * allograft survival * transplantation * sensitization * rejection * storage * atpase * HLA-DR positivity * Organ culture * Hypothermic storage * Immunohistochemistry Impact factor: 1.562, year: 2012

  2. Ante situm liver resection with inferior vena cava replacement under hypothermic cardiopolmunary bypass for hepatoblastoma: Report of a case and review of the literature

    Directory of Open Access Journals (Sweden)

    Roberta Angelico

    2017-01-01

    Conclusions: We report for the first time a case of ante situ liver resection and inferior-vena-cava replacement associated with hypothermic cardiopulmonary bypass in a child with hepatoblastoma. Herein, we extensively review the literature for hepatoblastoma with thumoral thrombi and we describe the technical aspects of ante situm approach, which is a realistic option in otherwise unresectable hepatoblastoma.

  3. Effect of in situ hypothermic perfusion on intrahepatic pO(2) and reactive oxygen species formation after partial hepatectomy under total hepatic vascular exclusion in pigs

    NARCIS (Netherlands)

    Heijnen, Bob H. M.; Straatsburg, Irene H.; Kager, Liesbeth M.; van der Kleij, Ad J.; Gouma, Dirk J.; van Gulik, Thomas M.

    2003-01-01

    Aim: This study examined attenuation of ischemia and reperfusion (I/R) induced liver injury during liver resections by hypothermic perfusion of the liver under total hepatic vascular exclusion (THVE). Method: Reactive oxygen species (ROS) formation, microcirculatory integrity and endothelial cell

  4. Lipid solubility of sedative-hypnotic drugs influences hypothermic and hypnotic responses of long-sleep and short-sleep mice.

    Science.gov (United States)

    De Fiebre, N C; Marley, R J; Wehner, J M; Collins, A C

    1992-10-01

    The anesthetic potency of many agents, including alcohols, barbiturates and other sedative-hypnotic drugs, is influenced by lipid solubility. Previous studies from our laboratory, however, have demonstrated that genetic factors influence this relationship. We have reported that mouse lines selectively bred for differences in duration of ethanol-induced anesthesia, the long-sleep (LS) and short-sleep (SS) mice, differ in sleep-time response to water-soluble, but not lipid-soluble, sedative-hypnotic drugs. The studies described here sought to determine whether this same relationship exists for the hypothermic response produced by 17 sedative-hypnotic drugs in the LS and SS mice. Dose-response and time course relationships for hypothermic actions were determined and were compared with the dose-related anesthetic effects of the drugs. Hypothermic potencies increased along with lipid solubility for both the LS and SS mouse lines, but the rate of change differed for the two mouse lines. LS mice were more responsive to ethanol and other water-soluble drugs whereas the SS were more responsive to lipid-soluble drugs; significant correlations were obtained between lipid solubility (log P-octanol-water partition coefficient) and relative LS-SS responsiveness to both the hypothermic and hypnotic actions of the 17 test drugs. Thus, both hypnotic and hypothermic actions of sedative-hypnotic drugs are correlated with lipid solubility. Possible explanation for these correlations include greater LS central nervous system sensitivity to water-soluble drugs and LS-SS differences in distribution of lipid-soluble drugs.

  5. Cardiac Rehabilitation

    Science.gov (United States)

    ... may also do muscle-strengthening exercises, such as lifting weights or other resistance training exercises, two or three ... health concerns. Education about nutrition, lifestyle and healthy weight ... the most benefits from cardiac rehabilitation, make sure your exercise and ...

  6. Cardiac MRI

    Science.gov (United States)

    ... such as coronary heart disease, heart valve problems, pericarditis, cardiac tumors, or damage from a heart attack. ... Palpitations Heart Valve Disease Implantable Cardioverter Defibrillators Pacemakers Pericarditis Stress Testing RELATED NEWS April 26, 2013 | News ...

  7. Cardiac Angiosarcoma

    Directory of Open Access Journals (Sweden)

    Monique Esteves Cardoso

    2011-01-01

    Full Text Available Despite cardiac metastases are found in about 20% of cancer deaths, the presence of primary cardiac tumors is rare. Most primary tumors are benign, and malignant tumors comprise about 15%. We report a 21-year-old man with fever, dyspnea, and hemoptysis that was diagnosed with angiosarcoma of the right atrium and pulmonary metastasis. Patient was submitted to surgical tumor resection without adjuvant therapy and died four months after diagnosis.

  8. Cardiac Angiosarcoma

    OpenAIRE

    Cardoso, Monique Esteves; Canale, Leonardo Secchin; Ramos, Rosana Grandelle; Salvador Junior, Edson da Silva; Lachtermacher, Stephan

    2011-01-01

    Despite cardiac metastases are found in about 20% of cancer deaths, the presence of primary cardiac tumors is rare. Most primary tumors are benign, and malignant tumors comprise about 15%. We report a 21-year-old man with fever, dyspnea, and hemoptysis that was diagnosed with angiosarcoma of the right atrium and pulmonary metastasis. Patient was submitted to surgical tumor resection without adjuvant therapy and died four months after diagnosis.

  9. Cardiac Angiosarcoma

    Science.gov (United States)

    Cardoso, Monique Esteves; Canale, Leonardo Secchin; Ramos, Rosana Grandelle; Salvador Junior, Edson da Silva; Lachtermacher, Stephan

    2011-01-01

    Despite cardiac metastases are found in about 20% of cancer deaths, the presence of primary cardiac tumors is rare. Most primary tumors are benign, and malignant tumors comprise about 15%. We report a 21-year-old man with fever, dyspnea, and hemoptysis that was diagnosed with angiosarcoma of the right atrium and pulmonary metastasis. Patient was submitted to surgical tumor resection without adjuvant therapy and died four months after diagnosis. PMID:24826214

  10. Targeted endothelial delivery of nanosized catalase immunoconjugates protects lung grafts donated after cardiac death.

    Science.gov (United States)

    Preissler, Gerhard; Loehe, Florian; Huff, Ines V; Ebersberger, Ulrich; Shuvaev, Vladimir V; Bittmann, Iris; Hermanns, Iris; Kirkpatrick, James C; Fischer, Karl; Eichhorn, Martin E; Winter, Hauke; Jauch, Karl W; Albelda, Steven M; Muzykantov, Vladimir R; Wiewrodt, Rainer

    2011-08-27

    Donor organ shortage represents a major problem in lung transplantation. Donation after cardiac death could help to expand the pool of organs, but the additional period of warm ischemia after cardiac arrest aggravates primary graft dysfunction. The pulmonary endothelium of the graft constitutes an important source and target of reactive oxygen species generated during ischemia and reperfusion. Targeted protection of graft pulmonary endothelial cells by the antioxidant enzyme catalase, conjugated with a platelet/endothelial cell adhesion molecule-1 (PECAM-1) antibody to nanosized particles (anti-PECAM/catalase conjugates), might improve outcome in lung transplantation using donors after cardiac death and prolonged hypothermic preservation. Left lung transplantation was performed in 18 pigs. Before cardiac arrest, donors received anti-PECAM/catalase, unconjugated component mixture or vehicle solution. After 90-min warm and 18-hr hypothermic ischemia, lungs were transplanted, and function was assessed during 6 hr after reperfusion. Samples of bronchoalveolar lavage fluid and lung tissue were taken thereafter. Six sham-operated animals served as controls. During 6-hr reperfusion, anti-PECAM/catalase significantly ameliorated graft function, evidenced by major improvements of gas exchange and reduced intrapulmonary shunt fraction. Furthermore, lipid peroxidation, alveolar leakage, and edema formation were reduced in protected grafts. Similarly moderate lung pathology was seen after transplantation. Augmentation of the antioxidant capacity of graft pulmonary endothelial cells with anti-PECAM/catalase nanoparticles represents a straightforward approach to enable a safe transplantation of prolonged preserved donation after cardiac death lungs. Anti-PECAM/catalase protection alleviated oxidative stress and allowed immediate reconstitution of normal gas exchange and pulmonary microcirculation, a prerequisite for improved graft and patient outcome.

  11. Thrombin generation and fibrin clot formation under hypothermic conditions: an in vitro evaluation of tissue factor initiated whole blood coagulation.

    Science.gov (United States)

    Whelihan, Matthew F; Kiankhooy, Armin; Brummel-Ziedins, Kathleen E

    2014-02-01

    Despite trauma-induced hypothermic coagulopathy being familiar in the clinical setting, empirical experimentation concerning this phenomenon is lacking. In this study, we investigated the effects of hypothermia on thrombin generation, clot formation, and global hemostatic functions in an in vitro environment using a whole blood model and thromboelastography, which can recapitulate hypothermia. Blood was collected from healthy individuals through venipuncture and treated with corn trypsin inhibitor, to block the contact pathway. Coagulation was initiated with 5pM tissue factor at temperatures 37°C, 32°C, and 27°C. Reactions were quenched over time, with soluble and insoluble components analyzed for thrombin generation, fibrinogen consumption, factor (f)XIII activation, and fibrin deposition. Global coagulation potential was evaluated through thromboelastography. Data showed that thrombin generation in samples at 37°C and 32°C had comparable rates, whereas 27°C had a much lower rate (39.2 ± 1.1 and 43 ± 2.4 nM/min vs 28.6 ± 4.4 nM/min, respectively). Fibrinogen consumption and fXIII activation were highest at 37°C, followed by 32°C and 27°C. Fibrin formation as seen through clot weights also followed this trend. Thromboelastography data showed that clot formation was fastest in samples at 37°C and lowest at 27°C. Maximum clot strength was similar for each temperature. Also, percent lysis of clots was highest at 37°C followed by 32°C and then 27°C. Induced hypothermic conditions directly affect the rate of thrombin generation and clot formation, whereas global clot stability remains intact. © 2013.

  12. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

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

  13. [Cardiac amyloidosis].

    Science.gov (United States)

    Boussabah, Elhem; Zakhama, Lilia; Ksontini, Iméne; Ibn Elhadj, Zied; Boukhris, Besma; Naffeti, Sana; Thameur, Moez; Ben Youssef, Soraya

    2008-09-01

    PREREQUIS: Amyloidosis is a rare infiltrative disease characterized by multiple clinical features. Various organs are involved and the cardiovascular system is a common target of amyloidosis. Cardiac involvement may occur with or without clinical manifestations and is considered as a major prognostic factor. To analyze the clinical features of cardiac involvement, to review actual knowledgement concerning echocardiographic diagnostic and to evaluate recent advances in treatment of the disease. An electronic search of the relevant literature was carried out using Medline and Pubmed. Keys words used for the final search were amyloidosis, cardiopathy and echocardiography. We considered for analysis reviews, studies and articles between 1990 and 2007. Amyloidosis represents 5 to 10% of non ischemic cardiomyoparhies. Cardiac involvement is the first cause of restrictive cardiomyopathy witch must be evoked in front of every inexplained cardiopathy after the age of forty. The amyloid nature of cardiopathy is suggered if some manifestations were associated as a peripheric neuropathy, a carpal tunnel sydrome and proteinuria > 3g/day. Echocardiography shows dilated atria, a granular sparkling appearance of myocardium, diastolic dysfunction and thickened left ventricle contrasting with a low electric voltage. The proof of amyloidosis is brought by an extra-cardiac biopsy, the indications of endomyocardial biopsy are very limited. The identification of the amyloid nature of cardiopathy has an direct therapeutic implication: it indicates the use of digitalis, calcium channel blockers and beta-blockers. Today the treatment of amyloidosis remains very unsatisfactory especially in the cardiac involvement. An early diagnosis before the cardiac damage may facilitate therapy and improve prognosis.

  14. Cardiac Pacemakers

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  15. Is the Deep Inspiration Breath-Hold Technique Superior to the Free Breathing Technique in Cardiac and Lung Sparing while Treating both Left-Sided Post-Mastectomy Chest Wall and Supraclavicular Regions

    Directory of Open Access Journals (Sweden)

    Anupama Darapu

    2017-01-01

    Full Text Available Aims: To evaluate the efficacy of the deep inspirational breath-hold (DIBH technique and its dosimetric advantages over the free breathing (FB technique in cardiac (heart and left anterior descending artery [LAD] and ipsilateral lung sparing in left-sided post-mastectomy field-in-field conformal radiotherapy. DIBH is highly reproducible, and this study aims to find out its dosimetric benefits over FB. Materials and Methods: Nineteen left-sided mastectomy patients were immobilized using breast boards with both arms positioned above the head. All patients had 2 sets of planning CT images (one in FB and another in DIBH with a Biograph TruePoint HD CT scanner in the same setup. DIBH was performed by tracking the respiratory cycles using a Varian Real-Time Position Management system. The target (chest wall and supraclavicular region, organs at risk (OARs; ipsilateral lung, contralateral lung, heart, LAD, and contralateral breast, and other organs of interests were delineated as per the RTOG (Radiation Therapy Oncology Group contouring guidelines. The single-isocenter conformal fields in the field treatment plans were generated with the Eclipse Treatment Planning System (Varian Medical Systems for both FB and DIBH images, and the doses to the target and OARs were compared. The standard fractionation regimen of 50 Gy in 25 fractions over a period of 5 weeks was used for all patients in this study. Results and Discussion: The target coverage parameters (V95, V105, V107, and Dmean were found to be 97.8 ± 0.9, 6.1 ± 3.4, 0.2 ± 0.3, and 101.9 ± 0.5% in the FB plans and 98.1 ± 0.8, 6.1 ± 3.2, 0.2 ± 0.3, and 101.9 ± 0.4% in the DIBH plans, respectively. The plan quality indices (conformity index and homogeneity index also showed 1.3 ± 0.2 and 0.1 for the FB plans and 1.2 ± 0.3 and 0.1 for the DIBH plans, respectively. There was a significant reduction in dose to the heart in the DIBH plans compared to the FB plans, with p values of nearly 0 for the

  16. Deep Value

    DEFF Research Database (Denmark)

    Asness, Clifford S.; Liew, John M.; Pedersen, Lasse Heje

    We define "deep value" as episodes where the valuation spread between cheap and expensive securities is wide relative to its history. Examining deep value across global individual equities, equity index futures, currencies, and global bonds provides new evidence on competing theories for the valu....... Lastly, we find that deep value episodes tend to cluster and a deep value trading strategy generates excess returns not explained by traditional risk factors.......We define "deep value" as episodes where the valuation spread between cheap and expensive securities is wide relative to its history. Examining deep value across global individual equities, equity index futures, currencies, and global bonds provides new evidence on competing theories for the value...... premium. Following these episodes, the value strategy has (1) high average returns; (2) low market betas, but high betas to a global value factor; (3) deteriorating fundamentals; (4) negative news sentiment; (5) selling pressure; (6) increased limits to arbitrage; and (7) increased arbitrage activity...

  17. Hypothermic oxygenated machine perfusion (HOPE) for orthotopic liver transplantation of human liver allografts from extended criteria donors (ECD) in donation after brain death (DBD): a prospective multicentre randomised controlled trial (HOPE ECD-DBD)

    Science.gov (United States)

    Czigany, Zoltan; Schöning, Wenzel; Ulmer, Tom Florian; Bednarsch, Jan; Amygdalos, Iakovos; Cramer, Thorsten; Rogiers, Xavier; Popescu, Irinel; Botea, Florin; Froněk, Jiří; Kroy, Daniela; Koch, Alexander; Tacke, Frank; Trautwein, Christian; Tolba, Rene H; Hein, Marc; Koek, Ger H; Dejong, Cornelis H C; Neumann, Ulf Peter; Lurje, Georg

    2017-01-01

    Introduction Orthotopic liver transplantation (OLT) has emerged as the mainstay of treatment for end-stage liver disease. In an attempt to improve the availability of donor allografts and reduce waiting list mortality, graft acceptance criteria were extended increasingly over the decades. The use of extended criteria donor (ECD) allografts is associated with a higher incidence of primary graft non-function and/or delayed graft function. As such, several strategies have been developed aiming at reconditioning poor quality ECD liver allografts. Hypothermic oxygenated machine perfusion (HOPE) has been successfully tested in preclinical experiments and in few clinical series of donation after cardiac death OLT. Methods and analysis HOPE ECD-DBD is an investigator-initiated, open-label, phase-II, prospective multicentre randomised controlled trial on the effects of HOPE on ECD allografts in donation after brain death (DBD) OLT. Human whole organ liver grafts will be submitted to 1–2 hours of HOPE (n=23) via the portal vein before implantation and are going to be compared with a control group (n=23) of patients transplanted after conventional cold storage. Primary (peak and Δ peak alanine aminotransferase within 7 days) and secondary (aspartate aminotransferase, bilirubin and international normalised ratio, postoperative complications, early allograft dysfunction, duration of hospital and intensive care unit stay, 1-year patient and graft survival) endpoints will be analysed within a 12-month follow-up. Extent of ischaemia–reperfusion (I/R) injury will be assessed using liver tissue, perfusate, bile and serum samples taken during the perioperative phase of OLT. Ethics and dissemination The study was approved by the institutional review board of the RWTH Aachen University, Aachen, Germany (EK 049/17). The current paper represent the pre-results phase. First results are expected in 2018. Trial registration number NCT03124641. PMID:29018070

  18. The Dynamics of Cardiac Electrical Instability.

    Science.gov (United States)

    Kaplan, Daniel Theodore

    This thesis examines the susceptibility of the heart to ventricular fibrillation from the point of view of nonlinear dynamical systems theory. Earlier work has established that susceptibility to fibrillation may be marked by an alternation from beat to beat in the shape of the ECG. This, as well as modeling of cardiac electrical conduction, led to speculation that fibrillation might be an instance of deterministic chaos, and that one of the theoretical routes to chaos--a cascade of period-doublings --might be followed. I study the possibility that fibrillation is deterministic chaos by the use of dimensionality calculations: the results suggest that there is not a low-dimensional dynamical system attractor underlying fibrillation. Both fibrillatory ECG's and models suggest that fibrillation may be a quasistationary transient. To search for evidence of high-order period-doublings, recordings from hypothermic dog and guinea pig hearts are studied using a variety of techniques based on state-space representations of the signals. As has been previously reported, alternation (period 2) is strongly associated with susceptibility to fibrillation. There is also some evidence of a 2^{nd} period -doubling (period 4) appearing in extremely hypothemic or rapidly paced hearts. A simple finite-element computer model of cardiac conduction is used to illustrate one possible mechanism of long periodicities (e.g. periods 2 and 4) in hearts. It is shown that incorporating a dependence of refractory period on stimulation rate permits the appearance in the model of the long periodicities observed in real data in a way which is independent of the geometry of the finite -element lattice used in the model. Furthermore, inclusion of refractory dynamics which allow individual cells to alternate disrupts the appearance of long periodicities and increases susceptibility to fibrillation.

  19. Postnatal changes in the cardiorespiratory response and ability to autoresuscitate from hypoxic and hypothermic exposure in mammals.

    Science.gov (United States)

    Fong, Angelina Y

    2010-11-30

    Most mammals are born immature and a great deal of maturational changes must occur early in the early postnatal life to prepare for life as an adult. In addition to the obvious changes such as physical and musculoskeletal growth, a myriad of physiological changes including the cardiorespiratory responses to hypoxia and hypothermia must also occur. The most intriguing developmental effect is perhaps the change in the ability to autoresuscitate, or spontaneous recovery from cardiorespiratory arrest induced by extreme hypoxia or hypothermia. For decades the ability of young animals to autoresuscitate from cardiorespiratory arrest induced by hypoxic or hypothermic exposure has been documented. In some mammalian species, including rats and humans, this ability is lost over development while others retain this ability. This review will examine the changes that occur in the cardiorespiratory response to hypoxia and hypothermia and the change to the ability to autoresuscitate from cardiorespiratory arrest over early postnatal development. Furthermore, the review will explore some of the potential neuroanatomical, neurochemical and neurophysiological changes during early postnatal development that might contribute to the altered reflex response to hypoxia and hypothermia and the ability to autoresuscitate. Copyright © 2010 Elsevier B.V. All rights reserved.

  20. Deep frying

    NARCIS (Netherlands)

    Koerten, van K.N.

    2016-01-01

    Deep frying is one of the most used methods in the food processing industry. Though practically any food can be fried, French fries are probably the most well-known deep fried products. The popularity of French fries stems from their unique taste and texture, a crispy outside with a mealy soft

  1. Deep learning

    CERN Document Server

    Goodfellow, Ian; Courville, Aaron

    2016-01-01

    Deep learning is a form of machine learning that enables computers to learn from experience and understand the world in terms of a hierarchy of concepts. Because the computer gathers knowledge from experience, there is no need for a human computer operator to formally specify all the knowledge that the computer needs. The hierarchy of concepts allows the computer to learn complicated concepts by building them out of simpler ones; a graph of these hierarchies would be many layers deep. This book introduces a broad range of topics in deep learning. The text offers mathematical and conceptual background, covering relevant concepts in linear algebra, probability theory and information theory, numerical computation, and machine learning. It describes deep learning techniques used by practitioners in industry, including deep feedforward networks, regularization, optimization algorithms, convolutional networks, sequence modeling, and practical methodology; and it surveys such applications as natural language proces...

  2. Effects of sympathetic stimulation during cooling on hypothermic as well as posthypothermic hemodynamic function.

    Science.gov (United States)

    Kondratiev, T V; Tveita, T

    2006-10-01

    This experimental study was performed to explore hemodynamic effects of a moderate dose epinephrine (Epi) during hypothermia and to test the hypothesis whether sympathetic stimulation during cooling affects myocardial function following rewarming. Two groups of male Wistar rats (each, n=7) were cooled to 15 degrees C, maintained at this temperature for 1 h, and then rewarmed. Group 1 received 1 microg/min Epi, i.v., for 1 h during cooling to 28 degrees C, a dose known to elevate cardiac output (CO) by approximately 25% at 37 degrees C. Group 2 served a saline solution control. At 37 degrees C, Epi infusion elevated CO, left ventricular systolic pressure, maximum rate of left ventricle pressure rise, and mean arterial pressure. During cooling to 28 degrees C, these variables, with the exception of mean arterial pressure, decreased in parallel to those in the saline solution group. In contrast, in the Epi group, mean arterial pressure remained increased and total peripheral resistance was significantly elevated at 28 degrees C. Compared with corresponding prehypothermic values, most hemodynamic variables were lowered after 1 h at 15 degrees C in both groups (except for stroke volume). After rewarming, alterations in hemodynamic variables in the Epi-treated group were more prominent than in saline solution controls. Thus, before cooling, continuous Epi infusion predominantly stimulates myocardial mechanical function, materialized as elevation of CO, left ventricular systolic pressure, and maximum rate of left ventricle pressure rise. Cooling, on the other hand, apparently eradicates central hemodynamic effects of Epi and during stable hypothermia, elevation of peripheral vascular vasopressor effects seem to take over. In contrast to temperature-matched, non-Epi stimulated control rats, a significant depression of myocardial mechanical function occurs during rewarming following a moderate sympathetic stimulus during initial cooling.

  3. Deep Habits

    OpenAIRE

    Morten O. Ravn; Stephanie Schmitt-Grohe

    2004-01-01

    This paper generalizes the standard habit formation model to an environment in which agents form habits over individual varieties of goods as opposed to over a composite consumption good. We refer to this preference specification as ‘deep habit formation’. Under deep habits, the demand function faced by individual producers depends on past sales. This feature is typically assumed ad-hoc in customer market and brand switching cost models. A central result of the paper is that deep habits giv...

  4. Cardiac conduction system

    Science.gov (United States)

    The cardiac conduction system is a group of specialized cardiac muscle cells in the walls of the heart that send signals to the ... contract. The main components of the cardiac conduction system are the SA node, AV node, bundle of ...

  5. Spermatogenesis after extreme hyperthermal, hypothermal and traumatic infl uences and the possibility of its drug correction in the experiment

    Directory of Open Access Journals (Sweden)

    N. V. Avramenko

    2013-12-01

    Full Text Available Introduction Infertility is an important component of the total medical-demographic problems, which accumulates the entire range of factors of socio - economic, behavioral, genetic and natural-climatic, ecological Genesis. Male infertility is founded in 35-40% of the causes of the couple infertility. Attention to the male reproductive function is increasing and it is caused by the appearance of a large number of messages about the increasing incidence of diseases of male reproductive organs, reduction of quantitative and qualitative characteristics of the semen, the significance of the male pathology in the formation of infertility in marriage. Research objective To analyze the status of spermatogenesis after extreme hyperthermal, hypothermal and traumatic effects and the possibility of drug correction in the experiment. Materials and methods Semantic evaluation of scientific documents, comparison, as well as the structural-logical analysis were used. In the literature there are reports of violation of the structure of the sperm. Causes may include testicular injury, surgery or epidemic parotitis (mumps in the past, severe allergic reactions, the impact of radiation, the use of some drugs. Chronic hyperthermia causes changes of all structural components of the tissues of the testicles, which slows down the processes of spermatogenesis. Conclusions There are several reasons for male infertility. Stress, fear of sexual or family relations, in some men are the unwillingness of paternity. Injury or genital mutilation, primarily on the testicles can lead to the violation of the gematotestcular barrier with the formation of specific substances, which destroy tubules of the testicle. Antisperm antibodies completely destroys tubular apparatus. Study of spermatogenesis in experimental models is important and promising direction. It gives both theoretical and practical points of view on the development of methods of prevention and medical correction of

  6. Salinity Effects on Strategies of Glycogen Utilization in Livers of Euryhaline Milkfish (Chanos chanos) under Hypothermal Stress

    Science.gov (United States)

    Chang, Chia-Hao; Huang, Jian-Jun; Yeh, Chun-Yi; Tang, Cheng-Hao; Hwang, Lie-Yueh; Lee, Tsung-Han

    2018-01-01

    The fluctuation of temperature affects many physiological responses in ectothermic organisms, including feed intake, growth, reproduction, and behavior. Changes in environmental temperatures affect the acquisition of energy, whereas hepatic glycogen plays a central role in energy supply for the homeostasis of the entire body. Glycogen phosphorylase (GP), which catalyzes the rate-limiting step in glycogenolysis, is also an indicator of environmental stress. Here, we examined the effects of salinity on glycogen metabolism in milkfish livers under cold stress. A reduction of feed intake was observed in both freshwater (FW) and seawater (SW) milkfish under cold adaptation. At normal temperature (28°C), compared to the FW milkfish, the SW milkfish exhibited greater mRNA abundance of the liver isoform of GP (Ccpygl), higher GP activity, and less glycogen content in the livers. Upon hypothermal (18°C) stress, hepatic Ccpygl mRNA expression of FW milkfish surged at 3 h, declined at 6 and 12 h, increased again at 24 h, and increased significantly after 96 h. Increases in GP protein, GP activity, and the phosphorylation state and the breakdown of glycogen were also found in FW milkfish livers after 12 h of exposure at 18°C. Conversely, the Ccpygl transcript levels in SW milkfish were downregulated after 1 h of exposure at 18°C, whereas the protein abundance of GP, GP activity, and glycogen content were not significantly altered. Taken together, under 18°C cold stress, FW milkfish exhibited an acute response with the breakdown of hepatic glycogen for maintaining energy homeostasis of the entire body, whereas no change was observed in the hepatic glycogen content and GP activity of SW milkfish because of their greater tolerance to cold conditions. PMID:29483878

  7. Salinity Effects on Strategies of Glycogen Utilization in Livers of Euryhaline Milkfish (Chanos chanos under Hypothermal Stress

    Directory of Open Access Journals (Sweden)

    Chia-Hao Chang

    2018-02-01

    Full Text Available The fluctuation of temperature affects many physiological responses in ectothermic organisms, including feed intake, growth, reproduction, and behavior. Changes in environmental temperatures affect the acquisition of energy, whereas hepatic glycogen plays a central role in energy supply for the homeostasis of the entire body. Glycogen phosphorylase (GP, which catalyzes the rate-limiting step in glycogenolysis, is also an indicator of environmental stress. Here, we examined the effects of salinity on glycogen metabolism in milkfish livers under cold stress. A reduction of feed intake was observed in both freshwater (FW and seawater (SW milkfish under cold adaptation. At normal temperature (28°C, compared to the FW milkfish, the SW milkfish exhibited greater mRNA abundance of the liver isoform of GP (Ccpygl, higher GP activity, and less glycogen content in the livers. Upon hypothermal (18°C stress, hepatic Ccpygl mRNA expression of FW milkfish surged at 3 h, declined at 6 and 12 h, increased again at 24 h, and increased significantly after 96 h. Increases in GP protein, GP activity, and the phosphorylation state and the breakdown of glycogen were also found in FW milkfish livers after 12 h of exposure at 18°C. Conversely, the Ccpygl transcript levels in SW milkfish were downregulated after 1 h of exposure at 18°C, whereas the protein abundance of GP, GP activity, and glycogen content were not significantly altered. Taken together, under 18°C cold stress, FW milkfish exhibited an acute response with the breakdown of hepatic glycogen for maintaining energy homeostasis of the entire body, whereas no change was observed in the hepatic glycogen content and GP activity of SW milkfish because of their greater tolerance to cold conditions.

  8. Dendrimer brain uptake and targeted therapy for brain injury in a large animal model of hypothermic circulatory arrest.

    Science.gov (United States)

    Mishra, Manoj K; Beaty, Claude A; Lesniak, Wojciech G; Kambhampati, Siva P; Zhang, Fan; Wilson, Mary A; Blue, Mary E; Troncoso, Juan C; Kannan, Sujatha; Johnston, Michael V; Baumgartner, William A; Kannan, Rangaramanujam M

    2014-03-25

    Treatment of brain injury following circulatory arrest is a challenging health issue with no viable therapeutic options. Based on studies in a clinically relevant large animal (canine) model of hypothermic circulatory arrest (HCA)-induced brain injury, neuroinflammation and excitotoxicity have been identified as key players in mediating the brain injury after HCA. Therapy with large doses of valproic acid (VPA) showed some neuroprotection but was associated with adverse side effects. For the first time in a large animal model, we explored whether systemically administered polyamidoamine (PAMAM) dendrimers could be effective in reaching target cells in the brain and deliver therapeutics. We showed that, upon systemic administration, hydroxyl-terminated PAMAM dendrimers are taken up in the brain of injured animals and selectively localize in the injured neurons and microglia in the brain. The biodistribution in other major organs was similar to that seen in small animal models. We studied systemic dendrimer-drug combination therapy with two clinically approved drugs, N-acetyl cysteine (NAC) (attenuating neuroinflammation) and valproic acid (attenuating excitotoxicity), building on positive outcomes in a rabbit model of perinatal brain injury. We prepared and characterized dendrimer-NAC (D-NAC) and dendrimer-VPA (D-VPA) conjugates in multigram quantities. A glutathione-sensitive linker to enable for fast intracellular release. In preliminary efficacy studies, combination therapy with D-NAC and D-VPA showed promise in this large animal model, producing 24 h neurological deficit score improvements comparable to high dose combination therapy with VPA and NAC, or free VPA, but at one-tenth the dose, while significantly reducing the adverse side effects. Since adverse side effects of drugs are exaggerated in HCA, the reduced side effects with dendrimer conjugates and suggestions of neuroprotection offer promise for these nanoscale drug delivery systems.

  9. The neuroprotective effect of post ischemic brief mild hypothermic treatment correlates with apoptosis, but not with gliosis in endothelin-1 treated rats

    Directory of Open Access Journals (Sweden)

    Zgavc Tine

    2012-08-01

    Full Text Available Abstract Background Stroke remains one of the most common diseases with a serious impact on quality of life but few effective treatments exist. Mild hypothermia (33°C is a promising neuroprotective therapy in stroke management. This study investigated whether a delayed short mild hypothermic treatment is still beneficial as neuroprotective strategy in the endothelin-1 (Et-1 rat model for a transient focal cerebral ischemia. Two hours of mild hypothermia (33°C was induced 20, 60 or 120 minutes after Et-1 infusion. During the experiment the cerebral blood flow (CBF was measured via Laser Doppler Flowmetry in the striatum, which represents the core of the infarct. Functional outcome and infarct volume were assessed 24 hours after the insult. In this sub-acute phase following stroke induction, the effects of the hypothermic treatment on apoptosis, phagocytosis and astrogliosis were assessed as well. Apoptosis was determined using caspase-3 immunohistochemistry, phagocytic cells were visualized by CD-68 expression and astrogliosis was studied by glial fibrillary acidic protein (GFAP staining. Results Cooling could be postponed up to 1 hour after the onset of the insult without losing its positive effects on neurological deficit and infarct volume. These results correlated with the caspase-3 staining. In contrast, the increased CD-68 expression post-stroke was reduced in the core of the insult with all treatment protocols. Hypothermia also reduced the increased levels of GFAP staining, even when it was delayed up to 2 hours after the insult. The study confirmed that the induction of the hypothermia treatment in the Et-1 model does not affect the CBF. Conclusions These data indicate that in the Et-1 rat model, a short mild hypothermic treatment delayed for 1 hour is still neuroprotective and correlates with apoptosis. At the same time, hypothermia also establishes a lasting inhibitory effect on the activation of astrogliosis.

  10. Cardiac pacemaker

    International Nuclear Information System (INIS)

    Kolenik, S.A.

    1976-01-01

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

  11. Mathematical Models of Cardiac Pacemaking Function

    Directory of Open Access Journals (Sweden)

    Pan eLi

    2013-10-01

    Full Text Available Over the past half century, there has been intense and fruitful interaction between experimental and computational investigations of cardiac function. This interaction has, for example, led to deep understanding of cardiac excitation-contraction coupling; how it works, as well as how it fails. However, many lines of inquiry remain unresolved, among them the initiation of each heartbeat. The sinoatrial node, a cluster of specialized pacemaking cells in the right atrium of the heart, spontaneously generates an electro-chemical wave that spreads through the atria and through the cardiac conduction system to the ventricles, initiating the contraction of cardiac muscle essential for pumping blood to the body. Despite the fundamental importance of this primary pacemaker, this process is still not fully understood, and ionic mechanisms underlying cardiac pacemaking function are currently under heated debate. Several mathematical models of sinoatrial node cell membrane electrophysiology have been constructed as based on different experimental data sets and hypotheses. As could be expected, these differing models offer diverse predictions about cardiac pacemaking activities. This paper aims to present the current state of debate over the origins of the pacemaking function of the sinoatrial node. Here, we will specifically review the state-of-the-art of cardiac pacemaker modeling, with a special emphasis on current discrepancies, limitations, and future challenges.

  12. Deep Fish.

    Science.gov (United States)

    Ishaq, Omer; Sadanandan, Sajith Kecheril; Wählby, Carolina

    2017-01-01

    Zebrafish ( Danio rerio) is an important vertebrate model organism in biomedical research, especially suitable for morphological screening due to its transparent body during early development. Deep learning has emerged as a dominant paradigm for data analysis and found a number of applications in computer vision and image analysis. Here we demonstrate the potential of a deep learning approach for accurate high-throughput classification of whole-body zebrafish deformations in multifish microwell plates. Deep learning uses the raw image data as an input, without the need of expert knowledge for feature design or optimization of the segmentation parameters. We trained the deep learning classifier on as few as 84 images (before data augmentation) and achieved a classification accuracy of 92.8% on an unseen test data set that is comparable to the previous state of the art (95%) based on user-specified segmentation and deformation metrics. Ablation studies by digitally removing whole fish or parts of the fish from the images revealed that the classifier learned discriminative features from the image foreground, and we observed that the deformations of the head region, rather than the visually apparent bent tail, were more important for good classification performance.

  13. Ulinastatin Protects against Acute Kidney Injury in Infant Piglets Model Undergoing Surgery on Hypothermic Low-Flow Cardiopulmonary Bypass.

    Directory of Open Access Journals (Sweden)

    Xiaocou Wang

    Full Text Available Infants are more vulnerable to kidney injuries induced by inflammatory response syndrome and ischemia-reperfusion injury following cardiopulmonary bypass especially with prolonged hypothermic low-flow (HLF. This study aims to evaluate the protective role of ulinastatin, an anti-inflammatory agent, against acute kidney injuries in infant piglets model undergoing surgery on HLF cardiopulmonary bypass.Eighteen general-type infant piglets were randomly separated into the ulinastatin group (Group U, n = 6, the control group (Group C, n = 6, and the sham operation group (Group S, n = 6, and anaesthetized. The groups U and C received following experimental procedure: median thoracotomy, routine CPB and HLF, and finally weaned from CPB. The group S only underwent sham median thoracotomy. Ulinastatin at a dose of 5,000 units/kg body weight and a certain volume of saline were administrated to animals of the groups U and C at the beginning of CPB and at aortic declamping, respectively. Venous blood samples were collected at 3 different time points: after anesthesia induction in all experimental groups, 5 minutes, and 120 minutes after CPB in the Groups U and C. Markers for inflammation and acute kidney injury were tested in the collected plasma. N-acetyl-β-D-glucosaminidase (NAG from urine, markers of oxidative stress injury and TUNEL-positive cells in kidney tissues were also detected.The expressions of plasma inflammatory markers and acute kidney injury markers increased both in Group U and Group C at 5 min and 120 min after CPB. Also, numbers of TUNEL-positive cells and oxidative stress markers in kidney rose in both groups. At the time point of 120-min after CPB, compared with the Group C, some plasma inflammatory and acute kidney injury markers as well as TUNEL-positive cells and oxidative stress markers in kidney were significantly reduced in the Group U. Histologic analyses showed that HLF promoted acute tubular necrosis and dilatation

  14. In vivo bleeding time and in vitro thrombelastography measurements are better indicators of dilutional hypothermic coagulopathy than prothrombin time.

    Science.gov (United States)

    Kheirabadi, Bijan S; Crissey, Jacqueline M; Deguzman, Rodolfo; Holcomb, John B

    2007-06-01

    The coagulopathy of trauma is generally confirmed by prothrombin time (PT) > or =16 seconds or an international normalized ratio > or =1.5. However, the utility of these values as a screening test is unknown. We examined different coagulation tests to determine the best predictor of coagulopathic bleeding and mortality in a small animal hemorrhage model. Coagulopathy was induced in male New Zealand White rabbits by warfarin (W; 2 mg/kg for 2 days; n = 7), or hemodilution and hypothermia (HH; 50% blood exchange with Hextend, 34.5 +/- 0.3 degrees C; n = 7). Normal (N) rabbits without pretreatment served as the control (n = 7). Blood samples collected after coagulopathy induction and analyzed by prothrombin time (PT), activated partial thromboplastin time (aPTT), and thromboelastography (TEG) tests. Liver bleeding time (BT) was also measured before injury. An uncontrolled hemorrhage was created by a longitudinal splenic incision and the abdomen was closed. Rabbits were resuscitated with Hextend solution (25 mL/kg) to return blood pressure to baseline and monitored for 2 hours or until death at which time blood loss was measured. Warfarin-induced coagulopathy increased BT, PT, and aPTT. TEG showed increased reaction (R) and clot formation (K) times and marked decrease in clotting rate (alpha angle and Vmax). Hemodilution hypothermia coagulopathy increased only BT and aPTT, and decreased the clotting rate (alpha angle and Vmax) and strength of the clot. After injury, blood losses were higher in coagulopathic rabbits (W = 54.6 +/- 4.2 and HH = 51.1 +/- 8.9 mL/kg) than in normal rabbits (30.6 +/- 12.4 mL/kg) and resulted in 86%, 100%, and 0% death, respectively. BT and Vmax consistently predicted coagulopathic bleeding and death in all animals. Although satisfactory in warfarin-induced coagulopathy, PT was not a valid screening test for dilutional and hypothermic coagulopathy. BT and TEG measurements of blood clotting rate are better indicators of coagulopathic bleeding

  15. Cardiac regeneration therapy: connections to cardiac physiology.

    Science.gov (United States)

    Takehara, Naofumi; Matsubara, Hiroaki

    2011-12-01

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

  16. Deep geothermics

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The hot-dry-rocks located at 3-4 km of depth correspond to low permeable rocks carrying a large amount of heat. The extraction of this heat usually requires artificial hydraulic fracturing of the rock to increase its permeability before water injection. Hot-dry-rocks geothermics or deep geothermics is not today a commercial channel but only a scientific and technological research field. The Soultz-sous-Forets site (Northern Alsace, France) is characterized by a 6 degrees per meter geothermal gradient and is used as a natural laboratory for deep geothermal and geological studies in the framework of a European research program. Two boreholes have been drilled up to 3600 m of depth in the highly-fractured granite massif beneath the site. The aim is to create a deep heat exchanger using only the natural fracturing for water transfer. A consortium of german, french and italian industrial companies (Pfalzwerke, Badenwerk, EdF and Enel) has been created for a more active participation to the pilot phase. (J.S.). 1 fig., 2 photos

  17. Deep Vein Thrombosis

    Science.gov (United States)

    Deep vein thrombosis, or DVT, is a blood clot that forms in a vein deep in the body. Most deep vein ... the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem ...

