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Sample records for hypertrophic contaminated shallow

  1. Diel vertical migration of zooplankton in a hypertrophic shallow ...

    African Journals Online (AJOL)

    Zooplankton as important links in the food web of aquatic ecosystems have been studied extensively. In current literature their diel vertical migration (DVM) is a highly discussed issue. In this investigation DVM by zooplankton is studied in a hypertrophic shallow lake in Germany. The objectives of the study were to see if ...

  2. diel vertical migration of zooplankton in a hypertrophic shallow

    African Journals Online (AJOL)

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    ABSTRACT: Zooplankton as important links in the food web of aquatic ecosystems have been studied extensively. In current literature their diel vertical migration (DVM) is a highly discussed issue. In this investigation DVM by zooplankton is studied in a hypertrophic shallow lake in Germany. The objectives of the study were ...

  3. Phytoplankton biodiversity changes in a shallow tropical reservoir during the hypertrophication process

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    LO. Crossetti

    Full Text Available Study aimed at evaluating phytoplankton biodiversity changes in a shallow tropical reservoir during its hypertrophication process. Samplings were carried out monthly during 8 consecutive years (1997-2004 in 5 depths. Conspicuous limnological changes in the reservoir derived from the presence and/or removal of the water hyacinth, characterized 3 different phases. Over the time series, reservoir changed from a typical polymictic eutrophic system to hypertrophic one, leading to a reduction of approximately 70 species (average 37%. Chlorophyceae accounted for the highest species richness (46% among all algal classes and strictly followed total species richness variation. Internal feedback mechanisms intensification over phase III clearly promoted the sharp decrease in biodiversity. Highest decreases, mainly during springs, occurred simultaneously to the highest Cyanobacteria blooms. Increased turbidity due to heavy phytoplankton blooms suppressed all other algal groups, so that at the end of the present study even Cyanobacteria species richness decreased. Total dissolved phosphorous was included in most of the best selected models used to analyze the temporal patterns in species richness loss. Present data show that biodiversity loss following trophic change was not a single dimension of a single factor but, rather, a template of factors (e.g. light, stability co-varying in consequence of the larger levels of biomass supported in the reservoir.

  4. Effect of substrate on periphyton communities and relationships among food web components in shallow hypertrophic lake

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    Tomasz Mieczan

    2012-07-01

    Full Text Available We studied the role of natural (common reed and artificial substrata (bamboo in structuring the abundance and taxonomic composition of periphyton assemblages. Investigations were conducted in a shallow, hypertrophic lake situated in the area of Polesie Lubelskie (Eastern Poland. Periphyton communities (algae, ciliates, small metazoa and chironomids on both types of substratum were sampled monthly, from May to November of 2007. Water samples for chemical analysis were collected together with biological samples. We selected the group of ten environmental variables which are the most important in determining the habitat conditions in highly eutrophic lakes: temperature, Secchi disc visibility, conductivity, dissolved oxygen, periphytic chlorophyll-a, N-NO3, N-NH4, TP, P-PO4 and total organic carbon (TOC. The abundances of periphytic algae, ciliates, metazoa and chironomids were significantly affected by season and substrate. On natural substrata, in all studied months, periphyton communities showed higher abundances. The results of PCA analysis confirmed the distinction between periphyton communities on natural and artificial substrata. The Monte Carlo permutation test showed that the periphyton communities on common reed were the most significantly affected by temperature, N-NO3, Secchi disc visibility and TOC. The communities on artificial substrata were significantly influenced by temperature, P-PO4 and TOC. On natural substrata biomass of periphytic algae was significantly negatively correlated with abundances of all groups of potential grazers (ciliates, metazoa, chironomids. On artificial substrata the relations between components of periphytic food web were stronger; correlation coefficients between algae, protists and chironomids were significant at P<0.01. The results of analysis indicate that periphytic algae can play an important role as food source for higher trophic levels. These interactions are less significant on natural (reed

  5. Using H2O2 treatments for the degradation of cyanobacteria and microcystins in a shallow hypertrophic reservoir.

    Science.gov (United States)

    Papadimitriou, Theodoti; Kormas, Konstantinos; Dionysiou, Dionysios D; Laspidou, Chrysi

    2016-11-01

    Toxins produced by cyanobacteria in freshwater ecosystems constitute a serious health risk worldwide for humans that may use the affected water bodies for recreation, drinking water, and/or irrigation. Cyanotoxins have also been deemed responsible for loss of animal life in many places around the world. This paper explores the effect of H2O2 treatments on cyanobacteria and microcystins in natural samples from a hypertrophic reservoir in microcosm experiments. According to the results, cyanobacteria were more easily affected by H2O2 than by other phytoplanktonic groups. This was shown by the increase in the fractions of chlorophyll-a (a proxy for phytoplankton) and chlorophyll-b (a proxy for green algae) over total phytoplankton pigments and the decrease in the fraction of phycocyanin (a proxy for cyanobacteria) over total phytoplankton pigments. Thus, while an overall increase in phytoplankton occurred, a preferential decrease in cyanobacteria was observed with H2O2 treatments over a few hours. Moreover, significant degradation of total microcystins was observed under H2O2 treatments, while more microcystins were degraded when UV radiation was used in combination with H2O2. The combination of H2O2 and ultraviolet (UV) treatment in natural samples resulted in total microcystin concentrations that were below the World Health Organization limit for safe consumption of drinking water of 1 μg/L. Although further investigation into the effects of H2O2 addition on ecosystem function must be performed, our results show that the application of H2O2 could be a promising method for the degradation of microcystins in reservoirs and the reduction of public health risks related to the occurrence of harmful algal blooms.

  6. Selection of an appropriate management strategy for contaminated sediment: A case study at a shallow contaminated harbour in Quebec, Canada.

    Science.gov (United States)

    Pourabadehei, Mehdi; Mulligan, Catherine N

    2016-12-01

    Harbours, as strategic places in tourism and transportation, are exposed to many sources of contamination. Assessing the quality of harbours sediment by guidelines and regulations does not reflect the actual level of contamination and the risk posed to aquatic ecosystems. Selection of an appropriate management technique for contaminated sediments in those strategic locations is crucial for the aquatic environment. The purpose of this study is to show that insufficient information, provided by sediment quality guidelines (SQGs) to identify the actual contaminants, could lead to a destructive or potentially ineffective decision for risk reduction in contaminated harbours. A comprehensive evaluation on physicochemical characteristics of sediment and water samples of a shallow harbour in St. Lawrence River was performed. Results of trace metal fractionation and risk assessment indicated that Cd and Pb were the contaminants that could pose a threat to aquatic ecosystem, although the SQG outcomes implied that Cu and Zn may cause an adverse effect on the benthic organisms. The results of multivariate statistical analysis demonstrated that the locations in the vicinity of the maintenance area contained the most contaminated sediment samples and require appropriate management. Antifouling paint particles and probably the runoff entering the harbour were the main sources of pollution. Among the diverse range of management strategies, the resuspension technique is suggested as a viable alternative in this specific case for shallow locations with contaminated sediments. A suitable management strategy could reduce the cost of remediation process by identifying the actual contaminated spots and also reduce the risk of remobilization of trace metals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  7. Remediating Contaminant Plumes in Groundwater with Shallow Excavations Containing Coarse Reactive Media.

    Science.gov (United States)

    Hudak, Paul F

    2018-02-01

    A groundwater flow and mass transport model tested the capability of shallow excavations filled with coarse, reactive media to remediate a hypothetical unconfined aquifer with a maximum saturated thickness of 5 m. Modeled as contaminant sinks, the rectangular excavations were 10 m downgradient of an initial contaminant plume originating from a source at the top of the aquifer. The initial plume was approximately 259 m long, 23 m wide, and 5 m thick, with a downgradient tip located approximately 100 m upgradient of the site boundary. The smallest trench capable of preventing offsite migration was 11 m long (measured perpendicular to groundwater flow), 4 m wide (measured parallel to groundwater flow), and 3 m deep. Results of this study suggest that shallow trenches filled with coarse filter media that partially penetrate unconfined aquifers may be a viable alternative for remediating contaminated groundwater at some sites.

  8. Understanding shallow groundwater contamination in Bwaise slum, Kampala, Uganda

    Science.gov (United States)

    Nyenje, P. M.; Havik, J.; Foppen, J. W.; Uhlenbrook, S.

    2012-04-01

    Groundwater in unsewered urban areas is heavily contaminated by onsite sanitation activities and is believed to be an important source of nutrients ex-filtrating into streams and thus contributing to eutrophication of Lakes in urban areas. Currently the fate of nutrients and especially phosphorus leached into groundwater in such areas is not well known. In this study, we undertook an extensive investigation of groundwater in Bwaise slum, Kampala Uganda to understand the distribution and fate of sanitation-related nutrients N and P that are leached into groundwater. Transects of monitoring wells were installed in Bwaise slum and downstream of the slum. From these wells, water levels were measured and water quality analyses done to understand the distribution and composition of the nutrients, how they evolve downstream and the possible subsurface processes affecting their fate during transport. These findings are necessary to evaluate the risk of eutrophication posed by unsewered areas in urban cities and to design/implement sanitation systems that will effectively reduce the enrichment of these nutrients in groundwater. Key words: fate, groundwater, nutrients, processes, slums

  9. Hypertrophic cardiomyopathy.

    Science.gov (United States)

    Santos Mateo, Juan José; Sabater Molina, María; Gimeno Blanes, Juan Ramón

    2017-11-14

    Hypertrophic cardiomyopathy is the most common inherited cardiovascular disease. It is characterized by increased ventricular wall thickness and is highly complex due to its heterogeneous clinical presentation, several phenotypes, large number of associated causal mutations and broad spectrum of complications. It is caused by mutations in sarcomeric proteins, which are identified in up to 60% of cases of the disease. Clinical manifestations of Hypertrophic Cardiomyopathy include shortness of breath, chest pain, palpitations and syncope, which are related to the onset of diastolic dysfunction, left ventricular outflow tract obstruction, ischemia, atrial fibrillation and abnormal vascular responses. It is associated with an increased risk of sudden cardiac death, heart failure and thromboembolic events. In this article, we discuss the diagnostic and therapeutic aspects of this disease. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  10. Hypertrophic cardiomyopathy.

    Science.gov (United States)

    Subasic, Kim

    2013-12-01

    Hypertrophic cardiomyopathy (HCM) is an autosomal dominant, cardiovascular disorder that carries the risk of sudden cardiac death. The prevalence of HCM is 1:500 persons. The purpose of this article is to provide an overview of the pathophysiology, symptoms, complications, diagnostic testing, and treatment. The silent presentation of HCM presents unique diagnostic challenges and complicates prompt identification. Diagnostic testing and management strategies for the care of a person with HCM are discussed. HCM has individualized presentation and therefore requires individualized therapy. Copyright © 2013 Elsevier Inc. All rights reserved.

  11. Arsenic contamination in shallow groundwater and agricultural soil of Chakdaha Block, West Bengal, India

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    Anamika eShrivastava

    2014-11-01

    Full Text Available The study area comes in one of the eight districts of West Bengal where groundwater contains arsenic above the prescribed limit by WHO (10μg/l. Each day groundwater is being withdrawn by the village people for the fulfillment of their basic needs and for agricultural purposes. With the groundwater along with high concentration of arsenic (As, many other heavy metals are also getting introduced in the environment. In the areas with a long history of use of such groundwater, the agricultural lands have been affected severely. The extent of contamination has increased to a level where the crops grown in those lands are becoming a major source for arsenic and other heavy metals poisoning and subsequently transfer to different trophic levels. Based on this concern a somewhat detailed study was carried out to obtain an idea about the magnitude of soil and water contamination in the area. The mean concentrations (mg/kg of As (9.67, Fe (9275.58, Mn (190.04, Cu (26.53 and Zn (36.04 in the control land soils were found within the normal range. Whereas the mean As (54.40, Fe (15745.50, Mn (307.90, Cu (69.33 and Zn (44.56 were found to be in higher, mainly arsenic which is at an alarming point. In case of water samples, the pond water was having the mean concentration (μg/l of As (32.63, Fe (57.21, Mn (30.25, Cu (0.82. Whereas in case of shallow groundwater there was more increase in the case of As (76.43, Fe (5493.22, Mn (253.63, and Cu (1.825. It was also observed that Zn although present in soil samples, it was below detection limits in case of water samples. The As concentration in soil and water showed a positive correlation. Also the correlation analyses between soil arsenic and other heavy metals shows a positive co-relation with all of them.

  12. MODIS-derived spatiotemporal water clarity patterns in optically shallow FloridaKeys waters: A new approach to remove bottom contamination

    Science.gov (United States)

    Retrievals of water quality parameters from satellite measurements over optically shallow waters have been problematic due to bottom contamination of the signals. As a result, large errors are associated with derived water column properties. These deficiencies greatly reduce the ...

  13. Monitoring Potential Transport of Radioactive Contaminants in Shallow Ephemeral Channels: FY2015 and FY2016

    Energy Technology Data Exchange (ETDEWEB)

    Mizell, Steve A [Desert Research Inst. (DRI), Las Vegas, NV (United States); Miller, Julianne J [Desert Research Inst. (DRI), Las Vegas, NV (United States); McCurdy, Greg [Desert Research Inst. (DRI), Las Vegas, NV (United States); Campbell, Scott A [Desert Research Inst. (DRI), Las Vegas, NV (United States)

    2017-10-01

    The Desert Research Institute (DRI) is conducting a field assessment of the potential for contaminated soil to be transported from the Smoky Contamination Area (CA) as a result of storm runoff. This activity supports Nevada Nuclear Security Administration (NNSA) efforts to complete regulatory closure of the Soils Corrective Action Unit (CAU) contamination areas. The work is intended to confirm the likely mechanism of transport and determine the meteorological conditions that might cause movement of contaminated soils, as well as determine the particle size fraction that is most closely associated with transported radionuclide-contaminated soils. These data will facilitate the appropriate closure design and post-closure monitoring program.

  14. Monitoring Potential Transport of Radioactive Contaminants in Shallow Ephemeral Channels: FY2013 and FY2014 (revised)

    Energy Technology Data Exchange (ETDEWEB)

    Mizell, Steve A. [Desert Research Inst. (DRI), Las Vegas, NV (United States); Miller, Julianne J. [Desert Research Inst. (DRI), Las Vegas, NV (United States); McCurdy, Greg D. [Desert Research Inst. (DRI), Reno, NV (United States); Campbell, Scott A. [Desert Research Inst. (DRI), Las Vegas, NV (United States)

    2017-06-01

    The Desert Research Institute (DRI) is conducting a field assessment of the potential for contaminated soil to be transported from the Smoky Contamination Area (CA) as a result of storm runoff, which supports National Nuclear Security Administration (NNSA) efforts to complete regulatory closure of the Soils Corrective Action Unit (CAU) contamination areas. The work is intended to confirm the likely mechanism of transport and determine the meteorological conditions that might cause movement of contaminated soils, as well as determine the particle size fraction that is most closely associated with transported radionuclide-contaminated soils. These data will facilitate the appropriate closure design and post-closure monitoring program.

  15. Hypertrophic Cardiomyopathy Association

    Science.gov (United States)

    ... organization improving the lives of those with hypertrophic cardiomyopathy, HCM, preventing untimely deaths and advancing global understanding. ... item purchased, 10% will be donated to Hypertrophic Cardiomyopathy Association. iGive.com - Online Shopping Joing iGive.com ...

  16. CO2 Leakage-Induced Shallow Aquifer Contaminations and Associated Health Risk Assessment.

    Science.gov (United States)

    Kim, C. Y.; Han, W. S.; Park, E.; Choung, S.; Piao, J.; Han, G.; Tianfu, X.

    2016-12-01

    Leakage of stored CO2 from designated deep formation could degrade portable groundwater quality in overlaying shallow aquifers. Dissolution of leaked CO2 causes to reduction of pH and alters dominant geochemical reactions, which ultimately enhances mobility of toxic heavy metals in shallow aquifer. In this study, among various toxic heavy metals, mobilization of As and U were focused because these metals are considered to be cancer potency factor when human being continuously exposes for long period. For this reason, it is critical to evaluate relationship between the amount of leaked CO2 into shallow aquifer and a degree of mobility in As and U. In the end, cancer risk to human body were quantified with probabilistic approach after accounting for shallow groundwater velocity, pumping rate from residential well, geologic heterogeneity. For this study, two-dimensional reactive transport models were developed. Geologic heterogeneity was accounted with three interbedded rock types, which consisted of sandstone, As and U bearing shale, and carbonate rocks, respectively. Within these three-rock types, variability includes changes in permeability, porosity, a type of minerals, and its volume fraction, accounting for both physical and chemical heterogeneities Finally, human health risk is calculated through multiplying cancer potency factor by average daily dose, which is obtained after acquiring for both As and U concentrations profile at residential well through reactive transport modeling. As per variability, a series of human health risks were calculated. Quantification of risk in conjunction with sensitivity analysis aids to evaluate a list of geologic parameters enhancing human health risk.

  17. Reducing organic contamination of shallow areas in brackish lagoons during rearing fish in cages in polyculture

    Directory of Open Access Journals (Sweden)

    P. Shekk

    2017-07-01

    Full Text Available Purpose. The development of the technology of the controlled rearing of marine fish remains one of the priority strategic trends of development of national mariculture. A study of the possibility of using polyculture for cage culture has a particular interest. Joint cultivation of several species of fish in the same cage, as practice of fish farming has demonstrated, does not have a tangible positive effect. At the same time, the use of cages of special design can provide significant additional fish products through the use of additional aquaculture objects. The ecological state of water areas, where the cages are located, is of great importance. High fish stocking density and the use of artificial feeds can serve as a source of powerful biogenic and organic pollution, which is especially important for shallow water areas with weak water exchange. The purpose of the study is to develop the methods for joint fish production in cage mariculture capable to provide high fish production and to weaken organic pollution of shallow water areas where cage farms are located. Methodology. The studies were conducted in 1999 and 2004. Cages of special design (internal 10 m3 and external 18.75 m3 installed in the brackish Shabolat Lagoon were used for rearing, steelhead trout, haarder, grass goby and round goby in polyculture. The standard aquaculture research methods were used. For express-analysis of environment hydrochemical parameters in cage location area the following devices were used: "ECOTEST-2000 T" (О2, NO2, NO3, NH4, CO2, phosphates, pH; termooksimetr "АJА-101М" (Т; О2; "pH meter-150 M; Refractometer "ATAGO-100" (salinity and water density. Findings. The results of marine fish cultivation in cages in polyculture in the shallow Shabolat lagoon are presented. It has been shown that joint cultivation of salmon, mullet and gobies in specially designed cages in shallow marine lagoons allows using artificial and natural feeds more fully and

  18. Geochemical and isotopic characteristics associated with high electrical conductivities in a shallow hydrocarbon-contaminated aquifer

    Science.gov (United States)

    Legall, F.; Atekwana, E.; Atekwana, E.; Krishnamurthy, R.; Sauck, W.

    2003-04-01

    Data collected from a network of in-situ vertical resistivity probes (VRPs) deployed within a hydrocarbon contaminated aquifer showed high soil conductivities associated with zones where residual and dissolved phase hydrocarbons (RDH) occur and zones where these phases coexist with free phase hydrocarbons (RDFH). Bulk soil conductivities were highest (12 to 30 mS/m) in the RDFH zone compared to the RDH zone (10 to 25 mS/m). Groundwater from closely spaced multi-level piezometers (MLPs) installed in the aquifer was analyzed to investigate the role of mineral weathering as the source of ions responsible for the high soil conductivity. Evidence for mineral weathering in the aquifer was assessed using major inorganic ions, dissolved inorganic carbon (DIC), stable carbon isotope ratio of DIC (δ13CDIC), and bulk soil conductivity. The link between bulk soil conductivity and δ13CDIC in contaminant plumes has never been reported in the literature. The results show higher Na, Ca, and Mg in the contaminated zone compared to background. The higher TDS in the contaminated zones is consistent with the weathering of carbonates and Na and Ca feldspars, the dominant minerals in the aquifer. Higher TDS at the contaminated locations was also coincident with higher DIC. The δ13CDIC values of 16.9 to 9.5 ppm suggest that DIC evolution within this zone is controlled by carbonate dissolution through enhanced CO_2 production related to microbial hydrocarbon degradation. Within the range of δ13CDIC values reported for groundwater at the RDH locations, the more positive δ13CDIC values were observed in zones where reduction of NO_3, Mn(IV), Fe(III), and SO_4 was occurring and was coincident with higher bulk soil conductivity. Within the portion of the aquifer with RDFH, δ13CDIC ranged from +6.5 to 4.4 ppm, suggesting that methanogenesis is the dominant redox process at this location. High DIC within the methanogenic zone is also coincident with higher bulk soil conductivity. Thus the

  19. Geochemical and isotopic characteristics associated with high soil conductivities in a shallow hydrocarbon-contaminated aquifer

    Science.gov (United States)

    Legall, Franklyn David

    Data collected from a network of in-situ vertical resistivity probes (VRPs) deployed at a hydrocarbon-contaminated site in SW Michigan showed high conductivities associated with the zone of contamination. Within the contaminated portion of the aquifer, different phases of hydrocarbon impact are recognized, namely, zones with residual and dissolved phase hydrocarbons (RDH) and zones where these phases coexist with free product (RDFH). Bulk soil conductivities were highest (12 to 30 mS/m) in the RDFH zone compared to the RDH zone (10 to 25 mS/m). Geochemical and isotopic data from closely spaced vertical samples within the high conductive zones were used to provide geochemical evidence for biodegradation and to investigate redox processes occurring within the conductive zones. Depth distribution of TEAs and educts showed evidence of reduction of nitrate, iron, manganese, and sulfate across steep vertical gradients. Within the portion of the plume characterized by RDH, SO4 reduction has supplanted denitrification via dissimilatory nitrate reduction, and the reduction of Fe (III) and Mn(IV) as the major observed redox process. This zone was also characterized by the highest DIC. The delta 13CDIC values of -16.9 to -9.5‰ suggest that DIC evolution within this zone is controlled by carbonate dissolution through enhanced CO2 production related to microbial hydrocarbon degradation. Within the portion of the aquifer with RDFH, DIC was lower compared to the RDH location with an associated delta13CDIC in the range of +6.5 to -4.4‰. Both the DIC and delta 13CDIC suggest that methanogenesis is the dominant redox process. With respect to mineral weathering as a possible source of ions contributing to high conductivities, the results show higher concentrations of Na, Ca, and Mg in the contaminated portion of the aquifer compared to uncontaminated parts. This is consistent with the weathering of carbonate and Na and Ca feldspars, the dominant minerals in the aquifer. Higher

  20. Baseline evaluation of sediment contamination in the shallow coastal areas of Saudi Arabian Red Sea.

    Science.gov (United States)

    Ruiz-Compean, Pedro; Ellis, Joanne; Cúrdia, João; Payumo, Richard; Langner, Ute; Jones, Burton; Carvalho, Susana

    2017-10-15

    Despite the growing recognition of the importance of water and sediment quality there is still limited information on contamination levels in many regions globally including the Red Sea. This study provides a comprehensive assessment of three classes of contaminants (Polycyclic Aromatic Hydrocarbons - PAH; metals; plastics) in coastal sediments along the Saudi Arabian Red Sea mainly collected using grabs. Background concentrations are provided for metals in the region. Concentrations of metals and PAH were generally low in comparison to international guidelines. A clear relationship between the concentration of metals and anthropogenic sources was not always apparent and dust and vegetation may be relevant players in the region. Microplastic items (mainly polyethylene) were abundant (reaching up to 1gm -2 and 160piecesm -2 ) and in general associated with areas of high human activity. This study provides critical information for future monitoring and the development of national policies within the Red Sea region. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Baseline evaluation of sediment contamination in the shallow coastal areas of Saudi Arabian Red Sea

    KAUST Repository

    Ruiz Compean, Pedro Javier

    2017-09-12

    Despite the growing recognition of the importance of water and sediment quality there is still limited information on contamination levels in many regions globally including the Red Sea. This study provides a comprehensive assessment of three classes of contaminants (Polycyclic Aromatic Hydrocarbons - PAH; metals; plastics) in coastal sediments along the Saudi Arabian Red Sea mainly collected using grabs. Background concentrations are provided for metals in the region. Concentrations of metals and PAH were generally low in comparison to international guidelines. A clear relationship between the concentration of metals and anthropogenic sources was not always apparent and dust and vegetation may be relevant players in the region. Microplastic items (mainly polyethylene) were abundant (reaching up to 1gm−2 and 160piecesm−2) and in general associated with areas of high human activity. This study provides critical information for future monitoring and the development of national policies within the Red Sea region.

  2. In-situ stabilization of radioactively contaminated low-level solid wastes buried in shallow trenches: an assessment

    Energy Technology Data Exchange (ETDEWEB)

    Arora, H.S.; Tamura, T.; Boegly, W.J.

    1980-09-01

    The potential effectiveness of materials for in-situ encapsulation of low-level, radioactively contaminated solid waste buried in shallow trenches is enumerated. Cement, clay materials, and miscellaneous sorbents, aqueous and nonaqueous gelling fluids and their combinations are available to solidify contaminated free water in trenches, to fill open voids, and to minimize radionuclide mobility. The success of the grouting technique will depend on the availability of reliable geohydrologic data and laboratory development of a mix with enhanced sorption capacity for dominant radionuclides present in the trenches. A cement-bentonite-based grout mix with low consistency for pumping, several hours controlled rate of hardening, negligible bleeding, and more than 170 kPa (25 psi) compressive strength are a few of the suggested parameters in laboratory mix development. Cost estimates of a cement-bentonite-based grout mix indicate that effective and durable encapsulation can be accomplished at a reasonable cost (about $113 per cubic meter). However, extensive implementation of the method suggests the need for a field demonstration of the method. 53 references.

  3. Field note: successful establishment of a phytoremediation system at a petroleum hydrocarbon contaminated shallow aquifer: trends, trials, and tribulations.

    Science.gov (United States)

    Cook, Rachel L; Landmeyer, James E; Atkinson, Brad; Messier, Jean-Pierre; Nichols, Elizabeth Guthrie

    2010-09-01

    We report the establishment of a mixed hybrid poplar (Populus spp.) and willow (Salix spp.) phytoremediation system at a fuel-contaminated site. Several approaches were used to balance competing goals of cost-effectiveness yet successful tree establishment without artificial irrigation or trenching. Bare root and unrooted cuttings were installed using either: (1) 1.2 m deep holes excavated with an 8 cm diameter auger using a direct-push rig and backfilled with the excavated, in situ soil; (2) 1.2 m deep holes created with a 23 cm diameter auger attached to a Bobcat rig and backfilled with clean topsoil from offsite; and (3) shallow holes between 15-30 cm deep that were created with a 1.3 cm diameter rod and no backfill. Tree mortality from initial plantings indicated contaminated zones not quantified in prior site investigations and remedial actions. Aquifer heterogeneity, underground utilities, and prior remediation infrastructure hampered the ability of the site to support a traditional experimental design. Total stem length and mortality were measured for all planted trees and were incorporated into a geographic information system. Planting early in the growing season, augering a larger diameter hole, and backfilling with clean, uncontaminated topsoil was cost effective and allowed for greater tree cutting growth and survival.

  4. Perfluorinated contaminants in sediments and aquatic organisms collected from shallow water and tidal flat areas of the Ariake Sea, Japan: environmental fate of perfluorooctane sulfonate in aquatic ecosystems.

    Science.gov (United States)

    Nakata, Haruhiko; Kannan, Kurunthachalam; Nasu, Tetsuya; Cho, Hyeon-Seo; Sinclair, Ewan; Takemurai, Akira

    2006-08-15

    Perfluorinated compounds (PFCs), such as perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorononanoate (PFNA), perfluorohexane sulfonate (PFHS), and perfluorooctane sulfonamide (PFOSA) are widely distributed in aquatic ecosystems. Despite studies reporting the occurrence of PFCs in aquatic organisms, the fate of PFCs in tidal flat and marine coastal ecosystems is not known. In this study, we determined concentrations of PFOS, PFOA, PFNA, PFHS, and PFOSA in sediments; benthic organisms, including lugworm, mussel, crab, clam, oyster, and mudskipper fish from tidal flat; and shallow water species, such as filefish, bream, flounder, shark, finless porpoise, gull, and mallard collected from the Ariake Sea, Japan. PFOS and PFOA were detected in most of the samples analyzed, followed by PFNA, PFOSA, and PFHS. In shallow water species, PFOS was the dominant contaminant, and elevated concentrations were found in higher trophic level species, such as marine mammals and omnivorous birds. These results suggest biomagnification of PFOS through the coastal food chain. In contrast, PFOA was the most abundant compound in tidal flat organisms and sediments. PFOA concentrations in sediments, lugworms, and omnivorous mudskippers in tidal flat were approximately 1 order of magnitude greater than the levels of PFOS. This indicates differences in exposure pattern and bioavailability of PFOS and PFOA between shallow water and tidal flat organisms. The accumulation profiles of PFCs were compared with those of organochlorines (polychlorinated biphenyls, PCB), organotin (tributyltin,TBT), and polycyclic aromatic hydrocarbons (PAHs) in tidal flat and shallow water samples collected from the Ariake Sea. Concentrations of PFCs in sediments and in tidal flat organisms were significantly lower than that found for PCBs, TBT, and PAHs. Nevertheless, PFOS concentrations in shallow water species were comparable to and/or significantly greater than those of other classes of

  5. HYPERTROPHIC CARDIOMYOPATHY IN MULTIMORBIDITY

    Directory of Open Access Journals (Sweden)

    A. I. Lakhonina

    2016-06-01

    Full Text Available Aspects of diagnosis, difficulties in the diagnosis and optimal therapeutic strategies in patient with hypertrophic cardiomyopathy and comorbid conditions such as arterial hypertension, ischemic heart disease, dyslipidemia, diabetes mellitus type 2, stenosis of the left renal artery, obesity are reviewed on the example of clinical case. Hypertrophic cardiomyopathy combined with multimorbidity conditions requires a high-quality medical management, where the main goal is to improve the quality and duration of patient's life. This goal is being achieved by optimizing patient's lifestyle and assigning only the minimum amount of medications. Necessity of careful diagnosis of hypertrophic cardiomyopathy, evaluation of the risk of sudden death and search of optimal treatment in patients with multimorbidity pathology are demonstrated in clinical case.

  6. Hypertrophic pachymeningitis: case report

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    Deus-Silva Leonardo de

    2003-01-01

    Full Text Available Hypertrophic pachymeningits is an unusual cause of neurological symptoms and is often secondary to infections, carcinomatosis or inflammatory diseases. It may also be idiopathic. We report a case of pachymeningitis which was manifested primarily by psychosis and visual loss with optic atrophy and destruction of nasal septum. The patient, a 45 year old woman was submitted to extensive investigation without evidence of any underlying disease. A meningeal biopsy was performed and showed a mostly unspecific inflammatory process with extensive fibrosis of the dura and few early stage granulomas. These findings suggest either neurosarcoidosis or idiopathic hypertrophic pachymeningitis.

  7. Infantile hypertrophic pyloric stenosis

    DEFF Research Database (Denmark)

    Pedersen, Rikke Neess; Garne, Ester; Loane, Maria

    2008-01-01

    OBJECTIVE: The objective of this study was to present epidemiologic data on infantile hypertrophic pyloric stenosis (IHPS) from seven well-defined European regions, and to compare incidence and changes in incidence over time between these regions. METHODS: This was a population-based study using...

  8. Diet of Cnesterodon decemmaculatus (Poeciliidae and Jenynsia multidentata (Anablepidae in a hypertrophic shallow lake of Uruguay Dieta de Cnesterodon decemmaculatus (Poeciliidae y Jenynsia multidentata (Anablepidae en un lago hipereutrófico de Uruguay

    Directory of Open Access Journals (Sweden)

    Federico Quintans

    2009-03-01

    Full Text Available Se analizaron las dietas de Cnesterodon decemmaculatus (Jenyns, 1842 y Jenynsia multidentata (Jenyns, 1842 en el Lago Rodó, un lago urbano hipereutrófico de Montevideo, Uruguay. Ambas especies mostraron un comportamiento omnívoro. Los ítems más consumidos por C. decemmaculatus fueron zooplancton, perifiton, fitoplancton y detritos; la dieta de J. multidentata incluyó zooplancton, insectos, crustáceos y peces juveniles. Estos resultados sugieren que ambas especies pueden actuar como planctívoros facultativos. La comunidad de peces de este lago se caracteriza por la dominancia de C. decemmaculatus y J. multidentata. Bajo esta condición, la depredación sobre el zooplancton de gran tamaño podría indirectamente estar contribuyendo a una alta abundancia de fitoplancton y una baja transparencia del agua.Diet of Cnesterodon decemmaculatus (Jenyns, 1842 and Jenynsia multidentata (Jenyns, 1842 were analysed in Lake Rodó, an urban hypertrophic lake from Montevideo, Uruguay. Both species displayed omnivory. The most consumed items for C. decemmaculatus were zooplankton, periphyton, phytoplankton and detritus; the diet of J. multidentata included zooplankton, insects, crustaceans and juvenile fish. Our results suggest that both species could be acting as facultative planktivores. The fish community of this lake is characterised by the dominance of C. decemmaculatus and J. multidentata. Under this condition, predation on large-bodied zooplankton could indirectly be contributing to maintain a high phytoplankton abundance and a low water transparency.

  9. Genetics Home Reference: familial hypertrophic cardiomyopathy

    Science.gov (United States)

    ... Home Health Conditions Familial hypertrophic cardiomyopathy Familial hypertrophic cardiomyopathy Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Familial hypertrophic cardiomyopathy is a heart condition characterized by thickening (hypertrophy) ...

  10. Assessment of multi-trophic changes in a shallow boreal lake simultaneously exposed to climate change and aerial deposition of contaminants from the Athabasca Oil Sands Region, Canada.

    Science.gov (United States)

    Summers, Jamie C; Kurek, Joshua; Rühland, Kathleen M; Neville, Erin E; Smol, John P

    2017-08-15

    The Athabasca Oil Sands Region (AOSR) has been intensely developed for industrial bitumen extraction and upgrading since the 1980s. A paucity of environmental monitoring prior to development raises questions about baseline conditions in freshwater systems in the region and ecological responses to industrial activities. Further, climatic changes prompt questions about the relative roles of climate and industry in shaping aquatic ecosystems through time. We use aquatic bioindicators from multiple trophic levels, concentrations of petrogenic contaminants (dibenzothiophenes), and spectrally-inferred chlorophyll-a preserved in well-dated sediments of a closed-basin, shallow lake ~50km away from the main area of industry, in conjunction with climate observations, to assess how the biotic assemblages of a typical AOSR lake have changed during the past ~75years. We examine the contributions of the area's stressors in structuring aquatic communities. Increases in sedimentary measures of petrogenic contaminants provide clear evidence of aerial contaminant deposition from local industry since its establishment, while climate records demonstrate consistent warming and a recent period of reduced precipitation. Quantitative comparisons of biological assemblages from before and after the establishment of regional industry find significant (pchanges are not consistent with a threshold-type shift in response to the onset of regional industry. Rather, biotic assemblages from multiple trophic levels suggest transitions to an increasingly complex benthic environment and relatively warmer waters, which, like the increasing trends in inferred primary production, are consistent with a changing climate. These findings highlight the important role of climate conditions in regulating primary production and structuring aquatic communities in these shallow systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Occurrence and distribution of enteric viruses in shallow ground water and factors affecting well vulnerability to microbiological contamination in Worcester and Wicomico counties, Maryland

    Science.gov (United States)

    Banks, William S.L.; Klohe, Cheryl A.; Battigelli, David A.

    2001-01-01

    The U.S. Geological Survey, in cooperation with the Maryland Department of the Environment and the Wisconsin State Laboratory of Hygiene, conducted a study to characterize the occurrence and distribution of viral contamination in small (withdrawing less than 10,000 gallons per day) public water-supply wells screened in the water-table aquifer in the Coastal Plain in Worcester and Wicomico Counties, Maryland.Two hundred seventy-eight well sites were evaluated with regard to simulated ground-water flow paths, land use, natural soils groups, and well characteristics, such as well depth and well age. Flow and transport simulations of the water-table aquifer indicated that wells screened less than about 50 feet below land surface (shallow wells) were most vulnerable to surface contamination, which in some cases could originate from as far as 2,000 feet upgradient of the well. Animal-feeding and agricultural-storage operations were considered among the most likely sources for viral contamination; therefore, sites close to these activities were considered most vulnerable. Soil groups were evaluated with regard to depth to water and moisture-holding capacity. Wells with shallow depths to water or in very sandy soils were considered more vulnerable to contamination than deep wells (greater than 50 feet) and those completed in finer-grained soils. Older wells and wells where coliform bacteria had been detected in the past were classified as highly vulnerable. On the basis of this evaluation, 27 sites considered to be susceptible were sampled.Samples were collected by pumping up to 400 gallons of untreated well water through an electropositive filter. Water concentrates were subjected to cell-culture assay for the detection of culturable viruses and reverse-transcription polymerase chain reaction/gene probe assays to detect nonculturable viruses; grab samples were analyzed for somatic and male-specific coliphages, Bacteroides fragilis, Clostridium perfringens, enterococci

  12. Contamination of shallow ground water in the area of building 95, Picatinny Arsenal, New Jersey, 1985-90

    Science.gov (United States)

    Sargent, B.P.; Storck, D.A.

    1994-01-01

    A zone of contaminated ground water at Picatinny Arsenal has resulted from the operation of a metal- plating facility in building 95 during 1960-81, and the wastewater-treatment system that is in and adjacent to the building. Thirty-two monitoring wells were installed in 1989 to supplement 12 previously installed wells. All wells were sampled in 1989 and 1990 for analysis of ground water for inorganic constituents, trace elements, volatile organic compounds, and nutrients. Four wells also were sampled for analysis for base/neutral- and acid-extractable compounds and pesticides, and soil gas from the unsaturated zone at eight sites was analyzed for volatile organic compounds. Concentrations of dissolved solids and sulfate in the study area were consistently above the U.S. Environmental Protection Agency's secondary drinking-water regulations. The areal distribution of sulfate differed from that of the volatile organic compounds. Concentrations of trace elements were not elevated downgradient from the source. The estimated average velocity of contaminant movement is 0.1 to 1.1 feet per day. The major organic contaminants identified in the study area are trichloroethylene, tetrachloroethylene, and 1,1,1-trichloroethane. Trichloroethylene was detected in wells upgradient from the wastewater- treatment site. Tetrachloroethylene and 1,1,1-trichloroethane might originate at tanks in the basement of building 95 rather than at the adjacent wastewater-treatment system. The pre- dominant gas-phase contaminant, 1,1,1- trichloroethane, was detected at a maximum con- centration of 15.7 micrograms per liter. Both trichoroethylene and tetrachloroethylene were detected in concentrations greater than 0.10 micrograms per liter in five of the eight soil- gas samples, indicating that volatilization and diffusion through the unsaturated zone could be a significant mechanism of contaminant loss from the aquifer.

  13. Spatial variability of shallow groundwater level, electrical conductivity and nitrate concentration, and risk assessment of nitrate contamination in North China Plain.

    Science.gov (United States)

    Hu, Kelin; Huang, Yuangfang; Li, Hong; Li, Baoguo; Chen, Deli; White, Robert Edlin

    2005-08-01

    In recent years, nitrate (NO3) contamination of groundwater has become a growing concern for people in rural areas in North China Plain (NCP) where groundwater is used as drinking water. The objective of this study was to evaluate groundwater resource level, to determine groundwater quality and to assess the risk of NO3 pollution in groundwater in Quzhou County in the NCP. Ordinary Kriging (OK) method was used to analyze the spatial variability of shallow groundwater level, groundwater electrical conductivity (EC) and NO3-N concentrations, and Indictor Kriging (IK) method was used to analyze the data with NO3-N concentrations equal or greater than the groundwater NO3 pollution threshold (20 mg L(-1)). The results indicated that groundwater level averaged 9.81 m, a level 6 m lower than in 1990. The spatial correlation distances for groundwater level, EC and NO3-N concentration were 21.93, 2.19 and 3.55 km, respectively. The contour map showed that shallow groundwater level areas extended from north to south across the County. Groundwater EC was above 3 dS m(-1) in the most part of the northern county. Groundwater NO3 pollution (NO3-N> or =20 mg L(-1)) mainly occurred in the County Seat areas due to wastewater irrigation and excessive fertilizer leaching from agricultural fields. At Henantuang town, besides suburban of the County Seat, groundwater was also contaminated by NO3 shown by the map generated using the IK method, which was not reflected in the map generated using the OK method. The map generated using the OK method could not reflect correctly the groundwater NO3 pollution status. The IK method is useful to assess the risk of NO3 pollution by giving the conditional probability of NO3 concentration exceeding the threshold value. It is suggested that risk assessment of NO3 pollution is useful for better managing groundwater resource, preventing soil salinization and minimizing NO3 pollution in groundwater.

  14. Hypertrophic Cardiomyopathy: A Review

    Science.gov (United States)

    Houston, Brian A; Stevens, Gerin R

    2014-01-01

    Hypertrophic cardiomyopathy (HCM) is a global disease with cases reported in all continents, affecting people of both genders and of various racial and ethnic origins. Widely accepted as a monogenic disease caused by a mutation in 1 of 13 or more sarcomeric genes, HCM can present catastrophically with sudden cardiac death (SCD) or ventricular arrhythmias or insidiously with symptoms of heart failure. Given the velocity of progress in both the fields of heart failure and HCM, we present a review of the approach to patients with HCM, with particular attention to those with HCM and the clinical syndrome of heart failure. PMID:25657602

  15. High-resolution geophysical imaging of shallow-water, contaminated wetlands: A novel application to Kearny freshwater marsh, New Jersey Meadowlands

    Science.gov (United States)

    Mansoor, Nasser M.

    The study investigated the transfer of state-of-the-art, geophysical technologies to permit effective characterization and monitoring of shallow-water wetlands. The innovative application was implemented in Kearney Marsh, NJ Meadowlands through three phases. Phase I (chapter 2) included laboratory-scale, induced polarization (IP) measurements conducted on marsh soils that were subsequently analyzed for heavy metal and physical properties. Phase II (chapter 3) included reconnaissance geophysical survey using terrain conductivity, magnetic gradiometry and surface water chemistry data from a shallow-draft paddleboat. Phase III (chapter 4) included continuous marine, electrical resistivity imaging (ERI) supported with rainfall and surface water data. Phase I revealed a linear relationship between the normalized chargeability and the estimated surface area to pore volume when the iron content is accounted for as a polarizable element of the soil. As the Fe concentration of soils is a critical biogeochemical parameter, IP measurements may provide a hitherto unrecognized approach to probing soil geochemistry, iron cycling and anaerobic microbial activity. The inverted sediment conductivity obtained from phase II resolved a contamination pattern probably attributable to leachate from adjacent landfills and/or salt water ingress from a partial tidal connection that is not obvious in the surface water data. Magnetic gradiometry and the in-phase component of the EM31 response both primarily reflect the distribution of junk metal associated with a legacy of illegal dumping. Historic aerial photographs suggest that this distribution reflects land-use history, defining the maximum previous extent of an adjacent landfill and a pattern of dumping correlated with historic roadways. The continuous ERI conducted during phase III is found to be an effective method for determining the resistivity structure of wetland sediments due to the shallow surface water layer. Temperature

  16. GIS Analysis of Available Data to Identify regions in the U.S. Where Shallow Ground Water Supplies are Particularly Vulnerable to Contamination by Releases to Biofuels from Underground Storage Tanks

    Science.gov (United States)

    GIS analysis of available data to identify regions in the U.S. where shallow ground water supplies are particularly vulnerable to contamination by releases of biofuels from underground storage tanks. In this slide presentation, GIS was used to perform a simple numerical and ...

  17. Misconceptions and Facts About Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Argulian, Edgar; Sherrid, Mark V; Messerli, Franz H

    2016-02-01

    Hypertrophic cardiomyopathy is the most common genetic heart disease. Once considered relentless, untreatable, and deadly, it has become a highly treatable disease with contemporary management. Hypertrophic cardiomyopathy is one of cardiology's "great masqueraders." Mistakes and delays in diagnosis abound. Hypertrophic cardiomyopathy commonly "masquerades" as asthma, anxiety, mitral prolapse, and coronary artery disease. However, once properly diagnosed, patients with hypertrophic cardiomyopathy can be effectively managed to improve both symptoms and survival. This review highlights some of the misconceptions about hypertrophic cardiomyopathy. Providers at all levels should have awareness of hypertrophic cardiomyopathy to promptly diagnose and properly manage these individuals. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Investigating the Sources of Nitrogen Contamination in the Shallow Aquifer of Jakarta using a Newly Developed Distributed River-Aquifer Flow and Transport Model

    Science.gov (United States)

    Costa, D.; Burlando, P.; Liong, S. Y.

