Stress Analysis of Transcatheter Aortic Valve Leaflets Under Dynamic Loading: Effect of Reduced Tissue Thickness.

Science.gov (United States)

Abbasi, Mostafa; Azadani, Ali N

2017-07-01

In order to accommodate transcatheter valves to miniaturized catheters, the leaflet thickness must be reduced to a value which is typically less than that of surgical bioprostheses. The study aim was to use finite-element simulations to determine the impact of the thickness reduction on stress and strain distribution. A 23 mm transcatheter aortic valve (TAV) was modelled based on the Edwards SAPIEN XT (Edwards Lifesciences, Irvine, CA, USA). Finite-element (FE) analysis was performed using the ABAQUS/Explicit solver. An ensemble-averaged transvalvular pressure waveform measured from in-vitro tests conducted in a pulse duplicator was applied to the leaflets. Through a parametric study, uniform TAV leaflet thickness was reduced from 0.5 to 0.18 mm. By reducing leaflet thickness, significantly higher stress values were found in the leaflet's fixed edge during systole, and in the commissures during diastole. Through dynamic FE simulations, the highest stress values were found during systole in the leaflet fixed edge. In contrast, at the peak of diastole high-stress regions were mainly observed in the commissures. The peak stress was increased by 178% and 507% within the leaflets after reducing the thickness of 0.5 mm to 0.18 mm at the peak of systole and diastole, respectively. The study results indicated that, the smaller the leaflet thickness, the higher the maximum principal stress. Increased mechanical stress on TAV leaflets may lead to accelerated tissue degeneration. By using a thinner leaflet, TAV durability may not atch with that of surgical bioprostheses.

First direct comparison of clinical outcomes between European and Asian cohorts in transcatheter aortic valve implantation: the Massy study group vs. the PREVAIL JAPAN trial.

Science.gov (United States)

Watanabe, Yusuke; Hayashida, Kentaro; Takayama, Morimasa; Mitsudo, Kazuaki; Nanto, Shinsuke; Takanashi, Shuichiro; Komiya, Tatsuhiko; Kuratani, Toru; Tobaru, Tetsuya; Goto, Tsuyoshi; Lefèvre, Thierry; Sawa, Yoshiki; Morice, Marie-Claude

2015-02-01

The efficacy and safety of transcatheter aortic valve implantation (TAVI) in Asian populations were unknown. The purpose of this study was to compare directly the clinical outcomes of the first Japanese trial and a European single-center experience after TAVI. Between April 2010 and October 2011, 64 patients were included in the PREVAIL JAPAN multicenter trial which was set up to evaluate the safety and efficacy of the Edwards SAPIEN XT™ (Edwards Lifesciences, Irvine, CA, USA) in high-risk Japanese patients with severe aortic stenosis. Between March 2010 and January 2012, 237 consecutive patients treated with TAVI using the Edwards SAPIEN XT™ prosthesis at Institut Cardiovasculaire Paris Sud were prospectively included in the Massy cohort. We compared the clinical outcomes of these two cohorts. Patients were of similar age (83.4±6.6 years vs. 84.5±6.1 years, p=0.25), but logistic EuroSCORE was higher in the Massy cohort (20.2±11.7% vs. 15.6±8.0%, pPREVAIL JAPAN cohort (1.41±0.14m(2) vs. 1.72±0.18m(2); pPREVAIL JAPAN cohort (12.7±11.4mmHg vs. 10.1±3.6mmHg, p=0.01), but satisfactory improvement in 6-month functional status was obtained in both cohorts (76.5% vs. 77.2%, p=0.91). Clinical outcomes after TAVI in the patients included in the PREVAIL JAPAN trial were acceptable and as safe as that of a single-center European cohort. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

The Fluid Mechanics of Transcatheter Heart Valve Leaflet Thrombosis in the Neosinus.

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Midha, Prem A; Raghav, Vrishank; Sharma, Rahul; Condado, Jose F; Okafor, Ikechukwu U; Rami, Tanya; Kumar, Gautam; Thourani, Vinod H; Jilaihawi, Hasan; Babaliaros, Vasilis; Makkar, Raj R; Yoganathan, Ajit P

2017-10-24

Transcatheter heart valve (THV) thrombosis has been increasingly reported. In these studies, thrombus quantification has been based on a 2-dimensional assessment of a 3-dimensional phenomenon. Postprocedural, 4-dimensional, volume-rendered CT data of patients with CoreValve, Evolut R, and SAPIEN 3 transcatheter aortic valve replacement enrolled in the RESOLVE study (Assessment of Transcatheter and Surgical Aortic Bioprosthetic Valve Dysfunction With Multimodality Imaging and Its Treatment with Anticoagulation) were included in this analysis. Patients on anticoagulation were excluded. SAPIEN 3 and CoreValve/Evolut R patients with and without hypoattenuated leaflet thickening were included to study differences between groups. Patients were classified as having THV thrombosis if there was any evidence of hypoattenuated leaflet thickening. Anatomic and THV deployment geometries were analyzed, and thrombus volumes were computed through manual 3-dimensional reconstruction. We aimed to identify and evaluate risk factors that contribute to THV thrombosis through the combination of retrospective clinical data analysis and in vitro imaging in the space between the native and THV leaflets (neosinus). SAPIEN 3 valves with leaflet thrombosis were on average 10% further expanded (by diameter) than those without (95.5±5.2% versus 85.4±3.9%; P <0.001). However, this relationship was not evident with the CoreValve/Evolut R. In CoreValve/Evolut Rs with thrombosis, the thrombus volume increased linearly with implant depth ( R 2 =0.7, P <0.001). This finding was not seen in the SAPIEN 3. The in vitro analysis showed that a supraannular THV deployment resulted in a nearly 7-fold decrease in stagnation zone size (velocities <0.1 m/s) when compared with an intraannular deployment. In addition, the in vitro model indicated that the size of the stagnation zone increased as cardiac output decreased. Although transcatheter aortic valve replacement thrombosis is a multifactorial process

Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 2).

Science.gov (United States)

Piazza, Nicolo; Bleiziffer, Sabine; Brockmann, Gernot; Hendrick, Ruge; Deutsch, Marcus-André; Opitz, Anke; Mazzitelli, Domenico; Tassani-Prell, Peter; Schreiber, Christian; Lange, Rüdiger

2011-07-01

This study sought to review the acute procedural outcomes of patients who underwent transcatheter aortic valve (TAV)-in-surgical aortic valve (SAV) implantation at the German Heart Center, Munich, and to summarize the existing literature on TAV-in-SAV implantation (n = 47). There are several case reports and small case series describing transcatheter aortic valve implantation for a failing surgical aortic valve bioprosthesis (TAV-in-SAV implantation). From January 2007 to March 2011, 20 out of 556 patients underwent a TAV-in-SAV implantation at the German Heart Center Munich. Baseline characteristics and clinical outcome data were prospectively entered into a dedicated database. The mean patient age was 75 ± 13 years, and the mean logistic European System for Cardiac Operative Risk Evaluation and Society of Thoracic Surgeons' Risk Model scores were 27 ± 13% and 7 ± 4%, respectively. Of the 20 patients, 14 had stented and 6 had stentless surgical bioprostheses. Most cases (12 of 20) were performed via the transapical route using a 23-mm Edwards Sapien prosthesis (Edwards Lifesciences, Irvine, California). Successful implantation of a TAV in a SAV with the patient leaving the catheterization laboratory alive was achieved in 18 of 20 patients. The mean transaortic valve gradient was 20.0 ± 7.5 mm Hg. None-to-trivial, mild, and mild-to-moderate paravalvular aortic regurgitation was observed in 10, 6, and 2 patients, respectively. We experienced 1 intraprocedural death following pre-implant balloon aortic valvuloplasty ("stone heart") and 2 further in-hospital deaths due to myocardial infarction. TAV-in-SAV implantation is a safe and feasible treatment for high-risk patients with failing aortic bioprosthetic valves and should be considered as part of the armamentarium in the treatment of aortic bioprosthetic valve failure. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Effect of tricuspid regurgitation and the right heart on survival after transcatheter aortic valve replacement: insights from the Placement of Aortic Transcatheter Valves II inoperable cohort.

Science.gov (United States)

Lindman, Brian R; Maniar, Hersh S; Jaber, Wael A; Lerakis, Stamatios; Mack, Michael J; Suri, Rakesh M; Thourani, Vinod H; Babaliaros, Vasilis; Kereiakes, Dean J; Whisenant, Brian; Miller, D Craig; Tuzcu, E Murat; Svensson, Lars G; Xu, Ke; Doshi, Darshan; Leon, Martin B; Zajarias, Alan

2015-04-01

Tricuspid regurgitation (TR) and right ventricular (RV) dysfunction adversely affect outcomes in patients with heart failure or mitral valve disease, but their impact on outcomes in patients with aortic stenosis treated with transcatheter aortic valve replacement has not been well characterized. Among 542 patients with symptomatic aortic stenosis treated in the Placement of Aortic Transcatheter Valves (PARTNER) II trial (inoperable cohort) with a Sapien or Sapien XT valve via a transfemoral approach, baseline TR severity, right atrial and RV size and RV function were evaluated by echocardiography according to established guidelines. One-year mortality was 16.9%, 17.2%, 32.6%, and 61.1% for patients with no/trace (n=167), mild (n=205), moderate (n=117), and severe (n=18) TR, respectively (Pright atrial and RV enlargement were also associated with increased mortality (Pright atrial and RV enlargement, but not RV dysfunction. There was an interaction between TR and mitral regurgitation severity (P=0.04); the increased hazard of death associated with moderate/severe TR only occurred in those with no/trace/mild mitral regurgitation. In inoperable patients treated with transcatheter aortic valve replacement, moderate or severe TR and right heart enlargement are independently associated with increased 1-year mortality; however, the association between moderate or severe TR and an increased hazard of death was only found in those with minimal mitral regurgitation at baseline. These findings may improve our assessment of anticipated benefit from transcatheter aortic valve replacement and support the need for future studies on TR and the right heart, including whether concomitant treatment of TR in operable but high-risk patients with aortic stenosis is warranted. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01314313. © 2015 American Heart Association, Inc.

Radial Force: An Underestimated Parameter in Oversizing Transcatheter Aortic Valve Replacement Prostheses: In Vitro Analysis with Five Commercialized Valves.

Science.gov (United States)

Egron, Sandrine; Fujita, Buntaro; Gullón, Lucía; Désirée, Pott; Schmitz-Rode, Thomas; Ensminger, Stephan; Steinseifer, Ulrich

2017-09-05

The goal is to inform in depth on transcatheter aortic valve replacement (TAVR) prosthesis mechanical behavior, depending on frame type, design, and size, and how it crucially impacts the oversizing issue in clinical use, and ultimately the procedure outcome. Transcatheter aortic valve replacement is an established therapy for high-risk patients suffering from aortic stenosis, and the indication for TAVR is progressively expanding to intermediate-risk patients. Choosing the optimal oversizing degree is crucial to safely anchor the TAVR valve-which involves limiting the risks for embolism, aortic regurgitation, conductance disturbance, or annulus rupture-and to increase the valve prosthesis performance. The radial force (RF) profiles of five TAVR prostheses were measured in vitro: the CoreValve 23 and 26 (Medtronic, MN), the Acurate neo S (Symetis, Switzerland), and the SAPIEN XT 23 and 26 (Edwards Lifesciences, CA). Measurements were run with the RX Machine equipment (Machine Solutions Inc., AZ), which is used in ISO standard tests for intravascular stents. Test protocols were adapted for TAVR prostheses. With the prostheses RF profiles' results, mechanical behavior differences could be described and discussed in terms of oversizing strategy and clinical impact for all five valves. Besides, crossing the prostheses' RF profiles with their recommended size windows made the assessment of borderline size cases possible and helped analyze the risks when accurate measurement of patient aortic annulus proves difficult. The prostheses' RF profiles bring new support in clinical decision-making for valve type and size in patients.

The flaws in the detail of an observational study on transcatheter aortic valve implantation versus surgical aortic valve replacement in intermediate-risks patients.

Science.gov (United States)

Barili, Fabio; Freemantle, Nick; Folliguet, Thierry; Muneretto, Claudio; De Bonis, Michele; Czerny, Martin; Obadia, Jean Francois; Al-Attar, Nawwar; Bonaros, Nikolaos; Kluin, Jolanda; Lorusso, Roberto; Punjabi, Prakash; Sadaba, Rafael; Suwalski, Piotr; Benedetto, Umberto; Böning, Andreas; Falk, Volkmar; Sousa-Uva, Miguel; Kappetein, Pieter A; Menicanti, Lorenzo

2017-06-01

The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results. The study by Thourani and colleagues showed several major methodological concerns: suboptimal methods in propensity score analysis with evident misspecification of the propensity scores (PS; no adjustment for the most significantly different covariates: left ventricular ejection fraction, moderate-severe mitral regurgitation and associated procedures); use of PS quintiles rather than matching; inference on not-adjusted Kaplan-Meier curves, although the authors correctly claimed for the need of balancing score adjusting for confounding factors in order to have unbiased estimates of the treatment effect; evidence of poor fit; lack of data on valve-related death.These methodological flaws invalidate direct comparison between treatments and cannot support authors' conclusions that TAVI with SAPIEN 3 in intermediate-risk patients is superior to surgery and might be the preferred treatment alternative to surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Transcatheter aortic valve replacement: historical perspectives, current evidence, and future directions.

Science.gov (United States)

Horne, Aaron; Reineck, Elizabeth A; Hasan, Rani K; Resar, Jon R; Chacko, Matthews

2014-10-01

Severe aortic stenosis (AS) results in considerable morbidity and mortality without aortic valve replacement and is expected to increase in prevalence with the aging population. Because AS primarily affects the elderly, many patients with comorbidities are poor candidates for surgical aortic valve replacement (SAVR) and may not be referred. Transcatheter aortic valve replacement (TAVR) has emerged as transformative technology for the management of AS over the past decade. Randomized trials have established the safety and efficacy of TAVR with improved mortality and quality of life compared with medical therapy in inoperable patients, while demonstrating noninferiority and even superiority to SAVR among high-risk operative candidates. However, early studies demonstrated an early penalty of stroke and vascular complications with TAVR as well as increased paravalvular leak as compared with SAVR. Two device platforms have been evaluated and approved for use in the United States: the Edwards SAPIEN and the Medtronic CoreValve. Early studies also suggest cost-effectiveness for TAVR. Ongoing studies are evaluating new iterations of the aforementioned TAVR devices, novel device designs, and applications of TAVR in expanded populations of patients including those with lower risk profiles as well as those with comorbidities that were excluded from early clinical trials. Future improvements in TAVR technology will likely reduce periprocedural and long-term complications. Further studies are needed to confirm device durability over long-term follow-up and explore the applicability of TAVR to broader AS patient populations. Copyright © 2014 Mosby, Inc. All rights reserved.

DEFINIENDO HOMO SAPIENS-SAPIENS: APROXIMACIÓN ANTROPOLÓGICA DEFININDO HOMO SAPIENS-SAPIENS: APROXIMAÇÃO ANTROPOLÓGICA DEFINING HOMO SAPIENS-SAPIENS: ANTHROPOLOGICAL APPROACH

Directory of Open Access Journals (Sweden)

Carolina Valdebenito

2007-06-01

Full Text Available Este artículo reflexiona sobre los encuentros y desencuentros entre el ser humano y el resto de los animales, en tanto miembros de sistemas en permanente interacción(1. Abordar la definición de Homo, repasar su evolución biológica y cultural y reflexionar sobre los resabios de animalidad que quedan en el comportamiento social del Homo sapiens-sapiens es su objetivo principal. Se busca reflexionar sobre los dilemas morales que acompañan al hombre en tanto ser cultural; para ello se analizan dos dilemas éticos: la violencia y el incestoEste artigo reflete sobre os encontros e desencontros entre o ser humano e os demais animais, enquanto membros de sistemas em permanente interação(1. Seu principal objetivo é abordar a definição de Homo, traçar um panorama de sua evolução biológica e cultural e refletir sobre os resquícios da animalidade que permanecem no comportamento social do Homo sapiens-sapiens. Busca-se refletir sobre os dilemas morais que acompanham o homem enquanto ser cultural, o que para isso são considerados como dilemas éticos: a violência e o incestoThis paper reflects on the similarities and differences between human beings and animals as members of systems in permanent interaction. The main goal is to define Homo, reviewing his/her biological and cultural evolution and reflecting on the animal social behaviors that still remain in Homo sapiens-sapiens. The paper reflect on the moral dilemmas present in humans as cultural beings, taking as example the ethical dilemmas of violence and incest

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

Science.gov (United States)

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

2017-04-07

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

Self-Expanding Transcatheter Aortic Valve System for Symptomatic High-Risk Patients With Severe Aortic Stenosis

DEFF Research Database (Denmark)

Reichenspurner, Hermann; Schaefer, Andreas; Schäfer, Ulrich

2017-01-01

BACKGROUND: The CENTERA transcatheter heart valve (THV) is a low-profile, self-expanding nitinol valve made from bovine pericardial tissue that is 14-F compatible with a motorized delivery system allowing for repositionability. OBJECTIVES: The pivotal study evaluated safety and efficacy of this THV...... permanent pacemaker was implanted in 4.5% of patients receiving the THV (4.9% for patients at risk). CONCLUSIONS: The herein described THV is safe and effective at 30 days with low mortality, significant improvements in hemodynamic outcomes, and low incidence of adverse events. Of particular interest...... is the low incidence of permanent pacemaker implantations. (Safety and Performance Study of the Edwards CENTERA-EU Self-Expanding Transcatheter Heart Valve [CENTERA-2]; NCT02458560)....

DEFINIENDO HOMO SAPIENS-SAPIENS: APROXIMACIÓN ANTROPOLÓGICA DEFININDO HOMO SAPIENS-SAPIENS: APROXIMAÇÃO ANTROPOLÓGICA DEFINING HOMO SAPIENS-SAPIENS: ANTHROPOLOGICAL APPROACH

OpenAIRE

Carolina Valdebenito

2007-01-01

Este artículo reflexiona sobre los encuentros y desencuentros entre el ser humano y el resto de los animales, en tanto miembros de sistemas en permanente interacción(1). Abordar la definición de Homo, repasar su evolución biológica y cultural y reflexionar sobre los resabios de animalidad que quedan en el comportamiento social del Homo sapiens-sapiens es su objetivo principal. Se busca reflexionar sobre los dilemas morales que acompañan al hombre en tanto ser cultural; para ello se analizan d...

High-risk Trans-Catheter Aortic Valve Replacement in a Failed Freestyle Valve with Low Coronary Height: A Case Report.

Science.gov (United States)

Karimi, Ashkan; Pourafshar, Negiin; Dibu, George; Beaver, Thomas M; Bavry, Anthony A

2017-06-01

A 55-year-old male with a history of two prior cardiac surgeries presented with decompensated heart failure due to severe bioprosthetic aortic valve insufficiency. A third operation was viewed prohibitively high risk and valve-in-valve trans-catheter aortic valve replacement was considered. There were however several high-risk features and technically challenging aspects including low coronary ostia height, poor visualization of the aortic sinuses, and difficulty in identification of the coplanar view due to severe aortic insufficiency, and a highly mobile aortic valve mass. After meticulous peri-procedural planning, trans-catheter aortic valve replacement was carried out with a SAPIEN 3 balloon-expandable valve without any complication. Strategies undertaken to navigate the technically challenging aspects of the case are discussed.

CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI)-predictive value and optimal thresholds for major anatomic parameters.

Science.gov (United States)

Schwarz, Florian; Lange, Philipp; Zinsser, Dominik; Greif, Martin; Boekstegers, Peter; Schmitz, Christoph; Reiser, Maximilian F; Kupatt, Christian; Becker, Hans C

2014-01-01

To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI) and to calculate optimal cutoff values for the selection of various prosthesis sizes. The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67). In the remaining 351 patients, the CoreValve (Medtronic) and the Edwards Sapien XT valve (Edwards Lifesciences) were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p'sprosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89). Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

THE PROGNOSIS IN TRANSCATHETER AORTIC VALVE IMPLANTATION

Directory of Open Access Journals (Sweden)

T. E. Imaev

2016-01-01

Full Text Available Aim. To study the effect of transcatheter aortic valve implantation (TAVI, performed by different types of prostheses and various surgical access, on the prognosis of patients with critical aortic stenosis and comorbidities.Material and methods. Patients (n=130 that had consistently performed 80 TAVI by Edwards valve transfemoral (n=50 and transapical (n=30 access, as well as 50 transcatheter aortic valve replacement by CoreValve system were included into the study. Complications including perioperative mortality, total 30-day mortality, as well as post-hospital mortality were registered during aortic valve replacement, immediately after surgery, before the expiry of 30 days. Mean follow-up was 2.2 years (range 0.2 to 5.2 years.Results. Hospital mortality was on average 6.9%. 121 patients had been discharged from the department after the surgery. The number of deaths in the post-hospital period was 14.8%. Valve type and the type of access had no effect on post-hospital mortality. Men died more than 2.5 times often than women, regardless of age. Atrioventricular block, pacemaker implantation, and history of chronic obstructive pulmonary disease were the most significant prognostic factors. An important role of minor stroke and renal failure should be noted. Mortality did not depend on the surgical access or valve type. All parameters characterizing the intervention were significantly associated with mortality, both during and after surgery. The proportion of survivors at the end of the first year of observation using Corvalve system was 86.9%, Edwards valve by transfemoral access - 88% and Edwards valve by transapical access – 85.4% (insignificant differences for all groups, p>0.05. Two-year survival was 77.5%, 82.5% and 82.7%, respectively (also insignificant differences for all groups, p>0.05.Conclusion. TAVI is the method of choice, reasonable alternative approach for surgical valve replacement in patients with high surgical risk, although

A comparison of tooth structure in Neanderthals and early Homo sapiens sapiens: a radiographic study.

OpenAIRE

Zilberman, U; Smith, P

1992-01-01

Tooth components of 1st and 2nd erupted permanent molars were measured from standardised radiographs of Homo sapiens sapiens and Homo sapiens neanderthalensis. Enamel height was greater in Homo sapiens sapiens but pulp height and width and the height of the enamel to floor of the pulp chamber were greater in Homo sapiens neanderthalensis. Dentine height, crown width and enamel width showed similar results in the two groups. Unerupted first molars were measured to analyse the influence of func...

Incidence of Renal Failure Requiring Hemodialysis Following Transcatheter Aortic Valve Replacement.

Science.gov (United States)

Ladia, Vatsal; Panchal, Hemang B; O׳Neil, Terrence J; Sitwala, Puja; Bhatheja, Samit; Patel, Rakeshkumar; Ramu, Vijay; Mukherjee, Debabrata; Mahmud, Ehtisham; Paul, Timir K

2016-09-01

Studies have shown that iodinated radiocontrast use is associated with acute renal failure especially in the presence of chronic kidney disease and multiple factors modulate this risk. The purpose of this meta-analysis is to compare the incidence of renal failure requiring hemodialysis between transfemoral (TF) and transapical (TA) transcatheter aortic valve replacement using the Edwards valve. The PubMed database was searched from January 2000 through December 2014. A total of 10 studies (n = 2,459) comparing TF (n = 1,268) and TA (n = 1,191) TAVR procedures using the Edwards valve were included. Variables of interest were baseline logistic EuroSCORE, prevalence of diabetes mellitus, hypertension, peripheral arterial disease, chronic kidney disease and amount of contrast used. The primary endpoint was incidence of renal failure requiring hemodialysis. The odds ratio and 95% CI were computed and P renal failure requiring hemodialysis was higher with the Edwards valve. This suggests that the incidence of renal failure requiring hemodialysis after TAVR is associated with baseline comorbidities in the TA-TAVR group rather than the volume of contrast used. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

CT-angiography-based evaluation of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI-predictive value and optimal thresholds for major anatomic parameters.

Directory of Open Access Journals (Sweden)

Florian Schwarz

Full Text Available BACKGROUND/OBJECTIVES: To evaluate the predictive value of CT-derived measurements of the aortic annulus for prosthesis sizing in transcatheter aortic valve implantation (TAVI and to calculate optimal cutoff values for the selection of various prosthesis sizes. METHODS: The local IRB waived approval for this single-center retrospective analysis. Of 441 consecutive TAVI-patients, 90 were excluded (death within 30 days: 13; more than mild aortic regurgitation: 10; other reasons: 67. In the remaining 351 patients, the CoreValve (Medtronic and the Edwards Sapien XT valve (Edwards Lifesciences were implanted in 235 and 116 patients. Optimal prosthesis size was determined during TAVI by inflation of a balloon catheter at the aortic annulus. All patients had undergone CT-angiography of the heart or body trunk prior to TAVI. Using these datasets, the diameter of the long and short axis as well as the circumference and the area of the aortic annulus were measured. Multi-Class Receiver-Operator-Curve analyses were used to determine the predictive value of all variables and to define optimal cutoff-values. RESULTS: Differences between patients who underwent implantation of the small, medium or large prosthesis were significant for all except the large vs. medium CoreValve (all p's<0.05. Furthermore, mean diameter, annulus area and circumference had equally high predictive value for prosthesis size for both manufacturers (multi-class AUC's: 0.80, 0.88, 0.91, 0.88, 0.88, 0.89. Using the calculated optimal cutoff-values, prosthesis size is predicted correctly in 85% of cases. CONCLUSION: CT-based aortic root measurements permit excellent prediction of the prosthesis size considered optimal during TAVI.

Bioprosthetic Valve Fracture to Facilitate Transcatheter Valve-in-Valve Implantation.

Science.gov (United States)

Allen, Keith B; Chhatriwalla, Adnan K; Cohen, David J; Saxon, John T; Aggarwal, Sanjeev; Hart, Anthony; Baron, Suzanne; Davis, J Russell; Pak, Alex F; Dvir, Danny; Borkon, A Michael

2017-11-01

Valve-in-valve transcatheter aortic valve replacement is less effective in small surgical bioprostheses. We evaluated the feasibility of bioprosthetic valve fracture with a high-pressure balloon to facilitate valve-in-valve transcatheter aortic valve replacement. In vitro bench testing on aortic tissue valves was performed on 19-mm and 21-mm Mitroflow (Sorin, Milan, Italy), Magna and Magna Ease (Edwards Lifesciences, Irvine, CA), Trifecta and Biocor Epic (St. Jude Medical, Minneapolis, MN), and Hancock II and Mosaic (Medtronic, Minneapolis, MN). High-pressure balloons Tru Dilation, Atlas Gold, and Dorado (C.R. Bard, Murray Hill, NJ) were used to determine which valves could be fractured and at what pressure fracture occurred. Mitroflow, Magna, Magna Ease, Mosaic, and Biocor Epic surgical valves were successfully fractured using high-pressures balloon 1 mm larger than the labeled valve size whereas Trifecta and Hancock II surgical valves could not be fractured. Only the internal valve frame was fractured, and the sewing cuff was never disrupted. Manufacturer's rated burst pressures for balloons were exceeded, with fracture pressures ranging from 8 to 24 atmospheres depending on the surgical valve. Testing further demonstrated that fracture facilitated the expansion of previously constrained, underexpanded transcatheter valves (both balloon and self-expanding) to the manufacturer's recommended size. Bench testing demonstrates that the frame of most, but not all, bioprosthetic surgical aortic valves can be fractured using high-pressure balloons. The safety of bioprosthetic valve fracture to optimize valve-in-valve transcatheter aortic valve replacement in small surgical valves requires further clinical investigation. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Aortic embolization of an Edwards SAPIEN prosthesis due to sigmoid left ventricular hypertrophy: Case report.

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Yuksel, Isa Öner; Koklu, Erkan; Arslan, Sakir; Cagirci, Goksel; Kucukseymen, Selcuk

2016-06-01

Transcatheter aortic valve implantation (TAVI) is considered an alternative therapy in high-risk patients with severe aortic stenosis. Although a minimally invasive procedure, it is not free from complications, one of which is valve embolization at the time of TAVI. We present a case of embolization of a balloon-expandable aortic valve due to sigmoid left ventricular hypertrophy and managed with a second valve without surgery. The embolized valve was repositioned in the aortic arch between the left common carotid artery and the brachiocephalic trunk. Copyright © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Surgical site infections following transcatheter apical aortic valve implantation: incidence and management.

Science.gov (United States)

Baillot, Richard; Fréchette, Éric; Cloutier, Daniel; Rodès-Cabau, Josep; Doyle, Daniel; Charbonneau, Éric; Mohammadi, Siamak; Dumont, Éric

2012-11-13

The present study was undertaken to examine the incidence and management of surgical site infection (SSI) in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI). From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES) at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ) as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Five (3.2%) patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI) and were considered as organ/space SSI's based on Center for Disease Control criteria (CDC). Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099) than the other patients in the cohort. While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major muscle were used successfully in these patients.

DEFINIENDO HOMO SAPIENS-SAPIENS: APROXIMACIÓN ANTROPOLÓGICA

OpenAIRE

Valdebenito, Carolina

2007-01-01

Este artículo reflexiona sobre los encuentros y desencuentros entre el ser humano y el resto de los animales, en tanto miembros de sistemas en permanente interacción(1). Abordar la definición de Homo, repasar su evolución biológica y cultural y reflexionar sobre los resabios de animalidad que quedan en el comportamiento social del Homo sapiens-sapiens es su objetivo principal. Se busca reflexionar sobre los dilemas morales que acompañan al hombre en tanto ser cultural; para ello se analizan d...

Aortic Regurgitation in Patients Undergoing Transcatheter Aortic Valve Replacement With the Self-Expanding CoreValve Versus the Balloon-Expandable SAPIEN XT Valve.

Science.gov (United States)

Kiramijyan, Sarkis; Magalhaes, Marco A; Koifman, Edward; Didier, Romain; Escarcega, Ricardo O; Baker, Nevin C; Negi, Smita I; Minha, Sa'ar; Torguson, Rebecca; Jiaxiang, Gai; Asch, Federico M; Wang, Zuyue; Okubagzi, Petros; Gaglia, Michael A; Ben-Dor, Itsik; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

2016-05-01

The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups. A multivariate logistic regression analysis was completed to evaluate for correlates of the primary end point. The secondary end points included the change in severity of AR at 30-day and 1-year follow-up. A total of 223 consecutive patients (53% men, mean age 82 years) who had transfemoral TAVR with either a CV (n = 119) or XT (n = 104) were evaluated. The rates of post-TAVR AR in the groups were similar, and there was no evidence of more-than-moderate AR in either group. There were significant differences in the rates of intraprocedural balloon postdilation with the CV (17.1%) versus XT valve (5.8%; p = 0.009) and in the rates of intraprocedural implantation of a second valve-in-valve prosthesis with the CV (9.9%) versus XT valve (2.2%; p = 0.036). There were no significant differences in inhospital safety outcomes between the 2 groups. In conclusion, the incidence of post-TAVR AR is similar between the CV and the XT valve when performed by experienced operators using optimal intraprocedural strategies, as deemed appropriate, to mitigate the severity of AR. Copyright © 2016 Elsevier Inc. All rights reserved.

Aortic Valve Predilatation with a Small Balloon, without Rapid Pacing, prior to Transfemoral Transcatheter Aortic Valve Replacement

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Anupama Shivaraju

2018-01-01

Full Text Available Objectives. The aim of this study is to assess the feasibility and clinical outcome of transcatheter aortic valve replacement (TAVR using aortic valve predilatation (AVPD with a small, nonocclusive balloon. Background. Balloon aortic valvuloplasty (BAV under rapid pacing is generally performed in TAVR to ensure the passage and sufficient deployment of the prosthesis in the stenotic AV. BAV may cause serious complications, such as left ventricular stunning or cerebrovascular embolism. Methods. A cohort of 50 consecutive patients with severe aortic stenosis underwent transfemoral TAVR with the Edwards Sapien 3-heart valve. All patients underwent AVPD with a small, nonocclusive balloon (12 × 60 or 14 × 60 mm without rapid pacing. Procedural data and clinical outcomes were analyzed. Results. The mean age of the cohort was 81±6 years and the mean logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation was 13±9. Crossing the AV and prosthesis implantation was successful in all cases. The postprocedural mean AV gradient was 12±5 mmHg. There were no cases of aortic regurgitation ≥ grade 2. No periprocedural stroke occurred. One patient (2% with chronic atrial fibrillation displayed a transient Wernicke aphasia occurring more than 24 hours after TAVR. Mortality was 0% at 30 days after procedure. Conclusion. In TAVR, AVPD with a small, nonocclusive balloon can be safely performed. By avoiding rapid pacing, this technique may be a valid alternative to traditional BAV. Whether or not the use of APVD without rapid pacing translates into less periprocedural complications needs to be assessed in future studies.

The Emergence of Homo sapiens.

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Rensberger, Boyce

1980-01-01

Describes chronologically the evolution of the human race on earth so as to refute Darwin's theory of descent from animals. Skull fragments from sites around the world suggest at least two possible routes toward the emergence of Homo sapiens sapiens. (Author/SK)

Spatial Construction Skills of Chimpanzees ("Pan Troglodytes") and Young Human Children ("Homo Sapiens Sapiens")

Science.gov (United States)

Poti, Patrizia; Hayashi, Misato; Matsuzawa, Tetsuro

2009-01-01

Spatial construction tasks are basic tests of visual-spatial processing. Two studies have assessed spatial construction skills in chimpanzees (Pan troglodytes) and young children (Homo sapiens sapiens) with a block modelling task. Study 1a subjects were three young chimpanzees and five adult chimpanzees. Study 1b subjects were 30 human children…

Surgical site infections following transcatheter apical aortic valve implantation: incidence and management

Directory of Open Access Journals (Sweden)

Baillot Richard

2012-11-01

Full Text Available Abstract Objective The present study was undertaken to examine the incidence and management of surgical site infection (SSI in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI. Methods From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Results Five (3.2% patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI and were considered as organ/space SSI’s based on Center for Disease Control criteria (CDC. Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099 than the other patients in the cohort. Conclusions While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major

The evolution of Homo sapiens denisova and Homo sapiens neanderthalensis miRNA targeting genes in the prenatal and postnatal brain.

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Gunbin, Konstantin V; Afonnikov, Dmitry A; Kolchanov, Nikolay A; Derevianko, Anatoly P; Rogaev, Eugeny I

2015-01-01

As the evolution of miRNA genes has been found to be one of the important factors in formation of the modern type of man, we performed a comparative analysis of the evolution of miRNA genes in two archaic hominines, Homo sapiens neanderthalensis and Homo sapiens denisova, and elucidated the expression of their target mRNAs in bain. A comparative analysis of the genomes of primates, including species in the genus Homo, identified a group of miRNA genes having fixed substitutions with important implications for the evolution of Homo sapiens neanderthalensis and Homo sapiens denisova. The mRNAs targeted by miRNAs with mutations specific for Homo sapiens denisova exhibited enhanced expression during postnatal brain development in modern humans. By contrast, the expression of mRNAs targeted by miRNAs bearing variations specific for Homo sapiens neanderthalensis was shown to be enhanced in prenatal brain development. Our results highlight the importance of changes in miRNA gene sequences in the course of Homo sapiens denisova and Homo sapiens neanderthalensis evolution. The genetic alterations of miRNAs regulating the spatiotemporal expression of multiple genes in the prenatal and postnatal brain may contribute to the progressive evolution of brain function, which is consistent with the observations of fine technical and typological properties of tools and decorative items reported from archaeological Denisovan sites. The data also suggest that differential spatial-temporal regulation of gene products promoted by the subspecies-specific mutations in the miRNA genes might have occurred in the brains of Homo sapiens denisova and Homo sapiens neanderthalensis, potentially contributing to the cultural differences between these two archaic hominines.

Bioprosthetic Valve Fracture Improves the Hemodynamic Results of Valve-in-Valve Transcatheter Aortic Valve Replacement.

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Chhatriwalla, Adnan K; Allen, Keith B; Saxon, John T; Cohen, David J; Aggarwal, Sanjeev; Hart, Anthony J; Baron, Suzanne J; Dvir, Danny; Borkon, A Michael

2017-07-01

Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) may be less effective in small surgical valves because of patient/prosthesis mismatch. Bioprosthetic valve fracture (BVF) using a high-pressure balloon can be performed to facilitate VIV TAVR. We report data from 20 consecutive clinical cases in which BVF was successfully performed before or after VIV TAVR by inflation of a high-pressure balloon positioned across the valve ring during rapid ventricular pacing. Hemodynamic measurements and calculation of the valve effective orifice area were performed at baseline, immediately after VIV TAVR, and after BVF. BVF was successfully performed in 20 patients undergoing VIV TAVR with balloon-expandable (n=8) or self-expanding (n=12) transcatheter valves in Mitroflow, Carpentier-Edwards Perimount, Magna and Magna Ease, Biocor Epic and Biocor Epic Supra, and Mosaic surgical valves. Successful fracture was noted fluoroscopically when the waist of the balloon released and by a sudden drop in inflation pressure, often accompanied by an audible snap. BVF resulted in a reduction in the mean transvalvular gradient (from 20.5±7.4 to 6.7±3.7 mm Hg, P valve effective orifice area (from 1.0±0.4 to 1.8±0.6 cm 2 , P valves to facilitate VIV TAVR with either balloon-expandable or self-expanding transcatheter valves and results in reduced residual transvalvular gradients and increased valve effective orifice area. © 2017 American Heart Association, Inc.

Transcatheter aortic valve replacement

Science.gov (United States)

... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

Programming and Playing with RoboSapien on line

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Vladimir M Cvjetkovic

2011-07-01

Full Text Available RoboSapien is famous human like robot toy intended for playing with, of interested in, of all ages, and learning through the game, of some basic characteristics of robots and robotic control. The programming of RoboSapien as described in user’s manual is limited with the internal memory, battery life, and not very convenient input of actions through the multipurpose buttons of the RoboSapien IR remote control device. In order to offer better conditions for experimenting and using of RoboSapien, the web user interface was developed, that provides interactive user control, programming of command sequences of arbitrary length, observing of RoboSapien actions using the web cam that shows the movements and actions on web page. Access and control of RoboSapien by remote user through the web page user interface, is controlled by access levels depending on whether the user is logged in or not. The whole system is implemented in C# as ASP.NET project with NI USB 6501 digital I/O driving the CMOS 4066 analog switches for controlling the RoboSapien IR remote control device.

Edward Settle | NREL

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Settle Photo of Edward Settle Edward Settle Senior Project Leader - Financing Edward.Settle energy microgrid project. He has more than 25 years of experience providing leadership and advisory projects. Research Interests Energy project finance Energy project tax matters Microgrids Resiliency

Diagnosing Homo sapiens in the fossil record.

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Stringer, Christopher Brian; Buck, Laura Tabitha

2014-01-01

Diagnosing Homo sapiens is a critical question in the study of human evolution. Although what constitutes living members of our own species is straightforward, in the fossil record this is still a matter of much debate. The issue is complicated by questions of species diagnoses and ideas about the mode by which a new species is born, by the arguments surrounding the behavioural and cognitive separateness of the species, by the increasing appreciation of variation in the early African H. sapiens record and by new DNA evidence of hybridization with extinct species. This study synthesizes thinking on the fossils, archaeology and underlying evolutionary models of the last several decades with recent DNA results from both H. sapiens and fossil species. It is concluded that, although it may not be possible or even desirable to cleanly partition out a homogenous morphological description of recent H. sapiens in the fossil record, there are key, distinguishing morphological traits in the cranium, dentition and pelvis that can be usefully employed to diagnose the H. sapiens lineage. Increasing advances in retrieving and understanding relevant genetic data provide a complementary and perhaps potentially even more fruitful means of characterizing the differences between H. sapiens and its close relatives.

PREVAIL TRANSAPICAL: multicentre trial of transcatheter aortic valve implantation using the newly designed bioprosthesis (SAPIEN-XT) and delivery system (ASCENDRA-II).

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Walther, Thomas; Thielmann, Matthias; Kempfert, Joerg; Schroefel, Holger; Wimmer-Greinecker, Gerhard; Treede, Hendrik; Wahlers, Thorsten; Wendler, Olaf

2012-08-01

Transapical (TA) aortic valve implantation (AVI) has evolved as an alternative procedure for high-risk patients. We evaluated the second-generation SAPIEN XT™ prosthesis in a prospective multicentre clinical trial. A total of 150 patients (age: 81.6 ± 5.8 years; 40.7% female) were included. Prosthetic valves (diameter: 23 mm (n = 36), 26 mm (n = 57) and 29 mm (n = 57)) were implanted. The ASCENDRA-II™ modified delivery system was used in the smaller sizes. Mean logistic EuroSCORE was 24.3 ± 7.0%, and mean STS score 7.5 ± 4.4%. All patients gave written informed consent. Off-pump AVI was performed using femoral arterial and venous access wires as a safety net. All but two patients received TA-AVI, as planned. The 29-mm valve showed similar function as the values of two other diameters did. Three patients (2%) required temporary cardiopulmonary bypass support. Postoperative complications included renal failure requiring long-term dialysis in four, bleeding requiring rethoracotomy in four, respiratory complication requiring reintubation in eight and sepsis in four patients, respectively. Thirty-day mortality was 13 (8.7%) for the total cohort and 2/57 (3.5%) for patients receiving the 29-mm valve, respectively. Echocardiography at discharge showed none or trivial aortic incompetence (AI) in 71% and mild-AI in 22% of the patients. Post-implantation AI was predominantly paravalvular and ≥ 2+ in 7% of patients. One patient required reoperation for AI within 30 days. The PREVAIL TA multicentre trial demonstrates good functionality and good outcomes for TA-AVI, using the SAPIEN XT™ prosthesis and its second-generation ASCENDRA-II™ delivery system, as well successful introduction of the 29-mm SAPIEN XT™ valve for the benefit of high-risk elderly patients.

TAVR Through Heavily Calcified Aorta Following Atheroma Retrieval With the "Elevator" Technique.

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Senguttuvan, N Boopathy; Ellozy, Sharif; Tejani, Furqan; Kovacic, Jason; Kini, Annapoorna S; Sharma, Samin K; Dangas, George D

2015-10-01

An 86-year-old Caucasian female with severe symptomatic, inoperable aortic stenosis was accepted for high-risk transfemoral transcatheter aortic valve replacement (TAVR) approach due to severe calcification of the aorta. During initial passage of a 22 Fr sheath, there was dislodgment with proximal migration of a circumferential tunnel of calcium from the infrarenal aorta. A novel "elevator" technique was used to secure and retrieve the dislodged aorta en bloc back to its original infrarenal aortic position and allow in situ fixation with stenting. A new TAVR system was then successfully placed through the stent and a 23 mm Edwards Sapien valve (Edwards Lifesciences) was implanted as planned. In case of calcification protruding into the lumen of the aorta and limiting the passage of the large valve delivery system sheath, the obstruction can be managed by stenting the calcification against the luminal wall under fluoroscopic and intravascular-ultrasound guidance, allowing successful passage of the valve delivery system. The elevator technique allows axial transportation of any calcified vascular fragments, should they become dislodged.

Delirium After Transcatheter Aortic Valve Replacement.

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Giuseffi, Jennifer L; Borges, Nyal E; Boehm, Leanne M; Wang, Li; McPherson, John A; Fredi, Joseph L; Ahmad, Rashid M; Ely, E Wesley; Pandharipande, Pratik P

2017-07-01

Postoperative delirium is associated with increased mortality. Patients undergoing transcatheter aortic valve replacement are at risk for delirium because of comorbid conditions. To compare the incidence, odds, and mortality implications of delirium between patients undergoing transcatheter replacement and patients undergoing surgical replacement. The Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the Intensive Care Unit were used to assess arousal level and delirium prospectively in all patients with severe aortic stenosis who had transcatheter or surgical aortic valve replacement at an academic medical center. Multivariable logistic regression was used to determine the relationship between procedure type and occurrence of delirium. Cox regression was used to assess the association between postoperative delirium and 6-month mortality. A total of 105 patients had transcatheter replacement and 121 had surgical replacement. Patients in the transcatheter group were older (median age, 81 vs 68 years; P replacement. Delirium is less likely to develop in the transcatheter group but is associated with higher mortality in both groups. ©2017 American Association of Critical-Care Nurses.

What constitutes Homo sapiens? Morphology versus received wisdom.

Science.gov (United States)

Schwartz, Jeffrey

2016-06-20

Although Linnaeus coined Homo sapiens in 1735, it was Blumenbach forty years later who provided the first morphological definition of the species. Since humans were not then allowed to be ante-Diluvian, his effort applied to the genus, as well. After the Feldhofer Grotto Neanderthal disproved this creationist notion, and human-fossil hunting became legitimate, new specimens were allocated either to sapiens or new species within Homo, or even to new species within new genera. Yet as these taxonomic acts reflected the morphological differences between specimens, they failed to address the question: What constitutes H. sapiens? When in 1950 Mayr collapsed all human fossils into Homo, he not only denied humans a diverse evolutionary past, he also shifted the key to identifying its species from morphology to geological age - a practice most paleoanthropologists still follow. Thus, for example, H. erectus is the species that preceded H. sapiens, and H. sapiens is the species into which H. erectus morphed. In order to deal with a growing morass of morphologically dissimilar specimens, the non-taxonomic terms "archaic" (AS) and "anatomically modern" (AMS) were introduced to distinguish between the earlier and later versions of H. sapiens, thereby making the species impossible to define. In attempting to disentangle fact from scenario, I begin from the beginning, trying to delineate features that may be distinctive of extant humans (ES), and then turning to the fossils that have been included in the species. With the exception of Upper Paleolithic humans - e.g. from Cro-Magnon, Dolni Vestonice, Mladeč - I argue that many specimens regarded as AMS, and all those deemed AS, are not H. sapiens. The features these AMS do share with ES suggest the existence of a sapiens clade. Further, restudy of near-recent fossils, especially from southwestern China (∼11-14.5 ka), reinforces what discoveries such as H. floresiensis indicate: "If it's recent, it's not necessarily H. sapiens".

One-year multicentre outcomes of transapical aortic valve implantation using the SAPIEN XT™ valve: the PREVAIL transapical study.

Science.gov (United States)

Walther, Thomas; Thielmann, Matthias; Kempfert, Joerg; Schroefel, Holger; Wimmer-Greinecker, Gerhard; Treede, Hendrik; Wahlers, Thorsten; Wendler, Olaf

2013-05-01

The study aimed to evaluate 1-year outcomes of the multicentre PREVAIL transapical (TA) study of TA-aortic valve implantation (AVI) in high-risk patients. From September 2009 to August 2010, a total of 150 patients, aged 81.6 ± 5.8 years, 40.7% female, were included at 12 European TA-AVI experienced sites. Patients received 23 (n = 36), 26 (n = 57) and 29 mm (n = 57) second-generation SAPIEN XT™ (Edwards Lifesciences, Irvine, CA, USA) valves. The mean logistic EuroSCORE was 24.3 ± 7.0, and mean Society Thoracic Surgeons score was 7.5 ± 4.4%. Survival was 91.3% at 30 days and 77.9% at 1 year. Subgroup analysis revealed survivals of 91.7/88.9, 86.0/70.2, 96.55/91.2% for patients receiving 23-, 26- and 29-mm valves at 30 days and at 1 year, respectively. Transthoracic echocardiography revealed preserved left ventricular ejection fraction and low gradients. Aortic incompetence was none in 41/48, trace 30/36, mild 22/12 and moderate in 7/4% at discharge and 1 year. Walking distance increased from 221 (postimplant) to 284 m (at 1 year, P = 0.0004). Three patients required reoperation due to increasing aortic incompetence during follow-up. Causes of mortality at 1 year were cardiac (n = 7), stroke (n = 1) and others (n = 5). The European PREVAIL multicentre trial demonstrates good functionality and good outcomes for TA-AVI using the second-generation SAPIEN XT prosthesis and the ASCENDRA-II delivery system. The 29-mm SAPIEN XT valve was successfully introduced and showed excellent results.

Incidence and impact of prosthesis-patient mismatch after transcatheter aortic valve implantation.

Science.gov (United States)

Bleiziffer, Sabine; Hettich, Ina; Hutter, Andrea; Wagner, Anke; Deutsch, Marcus-André; Piazza, Nicolo; Lange, Rüdiger

2013-05-01

The study aim was to investigate the incidence of patient-prosthesis mismatch (PPM) with new catheter valves, and its influence on the patients' clinical state. At present, few echocardiographic data are available on the incidence and impact of PPM with the CoreValve and Sapien prostheses for transcatheter aortic valve implantation (TAVI). The reliability of effective orifice area (EOA) measurements was assured by awaiting an interval of six months after TAVI. Of 256 survivors after TAVI, 149 complete echocardiographic data sets were available for the assessment of the indexed EOA (iEOA). In total, 106 CoreValve prostheses and 43 Sapien prostheses were implanted in this high-risk cohort (mean age 81 +/- 6 years, mean logistic EuroSCORE 20 +/- 13%). The overall incidence of PPM (iEOA body surface area were more likely to develop PPM (p = 0.001), while the prosthesis type, native annulus diameter, preoperative EOA, gender and prosthesis size had no influence. The mean aortic gradient was significantly higher in patients with PPM. A reduction in the left ventricular end-diastolic diameter was seen in all patients, without significant differences between groups. There were no differences in postoperative NYHA class or self-assessed health state between patients with or without PPM. PPM was common after TAVI in the presented cohort, presumably because the native calcium masses narrow the outflow area available for blood flow. As expected for low gradients, there was no impairment of left ventricular dimension regression or clinical state of the patients, even if severe PPM was present. Based on the presented data, it is assumed that PPM might be less relevant in TAVI patients.

Homophobia in Marlowe’s Edward II Homophobia in Marlowe’s Edward II

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Gelson Peres de Silva

2008-04-01

Full Text Available Drawing on queer theory, this essay demonstrates how homophobia motivates the plot of usurpation in Edward II, by Chistopher Marlowe (1564-1593, a play in which complex power relations can be verified. The main characters, King Edward II, Pierce of Gaveston, Mortimer Junior, Mortimer Senior and Queen Isabella, together with the nobles and the clerics, interact in a world of fierce political dispute. Power relations are at the core of the play and involve, on the one hand, the characters who envy and dispute Edward II’s royal power. On the other hand, the king suffers the effects of the power of his own homosexual drive and affective ties with Gaveston. Drawing on queer theory, this essay demonstrates how homophobia motivates the plot of usurpation in Edward II, by Chistopher Marlowe (1564-1593, a play in which complex power relations can be verified. The main characters, King Edward II, Pierce of Gaveston, Mortimer Junior, Mortimer Senior and Queen Isabella, together with the nobles and the clerics, interact in a world of fierce political dispute. Power relations are at the core of the play and involve, on the one hand, the characters who envy and dispute Edward II’s royal power. On the other hand, the king suffers the effects of the power of his own homosexual drive and affective ties with Gaveston.

Edward U Lorenz

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education. Edward U Lorenz. Articles written in Resonance – Journal of Science Education. Volume 20 Issue 3 March 2015 pp 260-263 Classics. Predictability: Does the Flap of a Butterfly's Wings in Brazil Set off a Tornado in Texas? Edward U Lorenz · More Details Fulltext ...

Sacral Variability in Tailless Species: Homo sapiens and Ochotona princeps.

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Tague, Robert G

2017-05-01

Homo sapiens is variable in number of sacral vertebrae, and this variability can lead to obstetrical complication. This study uses the comparative method to test the hypothesis that sacral variability in H. sapiens is associated with absence of a tail. Three species of lagomorphs are studied: Ochotona princeps (N = 271), which is tailless, and Lepus californicus (N = 212) and Sylvilagus audubonii (N = 206), which have tails. Results show that O. princeps has (1) higher diversity index for number of sacral vertebrae (0.49) compared to L. californicus (0.25) and S. audubonii (0.26) and (2) significantly higher percentage of individuals with the species-specific nonmodal number of sacral vertebrae (43.9%) compared to L. californicus (14.2%) and S. audubonii (15.5%). Comparison of H. sapiens (N = 1,030; individuals of age 20-39 years) with O. princeps shows similarities between the species in diversity index (also 0.49 in H. sapiens) and percentage of individuals with nonmodal number of sacral vertebrae (37.3% in H. sapiens). Homeotic transformation best explains the results. H. sapiens and O. princeps show propensity for caudal shift at the sacral-caudal border (i.e., homeotic transformation of the first caudal vertebra to a sacral vertebra). Caudal and cranial shift among presacral vertebrae increases or decreases this propensity, respectively. Increase in number of sacral vertebrae in H. sapiens by homeotic transformation reduces pelvic outlet capacity and can be obstetrically hazardous. Anat Rec, 300:798-809, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Transcatheter Replacement of Failed Bioprosthetic Valves

DEFF Research Database (Denmark)

Simonato, Matheus; Webb, John; Kornowski, Ran

2016-01-01

postprocedural gradients (mean >= 20 mm Hg). Optimal implantation depths were defined by receiver operating characteristic curve. A total of 292 consecutive patients (age, 78.9 +/- 8.7 years; 60.3% male; 157 CoreValve Evolut and 135 Sapien XT) were evaluated. High implantation was associated with significantly...... lower rates of elevated gradients in comparison with low implantation (CoreValve Evolut, 15% versus 34.2%; P=0.03 and Sapien XT, 18.5% versus 43.5%; P=0.03, respectively). Optimal implantation depths were defined: CoreValve Evolut, 0 to 5 mm; Sapien XT, 0 to 2 mm (0-10% frame height); sensitivities, 91...

The origin and evolution of Homo sapiens.

Science.gov (United States)

Stringer, Chris

2016-07-05

If we restrict the use of Homo sapiens in the fossil record to specimens which share a significant number of derived features in the skeleton with extant H. sapiens, the origin of our species would be placed in the African late middle Pleistocene, based on fossils such as Omo Kibish 1, Herto 1 and 2, and the Levantine material from Skhul and Qafzeh. However, genetic data suggest that we and our sister species Homo neanderthalensis shared a last common ancestor in the middle Pleistocene approximately 400-700 ka, which is at least 200 000 years earlier than the species origin indicated from the fossils already mentioned. Thus, it is likely that the African fossil record will document early members of the sapiens lineage showing only some of the derived features of late members of the lineage. On that basis, I argue that human fossils such as those from Jebel Irhoud, Florisbad, Eliye Springs and Omo Kibish 2 do represent early members of the species, but variation across the African later middle Pleistocene/early Middle Stone Age fossils shows that there was not a simple linear progression towards later sapiens morphology, and there was chronological overlap between different 'archaic' and 'modern' morphs. Even in the late Pleistocene within and outside Africa, we find H. sapiens specimens which are clearly outside the range of Holocene members of the species, showing the complexity of recent human evolution. The impact on species recognition of late Pleistocene gene flow between the lineages of modern humans, Neanderthals and Denisovans is also discussed, and finally, I reconsider the nature of the middle Pleistocene ancestor of these lineages, based on recent morphological and genetic data.This article is part of the themed issue 'Major transitions in human evolution'. © 2016 The Author(s).

Transcatheter Aortic Valve Replacement in Europe

DEFF Research Database (Denmark)

Mylotte, Darren; Osnabrugge, Ruben L J; Windecker, Stephan

2013-01-01

The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy.......The authors sought to examine the adoption of transcatheter aortic valve replacement (TAVR) in Western Europe and investigate factors that may influence the heterogeneous use of this therapy....

Is valve choice a significant determinant of paravalular leak post-transcatheter aortic valve implantation? A systematic review and meta-analysis.

Science.gov (United States)

O'Sullivan, Katie E; Gough, Aideen; Segurado, Ricardo; Barry, Mitchel; Sugrue, Declan; Hurley, John

2014-05-01

Paravalvular regurgitation (PVR) following transcatheter aortic valve implantation (TAVI) is associated with poor survival. The two main valve delivery systems used to date differ significantly in both structure and deployment technique. The primary objective of this study was to perform a systematic review and meta-analysis of studies identifying PVR in patients post-TAVI using Medtronic CoreValve (MCV) and Edward Sapien (ES) valves in order to identify whether a significant difference exists between valve types. The secondary objective was to identify additional factors predisposing to PVR to provide an overview of the other associated considerations. A systematic review and meta-analysis of the current literature to identify PVR rate in patients with MCV and ES valves was performed. We also sought to examine other factors predisposing to PVR. A total of 5910 patients were identified from 9 studies. PVR rates for MCV and ES were analysed. MCV was associated with a higher PVR rate of 15.75% [95% confidence interval (CI) 12.48-19.32] compared with ES 3.93% [95% CI 1.05-8.38]. We separately reviewed predisposing factors associated with PVR. A formal comparison of the MCV and ES valve leakage rates by mixed-effects meta-regression with a fixed-effect moderator variable for valve type (MCV or ES) suggested a statistically significant difference in leakage rate between the two valve types (P = 0.0002). Unfavourable anatomical and pathological factors as well as valve choice have an impact on rates of PVR. Additionally, certain anatomical features dictate valve choice. A direct comparison of all the predisposing factors at this time is not possible and will require prospective multivariate analysis. There is, however, a significant difference in the PVR rates between valves based on the published observational data available to date. The ES valve associated with a lower incidence of PVR overall; therefore, we conclude that valve choice is indeed a significant

Similar Pathogen Targets in Arabidopsis thaliana and Homo sapiens Protein Networks

Science.gov (United States)

2012-09-21

Similar Pathogen Targets in Arabidopsis thaliana and Homo sapiens Protein Networks Paulo Shakarian1*, J. Kenneth Wickiser2 1 Paulo Shakarian...significantly attacked. Citation: Shakarian P, Wickiser JK (2012) Similar Pathogen Targets in Arabidopsis thaliana and Homo sapiens Protein Networks...to 00-00-2012 4. TITLE AND SUBTITLE Similar Pathogen Targets in Arabidopsis thaliana and Homo sapiens Protein Networks 5a. CONTRACT NUMBER 5b

Anatomical challenges for transcatheter mitral valve intervention

DEFF Research Database (Denmark)

De Backer, Ole; Luk, Ngai H V; Søndergaard, Lars

2016-01-01

Following the success of transcatheter aortic and pulmonary valve implantation, there is a large interest in transcatheter mitral valve interventions to treat severe mitral regurgitation (MR). With the exception for the MitraClipTM (Abbott, Abbott Park, IL, USA) edge-to-edge leaflet plication...

Morphological comparison of archaic Homo sapiens crania from China and Africa.

Science.gov (United States)

Wu, X; Bräuer, G

1993-12-01

Regional features play a great role in the analysis of the differentiations of Homo erectus and Homo sapiens. However, this poses the question how widespread and variable these features are. In order to examine this with regard to the features commonly seen in China their occurrence and variability were determined in Chinese as well as in African crania of archaic and late Pleistocene/Holocene modern Homo sapiens. Furthermore, some features known from Africa were examined with regard to their occurrence and variability in China. Although the variability might change due to new finds, the present results for some features point to larger morphological spectra in the African than in the Chinese archaic Homo sapiens. It is furthermore remarkable that the early modern Chinese in many features show deviations from the pattern of archaic Homo sapiens of this region and exhibit broader spectra similar to those seen in African archaic and early modern Homo sapiens.

The future of transcatheter mitral valve interventions

DEFF Research Database (Denmark)

Maisano, Francesco; Alfieri, Ottavio; Banai, Shmuel

2015-01-01

of transcatheter mitral valve interventions will be. The purpose of the present report is to review the current state-of-the-art of mitral valve intervention, and to identify the potential future scenarios, which might benefit most from the transcatheter repair and replacement devices under development....

The origin and evolution of Homo sapiens

OpenAIRE

Stringer, Chris

2016-01-01

If we restrict the use of Homo sapiens in the fossil record to specimens which share a significant number of derived features in the skeleton with extant H. sapiens, the origin of our species would be placed in the African late middle Pleistocene, based on fossils such as Omo Kibish 1, Herto 1 and 2, and the Levantine material from Skhul and Qafzeh. However, genetic data suggest that we and our sister species Homo neanderthalensis shared a last common ancestor in the middle Pleistocene approx...

Stravovacích návyky z hlediska fylogeneze Homo sapiens sapiens.

OpenAIRE

HOLÁ, Marcela

2010-01-01

This Bachelor's thesis on the synthesis of literature, is attempting to create an overview of our human ancestor's dietary habits. The time frame is from the oldest representative of the hominoid family, genus Ardipithecus ramidus, to neolithic Homo sapiens.This will show the connection between the changing food spectrum and the phylogeny of our species.

Prosthetic valve endocarditis 7 months after transcatheter aortic valve implantation diagnosed with 3D TEE

Directory of Open Access Journals (Sweden)

Cenk Sarı

2016-03-01

Full Text Available Transcatheter aortic valve implantation (TAVI was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT with an uneventful postoperative stay. She was diagnosed with endocarditis using three dimensional (3D echocardiography on the TAVI device 7 months later and she subsequently underwent surgical aortic valve replacement. Little experience of the interpretation of transoesophageal echocardiography (TEE and the clinical course and effectiveness of treatment strategies in post-TAVI endocarditis exists. We report a case of PVE in a TAVI patient which was diagnosed with three-dimensional transoesophageal echocardiography (3DTEE.

ECM using Edwards curves

DEFF Research Database (Denmark)

Bernstein, Daniel J.; Birkner, Peter; Lange, Tanja

2013-01-01

-arithmetic level are as follows: (1) use Edwards curves instead of Montgomery curves; (2) use extended Edwards coordinates; (3) use signed-sliding-window addition-subtraction chains; (4) batch primes to increase the window size; (5) choose curves with small parameters and base points; (6) choose curves with large...

Fossil evidence for the origin of Homo sapiens.

Science.gov (United States)

Schwartz, Jeffrey H; Tattersall, Ian

2010-01-01

Our species Homo sapiens has never received a satisfactory morphological definition. Deriving partly from Linnaeus's exhortation simply to "know thyself," and partly from the insistence by advocates of the Evolutionary Synthesis in the mid-20th Century that species are constantly transforming ephemera that by definition cannot be pinned down by morphology, this unfortunate situation has led to huge uncertainty over which hominid fossils ought to be included in H. sapiens, and even over which of them should be qualified as "archaic" or as "anatomically modern," a debate that is an oddity in the broader context of paleontology. Here, we propose a suite of features that seems to characterize all H. sapiens alive today, and we review the fossil evidence in light of those features, paying particular attention to the bipartite brow and the "chin" as examples of how, given the continuum from developmentally regulated genes to adult morphology, we might consider features preserved in fossil specimens in a comparative analysis that includes extant taxa. We also suggest that this perspective on the origination of novelty, which has gained a substantial foothold in the general field of evolutionary developmental biology, has an intellectual place in paleoanthropology and hominid systematics, including in defining our species, H. sapiens. Beginning solely with the distinctive living species reveals a startling variety in morphologies among late middle and late Pleistocene hominids, none of which can be plausibly attributed to H. sapiens/H. neanderthalensis admixture. Allowing for a slightly greater envelope of variation than exists today, basic "modern" morphology seems to have appeared significantly earlier in time than the first stirrings of the modern symbolic cognitive system. Copyright © 2010 Wiley-Liss, Inc.

Transcatheter closure of patent ductus arteriosus: past, present and future.

Science.gov (United States)

Baruteau, Alban-Elouen; Hascoët, Sébastien; Baruteau, Julien; Boudjemline, Younes; Lambert, Virginie; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme; Pass, Robert

2014-02-01

This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Transcatheter Mitral Valve Devices - Functional Mechanical Designs.

Science.gov (United States)

Kliger, Chad

2014-03-01

Mitral regurgitation is a complex disorder involving a multitude of components of the mitral apparatus. With the desire for less invasive treatment approaches, transcatheter mitral valve therapies (TMVT) are directed at these components and available at varying stages of development. Therapeutic advancements and the potential to combine technologies may further improve their efficacy and safety. Transcatheter mitral valve replacement, while preserving the mitral apparatus, may emerge as an alternative or even a more suitable treatment option. In addition, early data on transcatheter mitral valve-in-valve and valve-in-ring implantation are encouraging and this approach may be an alternative to reoperation in the high-risk patient. This review details the expanding functional mechanical designs of current active TMVT.