  18. A novel hypothermic machine perfusion system using a LifePort Kidney Transporter for the preservation of rat liver

    Science.gov (United States)

    Zeng, Cheng; Hu, Xiaoyan; Wang, Yanfeng; Zeng, Xianpeng; Xiong, Yan; Li, Ling; Ye, Qifa

    2018-01-01

    The protective mechanisms for liver preservation associated with hypothermic machine perfusion (HMP) remain unclear. However, the lack of a common and portable HMP system for rat livers limits the study of HMP. The present study aimed to develop a novel, modified HMP system using a LifePort Kidney Transporter for preserving rat livers. A simple ‘Y’ shunt combined with a pressoreceptor for flow and pressure regulation was adapted to perfuse rat livers via the portal vein continuously using a LifePort Kidney Transporter under its ‘prime mode’ setting. An electronic scale was installed under the liver container to calculate the portal inflow according to the association with weight, density and volume of the perfusate. A total of 10 rat livers underwent 6 h of HMP using histidine-tryptophan-ketoglutarate solution enriched with acridine orange (AO) and propidium iodide (PI). The perfusion status of HMP was assessed by comparison of AO+PI-positive cell count in core region (CR) and peripheral region (PR) of rat liver under fluorescence microscopy. The dynamics (inflow, pressure and intrahepatic resistance of perfusion) were assessed to identify whether this system met the demands for HMP of rat livers. Biochemical [alanine transaminase (ALT), lactate dehydrogenase (LDH) and endothelin levels] and histological parameters (sinusoidal dilatation, endothelial cell detachment and vacuolization) were measured to determine cellular damage associated with HMP. No significant difference was observed between the CR and PR according to the comparison of the AO+PI-positive cell count, which indicated that complete perfusion was achieved. Intrahepatic resistance significantly decreased during the initial 3 h of HMP (P<0.01), but remained stable during the final 3 h. ALT and LDH levels significantly increased over the 6 h HMP duration: ALT (0 h, 42.67±5.81 U/l; 3 h, 90.67±6.74 U/l; 6 h, 164.33±7.31 U/l; P<0.01) and LDH (0 h, 492.90±90.20 U/l; 3 h, 973.53±97.4; 6 h, 1

  19. Cardiac sodium channelopathies

    NARCIS (Netherlands)

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

    2010-01-01

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

  20. Deep smarts.

    Science.gov (United States)

    Leonard, Dorothy; Swap, Walter

    2004-09-01

    When a person sizes up a complex situation and rapidly comes to a decision that proves to be not just good but brilliant, you think, "That was smart." After you watch him do this a few times, you realize you're in the presence of something special. It's not raw brainpower, though that helps. It's not emotional intelligence, either, though that, too, is often involved. It's deep smarts. Deep smarts are not philosophical--they're not"wisdom" in that sense, but they're as close to wisdom as business gets. You see them in the manager who understands when and how to move into a new international market, in the executive who knows just what kind of talk to give when her organization is in crisis, in the technician who can track a product failure back to an interaction between independently produced elements. These are people whose knowledge would be hard to purchase on the open market. Their insight is based on know-how more than on know-what; it comprises a system view as well as expertise in individual areas. Because deep smarts are experienced based and often context specific, they can't be produced overnight or readily imported into an organization. It takes years for an individual to develop them--and no time at all for an organization to lose them when a valued veteran walks out the door. They can be taught, however, with the right techniques. Drawing on their forthcoming book Deep Smarts, Dorothy Leonard and Walter Swap say the best way to transfer such expertise to novices--and, on a larger scale, to make individual knowledge institutional--isn't through PowerPoint slides, a Web site of best practices, online training, project reports, or lectures. Rather, the sage needs to teach the neophyte individually how to draw wisdom from experience. Companies have to be willing to dedicate time and effort to such extensive training, but the investment more than pays for itself.

  1. Anesthesia for coronary artery bypass grafting with hypothermic cardiopulmonary bypass in a patient with a A2B negative Blood Group

    Directory of Open Access Journals (Sweden)

    M Toufan

    2008-03-01

    Full Text Available A2B negative is one of rare subgroups of ABO blood group system. Herein, we report a 59-year-old male patientwho was candidate for coronary artery bypass grafting surgery (CABG due to coronary artery stenosis. The patient`s blood group was reported as AB negative in routine laboratory, and because of doubtful result, a complementary test confirmed his blood group as A2B negative. The consultant hematologist recommended reserving either negative A2B packed red blood cell (PRBC or if unavailable O- blood group. After induction of anesthesia three units of patient’s own blood were collected and replaced by colloid solution. The patient underwentCABG with hypothermic cardiopulmonary bypass. The collected autologous blood units were transfused at the end of operation. The patient received one unit of A2B- homologous PRBC in the postoperative period, and was discharged without any reaction to transfusion.

  2. Stable transmission and transcription of newfoundland ocean pout type III fish antifreeze protein (AFP) gene in transgenic mice and hypothermic storage of transgenic ovary and testis.

    Science.gov (United States)

    Bagis, Haydar; Aktoprakligil, Digdem; Mercan, Hande Odaman; Yurdusev, Nevzat; Turgut, Gazi; Sekmen, Sakir; Arat, Sezen; Cetin, Seyfettin

    2006-11-01

    Here we describe the generation of transgenic mice carrying type III fish antifreeze protein (AFP) gene and evaluate whether AFP type III protects transgenic mouse ovaries and testes from hypothermic storage. AFPs exist in many different organisms. In fish, AFPs protect the host from freezing at temperatures below the colligative freezing point by adsorbing to the surface of nucleating ice crystals and inhibiting their growth. The transgenic expression of AFP holds great promise for conferring freeze-resistant plant and animal species. AFP also exhibits a potential for the cryopreservation of tissues and cells. In this study, we have generated 42 founder mice harboring the Newfoundland ocean pout (OP5A) type III AFP transgene and established one transgenic line (the line #6). This study demonstrated that AFP gene construct has been stably transmitted to the mouse progeny in the F3 generations in the line #6. Furthermore, the presence of AFP transcripts was confirmed by RT-PCR analysis on cDNAs from liver, kidney, ovarian, and testis tissues of the mouse from F3 generation in this line. These results indicate that ocean pout type III AFP gene could be integrated and transmitted to the next generation and stably transcribed in transgenic mice. In histological analysis of testis and ovarian tissues of nontransgenic control and AFP transgenic mice it has been shown that both tissues of AFP transgenic mice were protected from hypothermic storage (+4 degrees C). The AFP III transgenic mice obtained for the first time in this study would be useful for investigating the biological functions of AFP in mammalian systems and also its potential role in cryopreservation.

  3. Avoiding Late Cardiac Effects of Radiation of Treatment of Breast Cancer by Simple Respiratory Maneuvers

    National Research Council Canada - National Science Library

    Lu, Hsiao-Ming

    2003-01-01

    .... This technique is based on the findings that holding one's breast after a deep inspiration can significantly reduce the volume of cardiac tissue in the treatment fields and thus reduce long-term...

  4. Cardiac gated ventilation

    Science.gov (United States)

    Hanson, C. William, III; Hoffman, Eric A.

    1995-05-01

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

  5. Shivering and rewarming after cardiac surgery: comparison of ventilator circuits with humidifier and heated wires to heat and moisture exchangers.

    Science.gov (United States)

    McEvoy, M T; Carey, T J

    1995-07-01

    Detrimental physiologic effects of shivering in the cardiac surgery patient have been well documented. Rewarming techniques have been compared, with noted differences in the incidence of shivering. Ventilator circuits have not been examined independently from other rewarming variables. To compare heated wire humidification circuits with heat and moisture exchanger circuits on the incidence of shivering and speed and pattern of rewarming in mechanically ventilated patients. A prospective, descriptive, correlational study was done on 140 adult cardiac surgery patients in a university teaching medical center. All subjects underwent cardiac surgical procedures with hypothermic cardiopulmonary bypass. Subjects were randomized to humidified, heated wire circuits (n = 70) or heat and moisture exchanger circuits (n = 70). Heated water blankets were used on all patients. Mean intensive care unit admission temperature was 35.28 degrees C. No statistical differences were found in preoperative, demographic, or operative course data between treatment and control groups. Shivering was more common in the heat and moisture exchanger group than in the heated wire group. In our analysis, the only variable associated with shivering was the type of ventilator circuit. Patients using heated wire systems rewarmed more rapidly and had significantly higher temperatures than did patients using heat and moisture exchangers. These data suggest that use of heated wire humidified ventilator circuits with heated water blankets in adult cardiac surgery patients significantly reduces the incidence of shivering and results in a more rapid return to normothermia.

  6. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

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

  7. Crystalloid vs. hypertonic crystalloid-colloid solutions for induction of mild therapeutic hypothermia after experimental cardiac arrest.

    Science.gov (United States)

    Miclescu, Adriana; Sharma, Hari Shanker; Wiklund, Lars

    2013-02-01

    To compare cerebral and hemodynamic consequences of different volumes of cold acetated Ringer's solution or cold hypertonic saline dextran administered in order to achieve mild hypothermia after cardiac arrest (CA) in a pig model of experimental cardiopulmonary resuscitation (CPR). Using an experimental pig model of 12 min CA (followed by 8 min CPR or no resuscitation) we compared four groups of piglets: a control group, a normothermic group and two groups with different solutions administered for induction of hypothermia. The control group of 5 piglets underwent 12 min CA without subsequent CPR, after which the brain of the animals was removed immediately. After restoration of spontaneous circulation (ROSC) the resuscitated piglets were randomized into a normothermic group (NT group=10), and two hypothermic groups that received cold infusions of either 30 mL/kg acetated Ringer's solution (Much fluid group, M, n=10) or 3mL/kg hypertonic saline dextran solution (Less fluid group, L, n=10), respectively, administered during 30 min. Additional external cooling with ice packs was used in hypothermic groups. Sixty or 180min after ROSC the experiment was terminated. Immediately after arrest the brain was removed for histological analyses. The median time to reach the target core temperature of 34 °C after ROSC was 51.5±7.8 min in L group and 48.8±8.6 min in M group. Less cerebral tissue content of water (psmall volumes of cold hypertonic crystalloid-colloids is less as effective as crystalloid's induced hypothermia in mitigating brain injury after cardiac arrest. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  8. Deep breathing after surgery

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000440.htm Deep breathing after surgery To use the sharing features on ... way to do so is by doing deep breathing exercises. Deep breathing keeps your lungs well-inflated ...

  9. Cardiac sodium channelopathies.

    Science.gov (United States)

    Amin, Ahmad S; Asghari-Roodsari, Alaleh; Tan, Hanno L

    2010-07-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (INa) during phase 0 of the cardiac action potential. The importance of INa for normal cardiac electrical activity is reflected by the high incidence of arrhythmias in cardiac sodium channelopathies, i.e., arrhythmogenic diseases in patients with mutations in SCN5A, the gene responsible for the pore-forming ion-conducting alpha-subunit, or in genes that encode the ancillary beta-subunits or regulatory proteins of the cardiac sodium channel. While clinical and genetic studies have laid the foundation for our understanding of cardiac sodium channelopathies by establishing links between arrhythmogenic diseases and mutations in genes that encode various subunits of the cardiac sodium channel, biophysical studies (particularly in heterologous expression systems and transgenic mouse models) have provided insights into the mechanisms by which INa dysfunction causes disease in such channelopathies. It is now recognized that mutations that increase INa delay cardiac repolarization, prolong action potential duration, and cause long QT syndrome, while mutations that reduce INa decrease cardiac excitability, reduce electrical conduction velocity, and induce Brugada syndrome, progressive cardiac conduction disease, sick sinus syndrome, or combinations thereof. Recently, mutation-induced INa dysfunction was also linked to dilated cardiomyopathy, atrial fibrillation, and sudden infant death syndrome. This review describes the structure and function of the cardiac sodium channel and its various subunits, summarizes major cardiac sodium channelopathies and the current knowledge concerning their genetic background and underlying molecular mechanisms, and discusses recent advances in the discovery of mutation-specific therapies in the management of these channelopathies.

  10. Hyperplastic Cardiac Sarcoma Recurrence

    Directory of Open Access Journals (Sweden)

    Masood A. Shariff

    2015-01-01

    Full Text Available Primary cardiac sarcomas are rare tumors with a median survival of 6–12 months. Data suggest that an aggressive multidisciplinary approach may improve patient outcome. We present the case of a male who underwent resection of cardiac sarcoma three times from the age of 32 to 34. This report discusses the malignant nature of cardiac sarcoma and the importance of postoperative multidisciplinary care.

  11. Giant cardiac myxoma.

    Science.gov (United States)

    Barlis, Peter; Lim, Eu Jin; Gow, Paul J; Seevanayagam, Siven; Calafiore, Paul; Chan, Robert K

    2007-10-01

    Although cardiac myxomas remain an uncommon group of malignancies, they are the most common form of primary cardiac tumour. Clinical presentations can be varied with local cardiac haemodynamic consequences, valvular insufficiency or even embolic phenomena. We present a case of a 46-year-old man with chronic abdominal pain and discuss a number of diagnostic challenges that were confronted up until a definitive diagnosis of cardiac myxoma was made. The resultant outcome was excellent with the patient achieving complete recovery from long term disabling symptoms.

  12. Cardiac event monitors

    Science.gov (United States)

    ... ECG) - ambulatory; Continuous electrocardiograms (EKGs); Holter monitors; Transtelephonic event monitors ... attached. You can carry or wear a cardiac event monitor up to 30 days. You carry the ...

  13. DeepPy: Pythonic deep learning

    DEFF Research Database (Denmark)

    Larsen, Anders Boesen Lindbo

    This technical report introduces DeepPy – a deep learning framework built on top of NumPy with GPU acceleration. DeepPy bridges the gap between highperformance neural networks and the ease of development from Python/NumPy. Users with a background in scientific computing in Python will quickly...

  14. DeepPy: Pythonic deep learning

    OpenAIRE

    Larsen, Anders Boesen Lindbo

    2016-01-01

    This technical report introduces DeepPy – a deep learning framework built on top of NumPy with GPU acceleration. DeepPy bridges the gap between highperformance neural networks and the ease of development from Python/NumPy. Users with a background in scientific computing in Python will quickly be able to understand and change the DeepPy codebase as it is mainly implemented using high-level NumPy primitives. Moreover, DeepPy supports complex network architectures by letting the user compose mat...

  15. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.

    2013-01-01

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

  16. [Advances in cardiac pacing].

    Science.gov (United States)

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

    2012-01-01

    This article contains a review of the current status of remote monitoring and follow-up involving cardiac pacing devices and of the latest developments in cardiac resynchronization therapy. In addition, the most important articles published in the last year are discussed. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  17. Acebutolol in Cardiac Arrhythmias

    African Journals Online (AJOL)

    1974-04-20

    Apr 20, 1974 ... the cardiac output at rest and on exercise is not altered by the administration of acebutolol, and in patients with coronary artery disease, intravenous acebutolol produces a small fall in cardiac index, stroke index and in the parameters which are used to measure left ventricular. contractilityYo. We have used ...

  18. Cardiac Catheterization (For Kids)

    Science.gov (United States)

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

  19. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

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

  20. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

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

  1. Sudden cardiac death

    Directory of Open Access Journals (Sweden)

    Neeraj Parakh

    2015-01-01

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

  2. Electromechanical vortex filaments during cardiac fibrillation

    Science.gov (United States)

    Christoph, J.; Chebbok, M.; Richter, C.; Schröder-Schetelig, J.; Bittihn, P.; Stein, S.; Uzelac, I.; Fenton, F. H.; Hasenfuß, G.; Gilmour, R. F., Jr.; Luther, S.

    2018-03-01

    The self-organized dynamics of vortex-like rotating waves, which are also known as scroll waves, are the basis of the formation of complex spatiotemporal patterns in many excitable chemical and biological systems. In the heart, filament-like phase singularities that are associated with three-dimensional scroll waves are considered to be the organizing centres of life-threatening cardiac arrhythmias. The mechanisms that underlie the onset, maintenance and control of electromechanical turbulence in the heart are inherently three-dimensional phenomena. However, it has not previously been possible to visualize the three-dimensional spatiotemporal dynamics of scroll waves inside cardiac tissues. Here we show that three-dimensional mechanical scroll waves and filament-like phase singularities can be observed deep inside the contracting heart wall using high-resolution four-dimensional ultrasound-based strain imaging. We found that mechanical phase singularities co-exist with electrical phase singularities during cardiac fibrillation. We investigated the dynamics of electrical and mechanical phase singularities by simultaneously measuring the membrane potential, intracellular calcium concentration and mechanical contractions of the heart. We show that cardiac fibrillation can be characterized using the three-dimensional spatiotemporal dynamics of mechanical phase singularities, which arise inside the fibrillating contracting ventricular wall. We demonstrate that electrical and mechanical phase singularities show complex interactions and we characterize their dynamics in terms of trajectories, topological charge and lifetime. We anticipate that our findings will provide novel perspectives for non-invasive diagnostic imaging and therapeutic applications.

  3. Greedy Deep Dictionary Learning

    OpenAIRE

    Tariyal, Snigdha; Majumdar, Angshul; Singh, Richa; Vatsa, Mayank

    2016-01-01

    In this work we propose a new deep learning tool called deep dictionary learning. Multi-level dictionaries are learnt in a greedy fashion, one layer at a time. This requires solving a simple (shallow) dictionary learning problem, the solution to this is well known. We apply the proposed technique on some benchmark deep learning datasets. We compare our results with other deep learning tools like stacked autoencoder and deep belief network; and state of the art supervised dictionary learning t...

  4. A method for calculating the gas volume proportions and inhalation temperature of inert gas mixtures allowing reaching normothermic or hypothermic target body temperature in the awake rat

    Directory of Open Access Journals (Sweden)

    Jacques H Abraini

    2017-01-01

    Full Text Available The noble gases xenon (Xe and helium (He are known to possess neuroprotective properties. Xe is considered the golden standard neuroprotective gas. However, Xe has a higher molecular weight and lower thermal conductivity and specific heat than those of nitrogen, the main diluent of oxygen (O2 in air, conditions that could impair or at least reduce the intrinsic neuroprotective properties of Xe by increasing the critical care patient's respiratory workload and body temperature. In contrast, He has a lower molecular weight and higher thermal conductivity and specific heat than those of nitrogen, but is unfortunately far less potent than Xe at providing neuroprotection. Therefore, combining Xe with He could allow obtaining, depending on the gas inhalation temperature and composition, gas mixtures with neutral or hypothermic properties, the latter being advantageous in term of neuroprotection. However, calculating the thermal properties of a mixture, whatever the substances – gases, metals, rubbers, etc. – is not trivial. To answer this question, we provide a graphical method to assess the volume proportions of Xe, He and O2 that a gas mixture should contain, and the inhalation temperature to which it should be administered to allow a clinician to maintain the patient at a target body temperature.

  5. A method for calculating the gas volume proportions and inhalation temperature of inert gas mixtures allowing reaching normothermic or hypothermic target body temperature in the awake rat.

    Science.gov (United States)

    Abraini, Jacques H; David, Hélène N; Blatteau, Jean-Éric; Risso, Jean Jacques; Vallée, Nicolas

    2017-01-01

    The noble gases xenon (Xe) and helium (He) are known to possess neuroprotective properties. Xe is considered the golden standard neuroprotective gas. However, Xe has a higher molecular weight and lower thermal conductivity and specific heat than those of nitrogen, the main diluent of oxygen (O2) in air, conditions that could impair or at least reduce the intrinsic neuroprotective properties of Xe by increasing the critical care patient's respiratory workload and body temperature. In contrast, He has a lower molecular weight and higher thermal conductivity and specific heat than those of nitrogen, but is unfortunately far less potent than Xe at providing neuroprotection. Therefore, combining Xe with He could allow obtaining, depending on the gas inhalation temperature and composition, gas mixtures with neutral or hypothermic properties, the latter being advantageous in term of neuroprotection. However, calculating the thermal properties of a mixture, whatever the substances - gases, metals, rubbers, etc . - is not trivial. To answer this question, we provide a graphical method to assess the volume proportions of Xe, He and O2 that a gas mixture should contain, and the inhalation temperature to which it should be administered to allow a clinician to maintain the patient at a target body temperature.

  6. Beneficial Effect of Short Pretransplant Period of Hypothermic Pulsatile Perfusion of the Warm-Ischemic Kidney after Cold Storage: Experimental Study.

    Science.gov (United States)

    Lázaro, Alberto; Humanes, Blanca; Jado, Juan Carlos; Mojena, Marina; González-Nicolás, María Ángeles; Del Cañizo, Juan Francisco; Tejedor, Alberto; Lledó-García, Enrique

    2016-01-01

    Warm ischemia (WI) produces a significant deleterious effect in potential kidney grafts. Hypothermic machine perfusion (HMP) seems to improve immediate graft function after transplant. Our aim was to analyze the effect of short pretransplant periods of pulsatile HMP on histology and renal injury in warm-ischemic kidneys. Twelve minipigs were used. WI was achieved in the right kidney by applying a vascular clamp for 45 min. After nephrectomy, autotransplant was performed following one of two strategies: cold storage of the kidneys or cold storage combined with perfusion in pulsatile HMP. The graft was removed early to study renal morphology, inflammation (fibrosis), and apoptosis. Proinflammatory activity and fibrosis were less pronounced after cold storage of the kidneys with HMP than after cold storage only. The use of HMP also decreased apoptosis compared with cold storage only. The detrimental effects on cells of an initial and prolonged period of WI seem to improve with a preservation protocol that includes a short period of pulsatile HMP after cold storage and immediately before the transplant, in comparison with cold storage only.

  7. Imaging for cardiac electrophysiology

    Directory of Open Access Journals (Sweden)

    Benoit Desjardins

    2016-11-01

    Full Text Available Clinical cardiac electrophysiology is the study of the origin and treatment of arrhythmia. There has been considerable recent development in this field, where imaging has had a transformational impact. In this invited review, we offer a global overview of the most important developments in the use of imaging in cardiac electrophysiology. We first describe the radiological imaging modalities involved in cardiac electrophysiology, to assess cardiac anatomy, function and scar. We then introduce an imaging modality with which readers are probably unfamiliar (electroanatomical mapping [EAM], but which is routinely used by electrophysiologists to plan and guide cardiac mapping and cardiac ablation therapy by catheter, a therapy which can reduce or even cure arrhythmia. We identify the limitations of EAM and describe how radiological imaging modalities can complement this technique. We then describe and illustrate how imaging has helped the diagnosis of arrhythmogenic conditions, and how imaging is used to plan and guide clinical cardiac electrophysiologic procedures and assess their results and complications. We focus on the two most common arrhythmias for which imaging has the greatest impact: atrial fibrillation and ventricular tachycardia.

  8. Cardiac tumors: echo assessment

    Directory of Open Access Journals (Sweden)

    Rekha Mankad MD

    2016-12-01

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

  9. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt

    2012-01-01

    cardiac rehabilitation programme. Methods: From 1 September 2002 to 31 December 2005, 388 first-incidence MI patients ≤75 years were hospitalised. Register check for newly hospitalised MI patients, screening interview, and systematic referral were conducted by a project nurse. Patients were referred...... to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  10. Cardiac Procedures and Surgeries

    Science.gov (United States)

    ... the Procedure Does A stent is a wire mesh tube used to prop open an artery during ... a Heart Attack • Heart Attack Tools & Resources • Support Network Heart Attack Tools & Resources My Cardiac Coach What ...

  11. Defining the Cardiac Fibroblast

    Science.gov (United States)

    Ivey, Malina J.; Tallquist, Michelle D.

    2017-01-01

    Cardiac fibrosis remains an important health concern, but the study of fibroblast biology has been hindered by a lack of effective means for identifying and tracking fibroblasts. Recent advances in fibroblast-specific lineage tags and reporters have permitted a better understanding of these cells. After injury multiple cell types have been implicated as the source for extracellular matrix producing cells, but emerging studies suggest that resident cardiac fibroblasts contribute substantially to the remodeling process. In this review, we discuss recent findings regarding cardiac fibroblast origin and identity. Our understanding of cardiac fibroblast biology and fibrosis is still developing and will expand profoundly in the next few years, with many of the recent findings regarding fibroblast gene expression and behavior laying down the groundwork for interpreting the purpose and utility of these cells before and after injury. PMID:27746422

  12. Cardiac Catheterization (For Parents)

    Science.gov (United States)

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

  13. Cardiac Catheterization (For Teens)

    Science.gov (United States)

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

  14. The accuracy of PiCCO® in measuring cardiac output in patients under therapeutic hypothermia: Comparison with transthoracic echocardiography.

    Science.gov (United States)

    Souto Moura, T; Aguiar Rosa, S; Germano, N; Cavaco, R; Sequeira, T; Alves, M; Papoila, A L; Bento, L

    2018-03-01

    Invasive cardiac monitoring using thermodilution methods such as PiCCO® is widely used in critically ill patients and provides a wide range of hemodynamic variables, including cardiac output (CO). However, in post-cardiac arrest patients subjected to therapeutic hypothermia, the low body temperature possibly could interfere with the technique. Transthoracic Doppler echocardiography (ECHO) has long proved its accuracy in estimating CO, and is not influenced by temperature changes. To assess the accuracy of PiCCO® in measuring CO in patients under therapeutic hypothermia, compared with ECHO. Thirty paired COECHO/COPiCCO measurements were analyzed in 15 patients subjected to hypothermia after cardiac arrest. Eighteen paired measurements were obtained at under 36°C and 12 at ≥36°C. A value of 0.5l/min was considered the maximum accepted difference between the COECHO and COPiCCO values. Under conditions of normothermia (≥36°C), the mean difference between COECHO and COPiCCO was 0.030 l/min, with limits of agreement (-0.22, 0.28) - all of the measurements differing by less than 0.5 l/min. In situations of hypothermia (<36°C), the mean difference in CO measurements was -0.426 l/min, with limits of agreement (-1.60, 0.75), and only 44% (8/18) of the paired measurements fell within the interval (-0.5, 0.5). The calculated temperature cut-off point maximizing specificity was 35.95°C: above this temperature, specificity was 100%, with a false-positive rate of 0%. The results clearly show clinically relevant discordance between COECHO and COPiCCO at temperatures of <36°C, demonstrating the inaccuracy of PiCCO® for cardiac output measurements in hypothermic patients. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  15. Cardiac biomarkers in Neonatology

    OpenAIRE

    Vijlbrief, D.C.

    2015-01-01

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

  16. Cardiac imaging in adults

    International Nuclear Information System (INIS)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority

  17. Cardiac imaging in adults

    Energy Technology Data Exchange (ETDEWEB)

    Jaffe, C.C.

    1987-01-01

    This book approaches adult cardiac disease from the correlative imaging perspective. It includes chest X-rays and angiographs, 2-dimensional echocardiograms with explanatory diagrams for clarity, plus details on digital radiology, nuclear medicine techniques, CT and MRI. It also covers the normal heart, valvular heart disease, myocardial disease, pericardial disease, bacterial endocarditis, aortic aneurysm, cardiac tumors, and congenital heart disease of the adult. It points out those aspects where one imaging technique has significant superiority.

  18. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  19. Therapeutic Hypothermia for Asphyxial Out-of-Hospital Cardiac Arrest Due to Drowning: A Systematic Review of Case Series and Case Reports.

    Science.gov (United States)

    Suen, K-F; Leung, Reynold; Leung, Ling-Pong

    2017-12-01

    The objective of this review was to summarize published evidence of the effectiveness of therapeutic hypothermia in patients with drowning-associated asphyxial out-of-hospital cardiac arrest (OHCA) and to explore any preliminary favorable factors in the management of therapeutic hypothermia to improve survival and neurological outcome. Drowning may result in asphyxial OHCA or hypothermic OHCA, but the former does not provide any potential neuroprotective effect as the latter may do. Electronic literature searches of Ovid Medline, Embase, Cochrane Library, and Scopus were performed for all years from inception to July 2016. Primary studies in the form of case reports, letters to the editor, and others with higher quality are included, but guidelines, reviews, editorials, textbook chapters, conference abstracts, and nonhuman studies are excluded. Non-English articles are excluded. Relevant studies are then deemed eligible if the drowning OHCA patient's initial temperature was above 28°C, which implies asphyxial cardiac arrest, and intentional therapeutic hypothermia was instituted. Because of the narrow scope of interest and strict definition of the condition, limited studies addressed it, and no randomized controlled trials (RCT) could be selected. Thirteen studies covering 35 patients are included. No quantitative synthesis, assessment of study quality, or assessment of bias was performed. It is conjectured that extended therapeutic hypothermia of 48-72 hours might help prevent reperfusion injury during the intermediate phase of postcardiac arrest care to benefit patients of drowning-associated asphyxial OHCA, but this finding only serves as preliminary observation for future research. No conclusive recommendation could be made regarding the duration of and the time of onset of therapeutic hypothermia. Future research should put effort on RCT, particularly the effect of extended duration of 48-72 hours. Important parameters should be reported in detail. Asphyxial

  20. Deep Incremental Boosting

    OpenAIRE

    Mosca, Alan; Magoulas, George D

    2017-01-01

    This paper introduces Deep Incremental Boosting, a new technique derived from AdaBoost, specifically adapted to work with Deep Learning methods, that reduces the required training time and improves generalisation. We draw inspiration from Transfer of Learning approaches to reduce the start-up time to training each incremental Ensemble member. We show a set of experiments that outlines some preliminary results on some common Deep Learning datasets and discuss the potential improvements Deep In...

  1. Deep Space Telecommunications

    Science.gov (United States)

    Kuiper, T. B. H.; Resch, G. M.

    2000-01-01

    The increasing load on NASA's deep Space Network, the new capabilities for deep space missions inherent in a next-generation radio telescope, and the potential of new telescope technology for reducing construction and operation costs suggest a natural marriage between radio astronomy and deep space telecommunications in developing advanced radio telescope concepts.

  2. Cardiac radiology: centenary review.

    Science.gov (United States)

    de Roos, Albert; Higgins, Charles B

    2014-11-01

    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  3. Benign neonatal deep hypothermia in rodents and its relations to hibernation.

    Science.gov (United States)

    Hill, Richard W

    2017-07-01

    The neonates of many rodent species survive deep hypothermia (T b  = 0-8 °C). In key respects, this hypothermia is more akin to hibernation than was thought during much of the twentieth century, indicating that studies of neonatal hypothermia may usefully supplement studies of hibernation in understanding evolved tissue adaptations to near-freezing T b . To clarify evolutionary diversity in neonatal survival of deep hypothermia, neonates of six species or strains were subjected to a standardized procedure: exposure for 2.5 h to test T b s followed by autoresuscitation. Mus and Peromyscus differed dramatically, the lowest T b survived by all ages studied (3-10 days) being 7-8 °C in Mus and 0-1 °C in Peromyscus. There was, however, no evidence of intrageneric plasticity because feral and laboratory Mus were identical, and Peromyscus species with cold- and warm-climate distribution ranges were identical. When neonates survive deep hypothermia, a key question is whether the experience is benign, meaning neonates tolerate hypothermia. To test the benign nature of deep hypothermia, neonates of Peromyscus leucopus were exposed four times (3 h each) to T b  = 1-2 °C when 3-10 days old; controls were same-sex siblings not hypothermia exposed. When 74 such sibling pairs were exposed after weaning to predation by screech owls, the hypothermia-treated and control siblings did not differ in which was caught first. Based on study of deaths in 253 sibling pairs prior to weaning while under parental care, parents cared for hypothermia-treated siblings as attentively as controls. The results indicate that the experience of multiple neonatal deep-hypothermic episodes is benign in P. leucopus.

  4. What Is Deep Vein Thrombosis?

    Science.gov (United States)

    ... To Health Topics / Deep Vein Thrombosis Deep Vein Thrombosis Leer en español What Is Deep vein thrombosis ( ... life-threatening problems if not treated. Deep Vein Thrombosis Only about half of the people who have ...

  5. Deep learning with Python

    CERN Document Server

    Chollet, Francois

    2018-01-01

    DESCRIPTION Deep learning is applicable to a widening range of artificial intelligence problems, such as image classification, speech recognition, text classification, question answering, text-to-speech, and optical character recognition. Deep Learning with Python is structured around a series of practical code examples that illustrate each new concept introduced and demonstrate best practices. By the time you reach the end of this book, you will have become a Keras expert and will be able to apply deep learning in your own projects. KEY FEATURES • Practical code examples • In-depth introduction to Keras • Teaches the difference between Deep Learning and AI ABOUT THE TECHNOLOGY Deep learning is the technology behind photo tagging systems at Facebook and Google, self-driving cars, speech recognition systems on your smartphone, and much more. AUTHOR BIO Francois Chollet is the author of Keras, one of the most widely used libraries for deep learning in Python. He has been working with deep neural ...

  6. Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

    OpenAIRE

    Dolansky, Mary A.; Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

    2011-01-01

    Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity wal...

  7. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  8. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  9. Cardiac optogenetics : using light to monitor cardiac physiology

    NARCIS (Netherlands)

    Koopman, Charlotte D.|info:eu-repo/dai/nl/41375491X; Zimmermann, Wolfram-Hubertus; Knöpfel, Thomas; de Boer, Teun P.|info:eu-repo/dai/nl/30481878X

    2017-01-01

    Our current understanding of cardiac excitation and its coupling to contraction is largely based on ex vivo studies utilising fluorescent organic dyes to assess cardiac action potentials and signal transduction. Recent advances in optogenetic sensors open exciting new possibilities for cardiac

  10. Cardiac output measurement

    Directory of Open Access Journals (Sweden)

    Andreja Möller Petrun

    2014-02-01

    Full Text Available In recent years, developments in the measuring of cardiac output and other haemodynamic variables are focused on the so-called minimally invasive methods. The aim of these methods is to simplify the management of high-risk and haemodynamically unstable patients. Due to the need of invasive approach and the possibility of serious complications the use of pulmonary artery catheter has decreased. This article describes the methods for measuring cardiac output, which are based on volume measurement (Fick method, indicator dilution method, pulse wave analysis, Doppler effect, and electrical bioimpedance.

  11. Quantitative cardiac computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, M.; Dueber, C.; Wolff, P.; Erbel, R.; Hoffmann, T.

    1985-06-01

    The scope and limitations of quantitative cardiac CT have been evaluated in a series of experimental and clinical studies. The left ventricular muscle mass was estimated by computed tomography in 19 dogs (using volumetric methods, measurements in two axes and planes and reference volume). There was good correlation with anatomical findings. The enddiastolic volume of the left ventricle was estimated in 22 patients with cardiomyopathies; using angiography as a reference, CT led to systematic under-estimation. It is also shown that ECG-triggered magnetic resonance tomography results in improved visualisation and may be expected to improve measurements of cardiac morphology.

  12. Mechanisms of Cardiac Regeneration

    Science.gov (United States)

    Uygur, Aysu; Lee, Richard T.

    2016-01-01

    Adult humans fail to regenerate their hearts following injury, and this failure to regenerate myocardium is a leading cause of heart failure and death worldwide. Although all adult mammals appear to lack significant cardiac regeneration potential, some vertebrates can regenerate myocardium throughout life. In addition, new studies indicate that mammals have cardiac regeneration potential during development and very soon after birth. The mechanisms of heart regeneration among model organisms, including neonatal mice, appear remarkably similar. Orchestrated waves of inflammation, matrix deposition and remodeling, and cardiomyocyte proliferation are commonly seen in heart regeneration models. Understanding why adult mammals develop extensive scarring instead of regeneration is a crucial goal for regenerative biology. PMID:26906733

  13. Direct Multitype Cardiac Indices Estimation via Joint Representation and Regression Learning.

    Science.gov (United States)

    Xue, Wufeng; Islam, Ali; Bhaduri, Mousumi; Li, Shuo

    2017-10-01

    Cardiac indices estimation is of great importance during identification and diagnosis of cardiac disease in clinical routine. However, estimation of multitype cardiac indices with consistently reliable and high accuracy is still a great challenge due to the high variability of cardiac structures and the complexity of temporal dynamics in cardiac MR sequences. While efforts have been devoted into cardiac volumes estimation through feature engineering followed by a independent regression model, these methods suffer from the vulnerable feature representation and incompatible regression model. In this paper, we propose a semi-automated method for multitype cardiac indices estimation. After the manual labeling of two landmarks for ROI cropping, an integrated deep neural network Indices-Net is designed to jointly learn the representation and regression models. It comprises two tightly-coupled networks, such as a deep convolution autoencoder for cardiac image representation, and a multiple output convolution neural network for indices regression. Joint learning of the two networks effectively enhances the expressiveness of image representation with respect to cardiac indices, and the compatibility between image representation and indices regression, thus leading to accurate and reliable estimations for all the cardiac indices. When applied with five-fold cross validation on MR images of 145 subjects, Indices-Net achieves consistently low estimation error for LV wall thicknesses (1.44 ± 0.71 mm) and areas of cavity and myocardium (204 ± 133 mm 2 ). It outperforms, with significant error reductions, segmentation method (55.1% and 17.4%), and two-phase direct volume-only methods (12.7% and 14.6%) for wall thicknesses and areas, respectively. These advantages endow the proposed method a great potential in clinical cardiac function assessment.

  14. Motion of the esophagus due to cardiac motion.

    Directory of Open Access Journals (Sweden)

    Jacob Palmer

    Full Text Available When imaging studies (e.g. CT are used to quantify morphological changes in an anatomical structure, it is necessary to understand the extent and source of motion which can give imaging artifacts (e.g. blurring or local distortion. The objective of this study was to assess the magnitude of esophageal motion due to cardiac motion. We used retrospective electrocardiogram-gated contrast-enhanced computed tomography angiography images for this study. The anatomic region from the carina to the bottom of the heart was taken at deep-inspiration breath hold with the patients' arms raised above their shoulders, in a position similar to that used for radiation therapy. The esophagus was delineated on the diastolic phase of cardiac motion, and deformable registration was used to sequentially deform the images in nearest-neighbor phases among the 10 cardiac phases, starting from the diastolic phase. Using the 10 deformation fields generated from the deformable registration, the magnitude of the extreme displacements was then calculated for each voxel, and the mean and maximum displacement was calculated for each computed tomography slice for each patient. The average maximum esophageal displacement due to cardiac motion for all patients was 5.8 mm (standard deviation: 1.6 mm, maximum: 10.0 mm in the transverse direction. For 21 of 26 patients, the largest esophageal motion was found in the inferior region of the heart; for the other patients, esophageal motion was approximately independent of superior-inferior position. The esophagus motion was larger at cardiac phases where the electrocardiogram R-wave occurs. In conclusion, the magnitude of esophageal motion near the heart due to cardiac motion is similar to that due to other sources of motion, including respiratory motion and intra-fraction motion. A larger cardiac motion will result into larger esophagus motion in a cardiac cycle.

  15. Improved prognosis after using mild hypothermia to treat cardiorespiratory arrest due to a cardiac cause: comparison with a control group.

    Science.gov (United States)

    Castrejón, Sergio; Cortés, Marcelino; Salto, María L; Benittez, Luiz C; Rubio, Rafael; Juárez, Miriam; López de Sá, Esteban; Bueno, Héctor; Sánchez, Pedro L; Fernández Avilés, Francisco

    2009-07-01

    Patients who survive a cardiac arrest have a poor short-term prognosis in terms of mortality and neurological function. The use of mild hypothermia has been investigated in only a few randomized studies, but appears to be effective for treating these patients. The aim of this study was to investigate the effect of this treatment on survival and neurological outcomes. We compared mild hypothermia and usual treatment in patients who had experienced a prolonged cardiac arrest due to ventricular fibrillation or tachycardia and who showed signs of neurological damage. Patient were divided into two groups: a control group of 28 patients and a group of 41 patients who were treated with hypothermia. Patients were assessed at discharge and at 6 months. There was no significant difference between the two groups in baseline characteristics, including those of the cardiac arrest, or in the time to treatment. At discharge, neurological status was good in 18 patients (43.9%) in the hypothermia group but in only five (17.9%) in the control group (risk ratio=2.46; 95% confidence interval, 1.11-3.98; P=.029). At 6 months after discharge, neurological status was found to be good in 19 patients (46.3%) in the treatment group and six (21.4%) in the control group (risk ratio=2.16; 95% confidence interval, 1.05-3.36; P=.038). The effect of hypothermia may have been affected by various confounding factors. Our findings demonstrate that hypothermic treatment after cardiac arrest prolonged by ventricular fibrillation or tachycardia helps improve the prognosis of anoxic encephalopathy.

  16. Neonatal cardiac emergencies

    African Journals Online (AJOL)

    Neonatal cardiac emergencies. The neonatal period is one that fills many generalists with fear – this article will help to dispel these concerns. George A Comitis, MB ChB, DCH (SA), DA (SA), FCPaed (SA), Cert Cardiology (SA) Paed. Consultant, Paediatric Cardiology Service of the Western Cape, Red Cross War Memorial ...

  17. Nonexercise cardiac stress testing

    International Nuclear Information System (INIS)

    Vacek, J.L.; Baldwin, T.

    1989-01-01

    Many patients who require evaluation for coronary artery disease are unable to undergo exercise stress testing because of physiologic or psychological limitations. Drs Vacek and Baldwin describe three alternative methods for assessment of cardiac function in these patients, all of which have high levels of diagnostic sensitivity and specificity. 23 references

  18. Cardiac magnetic resonance imaging

    African Journals Online (AJOL)

    2011-03-06

    Mar 6, 2011 ... Bruce Spottiswoode has a BSc in Electrical Engineering from the University of the Witwatersrand and a PhD in Biomedical Engineering on cardiac MRI from the. University of Cape Town. He has worked on developing electronics for the CSIR, on MRI image reconstruction for Siemens, and on X-ray imaging ...

  19. Sudden cardiac death

    DEFF Research Database (Denmark)

    Hougen, H P; Valenzuela, Antonio Jesus Sanchez; Lachica, E

    1992-01-01

    The study deals with the comparison of morphological, histochemical and biochemical methods applied to the detection of myocardial infarction in 150 medico-legal autopsies performed at the Institute of Forensic Pathology in Copenhagen. The study also included an NBT (formazan) test of cardiac cross...

  20. Cardiac magnetic resonance imaging

    African Journals Online (AJOL)

    2011-03-06

    Mar 6, 2011 ... Cardiac magnetic resonance imaging. Cardiovascular magnetic resonance imaging is becoming a routine diagnostic technique. BRUCE s sPOTTiswOOdE, PhD. MRC/UCT Medical Imaging Research Unit, University of Cape Town, and Division of Radiology, Stellenbosch University. Bruce Spottiswoode ...

  1. Post cardiac injury syndrome

    DEFF Research Database (Denmark)

    Nielsen, S L; Nielsen, F E

    1991-01-01

    The post-pericardiotomy syndrome is a symptom complex which is similar in many respects to the post-myocardial infarction syndrome and these are summarized under the diagnosis of the Post Cardiac Injury Syndrome (PCIS). This condition, which is observed most frequently after open heart surgery...

  2. Problems of Cold Agglutinins in Cardiac Surgery: How to Manage Cardiopulmonary Bypass and Myocardial Protection

    Directory of Open Access Journals (Sweden)

    Kambiz Alizadeh

    2014-02-01

    Full Text Available Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB. Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M autoantibodies to red blood cells, which activateat varying levels of hypothermia, can cause catastrophic hemagglutination,microvascular thrombosis, or hemolysis. Management of anesthesia in these patients includes strict maintenance of normothermia. Patients scheduled for the surgery requiring cardiopulmonary bypass present significant challenges. Use of systemic hypothermia may be contraindicated, and cold cardioplegia solutions may precipitate intracoronary hemagglutination with consequent thrombosis, ischemia, or infarction. Management of CPB andmyocardial protection requires individualized planning. We describea case of MV repair and CABG in a patient with high titercold agglutinins and high thermal amplitude for antibody activation.Normothermic CPB and continuous warm blood cardioplegia weresuccessfully used.

  3. IBM Deep Learning Service

    OpenAIRE

    Bhattacharjee, Bishwaranjan; Boag, Scott; Doshi, Chandani; Dube, Parijat; Herta, Ben; Ishakian, Vatche; Jayaram, K. R.; Khalaf, Rania; Krishna, Avesh; Li, Yu Bo; Muthusamy, Vinod; Puri, Ruchir; Ren, Yufei; Rosenberg, Florian; Seelam, Seetharami R.

