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Sample records for fourth ventricle case

  1. [Rosette-forming glioneuronal tumor of the fourth ventricle. Two cases report and literature review].

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    Choque Cuba, Bernardino; Ortega Zufiría, José Manuel; Poveda Núñez, Pedro Domingo; Lomillos Prieto, Noemí; Sierra Rodríguez, Mario; Tamarit Degenhardt, Martin; López Serrano, Remedios; Gómez Angulo Giner, Juan Carlos; Aramburu González, José Antonio

    2018-01-12

    Rosette-forming glioneuronal tumor of the fourth ventricle is a primary central nervous system tumor introduced in the group of glioneuronal tumors in the WHO classification of 2007. Initially it was described around the fourth ventricle, but recently have been published cases in different locations. We present 2cases of this rare tumor, both surgically treated. The first in a 41 year old man with typical symptoms of posterior fossa injury. The second in an 18 year old woman, with incidental finding of posterior fossa injury that was also surgically treated. We present pre- and post-surgical magnetic resonance images, histological pictures of this tumor and we make a review of the literature. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. De novo Craniopharyngioma of the Fourth Ventricle: Case Report and Review of Literature.

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    Algahtani, Abdulhadi Y; Algahtani, Hussein A; Jamjoom, Abdulhakim B; Samkari, Alaa M; Marzuk, Yousef I

    2018-01-01

    Craniopharyngiomas usually involve the sella and suprasellar space. Their occurrence in the posterior fossa without extension to the suprasellar region is uncommon with only 16 cases reported in the literature. We report a case of a primary posterior fossa craniopharyngioma that was managed by complete excision with a good recovery. Our case was unique in that the craniopharyngioma occurred in the fourth ventricle and extended downward to the level of C1, a manifestation that was reported only twice in the past. The literature on the topic is reviewed.

  3. Quarto ventrículo isolado: relato de dois casos Isolated fourth ventricle: report of two cases

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    JOSÉ ALBERTO GONÇALVES DA SILVA

    1998-09-01

    Full Text Available São descritos dois casos de quarto ventrículo isolado sendo o primeiro decorrente de hemorragia cerebelar e o segundo de hidrocefalia congênita com múltiplas revisões de válvula e cisto de Dandy-Walker. O tratamento cirúrgico é revisado na literatura. A abordagem direta à fossa posterior acha-se indicada nos casos de cisto no interior do quarto ventrículo. Naqueles sem a presença de cisto, deve-se empregar sistema de drenagem do quarto ventrículo, independente da drenagem supratentorial.Two cases of isolated fourth ventricle are reported, the first due to cerebellar haemorrhage, and the second due to congenital hydrocephalus with multiple shunt revisions and Dandy-Walker cyst. In our opinion, there are two basic treatment for isolated forth ventricle. The direct approach to the fourth ventricle is indicated when there is presence of an intraventricular cyst. The fourth ventricular shunting, independent of the supratentorial shunt, is the best treatments for patients with an isolated fourth ventricle without the presence of a cyst.

  4. Transtentorial herniation of the fourth ventricle

    International Nuclear Information System (INIS)

    Rosenfeld, D.L.; Lis, E.; DeMarco, K.

    1995-01-01

    Transtentorial herniation (TTH) of the fourth ventricle is the result of a progressive enlargement of an isolated fourth ventricle which herniates through the tentorial incisure into the middle cranial fossa. The characteristic CT-MR and neurosonographic findings are described. (orig.)

  5. Cephalometric Assessment of the Fourth Ventricles Using ...

    African Journals Online (AJOL)

    brain. To provide baseline data for measurements of normal fourth ventricle using ... (2001) normally the left ventricle was larger than the right one and both were larger in males among .... Kennedy, D.N., Caviness, Jr, V.S. and Tsuang,.

  6. A feline case of isolated fourth ventricle with syringomyelia suspected to be related with feline infectious peritonitis.

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    Kitagawa, Masato; Okada, Midori; Sato, Tsuneo; Kanayama, Kiichi; Sakai, Takeo

    2007-07-01

    A one-year-old female cat was unable to stand. Magnetic resonance imaging was performed, and an enlargement of the lateral, third, and fourth ventricles and syringomyelia were detected. The cat was diagnosed with an isolated fourth ventricle (IFV) with syringomyelia. The serum isoantibody test for the feline infectious peritonitis (FIP) virus was 1:3,200. After the cat died, a pathological examination revealed nonsuppurative encephalomyelitis. We suspected that the IFV, detected in the cat, was associated with FIP encephalomyelitis. To our knowledge, there has been no report on IFV in veterinary medicine.

  7. Neuroendoscopic management of posterior third ventricle ependymoma with intraaqueductal and fourth ventricle extension: a case report and review of the literature.

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    Prat-Acín, Ricardo; Evangelista, Rocío; Conde, Rebeca; Ayuso-Sacido, Angel; Galeano, Inma

    2017-11-01

    Posterior third ventricle ependymomas with intraaqueductal extension are relatively infrequent lesions. Its surgical management represents a formidable technical challenge and includes a wide variety of approaches. Minimally invasive surgery including the endoscopic management can play a crucial role to obtain an optimal clinical outcome. We report the clinical outcome of an 11-year-old female patient with a 6-year history of recurrent episodes of headache and vomiting. On brain MRI a posterior third ventricle lesion with extension to the aqueduct of Sylvius and fourth ventricle, and associated hydrocephalus was observed. Our management of the lesion included a two-step endoscopic surgery: first an anterior third ventriculostomy and biopsy of the lesion that was reported to be a low-grade ependymoma, and posteriorly an endoscopic-assisted resection of the lesion. Clinical outcome was optimal without neurological sequelae. The postoperative MRI showed a thickened ependymal area on the tumor base of implantation. It was considered to be a remnant of the lesion and subsequently treated with radiotherapy. Posterior third ventricle ependymomas with intraaqueductal extension can be endoscopically managed to obtain a successful outcome.

  8. Rosette-forming glioneuronal tumor of the fourth ventricle.

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    Preusser, Matthias; Dietrich, Wolfgang; Czech, Thomas; Prayer, Daniela; Budka, Herbert; Hainfellner, Johannes A

    2003-11-01

    Rosette-forming glioneuronal tumor (RGNT) of the fourth ventricle has been reported recently as a novel type of primary CNS neoplasm. We present the case of a 35-year-old male patient with RGNT of the fourth ventricle. The tumor was found incidentally; the patient did not suffer from any neurological symptoms. The tumor mass involved the caudal cerebellar vermis, filled the fourth ventricle and protruded into the caudal part of the mesencephalic aquaeduct. Smaller tumor nodules were visible in the adjacent right cerebellar hemisphere. Histologically, prominent neurocytic rosettes with synaptophysin expression were embedded in a glial tumor component resembling pilocytic astrocytoma. Clinicopathological features of our case closely resemble those reported in the original description. Thus, our case confirms RGNT as a new distinct type of primary CNS neoplasm. Due to its distinct features, adoption of RGNT as a new entity into the WHO classification of tumors should be considered.

  9. Successful surgical treatment of intractable hemifacial spasm: A case report and review of cerebellar hamartomas of the floor of the fourth ventricle

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    Joseph H. Miller

    2016-12-01

    Full Text Available Introduction: Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report: A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions: Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision. Keywords: Cerebellar, Seizure, Epilepsy, Hamartoma

  10. Anorexia: an early sign of fourth ventricle astrocytoma in children.

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    Leroy, Henri-Arthur; Baroncini, Marc; Delestret, Isabelle; Florent, Vincent; Vinchon, Matthieu

    2014-12-01

    Paediatric low-grade astrocytomas of the fourth ventricle are rare tumours, generally revealed by hydrocephalus. However, some patients present with a history of severe anorexia. It might be a harbinger, which if recognized, could lead to earlier diagnosis. We decided to examine our database in order to evaluate the incidence and signification of anorexia in this context. Retrospective monocentric study of cases of low-grade astrocytomas of the fourth ventricle operated between 1991 and 2012 in our paediatric neurosurgery department. We particularly observed the clinical presentation and long-term clinical, oncological and radiological evolution. Non-parametrical tests were used (Mann-Whitney, Fisher). We reviewed 34 cases, 31 pilocytic astrocytomas and 3 diffuse astrocytomas, 16 boys and 18 girls, (M/F ratio 0.89). Mean age at diagnosis was 8 years old. Seven presented with notable anorexia, the average BMI in this group was ≤2 standard deviation (SD); with clinical signs evolving for 11.5 months. Twenty-seven children had no anorexia; average BMI in this group was +1 SD, with clinical evolution for 6 months on an average of p anorexia, body mass index improved markedly in the postoperative follow-up, which lasted, on average, for 6 years. Anorexia with stunted body weight curve is a non-exceptional presentation in children with low-grade astrocytomas of the fourth ventricle. Unexplained or atypical anorexia with negative etiologic assessment should prompt cerebral imaging. Clinical improvement after surgical resection, could suggest a possible interaction between tumour tissue and appetite-suppressing peptide secretion.

  11. First-trimester visualization of the fourth ventricle in fetuses with and without spina bifida.

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    Solt, Ido; Acuna, Joann G; Adeniji, Beni A; Mirocha, James; Kim, Matthew J; Rotmensch, Siegfried

    2011-12-01

    The purpose of this study was to examine the efficacy of nonvisualization of the fourth ventricle for first-trimester detection of spina bifida. A total of 250 digitally stored sonographic examinations at gestational ages of 11 weeks to 13 weeks 6 days (245 normal and 5 randomly interspersed spina bifida cases) were retrospectively analyzed by 4 blinded reviewers for the presence or absence of the fourth ventricle followed by an anteroposterior ventricular dimension measurement. The ventricle size was related to the crown-rump length and gestational age by linear regression analysis and Pearson correlation. The fourth ventricle was identified in 971 of 1000 image readings (97.1%). False-negative and false-positive readings occurred in 11 of 20 (55.0%) and 20 of 980 (2.0%) cases, respectively (sensitivity, 0.45; specificity, 0.98.). False-negative and false-positive readings were evenly distributed throughout the gestational age range. When the ventricular size was measurable, its mean dimensions increased linearly with gestational age and were below the fifth percentile in 10 of 245 (4.0%) normal and 0 of 4 spina bifida cases, respectively. Intraclass correlation coefficient estimates were calculated based on the 2-way analysis of variance model and found to be 0.30 for a single rater and 0.64 for the mean of 4 raters. Nonvisualization of the first-trimester fourth ventricle is a less robust screening parameter for spina bifida than previously published.

  12. Preventing lower cranial nerve injuries during fourth ventricle tumor resection by utilizing intraoperative neurophysiological monitoring.

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    Jahangiri, Faisal R; Minhas, Mazhar; Jane, John

    2012-12-01

    We present two cases illustrating the benefit of utilizing intraoperative neurophysiological monitoring (IONM) for prevention of injuries to the lower cranial nerves during fourth ventricle tumor resection surgeries. Multiple cranial nerve nuclei are located on the floor of the fourth ventricle with a high risk of permanent damage. Two male patients (ages 8 and 10 years) presented to the emergency department and had brain magnetic resonance imaging (MRI) scans showing brainstem/fourth ventricle tumors. During surgery, bilateral posterior tibial and median nerve somatosensory evoked potentials (SSEPs); four-limb and cranial nerves transcranial electrical motor evoked potentials (TCeMEPs); brainstem auditory evoked responses (BAERs); and spontaneous electromyography (s-EMG) were recorded. Electromyography (EMG) was monitored bilaterally from cranial nerves V VII, IX, X, XI, and XII. Total intravenous anesthesia was used. Neuromuscular blockade was used only for initial intubation. Pre-incision baselines were obtained with good morphology of waveforms. After exposure the floor of the fourth ventricle was mapped by triggered-EMG (t-EMG) using 0.4 to 1.0 mA. In both patients the tumor was entangled with cranial nerves VII to XII on the floor of the fourth ventricle. The surgeon made the decision not to resect the tumor in one case and limited the resection to 70% of the tumor in the second case on the basis of neurophysiological monitoring. This decision was made to minimize any post-operative neurological deficits due to surgical manipulation of the tumor involving the lower cranial nerves. Intraoperative spontaneous and triggered EMG was effectively utilized in preventing injuries to cranial nerves during surgical procedures. All signals remained stable during the surgical procedure. Postoperatively both patients were well with no additional cranial nerve weakness. At three months follow-up, the patients continued to have no deficits.

  13. Study of cysticercosis in the fourth ventricle by CSF cinema MRI

    International Nuclear Information System (INIS)

    Wang Lianqing; Liu Lianxiang; Wu Jie; Wu Jing; Zhang Renshu; Wu Yujin

    1997-01-01

    Purpose: To evaluate the diagnostic value of cysticercosis in the fourth ventricle by CSF cinema MRI. Materials and methods: Nine patients with intraventricular cysticercosis in the fourth ventricle were studied. The diagnosis was confirmed by surgery in all cases. All of these patients were examined systematically before the operation and studied with CSF cinema MRI in mid sagittal section and finger-gated scan technique. Results: (1) The path of CSF flow was directly displayed. All cysticercosis presented as a filling defect, and a cyst with a smooth wall. (2) The ventricular compliance was normal in cysticercosis. (3) The cysticercosis in active stage was free in the fourth ventricle and could be rolled over, its shape might change slightly within a cardiac cycle. In the degenerative stage, its wall could adhere to the ependyma and obstruct the CSF flow. Conclusion: CSF cinema MRI can demonstrate the degree of obstruction and pattern of CSF flow in cysticercosis of the fourth ventricle, thereby providing useful information for proper management

  14. Ectopic craniopharyngioma of the fourth ventricle in a patient with Gardner syndrome.

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    Pena, Andres H; Chaudhry, Ammar; Seidman, Roberta J; Peyster, Robert; Bangiyev, Lev

    2016-01-01

    Ectopic craniopharyngioma is uncommon and a craniopharyngioma confined purely within the fourth ventricle is extremely rare. We report a craniopharyngioma of the fourth ventricle in a 20-year-old man with Gardner syndrome. Imaging characteristics of craniopharyngiomas and fourth ventricle lesions are discussed with a review of the literature regarding the pathogenesis of craniopharyngiomas and the possible association with Gardner syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Rosette forming glioneuronal tumor of the fourth ventricle in squash cytology smear

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    Amita Radhakrishnan Nair

    2014-01-01

    Full Text Available Rosette forming glioneuronal tumor (RGNT is a recently recognized and extremely rare glioneuronal tumor occurring in the fourth ventricle. It is crucial for the cytopathologist to be aware of this entity as it can be easily mistaken for more common neoplasms occurring at this site. We present here the cytology of such a rare case of RGNT that was misdiagnosed as ependymoma. The varying cytological features of this entity, as well as the common diagnostic difficulties encountered in cytology, are highlighted in this report.

  16. Chemotherapy administration directly into the fourth ventricle in a nonhuman primate model.

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    Sandberg, David I; Peet, M Melissa; Johnson, Mark D; Cole, Phaedra; Koru-Sengul, Tulay; Luqman, Ali W

    2012-05-01

    The authors hypothesized that chemotherapy infusions directly into the fourth ventricle might potentially play a role in treating malignant fourth ventricular tumors. The study tested the safety and pharmacokinetics of short- and long-term infusions of methotrexate into the fourth ventricle in a new nonhuman primate model. Six rhesus monkeys underwent posterior fossa craniectomy and catheter insertion into the fourth ventricle. In Group I (3 animals), catheters were externalized, and lumbar drain catheters were placed simultaneously to assess CSF distribution after short-term methotrexate infusions. In 2 animals, methotrexate (0.5 mg) was infused into the fourth ventricle daily for 5 days. Serial CSF and serum methotrexate levels were measured. The third animal had a postoperative neurological deficit, and the experiment was aborted prior to methotrexate administration. In Group II (3 animals), catheters were connected to a subcutaneously placed port for subsequent long-term methotrexate infusions. In 2 animals, 4 cycles of intraventricular methotrexate, each consisting of 4 daily infusions (0.5 mg), were administered over 8 weeks. The third animal received 3 cycles, and then the experiment was terminated due to self-inflicted wound breakdown. All animals underwent detailed neurological evaluations, MRI, and postmortem histological analysis. No neurological deficits were noted after intraventricular methotrexate infusions. Magnetic resonance images demonstrated catheter placement within the fourth ventricle and no signal changes in the brainstem or cerebellum. Histologically, two Group I animals, one of which did not receive methotrexate, had several small focal areas of brainstem injury. Two Group II animals had a small (≤ 1-mm) focus of axonal degeneration in the midbrain. Intraventricular and meningeal inflammation was noted in 4 animals after methotrexate infusions (one from Group I and all three from Group II). In all Group II animals, inflammation extended

  17. Effects of intra-fourth ventricle injection of crocin on capsaicin-induced orofacial pain in rats.

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    Tamaddonfard, Esmaeal; Tamaddonfard, Sina; Pourbaba, Salar

    2015-01-01

    Crocin, a constituent of saffron and yellow gardenia, possesses anti-nociceptive effects. In the present study, we investigated the effects of intra-fourth ventricle injection of crocin in a rat model of orofacial pain. The contribution of opioid system was assessed using intra-fourth ventricle injection of naloxone, an opioid receptor antagonist. A guide cannula was implanted into the fourth ventricle of brain in anesthetized rats. Orofacial pain was induced by subcutaneous (s.c.) injection of capsaicin (1.5 µg/20 µl) into the right vibrissa pad. The time spent face rubbing/grooming was recorded for a period of 20 min. Locomotor activity was measured using an open-field test. Intra-fourth ventricle injection of crocin (10 and 40 µg/rat) and morphine (10 and 40 µg/rat) and their co-administration (2.5 and 10 µg/rat of each) suppressed capsaicin-induced orofacial pain. The analgesic effect induced by 10 µg/rat of morphine, but not crocin (10 µg/rat), was prevented by 20 µg/rat of naloxone pretreatment. The above-mentioned chemical compounds did not affect locomotor activity. The results of this study showed that the injection of crocin into the cerebral fourth ventricle attenuates capsaicin-induced orofacial pain in rats. The anti-nociceptive effect of crocin was not attributed to the central opioid receptors.

  18. Effects of intra-fourth ventricle injection of crocin on capsaicin-induced orofacial pain in rats

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    Esmaeal Tamaddonfard

    2015-08-01

    Full Text Available Objectives: Crocin, a constituent of saffron and yellow gardenia, possesses anti-nociceptive effects. In the present study, we investigated the effects of intra-fourth ventricle injection of crocin in a rat model of orofacial pain. The contribution of opioid system was assessed using intra-fourth ventricle injection of naloxone, an opioid receptor antagonist. Materials and Methods: A guide cannula was implanted into the fourth ventricle of brain in anesthetized rats. Orofacial pain was induced by subcutaneous (s.c. injection of capsaicin (1.5 µg/20 µl into the right vibrissa pad. The time spent face rubbing/grooming was recorded for a period of 20 min. Locomotor activity was measured using an open-field test. Results: Intra-fourth ventricle injection of crocin (10 and 40 µg/rat and morphine (10 and 40 µg/rat and their co-administration (2.5 and 10 µg/rat of each suppressed capsaicin-induced orofacial pain. The analgesic effect induced by 10 µg/rat of morphine, but not crocin (10 µg/rat, was prevented by 20 µg/rat of naloxone pretreatment. The above-mentioned chemical compounds did not affect locomotor activity. Conclusion: The results of this study showed that the injection of crocin into the cerebral fourth ventricle attenuates capsaicin-induced orofacial pain in rats. The anti-nociceptive effect of crocin was not attributed to the central opioid receptors.

  19. Autonomic dysfunction elicited by a medulla oblongata injury after fourth ventricle tumor surgery in a pediatric patient.

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    Martín-Gallego, A; Andrade-Andrade, I; Dawid-Milner, M S; Domínguez-Páez, M; Romero-Moreno, L; González-García, L; Carrasco-Brenes, A; Segura-Fernández-Nogueras, M; Ros-López, B; Arráez-Sánchez, M A

    2016-01-01

    We report the case of a 9-year-old male patient with a recurrent fourth ventricle anaplastic ependymoma who developed severe arterial hypertension and blood pressure lability during and after surgery. A punctual bilateral lesion located within mid dorsal medulla oblongata caused by both infiltration and surgical resection was observed in postoperative MRI. Three years later, the patient remained neurologically stable but the family referred the presence of a chronic tachycardia as well as palpitations and sweating with flushing episodes related to environmental stress. On autonomic evaluation, an increase in sympathetic outflow with tachycardia together with orthostatic hypotension caused by baroreceptor reflex dysfunction was observed. We postulate that a bilateral injury to both nuclei of the solitary tract may have caused central dysautonomia. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Massive symptomatic subependymoma of the lateral ventricles: case report and review of the literature

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    Rath, T.J.; Sundgren, P.C.; Gebarski, S.S. [University of Michigan Health Systems, Department of Radiology, Ann Arbor, MI (United States); Brahma, B.; Chandler, W.F. [University of Michigan Health Systems, Department of Neurosurgery, Ann Arbor, MI (United States); Lieberman, A.P. [University of Michigan Health Systems, Department of Pathology, Ann Arbor, MI (United States)

    2005-03-01

    Subependymomas are benign intraventricular tumors with an indolent growth pattern, which are usually asymptomatic, and most commonly occur in the fourth and lateral ventricles. When symptomatic, subependymomas often obstruct critical portions of the cerebrospinal fluid (CSF) pathway, causing hydrocephalus, and range from 3 cm to 5 cm in size. We report a case of an unusually massive subependymoma of the lateral ventricles treated with subtotal resection, ventriculoperitoneal shunt, and post-surgical radiation. The clinical course, radiographic and pathologic characteristics of this massive intraventricular subependymoma are discussed, as well as the differential diagnosis of lateral ventricular masses and a review of the literature concerning subependymomas. (orig.)

  1. Surgical treatment of lesions in and around the fourth ventricle. Part 3: special reference to pre-surgical anatomical MRI

    International Nuclear Information System (INIS)

    Matsushima, Toshio; Ikezaki, Kiyonobu; Mihara, Futoshi; Fukui, Masashi

    1998-01-01

    MR images are presented to demonstrate how clearly and how much of the structures of the fourth ventricle can be shown. It then is stressed how useful the information obtained from the MR images can be in planning a surgical approach and determining preoperative prospects of the actual surgery. The information includes the location, extension, and original structure of the mass lesion and its infiltration into surrounding tissues. The MR midline sagittal view image showing the tent-like shape and components of the fourth ventricle can demonstrate whether the lesion originates from the roof or the floor of the ventricle, and how far it extends rostrally or caudally. The axial views at the levels of the medulla oblongata and the pons show a fourth ventricle of completely different shape. The former shows the ventricle in the shape of a slit and the latter in the shape of a pentagon. At the level of the medulla oblongata, the tela choroidea with the choroid plexus is seen as a membranous structure just posterior to the medulla oblongata. The space between the two structures is the ventricular space. Because the enhanced MRI clearly demonstrates the choroid plexus in the lateral recess, the cerebellomedullary fissure can be identified. In this view, the lateral extension of a lesion to the cerebellopontine cistern through the cerebellomedullary fissure or the lateral recess easily can be identified. In the coronal views, the floor and the roof of the ventricle appear on different slices. They clearly show the diamond-shaped floor, three cerebellar peduncles, and the lateral recesses. The striae medullares transversely course in the widest area of the floor at the level of the pontomedullary junction, and the lateral recess extends laterally from the widest area. These views demonstrate the lateral and/or inferior extension of a lesion. (author)

  2. Effects of the Fourth Ventricle Compression in the Regulation of the Autonomic Nervous System: A Randomized Control Trial

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    Ana Paula Cardoso-de-Mello-e-Mello-Ribeiro

    2015-01-01

    Full Text Available Introduction. Dysfunction of the autonomic nervous system is an important factor in the development of chronic pain. Fourth ventricle compression (CV-4 has been shown to influence autonomic activity. Nevertheless, the physiological mechanisms behind these effects remain unclear. Objectives. This study is aimed at evaluating the effects of fourth ventricle compression on the autonomic nervous system. Methods. Forty healthy adults were randomly assigned to an intervention group, on whom CV-4 was performed, or to a control group, who received a placebo intervention (nontherapeutic touch on the occipital bone. In both groups, plasmatic catecholamine levels, blood pressure, and heart rate were measured before and immediately after the intervention. Results. No effects related to the intervention were found. Although a reduction of norepinephrine, systolic blood pressure, and heart rate was found after the intervention, it was not exclusive to the intervention group. In fact, only the control group showed an increment of dopamine levels after intervention. Conclusion. Fourth ventricle compression seems not to have any effect in plasmatic catecholamine levels, blood pressure, or heart rate. Further studies are needed to clarify the CV-4 physiologic mechanisms and clinical efficacy in autonomic regulation and pain treatment.

  3. SURGERY FOR TUMORS OF THE FOURTH VENTRICLE: THE CHARACTERISTICS OF ACCESSES AND THE ROLE OF ENDOSCOPIC TECHNIQUES

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    V. B. Karakhan

    2012-01-01

    Full Text Available The use of current accesses to the tumors of the fourth ventricle, which fill and compress from the outside its cavity, was assessed in 28 patients. Original associated endomicrosurgical techniques were used. Two groups and five topographic types of fourth ventricle tumors are identified. Basic accesses — telovelar and supracerebellar — eliminate the necessity of dissecting the vermis cerebelli. The key endoscopic technique is to provide a simultaneous survey of the lower and upper poles of a tumor during its removal. The technique of trochlear removal of metastatic nodes from the fourth ventricle is shown. The benefits of endoscopic techniques are to early examine the vulnerable vascular and neural structures blocked by a tumor at the access step; to reduce the volume of an access itself and the traction of cerebellar and truncal structures; to completely survey the Sylvian aqueduct without additionally displacing or dissecting the vermis cerebelli; to maintain optical sharpness within sight of differently remote microstructures. Overall, incorporation of the endoscopic method realizes the principle of mini-invasive neurosurgery. 

  4. Primary intra-fourth ventricular meningioma: Report two cases

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    Nishanth Sadashiva

    2016-01-01

    Full Text Available Meningioma's occurring intraventricular region are rare and these occurring in the fourth ventricle is even rare. Because of the rarity, it is not usually considered as a differential diagnosis in any age group. Clinical features and Imaging is not characteristic, and most of them are thought to be some different tumor. Here, we discuss two cases harboring a primary fourth ventricular meningioma Grade II, which was surgically excised successfully. Total excision was achieved in both cases and as the tumor was firm to soft and vermian splitting was not required. Understanding the clinical features and a careful preoperative radiological examination is required to differentiate this tumor from more commonly occurring lesions at this location.

  5. Inter- and intrapatient variability of facial nerve response areas in the floor of the fourth ventricle.

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    Bertalanffy, Helmut; Tissira, Nadir; Krayenbühl, Niklaus; Bozinov, Oliver; Sarnthein, Johannes

    2011-03-01

    Surgical exposure of intrinsic brainstem lesions through the floor of the 4th ventricle requires precise identification of facial nerve (CN VII) fibers to avoid damage. To assess the shape, size, and variability of the area where the facial nerve can be stimulated electrophysiologically on the surface of the rhomboid fossa. Over a period of 18 months, 20 patients were operated on for various brainstem and/or cerebellar lesions. Facial nerve fibers were stimulated to yield compound muscle action potentials (CMAP) in the target muscles. Using the sites of CMAP yield, a detailed functional map of the rhomboid fossa was constructed for each patient. Lesions resected included 14 gliomas, 5 cavernomas, and 1 epidermoid cyst. Of 40 response areas mapped, 19 reached the median sulcus. The distance from the obex to the caudal border of the response area ranged from 8 to 27 mm (median, 17 mm). The rostrocaudal length of the response area ranged from 2 to 15 mm (median, 5 mm). Facial nerve response areas showed large variability in size and position, even in patients with significant distance between the facial colliculus and underlying pathological lesion. Lesions located close to the facial colliculus markedly distorted the response area. This is the first documentation of variability in the CN VII response area in the rhomboid fossa. Knowledge of this remarkable variability may facilitate the assessment of safe entry zones to the brainstem and may contribute to improved outcome following neurosurgical interventions within this sensitive area of the brain.

  6. Effects of the administration of a catalase inhibitor into the fourth cerebral ventricle on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke

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    Valenti, Vitor E.; Abreu, Luiz Carlos de; Fonseca, Fernando L. A.; Adami, Fernando; Sato, Monica A.; Vanderlei, Luiz Carlos M.; Ferreira, Lucas Lima; Rodrigues, Luciano M.; Ferreira, Celso

    2013-01-01

    OBJECTIVE: Previous studies have demonstrated a relationship between brain oxidative stress and cardiovascular regulation. We evaluated the effects of central catalase inhibition on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke. METHODS: Male Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SH) (16 weeks old) were implanted with a stainless steel guide cannula leading into the fourth cerebral ventricle (4...

  7. Fourth branchial complex anomalies: a case series.

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    Shrime, Mark; Kacker, Ashutosh; Bent, John; Ward, Robert F

    2003-11-01

    Anomalies of the fourth branchial arch complex are exceedingly rare, with approximately forty cases reported in the literature since 1972. The authors report experience with six fourth arch anomalies. Retrospective chart review of six consecutive patients presenting to the pediatric otolaryngology service at a tertiary care center with anomalies referable to the fourth branchial arch. All six patients presented within the first or second decade of life. All six had left-sided disease. Four patients presented with recurrent neck infection, one with asymptomatic cervical masses, and one with a neck mass and respiratory compromise. One patient had prior surgery presented with a recurrence. Diagnosis of fourth arch anomalies was suggested or confirmed by computed tomography and flexible laryngoscopy. Treatment was surgical in five patients; one patient is awaiting surgery. Surgical procedures included resection of the mass and endoscopic cauterization of the inner opening of the cyst. The presentation of a cervical mass, especially with recurrent infections and especially on the left side, in a child in the first or second decade of life heightens suspicion for an anomaly of the fourth branchial arch. Diagnosis can be difficult, but is aided by the use of flexible laryngoscopy, Computed tomography (CT) scanning and ultrasonography. Surgical resection of the cyst and cauterization of its pyriform sinus opening should be undertaken to minimize recurrence.

  8. Sidestream cigarette smoke effects on cardiovascular responses in conscious rats: involvement of oxidative stress in the fourth cerebral ventricle

    Directory of Open Access Journals (Sweden)

    Valenti Vitor E

    2012-03-01

    Full Text Available Abstract Background Cigarette exposure increases brain oxidative stress. The literature showed that increased brain oxidative stress affects cardiovascular regulation. However, no previous study investigated the involvement of brain oxidative stress in animals exposed to cigarette and its relationship with cardiovascular regulation. We aimed to evaluate the effects of central catalase inhibition on baroreflex and cardiovascular responses in rats exposed to sidestream cigarette smoke (SSCS. Methods We evaluated males Wistar rats (320-370 g, which were implanted with a stainless steel guide cannula into the fourth cerebral ventricle (4th V. Femoral artery and vein were cannulated for mean arterial pressure (MAP and heart rate (HR measurement and drug infusion, respectively. Rats were exposed to SSCS during three weeks, 180 minutes, 5 days/week (CO: 100-300 ppm. Baroreflex was tested with a pressor dose of phenylephrine (PHE, 8 μg/kg, bolus to induce bradycardic reflex and a depressor dose of sodium nitroprusside (SNP, 50 μg/kg, bolus to induce tachycardic reflex. Cardiovascular responses were evaluated before, 5, 15, 30 and 60 minutes after 3-amino-1,2,4-triazole (ATZ, catalase inhibitor, 0.001 g/100 μL injection into the 4th V. Results Central catalase inhibition increased basal HR in the control group during the first 5 minutes. SSCS exposure increased basal HR and attenuated bradycardic peak during the first 15 minutes. Conclusion We suggest that SSCS exposure affects cardiovascular regulation through its influence on catalase activity.

  9. Neuroradiological findings and clinical features of fourth-ventricular meningioma: A study of 10 cases

    International Nuclear Information System (INIS)

    Zhang, B.-Y.; Yin, B.; Li, Y.-X.; Wu, J.-S.; Chen, H.; Wang, X.-Q.; Geng Daoyng

    2012-01-01

    Aim: To present the neuroradiological and clinical findings of fourth-ventricular meningiomas to increase awareness of this entity. Materials and methods: The computed tomography (CT; n = 5), magnetic resonance imaging (MRI; n = 9) features and clinical presentations of 10 patients with pathologically documented fourth-ventricular meningiomas were retrospectively analysed. Results: All tumours appeared as well-demarcated masses in the fourth ventricle at CT and MRI. The tumour shape was round in eight cases (80%) and irregular in two cases (20%). The CT images of five cases showed predominantly isoattenuation in three cases and high attenuation in two cases, with a mean attenuation value of 52 HU. In addition, calcifications were seen in three cases. At MRI, nine masses were isointense (n = 6) or hypointense (n = 3) to grey matter on T1-weighted images and mildly hyperintense (n = 4), isointense (n = 3), hypointense (n = 1), and of mixed signal intensity (n = 1) on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. Signal voids were visible in two cases. Enhancement after injection of contrast material was marked homogeneous (n = 5) or heterogeneous (n = 5) on CT or T1-weighted images. Three tumours had mild peritumoural oedema. Three tumours were associated with obstructive hydrocephalus. The pathological subtype of the 10 meningiomas was fibromatous (n = 5), atypical (n = 2), and one each of transitional, psammomatous, and clear-cell type. Conclusion: Although fourth-ventricular meningioma is quite rare, it should be considered in differential diagnosis of neoplasms within the fourth ventricle. The relatively typical radiological appearance, combined the age and sex of patients, can suggest the diagnosis of fourth-ventricular meningioma.

  10. Neuroradiological findings and clinical features of fourth-ventricular meningioma: A study of 10 cases

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, B.-Y.; Yin, B.; Li, Y.-X. [Department of Radiology, Huashan Hospital, Fudan University, Shanghai (China); Wu, J.-S. [Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai (China); Chen, H. [Department of Neuropathology, Huashan Hospital, Fudan University, Shanghai (China); Wang, X.-Q., E-mail: wangxq10@126.com [Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai (China); Geng Daoyng, E-mail: fdhsgdy@126.com [Department of Radiology, Huashan Hospital, Fudan University, Shanghai (China)

    2012-05-15

    Aim: To present the neuroradiological and clinical findings of fourth-ventricular meningiomas to increase awareness of this entity. Materials and methods: The computed tomography (CT; n = 5), magnetic resonance imaging (MRI; n = 9) features and clinical presentations of 10 patients with pathologically documented fourth-ventricular meningiomas were retrospectively analysed. Results: All tumours appeared as well-demarcated masses in the fourth ventricle at CT and MRI. The tumour shape was round in eight cases (80%) and irregular in two cases (20%). The CT images of five cases showed predominantly isoattenuation in three cases and high attenuation in two cases, with a mean attenuation value of 52 HU. In addition, calcifications were seen in three cases. At MRI, nine masses were isointense (n = 6) or hypointense (n = 3) to grey matter on T1-weighted images and mildly hyperintense (n = 4), isointense (n = 3), hypointense (n = 1), and of mixed signal intensity (n = 1) on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. Signal voids were visible in two cases. Enhancement after injection of contrast material was marked homogeneous (n = 5) or heterogeneous (n = 5) on CT or T1-weighted images. Three tumours had mild peritumoural oedema. Three tumours were associated with obstructive hydrocephalus. The pathological subtype of the 10 meningiomas was fibromatous (n = 5), atypical (n = 2), and one each of transitional, psammomatous, and clear-cell type. Conclusion: Although fourth-ventricular meningioma is quite rare, it should be considered in differential diagnosis of neoplasms within the fourth ventricle. The relatively typical radiological appearance, combined the age and sex of patients, can suggest the diagnosis of fourth-ventricular meningioma.

  11. A case report of congenital coronary artery fistula to the left ventricle

    International Nuclear Information System (INIS)

    Lee, Byung Hee; Yu, Shi Joon; Moon, Eon Soo; Kim, Sam Hyun; Choi, Young Hi

    1987-01-01

    Congenital coronary artery fistula is a rare malformation with an incidence of 0.4% of congenital heart disease. Among the various subtypes, fistula to the left ventricle is extremely rare with 6 reported cases till 1983. We present a case of coronary artery fistula between the right coronary artery and the left ventricle. The dilated right coronary artery formed a mass like bulging the right lower heart border in the plain chest PA, we think this is first case with a coronary artery fistula to the left ventricle, reported in Korea

  12. MR imaging of a mature teratoma in third ventricle: case report

    International Nuclear Information System (INIS)

    Kim, Myung Soon; Sung, Ki Joon; Cho, Mee Yon

    1994-01-01

    Teratoma is very rarely developed in the third ventricle. We report a case of third ventricular mature teratoma in 12-year old boy with headache and precocious puberty. In T1WI and Gd-DTPA enhanced T1WI, the mass in the third ventricle showed mixed signal intensities with signal void and partial contrast enhancement. The tumor was confirmed as a mature teratoma including teeth and fatty tissue

  13. MR imaging of a mature teratoma in third ventricle: case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Myung Soon; Sung, Ki Joon; Cho, Mee Yon [Wonju College of Medicine, Yonsei University, Wonju (Korea, Republic of)

    1994-01-15

    Teratoma is very rarely developed in the third ventricle. We report a case of third ventricular mature teratoma in 12-year old boy with headache and precocious puberty. In T1WI and Gd-DTPA enhanced T1WI, the mass in the third ventricle showed mixed signal intensities with signal void and partial contrast enhancement. The tumor was confirmed as a mature teratoma including teeth and fatty tissue.

  14. Two-chambered right ventricle resulting from aberrant muscle bundles: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lim, T. H.; Ko, K. H.; Im, C. K.; Han, M. C.; Chi, J. G [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-12-15

    The 'Two-chambered right ventricle' is a rare, but unique congenital cardiac anomaly characterized by subdivision of the right ventricle into proximal high pressure chamber and distal low pressure chamber by hypertrophied aberrant muscle bundles. The aberrant muscle bundles traverse the right ventricle from the region of crista supraventricular is to the lower part of the anterior wall of the right ventricle. The ' Two-chambered right ventricle' is usually associated with other congenital cardiac anomalies such as ventricular septal defect, pulmonary valvular stenosis, etc. Therefore this anomaly could be mistakenly diagnosed as Tetralogy of Fallot or isolated interventricular septal defect. The need to separate this entity from other types of infundibular stenosis is emphasized because of the important surgical implications. Authors recently experienced a case of the {sup T}wo-chambered right ventricle' resulting from aberrant muscle bundles, that are associated with other cardiac anomalies i.e., pulmonary valvular stenosis, aysplastic tricuspid valve with regurgitation and partial anomalous pulmonary venous return to the right atrium. Here we present the findings of E.K.G., cardiac catheterization, simple chest pa, cine-right ventriculography, and autopsy together with a review of related articles.

  15. Two-chambered right ventricle resulting from aberrant muscle bundles: a case report

    International Nuclear Information System (INIS)

    Lim, T. H.; Ko, K. H.; Im, C. K.; Han, M. C.; Chi, J. G

    1979-01-01

    The 'Two-chambered right ventricle' is a rare, but unique congenital cardiac anomaly characterized by subdivision of the right ventricle into proximal high pressure chamber and distal low pressure chamber by hypertrophied aberrant muscle bundles. The aberrant muscle bundles traverse the right ventricle from the region of crista supraventricular is to the lower part of the anterior wall of the right ventricle. The ' Two-chambered right ventricle' is usually associated with other congenital cardiac anomalies such as ventricular septal defect, pulmonary valvular stenosis, etc. Therefore this anomaly could be mistakenly diagnosed as Tetralogy of Fallot or isolated interventricular septal defect. The need to separate this entity from other types of infundibular stenosis is emphasized because of the important surgical implications. Authors recently experienced a case of the T wo-chambered right ventricle' resulting from aberrant muscle bundles, that are associated with other cardiac anomalies i.e., pulmonary valvular stenosis, aysplastic tricuspid valve with regurgitation and partial anomalous pulmonary venous return to the right atrium. Here we present the findings of E.K.G., cardiac catheterization, simple chest pa, cine-right ventriculography, and autopsy together with a review of related articles.

  16. Role of Echocardiograghy in Treating a Case of Double Chamber Right Ventricle with Delayed Presentation.

    Science.gov (United States)

    Barik, Ramachandra

    2017-01-01

    The clinical diagnosis of double chamber right ventricle (DCRV) is not straightforward. Clinical history, clinical examination, 12-lead electrocardiogram, chest X-ray, and Echocardiography (echo) contribute to morphological diagnosis. Cardiac catheterization is essential for hemodynamic evaluation. A thorough presurgical workup helps the cardiac surgeon to choose the appropriate surgical approach and timing of surgery in an individual case. We present a case of a DCRV who presented to us in the fifth decade of life. Echo confirmed the morphological diagnosis and cardiac catheterization complemented the exact pull back gradient across the obstruction in the right ventricle. This patient was suggested muscle bundle resection and ventricular septal defect closure using right atrial approach.

  17. Phase-contrast cerebrospinal fluid flow magnetic resonance imaging in qualitative evaluation of patency of CSF flow pathways prior to infusion of chemotherapeutic and other agents into the fourth ventricle.

    Science.gov (United States)

    Patel, Rajan P; Sitton, Clark W; Ketonen, Leena M; Hou, Ping; Johnson, Jason M; Romo, Seferino; Fletcher, Stephen; Shah, Manish N; Kerr, Marcia; Zaky, Wafik; Rytting, Michael E; Khatua, Soumen; Sandberg, David I

    2018-03-01

    Nuclear medicine studies have previously been utilized to assess for blockage of cerebrospinal fluid (CSF) flow prior to intraventricular chemotherapy infusions. To assess CSF flow without nuclear medicine studies, we obtained cine phase-contrast MRI sequences that assess CSF flow from the fourth ventricle down to the sacrum. In three clinical trials, 18 patients with recurrent malignant posterior fossa tumors underwent implantation of a ventricular access device (VAD) into the fourth ventricle, either with or without simultaneous tumor resection. Prior to infusing therapeutic agents into the VAD, cine MRI phase-contrast CSF flow sequences of the brain and total spine were performed. Velocity encoding (VENC) of 5 and 10 cm/s was used to confirm CSF flow from the fourth ventricular outlets to the cervical, thoracic, and lumbar spine. Qualitative CSF flow was characterized by neuroradiologists as present or absent. All 18 patients demonstrated CSF flow from the outlets of the fourth ventricle down to the sacrum with no evidence of obstruction. One of these patients, after disease progression, subsequently showed obstruction of CSF flow. No patient required a nuclear medicine study to assess CSF flow prior to initiation of infusions. Fourteen patients have received infusions to date, and none has had neurological toxicity. CSF flow including the fourth ventricle and the total spine can be assessed noninvasively with phase-contrast MRI sequences. Advantages over nuclear medicine studies include avoiding both an invasive procedure and radiation exposure.

  18. Radiographic studies of the ventricles in syringomyelia

    International Nuclear Information System (INIS)

    West, R.J.; Williams, B.

    1980-01-01

    Radiographic investigations of 171 patients with communicating syringomyelia have been reviewed. Hydrocephalus was found in one third of the cases and has occasionally progressed after operation on the posterior fossa, sometimes with accompanying clinical deterioration. The outlets of the fourth ventricle were usually abnormal; tonsillar descent, arachnoiditis and both together were seen. Arachnoiditis correlated strongly with a history of difficult birth. The foramen of Magendie was sometimes patent and sometimes blocked. There was no consistent level of occulusion corresponding to a persistent roof of the fourth ventricle. The cisterna magna was usually small or obliterated but some examples of large cisterns or subarachnoid pouches were found. Radiological demonstration of a communication from the fourth ventricle to the syrinx occurred in only seven patients by positive contrast material and not by air. It is suggested that a sizable communication is rare at the time when patients seek treatment. (orig.)

  19. Radiological evaluation of double-outlet right ventricle - An analysis of cinecardioangiography in 44 cases -

    Energy Technology Data Exchange (ETDEWEB)

    Park, Cheong Hee; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-03-15

    Double-outlet right ventricle is defined as follows: both great arteries arise completely or nearly completely from the right ventricle; neither semilunar valve is in fibrous continuity with either atrioventricular valve; and usually a ventricular septal defect is present and the only outlet from the left ventricle. A total of 44 cases of double-outlet right ventricle is analyzed, in which cineangiocardiographies were done at the Department of Radiology, Seoul National University Hospital in recent 4 year and 6 months, with specific reference to the segmental combinations, the height of conus, the relationship of great arteries, the location of ventricular septal defects, and associated anomalies. The results were as follows; 1. Among 44 cases, 36 cases had normal cardiac position, 4 cases had dextrocardia with situs inversus 2 cases had dextrocardia with situs solitus, 1 case had levocardia with situs inversus, and another 1 case had mesocardia with situs ambiguus. 2. Segmental sets were [S,D,D] in 36 cases, [I,L,L] in 3 cases, [I,D,D] in 2 cases, [S,D,L], [S,L,L] and [A,D,D] in 1 case respectively. 3. All cases had bilateral conus. Aortic valve rings were same level as pulmonary valve rings in 25 cases, lower than pulmonary valve rings in 17 cases in which 15 cases were type A., and higher than pulmonary valve rings in 2 cases. 4. The relation of the great arteries were normal in 15 cases, side-by-side in 13 cases, dextromalposition in 13 cases, and levomal position in 3 cases. 5. The position of the ventricular septal defects with respect to the origins of the great arteries is subaortic (type A and type B) in 23 cases, subpulmonary (type C) in 13 cases, doubly committed (type D) in 3 cases, and uncommitted (type E) in 5 cases. 6. Associated cardiac malformations are pulmonary stenosis in 24 which had all cases of type A and type E, aortic stenosis in 6 which were only in type C, left SVC in 6, abnormality of atrioventricular valve in 5, single coronary artery

  20. Effects of the administration of a catalase inhibitor into the fourth cerebral ventricle on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke.

    Science.gov (United States)

    Valenti, Vitor E; Abreu, Luiz Carlos de; Fonseca, Fernando L A; Adami, Fernando; Sato, Monica A; Vanderlei, Luiz Carlos M; Ferreira, Lucas Lima; Rodrigues, Luciano M; Ferreira, Celso

    2013-06-01

    Previous studies have demonstrated a relationship between brain oxidative stress and cardiovascular regulation. We evaluated the effects of central catalase inhibition on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke. Male Wistar Kyoto (WKY) rats and spontaneously hypertensive rats (SH) (16 weeks old) were implanted with a stainless steel guide cannula leading into the fourth cerebral ventricle (4th V). The femoral artery and vein were cannulated for arterial pressure and heart rate measurement and drug infusion, respectively. The rats were exposed to sidestream cigarette smoke for 180 minutes/day, 5 days/week for 3 weeks (CO: 100-300 ppm). The baroreflex was tested using a pressor dose of phenylephrine (8 μg/kg, bolus) and a depressor dose of sodium nitroprusside (50 μg/kg, bolus). Cardiovascular responses were evaluated before and 5, 15, 30 and 60 minutes after injection of a catalase inhibitor (3-amino-1,2,4-triazole, 0.001 g/100 μL) into the 4th V. Vehicle administration into the 4th V did not affect the cardiovascular response, whereas administration of the central catalase inhibitor increased the basal HR and attenuated the bradycardic peak (peffect of the catalase inhibitor treatment was stronger in the fresh air condition (pcatalase inhibitor into the 4th V combined with exposure to sidestream cigarette smoke has a stronger effect in WKY rats than in SH rats.

  1. Fourth ventricle injection of ghrelin decreases angiotensin II-induced fluid intake and neuronal activation in the paraventricular nucleus of the hypothalamus.

    Science.gov (United States)

    Plyler, Kimberly S; Daniels, Derek

    2017-09-01

    Ghrelin acts in the CNS to decrease fluid intake under a variety of dipsogenic and natriorexigenic conditions. Previous studies on this topic, however, focused on the forebrain as a site of action for this effect of ghrelin. Because the hindbrain contains neural substrates that are capable of mediating the well-established orexigenic effects of ghrelin, the current study tested the hypothesis that ghrelin applied to the hindbrain also would affect fluid intake. To this end, water and saline intakes were stimulated by central injection of angiotensin II (AngII) in rats that also received injections of ghrelin (0.5μg/μl) into either the lateral or fourth ventricle. Ghrelin injected into either ventricle reduced both water and 1.8% NaCl intake that was stimulated by AngII. The nature of the intake effect revealed some differences between the injection sites. For example, forebrain application of ghrelin reduced saline intake by a reduction in both the number of licking bursts and the size of each licking burst, but hindbrain application of ghrelin had a more selective effect on burst number. In an attempt to elucidate a brain structure in which hindbrain-administered ghrelin and forebrain-administered AngII interact to cause the ingestive response, we used Fos-immunohistochemistry in rats given the treatments used in the behavioral experiments. Although several brain areas were found to respond to either ghrelin or AngII, of the sites examined, only the paraventricular nucleus of the hypothalamus (PVN) emerged as a potential site of interaction. Specifically, AngII treatment caused expression of Fos in the PVN that was attenuated by concomitant treatment with ghrelin. These experiments provide the novel finding that the hindbrain contains elements that can respond to ghrelin and cause decreases in AngII-induced fluid intake, and that direct actions by ghrelin on forebrain structures is not necessary. Moreover, these studies suggest that the PVN is an important site

  2. Ganglioglioma in the Third Ventricle: A Case Report and Literature Review

    Science.gov (United States)

    Higa, Nayuta; Yonezawa, Hajime; Oyoshi, Tatsuki; Hiraki, Tsubasa; Hirano, Hirofumi; Arita, Kazunori

    2016-01-01

    Gangliogliomas typically arise in the cerebral hemispheres, but may occur rarely in the ventricles. Herein, we report a 38-year-old woman who was treated for hydrocephalus caused by a ganglioglioma of the third ventricle. Magnetic resonance imaging (MRI) revealed a heterogeneously enhanced tumor occupying the anterior part of the third ventricle. A left trans-lateral ventricular trans-foramen of Monroi approach was effective in achieving subtotal resection of the tumor, which had arisen from the medial part of left thalamus to the hypothalamus. Follow-up MRI showed no recurrence of the tumor 5-years after surgery. On pathological examination, the tumor was composed of a glial component that presented features mimicking pilocytic astrocytoma with proliferations of large gangliocytic cells that stained positive for neuronal markers. A review of six similar cases in the literature, including our own, revealed hydrocephalus to be the main symptom of gangliogliomas, with pituitary insufficiencies and visual disturbances having also been reported. In conclusion, we highlight the importance of gangliogliomas in the differential diagnosis of third ventricular tumors presenting with hydrocephalus. PMID:28664007

  3. Effects of the administration of a catalase inhibitor into the fourth cerebral ventricle on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke

    Directory of Open Access Journals (Sweden)

    Vitor E. Valenti

    2013-06-01

    Full Text Available OBJECTIVE: Previous studies have demonstrated a relationship between brain oxidative stress and cardiovascular regulation. We evaluated the effects of central catalase inhibition on cardiovascular responses in spontaneously hypertensive rats exposed to sidestream cigarette smoke. METHODS: Male Wistar Kyoto (WKY rats and spontaneously hypertensive rats (SH (16 weeks old were implanted with a stainless steel guide cannula leading into the fourth cerebral ventricle (4th V. The femoral artery and vein were cannulated for arterial pressure and heart rate measurement and drug infusion, respectively. The rats were exposed to sidestream cigarette smoke for 180 minutes/day, 5 days/week for 3 weeks (CO: 100-300 ppm. The baroreflex was tested using a pressor dose of phenylephrine (8 μg/kg, bolus and a depressor dose of sodium nitroprusside (50 μg/kg, bolus. Cardiovascular responses were evaluated before and 5, 15, 30 and 60 minutes after injection of a catalase inhibitor (3-amino-1,2,4-triazole, 0.001 g/100 μL into the 4th V. RESULTS: Vehicle administration into the 4th V did not affect the cardiovascular response, whereas administration of the central catalase inhibitor increased the basal HR and attenuated the bradycardic peak (p<0.05 to a greater extent in WKY rats exposed to sidestream cigarette smoke than in WKY rats exposed to fresh air. However, in spontaneously hypertensive rats, the effect of the catalase inhibitor treatment was stronger in the fresh air condition (p<0.05. CONCLUSION: Administration of a catalase inhibitor into the 4th V combined with exposure to sidestream cigarette smoke has a stronger effect in WKY rats than in SH rats.

  4. Ventriculoscopic surgery for arachnoid cysts in the lateral ventricle: a comparative study of 21 consecutive cases

    Science.gov (United States)

    Shou, Xuefei; Zhao, Yao; Li, Shiqi; Wang, Yongfei

    2015-01-01

    Objective: To evaluate neuronavigation-guided ventriculoscopic technique in the treatment of arachnoid cysts in the lateral ventricle. Methods: Between January 2008 to November 2011, twenty-one neuronavigationguided ventriculoscopic surgery were performed for the treatment of symptomatic arachnoid cysts in 21 patients (14 male and 7 female patients, mean age 24.1 years [ranged 1.5-61 years]) Clinical presentations varied from headache, vomiting, hemiparesis and seizure. The trajectory of ventriculoscopy was dynamically monitored and guided in real time by neuronavigation system. Cysts fenestrations were performed in fourteen cases, and cysts resection in seven cases, respectively. All patients were prospectively had a regular follow-up. Results: After operation, all patients achieved symptom resolution without surgical mortality and morbidity. Aseptic meningitis was noted in four cases with cyst resection, and all recovered quickly without advanced treatments. However, a later ependymal adhesion, occurred in one case during follow-up period. Conclusion: The combination of ventriculoscopy and neuronavigation is an accurate, effective and safe approach for the treatment of the patients with arachnoid cysts in the lateral ventricle, especially, for overcoming the topographic variation caused by intraventricular pathologies. Cystoventriculostomy is the best choice. PMID:26885002

  5. P16.30 4th ventricle glioblastoma

    Science.gov (United States)

    Unal, E.; Isik, S.; Gurbuz, M.; Kilic, K.

    2017-01-01

    Abstract Introduction: We present the 2nd case ever known in English literature describing a glioblastoma of the fourth ventricle originating from cerebellar peduncle. CASE DESCIPTION: A 66 years old woman was admitted to hospital with dizziness and nausea for four months. An MRI scan showed fourth ventricle mass. First impression was an ependymoma due to MRI scan characteristics. Results: A surgery was performed and histopathology revealed Grade IV glial tumor. Radiotherapy was done. CONCLUSION: This report suggests that GBM can mimic every tumor in the CNS. Surgery is the best option for these tumors not only for aggressive behaviour of glioblastoma but also to prevent hydrocephalus and associated symptoms.

  6. Single ventricle cardiac defect

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  7. Case series: Endoscopic management of fourth branchial arch anomalies.

    Science.gov (United States)

    Watson, G J; Nichani, J R; Rothera, M P; Bruce, I A

    2013-05-01

    Fourth branchial arch anomalies represent branchial anomalies and present as recurrent neck infections or suppurative thyroiditis. Traditionally, management has consisted of treatment of the acute infection followed by hemithyroidectomy, surgical excision of the tract and obliteration of the opening in the pyriform fossa. Recently, it has been suggested that endoscopic obliteration of the sinus tract alone using laser, chemo or electrocautery is a viable alternative to open surgery. To determine the results of endoscopic obliteration of fourth branchial arch fistulae in children in our institute. Retrospective case note review of all children undergoing endoscopic treatment of fourth branchial arch anomalies in the last 7 years at the Royal Manchester Children's Hospital. Patient demographics, presenting symptoms, investigations and surgical technique were analysed. The primary and secondary outcome measures were resolution of recurrent infections and incidence of surgical complications, respectively. In total 5 cases were identified (4 females and 1 male) aged between 3 and 12 years. All presented with recurrent left sided neck abscesses. All children underwent a diagnostic laryngo-tracheo-bronchoscopy which identified a sinus in the apex of the left pyriform fossa. This was obliterated using electrocautery in 1 patient, CO₂ laser/Silver Nitrate chemocautery in 2 patients and Silver Nitrate chemocautery in a further 2 patients. There were no complications and no recurrences over a mean follow-up period of 25 months (range 11-41 months). Endoscopic obliteration of pyriform fossa sinus is a safe method for treating fourth branchial arch anomalies with no recurrence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Case of choroid plexus papilloma of the lateral ventricle presenting as a primary intracranial hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Kurokawa, Hiroyuki; Kikuchi, Kenji; Gito, Yoji; Goto, Tsuneo; Ito, Yasunobu; Fujii, Satoshi

    1988-04-01

    A case of a choroid plexus papilloma of the lateral ventricle that was revealed by a massive intracranial hemorrhage in a 61-year-old man is presented. This patient had an intracranial hemorrhage at the onset. The presence of brain tumor was suspected after a radiologic evaluation using computerized tomography (CT) and angiography; the correctness of this histological diagnosis was confirmed by surgical specimens. Choroid plexus papillomas, rare tumors of neuroectodermal origin, account for 0.5 to 0.6 % of all intracranial tumors. They most frequently appear during the first 2 years of life. A case manifesting intracranial hemorrhage associated with choroid plexus papilloma in an adult is described, with a review of the literature. The importance of adequate radiological investigation is emphasized.

  9. A case of choroid plexus papilloma of the lateral ventricle presenting as a primary intracranial hemorrhage

    International Nuclear Information System (INIS)

    Kurokawa, Hiroyuki; Kikuchi, Kenji; Gito, Yoji; Goto, Tsuneo; Ito, Yasunobu; Fujii, Satoshi

    1988-01-01

    A case of a choroid plexus papilloma of the lateral ventricle that was revealed by a massive intracranial hemorrhage in a 61-year-old man is presented. This patient had an intracranial hemorrhage at the onset. The presence of brain tumor was suspected after a radiologic evaluation using computerized tomography (CT) and angiography; the correctness of this histological diagnosis was confirmed by surgical specimens. Choroid plexus papillomas, rare tumors of neuroectodermal origin, account for 0.5 to 0.6 % of all intracranial tumors. They most frequently appear during the first 2 years of life. A case manifesting intracranial hemorrhage associated with choroid plexus papilloma in an adult is described, with a review of the literature. The importance of adequate radiological investigation is emphasized. (author)

  10. Integrated tumor and germline whole-exome sequencing identifies mutations in MAPK and PI3K pathway genes in an adolescent with rosette-forming glioneuronal tumor of the fourth ventricle

    Science.gov (United States)

    Lin, Frank Y.; Bergstrom, Katie; Person, Richard; Bavle, Abhishek; Ballester, Leomar Y.; Scollon, Sarah; Raesz-Martinez, Robin; Jea, Andrew; Birchansky, Sherri; Wheeler, David A.; Berg, Stacey L.; Chintagumpala, Murali M.; Adesina, Adekunle M.; Eng, Christine; Roy, Angshumoy; Plon, Sharon E.; Parsons, D. Williams

    2016-01-01

    The integration of genome-scale studies such as whole-exome sequencing (WES) into the clinical care of children with cancer has the potential to provide insight into the genetic basis of an individual's cancer with implications for clinical management. This report describes the results of clinical tumor and germline WES for a patient with a rare tumor diagnosis, rosette-forming glioneuronal tumor of the fourth ventricle (RGNT). Three pathogenic gene alterations with implications for clinical care were identified: somatic activating hotspot mutations in FGFR1 (p.N546K) and PIK3CA (p.H1047R) and a germline pathogenic variant in PTPN11 (p.N308S) diagnostic for Noonan syndrome. The molecular landscape of RGNT is not well-described, but these data are consistent with prior observations regarding the importance of the interconnected MAPK and PI3K/AKT/mTOR signaling pathways in this rare tumor. The co-occurrence of FGFR1, PIK3CA, and PTPN11 alterations provides further evidence for consideration of RGNT as a distinct molecular entity from pediatric low-grade gliomas and suggests potential therapeutic strategies for this patient in the event of tumor recurrence as novel agents targeting these pathways enter pediatric clinical trials. Although RGNT has not been definitively linked with cancer predisposition syndromes, two prior cases have been reported in patients with RASopathies (Noonan syndrome and neurofibromatosis type 1 [NF1]), providing an additional link between these tumors and the mitogen-activated protein kinase (MAPK) signaling pathway. In summary, this case provides an example of the potential for genome-scale sequencing technologies to provide insight into the biology of rare tumors and yield both tumor and germline results of potential relevance to patient care. PMID:27626068

  11. A calcified epidermoid cyst within right lateral ventricle: A report of a rare case

    Directory of Open Access Journals (Sweden)

    Ranjan Kumar Sahoo

    2016-01-01

    Full Text Available A young patient reported to neurosurgery outdoor department with symptoms of increased intracranial pressure. Noncontrast computed tomography examination showed a single calcified mass within right lateral ventricle with mild hydrocephalus. Contrast-enhanced magnetic resonance imaging revealed nonenhancing single mass within right lateral ventricle with mild hydrocephalus. Intraventricular calcified choroid papilloma/calcified epidermoid were radiological differentials. The mass was excised, removed from the lateral ventricles and found to be calcified epidermoid on gross and microscopic examination, which is rare.

  12. A calcified epidermoid cyst within right lateral ventricle: A report of a rare case

    OpenAIRE

    Ranjan Kumar Sahoo; Debahuti Mohapatra; Pradipta Tripathy

    2016-01-01

    A young patient reported to neurosurgery outdoor department with symptoms of increased intracranial pressure. Noncontrast computed tomography examination showed a single calcified mass within right lateral ventricle with mild hydrocephalus. Contrast-enhanced magnetic resonance imaging revealed nonenhancing single mass within right lateral ventricle with mild hydrocephalus. Intraventricular calcified choroid papilloma/calcified epidermoid were radiological differentials. The mass was excised, ...

  13. A rare case of retained fourth molar teeth in maxilla and mandible. Case report

    Directory of Open Access Journals (Sweden)

    Rahnama Mansur

    2014-06-01

    Full Text Available The study presents a case of the rarely occurring totally retained fourth molar teeth simultaneously in maxilla and mandible. The appearance of supernumerary teeth is a relatively uncommon dental anomaly and it is rare for patients to have impacted fourth molars in two quadrant. The aim of this work is to describe the presence of unilateral (right fourth molars in the maxilla and the mandible in a young female patient aged 24 years. Orthopantomogram revealed impacted lower third molars but also unerupted unilateral (right upper and lower fourth molars. Before orthodontic treatment, the patient was subsequently admitted for removal of third and fourth impacted upper and lower molars under local anesthesia.

  14. Expanded Endoscopic Transnasal Approach to the Chordoid Glioma of the Third Ventricle : The First Case Ever Reported.

    Science.gov (United States)

    Zeinalizadeh, Mehdi; Sadrehosseini, Seyed Mousa; Tayebi Meybodi, Keyvan; Sharifabadi, Ali Heidari

    2016-11-01

    Chordoid glioma of the third ventricle is a rare and challenging tumor to surgery because of its unique anatomical location and its close juxtaposition to the neurovascular structures and hypothalamus. The authors report a case of chordoid glioma of the third ventricle in a 43-year-old woman, who presented with headache and somnolence. The tumor was approached by endoscopic transnasal technique with a favorable result. Histopathologic examination disclosed a neoplastic tissue composed of eosinophilic epithelioid cells, mucinous, periodic acid Schiff-diastase positive, extracellular matrix, and scattered lymphoplasmacytic infiltrates. The best treatment option remains controversial. Customarily, the surgical route to remove chordoid glioma is transcranial; however, the undersurface of the optic chiasm and optic nerves preclude an adequate surgical visualization. In contrast, an expanded endoscopic transnasal approach provides a direct midline corridor to this region without any brain retraction.

  15. Double Outlet Right Ventricle

    Science.gov (United States)

    ... Right Ventricle Menu Topics Topics FAQs Double Outlet Right Ventricle Double outlet right ventricle (DORV) is a rare form of congenital heart disease. En español Double outlet right ventricle (DORV) is a rare form of congenital ...