    2015-12-01

    Recent observations in the shallow aquifer of Jakarta show a rise in nitrate (NO3-) levels. Groundwater is extensively used in the city to compensate for the limited public water supply network and therefore the risk to public health from a rise in NO3- concentration is high. NO3- has been identified as a cofactor for methemoglobinemia in infants, a disease which can lead to death in extreme cases. The NO3- levels detected are still below regulatory limits for drinking purposes but strategies are necessary to contain the growing problem. To this end, the main sources and pathways of inorganic compounds containing nitrogen (N) - i.e. nitrate, nitrite (NO2-) and ammonium (NH4+) - were investigated. We combined 3 years of field measurements in the Ciliwung River, the major river flowing through Jakarta, with a distributed river-aquifer interaction model to characterize the N-cycle in both systems and quantify the contribution of river infiltration in the overall groundwater N budget. The computed infiltration fluxes were compared to estimates of leaks from poorly maintained septic tanks, which are extensively used in the city, to identify the main source of groundwater contamination. Observations show a strong and interdependent spatial and seasonal variability in the levels of NO3-, NO2- and NH4+ in the river, which is caused by changes in nitrification/denitrification rates due to variations in dissolved oxygen concentrations. Simulation results suggest that such dynamics in the river cause river to aquifer contamination patterns to likewise change over space and time, which leads to heterogeneous vulnerability distributions. The estimated contribution of river-N infiltration to the observed NO3- groundwater levels is small if compared to that originating from all leaking septic tanks inside Jakarta. However, in the vicinity of the Ciliwung, river to groundwater N-loading can play an important role in the local NO3- groundwater levels because it is highly

  19. The structure of winter phytoplankton in Lake Nero, Russia, a hypertrophic lake dominated by Planktothrix-like Cyanobacteria

    OpenAIRE

    Babanazarova, Olga; Sidelev, Sergey; Schischeleva, Svetlana

    2013-01-01

    Background The permanent dominance of Planktothrix-like ?yanobacteria has been often reported for shallow eutrophic\\hypertrophic lakes in central Europe in summer\\autumn. However studies on phytoplankton growth under ice cover in nutrient-rich lakes are very scarce. Lake Nero provides a good example of the contrasting seasonal extremes in environmental conditions. Moreover, the ecosystem underwent a catastrophic transition from eutrophic to hypertrophic 2003?05, with dominance of filamentous ...

  20. Characteristics of organic matter as indicators of pollution from small-scale livestock and nitrate contamination of shallow groundwater in an agricultural area

    Science.gov (United States)

    Kim, Rak-Hyeon; Lee, Jeongho; Chang, Ho-Wan

    2003-08-01

    The main purpose of this study was to examine the hydrogeochemical factors leading to nitrate contamination of shallow groundwater in an agricultural area. Another purpose was to identify relationships between variations in organic matter levels (as estimated by the BOD and COD parameters) of groundwater that transports effluent from small-scale livestock holdings. Major cations, anions, BOD and COD of organic matter and total coliforms were analysed. It was found that groundwaters beneath cultivated areas and areas carrying livestock had higher concentrations of calcium, nitrate and chloride than did freshwater. Above all, the nitrification process increased concentrations of nitrate. Nitrate levels were depressed in some places where the groundwater was low in dissolved oxygen. Groundwaters affected by livestock activities showed high concentrations of organic matter (BOD, COD) and high microbial concentrations (as indicated by total coliforms). The COD/BOD ratio increased in the downward direction. It was inferred that this was due to the faster loss of easily biodegradable organic matter compared with non-biodegradable organic matter proceeding away from a discharge. Accordingly, it is possible to trace effluent in a small area back to a point source by monitoring the COD/BOD ratio of groundwater.

  1. HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    A. G. Osiev

    2015-01-01

    Full Text Available Hypertrophic cardiomyopathy (HCMP is a relatively common disease with genetic predisposition, that is widely spread irrespective of gender, race or ethnicity. The cause of this pathology are mutations of genes encoding synthesis of contracting proteins. Degree and type of mutations define clinical manifestation of the disease and its prognosis. HCMP is classified according to four main criteria: depending on morphology, presence of left ventricular outlet obstruction, pressure gradient and hemodynamic parameters. Its prevalence amounts to 1:500, and in the recent years mortality has decreased significantly to 1%. Main symptoms of HCMP include dyspnoea, dizziness, syncope, angina, and heart arrhythmias. HCMP does not manifest obligatorily with all above mentioned signs and symptoms. Presence and severity of any symptoms depend on morphological particulars of the disease. Particular attention should be paid to arrhythmias, with atrial fibrillation among them, that may cause hazardous and occasionally lethal complications. Electrocardiography and echocardiography are recognized as the “golden standard” of HCMP diagnostics, while in the recent years, magnetic resonance imaging has become a highly informative diagnostic tool. Radionuclide diagnostics is used less frequently, while physical examination and assessments have been moving backwards. At present, main strategies in HCMP include medical treatment with β-blockers, calcium antagonists, angiotensin-converting enzyme inhibitors and anti-arrhythmics. There are two techniques for surgical treatment, i.e. myectomy by Morrow and alcohol septal ablation that is becoming increasingly popular. The article reviews literature on state-of-the-art diagnostics and treatment of HCMP patients.

  2. DIFFERENTIAL DIAGNOSIS OF HYPERTROPHIC CARDIOMYOPATHY

    Directory of Open Access Journals (Sweden)

    I. V. Leontyeva

    2017-01-01

    Full Text Available Hypertrophic cardiomyopathy is the most common form of cardiomyopathy, occurring in childhood, occurring when a gene is mutated that encodes proteins of sarcomeric and non-sarcomeric complexes. The diagnosis of the disease is based on the data of echocardiography, revealing structural changes in the heart muscle according to the type of hypertrophy, while the genesis of these changes remains unclear. The causes of hypertrophic cardiomyopathy in childhood are diverse. Of great importance is the early diagnosis of metabolic forms of hypertrophic cardiomyopathy, so in some cases regress of hypertrophy is possible against the background of enzyme-substitution or other drug therapy. The article presents a clinical (cardiac and extracardiac symptoms and laboratory markers of hypertrophic cardiomyopathy with mutations of genes of proteins of the sarcomeric complex, congenital metabolic disorders (glycogenoses, lysosomal pathology, fatty acid metabolism disorders, and mitochondrial diseases, genetic syndromes (Noonan, LEOPARD, Costello, cardio-fascial-cutaneous, neuromuscular diseases. The criteria for differential diagnosis of genetic forms of hypertrophic cardiomyopathy and myocardial hypertrophy in athletes are presented. 

  3. diel vertical migration of zooplankton in a hypertrophic shallow

    African Journals Online (AJOL)

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    ABSTRACT: Zooplankton as important links in the food web of aquatic ecosystems have been studied extensively. In current literature ... food web as links between the primary producers and the vast spectrum of invertebrate and .... This was operated from a centrally located station (9 m deep) at five different depths of 0 m, 2 ...

  4. Study of Leachate Contamination in Bantar Gebang Landfill to Its Shallow Groundwater using Natural Isotope Tracers of 18O, 2H and 3H

    Directory of Open Access Journals (Sweden)

    E.R. Pujiindiyati

    2015-04-01

    Full Text Available Leaching from Bantar Gebang landfill, Jakarta’s main municipal landfill, especially from its two waste water treatment plants (plant A in zone-3 and plant B in Sumur Batu to underlying aquifer has been studied using isotope techniques. The study was based on the abundances of the heavier isotopes in water molocules namely 18O, 2H (deuterium and 3H (tritium. Because both water in the waste-water treatment plants and groundwater have undergone different independent physical processes, it was assumed that each water source has its own typical finger-print in term of the abundances of 18O, 2H (deuterium and 3H (tritium. Leachate from the two waste water treatment plants have higher 2H, 3H activities, and physical parameters (EC, TDS, and pH values than those of groundwater samples. Because of the age and size of the two waste water treatment plants are significantly different, it was also observed that the isotope contents of plant B, younger age and smaller size, was relatively lower in 2H values and 3H activities compared to those of plant A. These phenomena have been used to identify the leaching from waste-water treatment plants of Bantar Gebang landfill to the underlying aquifer. During the dry season, it was observed that 2H values in leachate were generally higher than those in rainy season. This result might be due to the extensive methane production in the treatment plants. Conversely, 18O-shifting in leachate from local meteoric line indicated that the leachate had experienced evaporation. Buried luminescent paints in the landfill were most likely the source of high tritium activity in leachate. Based on the samples collected from the study area (mostly from dug or bore wells, it was found that the underlying aquifer especially shallow groundwater has been contaminated up to as high as 33% with leachate

  5. 3D Traveltime Tomography and 1D Wavefield Inversion of Dense 3D Seismic Refraction Data From a Shallow Groundwater Contamination Site

    Science.gov (United States)

    Zelt, C. A.; Chen, J.; Levander, A.

    2016-12-01

    In 2012 Rice University carried out a shallow seismic survey in Rifle, Colorado where the groundwater was contaminated by vanadium and uranium ore-processing operations ending in 1958. The purpose of the seismic survey is to provide constraints to improve hydrogeologic modeling. The 3-D P-wave survey over 96 m x 60 m included 2158 shots recorded by 384 channels yielding 828,672 traces. An accelerated weight drop provided data with good signal-to-noise ratio (SNR) and a dominant frequency of 60 Hz. The overall good SNR allows for precise picking and an average uncertainty of 0.65 ms was assigned based on an analysis of all reciprocal time differences. Unreliable source triggering necessitated solving for shot time corrections during travelitme tomography, creating a mixed-parameter inverse problem. Several steps in addition to conventional 3-D traveltime tomography were applied to exploit the dense data and precise picking to overcome the data's low frequency content: (1) stacking the arrival-time-corrected traces in offset bins for 1-D reflectivity modeling to constrain discontinuities; (2) reduced smoothing regularization based on the local angular distribution of raypaths; and (3) a frequency-dependent form of traveltime tomography to account for the data's frequency content. Model assessment techniques include: (1) removal of the best and poorest fit data to assess the effect of outliers, (2) a jackknife procedure to estimate the uncertainty of each velocity node, and (3) checkerboard tests to estimate lateral model resolution using random shot and picking errors consistent with the real data. The results show that most of the velocity model has a relative error of less than 2% and lateral resolution of better than 5, 10 and 20 m to depths of 5, 10 and 20 m, respectively. Results include an isovelocity surface that represents the top of the Wasatch formation.

  6. Living with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Subasic, Kim

    2013-12-01

    The purpose of this study is to provide an insider's account of what it is like to live with hypertrophic cardiomyopathy (HCM), a genetic cardiovascular illness that carries the risk for sudden cardiac death. This study aims to reveal how HCM impacts the family and guides the decision whether or not to pursue genetic testing, how the physical limitations associated with HCM alter being-in-the-world, and how HCM alters social relationships. Fifteen adults with HCM were recruited for a longitudinal, phenomenological, qualitative study through purposive sampling and word of mouth. A total of 45 interviews were conducted by the researcher at a time and place designated by the participant between August 2011 and January 2012. The first interview with each participant was conducted in person. While efforts were made to conduct all interviews in person, a total of three interviews were conducted by telephone as requested by three participants due to scheduling conflicts. Through methods of interpretive phenomenology, three audio-recorded, semistructured interviews occurred over the course of 3 months. Detailed narratives were solicited and transcribed verbatim. Methodological and analytical documentation was supported with the identification of key phrases, similar experiences, themes, and documentation of the rationale for decisions throughout the research process. Participation in genetic testing carries a multitude of personal, familial, financial, and emotional implications. The results of a genetic test elicited an emotional response regardless of whether the results were negative, positive, or inconclusive. Living with a potentially life-threatening illness altered identity, disrupted social relationships, and generated chronic fear and uncertainty. A new normal was re-ordered or transformed by the demands and limitations posed by HCM, and by the person's concerns, priorities, and the meaning of the illness. Results from this study underscore the need for healthcare

  7. Update on hypertrophic scar treatment

    Science.gov (United States)

    Rabello, Felipe Bettini; Souza, Cleyton Dias; Júnior, Jayme Adriano Farina

    2014-01-01

    Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scar/span>s and keloids are pathological scar/span>s resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scar/span>s, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scar/span>s, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin. PMID:25141117

  8. Familial idiopathic hypertrophic subaortic stenosis

    Directory of Open Access Journals (Sweden)

    Shah Lilam

    1979-01-01

    Full Text Available Echocardiographic features of idiopathic hypertrophic subaortic stenosis (IHSS are described. Systolic anterior motion (SAM of anterior mitral leaflet and asymetric septal hypertrophy (ASH are considered as the diagnostic criteria of IHSS. Effects of amyl nitrite and propranolol-a beta blocker are studied. Echocardio-graphic screening of family members revealed this as a case of fami-lial IHSS.

  9. Hypertrophic osteoarthropathy in primary liver rhabdomyosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Geary, T.R.; Maclennan, A.C.; Irwin, G.J. [Radiology Dept., Royal Hospital for Sick Children, Yorkhill NHS Trust, Glasgow (United Kingdom)

    2004-03-01

    Hypertrophic osteoarthropathy is a well-documented paraneoplastic phenomenon in adults. It is a rare, but important finding in children with malignant disease as it can indicate prognosis. We present a case of hypertrophic osteoarthropathy associated with primary liver rhabdomyosarcoma in a 14-year-old boy. (orig.)

  10. Idiopathic hypertrophic pachymeningitis presenting with occipital ...

    African Journals Online (AJOL)

    Abstract: Background: Although occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition. Methods: We present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia. Results and conclusions: Idiopathic hypertrophic ...

  11. Idiopathic hypertrophic pachymeningitis presenting with occipital ...

    African Journals Online (AJOL)

    Background: Although occipital neuralgia is usually caused by degenerative arthropathy, nearly 20 other aetiologies may lead to this condition. Methods: We present the first case report of hypertrophic pachymeningitis revealed by isolated occipital neuralgia. Results and conclusions: Idiopathic hypertrophic ...

  12. Subendocardial ischemia in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kawasaki, Tatsuya; Sugihara, Hiroki

    2014-02-01

    Hypertrophic cardiomyopathy (HCM) patients often develop subendocardial ischemia in the left ventricle without atherosclerotic coronary stenosis. Myocardial ischemia plays an important role in the pathophysiology of HCM, but diagnostic techniques for the detection of subendocardial ischemia have not been widely available. We developed specific techniques to quantify subendocardial ischemia on stress scintigraphy, and have compared the results with various clinical features in patients with HCM. This article reviews our understanding of subendocardial ischemia in HCM based on more than 20 years of experience. Copyright © 2013 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  13. Hypertrophic Nonunion Humerus Mimicking an Enchondroma

    Directory of Open Access Journals (Sweden)

    N. K. Magu

    2014-01-01

    Full Text Available Introduction. Although fractures of humeral shaft show excellent results with conservative management, nonunion does occur. Case Report. We bring forth the case of a young male with a 1.5-year-old hypertrophic nonunion of the humerus mimicking an enchondroma. The initial X-ray images of the patient appeared to be an enchondroma, which only on further evaluation and histopathological analysis was diagnosed conclusively to be a hypertrophic nonunion. Discussion. Enchondromas are often incidentally diagnosed benign tumours. It is however not common to misdiagnose a hypertrophic nonunion to be an enchondroma. We present this case to highlight the unique diagnostic dilemma the treating team had to face.

  14. Hypertrophic lupus vulgaris: an unusual presentation.

    Science.gov (United States)

    Jain, Vijay K; Aggarwal, Kamal; Jain, Sarika; Singh, Sunita

    2009-07-01

    Lupus vulgaris is the most common form of cutaneous tuberculosis occurring in previously sensitized individuals with a high degree of tuberculin sensitivity. Various forms including plaque, ulcerative, hypertrophic, vegetative, papular, and nodular forms have been described. A 30-year-old male patient presented with a very large hypertrophic lupus vulgaris lesion over left side of chest since 22 years. Histopathological examination showed granulomatous infiltration without caseation necrosis. The Mantoux reaction was strongly positive. Hypertrophic lupus vulgaris of such a giant size and that too at an unusual site is extremely rare and hence is being reported.

  15. Hydrologic and Water-Quality Responses in Shallow Ground Water Receiving Stormwater Runoff and Potential Transport of Contaminants to Lake Tahoe, California and Nevada, 2005-07

    Science.gov (United States)

    Green, Jena M.; Thodal, Carl E.; Welborn, Toby L.

    2008-01-01

    Clarity of Lake Tahoe, California and Nevada has been decreasing due to inflows of sediment and nutrients associated with stormwater runoff. Detention basins are considered effective best management practices for mitigation of suspended sediment and nutrients associated with runoff, but effects of infiltrated stormwater on shallow ground water are not known. This report documents 2005-07 hydrogeologic conditions in a shallow aquifer and associated interactions between a stormwater-control system with nearby Lake Tahoe. Selected chemical qualities of stormwater, bottom sediment from a stormwater detention basin, ground water, and nearshore lake and interstitial water are characterized and coupled with results of a three-dimensional, finite-difference, mathematical model to evaluate responses of ground-water flow to stormwater-runoff accumulation in the stormwater-control system. The results of the ground-water flow model indicate mean ground-water discharge of 256 acre feet per year, contributing 27 pounds of phosphorus and 765 pounds of nitrogen to Lake Tahoe within the modeled area. Only 0.24 percent of this volume and nutrient load is attributed to stormwater infiltration from the detention basin. Settling of suspended nutrients and sediment, biological assimilation of dissolved nutrients, and sorption and detention of chemicals of potential concern in bottom sediment are the primary stormwater treatments achieved by the detention basins. Mean concentrations of unfiltered nitrogen and phosphorus in inflow stormwater samples compared to outflow samples show that 55 percent of nitrogen and 47 percent of phosphorus are trapped by the detention basin. Organic carbon, cadmium, copper, lead, mercury, nickel, phosphorus, and zinc in the uppermost 0.2 foot of bottom sediment from the detention basin were all at least twice as concentrated compared to sediment collected from 1.5 feet deeper. Similarly, concentrations of 28 polycyclic aromatic hydrocarbon compounds were

  16. Hypertrophic cardiomyopathy screening in young athletes

    Energy Technology Data Exchange (ETDEWEB)

    Rappoport, W.J. [Arizona Heart Inst., Phoenix, AZ (United States); Steingard, P.M. [Phoenix Suns, Phoenix, AZ (United States)

    2006-07-01

    Hypertrophic cardiomyopathy is the leading cause of sudden death during vigorous exercise. Early identification of this abnormality by ECG screening of high-school athletes before they participate in competitive sports helps save lives. (orig.)

  17. Verrucous (Hypertrophic) Cutaneous Lupus Erythematosus: A Case ...

    African Journals Online (AJOL)

    Abstract. Verrucous (Hypertrophic) Lupus Erythematosus (LE) represents a rare but distinct, variant of chronic discoid lupus erythematosus. We report a case of LE with verrucous lesions for its rarity and peculiar location posing a diagnostic dilemma.

  18. Source contamination and tectonomagmatic signals of overlapping Early to Middle Miocene orogenic magmas associated with shallow continental subduction and asthenospheric mantle flows in Western Anatolia: A record from Simav (Kütahya) region

    Science.gov (United States)

    Çoban, Hakan; Karacık, Zekiye; Ece, Ömer Işık

    2012-05-01

    The disappearances of mafic shoshonitic and ultrapotassic magma prior to Late Oligocene in Western Anatolia post-collisional tectonic settings, and the sudden appearance of Early-Middle Miocene potassic lavas with orogenic geochemical signatures, indicate a striking change of mantle sources during the Early-Middle Miocene period, and require a special explanation. In this regard, the Simav (Kütahya) region of Western Anatolia represents a critical area, where the Early-Middle Miocene mafic potassic (shoshonite, absarokite, ultrapotassic) and high-K calc-alkaline (andesite, dacite-rhyolite, granite) series rocks overlap in the extensional geotectonic setting in a back-arc position. The appraisal of petrological data obtained from Simav igneous complex indicates that there is a remarkable geochemical and isotopic similarity (e.g., negative Eu anomalies; Nb-Ta depletions; high Sr, low Nd and variable Pb isotope compositions) between coevally generated mafic potassic and high-K calc-alkaline magma series. The near primitive mafic potassic (MHKS) lavas with high Sr isotope compositions require a heterogeneous mantle source contaminated with crustal materials. Dragged and delaminated crustal components, caused by shallow continental subduction and the late arrived subducted terrigenous sediments from the Aegean trench are likely candidate sources of continental materials incorporated into the mantle source of the Simav mafic potassic (MHKS) magmas. The nature of these components also played a significant role in the compositional variations of Simav mafic series rocks. The Simav mafic potassic (MHKS) magmas were derived from a crust-contaminated, subduction-modified (metasomatized) EM-II type mantle source, interacting with influxed asthenosphere in a back-arc mantle wedge, whereas mixing of lower crustal silicic melts with underplated potassic mafic magmas resulted in coeval high-K calc-alkaline rocks, matched by the extent of crustal contamination observed in the more

  19. Hypoxia Inhibits Hypertrophic Differentiation and Endochondral Ossification in Explanted Tibiae

    NARCIS (Netherlands)

    Leijten, Jeroen Christianus Hermanus; Moreira Teixeira, Liliana; Landman, Ellie; van Blitterswijk, Clemens; Karperien, Hermanus Bernardus Johannes

    2012-01-01

    Purpose: Hypertrophic differentiation of growth plate chondrocytes induces angiogenesis which alleviates hypoxia normally present in cartilage. In the current study, we aim to determine whether alleviation of hypoxia is merely a downstream effect of hypertrophic differentiation as previously

  20. Prevention and curative management of hypertrophic scar formation

    NARCIS (Netherlands)

    Bloemen, M.C.; Veer, van der W.M.; Ulrich, M.; Zuijlen, van P.P.; Niessen, F.B.; Middelkoop, E.

    2009-01-01

    Although hypertrophic scarring commonly occurs following burns, many aspects such as incidence of and optimal treatment for scar hypertrophy remain unclear. This review will focus on hypertrophic scar formation after burn in particular, exploring multiple treatment options and describing their

  1. Microbial characterization of nitrification in a shallow, nitrogen-contaminated aquifer, Cape Cod, Massachusetts and detection of a novel cluster associated with nitrifying Betaproteobacteria

    Science.gov (United States)

    Miller, D.N.; Smith, R.L.

    2009-01-01

    Groundwater nitrification is a poorly characterized process affecting the speciation and transport of nitrogen. Cores from two sites in a plume of contamination were examined using culture-based and molecular techniques targeting nitrification processes. The first site, located beneath a sewage effluent infiltration bed, received treated effluent containing O2 (> 300????M) and NH4+ (51-800????M). The second site was 2.5??km down-gradient near the leading edge of the ammonium zone within the contaminant plume and featured vertical gradients of O2, NH4+, and NO3- (0-300, 0-500, and 100-200????M with depth, respectively). Ammonia- and nitrite-oxidizers enumerated by the culture-based MPN method were low in abundance at both sites (1.8 to 350??g- 1 and 33 to 35,000??g- 1, respectively). Potential nitrifying activity measured in core material in the laboratory was also very low, requiring several weeks for products to accumulate. Molecular analysis of aquifer DNA (nested PCR followed by cloning and 16S rDNA sequencing) detected primarily sequences associated with the Nitrosospira genus throughout the cores at the down-gradient site and a smaller proportion from the Nitrosomonas genus in the deeper anoxic, NH4+ zone at the down-gradient site. Only a single Nitrosospira sequence was detected beneath the infiltration bed. Furthermore, the majority of Nitrosospira-associated sequences represent an unrecognized cluster. We conclude that an uncharacterized group associated with Nitrosospira dominate at the geochemically stable, down-gradient site, but found little evidence for Betaproteobacteria nitrifiers beneath the infiltration beds where geochemical conditions were more variable.

  2. Apical Hypertrophic Cardiomyopathy in Association with PulmonaryArtery Hypertension

    Directory of Open Access Journals (Sweden)

    Mehdi Peighambari

    2012-09-01

    Full Text Available Apical Hypertrophic Cardiomyopathy is an uncommon condition constituting 1% -2% of the cases with Hypertrophic Cardiomyopathy (HCM diagnosis. We interestingly report two patients with apical hypertrophic cardiomyopathy in association with significant pulmonary artery hypertension without any other underlying reason for pulmonary hypertension. The patients were assessed by echocardiography, cardiac catheterization and pulmonary function parameters study.

  3. Apical Hypertrophic Cardiomyopathy in Association with Pulmonary Artery Hypertension

    OpenAIRE

    Peighambari, Mehdi; Parsaei, Mozghan; Sadeghpour, Anita; Alizadehasl, Azin

    2012-01-01

    Apical Hypertrophic Cardiomyopathy is an uncommon condition constituting 1% -2% of the cases with Hypertrophic Cardiomyopathy (HCM) diagnosis. We interestingly report two patients with apical hypertrophic cardiomyopathy in association with significant pulmonary artery hypertension without any other underlying reason for pulmonary hypertension. The patients were assessed by echocardiography, cardiac catheterization and pulmonary function parameters study.

  4. Multimodality imaging in apical hypertrophic cardiomyopathy

    Science.gov (United States)

    Parisi, Rosario; Mirabella, Francesca; Secco, Gioel Gabrio; Fattori, Rossella

    2014-01-01

    Apical hypertrophic cardiomyopathy (AHCM) is a relatively rare morphologic variant of HCM in which the hypertrophy of myocardium is localized to the left ventricular apex. Symptoms of AHCM might vary from none to others mimic coronary artery disease including acute coronary syndrome, thus resulting in inappropriate hospitalization. Transthoracic echocardiography is the first-line imaging technique for the diagnosis of hypertrophic cardiomyopathies. However, when the hypertrophy of the myocardium is localized in the ventricular apex might results in missed diagnosis. Aim of this paper is to review the different imaging techniques used for the diagnosis of AHCM and their role in the detection and comprehension of this uncommon disease. PMID:25276293

  5. On the surgical treatment of hypertrophic scars: a comprehensive guideline for the surgical treatment of hypertrophic scars

    NARCIS (Netherlands)

    Stekelenburg, C.M.; van der Wal, M.B.A.; Middelkoop, E.; Niessen, F.B.; van Zuijlen, P.P.M.

    2012-01-01

    Background: Treating the hypertrophic scar remains a challenging problem. It often leaves the clinician with the questions whether, when and how to treat a hypertrophic scar. Methods: This review will focus on the surgical treatment of hypertrophic scars considering the latest research in this

  6. Contractile Dysfunction in Sarcomeric Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    MacIver, David H; Clark, Andrew L

    2016-09-01

    The pathophysiological mechanisms underlying the clinical phenotype of sarcomeric hypertrophic cardiomyopathy are controversial. The development of cardiac hypertrophy in hypertension and aortic stenosis is usually described as a compensatory mechanism that normalizes wall stress. We suggest that an important abnormality in hypertrophic cardiomyopathy is reduced contractile stress (the force per unit area) generated by myocardial tissue secondary to abnormalities such as cardiomyocyte disarray. In turn, a progressive deterioration in contractile stress provokes worsening hypertrophy and disarray. A maintained or even exaggerated ejection fraction is explained by the increased end-diastolic wall thickness producing augmented thickening. We propose that the nature of the hemodynamic load in an individual with hypertrophic cardiomyopathy could determine its phenotype. Hypertensive patients with hypertrophic cardiomyopathy are more likely to develop exaggerated concentric hypertrophy; athletic individuals an asymmetric pattern; and inactive individuals a more apical hypertrophy. The development of a left ventricular outflow tract gradient and mitral regurgitation may be explained by differential regional strain resulting in mitral annular rotation. Copyright © 2016. Published by Elsevier Inc.

  7. Functional effects of losartan in hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Axelsson, Anna Karin Irene; Iversen, Kasper; Vejlstrup, Niels G.

    2016-01-01

    OBJECTIVE: There is a lack of disease-modifying treatments in hypertrophic cardiomyopathy (HCM). The aim of this randomised, placebo-controlled study was to assess if losartan could improve or ameliorate deterioration of cardiac function and exercise capacity. METHODS: Echocardiography, exercise...

  8. Fabry Disease in Families With Hypertrophic Cardiomyopathy

    DEFF Research Database (Denmark)

    Adalsteinsdottir, Berglind; Palsson, Runolfur; Desnick, Robert J

    2017-01-01

    BACKGROUND: The screening of Icelandic patients clinically diagnosed with hypertrophic cardiomyopathy resulted in identification of 8 individuals from 2 families with X-linked Fabry disease (FD) caused by GLA(α-galactosidase A gene) mutations encoding p.D322E (family A) or p.I232T (family B...

  9. Pregnancy in women with hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Pieper, P. G.; Walker, F.

    Hypertrophic cardiomyopathy (HCM) is increasingly being diagnosed in pregnant women. Women with HCM generally tolerate pregnancy well. The risk is however higher in women who are symptomatic before pregnancy or in those with severe left ventricular outflow tract obstruction. The incidence of

  10. Alcohol septal ablation for obstructive hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Steggerda, Robbert

    2015-01-01

    Hypertrophic cardiomyopathy is an inhered heart disease characterised by a thickened heart muscle, common in 1:500 persons. Obstruction of blood flow in the heart due the thickened heart muscle can occur and cause dyspnoea. A heart surgeon can cut away part of the thickened muscle (myectomy). With

  11. Hypertrophic Cardiomyopathy: Pathophysiology, Genetics and Invasive Treatment

    NARCIS (Netherlands)

    M. Michels (Michelle)

    2011-01-01

    textabstractHypertrophic cardiomyopathy (HCM) is the most common inheritable cardiac disorder with a phenotypic prevalence of 1:500. It is defined by the presence of left ventricular hypertrophy (LVH) in the absence of loading conditions (hypertension, valve disease) sufficient to cause the observed

  12. Evaluation of left ventricular torsion in children with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Prinz, Christian; Faber, Lothar; Horstkotte, Dieter; Körperich, Hermann; Moysich, Axel; Haas, Nikolaus; Kececioglu, Deniz; Thorsten Laser, Kai

    2014-04-01

    To evaluate the role of torsion in hypertrophic cardiomyopathy in children. A total of 88 children with idiopathic hypertrophic cardiomyopathy (n = 24) and concentric hypertrophy (n = 20) were investigated with speckle-tracking echocardiography and compared with age- and gender-matched healthy controls (n = 44). In hypertrophic cardiomyopathy, we found increased torsion (2.8 ± 1.6 versus 1.9 ± 1.0°/cm [controls], p Hypertrophic cardiomyopathy patients demonstrated a negative correlation between left ventricular muscle mass and torsion (r = -0.7, p hypertrophic cardiomyopathy is characterised by predominantly enhanced systolic basal clockwise rotation. Diastolic untwisting is delayed in both groups. Torsion may be an interesting marker to guide patients with hypertrophic cardiomyopathy.

  13. Extensive hypertrophic lupus erythematosus: Atypical presentation

    Directory of Open Access Journals (Sweden)

    Tarun Narang

    2012-01-01

    Full Text Available Lupus erythematosus (LE is a disease with a wide spectrum of cutaneous and systemic manifestations. Clinical features of patients with LE show a great variation, and for this reason it is difficult to develop a unifying concept of this disease. Our objective is to present a case of hypertrophic LE with atypical morphology and extensive involvement, who responded favorably to isotretinoin. Diagnosis of hypertrophic lupus erythematosus (HLE was confirmed by characteristic histopathological findings. Combination therapy with isotretinoin and hydroxychloroquine resulted in flattening and repression of previously refractory skin lesions. Sometimes, HLE lesions may present a diagnostic and therapeutic dilemma. In long standing lesions, squamous cell carcinoma may arise. Therefore, HLE requires adequate therapy with clinical and histopathological follow up.

  14. Hypertrophic cardiomyopathy: Part 1 - Introduction, pathology and pathophysiology

    OpenAIRE

    Praveen Kerala Varma; Praveen Kumar Neema

    2014-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease with many genotype and phenotype variations. Earlier terminologies, hypertrophic obstructive cardiomyopathy and idiopathic hypertrophic sub-aortic stenosis are no longer used to describe this entity. Patients present with or without left ventricular outflow tract (LVOT) obstruction. Resting or provocative LVOT obstruction occurs in 70% of patients and is the most common cause of heart failure. The pathology an...

  15. Primary hypertrophic osteoarthropathy: ultrasound and MRI findings

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Brook; Kraft, Jeannette K. [Leeds Children' s Hospital at The Leeds General Infirmary, Clarendon Wing Radiology Department, Leeds, West Yorkshire (United Kingdom); Amin, Tania; Leone, Valentina; Wood, Mark [Leeds Children' s Hospital at The Leeds General Infirmary, Department of Paediatric Rheumatology, Leeds (United Kingdom)

    2016-05-15

    Primary hypertrophic osteoarthropathy is a rare genetic disorder related to failures in prostaglandin metabolism. Patients present with joint pain, limb enlargement, skin thickening and finger clubbing. Radiographs show characteristic periosteal reaction and thickening along the long bones. We present MRI and US findings in a child with the condition. Ultrasound showed echogenic tissue surrounding the long bones, presumably reflecting oedema and inflammatory tissue. Doppler sonograms demonstrated increased vascularity on the surface of some superficial bony structures. (orig.)

  16. The embryological basis of subclinical hypertrophic cardiomyopathy.

    Science.gov (United States)

    Captur, Gabriella; Ho, Carolyn Y; Schlossarek, Saskia; Kerwin, Janet; Mirabel, Mariana; Wilson, Robert; Rosmini, Stefania; Obianyo, Chinwe; Reant, Patricia; Bassett, Paul; Cook, Andrew C; Lindsay, Susan; McKenna, William J; Mills, Kevin; Elliott, Perry M; Mohun, Timothy J; Carrier, Lucie; Moon, James C

    2016-06-21

    Hypertrophic cardiomyopathy (HCM) is caused by mutations in sarcomeric proteins, the commonest being MYBPC3 encoding myosin-binding protein C. It is characterised by left ventricular hypertrophy but there is an important pre-hypertrophic phenotype with features including crypts, abnormal mitral leaflets and trabeculae. We investigated these during mouse cardiac development using high-resolution episcopic microscopy. In embryonic hearts from wildtype, homozygous (HO) and heterozygous (HET) Mybpc3-targeted knock-out (KO) mice we show that crypts (one or two) are a normal part of wildtype development but they almost all resolve by birth. By contrast, HO and HET embryos had increased crypt presence, abnormal mitral valve formation and alterations in the compaction process. In scarce normal human embryos, crypts were sometimes present. This study shows that features of the human pre-hypertrophic HCM phenotype occur in the mouse. In an animal model we demonstrate that there is an embryological HCM phenotype. Crypts are a normal part of cardiac development but, along with the mitral valve and trabeculae, their developmental trajectory is altered by the presence of HCM truncating Mybpc3 gene mutation.

  17. Magnetic resonance imaging of hypertrophic olivary degeneration.

    Science.gov (United States)

    Blanco Ulla, M; López Carballeira, A; Pumar Cebreiro, J M

    2015-01-01

    To review the pathophysiologic mechanisms involved in hypertrophic olivary degeneration, with attention to epidemiologic and clinical aspects and especially to imaging findings. We reviewed 5 patients diagnosed with hypertrophic olivary degeneration at our center from 2010 through 2013, analyzing relevant clinical, epidemiologic, and radiologic findings. In all cases, a hyperintensity was seen in the inferior olivary nuclei in FLAIR and T2-weighted sequences. No signal alterations were seen on T1-weighted sequences, and no enhancement was seen after intravenous injection of contrast material. In the cases studied by diffusion-weighted imaging, no significant alterations were seen in these sequences. Olivary hypertrophy was seen in all patients except in one, in whom presumably not enough time had elapsed for hypertrophy to occur. The alterations were bilateral in two of the five cases. Only one case exhibited the typical clinical manifestations. Given that patients may not present clinical manifestations that can be attributed to hypertrophic olivary degeneration, it is important to recognize the characteristic radiologic signs of this entity. Copyright © 2014 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  18. Outcomes of acute myocardial infarction in patients with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Gupta, Tanush; Harikrishnan, Prakash; Kolte, Dhaval; Khera, Sahil; Aronow, Wilbert S; Mujib, Marjan; Palaniswamy, Chandrasekar; Sule, Sachin; Jain, Diwakar; Ahmed, Ali; Lanier, Gregg M; Cooper, Howard A; Frishman, William H; Fonarow, Gregg C; Panza, Julio A

    2015-08-01

    Acute myocardial infarction is a recognized complication in patients with hypertrophic cardiomyopathy. However, limited data are available on outcomes of patients with hypertrophic cardiomyopathy and acute myocardial infarction. We analyzed the 2003-2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years with a principal diagnosis of acute myocardial infarction. Patients with a concomitant diagnosis of hypertrophic cardiomyopathy were then identified and analyzed as a separate cohort. Multivariate logistic regression was used to compare outcomes in patients with acute myocardial infarction with and without hypertrophic cardiomyopathy. Of 5,901,827 patients with acute myocardial infarction, 5688 (0.1%) had a diagnosis of hypertrophic cardiomyopathy. Patients with hypertrophic cardiomyopathy were older, more likely to be female, and less likely to have traditional cardiovascular risk factors. Compared with patients without hypertrophic cardiomyopathy, patients with hypertrophic cardiomyopathy were less likely to present with ST-elevation myocardial infarction and more likely to present with non-ST-elevation myocardial infarction. Patients with hypertrophic cardiomyopathy with ST-elevation myocardial infarction or non-ST-elevation myocardial infarction were less likely to receive revascularization. In the overall population with acute myocardial infarction, there was no difference in risk-adjusted in-hospital mortality between patients with and without hypertrophic cardiomyopathy (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.84-1.11; P = .59). In the population with ST-elevation myocardial infarction, patients with hypertrophic cardiomyopathy had lower risk-adjusted in-hospital mortality than those without hypertrophic cardiomyopathy (OR, 0.75; 95% CI, 0.63-0.91; P = .003), whereas in the population with non-ST-elevation myocardial infarction, there was no difference in risk-adjusted in-hospital mortality between patients with

  19. Currently known risk factors for hypertrophic skin scarring : A review

    NARCIS (Netherlands)

    Butzelaar, L.; Ulrich, M. M W; Mink Van Der Molen, A. B.; Niessen, F. B.; Beelen, R. H J

    2016-01-01

    SummaryObjective The study aims to provide an overview of risk factors for hypertrophic scarring. Background Hypertrophic skin scarring remains a major concern in medicine and causes considerable morbidity. Despite extensive research on this topic, the precise mechanism of excessive scarring is

  20. Topical modalities for treatment and prevention of postsurgical hypertrophic scars.

    Science.gov (United States)

    Foo, Chong Wee; Tristani-Firouzi, Payam

    2011-08-01

    There is no universally accepted treatment regimen and no evidence-based literature to guide management of hypertrophic scars. This article summarizes the existing literature regarding topical treatments such as silicone gel sheeting and ointment, onion extract, vitamin E, pressure garment therapy, massage therapy, and topical imiquimod 5% cream in the management of hypertrophic scars. 2011 Elsevier Inc. All rights reserved.

  1. The KCNE genes in hypertrophic cardiomyopathy: a candidate gene study

    DEFF Research Database (Denmark)

    Hedley, Paula L; Haundrup, Ole; Andersen, Paal S

    2011-01-01

    as well as the T-tubules of the sarcolemma. It has been suggested that minK forms part of an "electro-mechanical feed-back" which links cardiomyocyte stretching to changes in ion channel function. We examined whether mutations in KCNE genes were associated with hypertrophic cardiomyopathy (HCM), a genetic...... disease associated with an improper hypertrophic response....

  2. Septal alcoholization in hypertrophic cardiomyopathy: about 11 cases

    African Journals Online (AJOL)

    Outcomes of septal alcoholization in hypertrophic obstructive cardiomyopathy are not enough studied in all centers. The purpose of this study was to determine the outcomes of septal alcoholization in hypertrophic obstructive cardiomyopathy in our hospital. A retrospective and prospective descriptive study focused on all ...

  3. Inhibited early immunologic response is associated with hypertrophic scarring

    NARCIS (Netherlands)

    Butzelaar, Liselotte; Schooneman, Dennis P. M.; Soykan, Ezgi A.; Talhout, Wendy; Ulrich, Magda M. W.; van den Broek, Lenie J.; Gibbs, Susan; Beelen, Robert H. J.; van der Molen, Aebele B. Mink; Niessen, Frank B.

    2016-01-01

    This study aimed to examine changes in the inflammatory response in early hypertrophic compared to normal wound healing. The immune system is thought to be involved in hypertrophic scar formation. However, the exact mechanism and time of onset of the derailment remain unknown. In a prospective

  4. Psychosocial impact of specialized cardiac genetic clinics for hypertrophic cardiomyopathy.

    Science.gov (United States)

    Ingles, Jodie; Lind, Joanne M; Phongsavan, Philayrath; Semsarian, Christopher

    2008-02-01

    The diagnosis of hypertrophic cardiomyopathy, an autosomal dominant chronic heart disease, can have significant implications, including increased risk of sudden death, exercise limitations, and risk of transmission to offspring. This study sought to describe the psychosocial factors associated with attending a specialty cardiac genetic clinic, and to determine whether these may be predictors of comorbid anxiety and depression in this population. Questionnaires were sent to 184 individuals attending the Royal Prince Alfred Hospital Hypertrophic Cardiomyopathy Clinic. Questionnaires were anonymous and comprised demographics, the Hospital Anxiety and Depression Scale, Patient Experience Scales, and Patient Satisfaction Scales. Completed questionnaires were returned by 109 participants (59.2% response rate), of which 76.9% had a diagnosis of hypertrophic cardiomyopathy, while 23.1% were at-risk relatives attending for clinical screening. Patient satisfaction scores were generally high to very high across all groups, though only 24% of HCM patients showed good adjustment to hypertrophic cardiomyopathy and 10% had low worry about hypertrophic cardiomyopathy scores. Within the disease group, logistic regression analysis adjusting for age, gender, and education revealed adjustment to hypertrophic cardiomyopathy and worry about hypertrophic cardiomyopathy scores to be significantly associated with anxiety, while adjustment scores and location of patient follow-up (i.e., Hypertrophic Cardiomyopathy clinic or another cardiologist) to be significantly associated with depression scores. HCM patients who attend specialized cardiac genetic clinics are better adjusted and worry less, than those who do not attend. An integrated approach, including a genetic counselor, is important in the management of HCM families.

  5. The Role of Echocardiography in Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Jing Ping Sun

    2017-02-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is a common genetic cardiovascular disease and appears in all ethnic groups. HCM is diagnosed on the basis of left ventricular hypertrophy. Echocardiography is a key technique in the diagnosis of HCM, the prognosis of patients with HCM, the management strategy for HCM, and the follow-up of patients with HCM. This review briefly describes and discusses the practical use of established echocardiography techniques and the current and emerging echocardiographic methods that can help physicians in the correct diagnostic and pathophysiological assessment of patients with HCM.

  6. Hypertrophic Cardiomyopathy—Past, Present and Future

    Directory of Open Access Journals (Sweden)

    Alphonsus C. Liew

    2017-12-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is the most common genetic cardiomyopathy with a prevalence of 1 in 500 in the general population. Since the first pathological case series at post mortem in 1957, we have come a long way in its understanding, diagnosis and management. Here, we will describe the history of our understanding of HCM including the initial disease findings, diagnostic methods and treatment options. We will review the current guidelines for the diagnosis and management of HCM, current gaps in the evidence base and discuss the new and promising developments in this field.

  7. Blepharoptosis and hypertrophic osteoarthropathy: A case report

    Directory of Open Access Journals (Sweden)

    Aysun Sanal Dogan

    2016-01-01

    Full Text Available A 52-year-old male patient presented to our hospital with a history of secondary hypertrophic osteoarthropathy (HOA associated with an abdominal neoplasia and blepharoptosis. He had finger clubbing, hyperhidrosis, and hypertrichosis. He also had a recent history of extensive abdominal surgery with a pathology report of myelolipoma. Routine blood work was unremarkable. Upper eyelid reconstruction with blepharoplasty, upper eyelid wedge resection, and brow suspension was performed to address his eyelid concerns. By this case report, we would like to attract notice that the eyelid involvement may be a part of HOA and to emphasize the importance of systemic and pathologic evaluation in failed blepharoptosis surgery.