    2017-01-01

    Deep learning driven by large neural network models is overtaking traditional machine learning methods for understanding unstructured and perceptual data domains such as speech, text, and vision. At the same time, the "as-a-Service"-based business model on the cloud is fundamentally transforming the information technology industry. These two trends: deep learning, and "as-a-service" are colliding to give rise to a new business model for cognitive application delivery: deep learning as a servi...

  4. Deep cascade learning

    OpenAIRE

    Marquez, Enrique, Salvador; Hare, Jonathon; Niranjan, Mahesan

    2018-01-01

    In this paper, we propose a novel approach for efficient training of deep neural networks in a bottom-up fashion using a layered structure. Our algorithm, which we refer to as Deep Cascade Learning, is motivated by the Cascade Correlation approach of Fahlman who introduced it in the context of perceptrons. We demonstrate our algorithm on networks of convolutional layers, though its applicability is more general. Such training of deep networks in a cascade, directly circumvents the well-know...

  5. Maternal cardiac metabolism in pregnancy

    Science.gov (United States)

    Liu, Laura X.; Arany, Zolt

    2014-01-01

    Pregnancy causes dramatic physiological changes in the expectant mother. The placenta, mostly foetal in origin, invades maternal uterine tissue early in pregnancy and unleashes a barrage of hormones and other factors. This foetal ‘invasion’ profoundly reprogrammes maternal physiology, affecting nearly every organ, including the heart and its metabolism. We briefly review here maternal systemic metabolic changes during pregnancy and cardiac metabolism in general. We then discuss changes in cardiac haemodynamic during pregnancy and review what is known about maternal cardiac metabolism during pregnancy. Lastly, we discuss cardiac diseases during pregnancy, including peripartum cardiomyopathy, and the potential contribution of aberrant cardiac metabolism to disease aetiology. PMID:24448314

  6. The pathogenesis of cardiac fibrosis.

    Science.gov (United States)

    Kong, Ping; Christia, Panagiota; Frangogiannis, Nikolaos G

    2014-02-01

    Cardiac fibrosis is characterized by net accumulation of extracellular matrix proteins in the cardiac interstitium, and contributes to both systolic and diastolic dysfunction in many cardiac pathophysiologic conditions. This review discusses the cellular effectors and molecular pathways implicated in the pathogenesis of cardiac fibrosis. Although activated myofibroblasts are the main effector cells in the fibrotic heart, monocytes/macrophages, lymphocytes, mast cells, vascular cells and cardiomyocytes may also contribute to the fibrotic response by secreting key fibrogenic mediators. Inflammatory cytokines and chemokines, reactive oxygen species, mast cell-derived proteases, endothelin-1, the renin/angiotensin/aldosterone system, matricellular proteins, and growth factors (such as TGF-β and PDGF) are some of the best-studied mediators implicated in cardiac fibrosis. Both experimental and clinical evidence suggests that cardiac fibrotic alterations may be reversible. Understanding the mechanisms responsible for initiation, progression, and resolution of cardiac fibrosis is crucial to design anti-fibrotic treatment strategies for patients with heart disease.

  7. Geochemistry of two contrasting deep fluids in the Sardinia microplate (western Mediterranean): Relationships with tectonics and heat sources

    Science.gov (United States)

    Paternoster, M.; Oggiano, G.; Sinisi, R.; Caracausi, A.; Mongelli, G.

    2017-04-01

    The Sardinia microplate in the western Mediterranean represents an ideal example for examining the relationship between fluid geochemistry, tectonic and heat sources in hydrothermal circuits. It consists of a portion of Variscan basement partly covered by sedimentary (mainly carbonate) and volcanic successions that record significant Permian to Pliocene geodynamic events within the southern European margin. The regional structure of the northern Sardinia is dominated by Tertiary ENE-WSW trending strike-slip and NNW-SSE trending normal faults, both capable of controlling deep and shallow fluid circulation. In this paper, results of a detailed geochemical investigation of waters and gases coming from a W-E trending section of central-north Sardinia are presented in order to explain the contrasting thermal and geochemical features of two - already known groups - of fluids. The Volcanic Logudoro Waters (VLW) is a group of cold to hypothermal Na-HCO3 waters characterised by high CO2 contents and mantle-derived He, that are localized in the volcanic-dominated Tertiary grabens. The He mantle signature within the VLW waters is associated with Plio-Pleistocene Quaternary volcanism where the outgassing of mantle-derived fluids is reasonably due recently active magma sources at depth. The currently active emission of mantle-derived gas linked to cold and hypothermal waters, provides evidence that the heat diffusion associated with the Plio-Pleistocene volcanism has already ended. In contrast, the Granite Variscan Basement Waters (GBW) group is characterised by hot-NaCl-rich waters, containing high concentrations of both dissolved N2 and radiogenic 4He. The high contribution of 4He produced by radiogenic decay of U and Th in the crust indicates a supply of radiogenic heat to the hydrothermal system localized within the granitic basement or in the tectonic contact between granite and Tertiary covers.

  8. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  9. Deep learning relevance

    DEFF Research Database (Denmark)

    Lioma, Christina; Larsen, Birger; Petersen, Casper

    2016-01-01

    train a Recurrent Neural Network (RNN) on existing relevant information to that query. We then use the RNN to "deep learn" a single, synthetic, and we assume, relevant document for that query. We design a crowdsourcing experiment to assess how relevant the "deep learned" document is, compared...

  10. Fetal cardiac assessment

    International Nuclear Information System (INIS)

    Greene, K.R.

    1983-01-01

    The better understanding of fetal cardiovascular physiology coupled with improved technology for non-invasive study of the fetus now enable much more detailed assessment of fetal cardiac status than by heart rate alone. Even the latter, relatively simple, measurement contains much more information than was previously realized. It is also increasingly clear that no single measurement will provide the answer to all clinical dilemmas either on cardiac function or the welfare of the fetus as a whole. There are obvious clinical advantages in measuring several variables from one signal and the measurement of heart rate, heart rate variation and waveform from the ECG in labour is a potentially useful combination. Systolic time intervals or flow measurements could easily be added or used separately by combining real-time and Doppler ultrasound probes

  11. Cardiac nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Gerson, M.C.

    1987-01-01

    The book begins with a review of the radionuclide methods available for evaluating cardiac perfusion and function. The authors discuss planar and tomographic thallium myocardial imaging, first-pass and equilibrium radionuclide angiography, and imaging with infarct-avid tracers. Several common but more specialized procedures are then reviewed: nonogemetric measurement of left ventricular volume, phase (Fourier) analysis, stroke volume ratio, right ventricular function, and diastolic function. A separate chapter is devoted to drug interventions and in particular the use of radionuclide ventriculography to monitor doxorubicin toxicity and therapy of congestive heart failure. The subsequent chapters provide a comprehensive guide to test selection, accuracy, and results in acute myocardial infarction, in postmyocardial infarction, in chronic coronary artery disease, before and after medical or surgical revascularization, in valvular heart disease, in cardiomyopathies, and in cardiac trauma.

  12. A risk-benefit assessment of aprotinin in cardiac surgical procedures.

    Science.gov (United States)

    Dobkowski, W B; Murkin, J M

    1998-01-01

    Aprotinin, a naturally occurring serine protease inhibitor, has found widespread application during cardiac surgical procedures as a consequence of its ability to decrease blood loss and transfusion requirements. While its efficacy in a variety of clinical situations associated with increased risk of blood loss has been well established, at the same time, various complications including anaphylaxis, renal insufficiency, graft closure and arterial thromboses have been reported in association with aprotinin administration. In order to more fully evaluate the risks and benefits associated with aprotinin usage, this review first of all examines the hazards associated with transfusion of blood and blood products. Consideration is then given to various alternatives to allogeneic transfusion, including autologous predonation, acute normovolemic hemodilution, perioperative cell salvage and intraoperative plasma sequestration. A critique of other available pharmacological therapies, specifically desmopressin, aminocaproic acid and tranexamic acid, reviewing their modes of action, efficacy and associated complications, is then made. The role of aprotinin in cardiac surgery is then discussed and its pharmacology, including consideration of its antifibrinolytic, platelet preserving and anti-inflammatory effects is reviewed. Finally, an analysis of potential complications associated with aprotinin administration is undertaken. Issues involving its influence on specific measures of anticoagulation, namely partial thromboplastin time and activated clotting time, and issues relating to graft patency, hypothermic circulatory arrest, renal function, and allergic reactions are analysed and interpreted. In summary, this review concludes that most of the risks associated with aprotinin administration primarily involve inadequate anticoagulation and those of developing an allergic reaction, particularly upon aproptinin re-exposure. The benefits of aproptinin to decrease blood loss and

  13. Molecular nuclear cardiac imaging

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Paeng, Jin Chul

    2004-01-01

    Molecular nuclear cardiac imaging has included Tc-99m Annexin imaging to visualize myocardial apoptosis, but is now usually associated with gene therapy and cell-based therapy. Cardiac gene therapy was not successful so far but cardiac reporter gene imaging was made possible using HSV-TK (herpes simplex virus thymidine kinase) and F-18 FHBG (fluoro-hydroxymethylbutyl guanine) or I-124 FIAU (fluoro-deoxyiodo-arabino-furanosyluracil). Gene delivery was performed by needle injection with or without catheter guidance. TK expression did not last longer than 2 weeks in myocardium. Cell-based therapy of ischemic heart or failing heart looks promising, but biodistribution and differentiation of transplanted cells are not known. Reporter genes can be transfected to the stem/progenitor cells and cells containing these genes can be transplanted to the recipients using catheter-based purging or injection. Repeated imaging should be available and if promoter are varied to let express reporter transgenes, cellular (trans)differentiation can be studied. NIS (sodium iodide symporter) or D2R receptor genes are promising in this aspect

  14. Cardiac morbidity risk and depression and anxiety: a disorder, symptom and trait analysis among cardiac surgery patients.

    Science.gov (United States)

    Tully, Phillip J; Pedersen, Susanne S; Winefield, Helen R; Baker, Robert A; Turnbull, Deborah A; Denollet, Johan

    2011-05-01

    The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity. Patients awaiting elective coronary artery bypass graft surgery (n=158; 20.9% female; 11.4% concomitant valve surgery; age M=64.7, SD=10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom Questionnaire and a measure of Type D personality traits. Postoperative cardiac morbidity was confirmed after surgery during the index hospitalization and included stroke,renal failure, ventilation>24 h, deep sternal wound infection, reoperation, arrhythmia and 30-day mortality at any location (n=59, 37.3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted analysis of personality traits revealed the NA component of Type D personality was associated with cardiac morbidity (OR=1.07, 95% CI 1.01-1.14, p=0.03). The Mood and Anxiety Symptom Questionnaire subscales were not associated with increased morbidity risk. Affective disorders, affective phenotypes, and personality traits were differentially associated with post-cardiac surgery morbidity outcomes independent of cardiac surgery morbidity risk factors. Concurrent investigation of depression and anxiety with respect to cardiac outcomes warrants further research. © 2011 Taylor & Francis

  15. Sleep disturbances after non-cardiac surgery

    DEFF Research Database (Denmark)

    Rosenberg, Jacob

    2001-01-01

    After major non-cardiac surgery sleep pattern is usually disturbed with initial suppression of rapid eye movement sleep with a subsequent rebound during the first post-operative week. Deep sleep is also suppressed for several days after the operation and subjective sleep quality is impaired....... The sleep disturbances seem to be related to the magnitude of trauma and thereby to the surgical stress response and/or post-operative opioid administration. Post-operative sleep disturbances may contribute to the development of early post-operative fatigue, episodic hypoxaemia, haemodynamic instability...... and altered mental status, all with a potential negative effect on post-operative outcome. Minimizing surgical trauma and avoiding or minimizing use of opioids for pain relief may prevent or reduce post-operative sleep disturbances. Post-operative sleep pattern represents an important research field, since...

  16. Dietary supplement of banana (Musa acuminata) peels hot-water extract to enhance the growth, anti-hypothermal stress, immunity and disease resistance of the giant freshwater prawn, Macrobrachium rosenbergii.

    Science.gov (United States)

    Rattanavichai, Wutti; Cheng, Winton

    2015-04-01

    In the present study, Macrobrachium rosenbergii were fed with diets containing extracts of banana, Musa acuminate, fruit's peel (banana peels extract, BPE) at 0, 1.0, 3.0 and 6.0 g kg(-1). The non-specific immune parameters, disease resistance and anti-hypothermal stress were evaluated at 2, 4, 8, 16 and 32 days of post feeding. Also, we demonstrated the percent weight gain (PWG), percent length gain (PLG), feeding efficiency (FE), and survival rate of giant freshwater prawn at 30, 60, 90, and 120 days of post feeding. The PWG, PLG, FE and survival rate of prawns fed at 0, 1.0, 3.0 and 6.0 g kg(-1) BPE-containing diets after 120 days were 69.5%, 75.4%, 77.8% and 83.3%; 21.8%, 23.6%, 27.8% and 33.9%; 0.60, 0.72, 0.75 and 0.90; and 55.4%, 62.2%, 62.3% and 75.3%, respectively. After 32 days of post feeding, a significant increase in total haemocyte count (THC), different haemocyte count (DHC), respiratory bursts (RBs), superoxide dismutase (SOD) activity, glutathione peroxidase (GPx) activity, phenoloxidase (PO) activity and transglutaminase (TG) activity, and meanwhile, a decreased haemolymph coagulation time was observed. Furthermore, phagocytic activity and clearance efficiency of prawns against Lactococcus garvieae infection were significantly increased. Prawns challenged with L. garvieae after 32 days of feeding at 1.0, 3.0 and 6.0 g kg(-1) had a significantly higher survival rate (33.3%, 40.0% and 56.7%) than those fed with the control diet. Subsequently, hypothermal (14 °C) stress was 43.4%, 50.0% and 50.0%, respectively. Altogether, we therefore recommend the dietary BPE administration at 6.0 g kg(-1) promotes growth, anti-hypothermal stress, and enhance immunity and resistance against L. garvieae in M. rosenbergii. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Deep learning in bioinformatics.

    Science.gov (United States)

    Min, Seonwoo; Lee, Byunghan; Yoon, Sungroh

    2017-09-01

    In the era of big data, transformation of biomedical big data into valuable knowledge has been one of the most important challenges in bioinformatics. Deep learning has advanced rapidly since the early 2000s and now demonstrates state-of-the-art performance in various fields. Accordingly, application of deep learning in bioinformatics to gain insight from data has been emphasized in both academia and industry. Here, we review deep learning in bioinformatics, presenting examples of current research. To provide a useful and comprehensive perspective, we categorize research both by the bioinformatics domain (i.e. omics, biomedical imaging, biomedical signal processing) and deep learning architecture (i.e. deep neural networks, convolutional neural networks, recurrent neural networks, emergent architectures) and present brief descriptions of each study. Additionally, we discuss theoretical and practical issues of deep learning in bioinformatics and suggest future research directions. We believe that this review will provide valuable insights and serve as a starting point for researchers to apply deep learning approaches in their bioinformatics studies. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Deep subsurface microbial processes

    Science.gov (United States)

    Lovley, D.R.; Chapelle, F.H.

    1995-01-01

    Information on the microbiology of the deep subsurface is necessary in order to understand the factors controlling the rate and extent of the microbially catalyzed redox reactions that influence the geophysical properties of these environments. Furthermore, there is an increasing threat that deep aquifers, an important drinking water resource, may be contaminated by man's activities, and there is a need to predict the extent to which microbial activity may remediate such contamination. Metabolically active microorganisms can be recovered from a diversity of deep subsurface environments. The available evidence suggests that these microorganisms are responsible for catalyzing the oxidation of organic matter coupled to a variety of electron acceptors just as microorganisms do in surface sediments, but at much slower rates. The technical difficulties in aseptically sampling deep subsurface sediments and the fact that microbial processes in laboratory incubations of deep subsurface material often do not mimic in situ processes frequently necessitate that microbial activity in the deep subsurface be inferred through nonmicrobiological analyses of ground water. These approaches include measurements of dissolved H2, which can predict the predominant microbially catalyzed redox reactions in aquifers, as well as geochemical and groundwater flow modeling, which can be used to estimate the rates of microbial processes. Microorganisms recovered from the deep subsurface have the potential to affect the fate of toxic organics and inorganic contaminants in groundwater. Microbial activity also greatly influences 1 the chemistry of many pristine groundwaters and contributes to such phenomena as porosity development in carbonate aquifers, accumulation of undesirably high concentrations of dissolved iron, and production of methane and hydrogen sulfide. Although the last decade has seen a dramatic increase in interest in deep subsurface microbiology, in comparison with the study of

  19. Blunt and Penetrating Cardiac Trauma.

    Science.gov (United States)

    Bellister, Seth A; Dennis, Bradley M; Guillamondegui, Oscar D

    2017-10-01

    Patients with traumatic cardiac injuries can present with wide variability in their severity of illness. The most severe will present in cardiac arrest, whereas the most benign may be altogether asymptomatic; most will fall somewhere in between. Management of cardiac injuries largely depends on mechanism of injury and patient physiology. Understanding the spectrum of injuries and their associated manifestations can help providers react more quickly and initiate potentially life-saving therapies more efficiently when time is critical. This article discusses the workup and management of both blunt and penetrating cardiac injuries. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Cardiac Dysautonomia in Huntington's Disease.

    Science.gov (United States)

    Abildtrup, Mads; Shattock, Michael

    2013-01-01

    Huntington's disease is a fatal, hereditary, neurodegenerative disorder best known for its clinical triad of progressive motor impairment, cognitive deficits and psychiatric disturbances. Although a disease of the central nervous system, mortality surveys indicate that heart disease is a leading cause of death. The nature of such cardiac abnormalities remains unknown. Clinical findings indicate a high prevalence of autonomic nervous system dysfunction - dysautonomia - which may be a result of pathology of the central autonomic network. Dysautonomia can have profound effects on cardiac health, and pronounced autonomic dysfunction can be associated with neurogenic arrhythmias and sudden cardiac death. Significant advances in the knowledge of neural mechanisms in cardiac disease have recently been made which further aid our understanding of cardiac mortality in Huntington's disease. Even so, despite the evidence of aberrant autonomic activity the potential cardiac consequences of autonomic dysfunction have been somewhat ignored. In fact, underlying cardiac abnormalities such as arrhythmias have been part of the exclusion criteria in clinical autonomic Huntington's disease research. A comprehensive analysis of cardiac function in Huntington's disease patients is warranted. Further experimental and clinical studies are needed to clarify how the autonomic nervous system is controlled and regulated in higher, central areas of the brain - and how these regions may be altered in neurological pathology, such as Huntington's disease. Ultimately, research will hopefully result in an improvement of management with the aim of preventing early death in Huntington's disease from cardiac causes.

  1. The frequency and pattern of cardiac autonomic neuropathy(CAN) in ...

    African Journals Online (AJOL)

    The frequency and pattern of cardiac autonomic neuropathy(CAN) in Type 2 DM patients in a diabetic clinic in Enugu South-east Nigeria. ... was determined using a battery of 5 non-invasive tests which include; Heart rate response (HRR) to Valsalva manoeuvre, HRR to deep breathing, HRR to standing, Resting heart rate, ...

  2. Deep Water Survey Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The deep water biodiversity surveys explore and describe the biodiversity of the bathy- and bentho-pelagic nekton using Midwater and bottom trawls centered in the...

  3. Deep Learning in Neuroradiology.

    Science.gov (United States)

    Zaharchuk, G; Gong, E; Wintermark, M; Rubin, D; Langlotz, C P

    2018-02-01

    Deep learning is a form of machine learning using a convolutional neural network architecture that shows tremendous promise for imaging applications. It is increasingly being adapted from its original demonstration in computer vision applications to medical imaging. Because of the high volume and wealth of multimodal imaging information acquired in typical studies, neuroradiology is poised to be an early adopter of deep learning. Compelling deep learning research applications have been demonstrated, and their use is likely to grow rapidly. This review article describes the reasons, outlines the basic methods used to train and test deep learning models, and presents a brief overview of current and potential clinical applications with an emphasis on how they are likely to change future neuroradiology practice. Facility with these methods among neuroimaging researchers and clinicians will be important to channel and harness the vast potential of this new method. © 2018 by American Journal of Neuroradiology.

  4. Deep Space Atomic Clock

    Data.gov (United States)

    National Aeronautics and Space Administration — The Deep Space Atomic Clock (DSAC) project will develop a small, low mass atomic clock based on mercury-ion trap technology and demonstrate it in space providing the...

  5. Deep Space Habitat Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The Deep Space Habitat was closed out at the end of Fiscal Year 2013 (September 30, 2013). Results and select content have been incorporated into the new Exploration...

  6. The beta 2-adrenoceptor agonists clenbuterol and salbutamol enhance the hypothermic action of 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) in mice by a central mechanism.

    Science.gov (United States)

    Green, A R; Goodwin, G M; De Souza, R J; Heal, D J

    1986-01-01

    The hypothermic response of mice to injection of 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) was enhanced by injection of the beta 2-adrenoceptor agonist clenbuterol with an ED50 of 0.4 mg/kg. This effect of clenbuterol is through a central mechanism since salbutamol, a beta 2-adrenoceptor agonist with poor penetration into the brain, had no effect at a dose of 2 mg/kg, whereas intracerebroventricular injection of clenbuterol (3 micrograms) or salbutamol (2 micrograms), produced a significant enhancement. The enhancing effect of clenbuterol was unaffected by pretreatment with the beta 1-adrenoceptor antagonist metoprolol but was totally antagonised by the beta 2-adrenoceptor antagonist ICI 118,551 and to a lesser extent by butoxamine. Clenbuterol therefore enhances the function of the presynaptic 5-HT1 receptor through a beta 2-adrenoceptor mechanism.

  7. Pathogenesis of deep endometriosis.

    Science.gov (United States)

    Gordts, Stephan; Koninckx, Philippe; Brosens, Ivo

    2017-12-01

    The pathophysiology of (deep) endometriosis is still unclear. As originally suggested by Cullen, change the definition "deeper than 5 mm" to "adenomyosis externa." With the discovery of the old European literature on uterine bleeding in 5%-10% of the neonates and histologic evidence that the bleeding represents decidual shedding, it is postulated/hypothesized that endometrial stem/progenitor cells, implanted in the pelvic cavity after birth, may be at the origin of adolescent and even the occasionally premenarcheal pelvic endometriosis. Endometriosis in the adolescent is characterized by angiogenic and hemorrhagic peritoneal and ovarian lesions. The development of deep endometriosis at a later age suggests that deep infiltrating endometriosis is a delayed stage of endometriosis. Another hypothesis is that the endometriotic cell has undergone genetic or epigenetic changes and those specific changes determine the development into deep endometriosis. This is compatible with the hereditary aspects, and with the clonality of deep and cystic ovarian endometriosis. It explains the predisposition and an eventual causal effect by dioxin or radiation. Specific genetic/epigenetic changes could explain the various expressions and thus typical, cystic, and deep endometriosis become three different diseases. Subtle lesions are not a disease until epi(genetic) changes occur. A classification should reflect that deep endometriosis is a specific disease. In conclusion the pathophysiology of deep endometriosis remains debated and the mechanisms of disease progression, as well as the role of genetics and epigenetics in the process, still needs to be unraveled. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Deep Time Contagion

    Directory of Open Access Journals (Sweden)

    Andy Weir

    2012-11-01

    Full Text Available An artist from London researching the effects of deprioritised subjectivity and contemporary art, Weir presents acoustic recordings made in deep geological repository sites. Repurposing these sites from their typical use as storage space for nuclear waste, Weir addresses the extra-human scale of Deep Time through sonic-fiction. Inhumanly enduring and impinging upon humanity largely imperceptibly, what agency—at what scale—is present?

  9. Auxiliary Deep Generative Models

    DEFF Research Database (Denmark)

    Maaløe, Lars; Sønderby, Casper Kaae; Sønderby, Søren Kaae

    2016-01-01

    Deep generative models parameterized by neural networks have recently achieved state-of-the-art performance in unsupervised and semi-supervised learning. We extend deep generative models with auxiliary variables which improves the variational approximation. The auxiliary variables leave...... faster with better results. We show state-of-the-art performance within semi-supervised learning on MNIST (0.96%), SVHN (16.61%) and NORB (9.40%) datasets....

  10. Mathematics of Deep Learning

    OpenAIRE

    Vidal, Rene; Bruna, Joan; Giryes, Raja; Soatto, Stefano

    2017-01-01

    Recently there has been a dramatic increase in the performance of recognition systems due to the introduction of deep architectures for representation learning and classification. However, the mathematical reasons for this success remain elusive. This tutorial will review recent work that aims to provide a mathematical justification for several properties of deep networks, such as global optimality, geometric stability, and invariance of the learned representations.

  11. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  12. Temporal and spatial dispersion of human body temperature during deep hypothermia.

    Science.gov (United States)

    Opatz, O; Trippel, T; Lochner, A; Werner, A; Stahn, A; Steinach, M; Lenk, J; Kuppe, H; Gunga, H C

    2013-11-01

    Clinical temperature management remains challenging. Choosing the right sensor location to determine the core body temperature is a particular matter of academic and clinical debate. This study aimed to investigate the relationship of measured temperatures at different sites during surgery in deep hypothermic patients. In this prospective single-centre study, we studied 24 patients undergoing cardiothoracic surgery: 12 in normothermia, 3 in mild, and 9 in deep hypothermia. Temperature recordings of a non-invasive heat flux sensor at the forehead were compared with the arterial outlet temperature of a heart-lung machine, with the temperature on a conventional vesical bladder thermistor and, for patients undergoing deep hypothermia, with oesophageal temperature. Using a linear model for sensor comparison, the arterial outlet sensor showed a difference among the other sensor positions between -0.54 and -1.12°C. The 95% confidence interval ranged between 7.06 and 8.82°C for the upper limit and -8.14 and -10.62°C for the lower limit. Because of the hysteretic shape, the curves were divided into phases and fitted into a non-linear model according to time and placement of the sensors. During cooling and warming phases, a quadratic relationship could be observed among arterial, oesophageal, vesical, and cranial temperature recordings, with coefficients of determination ranging between 0.95 and 0.98 (standard errors of the estimate 0.69-1.12°C). We suggest that measured surrogate temperatures as indices of the cerebral temperature (e.g. vesical bladder temperature) should be interpreted with respect to the temporal and spatial dispersion during cooling and rewarming phases.

  13. Exercise-related cardiac arrest in cardiac rehabilitation - The ...

    African Journals Online (AJOL)

    Prescribed physical activity plays a major role in the rehabilitation of patients with coronary artery disease, and as with any other form of treatment its benefits must be weighed against its possible risks. This study attempted to establish the safety of cardiac rehabilitation as a medical intervention at the Johannesburg Cardiac ...

  14. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  15. CSI cardiac prevent 2015

    Directory of Open Access Journals (Sweden)

    S Ramakrishnan

    2015-01-01

    Full Text Available The CSI Cardiac Prevent 2015 was held at Hotel Taj Palace, New Delhi, on September 25-27, 2015. The major challenge was to create interest among cardiologists and physicians on preventive cardiology, a neglected area. The theme of the conference was "Innovations in Heart Disease Prevention.′′ This conference included "CSI at WHF Roadmap Workshop, Inauguration Ceremony, scientific program, plenary sessions, Nursing/Dietician track, Industry Exhibition, Social Events," Great India blood pressure Survey, and CSI Smart Heart App. A total of 848 delegates/faculties attended this conference against a total of 1140 people registered for the meeting.

  16. Single ventricle cardiac defect

    International Nuclear Information System (INIS)

    Eren, B.; Turkmen, N.; Fedakar, R.; Cetin, V.

    2010-01-01

    Single ventricle heart is defined as a rare cardiac abnormality with a single ventricle chamber involving diverse functional and physiological defects. Our case is of a ten month-old baby boy who died shortly after admission to the hospital due to vomiting and diarrhoea. Autopsy findings revealed cyanosis of finger nails and ears. Internal examination revealed; large heart, weighing 60 grams, single ventricle, without a septum and upper membranous part. Single ventricle is a rare pathology, hence, this paper aims to discuss this case from a medico-legal point of view. (author)

  17. Why & When Deep Learning Works: Looking Inside Deep Learnings

    OpenAIRE

    Ronen, Ronny

    2017-01-01

    The Intel Collaborative Research Institute for Computational Intelligence (ICRI-CI) has been heavily supporting Machine Learning and Deep Learning research from its foundation in 2012. We have asked six leading ICRI-CI Deep Learning researchers to address the challenge of "Why & When Deep Learning works", with the goal of looking inside Deep Learning, providing insights on how deep networks function, and uncovering key observations on their expressiveness, limitations, and potential. The outp...

  18. Cardiac hypertrophy in chick embryos induced by hypothermia

    International Nuclear Information System (INIS)

    Boehm, C.; Johnson, T.R.; Caston, J.D.; Przybylski, R.J.

    1987-01-01

    A decrease in incubation temperature from 38 to 32 0 C elicits a decrease in chicken embryo size and weight with concomitant heart enlargement if done after day 10 of incubation. When assayed at day 18 of incubation with the hypothermia started on day 11 or 14, evidence is presented that the heart enlargement is an hypertrophy with no detectable hyperplasia. Supporting data are presented for various physical parameters showing increases in heart wet and dry weight, volume, area, wall thickness, and cell size. There was little difference in DNA content and nuclear [ 3 H]thymidine labeling index between hearts of control and hypothermic embryos. Hearts of hypothermic embryos showed a slight increase in water content and considerable increases in RNA, protein, and glycogen content per unit DNA. The average size of polysomes isolated from hypothermic hearts was larger than that of polysomes isolated from controls. Microscopic studies showed no obvious increase in amount of capillary beds, connective tissue, and myocardial cells. Annulate lamellae were found only in myocardial cells of hypothermic embryos in sparse amounts and low frequency but always associated with large deposits of glycogen

  19. Cardiac sarcoplasmic reticulum

    International Nuclear Information System (INIS)

    Jacobson, M.S.; Ambudkar, I.S.; Young, E.P.; Naseem, S.M.; Heald, F.P.; Shamoo, A.E.

    1985-01-01

    The effect on the cardiac sarcoplasmic reticulum of an atherogenic (1% cholesterol) diet fed during the neonatal vs the juvenile period of life was studied in Yorkshire swine. Male piglets were randomly assigned at birth to 1 of 4 groups: group I (control), group II (lactation feeding), group III (juvenile period feeding) and group IV (lactation and juvenile feeding). All animals were killed at 55 weeks of age and cardiac sarcoplasmic reticulum (SR) isolated for assay of calcium uptake, Ca 2+ -Mg 2+ ATPase activity, and lipid analysis by thin-layer chromatography and gas chromatography. The amount of cholesterol/mg SR protein and the cholesterol/phospholipid ratio were higher in the animals fed during lactation (groups II and IV) and lower in those fed only during the juvenile period (group III). Phospholipid fatty acid patterns as measured by gas chromatography were unaltered in any group. Calcium uptake was markedly diminished in all experimental conditions: group II 47%, group III 65% and group IV 96%. Compared to the observed changes in calcium transport, the ATP hydrolytic activity was relatively less affected. Only in group IV a significant decrease (41%) was seen. Groups II and III show no change in ATP hydrolytic activity. The decrease in calcium uptake and altered cholesterol/phospholipid ratio without effect on ATP hydrolytic activity is consistent with an uncoupling of calcium transport related to the atherogenic diet in early life. (author)

  20. Detecting atrial fibrillation by deep convolutional neural networks.

    Science.gov (United States)

    Xia, Yong; Wulan, Naren; Wang, Kuanquan; Zhang, Henggui

    2018-02-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. The incidence of AF increases with age, causing high risks of stroke and increased morbidity and mortality. Efficient and accurate diagnosis of AF based on the ECG is valuable in clinical settings and remains challenging. In this paper, we proposed a novel method with high reliability and accuracy for AF detection via deep learning. The short-term Fourier transform (STFT) and stationary wavelet transform (SWT) were used to analyze ECG segments to obtain two-dimensional (2-D) matrix input suitable for deep convolutional neural networks. Then, two different deep convolutional neural network models corresponding to STFT output and SWT output were developed. Our new method did not require detection of P or R peaks, nor feature designs for classification, in contrast to existing algorithms. Finally, the performances of the two models were evaluated and compared with those of existing algorithms. Our proposed method demonstrated favorable performances on ECG segments as short as 5 s. The deep convolutional neural network using input generated by STFT, presented a sensitivity of 98.34%, specificity of 98.24% and accuracy of 98.29%. For the deep convolutional neural network using input generated by SWT, a sensitivity of 98.79%, specificity of 97.87% and accuracy of 98.63% was achieved. The proposed method using deep convolutional neural networks shows high sensitivity, specificity and accuracy, and, therefore, is a valuable tool for AF detection. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Health Instruction Packages: Cardiac Anatomy.

    Science.gov (United States)

    Phillips, Gwen; And Others

    Text, illustrations, and exercises are utilized in these five learning modules to instruct nurses, students, and other health care professionals in cardiac anatomy and functions and in fundamental electrocardiographic techniques. The first module, "Cardiac Anatomy and Physiology: A Review" by Gwen Phillips, teaches the learner to draw…

  2. Pediatric Cardiac Surgery In Eritrea.

    African Journals Online (AJOL)

    The teams consisted of volunteer physicians from Germany, Italy and Switzerland including cardiac surgeons, pediatric cardiologists, cardiac anesthesiologists, pediatric intensivists, perfusionists, and other nursing staff. Each mission has routinely included at least 18 health professionals of different category to maximize the.

  3. Diagnostic value of cardiac cineangiography

    International Nuclear Information System (INIS)

    Han, Man Chung; Yeon, Kyung Mo; Im, Chung Gie; Yoo, Shi Joon

    1979-01-01

    Cineangiography is essential and excellent tool for evaluation of anatomy and pathophysiology of heart disease. 114 cases of cardiac cineangiography were analyzed. The following conditions are easily interpreted and diagnosed accurately by cineangiography. 1. Valvular insufficiency, especially small amount. 2. Valve motion, shape analysis. 3. Detection of shunt. 4. Ventricle wall movement. 5. Complexed congenita cardiac anomaly. 6. Coronary artery stenosis.

  4. The Danish Cardiac Rehabilitation Database

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne

    2016-01-01

    AIM OF DATABASE: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). STUDY POPULATION: Hospitalized patients with CHD with stenosis on coronary angiography treated with percutane...

  5. Neuromuscular diseases after cardiac transplantation

    NARCIS (Netherlands)

    Mateen, Farrah J.; van de Beek, Diederik; Kremers, Walter K.; Daly, Richard C.; Edwards, Brooks S.; McGregor, Christopher G. A.; Wijdicks, Eelco F. M.

    2009-01-01

    BACKGROUND: Cardiac transplantation is a therapeutic option in end-stage heart failure. Peripheral nervous system (PNS) disease is known to occur in cardiac transplant recipients but has not been fully characterized. METHODS: This retrospective cohort review reports the PNS-related concerns of 313

  6. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani

    2014-01-01

    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  7. Cardiac changes in anorexia nervosa.

    Science.gov (United States)

    Spaulding-Barclay, Michael A; Stern, Jessica; Mehler, Philip S

    2016-04-01

    Introduction Anorexia nervosa is an eating disorder, which is associated with many different medical complications as a result of the weight loss and malnutrition that characterise this illness. It has the highest mortality rate of any psychiatric disorder. A large portion of deaths are attributable to the cardiac abnormalities that ensue as a result of the malnutrition associated with anorexia nervosa. In this review, the cardiac complications of anorexia nervosa will be discussed. A comprehensive literature review on cardiac changes in anorexia nervosa was carried out. There are structural, functional, and rhythm-type changes that occur in patients with anorexia nervosa. These become progressively significant as ongoing weight loss occurs. Cardiac changes are inherent to anorexia nervosa and they become more life-threatening and serious as the anorexia nervosa becomes increasingly severe. Weight restoration and attention to these cardiac changes are crucial for a successful treatment outcome.

  8. [Maternal cardiac arrhythmias in pregnancy].

    Science.gov (United States)

    Swiatkowska-Freund, Małgorzata; Ciach, Katarzyna; Kowalewska-Włas, Agnieszka; Preis, Krzysztof

    2005-12-01

    Perinatal care of women with cardiac arrhythmias is very important for every obstetrician. Maternal heart disease complicates 0.2 to 4% of pregnancies. The purpose of this study was to analyze the course of pregnancy, delivery and postpartum period pregnant women with cardiac arrhythmias We analyzed 14 pregnant women with cardiac arrhythmias. hospitalized in the Department of Obstetrics of Medical University of Gdańsk, 1998-2003. Time of delivery, weight and length of neonates in patients with cardiac arrhythmias was presented. Delivery and postpartum period were uncomplicated in all the patients and no stimulation was used. In two women with congenital complete atrio-ventricular block dicavital heart stimulator was applied. All patients and infants were discharged from hospital in good condition. We found no cardiological complications during pregnancy in patients with cardiac arrhythmias.

  9. Cardiac asystole in partial seizures.

    Science.gov (United States)

    Scott, C A; Fish, D R

    2000-06-01

    Literature review shows many anecdotal case reports of cardiac asystole in ictal recordings of partial seizures. We have reviewed our data from the last five years, of patients who are being assessed for epilepsy surgery and found 2 out of more than 1,500 complex partial seizures, recorded in 589 consecutive patients, showing a significant period of asystole (13 and 15 seconds). Our previous studies of cardiac and respiratory parameters during partial seizures showed that a central apnoea occurred in 39%. It is probable that sudden death during seizures is due to the interaction of both cardiac and respiratory irregularities. Although rare (occurrence cardiac asystole occurring in an epilepsy monitoring unit highlights the need for resuscitation equipment to be readily available and for trained nursing staff. Furthermore, it is important to recognize that the semiology of seizures may be affected by the consequences of secondary cardiac asystole.

  10. The effect of three different doses of tranexamic acid on blood loss after cardiac surgery with mild systemic hypothermia (32 degrees C).

    Science.gov (United States)

    Karski, J M; Dowd, N P; Joiner, R; Carroll, J; Peniston, C; Bailey, K; Glynn, M F; Teasdale, S J; Cheng, D C

    1998-12-01

    Prophylactic administration of tranexamic acid (TA), an antifibrinolytic agent, decreases bleeding after cardiac surgery with systemic hypothermia (25 degrees C to 29 degrees C). Warmer systemic temperatures during cardiopulmonary bypass (CPB) may reduce bleeding and thus alter the requirement for TA. The effect of three different doses of TA on bleeding after cardiac surgery with mild systemic hypothermia (32 degrees C) is evaluated. Double-blind, prospective, randomized study. University hospital. One hundred fifty adult patients undergoing aortocoronary bypass or valvular cardiac surgery. Patients received TA, 50 (n = 50), 100 (n = 50), or 150 (n = 50) mg/kg intravenously before CPB with mild systemic hypothermia. Blood loss through chest drains over 6, 12, and 24 hours after surgery and total hemoglobin loss were measured. Autotransfused blood, transfused banked blood and blood products, and coagulation profiles were measured. Analysis of variance on log-transformed data for blood loss and confidence intervals (CIs) of 0.95 were calculated and transformed to milliliters of blood. No patient was re-explored for bleeding. Blood loss at 6 hours was statistically greater in the 50-mg/kg group compared with the other two groups (p = 0.03; p = 0.02). Total hemoglobin loss was statistically greater in the 50-mg/kg group compared with the 150-mg/kg group (p = 0.04). There was no statistical difference in blood tranfusion rate or coagulation profiles among the three groups. However, preoperative hemoglobin level was statistically lower in the 150-mg/kg group compared with the other two groups (p = 0.01). Of the three doses of TA studied, the most efficacious and cost-effective dose to reduce bleeding after cardiac surgery with mild hypothermic systemic perfusion is 100 mg/kg.

  11. Deep Overbite Dan Cara Penanggulangannya

    OpenAIRE

    Siti Rofiah Nasution

    2008-01-01

    Masalah deep overbite dan seluruh dimensi vertikal harus dipertimbangkan pada setiap perawatan maloklusi. Deep overbite merupakan keadaan pada relasi sentrik di mana terdapat jarak vertikal yang besar antara kedua insisal insisivus rahang atas dan bawah dengan hubungan oklusal posterior yang normal. Berdasarkan etiologi deep overbite dapat dibedakan atas dua bagian besar yaitu deep overbite dentoalveolar (melibatkan gigi dan tulang alveolar) dan deep overbite skeletal (melibatkan gigi, tulang...

  12. Contemporary management and outcomes of acute type A aortic dissection: An analysis of the STS adult cardiac surgery database.

    Science.gov (United States)

    Lee, Teng C; Kon, Zachary; Cheema, Faisal H; Grau-Sepulveda, Maria V; Englum, Brian; Kim, Sunghee; Chaudhuri, Paramita S; Thourani, Vinod H; Ailawadi, Gorav; Hughes, G Chad; Williams, Matthew L; Brennan, J Matthew; Svensson, Lars; Gammie, James S

    2018-01-01

    Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension. The most common arterial cannulation strategies included femoral (36%), axillary (27%), and direct aortic (19%). The median perfusion and cross-clamp times were 181 and 102 min, respectively. The lowest temperature on bypass showed significant variation. Hypothermic circulatory arrest (HCA) was used in 78% of cases. Among those undergoing HCA, brain protection strategies included antegrade cerebral perfusion (31%), retrograde cerebral perfusion (25%), both (4%), and none (40%). Median HCA plus cerebral perfusion time was 40 min. Major complications included prolonged ventilation (53%), reoperation (19%), renal failure (18%), permanent stroke (11%), and paralysis (3%). Operative mortality was 17%. The median intensive care unit and hospital length of stays were 4.7 and 9.0 days, respectively. Among 640 centers, the median number of cases performed during the study period was three. Resuscitation, unresponsive state, cardiogenic shock, inotrope use, age >70, diabetes, and female sex were found to be independent predictors of mortality. These data describe contemporary patient characteristics, operative strategies, and outcomes for AAAD in North America. Mortality and morbidity for AAAD remain high. © 2018 Wiley Periodicals, Inc.

  13. Deep Learning from Crowds

    DEFF Research Database (Denmark)

    Rodrigues, Filipe; Pereira, Francisco Camara

    Over the last few years, deep learning has revolutionized the field of machine learning by dramatically improving the stateof-the-art in various domains. However, as the size of supervised artificial neural networks grows, typically so does the need for larger labeled datasets. Recently......, crowdsourcing has established itself as an efficient and cost-effective solution for labeling large sets of data in a scalable manner, but it often requires aggregating labels from multiple noisy contributors with different levels of expertise. In this paper, we address the problem of learning deep neural...... networks from crowds. We begin by describing an EM algorithm for jointly learning the parameters of the network and the reliabilities of the annotators. Then, a novel general-purpose crowd layer is proposed, which allows us to train deep neural networks end-to-end, directly from the noisy labels...