  16. Double chambered right ventricle

    International Nuclear Information System (INIS)

    Cho, Chul Koo; Yu, Yun Jeong; Yeon, Kyung Mo; Han, Man Chung

    1983-01-01

    Fourteen cases of double chambered right ventricle were diagnosed angiographically and of these nine cases were confirmed after operation and autopsy at Seoul National University Hospital in recent four years since 1979. The clinical and radiological findings with the emphasis on the cinecardiographic findings were analysed. The summaries of the analysis are as follows: 1. Among 14 cases, 6 cases were male and 8 cases were female. Age distribution was from 4 years to 36 years. 2. In chest x-ray findings, pulmonary vascularity was increased in 8 cases, decreased in 4 cases, and normal in 2 cases. Cardiomegaly was observed in 8 cases and other showed normal heart size. 3. In cinecardiography, 11 cases had interventricular septal defect. Among these 11 cases, VSD located in proximal high pressure chamber was in 2 cases and located in distal low pressure chamber was in 9 cases. 4. The location of aberrant muscle bundle in sinus portion of right ventricle was in 8 cases. In the rest 6 cases, the aberrant muscle bundle was located below the infundibulum of right ventricle. 5. For accurate diagnosis and differential diagnosis with other congenital cardiac anomalies such as Tetralogy of Fallot or isolated pulmonic stenosis, biplane cineangiography and catheterization is an essential procedure

  17. Double chambered right ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Chul Koo; Yu, Yun Jeong; Yeon, Kyung Mo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1983-12-15

    Fourteen cases of double chambered right ventricle were diagnosed angiographically and of these nine cases were confirmed after operation and autopsy at Seoul National University Hospital in recent four years since 1979. The clinical and radiological findings with the emphasis on the cinecardiographic findings were analysed. The summaries of the analysis are as follows: 1. Among 14 cases, 6 cases were male and 8 cases were female. Age distribution was from 4 years to 36 years. 2. In chest x-ray findings, pulmonary vascularity was increased in 8 cases, decreased in 4 cases, and normal in 2 cases. Cardiomegaly was observed in 8 cases and other showed normal heart size. 3. In cinecardiography, 11 cases had interventricular septal defect. Among these 11 cases, VSD located in proximal high pressure chamber was in 2 cases and located in distal low pressure chamber was in 9 cases. 4. The location of aberrant muscle bundle in sinus portion of right ventricle was in 8 cases. In the rest 6 cases, the aberrant muscle bundle was located below the infundibulum of right ventricle. 5. For accurate diagnosis and differential diagnosis with other congenital cardiac anomalies such as Tetralogy of Fallot or isolated pulmonic stenosis, biplane cineangiography and catheterization is an essential procedure.

  18. Diagnosis of masses presenting within the ventricles on computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, B.; Reider-Grosswasser, I.; Valentine, A.

    1983-04-01

    The radiological and clinical features of 90 histologically verified intraventricular masses were reviewed. Computed tomography (CT) and plain X-rays were available in all and angiograms in over half the cases. The localisation, effects on the adjacent brain substance and the presence and degree of hydrocephalus was evident on CT. Two-thirds of colloid cysts presented as pathognomonic anterior third ventricular hyperdense masses and the other third were isodense; an alternative diagnosis should be considered for low density masses in this situation. Plexus papillomas and carcinomas mainly involved the trigone nd body of a lateal ventricle of young children and caused asymmetrical hydrocephalus; the third ventricle was occasionally affected also in children and the fourth ventricle more frequently and usually in adults. Two-thirds were hyper and one-third of mixed or lower density. The meningiomas were dense trigonal tumours of adults generally arising in the choroid plexus, but two tentorial meningiomas passed through the choroidal fissure and caused a predominantly intraventricular mass. Gliomas frequently thickened the septum and generally involved the frontal segments of the lateral ventricles. They may be supplied by perforating as well as by the choroidal arteries, which supply most other vascularised masses within the ventricles. Only 10% of our cases did not fall into one of the former categories; these included low density non-enhancing dermoid or epidermoid tumours and higher density enhancing metastatic or angiomatous masses.

  19. Right Valsalva Sinus Aneurysm Protruding Into the Right Ventricle: A Case Report

    Directory of Open Access Journals (Sweden)

    Ata H. Afshar

    2015-09-01

    Full Text Available A separation between the aortic media and annulus fibrosus causes a rare cardiac abnormality called sinus of Valsalva aneurysm (SVA that may be congenital or acquired. It is more prevalent in the right coronary sinus (65%-85% but it has been seen rarely in non-coronary (10%-30%or Left coronary sinus (<5%. The most common complication is rupture of the Aneurysm. We present an 80-year-old male with expanding right Valsalva sinus aneurysm and protruding into right ventricle. The conventional treatment is surgical repair under cardio-pulmonary bypass or percutaneous catheter closure. The aneurysm was successfully excised surgically under direct guidance of trans-esophageal echocardiography (TEE.

  20. Alveolar rhabdomyosarcoma originating between the fourth and fifth metatarsal--case report and literature review.

    LENUS (Irish Health Repository)

    Bolger, J C

    2010-09-01

    We report a case of alveolar rhabdomyosarcoma arising between the fourth and fifth metatarsal. A 13-year-old boy presented to outpatients with a history of pain and swelling in the lateral aspect of his left forefoot. Plain radiographs and MRI showed a soft tissue mass displacing the fourth metatarsal. Percutaneous biopsy revealed an alveolar rhabdomyosarcoma. Staging scans showed advanced metastatic disease. The patient was treated with chemotherapy. This highly malignant lesion remains challenging to diagnose, and difficult to treat successfully.

  1. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

    Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopatie produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties) as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies). This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopatie, endocardial fibroelastosis, dilated cardiomyopatie, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a history of chronic arterial hypertension and diabetes mellitus, prechordial chest pain and mild dyspnoea. An echocardiogram showed signs of non-compact left ventricle with prominent trabeculations and deep inter-trabecular recesses involving left ventricular apical segment and extending to the lateral and inferior walls. Literature on this topic is reviewed

  2. Syndrome of hypoplasic left ventricle, Description of a clinical case with survival after carrying out of Norwood technique

    International Nuclear Information System (INIS)

    Velasco B, Ana M; Lince V, Rafael; Zapata S, Jorge A and others

    2003-01-01

    A clinical case of a 72 hours newborn patient admitted to the pediatric intensive care unit for reduced cardiac output syndrome showing anuria, metabolic acidosis and respiratory distress, is reported. Mechanical ventilation, inotropic support and continuous prostaglandin e1 infusion were initiated. The echocardiogram showed hypoplasia of the left ventricle. The Norwood procedure stage i under extracorporeal circulation with deep hypothermia and circulatory arrest, was performed at the 6th day of life. During the early postoperative period, the patient developed hypoxaemia and pulmonary hypertension, which improved with controlled hyperventilation and vasodilatation therapy. Other complications were clinical sepsis and abstinence syndrome, which resolved with medical management. The patient was extubated on the sixth postoperative day. Subsequent echocardiograms showed tricuspid valve regurgitation, right ventricular dysfunction with dilation and an organized thrombus in the left atrium. These improved with diuretics, dopamine, milrinone and heparin. The patient was discharged after 32 days of the surgery without signs of congestive heart failure. This case is important, given the high mortality rate of this pathology. The Norwood procedure proved to be a palliative strategy versus the ortotopic cardiac transplant in newborns, because of the difficulty in finding donators at this age and the immunosuppressive therapy complications. This represents a great advance in the Colombian pediatric cardiology because until recent years these patients did not have any other surgical alternative

  3. Single Ventricle Defects

    Science.gov (United States)

    ... and right ventricle are more normal in size, open-heart surgery may help the heart work better. If ... and right ventricle are more normal in size, open-heart surgery may help the heart work better. If ...

  4. Isolated pseudohypoplasia of the right ventricle.

    Science.gov (United States)

    Pastor, Esteban; Aramendi, José I; Luis, Maite; Voces, Roberto; Rodríguez, Miguel A; Galdeano, José M

    2007-08-01

    We present a case of a 12-year-old girl with severe cyanosis due to abnormal moderator band producing a hidden trabecular component of the right ventricle, mimicking isolated hypoplasia of the right ventricle. A marked hypoplasia was confirmed by echocardiography and catheterization. At operation an anomalously thickened moderator band obstructing the apical infundibulum was found. Repair consisted of a section of the moderator band and closure of the atrial septal defect. Postoperatively the right ventricle showed normal dimension and function.

  5. Human case of gastric infection by a fourth larval stage of Pseudoterranova decipiens (Nematoda, Anisakidae

    Directory of Open Access Journals (Sweden)

    Mercado Rubén

    1997-01-01

    Full Text Available Only three cases of human infection by anisakid nematodes have been reported in Chile since 1976. In the present case, an anisakid worm, identified as a fourth-stage Pseudoterranova decipiens larva, was removed with a gastroendoscopic biopsy clipper from the stomach of a 45 year-old man from southern Chile. The patient, who presented acute epigastric pain and a continuous sensation of having an empty stomach, reported having eaten smoked fish. The worm was fixed in 70% ethanol and cleaned in lactophenol for morphological study. The morphometric characteristics of the worm are described and drawn. Anisakid larvae in fish flesh can be killed by freezing or cooking.

  6. Human case of gastric infection by a fourth larval stage of Pseudoterranova decipiens (Nematoda, Anisakidae

    Directory of Open Access Journals (Sweden)

    Rubén Mercado

    1997-04-01

    Full Text Available Only three cases of human infection by anisakid nematodes have been reported in Chile since 1976. In the present case, an anisakid worm, identified as a fourth-stage Pseudoterranova decipiens larva, was removed with a gastroendoscopic biopsy clipper from the stomach of a 45 year-old man from southern Chile. The patient, who presented acute epigastric pain and a continuous sensation of having an empty stomach, reported having eaten smoked fish. The worm was fixed in 70% ethanol and cleaned in lactophenol for morphological study. The morphometric characteristics of the worm are described and drawn. Anisakid larvae in fish flesh can be killed by freezing or cooking.

  7. Colloid cysts of the third ventricle

    International Nuclear Information System (INIS)

    Pina, J.I.; Medrano, J.; Benito, J.L. de; Lasierra, R.; Lopez, S.; Fernandez, J.A.; Villavieja, J.L.

    1994-01-01

    Colloid cysts (CC) are uncommon cystic endo dermal tumors located in the roof of the third ventricle. The clinical features depend on their capacity for obstructing the foramen of Monro, which results in univentricular or biventricular hydrocephalus. We present three cases of colloid cysts of the third ventricle, diagnosed by CT, reviewing their diagnostic, clinical and pathological features

  8. Case Report: Bone fragment in the third ventricle of a 22 year-old woman [v2; ref status: indexed, http://f1000r.es/58h

    Directory of Open Access Journals (Sweden)

    Sunil Munakomi

    2015-03-01

    Full Text Available Here we present a very rare case of a woman with a bone fragment in the third ventricle of the brain following compound-depressed skull fractures due to a road traffic accident. There are only few case reports of bullets and textiloma being removed from the third ventricle. Following operative removal of the fragment, the patient was started on cortisol, mineralocorticoid and thyroid hormone replacement. However, the patient eventually died of the severe traumatic hypothalamic insult.

  9. Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient

    Directory of Open Access Journals (Sweden)

    Christina S. Chen-Milhone

    2018-01-01

    Full Text Available Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.

  10. Case report 868. Congenital bilateral spondylolysis and spondylolisthesis of the fourth cervical vertebra.

    Science.gov (United States)

    Jeyapalan, K; Chavda, S V

    1994-10-01

    A case of congenital bilateral spondylolysis of fourth cervical vertebra was reported and the characteristic radiological features shown. Although the diagnosis is often suggested by the plain films, demonstration of the typical CT findings is often necessary to reach a final diagnosis. Awareness of this entity and its specific radiological features will help to differentiate this relatively benign cervical anomaly from other, more ominous, unstable causes of cervical spondylolisthesis such as those related to acute cervical injury. It may also prevent any inappropriate treatment from being undertaken.

  11. Case report 357: Chordoma of the fourth lumbar vertebra metastasizing to the thoracic spine and ribs

    Energy Technology Data Exchange (ETDEWEB)

    Abdelwahab, I.F.; Zwass, A.; O' Leary, P.F.; Steiner, G.C.

    1986-03-01

    In summary a fascinating case is presented in a 54-year-old man who developed a chordoma of the fourth lumbar vertebra which was treated by radiotherapy, with good results. The man remained asymptomatic relatively for several years and then presented with recurrence of back pain and neurological deficits. Plain films, CT and myelography showed considerable destruction of the body of L4 with a sclerotic pattern suggesting the effects of previous radiotherapy. A large paraspinal tissue mass extending into the spinal canal was present. Most interestingly the patient developed metastatic disease in the thoracic spine and ribs but no metastases other than in the skeleton. (orig./SHA).

  12. Fourth ventricular ependymoma with a distant intraventricular metastasis: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Sudheer Ambekar

    2013-01-01

    Full Text Available Ependymoma is one of the uncommon tumors of the central nervous system (CNS in the adult age group. These tumors have a distinct propensity for metastasis, both within and outside the CNS. However, dissemination at the time of first presentation and retrograde dissemination of the tumor is rare. We report the case of a patient with fourth ventricular anaplastic ependymoma who presented with left lateral ventricular metastasis which was anatomically different from the primary tumor. We describe the clinic-pathological detail of the patient and discuss the probable pathophysiological basis for this rare presentation and its significance in management of the patient.

  13. Unusual case of spindle cell sarcoma metastases to right ventricle: a case report and a literature review.

    Science.gov (United States)

    Frakulli, Rezarta; Cammelli, Silvia; Salvi, Fabrizio; Balestrini, Damiano; Baldissera, Antonella; Degli Esposti, Claudio; Martelli, Ombretta; Abate, Massimo; Piaoli, Anna; Ferrari, Stefano; Morganti, Alessio G; Frezza, Giovanni Piero

    2017-09-01

    Cardiac metastases from sarcoma are uncommon. Due to their rarity there is not a standard of care. However, complete cardiac metastases resection is the best option but most of patients has widespread disease. In these patients palliative radiotherapy (RT) might improve symptoms and prevent further cardiac function decline. Here we present the case of a symptomatic 30-year-old woman with spindle cell sarcoma metastasis of right ventriculum and widespread disease. The patient received radiotherapy to the heart with palliative intent. Cardiac metastases represent a challenging clinic problem. Treatment should be individualized in a multidisciplinary setting, when possible surgery seems to be the best options. However, radiotherapy even in case of widespread disease can improve clinical control symptoms by reducing the mass effect.

  14. [Fourth branchial cleft deformity with skin orifice: a series of 10 cases].

    Science.gov (United States)

    Huang, S L; Zhang, B; Chen, L S; Liang, L; Luo, X N; Lu, Z M; Zhang, S Y

    2016-10-07

    Objective: To report rare cases of congenital neck cutaneous sinus with an orifice near the sternoclavicular joint and to investigate their origins and managements. Methods: A total of ten patients with congenital neck cutaneous sinus having an orifice near the sternoclavicular joint treated in the Guangdong General Hospital from January 2010 to June 2015 were retrospectively analyzed. Results: There four boys and six girls, aging from 11 months to 96 months with an average of 33.4 months, and they had a common feature showing a congenital cutaneous sinus with an orifice near sternoclavicular joint. Discharge of pus from the orifice or abscess formation was commonly seen soon after infection. With bacteriological study, staphylococcus aureus was positive in five cases and klebsiella pneumonia in a case. Another orifice of fistula/sinus was not depicted in pyriform with barium swallow X-ray in five cases Ultrasound studies of three cases demonstrated anechoic (i.e., nearly black) and solid-cystic lesion near sternoclavicular joint with posterior acoustic enhancement. Magnetic resonance imaging (MRI) showed isointensity of the lesion on T1 and T2 weighted images with heterogeneous enhancement and a close relationship with sternoclavicular joint. All patients underwent laryngoscopic examination, which showed no orifice of sinus in pyriform at same side. Surgical resection of fistula/sinus was performed in all cases. The lengths of the fistula varied from 5 mm to 22 mm with an average of 11 mm. Postoperative pathological examination showed all specimens were accordance with fistula. No complications were noticed. Recurrence was not observed in the cases by following-up of 6 months to 70 months (median: 33 months). Conclusion: Congenital neck cutaneous sinus with orifice near the sternoclavicular joint maybe a special clinical phenotype of the fourth branchial cleft sinus with skin orifice in cervicothoracic junction. Differential diagnoses between low cervical diseases

  15. Cervical Mullerian Adenosarcoma with heterologous sarcomatous overgrowth: a fourth case and review of literature

    International Nuclear Information System (INIS)

    Patrelli, Tito Silvio; Gizzo, Salvatore; Di Gangi, Stefania; Guidi, Giorgia; Rondinelli, Mario; Nardelli, Giovanni Battista

    2011-01-01

    Uterine sarcomas are relatively rare tumors that account for approximately 1-3% of female genital tract malignancies and between 4-9% of uterine cancers. Less than 8% of all cases are Mullerian adenosarcoma, a distinctive uterine neoplasm characterized by a benign, but occasionally atypical, epithelial and a malignant, usually low-grade, stromal component, both of which should be integral and neoplastic constituents of the tumor. Mullerian adenosarcoma with sarcomatous overgrowth (MASO) is a very aggressive variant, associated with post-operative recurrence, metastases, even when diagnosed in early stage. We present a fourth MASO case derived from uterine cervix in a 72-year-old woman with metrorrhagia and a polypoid mass protruding through the cervical ostium. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, systematic pelvic lymph node dissection, omental biopsy and appendectomy were performed. Surgery treatment was associated with adjuvant whole-pelvis radiation (45 Gy) and adjuvant chemotherapy (cisplatin/ifosfamide). After nine months of follow up, the patient was free of tumor. The rarity of MASO of the cervix involves a management difficult. Most authors recommend total abdominal hysterectomy, usually accompanied by bilateral salpingo-oophorectomy. There is no common agreement on staging by lymphadenectomy during primary surgery and adjuvant chemo-radio therapy

  16. Magnetic resonance in the dilation of terminal ventricle

    International Nuclear Information System (INIS)

    Eulatem d, R. G.; Martinez, M. E.; Oleaga, L.; Grande, D.

    2001-01-01

    Describe de Magnetic Resonance (MR) findings in four cases of terminal ventricle dilation. We have studied four patients, all of them women, whose mean age range was 39 years. The studies were performed with a 1 Tesla magnet and the sequences used were sagittal and axial T1 and T2 weighted and sagittal and axial T1 weighted after the administration of gadolinium. the follow-up was clinical and by MRI. The four patients studied came due to low back pain. The MRI images demonstrated the presence of a cystic lesion located in the medullary cone, with a well defined contour and one that presented no type of enhancement in the study performed with gadolinium. In three cases, we had a MRI control at two years and the images had not varied. We have no control for the fourth cases of more recent diagnosis. The terminal ventricle is an ependymoma cavity located in the medullary cone. It can present a dilation and it is necessary to know its existence, typical location and signal characteristics to be able to diagnose and differentiate it from cystic tumors in this localization, that can present a similar appearance in the MRI. (Author) 7 refs

  17. Trans aqueductal, third ventricle - Cervical subarachnoid stenting: An adjuvant cerebro spinal fluid diversion procedure in midline posterior fossa tumors with hydrocephalus: The technical note and case series.

    Science.gov (United States)

    Teegala, Ramesh

    2016-01-01

    Persistent or progressive hydrocephalus is one of the complex problems of posterior fossa tumors associated with hydrocephalus. The author evaluated the effectiveness of single-stage tumor decompression associated with a stent technique (trans aqueductal third ventricle - Cervical subarachnoid stenting) as an adjuvant cerebro spinal fluid (CSF) diversion procedure in controlling the midline posterior fossa tumors with hydrocephalus. Prospective clinical case series of 15 patients was evaluated from July 2006 to April 2012. Fifteen clinicoradiological diagnosed cases of midline posterior fossa tumors with hydrocephalus were included in this study. All the tumors were approached through the cerebello medullary (telo velo tonsilar) fissure technique. Following the excision of the posterior fossa tumor, a sizable stent was placed across the aqueduct from the third ventricle to the cervical subarachnoid space. There were nine male and six female patients with an average age of 23 years. Complete tumor excision could be achieved in 12 patients and subtotal excision with clearance of aqueduct in remaining three patients. Hydrocephalus was controlled effectively in all the patients. There were no stent-related complications. This study showed the reliability of single-stage tumor excision followed by placement of aqueductal stent. The success rate of this technique is comparable to those of conventional CSF diversion procedures. This is a simple, safe, and effective procedure for the management of persistent and or progressive hydrocephalus. This technique may be very useful in situations where the patient's follow-up is compromised and the patients who are from a poor economic background. Long-term results need further evaluation to assess the overall functioning of this stent technique.

  18. A closed dorsolateral dislocation of PIP joint of the fourth toe-a case report and review of literature

    Directory of Open Access Journals (Sweden)

    Prof. Giris Kumar Singh

    2009-01-01

    Full Text Available Interphalangeal (IP joint dislocations of the toes are uncommon lesions. We present here a case of closed dorsolateral dislocation of proximal interphalangeal (PIP joint of the fourth toe. Closed reduction and buddy strapping have been done with middle toe for two weeks under digital block. There was painless full range of movement after 2 weeks. We propose that attempt of closed reduction must be given adequately under anesthesia before proceeding for open reduction.

  19. Septum formation of the lateral ventricles

    International Nuclear Information System (INIS)

    Celik, Hakan H.; Aldur, Mustafa M.; Tatar, I.; Tascioglu, A.B.

    2005-01-01

    In an MRI study examining anomalies of the septum pellucidum in 505 cases, we detected bilateral septum formation of the lateral ventricles in a 17-months-old-baby. In this study, we evaluate 505 (242 males and 263 females) patients referred to the Emaray Imaging Center, Ankara, Turkey with various prediagnoses. We specially selected all the cases from a non-psychotic population. We obtained MRI scans on a 1-Tesla imager (Picker International, Highland Heights, Ohio, USA), with slices of 5 and 6 mm thickness. In the axial and coronal sections, we observed septum formation laterally between the anterior horn and the ventricular body of the lateral ventricles. Radio opaque septum formations started from the caudate nucleus and stretched to the genu of the corpus callosum. There was a second septum formation between the posterior horn and the ventricular body of the right lateral ventricle. It started from the caudate nucleus and stretched to the cavum vergae. (author)

  20. A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses.

    Science.gov (United States)

    Nasreldin, Magda H A; Ibrahim, Eman A; Saad El-Din, Somaia A

    2016-01-01

    Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

  1. A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

    Directory of Open Access Journals (Sweden)

    Magda H. A. Nasreldin

    2016-01-01

    Full Text Available Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a clinical diagnosis suggestive of malignant thyroid tumor with metastasis to the cervical lymph nodes. Histopathological examination revealed that it was compatible with third/fourth branchial pouch-derived anomaly composed of mature cartilage and thymic and parathyroid tissues for clinical and radiological correlations.

  2. Isolated Bilateral Fourth Cranial Nerve Palsies as the Presenting Sign of Hydrocephalus

    Directory of Open Access Journals (Sweden)

    Dimosthenis Mantopoulos

    2011-07-01

    Full Text Available Midbrain lesions leading to bilateral fourth nerve palsies are typically accompanied by other brainstem symptomatology. Here we report a case of a 29-year-old man with hydrocephalus and significant third ventricle dilation applying pressure on the dorsal midbrain and having as the only manifestation isolated, bilateral fourth cranial nerve palsies. This finding, reported here for the first time, could be attributed to a partially working ventriculoperitoneal shunt previously placed in this patient, which was able to sporadically relieve the increases of the intraventricular pressure on the midbrain that would normally lead to other manifestations.

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  4. Aortic atresia with normal sized left ventricle

    Directory of Open Access Journals (Sweden)

    Priya Jagia

    2016-01-01

    Full Text Available Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best of our knowledge, use of multi-detector computed tomography in aortic atresia with well developed left ventricle has not been reported in literature till date.

  5. Reversible transinsular herniation of the lateral ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Holodny, Andrei I. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States); Memorial Sloan Kettering Cancer Center, The Department of Radiology, New York, NY (United States); Gor, Devang M.; Thaver, Hussain; Millian, Brian R. [UMDNJ-New Jersey Medical School, Department of Radiology, Newark, NJ (United States)

    2004-11-01

    We present a 7-year-old boy, with a history of neonatal intraventricular hemorrhage, leading to hydrocephalus with multiple shunt revisions. The current presentation of shunt failure and resultant hydrocephalus was complicated by herniation of the trigone of the lateral ventricle into the posterior fossa. Despite the dramatic radiological appearance, this herniation of the lateral ventricle was not accompanied by any additional clinical signs or symptoms other than those usually attributed to hydrocephalus. Following successful shunt revision, the patient returned to his baseline clinically with the trigone reverting back to its normal position. We also present a second companion case. (orig.)

  6. Craniopharyngioma in the third ventricle: necropsy findings and histogenesis.

    Science.gov (United States)

    Kunishio, K; Yamamoto, Y; Sunami, N; Asari, S; Akagi, T; Ohtsuki, Y

    1987-01-01

    A case of craniopharyngioma confined within the third ventricle with necropsy is reported. A stalk-like structure in this tumour was present in the wall of the third ventricle at its base. It is suggested that this tumour might have arisen from the remnants of Rathke's pouch persisting in the tuber cinereum. Images PMID:3655812

  7. Report of an adult with double-outlet right ventricle

    International Nuclear Information System (INIS)

    Munera E, Ana G; Florez C, Marina; Delgado de B, Jorge A and others

    2001-01-01

    The case of a 22 -year- old woman with a diagnosis of congenital heart disease, N Y H A class I, who complaints palpitations. By echocardiography, angiography and magnetic resonance imaging a diagnosis of double-outlet right ventricle was done. She was intervened for correction, creating an interventricular tunnel connecting the left ventricle to the aorta through the ventricular septal defect

  8. Anaplastic ependymoma of the fourth ventricle causing obstrictive ...

    African Journals Online (AJOL)

    An initial insertion of a ventriculo-peritoneal shunt (V-P) to deal with the acute intracranial hypertension was done. Subsequently, sub-occipital craniectomy and sub-total resection of the tumour were performed successfully. Post-operative radiotherapy was also undertaken on the patient. The pertinent literature is reviewed.

  9. A Case Report: A Third/Fourth Branchial Pouch Anomaly Presented by Solid Thyroid and Lateral Cervical Neck Masses

    OpenAIRE

    Magda H. A. Nasreldin; Eman A. Ibrahim; Somaia A. Saad El-Din

    2016-01-01

    Branchial pouch-derived anomalies may arise from remnants of the first, second, or third/fourth branchial arches. Branchial pouch-related structures are found within the thyroid gland in the form of solid cell rests, epithelial lined cyst with or without an associated lymphoid component, thymic and/or parathyroid tissue, and less commonly in the form of heterotopic cartilage. We present a rare case of left solid thyroid swelling nearby two cervical nodules in a seven-year-old female with a cl...

  10. Fourth Ventricular Schwannoma: Identical Clinicopathologic Features as Schwann Cell-Derived Schwannoma with Unique Etiopathologic Origins

    Directory of Open Access Journals (Sweden)

    Tiffany R. Hodges

    2011-01-01

    Full Text Available Background. To our knowledge, this is the sixth reported case in the literature of fourth ventricular schwannoma. The etiology and natural history of intraventricular schwannomas is not well understood. A thorough review of potential etiopathogenic mechanisms is provided in this case report. Case Description. A 69-year-old man presented with an incidentally found fourth ventricular tumor during an evaluation for generalized weakness, gait instability, and memory disturbance. Magnetic resonance imaging (MRI revealed a heterogeneously enhancing lesion in the fourth ventricle. A suboccipital craniotomy was performed to resect the lesion. Histopathological examination confirmed the diagnosis of schwannoma (WHO grade I. Conclusions. Schwannomas should be considered in the differential diagnosis of intraventricular tumors. Although the embryologic origins may be different from nerve sheath-derived schwannomas, the histologic, clinical, and natural history appear identical and thus should be managed similarly.

  11. Radionuclide diagnostics of right ventricle

    International Nuclear Information System (INIS)

    Zaorska-Rajca, J.

    1993-01-01

    Difficulties in evaluating the right ventricle function motivate to making research into new non-invasive methods. Four radionuclide methods that are used to access the right ventricle have been discussed in this paper: first-pass angiocardiography, gated equilibrium ventriculography with red blood cells labelled in vivo technetium- 99 Tc, ventriculography with radioactive xenon 133 and a computerized single probe. Advantages and disadvantages of using each method have been discussed. RNV 99m Tc method has been recognized as the best one to evaluate RV function. Results of the right ventricle assessment in patients have been discussed in the following clinical groups: chronic cor pulmonale (CP), chronic lung disease without pulmonary arterial hypertension (LD), coronary artery disease (CAD), in patients after infarction (IMA and IMi), dilated cardiomyopathy (KZ) and valvular heart diseases (Wm and Wa). Abnormals in right ventricle function occur with different intensity in all groups, although they no specificity. The highest abnormality occurs in patients with KZ, CP, IMi and Wm, the lowest one - in patients with CAD. Abnormalities are higher in patients with congestive heart failure. In most pathological groups the right ventricle dysfunction is connected with the left ventricle insufficiency. The interdependence between the dysfunction of both ventricles is differs in particular diseases. Assessment of right ventricle function with radionuclide methods plays an important role in diagnosis and control therapy of cardiopulmonary diseases. (author). 385 refs, 48 figs, 6 tabs

  12. A fatal and unusual iatrogenic fourth right lumbar artery injury complicating wrong-level hemilaminectomy: a case report and literature review.

    Science.gov (United States)

    Ventura, Francesco; Barranco, Rosario; Bernabei, Carlo; Castelletti, Lara; Castellan, Lucio

    2017-07-07

    The authors describe an unusual case of a fatal iatrogenic fourth lumbar artery injury during left hemilaminectomy in a 38-year-old woman. At autopsy, gross inspection revealed hemoperitoneum with 1,800 ml of free blood and massive retroperitoneal extravasation. A laceration with irregular and jagged margins was detected on the wall of the fourth right lumbar artery. The autopsy and the post-mortem TC investigations demonstrated that wrong-level hemilaminectomy was performed for the herniated disc.

  13. Fourth quantization

    Energy Technology Data Exchange (ETDEWEB)

    Faizal, Mir

    2013-12-18

    In this Letter we will analyze the creation of the multiverse. We will first calculate the wave function for the multiverse using third quantization. Then we will fourth-quantize this theory. We will show that there is no single vacuum state for this theory. Thus, we can end up with a multiverse, even after starting from a vacuum state. This will be used as a possible explanation for the creation of the multiverse. We also analyze the effect of interactions in this fourth-quantized theory.

  14. ACUTE MYOCARDIAL INFARCTION- AN UNUSUAL PRESENTATION OF A MASS IN LEFT VENTRICLE AND RIGHT VENTRICLE

    Directory of Open Access Journals (Sweden)

    Sunil Pisharadi

    2010-11-01

    Full Text Available Acute Myocardial infarction is not a rare finding in patients with a history of carcinoma with second aries. We report a case of a 38-year old man who presented with symptoms of acute MI. The echocardiography showed a rare finding of a mass in both right and left ventricle

  15. Aortic atresia with normal sized left ventricle

    OpenAIRE

    Priya Jagia; Arun Sharma; Saurabh K Gupta; Munish Guleria

    2016-01-01

    Aortic atresia with an associated ventricular septal defect and adequate sized left ventricle is extremely rare. We present two cases in which an alternate diagnosis was suggested on echocardiography because the hypoplastic aortic trunk was missed due to its small caliber. The final diagnosis was, however, clinched on dual source computed tomography, which not only showed the thin aortic trunk but also clearly depicted the coronary artery origins from the hypoplastic aortic root. To the best ...

  16. Coronary artery to left ventricle fistula

    Directory of Open Access Journals (Sweden)

    Kumar Vivek

    2005-11-01

    Full Text Available Abstract Background Coronary cameral fistulas are an uncommon entity, the etiology of which may be congenital or traumatic. They involve abnormal termination of a coronary artery, usually the right coronary, into a cardiac chamber, usually the right ventricle. Case Presentation We describe a case of female patient with severe aortic stenosis and interventricular septal hypertrophy that underwent bioprosthetic aortic valve replacement with concomitant septal myectomy. On subsequent follow-up an abnormal flow traversing the septum into the left ventricle was identified and Doppler interrogation demonstrated a continuous flow, with a predominantly diastolic component, consistent with coronary arterial flow. Conclusion The literature on coronary cameral fistulas is reviewed and the etiology of the diagnostic findings discussed. In our patient, a coronary artery to left ventricle fistula was the most likely explanation secondary to trauma to the septal perforator artery during myectomy. Since the patient was asymptomatic at the time of diagnosis no intervention was recommended and has done well on follow-up.

  17. Bilateral spondylolysis of inferior articular processes of the fourth lumbar vertebra: a case report.

    Science.gov (United States)

    Koakutsu, Tomoaki; Morozumi, Naoki; Hoshikawa, Takeshi; Ogawa, Shinji; Ishii, Yushin; Itoi, Eiji

    2012-03-01

    Lumbar spondylolysis, a well known cause of low back pain, usually affects the pars interarticularis of a lower lumbar vertebra and rarely involves the articular processes. We report a rare case of bilateral spondylolysis of inferior articular processes of L4 vertebra that caused spinal canal stenosis with a significant segmental instability at L4/5 and scoliosis. A 31-year-old male who had suffered from low back pain since he was a teenager presented with numbness of the right lower leg and scoliosis. Plain X-rays revealed bilateral spondylolysis of inferior articular processes of L4, anterolisthesis of the L4 vertebral body, and right lateral wedging of the L4/5 disc with compensatory scoliosis in the cephalad portion of the spine. MR images revealed spinal canal stenosis at the L4/5 disc level. Posterior lumbar interbody fusion of the L4/5 was performed, and his symptoms were relieved.

  18. The ventricles of the brain in the N. American mink (Mustela vison (Brisson, 1756))

    Energy Technology Data Exchange (ETDEWEB)

    Goscicka, D; Stankiewicz, W; Szpinda, M [Akademia Medyczna, Bydgoszcz (Poland)

    1994-12-31

    Using anatomical as well as radiographic and tomographic methods, sixty brains of the N. American mink were examined. It was found that the brain consists of four ventricles. Also, it was noted that the posterior horn was missing and that there was the olfactory recess present in the lateral ventricle, a large-size interthalamic connection present in the third ventricle, and a flat, necklace-like bottom in the fourth ventricle. Only recently, this ins and outs of the mink`s anatomical structure have begun to absorb anatomists. Apparently, it is related to the fact that furry animals, among them the mink, are being domesticated as if ``before our eyes``. For this reason and because of the easy access to material, examining of the brain ventricles in the mink was taken up. (author). 14 refs, 13 figs.

  19. Magnetic resonance in the dilation of terminal ventricle; Resonancia magnetica en la dilatacion del ventriculo terminal

    Energy Technology Data Exchange (ETDEWEB)

    Eulatem d, R. G.; Martinez, M. E.; Oleaga, L.; Grande, D.

    2001-07-01

    Describe de Magnetic Resonance (MR) findings in four cases of terminal ventricle dilation. We have studied four patients, all of them women, whose mean age range was 39 years. The studies were performed with a 1 Tesla magnet and the sequences used were sagittal and axial T1 and T2 weighted and sagittal and axial T1 weighted after the administration of gadolinium. the follow-up was clinical and by MRI. The four patients studied came due to low back pain. The MRI images demonstrated the presence of a cystic lesion located in the medullary cone, with a well defined contour and one that presented no type of enhancement in the study performed with gadolinium. In three cases, we had a MRI control at two years and the images had not varied. We have no control for the fourth cases of more recent diagnosis. The terminal ventricle is an ependymoma cavity located in the medullary cone. It can present a dilation and it is necessary to know its existence, typical location and signal characteristics to be able to diagnose and differentiate it from cystic tumors in this localization, that can present a similar appearance in the MRI. (Author) 7 refs.

  20. Looking Very Old Age in the Eye: A Nuanced Approach to the Fourth Age in Contemporary Irish Fiction: A Case Study.

    Science.gov (United States)

    Zamorano Llena, Carmen

    2018-04-21

    Associations of young-old age with successful aging have contributed to relegating negatively perceived aspects of aging to very old age. This has prompted the formation of the social imaginary of the fourth age. Re-examinations of the fourth age foreground the diversity of aging experiences among the oldest old. In this sense, literature is in a privileged position to contribute individual narratives of aging to this field. The main aim of this article is to analyze Irish writer Jennifer Johnston's later fiction and how particularly two of her later fictional works contribute a nuanced re-examination of the fourth age through the narrativization of individual aging experiences of the oldest old in the contemporary Irish context. The work of sociologists and social theorists on re-examinations of the fourth age functions as the framework to analyze the selected fictional texts. The analysis of the oldest old characters in Truth or Fiction and Naming the Stars shows the contribution of literary texts to rethinking the fourth age as a time characterized by the inextricable combination of gains and losses, with emphasis on the diversity of the aging experiences of the oldest old and on the importance of sociocultural influence on individual aging. Combining longitudinal analyses with case studies, such as the ones suggested by these fictional texts, can provide a more accurate knowledge of the experience of advanced old age and the fourth age.

  1. A study of the global and regional ventricle function using radionuclide ventriculography in the cases of patients with and without KHK under nitrate and placebo

    International Nuclear Information System (INIS)

    Kroth, B.

    1983-01-01

    In a controlled study of 74 patients with coronary heart disease (KHK) or without provable heart disease the ventricle function at rest and under ergonomic load before and after oral administration of nitrates, respectively placebos was studied with the help of radionuclide ventriculography. Radionuclide ventriculography proved itself thereby as a valuable method of high sensitivity for the recognition of KHK. The stress test increases the sensitivity and allows inferences to be made on the extent of the ischemia. The global function at rest is more a parameter for the functional restriction by infarct scars. A quantitative regional evaluation also makes possible the recognition of minor local changes. The additional study after nitrate administration allows a basis for the extent of reversibility in the stress-dependent functional restriction. The effects of a drug therapy become extrinsically presentable as a result of radionuclide ventriculography. (TRV) [de

  2. A Case of High-Grade Neuroendocrine Carcinoma That Improved with Bevacizumab plus Modified FOLFOX6 as the Fourth-Line Chemotherapy

    Directory of Open Access Journals (Sweden)

    Satoshi Takeuchi

    2011-05-01

    Full Text Available High-grade neuroendocrine carcinoma differs from usual neuroendocrine carcinoma, and its prognosis is dismal. In this case report, a case of high-grade neuroendocrine carcinoma that improved with bevacizumab plus modified FOLFOX6 as the fourth-line chemotherapy is presented. A 29-year-old male with a huge liver tumor was diagnosed with high-grade neuroendocrine carcinoma originating from the liver. Multiple liver and bone metastases were found one month after surgery. He was treated with three chemotherapy regimens used for the management of small-cell lung cancer with extensive disease. However, none of them could be maintained because of tumor progression. He was then treated with bevacizumab plus modified FOLFOX6 as the fourth-line regimen. Dramatic tumor shrinkage was obtained, and a partial response was achieved. This case suggests that high-grade neuroendocrine carcinoma can be treated with bevacizumab in combination with cytotoxic chemotherapy.

  3. [Endomyocardial fibrosis with massive calcification of the left ventricle].

    Science.gov (United States)

    Trigo, Joana; Camacho, Ana; Gago, Paula; Candeias, Rui; Santos, Walter; Marques, Nuno; Matos, Pedro; Brandão, Victor; Gomes, Veloso

    2010-03-01

    Endomyocardial fibrosis is a rare disease, endemic in tropical countries. It is characterized by fibrosis of the endocardium that can extend to myocardium. Important calcification of the endocardium is rare with only a few cases reported in the literature. We report a case of endomyocardial fibrosis in a european caucasian patient, associated with massive calcification of left ventricle.

  4. The Effects of the Davis Symbol Mastery System to Assist a Fourth Grader with Dyslexia in Spelling: A Case Report

    Science.gov (United States)

    Amsberry, Gianna; McLaughlin, T. F.; Derby, K. Mark; Waco, Teresa

    2012-01-01

    The purpose of this study was to determine the effectiveness of using the Davis Symbol Mastery Procedure for Words (Davis, 1994) for improving spelling skills. The participant was a fourth-grade male diagnosed with a significant learning disability. The intervention consisted of having the participant write each word, its definition, the word in a…

  5. Ruptured congenital aneurysm of the right sinus of Valsalva into the right ventricle: with special reference to pathoanatomic and hemodynamic characteristics in symptomless cases.

    Science.gov (United States)

    Chen, J J; Lien, W P; Chang, F Z; Lee, Y S; Hung, C R; Chu, S S; Wu, T L

    1980-02-01

    Clinical features of 19 cases with congenital aneurysm of the right sinus of Valsalva rupturing into the right ventricular outflow region (Type 1) were analysed in relation to their pathoanatomic lesions and hemodynamic alterations. Sixteen cases were operated with one surgical death. All were catheterized together with ascending aortographic study. Rupture of the aneurysm in many cases was silent or symptomless and progressive heart failure was not quite common. Symptomatology of the patients did not seem to be related entirely to status of the pathoanatomical lesions or hemodynamic alterations. Time of the rupture, and inherent right ventricular characteristics, tolerating volume overload rather well, might be, in part, responsible for its better prognosis in some cases. However, all patients with ruptured aneurysm of the sinus of Valsalva should be treated surgically. Bacterial endocarditis is a serious complication leading to death.

  6. A study on brain ventricle measurements of normal Korean adults using computed tomography

    International Nuclear Information System (INIS)

    Kim, Ung Jin; Chang, Kee Hyun; Han, Man Chung

    1981-01-01

    The study was undertaken to assess the ventricular system of the brain in normal Korean adults on the base of computed tomography. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed at Seoul National University Hospital, were evaluated. The cerebro- or cerebello-ventricular ratio, between ventricular size and brain parenchyme width, has been known to be reliable indicator of the ventricular size. This ratio was measured at the level of the lateral, third and fourth ventricles respectively. The shape of the quardigeminal and suprasellar cistern was analyzed. The results are as follows: 1. The cerebroventricular ratios of the lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30 ± 0.04 and 0.14 ± 0.02, respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than the right. 2. There was correlation between the cerebroventricular ratio and age, i.e., with increase of age, the C-V ratio increased slightly. 3. The cerebrocventricular ratio of the third ventricle was 0.03 ± 0.01. 4. The cerebroventricular ratio of the fourth ventricle in width and height was 0.14 ± 0.02 and 0.10 ± 0.03, respectively. The anteroposterior position index of the fourth ventricle was 0.42 ± 0.04. 5. The quadrigeminal cistern showed W-shape in 76.6% and U-shaped in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in 10.5%. 7. There was no significant difference between male and female according to the above results

  7. A study on brain ventricle measurement of normal Korean adults using computed tomography

    International Nuclear Information System (INIS)

    Kim, Ung Jin; Chang, Kee Hyun; Han, Man Chung

    1981-01-01

    The study was undertaken to assess the ventricular system of the brain in normal Korean adults on the base of computed tomography. The computerized tomographic examinations of 334 Korean adults between ages of 15 to 50 years, performed at Seoul National University Hospital, were evaluated. The cerebro- or cerebello-ventricular ratio, between ventricular size and brain parenchyme width, has been known to be a reliable indicator of the ventricular size. This ratio was measured at the level of the lateral, third and fourth ventricles respectively. The shape of the quardigeminal and suprasellar cistern was analyzed. The results are as follows: 1. The cerebroventricular ratios of the lateral ventricle at the level of the widest bifrontal and bicaudate diameters were 0.30 ± 0.04 and 0.14 ± 0.02, respectively. The lateral ventricle was asymmetric in 12.6%, of which the left side was usually larger than the right. 2. There was correlation between the cerebroventricular ratio and age, i.e., with increase of age, the C-V ratio increased slightly. 3. The cerebroventricular ratio of the third ventricle was 0.03 ± 0.01. 4. The cerebroventricular ratio of the fourth ventricle in width and height was 0.14± 0.02 and 0.10 ± 0.03, respectively. The anteroposterior position index of the fourth ventricle was 0.42 ± 0.04. 5. The quadrigeminal cistern showed W-shape in 76.6% and U-shape in 23.4%. 6. The suprasellar cistern showed pentagonal shape in 61.1%, round in 28.4% and hexagonal in 10.5%. 7. There was no significant difference between male and female according to the above results

  8. Plate Fixation With Autogenous Calcaneal Dowel Grafting Proximal Fourth and Fifth Metatarsal Fractures: Technique and Case Series.

    Science.gov (United States)

    Seidenstricker, Chad L; Blahous, Edward G; Bouché, Richard T; Saxena, Amol

    Metaphyseal and proximal diaphyseal fractures of the lateral column metatarsals can have problems with healing. In particular, those involving the fifth metatarsal have been associated with a high nonunion rate with nonoperative treatment. Although intramedullary screw fixation results in a high union rate, delayed healing and complications can occur. We describe an innovative technique to treat both acute and chronic injuries involving the metatarsal base from the metaphysis to the proximal diaphyseal bone of the fourth and fifth metatarsals. The surgical technique involves evacuation of sclerotic bone at the fracture site, packing the fracture site with compact cancellous bone, and plate fixation. In our preliminary results, 4 patients displayed 100% radiographic union at a mean of 4.75 (range 4 to 6) weeks with no incidence of refracture, at a mean follow-up point of 3.5 (range 1 to 5) years. The early results with our small series suggest that this technique is a useful treatment choice for metaphyseal and proximal diaphyseal fractures of the fourth and fifth metatarsals. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  9. [A case of rupture of the left ventricle free wall with papillary muscle dysfunction following acute myocardial infarction, operated on successfully].

    Science.gov (United States)

    de Lima, R; Perdigão, C; Neves, L; Cravino, J; Dantas, M; Bordalo, A; Pais, F; Diogo, A N; Ferreira, R; Ribeiro, C

    1990-09-01

    The authors present a case of left ventricular free wall rupture post acute myocardial infarction, associated with mitral papillary posterior muscle necrosis, operated by infartectomy and mitral valvular protesis replacement. They refer the various complications occurred during the hospital staying, and discuss its medical and surgical approach. The patient was discharged alive and six months after the infarction keeps a moderate activity.

  10. Estimating Costs and Benefits Associated with Evidence-Based Violence Prevention: Four Case Studies Based on the Fourth R Program

    Directory of Open Access Journals (Sweden)

    Claire V. Crooks

    2017-05-01

    Full Text Available Teen violence in dating and peer relationships has huge costs to society in numerous areas including health care, social services, the workforce and the justice system. Physical, psychological, and sexual abuse have long-lasting ramifications for the perpetrators as well as the victims, and for the families involved on both sides of that equation. An effective violence prevention program that is part of a school’s curriculum is beneficial not only for teaching teenagers what is appropriate behaviour in a relationship, but also for helping them break the cycle of violence which may have begun at home with their own maltreatment as children. The Fourth R program is an efficacious violence prevention program that was developed in Ontario and has been implemented in schools throughout Canada and the U.S. Covering relationship dynamics common to dating violence as well as substance abuse, peer violence and unsafe sex, the program can be adapted to different cultures and to same-sex relationships. The program, which gets its name from the traditional 3Rs — reading, ’riting and ’rithmetic — offers schools the opportunity to provide effective programming for teens to reduce the likelihood of them using relationship for violence as they move into adulthood. The federal government has estimated that the societal costs of relationship violence amount to more than $7 billion. These costs can continue to be incurred through the legal and health-care systems as the ripple effects of violence play out over the years, even after a relationship has ended. Other types of violence are also costly to society and not just in terms of dollars, but in young lives diverted into criminal activity. Up to 15 per cent of youth who become involved with the justice system grow into serious adult offenders who develop lengthy criminal careers. Yet, research shows that if prevention programs such as the Fourth R can deter just one 14-year-old high-risk juvenile from

  11. Takotsubo, discinesia apical transitoria: Presentacion de 4 casos y revisión de la literatura Takotsubo, reversible apical ballooning of the left ventricle: Report of 4 cases

    Directory of Open Access Journals (Sweden)

    Bárbara C. Finn

    2005-10-01

    Full Text Available En 1990 se describió un síndrome caracterizado por discinesia apical transitoria, cambios en el electrocardiograma (ECG, mínima elevación de enzimas cardíacas y arterias coronarias normales. Se presenta con mayor frecuencia en mujeres añosas y es precedido por un evento de estrés, ya sea físico o psíquico. La fisiopatología aún no está aclarada y se proponen diversas teorías. La de mayor peso es la que postula una afección secundaria a la descarga de catecolaminas desencadenada por el estrés, sobre un corazón incapaz de mantener una respuesta inotrópica adecuada. Se presentan cuatro casos de pacientes atendidos en nuestro hospital que se manifestaron con síntomas sugerentes de infarto agudo de miocardio asociados a insuficiencia cardiaca, en el contexto de un episodio estresante. Los síntomas preponderantes fueron dolor precordial opresivo y disnea. En el ECG se evidenciaron tanto supradesnivel del segmento ST, como inversión de la onda T. Todos los pacientes presentaron la imagen ecocardiográfica típica de discinesia apical, y todos tuvieron en la cinecoronariografía coronarias normales. Cabe destacar que tanto el ECG, como el ecocardiograma volvieron a la normalidad a partir de las dos semanas.A syndrome of apical ballooning, with ECG mimicking acute myocardial infarctation, mild or no enzymatic changes, and normal coronary angiogram was described in 1990. It presents mainly in middle aged and elderly women and it is preceded by stress triggering circumstances. Several mechanisms have been proposed although the precise cause remains unclear. The most accepted theory proposes the interaction of catecholamines and an inadequate inotropic response. We report four cases that presented with chest pain and sudden onset of heart failure, all patients had physical or emotional stress as a triggering factor. On ECG, ST segment elevation and inverted T waves were observed in the acute phase. All patients had typical echocardiogram

  12. Activation delay-induced mechanical dyssynchrony in single-ventricle heart disease

    DEFF Research Database (Denmark)

    Forsha, Daniel; Risum, Niels; Barker, Piers

    2017-01-01

    We present the case of an infant with a single functional ventricle who developed ventricular dysfunction and heart failure due to an electrical activation delay and dyssynchrony. Earlier recognition of this potentially reversible aetiology may have changed her poor outcome.......We present the case of an infant with a single functional ventricle who developed ventricular dysfunction and heart failure due to an electrical activation delay and dyssynchrony. Earlier recognition of this potentially reversible aetiology may have changed her poor outcome....

  13. The Right Ventricle in ARDS.

    Science.gov (United States)

    Zochios, Vasileios; Parhar, Ken; Tunnicliffe, William; Roscoe, Andrew; Gao, Fang

    2017-07-01

    ARDS is associated with poor clinical outcomes, with a pooled mortality rate of approximately 40% despite best standards of care. Current therapeutic strategies are based on improving oxygenation and pulmonary compliance while minimizing ventilator-induced lung injury. It has been demonstrated that relative hypoxemia can be well tolerated, and improvements in oxygenation do not necessarily translate into survival benefit. Cardiac failure, in particular right ventricular dysfunction (RVD), is commonly encountered in moderate to severe ARDS and is reported to be one of the major determinants of mortality. The prevalence rate of echocardiographically evident RVD in ARDS varies across studies, ranging from 22% to 50%. Although there is no definitive causal relationship between RVD and mortality, severe RVD is associated with increased mortality. Factors that can adversely affect RV function include hypoxic pulmonary vasoconstriction, hypercapnia, and invasive ventilation with high driving pressure. It might be expected that early diagnosis of RVD would be of benefit; however, echocardiographic markers (qualitative and quantitative) used to prospectively evaluate the right ventricle in ARDS have not been tested in adequately powered studies. In this review, we examine the prognostic implications and pathophysiology of RVD in ARDS and discuss available diagnostic modalities and treatment options. We aim to identify gaps in knowledge and directions for future research that could potentially improve clinical outcomes in this patient population. Copyright © 2017 American College of Chest Physicians. All rights reserved.

  14. Double-outlet right ventricle revisited.

    Science.gov (United States)

    Ebadi, Ameneh; Spicer, Diane E; Backer, Carl L; Fricker, F Jay; Anderson, Robert H

    2017-08-01

    Double-outlet right ventricle is a form of ventriculoarterial connection. The definition formulated by the International Society for Nomenclature of Paediatric and Congenital Heart Disease is based on hearts with both arterial trunks supported in their greater part by a morphologically right ventricle. Bilateral infundibula and ventricular septal defects are highly debated criteria. This study examines the anatomic controversies surrounding double-outlet right ventricle. We show that hearts with double-outlet right ventricle can have atrioventricular-to-arterial valvular continuity. We emphasize the difference between the interventricular communication and the zone of deficient ventricular septation. The hearts examined were from the University of Florida in Gainesville; Johns Hopkins All Children's Hospital, St Petersburg, Fla; and Lurie Children's Hospital, Chicago, Ill. Each specimen had at least 75% of both arterial roots supported by the morphologically right ventricle, with a total of 100 hearts examined. The morphologic method was used to assess anatomic features, including arterial-atrioventricular valvular continuity, subarterial infundibular musculature, and the location of the hole between the ventricles. Most hearts had fibrous continuity between one of the arterial valves and an atrioventricular valve, with bilateral infundibula in 23%, and intact ventricular septum in 5%. Bilateral infundibula are not a defining feature of double-outlet right ventricle, representing only 23% of the specimens in our sample. The interventricular communication can have a posteroinferior muscular rim or extend to become perimembranous (58%). Double-outlet right ventricle can exist with an intact ventricular septum. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

  15. [Report of a case with Joubert syndrome and literature review].

    Science.gov (United States)

    Yi, Ya-hui; Li, Gang; Lu, Zhong-lie; Zhou, Jian-sheng; Yao, Zhen-wei; Wang, Peng-fei; Yao, Jin-xiang

    2011-12-01

    To explore the clinical feature, imaging and their diagnostic value for Joubert syndrome (JS). The clinical data, imaging feature, and 31 references from China Biomedical literature database (CBMdise) were reviewed and analyzed. The age of onset of 32 patients including male 20 and female 12 ranged from 3 days to 6 years (mean 2.2 years). All the 32 patients with Joubert syndrome showed "slow growth" and "reduced muscle tension", 26 cases (81.3%) showed "gasp for breath", 26 cases (81.3%) showed "unusual motion of eyeball", 2 cases (6.3%) showed additional fingers (toes), 6 cases (18.8%) showed stretching tongue with agape. The typical imaging features of Joubert syndrome included "molar tooth sign", "midline cleavage" between cerebellar hemispheres and "bat-wing" like fourth ventricle, all the 32 patients with Joubert syndrome showed "midline cleavage", "molar tooth sign" was present in 29 cases (90.1%), and "bat-wing" like fourth ventricle in 30 cases (93.8%). Joubert syndrome is a rare congenital brain malformation. The typical clinical manifestations included "gasp for breath", "reduced tension of muscle", "slow growth" and "unusual motion of eyeball", and at the same time the patients had the following typical imaging features of brain: "molar tooth sign", "midline cleavage" and "bat-wing" like fourth ventricle.

  16. Endomyocardial fibrosis associated with massive calcification of the left ventricle

    Directory of Open Access Journals (Sweden)

    Canesin Manoel Fernandes

    1999-01-01

    Full Text Available This is the report of a rare case of endomyocardial fibrosis associated with massive calcification of the left ventricle in a male patient with dyspnea on great exertion, which began 5 years earlier and rapidly evolved. Due to lack of information and the absence of clinical signs that could characterize impairment of other organs, the case was initially managed as a disease with a pulmonary origin. With the evolution of the disease and in the presence of radiological images of heterogeneous opacification in the projection of the left ventricle, the diagnostic hypothesis of endomyocardial disease was established. This hypothesis was later confirmed on chest computed tomography. The patient died on the 16th day of the hospital stay, probably because of lack of myocardial reserve, with clinical findings of refractory heart failure, possibly aggravated by pulmonary infection. This shows that a rare disease such as endomyocardial fibrosis associated with massive calcification of the left ventricle may be suspected on a simple chest X-ray and confirmed by computed tomography.

  17. Colloid cyst of the third cerebral ventricle with an embryological remnant consistent with paraphysis cerebri in an adult human.

    Science.gov (United States)

    Nagaraju, S; O'Donovan, D G; Cross, J; Fernandes, H

    2010-01-01

    The histogenesis of colloid cysts of the third ventricle remains unsettled. Initial theories favored a neuroepithelial (paraphysis, ependyma, choroid plexus) origin and some investigators based on morphologic analysis have offered an alternative endodermal source. We report a case of colloid cyst of the third ventricle arising in association with a remnant which we believe corresponds to the paraphysis cerebri in man.

  18. Anti-Ge3 causes late-onset hemolytic disease of the newborn: the fourth case in three Hispanic families.

    Science.gov (United States)

    Pate, Lisa Lee; Myers, Jessica C; Palma, Jonathan P; Viele, Maurene; Galel, Susan A; Ferrer, Zenaida; Gonzalez, Christopher L; Benitz, William E; Garratty, George; Fontaine, Magali J

    2013-10-01

    The Gerbich (Ge) blood group system consists of 11 antigens carried on red blood cell (RBC) membrane glycophorins C and D; of these, Ge:3 antigen is of high prevalence, and the anti-Ge3 is found to be clinically significant. A 34-week neonate born to a Hispanic mother with anti-Ge3 developed late-onset hemolysis with hyperbilirubinemia and was successfully treated with transfusions from her mother. Relevant clinical findings and laboratory results for this case are summarized and compared to three other previously reported cases; all babies were born from a mother of Hispanic ethnicity. Hemolytic disease of the fetus and new born associated with anti-Ge3 is rare but should be considered when working up a broadly reactive RBC antibody screen in women of Hispanic ethnicity. Early identification of pregnant women with anti-Ge3 is recommended for prenatal transfusion planning and close monitoring of the newborn infant for evidence of late-onset anemia. © 2012 American Association of Blood Banks.

  19. Endoscopic Endonasal Surgery for Purely Intrathird Ventricle Craniopharyngioma.

    Science.gov (United States)

    Nishioka, Hiroshi; Fukuhara, Noriaki; Yamaguchi-Okada, Mitsuo; Yamada, Shozo

    2016-07-01

    Extended endoscopic transsphenoidal surgery (EETS) is a safe and effective treatment for many suprasellar craniopharyngiomas, including those with third-ventricle involvement. Craniopharyngioma entirely within the third ventricle (purely intraventricular type), however, is generally regarded unsuitable for treatment with EETS. Three patients underwent total removal of a purely intraventricular craniopharyngioma with inferior extension via EETS by direct incision of the bulging, stretched ventricular floor and fine dissection from the ventricular wall. In 2 patients with an anteriorly displaced chiasm, the space between the chiasm and pituitary stalk created a wide corridor to the ventricle, whereas in the third case, in which the infrachiasmal space was somewhat narrowed, partial sacrifice of the pituitary gland was necessary to obtain sufficient space. Despite preservation of the stalk in 2 patients, hypopituitarism and diabetes insipidus developed after surgery. There was no other complication including obesity. Selected patients with purely intraventricular craniopharyngioma can be treated effectively and safely with EETS. Those with inferior extension in the interpeduncular fossa and anterior displacement of the chiasm may be suitable candidates. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Selection of permanent pacing position of cardiac ventricle in patients with complete right bundle branch block

    International Nuclear Information System (INIS)

    Yang Minquan; Zhou Jun; Zhu Yan; Wang Jin; Rong Xin; Zhang Xiaoyi

    2005-01-01

    Objective: To find out the optimal pacing localization by comparing different pacing positions of the right ventricle in brady-cardiacarrhythmia patients with complete right bundle branch block. Methods: DDD type of double lumen permanent pacemaker was implanted in each of the 8 cases of sick sinus syndrome (SSS) and/or III degree atrioventricular block (III degree AVB) with complete right bundle branch block in normal heart function or class I. For each patient, four pacing positions in right ventricle were compared and the QRS pacing durations were recorded. The position with the shortest the QRS duration was chosen as the permanent pacing position. Heart function, chest X-rays and left ventricle ejection fraction (LVEF) were followed up after the operation. Results: In all the 8 cases, the posterior septum of the right ventricle were chosen as the permanent pacing position, with the shorter pacing QRS duration than that of pre-operation (P<0.05) and other pacing positions of the right ventricle. All parameters of this permanent pacing position were within the normal range. During the follow-up of 6-36 months, no abnormity was found in cardiac functions. Conclusion: In brady-cardiacarrhythmia patients with complete right bundle branch block, the implantation of permanent pacemaker should be at the junction region of inlet and outlet tracts, of the posterior septum of the right ventricle with ideal physiological function. (authors)

  1. Dynamic change in size of the lateral ventricle evaluated by cine MRI

    International Nuclear Information System (INIS)

    Abe, Toshi

    1990-01-01

    CSF pulsation suggests variation in the size of the cerebral ventricle during the cardiac cycle. CINE MRI, which is a useful technique for observation of the pulsatile CSF flow, demonstrates a dynamic change in size of the lateral ventricle. CINE MRI was performed on a 0.5 tesla MR imaging system (SMT-50, SHIMADZU). Sixteen different phased images during cardiac cycle were made by a gradient acho technique (STAGE: Short Tip Angle Gradient Echo, TE=14 msec, Flip Angle=30deg). From the measurement of the lateral ventricular areas of two different phases of CINE MRI during cadiac cycle, variation rate of cerebral ventricular area (VRCVA) was calculated. Twenty-five normal volunteers (14 younger adults aged 27-44 years, 11 older adults aged 56-73 years) and six cases of marked diffuse cerebral atrophy were studied. The results included: The mean VRCVA of younger adults was 14.4% (at right body of lateral ventricle) ∼ 30.0% (at left anterior horn of lateral ventricle). The mean VRCVA of younger adults is higher than the mean VRCVA of older adults. In the cases of marked diffuse cerebral atrophy, the mean VRCVA was very lower than the mean VRCVA of older adults. VRCVA of lateral ventricle calculated from CINE MRI seemed to have a good relationship to the brain elasticity. This noninvasive method would be used as an indication of the elastic response of the ventricles and the surrounding brain. (J.P.N.)

  2. Ventricle morphology in pelagic elasmobranch fishes.

    Science.gov (United States)

    Emery, S H; Mangano, C; Randazzo, V

    1985-01-01

    Ventricle weights of the warm-bodied great white shark, Atlantic shortfin mako, and the common thresher shark (the latter presumed to be warm-bodied) are similar to those of ectothermic blue sharks, sandbar sharks, dusky sharks, tiger sharks and scalloped hammerhead sharks. Ventricle muscularity, as estimated by the ratio of cortical to spongy layer thickness, is almost twice as great in the former three species than in the latter elasmobranchs. Measurements of ventricular volumes suggest that the ventricles of the great white, Atlantic shortfin mako and common thresher sharks are better adapted to respond to demands for increases in cardiac output via increased heartbeat frequency in comparison with ectothermic species of shark.

  3. Germinoma of the medulla oblongata - A case report.

    Science.gov (United States)

    Budohoski, Karol P; O'Donovan, Dominic G; Harris, Fiona; Santarius, Thomas

    2016-06-01

    We describe a case of primary intracranial medulla oblongata germinoma in a 23-year-old female who presented with deteriorating balance and mobility. Imaging demonstrated an exophytic lesion arising from the dorsal medulla oblongata and extending into the fourth ventricle. The tissue sample was obtained via suboccipital craniotomy and a diagnosis of a primary medullary germinoma was made. The patient underwent whole craniospinal axis radiotherapy and remains well and recurrence-free at 1-year follow up.

  4. Exercises in anatomy: holes between the ventricles.

    Science.gov (United States)

    Anderson, Robert H; Sarwark, Anne E; Spicer, Diane E; Backer, Carl L

    2014-01-01

    Holes between the ventricles are the commonest congenital cardiac malformations. As yet, however, there is no consensus as to how they can best be described and categorized. In this, our third exercise in cardiac anatomy, we address the issue of classification of ventricular septal defects. We begin our demonstration by analysing the normal heart. We show that the larger part of the ventricular septum is made up of its muscular component. The membranous part accounts for only a small portion, which is located centrally within the cardiac base. This small membranous part forms a boundary between the right-sided chambers and the aortic root. Holes at this site, therefore, which account for the commonest defects closed surgically, will open centrally in the cardiac base, being located postero-inferiorly relative to the supraventricular crest. We then show that the larger part of the crest itself is a free-standing muscular sleeve, which lifts the leaflets of the pulmonary valve away from the cardiac base. Only a very small part of the muscle forming the right ventricular outlet is located in the septal position. Turning our attention to malformed hearts, we show how holes between the ventricles can open centrally at the cardiac base, open to the inlet or outlet of the right ventricle or open within the substance of the apical muscular septum. We demonstrate, however, that description of such geographical location of the defects does not paint the full picture, since lesions with markedly different phenotypic features can open in comparable geographic locations. We illustrate how it is the phenotypic features, as seen from the right ventricle, which convey the crucial information for the surgeon with regard to the location of the atrioventricular conduction axis, using hearts with holes opening to the inlet of the right ventricle with muscular as opposed to partially fibrous borders to emphasize this point. We continue by showing how holes with different phenotypes can

  5. The fourth dimension

    CERN Document Server

    Rucker, Rudy

    2014-01-01

    ""This is an invigorating book, a short but spirited slalom for the mind."" - Timothy Ferris, The New York Times Book Review ""Highly readable. One is reminded of the breadth and depth of Hofstadter's Gödel, Escher, Bach."" - Science""Anyone with even a minimal interest in mathematics and fantasy will find The Fourth Dimension informative and mind-dazzling... [Rucker] plunges into spaces above three with a zest and energy that is breathtaking."" - Martin Gardner ""Those who think the fourth dimension is nothing but time should be encouraged to read The Fourth Dimension, along with anyone else

  6. Apoplexy of a pituitary macroadenoma with reversible third, fourth and sixth cranial nerve palsies following administration of hypothalamic releasing hormones: MR features

    International Nuclear Information System (INIS)

    Riedl, Michaela; Clodi, Martin; Kotzmann, Harald; Hainfellner, Johann A.; Schima, Wolfgang; Reitner, Andreas; Czech, Thomas; Luger, Anton

    2000-01-01

    Pituitary apoplexy in patients with pituitary macroadenomas can occur either spontaneously or following various interventions. We present a case of a 71-year-old woman who developed third, fourth, and sixth cranial nerve palsies following administration of the four hypothalamic releasing hormones for routine preoperative testing of pituitary function. The MR examination showed interval tumor growth with impression of the floor of the third ventricle. There were also changes in signal intensity characteristics of the mass, suggestive of intratumoral bleeding. A transsphenoidal surgery with subtotal resection of the pituitary adenoma was performed. Microscopical examination revealed large areas of necrosis and blood surrounded by adenomatous tissue. Third, fourth, and sixth cranial nerve palsies completely resolved within 4 months. We conclude that MR imaging is useful in the demonstration of pituitary apoplexy following preoperative stimulation tests, but we suggest that these tests should be abandoned in patients with pituitary macroadenomas

  7. Apoplexy of a pituitary macroadenoma with reversible third, fourth and sixth cranial nerve palsies following administration of hypothalamic releasing hormones: MR features

    Energy Technology Data Exchange (ETDEWEB)

    Riedl, Michaela E-mail: michaela.riedl@akh-wien.ac.at; Clodi, Martin; Kotzmann, Harald; Hainfellner, Johann A.; Schima, Wolfgang; Reitner, Andreas; Czech, Thomas; Luger, Anton

    2000-10-01

    Pituitary apoplexy in patients with pituitary macroadenomas can occur either spontaneously or following various interventions. We present a case of a 71-year-old woman who developed third, fourth, and sixth cranial nerve palsies following administration of the four hypothalamic releasing hormones for routine preoperative testing of pituitary function. The MR examination showed interval tumor growth with impression of the floor of the third ventricle. There were also changes in signal intensity characteristics of the mass, suggestive of intratumoral bleeding. A transsphenoidal surgery with subtotal resection of the pituitary adenoma was performed. Microscopical examination revealed large areas of necrosis and blood surrounded by adenomatous tissue. Third, fourth, and sixth cranial nerve palsies completely resolved within 4 months. We conclude that MR imaging is useful in the demonstration of pituitary apoplexy following preoperative stimulation tests, but we suggest that these tests should be abandoned in patients with pituitary macroadenomas.