Transcatheter Embolization of Pseudoaneurysms Complicating Pancreatitis

International Nuclear Information System (INIS)

Golzarian, Jafar; Nicaise, Nicole; Deviere, Jacques; Ghysels, Marc; Wery, Didier; Dussaussois, Luc; Gansbeke, Daniel van; Struyven, Julien

1997-01-01

Purpose: To evaluate the therapeutic role of angiography in patients with pseudoaneurysms complicating pancreatitis. Methods: Thirteen symptomatic pseudoaneurysms were treated in nine patients with pancreatitis. Eight patients had chronic pancreatitis and pseudocyst and one had acute pancreatitis. Clinical presentation included gastrointestinal bleeding in seven patients and epigastric pain without bleeding in two. All patients underwent transcatheter embolization. Results: Transcatheter embolization resulted in symptomatic resolution in all patients. Rebleeding occurred in two patients, 18 and 28 days after embolization respectively, and was successfully treated by repeated emnbolization. One patient with severe pancreatitis died from sepsis 28 days after embolization. Follow-up was then available for eight patients with no relapse of bleeding after a mean follow-up of 32 months (range 9-48 months). Conclusion: Transcatheter embolization is safe and effective in the management of pseudoaneurysms complicating pancreatitis

Treatment of hemobilia by transcatheter vascular occlusion

International Nuclear Information System (INIS)

Vaughan, R.; Roesch, J.; Keller, F.S.; Antonovic, R.; Veterans Administration Medical Center, Portland, OR

1984-01-01

Four cases of hemobilia treated by transcatheter arterial occlusion are presented and reviewed with 30 similar cases reported in the literature. Transcatheter vascular occlusion successfully controlled hemorrhage in all 34 patients. No obvious liver parenchymal damage appeared in 26 patients; transient elevation of liver enzymes occurred in 6 patients (18%) including one in our series; two of the patients reviewed died of acute hepatic insufficiency following nonselective hepatic artery embolization. Hemobilia should be considered when gastrointestinal hemorrhage occurs after abdominal trauma, liver biopsy or other manipulative liver procedures. Hepatic angiography establishes the diagnosis and selective vascular occlusion is the treatment of choice for control of intractable or recurrent hemorrhage. Techniques and precautions for the diagnosis and transcatheter therapy of hemobilia are discussed. (orig.)

Prosthetic valve endocarditis 7 months after transcatheter aortic valve implantation diagnosed with 3D TEE.

Science.gov (United States)

Sarı, Cenk; Durmaz, Tahir; Karaduman, Bilge Duran; Keleş, Telat; Bayram, Hüseyin; Baştuğ, Serdal; Özen, Mehmet Burak; Bayram, Nihal Akar; Bilen, Emine; Ayhan, Hüseyin; Kasapkara, Hacı Ahmet; Bozkurt, Engin

2016-01-01

Transcatheter aortic valve implantation (TAVI) was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR) with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE) seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT) with an uneventful postoperative stay. She was diagnosed with endocarditis using three dimensional (3D) echocardiography on the TAVI device 7 months later and she subsequently underwent surgical aortic valve replacement. Little experience of the interpretation of transoesophageal echocardiography (TEE) and the clinical course and effectiveness of treatment strategies in post-TAVI endocarditis exists. We report a case of PVE in a TAVI patient which was diagnosed with three-dimensional transoesophageal echocardiography (3DTEE). Copyright © 2016 Hellenic Cardiological Society. Published by Elsevier B.V. All rights reserved.

Is there a role for surgeons in transcatheter mitral valve procedures?

Science.gov (United States)

Buch, Mamta H; Trento, Alfredo; Kar, Saibal

2011-03-01

The rapid advancement in transcatheter therapies seeks to provide less invasive options compared with conventional surgery in the treatment of acquired valvular heart disease. A number of transcatheter mitral valve devices using a variety of approaches for the treatment of mitral regurgitation are under development or in early clinical application. Although yet to be clearly defined, there is no doubt that transcatheter mitral valve procedures will have a significant role alongside conventional surgery. The question is: will surgeons, who have led the treatment of mitral valve disease for the past 30 years, have a role in these procedures? In order to answer this question, this review discusses key understanding of mitral valve anatomy, function and disorder required to perform transcatheter mitral valve interventions. It assesses the potential role of transcatheter therapies with particular reference to percutaneous edge-to-edge repair using the Mitraclip system (Abbott Vascular Devices, California, USA). The new era in collaboration between surgeons and cardiologists is discussed and the potential role of the surgeon in percutaneous mitral valve procedures is examined. Transcatheter mitral valve procedures demand increasing collaboration between cardiologists and surgeons in order to achieve optimal outcomes. Interventional cardiologists will require dedicated training in the specialized field of transcatheter interventions in acquired structural heart diseases. As the delivery of such therapies brings the interface between interventional cardiology and cardiac surgery ever closer, there is the potential for a niche area in cardiac surgery to develop comprising minimally invasive surgical and transcatheter skills.

Fuelwood production in Prince Edward Island

International Nuclear Information System (INIS)

McCallum, B.

1992-01-01

The most recent Prince Edward Island Fuelwood Survey occurred in 1990-91. Consumption of fuelwood rose again to 49% of Prince Edward Island's 43,170 households. Total residential fuelwood consumption was estimated to be 242,000 m 3 . The fuelwood industry makes an important contribution to the economy of Prince Edward Island. In the 1990-91 heating season, fuelwood valued at USD 9 million displaced approximately 43 million litres of domestic heating oil valued at USD 16.4 million. In addition, it is estimated that 70 cents of every dollar spent on fuelwood remains in the province and contributes spin-off benefits, whereas 90 cents of every dollar spent on heating oil is lost to the economy of Prince Edward Island. The percentage of people cutting their own fuelwood decreased from 52 in 1984-85 to only 23.4 in 1990-91. The governments of Canada and Prince Edward Island have implemented a series of Forest Resource Development Agreements (FRDAs) starting in 1983. The current 1988-1993 FRDA provides USD 24 million for research and incentives for reforestation and management of Prince Edward Island woodlots. It is expected that 3,800 Prince Edward Island woodlot owners will be participating in a woodlot management program by 1993. Silviculture treatments of hardwood stands include thinning, stand conversion (removal of lowgrade softwoods such as balsam fir in mainly hardwood stands), and shelterwood (strip) cutting, particularly in marginal stands. (9 refs.)

Rethinking the dispersal of Homo sapiens out of Africa.

Science.gov (United States)

Groucutt, Huw S; Petraglia, Michael D; Bailey, Geoff; Scerri, Eleanor M L; Parton, Ash; Clark-Balzan, Laine; Jennings, Richard P; Lewis, Laura; Blinkhorn, James; Drake, Nick A; Breeze, Paul S; Inglis, Robyn H; Devès, Maud H; Meredith-Williams, Matthew; Boivin, Nicole; Thomas, Mark G; Scally, Aylwyn

2015-01-01

Current fossil, genetic, and archeological data indicate that Homo sapiens originated in Africa in the late Middle Pleistocene. By the end of the Late Pleistocene, our species was distributed across every continent except Antarctica, setting the foundations for the subsequent demographic and cultural changes of the Holocene. The intervening processes remain intensely debated and a key theme in hominin evolutionary studies. We review archeological, fossil, environmental, and genetic data to evaluate the current state of knowledge on the dispersal of Homo sapiens out of Africa. The emerging picture of the dispersal process suggests dynamic behavioral variability, complex interactions between populations, and an intricate genetic and cultural legacy. This evolutionary and historical complexity challenges simple narratives and suggests that hybrid models and the testing of explicit hypotheses are required to understand the expansion of Homo sapiens into Eurasia. © 2015 Wiley Periodicals, Inc.

Are Homo sapiens nonsupranuchal fossa and Neanderthal suprainiac fossa convergent traits?

Science.gov (United States)

Nowaczewska, Wioletta

2011-04-01

The autapomorphic status of the Neanderthal suprainiac fossa was recently confirmed. This was a result of a detailed analysis of the internal bone composition in the area of the suprainiac depression on Neanderthal and Homo sapiens specimens. However, while anatomical differences between Neanderthal suprainiac fossa and the depression in the inion region of the occipital bone of fossil and recent Homo sapiens have been discussed in detail, the etiology of these structures has not been resolved. In this article, the hypothesis that the Homo sapiens non-supranuchal fossa and the Neanderthal suprainiac fossa both formed to maintain the optimal shape of the occipital plane (to minimize strain on the posterior cranial vault) is tested. First, the variation in the expression of the fossa above inion in the crania of recent Homo sapiens from European, African, and Australian samples was examined, and the degree of structural similarity between these depressions and the Neanderthal suprainiac fossa was assessed. Next, the relationship between the shape of the occipital squama in the midsagittal plane and two particular features (the degree of the occipital torus development and the occurrence of a depression in the inion region that is not the supranuchal fossa) were analyzed. Based on the results, it is suggested that the Homo sapiens non-supranuchal fossa and Neanderthal suprainiac fossa are convergent traits. Copyright © 2010 Wiley-Liss, Inc.

Homo sapiens as physician and patient: a view from Darwinian medicine.

Science.gov (United States)

Román-Franco, Angel A

2013-09-01

Medicine's cardinal diagnostic and therapeutic resource is the clinical encounter. Over the last two centuries and particularly over the last five decades the function of the clinical encounter has been eroded to the point of near irrelevance because of the atomized and atomizing influence of technology and microspecialization. Meanwhile, over the past five decades the exceptionalist view of Homo sapiens inherent in the social and religious traditions of the West has similarly undergone radical changes. H. sapiens is now best understood as a microecosystem integrated into a much broader ecosystem: the biosphere. That human microecosystem is composed of constituents derived from the archaeal, bacterial, and eukaryan domains via endosymbiotic, commensalistic and mutualistic interactions. This amalgamation of 100 trillion cells and viral elements is regulated by a composite genome aggregated over the 3.8 billion years of evolutionary history of organic life. No component of H. sapiens or its genome can be identified as irreducibly and exclusively human. H. sapiens' humanity is an emergent property of the microecosystem. Ironically as H. sapiens is viewed by evolutionary science in a highly integrated manner medicine approaches it as a balkanized, deaggregated entity through the eye of 150 different specialties. To effectively address the needs of H sapiens in its role as patient by the same species in its role as physician the disparate views must be harmonized. Here I review some conceptual elements that would assist a physician in addressing the needs of the patient in integrum, as a microecosystem, by the former address the latter as a historical gestalt being. The optimal way to recover the harmony between patient and physician is through a revitalization of the clinical encounter via an ecological and Darwinian epistemology.

Cost comparison of transcatheter and operative closures of ostium secundum atrial septal defects

Science.gov (United States)

O’Byrne, Michael L.; Gillespie, Matthew J.; Shinohara, Russell T.; Dori, Yoav; Rome, Jonathan J.; Glatz, Andrew C.

2015-01-01

Background Clinical outcomes for transcatheter and operative closures of atrial septal defects (ASDs) are similar. Economic cost for each method has not been well described. Methods A single-center retrospective cohort study of children and adults cost of operative and transcatheter closures of ASD. A propensity score weight-adjusted multivariate regression model was used in an intention-to-treat analysis. Costs for reintervention and crossover admissions were included in primary analysis. Results A total of 244 subjects were included in the study (64% transcatheter and 36% operative), of which 2% (n = 5) were ≥18 years. Crossover rate from transcatheter to operative group was 3%. Risk of reintervention (P = .66) and 30-day mortality (P = .37) were not significantly different. In a multivariate model, adjusted cost of operative closure was 2012 US $60,992 versus 2012 US $55,841 for transcatheter closure (P cost favoring transcatheter closure were length of stay, medications, and follow-up radiologic and laboratory testing, overcoming higher costs of procedure and echocardiography. Professional costs did not differ. The rate of 30-day readmission was greater in the operative cohort, further increasing the cost advantage of transcatheter closure. Sensitivity analyses demonstrated that costs of follow-up visits influenced relative cost but that device closure remained favorable over a broad range of crossover and reintervention rates. Conclusion For single secundum ASD, cost comparison analysis favors transcatheter closure over the short term. The cost of follow-up regimens influences the cost advantage of transcatheter closure. PMID:25965721

Transcatheter Coil Embolization of Splenic Artery Aneurysm

International Nuclear Information System (INIS)

Yamamoto, Satoshi; Hirota, Shozo; Maeda, Hiroaki; Achiwa, Sachiko; Arai, Keisuke; Kobayashi, Kaoru; Nakao, Norio

2008-01-01

The purpose of this study was to evaluate clinical results and technical problems of transcatheter coil embolization for splenic artery aneurysm. Subjects were 16 patients (8 men, 8 women; age range, 40-80 years) who underwent transcatheter embolization for splenic artery aneurysm (14 true aneurysms, 2 false aneurysms) at one of our hospitals during the period January 1997 through July 2005. Two aneurysms (12.5%) were diagnosed at the time of rupture. Multiple splenic aneurysms were found in seven patients. Aneurysms were classified by site as proximal (or strictly ostial) (n = 3), middle (n = 3), or hilar (n = 10). The indication for transcatheter arterial embolization was a false or true aneurysm 20 mm in diameter. Embolic materials were fibered coils and interlocking detachable coils. Embolization was performed by the isolation technique, the packing technique, or both. Technically, all aneurysms were devascularized without severe complications. Embolized aneurysms were 6-40 mm in diameter (mean, 25 mm). Overall, the primary technical success rate was 88% (14 of 16 patients). In the remaining 2 patients (12.5%), partial recanalization occurred, and re-embolization was performed. The secondary technical success rate was 100%. Seven (44%) of the 16 study patients suffered partial splenic infarction. Intrasplenic branching originating from the aneurysm was observed in five patients. We conclude that transcatheter coil embolization should be the initial treatment of choice for splenic artery aneurysm

Transcatheter coil embolisation of pulmonary arteriovenous malformations

International Nuclear Information System (INIS)

Wingen, M.; Guenther, R.W.

2001-01-01

Evaluation of technical success, complications and long-term results of transcatheter coil embolisation in pulmonary arteriovenous malformations (pAVMs). Material and Methods: Transcatheter embolisations of 46 pAVMs in 14 patients were analysed retrospectively, and, 5 years after treatment, the patients were interviewed by telefone concerning persistent symptoms and complications. Main symptoms before embolisation were dyspnoe (86%), hypoxaemia (100%), cerebral ischemia (21%), and hemoptysis (14%); 11 patients (79%) suffered from hereditary hemorrhagic telangiectasia. Results: Embolisation with an average of 3,9 coils (min. 1, max. 19 coils) per pAVM yielded technical success in all cases. Only two minor complications, transitory pleuritis and a small lung infarction were observed. On follow up examination after 5 years either no residual complaints or substantial improvement of dyspnoe were reported; no patient suffered from neurologic or hemorrhagic complications after the embolisation. Conclusion: Transcatheter embolisation is a safe and minimally invasive therapy for pAVMs and has rightfully replaced surgical resection as the therapy of choice. (orig.) [de

Mandibular molar root morphology in Neanderthals and Late Pleistocene and recent Homo sapiens.

Science.gov (United States)

Kupczik, Kornelius; Hublin, Jean-Jacques

2010-11-01

Neanderthals have a distinctive suite of dental features, including large anterior crown and root dimensions and molars with enlarged pulp cavities. Yet, there is little known about variation in molar root morphology in Neanderthals and other recent and fossil members of Homo. Here, we provide the first comprehensive metric analysis of permanent mandibular molar root morphology in Middle and Late Pleistocene Homo neanderthalensis, and Late Pleistocene (Aterian) and recent Homo sapiens. We specifically address the question of whether root form can be used to distinguish between these groups and assess whether any variation in root form can be related to differences in tooth function. We apply a microtomographic imaging approach to visualise and quantify the external and internal dental morphologies of both isolated molars and molars embedded in the mandible (n=127). Univariate and multivariate analyses reveal both similarities (root length and pulp volume) and differences (occurrence of pyramidal roots and dental tissue volume proportion) in molar root morphology among penecontemporaneous Neanderthals and Aterian H. sapiens. In contrast, the molars of recent H. sapiens are markedly smaller than both Pleistocene H. sapiens and Neanderthals, but share with the former the dentine volume reduction and a smaller root-to-crown volume compared with Neanderthals. Furthermore, we found the first molar to have the largest average root surface area in recent H. sapiens and Neanderthals, although in the latter the difference between M(1) and M(2) is small. In contrast, Aterian H. sapiens root surface areas peak at M(2). Since root surface area is linked to masticatory function, this suggests a distinct occlusal loading regime in Neanderthals compared with both recent and Pleistocene H. sapiens. Copyright © 2010 Elsevier Ltd. All rights reserved.

Edward Said

DEFF Research Database (Denmark)

Botofte, John; Jensen, Lars

En gennemgang af Edward Saids forfatterskab. Skønt gennemgangen er relativt kronologisk, er det en hovedpointe med bogen at vise samspillet mellem Saids mangefacetterede interesser og publikationer. Endelig indeholder bogen et bibliografiessay og et essay om arven efter Said inden for det postkol...

EDWARD SUESS AND RUSSIAN GEOLOGISTS

Directory of Open Access Journals (Sweden)

Boris A. Natal’in

2011-01-01

Full Text Available The publication is devoted to the history of one of the greatest concepts of tectonics of Asia, that has been widely accepted and yet obliterated with time, while the splendors of this concept are doubtful. Numerous citations in the Russian papers to «The Face of the Earth» by Edward Suess and the fact that he was elected a Corresponding Member of the Imperial Saint Petersburg Academy of Sciences clearly demonstrate how highly Suess’s contribution to studies of the structure and geological evolution of Asia was valued by the Russian geological community. Suess’s letters to Vladimir A. Obruchev give evidence how close and productive the relationship between Edward Suess and the Russian researchers was in the late 19th and the early 20th centuries and also illustrate how the great tectonic concept of Asia [Suess, 1908] was born and developed. The idea of centrifugal propagation of tectonic waves of the Altaids from a continental node located somewhere in Siberia was mainly inspired by Suess’s profound scientific intuition. The idea matured after Edward Suess got acquainted with Ivan D. Chersky’s paper [Черский, 1886] that greatly facilitated in shaping and improving this idea. It was mailed to Suess by Vladimir A. Obruchev who translated the paper, attached his own map and provided explanations to Chersky’s ideas. The available historical documents suggest that Vladimir A. Obruchev facilitated communication between the Russian geologists, on the one side, and Edward Suess and other Austrian geologists who conducted geological studies in Asia, on the other side. Being actively involved in exchange of publications and cooperation in field data processing, Edward Suess was aware of all the details of the Russian geological studies.In addition to the concept of tectonic arcs of the Altaids and descriptions of main geological structures located in Northern Asia and China, Edward Suess adopted a concept of disjunctive dislocations

Sapiens a brief history of humankind

CERN Document Server

Harari, Yuval Noah

2015-01-01

From a renowned historian comes a groundbreaking narrative of humanity’s creation and evolution—a #1 international bestseller—that explores the ways in which biology and history have defined us and enhanced our understanding of what it means to be “human.” One hundred thousand years ago, at least six different species of humans inhabited Earth. Yet today there is only one—homo sapiens. What happened to the others? And what may happen to us? Most books about the history of humanity pursue either a historical or a biological approach, but Dr. Yuval Noah Harari breaks the mold with this highly original book that begins about 70,000 years ago with the appearance of modern cognition. From examining the role evolving humans have played in the global ecosystem to charting the rise of empires, Sapiens integrates history and science to reconsider accepted narratives, connect past developments with contemporary concerns, and examine specific events within the context of larger ideas. Dr. Harari also comp...

The evolution and development of cranial form in Homo sapiens

OpenAIRE

Lieberman, Daniel E.; McBratney, Brandeis M.; Krovitz, Gail

2002-01-01

Despite much data, there is no unanimity over how to define Homo sapiens in the fossil record. Here, we examine cranial variation among Pleistocene and recent human fossils by using a model of cranial growth to identify unique derived features (autapomorphies) that reliably distinguish fossils attributed to “anatomically modern” H. sapiens (AMHS) from those attributed to various taxa of “archaic” Homo spp. (AH) and to test hypotheses about the changes in cranial development that underlie the ...

Percutaneous Transcatheter PDA Device Closure in Infancy

International Nuclear Information System (INIS)

Ullah, M.; Sultan, M.; Akhtar, K.; Sadiq, N.; Akbar, H.

2014-01-01

Objective: To evaluate the results and complications associated with transcatheter closure of patent ductus arteriosus (PDA) in infants. Study Design: Quasi-experimental study. Place and Duration of Study: Paediatric Cardiology Department of Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from December 2010 to June 2012. Methodology: Infants undergoing transcatheter device closure of PDA were included. All patients were evaluated by experienced Paediatric Cardiologists with 2-D echocardiography and Doppler before the procedure. Success of closure and complications were recorded. Results: The age of patients varied from 05 - 12 months and 31 (56.4%) were females. Out of the 55 infants, 3 (5.4%) were not offered device closure after aortogram (two large tubular type ducts and one tiny duct, considered unsuitable for device closure); while in 50 (96.1%) patients out of remaining 52, the duct was successfully closed with transcatheter PDA device or coil. In one infant, device deployment resulted in acquired coarctation, necessitating device retrieval by Snare followed by surgical duct interruption and another patient had non-fatal cardiac arrest during device deployment leading to abandonment of procedure and subsequent successful surgical interruption. Local vascular complications occurred in 12 (21.8%) of cases and all were satisfactorily treated. Conclusion: Transcatheter device closure of PDA in infants was an effective procedure in the majority of cases; however, here were considerable number of local access site vascular complications. (author)

Percutaneous transcatheter sclerotherapy of oophoritic cysts

International Nuclear Information System (INIS)

Huang Youhua; Xu Qiang; Sun Jun; Shen Tao; Shi Hongjian; Tang Qingfang; Chen Qiying; Zhou Mingxia; Li Hongyao

2005-01-01

Objective: To evaluate the clinical value of percutaneous transcatheter sclerotherapy in oophoritic cysts. Methods: Seventy six oophoritic cysts incluoling 48 simple and 28 chocolate cysts of 64 patients were treated with percutaneous transcatheter sclerotherapy under CT guidance. 4F multisideholes pigtail catheter was introduced into cyst using absolute alcohol as sclerosing agents. Results: The successful rate of percutaneous oophoritc cyst puncture was 100% in all 64 patients. Among them 58 were cured (90.6%), 6 improved significantly (9.4%). The total effective rate reached 100% with no serious complications. Conclusions: Catheterization sclerotherapy for oophoritic cyst is a simple, complete, safe and effective method. (authors)

New fossils from Jebel Irhoud, Morocco and the pan-African origin of Homo sapiens

OpenAIRE

Hublin, Jean-Jacques; Ben-Ncer, Abdelouahed; Bailey, Shara E.; Freidline, Sarah E.; Neubauer, Simon; Skinner, Matthew M.; Bergmann, Inga; Le Cabec, Adeline; Benazzi, Stefano; Harvati, Katerina; Gunz, Philipp

2017-01-01

Fossil evidence points to an African origin of Homo sapiens from a group called either H. heidelbergensis or H. rhodesiensis. However, the exact place and time of emergence of H. sapiens remain obscure because the fossil record is scarce and the chronological age of many key specimens remains uncertain. In particular, it is unclear whether the present day ‘modern’ morphology rapidly emerged approximately 200 thousand years ago (ka) among earlier representatives of H. sapiens1 or evolved gradu...

The application of transcatheter closure procedure in congenital heart diseases

International Nuclear Information System (INIS)

Guo Haoxue; Liu Shuyong; Jiang Rutong; Bai Hongcan; Wang Yanwei; Du Yuying; Yang Qiaoji; Qin Yongwen

2003-01-01

Objective: To explore and evaluate the value of transcatheter closure procedure in congenital heart diseases. Methods: Transcatheter closure was performed in 12 patients with congenital heart diseases including 6 ventricular septal defect (VSD), 4 atrial septal defect (ASD), 2 patent ductus arteriosus (PDA), by the Amplatzer occlusion device under local or general anesthesia. Results: The procedure was successful in all patients outcoming with the disappearance of cardiac murmur. All of them could get out of the bed within 6 to 12 hours postoperatively, and were discharged from hospital after 4 to 6 days. Conclusions: Transcatheter treatment of congenital cardiac defects by Amplatzer occlusion device is less traumatic, with good effect, simultaneously

The application of transcatheter closure procedure in congenital heart diseases

Energy Technology Data Exchange (ETDEWEB)

Haoxue, Guo; Shuyong, Liu; Rutong, Jiang; Hongcan, Bai; Yanwei, Wang; Yuying, Du; Qiaoji, Yang; Yongwen, Qin [Henan Provincial Corps Hospital, Chinese People' s Police Forces, Zhengzhou (China). Dept. of Surgery

2003-10-01

Objective: To explore and evaluate the value of transcatheter closure procedure in congenital heart diseases. Methods: Transcatheter closure was performed in 12 patients with congenital heart diseases including 6 ventricular septal defect (VSD), 4 atrial septal defect (ASD), 2 patent ductus arteriosus (PDA), by the Amplatzer occlusion device under local or general anesthesia. Results: The procedure was successful in all patients outcoming with the disappearance of cardiac murmur. All of them could get out of the bed within 6 to 12 hours postoperatively, and were discharged from hospital after 4 to 6 days. Conclusions: Transcatheter treatment of congenital cardiac defects by Amplatzer occlusion device is less traumatic, with good effect, simultaneously.

Transcatheter emboilization therapy of massive colonic bleeding

International Nuclear Information System (INIS)

Shin, G. H.; Oh, J. H.; Yoon, Y.

1996-01-01

To evaulate the efficacy and safety of emergent superselective transcatheter embolization for controlling massive colonic bleeding. Six of the seven patients who had symptom of massive gastrointestinal bleeding underwent emergent transcatheter embolization for control of the bleeding. Gastrointestinal bleeding in these patients was originated from various colonic diseases: rectal cancer(n=1), proctitis(n=1), benign ulcer(n=1), mucosal injury by ventriculoperitoneal shunt(n=1), and unknown(n=2). All patients except one with rectal cancer were critically ill. Superselective embolization were done by using Gelfoam particles and/or coils. The vessels embolized were ileocolic artery(n=1). superior rectal artery(n=2), inferior rectal artery (n=1), and middle and inferior rectal arteries(n=1). Hemostasis was successful immediately in all patients. Two underwnet surgery due to recurrent bleeding developed 3 days after the procedure(n=1) or in associalion with underlying rectal cancer(n=1). On surgical specimen of two cases, there was no mucosal ischemic change. Transcatheter embolization is a safe and effective treatment of method for the control of massive colonic bleeding

Fürchtet China Edward Snowden?

OpenAIRE

Rühlig, Tim

2013-01-01

Vielfach ist argumentiert worden, China sei einer der Hauptprofiteure von den Enthüllungen des ehemaligen amerikanischen Geheimdienstmitarbeiters Edward Snowden. Amerikas früherer Vizepräsident Dick Cheney sieht in ihm gar einen Spion der Volksrepublik China. Peking wies das sofort zurück. Ein Blick auf die chinesische Diskussion um Edward Snowden zeigt: Nicht nur Cheneys Vermutung schießt deutlich über das Ziel hinaus. Denn die chinesische Führung beobachtet die Entwicklung gleichsam aufmerk...

Homo sapiens natriuretic peptide precursor type C (NPPC) mRNA,partial cds and 3' UTR.

OpenAIRE

Landi, Stefano; Melaiu, Ombretta; Cabiati, Manuela; Landi, Debora; Caselli, Chiara; Prescimone, Tommaso; Giannessi, Daniela; Gemignani, Federica; Del Ry, Silvia

2010-01-01

LOCUS HQ419060 318 bp mRNA linear PRI 24-NOV-2010 DEFINITION Homo sapiens natriuretic peptide precursor type C (NPPC) mRNA, partial cds and 3' UTR. ACCESSION HQ419060 VERSION HQ419060.1 GI:312261407 KEYWORDS . SOURCE Homo sapiens (human) ORGANISM Homo sapiens Eukaryota; Metazoa; Chordata; Craniata; Vertebrata; Euteleostomi; Mammalia; Eutheria; Euarchontoglires; Primates; Haplorrhini; Catarrhini; Hominidae; Homo. REFERENCE 1 (bases 1 to 318) AUTHORS Landi,S., Melaiu,O., Cabiati,M., Landi,D., C...

Homo sapiens in Arabia by 85,000 years ago.

Science.gov (United States)

Groucutt, Huw S; Grün, Rainer; Zalmout, Iyad A S; Drake, Nick A; Armitage, Simon J; Candy, Ian; Clark-Wilson, Richard; Louys, Julien; Breeze, Paul S; Duval, Mathieu; Buck, Laura T; Kivell, Tracy L; Pomeroy, Emma; Stephens, Nicholas B; Stock, Jay T; Stewart, Mathew; Price, Gilbert J; Kinsley, Leslie; Sung, Wing Wai; Alsharekh, Abdullah; Al-Omari, Abdulaziz; Zahir, Muhammad; Memesh, Abdullah M; Abdulshakoor, Ammar J; Al-Masari, Abdu M; Bahameem, Ahmed A; Al Murayyi, Khaled M S; Zahrani, Badr; Scerri, Eleanor L M; Petraglia, Michael D

2018-05-01

Understanding the timing and character of the expansion of Homo sapiens out of Africa is critical for inferring the colonization and admixture processes that underpin global population history. It has been argued that dispersal out of Africa had an early phase, particularly ~130-90 thousand years ago (ka), that reached only the East Mediterranean Levant, and a later phase, ~60-50 ka, that extended across the diverse environments of Eurasia to Sahul. However, recent findings from East Asia and Sahul challenge this model. Here we show that H. sapiens was in the Arabian Peninsula before 85 ka. We describe the Al Wusta-1 (AW-1) intermediate phalanx from the site of Al Wusta in the Nefud desert, Saudi Arabia. AW-1 is the oldest directly dated fossil of our species outside Africa and the Levant. The palaeoenvironmental context of Al Wusta demonstrates that H. sapiens using Middle Palaeolithic stone tools dispersed into Arabia during a phase of increased precipitation driven by orbital forcing, in association with a primarily African fauna. A Bayesian model incorporating independent chronometric age estimates indicates a chronology for Al Wusta of ~95-86 ka, which we correlate with a humid episode in the later part of Marine Isotope Stage 5 known from various regional records. Al Wusta shows that early dispersals were more spatially and temporally extensive than previously thought. Early H. sapiens dispersals out of Africa were not limited to winter rainfall-fed Levantine Mediterranean woodlands immediately adjacent to Africa, but extended deep into the semi-arid grasslands of Arabia, facilitated by periods of enhanced monsoonal rainfall.

Pleistocene Homo sapiens from Middle Awash, Ethiopia.

Science.gov (United States)

White, Tim D; Asfaw, Berhane; DeGusta, David; Gilbert, Henry; Richards, Gary D; Suwa, Gen; Howell, F Clark

2003-06-12

The origin of anatomically modern Homo sapiens and the fate of Neanderthals have been fundamental questions in human evolutionary studies for over a century. A key barrier to the resolution of these questions has been the lack of substantial and accurately dated African hominid fossils from between 100,000 and 300,000 years ago. Here we describe fossilized hominid crania from Herto, Middle Awash, Ethiopia, that fill this gap and provide crucial evidence on the location, timing and contextual circumstances of the emergence of Homo sapiens. Radioisotopically dated to between 160,000 and 154,000 years ago, these new fossils predate classic Neanderthals and lack their derived features. The Herto hominids are morphologically and chronologically intermediate between archaic African fossils and later anatomically modern Late Pleistocene humans. They therefore represent the probable immediate ancestors of anatomically modern humans. Their anatomy and antiquity constitute strong evidence of modern-human emergence in Africa.

Transcatheter closure of large patent ductus arteriosus using custom made devices.

Science.gov (United States)

Rohit, Manoj Kumar; Gupta, Ankur

2017-05-01

There has been a paradigm shift in the transcatheter closure of patent ductus arteriosus (PDA) over the last 45 years. With the availability of various coils, plugs and occluders, PDA of almost all shapes and sizes are amenable to transcatheter closure. However, very large PDA diagnosed late in life are being referred for surgical closure in the absence of availability of large size devices, especially in developing countries. In this case series, we have described four patients with large PDA, three of which were closed by transcatheter custom made PDA occluders. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Historical sites at the Prince Edward islands

CSIR Research Space (South Africa)

Cooper, J

1986-07-01

Full Text Available This report gives the results of a workshop held on historical sites at the sub-Antarctic Prince Edward islands, southern Indian Ocean. All known visits and sojourns on the Prince Edward islands up to 1948 are tabulated. All known historical sites...

Identification of the ancestral haplotype for apolipoprotein B suggests an African origin of Homo sapiens sapiens and traces their subsequent migration to Europe and the Pacific

Energy Technology Data Exchange (ETDEWEB)

Rapacz, J.; Hasler-Rapacz, J.O. (Univ. of Wisconsin, Madison (United States)); Chen, L.; Wu, Mingjiuan; Schumaker, V.N. (Univ. of California, Los Angeles (United States)); Butler-Brunner, E.; Butler, R. (Swiss Red Cross Blood Transfusion Service, Bern (Switzerland))

1991-02-15

The probable ancestral haplotype for human apolipoprotein B (apoB) has been identified through immunological analysis of chimpanzee and gorilla serum and sequence analysis of their DNA. Moreover, the frequency of this ancestral apoB haplotype among different human populations provides strong support for the African origin of Homo sapiens sapiens and their subsequent migration from Africa to Europe and to the Pacific. The approach used here for the identification of the ancestral human apoB haplotype is likely to be applicable to many other genes.

Identification of the ancestral haplotype for apolipoprotein B suggests an African origin of Homo sapiens sapiens and traces their subsequent migration to Europe and the Pacific

International Nuclear Information System (INIS)

Rapacz, J.; Hasler-Rapacz, J.O.; Chen, L.; Wu, Mingjiuan; Schumaker, V.N.; Butler-Brunner, E.; Butler, R.

1991-01-01

The probable ancestral haplotype for human apolipoprotein B (apoB) has been identified through immunological analysis of chimpanzee and gorilla serum and sequence analysis of their DNA. Moreover, the frequency of this ancestral apoB haplotype among different human populations provides strong support for the African origin of Homo sapiens sapiens and their subsequent migration from Africa to Europe and to the Pacific. The approach used here for the identification of the ancestral human apoB haplotype is likely to be applicable to many other genes

Transcatheter arterial embolization for upper gastrointestinal tract bleeding.

Science.gov (United States)

Širvinskas, Audrius; Smolskas, Edgaras; Mikelis, Kipras; Brimienė, Vilma; Brimas, Gintautas

2017-12-01

Transcatheter arterial embolization is a possible treatment for patients with recurrent bleeding from the upper gastrointestinal tract after failed endoscopic management and is also an alternative to surgical treatment. To analyze the outcomes of transcatheter arterial embolization and identify the clinical and technical factors that influenced the rates of morbidity and mortality. A retrospective analysis was carried out, based on the data of 36 patients who underwent transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding in 2013 to 2015 in our center. An analysis was performed between early rebleeding rates, mortality and the following factors: patient sex, age, number of units of packed red blood cells and packed plasma administered to the patients, length of hospital stay, therapeutic or prophylactic embolization. The technical success rate of the embolization procedure was 100%. There were 15 (41.70%) therapeutic embolizations and 21 (58.3%) prophylactic embolizations. There was a 77.8% clinical success rate. Following embolization, 10 (27.80%) patients had repeated bleeding and 9 (25.0%) patients died. Significant associations were found between rebleeding and prophylactic embolization (OR = 10.53; p = 0.04) and between mortality and prophylactic embolization (OR = 10.53; p = 0.04) and units of packed red blood cells (OR = 1.25; p < 0.01). In our experience, transcatheter arterial embolization is a safe treatment method for acute nonvariceal upper gastrointestinal bleeding and a possible alternative to surgery for high-risk patients.

Advances in Clinical Cardiology 2016: A Summary of the Key Clinical Trials.

Science.gov (United States)

Gray, Alastair; McQuillan, Conor; Menown, Ian B A

2017-07-01

The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA). Selection criteria were trials with a broad relevance to the cardiology community and those with potential to change current practice. A total of 57 key cardiology clinical trials were identified for inclusion. Here we describe and place in clinical context the key findings of new data relating to interventional and structural cardiology including delayed stenting following primary angioplasty, contrast-induced nephropathy, management of jailed wires, optimal duration of dual antiplatelet therapy (DAPT), stenting vs bypass for left main disease, new generation stents (BioFreedom, Orsiro, Absorb), transcatheter aortic valve implantation (Edwards Sapien XT, transcatheter embolic protection), and closure devices (Watchman, Amplatzer). New preventative cardiology data include trials of bariatric surgery, empagliflozin, liraglutide, semaglutide, PCSK9 inhibitors (evolocumab and alirocumab), and inclisiran. Antiplatelet therapy trials include platelet function monitoring and ticagrelor vs clopidogrel for peripheral vascular disease. New data are also presented in fields of heart failure (sacubitril/valsartan, aliskiren, spironolactone), atrial fibrillation (rivaroxaban in patients undergoing coronary intervention, edoxaban in DC cardioversion), cardiac devices (implantable cardioverter

Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

Energy Technology Data Exchange (ETDEWEB)

Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Abdominal Imaging, Paris cedex 10 (France); Morel, Olivier [Hopital Lariboisiere-AP-HP Universite Paris 7, Department of Obstetrics, Paris cedex 10 (France)

2008-06-15

The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

Severe postpartum haemorrhage from ruptured pseudoaneurysm: successful treatment with transcatheter arterial embolization

International Nuclear Information System (INIS)

Soyer, Philippe; Fargeaudou, Yann; Boudiaf, Mourad; Le Dref, Olivier; Rymer, Roland; Morel, Olivier

2008-01-01

The purpose of this retrospective study was to evaluate the role of transcatheter arterial embolization in the management of severe postpartum haemorrhage due to a ruptured pseudoaneurysm and to analyse the clinical symptoms that may suggest a pseudoaneurysm as a cause of postpartum haemorrhage. A retrospective search of our database disclosed seven women with severe postpartum haemorrhage in whom angiography revealed the presence of a uterine or vaginal artery pseudoaneurysm and who were treated using transcatheter arterial embolization. Clinical files were reviewed for possible clinical findings that could suggest pseudoaneurysm as a cause of bleeding. Angiography revealed extravasation of contrast material in five out of seven patients. Transcatheter arterial embolization allowed to control the bleeding in all patients and subsequently achieve vaginal suture in four patients with vaginal laceration. No complications related to transcatheter arterial embolization were noted. Only two patients had uterine atony, and inefficiency of sulprostone was observed in all patients. Transcatheter arterial embolization is an effective and secure technique for the treatment of severe postpartum haemorrhage due to uterine or vaginal artery pseudoaneurysm. Ineffectiveness of suprostone and absence of uterine atony should raise the possibility of a ruptured pseudoaneurysm. (orig.)

New fossils from Jebel Irhoud, Morocco and the pan-African origin of Homo sapiens.

Science.gov (United States)

Hublin, Jean-Jacques; Ben-Ncer, Abdelouahed; Bailey, Shara E; Freidline, Sarah E; Neubauer, Simon; Skinner, Matthew M; Bergmann, Inga; Le Cabec, Adeline; Benazzi, Stefano; Harvati, Katerina; Gunz, Philipp

2017-06-07

Fossil evidence points to an African origin of Homo sapiens from a group called either H. heidelbergensis or H. rhodesiensis. However, the exact place and time of emergence of H. sapiens remain obscure because the fossil record is scarce and the chronological age of many key specimens remains uncertain. In particular, it is unclear whether the present day 'modern' morphology rapidly emerged approximately 200 thousand years ago (ka) among earlier representatives of H. sapiens or evolved gradually over the last 400 thousand years. Here we report newly discovered human fossils from Jebel Irhoud, Morocco, and interpret the affinities of the hominins from this site with other archaic and recent human groups. We identified a mosaic of features including facial, mandibular and dental morphology that aligns the Jebel Irhoud material with early or recent anatomically modern humans and more primitive neurocranial and endocranial morphology. In combination with an age of 315 ± 34 thousand years (as determined by thermoluminescence dating), this evidence makes Jebel Irhoud the oldest and richest African Middle Stone Age hominin site that documents early stages of the H. sapiens clade in which key features of modern morphology were established. Furthermore, it shows that the evolutionary processes behind the emergence of H. sapiens involved the whole African continent.

Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation

DEFF Research Database (Denmark)

Thyregod, Hans Gustav; Lund, Jens Teglgaard; Engstrøm, Thomas

2010-01-01

Transcatheter aortic valve implantation is a new and rapidly evolving treatment option for high-risk surgical patients with degenerative aortic valve stenosis. Long-term results with these new valve prostheses are lacking, and potential valve dysfunction and failure would require valve replacemen....... We report the first case of surgical valve replacement in a patient with a dysfunctional transcatheter-implanted aortic valve prosthesis 4 months after implantation....

Transcatheter closure of ventricular septal defect with Occlutech Duct Occluder.

Science.gov (United States)

Atik-Ugan, Sezen; Saltik, Irfan Levent

2018-04-01

Patent ductus arteriosus occluders are used for transcatheter closure of ventricular septal defects, as well as for closure of patent ductus arteriosus. The Occlutech Duct Occluder is a newly introduced device for transcatheter closure of patent ductus arteriosus. Here, we present a case in which the Occlutech Duct Occluder was successfully used on a patient for the closure of a perimembraneous ventricular septal defect.

Transcatheter Patent Ductus Arteriosus Occlusion in Small Infants.

Science.gov (United States)

Schwartz, Matthew C; Nykanen, David; Winner, Lawrence H; Perez, Jose; McMahan, Michael; Munro, Hamish M; Suguna Narasimhulu, Sukumar

2016-12-01

Transcatheter patent ductus arteriosus (PDA) occlusion is feasible in small infants and may improve lung function in symptomatic patients. We aimed to describe transcatheter PDA closure in small infants including predictors of technical success and rate of complication and to identify factors associated with improved respiratory status after closure. All patients in the NICU at our center who were referred for transcatheter PDA occlusion between 1/2010 and 11/2014 were retrospectively identified. Relevant details were extracted. Additionally, a modification of the respiratory severity score (RSS) (FiO 2 × mean airway pressure) was used to characterize degree of pulmonary support before and at intervals after catheterization. Twenty patients were identified with median age of 96 days (13-247) and weight of 3.1 kg (1.7-4.7). The PDA was type F morphology in 14 (70%) patients. The PDA was successfully occluded in 16 (80%) patients. Ratio of minimum PDA diameter/length was >0.5 in all unsuccessful attempts and closure. © 2016 Wiley Periodicals, Inc.

Crystal structure of Homo sapiens protein LOC79017

Energy Technology Data Exchange (ETDEWEB)

Bae, Euiyoung; Bingman, Craig A.; Aceti, David J.; Phillips, Jr., George N. (UW)

2010-02-08

LOC79017 (MW 21.0 kDa, residues 1-188) was annotated as a hypothetical protein encoded by Homo sapiens chromosome 7 open reading frame 24. It was selected as a target by the Center for Eukaryotic Structural Genomics (CESG) because it did not share more than 30% sequence identity with any protein for which the three-dimensional structure is known. The biological function of the protein has not been established yet. Parts of LOC79017 were identified as members of uncharacterized Pfam families (residues 1-95 as PB006073 and residues 104-180 as PB031696). BLAST searches revealed homologues of LOC79017 in many eukaryotes, but none of them have been functionally characterized. Here, we report the crystal structure of H. sapiens protein LOC79017 (UniGene code Hs.530024, UniProt code O75223, CESG target number go.35223).

Cost-effectiveness of transcatheter versus surgical management of structural heart disease

Energy Technology Data Exchange (ETDEWEB)

Fanari, Zaher, E-mail: zfanari@gmail.com [Division of Cardiology, University of Kansas School of Medicine, Kansas City, KS (United States); Weintraub, William S. [Section of Cardiology, Christiana Care Health System, Newark, DE (United States); Value institute, Christiana Care Health System, Newark, DE (United States)

2016-01-15

Transcatheter management of valvular and structural heart disease is the most growing aspect of interventional cardiology. While the early experience was limited to patients who were not candidate for surgery, the continuous improvement in the efficacy and safety expanded its use to different degree depending on the procedure and the disease involved. The cost of these procedures is a major concern for health care in developed world. Cost-effectiveness of these transcatheter structural procedures varies depending on the procedure itself, the burden of the underlying disease, the feasibility and cost of both the Transcatheter and surgical procedures. In this review, we turn now to a specific discussion of the medical economics of percutaneous valvular and structural interventions.

Neurofibromatosis Type 1: Transcatheter Arterial Embolization for Ruptured Occipital Arterial Aneurysms

International Nuclear Information System (INIS)

Kanematsu, Masayuki; Kato, Hiroki; Kondo, Hiroshi; Goshima, Satoshi; Tsuge, Yusuke; Kojima, Toshiaki; Watanabe, Haruo

2011-01-01

Two cases of ruptured aneurysms in the posterior cervical regions associated with type-1 neurofibromatosis treated by transcatheter embolization are reported. Patients presented with acute onset of swelling and pain in the affected areas. Emergently performed contrast-enhanced CT demonstrated aneurysms and large hematomas widespread in the posterior cervical regions. Angiography revealed aneurysms and extravasations of the occipital artery. Patients were successfully treated by percutaneous transcatheter arterial microcoil embolization. Transcatheter arterial embolization therapy was found to be an effective method for treating aneurysmal rupture in the posterior cervical regions occurring in association with type-1 neurofibromatosis. A literature review revealed that rupture of an occipital arterial aneurysm, in the setting of neurofibromatosis type 1, has not been reported previously.

Is Homo sapiens polytypic? Human taxonomic diversity and its implications.

Science.gov (United States)

Woodley, Michael A

2010-01-01

The term race is a traditional synonym for subspecies, however it is frequently asserted that Homo sapiens is monotypic and that what are termed races are nothing more than biological illusions. In this manuscript a case is made for the hypothesis that H. sapiens is polytypic, and in this way is no different from other species exhibiting similar levels of genetic and morphological diversity. First it is demonstrated that the four major definitions of race/subspecies can be shown to be synonymous within the context of the framework of race as a correlation structure of traits. Next the issue of taxonomic classification is considered where it is demonstrated that H. sapiens possesses high levels morphological diversity, genetic heterozygosity and differentiation (F(ST)) compared to many species that are acknowledged to be polytypic with respect to subspecies. Racial variation is then evaluated in light of the phylogenetic species concept, where it is suggested that the least inclusive monophyletic units exist below the level of species within H. sapiens indicating the existence of a number of potential human phylogenetic species; and the biological species concept, where it is determined that racial variation is too small to represent differentiation at the level of biological species. Finally the implications of this are discussed in the context of anthropology where an accurate picture of the sequence and timing of events during the evolution of human taxa are required for a complete picture of human evolution, and medicine, where a greater appreciation of the role played by human taxonomic differences in disease susceptibility and treatment responsiveness will save lives in the future.

Cardiopulmonary bypass and intra-aortic balloon pump use is associated with higher short and long term mortality after transcatheter aortic valve replacement: a PARTNER trial substudy.

Science.gov (United States)

Shreenivas, Satya S; Lilly, Scott M; Szeto, Wilson Y; Desai, Nimesh; Anwaruddin, Saif; Bavaria, Joseph E; Hudock, Kristin M; Thourani, Vinod H; Makkar, Raj; Pichard, Augusto; Webb, John; Dewey, Todd; Kapadia, Samir; Suri, Rakesh M; Xu, Ke; Leon, Martin B; Herrmann, Howard C

2015-08-01

Transcatheter aortic valve replacement (TAVR) with the balloon-expandable Sapien transcatheter heart valve improves survival compared to standard therapy in patients with severe aortic stenosis (AS) and is noninferior to surgical aortic valve replacement (AVR) in patients at high operative risk. Nonetheless, a significant proportion of patients may require pre-emptive or emergent support with cardiopulmonary bypass (CPB) and/or intra-aortic balloon pump (IABP) during TAVR due to pre-existing comorbid conditions or as a result of procedural complications. We hypothesized that patients who required CPB or IABP would have increased periprocedural complications and reduced long-term survival. In addition, we sought to determine whether preprocedural variables could predict the need for CPB and IABP. The study population included 2,525 patients in the PARTNER Trial (Cohort A and B) and the continuing access registry (CAR). Patients that received CPB or IABP were compared to patients that did not receive either, and then further divided into those that received support pre-TAVR and those that were placed on support emergently. One-hundred sixty-three patients (6.5%) were placed on CPB and/or IABP. The use of CPB or IABP was associated with higher 1 year mortality (49.1% vs. 21.6%, P non-CPB/IABP cases (53.3% and 40.3% vs. 21.6%, P < 0.001). These findings indicate that CPB and IABP use in TAVR portends a poor prognosis and its utilization, particularly in the setting of pre-emptive use, needs reconsideration. © 2015 Wiley Periodicals, Inc.

Sapiens: Hayvanlar insanar

OpenAIRE

Yalı, Sibel

2018-01-01

Bu yazıda sizlere satış rekorları kıran bir tarihkitabından bahsetmek istiyorum. Kitap, 2011'de ibranice, 2014'te ingilizceyayımlandı ve şimdiye dek otuz civarında dile çevrildi. “Sapiens: İnsan Türünün Kısa Bir Tarihi” başlığı ile dilimizeçevrilen kitapta insanlık tarihinin serüvenine 70 bin yıllık zaman sürecindenbakılmaya çalışılıyor. Öyle bir kitap ki Amerika Başkanı Obama halkına bukitabı okumasını tavsiye ediyor. Öyle etkili bir kitap ki Facebook’un kurucusuMark Zuckerberg sos...

The effect of transcatheter arterial embolisation for nonvariceal upper gastrointestinal bleeding

DEFF Research Database (Denmark)

Andersen, Poul Erik; Duvnjak, Stevo

2010-01-01

The aim of this investigation was to evaluate the clinical efficacy and safety of transcatheter arterial embolisation with coils for nonvariceal upper gastrointestinal (GI) bleeding after failed endoscopic therapy.......The aim of this investigation was to evaluate the clinical efficacy and safety of transcatheter arterial embolisation with coils for nonvariceal upper gastrointestinal (GI) bleeding after failed endoscopic therapy....

Taxonomic differences in deciduous upper second molar crown outlines of Homo sapiens, Homo neanderthalensis and Homo erectus.

Science.gov (United States)

Bailey, Shara E; Benazzi, Stefano; Souday, Caroline; Astorino, Claudia; Paul, Kathleen; Hublin, Jean-Jacques

2014-07-01

A significant number of Middle to Late Pleistocene sites contain primarily (and sometimes only) deciduous teeth (e.g., Grotta del Cavallo, Mezmaiskaya, Blombos). Not surprisingly, there has been a recent renewed interest in deciduous dental variation, especially in the context of distinguishing Homo neanderthalensis and Homo sapiens. Most studies of the deciduous dentition of fossil hominins have focused on standard metrical variation but morphological (non-metric and morphometric) variation also promises to shed light on long standing taxonomic questions. This study examines the taxonomic significance of the crown outline of the deciduous upper second molar through principal components analysis and linear discriminant analysis. We examine whether or not the crown shape of the upper deciduous second molar separates H. neanderthalensis from H. sapiens and explore whether it can be used to correctly assign individuals to taxa. It builds on previous studies by focusing on crown rather than cervical outline and by including a large sample of geographically diverse recent human populations. Our samples include 17 H. neanderthalensis, five early H. sapiens, and 12 Upper Paleolithic H. sapiens. In addition, we include two Homo erectus specimens in order to evaluate the polarity of crown shape differences observed between H. neanderthalensis and H. sapiens. Our results show that crown outline shape discriminates H. sapiens and H. neanderthalensis quite well, but does not do well at distinguishing H. erectus from H. sapiens. We conclude that the crown outline shape observed in H. sapiens is a primitive retention and that the skewed shape observed in H. neanderthalensis is a derived condition. Finally, we explore the phylogenetic implications of the results for the H. erectus molars. Copyright © 2014 Elsevier Ltd. All rights reserved.

Síndrome de Edwards asociado a inmunodeficiencia combinada Edwards' syndrome associated to combined immunodeficiency

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Vianed Marsán Suárez

2011-09-01

Full Text Available El síndrome de Edwards es originado por un desbalance cromosómico representado por una trisomía 18. Alrededor de 95 % de los pacientes corresponden a trisomía completa, donde están presentes múltiples malformaciones en órganos y sistemas. El 5 % restante pertenece a trisomía parcial o mosaicismo, con un fenotipo incompleto por la ausencia de algunas anomalías típicas del síndrome. La inmunodeficiencia es una manifestación poco frecuente del síndrome Edwards. Se presenta el caso de una paciente de 9 meses de edad con trisomía 18 parcial e infecciones severas recurrentes desde la etapa neonatal, asociadas a anemia, linfopenia, trombocitopenia y neutrofilia. La ecografía mostró una hipoplasia del timo. Se encontraron cifras disminuidas de linfocitos TCD4+, CD8+ y de células asesinas naturales. La cuantificación de linfocitos B fue normal. Se hallaron concentraciones normales de inmunoglobulinas séricas IgM e IgG y disminuidas de IgA. Se encontró una disminución de la actividad hemolítica total de la vía clásica del complemento. No se encontraron alteraciones en la función opsonofagocítica. Se diagnosticó una inmunodeficiencia combinada asociada, hecho que demostró la heterogeneidad de la expresión clínica del síndrome Edwards y la relación entre el defecto cromosómico y la formación del sistema inmune en el período intrauterino.Edwards' syndrome is caused by a chromosomal imbalance represented by trisomy 18. Complete trisomy accounts for 95% of patients who present multiple malformations in organs and systems. The remaining 5% presents partial trisomy or mosaicism, with incomplete phenotype due to lack of some typical anomalies of this syndrome. Immunodeficiency is a rare manifestation of Edwards' syndrome. The case of a 9-months old female patient with partial trisomy 18 and recurrent severe infections since the neonatal phase, all associated to anemia, lymphopenia, thrombocytopenia and neutrophilia, was

Edward Banka Gariba

African Journals Online (AJOL)

Edward Banka Gariba. World Bank 1989. Sub-Saharan Africa: From crisis to sustainable growth, A long term perspective study. Washington, D.C., The World Bank. Zartman, I. William 1997. Introduction. In: Zartman, I. William ed. Governance as conflict management: Politics and violence in West Africa. Washington, D.C. ...

A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

Directory of Open Access Journals (Sweden)

Mei Jin

2015-01-01

Conclusions: Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.

From Purgatorius ceratops to Homo sapiens - Primate Evolutionary ...

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 11; Issue 7. From Purgatorius ceratops to Homo sapiens - Primate Evolutionary History. Sindhu Radhakrishna. General Article Volume 11 Issue 7 July 2006 pp 51-60. Fulltext. Click here to view fulltext PDF. Permanent link:

The Homo sapiens 'hemibun': its developmental pattern and the problem of homology.

Science.gov (United States)

Nowaczewska, W; Kuźmiński, L

2009-01-01

The occipital bun is widely considered a Neanderthal feature. Its homology to the 'hemibun' observed in some European Upper Palaeolithic anatomically modern humans is a current problem. This study quantitatively evaluates the degree of occipital plane convexity in African and Australian modern human crania to analyse a relationship between this feature and some neurocranial variables. Neanderthal and European Upper Palaeolithic Homo sapiens crania were included in the analysis as well. The results of this study indicated that there is a significant relationship between the degree of occipital plane convexity and the following two features in the examined crania of modern humans: the ratio of the maximum neurocranial height to the maximum width of the vault and the ratio of bregma-lambda chord to bregma-lambda arc. The results also revealed that some H. sapiens crania (modern and fossil) show the Neanderthal shape of the occipital plane and that the neurocranial height and shape of parietal midsagittal profile has an influence on occipital plane convexity in the hominins included in this study. This study suggests that the occurrence of the great convexity of the occipital plane in the Neanderthals and H. sapiens is a "by-product" of the relationship between the same neurocranial features and there is no convincing evidence that the Neanderthal occipital bun and the similar structure in H. sapiens develop during ontogeny in the same way.

Valve thrombosis following transcatheter aortic valve implantation: a systematic review.

Science.gov (United States)

Córdoba-Soriano, Juan G; Puri, Rishi; Amat-Santos, Ignacio; Ribeiro, Henrique B; Abdul-Jawad Altisent, Omar; del Trigo, María; Paradis, Jean-Michel; Dumont, Eric; Urena, Marina; Rodés-Cabau, Josep

2015-03-01

Despite the rapid global uptake of transcatheter aortic valve implantation, valve trombosis has yet to be systematically evaluated in this field. The aim of this study was to determine the clinical characteristics, diagnostic criteria, and treatment outcomes of patients diagnosed with valve thrombosis following transcatheter aortic valve implantation through a systematic review of published data. Literature published between 2002 and 2012 on valve thrombosis as a complication of transcatheter aortic valve implantation was identified through a systematic electronic search. A total of 11 publications were identified, describing 16 patients (mean age, 80 [5] years, 65% men). All but 1 patient (94%) received a balloon-expandable valve. All patients received dual antiplatelet therapy immediately following the procedure and continued to take either mono- or dual antiplatelet therapy at the time of valve thrombosis diagnosis. Valve thrombosis was diagnosed at a median of 6 months post-procedure, with progressive dyspnea being the most common symptom. A significant increase in transvalvular gradient (from 10 [4] to 40 [12] mmHg) was the most common echocardiographic feature, in addition to leaflet thickening. Thrombus was not directly visualized with echocardiography. Three patients underwent valve explantation, and the remaining received warfarin, which effectively restored the mean transvalvular gradient to baseline within 2 months. Systemic embolism was not a feature of valve thrombosis post-transcatheter aortic valve implantation. Although a rare, yet likely under-reported complication of post-transcatheter aortic valve implantation, progressive dyspnea coupled with an increasing transvalvular gradient on echocardiography within the months following the intervention likely signifies valve thrombosis. While direct thrombus visualization appears difficult, prompt initiation of oral anticoagulation therapy effectively restores baseline valve function. Copyright © 2014

The Lake Ndutu cranium and early Homo sapiens in Africa.

Science.gov (United States)

Rightmire, G P

1983-06-01

The partial cranium from Lake Ndutu, near Olduvai Gorge in northern Tanzania, has generally been viewed as Homo erectus, although points of similarity to H. sapiens have also been recognized. Bones of the vault are in fact quite thick, and the cranium is small. Length and breadth dimensions are comparable to those of earlier H. erectus from Koobi Fora and Ileret, and the Ndutu individual is more similar in size to O.H. 12 than to O.H. 9. Unfortunately, the facial skeleton and frontal bone are very incomplete, and little useful information can be obtained from these parts of the existing reconstruction. The parietals are also damaged, but the left temporal is more satisfactorily preserved, and the occiput is nearly complete. Occipital morphology, mastoid shape, and characteristics of the glenoid cavity and tympanic plate probably provide the best available guide to affinities of the Ndutu hominid. In many of these features the cranium resembles Broken Hill, Elandsfontein, and other African fossils referred to archaic H. sapiens. There are some similarities to modern humans also, but no ties to the Neanderthals of Europe. Allocation of Ndutu to an African subspecies of H. sapiens seems most appropriate, even if the pattern of relationships between such archaic populations and recent humans is still unclear.

Transcatheter closure of patent ductus arteriosus using the angled duct occluder

Energy Technology Data Exchange (ETDEWEB)

Yongwen, Qin; Xianxian, Zhao; Hong, Wu; Xing, Zheng; Jijun, Ding; Jianqiang, Hu [Second Military Medical Univ., Shanghai (China). Changhai Hospital, Dept. of Cardiology

2004-04-01

Objective: To assess the immediate efficacy of transcatheter closure of patent ductus arteriosus(PDA) using the angled duct occluder (ADO). Methods: 9 patients (1 male, 8 female) underwent transcatheter closure of PDA using the ADO. The mean PDA diameter at its narrowest segment was (5.8 {+-} 1.9) mm, ranging 3 to 10 mm. A 6 - 9F long sheath was used for the delivery of ADO. Results: The devices were deployed successfully in all patients. Angiographies showed no shunt across the device 15 min after the implantation of ADO. Within 1 week, echocardiography revealed complete closure in all patients. There were no complications. Conclusions: The transcatheter closure of PDA using ADO is an effective and safe procedure. The device matches with the shape of aortic cavity much more precisely than Amplatzer duct occluder. (authors)

Forearm articular proportions and the antebrachial index in Homo sapiens, Australopithecus afarensis and the great apes.

Science.gov (United States)

Williams, Frank L'Engle; Cunningham, Deborah L; Amaral, Lia Q

2015-12-01

When hominin bipedality evolved, the forearms were free to adopt nonlocomotor tasks which may have resulted in changes to the articular surfaces of the ulna and the relative lengths of the forearm bones. Similarly, sex differences in forearm proportions may be more likely to emerge in bipeds than in the great apes given the locomotor constraints in Gorilla, Pan and Pongo. To test these assumptions, ulnar articular proportions and the antebrachial index (radius length/ulna length) in Homo sapiens (n=51), Gorilla gorilla (n=88), Pan troglodytes (n=49), Pongo pygmaeus (n=36) and Australopithecus afarensis A.L. 288-1 and A.L. 438-1 are compared. Intercept-adjusted ratios are used to control for size and minimize the effects of allometry. Canonical scores axes show that the proximally broad and elongated trochlear notch with respect to size in H. sapiens and A. afarensis is largely distinct from G. gorilla, P. troglodytes and P. pygmaeus. A cluster analysis of scaled ulnar articular dimensions groups H. sapiens males with A.L. 438-1 ulna length estimates, while one A.L. 288-1 ulna length estimate groups with Pan and another clusters most closely with H. sapiens, G. gorilla and A.L. 438-1. The relatively low antebrachial index characterizing H. sapiens and non-outlier estimates of A.L. 288-1 and A.L. 438-1 differs from those of the great apes. Unique sex differences in H. sapiens suggest a link between bipedality and forearm functional morphology. Copyright © 2015 Elsevier GmbH. All rights reserved.

A Retrospective Study of 1,526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus.

Science.gov (United States)

Jin, Mei; Liang, Yong-Mei; Wang, Xiao-Fang; Guo, Bao-Jing; Zheng, Ke; Gu, Yan; Lyu, Zhen-Yu

2015-09-05

Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Median age and median weight were 4.0 years (range: 0.3-52.0 years old) and 15.3 kg (range: 4.5-91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%). Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently.