  14. Holography as deep learning

    Science.gov (United States)

    Gan, Wen-Cong; Shu, Fu-Wen

    Quantum many-body problem with exponentially large degrees of freedom can be reduced to a tractable computational form by neural network method [G. Carleo and M. Troyer, Science 355 (2017) 602, arXiv:1606.02318.] The power of deep neural network (DNN) based on deep learning is clarified by mapping it to renormalization group (RG), which may shed lights on holographic principle by identifying a sequence of RG transformations to the AdS geometry. In this paper, we show that any network which reflects RG process has intrinsic hyperbolic geometry, and discuss the structure of entanglement encoded in the graph of DNN. We find the entanglement structure of DNN is of Ryu-Takayanagi form. Based on these facts, we argue that the emergence of holographic gravitational theory is related to deep learning process of the quantum-field theory.

  15. Deep Dysgraphia in Turkish

    Directory of Open Access Journals (Sweden)

    Ilhan Raman

    2005-01-01

    Full Text Available Deep dysgraphic patients make semantic errors when writing to dictation and they cannot write nonwords. Extant reports of deep dysgraphia come from languages with relatively opaque orthographies. Turkish is a transparent orthography because the bidirectional mappings between phonology and orthography are completely predictable. We report BRB, a biscriptal Turkish-English speaker who has acquired dysgraphia characterised by semantic errors as well as effects of grammatical class and imageability on writing in Turkish. Nonword spelling is abolished. A similar pattern of errors is observed in English. BRB is the first report of acquired dysgraphia in a truly transparent writing system. We argue that deep dysgraphia results from damage to the mappings that are common to both languages between word meanings and orthographic representations.

  16. News on Deep Mixing

    Science.gov (United States)

    Lattanzio, John C.; Dearborn, Davis S. P.; Eggleton, Peter P.

    2008-04-01

    We briefly summarize the abundant observational evidence for the need of a ``deep mixing'' mechanism in first-ascent red-giant stars, and probably in AGB stars as well. By the term ``deep mixing'' we mean some mixing mechanism which operates in the radiative zone below the convective envelope, and which transports material from the convective region to hotter regions, near the top of the hydrogen shell, where nuclear burning may take place. We then discuss a recent discovery of deep-mixing caused by the burning of 3He following first dredge-up in low-mass stars. This is expected to be a thermohaline process and preliminary calculations show that it has many of the properties required to explain the observations.

  17. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    . The underlying posttranscriptional and posttranslational remodeling of the individual K(+) channels changes their activity and significance relative to each other, and they must be viewed together to understand their role in keeping a stable heart rhythm, also under menacing conditions like attacks of reentry......About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...... that they could constitute targets for new pharmacological treatment of atrial fibrillation. The interplay between the different K(+) channel subtypes in both atria and ventricle is dynamic, and a significant up- and downregulation occurs in disease states such as atrial fibrillation or heart failure...

  18. Cardiac Rehabilitation Series: Canada

    Science.gov (United States)

    Grace, Sherry L.; Bennett, Stephanie; Ardern, Chris I.; Clark, Alexander

    2015-01-01

    Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR Quality Indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally. PMID:24607018

  19. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

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

    2017-01-01

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

  20. Deep boreholes; Tiefe Bohrloecher

    Energy Technology Data Exchange (ETDEWEB)

    Bracke, Guido [Gesellschaft fuer Anlagen- und Reaktorsicherheit gGmbH Koeln (Germany); Charlier, Frank [NSE international nuclear safety engineering gmbh, Aachen (Germany); Geckeis, Horst [Karlsruher Institut fuer Technologie (Germany). Inst. fuer Nukleare Entsorgung; and others

    2016-02-15

    The report on deep boreholes covers the following subject areas: methods for safe enclosure of radioactive wastes, requirements concerning the geological conditions of possible boreholes, reversibility of decisions and retrievability, status of drilling technology. The introduction covers national and international activities. Further chapters deal with the following issues: basic concept of the storage in deep bore holes, status of the drilling technology, safe enclosure, geomechanics and stability, reversibility of decisions, risk scenarios, compliancy with safe4ty requirements and site selection criteria, research and development demand.

  1. Deep Learning Microscopy

    OpenAIRE

    Rivenson, Yair; Gorocs, Zoltan; Gunaydin, Harun; Zhang, Yibo; Wang, Hongda; Ozcan, Aydogan

    2017-01-01

    We demonstrate that a deep neural network can significantly improve optical microscopy, enhancing its spatial resolution over a large field-of-view and depth-of-field. After its training, the only input to this network is an image acquired using a regular optical microscope, without any changes to its design. We blindly tested this deep learning approach using various tissue samples that are imaged with low-resolution and wide-field systems, where the network rapidly outputs an image with rem...

  2. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  3. Cardiac syncope in pediatric patients.

    Science.gov (United States)

    Massin, Martial M; Malekzadeh-Milani, Sophie; Benatar, Avram

    2007-02-01

    To assess the epidemiology of cardiac syncope in children and evaluate the guidelines on its management. We analyzed the etiology to syncope and diagnostic workup in consecutive pediatric patients presenting with syncope in our emergency departments or cardiac outpatient clinics between 1997 and 2005, and who were subsequently diagnosed as having cardiac syncope. A primary cardiac cause was identified in 11 syncopal patients presenting to the emergency room and 14 patients to the cardiac clinic: supraventricular tachyarrhythmia in 9, ventricular tachyarrhythmia in 10, pacemaker dysfunction in 2, and isolated cases of sick sinus syndrome, hypoxic spell, hypertrophic cardiomyopathy, and primary pulmonary hypertension. Some elements suggested potential cardiac disease as a cause of syncope in all cases. The resting electrocardiogram and the echocardiogram were interpreted as positive and relevant to the diagnosis in 17 and 3 patients, respectively. Exercise electrocardiogram and Holter recording provided diagnostic information previously not seen on the resting electrocardiogram in six and three patients, respectively. Three children have died and one child has neurological sequelae following resuscitation. Our data support the premise that careful history taking with special focus on the events leading up to syncope, as well as a complete physical examination, can guide practitioners in discerning which syncopal children need further cardiac investigations. Copyright (c) 2007 Wiley Periodicals, Inc.

  4. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  5. Fetal cardiac rhabdomyoma: case report

    Directory of Open Access Journals (Sweden)

    Seyed Mostafa Ghavami

    2016-07-01

    Full Text Available Background: The primary manifestation of cardiac tumors in embryonic period is a very rare condition. Cardiac rhabdomyomas most frequently arise in the ventricular myocardium, they may also occur in the atria and the epicardial surface. In spite of its benign nature, the critical location of the tumor inside the heart can lead to lethal arrhythmias and chamber obstruction. Multiple rhabdomyomas are strongly associated with tuberous sclerosis which is associated with mental retardation and epilepsy of variable severity. Ultrasonography as a part of routine prenatal screening, is the best method for the diagnosis of cardiac rhabdomyomas. In the review of articles published in Iran, fetal cardiac rhabdomyoma was not reported. Case presentation: We report a case of cardiac rhabdomyoma on a 24-year-old gravid 1, referred to Day Medical Imaging Center for routine evaluation of fetal abnormalities at 31 weeks of her gestational age. Ultrasonographic examination displayed a homogenous echogenic mass (13×9mm, originating from the left ventricle of the fetal heart. It was a normal pregnancy without any specific complications. Other organs of the fetus were found normal and no cardiac abnormalities were appeared. No Pericardial fluid effusion was found. The parents did not have consanguineous marriage. They did not also have any specific disease such as tuberous sclerosis. Conclusion: The clinical features of cardiac rhabdomyomas vary widely, depending on the location, size, and number of tumors in the heart. Although cardiac rhabdomyoma is a benign tumor in many affected fetuses, an early prenatal diagnosis of the tumor is of great significance in making efficient planning and providing adequate follow up visits of the patients and the complications such as, heart failure and outlet obstruction of cardiac chambers.

  6. Cardiac cone-beam CT

    International Nuclear Information System (INIS)

    Manzke, Robert

    2005-01-01

    This doctoral thesis addresses imaging of the heart with retrospectively gated helical cone-beam computed tomography (CT). A thorough review of the CT reconstruction literature is presented in combination with a historic overview of cardiac CT imaging and a brief introduction to other cardiac imaging modalities. The thesis includes a comprehensive chapter about the theory of CT reconstruction, familiarizing the reader with the problem of cone-beam reconstruction. The anatomic and dynamic properties of the heart are outlined and techniques to derive the gating information are reviewed. With the extended cardiac reconstruction (ECR) framework, a new approach is presented for the heart-rate-adaptive gated helical cardiac cone-beam CT reconstruction. Reconstruction assessment criteria such as the temporal resolution, the homogeneity in terms of the cardiac phase, and the smoothness at cycle-to-cycle transitions are developed. Several reconstruction optimization approaches are described: An approach for the heart-rate-adaptive optimization of the temporal resolution is presented. Streak artifacts at cycle-to-cycle transitions can be minimized by using an improved cardiac weighting scheme. The optimal quiescent cardiac phase for the reconstruction can be determined automatically with the motion map technique. Results for all optimization procedures applied to ECR are presented and discussed based on patient and phantom data. The ECR algorithm is analyzed for larger detector arrays of future cone-beam systems throughout an extensive simulation study based on a four-dimensional cardiac CT phantom. The results of the scientific work are summarized and an outlook proposing future directions is given. The presented thesis is available for public download at www.cardiac-ct.net

  7. Acupuncture therapy related cardiac injury.

    Science.gov (United States)

    Li, Xue-feng; Wang, Xian

    2013-12-01

    Cardiac injury is the most serious adverse event in acupuncture therapy. The causes include needling chest points near the heart, the cardiac enlargement and pericardial effusion that will enlarge the projected area on the body surface and make the proper depth of needling shorter, and the incorrect needling method of the points. Therefore, acupuncture practitioners must be familiar with the points of the heart projected area on the chest and the correct needling methods in order to reduce the risk of acupuncture therapy related cardiac injury.

  8. Deep inelastic scattering

    International Nuclear Information System (INIS)

    Aubert, J.J.

    1982-01-01

    Deep inelastic lepton-nucleon interaction experiments are renewed. Singlet and non-singlet structure functions are measured and the consistency of the different results is checked. A detailed analysis of the scaling violation is performed in terms of the quantum chromodynamics predictions [fr

  9. Deep Vein Thrombosis

    Centers for Disease Control (CDC) Podcasts

    2012-04-05

    This podcast discusses the risk for deep vein thrombosis in long-distance travelers and ways to minimize that risk.  Created: 4/5/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 4/5/2012.

  10. Deep diode atomic battery

    International Nuclear Information System (INIS)

    Anthony, T.R.; Cline, H.E.

    1977-01-01

    A deep diode atomic battery is made from a bulk semiconductor crystal containing three-dimensional arrays of columnar and lamellar P-N junctions. The battery is powered by gamma rays and x-ray emission from a radioactive source embedded in the interior of the semiconductor crystal

  11. Teaching for Deep Learning

    Science.gov (United States)

    Smith, Tracy Wilson; Colby, Susan A.

    2007-01-01

    The authors have been engaged in research focused on students' depth of learning as well as teachers' efforts to foster deep learning. Findings from a study examining the teaching practices and student learning outcomes of sixty-four teachers in seventeen different states (Smith et al. 2005) indicated that most of the learning in these classrooms…

  12. Deep Trawl Dataset

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Otter trawl (36' Yankee and 4-seam net deepwater gear) catches from mid-Atlantic slope and canyons at 200 - 800 m depth. Deep-sea (200-800 m depth) flat otter trawls...

  13. The deep universe

    CERN Document Server

    Sandage, AR; Longair, MS

    1995-01-01

    Discusses the concept of the deep universe from two conflicting theoretical viewpoints: firstly as a theory embracing the evolution of the universe from the Big Bang to the present; and secondly through observations gleaned over the years on stars, galaxies and clusters.

  14. Deep Vein Thrombosis

    African Journals Online (AJOL)

    OWNER

    ABSTRACT. BACKGROUND: Deep vein thrombosis (DVT) is a cause of preventable morbidity and mortality in hospitalized surgical patients. The occurrence of the disease is related to presence of risk factors, which are related primarily to trauma, venous stasis and hyper-coagulability. DVT seems not to be taken seriously ...

  15. Deep Learning Policy Quantization

    NARCIS (Netherlands)

    van de Wolfshaar, Jos; Wiering, Marco; Schomaker, Lambertus

    2018-01-01

    We introduce a novel type of actor-critic approach for deep reinforcement learning which is based on learning vector quantization. We replace the softmax operator of the policy with a more general and more flexible operator that is similar to the robust soft learning vector quantization algorithm.

  16. Inverse correlation between cardiac injury and cardiac anxiety: A potential role for communication

    NARCIS (Netherlands)

    van Beek, M.H.C.T.; Voshaar, R.C.O.; van Deelen, F.M.; van Balkom, A.J.L.M.; Pop, G.; Speckens, A.E.M.

    2014-01-01

    Objective: General anxiety in cardiac patients is associated with worsened cardiac course. An acute coronary syndrome (ACS) might evoke specific cardiac anxiety. We explored the characteristics associated with cardiac anxiety in ACS patients. Methods: We assessed cardiac anxiety in 237 patients

  17. Inverse Correlation Between Cardiac Injury and Cardiac Anxiety A Potential Role for Communication

    NARCIS (Netherlands)

    van Beek, Maria H. C. T.; Oude Voshaar, Richard; van Deelen, Femke M.; van Balkom, Anton J. L. M.; Pop, Gheorghe; Speckens, Anne E. M.

    2014-01-01

    Objective: General anxiety in cardiac patients is associated with worsened cardiac course. An acute coronary syndrome (ACS) might evoke specific cardiac anxiety. We explored the characteristics associated with cardiac anxiety in ACS patients. Methods: We assessed cardiac anxiety in 237 patients

  18. Inverse correlation between cardiac injury and cardiac anxiety: a potential role for communication

    NARCIS (Netherlands)

    Beek, M.H.C.T. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J.L.M. van; Pop, G.A.; Speckens, A.E.M.

    2014-01-01

    OBJECTIVE: General anxiety in cardiac patients is associated with worsened cardiac course. An acute coronary syndrome (ACS) might evoke specific cardiac anxiety. We explored the characteristics associated with cardiac anxiety in ACS patients. METHODS: We assessed cardiac anxiety in 237 patients

  19. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson

    2008-11-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  20. Understanding traumatic blunt cardiac injury.

    Science.gov (United States)

    El-Menyar, Ayman; Al Thani, Hassan; Zarour, Ahmad; Latifi, Rifat

    2012-01-01

    Cardiac injuries are classified as blunt and penetrating injuries. In both the injuries, the major issue is missing the diagnosis and high mortality. Blunt cardiac injuries (BCI) are much more common than penetrating injuries. Aiming at a better understanding of BCI, we searched the literature from January 1847 to January 2012 by using MEDLINE and EMBASE search engines. Using the key word "Blunt Cardiac Injury," we found 1814 articles; out of which 716 articles were relevant. Herein, we review the causes, diagnosis, and management of BCI. In conclusion, traumatic cardiac injury is a major challenge in critical trauma care, but the guidelines are lacking. A high index of suspicion, application of current diagnostic protocols, and prompt and appropriate management is mandatory.

  1. Understanding traumatic blunt cardiac injury

    Directory of Open Access Journals (Sweden)

    Ayman El-Menyar

    2012-01-01

    Full Text Available Cardiac injuries are classified as blunt and penetrating injuries. In both the injuries, the major issue is missing the diagnosis and high mortality. Blunt cardiac injuries (BCI are much more common than penetrating injuries. Aiming at a better understanding of BCI, we searched the literature from January 1847 to January 2012 by using MEDLINE and EMBASE search engines. Using the key word "Blunt Cardiac Injury," we found 1814 articles; out of which 716 articles were relevant. Herein, we review the causes, diagnosis, and management of BCI. In conclusion, traumatic cardiac injury is a major challenge in critical trauma care, but the guidelines are lacking. A high index of suspicion, application of current diagnostic protocols, and prompt and appropriate management is mandatory.

  2. Recent developments in cardiac pacing.

    Science.gov (United States)

    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  3. Deep Convection in the Ocean

    National Research Council Canada - National Science Library

    McWilliams, James

    1999-01-01

    ... mechanism of water mass transformation. The resultant newly mixed deep water masses form a component of the thermohaline circulation, and hence it is essential to understand the deep convection process if the variability of the meridional...

  4. Cardiac Regeneration and Stem Cells.

    Science.gov (United States)

    Zhang, Yiqiang; Mignone, John; MacLellan, W Robb

    2015-10-01

    After decades of believing the heart loses the ability to regenerate soon after birth, numerous studies are now reporting that the adult heart may indeed be capable of regeneration, although the magnitude of new cardiac myocyte formation varies greatly. While this debate has energized the field of cardiac regeneration and led to a dramatic increase in our understanding of cardiac growth and repair, it has left much confusion in the field as to the prospects of regenerating the heart. Studies applying modern techniques of genetic lineage tracing and carbon-14 dating have begun to establish limits on the amount of endogenous regeneration after cardiac injury, but the underlying cellular mechanisms of this regeneration remained unclear. These same studies have also revealed an astonishing capacity for cardiac repair early in life that is largely lost with adult differentiation and maturation. Regardless, this renewed focus on cardiac regeneration as a therapeutic goal holds great promise as a novel strategy to address the leading cause of death in the developed world. Copyright © 2015 the American Physiological Society.

  5. Cardiac misconceptions in healthcare workers.

    Science.gov (United States)

    Angus, Neil; Patience, Fiona; Maclean, Elizabeth; Corrigall, Helen; Bradbury, Ian; Thompson, David R; Atherton, Iain; Leslie, Stephen J

    2012-12-01

    Cardiac misconceptions are common and may have a detrimental effect on patients. Such misconceptions may be introduced or reinforced by vague and inconsistent advice from healthcare staff and can adversely affect health outcomes. To assess whether level of cardiac misconceptions significantly differs between groups of healthcare staff based on occupation. The 22-item York cardiac beliefs questionnaire (YCBQ) was administered to a convenience sample of healthcare staff (n = 263) in direct contact with cardiac patients. Data was also collected on the occupation of healthcare staff and years worked. Medical staff had the lowest mean score (17.5, CI 15.6-19.4), indicating fewest misconceptions, and unqualified healthcare workers had the highest mean score (32.1, CI 28.4-35.7). Analysis by ANOVA indicated differences between staff groups to be statistically significant (F = 17.66, p misconception score (Pearson's r = - 0.243, p misconceptions in different groups of healthcare staff. Education to correct cardiac misconceptions should be particularly targeted at unqualified healthcare staff. The importance of maintaining appropriate ratios of qualified to unqualified healthcare staff in the care of cardiac patients is supported by this study.

  6. FGF21 and cardiac physiopathology

    Directory of Open Access Journals (Sweden)

    Anna ePlanavila

    2015-08-01

    Full Text Available The heart is not traditionally considered either a target or a site of fibroblast growth factor-21 (FGF21 production. However, recent findings indicate that FGF21 can act as a cardiomyokine; that is, it is produced by cardiac cells at significant levels and acts in an autocrine manner on the heart itself. The heart is sensitive to the effects of FGF21, both systemic and locally generated, owing to the expression in cardiomyocytes of β-Klotho, the key co-receptor known to confer specific responsiveness to FGF21 action. FGF21 has been demonstrated to protect against cardiac hypertrophy, cardiac inflammation, and oxidative stress. FGF21 expression in the heart is induced in response to cardiac insults, such as experimental cardiac hypertrophy and myocardial infarction in rodents, as well as in failing human hearts. Intracellular mechanisms involving PPARα and Sirt1 mediate transcriptional regulation of the FGF21 gene in response to exogenous stimuli. In humans, circulating FGF21 levels are elevated in coronary heart disease and atherosclerosis, and are associated with a higher risk of cardiovascular events in patients with type 2 diabetes. These findings provide new insights into the role of FGF21 in the heart and may offer potential therapeutic strategies for cardiac disease.

  7. Cardiac involvement in myotonic dystrophy

    DEFF Research Database (Denmark)

    Lund, Marie; Diaz, Lars Jorge; Ranthe, Mattis Flyvholm

    2014-01-01

    genetic testing for DM1. Information on incident cardiac diseases was obtained from the NPR. We estimated standardized incidence ratios (SIRs) of cardiac disease compared with the background population, overall and according to selected diagnostic subgroups (cardiomyopathy, heart failure, conduction...... disorders, arrhythmias, and device implantation). In the DM cohort, SIR for any cardiac disease was 3.42 [95% confidence interval (CI) 3.01-3.86]; for a cardiac disease belonging to the selected subgroups 6.91 (95% CI: 5.93-8.01) and for other cardiac disease 2.59 (95% CI: 2.03-3.25). For a cardiac disease...... belonging to the selected subgroups, the risk was particularly high in the first year after DM diagnosis [SIR 15.4 (95% CI: 10.9-21.3)] but remained significantly elevated in subsequent years [SIR 6.07 (95% CI: 5.11-7.16]). The risk was higher in young cohort members [e.g. 20-39 years: SIR 18.1 (95% CI: 12...

  8. Sudden Cardiac Death

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza

    2017-01-01

    Objectives This study sought to describe the use of pharmacotherapy in a nationwide cohort of young patients with sudden cardiac death (SCD). Background Several drugs have been associated with an increased risk of SCD and sudden arrhythmic death syndrome (SADS). It remains unclear how....... Autopsy was performed in 55%. Overall, 58% of SCD cases (n = 786) received at least 1 drug within 90 days before death. The most common drugs were analgesic drugs (n = 239; 18%), antihypertensive drugs (n = 234; 17%), and antibiotic drugs (n = 218; 16%). After multivariable adjustment, prescription...... of “brugadogenic” drugs or >1 QT-prolonging drug was associated with an increased risk of SADS compared with explained SCD (odds ratio: 2.16 [95% confidence interval: 1.12 to 4.17] and 2.91 [95% confidence interval: 1.46 to 5.81], respectively). Conclusions Pharmacotherapy was identified in 58% of the SCD cases...

  9. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from...... the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported...... a progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0...

  10. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    DEFF Research Database (Denmark)

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina

    2015-01-01

    AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...... the action and limitations of cardiac resynchronization therapy (CRT) in relieving myocardial dysfunction. METHODS AND RESULTS: In Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT), during 4 years of follow-up, 169 (9.3%) of 1820 patients died of known...... causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P

  11. Reduction of cardiac volume in left-breast treatment fields by respiratory maneuvers: a CT study

    International Nuclear Information System (INIS)

    Lu, H.-M.; Cash, Ethan; Chen, M.-H.; Chin Lee; Manning, Warren J.; Harris, Jay; Bornstein, Bruce

    2000-01-01

    Purpose: A previous study of healthy female volunteers suggested that deep inspiratory breath holding can reduce the cardiac volume in the treatment portals for left-breast cancer treatment. The reduction of irradiated cardiac volume may be important considering the reported late cardiac morbidity and mortality and the frequent coexistent use of potentially cardiotoxic chemotherapy in breast cancer patients. In the present study, we evaluated the heart volume in the fields and, thus, the true benefit of this respiratory maneuver in breast cancer patients undergoing CT simulation. Materials and Methods: Fifteen patients (median age, 53) were studied. For each patient, CT scans were performed both when the patient breathed normally (quiet respiration) and when the patient held her breath after a deep inspiration. Tangential fields were planned using the same medial, lateral, superior, and inferior borders on skin for the normal breathing and the breath-holding configurations. The cardiac and left-lung volumes within the tangential fields were calculated for both breathing configurations. Multiple scan series were performed for the breath-holding configuration to provide a more accurate delineation of the cardiac tissue and to study the reproducibility of the patient's position between different cycles of deep inspiration. Results: None of the patients had difficulty holding her breath for 20 s. The cardiac volume in the field was reduced (-86 ± 24%; p 3 vs 97 cm 3 , p < 0.001). However, the fractional volume of the left lung in the field was essentially unchanged. For all but 1 patient, the maximum difference between the external body contours from different breath holding cycles was 5 mm and occurred at the lateral aspect of the breast. At the medial aspect, as indicated by the position of the midline marker, the variations were well within the currently accepted tolerance for patient positioning during tangential treatment. Conclusions: Deep-inspiration breath

  12. Deep inelastic scattering

    International Nuclear Information System (INIS)

    Zakharov, V.I.

    1977-01-01

    The present status of the quark-parton-gluon picture of deep inelastic scattering is reviewed. The general framework is mostly theoretical and covers investigations since 1970. Predictions of the parton model and of the asymptotically free field theories are compared with experimental data available. The valence quark approximation is concluded to be valid in most cases, but fails to account for the data on the total momentum transfer. On the basis of gluon corrections introduced to the parton model certain predictions concerning both the deep inelastic structure functions and form factors are made. The contributions of gluon exchanges and gluon bremsstrahlung are highlighted. Asymptotic freedom is concluded to be very attractive and provide qualitative explanation to some experimental observations (scaling violations, breaking of the Drell-Yan-West type relations). Lepton-nuclear scattering is pointed out to be helpful in probing the nature of nuclear forces and studying the space-time picture of the parton model

  13. Deep Energy Retrofit

    DEFF Research Database (Denmark)

    Zhivov, Alexander; Lohse, Rüdiger; Rose, Jørgen

    Deep Energy Retrofit – A Guide to Achieving Significant Energy User Reduction with Major Renovation Projects contains recommendations for characteristics of some of core technologies and measures that are based on studies conducted by national teams associated with the International Energy Agency...... Energy Conservation in Buildings and Communities Program (IEA-EBC) Annex 61 (Lohse et al. 2016, Case, et al. 2016, Rose et al. 2016, Yao, et al. 2016, Dake 2014, Stankevica et al. 2016, Kiatreungwattana 2014). Results of these studies provided a base for setting minimum requirements to the building...... envelope-related technologies to make Deep Energy Retrofit feasible and, in many situations, cost effective. Use of energy efficiency measures (EEMs) in addition to core technologies bundle and high-efficiency appliances will foster further energy use reduction. This Guide also provides best practice...

  14. Deep Learning Online Course

    Science.gov (United States)

    2016-11-01

    Number of people who participated in n or more events .......................................................... 4 v 1. INTRODUCTION CS231N is a...talked about his work doing predictive analytics on V -22 aircraft for the Comprehensive Automated Maintenance Environment Optimized/Readiness... MOOC Wiki Page.” https://wiki.spawar.navy.mil/ confluence/display/ MOOC /Machine+Learning. Accessed 12 August 2016. 5. Rainey, K. 2016. “Deep Learning

  15. Deep Reinforcement Fuzzing

    OpenAIRE

    Böttinger, Konstantin; Godefroid, Patrice; Singh, Rishabh

    2018-01-01

    Fuzzing is the process of finding security vulnerabilities in input-processing code by repeatedly testing the code with modified inputs. In this paper, we formalize fuzzing as a reinforcement learning problem using the concept of Markov decision processes. This in turn allows us to apply state-of-the-art deep Q-learning algorithms that optimize rewards, which we define from runtime properties of the program under test. By observing the rewards caused by mutating with a specific set of actions...

  16. Deep Discrete Supervised Hashing

    OpenAIRE

    Jiang, Qing-Yuan; Cui, Xue; Li, Wu-Jun

    2017-01-01

    Hashing has been widely used for large-scale search due to its low storage cost and fast query speed. By using supervised information, supervised hashing can significantly outperform unsupervised hashing. Recently, discrete supervised hashing and deep hashing are two representative progresses in supervised hashing. On one hand, hashing is essentially a discrete optimization problem. Hence, utilizing supervised information to directly guide discrete (binary) coding procedure can avoid sub-opti...

  17. Deep learning from crowds

    OpenAIRE

    Rodrigues, Filipe; Pereira, Francisco

    2017-01-01

    Over the last few years, deep learning has revolutionized the field of machine learning by dramatically improving the state-of-the-art in various domains. However, as the size of supervised artificial neural networks grows, typically so does the need for larger labeled datasets. Recently, crowdsourcing has established itself as an efficient and cost-effective solution for labeling large sets of data in a scalable manner, but it often requires aggregating labels from multiple noisy contributor...

  18. Deep Mutual Learning

    OpenAIRE

    Zhang, Ying; Xiang, Tao; Hospedales, Timothy M.; Lu, Huchuan

    2017-01-01

    Model distillation is an effective and widely used technique to transfer knowledge from a teacher to a student network. The typical application is to transfer from a powerful large network or ensemble to a small network, that is better suited to low-memory or fast execution requirements. In this paper, we present a deep mutual learning (DML) strategy where, rather than one way transfer between a static pre-defined teacher and a student, an ensemble of students learn collaboratively and teach ...

  19. Deep Visual Attention Prediction

    Science.gov (United States)

    Wang, Wenguan; Shen, Jianbing

    2018-05-01

    In this work, we aim to predict human eye fixation with view-free scenes based on an end-to-end deep learning architecture. Although Convolutional Neural Networks (CNNs) have made substantial improvement on human attention prediction, it is still needed to improve CNN based attention models by efficiently leveraging multi-scale features. Our visual attention network is proposed to capture hierarchical saliency information from deep, coarse layers with global saliency information to shallow, fine layers with local saliency response. Our model is based on a skip-layer network structure, which predicts human attention from multiple convolutional layers with various reception fields. Final saliency prediction is achieved via the cooperation of those global and local predictions. Our model is learned in a deep supervision manner, where supervision is directly fed into multi-level layers, instead of previous approaches of providing supervision only at the output layer and propagating this supervision back to earlier layers. Our model thus incorporates multi-level saliency predictions within a single network, which significantly decreases the redundancy of previous approaches of learning multiple network streams with different input scales. Extensive experimental analysis on various challenging benchmark datasets demonstrate our method yields state-of-the-art performance with competitive inference time.

  20. Cardiac output monitoring

    Directory of Open Access Journals (Sweden)

    Mathews Lailu

    2008-01-01

    Full Text Available Minimally invasive and non-invasive methods of estimation of cardiac output (CO were developed to overcome the limitations of invasive nature of pulmonary artery catheterization (PAC and direct Fick method used for the measurement of stroke volume (SV. The important minimally invasive techniques available are: oesophageal Doppler monitoring (ODM, the derivative Fick method (using partial carbon dioxide (CO 2 breathing, transpulmonary thermodilution, lithium indicator dilution, pulse contour and pulse power analysis. Impedance cardiography is probably the only non-invasive technique in true sense. It provides information about haemodynamic status without the risk, cost and skill associated with the other invasive or minimally invasive techniques. It is important to understand what is really being measured and what assumptions and calculations have been incorporated with respect to a monitoring device. Understanding the basic principles of the above techniques as well as their advantages and limitations may be useful. In addition, the clinical validation of new techniques is necessary to convince that these new tools provide reliable measurements. In this review the physics behind the working of ODM, partial CO 2 breathing, transpulmonary thermodilution and lithium dilution techniques are dealt with. The physical and the physiological aspects underlying the pulse contour and pulse power analyses, various pulse contour techniques, their development, advantages and limitations are also covered. The principle of thoracic bioimpedance along with computation of CO from changes in thoracic impedance is explained. The purpose of the review is to help us minimize the dogmatic nature of practice favouring one technique or the other.

  1. Primary Cardiac Lymphoma

    Directory of Open Access Journals (Sweden)

    Shu-Ching Hsueh

    2006-04-01

    Full Text Available Primary cardiac lymphoma (PCL has rarely been reported in Chinese populations. PCL mostly occurs in the right atrium. The clinical manifestations may be variable and are attributed to its location, the presence of congestive heart failure, pericardial effusion, arrhythmia, and cardiomegaly. The prognosis is usually poor because it is usually found too late and therefore, clinicians should be aware of PCL. Imaging examinations are the best methods for initial diagnosis and include echocardiography, computed tomography (CT scan, magnetic resonance imaging (MRI, and radioisotope scan. However, the final diagnosis is made by pathology, such as cytologic examination of the effusive fluid and tissue biopsy. Because the tumors are difficult to resect, the main treatment for the disease is chemotherapy, which can be successful. Here, we report a 58-year-old man who had a tumor measuring 8 × 5 cm in the right atrium. By clinical staging, including chest X-ray, echocardiography, CT scan of the abdomen, MRI of the heart, whole body tumor Gallium scan, and gastrointestinal series, no metastatic lesion or involvement was found in other parts of the body. Pathologic findings including cytology of pericardial effusion and heart tumor biopsy revealed the case as a diffuse large B-cell lymphoma. After chemotherapy with COP (cyclophosphamide + vincristine + prednisone and CHOPBE (COP + doxorubicin + bleomycin + etoposide regimens, the intracardiac tumor had disappeared, but the patient survived for 12 months in total, despite additional radiotherapy over the pericardial lesions. It was presumed that because the tumor was very large and involved all 3 layers of the heart, it did not respond as well to the therapy as expected.

  2. Respiratory physiotherapy in the pulmonary dysfunction after cardiac surgery.

    Science.gov (United States)

    Renault, Julia Alencar; Costa-Val, Ricardo; Rossetti, Márcia Braz

    2008-01-01

    The aim of this work is to make a critical review about the different techniques of respiratory physiotherapy used following cardiac surgery and this effectiveness in reverting pulmonary dysfunction. It has been used as reference publications in English and Portuguese using as key words thoracic surgery, respiratory exercises, physical therapy modalities, postoperative complications and myocardial revascularization, contained in the following databases BIREME, SciELO Brazil, LILACS, PUBMED, from 1997 to 2007. A secondary search of the reference list of identified articles also was made. It has been selected eleven randomized trials (997 patients). For the articles included incentive spirometry was used in three; deep breathing exercises in six; deep breathing exercises added to positive expiratory pressure in four and positive airway pressure added to inspiratory resistance in two. Three trials used intermittent positive pressure breathing. Continuous positive airway pressure and bi-level positive airway pressure has been used in three and two trials. The protocols used in the studies were varied and the co interventions were present in a big part of these. The different analyzed varieties and the time of postoperatory follow up make a comparative analysis difficult. Pulmonary dysfunction is evident in the postoperatory period of cardiac surgery. The use of noninvasive ventilation has been associated with good results in the first postoperatory days. Despite the known importance of postoperatory respiratory physiotherapy, until now, there is no literary consensus about the superiority of one technique over the others.

  3. Expanded cardiac rehabilitation reduces cardiac events over five years.

    Science.gov (United States)

    Redfern, Julie

    2011-01-01

    In people with coronary artery disease, does an expanded cardiac rehabilitation program reduce cardiac deaths, myocardial infarctions, and hospital admissions due to cardiovascular disease? Randomised, controlled trial with intention-to-treat analysis. A University hospital in Sweden. People aged less than 75 years who had had a recent myocardial infarction or coronary artery bypass grafts were eligible to participate. Severe co-morbidities were exclusion criteria. Randomisation of 224 participants allocated 111 to undergo expanded cardiac rehabilitation and 113 to a control group. Both groups received standard cardiac rehabilitation, including physical training, education, group and individual counselling, and support to cease smoking. All participants received appropriate preventive medications. In addition, the intervention group received 20 group sessions of stress management, 3 sessions of cooking and diet counselling by a dietician, and a 5-day stay at a 'patient hotel' with several activities including physical training and information. Although other outcomes were reported at the conclusion of 1-year follow-up, the outcomes at the 5-year follow-up were rates of cardiac events: cardiovascular death, acute myocardial infarction, and readmission to a hospital due to other cardiovascular causes. All participants were followed up via national registers of health and mortality. During the 5-year follow-up, 53 (48%) participants in the expanded cardiac rehabilitation group and 68 (60%) participants in the control group had a cardiac event (hazard ratio 0.69, 95% CI 0.48 to 0.99). This difference was mainly due to only 12 (11%) participants having non-fatal myocardial infarctions in the treatment group versus 23 (20%) in the control group (hazard ratio 0.47, 95% CI 0.21 to 0.97). The number of hospitalisations and the number of days of hospitalisation were both significantly fewer in the treatment group than in the control group. Expanded cardiac rehabilitation

  4. Perioperative Rosuvastatin in Cardiac Surgery.

    Science.gov (United States)

    Zheng, Zhe; Jayaram, Raja; Jiang, Lixin; Emberson, Jonathan; Zhao, Yan; Li, Qi; Du, Juan; Guarguagli, Silvia; Hill, Michael; Chen, Zhengming; Collins, Rory; Casadei, Barbara

    2016-05-05

    Complications after cardiac surgery are common and lead to substantial increases in morbidity and mortality. Meta-analyses of small randomized trials have suggested that perioperative statin therapy can prevent some of these complications. We randomly assigned 1922 patients in sinus rhythm who were scheduled for elective cardiac surgery to receive perioperative rosuvastatin (at a dose of 20 mg daily) or placebo. The primary outcomes were postoperative atrial fibrillation within 5 days after surgery, as assessed by Holter electrocardiographic monitoring, and myocardial injury within 120 hours after surgery, as assessed by serial measurements of the cardiac troponin I concentration. Secondary outcomes included major in-hospital adverse events, duration of stay in the hospital and intensive care unit, left ventricular and renal function, and blood biomarkers. The concentrations of low-density lipoprotein cholesterol and C-reactive protein after surgery were lower in patients assigned to rosuvastatin than in those assigned to placebo (PSTICS ClinicalTrials.gov number, NCT01573143.).

  5. Comparing Methods for Cardiac Output

    DEFF Research Database (Denmark)

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

    2018-01-01

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

  6. Exercise-induced cardiac remodeling.

    Science.gov (United States)

    Weiner, Rory B; Baggish, Aaron L

    2012-01-01

    Early investigations in the late 1890s and early 1900s documented cardiac enlargement in athletes with above-normal exercise capacity and no evidence of cardiovascular disease. Such findings have been reported for more than a century and continue to intrigue scientists and clinicians. It is well recognized that repetitive participation in vigorous physical exercise results in significant changes in myocardial structure and function. This process, termed exercise-induced cardiac remodeling (EICR), is characterized by structural cardiac changes including left ventricular hypertrophy with sport-specific geometry (eccentric vs concentric). Associated alterations in both systolic and diastolic functions are emerging as recognized components of EICR. The increasing popularity of recreational exercise and competitive athletics has led to a growing number of individuals exhibiting these findings in routine clinical practice. This review will provide an overview of EICR in athletes. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Deep Space Positioning System

    Science.gov (United States)

    Vaughan, Andrew T. (Inventor); Riedel, Joseph E. (Inventor)

    2016-01-01

    A single, compact, lower power deep space positioning system (DPS) configured to determine a location of a spacecraft anywhere in the solar system, and provide state information relative to Earth, Sun, or any remote object. For example, the DPS includes a first camera and, possibly, a second camera configured to capture a plurality of navigation images to determine a state of a spacecraft in a solar system. The second camera is located behind, or adjacent to, a secondary reflector of a first camera in a body of a telescope.

  8. Deep penetration calculations

    International Nuclear Information System (INIS)

    Thompson, W.L.; Deutsch, O.L.; Booth, T.E.

    1980-04-01

    Several Monte Carlo techniques are compared in the transport of neutrons of different source energies through two different deep-penetration problems each with two parts. The first problem involves transmission through a 200-cm concrete slab. The second problem is a 90 0 bent pipe jacketed by concrete. In one case the pipe is void, and in the other it is filled with liquid sodium. Calculations are made with two different Los Alamos Monte Carlo codes: the continuous-energy code MCNP and the multigroup code MCMG

  9. [Deep mycoses rarely described].

    Science.gov (United States)

    Charles, D

    1986-01-01

    Beside deep mycoses very well known: histoplasmosis, candidosis, cryptococcosis, there are other mycoses less frequently described. Some of them are endemic in some countries: South American blastomycosis in Brazil, coccidioidomycosis in California; some others are cosmopolitan and may affect everyone: sporotrichosis, or may affect only immunodeficient persons: mucormycosis. They do not spare Africa, we may encounter basidiobolomycosis, rhinophycomycosis, dermatophytosis, sporotrichosis and, more recently reported, rhinosporidiosis. Important therapeutic progresses have been accomplished with amphotericin B and with antifungus imidazole compounds (miconazole and ketoconazole). Surgical intervention is sometime recommended in chromomycosis and rhinosporidiosis.

  10. Deep Red (Profondo Rosso)

    CERN Multimedia

    Cine Club

    2015-01-01

    Wednesday 29 April 2015 at 20:00 CERN Council Chamber    Deep Red (Profondo Rosso) Directed by Dario Argento (Italy, 1975) 126 minutes A psychic who can read minds picks up the thoughts of a murderer in the audience and soon becomes a victim. An English pianist gets involved in solving the murders, but finds many of his avenues of inquiry cut off by new murders, and he begins to wonder how the murderer can track his movements so closely. Original version Italian; English subtitles

  11. Out-of-hospital Cardiac Arrest (OHCA) Biomarkers

    Science.gov (United States)

    2017-12-21

    Neurological Outcome; Cardiac Arrest; Out-Of-Hospital Cardiac Arrest; Brain Anoxia Ischemia; Hypoxia, Brain; Hypoxia-Ischemia, Brain; Cardiac Arrest With Successful Resuscitation; Cardiac Arrest, Out-Of-Hospital; Brain Injuries

  12. An airline cardiac arrest program.

    Science.gov (United States)

    O'Rourke, M F; Donaldson, E; Geddes, J S

    1997-11-04

    As many as 1000 lives are lost annually from cardiac arrest in commercial aircraft. Ventricular fibrillation (VF), the most common mechanism, can be treated effectively only with prompt defibrillation, whereas the current policy of most airlines is to continue cardiopulmonary resuscitation pending aircraft diversion. The objective of this study was to assess the impact of making semiautomatic external defibrillators (AEDs) available for use on airline passengers with cardiac arrest. AEDs were installed on international Qantas aircraft and at major terminals, selected crew were trained in their use, and all crew members were trained in cardiopulmonary resuscitation. Supervision was provided by medical volunteers or (remotely) by airline physicians. During a 64-month period, AEDs were used on 109 occasions: 63 times for monitoring an acutely ill passenger and 46 times for cardiac arrest. Twenty-seven episodes of cardiac arrest occurred in aircraft, often (11 of 27 [41%]) unwitnessed, and they were usually (21 of 27 [78%]) associated with asystole or pulseless idioventricular rhythm. All 19 arrests in terminals were witnessed; VF was present in 17 (89%). Overall, defibrillation was initially successful in 21 of 23 cases (91%). Long-term survival from VF was achieved in 26% (2 of 6 in aircraft and 4 of 17 in terminals). The ability to monitor cardiac rhythm aided decisions on diversion, which was avoided in most passengers with asystole or idioventricular rhythm. AEDs in aircraft and terminals, with appropriate crew training, are helpful in the management of cardiac emergencies. Survival from VF is practicable and is comparable with the most effective prehospital ambulance emergency services. Costly aircraft diversions can be avoided in clearly futile situations, enhancing the cost-effectiveness of the program.