  8. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    NARCIS (Netherlands)

    van Rijn, Rick R.; Bilo, Rob A. C.; Robben, Simon G. F.

    2009-01-01

    BACKGROUND: Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases

  9. The Fourth Revolution

    Science.gov (United States)

    Abelson, Philip H.

    1972-01-01

    Comments on the conclusions of the Carnegie Commission on Higher Education's report, The Fourth Revolution: Instructional Technology in Higher Education,'' and advocates effort in exploiting the new technology and in assessing the possible adverse effects. (AL)

  10. A flexible endoscope-assisted interhemispheric transcallosal approach through the contralateral ventricle for the removal of a third ventricle craniopharyngioma: A technical report.

    Science.gov (United States)

    Yano, Shigetoshi; Hide, Takuichiro; Shinojima, Naoki; Ueda, Yutaka; Kuratsu, Jun-Ichi

    2015-01-01

    Intraventricular craniopharyngiomas are difficult to remove. We combined an interhemispheric transcallosal approach with a flexible endoscope (videoscope) for successful tumor removal. A 52-year-old male complained of general fatigue and memory disturbance. Magnetic resonance imaging revealed a well-enhanced third ventricle mass with dilatation of lateral ventricles. During removal with the interhemispheric transcallosal approach, a videoscope that was inserted into the left lateral ventricle revealed the interface of the tumor and the ventricular wall. The tumor was pushed to the right using forceps and removed totally through the right foramen of Monro without any fornix injury. This procedure is a safe option for removing third ventricular tumors especially in the case with hydrocephalus.

  11. The emerging fourth sector

    OpenAIRE

    Friis, Andreas

    2009-01-01

    The Fourth Sector is a new phenomenon related to dual social and financial value creation, until now not clearly defined with crisp sectoral boundaries and an operationalized definition. The phenomenon is getting increased attention in media, conferences, business schools and by organizations all over the world, and this study intends to explain the macroenvironmental changes that led to the rise of the fourth sector, describe new trends of social value creation in the private ...

  12. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Centre Amsterdam, Department of Radiology, Amsterdam Zuid-Oost (Netherlands); Bilo, Rob A.C. [Netherlands Forensic Institute, Department of Forensic Pathology, Amsterdam (Netherlands); Robben, Simon G.F. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands)

    2009-01-15

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  13. Birth-related mid-posterior rib fractures in neonates: a report of three cases (and a possible fourth case) and a review of the literature

    International Nuclear Information System (INIS)

    Rijn, Rick R. van; Bilo, Rob A.C.; Robben, Simon G.F.

    2009-01-01

    Posterior rib fractures in young children have a high positive predictive value for non-accidental injury (NAI). Combined data of five studies on birth trauma (115,756 live births) showed no cases of rib fractures resulting from birth trauma. There have, however, been sporadic cases reported in the literature. We present three neonates with both posterior rib fractures and ipsilateral clavicular fractures resulting from birth trauma. A review of the literature is also presented. The common denominator and a possible mechanical aetiology are discussed. In total, 13 cases of definitive birth-related posterior rib fractures were identified. Nearly all (9/10) posterior rib fractures were (as far as reported in the original publications) in the midline. In 12 of the 13 children, birth weight was high and in 7 children birth was complicated by shoulder dystocia. An interesting finding was that in cases where a clavicular fracture was present, this was on the ipsilateral side. Radiologists, when presented with a neonate with posterior rib fractures, should be aware of this rare differential diagnosis. (orig.)

  14. Penetrating Stab Wound of the Right Ventricle

    Directory of Open Access Journals (Sweden)

    Onursal Buğra

    2010-04-01

    Full Text Available 18 years old male patient was admitted to our emergency unit with a penetrating stab wound to the right ventricle. A stab wound to the right ventricle was found to be 3 cm in diameter. The bleeding was controlled by insertion of a Foley catheter and inflation of the balloon. The stab wound had transected distal acute marginal side ofthe right coronary artery. A successful repair was performed with the use of a foley catheter and application of the Medtronic Octopus Tissue Stabilization System. The wound was closed with pledgeted mattress sutures. The distal acute marginal side of the right coronary artery was ligated. In this presentation, the surgical intervention method was reported and followed by a discussion of emergency surgical procedures of the heart.

  15. One and a half ventricular repair as an alternative for hypoplastic right ventricle.

    Science.gov (United States)

    Maluf, Miguel Angel; Carvalho, Antonio Carlos; Carvalho, Werther Brunow

    2010-01-01

    Patients with complex congenital heart disease, characterized by right ventricle hypoplasia, had a palliative surgical option with one and a half ventricular repair. From July 2001 to March 2009, nine patients (mean age 5.2 years, range 3 to 9 years) with hypoplastic right ventricle, underwent correction with one and a half ventricle technique. Preoperative diagnoses included: pulmonary atresia with intact ventricular septum, in six and Ebstein's anomaly, in three cases. Six patients had bidirectional cavo-pulmonary shunt (Glenn operation) previously. The surgical approach was performed with cardiopulmonary bypass to correct intracardiac defects: atrial septal defect closure (nine cases); right ventricle outlet tract reconstruction with porcine pulmonary prosthesis (seven cases); tricuspid valvuloplasty (three cases). There was one (11.1%) hospital death. All the patients left the hospital in good clinical conditions. One patient presented pulmonary stenosis at distal prosthesis anastomosis and needed surgical correction. There was one (12.5%) late deaths after reoperation. At mean follow-up of 39.8 months (range 16 months to 8.4 years) seven patients are alive in functional class I (NYHA). Surgical treatment of congenital cardiac anomalies in the presence of a hypoplastic right ventricle by means of one and a half ventricle repair has the advantages of reducing the surgical risk of biventricular repair compared to the Fontan circulation; it maintains a low right atrium pressure, a pulsatile pulmonary blood flow and improves the systemic oxygen saturation with short and medium-term promising results. Longer follow-up is needed to prove the efficacy of such a repair in the long term.

  16. Scintigraphic assessment of double-chambered right ventricle

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Uehara, Toshiisa; Hayashida, Kohei

    1987-01-01

    A double-chambered right ventricle is often clinically misdiagnosed and may be missed even during cardiac catheterization. We encountered a 56-year-old male who had abnormal right ventricular thallium-201 uptake and a photon deficient area in the right ventricle by radionuclide cardioangiography. These findings strongly suggested the existence of anomalous muscle band in the right ventricle. It was demonstrated by contrast angiography that the right ventricle was divided into two chambers by a hypertrophic muscular band; the pressure gradient in the right ventricle was 98 mmHg. (author)

  17. Fourth human parechovirus serotype

    NARCIS (Netherlands)

    Benschop, Kimberley S. M.; Schinkel, Janke; Luken, Manon E.; van den Broek, Peter J. M.; Beersma, Matthias F. C.; Menelik, Negassi; van Eijk, Hetty W. M.; Zaaijer, Hans L.; Vandenbroucke-Grauls, Christina M. J. E.; Beld, Marcel G. H. M.; Wolthers, Katja C.

    2006-01-01

    We identified a novel human parechovirus (HPeV) type (K251176-02) from a neonate with fever. Analysis of the complete genome showed K251176-02 to be a new HPeV genotype. Since K251176-02 could not be neutralized with antibodies against known HPeV serotypes 1-3, it should be classified as a fourth

  18. Objective Ventricle Segmentation in Brain CT with Ischemic Stroke Based on Anatomical Knowledge

    Directory of Open Access Journals (Sweden)

    Xiaohua Qian

    2017-01-01

    Full Text Available Ventricle segmentation is a challenging technique for the development of detection system of ischemic stroke in computed tomography (CT, as ischemic stroke regions are adjacent to the brain ventricle with similar intensity. To address this problem, we developed an objective segmentation system of brain ventricle in CT. The intensity distribution of the ventricle was estimated based on clustering technique, connectivity, and domain knowledge, and the initial ventricle segmentation results were then obtained. To exclude the stroke regions from initial segmentation, a combined segmentation strategy was proposed, which is composed of three different schemes: (1 the largest three-dimensional (3D connected component was considered as the ventricular region; (2 the big stroke areas were removed by the image difference methods based on searching optimal threshold values; (3 the small stroke regions were excluded by the adaptive template algorithm. The proposed method was evaluated on 50 cases of patients with ischemic stroke. The mean Dice, sensitivity, specificity, and root mean squared error were 0.9447, 0.969, 0.998, and 0.219 mm, respectively. This system can offer a desirable performance. Therefore, the proposed system is expected to bring insights into clinic research and the development of detection system of ischemic stroke in CT.

  19. Diagnosis of Non-compacted Myocardium of the Left Ventricle in Children

    Directory of Open Access Journals (Sweden)

    I.B. Yershova

    2014-05-01

    Full Text Available The authors presented a review of published literature data on rare congenital abnormalities in children — a non-compacted myocardium of the left ventricle, which refers to unclassified cardiomyopathy. This pathology by the American Heart Association classification relates to genetic cardiomyopathy. Non-compacted myocardium of the left ventricle in children develops due to violation of myocardial induration of the fetus in utero. Diagnosis of the disease is difficult due to the lack of specific clinical signs. The authors also presented a clinical case of non-compacted left ventricular myocardium in 6-year-old girl.

  20. Single-Ventricle Palliation in a 4-Year-Old With Ehlers-Danlos Syndrome.

    Science.gov (United States)

    DeBoard, Zach M; Eckhauser, Aaron W; Griffiths, Eric

    2018-01-01

    We report the case of a 4-year-old boy with Ehlers-Danlos syndrome undergoing single-ventricle palliation for an unbalanced atrioventricular canal defect. No reports of single-ventricle palliation in the setting of connective tissue disorders exist in the current literature. Unique findings on the patient's preoperative imaging included a disproportionately large neoaortic root and a regurgitant atrioventricular valve, which may foretell the need for future intervention. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Indentation in the Right Ventricle by an Incomplete Pericardium on 3-Dimensional Reconstructed Computed Tomography

    Directory of Open Access Journals (Sweden)

    Hak Ju Kim

    2017-08-01

    Full Text Available We report the case of a 17-year-old girl who presented with an indentation in the right ventricle caused by an incomplete pericardium on preoperative 3-dimensional reconstructed computed tomography. She was to undergo surgery for a partial atrioventricular septal defect and secundum atrial septal defect. Preoperative electrocardiography revealed occasional premature ventricular beats. We found the absence of the left side of the pericardium intraoperatively, and this absence caused strangulation of the diaphragmatic surface of the right ventricle. After correcting the lesion, the patient’s rhythm disturbances improved.

  2. Small atrial septal defect associated with heart failure in an infant with a marginal left ventricle

    Directory of Open Access Journals (Sweden)

    Sandra D.K. Kingma

    2012-07-01

    Full Text Available Atrial septal defect (ASD is usually asymptomatic in infancy, unless pulmonary hypertension or severe co-morbidity is present. We report a case of a 4-week-old infant with moderate- sized ASD, small patent ductus arteriosus (PDA, and a borderline sized left ventricle that developed heart failure. Despite the relatively small diameter of the ASD, this defect influenced the mechanism of heart failure significantly. After surgical closure of both PDA and ASD, the signs of pulmonary hypertension resolved and the patient developed a normal sized left ventricle. This report illustrates that the presence of a small ASD in combination with a marginal left ventricle may result in inadequate left ventricular filling, pulmonary hypertension and heart failure.

  3. Fourth annual report 1991

    International Nuclear Information System (INIS)

    1991-01-01

    The Independent Radiation Monitoring Scheme for Clwyd began its monitoring programme in Clwyd in 1988. This is the fourth report on the results of the radiation monitoring carried out within Clwyd. The historical reasons for the conception of the Radiation Monitoring Scheme are given in the First Annual Report together with the protocol of operation and detailed sampling and monitoring information. The fourth Annual Report identifies any changes in techniques that have occurred in the last twelve months together with the latest monitoring and analytical data. Samples of air, beach materials, coastal sand and silt, seaweed, meat, fish and milk were taken from various locations within the county. No significant charges in radiation levels were found when compared with data from previous years. The values have remained within the range currently being expected throughout the United Kingdom. (author)

  4. Antenatal and postnatal sonographic imaging findings of a single ventricle presenting as double outlet right ventricle with rudimentary left ventricle and single atrium

    Directory of Open Access Journals (Sweden)

    Donboklang Lynser

    2015-11-01

    Full Text Available Congenital heart disease is a major cause of morbidity and mortality. Single ventricle is a rare finding and usually of left ventricular morphology. We present here interesting antenatal and postnatal echocardiographic findings of a baby having a rare single ventricle of right ventricular morphology with double outlet. Antenatally we saw a large ventricular septal defect indistinguishable from a single ventricle with left to right ventricular ratio of 1:1. Postnatally we saw a single ventricle having the outlets for both the main pulmonary artery and aortic root. The left ventricle is collapse with a rudimentary morphology possibly due to changes in hemodynamics after birth and absent of outlet from it.

  5. Neurosurgery. Fourth edition

    International Nuclear Information System (INIS)

    Simon, L.; Thomas, D.G.T.; Clark, W.K.

    1987-01-01

    The Fourth Edition of this volume in the Operative Surgery Series has been considerably revised to accommodate the many changes which have changed the practice of neurosurgery in the past eight years. There have been advances in technology, such as the wider application of CT scanning, in surgical technique, and in the design of new implantable materials. All these developments have substantially affected both the practice of neurosurgery and the prognosis for the patient and are fully reflected in the new edition

  6. Functional assessment of the right ventricle with gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Wadhwa, S.S.; Abbati, D.; Carolan, M.

    2002-01-01

    Full text: Evaluation of right ventricular function can provide valuable information in a variety of cardiac and non-cardiac conditions. Functional assessment of the right ventricle is difficult owing to its anatomy and geometry. We describe a method of assessing right ventricular function using gated myocardial perfusion SPECT. In 20 patients right and left ventricular ejection fractions (RVEF, LVEF) were determined using gated blood pool (GBPS) and gated myocardial perfusion SPECT (GSPECT). To avoid contamination with right atrial activity the two frame method was adopted for gated blood pool data when measuring RVEF. In 9 patients with normal right ventricles, an index of wall thickening for the right ventricle was derived from the peak systolic and diastolic counts in the free wall. There was good linear correlation between the two methods adopted for calculation of LVEF and RVEF. Bland - Airman analysis demonstrated good agreement between the two methods with no specific bias. The mean LVEF was 47.9 +/-12% (GBPS) and 47.3 +/- 12.4 (GSPECT). The mean RVEF was 43.2 +/- 9.6% (GBPS) and 44.2 +/- 8.5% (GSPECT). In both cases the values were significantly different. The mean wall motion index was 35%. There was no correlation between the wall thickness index and ejection fraction however the index was greater in patients with normal right ventricle than in those with reduced RVER Gated SPECT offers an alternative to GBPS for the functional assessment of the right ventricle. Utilising GSPECT will allow the simultaneous assessment of both the right and left ventricles. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  7. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion

    Directory of Open Access Journals (Sweden)

    Shyam Sundar Krishnan

    2015-01-01

    Full Text Available Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8 th cranial nerve (the vestibulo-cochlear nerve followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed.

  8. Fourth ventricular thyrotropin induces satiety and increases body temperature in rats.

    Science.gov (United States)

    Smedh, Ulrika; Scott, Karen A; Moran, Timothy H

    2018-05-01

    Besides its well-known action to stimulate thyroid hormone release, thyrotropin mRNA is expressed within the brain, and thyrotropin and its receptor have been shown to be present in brain areas that control feeding and gastrointestinal function. Here, the hypothesis that thyrotropin acts on receptors in the hindbrain to alter food intake and/or gastric function was tested. Fourth ventricular injections of thyrotropin (0.06, 0.60, and 6.00 µg) were given to rats with chronic intracerebroventricular cannulas aimed at the fourth ventricle. Thyrotropin produced an acute reduction of sucrose intake (30 min). The highest dose of thyrotropin caused inhibition of overnight solid food intake (22 h). In contrast, subcutaneous administration of corresponding thyrotropin doses had no effect on nutrient intake. The highest effective dose of fourth ventricular thyrotropin (6 µg) did not produce a conditioned flavor avoidance in a standardized two-bottle test, nor did it affect water intake or gastric emptying of glucose. Thyrotropin injected in the fourth ventricle produced a small but significant increase in rectal temperature and lowered plasma levels of tri-iodothyronin but did not affect plasma levels of thyroxine. In addition, there was a tendency toward a reduction in blood glucose 2 h after fourth ventricular thyrotropin injection ( P = 0.056). In conclusion, fourth ventricular thyrotropin specifically inhibits food intake, increases core temperature, and lowers plasma levels of tri-iodothyronin but does not affect gastromotor function.

  9. Fourth-rank cosmology

    International Nuclear Information System (INIS)

    Marrakchi, A.E.L.; Tapia, V.

    1992-05-01

    Some cosmological implications of the recently proposed fourth-rank theory of gravitation are studied. The model exhibits the possibility of being free from the horizon and flatness problems at the price of introducing a negative pressure. The field equations we obtain are compatible with k obs =0 and Ω obs t clas approx. 10 20 t Planck approx. 10 -23 s. When interpreted at the light of General Relativity the treatment is shown to be almost equivalent to that of the standard model of cosmology combined with the inflationary scenario. Hence, an interpretation of the negative pressure hypothesis is provided. (author). 8 refs

  10. Computed tomography in the diagnosis of a colloid cyst of the third ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Itoyama, Yohichi; Fukumura, Akinobu; Itoh, Yoshihiro; Saito, Yoshiki; Kuratsu, Jun-ichi; Matsukado, Yasuhiko

    1985-04-01

    A 58-year-old woman came to our hospital on July 19, 1984, with slowly progressive mental retardation, urinary incontinence, and gait disturbance of about six months' duration. Computed tomography (CT) revealed a low-density cyst in the third ventricle, a remarkable dilatation of the lateral ventricles, and P.V.L. The cyst was partially removed, and the V-P-shunt procedure was done. Her neurological complaints were completely relieved. The histological diagnosis was a colloid cyst. Although a colloid cyst is a relatively rare brain tumor, recently reports of the CT diagnosis of colloid cysts have been increasing in number; most of the cases have, though, been an iso- or high-density mass in the third ventricle. We here report an interesting case of a colloid cyst which appeared as a low-density mass in the third ventricle on CT. The colloid cysts, especially findings in the literature regarding the CT findings and the relationship between the density and the contents of the cyst, are reviewed.

  11. A study of acute expired cases with intraventricular hemorrhage

    International Nuclear Information System (INIS)

    Ikeda, Yukio; Higuchi, Hiroshi; Ueda, Kenji; Kobayashi, Shiro; Yajima, Kouzo

    1981-01-01

    Prior to the introduction of the CT scan, the diagnosis of intraventricular hemorrhage (IVH) was very difficult. The CT scan has, though, been recognized to be extremely informative in the evaluation of IVH. During the first three years we have had experience with 91 cases of IVH diagnosed by the CT scan. Acute death within seven days occurred in 42 of these cases. Hypertension was the most common Acute death within seven days occurred in 42 of these cases. Hypertension was the most common etiological factor, accounting for 18 cases. Cerebral aneurysm was the second most common cause, accounting for 10 cases. Head injury was seen in 8 cases, while the causes of 4 deaths were unknown. 31 cases were distributed over all ventricles. 30 cases revealed over two cast formations. The presence of IVH in the third and/or the fourth ventricle, which can easily affect the function of the hypothalamus and the brain stem anatomically, was closely correlated with the high mortality rate. The analysis of the CT findings regarding the mechanisms of IVH reveals three types: the direct type, which bleeds directly into ventricles without forming definite intracerebral hematomas; the extension type, which is characterized by extension and rupture from massive intracerebral hematoma, and the reflux type, which is characterized by a reflux of the subarachnoid blood. The prognosis depends on the differences in these mechanisms. (author)

  12. Thymic cyst: a fourth branchial cleft anomaly.

    Science.gov (United States)

    Nayan, Smriti; MacLean, Jonathan; Sommer, Doron

    2010-01-01

    We report a unique case of a fourth branchial cleft cyst found within the thymus of an adult patient. In the literature to date, there have been no reports of such a finding in the adult population. These anomalies can often cause recurrent acute suppurative thyroiditis or recurrent deep neck abscesses. Delay in recognizing the underlying etiology can lead to significant complications.

  13. Repair of isolated double-chambered right ventricle | El Kouache ...

    African Journals Online (AJOL)

    The finding of a double-chambered right ventricle (DCRV) is exceptionally rare as an isolated anomaly. It is a congenital cardiac anomaly in which the right ventricle is separated into two chambers, a proximal highpressure chamber and a distal low-pressure chamber, by anomalous muscles or fibrous tissues in the right ...

  14. COMPUTER MODELING IN THE DEVELOPMENT OF ARTIFICIAL VENTRICLES OF HEART

    Directory of Open Access Journals (Sweden)

    L. V. Belyaev

    2011-01-01

    Full Text Available In article modern researches of processes of development of artificial ventricles of heart are described. Advanta- ges of application computer (CAD/CAE technologies are shown by development of artificial ventricles of heart. The systems developed with application of the given technologies are submitted. 

  15. [A case report: anomaly of the fourth branchial pouch with recurring cervical abscesses. Cauterization with trichloroacetic acid closed the fistula opening and cured the patient].

    Science.gov (United States)

    Stenquist, Monika; Juhlin, Claes; Aström, Gunnar; Friberg, Ulla

    2003-04-24

    A fourth branchial pouch sinus is a rare congenital anomaly, which in a 13-year-old girl presented clinically as recurrent deep cervical abscesses. The location of the majority of these anomalies is the left side of the neck (90%). Radiological and endoscopic investigations verified the diagnosis. The internal orifice located at the apex of the pyriform sinus could facilitate contamination by infectious pharyngeal secretions and lead to abscess recurrence. Traditionally, the recommended treatment is radical surgery. It can, however, be technically difficult to excise the whole fistula tract. In this patient we used a non-invasive treatment modality; chemocauterization with 40% trichloroacetic acid (TCA). After three treatments the fistula was closed. To date (month no. 15) there has been no abscess recurrence. TCA chemocauterization seems to be a safe first-line treatment for patients with pyriform sinus fistulas.

  16. Automatic short axis orientation of the left ventricle in 3D ultrasound recordings

    Science.gov (United States)

    Pedrosa, João.; Heyde, Brecht; Heeren, Laurens; Engvall, Jan; Zamorano, Jose; Papachristidis, Alexandros; Edvardsen, Thor; Claus, Piet; D'hooge, Jan

    2016-04-01

    The recent advent of three-dimensional echocardiography has led to an increased interest from the scientific community in left ventricle segmentation frameworks for cardiac volume and function assessment. An automatic orientation of the segmented left ventricular mesh is an important step to obtain a point-to-point correspondence between the mesh and the cardiac anatomy. Furthermore, this would allow for an automatic division of the left ventricle into the standard 17 segments and, thus, fully automatic per-segment analysis, e.g. regional strain assessment. In this work, a method for fully automatic short axis orientation of the segmented left ventricle is presented. The proposed framework aims at detecting the inferior right ventricular insertion point. 211 three-dimensional echocardiographic images were used to validate this framework by comparison to manual annotation of the inferior right ventricular insertion point. A mean unsigned error of 8, 05° +/- 18, 50° was found, whereas the mean signed error was 1, 09°. Large deviations between the manual and automatic annotations (> 30°) only occurred in 3, 79% of cases. The average computation time was 666ms in a non-optimized MATLAB environment, which potentiates real-time application. In conclusion, a successful automatic real-time method for orientation of the segmented left ventricle is proposed.

  17. Obstrução da via de saída de ventrículo esquerdo por prótese mitral: apresentação de seis casos Obstruction of the left ventricle outlet by mitral valve prosthesis: report of six cases

    Directory of Open Access Journals (Sweden)

    Pablo M. A Pomerantzeff

    1990-08-01

    Full Text Available De janeiro de 1982 a março de 1984, foram implantadas 170 biopróteses de pericárdio bovino e alto perfil, no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com mortalidade hospitalar de 7,1%. Através do estudo anatomopatológico, foram identificados cinco casos em que ocorreu obstrução da via de saída do ventrículo esquerdo após substituição da valva mitral. Com base nessa experiência, a indicação de estudo hemodinâmico no 1º dia de pós-operatório em paciente em baixo débito, sem explicação, possibilitou identificar obstrução da via de saída do ventrículo esquerdo, com retroca valvar e boa evolução. Neste trabalho, são relatados detalhadamente os seis casos e discutidas as causas da obstrução da via de saída na substituição mitral.From January/1982 to March/1984, 170 high profile bovine pericardium bioprostheses were implanted in the INCOR (Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP. Hospital mortality amongst these patients was 7.1%. Anatomopathological studies identified five cases in which obstruction of the left ventricle outlet occurred after substitution of the mitral valve. Based on this experience, the indication of a hemodynamic study on the first postoperative day of a patient with an unexplained low cardiac output made it possible to identify obstruction of the left ventricle valve outlet in such patients, with resubstitution of the valve and a satisfactory evolution of the case. In this report we relate the six cases in detail and discuss the causes of the obstruction of the outlet in mitral valve substitutions.

  18. Case Studies for Management Development in Bangladesh. Fourth Book. Parepared for the World Bank/Bangladesh Management Education and Training Project.

    Science.gov (United States)

    McLean, Gary N.

    This document contains five case studies of management and finance situations in Bangladesh, which are intended to foster classroom discussion and thereby advance management development in that country. One to four discussion questions follow each case study. The titles and authors of the case studies on management are: "Azir Ahmed & Co.,…

  19. Endoscopic Removal of a Bullet That Migrated to the Third Ventricle Causing Hydrocephalus.

    Science.gov (United States)

    Aydoseli, Aydın; Unal, Tugrul Cem; Aras, Yavuz; Sabanci, Pulat Akın; Altunrende, Emre; Izgi, Nail

    2017-09-01

    Hydrocephalus caused by an intraventricular bullet is a rare event. We report a case of endoscopic removal of an intraventricular bullet. A 66-year-old man was admitted with a gunshot wound to the head after a suicide attempt. The bullet migrated from the frontal parenchyma to the third ventricle day 4 of admission. On day 21 of admission, the patient developed hydrocephalus with obstruction of the cerebral aqueduct. The bullet was accessed through an endoscopic third ventriculostomy and removed using an endoscope. Hydrocephalus may develop in patients with intraventricular foreign objects. When such objects must be removed, the endoscopic approach is a safe, efficient, and minimally invasive procedure. To our knowledge, this is the first case in the literature of foreign object removal from the ventricle via a transcortical endoscopic approach. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Endoscopic biopsy of foramen of Monro and third ventricle lesions guided by frameless neuronavigation: usefulness and limitations.

    Science.gov (United States)

    Prat, Ricardo; Galeano, Inmaculada

    2009-09-01

    To describe our institution experience regarding the usefulness and limitations of frameless neuronavigation in the endoscopic biopsy of foramen of Monro and third ventricle lesions. We report our experience with 22 patients harbouring intraventricular lesions located in the region of the foramen of Monro or the third ventricle who underwent endoscopic biopsy guided by the neuronavigation system. Nine lesions were located on the posterior aspect of the third ventricle or at the pineal region, and thirteen lesions were located at the foramen of Monro or anterior third ventricle region. The endoscopes were introduced via an operating sheath, which had previously been inserted with a trocar under neuronavigational control. After approaching the foramen of Monro from the planned angle, surgery was continued under direct visualisation until the lesion was reached, if it was located on the third ventricle. In cases where the lesion was located at the foramen of Monro, an excellent view of the lesion was obtained and neuronavigation was used to determine the location of critical areas. Histological examination of biopsy specimens obtained endoscopically was diagnostic in all cases. Open surgery following endoscopic biopsy was only needed in 1 patient out of 22. In our experience, image-guided neuroendoscopy can improve the accuracy of the endoscopic approach, minimising brain trauma. It can be particularly helpful when performing a brain biopsy in the absence of clear intraventricular landmarks or in the event of adverse visual conditions such as intraventricular bleeding.

  1. Synchronized multiple regression of diagnostic radiation-induced rather than spontaneous: disseminated primary intracranial germinoma in a woman: a case report

    Directory of Open Access Journals (Sweden)

    Natsumeda Manabu

    2011-01-01

    Full Text Available Abstract Introduction Examples of the spontaneous regression of primary intracranial germinomas can be found in the literature. We present the case of a patient with disseminated lesions of primary intracranial germinoma which synchronously shrunk following diagnostic irradiation. We will discuss whether this regression was spontaneous or radiation-induced. Case presentation A 43-year-old Japanese woman presented to our hospital complaining of memory problems over a period of one year and blurred vision over a period of three months. Following magnetic resonance imaging, she was found to have a massive lesion in the third ventricle and small lesions in the pineal region, fourth ventricle, and in the anterior horn of the left lateral ventricle. Prior to an open biopsy to confirm the pathology of the lesions, she underwent a single cranial computed tomography scan and a single cranial digital subtraction angiography for a transcranial biopsy. Fourteen days after the first magnetic resonance image - 12 and eight days after the computed tomography scan and digital subtraction angiography, respectively - a pre-operative magnetic resonance image was taken, which showed a notable synchronous shrinkage of the third ventricle tumor, as well as shrinkage of the lesions in the pineal region and in the fourth ventricle. She did not undergo steroid administration until after a biopsy that confirmed the pathological diagnosis of pure germinoma. She then underwent whole craniospinal irradiation and went into a complete remission. Conclusions In our case report, we state that diagnostic radiation can induce the regression of germinomas; this is the most reasonable explanation for the synchronous multiple regression observed in this case of germinoma. Clinicians should keep this non-spontaneous regression in mind and monitor germinoma lesions with minimal exposure to diagnostic radiation before diagnostic confirmation, and also before radiation treatment with or

  2. Fourth Generation Reactor Concepts

    International Nuclear Information System (INIS)

    Furtek, A.

    2008-01-01

    Concerns over energy resources availability, climate changes and energy supply security suggest an important role for nuclear energy in future energy supplies. So far nuclear energy evolved through three generations and is still evolving into new generation that is now being extensively studied. Nuclear Power Plants are producing 16% of the world's electricity. Today the world is moving towards hydrogen economy. Nuclear technologies can provide energy to dissociate water into oxygen and hydrogen and to production of synthetic fuel from coal gasification. The introduction of breeder reactors would turn nuclear energy from depletable energy supply into an unlimited supply. From the early beginnings of nuclear energy in the 1940s to the present, three generations of nuclear power reactors have been developed: First generation reactors: introduced during the period 1950-1970. Second generation: includes commercial power reactors built during 1970-1990 (PWR, BWR, Candu, Russian RBMK and VVER). Third generation: started being deployed in the 1990s and is composed of Advanced LWR (ALWR), Advanced BWR (ABWR) and Passive AP600 to be deployed in 2010-2030. Future advances of the nuclear technology designs can broaden opportunities for use of nuclear energy. The fourth generation reactors are expected to be deployed by 2030 in time to replace ageing reactors built in the 1970s and 1980s. The new reactors are to be designed with a view of the following objectives: economic competitiveness, enhanced safety, minimal radioactive waste production, proliferation resistance. The Generation IV International Forum (GIF) was established in January 2000 to investigate innovative nuclear energy system concepts. GIF members include Argentina, Brazil, Canada, Euratom, France Japan, South Africa, South Korea, Switzerland, United Kingdom and United States with the IAEA and OECD's NEA as permanent observers. China and Russia are expected to join the GIF initiative. The following six systems

  3. Embolization of an iodine-125 radioactive seed from the prostate gland into the right ventricle: An unusual pattern of seed migration

    International Nuclear Information System (INIS)

    Schild, Michael H.; Wong, William W.; Vora, Sujay A.; Ward, Lynn D.; Nguyen, Ba D.

    2009-01-01

    Transperineal permanent brachytherapy using iodine-125 or palladium-103 seeds is a standard treatment modality for localized prostate cancer. Migration of seeds to the lungs is a common phenomenon, whereas migration of seeds to the right ventricle is a rare event. We report a case of iodine-125 seed migration to the right ventricle as demonstrated by chest CT scan and add to the very few published reports on this finding. These rare patients did not suffer adverse effects from such event.

  4. The Emergence of a Fourth Type of Public Forum: Is the Quasi-Nonpublic Forum a New Paradigm for Student Free Speech Cases?

    Science.gov (United States)

    Lugg, Elizabeth T.; Paterson, Frances R. A.

    This paper is a presentation, in outline form, of the development of the "quasi-nonpublic forum," where cases involving student free speech push the envelope of what is acceptable under Constitutional law and what is appropriate/acceptable student behavior under constraints set by school regulations. Context is set by presenting court…

  5. Level of matrix metalloproteinase-9 and myocardium remodeling in patients with acute postinfarction aneurism of left ventricle

    Directory of Open Access Journals (Sweden)

    V. D. Syvolap

    2013-12-01

    Full Text Available 67 patients with diagnosis: Q-wave myocardial infarction – were examined. Level of matrix metalloproteinase-9, structural and functional indexes of myocardium remodeling were studied in patients with acute postinfarction aneurism of left ventricle. Early predictors of left ventricle aneurism formation were revealed in patients with acute Q-wave myocardial infarction. Abstract Background. Problem of acute myocardial infarction till nowadays remains relevant, because it’s one of the leading causes of mortality, morbidity and disability in most developed countries. Severity of postinfarction remodeling is a factor that determines the degree of myocardial dysfunction and prognosis of survival. During the first few days after the onset of AMI disproportionately thinned and stretched infarcted area, which is no longer able to resist to intraventricular pressure, which subsequently leads to an expansion of a heart attack until the formation of an aneurysm or heart failure. In this case, the structural and functional changes in the heart muscle affects both the affected and intact areas of the myocardium , marked by the passage of the phase of adaptive and maladaptive processes. Mechanisms of postinfarction remodeling caused by the interaction of cell as well as extracellular factors, starting immediately after coronary artery occlusion with the normal degradation of the extracellular matrix , migration of inflammatory cells to the site of damage and induction of biologically active peptides. In recent studies there was a high expression of MMP -9 in patients with acute coronary syndrome, showing the value of its serum concentration as a marker of inflammation, a predictor of restenosis and cardiovascular mortality in patients with coronary heart disease. This gives reason to explore the prognostic value of early detection of the level of MMP -9 in myocardial infarction as a marker of adverse postinfarction remodeling. Methods. Sixty seven patients

  6. Fourth Light at Paranal!

    Science.gov (United States)

    2000-09-01

    VLT YEPUN Joins ANTU, KUEYEN and MELIPAL It was a historical moment last night (September 3 - 4, 2000) in the VLT Control Room at the Paranal Observatory , after nearly 15 years of hard work. Finally, four teams of astronomers and engineers were sitting at the terminals - and each team with access to an 8.2-m telescope! From now on, the powerful "Paranal Quartet" will be observing night after night, with a combined mirror surface of more than 210 m 2. And beginning next year, some of them will be linked to form part of the unique VLT Interferometer with unparalleled sensitivity and image sharpness. YEPUN "First Light" Early in the evening, the fourth 8.2-m Unit Telescope, YEPUN , was pointed to the sky for the first time and successfully achieved "First Light". Following a few technical exposures, a series of "first light" photos was made of several astronomical objects with the VLT Test Camera. This instrument was also used for the three previous "First Light" events for ANTU ( May 1998 ), KUEYEN ( March 1999 ) and MELIPAL ( January 2000 ). These images served to evaluate provisionally the performance of the new telescope, mainly in terms of mechanical and optical quality. The ESO staff were very pleased with the results and pronounced YEPUN fit for the subsequent commissioning phase. When the name YEPUN was first given to the fourth VLT Unit Telescope, it was supposed to mean "Sirius" in the Mapuche language. However, doubts have since arisen about this translation and a detailed investigation now indicates that the correct meaning is "Venus" (as the Evening Star). For a detailed explanation, please consult the essay On the Meaning of "YEPUN" , now available at the ESO website. The first images At 21:39 hrs local time (01:39 UT), YEPUN was turned to point in the direction of a dense Milky Way field, near the border between the constellations Sagitta (The Arrow) and Aquila (The Eagle). A guide star was acquired and the active optics system quickly optimized the

  7. 3D MR ventricle segmentation in pre-term infants with post-hemorrhagic ventricle dilation

    Science.gov (United States)

    Qiu, Wu; Yuan, Jing; Kishimoto, Jessica; Chen, Yimin; de Ribaupierre, Sandrine; Chiu, Bernard; Fenster, Aaron

    2015-03-01

    Intraventricular hemorrhage (IVH) or bleed within the brain is a common condition among pre-term infants that occurs in very low birth weight preterm neonates. The prognosis is further worsened by the development of progressive ventricular dilatation, i.e., post-hemorrhagic ventricle dilation (PHVD), which occurs in 10-30% of IVH patients. In practice, predicting PHVD accurately and determining if that specific patient with ventricular dilatation requires the ability to measure accurately ventricular volume. While monitoring of PHVD in infants is typically done by repeated US and not MRI, once the patient has been treated, the follow-up over the lifetime of the patient is done by MRI. While manual segmentation is still seen as a gold standard, it is extremely time consuming, and therefore not feasible in a clinical context, and it also has a large inter- and intra-observer variability. This paper proposes a segmentation algorithm to extract the cerebral ventricles from 3D T1- weighted MR images of pre-term infants with PHVD. The proposed segmentation algorithm makes use of the convex optimization technique combined with the learned priors of image intensities and label probabilistic map, which is built from a multi-atlas registration scheme. The leave-one-out cross validation using 7 PHVD patient T1 weighted MR images showed that the proposed method yielded a mean DSC of 89.7% +/- 4.2%, a MAD of 2.6 +/- 1.1 mm, a MAXD of 17.8 +/- 6.2 mm, and a VD of 11.6% +/- 5.9%, suggesting a good agreement with manual segmentations.

  8. Colloid cyst of the third ventricle, hypothalamus, and heart: a dangerous link for sudden death

    Directory of Open Access Journals (Sweden)

    Turillazzi Emanuela

    2012-10-01

    Full Text Available Abstract Colloid cysts are rare congenital, intracranial neoplasms, commonly located in the third ventricle. Colloid cysts are endodermal congenital malformations. The cysts commonly range in size from 1–2 cm in diameter, although large cysts >3 cm in size have been reported. The components of the cyst include an outer fibrous capsule over an inner epithelium. The epithelium is usually a single layer of mucin-producing or ciliated cells. Such cysts contain mucoid and gelatinous material, which is positive for both Periodic acid Schiff (PAS and mucicarmen staining. Although colloid cysts usually represent histopathologically benign neoplasms, they can result in sudden, unexpected and potentially lethal complications. The mechanism(s of death is still a controversial subject and several mechanisms have been postulated to explain the sudden onset of severe symptoms and of fatal rapid deterioration in patients with colloid cysts. In this case, macroscopic and histological findings addressed the diagnosis of colloid cyst of the third ventricle with diffuse myocardial injury (coagulative myocytolysis or contraction band necrosis, CBN and led us to conclude that acute cardiac arrest due to hypothalamus stimulation in the context of colloid cyst of the third ventricle was the cause of death. As the hypothalamic structures which are involved in neuroendocrine and autonomic regulation playing a key role in cardiovascular control are located close to the walls of the third ventricle which is the most frequent anatomical site of colloid cyst, this may suggest that reflex cardiac effects due to the compression of the hypothalamic cardiovascular regulatory centers by the cyst explain the sudden death in patients harboring a colloid cyst when signs of hydrocephalus or brain herniation are lacking. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4915842848034158

  9. Ventrículo izquierdo no compacto/ventrículo izquierdo hipertrabeculado Non-compact left ventricle/hypertrabeculated left ventricle

    Directory of Open Access Journals (Sweden)

    Gustavo Restrepo

    2005-06-01

    Full Text Available El ventrículo izquierdo no compacto/ventrículo izquierdo hipertrabeculado, es un tipo de miocardiopatía que se produce por el cese del proceso de compactación normal del ventrículo izquierdo durante la embriogénesis temprana. Se asocia con anormalidades cardiacas (cardiopatías congénitas y extracardiacas (alteraciones neurológicas, faciales, hematológicas, cutáneas, esqueléticas y endocrinológicas. Esta entidad con frecuencia pasa desapercibida y usualmente sólo se detecta en centros médicos con experiencia en el diagnóstico y tratamiento de pacientes con miocardiopatías. Muchos casos de ventrículo izquierdo no compacto se han confundido inicialmente con diagnósticos de miocardiopatía hipertrófica, fibroelastosis endocárdica, miocardiopatía dilatada, miocardiopatía restrictiva y fibrosis endocárdica. Se presenta el caso de un paciente de 74 años, con historia de hipertensión arterial crónica y diabetes mellitus, dolor precordial y disnea leve, a quien durante un examen ecocardiográfico se le encontraron signos de miocardiopatía del tipo ventrículo izquierdo no compacto. Además, se hace una revisión de la literatura que existe acerca de esta entidad.Non-compact left ventricle/hypertrabeculated left ventricle is a myocardiopathy produced by an arrest of the normal left ventricular compaction process during the early embryogenesis. It is associated to cardiac anomalies (congenital cardiopaties as well as to extracardial conditions (neurological, facial, hematologic, cutaneous, skeletal and endocrinological anomalies. This entity is frequently unnoticed, being diagnosed only in centers with great experience in the diagnosis and treatment of myocardiopathies. Many cases of non-compact left ventricle have been initially misdiagnosed as hypertrophic myocardiopathy, endocardial fibroelastosis, dilated cardiomyopathy, restrictive cardiomyopathy and endocardial fibrosis. It is reported the case of a 74 years old man with a

  10. Bilateral primary adrenal lymphoma with central nervous system involvement: a case report

    International Nuclear Information System (INIS)

    Nacif, Marcelo Souto; Heizer, Marcia; Nahime, Carolina Benvegnu; Santos, Alair Augusto Sarmet Moreira Damas dos

    2005-01-01

    The authors review the main findings of primary adrenal lymphoma on abdominal and brain computed tomography (CT) scans and brain magnetic resonance imaging (MRI), and report a rare case of a 72-year-old male patient with deterioration in mental status progressing from recent memory loss to disorientation and ultimately dementia in a period of two months. The patient was investigated using imaging methods including brain (without intravenous administration of iodinated contrast media), chest and abdomen (pre and post intravenous administration of iodinated contrast media) CT scans and brain MRI (pre and post intravenous administration of gadolinium). Brain CT scan showed slightly hyperdense nodules adjacent to the lateral ventricles. No gross abnormalities were seen on the chest CT scan. CT of the abdomen showed solid nodules on both adrenals. Brain MRI showed diffuse nodular enhancement of the ependyma of the fourth ventricle, third ventricle, frontal and temporal horns, atria and body of the lateral ventricles. Definitive diagnosis was made by immunohistochemical study of the biopsed adrenal. After a comprehensive review of the literature the authors concluded that CT and MRI are essential methods for the detection and accurate evaluation of primary adrenal lymphomas, particularly when there is involvement of the central nervous system. MRI is more sensitive in the detection of extracerebral lesions in the epidural and subdural spaces, especially after intravenous administration of gadolinium. (author)

  11. Ventricular assist device use in single ventricle congenital heart disease.

    Science.gov (United States)

    Carlo, Waldemar F; Villa, Chet R; Lal, Ashwin K; Morales, David L

    2017-11-01

    As VAD have become an effective therapy for end-stage heart failure, their application in congenital heart disease has increased. Single ventricle congenital heart disease introduces unique physiologic challenges for VAD use. However, with regard to the mixed clinical results presented within this review, we suggest that patient selection, timing of implant, and center experience are all important contributors to outcome. This review focuses on the published experience of VAD use in single ventricle patients and details physiologic challenges and novel approaches in this growing pediatric and adult population. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Fibrosis-Related Gene Expression in Single Ventricle Heart Disease.

    Science.gov (United States)

    Nakano, Stephanie J; Siomos, Austine K; Garcia, Anastacia M; Nguyen, Hieu; SooHoo, Megan; Galambos, Csaba; Nunley, Karin; Stauffer, Brian L; Sucharov, Carmen C; Miyamoto, Shelley D

    2017-12-01

    To evaluate fibrosis and fibrosis-related gene expression in the myocardium of pediatric subjects with single ventricle with right ventricular failure. Real-time quantitative polymerase chain reaction was performed on explanted right ventricular myocardium of pediatric subjects with single ventricle disease and controls with nonfailing heart disease. Subjects were divided into 3 groups: single ventricle failing (right ventricular failure before or after stage I palliation), single ventricle nonfailing (infants listed for primary transplantation with normal right ventricular function), and stage III (Fontan or right ventricular failure after stage III). To evaluate subjects of similar age and right ventricular volume loading, single ventricle disease with failure was compared with single ventricle without failure and stage III was compared with nonfailing right ventricular disease. Histologic fibrosis was assessed in all hearts. Mann-Whitney tests were performed to identify differences in gene expression. Collagen (Col1α, Col3) expression is decreased in single ventricle congenital heart disease with failure compared with nonfailing single ventricle congenital heart disease (P = .019 and P = .035, respectively), and is equivalent in stage III compared with nonfailing right ventricular heart disease. Tissue inhibitors of metalloproteinase (TIMP-1, TIMP-3, and TIMP-4) are downregulated in stage III compared with nonfailing right ventricular heart disease (P = .0047, P = .013 and P = .013, respectively). Matrix metalloproteinases (MMP-2, MMP-9) are similar between nonfailing single ventricular heart disease and failing single ventricular heart disease, and between stage III heart disease and nonfailing right ventricular heart disease. There is no difference in the prevalence of right ventricular fibrosis by histology in subjects with single ventricular failure heart disease with right ventricular failure (18%) compared with those with normal right

  13. Fourth sound of holographic superfluids

    International Nuclear Information System (INIS)

    Yarom, Amos

    2009-01-01

    We compute fourth sound for superfluids dual to a charged scalar and a gauge field in an AdS 4 background. For holographic superfluids with condensates that have a large scaling dimension (greater than approximately two), we find that fourth sound approaches first sound at low temperatures. For condensates that a have a small scaling dimension it exhibits non-conformal behavior at low temperatures which may be tied to the non-conformal behavior of the order parameter of the superfluid. We show that by introducing an appropriate scalar potential, conformal invariance can be enforced at low temperatures.

  14. Parvalbumin-expressing ependymal cells in rostral lateral ventricle wall adhesions contribute to aging-related ventricle stenosis in mice.

    Science.gov (United States)

    Filice, Federica; Celio, Marco R; Babalian, Alexandre; Blum, Walter; Szabolcsi, Viktoria

    2017-10-15

    Aging-associated ependymal-cell pathologies can manifest as ventricular gliosis, ventricle enlargement, or ventricle stenosis. Ventricle stenosis and fusion of the lateral ventricle (LV) walls is associated with a massive decline of the proliferative capacities of the stem cell niche in the affected subventricular zone (SVZ) in aging mice. We examined the brains of adult C57BL/6 mice and found that ependymal cells located in the adhesions of the medial and lateral walls of the rostral LVs upregulated parvalbumin (PV) and displayed reactive phenotype, similarly to injury-reactive ependymal cells. However, PV+ ependymal cells in the LV-wall adhesions, unlike injury-reactive ones, did not express glial fibrillary acidic protein. S100B+/PV+ ependymal cells found in younger mice diminished in the LV-wall adhesions throughout aging. We found that periventricular PV-immunofluorescence showed positive correlation to the grade of LV stenosis in nonaged mice (wall adhesions and LV stenosis was significantly lower in mid-aged (>10-month-old) PV-knock out (PV-KO) mice. This suggests an involvement of PV+ ependymal cells in aging-associated ventricle stenosis. Additionally, we observed a time-shift in microglial activation in the LV-wall adhesions between age-grouped PV-KO and wild-type mice, suggesting a delay in microglial activation when PV is absent from ependymal cells. Our findings implicate that compromised ependymal cells of the adhering ependymal layers upregulate PV and display phenotype shift to "reactive" ependymal cells in aging-related ventricle stenosis; moreover, they also contribute to the progression of LV-wall fusion associated with a decline of the affected SVZ-stem cell niche in aged mice. © 2017 Wiley Periodicals, Inc.

  15. Double Chamber Left Ventricle Associated With Severe Form of the Hypertrophic Cardiomyopathy and High Left Intracavitary Pressure

    OpenAIRE

    Bejiqi, Ramush; Retkoceri, Ragip; Bejiqi, Hana; Zeka, Naim; Maloku, Arlinda; Berisha, Majlinda

    2013-01-01

    Double-chambered left ventricle (DCLV) is a rare congenital anomaly, and only a few cases have been reported in the literature, in which a 2-chambered LV is separated by the interventricular septum or an abnormal muscle bundle.We report a case of a girl who was presented at tertiary level for cardiological examination where, during the routine examination systolic murmur was registered. After echocardiographical examination DCLV was confirmed. Anomaly was associated with idiopathic hypertroph...

  16. Fandom and the fourth wall

    Directory of Open Access Journals (Sweden)

    Jenna Kathryn Ballinger

    2014-09-01

    Full Text Available I use the Teen Wolf fandom as an example to examine the ways social media has created a more complicated, nuanced relationship with fans. The collapse of the fourth wall between fans and The Powers That Be can have both positive and negative impacts, depending on the willingness of participants to maintain mutual respect and engage in meaningful dialogue.

  17. Wisconsin's fourth forest inventory, 1983.

    Science.gov (United States)

    John S. Jr. Spencer; W. Brad Smith; Jerold T. Hahn; Gerhard K. Raile

    1988-01-01

    The fourth inventory of the timber resource of Wisconsin shows that growing-stock volume increased from 11.2 to 15.5 billion cubic feet between 1968 and 1983, and area of timberland increased from 14.5 to 14.8 million acres. Presented are analysis and statistics on forest area and timber volume, growth, mortality, removals, and projections.

  18. Motion in fourth-rank gravity

    International Nuclear Information System (INIS)

    Tapia, V.

    1992-04-01

    Recently we have explored the consequences of describing the metric properties of our universe through a quartic line element. In this geometry the natural object is a fourth-rank metric, i.e., a tensor with four indices. Based on this geometry we constructed a simple field theory for the gravitational field. The field equations coincide with the Einstein field equations in the vacuum case. This fact, however, does not guarantee the observational equivalence of both theories since one must still verify that, as a consequence of the field equations, test particles move along geodesics. This letter is aimed at establishing this result. (author). 7 refs

  19. Search for fourth generation neutral heavy leptons

    International Nuclear Information System (INIS)

    Abachi, S.; Abbott, B.; Abolins, M.

    1995-07-01

    A search for fourth generation neutral heavy leptons (ν 4 ) in W decays was carried out the D0 detector at the Fermilab Tevatron at √ bar s = 1.8 TeV. The ν 4 is assumed to be produced via mixing with the first generation neutrino only. We looked for a three electron final state event topology. The data used in this analysis represent 12.2 pb -1 taken during the 1992--1993 run. No candidates were found. We set a preliminary limit beyond the LEP limit for the considered mixing case on the |U e4 | 2 - m ν4 plane

  20. Antagonism of corticotrophin-releasing factor receptors in the fourth ventricle modifies responses to mild but not restraint stress

    OpenAIRE

    Miragaya, Joanna R.; Harris, Ruth B. S.

    2008-01-01

    Repeated restraint stress (RRS; 3 h of restraint on 3 consecutive days) in rodents produces temporary hypophagia, but a long-term downregulation of body weight. The mild stress (MS) of an intraperitoneal injection of saline and housing in a novel room for 2 h also inhibits food intake and weight gain, but the effects are smaller than for RRS. Previous exposure to RRS exaggerates hypophagia, glucocorticoid release, and anxiety-type behavior caused by MS. Here we tested the involvement of brain...

  1. Successful Catheter Ablation for Paroxysmal Atrial Fibrillation in a Patient with Double-chambered Right Ventricle.

    Science.gov (United States)

    Shioji, Keisuke; Kurita, Takashi; Kawai, Takafumi; Uegaito, Takashi; Motoki, Koichiro; Matsuda, Mitsuo; Miyazaki, Shunichi

    2016-01-01

    We herein describe an adult case of double-chambered right ventricle (DCRV) with symptomatic drug-intolerant paroxysmal atrial fibrillation (PAf). The woman was referred to undergo radiofrequency ablation (RFA), and mapping of the pulmonary veins (PVs) demonstrated that a spontaneous spike potential originating from the left inferior PV (LIPV) induced sustained Af in the second procedure. Accordingly, the LIPV was regarded as the arrhythmogenic PV. Since complete isolation of the PVs, the sinus rhythm has been maintained for at least two years. This is the first report to describe that RFA for drug-intolerant PAf was useful in a patient with DCRV.

  2. Metastatic Ewing's sarcoma to the right ventricle

    OpenAIRE

    Datrice, Nicole; Milliken, Jeffrey; Kirsh, M.; Abolhoda, Amir; Saremi, Farhood; Sender, Leonard

    2011-01-01

    Ewing's sarcoma is a round cell neoplasm derived from neural crest cells that is part of the primitive neuroectodermal tumor (PNET) family. It is a rare, aggressive malignancy that affects young people, most commonly in the second decade of life. The treatment of localized disease has improved greatly over the past four decades, but the prognosis for metastatic disease remains poor. Cardiac metastases of Ewing's sarcoma are exceedingly rare, with only a few reported cases. This...

  3. Arnold-Chiari Type II Malformation: A Case Report and Review of Prenatal Sonographic Findings

    Directory of Open Access Journals (Sweden)

    Maryam Nik Nejadi

    2008-01-01

    Full Text Available The Arnold-Chiari malformation is a congenital abnormality of CNS, characterized by downwarddisplacement the parts of the cerebellum, fourth ventricle, pons and medulla oblongata into thespinal canal. This malformation is one of causative factor of death in neonates and infants. Athorough understanding of the direct and indirect sonographic findings is necessary for diagnosis ofChiari II malformation in the developing fetus.In this case report, we present a Chiari malformation II detected at 23 weeks of gestation by routinelysonographic screening. The Role of prenatal sonography in recognition of the malformation andprognostic value of these features are discussed.

  4. Searches for Fourth Generation Fermions

    Energy Technology Data Exchange (ETDEWEB)

    Ivanov, A.; /Fermilab

    2011-09-01

    We present the results from searches for fourth generation fermions performed using data samples collected by the CDF II and D0 Detectors at the Fermilab Tevatron p{bar p} collider. Many of these results represent the most stringent 95% C. L. limits on masses of new fermions to-date. A fourth chiral generation of massive fermions with the same quantum numbers as the known fermions is one of the simplest extensions of the SM with three generations. The fourth generation is predicted in a number of theories, and although historically have been considered disfavored, stands in agreement with electroweak precision data. To avoid Z {yields} {nu}{bar {nu}} constraint from LEP I a fourth generation neutrino {nu}{sub 4} must be heavy: m({nu}{sub 4}) > m{sub Z}/2, where m{sub Z} is the mass of Z boson, and to avoid LEP II bounds a fourth generation charged lepton {ell}{sub 4} must have m({ell}{sub 4}) > 101 GeV/c{sup 2}. At the same time due to sizeable radiative corrections masses of fourth generation fermions cannot be much higher the current lower bounds and masses of new heavy quarks t' and b' should be in the range of a few hundred GeV/c{sup 2}. In the four-generation model the present bounds on the Higgs are relaxed: the Higgs mass could be as large as 1 TeV/c{sup 2}. Furthermore, the CP violation is significantly enhanced to the magnitude that might account for the baryon asymmetry in the Universe. Additional chiral fermion families can also be accommodated in supersymmetric two-Higgs-doublet extensions of the SM with equivalent effect on the precision fit to the Higgs mass. Another possibility is heavy exotic quarks with vector couplings to the W boson Contributions to radiative corrections from such quarks with mass M decouple as 1/M{sup 2} and easily evade all experimental constraints. At the Tevatron p{bar p} collider 4-th generation chiral or vector-like quarks can be either produced strongly in pairs or singly via electroweak production, where the

  5. New families of conservative systems on $S^2$ possessing an integral of fourth degree in momenta

    OpenAIRE

    Selivanova, Elena N.

    1997-01-01

    There is a well-known example of integrable conservative system on $S^2$, the case of Kovalevskaya in the dynamics of a rigid body, possessing an integral of fourth degree in momenta. Goryachev proposed a one-parameter family of examples of conservative systems on $S^2$ possessing an integral of fourth degree in momenta which includes the case of Kovalevskaya. In this paper we proposed new examples of conservative systems on $S^2$ possessing an integral of fourth degree in momenta.

  6. Fourth-generation storage rings

    International Nuclear Information System (INIS)

    Galayda, J. N.

    1999-01-01

    It seems clear that a linac-driven free-electron laser is the accepted prototype of a fourth-generation facility. This raises two questions: can a storage ring-based light source join the fourth generation? Has the storage ring evolved to its highest level of performance as a synchrotrons light source? The answer to the second question is clearly no. The author thinks the answer to the first question is unimportant. While the concept of generations has been useful in motivating thought and effort towards new light source concepts, the variety of light sources and their performance characteristics can no longer be usefully summed up by assignment of a ''generation'' number

  7. The Fourth Way in Finland

    Directory of Open Access Journals (Sweden)

    Vesa Iitti

    2008-01-01

    Full Text Available This article focuses on the general history of the Fourth Way in Finland. The Fourth Way, or simply ‘the Work’, began as a Greco-Armenian man named Georges Ivanovich Gurdjieff (1866?–1949 gathered groups of pupils in St Petersburg and Moscow in 1912. To these groups, Gurdjieff started to teach what he had learned and synthesized between ca 1896 and 1912 during his travels on spiritual search of Egypt, Crete, Sumeria, Assyria, the Holy Land, Mecca, Ethiopia, Sudan, India, Afghanistan, the northern valleys of Siberia, and Tibet. Neither Gurdjieff nor any of his disciples called themselves a church, a sect, or anything alike, but referred to themselves simply as ‘the Work’, or as ‘the Fourth Way’. The name ‘the Fourth Way’ originates in a Gurdjieffian view that there are essentially three traditional ways of spiritual work: those of a monk, a fakir, and a yogi. These ways do not literally refer to the activities of a monk, a fakir, and a yogi, but to similar types of spiritual work emphasizing exercise of emotion, body, or mind. Gurdjieff’s teaching is a blend of various influences that include Suf­ism, orthodox Christianity, Buddhism, Kabbalah, and general elem­ents of various occult teachings of both the East and the West. Gurdjieff’s teaching is a blend of various influences that include Suf­ism, orthodox Christianity, Buddhism, Kabbalah, and general elem­ents of various occult teachings of both the East and the West. It is a unique combination of cosmology, psychology, theory of evolution, and overall theory and practise aiming to help individ­uals in their efforts towards what is called ‘self-remembering’.

  8. Unusual right ventricle aneurysm and dysplastic pulmonary valve with mitral valve hypoplasia

    Directory of Open Access Journals (Sweden)

    Ozge Pamukcu

    2013-01-01

    Full Text Available We report a newborn with an unusual combination of aneurysmally dilated thin-walled right ventricle with hypertrophy of the apical muscles of the right ventricle. There was narrow pulmonary annulus, pulmonary regurgitation, and hypoplasia of the mitral valve and left ventricle. We propose that this heart represents a partial form of Uhl`s anomaly.

  9. Critical stenosis of a right ventricle to coronary artery fistula seen at dual-source CT in a newborn with pulmonary atresia and intact ventricular septum

    Energy Technology Data Exchange (ETDEWEB)

    Seguela, Pierre-Emmanuel [Centre Chirurgical Marie Lannelongue, Department of Pediatric Cardiology, Le Plessis-Robinson (France); Hopital des Enfants, Toulouse Cedex 9 (France); Houyel, Lucile; Piot, Jean-Dominique [Centre Chirurgical Marie Lannelongue, Department of Pediatric Cardiology, Le Plessis-Robinson (France); Loget, Philippe [Centre Hospitalier Universitaire de Rennes, Department of Pathology, Rennes (France); Paul, Jean-Francois [Centre Chirurgical Marie Lannelongue, Department of Pediatric Radiology, Le Plessis-Robinson (France)

    2011-08-15

    We report the case of a newborn with pulmonary atresia with intact ventricular septum and right ventricle-dependent coronary circulation. He died several weeks after a Blalock-Taussig procedure because of a progressive stenosis of the main coronary artery. We present echocardiographic and dual-source CT images of the stenosis, with autopsy correlation. To our knowledge, CT images of this quality have never been reported in a newborn. This case illustrates the extreme difficulty in prognosticating the outcome for these patients and underlines the need for a detailed neonatal coronary mapping to assess right ventricle-dependent coronary circulation. (orig.)

  10. [Topography of the contours of the inner surface of the wall of the left ventricle of the heart in systole].

    Science.gov (United States)

    Uglov, F G; Zubtsovskiĭ, V N; Bol'shakov, O P; Mursalova, F A; Tarasov, A N

    1984-09-01

    Chosen at random 38 diastolic preparations of human hearts from persons having not any cardiac pathology, as demonstrate the postmortem examination, have been investigated. The left ventricle casts have been made during the first 24 hours after death according to a strictly fixed technique by means of filling the cardiac chambers with polymere mass--protacryl--under a physiological pressure of the diastolic filling. The trabecules are arranged as a spiral from the apex of the ventricle up to the atrioventricular fibrous ring, with approaching the apex the spiral step increases and the trabecules straighten. The left ventricle cast is devided into some planes, the envelopes and the trabecularity lines are measured. Average values of the shift in the trabecularity lines I, II, III and in the cross sections B, C, D, E are defined in relation to the plane A and in every case in relation to the previous plane Cn-1. The data obtained are presented in tables and diagrams. The greatest shift demonstrate the trabecularity lines I running predominantly along the posterior wall of the left ventricle in the planes B and which are situated nearer to the atrioventricular ring projection. Owing to the presence of the spiral-shaped course of the trabecules, it is possible to suppose that it influences the blood stream twisting clockwise in the left ventricle during the diastole phase. This indicates the necessity to work out some new constructions of artificial cardiac valves, securing the twisted blood stream. The condition mentioned should be taken into consideration while making prostheses of the cardiac valves.