A Retrospective Study of 1526 Cases of Transcatheter Occlusion of Patent Ductus Arteriosus

Science.gov (United States)

Jin, Mei; Liang, Yong-Mei; Wang, Xiao-Fang; Guo, Bao-Jing; Zheng, Ke; Gu, Yan; Lyu, Zhen-Yu

2015-01-01

Background: Patent ductus arteriosus (PDA) is one of the most common congenital heart diseases and began to get treated by transcatheter occlusion since 1997 in China. Since then, several devices have been invented for occluding PDA. This study aimed to evaluate the technical feasibility, safety, and efficacy of transcatheter occlusion of PDA with different devices. Methods: One thousand five hundred and twenty-six patients (537 boys, 989 girls) with PDA from January 1997 to September 2014 underwent descending aortogram and transcatheter occlusion procedure. We retrospectively analyzed data of these patients, including gender, age, weight, size and morphology of PDA, and devices used in transcatheter occlusion, outcomes, and postoperational complications. Results: Median age and median weight were 4.0 years (range: 0.3–52.0 years old) and 15.3 kg (range: 4.5–91.0 kg), respectively. Mean ductal diameter, aortic ductal diameter, ductal length, and pulmonary artery pressure were 3.50 ± 2.15 mm, 10.08 ± 2.46 mm, 7.49 ± 3.02 mm, and 30.21 ± 17.28 mmHg, respectively. Morphology of PDA assessed by descending aortogram was of type A in 1428 patients, type B in 6 patients, type C in 79 patients, type D in 4 patients, and type E in 9 patients according to the classification of Krichenko. Of all the 1526 patients, 1497 patients underwent transcatheter PDA closure, among which 1492 were successful. Devices used were Amplatzer duct occluder I (ADO I, 1280, 85.8%), Cook detachable coils (116, 7.8%), ADO II (ADO II, 68, 4.6%), muscular VSD occluder (12, 0.8%), and Amplatzer vascular plug (16, 1.0%). Conclusions: Excellent occlusion rates with low complication rates were achieved with all devices regardless of PDA types. With transcatheter occlusion technique and devices developing, more patients with PDA can be treated with transcatheter closure both safely and efficiently. PMID:26315073

Transcatheter aortic valve implantation and cerebrovascular accidents.

Science.gov (United States)

Stortecky, Stefan; Wenaweser, Peter; Windecker, Stephan

2012-09-01

Transcatheter aortic valve implantation (TAVI) is an evidence-based treatment alternative for selected high-risk patients with symptomatic severe aortic stenosis as acknowledged in the most recent edition of the ESC Guidelines on Valvular Heart Disease 2012. However, periprocedural complications and in particular cerebrovascular accidents remain a matter of concern. While transcatheter heart valve technology continuously improves and the development of novel and even less invasive implantation techniques is on-going, cerebrovascular events complicating TAVI may abrogate the usual improvement in terms of prognosis and quality of life. This article describes the incidence of cerebrovascular events after cardiovascular procedures, provides an overview of the pathophysiological mechanisms as well as the impact on outcomes and provides some insights into preventive strategies as well as the acute management of these events.

A Comprehensive Exploration of Java Man: Bio-Cultural Evolution from Homo erectus to Homo sapiens

Directory of Open Access Journals (Sweden)

Samuel J Haryono

2017-02-01

An overlap of time period between Homo erectus and Homo sapiens has not been confirmed. In the history of man, there have been two missing links: one between man and ape, and one between progressive Homo erectus and archaic Homo sapiens.  Specimen dating on Java Man has been discrepant among research groups, and the use of molecular biology in ancient specimens has been a novelty. This study intends to use fossilised specimens, to harvest DNA to be sequenced for ribosomal DNA analysis for comparative phylogeny among ancient and modern man and other hominids. Dental calculus will be analysed to identify starch, carbohydrate, and protein to illustrate paleo dietary pattern. Soil samples will be examined for pollen and phytoliths to elaborate on ancient ecosystem. Blood samples will be procured from indigenous people along the riverflow region of Bengawan Solo to analyse modern human DNA. We hope that we may reconstruct the evolution pathway, construct the phylogenetic tree between ancient and modern hominids, and discover the uniqueness of Homo sapiens sapiens. Keywords: Java Man, Ribosomal DNA, Hominid Phylogenetic,

Transcatheter Closure of Patent Foramen Ovale: Devices and Technique.

Science.gov (United States)

Price, Matthew J

2017-10-01

Transcatheter closure of a patent foramen ovale (PFO) reduces the risk of recurrent cryptogenic stroke compared with medical therapy. PFO closure is a prophylactic procedure, and will not provide the patient with symptomatic improvement, except in cases of hypoxemia due to right-to-left shunt or possibly migraine headaches. Therefore, appropriate patient selection is critical, and procedural safety is paramount. Herein, we review key characteristics of the devices currently available for transcatheter PFO closure within the United States, and highlight key technical aspects of the PFO closure procedure that will maximize procedural success. Copyright © 2017 Elsevier Inc. All rights reserved.

Transcatheter closure of patent ductus arteriosus using the angled duct occluder

International Nuclear Information System (INIS)

Qin Yongwen; Zhao Xianxian; Wu Hong; Zheng Xing; Ding Jijun; Hu Jianqiang

2004-01-01

Objective: To assess the immediate efficacy of transcatheter closure of patent ductus arteriosus(PDA) using the angled duct occluder (ADO). Methods: 9 patients (1 male, 8 female) underwent transcatheter closure of PDA using the ADO. The mean PDA diameter at its narrowest segment was (5.8 ± 1.9) mm, ranging 3 to 10 mm. A 6 - 9F long sheath was used for the delivery of ADO. Results: The devices were deployed successfully in all patients. Angiographies showed no shunt across the device 15 min after the implantation of ADO. Within 1 week, echocardiography revealed complete closure in all patients. There were no complications. Conclusions: The transcatheter closure of PDA using ADO is an effective and safe procedure. The device matches with the shape of aortic cavity much more precisely than Amplatzer duct occluder. (authors)

Stringent DDI-based prediction of H. sapiens-M. tuberculosis H37Rv protein-protein interactions.

Science.gov (United States)

Zhou, Hufeng; Rezaei, Javad; Hugo, Willy; Gao, Shangzhi; Jin, Jingjing; Fan, Mengyuan; Yong, Chern-Han; Wozniak, Michal; Wong, Limsoon

2013-01-01

H. sapiens-M. tuberculosis H37Rv protein-protein interaction (PPI) data are very important information to illuminate the infection mechanism of M. tuberculosis H37Rv. But current H. sapiens-M. tuberculosis H37Rv PPI data are very scarce. This seriously limits the study of the interaction between this important pathogen and its host H. sapiens. Computational prediction of H. sapiens-M. tuberculosis H37Rv PPIs is an important strategy to fill in the gap. Domain-domain interaction (DDI) based prediction is one of the frequently used computational approaches in predicting both intra-species and inter-species PPIs. However, the performance of DDI-based host-pathogen PPI prediction has been rather limited. We develop a stringent DDI-based prediction approach with emphasis on (i) differences between the specific domain sequences on annotated regions of proteins under the same domain ID and (ii) calculation of the interaction strength of predicted PPIs based on the interacting residues in their interaction interfaces. We compare our stringent DDI-based approach to a conventional DDI-based approach for predicting PPIs based on gold standard intra-species PPIs and coherent informative Gene Ontology terms assessment. The assessment results show that our stringent DDI-based approach achieves much better performance in predicting PPIs than the conventional approach. Using our stringent DDI-based approach, we have predicted a small set of reliable H. sapiens-M. tuberculosis H37Rv PPIs which could be very useful for a variety of related studies. We also analyze the H. sapiens-M. tuberculosis H37Rv PPIs predicted by our stringent DDI-based approach using cellular compartment distribution analysis, functional category enrichment analysis and pathway enrichment analysis. The analyses support the validity of our prediction result. Also, based on an analysis of the H. sapiens-M. tuberculosis H37Rv PPI network predicted by our stringent DDI-based approach, we have discovered some

Edward Hopper: The Watercolors.

Science.gov (United States)

Johnson, Mark M.

2000-01-01

Provides information on Edward Hopper, focusing on his use of watercolors. Explores five of his watercolor paintings: (1) "The Mansard Roof"; (2) "House on Pamet River"; (3) "Light at Two Lights"; (4) "Saltillo Mansion"; and (5) "Roofs of Washington Square." Addresses the exhibition "Edward…

Impact of institutional volume and experience with CT interpretation on sizing of transcatheter aortic valves: A multicenter retrospective study

International Nuclear Information System (INIS)

Verma, Divya Ratan; Pershad, Yash; Pershad, Ashish; Fang, Kenith; Gellert, George; Morris, Michael F.

2016-01-01

Background: Computed tomography (CT) has become the standard imaging modality for pre-procedural aortic annular sizing prior to transcatheter aortic valve replacement (TAVR). We hypothesized that the accuracy of CT derived annular measurements would be greater at sites with higher TAVR procedural volume. Methods: Within a large integrated health system, TAVR was performed at low ( 75 cases). 181 patients underwent TAVR with a Sapien XT transcatheter heart valve (THV). Two blinded experienced readers independently remeasured the annulus on CT and compared their measurements to site reported measurements. Hypothetical THV sizes were chosen based on measurements from site CT reports and independent readers’ measurements, and compared to the implanted THV size. Results: Correlation between site reported measurements and independent readers measurements of mean annulus size varied between low-volume (r = 0.31, p = 0.18), intermediate-volume (r = 0.34, p = 0.01), and high-volume sites (r = 0.96, p < 0.01). On multivariate analysis, interpretation of ≥20 CT scans (OR 0.29; 95% CI 0.03–0.81; p 0.02) and high-volume site (OR 0.16; 95% CI 0.10–0.82; p 0.02) were associated with reduced mismatch between the site predicted THV size and independent readers predicted THV size. Mismatch between site predicted THV size and implanted THV size was associated with a worse 30-day composite of mortality, dialysis-dependent renal failure, cerebrovascular accident, new permanent pacemaker, and hospital readmission (55.3 vs. 38.7%; p = 0.05). Conclusions: Accuracy of CT aortic annular sizing is improved with higher individual experience and site TAVR volume. These findings should be confirmed in larger, prospective studies. - Highlights: • Accuracy of CT aortic annular sizing is improved with higher individual experience and site TAVR volume. • CT readers with experience interpreting ≥20 pre-TAVR CT scans had significantly improved accuracy in identifying the annulus. �

Autopsy after transcatheter aortic valve implantation

NARCIS (Netherlands)

van Kesteren, F.; Wiegerinck, E. M. A.; Rizzo, S.; Baan, J.; Planken, R. N.; von der Thüsen, J. H.; Niessen, H. W. M.; van Oosterhout, M. F. M.; Pucci, A.; Thiene, G.; Basso, C.; Sheppard, M. N.; Wassilew, K.; van der Wal, A. C.

2017-01-01

Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview of

Biological survey of the Prince Edward Islands, December 2008

Directory of Open Access Journals (Sweden)

P.G. Ryan

2010-01-01

Full Text Available A biological survey of the Prince Edward Islands took place in December 2008. The survey repeated an earlier survey of the populations of surface-nesting seabirds on both islands and of fur seals (Arctocephalus spp. and alien plants on Prince Edward Island in December 2001. Observations on burrowing seabirds, macro-invertebrates and plant communities on Prince Edward Island and an oceanographic survey of surrounding waters were also included. The survey confirmed many of the observations made on the earlier survey and permitted an assessment of trends in the abundance and distribution of biota since 2001.

Bone strength and athletic ability in hominids: Ardipithecus ramidus to Homo sapiens

Science.gov (United States)

Lee, S. A.

2013-03-01

The ability of the femur to resist bending stresses is determined by its midlength cross-sectional geometry, its length and the elastic properties of the mineral part of the bone. The animal's athletic ability, determined by a ``bone strength index,'' is limited by this femoral bending strength in relation to the loads on the femur. This analysis is applied to the fossil record for Homo sapiens, Homo neanderthalensis, Homo erectus, Homo habilis, Australopithecus afarensis and Ardipithecus ramidus. Evidence that the femoral bone strength index of modern Homo sapiens has weakened over the last 50,000 years is found.

Application of transcatheter arterial embolization in the intractable epistaxis

International Nuclear Information System (INIS)

Huang Zhaodong; Li Mingjun; Zhang Chuanwen

2005-01-01

Objective: To evaluate the value of transcatheter arterial embolization (TAE) in the treatment of intractable epistaxis. Methods: TAE using gel form or polyvinyl alcohol (PVA) particles of forty-one patients with intractable epistaxis were undertaken by the femoral artery approach, through selective catheterization of involved maxillary artery or the bleeding arteries for the stoppage of bleeding. Results: Of the forty-one patient, 39 cases were cured by once TAE and the other 2 with recurrent bleeding on the next day after the TAE, to whom a second interventional treatment full filled the requirement. Conclusions: Transcatheter arterial embolization is a simple, safe and effective treatment for the intractable epistaxis. (authors)

Preoperative computer tomography evaluation in transcatheter aortic valve replacement (TAVI)

International Nuclear Information System (INIS)

Groudeva, V.; Stoynova, V.; Trendafilova, D.; Dzhorgova, Y.; Nachev, G.

2014-01-01

Transcatheter aortic valve replacement is rapidly emerging technique alternative to surgery in high risk patients. Imaging and especially computer tomography is important in preoperative assessment of the aortic ring and the prosthetic valve choice. The aim of this study is to share authors initial experience in CT assessment of the aortic ring prior to Transcatheter aortic valve replacement. 49 patients (mean age 76,55) underwent 320 rows MDCT (Acquilon One) prior TAVI. Protocol involved scanning from thoracic inlet to common femoral arteries. Aortic root size, aortic diameter at the level of coronary sinuses and the sinotubular junction and distance to coronary ostia were evaluated on a Vitrea work station. MDCT established maximal aortic ring diameter from 18 to 31 mm mean 25,04 mm while the lesser rate was from 16 to 21 mm. Accordingly positioned prostheses were in 34,75% No. 23, in 49% - No. 26 and in16,3% - No. 29. MDCT is crucial in aortic valve assessment prior to TAVI in experienced hands and multidisciplinary team. (authors) Key words: TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVI). MDCT AORTIC VALVE ASSESSMENT

Üleilmastumisel on linna nägu / Edward W. Soja ; interv. Karin Paulus

Index Scriptorium Estoniae

Soja, Edward W.

2008-01-01

Ameerika linnageograaf Edward W. Soja räägib globaliseerumisest, linnastumisest, rikkuse ebaühtlasest jaotumisest, subkultuuridest, inimese identiteedi muutumisest, raamatust "Thirdspace". Lühidalt Edward W. Soja tegevusest, foto. Lisa: Kes on Edward W. Soja?

Transcatheter embolization of pseudoaneurysms complicating acute severe pancreatitis

International Nuclear Information System (INIS)

Wu Hanping; Liang Huimin; Zheng Chuansheng; Feng Gansheng

2005-01-01

Objective: To evaluate the therapeutic roles of transcatheter embolization in patients with pseudoaneurysms complicating acute severe pancreatitis. Methods: Seven patients who suffered from pseudoaneurysms complicating acute severe pancreatitis received abdominal angiography and were treated with transcatheter embolization. The angiographic findings, complications related to the procedure and post- embolization, and rebleeding were observed. Results: The pseudoaneurysms developed at the splenic artery (n=5), right gastroepiploic artery (n=1), and left gastric artery (n=1), respectively. Findings of active bleeding were observed in 3 patients. Six of them were embolized with coils, and the bleedings were stopped immediately. Rebleeding occurred 14-60 days after the embolization in 3 patients, and in one of them, another pseudo aneurysm was observed in repeated angiography and was successfully treated by repeated embolization. No causes of bleeding were found in repeated angiography in the other 2 patients, who died from severe hemorrhage. One pseudo aneurysm was embolized with gelfoam granule. The gastrointestinal bleeding was not controlled and the patient died 3 days later. Procedure related complications occurred in 2 patients. One was celiac trunk rupture during angiography, the other was intima dissecting in splenic artery. Severe post procedure complications occurred in none of the patients. Conclusion: Transcatheter embolization is safe and relatively effective in the management of pseudoaneurysms complicating acute severe pancreatitis. (authors)

Dental size reduction in Indonesian Homo erectus: Implications for the PU-198 premolar and the appearance of Homo sapiens on Java.

Science.gov (United States)

Polanski, Joshua M; Marsh, Hannah E; Maddux, Scott D

2016-01-01

The recent recovery of a hominin maxillary third premolar, PU-198, within the faunal collections from Punung Cave (East Java) has led to assertions that Homo sapiens appeared on Java between 143,000 and 115,000 years ago. The taxonomic assignment of PU-198 to H. sapiens was based predominantly on the small size of the specimen, following an analysis which found little to no overlap in premolar size between Homo erectus and terminal Pleistocene/Holocene H. sapiens. Here, we re-evaluate the use of size in the taxonomic assignment of PU-198 in light of 1) new buccolingual and mesiodistal measurements taken on the fossil, 2) comparisons to a larger sample of H. erectus and H. sapiens maxillary third premolars, and 3) evidence of a diachronic trend in post-canine dental size reduction among Javan H. erectus. Our results demonstrate PU-198 to be slightly larger than previously suggested, reveal substantial overlap in premolar size between H. erectus and H. sapiens, and indicate a statistically significant reduction in premolar size between early and late Javan H. erectus. Our findings cast doubt on the assignment of PU-198 to H. sapiens, and accordingly, question the appearance of H. sapiens on Java between 143,000 and 115,000 years ago. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of transcatheter therapy for hepatocellular carcinoma

International Nuclear Information System (INIS)

Yamada, Toshihiko

1990-01-01

The author proposed improvement of the criteria for the effects of transcatheter therapy for hepatocellular carcinoma. 104 patients were treated by transcatheter therapy. Their responses were determined by the usual criteria. Next, they were classified and evaluated in 3 groups, with the area of lipiodol deposition on CT for over 4 weeks regarded as nacrosis. The result was determined, and its relationship to prognosis was studied in light of the repeated therapy. By the usual criteria, only 10% of patients were judged as PR, and there were no differences between therapies. Many of the NC cases had low AFP levels with therapy. At the initial therapy, the ratio of cases with low AFP levels was higher and the survival time was longer in the A group. So the A group was judged as most effective. Clinically, 10 patients were considered most benefitted by therapy. They were considered the A group, but all were judged as NC. Considering the effects of repeated therapy, 10 patients with NC were judged as the A-max group. Prognosis was poor in patients of the B-max and C-max groups. These results indicate that judgement by the usual criteria was inconsistent with clinical condition. It was improved by regarding the area of lipiodol deposition on CT for over 4 weeks as necrosis. Estimations of effects and prognosis were made more accurate by considering repeated therapy. Thus, the proposed improvement of the criteria by CT is more useful to estimate transcatheter therapy of the hepatocellular carcinoma. (author)

Transcatheter Therapies for Treating Tricuspid Regurgitation.

Science.gov (United States)

Rodés-Cabau, Josep; Hahn, Rebecca T; Latib, Azeem; Laule, Michael; Lauten, Alexander; Maisano, Francesco; Schofer, Joachim; Campelo-Parada, Francisco; Puri, Rishi; Vahanian, Alec

2016-04-19

Tricuspid valve (TV) disease has been relatively neglected, despite the known association between severe tricuspid regurgitation (TR) and mortality. Few patients undergo isolated tricuspid surgery, which remains associated with high in-hospital mortality rates, particularly in patients with prior left-sided valve surgery. Patients with severe TR are often managed medically for years before TV repair or replacement. Current guidelines recommend TV repair in the presence of a dilated tricuspid annulus at the time of a left-sided valve surgical intervention, even if regurgitation is mild. This proposed algorithm aims to prevent the inevitable progression to severe TR and the need for a second surgical intervention. Recently, novel transcatheter treatment options were developed for treating patients with severe TR and right heart failure with prohibitive surgical risk. Here we describe currently available transcatheter treatment options for severe TR implanted at different levels: the junction between vena cavae and right atrium; the tricuspid annulus; or between TV leaflets, improving coaptation. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Emergency transcatheter closure of patent ductus arteriosus complicated by severe pneumonia in infants

International Nuclear Information System (INIS)

Huang Xiyong; Xiao Yunbin; Chen Zhi; Wang Xiang; Wang Xun

2014-01-01

Objective: To evaluate the efficacy and safety of emergency transcatheter occlusion of patent ductus arteriosus associated with severe pneumonia in infants. Methods: During the period from Oct. 2011 to May 2012, 12 infants with patent ductus arteriosus complicated by severe pneumonia were admitted to the hospital. The infants had repeated episodes of pneumonia together with heart failure. Emergency transcatheter occlusion of patent ductus arteriosus was carried out in all infants. After the treatment the use of anti-bacterial drugs and cardiac stimulants was kept on. Routine examinations of blood and urine were made 24 hours after the management. Two-dimensional and color Doppler echocardiography, chest radiograph and electrocardiogram were performed at 24 hours, 1, 3, and 6 months after the surgery. The results were analyzed. Results: After emergency transcatheter closure, all patients recovered fully at the time of discharge. No intervention-related major complications occurred during short-term follow-up period. Conclusion: For the treatment of patent ductus arteriosus associated with severe pneumonia in infants, emergency transcatheter occlusion therapy is effective and safe. Optimal surgery time together with proper perioperative management is the key to ensure a successful operation. (authors)

Genetic, physiologic and ecogeographic factors contributing to variation in Homo sapiens: Homo floresiensis reconsidered.

Science.gov (United States)

Richards, Gary D

2006-11-01

A new species, Homo floresiensis, was recently named for Pleistocene hominid remains on Flores, Indonesia. Significant controversy has arisen regarding this species. To address controversial issues and refocus investigations, I examine the affinities of these remains with Homo sapiens. Clarification of problematic issues is sought through an integration of genetic and physiological data on brain ontogeny and evolution. Clarification of the taxonomic value of various 'primitive' traits is possible given these data. Based on this evidence and using a H. sapiens morphological template, models are developed to account for the combination of features displayed in the Flores fossils. Given this overview, I find substantial support for the hypothesis that the remains represent a variant of H. sapiens possessing a combined growth hormone-insulin-like growth factor I axis modification and mutation of the MCPH gene family. Further work will be required to determine the extent to which this variant characterized the population.

The dispersal of Homo sapiens across southern Asia: how early, how often, how complex?

Science.gov (United States)

Dennell, Robin; Petraglia, Michael D.

2012-07-01

The timing and the paths of colonization of southern Asia by Homo sapiens are poorly known, though many population geneticists, paleoanthropologists, and archaeologists have contended that this process began with dispersal from East Africa, and occurred between 60,000 and 40,000 years ago. However, the evidence for this scenario is very weak, particularly the lack of human skeletal evidence between the Levant and Borneo before 40 ka, and other explanations are possible. Here we argue that environmental and archaeological information is increasingly indicating the likelihood that H. sapiens exited Africa much earlier than commonly thought, and may have colonized much of southern Asia well before 60,000 years ago. Additionally, we cannot exclude the possibility that several dispersal events occurred, from both North and East Africa, nor the likelihood that early populations of H. sapiens in southern Asia interbred with indigenous populations of Neanderthals, Denisovans and Homo erectus. The population history of southern Asia during the Upper Pleistocene is likely far more complex than currently envisaged.

Edward Said and "Orientalism"

Science.gov (United States)

Chronicle of Higher Education, 2007

2007-01-01

In the nearly 30 years since Edward Said published the hugely influential Orientalism, his indictment of racism and imperialism in Western scholarship on the Orient has had its share of plaudits and condemnations. Now Robert Irwin, the Middle East editor of The Times Literary Supplement, has reignited the controversy with his broadside against the…

Initial experience of two national centers in transcatheter aortic prosthesis implantation.

Science.gov (United States)

Lluberas, Sebastián; Abizaid, Alexandre; Siqueira, Dimytri; Ramos, Auristela; Costa, J Ribamar; Arrais, Magaly; Kambara, Antônio; Bihan, David Le; Sousa, Amanda; Sousa, J Eduardo

2014-04-01

Transcatheter aortic valve implantation is an effective alternative to surgical treatment of severe aortic stenosis in patients who are inoperable or at high surgical risk. To report the immediate and follow-up clinical and echocardiographic results of the initial experience of transcatheter aortic valve implantation. From 2009 June to 2013 February, 112 patients underwent transcatheter aortic valve implantation. Mean age was 82.5 ± 6.5 years, and the logistic EuroSCORE was 23.6 ± 13.5. Procedural success was 84%. After the intervention, a reduction in the mean systolic gradient was observed (pre: 54.7 ± 15.3 vs. post: 11.7 ± 4.0 mmHg; p < 0.01). Cerebrovascular accidents occurred in 3.6%, vascular complications in 19% and permanent pacemaker was required by 13% of the patients. Thirty-day mortality and at follow-up of 16 ± 11 months was 14% and 8.9% respectively. The presence of chronic obstructive pulmonary disease was the only predictor of mortality at 30 days and at follow-up. During follow up, aortic valve area and mean systolic gradient did not change significantly. Transcatheter aortic valve implantation is an effective and safe procedure for the treatment of aortic stenosis in high-surgical risk or inoperable patients. The presence of chronic obstructive pulmonary disease was the only independent predictor of mortality identified both in the first month post-intervention and at follow-up.

MDCT angiography and transcatheter embolization in management ...

African Journals Online (AJOL)

Hassan Abdelsalam

2015-12-18

Dec 18, 2015 ... 14 patients did not have a MDCT and proceeded straight to angiography;. 6 of them showed active bleeding on angiography. Conclusion: MDCT is an excellent technique before angiography and embolization in cases with acute gastrointestinal bleeding. Transcatheter embolization is an effective tool for ...

Pacemaker implantation rate after transcatheter aortic valve implantation with early and new-generation devices: a systematic review.

Science.gov (United States)

van Rosendael, Philippe J; Delgado, Victoria; Bax, Jeroen J

2018-02-06

The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) with new-generation prostheses remains debated. This systematic review analyses the incidence of PPI after TAVI with new-generation devices and evaluates the electrical, anatomical, and procedural factors associated with PPI. In addition, the incidence of PPI after TAVI with early generation prostheses was reviewed for comparison. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, this systematic review screened original articles published between October 2010 and October 2017, reporting on the incidence of PPI after implantation of early and new-generation TAVI prostheses. Of the 1406 original articles identified in the first search for new-generation TAVI devices, 348 articles were examined for full text, and finally, 40 studies (n = 17 139) were included. The incidence of a PPI after the use of a new-generation TAVI prosthesis ranged between 2.3% and 36.1%. For balloon-expandable prostheses, the PPI rate remained low when using an early generation SAPIEN device (ranging between 2.3% and 28.2%), and with the new-generation SAPIEN 3 device, the PPI rate was between 4.0% and 24.0%. For self-expandable prostheses, the PPI rates were higher with the early generation CoreValve device (16.3-37.7%), and despite a reduction in PPI rates with the new Evolut R, the rates remained relatively higher (14.7-26.7%). When dividing the studies according to the highest (>26.0%) and the lowest (left ventricular outflow tract (anatomical factor), and balloon valvuloplasty and depth of implantation (procedural factors) were associated with increased risk of PPI. The rate of PPI after TAVI with new-generation devices is highly variable. Specific recommendations for implantation of each prosthesis, taking into consideration the presence of pre-existent conduction abnormalities and

Transcatheter closure of atrial septal defect in a patient with Noonan syndrome after corrective surgery

Directory of Open Access Journals (Sweden)

Mangovski Ljupčo

2015-01-01

Full Text Available Introduction. Transcatheter atrial septal defect (ASD closure is considered to be a gold standard for patients with the suitable anatomy as compared to cardiac surgery. Reocurrence of ASD after surgical closure is a very rare late complication which can be successfully managed with transcatheter procedure. Case report. We reported a female patient with Noonan syndrome who presented with hemodinamically significant ASD 37 years after the corrective cardiac surgery. Due to numerous comorbidities which included severe kyphoscoliosis, pectus excavatum and multiple surgeries we decided to perform transcatheter closure of ASD. The procedure itself was very challenging due to the patient’s short stature and heart’s orientation in the chest, but was performed successfully. The subsequent follow-up was uneventful and the patient reported improvement in the symptoms. Conclusion. Transcatheter closure of ASD in a patient with Noonan syndrome with the history of surgically corrected ASD can be performed successfully, despite challenging chest anatomy.

Transcatheter embolization therapy of the gastrointestinal hemorrhage

International Nuclear Information System (INIS)

Sim, Jae In; Park, Auh Whan; Ryeom, Hun Kyu; Kim, Yong Joo

1994-01-01

To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. The study was based on retrospective analysis of twelve cases(8 men, 4 woman) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(1), typhoid fever(1), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 required surgery and none showed serious complication. Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding

Transcatheter embolization therapy of the gastrointestinal hemorrhage

Energy Technology Data Exchange (ETDEWEB)

Sim, Jae In; Park, Auh Whan; Ryeom, Hun Kyu; Kim, Yong Joo [Kyungpook National University Hospital, Daegu (Korea, Republic of)

1994-05-15

To evaluate the effectiveness of transcatheter embolization for the treatment of massive gastrointestinal arterial bleeding. The study was based on retrospective analysis of twelve cases(8 men, 4 woman) including two patients with hemobilia in which transcatheter embolization was attempted for the control of massive gastrointestinal bleeding from March 1987 to October 1993. Clinical diagnoses of these patients were peptic ulcer(5), pseudoaneurysm formation(3) following percutaneous transhepatic biliary drainage or traffic accident, stomach cancer(1), typhoid fever(1), duodenal leiomyoma(1) and Osler-Weber-Rendu disease (1). Embolized vessels are as follows: gastroduodenal artery(6), left gastric artery(2), ileocolic artery(2), and hepatic artery(2). Embolization was effective in immediate control of bleeding in all patients. Although five of the six patients who had undergone embolization of the gastroduodenal artery developed rebleeding within 24 hour, only 2 required surgery and none showed serious complication. Embolization therapy is safe and effective initial treatment of choice for life-threatening massive gastrointestinal bleeding.

Mandibular ramus shape variation and ontogeny in Homo sapiens and Homo neanderthalensis.

Science.gov (United States)

Terhune, Claire E; Ritzman, Terrence B; Robinson, Chris A

2018-04-27

As the interface between the mandible and cranium, the mandibular ramus is functionally significant and its morphology has been suggested to be informative for taxonomic and phylogenetic analyses. In primates, and particularly in great apes and humans, ramus morphology is highly variable, especially in the shape of the coronoid process and the relationship of the ramus to the alveolar margin. Here we compare ramus shape variation through ontogeny in Homo neanderthalensis to that of modern and fossil Homo sapiens using geometric morphometric analyses of two-dimensional semilandmarks and univariate measurements of ramus angulation and relative coronoid and condyle height. Results suggest that ramus, especially coronoid, morphology varies within and among subadult and adult modern human populations, with the Alaskan Inuit being particularly distinct. We also identify significant differences in overall anterosuperior ramus and coronoid shapes between H. sapiens and H. neanderthalensis, both in adults and throughout ontogeny. These shape differences are subtle, however, and we therefore suggest caution when using ramus morphology to diagnose group membership for individual specimens of these taxa. Furthermore, we argue that these morphologies are unlikely to be representative of differences in masticatory biomechanics and/or paramasticatory behaviors between Neanderthals and modern humans, as has been suggested by previous authors. Assessments of ontogenetic patterns of shape change reveal that the typical Neanderthal ramus morphology is established early in ontogeny, and there is little evidence for divergent postnatal ontogenetic allometric trajectories between Neanderthals and modern humans as a whole. This analysis informs our understanding of intraspecific patterns of mandibular shape variation and ontogeny in H. sapiens and can shed further light on overall developmental and life history differences between H. sapiens and H. neanderthalensis. Copyright �

Similarity analysis between chromosomes of Homo sapiens and monkeys with correlation coefficient, rank correlation coefficient and cosine similarity measures.

Science.gov (United States)

Someswara Rao, Chinta; Viswanadha Raju, S

2016-03-01

In this paper, we consider correlation coefficient, rank correlation coefficient and cosine similarity measures for evaluating similarity between Homo sapiens and monkeys. We used DNA chromosomes of genome wide genes to determine the correlation between the chromosomal content and evolutionary relationship. The similarity among the H. sapiens and monkeys is measured for a total of 210 chromosomes related to 10 species. The similarity measures of these different species show the relationship between the H. sapiens and monkey. This similarity will be helpful at theft identification, maternity identification, disease identification, etc.

Transcatheter arterial embolization for congenital renal arteriovenous malformation

International Nuclear Information System (INIS)

Zhou Jun; Hu Tingyang; Yuan Jianhua; Yu Wenqiang

2008-01-01

Objective: To evaluate the effectiveness of transcatheter arterial embolization for congenital renal arteriovenous malformation. Methods: Seven cases of congenital renal arteriovenous malformation causing gross hematuria were retrospectively studied. All of 7 cases were demonstrated by means of angiography and then the catheter was placed superselectively into the involved arterial end of the malformation undertaking embolization with gelfoam, dehydrated ethanol, coils, etc. Results: All the malformations of the 7 cases were successfully embolized with stoppage of gross hematuria within 24 hours. No serious complications occurred except lumbago, fever, gastrointestinal reaction for one week. There was no recurrence of haematuria and the renal function was also normal in all cases during the follow-up for 36 to 98 months. Conclusions: Transcatheter renal arterial angiography and embolization are the important and effective management for the diagnosis and treatment of congenital renal arteriovenous malformation. (authors)

Therapeutic effect of transcatheter arterial infusion chemotherapy in the treatment of advanced pancreatic cancer

International Nuclear Information System (INIS)

Lin Junhua; Song Mingzhi; Zhang Yuanyuan; Xu Yiyu; Chen Jing

2001-01-01

Objective: To evaluate the clinical efficacy of transcatheter arterial infusion (TAI) or transcatheter arterial chemo-embolization (TACE) in the treatment of advanced pancreatic cancer. Methods: 36 cases of advanced pancreatic cancer were divided into two groups, 18 cases were treated with TAI or TACE (group A), other 18 cases were treated with systemic chemotherapy (group B). Results: The clinical benefit response rate of the group A was 55.6% (10/18) and that of the group B was 16.7%(3/18), respectively (P 0.05). Conclusions: In the transcatheter arterial infusion group, no survival advantage could be demonstrated when compared with the controls, but TAI could effectively increase clinical benefit response and improve the quality of life of advanced pancreatic cancer

Systematic review of the cost-effectiveness of transcatheter interventions for valvular heart disease.

Science.gov (United States)

Gialama, Fotini; Prezerakos, Panagiotis; Apostolopoulos, Vasilis; Maniadakis, Nikolaos

2018-04-01

Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach. Twenty-four, good to high quality, evaluations were identified, representing different viewpoints, modelling techniques and willingness-to-pay thresholds. Studies show that in high-risk patients with symptomatic aortic stenosis, TAVI may be cost-effective compared with medical management (MM) across many health care settings. In contrast, studies of TAVI compared with surgical aortic valve replacement (SAVR) yield conflicting and inconclusive results. The limited data available show that TMVR may also be cost-effective relative to MM in mitral valve disease. Existing evidence indicates that transcatheter techniques may be cost-effective options, relative to MM, in high-risk patients with valvular disease. Nonetheless, more research is needed to establish their economic value further, to investigate the drives of cost-effectiveness, and to evaluate surgical with transcatheter techniques in aortic valvular disease.

RNA editing differently affects protein-coding genes in D. melanogaster and H. sapiens.

Science.gov (United States)

Grassi, Luigi; Leoni, Guido; Tramontano, Anna

2015-07-14

When an RNA editing event occurs within a coding sequence it can lead to a different encoded amino acid. The biological significance of these events remains an open question: they can modulate protein functionality, increase the complexity of transcriptomes or arise from a loose specificity of the involved enzymes. We analysed the editing events in coding regions that produce or not a change in the encoded amino acid (nonsynonymous and synonymous events, respectively) in D. melanogaster and in H. sapiens and compared them with the appropriate random models. Interestingly, our results show that the phenomenon has rather different characteristics in the two organisms. For example, we confirm the observation that editing events occur more frequently in non-coding than in coding regions, and report that this effect is much more evident in H. sapiens. Additionally, in this latter organism, editing events tend to affect less conserved residues. The less frequently occurring editing events in Drosophila tend to avoid drastic amino acid changes. Interestingly, we find that, in Drosophila, changes from less frequently used codons to more frequently used ones are favoured, while this is not the case in H. sapiens.

The labour ward analgesic service at King Edward VIII Hospital ...

African Journals Online (AJOL)

The labour ward analgesic service at King Edward VIII. Hospital, Durban. D. A. ROCKE, C. C. ROUT, H. D. RUSSELL, S. SINGH. Abstract The provision of analgesic services to the labour ward at King Edward VIII Hospital was studied during a I-week period. Of249 patients, 113 (45%) received no analgesia whatsoever.

Edward Said on Popular Music

NARCIS (Netherlands)

Capitain, W.H.P.

2017-01-01

Although Edward Said, generally known as one of the founders of postcolonial studies, has written extensively on music, he almost completely ignores popular music. However, the few moments in which he does reflect on popular music are highly revealing. In this article I provide a comprehensive

Reading Edward Said in Myanmar

DEFF Research Database (Denmark)

Jensen, Lars

2014-01-01

Twenty years after its publication, Culture and Imperialism continues to be seen as part of the defining moment of postcolonial readings of our contemporary world. The anniversary marks an opportunity to revisit the landscape of culture and imperialism as envisaged by Edward Said, but also to dis...

Transcatheter aortic-valve replacement with a self-expanding prosthesis.

Science.gov (United States)

Adams, David H; Popma, Jeffrey J; Reardon, Michael J; Yakubov, Steven J; Coselli, Joseph S; Deeb, G Michael; Gleason, Thomas G; Buchbinder, Maurice; Hermiller, James; Kleiman, Neal S; Chetcuti, Stan; Heiser, John; Merhi, William; Zorn, George; Tadros, Peter; Robinson, Newell; Petrossian, George; Hughes, G Chad; Harrison, J Kevin; Conte, John; Maini, Brijeshwar; Mumtaz, Mubashir; Chenoweth, Sharla; Oh, Jae K

2014-05-08

We compared transcatheter aortic-valve replacement (TAVR), using a self-expanding transcatheter aortic-valve bioprosthesis, with surgical aortic-valve replacement in patients with severe aortic stenosis and an increased risk of death during surgery. We recruited patients with severe aortic stenosis who were at increased surgical risk as determined by the heart team at each study center. Risk assessment included the Society of Thoracic Surgeons Predictor Risk of Mortality estimate and consideration of other key risk factors. Eligible patients were randomly assigned in a 1:1 ratio to TAVR with the self-expanding transcatheter valve (TAVR group) or to surgical aortic-valve replacement (surgical group). The primary end point was the rate of death from any cause at 1 year, evaluated with the use of both noninferiority and superiority testing. A total of 795 patients underwent randomization at 45 centers in the United States. In the as-treated analysis, the rate of death from any cause at 1 year was significantly lower in the TAVR group than in the surgical group (14.2% vs. 19.1%), with an absolute reduction in risk of 4.9 percentage points (upper boundary of the 95% confidence interval, -0.4; P<0.001 for noninferiority; P = 0.04 for superiority). The results were similar in the intention-to-treat analysis. In a hierarchical testing procedure, TAVR was noninferior with respect to echocardiographic indexes of valve stenosis, functional status, and quality of life. Exploratory analyses suggested a reduction in the rate of major adverse cardiovascular and cerebrovascular events and no increase in the risk of stroke. In patients with severe aortic stenosis who are at increased surgical risk, TAVR with a self-expanding transcatheter aortic-valve bioprosthesis was associated with a significantly higher rate of survival at 1 year than surgical aortic-valve replacement. (Funded by Medtronic; U.S. CoreValve High Risk Study ClinicalTrials.gov number, NCT01240902.).

Transcatheter arterial embolization for traumatic bleeding control

International Nuclear Information System (INIS)

Ryu, Choon Wook; Lee, Sang Kwon; Suh, Kyung Jin; Kim, Tae Heon; Kim, Yong Joo; Kang, Duck Sik

1989-01-01

Angiography is essential for the detection of bleeding vessels in traumatic vascular injury. Immediately after the diagnosis, transcatheter embolization can be performed for the control of bleeding effectively and easily with proper use of embolic materials. Transcatheter embolization is believed to be the treatment of choice when emergency control is needed, where surgical approach is difficult and in those who are poor candidate for surgery. We have tried bleeding control in 18 cases of trauma over recent 4 years. The results were as follows; 1. Causes of bleeding(cases): Blunt or penetrating trauma (10), latrogenic trauma (8), (Postoperative (5), Needle biopsy (2), Percutaneous hepatic procedure (1)) 2. Embolized vessels: Renal artery branches (8), Hepatic artery branches (2), Arteries supplying chest wall (2), External carotid artery branches (3), Internal carotid artery (1), Circumflex humeral artery (1), Internal iliac artery branches (1). 3. Embolic agents: Gelfoam cubes (16), Stainless steel coils (3), Detachable latex balloon (1). 4. Successful bleeding control was achieved in 17 cases and reduction of the amount of bleeding in one case without significant complications

Stringent homology-based prediction of H. sapiens-M. tuberculosis H37Rv protein-protein interactions.

Science.gov (United States)

Zhou, Hufeng; Gao, Shangzhi; Nguyen, Nam Ninh; Fan, Mengyuan; Jin, Jingjing; Liu, Bing; Zhao, Liang; Xiong, Geng; Tan, Min; Li, Shijun; Wong, Limsoon

2014-04-08

H. sapiens-M. tuberculosis H37Rv protein-protein interaction (PPI) data are essential for understanding the infection mechanism of the formidable pathogen M. tuberculosis H37Rv. Computational prediction is an important strategy to fill the gap in experimental H. sapiens-M. tuberculosis H37Rv PPI data. Homology-based prediction is frequently used in predicting both intra-species and inter-species PPIs. However, some limitations are not properly resolved in several published works that predict eukaryote-prokaryote inter-species PPIs using intra-species template PPIs. We develop a stringent homology-based prediction approach by taking into account (i) differences between eukaryotic and prokaryotic proteins and (ii) differences between inter-species and intra-species PPI interfaces. We compare our stringent homology-based approach to a conventional homology-based approach for predicting host-pathogen PPIs, based on cellular compartment distribution analysis, disease gene list enrichment analysis, pathway enrichment analysis and functional category enrichment analysis. These analyses support the validity of our prediction result, and clearly show that our approach has better performance in predicting H. sapiens-M. tuberculosis H37Rv PPIs. Using our stringent homology-based approach, we have predicted a set of highly plausible H. sapiens-M. tuberculosis H37Rv PPIs which might be useful for many of related studies. Based on our analysis of the H. sapiens-M. tuberculosis H37Rv PPI network predicted by our stringent homology-based approach, we have discovered several interesting properties which are reported here for the first time. We find that both host proteins and pathogen proteins involved in the host-pathogen PPIs tend to be hubs in their own intra-species PPI network. Also, both host and pathogen proteins involved in host-pathogen PPIs tend to have longer primary sequence, tend to have more domains, tend to be more hydrophilic, etc. And the protein domains from both

Impact of institutional volume and experience with CT interpretation on sizing of transcatheter aortic valves: A multicenter retrospective study

Energy Technology Data Exchange (ETDEWEB)

Verma, Divya Ratan [Cardiovascular Institute, Banner University Medical Center, Phoenix, AZ (United States); Division of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ (United States); Pershad, Yash [Department of Radiology, Banner University Medical Center, Phoenix, AZ (United States); Pershad, Ashish [Cardiovascular Institute, Banner University Medical Center, Phoenix, AZ (United States); Division of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ (United States); Fang, Kenith [Cardiovascular Institute, Banner University Medical Center, Phoenix, AZ (United States); Division of Cardiothoracic Surgery, Banner University Medical Center, Phoenix, AZ (United States); Gellert, George [Cardiovascular Institute, Banner University Medical Center, Phoenix, AZ (United States); Department of Anesthesiology, Banner University Medical Center, Phoenix, AZ (United States); Morris, Michael F., E-mail: mfmorris@mail.arizona.edu [Cardiovascular Institute, Banner University Medical Center, Phoenix, AZ (United States); Department of Radiology, Banner University Medical Center, Phoenix, AZ (United States)

2016-12-15

Background: Computed tomography (CT) has become the standard imaging modality for pre-procedural aortic annular sizing prior to transcatheter aortic valve replacement (TAVR). We hypothesized that the accuracy of CT derived annular measurements would be greater at sites with higher TAVR procedural volume. Methods: Within a large integrated health system, TAVR was performed at low (<40 cases), intermediate (40–75 cases), and high-volume sites (>75 cases). 181 patients underwent TAVR with a Sapien XT transcatheter heart valve (THV). Two blinded experienced readers independently remeasured the annulus on CT and compared their measurements to site reported measurements. Hypothetical THV sizes were chosen based on measurements from site CT reports and independent readers’ measurements, and compared to the implanted THV size. Results: Correlation between site reported measurements and independent readers measurements of mean annulus size varied between low-volume (r = 0.31, p = 0.18), intermediate-volume (r = 0.34, p = 0.01), and high-volume sites (r = 0.96, p < 0.01). On multivariate analysis, interpretation of ≥20 CT scans (OR 0.29; 95% CI 0.03–0.81; p 0.02) and high-volume site (OR 0.16; 95% CI 0.10–0.82; p 0.02) were associated with reduced mismatch between the site predicted THV size and independent readers predicted THV size. Mismatch between site predicted THV size and implanted THV size was associated with a worse 30-day composite of mortality, dialysis-dependent renal failure, cerebrovascular accident, new permanent pacemaker, and hospital readmission (55.3 vs. 38.7%; p = 0.05). Conclusions: Accuracy of CT aortic annular sizing is improved with higher individual experience and site TAVR volume. These findings should be confirmed in larger, prospective studies. - Highlights: • Accuracy of CT aortic annular sizing is improved with higher individual experience and site TAVR volume. • CT readers with experience interpreting ≥20 pre-TAVR CT scans had

Sizing of patent ductus arteriosus in adults for transcatheter closure using the balloon pull-through technique.

Science.gov (United States)

Shafi, Nabil A; Singh, Gagan D; Smith, Thomas W; Rogers, Jason H

2018-05-01

To describe a novel balloon sizing technique used during adult transcatheter patent ductus arteriosus (PDA) closure. In addition, to determine the clinical and procedural outcomes in six patients who underwent PDA balloon sizing with subsequent deployment of a PDA occluder device. Transcatheter PDA closure in adults has excellent safety and procedural outcomes. However, PDA sizing in adults can be challenging due to variable defect size, high flow state, or anatomical complexity. We describe a series of six cases where the balloon- pull through technique was successfully performed for PDA sizing prior to transcatheter closure. Consecutive adult patients undergoing adult PDA closure at our institution were studied retrospectively. A partially inflated sizing balloon was pulled through the defect from the aorta into the pulmonary artery and the balloon waist diameter was measured. Procedural success and clinical outcomes were obtained. Six adult patients underwent successful balloon pull-through technique for PDA sizing during transcatheter PDA closure, since conventional angiography often gave suboptimal opacification of the defect. All PDAs were treated with closure devices based on balloon PDA sizing with complete closure and no complications. In three patients that underwent preprocedure computed tomography, the balloon size matched the CT derived measurements. The balloon pull-through technique for PDA sizing is a safe and accurate sizing modality in adults undergoing transcatheter PDA closure. © 2017 Wiley Periodicals, Inc.

Transcatheter Closure of Patent Foramen Ovale: A Single Center Experience

Directory of Open Access Journals (Sweden)

Ivan Milev

2016-10-01

CONCLUSIONS: Percutaneous transcatheter closure of PFO is a safe and effective procedure showing mid-term relief of neurological symptoms in patients as well as significant reduction of migraine symptoms.

New records of Acari from the sub-Antarctic Prince Edward Islands

NARCIS (Netherlands)

Marshall, D.J.; Gremmen, N.J.M.; Coetzee, L.; Oconnor, B.M.; Pugh, P.J.A.; Theron, P.D.; Ueckermann, E.A.

1999-01-01

Sixty species of Acari are recorded from the sub-Antarctic Marion and Prince Edward Islands (the Prince Edward archipelago). Twenty of the 45 species collected on recent expeditions are new and currently undescribed. Other new taxa include a family of Mesostigmata, four new genera, and the first

Platypnea-Orthodeoxia Syndrome after Transcatheter Aortic Valve Implantation

Directory of Open Access Journals (Sweden)

Andrew K. Roy

2016-01-01

Full Text Available Progressive dyspnea and hypoxaemia in the subacute phase after transcatheter aortic valve implantation (TAVI are uncommon and warrant immediate assessment of valve and prosthesis leaflet function to exclude thrombosis, as well as investigation for other causes related to the procedure, such as left ventricular dysfunction, pulmonary embolism, and respiratory sepsis. In this case, we report the observation of a patient presenting two weeks after TAVI with arterial hypoxaemia in an upright position, relieved by lying flat, and coupled with an intracardiac shunt detected on echocardiography in the absence of pulmonary hypertension, raising the suspicion of Platypnea-Orthodeoxia Syndrome (POS. Invasive intracardiac haemodynamic assessment showed a significant right-to-left shunt (Qp/Qs = 0.74, which confirmed the diagnosis, with subsequent closure of the intracardiac defect resulting in immediate relief of symptoms and hypoxaemia. To our knowledge, this is the first reported case of an interatrial defect and shunt causing Platypnea-Orthodeoxia Syndrome after transcatheter aortic valve implantation, resolved by percutaneous device closure.

Creation of transcatheter aortopulmonary and cavopulmonary shunts using magnetic catheters: feasibility study in swine.

Science.gov (United States)

Levi, Daniel S; Danon, Saar; Gordon, Brent; Virdone, Nicky; Vinuela, Fernando; Shah, Sanjay; Carman, Greg; Moore, John W

2009-05-01

Surgical shunts are the basic form of palliation for many types of congenital heart disease. The Glenn shunt (superior cavopulmonary connection) and central shunt (aortopulmonary connection) represent surgical interventions that could potentially be accomplished by transcatheter techniques. We sought to investigate the efficacy of using neodymium iron boron (NdFeB) magnetic catheters to create transcatheter cavopulmonary and aortopulmonary shunts. NdFeB magnets were machined and integrated into catheters. "Target" catheters were placed in the pulmonary arteries (PAs), and radiofrequency "perforation" catheters were placed in either the descending aorta (DAo) for central shunts or the superior vena cava (SVC) for Glenn shunts. The magnet technique or "balloon target" method was used to pass wires from the DAo or the SVC into the PA. Aortopulmonary and cavopulmonary connections were then created using Atrium iCAST covered stents. Magnet catheters were used to perforate the left pulmonary artery from the DAo, thereby establishing a transcatheter central shunt. Given the orientation of the vasculature, magnetic catheters could not be used for SVC-to-PA connections; however, perforation from the SVC to the right pulmonary artery was accomplished with a trans-septal needle and balloon target. Transcatheter Glenn or central shunts were successfully created in four swine.

Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves

DEFF Research Database (Denmark)

Dvir, Danny; Webb, John; Brecker, Stephen

2012-01-01

Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry....

A Romanian Jew in Hollywood: Edward G. Robinson

Directory of Open Access Journals (Sweden)

Moldovan Raluca

2014-08-01

Full Text Available The present study aims to investigate the contribution that actor Edward G. Robinson brought to the American film industry, beginning with his iconic role as gangster Little Caesar in Mervyn Le Roy’s 1931 production, and continuing with widely-acclaimed parts in classic film noirs such as Double Indemnity, The Woman in the Window and Scarlet Street. Edward G. Robinson was actually a Romanian Jew, born Emmanuel Goldenberg in Bucharest, in 1893, a relatively little known fact nowadays. By examining his biography, filmography and his best-known, most successful films (mentioned above, I show that Edward G. Robinson was one of classical Hollywood’s most influential actors; for instance, traits of his portrayal of Little Caesar (one of the very first American gangster films can be found in almost all subsequent cinematic gangster figures, from Scarface to Vito Corleone. In the same vein, the doomed noir characters he played in Fritz Lang’s The Woman in the Window and Scarlet Street are still considered by film critics today to be some of the finest, most nuanced examples of noir heroes. Therefore, the main body of my article will be dedicated to a more detailed analysis of these films, while the introductory section will trace his biography and discuss some of his better-known films, such as Confessions of a Nazi Spy and Key Largo. The present study highlights Edward G. Robinson’s merits and impact on the cinema industry, proving that this diminutive Romanian Jew of humble origins was indeed something of a giant during Hollywood’s classical era.

Latest-Generation Transcatheter Aortic Valve Replacement Devices and Procedures.

Science.gov (United States)

Chamandi, Chekrallah; Puri, Rishi; Rodriguez-Gabella, Tania; Rodés-Cabau, Josep

2017-09-01

Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks. This article reviews the main characteristics of, and clinical results associated with, the newer-generation THVs while providing an overview of novel TAVR indications. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

An unusual case of coronary artery compression that did not preclude successful transcatheter pulmonary valve placement.

Science.gov (United States)

Schwartz, Matthew C; Felix, Donald; Iacono, Karen; Nykanen, David

2018-04-16

During transcatheter pulmonary valve placement, coronary compression observed during simultaneous right ventricular outflow tract angioplasty and coronary angiography typically contraindicates valve implantation. We present a unique patient with tetralogy of Fallot who underwent successful transcatheter Melody valve placement despite coronary compression observed during right ventricular outflow tract balloon angioplasty. © 2018 Wiley Periodicals, Inc.

The biting performance of Homo sapiens and Homo heidelbergensis.

Science.gov (United States)

Godinho, Ricardo Miguel; Fitton, Laura C; Toro-Ibacache, Viviana; Stringer, Chris B; Lacruz, Rodrigo S; Bromage, Timothy G; O'Higgins, Paul

2018-05-01

Modern humans have smaller faces relative to Middle and Late Pleistocene members of the genus Homo. While facial reduction and differences in shape have been shown to increase biting efficiency in Homo sapiens relative to these hominins, facial size reduction has also been said to decrease our ability to resist masticatory loads. This study compares crania of Homo heidelbergensis and H. sapiens with respect to mechanical advantages of masticatory muscles, force production efficiency, strains experienced by the cranium and modes of deformation during simulated biting. Analyses utilize X-ray computed tomography (CT) scan-based 3D models of a recent modern human and two H. heidelbergensis. While having muscles of similar cross-sectional area to H. heidelbergensis, our results confirm that the modern human masticatory system is more efficient at converting muscle forces into bite forces. Thus, it can produce higher bite forces than Broken Hill for equal muscle input forces. This difference is the result of alterations in relative in and out-lever arm lengths associated with well-known differences in midfacial prognathism. Apparently at odds with this increased efficiency is the finding that the modern human cranium deforms more, resulting in greater strain magnitudes than Broken Hill when biting at the equivalent tooth. Hence, the facial reduction that characterizes modern humans may not have evolved as a result of selection for force production efficiency. These findings provide further evidence for a degree of uncoupling between form and function in the masticatory system of modern humans. This may reflect the impact of food preparation technologies. These data also support previous suggestions that differences in bite force production efficiency can be considered a spandrel, primarily driven by the midfacial reduction in H. sapiens that occurred for other reasons. Midfacial reduction plausibly resulted in a number of other significant changes in morphology, such

Quality and Safety in Health Care, Part XXX: Transcatheter Aortic Valve Therapy.

Science.gov (United States)

Harolds, Jay A

2017-12-01

Initially, the transcatheter aortic valve replacement procedure was approved only for patients with aortic stenosis that was both severe and symptomatic who either also had too high a risk of aortic valve replacement surgery to have the surgery or who had a high risk for the surgery. Between the years 2012 and 2015, the death rate at 30 days declined from an initial rate of 7.5% to 4.6%. There has also been more use of the transfemoral approach over the years. In 2016, the transcatheter aortic valve replacement was approved for patients with aortic stenosis at intermediate risk of surgery.

Longitudinal Hemodynamics of Transcatheter and Surgical Aortic Valves in the PARTNER Trial.

Science.gov (United States)

Douglas, Pamela S; Leon, Martin B; Mack, Michael J; Svensson, Lars G; Webb, John G; Hahn, Rebecca T; Pibarot, Philippe; Weissman, Neil J; Miller, D Craig; Kapadia, Samir; Herrmann, Howard C; Kodali, Susheel K; Makkar, Raj R; Thourani, Vinod H; Lerakis, Stamatios; Lowry, Ashley M; Rajeswaran, Jeevanantham; Finn, Matthew T; Alu, Maria C; Smith, Craig R; Blackstone, Eugene H

2017-11-01

Use of transcatheter aortic valve replacement (TAVR) for severe aortic stenosis is growing rapidly. However, to our knowledge, the durability of these prostheses is incompletely defined. To determine the midterm hemodynamic performance of balloon-expandable transcatheter heart valves. In this study, we analyzed core laboratory-generated data from echocardiograms of all patients enrolled in the Placement of Aortic Transcatheter Valves (PARTNER) 1 Trial with successful TAVR or surgical AVR (SAVR) obtained preimplantation and at 7 days, 1 and 6 months, and 1, 2, 3, 4, and 5 years postimplantation. Patients from continued access observational studies were included for comparison. Successful implantation after randomization to TAVR vs SAVR (PARTNER 1A; TAVR, n = 321; SAVR, n = 313), TAVR vs medical treatment (PARTNER 1B; TAVR, n = 165), and continued access (TAVR, n = 1996). Five-year echocardiogram data were available for 424 patients after TAVR and 49 after SAVR. Death or reintervention for aortic valve structural indications, measured using aortic valve mean gradient, effective orifice area, Doppler velocity index, and evidence of hemodynamic deterioration by reintervention, adverse hemodynamics, or transvalvular regurgitation. Of 2795 included patients, the mean (SD) age was 84.5 (7.1) years, and 1313 (47.0%) were female. Population hemodynamic trends derived from nonlinear mixed-effects models showed small early favorable changes in the first few months post-TAVR, with a decrease of -2.9 mm Hg in aortic valve mean gradient, an increase of 0.028 in Doppler velocity index, and an increase of 0.09 cm2 in effective orifice area. There was relative stability at a median follow-up of 3.1 (maximum, 5) years. Moderate/severe transvalvular regurgitation was noted in 89 patients (3.7%) after TAVR and increased over time. Patients with SAVR showed no significant changes. In TAVR, death/reintervention was associated with lower ejection fraction, stroke volume

Structural and molecular study of the supraspinatus muscle of modern humans (Homo sapiens) and common chimpanzees (Pan troglodytes).

Science.gov (United States)

Potau, J M; Casado, A; de Diego, M; Ciurana, N; Arias-Martorell, J; Bello-Hellegouarch, G; Barbosa, M; de Paz, F J; Pastor, J F; Pérez-Pérez, A

2018-04-21

To analyze the muscle architecture and the expression pattern of the myosin heavy chain (MyHC) isoforms in the supraspinatus of Pan troglodytes and Homo sapiens in order to identify differences related to their different types of locomotion. We have analyzed nine supraspinatus muscles of Pan troglodytes and ten of Homo sapiens. For each sample, we have recorded the muscle fascicle length (MFL), the pennation angle, and the physiological cross-sectional area (PCSA). In the same samples, by real-time quantitative polymerase chain reaction, we have assessed the percentages of expression of the MyHC-I, MyHC-IIa, and MyHC-IIx isoforms. The mean MFL of the supraspinatus was longer (p = 0.001) and the PCSA was lower (p sapiens than in Pan troglodytes. Although the percentage of expression of MyHC-IIa was lower in Homo sapiens than in Pan troglodytes (p = 0.035), the combination of MyHC-IIa and MyHC-IIx was expressed at a similar percentage in the two species. The longer MFL in the human supraspinatus is associated with a faster contractile velocity, which reflects the primary function of the upper limbs in Homo sapiens-the precise manipulation of objects-an adaptation to bipedal locomotion. In contrast, the larger PCSA in Pan troglodytes is related to the important role of the supraspinatus in stabilizing the glenohumeral joint during the support phase of knuckle-walking. These functional differences of the supraspinatus in the two species are not reflected in differences in the expression of the MyHC isoforms. © 2018 Wiley Periodicals, Inc.

Earliest evidence for the structure of Homo sapiens populations in Africa

Science.gov (United States)

Scerri, Eleanor M. L.; Drake, Nick A.; Jennings, Richard; Groucutt, Huw S.

2014-10-01

Understanding the structure and variation of Homo sapiens populations in Africa is critical for interpreting multiproxy evidence of their subsequent dispersals into Eurasia. However, there is no consensus on early H. sapiens demographic structure, or its effects on intra-African dispersals. Here, we show how a patchwork of ecological corridors and bottlenecks triggered a successive budding of populations across the Sahara. Using a temporally and spatially explicit palaeoenvironmental model, we found that the Sahara was not uniformly ameliorated between ∼130 and 75 thousand years ago (ka), as has been stated. Model integration with multivariate analyses of corresponding stone tools then revealed several spatially defined technological clusters which correlated with distinct palaeobiomes. Similarities between technological clusters were such that they decreased with distance except where connected by palaeohydrological networks. These results indicate that populations at the Eurasian gateway were strongly structured, which has implications for refining the demographic parameters of dispersals out of Africa.

Infective endocarditis following transcatheter edge-to-edge mitral valve repair: A systematic review.

Science.gov (United States)

Asmarats, Lluis; Rodriguez-Gabella, Tania; Chamandi, Chekrallah; Bernier, Mathieu; Beaudoin, Jonathan; O'Connor, Kim; Dumont, Eric; Dagenais, François; Paradis, Jean-Michel; Rodés-Cabau, Josep

2018-05-10

To assess the clinical characteristics, management, and outcomes of patients diagnosed with infective endocarditis (IE) after edge-to-edge mitral valve repair with the MitraClip device. Transcatheter edge-to-edge mitral valve repair has emerged as an alternative to surgery in high-risk patients. However, few data exist on IE following transcatheter mitral procedures. Four electronic databases (PubMed, Google Scholar, Embase, and Cochrane Library) were searched for original published studies on IE after edge-to-edge transcatheter mitral valve repair from 2003 to 2017. A total of 10 publications describing 12 patients with definitive IE (median age 76 years, 55% men) were found. The mean logistic EuroSCORE/EuroSCORE II were 41% and 45%, respectively. The IE episode occurred early (within 12 months post-procedure) in nine patients (75%; within the first month in five patients). Staphylococcus aureus was the most frequent (60%) causal microorganism, and severe mitral regurgitation was present in all cases but one. Surgical mitral valve replacement (SMVR) was performed in most (67%) patients, and the mortality associated with the IE episode was high (42%). IE following transcatheter edge-to-edge mitral valve repair is a rare but life-threatening complication, usually necessitating SMVR despite the high-risk profile of the patients. These results highlight the importance of adequate preventive measures and a prompt diagnosis and treatment of this serious complication. © 2018 Wiley Periodicals, Inc.

Homo sapiens zestárl o 100 tisíc let

Czech Academy of Sciences Publication Activity Database

Nývltová Fišáková, Miriam

2017-01-01

Roč. 1, č. 3 (2017), s. 12 ISSN 2533-784X Institutional support: RVO:68081758 Keywords : paleoanthropology * hominization * Homo sapiens * human fossils * archaeological dating Subject RIV: AC - Archeology, Anthropology, Ethnology http://www.avcr.cz/opencms/export/sites/avcr.cz/.content/galerie-souboru/AB/A_03_2017_web.pdf

Sequential transcatheter aortic valve implantation due to valve dislodgement

DEFF Research Database (Denmark)

Campante Teles, Rui; Costa, Cátia; Almeida, Manuel

2017-01-01

Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected...

Prince Edward Island's School Psychology Report

Science.gov (United States)

Matters, Rhonda

2016-01-01

The Prince Edward Island (PEI) school system has been struggling with issues of recruitment and particularly retention for psychologists. Reasons include concerns about professional autonomy; having more limited roles, which are heavily assessment focused; reduced job satisfaction; and restrictions on additional private practice work. The waiting…

Influence of transcatheter hepatic artery embolization using iodized oil on radiofrequency ablation of hepatic neoplasms

International Nuclear Information System (INIS)

Du Xilin; Ma Qingjiu; Wang Yiqing; Wang Zhimin; Zhang Hongxin

2004-01-01

Objective: To observe the effect of iodized oil on radiofrequency thermal ablation (RFA) of hepatic neoplasms by using a cluster array of ten separate electrodes. Methods: The patients were divided into 2 groups, group A with transcatheter hepatic artery embolization, group B without transcatheter hepatic artery embolization. All patients were undergone radiofrequency ablation of hepatic neoplasms. Results: The time of RFA for group A was (9 ± 2.1) minutes, showing the diameter of necrosis of (5.3 ± 1.4) cm. The time of RFA for group B was (16 ± 4. 6) minutes demonstrating the diameter of necrosis of (3.5 ± 1.8) cm (P<0.01). Conclusions: These findings suggest that radiofrequency thermal ablation of hepatic neoplasms with transcatheter hepatic artery embolization using iodized oil might improve the safety and synergic effect

van den Heuvel, Prof. Edward P J

Indian Academy of Sciences (India)

van den Heuvel, Prof. Edward P J . Date of birth: 2 November 1940. Address: Professor of Astrophysics, Astronomical Inst. Anton Pannekoek, Postbus 94249, 1090 GE Amsterdam, The Netherlands Contact: Office: (+31-20) 525 ...