  13. Determinants of occurrence and survival after sudden cardiac arrest-A European perspective

    DEFF Research Database (Denmark)

    Empana, Jean-Philippe; Blom, Marieke T; Bӧttiger, Bernd W

    2018-01-01

    AIMS: The ESCAPE-NET project ("European Sudden Cardiac Arrest network- towards Prevention, Education and New Effective Treatments") aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies...... for survival after SCA on a European scale. METHODS: This is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival...... after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. RESULTS: The 11 clinical studies with SCA cases...

  14. Cardiac index in atrio- and interventricular delay optimized cardiac resynchronization therapy and cardiac contractility modulation

    Directory of Open Access Journals (Sweden)

    Tumampos J.

    2015-09-01

    Full Text Available Cardiac resynchronization therapy (CRT is an established therapy for heart failure patients and improves quality of life in patients with sinus rhythm, reduced left ventricular ejection fraction (LVEF, left bundle branch block and wide QRS duration. Since approximately sixty percent of heart failure patients have a normal QRS duration they do not benefit or respond to the CRT. Cardiac contractility modulation (CCM releases nonexcitatoy impulses during the absolute refractory period in order to enhance the strength of the left ventricular contraction. The aim of the investigation was to evaluate differences in cardiac index between optimized and nonoptimized CRT and CCM devices versus standard values. Impedance cardiography, a noninvasive method was used to measure cardiac index (CI, a useful parameter which describes the blood volume during one minutes heart pumps related to the body surface. CRT patients indicate an increase of 39.74 percent and CCM patients an improvement of 21.89 percent more cardiac index with an optimized device.

  15. Hypokalemia and sudden cardiac death

    DEFF Research Database (Denmark)

    Kjeldsen, Keld

    2010-01-01

    Worldwide, approximately three million people suffer sudden cardiac death annually. These deaths often emerge from a complex interplay of substrates and triggers. Disturbed potassium homeostasis among heart cells is an example of such a trigger. Thus, hypokalemia and, also, more transient......, drugs with a proven significant positive effect on mortality and morbidity rates in heart failure patients all increase plasma potassium concentration. Thus, it may prove beneficial to pay more attention to hypokalemia and to maintain plasma potassium levels in the upper normal range. The more at risk...... of fatal arrhythmia and sudden cardiac death a patient is, the more attention should be given to the potassium homeostasis....

  16. Measuring Cardiac Output during Cardiopulmonary Exercise Testing.

    Science.gov (United States)

    Vignati, Carlo; Cattadori, Gaia

    2017-07-01

    Cardiac output is a key parameter in the assessment of cardiac function, and its measurement is fundamental to the diagnosis, treatment, and prognostic evaluation of all heart diseases. Until recently, cardiac output determination during exercise had been only possible through invasive methods, which were not practical in the clinical setting. Because [Formula: see text]o 2 is cardiac output times arteriovenous content difference, evaluation of cardiac output is usually included in its measurement. Because of the difficulty of directly measuring peak exercise cardiac output, indirect surrogate parameters have been proposed, but with only modest clinical usefulness. Direct measurement of cardiac output can now be made by several noninvasive techniques, such as rebreathing inert gases, impedance cardiology, thoracic bioreactance, estimated continuous cardiac output technology, and transthoracic echocardiography coupled to cardiopulmonary exercise testing, which allow more definitive results and better understanding of the underlying physiopathology.

  17. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard

    2014-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  18. Cardiac symptoms before sudden cardiac death caused by hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Lynge, Thomas Hadberg; Risgaard, Bjarke; Jabbari, Reza

    2016-01-01

    AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. METHODS AND RESULTS: Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years...

  19. Deep Learning in Radiology.

    Science.gov (United States)

    McBee, Morgan P; Awan, Omer A; Colucci, Andrew T; Ghobadi, Comeron W; Kadom, Nadja; Kansagra, Akash P; Tridandapani, Srini; Auffermann, William F

    2018-03-29

    As radiology is inherently a data-driven specialty, it is especially conducive to utilizing data processing techniques. One such technique, deep learning (DL), has become a remarkably powerful tool for image processing in recent years. In this work, the Association of University Radiologists Radiology Research Alliance Task Force on Deep Learning provides an overview of DL for the radiologist. This article aims to present an overview of DL in a manner that is understandable to radiologists; to examine past, present, and future applications; as well as to evaluate how radiologists may benefit from this remarkable new tool. We describe several areas within radiology in which DL techniques are having the most significant impact: lesion or disease detection, classification, quantification, and segmentation. The legal and ethical hurdles to implementation are also discussed. By taking advantage of this powerful tool, radiologists can become increasingly more accurate in their interpretations with fewer errors and spend more time to focus on patient care. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  20. Deep Learning Microscopy

    KAUST Repository

    Rivenson, Yair

    2017-05-12

    We demonstrate that a deep neural network can significantly improve optical microscopy, enhancing its spatial resolution over a large field-of-view and depth-of-field. After its training, the only input to this network is an image acquired using a regular optical microscope, without any changes to its design. We blindly tested this deep learning approach using various tissue samples that are imaged with low-resolution and wide-field systems, where the network rapidly outputs an image with remarkably better resolution, matching the performance of higher numerical aperture lenses, also significantly surpassing their limited field-of-view and depth-of-field. These results are transformative for various fields that use microscopy tools, including e.g., life sciences, where optical microscopy is considered as one of the most widely used and deployed techniques. Beyond such applications, our presented approach is broadly applicable to other imaging modalities, also spanning different parts of the electromagnetic spectrum, and can be used to design computational imagers that get better and better as they continue to image specimen and establish new transformations among different modes of imaging.

  1. Deep Transfer Metric Learning.

    Science.gov (United States)

    Junlin Hu; Jiwen Lu; Yap-Peng Tan; Jie Zhou

    2016-12-01

    Conventional metric learning methods usually assume that the training and test samples are captured in similar scenarios so that their distributions are assumed to be the same. This assumption does not hold in many real visual recognition applications, especially when samples are captured across different data sets. In this paper, we propose a new deep transfer metric learning (DTML) method to learn a set of hierarchical nonlinear transformations for cross-domain visual recognition by transferring discriminative knowledge from the labeled source domain to the unlabeled target domain. Specifically, our DTML learns a deep metric network by maximizing the inter-class variations and minimizing the intra-class variations, and minimizing the distribution divergence between the source domain and the target domain at the top layer of the network. To better exploit the discriminative information from the source domain, we further develop a deeply supervised transfer metric learning (DSTML) method by including an additional objective on DTML, where the output of both the hidden layers and the top layer are optimized jointly. To preserve the local manifold of input data points in the metric space, we present two new methods, DTML with autoencoder regularization and DSTML with autoencoder regularization. Experimental results on face verification, person re-identification, and handwritten digit recognition validate the effectiveness of the proposed methods.

  2. Brain Gray Matter MRI Morphometry for Neuroprognostication After Cardiac Arrest.

    Science.gov (United States)

    Silva, Stein; Peran, Patrice; Kerhuel, Lionel; Malagurski, Briguita; Chauveau, Nicolas; Bataille, Benoit; Lotterie, Jean Albert; Celsis, Pierre; Aubry, Florent; Citerio, Giuseppe; Jean, Betty; Chabanne, Russel; Perlbarg, Vincent; Velly, Lionel; Galanaud, Damien; Vanhaudenhuyse, Audrey; Fourcade, Olivier; Laureys, Steven; Puybasset, Louis

    2017-08-01

    We hypothesize that the combined use of MRI cortical thickness measurement and subcortical gray matter volumetry could provide an early and accurate in vivo assessment of the structural impact of cardiac arrest and therefore could be used for long-term neuroprognostication in this setting. Prospective cohort study. Five Intensive Critical Care Units affiliated to the University in Toulouse (France), Paris (France), Clermont-Ferrand (France), Liège (Belgium), and Monza (Italy). High-resolution anatomical T1-weighted images were acquired in 126 anoxic coma patients ("learning" sample) 16 ± 8 days after cardiac arrest and 70 matched controls. An additional sample of 18 anoxic coma patients, recruited in Toulouse, was used to test predictive model generalization ("test" sample). All patients were followed up 1 year after cardiac arrest. None. Cortical thickness was computed on the whole cortical ribbon, and deep gray matter volumetry was performed after automatic segmentation. Brain morphometric data were employed to create multivariate predictive models using learning machine techniques. Patients displayed significantly extensive cortical and subcortical brain volumes atrophy compared with controls. The accuracy of a predictive classifier, encompassing cortical and subcortical components, has a significant discriminative power (learning area under the curve = 0.87; test area under the curve = 0.96). The anatomical regions which volume changes were significantly related to patient's outcome were frontal cortex, posterior cingulate cortex, thalamus, putamen, pallidum, caudate, hippocampus, and brain stem. These findings are consistent with the hypothesis of pathologic disruption of a striatopallidal-thalamo-cortical mesocircuit induced by cardiac arrest and pave the way for the use of combined brain quantitative morphometry in this setting.

  3. Deep Reinforcement Learning: An Overview

    OpenAIRE

    Li, Yuxi

    2017-01-01

    We give an overview of recent exciting achievements of deep reinforcement learning (RL). We discuss six core elements, six important mechanisms, and twelve applications. We start with background of machine learning, deep learning and reinforcement learning. Next we discuss core RL elements, including value function, in particular, Deep Q-Network (DQN), policy, reward, model, planning, and exploration. After that, we discuss important mechanisms for RL, including attention and memory, unsuperv...

  4. Deep Feature Consistent Variational Autoencoder

    OpenAIRE

    Hou, Xianxu; Shen, Linlin; Sun, Ke; Qiu, Guoping

    2016-01-01

    We present a novel method for constructing Variational Autoencoder (VAE). Instead of using pixel-by-pixel loss, we enforce deep feature consistency between the input and the output of a VAE, which ensures the VAE's output to preserve the spatial correlation characteristics of the input, thus leading the output to have a more natural visual appearance and better perceptual quality. Based on recent deep learning works such as style transfer, we employ a pre-trained deep convolutional neural net...

  5. Genetic testing for inheritable cardiac channelopathies.

    Science.gov (United States)

    Szepesváry, Eszter; Kaski, Juan Pablo

    2016-05-01

    Cardiac channelopathies are linked to an increased risk of ventricular arrhythmia and sudden death. This article reviews the clinical characteristics and genetic basis of common cardiac ion-channel diseases, highlights some genotype-phenotype correlations, and summarizes genetic testing for inheritable cardiac channelopathies.

  6. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness,

  7. Childhood cancer survivors: cardiac disease & social outcomes

    NARCIS (Netherlands)

    Feijen, E.A.M.

    2015-01-01

    The thesis is divided in two parts; Cardiac health problems and healthcare consumption & social outcomes in CCS. The general aims of part 1 creates optimal conditions for the evaluation of cardiac events in 5-year childhood cancer survivors, evaluation of the long term risk of cardiac events, and to

  8. An Overview of Techniques for Cardiac Left Ventricle Segmentation on Short-Axis MRI

    Directory of Open Access Journals (Sweden)

    Krasnobaev Arseny

    2016-01-01

    Full Text Available Nowadays, heart diseases are the leading cause of death. Left ventricle segmentation of a human heart in magnetic resonance images (MRI is a crucial step in both cardiac diseases diagnostics and heart internal structure reconstruction. It allows estimating such important parameters as ejection faction, left ventricle myocardium mass, stroke volume, etc. In addition, left ventricle segmentation helps to construct the personalized heart computational models in order to conduct the numerical simulations. At present, the fully automated cardiac segmentation methods still do not meet the accuracy requirements. We present an overview of left ventricle segmentation algorithms on short-axis MRI. A wide variety of completely different approaches are used for cardiac segmentation, including machine learning, graph-based methods, deformable models, and low-level heuristics. The current state-of-the-art technique is a combination of deformable models with advanced machine learning methods, such as deep learning or Markov random fields. We expect that approaches based on deep belief networks are the most promising ones because the main training process of networks with this architecture can be performed on the unlabelled data. In order to improve the quality of left ventricle segmentation algorithms, we need more datasets with labelled cardiac MRI data in open access.

  9. Deep learning for image classification

    Science.gov (United States)

    McCoppin, Ryan; Rizki, Mateen

    2014-06-01

    This paper provides an overview of deep learning and introduces the several subfields of deep learning including a specific tutorial of convolutional neural networks. Traditional methods for learning image features are compared to deep learning techniques. In addition, we present our preliminary classification results, our basic implementation of a convolutional restricted Boltzmann machine on the Mixed National Institute of Standards and Technology database (MNIST), and we explain how to use deep learning networks to assist in our development of a robust gender classification system.

  10. Current Perspectives in Cardiac Laterality

    Directory of Open Access Journals (Sweden)

    Marina Campione

    2016-12-01

    Full Text Available The heart is the first organ to break symmetry in the developing embryo and onset of dextral looping is the first indication of this event. Looping is a complex process that progresses concomitantly to cardiac chamber differentiation and ultimately leads to the alignment of the cardiac regions in their final topology. Generation of cardiac asymmetry is crucial to ensuring proper form and consequent functionality of the heart, and therefore it is a highly regulated process. It has long been known that molecular left/right signals originate far before morphological asymmetry and therefore can direct it. The use of several animal models has led to the characterization of a complex regulatory network, which invariably converges on the Tgf-β signaling molecule Nodal and its downstream target, the homeobox transcription factor Pitx2. Here, we review current data on the cellular and molecular bases of cardiac looping and laterality, and discuss the contribution of Nodal and Pitx2 to these processes. A special emphasis will be given to the morphogenetic role of Pitx2 and to its modulation of transcriptional and functional properties, which have also linked laterality to atrial fibrillation.

  11. The cardiac patient in Ramadan

    Science.gov (United States)

    Chamsi-Pasha, Majed; Chamsi-Pasha, Hassan

    2016-01-01

    Ramadan is one of the five fundamental pillars of Islam. During this month, the majority of the 1.6 billion Muslims worldwide observe an absolute fast from dawn to sunset without any drink or food. Our review shows that the impact of fasting during Ramadan on patients with stable cardiac disease is minimal and does not lead to any increase in acute events. Most patients with the stable cardiac disease can fast safely. Most of the drug doses and their regimen are easily manageable during this month and may need not to be changed. Ramadan fasting is a healthy nonpharmacological means for improving cardiovascular risk factors. Most of the Muslims, who suffer from chronic diseases, insist on fasting Ramadan despite being exempted by religion. The Holy Quran specifically exempts the sick from fasting. This is particularly relevant if fasting worsens one's illness or delays recovery. Patients with unstable angina, recent myocardial infarction, uncontrolled hypertension, decompensated heart failure, recent cardiac intervention or cardiac surgery or any debilitating diseases should avoid fasting. PMID:27144139

  12. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...

  13. Lentiginosis, Deafness and Cardiac Abnormalities*

    African Journals Online (AJOL)

    1973-01-06

    Jan 6, 1973 ... death. The familia:l form is milder. The cardiac lesion commonly consists of hypertrophic obstructive cardiomyopathy of either ventricle or abnor- malities of the ECG.' The obstructive lesion may be pro- gressive ... that the more severe cases would be unable to bear child- ren, even if they lived long enough.

  14. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  15. Deep inelastic phenomena

    International Nuclear Information System (INIS)

    Aubert, J.J.

    1982-01-01

    The experimental situation of the deep inelastic scattering for electrons (muons) is reviewed. A brief history of experimentation highlights Mohr and Nicoll's 1932 experiment on electron-atom scattering and Hofstadter's 1950 experiment on electron-nucleus scattering. The phenomenology of electron-nucleon scattering carried out between 1960 and 1970 is described, with emphasis on the parton model, and scaling. Experiments at SLAC and FNAL since 1974 exhibit scaling violations. Three muon-nucleon scattering experiments at BFP, BCDMA, and EMA, currently producing new results in the high Q 2 domain suggest a rather flat behaviour of the structure function at fixed x as a function of Q 2 . It is seen that the structure measured in DIS can then be projected into a pure hadronic process to predict a cross section. Protonneutron difference, moment analysis, and Drell-Yan pairs are also considered

  16. Deep 6-DOF Tracking.

    Science.gov (United States)

    Garon, Mathieu; Lalonde, Jean-Francois

    2017-11-01

    We present a temporal 6-DOF tracking method which leverages deep learning to achieve state-of-the-art performance on challenging datasets of real world capture. Our method is both more accurate and more robust to occlusions than the existing best performing approaches while maintaining real-time performance. To assess its efficacy, we evaluate our approach on several challenging RGBD sequences of real objects in a variety of conditions. Notably, we systematically evaluate robustness to occlusions through a series of sequences where the object to be tracked is increasingly occluded. Finally, our approach is purely data-driven and does not require any hand-designed features: robust tracking is automatically learned from data.

  17. Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Astrid T Berg

    2015-04-01

    Full Text Available Objectives: To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain. Methods: A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life. Results: Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (–17.6, 95% confidence interval: –30.5, –4.7; p < 0.01, and the reduction was persistent at 3 months’ follow-up (–15.2, 95% confidence interval: –28.5, –1.8; p = 0.03. Health-related quality of life improved in all three domains in patients with no significant difference between groups. Conclusion: Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.

  18. Physical therapy intervention in patients with non-cardiac chest pain following a recent cardiac event: A randomized controlled trial.

    Science.gov (United States)

    Berg, Astrid T; Stafne, Signe N; Hiller, Aud; Slørdahl, Stig A; Aamot, Inger-Lise

    2015-01-01

    To assess the effect of two different physical therapy interventions in patients with stable coronary heart disease and non-cardiac chest pain. A randomized controlled trial was carried out at a university hospital in Norway. A total of 30 patients with known and stable coronary heart disease and self-reported persistent chest pain reproduced by palpation of intercostal trigger points were participating in the study. The intervention was deep friction massage and heat pack versus heat pack only. The primary outcome was pain intensity after the intervention period and 3 months after the last treatment session, measured by Visual Analogue Scale, 0 to 100. Secondary outcome was health-related quality of life. Treatment with deep friction massage and heat pack gave significant pain reduction compared to heat pack only (-17.6, 95% confidence interval: -30.5, -4.7; p life improved in all three domains in patients with no significant difference between groups. Deep friction massage combined with heat pack is an efficient treatment of musculoskeletal chest pain in patients with stable coronary heart disease.

  19. Deep Ecology: Beyond Mere Environmentalism.

    Science.gov (United States)

    Weber, Suzanne

    1994-01-01

    Outlines the principles of deep ecology, a movement that questions the societal values that have resulted in damage to the earth's life-supporting biosphere. In contrast to shallow reform, deep ecology encourages individuals to examine their values and relationship to nature to address the environmental crisis. (LP)

  20. Context and Deep Learning Design

    Science.gov (United States)

    Boyle, Tom; Ravenscroft, Andrew

    2012-01-01

    Conceptual clarification is essential if we are to establish a stable and deep discipline of technology enhanced learning. The technology is alluring; this can distract from deep design in a surface rush to exploit the affordances of the new technology. We need a basis for design, and a conceptual unit of organization, that are applicable across…

  1. The Capodimonte Deep Field

    Science.gov (United States)

    2001-04-01

    A Window towards the Distant Universe Summary The Osservatorio Astronomico Capodimonte Deep Field (OACDF) is a multi-colour imaging survey project that is opening a new window towards the distant universe. It is conducted with the ESO Wide Field Imager (WFI) , a 67-million pixel advanced camera attached to the MPG/ESO 2.2-m telescope at the La Silla Observatory (Chile). As a pilot project at the Osservatorio Astronomico di Capodimonte (OAC) [1], the OACDF aims at providing a large photometric database for deep extragalactic studies, with important by-products for galactic and planetary research. Moreover, it also serves to gather experience in the proper and efficient handling of very large data sets, preparing for the arrival of the VLT Survey Telescope (VST) with the 1 x 1 degree 2 OmegaCam facility. PR Photo 15a/01 : Colour composite of the OACDF2 field . PR Photo 15b/01 : Interacting galaxies in the OACDF2 field. PR Photo 15c/01 : Spiral galaxy and nebulous object in the OACDF2 field. PR Photo 15d/01 : A galaxy cluster in the OACDF2 field. PR Photo 15e/01 : Another galaxy cluster in the OACDF2 field. PR Photo 15f/01 : An elliptical galaxy in the OACDF2 field. The Capodimonte Deep Field ESO PR Photo 15a/01 ESO PR Photo 15a/01 [Preview - JPEG: 400 x 426 pix - 73k] [Normal - JPEG: 800 x 851 pix - 736k] [Hi-Res - JPEG: 3000 x 3190 pix - 7.3M] Caption : This three-colour image of about 1/4 of the Capodimonte Deep Field (OACDF) was obtained with the Wide-Field Imager (WFI) on the MPG/ESO 2.2-m telescope at the la Silla Observatory. It covers "OACDF Subfield no. 2 (OACDF2)" with an area of about 35 x 32 arcmin 2 (about the size of the full moon), and it is one of the "deepest" wide-field images ever obtained. Technical information about this photo is available below. With the comparatively few large telescopes available in the world, it is not possible to study the Universe to its outmost limits in all directions. Instead, astronomers try to obtain the most detailed

  2. Cardiac troponin: an emerging cardiac biomarker in animal health

    Directory of Open Access Journals (Sweden)

    Vishal V. Undhad

    Full Text Available Analysis of cardiac troponin I (cTn I and T (cTnT are considered the “gold standard” for the non-invasive diagnosis of myocardial injury in human and animals. It has replaced traditionally used cardiac biomarkers such as myoglobin, lactate dehydrogenase (LDH, creatine kinase (CK and CK-MB due to its high sensitivity and specificity for the detection of myocardial injury. Cardiac troponins are proteins that control the calcium-mediated interaction between actin and myosin, allowing contraction at the sarcomere level. Concentration of the cTn can be correlated microscopic lesion and loss of immunolabeling in myocardium damage. Troponin concentration remains elevated in blood for 1-2wks so that wide window is available for diagnosis of myocardial damage. The cTn test has >95% specificity and sensitivity and test is less time consuming (10 to 15 minutes and less costly (INR 200 to INR 500. [Vet. World 2012; 5(8.000: 508-511

  3. Feasibility Study on Cardiac Arrhythmia Ablation Using High-Energy Heavy Ion Beams

    Science.gov (United States)

    Lehmann, H. Immo; Graeff, Christian; Simoniello, Palma; Constantinescu, Anna; Takami, Mitsuru; Lugenbiel, Patrick; Richter, Daniel; Eichhorn, Anna; Prall, Matthias; Kaderka, Robert; Fiedler, Fine; Helmbrecht, Stephan; Fournier, Claudia; Erbeldinger, Nadine; Rahm, Ann-Kathrin; Rivinius, Rasmus; Thomas, Dierk; Katus, Hugo A.; Johnson, Susan B.; Parker, Kay D.; Debus, Jürgen; Asirvatham, Samuel J.; Bert, Christoph; Durante, Marco; Packer, Douglas L.

    2016-12-01

    High-energy ion beams are successfully used in cancer therapy and precisely deliver high doses of ionizing radiation to small deep-seated target volumes. A similar noninvasive treatment modality for cardiac arrhythmias was tested here. This study used high-energy carbon ions for ablation of cardiac tissue in pigs. Doses of 25, 40, and 55 Gy were applied in forced-breath-hold to the atrioventricular junction, left atrial pulmonary vein junction, and freewall left ventricle of intact animals. Procedural success was tracked by (1.) in-beam positron-emission tomography (PET) imaging; (2.) intracardiac voltage mapping with visible lesion on ultrasound; (3.) lesion outcomes in pathohistolgy. High doses (40-55 Gy) caused slowing and interruption of cardiac impulse propagation. Target fibrosis was the main mediator of the ablation effect. In irradiated tissue, apoptosis was present after 3, but not 6 months. Our study shows feasibility to use high-energy ion beams for creation of cardiac lesions that chronically interrupt cardiac conduction.

  4. Systemic Amyloidosis and Cardiac Autonomic Neuropathy Associated with Waldenstrom’s Macroglobulinemia

    Directory of Open Access Journals (Sweden)

    Aasems Jacob

    2017-01-01

    Full Text Available A 73-year-old male with long-standing Waldenstrom’s macroglobulinemia complicated with systemic amyloidosis presented with a witnessed syncopal episode. He had complaints of orthostatic dizziness and palpitations for few months. Orthostatic hypotension and peripheral neuropathy were demonstrated on physical examination. EKG, 24-hour Holter monitoring, and 2D echocardiogram were unremarkable. MRI of the brain ruled out stroke. Patients with amyloidosis can develop cardiovascular disease through amyloid cardiomyopathy, small vessel disease, conduction defects, pericardial effusion, or autonomic denervation. After ruling out other life-threatening causes, Ewing’s battery of tests was done to rule out cardiac autonomic neuropathy. Two heart rate tests and one blood pressure test were abnormal which indicated severe cardiac autonomic neuropathy. Cardiac autonomic neuropathy can mask symptoms of acute coronary syndrome and hence early diagnosis using the simple bedside maneuver is beneficial. The test is also important for prognostication. Absence of augmentation of cardiac output from inadequate autonomic stimulation will lead to postural hypotension, exercise intolerance, and tachycardia. There may be no change in heart rate with Valsalva or deep breathing both of which increase parasympathetic tone. As the condition progresses, it may result in cardiac denervation which can result in silent myocardial infarction, syncope, and sudden death.

  5. Deep Learning the Universe

    Science.gov (United States)

    Singh, Shiwangi; Bard, Deborah

    2017-01-01

    Weak gravitational lensing is an effective tool to map the structure of matter in the universe, and has been used for more than ten years as a probe of the nature of dark energy. Beyond the well-established two-point summary statistics, attention is now turning to methods that use the full statistical information available in the lensing observables, through analysis of the reconstructed shear field. This offers an opportunity to take advantage of powerful deep learning methods for image analysis. We present two early studies that demonstrate that deep learning can be used to characterise features in weak lensing convergence maps, and to identify the underlying cosmological model that produced them.We developed an unsupervised Denoising Convolutional Autoencoder model in order to learn an abstract representation directly from our data. This model uses a convolution-deconvolution architecture, which is fed with input data (corrupted with binomial noise to prevent over-fitting). Our model effectively trains itself to minimize the mean-squared error between the input and the output using gradient descent, resulting in a model which, theoretically, is broad enough to tackle other similarly structured problems. Using this model we were able to successfully reconstruct simulated convergence maps and identify the structures in them. We also determined which structures had the highest “importance” - i.e. which structures were most typical of the data. We note that the structures that had the highest importance in our reconstruction were around high mass concentrations, but were highly non-Gaussian.We also developed a supervised Convolutional Neural Network (CNN) for classification of weak lensing convergence maps from two different simulated theoretical models. The CNN uses a softmax classifier which minimizes a binary cross-entropy loss between the estimated distribution and true distribution. In other words, given an unseen convergence map the trained CNN determines

  6. In Vivo Genome Editing Restores Dystrophin Expression and Cardiac Function in Dystrophic Mice.

    Science.gov (United States)

    El Refaey, Mona; Xu, Li; Gao, Yandi; Canan, Benjamin D; Adesanya, T M Ayodele; Warner, Sarah C; Akagi, Keiko; Symer, David E; Mohler, Peter J; Ma, Jianjie; Janssen, Paul M L; Han, Renzhi

    2017-09-29

    Duchenne muscular dystrophy is a severe inherited form of muscular dystrophy caused by mutations in the reading frame of the dystrophin gene disrupting its protein expression. Dystrophic cardiomyopathy is a leading cause of death in Duchenne muscular dystrophy patients, and currently no effective treatment exists to halt its progression. Recent advancement in genome editing technologies offers a promising therapeutic approach in restoring dystrophin protein expression. However, the impact of this approach on Duchenne muscular dystrophy cardiac function has yet to be evaluated. Therefore, we assessed the therapeutic efficacy of CRISPR (clustered regularly interspaced short palindromic repeats)-mediated genome editing on dystrophin expression and cardiac function in mdx/Utr +/- mice after a single systemic delivery of recombinant adeno-associated virus. To examine the efficiency and physiological impact of CRISPR-mediated genome editing on cardiac dystrophin expression and function in dystrophic mice. Here, we packaged SaCas9 (clustered regularly interspaced short palindromic repeat-associated 9 from Staphylococcus aureus ) and guide RNA constructs into an adeno-associated virus vector and systemically delivered them to mdx/Utr +/- neonates. We showed that CRIPSR-mediated genome editing efficiently excised the mutant exon 23 in dystrophic mice, and immunofluorescence data supported the restoration of dystrophin protein expression in dystrophic cardiac muscles to a level approaching 40%. Moreover, there was a noted restoration in the architecture of cardiac muscle fibers and a reduction in the extent of fibrosis in dystrophin-deficient hearts. The contractility of cardiac papillary muscles was also restored in CRISPR-edited cardiac muscles compared with untreated controls. Furthermore, our targeted deep sequencing results confirmed that our adeno-associated virus-CRISPR/Cas9 strategy was very efficient in deleting the ≈23 kb of intervening genomic sequences. This

  7. Sudden cardiac death in athletes

    Directory of Open Access Journals (Sweden)

    Fábio Camilo Pellegrino dos Santos

    2012-11-01

    Full Text Available ABSTRACT The most accepted definition of sudden cardiac death nowadays is an unexplained death occurred suddenly within one hour of symptom onset. If it was not witnessed, individuals need to had been observed for at least 24 hours before the event and should be discarded the possibility of non cardiac causes of sudden death, pulmonary embolism or extensive malignancy. The term athlete refers to individuals of any age who participate in collective or individual regular physical activity, as well as physical training program for regular competitions. The sudden death of a young athlete, whether amateur or professional, especially during competitions, is always dramatic, with strong negative social impact and in the media. The fact that sports are recommended as a formula for longevity and quality of life makes these events a cause for concern in sports and society in general.

  8. Massage therapy after cardiac surgery.

    Science.gov (United States)

    Wang, Amy T; Sundt, Thoralf M; Cutshall, Susanne M; Bauer, Brent A

    2010-01-01

    Cardiac surgery presents a life-saving and life-enhancing opportunity to hundreds of thousands of patients each year in the United States. However, many patients face significant challenges during the postoperative period, including pain, anxiety, and tension. Mounting evidence demonstrates that such challenges can impair immune function and slow wound healing, in addition to causing suffering for the patient. Finding new approaches to mitigate these challenges is necessary if patients are to experience the full benefits of surgery. Massage therapy is a therapy that has significant evidence to support its role in meeting these needs. This paper looks at the data surrounding the use of massage therapy in cardiac surgery patients, with a special focus on the experience at Mayo Clinic. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Cardiac blood pool emission tomography

    International Nuclear Information System (INIS)

    Itti, R.; Philippe, L.; Lorgeron, J.M.; Charbonnier, B.; Raynaud, P.; Brochier, M.

    1983-01-01

    After blood pool labeling using technetium-99m, a series of cardiac pictures is acquired during the rotation of a gamma-camera about the patient. Computer processing leads to reconstruction of various tomographic slices from the original planar projection. Electrocardiographic gating selects the different phases of the cardiac cycle. Individual slices through the left ventricular region are added in order to provide ''thick'' slices on which global and regional parameters of the left ventricular function can be determined. Due to the proportionality existing between count rates and labeled blood volumes, any geometrical model can be avoided. The delineation of regions of interest for count integration is made easier due to the absence of superimposition of structures; no correction for background is necessary. Tomography thus appears to be more consistent and more accurate than the classical methods using planar projections. In addition, right ventricular morphological and kinetic studies can be performed in the same conditions as for the left ventricle [fr

  10. Metabolic, Cardiac, and Renal Effects of the Slow Hydrogen Sulfide-Releasing Molecule GYY4137 During Resuscitated Septic Shock in Swine with Pre-Existing Coronary Artery Disease.

    Science.gov (United States)

    Nußbaum, Benedikt L; Vogt, Josef; Wachter, Ulrich; McCook, Oscar; Wepler, Martin; Matallo, José; Calzia, Enrico; Gröger, Michael; Georgieff, Michael; Wood, Mark E; Whiteman, Matthew; Radermacher, Peter; Hafner, Sebastian

    2017-08-01

    Decreased levels of endogenous hydrogen sulfide (H2S) contribute to atherosclerosis, whereas equivocal data are available on H2S effects during sepsis. Moreover, H2S improved glucose utilization in anaesthetized, ventilated, hypothermic mice, but normothermia and/or sepsis blunted this effect. The metabolic effects of H2S in large animals are controversial. Therefore, we investigated the effects of the H2S donor GYY4137 during resuscitated, fecal peritonitis-induced septic shock in swine with genetically and diet-induced coronary artery disease (CAD). Twelve and 18 h after peritonitis induction, pigs received either GYY4137 (10 mg kg, n = 9) or vehicle (n = 8). Before, at 12 and 24 h of sepsis, we assessed left ventricular (pressure-conductance catheters) and renal (creatinine clearance, blood NGAL levels) function. Endogenous glucose production and glucose oxidation were derived from the plasma glucose isotope and the expiratory CO2/CO2 enrichment during continuous i.v. 1,2,3,4,5,6-C6-glucose infusion. GYY4137 significantly increased aerobic glucose oxidation, which coincided with higher requirements of exogenous glucose to maintain normoglycemia, as well as significantly lower arterial pH and decreased base excess. Apart from significantly lower cardiac eNOS expression and higher troponin levels, GYY4137 did not significantly influence cardiac and kidney function or the systemic inflammatory response. During resuscitated septic shock in swine with CAD, GYY4137 shifted metabolism to preferential carbohydrate utilization. Increased troponin levels are possibly due to reduced local NO availability. Cautious dosing, the timing of GYY4137 administration, and interspecies differences most likely account for the absence of any previously described anti-inflammatory or organ-protective effects of GYY4137 in this model.

  11. Deep video deblurring

    KAUST Repository

    Su, Shuochen

    2016-11-25

    Motion blur from camera shake is a major problem in videos captured by hand-held devices. Unlike single-image deblurring, video-based approaches can take advantage of the abundant information that exists across neighboring frames. As a result the best performing methods rely on aligning nearby frames. However, aligning images is a computationally expensive and fragile procedure, and methods that aggregate information must therefore be able to identify which regions have been accurately aligned and which have not, a task which requires high level scene understanding. In this work, we introduce a deep learning solution to video deblurring, where a CNN is trained end-to-end to learn how to accumulate information across frames. To train this network, we collected a dataset of real videos recorded with a high framerate camera, which we use to generate synthetic motion blur for supervision. We show that the features learned from this dataset extend to deblurring motion blur that arises due to camera shake in a wide range of videos, and compare the quality of results to a number of other baselines.

  12. Operation Deep Sweep

    Science.gov (United States)

    Bell, Peter M.

    Fifty scientists and a crew of 18 have embarked on a 64,000 km odyssey to explore the Pacific from pole to pole—the most ambitious program in the history of the marine geology branch of the U.S. Geological Survey (USGS). Called Operation Deep Sweep, the 1-year cruise will search areas above the Arctic Circle, off of Alaska, to McMurdo Sound in Antarctica. The 63-m, 1,300-tonne research vessel Samuel P. Lee sailed from its home port of Redwood City, Calif., to San Francisco to begin the first leg of the lengthy journey.According to USGS officials and the cosponsoring Circum-Pacific Council for Energy and Mineral Resources of the American Association of Petroleum Geologists, the cruise will ultimately involve 150 scientists, some of them representing Germany, France, Australia, and New Zealand. David Howell, branch chief of Pacific Marine Geology for the USGS, said the voyage of the Lee was “the most far reaching and of the longest duration” ever attempted by his unit. He said the cruise would string together a large number of scientific experiments spanning the Pacific. Howell likened the voyage to the Lewis and Clark Expedition of 1803-1806 (which explored Louisiana and the western United States) because “we're going into unknown territory and into regions not studied except in the most cursory manner.”

  13. Deep inelastic final states

    International Nuclear Information System (INIS)

    Girardi, G.

    1980-11-01

    In these lectures we attempt to describe the final states of deep inelastic scattering as given by QCD. In the first section we shall briefly comment on the parton model and give the main properties of decay functions which are of interest for the study of semi-inclusive leptoproduction. The second section is devoted to the QCD approach to single hadron leptoproduction. First we recall basic facts on QCD log's and derive after that the evolution equations for the fragmentation functions. For this purpose we make a short detour in e + e - annihilation. The rest of the section is a study of the factorization of long distance effects associated with the initial and final states. We then show how when one includes next to leading QCD corrections one induces factorization breaking and describe the double moments useful for testing such effects. The next section contains a review on the QCD jets in the hadronic final state. We begin by introducing the notion of infrared safe variable and defining a few useful examples. Distributions in these variables are studied to first order in QCD, with some comments on the resummation of logs encountered in higher orders. Finally the last section is a 'gaullimaufry' of jet studies

  14. Deep space telescopes

    CERN Multimedia

    CERN. Geneva

    2006-01-01

    The short series of seminars will address results and aims of current and future space astrophysics as the cultural framework for the development of deep space telescopes. It will then present such new tools, as they are currently available to, or imagined by, the scientific community, in the context of the science plans of ESA and of all major world space agencies. Ground-based astronomy, in the 400 years since Galileo’s telescope, has given us a profound phenomenological comprehension of our Universe, but has traditionally been limited to the narrow band(s) to which our terrestrial atmosphere is transparent. Celestial objects, however, do not care about our limitations, and distribute most of the information about their physics throughout the complete electromagnetic spectrum. Such information is there for the taking, from millimiter wavelengths to gamma rays. Forty years astronomy from space, covering now most of the e.m. spectrum, have thus given us a better understanding of our physical Universe then t...

  15. Cardiac surgery in the parturient.

    Science.gov (United States)

    Chandrasekhar, Shobana; Cook, Christopher R; Collard, Charles D

    2009-03-01

    Heart disease is the primary cause of nonobstetric mortality in pregnancy, occurring in 1%-3% of pregnancies and accounting for 10%-15% of maternal deaths. Congenital heart disease has become more prevalent in women of childbearing age, representing an increasing percentage (up to 75%) of heart disease in pregnancy. Untreated maternal heart disease also places the fetus at risk. Independent predictors of neonatal complications include a maternal New York Heart Association heart failure classification >2, anticoagulation use during pregnancy, smoking, multiple gestation, and left heart obstruction. Because cardiac surgical morbidity and mortality in the parturient is higher than nonpregnant patients, most parturients with cardiac disease are first managed medically, with cardiac surgery being reserved when medical management fails. Risk factors for maternal mortality during cardiac surgery include the use of vasoactive drugs, age, type of surgery, reoperation, and maternal functional class. Risk factors for fetal mortality include maternal age >35 yr, functional class, reoperation, emergency surgery, type of myocardial protection, and anoxic time. Nonetheless, acceptable maternal and fetal perioperative mortality rates may be achieved through such measures as early preoperative detection of maternal cardiovascular decompensation, use of fetal monitoring, delivery of a viable fetus before the operation and scheduling surgery on an elective basis during the second trimester. Additionally, fetal morbidity may be reduced during cardiopulmonary bypass by optimizing maternal oxygen-carrying capacity and uterine blood flow. Current maternal bypass recommendations include: 1) maintaining the pump flow rate >2.5 L x min(-1) x m(-2) and perfusion pressure >70 mm Hg; 2) maintaining the hematocrit > 28%; 3) using normothermic perfusion when feasible; 4) using pulsatile flow; and 5) using alpha-stat pH management.

  16. The paediatrician and cardiac auscultation

    OpenAIRE

    Roy, Douglas L

    2003-01-01

    The cardiac auscultation (CA) skills of paediatric residents and office-based paediatricians have recently been shown to be suboptimal. CA is known to have a high degree of specificity and sensitivity, and is inexpensive. New teaching aids and availability of surrogate patient heart sounds and murmurs now allow most physicians to acquire CA skills. These teaching aids should be available in all medical schools and in all postgraduate paediatric training programs. While the relationship betwee...

  17. Neurological Complications of Cardiac Surgery

    OpenAIRE

    Gottesman, Rebecca F.; McKhann, Guy M.; Hogue, Charles W.

    2008-01-01

    Neurological injury resulting from cardiac surgery has a range of manifestations from focal neurological deficit to encephalopathy or coma. As the safety of drug-eluting stents comes into question, more patients will likely undergo coronary artery bypass graft surgery. These projections, along with the growing proportions of elderly patients and those with comorbidities, portend the potential for rising rates of perioperative neurological complications. The risk for neurological injury may be...