  8. Hypertrophic Cardiomyopathy—Past, Present and Future

    Science.gov (United States)

    Liew, Alphonsus C.; Vassiliou, Vassilios S.; Cooper, Robert; Raphael, Claire E.

    2017-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiomyopathy with a prevalence of 1 in 500 in the general population. Since the first pathological case series at post mortem in 1957, we have come a long way in its understanding, diagnosis and management. Here, we will describe the history of our understanding of HCM including the initial disease findings, diagnostic methods and treatment options. We will review the current guidelines for the diagnosis and management of HCM, current gaps in the evidence base and discuss the new and promising developments in this field. PMID:29231893

  9. Hypoxia inhibits hypertrophic differentiation and endochondral ossification in explanted tibiae.

    Directory of Open Access Journals (Sweden)

    Jeroen C H Leijten

    Full Text Available Hypertrophic differentiation of growth plate chondrocytes induces angiogenesis which alleviates hypoxia normally present in cartilage. In the current study, we aim to determine whether alleviation of hypoxia is merely a downstream effect of hypertrophic differentiation as previously described or whether alleviation of hypoxia and consequent changes in oxygen tension mediated signaling events also plays an active role in regulating the hypertrophic differentiation process itself.Fetal mouse tibiae (E17.5 explants were cultured up to 21 days under normoxic or hypoxic conditions (21% and 2.5% oxygen respectively. Tibiae were analyzed on growth kinetics, histology, gene expression and protein secretion.The oxygen level had a strong influence on the development of explanted fetal tibiae. Compared to hypoxia, normoxia increased the length of the tibiae, length of the hypertrophic zone, calcification of the cartilage and mRNA levels of hypertrophic differentiation-related genes e.g. MMP9, MMP13, RUNX2, COL10A1 and ALPL. Compared to normoxia, hypoxia increased the size of the cartilaginous epiphysis, length of the resting zone, calcification of the bone and mRNA levels of hyaline cartilage-related genes e.g. ACAN, COL2A1 and SOX9. Additionally, hypoxia enhanced the mRNA and protein expression of the secreted articular cartilage markers GREM1, FRZB and DKK1, which are able to inhibit hypertrophic differentiation.Collectively our data suggests that oxygen levels play an active role in the regulation of hypertrophic differentiation of hyaline chondrocytes. Normoxia stimulates hypertrophic differentiation evidenced by the expression of hypertrophic differentiation related genes. In contrast, hypoxia suppresses hypertrophic differentiation of chondrocytes, which might be at least partially explained by the induction of GREM1, FRZB and DKK1 expression.

  10. The 50-Year History, Controversy, and Clinical Implications of Left Ventricular Outflow Tract Obstruction in Hypertrophic Cardiomyopathy: From Idiopathic Hypertrophic Subaortic Stenosis to Hypertrophic Cardiomyopathy

    National Research Council Canada - National Science Library

    Barry J Maron; Martin S Maron; E Douglas Wigle; Eugene Braunwald

    2009-01-01

    ...) clinical descriptions of hypertrophic cardiomyopathy (HCM) and has proved to be a complex phenomenon unique in many respects, as well as arguably the most visible and well-known pathophysiologic component of this heterogeneous disease...

  11. Apical hypertrophic cardiomyopathy: clinical and metabolic studies.

    Science.gov (United States)

    Bertrand, M E; Tilmant, P Y; Lablanche, J M; Thieuleux, F A

    1983-11-01

    Among the hypertrophic non-obstructive cardiomyopathies, a particular group of patients with concentric apical hypertrophy can be described. We studied seven patients (five men and two women) who underwent heart catheterization because they had giant negative T waves in the precordial leads. M-mode and two-dimensional echocardiograms revealed no obstruction within the outflow tract of the ventricle. Coronary angiography was normal in all cases. None of these patients demonstrated any significant peak systolic pressure gradient in the outflow tract. A characteristic spade-like configuration (concentric apical hypertrophy) was observed in the right anterior oblique ventriculogram at end diastole. The apical thickness reached 17.2 +/- 0.85 mm and was significantly greater than mid-anterior wall thickness (9.8 +/- 2.14 mm). In five cases, atrial pacing with coronary arterial and venous lactate sampling revealed abnormalities in myocardial metabolism. With a mean follow up of 43 months, three patients remain asymptomatic and one had heart failure. ECG abnormalities were unchanged and echocardiograms showed an increase of the septal and posterior wall thickness, suggesting a transformation in concentric diffuse hypertrophic cardiomyopathy.

  12. Clinical predictors of genetic testing outcomes in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Ingles, Jodie; Sarina, Tanya; Yeates, Laura; Hunt, Lauren; Macciocca, Ivan; McCormack, Louise; Winship, Ingrid; McGaughran, Julie; Atherton, John; Semsarian, Christopher

    2013-12-01

    Genetic testing for hypertrophic cardiomyopathy has been commercially available for almost a decade; however, low mutation detection rate and cost have hindered uptake. This study sought to identify clinical variables that can predict probands with hypertrophic cardiomyopathy in whom a pathogenic mutation will be identified. Probands attending specialized cardiac genetic clinics across Australia over a 10-year period (2002-2011), who met clinical diagnostic criteria for hypertrophic cardiomyopathy and who underwent genetic testing for hypertrophic cardiomyopathy were included. Clinical, family history, and genotype information were collected. A total of 265 unrelated individuals with hypertrophic cardiomyopathy were included, with 138 (52%) having at least one mutation identified. The mutation detection rate was significantly higher in the probands with hypertrophic cardiomyopathy with an established family history of disease (72 vs. 29%, P < 0.0001), and a positive family history of sudden cardiac death further increased the detection rate (89 vs. 59%, P < 0.0001). Multivariate analysis identified female gender, increased left-ventricular wall thickness, family history of hypertrophic cardiomyopathy, and family history of sudden cardiac death as being associated with greatest chance of identifying a gene mutation. Multiple mutation carriers (n = 16, 6%) were more likely to have suffered an out-of-hospital cardiac arrest or sudden cardiac death (31 vs. 7%, P = 0.012). Family history is a key clinical predictor of a positive genetic diagnosis and has direct clinical relevance, particularly in the pretest genetic counseling setting.

  13. Rupture of mitral valve chordae in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Boissier, Florence; Achkouty, Guy; Bruneval, Patrick; Fabiani, Jean-Noël; Nguyen, Anh Tuan; Riant, Elisabeth; Desnos, Michel; Hagège, Albert

    2015-04-01

    While occasional reports of mitral valve chordal rupture have been described in hypertrophic cardiomyopathy, the exact prevalence and characteristics of this event in a large medical cohort have not been reported. To assess the prevalence of mitral valve chordal rupture in hypertrophic cardiomyopathy and the clinical, echocardiographic, surgical and histological profiles of those patients. We searched for patients with mitral valve chordal rupture diagnosed by echocardiography among all electronic files of patients admitted to our centre for hypertrophic cardiomyopathy between 2000 and 2010. Among 580 patients admitted for hypertrophic cardiomyopathy, six patients (1%, 5 men, age 68-71 years) presented with mitral valve chordal rupture, symptomatic in five cases, always involving the posterior mitral leaflet. In all cases, echocardiography before rupture showed mitral valve systolic anterior motion, with anterior (and not posterior) leaflet elongation compared with a random sample of patients with non-obstructive hypertrophic cardiomyopathy (P=0.006) (and similar to that observed in obstructive hypertrophic cardiomyopathy). Significant resting left ventricular outflow tract obstruction was always present before rupture and disappeared after rupture in the five cases requiring mitral valve surgery for severe mitral regurgitation. Histological findings were consistent with extensive myxomatous degeneration in all cases. Mitral valve chordal rupture is: infrequent in hypertrophic cardiomyopathy; occurs in aged patients with obstructive disease; involves, essentially, the posterior mitral leaflet; and causes, in general, severe mitral regurgitation requiring surgery. Myxomatous degeneration may be the substrate for rupture in these patients. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Determining shallow aquifer vulnerability by the DRASTIC model ...

    Indian Academy of Sciences (India)

    Shallow aquifer vulnerability has been assessed using GIS-based DRASTIC model by incorporating the major geological and hydrogeological factors that affect and control the groundwater contamination in a granitic terrain. It provides a relative indication of aquifer vulnerability to the contamination. Further, it has been ...

  15. Determining shallow aquifer vulnerability by the DRASTIC model ...

    Indian Academy of Sciences (India)

    N C Mondal

    2017-09-02

    Sep 2, 2017 ... Shallow aquifer vulnerability has been assessed using GIS-based DRASTIC model by incorporating the major geological and hydrogeological factors that affect and control the groundwater contamination in a granitic terrain. It provides a relative indication of aquifer vulnerability to the contamination.

  16. Cardiovascular magnetic resonance in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Shiozaki, Afonso Akio; Parga, Jose Rodrigues; Arteaga, Edmundo; Rochitte, Carlos Eduardo [Sao Paulo Univ. (USP), SP (Brazil). Instituto do Coracao. Setor de Tomografia Computarizada e Ressonancia Magnetica Cardiovascular]. E-mail: rochitte@incor.usp.br; Kim, Raymond J. [Duke Cardiovascular Magnetic Resonance Center, Durham, NC (United States); Tassi, Eduardo Marinho [Diagnosticos da America S.A., Rio de Janeiro, RJ (Brazil). Sector of Cardiovascular Magnetic Resonance and Computed Tomography

    2007-03-15

    Hypertrophic cardiomyopathy (HCM) is the most frequent genetic cardiac disease that causes sudden death in young people, with an incidence of 1:500 adults. The routinely used criteria for worst prognosis have limited sensitivity and specificity. Thus, the estimated risk of evolving to dilated cardiomyopathy or sudden death is somewhat inaccurate, leading to management uncertainty of HCM patients. Therefore, an accurate noninvasive method for the diagnosis of HCM with prognostic value is of great importance. In the last years, Cardiovascular Magnetic Resonance (CMR) emerged not only as a diagnostic tool, but also as a study with prognostic values, by characterizing myocardial fibrosis with great accuracy in HCM patients. Additionally, CMR identifies the types of hypertrophy, analyses the ventricular function, estimates the intraventricular gradient and allows the determination of differential diagnosis. Moreover, CMR can uniquely access myocardial fibrosis in HCM. (author)

  17. Electrodiagnostic evaluation in feline hypertrophic muscular dystrophy.

    Science.gov (United States)

    Howard, J; Jaggy, A; Busato, A; Gaschen, F

    2004-07-01

    Standard needle electromyography (EMG) of 56 muscles and nerve conduction velocities (NCV) of the ulnar and common peroneal nerves were investigated in each of six cats affected with hypertrophic feline muscular dystrophy, 10 related heterozygote carriers and 10 normal cats. The EMG findings were considered normal in carrier and control cats, and consisted of 33% normal readings, 22% myotonic discharges, 18% fibrillation potentials, 11% prolonged insertional potentials, 10% complex repetitive discharges and 6% positive sharp waves in affected cats. Muscles of the proximal limbs were most frequently affected. No differences in NCV were found between the three cat groups. It was concluded that dystrophin-deficient dystrophic cats have widespread and frequent EMG changes, predominantly myotonic discharges and fibrillation potentials, which are most pronounced in the proximal appendicular muscles.

  18. MT-CYB mutations in hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Hagen, Christian M; Aidt, Frederik H; Havndrup, Ole

    2013-01-01

    Mitochondrial dysfunction is a characteristic of heart failure. Mutations in mitochondrial DNA, particularly in MT-CYB coding for cytochrome B in complex III (CIII), have been associated with isolated hypertrophic cardiomyopathy (HCM). We hypothesized that MT-CYB mutations might play an important...... and m.15482T>C; p.S246P were identified. Modeling showed that the p.C93Y mutation leads to disruption of the tertiary structure of Cytb by helix displacement, interfering with protein-heme interaction. The p.S246P mutation induces a diproline structure, which alters local secondary structure and induces...... of HCM patients. We propose that further patients with HCM should be examined for mutations in MT-CYB in order to clarify the role of these variants....

  19. Hypertrophic Obesity and Subcutaneous Adipose Tissue Dysfunction

    Directory of Open Access Journals (Sweden)

    Anna Meiliana

    2014-08-01

    Full Text Available BACKGROUND: Over the past 50 years, scientists have recognized that not all adipose tissue is alike, and that health risk is associated with the location as well as the amount of body fat. Different depots are sufficiently distinct with respect to fatty-acid storage and release as to probably play unique roles in human physiology. Whether fat redistribution causes metabolic disease or whether it is a marker of underlying processes that are primarily responsible is an open question. CONTENT: The limited expandability of the subcutaneous adipose tissue leads to inappropriate adipose cell expansion (hypertrophic obesity with local inflammation and a dysregulated and insulin-resistant adipose tissue. The inability to store excess fat in the subcutaneous adipose tissue is a likely key mechanism for promoting ectopic fat accumulation in tissues and areas where fat can be stored, including the intra-abdominal and visceral areas, in the liver, epi/pericardial area, around vessels, in the myocardium, and in the skeletal muscles. Many studies have implicated ectopic fat accumulation and the associated lipotoxicity as the major determinant of the metabolic complications of obesity driving systemic insulin resistance, inflammation, hepatic glucose production, and dyslipidemia. SUMMARY: In summary, hypertrophic obesity is due to an impaired ability to recruit and differentiate available adipose precursor cells in the subcutaneous adipose tissue. Thus, the subcutaneous adipose tissue may be particular in its limited ability in certain individuals to undergo adipogenesis during weight increase. Inability to promote subcutaneous adipogenesis under periods of affluence would favor lipid overlow and ectopic fat accumulation with negative metabolic consequences. KEYWORDS: obesity, adipogenesis, subcutaneous adipose tissue, visceral adipose tissue, adipocyte dysfunction.

  20. Current Therapeutic Approach to Hypertrophic Scars

    Directory of Open Access Journals (Sweden)

    Zrinka Bukvić Mokos

    2017-06-01

    Full Text Available Abnormal scarring and its accompanying esthetic, functional, and psychological sequelae still pose significant challe nges. To date, there is no satisfactory prevention or treatment option for hypertrophic scars (HSs, which is mostly due to not completely comprehending the mechanisms underlying their formation. That is why the apprehension of regular and controlled physiological processes of scar formation is of utmost importance when facing hypertrophic scarring, its pathophysiology, prevention, and therapeutic approach. When treating HSs and choosing the best treatment and prevention modality, physicians can choose from a plethora of therapeutic options and many commercially available products, among which currently there is no efficient option that can successfully overcome impaired skin healing. This article reviews current therapeutic approach and emerging therapeutic strategies for the management of HSs, which should be individualized, based on an evaluation of the scar itself, patients’ expectations, and practical, evidence-based guidelines. Clinicians are encouraged to combine various prevention and treatment modalities where combination therapy that includes steroid injections, 5-fluorouracil, and pulsed-dye laser seems to be the most effective. On the other hand, the current therapeutic options are usually empirical and their results are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a particular factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extracellular matrix has a crucial role in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may throw up new therapeutic approach for reduction or prevention of HSs with functionally and cosmetically acceptable outcome.

  1. Hypertrophic Synovitis of the Facet Joint Causing Root Pain

    Directory of Open Access Journals (Sweden)

    Koichi Iwatsuki M.D.

    2008-01-01

    Full Text Available Osteoarthritic changes in the facet joints are common in the presence of degenerative disc disease. Changes in the joint capsule accompany changes in the articular surfaces. Intraspinal synovial cysts that cause radicular pain, cauda equina syndrome, and myelopathy have been reported; however, there have been few reports in orthopedic or neurosurgical literature regarding hypertrophic synovitis of the facet joint presenting as an incidental para-articular mass. Here, we report a case of hypertrophic synovitis causing root pain. We describe the case of a 65-year-old man suffering from right sciatica and right leg pain in the L5 nerve-root dermatome for 1 year; magnetic resonance imaging (MRI revealed an enhanced mass around the L4–5 facet joint. We investigated this mass pathologically. After right medial facetectomy, the symptoms resolved. Pathological investigation revealed this mass was hypertrophic synovitis. Hypertrophic synovitis of the facet joint might cause root pain.

  2. Regional ischemia in hypertrophic Langendorff-perfused rat hearts

    NARCIS (Netherlands)

    J.F. Ashruf; C. Ince (Can); H.A. Bruining (Hajo)

    1999-01-01

    textabstractMyocardial hypertrophy decreases the muscle mass-to-vascularization ratio, thereby changing myocardial perfusion. The effect of these changes on myocardial oxygenation in hypertrophic Langendorff-perfused rat hearts was measured using epimyocardial NADH

  3. Hypertrophic Pulmonary Osteoarthropathy Associated with Primary Adenocarcinoma of the Lung

    OpenAIRE

    Ayabe, Hiroyoshi; Hisano, Hiroshi; Oka, Tadayuki; Tsuji, Hiroharu; Hara, Shinsuke; Tagawa, Yutaka; Kawahara, Katsunobu; Tomita, Masaotomita

    1991-01-01

    Hypertrophic pulmonary osteoarthropathy (HPOA) associated with primary lung cancer is reported in a fifty-four-year-old man. Symptoms of HPOA were makedly improved following lung resection for adenocarcinoma of the lung.

  4. Cyanobacteria-phytoplankton dynamics of a hypertrophic African lake

    CSIR Research Space (South Africa)

    Zohary, T

    1995-01-01

    Full Text Available Phytoplankton species composition and abundance were recorded weekly or biweekly for nearly 7 years in a hypertrophic lake ( Hartbeespoort Dam, South Africa), together with a range of physical and chemical parameters. A total of 73 species were...

  5. On the surgical treatment of hypertrophic scars: a comprehensive guideline for the surgical treatment of hypertrophic scars

    NARCIS (Netherlands)

    Stekelenburg, C.M.; van der Wal, M.B.A.; Middelkoop, E.; Niessen, F.B.; van Zuijlen, P.P.M.

    2012-01-01

    Background: Treating the hypertrophic scar remains a challenging problem. It often leaves the clinician with the questions whether, when and how to treat a hypertrophic scar. Methods: This review will focus on the surgical treatment of hypertrophic scars considering the latest research in this

  6. A novel instrument aimed at measuring hypertrophic scar formation

    Energy Technology Data Exchange (ETDEWEB)

    Ramella-Roman, J C; Nguyen, T A; Lemaillet, P [Department of Biomedical Engineering, Catholic University of America (United States); Pavlovich, A R; Jordan, M H; Shupp, J W, E-mail: ramella@cua.edu [Burn Center, Department of Surgery, Washington Hospital Center-MedStar Health Research Institute, Washington, DC (United States)

    2011-01-01

    Hypertrophic scaring is a condition that can occur after thermal trauma and can lead to loss of function and psyco-social complications. Assessment of the development of a hypertrophic scar currently relies on visual inspection and grading. In this paper we propose a system based on polarized illumination and collection capable of capturing images of scars and quantify their roughness. Models of rough surface roughness are ultimately used to quantify the level of roughness of scarred skin compared to normal skin.

  7. Hypertrophic cardiomyopathy with mid-ventricular obstruction and apical aneurysm

    Directory of Open Access Journals (Sweden)

    N.D. Oryshchyn

    2016-11-01

    Full Text Available A case report of apical left ventricular aneurysm in patient with hypertrophic cardiomyopathy with mid-ventricular obstruction (diagnosis and surgical treatment is presented. We revealed apical aneurysm and mid-ventricular obstruction during echocardiography and specified anatomical characteristics of aneurysm during computer tomography. There was no evidence of obstructive coronary artery disease during coronary angiography. Taking into consideration multiple cerebral infarcts, aneurysm resection and left ventricular plastics was performed. Electronic microscopy of myocardium confirmed the diagnosis of hypertrophic cardiomyopathy.

  8. Rapid shallow breathing

    Science.gov (United States)

    ... the smallest air passages of the lungs in children ( bronchiolitis ) Pneumonia or other lung infection Transient tachypnea of the newborn Anxiety and panic Other serious lung disease Home Care Rapid, shallow breathing should not be treated at home. It is ...

  9. Comparison among patients with hypertrophic cardiomyopathy, hypertrophic cardiomyopathy with hypertension and hypertensive heart disease by {sup 123}I-BMIPP myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yoneyama, Satoshi; Sugihara, Hiroki; Ito, Kazuki [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1997-12-01

    The usefulness of {sup 123}I-BMIPP myocardial SPECT in discriminating hypertrophic cardiomyopathy (46 patients), hypertrophic cardiomyopathy with hypertension (23 patients), and hypertensive hypertrophic heart (20 patients) was studied. SPECT image was divided into 17 domains, and dimension of decreased accumulation was decided visually at each domain as four classes called defect score (DS). Summation of DS (TDS) of each group was used to compare frequency and dimension of decreased accumulation, and characteristic of each site. Frequency of decreased accumulation and TDS in hypertrophic cardiomyopathy were similar in dimension with those in hypertrophic cardiomyopathy with hypertension, and those data in hypertensive hypertrophic heart were lower than those in above-mentioned 2 groups. In the cases of hypertrophic cardiomyopathy and hypertrophic cardiomyopathy with hypertension, decreased accumulation site was similar and was anterior wall-septum junction, septum-posterior wall junction and apex of heart. In the case of hypertensive hypertrophic heart, decreased accumulation site was only the posterior wall. Frequency, dimension and site of decreased accumulation in hypertrophic cardiomyopathy were different from those in hypertensive hypertrophic heart, and BMIPP was thought to be useful in discriminating these diseases. (K.H.)

  10. [Hypertrophic cardiomyopathy with left ventricular dilatation].

    Science.gov (United States)

    Iwami, G; Miyazaki, Y; Matsuyama, K; Shida, M; Ooga, M; Furuta, Y; Ikeda, H; Toshima, H; Chiba, M; Koga, Y

    1988-06-01

    There is increasing interest in the notion that some patients with hypertrophic cardiomyopathy (HCM) progress to morphological and functional manifestations similar to those of dilated cardiomyopathy (DCM). From 165 consecutive patients with HCM, 20 patients with left ventricular dilatation (left ventricular end-diastolic diameter greater than or equal to 50 mm) were selected and designated as dilated HCM. The diagnosis of HCM was established in these patients either by detection of the classical form of HCM in family members, with 2-dimensional echocardiographic evidence of asymmetric septal hypertrophy (ASH; septal thickness greater than or equal to 15 mm and a ratio of septal to posterior wall thickness greater than or equal to 1.3); or by demonstrating myocardial fiber disarray in autopsy or biopsy samples. The clinical manifestations of these patients with dilated HCM were then compared with those of other forms of HCM without left ventricular dilatation; 1) 40 patients with hypertrophic obstructive cardiomyopathy (HOCM) who had resting intraventricular pressure gradients of 20 mmHg or more, 2) 80 patients with non-obstructive HCM, each of whom had ASH of the entire ventricular septum (typical ASH), and 3) 25 non-obstructive patients whose hypertrophy was localized to the apical region of the ventricular septum (apical ASH). Patients having apical hypertrophy with a spade-like configuration on the left ventriculogram were excluded from the study. Compared with HOCM and typical ASH groups, the patients with dilated HCM had family histories of significantly more frequent HCM and less frequent hypertension. The patients with dilated HCM also had significantly less fractional shortening (FS), decreased interventricular septal thickness, greater left ventricular end-diastolic pressure (LVEDP), and left ventricular dilatation. During the follow-up period (average: 3.5 years), seven patients (35%) with dilated HCM died; five from congestive heart failure (CHF), one

  11. Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment.

    Science.gov (United States)

    Berman, Brian; Maderal, Andrea; Raphael, Brian

    2017-01-01

    Keloid and hypertrophic scars represent an aberrant response to the wound healing process. These scars are characterized by dysregulated growth with excessive collagen formation, and can be cosmetically and functionally disruptive to patients. Objectives are to describe the pathophysiology of keloid and hypertrophic scar, and to compare differences with the normal wound healing process. The classification of keloids and hypertrophic scars are then discussed. Finally, various treatment options including prevention, conventional therapies, surgical therapies, and adjuvant therapies are described in detail. Literature review was performed identifying relevant publications pertaining to the pathophysiology, classification, and treatment of keloid and hypertrophic scars. Though the pathophysiology of keloid and hypertrophic scars is not completely known, various cytokines have been implicated, including interleukin (IL)-6, IL-8, and IL-10, as well as various growth factors including transforming growth factor-beta and platelet-derived growth factor. Numerous treatments have been studied for keloid and hypertrophic scars,which include conventional therapies such as occlusive dressings, compression therapy, and steroids; surgical therapies such as excision and cryosurgery; and adjuvant and emerging therapies including radiation therapy, interferon, 5-fluorouracil, imiquimod, tacrolimus, sirolimus, bleomycin, doxorubicin, transforming growth factor-beta, epidermal growth factor, verapamil, retinoic acid, tamoxifen, botulinum toxin A, onion extract, silicone-based camouflage, hydrogel scaffold, and skin tension offloading device. Keloid and hypertrophic scars remain a challenging condition, with potential cosmetic and functional consequences to patients. Several therapies exist which function through different mechanisms. Better understanding into the pathogenesis will allow for development of newer and more targeted therapies in the future.

  12. Hypertrophic osteopathy associated with mycotic pneumonia in two juvenile elk (Cervus elaphus).

    Science.gov (United States)

    Ferguson, Nicole M; Lévy, Michel; Ramos-Vara, José A; Baird, Debra K; Wu, Ching Ching

    2008-11-01

    Two yearling bull elk (cervus claphus) from the same farm developed anorexia, weight loss, and lameness. On physical examination, both elk were thin and showed diffuse swelling of all lower limbs. Radiographs of the lower limbs showed periosteal thickening of the distal extremities, consistent with hypertrophic osteopathy. Thoracic radiographs indicated the presence of pulmonary nodules. Cytologic evaluations of tracheal washes on both elk were consistent with inflammation. Acid-fast stains on both samples were negative. Because of the poor prognosis, both elk were euthanized. At necropsy, the carpal, metacarpal, tarsal, and metatarsal bones, as well as the radius, ulna, and tibia had thickening of cortical bone. There were multiple encapsulated nodules throughout the lungs, lymph nodes, and kidney, and smaller nodules in the myocardium. On microscopic examination, these nodules contained myriads of hyphae, and immunohistochemistry for Aspergillus sp. was strongly positive. Aspergillus fumigatus was isolated from affected tissue in 1 elk. Necropsy findings in both elk were consistent with disseminated fungal granulomas and periosteal hyperostosis. This case presents the first description of hypertrophic osteopathy in elk. The source of infection was undetermined, but inhalation of spores from contaminated feed or bedding was suspected.

  13. Hypertrophic osteoarthropathy associated with metastatic melanoma.

    Science.gov (United States)

    Thompson, Michael A; Warner, Noranna B; Hwu, Wen-Jen

    2005-12-01

    Hypertrophic osteoarthropathy (HOA) is one of the paraneoplastic syndromes most commonly associated with non-small-cell lung cancer. Although pulmonary metastasis is the second most common initial site of melanoma metastasis, HOA is rarely detected in patients with metastatic melanoma in the lung. We report a case of a 45-year-old woman with advanced melanoma who developed HOA after her disease had progressed through first-line systemic therapy. The patient's diagnosis of HOA was made on the basis of digital clubbing, arthralgia, pain, joint effusion and periosteal bone formation on X-ray with negative rheumatologic laboratory studies. Only six cases of HOA in metastatic melanoma have been reported previously. This diagnosis should be considered with lung metastases and the presentation of polyarthralgia with appropriate laboratory and imaging findings. Interestingly, the patient responded to bisphosphonates and second-line chemotherapy with carboplatin and paclitaxel, which is commonly used for lung cancer, not advanced melanoma. As with many paraneoplastic syndromes, successful treatment of the underlying disease was associated with a rapid resolution of the symptoms.

  14. Right ventricular involvement in feline hypertrophic cardiomyopathy.

    Science.gov (United States)

    Schober, K E; Savino, S I; Yildiz, V

    2016-12-01

    To evaluate right ventricular (RV) wall thickness and chamber dimensions in cats with hypertrophic cardiomyopathy (HCM). One hundred fifty-one healthy control cats and 200 cats with HCM. Retrospective, observational, clinical cohort study. Two-dimensional echocardiograms from all cats were analyzed. Right atrial diameter, RV free wall thickness, and RV chamber diameter were quantified using multiple imaging views. Conventional (mean ± 2 standard deviations) and allometrically scaled (Y = a × M b ) reference values were determined in normal cats and compared to values found in cats with HCM. Linear and logistic regression, multivariate regression, and mixed model analysis were performed to identify associations between RV wall thickness and severity of left ventricular (LV) hypertrophy, clinical severity of HCM, and presence of pleural effusion. Mean RV wall thickness was increased in HCM (p0.05) in control cats. Increased RV wall thickness is common in cats with HCM and relates to severity of LV hypertrophy and clinical status. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. A One Health Approach to Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Ueda, Yu; Stern, Joshua A.

    2017-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease in humans and results in significant morbidity and mortality. Research over the past 25 years has contributed enormous insight into this inherited disease particularly in the areas of genetics, molecular mechanisms, and pathophysiology. Our understanding continues to be limited by the heterogeneity of clinical presentations with various genetic mutations associated with HCM. Transgenic mouse models have been utilized especially studying the genotypic and phenotypic interactions. However, mice possess intrinsic cardiac and hemodynamic differences compared to humans and have limitations preventing their direct translation. Other animal models of HCM have been studied or generated in part to overcome these limitations. HCM in cats shows strikingly similar molecular, histopathological, and genetic similarities to human HCM, and offers an important translational opportunity for the study of this disease. Recently, inherited left ventricular hypertrophy in rhesus macaques was identified and collaborative investigations have been conducted to begin to develop a non-human primate HCM model. These naturally-occurring large-animal models may aid in advancing our understanding of HCM and developing novel therapeutic approaches to this disease. This review will highlight the features of HCM in humans and the relevant available and developing animal models of this condition. PMID:28955182

  16. MR imaging findings of hypertrophic olivary degeneration

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Do Joong; Jeon, Pyung; Kim, Dong Ik [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

    1997-06-01

    To describe the magnetic resonance (MR) imaging findings of hypertrophic olivary degeneration (HOD) MR images of seven patients with HOD were retrospectively reviewed. Two were women and five were men, and they were aged between 48 and 65 (mean 58) years. Imaging examinations were performed with a 1.5-T unit, and the findings were used to evaluate the size and signal intensity of olivary lesions. The time interval from hemorrhagic ictus to MR imaging was between two and 30 months. Follow-up examinations were performed in two patients. All four patients with hemorrhages involving the central tegmental tract in the pons or midbrain showed ipsilateral HOD. Among these four, bilateral HOD was seen in one patient with hemorrhage involving the bilateral central tegmental tract, and in another with tegmental hemorrhage extending to the ipsilateral superior cerebellar peduncle. One patient with cerebellar hemorrhage involving the dentate nucleus had contralateral HOD. Two patients with multiple hemorrhages involving both the pons and cerebellum showed bilateral HOD. Axial MR images showed mild enlargement of the involved olivary mucleus, with high signal intensity on both proton density and T2 weighted images. There was no apparent enhancement on postcontrast T1-weighted images. MR imaging can clearly distinguish secondary olivary degeneration from underlying pathology involving the central tegmental tract in the pons or midbrain and cerebellum. These olivary abnormalities should not, however, be mistaken for primary medullary lesions.

  17. Omentin functions to attenuate cardiac hypertrophic response.

    Science.gov (United States)

    Matsuo, Kazuhiro; Shibata, Rei; Ohashi, Koji; Kambara, Takahiro; Uemura, Yusuke; Hiramatsu-Ito, Mizuho; Enomoto, Takashi; Yuasa, Daisuke; Joki, Yusuke; Ito, Masanori; Hayakawa, Satoko; Ogawa, Hayato; Kihara, Shinji; Murohara, Toyoaki; Ouchi, Noriyuki

    2015-02-01

    Cardiac hypertrophy occurs in many obesity-related conditions. Omentin is an adipose-derived plasma protein that is downregulated under obese conditions. Here, we investigated whether omentin modulates cardiac hypertrophic responses in vivo and in vitro. Systemic administration of an adenoviral vector expressing human omentin (Ad-OMT) to wild-type (WT) mice led to the attenuation of cardiac hypertrophy, fibrosis and ERK phosphorylation induced by transverse aortic constriction (TAC) or angiotensin II infusion. In cultured cardiomyocytes, stimulation with phenylephrine (PE) led to an increase in myocyte size, which was prevented by pretreatment with human omentin protein. Pretreatment of cardiomyocytes with omentin protein also reduced ERK phosphorylation in response to PE stimulation. Ad-OMT enhanced phosphorylation of AMP-activated protein kinase (AMPK) in the heart of WT mice after TAC operation. Blockade of AMPK activation by transduction with dominant-negative mutant forms of AMPK reversed the inhibitory effect of omentin on myocyte hypertrophy and ERK phosphorylation following PE stimulation. Moreover, fat-specific transgenic mice expressing human omentin showed reduced cardiac hypertrophy and ERK phosphorylation following TAC surgery compared to littermate controls. These data suggest that omentin functions to attenuate the pathological process of myocardial hypertrophy via the activation of AMPK in the heart, suggesting that omentin may represent a target molecule for the treatment of cardiac hypertrophy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Hypertrophic cardiomyopathy in adults: an overview.

    Science.gov (United States)

    Jacobs, Cynthia

    2014-09-01

    To present an overview of clinical issues related to adults with hypertrophic cardiomyopathy (HCM), their presenting symptoms, diagnosis, physical examination findings, treatment, and follow-up care. A comprehensive search of Medline (PubMed) and CINAHL was conducted using the key terms HCM, treatment, diagnosis, sudden cardiac death (SCD), and complications. This search yielded 21 articles used for this article. There were three reference books used for background, diagnosis, and treatment information as well. Although HCM is the most prevalent genetic disorder affecting the heart, it often goes undiagnosed until midlife after patients show symptoms of myocardial remodeling. Adults with cardiomyopathy suffer SCD or adverse events such as stroke and heart failure from HCM. Early diagnosis will prevent SCD, improve quality of life, and slow patient's progression to heart failure. Early recognition of HCM in adults by their primary care providers will improve patients' quality of life and reduce incidence of SCD, heart failure, and stroke. ©2014 American Association of Nurse Practitioners.

  19. Prevalence of hypertrophic cardiomyopathy in highly trained athletes: relevance to pre-participation screening

    National Research Council Canada - National Science Library

    Basavarajaiah, Sandeep; Wilson, Matthew; Whyte, Gregory; Shah, Ajay; McKenna, William; Sharma, Sanjay

    2008-01-01

    This study sought to determine the prevalence of hypertrophic cardiomyopathy (HCM) in elite athletes. Hypertrophic cardiomyopathy is considered to be the most common cause of exercise-related sudden death in young athletes...

  20. HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY AS A SIDE-EFFECT OF DEXAMETHASONE TREATMENT FOR BRONCHOPULMONARY DYSPLASIA

    NARCIS (Netherlands)

    BRAND, PLP; VANLINGEN, RA; BRUS, F; TALSMA, MD; ELZENGA, NJ

    1993-01-01

    We report three infants who developed hypertrophic obstructive cardiomyopathy during dexamethasone treatment for bronchopulmonary dysplasia. In all three infants, echocardiography had ruled out cardiac abnormalities prior to the dexamethasone course. The hypertrophic obstructive cardiomyopathy

  1. Pharmacological and non-pharmacological treatment of obstructive hypertrophic cardiomyopathy.

    Science.gov (United States)

    Hidalgo, Luis F; Naidu, Srihari S; Aronow, Wilbert S

    2018-01-01

    Hypertrophic obstructive cardiomyopathy has been rising in prevalence, due to increased awareness and advanced imaging. For the symptomatic patient, pharmacological management remains an effective approach to the majority of patients with obstructive hypertrophic cardiomyopathy. However, a significant subset fails to improve sufficiently with medical therapy initially, or progressively becomes more symptomatic despite augmented medications over time. Most of the advances in the treatment of obstructive hypertrophic cardiomyopathy have therefore been made in the area of non-pharmacologic management, particularly septal reduction therapy. Both surgical myectomy and alcohol septal ablation have undergone iterative modifications that improve outcomes. Current guidelines support these therapies based on large observational studies, with choice of therapy based on a variety of factors but again based primarily on expert consensus opinion. Areas covered: This article reviews both pharmacological and non-pharmacological interventions to improve outflow tract obstruction and symptoms, and provides an algorithm for addressing the symptomatic obstructive patient. Expert commentary: Current options for hypertrophic cardiomyopathy allow the majority of patients to live their lives with no more than NYHA Class 2 heart failure symptoms. Treatment algorithms can add in identification of patients who may benefit from advanced therapies, and should be instituted routinely to improve care for the majority of patients with symptomatic hypertrophic cardiomyopathy.

  2. Investigating the role of P311 in the hypertrophic scar.

    Directory of Open Access Journals (Sweden)

    Jianglin Tan

    Full Text Available The mechanisms of hypertrophic scar formation are not fully understood. We previously screened the differentially expressed genes of human hypertrophic scar tissue and identified P311 gene as upregulated. As the activities of P311 in human fibroblast function are unknown, we examined the distribution of it and the effects of forced expression or silencing of expression of P311. P311 expression was detected in fibroblast-like cells from the hypertrophic scar of burn injury patients but not in peripheral blood mononuclear cells, bone marrow mesenchymal stem cells, epidermal cells or normal skin dermal cells. Transfection of fibroblasts with P311 gene stimulated the expression of alpha-smooth muscle actin (alpha-SMA, TGF-beta1 and alpha1(I collagen (COL1A1, and enhanced the contraction of fibroblast populated collagen lattices (FPCL. In contrast, interference of fibroblast P311 gene expression decreased the TGF-beta1 mRNA expression and reduced the contraction of fibroblasts in FPCL. These results suggest that P311 may be involved in the pathogenesis of hypertrophic scar via induction of a myofibroblastic phenotype and of functions such as TGF-beta1 expression. P311 could be a novel target for the control of hypertrophic scar development.

  3. Process of Hypertrophic Scar Formation: Expression of Eukaryotic Initiation Factor 6

    OpenAIRE

    Qing-Qing Yang; Si-Si Yang; Jiang-Lin Tan; Gao-Xing Luo; Wei-Feng He; Jun Wu

    2015-01-01

    Background: Hypertrophic scar is one of the most common complications and often causes the disfigurement or deformity in burn or trauma patients. Therapeutic methods on hypertrophic scar treatment have limitations due to the poor understanding of mechanisms of hypertrophic scar formation. To throw light on the molecular mechanism of hypertrophic scar formation will definitely improve the outcome of the treatment. This study aimed to illustrate the negative role of eukaryotic initiation factor...

  4. Suppressed inflammatory gene expression during human hypertrophic scar compared to normotrophic scar formation

    NARCIS (Netherlands)

    van den Broek, L.J.; van der Veer, W.M.; de Jong, E.H.; Gibbs, S.; Niessen, F.B.

    2015-01-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic

  5. An unusual ST-segment elevation: apical hypertrophic cardiomyopathy shows the ace up its sleeve.

    Science.gov (United States)

    de Santis, Francesco; Pergolini, Amedeo; Zampi, Giordano; Pero, Gaetano; Pino, Paolo Giuseppe; Minardi, Giovanni

    2013-01-01

    Apical hypertrophic cardiomyopathy is part of the broad clinical and morphologic spectrum of hypertrophic cardiomyopathy. We report a patient with electrocardiographic abnormalities in whom acute coronary syndrome was excluded and apical hypertrophic cardiomyopathy was demonstrated by careful differential diagnosis. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  6. Hypertrophic olivary degeneration and cerebrovascular disease: movement in a triangle.

    Science.gov (United States)

    Santos, Ana Filipa; Rocha, Sofia; Varanda, Sara; Pinho, João; Rodrigues, Margarida; Ramalho Fontes, João; Soares-Fernandes, João; Ferreira, Carla

    2015-02-01

    Hypertrophic olivary degeneration is a rare kind of trans-synaptic degeneration that occurs after lesions of the dentatorubro-olivary pathway. The lesions, commonly unilateral, may result from hemorrhage due to vascular malformation, trauma, surgical intervention or hypertension, tumor, or ischemia. Bilateral cases are extremely rare. This condition is classically associated with development of palatal tremor, but clinical manifestations can include other involuntary movements. We describe 2 cases: unilateral hypertrophic olivary degeneration in a 60-year-old man with contralateral athetosis and neurologic worsening developing several years after a pontine hemorrhage and bilateral hypertrophic olivary degeneration in a 77-year-old woman with development of palatal tremor, probably secondary to pontine ischemic lesions (small vessel disease). Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  7. Hypertrophic scarring: the greatest unmet challenge following burn injury

    Science.gov (United States)

    Finnerty, Celeste C; Jeschke, Marc G; Branski, Ludwik K; Barret, Juan P.; Dziewulski, Peter; Herndon, David N

    2017-01-01

    Summary Improvements in acute burn care have enabled patients to survive massive burns which would have once been fatal. Now up to 70% of patients develop hypertrophic scars following burns. The functional and psychosocial sequelae remain a major rehabilitative challenge, decreasing quality of life and delaying reintegration into society. The current approach is to optimise the healing potential of the burn wound using targeted wound care and surgery in order to minimise the development of hypertrophic scarring. This approach often fails, and modulation of established scar is continued although the optimal indication, timing, and combination of therapies have yet to be established. The need for novel treatments is paramount, and future efforts to improve outcomes and quality of life should include optimisation of wound healing to attenuate or prevent hypertrophic scarring, well-designed trials to confirm treatment efficacy, and further elucidation of molecular mechanisms to allow development of new preventative and therapeutic strategies. PMID:27707499

  8. Hypertrophic cardiomyopathy: Part 1 - Introduction, pathology and pathophysiology

    Directory of Open Access Journals (Sweden)

    Praveen Kerala Varma

    2014-01-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is the most common genetic cardiovascular disease with many genotype and phenotype variations. Earlier terminologies, hypertrophic obstructive cardiomyopathy and idiopathic hypertrophic sub-aortic stenosis are no longer used to describe this entity. Patients present with or without left ventricular outflow tract (LVOT obstruction. Resting or provocative LVOT obstruction occurs in 70% of patients and is the most common cause of heart failure. The pathology and pathophysiology of HCM includes hypertrophy of the left ventricle with or without right ventricular hypertrophy, systolic anterior motion of mitral valve, dynamic and mechanical LVOT obstruction, mitral regurgitation, diastolic dysfunction, myocardial ischemia, and fibrosis. Thorough understanding of pathology and pathophysiology is important for anesthetic and surgical management.