  11. Um sistema de ventrículo pulmonar produzindo pressão pulsátil em único ventrículo: modelo experimental A pulmonary ventricle system producing pulsatile pressure in single ventricle: experimental model

    Directory of Open Access Journals (Sweden)

    Bilgein Emrecan

    2006-09-01

    Full Text Available OBJETIVO: Pacientes com ventrículo único funcional têm prognóstico ruim, que resulta em insuficiência cardíaca, mesmo após tratamento cirúrgico. As operações derivação cavo-pulmonar (exceto pelas conexões do átrio direito ao ventrículo direito não apresentam sistema ventricular pulmonar com pressão pulsátil, além do fluxo reduzido ao ventrículo único. Para resolver o problema, tentamos criar um ventrículo pulmonar que produza pressão pulsátil experimentalmente. MÉTODO: Tentamos criar um sistema ventricular direito que produzisse pressão pulsátil. O modelo experimental foi realizado em seis ovelhas. As pressões do ventrículo pulmonar criado, da artéria pulmonar e do ventrículo esquerdo foram medidas após a saída da circulação extracorpórea. RESULTADOS: A média das pressões arteriais pulmonares sistólica e diastólica foi 15,6 ± 2,0 mmHg e 4,5 ± 1,5 mmHg. A média da pressão sistólica ventricular esquerda foi 76,6 ± 4,4 mmHg. CONCLUSÃO: Um ventrículo que produza pressão pulsátil é necessário para a regulação do fluxo da artéria pulmonar, com pressão venosa central e pressão pulmonar não pulsátil nas anomalias como ventrículos únicos funcionais.OBJECTIVE: Patients with functional single ventricle show bad survey, most of which result in cardiac failure even in the case that they are operated. The right heart bypass operations except for right atrium and right ventricle connections lack pulsatile pulmonary ventricle system besides the volume lack coming to the common ventricle. To solve the problem, we tried to create a pulmonary ventricle which produces pulsatile pressure experimentally. METHODS: We tried to form a right ventricle system which produces pulsatile pressure. The experimental model was carried on six sheep. The pressures of the created pulmonary ventricle, pulmonary artery and the left ventricle were measured after leaving the cardiopulmonary bypass. RESULTS: The mean of the

  12. Fourth-rank gravity. A progress report

    International Nuclear Information System (INIS)

    Tapia, V.

    1992-04-01

    We consider the consequences of describing the metric properties of space-time through a quartic line element. The associated ''metric'' is a fourth-rank tensor. After developing some fundamentals for such geometry, we construct a field theory for the gravitational field. This theory coincides with General Relativity in the vacuum case. Departures from General Relativity are obtained only in the presence of matter. We develop a simple cosmological model which is not in contradiction with the observed value Ω approx. 0.2-0.3 for the energy density parameter. A further application concerns conformal field theory. We are able to prove that a conformal field theory possesses an infinite-dimensional symmetry group only if the dimension of space-time is equal to the rank of the metric. In this case we are able to construct an integrable conformal field theory in four dimensions. The model is renormalisable by power counting. (author). 9 refs

  13. Magnetic resonance findings in arrhythmogenic dysplasia of right ventricle

    International Nuclear Information System (INIS)

    Ramiro, E.; Villacastin, B. P.; Farre, J.

    1999-01-01

    To compare the magnetic resonance (MR) findings in patients with arrhythmogenic dysplasia of right ventricle (ADRV) with the images of right ventricle (RV) presenting normal morphology. Three groups of patients were studied by MR: a) a group of 20 healthy volunteers; b) 22 patients with ADRV diagnosed by other methods; and c) 11 patients presenting right ventricular tachycardia (VT) with no evidence of ADRV. When compared with the other two groups, the patients with ADRV were found to have an enlarged right atrium and RV, one wall of RV abnormally thin, changes in the myocardial signal and significant left ventricular involvement. MR is a noninvasive method that is useful in the assessment of RV dilation, ventricular wall thinning, deformities and sacculations and in the detection of changes in the myocardial MR signal produced by the replacement. It aids in the localization, characterization and quantification of morphological changes in RV. (Author) 36 refs

  14. Flow Topology in the Right Ventricle after Tetralogy of Fallot Repair

    Science.gov (United States)

    Mikhail, Amanda; Kadem, Lyes; di Labbio, Giuseppe

    2016-11-01

    Among all of the known congenital heart defects, Tetralogy of Fallot (TOF) is the most common cyanotic defect, accounting for 5% of all detected defects. Approximately 1 in 2518 births will result with TOF, leading to about 1657 cases per year in the United States alone. All of those affected will need surgical repair in order to have a relatively normal life and longer life span. Unfortunately, pulmonary regurgitation (PR) has been observed to appear two to three decades after the initial operation in 50% of operated cases. PR results in abnormal flow patterns in the right ventricle, which are currently poorly understood. In this experimental study, several severities of pulmonary regurgitation were simulated on a newly developed right ventricle using a cardiovascular simulator. The interaction between the tricuspid valve inflow and the pulmonary regurgitation was investigated using Time-resolved particle image velocimetry (TR-PIV). PR resulted in a turbulent jet that disturbed the optimal filling of the RV. Energy losses and viscous shear stresses were observed to significantly increase with the severity of PR. This study can contribute towards a better understanding of the suboptimal performance in patients with repaired TOF.

  15. Fourth sound in relativistic superfluidity theory

    International Nuclear Information System (INIS)

    Vil'chinskij, S.I.; Fomin, P.I.

    1995-01-01

    The Lorentz-covariant equations describing propagation of the fourth sound in the relativistic theory of superfluidity are derived. The expressions for the velocity of the fourth sound are obtained. The character of oscillation in sound is determined

  16. Intelligence Strategy for Fourth Generation Warfare

    National Research Council Canada - National Science Library

    Jamison, Edward P

    2006-01-01

    ...." They have named this new era of war "fourth generation warfare." Currently the Department of Defense's intelligence strategy is designed to defeat conventional adversaries vise a fourth generation warfare opponent...

  17. Successful Percutaneous Retrieval of an Inferior Vena Cava Filter Migrating to the Right Ventricle in a Bariatric Patient

    International Nuclear Information System (INIS)

    Veerapong, Jula; Wahlgren, Carl Magnus; Jolly, Neeraj; Bassiouny, Hisham

    2008-01-01

    The use of an inferior vena cava filter has an important role in the management of patients who are at high risk for development of pulmonary embolism. Migration is a rare but known complication of inferior vena cava filter placement. We herein describe a case of a prophylactic retrievable vena cava filter migrating to the right ventricle in a bariatric patient. The filter was retrieved percutaneously by transjugular approach and the patient did well postoperatively. A review of the current literature is given.

  18. Automatic extraction of left ventricle in SPECT myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Liu Li; Zhao Shujun; Yao Zhiming; Wang Daoyu

    1999-01-01

    An automatic method of extracting left ventricle from SPECT myocardial perfusion data was introduced. This method was based on the least square analysis of the positions of all short-axis slices pixels from the half sphere-cylinder myocardial model, and used a iterative reconstruction technique to automatically cut off the non-left ventricular tissue from the perfusion images. Thereby, this technique provided the bases for further quantitative analysis

  19. The fourth dimension simply explained

    CERN Document Server

    Manning, Henry P

    2005-01-01

    To remove the contents of an egg without puncturing its shell or to drink the liquor in a bottle without removing the cork is clearly unthinkable - or is it? Understanding the world of Einstein and curved space requires a logical conception of the fourth dimension.This readable, informative volume provides an excellent introduction to that world, with 22 essays that employ a minimum of mathematics. Originally written for a contest sponsored by Scientific American, these essays are so well reasoned and lucidly written that they were judged to merit publication in book form. Their easily unders

  20. The fourth Board of Governors

    International Nuclear Information System (INIS)

    1961-01-01

    The General Conference of the International Atomic Energy Agency at its fourth regular session, which was held in Vienna from 20 September to 1 October 1960, elected five Member States to serve a two-year term on the Agency's Board of Governors. The five were Argentina, El Salvador, the Federal Republic of Germany, Iraq and Thailand. The new members succeed Indonesia, the Netherlands, Peru, the United Arab Republic and Venezuela, which were elected for a two-year term by the second session of the General Conference in 1958

  1. Pacemaker lead perforation of the right ventricle associated with Moraxella phenylpyruvica infection in a dog.

    Science.gov (United States)

    Ciavarella, A; Nimmo, J; Hambrook, L

    2016-04-01

    A 13-year-old neutered male Border Collie was presented with acute onset syncope, weakness and anorexia 10 months after transvenous pacemaker implantation. The patient was laterally recumbent, bradycardic (36 beats/min) and febrile (40.7°C) on presentation. An electrocardiogram (ECG) revealed recurrence of third-degree atrioventricular block with a ventricular escape rhythm. Fluoroscopy identified migration of the pacemaker tip through the apex of the right ventricle. Echocardiography failed to reveal any evidence of pericardial effusion or cardiac tamponade. Full postmortem was performed after euthanasia. The pacemaker lead had perforated the apex of the right ventricle and lodged in the right pleural space. Culture of blood (taken antemortem), pericardial sac, right ventricular wall (surrounding pacemaker lead), pacemaker lead tip and pericardial fluid revealed a pure growth of Moraxella phenylpyruvica. Bacteraemia associated with M. phenylpyruvica has never been reported in the dog, but sporadic cases are reported in humans. Infection could have resulted from either pre-existing myocarditis or opportunistic infection and bacteraemia post pacemaker implantation. Evaluation of the pacemaker function at regular intervals would allow early detection of poor pacemaker-to-myocardium contact, which would prompt further investigation of pacemaker lead abnormalities such as perforation. © 2016 Australian Veterinary Association.

  2. Double Outlet Right Ventricle With Intact Ventricular Septum: Avulsion or Exclusion.

    Science.gov (United States)

    Menon, Sabarinath; Kumar, C J Ashok; Mathew, Thomas; Venkateshwarn, S; Jayakumar, K; Dharan, Baiju S

    2016-03-01

    Double outlet right ventricle (DORV) is almost always associated with a ventricular septal defect. The variant of DORV with intact ventricular septum is very uncommon and may be associated with fetal demise or death immediately after birth. Reports of successful palliation of these patients to the stage of superior cavopulmonary anastomosis (bidirectional Glenn shunt) are rare. We describe the case of a child with DORV with intact ventricular septum who underwent successful palliation. This condition often provides a diagnostic, interventional, and surgical challenge. Patients generally require either balloon atrial septostomy or surgical atrial septectomy for survival, with the addition of a Blalock-Tausig shunt or pulmonary artery band depending on the pulmonary blood flow. Very few patients survive to a Glenn procedure. For those who do survive, a decision must be made regarding the management of the hypertensive and hypoplastic left ventricle (LV) and associated mitral regurgitation. The LV can be excluded by either mitral valve avulsion or closure (exclusion) of the mitral valve with a patch. The choice of the technique should be carefully made and depends in part on the size of the LV. In our patient, who was successfully palliated by bidirectional Glenn shunt, the LV was managed by means of mitral valve avulsion. © The Author(s) 2015.

  3. CORONARY EMBOLISM WITH FRAGMENTED THROMBUS FROM THE LEFT VENTRICLE IN PATIENT WITH POSTINFARCTION ANEURYSM

    Directory of Open Access Journals (Sweden)

    Yu. F. Salakhova

    2011-01-01

    Full Text Available The thrombus formation in the left ventricle (LV cavity is a frequent complication of myocardial infarction (MI as well as a risk factor for peripheral arterial embolism. Probability of intraventricular thrombus depends on MI location and its therapy. A case of coronary embolism in a patient with anterior MI and thrombus in the LV aneurysm is considered in details. Successful percutaneous coronary intervention (PCI in the first 90 minutes after admission was performed. Decision to appoint a three-component antithrombotic therapy (acetylsalicylic acid, clopidogrel, warfarin was made on the 4th day of disease onset taking into account the combination of MI, stent placement in the anterior interventricular artery and the presence of left ventricular aneurysm with parietal thrombus. Recurrence of MI developed on the 9th day of disease onset. Aspiration thromboembolectomy was performed taking into account thrombosis of two coronary arteries. Warfarin therapy was discontinued in connection with subsequent clot lysis and development of not intensive nosebleed. Subsequent MI course was uneventful. In conclusion, even in spite of the timely achievement of PCI and early reperfusion, MI course can be complicated by thrombosis of the left ventricle and subsequent development of thromboembolic complications.

  4. Epigastric heteropagus associated with an omphalocele and double outlet right ventricle

    Directory of Open Access Journals (Sweden)

    Tatsuma Sakaguchi

    2015-10-01

    Full Text Available Incomplete or asymmetrical conjoined twins are extremely rare congenital anomalies. We report a case of epigastric heteropagus associated with an omphalocele and double outlet right ventricle. The cystic legion of the epigastrium was detected in our patient by an ultrasound scan at 28 weeks' gestation. He was born at 37 weeks' gestation by scheduled caesarean section. A parasite with an incomplete head and lower limb was attached to the epigastrium of the autosite. Surgical separation of the parasite and silo placement for an omphalocele was successfully performed on the 4th day of life. He underwent secondary surgical closure of the omphalocele on the 10th day. For treatment of the cardiac anomaly, he underwent an operation of Blalock–Taussig shunt because of pulmonary artery stenosis at the age of 3 months and correction of double outlet right ventricle at the age of 10 months. At the 20-month follow-up, he was alive and showed a normal growth pattern.

  5. Lagrangian coherent structures in the left ventricle in the presence of aortic valve regurgitation

    Science.gov (United States)

    di Labbio, Giuseppe; Vetel, Jerome; Kadem, Lyes

    2017-11-01

    Aortic valve regurgitation is a rather prevalent condition where the aortic valve improperly closes, allowing filling of the left ventricle of the heart to occur partly from backflow through the aortic valve. Although studies of intraventricular flow are rapidly gaining popularity in the fluid dynamics research community, much attention has been given to the left ventricular vortex and its potential for early detection of disease, particularly in the case of dilated cardiomyopathy. Notably, the subsequent flow in the left ventricle in the presence of aortic valve regurgitation ought to be appreciably disturbed and has yet to be described. Aortic valve regurgitation was simulated in vitro in a double-activation left heart duplicator and the ensuing flow was captured using two-dimensional time-resolved particle image velocimetry. Further insight into the regurgitant flow is obtained by computing attracting and repelling Lagrangian coherent structures. An interesting interplay between the two inflowing jets and their shear layer roll-up is observed for various grades of regurgitation. This study highlights flow features which may find use in further assessing regurgitation severity.

  6. The Fourth Branchial Complex Anomaly: A Rare Clinical Entity

    OpenAIRE

    Patel, Alpen B.; Hinni, Michael L.

    2011-01-01

    Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies.

  7. The fourth branchial complex anomaly: a rare clinical entity.

    Science.gov (United States)

    Patel, Alpen B; Hinni, Michael L

    2011-01-01

    Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies.

  8. Using fourth-year medical students' reflections to propose strategies ...

    African Journals Online (AJOL)

    2011-12-13

    Dec 13, 2011 ... S Afr Fam Pract 2012;54(6):513-517. Using fourth-year .... cope with the psychological impact of certain cases and to distance myself .... requirements. They should have an opportunity to test ... Reynolds HY. On becoming a ...

  9. 3D Printing in Surgical Management of Double Outlet Right Ventricle.

    Science.gov (United States)

    Yoo, Shi-Joon; van Arsdell, Glen S

    2017-01-01

    Double outlet right ventricle (DORV) is a heterogeneous group of congenital heart diseases that require individualized surgical approach based on precise understanding of the complex cardiovascular anatomy. Physical 3-dimensional (3D) print models not only allow fast and unequivocal perception of the complex anatomy but also eliminate misunderstanding or miscommunication among imagers and surgeons. Except for those cases showing well-recognized classic surgical anatomy of DORV such as in cases with a typical subaortic or subpulmonary ventricular septal defect, 3D print models are of enormous value in surgical decision and planning. Furthermore, 3D print models can also be used for rehearsal of the intended procedure before the actual surgery on the patient so that the outcome of the procedure is precisely predicted and the procedure can be optimally tailored for the patient's specific anatomy. 3D print models are invaluable resource for hands-on surgical training of congenital heart surgeons.

  10. 3D Printing in Surgical Management of Double Outlet Right Ventricle

    Directory of Open Access Journals (Sweden)

    Shi-Joon Yoo

    2018-01-01

    Full Text Available Double outlet right ventricle (DORV is a heterogeneous group of congenital heart diseases that require individualized surgical approach based on precise understanding of the complex cardiovascular anatomy. Physical 3-dimensional (3D print models not only allow fast and unequivocal perception of the complex anatomy but also eliminate misunderstanding or miscommunication among imagers and surgeons. Except for those cases showing well-recognized classic surgical anatomy of DORV such as in cases with a typical subaortic or subpulmonary ventricular septal defect, 3D print models are of enormous value in surgical decision and planning. Furthermore, 3D print models can also be used for rehearsal of the intended procedure before the actual surgery on the patient so that the outcome of the procedure is precisely predicted and the procedure can be optimally tailored for the patient’s specific anatomy. 3D print models are invaluable resource for hands-on surgical training of congenital heart surgeons.

  11. Hemorrhagic Onset of Hemangioblastoma Located in the Dorsal Medulla Oblongata Presenting with Tako-Tsubo Cardiomyopathy and Neurogenic Pulmonary Edema: A Case Report

    Directory of Open Access Journals (Sweden)

    Masayuki Gekka

    2014-03-01

    Full Text Available Here, we present a case of dorsal medulla oblongata hemangioblastoma with fourth ventricular hemorrhage. A 23-year-old female developed sudden consciousness disturbance, and CT revealed hemorrhage in all cerebral ventricles and a hyperdense mass in the cisterna magna. Although the reddish tumor located in the dorsal medulla oblongata was successfully removed, she suffered from severe tako-tsubo cardiomyopathy (TTC and neurogenic pulmonary edema (NPE because of baroreflex failure and damage to the solitary tract nuclei. After intensive care for 12 weeks following surgery, she was discharged without any neurological or radiological deficits. Pathogenesis of TTC/NPE is discussed in this paper.

  12. Hemorrhagic onset of hemangioblastoma located in the dorsal medulla oblongata presenting with tako-tsubo cardiomyopathy and neurogenic pulmonary edema: a case report.

    Science.gov (United States)

    Gekka, Masayuki; Yamaguchi, Shigeru; Kazumata, Ken; Kobayashi, Hiroyuki; Motegi, Hiroaki; Terasaka, Shunsuke; Houkin, Kiyohiro

    2014-01-01

    Here, we present a case of dorsal medulla oblongata hemangioblastoma with fourth ventricular hemorrhage. A 23-year-old female developed sudden consciousness disturbance, and CT revealed hemorrhage in all cerebral ventricles and a hyperdense mass in the cisterna magna. Although the reddish tumor located in the dorsal medulla oblongata was successfully removed, she suffered from severe tako-tsubo cardiomyopathy (TTC) and neurogenic pulmonary edema (NPE) because of baroreflex failure and damage to the solitary tract nuclei. After intensive care for 12 weeks following surgery, she was discharged without any neurological or radiological deficits. Pathogenesis of TTC/NPE is discussed in this paper.

  13. Endovascular Treatment of Two Pseudoaneurysms Originating From the Left Ventricle

    Energy Technology Data Exchange (ETDEWEB)

    Cwikiel, Wojciech, E-mail: wcwikiel@gmail.com; Keussen, Inger [Skane University Hospital, Department of Radiology (Sweden); Gustafsson, Ronny; Mokhtari, Arash [Skane University Hospital, Department of Thoracic Surgery (Sweden)

    2013-12-15

    A 67-year-old woman resented with an acute type A aortic dissection, which was treated surgically with aortic valve replacement as a composite graft with reimplantation of the coronary arteries. At the end of surgery, a left-ventricular venting catheter was placed through the apex and closed with a buffered suture. Consecutive computed tomography (CT) examinations verified a growing apex pseudoaneurysm. Communication between the ventricle and the pseudoaneurysm was successfully closed with an Amplatz septal plug by the transfemoral route. Follow-up CT showed an additional pseudoaneurysm, which also was successfully closed using the same method.

  14. Endovascular Treatment of Two Pseudoaneurysms Originating From the Left Ventricle

    International Nuclear Information System (INIS)

    Cwikiel, Wojciech; Keussen, Inger; Gustafsson, Ronny; Mokhtari, Arash

    2013-01-01

    A 67-year-old woman resented with an acute type A aortic dissection, which was treated surgically with aortic valve replacement as a composite graft with reimplantation of the coronary arteries. At the end of surgery, a left-ventricular venting catheter was placed through the apex and closed with a buffered suture. Consecutive computed tomography (CT) examinations verified a growing apex pseudoaneurysm. Communication between the ventricle and the pseudoaneurysm was successfully closed with an Amplatz septal plug by the transfemoral route. Follow-up CT showed an additional pseudoaneurysm, which also was successfully closed using the same method

  15. Fourth Branchial Anomaly Presenting with a Lateral Neck Mass in a Neonate

    OpenAIRE

    Yoo, Tae-Kyung; Kim, Soo-Hong; Kim, Ha-Shin; Kim, Hyun-Young; Park, Kwi-Won

    2014-01-01

    Branchial cleft anomalies are an important differential diagnosis in congenital neck masses in infants. The third and fourth branchial anomalies are rare branchial cleft anomalies, which are hard to differentiate. We report here an uncommon case of the fourth branchial anomaly that was presented as an asymptomatic neck mass in a neonate.

  16. Fourth branchial anomaly presenting with a lateral neck mass in a neonate.

    Science.gov (United States)

    Yoo, Tae-Kyung; Kim, Soo-Hong; Kim, Ha-Shin; Kim, Hyun-Young; Park, Kwi-Won

    2014-01-01

    Branchial cleft anomalies are an important differential diagnosis in congenital neck masses in infants. The third and fourth branchial anomalies are rare branchial cleft anomalies, which are hard to differentiate. We report here an uncommon case of the fourth branchial anomaly that was presented as an asymptomatic neck mass in a neonate.

  17. In vivo validation of a 3D ultrasound system for imaging the lateral ventricles of neonates

    Science.gov (United States)

    Kishimoto, J.; Fenster, A.; Chen, N.; Lee, D.; de Ribaupierre, S.

    2014-03-01

    Dilated lateral ventricles in neonates can be due to many different causes, such as brain loss, or congenital malformation; however, the main cause is hydrocephalus, which is the accumulation of fluid within the ventricular system. Hydrocephalus can raise intracranial pressure resulting in secondary brain damage, and up to 25% of patients with severely enlarged ventricles have epilepsy in later life. Ventricle enlargement is clinically monitored using 2D US through the fontanels. The sensitivity of 2D US to dilation is poor because it cannot provide accurate measurements of irregular volumes such as the ventricles, so most clinical evaluations are of a qualitative nature. We developed a 3D US system to image the cerebral ventricles of neonates within the confines of incubators that can be easily translated to more open environments. Ventricle volumes can be segmented from these images giving a quantitative volumetric measurement of ventricle enlargement without moving the patient into an imaging facility. In this paper, we report on in vivo validation studies: 1) comparing 3D US ventricle volumes before and after clinically necessary interventions removing CSF, and 2) comparing 3D US ventricle volumes to those from MRI. Post-intervention ventricle volumes were less than pre-intervention measurements for all patients and all interventions. We found high correlations (R = 0.97) between the difference in ventricle volume and the reported removed CSF with the slope not significantly different than 1 (p < 0.05). Comparisons between ventricle volumes from 3D US and MR images taken 4 (±3.8) days of each other did not show significant difference (p=0.44) between 3D US and MRI through paired t-test.

  18. Transmural distribution of myocardial infarction: difference between the right and left ventricles in a canine model

    International Nuclear Information System (INIS)

    Ohzono, K.; Koyanagi, S.; Urabe, Y.; Harasawa, Y.; Tomoike, H.; Nakamura, M.

    1986-01-01

    The evolution of myocardial infarction 24 hours after ligating both the right coronary artery and the obtuse marginal branch of the left circumflex coronary artery was examined in 33 anesthetized dogs. Postmortem coronary angiography and a tracer microsphere technique were used to determine risk areas and their collateral blood flows, respectively. The mean weight of the risk areas was 11.3 +/- 0.5 g (mean +/- SEM) in the right ventricle and 10.5 +/- 0.9 g in the left ventricle (NS). The weight of infarcted tissue was 5.7 +/- 0.7 g in the right ventricle and 5.2 +/- 0.9 g in the left ventricle (NS). In both ventricles, infarct weight was linearly related to risk area size, and the percent of risk area necrosis was inversely correlated with the extent of collateral flow at 24 hours of coronary ligation, defined as the mean myocardial blood flow inside the central risk area. Ratios of infarct to risk area between the subendocardial and subepicardial layers were 0.76 +/- 0.06 and 0.28 +/- 0.05 in the right and left ventricles, respectively (p less than 0.01, between ventricles, n = 31), which coincided well with subendocardial-to-subepicardial-flow ratios at 24 hours, ie, 0.86 +/- 0.04 in the right ventricle and 0.32 +/- 0.06 in the left ventricle (p less than 0.01). The regional distribution of myocardial infarction correlated well with flow distribution inside the risk area; the slope of these relations was similar between the subendocardium and subepicardium in the right ventricle, whereas in the left ventricle it was larger in the subendocardium than in the subepicardium. Thus, in the dog, the inherent change in the regional distribution of coronary collateral blood flow is an important modifier in the evolution of myocardial infarction, especially in the left ventricle

  19. Factors Associated with Neurodevelopment for Children with Single Ventricle Lesions

    Science.gov (United States)

    Goldberg, Caren S.; Lu, Minmin; Sleeper, Lynn A.; Mahle, William T.; Gaynor, J. William; Williams, Ismee A.; Mussatto, Kathleen A.; Ohye, Richard G.; Graham, Eric M.; Frank, Deborah U.; Jacobs, Jeffrey P.; Krawczeski, Catherine; Lambert, Linda; Lewis, Alan; Pemberton, Victoria L.; Sananes, Renee; Sood, Erica; Wechsler, Stephanie B.; Bellinger, David C.; Newburger, Jane W.

    2014-01-01

    Objective To measure neurodevelopment at 3 years in children with single right ventricle anomalies and to assess its relationship to Norwood shunt type, neurodevelopment at 14 months, and patient and medical factors. Study design All subjects in the Single Ventricle Reconstruction Trial who were alive without cardiac transplant were eligible for inclusion. The Ages and Stages Questionnaire (ASQ, n=203) and other measures of behavior, and quality of life (QOL) were completed at age 3 years. Medical history, including measures of growth, feeding, and complications, was assessed through annual record review and phone interview. The Bayley Scales of Infant Development-II (BSID-II) scores from age 14 months were also evaluated as predictors. Results Scores on each ASQ domain were significantly lower than normal (p<0.001). ASQ domain scores at 3 years varied nonlinearly with 14-month BSID-II. More complications, abnormal growth, and evidence of feeding, vision, or hearing problems, were independently associated with lower ASQ scores, although models explained < 30% of variation. Shunt type was not associated with any ASQ domain score, or with behavior or QOL measures. Conclusion Children with SV have impaired neurodevelopment at 3 years. Lower ASQ scores are associated with medical morbidity, and lower BSID-II scores, but not with shunt type. However, because only a modest percentage of variation in 3-year neurodevelopmental outcome could be predicted from early measures, all children with SV should be followed longitudinally to improve recognition of delays. PMID:24952712

  20. Vortex formation and instability in the left ventricle

    Science.gov (United States)

    Le, Trung Bao; Sotiropoulos, Fotis; Coffey, Dane; Keefe, Daniel

    2012-09-01

    We study the formation of the mitral vortex ring during early diastolic filling in a patient-specific left ventricle (LV) using direct numerical simulation. The geometry of the left ventricle is reconstructed from Magnetic Resonance Imaging (MRI) data of a healthy human subject. The left ventricular kinematics is modeled via a cell-based activation methodology, which is inspired by cardiac electro-physiology and yields physiologic LV wall motion. In the fluid dynamics videos, we describe in detail the three-dimensional structure of the mitral vortex ring, which is formed during early diastolic filling. The ring starts to deform as it propagates toward the apex of the heart and becomes inclined. The trailing secondary vortex tubes are formed as the result of interaction between the vortex ring and the LV wall. These vortex tubes wrap around the circumference and begin to interact with and destabilize the mitral vortex ring. At the end of diastole, the vortex ring impinges on the LV wall and the large-scale intraventricular flow rotates in clockwise direction. We show for the first time that the mitral vortex ring evolution is dominated by a number of vortex-vortex and vortex-wall interactions, including lateral straining and deformation of vortex ring, the interaction of two vortex tubes with unequal strengths, helicity polarization of vortex tubes and twisting instabilities of the vortex cores.

  1. Colloid cysts of the third ventricle exhibit heterogeneous clinical picture

    Directory of Open Access Journals (Sweden)

    Janez Ravnik

    2014-08-01

    Full Text Available Background: Colloid cysts are rare benign intracranial tumours generally occurring in the front part of the third ventricle. Clinical picture may be non-specific. Various problems are usually associated with hydrocephalus that these cysts may cause.Methods: Five patients with colloid cyst of the third ventricle were consecutively operated on at our department. All had different clinical pictures. Two patients suffered from acute hydrocephalus, one of them also from rapid deterioration of consciousness. In two patients, the cyst was discovered accidentally owing to non-specific problems. One patient experienced progressive deterioration due to chronic hydrocephalus.Results: All patients had a colloid cyst removed via the right anterior interhemispheric transcallosal approach. One patient had surgical complication with transient left-sided haemiparesis, followed by osteomyelitis. Postoperative course in all other patients was unremarkable.Conclusions: Due to a high risk of potential sudden deterioration the colloid cysts may cause, a rapid surgical intervention is generally needed. The anterior interhemispheric transcallosal approach is a well accepted and safe surgical option.

  2. A Large Left Ventricle Myxoma: Presenting with Epigastric Pain and Weight Loss

    Directory of Open Access Journals (Sweden)

    Solmaz Fakhari

    2016-01-01

    Full Text Available Cardiac myxomas are the most common benign tumors found in the heart. They usually appear in the left atrium. Those originating from the left ventricle (LV are rare. Although clinical presentation may vary, dyspnea and embolism are the most commonly reported symptoms. In the present case study, a 27-year-old woman with a large myxoma originating from the left ventricular free wall is studied. She had atypical complaints, mainly epigastric discomfort, nausea, vomiting, and anorexia. She was hospitalized for acute abdomen, but subsequent investigations revealed a large myxoma that fully filled the LV and severely compromised the flow of the aortic and mitral valves. After successful emergency tumor resection, all symptoms disappeared. The uncommon presentation caused by these tumors is discussed in this study.

  3. Fourth international radiopharmaceutical dosimetry symposium

    International Nuclear Information System (INIS)

    Schlafke-Stelson, A.T.; Watson, E.E.

    1986-04-01

    The focus of the Fourth International Radiopharmaceutical Dosimetry Symposium was to explore the impact of current developments in nuclear medicine on absorbed dose calculations. This book contains the proceedings of the meeting including the edited discussion that followed the presentations. Topics that were addressed included the dosimetry associated with radiolabeled monoclonal antibodies and blood elements, ultrashort-lived radionuclides, and positron emitters. Some specific areas of discussion were variations in absorbed dose as a result of alterations in the kinetics, the influence of radioactive contaminants on dose, dose in children and in the fetus, available instrumentation and techniques for collecting the kinetic data needed for dose calculation, dosimetry requirements for the review and approval of new radiopharmaceuticals, and a comparison of the effect on the thyroid of internal versus external irradiation. New models for the urinary blader, skeleton including the active marrow, and the blood were presented. Several papers dealt with the validity of traditional ''average-organ'' dose estimates to express the dose from particulate radiation that has a short range in tissue. These problems are particularly important in the use of monoclonal antibodies and agents used to measure intracellular functions. These proceedings have been published to provide a resource volume for anyone interested in the calculation of absorbed radiation dose

  4. Fourth Lepton Family is Natural in Technicolor

    DEFF Research Database (Denmark)

    T. Frandsen, Mads; Masina, Isabella; Sannino, Francesco

    2010-01-01

    Imagine to discover a new fourth family of leptons at the Large Hadron Collider (LHC) but no signs of an associated fourth family of quarks. What would that imply? An intriguing possibility is that the new fermions needed to compensate for the new leptons gauge anomalies simultaneously address...

  5. Systems Prototyping with Fourth Generation Tools.

    Science.gov (United States)

    Sholtys, Phyllis

    1983-01-01

    The development of information systems using an engineering approach that uses both traditional programing techniques and fourth generation software tools is described. Fourth generation applications tools are used to quickly develop a prototype system that is revised as the user clarifies requirements. (MLW)

  6. The fourth family of quarks and leptons

    International Nuclear Information System (INIS)

    Cline, D.B.; Soni, A.

    1987-01-01

    This book presents the proceedings of The Fourth Family of Quarks and Leptons. Topics covered include: Missing Transverse Energy Events and a Search for Additional Neutrino Families and a Fourth-Generation Lepton; Cosmological Limit on the Number of Families; and Charmed Baryon Decay

  7. Magendie and Luschka: Holes in the 4th ventricle

    Directory of Open Access Journals (Sweden)

    Eliasz Engelhardt

    Full Text Available ABSTRACT Cerebrospinal fluid (CSF is a complex liquid formed mainly by the choroid plexuses. After filling the ventricular system where it circulates, CSF flows out to the subarachnoid spaces through openings in the 4th ventricle. Following numerous studies on CSF pathways, these openings were first discovered in the 19th century by two notable researchers, François Magendie and Hubert von Luschka, who described the median and lateral openings subsequently named after them. Even after the studies of Axel Key and Gustav Magnus Retzius confirming these openings, their existence was questioned by many anatomists, yet acknowledged by others. Finally gaining the acceptance of all, recognition of the holes endures to the present day. Interest in these openings may be attributed to the several congenital or acquired pathological conditions that may affect them, usually associated with hydrocephalus. We report some historical aspects of these apertures and their discoverers.

  8. Isolated Non-Compaction of the Left Ventricle in a Patient with New-Onset Heart Failure: Morphologic and Functional Evaluation with Cardiac Multidetector Computed Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Heon [Soonchuhyang University Bucheon Hospital, Bucheon (Korea, Republic of); Kim, Seok Yeon [Seoul Medical Center, Seoul (Korea, Republic of); Schoepf, U. Joseph [Medical University of South Carolina, SC (United States)

    2012-03-15

    We describe a case of new-onset heart failure in a patient in whom cardiac CT enabled the non-invasive diagnosis of isolated non-compaction and associated functional abnormalities of the left ventricle with the concomitant evaluation of coronary arteries. This case highlights the utility of cardiac CT for the morphological and functional evaluation of the heart as a single imaging modality.

  9. Passive and active ventricular elastances of the left ventricle

    Directory of Open Access Journals (Sweden)

    Ng Eddie YK

    2005-02-01

    Full Text Available Abstract Background Description of the heart as a pump has been dominated by models based on elastance and compliance. Here, we are presenting a somewhat new concept of time-varying passive and active elastance. The mathematical basis of time-varying elastance of the ventricle is presented. We have defined elastance in terms of the relationship between ventricular pressure and volume, as: dP = EdV + VdE, where E includes passive (Ep and active (Ea elastance. By incorporating this concept in left ventricular (LV models to simulate filling and systolic phases, we have obtained the time-varying expression for Ea and the LV-volume dependent expression for Ep. Methods and Results Using the patient's catheterization-ventriculogram data, the values of passive and active elastance are computed. Ea is expressed as: ; Epis represented as: . Ea is deemed to represent a measure of LV contractility. Hence, Peak dP/dt and ejection fraction (EF are computed from the monitored data and used as the traditional measures of LV contractility. When our computed peak active elastance (Ea,max is compared against these traditional indices by linear regression, a high degree of correlation is obtained. As regards Ep, it constitutes a volume-dependent stiffness property of the LV, and is deemed to represent resistance-to-filling. Conclusions Passive and active ventricular elastance formulae can be evaluated from a single-beat P-V data by means of a simple-to-apply LV model. The active elastance (Ea can be used to characterize the ventricle's contractile state, while passive elastance (Ep can represent a measure of resistance-to-filling.

  10. Rare association between cystic fibrosis, Chiari I malformation, and hydrocephalus in a baby: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jea Andrew

    2011-08-01

    Full Text Available Abstract Introduction Cystic fibrosis, an epithelial cell transport disorder caused by mutations of the cystic fibrosis transmembrane conductance regulator gene, is not generally associated with malformations of the central nervous system. We review eight previously published reports detailing an infrequent association between cystic fibrosis and Chiari I malformation. Case presentation To the best of our knowledge, our report describes only the ninth case of a baby presenting with a new diagnosis of cystic fibrosis and Chiari I malformation, in this case in a 10-month-old, full-term Caucasian baby boy from the United States of America. Neurosurgical consultation was obtained for associated developmental delay, macrocephaly, bulging anterior fontanel, and papilledema. An MRI scan demonstrated an extensive Chiari I malformation with effacement of the fourth ventricle, obliteration of the outlets of the fourth ventricle and triventricular hydrocephalus without aqueductal stenosis. Our patient was taken to the operating room for ventriculoperitoneal shunt placement. Conclusions It is possible that the cystic fibrosis transmembrane conductance regulator gene may play a previously unrecognized role in central nervous system development; alternatively, this central nervous system abnormality may have been acquired due to constant valsalva from recurrent coughing or wheezing or metabolic and electrolyte imbalances that occur characteristically in cystic fibrosis.

  11. A roentgenographical study of the morphology of ventricles of the brain using computed tomography (CT)

    International Nuclear Information System (INIS)

    Inugami, Atsushi

    1981-01-01

    A basic experiment using an experimental model for the ventricles of the brain was made of the reproductivity of CT images using a whole body CT scanner, and the dimensions of the ventricles of 450 children on CT images were measured, to study changes in dimensions of the ventricles with the method for providing the sectional planes, or with the type of the CT scanner used, and the children with ventricular abnormalities were further studied. The sectional plane at OM-0 0 clinically gave a better reproductivity of the ventricles than at OM-15 0 . The measurements of the ventricles proved to vary with the mean value and also with the window width. In measuring the dimensions of the ventricles on the CT image, the ratio of widths of the anterior horn, third ventricle, corpus and posterior horn to that of the cerebral parenchyma was found to be correlated to the dimensions of the ventricles. No particular changes with the age structure of each cerebroventricular index (CVI) were noted. Apparent differences in the measurement were noted between each CVI of the abnormal group and the normal. CT scanning is a safe, easy non-invasive method for screening and observing the couse of ventricular diseases, accompanied by less risk. (author)

  12. Microbiology of third and fourth branchial pouch cysts.

    Science.gov (United States)

    Pahlavan, Shane; Haque, Waqar; Pereira, Kevin; Larrier, Deidre; Valdez, Tulio A

    2010-03-01

    To identify the most common pathogens involved in infections of third and fourth branchial pouch cysts. Third and fourth branchial pouch cyst infections are an uncommon cause of anterior neck abscesses often confused with other entities, such as thyroglossal duct cysts and thyroid abscesses leading to misdiagnosis, recurrence, and increased morbidity related to a delay in diagnosis and appropriate treatment. Retrospective chart and literature review. Retrospective chart review case series of patients presenting to the Bobby R. Alford Department of Otolaryngology at Texas Children's Hospital from July 2004 to July 2008 with third and fourth branchial pouch cysts. A total of 11 patients were identified. All patients had left-sided lesions. Eikenella corrodens was found in 60% of cultures and was the most common organism identified in our patient group. Furthermore, 56% of the organisms isolated were anaerobic. All organisms with the exception of Staphylococcus aureus were identified as oral cavity flora. Third and fourth branchial pouch cysts provide a communication between the neck and the oral cavity through pyriform sinus tracts. The presence of oral cavity flora in a left anterior neck abscess should raise the suspicion of a branchial pouch anomaly, and subsequently alter therapeutic management.

  13. [Diagnosis and surgical operation for fourth branchial cleft anomalies].

    Science.gov (United States)

    Zhu, Ting; Hua, Qingquan

    2011-11-01

    To explore diagnosis and surgical operation through analyzing clinical features of the fourth branchial cleft anomalies. Clinical materials of 10 patients with the fourth branchial cleft anomalies were retrospectively analyzed, and literatures were studied to explore the diagnosis, differential diagnosis and treatment methods of surgical operation; lesions of 10 patients were completely removed by surgical operation, and internal sinus was properly handled. All 10 cases were cured, no recurrence were observed during a follow-up of 1-3 years. 1 patient appeared low voice, and drinking cough, back to normality after 2 weeks; 1 patient appeared paralysis of left hypoglossal nerves, back to normality after 3 months. Recurrent deep neck abscess and chronic sinus infections of anterior area in the lower part of neck should be considered with the diagnosis of the fourth branchial cleft anomalies. Enhanced neck CT scan and barium sulfate meal examination aid to diagnosis, pathological examination can be confirmed. Complete surgical removal of lesions is an effective treatment of fourth branchial cleft anomalies, knowing of the courses of internal sinus and spread of infection, and use of principle of selective neck dissection is the key to ensure complete removal of lesions.

  14. Inferior Vena Cava Filter Limb Fracture with Embolization to the Right Ventricle.

    Science.gov (United States)

    Jackson, Bradley S; Sepula, Mykel; Marx, Jared T; Cannon, Chad M

    2017-08-01

    Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain. Chest radiography was reviewed and originally thought to have no abnormalities. Chest computed tomography angiography was negative for filling defects or foreign bodies. A possible foreign body in the heart was noted by a radiologist's over-read of the original chest radiograph. An echocardiogram done by Cardiology was negative for foreign bodies or other abnormalities. Next, an emergency physician performed a bedside echocardiogram, with focused attention to the right side of the heart. An echogenic foreign body was visualized in the right ventricle. The patient was subsequently taken to the cardiac catheterization laboratory, where fluoroscopic visualization of a limb wire of an IVC filter within the right ventricle was obtained. That foreign body was subsequently removed successfully, along with removal of the broken IVC filter. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report highlights the utility of point-of-care ultrasound in the work-up of a patient with an embolized IVC filter wire. Chest pain patients frequently receive point-of-care echocardiography in the ED, and these ultrasound findings should be recognized and used to guide further treatment and consultation. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Endodontic management of a mandibular third molar fused with a fourth molar.

    Science.gov (United States)

    Turell, I L; Zmener, O

    1999-05-01

    Developmental anomalies in permanent molars frequently require surgical intervention. A case of a mandibular third molar fused with a fourth molar which was successfully treated with conservative endodontic therapy is reported.

  16. The Fourth Branchial Complex Anomaly: A Rare Clinical Entity

    Directory of Open Access Journals (Sweden)

    Alpen B. Patel

    2011-01-01

    Full Text Available Fourth branchial pouch anomalies are rare congenital disorders of the neck and are a consequence of abnormal development of the branchial apparatus during embryogenesis. Failure to appropriately recognize these anomalies may result in misdiagnosis, insufficient treatment, and continued recurrence. Here, we present an unique presentation of two cases, describe their diagnosis, clinical course, and management, and review the literature regarding these interesting anomalies.

  17. Examination of nuclear systems of fourth generation

    International Nuclear Information System (INIS)

    2015-01-01

    This report proposes a detailed discussion of the six nuclear systems selected by the Generation IV International Forum with the objective of coordinating research and development activities which should result in the deployment of nuclear systems (reactors and associated fuel cycle installations) of fourth generation by the second half of the 21. century. These systems are: sodium cooled fast reactors (SFR), very high temperature reactors (VHTR), gas cooled fast reactors (GFR), lead cooled fast reactors (LFR) or lead bismuth eutectic reactors (LBE), molten salt reactors (MSR), and supercritical water reactors (SCWR). Fast systems are interesting as they favour the transmutation of fertile materials into fissile materials. History and perspectives of development, main characteristics, management of safety functions, risk analysis, impact on the environment, radiation protection and decommissioning, concept maturity and R and D needs are discussed for each of these systems. A comparison is reported in terms of main characteristics of reactors, of neutron characteristics and reactivity control, of sensitivity to cooling losses, of confinement function, of exploitation safety, of in-service inspection, of behaviour in case of severe accident, of toxicity of chemical substances, of sensitivity to aggressions (seism), of concept maturity and technological difficulties. The report also proposes a review of the various fuels which can be used in these different systems and which have been considered as eligible by the International Forum: oxides, carbides, nitrides, metals, waste processing. The last part addresses the transmutation of long life radioactive elements: physics, context, assessment of scenarios soundness, influence of transmutation on installations and transports

  18. A case of obstructive hydrocephalus by aqueduct stenosis following gamma knife surgery for arteriovenous malformation around the pineal body

    International Nuclear Information System (INIS)

    Funakoshi, Yusuke; Natori, Yoshihiro; Imamoto, Naoyuki; Inoue, Daisuke; Mori, Megumu; Yamada, Tetsuhisa

    2017-01-01

    Stereotactic radiosurgery, including gamma knife surgery, has been widely performed as minimally invasive treatment for arteriovenous malformation (AVM). While its safety and efficacy have been well reported, some problems also have been reported. Patients who undergo radiosurgery must wait for a few years from the time of treatment and remain exposed to the risk of bleeding until obliteration of the AVM is confirmed, and technical limitations may lead to incomplete administration of the intended treatment. In addition, severe complications are occasionally reported. Here, we present a case of obstructive hydrocephalus caused by aqueductal stenosis in a 63-year-old man who underwent gamma knife surgery for AVM around the pineal body 8 years previously. On visiting our department, he presented with mild disturbance of gait and consciousness. Other physical and neurological examinations were unremarkable. CT demonstrated dilatation of the lateral ventricles and the third ventricle. Because the aqueduct of the midbrain and fourth ventricle were not dilated, obstructive hydrocephalus due to localized aqueductal stenosis was suspected. Endoscopic neurosurgery was performed and stenosis in the aqueduct of the midbrain caused by a membrane-like structure was confirmed. Aqueductal stenosis occurred as a result of inflammation following gamma knife surgery, which extended to the cicatricial tissue and eventually caused a stenosed aqueduct of the midbrain. After the endoscopic third ventriculostomy, the hydrocephalus improved and no recurrence has appeared since. To the best of our knowledge, there have been no previous reports of obstructive hydrocephalus attributable to aqueductal stenosis caused by inflammation following gamma knife surgery. (author)

  19. Rotation curves of galaxies by fourth order gravity

    International Nuclear Information System (INIS)

    Stabile, A.; Scelza, G.

    2011-01-01

    We investigate the radial behavior of galactic rotation curves by a Fourth Order Gravity adding also the dark matter component. The Fourth Order Gravity is a theory of gravity described by Lagrangian generalizing the one of Hilbert-Einstein containing a generic function of the Ricci scalar, the Ricci and Riemann tensor. A systematic analysis of rotation curves, in the Newtonian Limit of theory, induced by all galactic substructures of ordinary matter is shown. This analysis is presented for Fourth Order Gravity with and without dark matter. The outcomes are compared with respect to the classical outcomes of General Relativity. The gravitational potential of pointlike mass is the usual potential corrected by two Yukawa terms. The rotation curve is higher or also lower than curve of General Relativity if in the Lagrangian the Ricci scalar square is dominant or not with respect to the contribution of the Ricci tensor square. The theoretical spatial behaviors of rotation curve are compared with the experimental data for the Milky Way and the galaxy NGC 3198. Although the Fourth Order Gravity gives more rotational contributions, in the limit of large distances the Keplerian behavior is ever present, and it is missing only if we add the dark matter component. However by modifying the theory of gravity, consequently, also the spatial description of dark matter could undergo a modification and the free parameters of model can assume different values. After an analytical discussion of theoretical behaviors and the comparing with experimental evidence we can claim that any Fourth Order Gravity is not successful to explain the galactic rotation curves. In the last part of paper we analyze the gravitational potential induced by Lagrangian containing only powers of Ricci scalar. In this case we find an inconsistency in the boundary conditions in the passage from matter to the vacuum.

  20. Fourth lepton family is natural in technicolor

    International Nuclear Information System (INIS)

    Frandsen, Mads T.; Masina, Isabella; Sannino, Francesco

    2010-01-01

    Imagine discovering a new fourth family of leptons at the Large Hadron Collider (LHC) but no signs of an associated fourth family of quarks. What would that imply? An intriguing possibility is that the new fermions needed to compensate for the new leptons gauge anomalies simultaneously address the big hierarchy problem of the standard model. A natural way to accomplish such a scenario is to have the Higgs itself be a composite of these new fermions. This is the setup we are going to investigate in this paper using as a template minimal walking technicolor. We analyze a general heavy neutrino mass structure with and without mixing with the standard model families. We also analyze the LHC potential to observe the fourth lepton family in tandem with the new composite Higgs dynamics. We finally introduce a model uniting the fourth lepton family and the technifermion sector at higher energies.

  1. The Fourth Revolution: Educating Engineers for Leadership.

    Science.gov (United States)

    Mark, Hans; Carver, Larry

    1988-01-01

    Urges a change in engineering education for developing leaders. Describes three previous revolutions in American higher education which responded to the needs of the community. Suggests lifelong education as the fourth revolution. (YP)

  2. Communications Style Guide. Fourth Edition

    Science.gov (United States)

    2010-08-01

    Example 2: The general’s dog, obedient and loyal, was the perfect companion . 2. Adverbial modifiers: Adverbial modifiers are usually followed...pronoun in this case. Example 3: Us chefs like to cook.  You wouldn’t say, “Us like to cook,” so the appropriate pronoun here is we. 2...in Chicago Style. Resources for Additional Help:  Alred, Gerald J., Charles T. Brusaw, and Walter E. Oliu. The Business Writer’s Companion

  3. Characterizing the angiogenic activity of patients with single ventricle physiology and aortopulmonary collateral vessels.

    Science.gov (United States)

    Sandeep, Nefthi; Uchida, Yutaka; Ratnayaka, Kanishka; McCarter, Robert; Hanumanthaiah, Sridhar; Bangoura, Aminata; Zhao, Zhen; Oliver-Danna, Jacqueline; Leatherbury, Linda; Kanter, Joshua; Mukouyama, Yoh-Suke

    2016-04-01

    Patients with single ventricle congenital heart disease often form aortopulmonary collateral vessels via an unclear mechanism. To gain insights into the pathogenesis of aortopulmonary collateral vessels, we correlated angiogenic factor levels with in vitro activity and angiographic aortopulmonary collateral assessment and examined whether patients with single ventricle physiology have increased angiogenic factors that can stimulate endothelial cell sprouting in vitro. In patients with single ventricle physiology (n = 27) and biventricular acyanotic control patients (n = 21), hypoxia-inducible angiogenic factor levels were measured in femoral venous and arterial plasma at cardiac catheterization. To assess plasma angiogenic activity, we used a 3-dimensional in vitro cell sprouting assay that recapitulates angiogenic sprouting. Aortopulmonary collateral angiograms were graded using a 4-point scale. Compared with controls, patients with single ventricle physiology had increased vascular endothelial growth factor (artery: 58.7 ± 1.2 pg/mL vs 35.3 ± 1.1 pg/mL, P collateral severity. We are the first to correlate plasma angiogenic factor levels with angiography and in vitro angiogenic activity in patients with single ventricle disease with aortopulmonary collaterals. Patients with single ventricle disease have increased stromal-derived factor 1-alpha and soluble fms-like tyrosine kinase-1, and their roles in aortopulmonary collateral formation require further investigation. Plasma factors and angiogenic activity correlate poorly with aortopulmonary collateral severity in patients with single ventricles, suggesting complex mechanisms of angiogenesis. Published by Elsevier Inc.

  4. Myocardial Response to Milrinone in Single Right Ventricle Heart Disease.

    Science.gov (United States)

    Nakano, Stephanie J; Nelson, Penny; Sucharov, Carmen C; Miyamoto, Shelley D

    2016-07-01

    Empiric treatment with milrinone, a phosphodiesterase (PDE) 3 inhibitor, has become increasingly common in patients with single ventricle heart disease of right ventricular (RV) morphology (SRV); our objective was to characterize the myocardial response to PDE3 inhibition (PDE3i) in the pediatric population with SRV. Cyclic adenosine monophosphate levels, PDE activity, and phosphorylated phospholamban (PLN) were determined in explanted human ventricular myocardium from nonfailing pediatric donors (n = 10) and pediatric patients transplanted secondary to SRV. Subjects with SRV were further classified by PDE3i treatment (n = 13 with PDE3i and n = 12 without PDE3i). In comparison with nonfailing RV myocardium (n = 8), cyclic adenosine monophosphate levels are lower in patients with SRV treated with PDE3i (n = 12, P = .021). Chronic PDE3i does not alter total PDE or PDE3 activity in SRV myocardium. Compared with nonfailing RV myocardium, SRV myocardium (both with and without PDE3i) demonstrates equivalent phosphorylated PLN at the protein kinase A phosphorylation site. As evidenced by preserved phosphorylated PLN, the molecular adaptation associated with SRV differs significantly from that demonstrated in pediatric heart failure because of dilated cardiomyopathy. These alterations support a pathophysiologically distinct mechanism of heart failure in pediatric patients with SRV, which has direct implications regarding the presumed response to PDE3i treatment in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Stem cell therapy for the systemic right ventricle.

    Science.gov (United States)

    Si, Ming-Sing; Ohye, Richard G

    2017-11-01

    In specific forms of congenital heart defects and pulmonary hypertension, the right ventricle (RV) is exposed to systemic levels of pressure overload. The RV is prone to failure in these patients because of its vulnerability to chronic pressure overload. As patients with a systemic RV reach adulthood, an emerging epidemic of RV failure has become evident. Medical therapies proven for LV failure are ineffective in treating RV failure. Areas covered: In this review, the pathophysiology of the failing RV under pressure overload is discussed, with specific emphasis on the pivotal roles of angiogenesis and oxidative stress. Studies investigating the ability of stem cell therapy to improve angiogenesis and mitigate oxidative stress in the setting of pressure overload are then reviewed. Finally, clinical trials utilizing stem cell therapy to prevent RV failure under pressure overload in congenital heart disease will be discussed. Expert commentary: Although considerable hurdles remain before their mainstream clinical implementation, stem cell therapy possesses revolutionary potential in the treatment of patients with failing systemic RVs who currently have very limited long-term treatment options. Rigorous clinical trials of stem cell therapy for RV failure that target well-defined mechanisms will ensure success adoption of this therapeutic strategy.

  6. Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction.

    Science.gov (United States)

    Freitas, Felipe; Estato, Vanessa; Carvalho, Vinícius Frias; Torres, Rafael Carvalho; Lessa, Marcos Adriano; Tibiriçá, Eduardo

    2013-10-01

    The pathophysiology underlying hyperthyroidism-induced left ventricle (LV) dysfunction and hypertrophy directly involves the heart and indirectly involves the neuroendocrine systems. The effects of hyperthyroidism on the microcirculation are still controversial in experimental models. We investigated the effects of hyperthyroidism on the cardiac function and microcirculation of an experimental rat model. Male Wistar rats (170-250 g) were divided into two groups: the euthyroid group (n = 10), which was treated with 0.9% saline solution, and the hyperthyroid group (n = 10), which was treated with l-thyroxine (600 μg/kg/day, i.p.) during 14 days. An echocardiographic study was performed to evaluate the alterations in cardiac function, structure and geometry. The structural capillary density and the expression of angiotensin II AT1 receptor in the LV were analyzed using histochemistry and immunohistochemistry, respectively. Hyperthyroidism was found to induce profound cardiovascular alterations, such as systolic hypertension, tachycardia, LV dysfunction, cardiac hypertrophy, and myocardial fibrosis. This study demonstrates the existence of structural capillary rarefaction and the down-regulation of the cardiac angiotensin II AT1 receptor in the myocardium of hyperthyroid rats in comparison with euthyroid rats. Microvascular rarefaction may be involved in the pathophysiology of hyperthyroidism-induced cardiovascular alterations. © 2013 John Wiley & Sons Ltd.

  7. Electroencephalography in ellipsoidal geometry with fourth-order harmonics.

    Science.gov (United States)

    Alcocer-Sosa, M; Gutierrez, D

    2016-08-01

    We present a solution to the electroencephalographs (EEG) forward problem of computing the scalp electric potentials for the case when the head's geometry is modeled using a four-shell ellipsoidal geometry and the brain sources with an equivalent current dipole (ECD). The proposed solution includes terms up to the fourth-order ellipsoidal harmonics and we compare this new approximation against those that only considered up to second- and third-order harmonics. Our comparisons use as reference a solution in which a tessellated volume approximates the head and the forward problem is solved through the boundary element method (BEM). We also assess the solution to the inverse problem of estimating the magnitude of an ECD through different harmonic approximations. Our results show that the fourth-order solution provides a better estimate of the ECD in comparison to lesser order ones.

  8. Recurrent thyroid abscess - Is it a fourth branchial archanomaly?

    Science.gov (United States)

    Desai, A A; Pandya, V K; Chougule, Sachin; Nair, Unnikrishnnan

    2006-04-01

    Branchial fistulae are of congenital origin(6) and consists of skin lined tract opening internally at junction of cartilaginous and bony meatus in case of 1(st) arch anomaly, tonsillar fossa in case of 2(nd) arch, while 3(rd) and 4(th) arch sinuses have internal opening at level of pyriform sinus or below. A complete tract of 3(rd) or 4(th) arch fistulae is yet to be described. Fourth arch fistulae(1) have a distinct clinical pattern of internal opening at pyriform apex, are left sided and associated with suppurative thyroiditis(3), they manifest at a younger age and treatment involves excision of tract with ipsilateral thyroid lobectomy.

  9. Visualization of Fiber Structure in the Left and Right Ventricle of a Human Heart

    International Nuclear Information System (INIS)

    Rohmer, Damien; Sitek, Arkadiusz; Gullberg, Grant T.

    2006-01-01

    The human heart is composed of a helical network of muscle fibers. Anisotropic least squares filtering followed by fiber tracking techniques were applied to Diffusion Tensor Magnetic Resonance Imaging(DTMRI) data of the excised human heart. The fiber configuration was visualized by using thin tubes to increase 3-dimensional visual perception of the complex structure. All visualizations were performed using the high-quality ray-tracing software POV-Ray. The fibers are shown within the left and right ventricles. Both ventricles exhibit similar fiber architecture and some bundles of fibers are shown linking right and left ventricles on the posterior region of the heart

  10. Joubert Syndrome: Imaging Features and Illustration of a Case

    International Nuclear Information System (INIS)

    Arora, Richa

    2014-01-01

    Joubert Syndrome (JS) is a rare autosomal recessive disorder characterised clinically by neonatal breathing dysregulation, developmental delay, intellectual disability, hypotonia, ataxia, nystagmus. We present another case of this uncommon syndrome in a 12 years old patient presenting with classical complaints of developmental delay, intellectual impairment, weakness in both lower limbs, ataxia and abnormal facies and diagnosed on Computed Tomography. Joubert Syndrome should be ruled out in all patients presenting with hypotonia, ataxia, nystagmus, breathing abnormalities and developmental delay. Its neuroimaging hallmarks include molar tooth sign and batwing shaped fourth ventricle. As JS is associated with multiorgan involvement, these patients should enter a diagnostic protocol to assess systemic abnormalities. Extreme caution should be taken while administering drugs in these patients as they are prone to respiratory depression

  11. #SocialMedia, Advancement, and Fundraising in Education. [Fourth Annual Survey of Social Media in Advancement

    Science.gov (United States)

    Slover-Linett, Cheryl; Stoner, Michael

    2013-01-01

    This white paper reports on findings from the fourth survey of social media in advancement, conducted in January and February, 2013 by the Council for Advancement and Support of Education (CASE), Huron Education, and mStoner. The survey was taken by more than 1,000 CASE members. Featured are six case studies on the effective use of social media in…

  12. CT abnormality in multiple sclerosis analysis based on 28 probable cases and correlation with clinical manifestations

    International Nuclear Information System (INIS)

    Kakigi, Ryusuke; Shibasaki, Hiroshi; Tabira, Takeshi; Kuroiwa, Yoshigoro; Numaguchi, Yuji.

    1981-01-01

    In order to investigate the occurrence and nature of CT abnormality and its correlation with clinical manifestations in multiple sclerosis, 34 CT records obtained from 28 consecutive patients with probable multiple sclerosis were reviewed. Forty-six percent of all cases showed abnormal CT. Dilatation of cortical sulci was found in 39%; dilatation of the lateral ventricle in 36%; dilatation of prepontine or cerebello-pontine cistern and the fourth ventricle, suggesting brainstem atrophy, in 18%; dilatation of cerebellar sulci, superior cerebellar cistern and cisterna magna, suggesting cerebellar atrophy, in 11%. Low density area was found in the cerebral hemisphere in 11% of cases. Contrast enhancement, performed on 25 CT records, did not show any change. There was no correlation between CT abnormality and duration of the illness. Although abnormal CT tended to occur more frequently during exacerbations and chronic stable state than during remissions, the difference was not statistically significant. CT abnormalities suggesting brainstem atrophy, cerebellar atrophy or plaques were found exclusively during exacerbations and chronic stable state. The occurrence of CT abnormalities was not significantly different among various clinical forms which were classified based on clinically estimated sites of lesion, except that abnormal CT tended to occur less frequently in cases classified as the optic-spinal form. It is noteworthy that cerebral cortical atrophy and/or dilatation of the lateral ventricle were found in 31% of cases who did not show any clinical sign of cerebral involvement. There was a statistically significant correlation between CT abnormalities and levels of clinical disability. Eighty percent of the bedridden or severely disabled patients showed abnormal CT, in contrast with only 29% of those with moderate, slight or no disability. (author)

  13. CT abnormality in multiple sclerosis analysis based on 28 probable cases and correlation with clinical manifestations

    Energy Technology Data Exchange (ETDEWEB)

    Kakigi, R.; Shibasaki, H.; Tabira, T.; Kuroiwa, Y. (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine); Numaguchi, Y.

    1981-10-01

    In order to investigate the occurrence and nature of CT abnormality and its correlation with clinical manifestations in multiple sclerosis, 34 CT records obtained from 28 consecutive patients with probable multiple sclerosis were reviewed. Forty-six percent of all cases showed abnormal CT. Dilatation of cortical sulci was found in 39%; dilatation of the lateral ventricle in 36%; dilatation of prepontine or cerebello-pontine cistern and the fourth ventricle, suggesting brainstem atrophy, in 18%; dilatation of cerebellar sulci, superior cerebellar cistern and cisterna magna, suggesting cerebellar atrophy, in 11%. Low density area was found in the cerebral hemisphere in 11% of cases. Contrast enhancement, performed on 25 CT records, did not show any change. There was no correlation between CT abnormality and duration of the illness. Although abnormal CT tended to occur more frequently during exacerbations and chronic stable state than during remissions, the difference was not statistically significant. CT abnormalities suggesting brainstem atrophy, cerebellar atrophy or plaques were found exclusively during exacerbations and chronic stable state. The occurrence of CT abnormalities was not significantly different among various clinical forms which were classified based on clinically estimated sites of lesion, except that abnormal CT tended to occur less frequently in cases classified as the optic-spinal form. It is noteworthy that cerebral cortical atrophy and/or dilatation of the lateral ventricle were found in 31% of cases who did not show any clinical sign of cerebral involvement. There was a statistically significant correlation between CT abnormalities and levels of clinical disability. Eighty percent of the bedridden or severely disabled patients showed abnormal CT, in contrast with only 29% of those with moderate, slight or no disability.

  14. Age-related changes in volumes of the ventricles, sulci and periventricular hyperintensity area

    International Nuclear Information System (INIS)

    Yamada, Kenji; Matsuzawa, Taiju; Ono, Shuichi; Kawashima, Ryuta; Matsui, Hiroshige; Yamada, Susumu; Hishinuma, Takashi

    1987-01-01

    Brain atrophy in 47 subjects without neurologic disturbances, ranging in age from 46 to 82 years, was studied using magnetic resonance imaging (MRI). Moreover, the association of the periventricular hyperintensity area (PVH) recognized with MRI, was also investigated. The volume percentages of the brain, the ventricles and sulci to cranial cavity were calculated as indicators of brain atrophy. The brain volume index decreased and the indeces of the ventricles and sulci linearly increased with age, significantly. The volume ratio of the ventricles to sulci significantly increased with increasing age (p < 0.01) and the correlation coefficient was 0.38. This ratio showed negative correlation to the brain volume index. The volume percentage of PVH to the cranial cavity started to increase in the sixties and negatively correlated with the brain volume index. There was positive correlation between the ratio of the ventricles to sulci and the index of PVH. (author)

  15. Exercise and the right ventricle: a potential Achilles' heel.

    Science.gov (United States)

    La Gerche, Andre; Rakhit, Dhrubo J; Claessen, Guido

    2017-10-01

    Exercise is associated with unequivocal health benefits and results in many structural and functional changes of the myocardium that enhance performance and prevent heart failure. However, intense exercise also presents a significant hemodynamic challenge in which the right-sided heart chambers are exposed to a disproportionate increase in afterload and wall stress that can manifest as myocardial fatigue or even damage if intense exercise is sustained for prolonged periods. This review focuses on the physiological factors that result in a disproportionate load on the right ventricle during exercise and the long-term consequences. The changes in cardiac structure and function that define 'athlete's heart' disproportionately affect the right-sided heart chambers and this can raise important diagnostic overlap with some cardiac pathologies, particularly some inherited cardiomyopathies. The interaction between exercise and arrhythmogenic right ventricular cardiomyopathy (ARVC) will be highlighted as an important example of how hemodynamic stressors can combine with deficiencies in cardiac structural elements to cause cardiac dysfunction predisposing to arrhythmias. The extent to which extreme exercise can cause adverse remodelling in the absence of a genetic predisposition remains controversial. In the athlete with profound changes in heart structure, it can be extremely challenging to determine whether common symptoms such as palpitations may be a marker of more sinister arrhythmias. This review discusses some of the techniques that have recently been proposed to identify pathology in these circumstances. Finally, we will discuss recent evidence defining the role of exercise restriction as a therapeutic intervention in individuals predisposed to arrhythmogenic cardiomyopathy. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  16. Graph cut-based method for segmenting the left ventricle from MRI or echocardiographic images.