  18. Clinical application of cardiac SPECT

    International Nuclear Information System (INIS)

    Nishimura, Shigeyuki

    1999-01-01

    Single-photon emission computed tomography (SPECT) has replaced planar imaging techniques for myocardial scintigraphy. Thallium-201 was the dominant agent employed for myocardial perfusion imaging. Today new technetium-99m labelled radionuclides have been used as excellent alternatives to 201 Tl for detection of coronary artery disease, prognostification, and even assessment of myocardial viability. Pharmacologic stress imaging using either dipyridamole, adenosine or dobutamine is a substitute for exercise stress. Accurate determination of myocardial viability is vitally important for clinical decision making for patients with LV dysfunction who will most benefit from revascularization. Stunned and hibernated myocardium may result in profound regional LTV dysfunction in absence of necrosis. The various approach such as stress-redistribution-reinjection imaging, rest-redistribution imaging and stress-redistribution-24 hours delayed imaging has been utilized to assess myocardial viability with 201 Tl. Quantitative assessment of 99m Tc MIBI uptake reflect the degree of viability. 123 I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by 123 I-MIBG, due to ischemia in non-Q myocardial infarction and unstable angina has been shown. Quantitative cardiac MIBG scintigram was shown to have prognostic value in patients with severe congestive heart failure. 23 I-BMIPP (ρ-methyl-iodophenyl pentadecanoic acid) has been used to assess myocardial fatty acid utilization. BMIPP has the memory function of ischemia in unstable angina, since decreased BMIPP uptake persists several days after ischemic episode. Nuclear cardiology in Japan has experienced an expansion in the techniques including use of new radionuclides, 99m Tc perfusion agents, 123 I-MIBG and 23 I-BMIPP and in associated clinical application to the various cardiac diseases

  19. Clinical application of cardiac SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nishimura, Shigeyuki [Yokohama Rosai Hospital (Japan)

    1999-07-01

    Single-photon emission computed tomography (SPECT) has replaced planar imaging techniques for myocardial scintigraphy. Thallium-201 was the dominant agent employed for myocardial perfusion imaging. Today new technetium-99m labelled radionuclides have been used as excellent alternatives to {sup 201}Tl for detection of coronary artery disease, prognostification, and even assessment of myocardial viability. Pharmacologic stress imaging using either dipyridamole, adenosine or dobutamine is a substitute for exercise stress. Accurate determination of myocardial viability is vitally important for clinical decision making for patients with LV dysfunction who will most benefit from revascularization. Stunned and hibernated myocardium may result in profound regional LTV dysfunction in absence of necrosis. The various approach such as stress-redistribution-reinjection imaging, rest-redistribution imaging and stress-redistribution-24 hours delayed imaging has been utilized to assess myocardial viability with {sup 201}Tl. Quantitative assessment of {sup 99m}Tc MIBI uptake reflect the degree of viability. {sup 123}I-Metaiodobenzylguanidine (MIBG), an analog of norepinephrine, has been used for scintigraphic assessment of regional cardiac adrenergic innervation. Cardiac sympathetic denervation, assessed by {sup 123}I-MIBG, due to ischemia in non-Q myocardial infarction and unstable angina has been shown. Quantitative cardiac MIBG scintigram was shown to have prognostic value in patients with severe congestive heart failure. {sup 23}I-BMIPP ({rho}-methyl-iodophenyl pentadecanoic acid) has been used to assess myocardial fatty acid utilization. BMIPP has the memory function of ischemia in unstable angina, since decreased BMIPP uptake persists several days after ischemic episode. Nuclear cardiology in Japan has experienced an expansion in the techniques including use of new radionuclides, {sup 99m}Tc perfusion agents, {sup 123}I-MIBG and {sup 23}I-BMIPP and in associated clinical

  20. Gene Therapy in Cardiac Arrhythmias

    OpenAIRE

    Praveen, S.V; Francis, Johnson; Venugopal, K

    2006-01-01

    Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV...

  1. Pregnancy as a cardiac stress model

    Science.gov (United States)

    Chung, Eunhee; Leinwand, Leslie A.

    2014-01-01

    Cardiac hypertrophy occurs during pregnancy as a consequence of both volume overload and hormonal changes. Both pregnancy- and exercise-induced cardiac hypertrophy are generally thought to be similar and physiological. Despite the fact that there are shared transcriptional responses in both forms of cardiac adaptation, pregnancy results in a distinct signature of gene expression in the heart. In some cases, however, pregnancy can induce adverse cardiac events in previously healthy women without any known cardiovascular disease. Peripartum cardiomyopathy is the leading cause of non-obstetric mortality during pregnancy. To understand how pregnancy can cause heart disease, it is first important to understand cardiac adaptation during normal pregnancy. This review provides an overview of the cardiac consequences of pregnancy, including haemodynamic, functional, structural, and morphological adaptations, as well as molecular phenotypes. In addition, this review describes the signalling pathways responsible for pregnancy-induced cardiac hypertrophy and angiogenesis. We also compare and contrast cardiac adaptation in response to disease, exercise, and pregnancy. The comparisons of these settings of cardiac hypertrophy provide insight into pregnancy-associated cardiac adaptation. PMID:24448313

  2. Neurological complications of cardiac surgery.

    Science.gov (United States)

    Gottesman, Rebecca F; McKhann, Guy M; Hogue, Charles W

    2008-11-01

    Neurological injury resulting from cardiac surgery has a range of manifestations from focal neurological deficit to encephalopathy or coma. As the safety of drug-eluting stents comes into question, more patients will likely undergo coronary artery bypass graft surgery. These projections, along with the growing proportions of elderly patients and those with comorbidities, portend the potential for rising rates of perioperative neurological complications. The risk for neurological injury may be determined by the type of procedure, by patient-specific characteristics, and by the extent of cerebral embolization and hypoperfusion during and after surgery. Changes in surgical techniques, including the use of off-pump surgery, have not decreased rates of brain injury from cardiac surgery. When appropriate, modern neuroimaging techniques should be used in postoperative patients to confirm diagnosis, to provide information on potential etiology, to direct appropriate therapy, and to help in prognostication. Management of postoperative medications and early use of rehabilitation services is a recommended strategy to optimize the recovery for individuals with neurological injury after cardiac surgery.

  3. Cardiac MRI in restrictive cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Singh Gulati, G., E-mail: gulatigurpreet@rediffmail.com [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Seth, S. [Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Sharma, S. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India)

    2012-02-15

    Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.

  4. Deep Mapping and Spatial Anthropology

    Directory of Open Access Journals (Sweden)

    Les Roberts

    2016-01-01

    Full Text Available This paper provides an introduction to the Humanities Special Issue on “Deep Mapping”. It sets out the rationale for the collection and explores the broad-ranging nature of perspectives and practices that fall within the “undisciplined” interdisciplinary domain of spatial humanities. Sketching a cross-current of ideas that have begun to coalesce around the concept of “deep mapping”, the paper argues that rather than attempting to outline a set of defining characteristics and “deep” cartographic features, a more instructive approach is to pay closer attention to the multivalent ways deep mapping is performatively put to work. Casting a critical and reflexive gaze over the developing discourse of deep mapping, it is argued that what deep mapping “is” cannot be reduced to the otherwise a-spatial and a-temporal fixity of the “deep map”. In this respect, as an undisciplined survey of this increasing expansive field of study and practice, the paper explores the ways in which deep mapping can engage broader discussion around questions of spatial anthropology.

  5. Deep learning for computational chemistry.

    Science.gov (United States)

    Goh, Garrett B; Hodas, Nathan O; Vishnu, Abhinav

    2017-06-15

    The rise and fall of artificial neural networks is well documented in the scientific literature of both computer science and computational chemistry. Yet almost two decades later, we are now seeing a resurgence of interest in deep learning, a machine learning algorithm based on multilayer neural networks. Within the last few years, we have seen the transformative impact of deep learning in many domains, particularly in speech recognition and computer vision, to the extent that the majority of expert practitioners in those field are now regularly eschewing prior established models in favor of deep learning models. In this review, we provide an introductory overview into the theory of deep neural networks and their unique properties that distinguish them from traditional machine learning algorithms used in cheminformatics. By providing an overview of the variety of emerging applications of deep neural networks, we highlight its ubiquity and broad applicability to a wide range of challenges in the field, including quantitative structure activity relationship, virtual screening, protein structure prediction, quantum chemistry, materials design, and property prediction. In reviewing the performance of deep neural networks, we observed a consistent outperformance against non-neural networks state-of-the-art models across disparate research topics, and deep neural network-based models often exceeded the "glass ceiling" expectations of their respective tasks. Coupled with the maturity of GPU-accelerated computing for training deep neural networks and the exponential growth of chemical data on which to train these networks on, we anticipate that deep learning algorithms will be a valuable tool for computational chemistry. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  6. Deep learning for computational chemistry

    Energy Technology Data Exchange (ETDEWEB)

    Goh, Garrett B. [Advanced Computing, Mathematics, and Data Division, Pacific Northwest National Laboratory, 902 Battelle Blvd Richland Washington 99354; Hodas, Nathan O. [Advanced Computing, Mathematics, and Data Division, Pacific Northwest National Laboratory, 902 Battelle Blvd Richland Washington 99354; Vishnu, Abhinav [Advanced Computing, Mathematics, and Data Division, Pacific Northwest National Laboratory, 902 Battelle Blvd Richland Washington 99354

    2017-03-08

    The rise and fall of artificial neural networks is well documented in the scientific literature of both the fields of computer science and computational chemistry. Yet almost two decades later, we are now seeing a resurgence of interest in deep learning, a machine learning algorithm based on “deep” neural networks. Within the last few years, we have seen the transformative impact of deep learning the computer science domain, notably in speech recognition and computer vision, to the extent that the majority of practitioners in those field are now regularly eschewing prior established models in favor of deep learning models. In this review, we provide an introductory overview into the theory of deep neural networks and their unique properties as compared to traditional machine learning algorithms used in cheminformatics. By providing an overview of the variety of emerging applications of deep neural networks, we highlight its ubiquity and broad applicability to a wide range of challenges in the field, including QSAR, virtual screening, protein structure modeling, QM calculations, materials synthesis and property prediction. In reviewing the performance of deep neural networks, we observed a consistent outperformance against non neural networks state-of-the-art models across disparate research topics, and deep neural network based models often exceeded the “glass ceiling” expectations of their respective tasks. Coupled with the maturity of GPU-accelerated computing for training deep neural networks and the exponential growth of chemical data on which to train these networks on, we anticipate that deep learning algorithms will be a useful tool and may grow into a pivotal role for various challenges in the computational chemistry field.

  7. [Vacuum-assisted closure as a treatment modality for surgical site infection in cardiac surgery].

    Science.gov (United States)

    Simek, M; Nemec, P; Zálesák, B; Hájek, R; Kaláb, M; Fluger, I; Kolár, M; Jecmínková, L; Gráfová, P

    2007-08-01

    The vacuum-asssited closure has represented an encouraging treatment modality in treatment of surgical site infection in cardiac surgery, providing superior results compared with conventional treatment strategies, particularly in the treatment of deep sternal wound infection. From November 2004 to January 2007, 40 patients, undergoing VAC therapy (VAC system, KCI, Austria, Hartmann-Rico Inc., Czech Republic) for surgical site infection following cardiac surgery, were prospectively evaluated. Four patients (10%) were treated for extensive leg-wound infection, 10 (25%) were treated for superficial sternal wound infection and 26 (65%) for deep sternal wound infection. The median age was 69.9 +/- 9.7 years and the median BMI was 33.2 +/- 5.0 kg/m2. Twenty-three patients (57%) were women and diabetes was present in 22 patients (55%). The VAC was employed after the previous failure of the conventional treatment strategy in 7 patients (18%). Thirty-eight patients (95%) were successfully healed. Two patients (5%) died, both of deep sternal infetion consequences. The overall length of hospitalization was 36.4 +/- 22.6 days. The median number of dressing changes was 4.6 +/- 1.8. The median VAC treatment time until surgical closure was 9.7 +/- 3.9 days. The VAC therapy was solely used as a bridge to the definite wound closure. Four patients (10%) with a chronic fistula were re-admitted with the range of 1 to 12 months after the VAC therapy. The VAC therapy is a safe and reliable option in the treatment of surgical site infection in the field of cardiac surgery. The VAC therapy can be considered as an effective adjunct to convetional treatment modalities for the therapy of extensive and life-threatening wound infection following cardiac surgery, particurlarly in the group of high-risk patients.

  8. Deep learning applications in ophthalmology.

    Science.gov (United States)

    Rahimy, Ehsan

    2018-05-01

    To describe the emerging applications of deep learning in ophthalmology. Recent studies have shown that various deep learning models are capable of detecting and diagnosing various diseases afflicting the posterior segment of the eye with high accuracy. Most of the initial studies have centered around detection of referable diabetic retinopathy, age-related macular degeneration, and glaucoma. Deep learning has shown promising results in automated image analysis of fundus photographs and optical coherence tomography images. Additional testing and research is required to clinically validate this technology.

  9. Distributed Deep Q-Learning

    OpenAIRE

    Ong, Hao Yi; Chavez, Kevin; Hong, Augustus

    2015-01-01

    We propose a distributed deep learning model to successfully learn control policies directly from high-dimensional sensory input using reinforcement learning. The model is based on the deep Q-network, a convolutional neural network trained with a variant of Q-learning. Its input is raw pixels and its output is a value function estimating future rewards from taking an action given a system state. To distribute the deep Q-network training, we adapt the DistBelief software framework to the conte...

  10. Deep-sea genetic resources

    OpenAIRE

    Desbruyere, D; Arnaud-haond, Sophie; Fabri, Marie-claire; Guezennec, Jean; Querellou, Joel

    2007-01-01

    Two third of our Planet are covered by oceans more than 3,000m deep (~ 307 millions km2) and the mean depth of the sea is approximately 3,800m. The volume of the deep ocean (aphotic) is about 1,280 Millions of km3 while the volume of terrestrial ecosystems is only 125 Millions of km3. Therefore, the deep-sea ecosystem is by far the largest complex biome on the Earth. However, it suffers from a general disinterest of the public and decision makers due to its remoteness and inaccessibility. Edw...

  11. Deep Brain Stimulation for Parkinson's Disease

    Science.gov (United States)

    ... Home » Disorders » All Disorders Deep Brain Stimulation for Parkinson's Disease Information Page Deep Brain Stimulation for Parkinson's Disease Information Page What research is being done? The ...

  12. DEEP INFILTRATING ENDOMETRIOSIS

    Directory of Open Access Journals (Sweden)

    Martina Ribič-Pucelj

    2018-02-01

    Full Text Available Background: Endometriosis is not considered a unified disease, but a disease encompassing three differ- ent forms differentiated by aetiology and pathogenesis: peritoneal endometriosis, ovarian endometriosis and deep infiltrating endometriosis (DIE. The disease is classified as DIE when the lesions penetrate 5 mm or more into the retroperitoneal space. The estimated incidence of endometriosis in women of reproductive age ranges from 10–15 % and that of DIE from 3–10 %, the highest being in infertile women and in those with chronic pelvic pain. The leading symptoms of DIE are chronic pelvic pain which increases with age and correlates with the depth of infiltration and infertility. The most important diagnostic procedures are patient’s history and proper gynecological examination. The diagnosis is confirmed with laparoscopy. DIE can affect, beside reproductive organs, also bowel, bladder and ureters, therefore adi- tional diagnostic procedures must be performed preopertively to confirm or to exclude the involvement of the mentioned organs. Endometriosis is hormon dependent disease, there- fore several hormonal treatment regims are used to supress estrogen production but the symptoms recurr soon after caesation of the treatment. At the moment, surgical treatment with excision of all lesions, including those of bowel, bladder and ureters, is the method of choice but requires frequently interdisciplinary approach. Surgical treatment significantly reduces pain and improves fertility in inferile patients. Conclusions: DIE is not a rare form of endometriosis characterized by chronic pelvic pain and infertility. Medical treatment is not efficient. The method of choice is surgical treatment with excision of all lesions. It significantly reduces pelvic pain and enables high spontaneus and IVF preg- nacy rates.Therefore such patients should be treated at centres with experience in treatment of DIE and with possibility of interdisciplinary approach.

  13. Mast Cells: Key Contributors to Cardiac Fibrosis

    Directory of Open Access Journals (Sweden)

    Scott P. Levick

    2018-01-01

    Full Text Available Historically, increased numbers of mast cells have been associated with fibrosis in numerous cardiac pathologies, implicating mast cells in the development of cardiac fibrosis. Subsequently, several approaches have been utilised to demonstrate a causal role for mast cells in animal models of cardiac fibrosis including mast cell stabilising compounds, rodents deficient in mast cells, and inhibition of the actions of mast cell-specific proteases such as chymase and tryptase. Whilst most evidence supports a pro-fibrotic role for mast cells, there is evidence that in some settings these cells can oppose fibrosis. A major gap in our current understanding of cardiac mast cell function is identification of the stimuli that activate these cells causing them to promote a pro-fibrotic environment. This review will present the evidence linking mast cells to cardiac fibrosis, as well as discuss the major questions that remain in understanding how mast cells contribute to cardiac fibrosis.

  14. Cardiac tamponade: contrast reflux as an indicator of cardiac chamber equalization

    Directory of Open Access Journals (Sweden)

    Nauta Foeke Jacob

    2012-05-01

    Full Text Available Abstract Background Traumatic hemopericardium remains a rare entity; it does however commonly cause cardiac tamponade which remains a major cause of death in traumatic blunt cardiac injury. Objectives We present a case of blunt chest trauma complicated by cardiac tamponade causing cardiac chamber equalization revealed by reflux of contrast. Case report A 29-year-old unidentified male suffered blunt chest trauma in a motor vehicle collision. Computed tomography (CT demonstrated a periaortic hematoma and hemopericardium. Significant contrast reflux was seen in the inferior vena cava and hepatic veins suggesting a change in cardiac chamber pressures. After intensive treatment including cardiac massage this patient expired of cardiac arrest. Conclusion Reflux of contrast on CT imaging can be an indicator of traumatic cardiac tamponade.

  15. Cardiac-specific ablation of glutaredoxin 3 leads to cardiac hypertrophy and heart failure

    Science.gov (United States)

    Experimental and clinical investigations have demonstrated that reactive oxygen species (ROS) production is increased during cardiac hypertrophy and heart failure. Excess ROS can directly impair cardiac contraction through modification of Ca2+ handling proteins or activate multiple effectors and sig...

  16. Sensing Cardiac Electrical Activity With a Cardiac Myocyte--Targeted Optogenetic Voltage Indicator

    NARCIS (Netherlands)

    Chang Liao, Mei-Ling; de Boer, Teun P|info:eu-repo/dai/nl/30481878X; Mutoh, Hiroki; Raad, Nour; Richter, Claudia; Wagner, Eva; Downie, Bryan R; Unsöld, Bernhard; Arooj, Iqra; Streckfuss-Bömeke, Katrin; Döker, Stephan; Luther, Stefan; Guan, Kaomei; Wagner, Stefan; Lehnart, Stephan E; Maier, Lars S; Stühmer, Walter; Wettwer, Erich; van Veen, Toon|info:eu-repo/dai/nl/229701310; Morlock, Michael M; Knöpfel, Thomas; Zimmermann, Wolfram-Hubertus

    2015-01-01

    RATIONALE: Monitoring and controlling cardiac myocyte activity with optogenetic tools offer exciting possibilities for fundamental and translational cardiovascular research. Genetically encoded voltage indicators may be particularly attractive for minimal invasive and repeated assessments of cardiac

  17. Deep Space Optical Communications (DSOC)

    Data.gov (United States)

    National Aeronautics and Space Administration — The GCD Program funded Deep Space Optical Communications (DSOC) Project is targeting at least 10x higher instantaneous downlink data-rate while utilizing the...

  18. Telepresence for Deep Space Missions

    Data.gov (United States)

    National Aeronautics and Space Administration — Incorporating telepresence technologies into deep space mission operations can give the crew and ground personnel the impression that they are in a location at time...

  19. Sudden cardiac death with triple pathologies: A case report

    Directory of Open Access Journals (Sweden)

    R. Razuin

    2017-06-01

    Full Text Available Sudden cardiac death in young adults may be associated with rare cardiomyopathies such as left ventricular noncompaction (LVNC and arrhythmogenic right ventricular (ARVC cardiomyopathies. LVNC is characterised by hypertrabeculations and deep recesses of the left ventricle. ARVC presents with thin myocardium as a result of extensive fibro-fatty infiltrations. In both conditions, death may be due to arrhythmia, thromboembolic events or heart failure. We report a case of a 21-year old athletic young man who collapsed at the futsal court right after the game. He was resuscitated but expired at the hospital after a brief admission. A week earlier, he had a similar episode of syncope and revived through cardio-pulmonary resuscitation at the site. Post mortem examination showed extensive acute myocardial infarction (AMI involving the papillary muscles and the left ventricular wall. Features of LVNC were also observed. On top of that, the right ventricle showed patchy thin myocardium as the wall was largely comprised of fat. Histology examination confirmed the presence of AMI and massive fibro-fatty infiltrations of the right ventricle. This unfortunate young man had co-existing cardiomyopathies which is rare indeed. As he succumbed to AMI, this mechanism of death is also uncommonly associated with neither LVNC nor ARVC. In conclusion, young and physically active individuals may not be spared of sudden cardiac death. Mild and non-specific symptoms should not be taken lightly as it may be the subtle signs of cardiomyopathies.

  20. Complexity analysis of experimental cardiac arrhythmia

    OpenAIRE

    Xu, Binbin; Binczak, Stéphane; Jacquir, Sabir; Pont, Oriol; Yahia, Hussein

    2014-01-01

    International audience; To study the cardiac arrhythmia, an in vitro experimental model and Multielectrodes Array (MEA) are used. This platform serves as an intermediary of the electrical activities of cardiac cells and the signal processing / dynamics analysis. Through it the extracellular potential of cardiac cells is acquired, allowing a real-time monitoring / analyzing. Since MEA has 60 electrodes / channels dispatched in a rectangular region, it allows real-time monitoring and signal acq...

  1. Trigeminal cardiac reflex and cerebral blood flow regulation

    Directory of Open Access Journals (Sweden)

    Dominga Lapi

    2016-10-01

    Full Text Available The stimulation of some facial regions is known to trigger the trigemino-cardiac reflex: the main stimulus is represented by the contact of the face with water. This phenomenon called diving reflex induces a set of reactions in the cardiovascular and respiratory systems occurring in all mammals, especially marine (whales, seals. During the immersion of the face in the water, the main responses are aimed at reducing the oxygen consumption of the organism. Accordingly reduction in heart rate, peripheral vasoconstriction, blood pooling in certain organs, especially the heart and brain, and an increase in blood pressure have been reported. Moreover, the speed and intensity of the reflex is inversely proportional to the temperature of the water: more cold the water, more reactions as described are strong. In the case of deep diving an additional effect, such as blood deviation, has been reported: the blood is requested within the lungs, to compensate for the increase in the external pressure, preventing them from collapsing.The trigeminal-cardiac reflex is not just confined to the diving reflex; recently it has been shown that a brief proprioceptive stimulation (10 min by jaw extension in rats produces interesting effects both at systemic and cerebral level, reducing the arterial blood pressure and vasodilating the pial arterioles. The arteriolar dilation is associated with rhythmic diameter changes characterized by an increase in the endothelial activity. Fascinating the stimulation of trigeminal nerve is able to activated the nitric oxide release by vascular endothelial. Therefore the aim of this review was to highlight the effects due to trigeminal cardiac reflex induced by a simple mandibular extension, because produced opposite effects compared to those elicited by the diving reflex as it induces hypotension and modulation of cerebral arteriolar tone.

  2. Weakly Supervised Deep Detection Networks

    OpenAIRE

    Bilen, Hakan; Vedaldi, Andrea

    2015-01-01

    Weakly supervised learning of object detection is an important problem in image understanding that still does not have a satisfactory solution. In this paper, we address this problem by exploiting the power of deep convolutional neural networks pre-trained on large-scale image-level classification tasks. We propose a weakly supervised deep detection architecture that modifies one such network to operate at the level of image regions, performing simultaneously region selection and classificati...

  3. Deep Learning and Bayesian Methods

    OpenAIRE

    Prosper Harrison B.

    2017-01-01

    A revolution is underway in which deep neural networks are routinely used to solve diffcult problems such as face recognition and natural language understanding. Particle physicists have taken notice and have started to deploy these methods, achieving results that suggest a potentially significant shift in how data might be analyzed in the not too distant future. We discuss a few recent developments in the application of deep neural networks and then indulge in speculation about how such meth...

  4. Deep space infections of neck

    OpenAIRE

    Kaluskar, S.; Bajaj, P.; Bane, P.

    2007-01-01

    A retrospective study was performed on fourteen cases of deep cervical space infections in the neck admitted for diagnosis and treatment to the ENT Department, during a period of seven years from 1989–1997. Of the fourteen, four patients had Ludwig’s angina and of the fourteen, one had a very serious complication resulting in death. Early diagnosis and adequate treatment were of paramount importance. The role of tracheostomy and management of airway in deep cervical space infections of the ne...

  5. Penetrating cardiac injury following sewing needle ingestion.

    Science.gov (United States)

    Sobnach, Sanju; Castillo, Franco; Blanco Vinent, René; Kahn, Delawir; Bhyat, Ahmed

    2011-07-01

    Penetrating cardiac injuries are common in South Africa. Reports describing traumatic lesions to the heart caused by caudo-cranial migration of ingested foreign bodies are however extremely rare. Delayed presentation and intervention are associated with poor outcome in these patients; cardiac tamponade remains the most serious complication. We present the case of a 19 year-old man who sustained a left ventricular injury after intentionally swallowing eight sewing needles. The impacted needle was removed through a median sternotomy and the patient recovered uneventfully. Copyright © 2011 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

  6. Preserved heart rate variability during therapeutic hypothermia correlated to 96 hrs neurological outcomes and survival in a pig model of cardiac arrest.

    Science.gov (United States)

    Li, Yongqin; Ristagno, Giuseppe; Guan, Jun; Barbut, Denise; Bisera, Joe; Weil, Max Harry; Tang, Wanchun

    2012-02-01

    Therapeutic hypothermia initiated with cardiopulmonary resuscitation improves neurologic outcomes and survival after prolonged cardiac arrest. However, the potential mechanism by which hypothermia improves neurologic outcomes remains unclear. In the current study, we investigated the effect of rapid head cooling on 96-hr neurologic outcomes and survival by heart rate variability analysis in a pig model of prolonged cardiac arrest. Prospective randomized controlled animal study. University-affiliated research laboratory. Yorkshire-X domestic pigs (Sus scrofa). A protocol of 10 mins of untreated ventricular fibrillation followed by 5 mins of cardiopulmonary resuscitation in a pig model of cardiac arrest was used in this study. Sixteen male domestic pigs weighing between 39 and 45 kg were randomized into two groups, hypothermia (n = 8) and control (n = 8). For the hypothermia group, intranasal-induced head cooling was initiated with cardiopulmonary resuscitation and persisted for 4 hrs after resuscitation. For the control group, cardiopulmonary resuscitation was started with normothermia. Time and frequency domain heart rate variability was calculated in 5-min sections of electrocardiographic recordings at baseline and 4 hrs after resuscitation. Neurologic outcomes were evaluated every 24 hrs during the 96-hr postresuscitation observation period. No differences in the baseline measurement and resuscitation outcome were observed between the groups. However, the 96-hr cerebral performance categories of the hypothermic group were significantly lower than control (1.0 ± 0.0 vs. 4.0 ± 1.9, p = .003). Four hrs after resuscitation, mean RR interval, heart rate variability triangular index, and normalized very-low-frequency power were restored to baseline in the hypothermia group. Square root of the mean squared differences of successive RR intervals and SD of instantaneous RR intervals were significantly improved in the cooled animals compared with controls. A significant

  7. Hot, deep origin of petroleum: deep basin evidence and application

    Science.gov (United States)

    Price, Leigh C.

    1978-01-01

    Use of the model of a hot deep origin of oil places rigid constraints on the migration and entrapment of crude oil. Specifically, oil originating from depth migrates vertically up faults and is emplaced in traps at shallower depths. Review of petroleum-producing basins worldwide shows oil occurrence in these basins conforms to the restraints of and therefore supports the hypothesis. Most of the world's oil is found in the very deepest sedimentary basins, and production over or adjacent to the deep basin is cut by or directly updip from faults dipping into the basin deep. Generally the greater the fault throw the greater the reserves. Fault-block highs next to deep sedimentary troughs are the best target areas by the present concept. Traps along major basin-forming faults are quite prospective. The structural style of a basin governs the distribution, types, and amounts of hydrocarbons expected and hence the exploration strategy. Production in delta depocenters (Niger) is in structures cut by or updip from major growth faults, and structures not associated with such faults are barren. Production in block fault basins is on horsts next to deep sedimentary troughs (Sirte, North Sea). In basins whose sediment thickness, structure and geologic history are known to a moderate degree, the main oil occurrences can be specifically predicted by analysis of fault systems and possible hydrocarbon migration routes. Use of the concept permits the identification of significant targets which have either been downgraded or ignored in the past, such as production in or just updip from thrust belts, stratigraphic traps over the deep basin associated with major faulting, production over the basin deep, and regional stratigraphic trapping updip from established production along major fault zones.

  8. The need for cardiac follow-up in adults with mild congenital cardiac disease

    NARCIS (Netherlands)

    Kamphuis, Mascha; Vliegen, Hubert W.; Vogels, Ton; Zwinderman, Koos H.; van der Wall, Ernst E.; Verloove-Vanhorick, S. Pauline; Ottenkamp, Jaap

    2002-01-01

    To discuss the need for continuing cardiac surveillance in adults with hemodynamically insignificant congenital cardiac disease. In 82 patients with mild congenital cardiac malformations, aged from 17 to 32 years, we investigated the subjective health status, the health-related quality of life, any

  9. Effects of hot-water extract of banana (Musa acuminata) fruit's peel on the antibacterial activity, and anti-hypothermal stress, immune responses and disease resistance of the giant freshwater prawn, Macrobrachium rosenbegii.

    Science.gov (United States)

    Rattanavichai, Wutti; Cheng, Winton

    2014-08-01

    The hot-extracts isolated from fruit's peel of banana, Musa acuminata, was evaluated on the antibacterial activity to pathogens from aquatic animals, and immunostimulating potential, disease resistance and anti-hypothermal stress in giant freshwater prawn, Macrobrachium rosenbergii through injection administration. The banana peel extract (BPE) showed good activity against 1 Gram-positive and 3 Gram-negative pathogens, including Lactococcus garvieae, Photobacteria damsella, Vibrio alginolyticus and Vibrio parahemolyticus especially in prawn pathogen of L. garvieae strain, which were carried out by a disk diffusion method. Prawn received BPE via injection administration at 1-6 μg (g prawn)(-1) significantly increased total haemocyte count (THC), hyaline cell (HC), granular cell (GC), phenoloxidase (PO) activity and phagocytic activity against L. garvieae from 3 to 6 days, and significantly increased clearance efficiency against L. garvieae and a significantly decreased coagulation time of prawn from 1 to 6 days. Prawn injected with BPE at 6.0 μg (g prawn)(-1) for 6 days showed significantly increased superoxide dismutase (SOD) activity, but significantly decreased respiratory bursts (RBs) of per haemocyte. Survival rates of M. rosenbergii injected with BPE at concentrations of 1, 3 and 6 μg (g prawn)(-1) were significantly higher than those injected with saline control after challenge with L. garvieae for 4-6 days, and the respective relative survival percentages of prawn were 28.6%, 38.1%, and 47.8%, respectively at 6 days. The sublethal time of prawns that had received saline and BPE at 1, 3 and 6 μg (g prawn)(-1) for 6 days and then were transferred from 28 °C to 14 °C were 69.4, 79.8, 83.6, and 90.2 h, respectively. It was concluded that the BPE can be used as the bacteriostat, and immunostimulant and physiological regulator for prawn through injection administration to enhance immunity, physiological responses, and resistance against L. garvieae

  10. The first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape Town - with reference to : the operation. A human cardiac transplant : an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town.

    Science.gov (United States)

    Brink, J G; Hassoulas, J

    2009-01-01

    Christiaan (Chris) Barnard was born in 1922 and qualified in medicine at the University of Cape Town in 1946. Following surgical training in South Africa and the USA, Barnard established a successful open-heart surgery programme at Groote Schuur Hospital and the University of Cape Town in 1958. In 1967, he led the team that performed the world's first human-to-human heart transplant. The article describing this remarkable achievement was published in the South African Medical Journal just three weeks after the event and is one of the most cited articles in the cardiovascular field. In the lay media as well, this first transplant remains the most publicised event in world medical history. Although the first heart transplant patient survived only 18 days, four of Groote Schuur Hospital's first 10 patients survived for more than one year, two living for 13 and 23 years, respectively. This relative success amid many failures worldwide did much to generate guarded optimism that heart transplantation would eventually become a viable therapeutic option. This first heart transplant and subsequent ongoing research in cardiac transplantation at the University of Cape Town and in a few other dedicated centres over the subsequent 15 years laid the foundation for heart transplantation to become a well-established form of therapy for end-stage cardiac disease. During this period from 1968 to 1983, Chris Barnard and his team continued to make major contributions to organ transplantation, notably the development of the heterotopic ( 'piggy-back') heart transplants; advancing the concept of brain death, organ donation and other related ethical issues; better preservation and protection of the donor heart (including hypothermic perfusion storage of the heart; studies on the haemodynamic and metabolic effects of brain death; and even early attempts at xenotransplantation.

  11. Cardiac disorders with psychosomatic background

    Directory of Open Access Journals (Sweden)

    Ada Bielejewska

    2017-12-01

    Full Text Available Psychosomatic disorders can be described as psychosocial-derived organic disorders. The influence of depression, sleep disorders, quality of life, addictions, work environment, family situation, and stress on atrial fibrillation, palpitations, syncope, chest pain, coronary heart disease, and heart failure has been analysed in this paper. The correlation between psychosomatic disorders and the cardiovascular system has been shown. It allows us to conclude that an attending physician, while taking medical history of cardiac patients, should take into consideration factors that may have a negative impact on their mental health, which can be risk factors in the development or aggravation of an already present cardiovascular disease.

  12. Respiratory gating in cardiac PET

    DEFF Research Database (Denmark)

    Lassen, Martin Lyngby; Rasmussen, Thomas; Christensen, Thomas E

    2017-01-01

    BACKGROUND: Respiratory motion due to breathing during cardiac positron emission tomography (PET) results in spatial blurring and erroneous tracer quantification. Respiratory gating might represent a solution by dividing the PET coincidence dataset into smaller respiratory phase subsets. The aim...... stress (82)RB-PET. Respiratory rates and depths were measured by a respiratory gating system in addition to registering actual respiratory rates. Patients undergoing adenosine stress showed a decrease in measured respiratory rate from initial to later scan phase measurements [12.4 (±5.7) vs 5.6 (±4.......7) min(-1), P PET...

  13. FGF21 and Cardiac Physiopathology

    OpenAIRE

    Planavila, Anna; Redondo-Angulo, Ibon; Villarroya, Francesc

    2015-01-01

    The heart is not traditionally considered either a target or a site of fibroblast growth factor-21 (FGF21) production. However, recent findings indicate that FGF21 can act as a cardiomyokine; that is, it is produced by cardiac cells at significant levels and acts in an autocrine manner on the heart itself. The heart is sensitive to the effects of FGF21, both systemic and locally generated, owing to the expression in cardiomyocytes of β-Klotho, the key co-receptor known to confer specific resp...

  14. Cardiac leiomyosarcoma, a case report

    DEFF Research Database (Denmark)

    Andersen, Rikke; Kristensen, Bjarne W; Gill, Sabine

    2013-01-01

    In this case report we present the history of a patient admitted with recurrent pulmonary edema. Transesophageal chocardiography showed a tumour in the left atrium, occluding the ostium of the mitral valve and mimicking intermittent mitral stenosis. Cardiac surgery followed by pathological...... examination revealed that the tumour was a leiomyosarcoma. Images from the echocardiography as well as the pathological findings are shown and discussed. The present case report illustrates that atrial tumors comprise also sarcomas, suggesting the use of careful, rapid diagnostic procedures and treatment...

  15. [Cardiac effects of radiation therapy].

    Science.gov (United States)

    Tuohinen, Suvi; Turpeinen, Anu; Skyttä, Tanja; Kellokumpu-Lehtinen, Pirkko-Liisa

    2015-01-01

    Because of increased life-expentancy cancer patients having undergone radiation therapy nowadays live longer, and late-appearing adverse effects are therefore playing a more significant role. Radiation therapy given to the chest is known to approximately double the risk of heart disease, the cumulative total radiation dose being the most important risk-increasing factor. The most significant adverse effects appear only years after the treatment. The mortality from late manifestations reduces the total benefit of radiation therapy. Patients with radiation therapy due to a cancer of the left breast or Hodgkin's lymphoma are particularly susceptible to cardiac effects. A safe radiation dose is not known.

  16. Response to cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Versteeg, Henneke; Schiffer, Angélique A; Widdershoven, Jos W

    2009-01-01

    Cardiac resynchronization therapy (CRT) is a promising treatment for a subgroup of patients with advanced congestive heart failure and a prolonged QRS interval. Despite the majority of patients benefiting from CRT, 10-40% of patients do not respond to this treatment and are labeled as nonresponders....... Given that there is a lack of consensus on how to define response to CRT, the purpose of this viewpoint is to discuss currently used definitions and their shortcomings, and to provide recommendations as to how an expansion of the criteria for CRT response may be useful to clinicians....

  17. Hybrid deep drawing tool for lubricant free deep drawing

    Science.gov (United States)

    Guilleaume, Christina; Mousavi, Ali; Brosius, Alexander

    2017-10-01

    This paper presents a concept for a hybrid deep drawing tool based on polymer concrete and first results from actual deep drawing tests using a prototype of the newly developed tool. The hybrid tool presented here has a defined macro-structure of the blankholder and drawing die as implemented before by Brosius et al. [1] in a steel tool for a lubricant free deep drawing process. The macro structure has a positive effect on the lubrication free deep drawing process, because it reduces the contact surface, increases the sheet's stability against wrinkling in the flange, reduces the necessary blank holder force and thereby the contact pressure, and offers a means to control the material flow [1]. The main objective in transferring this concept to a new hybrid tool from polymer concrete is an enhanced possibility to easily integrate other functional elements like temperature and pressure sensors, graphite inlays or roller bearings into the drawing die or blankholder. Since polymer concrete is cast in a cold exothermal process of no more than 60° Celsius, these elements are not subjected to high thermal loads and their positioning is relatively simple and precise. Polymer concrete moreover has good mechanical properties regarding compressive strength [2] and Young's modulus [3] and is therefore well suited for a deep drawing tool application.

  18. Heart Attack or Sudden Cardiac Arrest: How Are They Different?

    Science.gov (United States)

    ... Attack or Sudden Cardiac Arrest: How Are They Different? Updated:Mar 15,2018 People often use these ... The heart attack symptoms in women can be different than men. What is cardiac arrest? Sudden cardiac ...

  19. FORT UNION DEEP

    Energy Technology Data Exchange (ETDEWEB)

    Lyle A. Johnson Jr.

    2002-03-01

    Coalbed methane (CBM) is currently the hottest area of energy development in the Rocky Mountain area. The Powder River Basin (PRB) is the largest CBM area in Wyoming and has attracted the majority of the attention because of its high permeability and relatively shallow depth. Other Wyoming coal regions are also being targeted for development, but most of these areas have lower permeability and deeper coal seams. This project consists of the development of a CBM stimulation system for deep coal resources and involves three work areas: (1) Well Placement, (2) Well Stimulation, and (3) Production Monitoring and Evaluation. The focus of this project is the Washakie Basin. Timberline Energy, Inc., the cosponsor, has a project area in southern Carbon County, Wyoming, and northern Moffat County, Colorado. The target coal is found near the top of the lower Fort Union formation. The well for this project, Evans No.1, was drilled to a depth of 2,700 ft. Three coal seams were encountered with sandstone and some interbedded shale between seams. Well logs indicated that the coal seams and the sandstone contained gas. For the testing, the upper seam at 2,000 ft was selected. The well, drilled and completed for this project, produced very little water and only occasional burps of methane. To enhance the well, a mild severity fracture was conducted to fracture the coal seam and not the adjacent sandstone. Fracturing data indicated a fracture half-length of 34 ft, a coal permeability of 0.2226 md, and permeability of 15.3 md. Following fracturing, the gas production rate stabilized at 10 Mscf/day within water production of 18 bpd. The Western Research Institute (WRI) CBM model was used to design a 14-day stimulation cycle followed by a 30-day production period. A maximum injection pressure of 1,200 psig to remain well below the fracture pressure was selected. Model predictions were 20 Mscf/day of air injection for 14 days, a one-day shut-in, then flowback. The predicted flowback

  20. FORT UNION DEEP

    Energy Technology Data Exchange (ETDEWEB)

    Lyle A. Johnson Jr.

    2002-09-01

    Coalbed methane (CBM) is currently the hottest area of energy development in the Rocky Mountain area. The Powder River Basin (PRB) is the largest CBM area in Wyoming and has attracted the majority of the attention because of its high permeability and relatively shallow depth. Other Wyoming coal regions are also being targeted for development, but most of these areas have lower permeability and deeper coal seams. This project consists of the development of a CBM stimulation system for deep coal resources and involves three work areas: (1) Well Placement, (2) Well Stimulation, and (3) Production Monitoring and Evaluation. The focus of this project is the Washakie Basin. Timberline Energy, Inc., the cosponsor, has a project area in southern Carbon County, Wyoming, and northern Moffat County, Colorado. The target coal is found near the top of the lower Fort Union formation. The well for this project, Evans No.1, was drilled to a depth of 2,700 ft. Three coal seams were encountered with sandstone and some interbedded shale between seams. Well logs indicated that the coal seams and the sandstone contained gas. For the testing, the upper seam at 2,000 ft was selected. The well, drilled and completed for this project, produced very little water and only occasional burps of methane. To enhance the well, a mild severity fracture was conducted to fracture the coal seam and not the adjacent sandstone. Fracturing data indicated a fracture half-length of 34 ft, a coal permeability of 0.2226 md, and permeability of 15.3 md. Following fracturing, the gas production rate stabilized at 10 Mscf/day within water production of 18 bpd. The Western Research Institute (WRI) CBM model was used to design a 14-day stimulation cycle followed by a 30-day production period. A maximum injection pressure of 1,200 psig to remain well below the fracture pressure was selected. Model predictions were 20 Mscf/day of air injection for 14 days, a one-day shut-in, then flowback. The predicted flowback

  1. Risk Factors Associated With Pressure Ulcer Formation in Critically Ill Cardiac Surgery Patients: A Systematic Review.

    Science.gov (United States)

    Rao, Aditi D; Preston, Ave M; Strauss, Robyn; Stamm, Rebecca; Zalman, Demetra C

    2016-01-01

    Cardiac surgery patients are among those most at risk for developing pressure ulcers (PUs), with a reported incidence as high as 29.5%. Although numerous studies documenting PU risk factors and prevention strategies exist, the availability of literature examining risk factors specific to the cardiac surgery population is limited. A systematic review was completed that aimed to identify the risk factors associated with PU development in critically ill, adult, cardiac surgery patients. The MEDLINE, CINAHL, and Cochrane databases were searched. Studies that focused on PU risk factors in critical care, surgical intensive care, or cardiac surgery populations and used PU occurrences as an outcome variable were included in the review. Twelve high-quality studies were retrieved and included in the review; they revealed 30 potential PU risk factors. Current evidence is limited in 2 important ways. First, the impact of intraoperative factors, such as cardiopulmonary bypass time or body temperature, appears to be underexplored. Second, a substantive discussion of the risk factors associated specifically with deep tissue injuries, a unique PU category, is absent. The relatively high PU incidence among cardiac surgery patients suggests that typical PU prevention methods are insufficient for this population. Targeted prevention measures must be developed and implemented. Completion of this task required identification of risk factors unique to this population. Specific risk factors likely to increase risk among cardiac surgery patients include prolonged exposure to pressure during long surgical procedures, vascular disease, and/or vasopressor use postoperatively. Additional research concerning risk factors specific to this population is urgently needed.