  9. Scar massage for hypertrophic burns scarring-A systematic review.

    Science.gov (United States)

    Ault, P; Plaza, A; Paratz, J

    2017-06-29

    Scar massage is used in burn units globally to improve functional and cosmetic outcomes of hypertrophic scarring following a burn, however, the evidence to support this therapy is unknown. To review the literature and assess the efficacy of scar massage in hypertrophic burn scars. MEDLINE, PubMed, Embase, CINAHL and the Cochrane Library were searched using the key words "burn", "burn injury", "thermal injury" and "scar", "hypertrophic scar" and "massage", "manipulation", "soft tissue mobilisation", "soft tissue manipulation". The articles were scored by the assessors using the Physiotherapy Evidence Database (PEDro) scale and outcome measures on range of motion (ROM), cosmesis (vascularity, pliability, height), pain scores, pruritus, and psychological measures of depression and anxiety were extracted. Eight publications were included in the review with 258 human participants and 15 animal subjects who received scar massage following a thermal injury resulting in hypertrophic scarring. Outcome measures that demonstrated that scar massage was effective included scar thickness as measured with ultrasonography (p=0.001; g=-0.512); depression (Centre for Epidemiologic Studies - Depression [CES-D]) (p=0.031; g=-0.555); pain as measured with Visual Analogue Scale (VAS) (p=0.000; g=-1.133) and scar characteristics including vascularity (p=0.000; g=-1.837), pliability (p=0.000; g=-1.270) and scar height (p=0.000; g=-2.054). Outcome measures that trended towards significance included a decrease in pruritus (p=0.095; g=-1.157). It appears that there is preliminary evidence to suggest that scar massage may be effective to decrease scar height, vascularity, pliability, pain, pruritus and depression in hypertrophic burns scaring. This review reflects the poor quality of evidence and lack of consistent and valid scar assessment tools. Controlled, clinical trials are needed to develop evidence-based guidelines for scar massage in hypertrophic burns scarring. Copyright © 2017

  10. Shallow Junction Technology.

    Science.gov (United States)

    Liu, Teyin Mark

    Shallow junction technology is a necessity to maintain the performance of the scaled integrated devices in VLSL. In this work, various approaches to the process design of shallow junctions in implantation/diffusion technology are explored. The high concentration shallow arsenic implant/diffusion profile is described by the Chebyshev polynomial model. Based on the model, the inter-relationships of four design parameters: sheet resistance, junction depth, effective surface concentration, and thermal cycle are analytically derived. A general design graph for shallow arsenic junctions is developed. A similar methodology is applied to describe the high concentration boron shallow junctions design. At very high concentration, arsenic clustering and boron precipitation limit the achievable lower bound of sheet resistance. The sheet resistance is experimentally characterized and modeled. The ultimate limitations on sheet resistance due to these effects are defined. Unintentional channeling in low energy ion-implantation of boron into silicon results in much deeper junctions than predicted by LSS theory, even for wafers tilted well off the channeling directions. The channeling tail imposes an unexpected limitation on the achievable shallow junction depth. This partial channeling effect caused by boron ions being randomly scattered into crystal channels is examined by a calculation of the angular spreading for boron ions in silicon. An empirical formula is found to describe the enhancement of junction depth. To prevent the boron channeling, two methods of dechanneling are explored. Dechanneling by surface oxide layers is found to be ineffective. As-implanted junction depths much deeper than the predictions of LSS theory cannot be avoided. Based on a "lucky" ion model, the as-implanted junction depth with the surface oxide can be predicted. Silicon pre-implantation is found very effective in reducing the junction depth. The amorphization process by the silicon pre

  11. Process of Hypertrophic Scar Formation: Expression of Eukaryotic Initiation Factor 6

    Science.gov (United States)

    Yang, Qing-Qing; Yang, Si-Si; Tan, Jiang-Lin; Luo, Gao-Xing; He, Wei-Feng; Wu, Jun

    2015-01-01

    Background: Hypertrophic scar is one of the most common complications and often causes the disfigurement or deformity in burn or trauma patients. Therapeutic methods on hypertrophic scar treatment have limitations due to the poor understanding of mechanisms of hypertrophic scar formation. To throw light on the molecular mechanism of hypertrophic scar formation will definitely improve the outcome of the treatment. This study aimed to illustrate the negative role of eukaryotic initiation factor 6 (eIF6) in the process of human hypertrophic scar formation, and provide a possible indicator of hypertrophic scar treatment and a potential target molecule for hypertrophic scar. Methods: In the present study, we investigated the protein expression of eIF6 in the human hypertrophic scar of different periods by immunohistochemistry and Western blot analysis. Results: In the hypertrophic scar tissue, eIF6 expression was significantly decreased and absent in the basal layer of epidermis in the early period, and increased slowly and began to appear in the basal layer of epidermis by the scar formation time. Conclusions: This study confirmed that eIF6 expression was significantly related to the development of hypertrophic scar, and the eIF6 may be a target molecule for hypertrophic scar control or could be an indicator of the outcomes for other treatment modalities. PMID:26481747

  12. Water contamination, land prices, and the statute of repose

    Science.gov (United States)

    John F. Chamblee; Carolyn A. Dehring; Craig A. Depken; Joseph R. Nicholson

    2015-01-01

    We examine how water contamination risk from an inactive hazardous waste site is capitalized into surrounding vacant land prices. After public knowledge of the first instance of off-site contamination, we find that shallow groundwater contamination potential is negatively capitalized into land prices, as is proximity to a known contaminated well. Public knowledge of...

  13. Prognosis in hypertrophic cardiomyopathy observed in a large clinic population

    NARCIS (Netherlands)

    M.J.M. Kofflard (Marcel); D.J. Waldstein; J. Vos (Jeroen); F.J. ten Cate (Folkert)

    1993-01-01

    textabstractOverall annual cardiac mortality in hypertrophic cardiomyopathy (HC) has been reported to be between 2 and 4%, although these numbers are primarily from retrospective studies of patients referred to large research institutions. A clinic population of 113 patients with HC was

  14. Hypertrophic cardiomyopathy in South African Blacks | Lewis | South ...

    African Journals Online (AJOL)

    Hypertrophic cardiomyopathy (HCM) has been considered rare among the Black population of southern Africa. We report 7 patients with the disease who presented during a 14-month period. Current concepts in the approach to the diagnosis and treatment of HCM are discussed. It is possible that with greater awareness of ...

  15. Potential cellular and molecular causes of hypertrophic scar formation

    NARCIS (Netherlands)

    Veer, van der W.M.; Bloemen, M.C.; Ulrich, M.; Molema, G.; Zuijlen, van P.P.; Middelkoop, E.; Niessen, F.B.

    2009-01-01

    A scar is an expected result of wound healing. However, in some individuals, and particularly in burn victims, the wound healing processes may lead to a fibrotic hypertrophic scar, which is raised, red, inflexible and responsible for serious functional and cosmetic problems. It seems that a wide

  16. Potential cellular and molecular causes of hypertrophic scar formation

    NARCIS (Netherlands)

    van der Veer, Willem M.; Bloemen, Monica C. T.; Ulrich, Magda M. W.; Molema, Grietje; van Zuijlen, Paul P.; Middelkoop, Esther; Niessen, Frank B.

    A scar is an expected result of wound healing. However, in some individuals, and particularly in burn victims, the wound healing processes may lead to a fibrotic hypertrophic scar, which is raised, red, inflexible and responsible serious functional and cosmetic problems. It seems that a wide array

  17. A case of idiopathc hypertrophic pachtymeningitis | Minne | SA ...

    African Journals Online (AJOL)

    SA Journal of Radiology. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 8, No 4 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. A case of idiopathc hypertrophic pachtymeningitis. C Minne, N Khan. Abstract.

  18. Infantile hypertrophic pyloric stenosis: A case report | Okafor ...

    African Journals Online (AJOL)

    Background: The frequency of infantile hypertrophic stenosis is not known in Nigeria. The first case coming to our attention is described. Method: Descriptive case report. Results and conclusion: The infant was otherwise well with low birth weight.. A suggestive abdominal ultrasound was confirmed by barium contrast study ...

  19. Bilious Vomiting in Infantile Hypertrophic Pyloric Stenosis | Tan ...

    African Journals Online (AJOL)

    Infantile Hypertrophic Pyloric Stenosis (IHPS) is the most common cause of intestinal obstruction requiring surgery in the newborn. The exact aetiology is unknown. IHPS classically presents with non-bilious vomiting. Bilious vomiting is a rare presentation of IHPS that could lead to confusion in diagnosis. In this report we ...

  20. Gastric emptying in adults treated for infantile hypertrophic pyloric stenosis

    DEFF Research Database (Denmark)

    Rasmussen, L; Oster-Jörgensen, E; Hansen, L P

    1989-01-01

    The gastric emptying rate was scintigraphically determined in 6 women and 26 men who had undergone medical or surgical treatment for infantile hypertrophic pyloric stenosis a median of 29 years previously. Dyspeptic complaints were reported by four of the seven medically treated and nine of the 25...

  1. Orchidectomy Ameliorates the Vascular Hypertrophic Effect of A ...

    African Journals Online (AJOL)

    Dr Olaleye Samuel

    Orchidectomy Ameliorates the Vascular Hypertrophic Effect of A. High Salt Diet in Sprague-Dawley Rats. Oloyo, AK1, Vineetha VP 2 , Anigbogu CN1 and Sofola, OA1. 1Department of Physiology, College of Medicine, University of Lagos. 2Laboratory for Experimental Pathology, Biomedical Technology (BMT) Wing, Sree ...

  2. Hypertrophic Cardiomyopathy in a Middle Aged Man - A Case Report

    African Journals Online (AJOL)

    Recognition of the condition in our environment is often difficult because of dearth of facilities and expertise for echocardiograghy in most of our hospitals. Objective: To draw attention to the existence of hypertrophic cardiomyopathy in our environment and need to use echocardiography in evaluating patients with cardiac ...

  3. Penetrance of Hypertrophic Cardiomyopathy in Children and Adolescents

    DEFF Research Database (Denmark)

    Jensen, Morten K; Havndrup, Ole; Christiansen, Michael

    2013-01-01

    The penetrance of hypertrophic cardiomyopathy (HCM) during childhood and adolescence has been only sparsely described. We studied the penetrance of HCM and the short- and long-term outcomes of clinical screening and predictive genetic testing of child relatives of patients with HCM....

  4. Private mitochondrial DNA variants in danish patients with hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Hagen, Christian M; Aidt, Frederik H; Havndrup, Ole

    2015-01-01

    Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease primarily caused by mutations in genes coding for sarcomeric proteins. A molecular-genetic etiology can be established in ~60% of cases. Evolutionarily conserved mitochondrial DNA (mtDNA) haplogroups are susceptibility factors for HCM...

  5. Founder mutations in hypertrophic cardiomyopathy patients in the Netherlands

    NARCIS (Netherlands)

    Christiaans, I.; Nannenberg, E. A.; Dooijes, D.; Jongbloed, R. J. E.; Michels, M.; Postema, P. G.; Majoor-Krakauer, D.; van den Wijngaard, A.; Mannens, M. M. A. M.; van Tintelen, J. P.; van Langen, I. M.; Wilde, A. A. M.

    In this part of a series on cardiogenetic founder mutations in the Netherlands, we review the Dutch founder mutations in hypertrophic cardiomyopathy (HCM) patients. HCM is a common autosomal dominant genetic disease affecting at least one in 500 persons in the general population. Worldwide, most

  6. Infantile Hypertrophic pyloric stenosis: A retrospective study from a ...

    African Journals Online (AJOL)

    Back ground: Infantile hypertrophic pyloric stenosis(IHPS) is a common infantile disorder characterized by enlarged pyloric musculature and gastric outlet obstruction(1). IHPS typically presents with progressive projectile non-bilious vomiting this usually commences between second and eighth week of age. To date there is ...

  7. Symmetric Dimethylarginine in Cats with Hypertrophic Cardiomyopathy and Diabetes Mellitus

    DEFF Research Database (Denmark)

    Langhorn, R.; Kieler, I. N.; Koch, J.

    2018-01-01

    Background: Symmetric dimethylarginine (SDMA) has been increasingly used as a marker of early chronic kidney disease (CKD) in cats, but little is known about the influence of comorbidities on SDMA in this species. Hypothesis: Hypertrophic cardiomyopathy (HCM) and diabetes mellitus (DM), independe...

  8. Peripheral vascular structure and function in hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Rowley, N.J.; Green, D.J.; George, K.; Thijssen, D.H.J.; Oxborough, D.; Sharma, S.; Somauroo, J.D.; Jones, J.; Sheikh, N.; Whyte, G.

    2012-01-01

    BACKGROUND: Hypertrophic cardiomyopathy (HCM) is characterised by idiopathic cardiac enlargement and represents the most frequent cause of sudden cardiac death in athletes under the age of 35 years. Differentiation between physiological (ie, exercise-related) and pathological (ie, HCM-related)

  9. Quantification of Shallow Groundwater Nutrient Dynamics in Septic Areas

    Science.gov (United States)

    Ying Ouyang; Jia-En Zhang

    2012-01-01

    Of all groundwater pollution sources, septic systems are the second largest source of groundwater nitrate contamination in USA. This study investigated shallow groundwater (SGW) nutrient dynamics in septic areas at the northern part of the Lower St. Johns River Basin, Florida, USA. Thirty-five SGW-monitoring wells, located at nine different urban areas served by septic...

  10. Invasive alien species water hyacinth Eichhornia crassipes as abode for macroinvertebrates in hypertrophic Ramsar Site, Lake Xochimilco, Mexico.

    Science.gov (United States)

    Rocha-Ramirez, A; Robles-Valderrama, E; Ramirez-Flores, E

    2014-11-01

    This paper presents information on the density, diversity and functional feeding groups of macroinvertebrate assemblages associated with water hyacinth in Antiguo Canal Cuemanco, part of Lake Xochimilco in Mexico City. Rare (low frequency and density) and dominant (high frequency and density) taxa prevailed in the assemblages, with the most predominant being Hyalella azteca, Chironomus plumosus and Ischnura denticollis. Nonmetric Multidimensional Scaling confirmed two climatic seasons: warm-rainy and cold-dry; the former with the highest diversity and density of taxa. Canonical Correspondence Analysis showed that conductivity, nitrates and turbidity explained the density variations of taxa. Antiguo Canal Cuemanco waters are spatially homogeneous with the characteristics of hypertrophic shallow lakes, inhabited by scrapers and gathering-collectors. The species found were tolerant to organic pollution.

  11. Myocardial ischemia in hypertrophic cardiomyopathy; Isquemia miocardica na cardiomiopatia hipertrofica

    Energy Technology Data Exchange (ETDEWEB)

    Lima Filho, Moyses de Oliveira; Figueiredo, Geraldo L.; Simoes, Marcus V.; Pyntia, Antonio O.; Marin Neto, Jose Antonio [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia

    2000-08-01

    Myocardial ischemia in hypertrophic cardiomyopathy is multifactorial and explains the occurrence of angina, in about 50% of patients. The pathophysiology of myocardial ischemia may be explained by the increase of the ventricular mass and relative paucity of the coronary microcirculation; the elevated ventricular filling pressures and myocardial stiffness causing a compression of the coronary microvessels; the impaired coronary vasodilator flow reserve caused by anatomic and functional abnormalities; and the systolic compression of epicardial vessel (myocardial bridges). Myocardial ischemia must be investigated by perfusion scintigraphic methods since its presence influences the prognosis and has relevant clinical implications for management of patients. Patients with hypertrophic cardiomyopathy and documented myocardial ischemia usually need to undergo invasive coronary angiography to exclude the presence of concomitant atherosclerotic coronary disease. (author)

  12. Atrial myxoma in a patient with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Abdou, Mahmoud; Hayek, Salim; Williams, Byron R

    2013-01-01

    Atrial myxoma is the most common primary cardiac tumor. Patients with atrial myxoma typically present with obstructive, embolic, or systemic symptoms; asymptomatic presentation is very rare. To our knowledge, isolated association of atrial myxoma with hypertrophic cardiomyopathy has been reported only once in the English-language medical literature. We report the case of an asymptomatic 71-year-old woman with known hypertrophic cardiomyopathy in whom a left atrial mass was incidentally identified on cardiac magnetic resonance images. After surgical excision of the mass and partial excision of the left atrial septum, histopathologic analysis confirmed the diagnosis of atrial myxoma. The patient was placed on preventive implantable cardioverter-defibrillator therapy and remained asymptomatic. The management of asymptomatic cardiac myxoma is a topic of debate, because no reports definitively favor either conservative or surgical measures.

  13. Prosthodontist contribution in treating post-burn hypertrophic facial scars

    Directory of Open Access Journals (Sweden)

    Padmanabhan T

    2010-01-01

    Full Text Available The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.

  14. Clinicopathological profiles of progressive heart failure in hypertrophic cardiomyopathy

    OpenAIRE

    Melacini, Paola; Basso, Cristina; Angelini, Annalisa; Calore, Chiara; Bobbo, Fabiana; Tokajuk, Barbara; Bellini, Nicoletta; Smaniotto, Gessica; Zucchetto, Mauro; Iliceto, Sabino; Thiene, Gaetano; Maron, Barry J.

    2010-01-01

    Aims Hypertrophic cardiomyopathy (HCM) is an important cause of heart failure-related disability over a wide range of ages. Profiles of severe progressive heart failure symptoms and death, or heart transplantation deserve more complete definition within large patient cohorts. Methods and results Clinical and morphological features of heart failure were assessed in 293 consecutive HCM patients over a median follow-up of 6 (inter-quartile range 2?11) years. Gross and histopathological features ...

  15. Hypertrophic neuropathy in Noonan syndrome with multiple lentigines.

    Science.gov (United States)

    Maridet, Claire; Sole, Guilhem; Morice-Picard, Fanny; Taieb, Alain

    2016-06-01

    RASopathies comprise several genetic syndromes with mainly cardio-facial-cutaneous manifestations. We report a patient with Noonan syndrome with multiple lentigines (NSML) due to a PTPN11 (p.Thr468Met) mutation associated with hypertrophic neuropathy of lumbar plexus in an adult woman, initially referred for neuropathic pain. Differential diagnosis of neurofibromatosis type 1 (NF1) and other RASopathies is difficult without molecular testing. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Cardiac troponin T and familial hypertrophic cardiomyopathy: an energetic affair

    Science.gov (United States)

    Schwartz, Ketty; Mercadier, Jean-Jacques

    2003-01-01

    It has long been noted that while patients with familial hypertrophic cardiomyopathy due to cardiac troponin T (cTnT) mutations often suffer sudden cardiac death, they do not develop significant ventricular hypertrophy, suggesting that a distinct cellular mechanism apart from alterations in myocardial contractility is responsible. A new study has revealed that a single missense mutation in cTnT causes a striking disruption to energy metabolism, leading to cardiomyopathy. PMID:12952912

  17. Management of Keloid and Hypertrophic Scar/span>s

    Science.gov (United States)

    Edriss, A.S.; Mesták, J.

    2005-01-01

    Summary Scar management for the prevention of excessive scar formation has always been important but never so important as it is today. Optimal management continues to be an enigma for surgeons, and the best modality of treatment has been debated for many years. However, most studies have unfortunately been either retrospective or case report descriptions. Advances in scar management have been hampered by confusing or ambiguous terminology. There is no consensus on what amount of post-traumatic skin scar formation is "normal" and what should be considered "hypertrophic". In the World Health Organization's ICD-9, there is no diagnostic code for hypertrophic scar - only keloid is listed. Yet the medical and scientific literature distinguishes them as different conditions. This confusion results in inappropriate management of scar formation, and occasionally contributes to decision making related to elective or cosmetic surgery. Our experience suggests that there is no single treatment for scars that is adequate and that clinical judgement is very important when considering treatment and balancing the potential benefits of the various treatments available. The goal of treating scars is to restore functionality, provide relief of symptoms, enhance cosmetics, and prevent recurrence. This article is based on our scientific and clinical experiences and focuses on over-the-counter options to manage keloid and hypertrophic scar/span>s. PMID:21991008

  18. Two cases of apical ballooning syndrome masking apical hypertrophic cardiomyopathy.

    Science.gov (United States)

    Roy, Ranjini Raina; Hakim, Fayaz A; Hurst, R Todd; Simper, David; Appleton, Christopher P

    2014-04-01

    Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apical-variant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy.

  19. Fundamentals of Shallow Water Acoustics

    CERN Document Server

    Katsnelson, Boris; Lynch, James

    2012-01-01

    Shallow water acoustics (SWA), the study of how low and medium frequency sound propagates and scatters on the continental shelves of the world's oceans, has both technical interest and a large number of practical applications. Technically, shallow water poses an interesting medium for the study of acoustic scattering, inverse theory, and propagation physics in a complicated oceanic waveguide. Practically, shallow water acoustics has interest for geophysical exploration, marine mammal studies, and naval applications. Additionally, one notes the very interdisciplinary nature of shallow water acoustics, including acoustical physics, physical oceanography, marine geology, and marine biology. In this specialized volume, the authors, all of whom have extensive at-sea experience in U.S. and Russian research efforts, have tried to summarize the main experimental, theoretical, and computational results in shallow water acoustics, with an emphasis on providing physical insight into the topics presented.

  20. Hypertrophic Olivary Degeneration and Palatal or Oculopalatal Tremor

    Directory of Open Access Journals (Sweden)

    Caroline Tilikete

    2017-06-01

    Full Text Available Hypertrophic degeneration of the inferior olive is mainly observed in patients developing palatal tremor (PT or oculopalatal tremor (OPT. This syndrome manifests as a synchronous tremor of the palate (PT and/or eyes (OPT that may also involve other muscles from the branchial arches. It is associated with hypertrophic inferior olivary degeneration that is characterized by enlarged and vacuolated neurons, increased number and size of astrocytes, severe fibrillary gliosis, and demyelination. It appears on MRI as an increased T2/FLAIR signal intensity and enlargement of the inferior olive. There are two main conditions in which hypertrophic degeneration of the inferior olive occurs. The most frequent, studied, and reported condition is the development of PT/OPT and hypertrophic degeneration of the inferior olive in the weeks or months following a structural brainstem or cerebellar lesion. This “symptomatic” condition requires a destructive lesion in the Guillain–Mollaret pathway, which spans from the contralateral dentate nucleus via the brachium conjunctivum and the ipsilateral central tegmental tract innervating the inferior olive. The most frequent etiologies of destructive lesion are stroke (hemorrhagic more often than ischemic, brain trauma, brainstem tumors, and surgical or gamma knife treatment of brainstem cavernoma. The most accepted explanation for this symptomatic PT/OPT is that denervated olivary neurons released from inhibitory inputs enlarge and develop sustained synchronized oscillations. The cerebellum then modulates/accentuates this signal resulting in abnormal motor output in the branchial arches. In a second condition, PT/OPT and progressive cerebellar ataxia occurs in patients without structural brainstem or cerebellar lesion, other than cerebellar atrophy. This syndrome of progressive ataxia and palatal tremor may be sporadic or familial. In the familial form, where hypertrophic degeneration of the inferior olive may not

  1. The application of surface electrical and shallow geothermic methods in monitoring network design.

    Science.gov (United States)

    Gilkeson, R.H.; Cartwright, K.

    1983-01-01

    There are a variety of surface geophysical methods that are routinely used in geologic investigations. The three broad applications of these methods to evaluate the impact of waste disposal on shallow groundwater flow systems are: 1) evaluation of proposed waste disposal sites; 2) monitoring of site performance; and 3) investigation of contaminant migration at existing sites. Electrical and shallow geothermic are two surface geophysical methods that have application to waste disposal investigations. Of the electrical methods, electrical resistivity has the greatest application with a variety of techniques available. The distribution of temperature in shallow geologic materials (shallow geothermics) may define characteristics of shallow groundwater flow systems including zones of recharge and discharge and lithologic variation in the shallow geologic materials.-from Authors

  2. Topical Calcipotriol for Preventive Treatment of Hypertrophic Scars A Randomized, Double-blind, Placebo-Controlled Trial

    NARCIS (Netherlands)

    van der Veer, Willem M.; Jacobs, Xander E.; Waardenburg, Ingmar E.; Ulrich, Magda M.; Niessen, Frank B.

    2009-01-01

    Objectives: To evaluate the efficacy of topical application of calcipotriol to healing wounds in preventing or reducing hypertrophic scar formation and to investigate the biochemical properties of the epidermis associated with hypertrophic scar formation. Design: Randomized, double-blind,

  3. Topical Calcipotriol for Preventive Treatment of Hypertrophic Scars A Randomized, Double-blind, Placebo-Controlled Trial

    NARCIS (Netherlands)

    van der Veer, Willem M.; Jacobs, Xander E.; Waardenburg, Ingmar E.; Ulrich, Magda M.; Niessen, Frank B.

    2009-01-01

    Objectives: To evaluate the efficacy of topical application of calcipotriol to healing wounds in preventing or reducing hypertrophic scar formation and to investigate the biochemical properties of the epidermis associated with hypertrophic scar formation. Design: Randomized, double-blind,

  4. Hypertrophic scars after therapy with CO2 laser for treatment of multiple cutaneous neurofibromas

    NARCIS (Netherlands)

    J.U. Ostertag (Judith); C.C.W. Theunissen (Chantal); H.A.M. Neumann (Martino)

    2002-01-01

    textabstractBACKGROUND. CO2 laser surgery is a treatment modality for cutaneous neurofibromas. OBJECTIVE. Hypertrophic and atrophic scars can result from treatment with CO2 laser surgery. We present a case of cutaneous neurofibromatosis that developed hypertrophic scars postoperatively. METHODS.

  5. Survival and sudden cardiac death after septal ablation for hypertrophic obstructive cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten Kvistholm; Havndrup, Ole; Hassager, Christian

    2011-01-01

    Reports of long-term survival and the risk of sudden cardiac death (SCD) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are sparse.......Reports of long-term survival and the risk of sudden cardiac death (SCD) after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) are sparse....

  6. Influence of Septal Thickness on the Clinical Outcome After Alcohol Septal Alation in Hypertrophic Cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten K; Jacobsson, Linda; Almaas, Vibeke Marie

    2016-01-01

    BACKGROUND: We assessed the influence of interventricular septal thickness (IVSd) on the clinical outcome and survival after alcohol septal ablation (ASA) in patient with hypertrophic cardiomyopathy. METHODS AND RESULTS: We analyzed 531 patients with hypertrophic cardiomyopathy (age: 56±14 years...

  7. HYPERTROPHIC CARDIOMYOPATHY AS A PART OF INHERITED MALFORMATION SYNDROMES IN INFANTS

    Directory of Open Access Journals (Sweden)

    M.V. Tural'chuk

    2011-01-01

    Full Text Available The data of clinical and instrumental examination of two infantile patients with obstructive hypertrophic cardiomyopathy in association with marked multisystem involvement as a picture of inherited malformation syndromes are given.Key words: infants, hypertrophic cardiomyopathy, LEOPARD syndrome, Noonan syndrome.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 166–169

  8. Outcome of Alcohol Septal Ablation in Mildly Symptomatic Patients With Hypertrophic Obstructive Cardiomyopathy

    DEFF Research Database (Denmark)

    Veselka, Josef; Faber, Lothar; Liebregts, Max

    2017-01-01

    BACKGROUND: The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive...

  9. Development and evaluation of shallow injection of slurry into ley

    OpenAIRE

    Rodhe, Lena

    2004-01-01

    Shallow injection of slurry on grassland can reduce ammonia emissions compared to surface spreading and increase plant nitrogen utilisation. Other advantages include enhanced silage quality and lower odour. Disadvantages include higher investment costs, increased draught requirements and potential crop damage. The objective of this thesis was to determine appropriate techniques for slurry injection into ley that would minimise ammonia emissions, contamination of crops and energy inputs, while...

  10. Shallow-Water Mud Acoustics

    Science.gov (United States)

    2015-09-30

    1 DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited. Shallow-Water Mud Acoustics William L. Siegmann...models and methods that explain observed material and acoustic properties of different physical types of shallow-ocean mud sediments. Other goals...are to assess prior data relating to the acoustic properties of mud and to provide guidance in the development and interpretation of experiments. A

  11. Compression therapy affects collagen type balance in hypertrophic scar.

    Science.gov (United States)

    Tejiram, Shawn; Zhang, Jenny; Travis, Taryn E; Carney, Bonnie C; Alkhalil, Abdulnaser; Moffatt, Lauren T; Johnson, Laura S; Shupp, Jeffrey W

    2016-04-01

    The effects of pressure on hypertrophic scar are poorly understood. Decreased extracellular matrix deposition is hypothesized to contribute to changes observed after pressure therapy. To examine this further, collagen composition was analyzed in a model of pressure therapy in hypertrophic scar. Hypertrophic scars created on red Duroc swine (n = 8) received pressure treatment (pressure device mounting and delivery at 30 mm Hg), sham treatment (device mounting and no delivery), or no treatment for 2 wk. Scars were assessed weekly and biopsied for histology, hydroxyproline quantification, and gene expression analysis. Transcription levels of collagen precursors COL1A2 and COL3A1 were quantified using reverse transcription-polymerase chain reaction. Masson trichrome was used for general collagen quantification, whereas immunofluorescence was used for collagen types I and III specific quantification. Total collagen quantification using hydroxyproline assay showed a 51.9% decrease after pressure initiation. Masson trichrome staining showed less collagen after 1 (P < 0.03) and 2 wk (P < 0.002) of pressure application compared with sham and untreated scars. Collagen 1A2 and 3A1 transcript decreased by 41.9- and 42.3-fold, respectively, compared with uninjured skin after pressure treatment, whereas a 2.3- and 1.3-fold increase was seen in untreated scars. This decrease was seen in immunofluorescence staining for collagen types I (P < 0.001) and III (P < 0.04) compared with pretreated levels. Pressure-treated scars also had lower levels of collagen I and III after pressure treatment (P < 0.05) compared with sham and untreated scars. These results demonstrate the modulation of collagen after pressure therapy and further characterize its role in scar formation and therapy. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Chronic hypertrophic cranial pachymeningitis associated with HTLV-I infection.

    Science.gov (United States)

    Kawano, Y; Kira, J

    1995-10-01

    Two patients presenting with recurrent multiple cranial neuropathy showed diffuse thickening and gadolinium enhancement of the dura mater on brain MRI. Both had anti-HTLV-I antibodies in serum. A quantitative polymerase chain reaction study of the peripheral blood disclosed that the HTLV-I proviral DNA loads increased considerably in one case and moderately in the other. Both showed a spontaneous proliferation of peripheral blood lymphocytes as well as an increase in helper/inducer T cells. Neither had any other underlying infections or autoimmune diseases. Thus it is possible that hypertrophic pachymeningitis developed as a result of multiorgan involvement of HTLV-I infection in these patients.

  13. Collecting, Analyzing, and Publishing Massive Data about the Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Montserrat, Lorenzo; Cotelo-Lema, Jose Antonio; Luaces, Miguel R.; Seco, Diego

    We present in this paper the architecture and some implementation details of a Document Management System and Workflow to help in the diagnosis of the hypertrophic cardiomyopathy, one of the most frequent genetic cardiovascular diseases. The system allows a gradual and collaborative creation of a knowledge base about the mutations associated with this disease. The system manages both the original documents of the scientific papers and the data extracted from these papers by the experts. Furthermore, a semiautomatic report generation module exploits this knowledge base to create high quality reports about the studied mutations.

  14. Histologic Sequelae of Apical Hypertrophic Cardiomyopathy: Dystrophic Calcification

    Directory of Open Access Journals (Sweden)

    Shahryar G Saba

    2017-05-01

    Full Text Available We present cardiac computed tomography (CT findings demonstrating apical hypertrophic cardiomyopathy with dystrophic calcification of the left ventricular apex. The absence of significant epicardial coronary artery disease demonstrated by coronary CT angiography suggests that increased wall tension and decreased microvascular perfusion over time account for the dyskinetic apical myocardium, rather than myocardial infarction secondary to atherosclerotic plaque rupture. These observations support CT as the imaging modality of choice to visualize the deposition of calcium in injured myocardial tissue, a recognized occurrence in chronically infarcted myocardium.

  15. [Hypertrophic pyloric stenosis. Review of 314 cases (author's transl)].

    Science.gov (United States)

    De Jaureguizar, E; Cabrera, R; Herrero, E; Monereo, J

    1978-04-01

    Three hundred fourteen patients with hypertrophic pyloric stenosis have been operated from 1969 to 1976. The different etiologies are discussed. Clinical and analytical data are evaluated. Radiology is employed in 99 per 100 of the cases with no complications. Medical treatment used is exposed clearly as well as the surgical procedure (Monereo's modification of the classical Fredet-Ramstedt technique). Postoperative results and complications such as vomiting, wound infection (4.4 per 100), eventration (0.6 per 100) and fatal outcome (0.6 per 100) are thouroughly detailed as well as the associated pathology.

  16. Lung carcinoma with hypertrophic osteoarthropathy in a teenager

    Directory of Open Access Journals (Sweden)

    Jeremy Whelan

    2011-03-01

    Full Text Available Hypertrophic osteoarthropathy (HOA characterised by arthralgia, clubbing and periosteal proliferation of long bones, is rarely encountered in children and adolescents. Whereas in adults over 80% of cases are associated with malignancy, in children the majority of cases are due to non-neoplastic causes such as cystic fibrosis, bilary atresia and congenital heart disease. Up to 5% of adults with lung cancer demonstrate signs of HOA. However, lung cancer is extremely uncommon in children and young people. Here we report a case of lung adenocarcinoma in an 18 year old male associated with HOA present both at diagnosis and at subsequent disease progression.

  17. The structure of winter phytoplankton in Lake Nero, Russia, a hypertrophic lake dominated by Planktothrix-like Cyanobacteria

    Science.gov (United States)

    2013-01-01

    Background The permanent dominance of Planktothrix-like сyanobacteria has been often reported for shallow eutrophic\\hypertrophic lakes in central Europe in summer\\autumn. However studies on phytoplankton growth under ice cover in nutrient-rich lakes are very scarce. Lake Nero provides a good example of the contrasting seasonal extremes in environmental conditions. Moreover, the ecosystem underwent a catastrophic transition from eutrophic to hypertrophic 2003–05, with dominance of filamentous cyanobacteria in summer\\autumn. Towards the end of the period of ice cover, there is an almost complete lack of light and oxygen but abundance in nutrients, especially ammonium nitrogen, soluble reactive phosphorus and total phosphorus in lake Nero. The aim of the present study was to describe species composition and abundance of the phytoplankton, in relation to the abiotic properties of the habitat to the end of winters 1999–2010. We were interested if Planktothrix-like сyanobacteria kept their dominant role under the ice conditions or only survived, and how did the under-ice phytoplankton community differ from year to year. Results Samples collected contained 172 algal taxa of sub-generic rank. Abundance of phytoplankton varied widely from very low to the bloom level. Cyanobacteria (Limnothrix, Pseudanabaena, Planktothrix) were present in all winter samples but did not always dominate. Favourable conditions included low winter temperature, thicker ice, almost complete lack of oxygen and high ammonium concentration. Flagellates belonging to Euglenophyta and Cryptophyta dominated in warmer winters, when phosphorus concentrations increased. Conclusion A full picture of algal succession in the lake may be obtained only if systematic winter observations are taken into account. Nearly anoxic conditions, severe light deficiency and high concentration of biogenic elements present a highly selective environment for phytoplankton. Hypertrophic water bodies of moderate zone

  18. The structure of winter phytoplankton in Lake Nero, Russia, a hypertrophic lake dominated by Planktothrix-like Cyanobacteria.

    Science.gov (United States)

    Babanazarova, Olga; Sidelev, Sergey; Schischeleva, Svetlana

    2013-09-30

    The permanent dominance of Planktothrix-like сyanobacteria has been often reported for shallow eutrophic\\hypertrophic lakes in central Europe in summer\\autumn. However studies on phytoplankton growth under ice cover in nutrient-rich lakes are very scarce. Lake Nero provides a good example of the contrasting seasonal extremes in environmental conditions. Moreover, the ecosystem underwent a catastrophic transition from eutrophic to hypertrophic 2003-05, with dominance of filamentous cyanobacteria in summer\\autumn. Towards the end of the period of ice cover, there is an almost complete lack of light and oxygen but abundance in nutrients, especially ammonium nitrogen, soluble reactive phosphorus and total phosphorus in lake Nero. The aim of the present study was to describe species composition and abundance of the phytoplankton, in relation to the abiotic properties of the habitat to the end of winters 1999-2010. We were interested if Planktothrix-like сyanobacteria kept their dominant role under the ice conditions or only survived, and how did the under-ice phytoplankton community differ from year to year. Samples collected contained 172 algal taxa of sub-generic rank. Abundance of phytoplankton varied widely from very low to the bloom level. Cyanobacteria (Limnothrix, Pseudanabaena, Planktothrix) were present in all winter samples but did not always dominate. Favourable conditions included low winter temperature, thicker ice, almost complete lack of oxygen and high ammonium concentration. Flagellates belonging to Euglenophyta and Cryptophyta dominated in warmer winters, when phosphorus concentrations increased. A full picture of algal succession in the lake may be obtained only if systematic winter observations are taken into account. Nearly anoxic conditions, severe light deficiency and high concentration of biogenic elements present a highly selective environment for phytoplankton. Hypertrophic water bodies of moderate zone covered by ice in winter and

  19. FACTORS INFLUENCING THE OCCURRENCE OF HYPERTROPHIC SCARS AMONG POSTOPERATIVE PATIENTS IN GARUT, INDONESIA

    Directory of Open Access Journals (Sweden)

    Andri Nugraha

    2017-02-01

    Full Text Available Background: Hypertrophic scar causes physical and psychological problems. Thus understanding the factors related to the occurrence of hypertrophic scar tissue is needed. Little is known about its influencing factors in Indonesia, especially in Garut. Objective: This study aims to examine the relationships between hypertrophic scar and its influencing factors, and identify the most dominant factor of the occurrence of hypertrophic scars. Methods: This was an observational case control study using retrospective approach in Polyclinic of Surgery of Regional Public Hospital of dr. Slamet of Garut Regency. There were 40 samples recruited in this study by purposive sampling, which was divided to be case group (20 patients and control group (20 patients. Data were collected using Stony Brook Scar Evaluation Scale by observation and documentation of the medical records of patients. Data were analyzed using logistic regression analysis Results: Findings indicated that there were significant relationships between the surgical wound infection (p = 0.02, family history (p = 0.026, and type of suture (p = 0.043 with the occurrence of hypertrophic scars. The most dominant factor on the occurrence of hypertrophic scars was type of suture, acid polyglactin 910. The variables that had no significant relationships with the occurrence of hypertrophic scar tissue were age (p = 0.34, area of surgical wound (p = 0.177, and smoking habit (p = 0.479. Conclusion: There were significant relationships between infection of surgical wound, genetic history, the type of suture, and the occurrence of hypertrophic scar tissue. The most dominant factor that influenced the occurrence of hypertrophic scar tissue was the type of suture. Therefore, it is suggested to health professionals to modify the using of acid polyglactin 910 sutures, and nurses particularly need to provide the information regarding the family history and genetic-related hypertrophic scar, and prevent the

  20. Scintigraphic evaluation of regional myocardial sympathetic activity in patients with hypertrophic cardiomyopathy. Comparison between asymmetrical hypertrophic cardiomyopathy and apical hypertrophy

    Energy Technology Data Exchange (ETDEWEB)

    Eno, Shin; Takeo, Eiichiro; Sasaki, Satoshi; Matsuda, Keiji; Fujii, Hideaki; Kanazawa, Ikuo [Chugoku Rosai General Hospital, Kure, Hiroshima (Japan)

    1998-02-01

    Using {sup 123}I-MIBG (metaiodobenzylguanidine) and {sup 201}Tl imagings, an examination concerning the relation between the hypertrophic region and its sympathetic nervous function was done. Subjects were 12 normal adults (4 males and 8 females, mean age 61.3 yr), 13 patients with asymmetrical hypertrophic cardiomyopathy (10 males and 3 females, 63.9 yr) and 13 patients with apical hypertrophy (9 males and 4 females, 67.2 yr). The SPECT apparatus was Toshiba two-gated gamma camera GCA 7200A. At 20 min and 3 hr after intravenous injection of 111 MBq of {sup 123}I-MIBG, myocardial SPECT and planar images were obtained with collimator LEHR under following conditions: photoelectric peak 159 KeV, window width 20%, matrix size 64 x 64 (256 x 256 for the planar image), step angle 6deg, 40 sec/step and 180deg for 1 camera. In another day, {sup 201}Tl SPECT and planar imagings were performed 10 min after intravenous injection of 111 MBq of {sup 201}Tl for the photoelectric peak 72 KeV under similar conditions to above. SPECT images were reconstructed using Butterworth filter and Shepp and Logan filter. Images were examined for the defect score, myocardium/mediastinum ratio, whole heart washout rate and regional washout rate. In the asymmetrical hypertrophic myopathy, abnormal sympathetic nerve function was recognized on the regions regardless of their disease severity while in the apical hypertrophy, abnormality was restricted on the apical region. Therefore, the two diseases were found different from each other from the aspect of sympathetic nerve functions. (K.H.)

  1. Subaortic and midventricular obstructive hypertrophic cardiomyopathy with extreme segmental hypertrophy

    Directory of Open Access Journals (Sweden)

    Karoulas Takis

    2007-03-01

    Full Text Available Abstract Background Subaortic and midventricular hypertrophic cardiomyopathy in a patient with extreme segmental hypertrophy exceeding the usual maximum wall thickness reported in the literature is a rare phenomenon. Case Presentation A 19-year-old man with recently diagnosed hypertrophic cardiomyopathy (HCM was referred for sudden death risk assessment. The patient had mild exertional dyspnea (New York Heart Association functional class II, but without syncope or chest pain. There was no family history of HCM or sudden death. A two dimensional echocardiogram revealed an asymmetric type of LV hypertrophy; anterior ventricular septum = 49 mm; posterior ventricular septum = 20 mm; anterolateral free wall = 12 mm; and posterior free wall = 6 mm. The patient had 2 types of obstruction; a LV outflow obstruction due to systolic anterior motion of both mitral leaflets (Doppler-estimated 38 mm Hg gradient at rest; and a midventricular obstruction (Doppler-estimated 43 mm Hg gradient, but without apical aneurysm or dyskinesia. The patient had a normal blood pressure response on exercise test and no episodes of non-sustained ventricular tachycardia in 24-h ECG recording. Cardiac MRI showed a gross late enhancement at the hypertrophied septum. Based on the extreme degree of LV hypertrophy and the myocardial hyperenhancement, an implantation of a cardioverter-defibrillator was recommended prophylactically for primary prevention of sudden death. Conclusion Midventricular HCM is an infrequent phenotype, but may be associated with an apical aneurysm and progression to systolic dysfunction (end-stage HCM.

  2. Family communication in a population at risk for hypertrophic cardiomyopathy.

    Science.gov (United States)

    Batte, Brittany; Sheldon, Jane P; Arscott, Patricia; Huismann, Darcy J; Salberg, Lisa; Day, Sharlene M; Yashar, Beverly M

    2015-04-01

    Encouraging family communication is an integral component of genetic counseling; therefore, we sought to identify factors impacting communication to family members at risk for Hypertrophic Cardiomyopathy (HCM). Participants (N = 383) completed an online survey assessing: 1) demographics (gender, genetic test results, HCM family history, and disease severity); 2) illness representations; 3) family functioning and cohesiveness; 4) coping styles; 5) comprehension of HCM autosomal dominant inheritance; and 6) communication of HCM risk information to at-risk relatives. Participants were a national sample of individuals with HCM, recruited through the Hypertrophic Cardiomyopathy Association. Data from 183 participants were analyzed using a logistic regression analysis, with family communication as a dichotomous dependent variable. We found that female gender and higher comprehension of autosomal dominant inheritance were significant predictors of participants' communication of HCM risk information to all their siblings and children. Our results suggest that utilizing interventions that promote patient comprehension (e.g., a teaching-focused model of genetic counseling) are important and may positively impact family communication within families with HCM.

  3. CT findings of intrathoricic neoplasm associated with hypertrophic osteoarthropathy

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Hee Sung; Choe, Kyu Ok; Chung, Jin Il; Oh, Sei Chung [College of Medicine Yonsei University, Seoul (Korea, Republic of)

    1994-02-15

    Hypertrophic osteoarthropathy(HOA) is a clinical syndrome consisting of clubbing, periostitis and synovitis. Most frequent causes of hypertrophic osteoarthropathy are intrathoracic neoplasms, among which the bronchogenic carcinoma ranks the highest. But computed tomographic evaluation of intrathoracic neoplasm associated with HOA has been seldom reported. The purpose of this study is to evaluate CT findings of intrathoracic neoplasm associated with HOA, and to infer possible mechanism. Seven cases of intrathoracic neoplasm associated with HOA were included in our study. Diagnoses of HOA were made by Tc99m bone scintigraphy or plain radiography. The findings of chest CT scans were reviewed retrospectively, with main interests on their size, location and internal characteristics, ect. Seven cases of intrathoracic neoplasm consisted of five bronchogenic carcinomas and two thymic tumors. The size of intrathoracic tumors were relatively large ranging from 6cm to 13cm(average 8.0cm). All thoracic neoplasms showed wide pleural contact, and one of them invaded thoracic wall. The range of length of pleural contact was 5-18cm(average 9.9cm). All of seven patients had internal necrosis, and one of them showed cavitation in thoracic mass. Intrathoracic neoplasms associated with HOA had a tendency to be large, to contain internal necrosis, and to widely abut the thoracic pleura.

  4. Planktonic ciliates in a hypertrophic pond: functional role and importance.

    Science.gov (United States)

    Sanchez Rodriguez, Ma del Rosario; Lugo Vazquez, Alfonso; Oliva Martinez, Ma Guadalupe; Verver y Vargas, Jaqueline Garcia; Rodriguez Rocha, Armando; Peralta Soriano, Laura

    2011-07-01

    Taxonomical composition and abundance of the planktonic ciliate assemblage in a Lake Tezozomoc, a hypertrophic pond located into an urban park in Mexico City, was investigated along the rainy season (May to October). The aims of the study were to know the main trophic roles and ecological significance of ciliates in a highly productive environment. A low number of taxa (27) and a wide abundance fluctuation (104-387 cil ml(-1)) were found. The most abundant species (up to 162 cil ml(-1)) was Halteria grandinella, an oligotrich ciliate that graze on bacteria and picoplankton, but also several big body sized species that feed on pico and nanoplankton were abundant. Sudden temporal changes in species dominance occurred. Ciliate biomass was very high and fluctuated widely (1.6-88 10(6) microm(3) ml(-1)) being dominated by the >50 microm size fraction that mainly included the pico and nanoplankton feeders. Ciliates are a very important component in the plankton of hypertrophic lakes and their main control factor seems to be the grazing by big-body size Daphnia species.