    Science.gov (United States)

    Bernier, Michael; Jodoin, Pierre-Marc; Humbert, Olivier; Lalande, Alain

    2017-06-01

    In this paper, we present a fast and interactive graph cut method for 3D segmentation of the endocardial wall of the left ventricle (LV) adapted to work on two of the most widely used modalities: magnetic resonance imaging (MRI) and echocardiography. Our method accounts for the fundamentally different nature of both modalities: 3D echocardiographic images have a low contrast, a poor signal-to-noise ratio and frequent signal drop, while MR images are more detailed but also cluttered and contain highly anisotropic voxels. The main characteristic of our method is to work in a 3D Bezier coordinate system instead of the original Euclidean space. This comes with several advantages, including an implicit shape prior and a result guarantied not to have any holes in it. The proposed method is made of 4 steps. First, a 3D sampling of the LV cavity is made based on a Bezier coordinate system. This allows to warp the input 3D image to a Bezier space in which a plane corresponds to an anatomically plausible 3D Euclidean bullet shape. Second, a 3D graph is built and an energy term (which is based on the image gradient and a 3D probability map) is assigned to each edge of the graph, some of which being given an infinite energy to ensure the resulting 3D structure passes through key anatomical points. Third, a max-flow min-cut procedure is executed on the energy graph to delineate the endocardial surface. And fourth, the resulting surface is projected back to the Euclidean space where a post-processing convex hull algorithm is applied on every short axis slice to remove local concavities. Results obtained on two datasets reveal that our method takes between 2 and 5s to segment a 3D volume, it has better results overall than most state-of-the-art methods on the CETUS echocardiographic dataset and is statistically as good as a human operator on MR images. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. A fourth order spline collocation approach for a business cycle model

    Science.gov (United States)

    Sayfy, A.; Khoury, S.; Ibdah, H.

    2013-10-01

    A collocation approach, based on a fourth order cubic B-splines is presented for the numerical solution of a Kaleckian business cycle model formulated by a nonlinear delay differential equation. The equation is approximated and the nonlinearity is handled by employing an iterative scheme arising from Newton's method. It is shown that the model exhibits a conditionally dynamical stable cycle. The fourth-order rate of convergence of the scheme is verified numerically for different special cases.

  18. A solution to meningiomas at the trigone of the lateral ventricle using a contralateral transfalcine approach.

    Science.gov (United States)

    Zhu, Wei; Xie, Tao; Zhang, Xiaobiao; Ma, Bingbing; Wang, Xuejian; Gu, Ye; Ge, Junqi; Xu, Wenlong; Hu, Fan; Zhang, Yu; Li, Qiuping; Yu, Yong; Zhou, Hao; Jiang, Yinchuan; Li, Wensheng

    2013-01-01

    Access to the trigone of the lateral ventricle is challenging because of the deep location and the intimate relationships to eloquent areas. A novel posterior interhemispheric transfalx transprecuneus approach for two meningiomas at the trigone of the lateral ventricle is described. The meningiomas were resected completely with good neurologic outcomes and no operative mortality. The feasibilities and advantages of this novel approach are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. The estimation diastolic properties of the right and left heart's ventricles by a magnetic resonance imaging

    International Nuclear Information System (INIS)

    Myagkov, A.P.; Cherepok, A.A.

    2003-01-01

    On the basis of comparison of data heart's catheterization nd magnetic resonance imaging the technique of determination initial and enddiastolic pressure in heart's ventricles is developed. It has allowed to determine a diastolic extensibility, hardness, initial and enddiastolic pressure gradients for right and left ventricle. All necessary formulas and calculations techniques, control data of the models, received at the research of healthy subjects are described

  20. Patient-Specific Modeling of Interventricular Hemodynamics in Single Ventricle Physiology

    Science.gov (United States)

    Vedula, Vijay; Feinstein, Jeffrey; Marsden, Alison

    2016-11-01

    Single ventricle (SV) congenital heart defects, in which babies are born with only functional ventricle, lead to significant morbidity and mortality with over 30% of patients developing heart failure prior to adulthood. Newborns with SV physiology typically undergo three palliative surgeries, in which the SV becomes the systemic pumping chamber. Depending on which ventricle performs the systemic function, patients are classified as having either a single left ventricle (SLV) or a single right ventricle (SRV), with SRV patients at higher risk of failure. As the native right ventricles are not designed to meet systemic demands, they undergo remodeling leading to abnormal hemodynamics. The hemodynamic characteristics of SLVs compared with SRVs is not well established. We present a validated computational framework for performing patient-specific modeling of ventricular flows, and apply it across 6 SV patients (3SLV + 3SRV), comparing hemodynamic conditions between the two subgroups. Simulations are performed with a stabilized finite element method coupled with an immersed boundary method for modeling heart valves. We discuss identification of hemodynamic biomarkers of ventricular remodeling for early risk assessment of failure. This research is supported in part by the Stanford Child Health Research Institute and the Stanford NIH-NCATS-CTSA through Grant UL1 TR001085 and due to U.S. National Institute of Health through NIH NHLBI R01 Grants 5R01HL129727-02 and 5R01HL121754-03.

  1. Morphological analysis of enlarged ventricle on CT image, using multivariate analysis

    International Nuclear Information System (INIS)

    Iwasaki, Satoru; Kichikawa, Kimihiko; Otsuji, Hideyuki; Fukusumi, Akio; Kobayashi, Yasuo.

    1983-01-01

    Multivariate analysis of enlarged cerebral ventricle on CT was undertaken to study the characteristics of ventricular morphology. Several ventricular segments of enlarged ventricle, defined on the basis of the study of normal group, were linearly measured on CT image. Then the discriminant analysis with the increase and decrease of variable was applied. The following are the results obtained. The error ratio of discrimination between pressure hydrocephalus and cerebral atrophy was 8.4 %, and between obstructive hydrocephalus and communicating hydrocephalus was 11.3 %. Ventricular segments were divided into three groups according to their character of enlargement: (1) the temporal horn and trigone are large in pressure hydrocephalus; (2) the hypothalamic segment of the third ventricle and the body of lateral ventricle are larger in obstructive hydrocephalus than in communicating hydrocephalus; (3) the anterior horn, cellae mediae at the level of the head of caudate nuclei and thalamic segment of the third ventricle are relatively large in cerebral atrophy and communicating hydrocephalus. The hypothalamic segment of the third ventricle assumes a round or oval shape in pressure hydrocephalus but a rectangular or teardrop shape in cerebral atrophy. These findings are contributory to pathological evaluation of ventricular enlargement. (author)

  2. Selection of reference genes for gene expression studies in heart failure for left and right ventricles.

    Science.gov (United States)

    Li, Mengmeng; Rao, Man; Chen, Kai; Zhou, Jianye; Song, Jiangping

    2017-07-15

    Real-time quantitative reverse transcriptase-PCR (qRT-PCR) is a feasible tool for determining gene expression profiles, but the accuracy and reliability of the results depends on the stable expression of selected housekeeping genes in different samples. By far, researches on stable housekeeping genes in human heart failure samples are rare. Moreover the effect of heart failure on the expression of housekeeping genes in right and left ventricles is yet to be studied. Therefore we aim to provide stable housekeeping genes for both ventricles in heart failure and normal heart samples. In this study, we selected seven commonly used housekeeping genes as candidates. By using the qRT-PCR, the expression levels of ACTB, RAB7A, GAPDH, REEP5, RPL5, PSMB4 and VCP in eight heart failure and four normal heart samples were assessed. The stability of candidate housekeeping genes was evaluated by geNorm and Normfinder softwares. GAPDH showed the least variation in all heart samples. Results also indicated the difference of gene expression existed in heart failure left and right ventricles. GAPDH had the highest expression stability in both heart failure and normal heart samples. We also propose using different sets of housekeeping genes for left and right ventricles respectively. The combination of RPL5, GAPDH and PSMB4 is suitable for the right ventricle and the combination of GAPDH, REEP5 and RAB7A is suitable for the left ventricle. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Crossed cerebellar atrophy in cases with cerebrovascular disease

    International Nuclear Information System (INIS)

    Yagishita, Toshiyuki; Kojima, Shigeyuki; Hirayama, Keizo; Iwabuchi, Sadamu.

    1989-01-01

    Crossed cerebellar atrophy (CCA) was investigated by X-ray CT to establish the incidence, mechanism, and the relation to cerebral lesions in 130 cases of unilateral supratentorial cerebrovascular diseases. The 130 cases consisted of 83 males and 47 females with cerebral infarction (65 cases) and cerebral hemorrhage (65 cases). The patients' average age was 57.6 years. Crossed cerebellar atrophy was demonstrated in 8 cases (6.2%), 6 of whom had massive cerebral infarction in the middle cerebral artery area (9.2% of the 65 cases of cerebral infarction. The six cases of CCA caused by cerebral infarction had lesions in the frontal and temporal lobes. Two had a cerebral hemorrhage in the putamen and in the thalamus, respectively, accounting for 3.1% of the 65 cases of cerebral hemorrhage. Of the 2 cases, one had putaminal hemorrhage, and the other had thalamic hemorrhage. Cerebrovascular stroke had occured in these patients with CCA more than 2 months previously. In 5 of the 8 cases of CCA, atrophy was present in the basis pedunculi and the basis pontis on the side of the cerebral lesion. However, neither dilation nor deformity of the fourth ventricle was present in any of the patients, suggesting that none of the CCA patients had atrophy of the dentate nucleus. The CCA patients had massive cerebral lesion in the frontal and temporal lobes or atrophy of the basis pedunculi and basis pontis, suggesting the presence of the transsynaptic degeneration of the cortico-ponto-cerebellar pathway. In the case of the thalamic hemorrhage, who had not hemorrhagic lesion in the frontal and temporal lobes, atrophy of the basis peduncli and basis pontis was not observed. Though dilation or deformity of the fourth ventricle is not observed in this case, presence of the degeneration of the dentate-rubro-thalamic pathway cannot be denied. CCA seems to be caused by both the transsynaptic degeneration of the cortico-ponto-cerebellar pathway and the dentate-rubro-thalamic pathway. (J.P.N.)

  4. Proper Orthogonal Decomposition and Dynamic Mode Decomposition in the Right Ventricle after Repair of Tetralogy of Fallot

    Science.gov (United States)

    Mikhail, Amanda; Kadem, Lyes; di Labbio, Giuseppe

    2017-11-01

    Tetralogy of Fallot accounts for 5% of all cyanotic congenital heart defects, making it the most predominant today. Approximately 1660 cases per year are seen in the United States alone. Once repaired at a very young age, symptoms such as pulmonary valve regurgitation seem to arise two to three decades after the initial operation. Currently, not much is understood about the blood flow in the right ventricle of the heart when regurgitation is present. In this study, the interaction between the diastolic interventricular flow and the regurgitating pulmonary valve are investigated. This experimental work aims to simulate and characterize this detrimental flow in a right heart simulator using time-resolved particle image velocimetry. Seven severities of regurgitation were simulated. Proper Orthogonal Decomposition (POD) and Dynamic Mode Decomposition (DMD) revealed intricate coherent flow structures. With regurgitation severity, the modal energies from POD are more distributed among the modes while DMD reveals more unstable modes. This study can contribute to the further investigation of the detrimental effects of right ventricle regurgitation.

  5. Influence of the heart rate and atrioventricular delays on vortex evolution and blood transport inside the left ventricle

    Science.gov (United States)

    Hendabadi, Sahar; Martinez-Legazpi, Pablo; Benito, Yolanda; Bermejo, Javier; Del Alamo, Juan Carlos; Shadden, Shawn

    2013-11-01

    Cardiac resynchronization therapy (CRT) is used to help restore coordinated pumping of the ventricles by overcoming delays in electrical conduction due to cardiac disease. This is accomplished by a specialized cardiac pacemaker that is able to adjust the atrioventricular (AV) delay.A major clinical challenge is to adjust the pacing strategy to best coordinate the blood flow mechanics of ventricular filling and ejection. To this end, we have studied the difference in the vortex formation and its evolution inside the left ventricle (LV) for 4 different AV delays in a cohort of patients with implanted pacemakers. A reconstruction algorithm was used to obtain 2D velocity over the apical long-axis view of the LV from color Doppler and B-mode ultrasound data. To study blood transport, we have identified Lagrangian coherent structures to determine moving boundaries of the blood volumes injected to the LV in diastole and ejected to the aorta in systole. In all cases, we have analyzed the differences in filling and ejection patterns and the blood transport during the E-wave and A-wave formation.Finally we have assessed the influence of the AV delay on 2 indices of stasis, direct flow and residence time.The findings shed insight to the optimization of AV delays in patients undergoing CRT. NIH award 5R21HL108268 and grants PIS09/02603 and RD06/0010 from the Plan Nacional de Investigacion Cientifica, Spain.

  6. Ectopic pituitary null cell adenoma arising from the infundibulum in the third ventricle: A successful endonasal transsphenoidal resection after long-term follow-up MR imaging – A technical note

    Directory of Open Access Journals (Sweden)

    Yuichiro Yoneoka, M.D., Ph.D.

    2017-12-01

    Conclusion: To our best knowledge, this is the first case with long-term preoperative follow-up images, which can bridge the knowledge gap in operations of third ventricle ectPA as following: (1 Truly third ventricle ectPA can exist, (2 the third ventricle ectPA extended into the sella turcica along the pituitary stalk, (3 this ectPA can arise from the suprasellar peri-infundibular ectopic pituitary cells or the pars tuberalis of the adenohypophysis, and therefore adhere to the optic chiasm, (4 thus neurosurgeons should take great care in resection of ectPA arising from the infundibulum, and (5 it can be resected through an endoscopic extended transsphenoidal approach.

  7. Single-breath-hold 3-D CINE imaging of the left ventricle using Cartesian sampling.

    Science.gov (United States)

    Wetzl, Jens; Schmidt, Michaela; Pontana, François; Longère, Benjamin; Lugauer, Felix; Maier, Andreas; Hornegger, Joachim; Forman, Christoph

    2018-02-01

    Our objectives were to evaluate a single-breath-hold approach for Cartesian 3-D CINE imaging of the left ventricle with a nearly isotropic resolution of [Formula: see text] and a breath-hold duration of [Formula: see text]19 s against a standard stack of 2-D CINE slices acquired in multiple breath-holds. Validation is performed with data sets from ten healthy volunteers. A Cartesian sampling pattern based on the spiral phyllotaxis and a compressed sensing reconstruction method are proposed to allow 3-D CINE imaging with high acceleration factors. The fully integrated reconstruction uses multiple graphics processing units to speed up the reconstruction. The 2-D CINE and 3-D CINE are compared based on ventricular function parameters, contrast-to-noise ratio and edge sharpness measurements. Visual comparisons of corresponding short-axis slices of 2-D and 3-D CINE show an excellent match, while 3-D CINE also allows reformatting to other orientations. Ventricular function parameters do not significantly differ from values based on 2-D CINE imaging. Reconstruction times are below 4 min. We demonstrate single-breath-hold 3-D CINE imaging in volunteers and three example patient cases, which features fast reconstruction and allows reformatting to arbitrary orientations.

  8. Fully automated segmentation of left ventricle using dual dynamic programming in cardiac cine MR images

    Science.gov (United States)

    Jiang, Luan; Ling, Shan; Li, Qiang

    2016-03-01

    Cardiovascular diseases are becoming a leading cause of death all over the world. The cardiac function could be evaluated by global and regional parameters of left ventricle (LV) of the heart. The purpose of this study is to develop and evaluate a fully automated scheme for segmentation of LV in short axis cardiac cine MR images. Our fully automated method consists of three major steps, i.e., LV localization, LV segmentation at end-diastolic phase, and LV segmentation propagation to the other phases. First, the maximum intensity projection image along the time phases of the midventricular slice, located at the center of the image, was calculated to locate the region of interest of LV. Based on the mean intensity of the roughly segmented blood pool in the midventricular slice at each phase, end-diastolic (ED) and end-systolic (ES) phases were determined. Second, the endocardial and epicardial boundaries of LV of each slice at ED phase were synchronously delineated by use of a dual dynamic programming technique. The external costs of the endocardial and epicardial boundaries were defined with the gradient values obtained from the original and enhanced images, respectively. Finally, with the advantages of the continuity of the boundaries of LV across adjacent phases, we propagated the LV segmentation from the ED phase to the other phases by use of dual dynamic programming technique. The preliminary results on 9 clinical cardiac cine MR cases show that the proposed method can obtain accurate segmentation of LV based on subjective evaluation.

  9. Flow dynamics and energy efficiency of flow in the left ventricle during myocardial infarction.

    Science.gov (United States)

    Vasudevan, Vivek; Low, Adriel Jia Jun; Annamalai, Sarayu Parimal; Sampath, Smita; Poh, Kian Keong; Totman, Teresa; Mazlan, Muhammad; Croft, Grace; Richards, A Mark; de Kleijn, Dominique P V; Chin, Chih-Liang; Yap, Choon Hwai

    2017-10-01

    Cardiovascular disease is a leading cause of death worldwide, where myocardial infarction (MI) is a major category. After infarction, the heart has difficulty providing sufficient energy for circulation, and thus, understanding the heart's energy efficiency is important. We induced MI in a porcine animal model via circumflex ligation and acquired multiple-slice cine magnetic resonance (MR) images in a longitudinal manner-before infarction, and 1 week (acute) and 4 weeks (chronic) after infarction. Computational fluid dynamic simulations were performed based on MR images to obtain detailed fluid dynamics and energy dynamics of the left ventricles. Results showed that energy efficiency flow through the heart decreased at the acute time point. Since the heart was observed to experience changes in heart rate, stroke volume and chamber size over the two post-infarction time points, simulations were performed to test the effect of each of the three parameters. Increasing heart rate and stroke volume were found to significantly decrease flow energy efficiency, but the effect of chamber size was inconsistent. Strong complex interplay was observed between the three parameters, necessitating the use of non-dimensional parameterization to characterize flow energy efficiency. The ratio of Reynolds to Strouhal number, which is a form of Womersley number, was found to be the most effective non-dimensional parameter to represent energy efficiency of flow in the heart. We believe that this non-dimensional number can be computed for clinical cases via ultrasound and hypothesize that it can serve as a biomarker for clinical evaluations.

  10. Convolutional neural network regression for short-axis left ventricle segmentation in cardiac cine MR sequences.

    Science.gov (United States)

    Tan, Li Kuo; Liew, Yih Miin; Lim, Einly; McLaughlin, Robert A

    2017-07-01

    Automated left ventricular (LV) segmentation is crucial for efficient quantification of cardiac function and morphology to aid subsequent management of cardiac pathologies. In this paper, we parameterize the complete (all short axis slices and phases) LV segmentation task in terms of the radial distances between the LV centerpoint and the endo- and epicardial contours in polar space. We then utilize convolutional neural network regression to infer these parameters. Utilizing parameter regression, as opposed to conventional pixel classification, allows the network to inherently reflect domain-specific physical constraints. We have benchmarked our approach primarily against the publicly-available left ventricle segmentation challenge (LVSC) dataset, which consists of 100 training and 100 validation cardiac MRI cases representing a heterogeneous mix of cardiac pathologies and imaging parameters across multiple centers. Our approach attained a .77 Jaccard index, which is the highest published overall result in comparison to other automated algorithms. To test general applicability, we also evaluated against the Kaggle Second Annual Data Science Bowl, where the evaluation metric was the indirect clinical measures of LV volume rather than direct myocardial contours. Our approach attained a Continuous Ranked Probability Score (CRPS) of .0124, which would have ranked tenth in the original challenge. With this we demonstrate the effectiveness of convolutional neural network regression paired with domain-specific features in clinical segmentation. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Lepton sector of a fourth generation

    International Nuclear Information System (INIS)

    Burdman, G.; Da Rold, L.; Matheus, R. D.

    2010-01-01

    In extensions of the standard model with a heavy fourth generation, one important question is what makes the fourth-generation lepton sector, particularly the neutrinos, so different from the lighter three generations. We study this question in the context of models of electroweak symmetry breaking in warped extra dimensions, where the flavor hierarchy is generated by choosing the localization of the zero-mode fermions in the extra dimension. In this setup the Higgs sector is localized near the infrared brane, whereas the Majorana mass term is localized at the ultraviolet brane. As a result, light neutrinos are almost entirely Majorana particles, whereas the fourth-generation neutrino is mostly a Dirac fermion. We show that it is possible to obtain heavy fourth-generation leptons in regions of parameter space where the light neutrino masses and mixings are compatible with observation. We study the impact of these bounds, as well as the ones from lepton flavor violation, on the phenomenology of these models.

  12. Trend chart: wind power. Fourth quarter 2017

    International Nuclear Information System (INIS)

    Moreau, Sylvain

    2018-02-01

    This publication presents the wind energy situation of continental France and overseas territories during the fourth quarter 2017: total connected load, new connected facilities, regional distribution of wind power production, evolution of quarterly production, distribution of facilities versus power, evolution forecasts of the French wind power park, projects in progress, detailed regional results, revision of results

  13. Report of the Fourth District Economists' Roundtable

    OpenAIRE

    Michael F. Bryan; John B. Martin

    1994-01-01

    A summary of the 1994 forecasts for real output and inflation presented by 15 members of the Fourth District Economists' Roundtable at their January 1994 meeting, highlighting the measurement of service sector prices and the role of small businesses in creating jobs.

  14. Fourth Dutch Process Security Control Event

    NARCIS (Netherlands)

    Luiijf, H.A.M.; Zielstra, A.

    2010-01-01

    On December 1st, 2009, the fourth Dutch Process Control Security Event took place in Baarn, The Netherlands. The security event with the title ‘Manage IT!’ was organised by the Dutch National Infrastructure against Cybercrime (NICC). Mid of November, a group of over thirty people participated in the

  15. Diet and Cancer: The Fourth Paradigm

    Science.gov (United States)

    Walter C. Willett, MD, DrPH, an international expert in diet and nutrition, with posts as a Professor of Epidemiology and Nutrition and Chairman of the Department of Nutrition at Harvard School of Public Health and as Professor of Medicine at Harvard Medical School, presented "Diet and Cancer: The Fourth Paradigm".

  16. The Computer and the Fourth Revolution.

    Science.gov (United States)

    Molnar, Andrew R.

    An overview is provided of the Fourth Revolution, i.e., the revolution which is taking place in education as a result of the introduction of computers into the field. The growth of computing in education, especially in higher education, is traced, and some major National Science Foundation (NSF) programs are mentioned. Following this, a few of the…

  17. Nanoethics, Science Communication, and a Fourth Model for Public Engagement.

    Science.gov (United States)

    Miah, Andy

    2017-01-01

    This paper develops a fourth model of public engagement with science, grounded in the principle of nurturing scientific agency through participatory bioethics. It argues that social media is an effective device through which to enable such engagement, as it has the capacity to empower users and transforms audiences into co-producers of knowledge, rather than consumers of content. Social media also fosters greater engagement with the political and legal implications of science, thus promoting the value of scientific citizenship. This argument is explored by considering the case of nanoscience and nanotechnology, as an exemplar for how emerging technologies may be handled by the scientific community and science policymakers.

  18. Fourth branchial cleft anomaly: management strategy in acute presentation.

    Science.gov (United States)

    Carta, Filippo; Sionis, Sara; Mascia, Luigi; Puxeddu, Roberto

    2014-09-01

    Branchial malformations are common congenital head and neck lesions usually diagnosed in childhood during the first decade of life. Acute presentation is usually managed with conservative protocols before a definitive surgical procedure although the risk of life-treating septic complications may influence the physician's decision. Surgery is the treatment of choice with the removal of the lesion alone, nevertheless more aggressive approaches must be considered in complicated cases. Selective neck dissection including the removal of part of the thyroid lobe with the congenital lesion should be considered as the "ultima ratio" treatment to avoid recurrence. We reviewed literature and report our experience concerning two patients with fourth branchial cleft sinus. A three-year-old child with a clinical history of recurrent neck abscess was referred to our department after several drainages performed in another centre. A three-year-old child referred to our department for a left side lower primary neck abscess. In both cases the diagnosis of a complicated fourth cleft remnant was confirmed by rigid endoscopic visualization of the mucosal orifice of the sinus in the pyriform fossa. Surgical management during acute presentation was challenging; in one patient the early fasciitis required an emergency procedure to remove the infected sinus that were strictly adherent to the deep vascular-nervous axis. Surgery was the definitive treatment in both cases and at 12 and 25 months follow-up respectively no recurrences were observed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Ten years of experience with third and fourth branchial remnants.

    Science.gov (United States)

    Liberman, Moishe; Kay, Saundra; Emil, Sherif; Flageole, Hélène; Nguyen, Luong T; Tewfik, Ted L; Oudjhane, Kamal; Laberge, Jean-Martin

    2002-05-01

    Third and fourth branchial remnants may result in cysts and abscesses that are in close contact with the thyroid gland. These anomalies are rare and often present diagnostic and therapeutic challenges. The charts of patients diagnosed with a branchial anomaly between July 1991 and July 2001 at the Montreal Children's Hospital were reviewed. All cases of third and fourth branchial remnants or pyriform sinus fistulae were identified. Clinical presentation, imaging, treatment, and outcome were recorded. Eight patients with a third or fourth branchial anomaly were identified and ranged in age from birth to 13 years. All anomalies were left sided. Presenting symptoms consisted of an asymptomatic cervical mass (n = 1), an infected mass (n = 5), neonatal respiratory distress (n = 1), and 1 incidental cyst found on magnetic resonance imaging. Ultrasonography was useful in suggesting the diagnosis in 7 cases. Barium swallow was performed in 3 patients with 2 positive results. Pharyngoscopy results showed the internal opening in 2 of 7 patients. A portion of the thyroid gland was resected in 6 patients. One patient has not yet undergone a definitive procedure. There was 1 recurrence in a patient whose pathology did not confirm a branchial remnant. The diagnosis and management of pyriform sinus anomalies are challenging. Ultrasound scan, computed tomography scan, barium swallow, and pharyngoscopy are all useful. The portion of thyroid involved in the fistula must be excised en bloc with the inflammatory mass, and the tract should be ligated at the level of the pharynx to minimize recurrence. Copyright 2002, Elsevier Science (USA). All rights reserved.

  20. Large cell/anaplastic medulloblastoma with myogenic, melanotic and neuronal differentiation: A case report of a rare tumor

    Directory of Open Access Journals (Sweden)

    Amany A. Fathaddin

    2014-01-01

    Full Text Available Medulloblastoma is an embryonal neuroepithelial tumor of the cerebellum and is the most common malignant central nervous system tumor in children. Different histological variants and patterns have been described. The classic variant represents the majority of cases. This report describes a rare case of large cell/anaplastic medulloblastoma with myogenic, melanotic and neuronal differentiation arising in the cerebellum of a 3-year-old boy who presented with headache and vomiting. Magnetic resonance imaging demonstrated a heterogeneously enhanced lesion in the fourth ventricle. Surgical resection of the tumor was accomplished, but a residual tumor was left behind because of the involvement of the brainstem. Postoperatively, the patient received chemotherapy and radiotherapy. Currently, 20 months after treatment, the patient has survived without further progression. Pathological examination revealed a high grade primitive neuronal tumor with foci of myogenic features, melanin containing epithelial elements and ganglion-like cells, which were confirmed by immunohistochemistry.

  1. Comparative evaluation of the ventricles in the Yorkshire Terrier and the German Shepherd dog using low-field MRI.

    Science.gov (United States)

    Esteve-Ratsch, B; Kneissl, S; Gabler, C

    2001-01-01

    MR images provide for the exact assessment of the brain, including ventricular size. Still inter- and intrabreed comparison of ventricle size is difficult due to the varying anatomies in dogs. To compare the ventricle area of different sized breeds, 25 dogs (13 Yorkshire Terriers and 12 German Shepard dogs) were reviewed, retrospectively. Hemisphere and ventricle of each side were outlined manually three times. All measurements were averaged and their percentage (ventricle area by hemisphere area) was defined as the relative ventricle area. This value in Yorkshire Terriers (5.3) was significantly higher compared to German Shepard dogs (1.7). However, on the basis of the neurologically symptomatic sample (7 Yorkshire Terriers) in this study, threshold values of normal and abnormal relative ventricle areas could not be detected.

  2. Integration of electro-anatomical and imaging data of the left ventricle: An evaluation framework.

    Science.gov (United States)

    Soto-Iglesias, David; Butakoff, Constantine; Andreu, David; Fernández-Armenta, Juan; Berruezo, Antonio; Camara, Oscar

    2016-08-01

    Integration of electrical and structural information for scar characterization in the left ventricle (LV) is a crucial step to better guide radio-frequency ablation therapies, which are usually performed in complex ventricular tachycardia (VT) cases. This integration requires finding a common representation where to map the electrical information from the electro-anatomical map (EAM) surfaces and tissue viability information from delay-enhancement magnetic resonance images (DE-MRI). However, the development of a consistent integration method is still an open problem due to the lack of a proper evaluation framework to assess its accuracy. In this paper we present both: (i) an evaluation framework to assess the accuracy of EAM and imaging integration strategies with simulated EAM data and a set of global and local measures; and (ii) a new integration methodology based on a planar disk representation where the LV surface meshes are quasi-conformally mapped (QCM) by flattening, allowing for simultaneous visualization and joint analysis of the multi-modal data. The developed evaluation framework was applied to estimate the accuracy of the QCM-based integration strategy on a benchmark dataset of 128 synthetically generated ground-truth cases presenting different scar configurations and EAM characteristics. The obtained results demonstrate a significant reduction in global overlap errors (50-100%) with respect to state-of-the-art integration techniques, also better preserving the local topology of small structures such as conduction channels in scars. Data from seventeen VT patients were also used to study the feasibility of the QCM technique in a clinical setting, consistently outperforming the alternative integration techniques in the presence of sparse and noisy clinical data. The proposed evaluation framework has allowed a rigorous comparison of different EAM and imaging data integration strategies, providing useful information to better guide clinical practice in

  3. Origins and consequences of congenital heart defects affecting the right ventricle.

    Science.gov (United States)

    Woudstra, Odilia I; Ahuja, Suchit; Bokma, Jouke P; Bouma, Berto J; Mulder, Barbara J M; Christoffels, Vincent M

    2017-10-01

    Congenital heart disease is a major health issue, accounting for a third of all congenital defects. Improved early surgical management has led to a growing population of adults with congenital heart disease, including patients with defects affecting the right ventricle, which are often classified as severe. Defects affecting the right ventricle often cause right ventricular volume or pressure overload and affected patients are at high risk for complications such as heart failure and sudden death. Recent insights into the developmental mechanisms and distinct developmental origins of the left ventricle, right ventricle, and the outflow tract have shed light on the common features and distinct problems arising in specific defects. Here, we provide a comprehensive overview of the current knowledge on the development into the normal and congenitally malformed right heart and the clinical consequences of several congenital heart defects affecting the right ventricle. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  4. Coronary reserve of the right ventricle evaluated by double dose Tl-201 scintigraphy

    International Nuclear Information System (INIS)

    Sugihara, Hiroki; Adachi, Haruhiko; Nakagawa, Hiroaki

    1985-01-01

    Thallium-201 double dose scintigraphy was applied to exercise to estimate the coronary blood flow reserve of the left and right ventricles and this was compared with the degree of coronary artery stenosis. As an index of coronary reserve we measured the rate of change of blood flow distribution (ΔF) calculated from the change in myocardial radioactivity following thallium-201 injections, once at rest and once during exercise. With submaximal exercise the increases in ΔF of the left ventricle were less in patients with ischemic heart disease than in the control subjects, and were less as the number of diseased coronary vessels increased. The increases of ΔF of the right ventricle were less in patients with stenosis of the proximal portion of the right coronary artery than in patients without stenosis and in the control subjects. The more severe the stenosis of the proximal portion of the right coronary artery, the smaller the ΔF of the right ventricle. These results indicate that evaluation of the ΔF in the left and right ventricles is useful in estimating coronary artery stenosis. (author)

  5. Echocardiographic assessment of the right ventricle in the current era: Application in clinical practice.

    Science.gov (United States)

    Venkatachalam, Sridhar; Wu, Geru; Ahmad, Masood

    2017-12-01

    The right ventricle has unique structural and functional characteristics. It is now well recognized that the so-called forgotten ventricle is a key player in cardiovascular physiology. Furthermore, there is accumulating evidence that demonstrates right ventricular dysfunction as an important marker of morbidity and mortality in several commonly encountered clinical situations such as heart failure, pulmonary hypertension, pulmonary embolism, right ventricular myocardial infarction, and adult congenital heart disease. In contrast to the left ventricle, echocardiographic assessment of right ventricular function is more challenging as volume estimations are not possible without the use of three-dimensional (3D) echocardiography. Guidelines on chamber quantification provide a standardized approach to assessment of the right ventricle. The technique and limitations of each of the parameters for RV size and function need to be fully understood. In this era of multimodality imaging, echocardiography continues to remain a useful tool for the initial assessment and follow-up of patients with right heart pathology. Several novel approaches such as 3D and strain imaging of the right ventricle have expanded the usefulness of this indispensable modality. © 2017, Wiley Periodicals, Inc.

  6. Exclusive double outlet right ventricle with atrioventricular concordance and pulmonary stenosis. Results of reconstructive surgery.

    Science.gov (United States)

    Busquet, J; Fontan, F; Choussat, A; Caianiello, G; Fernandez, G

    1988-01-01

    Double outlet right ventricle associated with atrioventricular concordance, pulmonary stenosis and situs solitus of the atria is a subset of double outlet right ventricle related through the surgical treatment. From 1974 to 1985, 14 patients, 5 males, 9 females (mean age 8.9 years, range 13 months-22 years) were operated upon. All patients had infundibular stenosis and normal or large pulmonary arteries. The apex of the heart was to the right in 2 patients, the right and left ventricles were superior and inferior in 2 patients and 1 patient had both anomalies. The ventricular septal defect was subaortic in 11 patients (aorto-mitral discontinuity in 5) and non-committed in 3 patients. Three patients had 2 ventricular septal defects. The aorta was anterior in 3 patients and to the right of the pulmonary artery in 11 patients. All patients, through a transventricular and transatrial approach, had a reconstructive surgery. In 3 patients, an aortic homograft valved conduit was used. One patient had the ventricular septal defect enlarged. There was one early death (7.1%) from high residual right ventricle pressure and no late death. One patient had a transient atrioventricular block. One patient was reoperated upon for a residual ventricular septal defect. All survivors had a good clinical result. Re-evaluation in 8 patients confirmed excellent haemodynamics: the right ventricle to pulmonary artery pressure gradient decreased from 80 mm Hg (range 60-95) preoperatively to 24 mm Hg (range 3-32) postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    Directory of Open Access Journals (Sweden)

    Krasnobaev Arseny

    2016-01-01

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

  8. Serial right ventricle 201Tl imaging after exercise: relation to anatomy of the right coronary artery

    International Nuclear Information System (INIS)

    Brown, K.A.; Boucher, C.A.; Okada, R.D.; Strauss, H.W.; McKusick, K.A.; Pohost, G.M.

    1982-01-01

    The relation of the appearance of the right ventricle on serium 201 Tl myocardial imaging to coronary artery anatomy was examined in 88 consecutive patients undergoing exercise 201 Tl testing and coronary angiography for the evaluation of chest pain. Transient defects in the right ventricle were found in 8 patients. All had high grade (greater than or equal to 90%) stenosis of the proximal right coronary artery. Nonvisualization of right ventricular (RV) activity occurred in 10 patients. Nine of the 10 (90%) had significant (greater than or equal to 50% stenosis) disease of the proximal right coronary artery and 7 (70%) had high grade stenosis. The right ventricle appeared normal in 70 patients. Twenty-nine (41%) of these patients had significant proximal right coronary artery disease. Right ventricular appearance was not affected by the presence or absence of disease of the left anterior descending or left circumflex artery or by the appearance of the left ventricle. Thus, with serial RV thallium-201 myocardial imaging after exercise, we found that (1) RV transient defects suggest the presence of high grade proximal right coronary artery stenosis, (2) non-visualization of RV activity also predicts significant proximal right coronary disease, and (3) the right ventricle frequently appears normal despite proximal right coronary artery disease and therefore this finding does not exclude such disease

  9. Characterization of neonatal patients with intraventricular hemorrhage using 3D ultrasound cerebral ventricle volumes

    Science.gov (United States)

    Kishimoto, Jessica; Fenster, Aaron; Lee, David S. C.; de Ribaupierre, Sandrine

    2015-03-01

    One of the major non-congenital cause of neurological impairment among neonates born very preterm is intraventricular hemorrhage (IVH) - bleeding within the lateral ventricles. Most IVH patients will have a transient period of ventricle dilation that resolves spontaneously. However, those patients most at risk of long-term impairment are those who have progressive ventricle dilation as this causes macrocephaly, an abnormally enlarged head, then later causes increases intracranial pressure (ICP). 2D ultrasound (US) images through the fontanelles of the patients are serially acquired to monitor the progression of the ventricle dilation. These images are used to determine when interventional therapies such as needle aspiration of the built up CSF might be indicated for a patient. Initial therapies usually begin during the third week of life. Such interventions have been shown to decrease morbidity and mortality in IVH patients; however, this comes with risks of further hemorrhage or infection; therefore only patients requiring it should be treated. Previously we have developed and validated a 3D US system to monitor the progression of ventricle volumes (VV) in IVH patients. This system has been validated using phantoms and a small set of patient images. The aim of this work is to determine the ability of 3D US generated VV to categorize patients into those who will require interventional therapies, and those who will have spontaneous resolution. Patients with higher risks could therefore be monitored better, by re-allocating some of the resources as the low risks infants would need less monitoring.

  10. The "fourth dimension" of gene transcription.

    Science.gov (United States)

    O'Malley, Bert W

    2009-05-01

    The three dimensions of space provide our relationship to position on the earth, but the fourth dimension of time has an equally profound influence on our lives. Everything from light and sound to weather and biology operate on the principle of measurable temporal periodicity. Consequently, a wide variety of time clocks affect all aspects of our existence. The annual (and biannual) cycles of activity, metabolism, and mating, the monthly physiological clocks of women and men, and the 24-h diurnal rhythms of humans are prime examples. Should it be surprising to us that the fourth dimension also impinges upon gene expression and that the genome itself is regulated by the fastest running of all biological clocks? Recent evidence substantiates the existence of such a ubiquitin-dependent transcriptional clock that is based upon the activation and destruction of transcriptional coactivators.

  11. Horizon thermodynamics in fourth-order gravity

    Directory of Open Access Journals (Sweden)

    Meng-Sen Ma

    2017-03-01

    Full Text Available In the framework of horizon thermodynamics, the field equations of Einstein gravity and some other second-order gravities can be rewritten as the thermodynamic identity: dE=TdS−PdV. However, in order to construct the horizon thermodynamics in higher-order gravity, we have to simplify the field equations firstly. In this paper, we study the fourth-order gravity and convert it to second-order gravity via a so-called “Legendre transformation” at the cost of introducing two other fields besides the metric field. With this simplified theory, we implement the conventional procedure in the construction of the horizon thermodynamics in 3 and 4 dimensional spacetime. We find that the field equations in the fourth-order gravity can also be written as the thermodynamic identity. Moreover, we can use this approach to derive the same black hole mass as that by other methods.

  12. Patronage and clientelism in the fourth gospel

    Directory of Open Access Journals (Sweden)

    Abiola Mbamalu

    2013-08-01

    Full Text Available Patronage and clientelism as a social-scientific model is used in this article to read the fourth gospel. It is the contention of the article that this model affords the reader fresh vistas of meaning that otherwise would have remained unexplored. It is a reading amongst other readings and does not make pretensions to illuminate every segment of the fourth gospel. Rather, it selectively looks at areas where reading against the backdrop of a patron-client model illuminates the text. This reading sheds light on the greatest gift Jesus came to give, the gift of life as a beneficium, and affirms that the signs that Jesus performed are commendationes. Jesus brokers the blessings of the kingdom to those who believe in him on behalf of the father who is the ultimate patron. Jesus also challenges popular notions of patronage by performing acts reserved for slaves by, for example, washing the feet of his disciples.

  13. Bounding CKM mixing with a fourth family

    International Nuclear Information System (INIS)

    Chanowitz, Michael S.

    2009-01-01

    CKM mixing between third-family quarks and a possible fourth family is constrained by global fits to the precision electroweak data. The dominant constraint is from nondecoupling oblique corrections rather than the vertex correction to Z→bb used in previous analyses. The possibility of large mixing suggested by some recent analyses of flavor-changing neutral-current processes is excluded, but 3-4 mixing of the same order as the Cabbibo mixing of the first two families is allowed.

  14. SEIZURE PREDICTION: THE FOURTH INTERNATIONAL WORKSHOP

    Science.gov (United States)

    Zaveri, Hitten P.; Frei, Mark G.; Arthurs, Susan; Osorio, Ivan

    2010-01-01

    The recently convened Fourth International Workshop on Seizure Prediction (IWSP4) brought together a diverse international group of investigators, from academia and industry, including epileptologists, neurosurgeons, neuroscientists, computer scientists, engineers, physicists, and mathematicians who are conducting interdisciplinary research on the prediction and control of seizures. IWSP4 allowed the presentation and discussion of results, an exchange of ideas, an assessment of the status of seizure prediction, control and related fields and the fostering of collaborative projects. PMID:20674508

  15. On a fourth order superlinear elliptic problem

    Directory of Open Access Journals (Sweden)

    M. Ramos

    2001-01-01

    Full Text Available We prove the existence of a nonzero solution for the fourth order elliptic equation $$Delta^2u= mu u +a(xg(u$$ with boundary conditions $u=Delta u=0$. Here, $mu$ is a real parameter, $g$ is superlinear both at zero and infinity and $a(x$ changes sign in $Omega$. The proof uses a variational argument based on the argument by Bahri-Lions cite{BL}.

  16. Flavour democracy calls for the fourth generation

    International Nuclear Information System (INIS)

    Datta, A.

    1992-07-01

    It is argued with the help of an illustrative mode, that the inter species hierarchy among the fermion masses and the quark mixing angles can be accommodated naturally in the standard model with (approximate) flavour democracy provided there are four families of sequential quark-leptons with all members of the fourth family having roughly equal masses. The special problem of light neutrino masses (if any) and possible solutions are also discussed. (author). 15 refs

  17. Fourth international conference on Networks & Communications

    CERN Document Server

    Meghanathan, Natarajan; Nagamalai, Dhinaharan; Computer Networks & Communications (NetCom)

    2013-01-01

    Computer Networks & Communications (NetCom) is the proceedings from the Fourth International Conference on Networks & Communications. This book covers theory, methodology and applications of computer networks, network protocols and wireless networks, data communication technologies, and network security. The proceedings will feature peer-reviewed papers that illustrate research results, projects, surveys and industrial experiences that describe significant advances in the diverse areas of computer networks & communications.

  18. Art meets mathematics in the fourth dimension

    CERN Document Server

    Lipscomb, Stephen Leon

    2014-01-01

    To see objects that live in the fourth dimension we humans would need to add a fourth dimension to our three-dimensional vision. An example of such an object that lives in the fourth dimension is a hyper-sphere or “3-sphere”. The quest to imagine the elusive 3-sphere has deep historical roots: medieval poet Dante Alighieri, in his circa 1300 AD Divine Comedy, used a 3-sphere to convey his allegorical vision of the Christian afterlife. In 1917, Albert Einstein visualized the universe, at each instant in time, as a 3-sphere. He described his representation as “…the place where the reader’s imagination boggles. Nobody can imagine this thing.” Over time, however, our understanding of the concept of dimension evolved. By 2003, a researcher had successfully rendered into human vision the structure of a 4-web (think of an every increasingly-dense spider’s web). In this text Stephen Lipscomb takes his innovative dimension theory research a step further, using the 4-web to reveal a new partial image of a...

  19. Fourth-rank gravity and cosmology

    International Nuclear Information System (INIS)

    Marrakchi, A.L.; Tapia, V.

    1992-07-01

    We consider the consequences of describing the metric properties of space-time through a quartic line element. The associated ''metric'' is a fourth-rank tensor G μυλπ . In order to recover a Riemannian behaviour of the geometry it is necessary to have G μυλπ = g (μυ g λπ) . We construct a theory for the gravitational field based on the fourth-rank metric G μυλπ . In the absence of matter the fourth-rank metric becomes separable and the theory coincides with General Relativity. In the presence of matter we can maintain Riemmanianicity, but now gravitation couples, as compared to General Relativity, in a different way to matter. We develop a simple cosmological model based on a FRW metric with matter described by a perfect fluid. For the present time the field equations are compatible with k OBS = O and Ω OBS t CLAS approx. 10 20 t PLANCK approx. 10 -23 s. Our final and most important result is the fact that the entropy is an increasing function of time. When interpreted at the light of General Relativity the treatment is shown to be almost equivalent to that of the standard model of cosmology combined with the inflationary scenario. (author). 16 refs, 1 fig

  20. Telling time in the Fourth Gospel

    Directory of Open Access Journals (Sweden)

    Jerome H. Neyrey

    2008-01-01

    Full Text Available When we begin the task of telling time in the Fourth Gospel, we bring something not found in any previous study, namely, a model of time articulated by cross- ultural anthropologists (Bordieu, in Pitt-Rivers 1963:55-72, Ayoade, in Wright 1984:71-89. As much as we admire Davies’ study, she has no notes to her chapter on time nor any citations in her bibliography to indicate that she has any conversation partners, much less cultural experts, a deficit to be filled in this study. Learning to tell time entails three theoretical considerations: a definition of time, key classifications of it, and special attention to what the ancients meant by past, present and future. With these lenses we are prepared to do as thorough a study as we can on telling time in the Fourth Gospel. As we consider each classification, we will suggest a brief meaning of it from the experts on time, then present a body of Greco-Roman materials illustrative of the classification, and finally use it to gather and interpret data in John. Proving the native existence of these classifications for telling time in antiquity is essential for readers to have a background against which to compare their usage with that of the Fourth Gospel.

  1. Testosterone affects hormone-sensitive lipase (HSL) activity and lipid metabolism in the left ventricle

    DEFF Research Database (Denmark)

    Langfort, Jozef; Jagsz, Slawomir; Dobrzyn, Pawel

    2010-01-01

    tissue suggests that testosterone regulates HSL activity. To test whether this is also true in the heart, we measured HSL activity in the left ventricle of sedentary male rats that had been treated with testosterone supplementation or orchidectomy with or without testosterone substitution. Left ventricle...... HSL activity against TG was significantly elevated in intact rats supplemented with testosterone. HSL activity against both TG and diacylglyceride was reduced by orchidectomy, whereas testosterone replacement fully reversed this effect. Moreover, testosterone increased left ventricle free fatty acid...... levels, caused an inhibitory effect on carbohydrate metabolism in the heart, and elevated left ventricular phosphocreatine and ATP levels as compared to control rats. These data indicate that testosterone is involved in cardiac HSL activity regulation which, in turn, may affect cardiac lipid...

  2. Third ventricle midline shift on computed tomography as an alternative to septum pellucidum shift

    International Nuclear Information System (INIS)

    Santiago, Carlos Francis A.; Oropilla, Jean Quint L; Alvarez, Victor M.

    2000-01-01

    The cerebral midline shift is measured using the displacement from midline of the third ventricle. It is an easily determined criterion from which CT scans of patients with spontaneous intracerebral hematoma may be investigated. Midline shift is a significant criteria in which to gauge the neurological status of patients. In a retrospective study of 32 patients with spontaneous unilateral intracerebral hemorrhage, a midline third ventricle shift correlated well with septum pellucidum shift. A greater than 7 mm midline third ventricle shift was associated with a significantly lower Glasgow Coma scale score compared a shift less than 7mm. For the septum pellucidum, a greater than 10 mm shift was similarly associated with a significantly lower Glasgow Coma scale score. (Author)

  3. SPECIFICS OF LEFT VENTRICLE REMODELLING IN CHILDREN WHO HAVE HAD DIPHTHERITIC CARDITIS

    Directory of Open Access Journals (Sweden)

    U.K. Gadzhieva

    2009-01-01

    Full Text Available Carditis has a special place among diphtheritic complications determining a disease prognosis. The article provides results of studying a functional status of cardiac muscle in children who have had diphtheritic complications in the short-term (2–3 years; n = 35 and longterm (9–10 years; n = 15 follow-up. Echo cardiographic test showed there were three hemodynamic options available for diphtheritic carditis development: normal volumetric parameters of the left ventricle cavity; an enlarged left ventricle cavity and reduced myocardial contractility (dilated cardiomyopathy; a reduced left ventricle cavity with intact myocardial contractility (diastolic dysfunction. Including vitamin E and Carnitine chloride into the treatment for children who have had Diphtheritic Carditis results in improvements both to the cardiac systolic and diastolic functions.Key words: children, diphtheritic carditis, cardiac remodelling, cardiomyopathy, diastolic function.

  4. Acute intestinal anisakiasis in Spain: a fourth-stage Anisakis simplex larva

    Directory of Open Access Journals (Sweden)

    Mª José Rosales

    1999-11-01

    Full Text Available A case of acute intestinal anisakiasis has been reported; a nematode larva being found in the submucosa of the ileum of a woman in Jaén (Spain. The source of infection was the ingestion of raw Engraulis encrasicholus. On the basis of its morphology, the worm has been identified as a fourth-stage larva of Anisakis simplex. In Spain, this is the ninth report of human anisakiasis and also probably the first case of anisakiasis caused by a fourth-stage larva of A. simplex.

  5. Solving Variable Coefficient Fourth-Order Parabolic Equation by ...

    African Journals Online (AJOL)

    Solving Variable Coefficient Fourth-Order Parabolic Equation by Modified initial guess Variational ... variable coefficient fourth order parabolic partial differential equations. The new method shows rapid convergence to the exact solution.

  6. Clinico-morphological correlations in the categorization of holes between the ventricles

    Directory of Open Access Journals (Sweden)

    Friedman Brad

    2010-01-01

    Full Text Available Controversy still exists in the categorization of holes between the ventricles, although they are the most common congenital cardiac malformation. Advanced imaging techniques such as three-dimensional echocardiography and computed tomographic angiography offer superb anatomical details of these defects. In this review, we have sought to collate the features highlighted in different categorizations and identify their similarities, but also emphasize their differences. We hope that an analysis of this type, now achievable during life, using advanced imaging, might lead to the appearance of a unified system for diagnosis and description of holes between the ventricles.

  7. A double-chambered left ventricle in a patient with palpitation

    International Nuclear Information System (INIS)

    Stathaki, M.; Velidaki, A.; Koukouraki, S.; Koxiadakis, G.; Vardas, P.; Karkavitsas, N.

    2005-01-01

    A 28 years old male patient was admitted to the department of cardiology after an episode of atypical chest pain, exertional dyspnea and palpitation on exercise. He was a chronic smoker and was smoking about 15 cigarettes per day, but had no family history of early heart disease. The echocardiography demonstrated the presence of an abnormal chamber in close contact to the left ventricle that followed systole and diastole. The coronary angiography was normal and the left ventriculography showed a double-chambered left ventricle. Theradionuclide ventriculography confirmed the presence of two separate chambers that communicate with each other and the ejection fraction obtained was 43%. (author)

  8. Automatic determination of the regional ejection fraction of the left ventricle (gated bloodpool)

    International Nuclear Information System (INIS)

    Feser, J.A.

    1982-01-01

    The left ventricular volume curve and the ejection fraction are calculated according to the ''sliding region of interest'' method in which the ventricle contour is redetermined for every single picture of the various phases of the heart beat. The original set of data, consisting of 32 pictures in 64 x 64 matrix resolution, is processed by a three-dimensional filtering process in space (x,y) and time (t). The ventricle contour is determined by convolution of the filtered images with a 7-point Laplacian operator in 4 independent directions. The atrial and ventricular phase histograms are then calculated on the basis of this contour. (WU) [de

  9. 7 CFR 51.2296 - Three-fourths half kernel.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Three-fourths half kernel. 51.2296 Section 51.2296 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards...-fourths half kernel. Three-fourths half kernel means a portion of a half of a kernel which has more than...

  10. Short-Term Energy Outlook: Quarterly projections. Fourth quarter 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-05

    The Energy Information Administration (EIA) prepares quarterly, short-term energy supply, demand, and price projections for publication in February, May, August, and November in the Short-Term Energy Outlook (Outlook). An annual supplement analyzes the performance of previous forecasts, compares recent cases with those of other forecasting services, and discusses current topics related to the short-term energy markets. (See Short-Term Energy Outlook Annual Supplement, DOE/EIA-0202.) The forecast period for this issue of the Outlook extends from the fourth quarter of 1993 through the fourth quarter of 1994. Values for the third quarter of 1993, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in the Weekly Petroleum Status Report) or are calculated from model simulations using the latest exogenous information available (for example, electricity sales and generation are simulated using actual weather data). The historical energy data are EIA data published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications.

  11. Geometry, relativity and the fourth dimension

    CERN Document Server

    Rucker, Rudolf

    1977-01-01

    This is a highly readable, popular exposition of the fourth dimension and the structure of the universe. A remarkable pictorial discussion of the curved space-time we call home, it achieves even greater impact through the use of 141 excellent illustrations. This is the first sustained visual account of many important topics in relativity theory that up till now have only been treated separately.Finding a perfect analogy in the situation of the geometrical characters in Flatland, Professor Rucker continues the adventures of the two-dimensional world visited by a three-dimensional being to expl

  12. Analiticity in fourth-order wave equations

    International Nuclear Information System (INIS)

    Bollini, C.G.; Giambiagi, J.J.

    1987-01-01

    In this paper it is presented, through a familiar example (δ-function potential in one dimension), the analytic properties of Jost functions associated with fourth-order equations. It is shown how to construct the Jost functions and the two discontinuity matrices associated with the line of singularities. The latter divide the complex k-plane in eight regions of analiticity. One of these matrices is related to the asymptotic behaviour of the scattering state. The other is not. Both are necessary to solve the inverse problem. Besides the usual poles related to bound states there are also other poles associated with total reflexion

  13. Fourth international seminar on horizontal steam generators

    Energy Technology Data Exchange (ETDEWEB)

    Tuomisto, H. [ed.] [IVO Group, Vantaa (Finland); Purhonen, H. [ed.] [VTT, Espoo (Finland); Kouhia, V. [ed.] [Lappeenranta Univ. of Technology (Finland)

    1997-12-31

    The general objective of the International Seminars of Horizontal Steam Generator Modelling has been the improvement in understanding of realistic thermal hydraulic behaviour of the generators when performing safety analyses for VVER reactors. The main topics presented in the fourth seminar were: thermal hydraulic experiments and analyses, primary collector integrity, feedwater distributor replacement, management of primary-to-secondary leakage accidents and new developments in the VVER safety technology. The number of participants, representing designers and manufacturers of the horizontal steam generators, plant operators, engineering companies, research organizations, universities and regulatory authorities, was 70 from 10 countries.

  14. The fourth pattern of attachment: Disorganized / disoriented

    Directory of Open Access Journals (Sweden)

    Zlatka Cugmas

    2003-09-01

    Full Text Available On the basis of the study of recent scientific literature about the development of attachment behavior, the author answers the following questions about: the behavior children categorized as Disorganized/disorientated or Controlling in the procedure of the Strange situation; the life circumstances, in which these children live; the reasons for lack of balanced strategies of attachment and characteristics of their general manner of adaptation. The author finds the characteristics of the mothers' (insensitivity to be significantly influential for the emergence of the fourth pattern of attachment. These children are heterogeneous regarding adaptation in general. Professional help preceding negative consequences for their socioemotional development is neccesary.

  15. Analiticity in fourth order wave equations

    International Nuclear Information System (INIS)

    Bollini, C.G.

    1987-01-01

    Through a familiar example (δ-function potential in one dimension) the analytic properties of Jost functions associated with fourth order equations are presented. It is shown how to construct the Jost functions and the two discontinuities matrices associated to the line of singularities. The latter divide the complex k-plane in eight regions of analiticity. One of these matrices is related to the asymptotic behaviour of scattering state. The other is not. Both being necessary to solve the inverse problem. Besides the usual poles related to bound states there are also other poles associated with total reflexion. (Author) [pt

  16. Fourth international seminar on horizontal steam generators

    Energy Technology Data Exchange (ETDEWEB)

    Tuomisto, H [ed.; IVO Group, Vantaa (Finland); Purhonen, H [ed.; VTT, Espoo (Finland); Kouhia, V [ed.; Lappeenranta Univ. of Technology (Finland)

    1998-12-31

    The general objective of the International Seminars of Horizontal Steam Generator Modelling has been the improvement in understanding of realistic thermal hydraulic behaviour of the generators when performing safety analyses for VVER reactors. The main topics presented in the fourth seminar were: thermal hydraulic experiments and analyses, primary collector integrity, feedwater distributor replacement, management of primary-to-secondary leakage accidents and new developments in the VVER safety technology. The number of participants, representing designers and manufacturers of the horizontal steam generators, plant operators, engineering companies, research organizations, universities and regulatory authorities, was 70 from 10 countries.

  17. Fourth international seminar on horizontal steam generators

    International Nuclear Information System (INIS)

    Tuomisto, H.; Purhonen, H.; Kouhia, V.

    1997-01-01

    The general objective of the International Seminars of Horizontal Steam Generator Modelling has been the improvement in understanding of realistic thermal hydraulic behaviour of the generators when performing safety analyses for VVER reactors. The main topics presented in the fourth seminar were: thermal hydraulic experiments and analyses, primary collector integrity, feedwater distributor replacement, management of primary-to-secondary leakage accidents and new developments in the VVER safety technology. The number of participants, representing designers and manufacturers of the horizontal steam generators, plant operators, engineering companies, research organizations, universities and regulatory authorities, was 70 from 10 countries

  18. An experiment with the fourth Futamura projection

    DEFF Research Database (Denmark)

    Glück, Robert

    2010-01-01

    We have experimentally validated the theoretical insight, that a compiler generator is an Ershov generating extension of a program specializer, by showing that an existing offline partial evaluator can perform the fourth Futamura projection. Specifically, an online and an offline partial evaluator...... for an imperative flowchart language were transformed into two new compiler generators by Romanenko’s classical partial evaluator Unmix. The two partial evaluators are described, as is a novel recursive method for polyvariant specialization. The new compiler generators are demonstrated by converting a universal...

  19. Redistribution of thallium-201 into right ventricle through collateral circulation

    International Nuclear Information System (INIS)

    Kataoka, Hajime; Ohkubo, Toshitaka; Takaoka, Shigeru; Ohshige, Tamao; Miyahara, Kenkichi.

    1984-01-01

    The cases of reversible right ventricular ischemia, which demonstrated redistribution of thallium (Tl)-201 into the right ventricular free wall (RVFW) through collateral channels, were reported. Two cases with complete obstruction in the proximal right coronary artery accompanied by collateral channels (left coronary artery to distal right coronary artery) underwent submaximal exercise stress Tl-201 myocardial imaging. Although the RVFW was not visualized on immediate myocardial images in one or both of the 30 0 and 60 0 left anterior oblique views in each case, three-hour delayed myocardial images showed redistribution of Tl-201 into the RVFW. It was concluded that collateral circulation affects the occurrence of redistribution of Tl-201 into the RVFW. (author)

  20. Branchial sinus of the piriform fossa: reappraisal of third and fourth branchial anomalies.

    Science.gov (United States)

    James, Adrian; Stewart, Craig; Warrick, Paul; Tzifa, Constance; Forte, Vito

    2007-11-01

    The objective of this study was to review clinical and embryologic aspects of third and fourth branchial anomalies. Retrospective study. We reviewed the institutional and departmental databases at our institution to identify all cases of third and fourth branchial anomalies encountered from 1992 to 2006. All patient records were examined with respect to demographics, clinical history, and radiologic and pathologic reports. We identified 17 cases of third and fourth branchial anomalies, the largest series of its kind reported to date. The lesions were predominantly left sided, all presenting with neck infection. Fistula formation was iatrogenic, secondary to incision and drainage. Preoperative direct laryngoscopy always revealed a pit within the apex of the piriform fossa. Surgical excision involved ipsilateral thyroidectomy as the lesion passed through the thyroid gland. No lesions following the classical course of a either a third or fourth branchial anomaly were identified. The clinical presentation of branchial sinuses arising from the piriform fossa is more in keeping with derivation from the thymopharyngeal duct (of the third pouch) than the hypothetical course of third and fourth branchial fistulae.

  1. Evaluation of Radioactivity in the Bladder after Injection of 131I Hippurate into Lateral Ventricles of Hydrocephalic Patients

    NARCIS (Netherlands)

    DIJKSTRA, J.; H.W.M. Baars (Hennie)

    1972-01-01

    textabstractThis correlative study sought an explanation for the appearance in the bladder of 131I hippurate injected into the lateral ventricle. Part of the excretion seemed to depend upon a ventricular process. High disappearance constants and early onset times were related to small ventricles,

  2. Evaluation of Right Ventricle Function in Children With Primary Nephrotic Syndrome

    Directory of Open Access Journals (Sweden)

    Qiang Qin

    2010-06-01

    Conclusion: Right ventricle function was impaired in children with PNS. The characteristics were unrelated to blood pressure and IGF-1, but may be correlated with TNF-α and disease duration. Further studies are needed to evaluate the etiology and clinical implications of this abnormality.

  3. Two different gene loci related to the spatial patterning of brain ventricle in vertebrate

    Institute of Scientific and Technical Information of China (English)

    LUO Minna; LI Bingxia; TONG Ying; ZHAO Shufang; LUO Chen

    2007-01-01

    Observations on living embryonic brains and the microstructure of brain ventricle of goldfish revealed that there are two brain ventricle phenotypes in gynogenetic haploid embryos. One phenotype is as normal as that of the control inbreeding diploid embryos,which has normal differentiated forebrain, midbrain and hindbrain. Another phenotype is obviously abnormal, the brain patterning is irregular, and no distinct brain ventricle can be observed. The ratio of haploid embryos with normal brain pattern to that with abnormal brain pattern is 1:3. This ratio indicates that there are two gene loci involved in the spatial patterning of the brain ventricle. Since the possibility that deleterious recessive mutant alleles exist on both of the two gene loci had been excluded in this experiment, the phenotype represented the expressional state rather than the genotype of these two genes. Therefore, the ratio of 1∶ 3 suggests that the expressing probability for each copy of the two genes is 50%, and the regulatory mechanism of the expression is based on two sets of chromosomes, controlled by the rule of the diploid-dependent regulatory mechanism.

  4. Rationale and Description of Right Ventricle-Protective Ventilation in ARDS.

    Science.gov (United States)

    Paternot, Alexis; Repessé, Xavier; Vieillard-Baron, Antoine

    2016-10-01

    Pulmonary vascular dysfunction is associated with ARDS and leads to increased right-ventricular afterload and eventually right-ventricular failure, also called acute cor pulmonale. Interest in acute cor pulmonale and its negative impact on outcome in patients with ARDS has grown in recent years. Right-ventricular function in these patients should be closely monitored, and this is helped by the widespread use of echocardiography in intensive care units. Because mechanical ventilation may worsen right-ventricular failure, the interaction between the lungs and the right ventricle appears to be a key factor in the ventilation strategy. In this review, a rationale for a right ventricle-protective ventilation approach is provided, and such a strategy is described, including the reduction of lung stress (ie, the limitation of plateau pressure and driving pressure), the reduction of PaCO2 , and the improvement of oxygenation. Prone positioning seems to be a crucial part of this strategy by protecting both the lungs and the right ventricle, resulting in increased survival of patients with ARDS. Further studies are required to validate the positive impact on prognosis of right ventricle-protective mechanical ventilation. Copyright © 2016 by Daedalus Enterprises.

  5. Effect of skull type on the relative size of cerebral cortex and lateral ventricles in dogs

    DEFF Research Database (Denmark)

    Pilegaard, Anders M.; Berendt, Mette; Holst, Pernille

    2017-01-01

    Volume measurements of the brain are of interest in the diagnosis of brain pathology. This is particularly so in the investigation hydrocephalus and canine cognitive dysfunction (CCD), both of which result in thinning of the cerebral cortex and enlarged ventricles. Volume assessment can be made...

  6. Acute hydrocephalus in a child with a third ventricle arachnoid cyst and coincidental enteroviral meningitis

    NARCIS (Netherlands)

    Jeltema, Hanne-Rinck; Kuijlen, Jos M. A.; Hoving, Eelco W.

    We present a 2.5-year-old child suffering from acute hydrocephalus. First, the child was diagnosed with aseptic viral meningitis. The PCR of the cerebrospinal fluid (CSF) was positive for enterovirus. Subsequently, MRI revealed that the hydrocephalus was caused by a cyst in the third ventricle.