  2. Comparison of an Endotracheal Cardiac Output Monitor to a Pulmonary Artery Catheter

    Science.gov (United States)

    2017-12-04

    ile methods of fluid resuscitation remain controversial , maintenance of a patent airway and hemodynamic stabi lity as indicated by invasive...Edwards LifeSciences, Irvine, CA) pulmonary artery catheter (PAC) under hypothermic and hemorrhagic conditions. Methods Power analysis (G*Power...3.1) suggested 8 an imals would be sufficient for comparisons. After induction of anesthesia, instrumentation , and stabilization in experiment 1

  3. Cardiac angiosarcoma: an unexpected diagnosis

    Directory of Open Access Journals (Sweden)

    Milton Roberto Furst Crenitte

    2014-09-01

    Full Text Available Cardiac angiosarcoma is a rare entity. The incidence through autopsy findings ranges between 0.001% and 0.03%. The disease usually presents with non-specific symptoms, although asymptomatic cases are frequent; therefore, diagnosis is unexpected and consequently delayed. The authors report the case of a middle-aged man with a recent onset cough and dyspnea. He sought medical care several times without receiving a definite diagnosis until a plain chest radiography was taken showing a mediastinal enlargement, which was the reason why he was hospitalized for clinical investigation. During the diagnostic workup, an echodopplercardiogram and a thoracic computed tomography were performed, showing a heterogeneous soft-tissue mass infiltrating the pericardium and the anterior atrial wall. Multiple and scattered pulmonary nodules were also present. A pulmonary nodule was biopsied, which revealed an angiosarcoma. The clinical features added to the radiological and histological findings permitted the diagnosis of right atrial angiosarcoma. The authors highlight the unexpected pattern in the presentation of cardiac tumors.

  4. Hemodynamics driven cardiac valve morphogenesis.

    Science.gov (United States)

    Steed, Emily; Boselli, Francesco; Vermot, Julien

    2016-07-01

    Mechanical forces are instrumental to cardiovascular development and physiology. The heart beats approximately 2.6 billion times in a human lifetime and heart valves ensure that these contractions result in an efficient, unidirectional flow of the blood. Composed of endocardial cells (EdCs) and extracellular matrix (ECM), cardiac valves are among the most mechanically challenged structures of the body both during and after their development. Understanding how hemodynamic forces modulate cardiovascular function and morphogenesis is key to unraveling the relationship between normal and pathological cardiovascular development and physiology. Most valve diseases have their origins in embryogenesis, either as signs of abnormal developmental processes or the aberrant re-expression of fetal gene programs normally quiescent in adulthood. Here we review recent discoveries in the mechanobiology of cardiac valve development and introduce the latest technologies being developed in the zebrafish, including live cell imaging and optical technologies, as well as modeling approaches that are currently transforming this field. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel. Copyright © 2015. Published by Elsevier B.V.

  5. Cardiac arrhythmia detection using photoplethysmography.

    Science.gov (United States)

    Paradkar, Neeraj; Chowdhury, Shubhajit Roy

    2017-07-01

    Cardiovascular Diseases (CVDs) cause a very large number of casualties around the world every year and cardiac arrhythmias contribute to significant proportion of CVD related deaths. Bedside cardiac activity monitors in hospitals are based on electrocardiogram (ECG) processing and are known to produce too many false alarms. Moving beyond bedside care, ECG is not very suitable for use in wearable devices. Photoplethysmography (PPG) on the other hand provides an inexpensive and more wearable device-friendly alternative. This work presents a technique to detect life threatening arrhythmias using only PPG waveforms. PhysioNet Challenge 2015 data is used to detect five types of arrhythmias namely, tachycardia, bradycardia, asystole, ventricular tachycardia and ventricular fibrillation. A novel technique is employed to assign pulse quality index to every PPG pulse and highest quality portion of the signal is used for detection. Results indicate that PPG provides a viable alternative for conventional ECG based detection. An overall true positive rate (TPR) of 93% was achieved with true negative rate (TNR) of 53.78% suggesting that PPG is a viable option for arrhythmia detection.

  6. Sudden Cardiac Death in Children. Part 1

    Directory of Open Access Journals (Sweden)

    Ye.V. Pshenichnaya

    2013-02-01

    Full Text Available This article presents the prevalence, terminology, classification of sudden cardiac death. A description of congenital structural heart diseases associated with a risk of sudden cardiac death is given. The issues of etiology and pathogenesis of life-threatening conditions are described in detail.

  7. Sudden Cardiac Death in Children. Part 2

    Directory of Open Access Journals (Sweden)

    Ye.V. Pshenichnaya

    2013-03-01

    Full Text Available This article deals with the dysplastic changes in musculo-valve structures of the heart, arrhythmias and conduction disorders, associated with a risk of sudden cardiac death. The diagnostic criteria for sudden cardiac death, the events of cardio-pulmonary resuscitation, prevention of life-threatening conditions in children are provided.

  8. MicroRNAs in cardiac arrhythmia

    DEFF Research Database (Denmark)

    Hedley, Paula L; Carlsen, Anting L; Christiansen, Kasper M

    2014-01-01

    Long QT syndrome (LQTS) is a genetic cardiac condition associated with prolonged ventricular repolarization, primarily a result of perturbations in cardiac ion channels, which predisposes individuals to life-threatening arrhythmias. Using DNA screening and sequencing methods, over 700 different L...

  9. Cardiac arrhythmias in adult patients with asthma

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Kors, Jan A

    2012-01-01

    OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias...

  10. Cardiac MRI of the athlete's heart

    NARCIS (Netherlands)

    Prakken, N.H.J.

    2010-01-01

    The increase in pre-participation cardiovascular screening using the Lausanne protocol will ultimately lead to an increased use of cardiac MRI and MDCT in the cardiovascular work-up of athletes. The role of cardiac MRI is well established in the evaluation of cardiomyopathies, myocarditis, aortic

  11. Athletes at Risk for Sudden Cardiac Death

    Science.gov (United States)

    Subasic, Kim

    2010-01-01

    High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to…

  12. Fetal Primary Cardiac Tumors During Perinatal Period

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2017-06-01

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

  13. Corticosteroids in cardiac surgery: a continuing controversy

    NARCIS (Netherlands)

    Dieleman, J.M.

    2015-01-01

    Cardiac surgery leads to significant improvements in symptoms of cardiac disease and quality of life, but is still associated with a substantial risk of adverse events and postoperative disability. The perioperative systemic inflammatory response syndrome (SIRS) likely plays a role in the

  14. Acute cardiac failure in neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Sparrow, Patrick

    2012-02-03

    We present a case of rapid onset acute cardiac failure developing as part of neuroleptic malignant syndrome in a 35-year-old woman following treatment with thioridazine and lithium. Post mortem histology of cardiac and skeletal muscle showed similar changes of focal cellular necrosis and vacuolation suggesting a common disease process.

  15. Stem cell sources for cardiac regeneration

    NARCIS (Netherlands)

    Roccio, M.; Goumans, M. J.; Sluijter, J. P. G.; Doevendans, P. A.

    Cell-based cardiac repair has the ambitious aim to replace the malfunctioning cardiac muscle developed after myocardial infarction, with new contractile cardiomyocytes and vessels. Different stem cell populations have been intensively studied in the last decade as a potential source of new

  16. Is fetal cardiac function gender dependent?

    NARCIS (Netherlands)

    Clur, S. A. B.; Oude Rengerink, K.; Mol, B. W.; Ottenkamp, J.; Bilardo, C. M.

    2011-01-01

    An increased nuchal translucency (NT) is more common in males. A delayed diastolic cardiac function maturation has been proposed to explain this and the reported gender-related differences in ductus venosus (DV) flow. To investigate gender-related differences in fetal cardiac function. One hundred

  17. Is fetal cardiac function gender dependent?

    NARCIS (Netherlands)

    Clur, S. A. B.; Rengerink, K. Oude; Mol, B. W.; Ottenkamp, J.; Bilardo, C. M.

    Introduction An increased nuchal translucency (NT) is more common in males. A delayed diastolic cardiac function maturation has been proposed to explain this and the reported gender-related differences in ductus venosus (DV) flow. Objective To investigate gender-related differences in fetal cardiac

  18. Cyanide poisoning and cardiac disorders: 161 cases.

    Science.gov (United States)

    Fortin, Jean-Luc; Desmettre, Thibault; Manzon, Cyril; Judic-Peureux, Virginie; Peugeot-Mortier, Caroline; Giocanti, Jean-Pascal; Hachelaf, Mohamed; Grangeon, Marie; Hostalek, Ulrike; Crouzet, Julien; Capellier, Gilles

    2010-05-01

    Inhalation of hydrogen cyanide from smoke in structural fires is common, but cardiovascular function in these patients is poorly documented. The objective was to study the cardiac complications of cyanide poisoning in patients who received early administration of a cyanide antidote, hydroxocobalamin (Cyanokit; Merck KGaA, Darmstadt, Germany [in the United States, marketed by Meridian Medical Technologies, Bristol, TN]). The medical records of 161 fire survivors with suspected or confirmed cyanide poisoning were reviewed in an open, multicenter, retrospective review of cases from the Emergency Medical Assistance Unit (Service d'Aide Médical d'Urgence) in France. Cardiac arrest (61/161, 58 asystole, 3 ventricular fibrillation), cardiac rhythm disorders (57/161, 56 supraventricular tachycardia), repolarization disorders (12/161), and intracardiac conduction disorders (5/161) were observed. Of the total 161 patients studied, 26 displayed no cardiac disorder. All patients were given an initial dose of 5 g of hydroxocobalamin. Non-responders received a second dose of 5 g of hydroxocobalamin. Of the patients initially in cardiac arrest, 30 died at the scene, 24 died in hospital, and 5 survived without cardiovascular sequelae. Cardiac disorders improved with increasing doses of hydroxocobalamin, and higher doses of the antidote seem to be associated with a superior outcome in patients with initial cardiac arrest. Cardiac complications are common in cyanide poisoning in fire survivors. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  19. Ultrasound Imaging in Teaching Cardiac Physiology

    Science.gov (United States)

    Johnson, Christopher D.; Montgomery, Laura E. A.; Quinn, Joe G.; Roe, Sean M.; Stewart, Michael T.; Tansey, Etain A.

    2016-01-01

    This laboratory session provides hands-on experience for students to visualize the beating human heart with ultrasound imaging. Simple views are obtained from which students can directly measure important cardiac dimensions in systole and diastole. This allows students to derive, from first principles, important measures of cardiac function, such…

  20. Cardiac spindle cell hemangioma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ju Young; Lee, In Jae; Min, Kwang Sun; Jeon, Eui Yong; Lee, Yul; Bae, Sang Hoon [Hallym University College of Medicine, Anyang (Korea, Republic of)

    2007-04-15

    Spindle cell hemangioma is an uncommon vascular lesion histologically resembling a cavernous hemangioma and Kaposi's sarcoma with a predilection for the extremities. There are no radiologic reports concerning cardiac spindle cell hemangioma in the current literature. We report here a case of cardiac spindle cell hemangioma.

  1. Tannin, oxalate, saponin, cyanogenic and cardiac glycosides ...

    African Journals Online (AJOL)

    Two species of cola, Cola nitida and Cola acuminate, were investigated for their possible relative contents of the secondary plant products:- tannin, oxalate, saponin, cyanogenic and cardiac glycosides. The two cola species gave low levels of tannin and oxalate but very high levels of cyanogenic and cardiac glycosides as ...

  2. What Really is Deep Learning Doing?

    OpenAIRE

    Xiong, Chuyu

    2017-01-01

    Deep learning has achieved a great success in many areas, from computer vision to natural language processing, to game playing, and much more. Yet, what deep learning is really doing is still an open question. There are a lot of works in this direction. For example, [5] tried to explain deep learning by group renormalization, and [6] tried to explain deep learning from the view of functional approximation. In order to address this very crucial question, here we see deep learning from perspect...

  3. FET-biosensor for cardiac troponin biomarker

    Science.gov (United States)

    Arshad, Mohd Khairuddin Md; Faris Mohamad Fathil, Mohamad; Hashim, Uda

    2017-11-01

    Acute myocardial infarction or myocardial infarction (MI) is a major health problem, due to diminished flow of blood to the heart, leads to higher rates of mortality and morbidity. The most specific markers for cardiac injury are cardiac troponin I (cTnI) and cardiac troponin T (cTnT) which have been considered as `gold standard'. Due to higher specificity, determination of the level of cardiac troponins became a predominant indicator for MI. Currently, field-effect transistor (FET)-based biosensors have been main interest to be implemented in portable sensors with the ultimate application in point-of-care testing (POCT). In this paper, we review on the FET-based biosensor based on its principle of operation, integration with nanomaterial, surface functionalization as well as immobilization, and the introduction of additional gate (for ambipolar conduction) on the device architecture for the detection of cardiac troponin I (cTnI) biomarker.

  4. Cardiac fluid dynamics meets deformation imaging.

    Science.gov (United States)

    Dal Ferro, Matteo; Stolfo, Davide; De Paris, Valerio; Lesizza, Pierluigi; Korcova, Renata; Collia, Dario; Tonti, Giovanni; Sinagra, Gianfranco; Pedrizzetti, Gianni

    2018-02-20

    Cardiac function is about creating and sustaining blood in motion. This is achieved through a proper sequence of myocardial deformation whose final goal is that of creating flow. Deformation imaging provided valuable contributions to understanding cardiac mechanics; more recently, several studies evidenced the existence of an intimate relationship between cardiac function and intra-ventricular fluid dynamics. This paper summarizes the recent advances in cardiac flow evaluations, highlighting its relationship with heart wall mechanics assessed through the newest techniques of deformation imaging and finally providing an opinion of the most promising clinical perspectives of this emerging field. It will be shown how fluid dynamics can integrate volumetric and deformation assessments to provide a further level of knowledge of cardiac mechanics.

  5. FET-biosensor for cardiac troponin biomarker

    Directory of Open Access Journals (Sweden)

    Md Arshad Mohd Khairuddin

    2017-01-01

    Full Text Available Acute myocardial infarction or myocardial infarction (MI is a major health problem, due to diminished flow of blood to the heart, leads to higher rates of mortality and morbidity. The most specific markers for cardiac injury are cardiac troponin I (cTnI and cardiac troponin T (cTnT which have been considered as ‘gold standard’. Due to higher specificity, determination of the level of cardiac troponins became a predominant indicator for MI. Currently, field-effect transistor (FET-based biosensors have been main interest to be implemented in portable sensors with the ultimate application in point-of-care testing (POCT. In this paper, we review on the FET-based biosensor based on its principle of operation, integration with nanomaterial, surface functionalization as well as immobilization, and the introduction of additional gate (for ambipolar conduction on the device architecture for the detection of cardiac troponin I (cTnI biomarker.

  6. Suction-irrigation drainage: an underestimated therapeutic option for surgical treatment of deep sternal wound infections.

    Science.gov (United States)

    Deschka, Heinz; Erler, Stefan; El-Ayoubi, Lemir; Vogel, Cordula; Vöhringer, Luise; Wimmer-Greinecker, Gerhard

    2013-07-01

    Deep sternal wound infections are significant and severe complications following cardiac surgery and substantially influence perioperative morbidity and mortality. We present the experience of our department using two different surgical treatments over a three-year period. Between January 2009 and December 2011, a total of 3274 cardiac procedures with complete median sternotomy were performed in our department. In 94 patients (3%), a deep sternal wound infection occurred, including sternal instability with consecutive surgical treatment. The patients either received wound debridement with sternum refixation and suction-irrigation drainage (SID; n = 72) or sternum refixation only (RF; n = 22) if there was sternal instability with limited signs of infection. SID was routinely installed for 7 days: the irrigation solution contained neomycin. In all cases, swabs were taken and analysed. The different methods were evaluated in respect of their clinical outcomes. The success rate-defined as single, uncomplicated procedure-of the SID treatment was 74%, compared with 59% of the isolated sternum refixation. Complications included continuous infection, recurrence of sternal instability and wound necrosis. Eighty-eight percent of the swabs in the SID group were positive, compared with 32% in the sternal refixation only group. The dominating pathogenic germs were coagulase-negative staphylococci and staphylococcus aureus. Mortality was 10% for the SID group and 5% for the RF group. Contrary to accepted opinion, the suction-irrigation drainage is an appropriate therapy for deep sternal wound infections. Nevertheless, deep sternal wound infections after cardiac surgery remain severe complications and are related to increased morbidity and mortality.

  7. Association between dental caries and out-of-hospital cardiac arrests of cardiac origin in Japan.

    Science.gov (United States)

    Suematsu, Yasunori; Miura, Shin-Ichiro; Zhang, Bo; Uehara, Yoshinari; Ogawa, Masahiro; Yonemoto, Naohiro; Nonogi, Hiroshi; Nagao, Ken; Kimura, Takeshi; Saku, Keijiro

    2016-04-01

    Oral infection contributes to atherosclerosis and coronary heart disease. We hypothesized that dental caries may be associated with out-of-hospital cardiac arrests (OHCA) of cardiac origin, but not non-cardiac origin. We compared the age-adjusted incidence of OHCA (785,591 cases of OHCA: 55.4% of cardiac origin and 44.6% of non-cardiac origin) to the age-adjusted prevalence of dental caries between 2005 and 2011 in the 47 prefectures of Japan. In both the total population and males over 65 years, the number of cases of dental caries was significantly associated with the number of OHCA of total and cardiac origin from 2005 to 2011, but not those of non-cardiac origin. In the total population, the age-adjusted prevalence of dental caries was not significantly associated with the age-adjusted incidence of OHCA (total OHCA: r correlation coefficient=0.22, p=0.14; OHCA of cardiac origin: r=0.25, p=0.09; OHCA of non-cardiac origin: r=-0.002, p=0.99). Among male patients over 65 years, the age-adjusted prevalence of dental caries was significantly associated with OHCA of total and cardiac origin, but not non-cardiac origin (total OHCA: r=0.47, p<0.001; OHCA of cardiac origin: r=0.37, p=0.01; OHCA of non-cardiac origin: r=0.28, p=0.054). While oral hygiene is important in all age groups, it may be particularly associated with OHCAs of cardiac origin in males over 65 years. Copyright © 2015. Published by Elsevier Ltd.

  8. Major Cardiac Events After Non-cardiac Surgery.

    Science.gov (United States)

    Sousa, Gabriela; Lopes, Ana; Reis, Pedro; Carvalho, Vasco; Santos, Alice; Abelha, Fernando José

    2016-08-01

    Postoperative cardiovascular complications might be difficult to assess and are known to be associated with longer hospital stay and increased costs as well as higher morbidity and mortality rates. The aim of this study was to evaluate the predictors for major cardiac events (MCE) after non-cardiac surgery. The study included 4398 patients who were admitted to the Surgical Intensive Care Unit between January 1, 2006 and July 19, 2013. Acute physiology and chronic health evaluation II score and simplified acute physiology score (SAPS II) were calculated, and all variables entered as parameters were evaluated independently. Multivariate logistic regression analysis was performed to assess the independent factors for MCE. A total of 107 people experienced MCE. The independent predictors for postoperative MCE were higher fraction of inspired oxygen (FiO2) (odds ratio [OR] 38.97; 95 % confidence interval [CI] 10.81-140.36), history of ischemic heart disease (OR 3.38; 95 % CI 2.12-5.39), history of congestive heart disease (OR 2.39; 95 % CI 1.49-3.85), history of insulin therapy for diabetes (OR 2.93; 95 % CI 1.66-5.19), and increased SAPS II (OR 1.03; 95 % CI 1.01-1.05). Having a MCE was associated with a longer length of stay in the surgical intensive care unit (OR 1.01, 95 % CI 1.00-1.01). FiO2, ischemic heart disease, congestive heart disease, insulin therapy for diabetes, SAPS II, and length of stay in the surgical intensive care unit were independent predictors for MCE.

  9. Deep Learning in Drug Discovery.

    Science.gov (United States)

    Gawehn, Erik; Hiss, Jan A; Schneider, Gisbert

    2016-01-01

    Artificial neural networks had their first heyday in molecular informatics and drug discovery approximately two decades ago. Currently, we are witnessing renewed interest in adapting advanced neural network architectures for pharmaceutical research by borrowing from the field of "deep learning". Compared with some of the other life sciences, their application in drug discovery is still limited. Here, we provide an overview of this emerging field of molecular informatics, present the basic concepts of prominent deep learning methods and offer motivation to explore these techniques for their usefulness in computer-assisted drug discovery and design. We specifically emphasize deep neural networks, restricted Boltzmann machine networks and convolutional networks. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  10. Deep Learning and Bayesian Methods

    Directory of Open Access Journals (Sweden)

    Prosper Harrison B.

    2017-01-01

    Full Text Available A revolution is underway in which deep neural networks are routinely used to solve diffcult problems such as face recognition and natural language understanding. Particle physicists have taken notice and have started to deploy these methods, achieving results that suggest a potentially significant shift in how data might be analyzed in the not too distant future. We discuss a few recent developments in the application of deep neural networks and then indulge in speculation about how such methods might be used to automate certain aspects of data analysis in particle physics. Next, the connection to Bayesian methods is discussed and the paper ends with thoughts on a significant practical issue, namely, how, from a Bayesian perspective, one might optimize the construction of deep neural networks.

  11. Deep Learning in Gastrointestinal Endoscopy.

    Science.gov (United States)

    Patel, Vivek; Armstrong, David; Ganguli, Malika; Roopra, Sandeep; Kantipudi, Neha; Albashir, Siwar; Kamath, Markad V

    2016-01-01

    Gastrointestinal (GI) endoscopy is used to inspect the lumen or interior of the GI tract for several purposes, including, (1) making a clinical diagnosis, in real time, based on the visual appearances; (2) taking targeted tissue samples for subsequent histopathological examination; and (3) in some cases, performing therapeutic interventions targeted at specific lesions. GI endoscopy is therefore predicated on the assumption that the operator-the endoscopist-is able to identify and characterize abnormalities or lesions accurately and reproducibly. However, as in other areas of clinical medicine, such as histopathology and radiology, many studies have documented marked interobserver and intraobserver variability in lesion recognition. Thus, there is a clear need and opportunity for techniques or methodologies that will enhance the quality of lesion recognition and diagnosis and improve the outcomes of GI endoscopy. Deep learning models provide a basis to make better clinical decisions in medical image analysis. Biomedical image segmentation, classification, and registration can be improved with deep learning. Recent evidence suggests that the application of deep learning methods to medical image analysis can contribute significantly to computer-aided diagnosis. Deep learning models are usually considered to be more flexible and provide reliable solutions for image analysis problems compared to conventional computer vision models. The use of fast computers offers the possibility of real-time support that is important for endoscopic diagnosis, which has to be made in real time. Advanced graphics processing units and cloud computing have also favored the use of machine learning, and more particularly, deep learning for patient care. This paper reviews the rapidly evolving literature on the feasibility of applying deep learning algorithms to endoscopic imaging.

  12. Producing deep-water hydrocarbons

    International Nuclear Information System (INIS)

    Pilenko, Thierry

    2011-01-01

    Several studies relate the history and progress made in offshore production from oil and gas fields in relation to reserves and the techniques for producing oil offshore. The intention herein is not to review these studies but rather to argue that the activities of prospecting and producing deep-water oil and gas call for a combination of technology and project management and, above all, of devotion and innovation. Without this sense of commitment motivating men and women in this industry, the human adventure of deep-water production would never have taken place

  13. Deep Learning and Music Adversaries

    DEFF Research Database (Denmark)

    Kereliuk, Corey Mose; Sturm, Bob L.; Larsen, Jan

    2015-01-01

    An adversary is an agent designed to make a classification system perform in some particular way, e.g., increase the probability of a false negative. Recent work builds adversaries for deep learning systems applied to image object recognition, exploiting the parameters of the system to find...... the minimal perturbation of the input image such that the system misclassifies it with high confidence. We adapt this approach to construct and deploy an adversary of deep learning systems applied to music content analysis. In our case, however, the system inputs are magnitude spectral frames, which require...

  14. Deep space infections of neck.

    Science.gov (United States)

    Kaluskar, S; Bajaj, P; Bane, P

    2007-03-01

    A retrospective study was performed on fourteen cases of deep cervical space infections in the neck admitted for diagnosis and treatment to the ENT Department, during a period of seven years from 1989-1997. Of the fourteen, four patients had Ludwig's angina and of the fourteen, one had a very serious complication resulting in death. Early diagnosis and adequate treatment were of paramount importance. The role of tracheostomy and management of airway in deep cervical space infections of the neck is discussed to gether with bacteriology, antibiotic treatment and surgical management.

  15. Deep learning? What deep learning? | Fourie | South African ...

    African Journals Online (AJOL)

    The purpose of this research is, therefore, to discuss the extent to which a South African Higher Education institute promotes and develops a deep approach to learning in its undergraduates, and to describe any changes in students' approaches to learning as they progress through their studies. (South African Journal of ...

  16. Heparin-Induced Cardiac Tamponade and Life-Threatening Hyperkalemia in a Patient with Chronic Hemodialysis

    Directory of Open Access Journals (Sweden)

    Ho-Ming Su

    2005-03-01

    Full Text Available Heparin, a commonly used anticoagulant agent, is frequently used in patients undergoing hemodialysis. As with most medications, heparin has a significant side effect profile. Two of its most important side effects, major bleeding and hyperkalemia, may be devastating without immediate diagnosis and treatment. Major bleeding such as gastrointestinal, genitourinary or intracranial bleeding is occasionally encountered and rarely neglected. However, heparin-induced cardiac tamponade is rarely encountered and may be easily overlooked. Another side effect, heparin-induced hyperkalemia, an unusual but well-described side effect, is frequently forgotten until life-threatening arrhythmia has occurred. We report a case involving a 40-year-old male patient with uremia, who had received heparin for 10 days for deep vein thrombosis in the left lower extremity. Hemopericardium with cardiac tamponade and life-threatening hyperkalemia were both noted in this patient.

  17. Audio-visual relaxation training for anxiety, sleep, and relaxation among Chinese adults with cardiac disease.

    Science.gov (United States)

    Tsai, Sing-Ling

    2004-12-01

    The long-term effect of an audio-visual relaxation training (RT) treatment involving deep breathing, exercise, muscle relaxation, guided imagery, and meditation was compared with routine nursing care for reducing anxiety, improving sleep, and promoting relaxation in Chinese adults with cardiac disease. This research was a quasi-experimental, two-group, pretest-posttest study. A convenience sample of 100 cardiology patients (41 treatment, 59 control) admitted to one large medical center hospital in the Republic of China (ROC) was studied for 1 year. The hypothesized relationships were supported. RT significantly (p anxiety, sleep, and relaxation in the treatment group as compared to the control group. It appears audio-visual RT might be a beneficial adjunctive therapy for adult cardiac patients. However, considerable further work using stronger research designs is needed to determine the most appropriate instructional methods and the factors that contribute to long-term consistent practice of RT with Chinese populations.

  18. DeepSimulator: a deep simulator for Nanopore sequencing

    KAUST Repository

    Li, Yu

    2017-12-23

    Motivation: Oxford Nanopore sequencing is a rapidly developed sequencing technology in recent years. To keep pace with the explosion of the downstream data analytical tools, a versatile Nanopore sequencing simulator is needed to complement the experimental data as well as to benchmark those newly developed tools. However, all the currently available simulators are based on simple statistics of the produced reads, which have difficulty in capturing the complex nature of the Nanopore sequencing procedure, the main task of which is the generation of raw electrical current signals. Results: Here we propose a deep learning based simulator, DeepSimulator, to mimic the entire pipeline of Nanopore sequencing. Starting from a given reference genome or assembled contigs, we simulate the electrical current signals by a context-dependent deep learning model, followed by a base-calling procedure to yield simulated reads. This workflow mimics the sequencing procedure more naturally. The thorough experiments performed across four species show that the signals generated by our context-dependent model are more similar to the experimentally obtained signals than the ones generated by the official context-independent pore model. In terms of the simulated reads, we provide a parameter interface to users so that they can obtain the reads with different accuracies ranging from 83% to 97%. The reads generated by the default parameter have almost the same properties as the real data. Two case studies demonstrate the application of DeepSimulator to benefit the development of tools in de novo assembly and in low coverage SNP detection. Availability: The software can be accessed freely at: https://github.com/lykaust15/DeepSimulator.

  19. Stimulation Technologies for Deep Well Completions

    Energy Technology Data Exchange (ETDEWEB)

    None

    2003-09-30

    The Department of Energy (DOE) is sponsoring the Deep Trek Program targeted at improving the economics of drilling and completing deep gas wells. Under the DOE program, Pinnacle Technologies is conducting a study to evaluate the stimulation of deep wells. The objective of the project is to assess U.S. deep well drilling & stimulation activity, review rock mechanics & fracture growth in deep, high pressure/temperature wells and evaluate stimulation technology in several key deep plays. An assessment of historical deep gas well drilling activity and forecast of future trends was completed during the first six months of the project; this segment of the project was covered in Technical Project Report No. 1. The second progress report covers the next six months of the project during which efforts were primarily split between summarizing rock mechanics and fracture growth in deep reservoirs and contacting operators about case studies of deep gas well stimulation.

  20. STIMULATION TECHNOLOGIES FOR DEEP WELL COMPLETIONS

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Wolhart

    2003-06-01

    The Department of Energy (DOE) is sponsoring a Deep Trek Program targeted at improving the economics of drilling and completing deep gas wells. Under the DOE program, Pinnacle Technologies is conducting a project to evaluate the stimulation of deep wells. The objective of the project is to assess U.S. deep well drilling & stimulation activity, review rock mechanics & fracture growth in deep, high pressure/temperature wells and evaluate stimulation technology in several key deep plays. Phase 1 was recently completed and consisted of assessing deep gas well drilling activity (1995-2007) and an industry survey on deep gas well stimulation practices by region. Of the 29,000 oil, gas and dry holes drilled in 2002, about 300 were drilled in the deep well; 25% were dry, 50% were high temperature/high pressure completions and 25% were simply deep completions. South Texas has about 30% of these wells, Oklahoma 20%, Gulf of Mexico Shelf 15% and the Gulf Coast about 15%. The Rockies represent only 2% of deep drilling. Of the 60 operators who drill deep and HTHP wells, the top 20 drill almost 80% of the wells. Six operators drill half the U.S. deep wells. Deep drilling peaked at 425 wells in 1998 and fell to 250 in 1999. Drilling is expected to rise through 2004 after which drilling should cycle down as overall drilling declines.

  1. Descartes, Cardiac Heat, and Alchemy.

    Science.gov (United States)

    Heitsch, Dorothea

    2016-11-01

    René Descartes (1596-1650) insisted on a heat and light theory to explain cardiac movement, and used concepts such as distillation of the vital spirits, fermentation in the digestive process, and fermentation in the circulation of the blood. I argue that his theory of the body as a heat-exchange system was based on alchemical and natural philosophical notions of fire and light expounded by precursors and contemporaries who included Jean D'Espagnet, Jean Fernel, Jan Baptist van Helmont, and Andreas Libavius. Descartes endeavoured to mechanise their approaches, creating a theory in which fire and heat, a legacy from thermal explanations of physiology, were transformed into alchemical fire, and then into mechanistic or physicalist heat.

  2. Multiscale measurement of cardiac energetics.

    Science.gov (United States)

    Goo, Soyeon; Pham, Toan; Han, Jun-Chiew; Nielsen, Poul; Taberner, Andrew; Hickey, Anthony; Loiselle, Denis

    2013-09-01

    Herein we describe our laboratories' experimental methods for interrogating cardiac energetics at the organ (whole heart), tissue (trabecula) and perforated fibre (mitochondrial) levels. In whole heart and trabecula experiments, we focus on measuring pressure-volume (force-length) work and oxygen consumption (heat production) from which mechanical efficiency is derived. In both preparations (i.e. across scales differing by three orders of magnitude) we find efficiency values of 10%-15%. Mitochondrial experiments invoke a trio of titration protocols to yield information on oxygen consumption, ATP flux, membrane potential, electron leak and reactive oxygen species production, the latter two of which index energy transfer inefficiencies. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  3. Fractals analysis of cardiac arrhythmias.

    Science.gov (United States)

    Saeed, Mohammed

    2005-09-06

    Heart rhythms are generated by complex self-regulating systems governed by the laws of chaos. Consequently, heart rhythms have fractal organization, characterized by self-similar dynamics with long-range order operating over multiple time scales. This allows for the self-organization and adaptability of heart rhythms under stress. Breakdown of this fractal organization into excessive order or uncorrelated randomness leads to a less-adaptable system, characteristic of aging and disease. With the tools of nonlinear dynamics, this fractal breakdown can be quantified with potential applications to diagnostic and prognostic clinical assessment. In this paper, I review the methodologies for fractal analysis of cardiac rhythms and the current literature on their applications in the clinical context. A brief overview of the basic mathematics of fractals is also included. Furthermore, I illustrate the usefulness of these powerful tools to clinical medicine by describing a novel noninvasive technique to monitor drug therapy in atrial fibrillation.

  4. Biomagnetic study of cardiac arrhythmias.

    Science.gov (United States)

    Fenici, R R; Melillo, G

    1991-01-01

    Clinical magnetocardiographic mapping was initiated in the Cardiovascular Biomagnetism Unit of the Catholic University of Rome about 10 years ago. Since then several hundred patients have been investigated. However, the most interesting data have been collected after the development, in 1984, of the present laboratory configuration, which allows simultaneous MCG mapping and invasive electrophysiological procedures. Perspective studies have been carried out to validate the accuracy of MCG for localisation of arrhythmogenic structures and for early detection of patients at risk of sudden death. Although the diagnostic applicability of the method is still under evaluation, preliminary results are reported, concerning 120 patients, investigated between 1985 and 1990, with cardiac arrhythmias associated with ventricular pre-excitation, ischaemic heart disease or cardiomyopathies.

  5. Approach to cardiac resyncronization therapy

    DEFF Research Database (Denmark)

    Dobreanu, Dan; Dagres, Nikolaos; Svendsen, Jesper Hastrup

    2012-01-01

    and completed the questions. Thirty-two per cent of the responding centres always use CRT in heart failure (HF) patients with New York Heart Association functional class II and QRS width >120 ms, and 55% of the responding centres demand additional criteria when indicating CRT, most often QRS width >150 ms (49......%) and echocardiographic criteria of asynchrony (34%). Only 10% of centres indicate CRT in all HF patients with QRS >120 ms and right bundle branch block, and 51% demand additional criteria, most frequently echocardiographic asynchrony parameters. The vast majority of centres also indicate CRT in patients with atrial...... fibrillation and standard criteria for CRT. In 24% of the centres, biventricular pacemaker (CRT-P) is implanted in all situations, unless there is an indication for secondary prevention of sudden cardiac death, while 10% always choose to implant a biventricular defibrillator (CRT-D). There are no clear...

  6. Gene Therapy in Cardiac Arrhythmias

    Directory of Open Access Journals (Sweden)

    Praveen S.V

    2006-04-01

    Full Text Available Gene therapy has progressed from a dream to a bedside reality in quite a few human diseases. From its first application in adenosine deaminase deficiency, through the years, its application has evolved to vascular angiogenesis and cardiac arrhythmias. Gene based biological pacemakers using viral vectors or mesenchymal cells tested in animal models hold much promise. Induction of pacemaker activity within the left bundle branch can provide stable heart rates. Genetic modification of the AV node mimicking beta blockade can be therapeutic in the management of atrial fibrillation. G protein overexpression to modify the AV node also is experimental. Modification and expression of potassium channel genes altering the delayed rectifier potassium currents may permit better management of congenital long QT syndromes. Arrhythmias in a failing heart are due to abnormal calcium cycling. Potential targets for genetic modulation include the sarcoplasmic reticulum calcium pump, calsequestrin and sodium calcium exchanger.Lastly the ethical concerns need to be addressed.

  7. Cardiac Function Remains Impaired Despite Reversible Cardiac Remodeling after Acute Experimental Viral Myocarditis

    Directory of Open Access Journals (Sweden)

    Peter Moritz Becher

    2017-01-01

    Full Text Available Background. Infection with Coxsackievirus B3 induces myocarditis. We aimed to compare the acute and chronic phases of viral myocarditis to identify the immediate effects of cardiac inflammation as well as the long-term effects after resolved inflammation on cardiac fibrosis and consequently on cardiac function. Material and Methods. We infected C57BL/6J mice with Coxsackievirus B3 and determined the hemodynamic function 7 as well as 28 days after infection. Subsequently, we analyzed viral burden and viral replication in the cardiac tissue as well as the expression of cytokines and matrix proteins. Furthermore, cardiac fibroblasts were infected with virus to investigate if viral infection alone induces profibrotic signaling. Results. Severe cardiac inflammation was determined and cardiac fibrosis was consistently colocalized with inflammation during the acute phase of myocarditis. Declined cardiac inflammation but no significantly improved hemodynamic function was observed 28 days after infection. Interestingly, cardiac fibrosis declined to basal levels as well. Both cardiac inflammation and fibrosis were reversible, whereas the hemodynamic function remains impaired after healed viral myocarditis in C57BL/6J mice.

  8. Negative predictive value of cardiac troponin for predicting adverse cardiac events following blunt chest trauma.

    Science.gov (United States)

    Guild, Cameron S; deShazo, Matthew; Geraci, Stephen A

    2014-01-01

    Cardiac-specific troponins (Tns) are sensitive and specific markers of myocardial injury that have been shown to be predictive of outcomes in many cardiac and noncardiac conditions. We sought to determine whether normal cardiac Tn concentrations obtained during the first 24 hours following blunt chest trauma would predict good cardiac outcomes. A PubMed/MEDLINE search was performed to identify prospective studies in patients with blunt chest trauma in which serial cardiac TnT or TnI values were measured within 24 hours of admission and clinical outcomes assessed. Ten studies qualified for review. Studies that used the lower reference limit of Tn as the cutoff for cardiac injury showed 100% negative predictive value (NPV) for developing cardiac complications, whereas studies using higher Tn cutoffs showed wider variation in NPV (50%-98%). Cardiac Tn measured within 24 hours using the lower reference limit (LRL) as the cutoff appears to have excellent NPV for clinically significant adverse cardiac events. This could allow for early discharge after a 24-hour observation period in otherwise uncomplicated blunt chest trauma patients and avoid the need for more expensive cardiac imaging and additional resource utilization.

  9. Regulation of cardiac remodeling by cardiac Na/K-ATPase isoforms

    Directory of Open Access Journals (Sweden)

    Lijun Catherine Liu

    2016-09-01

    Full Text Available Cardiac remodeling occurs after cardiac pressure/volume overload or myocardial injury during the development of heart failure and is a determinant of heart failure. Preventing or reversing remodeling is a goal of heart failure therapy. Human cardiomyocyte Na+/K+-ATPase has multiple α isoforms (1-3. The expression of the α subunit of the Na+/K+-ATPase is often altered in hypertrophic and failing hearts. The mechanisms are unclear. There are limited data from human cardiomyocytes. Abundant evidences from rodents show that Na+/K+-ATPase regulates cardiac contractility, cell signaling, hypertrophy and fibrosis. The α1 isoform of the Na+/K+-ATPase is the ubiquitous isoform and possesses both pumping and signaling functions. The α2 isoform of the Na+/K+-ATPase regulates intracellular Ca2+ signaling, contractility and pathological hypertrophy. The α3 isoform of the Na+/K+-ATPase may also be a target for cardiac hypertrophy. Restoration of cardiac Na+/K+-ATPase expression may be an effective approach for prevention of cardiac remodeling. In this article, we will overview: (1 the distribution and function of isoform specific Na+/K+-ATPase in the cardiomyocytes. (2 the role of cardiac Na+/K+-ATPase in the regulation of cell signaling, contractility, cardiac hypertrophy and fibrosis in vitro and in vivo. Selective targeting of cardiac Na+/K+-ATPase isoform may offer a new target for the prevention of cardiac remodeling.

  10. Impact of prolonged walking exercise on cardiac structure and function in cardiac patients versus healthy controls.

    Science.gov (United States)

    Benda, Nathalie Mm; Hopman, Maria Te; van Dijk, Arie Pj; Oxborough, David; George, Keith P; Thijssen, Dick Hj; Eijsvogels, Thijs Mh

    2016-08-01

    Previous studies have demonstrated that endurance exercise can cause an acute transient decrease in cardiac function in healthy subjects. Whether this also occurs in cardiac patients is unknown. We investigated the impact of prolonged single day and three-day walking exercise on cardiac function and cardiac biomarkers between cardiac patients and healthy controls in an observational study. We recruited 10 cardiac patients (nine males, one female, 68 ± 5 years) and 10 age- and sex-matched healthy control subjects (nine males, one female, 68 ± 4 years) to perform 30 or 40 km of walking exercise per day for three consecutive days. Cardiac function was examined using echocardiography and cardiac biomarkers (cardiac troponin and B-type natriuretic peptide) with blood samples. Data were collected before walking and directly after walking on day 1 and day 3. Post-exercise early systolic tissue contraction velocity of the left ventricle (p = 0.005) and global longitudinal left ventricle strain (P = 0.026) were increased in both groups compared with baseline. Post-exercise right ventricle peak early diastolic tissue filling velocity and systolic blood pressure/left ventricle end-systolic volume ratio decreased in both groups (p = 0.043 and p = 0.028, respectively). Post-exercise cardiac troponin levels increased (p = 0.045) but did not differ across groups (p = 0.60), whereas B-type natriuretic peptide levels did not change (p = 0.43). This study suggests that stable cardiac patients are capable of performing three days of prolonged walking exercise without clinically significant acute overall deterioration in cardiac function or more pronounced increase in cardiac biomarkers compared with healthy controls. © The European Society of Cardiology 2016.