Treatment of Nonvariceal Gastrointestinal Hemorrhage by Transcatheter Embolization

International Nuclear Information System (INIS)

Ali, Muhammad; Ul Haq, Tanveer; Salam, Basit; Beg, Madiha; Sayani, Raza; Azeemuddin, Muhammad

2013-01-01

Purpose. To investigate the sensitivity of mesenteric angiography, technical success of hemostasis, clinical success rate, and complications of transcatheter embolization for the treatment of acute nonvariceal gastrointestinal hemorrhage. Material and Methods. A retrospective review of 200 consecutive patients who underwent mesenteric arteriography for acute nonvariceal gastrointestinal hemorrhage between February 2004 and February 2011 was done. Results. Of 200 angiographic studies, 114 correctly revealed the bleeding site with mesenteric angiography. 47 (41%) patients had upper gastrointestinal hemorrhage and 67 (59%) patients had lower gastrointestinal hemorrhage. Out of these 114, in 112 patients (98%) technical success was achieved with immediate cessation of bleeding. 81 patients could be followed for one month. Clinical success was achieved in 72 out of these 81 patients (89%). Seven patients rebled. 2 patients developed bowel ischemia. Four patients underwent surgery for bowel ischemia or rebleeding. Conclusion. The use of therapeutic transcatheter embolization for treatment of acute gastrointestinal hemorrhage is highly successful and relatively safe with 98% technical success and 2.4% postembolization ischemia in our series. In 89% of cases it was definitive without any further intervention

Life as a Cosmic Phenomenon: 2. the Panspermic Trajectory of Homo Sapiens

Science.gov (United States)

Tokoro, Gensuke; Wickramasinghe, N. Chandra

We discuss the origin and evolution of Homo sapiens in a cosmic context, and in relation to the Hoyle-Wickramasinghe theory of panspermia for which there is now overwhelming evidence. It is argued that the first bacteria (archea) incident on the Earth via the agency of comets 3.8-4 billion years ago continued at later times to be augmented by viral genes (DNA, RNA) from space that eventually led to the evolutionary patterns we see in present-day biology. We argue that the current evolutionary status of Homo sapiens as well as its future trajectory is circumscribed by evolutionary processes that were pre-determined on a cosmic scale -- over vast distances and enormous spans of cosmic time. Based on this teleological hypothesis we postulate that two distinct classes of cosmic viruses (cosmic viral genes) are involved in accounting for the facts relating to the evolution of life.

Assessment of structural valve deterioration of transcatheter aortic bioprosthetic balloon-expandable valves using the new European consensus definition.

Science.gov (United States)

Eltchaninoff, Hélène; Durand, Eric; Avinée, Guillaume; Tron, Christophe; Litzler, Pierre-Yves; Bauer, Fabrice; Dacher, Jean-Nicolas; Werhlin, Camille; Bouhzam, Najime; Bettinger, Nicolas; Candolfi, Pascal; Cribier, Alain

2018-03-30

Durability of transcatheter aortic bioprosthetic valves remains a major issue. Standardised definitions of deterioration and failure of bioprosthetic valves have recently been proposed. The aim of this study was to assess structural transcatheter valve deterioration (SVD) and bioprosthetic valve failure (BVF) using these new definitions. All TAVI patients implanted up to September 2012 with a minimal theoretical five-year follow-up were included. Systematic clinical and echocardiographic follow-up was performed annually. New standardised definitions were used to assess durability of transcatheter aortic bioprosthetic valves. From 2002 to 2012, 378 patients were included. Mean age and logistic EuroSCORE were 83.3±6.8 years and 22.8±13.1%. Thirty-day mortality was 13.2%. Nine patients had SVD including two severe forms and two patients had definite late BVF. The incidence of SVD and BVF at eight years was 3.2% (95% CI: 1.45-6.11) and 0.58% (95% CI: 0.15-2.75), respectively. Even though limited by the poor survival of the very high-risk/compassionate early population, our data do not demonstrate any alarm concerning transcatheter aortic valve durability. Careful prospective assessment in younger and lower-risk patients and comparison with surgical bioprosthetic valves are required for further assessment of the long-term durability of transcatheter valves.

Intracardiac echocardiography: use during transcatheter device closure of a patent ductus arteriosus in a dog.

Science.gov (United States)

Chetboul, V; Damoiseaux, C; Behr, L; Morlet, A; Moise, N S; Gouni, V; Lavennes, M; Pouchelon, J-L; Laborde, F; Borenstein, N

2017-06-01

Intracardiac echocardiography (ICE) is used in humans for percutaneous interventional procedures, such as transcatheter device closures. Intracardiac echocardiography provides high-resolution imaging of cardiac structures with two-dimensional, M-mode, Doppler, and also three-dimensional modalities. The present report describes application of ICE during transcatheter occlusion of patent ductus arteriosus using a canine ductal occluder in a dog for which transesophageal echocardiography could not provide an optimal acoustic window. Copyright © 2017 Elsevier B.V. All rights reserved.

Transcatheter embolization in a haemophiliac with post-traumatic renal haemorrhage

Energy Technology Data Exchange (ETDEWEB)

Klamut, M; Szczerbo-Trojanowska, M; Kowalewski, J; Nowakowski, A [Akademia Medyczna, Lublin (Poland)

1979-01-01

Percutaneous transcatheter arterial embolization was performed in a case of severe haemophilia A to control haemorrhage secondary to renal trauma. The treatment proved to be life-saving. Eighteen months follow-up revealed no evidence of hypertension, renal failure or infection.

Transcatheter Embolotherapy with N-Butyl Cyanoacrylate for Ectopic Varices

Energy Technology Data Exchange (ETDEWEB)

Choi, Jin Woo; Kim, Hyo-Cheol, E-mail: angiointervention@gmail.com; Jae, Hwan Jun, E-mail: jaemdphd@gmail.com; Jung, Hyun-Seok; Hur, Saebeom; Lee, Myungsu; Chung, Jin Wook [Seoul National University Hospital, Department of Radiology, Seoul National University College of Medicine (Korea, Republic of)

2015-04-15

PurposeTo address technical feasibility and clinical outcome of transcatheter embolotherapy with N-butyl cyanoacrylate (NBCA) for bleeding ectopic varices.MethodsThe institutional review board approved this retrospective study and waived informed consent. From January 2004 to June 2013, a total of 12 consecutive patients received transcatheter embolotherapy using NBCA for bleeding ectopic varices in our institute. Clinical and radiologic features of the endovascular procedures were comprehensively reviewed.ResultsPreprocedural computed tomography images revealed ectopic varices in the jejunum (n = 7), stoma (n = 2), rectum (n = 2), and duodenum (n = 1). The 12 procedures consisted of solitary embolotherapy (n = 8) and embolotherapy with portal decompression (main portal vein stenting in 3, transjugular intrahepatic portosystemic shunt in 1). With regard to vascular access, percutaneous transhepatic access (n = 7), transsplenic access (n = 4), and transjugular intrahepatic portosystemic shunt tract (n = 1) were used. There was no failure in either the embolotherapy or the vascular accesses (technical success rate, 100 %). Two patients died within 1 month from the procedure from preexisting fatal medical conditions. Only one patient, with a large varix that had been partially embolized by using coils and NBCA, underwent rebleeding 5.5 months after the procedure. The patient was retreated with NBCA and did not undergo any bleeding afterward for a follow-up period of 2.5 months. The remaining nine patients did not experience rebleeding during the follow-up periods (range 1.5–33.2 months).ConclusionTranscatheter embolotherapy using NBCA can be a useful option for bleeding ectopic varices.

Percutaneous N-Butyl cyanoacrylate embolization of a pancreatic pseudoaneurysm after failed attempts of transcatheter embolization

Energy Technology Data Exchange (ETDEWEB)

Kim, Ri Hyeon; Yoo, Roh Eul; Kim, Hyo Cheol [Seoul National University Medical Research Center, and Clinical Research Institute, Seoul National University Hospital, Seoul (Korea, Republic of)

2014-10-15

One common complication after major pancreatic surgery is bleeding. Herein we describe a case of pancreatic pseudoaneurysm which developed after pylorous preserving pancreaticoduodenectomy for common bile duct cancer. Three attempts of transcatheter embolization failed since feeders to the pseudoaneurysm had unfavorable anatomy. Direct percutaneous N-butyl cyanoacrylate injection was performed under fluoroscopy-guidance and the pseudoaneurysm was successfully treated. Percutaneous fluoroscopy-guided direct N-butyl cyanoacrylate injection may be a useful alternative when selective transcatheter embolization fails or is technically challenging.

Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients

DEFF Research Database (Denmark)

Reardon, Michael J; Van Mieghem, Nicolas M; Popma, Jeffrey J

2017-01-01

BACKGROUND: Although transcatheter aortic-valve replacement (TAVR) is an accepted alternative to surgery in patients with severe aortic stenosis who are at high surgical risk, less is known about comparative outcomes among patients with aortic stenosis who are at intermediate surgical risk. METHO...

Transcatheter aortic valve prosthesis surgically replaced 4 months after implantation

DEFF Research Database (Denmark)

Thyregod, Hans Gustav; Lund, Jens Teglgaard; Engstrøm, Thomas

2010-01-01

Transcatheter aortic valve implantation is a new and rapidly evolving treatment option for high-risk surgical patients with degenerative aortic valve stenosis. Long-term results with these new valve prostheses are lacking, and potential valve dysfunction and failure would require valve replacemen...

An intractable case of lower gastrointestinal hemorrhage due to radiation colitis. Usefulness of transcatheter arterial embolization

Energy Technology Data Exchange (ETDEWEB)

Inoue, Koichi; Koyama, Tukasa [Yoka Hospital, Hyogo (Japan); Sugamura, Kenji; Ogawa, Toshihide [Tottori Univ., Yonago (Japan). Faculty of Medicine

2003-05-01

We tried transcatheter arterial embolization for lower gastrointestinal hemorrhage due to radiation colitis. In this case, colostomy and endoscopic therapy were not effective. We succeeded in arresting the hemorrhage without any complications. Transcatheter embolization is a low-invasive and safe method of treatment. For prevention of inflammation and iatrogenic abscess formation, we repeated this therapy and we tried arterial injection of antibiotics and steroid. And so, this therapy is one of the effective methods. (author)

Constitutive equations for the Doi-Edwards model without independent alignment

DEFF Research Database (Denmark)

Hassager, Ole; Hansen, Rasmus

2010-01-01

We present two representations of the Doi-Edwards model without Independent Alignment explicitly expressed in terms of the Finger strain tensor, its inverse and its invariants. The two representations provide explicit expressions for the stress prior to and after Rouse relaxation of chain stretch......, respectively. The maximum deviations from the exact representations in simple shear, biaxial extension and uniaxial extension are of order 2%. Based on these two representations, we propose a framework for Doi-Edwards models including chain stretch in the memory integral form....

Transcatheter closure of patent ductus arteriosus: 11 years of clinical experience in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

Science.gov (United States)

Djer, Mulyadi M; Saputro, Dimas Dwi; Putra, Sukman Tulus; Idris, Nikmah Salamia

2015-06-01

Transcatheter closure of patent ductus arteriosus (PDA) has been suggested to be the standard treatment of PDA. Although, in general, the procedure shows a high successful rate, outcomes may vary among pediatric cardiology centers. To evaluate the effectiveness of transcatheter closure of PDA in Cipto Mangunkusumo Hospital, Jakarta, Indonesia, this was a retrospective study on patients who underwent transcatheter closure of PDA in Cipto Mangunkusumo Hospital during the period of 2002-2013. Hospital registry was reviewed and data about patients' characteristics, PDA severity, procedure, and outcomes were retrieved. There were 298 patients, of whom 90 were males, who underwent transcatheter closure of PDA during the study period. Median age was 3.4 years (1 months-18 years), and median body weight was 12 (3.6-59) kg. The diameter of PDA ranged from 1.1 to 15.4 mm with a median of 3.7 mm. Device could be deployed in all patients, in which most were the Amplatzer ductal occluder (69.8 %) and the remainders were coils. Median fluoroscopy time was 15.4 (1.5-87) min, and procedure time was 76 (30-200) min. Complete closure was achieved in most patients (97.3 %), whereas device migration occurred in a minority (0.3 %) of patients. No major complication occurred during or after the procedure. Transient anemia and bradycardia were found in 3.7 and 1.3 % patients, respectively. Most patients were discharged from the hospital at 1 day after the procedure. Transcatheter closure method is a safe and effective procedure to close PDA.

Pygmoid Australomelanesian Homo sapiens skeletal remains from Liang Bua, Flores: population affinities and pathological abnormalities.

Science.gov (United States)

Jacob, T; Indriati, E; Soejono, R P; Hsü, K; Frayer, D W; Eckhardt, R B; Kuperavage, A J; Thorne, A; Henneberg, M

2006-09-05

Liang Bua 1 (LB1) exhibits marked craniofacial and postcranial asymmetries and other indicators of abnormal growth and development. Anomalies aside, 140 cranial features place LB1 within modern human ranges of variation, resembling Australomelanesian populations. Mandibular and dental features of LB1 and LB6/1 either show no substantial deviation from modern Homo sapiens or share features (receding chins and rotated premolars) with Rampasasa pygmies now living near Liang Bua Cave. We propose that LB1 is drawn from an earlier pygmy H. sapiens population but individually shows signs of a developmental abnormality, including microcephaly. Additional mandibular and postcranial remains from the site share small body size but not microcephaly.

Similarity analysis between chromosomes of Homo sapiens and monkeys with correlation coefficient, rank correlation coefficient and cosine similarity measures

OpenAIRE

Someswara Rao, Chinta; Viswanadha Raju, S.

2016-01-01

In this paper, we consider correlation coefficient, rank correlation coefficient and cosine similarity measures for evaluating similarity between Homo sapiens and monkeys. We used DNA chromosomes of genome wide genes to determine the correlation between the chromosomal content and evolutionary relationship. The similarity among the H. sapiens and monkeys is measured for a total of 210 chromosomes related to 10 species. The similarity measures of these different species show the relationship b...

Simulation of groundwater flow in the Edwards-Trinity and related aquifers in the Pecos County region, Texas

Science.gov (United States)

Clark, Brian R.; Bumgarner, Johnathan R.; Houston, Natalie A.; Foster, Adam L.

2014-01-01

The Edwards-Trinity aquifer is a vital groundwater resource for agricultural, industrial, and public supply uses in the Pecos County region of western Texas. The U.S. Geological Survey completed a comprehensive, integrated analysis of available hydrogeologic data to develop a numerical groundwater-flow model of the Edwards-Trinity and related aquifers in the study area in parts of Brewster, Jeff Davis, Pecos, and Reeves Counties. The active model area covers about 3,400 square miles of the Pecos County region of Texas west of the Pecos River, and its boundaries were defined to include the saturated areas of the Edwards-Trinity aquifer. The model is a five-layer representation of the Pecos Valley, Edwards-Trinity, Dockum, and Rustler aquifers. The Pecos Valley aquifer is referred to as the alluvial layer, and the Edwards-Trinity aquifer is divided into layers representing the Edwards part of the Edwards-Trinity aquifer and the Trinity part of the Edwards-Trinity aquifer, respectively. The calibration period of the simulation extends from 1940 to 2010. Simulated hydraulic heads generally were in good agreement with observed values; 1,684 out of 2,860 (59 percent) of the simulated values were within 25 feet of the observed value. The average root mean square error value of hydraulic head for the Edwards-Trinity aquifer was 34.2 feet, which was approximately 4 percent of the average total observed change in groundwater-level altitude (groundwater level). Simulated spring flow representing Comanche Springs exhibits a pattern similar to observed spring flow. Independent geochemical modeling corroborates results of simulated groundwater flow that indicates groundwater in the Edwards-Trinity aquifer in the Leon-Belding and Fort Stockton areas is a mixture of recharge from the Barilla and Davis Mountains and groundwater that has upwelled from the Rustler aquifer.

Fallopian tube occlusion by selective transcatheter radiofrequency electrocautery

Energy Technology Data Exchange (ETDEWEB)

Oh, Joo Hyeong; Yoon, Yup; Ko, Young Tae; Nam, Duck Ho; Park, Yong Koo [Kyung Hee University Hospital, Seoul (Korea, Republic of)

1998-04-01

The purpose of this study is to access the usefulness of transcatheter radiofrequency (RF) electrocautery as a method of nonsurgical tubal occlusion. Using the coaxial technique under fluoroscopic guidance, transvaginal fluoroscopic fallopian tube catheterization was performed in thirteen rabbits. In each rabbit, unilateral tubal ablation was performed using RF electrocautery. A 0.018 inch metallic wire protruding from the microcatheter tip was used as the source of the RF energy; the length of the noninsulated part of this wire was 10 mm and the duration of RF energy; the length of the noninsulated part of this wire 10 mm and the duration of RF supply was 20 seconds. The contralateral normal fallopian tube and uterus were used as a control. All 13 rabbits were randomly sacrificed on two days (group I) or 30 days (group II) after the procedure, and tubal patency and histologic change were evaluated. Transcatheter RF electrocautery is though to be a useful method for tubal occlusion. It is simple, safe, and less expensive and might have a role in future female tubal sterilization. (author). 25 refs., 1 tab., 4 figs.

Fallopian tube occlusion by selective transcatheter radiofrequency electrocautery

International Nuclear Information System (INIS)

Oh, Joo Hyeong; Yoon, Yup; Ko, Young Tae; Nam, Duck Ho; Park, Yong Koo

1998-01-01

The purpose of this study is to access the usefulness of transcatheter radiofrequency (RF) electrocautery as a method of nonsurgical tubal occlusion. Using the coaxial technique under fluoroscopic guidance, transvaginal fluoroscopic fallopian tube catheterization was performed in thirteen rabbits. In each rabbit, unilateral tubal ablation was performed using RF electrocautery. A 0.018 inch metallic wire protruding from the microcatheter tip was used as the source of the RF energy; the length of the noninsulated part of this wire was 10 mm and the duration of RF energy; the length of the noninsulated part of this wire 10 mm and the duration of RF supply was 20 seconds. The contralateral normal fallopian tube and uterus were used as a control. All 13 rabbits were randomly sacrificed on two days (group I) or 30 days (group II) after the procedure, and tubal patency and histologic change were evaluated. Transcatheter RF electrocautery is though to be a useful method for tubal occlusion. It is simple, safe, and less expensive and might have a role in future female tubal sterilization. (author). 25 refs., 1 tab., 4 figs

Autopsy after transcatheter aortic valve implantation

DEFF Research Database (Denmark)

van Kesteren, F; Wiegerinck, E M A; Rizzo, S

2017-01-01

Autopsy after transcatheter aortic valve implantation (TAVI) is a new field of interest in cardiovascular pathology. To identify the cause of death, it is important to be familiar with specific findings related to the time interval between the procedure and death. We aimed to provide an overview...... different cause of death as was clinically determined. Autopsy on patients who underwent TAVI reveals specific patterns of cardiovascular pathology that clearly relate to the time interval between TAVI and death and significantly adds to the clinical diagnosis. Our data support the role of autopsy including...

Treatment of Non variceal Gastrointestinal Hemorrhage by Transcatheter Embolization

International Nuclear Information System (INIS)

Ali, M.; Ul Haq, T.; Salam, B.; Beg, M.; Sayani, R.; Azeemuddin, M.

2013-01-01

To investigate the sensitivity of mesenteric angiography, technical success of hemostasis, clinical success rate, and complications of transcatheter embolization for the treatment of acute non variceal gastrointestinal hemorrhage. Material and Methods. A retrospective review of 200 consecutive patients who underwent mesenteric arteriography for acute non variceal gastrointestinal hemorrhage between February 2004 and February 2011 was done. Results. Of 200 angiographic studies, 114 correctly revealed the bleeding site with mesenteric angiography. 47 (41%) patients had upper gastrointestinal hemorrhage and 67 (59%) patients had lower gastrointestinal hemorrhage. Out of these 114, in 112 patients (98%) technical success was achieved with immediate cessation of bleeding. 81 patients could be followed for one month. Clinical success was achieved in 72 out of these 81 patients (89%). Seven patients rebled. 2 patients developed bowel ischemia. Four patients underwent surgery for bowel ischemia or rebleeding. Conclusion. The use of therapeutic transcatheter embolization for treatment of acute gastrointestinal hemorrhage is highly successful and relatively safe with 98% technical success and 2.4% post embolization ischemia in our series. In 89% of cases it was definitive without any further intervention.

Transcatheter closure of patent ductus arteriosus with special conformation

International Nuclear Information System (INIS)

Zhang Yigang; Li Shijie; Fu Qiang

2009-01-01

Objective: To discuss the technique of transcatheter closure for the treatment of patent ductus arteriosus (PDA) with special conformation so as to improve the technical success rate and clinical safety. Methods: Transcatheter closure was performed in 23 patients with PDA of special types by using different devices according to the angiocardiographic conformation and the clinical manifestation. The therapeutic results were evaluated by transthoracic color Doppler echocardiography at 24 hours, one, three and six months after the operation. Results: Different occluders were successfully implanted in all patients. PDA of special types was found in 23 patients, which included: (1) special conformation (n=12), consisting of small type (n=5), huge type (n=3), aneurismal type (n=2) and displayed on special exposure position (n=2), (2) accompanied by other malformations (n=2), containing dextroaortic arch (n=1) and dextrocardia (n=1), (3) associated with severe pulmonary hypertension (n=8) and (4) recanalization after surgery (n=1). Conclusion: For PDA with special conformation, therapeutic strategy should be individually formulated in order to smoothly bring the closure procedure to success. (authors)

Transcatheter mitral valve repair in osteogenesis imperfecta associated mitral valve regurgitation.

Science.gov (United States)

van der Kley, Frank; Delgado, Victoria; Ajmone Marsan, Nina; Schalij, Martin J

2014-08-01

Osteogenesis imperfecta is associated with increased prevalence of significant mitral valve regurgitation. Surgical mitral valve repair and replacement are feasible but are associated with increased risk of bleeding and dehiscence of implanted valves may occur more frequently. The present case report describes the outcomes of transcatheter mitral valve repair in a patient with osteogenesis imperfecta. A 60 year-old patient with osteogenesis imperfecta and associated symptomatic moderate to severe mitral regurgitation underwent transthoracic echocardiography which showed a nondilated left ventricle with preserved systolic function and moderate to severe mitral regurgitation. On transoesophageal echocardiography the regurgitant jet originated between the anterolateral scallops of the anterior and posterior leaflets (A1-P1). Considering the comorbidities associated with osteogenesis imperfecta the patient was accepted for transcatheter mitral valve repair using the Mitraclip device (Abbott vascular, Menlo, CA). Under fluoroscopy and 3D transoesophageal echocardiography guidance, a Mitraclip device was implanted between the anterolateral and central scallops with significant reduction of mitral regurgitation. The postoperative evolution was uneventful. At one month follow-up, transthoracic echocardiography showed a stable position of the Mitraclip device with no mitral regurgitation. Transcatheter mitral valve repair is feasible and safe in patients with osteogenesis imperfecta and associated symptomatic significant mitral regurgitation. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Self-domestication in Homo sapiens: Insights from comparative genomics.

Science.gov (United States)

Theofanopoulou, Constantina; Gastaldon, Simone; O'Rourke, Thomas; Samuels, Bridget D; Messner, Angela; Martins, Pedro Tiago; Delogu, Francesco; Alamri, Saleh; Boeckx, Cedric

2017-01-01

This study identifies and analyzes statistically significant overlaps between selective sweep screens in anatomically modern humans and several domesticated species. The results obtained suggest that (paleo-)genomic data can be exploited to complement the fossil record and support the idea of self-domestication in Homo sapiens, a process that likely intensified as our species populated its niche. Our analysis lends support to attempts to capture the "domestication syndrome" in terms of alterations to certain signaling pathways and cell lineages, such as the neural crest.

Implantation and 30-Day Follow-Up on All 4 Valve Sizes Within the Portico Transcatheter Aortic Bioprosthetic Family

DEFF Research Database (Denmark)

Möllmann, Helge; Linke, Axel; Holzhey, David M

2017-01-01

OBJECTIVES: The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND: The Portico transcatheter aortic heart valve is a fully resheathable, repositionable.......8% of patients improved by ≥1 New York Heart Association functional class at 30 days. The rate of moderate paravalvular leak was 5.7%, with no severe paravalvular leak reported. No differences in paravalvular leak incidence and severity were observed among valve sizes (p = 0.24). CONCLUSIONS: Across all valve...... sizes, use of the repositionable Portico transcatheter aortic valve replacement system resulted in safe and effective treatment of aortic stenosis in high-risk patients....

Transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization for the treatment of hepatic metastases from colorectal carcinoma

International Nuclear Information System (INIS)

Wang Xuan; Chen Xiaofei

2009-01-01

Objective: To evaluate the clinical efficacy of transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization in the treatment of hepatic metastases from colorectal carcinoma. Methods: Sixty-eight cases with hepatic metastases from colorectal carcinoma were equally and randomly divided into two groups. The patients in study group were treated with transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization, while the patients in control group were treated with conventional (normal temperature) transcatheter hepatic arterial chemotherapy lipiodol embolization. Results: The effective rate of study group and control group was 65%(22/34) and 32%(11/34) respectively, the difference between two groups was statistically significant (P<0.05). No significant difference in the postoperative changes of hepatic function tests was found between the two groups. The survival rate at 6,12,18 and 24 months after the treatment was 100%, 82%, 44% and 18% respectively in study group, while it was 91%, 47%, 15% and 6% respectively in control group. Conclusion: Transcatheter hepatic arterial thermo-chemotherapy and thermo-lipiodol embolization is an effective and safe treatment for the hepatic metastases from colorectal carcinoma and has no obvious damage to the hepatic function. (authors)

Additions and corrections to the lichen mycobiota of the subantarctic Prince Edward Islands

NARCIS (Netherlands)

Øvstedal, D.O.; Gremmen, N.J.M.

2007-01-01

Fifteen species are reported as new to the subantarctic Prince Edward Islands (47 degrees S, 38 degrees E). Of these 12 are added to the known lichens of Prince Edward Island, and four are added to the Marion Island species list. Two species are new to science, viz. Gyalecta azorellae Ovstedal, with

The mitogenome of a 35,000-year-old Homo sapiens from Europe supports a Palaeolithic back-migration to Africa

OpenAIRE

Hervella, M.; Svensson, E. M.; Alberdi, A.; G?nther, T.; Izagirre, N.; Munters, A. R.; Alonso, S.; Ioana, M.; Ridiche, F.; Soficaru, A.; Jakobsson, M.; Netea, M. G.; de-la-Rua, C.

2016-01-01

After the dispersal of modern humans (Homo sapiens) Out of Africa, hominins with a similar morphology to that of present-day humans initiated the gradual demographic expansion into Eurasia. The mitogenome (33-fold coverage) of the Pestera Muierii 1 individual (PM1) from Romania (35 ky cal BP) we present in this article corresponds fully to Homo sapiens, whilst exhibiting a mosaic of morphological features related to both modern humans and Neandertals. We have identified the PM1 mitogenome as ...

Effect of permanent pacemaker on mortality after transcatheter aortic valve replacement

DEFF Research Database (Denmark)

Engborg, Jonathan; Riechel-Sarup, Casper; Gerke, Oke

2017-01-01

OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect...

Early results of transcatheter closure of patent ductus arteriosus: retrospective study of 61 patients

International Nuclear Information System (INIS)

Beg, A.M.; Younas, M.; Chaudary, A.T.

2013-01-01

Patent ductus arteriosus (PDA) accounts for 6 - 11% of all congenital heart defects. Complications of PDA include congestive heart failure, repeated chest infections, pulmonary hypertension, and an increased risk of infective endocarditis. Transcatheter closure of PDA has largely replaced surgical ligation in different age groups. Currently, surgical intervention is restricted to premature babies or small infants with large symptomatic PDA, cases with unfavorable duct anatomy, and whenever the cost of the closure devices is unaffordable. PDA was the first example of congenital heart dis-ease to be treated by transcatheter closure, which becomes an established form of treatment for the majority of patients with PDA and as a safe alternative to surgery. The per-cutaneous technique was first described by Porstmanur et al., since then various devices such as Rashkind PDA umbrella, button device, PDA coils and most recently the Amplatzer duct occluder (ADO) have been introduced. The ADO device was designed to provide the most desirable characteristics for a percutaneous closure device that can be used in most if not all patients with PDA. These include user - friendly delivery system, high complete closure rate, small delivery system (allowing its use in small infants), trans-venous delivery route, ability to adapt to various PDA sizes and types, and the ability to retrieve or reposition the device prior to release from a secure delivery system. Common complications of trans-catheter closure of PDA include residual shunt, left pulmonary artery (LPA) obstruction, protrusion of the device into the aorta, and embolization of the device. Incidence of complications increases with certain types and large size ducts, and with the use of multiple coils for occlusion. There are only a few reports correlating out-come and complications with the learning curve and experience. In this study, we are reporting our initial experience with PDA closure using Amplatzer duct occluder (ADO

Prediction of host - pathogen protein interactions between Mycobacterium tuberculosis and Homo sapiens using sequence motifs.

Science.gov (United States)

Huo, Tong; Liu, Wei; Guo, Yu; Yang, Cheng; Lin, Jianping; Rao, Zihe

2015-03-26

Emergence of multiple drug resistant strains of M. tuberculosis (MDR-TB) threatens to derail global efforts aimed at reigning in the pathogen. Co-infections of M. tuberculosis with HIV are difficult to treat. To counter these new challenges, it is essential to study the interactions between M. tuberculosis and the host to learn how these bacteria cause disease. We report a systematic flow to predict the host pathogen interactions (HPIs) between M. tuberculosis and Homo sapiens based on sequence motifs. First, protein sequences were used as initial input for identifying the HPIs by 'interolog' method. HPIs were further filtered by prediction of domain-domain interactions (DDIs). Functional annotations of protein and publicly available experimental results were applied to filter the remaining HPIs. Using such a strategy, 118 pairs of HPIs were identified, which involve 43 proteins from M. tuberculosis and 48 proteins from Homo sapiens. A biological interaction network between M. tuberculosis and Homo sapiens was then constructed using the predicted inter- and intra-species interactions based on the 118 pairs of HPIs. Finally, a web accessible database named PATH (Protein interactions of M. tuberculosis and Human) was constructed to store these predicted interactions and proteins. This interaction network will facilitate the research on host-pathogen protein-protein interactions, and may throw light on how M. tuberculosis interacts with its host.

The subantarctic Prince Edward Islands are globally important ...

African Journals Online (AJOL)

spamer

(Vulnerable) has increased significantly, making Prince Edward Island equal with Marion Island as supporting ... 3 Marine & Coastal Management, Department of Environmental Affairs and Tourism, ... breeding on inaccessible cliff areas were estimated by ...... Penguin Conservation Assessment and Management Plan.

Homo sapiens, Homo neanderthalensis and the Denisova specimen: New insights on their evolutionary histories using whole-genome comparisons.

Science.gov (United States)

Paixão-Côrtes, Vanessa Rodrigues; Viscardi, Lucas Henrique; Salzano, Francisco Mauro; Hünemeier, Tábita; Bortolini, Maria Cátira

2012-12-01

After a brief review of the most recent findings in the study of human evolution, an extensive comparison of the complete genomes of our nearest relative, the chimpanzee (Pan troglodytes), of extant Homo sapiens, archaic Homo neanderthalensis and the Denisova specimen were made. The focus was on non-synonymous mutations, which consequently had an impact on protein levels and these changes were classified according to degree of effect. A total of 10,447 non-synonymous substitutions were found in which the derived allele is fixed or nearly fixed in humans as compared to chimpanzee. Their most frequent location was on chromosome 21. Their presence was then searched in the two archaic genomes. Mutations in 381 genes would imply radical amino acid changes, with a fraction of these related to olfaction and other important physiological processes. Eight new alleles were identified in the Neanderthal and/or Denisova genetic pools. Four others, possibly affecting cognition, occured both in the sapiens and two other archaic genomes. The selective sweep that gave rise to Homo sapiens could, therefore, have initiated before the modern/archaic human divergence.

Ecospaces occupied by Homo erectus and Homo sapiens in insular Southeast Asia in the Pleistocene

Science.gov (United States)

Hertler, Christine; Haupt, Susanne; Volmer, Rebekka; Bruch, Angela

2014-05-01

Hominins migrated to the islands of the Sunda Shelf multiple times. At least two immigration events are evident, an early immigration of Homo erectus in the late Early Pleistocene and a second immigration of Homo sapiens during the Late Pleistocene. Regional environments changed considerably in the Pleistocene. Expansion patterns among hominins are at least co-determined by their ecologies and environmental change. We examine these expansion patterns on the basis of habitat reconstructions. Mammalian communities provide a geographically extensive record and permit to assess hominin ecospaces. Although chronological resolution is low, they represent the most complete record of habitat changes associated with hominin expansion patterns. In order to reconstruct and compare hominin ecospaces on a quantitative scale, we set up a reference sample consisting of mammalian communities of 117 national parks in South Asia and Sub-Saharan Africa. The diversity of such communities is assessed by ecological profiling of specialized herbivore taxa. Moreover, datasets on climate and vegetation correlate with the diversity structure of such specialized herbivore communities. Reconstructing the diversity structure of communities at key sites in Pleistocene Southeast Asia permits to infer features of the climatic and vegetation framework associated with different hominin taxa. Our results show that Homo erectus and Homo sapiens did not occupy similar ecospaces. The ecospace of Homo erectus is characterized by comparatively low diversity among frugivorous and folivorous taxa, while obligate grazers are part of the assemblages. Specialized herbivore communities with such a diversity structure occur at present in East Africa, while they are absent in Southeast Asia. In the reference sample, this type of ecospace corresponds to seasonal wetlands. Although Homo sapiens still inhabits this type of environment in Southeast Asia, his ecospace is wider. Homo sapiens is associated with

The aquatic Coleoptera of Prince Edward Island, Canada: new records and faunal composition

Directory of Open Access Journals (Sweden)

Christopher Majka

2008-09-01

Full Text Available The aquatic Coleoptera (Gyrinidae, Haliplidae, Dytiscidae, Hydrophilidae, Elmidae, Dryopidae, Heteroceridae of Prince Edward Island, Canada is surveyed. Seventy-two species are now known to occur on Prince Edward Island, 26 of which are added to the island's faunal list. Three species, Gyrinus aquiris LeConte, Oulimnius latiusculus (LeConte, and Helichus striatus LeConte, are removed since there are no voucher specimens or published records to substantiate their presence. The name Dineutus horni is designated as an incorrect subsequent spelling of Dineutus hornii Roberts, 1895. The composition of the fauna is briefly discussed, both from regional and zoogeographic perspectives. There is only one introduced species, Helophorus grandis Illiger. Only one third of the aquatic fauna recorded on the neighbouring mainland has been found on Prince Edward Island, perhaps reflecting an island-associated diminution, the paucity of collecting, an area effect, or a combination of all these factors. The island faunas of Prince Edward Island, Cape Breton Island, and insular Newfoundland are compared. Prince Edward Island's is 36% smaller than the others, in contrast with the island's carabid fauna which is almost identical in magnitude with that of Cape Breton. This might reflect dispersal obstacles, the relative paucity of aquatic habitats on the island, or an insufficient collecting effort. Further research would be desirable, both to better discern the composition of the province's fauna, as well as to monitor the health of aquatic ecosystems in relation to anthropogenic activities.

Transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium.

Science.gov (United States)

Luciano, Debora; Laux, Daniela; Boudjemline, Younes; Hascoët, Sébastien; Lusson, Jean-René; Sorensen, Clio; Ovaert, Caroline; Kreitmann, Bernard; Van Praagh, Richard; Fraisse, Alain

2013-12-10

A persistent anastomosis between the pulmonary veins that connect with the left atrium and the systemic vein that drains into the right atrium has occasionally been reported. We report characteristics and transcatheter therapy in partially abnormal pulmonary venous return with additional drainage to the left atrium. We retrospectively studied such patients in 5 institutions. Ten patients (6 girls) presented at a median age of 8 (0.1 to 54) years with 2 anatomic types: 8 vertical vein types with drainage of the left upper lobe to the innominate vein via a large vertical vein (left superior cardinal vein) and to the left atrium via the left upper pulmonary vein; and 2 scimitar vein (SV) types with drainage of the right middle and lower pulmonary veins into the inferior vena cava and to the left atrium via an anomalous connecting vein. Associated malformations were aortic coarctation (n=2) and secundum atrial septal defects (n=3). Two patients of the vertical vein type were operated. Transcatheter occlusion of the abnormal pulmonary venous return was performed in 7 cases, associated with occlusion of systemic arterial supply (n=2), secundum atrial septal closure (n=2), left upper pulmonary vein stenosis stenting (n=1), and coarctation stenting (n=1). Including previously published cases, 18 patients (13 vertical veins and 5 scimitar veins) underwent transcatheter repair. Patients over 40 years of age tend to be symptomatic at presentation (p=0.056). In partially abnormal pulmonary venous return with dual drainage, transcatheter therapy can be offered in the majority of patients. © 2013.

Transcatheter Mitral Valve-in-Ring Implantation

LENUS (Irish Health Repository)

Tanner, RE

2018-05-01

Failed surgical mitral valve repair using an annuloplasty ring has traditionally been treated with surgical valve replacement or repair1. For patients at high risk for repeat open heart surgery, placement of a trans-catheter aortic valve (i.e., TAVI valve) within the mitral ring (i.e., Mitral-Valve-in-Ring, MViR) has emerged as a novel alternative treatment strategy2-5 . We describe our experience of a failed mitral valve repair that was successfully treated with a TAVI valve delivered via the trans-septal approach, and summarise the data relating to this emerging treatment strategy.

Inter- and Intraspecific Variations in the Pectoral Muscles of Common Chimpanzees (Pan troglodytes), Bonobos (Pan paniscus), and Humans (Homo sapiens)

OpenAIRE

Potau, J. M.; Arias-Martorell, J.; Bello-Hellegouarch, G.; Casado, A.; Pastor, J. F.; de Paz, F.; Diogo, R.

2018-01-01

We have analyzed anatomic variations in the pectoralis major and pectoralis minor muscles of common chimpanzees (Pan\\ud troglodytes) and bonobos(Pan paniscus) and compared them to anatomic variations in these muscles in humans(Homo sapiens). We\\ud have macroscopically dissected these muscles in six adult Pan troglodytes, five Pan paniscus of ages ranging from fetus to adult, and\\ud five adult Homo sapiens. Although Pan troglodytes are thought to lack a separate pectoralis abdominis muscle, we...

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

Energy Technology Data Exchange (ETDEWEB)

Okuno, Yuji, E-mail: how-lowlow@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan); Korchi, Amine Mohamed, E-mail: amine.korchi@gmail.com [Geneva University Hospitals, Department of Diagnostic and Interventional Radiology (Switzerland); Shinjo, Takuma, E-mail: shin.takuma@a7.keio.jp [Keio University, Institute for Integrated Sports Medicine, School of Medicine (Japan); Kato, Shojiro, E-mail: shojiro7@yahoo.co.jp [Edogawa Hospital, Department of Orthopedic Surgery (Japan)

2015-04-15

PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function.

Transcatheter Arterial Embolization as a Treatment for Medial Knee Pain in Patients with Mild to Moderate Osteoarthritis

International Nuclear Information System (INIS)

Okuno, Yuji; Korchi, Amine Mohamed; Shinjo, Takuma; Kato, Shojiro

2015-01-01

PurposeOsteoarthritis is a common cause of pain and disability. Mild to moderate knee osteoarthritis that is resistant to nonsurgical options and not severe enough to warrant joint replacement represents a challenge in its management. On the basis of the hypothesis that neovessels and accompanying nerves are possible sources of pain, previous work demonstrated that transcatheter arterial embolization for chronic painful conditions resulted in excellent pain relief. We hypothesized that transcatheter arterial embolization can relieve pain associated with knee osteoarthritis.MethodsTranscatheter arterial embolization for mild to moderate knee osteoarthritis using imipenem/cilastatin sodium or 75 μm calibrated Embozene microspheres as an embolic agent has been performed in 11 and three patients, respectively. We assessed adverse events and changes in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores.ResultsAbnormal neovessels were identified within soft tissue surrounding knee joint in all cases by arteriography. No major adverse events were related to the procedures. Transcatheter arterial embolization rapidly improved WOMAC pain scores from 12.2 ± 1.9 to 3.3 ± 2.1 at 1 month after the procedure, with further improvement at 4 months (1.7 ± 2.2) and WOMAC total scores from 47.3 ± 5.8 to 11.6 ± 5.4 at 1 month, and to 6.3 ± 6.0 at 4 months. These improvements were maintained in most cases at the final follow-up examination at a mean of 12 ± 5 months (range 4–19 months).ConclusionTranscatheter arterial embolization for mild to moderate knee osteoarthritis was feasible, rapidly relieved resistant pain, and restored knee function

Transcatheter embolization of hepatic arteriovenous fistulas for control of hemobilia

Energy Technology Data Exchange (ETDEWEB)

Clark, R A; Colley, D P; Frey, R T; Eiseman, W R

1981-10-15

Two cases of traumatic hemobilia are presented in which hemorrhage was controlled by transcatheter vascular occlusion with stainless steel coils. Embolic therapy was safely performed without liver necrosis, despite the presence of portal hypertension in 1 patient. The technique is a useful alternative to surgery, which did not control hemorrhage in 1 case.

Recanalization of Splenic Artery Aneurysm After Transcatheter Arterial Embolization Using N-Butyl Cyanoacrylate

International Nuclear Information System (INIS)

Matsumoto, Keiji; Ushijima, Yasuhiro; Tajima, Tsuyoshi; Nishie, Akihiro; Hirakawa, Masakazu; Ishigami, Kousei; Yamaji, Yukiko; Honda, Hiroshi

2010-01-01

A 65-year-old woman who had been diagnosed as having microscopic polyangiitis developed sudden abdominal pain and entered a state of shock. Abdominal CT showed massive hemoperitoneum, and emergent angiography revealed a ruptured splenic artery aneurysm. After direct catheterization attempts failed due to tortuous vessels and angiospasm, transcatheter arterial embolization using an n-butyl cyanoacrylate (NBCA)-lipiodol mixture was successfully performed. Fifty days later, the patient developed sudden abdominal pain again. Repeated angiography demonstrated recanalization of the splenic artery and splenic artery aneurysm. This time, the recanalized aneurysm was embolized using metallic coils with the isolation method. Physicians should keep in mind that recanalization can occur after transcatheter arterial embolization using N-butyl cyanoacrylate, which has been used as a permanent embolic agent.

Assessment of the transcatheter closure of patent ductus arteriosus

International Nuclear Information System (INIS)

Yu Zhiqing; Zhou Aiqing; Gao Wei; Li Feng; Zhang Yuqi

2004-01-01

Objective: To explore the variation in blood pressure after transcatheter closure of PDA and assess the left ventricle function with echocardiography (ECHO). Methods: 300 cases were selected from April 1997 to May 2002 with mean age of 4.3 years. Cases with diameter of PDA <2.0 mm were occluded by using Pfm company produced Duct-occluder detachable coil; ≥2.0 mm used AGA company produced Amplatzer Duct-Occluder. Follow-up in 24 hours, one month, three months with ECHO, including residual shunt, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS). Results: There were 79 cases of hypertension after operation, Qp/Qs≥2 were obviously more then Qp/Qs<2 (P<0.05). All recovered within one to three days; 8 cases had mild residual shunt in 24 hours, only 1 case in one month, LVEDD, LVESD reduced obviously (P<0.05); EF, FS decreased slightly in 15 cases. Conclusions: Transcatheter closure of PDA shows good clinical efficacy and safety with some incidences of hypertension probably due to high volume of pulmonary blood flow. ECHO is useful in evaluation of left ventricular function. (authors)

Assessment of the transcatheter closure of patent ductus arteriosus

Energy Technology Data Exchange (ETDEWEB)

Zhiqing, Yu; Aiqing, Zhou; Wei, Gao; Feng, Li; Yuqi, Zhang [Affiliated to Shanghai Second Medical Univ., Shanghai (China). Shanghai Children' s Medical Center, Shanghai Xinhua Hospital

2004-12-15

Objective: To explore the variation in blood pressure after transcatheter closure of PDA and assess the left ventricle function with echocardiography (ECHO). Methods: 300 cases were selected from April 1997 to May 2002 with mean age of 4.3 years. Cases with diameter of PDA <2.0 mm were occluded by using Pfm company produced Duct-occluder detachable coil; {>=}2.0 mm used AGA company produced Amplatzer Duct-Occluder. Follow-up in 24 hours, one month, three months with ECHO, including residual shunt, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS). Results: There were 79 cases of hypertension after operation, Qp/Qs{>=}2 were obviously more then Qp/Qs<2 (P<0.05). All recovered within one to three days; 8 cases had mild residual shunt in 24 hours, only 1 case in one month, LVEDD, LVESD reduced obviously (P<0.05); EF, FS decreased slightly in 15 cases. Conclusions: Transcatheter closure of PDA shows good clinical efficacy and safety with some incidences of hypertension probably due to high volume of pulmonary blood flow. ECHO is useful in evaluation of left ventricular function. (authors)

Transcatheter closure of small ductus arteriosus with amplatzer vascular plug

Directory of Open Access Journals (Sweden)

Eunhyun Cho

2013-09-01

Full Text Available Purpose: The purpose of this study was to share our experience of transcatheter closure of small patent ductus arteriosus (PDA by using an Amplatzer vascular plug (AVP.&lt;br&gt; Methods: We reviewed the medical records of 20 patients who underwent transcatheter closure at Samsung Medical Center and Sejong General Hospital from January 2008 to August 2012. The size and shape of the PDAs were evaluated by performing angiograms, and the PDA size and the AVP devices size were compared.&lt;br&gt;Results: The mean age of the patients was 54.9±45.7 months old. The PDAs were of type C (n=5, type D (n=12 and type E (n=3. The mean pulmonary end diameter of the PDA was 1.7±0.6 mm, and the aortic end diameter was 3.6±1.4 mm. The mean length was 7.3±1.8 mm. We used 3 types of AVP devices: AVP I (n=5, AVP II (n=7, and AVP IV (n=8. The ratio of AVP size to the pulmonary end diameter was 3.37±1.64, and AVP size/aortic end ratio was 1.72±0.97. The aortic end diameter was significantly larger in those cases repaired with AVP II than in the others (P =0.002. The AVP size did not significantly correlate with the PDA size, but did correlate with smaller ratio of AVP size to aortic end diameter (1.10±0.31, P =0.032. &lt;br&gt;Conclusion: Transcatheter closure of small PDA with AVP devices yielded satisfactory outcome. AVP II was equally effective with smaller size of device, compared to others.

Transcatheter Device Closure of Patent Ductus Arteriosus

International Nuclear Information System (INIS)

Sultan, M.; Ullah, M.; Sadiq, N.; Akhtar, K.; Akbar, H.

2014-01-01

Objective: To determine the efficacy, safety and immediate complications encountered during percutaneous device closure of patent ductus arteriosus (PDA). Study Design: Case series. Place and Duration of Study: Department of Paediatric Cardiology, AFIC/NIHD, Rawalpindi, from January 2005 to December 2010. Methodology: Consecutive 500 patients who underwent attempted transcatheter PDA device closure were included in the study. Device type position, success of closure and complications were described as frequency percentage. Results: In 491 cases (98.2%), PDA was successfully occluded including 4 cases (0.8%) where devices were dislodged but retrieved and redeployed in Cath laboratory. PDA occluder devices used in 448 cases (91%) while coils (single or multiple) were used in 42 cases (8.5%) and in one case (0.2%) ASD occluder device was used to occlude the PDA. There were 09 (1.8%) unsuccessful cases, 06 (1.2%) were abandoned as ducts were considered unsuitable for device closure, 02 (0.4%) devices dislodged and needed surgical retrieval and one case (0.2%) was abandoned due to faulty equipment. The narrowest PDA diameter ranged from 0.5 - 14 mm with mean of 4.5 +- 2.4 mm. There was a single (0.2%) mortality. Conclusion: Transcatheter occlusion of PDA by coil or occluder device is an effective therapeutic option with high success rate. Complication rate is low in the hands of skilled operators yet paediatric cardiac surgical back-up cover is mandatory. (author)

SAPIENS: Spreading Activation Processor for Information Encoded in Network Structures. Technical Report No. 296.

Science.gov (United States)

Ortony, Andrew; Radin, Dean I.

The product of researchers' efforts to develop a computer processor which distinguishes between relevant and irrelevant information in the database, Spreading Activation Processor for Information Encoded in Network Structures (SAPIENS) exhibits (1) context sensitivity, (2) efficiency, (3) decreasing activation over time, (4) summation of…

Association Between Transcatheter Aortic Valve Replacement and Subsequent Infective Endocarditis and In-Hospital Death

DEFF Research Database (Denmark)

Regueiro, Ander; Linke, Axel; Latib, Azeem

2016-01-01

IMPORTANCE: Limited data exist on clinical characteristics and outcomes of patients who had infective endocarditis after undergoing transcatheter aortic valve replacement (TAVR). OBJECTIVE: To determine the associated factors, clinical characteristics, and outcomes of patients who had infective...... endocarditis after TAVR. DESIGN, SETTING, AND PARTICIPANTS: The Infectious Endocarditis after TAVR International Registry included patients with definite infective endocarditis after TAVR from 47 centers from Europe, North America, and South America between June 2005 and October 2015. EXPOSURE: Transcatheter...... aortic valve replacement for incidence of infective endocarditis and infective endocarditis for in-hospital mortality. MAIN OUTCOMES AND MEASURES: Infective endocarditis and in-hospital mortality after infective endocarditis. RESULTS: A total of 250 cases of infective endocarditis occurred in 20...

Elevation of B-Type Natriuretic Peptide at Discharge is Associated With 2-Year Mortality After Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis: Insights From a Multicenter Prospective OCEAN-TAVI (Optimized Transcatheter Valvular Intervention-Transcatheter Aortic Valve Implantation) Registry.

Science.gov (United States)

Mizutani, Kazuki; Hara, Masahiko; Iwata, Shinichi; Murakami, Takashi; Shibata, Toshihiko; Yoshiyama, Minoru; Naganuma, Toru; Yamanaka, Futoshi; Higashimori, Akihiro; Tada, Norio; Takagi, Kensuke; Araki, Motoharu; Ueno, Hiroshi; Tabata, Minoru; Shirai, Shinichi; Watanabe, Yusuke; Yamamoto, Masanori; Hayashida, Kentaro

2017-07-14

In this study, we sought to investigate the 2-year prognostic impact of B-type natriuretic peptide (BNP) levels at discharge, following transcatheter aortic valve replacement. We enrolled 1094 consecutive patients who underwent transcatheter aortic valve replacement between 2013 and 2016. Study patients were stratified into 2 groups according to survival classification and regression tree analysis (high versus low BNP groups). We evaluated the impact of high BNP on 2-year mortality compared with that of low BNP using a multivariable Cox model, and assessed whether this stratification would improve predictive accuracy for determining 2-year mortality by assessing time-dependent net reclassification improvement and integrated discrimination improvement. The median age of patients was 85 years (quartile 82-88), and 29.2% of the study population were men. The median Society of Thoracic Surgeons score was 6.8 (4.7-9.5), and BNP at discharge was 186 (93-378) pg/mL. All-cause mortality following discharge was 7.9% (95% CI, 5.8-9.9%) at 1 year and 15.4% (95% CI, 11.6-19.0%) at 2 years. The survival classification and regression tree analysis revealed that the discriminating BNP level to discern 2-year mortality was 202 pg/mL, and that elevated BNP had a statistically significant impact on outcomes, with an adjusted hazard ratio of 2.28 (1.36-3.82, P =0.002). The time-dependent net reclassification improvement ( P =0.047) and integrated discrimination improvement ( P =0.029) analysis revealed that the incorporation of BNP stratification with other clinical variables significantly improved predictive accuracy for 2-year mortality. Elevation of BNP at discharge is associated with 2-year mortality after transcatheter aortic valve replacement. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Infective endocarditis following transcatheter aortic valve replacement-

DEFF Research Database (Denmark)

Loh, Poay Huan; Bundgaard, Henning; S�ndergaard, Lars

2013-01-01

Transcatheter aortic valve replacement (TAVR) can improve the symptoms and prognosis of patients with severe aortic stenosis who, due to a high expected operative risk, would not have otherwise been treated surgically. If these patients develop prosthetic valve endocarditis, their presentations may...... be atypical causing a delay in the diagnosis and treatment. The management is also complicated by their comorbidities, and surgical treatment may not be feasible leading to a significant morbidity and mortality. We describe a case of an 85-year-old man with TAVI prosthetic valve endocarditis successfully...

Treatment of primany hepatic carcinoma with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization

International Nuclear Information System (INIS)

Wu Li; Wen Xiaoping; Huang Wei

2006-01-01

Objective: To evaluate the effects of three-dimensional conformal radiation therapy (3DCRT) combined with transcatheter arterial chemoembolization (TACE) on stage m/IV primary hepatic carcinoma. Methods: Eighty cases of stage III/IV primary hepatic carcinoma were randomly divided into two groups: 40 cases treated with three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization (3DCRT + TACE group) and 40 cases treated with three-dimensional conformal radiation therapy associated with hepatic arterial infusion chemotherapy (3DCRT +HAI group). Results: The response rates were 75% and 45% in 3DCRT + TACE group and 3DCRT + HAI group, respectively; and the difference between the two groups was statistically significant (P 0.05), The 0.5-, 1- and 2-year survival rates were 73% , 45% and 28% in 3DCRT + TACE group, and 45%, 25% and 13% in 3DCRT + HAI group, respectively; and the difference between the two groups was statistically significant (P 0.05). Conclusion: Three-dimensional conformal radiation therapy combined with transcatheter arterial chemoembolization improved prognosis of stage III/IV primary hepatic carcinoma. (authors)

Emergence of a Homo sapiens-specific gene family and chromosome 16p11.2 CNV susceptibility.

Science.gov (United States)

Nuttle, Xander; Giannuzzi, Giuliana; Duyzend, Michael H; Schraiber, Joshua G; Narvaiza, Iñigo; Sudmant, Peter H; Penn, Osnat; Chiatante, Giorgia; Malig, Maika; Huddleston, John; Benner, Chris; Camponeschi, Francesca; Ciofi-Baffoni, Simone; Stessman, Holly A F; Marchetto, Maria C N; Denman, Laura; Harshman, Lana; Baker, Carl; Raja, Archana; Penewit, Kelsi; Janke, Nicolette; Tang, W Joyce; Ventura, Mario; Banci, Lucia; Antonacci, Francesca; Akey, Joshua M; Amemiya, Chris T; Gage, Fred H; Reymond, Alexandre; Eichler, Evan E

2016-08-11

Genetic differences that specify unique aspects of human evolution have typically been identified by comparative analyses between the genomes of humans and closely related primates, including more recently the genomes of archaic hominins. Not all regions of the genome, however, are equally amenable to such study. Recurrent copy number variation (CNV) at chromosome 16p11.2 accounts for approximately 1% of cases of autism and is mediated by a complex set of segmental duplications, many of which arose recently during human evolution. Here we reconstruct the evolutionary history of the locus and identify bolA family member 2 (BOLA2) as a gene duplicated exclusively in Homo sapiens. We estimate that a 95-kilobase-pair segment containing BOLA2 duplicated across the critical region approximately 282 thousand years ago (ka), one of the latest among a series of genomic changes that dramatically restructured the locus during hominid evolution. All humans examined carried one or more copies of the duplication, which nearly fixed early in the human lineage--a pattern unlikely to have arisen so rapidly in the absence of selection (P sapiens-specific duplication. In summary, the duplicative transposition of BOLA2 at the root of the H. sapiens lineage about 282 ka simultaneously increased copy number of a gene associated with iron homeostasis and predisposed our species to recurrent rearrangements associated with disease.

Transcatheter occlusion of secundum atrial septal defect in elderly patients with pulmonary hypertension

International Nuclear Information System (INIS)

Hu Jian; Zhang Qi; Ding Fenghua; Yang Zhenkun; Zhang Ruiyan; Zhang Jiansheng; Shen Weifeng

2008-01-01

Objective: To evaluate the effect and safety of transcatheter occlusion for secundum atrial septal defect (ASD)in elderly patients with pulmonary hypertension. Methods: Thirty four patients underwent transcatheter occlusion of ASD from January 2002 to December 2006. Fifteen of them aged over 65 and accompanied with pulmonary hypertension (pulmonary hypertension group). All patients received thoracic cardiodynamic ultrasonography and 12 leads ECG before and 1 d, 1 mon, 3 mon, 6 mon, 12 mon after the procedure. Under the guidance of fluoroscopy and transthoracic cardio-ultrasonography, Amplatzer occluders was implanted for the atrial septal defect. Results: The successful rate of placement of the Amplatzer occluder was 100% and no complication was found during the procedure and follow-up period. There were significant differences between pulmonary hypertension group and non-pulmonary hypertension group in age (66.7 ± 5.0y vs 24.1 ± 9.0 y, P<0.001), classification of heart function (NYHA) (2.8 ± 0.7 vs 1.7 ± 0.7, P<0.001), diameter of ASD(30.5 ± 3.2 mm vs 14.2 ± 4.0 mm, P<0.001), size of Amplatzer occluder(35.3 ± 4.5 mm vs 18.2 ± 4.4 mm, P<0.001), systolic pulmonary artery pressure(65.2 ± 11.2 mmHg vs 29.5 ± 3.3 mmHg, P<0.001)and mean pulmonary artery pressure (31.5 ± 4.6 mmHg vs 17.9 ± 1.1 mmHg, P<0.001). After transcatheter closure of ASD, the parameters the systolic pulmonary artery pressure (36.6 ± 11.4 mmHg)and mean pulmonary artery pressure (21.6 ± 4.3 mmHg)decreased significantly in pulmonary hypertension group compared with those before procedure, and the classification of heart function (NYHA)improved (from 2.8 ± 0.7 to 1.8 ± 0.8, P<0.001). Conclusion: Transcatheter occlusion of secundum ASD in elderly patients with pulmonary hypertension is safe and effective. (authors)

Transcatheter shunt embolotherapy in multiple myeloma with high output heart failure

Energy Technology Data Exchange (ETDEWEB)

Kim, Jeong Ho [Wonkwang University School of Medicine, Iksan (Korea, Republic of); Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo [Ulsan University College of Medicine, Seoul (Korea, Republic of)

2002-12-01

High-output heart failure may be fairly common in patients with multiple myeloma and is associated with severe bone involvement. In this report, we describe the case of a 67-year-old man with multiple myeloma who presented with high output heart failure subsequently treated by transcatheter arterial embolization.

Transcatheter shunt embolotherapy in multiple myeloma with high output heart failure

International Nuclear Information System (INIS)

Kim, Jeong Ho; Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo

2002-01-01

High-output heart failure may be fairly common in patients with multiple myeloma and is associated with severe bone involvement. In this report, we describe the case of a 67-year-old man with multiple myeloma who presented with high output heart failure subsequently treated by transcatheter arterial embolization

Homo sapiens, Homo neanderthalensis and the Denisova specimen: new insights on their evolutionary histories using whole-genome comparisons

Directory of Open Access Journals (Sweden)

Vanessa Rodrigues Paixão-Côrtes

2012-01-01

Full Text Available After a brief review of the most recent findings in the study of human evolution, an extensive comparison of the complete genomes of our nearest relative, the chimpanzee (Pan troglodytes, of extant Homo sapiens, archaic Homo neanderthalensis and the Denisova specimen were made. The focus was on non-synonymous mutations, which consequently had an impact on protein levels and these changes were classified according to degree of effect. A total of 10,447 non-synonymous substitutions were found in which the derived allele is fixed or nearly fixed in humans as compared to chimpanzee. Their most frequent location was on chromosome 21. Their presence was then searched in the two archaic genomes. Mutations in 381 genes would imply radical amino acid changes, with a fraction of these related to olfaction and other important physiological processes. Eight new alleles were identified in the Neanderthal and/or Denisova genetic pools. Four others, possibly affecting cognition, occured both in the sapiens and two other archaic genomes. The selective sweep that gave rise to Homo sapiens could, therefore, have initiated before the modern/archaic human divergence.

Edward Bond El teatro de compromiso social

Directory of Open Access Journals (Sweden)

Rosa López de D’Amico

2015-10-01

Full Text Available Este trabajo muestra un estudio de la obra del dramaturgo contemporáneo británico Edward Bond. El análisis está basado en la crítica literaria social a través del cual se estudia la violencia presente en la obra de Edward Bond. La investigación se presenta en secciones. En primera instancia, se propone una biografía del autor y la función que este le asigna al teatro. Seguidamente, se expone brevemente el desarrollo del teatro británico en el siglo XX. Luego se plantea un resumen de la obra objeto de estudio, Saved, y a continuación su correspondiente análisis, señalando las acciones violentas y su respectivo estudio. Además, se incluye un subcapítulo en donde se plantea la interrogante acerca de los aspectos positivos o negativos de la obra. En la última parte, se hace una breve revisión de otras obras escritas por el autor en donde se evidencia constantemente la violencia. En las conclusiones se exponen algunas ideas del autor, se plantea la validez del trabajo del escritor y se señala la importancia de este estudio en el proceso de enseñanza del inglés. AbstractThis paper presents a study of the works of the contemporary British playwright Edward Bond. The analysis is based on literary social criticism through which the violence present in the work of Edward Bond is studied. The research is presented in sections. In the first instance, there is a biography of the author and how this was refl ected in his work. Then the study describes briefl y the development of British theater in the twentieth century. Then the study presents a summary of the work under consideration and its corresponding analysis indicating the violent actions and their respective study. Also included is a subchapter where the question arises about the positive or negative aspects of the work. In the last part, there is a brief review of other works written by the author where violence is demonstrated consistently. The

Transcatheter closure of re-canalized patent ductus arteriosus after surgical ligation

International Nuclear Information System (INIS)

Zhang Qingqiao; Jiang Shiliang; Huang Lianjun; Zhao Shihua; Zheng Hong; Ling Jian; Jin Jinglin; Xu Zhongying; Xie Ruolan; Dai Ruping

2002-01-01

Objective: To evaluate the effectiveness of transcatheter closure of re-canalized patent ductus arteriosus (PDA) after surgical ligation. Methods: Between June 1995 and November 2000, 14 patients (5 male, 9 female) with re-canalized PDA after surgical ligation underwent transcatheter closure, their median age was 13 years (range 4 to 48 years). The time between surgical ligation and the interventional procedure ranged from one month to twenty-two years. Implantations of Amplatzer duct occluder and Rashkind occluder were performed trans-venously. Cook coil occlusions was performed trans-arterially. Follow-up with X-ray radiograph and echocardiography was made 24 hours, 1, 3, 6 months, and more than 1 year after the procedure. Results: Twelve PDAs were of funnel shape, and the remaining two PDAs were of tubular shape. The median minimum diameter of re-canalized PDA after ligation was 4 mm (range 1 to 8 mm). Aortograms ten minutes after closure showed complete closure and trivial residual shunt in 11 and 3 patients, respectively. The technical success rate was 100%, and there were no complications. Echocardiography showed complete closure in all patients within 24 hours. All patients were discharged in one to two days after the procedure. At a follow-up of one to eighteen months in ten patients, there were no migration of devices and residual PDA. Conclusion: Transcatheter closure using Amplatzer duct occluder, coil (Cook company or Pfm company) and Rashkind occluder was an effective method for patients with re-canalized PDA after surgical ligation. It may be an alternative to second surgery owing to its safety, reliability, min-invasiveness, and short hospitalization

Transcatheter closure of re-canalized patent ductus arteriosus after surgical ligation

Energy Technology Data Exchange (ETDEWEB)

Qingqiao, Zhang; Shiliang, Jiang; Lianjun, Huang; Shihua, Zhao; Hong, Zheng; Jian, Ling; Jinglin, Jin; Zhongying, Xu; Ruolan, Xie; Ruping, Dai [Chinese Academy of Medical Science, Beijing Union Medical College, Beijing (China). Cardiovascular Inst. and Fuwai Hospital, Dept. of Radiology

2002-02-01

Objective: To evaluate the effectiveness of transcatheter closure of re-canalized patent ductus arteriosus (PDA) after surgical ligation. Methods: Between June 1995 and November 2000, 14 patients (5 male, 9 female) with re-canalized PDA after surgical ligation underwent transcatheter closure, their median age was 13 years (range 4 to 48 years). The time between surgical ligation and the interventional procedure ranged from one month to twenty-two years. Implantations of Amplatzer duct occluder and Rashkind occluder were performed trans-venously. Cook coil occlusions was performed trans-arterially. Follow-up with X-ray radiograph and echocardiography was made 24 hours, 1, 3, 6 months, and more than 1 year after the procedure. Results: Twelve PDAs were of funnel shape, and the remaining two PDAs were of tubular shape. The median minimum diameter of re-canalized PDA after ligation was 4 mm (range 1 to 8 mm). Aortograms ten minutes after closure showed complete closure and trivial residual shunt in 11 and 3 patients, respectively. The technical success rate was 100%, and there were no complications. Echocardiography showed complete closure in all patients within 24 hours. All patients were discharged in one to two days after the procedure. At a follow-up of one to eighteen months in ten patients, there were no migration of devices and residual PDA. Conclusion: Transcatheter closure using Amplatzer duct occluder, coil (Cook company or Pfm company) and Rashkind occluder was an effective method for patients with re-canalized PDA after surgical ligation. It may be an alternative to second surgery owing to its safety, reliability, min-invasiveness, and short hospitalization.