  7. Long-term benefits of exercise training in patients with a systemic right ventricle

    NARCIS (Netherlands)

    van der Bom, Teun; Winter, Michiel M.; Knaake, Jennifer L.; Cervi, Elena; de Vries, Leonie S. C.; Balducci, Anna; Meregalli, Paola G.; Pieper, Petronella G.; van Dijk, Arie P. J.; Bonvicini, Marco; Mulder, Barbara J. M.; Bouma, Berto J.

    2015-01-01

    The aim of the present study is to determine the long-term effects of a ten-week exercise training program in adult patients with a systemic right ventricle. All patients who participated in a 2009 randomized controlled trial were approached. At approximately three years of follow-up from initial

  8. Long-term benefits of exercise training in patients with a systemic right ventricle

    NARCIS (Netherlands)

    van der Bom, Teun; Winter, Michiel M.; Knaake, Jennifer L.; Cervi, Elena; de Vries, Leonie S. C.; Balducci, Anna; Meregalli, Paola G.; Pieper, Petronella G.; van Dijk, Arie P. J.; Bonvicini, Marco; Mulder, Barbara J. M.; Bouma, Berto J.

    2015-01-01

    Objectives: The aim of the present study is to determine the long-term effects of a ten-week exercise training program in adult patients with a systemic right ventricle. Methods: All patients who participated in a 2009 randomized controlled trial were approached. At approximately three years of

  9. Statistical 3D shape analysis of gender differences in lateral ventricles

    Science.gov (United States)

    He, Qing; Karpman, Dmitriy; Duan, Ye

    2010-03-01

    This paper aims at analyzing gender differences in the 3D shapes of lateral ventricles, which will provide reference for the analysis of brain abnormalities related to neurological disorders. Previous studies mostly focused on volume analysis, and the main challenge in shape analysis is the required step of establishing shape correspondence among individual shapes. We developed a simple and efficient method based on anatomical landmarks. 14 females and 10 males with matching ages participated in this study. 3D ventricle models were segmented from MR images by a semiautomatic method. Six anatomically meaningful landmarks were identified by detecting the maximum curvature point in a small neighborhood of a manually clicked point on the 3D model. Thin-plate spline was used to transform a randomly selected template shape to each of the rest shape instances, and the point correspondence was established according to Euclidean distance and surface normal. All shapes were spatially aligned by Generalized Procrustes Analysis. Hotelling T2 twosample metric was used to compare the ventricle shapes between males and females, and False Discovery Rate estimation was used to correct for the multiple comparison. The results revealed significant differences in the anterior horn of the right ventricle.

  10. Decreased expression of natriuretic peptides associated with lipid accumulation in cardiac ventricle of obese mice

    DEFF Research Database (Denmark)

    Bartels, E.D.; Nielsen, J.M.; Bisgaard, L.S.

    2010-01-01

    % (P depression of ANP mRNA expression in cultured HL-1 atrial myocytes. The data suggest that obesity and altered cardiac lipid metabolism are associated with reduced production of ANP and BNP in the cardiac ventricles in the setting of normal as well as impaired cardiac function....

  11. Differential effects of the transient outward K(+) current activator NS5806 in the canine left ventricle

    DEFF Research Database (Denmark)

    Calloe, Kirstine; Soltysinska, Ewa; Jespersen, Thomas

    2009-01-01

    To examine the electrophysiological and molecular properties of the transient outward current (I(to)) in canine left ventricle using a novel I(to) activator, NS5806, I(to) was measured in isolated epicardial (Epi), midmyocardial (Mid) and endocardial (Endo) cells using whole-cell patch-clamp tech...

  12. A comparative study of contractility of the heart ventricle in some ectothermic vertebrates

    Directory of Open Access Journals (Sweden)

    Sergey Kharin

    2009-07-01

    Full Text Available The purpose of this study was to analyze contractility of the heart ventricle in selected reptilian and amphibian species having the same ventricular excitation pattern. Systolic time intervals and indices of contractility of the heart ventricle were measured in anaesthetized frogs, snakes, and tortoises by use of polycardiography. The electromechanical delay was significantly shorter in tortoises compared with the other two species. The isovolumetric contraction time in frogs was approximately twofold longer than in reptiles. The pre-ejection period was the longest in frogs and the shortest in tortoises, whereas snakes were intermediate. The ejection time was slightly longer in tortoises compared with the other two species. The greatest isovolumetric contraction index and the smallest myocardial tension index corresponded to the frog and tortoise heart ventricle, respectively. The intrasystolic index in tortoises was significantly greater than in frogs, whereas quite similar to that in snakes. The frog ventricle had lower contractility compared with the reptilian one. Although ventricular contractility tended to be lower in snakes compared with tortoises, this difference was not statistically significant. Possible causes for these differences are discussed. We suppose a large variety in ventricular contractility among amphibian and reptilian species having the same ventricular activation pattern. This variety may be conditioned by heart anatomy, intracardiac shunting, lifestyles, and habitats. It can only be hypothesized that on the average, ventricular contractility is higher in reptiles compared with amphibians and in chelonians compared with snakes.

  13. Novel presentation of a fourth branchial cleft anomaly in a male infant.

    Science.gov (United States)

    Evans, Seth H; Marinello, Mark; Dodson, Kelley M

    2010-01-01

    Fourth branchial cleft anomalies are rare congenital disorders of the neck. We describe a case involving a unique presentation of this entity as well as a review of the literature concerning its management. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  14. Giant posterior fossa mature teratoma with adjacent subacute haematoma, compressive on the brainstem, with acute hydrocephalus. Case report

    Directory of Open Access Journals (Sweden)

    Balasa D.

    2016-09-01

    Full Text Available Mature teratoma of the vermis is a rare entity in neurosurgical adulthood pathology. We present the case of a 65 years old patient, admited as an emergency for intense headache (VAS 8/10, nausea, vomiting, gait ataxia, orizontal nistagmus, dismetria, disdiadocokinezia, predominant on the left side, long tracts signs, predominant on the left side. Native and contrast CT and MRI scan of the head revealed a tumoral lesion, in the vermian, paravermian and in the fourth ventricle, with the aspect of a teratoma with intratumoral subacute haemorrhage including a giant lesion 5,5/5/4,5 cm, compressive on mesencephalon, and with suprajacent acute internal hidrocephalus. Emergency neurosurgery was performed (occipital infratentorial craniectomy, microneurosurgical total tumoral resection and haematoma evacuation. Postoperative, the patient recovered progressivelly , subtotal neo and arhicerebellar symptoms. The motor long tract signs recovered slower and persisted incomplete.

  15. Atrioventricular valve repair in patients with functional single-ventricle physiology: impact of ventricular and valve function and morphology on survival and reintervention.

    Science.gov (United States)

    Honjo, Osami; Atlin, Cori R; Mertens, Luc; Al-Radi, Osman O; Redington, Andrew N; Caldarone, Christopher A; Van Arsdell, Glen S

    2011-08-01

    This study was to determine whether atrioventricular valve repair modifies natural history of single-ventricle patients with atrioventricular valve insufficiency and to identify factors predicting survival and reintervention. Fifty-seven (13.5%) of 422 single-ventricle patients underwent atrioventricular valve repair. Valve morphology, regurgitation mechanism, and ventricular morphology and function were analyzed for effect on survival, transplant, and reintervention with multivariate logistic and Cox regression models. Comparative analysis used case-matched controls. Atrioventricular valve was tricuspid in 67% and common in 28%. Ventricular morphology was right in 83%. Regurgitation mechanisms were prolapse (n = 24, 46%), dysplasia (n = 18, 35%), annular dilatation (n = 8, 15%), and restriction or cleft (n = 2, 4%). Postrepair insufficiency was none or trivial in 14 (26%), mild in 33 (61%), and moderate in 7 (13%). Survival in repair group was lower than in matched controls (78.9% vs 92.7% at 1 year, 68.7% vs 90.6% at 3 years, P = .015). Patients with successful repair and normal ventricular function had equivalent survival to matched controls (P = .36). Independent predictors for death or transplant included increased indexed annular size (P = .05), increased cardiopulmonary bypass time (P = .04), and decreased postrepair ventricular function (P = .01). Ventricular dilation was a time-related factor for all events, including failed repair. Survival was lower in single-ventricle patients operated on for atrioventricular valve insufficiency than in case-matched controls. Patients with little postoperative residual regurgitation and preserved ventricular function had equivalent survival to controls. Lower grade ventricular function and ventricular dilation correlated with death and repair failure, suggesting that timing of intervention may affect outcome. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All

  16. Fourth International Conference on Complex Systems

    CERN Document Server

    Minai, Ali A; Unifying Themes in Complex Systems IV

    2008-01-01

    In June of 2002, over 500 professors, students and researchers met in Boston, Massachusetts for the Fourth International Conference on Complex Systems. The attendees represented a remarkably diverse collection of fields: biology, ecology, physics, engineering, computer science, economics, psychology and sociology, The goal of the conference was to encourage cross-fertilization between the many disciplines represented and to deepen understanding of the properties common to all complex systems. This volume contains 43 papers selected from the more than 200 presented at the conference. Topics include: cellular automata, neurology, evolution, computer science, network dynamics, and urban planning. About NECSI: For over 10 years, The New England Complex Systems Institute (NECSI) has been instrumental in the development of complex systems science and its applications. NECSI conducts research, education, knowledge dissemination, and community development around the world for the promotion of the study of complex sys...

  17. Fourth Thematic CERN School of Computing

    CERN Multimedia

    Alberto Pace, CSC Director

    2016-01-01

    The Fourth Thematic School of Computing (tCSC2016) takes place this year in Split, Croatia, from 22 to 28 May 2016.   The theme is "Efficient and Parallel Processing of Scientific Data", looking at: The challenge of scientific data processing: commonalities, analogies and the main differences between different sciences. Size of scientific software projects. Parallelism and asynchronism: computation and I/O. The School is open to postgraduate students and research workers with a few years' experience in elementary particle physics, computing, engineering or related fields.  All applicants are welcome, including former and future participants in the main CSC summer school. Registration will close on 15 February and participation is limited to 24 students. To register, please go here. About: The Thematic Schools are part of the annual series of CERN Schools of Computing, to promote advanced learning and knowledge exchange on the subject of scientific compu...

  18. Fourth World Theory: The Evolution of . . .

    Directory of Open Access Journals (Sweden)

    Olon F. Dotson

    2014-05-01

    Full Text Available Fourth World theory is a methodology for examining and developing greater understanding of the extent of the distress and abandonment commonly found in the cores of American cities resulting from de-industrialization, historic segregation and discrimination patterns, suburban sprawl, erosion of a viable tax base, racism, inability to embrace the concept of desegregation and civil rights legislation, fear, despair, crumbling infrastructure systems, disinvestment in urban school systems, and environmental justice issues. This article uses the analytical lens of Fourth World theory to examine how such structural and cultural forces contributed to the severely distressed conditions now found in the city of Gary, Indiana. Tracking its one-hundred-year history, from its founding as an industrial town through its post-industrial decline occurring during the city’s first African-American mayor’s five terms in office, the methodology clearly demonstrates how the social construction of race has systematically undermined every aspect of Gary’s overall quality of life. To illustrate that this city is not an anomaly but rather reflects a typical pattern of disparity and uneven development arising from racist practices, Gary is compared to other cities of similar size and also to the much larger Detroit. The article triangulates academic literature, news media archives, and an oral history provided by the mayor to show how Gary evolved from being a model industrial city to a cauldron of racial disparity. The paper concludes by arguing that continued absence of reflection on the nation’s historical racialization of place threatens not just impoverished communities of color, but also the sustainability of the entire nation.

  19. The τ-lepton lifetime discrepancy as evidence for the fourth family

    International Nuclear Information System (INIS)

    Rajpoot, S.

    1989-01-01

    According to this paper, the measured lifetime of the tau lepton suggests that the e - μuniversality may not hold in the case of the third generation leptons. The universality of weak interactions can be restored by involving the existence of a fourth family of leptons and quarks. The charged lepton of the fourth family mixes with the tau lepton with a Cabibbo-like mixing angle. Agreement between the experimentally measured lifetime and the theoretical value as predicted by the standard SU(2) l x U(1) model on the basis of universality of weak interactions required the Cabibbo-like mixing angle (φ) to satisfy cosφ = 0.96 ± 0.02. For this mixing to be nontrivial, the neutrino associated with the fourth family charged lepton must be more massive than the tau lepton. The mass of the fourth family charged lepton is predicted to be less than 45 GeV if the relation between the masses and the mixing angle is given by Weinberg type formula i.e. tanφ = Square root of mτ/mχ where χ denotes the charged lepton of the fourth family

  20. CSF in the ventricles of the brain behaves as a relay medium for arteriovenous pulse wave phase coupling.

    Directory of Open Access Journals (Sweden)

    William E Butler

    Full Text Available The ventricles of the brain remain perhaps the largest anatomic structure in the human body without established primary purpose, even though their existence has been known at least since described by Aristotle. We hypothesize that the ventricles help match a stroke volume of arterial blood that arrives into the rigid cranium with an equivalent volume of ejected venous blood by spatially configuring cerebrospinal fluid (CSF to act as a low viscosity relay medium for arteriovenous pulse wave (PW phase coupling. We probe the hypothesis by comparing the spatiotemporal behavior of vascular PW about the ventricular surfaces in piglets to internal observations of ventricle wall motions and adjacent CSF pressure variations in humans. With wavelet brain angiography data obtained from piglets, we map the travel relative to brain pulse motion of arterial and venous PWs over the ventricle surfaces. We find that arterial PWs differ in CF phase from venous PWs over the surfaces of the ventricles consistent with arteriovenous PW phase coupling. We find a spatiotemporal difference in vascular PW phase between the ventral and dorsal ventricular surfaces, with the PWs arriving slightly sooner to the ventral surfaces. In humans undergoing neuroendoscopic surgery for hydrocephalus, we measure directly ventricle wall motions and the adjacent internal CSF pressure variations. We find that CSF pressure peaks slightly earlier in the ventral Third Ventricle than the dorsal Lateral Ventricle. When matched anatomically, the peri-ventricular vascular PW phase distribution in piglets complements the endo-ventricular CSF PW phase distribution in humans. This is consistent with a role for the ventricles in arteriovenous PW coupling and may add a framework for understanding hydrocephalus and other disturbances of intracranial pressure.

  1. Remote and chronic access to the third cerebral ventricle of the unrestrained prepubertal rhesus monkey.

    Science.gov (United States)

    Gay, V L; Mikuma, N; Plant, T M

    1993-03-01

    One channel of a commercially available standard-size three-channel fluid swivel was modified to permit continuous access to the brain of unrestrained prepubertal rhesus monkeys via a continuous length of small-bore Teflon tube originating from a swivel device on top of the animal's cage and terminating in the third cerebral ventricle. This system was employed to achieve continuous access to the third cerebroventricle in four monkeys for periods of up to 12 mo. The value of the system for studies of the neurochemical control of hypothalamic-releasing factor secretion was established by monitoring adenohypophysial responses to neurotransmitter receptor agonists infused into the third ventricle. Specifically, repetitive infusions of morphine (30 micrograms/infusion) elicited a robust train of prolactin discharges, and third ventricular administration of N-methyl-DL-aspartic acid (NMA; 20 micrograms) resulted in striking discharges of LH.

  2. Substance Use, Dental Hygiene, and Physical Activity in Adult Patients with Single Ventricle Physiology

    DEFF Research Database (Denmark)

    Schrader, Anne-Marie Voss

    2013-01-01

    % are not flossing their teeth (32% in controls; OR = 1.32; P = 0.239); and 39% are not physically active (24% in controls; OR = 1.63; P = 0.069). CONCLUSIONS: While in general there was no significant differences in overall health behaviors between SVP patients and controls, SVP patients are less physically active......Substance Use, Dental Hygiene, and Physical Activity in Adult Patients with Single Ventricle Physiology. Overgaard D, Schrader AM, Lisby KH, King C, Christensen RF, Jensen HF, Moons P. Author information OBJECTIVES: The study aims to describe substance use, dental hygiene, and physical activity...... in adult survivors with single ventricle physiology (SVP) and to compare the behaviors with matched controls, while the patients are particularly at risk for general health problems. DESIGN: The present study is part of a larger research project on long-term outcomes in adult patients with SVP. A cross...

  3. Influence of chronic prenatal hypoxia on the specialized contact apparatus of rat heart ventricles during ontogeny

    Directory of Open Access Journals (Sweden)

    N. S. Petruk

    2014-08-01

    day of embryogenesis is lower in experimental group by 31,3% (p <0,05 in the left ventricle and 30,8% (p <0,05 in the right ventricle than parameters in the control group. The slowdown of growth of the profile length density of fascia adhaerens in the myocardium increases on the 20th day of cardiogeny and it was lower by 32,9% (p <0,05 in the left ventricle and 37,3% (p <0,05 in the right ventricle as compared with the control. During normal prenatal cardiogeny ventricular level of communicative contacts in cardiomyocytes respectably increases and shows a significant increase in nexus mean length from 14th to 18th day of embryogenesis by 75,5% in the control and insignificant increase in the left ventricle in experimental group – 23,6%. The increase in value of the convolution index of intercalated disc of rats with hypoxic myocardial damage as compared with the corresponding value in the neonatal period was 85,4% (p <0,05 in the left ventricle and 52,3% (p <0,05 in the right ventricle. Conclusion. It was established that the alterative influence of intrauterine hypoxia factor is associated with the formation delay of the mechanical and electrical contacts between the contractive cardiomyocytes of the left and right ventricles of rat heart at the stages of prenatal ontogeny. The increasing complexity of the geometry of the intercalated disc is characterized by slower growth of convolution index.

  4. Nuclear thyroid hormone receptors in rabbit heart: reduced triiodothyronine binding in atrium compared with ventricle

    International Nuclear Information System (INIS)

    Banerjee, S.K.; Ulrich, J.M.; Kaldor, G.J.

    1988-01-01

    Radiolabeled triiodothyronine (T3) binding to isolated nuclei was measured to compare the binding characteristics of the nuclear receptors in rabbit ventricular and atrial muscle cells. Scatchard analysis of the binding data yielded a maximum binding capacity of 170 +/- 20 fmol per mg DNA and apparent dissociation constant of 525 +/- 100 pM for ventricular nuclei. The binding capacity and the dissociation constant for the atrial muscle cell nuclei were 55 +/- 10 fmol per mg DNA and 500 +/- 75 pM, respectively. The results suggest that the binding capacity for T3 receptor in the atrium is considerably lower than that found in the ventricle. The reduced binding capacity of the T3 receptor in the atrium might reflect differences in the nuclear T3 receptors between ventricle and atrium

  5. The dorso-lateral recess of the hypothalamic ventricle in neonatal rats.

    Science.gov (United States)

    Menéndez, A; Alvarez-Uría, M

    1987-10-01

    Light and electron microscopy of the hypothalamic ventricle in neonatal rats demonstrate morphological specializations of the ventricular wall at the level of the premammillary region of the third ventricle. The morphological features are: (1) A ventricular recess that we have called the "hypothalamic dorso-lateral recess" (HDR). (2) The presence of intraventricular capillaries near the dorso-lateral recess. (3) The HDR possessing a specialized ependymal lining; this consists of non-ciliated cells with short microvilli and bleb-like processes. (4) The existence of cerebrospinal fluid-contacting neurons within the HDR. (5) The presence of numerous phagocytic supraependymal cells. The HDR is not found in adult rats. This indicates that the dorso-lateral recess may play a physiological role during development.

  6. A novel type of self-beating cardiomyocytes in adult mouse ventricles

    International Nuclear Information System (INIS)

    Omatsu-Kanbe, Mariko; Matsuura, Hiroshi

    2009-01-01

    This study was designed to investigate the presence of resident heart cells that are distinct from terminally-differentiated cardiomyocytes. Adult mouse heart was coronary perfused with collagenase, and ventricles were excised and further digested. After spinning cardiomyocyte-containing fractions down, the supernatant fraction was collected and cultured without adding any chemicals. Two to five days after plating, some of rounded cells adhered to the culture dish, gradually changed their shape and then started self-beating. These self-beating cells did not appreciably proliferate but underwent a further morphological maturation process to form highly branched shapes with many projections. These cells were mostly multinucleated, well sarcomeric-organized and expressed cardiac marker proteins, defined as atypically-shaped cardiomyocytes (ACMs). Patch-clamp experiments revealed that ACMs exhibited spontaneous action potentials arising from the preceding slow diastolic depolarization. We thus found a novel type of resident heart cells in adult cardiac ventricles that spontaneously develop into self-beating cardiomyocytes.

  7. Evaluation of CSF flow in patients after endoscopic ventriculostomy of 3th ventricle with MRI

    International Nuclear Information System (INIS)

    Petkov, R.

    2006-01-01

    Full text: Phase-contrast MR imaging is wide used for qualitative assessment and quantification of the CSF flow under normal and pathologic conditions. The increasing popularity of minimally invasive liquor derivation procedures - namely endoscopic ventriculostomy of 3-th ventricle - in neurosurgery raises the question of their actual effect on CSF flow in various types of hydrocephalus. We present our experience with 2D and 3D PC MRI in qualitative assessment and quantification of the CSF flow in 23 patients after endoscopic ventriculostomy of the 3-th ventricle for hyper- or normotensive hydrocephalus of various origins. We compare parameters of the CSF flow (direction, rate and net volume for one cardiac cycle) before and after the ventriculostomy

  8. Usefulness of electrocardiography-gated dual-source computed tomography for evaluating morphological features of the ventricles in children with complex congenital heart defects

    International Nuclear Information System (INIS)

    Nakagawa, Motoo; Hara, Masaki; Sakurai, Keita; Asano, Miki; Shibamoto, Yuta; Ohashi, Kazuya

    2011-01-01

    Improved time resolution using dual-source computed tomography (DSCT) enabled adaptation of electrocardiography (ECG)-gated cardiac CT for children with a high heart rate. In this study, we evaluated the ability of ECG-gated DSCT (ECG-DSCT) to depict the morphological ventricular features in patients with congenital heart disease (CHD). Between August 2006 and March 2010, a total of 66 patients with CHD (aged 1 day to 9 years, median 11 months) were analyzed using ECG-DSCT. The type of anomaly was ventricular septal defect (VSD) in 32 (malaligned type in 20, perimembranous type in 7, supracristal type in 3, muscular type in 2), single ventricle (SV) in 11, and corrected transposition of the great arteries (cTGA) in 3. All patients underwent ECG-DSCT and ultrasonography (US). We evaluated the accuracy of diagnosing the type of VSD. For the cases with SV and cTGA, we evaluated the ability to depict anatomical ventricular features. In all 32 cases of VSD, DSCT could confirm the VSD defects, and the findings were identical to those obtained by US. Anatomical configurations of the SV and cTGA were correctly diagnosed, similar to that on US. Our study suggests that ECG-DSCT can clearly depict the configuration of ventricles. (author)

  9. Patronage and clientelism in the fourth gospel

    Directory of Open Access Journals (Sweden)

    Abiola Mbamalu

    2013-08-01

    Full Text Available Patronage and clientelism as a social-scientific model is used in this article to read the fourth gospel. It is the contention of the article that this model affords the reader fresh vistas of meaning that otherwise would have remained unexplored. It is a reading amongst other readings and does not make pretensions to illuminate every segment of the fourth gospel. Rather, it selectively looks at areas where reading against the backdrop of a patron-client model illuminates the text. This reading sheds light on the greatest gift Jesus came to give, the gift of life as a beneficium, and affirms that the signs that Jesus performed are commendationes. Jesus brokers the blessings of the kingdom to those who believe in him on behalf of the father who is the ultimate patron. Jesus also challenges popular notions of patronage by performing acts reserved for slaves by, for example, washing the feet of his disciples. In hierdie artikel word die begrippe begunstiging en kliëntskap as ’n sosiaal-wetenskaplike model vir die verstaan van die vierde evangelie aangewend. Die doel van hierdie artikel is om aan die leser ’n nuwe begrip te bied wat andersins onontgin sou bly. Die teks van die vierde evangelie word vanuit een invalshoek onder ander invalshoeke gelees en daar word nie voorgegee dat elke segment van hierdie betrokke evangelie daardeur belig sal kan word nie. Daar word vanuit ’n selektiewe invalshoek gefokus op sekere dele waarin die teks verlig word deur perspektiewe wat deur die beskermheer-kliënt model gebied word. So ’n fokus beklemtoon juis die grootste geskenk wat Jesus Christus aan die mensdom gee, naamlik die gawe van lewe. Jesus gee namens die Vader, wie die uiteindelike beskermheer is, die seëninge van die koninkryk aan diegene wat in Hom glo. Terselfdertyd daag Jesus ook die aanvaarde model rakende die draagwydte van beskermheer-skap uit deur verskeie handelinge wat vir slawe gereserveer was, self te verrig, soos dit blyk uit die

  10. Estimation of global and regional ejection fraction of the left ventricle using a fully digitalised technique

    International Nuclear Information System (INIS)

    Tuengerthal, S.; Reifart, N.; Standke, R.; Lang, J.; Kollath, J.; Riemann, H.E.; Frankfurt Univ.; Frankfurt Univ.

    1984-01-01

    Subtraction angiocardiography (DSAK) with a fully digitalised system (DR 960) provides a well defined demonstration of the left ventricle after peripheral venous contrast injection. Cardiac volume and ejection fractions were calculated by a dedicated software programme and the findings correlated with cine ventriculography (CA) (r=0.91), biplane echo cardiography (2 DE) (r=0.77) and radionucleid ventriculography (RNV) (r=0.85); the method can be used even with reduced cardiac output (EF [de

  11. Patient-reported outcomes in adult survivors with single-ventricle physiology

    DEFF Research Database (Denmark)

    Overgaard, Dorthe; Schrader, Anne-Marie; Lisby, Karen H

    2011-01-01

    Objectives: Data on patient-reported outcomes (PROs) in patients with single-ventricle physiology (SVP) are scarce. We sought (1) to describe the perceived health status, quality of life, symptoms of anxiety and depression, and sense of coherence in adult survivors with SVP, (2) to compare PROs a...... of perceived health and quality of life. For patients in Ability Index class II and III, PROs were poorer. Conclusions: PROs in patients with SVP are generally good....

  12. VACTERL association with double-chambered left ventricle: A rare occurrence

    Directory of Open Access Journals (Sweden)

    Abdulla Al-Farqani

    2013-01-01

    Full Text Available VACTERL association is a non-random association of birth defects of unknown etiology derived from structures of embryonic mesoderm. The common cardiac defects seen with VACTERL association are ventricular septal defects, atrial septal defects, and tetralogy of Fallot. We present a 2-year-old child with VACTERL association in whom we detected double-chambered left ventricle on transthoracic echocardiography.

  13. Ca2+-regulatory proteins in cardiomyocytes from the right ventricle in children with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Wu Yihe

    2012-04-01

    Full Text Available Abstract Background Hypoxia and hypertrophy are the most frequent pathophysiological consequence of congenital heart disease (CHD which can induce the alteration of Ca2+-regulatory proteins and inhibit cardiac contractility. Few studies have been performed to examine Ca2+-regulatory proteins in human cardiomyocytes from the hypertrophic right ventricle with or without hypoxia. Methods Right ventricle tissues were collected from children with tetralogy of Fallot [n = 25, hypoxia and hypertrophy group (HH group], pulmonary stenosis [n = 25, hypertrophy group (H group], or small isolated ventricular septal defect [n = 25, control group (C group] during open-heart surgery. Paraffin sections of tissues were stained with 3,3′-dioctadecyloxacarbocyanine perchlorate to measure cardiomyocyte size. Expression levels of Ca2+-regulatory proteins [sarcoplasmic reticulum Ca2+-ATPase (SERCA2a, ryanodine receptor (RyR2, sodiumcalcium exchanger (NCX, sarcolipin (SLN and phospholamban (PLN] were analysed by means of real-time PCR, western blot, or immunofluorescence. Additionally, phosphorylation level of RyR and PLN and activity of protein phosphatase (PP1 were evaluated using western blot. Results Mild cardiomyocyte hypertrophy of the right ventricle in H and HH groups was confirmed by comparing cardiomyocyte size. A significant reduction of SERCA2a in mRNA (P16-phosphorylated PLN was down-regulated (PP Conclusions The decreased SERCA2a mRNA may be a biomarker of the pathological process in the early stage of cyanotic CHD with the hypertrophic right ventricle. A combination of hypoxia and hypertrophy can induce the adverse effect of PLN-Ser16 dephosphorylation. Increased PP1 could result in the decreased PLN-Ser16 and inhibition of PP1 is a potential therapeutic target for heart dysfunction in pediatrics.

  14. Is exercise good for the right ventricle? Concepts for health and disease.

    Science.gov (United States)

    La Gerche, André; Claessen, Guido

    2015-04-01

    There is substantial evidence supporting the prescription of exercise training in patients with left-sided heart disease, but data on the effects of exercise are far more limited for conditions that primarily affect the right ventricle. There is evolving evidence that right ventricular (RV) function is of critical importance to circulatory function during exercise. Even in healthy individuals with normal pulmonary vascular function, the hemodynamic load on the right ventricle increases relatively more during exercise than that of the left ventricle, and this disproportionate load is far greater in patients with pulmonary hypertension. Exercise-induced increases in pulmonary artery pressures can exceed RV contractile reserve (so-called arterioventricular uncoupling), resulting in attenuated cardiac output and exercise intolerance. In this review, we explore the spectrum of RV reserve-from transient RV dysfunction observed in athletes after extreme bouts of intense endurance exercise to RV failure with minimal exertion in patients with advanced pulmonary hypertension. Recent advances and novel approaches to echocardiographic and cardiac magnetic resonance imaging have provided more accurate means of assessing the right ventricle and pulmonary circulation during exercise such that quantification of exercise reserve may provide a valuable means of assessing prognosis and response to therapies. We discuss the potential benefits and risks of exercise training in both health and disease while recognizing the need for prospective studies that assess the long-term efficacy and safety of exercise interventions in patients with pulmonary vascular and RV pathologic conditions. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  15. Idiopathic dilated cardiomyopathy: computerized anatomic study of relashionship between septal and free left ventricle wall.

    Science.gov (United States)

    Juliani, Paulo Sérgio; Costa, Eder França da; Correia, Aristides Tadeu; Monteiro, Rosangela; Jatene, Fabio Biscegli

    2014-01-01

    A feature of dilated cardiomyopathy is the deformation of ventricular cavity, which contributes to systolic dysfunction. Few studies have evaluated this deformation bearing in mind ventricular regions and segments of the ventricle, which could reveal important details of the remodeling process, supporting a better understanding of its role in functional impairment and the development of new therapeutic strategies. To evaluate if, in basal, equatorial and apical regions, increased internal transverse perimeter of left ventricle in idiopathic dilated cardiomyopathy occurs proportionally between the septal and non-septal segment. We performed an anatomical study with 28 adult hearts from human cadavers. One group consisted of 18 hearts with idiopathic dilated cardiomyopathy and another group with 10 normal hearts. After lamination and left ventricle digital image capture, in three different regions (base, equator and apex), the transversal internal perimeter of left ventricle was divided into two segments: septal and not septal. These segments were measured by proper software. It was established an index of proportionality between these segments, called septal and non-septal segment index. Then we determined whether this index was the same in both groups. Among patients with normal hearts and idiopathic dilated cardiomyopathy, the index of proportionality between the two segments (septal and non-septal) showed no significant difference in the three regions analyzed. The comparison results of the indices NSS/SS among normal and enlarged hearts were respectively: in base 1.99 versus 1.86 (P=0.46), in equator 2.22 versus 2.18 (P=0.79) and in apex 2.96 versus 3.56 (P=0.11). In the idiopathic dilated cardiomyopathy, the transversal dilatation of left ventricular internal perimeter occurs proportionally between the segments corresponding to the septum and free wall at the basal, equatorial and apical regions of this chamber.

  16. Left and right ventricle late remodeling following myocardial infarction in rats.

    Science.gov (United States)

    Stefanon, Ivanita; Valero-Muñoz, María; Fernandes, Aurélia Araújo; Ribeiro, Rogério Faustino; Rodríguez, Cristina; Miana, Maria; Martínez-González, José; Spalenza, Jessica S; Lahera, Vicente; Vassallo, Paula F; Cachofeiro, Victoria

    2013-01-01

    The mechanisms involved in cardiac remodeling in left (LV) and right ventricles (RV) after myocardial infarction (MI) are still unclear. We assayed factors involved in collagen turnover in both ventricles following MI in rats either presenting signs of heart failure (pulmonary congestion and increased LVEDP) or not (INF-HF or INF, respectively). MI was induced in male rats by ligation of the left coronary artery. Four weeks after MI gene expression of collagen I, connective tissue growth factor (CTGF), transforming growth factor β (TGF-β) and lysyl oxidase (LOX), metalloproteinase-2 (MMP2) and tissue inhibitor metalloproteinase-2 (TIMP2) as well as cardiac hemodynamic in both ventricles were evaluated. Ventricular dilatation, hypertrophy and an increase in interstitial fibrosis and myocyte size were observed in the RV and LV from INF-HF animals, whereas only LV dilatation and fibrosis in RV was present in INF. The LV fibrosis in INF-HF was associated with higher mRNA of collagen I, CTGF, TGF-β and LOX expressions than in INF and SHAM animals, while MMP2/TIMP2 mRNA ratio did not change. RV fibrosis in INF and INF-HF groups was associated with an increase in LOX mRNA and a reduction in MMP2/TIMP2 ratio. CTGF mRNA was increased only in the INF-HF group. INF and INF-HF animals presented different patterns of remodeling in both ventricles. In the INF-HF group, fibrosis seems to be consequence of collagen production in LV, and by reductions in collagen degradation in RV of both INF and INF-HF animals.

  17. Left and right ventricle late remodeling following myocardial infarction in rats.

    Directory of Open Access Journals (Sweden)

    Ivanita Stefanon

    Full Text Available BACKGROUND: The mechanisms involved in cardiac remodeling in left (LV and right ventricles (RV after myocardial infarction (MI are still unclear. We assayed factors involved in collagen turnover in both ventricles following MI in rats either presenting signs of heart failure (pulmonary congestion and increased LVEDP or not (INF-HF or INF, respectively. METHODS: MI was induced in male rats by ligation of the left coronary artery. Four weeks after MI gene expression of collagen I, connective tissue growth factor (CTGF, transforming growth factor β (TGF-β and lysyl oxidase (LOX, metalloproteinase-2 (MMP2 and tissue inhibitor metalloproteinase-2 (TIMP2 as well as cardiac hemodynamic in both ventricles were evaluated. RESULTS: Ventricular dilatation, hypertrophy and an increase in interstitial fibrosis and myocyte size were observed in the RV and LV from INF-HF animals, whereas only LV dilatation and fibrosis in RV was present in INF. The LV fibrosis in INF-HF was associated with higher mRNA of collagen I, CTGF, TGF-β and LOX expressions than in INF and SHAM animals, while MMP2/TIMP2 mRNA ratio did not change. RV fibrosis in INF and INF-HF groups was associated with an increase in LOX mRNA and a reduction in MMP2/TIMP2 ratio. CTGF mRNA was increased only in the INF-HF group. CONCLUSIONS: INF and INF-HF animals presented different patterns of remodeling in both ventricles. In the INF-HF group, fibrosis seems to be consequence of collagen production in LV, and by reductions in collagen degradation in RV of both INF and INF-HF animals.

  18. Surgical Treatment of Double Outlet Right Ventricle Complicated by Pulmonary Hypertension

    Directory of Open Access Journals (Sweden)

    Qing-Yu Wu

    2017-01-01

    Conclusions: PAP of patients with DORV complicated by PH can be expected to fall significantly after surgery. An arterial switch procedure can achieve excellent results in patients with transposition of the great arteries type. Higher incidence of complications may occur in patients with ventricular septal defect (VSD type before 1 year of age. For those with remote VSD type, VSD enlargement and right ventricle outflow tract reconstruction are usually required with acceptable results. The degree of aortic overriding does not influence surgical outcome.

  19. Evidence of ventricular contamination of the optical signal in preterm neonates with post hemorrhagic ventricle dilation

    Science.gov (United States)

    Kishimoto, J.; Diop, M.; McLachlan, P.; de Ribaupierre, S.; Lee, D. S. C.; St. Lawrence, K.

    2015-03-01

    Dilation of the cerebral ventricles is a common condition in preterm neonates with intraventricular hemorrhage (IVH). This post hemorrhagic ventricle dilation (PHVD) can lead to lifelong neurological impairment through ischemic injury due to increased intracranial pressure (ICP). Interventions, such as ventricular tapping to remove cerebrospinal fluid (CSF), are used to prevent injury, but determining the optimal time for treatment is difficult as clinical signs of increased ICP lack sensitivity. There is a growing interest in using near-infrared spectroscopy (NIRS) because of its ability to monitor cerebral oxygen saturation (StO2) at the bedside. However, the accuracy of NIRS may be affected by signal contamination from enlarged ventricles, especially if there are blood breakdown products (bbp) in CSF following IVH. To investigate this, serial NIR spectra from the head and from CSF samples were acquired over a month from seven IVH patients undergoing treatment for PHVD. Over time, the visual appearance of the CSF samples progressed from dark brown ("tea color") to clear yellow, reflecting the reduction in bbp concentration as confirmed by the stronger absorption around 760 nm at the earlier time points. All CSF samples contained strong absorption at 960 nm due to water. More importantly the same trend in these absorption features was observed in the in vivo spectra, and Monte Carlo simulations confirmed the potential for signal contamination from enlarged ventricles. These findings highlight the challenges of accurately measuring StO2 in this patient population and the necessity of using a hyperspectral NIRS system to resolve the additional chromophores.

  20. Left ventricle function in patients with ischemic cardiopathy: determination of the expulsion fraction of the left ventricle with gated-SPECT. Experience in the CMN 20 de Noviembre ISSSTE

    International Nuclear Information System (INIS)

    Mendoza, L.; Puente, A.; Hernandez, T.; Jimenez, L.

    2007-01-01

    The objective of this work is to correlate the expulsion fraction of the left ventricle (FEVI) obtained by means of g-SPECT and other diagnostic methods: ECO 2D and ventriculography for heart catheterization (CTT). (Author)

  1. Diagnostic value of visualization of the right ventricle using thallium-201 myocardial imaging

    International Nuclear Information System (INIS)

    Khaja, F.; Alam, M.; Goldstein, S.; Anbe, D.T.; Marks, D.S.

    1979-01-01

    The diagnostic significance of visualizing the right ventricle on thallium-201 myocardial perfusion scans (T-scan) at rest was studied in 53 patients. In 33 patients, the right ventricle was visualized clearly on the T-scan (group A). Hemodynamic evidence of right ventricular hypertension with systolic pressure greater than or equal to 30 mm Hg was present in 28 of 33 (85%) of these patients. Right ventricular volume overload with left-to-right shunt > 2:1 was present in three patients. Other tests were diagnostic for right ventricular enlargement and or pulmonary hypertension as follows: chest x-ray (58%), echocardiogram (36%), and electrocardiogram (15%). In an unselected group of 20 patients (group B) where resting T-scan did not show visualization of the right ventricle, the right ventricular systolic pressure was < 30 mm Hg in all. The other noninvasive tests did not reveal presence of right ventricular hypertrophy or enlargement. T-scan appears to be a useful and sensitivie test in detecting right ventricular pressure or volume overload compared with other noninvasive tests. This may be useful in detection of patients with right ventricular hypertrophy or enlargement secondary to pulmonary hypertension or other causes

  2. Cilia induced cerebrospinal fluid flow in the third ventricle of brain

    Science.gov (United States)

    Wang, Yong; Westendorf, Christian; Faubel, Regina; Eichele, Gregor; Bodenschatz, Eberhard

    2016-11-01

    Cerebrospinal fluid (CSF) conveys many physiologically important signaling factors through the ventricles of the mammalian brain. The walls of the ventricles are covered with motile cilia that were thought to generate a laminar flow purely following the curvature of walls. However, we recently discovered that cilia of the ventral third ventricle (v3V) generate a complex flow network along the wall, leading to subdivision of the v3V. The contribution of such cilia induced flow to the overall three dimensional volume flow remains to be investigated by using numerical simulation, arguably the best approach for such investigations. The lattice Boltzmann method is used to study the CFS flow in a reconstructed geometry of the v3V. Simulation of CSF flow neglecting cilia in this geometry confirmed that the previous idea about pure confined flow does not reflect the reality observed in experiment. The experimentally recorded ciliary flow network along the wall was refined with the smoothed particle hydrodynamics and then adapted as boundary condition in simulation. We study the contribution of the ciliary network to overall CSF flow and identify site-specific delivery of CSF constituents with respect to the temporal changes.

  3. Complex blood flow patterns in an idealized left ventricle: A numerical study

    Science.gov (United States)

    Tagliabue, Anna; Dedè, Luca; Quarteroni, Alfio

    2017-09-01

    In this paper, we study the blood flow dynamics in a three-dimensional (3D) idealized left ventricle of the human heart whose deformation is driven by muscle contraction and relaxation in coordination with the action of the mitral and aortic valves. We propose a simplified but realistic mathematical treatment of the valves function based on mixed time-varying boundary conditions (BCs) for the Navier-Stokes equations modeling the flow. These switchings in time BCs, from natural to essential and vice versa, model either the open or the closed configurations of the valves. At the numerical level, these BCs are enforced by means of the extended Nitsche's method (Tagliabue et al., Int. J. Numer. Methods Fluids, 2017). Numerical results for the 3D idealized left ventricle obtained by means of Isogeometric Analysis are presented, discussed in terms of both instantaneous and phase-averaged quantities of interest and validated against those available in the literature, both experimental and computational. The complex blood flow patterns are analysed to describe the characteristic fluid properties, to show the transitional nature of the flow, and to highlight its main features inside the left ventricle. The sensitivity of the intraventricular flow patterns to the mitral valve properties is also investigated.

  4. Method of segmenting inferior horns of lateral ventricles using active contour models

    International Nuclear Information System (INIS)

    Hattori, Masumi; Koyama, Shuji; Kodera, Yoshie

    2007-01-01

    Recent research has suggested that the measurement of regional atrophy in the structure of the medial temporal lobe is a promising way to discriminate Alzheimer-type dementia patients from healthy control subjects. There are some reports that the inferior horns of the lateral ventricles are expanded by atrophying the structure of the medial temporal lobe. We developed a technique to automatically detect the region of the inferior horns of the lateral ventricles by gray-level thresholding and morphological processing. However, there were some incorrect regions in this method. Accordingly, we proposed a technique for which active contour models (ACM) were used. Our ACM incorporates the improved edge-based image and the external constraint to improve convergence and to reduce its dependence on initial estimation. In this study, we present the details of an algorithm that traces the contours of the inferior horns of the lateral ventricles and its performance relative to manual methods. The average degree of correspondence between the extract region and manual trace was measured in 30 inferior horns of 15 subjects. The average degree of correspondence of the proposed method was about 4% higher than that of the conventional method. These results suggest that the proposed method is more accurate than the conventional method. (author)

  5. Fluid Structure Interaction simulation of heart prosthesis in patient-specific left-ventricle/aorta anatomies

    Science.gov (United States)

    Le, Trung; Borazjani, Iman; Sotiropoulos, Fotis

    2009-11-01

    In order to test and optimize heart valve prosthesis and enable virtual implantation of other biomedical devices it is essential to develop and validate high-resolution FSI-CFD codes for carrying out simulations in patient-specific geometries. We have developed a powerful numerical methodology for carrying out FSI simulations of cardiovascular flows based on the CURVIB approach (Borazjani, L. Ge, and F. Sotiropoulos, Journal of Computational physics, vol. 227, pp. 7587-7620 2008). We have extended our FSI method to overset grids to handle efficiently more complicated geometries e.g. simulating an MHV implanted in an anatomically realistic aorta and left-ventricle. A compliant, anatomic left-ventricle is modeled using prescribed motion in one domain. The mechanical heart valve is placed inside the second domain i.e. the body-fitted curvilinear mesh of the anatomic aorta. The simulations of an MHV with a left-ventricle model underscore the importance of inflow conditions and ventricular compliance for such simulations and demonstrate the potential of our method as a powerful tool for patient-specific simulations.

  6. Selective scanning of the right ventricle with the ultrashort-lived isotope krypton-81m

    International Nuclear Information System (INIS)

    Horn, M.; Witztum, K.; Neveu, C.; Perkins, G.

    1985-01-01

    The measurement of right ventricular function using /sup 99m/Tc gated blood-pool imaging is hampered by the difficulty in separating the right ventricle from the left heart as well as from the right atrium. Krypton-81m, an ultrashort-lived isotope (t/sub 1/2/, 13 sec) with a single 190-keV gamma ray, can be infused into the venous circulation to yield stable count rates over the right heart. The authors have developed a technique for delivering a continuous infusion of /sup 81m/Kr via an antecubital vein for gated right ventricle (RV) equilibrium studies. Preliminary rest studies have been performed in 15 normal subjects ranging in age from 23 to 62 years. Right-heart structures including the right atrium, tricuspid valve, right ventricle, pulmonic valve, and pulmonary outflow tract are clearly identifiable. Essentially no counts are present over the left heart. RV ejection fractions in this group averaged 48.3 (+/- 5.7)%. Changes in pulmonary blood flow distribution from supine to upright position, which may be an index of pulmonary arterial pressures, are also easily demonstrated

  7. Cardiac magnetic resonance imaging in evaluation of anatomical structure and function of the ventricles

    International Nuclear Information System (INIS)

    Suzuki, Jun-ichi; Usui, Masahiro; Takenaka, Katsu

    1990-01-01

    Cardiac magnetic resonance imaging (MRI) is being widely employed for evaluation of cardiovascular anatomies and functions. However, the indications for cardiac MRI to obtain information which cannot be obtained using other conventional methods have not yet been determined. To demonstrate the usefulness of MRI in delineating the apex of the left ventricle and free wall of the right ventricle, end-diastolic short axis MRI images were obtained in 20 patients with apical hypertrophy and in 9 normal volunteers. To compare the accuracy of estimations of left ventricular volumes obtained using the modified Simpson's method of MRI with that using the MRI area length method, 19 patients, in whom left ventriculography had been performed, were studied. The apex of the left ventricle was evaluated circumferentially and distribution of hypertrophied muscles was defined. Sixty-five percent of the length of the right ventricular free wall was clearly delineated. Correlation coefficients of the ejection fraction between MRI and angiography were 0.85 with the modified Simpson's method of MRI, and 0.62 with the area length method of MRI. Three themes were chosen to demonstrate good clinical indications for cardiac MRI. (author)

  8. [Diagnosis and treatment of congenital fourth branchial anomaly].

    Science.gov (United States)

    Chen, Liang-si; Zhang, Si-yi; Luo, Xiao-ning; Song, Xin-han; Zhan, Jian-dong; Chen, Shao-hua; Lu, Zhong-ming

    2010-10-01

    To discuss the anatomic features, clinical presentations, diagnosis, differentiations and treatments of congenital fourth branchial anomaly(CFBA). The clinical data of 8 patients with CFBA were retrospectively analyzed. Of the 8 patients aging from 27 to 300 months (median age: 114 months), 4 male and 4 female; 3 untreated previously and 5 recurrent. All lesions, including 1 cyst, 3 sinus (with internal opening) and 4 fistula, located in the left necks. Three patients presented acute suppurative thyroiditis, 4 deep neck abscesses, and 1 neck lump. Preoperative examinations included barium esophagogram, direct laryngoscopy, ultrasonography, CT, MRI, and so on. The principles of managements were adequate drainage, infection control during acute period and radical surgery during quiescent period. Classic surgical approach consisted of complete excision of branchial lesions, dissection of recurrent laryngeal nerve and partial thyroidectomy. Selective neck dissection was applied in recurrent cases to extirpate branchial lesions, scarrings and inflammatory granuloma. Postoperatively, 1 case was with local incision infection which healed by wound care; 1 case was with temporary vocal cord paralysis which completely recovered 1 month after operation. No recurrence was found in all of 8 cases with follow-up of 13 to 42 months (median: 21 months). CFBA relates closely anatomically with recurrent laryngeal nerve and thyroid grand. The barium esophagogram and direct laryngoscopy are the most useful diagnostic tools. CT and MRI are all beneficial to the diagnosis of CFBA. The treatment key to CFBA is the complete excision of lesion during a quiescent period after inflammatory control, together with the dissection of recurrent laryngeal nerve, partial thyroidectomy and partial resection of lamina of thyroid cartilage (if necessary), which all can decrease the risk of complications and recurrence. For recurrent cases, selective neck dissection is a safe and effective surgical

  9. Mandibular asymmetry and the fourth dimension.

    Science.gov (United States)

    Kaban, Leonard B

    2009-03-01

    This paper represents more than 30 years of discussion and collaboration with Drs Joseph Murray and John Mulliken in an attempt to understand growth patterns over time (ie, fourth dimension) in patients with hemifacial microsomia (HFM). This is essential for the development of rational treatment protocols for children and adults with jaw asymmetry. Traditionally, HFM was thought of as a unilateral deformity, but it was recognized that 20% to 30% of patients had bilateral abnormalities. However, early descriptions of skeletal correction addressed almost exclusively lengthening of the short (affected) side of the face. Based on longitudinal clinical observations of unoperated HFM patients, we hypothesized that abnormal mandibular growth is the earliest skeletal manifestation and that restricted growth of the mandible plays a pivotal role in progressive distortion of both the ipsilateral and contralateral facial skeleton. This hypothesis explains the progressive nature of the asymmetry in patients with HFM and provides the rationale for surgical lengthening of the mandible in children to prevent end-stage deformity. During the past 30 years, we have learned that this phenomenon of progressive distortion of the adjacent and contralateral facial skeleton occurs with other asymmetric mandibular undergrowth (tumor resection, radiation therapy, or posttraumatic defects) and overgrowth (mandibular condylar hyperplasia) conditions. In this paper, I describe the progression of deformity with time in patients with mandibular asymmetry as a result of undergrowth and overgrowth. Understanding these concepts is critical for the development of rational treatment protocols for adults with end-stage asymmetry and for children to minimize secondary deformity.

  10. Proceedings of the Fourth Compton Symposium. Proceedings

    International Nuclear Information System (INIS)

    Dermer, C.D.; Strickman, M.S.; Kurfess, J.D.

    1997-01-01

    These proceedings represent the papers presented at the Fourth Compton Symposium held in Williamsburg, Virginia in April, 1997. This symposium gives the latest development in gamma ray astronomy and summarizes the results obtained by the Compton Gamma Ray Observatory. One of the missions of the Observatory has been the study of physical processes taking place in the most dynamic sites in the Universe, including supernovae, novae, pulsars, black holes, active galaxies, and gamma-ray bursts. The energies covered range from hard X-ray to gamma-ray regions from 15 KeV to 30 GeV. The Burst and Transient Experiment (BASTE) measures brightness variations in gamma-ray bursts and solar flares. The Oriented Scintillation Spectroscopy Experiment (OSSE), measures spectral output of astrophysical sources in the 0.05 to 10 MeV range. The Imaging Compton Telescope (COMPTEL) detects gamma-rays and performs sky survey in the energy range 1 to 30 MeV. The Energetic Gamma Ray Experiment Telescope (EGRET) covers the broadest energy range from 20 MeV to 30 GeV. The papers presented result from all of the above. There were 249 papers presented and out of these, 6 have been abstracted for the Energy, Science and Technology database

  11. IAEA research contracts. Fourth annual report

    International Nuclear Information System (INIS)

    1964-01-01

    This volume represents the fourth annual report on the results obtained under the Agency's research contract programme. During the short life of this programme, which is not quite six years old, a total investment of more than three million dollars has been made to support research in selected fields at institutes in 50 Member States. Extensive summaries are presented herein for all final reports relating to contracts which were completed during 1963. As it is the policy of the Agency to encourage publication in the open scientific literature of the results of work done under research contracts, a number of papers have also appeared in the appropriate journals - the Agency having been notified of 75 such publications in 1963. A complete list of references to these is given at the end of this report. The scientific data presented in the summaries of course remain the responsibility of the contractor. The Agency, however, is responsible for any additional observations. The reports presented are related to research in the field of radioactive waste management and environmental sciences; health physics and radiation protection; radiobiology; nuclear reactors physics and nuclear fuels; radioisotope applications in agriculture and medicine

  12. Heading for the fourth nuclear age

    Energy Technology Data Exchange (ETDEWEB)

    Levite, A.E.

    2009-07-01

    The author examines the evolution of the global nuclear order since the advent of nuclear weapons in 1945 to present by breaking down the sixty-plus years of nuclear history into three analytically distinct 'ages', each lasting roughly twenty years. By doing so, the author traces back the roots of the current nuclear predicament to some early seeds of trouble which have gradually grown more profound. He attributes much of the unraveling of the nuclear order to: - Certain inherent weaknesses in the original NPT formula; - Changes in the global distribution of power since the codification of the nuclear order in the 1960's; - The dissemination of nuclear weapon technology; and - Complacency and subsequent disillusionment with the nuclear order since the early 1990's. The paper further analyzes what could precipitate a new nuclear age around 2010. The author argues that such a 'fourth nuclear age' would likely be characterized by either a nuclear anarchy, which he believes has become the default option, or a more benign nuclear order manifested by lower numbers of weapons and stringent controls and restrictions on remaining nuclear arsenals and activities. He concludes by considering the more pressing requirements for regaining nuclear stability

  13. IAEA research contracts. Fourth annual report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1964-04-01

    This volume represents the fourth annual report on the results obtained under the Agency's research contract programme. During the short life of this programme, which is not quite six years old, a total investment of more than three million dollars has been made to support research in selected fields at institutes in 50 Member States. Extensive summaries are presented herein for all final reports relating to contracts which were completed during 1963. As it is the policy of the Agency to encourage publication in the open scientific literature of the results of work done under research contracts, a number of papers have also appeared in the appropriate journals - the Agency having been notified of 75 such publications in 1963. A complete list of references to these is given at the end of this report. The scientific data presented in the summaries of course remain the responsibility of the contractor. The Agency, however, is responsible for any additional observations. The reports presented are related to research in the field of radioactive waste management and environmental sciences; health physics and radiation protection; radiobiology; nuclear reactors physics and nuclear fuels; radioisotope applications in agriculture and medicine.

  14. Heading for the fourth nuclear age

    International Nuclear Information System (INIS)

    Levite, A.E.

    2009-01-01

    The author examines the evolution of the global nuclear order since the advent of nuclear weapons in 1945 to present by breaking down the sixty-plus years of nuclear history into three analytically distinct 'ages', each lasting roughly twenty years. By doing so, the author traces back the roots of the current nuclear predicament to some early seeds of trouble which have gradually grown more profound. He attributes much of the unraveling of the nuclear order to: - Certain inherent weaknesses in the original NPT formula; - Changes in the global distribution of power since the codification of the nuclear order in the 1960's; - The dissemination of nuclear weapon technology; and - Complacency and subsequent disillusionment with the nuclear order since the early 1990's. The paper further analyzes what could precipitate a new nuclear age around 2010. The author argues that such a 'fourth nuclear age' would likely be characterized by either a nuclear anarchy, which he believes has become the default option, or a more benign nuclear order manifested by lower numbers of weapons and stringent controls and restrictions on remaining nuclear arsenals and activities. He concludes by considering the more pressing requirements for regaining nuclear stability

  15. Endocardial left ventricle feature tracking and reconstruction from tri-plane trans-esophageal echocardiography data

    Science.gov (United States)

    Dangi, Shusil; Ben-Zikri, Yehuda K.; Cahill, Nathan; Schwarz, Karl Q.; Linte, Cristian A.

    2015-03-01

    Two-dimensional (2D) ultrasound (US) has been the clinical standard for over two decades for monitoring and assessing cardiac function and providing support via intra-operative visualization and guidance for minimally invasive cardiac interventions. Developments in three-dimensional (3D) image acquisition and transducer design and technology have revolutionized echocardiography imaging enabling both real-time 3D trans-esophageal and intra-cardiac image acquisition. However, in most cases the clinicians do not access the entire 3D image volume when analyzing the data, rather they focus on several key views that render the cardiac anatomy of interest during the US imaging exam. This approach enables image acquisition at a much higher spatial and temporal resolution. Two such common approaches are the bi-plane and tri-plane data acquisition protocols; as their name states, the former comprises two orthogonal image views, while the latter depicts the cardiac anatomy based on three co-axially intersecting views spaced at 600 to one another. Since cardiac anatomy is continuously changing, the intra-operative anatomy depicted using real-time US imaging also needs to be updated by tracking the key features of interest and endocardial left ventricle (LV) boundaries. Therefore, rapid automatic feature tracking in US images is critical for three reasons: 1) to perform cardiac function assessment; 2) to identify location of surgical targets for accurate tool to target navigation and on-target instrument positioning; and 3) to enable pre- to intra-op image registration as a means to fuse pre-op CT or MR images used during planning with intra-operative images for enhanced guidance. In this paper we utilize monogenic filtering, graph-cut based segmentation and robust spline smoothing in a combined work flow to process the acquired tri-plane TEE time series US images and demonstrate robust and accurate tracking of the LV endocardial features. We reconstruct the endocardial LV

  16. Primary left ventricular hydatid cyst in a child: case report

    International Nuclear Information System (INIS)

    Turkvatan, A.; Yelgec, N.S.; Calikoglu, U.; Olcer, T.

    2000-01-01

    The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

  17. Primary left ventricular hydatid cyst in a child: case report

    Energy Technology Data Exchange (ETDEWEB)

    Turkvatan, A. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey); Yelgec, N.S. [Turkiye Yuksek Ihtisas Hospital, Dept. of Cardiology, Ankara (Turkey); Calikoglu, U.; Olcer, T. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey)

    2000-12-01

    The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

  18. A robust automated left ventricle region of interest localization technique using a cardiac cine MRI atlas

    Science.gov (United States)

    Ben-Zikri, Yehuda Kfir; Linte, Cristian A.

    2016-03-01

    Region of interest detection is a precursor to many medical image processing and analysis applications, including segmentation, registration and other image manipulation techniques. The optimal region of interest is often selected manually, based on empirical knowledge and features of the image dataset. However, if inconsistently identified, the selected region of interest may greatly affect the subsequent image analysis or interpretation steps, in turn leading to incomplete assessment during computer-aided diagnosis or incomplete visualization or identification of the surgical targets, if employed in the context of pre-procedural planning or image-guided interventions. Therefore, the need for robust, accurate and computationally efficient region of interest localization techniques is prevalent in many modern computer-assisted diagnosis and therapy applications. Here we propose a fully automated, robust, a priori learning-based approach that provides reliable estimates of the left and right ventricle features from cine cardiac MR images. The proposed approach leverages the temporal frame-to-frame motion extracted across a range of short axis left ventricle slice images with small training set generated from les than 10% of the population. This approach is based on histogram of oriented gradients features weighted by local intensities to first identify an initial region of interest depicting the left and right ventricles that exhibits the greatest extent of cardiac motion. This region is correlated with the homologous region that belongs to the training dataset that best matches the test image using feature vector correlation techniques. Lastly, the optimal left ventricle region of interest of the test image is identified based on the correlation of known ground truth segmentations associated with the training dataset deemed closest to the test image. The proposed approach was tested on a population of 100 patient datasets and was validated against the ground truth

  19. Human Resources Administration: A School-Based Perspective. Fourth Edition

    Science.gov (United States)

    Smith, Richard

    2009-01-01

    Enhanced and updated, this Fourth Edition of Richard E. Smith's highly successful text examines the growing role of the principal in planning, hiring, staff development, supervision, and other human resource functions. The Fourth Edition includes new sections on ethics, induction, and the role of the mentor teacher. This edition also introduces…

  20. New singularities in nonrelativistic coupled channel scattering. II. Fourth order

    International Nuclear Information System (INIS)

    Khuri, N.N.; Tsun Wu, T.

    1997-01-01

    We consider a two-channel nonrelativistic potential scattering problem, and study perturbation theory in fourth order for the forward amplitude. The main result is that the new singularity demonstrated in second order in the preceding paper I also occurs at the same point in fourth order. Its strength is again that of a pole. copyright 1997 The American Physical Society

  1. The fourth national anti-tuberculosis drug resistance survey in Viet Nam.

    Science.gov (United States)

    Nhung, N V; Hoa, N B; Sy, D N; Hennig, C M; Dean, A S

    2015-06-01

    Viet Nam's Fourth National Anti-Tuberculosis Drug Resistance Survey was conducted in 2011. To determine the prevalence of resistance to the four main first-line anti-tuberculosis drugs in Viet Nam. Eighty clusters were selected using a probability proportion to size approach. Drug susceptibility testing (DST) against the four main first-line anti-tuberculosis drugs was performed. A total of 1629 smear-positive tuberculosis (TB) patients were eligible for culture. Of these, DST results were available for 1312 patients, including 1105 new TB cases, 195 previously treated TB cases and 12 cases with an unknown treatment history. The proportion of cases with resistance to any drug was 32.7% (95%CI 29.1-36.5) among new cases and 54.2% (95%CI 44.3-63.7) among previously treated cases. The proportion of multidrug-resistant TB (MDR-TB) cases was 4.0% (95%CI 2.5-5.4) in new cases and 23.3 (95%CI 16.7-29.9) in previously treated cases. The fourth drug resistance survey in Viet Nam found that the proportion of MDR-TB among new and previously treated cases was not significantly different from that in the 2005 survey. The National TB Programme should prioritise the detection and treatment of MDR-TB to reduce transmission of MDR-TB in the community.

  2. Toward a fourth-generation light source

    International Nuclear Information System (INIS)

    Moncton, D. E.

    1999-01-01

    Historically, x-ray research has been propelled by the existence of urgent and compelling scientific questions and the push of powerful and exquisite source technology. These two factors have gone hand in hand since Rontgen discovered x-rays. Here we review the progress being made with existing third-generation synchrotron-radiation light sources and the prospects for a fourth-generation light source with dramatically improved laser-like beam characteristics. The central technology for high-brilliance x-ray beams is the x-ray undulator, a series of alternating-pole magnets situated above and below the particle beam. When the particle beam is oscillated by the alternating magnetic fields, a set of. interacting and interfering wave fronts is produced, which leads to an x-ray beam with extraordinary properties. Third-generation sources of light in the hard x-ray range have been constructed at three principal facilities: the European Synchrotrons Radiation Facility (ESRF) in France; the Super Photon Ring 8-GeV (or Spring-8) in Japan; and the Advanced Photon Source (APS) in the US. Undulator technology is also used on a number of low-energy machines for radiation in the ultraviolet and soft x-ray regimes. At the APS, these devices exceed all of our original expectations for beam brilliance, tunability, spectral range, and operational flexibility. Shown in Fig. 1 are the tuning curves of the first few harmonics, showing x-ray production from a few kV to better than 40 keV. High-brilliance radiation extends to over 100 keV

  3. [Nitrid oxide, levosimendan and sildenafile in a patient with right ventricle dysfunction and severe pulmonary hypertension after cardiac surgery].

    Science.gov (United States)

    Aleixandre, L; Cortell, J; Vicente, R; Herrera, P; Loro, J M; Valera, F

    2014-11-01

    Pulmonary hypertension (PHT) and the resulting right ventricle dysfunction are important risk factors in patients who undergo cardiac surgery. The treatment of PHT and right ventricle dysfunction should be focused on maintaining the correct right ventricle after load, improving right ventricle function and reducing the right ventricle pre-load and therefore reducing pulmonary vascular resistance by means of vasodilators. A combined therapy of vasodilators and medicines which have different mechanisms of action, is becoming an option for the treatment of PHT. We present a 65 year old woman that suffered from mitral regurgitation, aortic valve disease, tricuspid and ascending aortic dilation with 115mmHg of pulmonary artery pressure (by ultrasound evaluation). The patient was operated on of mitral, aortic valve and tricuspid plastia and proximal aortic artery plastia as well. Previosly to surgery the patient suffered right ventricle dysfunction and PHT and was treated with nitric oxide, intravenous sildenafil and levosimendan. Subsequent evolution was satisfactory, PHT being controlled, without arterial hypotension nor respiratory alterations. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Peripheral Artery Disease and Continuous Flow Left Ventricle Assist Device: An Engaging Complement Analysis May Help to Guide Treatment.

    Science.gov (United States)

    Falletta, Calogero; Pasta, Salvatore; Raffa, Giuseppe Maria; Crinò, Francesca; Sciacca, Sergio; Clemenza, Francesco

    2018-02-13

    Use of continuous flow left ventricle assist device (CF-LVAD) in advanced heart failure (HF) patients results in clinically relevant improvements in survival, functional capacity, and quality of life. Peripheral artery disease (PAD) can occur in patients with CF-LVAD due to the high rate of concomitance between risk factors for atherosclerosis and HF. Diagnosis of PAD can be difficult in the specific setting of a patient supported by this kind of device because of the marked alteration in waveform morphology and velocity created by the artificial physiology of an LVAD. We report the case of a 53-year-old man with HF secondary to ischemic cardiomyopathy supported by the HeartWare HVAD as bridge to transplant, who after the implant developed symptoms suggestive of PAD. We describe additional computational flow analysis for the study of PAD-related hemodynamic disturbances induced by a CF-LVAD. Flow simulations enhance the information of clinical image data, and may have an application in clinical investigations of the risk of hemodynamic disturbances induced by LVAD implantation. © 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  5. Personality as a Fourth Criterion for Tenure.