  5. Water quality assessment in a shallow lake used for tourism

    Directory of Open Access Journals (Sweden)

    Dembowska Ewa A.

    2015-12-01

    Full Text Available The routine evaluation of water quality is limited to lakes with the largest area. In Poland, only lakes with an area exceeding 50 hectares are monitored by the State Environmental Monitoring System. For many local communities, however, small lakes are more important. This applies mainly to areas with a small number of lakes, where even the smallest lakes are used for various purposes. This paper presents the results of phytoplankton analysis in a small and shallow lake used for recreation. The study was conducted at three sites located in different parts of the lake. A total of 122 algae taxa were identified in the phytoplankton, mainly diatoms and green algae. The most constant taxa in the lake were: Stephanodiscus hantzschii, Desmodesmus communis, Pediastrum tetras and Crucigenia tetrapedia. The average phytoplankton biomass was 37 mg l−1. The maximum biomass, almost 140 mg dm−3, was recorded in late July at the site located near the beach. At that time, there was a massive cyanobacterial bloom composed of Microcystis wesenbergii and Aphanizomenon issatschenkoi. Based on these studies, the lake should be classified as hypertrophic with bad ecological status. This lake should not be used for recreational purposes in the current state.

  6. Upregulation of TRPC1 contributes to contractile function in isoproterenol-induced hypertrophic myocardium of rat.

    Science.gov (United States)

    Chen, Mo-Si; Xiao, Jun-Hua; Wang, Yong; Xu, Bo-Ming; Gao, Lu; Wang, Jia-Ling

    2013-01-01

    The transient receptor potential canonical channel 1 (TRPC1) is a crucial component of the stretch-activated ion channels (SACs). The objective of this research was to demonstrate the contribution of TRPC1 in maintaining cardiac contractile function in the hypertrophic myocardium. Hypertrophic rat hearts were induced by injecting isoproterenol intraperitoneally, and the expressions of TRPC1/3/6 and Na(+)/Ca(2+) exchanger 1 (NCX1) proteins were analyzed by Western blot. The intracellular calcium images, the action potential of myocardium, the length-dependent contractile force of ventricle muscle and the cardiac output of isolated heart were investigated. The expression of TRPC1 was increased in the hypertrophic myocardium. After being stretched, the ascendant amplitude of the increase in the intracellular calcium ion concentration ([Ca(2+)]i) in the hypertrophic myocardium was higher than that in the normal myocardium. The increase of the APD50 and the amplitude of the membrane potential depolarization were more significant in the hypertrophic myocardium after the activation of SACs. When the heart preparations were perfused with Tyrode's solution, there was no difference in the cardiac systolic function between the cardiac hypertrophy group and the control group. Gadolinium, a SACs blocker, reduced the length-dependent contractile force and suppressed the ascending limb of the Frank-Starling curves in the hypertrophic heart. The upregulation of TRPC1 contributes to the contractile function in the hypertrophic myocardium by increasing [Ca(2+)]i through the SACs. © 2013 S. Karger AG, Basel

  7. Squamous Cell Carcinoma Arising in Hypertrophic Lichen Planus: A Review and Analysis of 38 Cases.

    Science.gov (United States)

    Knackstedt, Thomas J; Collins, Lindsey K; Li, Zhongze; Yan, Shaofeng; Samie, Faramarz H

    2015-12-01

    Hypertrophic lichen planus is a chronic variant of lichen planus with controversial malignant association. To describe and analyze the relationship of squamous cell carcinoma (SCC) and hypertrophic lichen planus. A retrospective chart review of patients with hypertrophic lichen planus and SCC was performed at the authors' institution. Thereafter, scientific databases were searched for articles reporting cases of SCC arising in hypertrophic lichen planus. Patient demographics, immune status, lichen planus features, and SCC data points were extracted for each patient and evaluated. Thirty-eight cases of SCC in hypertrophic lichen planus occurred in 16 women, average age: 61.4, and 22 men, average age: 51.3, after a lag time of 88 days to 40 years. Squamous cell carcinoma was uniformly located on the lower extremity. Men had larger SCC than women (p = .027) and a significantly longer lag time to SCC development (p = .002). Long lag time was associated with a smaller SCC size (p = .032). In the past, hypertrophic lichen planus and SCC have been considered isolated diseases. Based on an increasing number of cases, the association between hypertrophic lichen planus and keratinocyte malignancies warrants surveillance.

  8. Changes in gadolinium-DTPA enhanced magnetic resonance signal intensity ratio in hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Tsukihashi, Hironori; Ishibashi, Yutaka; Shimada, Toshio; Hatano, Jun; Tanabe, Kazuaki; Ooyake, Nobuyuki; Morioka, Shigefumi; Moriyama, Katsutoshi (Shimane Medical Univ., Izumo (Japan))

    Serial gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA) enhanced magnetic resonance (MR) signal intensity ratios were measured in 6 normal subjects and 20 hypertrophic cardiomyopathy (HCM) patients to try to differentiate normal from disorganized myocardial tissue. Images were obtained at 10-minute intervals 5-60 minutes after Gd-DTPA (0.1 mmol/kg) injection. The signal intensity ratio (myocardial signal intensity/skeletal muscle signal intensity) was measured at both hypertrophic and non-hypertrophic regions in each image at the apex and mid-ventricular levels. The signal intensity ratio was standardized to compare each case. Hypertrophic myocardium was classified into two types. Type I in 11 of 20 patients was visualized as a homogeneous image, while type II in the other 9 patients was revealed as a mixed isointensity and high intensity area. The peak value of the standardized signal intensity ratio at the apex level was 1.28[+-]0.09 in HCM patients and 1.23[+-]0.06 in normal subjects, and at the mid ventricular level was 1.26[+-]0.07 in hypertrophic regions, 1.17[+-]0.12 in non-hypertrophic regions, and 1.16[+-]0.07 in normal subjects. Thirty minutes after Gd injection, the standardized signal intensity ratio at the apex level was 1.21[+-]0.08 in HCM patients and 1.07[+-]0.08 in normal subjects, and those at the mid ventricular level was 1.20[+-]0.09 in hypertrophic regions, 1.11[+-]0.11 in non-hypertrophic regions, and 1.04[+-]0.06 in normal subjects. The delayed decay of the signal intensity ratio and high signal intensity ratio in Gd-DTPA enhanced MR images are useful in myocardial tissue characterization in hypertrophic cardiomyopathy. (author).

  9. Cardiac sarcoid: a chameleon masquerading as hypertrophic cardiomyopathy and dilated cardiomyopathy in the same patient.

    Science.gov (United States)

    Agarwal, Anushree; Sulemanjee, Nasir Z; Cheema, Omar; Downey, Francis X; Tajik, A Jamil

    2014-05-01

    Sarcoidosis is a multisystem, granulomatous disease of unknown etiology often seen in young adults, with cardiac involvement in more than one-quarter of sarcoid patients. The clinical presentation of cardiac sarcoid depends upon the location and extent of myocardium involved. Although cardiac sarcoid may produce asymmetrical septal hypertrophy, it is most commonly considered in the differential diagnosis of dilated cardiomyopathy. The hypertrophic stage of cardiac sarcoid is rarely seen. We describe a case of cardiac sarcoid in a young patient wherein a distinctive appearance of the cardiac sarcoid spectrum from "hypertrophic" stage to thinned/scarred stage, masquerading as hypertrophic cardiomyopathy followed by dilated cardiomyopathy, is demonstrated. © 2014, Wiley Periodicals, Inc.

  10. Down Syndrome with Complete Atrioventricular Septal Defect, Hypertrophic Cardiomyopathy, and Pulmonary Vein Stenosis.

    Science.gov (United States)

    Mahadevaiah, Guruprasad; Gupta, Manoj; Ashwath, Ravi

    2015-10-01

    The prevalence of congenital heart disease in infants with Down syndrome is 40%, compared with 0.3% in children who have normal chromosomes. Atrioventricular and ventricular septal defects are often associated with chromosomal aberrations, such as in trisomy 21, whereas hypertrophic cardiomyopathy is chiefly thought to be secondary to specific gene mutations. We found only one reported case of congenital hypertrophic cardiomyopathy and atrioventricular septal defect in an infant with Down syndrome. Here, we report atrioventricular septal defect, hypertrophic cardiomyopathy, and pulmonary vein stenosis in a neonate with Down syndrome-an apparently unique combination. In addition, we discuss the relevant medical literature.

  11. Perioperative anesthetic management of patients with hypertrophic cardiomyopathy for noncardiac surgery: A case series

    Directory of Open Access Journals (Sweden)

    Sahoo Rajendra

    2010-01-01

    Full Text Available Hypertrophic cardiomyopathy with or without left ventricular outflow tract obstruction is characterized by asymmetric hypertrophy of the interventricular septum causing intermittent obstruction of the left ventricular outflow tract. Because Hypertrophic cardiomyopathy is the most common genetic cardiovascular disease, it may present to the anesthesiologist more often than anticipated, sometimes in undiagnosed form during routine preoperative visit. Surgery and anesthesia often complicate the perioperative outcome if adequate monitoring and proper care are not taken. Therefore, a complete understanding of the pathophysiology, hemodynamic changes and anesthetic implications is needed for successful perioperative outcome. We hereby describe the perioperative management of three patients with Hypertrophic cardiomyopathy for different surgical procedures.

  12. Shallow water sponges of Jamaica

    NARCIS (Netherlands)

    Lehnert, Helmut; Soest, van Rob W.M.

    1998-01-01

    An annotated comprehensive list is provided of all shallow-water sponges (down to 60 m) recently collected and previously recorded from Jamaica. Five new species are described, Plakina jamaicensis, Melophlus ruber, Agelas repens, Stylissa caribica and Hyrtios tubulatus, two of which belong to genera

  13. Ultrastructural myocardial changes in seven cats with spontaneous hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Christiansen, Liselotte Bruun; Prats Gavalda, Clara; Hyttel, Poul

    2015-01-01

    OBJECTIVES: Hypertrophic cardiomyopathy (HCM) is the most common heart disease in cats and shares clinical and pathological characteristics with human HCM. Little is known about the pathogenic mechanisms underlying development of spontaneous feline HCM. ANIMALS: The study population consisted...... of seven cats diagnosed with HCM and eight age-matched cats with no evidence of cardiac disease. METHODS: Fresh myocardial biopsies taken from the middle of the left ventricular posterior free wall were obtained and examined with transmission electron microscopy. RESULTS: Electron microscopic examination...... showed ultrastructural aberrations of the myocardial cytoarchitecture and of the interstitium in the seven cats with HCM. In the most severely affected cats the myofibrils were disorganized and subsarcolemmal mitochondria were depleted. In control cats, contraction band artifacts were commonly seen...

  14. Hypertrophic osteoarthropathy manifested with isolated calcaneal periostitis in bone scintigraphy.

    Science.gov (United States)

    Moralidis, Efstratios; Gerasimou, Georgios; Theodoridou, Athina; Hilidis, Ilias; Mylonaki, Efrosyni; Gotzamani-Psarrakou, Anna

    2010-05-01

    Hypertrophic osteoarthropathy (HOA) is an incompletely understood syndrome characterized by digital clubbing and periosteal proliferation of long bones and it is commonly associated with primary lung tumors. Bone scintigraphy is a sensitive method in detecting HOA and characteristic findings have been reported. We present the case of a man with newly diagnosed non-small cell lung cancer, unremarkable clinical examination and blood tests and no digital clubbing. During disease staging, however, bone scintigraphy showed intense calcaneal cortical proliferation bilaterally without involvement of other parts of the skeleton. Cortical reaction of both calcanei resolved significantly after chemotherapy. This case indicates that HOA may manifest with isolated calcaneal periostitis bilaterally, which is a new addition to the literature.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    AIMS: Hypertrophic cardiomyopathy (HCM) is a frequent cause of sudden cardiac death (SCD) among the young (SCDY). The aim of this study was to characterize symptoms before SCDY due to HCM. METHODS AND RESULTS: Through review of all death certificates, we identified all SCDs in Danes aged 1-35 years...... in 2000-2009. Nationwide we included all deaths (n = 8756) and identified 431 autopsied SCDYs. All available records from hospitals and general practitioners were retrieved. To compare symptoms, we included a control groups consisting of traffic accident victims (n = 74). In the 10-year study period, 431...... autopsied SCDY cases were reviewed and 38 cases (9%) were included, of which 22 (58%) had morphologic findings diagnostic of HCM and 16 (42%) had findings suggestive, but not diagnostic, of HCM ('possible HCM'). Cardiac symptoms >1 h prior to death were reported in 21 (55%) of cases, and 16 (42%) sought...

  16. Cubital tunnel syndrome caused by hypertrophic burn scarring: Sonographic envisage

    Directory of Open Access Journals (Sweden)

    Alparslan Bayram Carli

    2015-08-01

    Full Text Available In nerve entrapment syndromes, an electrodiagnostic study during physical examination would usually suffice to assess localization of injury. However, in daily clinical practice, sometimes it may be necessary to depict the insight; in other words to use an imaging tool. From this point of view, with its manifold advantages, ultrasound (US is superior to other imaging technologies such as magnetic resonance imaging (MRI. According to a study, US increased the sensitivity of electrodiagnostic studies from 78% to 98%. By presenting a patient with cubital tunnel syndrome caused by hypertrophic scarring, we wanted to highlight the complementary role of US in nerve entrapment syndromes in confirming the entrapment, as well as the usefulness of it in the follow-up period of burn patients. [Hand Microsurg 2015; 4(2.000: 44-46

  17. Serious arrhythmias in patients with apical hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Okishige, Kaoru; Sasano, Tetsuo; Yano, Kei; Azegami, Kouji; Suzuki, Kou; Itoh, Kuniyasu [Yokohama Red Cross Hospital (Japan)

    2001-05-01

    We report cases of serious arrhythmias associated with apical hypertrophic cardiomyopathy (AHCM). Thirty-one patients were referred to our institute to undergo further assessment of their AHCM from 1988 to 1999. Three patients with nonsustained ventricular tachycardia demonstrated an {sup 123}I-MIBG regional reduction in the tracer uptake. In two patients with ventricular fibrillation (VF), the findings from {sup 123}I-MIBG imaging revealed regional sympathetic denervation in the inferior and lateral regions. Electrophysiologic study demonstrated reproducible induction of VF in aborted sudden death and presyncopal patients, resulting in the need for an implantable defibrillator device and amiodarone in each patient. Patients with refractory atrial fibrillation with a rapid ventricular response suffered from serious congestive heart failure. A prudent assessment and strategy in patients with this disease would be indispensable in avoiding a disastrous outcome. (author)

  18. Hypertrophic osteopathy associated with pulmonary adenosquamous carcinoma in a dog.

    Science.gov (United States)

    Lee, Jung-Ha; Lee, Jong-Hoon; Yoon, Hun-Young; Kim, Na-Hyun; Sur, Jung-Hyang; Jeong, Soon-Wuk

    2012-05-01

    A six-year-old intact female Maltese dog weighing 3.8 kg presented with a history of mild lameness and swelling on both forelimbs. Radiographic and computed tomographic views revealed an extensive periosteal reaction in all four limbs and a large round mass on the right middle lung lobe. A total lobectomy was performed and pulmonary adenosquamous carcinoma was histologically confirmed. A diagnosis of hypertrophic osteopathy (HO) secondary to a lung tumor was made. Periosteal proliferation decreased significantly after surgery; however, there was evidence of dyspnea, mass recurrence, and periosteal reaction three months post-operatively. This is the first case report of pulmonary adenosquamous carcinoma with HO in a dog in which we describe clinical, imaging, surgical, and histological findings.

  19. The prevention of sudden death in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Sachdev, Bhavesh; Hamid, M Shoaib; Elliott, Perry M

    2002-05-01

    Hypertrophic cardiomyopathy (HCM) is a familial myocardial disease caused by mutations in cardiac sarcomeric proteins. HCM is characterised by myocyte disarray and myocardial fibrosis. Most patients are largely asymptomatic but some are prone to a number of disease-related complications, the most problematic of which is sudden cardiac death. Diagnosing patients who are at risk has not been easy because of the clinical heterogeneity of the disease, the frequent absence of symptoms prior to sudden cardiac death and the relatively low disease prevalence and annual mortality rates. To date, both low-dose amiodarone and internal cardioverter/defibrillator implantation have been advocated in high-risk individuals. Further improvements in clinical understanding and risk stratification are necessary to identify HCM patients who are at high risk of sudden death.

  20. Hypertrophic Cardiomyopathy: How do Mutations Lead to Disease?

    Energy Technology Data Exchange (ETDEWEB)

    Marsiglia, Júlia Daher Carneiro, E-mail: julia.marsiglia@usp.br; Pereira, Alexandre Costa [Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP (Brazil)

    2014-03-15

    Hypertrophic cardiomyopathy (HCM) is the most common monogenic genetic cardiac disease, with an estimated prevalence of 1:500 in the general population. Clinically, HCM is characterized by hypertrophy of the left ventricle (LV) walls, especially the septum, usually asymmetric, in the absence of any cardiac or systemic disease that leads to a secondary hypertrophy. The clinical course of the disease has a large inter- and intrafamilial heterogeneity, ranging from mild symptoms of heart failure late in life to the onset of sudden cardiac death at a young age and is caused by a mutation in one of the genes that encode a protein from the sarcomere, Z-disc or intracellular calcium modulators. Although many genes and mutations are already known to cause HCM, the molecular pathways that lead to the phenotype are still unclear. This review focus on the molecular mechanisms of HCM, the pathways from mutation to clinical phenotype and how the disease's genotype correlates with phenotype.

  1. Hypertrophic cardiomyopathy secondary to hepatitis C virus-related vasculitis.

    Science.gov (United States)

    Cavalli, Giulio; Berti, Alvise; Fragasso, Gabriele; De Cobelli, Francesco

    2016-12-01

    : Almost invariably associated with chronic HCV infection, cryoglobulinemic vasculitis is a small-vessel vasculitis commonly affecting the skin, kidneys, and peripheral nervous system. Cardiac involvement, possibly due to cardiac microcirculation involvement, is an utterly rare and severe complication. We describe a case of hypertrophic cardiomyopathy secondary to cryoglobulinemic vasculitis. Evaluation with transthoracic cardiac ultrasound and cardiac MRI evidenced severe left ventricular hypertrophy and diffuse hypokinesia, a marked decrease in left ventricular ejection fraction, and a subtle late enhancement of inferior and lateral left ventricular walls. Upon clinical stabilization, the patient received treatment with anti-CD20 monoclonal antibody rituximab. Clinical and radiological follow-up with cardiac ultrasound and cardiac MRI documented a dramatic and sustained clinical improvement, with marked reduction of left ventricular hypertrophy, resolution of late enhancement, recovery of left ventricular contractility and function.

  2. Idiopathic hypertrophic pachymeningitis mimicking hemicrania continua: An unusual clinical case.

    Science.gov (United States)

    Russo, Antonio; Silvestro, Marcello; Cirillo, Mario; Tessitore, Alessandro; Tedeschi, Gioacchino

    2017-01-01

    Background Hemicrania continua (HC) is a primary headache syndrome characterized by a unilateral, moderate, continuous headache with exacerbations marked by migrainous and cranial autonomic symptoms. However, clinical phenotypes similar to primary HC may be subtended by several disorders. Case report We report the case of a 62-year-old man experiencing, over the previous year, a headache completely consistent with HC and its absolute responsiveness to indomethacin therapy. Later, the patient developed diplopia caused by sixth cranial nerve palsy ipsilateral to headache. In this frame, clinical, laboratory and neuroimaging characteristics supported the diagnosis of idiopathic hypertrophic pachymeningitis (IHP). Conclusions IHP is a rare fibrosing inflammatory disorder leading to a localized or diffuse dura mater thickening. IHP clinical manifestations are a progressively worsening headache and signs related to cranial nerves involvement and venous sinus thrombosis. Here, we report, for the first time, a HC phenotype subtended by IHP.

  3. Hypertrophic cardiomyopathy and ultra-endurance running - two incompatible entities?

    Directory of Open Access Journals (Sweden)

    Wilson Mathew G

    2011-11-01

    Full Text Available Abstract Regular and prolonged exercise is associated with increased left ventricular wall thickness that can overlap with hypertrophic cardiomyopathy (HCM. Differentiating physiological from pathological hypertrophy has important implications, since HCM is the commonest cause of exercise-related sudden cardiac death in young individuals. Most deaths have been reported in intermittent 'start-stop' sports such as football (soccer and basketball. The theory is that individuals with HCM are unable to augment stroke volume sufficiently to meet the demands of endurance sports and are accordingly 'selected-out' of participation in such events. We report the case of an ultra-endurance athlete with 25 years of > 50 km competitive running experience, with genetically confirmed HCM; thereby demonstrating that these can be two compatible entities.

  4. Hypertrophic cardiomyopathy and ultra-endurance running - two incompatible entities?

    Science.gov (United States)

    Wilson, Mathew G; Chandra, Navin; Papadakis, Michael; O'Hanlon, Rory; Prasad, Sanjay K; Sharma, Sanjay

    2011-11-29

    Regular and prolonged exercise is associated with increased left ventricular wall thickness that can overlap with hypertrophic cardiomyopathy (HCM). Differentiating physiological from pathological hypertrophy has important implications, since HCM is the commonest cause of exercise-related sudden cardiac death in young individuals. Most deaths have been reported in intermittent 'start-stop' sports such as football (soccer) and basketball. The theory is that individuals with HCM are unable to augment stroke volume sufficiently to meet the demands of endurance sports and are accordingly 'selected-out' of participation in such events. We report the case of an ultra-endurance athlete with 25 years of > 50 km competitive running experience, with genetically confirmed HCM; thereby demonstrating that these can be two compatible entities.

  5. Determination of multidirectional myocardial deformations in cats with hypertrophic cardiomyopathy by using two-dimensional speckle-tracking echocardiography.

    Science.gov (United States)

    Suzuki, Ryohei; Mochizuki, Yohei; Yoshimatsu, Hiroki; Teshima, Takahiro; Matsumoto, Hirotaka; Koyama, Hidekazu

    2017-12-01

    Objectives Hypertrophic cardiomyopathy, a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of myocardial deformation with two-dimensional speckle-tracking echocardiography in cats with various stages of hypertrophic cardiomyopathy has not yet been reported. This study was designed to measure quantitatively multidirectional myocardial deformations of cats with hypertrophic cardiomyopathy. Methods Thirty-two client-owned cats with hypertrophic cardiomyopathy and 14 healthy cats serving as controls were enrolled and underwent assessment of myocardial deformation (peak systolic strain and strain rate) in the longitudinal, radial and circumferential directions. Results Longitudinal and radial deformations were reduced in cats with hypertrophic cardiomyopathy, despite normal systolic function determined by conventional echocardiography. Cats with severely symptomatic hypertrophic cardiomyopathy also had lower peak systolic circumferential strain, in addition to longitudinal and radial strain. Conclusions and relevance Longitudinal and radial deformation may be helpful in the diagnosis of hypertrophic cardiomyopathy. Additionally, the lower circumferential deformation in cats with severe hypertrophic cardiomyopathy may contribute to clinical findings of decompensation, and seems to be related to severe cardiac clinical signs. Indices of multidirectional myocardial deformations by two-dimensional speckle-tracking echocardiography may be useful markers and help to distinguish between cats with hypertrophic cardiomyopathy and healthy cats. Additionally, they may provide more detailed assessment of contractile function in cats with hypertrophic cardiomyopathy.

  6. Current Therapeutic Approach to Hypertrophic Scar/span>s

    Science.gov (United States)

    Mokos, Zrinka Bukvić; Jović, Anamaria; Grgurević, Lovorka; Dumić-Čule, Ivo; Kostović, Krešimir; Čeović, Romana; Marinović, Branka

    2017-01-01

    Abnormal scarring and its accompanying esthetic, functional, and psychological sequelae still pose significant challe nges. To date, there is no satisfactory prevention or treatment option for hypertrophic scar/span>s (HSs), which is mostly due to not completely comprehending the mechanisms underlying their formation. That is why the apprehension of regular and controlled physiological processes of scar formation is of utmost importance when facing hypertrophic scarring, its pathophysiology, prevention, and therapeutic approach. When treating HSs and choosing the best treatment and prevention modality, physicians can choose from a plethora of therapeutic options and many commercially available products, among which currently there is no efficient option that can successfully overcome impaired skin healing. This article reviews current therapeutic approach and emerging therapeutic strategies for the management of HSs, which should be individualized, based on an evaluation of the scar itself, patients’ expectations, and practical, evidence-based guidelines. Clinicians are encouraged to combine various prevention and treatment modalities where combination therapy that includes steroid injections, 5-fluorouracil, and pulsed-dye laser seems to be the most effective. On the other hand, the current therapeutic options are usually empirical and their results are unreliable and unpredictable. Therefore, there is an unmet need for an effective, targeted therapy and prevention, which would be based on an action or a modulation of a particular factor with clarified mechanism of action that has a beneficial effect on wound healing. As the extracellular matrix has a crucial role in cellular and extracellular events that lead to pathological scarring, targeting its components mostly by regulating bone morphogenetic proteins may throw up new therapeutic approach for reduction or prevention of HSs with functionally and cosmetically acceptable outcome. PMID:28676850

  7. Hypertrophic olivary degeneration: A clinico-radiologic study.

    Science.gov (United States)

    Konno, Takuya; Broderick, Daniel F; Tacik, Pawel; Caviness, John N; Wszolek, Zbigniew K

    2016-07-01

    The frequency and causes of hypertrophic olivary degeneration (HOD) are unknown. We compared the clinical and radiological characteristics of unilateral HOD and bilateral HOD. We performed a search of a radiologic report database for patients who were radiologically diagnosed as having HOD. This database includes the patients examined at the Mayo Clinic in Florida and Arizona. We used the search terms "hypertrophic olivary degeneration", "HOD", and "olivary" in the reports recorded from 1995 to 2015. Pertinent medical records and magnetic resonance imaging (MRI) scans of the brain for those with HOD were reviewed retrospectively. We identified 142 MRI studies on 95 cases who had radiologically proven HOD, 39 cases had unilateral HOD and 56 with bilateral HOD. In symptomatic cases, the most common symptom was ataxia. Palatal tremor was observed in almost half of all HOD cases. While cerebrovascular diseases were the most frequent etiology in both types of HOD (n = 24, 62% in unilateral; n = 17, 30% in bilateral), more than half of bilateral HOD cases had an unknown etiology (52%, n = 29), whereas only 13% (n = 5) of the unilateral cases had an unknown etiology (χ(2) test, P < 0.001). The lesions of unilateral HOD had a tendency to improve radiologically over time, whereas those associated with bilateral HOD were likely to worsen (χ(2) test, P < 0.05). Our study showed that bilateral HOD is more common than unilateral HOD. Half of bilateral HOD cases had no obvious cause and some worsened over time. This may implicate a possible primary neurodegenerative process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Decreased coronary flow reserve in hypertrophic cardiomyopathy is related to remodeling of the coronary microcirculation

    NARCIS (Netherlands)

    M.J.M. Kofflard (Marcel); D.J.G.M. Duncker (Dirk); C. von Birgelen (Clemens); S.G. Carlier (Stephan); M. Kliffen (Mike); P.W.J.C. Serruys (Patrick); R. Krams (Rob); F.J. ten Cate (Folkert)

    1998-01-01

    textabstractBACKGROUND: Ischemia occurs frequently in hypertrophic cardiomyopathy (HCM) without evidence of epicardial stenosis. This study evaluates the hypothesis that the occurrence of ischemia in HCM is related to remodeling of the coronary microcirculation. METHODS AND

  9. Keloids and Hypertrophic Scars: Update and Future Directions

    National Research Council Canada - National Science Library

    Huang, Chenyu; Murphy, George F; Akaishi, Satoshi; Ogawa, Rei

    2013-01-01

    The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated...

  10. Nd:YAG Laser Treatment of Keloids and Hypertrophic Scars

    National Research Council Canada - National Science Library

    Akaishi, Satoshi; Koike, Sachiko; Dohi, Teruyuki; Kobe, Kyoko; Hyakusoku, Hiko; Ogawa, Rei

    2012-01-01

    .... Our group has been using long-pulsed, 1064-nm Nd:YAG laser in noncontact mode with low fluence and a submillisecond pulse duration to treat keloids and hypertrophic scars since 2006 with satisfactory results...

  11. Medicinal Plants for the Treatment of Hypertrophic Scars

    National Research Council Canada - National Science Library

    Ye, Qi; Wang, Su-Juan; Chen, Jian-Yu; Rahman, Khalid; Xin, Hai-Liang; Zhang, Hong

    2015-01-01

    .... Although a large amount of scientific research has been reported on the use of medicinal plants as a natural source of treatment for hypertrophic scarring, it is currently scattered across a wide range of publications...

  12. Burden of Recurrent and Ancestral Mutations in Families With Hypertrophic Cardiomyopathy

    NARCIS (Netherlands)

    Ross, Samantha Barratt; Bagnall, Richard D.; Ingles, Jodie; van Tintelen, J. Peter; Semsarian, Christopher

    2017-01-01

    Hypertrophic cardiomyopathy is a genetically heterogeneous myocardial disease with >1000 causal variants identified. Nonunique variants account for disease in many families. We sought to characterize nonunique variants in Australian families and determine whether they arise from common ancestral

  13. Investigating the potential of Shikonin as a novel hypertrophic scar treatment

    National Research Council Canada - National Science Library

    Fan, Chen; Xie, Yan; Dong, Ying; Su, Yonghua; Upton, Zee

    2015-01-01

    Hypertrophic scarring is a highly prevalent condition clinically and results from a decreased number of apoptotic fibroblasts and over-abundant production of collagen during scar formation following wound healing...

  14. Hypertrophic cardiomyopathy family with double-heterozygous mutations; does disease severity suggest doubleheterozygosity?

    OpenAIRE

    van Rijsingen, I.A.W.; Hermans-van Ast, J.F.; Arens, Y.H.J.M.; Schalla, S.M.; de Die-Smulders, C.E.M.; van den Wijngaard, A.; Pinto, Y.M.

    2009-01-01

    Background. With the improvement in genetic testing over time, double-heterozygous mutations are more often found by coincidence in families with hypertrophic cardiomyopathy (HCM). Double heterozygosity can be a cause of the wellknown clinical diversity within HCM families.

  15. Granulomatosis With Polyangiitis-Associated Hypertrophic Pachymeningitis Mimicking Spontaneous Intracranial Hypotension: A Case Report.

    Science.gov (United States)

    Jung, Young Hee; Lee, Mi Ji; Lee, Chungbin; Cha, Jihoon; Chung, Chin-Sang

    2017-03-01

    Dural enhancement is a characteristic finding in both spontaneous intracranial hypotension and hypertrophic pachymeningitis. Positional headache is the most important feature that distinguishes the two diseases. We report a patient with granulomatosis with polyangiitis (formerly Wegener's granulomatosis) who initially manifested like spontaneous intracranial hypotension. We report here the case of a 63-year old man who presented with severe positional headache. The patient had typical symptoms, symmetric dural enhancement, and a recent history of nontraumatic subdural hygroma which led to the diagnosis of spontaneous intracranial hypotension, but was finally diagnosed as granulomatosis with polyangiitis-associated secondary hypertrophic pachymeningitis. Cyclophosphamide therapy was effective for the maintenance of remission. Hypertrophic pachymeningitis associated with granulomatosis with polyangiitis can present with positional headache and subdural hygroma, mimicking spontaneous intracranial hypotension. Granulomatosis with polyangiitis should be suspected when patients with spontaneous intracranial hypotension or hypertrophic pachymeningitis show atypical features. © 2016 American Headache Society.

  16. Echocardiographic evaluation of pre-diagnostic development in young relatives genetically predisposed to hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten K; Havndrup, Ole; Christiansen, Michael

    2015-01-01

    Identification of the first echocardiographic manifestations of hypertrophic cardiomyopathy may be important for clinical management and our understanding of the pathogenesis. We studied the development of pre-diagnostic echocardiographic changes in young relatives to HCM patients during long...

  17. Angiotensin II type 2 receptors and cardiac hypertrophy in women with hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    J. Deinum (Jacob); J.M. van Gool (Jeanette); M.J.M. Kofflard (Marcel); A.H.J. Danser (Jan); F.J. ten Cate (Folkert)

    2001-01-01

    textabstractThe development of left ventricular hypertrophy in subjects with hypertrophic cardiomyopathy (HCM) is variable, suggesting a role for modifying factors such as angiotensin II. Angiotensin II mediates both trophic and antitrophic effects, via angiotensin II type 1

  18. The role of autologous bone graft in surgical treatment of hypertrophic nonunion of midshaft clavicle fractures

    Directory of Open Access Journals (Sweden)

    Hui-Kuang Huang

    2012-05-01

    Conclusion: LC-DCP fixation is an effective method for treating hypertrophic nonunion of mid-shaft clavicle fracture. Local bone graft is sufficient to achieve necessary union, and autologous bone graft from other sites of the body appears unnecessary.

  19. Extent of hypertrophy in hypertrophic cardiomyopathy: two-dimensional echocardiographic and angiographic correlation

    NARCIS (Netherlands)

    S. Domenicucci; S.K. Das (Swadesh); P.W.J.C. Serruys (Patrick); W.B. Vletter (Wim); J.R.T.C. Roelandt (Jos); F.J. ten Cate (Folkert)

    1983-01-01

    textabstractSince the first anatomical and functional descriptions of hypertrophic cardiomyopathy (HCM) there have been convincing attempts at better understanding and definition of the controversial aspects of this complex disease.

  20. Impaired cardiac mitochondrial oxidative phosphorylation and enhanced mitochondrial oxidative stress in feline hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Christiansen, Liselotte Bruun; Dela, Flemming; Koch, Jørgen

    2015-01-01

    Mitochondrial dysfunction and oxidative stress are important players in the development of various cardiovascular diseases, but their roles in hypertrophic cardiomyopathy (HCM) remain unknown. We examined whether mitochondrial oxidative phosphorylation (OXPHOS) capacity was impaired with enhanced...

  1. ACE I/D polymorphism in Indian patients with hypertrophic cardiomyopathy and dilated cardiomyopathy

    DEFF Research Database (Denmark)

    Rai, Taranjit Singh; Dhandapany, Perundurai Subramaniam; Ahluwalia, Tarun Veer Singh

    2008-01-01

    The study was carried to determine the association of angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism with the risk of hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and restrictive cardiomyopathy (RCM).......The study was carried to determine the association of angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism with the risk of hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and restrictive cardiomyopathy (RCM)....

  2. Leopard syndrome and hypertrophic cardiomyopathy: an association related to sudden death.

    Science.gov (United States)

    Antunes, Murillo de Oliveira; Arteaga, Edmundo; Matsumoto, Afonso Yoshikiro; Ianni, Barbara Maria

    2009-06-01

    We describe an uncommon association between Leopard syndrome and hypertrophic cardiomyopathy in a 27-year-old woman, who was little symptomatic and came for sudden death risk stratification and prevention. She has a rare syndrome, whose symptoms are maculae over the body and abnormalities in eyes, genital organs, heart and in growth. Association of hypertrophic cardiomyopathy with sudden death risk factors determined the implantation of cardioverter-defibrillator (ICD) for primary prevention.

  3. Comparison Between Clinical and Echocardiographic Findings in Infants and Children Diagnosed with Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Cristina Blesneac

    2015-06-01

    Full Text Available Background: Hypertrophic cardiomyopathy is a rather common hereditary disease with an autozomal dominant character, caused by mutations of genes that code for proteins of the cardiac sarcomere. The observed prevalence of this disease is much lower in pediatric patients compared to adults, because it’s late gene expression. Hypertrophic cardiomyopathy presenting in infancy has been shown to have a very high mortality.

  4. The Comparision of Left Atrial Functions Between Hypertrophic Cardiomyopathy and Hypertension

    Directory of Open Access Journals (Sweden)

    Ahmet Akdi

    2016-12-01

    Full Text Available INTRODUCTION: The presence of left ventricule hypertrophy (LVH due to arterial hypertension may impair atrial function. Also, hypertrophic cardiomyopathy (HCM represents a generalized myopathic process affecting both ventricular and atrial myocardium. In this study we aimed to evaluate left atrial volumes, phasic functions in hypertrophic cardiomyopathy and hypertensive heart disease. METHODS: The study consisted of 42 patients (25 men, 17 women; mean age 51.2 years with hypertrophic cardiomyopathy (n = 20 or hypertensive heart disease (n = 22. Two-dimensional echocardiographic left atrial volumes (maximal, minimal and pre-contraction volumes were obtained and left atrial phasic functions (reservoir, conduit, and pumping functions were calculated. The findings were compared with those of age- and sex-matched 20 controls (9 men, 11 women; mean age 44.2 years without structural heart disease. RESULTS: Left atrial volumes were found to be significantly increased in patients with hypertrophic cardiomyopathy and hypertensive heart disease compared with control groups. Left atrial reservoir and conduit functions were significantly lower in patients with hypertrophic cardiomyopathy than in those with hypertensive heart disease and control groups (p < 0.01 and p < 0.01, respectively. There was no significant difference of left atrial pumping functions between study groups (p = 0.2. DISCUSSION AND CONCLUSION: This study showed that left atrial minimal, maximal and pre-contraction volume indexes are increased in hypertensive and hypertrophic cardiomyopathy groups compared with control group, but there was no significant difference between hypertrophic cardiomyopathy and hypertensive patients. In hypertrophic cardiomyopathy group left atrial phasic functions, including conduit, reservoir and pump, were decreased significantly more than hypertensive and control group. In hypertensive patients left atrial phasic functions were decreased but compared with

  5. SFRP2 and Slug Contribute to Cellular Resistance to Apoptosis in Hypertrophic Scars

    OpenAIRE

    Liang Chen; Zhenxiang Wang; Shirong Li; Guangjian Zhao; Maosheng Tian; Zhicheng Sun

    2012-01-01

    Hypertrophic scars (HS) are skin disorders which occur after wounding and thermal injury. Our previous studies have suggested that secreted frizzled-related protein 2 (SFRP2) is involved in HS formation and that the suppression of SFRP2 promotes apoptosis of hypertrophic scar fibroblasts (HSFBs). However, the mechanisms have not been clarified. Previous studies revealed that Slug expression inhibits cell apoptosis, in vitro and in vivo, and SFRP2 regulates the expression of Slug in cervical c...

  6. [Gene mutation and clinical phenotype analysis of patients with Noonan syndrome and hypertrophic cardiomyopathy].

    Science.gov (United States)

    Liu, X H; Ding, W W; Han, L; Liu, X R; Xiao, Y Y; Yang, J; Mo, Y

    2017-10-02

    Objective: To analyze the gene mutations and clinical features of patients with Noonan syndrome and hypertrophic cardiomyopathy. Method: Determined the mutation domain in five cases diagnosed with Noonan syndrome and hypertrophic cardiomyopathy and identified the relationship between the mutant domain and hypertrophic cardiomyopathy by searching relevant articles in pubmed database. Result: Three mutant genes (PTPN11 gene in chromosome 12, RIT1 gene in chromosome 1 and RAF1 gene in chromosome 3) in five cases all had been reported to be related to hypertrophic cardiomyopathy. The reported hypertrophic cardiomyopathy relevant genes MYPN, MYH6 and MYBP3 had also been found in case 1 and 2. Patients with same gene mutation had different clinical manifestations. Both case 4 and 5 had RAF1 mutation (c.770C>T). However, case 4 had special face, low IQ, mild pulmonary artery stenosis, and only mild ventricular hypertrophy. Conclusion: Noonan syndrome is a genetic heterogeneity disease. Our study identified specific gene mutations that could result in Noonan syndrome with hypertrophic cardiomyopathy through molecular biology methods. The results emphasize the importance of gene detection in the management of Noonan syndrome.

  7. Hypertrophic cardiomyopathy: prognostic factors and survival analysis in 128 Egyptian patients.

    Science.gov (United States)

    El-Saiedi, Sonia A; Seliem, Zeinab S; Esmail, Reem I

    2014-08-01

    Hypertrophic cardiomyopathy is an important cause of disability and death in patients of all ages. Egyptian children may differ from Western and Asian patients in the pattern of hypertrophy distribution, clinical manifestations, and risk factors. The aim of our study was to report the clinical characteristics and outcomes of Egyptian children with hypertrophic cardiomyopathy studied over a 7-year duration and to determine whether the reported adult risk factors for sudden cardiac death are predictive of the outcome in these affected children. This retrospective study included 128 hypertrophic cardiomyopathy children. The data included personal history, family history, physical examination, baseline laboratory measurements, electrocardiogram, and Holter and echocardiographic results. Logistic regression analysis was used for the detection of risk factors of death. Fifty-one out of 128 patients died during the period of the study. Of the 51 deaths, 36 (70.5%) occurred in patients presenting before 1 year of age. Only eight patients had surgical intervention. Extreme left ventricular hypertrophy, that is, interventricular septal wall thickness or posterior wall thickness Z-score >6, sinus tachycardia, and supraventricular tachycardia were found to be independent risk factors for prediction of death in patients with hypertrophic cardiomyopathy. At our Egyptian tertiary care centre, hypertrophic cardiomyopathy has a relatively worse prognosis when compared with reports from Western and Asian series. Infants have a worse outcome than children presenting after the age of 1 year. A poorer prognosis in childhood hypertrophic cardiomyopathy is predicted by an extreme left ventricular hypertrophy, the presence of sinus tachycardia, and supraventricular tachycardia.

  8. 2010 Hudson River Shallow Water Sediment Cores

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Hudson River Shallow Water Mapping project characterizes the bottom of the Hudson River Estuary in shallow water (<3 m). The characterization includes...

  9. 2010 Hudson River Shallow Water Sediment Grabs

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Hudson River Shallow Water Mapping project characterizes the bottom of the Hudson River Estuary in shallow water (<3 m). The characterization includes...

  10. Shallow water reverberation measurement and prediction

    OpenAIRE

    Muggleworth, Charles E.

    1994-01-01

    Approved for public release; distribution is unlimited Low frequency active sonar performance in shallow water is often limited by reverberation. Reverberation modeling in shallow water has been difficult due to the complexity of the multipath acoustic propagation problem inherent in shallow environments. In August 1992, a shallow water, low-frequency reverberation measurement was made in the Barents Sea utilizing explosive signal, underwater sound (SUS) charges as sound sources and a 16-e...

  11. Electrostatically Tunable Nanomechanical Shallow Arches

    KAUST Repository

    Kazmi, Syed N. R.

    2017-11-03

    We report an analytical and experimental study on the tunability of in-plane doubly-clamped nanomechanical arches under varied DC bias conditions at room temperature. For this purpose, silicon based shallow arches are fabricated using standard e-beam lithography and surface nanomachining of a highly conductive device layer on a silicon-on-insulator (SOI) wafer. The experimental results show good agreement with the analytical results with a maximum tunability of 108.14% for 180 nm thick arch with a transduction gap of 1 μm between the beam and the driving/sensing electrodes. The high tunability of shallow arches paves the ways for highly tunable band pass filtering applications in high frequency range.

  12. Sede Boqer shallow pond project

    Science.gov (United States)

    Kudish, A.

    1981-03-01

    The use of shallow solar ponds for the conversion of solar energy into low grade thermal energy is examined at Sede Boqer, Israel with an emphasis placed upon the utilization of locally manufactured components. The daily performance of four small-module shallow solar ponds was monitored almost continuously between Aug 1978 and May 1979. The ponds all used PVC lower film but differed in the type of transparent upper film, glazing material or glazing angle. The daily performance is characterized by the maximum daily water temperature achieved, the total daily thermal energy collected, and the daily efficiency. The results indicate that the SSP system can supply approximately 3 GJ per square meter of thermal energy a year under semi-arid climatic conditions. The economic feasibility of the system is analyzed in comparison with oil (heavy fraction), natural gas, and electrical sources of energy.

  13. Shallow Water Waves and Solitary Waves

    OpenAIRE

    Hereman, Willy

    2013-01-01

    Encyclopedic article covering shallow water wave models used in oceanography and atmospheric science. Sections: Definition of the Subject; Introduction and Historical Perspective; Completely Integrable Shallow Water Wave Equations; Shallow Water Wave Equations of Geophysical Fluid Dynamics; Computation of Solitary Wave Solutions; Numerical Methods; Water Wave Experiments and Observations; Future Directions, and Bibliography.