Cleveland's Multicultural Librarian: Eleanor (Edwards) Ledbetter, 1870-1954

Science.gov (United States)

Jones, Plummer Alston, Jr.

2013-01-01

Eleanor (Edwards) Ledbetter, who served immigrant populations in Cleveland throughout most of the Progressive Era and the Great Depression, was one of the first librarians to advocate for multiculturalism (then called cultural pluralism) as opposed to Americanism. In providing multicultural and multilingual library services for immigrants,…

Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder

Energy Technology Data Exchange (ETDEWEB)

Yongwen, Qin; Xianxian, Zhao; Xing, Zheng; Jijun, Ding; Jiang, Cao [Second Military Medical Univ., Shanghai (China). Changhai Hospital, Dept. of Cardiology

2004-04-01

Objective: To evaluate the feasibility and efficacy of transcatheter perimembranous ventricular septal defects (VSD) occlusion with home-made nitinol occluder. Methods: Transcatheter closure was attempted in 196 patients with perimembranous VSD. The diameter of VSD measured by echocardiography was 3 to 15 mm, mean (4.94 {+-} 2.23) mm. The angiographic diameter of the VSD was 3 to 6 mm, mean (3.92 {+-} 1.44) mm. A 7-10 F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein to deploy the occluder with the guidance of echocardiography and fluoroscopy. The device diameter selected was from 4 to 20 mm, mean (6.68 {+-} 2.76) mm. Left ventriculography and transthoracic echocardiography were repeated to assess the closure of the defects 15 min after the procedure. Continuous electrocardiogram monitoring lasted for 5 days. The echocardiography and electrocardiogram examination were scheduled for 1, 6 and 12 months of follow-up. Results: The occluders were successfully deployed in 191 patients. There were five procedural failures, two with device-related aortic insufficiency, and three of inability to pass through VSD. After deployment of the devices, there were no residual shunt in 180 of 191 patients, 11 patients with a trivial residual shunt that disappeared in 8 patients after one month of follow up. 3 patients developed mild tricuspid insufficiency. 12 developed transient complete right bundle branch block, and 5 transient complete left bundle branch block, and 2 transient complete atrioventricular block. There were repetitive nonparoxysmal ventricular tachycardia in 4 patients 1 week after the procedure. One patient had a detached device embolized into the left pulmonary artery but with a successful catheter retrieval by snare and transcatheter closure. The devices were similarly applied to patients with VSD associated with patent ductus arteriosus, and 4 patients with VSD complicated by atrial septal defects. The fluoroscopy time

Embrella embolic deflection device for cerebral protection during transcatheter aortic valve replacement

NARCIS (Netherlands)

Samim, Mariam; Agostoni, Pierfrancesco; Hendrikse, Jeroen; Budde, Ricardo P J; Nijhoff, Freek; Kluin, Jolanda; Ramjankhan, Faiz; Doevendans, Pieter A.; Stella, Pieter R.

2015-01-01

AIMS: To compare the extent of cerebral ischemic injury after transcatheter aortic valve replacement (TAVR) with the use of an Embrella Embolic Deflector System versus unprotected TAVR. METHODS: Fifteen patients with severe symptomatic aortic stenosis underwent TAVR with use of the Embrella Embolic

Embrella embolic deflection device for cerebral protection during transcatheter aortic valve replacement

NARCIS (Netherlands)

Samim, Mariam; Agostoni, Pierfrancesco; Hendrikse, Jeroen; Budde, Ricardo P. J.; Nijhoff, Freek; Kluin, Jolanda; Ramjankhan, Faiz; Doevendans, Pieter A.; Stella, Pieter R.

2015-01-01

Aims: To compare the extent of cerebral ischemic injury after transcatheter aortic valve replacement (TAVR) with the use of an Embrella Embolic Deflector System versus unprotected TAVR. Methods: Fifteen patients with severe symptomatic aortic stenosis underwent TAVR with use of the Embrella Embolic

Transcatheter closure of post-operative residual ventricular septal defect using a patent ductus arteriosus closure device in an adult: a case report.

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Djer, Mulyadi M; Idris, Nikmah S; Alwi, Idrus; Wijaya, Ika P

2014-07-01

Transcatheter closure of perimembranous and muscular ventricular septal defect (VSD) has been performed widely and it has more advantages compare to surgery. However, transcatheter closure of residual VSD post operation of complex congenital heart disease is still challenging because of the complexity of anatomy and concern about device stability, so the operator should meticulously choose the most appropriate technique and device. We would like to report a case of transcatheter closure of residual VSD post Rastelli operation in a patient with double outlet right ventricle (DORV), sub-aortic VSD, severe infundibulum pulmonary stenosis (PS) and single coronary artery. The patient had undergone operations for four times, but he still had intractable heart failure that did not response to medications. On the first attempt. we closed the VSD using a VSD occluder, unfortunately the device embolized into the descending aorta, but fortunately we was able to snare it out. Then we decided to close the VSD using a patent ductus arteriosus (PDA occluder). On transesophageal echocardiography (TEE) and angiography evaluation, the device position was stable. Post transcatheter VSD closure, the patient clinical condition improved significantly and he could finally be discharged after a long post-surgery hospitalization. Based on this experience we concluded that the transcatheter closure of residual VSD in complex CHD using PDA occluder could be an effective alternative treatment.

Mortality Risk After Transcatheter Aortic Valve Implantation: Analysis of the Predictive Accuracy of the Transcatheter Valve Therapy Registry Risk Assessment Model.

Science.gov (United States)

Codner, Pablo; Malick, Waqas; Kouz, Remi; Patel, Amisha; Chen, Cheng-Han; Terre, Juan; Landes, Uri; Vahl, Torsten Peter; George, Isaac; Nazif, Tamim; Kirtane, Ajay J; Khalique, Omar K; Hahn, Rebecca T; Leon, Martin B; Kodali, Susheel

2018-05-08

Risk assessment tools currently used to predict mortality in transcatheter aortic valve implantation (TAVI) were designed for patients undergoing cardiac surgery. We aim to assess the accuracy of the TAVI dedicated American College of Cardiology / Transcatheter Valve Therapies (ACC/TVT) risk score in predicting mortality outcomes. Consecutive patients (n=1038) undergoing TAVI at a single institution from 2014 to 2016 were included. The ACC/TVT registry mortality risk score, the Society of Thoracic Surgeons - Patient Reported Outcomes (STS-PROM) score and the EuroSCORE II were calculated for all patients. In hospital and 30-day all-cause mortality rates were 1.3% and 2.9%, respectively. The ACC/TVT risk stratification tool scored higher for patients who died in-hospital than in those who survived the index hospitalization (6.4 ± 4.6 vs. 3.5 ± 1.6, p = 0.03; respectively). The ACC/TVT score showed a high level of discrimination, C-index for in-hospital mortality 0.74, 95% CI [0.59 - 0.88]. There were no significant differences between the performance of the ACC/TVT registry risk score, the EuroSCORE II and the STS-PROM for in hospital and 30-day mortality rates. The ACC/TVT registry risk model is a dedicated tool to aid in the prediction of in-hospital mortality risk after TAVI.

Short-term outcomes of transcatheter closure of secundum atrial septal defect in children and adolescents: An experience of two centers in Upper Egypt

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Safaa H. Ali

2018-01-01

Conclusions: Transcatheter closure of ASDs in children and adolescents was feasible and safe in the first 4 years experience in our centers, with good short-term outcome. Balloon sizing is not necessary for transcatheter closure of secundum ASD. Multiple defects can be safety closed by a single device.

Safety and Efficacy of Transcatheter Closure of Patent Ductus Arteriosus With Severe Mitral Regurgitation in Adults.

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Wang, Zhongkai; Chen, Tao; Chen, Liang; Qin, Yongwen; Zhao, Xianxian

2016-01-01

Transcatheter closure is the usual treatment for patent ductus arteriosus (PDA), but its safety and efficacy have not been reported in adult PDA patients with severe mitral regurgitation. A retrospective study on 27 consecutive patients diagnosed with PDA and severe mitral regurgitation and treated using transcatheter closure between September 2010 and September 2012 at the Department of Cardiology of Changhai Hospital in Changhai, China. Left ventricular (LV) diastolic volume and function, pulmonary artery pressure, and instantaneous reverse-flow volume were examined by echocardiography before PDA closure, immediately after closure, and 1 year after closure. After the procedure, the LV diastolic volume (P.05). Pulmonary arterial systolic pressure was unchanged 1 year after closure (from 46.41 ± 19.92 mm Hg to 45.43 ± 13.64 mm Hg; P=.58). All procedures were uneventful and only mild complications occurred (hemolysis in 2 cases, subcutaneous hematoma in 4 cases, and fever in 2 cases). Transcatheter closure can decrease the LV volume and instantaneous reverse-flow volume in adult PDA patients with severe mitral regurgitation. This procedure is effective and has a good safety profile.

Silent ischemic brain lesions after transcatheter aortic valve replacement : lesion distribution and predictors

NARCIS (Netherlands)

Samim, Mariam; Hendrikse, Jeroen; van der Worp, H. Bart; Agostoni, Pierfrancesco; Nijhoff, Freek; Doevendans, Pieter A.; Stella, Pieter R.

Silent ischemic brain lesions and ischemic stroke are known complications of transcatheter aortic valve replacement (TAVR). We aimed to investigate the occurrence and distribution of TAVR-related silent ischemic brain lesions using diffusion-weighted magnetic resonance imaging (DWI). Consecutive

Radiation exposure in transcatheter patent ductus arteriosus closure: time to tune?

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Villemain, Olivier; Malekzadeh-Milani, Sophie; Sitefane, Fidelio; Mostefa-Kara, Meriem; Boudjemline, Younes

2018-05-01

The aims of this study were to describe radiation level at our institution during transcatheter patent ductus arteriosus occlusion and to evaluate the components contributing to radiation exposure. Transcatheter occlusion relying on X-ray imaging has become the treatment of choice for patients with patent ductus arteriosus. Interventionists now work hard to minimise radiation exposure in order to reduce risk of induced cancers. We retrospectively reviewed all consecutive children who underwent transcatheter closure of patent ductus arteriosus from January 2012 to January 2016. Clinical data, anatomical characteristics, and catheterisation procedure parameters were reported. Radiation doses were analysed for the following variables: total air kerma, mGy; dose area product, Gy.cm2; dose area product per body weight, Gy.cm2/kg; and total fluoroscopic time. A total of 324 patients were included (median age=1.51 [Q1-Q3: 0.62-4.23] years; weight=10.3 [6.7-17.0] kg). In all, 322/324 (99.4%) procedures were successful. The median radiation doses were as follows: total air kerma: 26 (14.5-49.3) mGy; dose area product: 1.01 (0.56-2.24) Gy.cm2; dose area product/kg: 0.106 (0.061-0.185) Gy.cm2/kg; and fluoroscopic time: 2.8 (2-4) min. In multivariate analysis, a weight >10 kg, a ductus arteriosus width <2 mm, complications during the procedure, and a high frame rate (15 frames/second) were risk factors for an increased exposure. Lower doses of radiation can be achieved with subsequent recommendations: technical improvement, frame rate reduction, avoidance of biplane cineangiograms, use of stored fluoroscopy as much as possible, and limitation of fluoroscopic time. A greater use of echocardiography might even lessen the exposure.

The effects of contrast media volume on acute kidney injury after transcatheter aortic valve replacement: a systematic review and meta-analysis.

Science.gov (United States)

Thongprayoon, Charat; Cheungpasitporn, Wisit; Podboy, Alexander J; Gillaspie, Erin A; Greason, Kevin L; Kashani, Kianoush B

2016-11-01

The goal of this systematic review was to assess the effects of contrast media volume on transcatheter aortic valve replacement-related acute kidney injury. A literature search was performed using Medline, EMbase, the Cochrane Database of Systematic Reviews, and clinicaltrials.gov from the inception of these databases through December 2015. Studies that reported relative risk, odds ratio, or hazard ratio comparing the risks of acute kidney injury following transcatheter aortic valve replacement in patients who received high contrast media volume were included. Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated using a random-effect, generic inverse variance method. Four cohort studies composed of 891 patients were included in the analyses to assess the risk of acute kidney injury after transcatheter aortic valve replacement in patients who received high contrast media volume. The pooled RR of acute kidney injury after transcatheter aortic valve replacement in patients who received a large volume of contrast media was 1.41 (95% CI, 0.87 to 2.28) compared with low contrast media volume. The meta-analysis was limited to studies using standard acute kidney injury definitions, and the pooled RR of acute kidney injury in patients who received high contrast media volume is 1.12 (95% CI, 0.78 to 1.62). Our meta-analysis shows no significant association between contrast media volume and risk of acute kidney injury after transcatheter aortic valve replacement. © 2016 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

Reevaluation of the indications for permanent pacemaker implantation after transcatheter aortic valve implantation

DEFF Research Database (Denmark)

Bjerre Thygesen, Julie; Loh, Poay Huan; Cholteesupachai, Jiranut

2014-01-01

AIMS: Conduction abnormalities (CA) requiring permanent pacemaker (PPM) are a well-known complication after transcatheter aortic valve implantation (TAVI). This study aimed to determine the incidence of TAVI-related PPM and reevaluate the indications for PPM after the periprocedural period. METHO...

Introducing Edward L. Bernays, the "Father of Public Relations."

Science.gov (United States)

Yeager, Robert J.

1985-01-01

Relates some of the public relations achievements and techniques of Edward L. Bernays. Sees modern public relations proceeding from an understanding of individuals, institutions and social groups, and their interrelationships. Considers the information dissemination, persuasion, and attitude integration functions of public relations. Lists…

A new species of Trichopeltarion A. Milne-Edwards, 1880, from the Southwestern Atlantic (Crustacea: Brachyura: Atelecyclidae

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Marcos Tavares

2005-01-01

Full Text Available A new species of Trichopeltarion A. Milne-Edwards, 1880, is described from off coast of Brazil, namely Trichopeltarion pezzutoi n. sp. The new species is compared to its Atlantic congeners, Trichopeltarion nobile A. Milne-Edwards, 1880, and Trichopeltarion intesi (Crosnier, 1981. The record of T. nobile from Brazil should actually be attributed to T. pezzutoi n. sp. The differences between the genera Trichopeltarion and Peltarion Jacquinot, 1847 are discussed.Uma nova espécie do gênero Trichopeltarion A. Milne-Edwards, 1880 coligida no talude continental brasileiro é descrita e ilustrada, nomeadamente Trichopeltarion pezzutoi n. sp. A nova espécie é comparada às suas congêneres do oceano Atlântico, Trichopeltarion nobile A. Milne-Edwards, 1880 e Trichopeltarion intesi (Crosnier, 1981. O registro de T. nobile para o Brasil deve ser atribuído à T. pezzutoi n. sp. São discutidas as diferenças entre os gêneros Trichopeltarion e Peltarion Jacquinot, 1847.

LB1 and LB6 Homo floresiensis are not modern human (Homo sapiens) cretins.

Science.gov (United States)

Brown, Peter

2012-02-01

Excavations in the late Pleistocene deposits at Liang Bua cave, Flores, have uncovered the skeletal remains of several small-bodied and small-brained hominins in association with stone artefacts and the bones of Stegodon. Due to their combination of plesiomorphic, unique and derived traits, they were ascribed to a new species, Homo floresiensis, which, along with Stegodon, appears to have become extinct ∼17 ka (thousand years ago). However, recently it has been argued that several characteristics of H. floresiensis were consistent with dwarfism and evidence of delayed development in modern human (Homo sapiens) myxoedematous endemic (ME) cretins. This research compares the skeletal and dental morphology in H. floresiensis with the clinical and osteological indicators of cretinism, and the traits that have been argued to be associated with ME cretinism in LB1 and LB6. Contrary to published claims, morphological and statistical comparisons did not identify the distinctive skeletal and dental indicators of cretinism in LB1 or LB6 H. floresiensis. Brain mass, skeletal proportions, epiphyseal union, orofacial morphology, dental development, size of the pituitary fossa and development of the paranasal sinuses, vault bone thickness and dimensions of the hands and feet all distinguish H. floresiensis from modern humans with ME cretinism. The research team responsible for the diagnosis of ME cretinism had not examined the original H. floresiensis skeletal materials, and perhaps, as a result, their research confused taphonomic damage with evidence of disease, and thus contained critical errors of fact and interpretation. Behavioural scenarios attempting to explain the presence of cretinous H. sapiens in the Liang Bua Pleistocene deposits, but not unaffected H. sapiens, are both unnecessary and not supported by the available archaeological and geochronological evidence from Flores. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Edward Christopher Williams and His Impact on Librarianship.

Science.gov (United States)

Latimer, Carlos

Edward Christopher Williams had a major impact on librarianship, not only as the first documented African American to graduate from a library school, but also as a developer of education for librarians and as an active member of the American Library Association (ALA) and the Ohio Library Association. This study used the historical methodology…

Percutaneous transcatheter closure of patent ductus arteriosus: Initial experience of Sohag University

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Safaa Husein Ali

2014-06-01

Conclusion: Our initial results show that transcatheter occlusion of PDA using different types of devices is safe and effective with good midterm outcome alternative to surgery. Complications occurred in those with unfavorable duct anatomy and presence of pulmonary hypertension. Surgical backup was not important for such interventional procedures.

Feyz Kashani and Jonathan Edwards on the Place of Heart in Religious Knowledge

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Saham Asadinia

2014-08-01

Full Text Available This essay seeks to summarize and compare the theological ideas of Jonathan Edwards, a western philosopher, with those of Feyz Kashani, an eastern philosopher. The reason for this study is the numerous conjunctions that are seen in their ideas. These include the harmony of heart and reason in respect to belief, the priority of the heart in the reflection of truth, the belief in centrality of the religion of heart, the necessity of divine grace in the flow of religious knowledge, the emphasis on the esoteric side of religion as opposed to the exoteric side, and the importance of a practical approach to religion. Significant differences also exist between their ideas. For instance, Edwards believes that human nature is sinful and corrupted while Feyz does not believe this is true. Furthermore, Feyz interprets the path of heart to be based on reason, while Edwards has a different point of view.

Social Perspective and Educational Knowledge: Edward L. Thorndike Reexamined.

Science.gov (United States)

Franklin, Barry M.

This paper examines the relationship between educational theorist Edward L. Thorndike's psychology and his social viewpoint. Many of the revisionists in educational history have oversimplified Thorndike's thought by not examining his views from this perspective. Thorndike's educational ideas and practices are reflections of certain fundamental…

The nordic aortic valve intervention (NOTION) trial comparing transcatheter versus surgical valve implantation

DEFF Research Database (Denmark)

Thyregod, Hans Gustav; Søndergaard, Lars; Ihlemann, Nikolaj

2013-01-01

Degenerative aortic valve (AV) stenosis is the most prevalent heart valve disease in the western world. Surgical aortic valve replacement (SAVR) has until recently been the standard of treatment for patients with severe AV stenosis. Whether transcatheter aortic valve implantation (TAVI) can...

Prosthetic valve endocarditis after transcatheter aortic valve implantation

DEFF Research Database (Denmark)

Olsen, Niels Thue; De Backer, Ole; Thyregod, Hans G H

2015-01-01

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an advancing mode of treatment for inoperable or high-risk patients with aortic stenosis. Prosthetic valve endocarditis (PVE) after TAVI is a serious complication, but only limited data exist on its incidence, outcome, and procedural......%) were treated conservatively and 1 with surgery. Four patients (22%) died from endocarditis or complications to treatment, 2 of those (11%) during initial hospitalization for PVE. An increased risk of TAVI-PVE was seen in patients with low implanted valve position (hazard ratio, 2.8 [1.1-7.2]), moderate...

Transcatheter arterial embolization for acute nonvariceal upper gastrointestinal bleeding: Indications, techniques and outcomes.

Science.gov (United States)

Loffroy, R; Favelier, S; Pottecher, P; Estivalet, L; Genson, P Y; Gehin, S; Cercueil, J P; Krausé, D

2015-01-01

Over the past three decades, transcatheter arterial embolization has become the first-line therapy for the management of acute nonvariceal upper gastrointestinal bleeding that is refractory to endoscopic hemostasis. Advances in catheter-based techniques and newer embolic agents, as well as recognition of the effectiveness of minimally invasive treatment options, have expanded the role of interventional radiology in the treatment of bleeding for a variety of indications. Transcatheter arterial embolization is a fast, safe, and effective minimally invasive alternative to surgery, when endoscopic treatment fails to control acute bleeding from the upper gastrointestinal tract. This article describes the role of arterial embolization in the management of acute nonvariceal upper gastrointestinal bleeding and summarizes the literature evidence on the outcomes of endovascular therapy in such a setting. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Transcatheter closure of membranous ventricular septal defects with home-made nitinol occluder

International Nuclear Information System (INIS)

Qin Yongwen; Zhao Xianxian; Zheng Xing; Ding Jijun; Cao Jiang

2004-01-01

Objective: To evaluate the feasibility and efficacy of transcatheter perimembranous ventricular septal defects (VSD) occlusion with home-made nitinol occluder. Methods: Transcatheter closure was attempted in 196 patients with perimembranous VSD. The diameter of VSD measured by echocardiography was 3 to 15 mm, mean (4.94 ± 2.23) mm. The angiographic diameter of the VSD was 3 to 6 mm, mean (3.92 ± 1.44) mm. A 7-10 F delivery sheath was advanced across the perimembranous VSD over a wire from femoral vein to deploy the occluder with the guidance of echocardiography and fluoroscopy. The device diameter selected was from 4 to 20 mm, mean (6.68 ± 2.76) mm. Left ventriculography and transthoracic echocardiography were repeated to assess the closure of the defects 15 min after the procedure. Continuous electrocardiogram monitoring lasted for 5 days. The echocardiography and electrocardiogram examination were scheduled for 1, 6 and 12 months of follow-up. Results: The occluders were successfully deployed in 191 patients. There were five procedural failures, two with device-related aortic insufficiency, and three of inability to pass through VSD. After deployment of the devices, there were no residual shunt in 180 of 191 patients, 11 patients with a trivial residual shunt that disappeared in 8 patients after one month of follow up. 3 patients developed mild tricuspid insufficiency. 12 developed transient complete right bundle branch block, and 5 transient complete left bundle branch block, and 2 transient complete atrioventricular block. There were repetitive nonparoxysmal ventricular tachycardia in 4 patients 1 week after the procedure. One patient had a detached device embolized into the left pulmonary artery but with a successful catheter retrieval by snare and transcatheter closure. The devices were similarly applied to patients with VSD associated with patent ductus arteriosus, and 4 patients with VSD complicated by atrial septal defects. The fluoroscopy time for the

Carabelli's trait revisited: an examination of mesiolingual features at the enamel-dentine junction and enamel surface of Pan and Homo sapiens upper molars.

Science.gov (United States)

Ortiz, Alejandra; Skinner, Matthew M; Bailey, Shara E; Hublin, Jean-Jacques

2012-10-01

Carabelli's trait is a morphological feature that frequently occurs on the mesiolingual aspect of Homo sapiens upper molars. Similar structures also referred to as Carabelli's trait have been reported in apes and fossil hominins. However, the morphological development and homology of these mesiolingual structures among hominoids are poorly understood. In this study, we employ micro-computed tomography to image the enamel-dentine junction (EDJ) and outer enamel surface (OES) of Pan (n = 48) and H. sapiens (n = 52) upper molars. We investigate the developmental origin of mesiolingual features in these taxa and establish the relative contribution of the EDJ and enamel cap to feature expression. Results demonstrate that mesiolingual features of H. sapiens molars develop at the EDJ and are similarly expressed at the OES. Morphological variation at both surfaces in this taxon can satisfactorily be assessed using standards for Carabelli's trait developed by the Arizona State University Dental Anthropology System (ASUDAS). Relative to H. sapiens, Pan has an even greater degree of correspondence in feature expression between the EDJ and OES. Morphological manifestations in Pan molars are not necessarily limited to the protocone and are best characterized by a lingual cingulum that cannot be captured by the ASUDAS. Cusp-like structures, similar to those seen in marked Carabelli's trait expressions in H. sapiens, were not found in Pan. This study provides a foundation for further analyses on the evolutionary history of mesiolingual dental traits within the hominoid lineage. It also highlights the wealth of morphological data that can be obtained at the EDJ for understanding tooth development and for characterizing tooth crown variation in worn fossil teeth. Copyright © 2012 Elsevier Ltd. All rights reserved.

Transcatheter Aortic Valve Implantation and Morbidity and Mortality-Related Factors: a 5-Year Experience in Brazil

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André Luiz Silveira Souza

2016-01-01

Full Text Available Abstract Background: Transcatheter aortic valve implantation has become an option for high-surgical-risk patients with aortic valve disease. Objective: To evaluate the in-hospital and one-year follow-up outcomes of transcatheter aortic valve implantation. Methods: Prospective cohort study of transcatheter aortic valve implantation cases from July 2009 to February 2015. Analysis of clinical and procedural variables, correlating them with in-hospital and one-year mortality. Results: A total of 136 patients with a mean age of 83 years (80-87 underwent heart valve implantation; of these, 49% were women, 131 (96.3% had aortic stenosis, one (0.7% had aortic regurgitation and four (2.9% had prosthetic valve dysfunction. NYHA functional class was III or IV in 129 cases (94.8%. The baseline orifice area was 0.67 ± 0.17 cm2 and the mean left ventricular-aortic pressure gradient was 47.3±18.2 mmHg, with an STS score of 9.3% (4.8%-22.3%. The prostheses implanted were self-expanding in 97% of cases. Perioperative mortality was 1.5%; 30-day mortality, 5.9%; in-hospital mortality, 8.1%; and one-year mortality, 15.5%. Blood transfusion (relative risk of 54; p = 0.0003 and pulmonary arterial hypertension (relative risk of 5.3; p = 0.036 were predictive of in-hospital mortality. Peak C-reactive protein (relative risk of 1.8; p = 0.013 and blood transfusion (relative risk of 8.3; p = 0.0009 were predictive of 1-year mortality. At 30 days, 97% of patients were in NYHA functional class I/II; at one year, this figure reached 96%. Conclusion: Transcatheter aortic valve implantation was performed with a high success rate and low mortality. Blood transfusion was associated with higher in-hospital and one-year mortality. Peak C-reactive protein was associated with one-year mortality.

Clinical assessment of transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention using Amplatzer occluder

Energy Technology Data Exchange (ETDEWEB)

Xiumin, Han; Xianyang, Zhu; Yuwei, Zhang; Yan, Jin; Dong' an, Deng; Chanju, Hou; Wei, Quan [Shenyang General Hospital, PLA, Shenyang (China)

2004-04-01

Objective: To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device. Methods: Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7 {+-} 13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0 {+-} 2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results: The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7 {+-} 13.5) (range 70 to 137) to mmHg to (46.1 {+-} 14.9) (24 to 109) mmHg, and the mean pulmonary pressure decreased from (65.0 {+-} 11.5) (42 to 97) mmHg to (31.3 {+-} 11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up. Conclusion: Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results. (authors)

Clinical assessment of transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention using Amplatzer occluder

International Nuclear Information System (INIS)

Han Xiumin; Zhu Xianyang; Zhang Yuwei; Jin Yan; Deng Dong'an; Hou Chanju; Quan Wei

2004-01-01

Objective: To evaluate the application of transcatheter closure of patent ductus arteriosus (PDA) with severe pulmonary hypertention using the Amplatzer occluder device. Methods: Fifty-one cases of PDA with severe pulmonary hypertention were treated by transcatheter closure with Amplatzer occluder. Patients mean age was 9.4 years (ranging 3 months to 60 years) and the mean weight was (18.7 ± 13.8) kg (ranging 5.0 to 65.0 kg). The mean PDA diameter at its narrowest segment was (7.0 ± 2.4) (ranging 3.0 to 15.0) mm. The achievement of permanent transcatheter closure was decided according to the change of the pulmonary arterial pressure, aortic pressure and oxygen saturation. Results: The devices were successfully placed in all patients except one failure owing to the resistance of pulmonary hypertention. The systolic pulmonary pressure decreased from (84.7 ± 13.5) (range 70 to 137) to mmHg to (46.1 ± 14.9) (24 to 109) mmHg, and the mean pulmonary pressure decreased from (65.0 ± 11.5) (42 to 97) mmHg to (31.3 ± 11.6) (14 to 69) mmHg. Complete angiographic closure was seen 10 minutes after the device deployment in 30 out of 50 patients (60%), while trivial to small leak was present in 20 (40%). Complete echocardiographic closure was demonstrated in 49 out of 50 patients (98%) at 10 min, and 100% at 6-month follow-up in all patients. There were no PDA recanalization and migration of devices after the complete occlusion during following up. Conclusion: Transcatheter closure of patent ductus arteriosus with severe pulmonary hypertention by using the Amplatzer occluder is a safe and effective interventional method with excellent short-term and middle-term results. (authors)

Freies Geleit für Edward Snowden? / Matthias Friehe, Christopher Lipp

Index Scriptorium Estoniae

Friehe, Matthias

2014-01-01

Parlamendi uurimiskomisjoni ette kutsutavate tunnistajate julgeoleku tagamisest Edward Snowdeni juhtumi põhjal; kurjategija väljaandmiskohustusest ja tema karistuse käsitlusest Saksa karistusseadustiku järgi

Multiple small pseudoaneurysms complicating pancreatitis: angiographic diagnosis and transcatheter embolization

International Nuclear Information System (INIS)

Maleux, G.; Stockx, L.; Vanbeckevoort, D.; Wilms, G.; Marchal, G.; Steenbergen, W. van

2000-01-01

We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis. Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any recurrent bleeding. (orig.)

Association of aortic valve calcification severity with the degree of aortic regurgitation after transcatheter aortic valve implantation.

Science.gov (United States)

Koos, Ralf; Mahnken, Andreas Horst; Dohmen, Guido; Brehmer, Kathrin; Günther, Rolf W; Autschbach, Rüdiger; Marx, Nikolaus; Hoffmann, Rainer

2011-07-15

This study sought to examine a possible relationship between the severity of aortic valve calcification (AVC), the distribution of AVC and the degree of aortic valve regurgitation (AR) after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS). 57 patients (22 men, 81 ± 5 years) with symptomatic AS and with a logistic EuroSCORE of 24 ± 12 were included. 38 patients (67%) received a third (18F)-generation CoreValve® aortic valve prosthesis, in 19 patients (33%) an Edwards SAPIEN™ prosthesis was implanted. Prior to TAVI dual-source computed tomography for assessment of AVC was performed. To determine the distribution of AVC the percentage of the calcium load of the most severely calcified cusp was calculated. After TAVI the degree of AR was determined by angiography and echocardiography. The severity of AR after TAVI was related to the severity and distribution of AVC. There was no association between the distribution of AVC and the degree of paravalvular AR after TAVI as assessed by angiography (r = -0.02, p = 0.88). Agatston AVC scores were significantly higher in patients with AR grade ≥ 3 (5055 ± 1753, n = 3) than in patients with AR grade AVC scores > 3000 were associated with a relevant paravalvular AR and showed a trend for increased need for second manoeuvres. There was a significant correlation between the severity of AVC and the degree of AR after AVR (r = 0.50, p AVC have an increased risk for a relevant AR after TAVI as well as a trend for increased need for additional procedures. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Optimization of Edwards vacuum coating unit model E12E for the production of thin films.; Optimizacion de la evaporadora Edwards modelo E12E para la fabricacion de peliculas delgadas.

Energy Technology Data Exchange (ETDEWEB)

Ruiz P, H S

1995-10-01

This work is about an Edwards vacuum coating unit model E12E, it shows the principle of vacuum thermal evaporation, some observations in the operation of vacuum diffusion pumps, mechanical pumps, vacuum gauge, Penning and Pirani, and some equations of leak vacuum, after the modifications and additions of Edwards vacuum coating unit for optimization, the last part contains a concise introduction about thin films and one specific application, it also contains the recommendations and requirements to keep the system in good conditions. (Author).

Struggles for Educational Equity in Prince Edward County, VA: Resistance, Southern Manifesto Ideologies, and School Choice

Science.gov (United States)

Tillerson-Brown, Amy

2016-01-01

In light of contemporary school choice proposals and the 60th anniversary of the Southern Manifesto, the Prince Edward County, Virginia public schools crisis provides interesting historical discussion. Prince Edward County (PEC), a rural community in central Virginia, was one of five school districts represented in the 1954 "Brown v. Board of…

Hepatocellular carcinoma: treatment with transcatheter arterial chemoembolization

International Nuclear Information System (INIS)

Acunas, Buelent; Rozanes, Izzet

1999-01-01

This article presents a review of the literature regarding the use of transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC). There have been two different approaches to the treatment: (a) percutaneous tumor ablation methods which can be divided into injectable and thermal methods; percutaneous ethanol injection (PEI) is the most widely used method, and (b) TACE. PEI is the treatment of choice for single HCCs smaller or equal to 3 cm in size. For patients with large HCCs combined TACE and PEI is probably the most effective nonsurgical treatment. In the presence of multiple HCC nodules, TACE remains the treatment of choice

Edward Teller Biographical Memoir

Energy Technology Data Exchange (ETDEWEB)

Libby, S B; Sessler, A M

2009-07-27

Edward Teller died on September 9, 2003 in Stanford, California at the age of 95. He was both one of the great theoretical physicists of the twentieth century and a leading figure in the development of nuclear weapons and broader defense advocacy. Teller's work in physics, spanning many decades of the twentieth century, includes some of the most fundamental insights in the quantum behaviors of molecules and their spectra, nuclei, surfaces, solid state and spin systems, and plasmas. In the defense arena, Teller is best known for his key insight that made thermonuclear weapons possible. Teller was both a great scientific collaborator and physics teacher at all levels, known for his openness, generosity, personal warmth, and powerful physical intuition. Many of his graduate students went on to illustrious careers.

Inter- and Intraspecific Variations in the Pectoral Muscles of Common Chimpanzees (Pan troglodytes), Bonobos (Pan paniscus), and Humans (Homo sapiens).

Science.gov (United States)

Potau, J M; Arias-Martorell, J; Bello-Hellegouarch, G; Casado, A; Pastor, J F; de Paz, F; Diogo, R

2018-01-01

We have analyzed anatomic variations in the pectoralis major and pectoralis minor muscles of common chimpanzees (Pan troglodytes) and bonobos (Pan paniscus) and compared them to anatomic variations in these muscles in humans (Homo sapiens) . We have macroscopically dissected these muscles in six adult Pan troglodytes , five Pan paniscus of ages ranging from fetus to adult, and five adult Homo sapiens . Although Pan troglodytes are thought to lack a separate pectoralis abdominis muscle, we have identified this muscle in three of the Pan troglodytes ; none of the Pan paniscus , however, had this muscle. We have also found deep supernumerary fascicles in the pectoralis major of two Pan troglodytes and all five Pan paniscus . In all six Pan troglodytes , the pectoralis minor was inserted at the supraspinatus tendon, while, in Pan paniscus and Homo sapiens , it was inserted at the coracoid process of the scapula. Some of the anatomic features and variations of these muscles in common chimpanzees and bonobos are similar to those found in humans, therefore enhancing our knowledge of primate comparative anatomy and evolution and also shedding light on several clinical issues.

Inter- and Intraspecific Variations in the Pectoral Muscles of Common Chimpanzees (Pan troglodytes, Bonobos (Pan paniscus, and Humans (Homo sapiens

Directory of Open Access Journals (Sweden)

J. M. Potau

2018-01-01

Full Text Available We have analyzed anatomic variations in the pectoralis major and pectoralis minor muscles of common chimpanzees (Pan troglodytes and bonobos (Pan paniscus and compared them to anatomic variations in these muscles in humans (Homo sapiens. We have macroscopically dissected these muscles in six adult Pan troglodytes, five Pan paniscus of ages ranging from fetus to adult, and five adult Homo sapiens. Although Pan troglodytes are thought to lack a separate pectoralis abdominis muscle, we have identified this muscle in three of the Pan troglodytes; none of the Pan paniscus, however, had this muscle. We have also found deep supernumerary fascicles in the pectoralis major of two Pan troglodytes and all five Pan paniscus. In all six Pan troglodytes, the pectoralis minor was inserted at the supraspinatus tendon, while, in Pan paniscus and Homo sapiens, it was inserted at the coracoid process of the scapula. Some of the anatomic features and variations of these muscles in common chimpanzees and bonobos are similar to those found in humans, therefore enhancing our knowledge of primate comparative anatomy and evolution and also shedding light on several clinical issues.

Geologic framework and hydrostratigraphy of the Edwards and Trinity aquifers within northern Bexar and Comal Counties, Texas

Science.gov (United States)

Clark, Allan K.; Golab, James A.; Morris, Robert R.

2016-11-28

During 2014–16, the U.S. Geological Survey, in cooperation with the Edwards Aquifer Authority, documented the geologic framework and hydrostratigraphy of the Edwards and Trinity aquifers within northern Bexar and Comal Counties, Texas. The Edwards and Trinity aquifers are major sources of water for agriculture, industry, and urban and rural communities in south-central Texas. Both the Edwards and Trinity are classified as major aquifers by the State of Texas.The purpose of this report is to present the geologic framework and hydrostratigraphy of the Edwards and Trinity aquifers within northern Bexar and Comal Counties, Tex. The report includes a detailed 1:24,000-scale hydrostratigraphic map, names, and descriptions of the geology and hydrostratigraphic units (HSUs) in the study area.The scope of the report is focused on geologic framework and hydrostratigraphy of the outcrops and hydrostratigraphy of the Edwards and Trinity aquifers within northern Bexar and Comal Counties, Tex. In addition, parts of the adjacent upper confining unit to the Edwards aquifer are included.The study area, approximately 866 square miles, is within the outcrops of the Edwards and Trinity aquifers and overlying confining units (Washita, Eagle Ford, Austin, and Taylor Groups) in northern Bexar and Comal Counties, Tex. The rocks within the study area are sedimentary and range in age from Early to Late Cretaceous. The Miocene-age Balcones fault zone is the primary structural feature within the study area. The fault zone is an extensional system of faults that generally trends southwest to northeast in south-central Texas. The faults have normal throw, are en echelon, and are mostly downthrown to the southeast.The Early Cretaceous Edwards Group rocks were deposited in an open marine to supratidal flats environment during two marine transgressions. The Edwards Group is composed of the Kainer and Person Formations. Following tectonic uplift, subaerial exposure, and erosion near the end of

Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

Science.gov (United States)

Wuerzner, Gregoire; Muller, Olivier; Erne, Paul; Cook, Stéphane; Sudano, Isabella; Lüscher, Thomas F; Noll, Georg; Kaufmann, Urs; Rickli, Hans; Waeber, Bernard; Kaiser, Christophe; Sticherling, Christian; Pechère-Bertschi, Antoinette; Baumgartner, Iris; Jacob, Augustinus L; Burnier, Michel; Qanadli, Salah D

2014-03-20

Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age.

Science.gov (United States)

Agha, Hala Mounir; Hamza, Hala S; Kotby, Alyaa; Ganzoury, Mona E L; Soliman, Nanies

2017-10-01

To evaluate the left ventricular function before and after transcatheter percutaneous patent ductus arteriosus (PDA) closure, and to identify the predictors of myocardial dysfunction post-PDA closure if present. Transcatheter PDA closure; conventional, Doppler, and tissue Doppler imaging; and speckle tracking echocardiography. To determine the feasibility and reliability of tissue Doppler and myocardial deformation imaging for evaluating myocardial function in children undergoing transcatheter PDA closure. Forty-two children diagnosed with hemodynamically significant PDA underwent percutaneous PDA closure. Conventional, Doppler, and tissue Doppler imaging, and speckle-derived strain rate echocardiography were performed at preclosure and at 48 hours, 1 month, and 6 months postclosure. Tissue Doppler velocities of the lateral and septal mitral valve annuli were obtained. Global and regional longitudinal peak systolic strain values were determined using two-dimensional speckle tracking echocardiography. The median age of the patients was 2 years and body weight was 15 kg, with the mean PDA diameter of 3.11 ± 0.99 mm. M-mode measurements (left ventricular end diastolic diameter, left atrium diameter to aortic annulus ratio, ejection fraction, and shortening fraction) reduced significantly early after PDA closure ( p  closure causes a significant decrease in left ventricular performance early after PDA closure, which recovers completely within 1 month. Preclosure global longitudinal strain can be a predictor of postclosure myocardial dysfunction.

conserving surface-nesting seabirds at the prince edward islands

African Journals Online (AJOL)

South Africa's subantarctic Prince Edward Islands support substantial proportions of the global populations of a number of surface-nesting seabirds. Populations of most of these have decreased at the islands since the 1980s and 12 of 16 species are regarded as Threatened or Near Threatened regionally or internationally.

3D Assessment of Features Associated With Transvalvular Aortic Regurgitation After TAVR: A Real-Time 3D TEE Study.

Science.gov (United States)

Shibayama, Kentaro; Mihara, Hirotsugu; Jilaihawi, Hasan; Berdejo, Javier; Harada, Kenji; Itabashi, Yuji; Siegel, Robert; Makkar, Raj R; Shiota, Takahiro

2016-02-01

This study of 3-dimensional (3D) transesophageal echocardiography (TEE) aimed to demonstrate features associated with transvalvular aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) and to confirm the fact that a gap between the native aortic annulus and prosthesis is associated with paravalvular AR. The mechanism of AR after TAVR, particularly that of transvalvular AR, has not been evaluated adequately. All patients with severe aortic stenosis who underwent TAVR with the Sapien device (Edwards Lifesciences, Irvine, California) had 3D TEE of the pre-procedural native aortic annulus and the post-procedural prosthetic valve. In the 201 patients studied, the total AR was mild in 67 patients (33%), moderate in 21 patients (10%), and severe in no patients. There were 20 patients with transvalvular AR and 82 patients with paravalvular AR. Fourteen patients had both transvalvular and paravalvular AR. Patients with transvalvular AR had larger prosthetic expansion (p prosthetic shape at the prosthetic commissure level (p prosthetic commissures in relation to the native commissures, than the patients without transvalvular AR. Age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.01 to 1.09; p 3D TEE successfully demonstrated the features associated with transvalvular AR, such as large prosthetic expansion, elliptical prosthetic shape, and anti-anatomical position of prosthesis. Additionally, effective area oversizing was associated with paravalvular AR. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cold Spring Harbor symposia on quantitative biology: Volume 51, Molecular biology of /ital Homo sapiens/

International Nuclear Information System (INIS)

1986-01-01

This volume is the second part of a collection of papers submitted by the participants to the 1986 Cold Spring Harbor Symposium on Quantitative Biology entitled Molecular Biology of /ital Homo sapiens/. The 49 papers included in this volume are grouped by subject into receptors, human cancer genes, and gene therapy. (DT)

Dating Of Remains Of Neanderthals And Homo Sapiens From Anatolian Region By ESR-US Combined Methods Preliminary Results

Directory of Open Access Journals (Sweden)

Samer Farkh

2015-08-01

Full Text Available We tried in the present study to apply the electron spin resonance method ESR combined with uranium-series method US for dating fossilized human teeth and found valuable archaeological sites such as Karain Cave in Anatolia. Karain Cave is a crucial site in a region that has yielded remains of Neanderthals and Homo sapiens our direct ancestors. The dating of these remains allowed us to trace the history since the presence of man on earth. Indeed Anatolia in Turkey is an important region of the world because it represents a passage between Africa the Middle East and Europe. Our study was conducted on faunal teeth found near human remains. The combination of ESR and US data on the teeth provides an understanding of their complex geochemical evolution and get better estimated results. Our samples were taken from the central cutting where geological layers are divided into archaeological horizons each 10 cm. The AH4 horizon of I.3 layer which represents the boundary between the Middle Paleolithic and Upper Paleolithic is dated to 29 4 ka by the ESR-US model. Below two horizons AH6 and AH8 in the same layer I.4 are dated respectively 40 6 and 45 7 ka using the ESR-US model. In layer II where a stalagmite floor was taken we made two U-Th dating at the base and on the top ages oscillated around 120 ka. Since human remains were collected from AH3 horizon for Homo sapiens and AH5 and AH7 horizons for the Neanderthal man so the dates obtained in AH4 AH6 and AH8 represent maximum ages. Thus they provide the disappearance of Neanderthal man between 45 and 40 ka and the appearance of Homo sapiens in 29 ka in Anatolia region. Undoubtedly there is a chronological gap between the Middle and Upper Paleolithic represented by the disappearance of Neanderthals and the appearance of sapiens and none of our results confirm the contemporaneity of these two species in this region.

Early clinical outcome of aortic transcatheter valve-in-valve implantation in the Nordic countries

DEFF Research Database (Denmark)

Ihlberg, Leo; Nissen, Henrik Hoffmann; Nielsen, Niels Erik

2013-01-01

Transcatheter valve-in-valve implantation has emerged as an option, in addition to reoperative surgical aortic valve replacement, to treat failed biologic heart valve substitutes. However, the clinical experience with this approach is still limited. We report the comprehensive experience...

Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients.

Science.gov (United States)

Chen, L; Shen, J; Shan, X; Wang, F; Kan, T; Tang, X; Zhao, X; Qin, Y

2017-07-19

Adult patients with undiagnosed atrial septal defect (ASD) may have right heart cavity enlargement and functional tricuspid valve insufficiency. Moderate or more severe tricuspid regurgitation has been associated with a worse prognosis, and more serious complications are typically seen in older patients. This study aimed to evaluate the improvement in functional tricuspid regurgitation and heart geometry after transcatheter ASD closure in older patients. The data of 111 patients over 60 years of age with moderate or severe tricuspid regurgitation before ASD closure were analyzed. At the 1‑month and 6‑month follow-up after closure, both tricuspid regurgitation jet area and right atrial volume decreased significantly. Right ventricular volume decreased 1 month after closure, showing a further decrease at the end of the 6‑month follow-up. However, 24 patients (21.6%) still had persistent severe tricuspid regurgitation after the procedure. Multivariate analysis revealed that patient age at ASD closure and pulmonary artery systolic pressure determined by echocardiography before closure were predictors of persistent tricuspid regurgitation after closure. Transcatheter ASD closure in older patients could significantly decrease tricuspid regurgitation and improve right heart geometry.

Acquired uterine vascular malformations: radiological and clinical outcome after transcatheter embolotherapy

Energy Technology Data Exchange (ETDEWEB)

Maleux, Geert; Heye, Sam; Wilms, Guy [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Timmerman, Dirk [University Hospitals Gasthuisberg, Department of Obstetrics and Gynecology, Leuven (Belgium)

2006-02-01

The purpose of this retrospective study is to assess the radiological and clinical outcome of transcatheter embolization of acquired uterine vascular malformations in patients presenting with secondary postpartum or postabortion vaginal hemorrhage. In a cohort of 17 patients (mean age: 29.7 years; standard deviation: 4.23; range: 25-38 years) 18 embolization procedures were performed. Angiography demonstrated a uterine parenchymal hyperemia with normal drainage into the large pelvic veins (''low-flow uterine vascular malformation'') in 83% (n=15) or a direct arteriovenous fistula (''high-flow uterine vascular malformation'') in 17% (n=3). Clinically, in all patients the bleeding stopped after embolization but in 1 patient early recurrence of hemorrhage occurred and was treated by hysterectomy. Pathological analysis revealed a choriocarcinoma. During follow-up (mean time period: 18.8 months; range: 1-36 months) 6 patients became pregnant and delivered a healthy child. Transcatheter embolization of the uterine arteries, using microparticles, is safe and highly effective in the treatment of a bleeding acquired uterine vascular malformation. In case of clinical failure, an underlying neoplastic disease should be considered. Future pregnancy is still possible after embolization. (orig.)

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

DEFF Research Database (Denmark)

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

2015-01-01

BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review of databa......BACKGROUND: Right ventricular outflow tract (RVOT) conduit dysfunction is a limitation of the Ross procedure. Transcatheter pulmonary valve replacement (TPVR) could alter the impact of conduit dysfunction and the risk-benefit balance for the Ross procedure. METHODS: Retrospective review....... Of these, 56 (84%) received a Melody valve; in 5 of the 11 patients who did not, the implant was aborted due to concern for coronary artery compression, and 1 implanted patient required emergent surgery for left coronary compression. The RVOT gradient decreased from a median 38 mm Hg to 13.5 mm Hg (p

Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age

Directory of Open Access Journals (Sweden)

Hala Mounir Agha

2017-10-01

Conclusion: Transcatheter PDA closure causes a significant decrease in left ventricular performance early after PDA closure, which recovers completely within 1 month. Preclosure global longitudinal strain can be a predictor of postclosure myocardial dysfunction.

Evaluating the transitional mosaic: frameworks of change from Neanderthals to Homo sapiens in eastern Europe

Science.gov (United States)

Davies, William; White, Dustin; Lewis, Mark; Stringer, Chris

2015-06-01

Defining varying spatial and temporal analytical scales is essential before evaluating the responses of late Neanderthals and early Homo sapiens to Abrupt Environmental Transitions (AETs) and environmental disasters for the period 130-25 ka. Recent advances in addressing the population histories and interactions (using both genetic and archaeological evidence) of Neanderthals and H. sapiens have encouraged consideration of more subtle dynamics of archaeological change. Descriptions of change based on methodologies pioneered some 160 years ago are no longer adequate to explain the patterning we now see in the record. New chronological results, using multiple dating methods, allow us to begin to unpick the spatial and temporal scales of change. Isochronic markers (such as specific volcanic eruptions) can be used to create temporal frameworks (lattices), and results from other dating techniques compared against them. A combination of chronological lattices and direct dating of diagnostic artefacts and human fossils permits us, for the first time, to have greater confidence in connecting human (recent hominin) species and their behavioural responses to environmental conditions, and in quantifying scales of change over time and space (time-transgression). The timing of innovations, particularly those in bone, antler and ivory, can be directly quantified and tested, and used to re-evaluate longstanding models of cultural change. This paper also uses these new chronologies to explore the ecologies of late Neanderthals and early H. sapiens: their population densities, mobilities, resources exploited and possible interactions. Environmental productivity estimates are used to generate new questions of potential population densities and mobilities, and thus the sensitivity of these groups to environmental perturbations. Scales and intensities of effect on environments from natural disasters and AETs (notably Heinrich Events and the Campanian Ignimbrite eruption) are defined

Earliest evidence of modern human life history in North African early Homo sapiens.

Science.gov (United States)

Smith, Tanya M; Tafforeau, Paul; Reid, Donald J; Grün, Rainer; Eggins, Stephen; Boutakiout, Mohamed; Hublin, Jean-Jacques

2007-04-10

Recent developmental studies demonstrate that early fossil hominins possessed shorter growth periods than living humans, implying disparate life histories. Analyses of incremental features in teeth provide an accurate means of assessing the age at death of developing dentitions, facilitating direct comparisons with fossil and modern humans. It is currently unknown when and where the prolonged modern human developmental condition originated. Here, an application of x-ray synchrotron microtomography reveals that an early Homo sapiens juvenile from Morocco dated at 160,000 years before present displays an equivalent degree of tooth development to modern European children at the same age. Crown formation times in the juvenile's macrodont dentition are higher than modern human mean values, whereas root development is accelerated relative to modern humans but is less than living apes and some fossil hominins. The juvenile from Jebel Irhoud is currently the oldest-known member of Homo with a developmental pattern (degree of eruption, developmental stage, and crown formation time) that is more similar to modern H. sapiens than to earlier members of Homo. This study also underscores the continuing importance of North Africa for understanding the origins of human anatomical and behavioral modernity. Corresponding biological and cultural changes may have appeared relatively late in the course of human evolution.

Environmental Assessment of Lead at Camp Edwards, Massachusetts, Small Arms Ranges

National Research Council Canada - National Science Library

Clausen, Jay L; Korte, Nic; Bostick, Benjamin; Rice, Benjamin; Walsh, Matthew; Nelson, Andrew

2007-01-01

Environmental issues for small arms training with lead projectiles are examined in this report for Camp Edwards, Massachusetts, in order to evaluate whether past or future use of lead in small arms...

Vascular complications associated with transcatheter aortic valve replacement.

Science.gov (United States)

Sardar, M Rizwan; Goldsweig, Andrew M; Abbott, J Dawn; Sharaf, Barry L; Gordon, Paul C; Ehsan, Afshin; Aronow, Herbert D

2017-06-01

Transcatheter aortic valve replacement (TAVR) is now an accepted pathway for aortic valve replacement for patients who are at prohibitive, severe and intermediate risk for traditional aortic valve surgery. However, with this rising uptrend and adaptation of this new technology, vascular complications and their management remain an Achilles heel for percutaneous aortic valve replacement. The vascular complications are an independent predictor of mortality for patients undergoing TAVR. Early recognition of these complications and appropriate management is paramount. In this article, we review the most commonly encountered vascular complications associated with currently approved TAVR devices and their optimal percutaneous management techniques.

Transcatheter embolization of renal neoplasms. A comparison of the merits of the radio-active infarct implant versus total embolization with inert material

International Nuclear Information System (INIS)

Lang, E.K.; Pisco, J.M.

1980-01-01

Transcatheter embolization with radio-active infarct particles and inert embolic material has been proposed for adjuvant therapy in the management of renal cell carcinoma. Transcatheter embolization with inert embolic material has been advocated in preparation for surgical resection of renal tumours. Embolization with radio-active infarct particles is undertaken to deliver a tumouricidal dose to the primary neoplasm. The resultant interstitial implant offers the advantage of a high dose to the primary tumour, choice of time of delivery of the radiant energy by selection of a radio-isotope with appropriate half-life, and limitation of the integral dose to the patient by selection of appropriate physical characteristics of the radio-isotope utilized. Transcatheter embolization with radio-active infarct particles is advocated either as definitive therapy for clearly inoperable neoplasms, or in hope to make an initially inoperable neoplasm operable. (Auth.)

Five-Year Outcomes of the First Pivotal Clinical Trial of Balloon-Expandable Transcatheter Aortic Valve Replacement in Japan (PREVAIL JAPAN).

Science.gov (United States)

Sawa, Yoshiki; Takayama, Morimasa; Goto, Tsuyoshi; Takanashi, Shuichiro; Komiya, Tatsuhiko; Tobaru, Tetsuya; Maeda, Koichi; Kuratani, Toru; Sakata, Yasushi

2017-07-25

Transcatheter aortic valve replacement (TAVR) has been an alternative less invasive therapy for high-surgical risk/inoperable patients with aortic valve stenosis (AS) in Japan. We report 5-year outcomes of the first pivotal clinical trial of TAVR in Japan (PREVAIL JAPAN).Methods and Results:A total of 64 patients with AS who were considered unsuitable candidates for surgery were enrolled at 3 centers in Japan (mean age: 84.3±6.1 years, female: 65.6%, STS score: 9.0±4.5%). Transfemoral approach (TF) and transapical approach (TA) was performed in 37 patients and 27 patients, respectively. At 5 years, freedom from all-cause death was 52.7% (TF: 51.3%, TA: 56.3%). Risk of all stroke at 5-year was 15.8% (TF: 8.9%, TA: 25.5%) and risk of major adverse cardiac and cerebrovascular events at 5 years was 58.0% (TF: 51.3%, TA: 69.2%). Mild or greater aortic regurgitation (AR) at 1 week was not associated with increased all-cause death at 5 years (69.1%) compared with none or trace AR (48.3%) (P=0.184). Patients with high STS score (>8) had higher mortality rate than those with low STS scores (≤8). The 5-year data from PREVAIL JAPAN show the clinical benefit of TAVR and suggest that balloon-expandable TAVR is an effective treatment option for Japanese patients with severe AS who are not suitable for surgery. (Funded by Edwards Lifesciences Limited; ClinicalTrials.gov number, NCT01113983.).

A comparison of conventional surgery, transcatheter aortic valve replacement, and sutureless valves in "real-world" patients with aortic stenosis and intermediate- to high-risk profile.

Science.gov (United States)

Muneretto, Claudio; Alfieri, Ottavio; Cesana, Bruno Mario; Bisleri, Gianluigi; De Bonis, Michele; Di Bartolomeo, Roberto; Savini, Carlo; Folesani, Gianluca; Di Bacco, Lorenzo; Rambaldini, Manfredo; Maureira, Juan Pablo; Laborde, Francois; Tespili, Maurizio; Repossini, Alberto; Folliguet, Thierry

2015-12-01

We sought to investigate the clinical outcomes of patients with isolated severe aortic stenosis and an intermediate- to high-risk profile treated by means of conventional surgery (surgical aortic valve replacement), sutureless valve implantation, or transcatheter aortic valve replacement in a multicenter evaluation. Among 991 consecutive patients with isolated severe aortic stenosis and an intermediate- to high-risk profile (Society of Thoracic Surgeons score >4 and logistic European System for Cardiac Operative Risk Evaluation I >10), a propensity score analysis was performed on the basis of the therapeutic strategy: surgical aortic valve replacement (n = 204), sutureless valve implantation (n = 204), and transcatheter aortic valve replacement (n = 204). Primary end points were 30-day mortality and overall survival at 24-month follow-up; the secondary end point was survival free from a composite end point of major adverse cardiac events (defined as cardiac-related mortality, myocardial infarction, cerebrovascular accidents, and major hemorrhagic events) and periprosthetic regurgitation greater than 2. Thirty-day mortality was significantly higher in the transcatheter aortic valve replacement group (surgical aortic valve replacement = 3.4% vs sutureless = 5.8% vs transcatheter aortic valve replacement = 9.8%; P = .005). The incidence of postprocedural was 3.9% in asurgical aortic valve replacement vs 9.8% in sutureless vs 14.7% in transcatheter aortic valve replacement (Prisk factor for overall mortality hazard ratio (hazard ratio, 2.5; confidence interval, 1.1-4.2; P = .018). The use of transcatheter aortic valve replacement in patients with an intermediate- to high-risk profile was associated with a significantly higher incidence of perioperative complications and decreased survival at short- and mid-term when compared with conventional surgery and sutureless valve implantation. Copyright © 2015 The American Association for Thoracic Surgery. Published by

President Edwards and the Sage of Highgate: Determinism, Depravity, and the Supernatural Will.

Science.gov (United States)

Bannon, Brad

2016-01-01

Scarce attention has been given to Samuel Taylor Coleridge's engagement with the philosophical theology of Jonathan Edwards, and yet a clear understanding of each thinker's position on determinism and Original Sin is of vital importance if we are understand the lasting significance of their disagreements. There have been a number of studies to take up Coleridge's influence on the American Romantics, but there is no scholarship that has taken into account how the reception of this influence was inflected both by the legacy of Edwards and by the critical response that his theology elicited from Coleridge.

The use of transcatheter aortic valve replacement vs surgical aortic valve replacement for the treatment of aortic stenosis

Directory of Open Access Journals (Sweden)

Jensen HA

2015-08-01

Full Text Available Hanna A Jensen, Lillian L Tsai, Vinod H Thourani Division of Cardiothoracic Surgery, Joseph B Whitehead Department of Surgery, Structural Heart and Valve Center, Emory University School of Medicine, Atlanta, GA, USA Abstract: Severe aortic stenosis (AS is associated with considerable morbidity and mortality and is increasing in prevalence as the global population increases. Since AS primarily affects the elderly, many of these patients have comorbidities that make them poor candidates for the gold standard treatment for AS, surgical aortic valve replacement. Transcatheter aortic valve replacement has emerged as a novel technology for the management of AS in higher risk patients over the past decade. Randomized trials have established the safety and efficacy of transcatheter aortic valve replacement, and the medical community has rallied to identify the patients who are most suitable for this transformative treatment. This review focuses on outlining the key procedural differences, describing the unique challenges of both operations, and finally assessing and comparing outcomes both on a general level and in challenging patient subgroups. Keywords: aortic valve replacement, transcatheter aortic valve replacement, surgical aortic valve replacement 

Sequential transcatheter aortic valve implantation due to valve dislodgement - a Portico valve implanted over a CoreValve bioprosthesis.