    Science.gov (United States)

    Zirkel, Perry A.

    1985-01-01

    A hypothetical case of denial of tenure by a public institution to a faculty member with persistent personality conflicts with colleagues is the context for a discussion of related legal issues and the results of previous court litigation. (MSE)

  6. Fourth Issue of the Journal of Problem Based Learning in Higher Education

    DEFF Research Database (Denmark)

    Davidsen, Jacob; Ryberg, Thomas

    2015-01-01

    We are pleased to introduce the fourth issue of the Journal of Problem Based Learning in Higher Education. Current issue is composed of five research papers and two PBL cases. These address different aspects of PBL in higher education as and represent an international experiences and knowledge...... with contributions from Brazil, Denmark, Germany and Morocco. The first three papers and the two cases touch upon the role of the teacher in facilitating problem based learning processes. These papers address the complex questions of how teachers can actually implement and teach PBL to students. The fourth paper...... a diverse set of aspects related to research in Problem Based Learning: teachers and supervisors roles, implementation of PBL curricular, assessment formats supporting PBL and new advances in combining technology and PBL....

  7. Infective endocarditis due to Enterobacter cloacae resistant to third- and fourth-generation cephalosporins.

    Science.gov (United States)

    Yoshino, Yusuke; Okugawa, Shu; Kimura, Satoshi; Makita, Eiko; Seo, Kazunori; Koga, Ichiro; Matsunaga, Naohisa; Kitazawa, Takatoshi; Ota, Yasuo

    2015-04-01

    We report the case of using a long-term combination of meropenem and amikacin to treat infective endocarditis caused by Enterobacter cloacae resistant to third- and fourth-generation cephalosporins. Multi-drug resistant Gram-negative bacilli, such as the E. cloacae in our study, may become possible pathogens of infective endocarditis. Our experience with this case indicates that long-term use of a combination of β-lactam and aminoglycosides might represent a suitable management option for future infective endocarditis cases due to non-Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, Kingella spp. (HACEK group) Gram-negative bacilli such as ours. Copyright © 2012. Published by Elsevier B.V.

  8. Nonthrombotic artificial mass in right ventricle and pulmonary circulation as a sequence of vertebroplasty

    International Nuclear Information System (INIS)

    Monovska, T.; Kirova, G.; Bojinov, D.; Kichukov, K.

    2013-01-01

    Full text: Introduction: Percutaneous vertebroplasty for the treatment of the vertebral body fractures is considered to be relatively safe therapeutic procedure. Nevertheless there is a potential risk of spread of emboli from artificial material through external vertebral venous plexus. What you will learn: This is a 60 -year-old patient with primary diagnosis of multiple myeloma and conducted vertebroplasty due to the vertebral bodies fractures. Accompanying symptoms are: coughing up blood and pain in the right the chest with medication for micro thromboembolism form of Pulmonary thromboembolism (PTE). There are echocardiographic data on hospitalization for a formation in the right ventricle. Based on additionally performed CT study, a ‘foreign body’ - artificial material in right ventricle and subsegmentary branches of the pulmonary arteries as a complication of previous vertebroplasty has been recorded. Paravertebral venous vessels in the area of the thoracic section filled with cement have been noticed. Discussion: non-thrombotic embolism of artificial material prior vertebroplasty can be asymptomatic, or condition may be associated with life-threatening symptoms - compression of the spinal cord resulting in paraplegia, emboli in the cerebral vessels, right ventricle, kidney arteries. The frequency of the topical flowing of the used material is relatively high (80-90 %) to the para-vertebral vein (over 24%), with subsequent pulmonary emboli (4.6 to 6.8 %). The path of the embolization material dissemination is in the course of the para-vertebral veins, v. azygos and v. cafa inf., with the end goal pulmonary circulation. Conclusion: Follow-up of patients after the therapeutic vertebroplasty and integrated diagnostic approach with appropriate imaging methods allow timely diagnosis and treatment of this unusual form of non-thrombotic embolism

  9. Neurological Injury and Cerebral Blood Flow in Single Ventricles Throughout Staged Surgical Reconstruction.

    Science.gov (United States)

    Fogel, Mark A; Li, Christine; Elci, Okan U; Pawlowski, Tom; Schwab, Peter J; Wilson, Felice; Nicolson, Susan C; Montenegro, Lisa M; Diaz, Laura; Spray, Thomas L; Gaynor, J William; Fuller, Stephanie; Mascio, Christopher; Keller, Marc S; Harris, Matthew A; Whitehead, Kevin K; Bethel, Jim; Vossough, Arastoo; Licht, Daniel J

    2017-02-14

    Patients with a single ventricle experience a high rate of brain injury and adverse neurodevelopmental outcome; however, the incidence of brain abnormalities throughout surgical reconstruction and their relationship with cerebral blood flow, oxygen delivery, and carbon dioxide reactivity remain unknown. Patients with a single ventricle were studied with magnetic resonance imaging scans immediately prior to bidirectional Glenn (pre-BDG), before Fontan (BDG), and then 3 to 9 months after Fontan reconstruction. One hundred sixty-eight consecutive subjects recruited into the project underwent 235 scans: 63 pre-BDG (mean age, 4.8±1.7 months), 118 BDG (2.9±1.4 years), and 54 after Fontan (2.4±1.0 years). Nonacute ischemic white matter changes on T2-weighted imaging, focal tissue loss, and ventriculomegaly were all more commonly detected in BDG and Fontan compared with pre-BDG patients ( P <0.05). BDG patients had significantly higher cerebral blood flow than did Fontan patients. The odds of discovering brain injury with adjustment for surgical stage as well as ≥2 coexisting lesions within a patient decreased (63%-75% and 44%, respectively) with increasing amount of cerebral blood flow ( P <0.05). In general, there was no association of oxygen delivery (except for ventriculomegaly in the BDG group) or carbon dioxide reactivity with neurological injury. Significant brain abnormalities are commonly present in patients with a single ventricle, and detection of these lesions increases as children progress through staged surgical reconstruction, with multiple coexisting lesions more common earlier than later. In addition, this study demonstrated that BDG patients had greater cerebral blood flow than did Fontan patients and that an inverse association exists of various indexes of cerebral blood flow with these brain lesions. However, CO 2 reactivity and oxygen delivery (with 1 exception) were not associated with brain lesion development. URL: http

  10. Neurologic Injury and Cerebral Blood Flow In Single Ventricles Throughout Staged Surgical Reconstruction

    Science.gov (United States)

    Fogel, Mark A.; Li, Christine; Elci, Okan U.; Pawlowski, Tom; Schwab, Peter J.; Wilson, Felice; Nicolson, Susan C.; Montenegro, Lisa M.; Diaz, Laura; Spray, Thomas L.; Gaynor, J William; Fuller, Stephanie; Mascio, Christopher; Keller, Marc S.; Harris, Matthew A.; Whitehead, Kevin K.; Bethel, Jim; Vossough, Arastoo; Licht, Daniel J.

    2017-01-01

    Background Single ventricle patients experience a high rate of brain injury and adverse neurodevelopmental outcome, however, the incidence of brain abnormalities throughout surgical reconstruction and its relationship with cerebral blood flow, oxygen delivery and carbon dioxide reactivity remains unknown. Methods Single ventricle patients were studied with MRI scans immediately prior to bidirectional Glenn (pre-BDG), prior to Fontan and then 3–9 months after Fontan reconstruction. Results One hundred and sixty eight consecutive subjects recruited into the project underwent 235 scans: 63 pre-BDG (mean age 4.8+1.7 months), 118 BDG (2.9+1.4 years) and 54 after Fontan (2.4+1.0 years). Non-acute ischemic white matter changes on T2 weighted imaging, focal tissue loss, and ventriculomegaly were all more commonly detected in BDG and Fontans compared to pre-BDG (P<0.05). BDG patients has significantly higher CBF than Fontan patients. The odds of discovering brain injury adjusting for surgical stage as well as 2 or more co-existing lesions within a patient all decreased (63–75% and 44% respectively) with increasing amount of cerebral blood flow (P<0.05). In general, there was no association of oxygen delivery (with the exception of ventriculomegaly in the BDG group) or carbon dioxide reactivity with neurological injury. Conclusion Significant brain abnormalities are commonly present in single ventricle patients and detection of these lesions increase as children progress through staged surgical reconstruction with multiple co-existing lesions more common earlier than later. In addition, this study demonstrated that BDG patients had greater CBF than Fontan patients and that there exists an inverse association of various indices of CBF with these brain lesions, however, CO2 reactivity, oxygen delivery (with one exception) were not associated with brain lesion development. PMID:28031423

  11. Brain Magnetic Resonance Immediately Prior To Surgery In Single Ventricles and Surgical Postponement

    Science.gov (United States)

    Fogel, Mark A.; Pawlowski, Tom; Schwab, Peter J.; Nicolson, Susan C.; Montenegro, Lisa M.; Berenstein, Laura Diaz; Spray, Thomas L.; Gaynor, J William; Fuller, Stephanie; Keller, Marc S.; Harris, Matthew A.; Whitehead, Kevin K.; Vossough, Arastoo; Licht, Daniel J.

    2014-01-01

    Background Single ventricle patients undergoing surgical reconstruction experience a high rate of brain injury; incidental findings on pre-operative brain scans may result in safety considerations involving hemorrhage extension during cardiopulmonary bypass that result in surgical postponement. Methods Single ventricle patients were studied with brain scans immediately preoperatively as part of a National Institute of Health study and were reviewed by neuroradiology immediately prior to cardiopulmonary bypass. Results One hundred and thirty four consecutive subjects recruited into the project were studied: 33 prior to stage I (3.7±1.8 days), 34 prior to bidirectional Glenn (5.8±3.5 months) and 67 prior to Fontan (3.3±1.1 years). Six (4.5%) surgeries were postponed because of concerning imaging findings on brain MRI; 2 prior to stage I, 3 prior to bidirectional Glenn and 1 prior to Fontan. Five were due to unexpected incidental findings of acute intracranial hemorrhage and one due to diffuse cerebellar cytotoxic edema; none who proceeded to surgery had these lesions. Prematurity as well as genetic syndromes were not present in any with postponed surgery. Four of 4 prior to bidirectional Glenn/Fontan with surgical delays had hypoplastic left heart syndrome compared with 44/97 who did not (P=0.048). After observation and follow up, all eventually had successful surgeries with bypass. Conclusion Preoperative brain MRI performed in children with single ventricles disclosed injuries in 4.5% leading to surgical delay; hemorrhagic lesions were most common and raised concerns for extension during surgery. The true risk of progression and need for delay of surgery due to heparinization associated with these lesions remains uncertain. PMID:25149046

  12. Congenital cutaneous fistula at the sternoclavicular joint - Not a dermoid fistula but the remnant of the fourth branchial (pharyngeal) cleft ?

    Science.gov (United States)

    Ohno, Michinobu; Kanamori, Yutaka; Tomonaga, Kotaro; Yamashita, Tatsuya; Migita, Misato; Takezoe, Toshiko; Watanabe, Toshihiko; Fuchimoto, Yasushi; Matsuoka, Kentaro

    2015-12-01

    A fourth branchial pouch remnant is well known as a pyriform sinus fistula. However, there has been no report of a fistula composed of the complete remnant of the fourth branchial apparatus. We experienced patients with a congenital lower neck cutaneous fistula which was thought to be the skin-side remnant of the fourth branchial cleft. Seven children were referred to our hospital from 2009 to 2015 for the treatment of a cutaneous fistula situated near the sternoclavicular joint. All of them were surgically resected and their pathological characteristics were examined. Clinical charts were retrospectively reviewed. In six cases, the left side was affected. All cutaneous fistulas had a small skin orifice near the sternoclavicular joint and they were situated at the anterior edge of the sternocleidomastoid muscle. Abscess formation was seen in four cases. Surgical resection was performed at the age of 6 months to 9 years. These fistulas ran deep into the subcutaneous tissue and had a blind end. Pathological examination showed that the epithelial layer was mainly composed of a stratified squamous epithelium. In two cases the epithelium was composed of ciliated columnar epithelium. Recurrence has not been observed in any of the cases. The seven cases had a common clinical feature and were a definite clinical entity. Judging from the characteristics of our cases and the previous literature, we concluded that this lower neck cutaneous fistula was most likely a congenital skin-side remnant of the fourth branchial cleft. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Open and Endoscopic Management of Fourth Branchial Pouch Sinus – Our Experience

    Directory of Open Access Journals (Sweden)

    Arunachalam, Pavai

    2015-07-01

    Full Text Available Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children. Methods The study involved performing a retrospective review of five cases in PSG Institute of Medical Sciences & Research. All cases were evaluated radiologically and with Direct Rigid hypopharyngoscopy. Definitive surgery was performed, including hemithyroidectomy. Results The patients consisted of five children, two boys and three girls. All of them presented with recurrent episodes of neck infection. Investigations performed included computed tomography (CT fistulography, rigid hypopharyngoscopy and ultrasound, which were useful in preoperatively delineating pyriform sinus fistulous tract. All patients underwent neck exploration with excision of the fistulous tract and hemithyroidectomy. Upon follow-up, all patients are asymptomatic. Conclusions Recurrent neck abscesses in a child should alert the clinician to the possibility of a fourth branchial arch anomaly; therefore, children with this condition require a complete evaluation so the anomaly can be ruled out.

  14. Open and Endoscopic Management of Fourth Branchial Pouch Sinus – Our Experience

    Science.gov (United States)

    Arunachalam, Pavai; Vaidyanathan, Venkatraman; Sengottan, Palaninathan

    2015-01-01

    Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children. Methods The study involved performing a retrospective review of five cases in PSG Institute of Medical Sciences & Research. All cases were evaluated radiologically and with Direct Rigid hypopharyngoscopy. Definitive surgery was performed, including hemithyroidectomy. Results The patients consisted of five children, two boys and three girls. All of them presented with recurrent episodes of neck infection. Investigations performed included computed tomography (CT) fistulography, rigid hypopharyngoscopy and ultrasound, which were useful in preoperatively delineating pyriform sinus fistulous tract. All patients underwent neck exploration with excision of the fistulous tract and hemithyroidectomy. Upon follow-up, all patients are asymptomatic. Conclusions Recurrent neck abscesses in a child should alert the clinician to the possibility of a fourth branchial arch anomaly; therefore, children with this condition require a complete evaluation so the anomaly can be ruled out. PMID:26491476

  15. Open and Endoscopic Management of Fourth Branchial Pouch Sinus - Our Experience.

    Science.gov (United States)

    Arunachalam, Pavai; Vaidyanathan, Venkatraman; Sengottan, Palaninathan

    2015-10-01

    Introduction Acute suppurative neck infections associated with third or fourth branchial arch fistulas are frequently recurrent. Third and fourth branchial arch anomalies are much less common and usually present with recurrent left thyroid lobe abscesses. Objectives The authors present their experience in treating such cases that were observed exclusively in children. Methods The study involved performing a retrospective review of five cases in PSG Institute of Medical Sciences & Research. All cases were evaluated radiologically and with Direct Rigid hypopharyngoscopy. Definitive surgery was performed, including hemithyroidectomy. Results The patients consisted of five children, two boys and three girls. All of them presented with recurrent episodes of neck infection. Investigations performed included computed tomography (CT) fistulography, rigid hypopharyngoscopy and ultrasound, which were useful in preoperatively delineating pyriform sinus fistulous tract. All patients underwent neck exploration with excision of the fistulous tract and hemithyroidectomy. Upon follow-up, all patients are asymptomatic. Conclusions Recurrent neck abscesses in a child should alert the clinician to the possibility of a fourth branchial arch anomaly; therefore, children with this condition require a complete evaluation so the anomaly can be ruled out.

  16. Significance of blood pool scintigraphy and echocardiography in the investigation of left heart ventricle

    International Nuclear Information System (INIS)

    Otto, L.; Krosse, B.; Neumann, G.; Rother, T.; Loebe, M.; Otto, J.; Koegler, A.; Wuensche, A.; Schneider, G.

    1990-01-01

    Left ventricular ejection (LVEF) was assessed by both radionuclide ventriculography and echocardiography. The correlation coefficient of 0.74 revealed a just good agreement. It was better in the range of normal than of pathological values. The analysis of regional wall motion performed by echocardiography was not as reliable as by radionuclide ventriculography. The main advantage of echocardiography is its good spatial resolution. Its domain is the diagnosis of pathomorphological changes including valvular disorders. Advantages of radionuclide ventriculography are good temporal resolution, registration of the third dimension practicability during exercise and as bedside method (nuclear stethoscope). Functional disturbances of both ventricles are its field of application. (author)

  17. Choosing between endoscopic or microscopic removal of third ventricle colloid cysts.

    Science.gov (United States)

    Haider, Ghani; Laghari, Altaf Ali; Shamim, Muhammad Shahzad

    2017-09-01

    Colloid cysts are benign lesions, found in the anterior part of the roof of the third ventricle. A PubMED search of literature was performed to identify the evidence on different treatment options and surgical approaches for removal of colloid cysts. Evidence on endoscopic versus microsurgical resection of colloid cysts showed that microsurgical approach had significantly higher rates of gross total resection, lower recurrence rate and lower re-operation rate. No significant difference with respect to the mortality rate or the need for a shunt was found between the two groups. However, the overall morbidity rate was lower for the endoscopic group. .

  18. Measurement of blood flow from an assist ventricle by computation of pneumatic driving parameters.

    Science.gov (United States)

    Qian, K X

    1992-03-01

    The measurement of blood flow from an assist ventricle is important but sometimes difficult in artificial heart experiments. Along with the development of a pneumatic cylinder-piston driver coupled with a ventricular assist device, a simplified method for measuring pump flow was established. From driving parameters such as the piston (or cylinder) displacement and air pressure, the pump flow could be calculated by the use of the equation of state for an ideal gas. The results of this method are broadly in agreement with electromagnetic and Doppler measurements.

  19. Determination of Three-Dimensional Left Ventricle Motion to Analyze Ventricular Dyssyncrony in SPECT Images

    DEFF Research Database (Denmark)

    de Sá Rebelo, Marina; Aarre, Ann Kirstine Hummelgaard; Clemmesen, Karen-Louise

    2010-01-01

    A method to compute three-dimension (3D) left ventricle (LV) motion and its color coded visualization scheme for the qualitative analysis in SPECT images is proposed. It is used to investigate some aspects of Cardiac Resynchronization Therapy (CRT). The method was applied to 3D gated-SPECT images...... sets from normal subjects and patients with severe Idiopathic Heart Failure, before and after CRT. Color coded visualization maps representing the LV regional motion showed significant difference between patients and normal subjects. Moreover, they indicated a difference between the two groups...

  20. Measurements of the normal ventricles and cerebral cisterns of 100 adults with computed tomography

    International Nuclear Information System (INIS)

    Miyamoto, Kyoji

    1979-01-01

    The computed tomographical examinations of 100 patients with normal neurological findings including some volunteers between the ages of 20 to 68 years were evaluated. Measurements of various parts of the ventricular system on the polaroid pictures showed an increase with age and sexual difference. The lateral ventricles were found to be larger in the male in the female. Inverse cella media index, bifrontal cerebroventricular index and bicaudate cerebroventricular index were found to be reliable indicators of ventricular size, when the age and the sex is known. (author)

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

    Directory of Open Access Journals (Sweden)

    Bortolo Martini

    2015-01-01

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

  2. [The fourth horseman: The yellow fever].

    Science.gov (United States)

    Vallejos-Parás, Alfonso; Cabrera-Gaytán, David Alejandro

    2017-01-01

    Dengue virus three, Chikunguya and Zika have entered the national territory through the south of the country. Cases and outbreaks of yellow fever have now been identified in the Americas where it threatens to expand. Although Mexico has a robust epidemiological surveillance system for vector-borne diseases, our country must be alert in case of its possible introduction into the national territory. This paper presents theoretical assumptions based on factual data on the behavior of yellow fever in the Americas, as well as reflections on the epidemiological surveillance of vector-borne diseases.

  3. Affective Temporality: Towards a Fourth Wave

    Science.gov (United States)

    Chamberlain, Prudence

    2016-01-01

    This article considers the way in which the wave has been constructed as a negative means by which to understand feminism, making a case for reconceptualising the wave as an "affective temporality". Focusing on both feeling and historically specific forms of activism, the article suggests that the wave should not be considered as…

  4. Solar Energy Technologies Program Newsletter - Fourth Quarter 2009

    Energy Technology Data Exchange (ETDEWEB)

    DOE Solar Energy Technologies Program

    2009-12-31

    The Fourth Quarter 2009 edition of the Solar Energy Technologies Program newsletter summarizes the activities for the past three months, funding opportunities, highlights from the national labs, and upcoming events.

  5. Properties of bound states containing fourth family quarks

    International Nuclear Information System (INIS)

    Bashiry, V; Azizi, K; Sultansoy, S

    2012-01-01

    The heavy fourth generation of quarks that have sufficiently small mixing with the three known SM families form hadrons. In the present work, we calculate the masses and decay constants of mesons containing either both quarks from the fourth generation or one from fourth family and the other from observed SM quarks, namely charm or bottom quark, in the framework of the QCD sum rules. In the calculations, the two gluon condensate diagrams as nonperturbative contributions are taken into account. The obtained numerical results are reduced to the known masses and decay constants of the b-bar b and c-bar c quarkonia, when the fourth family quark is replaced by the bottom or charm quark.

  6. Foreword The fourth International Conference on Gravitation and ...

    Indian Academy of Sciences (India)

    The fourth International Conference on Gravitation and Cosmology (ICGC ... acknowledge the hard work put up by faculty members and students here at IIT, Kharagpur and, in particular, by Akhilesh Singh, without whom much of our success ...

  7. zimbabwean fourth social workers conference and winter school

    African Journals Online (AJOL)

    cswserver

    commercial 4.0 International License. ZIMBABWEAN FOURTH SOCIAL WORKERS CONFERENCE AND WINTER. SCHOOL. Noah Mudenda. The Council of Social Workers (CSW or Council) was established under the Social Workers Act 27:21 ...

  8. Oscillation criteria for fourth-order nonlinear delay dynamic equations

    Directory of Open Access Journals (Sweden)

    Yunsong Qi

    2013-03-01

    Full Text Available We obtain criteria for the oscillation of all solutions to a fourth-order nonlinear delay dynamic equation on a time scale that is unbounded from above. The results obtained are illustrated with examples

  9. Quasipotential in the fourth order of perturbation theory

    International Nuclear Information System (INIS)

    Bojkova, N.A.; Dvoeglazov, V.V.; Tyukhtyaev, Yu.N.; Faustov, R.N.

    1992-01-01

    The quasipotential in the fourth order of perturbation theory is calculated in the Coulomb gauge for the unequal mass particles. It could be used for the future calculations of energy spectra in two-body systems. 15 refs.; 1 fig

  10. Investing in self-reliance: IDRC's fourth annual public meeting ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-15

    Apr 15, 2016 ... Investing in self-reliance: IDRC's fourth annual public meeting ... to advance the Government of Canada's priorities in international development, in areas ... Flexible intellectual property rights lead to greater innovation in Africa.

  11. On a class of fourth order linear recurrence equations

    Directory of Open Access Journals (Sweden)

    Sui-Sun Cheng

    1984-01-01

    Full Text Available This paper is concerned with sequences that satisfy a class of fourth order linear recurrence equations. Basic properties of such sequences are derived. In addition, we discuss the oscillatory and nonoscillatory behavior of such sequences.

  12. Fourth Generation Warfare: The Need for a Comprehensive Approach

    National Research Council Canada - National Science Library

    Benton, LeRoy D

    2008-01-01

    .... A definition of Fourth Generation Warfare is developed, based on Col. Thomas X. Hammes' writings. The definition is further developed to show relevance and applicability to current operations in the Long War on Terrorism...

  13. Microcephaly-chorioretinopathy syndrome, autosomal recessive form. A case report

    Directory of Open Access Journals (Sweden)

    Rafael Fabiano Machado Rosa

    Full Text Available CONTEXT: The autosomal recessive form of microcephaly-chorioretinopathy syndrome is a rare genetic condition that is considered to be an important differential diagnosis with congenital toxoplasmosis.CASE REPORT: Our patient was a seven-year-old white boy who was initially diagnosed with congenital toxoplasmosis. However, his serological tests for congenital infections, including toxoplasmosis, were negative. He was the first child of young, healthy and consanguineous parents (fourth-degree relatives. The parents had normal head circumferences and intelligence. The patient presented microcephaly and specific abnormalities of the retina, with multiple diffuse oval areas of pigmentation and patches of chorioretinal atrophy associated with diffuse pigmentation of the fundus. Ophthalmological evaluations on the parents were normal. A computed tomography scan of the child's head showed slight dilation of lateral ventricles and basal cisterns without evidence of calcifications. We did not find any lymphedema in his hands and feet. He had postnatal growth retardation, severe mental retardation and cerebral palsy.CONCLUSIONS: The finding of chorioretinal lesions in a child with microcephaly should raise suspicions of the autosomal recessive form of microcephaly-chorioretinopathy syndrome, especially in cases with an atypical pattern of eye fundus and consanguinity. A specific diagnosis is essential for an appropriate clinical evaluation and for genetic counseling for the patients and their families.

  14. Right ventricle performances with echocardiography and 99mTc myocardial perfusion imaging in pulmonary arterial hypertension patients.

    Science.gov (United States)

    Liu, Jie; Fei, Lei; Huang, Guang-Qing; Shang, Xiao-Ke; Liu, Mei; Pei, Zhi-Jun; Zhang, Yong-Xue

    2018-05-01

    Right heart catheterization is commonly used to measure right ventricle hemodynamic parameters and is the gold standard for pulmonary arterial hypertension diagnosis; however, it is not suitable for patients' long-term follow-up. Non-invasive echocardiography and nuclear medicine have been applied to measure right ventricle anatomy and function, but the guidelines for the usefulness of clinical parameters remain to be established. The goal of this study is to identify reliable clinical parameters of right ventricle function in pulmonary arterial hypertension patients and analyze the relationship of these clinical parameters with the disease severity of pulmonary arterial hypertension. In this study, 23 normal subjects and 23 pulmonary arterial hypertension patients were recruited from January 2015 to March 2016. Pulmonary arterial hypertension patients were classified into moderate and severe pulmonary arterial hypertension groups according to their mean pulmonary arterial pressure levels. All the subjects were subjected to physical examination, chest X-ray, 12-lead electrocardiogram, right heart catheterization, two-dimensional echocardiography, and technetium 99m ( 99m Tc) myocardial perfusion imaging. Compared to normal subjects, the right heart catheterization indexes including right ventricle systolic pressure, right ventricle end diastolic pressure, pulmonary artery systolic pressure, pulmonary artery diastolic pressure, pulmonary vascular resistance, and right ventricle end systolic pressure increased in pulmonary arterial hypertension patients and were correlated with mean pulmonary arterial pressure levels. Echocardiography parameters, including tricuspid regurgitation peak velocity, tricuspid regurgitation pressure gradient, tricuspid annular plane systolic excursion and fractional area, right ventricle-myocardial performance index, were significantly associated with the mean pulmonary arterial pressure levels in pulmonary arterial hypertension patients

  15. Supernumerary maxillary and Mandibular Fourth Molars.

    Science.gov (United States)

    1981-09-23

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    Chatrchyan, Serguei; Sirunyan, Albert M; Tumasyan, Armen; Adam, Wolfgang; Aguilo, Ernest; Bergauer, Thomas; Dragicevic, Marko; Erö, Janos; Fabjan, Christian; Friedl, Markus; Fruehwirth, Rudolf; Ghete, Vasile Mihai; Hammer, Josef; Hörmann, Natascha; Hrubec, Josef; Jeitler, Manfred; Kiesenhofer, Wolfgang; Knünz, Valentin; Krammer, Manfred; Krätschmer, Ilse; Liko, Dietrich; Mikulec, Ivan; Pernicka, Manfred; Rahbaran, Babak; Rohringer, Christine; Rohringer, Herbert; Schöfbeck, Robert; Strauss, Josef; Taurok, Anton; Waltenberger, Wolfgang; Walzel, Gerhard; Widl, Edmund; Wulz, Claudia-Elisabeth; Mossolov, Vladimir; Shumeiko, Nikolai; Suarez Gonzalez, Juan; Bansal, Monika; Bansal, Sunil; Cornelis, Tom; De Wolf, Eddi A; Janssen, Xavier; Luyckx, Sten; Mucibello, Luca; Ochesanu, Silvia; Roland, Benoit; Rougny, Romain; Selvaggi, Michele; Staykova, Zlatka; Van Haevermaet, Hans; Van Mechelen, Pierre; Van Remortel, Nick; Van Spilbeeck, Alex; Blekman, Freya; Blyweert, Stijn; D'Hondt, Jorgen; Gonzalez Suarez, Rebeca; 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Zhokin, Alexander; Belyaev, Andrey; Boos, Edouard; Bunichev, Viacheslav; Dubinin, Mikhail; Dudko, Lev; Gribushin, Andrey; Klyukhin, Vyacheslav; Kodolova, Olga; Lokhtin, Igor; Markina, Anastasia; Obraztsov, Stepan; Perfilov, Maxim; Petrushanko, Sergey; Popov, Andrey; Sarycheva, Ludmila; Savrin, Viktor; Snigirev, Alexander; Andreev, Vladimir; Azarkin, Maksim; Dremin, Igor; Kirakosyan, Martin; Leonidov, Andrey; Mesyats, Gennady; Rusakov, Sergey V; Vinogradov, Alexey; Azhgirey, Igor; Bayshev, Igor; Bitioukov, Sergei; Grishin, Viatcheslav; Kachanov, Vassili; Konstantinov, Dmitri; Korablev, Andrey; Krychkine, Victor; Petrov, Vladimir; Ryutin, Roman; Sobol, Andrei; Tourtchanovitch, Leonid; Troshin, Sergey; Tyurin, Nikolay; Uzunian, Andrey; Volkov, Alexey; Adzic, Petar; Djordjevic, Milos; Ekmedzic, Marko; Krpic, Dragomir; Milosevic, Jovan; Aguilar-Benitez, Manuel; Alcaraz Maestre, Juan; Arce, Pedro; Battilana, Carlo; Calvo, Enrique; Cerrada, Marcos; Chamizo Llatas, Maria; Colino, Nicanor; De La Cruz, Begona; 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Mitselmakher, Guenakh; Muniz, Lana; Remington, Ronald; Rinkevicius, Aurelijus; Sellers, Paul; Skhirtladze, Nikoloz; Snowball, Matthew; Yelton, John; Zakaria, Mohammed; Gaultney, Vanessa; Hewamanage, Samantha; Lebolo, Luis Miguel; Linn, Stephan; Markowitz, Pete; Martinez, German; Rodriguez, Jorge Luis; Adams, Todd; Askew, Andrew; Bochenek, Joseph; Chen, Jie; Diamond, Brendan; Gleyzer, Sergei V; Haas, Jeff; Hagopian, Sharon; Hagopian, Vasken; Jenkins, Merrill; Johnson, Kurtis F; Prosper, Harrison; Veeraraghavan, Venkatesh; Weinberg, Marc; Baarmand, Marc M; Dorney, Brian; Hohlmann, Marcus; Kalakhety, Himali; Vodopiyanov, Igor; Adams, Mark Raymond; Anghel, Ioana Maria; Apanasevich, Leonard; Bai, Yuting; Bazterra, Victor Eduardo; Betts, Russell Richard; Bucinskaite, Inga; Callner, Jeremy; Cavanaugh, Richard; Evdokimov, Olga; Gauthier, Lucie; Gerber, Cecilia Elena; Hofman, David Jonathan; Khalatyan, Samvel; Lacroix, Florent; Malek, Magdalena; O'Brien, Christine; Silkworth, Christopher; Strom, Derek; 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Calvert, Brian; Eno, Sarah Catherine; Gomez, Jaime; Hadley, Nicholas John; Kellogg, Richard G; Kirn, Malina; Kolberg, Ted; Lu, Ying; Marionneau, Matthieu; Mignerey, Alice; Pedro, Kevin; Peterman, Alison; Skuja, Andris; Temple, Jeffrey; Tonjes, Marguerite; Tonwar, Suresh C; Twedt, Elizabeth; Apyan, Aram; Bauer, Gerry; Bendavid, Joshua; Busza, Wit; Butz, Erik; Cali, Ivan Amos; Chan, Matthew; Dutta, Valentina; Gomez Ceballos, Guillelmo; Goncharov, Maxim; Hahn, Kristan Allan; Kim, Yongsun; Klute, Markus; Krajczar, Krisztian; Li, Wei; Luckey, Paul David; Ma, Teng; Nahn, Steve; Paus, Christoph; Ralph, Duncan; Roland, Christof; Roland, Gunther; Rudolph, Matthew; Stephans, George; Stöckli, Fabian; Sumorok, Konstanty; Sung, Kevin; Velicanu, Dragos; Wenger, Edward Allen; Wolf, Roger; Wyslouch, Bolek; Yang, Mingming; Yilmaz, Yetkin; Yoon, Sungho; Zanetti, Marco; Cooper, Seth; Dahmes, Bryan; De Benedetti, Abraham; Franzoni, Giovanni; Gude, Alexander; Kao, Shih-Chuan; Klapoetke, Kevin; Kubota, Yuichi; Mans, Jeremy; Pastika, Nathaniel; Rusack, Roger; Sasseville, Michael; Singovsky, Alexander; Tambe, Norbert; Turkewitz, Jared; Cremaldi, Lucien Marcus; Kroeger, Rob; Perera, Lalith; Rahmat, Rahmat; Sanders, David A; Avdeeva, Ekaterina; Bloom, Kenneth; Bose, Suvadeep; Butt, Jamila; Claes, Daniel R; Dominguez, Aaron; Eads, Michael; Keller, Jason; Kravchenko, Ilya; Lazo-Flores, Jose; Malbouisson, Helena; Malik, Sudhir; Snow, Gregory R; Baur, Ulrich; Godshalk, Andrew; Iashvili, Ia; Jain, Supriya; Kharchilava, Avto; Kumar, Ashish; Shipkowski, Simon Peter; Smith, Kenneth; Alverson, George; Barberis, Emanuela; Baumgartel, Darin; Chasco, Matthew; Haley, Joseph; Nash, David; Trocino, Daniele; Wood, Darien; Zhang, Jinzhong; Anastassov, Anton; Kubik, Andrew; Mucia, Nicholas; Odell, Nathaniel; Ofierzynski, Radoslaw Adrian; Pollack, Brian; Pozdnyakov, Andrey; Schmitt, Michael Henry; Stoynev, Stoyan; Velasco, Mayda; Won, Steven; Antonelli, Louis; Berry, Douglas; Brinkerhoff, Andrew; Hildreth, Michael; 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Contreras-Campana, Emmanuel; Duggan, Daniel; Ferencek, Dinko; Gershtein, Yuri; Gray, Richard; Halkiadakis, Eva; Hidas, Dean; Lath, Amitabh; Panwalkar, Shruti; Park, Michael; Patel, Rishi; Rekovic, Vladimir; Robles, Jorge; Rose, Keith; Salur, Sevil; Schnetzer, Steve; Seitz, Claudia; Somalwar, Sunil; Stone, Robert; Thomas, Scott; Cerizza, Giordano; Hollingsworth, Matthew; Spanier, Stefan; Yang, Zong-Chang; York, Andrew; Eusebi, Ricardo; Flanagan, Will; Gilmore, Jason; Kamon, Teruki; Khotilovich, Vadim; Montalvo, Roy; Osipenkov, Ilya; Pakhotin, Yuriy; Perloff, Alexx; Roe, Jeffrey; Safonov, Alexei; Sakuma, Tai; Sengupta, Sinjini; Suarez, Indara; Tatarinov, Aysen; Toback, David; Akchurin, Nural; Damgov, Jordan; Dragoiu, Cosmin; Dudero, Phillip Russell; Jeong, Chiyoung; Kovitanggoon, Kittikul; Lee, Sung Won; Libeiro, Terence; Roh, Youn; Volobouev, Igor; Appelt, Eric; Delannoy, Andrés G; Florez, Carlos; Greene, Senta; Gurrola, Alfredo; Johns, Willard; Johnston, Cody; Kurt, Pelin; Maguire, Charles; Melo, Andrew; Sharma, Monika; Sheldon, Paul; Snook, Benjamin; Tuo, Shengquan; Velkovska, Julia; Arenton, Michael Wayne; Balazs, Michael; Boutle, Sarah; Cox, Bradley; Francis, Brian; Goodell, Joseph; Hirosky, Robert; Ledovskoy, Alexander; Lin, Chuanzhe; Neu, Christopher; Wood, John; Yohay, Rachel; Gollapinni, Sowjanya; Harr, Robert; Karchin, Paul Edmund; Kottachchi Kankanamge Don, Chamath; Lamichhane, Pramod; Sakharov, Alexandre; Anderson, Michael; Belknap, Donald; Borrello, Laura; Carlsmith, Duncan; Cepeda, Maria; Dasu, Sridhara; Friis, Evan; Gray, Lindsey; Grogg, Kira Suzanne; Grothe, Monika; Hall-Wilton, Richard; Herndon, Matthew; Hervé, Alain; Klabbers, Pamela; Klukas, Jeffrey; Lanaro, Armando; Lazaridis, Christos; Leonard, Jessica; Loveless, Richard; Mohapatra, Ajit; Ojalvo, Isabel; Palmonari, Francesco; Pierro, Giuseppe Antonio; Ross, Ian; Savin, Alexander; Smith, Wesley H; Swanson, Joshua

    2012-01-01

    Results are presented from a search for a fourth generation of quarks produced singly or in pairs in a data set corresponding to an integrated luminosity of 5 inverse femtobarns recorded by the CMS experiment at the LHC in 2011. A novel strategy has been developed for a combined search for quarks of the up- and down-type in decay channels with at least one isolated muon or electron. Limits on the mass of the fourth-generation quarks and the relevant CKM matrix elements are derived in the context of a simple extension of the standard model with a sequential fourth generation of fermions. The existence of mass-degenerate fourth-generation quarks with masses below 685 GeV is excluded at 95% confidence level for minimal off-diagonal mixing between the third- and the fourth-generation quarks. With a mass difference of 25 GeV between the quark masses, the obtained limit on the masses of the fourth-generation quarks shifts by about +/- 20 GeV. This result significantly reduces the allowed parameter space for a fourt...

  17. Diagnostic value of transient dilatation of the left ventricle in negative dipyridamole-thallium imaging

    International Nuclear Information System (INIS)

    Seo, Hiromi; Doi, Y.L.; Yonezawa, Yoshihiro; Chikamori, Taishiro; Yamada, Mitsutoshi; Ozawa, Toshio

    1994-01-01

    To evaluate the diagnostic value of a transient dilatation of the left ventricle during dipyridamole-thallium imaging (DTI) for detecting significant coronary artery disease (CAD) in patients with negative DTI results, 81 consecutive patients were studied. Twenty one patients (26%) had CAD and 60 patients had normal coronary anatomy (NCA). The initial/delayed ratio of the left ventricular dimension, which was measured as the distance between the 2 peaks of a count profile curve on a 45deg left anterior oblique planar image, was defined as the dilatation ratio (DR) of the left ventricle. Patients with CAD had a higher incidence of chest pain after dipyridamole infusion (35 vs 13%; p 1.03) when it was greater than the mean +2 standard deviations of the DR in NCA patients. Seventy-six percent of CAD patients had an abnormal DR. A stepwise discriminant analysis revealed that an abnormal DR alone had the same ability to predict CAD (sensitivity 76%, specificity 98%, chi-square 80.9, p 1.03) is a highly specific marker for detecting CAD, even in patients with negative dipyridamole-thallium imaging. (author)

  18. Challenges of management and therapy in patients with a functionally single ventricle after Fontan operation.

    Science.gov (United States)

    Trojnarska, Olga; Ciepłucha, Aleksandra

    2011-01-01

    Forty years ago, Fontan and Baudet performed the first life-saving operation on a patient with a functionally single ventricle. This multi-stage procedure established the connection between systemic venous circulation and pulmonary arteries. As a consequence, the pulmonary circulation is supplied in a passive way, whereas the single ventricle pumps the blood into the systemic circulation only. Over the years, the technique of creating the abovementioned vascular connections has undergone several modifications. Due to the fundamental non-physiological hemodynamic relations between arterial pulmonary and systemic venous pressures, numerous complications can be observed in these patients including: supraventricular arrhythmias, thromboemboli, hepatic dysfunction, protein-losing enteropathy, heart failure, worsening cyanosis, systemic venous collateralization, and pulmonary arteriovenous malformations, as well as connective tissue lesions in bronchi. Although based on an ingenious concept, the operation remains of a palliative character. Occasionally, heart transplantation is the ultimate resolution. Pharmacological therapy, and surgical conversion, often appear to be ineffective. However, this procedure has enabled many patients to reach adulthood and enjoy their lives to the full. This fact poses a great challenge for cardiologists wishing to become more knowledgeable and experienced as regards such patients, if we are not to waste such fabulous surgical achievements.

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

    Science.gov (United States)

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

    2017-02-01

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

  20. The benefit of image guidance for the contralateral interhemispheric approach to the lateral ventricle.

    Science.gov (United States)

    Fronda, Chiara; Miller, Dorothea; Kappus, Christoph; Bertalanffy, Helmut; Sure, Ulrich

    2008-06-01

    Recently, neurosurgeons have increasingly faced small intracerebral lesions in asymptomatic or minimally symptomatic patients. Here, we evaluated a series of four patients with nearly asymptomatic intraventricular tumors close to the corpus callosum that had been treated with the aid of an image-guided transcallosal approach. Four consecutive patients suffering from left intra- and paraventricular tumors were operated on via a contralateral interhemispheric transcallosal approach with the aid of neuronavigation. Our image-guided system directed: (1) the skin incision, (2) the interhemispheric dissection, and (3) the incision of the corpus callosum. Using the image-guided contralateral interhemispheric transcallosal approach to the left ventricle all lesions have been completely resected without the risk of damage to the dominant hemisphere. The callosal incision was kept as limited as possible (1.2-2.1cm) depending on the size of the tumor. No postoperative neurological or neuropsychological deficit was observed in our series. Neuronavigation facilitates a safe and targeted contralateral interhemispheric transcallosal approach to the dominant hemisphere's lateral ventricle. Our technique minimizes the risk of damage to the dominant hemisphere and requires only a limited opening of the corpus callosum, which might decrease the risk of neuropsychological morbidity.

  1. Greater ATP dependence than sodium dependence of radiocalcium efflux in bullfrog ventricle

    International Nuclear Information System (INIS)

    Brommundt, G.; Kavaler, F.

    1985-01-01

    45 Ca efflux was studied in intact bullfrog ventricles following a 2-h period of loading with radiocalcium-containing Ringer solution. The cannulated ventricle was placed in a closed air-filled container to which were applied rhythmic, electronically timed, positive- and negative-pressure pulsations, which induced ventricular volume excursions. The mechanical arrangement and timing circuitry made it possible for each period to be as short in duration as 15 s. By use of this technique, penetration of the extracellular space by [ 14 C]inulin was found to be complete within 30 s, and recovery of the inulin proceeded with a time constant of 17-24 s, indicating a completeness of recovery of 98% within 90 s. Washout of added 45 Ca was quantitatively quite close to that of inulin, and in addition the estimated rate of sequestration of the isotope was slow enough to introduce only a small error into the experimental results. 45 Ca efflux was only slightly (15%) sensitive to replacement of extracellular sodium but was profoundly sensitive to the inhibitors of ATP synthesis, cyanide and 2-deoxy-glucose

  2. Study on CT scanning technique of inferior horn of lateral ventricle

    International Nuclear Information System (INIS)

    Kakoi, Iwao; Okubo, Mitsuo; Nakamura, Sumio; Yoshinaga, Toshihiko; Shimono, Tetsuo

    1984-01-01

    It is said that temporal lobe epilepsy (TLE), one of the incurable epilepsies, results from the lesions of various structrues located in the medial and deep portion of the temporal lobe such as the hippocampus and amygdaloid nucleus. Routine CT scanning techniques cannot adequately delineate these structures in the assessment of TLE. The anatomical relationship between these medial temporal structures and the inferior horn of lateral ventricle which is lateral to them and easily identified by CT lead us to believe that the sections through the longitudinal plane of the inferior horn may clearly delineate them. The present experimental study was undertaken to develop the CT scan technique of the inferior horn of lateral ventricle, which results in the clear delineation of the region of the hippocampus and amygdaloid nucleus. As a result, A total of the 3-4 reversed axial 5 mm-thick section centered at 2.5 cm cephalad to the roof of the external auditory canal at a reversed 25 0 angle to ABL are adequate to delineate the inferior horn and the medial temporal structures. This scan technique is considered to be useful in the assessment of TLE. (author)

  3. Shape Optimization of the Assisted Bi-directional Glenn surgery for stage-1 single ventricle palliation

    Science.gov (United States)

    Verma, Aekaansh; Shang, Jessica; Esmaily-Moghadam, Mahdi; Wong, Kwai; Marsden, Alison

    2016-11-01

    Babies born with a single functional ventricle typically undergo three open-heart surgeries starting as neonates. The first of these stages (BT shunt or Norwood) has the highest mortality rates of the three, approaching 30%. Proceeding directly to a stage-2 Glenn surgery has historically demonstrated inadequate pulmonary flow (PF) & high mortality. Recently, the Assisted Bi-directional Glenn (ABG) was proposed as a promising means to achieve a stable physiology by assisting the PF via an 'ejector pump' from the systemic circulation. We present preliminary parametrization and optimization results for the ABG geometry, with the goal of increasing PF. To limit excessive pressure increases in the Superior Vena Cava (SVC), the SVC pressure is included as a constraint. We use 3-D finite element flow simulations coupled with a single ventricle lumped parameter network to evaluate PF & the pressure constraint. We employ a derivative free optimization method- the Surrogate Management Framework, in conjunction with the OpenDIEL framework to simulate multiple simultaneous evaluations. Results show that nozzle diameter is the most important design parameter affecting ABG performance. The application of these results to patient specific situations will be discussed. This work was supported by an NSF CAREER award (OCI1150184) and by the XSEDE National Computing Resource.

  4. Flow pattern in the ventricle of brain with cilia beating and CSF circulation

    Science.gov (United States)

    Wang, Yong; Westendorf, Christian; Faubel, Regina; Eichele, Gregor; Bodenschatz, Eberhard

    We recently discovered that cilia of the ventral third ventricle (v3V) of mammalian brain generate a complex flow network close to the wall. However, the flow pattern in the overall three dimensional v3V, especially under physiological condition, remains to be investigated. Computational fluid dynamics is arguably the best approach for such investigations. Several v3V geometries are reconstructed from different data for comparison study. The lattice Boltzmann method and immersed boundary method are used to reproduce the experimental set-up for an opened v3V firstly. The experimentally recorded cilia induced flow network is projected on the curved v3V wall. The flow maps obtained numerically at different heights from the v3V wall agree with the experimental data qualitatively. We then consider the entire v3V with ciliary flow network along the wall for boundary condition. Moreover, we add a time dependent flow rate to represent the CSF circulation, and study flow pattern in the ventricle. We thank the Max Planck Society (MPG) for financial support. This work is conducted within the Physics and Medicine Initiative at Goettingen Campus between MPG and University Medical Center.

  5. Epidemiological and morphological studies of double-chambered right ventricle in dogs.

    Science.gov (United States)

    Fukushima, Ryuji; Tanaka, Ryou; Suzuki, Shuji; Hamabe, Rina; Machida, Noboru; Nakao, Shu; Saida, Yuto; Takashima, Kazuaki; Matsumoto, Hirotaka; Koyama, Hidekazu; Hirose, Hisashi; Yamane, Yoshihisa

    2011-10-01

    The double-chambered right ventricle (DCRV) is a rare congenital cardiac disease in dogs, and its detailed epidemiological and morphological features are not clearly understood. By investigating the profile, clinical signs, and characteristics of examination findings of eleven dogs with DCRV by means of a retrospective study, we attempted to clarify the epidemiology and morphology of the condition. The study group consisted of nine males and two females. Breeds included Pug (n=3), Miniature Dachshund (n=1), French Bull-dog (n=1), Shiba (n=1), and Retrievers (n=5). The attachment site of the anomalous muscular bundle was continuous with the cardiac apex in nine dogs, and it was attached to the right ventricle free wall in the other two dogs. In dogs with DCRV, at least one of the following conditions was present concurrently: congenital or acquired tricuspid valve regurgitation (TR), ventricular septal defect, and atrial septal defect. Also, the pressure difference between the two chambers increased over time, and progressive right-sided heart failure was observed. In summary, DCRV occurs in small breeds of dog as well as in large breeds of dog and it may be more prevalent in males. The existence of two types of DCRV in dogs was established. Dog with DCRVs will have a high incidence of concurrent cardiac abnormalities. Concurrent TR may be either congenital or acquired. DCRV is a congenital disorder, but the clinical condition progresses as the dog develops.

  6. One-stage surgery for removal of intravascular leiomyomatosis extending to right ventricle.

    Science.gov (United States)

    Chiang, Ching-Shu; Chen, Po-Lin; Kuo, Tzu-Ting; Chen, I-Ming; Wu, Nai-Yuan; Chang, Hsiao-Huang

    2018-03-01

    Intravascular leiomyomatosis (IVL) is a rare nonmalignant tumor that can be fatal if untreated. A 49-year-old nulliparous Asian woman who underwent hysterectomy and left salpingo-oophorectomy for multiple uterine leiomyomas 18 months prior presented complaining of intermittent palpitation and chest tightness for approximately 1 month. Echocardiography revealed a large mobile tumor mass extending from the inferior vena cava (IVC) to the right atrium that partially obstructed IVC flow and tricuspid inflow. Thoracicabdominopelvic computed tomography revealed a left adnexal tumor (4.8 × 2.5 cm) causing intravascular obstruction extending from the left internal iliac vein to the IVC, right atrium, and right ventricle. IVL with right heart involvement INTERVENTIONS:: Under cardiopulmonary bypass, a one-stage surgery combining sternotomy and laparotomy was performed. The tumor was approached and extracted via sternotomy, and tumor detachment and removal of residual tumors was accomplished via laparotomy. A firm, smooth, and regularly shape tumor 15.5 × 5.5 × 2.5 in size was completely removed and histopathologically confirmed as IVL. The patient tolerated the surgical procedure well and no postoperative complication was noted. We describe a one-stage surgical approach to completely remove an IVL extending to the right ventricle.

  7. Primary hemochromatosis: anatomic and physiologic characteristics of the cardiac ventricles and their response to phlebotomy

    International Nuclear Information System (INIS)

    Dabestani, A.; Child, J.S.; Henze, E.; Perloff, J.K.; Schon, H.; Figueroa, W.G.; Schelbert, H.R.; Thessomboon, S.

    1984-01-01

    M-mode and 2-dimensional echocardiography and gated equilibrium blood pool imaging (rest and exercise) were used in 10 patients with primary hemochromatosis to characterize the spectrum of pathophysiologic abnormalities of the cardiac ventricles and to determine the response to chronic therapeutic phlebotomy. Dilated and restrictive cardiomyopathic patterns were identified in 1 patient each, but our data do not permit conclusions on when in the natural history a given pattern becomes overt. On entry into study, 3 patients had normal ventricles and 7 had ventricular abnormalities on echocardiography and blood pool angiography. In 2 of the latter patients, biventricular dysfunction and increased left ventricular (LV) mass normalized after phlebotomy; 1 patient achieved a normal LV response to exercise. Of the 4 patients with isolated abnormal LV ejection fraction responses to exercise, the EF normalized in 2 after phlebotomy. In 1 patient, isolated right ventricular enlargement and dysfunction (echocardiographic and radionuclide imaging) normalized after phlebotomy. Thus, primary hemochromatosis can effect LV and RV size and function; clinically occult cardiac involvement can be identified by echocardiography and equilibrium blood pool imaging; therapeutic phlebotomy can ameliorate or reverse the deleterious effects of excess cardiac iron deposition which appears to exert its harm, at least in part, by a mechanism other than irreversible connective tissue replacement

  8. Echocardiographic Classification and Surgical Approaches to Double-Outlet Right Ventricle for Great Arteries Arising Almost Exclusively from the Right Ventricle.

    Science.gov (United States)

    Pang, Kun-Jing; Meng, Hong; Hu, Sheng-Shou; Wang, Hao; Hsi, David; Hua, Zhong-Dong; Pan, Xiang-Bin; Li, Shou-Jun

    2017-08-01

    Selecting an appropriate surgical approach for double-outlet right ventricle (DORV), a complex congenital cardiac malformation with many anatomic variations, is difficult. Therefore, we determined the feasibility of using an echocardiographic classification system, which describes the anatomic variations in more precise terms than the current system does, to determine whether it could help direct surgical plans. Our system includes 8 DORV subtypes, categorized according to 3 factors: the relative positions of the great arteries (normal or abnormal), the relationship between the great arteries and the ventricular septal defect (committed or noncommitted), and the presence or absence of right ventricular outflow tract obstruction (RVOTO). Surgical approaches in 407 patients were based on their DORV subtype, as determined by echocardiography. We found that the optimal surgical management of patients classified as normal/committed/no RVOTO, normal/committed/RVOTO, and abnormal/committed/no RVOTO was, respectively, like that for patients with large ventricular septal defects, tetralogy of Fallot, and transposition of the great arteries without RVOTO. Patients with abnormal/committed/RVOTO anatomy and those with abnormal/noncommitted/RVOTO anatomy underwent intraventricular repair and double-root translocation. For patients with other types of DORV, choosing the appropriate surgical approach and biventricular repair techniques was more complex. We think that our classification system accurately groups DORV patients and enables surgeons to select the best approach for each patient's cardiac anatomy.

  9. [Clinical characteristics and surgical management in patients with third and fourth branchial anomalies].

    Science.gov (United States)

    Li, Y X; He, X G; Wang, Y; Yang, X

    2016-08-05

    Objective: To analysize the clinical characteristics as well as the effect and methods of the surgical treatment in patiets with the third and fourth branchial anomalies. Method: The clinical data of 25 patients diagnosed as third and fourth branchial cleft fistula by pathological method were analyzed retrospectively.Two of 25 patients had undergone fistulectomy simply.Based on the embryologicc and anatomic features of branchial anomalies,23 of 25 patients had received different types of selective neck dissection.All of lesions were confirmed as branchial cleft fistula by pathology.All patients were received the examinations of Esophagus myelography,MRI and CT preoperatively. Result: The features of the third and the fourth bianchial fistula were as following:most patients suffered from recurrent neck abscess and had undergone incision and drainage. Esophagus myelography and CT were important auxiliary examination for branchial anomalies.No recurrent and complications were found in all patients by using treatment of selective neck dissection (23/25 cases) and fistulectomy simply(2/25 cases) within 12 to 36 months following-up,postoperatively. Conclusion: Branchial anomalies is characterized by recurrent acute abscess,acute thyroiditis or fistula secretion inferior to neck.Complete removal of branchial lesions and inflammatory granuloma using selective neck dissection is a safty and effective treatment for recurrent branchial anomalies. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.

  10. Case report: microcephaly associated with Zika virus infection, Colombia.

    Science.gov (United States)

    Mattar, Salim; Ojeda, Carolina; Arboleda, Janna; Arrieta, German; Bosch, Irene; Botia, Ingrid; Alvis-Guzman, Nelson; Perez-Yepes, Carlos; Gerhke, Lee; Montero, German

    2017-06-13

    Recently there has been a large outbreak of Zika virus infections in Colombia, South America. The epidemic began in September 2015 and continued to April 2017, for the total number of Zika cases reported of 107,870. For those confirmed Zika cases, there were nearly 20,000 (18.5%) suspected to be pregnant women, resulting in 157 confirmed cases of microcephaly in newborns reported by their health government agency. There is a clear under-estimation of the total number of cases and in addition no prior publications have been published to demonstrate the clinical aspects of the Zika infection in Colombia. We characterized one Zika presentation to be able to compare and contrast with other cases of Zika infection already reported in the literature. In this case report, we demonstrate congenital microcephaly at week 19 of gestation in a 34-year-old mother who showed symptoms compatible with Zika virus infection from Sincelejo, State of Sucre, in the Colombian Caribbean. Zika virus RNA was detected in the placenta using real-time reverse transcriptase polymerase chain reaction (RT-PCR). At week 25, the fetus weigh estimate was 770 g, had a cephalic perimeter of 20.2 cm (5th percentile), ventriculomegaly on the right side and dilatation of the fourth ventricle. At week 32, the microcephaly was confirmed with a cephalic perimeter of 22 cm, dilatation of the posterior atrium to 13 mm, an abnormally small cerebellum (29 mm), and an augmented cisterna magna. At birth (39 weeks by cesarean section), the head circumference was 27.5 cm, and computerized axial tomography (Siemens Corp, 32-slides) confirmed microcephaly with calcifications. We report a first case of maternal Zika virus infection associated with fetal microcephaly in Colombia and confirmed similar presentation to those observed previous in Brazil, 2015-2016.

  11. Exploring a fourth dimension: spirituality as a resource for the couple therapist.

    Science.gov (United States)

    Anderson, D A; Worthen, D

    1997-01-01

    This article explores ways in which the therapist's own spirituality can serve as a resource in couple therapy. Spirituality is defined as subjective engagement with a fourth, transcendent dimension of human experience. This engagement enhances human life and evokes corresponding behavior. Spiritually based therapy may be influenced by three assumptions: that God or a Divine Being exists, that human-kind yearns innately for connection with this Being, and that this Being is interested in humans and acts upon and within their relationships to promote beneficial change. In therapy these assumptions affect how the therapist listens and responds throughout sessions. The authors incorporate a case example illustrating the application of this fourth dimension in couple therapy.

  12. CT diagnosis and clinical of leukoaraosis (with 145 cases report)

    International Nuclear Information System (INIS)

    Yang Minzheng

    2005-01-01

    Objective: To investigate pathogenesis of leukoaraosis, the correlation between CT presentation and clinical symptom and to provide useful evidence for clinical diagnosis and treatment. Methods: CT presentation and clinical symptoms in the Leukoaraosis of 145 cases were retrospectively analyzed. Results: Leukoaraosis manifested symmetrical hypo-dense lesion adjacent to frontal horn and/or occipital horn of bilateral ventricles; symmetrical hypo-dense peri-ventricle patches; or diffuse hypo-dense white matter. Lacunar infarction or hemorrhage of basal ganglion and/or thalamus may also be revealed. Conclusion: Leukoaraosis often involves the white matter adjacent to the frontal horn and occipital horn of bilateral ventricles. And entire peri-ventricle white matter may be affected in severe cases. The pathology of the disease is related to demyelination of brain white matter, resulting in the characteristic vascularity in white matter, which may alter under hypertension. (authors)

  13. Cirugía de tipo uno y medioventricular en la doble salida del ventrículo izquierdo One a half ventricular surgery type in the double outlet of left ventricle

    Directory of Open Access Journals (Sweden)

    Luis Marcano Sanz

    2012-03-01

    Full Text Available La doble salida del ventrículo izquierdo es muy poco frecuente, en la cual la aorta y la arteria pulmonar, emergen completa o predominantemente del ventrículo izquierdo. Cuando se acompañan de comunicación interventricular y de estenosis pulmonar la corrección se realiza usualmente con interposición de un conducto entre el ventrículo derecho y la arteria pulmonar. El objetivo del presente trabajo es presentar un caso tratado con cirugía de tipo uno y medio ventricular, pues, hasta donde conocemos, esta técnica no ha sido empleada en esta enfermedad para evitar el uso de conductos protésicos. Se reporta en una niña de 3 años de edad, a quien se le cerró la comunicación interventricular, se desconectó la arteria pulmonar del ventrículo izquierdo y se anastomosó al nuevo tracto de salida del ventrículo derecho, y se realizó derivación cavopulmonar parcial. Después de 6 años de seguimiento presenta buena evolución clínica, ecocardiográfica y capacidad funcional adecuada.The double outlet of the left ventricle is uncommon, where the aorta and the pulmonary artery emerge total or predominantly from the left ventricle. When they are accompanied of an interventricular communication and of pulmonary stenosis, the correction is usually carried out with the insertion of a conduct between the right ventricle and the pulmonary artery. The objective of present paper is to present a case treated with one half ventricular surgery type and ventricular medium, since until is known, this technique has not used in this disease to avoid the use of prosthetic conducts. Authors reports the case of a girl aged 3 undergoes the closure of the interventricular communication, switching off the pulmonary artery of the left ventricle and anastomosing it to the new outlet tract of right ventricle, carrying out a partial cavopulmonary bypass. After 6 years of follow-up she has a good clinical and echocardiographic evolution as well as a appropriate

  14. Interstage evaluation of homograft-valved right ventricle to pulmonary artery conduits for palliation of hypoplastic left heart syndrome.

    Science.gov (United States)

    Sandeep, Nefthi; Punn, Rajesh; Balasubramanian, Sowmya; Smith, Shea N; Reinhartz, Olaf; Zhang, Yulin; Wright, Gail E; Peng, Lynn F; Wise-Faberowski, Lisa; Hanley, Frank L; McElhinney, Doff B

    2018-04-01

    Palliation of hypoplastic left heart syndrome with a standard nonvalved right ventricle to pulmonary artery conduit results in an inefficient circulation in part due to diastolic regurgitation. A composite right ventricle pulmonary artery conduit with a homograft valve has a hypothetical advantage of reducing regurgitation, but may differ in the propensity for stenosis because of valve remodeling. This retrospective cohort study included 130 patients with hypoplastic left heart syndrome who underwent a modified stage 1 procedure with a right ventricle to pulmonary artery conduit from 2002 to 2015. A composite valved conduit (cryopreserved homograft valve anastomosed to a polytetrafluoroethylene tube) was placed in 100 patients (47 aortic, 32 pulmonary, 13 femoral/saphenous vein, 8 unknown), and a nonvalved conduit was used in 30 patients. Echocardiographic functional parameters were evaluated before and after stage 1 palliation and before the bidirectional Glenn procedure, and interstage interventions were assessed. On competing risk analysis, survival over time was better in the valved conduit group (P = .040), but this difference was no longer significant after adjustment for surgical era. There was no significant difference between groups in the cumulative incidence of bidirectional Glenn completion (P = .15). Patients with a valved conduit underwent more interventions for conduit obstruction in the interstage period, but this difference did not reach significance (P = .16). There were no differences between groups in echocardiographic parameters of right ventricle function at baseline or pre-Glenn. In this cohort of patients with hypoplastic left heart syndrome, inclusion of a valved right ventricle to pulmonary artery conduit was not associated with any difference in survival on adjusted analysis and did not confer an identifiable benefit on right ventricle function. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier

  15. Assessment of sistemic ventricle function in corrected transposition of great arteries with Gated SPECT: comparison with radionuclide ventriculography

    International Nuclear Information System (INIS)

    Alexanderson, E.; Espinola, N.; Duenas, D.; Fermon, S.; Acevedo, C.; Martinez, C.

    2002-01-01

    Corrected trasposition of great arteries is a uncommon congenital heart disease where the right ventricle works as the sistemic one. QGS Gated SPECT program was designed to recognize the contours of left ventricle being a good method to evaluate left ventricle ejection fraction. The purpose of this study was to evaluate the right ventricle ejection fraction (RVEF) by gated SPECT using Tc-99mSestaMIBI in comparison with radionuclide ventriculography (RVG) in patients with corrected trasposition of great arteries. Methods: We performed gated SPECT and radionuclide ventriculography within 15 days of each other in 7 adults consecutive patients with the diagnosis of corrected trasposition of great arteries (5 men, 2 women; mean age 47 y). Gated tomographic data, including ventricular volumes and ejection fraction, were processed using QGS automatic algorithm, whereas equilibrium radionuclide ventriculography used standard techniques. Results: We found a good correlation between right ventricle ejection fraction obtained with Gated SPECT compared with equilibrium radionuclide ventriculography. The mean of the RVEF with Gated SPECT was 41.2% compared with 44.2% of RVEF with equilibrium radionuclide ventriculography. Both methods recognized abnormal RVEF in 5 patients ( 50%) with Gated SPECT and abnormal with RVG meanwhile another patient had normal RVEF with RVG and abnormal with Gated SPECT. Conclusion: Quantitative gated tomography, using Tc 99mSestaMIBI, has a good correlation with radionuclide ventriculography for the assessment of right ventricle ejection fraction in patients with corrected trasposition of great arteries. These results support the clinical use of this technique among these patients

  16. Anatomical reconstruction of the fourth brachymetatarsia with one-stage iliac bone and cartilage cap grafting.

    Science.gov (United States)

    Woo, Sang Hyun; Bang, Chi Young; Ahn, Hee-Chan; Kim, Sung-Jung; Choi, Jun-Young

    2017-05-01

    We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis. The length of the harvested iliac bone graft was 22.9 mm on average. The mean fixation period was 58.5 days, and the mean gain in length and percentage increase was 20.9 mm and 39%, respectively. MRI showed a stable MTP joint over viable cartilage cap in 83.3% of the cases. Mean postoperative American Orthopedic Foot and Ankle Society lesser MTP-interphalangeal score was 82.0. Neither neurovascular impairment nor recurrence of brachymetatarsia occurred in the mean follow-up period of 43.6 months. All patients were satisfied with the postoperative cosmetic results. Thirteen patients (23.2%) complained of limited active dorsiflexion of the fourth toe, and extensor adhesion was released by extensor tenolysis in only one patient. In a single case of nonunion at the bone graft site, additional surgery was not necessary. Anatomical reconstruction of the fourth brachymetatarsia with one-stage interpositional iliac bone and cartilage cap grafting resulted in excellent cosmetic results and a physiologic MTP joint, providing the benefits of one-stage lengthening with a low complication rate. Therapeutic, IV. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Using the trans-lamina terminalis route via a pterional approach to resect a retrochiasmatic craniopharyngioma involving the third ventricle.