  11. The cardiac glycoside ouabain activates NLRP3 inflammasomes and promotes cardiac inflammation and dysfunction.

    Directory of Open Access Journals (Sweden)

    Motoi Kobayashi

    Full Text Available Cardiac glycosides such as digoxin are Na+/K+-ATPase inhibitors that are widely used for the treatment of chronic heart failure and cardiac arrhythmias; however, recent epidemiological studies have suggested a relationship between digoxin treatment and increased mortality. We previously showed that nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3 inflammasomes, which regulate caspase-1-dependent interleukin (IL-1β release, mediate the sterile cardiovascular inflammation. Because the Na+/K+-ATPase is involved in inflammatory responses, we investigated the role of NLRP3 inflammasomes in the pathophysiology of cardiac glycoside-induced cardiac inflammation and dysfunction. The cardiac glycoside ouabain induced cardiac dysfunction and injury in wild-type mice primed with a low dose of lipopolysaccharide (LPS, although no cardiac dysfunction was observed in mice treated with either ouabain or LPS alone. Ouabain also induced cardiac inflammatory responses, such as macrophage infiltration and IL-1β release, when mice were primed with LPS. These cardiac manifestations were all significantly attenuated in mice deficient in IL-1β. Furthermore, deficiency of NLRP3 inflammasome components, NLRP3 and caspase-1, also attenuated ouabain-induced cardiac dysfunction and inflammation. In vitro experiments revealed that ouabain induced NLRP3 inflammasome activation as well as subsequent IL-1β release from macrophages, and this activation was mediated by K+ efflux. Our findings demonstrate that cardiac glycosides promote cardiac inflammation and dysfunction through NLRP3 inflammasomes and provide new insights into the mechanisms underlying the adverse effects of cardiac glycosides.

  12. Pharmacological bridge to cardiac transplantation.

    Science.gov (United States)

    Loisance, D; Dubois Rande, J L; Deleuze, P H; Hillion, M L; Duval, A M; Tavolaro, O; Romano, P; Castaigne, A; Tarral, A; Cachera, J P

    1989-01-01

    From September 1985 to August 1988, 32 patients were referred from various intensive care units throughout Paris for urgent cardiac transplantation or for a mechanical bridge to transplantation. At time of admission, under maximal sympathomimetic therapy, the cardiac index (CI) was 1.81 +/- 0.26 l/min per m2, the pulmonary capillary wedge pressure (PCWP 31 +/- 7 mmHg), systemic vascular resistances (SVR) 2053 +/- 469 dynes s cm-5. In 25, diuresis was less than 25 ml/h. Five were anuric. Prior to any final decision, a new inotropic agent, enoximone, was infused in addition to previous treatment as a 10 min bolus iv 1.5-2 mg/kg every 8 h. In 3, the situation further deteriorated, leading to a Jarvik 7-70 implantation within 12 h. In 29 however, within 3 h, the Cl increased to 2.69 +/- 0.56 as SVR dropped to 1410 +/- 453 and PCWP to 18 +/- 7. Diuresis increased to more than 100 ml/h in all. This permitted an indepth evaluation of the transplant candidates leading to contraindications to transplantation in 16. Nine patients could be weaned off iv enoximone. Four of these are still living (NYHA class III) with a follow up of 6-17 months. In 11, transplantation was performed within 2 days. Four died within a month, 2 with multiple organ failure. One patient died after 5 months. Six are back to normal life, NYHA class I (follow up 10 months-2.5 years). This protocol suggests that in patients with extreme heart failure, immediate survival may be increased by iv enoximone therapy, permitting a better selection of the recipients, more efficient pre-transplantation intensive care and consequently a decrease in the indications for a temporary mechanical bridge to a staged transplantation.

  13. Assessing quality in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Samer A.M. Nashef

    2005-07-01

    Full Text Available There is a the strong temporal, if not causal, link between the intervention and the outcome in cardiac surgery and therefore a link becomes established between operative mortality and the measurement of surgical performance. In Britain the law stipulates that data collected by any public body or using public funds must be made freely available. Tools and mechanisms we devise and develop are likely to form the models on which the quality of care is assessed in other surgical and perhaps medical specialties. Measuring professional performance should be done by the profession. To measure risk there are a number of scores as crude mortality is not enough. A very important benefit of assessing the risk of death is to use this knowledge in the determination of the indication to operate. The second benefit is in the assessment of the quality of care as risk prediction gives a standard against performance of hospitals and surgeons. Peer review and “naming and shaming” are two mechanisms to monitor quality. There are two potentially damaging outcomes from the publication of results in a league-table form: the first is the damage to the hospital; the second is to refuse to operate on high-risk patients. There is a real need for quality monitoring in medicine in general and in cardiac surgery in particular. Good quality surgical work requires robust knowledge of three crucial variables: activity, risk prediction and performance. In Europe, the three major specialist societies have agreed to establish the European Cardiovascular and Thoracic Surgery Institute of Accreditation (ECTSIA. Performance monitoring is soon to become imperative. If we surgeons are not on board, we shall have no control on its final destination, and the consequences may be equally damaging to us and to our patients.

  14. ICD in cardiac resinhronization therapy

    Directory of Open Access Journals (Sweden)

    Damijan Vokač

    2005-12-01

    Full Text Available Background: Patients with advanced heart failure bears bad prognosis, despite modern medical treatment year mortality rate spans from 30 up to 70%. Besides terminal heart failure the second most frequent cause is sudden death due to ventricular tachyarrhythmias as ventricular tachycardia and fibrillation. Ventricular fibrillation is very frequent cause of mortality of terminal heart failure especially in ischemic subgroup. Clinical studies have presented improvement of heart function by use of biventricular stimulation of patients with advanced heart failure and intraventricular conduction defects as left bundle branch block. Method very successfully improves acute hemodynamic parameters due to resynchronization of septal and lateral wall of left ventricle and improves economy of the heart contraction. Although these effects are present immediately after implantation they persist also through longer period. Method improves quality of life and also decreases mortality rate proved by clinical studies. Despite successful therapy mortality rate due to sudden death remains high. Implantable cardioverters defibrillators successfully prevent sudden cardiac death due to ventricular tachyarrhythmia. They are successful due to straightforward recognition of ventricular tachycardia or fibrillation and immediate electrical schock delivery. Cardiovertes defibrillators are successful in prevention of sudden cardiac death but they do not improve quality of life of heart failure patients like resynchronization therapy. Thus, combined therapy resynchronization and cardioverter defibrillator as a single implantable device has been developed.Conclusions: Due to very successful combined therapy the application of biventricular cardioverters defibrillators into clinical practice has increased. Implantation of biventricular cardioverter defibrillator is complex but very successful procedure. It is economically acceptable when proper indication has been stated. Large

  15. The Danish Cardiac Rehabilitation Database.

    Science.gov (United States)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne; Foghmar, Sussie; Eichhorst, Regina; Prescott, Eva; Cerqueira, Charlotte; Soja, Anne Merete Boas; Gislason, Gunnar H; Larsen, Mogens Lytken; Andersen, Ulla Overgaard; Gustafsson, Ida; Thomsen, Kristian K; Boye Hansen, Lene; Hammer, Signe; Viggers, Lone; Christensen, Bo; Kvist, Birgitte; Lindström Egholm, Cecilie; May, Ole

    2016-01-01

    The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward. Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year. Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients.

  16. The role of autophagy in cardiac hypertrophy

    Science.gov (United States)

    Li, Lanfang; Xu, Jin; He, Lu; Peng, Lijun; Zhong, Qiaoqing; Chen, Linxi; Jiang, Zhisheng

    2016-01-01

    Autophagy is conserved in nature from lower eukaryotes to mammals and is an important self-cannibalizing, degradative process that contributes to the elimination of superfluous materials. Cardiac hypertrophy is primarily characterized by excess protein synthesis, increased cardiomyocyte size, and thickened ventricular walls and is a major risk factor that promotes arrhythmia and heart failure. In recent years, cardiomyocyte autophagy has been considered to play a role in controlling the hypertrophic response. However, the beneficial or aggravating role of cardiomyocyte autophagy in cardiac hypertrophy remains controversial. The exact mechanism of cardiomyocyte autophagy in cardiac hypertrophy requires further study. In this review, we summarize the controversies associated with autophagy in cardiac hypertrophy and provide insights into the role of autophagy in the development of cardiac hypertrophy. We conclude that future studies should emphasize the relationship between autophagy and the different stages of cardiac hypertrophy, as well as the autophagic flux and selective autophagy. Autophagy will be a potential therapeutic target for cardiac hypertrophy. PMID:27084518

  17. Pharmacological blockade of the cold receptor TRPM8 attenuates autonomic and behavioral cold defenses and decreases deep body temperature.

    Science.gov (United States)

    Almeida, M Camila; Hew-Butler, Tamara; Soriano, Renato N; Rao, Sara; Wang, Weiya; Wang, Judy; Tamayo, Nuria; Oliveira, Daniela L; Nucci, Tatiane B; Aryal, Prafulla; Garami, Andras; Bautista, Diana; Gavva, Narender R; Romanovsky, Andrej A

    2012-02-08

    We studied N-(2-aminoethyl)-N-(4-(benzyloxy)-3-methoxybenzyl)thiophene-2-carboxamide hydrochloride (M8-B), a selective and potent antagonist of the transient receptor potential melastatin-8 (TRPM8) channel. In vitro, M8-B blocked cold-induced and TRPM8-agonist-induced activation of rat, human, and murine TRPM8 channels, including those on primary sensory neurons. In vivo, M8-B decreased deep body temperature (T(b)) in Trpm8(+/+) mice and rats, but not in Trpm8(-/-) mice, thus suggesting an on-target action. Intravenous administration of M8-B was more effective in decreasing T(b) in rats than intrathecal or intracerebroventricular administration, indicating a peripheral action. M8-B attenuated cold-induced c-Fos expression in the lateral parabrachial nucleus, thus indicating a site of action within the cutaneous cooling neural pathway to thermoeffectors, presumably on sensory neurons. A low intravenous dose of M8-B did not affect T(b) at either a constantly high or a constantly low ambient temperature (T(a)), but the same dose readily decreased T(b) if rats were kept at a high T(a) during the M8-B infusion and transferred to a low T(a) immediately thereafter. These data suggest that both a successful delivery of M8-B to the skin (high cutaneous perfusion) and the activation of cutaneous TRPM8 channels (by cold) are required for the hypothermic action of M8-B. At tail-skin temperatures cold) activation of TRPM8. M8-B affected all thermoeffectors studied (thermopreferendum, tail-skin vasoconstriction, and brown fat thermogenesis), thus suggesting that TRPM8 is a universal cold receptor in the thermoregulation system.

  18. Pharmacological blockade of the cold receptor TRPM8 attenuates autonomic and behavioral cold defenses and decreases deep body temperature

    Science.gov (United States)

    Almeida, M. Camila; Hew-Butler, Tamara; Soriano, Renato N.; Rao, Sara; Wang, Weiya; Wang, Judy; Tamayo, Nuria; Oliveira, Daniela L.; Nucci, Tatiane B.; Aryal, Prafulla; Garami, Andras; Bautista, Diana; Gavva, Narender R.; Romanovsky, Andrej A.

    2012-01-01

    We studied M8-B, a selective and potent antagonist of the transient receptor potential melastatin-8 (TRPM8) channel. In vitro, M8-B blocked cold-induced and TRPM8-agonist-induced activation of rat, human, and murine TRPM8 channels, including those on primary sensory neurons. In vivo, M8-B decreased deep body temperature (Tb) in Trpm8+/+ mice and rats, but not in Trpm8−/− mice, thus suggesting an on-target action. The intravenous administration of M8-B was more effective in decreasing Tb in rats than the intrathecal or intracerebroventricular administration, indicating a peripheral action. M8-B attenuated cold-induced c-Fos expression in the lateral parabrachial nucleus, thus indicating a site of action within the cutaneous cooling neural pathway to thermoeffectors, presumably on sensory neurons. A low intravenous dose of M8-B did not affect Tb at either a constantly high or a constantly low ambient temperature (Ta), but the same dose readily decreased Tb if rats were kept at a high Ta during the M8-B infusion and transferred to a low Ta immediately thereafter. These data suggest that both a successful delivery of M8-B to the skin (high cutaneous perfusion) and the activation of cutaneous TRPM8 channels (by cold) are required for the hypothermic action of M8-B. At tail skin temperatures cold) activation of TRPM8. M8-B affected all thermoeffectors studied (thermopreferendum, tail skin vasoconstriction, and brown fat thermogenesis), thus suggesting that TRPM8 is a universal cold receptor in the thermoregulation system. PMID:22323721

  19. A Deep-Sea Simulation.

    Science.gov (United States)

    Montes, Georgia E.

    1997-01-01

    Describes an activity that simulates exploration techniques used in deep-sea explorations and teaches students how this technology can be used to take a closer look inside volcanoes, inspect hazardous waste sites such as nuclear reactors, and explore other environments dangerous to humans. (DDR)

  20. Electrochemical Machining Removes Deep Obstructions

    Science.gov (United States)

    Catania, Mark J.

    1987-01-01

    Electrochemical machining (ECM) is effective way of removing obstructing material between two deep holes supposed to intersect but do not because of misalignment of drilling tools. ECM makes it possible to rework costly castings otherwise scrapped. Method fast even for tough or hard alloys and complicated three-dimensional shapes.

  1. Digging Deeper: The Deep Web.

    Science.gov (United States)

    Turner, Laura

    2001-01-01

    Focuses on the Deep Web, defined as Web content in searchable databases of the type that can be found only by direct query. Discusses the problems of indexing; inability to find information not indexed in the search engine's database; and metasearch engines. Describes 10 sites created to access online databases or directly search them. Lists ways…

  2. Ploughing the deep sea floor.

    Science.gov (United States)

    Puig, Pere; Canals, Miquel; Company, Joan B; Martín, Jacobo; Amblas, David; Lastras, Galderic; Palanques, Albert

    2012-09-13

    Bottom trawling is a non-selective commercial fishing technique whereby heavy nets and gear are pulled along the sea floor. The direct impact of this technique on fish populations and benthic communities has received much attention, but trawling can also modify the physical properties of seafloor sediments, water–sediment chemical exchanges and sediment fluxes. Most of the studies addressing the physical disturbances of trawl gear on the seabed have been undertaken in coastal and shelf environments, however, where the capacity of trawling to modify the seafloor morphology coexists with high-energy natural processes driving sediment erosion, transport and deposition. Here we show that on upper continental slopes, the reworking of the deep sea floor by trawling gradually modifies the shape of the submarine landscape over large spatial scales. We found that trawling-induced sediment displacement and removal from fishing grounds causes the morphology of the deep sea floor to become smoother over time, reducing its original complexity as shown by high-resolution seafloor relief maps. Our results suggest that in recent decades, following the industrialization of fishing fleets, bottom trawling has become an important driver of deep seascape evolution. Given the global dimension of this type of fishery, we anticipate that the morphology of the upper continental slope in many parts of the world’s oceans could be altered by intensive bottom trawling, producing comparable effects on the deep sea floor to those generated by agricultural ploughing on land.

  3. Deep-Sky Video Astronomy

    CERN Document Server

    Massey, Steve

    2009-01-01

    A guide to using modern integrating video cameras for deep-sky viewing and imaging with the kinds of modest telescopes available commercially to amateur astronomers. It includes an introduction and a brief history of the technology and camera types. It examines the pros and cons of this unrefrigerated yet highly efficient technology

  4. Distributed Episodic Exploratory Planning (DEEP)

    Science.gov (United States)

    2012-04-01

    38 Figure 16: Chromosome representation for the DEEP-StarCraft GA ......................................................... 39 Figure 17...air mission planning and execution environment. The JAGUAR case base contains historical executed plans and objectives, along with the anomalies ... anomalies detected during execution of the underlying models, and plan message data (e.g., world state, monitored events), that was collected during the

  5. Deep Space Gateway "Recycler" Mission

    Science.gov (United States)

    Graham, L.; Fries, M.; Hamilton, J.; Landis, R.; John, K.; O'Hara, W.

    2018-02-01

    Use of the Deep Space Gateway provides a hub for a reusable planetary sample return vehicle for missions to gather star dust as well as samples from various parts of the solar system including main belt asteroids, near-Earth asteroids, and Mars moon.

  6. Associative Learning Should Go Deep.

    Science.gov (United States)

    Mondragón, Esther; Alonso, Eduardo; Kokkola, Niklas

    2017-11-01

    Conditioning, how animals learn to associate two or more events, is one of the most influential paradigms in learning theory. It is nevertheless unclear how current models of associative learning can accommodate complex phenomena without ad hoc representational assumptions. We propose to embrace deep neural networks to negotiate this problem. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Deep Space Climate Observatory (DSCOVR)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Deep Space Climate ObserVatoRy (DSCOVR) satellite is a NOAA operated asset at the first Lagrange (L1) point. The primary space weather instrument is the PlasMag...

  8. Stimulation Technologies for Deep Well Completions

    Energy Technology Data Exchange (ETDEWEB)

    Stephen Wolhart

    2005-06-30

    The Department of Energy (DOE) is sponsoring the Deep Trek Program targeted at improving the economics of drilling and completing deep gas wells. Under the DOE program, Pinnacle Technologies conducted a study to evaluate the stimulation of deep wells. The objective of the project was to review U.S. deep well drilling and stimulation activity, review rock mechanics and fracture growth in deep, high-pressure/temperature wells and evaluate stimulation technology in several key deep plays. This report documents results from this project.

  9. Cardiac myxoma in pregnancy: a comprehensive review.

    Science.gov (United States)

    Yuan, Shi-Min

    2015-01-01

    Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses. A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review. Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49); while no surgical resection was performed in 4.1% (2/49) patients (P=0.000). More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47) vs. 12.8% (6/47), P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7%) cases. In the remaining 31 (60.8%) pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%), 14 (38.9%) and 17 (47.2%) patients, respectively. No patients died. In the delivery group, 20 (76.9%) neonates were event-free survivals, 4 (15.4%) were complicated and 2 (7.7%) died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery. The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in even better maternal and feto-neonatal survivals.

  10. The Western Denmark Cardiac Computed Tomography Registry

    DEFF Research Database (Denmark)

    Nielsen, Lene Hüche; Nørgaard, Bjarne Linde; Tilsted, Hans-Henrik

    2015-01-01

    BACKGROUND: As a subregistry to the Western Denmark Heart Registry (WDHR), the Western Denmark Cardiac Computed Tomography Registry (WDHR-CCTR) is a clinical database established in 2008 to monitor and improve the quality of cardiac computed tomography (CT) in Western Denmark. OBJECTIVE: We...... positive and negative predictive values for both university (96%/99%) and nonuniversity centers (97%/99%). CONCLUSION: WDHR-CCTR provides ongoing prospective registration of all cardiac CTs performed in Western Denmark since 2008. Overall, the registry data have a high degree of completeness and validity...

  11. Cardiac myxoma in pregnancy: a comprehensive review

    Directory of Open Access Journals (Sweden)

    Shi-Min Yuan

    2015-09-01

    Full Text Available AbstractObjective:Cardiac myxoma in pregnancy is rare and the clinical characteristics of this entity have been insufficiently elucidated. This article aims to describe the treatment options and the risk factors responsible for the maternal and feto-neonatal prognoses.Methods:A comprehensive search of the literature of cardiac myxoma in pregnancy was conducted and 44 articles with 51 patients were included in the present review.Results:Transthoracic echocardiography was the most common diagnostic tool for the diagnosis of cardiac myxoma during pregnancy. Cardiac myxoma resection was performed in 95.9% (47/49; while no surgical resection was performed in 4.1% (2/49 patients (P=0.000. More patients had an isolated cardiac myxoma resection in comparison to those with a concurrent or staged additional cardiac operation [87.2% (41/47 vs. 12.8% (6/47, P=0.000]. A voluntary termination of the pregnancy was done in 7 (13.7% cases. In the remaining 31 (60.8% pregnant patients, cesarean section was the most common delivery mode representing 61.3% and vaginal delivery was more common accounting for 19.4%. Cardiac surgery was performed in the first, second and third trimester in 5 (13.9%, 14 (38.9% and 17 (47.2% patients, respectively. No patients died. In the delivery group, 20 (76.9% neonates were event-free survivals, 4 (15.4% were complicated and 2 (7.7% died. Neonatal prognoses did not differ between the delivery modes, treatment options, timing of cardiac surgery and sequence of cardiac myxoma resection in relation to delivery.Conclusion:The diagnosis of cardiac myxoma in pregnancy is important. Surgical treatment of cardiac myxoma in the pregnant patients has brought about favorable maternal and feto-neonatal outcomes in the delivery group, which might be attributable to the shorter operation duration and non-emergency nature of the surgical intervention. Proper timing of cardiac surgery and improved cardiopulmonary bypass conditions may result in

  12. Reduction of cardiac and pulmonary complication probabilities after breathing adapted radiotherapy for breast cancer

    DEFF Research Database (Denmark)

    Korreman, Stine S; Pedersen, Anders N; Aarup, Lasse Rye

    2006-01-01

    PURPOSE: Substantial reductions of cardio-pulmonary radiation doses can be achieved using voluntary deep inspiration breath-hold (DIBH) or free breathing inspiration gating (IG) in radiotherapy after conserving surgery for breast cancer. The purpose of this study is to evaluate the radiobiological...... implications of such dosimetric benefits. METHODS AND MATERIALS: Patients from previously reported studies were pooled for a total of 33 patients. All patients underwent DIBH and free breathing (FB) scans, and 17 patients underwent an additional IG scan. Tangential conformal treatment plans covering...... voluntary DIBH and free breathing IG to reduce the risk of both cardiac mortality and pneumonitis for the common technique of adjuvant tangential breast irradiation....

  13. Cardiac Electrophysiology: Normal and Ischemic Ionic Currents and the ECG

    Science.gov (United States)

    Klabunde, Richard E.

    2017-01-01

    Basic cardiac electrophysiology is foundational to understanding normal cardiac function in terms of rate and rhythm and initiation of cardiac muscle contraction. The primary clinical tool for assessing cardiac electrical events is the electrocardiogram (ECG), which provides global and regional information on rate, rhythm, and electrical…

  14. Cardiac conduction system anomalies and sudden cardiac death: insights from murine models

    Directory of Open Access Journals (Sweden)

    Amelia Eva Aranega

    2012-06-01

    Full Text Available The cardiac conduction system (CCS is a series of specialized tissues in the heart responsible for the initiation and co-ordination of the heartbeat. Alterations in the CCS, especially the His-Purkinje system, have been identified as an important player in the generation of lethal arrhythmias. Unstable arrhythmias secondary to channelopathies highly increase the risk of sudden cardiac death (SCD. Sudden cardiac death is a major contributor to mortality in industrialized nations, and most cases of SCD in the young are related to inherited ion channel diseases. In this review we examine how murine transgenic models have contributed to understanding that a broad variety of cardiac arrhythmias involve the cardiac specialized conduction system and may lead to sudden cardiac death.

  15. Cardiac carcinoid: tricuspid delayed hyperenhancement on cardiac 64-slice multidetector CT and magnetic resonance imaging.

    LENUS (Irish Health Repository)

    Martos, R

    2012-02-01

    INTRODUCTION: Carcinoid heart disease is a rare condition in adults. Its diagnosis can be easily missed in a patient presenting to a primary care setting. We revised the advantages of using coronary multidetector computed tomography (MDCT) and cardiac magnetic resonance imaging (MRI) in diagnosing this condition. MATERIALS AND METHODS: We studied a 65-year-old patient with carcinoid heart disease and right heart failure using transthoracic Doppler-echocardiogram, cardiac MDCT and MRI. Cardiac echocardiogram revealed marked thickening and retraction of the tricuspid leaflets with dilated right atrium and ventricle. Cardiac MDCT and MRI demonstrated fixation and retraction of the tricuspid leaflets with delayed contrast hyperenhancement of the tricuspid annulus. CONCLUSION: This case demonstrates fascinating imaging findings of cardiac carcinoid disease and highlights the increasing utility of contrast-enhanced MRI and cardiac MDCT in the diagnosis of this interesting condition.

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

    International Nuclear Information System (INIS)

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

    1980-01-01

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

  17. Combined arterial and venous whole-body MR angiography with cardiac MR imaging in patients with thromboembolic disease - initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Vogt, Florian M.; Hunold, Peter; Barkhausen, Joerg [University Hospital Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany); Herborn, Christoph U. [University Hospital Hamburg-Eppendorf, Medical Prevention Center Hamburg (MPCH) at University Hospital Hamburg-Eppendorf, Hamburg (Germany); Ruehm, Stefan G. [David Geffen School of Medicine at UCLA, Department of Radiology, Los Angeles, CA (United States); Kroger, Knut [University Hospital Essen, Department of Angiology, Essen (Germany)

    2008-05-15

    The objective was to assess the feasibility of a combined arterial and venous whole-body three-dimensional magnetic resonance (MR) angiography, together with a cardiac MR examination, in patients with arterial thromboembolism. Ten patients with arterial thromboembolism underwent a contrast-enhanced whole-body MR examination of the arterial and venous vessels, followed by a cardiac MR examination on a separate occasion within 24 h. All examinations were performed on a 1.5-T MR scanner. For both arterial and venous MR angiography only one injection of contrast agent was necessary. The cardiac imaging protocol included dark-blood-prepared half-Fourier acquisition single-shot turbo-spin-echo sequences, fast steady-state free precession cine sequences, T2-weighted turbo-spin-echo sequences and inversion recovery gradient-echo fast low-angle-shot sequences after injection of contrast agent. MR imaging revealed additional clinically unknown arterial thromboembolisms in four patients. The thoracic aorta was depicted as embolic source in four patients, while deep vein thrombosis (DVT) was found in one patient as the underlying disease. Unsuspected infarction of parenchymal organs was detected by MRI in two patients. An unknown additional DVT was found in one patient. Four patients were considered to have arterial emboli of cardiac origin. In conclusion, acquisition of arterial and venous MR angiograms of the entire vascular system combined with cardiac MR imaging is a most comprehensive and valuable strategy in patients with arterial thromboembolism. (orig.)

  18. Deep Web and Dark Web: Deep World of the Internet

    OpenAIRE

    Çelik, Emine

    2018-01-01

    The Internet is undoubtedly still a revolutionary breakthrough in the history of humanity. Many people use the internet for communication, social media, shopping, political and social agenda, and more. Deep Web and Dark Web concepts not only handled by computer, software engineers but also handled by social siciensists because of the role of internet for the States in international arenas, public institutions and human life. By the moving point that very importantrole of internet for social s...

  19. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic cholecys...

  20. Hot and sour in the deep ocean

    Science.gov (United States)

    Sabine, Christopher L.

    2017-12-01

    Stable layering in the ocean limits the rate that human-derived carbon dioxide can acidify the deep ocean. Now observations show that ocean warming, however, can enhance deep-ocean acidification through increased organic matter decomposition.

  1. The Danish Cardiac Rehabilitation Database

    Directory of Open Access Journals (Sweden)

    Zwisler AD

    2016-10-01

    Full Text Available Ann-Dorthe Zwisler,1 Henriette Knold Rossau,1 Anne Nakano,2,3 Sussie Foghmar,4 Regina Eichhorst,5 Eva Prescott,6 Charlotte Cerqueira,7 Anne Merete Boas Soja,4 Gunnar H Gislason,8–10 Mogens Lytken Larsen,5 Ulla Overgaard Andersen,11 Ida Gustafsson,4 Kristian K Thomsen,12 Lene Boye Hansen,13 Signe Hammer,14 Lone Viggers,15 Bo Christensen,16 Birgitte Kvist,17 Cecilie Lindström Egholm,18 Ole May19 On behalf of the Working Group of Preventive Cardiology and Rehabilitation, Danish Society of Cardiology, and the Working Group of Cardiac Clinical Registries, Danish Society of Cardiology 1Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3Registry Support Centre (West – Clinical Quality Improvement & Health Informatics, Aarhus, 4Department of Cardiology, Copenhagen University Hospital, Hvidovre, 5Department of Cardiology, Aalborg University Hospital, Aalborg, 6Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, 7Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, 8Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, 9The Danish Heart Foundation, Copenhagen, 10The National Institute of Public Health, University of Southern Denmark, 11Department of Cardiology, Holbaek Hospital, University of Copenhagen, Copenhagen, 12Department of Cardiology, Hospital of Southwest Jutland, Esbjerg, 13Department of Cardiology, Gentofte Hospital, Gentofte, 14Department of Occupational Therapy and Physiotherapy, Herlev Hospital, Herlev, 15Department of Nutrition, Regional Hospital West Jutland, Holstebro, 16Department of General Medicine, School of Public Health, Aarhus University, Aarhus, 17Department of Health Care and Prevention, Municipality of Frederikshavn, Frederikshavn, 18

  2. DeepSurveyCam—A Deep Ocean Optical Mapping System

    Science.gov (United States)

    Kwasnitschka, Tom; Köser, Kevin; Sticklus, Jan; Rothenbeck, Marcel; Weiß, Tim; Wenzlaff, Emanuel; Schoening, Timm; Triebe, Lars; Steinführer, Anja; Devey, Colin; Greinert, Jens

    2016-01-01

    Underwater photogrammetry and in particular systematic visual surveys of the deep sea are by far less developed than similar techniques on land or in space. The main challenges are the rough conditions with extremely high pressure, the accessibility of target areas (container and ship deployment of robust sensors, then diving for hours to the ocean floor), and the limitations of localization technologies (no GPS). The absence of natural light complicates energy budget considerations for deep diving flash-equipped drones. Refraction effects influence geometric image formation considerations with respect to field of view and focus, while attenuation and scattering degrade the radiometric image quality and limit the effective visibility. As an improvement on the stated issues, we present an AUV-based optical system intended for autonomous visual mapping of large areas of the seafloor (square kilometers) in up to 6000 m water depth. We compare it to existing systems and discuss tradeoffs such as resolution vs. mapped area and show results from a recent deployment with 90,000 mapped square meters of deep ocean floor. PMID:26828495

  3. DeepSurveyCam--A Deep Ocean Optical Mapping System.

    Science.gov (United States)

    Kwasnitschka, Tom; Köser, Kevin; Sticklus, Jan; Rothenbeck, Marcel; Weiß, Tim; Wenzlaff, Emanuel; Schoening, Timm; Triebe, Lars; Steinführer, Anja; Devey, Colin; Greinert, Jens

    2016-01-28

    Underwater photogrammetry and in particular systematic visual surveys of the deep sea are by far less developed than similar techniques on land or in space. The main challenges are the rough conditions with extremely high pressure, the accessibility of target areas (container and ship deployment of robust sensors, then diving for hours to the ocean floor), and the limitations of localization technologies (no GPS). The absence of natural light complicates energy budget considerations for deep diving flash-equipped drones. Refraction effects influence geometric image formation considerations with respect to field of view and focus, while attenuation and scattering degrade the radiometric image quality and limit the effective visibility. As an improvement on the stated issues, we present an AUV-based optical system intended for autonomous visual mapping of large areas of the seafloor (square kilometers) in up to 6000 m water depth. We compare it to existing systems and discuss tradeoffs such as resolution vs. mapped area and show results from a recent deployment with 90,000 mapped square meters of deep ocean floor.

  4. DeepSurveyCam—A Deep Ocean Optical Mapping System

    Directory of Open Access Journals (Sweden)

    Tom Kwasnitschka

    2016-01-01

    Full Text Available Underwater photogrammetry and in particular systematic visual surveys of the deep sea are by far less developed than similar techniques on land or in space. The main challenges are the rough conditions with extremely high pressure, the accessibility of target areas (container and ship deployment of robust sensors, then diving for hours to the ocean floor, and the limitations of localization technologies (no GPS. The absence of natural light complicates energy budget considerations for deep diving flash-equipped drones. Refraction effects influence geometric image formation considerations with respect to field of view and focus, while attenuation and scattering degrade the radiometric image quality and limit the effective visibility. As an improvement on the stated issues, we present an AUV-based optical system intended for autonomous visual mapping of large areas of the seafloor (square kilometers in up to 6000 m water depth. We compare it to existing systems and discuss tradeoffs such as resolution vs. mapped area and show results from a recent deployment with 90,000 mapped square meters of deep ocean floor.

  5. Cardiac channelopathies: genetic and molecular mechanisms.

    Science.gov (United States)

    Abriel, Hugues; Zaklyazminskaya, Elena V

    2013-03-15

    Channelopathies are diseases caused by dysfunctional ion channels, due to either genetic or acquired pathological factors. Inherited cardiac arrhythmic syndromes are among the most studied human disorders involving ion channels. Since seminal observations made in 1995, thousands of mutations have been found in many of the different genes that code for cardiac ion channel subunits and proteins that regulate the cardiac ion channels. The main phenotypes observed in patients carrying these mutations are congenital long QT syndrome (LQTS), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), short QT syndrome (SQTS) and variable types of conduction defects (CD). The goal of this review is to present an update of the main genetic and molecular mechanisms, as well as the associated phenotypes of cardiac channelopathies as of 2012. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Air medical transport of cardiac patients.

    Science.gov (United States)

    Essebag, Vidal; Halabi, Abdul R; Churchill-Smith, Michael; Lutchmedial, Sohrab

    2003-11-01

    The air medical transport of cardiac patients is a rapidly expanding practice. For various medical, social, and economic indications, patients are being flown longer distances at commercial altitudes, including international and intercontinental flights. There are data supporting the use of short-distance helicopter flights early in the course of a cardiac event for patients needing emergent transfer for percutaneous coronary intervention or aortocoronary bypass. When considering elective long-distance air medical transport of cardiac patients for social or economic reasons, it is necessary to weigh the benefits against the potential risks of flight. A few recent studies suggest that long-distance air medical transport is safe under certain circumstances. Current guidelines for air travel after myocardial infarction do not address the use of medical escorts or air ambulances equipped with intensive care facilities. Further research using larger prospective studies is needed to better define criteria for safe long-distance air medical transport of cardiac patients.

  7. Interactions between antiarrhythmic drugs and cardiac memory

    NARCIS (Netherlands)

    Plotnikov, A. N.; Shvilkin, A.; Xiong, W.; de Groot, J. R.; Rosenshtraukh, L.; Feinmark, S.; Gainullin, R.; Danilo, P.; Rosen, M. R.

    2001-01-01

    Ventricular pacing or arrhythmias can induce cardiac memory (CM). We hypothesized that clinically administered antiarrhythmic drugs alter the expression of CM, and that the repolarization changes characteristic of CM can modulate the effects of antiarrhythmic drugs. We studied conscious,

  8. Cardiac Rehabilitation in the Mid-1980s.

    Science.gov (United States)

    Cantwell, John D.

    1986-01-01

    The author describes a state-of-the-art cardiac rehabilitation program consisting of training and supervision in exercise, nutrition, and stress management. Inpatient, postdischarge, and late postdischarge regimens are presented. (MT)

  9. Targeting sodium channels in cardiac arrhythmia

    NARCIS (Netherlands)

    Remme, Carol Ann; Wilde, Arthur A. M.

    2014-01-01

    Cardiac voltage-gated sodium channels are responsible for proper electrical conduction in the heart. During acquired pathological conditions and inherited sodium channelopathies, altered sodium channel function causes conduction disturbances and ventricular arrhythmias. Although the clinical,

  10. Cardiac, Skeletal, and smooth muscle mitochondrial respiration

    DEFF Research Database (Denmark)

    Park, Song-Young; Gifford, Jayson R; Andtbacka, Robert H I

    2014-01-01

    in cardiac, skeletal, and smooth muscle suggest all mitochondria are created equal, the contrasting RCR and non-phosphorylating respiration highlight the existence of intrinsic functional differences between these muscle mitochondria. This likely influences the efficiency of oxidative phosphorylation...

  11. Automated Segmentation of Cardiac Magnetic Resonance Images

    DEFF Research Database (Denmark)

    Stegmann, Mikkel Bille; Nilsson, Jens Chr.; Grønning, Bjørn A.

    2001-01-01

    Magnetic resonance imaging (MRI) has been shown to be an accurate and precise technique to assess cardiac volumes and function in a non-invasive manner and is generally considered to be the current gold-standard for cardiac imaging [1]. Measurement of ventricular volumes, muscle mass and function...... is based on determination of the left-ventricular endocardial and epicardial borders. Since manual border detection is laborious, automated segmentation is highly desirable as a fast, objective and reproducible alternative. Automated segmentation will thus enhance comparability between and within cardiac...... studies and increase accuracy by allowing acquisition of thinner MRI-slices. This abstract demonstrates that statistical models of shape and appearance, namely the deformable models: Active Appearance Models, can successfully segment cardiac MRIs....

  12. National Cardiac Device Surveillance Program Database

    Data.gov (United States)

    Department of Veterans Affairs — The National Cardiac Device Surveillance Program Database supports the Eastern Pacemaker Surveillance Center (EPSC) staff in its function of monitoring some 11,000...

  13. Spatiotemporal Stability of Public Cardiac Arrests

    NARCIS (Netherlands)

    Demirtas, Derya; Brooks, Steven C.; Morrison, Laurie J.; Chan, Timothy C.Y.

    2015-01-01

    Background: Public access automated external defibrillator (AED) deployment and community cardiopulmonary resuscitation (CPR) programs should target geographical areas with high risk of out-of-hospital cardiac arrest (OHCA). Although these long-term, location-based interventions implicitly assume

  14. Incidental Cardiac Findings on Thoracic Imaging.

    LENUS (Irish Health Repository)

    Kok, Hong Kuan

    2013-02-07

    The cardiac structures are well seen on nongated thoracic computed tomography studies in the investigation and follow-up of cardiopulmonary disease. A wide variety of findings can be incidentally picked up on careful evaluation of the pericardium, cardiac chambers, valves, and great vessels. Some of these findings may represent benign variants, whereas others may have more profound clinical importance. Furthermore, the expansion of interventional and surgical practice has led to the development and placement of new cardiac stents, implantable pacemaker devices, and prosthetic valves with which the practicing radiologist should be familiar. We present a collection of common incidental cardiac findings that can be readily identified on thoracic computed tomography studies and briefly discuss their clinical relevance.

  15. An update on insertable cardiac monitors

    DEFF Research Database (Denmark)

    Olsen, Flemming J; Biering-Sørensen, Tor; Krieger, Derk W

    2015-01-01

    Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring...... turning point in the field of arrhythmia management. However, their role in the detection of paroxysmal atrial fibrillation after cryptogenic strokes has yet to evolve. This will be the main focus of this review. Issues surrounding patient selection, clinical relevance and determination of cost......-effectiveness for prolonged cardiac monitoring require further studies. Furthermore, insertable cardiac monitoring has not only the potential to augment diagnostic capabilities but also to improve the management of paroxysmal atrial fibrillation....

  16. Therapeutic Utilities of Pediatric Cardiac Catheterization

    Science.gov (United States)

    Moustafa, Giannis A.; Kolokythas, Argyrios; Charitakis, Konstantinos; Avgerinos, Dimitrios 
V.

    2016-01-01

    In an era when less invasive techniques are favored, therapeutic cardiac catheterization constantly evolves and widens its spectrum of usage in the pediatric population. The advent of sophisticated devices and well-designed equipment has made the management of many congenital cardiac lesions more efficient and safer, while providing more comfort to the patient. Nowadays, a large variety of heart diseases are managed with transcatheter techniques, such as patent foramen ovale, atrial and ventricular septal defects, valve stenosis, patent ductus arteriosus, aortic coarctation, pulmonary artery and vein stenosis and arteriovenous malformations. Moreover, hybrid procedures and catheter ablation have opened new paths in the treatment of complex cardiac lesions and arrhythmias, respectively. In this article, the main therapeutic utilities of cardiac catheterization in children are discussed. PMID:26926291

  17. Cardiac transplantation: 15 years experience Cardiology Institute of Child

    International Nuclear Information System (INIS)

    Ceruti, B; Chiesa, P.; Tambasco, J.; Anzibar, R.; Gutierrez, C.; Barboza, S.; Manfredi, A.; Leone, R.

    2012-01-01

    The cardiac transplant is the treatment of choice for the cardiac insufficiency when there is not another therapeutic alternative that prolongs the life expectancy. On December 1996 The Cardiology Institute of child begin the program of Cardiac Insufficiency and Transplants of the Institute of Pediatric Cardiology, achieving the first cardiac transplant in a 14-year-old child in Uruguay. Three years later they put in practice the program of cardiac transplant in adults

  18. Efficacy and safety of peripherally inserted central venous catheters in acute cardiac care management.

    Science.gov (United States)

    Poletti, Fabrizio; Coccino, Claudio; Monolo, Davide; Crespi, Paolo; Ciccioli, Giorgio; Cordio, Giuseppe; Seveso, Giovanni; De Servi, Stefano

    2018-03-01

    Patients admitted to cardiac intensive care unit need administration of drugs intravenously often in concomitance of therapeutic techniques such as non-invasive ventilation, continuous renal replacement therapy and intra-aortic balloon counterpulsation. Therefore, the insertion of central venous catheters provides a reliable access for delivering medications, laboratory testing and hemodynamic monitoring, but it is associated with the risk of important complications. In our study, we tested the efficacy and safety of peripherally inserted central catheters to manage cardiac intensive care. All patients admitted to cardiac intensive care unit with indication for elective central venous access were checked by venous arm ultrasound for peripherally inserted central catheter's implantation. Peripherally inserted central catheters were inserted by ultrasound-guided puncture. After 7 days from the catheter's placement and at the removal, vascular ultrasound examination was performed searching signs of upper extremity deep venous thrombosis. In case of sepsis, blood cultures peripherally from the catheter and direct culture of the tip of the catheter were done to establish a catheter-related blood stream infection. In our cardiac intensive care unit, 137 peripherally inserted central catheters were placed: 80.3% of patients eligible for a peripherally inserted central catheter were implanted. The rate of symptomatic catheter-related peripheral venous thrombosis was 1.4%. Catheter-related blood stream infection was diagnosed in one patient (0.7%; 5.7 × 1000 peripherally inserted central catheter days). All peripherally inserted central catheters were inserted successfully without other major complications. In patients admitted to cardiac intensive care unit, peripherally inserted central catheters' insertion was feasible in a high percentage of patients and was associated with low infective complications and clinical thrombosis rate.

  19. Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Herring, W Joseph; Blobner, Manfred

    2017-01-01

    INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic cholecys......INTRODUCTION: Sustained deep neuromuscular blockade (NMB) during laparoscopic surgery may facilitate optimal surgical conditions. This exploratory study assessed whether deep NMB improves surgical conditions and, in doing so, allows use of lower insufflation pressures during laparoscopic...

  20. Genetic Algorithms for Evolving Deep Neural Networks

    OpenAIRE

    David, Eli; Greental, Iddo

    2017-01-01

    In recent years, deep learning methods applying unsupervised learning to train deep layers of neural networks have achieved remarkable results in numerous fields. In the past, many genetic algorithms based methods have been successfully applied to training neural networks. In this paper, we extend previous work and propose a GA-assisted method for deep learning. Our experimental results indicate that this GA-assisted approach improves the performance of a deep autoencoder, producing a sparser...