Science.gov (United States)

Campante Teles, Rui; Costa, Cátia; Almeida, Manuel; Brito, João; Sondergaard, Lars; Neves, José P; Abecasis, João; M Gabriel, Henrique

2017-03-01

Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve ® , which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved. After several months, she required another intervention, performed with a St. Jude Portico ® repositionable self-expanding transcatheter aortic valve. There was a good clinical response that was maintained at one-year follow-up. The use of a self-expanding transcatheter bioprosthesis with repositioning features is a solution in cases of valve dislocation to avoid suboptimal positioning of a second implant, especially when the two valves have to be positioned overlapping or partially overlapping each other. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Preoperative transcatheter renal artery embolization with absolute alcohol for the treatment of renal carcinoma: a clinical efficacy analysis

International Nuclear Information System (INIS)

Shang Mingyi; Wang Guoliang; Han Hongjie; Xi Qian; Huang Zongliang; Tang Junjun; Gao Xiaolong; Wang Peijun; Lu Ying; Xu Weiguo

2010-01-01

Objective: To access the effectiveness of preoperative transcatheter renal artery embolization with absolute alcohol performed before nephrectomy in treating renal carcinoma. Methods: Preoperative transcatheter renal artery embolization with absolute alcohol was performed in 32 patients with renal carcinoma. The renal arteries of the diseased side were progressively occluded, from distal small branches to proximal larger ones, and the renal artery trunk was embolized with gelatin sponge. Radical nephrectomy was carried out 2-5 days after the embolization procedure. The resectional rate of the tumor, the blood loss during the surgery and the operation time were recorded and analyzed. Results: Angiography performed immediately after the embolization showed that complete embolization of the main renal artery was achieved in all 32 patients. The resectional rate of the tumor was 100%. During the surgery, shrinkage of tumor, collapse of renal superficial veins and marked perinephric edema were observed. The blood loss during the surgery was much less and the operation time cost was much shorter than a usual nephrectomy did. Conclusion: The preoperative transcatheter renal artery embolization with absolute alcohol is an effective therapeutic means for renal carcinoma, it can definitely reduce the surgical blood loss and shorten the operative time. (authors)

Granular statistical mechanics - Building on the legacy of Sir Sam Edwards

Science.gov (United States)

Blumenfeld, Raphael

When Sir Sam Edwards laid down the foundations for the statistical mechanics of jammed granular materials he opened a new field in soft condensed matter and many followed. In this presentation we review briefly the Edwards formalism and some of its less discussed consequences. We point out that the formalism is useful for other classes of systems - cellular and porous materials. A certain shortcoming of the original formalism is then discussed and a modification to overcome it is proposed. Finally, a derivation of an equation of state with the new formalism is presented; the equation of state is analogous to the PVT relation for thermal gases, relating the volume, the boundary stress and measures of the structural and stress fluctuations. NUDT, Changsha, China, Imperial College London, UK, Cambridge University, UK.

Norforce: Major General Edward Northey and the Nyasaland and ...

African Journals Online (AJOL)

The campaign in East and Central Africa during the First World War has received relatively little attention despite the remarkable exploits of Major General Edward Northey and Norforce. In field command for two and a half years, he successfully led a multi-ethnic and polyglot force across some of the most difficult terrain of ...

Edward Jenner and the small pox vaccine

OpenAIRE

Kendall A Smith

2011-01-01

Edward Jenner, who discovered that it is possible to vaccinate against Small Pox using material from Cow Pox, is rightly the man who started the science of immunology. However, over the passage of time many of the details surrounding his astounding discovery have been lost or forgotten. Also, the environment within which Jenner worked as a physician in the countryside, and the state of the art of medicine and society are difficult to appreciate today. It is important to recall that people wer...

Edward C. Little Water Recycling Plant, El Segundo, CA: CA0063401

Science.gov (United States)

Joint EPA and Los Angeles Regional Water Quality Control Board NPDES Permit and Waiver from Secondary Treatment for the West Basin Municipal Water District Edward C. Little Water Recycling Plant, El Segundo, CA: CA0063401

Immediate post-operative responses to transcatheter aortic valve implantation

DEFF Research Database (Denmark)

Egerod, Ingrid; Nielsen, Susanne; Lisby, Karen H.

2015-01-01

Background:Conventional treatment for patients with severe symptomatic aortic stenosis is surgical aortic valve replacement (SAVR), but transcatheter aortic valve implantation (TAVI) has become a reliable alternative in high-risk patients.Aims:The aim of our study was to describe the post......-operative patient response to TAVI on the evening of the procedure and the following day before discharge from the coronary care unit. A secondary aim was to compare responses of patients younger and older than 80 years of age.Methods:A prospective, comparative observational study triangulating nurse assessment...

Long-term results of heart valve replacement with the Edwards Duromedics bileaflet prosthesis: a prospective ten-year clinical follow-up.

Science.gov (United States)

Podesser, B K; Khuenl-Brady, G; Eigenbauer, E; Roedler, S; Schmiedberger, A; Wolner, E; Moritz, A

1998-05-01

The Edwards Duromedics valve (Baxter Healthcare Corp., Edwards Division, Santa Ana, Calif.) was designed with a self-irrigating hinge mechanism to reduce thromboembolic complications. After good initial clinical results, distribution was suspended in 1988 after reports of valve fracture after 20,000 valves had been implanted. The manufacturer conducted extensive studies to improve the Edwards Duromedics and reintroduced a modified version, which is available as Edwards Tekna. The purpose of the study was the evaluation of long-term results of the original Edwards Duromedics that might be important for the current version, the Edwards Tekna valve. A prospective clinical 10-year follow-up was performed of 508 patients who underwent valve replacement with the Edwards Duromedics valve in the aortic (n = 268), mitral (n = 183), and aortic and mitral (n = 56) position. The perioperative mortality rate was 6.9%; follow-up was 98% complete, comprising 3648 patient-years for a mean follow-up of 86 months (range: 33 to 144 months). The actuarial freedom from complications at the 10-year follow-up and the incidence rate (percent per patient-year) were as follows: late mortality rate, 69.2% +/- 2.4% (3.5% per patient-year); thromboembolism, 90.7% +/- 1.6% (0.96% per patient-year); anticoagulation-related hemorrhage, 87.7% +/- 1.7% (1.34% per patient-year); prosthetic valve endocarditis, 96.7% +/- 0.09% (0.38% per patient-year); valve-related mortality rate, 89.3% +/- 1.6% (1.21% per patient-year); valve failure, 86.2% +/- 1.85% (1.54% per patient-year); and valve-related morbidity and mortality rate, 71.1% +/- 2.3% (3.2% per patient-year). Three leaflet escapes were observed (one lethal, two successful reoperations; 99.1% +/- 0.05% freedom, 0.08% per patient-year). All patients functionally improved (86% in New York Heart Association classes I and II), and incidence of anemia was insignificant. These results confirm that the Edwards Duromedics valve shows excellent performance

Bibliography of the Edwards Aquifer, Texas, through 1993

Science.gov (United States)

Menard, J.A.

1995-01-01

The bibliography comprises 1,022 multidisciplinary references to technical and general literature for the three regions of the Edwards aquifer, Texas-San Antonio area; Barton Springs segment, Austin area; and northern segment, Austin area. The references in the bibliography were compiled from computerized data bases and from published bibliographies and reports. Dates of references range from the late 1800's through 1993. Subject and author indexes are included.

Reception of Edward Bernays' Doctrine of "Manipulating Public Opinion."

Science.gov (United States)

Olasky, Marvin N.

Ivy Lee and Edward Bernays are generally regarded as the founding fathers of modern public relations. While Lee has been the subject of a full biography that included contemporary reaction to his ideas, there has been no similar work on how Bernays' ideas were received, though his ideas were in some ways more radical. He believed that propaganda…

The Marine Mammal Programme at the Prince Edward Islands: 38 ...

African Journals Online (AJOL)

The Marine Mammal Programme (MMP) conducts research on pinnipeds and killer whales Orcinus orca at Marion Island, Prince Edward Islands, under the auspices of the Mammal Research Institute, Department of Zoology and Entomology, University of Pretoria. The history of the MMP, which has benefited from ...

Julgeolekuekspert : unustage jutud Eesti palgaarmeest / Edward N. Luttwak ; interv. Peeter Kuimet

Index Scriptorium Estoniae

Luttwak, Edward N.

2006-01-01

USA julgeolekuanalüütik soovitab Venemaa naabruses oleval Eestil oma riigikaitse üles ehitada Soome eeskujul, ajateenistus peab olema kohustuslik, et vajaduse korral end ise kaitsta, sest NATO abi ei saabu automaatselt. Lisa: Edward Nicolae Luttwak

Transcatheter closure of a large patent ductus arteriosus using jugular access in an infant.

Science.gov (United States)

Fernandes, Precylia; Assaidi, Anass; Baruteau, Alban-Elouen; Fraisse, Alain

2018-03-01

Trans-catheter device closure of patent ductus arteriosus (PDA) via femoral route is the commonly used, safe and effective procedure. Trans-jugular approach has been successfully used in older children with interrupted inferior vena cava. We report a case of successful occlusion of PDA using Amplatzer duct occluder (ADO) via trans-jugular approach following difficulties encountered in gaining femoral venous access. A 6-month-old male infant, weighing 8 kg was admitted for percutaneous catheter closure of PDA. Echocardiogram showed a 4.5 mm duct and left heart dilatation. Femoral venous access was not possible; therefore, we decided to use a trans-jugular approach. The duct was occluded using 8/6 mm ADO. Successful closure of the duct was confirmed with an aortogram. Post procedure echocardiogram showed no residual shunt across the duct. We highlight that trans-catheter closure of PDA using jugular venous access is safe and effective even in infants.

Transcatheter treatment of severe tricuspid regurgitation with the MitraClip system.

Science.gov (United States)

Hammerstingl, Christoph; Schueler, Robert; Malasa, Margarita; Werner, Nikos; Nickenig, Georg

2016-03-07

The aim of this study was to show technical principles and feasibility of transcatheter tricuspid valve repair by use of the MitraClip system. Three consecutive patients were treated successfully for severe symptomatic Tricuspid regurgitation. Three-dimensional transoesophageal echocardiography confirmed reduction of measured effective regurgitant orifice in all patients [effective regurgitant orifice area-baseline/post-procedure (cm(2)): 0.7/0.3; 1.5/0.8; 0.4/0.1], which was accompanied by an increase in left ventricular stroke volumes [baseline/post-procedure (mL): 42.8/45.4; 38/45; 35.2/45], decrease of measured levels of N terminal pro brain natriuretic peptide (pg/mL: baseline/post-procedure: 548/440; 2526/1702; 1754/623), and significant relief of clinical symptoms for chronic right heart failure in all patients. Transcatheter tricuspid valve repair by use of interventional edge-to-edge repair with the MitraClip system was feasible, and safe in three consecutive patients. Reduction of tricuspid insufficiency associates with relief of clinical symptoms for right heart failure. This strategy seems a promising treatment option for patients at prohibitive surgical risk. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Data of 10 SSR markers for genomes of homo sapiens and monkeys.

Science.gov (United States)

Reddy, K K V V V S; Raju, S Viswanadha; Someswara Rao, Chinta

2017-06-01

In this data, we present 10 Simple Sequence Repeat(SSR) markers TAGA, TCAT, GAAT, AGAT, AGAA, GATA, TATC, CTTT, TCTG and TCTA which are extracted from the genomes of homo sapiens and monkeys using string matching mechanism [1]. All loci showed 4 Base Pair(bp) in allele size, indicating that there are some polymorphisms between individuals correlating to the number of SSR repeats that maybe useful for the detection of similarity among the genotypes. Collectively, these data show that the SSR extraction is a valuable method to illustrate genetic variation of genomes.

Invited commentary on 'Robert G Edwards and the Roman Catholic Church'.

Science.gov (United States)

Head, Ivan Francis

2011-06-01

In this issue of Reproductive BioMedicine Online, Benagiano, Carrara and Filippi have produced a clearly written and comprehensive account of why the Roman Catholic Church has not welcomed the award of the 2010 Nobel Prize in Physiology and Medicine to Dr Robert G Edwards for the development of human IVF. I commend the article for its clarity and lucidity but attempt to point out some areas where disagreement even with its nuanced opposition to IVF may be legitimate. I try to make some simple comments that explain why this is so and I suggest some areas to which contemporary theology and philosophy can commit itself. But it is good to see even a nuanced response to the work of Robert G Edwards rather than a blanket condemnation. Copyright © 2011 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Imaging and transcatheter arterial embolization for traumatic splenic injuries: review of the literature.

Science.gov (United States)

Raikhlin, Antony; Baerlocher, Mark Otto; Asch, Murray R; Myers, Andy

2008-12-01

The spleen is the most commonly injured visceral organ in blunt abdominal trauma in both adults and children. Nonoperative management is the current standard of practice for patients who are hemodynamically stable. However, simple observation alone has been reported to have a failure rate as high as 34%; the rate is even higher among patients with high-grade splenic injuries (American Association for the Surgery of Trauma [AAST] grade III-V). Over the past decade, angiography with transcatheter splenic artery embolization, an alternative nonoperative treatment for splenic injuries, has increased splenic salvage rates to as high as 97%. With the help of splenic artery embolization, success rates of more than 80% have also been described for high-grade splenic injuries. We discuss the role of computed tomography and transcatheter splenic artery embolization in the diagnosis and treatment of blunt splenic trauma. We review technical considerations, indications, efficacy and complication rates. We also propose an algorithm to guide the use of angiography and splenic embolization in patients with traumatic splenic injury.

Clinical and Echocardiographic Outcomes Following Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: Meta-Analysis and Meta-Regression.

Science.gov (United States)

Mohananey, Divyanshu; Jobanputra, Yash; Kumar, Arnav; Krishnaswamy, Amar; Mick, Stephanie; White, Jonathon M; Kapadia, Samir R

2017-07-01

Transcatheter aortic valve replacement has become the procedure of choice for inoperable, high-risk, and many intermediate-risk patients with aortic stenosis. Conduction abnormalities are a common finding after transcatheter aortic valve replacement and often result in permanent pacemaker (PPM) implantation. Data pertaining to the clinical impact of PPM implantation are controversial. We used meta-analysis techniques to summarize the effect of PPM implantation on clinical and echocardiographic outcomes after transcatheter aortic valve replacement. Data were summarized as Mantel-Haenszel relative risk (RR) and 95% confidence intervals (CIs) for dichotomous variables and as standardized mean difference and 95% CI for continuous variables We used the Higgins I 2 statistic to evaluate heterogeneity. We found that patients with and without PPM have similar all-cause mortality (RR, 0.85; 95% CI, 0.70-1.03), cardiovascular mortality (RR, 0.84; 95% CI, 0.59-1.18), myocardial infarction (RR, 0.47; 95% CI, 0.20-1.11), and stroke (RR, 1.26; 95% CI, 0.70-2.26) at 30 days. The groups were also comparable in all-cause mortality (RR, 1.03; 95% CI, 0.92-1.16), cardiovascular mortality (RR, 0.69; 95% CI, 0.39-1.24), myocardial infarction (RR, 0.58; 95% CI, 0.30-1.13), and stroke (RR, 0.70; 95% CI, 0.47-1.04) at 1 year. We observed that the improvement in left ventricular ejection fraction was significantly greater in the patients without PPM (standardized mean difference, 0.22; 95% CI, 0.12-0.32). PPM implantation is not associated with increased risk of all-cause mortality, cardiovascular mortality, stroke, or myocardial infarction both at short- and long-term follow-up. However, PPM is associated with impaired left ventricular ejection fraction recovery post-transcatheter aortic valve replacement. © 2017 American Heart Association, Inc.

Comparison of long-term clinical outcome between transcatheter Amplatzer occlusion and surgical closure of isolated patent ductus arteriosus.

Science.gov (United States)

Chen, Zhao-yang; Wu, Li-ming; Luo, Yu-kun; Lin, Chao-gui; Peng, Ya-fei; Zhen, Xing-chun; Chen, Liang-long

2009-05-20

Transcatheter Amplatzer occlusion of patent ductus artertiosus (PDA) has emerged as a minimally invasive alternative to surgical closure. The goal of this study was to compare long-term clinical outcomes between two procedures, especially on chronic residual shunt, late or very late procedure-related complications, and regression of pulmonary hypertension and left ventricular dilation. A total 255 patients having isolated PDA with a minimal diameter of >or= 4 mm treated from January 2000 to July 2003 were included in this study and have been followed up until July 2008. The patients were assigned to either the device or surgical closure group according to the patients' and/or their parents' preference. Baseline physical exams, chest roentgenography, electrocardiography, and echocardiography were performed preprocedure and at each follow-up. Seventy-two patients accepted the transcatheter procedure (Group-TC) and 183 underwent surgical operation (Group-SO) for PDA closure, both groups were similar in their demographics and preoperative clinical characteristics. There were no cardiac deaths and late complications such as infectious endocarditis and Amplatzer duct occluder (ADO) dislodge in either group. More acute procedure-related complications were recorded in Group-SO (13.7%) compared with Group-TC (1.4%) (P = 0.004). The recovery time was (8.7 +/- 2.3) days for the Group-SO and (1.3 +/- 0.5) days for the Group-TC (P ventricular dilation; neither survival freedom from pulmonary hypertension nor abnormal left ventricular end-diastolic volume index were significantly different between the surgical group and the Amplatzer group. Our study confirmed the long-term safety and efficacy of transcatheter Amplatzer occlusion. In comparison to the time-proven surgical closure, transcatheter Amplatzer occlusion was less invasive and associated with fewer complications and residual shunt, and as effective in the regression of pulmonary hypertension and left ventricular

Burrowing Owl and Other Migratory Bird Mitigation for a Runway Construction Project at Edwards AFB

OpenAIRE

Hoehn, Amber L.; Hagan, Mark; Bratton, Mark

2009-01-01

Edwards Air Force Base (AFB) scheduled the construction of a runway in the spring of 2007. The runway would be in an area that contained migratory birds and their habitat. The construction project would be near Edwards AFB main runway and had the potential not only to impact species protected under the Migratory Bird Treaty Act (MBTA), including the burrowing owl (Athene cunicularia), but also to increase bird and wildlife–aircraft strike hazards in the active flightline areas. To discourage ...

Investigation on the clinical practice of transcatheter embolization for acute gastrointestinal hemorrhage

International Nuclear Information System (INIS)

Gao Bin; Xu Shengde; Cheng Bing; Peng Qiong; Hong Ci; Xu Guozhong; Wang Tao

2002-01-01

Objective: To study the tactics, methods and relevant factors of transcatheter embolization for acute gastrointestinal hemorrhage. Methods: Fifteen patients with acute gastrointestinal hemorrhage were embolized by one of the methods of Polyvinyl Alcohol (PVA), gelfoam or metal coils. Four of the fifteen patients were upper gastrointestinal hemorrhage, the other cases were lower gastrointestinal hemorrhage which were embolized using coaxial microcatheter. Results: Fourteen of the fifteen patients were treated successfully by these methods. There were total 17 times of embolization for 16 parts, the success rate reached 94. 1%. The other one revealed an infarction of intestine after the embolization and was cured by resection. One of the fifteen patients appeared a recurrent hemorrhage 3 months later, and confirmed to be a hemangiolymphangioma. Two patients with malignant tumor were operated upon selectively. The other patient of intestinal hemorrhage was embolized successfully by using a metal coil after shock. Leiomyoma complicated with large area of bleeding was finally proven by operation. Conclusions: Transcatheter embolization for acute massive gastrointestinal hemorrhage is safe and efficient under different choice of methods. The key of success is the right selection of embolized target artery and dosage of emboli

The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

International Nuclear Information System (INIS)

Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo

2000-01-01

To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or 99m Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of radionuclide in

The efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury

Energy Technology Data Exchange (ETDEWEB)

Kwack, Kyu Sung; Kim, Young Ju; Lee, Myung Sub; Kim, Dong Jin; Hong, In Soo [Wonju Christian Hospital, College of Medicine, Yonsei University, Wonju (Korea, Republic of)

2000-07-01

To evaluate the efficacy and benefits of transcatheter arterial embolization (TAE) in patients with blunt splenic injury after blunt abdominal trauma. We retrospectively analyzed the results of transcatheter arterial embolization in 23 patients who suffered splenic injury after blunt abdominal trauma. Fourteen of the patients were male, and 9 were female; 13 were adults, and 10 were children. Transcatheter arterial embolization was performed in patients with hypotension, tachycardia, evidence of hemodynamic instability due, for example, to low levels of Hgb and Hct, or those who needed fluid therapy or blood transfusion. After embolization the patients' progress was monitored by CT scanning, abdominal sonography, or {sup 99m}Tc-sulfur colloid scintigraphy. The degree of splenic injury was classified according to the system devised by Mirvis et al.; nine cases were CT grade III, and 14 were grade IV. After demonstrating angiographically the site of contrast leakage, embolization was performed; for this, a coil only was used in 16 cases, gelfoam only in four, and both coil and gelfoam in three. There were three sites of vascular embolization: 16 procedures were performed in the proximal part of the main trunk of the splenic artery, four in a superselected branch of this same artery, and three in both the splenic artery and one of its superselected branches. Of the 23 cases, 18 recovered without splenectomy after embolization, three adult patients died from coexisting conditions (spinal or cerebral injuries, liver cirrhosis, or pelvic bone fracture) or complications (acute renal failure or disseminated intravascular coagulation). Due to co-existing pancreatic and mesenteric vessel injury, two of the adult patients who underwent TAE also underwent delayed surgery; intraoperatively, there was no evidence of splenic rebleeding. In all patients who did not undergo surgery, follow-up observation revealed a decreased volume of hemoperitoneum, increased uptake of

Prevalence, predictors, and prognostic implications of residual impairment of functional capacity after transcatheter aortic valve implantation

NARCIS (Netherlands)

M. Abdelghani (Mohammad); R. Cavalcante (Rafael); Y. Miyazaki (Yosuke); R.J. de Winter (Robbert); R. Sarmento-Leite (Rogerio); J.A. Mangione (José A.); A.C. Abizaid (Alexandre); P.A. Lemos Neto (Pedro); P.W.J.C. Serruys (Patrick); F.S. De Brito Jr. (Fabio)

2017-01-01

markdownabstractBackground: Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after

Evolutionary genetic analyses of MEF2C gene: implications for learning and memory in Homo sapiens.

Science.gov (United States)

Kalmady, Sunil V; Venkatasubramanian, Ganesan; Arasappa, Rashmi; Rao, Naren P

2013-02-01

MEF2C facilitates context-dependent fear conditioning (CFC) which is a salient aspect of hippocampus-dependent learning and memory. CFC might have played a crucial role in human evolution because of its advantageous influence on survival of species. In this study, we analyzed 23 orthologous mammalian gene sequences of MEF2C gene to examine the evidence for positive selection on this gene in Homo sapiens using Phylogenetic Analysis by Maximum Likelihood (PAML) and HyPhy software. Both PAML Bayes Empirical Bayes (BEB) and HyPhy Fixed Effects Likelihood (FEL) analyses supported significant positive selection on 4 codon sites in H. sapiens. Also, haplotter analysis revealed significant ongoing positive selection on this gene in Central European population. The study findings suggest that adaptive selective pressure on this gene might have influenced human evolution. Further research on this gene might unravel the potential role of this gene in learning and memory as well as its pathogenetic effect in certain hippocampal disorders with evolutionary basis like schizophrenia. Copyright © 2012 Elsevier B.V. All rights reserved.

Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch.

Science.gov (United States)

Millan-Iturbe, Oscar; Sawaya, Fadi J; Bieliauskas, Gintautas; Chow, Danny H F; De Backer, Ole; Søndergaard, Lars

2017-09-01

Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for high/intermediate-risk patients with severe symptomatic aortic stenosis (AS). Although TAVR is used to treat bicuspid severe AS, the large randomized trials typically excluded bicuspid AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a "gothic aortic arch"; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled a sharply angulated aortic arch. This life-threatening complication was successfully treated by thoracic endovascular aortic repair. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Translational mini-review series on vaccines: The Edward Jenner Museum and the history of vaccination.

Science.gov (United States)

Morgan, A J; Parker, S

2007-03-01

Edward Jenner's discovery of vaccination must rank as one of the most important medical advances of all time and is a prominent example of the power of rational enquiry being brought to bear during the Age of Enlightenment in 18th century Europe. In the modern era many millions of lives are saved each year by vaccines that work essentially on the same principles that were established by Edward Jenner more than 200 years ago. His country home in Berkeley, Gloucestershire, is where he carried out his work and where he spent most of his life. The building is now a museum in which the life and times of Jenner are commemorated including not only the discovery of smallpox vaccination but also his other important scientific contributions to natural history and medicine. The trustees of the Edward Jenner museum are committed to promoting the museum as a real and "virtual" educational centre that is both entertaining and informative.

Bed-material entrainment and associated transportation infrastructure problems in streams of the Edwards Plateau, central Texas

Science.gov (United States)

Heitmuller, Franklin T.; Asquith, William H.

2008-01-01

The Texas Department of Transportation commonly builds and maintains low-water crossings (LWCs) over streams in the Edwards Plateau in Central Texas. LWCs are low-height structures, typically constructed of concrete and asphalt, that provide acceptable passage over seasonal rivers or streams with relatively low normal-depth flow. They are designed to accommodate flow by roadway overtopping during high-flow events. The streams of the Edwards Plateau are characterized by cobble- and gravel-sized bed material and highly variable flow regimes. Low base flows that occur most of the time occasionally are interrupted by severe floods. The floods entrain and transport substantial loads of bed material in the stream channels. As a result, LWCs over streams in the Edwards Plateau are bombarded and abraded by bed material during floods and periodically must be maintained or even replaced.

77 FR 17530 - Order Granting an Application of Edward Jones & Co. LLP Exemption From Exchange Act Section 11(d...

Science.gov (United States)

2012-03-26

...'') requested that the Securities and Exchange Commission (``Commission'') issue to Edward Jones an exemption... subject to the conditions contained in this order, is exempt from the new issue lending restriction of... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-66624] Order Granting an Application of Edward...

Teacher Education in Prince Edward Island. Occasional Papers No. 13.

Science.gov (United States)

Brehaut, Willard

This booklet evaluates teacher education in Prince Edward Island and recommends some immediate changes. The evaluation was occasioned by the changing role of the teacher in the world today from being "the prime source," a position that causes inadequacies and insecurity, to being the guide of individual children through appropriate…

Persistent or recurrent varicocoele after failed varicocoelectomy: Outcome in patients treated using percutaneous transcatheter embolization

International Nuclear Information System (INIS)

Kim, J.; Shin, J.H.; Yoon, H.K.; Ko, G.Y.; Gwon, D.I.; Kim, E.Y.; Sung, K.B.

2012-01-01

Aim: To determine the efficacy of percutaneous transcatheter embolization in the management of patients with spermatic varicocoeles persisting or recurring after surgery. Materials and methods: Over a period of 10 years, 28 patients (age range 13–55 years) were referred for percutaneous transcatheter embolization of postsurgical, recurrent varicocoeles. Medical documents were retrospectively reviewed to evaluate past surgical history, subjective symptoms, and results of scrotal examination, ultrasound, and semen parameters. Pre-embolization venograms were analysed to assess the anatomy of the testicular vein. The technical and clinical outcomes of embolization were then determined. Results: The 28 patients included in the study had undergone laparoscopic varicocoelectomy (39.3%), high retroperitoneal ligation (25%), or inguinal ligation (25%). Subjective symptoms were scrotal pain (60.7%) and a palpable scrotal mass (50%) exclusively on the left side. Venograms revealed abnormalities of the left testicular vein in all cases. Embolization was technically successful in all but two cases, thus yielding an occlusion rate of 93%; a single case of suspected thrombophlebitis was the only complication. After excluding two, technically unsuccessful cases and one patient who was lost to follow-up, 25 patients underwent scrotal examination after embolization, which revealed complete resolution in 20 cases (80%), partial improvement in four cases (16%), and no improvement in a single case (4%). Among the follow-up group of patients, of the 12 who initially presented with scrotal pain, six (50%) were symptom-free and four (33.3%) had partial improvement. Conclusion: Percutaneous transcatheter embolization of the testicular vein is technically feasible and effective for managing postsurgical recurrent varicocoeles.

Persistent or recurrent varicocoele after failed varicocoelectomy: Outcome in patients treated using percutaneous transcatheter embolization

Energy Technology Data Exchange (ETDEWEB)

Kim, J. [Department of Radiology, Hanyang University, College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do (Korea, Republic of); Shin, J.H., E-mail: jhshin@amc.seoul.kr [Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Yoon, H.K.; Ko, G.Y.; Gwon, D.I.; Kim, E.Y.; Sung, K.B. [Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

2012-04-15

Aim: To determine the efficacy of percutaneous transcatheter embolization in the management of patients with spermatic varicocoeles persisting or recurring after surgery. Materials and methods: Over a period of 10 years, 28 patients (age range 13-55 years) were referred for percutaneous transcatheter embolization of postsurgical, recurrent varicocoeles. Medical documents were retrospectively reviewed to evaluate past surgical history, subjective symptoms, and results of scrotal examination, ultrasound, and semen parameters. Pre-embolization venograms were analysed to assess the anatomy of the testicular vein. The technical and clinical outcomes of embolization were then determined. Results: The 28 patients included in the study had undergone laparoscopic varicocoelectomy (39.3%), high retroperitoneal ligation (25%), or inguinal ligation (25%). Subjective symptoms were scrotal pain (60.7%) and a palpable scrotal mass (50%) exclusively on the left side. Venograms revealed abnormalities of the left testicular vein in all cases. Embolization was technically successful in all but two cases, thus yielding an occlusion rate of 93%; a single case of suspected thrombophlebitis was the only complication. After excluding two, technically unsuccessful cases and one patient who was lost to follow-up, 25 patients underwent scrotal examination after embolization, which revealed complete resolution in 20 cases (80%), partial improvement in four cases (16%), and no improvement in a single case (4%). Among the follow-up group of patients, of the 12 who initially presented with scrotal pain, six (50%) were symptom-free and four (33.3%) had partial improvement. Conclusion: Percutaneous transcatheter embolization of the testicular vein is technically feasible and effective for managing postsurgical recurrent varicocoeles.

Map Showing Geology and Hydrostratigraphy of the Edwards Aquifer Catchment Area, Northern Bexar County, South-Central Texas

Science.gov (United States)

Clark, Amy R.; Blome, Charles D.; Faith, Jason R.

2009-01-01

Rock units forming the Edwards and Trinity aquifers in northern Bexar County, Texas, are exposed within all or parts of seven 7.5-minute quadrangles: Bulverde, Camp Bullis, Castle Hills, Helotes, Jack Mountain, San Geronimo, and Van Raub. The Edwards aquifer is the most prolific ground-water source in Bexar County, whereas the Trinity aquifer supplies water for residential, commercial, and industrial uses for areas north of the San Antonio. The geologic map of northern Bexar County shows the distribution of informal hydrostratigraphic members of the Edwards Group and the underlying upper member of the Glen Rose Limestone. Exposures of the Glen Rose Limestone, which forms the Trinity aquifer alone, cover approximately 467 km2 in the county. This study also describes and names five informal hydrostratigraphic members that constitute the upper member of the Glen Rose Limestone; these include, in descending order, the Caverness, Camp Bullis, Upper evaporite, Fossiliferous, and Lower evaporite members. This study improves our understanding of the hydrogeologic connection between the two aquifers as it describes the geology that controls the infiltration of surface water and subsurface flow of ground water from the catchment area (outcropping Trinity aquifer rocks) to the Edwards water-bearing exposures.

Dual or Single Antiplatelet Therapy After Transcatheter Aortic Valve Implantation? A Systematic Review and Meta-Analysis.

Science.gov (United States)

Vavuranakis, Manolis; Siasos, Gerasimos; Zografos, Theodoros; Oikonomou, Evangelos; Vrachatis, Dimitris; Kalogeras, Konstantinos; Papaioannou, Theodoros; Kolokathis, Michail-Aggelos; Moldovan, Carmen; Tousoulis, Dimitrios

2016-01-01

Transcatheter aortic valve implantation (TAVI) has undeniably earned a prestigious post in the quiver of interventional cardiologists against symptomatic severe aortic stenosis. Cerebrovascular events are listed within the most frequent complications. We performed a systematic search of EMBASE, MEDLINE, and the Cochrane library from inception to March 2016 for the following search terms (transcatheter AND antiplatelet) OR (transcatheter AND antithrombotic) to retrieve studies of dual antiplatelet treatment (DAPT) and single antiplatelet treatment (SAPT) in patients after TAVI to study thrombotic, hemorrhagic and cardiovascular events at 30 days post procedure. From a total of 208 records 4 studies met inclusion criteria. In the included studies, 286 patients were enrolled in the DAPT group and 354 patients in the SAPT group. There was no difference in all-cause mortality, cardiovascular mortality, stroke, and myocardial infraction 30 days post TAVI between DAPT and SAPT. However, patients in the DAPT group had a significantly increased incidence of lethal and major bleeding at 30 days of follow-up and the incidence of the combined end-point of stroke, spontaneous MI, all-cause mortality and major bleeding was significantly higher in the DAPT group in comparison to the SAPT group. DAPT compared to SAPT in patients after TAVI increases incidence of hemorrhagic events with no benefits in terms of thrombotic events and cardiovascular mortality. However, these data must be interpreted cautiously and the choice of DAPT over SAPT must be based on an individual patient characteristic according to medical practice criteria.

Prevalence, predictors, and prognostic implications of residual impairment of functional capacity after transcatheter aortic valve implantation

NARCIS (Netherlands)

Abdelghani, Mohammad; Cavalcante, Rafael; Miyazaki, Yosuke; de Winter, Robbert J.; Sarmento-Leite, Rogério; Mangione, José A.; Abizaid, Alexandre; Lemos, Pedro A.; Serruys, Patrick W.; de Brito, Fabio S.

2017-01-01

Background Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after valve replacement. We

Transcatheter closure of Patent Ductus Arteriosus through only venous route.

Science.gov (United States)

Sheikh, Abdul Malik; Duke, Abdul Karim; Sattar, Hina

2018-03-01

Patent ductus arteriosus is a common congenital cardiac defect comprising 5-10% of all these defects in term neonates. Although open chest and video-assisted interruption are still in use, transcatheter occlusion has rapidly become the first choice for patent ductus arteriosus closure in the appropriate patient. Percutaneous closure of patent ductus arteriosus is widely done by transvenous approach guided by aortic access. We present the case of a 2 year old girl who underwent patent ductus arteriosus device occlusion with transvenous access only.

Impact of Transcatheter Closure of Atrial Septal Defects in Pediatric Patients on Body Weight

Directory of Open Access Journals (Sweden)

Mao-Hung Lo

2011-07-01

Conclusion: Transcatheter closure of ASD positively affects weight gain. An increase of 7 percentile weight was observed at 1 year of follow-up. Patients with a younger age, higher pulmonary/systemic blood flow ratio, and a larger ratio of ASD diameter/body surface area may have better weight gain after ASD closure.

Enhancing Undergraduates' Capabilities through Team-Based Competitions: The Edward Jones Challenge

Science.gov (United States)

Umble, Elisabeth J.; Umble, Michael; Artz, Kendall

2008-01-01

The Edward Jones Company recently initiated financial sponsorship of team-based competitions in six undergraduate business core classes at Baylor University. The challenges were chosen to take place in an introductory freshman business class, Managerial Accounting, Principles of Marketing, Corporate Finance, Operations Management, and Strategic…

Transcatheter device closure of ruptured sinus of Valsalva: Immediate results and short term follow up

Directory of Open Access Journals (Sweden)

Sen Supratim

2009-01-01

Full Text Available This is a retrospective, observational study comprising of eight patients with isolated rupture of the sinus of Valsalva (RSOV who underwent transcatheter device closure. The mean age of presentation was 32.8 ± 10.0 years. New York Heart Association (NYHA class at the time of presentation was II (six patients and III (two patients. The RSOVs were all closed using a patent ductus arteriosus device. The mean procedural time was 42.3 ± 5.4 minutes, while the fluoroscopic time was 24.5 ± 6.9 minutes. All had complete closure of the shunt. The average hospital stay was 2.9 ± 1.1 days. There were no major complications. The patients were followed up for a mean of 11.3 ± 4.1 months. At the time of the last follow up all the patients were in NYHA class I. We conclude that in the short term, transcatheter closure of isolated RSOV is a viable alternative to surgical repair.

Dynamic data analysis of climate and recharge conditions over time in the Edwards Aquifer, Texas

Science.gov (United States)

Pierce, S. A.; Collins, J.; Banner, J.

2017-12-01

Understanding the temporal patterns in datasets related to climate, recharge, and water resource conditions is important for informing water management and policy decisions. Data analysis and pipelines for evaluating these disparate sources of information are challenging to set up and rely on emerging informatics tools to complete. This project gathers data from both historical and recent sources for the Edwards Aquifer of central Texas. The Edwards faces a unique array of challenges, as it is composed of karst limestone, is susceptible to contaminants and climate change, and is expected to supply water for a rapidly growing population. Given these challenges, new approaches to integrating data will be particularly important. Case study data from the Edwards is used to evaluate aquifer and hydrologic system conditions over time as well as to discover patterns and possible relationships across the information sources. Prior research that evaluated trends in discharge and recharge of the aquifer is revisited by considering new data from 1992-2015, and the sustainability of the Edwards as a water resource within the more recent time period is addressed. Reusable and shareable analytical data pipelines are constructed using Jupyter Notebooks and Python libraries, and an interactive visualization is implemented with the information. In addition to the data sources that are utilized for the water balance analyses, the Global Surface Water Monitoring System from the University of Minnesota, a tool that integrates a wide number of satellite datasets with known surface water dynamics and machine learning, is used to evaluate water body persistence and change over time at regional scales. Preliminary results indicate that surface water body over the Edwards with differing aerial extents are declining, excepting some dam-controlled lakes in the region. Other existing tools and machine learning applications are also considered. Results are useful to the Texas Water Research

[Selection of patients for transcatheter aortic valve implantation].

Science.gov (United States)

Tron, Christophe; Godin, Matthieu; Litzler, Pierre-Yves; Bauer, Fabrice; Caudron, Jérome; Dacher, Jean-Nicolas; Borz, Bogdan; Canville, Alexandre; Kurtz, Baptiste; Bessou, Jean-Paul; Cribier, Alain; Eltchaninoff, Hélène

2012-06-01

A good selection of patients is a crucial step before transcatheter aortic valve implantation (TAVI) in order to select the good indications and choose the access route. TAVI should be considered only in patients with symptomatic severe aortic stenosis and either contraindication or high surgical risk. Indication for TAVI should be discussed in a multidisciplinary team meeting. Echocardiography and/or CT scan are mandatory to evaluate the aortic annulus size and select the good prosthesis size. The possibility of transfemoral implantation is evaluated by angiography and CT scan, and based on the arterial diameters, but also on the presence of tortuosities and arterial calcifications. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Orsang Man: a robust Homo sapiens in Central India with Asian Homo erectus features

OpenAIRE

Dambricourt-Malassé, Anne; Raj, Rachna; Shah, Samit

2013-01-01

17th World Congress of the International Union of Anthropological and Ethnological Sciences "Evolving Humanity, Emerging Worlds", Manchester, August 5th-10th, 2013 Accepted preprint; A Homo sapiens calvarium recovered in a fluvial deposit of the Orsang River give evidence of genetic continuity between late Asian Homo erectus suggesting an Asian "like-cromagnoid" stadium in the evolutionary process. IRSL dating of the host sediments provided an age ranging from 50 to 30 ka. The interesting fea...

Successful transcatheter closure of coronary artery fistula in a child with single coronary artery: a heavy load and a long road.

Science.gov (United States)

Phasalkar, Manjunath; Thakkar, Bhavesh; Poptani, Vishal

2013-07-01

Single coronary artery is an uncommon variation of the coronary circulation. After transposition of great arteries, coronary artery fistulas are the most common associated cardiac anomalies in these patients. Transcatheter closure of coronary artery fistula (CAF) involving single coronary artery is a challenging intervention. In the absence of contralateral coronary artery, a complex anatomy of the CAF and a large myocardial perfusion territory of the dominant circulation pose an additional risk during interventional procedure. We report our experience of a successful transcatheter closure of a coronary artery fistula in a patient with single coronary artery. Copyright © 2013 Wiley Periodicals, Inc.

Building foundations for transcatheter intervascular anastomoses: 3D anatomy of the great vessels in large experimental animals

NARCIS (Netherlands)

Sizarov, Aleksander; de Bakker, Bernadette S.; Klein, Karina; Ohlerth, Stefanie

2014-01-01

To provide comprehensive illustrations of anatomy of the relevant vessels in large experimental animals in an interactive format as preparation for developing an effective and safe transcatheter technique of aortopulmonary and bidirectional cavopulmonary intervascular anastomoses. Computed

1995 Edward teller lecture. Patience and optimism

International Nuclear Information System (INIS)

Miley, G.H.

1996-01-01

Remarks made in the author close-quote s acceptance lecture for the 1995 Edward Teller Medal are presented and expanded. Topics covered include research on nuclear-pumped lasers, the first direct e-beam-pumped laser, direct energy conversion and advanced fuel fusion, plus recent work on inertial electrostatic confinement. open-quote open-quote Patience close-quote close-quote and open-quote open-quote optimism close-quote close-quote are viewed as essential elements needed by scientists following the open-quote open-quote zig-zag close-quote close-quote path to fusion energy production. copyright 1996 American Institute of Physics

Edward Cullen: el nuevo concepto de vampiro

OpenAIRE

Graillet Carrasco, Yolanda de

2010-01-01

El vampiro, como esa parte de sombra del inconsciente, evoluciona de diablo a ángel como se manifiesta en Crepúsculo de Stephenie Meyer. Para analizar este proceso, se traza el paso del vampiro moderno al post-moderno a través de tres figuras básicas: Drácula, Lestat y Edward Cullen, con la ayuda de los conceptos de Jung de sombra y héroe, y la teoría del cerebro triuno de McLean. Sangre, alma y sexo se desarrollan con este nuevo concepto de vampiro que comienza a revelar su reflejo para deja...

Edward Cullen : el nuevo concepto de vampiro

OpenAIRE

Graillet Carrasco, Yolanda de

2010-01-01

El vampiro, como esa parte de sombra del inconsciente, evoluciona de diablo a ángel como se manifiesta en Crepúsculo de Stephenie Meyer. Para analizar este proceso, se traza el paso del vampiro moderno al post-moderno a través de tres figuras básicas: Drácula, Lestat y Edward Cullen, con la ayuda de los conceptos de Jung de sombra y héroe, y la teoría del cerebro triuno de McLean. Sangre, alma y sexo se desarrollan con este nuevo concepto de vampiro que comienza a revelar su reflejo para deja...

Biomedical Impact in Implantable Devices-The Transcatheter Aortic Valve as an example

Science.gov (United States)

Anastasiou, Alexandros; Saatsakis, George

2015-09-01

Objective: To update of the scientific community about the biomedical engineering involvement in the implantable devices chain. Moreover the transcatheter Aortic Valve (TAV) replacement, in the field of cardiac surgery, will be analyzed as an example of contemporary implantable technology. Methods: A detailed literature review regarding biomedical engineers participating in the implantable medical product chain, starting from the design of the product till the final implantation technique. Results: The scientific role of biomedical engineers has clearly been established. Certain parts of the product chain are implemented almost exclusively by experienced biomedical engineers such as the transcatheter aortic valve device. The successful professional should have a multidisciplinary knowledge, including medicine, in order to pursue the challenges for such intuitive technology. This clearly indicates that biomedical engineers are among the most appropriate scientists to accomplish such tasks. Conclusions: The biomedical engineering involvement in medical implantable devices has been widely accepted by the scientific community, worldwide. Its important contribution, starting from the design and extended to the development, clinical trials, scientific support, education of other scientists (surgeons, cardiologists, technicians etc.), and even to sales, makes biomedical engineers a valuable player in the scientific arena. Notably, the sector of implantable devices is constantly raising, as emerging technologies continuously set up new targets.

Will Transcatheter Aortic Valve Replacement (TAVR be the Primary Therapy for Aortic Stenosis?

Directory of Open Access Journals (Sweden)

Jose F. Condado, MD, MS

2016-05-01

Full Text Available Transcatheter aortic valve replacement (TAVR is increasingly used for the treatment of high or very high surgical risk patients with severe aortic stenosis (AS or failing surgical bioprosthesis (valve-in-valve, VIV-TAVR. In TAVR, the collapsed transcatheter heart valve (THV is introduced using the delivery system inserted from the femoral artery (preferred or other alternative accesses (transapical, transaortic, transcarotid, subclavian/transinnominate or transcaval. The delivery system is then advanced until coaxially aligned with the aortic annulus, where the THV is deployed. This procedure can be associated with complications such as access site injury (vascular complication, paravalvar leak, cerebrovascular events and conduction disturbances. However, the rapid acceptance and successes observed with TAVR have been made possible through careful patient selection, preprocedural planning (i.e. MDCT annular sizing, THV technology (i.e. new generation valves, and procedural techniques (i.e. minimalist TF-TAVR and alternative percutaneous access options, as well as a decrease in complications as TAVR experience grows. Though the results or ongoing clinical trials evaluating TAVR in intermediate surgical risk patients are pending, it is likely that TAVR will soon be approved for lower risk patients as well.

Transcatheter aortic valve implantation: emerging role in poor left ventricular function severe aortic stenosis?

Directory of Open Access Journals (Sweden)

K. M. John Chan

2014-01-01

Full Text Available Transcatheter aortic valve implantation (TAVI has become an established treatment option for high risk elderly patients with symptomatic severe aortic stenosis. Its role in less high risk patients is being evaluated in clinical trials. Patients with severely impaired left ventricular function may be another group who may benefit from this emerging percutaneous treatment option.

Optimization of Edwards vacuum coating unit model E12E for the production of thin films

International Nuclear Information System (INIS)

Ruiz P, H.S.

1995-01-01

This work is about an Edwards vacuum coating unit model E12E, it shows the principle of vacuum thermal evaporation, some observations in the operation of vacuum diffusion pumps, mechanical pumps, vacuum gauge, Penning and Pirani, and some equations of leak vacuum, after the modifications and additions of Edwards vacuum coating unit for optimization, the last part contains a concise introduction about thin films and one specific application, it also contains the recommendations and requirements to keep the system in good conditions. (Author)

Dynamics of the aortic annulus in 4D CT angiography for transcatheter aortic valve implantation patients

NARCIS (Netherlands)

Elattar, Mustafa A.; Vink, Leon W.; van Mourik, Martijn S.; Baan, Jan; Vanbavel, Ed T.; Planken, R. Nils; Marquering, Henk A.

2017-01-01

Transcatheter aortic valve implantation (TAVI) is a well-established treatment for patients with severe aortic valve stenosis. This procedure requires pre-operative planning by assessment of aortic dimensions on CT Angiography (CTA). It is well-known that the aortic root dimensions vary over the

Edward A. Bouchet

Science.gov (United States)

Mickens, R. E.

2002-04-01

Edward A. Bouchet was the first African American to receive the doctorate in any field of knowledge in the United States and that area was physics. He was granted the degree in 1876 from Yale University making him at that time one of the few persons to hold the physics doctorate from an American university. His prior education included the Hopkins Grammar School and Yale College (BA in 1874). After Yale, Bouchet taught mathematics, physics, and chemistry for over twenty-five years at the Institute for Colored Youth in Philadelphia. During the following two decades, he was employed in positions ranging from high school principal to employment by the federal government. Bouchet played a significant role in the education of African Americans through his teaching and mentoring activities. He was one among a small group of African Americans who achieved advanced training and education within decades of the American civil war. These individuals provided direction, leadership, and role models for what eventually became the civil/human rights movements. The year 2001 marks the 125th celebration of his receiving the doctorate. We present details of his life and career with an emphasis on the influence of the political and social forces exerted on him by society.

Pygmoid Australomelanesian Homo sapiens skeletal remains from Liang Bua, Flores: Population affinities and pathological abnormalities

OpenAIRE

Jacob, T.; Indriati, E.; Soejono, R. P.; Hsü, K.; Frayer, D. W.; Eckhardt, R. B.; Kuperavage, A. J.; Thorne, A.; Henneberg, M.

2006-01-01

Liang Bua 1 (LB1) exhibits marked craniofacial and postcranial asymmetries and other indicators of abnormal growth and development. Anomalies aside, 140 cranial features place LB1 within modern human ranges of variation, resembling Australomelanesian populations. Mandibular and dental features of LB1 and LB6/1 either show no substantial deviation from modern Homo sapiens or share features (receding chins and rotated premolars) with Rampasasa pygmies now living near Liang Bua Cave. We propose ...

Transcatheter closure of patent ductus arteriosus using Flipper coil and Amplatzer Duct Occluder: Ten-year experience from a single center

Directory of Open Access Journals (Sweden)

Đukić Milan

2017-01-01

Full Text Available Introduction/Objective. Transcatheter closure is a well-established procedure for treatment of patent ductus arteriosus (PDA. We aimed to make a comparison between transcatheter PDA occlusion with Flipper coil and Amplatzer Duct Occluder (ADO and to determine the incidence and significance of procedural complications. Methods. Between November 2004 and October 2014, 148 patients were eligible for transcatheter PDA closure at the University Children’s Hospital in Belgrade, Serbia. The median age was 5.9 years (the range of 0.9 years to 17.3 years and the median weight was 21 kg (the range of 8.8 kg to 94 kg. Follow-up evaluations with Doppler echocardiogram were performed at one day, three months, and one and two years after the PDA occlusion. Results. Median narrowest PDA diameter was 1.5 mm (the range of 0.5 mm to 5.6 mm. Flipper coil was used for PDA closure in 84 (59.2% and ADO in 58 patients (40.8%. There was no significant difference in the rate of immediate complete closure between the coil and the ADO group (86.9% vs. 75.9%, p = 0.089, but a significantly higher rate of complete closure was achieved with ADO at one day (83.3% vs. 98.3%, p = 0.004, three months (85.7% vs. 100%, p = 0.002, and both one and two years after the implantation (91.7% vs. 100%, p = 0.041. In total, 12 complications occurred during the procedure, seven of which with coil and five with ADO occlusion of PDA. Conclusion. Transcatheter closure of PDA using both coils and ADOs is a very safe and effective procedure. ADO proved superior to coil in terms of complete closure rate as early as one day after the procedure.

Automatic segmentation of the aortic root in CT angiography of candidate patients for transcatheter aortic valve implantation

NARCIS (Netherlands)

Elattar, M.A.; Wiegerinck, E.; Planken, R.N.; VanBavel, E.T.; Assen, van H.C.; Baan Jr., J.; Marquering, H.A.

2014-01-01

Transcatheter aortic valve implantation is a minimal-invasive intervention for implanting prosthetic valves in patients with aortic stenosis. Accurate automated sizing for planning and patient selection is expected to reduce adverse effects such as paravalvular leakage and stroke. Segmentation of

Bedrock geology and hydrostratigraphy of the Edwards and Trinity aquifers within the Driftwood and Wimberley 7.5-minute quadrangles, Hays and Comal Counties, Texas

Science.gov (United States)

Clark, Allan K.; Morris, Robert R.

2017-11-16

The Edwards and Trinity aquifers are major sources of water in south-central Texas and are both classified as major aquifers by the State of Texas. The population in Hays and Comal Counties is rapidly growing, increasing demands on the area’s water resources. To help effectively manage the water resources in the area, refined maps and descriptions of the geologic structures and hydrostratigraphic units of the aquifers are needed. This report presents the detailed 1:24,000-scale bedrock hydrostratigraphic map as well as names and descriptions of the geologic and hydrostratigraphic units of the Driftwood and Wimberley 7.5-minute quadrangles in Hays and Comal Counties, Tex.Hydrostratigraphically, the rocks exposed in the study area represent a section of the upper confining unit to the Edwards aquifer, the Edwards aquifer, the upper zone of the Trinity aquifer, and the middle zone of the Trinity aquifer. In the study area, the Edwards aquifer is composed of the Georgetown Formation and the rocks forming the Edwards Group. The Trinity aquifer is composed of the rocks forming the Trinity Group. The Edwards and Trinity aquifers are karstic with high secondary porosity along bedding and fractures. The Del Rio Clay is a confining unit above the Edwards aquifer and does not supply appreciable amounts of water to wells in the study area.The hydrologic connection between the Edwards and Trinity aquifers and the various hydrostratigraphic units is complex because the aquifer system is a combination of the original Cretaceous depositional environment, bioturbation, primary and secondary porosity, diagenesis, and fracturing of the area from Miocene faulting. All of these factors have resulted in development of modified porosity, permeability, and transmissivity within and between the aquifers. Faulting produced highly fractured areas which allowed for rapid infiltration of water and subsequently formed solutionally enhanced fractures, bedding planes, channels, and caves that

The predictors of dislodgement and outcomes of transcatheter closure of complex atrial septal defects in adolescents and adults

Directory of Open Access Journals (Sweden)

Wei-Chieh Lee

2015-11-01

Conclusion: Eroded and floppy IAS or aneurysm formation post ASO implantation and peri-procedure arrhythmia could predict ASO dislodgement in complex ASD closure. Transcatheter closure of ASDs under TEE guidance is feasible in complex cases.

Transcatheter Aortic Valve Implantation in Lower-Risk Patients With Aortic Stenosis: Is It Justified to Be the Preferred Treatment?

Science.gov (United States)

Abdelghani, Mohammad; Serruys, Patrick W

2016-04-01

Transcatheter aortic valve implantation underwent progressive improvements until it became the default therapy for inoperable patients, and a recommended therapy in high-risk operable patients with symptomatic severe aortic stenosis. In the lower-risk patient strata, a currently costly therapy that still has important complications with questionable durability is competing with the established effective and still-improving surgical replacement. This report tries to weigh the clinical evidence, the recent technical improvements, the durability, and the cost-effectiveness claims supporting the adoption of transcatheter aortic valve implantation in intermediate-low risk patients. The importance of appropriate patients' risk stratification and a more comprehensive approach to estimate that risk are also emphasized in the present report. © 2016 American Heart Association, Inc.

Imaging techniques in transcatheter aortic valve replacement

Directory of Open Access Journals (Sweden)

Quaife RA

2013-11-01

Full Text Available Robert A Quaife, Jennifer Dorosz, John C Messenger, Ernesto E Salcedo Division of Cardiology, University of Colorado, Aurora, CO, USA Abstract: Calcific aortic stenosis is now understood as a complex valvular degenerative process sharing many risk factors with atherosclerosis. Once patients develop symptomatic calcific aortic stenosis, the only effective treatment is aortic valve replacement. In the past decade, transcatheter aortic valve replacement (TAVR has been developed as an alternative to surgery to treat severe calcific aortic stenosis. Cardiac imaging plays a pivotal role in the contemporary management of patients with calcific aortic stenosis, and particularly in patients being considered for TAVR, who demand detailed imaging of the aortic valve apparatus. In this review, we highlight the role of cardiac imaging for patient selection, procedural guidance, and evaluation of results of TAVR. Keywords: aortic stenosis, cardiovascular imaging, transcutaneous aortic valve replacement

Transcatheter heart valve in valve implantation with Edwards SAPIEN bioprosthetic valve for different degenerated bioprosthetic valve positions (First Iranian ViV report with mid-term follow up

Directory of Open Access Journals (Sweden)

Ali Mohammad Haji Zeinali

2017-09-01

Conclusion: As the first Iranian all-comers case series with midterm follow up for ViV implantation, we had no mortality. Interestingly none of our patients had neurologic sequelae after the procedure. Midterm follow up for our patients was acceptable with good functional class and appropriate echocardiographic findings. Due to high surgical risk of the redo procedure after failing of a bioprosthetic valve especially in elderly patients with comorbidities, ViV implantation would be a good alternative to surgery for this high risk group.

Edward Lee Thorndike and John Dewey on the Science of Education.

Science.gov (United States)

Tomlinson, Stephen

1997-01-01

Reviews the contributions of Edward Thorndike and John Dewey to U.S. educational theory. Notes that both believed teaching could be transformed into a science, but disagreed in their views of human nature. Discusses the failings of Thorndike's program in U.S. schools and the implications of Dewey's arguments for educational practice. (DSK)

Transcatheter arterial embolization of a pseudoaneurysm of gastroduodenal artery: a case report

Energy Technology Data Exchange (ETDEWEB)

Han, Young Min; Kang, Sung Soo; Lee, Jeong Min; Chung, Jin Young; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National University School of Medicine, Chonju (Korea, Republic of)

1997-01-01

Gastroduodenal artery pseudoaneurysm is a relatively rare and potentionally life-threatening complication of chronic pancreatitis, which is thought to occur because of autodigestion of arterial walls by pancreatic enzymes. Embolotherapy should probably be the first method of treatment, since surgical treatment carries a high risk of mortality and morbidity. We report the case of 30-year-old male with gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis which was successfully treated by transcatheter embolization using Gianturco spring coils.

Transcatheter arterial embolization of a pseudoaneurysm of gastroduodenal artery: a case report

International Nuclear Information System (INIS)

Han, Young Min; Kang, Sung Soo; Lee, Jeong Min; Chung, Jin Young; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul

1997-01-01

Gastroduodenal artery pseudoaneurysm is a relatively rare and potentionally life-threatening complication of chronic pancreatitis, which is thought to occur because of autodigestion of arterial walls by pancreatic enzymes. Embolotherapy should probably be the first method of treatment, since surgical treatment carries a high risk of mortality and morbidity. We report the case of 30-year-old male with gastroduodenal artery pseudoaneurysm caused by chronic pancreatitis which was successfully treated by transcatheter embolization using Gianturco spring coils

Updated standardized endpoint definitions for transcatheter aortic valve implantation: The Valve Academic Research Consortium-2 consensus document

NARCIS (Netherlands)

A.P. Kappetein (Arie Pieter); S.J. Head (Stuart); P. Généreux (Philippe); N. Piazza (Nicolo); N.M. van Mieghem (Nicolas); E.H. Blackstone (Eugene); T.G. Brott (Thomas); D.J. Cohen (David J.); D.E. Cutlip (Donald); G.A. van Es (Gerrit Anne); R.T. Hahn (Rebecca); A.J. Kirtane (Ajay); M. Krucoff (Mitchell); S. Kodali (Susheel); M.J. Mack (Michael); R. Mehran (Roxana); J. Rodés-Cabau (Josep); P. Vranckx (Pascal); J.G. Webb (John); S.W. Windecker (Stephan); P.W.J.C. Serruys (Patrick); M.B. Leon (Martin)

2012-01-01

textabstractObjectives: The aim of the current Valvular Academic Research Consortium (VARC)-2 initiative was to revisit the selection and definitions of transcatheter aortic valve implantation (TAVI)- clinical endpoints to make them more suitable to the present and future needs of clinical trials.

The mitogenome of a 35,000-year-old Homo sapiens from Europe supports a Palaeolithic back-migration to Africa

NARCIS (Netherlands)

Hervella, M.; Svensson, E.M.; Alberdi, A.; Gunther, T.; Izagirre, N.; Munters, A.R.; Alonso, S.; Ioana, M.; Ridiche, F.; Soficaru, A.; Jakobsson, M.; Netea, M.G.; Rua, C. de la

2016-01-01

After the dispersal of modern humans (Homo sapiens) Out of Africa, hominins with a similar morphology to that of present-day humans initiated the gradual demographic expansion into Eurasia. The mitogenome (33-fold coverage) of the Pestera Muierii 1 individual (PM1) from Romania (35 ky cal BP) we

Relationships Between the Vocational Preference Inventory and the Edwards Personal Preference Schedule

Science.gov (United States)

Wakefield, James A., Jr.; Cunningham, Claude H.

1975-01-01

The Vocational Preference Inventory and the Edwards Personal Preference Schedule were administered to 372 undergraduates. The two instruments were compared using canonical analysis. The analysis revealed three significant relationships between components of the two instruments. The relationships were viewed as supportive of Holland's theory of…

Stealing the gold a celebration of the pioneering physics of Sam Edwards

CERN Document Server

Goldenfeld, Nigel; Sherrington, D C; Edwards, S F

2004-01-01

This title presents a survey of some of the most exciting topics in condensed matter physics today, from the perspective of the pioneering work of Sam Edwards. Original articles from leaders in the field highlight the historical development as well as new and emerging areas.

Transcatheter aortic value implantation with self-expandable nitinol valved stent: an experimental study in sheep

International Nuclear Information System (INIS)

Jiang Haibin; Huang Xinmiao; Bai Yuan

2011-01-01

Objective: to determine the feasibility and safety of transcatheter aortic valve implantation with domestic self-expandable nitinol valved stent in experimental sheep. Methods: A fresh pig pericardium was cross-linked with a 0.6% glutaraldehyde solution for 36 hours and then sutured on a nitinol self-expandable stent. Ten healthy sheep of (46.00±2.60) kg body weight were chosen for the study. Under general anesthesia, the device was delivered through catheter into the native aortic valve of the sheep via the femoral artery or abdominal aorta. The animals were followed up for three months. Results: Six devices were successfully delivered at the desired position in six sheep with no occurrence of complications. Angiographic and hemodynamic studies confirmed that the stents were fixed at correct position with competent valve function immediately and 90 days after the procedure. Technical failure or fatal complications occurred in the remaining four sheep. Conclusion: Implantation of a domestic nitinol self-expandable stent at the aortic valve position through a transcatheter approach is feasible in experimental sheep. (authors)

Long-Term Results of Transcatheter Closure of Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder

Science.gov (United States)

Behjati-Ardakani, Mostafa; Behjati-Ardakani, Mohammad-Amin; Hosseini, Seyed-Habibolla; Noori, Noormohammad

2013-01-01

Objective Patent ductus arteriosus (PDA) is one of the most frequently seen congenital heart diseases. Its closure is recommended because of the risk of infective endocardis, as well as morbidity and mortality in the long. The aim of this study was to assess the long term results of the transcatheter closure of PDA in infants using amplatzer duct occlude (ADO). Methods From May 2004 to September 2011, forty eight infants underwent transcatheter closure of PDA. A lateral or right anterior oblique view aortogram was done to locate PDA and to measure its size. Before discharge, repeat aortogram was performed to evaluate eventual residual shunt and to confirm the appropriate deployment of the ADO. Follow up evaluations were done with transthoracic echocardiography at discharge, 1 month, 6 months, 12 months and yearly thereafter. Findings The mean age of patients at procedure was 9.18±2.32 (range 3 to 12) months, mean weight 6.73±1.16 (range 4.5 to 10.1) kg. The PDA occluded completely in 20 out of the 48 patients. Twenty four patients had trivial or mild shunt and two patients had moderate residual shunt which disappeared in one patient within 24 hours and other patient with moderate shunt in 1 month. One patient (age 8 months) had mild LPA stenosis. The device emobolization occurred in two patients, immediately after the procedure in one and during night in the other patient Conclusion The long term results suggested that transcatheter closure of PDA using Amplatzer duct occluder is a safe and effective treatment in infants less than 1 year of age with minimal complications. PMID:24427494

Transcatheter closure of ruptured sinus of valsalva aneurysms: evaluation of therapeutic results

International Nuclear Information System (INIS)

Wu Guangwei; Xu Nengwen; Wang Mengjie; Wu Xubin

2014-01-01

Objective: To discuss the clinical effects and safety, of transcatheter closure in treating ruptured sinus of valsalva aneurysm (RSVA). Methods: During the period from May 2007 to June 2012, 5 patients (4 males and 1 female) with RSVA were treated with interventional occlusion therapy at authors' hospital. The aortic root angiography and echocardiography indicated that all the five patients had single sinus of valsalva aneurysm, including rupture of right coronary sinus of valsalva aneurysm into the right ventricle (n=3) and into the right atrium (n=2). Results: The occluder placement was successfully accomplished in all the 5 patients. Patent arterial duct occluder was employed in two patients, while ventricular septal defect occluder was adopted in three patients, After the procedure, the five patients were followed up for 12- 60 months (mean 30.2 months), and echocardiography and electrocardiography were conducted to evaluate the clinical effects. After the interventional occlusion therapy, in all patients the inner-diameters of the right ventricular and right atrium were markedly reduced, and the heart murmur disappeared. The occluder was situated in the right place. No complications such as hemolysis or aortic regurgitation occurred. Conclusion: Transcatheter closure is a mini-invasive, safe, simple and effective technique for the treatment of ruptured sinus of valsalva aneurysm. The short-term result is satisfactory, although its long-term efficacy needs to be further studied. (authors)

Ex vivo hydrodynamics after central and paracommissural edge-to-edge technique: A further step toward transcatheter tricuspid repair?