  14. Petroleum Hydrocarbons Contamination Profile of Ochani Stream in ...

    African Journals Online (AJOL)

    Michael Horsfall

    ABSTRACT: Petroleum hydrocarbon contamination profile, heavy metals and some physicochemical ... Ground water contamination by crude oil therefore is becoming an increasing sensitive issue in Nigeria because most of the water supply is derived from shallow and ..... patches of weathered, partially degraded oil on the.

  15. Alternative Attractors of Shallow Lakes

    Directory of Open Access Journals (Sweden)

    Marten Scheffer

    2001-01-01

    Full Text Available Ponds and shallow lakes can be very clear with abundant submerged plants, or very turbid due to a high concentration of phytoplankton and suspended sediment particles. These strongly contrasting ecosystem states have been found to represent alternative attractors with distinct stabilizing feedback mechanisms. In the turbid state, the development of submerged vegetation is prevented by low underwater light levels. The unprotected sediment frequently is resuspended by wave action and by fish searching for food causing a further decrease of transparency. Since there are no plants that could serve as refuges, zooplankton is grazed down by fish to densities insufficient to control algal blooms. In contrast, the clear state in eutrophic shallow lakes is dominated by aquatic macrophytes. The submerged macrophytes prevent sediment resuspension, take up nutrients from the water, and provide a refuge for zooplankton against fish predation. These processes buffer the impacts of increased nutrient loads until they become too high. Consequently, the response of shallow lakes to eutrophication tends to be catastrophic rather than smooth, and various lakes switch back and forth abruptly between a clear and a turbid state repeatedly without obvious external forcing. Importantly, a switch from a turbid to a stable clear state often can be invoked by means of biomanipulation in the form of a temporary reduction of the fish stock.

  16. Potential impact of large scale abstraction on the quality of shallow ...

    African Journals Online (AJOL)

    Though post irrigation rainfall will be adequate to nullify the water table depression, once the fresh water is contaminated, it is extremely difficult to decontaminate. Consequently, the shallow groundwater will evolve from medium through high to very high salinity hazard to crops. Specific ions toxicity will also increase due to ...

  17. An Integrated Approach to Understand Relationships Between Shallow Water Benthic Community Structure and Ecosystem Function

    Science.gov (United States)

    2008-11-01

    of evidence (MLOE), with specific indicators, such as sediment contaminant concentrations, benthic community composition and bioassays forming the...respectively. Two of our degraded study sites (Elizabeth, Anacostia) were in tributaries given a “Region of Concern” designation for chemical ...effects of regional water quality impairments.  Benthic microalgae , which due to light availability are most abundant in shallow, nearshore waters

  18. Transaortic Chordal Cutting: Mitral Valve Repair for Obstructive Hypertrophic Cardiomyopathy With Mild Septal Hypertrophy.

    Science.gov (United States)

    Ferrazzi, Paolo; Spirito, Paolo; Iacovoni, Attilio; Calabrese, Alice; Migliorati, Katrin; Simon, Caterina; Pentiricci, Samuele; Poggio, Daniele; Grillo, Massimiliano; Amigoni, Pietro; Iascone, Maria; Mortara, Andrea; Maron, Barry J; Senni, Michele; Bruzzi, Paolo

    2015-10-13

    In severely symptomatic patients with obstructive hypertrophic cardiomyopathy (HCM) and mild septal hypertrophy, mitral valve (MV) abnormalities may play an important role in MV displacement into the left ventricular (LV) outflow tract. Therefore, isolated myectomy may not relieve outflow obstruction and symptoms, and MV replacement is often the surgical alternative. This study sought to assess the clinical and hemodynamic results of cutting thickened secondary MV chordae combined with a shallow septal muscular resection in severely symptomatic patients with obstructive HCM and mild septal hypertrophy. Clinical features were compared before surgery and at most recent clinical evaluation in 39 consecutive patients with obstructive HCM. Over a 23 ± 2 months follow-up, New York Heart Association functional class decreased from 2.9 ± 0.5 pre-operatively to 1.1 ± 1.1 post-operatively (p < 0.001), with no patient in class III at most recent evaluation. The resting outflow gradient decreased from 82 ± 43 mm Hg to 9 ± 5 mm Hg (p < 0.001) and septal thickness decreased from 17 ± 1 mm to 14 ± 2 mm (p < 0.001). No patient had MV prolapse or flail and 1 had residual moderate-to-severe MV regurgitation at most recent evaluation. MV geometry before and after surgery was compared with that of 25 consecutive patients with similar clinical profile and septal thickness that underwent isolated myectomy. After adjustment for differences in pre-operative values between the groups, the post-operative anterior MV leaflet-annulus ratio was 17% greater and tenting area 24% smaller in patients with chordal cutting, indicating that MV apparatus had moved to a more normal posterior position within the LV cavity, preventing MV systolic displacement into the outflow tract and outflow obstruction. This procedure relieves heart failure symptoms, abolishes LV outflow gradient, and avoids MV replacement in patients with obstructive HCM and mild septal thickness. Copyright © 2015 American

  19. MicroRNA-21 regulates hTERT via PTEN in hypertrophic scar fibroblasts.

    Directory of Open Access Journals (Sweden)

    Hua-Yu Zhu

    Full Text Available As an important oncogenic miRNA, microRNA-21 (miR-21 is associated with various malignant diseases. However, the precise biological function of miR-21 and its molecular mechanism in hypertrophic scar fibroblast cells has not been fully elucidated.Quantitative Real-Time PCR (qRT-PCR analysis revealed significant upregulation of miR-21 in hypertrophic scar fibroblast cells compared with that in normal skin fibroblast cells. The effects of miR-21 were then assessed in MTT and apoptosis assays through in vitro transfection with a miR-21 mimic or inhibitor. Next, PTEN (phosphatase and tensin homologue deleted on chromosome ten was identified as a target gene of miR-21 in hypertrophic scar fibroblast cells. Furthermore, Western-blot and qRT-PCR analyses revealed that miR-21 increased the expression of human telomerase reverse transcriptase (hTERT via the PTEN/PI3K/AKT pathway. Introduction of PTEN cDNA led to a remarkable depletion of hTERT and PI3K/AKT at the protein level as well as inhibition of miR-21-induced proliferation. In addition, Western-blot and qRT-PCR analyses confirmed that hTERT was the downstream target of PTEN. Finally, miR-21 and PTEN RNA expression levels in hypertrophic scar tissue samples were examined. Immunohistochemistry assays revealed an inverse correlation between PTEN and hTERT levels in high miR-21 RNA expressing-hypertrophic scar tissues.These data indicate that miR-21 regulates hTERT expression via the PTEN/PI3K/AKT signaling pathway by directly targeting PTEN, therefore controlling hypertrophic scar fibroblast cell growth. MiR-21 may be a potential novel molecular target for the treatment of hypertrophic scarring.

  20. Hypertrophic Osteodystrophy in Two Red Wolf (Canis rufus Pups

    Directory of Open Access Journals (Sweden)

    Jenessa L. Gjeltema

    2015-01-01

    Full Text Available A 6-month-old red wolf (Canis rufus pup presented for evaluation of progressive thoracic and pelvic limb lameness, joint swelling, and decreased body condition. Radiographic evaluation revealed medullary sclerosis centered at the metaphyses of multiple long bones, well-defined irregular periosteal proliferation, and ill-defined lucent zones paralleling the physes, consistent with hypertrophic osteodystrophy (HOD. Biopsies of affected bone revealed medullary fibrosis and new bone formation. The pup improved following treatment with nonsteroidal anti-inflammatories, opioids, and supportive care over the course of 4 weeks. Metaphyseal periosteal bone proliferation persisted until the animal was humanely euthanized several years later for poor quality of life associated with bilateral cranial cruciate ligament rupture. A second red wolf pup of 4.5 months of age presented for evaluation of lethargy, kyphotic posture, and swollen carpal and tarsal joints. Radiographs revealed bilateral medullary sclerosis and smooth periosteal reaction affecting multiple long bones, suggestive of HOD. Further diagnostics were not pursued in this case to confirm the diagnosis, and the clinical signs persisted for 4 weeks. In light of these two case reports, HOD should be recognized as a developmental orthopedic disease in growing red wolves.

  1. The Signaling Pathways Involved in Chondrocyte Differentiation and Hypertrophic Differentiation

    Directory of Open Access Journals (Sweden)

    Jianmei Li

    2016-01-01

    Full Text Available Chondrocytes communicate with each other mainly via diffusible signals rather than direct cell-to-cell contact. The chondrogenic differentiation of mesenchymal stem cells (MSCs is well regulated by the interactions of varieties of growth factors, cytokines, and signaling molecules. A number of critical signaling molecules have been identified to regulate the differentiation of chondrocyte from mesenchymal progenitor cells to their terminal maturation of hypertrophic chondrocytes, including bone morphogenetic proteins (BMPs, SRY-related high-mobility group-box gene 9 (Sox9, parathyroid hormone-related peptide (PTHrP, Indian hedgehog (Ihh, fibroblast growth factor receptor 3 (FGFR3, and β-catenin. Except for these molecules, other factors such as adenosine, O2 tension, and reactive oxygen species (ROS also have a vital role in cartilage formation and chondrocyte maturation. Here, we outlined the complex transcriptional network and the function of key factors in this network that determine and regulate the genetic program of chondrogenesis and chondrocyte differentiation.

  2. MRI diagnosis of hypertrophic osteoarthropathy from a remote childhood malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Sainani, Nisha I.; Lawande, Malini A.; Pungavkar, Sona A.; Patkar, Deepak P.; Sase, Kirti S. [Dr. Balabhai Nanavati Hospital and Research Centre, Department of MRI, Mammography and BMD, Mumbai (India); Parikh, Vipul P. [Dr. Balabhai Nanavati Hospital and Research Centre, Department of CT and USG, Mumbai (India)

    2007-06-15

    Hypertrophic osteoarthropathy (HOA) is a clinico-radiological syndrome characterized by digital clubbing, periosteal proliferation, bone pain, synovitis and arthralgia, all of these being commonly symmetrical. It is occasionally associated with nasopharyngeal lymphoepitheliomas and may develop before or after development of lung metastases in these patients. We report a case of a healthy 22-year-old female who presented to our institution with pain and swelling in the thighs and legs. She had a history of childhood nasopharyngeal lymphoepithelioma. Radiographs of the knees were negative. Magnetic resonance imaging (MRI) showed features suggestive of bilateral periostitis. Because of the propensity of the rare childhood nasopharyngeal lymphoepithelioma to present with HOA, this entity was included in the differential diagnosis. A subsequent chest radiograph and CT demonstrated a lung and mediastinal mass that were histologically confirmed to be metastatic. To the best of our knowledge, HOA and metastases from nasopharyngeal lymphoepithelioma occurring after such a long time interval have not been previously reported. Early demonstration and consideration of HOA on the basis of MRI, lead to expeditious and appropriate subsequent investigation. (orig.)

  3. Keloids and Hypertrophic Scars: Update and Future Directions

    Directory of Open Access Journals (Sweden)

    Chenyu Huang, MD, PhD

    2013-07-01

    Full Text Available Summary: The development of cutaneous pathological scars, namely, hypertrophic scars (HSs and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions.

  4. Surgeon as educator: bedside ultrasound in hypertrophic pyloric stenosis.

    Science.gov (United States)

    Wyrick, Deidre L; Smith, Samuel D; Dassinger, Melvin S

    2014-01-01

    Our institution has demonstrated the diagnostic accuracy of surgeon-performed ultrasound (US) in the diagnosis of hypertrophic pyloric stenosis (HPS). Moreover, we have also shown this modality to be accurate and reproducible through surgeon-to-surgeon instruction. The purpose of this study was to determine whether a surgical resident with experience in diagnosing HPS can teach pediatric emergency medicine (PEM) fellows, with little experience in sonography, to accurately measure the pyloric channel with bedside US. A surgical resident with experience in diagnosing HPS with US-proctored 4 emergency medicine fellows for 5 bedside US examinations each. A PEM fellow, who was blinded to the results from the radiology department US, then performed bedside US and measured the pyloric channel in patients presenting to the emergency department with HPS. Results between the radiology department and the fellows were compared using the Student t test. In total, 18 USs were performed on 17 patients. There were no false-negative or false-positive results. There was no statistical difference between the radiology department and fellow measurement when evaluating muscle width (p = 0.21, mean deviation = 0.2 mm) or channel length (p = 0.47, mean deviation = 0.6 mm). Bedside-performed US technique for measuring the pylorus length and width in patients with HPS is reproducible and accurate when taught to PEM providers. The learning curve for this technique is short. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy.

    Science.gov (United States)

    Timmer, Stefan A J; Germans, Tjeerd; Götte, Marco J W; Rüssel, Iris K; Dijkmans, Pieter A; Lubberink, Mark; ten Berg, Jurrien M; ten Cate, Folkert J; Lammertsma, Adriaan A; Knaapen, Paul; van Rossum, Albert C

    2010-04-01

    Next to hypertrophy, hypertrophic cardiomyopathy (HCM) is characterized by alterations in myocardial energetics. A small number of studies have shown that myocardial external efficiency (MEE), defined by external work (EW) in relation to myocardial oxidative metabolism (MVO(2)), is reduced. The present study was conducted to identify determinants of MEE in patients with HCM by use of dynamic positron emission tomography (PET) and cardiovascular magnetic resonance imaging (CMR). Twenty patients with HCM (12 men, mean age: 55.2 + or - 13.9 years) and 11 healthy controls (7 men, mean age: 48.1 + or - 10 years) were studied with [(11)C]acetate PET to assess MVO(2). CMR was performed to determine left ventricular (LV) volumes and mass (LVM). Univariate and multivariate analyses were employed to determine independent predictors of myocardial efficiency. Between study groups, MVO(2) (controls: 0.12 + or - 0.04 ml x min(-1) x g(-1), HCM: 0.13 + or - 0.05 ml x min(-1) x g(-1), p = 0.64) and EW (controls: 9,139 + or - 2,484 mmHg x ml, HCM: 9,368 + or - 2,907 mmHg x ml, p = 0.83) were comparable, whereas LVM was significantly higher (controls: 99 + or - 21 g, HCM: 200 + or - 76 g, p efficiency. Mechanical external efficiency could independently be predicted by SV and LVM.

  6. Diastolic filling in a physical model of obstructive hypertrophic cardiomyopathy

    Science.gov (United States)

    Schovanec, Joseph; Samaee, Milad; Lai, Hong Kuan; Santhanakrishnan, Arvind

    2015-11-01

    Hypertrophic Cardiomyopathy (HCM) is an inherited heart disease that affects as much as one in 500 individuals, and is the most common cause of sudden death in young athletes. The myocardium becomes abnormally thick in HCM and deforms the internal geometry of the left ventricle (LV). Previous studies have shown that a vortex is formed during diastolic filling, and further that the dilated LV morphology seen in systolic heart failure results in altering the filling vortex from elliptical to spherical shape. We have also previously shown that increasing LV wall stiffness decreases the filling vortex circulation. However, alterations to intraventricular filling fluid dynamics due to an obstructive LV morphology and locally elevated wall stiffness (in the hypertrophied region) have not been previously examined from a mechanistic standpoint. We conducted an experimental study using an idealized HCM physical model and compared the intraventricular flow fields obtained from 2D PIV to a baseline LV physical model with lower wall stiffness and anatomical geometry. The obstruction in the HCM model leads to earlier breakdown of the filling vortex as compared to the anatomical LV. Intraventricular filling in both models under increased heart rates will be discussed.

  7. The diagnosis of hypertrophic cardiomyopathy by cardiovascular magnetic resonance

    Science.gov (United States)

    2012-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common genetic disease of the heart. HCM is characterized by a wide range of clinical expression, ranging from asymptomatic mutation carriers to sudden cardiac death as the first manifestation of the disease. Over 1000 mutations have been identified, classically in genes encoding sarcomeric proteins. Noninvasive imaging is central to the diagnosis of HCM and cardiovascular magnetic resonance (CMR) is increasingly used to characterize morphologic, functional and tissue abnormalities associated with HCM. The purpose of this review is to provide an overview of the clinical, pathological and imaging features relevant to understanding the diagnosis of HCM. The early and overt phenotypic expression of disease that may be identified by CMR is reviewed. Diastolic dysfunction may be an early marker of the disease, present in mutation carriers prior to the development of left ventricular hypertrophy (LVH). Late gadolinium enhancement by CMR is present in approximately 60% of HCM patients with LVH and may provide novel information regarding risk stratification in HCM. It is likely that integrating genetic advances with enhanced phenotypic characterization of HCM with novel CMR techniques will importantly improve our understanding of this complex disease. PMID:22348519

  8. Flow-Induced Mitral Leaflet Motion in Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Meschini, Valentina; Mittal, Rajat; Verzicco, Roberto

    2017-11-01

    Hypertrophic cardiomyopathy (HCM) is considered the cause of sudden cardiac death in developed countries. Clinically it is found to be related to the thickening of the intra-ventricular septum combined with elongated mitral leaflets. During systole the low pressure, induced by the abnormal velocities in the narrowed aortic channel, can attract one or both the mitral leaflets causing the aortic obstruction and sometimes instantaneous death. In this paper a fluid structure interaction model for the flow in the left ventricle with a native mitral valve is employed to investigate the physio-pathology of HCM. The problem is studied using direct numerical simulations of the Navier-Stokes equations with a two-way coupled structural solver based on interaction potential approach for the structure dynamics. Simulations are performed for two different degrees of hypertrophy, and two values of pumping efficiency. The leaflets dynamics and the ventricle deformation resulting from the echocardiography of patients affected by HCM are well captured by the simulations. Moreover, the procedures of leaflets plication and septum myectomy are simulated in order to get insights into the efficiency and reliability of such surgery.

  9. Hypertrophic Obstructive Cardiomyopathy: Surgical Myectomy and Septal Ablation.

    Science.gov (United States)

    Nishimura, Rick A; Seggewiss, Hubert; Schaff, Hartzell V

    2017-09-15

    Hypertrophic cardiomyopathy is a genetic disorder characterized by marked hypertrophy of the myocardium. It is frequently accompanied by dynamic left ventricular outflow tract obstruction and symptoms of dyspnea, angina, and syncope. The initial therapy for symptomatic patients with obstruction is medical therapy with β-blockers and calcium antagonists. However, there remain a subset of patients who have continued severe symptoms, which are unresponsive to medical therapy. These patients can be treated with septal reduction therapy, either surgical septal myectomy or alcohol septal ablation. When performed by experienced operators working in high-volume centers, septal myectomy is highly effective with a >90% relief of obstruction and improvement in symptoms. The perioperative mortality rate for isolated septal myectomy in most centers is <1%. Alcohol septal ablation is a less invasive treatment. In many patients, the hemodynamic and clinical results are comparable to that of septal myectomy. However, the results of alcohol septal ablation are dependent on the septal perforator artery supplying the area of the contact between the hypertrophied septum and the anterior leaflet of the mitral valve. There are some patients, particularly younger patients with severe hypertrophy, who do not uniformly experience complete relief of obstruction and symptoms. Both techniques of septal reduction therapy are highly operator dependent. The final decision as to which approach should be selected in any given patient is dependent up patient preference and the availability and experience of the operator and institution at which the patient is being treated. © 2017 American Heart Association, Inc.

  10. Hypertrophic cardiomyopathy in 2013: Current speculations and future perspectives

    Science.gov (United States)

    Efthimiadis, Georgios K; Pagourelias, Efstathios D; Gossios, Thomas; Zegkos, Thomas

    2014-01-01

    Hypertrophic cardiomyopathy (HCM), the most variable cardiac disease in terms of phenotypic presentation and clinical outcome, represents the most common inherited cardiomyopathic process with an autosomal dominant trait of inheritance. To date, more than 1400 mutations of myofilament proteins associated with the disease have been identified, most of them “private” ones. This striking allelic and locus heterogeneity of the disease certainly complicates the establishment of phenotype-genotype correlations. Additionally, topics pertaining to patients’ everyday lives, such as sudden cardiac death (SCD) risk stratification and prevention, along with disease prognosis, are grossly related to the genetic variation of HCM. This review incorporates contemporary research findings and addresses major aspects of HCM, including preclinical diagnosis, genetic analysis, left ventricular outflow tract obstruction and SCD. More specifically, the spectrum of genetic analysis, the selection of the best method for obstruction alleviation and the need for a unique and accurate factor for SCD risk stratification are only some of the controversial HCM issues discussed. Additionally, future perspectives concerning HCM and myocardial ischemia, as well as atrial fibrillation, are discussed. Rather than enumerating clinical studies and guidelines, challenging problems concerning the disease are critically appraised by this review, highlighting current speculations and recommending future directions. PMID:24575171

  11. Hypertrophic cardiomyopathy: an autopsy analysis of 14 cases.

    Directory of Open Access Journals (Sweden)

    Phadke R

    2001-07-01

    Full Text Available BACKGROUND: Hypertrophic cardiomyopathy (HCM is one of the less common forms of primary cardiomyopathies. There is little data available on HCM in Indian literature. AIMS: To assess the incidence and analyse the clinicopathological features of HCM. SETTINGS: Analysis of data of 15 years from a tertiary care centre. METHODS AND MATERIAL: The clinical and pathological data in fourteen cases of HCM with respect to their gross and microscopic features and clinical presentation were reviewed. RESULTS: Incidence of HCM amongst the autopsied primary cardiomyopathies (N = 101 was 13.9% (n=14. Males were affected more. Common presenting symptoms were exertional dyspnoea, angina and palpitations. Concentric and asymmetric hypertrophy was equally seen. Obliterative small vessel disease was noted in 50% of the cases. Although significant myofibre disarray (>5% was seen in all fourteen cases, it could be demonstrated in only 40- 50% of an average of twenty sections studied. Type IA myofibre disarray was the commonest. Six of the fourteen patients died suddenly. Cardiac failure was the commonest cause of death. CONCLUSIONS: Myofibre disarray is a highly sensitive and specific marker for HCM only when considered in a quantitative rather than a qualitative fashion. In this context, the rationale for performing endomyocardial biopsy is to rule out mimics of HCM.

  12. Determining pathogenicity of genetic variants in hypertrophic cardiomyopathy: importance of periodic reassessment.

    Science.gov (United States)

    Das K, Jipin; Ingles, Jodie; Bagnall, Richard D; Semsarian, Christopher

    2014-04-01

    Major advances have been made in our understanding and clinical application of genetic testing in hypertrophic cardiomyopathy. Determining pathogenicity of a single-nucleotide variant remains a major clinical challenge. This study sought to reassess single-nucleotide variant classification in hypertrophic cardiomyopathy probands. Consecutive probands with hypertrophic cardiomyopathy with a reported pathogenic mutation or variation of uncertain significance were included. Family and medical history were obtained. Each single-nucleotide variant was reassessed by a panel of four reviewers for pathogenicity based on established criteria together with updated cosegregation data and current population-based allele frequencies. From 2000 to 2012, a total of 136 unrelated hypertrophic cardiomyopathy probands had genetic testing, of which 63 (46%) carried at least one pathogenic mutation. MYBPC3 (n = 34; 47%) and MYH7 (n = 23; 32%) gene variants together accounted for 79%. Five variants in six probands (10%) were reclassified: two variation of uncertain significance were upgraded to pathogenic, one variation of uncertain significance and one pathogenic variant were downgraded to benign, and one pathogenic variant (found in two families) was downgraded to variation of uncertain significance. None of the reclassifications had any adverse clinical consequences. Given the rapid growth of genetic information available in both disease and normal populations, periodic reassessment of single-nucleotide variant data is essential in hypertrophic cardiomyopathy.

  13. Effect of hematoporphyrin monomethyl ether-sonodynamic therapy (HMME-SDT on hypertrophic scarring.

    Directory of Open Access Journals (Sweden)

    Hanjun Zhang

    Full Text Available OBJECTIVE: The aim of the present study was to explore the potential for hematoporphyrin monomethyl ether-Sonodynamic Therapy (HMME-SDT treatment of hypertrophic scars within rabbit ears. METHODS: 60 white rabbits were randomly divided into five groups: (1 untreated controls, (2 lesioned, (3 lesioned + HMME, (4 lesioned + US (Ultrasound, and (5 lesioned +HMME-SDT. After induction of a lesion upon the ears of the rabbits, hypertrophic scars were assessed at 14, 28, 42 and 56 days post-lesion +/- treatment. Assessments consisted of visual inspection in the change of the skin, scar formation pathological morphology by hematoxylin and eosin (HE staining technique with optical microscopy, calculation of a hypertrophic index, fibroblastic density measures, and observation of collagen changes in the scar tissue by Van Gieson's (VGStain along with calculation of collagen area density. RESULTS: With continued HMME-SDT treatment there was a gradual improvement in all parameters over the duration of the experiment. The lesion-induced scars of rabbits receiving HMME-SDT treatment were soft, the size was reduced, hyperplasia was flat and the color pale. The fibroblasts and collagens were reduced and the collagens were light red, sparse and orderly. The hypertrophic index was reduced, since the fibroblastic density was lowered and collagen area density was decreased. CONCLUSION: HMME is an effective sonosensitizer and the combination of HMME-SDT treatment can exert significant benefits in reducing the formation of hypertrophic scars.

  14. Highly tunable NEMS shallow arches

    KAUST Repository

    Kazmi, Syed N. R.

    2017-11-30

    We report highly tunable nanoelectromechanical systems NEMS shallow arches under dc excitation voltages. Silicon based in-plane doubly clamped bridges, slightly curved as shallow arches, are fabricated using standard electron beam lithography and surface nanomachining of a highly conductive device layer on a silicon-on-insulator wafer. By designing the structures to have gap to thickness ratio of more than four, the mid-plane stretching of the nano arches is maximized such that an increase in the dc bias voltage will result into continuous increase in the resonance frequency of the resonators to wide ranges. This is confirmed analytically based on a nonlinear beam model. The experimental results are found to be in good agreement with that of the results from developed analytical model. A maximum tunability of 108.14% for a 180 nm thick arch with an initially designed gap of 1 μm between the beam and the driving/sensing electrodes is achieved. Furthermore, a tunable narrow bandpass filter is demonstrated, which opens up opportunities for designing such structures as filtering elements in high frequency ranges.

  15. Water Contamination

    Science.gov (United States)

    ... Statistics Training & Education Policy & Recommendations Fast Facts Healthy Water Sites Healthy Water Drinking Water Healthy Swimming Global ... type=”submit” value=”Submit” /> Healthy Water Home Water Contamination Recommend on Facebook Tweet Share Compartir On ...

  16. Groundwater Contamination

    Science.gov (United States)

    ... Payment Methods Shipping & Handling Donate Potential Threats to Groundwater The Basics What is Groundwater The Hydrologic Cycle ... Quick Facts Read The Aquifer Get Our Newsletters Groundwater Contamination Over 50% of the United States population ...

  17. Bimodal spectroscopy for in vivo characterization of hypertrophic skin tissue: pre-clinical experimentation, spectral data selection and classification

    Science.gov (United States)

    Liu, Honghui; Gisquet, Héloïse; Guillemin, F.; Blondel, Walter C. P. M.

    2011-07-01

    Objective: The objective of this study was two folds: firstly, we would like to investigate the efficiency of bimodal spectroscopic technique in characterization of hypertrophic scarring tissue deliberately created on a preclinical model (rabbit's ear); on the other hand, we evaluate the inhibition effect of an anti-inflammatory medication (tacrolimus) on hypertrophic formation in scar by using our bimodal spectroscopic system. Study design: This study was conducted on 20 New Zealand Rabbits receiving hypertrophic scarring treatment on their ears. Fluorescence and Diffuse Reflectance spectra were collected from each scar, amongst which some had received tacrolimus treatment. Features were extracted from corrected spectral data and analyzed to classify the scarring tissues into hypertrophic or non-hypertrophic. Diagnostic algorithms were developed with the use of k-NN classifier and validated by comparing to histological classification result with Leave-one- out cross validation. Results and discussion: The accuracy of our bimodal spectroscopy method for detecting hypertrophic scarring scar tissue was good (sensibility: 90.84%, specificity: 94.44%). The features used for classification were mainly extracted from the spectra exited at 360, 410 and 420 nm. This indicates that the difference between the spectra acquired from hypertrophic and non-hypertrophic tissue may be due to the different intensity distribution of several fluorophores (collagen,elastin and NADH) excited in this range, or to the change in proportion of tissue layers (epidermis and dermis) explored by the CEFS in use.

  18. Laser and intense pulsed light therapy for the treatment of hypertrophic scars: a systematic review

    NARCIS (Netherlands)

    Vrijman, C.; van Drooge, A. M.; Limpens, J.; Bos, J. D.; van der Veen, J. P. W.; Spuls, P. I.; Wolkerstorfer, A.

    2011-01-01

    Hypertrophic scars are difficult to improve and remain a therapeutic challenge. Several lasers and light sources have been evaluated in the past decades and have been shown to improve hypertrophic scars. However, a systematic review is not available. To assess current evidence of efficacy of all

  19. Hypertrophic scars after therapy with CO2 laser for treatment of multiple cutaneous neurofibromas

    NARCIS (Netherlands)

    J.U. Ostertag (Judith); C.C.W. Theunissen (Chantal); H.A.M. Neumann (Martino)

    2002-01-01

    textabstractBACKGROUND. CO2 laser surgery is a treatment modality for cutaneous neurofibromas. OBJECTIVE. Hypertrophic and atrophic scars can result from treatment with CO2 laser surgery. We present a case of cutaneous neurofibromatosis that developed hypertrophic scars postoperatively. METHODS.

  20. Long-term outcome of percutaneous transluminal septal myocardial ablation in hypertrophic obstructive cardiomyopathy: a Scandinavian multicenter study

    DEFF Research Database (Denmark)

    Jensen, Morten Kvistholm; Almaas, Vibeke Marie; Jacobsson, Linda

    2011-01-01

    Single-center reports on percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy have shown considerable differences in outcome.......Single-center reports on percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy have shown considerable differences in outcome....

  1. Successful management of hypertrophic cardiomyopathy in a Matschie's tree kangaroo (Dendrolagus matschiei).

    Science.gov (United States)

    Fredholm, Daniel V; Jones, Ashley E; Hall, Natalie H; Russell, Kathleen; Heard, Darryl J

    2015-03-01

    A 3-yr-old, intact male Matschie's tree kangaroo (Dendrolagus matschiei) was examined for a 1-wk history of intermittent lethargy and tachypnea. An echocardiogram revealed concentric hypertrophy of the left ventricular free wall and interventricular septum. These findings were compared to measurements from healthy Matschie's tree kangaroos, supporting a diagnosis of hypertrophic cardiomyopathy. At the time of publication, the patient has been managed for over 11.5 yr, using a combination of enalapril, furosemide, diltiazem, and diet modifications. Hypertrophic cardiomyopathy should be considered as a differential diagnosis in tree kangaroos exhibiting signs of cardiovascular or respiratory distress. This case represents the first report of antemortem diagnosis and successful management of hypertrophic cardiomyopathy in a Matschie's tree kangaroo.

  2. Outcome of alcohol septal ablation in mildly symptomatic patients with hypertrophic obstructive cardiomyopathy

    DEFF Research Database (Denmark)

    Veselka, Josef; Faber, Lothar; Liebregts, Max

    2017-01-01

    Background- The long-term efficacy and safety of alcohol septal ablation (ASA) in patients with highly symptomatic hypertrophic obstructive cardiomyopathy has been demonstrated. The aim of this study was to evaluate the long-term outcomes of mildly symptomatic patients with hypertrophic obstructive......, and III at the last clinical checkup, respectively. Conclusions- Mildly symptomatic hypertrophic obstructive cardiomyopathy patients treated with ASA had sustained symptomatic and hemodynamic relief with a low risk of developing severe heart failure. Their survival is comparable to the general population....... cardiomyopathy treated with ASA. Methods and Results- We retrospectively evaluated consecutive patients enrolled in the Euro-ASA registry (1427 patients) and identified 161 patients (53±13 years; 27% women) who were mildly symptomatic (New York Heart Association [NYHA] class II) pre-ASA. The median...

  3. Evaluation of Surface Ducts in Shallow Water.

    Science.gov (United States)

    1982-03-29

    to determine optimum freouency domains for sound propagation at those sites. 1.2 Background Ten shallow water stations were occupied during the FASOR ...selected two of the FASOR shallow water stations for an optimum frequency study. Results for a downward refraction profile were compared to optimum...and Reverberation from the Shallow-Water FASOR Areas with Comparisons to Propagation Loss Models, J. A. Whitney, Naval Ocean Systems Center TR 400

  4. Nonfamilial Hypertrophic Cardiomyopathy: Prevalence, Natural History, and Clinical Implications.

    Science.gov (United States)

    Ingles, Jodie; Burns, Charlotte; Bagnall, Richard D; Lam, Lien; Yeates, Laura; Sarina, Tanya; Puranik, Rajesh; Briffa, Tom; Atherton, John J; Driscoll, Tim; Semsarian, Christopher

    2017-04-01

    Yield of causative variants in hypertrophic cardiomyopathy (HCM) is increased in some probands, suggesting different clinical subgroups of disease occur. We hypothesized that a negative family history and no sarcomere mutations represent a nonfamilial subgroup of HCM. We sought to determine the prevalence, natural history, and potential clinical implications of this nonfamilial subgroup of HCM. Four hundred and thirteen unrelated probands with HCM seen in a specialized HCM center between 2002 and 2015 and genetic testing performed were included in this retrospective cohort study. There were 251 (61%) probands with no reported family history of HCM, including 166 (40% of total) probands with no sarcomere mutation, that is, nonfamilial HCM. Quantified family pedigree data revealed no difference in mean number of first-degree relatives screened between nonfamilial and sarcomere-positive groups. Adjusted predictors of nonfamilial status were older age (odds ratio, 1.04; 95% confidence interval, 1.02-1.06; P =0.0001), male sex (odds ratio, 1.96; 95% confidence interval, 1.11-3.45; P =0.02), hypertension (odds ratio, 2.80; 95% confidence interval, 1.57-5.00; P =0.0005), and nonasymmetric septal morphology (odds ratio, 3.41; 95% confidence interval, 1.64-7.08; P =0.001). They had a less severe clinical course with greater event-free survival from major cardiac events ( P =0.04) compared with sarcomere-positive HCM probands. Genotype prediction scores showed good performance in identifying genotype-positive patients (area under the curve, 0.71-0.75) and, in combination with pedigree characteristics, were further improved. Approximately 40% of HCM probands have a nonfamilial subtype, with later onset and less severe clinical course. We propose a revised clinical pathway for management, highlighting the role of genetic testing, a detailed pedigree, and refined clinical surveillance recommendations for family members. © 2017 American Heart Association, Inc.

  5. Social determinants of health in the setting of hypertrophic cardiomyopathy.

    Science.gov (United States)

    Ingles, Jodie; Johnson, Renee; Sarina, Tanya; Yeates, Laura; Burns, Charlotte; Gray, Belinda; Ball, Kylie; Semsarian, Christopher

    2015-04-01

    Social determinants of health play an important role in explaining poor health outcomes across many chronic disease states. The impact of the social gradient in the setting of an inherited heart disease, hypertrophic cardiomyopathy (HCM), has not been investigated. This study sought to profile the socioeconomic status of patients attending a specialized multidisciplinary clinic and to determine the impact on clinical factors, psychosocial wellbeing and adherence to medical advice. Patients with HCM and at-risk relatives attending a specialized multidisciplinary clinic in Sydney Australia between 2011 and 2013 were included. Clinical, socioeconomic, geographic remoteness and adherence data were available. A broader clinic and registry-based group completed a survey including psychological wellbeing, health-related quality of life, Morisky Medication Adherence Scale and individual-level socioeconomic information. Over a 3-year period, 486 patients were seen in the specialized clinic. There was an over-representation of patients from socioeconomically advantaged and the least geographically remote areas. Socioeconomic disadvantage was associated with comorbidities, poor psychological wellbeing and health-related quality of life, lower understanding of HCM and more complex clinical management issues such as NYHA class, atrial fibrillation and left ventricular outflow tract obstruction. Approximately 10% of patients were non-adherent to medical advice, and poor medication adherence was seen in 30% of HCM patients with associated factors being younger age, minority ethnicity, anxiety and poor mental quality of life. Of all the patients attending a specialized cardiac genetic clinic, there is an overrepresentation of patients from very advantaged and major metropolitan areas and suggests that those most in need of a multidisciplinary approach to care are not accessing it. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Clinical Characteristics and Prognosis of End-stage Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Yan Xiao

    2015-01-01

    Full Text Available Background: End-stage hypertrophic cardiomyopathy (HCM is complicated by substantial adverse events. However, few studies have focused on electrocardiographic features and their prognostic values in HCM. This study aimed to evaluate the clinical manifestations and prognostic value of electrocardiography in patients with end-stage HCM. Methods: End-stage HCM patients were enrolled from a total of 1844 consecutive HCM patients from April 2002 to November 2013 at Fuwai Hospital. Clinical data, including medical history, electrocardiography, and echocardiography, were analyzed. Cox hazards regression analysis was used to assess the risk factors for cardiovascular mortality. Results: End-stage HCM was identified in 99 (5.4% patients, averaged at 52 ± 16 years old at entry. Atrial fibrillation was observed in 53 patients and mural thrombus in 19 patients. During 3.9 ± 3.0 years of follow-up, embolic stroke, refractory heart failure, and death or transplantation were observed in 20, 39, and 51 patients, respectively. The incidence of annual mortality was 13.2%. Multivariate Cox hazards regression analysis identified New York Heart Association Class (NYHA III/IV at entry (hazard ratio [HR]: 1.99; 95% confidence interval [CI]: 1.05-3.80; P = 0.036, left bundle branch block (LBBB (HR: 2.80; 95% CI: 1.47-5.31; P = 0.002, and an abnormal Q wave (HR: 2.21; 95% CI: 1.16-4.23; P = 0.016 as independent predictors of cardiovascular death, in accordance with all-cause death and heart failure-related death. Conclusions: LBBB and an abnormal Q wave are risk factors of cardiovascular mortality in end-stage HCM and provide new evidence for early intervention. Susceptibility of end-stage HCM patients to mural thrombus and embolic events warrants further attention.

  7. Ventricular arrhythmias and left ventricular hypertrophy in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Piva e Mattos, Beatriz; Torres, Marco Antonio Rodrigues; Freitas, Valéria Centeno de; Scolari, Fernando Luís; Loreto, Melina Silva de

    2013-05-01

    In hypertrophic cardiomyopathy (HCM), the degree of left ventricular hypertrophy (LVH) could influence the development of ventricular arrhythmias. In HCM, analyze the association between the occurrence of ventricular arrhythmias determined by Holter electrocardiogram (ECG-Holter) and the degree of LVH determined by maximum wall thickness (MWT) in echocardiography and body mass index (BMI). Fifty-four consecutive patients with HCM underwent 24-hour ECG-Holter and echocardiography for assessment of level of LVH through MWT and BMI. Two levels were established for the occurrence of Ventricular Arrhythmias: I - alone or paired extrasystoles and II - Non- Sustained Ventricular Tachycardia (NSVT). In 13 patients (24%) with NSVT (level II), there was a higher frequency of MWT of the left ventricle (LV) > 21 mm (n = 10, 77%, 25 ± 4 mm) and LLLV = 144 g/m² (n = 10, 77%, 200 ± 30 g/m²), in comparison with those presenting with extrasystole arrhythmias (level I) (n = 41, 76%), in which these measures were identified in, respectively, 37 % (n= 15, 23 ± 1 mm), p = 0.023, and 39% (n = 16, 192 ± 53 g / m²) of the cases (p = 0.026). The cut-off values mentioned were determined by the ROC curve with a confidence interval of 95%. NSVT was more common in patients with MWTLV > 21 mm and LLLV > 144 g/m² (8 of 13, 62%) than in those with (4 of 13, 31%) or without (1 of 13; 8%) echocardiographic variables above cut-off values (p = 0.04). In HCM, occurrence of ventricular arrhythmias by Holter was associated with the degree of LVH assessed by echocardiography through MWT and BMI.

  8. Sudden death during empiric amiodarone therapy in symptomatic hypertrophic cardiomyopathy.

    Science.gov (United States)

    Fananapazir, L; Leon, M B; Bonow, R O; Tracy, C M; Cannon, R O; Epstein, S E

    1991-01-15

    Amiodarone is reported to improve symptoms and to prevent sudden death in patients with hypertrophic cardiomyopathy (HC). Amiodarone treatment (loading dose 30 g given over 6 weeks; maintenance dose 400 mg/day) was prospectively evaluated in 50 patients with HC in whom the drug was initiated because of symptoms refractory to conventional drug therapy (calcium antagonists and beta blockers). Twenty-one (42%) patients had ventricular tachycardia (VT) during Holter monitoring. Amiodarone significantly and often markedly improved the patients' New York Heart Association functional class status (from 3.3 to 2.7 at 2 months, p less than 0.001) and treadmill exercise duration (p less than 0.001). Eight patients, however, died (7 suddenly) during a mean follow-up period of 2.2 +/- 1.8 years. Of the 7 sudden deaths, 6 occurred within 5 months of initiation of treatment. The 6-month and 1- and 2-year survival rates were 87, 85 and 80%, respectively. The survival rate of patients with VT was significantly worse than that of patients without VT (61 vs 97% at 2 years; p less than 0.01). Sudden death occurred despite abolition of VT on Holter monitoring. Amiodarone increased left ventricular peak filling rate by radionuclide angiography in 20 of 33 patients (61%) (p less than 0.01). Decrease in peak left ventricular filling rate within 10 days of amiodarone therapy (8 of 33 patients) was associated with subsequent sudden death (p less than 0.04).(ABSTRACT TRUNCATED AT 250 WORDS)

  9. A Murine Hypertrophic Cardiomyopathy Model: The DBA/2J Strain.

    Directory of Open Access Journals (Sweden)

    Wenyuan Zhao

    Full Text Available Familial hypertrophic cardiomyopathy (HCM is attributed to mutations in genes that encode for the sarcomere proteins, especially Mybpc3 and Myh7. Genotype-phenotype correlation studies show significant variability in HCM phenotypes among affected individuals with identical causal mutations. Morphological changes and clinical expression of HCM are the result of interactions with modifier genes. With the exceptions of angiotensin converting enzyme, these modifiers have not been identified. Although mouse models have been used to investigate the genetics of many complex diseases, natural murine models for HCM are still lacking. In this study we show that the DBA/2J (D2 strain of mouse has sequence variants in Mybpc3 and Myh7, relative to widely used C57BL/6J (B6 reference strain and the key features of human HCM. Four-month-old of male D2 mice exhibit hallmarks of HCM including increased heart weight and cardiomyocyte size relative to B6 mice, as well as elevated markers for cardiac hypertrophy including β-myosin heavy chain (MHC, atrial natriuretic peptide (ANP, brain natriuretic peptide (BNP, and skeletal muscle alpha actin (α1-actin. Furthermore, cardiac interstitial fibrosis, another feature of HCM, is also evident in the D2 strain, and is accompanied by up-regulation of type I collagen and α-smooth muscle actin (SMA-markers of fibrosis. Of great interest, blood pressure and cardiac function are within the normal range in the D2 strain, demonstrating that cardiac hypertrophy and fibrosis are not secondary to hypertension, myocardial infarction, or heart failure. Because D2 and B6 strains have been used to generate a large family of recombinant inbred strains, the BXD cohort, the D2 model can be effectively exploited for in-depth genetic analysis of HCM susceptibility and modifier screens.

  10. Biventricular / Left Ventricular Pacing in Hypertrophic Obstructive Cardiomyopathy: An Overview

    Directory of Open Access Journals (Sweden)

    Radu Vatasescu, MD

    2012-05-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is an autosomal dominant inherited genetic disease characterized by compensatory pathological left ventricle (LV hypertrophy due to sarcomere dysfunction. In an important proportion of patients with HCM, the site and extent of cardiac hypertrophy results in severe obstruction to LV outflow tract (LVOT, contributing to disabling symptoms and increasing the risk of sudden cardiac death (SCD. In patients with progressive and/or refractory symptoms despite optimal pharmacological treatment, invasive therapies that diminish or abolish LVOT obstruction relieve heart failure-related symptoms, improve quality of life and could be associated with long-term survival similar to that observed in the general population. The gold standard in this respect is surgical septal myectomy, which might be supplementary associated with a reduction in SCD. Percutaneous techniques, particularly alcohol septal ablation (ASA and more recently radiofrequency (RF septal ablation, can achieve LVOT gradient reduction and symptomatic benefit in a large proportion of HOCM patients at the cost of a supposedly limited septal myocardial necrosis and a 10-20% risk of chronic atrioventricular block. After an initial period of enthusiasm, standard DDD pacing failed to show in randomized trials significant LVOT gradient reductions and objective improvement in exercise capacity. However, case reports and recent small pilot studies suggested that atrial synchronous LV or biventricular (biV pacing significantly reduce LVOT obstruction and improve symptoms (acutely as well as long-term in a large proportion of severely symptomatic HOCM patients not suitable to other gradient reduction therapies. Moreover, biV/LV pacing in HOCM seems to be associated with significant LV reverse remodelling.