    Science.gov (United States)

    Weil, Alexander G; Robert, Thomas; Alsaiari, Sultan; Obaid, Sami; Bojanowski, Michel W

    2016-01-01

    Retrochiasmatic craniopharyngiomas involving the anterior third ventricle are challenging to access. Although the pterional approach is a common route for suprasellar lesions, when the craniopharyngioma extends behind the chiasma into the third ventricle, access is even more difficult, and the lamina terminalis may offer a good working window. The translamina terminalis approach provides direct access to the retrochiasmatic portion of the tumor with minimal brain retraction and no manipulation of the visual nerves. In this video, we emphasize the utility of using the lamina terminalis corridor to resect the retrochiasmatic intraventricular portion of a craniopharyngioma. The video can be found here: https://youtu.be/hrLNC0hDKe4 .

  18. One-and-a-half ventricular repair for isolated right ventricle metastatic tumor resection after lobectomy for lung cancer.

    Science.gov (United States)

    Shiose, Akira; Desai, Parag; Criner, Gerard J; Pai, Sheela; Steiner, Robert M; Kaiser, Larry R; Guy, T Sloane; Toyoda, Yoshiya

    2014-01-01

    A 77-year-old woman presented with shortness of breath 1 year after a right upper lobectomy for lung cancer. She showed a possible intracardiac metastasis on positron emission tomography scan. There was no other evidence of recurrence. The large right ventricular mass was associated with the right ventricle free wall, the apex, the papillary muscle, and the chordae to the tricuspid valve. After mass resection of the right ventricle, a one-and-a-half ventricular repair was performed with tricuspid valve replacement and defect closure. The patient was discharged on postoperative day 14 without complications and has been well for the first 3 months after the surgery.

  19. Evaluation of Ventricle Size Measurements in Infants by Pediatric Emergency Medicine Physicians.

    Science.gov (United States)

    Halm, Brunhild M; Leone, Tina A; Chaudoin, Lindsey T; McKinley, Kenneth W; Ruzal-Shapiro, Carrie; Franke, Adrian A; Tsze, Daniel S

    2018-06-05

    The identification of hydrocephalus in infants by pediatric emergency medicine (PEM) physicians using cranial point-of-care ultrasound (POCUS) has not been evaluated. We aimed to conduct a pilot/proof-of-concept study to evaluate whether PEM physicians can identify hydrocephalus (anterior horn width >5 mm) in 15 infants (mean 69 ± 42 days old) from the neonatal intensive care unit using POCUS. Our exploratory aims were to determine the test characteristics of cranial POCUS performed by PEM physicians for diagnosing hydrocephalus and the interrater reliability between measurements made by the PEM physicians and the radiologist. Depending on the availability, 1 or 2 PEM physicians performed a cranial POCUS through the open anterior fontanel for each infant after a 30-minute didactic lecture to determine the size of the left and right ventricles by measuring the anterior horn width at the foramen of Monroe in coronal view. Within 1 week, an ultrasound (US) technologist performed a cranial US and a radiologist determined the ventricle sizes from the US images; these measurements were the criterion standard. A radiologist determined 12 of the 30 ventricles as hydrocephalic. The sensitivity and specificity of the PEM physicians performed cranial POCUS was 66.7% (95% confidence interval [CI], 34.9%-90.1%) and 94.4% (95% CI, 72.7%-99.9%), whereas the positive and negative predictive values were 88.9% (95% CI, 53.3%-98.2%) and 81.0% (95% CI, 65.5%-90.5%), respectively. The interrater reliability between the PEM physician's and radiologist's measurements was r = 0.91. The entire POCUS examinations performed by the PEM physicians took an average of 1.5 minutes. The time between the cranial POCUS and the radiology US was, on average, 4 days. While the PEM physicians in our study were able to determine the absence of hydrocephalus in infants with high specificity using cranial POCUS, there was insufficient evidence to support the use of this modality for identifying

  20. Effects of early afterdepolarizations on excitation patterns in an accurate model of the human ventricles

    Science.gov (United States)

    Seemann, Gunnar; Panfilov, Alexander V.; Vandersickel, Nele

    2017-01-01

    Early Afterdepolarizations, EADs, are defined as the reversal of the action potential before completion of the repolarization phase, which can result in ectopic beats. However, the series of mechanisms of EADs leading to these ectopic beats and related cardiac arrhythmias are not well understood. Therefore, we aimed to investigate the influence of this single cell behavior on the whole heart level. For this study we used a modified version of the Ten Tusscher-Panfilov model of human ventricular cells (TP06) which we implemented in a 3D ventricle model including realistic fiber orientations. To increase the likelihood of EAD formation at the single cell level, we reduced the repolarization reserve (RR) by reducing the rapid delayed rectifier Potassium current and raising the L-type Calcium current. Varying these parameters defined a 2D parametric space where different excitation patterns could be classified. Depending on the initial conditions, by either exciting the ventricles with a spiral formation or burst pacing protocol, we found multiple different spatio-temporal excitation patterns. The spiral formation protocol resulted in the categorization of a stable spiral (S), a meandering spiral (MS), a spiral break-up regime (SB), spiral fibrillation type B (B), spiral fibrillation type A (A) and an oscillatory excitation type (O). The last three patterns are a 3D generalization of previously found patterns in 2D. First, the spiral fibrillation type B showed waves determined by a chaotic bi-excitable regime, i.e. mediated by both Sodium and Calcium waves at the same time and in same tissue settings. In the parameter region governed by the B pattern, single cells were able to repolarize completely and different (spiral) waves chaotically burst into each other without finishing a 360 degree rotation. Second, spiral fibrillation type A patterns consisted of multiple small rotating spirals. Single cells failed to repolarize to the resting membrane potential hence

  1. Fourth standard model family neutrino at future linear colliders

    International Nuclear Information System (INIS)

    Ciftci, A.K.; Ciftci, R.; Sultansoy, S.

    2005-01-01

    It is known that flavor democracy favors the existence of the fourth standard model (SM) family. In order to give nonzero masses for the first three-family fermions flavor democracy has to be slightly broken. A parametrization for democracy breaking, which gives the correct values for fundamental fermion masses and, at the same time, predicts quark and lepton Cabibbo-Kobayashi-Maskawa (CKM) matrices in a good agreement with the experimental data, is proposed. The pair productions of the fourth SM family Dirac (ν 4 ) and Majorana (N 1 ) neutrinos at future linear colliders with √(s)=500 GeV, 1 TeV, and 3 TeV are considered. The cross section for the process e + e - →ν 4 ν 4 (N 1 N 1 ) and the branching ratios for possible decay modes of the both neutrinos are determined. The decays of the fourth family neutrinos into muon channels (ν 4 (N 1 )→μ ± W ± ) provide cleanest signature at e + e - colliders. Meanwhile, in our parametrization this channel is dominant. W bosons produced in decays of the fourth family neutrinos will be seen in detector as either di-jets or isolated leptons. As an example, we consider the production of 200 GeV mass fourth family neutrinos at √(s)=500 GeV linear colliders by taking into account di-muon plus four jet events as signatures

  2. One and a half ventricle repair in association with tricuspid valve repair according to "peacock tail" technique in patients with Ebstein's malformation and failing right ventricle.

    Science.gov (United States)

    Prifti, Edvin; Baboci, Arben; Esposito, Giampiero; Kajo, Efrosina; Dado, Elona; Vanini, Vittorio

    2014-05-01

    The aim of this study was to evaluate the outcome in a series of patients with Ebstein's anomaly and a failing right ventricle (RV) undergoing tricuspid valve (TV) repair and bidirectional Glenn cavopulmonary anastomosis (BDG). Between January 2006 and September 2013, 11 consecutive patients diagnosed with severe forms of Ebstein's anomaly and a failing RV underwent TV surgery and BDG. The mean age was 16.5 ± 7 years. Most frequently found symptoms were cyanosis, dyspnea, and arrhythmias. The azygos or hemiazygos veins were left open. The TV was repaired using the "peacock tail" technique, which consisted of total detachment of the anterior and posterior leaflets of the TV and rotation in both directions reimplanting them to the true annulus. The mean follow-up was 3.8 ± 2.4 years (range three months to six years). Hospital mortality was 9% (one patient). TV repair was possible in 10 patients. None of the patients had AV block postoperatively. At one year after surgery, the indexed RV and RA diameter were reduced significantly versus the preoperative data (p = 0.003 and p TV area were 1.2 ± 0.42 and 1.6 ± 0.6 (mm/m2), significantly lower than preoperatively (p = 0.001 and p = 0.008, respectively). The mean NYHA functional class, SaO2 , and cardiothoracic ratio were significantly improved. The peacock tail technique for TV repair in combination with BDG in patients with Ebstein's malformation and depressed RV function results in TV preservation, a low incidence of recurrent regurgitation, favorable functional status and RV function, and resolution of cyanosis. © 2014 Wiley Periodicals, Inc.

  3. Living with half a heart - experiences of young adults with single ventricle physiology

    DEFF Research Database (Denmark)

    Overgaard, Dorthe; King, Catriona; Christensen, Rie F

    2013-01-01

    Background and Research Objective: Approximately 3% of children with congenital heart disease born in Denmark have single ventricle physiology (SVP). In previous decades, these children did not survive into adulthood. However, because of new surgical techniques and improved medical care, they now...... have a 90% survival rate. Several studies have described the somatic status of SVP patients using clinical parameters; however, only a few studies have researched the life perspectives and coping skills in this patient group. The aim of this study was to investigate how young adults with an SVP...... diagnosis are coping with adulthood and the emotional experiences of daily life. Subjects and Methods: Semistructured, qualitative interviews were held with 11 SVP respondents, selected by physical and psychological parameters identified in an earlier quantitative study. Data from the interviews were...

  4. Types of Diastolic Dysfunction of the Left Ventricle in Adolescents with Myocardial Pathology

    Directory of Open Access Journals (Sweden)

    L.F. Bogmat

    2014-05-01

    Full Text Available In adolescents with myocardial pathology during isometric tests we detected three types of diastolic dysfunction of the left ventricle (LV of the heart, depending on E/A ratio. The most pronounced signs of diastolic filling disorders were detected in the third group of patients, as evidenced: by a tendency to increase isovolumic relaxation time, a significant increase of slowing down time of the first phase of left ventricular filling, reduced LV filling rate both in the first phase of the passive filling and the second phase of active LV filling, increasing E/A ratio of more than 2, significant dilation of the left atrium, as well as positive increase in diastolic reserve that confirms deeper diastolic dysfunction in these adolescents compared with other subgroups.

  5. Deconvolving out indicator smearing in the right ventricle facilities left-to-right shunt quantitation

    International Nuclear Information System (INIS)

    Eterovic, D.; Popovic, S.; Dujic, Z.

    1994-01-01

    A simple algorithm is developed to enhance the resolution of components of multimodal pulmonary radiohistogram. Based on the assessed right ventricular ejection fraction (RVEF), it deconvolves out the effect of indicator smearing in the right ventricle on the heart rate samples of the pulmonary radiohistogram, c k . The output is the ideal curve, c k =c k /RVEF-(1-EF)xC k-1 /RVEF, that would be obtained if RVEF equalled unity. Since the formula is not a recursive one it does not suffer from error propagation pertinent to numerical deconvolution. Once RVEF is known, implementation of the algorithm is trivial. If RVEF is not known accurately it may be replaced with its upper estimate, RVEF upp > RVEF, yielding a partial deconvolution of the curve. When applied to patients with left-to-right shunt the method improves the accuracy and lessens the interobserver variation of the Maltz-Treves method. (author)

  6. Double-chambered right ventricle, ventricular septal defect, patent ductus arteriosus in a dog

    Energy Technology Data Exchange (ETDEWEB)

    Morozumi, M. [Togasaki Animal Hospital, Misato, Saitama (Japan); Kurosu, Y.; Kogure, K.; Chimura, S.; Shibata, S.; Kanemoto, I.

    1989-12-15

    A 4-month-old female mongrel puppy was presented with an anophthalmos. On physical examination, systolic murmur was heard at the 4th left intercostal space near the sternum. However the dog appeared healthy without cyanosis and had no history of exercise intolerance. The phonocardiogram revealed a pansystolic murmur and a continuous murmur on the mitral area. A systolic ejection murmur was also recorded on the pulmonic area. The electrocardiogram indicated bi-ventricular hypertrophy. Left ventricular enlargement was seen on chest radiographs. Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) were diagnosed from these findings. PDA closure was performed at 2 years of age. After 2 months from the operation, the dog died during an attempted repair of the VSD. At necropsy, it was found that the double-chambered right ventricle (DCRV) was formed by an anomalous septal band. The VSD was localized on the proximal conus and was 8 mm in diameter. (author)

  7. Double-chambered right ventricle, ventricular septal defect, patent ductus arteriosus in a dog

    International Nuclear Information System (INIS)

    Morozumi, M.; Kurosu, Y.; Kogure, K.; Chimura, S.; Shibata, S.; Kanemoto, I.

    1989-01-01

    A 4-month-old female mongrel puppy was presented with an anophthalmos. On physical examination, systolic murmur was heard at the 4th left intercostal space near the sternum. However the dog appeared healthy without cyanosis and had no history of exercise intolerance. The phonocardiogram revealed a pansystolic murmur and a continuous murmur on the mitral area. A systolic ejection murmur was also recorded on the pulmonic area. The electrocardiogram indicated bi-ventricular hypertrophy. Left ventricular enlargement was seen on chest radiographs. Ventricular septal defect (VSD) and patent ductus arteriosus (PDA) were diagnosed from these findings. PDA closure was performed at 2 years of age. After 2 months from the operation, the dog died during an attempted repair of the VSD. At necropsy, it was found that the double-chambered right ventricle (DCRV) was formed by an anomalous septal band. The VSD was localized on the proximal conus and was 8 mm in diameter. (author)

  8. Endoventricular Deep Brain Stimulation of the Third Ventricle: Proof of Concept and Application to Cluster Headache.

    Science.gov (United States)

    Chabardès, Stéphan; Carron, Romain; Seigneuret, Eric; Torres, Napoleon; Goetz, Laurent; Krainik, Alexandre; Piallat, Brigitte; Pham, Pascale; David, Olivier; Giraud, Pierrick; Benabid, Alim Louis

    2016-12-01

    The third ventricle (3rd V) is surrounded by centers related to satiety, homeostasis, hormones, sleep, memory, and pain. Stimulation of the wall of the 3rd V could be useful to treat disorders related to dysfunction of the hypothalamus. To assess safety and efficacy of endoventricular electrical stimulation of the hypothalamus using a floating deep brain stimulation (DBS) lead laid on the floor of the 3rd V to treat refractory cluster headaches (CH). Seven patients, aged 24 to 60 years, experiencing chronic CH (mean chronic duration 5.8 ± 2.5 years) were enrolled in this pilot, prospective, open study assessing the safety and potential efficacy of chronic DBS of the 3rd V. Number of attacks was collected during baseline and was compared with those occurring at 3, 6, and 12 months postoperation. Any side effects that occurred during or after surgery were reported. Effect on mood was assessed using the Hospital Anxiety and Depression scale during baseline and at 6 and 12 months postoperation. Insertion of the lead into the posterior 3rd V and chronic stimulation was feasible and safe in all patients. The voltage ranged from 0.9 to 2.3 volts. The most common side effect was transient trembling vision during stimulation. At 12 months, 3 of 7 patients were pain free, 2 had 90% improvement, 1 of 7 had 75% improvement, and 1 of 7 was not significantly improved. This proof of concept demonstrates the feasibility, safety, and potential efficacy of 3rd V DBS using an endoventricular road that could be applied to treat various diseases involving hypothalamic areas. CCH, chronic cluster headacheCH, cluster headacheDBS, deep brain stimulationHAD, hospital anxiety depressionONS, occipital nerve stimulationPAG, periaqueductal gray matterPH, posterior hypothalamusPVG, periventricular gray matter3rd V, third ventricle.

  9. Coronal MRI in the diagnosis of corona radiata infarcts adjacent to the lateral ventricles

    Energy Technology Data Exchange (ETDEWEB)

    Iwamoto, Toshihiko; Abe, Shin-e; Kanaya, Kiyoshi; Kubo, Hideki; Takasaki, Masaru (Tokyo Medical Coll. (Japan))

    1992-04-01

    To clarify pathophysiology of vascular lesions in corona radiata infarcts adjacent to the body of the lateral ventricle (CRILV), 17 patients with CRILV were studied by using magnetic resonance (MR) imaging. Based on the coronal MR images obtained between the anterior and posterior commissures, the patients were divided into two groups: (I) the group having infarcts below a line extending from the upper edge of the insular cistern to the external angle of the lateral ventricle adjacent to the corpus callosum (n=11); and (II) the group having lesions above the line towards the centrum semiovale (n=6). Most of the patients in both groups were male and had hypertension. Symptoms were gradually deteriorated and stroke in the morning was frequent in both groups, althrough the time from onset to completion was longer in Group II than Group I. In comparing clinical manifestations in Groups I and II, pure motor hemiparesis was found in 5 and 3 patients, and sensorimotor stroke in 2 and one patients, respectively. Drowsiness was found in 2 for Group I, while aphasia occurred in 2 for Group II. In addition, pseudobular and asymptomatic palsy occurred in each one patient for Group I. Prognosis was favorable in both groups, except for 2 who died of aspiration pneumonia. In Group I, 11 infarcts were well-defined, less than 15 mm in diameter on CT scans and were sclerotic in the main arteries without obstruction on angiograms. In contrast, Group II had ill-defined, larger low-density areas on CT scans and trunk obstruction of the internal carotid or middle cerebral arteries on angiograms. SPECT scans showed diffuse defect in Group II, in contrast to normal to diffuse or multiple defects in Group I. In Group I, lacunar lesions seemed to be caused by ischemia of the perforators, and in Group II, terminal zone infarcts in the territory of the cortical branches or watershed infarcts seemd to be caused by main trunk obstruction. (N.K.).

  10. Patient-specific parameter estimation in single-ventricle lumped circulation models under uncertainty

    Science.gov (United States)

    Schiavazzi, Daniele E.; Baretta, Alessia; Pennati, Giancarlo; Hsia, Tain-Yen; Marsden, Alison L.

    2017-01-01

    Summary Computational models of cardiovascular physiology can inform clinical decision-making, providing a physically consistent framework to assess vascular pressures and flow distributions, and aiding in treatment planning. In particular, lumped parameter network (LPN) models that make an analogy to electrical circuits offer a fast and surprisingly realistic method to reproduce the circulatory physiology. The complexity of LPN models can vary significantly to account, for example, for cardiac and valve function, respiration, autoregulation, and time-dependent hemodynamics. More complex models provide insight into detailed physiological mechanisms, but their utility is maximized if one can quickly identify patient specific parameters. The clinical utility of LPN models with many parameters will be greatly enhanced by automated parameter identification, particularly if parameter tuning can match non-invasively obtained clinical data. We present a framework for automated tuning of 0D lumped model parameters to match clinical data. We demonstrate the utility of this framework through application to single ventricle pediatric patients with Norwood physiology. Through a combination of local identifiability, Bayesian estimation and maximum a posteriori simplex optimization, we show the ability to automatically determine physiologically consistent point estimates of the parameters and to quantify uncertainty induced by errors and assumptions in the collected clinical data. We show that multi-level estimation, that is, updating the parameter prior information through sub-model analysis, can lead to a significant reduction in the parameter marginal posterior variance. We first consider virtual patient conditions, with clinical targets generated through model solutions, and second application to a cohort of four single-ventricle patients with Norwood physiology. PMID:27155892

  11. Intracellular calcium and the mechanism of anodal supernormal excitability in langendorff perfused rabbit ventricles.

    Science.gov (United States)

    Joung, Boyoung; Park, Hyung-Wook; Maruyama, Mitsunori; Tang, Liang; Song, Juan; Han, Seongwook; Piccirillo, Gianfranco; Weiss, James N; Lin, Shien-Fong; Chen, Peng-Sheng

    2011-01-01

    Anodal stimulation hyperpolarizes the cell membrane and increases the intracellular Ca(2+) (Ca(i)) transient. This study tested the hypothesis that the maximum slope of the Ca(i) decline (-(dCa(i)/dt)(max)) corresponds to the timing of anodal dip on the strength-interval curve and the initiation of repetitive responses and ventricular fibrillation (VF) after a premature stimulus (S(2)). We simultaneously mapped the membrane potential (V(m)) and Ca(i) in 23 rabbit ventricles. A dip in the anodal strength-interval curve was observed. During the anodal dip, ventricles were captured by anodal break excitation directly under the S(2) electrode. The Ca(i) following anodal stimuli is larger than that following cathodal stimuli. The S(1)-S(2) intervals of the anodal dip (203±10 ms) coincided with the -(dCa(i)/dt)(max) (199±10 ms, P=NS). BAPTA-AM (n=3), inhibition of the electrogenic Na(+)-Ca(2+) exchanger current (I(NCX)) by low extracellular Na(+) (n=3), and combined ryanodine and thapsigargin infusion (n=2) eliminated the anodal supernormality. Strong S(2) during the relative refractory period (n=5) induced 29 repetitive responses and 10 VF episodes. The interval between S(2) and the first non-driven beat was coincidental with the time of -(dCa(i)/dt)(max). Larger Ca(i) transient and I(NCX) activation induced by anodal stimulation produces anodal supernormality. The time of maximum I(NCX) activation is coincidental to the induction of non-driven beats from the Ca(i) sinkhole after a strong premature stimulation. All rights are reserved to the Japanese Circulation Society.

  12. Echocardiographic right ventricle longitudinal contraction indices cannot predict ejection fraction in post-operative Fallot children.

    Science.gov (United States)

    Bonnemains, Laurent; Stos, Bertrand; Vaugrenard, Thibaud; Marie, Pierre-Yves; Odille, Freddy; Boudjemline, Younes

    2012-03-01

    To examine in a population of post-operative tetralogy of Fallot patients, the correlation between right ventricle (RV) ejection fractions (EF) computed from magnetic resonance imaging (MRI) and three echocardiographic indices of RV function: TAPSE, longitudinal strain and strain rate. Indeed, these patients present a pulmonary regurgitation which is responsible for progressive dilatation of the RV. An echocardiographic assessment of the RV function would be very useful in determining the timing of pulmonary revalvulation for Fallot patients. However, these indices are generally based on the ventricle contraction in the long axis direction which is impaired in this population and does not seem to correlate with the EF. Thirty-five post-operative tetralogy of Fallot patients and 20 patients with normal RVs were included. In both groups, RVEF, assessed by MRI, was compared with the three echocardiographic indices. Longitudinal strain and strain rates were computed both on the free wall and on the whole RV. No correlation was found between the echocardiographic indices and the MRI EF in our Fallot population. The accuracy of those indices as a diagnostic test of an altered RV was low with Younden's indices varying from -0.18 to 0.5 and areas under the Receiver Operating Characterictic (ROC) curves equal to 0.54 for tricuspid annulus plane systolic excursion, 0.59-0.62 for strain and 0.57-0.63 for strain rate. Three conventional echocardiographic indices based on RV longitudinal contraction failed to assess the EF in our population of post-operative tetralogy of Fallot patients.

  13. Repeated restraint stress lowers the threshold for response to third ventricle CRF administration.

    Science.gov (United States)

    Harris, Ruth B S

    2017-03-01

    Rats and mice exposed to repeated stress or a single severe stress exhibit a sustained increase in energetic, endocrine, and behavioral response to subsequent novel mild stress. This study tested whether the hyper-responsiveness was due to a lowered threshold of response to corticotropin releasing factor (CRF) or an exaggerated response to a standard dose of CRF. Male Sprague-Dawley rats were subjected to 3h of restraint on each of 3 consecutive days (RRS) or were non-restrained controls. RRS caused a temporary hypophagia but a sustained reduction in body weight. Eight days after the end of restraint, rats received increasing third ventricle doses of CRF (0-3.0μg). The lowest dose of CRF (0.25μg) increased corticosterone release in RRS, but not control rats. Higher doses caused the same stimulation of corticosterone in the two groups of rats. Fifteen days after the end of restraint, rats were food deprived during the light period and received increasing third ventricle doses of CRF at the start of the dark period. The lowest dose of CRF inhibited food intake during the first hour following infusion in RRS, but not control rats. All other doses of CRF inhibited food intake to the same degree in both RRS and control rats. The lowered threshold of response to central CRF is consistent with the chronic hyper-responsiveness to CRF and mild stress in RRS rats during the post-restraint period. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. A mathematical model for active contraction in healthy and failing myocytes and left ventricles.

    Directory of Open Access Journals (Sweden)

    Li Cai

    Full Text Available Cardiovascular disease is one of the leading causes of death worldwide, in particular myocardial dysfunction, which may lead to heart failure eventually. Understanding the electro-mechanics of the heart will help in developing more effective clinical treatments. In this paper, we present a multi-scale electro-mechanics model of the left ventricle (LV. The Holzapfel-Ogden constitutive law was used to describe the passive myocardial response in tissue level, a modified Grandi-Pasqualini-Bers model was adopted to model calcium dynamics in individual myocytes, and the active tension was described using the Niederer-Hunter-Smith myofilament model. We first studied the electro-mechanics coupling in a single myocyte in the healthy and diseased left ventricle, and then the single cell model was embedded in a dynamic LV model to investigate the compensation mechanism of LV pump function due to myocardial dysfunction caused by abnormality in cellular calcium dynamics. The multi-scale LV model was solved using an in-house developed hybrid immersed boundary method with finite element extension. The predictions of the healthy LV model agreed well with the clinical measurements and other studies, and likewise, the results in the failing states were also consistent with clinical observations. In particular, we found that a low level of intracellular Ca2+ transient in myocytes can result in LV pump function failure even with increased myocardial contractility, decreased systolic blood pressure, and increased diastolic filling pressure, even though they will increase LV stroke volume. Our work suggested that treatments targeted at increased contractility and lowering the systolic blood pressure alone are not sufficient in preventing LV pump dysfunction, restoring a balanced physiological Ca2+ handling mechanism is necessary.

  15. Measurement of Strain in the Left Ventricle during Diastole withcine-MRI and Deformable Image Registration

    Energy Technology Data Exchange (ETDEWEB)

    Veress, Alexander I.; Gullberg, Grant T.; Weiss, Jeffrey A.

    2005-07-20

    The assessment of regional heart wall motion (local strain) can localize ischemic myocardial disease, evaluate myocardial viability and identify impaired cardiac function due to hypertrophic or dilated cardiomyopathies. The objectives of this research were to develop and validate a technique known as Hyperelastic Warping for the measurement of local strains in the left ventricle from clinical cine-MRI image datasets. The technique uses differences in image intensities between template (reference) and target (loaded) image datasets to generate a body force that deforms a finite element (FE) representation of the template so that it registers with the target image. To validate the technique, MRI image datasets representing two deformation states of a left ventricle were created such that the deformation map between the states represented in the images was known. A beginning diastoliccine-MRI image dataset from a normal human subject was defined as the template. A second image dataset (target) was created by mapping the template image using the deformation results obtained from a forward FE model of diastolic filling. Fiber stretch and strain predictions from Hyperelastic Warping showed good agreement with those of the forward solution. The technique had low sensitivity to changes in material parameters, with the exception of changes in bulk modulus of the material. The use of an isotropic hyperelastic constitutive model in the Warping analyses degraded the predictions of fiber stretch. Results were unaffected by simulated noise down to an SNR of 4.0. This study demonstrates that Warping in conjunction with cine-MRI imaging can be used to determine local ventricular strains during diastole.

  16. Scaling, Similarity, and the Fourth Paradigm for Hydrology

    Science.gov (United States)

    Peters-Lidard, Christa D.; Clark, Martyn; Samaniego, Luis; Verhoest, Niko E. C.; van Emmerik, Tim; Uijlenhoet, Remko; Achieng, Kevin; Franz, Trenton E.; Woods, Ross

    2017-01-01

    In this synthesis paper addressing hydrologic scaling and similarity, we posit that roadblocks in the search for universal laws of hydrology are hindered by our focus on computational simulation (the third paradigm), and assert that it is time for hydrology to embrace a fourth paradigm of data-intensive science. Advances in information-based hydrologic science, coupled with an explosion of hydrologic data and advances in parameter estimation and modelling, have laid the foundation for a data-driven framework for scrutinizing hydrological scaling and similarity hypotheses. We summarize important scaling and similarity concepts (hypotheses) that require testing, describe a mutual information framework for testing these hypotheses, describe boundary condition, state flux, and parameter data requirements across scales to support testing these hypotheses, and discuss some challenges to overcome while pursuing the fourth hydrological paradigm. We call upon the hydrologic sciences community to develop a focused effort towards adopting the fourth paradigm and apply this to outstanding challenges in scaling and similarity.

  17. IEC Newsletter, No. 46, Fourth Quarter 2013

    International Nuclear Information System (INIS)

    2014-02-01

    ConvEx exercises (Convention Exercises) are prepared for Member States and relevant international organizations by the IAEA under the framework of the Convention on Early Notification of a Nuclear Accident and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency. These exercises are carried out at three levels of complexity with the third level (ConvEx-3) being a full scale exercise prepared every three to five years within the Inter-Agency Committee on Radiological and Nuclear Emergencies (IACRNE), which comprises 17 international intergovernmental organizations. ConvEx-3 (2013), code-named 'Bab Al Maghrib', was hosted by Morocco and designed to allow Member States and international organizations to evaluate their response in a severe radiological emergency triggered by a nuclear security event and to identify emergency preparedness and response (EPR) areas requiring improvements. The exercise was conducted on 20 and 21 November 2013 and lasted approximately 25 hours. Fifty-nine Member States (including Morocco) and ten international organizations (including the IAEA) participated in the exercise. Twenty-four of the participating Member States and six of the international organizations participated in the exercise at the highest level possible (Level B) to actively test their EPR arrangements and capabilities for responding to such an event, and to test the sharing and exchange of information internationally. During the exercise, several Member States actively offered their national assistance capabilities to the exercise Accident State (Morocco). It was the first time in the history of ConvEx-3 exercises that country specific injects were prepared in a way that required specific Member State responses. The active participation of relevant international organizations (including INTERPOL and EUROPOL), information sharing, response coordination and sharing public updates among press officers of these organizations contributed to a

  18. IEC Newsletter, No. 46, Fourth Quarter 2013

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-02-15

    ConvEx exercises (Convention Exercises) are prepared for Member States and relevant international organizations by the IAEA under the framework of the Convention on Early Notification of a Nuclear Accident and the Convention on Assistance in the Case of a Nuclear Accident or Radiological Emergency. These exercises are carried out at three levels of complexity with the third level (ConvEx-3) being a full scale exercise prepared every three to five years within the Inter-Agency Committee on Radiological and Nuclear Emergencies (IACRNE), which comprises 17 international intergovernmental organizations. ConvEx-3 (2013), code-named 'Bab Al Maghrib', was hosted by Morocco and designed to allow Member States and international organizations to evaluate their response in a severe radiological emergency triggered by a nuclear security event and to identify emergency preparedness and response (EPR) areas requiring improvements. The exercise was conducted on 20 and 21 November 2013 and lasted approximately 25 hours. Fifty-nine Member States (including Morocco) and ten international organizations (including the IAEA) participated in the exercise. Twenty-four of the participating Member States and six of the international organizations participated in the exercise at the highest level possible (Level B) to actively test their EPR arrangements and capabilities for responding to such an event, and to test the sharing and exchange of information internationally. During the exercise, several Member States actively offered their national assistance capabilities to the exercise Accident State (Morocco). It was the first time in the history of ConvEx-3 exercises that country specific injects were prepared in a way that required specific Member State responses. The active participation of relevant international organizations (including INTERPOL and EUROPOL), information sharing, response coordination and sharing public updates among press officers of these organizations contributed to a

  19. Search for fourth sound propagation in supersolid 4He

    International Nuclear Information System (INIS)

    Aoki, Y.; Kojima, H.; Lin, X.

    2008-01-01

    A systematic study is carried out to search for fourth sound propagation solid 4 He samples below 500 mK down to 40 mK between 25 and 56 bar using the techniques of heat pulse generator and titanium superconducting transition edge bolometer. If solid 4 He is endowed with superfluidity below 200 mK, as indicated by recent torsional oscillator experiments, theories predict fourth sound propagation in such a supersolid state. If found, fourth sound would provide convincing evidence for superfluidity and a new tool for studying the new phase. The search for a fourth sound-like mode is based on the response of the bolometers to heat pulses traveling through cylindrical samples of solids grown with different crystal qualities. Bolometers with increasing sensitivity are constructed. The heater generator amplitude is reduced to the sensitivity limit to search for any critical velocity effects. The fourth sound velocity is expected to vary as ∞ √ Ρ s /ρ. Searches for a signature in the bolometer response with such a characteristic temperature dependence are made. The measured response signal has not so far revealed any signature of a new propagating mode within a temperature excursion of 5 μK from the background signal shape. Possible reasons for this negative result are discussed. Prior to the fourth sound search, the temperature dependence of heat pulse propagation was studied as it transformed from 'second sound' in the normal solid 4 He to transverse ballistic phonon propagation. Our work extends the studies of [V. Narayanamurti and R. C. Dynes, Phys. Rev. B 12, 1731 (1975)] to higher pressures and to lower temperatures. The measured transverse ballistic phonon propagation velocity is found to remain constant (within the 0.3% scatter of the data) below 100 mK at all pressures and reveals no indication of an onset of supersolidity. The overall dynamic thermal response of solid to heat input is found to depend strongly on the sample preparation procedure

  20. Long term follow up after surgery in congenitally corrected transposition of the great arteries with a right ventricle in the systemic circulation

    NARCIS (Netherlands)

    A.J.J.C. Bogers (Ad); S.J. Head (Stuart); P.L. de Jong (Peter); M. Witsenburg (Maarten); A.P. Kappetein (Arie Pieter)

    2010-01-01

    textabstractAim of the study: To investigate the long-term outcome of surgical treatment for congenitally corrected transposition of the great arteries (CCTGA), in patients with biventricular repair with the right ventricle as systemic ventricle.Methods: A total of 32 patients with CCTGA were

  1. A case of acute lymphoblastic leukemia with an intracerebellar mass

    International Nuclear Information System (INIS)

    Oshima, Yukio; Shitara, Toshiji; Kuribayashi, Toshio; Noji, Takashi; Kuroume, Takayoshi

    1983-01-01

    A 3-year-old boy, who had a complaint of hemorrhagic diathesis, was diagnosed as having acute lymphoblastic leukemia. Remission was induced by a combination of vincristine and prednisolone. Prophylactic intrathecal methotrexate and cranial irradiation were administered. Two years later, he was hospitalized for CNS leukemia and treated with multiple doses of intrathecal methotrexate. At the time, the results of CT scanning were normal. Six months later, though, he developed vomiting and lethargy. CT scanning showed a mass of an increased density in the right cerebellar hemisphere that displaced the fourth ventricle to the left and resulted in an obstructive hydrocephalus. Decompression was done by means of Ommaya reservoir setting. Soon his consciousness returned to normal, and CT scanning revealed no abnormal mass three weeks later. A month later, though, the CNS leukemia returned. He developed vomiting and a headache, and CT scanning showed a high-density mass in the right cerebellar hemisphere. The mass was diagnosed as hematoma. He died one month later. In this case, the previous mass showed evidence of a relatively uniform contrast enhancement, which is consistent with the intracerebral leukemic mass reported by Wendling. In Japan, this is the first report of an intracerebellar mass of acute lymphoblastic leukemia as perceived by CT scanning. (author)

  2. Towards Reviving Electroweak Baryogenesis with a Fourth Generation

    Directory of Open Access Journals (Sweden)

    Wei-Shu Hou

    2013-01-01

    universe. However, it does not work within the standard model due to two reasons: (1 the strength of CP violation from the Kobayashi-Maskawa mechanism with three generations is too small; (2 the electroweak phase transition is not first order for the experimentally allowed Higgs boson mass. We discuss possibilities to solve these problems by introducing a fourth generation of fermions and how electroweak baryogenesis might be revived. We also discuss briefly the recent observation of a Higgs-like boson with mass around 125 GeV, which puts the fourth generation in a difficult situation, and the possible way out.

  3. Heart rate variability and hear left ventricle hypertrophy in clean-up workers after Chernobyl accident with essential hypertension

    International Nuclear Information System (INIS)

    Khomazyuk, Yi.M.; Sidorenko, G.V.

    2004-01-01

    Correlation of heart rate variability (HRV) and hear left ventricle hypertrophy (LVH) in clean-up workers of Chernobyl accident with essential hypertension was estimated. Lowering of total HRV, parasympathetic and sympathetic activity associated with increased range of LVH was discovered

  4. Macrophage-derived osteopontin is fragmented by MMP-9 to hinder angiogenesis in the post-myocardial infarction left ventricle

    DEFF Research Database (Denmark)

    Nielsen, Signe Holm; Flynn, E.R.; Lindsey, M.

    2017-01-01

    Extracellular matrix (ECM) turnover is a key event during remodeling of the left ventricle (LV) following myocardial infarction (MI). Turnover includes ECM degradation of existing ECM to remove necrotic myocytes and synthesis to produce new ECM to form the infarct scar. Matrix metalloproteinases...

  5. Integrating atlas and graph cut methods for right ventricle blood-pool segmentation from cardiac cine MRI

    Science.gov (United States)

    Dangi, Shusil; Linte, Cristian A.

    2017-03-01

    Segmentation of right ventricle from cardiac MRI images can be used to build pre-operative anatomical heart models to precisely identify regions of interest during minimally invasive therapy. Furthermore, many functional parameters of right heart such as right ventricular volume, ejection fraction, myocardial mass and thickness can also be assessed from the segmented images. To obtain an accurate and computationally efficient segmentation of right ventricle from cardiac cine MRI, we propose a segmentation algorithm formulated as an energy minimization problem in a graph. Shape prior obtained by propagating label from an average atlas using affine registration is incorporated into the graph framework to overcome problems in ill-defined image regions. The optimal segmentation corresponding to the labeling with minimum energy configuration of the graph is obtained via graph-cuts and is iteratively refined to produce the final right ventricle blood pool segmentation. We quantitatively compare the segmentation results obtained from our algorithm to the provided gold-standard expert manual segmentation for 16 cine-MRI datasets available through the MICCAI 2012 Cardiac MR Right Ventricle Segmentation Challenge according to several similarity metrics, including Dice coefficient, Jaccard coefficient, Hausdorff distance, and Mean absolute distance error.

  6. Fate of tumor cells injected into left ventricle of heart in BALB/c mice: role of natural killer cells

    DEFF Research Database (Denmark)

    Basse, P; Hokland, P; Heron, I

    1988-01-01

    The arrest, retention, and elimination (i.e., clearance) of radiolabeled YAC-1 lymphoma cells injected either iv or into the left ventricle (LV) of the heart were studied in male BALB/c mice, with special emphasis on the role of natural killer (NK) cells. After iv injection YAC-1 cells were...

  7. Exercise training improves exercise capacity in adult patients with a systemic right ventricle : a randomized clinical trial

    NARCIS (Netherlands)

    Winter, Michiel M.; van der Bom, Teun; de Vries, Leonie C. S.; Balducci, Anna; Bouma, Berto J.; Pieper, Petronella G.; van Dijk, Arie P. J.; van der Plas, Mart N.; Picchio, Fernando M.; Mulder, Barbara J. M.

    To assess whether exercise training in adult patients with a systemic right ventricle (RV) improves exercise capacity and quality of life and lowers serum N-terminal prohormone brain natriuretic peptide (NT-proBNP) levels. Multi-centre parallel randomized controlled trial. Patients with a systemic

  8. Urinary albumin excretion in hospitalized patients with acute myocardial infarction. Prevalence of microalbuminuria and correlation to left ventricle wall thickness

    DEFF Research Database (Denmark)

    Taskiran, M; Feldt-Rasmussen, B; Jensen, G B

    1998-01-01

    was independent of blood pressure, body weight, smoking, diabetes mellitus, renal disease, and thrombolytic treatment. There was a positive correlation between urinary albumin excretion and thickness of the left ventricle wall (R = 0.28; p = 0.001) which was independent of blood pressure. Follow-up examination...

  9. Surgical anatomy of the atrioventricular conduction bundle in anomalous muscle bundle of the right ventricle with subarterial ventricular septal defect

    NARCIS (Netherlands)

    Kurosawa, H.; Becker, A. E.

    1985-01-01

    A stillborn baby girl was found to have an anomalous muscle bundle of the right ventricle, associated with a doubly committed subarterial ventricular septal defect. The latter was separated from the area of the atrioventricular conduction bundle by muscle. Serial histologic sectioning of the

  10. An Optical Method for the In-Vivo Characterization of the Biomechanical Response of the Right Ventricle.

    Science.gov (United States)

    Soltani, A; Lahti, J; Järvelä, K; Curtze, S; Laurikka, J; Hokka, M; Kuokkala, V-T

    2018-05-01

    The intraoperative in-vivo mechanical function of the left ventricle has been studied thoroughly using echocardiography in the past. However, due to technical and anatomical issues, the ultrasound technology cannot easily be focused on the right side of the heart during open-heart surgery, and the function of the right ventricle during the intervention remains largely unexplored. We used optical imaging and digital image correlation for the characterization of the right ventricle motion and deformation during open-heart surgery. This work is a pilot study focusing on one patient only with the aim of establishing the framework for long term research. These experiments show that optical imaging and the analysis of the images can be used to obtain similar parameters, and partly at higher accuracy, for describing the mechanical functioning of the heart as the ultrasound technology. This work describes the optical imaging based method to characterize the mechanical response of the heart in-vivo, and offers new insight into the mechanical function of the right ventricle.

  11. Automated segmentation of ventricles from serial brain MRI for the quantification of volumetric changes associated with communicating hydrocephalus in patients with brain tumor

    Science.gov (United States)

    Pura, John A.; Hamilton, Allison M.; Vargish, Geoffrey A.; Butman, John A.; Linguraru, Marius George

    2011-03-01

    Accurate ventricle volume estimates could improve the understanding and diagnosis of postoperative communicating hydrocephalus. For this category of patients, associated changes in ventricle volume can be difficult to identify, particularly over short time intervals. We present an automated segmentation algorithm that evaluates ventricle size from serial brain MRI examination. The technique combines serial T1- weighted images to increase SNR and segments the means image to generate a ventricle template. After pre-processing, the segmentation is initiated by a fuzzy c-means clustering algorithm to find the seeds used in a combination of fast marching methods and geodesic active contours. Finally, the ventricle template is propagated onto the serial data via non-linear registration. Serial volume estimates were obtained in an automated robust and accurate manner from difficult data.

  12. Exploring Deep Space - Uncovering the Anatomy of Periventricular Structures to Reveal the Lateral Ventricles of the Human Brain.

    Science.gov (United States)

    Colibaba, Alexandru S; Calma, Aicee Dawn B; Webb, Alexandra L; Valter, Krisztina

    2017-10-22

    Anatomy students are typically provided with two-dimensional (2D) sections and images when studying cerebral ventricular anatomy and students find this challenging. Because the ventricles are negative spaces located deep within the brain, the only way to understand their anatomy is by appreciating their boundaries formed by related structures. Looking at a 2D representation of these spaces, in any of the cardinal planes, will not enable visualisation of all of the structures that form the boundaries of the ventricles. Thus, using 2D sections alone requires students to compute their own mental image of the 3D ventricular spaces. The aim of this study was to develop a reproducible method for dissecting the human brain to create an educational resource to enhance student understanding of the intricate relationships between the ventricles and periventricular structures. To achieve this, we created a video resource that features a step-by-step guide using a fiber dissection method to reveal the lateral and third ventricles together with the closely related limbic system and basal ganglia structures. One of the advantages of this method is that it enables delineation of the white matter tracts that are difficult to distinguish using other dissection techniques. This video is accompanied by a written protocol that provides a systematic description of the process to aid in the reproduction of the brain dissection. This package offers a valuable anatomy teaching resource for educators and students alike. By following these instructions educators can create teaching resources and students can be guided to produce their own brain dissection as a hands-on practical activity. We recommend that this video guide be incorporated into neuroanatomy teaching to enhance student understanding of the morphology and clinical relevance of the ventricles.

  13. Demyelinating disease masquerading as a surgical problem: a case series

    Directory of Open Access Journals (Sweden)

    Awang Saufi M

    2009-08-01

    Full Text Available Abstract Introduction We report three cases of demyelinating disease with tumor-like presentation. This information is particularly important to both neurosurgeons and neurologists who should be aware that inflammatory demyelinating diseases can present as a mass lesion, which is indistinguishable from a tumor, both clinically and radiologically, especially when there is no evidence of temporal dissemination of this disease. Case presentation The first patient was a 42-year-old Malay woman who developed subacute onset of progressive quadriparesis with urinary incontinence. Magnetic resonance imaging of her spine showed an intramedullary lesion at the C5-C7 level. She was operated on and biopsy was suggestive of a demyelinating disease. Retrospective history discovered two episodes of acute onset of neurological deficits with partial recovery and magnetic resonance imaging of her brain revealed demyelinating plaques in the centrum semiovale. The second patient was a 16-year-old Malay boy who presented with symptoms of raised intracranial pressure. A computed tomography brain scan revealed obstructive hydrocephalus with a lesion adjacent to the fourth ventricle. An external ventricular drainage was inserted. Subsequently, a stereotactic biopsy was taken and histopathology was reported as demyelination. Retrospective history revealed similar episodes with full recovery in between episodes. The third case was a 28-year-old Malay man who presented with acute bilateral visual loss and confusion. Magnetic resonance imaging of his brain showed a large mass lesion in the right temporoparietal region. Biopsy was consistent with demyelinating disease. Reexamination of the patient revealed bilateral papillitis and not papilledema. Visual evoked potential was prolonged bilaterally. In all three cases, lumbar puncture for cerebrospinal fluid study was not carried out due to lack of patient consent. Conclusions These cases illustrate the importance of

  14. An Inquiry into Flipped Learning in Fourth Grade Math Instruction

    Science.gov (United States)

    D'addato, Teresa; Miller, Libbi R.

    2016-01-01

    The objective of this action research project was to better understand the impact of flipped learning on fourth grade math students in a socioeconomically disadvantaged setting. A flipped instructional model was implemented with the group of students enrolled in the researcher's class. Data was collected in the form of classroom observations,…

  15. North Carolina Tales Fly with Fourth Grade Tellers

    Science.gov (United States)

    Westman, Gretchen Daub

    2008-01-01

    In fourth grade, North Carolina students are required to write their own personal narratives. The teachers felt that telling a story would be a great stepping stone toward writing one. Rather than focusing on grammar and the mechanics of writing, students could focus on story development and creativity. In this article, the author describes how…

  16. ORAL DRILLS AND WRITING IMPROVEMENT IN THE FOURTH GRADE.

    Science.gov (United States)

    MILLER, BARBARA D.; NEY, JAMES W.

    BELIEVING FORMAL WRITTEN ENGLISH TO BE A "FOREIGN LANGUAGE" TO MOST AMERICAN PUBLIC SCHOOL STUDENTS, RESEARCHERS USED THE AUDIO-LINGUAL METHOD OF FOREIGN LANGUAGE INSTRUCTION TO PROMOTE WRITING IMPROVEMENT IN FOURTH-GRADERS. TWO RANDOMLY-SELECTED CLASSES OF STUDENTS OF AVERAGE ABILITY COMPOSED THE STUDY POPULATION--ONE CLASS FOR THE EXPERIMENT,…

  17. Temperature coefficients of reactivity in the fourth loading of ZENITH

    International Nuclear Information System (INIS)

    Caro Manso, R.; Freemantle, R.G.; Rogers, J.D.

    1962-10-01

    Measurements have been made of the temperature coefficients of reactivity associated with the core plus end reflectors and the side reflector of the fourth core loading of ZENITH, which had a carbon/U235 atomic ratio of 7788 and no other absorber. (author)

  18. Fourth annual conference on materials for coal conversion and utilization

    Energy Technology Data Exchange (ETDEWEB)

    1979-01-01

    The fourth annual conference on materials for coal conversion and utilization was held October 9 to 11, 1979, at the National Bureau of Standards, Gaithersburg, Maryland. It was sponsored by the National Bureau of Standards, the Electric Power Research Institute, the US Department of Energy, and the Gas Research Institute. The papers have been entered individually into EDB and ERA. (LTN)

  19. Benthic macroinvertebrate community of a fourth order stream in ...

    African Journals Online (AJOL)

    cinthia

    Full Length Research Paper. Benthic macroinvertebrate community of a fourth order stream in Kashmir Himalaya, India. Shazia Habib1* and A.R. Yousuf2. 1Department of Environmental Science, University of Kashmir, Srinagar, India. 2National Green Tribunal, Government of India, India. Received 31 December, 2013; ...

  20. Brown Boveri moves to fourth generation MSRs [moisture separator reheaters

    International Nuclear Information System (INIS)

    Boeckh, P. von

    1987-01-01

    The fourth, space saving, generation of moisture separator reheaters from Brown Boveri and Cie (BBC) consists of two types of high velocity moisture separators, 'Mops' and 'Scrups', and the small size reheater, 'Road' . The design of the unit is described, together with operational experience. (author)

  1. Temperature coefficients of reactivity in the fourth loading of ZENITH

    Energy Technology Data Exchange (ETDEWEB)

    Caro Manso, R; Freemantle, R G; Rogers, J D [Graphite Reactor Physics Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1962-10-15

    Measurements have been made of the temperature coefficients of reactivity associated with the core plus end reflectors and the side reflector of the fourth core loading of ZENITH, which had a carbon/U235 atomic ratio of 7788 and no other absorber. (author)

  2. Fourth-order discrete anisotropic boundary-value problems

    Directory of Open Access Journals (Sweden)

    Maciej Leszczynski

    2015-09-01

    Full Text Available In this article we consider the fourth-order discrete anisotropic boundary value problem with both advance and retardation. We apply the direct method of the calculus of variations and the mountain pass technique to prove the existence of at least one and at least two solutions. Non-existence of non-trivial solutions is also undertaken.

  3. The fourth sound of Korotkoff in pregnancy: a myth

    NARCIS (Netherlands)

    Franx, A.; Evers, I. M.; van der Pant, K. A.; van der Post, J. A.; Bruinse, H. W.; Visser, G. H.

    1998-01-01

    To determine the detection rate and the reproducibility of the first (K1), the fourth (K4) and the fifth (K5) phases of the Korotkoff sounds in pregnant women. In 77 pregnant women receiving antenatal care in a tertiary referral centre, two observers took 231 simultaneous blood pressure measurements

  4. Did that Dog Sniff Violate the Fourth Amendment?

    Science.gov (United States)

    Hawke, Catherine; Middleton, Tiffany

    2012-01-01

    Is sniffing at the front door of a private home by a trained narcotics detection dog a Fourth Amendment search requiring probable cause? Is a "drug dog" somehow like a manmade technology, such as a thermal imaging device? These were a couple of the questions recently presented to the U.S. Supreme Court during arguments in "Florida v. Jardines."…

  5. Local government and intergovernmental relations in Nigeria fourth ...

    African Journals Online (AJOL)

    The study adopts secondary source of data collection. ... The study reveals that intergovernmental relations among the levels of government in the fourth republic has been in disarray due to the conflicts arisen over issues of tax jurisdiction, revenue allocation, intergovernmental relations fund transfers, overconcentration of ...

  6. Constraints on Majorana dark matter from a fourth lepton family

    DEFF Research Database (Denmark)

    Hapola, T.; Jarvinen, M.; Kouvaris, C.

    2014-01-01

    We study the possibility of dark matter in the form of heavy neutrinos from a fourth lepton family with helicity suppressed couplings such that dark matter is produced thermally via annihilations in the early Universe. We present all possible constraints for this scenario coming from LHC...... account for the dark matter abundance....

  7. Short-term energy outlook: Quarterly projections, fourth quarter 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-14

    The Energy Information Administration (EIA) prepares quarterly short-term energy supply, demand, and price projections for printed publication in January, April, July, and October in the Short-Term Energy Outlook. The details of these projections, as well as monthly updates on or about the 6th of each interim month, are available on the internet at: www.eia.doe.gov/emeu/steo/pub/contents.html. The forecast period for this issue of the Outlook extends from the fourth quarter of 1997 through the fourth quarter of 1998. Values for the fourth quarter of 1997, however, are preliminary EIA estimates (for example, some monthly values for petroleum supply and disposition are derived in part from weekly data reported in EIA`s Weekly Petroleum Status Report) or are calculated from model simulations that use the latest exogenous information available (for example, electricity sales and generation are simulated by using actual weather data). The historical energy data, compiled in the fourth quarter 1997 version of the Short-Term Integrated Forecasting System (STIFS) database, are mostly EIA data regularly published in the Monthly Energy Review, Petroleum Supply Monthly, and other EIA publications. Minor discrepancies between the data in these publications and the historical data in this Outlook are due to independent rounding. The STIFS model is driven principally by three sets of assumptions or inputs: estimates of key macroeconomic variables, world oil price assumptions, and assumptions about the severity of weather. 19 tabs.

  8. Transactions of the fourth symposium on space nuclear power systems

    Energy Technology Data Exchange (ETDEWEB)

    El-Genk, M.S.; Hoover, M.D. (eds.)

    1987-01-01

    This paper contains the presented papers at the fourth symposium on space nuclear power systems. Topics of these papers include: space nuclear missions and applications, reactors and shielding, nuclear electric and nuclear propulsion, refractory alloys and high-temperature materials, instrumentation and control, energy conversion and storage, space nuclear fuels, thermal management, nuclear safety, simulation and modeling, and multimegawatt system concepts. (LSP)

  9. Fourth Order Nonlinear Intensity and the corresponding Refractive ...

    African Journals Online (AJOL)

    Nonlinear effects occur whenever the optical fields associated with one or more intense light such as from laser beams propagating in a crystal are large enough to produce polarization fields. This paper describes how the fourth order nonlinear intensity and the corresponding effective refractive index that is intensity ...

  10. Cultural Literacy of Fourth-Year Medical Students.

    Science.gov (United States)

    King, Charles R.

    1988-01-01

    A survey of fourth-year students in obstetrics at one medical school confirmed the absence of a liberal undergraduate education and indicated their failure to acquire cultural knowledge during their premedical and medical education. Knowledge deficits extended beyond the humanities to nonmedical sciences and the history and philosophy of medicine.…

  11. The Fourth Revolution in Teaching: Meta-Analyses.

    Science.gov (United States)

    Kulik, James A.

    Three major educational revolutions have been the advent of writing, the use of books as teaching tools, and the shift in educational responsibility from the home to the school. The fourth revolution, which is based on the use of electronic technology in teaching, began with programmed teaching machines, individualized instruction, and the…

  12. Fourth Graders Make Inventions Using SCAMPER and Animal Adaptation Ideas

    Science.gov (United States)

    Hussain, Mahjabeen; Carignan, Anastasia

    2016-01-01

    This study explores to what extent the SCAMPER (Substitute, Combine, Adapt, Modify, Put to another use, Eliminate, and Rearrange) technique combined with animal adaptation ideas learned through form and function analogy activities can help fourth graders generate creative ideas while augmenting their inventiveness. The sample consisted of 24…

  13. Proceedings of the fourth WHBBN workshop, Brazil 2010

    Science.gov (United States)

    Maria Isabel Moreno; Pablo Elizondo; C. John Ralph

    2011-01-01

    The fourth workshop of the Western Hemisphere Bird Banding Network (WHBBN) was held at the 25th International Ornithological Congress in Compos do Jordão, Brazil on August 22, 2010. 38 individuals representing 11 countries within the Americas attended the congress, as well as individuals from Australia and the UK. A total of 6 people were able to attend the workshop...

  14. Experiments on ion cyclotron damping at the deuterium fourth harmonic in DIII-D

    International Nuclear Information System (INIS)

    Pinsker, R.I.; Petty, C.C.; Baity, F.W.; Bernabei, S.; Greenough, N.; Heidbrink, W.W.; Mau, T.K.; Porkolab, M.

    1999-05-01

    Absorption of fast Alfven waves by the energetic ions of an injected beam is evaluated in the DIII-D tokamak. Ion cyclotron resonance absorption at the fourth harmonic of the deuteron cyclotron frequency is observed with deuterium neutral beam injection (f = 60 MHz, B T = 1.9 T). Enhanced D-D neutron rates are evidence of absorption at the Doppler-shifted cyclotron resonance. Characteristics of global energy confinement provide further proof of substantial beam acceleration by the rf. In many cases, the accelerated deuterons cause temporary stabilization of the sawtooth (monster sawteeth), at relatively low rf power levels of ∼1 MW

  15. Experiments on ion cyclotron damping at the deuterium fourth harmonic in DIII-D

    International Nuclear Information System (INIS)

    Pinsker, R. I.; Baity, F. W.; Bernabei, S.; Greenough, N.; Heidbrink, W. W.; Mau, T. K.; Petty, C. C.; Porkolab, M.

    1999-01-01

    Absorption of fast Alfven waves by the energetic ions of an injected beam is evaluated in the DIII-D tokamak. Ion cyclotron resonance absorption at the fourth harmonic of the deuteron cyclotron frequency is observed with deuterium neutral beam injection (f=60 MHz, B T =1.9 T). Enhanced D-D neutron rates are evidence of absorption at the Doppler-shifted cyclotron resonance. Characteristics of global energy confinement provide further proof of substantial beam acceleration by the rf. In many cases, the accelerated deuterons cause temporary stabilization of the sawtooth (''monster sawteeth''), at relatively low rf power levels of ∼1 MW. (c) 1999 American Institute of Physics

  16. The fourth-order non-linear sigma models and asymptotic freedom in four dimensions

    International Nuclear Information System (INIS)

    Buchbinder, I.L.; Ketov, S.V.

    1991-01-01

    Starting with the most general Lagrangian of the fourth-order non-linear sigma model in four space-time dimensions, we calculate the one-loop, on-shell ultra-violet-divergent part of the effective action. The formalism is based on the background field method and the generalised Schwinger-De Witt technique. The multiplicatively renormalisable case is investigated in some detail. The renormalisation group equations are obtained, and the conditions for a realisation of asymptotic freedom are considered. (orig.)

  17. Lhermitte-Duclos disease presenting with positron emission tomography-magnetic resonance fusion imaging: a case report

    Directory of Open Access Journals (Sweden)

    Calabria Ferdinando

    2012-03-01

    Full Text Available Abstract Introduction Lhermitte-Duclos disease or dysplastic gangliocytoma of the cerebellum is an extremely rare tumor. It is a slowly enlarging mass within the cerebellar cortex. The majority of cases are diagnosed in the third or fourth decade of life. Case presentation We report the case of a 37-year-old Caucasian woman who underwent positron emission tomography-computed tomography with fluorine-18-fluorodeoxyglucose for evaluation of a solitary lung node. No pathological uptake was detected in the solitary lung node but the positron emission tomography-computed tomography of her brain showed intense tracer uptake, suggestive of a malignant neoplasm, in a mass in her left cerebellar lobe. Our patient had experienced two years of occipital headache and movement disorder. Subsequently, magnetic resonance imaging was performed with contrast agent administration, showing a large subtentorial mass in her left cerebellar hemisphere, with compression and dislocation of the fourth ventricle. Metabolic data provided by positron emission tomography and morphological magnetic resonance imaging views were fused in post-processing, allowing a diagnosis of dysplastic gangliocytoma with increased glucose metabolism. Total resection of the tumor was performed and histological examination confirmed the diagnosis of Lhermitte-Duclos disease. Conclusions Our case indicates that increased uptake of fluorine-18-fluorodeoxyglucose may be misinterpreted as a neoplastic process in the evaluation of patients with Lhermitte-Duclos disease, but supports the usefulness of integrated positron emission tomography-magnetic resonance imaging in the exact pathophysiologic explanation of this disease and in making the correct diagnosis. However, an accurate physical examination and exact knowledge of clinical data is of the utmost importance.

  18. Chondrosarcoma of the Proximal Phalanx of the Fourth Digit: A Rare Location

    Directory of Open Access Journals (Sweden)

    Thivi Vasilakaki

    2012-10-01

    Full Text Available Introduction: Cartilaginous tumors involving the small bones of the hands and feet are usually benign such as enchondroma, chondromyxoid fibroma and chondroblastoma. The small bones of the hands and feet are rarely involved by primary chondrosarcoma. Proximal phalanges are the most common sites in the hands, but the fourth digit is the least common site. Case Presentation: We report a case of a 76-year-old Greek female who presented to our hospital with a painful swollen mass measuring 4.5 × 2.6 cm on the fourth digit of the left hand. The radiograph showed a destructive, permeative lytic tumor of the proximal phalanx with extension into soft tissue. The patient underwent curettage, and the microscopic examination of the specimen revealed grade 2 chondrosarcoma. Conclusion: Cartilaginous tumors involving the small bones of the hands and feet are usually benign such as enchondroma, chondromyxoid fibroma and chondroblastoma. Primary chondrosarcoma is the third most common malignancy of bone after myeloma and osteosarcoma, but the small bones of the hands and feet are very rarely involved by chondrosarcoma (1% of all chondrosarcoma. However, in these cases differentiation between a benign lesion and chondrosarcoma may be difficult. Occasionally chondrosarcoma of the hands and feet is associated with multiple recurrences or distal metastasis.

  19. [Major tricuspid insufficiency and absence of systolic valvular coaptation. Echocardiographic study. Apropos of 6 cases].

    Science.gov (United States)

    Roudaut, R; Héraudeau, A; Gosse, P; Aouizerate, E; Dequecker, J L; Dallocchio, M

    1986-09-01

    In a retrospective series of 960 cases of tricuspid regurgitation studied by two-dimensional echocardiography 6 patients presented a systolic defect of valvular coaptation. The origin of this defect varied: one case was due to carcinoid, two to rheumatic cardiopathy, two to papyraceous right ventricle and one to sclerodermia associated with pulmonary arterial hypertension. The mechanism of the lacking coaptation varies according to the etiology: valvular retraction in carcinoid cardiopathy, right-ventricle dilatation, dilatation of the tricuspid ring and altered kinetics of the right ventricle in the other cases. Changed contractility of the right ventricle is the only element allowing to distinguish tricuspid regurgitation with and without a coaptation defect. Clinically this abnormality always points to an advanced stage of severe tricuspid regurgitation.

  20. Inotropic responses of the frog ventricle to adenosine triphosphate and related changes in endogenous cyclic nucleotides.

    Science.gov (United States)

    Flitney, F W; Singh, J

    1980-07-01

    1. A study has been made of a well documented but poorly understood response of the isolated frog ventricle to treatment with exogenous adenosine 5' triphosphate (ATP). Measurements of membrane potential, isometric twitch tension and levels of endogenous 3',5'-cyclic nucleotides have been made at various times during the ATP-induced response. 2. ATP elicits a characteristic triphasic response, which comprises an initial, abrupt increase in contractility, rising to a maximum within a few beats (first phase); followed by a period when the twitch amplitude falls, sometimes to below the control level (second phase); and superceded by a more slowly developing and longer-lasting increase in contractile force (third phase). The response is unaffected by atropine, propranolol or phentolamine. However, the prostaglandin synthetase inhibitor indomethacin depresses the first phase and entirely suppresses the third phase. 3. The inotropic effects of ATP are accompanied by changes in the shape of the action potential. These effects are dose-related. The duration of the action potential (D-30mV) and its positive overshoot (O) are increased during all phases of the response, for [ATP]o's up to 10(-5) M. However, at higher [ATP]o's, D-30mV and O ar both reduced during the second phase (but not the first or third phase), when isometric twitch tension is also depressed. The relationship between action potential duration and twitch tension (P) for different [ATP]o's is linear for all three phases of the response, but the slopes of the curves (delta P/delta D) are markedly different, indicating that the sensitivity of the contractile system to membrane depolarization is not constant, but varies continuously throughout the response. 4. ATP has a potent stimulatory effect on the metabolism of endogenous 3',5'-cyclic nucleotides. The time courses of the changes in adenosine 3','5-cyclic monophosphate (3',5'-cyclic AMP) and guanosine 3',5'-cyclic monophosphate (3',5'-cyclic GMP) are