Science.gov (United States)

Stock, Sina; Bohm, Heidemarie; Scharfschwerdt, Michael; Richardt, Doreen; Meyer-Saraei, Roza; Tsvelodub, Stanislav; Sievers, Hans-Hinrich

2018-03-01

Transcatheter approaches in heart valve disease became tremendously important and are currently established in the aortic position, but transcatheter tricuspid repair is still in its beginning and remains challenging. Replicating the surgical edge-to-edge technique, for example, with the MitraClip System (Abbott Vascular, Santa Clara, Calif), represents a promising option and has been reported successfully in small numbers of cases. However, up to now, few data considering the edge-to-edge technique as a transcatheter approach are available. This study aims to determine the ex vivo hydrodynamics after the central and paracommissural edge-to-edge technique in different pathologies. Because of basal or apical dislocation of papillary muscles, leaflet prolapse or tethering was simulated in porcine tricuspid valves mounted on a flexible holding device. Central and paracommissural edge-to-edge techniques were evaluated successively in these pathologies. Regurgitant volume and mean transvalvular gradient were determined in a pulse duplicator. In this ex vivo model, the isolated edge-to-edge technique reduced tricuspid regurgitation. In the prolapse model, regurgitant volume decreased significantly after central edge-to-edge technique (from 49.4 ± 13.6 mL/stroke to 39.3 ± 14.1 mL/stroke). In the tethering model, both the central and the paracommissural edge-to-edge techniques led to a significant decrease (from 48.7 ± 13.9 to 43.6 ± 15.6 and to 41.1 ± 13.8 mL/stroke). In all cases, the reduction of regurgitant volume was achieved at the cost of significantly increased mean transvalvular gradient. This study provides a reduction of tricuspid regurgitation after the edge-to-edge technique in the specific experimental setup. Whether this reduction is sufficient to treat tricuspid regurgitation successfully in clinical practice remains to be established. Transcatheter approaches need to be evaluated further, probably with regard to concomitant annuloplasty

Transcatheter pulmonary valve replacement by hybrid approach using a novel polymeric prosthetic heart valve: proof of concept in sheep.

Directory of Open Access Journals (Sweden)

Ben Zhang

Full Text Available Since 2000, transcatheter pulmonary valve replacement has steadily advanced. However, the available prosthetic valves are restricted to bioprosthesis which have defects like poor durability. Polymeric heart valve is thought as a promising alternative to bioprosthesis. In this study, we introduced a novel polymeric transcatheter pulmonary valve and evaluated its feasibility and safety in sheep by a hybrid approach.We designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent, and the valve leaflets were made of 0.1-mm expanded polytetrafluoroethylene (ePTFE coated with phosphorylcholine. We chose glutaraldehyde-treated bovine pericardium valves as control. Pulmonary valve stents were implanted in situ by a hybrid transapical approach in 10 healthy sheep (8 for polymeric valve and 2 for bovine pericardium valve, weighing an average of 22.5±2.0 kg. Angiography and cardiac catheter examination were performed after implantation to assess immediate valvular functionality. After 4-week follow-up, angiography, echocardiography, computed tomography, and cardiac catheter examination were used to assess early valvular function. One randomly selected sheep with polymeric valve was euthanized and the explanted valved stent was analyzed macroscopically and microscopically.Implantation was successful in 9 sheep. Angiography at implantation showed all 9 prosthetic valves demonstrated orthotopic position and normal functionality. All 9 sheep survived at 4-week follow-up. Four-week follow-up revealed no evidence of valve stent dislocation or deformation and normal valvular and cardiac functionality. The cardiac catheter examination showed the peak-peak transvalvular pressure gradient of the polymeric valves was 11.9±5.0 mmHg, while that of two bovine pericardium valves were 11 and 17 mmHg. Gross morphology demonstrated good opening and closure characteristics. No thrombus or calcification was seen macroscopically

Reoperative aortic valve replacement in the octogenarians-minimally invasive technique in the era of transcatheter valve replacement

NARCIS (Netherlands)

Kaneko, Tsuyoshi; Loberman, Dan; Gosev, Igor; Rassam, Fadi; McGurk, Siobhan; Leacche, Marzia; Cohn, Lawrence

2014-01-01

Objective: Reoperative aortic valve replacement (re-AVR) in octogenarians is considered high risk and therefore might be indicated for transcatheter AVR. The minimally invasive technique for re-AVR limits dissection and might benefit this patient population. We report the outcomes of re-AVR in

De eerste 'European Day Without A Road Death' : maak kennis met EDWARD.

NARCIS (Netherlands)

Preusting, G.

2016-01-01

Op 21 september 2016 vond de eerste European Day Without A Road Death plaats. Het project - naar goed Europees gebruik met een acronym 'EDWARD' gedoopt - is een initiatief van TISPOL, het European Traffic Police Network. TISPOL, waarbij dertig landen zijn aangesloten, vraagt nu aan elke Europese

L'evolució del cervell humà: des d'Homo erectus a Homo sapiens

OpenAIRE

Coma Almenar, Herena

2017-01-01

Homo sapiens presenta unes característiques morfològiques cerebrals que han possibilitat les capacitats cognitives que podem observar actualment. Però no ha estat a causa d'un fet puntual en la nostra historia evolutiva, sinó que anys de canvis en la dotació genètica i l'adaptació a l'entorn ha procurat el nostre augment del volum encefàlic i de la seva reorganització i connectivitat, on la asimetria cerebral ha estat l'estratègia per optimitzar els recursos neuronals. No obstant, en el regis...

Supra-annular valve strategy for an early degenerated transcatheter balloon-expandable heart valve.

Science.gov (United States)

Kamioka, Norihiko; Caughron, Hope; Corrigan, Frank; Block, Peter; Babaliaros, Vasilis

2018-01-23

Currently, there are no recommendations regarding the selection of valve type for a transcatheter heart valve (THV)-in-THV procedure. A supra-annular valve design may be superior in that it results in a larger effective orifice area and may have a lower chance of valve thrombosis after THV-in-THV. In this report, we describe the use of a supra-annular valve strategy for an early degenerated THV. © 2018 Wiley Periodicals, Inc.

Transcatheter Arterial Embolization of Cystic Artery Pseudoaneurysm in Acalculous Cholecystitis: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Hyung Ook; Lee, Young Hwan [Dept. of Radiology, Daegu Catholic University College of Medicine, Daegu (Korea, Republic of); Kim, Young Hwan [Dept. of Diagnostic Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

2011-04-15

A pseudoaneurysm of the cystic artery is a rare complication of cholecystitis, and is manifested by hemobilia or hematemesis. An early diagnosis is required for the successful treatment by cholecystectomy and ligation of the cystic artery. Herein, we report a case of a pseudoaneurysm of the cystic artery diagnosed by color Doppler ultrasonography and CT, and successfully treated by transcatheter arterial embolization with N-butyl cyanoacrylate in a high-risk surgical patient.

Aortic root geometry in aortic stenosis patients (a SEAS substudy)

DEFF Research Database (Denmark)

Bahlmann, Edda; Nienaber, Christoph A; Cramariuc, Dana

2011-01-01

-specified requirements for the aortic root geometry for current available prostheses, CoreValve and Edwards-Sapien. The ratio of sinus of Valsalva height to sinus width was 1:2. In multivariate linear regression analysis, larger sinus of Valsalva height was associated with older age, larger sinus of Valsalva diameter......, lower ejection fraction and smaller supracoronary diameter (multiple R(2) = 0.19, PSapien prosthesis in 66.9%. Overall, annular dimension feasible for TAVI using any available prosthesis was found...

The distribution and spread of alien vascular plants on Prince Edward Island

NARCIS (Netherlands)

Ryan, P.G.; Smith, V.; Gremmen, N.J.M.

2003-01-01

Surveys of alien plants at subantarctic Prince Edward Island in 2001 show that the ranges of all three introduced species have increased since the last survey in 1998. Poa annua, the longest-established species, increased its range substantially after 1987, prior to which it was confined to a single

Numerical analysis of the in-well vapor-stripping system demonstration at Edwards Air Force Base

International Nuclear Information System (INIS)

White, M.D.; Gilmore, T.J.

1996-10-01

Numerical simulations, with the Subsurface Transport Over Multiple Phases (STOMP) simulator, were applied to the field demonstration of an in-well vapor-stripping system at Edwards Air Force Base (AFB), near Mojave, California. The demonstration field site on the Edwards AFB was previously contaminated from traversing groundwater that was contained a varied composition of volatile organic compounds (VOCs), which primarily includes trichloroethylene (TCE). Contaminant TCE originated from surface basin that had been used to collect runoff during the cleaning of experimental rocket powered planes in the 1960s and 1970s. This report documents those simulations and associated numerical analyses. A companion report documents the in- well vapor-stripping demonstration from a field perspective

Ranking U-Sapiens 2010-2

Directory of Open Access Journals (Sweden)

Carlos-Roberto Peña-Barrera

2011-08-01

Full Text Available Los principales objetivos de esta investigación son los siguientes: (1 que la comunidad científica nacional e internacional y la sociedad en general co-nozcan los resultados del Ranking U-Sapiens Colombia 2010_2, el cual clasifica a cada institución de educación superior colombiana según puntaje, posición y cuartil; (2 destacar los movimientos más importantes al comparar los resultados del ranking 2010_1 con los del 2010_2; (3 publicar las respuestas de algunos actores de la academia nacional con respecto a la dinámica de la investigación en el país; (4 reconocer algunas instituciones, medios de comunicación e investigadores que se han interesado a modo de reflexión, referenciación o citación por esta investigación; y (5 dar a conocer el «Sello Ranking U-Sapiens Colombia» para las IES clasificadas. El alcance de este estudio en cuanto a actores abordó todas y cada una de las IES nacionales (aunque solo algunas lograran entrar al ranking y en cuanto a tiempo, un periodo referido al primer semestre de 2010 con respecto a: (1 los resultados 2010-1 de revistas indexadas en Publindex, (2 los programas de maestrías y doctorados activos durante 2010-1 según el Ministerio de Educación Nacional, y (3 los resultados de grupos de investigación clasificados para 2010 según Colciencias. El método empleado para esta investigación es el mismo que para el ranking 2010_1, salvo por una especificación aún más detallada en uno de los pasos del modelo (las variables α, β, γ; es completamente cuantitativo y los datos de las variables que fundamentan sus resultados provienen de Colciencias y el Ministerio de Educación Nacional; y en esta ocasión se darán a conocer los resultados por variable para 2010_1 y 2010_2. Los resultados más relevantes son estos: (1 entraron 8 IES al ranking y salieron 3; (2 las 3 primeras IES son públicas; (3 en total hay 6 instituciones universitarias en el ranking; (4 7 de las 10 primeras IES son

Initial experience with percutaneous edge-to-edge transcatheter mitral valve repair in a tertiary medical center in Taiwan

Directory of Open Access Journals (Sweden)

Ching-Wei Lee

2018-04-01

Full Text Available Background: The transcatheter edge-to-edge mitral valve repair, using MitraClip, has been a safe and effective treatment for severe mitral regurgitation (SMR in the westerners. However, the therapeutic results of the MitralClip in Taiwan remained elucidated. Methods: Patients with symptomatic SMR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. During procedure, continuous hemodynamic monitoring was conducted. Transthoracic echocardiography (TTE, blood tests, and six-minute walk test (6MWT were performed before and 1-month after surgery. Results: A total of 20 patients (73.4 ± 11.1 years, 85% male with a mean Euroscore II of 13.2 ± 17.7% and a mean STS score of 8.7 ± 9.0% for mortality were enrolled. After a mean procedural time of 239 ± 95 min, an average of 1.8 ± 0.7 clips were used in each procedure. The procedural successful rate was 95% to achieve mild residual mitral regurgitation. Cardiac output was increased from 3.6 ± 0.9 to 4.6 ± 1.4 (p = 0.008 and V-wave of left atrial pressure declined from 24.4 ± 9.8 to 19.3 ± 7.1 (p = 0.030 immediately during the index procedure. There was no peri-procedural death, myocardial infarction, stroke or any events requiring emergent cardiac surgery. All patients experienced significant improvement in heart failure symptoms. The 6-min walk distance increased from 219.6 ± 118.4 m to 279.1 ± 111.6 (p = 0.04 at 1 month. The echocardiogram further showed significant improvements of mitral regurgitation, pulmonary artery systolic pressure, and the left ventricular end-diastolic volume. Conclusion: Trans-catheter edge-to-edge mitral valve repairs are safe and effective in Asians with symptomatic SMR, regarding the improvements of clinical symptoms and exercise capacities. MitraClips is also associated with reverse remodeling of pulmonary hypertension and left

A Recently Discovered Photograph of Edward Joshua Cooper of Markree (1797-1863)

Science.gov (United States)

Coffey, P.

1998-01-01

A photograph of Edward Joshua Cooper, as well as a collection of letters to his brother-in-law, George Burdett L'Estrange, have been found in papers belonging to the author's family. One letter mentions the Markree telescope. It is thought that this is the only extant photograph of Cooper.

Reidentification of Ebola Virus E718 and ME as Ebola Virus/H.sapiens-tc/COD/1976/Yambuku-Ecran.

Science.gov (United States)

Kuhn, Jens H; Lofts, Loreen L; Kugelman, Jeffrey R; Smither, Sophie J; Lever, Mark S; van der Groen, Guido; Johnson, Karl M; Radoshitzky, Sheli R; Bavari, Sina; Jahrling, Peter B; Towner, Jonathan S; Nichol, Stuart T; Palacios, Gustavo

2014-11-20

Ebola virus (EBOV) was discovered in 1976 around Yambuku, Zaire. A lack of nomenclature standards resulted in a variety of designations for each isolate, leading to confusion in the literature and databases. We sequenced the genome of isolate E718/ME/Ecran and unified the various designations under Ebola virus/H.sapiens-tc/COD/1976/Yambuku-Ecran. Copyright © 2014 Kuhn et al.

Assisted care as a baseline patient risk characteristic affecting the outcome of transcatheter aortic valve insertion.

Science.gov (United States)

Traynor, Megan M; Greason, Kevin L; Nkomo, Vuyisile T; Pochettino, Alberto; Holmes, David R; Rihal, Charanjit S; Reeder, Guy S; Bresnahan, John F; Mathew, Verghese

2017-06-01

Objective measures of frailty have not been well defined as risk factors for a poor outcome after transcatheter aortic valve insertion. We hypothesized that assisted care as a baseline patient characteristic was a simple objective measure of frailty. We reviewed our experience to assess for an association between assisted care and outcome of operation. We retrospectively reviewed the records of 597 patients operated with transcatheter aortic valve insertion from November 2008 through July 2015. The study cohort included patients with a dichotomous baseline characteristic of receiving assisted care (AC group, n = 60, 10.1%) or not receiving assisted care (NC group, n = 537, 89.9%). The endpoints of the study were operative stroke/death and 1-year survival. The age of the patients was 80.6 ± 9.0 years, male sex was present in 349 (58.5%), and STS predicted risk of mortality was 9.2 ± 6.2%. Alternate access was used in 26 (43.3%) patients in the AC care group and in 220 (41.0%) in the NC group (P = 0.724). Operative stroke/death occurred in 4 (6.7%) patients in the AC group and in 25 (4.7%) in the NC group (P = 0.492). Mortality at 1 year in the AC group was 14.8 ± 5.2% and in the NC group was 12.9 ± 1.7%; (P = 0. 250). Assisted care as a baseline patient characteristic does not result in increased operative stroke/death or 1-year mortality in patients following transcatheter aortic valve insertion. Assisted care should not by itself preclude operation. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Transcatheter closure of patent ductus arteriosus: Evaluating the effect of the learning curve on the outcome

Directory of Open Access Journals (Sweden)

Azhar Ahmad

2009-01-01

Full Text Available Background and Objectives : Initial experience with transcatheter closure of patent ductus arteriosus (PDA using detachable coils and Amplatzer duct occluder devices is reported. We evaluated the outcome, complications, and influence of the learning curve, and also assessed the need of surgical backup for such interventional procedures. Methods: From January 2000 to December 2004, 121 patients underwent transcatheter closure of PDA. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for appropriately choosing the occluder device type and size. A second aortic angiogram was performed 10 minutes after device deployment. Echocardiography was repeated at intervals of 24 hours, then at 1, 3, and 6 months after the procedure to assess complications. Stepwise multiple regression analysis was used to assess the role of experience in improving the outcome of the procedure. Results: Of 121 cases, four patients had pulmonary artery embolization of the occluder device which was successfully retrieved in the catheterization laboratory, while two others had embolization that required surgical intervention. Four patients had temporary residual leak, nine had protrusion of the device into the aorta without significant Doppler pressure gradient or hemolysis on follow-up, and five had partial hemodynamically insignificant obstruction to the left pulmonary artery. Statistical analysis showed that the effect of the learning curve and experience was responsible for 93% improvement in the procedural outcome over the five-year study period. Conclusion: Transcatheter occlusion of PDA is safe and effective alternative to surgery. Complications occurred in those with unfavorable duct anatomy and with the use of multiple coils. Surgical backup was important for such interventional procedures. Experience played a major role in the proper choice of device type and size which greatly influenced the outcome of the procedure.

Study on transcatheter ASD occlusion using modified atrial septal defect occluder with no stainless steel screw in canine model

International Nuclear Information System (INIS)

Xuan Bin; Qin Yongwen; Hu Jianqiang; Wu Hong

2006-01-01

Objective: To evaluate the safety, biocompatibility and efficacy of transcatheter closure of atrial septal defect (ASD) with no stainless-steel-screw occluder in canine model. Methods: The device was constructed from superelastic Nitinol wires tightly woven into two flat disks and sewed with polyester fibers inside, with a pliable loop on the right-atrial-disk of the device, connecting to the delivery cable. ASD was created by transcatheter puncture and balloon dilatation and then closed by occluder under fluoroscopy in the catheterization laboratory. the location and the influence of the implanted device on function of tricuspid valve and mitral valve were evaluated by echocardiography. At 1, 2, 3 and 6 months after the operation, the animals were killed and autopsy was conducted. Results: Eight dogs with puncture-produced ASD underwent ASD closing procedure successfully. the occluder showed no influence on the function of MV and AV demonstrated by echocardiogram. The two disks of the implanted device were covered with a smooth intact neogenesis layer in all dogs. Endocardial cells fully covered the surface of the two disk without inflammating reaction 3 months later. There was no evidence of corrosion on the surface of the nitinol wire removed from the dog after 6 months. Light microscopic examination of the liver, kidney, lung and spleen showed no evidence of embolization and inflammation. Conclusion: Transcatheter ASD occlusion with new-type occluder is safe, feasible, effective and good biocompatibility with a good prospective clinical application. (authors)

Complete filter-based cerebral embolic protection with transcatheter aortic valve replacement.

Science.gov (United States)

Van Gils, Lennart; Kroon, Herbert; Daemen, Joost; Ren, Claire; Maugenest, Anne-Marie; Schipper, Marguerite; De Jaegere, Peter P; Van Mieghem, Nicolas M

2018-03-01

To evaluate the value of left vertebral artery filter protection in addition to the current filter-based embolic protection technology to achieve complete cerebral protection during TAVR. The occurrence of cerebrovascular events after transcatheter aortic valve replacement (TAVR) has fueled concern for its potential application in younger patients with longer life expectancy. Transcatheter cerebral embolic protection (TCEP) devices may limit periprocedural cerebrovascular events by preventing macro and micro-embolization to the brain. Conventional filter-based TCEP devices cover three extracranial contributories to the brain, yet leave the left vertebral artery unprotected. Patients underwent TAVR with complete TCEP. A dual-filter system was deployed in the brachiocephalic trunk and left common carotid artery with an additional single filter in the left vertebral artery. After TAVR all filters were retrieved and sent for histopathological evaluation by an experienced pathologist. Eleven patients received a dual-filter system and nine of them received an additional left vertebral filter. In the remaining two patients, the left vertebral filter could not be deployed. No periprocedural strokes occurred. We found debris in all filters, consisting of thrombus, tissue derived debris, and foreign body material. The left vertebral filter contained debris in an equal amount of patients as the Sentinel filters. The size of the captured particles was similar between all filters. The left vertebral artery is an important entry route for embolic material to the brain during TAVR. Selective filter protection of the left vertebral artery revealed embolic debris in all patients. The clinical value of complete filter-based TCEP during TAVR warrants further research. © 2017 Wiley Periodicals, Inc.

Transcatheter Retrieval of Embolized Atrial Septal Defect Occluder Device by Waist Capture Technique.

Science.gov (United States)

Her, Ae-Young; Lim, Kyung-Hun; Shin, Eun-Seok

2018-01-27

This case study describes the successful percutaneous transcatheter retrieval of an embolized Amplatzer occluder device using the "waist capture technique" in a patient with an atrial septal defect. This technique allowed for stability of the Amplatzer device, compression of the atrial discs for easier removal, prevention of further embolization, and minimal injury to vasculature during device retrieval. This novel and effective technique can be used safely for the retrieval of Amplatzer devices in the venous system.

Kepentingan Rusia Dalam Memberikan Suaka Politik Kepada Edward Joseph Snowden

OpenAIRE

", Ibrahim; Iskandar, Irwan

2017-01-01

This research to explain interest of Russia with Snowden. Edward Joseph Snowden is a former Central Intelligence Agency (CIA) employee and a former contractor for National Security Agency (NSA) who leaked classified information to The Guardian and The Washington Post. Snowden who leaked classified information have Surveillance program doing by United State of America. The Surveillance Program is a cooperate between 9 big companies from United States, which: Yahoo!, Facebook, Google, Apple, Sk...

Aortic valve calcification as a predictor of location and severity of paravalvular regurgitation after transcatheter aortic valve implantation

NARCIS (Netherlands)

Koh, Ezra Y.; Lam, Kayan Y.; Bindraban, Navin R.; Cocchieri, Riccardo; Planken, R. Nils; Koch, Karel T.; Baan, Jan; de Mol, Bas A.; Marquering, Henk A.

2015-01-01

To determine whether the location of aortic valve calcium (AVC) influences the location of paravalvular regurgitation (PR). PR is an adverse effect of transcatheter aortic valve implantation (TAVI) with a negative effect on long-term patient survival. The relationship between AVC and the occurrence

Massive tumor pulmonary embolism following transcatheter arterial chemoembolization of hepatocellular carcinoma

International Nuclear Information System (INIS)

Kim, Jeong Ho; Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo

2002-01-01

Pulmonary embolism complicated by transcatheter arterial chemoembolization (TACE) in known to be due to the use of large amount of lipiodol as an embolic agent. To our knowledge, massive tumoral pulmonary embolism following TACE and confirmed by surgery has not been described in the literature. In this report, we detail the cas of a 49-year-old man in whom cyanosis and hypotension developed abruptly on the day of TACE.. Chest CT revealed diffuse low-attenuated lesions in both pulmonary arteries. Histopathological specimens after emergent pulmonary arterial embolectomy confirmed the presence of massive tumor emboli of hepatocellular carcinoma

Massive tumor pulmonary embolism following transcatheter arterial chemoembolization of hepatocellular carcinoma

International Nuclear Information System (INIS)

Kim, Jeong Ho; Ko, Gi Young; Yoon, Hyun Ki; Sung, Kyu Bo

2002-01-01

Pulmonary embolism complicated by transcatheter arterial chemoembolization (TACE) is known to be due to the use of large amount of lipiodol as an embolic agent. To our knowledge, massive tumoral pulmonary embolism following TACE and confirmed by surgery has not been described in the literature. In this report, we detail the case of a 49-year-old man in whom cyanosis and hypotension developed abruptly on the day of TACE. Chest CT revealed diffuse low-attenuated lesions in both pulmonary arteries. Histopathological specimens after emergent pulmonary arterial embolectomy confirmed the presence of massive tumor emboli of hepatocellular carcinoma

Rupture of hepatocellular carcinoma following transcatheter arterial chemoembolization: A case report

Energy Technology Data Exchange (ETDEWEB)

Kang, Hyo Jin; Lee, Byung Hoon; Hwang, Yoon Joon; Kim, Su Young; Lee, Ji Young [Ilsan Paik Hospital/Inje Univ. School of Medicine, Goyang (Korea, Republic of); Han, Yoon Hee [Seonam Hospital/Ewha Womans Univ. School of Medicine, Seoul (Korea, Republic of)

2012-08-15

Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment for unresectable hepatocellular carcinoma (HCC). Serious complications, such as neutropenic sepsis and hepatic decompensation, are well known. A HCC rupture following TACE is a rare complication; however, it can be life threatening if it occurs. In a 75 year old male patient who subsequently developed capsular rupture of the lipiodol laden mass and several free intraperitoneal chemoembolization agents with hemoperitoneum, we report a case of a ruptured HCC that superficially located arterial enhancing and early wash out mass in the right hepatic dome following TACE.

Reflexões sobre a articulação entre o homo faber e o homo sapiens na enfermagem

Directory of Open Access Journals (Sweden)

Cecilia Nogueira Valenca

2013-09-01

Full Text Available Estudo reflexivo com o objetivo de analisar a articulação entre o enfermeiro-docente (Homo sapiens e o enfermeiro-assistencial (Homo faber no ambiente hospitalar, à luz do pensamento gramsciano. Na Enfermagem, coexistem duas dimensões: a teórica, exemplificada na figura do enfermeiro docente com seus projetos de pesquisa e publicações científicas; e a dimensão prática, com a atuação técnico-assistencial. Evidencia-se o distanciamento do enfermeiro docente em relação aos cenários de prática da graduação, assim como do enfermeiro assistencial, da pesquisa e da prática baseada em evidências científicas. Face ao dilema entre Homo faber e Homo sapiens na Enfermagem, emerge a importância de refletir sobre a dimensão ética subjacente às ações de ambos, centradas no ser humano. Este diálogo não pode ser ignorado, pois dele depende o desbravamento de novos horizontes e o crescimento da Enfermagem enquanto ciência e prática social.

Transcatheter closure of moderate-to-large patent ductus arteriosus in infants using Amplatzer duct occluder.

Science.gov (United States)

Wang, Jou-Kou; Wu, Mei-Hwan; Lin, Ming-Tai; Chiu, Shuenn-Nan; Chen, Chun-An; Chiu, Hsin-Hui

2010-02-01

There are difficulties in transcatheter closure of patent ductus arteriosus (PDA) in infants. The 46 infants (mean age 6.2+/-2.7 months; mean body weight 6.3+/-1.6 kg) who underwent PDA closure using the Amplatzer duct occluder (ADO). The indication for using an ADO was a ductus diameter > or =2.5 or 3 mm. Device diameter selected was 1-3 mm larger than ductal diameter. The mean systolic pulmonary artery pressure was 40.9+/-18.2 mmHg. The mean Qp/Qs ratio was 3.1+/-1.2. The mean ductus diameter was 3.3+/-0.8 mm. ADO was successfully deployed in 45 patients. Failure occurred in 1 case. The mean diameter of device used was 5.4+/-1.1 mm. No severe complications occurred. At the 1-month echocardiographic follow-up, a small residual shunt was present in 4 of 45 patients and had disappeared in all 4 patients at the 3-month follow-up. One patient developed a moderate degree of left ventricular outflow tract obstruction 2.3 years after the procedure. Transcatheter closure of PDA in infants using the ADO is a safe and effective method.

O humanismo crítico de Edward W. Said Edward W. Said's critical humanism

Directory of Open Access Journals (Sweden)

Marcos Costa Lima

2008-01-01

Full Text Available Este trabalho pretende fazer uma abordagem da obra de Edward Said capaz de aportar contribuições teóricas para o campo da Política Internacional. Para além de uma atualização do conceito de imperialismo, central em sua obra, quatro outros temas tratados por ele nos interessam aqui diretamente: o primeiro é o presente poder hegemônico exercido pelo governo dos Estados Unidos desde o fim da Segunda Guerra Mundial e que nos interpela sobre os desafios de uma interdependência transnacional, sobre a construção de uma ordem mundial efetivamente democrática. O segundo tema é a questão nacional, quando o autor aponta os riscos de uma consciência nacional despreparada ou ainda desvirtuada após as lutas de independência e libertação. O terceiro é a sua revolta com os estereótipos e preconceitos contra a civilização árabe-muçulmana, também vinculada à ignorância ocidental sobre esta cultura, sobre suas contribuições. Em quarto lugar, a visibilidade que dá à contribuição intelectual periférica de autores como Eqbal Ahmad (paquistanês, Ngugi Wa Thongo (queniano, Ali Shariat (iraniano, Wole Soyinka (nigeriano, C. L. R. James (de Trinidad-Tobago, Faiz Ahmada Faiz (paquistanês, José Martí (cubano, Ranajit Guha (indiano, Aimé Césaire (martiniquenho, entre outros.This paper intends to present an approach to Edward Said's work and to give some light to his unexpected theoretical contributions for International Politics. Beyond the effort of updating the concept of imperialism, central in his premises, five others themes among his books interest us directly. The first one is the present hegemonic power exerted by the USA government since the Second World War, that interrogates us about the possibilities to build an effectively democratic world order. The second is about the national question, where the author points out the risks of an unprepared national conscience or still depreciated after the fights for independence and

Clinical efficacy and safety of transcatheter embolization for vascular complications after percutaneous nephrolithotomy.

Science.gov (United States)

Poyraz, Necdet; Balasar, Mehmet; Gökmen, İbrahim Erdem; Koç, Osman; Sönmez, Mehmet Giray; Aydın, Arif; Göger, Yunus Emre; Öztürk, Ahmet

2017-12-01

Percutaneous nephrolithotomy (PNL) is the preferred procedure for safe and effective surgical treatment of kidney stones. Hemorrhage is the most serious complication of PNL, resulting from pseudoaneurysm (PA) or arteriovenous fistula (AVF), and can usually be controlled with conservative treatment. To evaluate endovascular treatments and outcomes of vascular complications observed after PNL. We retrospectively reviewed data on 19 patients who underwent renal embolization due to post-PNL renal artery bleeding between March 2005 and September 2016. Embolization materials included embolization coils and glue. The incidence of post-PNL vascular complications and their endovascular treatments, outcomes, and the follow-up data were analyzed. Nineteen (1.1%) of 1,609 patients (mean age: 44.9 years, range: 19-75 years) underwent angiography and subsequent transcatheter embolization to control bleeding. The mean time to onset of hemorrhage was 7.2 days after PNL (range: 3-18 days). The PNL entry site was the lower calyx in 15 patients, the middle calyx in 3, and the upper calyx in 1. PA, AVF, and PA plus AVF occurred in 14, 5, and 3 of the 19 renal angiography patients, respectively. Embolization of the affected vessels was successful in all 19 patients. The embolization materials of coil, glue, and coil plus glue were used in 16, 3, and 2 patients, respectively. Severe hematuria is a rare complication of PNL and can be successfully treated with transcatheter embolization.

The efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury

International Nuclear Information System (INIS)

Park, Si Kyun; Kim, Young Ju; Kwon, Taek Sang; Kim, Jong Jin; Ko, Sung Min; Sung, Ki Joon

1998-01-01

The purpose of this study is to evaluate the efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury. The results of transcatheter splenic arterial embolization in nine children who suffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated by CT, and the findings were evaluated according to the classification of Mirvis et al.; two patients were grade 3 and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if a patient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintain hemodynamic stability; or (2) rapid Hb/Hct decrease; or (3) both. Splenic function was subsequently estimated according to the results of 09m Tc-sulfur colloid scintigraphy and/or CT scanning. TAE was successful in all nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil. Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches. Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. TAE of the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injury in children, and can preserve splenic function. (author). 18 refs., 2 tabs., 3 figs

The efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury

Energy Technology Data Exchange (ETDEWEB)

Park, Si Kyun; Kim, Young Ju; Kwon, Taek Sang; Kim, Jong Jin; Ko, Sung Min; Sung, Ki Joon [Yonsei University, Wonju (Korea, Republic of). Wonju Coll. of Medicine

1998-06-01

The purpose of this study is to evaluate the efficacy of transcatheter arterial embolization (TAE) in children with blunt splenic injury. The results of transcatheter splenic arterial embolization in nine children who suffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated by CT, and the findings were evaluated according to the classification of Mirvis et al.; two patients were grade 3 and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if a patient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintain hemodynamic stability; or (2) rapid Hb/Hct decrease; or (3) both. Splenic function was subsequently estimated according to the results of {sup 09m}Tc-sulfur colloid scintigraphy and/or CT scanning. TAE was successful in all nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil. Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches. Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. TAE of the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injury in children, and can preserve splenic function. (author). 18 refs., 2 tabs., 3 figs.

Southern Stalemate: Five Years without Public Education in Prince Edward County, Virginia

Science.gov (United States)

Bonastia, Christopher

2012-01-01

In 1959, Virginia's Prince Edward County closed its public schools rather than obey a court order to desegregate. For five years, black children were left to fend for themselves while the courts decided if the county could continue to deny its citizens public education. Investigating this remarkable and nearly forgotten story of local, state, and…

Impact of the learning curve on outcome after transcatheter mitral valve repair

DEFF Research Database (Denmark)

Ledwoch, Jakob; Franke, Jennifer; Baldus, Stephan

2014-01-01

AIMS: This analysis from the German Mitral Valve Registry investigates the impact of the learning curve with the MitraClip(®) technique on procedural success and complications. METHODS AND RESULTS: Consecutive patients treated since 2009 in centers that performed more than 50 transcatheter mitral...... not decrease over time. CONCLUSION: A learning curve using the MitraClip(®) device does not appear to significantly affect acute MR reduction, hospital and 30-day mortality. Most likely, the proctor system leads to already high initial procedure success and relatively short procedure time....

A case study of contaminants on military ranges: Camp Edwards, Massachusetts, USA

International Nuclear Information System (INIS)

Clausen, Jay; Robb, Joe; Curry, Diane; Korte, Nic

2004-01-01

An extensive investigation at the Camp Edwards, Massachusetts Military Reservation (MMR) demonstrates that assessment of groundwater and soil contamination at military ranges can be limited primarily to explosive-related compounds such as RDX, HMX, perchlorate, TNT and their transformation products. A modified analytical method is recommended to expand the list of explosives and to improve the detection limits. Analyses of metals, VOCs, SVOCs, and TICs are unnecessary. Soil samples may require the analyses of PAHs and PCNs for burn areas. Camp Edwards, as one of the few military ranges that have been exhaustively investigated for contaminants, is an ideal point of departure for evaluating other ranges. The permeable site soils promote leaching of contaminants and inhibit biotic and abiotic transformations. Moreover, the site has experienced an unusual extent of activities in its more than ninety years of active use. The recommendations in this report are based on data obtained for more than 200 analytes from more than 15,000 environmental samples. - Assessment of groundwater and soil contamination at US military ranges can be limited primarily to explosive-related compounds

Molecular biology of Homo sapiens: Abstracts of papers presented at the 51st Cold Spring Harbor symposium on quantitative biology

International Nuclear Information System (INIS)

Watson, J.D.; Siniscalco, M.

1986-01-01

This volume contains abstracts of papers presented at the 51st Cold Springs Harbor Symposium on Quantitative Biology. The topic for this meeting was the ''Molecular Biology of Homo sapiens.'' Sessions were entitled Human Gene Map, Human Cancer Genes, Genetic Diagnosis, Human Evolution, Drugs Made Off Human Genes, Receptors, and Gene Therapy. (DT)

Acute Aortic Arch Perforation During Transcatheter Aortic Valve Replacement in Bicuspid Aortic Stenosis and a Gothic Aortic Arch

DEFF Research Database (Denmark)

Millan-Iturbe, Oscar; Sawaya, Fadi J.; Bieliauskas, Gintautas

2017-01-01

AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a “gothic aortic arch”; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled...

“Sex and the Island”: Lives of Single Women in Prince Edward Island

Directory of Open Access Journals (Sweden)

Kristie Collins

2011-05-01

Full Text Available This article considers the significance attributed to Prince Edward Island in managing a marginalized single female identity, as presented by accounts of thirty never-married and previously-married Island women, aged twenty-seven through sixty-five. As popular media and social narratives overwhelmingly position contemporary single women against an urban backdrop, the question arises as to whether unmarried Island women feel “marooned” in ways their urban counterparts may not. In accordance with feminist aims to produce research for, rather than about, women’s lives, the paper focuses on two themes from fieldwork interviews that were of particular interest to participants. The first theme relates to negotiating female singleness within the Island’s family-centered culture, and the second theme presents participants’ talk around advantages and disadvantages of living in Prince Edward Island, Canada, as single women. The paper concludes with a summary of other findings from the study and suggestions for future research on female singleness and island locales.

Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves

DEFF Research Database (Denmark)

Fuchs, Andreas; De Backer, Ole; Brooks, Matthew

2017-01-01

AIMS: This study aimed to assess the potential relationship between subclinical leaflet thickening and stent frame geometry in patients who underwent aortic valve replacement with a self-expanding transcatheter heart valve (THV). METHODS AND RESULTS: Seventy-five patients with a self-expanding THV....... CONCLUSIONS: Regional THV stent frame underexpansion is associated with an increased risk of leaflet thickening. Post-dilatation of self-expanding THV as well as a supra-annular valve position seem to reduce the occurrence of this phenomenon....

Transcatheter arterial embolization is the first-line therapy of choice in peptic ulcer bleeding not responding to endoscopic therapy

DEFF Research Database (Denmark)

Laursen, Stig Borbjerg; Jakobsen, Mark; Nielsen, Michael Milek

2015-01-01

Abstract Objective. In 5-10% of patients with peptic ulcer bleeding (PUB) it is impossible to achieve endoscopic hemostasis because of severe bleeding. These patients have traditionally been treated surgically. Transcatheter arterial embolization (TAE) may, however, be associated with a better ou...

Burkhardt : dividendi võimaldab välja võtta maksude optimeerimine / Edward Burkhardt ; interv. Andres Reimer

Index Scriptorium Estoniae

Burkhardt, Edward

2002-01-01

Eesti Raudtee nõukogu esimees Edward Burkhardt õigustab ettevõttest suuremahuliste dividendide väljavõtmist ja põhjendab seda maksude optimeerimisega. Kommenteerib majandusminister Liina Tõnisson

Outcomes of patients with chronic lung disease and severe aortic stenosis treated with transcatheter versus surgical aortic valve replacement or standard therapy: insights from the PARTNER trial (placement of AoRTic TraNscathetER Valve).

Science.gov (United States)

Dvir, Danny; Waksman, Ron; Barbash, Israel M; Kodali, Susheel K; Svensson, Lars G; Tuzcu, E Murat; Xu, Ke; Minha, Sa'ar; Alu, Maria C; Szeto, Wilson Y; Thourani, Vinod H; Makkar, Raj; Kapadia, Samir; Satler, Lowell F; Webb, John G; Leon, Martin B; Pichard, Augusto D

2014-01-28

The study aimed to evaluate the impact of chronic lung disease (CLD) on outcomes of severe aortic stenosis patients across all treatment modalities. Outcomes of patients with CLD undergoing transcatheter aortic valve replacement (TAVR) have not been systematically examined. All patients who underwent TAVR in the PARTNER (Placement of AoRTic TraNscathetER Valve) trial, including the continued access registry (n = 2,553; 1,108 with CLD), were evaluated according to CLD clinical severity. Additionally, outcomes of CLD patients included in the randomization arms of the PARTNER trial were compared: Cohort A patients (high-risk operable) treated by either TAVR (n = 149) or surgical aortic valve replacement (SAVR); (n = 138); and Cohort B patients (inoperable) treated by either TAVR (n = 72) or standard therapy only (n = 95). Among all TAVR-treated patients, at 1-year follow-up, patients with CLD had higher mortality than those without it (23.4% vs. 19.6%, p = 0.02). Baseline characteristics of CLD patients who underwent TAVR were similar to respective controls. In Cohort A, 2-year all-cause death rates were similar (TAVR 35.2% and SAVR 33.6%, p = 0.92), whereas in Cohort B, the death rate was lower after TAVR (52.0% vs. 69.6% after standard therapy only, p = 0.04). Independent predictors for mortality in CLD patients undergoing TAVR included poor mobility (6-min walk test CLD patients undergoing TAVR have worse outcomes than patients without CLD, TAVR is better in these patients than standard therapy and is similar to SAVR. Although patients with CLD undergoing TAVR had worse outcomes than patients without CLD, TAVR performed better in these patients than standard therapy and was similar to SAVR. However, CLD patients who were either poorly mobile or oxygen-dependent had poor outcomes. (THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial; NCT00530894). Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights

Representation and Imperialism in Edward Said

Directory of Open Access Journals (Sweden)

Bruno Sciberras de Carvalho

2010-12-01

Full Text Available Based on the idea that culture and identities involve a politically built process, the importance of the concepts of representation and imperialism in the work of Edward Said is discussed. The article analyses two of the author’s general proposals. Firstly, the thesis of the centrality of cultural dimension in political relations, which leads to the review of postulates that consider culture as a mere reflection of a phenomena seen as essential or as a sphere isolated from the power practices. Secondly, the study examines how the author’s conception of imperialism is used as a means of identification that keep structures of authority and hegemony, which, in turn, may be defied by processes of resistance. Finally, the validity of the open character of Said’s political theory is debated, which encompasses both the power of representations and an action of political questioning.

Protamines and spermatogenesis in Drosophila and Homo sapiens : A comparative analysis.

Science.gov (United States)

Kanippayoor, Rachelle L; Alpern, Joshua H M; Moehring, Amanda J

2013-04-01

The production of mature and motile sperm is a detailed process that utilizes many molecular players to ensure the faithful execution of spermatogenesis. In most species that have been examined, spermatogenesis begins with a single cell that undergoes dramatic transformation, culminating with the hypercompaction of DNA into the sperm head by replacing histones with protamines. Precise execution of the stages of spermatogenesis results in the production of motile sperm. While comparative analyses have been used to identify similarities and differences in spermatogenesis between species, the focus has primarily been on vertebrate spermatogenesis, particularly mammals. To understand the evolutionary basis of spermatogenetic variation, however, a more comprehensive comparison is needed. In this review, we examine spermatogenesis and the final packaging of DNA into the sperm head in the insect Drosophila melanogaster and compare it to spermatogenesis in Homo sapiens.

Fenestrated Transcatheter ASD Closure in Adults with Diastolic Dysfunction and/or Pulmonary Hypertension: Case Series and Review of the Literature.

Science.gov (United States)

Abdelkarim, Ayman; Levi, Daniel S; Tran, Bao; Ghobrial, Joanna; Aboulhosn, Jamil

2016-12-01

This study aims to evaluate the safety and efficacy of transcatheter fenestrated ASD closure and to summarize the literature regarding the published techniques and outcomes of transcatheter partial ASD closure. Patients with left ventricular diastolic dysfunction (LVDD) or right ventricular (RV) dysfunction and/or pulmonary hypertension (PHT) may suffer untoward consequences of complete closure of an ostium secundum atrial septal defect (ASD). Therefore, for patients that fall under these categories we suggest partial occlusion of the defect, which may be better tolerated than complete defect closure. After obtaining IRB approval, a search for patients that have undergone percutaneous ASD closure was performed in the Ahmanson/UCLA Adult Congenital Heart Disease Center database to identify which patients received a fenestrated ASD closure device. Eight consecutive patients ranging between 22 and 83 years of age (mean 48 years) with PHT and/or LVDD or RV dysfunction who underwent fenestrated transcatheter ASD closure at UCLA were identified. None of the subjects experienced complications related to the procedure. Postprocedure clinical evaluation showed improvement in symptoms and exercise capacity. Available follow-up transthoracic echocardiography data (mean 4 months, range 0-20 months) demonstrated patent fenestrations in four of eight patients. None of the patients had thromboembolic or infectious complications and there were no device migrations, erosions or embolizations. Partial ASD occlusion in patients with diastolic dysfunction or RV dysfunction and/or PHT is safe and may be better tolerated than complete ASD closure in selected patients. © 2016 Wiley Periodicals, Inc.

Transcatheter closure of patent ductus arteriosus in children weighing 10 kg or less: Initial experience at Sohag University Hospital.

Science.gov (United States)

Ali, Safaa; El Sisi, Amel

2016-04-01

To assess the challenges, feasibility, and efficacy of device closure of patent ductus arteriosus (PDA) in small children weighing ⩽10 kg for different types of devices used in an initial experience at Sohag University hospital. Between March 2011 and September 2014, 91 patients with PDA underwent transcatheter closure in our institute, among whom 54 weighed ⩽10 kg. All of these patients underwent transcatheter closure of PDA using either a Cook Detachable Coil, PFM Nit-Occlud, or Amplatzer duct occluder. A retrospective review of the treatment results and adverse events was performed. Successful device placement was achieved in 53/54 small children (98.1%). The median minimum PDA diameter was 2.4 mm [interquartile range (IQR, 1.8-3.5 mm), median weight 8 kg (IQR, 7-10 kg), and median age 10 months (IQR, 8-17 months)]. Mild aortic obstruction occurred in one case (1.9%), as the device became displaced towards the aorta after release. The device embolized in one case (1.9%) and no retrieval attempt was made. Five cases (9.3%) had minor vascular complications. With the current availability of devices for PDA closure, transcatheter closure of PDA is considered safe and efficacious in small children weighing ⩽10 kg with good mid-term outcome. The procedure had a low rate of high-severity adverse events even with the initial experience of the catheterization laboratory.

Alternative Education on Prince Edward Island: A Hybrid of "Mainstream" and Special Education

Science.gov (United States)

Thorne, Carolyn M.

2017-01-01

Alternative education programmes have acted as a disciplinary practice used by schools in Prince Edward Island (PEI), Canada, as a response to providing students, especially those identified with challenging behaviours, who do not fit into "mainstream" schools. This article highlights the emergence of alternative education in PEI and…

Transcatheter radiofrequency ablation under the guidance of three-dimensional mapping for the treatment of complex cardiac arrhythmias

International Nuclear Information System (INIS)

Hong Lang; Wang Hong; Lai Hengli; Ying Qiulin; Chen Zhangqiang; Lu Linxiang; Qiu Yun; Xiao Chengwei

2010-01-01

Objective: To investigate the effectiveness and safety of transcatheter radiofrequency ablation guided by a three-dimensional mapping system (Ensite or Carto) for the treatment of complex cardiac arrhythmias. Methods: A cohort of 123 consecutive hospitalized inpatients during the period from February 2006 to December 2008 were selected for this study. These patients suffered from various arrhythmias, including paroxysmal atrial fibrillation (n = 58), persistent or permanent atrial fibrillation (n = 10), atrial flutter (n = 13), atrial tachycardia (n = 12) and ventricular tachycardia or frequent ventricular premature beats (n = 30). Transcatheter radiofrequency ablation for arrhythmias was performed under the guidance of an EnSite3000 / NavX or Array mapping system in 80 cases, and under the guidance of a CARTO mapping system in the remaining 43 cases. Results: Successful ablation of arrhythmias was obtained by single operation in 106 cases (86.18%), including 59 cases with atrial fibrillation, 11 cases with atrial flutter, 10 cases with atrial tachycardia, and 26 cases with ventricular tachycardia or premature ventricular beat.Ablation procedure was carried out and was successful in 10 cases with a successful rate of 94.31%, including 5 cases with atrial fibrillation, 1 case with recurred atrial flutter, 1 case with recurrent atrial tachycardia, and 3 cases with ventricular tachycardia or premature ventricular beat.After operation, complications occurred in 6 cases, including cardiac tamponade in 4 cases, distal embolism of the left anterior descending coronary artery in 1 case, and pulmonary embolism in 1 case. Conclusion: Three-dimensional mapping system can clearly and stereoscopically display the cardiac structures. Therefore, this technique is of great value in guiding the transcatheter radiofrequency ablation for complex arrhythmias, in improving the success rate of ablation and in increasing the safety of the procedure. (authors)

Further contributions to the Hydradephaga (Coleoptera, Haliplidae, Gyrinidae and Dytiscidae) fauna of Prince Edward Island, Canada: new records, distributions and faunal composition.

Science.gov (United States)

Alarie, Yves

2016-01-01

The Haliplidae, Gyrinidae and Dytiscidae (Coleoptera) of Prince Edward Island, Canada were surveyed during the years 2004-2005. A total of 2450 individuals from 79 species were collected from 98 different localities, among which 30 species are newly recorded from that region. Among these, Acilius sylvanus Hilsenhoff, Rhantus consimilis Motschulsky and Neoporus sulcipennis (Fall) stand out as representing the easternmost reports of these species in Canada. Once removed, Gyrinus aquiris LeConte (Gyrinidae) is reinstated in the faunal list of Prince Edward Island. According to this study and literature 84 species of Hydradephaga are currently known from Prince Edward Island. The Nearctic component of the fauna is made up of 68 species (80.9%) and the Holarctic component of 16 species (19.1%). Most species are characteristic of the Boreal and Atlantic Maritime Ecozones and have a transcontinental distribution. In an examination of the Hydradephaga of insular portions of Atlantic Canada, we found that despite significantly different land areas and different distances to the neighbouring continental mainland the island faunas of Prince Edward Island and insular Newfoundland are very similar in the number of species (84 and 94 species respectively) despite differences in composition. With a land area significantly larger than that of Prince Edward Island, however, the fauna of Cape Breton Island was 39% smaller consisting of 53 species. This difference could be due to the comparative lack of collecting efforts on Cape Breton Island.

Catheter Ablation of Focal Atrial Tachycardia Using Remote Magnetic Navigation.

Science.gov (United States)

Webster, Mark; Pasupati, Sanjeevan; Lever, Nigel; Stiles, Martin

2018-05-01

This first-in-human study evaluated the safety and technical feasibility of the Tempo temporary cardiac pacing lead (BioTrace Medical), which includes a novel fixation mechanism and soft tip. Complications of temporary pacing leads include dislodgment, arrhythmias, and ventricular perforation. Temporary pacing applications have increased with transcatheter aortic valve replacement (TAVR) growth, for rapid pacing during balloon valvuloplasty (BAV) and valve deployment, and for periprocedural bradyarrhythmia support. Eligible patients required temporary pacing for TAVR, BAV, or electrophysiology (EP) procedures. Transthoracic echocardiograms were obtained at baseline and 24 hours after lead removal. Safety was defined as freedom from pericardial effusion requiring intervention or evidence of tamponade. Technical feasibility involved successful intracardiac delivery and pace capture. Additional evaluations included pacing threshold (PCT), rapid pacing, dislodgment, or sustained ventricular arrhythmias. Follow-up was to 30 days. Twenty-five patients (60% female; mean age, 64 ± 19 years) underwent 13 TAVRs (7 Sapien 3 valves [Edwards Lifesciences], 4 CoreValves [Medtronic], and 2 Lotus valves [Boston Scientific]), 11 EP procedures, and 1 BAV at two New Zealand centers from January 2016 to June 2016. Safety was met in all patients, with no device-related adverse events. Technical feasibility was achieved in 23 cases (92%); 2 patients had unsuitable anatomy. No patient had lead dislodgment or sustained ventricular arrhythmias, and the final procedural PCT was 0.7 ± 0.5 mA. Rapid pacing was successful in all cases. Five patients had successful postprocedural use up to 5 days. This first-in-human study demonstrates the safety and technical feasibility of the Tempo lead, providing stable periprocedural temporary pacing support.

The rationale and design of the Micra Transcatheter Pacing Study: safety and efficacy of a novel miniaturized pacemaker.

Science.gov (United States)

Ritter, Philippe; Duray, Gabor Z; Zhang, Shu; Narasimhan, Calambur; Soejima, Kyoko; Omar, Razali; Laager, Verla; Stromberg, Kurt; Williams, Eric; Reynolds, Dwight

2015-05-01

Recent advances in miniaturization technologies and battery chemistries have made it possible to develop a pacemaker small enough to implant within the heart while still aiming to provide similar battery longevity to conventional pacemakers. The Micra Transcatheter Pacing System is a miniaturized single-chamber pacemaker system that is delivered via catheter through the femoral vein. The pacemaker is implanted directly inside the right ventricle of the heart, eliminating the need for a device pocket and insertion of a pacing lead, thereby potentially avoiding some of the complications associated with traditional pacing systems. The Micra Transcatheter Pacing Study is currently undergoing evaluation in a prospective, multi-site, single-arm study. Approximately 720 patients will be implanted at up to 70 centres around the world. The study is designed to have a continuously growing body of evidence and data analyses are planned at various time points. The primary safety and efficacy objectives at 6-month post-implant are to demonstrate that (i) the percentage of Micra patients free from major complications related to the Micra system or implant procedure is significantly higher than 83% and (ii) the percentage of Micra patients with both low and stable thresholds is significantly higher than 80%. The safety performance benchmark is based on a reference dataset of 977 subjects from 6 recent pacemaker studies. The Micra Transcatheter Pacing Study will assess the safety and efficacy of a miniaturized, totally endocardial pacemaker in patients with an indication for implantation of a single-chamber ventricular pacemaker. NCT02004873. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Transcatheter aortic valve implantation: durability of clinical and hemodynamic outcomes beyond 3 years in a large patient cohort.

Science.gov (United States)

Gurvitch, R; Wood, D A; Tay, E L; Leipsic, J; Ye, J; Lichtenstein, S V; Thompson, C R; Carere, R G; Wijesinghe, N; Nietlispach, F; Boone, R H; Lauck, S; Cheung, A; Webb, J G

2010-09-28

Although short- and medium-term outcomes after transcatheter aortic valve implantation are encouraging, long-term data on valve function and clinical outcomes are limited. Consecutive high-risk patients who had been declined as surgical candidates because of comorbidities but who underwent successful transcatheter aortic valve implantation with a balloon-expandable valve between January 2005 and December 2006 and survived past 30 days were assessed. Clinical, echocardiographic, and computed tomographic follow-up examinations were performed. Seventy patients who underwent successful procedures and survived longer than 30 days were evaluated at a minimum follow-up of 3 years. At a median follow-up of 3.7 years (interquartile range 3.4 to 4.3 years), survival was 57%. Survival at 1, 2, and 3 years was 81%, 74%, and 61%, respectively. Freedom from reoperation was 98.5% (1 patient with endocarditis). During this early procedural experience, 11 patients died within 30 days, and 8 procedures were unsuccessful. When these patients were included, overall survival was 51%. Transaortic pressure gradients increased from 10.0 mm Hg (interquartile range 8.0 to 12.0 mm Hg) immediately after the procedure to 12.1 mm Hg (interquartile range 8.6 to 16.0 mm Hg) after 3 years (P=0.03). Bioprosthetic valve area decreased from a mean of 1.7±0.4 cm(2) after the procedure to 1.4±0.3 cm(2) after 3 years (Pfracture, deformation, or valve migration. Transcatheter aortic valve implantation demonstrates good medium- to long-term durability and preserved hemodynamic function, with no evidence of structural failure. The procedure appears to offer an adequate and lasting resolution of aortic stenosis in selected patients.

Intraoperative three-dimensional transesophageal echocardiography for assessing the defect geometries of mitral prosthetic paravalvular leak during transcatheter closure.

Science.gov (United States)

Wei, Jeng; Yin, Wei-Hsian; Lee, Yung-Tsai; Hsiung, Ming C; Tsai, Shen-Kou; Chuang, Yi Cheng; Ou, Ching-Huei; Chou, Yi-Pen

2015-03-01

Paravalvular leaks (PVLs) are a common complication of prosthetic valve replacement. Use of the transcatheter intervention technique is a suitable alternative in high-risk patients who may not tolerate repeat surgery. Common reasons for failure of this demanding intervention include poor imaging quality and unsuitable anatomy. The purpose of this study was to assess the usefulness and the incremental value of real-time three-dimensional (RT 3D) transesophageal echocardiography (TEE) over two-dimensional (2D) TEE findings in the evaluation of the geometry and track of mitral PVLs during transcatheter closure. Five patients with six mitral PVLs at high risk for repeat surgery underwent transcatheter leak closure. Intraoperative RT 3DTEE was used to assess the location, shape, number, and size of the defects. Transapical approaches were used in all cases with fluoroscopic and RT 3D TEE guidance of the wire and catheter, device positioning, and assessment of residual leak after the procedure. In all of the cases, defects with irregular crescent shapes and distorted tracks were clearly delineated by RT 3D TEE. This was compared to those results obtained through 2D TEE, which was unable to characterize the defects. Three cases showed small leaks, which were completely occluded with a patent ductus arteriosus (PDA) device in two cases, and a muscular ventricular septal defect (mVSD) occluder combined with coil devices in one case. One case involved a large leak and early device embolization of the muscular VSD occluder, which was removed surgically, and demonstrated a crescent-shaped defect. One patient had two releaks 2 months subsequent to the procedure due to two new extended leaks at the tails of the crescent-shaped defect. RT 3D TEE can clearly delineate the geometries of defects in their entirety, including shape, size, and location of the defect and track canal. It would also appear that RT 3D TEE is superior to 2D TEE in the process of guiding the wire through the

Molecular biology of Homo sapiens: Abstracts of papers presented at the 51st Cold Spring Harbor symposium on quantitative biology

Energy Technology Data Exchange (ETDEWEB)

Watson, J.D.; Siniscalco, M.

1986-01-01

This volume contains abstracts of papers presented at the 51st Cold Springs Harbor Symposium on Quantitative Biology. The topic for this meeting was the ''Molecular Biology of Homo sapiens.'' Sessions were entitled Human Gene Map, Human Cancer Genes, Genetic Diagnosis, Human Evolution, Drugs Made Off Human Genes, Receptors, and Gene Therapy. (DT)

Transcatheter Embolization for Giant Splenic Artery Aneurisms: Still an Open Question

Directory of Open Access Journals (Sweden)

Marianna Mastroroberto

2012-01-01

patients with portal hypertension. It is indicated when the SAA diameter reaches 20 mm. Although endovascular techniques are effective and safe for the treatment of medium-sized SAAs, little is known about their applicability to large-sized SAAs. Herein, we report a case of giant SAA, which was treated with transcatheter coil embolization. The case was not considered suitable for surgery because of the presence of severe portal hypertension. The procedure was complicated by bacterial infection of the coils within the aneurismatic sac, leading to the development of hepatic failure. A liver transplant was then successfully performed despite the presence of a nonresponsive infection.

Transcatheter Closure of Bilateral Multiple Huge Pulmonary Arteriovenous Malformations with Homemade Double-Umbrella Occluders

International Nuclear Information System (INIS)

Zhong Hongshan; Xu Ke; Shao Haibo

2008-01-01

A 28-year-old man underwent successful transcatheter occlusion of three huge pulmonary arteriovenous malformations (PAVMs) using homemade double-umbrella occluders and stainless steel coils. Thoracic CT with three-dimensional reconstruction and pulmonary angiography were used for treatment planning and follow-up. The diameters of the feeding vessels were 11 mm, 13 mm, and 14 mm, respectively. This report demonstrates the novel design and utility of the double-umbrella occluder, an alternative tool for treatment of large PAVMs.

Successful repeat transcatheter ablation of a mediastinal parathyroid adenoma 6 years after alcohol embolization

International Nuclear Information System (INIS)

Cook, Gary J. R.; Fogelman, Ignac; Reidy, John F.

1997-01-01

Recurrent hyperparathyroidism is rare following transcatheter ablation of mediastinal parathyroid adenomas. When it occurs it is usually early and resistant to further attempts at ablation. We present a patient with primary hyperparathyroidism in whom two surgical attempts at cure had been unsuccessful. Subsequently, a mediastinal adenoma was demonstrated angiographically and embolized with absolute alcohol. Hyperparathyroidism recurred 6 years later and the mediastinal adenoma was subsequently successfully ablated a second time by angiographic embolization with ionic contrast medium

Experiencia inicial con la prótesis de despliegue rápido en posición aórtica Edwards Intuity

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José M. Arribas

2016-03-01

Conclusiones: El implante de la válvula Edwards Intuity para el tratamiento de la estenosis aórtica ha sido factible, seguro y eficaz. Los tiempos de isquemia miocárdica y de circulación extracorpórea parecen reducirse en comparación con la cirugía valvular aórtica habitual. El comportamiento hemodinámico inicial de la prótesis Edwards Intuity es excelente.

Transcatheter device closure of secundum atrial septal defect (ASD) in young children

International Nuclear Information System (INIS)

Sadiq, N.; Ullah, M.; Sultan, M.; Akhtar, K.; Akbar, H.

2014-01-01

To analyze the safety and efficacy of device closure of secundum atrial septal defect in children = 5 years of age. Study Design: Quasi-experimental study. Place and Duration of Study: The study was conducted at Armed Forces Institute of Cardiology / National Institute of Heart Diseases Rawalpindi, Pakistan from Dec 2010 - Dec 2012. Patients and Method: Forty eight patients = 5 years of age underwent transcatheter closure of secundum ASD during two years. All patients were evaluated with 2-D echocardiography before the procedure. The sizing balloon was used in 6% and general anaesthesia was given in 83% (n=40) of patients. Results: Ninety seven point nine percent (47/48) had successful closure of ASD. The mean age was 4.1 +- 6.8 years (range 2.5-5 years) and 58.4% (28/48) were females. The defect size and occluders used were between 5-20 mm (mean 12 +-- 3.5) and 8-22 mm (mean 15 +- 3.9) respectively, three patients had simultaneous procedures including pulmonary valvuloplasty in two and percutaneous transmitral commissurotomy (PTMC) in one. The major complications remained 2% (1/48) which included device embolization just after release of device while minor complication rate was 12.5%. The median procedure time was 30 min (15-100 min) and median fluoroscopic time was 6 min (1.50-45 min). There was no emergency surgical exploration or death during this period. Conclusion: Transcatheter device closure of suitable secundum atrial septal defect is effective and safe in young children in skilled and professional hands. (author)

Edward Henry Sieveking and the demise of essential epilepsy.

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Bladin, Peter F

2008-04-01

Edward Henry Sieveking, eminent London physician of Victorian times, is best known as the speaker at the historic meeting at which the chairman, Sir Charles Locock, seem to overshadow him in announcing the introduction of bromide--the first effective anti-convulsant. But in fact Sieveking had announced a most important conceptual advance in epileptology--the demise of "essential epilepsy". In addition his book, published soon after and based upon his lecture, is an important historical resumé of Victorian era concepts and management of epilepsy. His important contributions to the understanding and management of this condition are discussed herein.

Diatom communities from the sub-Antarctic Prince Edward Islands: diversity and distribution patterns

NARCIS (Netherlands)

Van de Vijver, B.; Gremmen, N.J.M.; Smith, V.

2008-01-01

During an extensive survey of the freshwater and moss-inhabiting diatoms of the Prince Edward Islands, a total of 214 taxa belonging to 60 genera were found. Three main communities can be found on the two islands. A large part of the samples was grouped into an aquatic group, bringing together all

Edward A. Delgado-Romero: Award for Distinguished Early Career Contributions to Psychology in the Public Interest.

Science.gov (United States)

2011-11-01

Presents Edward A. Delgado-Romero, the 2011 winner of the American Psychological Association Award for Distinguished Early Career Contributions to Psychology in the Public Interest. "Societies, professions, and individual citizens are enriched by the contributions of those who care. Edward A. Delgado-Romero has demonstrated through his scholarship, leadership in psychological associations such as the National Latina/Latino Psychological Association, and collaborations with universities and school districts in Georgia that he cares and is committed to addressing challenges in the provision of culturally sensitive psychological services to benefit the public interest. His example of servant leadership leaves a legacy to other early career professionals and graduate students alike. Es un hijo honorado." (PsycINFO Database Record (c) 2011 APA, all rights reserved). 2011 APA, all rights reserved

Follow-up of P dispersion after transcatheter closure of an atrial septal defect in children

International Nuclear Information System (INIS)

Baspinar, O.; Kervancioglu, M.; Kilinc, M.; Irdem, A.; Koruk, S.

2014-01-01

Objectives: To determine in paediatric patients with atrial septal defects whether differences in P wave dispersion occurred with transcatheter closures using the Amplatzer septal occluder. Method: A total of 31 children who had undergone transcathater closures were evaluated. P maximum, P minimum, and P dispersion were measured with 12-lead surface electrocardiography, before the procedure and one week, one month, three months, six months and one year following the procedure. SPSS 10 was used for statistical analysis. Results: There were 23 (74.2%) females and 8 (25.8%) males with an overall mean age of 7.5+-4.1 years and mean weight of 26.2+-16.9kg. The P maximum and P minimum measurements differed between patients during the follow-up period. Both measurements decreased with time. However, P dispersion was not significantly different throughout the follow-up period (before the procedure P maximum 95.4+-15.6 ms, P minimum 64.5+-15.4 ms, and P dispersion 30.8+-11.4ms; one year later, P maximum 76.1+-14.6 ms, P minimum 47.1+-12.1 ms, and P dispersion 29.1+-9.1ms). Conclusion: Over time, there are no P dispersion differences in transcatheter closures using the Amplatzer septal occluder. (author)

Risk stratification using lean body mass in patients undergoing transcatheter aortic valve replacement.