  11. Clinicopathological profiles of progressive heart failure in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Melacini, Paola; Basso, Cristina; Angelini, Annalisa; Calore, Chiara; Bobbo, Fabiana; Tokajuk, Barbara; Bellini, Nicoletta; Smaniotto, Gessica; Zucchetto, Mauro; Iliceto, Sabino; Thiene, Gaetano; Maron, Barry J

    2010-09-01

    Hypertrophic cardiomyopathy (HCM) is an important cause of heart failure-related disability over a wide range of ages. Profiles of severe progressive heart failure symptoms and death, or heart transplantation deserve more complete definition within large patient cohorts. Clinical and morphological features of heart failure were assessed in 293 consecutive HCM patients over a median follow-up of 6 (inter-quartile range 2-11) years. Gross and histopathological features were analysed in 12 patients for whom the heart was available for inspection. Of the 293 patients, 50 (17%) developed severe progressive heart failure, including 18 who died or were transplanted. Three profiles of heart failure were identified predominantly associated with: (i) end-stage systolic dysfunction (ejection fraction heart failure in 32 patients (64%) among the three profiles. Compared with other patients, those non-obstructive with preserved systolic function had earlier onset of heart failure symptoms mainly due to diastolic dysfunction, and the most accelerated progression to advanced heart failure and adverse outcome (P = 0.04). Thrombi were identified in the left atrial appendage of five gross heart specimens all belonging to patients with AF, including three of which were unrecognized clinically and had previously embolized. Extensive myocardial scarring with LV remodelling was evident in all end-stage patients; no or only focal scars were present in other patients. Profiles of advanced heart failure in HCM are due to diverse pathophysiological mechanisms, including LV outflow obstruction and diastolic or global systolic ventricular dysfunction. Atrial fibrillation proved to be the most common disease variable associated with progressive heart failure. Recognition of the heterogeneous pathophysiology of heart failure in HCM is relevant, given the targeted management strategies necessary in this disease.

  12. Hypertrophic cardiomyopathy with aortic dilation: a novel observation.

    Science.gov (United States)

    Yousefzai, Rayan; Agarwal, Anushree; Fuad Jan, M; Cho, Chi; Anigbogu, Michael; Shetabi, Kambiz; Singh, Maharaj; Bush, Michelle; Treiber, Shannon; Port, Steven; Ammar, Khawaja Afzal; Paterick, Timothy E; Jain, Renuka; Khandheria, Bijoy K; Jamil Tajik, A

    2017-12-01

    Our goal was to identify the prevalence of aortic dilation in patients with hypertrophic cardiomyopathy (HCM), the most prevalent (0.2%) heritable, genetic cardiovascular disease. Aortic dilation also represents a spectrum of familial inheritance. However, data regarding the prevalence of aortic dilation in HCM patients is lacking. This is an observational retrospective study of all patients referred to our HCM centre. Aortic dilation was defined based on recent American Society of Echocardiography and European Association of Cardiovascular Imaging published guidelines. Of the 201 HCM patients seen between Jan. 1, 2011 and March 31, 2014, 18 (9.0%) met the definition of aortic dilation. Mean age was 56.3 ± 9.3 years, 77.8% were male, mean ascending aorta diameter was 4.0 ± 0.4 cm in males and 3.8 ± 0.2 cm in females, mean sinuses of Valsalva diameter was 4.2 ± 0.2 cm in males and 3.8 ± 0.4 cm in females, and 13 (72.2%) had left ventricular outflow tract obstruction. HCM patients with dilated aorta were more likely males, less likely hypertensive and had larger left ventricle diameter and more aortic valve regurgitation; remaining characteristics were similar. We report a novel observation with 9.0% prevalance of dilated aorta in HCM patients. Further studies are needed to help define the genetic and pathophysiologic basis as well as the clinical implications of this association in a larger group of HCM patients.

  13. Hypertrophic Osteoarthropathy and Follicular Thyroid Cancer: A Rare Paraneoplastic Syndrome.

    Science.gov (United States)

    Tavarelli, Martina; Sarfati, Julie; De Gennes, Christian; Haroche, Julien; Buffet, Camille; Ghander, Cécile; Simon, Jean Marc; Ménégaux, Fabrice; Leenhardt, Laurence

    2015-12-01

    Hypertrophic osteoarthropathy (HOA) is a rare condition characterized by bone and joint pain and digital clubbing usually associated with bronchopulmonary diseases. Primary HOA is rare and the pathogenesis remains unclear. Cases of HOA as a paraneoplastic syndrome associated with thyroid carcinoma are very rare - only 2 cases have been described in the literature. We present the first case of a 40-year-old patient affected by HOA associated with invasive differentiated follicular thyroid carcinoma operated in 2 stages. Both operations were followed by radioiodine ablation, and then a rapid unresectable local recurrence developed requiring cervical radiotherapy (70 Gy). A second treatment with 100 mCi of (131)I confirmed it was a refractory thyroid cancer. Further surgery confirmed a poorly differentiated follicular cancer and 12 cycles of chemotherapy by gemcitabine and oxaliplatin followed. During the 8 years of follow-up, cervical recurrence was stable, but severe episodes of hemoptysis occurred requiring iterative embolization of the bronchial and tracheal arteries. Other lung diseases were excluded. Digital clubbing appeared, which was associated with arthritis, bone pain and inflammatory syndrome. X-rays and magnetic resonance imaging found periosteal apposition in the long bones; bone scintigraphy confirmed the HOA diagnosis. Other causes of arthritis were eliminated. She was treated with colchicine, corticosteroids and nonsteroidal anti-inflammatory drugs, but only the combination of methotrexate and hydroxychloroquine reduced the morphine requirements. HOA is exceptionally associated with thyroid cancer and we raised the hypothesis of the secretion of a circulating factor in a patient with invasive and recurrent follicular thyroid cancer, refractory to radioiodine.

  14. Controlling cyanobacterial blooms in hypertrophic Lake Taihu, China: will nitrogen reductions cause replacement of non-N2 fixing by N2 fixing taxa?

    Directory of Open Access Journals (Sweden)

    Hans W Paerl

    Full Text Available Excessive anthropogenic nitrogen (N and phosphorus (P inputs have caused an alarming increase in harmful cyanobacterial blooms, threatening sustainability of lakes and reservoirs worldwide. Hypertrophic Lake Taihu, China's third largest freshwater lake, typifies this predicament, with toxic blooms of the non-N2 fixing cyanobacteria Microcystis spp. dominating from spring through fall. Previous studies indicate N and P reductions are needed to reduce bloom magnitude and duration. However, N reductions may encourage replacement of non-N2 fixing with N2 fixing cyanobacteria. This potentially counterproductive scenario was evaluated using replicate, large (1000 L, in-lake mesocosms during summer bloom periods. N+P additions led to maximum phytoplankton production. Phosphorus enrichment, which promoted N limitation, resulted in increases in N2 fixing taxa (Anabaena spp., but it did not lead to significant replacement of non-N2 fixing with N2 fixing cyanobacteria, and N2 fixation rates remained ecologically insignificant. Furthermore, P enrichment failed to increase phytoplankton production relative to controls, indicating that N was the most limiting nutrient throughout this period. We propose that Microcystis spp. and other non-N2 fixing genera can maintain dominance in this shallow, highly turbid, nutrient-enriched lake by outcompeting N2 fixing taxa for existing sources of N and P stored and cycled in the lake. To bring Taihu and other hypertrophic systems below the bloom threshold, both N and P reductions will be needed until the legacy of high N and P loading and sediment nutrient storage in these systems is depleted. At that point, a more exclusive focus on P reductions may be feasible.

  15. Myocardial glucose metabolism in patients with hypertrophic cardiomyopathy. Assessment by F-18-FDG PET study

    Energy Technology Data Exchange (ETDEWEB)

    Uehara, Toshiisa [Osaka Univ., Suita (Japan). Medical School; Ishida, Yoshio; Hayashida, Kohei [and others

    1998-04-01

    In an investigation of myocardial metabolic abnormalities in hypertrophic myocardium, the myocardial glucose metabolism was evaluated with F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in 32 patients with hypertrophic cardiomyopathy, and the results were compared with those in 9 patients with hypertensive heart disease. F-18-FDG PET study was performed in the fasting and glucose-loading states. The myocardial regional %dose uptake was calculated quantitatively. The average regional %dose uptake in the fasting state in the patients with asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy was significantly higher than that in the patients with hypertensive heart disease (0.75{+-}0.34%, 0.65{+-}0.25%, and 0.43{+-}0.22%/100 g myocardium, respectively). In contrast, the average %dose uptake in the glucose-loading state in the patients with asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy was not significantly different from that in patients with hypertensive heart disease (1.17{+-}0.49%, 0.80{+-}0.44% and 0.99{+-}0.45%, respectively). The patients with apical hypertrophy had also low %dose uptake in the fasting state (0.38{+-}0.21%) as in the hypertensive heart disease patients, so that the characteristics of asymmetric septal hypertrophy and dilated-phase hypertrophic cardiomyopathy are considered to be high FDG uptake throughout the myocardium in the fasting state. Patients with apical hypertrophy are considered to belong to other disease categories metabolically. F-18-FDG PET study is useful in the evaluation of the pathophysiologic diagnosis of patients with hypertrophic cardiomyopathy. (author)

  16. [Experimental research of correlation between anatomy structure of rabbit ear and creating hypertrophic scar animal model].

    Science.gov (United States)

    Zhu, Gui-Ying; Xu, Bin; Cai, Jing-Long

    2008-05-01

    To observe the anatomy structure of rabbit ear and the effect of different operation methods and post-operative treatments on the formation of hypertrophic scar. The experimental animals were 25 New Zealand white rabbits. 6 pieces of full skin specimens were obtained from each of the ears in 5 rabbits for histological examination. 6 full-thickness skin wounds (d = 8 mm) were made on different sites of ventral side of each ear in the other 20 rabbits. The total number of the wounds was 240. 120 wounds in 10 rabbits were divided into 4 groups randomly to receive different treatments on day 7 postoperatively. No treatment was performed in the other 120 wounds. The wounds healing and the scar formation were observed for six months. The scars were harvested 4 weeks and 8 weeks after operation for pathologic examination and measurement of scar elevation index (SEI). Histological analysis showed that the anatomy structure was different in different sites of the rabbit ear. The best sites for creating hypertrophic scar model were on the medial margin of the middle- and inferior part of ear. The depth of the wound should reach the cartilage membrane of the ear to facilitate the formation of hypertrophic scar. The second strip crust on day 7 postoperatively enhanced the wounds healing and minimized the scar proliferation and hypertrophy. There is a close correlation between the anatomy structure of the ear and the creation of hypertrophic scar animal model. The wound site, the depth of wound and the post-operative treatment will affect the formation of hypertrophic scar. The study can help to improve the successful rate of creating hypertrophic scar animal model.

  17. Paclitaxel reduces formation of hypertrophic scars in the rabbit ear model

    Directory of Open Access Journals (Sweden)

    Huang LP

    2015-07-01

    Full Text Available Li-ping Huang,1* Guo-qi Wang,2* Zi-shan Jia,1 Jing-wen Chen,1 Gang Wang,1 Xing-lin Wang1   1Department of Physical Therapy, 2Department of Orthopedics, Chinese PLA General Hospital, Beijing, People’s Republic of China *These authors contributed equally to this work Background and objective: The onset and progression of pathological scarring involves multiple cytokines and complex mechanisms. However, hyperplasia of fibroblasts and neovascularization plays important roles, which can be inhibited by paclitaxel. The aim of this study was to investigate the efficacy of paclitaxel in the treatment of hypertrophic scars on rabbit ears. Methods: Rabbit ear models of hypertrophic scars were established to observe the therapeutic effects of paclitaxel at different concentrations (12 mg/L, 24 mg/L, 48 mg/L, 96 mg/L, 18 mg/L, 54 mg/L, 162 mg/L, 486 mg/L, 30 mg/L, 150 mg/L, 750 mg/L, 3,750 mg/L. The outcome measures included hypertrophic index (HI, density of fibroblasts, density of collagenous fibers, and microvessel density. Results: In comparison with the control group, the concentrations of 96 mg/L, 150 mg/L, and 162 mg/L significantly reduce the formation of hypertrophic scars in the rabbit ear models. However, local necrosis was found in the rabbit ear models treated with paclitaxel solution >400 mg/L. Conclusion: Paclitaxel has strong inhibitory effects on the hyperplasia of fibroblasts, deposition of collagen, and microangiogenesis in hypertrophic scars on rabbit ears within the concentration range from 48 mg/L to 162 mg/L, without causing local necrosis. Keywords: hypertrophic scar, paclitaxel, rabbit ear model

  18. Shallow water cnoidal wave interactions

    Directory of Open Access Journals (Sweden)

    A. R. Osborne

    1994-01-01

    Full Text Available The nonlinear dynamics of cnoidal waves, within the context of the general N-cnoidal wave solutions of the periodic Korteweg-de Vries (KdV and Kadomtsev-Petvishvilli (KP equations, are considered. These equations are important for describing the propagation of small-but-finite amplitude waves in shallow water; the solutions to KdV are unidirectional while those of KP are directionally spread. Herein solutions are constructed from the 0-function representation of their appropriate inverse scattering transform formulations. To this end a general theorem is employed in the construction process: All solutions to the KdV and KP equations can be written as the linear superposition of cnoidal waves plus their nonlinear interactions. The approach presented here is viewed as significant because it allows the exact construction of N degree-of-freedom cnoidal wave trains under rather general conditions.

  19. Contamination vs. Exposure

    Science.gov (United States)

    ... Health Matters Information on Specific Types of Emergencies Contamination vs. exposure Recommend on Facebook Tweet Share Compartir ... contaminate their surroundings and personal property. Types of Contamination Internal Contamination Internal contamination occurs when people swallow ...

  20. Pathophysiology and meaning of washout rate in hypertrophic heart. Comparison between hypertensive cardiac hypertrophy and hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Nitta, Yutaka (Kanazawa Univ. (Japan). School of Medicine)

    1989-02-01

    The present study was attempted to clarify clinically the pathogenesis of hypertensive cardiac hypertrophy (HT) and hypertrophic cardiomyopathy (HCM). The exercise thallium-201 (Tl-201) myocardial scintigraphy by bicycle ergometer was performed in three groups: control, HT and HCM. The scintigrams were evaluated by circumferential profile analysis. Furthermore, the change of Tl-201 dynamics of exercise Tl-201 scintigraphy with verapamil injection was compared with the change of coronary sinus flow after verapamil injection at cardiac catheterization. The analysis of exercise Tl-201 scintigraphy without verapamil injection showed that initial uptake was not different among the three groups, but washout rate at three hours after Tl-201 injection (WR{sub 3}) was different among the three groups. Although WR{sub 3} of HT was not different from that of control, WR{sub 3} of HCM was lower than that of control. Comparison of WR{sub 3} with and without verapamil was performed. Although WR{sub 3} with verapamil injection was equal to that without verapamil injection in control and HT, WR{sub 3} with verapamil injection decreased compared to that without verapamil injection in HCM. As an index at the time that circulation changes rapidly and on a large scale, washout rate at one hour after Tl-201 injection (WR{sub 1}) was calculated. WR{sub 1} without verapamil injection was not different in the three groups and did not differ from that with verapamil injection in each group. By intravenous administration of verapamil, coronary sinus flow (CSF) increased to the same extent in the three groups. And the increment of CSF was not different in the three groups. (J.P.N.).

  1. Probability of nitrate contamination of recently recharged ground waters in the conterminous United States

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — This data set is a national map of predicted probability of nitrate contamination of shallow ground waters based on a logistic regression (LR) model. The LR model...

  2. Characterization of the Geology of Subsurface Shallow ...

    African Journals Online (AJOL)

    Michael Horsfall

    ABSTRACT: The 2D electrical resistivity imaging study is the rising tool used for characterization of the geology of subsurface diamondiferous shallow conglomerate and geological condition at Baragadi, Panna District,. Madhya Pradesh, India. In the present study, the 2D electrical resistivity imaging of subsurface shallow ...

  3. Left Atrial Mechanical Function and Global Strain in Hypertrophic Cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Kyung-Jin Kim

    Full Text Available Atrial fibrillation is the most common arrhythmia and is associated with adverse outcomes in hypertrophic cardiomyopathy (HCM. Although left atrial (LA remodeling and dysfunction are known to associate with the development of atrial fibrillation in HCM, the changes of the LA in HCM patients remain unclear. This study aimed to evaluate the changes in LA size and mechanical function in HCM patients compared to control subjects and to determine the characteristics of HCM associated with LA remodeling and dysfunction.Seventy-nine HCM patients (mean age, 54 ± 11 years; 76% were men were compared to 79 age- and sex-matched controls (mean age, 54 ± 11 years; 76% were men and 20 young healthy controls (mean age, 33 ± 5 years; 45% were men. The LA diameter, volume, and mechanical function, including global strain (ε, were evaluated by 2D-speckle tracking echocardiography. The phenotype of HCM, maximal left ventricular (LV wall thickness, LV mass, and presence and extent of late gadolinium enhancement (LGE were evaluated with cardiac magnetic resonance imaging.HCM patients showed increased LA volume index, impaired reservoir function, and decreased LA ε compared to the control subjects. When we divided the HCM group according to a maximal LA volume index (LAVImax of 38.7 ml/m2 or LA ε of 21%, no significant differences in the HCM phenotype and maximal LV wall thickness were observed for patients with LAVImax >38.7 ml/m2 or LA ε ≤21%. Conversely, the LV mass index was significantly higher both in patients with maximal LA volume index >38.7 ml/m2 and with LA ε ≤21% and was independently associated with LAVImax and LA ε. Although the LGE extent was increased in patients with LA ε ≤21%, it was not independently associated with either LAVImax or LA ε.HCM patients showed progressed LA remodeling and dysfunction; the determinant of LA remodeling and dysfunction was LV mass index rather than LV myocardial fibrosis by LGE-magnetic resonance

  4. Is abandonment of nonoperative management of hypertrophic pyloric stenosis warranted?

    Science.gov (United States)

    Lukac, Marija; Antunovic, Sanja Sindjic; Vujovic, Dragana; Pavicevic, Polina; Jesic, Milos; Krstajic, Tamara; Petronic, Ivana; Nikolic, Dejan

    2013-02-01

    Evaluation of the effectiveness of oral atropine versus surgical therapy for hypertrophic pyloric stenosis (HPS). A total of 66 consecutive patients with HPS were treated at the University Children's Hospital between January 2006 and December 2011. The diagnosis was initially based on medical history and confirmed by ultrasonography (US). The patients were divided into two groups according to the treatment preferred by their parents. The conservatively treated group, consisting of 33 boys and 7 girls, mean age 22.25 days, was given water-soluble atropine sulfate therapy at an initial dose of 0.05 mg/kg/day divided into 8 single doses, and administered after stomach decompression, 20 minutes prior to feeding. If vomiting persisted, the daily dose was progressively increased up to 0.18 mg/kg. If vomiting did not stop and full oral feeding was not reestablished in a week, surgery was done. The second group of 26 patients, mean age 20.86 days, underwent an operative procedure, Ramstedt extramucosal pyloromyotomy after the initial resuscitation. US evaluation was performed on days 7, 14, and 21. The outcome of the treatment was tested by Yates modification of the χ2 test. In the group of patients treated with atropine sulfate, 10 (25%) failed to respond to therapy, therefore, 8 boys and 2 girls underwent surgical treatment between the fifth and seventh day following institution of therapy. The remaining patients who received atropine sulfate (75%) were discharged when vomiting ceased, between the sixth and eighth day. They continued to take oral medication for 4 to 6 weeks, and were followed up by an ultrasound examination. The operated patients were discharged between the third and fifth day after surgery. There was a significant statistical difference between the groups regarding the outcome at a significance level of p < 0.05 (Yates χ2 = 5.839), with no complications regardless of the treatment option. However, at the significance level of p < 0.01 (Yates χ2 = 7

  5. Clinical Utility of Cardiovascular Magnetic Resonance in Hypertrophic Cardiomyopathy

    Science.gov (United States)

    2012-01-01

    Hypertrophic cardiomyopathy (HCM) is characterized by substantial genetic and phenotypic heterogeneity, leading to considerable diversity in clinical course including the most common cause of sudden death in young people and a determinant of heart failure symptoms in patients of any age. Traditionally, two-dimensional echocardiography has been the most reliable method for establishing a clinical diagnosis of HCM. However, cardiovascular magnetic resonance (CMR), with its high spatial resolution and tomographic imaging capability, has emerged as a technique particularly well suited to characterize the diverse phenotypic expression of this complex disease. For example, CMR is often superior to echocardiography for HCM diagnosis, by identifying areas of segmental hypertrophy (ie., anterolateral wall or apex) not reliably visualized by echocardiography (or underestimated in terms of extent). High-risk HCM patient subgroups identified with CMR include those with thin-walled scarred LV apical aneurysms (which prior to CMR imaging in HCM remained largely undetected), end-stage systolic dysfunction, and massive LV hypertrophy. CMR observations also suggest that the cardiomyopathic process in HCM is more diffuse than previously regarded, extending beyond the LV myocardium to include thickening of the right ventricular wall as well as substantial morphologic diversity with regard to papillary muscles and mitral valve. These findings have implications for management strategies in patients undergoing invasive septal reduction therapy. Among HCM family members, CMR has identified unique phenotypic markers of affected genetic status in the absence of LV hypertrophy including: myocardial crypts, elongated mitral valve leaflets and late gadolinium enhancement. The unique capability of contrast-enhanced CMR with late gadolinium enhancement to identify myocardial fibrosis has raised the expectation that this may represent a novel marker, which may enhance risk stratification. At

  6. Contemporary Natural History and Management of Nonobstructive Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Maron, Martin S; Rowin, Ethan J; Olivotto, Iacopo; Casey, Susan A; Arretini, Anna; Tomberli, Benedetta; Garberich, Ross F; Link, Mark S; Chan, Raymond H M; Lesser, John R; Maron, Barry J

    2016-03-29

    Left ventricular outflow tract gradients are absent in an important proportion of patients with hypertrophic cardiomyopathy (HCM). However, the natural course of this important patient subgroup remains largely unresolved. The authors systematically employed exercise (stress) echocardiography to define those patients without obstruction to left ventricular outflow at rest and/or under physiological exercise and to examine their natural history and clinical course to create a more robust understanding of this complex disease. We prospectively studied 573 consecutive HCM patients in 3 centers (44 ± 17 years; 66% male) with New York Heart Association functional class I/II symptoms at study entry, including 249 in whom left ventricular outflow tract obstruction was absent both at rest and following physiological exercise (<30 mm Hg; nonobstructive HCM) and retrospectively assembled clinical follow-up data. Over a median follow-up of 6.5 years, 225 of 249 nonobstructive patients (90%) remained in classes I/II, whereas 24 (10%) developed progressive heart failure to New York Heart Association functional classes III/IV. Nonobstructive HCM patients were less likely to experience advanced limiting class III/IV symptoms than the 324 patients with outflow obstruction (1.6%/year vs. 7.4%/year rest obstruction vs. 3.2%/year provocable obstruction; p < 0.001). However, 7 nonobstructive patients (2.8%) did require heart transplantation for progression to end stage versus none of the obstructive patients. HCM-related mortality among nonobstructive patients was low (n = 8; 0.5%/year), with 5- and 10-year survival rates of 99% and 97%, respectively, which is not different from expected all-cause mortality in an age- and sex-matched U.S. population (p = 0.15). HCM patients with nonobstructive disease appear to experience a relatively benign clinical course, associated with a low risk for advanced heart failure symptoms, other disease complications, and HCM-related mortality, and

  7. Determinants of myocardial energetics and efficiency in symptomatic hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Timmer, Stefan A.J.; Germans, Tjeerd; Goette, Marco J.W.; Ruessel, Iris K.; Dijkmans, Pieter A.; Knaapen, Paul; Rossum, Albert C. van [VU University Medical Center, Department of Cardiology, 5F, Amsterdam (Netherlands); Lubberink, Mark; Lammertsma, Adriaan A. [VU University Medical Center, Department of Nuclear Medicine and PET Research, Amsterdam (Netherlands); Berg, Jurrien M. ten [St. Antonius Hospital, Department of Cardiology, Nieuwegein (Netherlands); Cate, Folkert J. ten [Thoraxcenter Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands)

    2010-04-15

    Next to hypertrophy, hypertrophic cardiomyopathy (HCM) is characterized by alterations in myocardial energetics. A small number of studies have shown that myocardial external efficiency (MEE), defined by external work (EW) in relation to myocardial oxidative metabolism (MVO{sub 2}), is reduced. The present study was conducted to identify determinants of MEE in patients with HCM by use of dynamic positron emission tomography (PET) and cardiovascular magnetic resonance imaging (CMR). Twenty patients with HCM (12 men, mean age: 55.2 {+-} 13.9 years) and 11 healthy controls (7 men, mean age: 48.1 {+-} 10 years) were studied with [{sup 11}C]acetate PET to assess MVO{sub 2}. CMR was performed to determine left ventricular (LV) volumes and mass (LVM). Univariate and multivariate analyses were employed to determine independent predictors of myocardial efficiency. Between study groups, MVO{sub 2} (controls: 0.12 {+-} 0.04 ml.min{sup -1}.g{sup -1}, HCM: 0.13 {+-} 0.05 ml.min{sup -1}.g{sup -1}, p = 0.64) and EW (controls: 9,139 {+-} 2,484 mmHg.ml, HCM: 9,368 {+-} 2,907 mmHg.ml, p = 0.83) were comparable, whereas LVM was significantly higher (controls: 99 {+-} 21 g, HCM: 200 {+-} 76 g, p < 0.001) and MEE was decreased in HCM patients (controls: 35 {+-} 8%, HCM: 21 {+-} 10%, p < 0.001). MEE was related to stroke volume (SV), LV outflow tract gradient, NH{sub 2}-terminal pro-brain natriuretic peptide (NT-proBNP) and serum free fatty acid levels (all p < 0.05). Multivariate analysis revealed that SV (ss = 0.74, p < 0.001) and LVM (ss = -0.43, p = 0.013) were independently related to MEE. HCM is characterized by unaltered MVO{sub 2}, impaired EW generation per gram of myocardial tissue and subsequent deteriorated myocardial efficiency. Mechanical external efficiency could independently be predicted by SV and LVM. (orig.)

  8. Geohydrology of the shallow aquifers in the Denver metropolitan area, Colorado

    Science.gov (United States)

    Robson, Stanley G.

    1996-01-01

    The Denver metropolitan area is underlain by shallow layers of water-bearing sediments (aquifers) consisting of unconsolidated gravel, sand, silt, and clay. The depth to water in these aquifers is less than 20 feet in much of the area, and the aquifers provide a ready source of water to numerous shallow, small-capacity wells. The shallow depth to water also makes the aquifers susceptible to contamination from the land surface. Water percolating downward from residential, commercial, and industrial property, spills of hazardous materials, and leaks from underground storage tanks and pipelines can cause contaminants to enter the shallow aquifers. Wet basements, unstable foundation materials, and waterlogged soils also are common in areas of very shallow ground water.Knowledge of the extent, thickness, and water-table altitude of the shallow aquifers is incomplete. This, coupled with the complexity of development in this large metropolitan area, makes effective use, management, and protection of these aquifers extremely difficult. Mapping of the geologic and hydrologic characteristics of these aquifers would provide the general public and technical users with information needed to better use, manage, and protect this water resource. A study to map the geohydrology of shallow aquifers in the Denver metropolitan area was begun in 1994. The work was undertaken by the U.S. Geological Survey in cooperation with the U.S. Army-Rocky Mountain Arsenal, U.S. Department of Energy-Rocky Flats Field Office, Colorado Department of Public Health and Environment, Colorado Department of Natural Resources-State Engineers Office, Denver Water Department, Littleton-Englewood Wastewater Treatment Plant, East Cherry Creek Valley Water and Sanitation District, Metro Wastewater Reclamation District, Willows Water District, and the cities of Aurora, Lakewood, and Thornton.This report presents the results of a systematic mapping of the extent, thickness, and water-table altitude of the shallow

  9. Psychosocial adjustment and quality of life in children undergoing screening in a specialist paediatric hypertrophic cardiomyopathy clinic.

    Science.gov (United States)

    Spanaki, Adriani; O'Curry, Sara; Winter-Beatty, Jasmine; Mead-Regan, Sarah; Hawkins, Kate; English, Jennifer; Head, Catherine; Ridout, Deborah; Tome-Esteban, Maria T; Elliott, Perry; Kaski, Juan P

    2016-06-01

    This study aimed to assess the psychological well-being and quality of life in children with hypertrophic cardiomyopathy and the potential psychosocial impact of screening. A total of 152 children (aged 3-18 years) attending a specialist paediatric hypertrophic cardiomyopathy clinic, and their parents completed the Generic Core Scales and Cardiac Module of the Paediatric Quality of Life Inventory (PedsQL) questionnaire as well as the Strengths and Difficulties Questionnaire; 21 patients (14%) had hypertrophic cardiomyopathy (group A); 23 children (15%) harboured hypertrophic cardiomyopathy-causing sarcomeric mutations with normal echocardiograms (group G); and 108 children (71%) had a family history of hypertrophic cardiomyopathy with normal investigations and attended for clinical cardiological screening (group S). In group A, mean PedsQLTM total scores reported by children and parents were lower than those reported by unaffected children (pchildren and parents were lower in children with hypertrophic cardiomyopathy compared with unaffected patients [mean child-reported total score 86.4 in group S versus 72.3 in group A (pChildren with hypertrophic cardiomyopathy have a significantly reduced quality of life. Importantly, Quality-of-Life scores among unaffected children attending for screening were not different compared with scores from a normative UK population.

  10. MicroRNA 181b regulates decorin production by dermal fibroblasts and may be a potential therapy for hypertrophic scar.

    Directory of Open Access Journals (Sweden)

    Peter Kwan

    Full Text Available Hypertrophic scarring is a frequent fibroproliferative complication following deep dermal burns leading to impaired function and lifelong disfigurement. Decorin reduces fibrosis and induces regeneration in many tissues, and is significantly downregulated in hypertrophic scar and normal deep dermal fibroblasts. It was hypothesized that microRNAs in these fibroblasts downregulate decorin and blocking them would increase decorin and may prevent hypertrophic scarring. Lower decorin levels were found in hypertrophic scar as compared to normal skin, and in deep as compared to superficial dermis. A decorin 3' un-translated region reporter assay demonstrated microRNA decreased decorin in deep dermal fibroblasts, and microRNA screening predicted miR- 24, 181b, 421, 526b, or 543 as candidates. After finding increased levels of mir-181b in deep dermal fibroblasts, it was demonstrated that TGF-β1 stimulation decreased miR-24 but increased miR-181b and that hypertrophic scar and deep dermis contained increased levels of miR-181b. By blocking miR-181b with an antagomiR, it was possible to increase decorin protein expression in dermal fibroblasts. This suggests miR-181b is involved in the differential expression of decorin in skin and wound healing. Furthermore, blocking miR-181b reversed TGF-β1 induced decorin downregulation and myofibroblast differentiation in hypertrophic scar fibroblasts, suggesting a potential therapy for hypertrophic scar.

  11. Effects of Autologous Fat and ASCs on Swine Hypertrophic Burn Scars: A Multimodal Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Scott J. Rapp, MD

    2017-11-01

    Conclusion:. Early results suggest that autologous fat and/or ASCs may improve healing of hypertrophic scarring by altering the cellular and structural components during wound remodeling up to 20 weeks after injury. This may have beneficial applications in early treatment of large or cosmetically sensitive immature burn scars.

  12. Altering the architecture of tissue engineered hypertrophic cartilaginous grafts facilitates vascularisation and accelerates mineralisation.

    Directory of Open Access Journals (Sweden)

    Eamon J Sheehy

    Full Text Available Cartilaginous tissues engineered using mesenchymal stem cells (MSCs can be leveraged to generate bone in vivo by executing an endochondral program, leading to increased interest in the use of such hypertrophic grafts for the regeneration of osseous defects. During normal skeletogenesis, canals within the developing hypertrophic cartilage play a key role in facilitating endochondral ossification. Inspired by this developmental feature, the objective of this study was to promote endochondral ossification of an engineered cartilaginous construct through modification of scaffold architecture. Our hypothesis was that the introduction of channels into MSC-seeded hydrogels would firstly facilitate the in vitro development of scaled-up hypertrophic cartilaginous tissues, and secondly would accelerate vascularisation and mineralisation of the graft in vivo. MSCs were encapsulated into hydrogels containing either an array of micro-channels, or into non-channelled 'solid' controls, and maintained in culture conditions known to promote a hypertrophic cartilaginous phenotype. Solid constructs accumulated significantly more sGAG and collagen in vitro, while channelled constructs accumulated significantly more calcium. In vivo, the channels acted as conduits for vascularisation and accelerated mineralisation of the engineered graft. Cartilaginous tissue within the channels underwent endochondral ossification, producing lamellar bone surrounding a hematopoietic marrow component. This study highlights the potential of utilising engineering methodologies, inspired by developmental skeletal processes, in order to enhance endochondral bone regeneration strategies.

  13. Enhanced in Vivo Delivery of 5-Fluorouracil by Ethosomal Gels in Rabbit Ear Hypertrophic Scar Model

    Directory of Open Access Journals (Sweden)

    Yan Wo

    2014-12-01

    Full Text Available Applying Ethosomal Gels (EGs in transdermal drug delivery systems has evoked considerable interest because of their good water-solubility and biocompatibility. However, there has not been an explicit description of applying EGs as a vehicle for hypertrophic scars treatment. Here, a novel transdermal EGs loaded with 5-fluorouracil (5-FU EGs was successfully prepared and characterized. The stability assay in vitro revealed that 5-FU EGs stored for a period of 30 days at 4 ± 1 °C had a better size stability than that at 25 ± 1 °C. Furthermore, using confocal laser scanning microscopy, EGs labeled with Rhodamine 6 G penetrated into the deep dermis of the hypertrophic scar within 24 h in the rabbit ear hypertrophic model suggested that the EGs were an optional delivery carrier through scar tissues. In addition, the value of the Scar Elevation Index (SEI of 5-FU EGs group in the rabbit ear scar model was lower than that of 5-FU Phosphate Buffered Saline gel and Control groups. To conclude, these results suggest that EGs delivery system loaded 5-fluorouracil is a perfect candidate drug for hypertrophic scars therapy in future.

  14. Echocardiographic strain imaging to assess early and late consequences of sarcomere mutations in hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Ho, Carolyn Y; Carlsen, Christian; Thune, Jens Jakob

    2009-01-01

    BACKGROUND: Genetic testing identifies sarcomere mutation carriers (G+) before clinical diagnosis of hypertrophic cardiomyopathy (HCM), allowing characterization of initial disease manifestations. Previous studies demonstrated that impaired relaxation develops before left ventricular hypertrophy...... to reshape the clinical paradigm for treatment, based on early diagnosis and disease prevention....

  15. Hypertrophic scar formation is associated with an increased number of epidermal Langerhans cells.

    NARCIS (Netherlands)

    Niessen, F.B.; Schalkwijk, J.; Vos, H.; Timens, W.

    2004-01-01

    The exact pathogenesis of hypertrophic scar and keloid formation is still unknown and a good therapy to prevent or treat these scars is lacking. Because immunological processes seem to be important in excessive scar formation, immunological cells and parameters were studied in a standardized breast

  16. Hypertrophic scar formation is associated with an increased number of epidermal Langerhans cells

    NARCIS (Netherlands)

    Niessen, FB; Schalkwijk, J; Vos, H; Timens, W

    The exact pathogenesis of hypertrophic scar and keloid formation is still unknown and a good therapy to prevent or treat these scars is lacking. Because immunological processes seem to be important in excessive scar formation, immunological cells and parameters were studied in a standardized breast

  17. Rising CO2 levels will intensify phytoplankton blooms in eutrophic and hypertrophic lakes

    NARCIS (Netherlands)

    Verspagen, J.M.H.; van de Waal, D.B.; Finke, J.F.; Visser, P.M.; van Donk, E.; Huisman, J.

    2014-01-01

    Harmful algal blooms threaten the water quality of many eutrophic and hypertrophic lakes and cause severe ecological and economic damage worldwide. Dense blooms often deplete the dissolved CO2 concentration and raise pH. Yet, quantitative prediction of the feedbacks between phytoplankton growth, CO2

  18. Morphological and Tissue Alterations in one Papillary Muscle: an Early Sign of Hypertrophic Cardiomyopathy?

    Directory of Open Access Journals (Sweden)

    Alberto Cresti

    2016-12-01

    Full Text Available Isolated Papillary Muscle (PM hypertrophy has been supposed to be a phenotypic variant of hypertrophic cardiomyopathy. Whether this finding may explain an electrocardiographic pattern of left ventricular hypertrophy has to be demonstrated. A cardiac magnetic resonance imaging may add additional crucial information. Our case was a 26-year-old asymptomatic male cyclist who underwent routine sport medicine screening. His cousin had suddenly died during a bicycle race at 40 years of age, and autopsy had revealed a hypertrophic cardiomyopathy. Screening revealed an electrocardiographic pattern of left ventricular hypertrophy. A multimodal imaging examination was also performed and the only abnormal finding was a hypertrophic anterolateral PM and cardiac magnetic resonance imaging showed fibrotic substitution of its head. An otherwise unexplained electrocardiographic pattern of left ventricular hypertrophy can be justified by an isolated PM hypertrophy. Cardiac magnetic resonance imaging is crucial for precise ventricular wall and papillary thickness measurement. In the presence of an isolated PM hypertrophy, postgadolinium T1 mapping can demonstrate the presence of abnormal tissue and probably fibrosis of the papillary head, which can confirm the presence of a strictly localized form of hypertrophic cardiomyopathy.

  19. High T2-weighted signal intensity is associated with elevated troponin T in hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Gommans, D.H.F.; Cramer, G.E.; Bakker, J.; Michels, M; Dieker, H.J.; Timmermans, J.; Fouraux, M.A.; Marcelis, C.L.M.; Verheugt, F.W.A.; Brouwer, M.A.; Kofflard, M.J.M.

    2017-01-01

    OBJECTIVE: Areas of high signal intensity (HighT2) on T2-weighted cardiovascular magnetic resonance (CMR) imaging have been demonstrated in hypertrophic cardiomyopathy (HCM). It has been hypothesised that HighT2 may indicate active tissue injury in HCM. In this context, we studied HighT2 in relation

  20. The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: a randomized controlled trial.

    Science.gov (United States)

    Cho, Yoon Soo; Jeon, Jong Hyun; Hong, Aram; Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kim, Do-Hern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Lee, Boung Chul; Seo, Cheong Hoon

    2014-12-01

    To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn. One hundred and forty-six burn patients with hypertrophic scar(s) were randomly divided into an experimental group and a control group. All patients received standard rehabilitation therapy for hypertrophic scars and 76 patients (massage group) additionally received burn scar rehabilitation massage therapy. Both before and after the treatment, we determined the scores of visual analog scale (VAS) and itching scale and assessed the scar characteristics of thickness, melanin, erythema, transepidermal water loss (TEWL), sebum, and elasticity by using ultrasonography, Mexameter(®), Tewameter(®), Sebumeter(®), and Cutometer(®), respectively. The scores of both VAS and itching scale decreased significantly in both groups, indicating a significant intragroup difference. With regard to the scar characteristics, the massage group showed a significant decrease after treatment in scar thickness, melanin, erythema, TEWL and a significant intergroup difference. In terms of scar elasticity, a significant intergroup difference was noted in immediate distension and gross skin elasticity, while the massage group significant improvement in skin distensibility, immediate distension, immediate retraction, and delayed distension. Our results suggest that burn rehabilitation massage therapy is effective in improving pain, pruritus, and scar characteristics in hypertrophic scars after burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  1. Successful treatment of hypertrophic lichen planus with betamethasone under occlusion and TCA-peelings.

    Science.gov (United States)

    Theodosiou, Grigorios; Papageorgiou, Marina; Vakirlis, Efstratios; Mandekou-Lefaki, Ioanna

    2016-09-01

    Hypertrophic lichen planus (HLP) is a variant of lichen planus characterized by marked epidermal hyperplasia and severe pruritus. We present a case of a female patient with HLP and concomitant primary biliary cirrhosis, which responded to topical therapy with betamethasone under occlusion and TCA-peelings. © 2016 Wiley Periodicals, Inc.

  2. Human hypertrophic and keloid scar models: principles, limitations and future challenges from a tissue engineering perspective

    NARCIS (Netherlands)

    van den Broek, L.J.; Limandjaja, G.C.; Niessen, F.B.; Gibbs, S.

    2014-01-01

    Most cutaneous wounds heal with scar formation. Ideally, an inconspicuous normotrophic scar is formed, but an abnormal scar (hypertrophic scar or keloid) can also develop. A major challenge to scientists and physicians is to prevent adverse scar formation after severe trauma (e.g. burn injury) and

  3. Assessment of quantitative hypertrophy scores in hypertrophic cardiomyopathy : Magnetic resonance imaging versus echocardiography

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; vanderWall, EE; Hamer, HPM; Mooyaart, EL; Lie, KI

    1996-01-01

    To compare the diagnostic value of spin-echo magnetic resonance (MR) imaging and transthoracic echocardiography in quantitative assessment of the extent of hypertrophy in patients with hypertrophic cardiomyopathy (HCM), we examined 52 consecutive patients with HCM. The Spirito-Maron and Wigle

  4. Hypertrophic cardiomyopathy family with double-heterozygous mutations; does disease severity suggest doubleheterozygosity?

    NARCIS (Netherlands)

    van Rijsingen, I. A. W.; Hermans-van Ast, J. F.; Arens, Y. H. J. M.; Schalla, S. M.; de Die-Smulders, C. E. M.; van den Wijngaard, A.; Pinto, Y. M.

    2009-01-01

    Background. With the improvement in genetic testing over time, double-heterozygous mutations are more often found by coincidence in families with hypertrophic cardiomyopathy (HCM). Double heterozygosity can be a cause of the wellknown clinical diversity within HCM families.Methods and results. We

  5. Comparison of intralesional verapamil with intralesional triamcinolone in the treatment of hypertrophic scars and keloids

    Directory of Open Access Journals (Sweden)

    Margaret Shanthi F

    2008-01-01

    Full Text Available Background : The calcium channel blocker, verapamil stimulates procollagenase synthesis in keloids and hypertrophic scars. Aim : To study the effect of verapamil in the treatment of hypertrophic scars and keloids and to evaluate the effect of verapamil on the rate of reduction of hypertrophic scars and keloids in comparison with triamcinolone. Methods : The study was a randomized, single blind, parallel group study in which 54 patients were allocated to to receive either verapamil or triamcinolone. Drugs were administered intralesionally in both groups. Improvement of the scar was measured using modified Vancouver scale and by using a centimeter scale serially till the scar flattened. Results : There was a reduction in vascularity, pliability, height and width of the scar with both the drugs after 3 weeks of treatment. These changes were present at one year of follow-up after stopping treatment. Scar pigmentation was not changed desirably by either drug. Length of the scars was also not altered significantly by either drug. The rate of reduction in vascularity, pliability, height and width of the scar with triamcinolone was faster than with verapamil. Adverse drug reactions were more with triamcinolone than with verapamil. Conclusion : Intralesional verapamil may be a suitable alternative to triamcinolone in the treatment of hypertrophic scars and keloids.

  6. Hypertrophic phenotype in cardiac cell assemblies solely by structural cues and ensuing self-organization.

    Science.gov (United States)

    Chung, Chiung-yin; Bien, Harold; Sobie, Eric A; Dasari, Vikram; McKinnon, David; Rosati, Barbara; Entcheva, Emilia

    2011-03-01

    In vitro models of cardiac hypertrophy focus exclusively on applying "external" dynamic signals (electrical, mechanical, and chemical) to achieve a hypertrophic state. In contrast, here we set out to demonstrate the role of "self-organized" cellular architecture and activity in reprogramming cardiac cell/tissue function toward a hypertrophic phenotype. We report that in neonatal rat cardiomyocyte culture, subtle out-of-plane microtopographic cues alter cell attachment, increase biomechanical stresses, and induce not only structural remodeling, but also yield essential molecular and electrophysiological signatures of hypertrophy. Increased cell size and cell binucleation, molecular up-regulation of released atrial natriuretic peptide, altered expression of classic hypertrophy markers, ion channel remodeling, and corresponding changes in electrophysiological function indicate a state of hypertrophy on par with other in vitro and in vivo models. Clinically used antihypertrophic pharmacological treatments partially reversed hypertrophic behavior in this in vitro model. Partial least-squares regression analysis, combining gene expression and functional data, yielded clear separation of phenotypes (control: cells grown on flat surfaces; hypertrophic: cells grown on quasi-3-dimensional surfaces and treated). In summary, structural surface features can guide cardiac cell attachment, and the subsequent syncytial behavior can facilitate trophic signals, unexpectedly on par with externally applied mechanical, electrical, and chemical stimulation.