Science.gov (United States)

Hioki, Hirofumi; Watanabe, Yusuke; Kozuma, Ken; Yamamoto, Masanori; Naganuma, Toru; Araki, Motoharu; Tada, Norio; Shirai, Shinichi; Yamanaka, Futoshi; Higashimori, Akihiro; Mizutani, Kazuki; Tabata, Minoru; Takagi, Kensuke; Ueno, Hiroshi; Hayashida, Kentaro

2018-02-22

The prognostic impact of skeletal muscle mass, assessed using lean body mass (LBM), remain unclear in patients who underwent transcatheter aortic valve replacement (TAVR). The aim of this study to assess prognostic impact of LBM on mortality after TAVR. We assessed 1,613 patients (median age 85 years, 70% female) who underwent TAVI from October 2013 to April 2016 using OCEAN (Optimized transCathEter vAlvular interveNtion)-TAVI registry data. LBM was calculated using the James formula. The primary endpoint was all-cause death after TAVR. Median follow-up period was 287 days (interquartile range 110-462). The Kaplan-Meier analysis demonstrated that patients with low LBM had significantly higher incidence of all-cause death than those with high LBM in male (32.3% vs. 9.9%, log rank P LBM was an independent predictor of all-cause death in male (Hazard ratio [HR] 0.93; 95% confidence interval [CI] 0.89-0.98) and female (HR 0.94; 95% CI 0.89-0.99). Inversely, the assessment using BMI could not identify the high-risk population in a female. The patients with low LBM had the higher incidence of all-cause death after TAVR than those with high LBM, regardless of gender. Thus, the risk stratification using LBM might provide further insight to identify the high-risk TAVR population, compared to conventional risk stratification using BMI. © 2018 Wiley Periodicals, Inc.

Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

International Nuclear Information System (INIS)

Piccoli, Anna; Lunardi, Mattia; Ariotti, Sara; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio

2015-01-01

Summary: Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described

Expanding TAVI options: elective rotational atherectomy during trans-catheter aortic valve implantation

Energy Technology Data Exchange (ETDEWEB)

Piccoli, Anna; Lunardi, Mattia; Ariotti, Sara; Ferrero, Valeria; Vassanelli, Corrado; Ribichini, Flavio, E-mail: flavio.ribichini@univr.it

2015-01-15

Summary: Aortic valve stenosis (AVS) in the elderly is frequently associated to coronary artery disease (CAD). In patients with significant coronary stenosis surgical valve replacement is associated to coronary bypass grafting, but whether coronary angioplasty is needed in patients receiving trans-catheter aortic valve implantation (TAVI) is unknown. Given the frequent complexity of CAD in the elderly with calcific AVS, rotational atherectomy (RA) may be needed in some cases. No data are available about feasibility and safety of RA during TAVI. The need for myocardial revascularization in TAVI candidates is discussed, and a series of RA cases performed during TAVI is described.

Transcatheter coil occluder for closure of ventricular septal defect (a report of 4 cases)

International Nuclear Information System (INIS)

Gao Wei; Zhou Aiqing; Yu Zhiqing; Li Fen; Zhong Yumin; Zhang Yuqi; Huang Meirong; Sun Kun

2005-01-01

Objective: To explore the indication, methodology and complication of transcatheter coil closure of ventricular septal defect (VSD) in children. Methods: Transcatheter closure of perimembranous VSD with coils was performed in 4 cases from 2003 to 2005. The Duct-Occlude (pfm) and detachable coil (Cook) were chosen for embolization depending on the results of the left ventricular angiogram. The coil size was generally about 1-4 mm larger than the diameter of VSD. Follow up was carried out with echocardiography, ultrasound and clinical examination. Results: The defect diameters of the four cases were 2.0 mm, 2.7 mm, 2.5 mm and 1.5 mm respectively. The Duct-Occlude were successfully implanted in 3 cases of perimembranous VSD with the same type coil (OD[mm]7-3-6, windings 5-3-4) for each. One detachable coil (Cook) (5 x 5) was implanted in the remaining case. All cases had trivial residual shunt immediately after implantation which disappeared 24 hours later. Follow-up for 2 months to one year showed no coil displacement and secondary bacterial arteritis. No tricuspid and aortic regurgitation, no emboli, no endocarditis, and no arrhythmia were found. Conclusions: Coil closure of some small VSD with membranate part pseudo-ventricular aneurysm has good efficacy with the advantages of simple operation, less metal content and mini-invasion also applicable for infants. (authors)

Cultural Imperialism of the West in the Work of Edward W. Said

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Ranka Jeknić

2006-09-01

Full Text Available This article presents the main ideas and views of Edward W. Said on the relationship between culture and imperialism, and also on the link between Western culture and the formation of imperialism. Hence, special attention is given to Said’s interpretation of novels as constructions of the geopolitical reality: i.e. the characteristics of “imperialism” are examined as found in such English and French writers as Jane Austen, Rudyard Kipling, Joseph Conrad and Albert Camus, illustrating the way how novels as an aesthetic form participated in the “cultural construction” of colonialism. In the next part of the discussion, the paper presents another main topic of Edward Said that reveals how “cultural imperialism”, “orientalism” and “covering Islam” are still, unfortunately, current topics. Special attention is given to Said's demystification of the opposition between “us” and “them”, or “the West” and “Others”, through the example of the relationship between “the West” and “Islam”. Behind this issue, unequal power relations exist, as well as unequal relations of power and knowledge; “anti-systemic movements”, especially, and the “post-colonial discourse”, in general, warns us of this.

Edward Albee’s The Zoo Story: Echo/es of Contemporary Subversive Culture

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Naqibun Nabi

2016-02-01

Full Text Available The post-world war II American social and cultural setting was ambiguously featured with enforced conformity in the name of prosperity and Americanization of the nation. Despite of this fact, American writers, especially, dramatists conveyed their message against this fixation through variety and intellectuality. Edward Albee’s The Zoo Story is one of those literary assets which dedicatedly cut through the illusions of contemporary American social and cultural ethos. Here, his characters are seen struggling constantly with their insecurities and existential angst in the society. He presents America, the so-called ‘Land of Free and Home of Braves’ (note 1, in such a portrayal that unveils the traps of cages and confinement underneath. The target of this paper is to trace Edward Albee’s heightened awareness about the post-war American socio-cultural reality evident in The Zoo Story. It also looks for the voice in which the text echoes out the anti-communist, materialistic, gender-coded boundaries, coupled with paradoxical media representations, religious bordering and how Albee challenges these issues with an anti-establishment tone. Keywords: subversive culture, anti-communism, media, religion and homosexuality

Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder II

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Koh Ghee

2009-01-01

Full Text Available We report a case of transcatheter closure of patent ductus arteriosus using the new Amplatzer duct occluder II in an adult patient with interrupted inferior vena cava with azygous continuation via the femoral artery approach.

Learning a Weighted Sequence Model of the Nucleosome Core and Linker Yields More Accurate Predictions in Saccharomyces cerevisiae and Homo sapiens

Science.gov (United States)

Reynolds, Sheila M.; Bilmes, Jeff A.; Noble, William Stafford

2010-01-01

DNA in eukaryotes is packaged into a chromatin complex, the most basic element of which is the nucleosome. The precise positioning of the nucleosome cores allows for selective access to the DNA, and the mechanisms that control this positioning are important pieces of the gene expression puzzle. We describe a large-scale nucleosome pattern that jointly characterizes the nucleosome core and the adjacent linkers and is predominantly characterized by long-range oscillations in the mono, di- and tri-nucleotide content of the DNA sequence, and we show that this pattern can be used to predict nucleosome positions in both Homo sapiens and Saccharomyces cerevisiae more accurately than previously published methods. Surprisingly, in both H. sapiens and S. cerevisiae, the most informative individual features are the mono-nucleotide patterns, although the inclusion of di- and tri-nucleotide features results in improved performance. Our approach combines a much longer pattern than has been previously used to predict nucleosome positioning from sequence—301 base pairs, centered at the position to be scored—with a novel discriminative classification approach that selectively weights the contributions from each of the input features. The resulting scores are relatively insensitive to local AT-content and can be used to accurately discriminate putative dyad positions from adjacent linker regions without requiring an additional dynamic programming step and without the attendant edge effects and assumptions about linker length modeling and overall nucleosome density. Our approach produces the best dyad-linker classification results published to date in H. sapiens, and outperforms two recently published models on a large set of S. cerevisiae nucleosome positions. Our results suggest that in both genomes, a comparable and relatively small fraction of nucleosomes are well-positioned and that these positions are predictable based on sequence alone. We believe that the bulk of the

Learning a weighted sequence model of the nucleosome core and linker yields more accurate predictions in Saccharomyces cerevisiae and Homo sapiens.

Directory of Open Access Journals (Sweden)

Sheila M Reynolds

2010-07-01

Full Text Available DNA in eukaryotes is packaged into a chromatin complex, the most basic element of which is the nucleosome. The precise positioning of the nucleosome cores allows for selective access to the DNA, and the mechanisms that control this positioning are important pieces of the gene expression puzzle. We describe a large-scale nucleosome pattern that jointly characterizes the nucleosome core and the adjacent linkers and is predominantly characterized by long-range oscillations in the mono, di- and tri-nucleotide content of the DNA sequence, and we show that this pattern can be used to predict nucleosome positions in both Homo sapiens and Saccharomyces cerevisiae more accurately than previously published methods. Surprisingly, in both H. sapiens and S. cerevisiae, the most informative individual features are the mono-nucleotide patterns, although the inclusion of di- and tri-nucleotide features results in improved performance. Our approach combines a much longer pattern than has been previously used to predict nucleosome positioning from sequence-301 base pairs, centered at the position to be scored-with a novel discriminative classification approach that selectively weights the contributions from each of the input features. The resulting scores are relatively insensitive to local AT-content and can be used to accurately discriminate putative dyad positions from adjacent linker regions without requiring an additional dynamic programming step and without the attendant edge effects and assumptions about linker length modeling and overall nucleosome density. Our approach produces the best dyad-linker classification results published to date in H. sapiens, and outperforms two recently published models on a large set of S. cerevisiae nucleosome positions. Our results suggest that in both genomes, a comparable and relatively small fraction of nucleosomes are well-positioned and that these positions are predictable based on sequence alone. We believe that the

Learning a weighted sequence model of the nucleosome core and linker yields more accurate predictions in Saccharomyces cerevisiae and Homo sapiens.

Science.gov (United States)

Reynolds, Sheila M; Bilmes, Jeff A; Noble, William Stafford

2010-07-08

DNA in eukaryotes is packaged into a chromatin complex, the most basic element of which is the nucleosome. The precise positioning of the nucleosome cores allows for selective access to the DNA, and the mechanisms that control this positioning are important pieces of the gene expression puzzle. We describe a large-scale nucleosome pattern that jointly characterizes the nucleosome core and the adjacent linkers and is predominantly characterized by long-range oscillations in the mono, di- and tri-nucleotide content of the DNA sequence, and we show that this pattern can be used to predict nucleosome positions in both Homo sapiens and Saccharomyces cerevisiae more accurately than previously published methods. Surprisingly, in both H. sapiens and S. cerevisiae, the most informative individual features are the mono-nucleotide patterns, although the inclusion of di- and tri-nucleotide features results in improved performance. Our approach combines a much longer pattern than has been previously used to predict nucleosome positioning from sequence-301 base pairs, centered at the position to be scored-with a novel discriminative classification approach that selectively weights the contributions from each of the input features. The resulting scores are relatively insensitive to local AT-content and can be used to accurately discriminate putative dyad positions from adjacent linker regions without requiring an additional dynamic programming step and without the attendant edge effects and assumptions about linker length modeling and overall nucleosome density. Our approach produces the best dyad-linker classification results published to date in H. sapiens, and outperforms two recently published models on a large set of S. cerevisiae nucleosome positions. Our results suggest that in both genomes, a comparable and relatively small fraction of nucleosomes are well-positioned and that these positions are predictable based on sequence alone. We believe that the bulk of the

Edward Y. Hartshorne and the Reopening of German Universities, 1945-1946: His Personal Account.

Science.gov (United States)

Tent, James F.

1997-01-01

Characterizes U.S. Edward Y. Hartshorne as a "manager of German social recovery." An instructor at Harvard University and protege of sociologist Talcott Parsons, Hartshorne was instrumental in the post-war reopening of German universities. Discusses Hartshorne's activities in military intelligence and psychological warfare, as well as…

Pros and cons of transcatheter aortic valve implantation (TAVI).

Science.gov (United States)

Terré, Juan A; George, Isaac; Smith, Craig R

2017-09-01

Transcatheter aortic valve implantation (TAVI) or replacement (TAVR) was recently approved by the FDA for intermediate risk patients with severe aortic stenosis (AS). This technique was already worldwide adopted for inoperable and high-risk patients. Improved device technology, imaging analysis and operator expertise has reduced the initial worrisome higher complications rate associated with TAVR, making it comparable to surgical aortic valve replacement (SAVR). However, many answers need to be addressed before adoption in lower risk patients. This paper highlights the pros and cons of TAVI based mostly on randomized clinical trials involving the two device platforms approved in the United States. We focused our analysis on metrics that will play a key role in expanding TAVR indication in healthier individuals. We review the significance and gave a perspective on paravalvular leak (PVL), valve performance, valve durability, leaflet thrombosis, stroke and pacemaker requirement.

Transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of perimembranous ventricular septal defects in children: a protocol for a network meta-analysis.

Science.gov (United States)

You, Tao; Yi, Kang; Ding, Zhao-Hong; Hou, Xiao-Dong; Liu, Xing-Guang; Wang, Xin-Kuan; Ge, Long; Tian, Jin-Hui

2017-06-21

Both transcatheter device closure and surgical repair are effective treatments with excellent midterm outcomes for perimembranous ventricular septal defects (pmVSDs) in children. The mini-invasive periventricular device occlusion technique has become prevalent in research and application, but evidence is limited for the assessment of transcatheter closure, mini-invasive closure and open-heart surgical repair. This study comprehensively compares the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair for treatment of pmVSDs in children using Bayesian network meta-analysis. A systematic search will be performed using Chinese Biomedical Literature Database, China National Knowledge Infrastructure, PubMed, EMBASE.com and the Cochrane Central Register of Controlled Trials to include random controlled trials, prospective or retrospective cohort studies comparing the efficacy, safety and costs of transcatheter closure, mini-invasive closure and open-heart surgical repair. The risk of bias for the included prospective or retrospective cohort studies will be evaluated according to the risk of bias in non-randomised studies of interventions (ROBINS-I). For random controlled trials, we will use risk of bias tool from Cochrane Handbook version 5.1.0. A Bayesian network meta-analysis will be conducted using R-3.3.2 software. Ethical approval and patient consent are not required since this study is a network meta-analysis based on published trials. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication. CRD42016053352. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The relationship of uranium isotopes to oxidation/reduction in the Edwards carbonate aquifer of Texas

International Nuclear Information System (INIS)

Cowart, J.B.

1980-01-01

The concentration of dissolved uranium and 234 U/ 238 U alpha activity ratio ( A.R. ) were determined in water samples from 23 locations in the Edwards carbonate aquifer of south central Texas by isotope dilution methods and alpha spectrometry. (orig./ME)

Trial design: Rivaroxaban for the prevention of major cardiovascular events after transcatheter aortic valve replacement: Rationale and design of the GALILEO study

NARCIS (Netherlands)

Windecker, Stephan; Tijssen, Jan; Giustino, Gennaro; Guimarães, Ana H. C.; Mehran, Roxana; Valgimigli, Marco; Vranckx, Pascal; Welsh, Robert C.; Baber, Usman; van Es, Gerrit-Anne; Wildgoose, Peter; Volkl, Albert A.; Zazula, Ana; Thomitzek, Karen; Hemmrich, Melanie; Dangas, George D.

2017-01-01

Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. GALILEO is an international, randomized,

New records of alien vascular plants from Marion and Prince Edward Islands, sub-Antarctic

NARCIS (Netherlands)

Gremmen, N.J.M.; Smith, V.

1999-01-01

A survey was made of the distribution of introduced vascular plants on Marion and Prince Edward Islands. The results of this survey were compared to results of previous surveys (1965/66, 1975, 1981, 1989). Four new introductions to Marion Island have taken place, three of which involved species that

Obituary: Edward W. Burke, Jr. (1924-2011)

Science.gov (United States)

Bloomer, Raymond, Jr.

2011-12-01

Dr. Edward W. Burke Jr. passed away on June 15, 2011, after suffering a heart attack. Dr. Burke devoted his professional life to the research and teaching of physics and astronomy at King College in Bristol, Tennessee. Edward W. Burke, Jr., was born in Macon, Georgia, on September 16, 1924. He was a Navy veteran, having been commissioned as an ensign in 1944. He served in the Pacific near the end of World War II. He proceeded to complete his undergraduate degree in mathematics from Presbyterian College in 1947 and pursued the M.S. and Ph.D. in physics (1949 and 1954, respectively) at the University of Wisconsin. Under the direction of Professor Julian Mack, his thesis was titled "Isotope Shift in the Spectra of Boron." Although he did research in atomic spectra in the early part of his career, his interest in astronomy and variable stars in particular were his primary interests during his long academic career. Dr. Burke began his illustrious career at King College in 1949. He initiated the astronomy program there in 1950, included constructing a 12.5 inch Newtonian telescope, homemade as was most everything in those days. Many of his students learned about photometry at the Burke Observatory on the college campus. Burke was known for his trips to the Kitt Peak and Lowell observatories accompanied by undergraduate students on his trips, all of which were made by automobile which he preferred over flying. His initial interest in Ap stars later broadened into variable and especially eclipsing binary stars. His motivation was maintained by his desire to have his students experience basic research and to spark their interest in advanced degrees. Numerous students achieved advanced science and medical degrees because of Burke's encouragement and mentoring. In 1959, Dr. Burke was awarded a Fulbright professorship and traveled to Chile where he taught physics for a year in the Engineering School at the University of Chile in Santiago. He worked to establish a physics

Catheterization Laboratory: Structural Heart Disease, Devices, and Transcatheter Aortic Valve Replacement.

Science.gov (United States)

Fiorilli, Paul N; Anwaruddin, Saif; Zhou, Elizabeth; Shah, Ronak

2017-12-01

The cardiac catheterization laboratory is advancing medicine by performing procedures on patients who would usually require sternotomy and cardiopulmonary bypass. These procedures are done percutaneously, allowing them to be performed on patients considered inoperable. Patients have compromised cardiovascular function or advanced age. An anesthesiologist is essential for these procedures in case of hemodynamic compromise. Interventionalists are becoming more familiar with transcatheter aortic valve replacement and the device has become smaller, both contributing to less complications. Left atrial occlusion and the endovascular edge-to-edge mitral valve repair devices were approved. Although these devices require general anesthesia, an invasive surgery and cardiopulmonary bypass machine are not necessary for deployment. Copyright © 2017 Elsevier Inc. All rights reserved.

Clinical value of arteriography in postpartum hemorrhage by transcatheter arterial embolization

International Nuclear Information System (INIS)

Wang Kai; Jiang Guomin; Zhao Jinwei; Huang Wenhua; Liu Yizhi; Jin Yonghai

2010-01-01

Objective: To analyze the arterial supply in postpartum hemorrhage and to evaluate the clinical value of arteriography in transcatheter arterial embolization (TAE) for treating postpartum hemorrhage. Methods: The arteriography of 37 patients with postpartum hemorrhage was analyzed. TAE were performed after the bleeding artery was identified. Post TAE angiography was performed to confirm the success of embolization. Results: The bleeding artery in atonic uterus and abnormal placenta was the uterine artery. The bleeding artery in birth canal laceration is mainly non-uterine artery. Postpartum hemorrhage was successfully controlled in all 37 patients without sever complication of TAE. Conclusion: Arteriography in postpartum hemorrhage can demonstrate the bleeding artery and is potential collaterals allowing adequate embolization without complication. (authors)

Cultural Pragmatics in Edward Albee’s The Zoo Story

Directory of Open Access Journals (Sweden)

Dodhy S.

2016-01-01

Full Text Available This article engages debates on how changing cultural values impinge on the behavioral patterns of an individual by considering social actions as distinctly mobile engagement with the environment. Cultural Pragmatics is essential for a close examination of Edward Albee’s The Zoo Story. This article attempts to investigate how intentions of interactants are culture driven and culture related. People are led to a state of disorientation due to collapse of cultural values and discontinuity of conventional view points and beliefs. The speaker’s discourse highlights the character’s inability to communicate to suggest the emptiness of hackneyed social intercourse resulting in psychopathological diseases among individuals.

A Review on Structures and Functions of Bcl-2 Family Proteins from Homo sapiens.

Science.gov (United States)

Sivakumar, Dakshinamurthy; Sivaraman, Thirunavukkarasu

2016-01-01

Cancer cells evade apoptosis, which is regulated by proteins of Bcl-2 family in the intrinsic pathways. Numerous experimental three-dimensional (3D) structures of the apoptotic proteins and the proteins bound with small chemical molecules/peptides/proteins have been reported in the literature. In this review article, the 3D structures of the Bcl-2 family proteins from Homo sapiens and as well complex structures of the anti-apoptotic proteins bound with small molecular inhibitors reported in the literature to date have been comprehensively listed out and described in detail. Moreover, the molecular mechanisms by which the Bcl-2 family proteins modulate the apoptotic processes and strategies for designing antagonists to anti-apoptotic proteins have been concisely discussed.

Novel self-expandable, stent-based transcatheter pulmonic valve: a preclinical animal study.

Science.gov (United States)

Kim, Gi Beom; Lim, Hong-Gook; Kim, Yong Jin; Choi, Eun Young; Kwon, Bo Sang; Jeong, Saeromi

2014-04-15

Because transcatheter implantation of pulmonary valve is indicated for limited-size dysfunctional right ventricular outflow tract only as a balloon-expandable stent, we investigated the feasibility of a large-diameter self-expandable valved stent and the durability of the valve after >6 months. We made a nitinol-wire-based, self-expandable valved stent with leaflets made from porcine pericardium. The porcine pericardium was treated with α-galactosidase, glutaraldehyde, and glycine after decellularization. After cutting the inguinal or cervical area, we implanted a valved stent in 12 sheep through the femoral or jugular vein by using an 18-Fr delivery catheter, controlling the catheter handles and hook block under fluoroscopic and echocardiographic guidance. The mean body weight of sheep was 43.9 kg. We successfully implanted valved stents (diameter: 24 mm in 7 sheep, 26 mm in 5 sheep) in good position in 8 sheep, in the main pulmonary artery (PA) in 2 sheep, and in the right ventricular outlet tract (RVOT) in 2 sheep. We sacrificed 8 sheep (6 sheep in good position, 1 sheep in the main PA, and 1 sheep in the RVOT) after >6 months. Five of the 6 sheep implanted in good position showed well-preserved valve morphology at the time of sacrifice. Histologic findings after routine sacrifice showed well-maintained collagen wave structure and no visible calcification in all explanted valve leaflets. Transcatheter implantation of a nitinol-wire-based, self-expandable valved stent in the pulmonic valve was feasible, and stents implanted in good position showed well-preserved valve leaflets with functional competence in the mid-term results. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Annual Outcomes With Transcatheter Valve Therapy: From the STS/ACC TVT Registry.

Science.gov (United States)

Holmes, David R; Nishimura, Rick A; Grover, Frederick L; Brindis, Ralph G; Carroll, John D; Edwards, Fred H; Peterson, Eric D; Rumsfeld, John S; Shahian, David M; Thourani, Vinod H; Tuzcu, E Murat; Vemulapalli, Sreekanth; Hewitt, Kathleen; Michaels, Joan; Fitzgerald, Susan; Mack, Michael J

2016-02-01

The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease. This report provides an overview on current U.S. TVT practice and trends. The emphasis is on demographics, in-hospital procedural characteristics, and outcomes of patients having transcatheter aortic valve replacement (TAVR) performed at 348 U.S. centers. The TVT Registry captured 26,414 TAVR procedures as of December 31, 2014. Temporal trends between 2012 and 2013 versus 2014 were compared. Comparison of the 2 time periods reveals that TAVR patients remain elderly (mean age 82 years), with multiple comorbidities, reflected by a high mean STS predicted risk of mortality (STS PROM) for surgical valve replacement (8.34%), were highly symptomatic (New York Heart Association functional class III/IV in 82.5%), frail (slow 5-m walk test in 81.6%), and have poor self-reported health status (median baseline Kansas City Cardiomyopathy Questionnaire score of 39.1). Procedure performance is changing, with an increased use of moderate sedation (from 1.6% to 5.1%) and increase in femoral access using percutaneous techniques (66.8% in 2014). Vascular complication rates are decreasing (from 5.6% to 4.2%), whereas site-reported stroke rates remain stable at 2.2%. The TVT Registry provides important information on characteristics and outcomes of TAVR in contemporary U.S. clinical practice. It can be used to identify trends in practice and opportunities for quality improvement.

Staged Transcatheter Treatment of Portal Hypoplasia and Congenital Portosystemic Shunts in Children

Energy Technology Data Exchange (ETDEWEB)

Bruckheimer, Elchanan, E-mail: elchananb@bezeqint.net; Dagan, Tamir [Schneider Children' s Medical Center Israel, Section of Pediatric Cardiology (Israel); Atar, Eli; Schwartz, Michael [Schneider Children' s Medical Center Israel, Section of Radiology (Israel); Kachko, Ludmila [Schneider Children' s Medical Center Israel, Section of Anesthesiology (Israel); Superina, Riccardo; Amir, Gabriel [Schneider Children' s Medical Center Israel, Section of Pediatric Cardiology (Israel); Shapiro, Rivka [Schneider Children' s Medical Center Israel, Section of Gastroenterology (Israel); Birk, Einat [Schneider Children' s Medical Center Israel, Section of Pediatric Cardiology (Israel)

2013-12-15

Purpose: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. Methods: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) during temporary occlusion of the shunt were performed. If vessels were diminutive and the pressure was above 18 mmHg, a staged approach was performed, which included implantation of a tailored reducing stent to reduce shunt diameter by {approx}50 %. Recatheterization was performed approximately 3 months later. If the portal pressure was below 18 mmHg and vessels had developed, the shunt was closed with a device. Results: Six patients (5 boys, 1 girl) with a median age of 3.3 (range 0.5-13) years had CPSS portal venous hypoplasia and hyperammonemia. Five patients underwent staged closure. One patient tolerated acute closure. One patient required surgical shunt banding because a reducing stent could not be positioned. At median follow-up of 3.8 (range 2.2-8.4) years, a total of 21 procedures (20 transcatheter, 1 surgical) were performed. In all patients, the shunt was closed with a significant reduction in portal pressure (27.7 {+-} 11.3 to 10.8 {+-} 1.8 mmHg; p = 0.016), significant growth of the portal vessels (0.8 {+-} 0.5 to 4.0 {+-} 2.4 mm; p = 0.037), and normalization of ammonia levels (202.1 {+-} 53.6 to 65.7 {+-} 9.6 {mu}mol/L; p = 0.002) with no complications. Conclusion: Staged CPSS closure is effective in causing portal vessel growth and treating hyperammonemia.

New-Onset Atrial Fibrillation After Surgical Aortic Valve Replacement and Transcatheter Aortic Valve Implantation

DEFF Research Database (Denmark)

Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav

2015-01-01

Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...... (NOAF) is 31%-64% and 4%-32%, respectively. NOAF is independently associated with adverse events such as stroke, death, and increased length of hospital stay. Increasing the knowledge of predisposing factors, optimal postprocedural monitoring, and prophylactic antiarrhythmic and antithrombotic therapy...

New-onset atrial fibrillation after surgical aortic valve replacement and transcatheter aortic valve implantation

DEFF Research Database (Denmark)

Jørgensen, Troels Højsgaard; Thygesen, Julie Bjerre; Thyregod, Hans Gustav

2015-01-01

Surgical aortic valve replacement (SAVR) and, more recently, transcatheter aortic valve implantation (TAVI) have been shown to be the only treatments that can improve the natural cause of severe aortic valve stenosis. However, after SAVR and TAVI, the incidence of new-onset atrial fibrillation...... (NOAF) is 31%-64% and 4%-32%, respectively. NOAF is independently associated with adverse events such as stroke, death, and increased length of hospital stay. Increasing the knowledge of predisposing factors, optimal postprocedural monitoring, and prophylactic antiarrhythmic and antithrombotic therapy...

Structural modelling and comparative analysis of homologous, analogous and specific proteins from Trypanosoma cruzi versus Homo sapiens: putative drug targets for chagas' disease treatment.

Science.gov (United States)

Capriles, Priscila V S Z; Guimarães, Ana C R; Otto, Thomas D; Miranda, Antonio B; Dardenne, Laurent E; Degrave, Wim M

2010-10-29

Trypanosoma cruzi is the etiological agent of Chagas' disease, an endemic infection that causes thousands of deaths every year in Latin America. Therapeutic options remain inefficient, demanding the search for new drugs and/or new molecular targets. Such efforts can focus on proteins that are specific to the parasite, but analogous enzymes and enzymes with a three-dimensional (3D) structure sufficiently different from the corresponding host proteins may represent equally interesting targets. In order to find these targets we used the workflows MHOLline and AnEnΠ obtaining 3D models from homologous, analogous and specific proteins of Trypanosoma cruzi versus Homo sapiens. We applied genome wide comparative modelling techniques to obtain 3D models for 3,286 predicted proteins of T. cruzi. In combination with comparative genome analysis to Homo sapiens, we were able to identify a subset of 397 enzyme sequences, of which 356 are homologous, 3 analogous and 38 specific to the parasite. In this work, we present a set of 397 enzyme models of T. cruzi that can constitute potential structure-based drug targets to be investigated for the development of new strategies to fight Chagas' disease. The strategies presented here support the concept of structural analysis in conjunction with protein functional analysis as an interesting computational methodology to detect potential targets for structure-based rational drug design. For example, 2,4-dienoyl-CoA reductase (EC 1.3.1.34) and triacylglycerol lipase (EC 3.1.1.3), classified as analogous proteins in relation to H. sapiens enzymes, were identified as new potential molecular targets.

The mitogenome of a 35,000-year-old Homo sapiens from Europe supports a Palaeolithic back-migration to Africa.

Science.gov (United States)

Hervella, M; Svensson, E M; Alberdi, A; Günther, T; Izagirre, N; Munters, A R; Alonso, S; Ioana, M; Ridiche, F; Soficaru, A; Jakobsson, M; Netea, M G; de-la-Rua, C

2016-05-19

After the dispersal of modern humans (Homo sapiens) Out of Africa, hominins with a similar morphology to that of present-day humans initiated the gradual demographic expansion into Eurasia. The mitogenome (33-fold coverage) of the Peştera Muierii 1 individual (PM1) from Romania (35 ky cal BP) we present in this article corresponds fully to Homo sapiens, whilst exhibiting a mosaic of morphological features related to both modern humans and Neandertals. We have identified the PM1 mitogenome as a basal haplogroup U6*, not previously found in any ancient or present-day humans. The derived U6 haplotypes are predominantly found in present-day North-Western African populations. Concomitantly, those found in Europe have been attributed to recent gene-flow from North Africa. The presence of the basal haplogroup U6* in South East Europe (Romania) at 35 ky BP confirms a Eurasian origin of the U6 mitochondrial lineage. Consequently, we propose that the PM1 lineage is an offshoot to South East Europe that can be traced to the Early Upper Paleolithic back migration from Western Asia to North Africa, during which the U6 lineage diversified, until the emergence of the present-day U6 African lineages.

Transcatheter, valve-in-valve transapical aortic and mitral valve implantation, in a high risk patient with aortic and mitral prosthetic valve stenoses

Directory of Open Access Journals (Sweden)

Harish Ramakrishna

2015-01-01

Full Text Available Transcatheter valve implantation continues to grow worldwide and has been used principally for the nonsurgical management of native aortic valvular disease-as a potentially less invasive method of valve replacement in high-risk and inoperable patients with severe aortic valve stenosis. Given the burden of valvular heart disease in the general population and the increasing numbers of patients who have had previous valve operations, we are now seeing a growing number of high-risk patients presenting with prosthetic valve stenosis, who are not potential surgical candidates. For this high-risk subset transcatheter valve delivery may be the only option. Here, we present an inoperable patient with severe, prosthetic valve aortic and mitral stenosis who was successfully treated with a trans catheter based approach, with a valve-in-valve implantation procedure of both aortic and mitral valves.

Inferential reasoning by exclusion in children (Homo sapiens).

Science.gov (United States)

Hill, Andrew; Collier-Baker, Emma; Suddendorf, Thomas

2012-08-01

The cups task is the most widely adopted forced-choice paradigm for comparative studies of inferential reasoning by exclusion. In this task, subjects are presented with two cups, one of which has been surreptitiously baited. When the empty cup is shaken or its interior shown, it is possible to infer by exclusion that the alternative cup contains the reward. The present study extends the existing body of comparative work to include human children (Homo sapiens). Like chimpanzees (Pan troglodytes) that were tested with the same equipment and near-identical procedures, children aged three to five made apparent inferences using both visual and auditory information, although the youngest children showed the least-developed ability in the auditory modality. However, unlike chimpanzees, children of all ages used causally irrelevant information in a control test designed to examine the possibility that their apparent auditory inferences were the product of contingency learning (the duplicate cups test). Nevertheless, the children's ability to reason by exclusion was corroborated by their performance on a novel verbal disjunctive syllogism test, and we found preliminary evidence consistent with the suggestion that children used their causal-logical understanding to reason by exclusion in the cups task, but subsequently treated the duplicate cups information as symbolic or communicative, rather than causal. Implications for future comparative research are discussed. 2012 APA, all rights reserved

Biometria de una población de Homalaspis plana (Milne Edwards, 1834 en Punta Maule (Coronel, Chile

Directory of Open Access Journals (Sweden)

Marco A Retamal

1980-12-01

Full Text Available This work deals with the bionomy of the population of Homalaspis plana (Milne Edwards, 1834 sampled in Coronel, Chile. Homalaspis plana share his biotope with: Paraxanthus barbiger (Poeppig, 1836 and Gaudichaudia gaudichaudi (Milne Edwards, 1834. A marked sexual dimorphism is apparent, the males are larger and heavier than the females; moreover, the volumes of the chelae of the first are also larger. The percentaje of the female population was significantly larger than the males population. The spawning extends from June to December. Each class of the ovigerous females, gives a different contribution, the maxima is done by the 5,74 cm class with 29,21%. The minimum size of ovigerous females is 49,3 mm L.C

A social desirability scale for the MMPI-2. Which of the two: Wiggins (WSD or Edwards (ESD?

Directory of Open Access Journals (Sweden)

Cristina Tobon

2009-07-01

Full Text Available The objective of this research aims to comparatively analyze the diagnostic accuracy of two social desirability detection scales that have been obtained from the 567 items that comprise the Minnesota Multiphasic Personality Inventory-2 (MMPI-2: Wiggins Wsd Scale and Edwards ESD Scale. The 583 participants (232 men and 351 women were differentiated into two groups according to their way of answering: Honest response group (N = 310 who replied truthfully following the guidelines of MMPI-2, and simulated response group (N = 273 who were instructed to intentionally and consistently show a positive image of themselves. The results have shown a higher diagnostic accuracy and predictive power, although less reliability (Cronbach's α for the Wiggins (Wsd Scale than for Edwards (ESD.

Transcatheter Embolization of a Renal Artery Aneurysm Using Ethylene Vinyl Alcohol Copolymer

International Nuclear Information System (INIS)

Rautio, Riitta; Haapanen, Arto

2007-01-01

Our aim was to treat a clinically silent renal artery aneurysm. The patient was a 76-year-old man with elevated prostate-specific antigen and prostata biopsies with a gradus II-III adenocarcinoma who was incidentally found to have an aneurysm in his right renal artery. We performed a successful transcatheter embolization of the aneurysm using ethylene vinyl alcohol copolymer (Onyx). To avoid migration of the liquid material into the parent artery, a balloon was inflated in the orifice of the neck of the aneurysm while the liquid was injected. Five-month follow-up computed tomography (CT) imaging confirmed total occlusion of the aneurysm

Bibliography of seabirds in the waters of Southern Africa, the Prince Edward and Tristan groups

CSIR Research Space (South Africa)

Cooper, J

1981-12-01

Full Text Available The titles of 2 088 publications are given which refer to seabirds in the waters of southern Africa, the Prince Edward Islands, the Tristan da Cunha group and Gough Island. An index lists the relevant publications by number for 117 species...

Neue Taxa von Lunatipula Edwards aus der mediterranen Subregion der Palaearktis (Diptera, Tipulidae, Tipula Linnaeus)

NARCIS (Netherlands)

Theischinger, Günther

1979-01-01

Eight new species and three new subspecies of Lunatipula Edwards are described and their affinities are discussed. The new taxa are: Tipula (Lunatipula) rocina from Spain, T. (L.) antichasia, T. (L.) hera, T. (L.) klytaimnestra, T. (L.) pythia. T. (L.) caudispina parnonensis, T. (L.) penelope

"Affection in Education": Edward Carpenter, John Addington Symonds and the Politics of Greek Love

Science.gov (United States)

Quinn, Josephine Crawley; Brooke, Christopher

2011-01-01

The paper examines Edward Carpenter's 1899 essay on education that defended the value of powerful same-sex attachments, either between older and younger boys or between teachers and pupils, in the context of Victorian ideologies of same-sex affection. Linda Dowling has described how "a homosexual counterdiscourse able to justify male love in…

An Appreciation and Analysis of "Edward Burtynsky--Manufactured Landscapes": A Film by Jennifer Baichwal

Science.gov (United States)

Donar, Ann

2010-01-01

This article begins with a synopsis of the film "Edward Burtynsky: Manufactured Landscapes", directed by Jennifer Baichwal. While the author can relate to the statements made in this synopsis, her experience and understanding of this 90-minute journey is much more intense and complex. In this essay, she attempts to dissect and examine…

Edward jenner and the small pox vaccine.

Science.gov (United States)

Smith, Kendall A

2011-01-01

Edward Jenner, who discovered that it is possible to vaccinate against Small Pox using material from Cow Pox, is rightly the man who started the science of immunology. However, over the passage of time many of the details surrounding his astounding discovery have been lost or forgotten. Also, the environment within which Jenner worked as a physician in the countryside, and the state of the art of medicine and society are difficult to appreciate today. It is important to recall that people were still being bled at the time, to relieve the presence of evil humors. Accordingly, this review details Jenner's discovery and attempts to place it in historical context. Also, the vaccine that Jenner used, which decreased the prevalence of Small Pox worldwide in his own time, and later was used to eradicate Small Pox altogether, is discussed in light of recent data.

Edward Jenner and the small pox vaccine

Directory of Open Access Journals (Sweden)

Kendall A Smith

2011-06-01

Full Text Available Edward Jenner, who discovered that it is possible to vaccinate against Small Pox using material from Cow Pox, is rightly the man who started the science of immunology. However, over the passage of time many of the details surrounding his astounding discovery have been lost or forgotten. Also, the environment within which Jenner worked as a physician in the countryside, and the state of the art of medicine and society are difficult to appreciate today. It is important to recall that people were still being bled at the time, to relieve the presence of evil humors. Accordingly, this review details Jenner’s discovery and attempts to place it in historical context. Also, the vaccine that Jenner used, which decreased the prevelance of Small Pox worldwide in his own time, and later was used to eradicate Small Pox altogether, is discussed in light of recent data.

Transcatheter aortic valve implantation in failed bioprosthetic surgical valves

DEFF Research Database (Denmark)

Dvir, Danny; Webb, John G; Bleiziffer, Sabine

2014-01-01

for patients with structural valve deterioration; however, a comprehensive evaluation of survival after the procedure has not yet been performed. OBJECTIVE: To determine the survival of patients after transcatheter valve-in-valve implantation inside failed surgical bioprosthetic valves. DESIGN, SETTING......, stroke, and New York Heart Association functional class. RESULTS: Modes of bioprosthesis failure were stenosis (n = 181 [39.4%]), regurgitation (n = 139 [30.3%]), and combined (n = 139 [30.3%]). The stenosis group had a higher percentage of small valves (37% vs 20.9% and 26.6% in the regurgitation...... and combined groups, respectively; P = .005). Within 1 month following valve-in-valve implantation, 35 (7.6%) patients died, 8 (1.7%) had major stroke, and 313 (92.6%) of surviving patients had good functional status (New York Heart Association class I/II). The overall 1-year Kaplan-Meier survival rate was 83...

Edward B. Aveling: the people's Darwin.

Science.gov (United States)

Paylor, Suzanne

2005-06-01

By the late-19th century, evolutionary theory, known by most people as Darwinism, had earned a reputation as an atheistic theory that challenged religious orthodoxy. From recent historical work we now know a great deal about how those with religious convictions received Darwinian ideas, and the role that professional scientists played in styling and communicating 'Darwinism' to the wider public and between themselves. However, relatively little is known about how Darwinian ideas were received and used by avowedly irreligious groups, and how these groups set about communicating their own version of Darwinism to a public hungry for cheap and accessible science. The activities of the Secularist Edward Bibbins Aveling, a prolific popularizer of Darwinian ideas in the late-19th century, offer a unique insight into this relatively uncharted territory. His work helped to develop the polemic of popular irreligious groups and imbue Darwinism with overtly atheistic connotations; it also engendered unprecedented support for atheism from the general public, and challenged the monopoly that some professional scientists enjoyed over imparting serious scientific knowledge to them.

Neotectonic investigations in Southern Ontario. Prince Edward County - Phase 2

International Nuclear Information System (INIS)

McFall, G.H.; Allam, A.

1991-06-01

This report summarizes the preliminary results of geological and geophysical investigations and offshore side scan sonar surveys of the bedrock and unconsolidated sediments in Prince Edward County, Southern Ontario, by the Ontario Geological Survey in 1989. Investigations were focused on deformations in the bedrock and the surficial deposits. Some of these deformations may be neotectonic in origin. Low magnitude seismicity in the Prince Edward County region appears to be spatially related to a major regional fault system that crosses Lake Ontario and consists of the seismically active Clarendon-Linden Fault System in New York State, the Picton-Napanee and Rideau Faults, the Frontenac-Sharbot Lake Terrane Boundary and the assumed Salmon River Fault in Ontario. Detailed observations were made in the Long Point study area and the Mountain View and Picton Quarries. Bedrock structural features were documented, including: joints; normal, reverse and strike strip faults; brittle folds; and Jurassic age ultramafic dyke. Detailed refraction seismic surveys were conducted across a local fault and possible fold structures. Magnetic surveys, conducted in conjunction with the offshore side scan sonar surveys, documented large magnetic anomalies southeast of Point Petre and at the northeast end of Long Reach. Side scan sonar surveys of the lake bottom to the east of Point Petre confirm the presence of pop-ups in that area of the lake bottom which is immediately adjacent to where pop-ups are observed on land. The pop-ups present in the lake bottom have similar orientations to those mapped in the study area

The success of failed Homo sapiens dispersals out of Africa and into Asia.

Science.gov (United States)

Rabett, Ryan J

2018-02-01

The evidence for an early dispersal of Homo sapiens from Africa into the Levant during Marine Isotope Stage 5 (MIS-5) 126-74 ka (thousand years ago) was characterized for many years as an 'abortive' expansion: a precursor to a sustained dispersal from which all extant human populations can be traced. Recent archaeological and genetic data from both western and eastern parts of Eurasia and from Australia are starting to challenge that interpretation. This Perspective reviews the current evidence for a scenario where the MIS-5 dispersal encompassed a much greater geographic distribution and temporal duration. The implications of this for tracking and understanding early human dispersal in Southeast Asia specifically are considered, and the validity of measuring dispersal success only through genetic continuity into the present is examined.

Geologic framework and hydrogeologic characteristics of the outcrops of the Edwards and Trinity aquifers, Medina Lake area, Texas

Science.gov (United States)

Small, Ted A.; Lambert, Rebecca B.

1998-01-01

The hydrogeologic subdivisions of the Edwards aquifer outcrop in the Medina Lake area in Medina and Bandera Counties generally are porous and permeable. The most porous and permeable appear to be hydrogeologic subdivision VI, the Kirschberg evaporite member of the Kainer Formation; and hydrogeologic subdivision III, the leached and collapsed members, undivided, of the Person Formation. The porosity of the rocks in the Edwards aquifer outcrop is related to depositional or diagenetic elements along specific stratigraphic horizons (fabric selective) and to dissolution and structural elements that can occur in any lithostratigraphic horizon (not fabric selective). Permeability depends on the physical properties of the rock such as size, shape, and distribution of pores.

Neue Taxa von Lunatipula Edwards aus der mediterranen Subregion der Palaearktis (Diptera, Tipulidae, Tipula Linnaeus)

NARCIS (Netherlands)

Theischinger, Günther

1987-01-01

12 new species and 3 new subspecies of Lunatipula Edwards from Greece and Turkey are described or defined. The new taxa are: T. (L.) montifer tasucuensis, T. (L.) musensis, T. (L.) vermooleni, T. (L.) lyrion, Tipula (Lunatipula) paravelox, T. (L.) soosi izmirensis, T. (L.) brinki, T. (L.)

The Italian Job: Giambattista Vico at the Origin of Edward Said’s Humanism

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Mauro Scalercio

2016-08-01

Full Text Available The aim of this paper is twofold. First, it will try to clarify the importance of the Italian philosopher Giambattista Vico (1668-1744 in shaping Edward Said’s categories. Second, it will shed light on the theoretical importance of such genealogy. From the philological point of view, it is important to show how profound Said’s knowledge of Vico’s work is. Therefore, this paper will follow references to Vico within the whole of Said’s work, from late the sixties ones to the posthumous Humanism and Democratic Criticism. As far as theory is concerned, understanding Said’s use of Vico’s concepts explains why Said refers to his own work with the controversial term “humanism.” Vico, critiquing modernity from the onset, is the basis on which Said built a new critical humanism. In particular, Said uses the very essential elements of the philosophy of Vico: the importance of body as the source of humanity, the critique of modern abstractions, the idea that man knows what he makes, and the idea of the historicity of every human invention and construction.   Keywords: Edward Said; Vico; Humanism; Modernity; Historicity; Facticity.

Protein-protein interaction site prediction in Homo sapiens and E. coli using an interaction-affinity based membership function in fuzzy SVM.

Science.gov (United States)

Sriwastava, Brijesh Kumar; Basu, Subhadip; Maulik, Ujjwal

2015-10-01

Protein-protein interaction (PPI) site prediction aids to ascertain the interface residues that participate in interaction processes. Fuzzy support vector machine (F-SVM) is proposed as an effective method to solve this problem, and we have shown that the performance of the classical SVM can be enhanced with the help of an interaction-affinity based fuzzy membership function. The performances of both SVM and F-SVM on the PPI databases of the Homo sapiens and E. coli organisms are evaluated and estimated the statistical significance of the developed method over classical SVM and other fuzzy membership-based SVM methods available in the literature. Our membership function uses the residue-level interaction affinity scores for each pair of positive and negative sequence fragments. The average AUC scores in the 10-fold cross-validation experiments are measured as 79.94% and 80.48% for the Homo sapiens and E. coli organisms respectively. On the independent test datasets, AUC scores are obtained as 76.59% and 80.17% respectively for the two organisms. In almost all cases, the developed F-SVM method improves the performances obtained by the corresponding classical SVM and the other classifiers, available in the literature.

The botanical activities of George Edward Post (1838-1909).

Science.gov (United States)

Musselman, Lytton John

2006-01-01

George Edward Post wrote the first flora of the Middle East in English. His other botanical activities are less familiar. In addition to the flora, this paper discusses his teaching, fieldwork, contribution to Bible dictionaries, relations with the Boissier Herbarium in Geneva, establishment of the herbarium, and letters. Those letters are used here for the first time. Post corresponded with botanical luminaries of his day including Autran, Baker, Balfour, Barbey, Boissier, Bornmüller, Carruthers, Denslow, Haussknecht, Hooker, Schweinfurth, Thistleton-Dyer, Torrey, and Winkler. His long-term relationship with the herbarium at Geneva is highlighted. In addition, some of the lesser understood aspects of his life including chaplaincy during the American Civil War, and missionary to Syria are discussed.

The Use of Technology in Prince Edward Island (Canada) High Schools: Perceptions of School Leaders

Science.gov (United States)

Preston, Jane P; Moffatt, Lyndsay; Wiebe, Sean; McAuley, Alexander; Campbell, Barbara; Gabriel, Martha

2015-01-01

The purpose of this paper is to document the perceptions of school leaders regarding the technological use, skills, and attitudes of high school teachers. Using a qualitative research approach, 11 educational leaders from Prince Edward Island (Canada) were individually interviewed. Participants represented the Department of Education, principals,…

Staged Transcatheter Treatment of Portal Hypoplasia and Congenital Portosystemic Shunts in Children

International Nuclear Information System (INIS)

Bruckheimer, Elchanan; Dagan, Tamir; Atar, Eli; Schwartz, Michael; Kachko, Ludmila; Superina, Riccardo; Amir, Gabriel; Shapiro, Rivka; Birk, Einat

2013-01-01

Purpose: Congenital portosystemic shunts (CPSS) with portal venous hypoplasia cause hyperammonemia. Acute shunt closure results in portal hypertension. A transcatheter method of staged shunt reduction to afford growth of portal vessels followed by shunt closure is reported. Methods: Pressure measurements and angiography in the CPSS or superior mesenteric artery (SMA) during temporary occlusion of the shunt were performed. If vessels were diminutive and the pressure was above 18 mmHg, a staged approach was performed, which included implantation of a tailored reducing stent to reduce shunt diameter by ∼50 %. Recatheterization was performed approximately 3 months later. If the portal pressure was below 18 mmHg and vessels had developed, the shunt was closed with a device. Results: Six patients (5 boys, 1 girl) with a median age of 3.3 (range 0.5–13) years had CPSS portal venous hypoplasia and hyperammonemia. Five patients underwent staged closure. One patient tolerated acute closure. One patient required surgical shunt banding because a reducing stent could not be positioned. At median follow-up of 3.8 (range 2.2–8.4) years, a total of 21 procedures (20 transcatheter, 1 surgical) were performed. In all patients, the shunt was closed with a significant reduction in portal pressure (27.7 ± 11.3 to 10.8 ± 1.8 mmHg; p = 0.016), significant growth of the portal vessels (0.8 ± 0.5 to 4.0 ± 2.4 mm; p = 0.037), and normalization of ammonia levels (202.1 ± 53.6 to 65.7 ± 9.6 μmol/L; p = 0.002) with no complications. Conclusion: Staged CPSS closure is effective in causing portal vessel growth and treating hyperammonemia

Multidetector CT predictors of prosthesis-patient mismatch in transcatheter aortic valve replacement.

Science.gov (United States)

Freeman, Melanie; Webb, John G; Willson, Alexander B; Wheeler, Miriam; Blanke, Philipp; Moss, Robert R; Thompson, Christopher R; Munt, Brad; Norgaard, Bjarne L; Yang, Tae-Hyun; Min, James K; Poulsen, Steen; Hansson, Nicolaj C; Binder, Ronald K; Toggweiler, Stefan; Hague, Cameron; Wood, David A; Pibarot, Philippe; Leipsic, Jonathon

2013-01-01

Prosthesis-patient mismatch (PPM) is a predictor of mortality after aortic valve replacement (AVR). We examined whether accurate 3-dimensional annular sizing with multidetector CT (MDCT) is predictive of PPM after transcatheter AVR (TAVR). One hundred twenty-eight patients underwent MDCT then TAVR. Moderate PPM was defined as an indexed effective orifice area ≤0.85 cm²/m² and severe ≤0.65 cm²/m². MDCT annular measurements (area, short and long axis) were compared with the size of the selected transcatheter heart valve (THV) to obtain (1) the difference between prosthesis size and CT-measured mean annular diameter and (2) the percentage of undersizing or oversizing (calculated as 100 × [MDCT annular area--THV nominal area]/THV nominal area). In addition, the MDCT annular area was indexed to body surface area. These measures were evaluated as potential PPM predictors. We found that 42.2% of patients had moderate PPM and 9.4% had severe PPM. Procedural characteristics and in-hospital outcomes were similar between patients with or without PPM. THV undersizing of the mean aortic annulus diameter was not predictive of PPM (odds ratio [OR], 0.84; 95% CI, 0.65-1.07; P = .16; area under the receiver-operating characteristic curve [AUC], 0.58). THV undersizing of annular area was not predictive of PPM (OR, 0.96; 95% CI, 0.80-1.16; P = .69; AUC, 0.52). Indexed MDCT annular area was, however, predictive of PPM (OR, 0.24; 95% CI, 0.10-0.59; P < .001; AUC, 0.66). PPM is frequent after TAVR. Appropriate annular oversizing does not reduce the rate or severity of PPM. Patient annulus size mismatch, identified by indexed MDCT annular area, is a significant predictor of PPM. Copyright © 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

MD-11 PCA - First Landing at Edwards

Science.gov (United States)

1995-01-01

This McDonnell Douglas MD-11 approaches the first landing ever of a transport aircraft under engine power only on Aug. 29, 1995, at NASA's Dryden Flight Research Center, Edwards, California. The milestone flight, flown by NASA research pilot and former astronaut Gordon Fullerton, was part of a NASA project to develop a computer-assisted engine control system that enables a pilot to land a plane safely when it normal control surfaces are disabled. The Propulsion-Controlled Aircraft (PCA) system uses standard autopilot controls already present in the cockpit, together with the new programming in the aircraft's flight control computers. The PCA concept is simple--for pitch control, the program increases thrust to climb and reduces thrust to descend. To turn right, the autopilot increases the left engine thrust while decreasing the right engine thrust. The initial Propulsion-Controlled Aircraft studies by NASA were carried out at Dryden with a modified twin-engine F-15 research aircraft.

Lumbar artery pseudoaneurysm and arteriovenous fistula as a complication of laparoscopic splenectomy: treatment by transcatheter embolization

International Nuclear Information System (INIS)

Maleux, G.; Wilms, G.; Vermylen, J.

2002-01-01

Iatrogenic injury of a lumbar artery is very rare and mostly causes retroperitoneal hemorrhage. We report a case of a lumbar artery pseudoaneurysm and a concomitant arteriovenous fistula complicating laparoscopic splenectomy and provoking renal colic-like flank pain due to mass effect on the left ureter. Definitive treatment of both vascular lesions was obtained after percutaneous transcatheter embolization of several lumbar arteries. Control computed tomography scan 3 months after embolization showed almost complete resorption of the retroperitoneal hematoma. (orig.)

Lumbar artery pseudoaneurysm and arteriovenous fistula as a complication of laparoscopic splenectomy: treatment by transcatheter embolization

Energy Technology Data Exchange (ETDEWEB)

Maleux, G.; Wilms, G. [Department of Radiology, University Hospitals, Leuven (Belgium); Vermylen, J. [Department of Internal Medicine-Vascular Diseases, University Hospitals, Leuven (Belgium)

2002-06-01

Iatrogenic injury of a lumbar artery is very rare and mostly causes retroperitoneal hemorrhage. We report a case of a lumbar artery pseudoaneurysm and a concomitant arteriovenous fistula complicating laparoscopic splenectomy and provoking renal colic-like flank pain due to mass effect on the left ureter. Definitive treatment of both vascular lesions was obtained after percutaneous transcatheter embolization of several lumbar arteries. Control computed tomography scan 3 months after embolization showed almost complete resorption of the retroperitoneal hematoma. (orig.)

Simultaneous occurrence of a severe Morel-Lavallée lesion and gluteal muscle necrosis as a sequela of transcatheter angiographic embolization following pelvic fracture: a case report.

Science.gov (United States)

Shimizu, Takayoshi; Matsuda, Shuichi; Sakuragi, Atsushi; Tsukie, Tomio; Kawanabe, Keiichi

2015-03-26

Morel-Lavallée lesions are posttraumatic hemolymphatic collections caused by disruption of the interfascial planes between the subcutaneous soft tissue and muscle. Severe peripelvic Morel-Lavallée lesions have rarely been reported in the literature. By contrast, a number of cases of gluteal muscle necrosis following transcatheter angiographic embolization for pelvic fracture have been reported. Each entity can result in severe infection and sepsis, and the mortality rate in such cases is quite high. However, to date, no previous reports have described a case in which these life-threatening entities occurred simultaneously. A 32-year-old Asian man simultaneously developed severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis with sepsis following transcatheter angiographic embolization after an unstable pelvic fracture. Extremely large skin and soft tissue defects, which were untreatable with any commonly used flaps, were generated after repeated debridement. In addition, a deep-bone infection was suspected in his left fractured iliac bone, while motor function was almost completely lost in his left leg, possibly as a sequela of transcatheter angiographic embolization. As a result of his condition, a left hemipelvectomy was unavoidable. A pedicled fillet flap from his sacrificed left limb was used for the treatment of the defects and to provide a durable base for a prosthesis. Our patient survived and returned to his previous job 24 months after the surgery wearing a prosthetic left leg. As illustrated by the present case, severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis following transcatheter angiographic embolization can occur simultaneously after unstable pelvic fractures. Physicians should recognize that these entities can result in life-threatening sepsis and, therefore, should attempt to detect them as early as possible. When hemipelvectomy is unavoidable, a pedicled upper and lower leg in-continuity fillet flap may

Cultural Imperialism of the West in the Work of Edward W. Said

OpenAIRE

Ranka Jeknić

2006-01-01

This article presents the main ideas and views of Edward W. Said on the relationship between culture and imperialism, and also on the link between Western culture and the formation of imperialism. Hence, special attention is given to Said’s interpretation of novels as constructions of the geopolitical reality: i.e. the characteristics of “imperialism” are examined as found in such English and French writers as Jane Austen, Rudyard Kipling, Joseph Conrad and Albert Camus, illustrating the way ...

IMPLEMENTING EDWARD DE BONO’S APPROACHES OF STRATEGIC THINKING IN THE FIELD OF PROFESSIONAL EDUCATION

Directory of Open Access Journals (Sweden)

Olena Lykholat

2017-04-01

Full Text Available Education is always regarded as a necessary factor of social development. One of the positive means to solve urgent problems in the field of professional education is not only systematization of the information, but also the creative accumulation and assimilation of the cultural experience and, as a result, of the scientific, artistic-design, project-constructive and/or technological principles of activities. The high standards to the future teachers’ professional education are caused by the binary character of the future activities: the teacher should be both a professional and a pedagogue. The transformation of the professional education, while there are lots of global challenges in the world, leads to the activation of the creative potential of the future pedagogue at a professional educational institution. The goal of this article is to analyze systems of thinking suggested by Edward de Bono, and to attempt implementing partially these approaches into strategic thinking in the field of professional education, i.e. in the future teachers’ sewing specialization at a professional educational institution. According to the goal of the article, the whole complex of scientific approaches and methods has been used at the different theoretical and empirical levels. The systemic approach is in the core of the research, following the idea of the integrity of thinking expressed by Edward de Bono and of mechanisms which facilitate it. At the moment in our volatile world there is a clear need in new type of thinking – creative and constructive, which allows to form new ideas and ways for development. The system of such a kind of thinking was developed by Edward de Bono. According to him, the main method for the process of problem solving should be: refusal from cliché and established patters of thinking; perception of the problem with humor; continuous questioning of permissiveness; change in the way of seeking for information; creation of integral

Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

DEFF Research Database (Denmark)

Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

2009-01-01

Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

Contemporary Costs Associated With Transcatheter Aortic Valve Replacement: A Propensity-Matched Cost Analysis.

Science.gov (United States)

Ailawadi, Gorav; LaPar, Damien J; Speir, Alan M; Ghanta, Ravi K; Yarboro, Leora T; Crosby, Ivan K; Lim, D Scott; Quader, Mohammed A; Rich, Jeffrey B

2016-01-01

The Placement of Aortic Transcatheter Valve (PARTNER) trial suggested an economic advantage for transcatheter aortic valve replacement (TAVR) for high-risk patients. The purpose of this study was to evaluate the cost effectiveness of TAVR in the "real world" by comparing TAVR with surgical aortic valve replacement (SAVR) in intermediate-risk and high-risk patients. A multiinstitutional database of The Society of Thoracic Surgeons (STS) (2011 to 2013) linked with estimated cost data was evaluated for isolated TAVR and SAVR operations (n = 5,578). TAVR-treated patients (n = 340) were 1:1 propensity matched with SAVR-treated patients (n = 340). Patients undergoing SAVR were further stratified into intermediate-risk (SAVR-IR: predicted risk of mortality [PROM] 4% to 8%) and high-risk (SAVR-HR: PROM >8%) cohorts. Median STS PROM for TAVR was 6.32% compared with 6.30% for SAVR (SAVR-IR 4.6% and SAVR-HR 12.4%). A transfemoral TAVR approach was most common (61%). Mortality was higher for TAVR (10%) compared with SAVR (6%, p costs compared with SAVR ($69,921 vs $33,598, p cost of TAVR was largely driven by the cost of the valve (all p cost savings versus TAVR. TAVR was associated with greater total costs and mortality compared with SAVR in intermediate-risk and high-risk patients while conferring lower major morbidity and improved resource use. Increased cost of TAVR appears largely related to the cost of the valve. Until the price of TAVR valves decreases, these data suggest that TAVR may not provide the most cost-effective strategy, particularly for intermediate-risk patients. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Procedural Experience for Transcatheter Aortic Valve Replacement and Relation to Outcomes: The STS/ACC TVT Registry.

Science.gov (United States)

Carroll, John D; Vemulapalli, Sreekanth; Dai, Dadi; Matsouaka, Roland; Blackstone, Eugene; Edwards, Fred; Masoudi, Frederick A; Mack, Michael; Peterson, Eric D; Holmes, David; Rumsfeld, John S; Tuzcu, E Murat; Grover, Frederick

2017-07-04

Transcatheter aortic valve replacement (TAVR) has been introduced into U.S. clinical practice with efforts to optimize outcomes and minimize the learning curve. The goal of this study was to assess the degree to which increasing experience during the introduction of this procedure, separated from other outcome determinants including patient and procedural characteristics, is associated with outcomes. The authors evaluated the association of hospital TAVR volume and patient outcomes for TAVR by using data from 42,988 commercial procedures conducted at 395 hospitals submitting to the Transcatheter Valve Therapy Registry from 2011 through 2015. Outcomes assessed included adjusted and unadjusted in-hospital major adverse events. Increasing site volume was associated with lower in-hospital risk-adjusted outcomes, including mortality (p < 0.02), vascular complications (p < 0.003), and bleeding (p < 0.001) but was not associated with stroke (p = 0.14). From the first case to the 400th case in the volume-outcome model, risk-adjusted adverse outcomes declined, including mortality (3.57% to 2.15%), bleeding (9.56% to 5.08%), vascular complications (6.11% to 4.20%), and stroke (2.03% to 1.66%). Vascular and bleeding volume-outcome associations were nonlinear with a higher risk of adverse outcomes in the first 100 cases. An association of procedure volume with risk-adjusted outcomes was also seen in the subgroup having transfemoral access. The initial adoption of TAVR into practice in the United States showed that increasing experience was associated with better outcomes. This association, whether deemed a prolonged learning curve or a manifestation of a volume-outcome relationship, suggested that concentrating experience in higher volume heart valve centers might be a means of improving outcomes. (STS/ACC Transcatheter Valve Therapy Registry [TVT Registry]; NCT01737528). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All