  7. Heterogeneity of myocardial fluoro-18 2-deoxyglucose uptake in patients with apical hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Shiba, Nobuyuki; Kagaya, Yutaka; Ishide, Nobumasa [Tohoku Univ., Sendai (Japan). School of Medicine] [and others

    1997-03-01

    We have shown that myocardial glucose metabolism is heterogeneous in patients with hypertrophic cardiomyopathy. It is not known, however, whether glucose metabolism is impaired in patients with apical hypertrophic cardiomyopathy, which is fairly common in Japan. We studied 7 patients with apical hypertrophic cardiomyopathy and 5 normal subjects using fluoro-18 2-deoxyglucose (FDG) and positron emission tomography (PET). We calculated regional FDG fractional uptake and the inter-regional coefficient of variation (CV) of FDG fractional uptake in the interventricular septal, anteroapical, and posterolateral regions. The regional FDG fractional uptake was similar in the 2 groups and among the 3 different segments within each group. However, the inter-regional CV of FDG fractional uptake was increased in the anteroapical wall segment of the patient group compared with the control group and also with the other 2 regions in the patient group. The results did not differ when we studied another 5 patients and 6 normal control subjects with a PET scanner with higher spatial resolution. These data suggest that myocardial glucose metabolism may be impaired in the anteroapical wall segment of patients with apical hypertrophic cardiomyopathy. (author)

  8. Regression of outflow tract obstruction subsequent to treatment with verapamil in hypertrophic obstructive cardiomyopathy

    DEFF Research Database (Denmark)

    Frandsen, F; Mickley, H

    1990-01-01

    A 29-year-old man suffering from hypertrophic obstructive cardiomyopathy was treated with verapamil 240 mg daily for 4.5 years. During this period the symptoms were reduced, and an intraventricular gradient diminished from 80 to 20 mm Hg, possibly due to a decrease in left ventricular ejection fr...

  9. Systolic anterior motion of the tricuspid valve in a patient with hypertrophic obstructive cardiomyopathy

    NARCIS (Netherlands)

    Farag, Emile S.; Planken, R. Nils; Boekholdt, S. Matthijs; Kluin, Jolanda

    2017-01-01

    Hypertrophic cardiomyopathy is a heterogeneous myocardial disease and is characterized by increased left ventricular wall thickness. Left ventricular outflow tract obstruction occurs in up to 70% of patients and is often caused by systolic anterior motion of the mitral valve, a paradoxical

  10. Uptake of genetic counselling and predictive DNA testing in hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Christiaans, Imke; Birnie, Erwin; Bonsel, Gouke J.; Wilde, Arthur A.M.; van Langen, Irene M.

    2008-01-01

    Hypertrophic cardiomyopathy is a common autosomal dominant disease, associated with heart failure and arrhythmias predisposing to sudden cardiac death. After the detection of the causal mutation in the proband predictive DNA testing of relatives is possible (cascade screening). Prevention of sudden

  11. Long-term clinical outcome after alcohol septal ablation for obstructive hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Veselka, Josef; Jensen, Morten Kvistholm; Liebregts, Max

    2016-01-01

    AIMS: The first cases of alcohol septal ablation (ASA) for obstructive hypertrophic cardiomyopathy (HCM) were published two decades ago. Although the outcomes of single-centre and national ASA registries have been published, the long-term survival and clinical outcome of the procedure are still...

  12. [Sigmoid septum: A variant of the ventricular hypertrophy or of the hypertrophic cardiomyopathy?].

    Science.gov (United States)

    Gentille-Lorente, Delicia; Salvadó-Usach, Teresa

    2016-01-01

    Sigmoid septum and hypertrophic cardiomyopathy presenting with left ventricular hypertrophy and, although they appear to be different entities, often involve problems in the differential diagnosis. This study was carried out to assess the prevalence and characteristics of the echocardiographic sigmoid septum and its differential findings regarding hypertrophic cardiomyopathy. Descriptive, observational and prospective study. A total of 1,770 patients were studied by echocardiography. Sigmoid septum (focal and isolated hypertrophy of the basal interventricular septum≥13mm in men and ≥12mm in women, exceeding ≥50% of the median septum thickness) was classified as «Type 1» (≤14mm) and «Type 2» (≥15mm). There were 59 cases of sigmoid septum (prevalence of 3.3%): 26 (1.5%) patients with type 1 (50% male) and 33 (1.9%) patients with type 2 (72.7% male); there were 25 (1.4%) cases of hypertrophic cardiomyopathy (76% male). The group with type 2 sigmoid septum differed from hypertrophic cardiomyopathy in: was older (73±10.5years; Phypertrophic cardiomyopathy, patients with type 2 sigmoid septum are older and generally hypertensive; otherwise, often they have no clear differences in their clinical, electrocardiographic or echocardiographic characteristics. Therefore, cardiac resonance is helpful in the differential diagnosis. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

  13. Cardiac troponin I degradation in serum of patients with hypertrophic obstructive cardiomyopathy undergoing percutaneous septal ablation

    DEFF Research Database (Denmark)

    Madsen, Lene H; Lund, Terje; Grieg, Zanina

    2009-01-01

    : percutaneous transluminal septal myocardial ablation (PTSMA) of hypertrophic obstructive cardiomyopathy (HOCM). Here the iatrogenic induction of myocardial necrosis occurs in vivo, allowing us to investigate degradation of cTnI by the second. METHODS: Blood samples were obtained from 8 patients with HOCM just...

  14. Electrocardiographic features of sarcomere mutation carriers with and without clinically overt hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Lakdawala, Neal K; Thune, Jens Jakob; Maron, Barry J

    2011-01-01

    In hypertrophic cardiomyopathy (HC), electrocardiographic (ECG) changes have been postulated to be an early marker of disease, detectable in sarcomere mutation carriers when left ventricular (LV) wall thickness is still normal. However, the ECG features of mutation carriers have not been fully...

  15. Familial hypertrophic cardiomyopathy: Functional effects of myosin mutation R723G in cardiomyocytes

    NARCIS (Netherlands)

    Kraft, T.; Witjas-Paalberends, E.R.; Boontje, N.; Tripathi, S.; Brandis, A.; Montag, J.; Hodgkinson, J.L.; Francino, A.; Navarro-Lopez, F.; Brenner, B.; Stienen, G.J.M.; van der Velden, J.

    2013-01-01

    Familial Hypertrophic Cardiomyopathy (FHC) is frequently caused by mutations in the β-cardiac myosin heavy chain (β-MyHC). To identify changes in sarcomeric function triggered by such mutations, distinguishing mutation effects from other functional alterations of the myocardium is essential. We

  16. Enhanced in Vivo Delivery of 5-Fluorouracil by Ethosomal Gels in Rabbit Ear Hypertrophic Scar Model

    Science.gov (United States)

    Wo, Yan; Zhang, Zheng; Zhang, Yixin; Zhang, Zhen; Wang, Kan; Mao, Xiaohui; Su, Weijie; Li, Ke; Cui, Daxiang; Chen, Jun

    2014-01-01

    Applying Ethosomal Gels (EGs) in transdermal drug delivery systems has evoked considerable interest because of their good water-solubility and biocompatibility. However, there has not been an explicit description of applying EGs as a vehicle for hypertrophic scars treatment. Here, a novel transdermal EGs loaded with 5-fluorouracil (5-FU EGs) was successfully prepared and characterized. The stability assay in vitro revealed that 5-FU EGs stored for a period of 30 days at 4 ± 1 °C had a better size stability than that at 25 ± 1 °C. Furthermore, using confocal laser scanning microscopy, EGs labeled with Rhodamine 6 G penetrated into the deep dermis of the hypertrophic scar within 24 h in the rabbit ear hypertrophic model suggested that the EGs were an optional delivery carrier through scar tissues. In addition, the value of the Scar Elevation Index (SEI) of 5-FU EGs group in the rabbit ear scar model was lower than that of 5-FU Phosphate Buffered Saline gel and Control groups. To conclude, these results suggest that EGs delivery system loaded 5-fluorouracil is a perfect candidate drug for hypertrophic scars therapy in future. PMID:25501333

  17. Obtaining insurance after DNA diagnostics : A survey among hypertrophic cardiomyopathy mutation carriers

    NARCIS (Netherlands)

    Christiaans, Imke; Kok, Tjitske M.; Van Langen, Irene M.; Birnie, Erwin; Bonsel, Gouke J.; Wilde, Arthur A. M.; Smets, Ellen M. A.

    2010-01-01

    Hypertrophic cardiomyopathy (HCM) is a common hereditary heart disease associated with increased mortality. Disclosure of DNA test results may have social implications such as low access to insurance. In the Netherlands, insurance companies are restricted in the use of genetic information of their

  18. Obtaining insurance after DNA diagnostics: a survey among hypertrophic cardiomyopathy mutation carriers

    NARCIS (Netherlands)

    Christiaans, Imke; Kok, Tjitske M.; van Langen, Irene M.; Birnie, Erwin; Bonsel, Gouke J.; Wilde, Arthur A. M.; Smets, Ellen M. A.

    2010-01-01

    Hypertrophic cardiomyopathy (HCM) is a common hereditary heart disease associated with increased mortality. Disclosure of DNA test results may have social implications such as low access to insurance. In the Netherlands, insurance companies are restricted in the use of genetic information of their

  19. Genetic counseling and cardiac care in predictively tested hypertrophic cardiomyopathy mutation carriers: The patients' perspective

    NARCIS (Netherlands)

    Christiaans, Imke; Van Langen, Irene M.; Birnie, Erwin; Bonsel, Gouke J.; Wilde, Arthur A. M.; Smets, Ellen M. A.

    2009-01-01

    Hypertrophic cardiomyopathy (HCM) is a common hereditary heart disease associated with sudden cardiac death. Predictive genetic counseling and testing are performed using adapted Huntington guidelines, that is, psychosocial care and time for reflection are not obligatory and the test result can be

  20. Hypertrophic nerve roots in a case of Roussy-Levy syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Haubrich, C.; Senderek, J.; Noth, J.; Toepper, R. [Neurologische Klinik, Aachen University, Pauwelsstrasse 30, 52074 Aachen (Germany); Krings, T. [Klinik fuer Neuroradiologische Diagnostik, Aachen University, Pauwelsstrasse 30, 52074 Aachen (Germany); Zuechner, S.; Schroeder, J.M. [Institut fuer Neuropathologie, Aachen University, Pauwelsstrasse 30, 52074 Aachen (Germany)

    2002-11-01

    Hypertrophic radiculopathy is a rare feature of neuropathies. Single cases of enlarged nerve roots have been described in hereditary motor sensory neuropathies (HMSN) and chronic inflammatory demyelinating diseases (CIDP). This is the first description of hypertrophied nerve roots in a patient with Roussy-Levy syndrome. MRI did not show contrast enhancement of the enlarged nerve roots or nodular lesions. (orig.)

  1. Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy : Systematic review of clinical risk markers

    NARCIS (Netherlands)

    Christiaans, Imke; Van Engelen, Klaartje; Van Langen, Irene M.; Birnie, Erwin; Bonsel, Gouke J.; Elliott, Perry M.; Wilde, Arthur A.M.

    2010-01-01

    We performed a systematic literature review of recommended 'major' and 'possible' clinical risk markers for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We searched the Medline, Embase and Cochrane databases for articles published between 1971 and 2007. We included English

  2. Risk stratification for sudden cardiac death in hypertrophic cardiomyopathy: systematic review of clinical risk markers

    NARCIS (Netherlands)

    Christiaans, Imke; van Engelen, Klaartje; van Langen, Irene M.; Birnie, Erwin; Bonsel, Gouke J.; Elliott, Perry M.; Wilde, Arthur A. M.

    2010-01-01

    We performed a systematic literature review of recommended 'major' and 'possible' clinical risk markers for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We searched the Medline, Embase and Cochrane databases for articles published between 1971 and 2007. We included English

  3. Electrocardiographic features of sarcomere mutation carriers with and without clinically overt hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Lakdawala, Neal K; Thune, Jens Jakob; Maron, Barry J

    2011-01-01

    In hypertrophic cardiomyopathy (HC), electrocardiographic (ECG) changes have been postulated to be an early marker of disease, detectable in sarcomere mutation carriers when left ventricular (LV) wall thickness is still normal. However, the ECG features of mutation carriers have not been fully ch...

  4. Three patients presenting with severe macrosomia and congenital hypertrophic cardiomyopathy: a case series.

    Science.gov (United States)

    Vincent, Marie; Benbrik, Nadir; Romefort, Bénédicte; Colombel, Agnès; Bézieau, Stéphane; Isidor, Bertrand

    2017-03-24

    Macrosomia and hypertrophic cardiomyopathy are two features often associated in neonates of diabetic mothers. We report the cases of three patients with severe macrosomia and critical hypertrophic cardiomyopathy without severely unbalanced maternal diabetes. Only three patients with those two features and no uncontrolled maternal diabetes have been previously reported. The first patient was a 39-week-old girl, the second patient was a 39-week-old girl, and the third patient was a 41-week-old boy. The two French girls and the French boy had severe macrosomia and hypertrophic cardiomyopathy, leading to the death of the boy. The outcome of the two girls was favorable, with a standardization of growth curves and ventricular hypertrophy. Their mothers presented with high body mass index but no severe documented maternal diabetes; glycemic imbalance was only suspected on postnatal analyses. There was no hydramnios during pregnancy and no other environmental factor, especially toxic exposure. Their parents are from Mayotte, Guadeloupe, and Guinea-Conakry. The usual genetics causes, Beckwith-Wiedemann syndrome, and chromosomal copy number variation, were also excluded. This report suggests the implication of other factors in addition to glycemic disorders, including genetic factors, in the occurrence of macrosomia and severe hypertrophic cardiomyopathy in neonates. These three original observations indicate that gynecologists and neonatologists should pay attention to neonates from mothers with a high body mass index and when maternal diabetes is not documented.

  5. Observational retrospective study evaluating the effects of oral isotretinoin in keloids and hypertrophic scars.

    Science.gov (United States)

    Guadanhim, Lilia R S; Gonçalves, Rubens G; Bagatin, Ediléia

    2016-11-01

    Acne vulgaris is a chronic inflammatory disease characterized by non-inflammatory and inflammatory lesions that can cause scarring. Oral isotretinoin is the current recommended treatment for moderate and severe cases; however, there are reports of possible influences on the healing process of the skin, leading to an increase in the risk for hypertrophic scars and keloids. This hypothesis, although unproven, represents a contraindication to the treatment of acne scars during the 6-12 months after the cessation of isotretinoin. The aim of this study was to investigate the prevalences of hypertrophic scars and keloids in acne patients treated with oral isotretinoin. Three data collection strategies were used: (i) clinical examination of patients with acne vulgaris, exposed or unexposed to oral isotretinoin, focusing on the occurrence of hypertrophic scars and/or keloids; (ii) telephone interviews of patients using oral isotretinoin to treat acne vulgaris on the occurrence or worsening of keloids; and (iii) clinical examination of patients with previous use of oral isotretinoin followed at a specific keloid treatment clinic. The resulting data showed no differences in wound healing. These findings may indicate that the occurrence of hypertrophic scars or keloids in patients using oral isotretinoin is an undesirable event arising from an individual response and may be related to inflammatory acne evolution. © 2016 The International Society of Dermatology.

  6. Establishing a Reproducible Hypertrophic Scar following Thermal Injury: A Porcine Model

    Directory of Open Access Journals (Sweden)

    Scott J. Rapp, MD

    2015-02-01

    Conclusions: Deep partial-thickness thermal injury to the back of domestic swine produces an immature hypertrophic scar by 10 weeks following burn with thickness appearing to coincide with the location along the dorsal axis. With minimal pig to pig variation, we describe our technique to provide a testable immature scar model.

  7. Altering the architecture of tissue engineered hypertrophic cartilaginous grafts facilitates vascularisation and accelerates mineralisation.

    Science.gov (United States)

    Sheehy, Eamon J; Vinardell, Tatiana; Toner, Mary E; Buckley, Conor T; Kelly, Daniel J

    2014-01-01

    Cartilaginous tissues engineered using mesenchymal stem cells (MSCs) can be leveraged to generate bone in vivo by executing an endochondral program, leading to increased interest in the use of such hypertrophic grafts for the regeneration of osseous defects. During normal skeletogenesis, canals within the developing hypertrophic cartilage play a key role in facilitating endochondral ossification. Inspired by this developmental feature, the objective of this study was to promote endochondral ossification of an engineered cartilaginous construct through modification of scaffold architecture. Our hypothesis was that the introduction of channels into MSC-seeded hydrogels would firstly facilitate the in vitro development of scaled-up hypertrophic cartilaginous tissues, and secondly would accelerate vascularisation and mineralisation of the graft in vivo. MSCs were encapsulated into hydrogels containing either an array of micro-channels, or into non-channelled 'solid' controls, and maintained in culture conditions known to promote a hypertrophic cartilaginous phenotype. Solid constructs accumulated significantly more sGAG and collagen in vitro, while channelled constructs accumulated significantly more calcium. In vivo, the channels acted as conduits for vascularisation and accelerated mineralisation of the engineered graft. Cartilaginous tissue within the channels underwent endochondral ossification, producing lamellar bone surrounding a hematopoietic marrow component. This study highlights the potential of utilising engineering methodologies, inspired by developmental skeletal processes, in order to enhance endochondral bone regeneration strategies.

  8. Hypertrophic cardiomyopathy in pompe disease is not limited to the classic infantile-onset phenotype.

    Science.gov (United States)

    Lee, Dong-Hwan; Qiu, Wen-Juan; Lee, Jeongho; Chien, Yin-Hsiu; Hwu, Wuh-Liang

    2014-01-01

    Pompe disease is a genetic disorder caused by a deficiency of acid α-glucosidase (GAA). Patients with classic infantile-onset Pompe disease usually present with hypertrophic cardiomyopathy and die before 1 year of age, if not treated with enzyme replacement therapy (ERT). In comparison, patients with late-onset Pompe disease typically do not have hypertrophic cardiomyopathy. However, here we describe five patients who presented with hypertrophic cardiomyopathy but did not fit the criteria of classic infantile-onset Pompe disease. Their ages at diagnosis of cardiomyopathy were 1 month in two patients following detection of an audible cardiac murmur and 2-3 years in the three remaining patients. All patients survived for 5-8 years without ERT. Three patients died before the advent of ERT from causes other than congestive heart failure. One patient had a good response to ERT starting at 5 years of age. The sibling of one patient, who did not receive ERT and died at age seven, was diagnosed prenatally. At 3 months of age, the sibling had hypertrophic cardiomyopathy, and a muscle biopsy at that time revealed glycogen accumulation.This case series demonstrates that Pompe disease is a continuum of disease, and the development of cardiomyopathy is not limited to classic infantile-onset Pompe disease. These patients do not fit into the discrete phenotypes of infantile- or late-onset Pompe disease, which may suggest reconsidering the nomenclature of Pompe disease.

  9. Shallow Carbon Sequestration Demonstration Project

    Energy Technology Data Exchange (ETDEWEB)

    Pendergrass, Gary; Fraley, David; Alter, William; Bodenhamer, Steven

    2013-09-30

    The potential for carbon sequestration at relatively shallow depths was investigated at four power plant sites in Missouri. Exploratory boreholes were cored through the Davis Shale confining layer into the St. Francois aquifer (Lamotte Sandstone and Bonneterre Formation). Precambrian basement contact ranged from 654.4 meters at the John Twitty Energy Center in Southwest Missouri to over 1100 meters near the Sioux Power Plant in St. Charles County. Investigations at the John Twitty Energy Center included 3D seismic reflection surveys, downhole geophysical logging and pressure testing, and laboratory analysis of rock core and water samples. Plans to perform injectivity tests at the John Twitty Energy Center, using food grade CO{sub 2}, had to be abandoned when the isolated aquifer was found to have very low dissolved solids content. Investigations at the Sioux Plant and Thomas Hill Energy Center in Randolph County found suitably saline conditions in the St. Francois. A fourth borehole in Platte County was discontinued before reaching the aquifer. Laboratory analyses of rock core and water samples indicate that the St. Charles and Randolph County sites could have storage potentials worthy of further study. The report suggests additional Missouri areas for further investigation as well.

  10. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars.

    Science.gov (United States)

    O'Brien, Lisa; Jones, Daniel J

    2013-09-12

    Keloid and hypertrophic scars are common and are caused by a proliferation of dermal tissue following skin injury. They cause functional and psychological problems for patients, and their management can be difficult. The use of silicone gel sheeting to prevent and treat hypertrophic scarring is still relatively new and started in 1981 with treatment of burn scars. To determine the effectiveness of silicone gel sheeting for:(1) prevention of hypertrophic or keloid scarring in people with newly healed wounds (e.g. post surgery);(2) treatment of established scarring in people with existing keloid or hypertrophic scars. In May 2013 we searched the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL for this second update. Any randomised or quasi-randomised controlled trials, or controlled clinical trials, comparing silicone gel sheeting for prevention or treatment of hypertrophic or keloid scars with any other non surgical treatment, no treatment or placebo. We assessed all relevant trials for methodological quality. Three review authors extracted data independently using a standardised form and cross-checked the results. We assessed all trials meeting the selection criteria for methodological quality. We included 20 trials involving 873 people, ranging in age from 1.5 to 81 years. The trials compared adhesive silicone gel sheeting with no treatment; non silicone dressing; other silicone products; laser therapy; triamcinolone acetonide injection; topical onion extract and pressure therapy. In the prevention studies, when compared with a no treatment option, whilst silicone gel sheeting reduced the incidence of hypertrophic scarring in people prone to scarring (risk ratio (RR) 0.46, 95% confidence interval (CI) 0.21 to 0.98) these studies were highly susceptible to bias. In treatment studies, silicone gel sheeting

  11. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

    Directory of Open Access Journals (Sweden)

    Rei Ogawa

    2017-03-01

    Full Text Available Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection. Notably, superficial injuries that do not reach the reticular dermis never cause keloidal and hypertrophic scarring. This suggests that these pathological scars are due to injury to this skin layer and the subsequent aberrant wound healing therein. The latter is characterized by continuous and histologically localized inflammation. As a result, the reticular layer of keloids and hypertrophic scars contains inflammatory cells, increased numbers of fibroblasts, newly formed blood vessels, and collagen deposits. Moreover, proinflammatory factors, such as interleukin (IL-1α, IL-1β, IL-6, and tumor necrosis factor-α are upregulated in keloid tissues, which suggests that, in patients with keloids, proinflammatory genes in the skin are sensitive to trauma. This may promote chronic inflammation, which in turn may cause the invasive growth of keloids. In addition, the upregulation of proinflammatory factors in pathological scars suggests that, rather than being skin tumors, keloids and hypertrophic scars are inflammatory disorders of skin, specifically inflammatory disorders of the reticular dermis. Various external and internal post-wounding stimuli may promote reticular inflammation. The nature of these stimuli most likely shapes the characteristics, quantity, and course of keloids and hypertrophic scars. Specifically, it is likely that the intensity, frequency, and duration of these stimuli determine how quickly the scars appear, the direction and speed of growth, and the intensity of symptoms. These proinflammatory stimuli include a variety of local, systemic, and genetic factors. These observations together suggest that the clinical differences between keloids and hypertrophic scars merely reflect differences in the intensity, frequency

  12. A new 4D trajectory-based approach unveils abnormal LV revolution dynamics in hypertrophic cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Andrea Madeo

    Full Text Available The assessment of left ventricular shape changes during cardiac revolution may be a new step in clinical cardiology to ease early diagnosis and treatment. To quantify these changes, only point registration was adopted and neither Generalized Procrustes Analysis nor Principal Component Analysis were applied as we did previously to study a group of healthy subjects. Here, we extend to patients affected by hypertrophic cardiomyopathy the original approach and preliminarily include genotype positive/phenotype negative individuals to explore the potential that incumbent pathology might also be detected. Using 3D Speckle Tracking Echocardiography, we recorded left ventricular shape of 48 healthy subjects, 24 patients affected by hypertrophic cardiomyopathy and 3 genotype positive/phenotype negative individuals. We then applied Generalized Procrustes Analysis and Principal Component Analysis and inter-individual differences were cleaned by Parallel Transport performed on the tangent space, along the horizontal geodesic, between the per-subject consensuses and the grand mean. Endocardial and epicardial layers were evaluated separately, different from many ecocardiographic applications. Under a common Principal Component Analysis, we then evaluated left ventricle morphological changes (at both layers explained by first Principal Component scores. Trajectories' shape and orientation were investigated and contrasted. Logistic regression and Receiver Operating Characteristic curves were used to compare these morphometric indicators with traditional 3D Speckle Tracking Echocardiography global parameters. Geometric morphometrics indicators performed better than 3D Speckle Tracking Echocardiography global parameters in recognizing pathology both in systole and diastole. Genotype positive/phenotype negative individuals clustered with patients affected by hypertrophic cardiomyopathy during diastole, suggesting that incumbent pathology may indeed be foreseen by

  13. Comparative effect and safety of verapamil in keloid and hypertrophic scar treatment: a meta-analysis

    Science.gov (United States)

    Li, Zhouna; Jin, Zhehu

    2016-01-01

    Background Keloids and hypertrophic scar/span>s are the most common types of pathological scarring. Traditionally, keloids have been considered as a result of aberrant wound healing, involving excessive fibroblast participation that is characterized by hyalinized collagen bundles. However, the usefulness of this characterization has been questioned. In recent years, studies have reported the appropriate use of verapamil for keloids and hypertrophic scar/span>s. Methods Searches were conducted on the databases Medline, Embase, Cochrane, PubMed, and China National Knowledge Infrastructure from 2006 to July 2016. State12.0 was used for literature review, data extraction, and meta-analysis. Treatment groups were divided into verapamil and nonverapamil group. Nonverapamil group includes steroids and intense pulsed light (IPL) therapy. Total effective rates include cure rate and effective rate. Cure: skin lesions were completely flattened, became soft and symptoms disappeared. Efficacy: skin lesions subsided, patient significantly reduced symptoms. Inefficient definition of skin was progression free or became worse. Random-effects model was used for the meta-analysis. Results Six studies that included 331 patients with keloids and hypertrophic scar/span>s were analyzed. Analysis of the total effective rate of skin healing was performed. The total effective rates in the two groups were 54.07% (verapamil) and 53.18% (nonverapamil), respectively. The meta-analysis showed that there was no difference between the two groups. We also compared the adverse reactions between the verapamil treatment group and the steroids treatment group in two studies, and the result indicated that the verapamil group showed less adverse reactions. Conclusion There were no differences between the application of verapamil and nonverapamil group in keloids and hypertrophic scar/span>s treatment. Verapamil could act as an effective alternative modality in the prevention and treatment of keloid and

  14. Unconventional shallow biogenic gas systems

    Science.gov (United States)

    Shurr, G.W.; Ridgley, J.L.

    2002-01-01

    Unconventional shallow biogenic gas falls into two distinct systems that have different attributes. Early-generation systems have blanketlike geometries, and gas generation begins soon after deposition of reservoir and source rocks. Late-generation systems have ringlike geometries, and long time intervals separate deposition of reservoir and source rocks from gas generation. For both types of systems, the gas is dominantly methane and is associated with source rocks that are not thermally mature. Early-generation biogenic gas systems are typified by production from low-permeability Cretaceous rocks in the northern Great Plains of Alberta, Saskatchewan, and Montana. The main area of production is on the southeastern margin of the Alberta basin and the northwestern margin of the Williston basin. The huge volume of Cretaceous rocks has a generalized regional pattern of thick, non-marine, coarse clastics to the west and thinner, finer grained marine lithologies to the east. Reservoir rocks in the lower part tend to be finer grained and have lower porosity and permeability than those in the upper part. Similarly, source beds in the units have higher values of total organic carbon. Patterns of erosion, deposition, deformation, and production in both the upper and lower units are related to the geometry of lineament-bounded basement blocks. Geochemical studies show that gas and coproduced water are in equilibrium and that the fluids are relatively old, namely, as much as 66 Ma. Other examples of early-generation systems include Cretaceous clastic reservoirs on the southwestern margin of Williston basin and chalks on the eastern margin of the Denver basin. Late-generation biogenic gas systems have as an archetype the Devonian Antrim Shale on the northern margin of the Michigan basin. Reservoir rocks are fractured, organic-rich black shales that also serve as source rocks. Although fractures are important for production, the relationships to specific geologic structures are

  15. The Argentinean network for the assessment and monitoring of Pampean shallow-lakes (PAMPA2)

    Science.gov (United States)

    Zagarese, H. E.

    2012-12-01

    The Pampa region of Argentina is an extensive wetland containing nearly 200,000 shallow-lakes. The region is under increasing agricultural pressure resulting from climate change (increased temperature and precipitation) and the substitution of cattle breeding and traditional cultures by transgenic soy. Among the many services that they provide, shallow-lakes are highly responsive to changes in climate and land use. Therefore, long-term studies of shallow-lakes provide useful clues to understand and track changes occurring in their complex watersheds. PAMPA2 is a recently funded, long-term network project, with wide geographic coverage, aimed at studying Pampean shallow-lakes. Thirteen network sites (i.e., shallow lakes) occurring along the precipitation gradient (from 1000 mm y-1) form the core of the project. The network integrates various research teams from eight universities and research centers, with a strong multidisciplinary component. The approaches combine traditional sampling; high-rate monitoring using automated sensors; and remote sensing. The network develops and manufactures most the instruments, including automated buoys and unmanned aircrafts. In this presentation, we will provide details on the structure and state of development of the PAMPA2 network, and present a long-term case study of a large Pampean shallow-lake, exemplifying the strong dependence of lake processes on weather variables. Laguna Chascomús is a large, hypertrophic shallow-lake. Chascomús is one of the PAMPA2 study sites that have been more extensively studied. In this shallow-lake, high nutrient availability permits the development of a dense microbial plankton community, which in turn translates into exceptionally high water turbidity. Phytoplankton primary production is strongly limited by light availability. As a consequence, turbidity is strongly and positively correlated to the incoming solar radiation, resulting in a remarkable seasonal pattern of water transparency

  16. Shallow cumulus rooted in photosynthesis

    Science.gov (United States)

    Vila-Guerau Arellano, J.; Ouwersloot, H.; Horn, G.; Sikma, M.; Jacobs, C. M.; Baldocchi, D.

    2014-12-01

    We investigate the interaction between plant evapotranspiration, controlled by photosynthesis (for a low vegetation cover by C3 and C4 grasses), and the moist thermals that are responsible for the formation and development of shallow cumulus clouds (SCu). We perform systematic numerical experiments at fine spatial scales using large-eddy simulations explicitly coupled to a plant-physiology model. To break down the complexity of the vegetation-atmospheric system at the diurnal scales, we design the following experiments with increasing complexity: (a) clouds that are transparent to radiation, (b) clouds that shade the surface from the incoming shortwave radiation and (c) plant stomata whose apertures react with an adjustment in time to cloud perturbations. The shading by SCu leads to a strong spatial variability in photosynthesis and the surface energy balance. As a result, experiment (b) simulates SCu that are characterized by less extreme and less skewed values of the liquid water path and cloud-base height. These findings are corroborated by the calculation of characteristics lengths scales of the thermals and clouds using autocorrelation and spectral analysis methods. We find that experiments (a) and (b) are characterized by similar cloud cover evolution, but different cloud population characteristics. Experiment (b), including cloud shading, is characterized by smaller clouds, but closer to each other. By performing a sensitivity analysis on the exchange of water vapor and carbon dioxide at the canopy level, we show that the larger water-use efficiency of C4 grass leads to two opposing effects that directly influence boundary-layer clouds: the thermals below the clouds are more vigorous and deeper driven by a larger buoyancy surface flux (positive effect), but are characterized by less moisture content (negative effect). We conclude that under the investigated mid-latitude atmospheric and well-watered soil conditions, SCu over C4 grass fields is characterized

  17. High-resolution geophysical characterization of shallow-water wetlands

    DEFF Research Database (Denmark)

    Mansoor, N; Slater, L; Artigas, F

    2006-01-01

    We describe a procedure for rapid characterization ofshallow-water, contaminated wetlands. Terrain-conductivityTC, vertical-magnetic-gradiometry, and surface-waterchemistrydata were obtained from a shallow-draft paddleboatoperable in as little as 0.3 m of water. Measurementswere taken every 2 s......, with data-acquisition rates exceeding10 km of line 12 000 data points per 8-hr field day.We applied this procedure to an urban wetland that is affectedby point and nonpoint sources of pollution.We used aone-dimensional, laterally constrained inversion algorithmto invert the apparent-conductivity data set...... obtained from theTC survey and to create a pseudo-2D image of sediment conductivity.The continuously recorded surface-water depthand conductivity values were input as a priori information inthe inversion.We used soil chemistry determined for 28 sedimentsamples collected from the site, as well...

  18. REX XML shallow parsing with regular expressions

    CERN Document Server

    Cameron, R D

    1999-01-01

    The syntax of XML is simple enough that it is possible to parse an XML document into a list of its markup and text items using a single regular expression. Such a shallow parse of an XML document can be very useful for the construction of a variety of lightweight XML processing tools. However, complex regular expressions can be difficult to construct and even more difficult to read. Using a form of literate programming for regular expressions, this paper documents a set of XML shallow parsing expressions that can be used a basis for simple, correct, efficient, robust and language-independent XML shallow parsing. Complete shallow parser implementations of less than 50 lines each in Perl, JavaScript and Lex/Flex are also given. (0 refs).

  19. Comparison of borehole geophysics, CPT, resistivity, GPR, and high-resolution seismic data across a shallow structure in unconsolidated sediments

    Energy Technology Data Exchange (ETDEWEB)

    Temples, T.J.; Wyatt, D.E.; Cumbest, R.; Waddell, M.G.

    1995-12-31

    The geological characterization of the shallow subsurface in the unconsolidated sediments of the Atlantic Coastal Plain, and other unconsolidated sediment regimes, may involve faulting and channeling not readily detectable by conventional drilling and mapping. A knowledge of these features is required in environment and geotechnical studies in areas that may have critical impact to groundwater flow and contaminant transport. In many cases, shallow structural influences are missed during site characterization. A case study is presented using ground penetrating radar (GPR) and high resolution seismic data, compared with a geologic interpretation from borehole logs and core data, with Wenner and dipole-dipole resistivity data and with cone penetrometer (CPT) data in an area where shallow structure is probable and contamination exists.

  20. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

    National Research Council Canada - National Science Library

    Rei Ogawa

    2017-01-01

    Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection...

  1. Comparison of Valsalva manoeuvre and exercise in echocardiographic evaluation of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten Krogh; Havndrup, Ole; Pecini, Redi

    2010-01-01

    Several methods are used to induce latent left ventricular outflow tract (LVOT) gradients in patients with hypertrophic cardiomyopathy (HCM). We compared LVOT gradients induced by Valsalva manoeuvre (VM) and exercise echocardiography (EE) in patients with HCM treated with percutaneous translumina...

  2. Comparison of Valsalva manoeuvre and exercise in echocardiographic evaluation of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Jensen, Morten Krogh; Havndrup, Ole; Pecini, Redi

    2010-01-01

    Several methods are used to induce latent left ventricular outflow tract (LVOT) gradients in patients with hypertrophic cardiomyopathy (HCM). We compared LVOT gradients induced by Valsalva manoeuvre (VM) and exercise echocardiography (EE) in patients with HCM treated with percutaneous transluminal...

  3. In vivo cardiovascular magnetic resonance diffusion tensor imaging shows evidence of abnormal myocardial laminar orientations and mobility in hypertrophic cardiomyopathy

    National Research Council Canada - National Science Library

    Ferreira, Pedro F; Kilner, Philip J; McGill, Laura-Ann; Nielles-Vallespin, Sonia; Scott, Andrew D; Ho, Siew Y; McCarthy, Karen P; Haba, Margarita M; Ismail, Tevfik F; Gatehouse, Peter D; de Silva, Ranil; Lyon, Alexander R; Prasad, Sanjay K; Firmin, David N; Pennell, Dudley J

    2014-01-01

    ... orientation and mobility in hypertrophic cardiomyopathy (HCM). We performed cDTI in vivo at 3 Tesla at end-systole and late diastole in 11 healthy controls and 11 patients with HCM, as well as late gadolinium enhancement (LGE...

  4. Unravelling the grey zone : Cardiac MRI volume to wall mass ratio to differentiate hypertrophic cardiomyopathy and the athlete's heart

    NARCIS (Netherlands)

    Luijkx, Tim; Cramer, Maarten J.; Buckens, Stan; Zaidi, Abbas; Rienks, R; Mosterd, Arend; Prakken, Niek H J; Dijkman, Barbara; Mali, W.P.; Velthuis, BK

    2015-01-01

    Background Differentiating physiological left ventricular hypertrophy (LVH) in athletes from pathological hypertrophic cardiomyopathy (HCM) can be challenging. This study assesses the ability of cardiac MRI (CMR) to distinguish between physiological LVH (so-called athlete's heart) and HCM. Methods

  5. Acoustics of Shallow Water: A Status Report

    Science.gov (United States)

    1984-09-13

    loss tend to have high reverberation. Figure 11, based on data from the four shallow water stations of FASOR 1 (25], shows the general correlation...derived from the FASOR program [241. Values of scattering strength for various angles are shown 24 ’% . .% % - . *.. ’ . ... ~. .. . - a...34.-. ..% . . -.. ’ 24. J. A. Whitney, "Propagation Losses and Reverberation from the Shallow- Water Fasor Areas with Comparisons to Propagation Loss

  6. Shallow seismicity at open-vent volcanoes

    Science.gov (United States)

    Girona, T.; Caudron, C.; Huber, C.

    2016-12-01

    Understanding the origin of the shallow seismicity detected at active volcanoes is fundamental to interpret geophysical and geochemical signals in terms of sub-surface magmatic processes. One of the most intriguing seismic signals is shallow tremor, which is long-lasting (from minutes to months), is usually sourced at shallow levels ( 100's of meters), has dominant frequencies in the range 0.1-20 Hz, and is common to many open-vent and hydrothermal systems. Here, we present a viable mechanism to explain the origin of shallow tremor and its correlation with magma degassing. In particular, we show from basic principles (mass and momentum balance) that shallow tremor can emerge spontaneously as a result of three coupled processes: (1) the formation of gas pockets beneath rheological or geometrical barriers; (2) the intermittent supply of volatiles from depth, e.g., through a bubbly magma column; and (3) the permeable transfer of these gases through a porous lava dome, conduit, or volcanic edifice. Our model, which can be solved analytically at first order, reproduces and provides an explanation for the main features of shallow tremor, including frequency gliding, changes of seismic amplitude when volcanoes enter a period of unrest, and the different types of amplitude spectra observed (i.e., monochromatic, harmonic, and broadband). A crucial conclusion of our study is that different processes (e.g., magma ascent and sealing of gas pathways) cause distinguishable variations in the tremor properties, which could be used by monitoring agencies to improve volcanic forecasting.

  7. Biological and Chemical Removal of Primary Cilia Affects Mechanical Activation of Chondrogenesis Markers in Chondroprogenitors and Hypertrophic Chondrocytes

    Directory of Open Access Journals (Sweden)

    Matthew E. Deren

    2016-02-01

    Full Text Available Chondroprogenitors and hypertrophic chondrocytes, which are the first and last stages of the chondrocyte differentiation process, respectively, are sensitive to mechanical signals. We hypothesize that the mechanical sensitivity of these cells depends on the cell surface primary cilia. To test this hypothesis, we removed the primary cilia by biological means with transfection with intraflagellar transport protein 88 (IFT88 siRNA or by chemical means with chloral hydrate treatment. Transfection of IFT88 siRNA significantly reduced the percentage of ciliated cells in both chondroprogenitor ATDC5 cells as well as primary hypertrophic chondrocytes. Cyclic loading (1 Hz, 10% matrix deformation of ATDC5 cells in three-dimensional (3D culture stimulates the mRNA levels of chondrogenesis marker Type II collagen (Col II, hypertrophic chondrocyte marker Type X collagen (Col X, and a molecular regulator of chondrogenesis and chondrocyte hypertrophy bone morphogenetic protein 2 (BMP-2. The reduction of ciliated chondroprogenitors abolishes mechanical stimulation of Col II, Col X, and BMP-2. In contrast, cyclic loading stimulates Col X mRNA levels in hypertrophic chondrocytes, but not those of Col II and BMP-2. Both biological and chemical reduction of ciliated hypertrophic chondrocytes reduced but failed to abolish mechanical stimulation of Col X mRNA levels. Thus, primary cilia play a major role in mechanical stimulation of chondrogenesis and chondrocyte hypertrophy in chondroprogenitor cells and at least a partial role in hypertrophic chondrocytes.

  8. Geophysical characterization of shallow karst

    Science.gov (United States)

    Schmelzbach, Cedric; Jordi, Claudio; Sollberger, David; Doetsch, Joseph; Kaufmann, Manuela; Robertsson, Johan; Maurer, Hansruedi; Greenhalgh, Stewart

    2015-04-01

    -wave velocity tomograms and resistivity images exhibit significant parameter variations in both the horizontal and vertical directions; the P-wave tomograms, for example, indicate velocity changes from a few hundred to a few thousand m/s over short distances for carbonate rocks close to the surface. These variations in physical parameters are likely caused by changes in the lithology and in the degree of karstification, with the latter seeming to be the dominating factor. With respect to the karst impact on seismic wave propagation, we observe pronounced lateral changes in the characteristics of the densely sampled wavefield. For example, distinct changes in the surface-wavetrain characteristics can be related to strong lateral seismic-velocity changes observed in the tomograms. ERT-derived resistivity models show sub-horizontal layering at the 10-meter scale with an orientation (dip, strike) that agrees with the geological model of the area. The complementary EM soundings largely concur with the shallow ERT models, but ERT and EM results show only moderate correlation with the P-wave tomograms indicating that seismic and electric/electromagnetic properties of the karstified carbonates are only weakly linked. The GPR images show shallowly dipping reflectors with dips that are in overall agreement with observed dips of the surface-exposed bedding.

  9. Doppler echocardiography underestimates the prevalence and magnitude of mid-cavity obstruction in patients with symptomatic hypertrophic cardiomyopathy.

    Science.gov (United States)

    Malcolmson, James W; Hamshere, Stephen M; Joshi, Abhishek; O'Mahony, Constantinos; Dhinoja, Mehul; Petersen, Steffen E; Sekhri, Neha; Mohiddin, Saidi A

    2017-08-02

    To evaluate utility of Doppler echocardiography in the assessment of left ventricular (LV) mid-cavity obstructive (LVMCO) hypertrophic cardiomyopathy (HCM). LVMCO is a relatively under-diagnosed complication of HCM and may occur alone or in combination with LV outflow tract obstruction (LVOTO). Identifying and quantifying LVMCO and differentiating it from LVOTO has important implications for patient management. We aimed to assess diagnostic performance of Doppler echocardiography in the assessment of suspected LV obstruction. Forty symptomatic HCM patients with suspected obstruction underwent cardiac catheterization, and comparison of location and magnitude of Doppler derived gradients with synchronous invasive measurements (reference standard), at rest and isoprenaline stress (IS). Doppler's diagnostic accuracy for any obstruction (≥30 mmHg) in this cohort was 75% with false positive and false negative rates of 2.5 and 22.5%, respectively. During subanalysis, Doppler's diagnostic accuracy for isolated LVOTO in this selected cohort is 83% with false positive and false negative rates of 4 and 12.5%, respectively. For LVMCO, the accuracy is only 50%, with false positive and false negative rates of 10 and 40%, respectively. Doppler gradients for isolated LVOTO were similar to invasive: 85 ± 51 and 87 ± 35 mmHg, respectively (P = 0.77). Doppler gradients in LVMCO were consistently lower than invasive: 45 ± 38 and 81 ± 31 mmHg, respectively (P = 0.0002). Mid-systolic flow cessation and/or contamination of spectral signals were identified as causes of Doppler-derived inaccuracies. Doppler echocardiography under-diagnoses and underestimates severity of LVMCO in symptomatic HCM patients. Recognition of abrupt mid-systolic flow cessation and invasive measurements may improve detection of LVMCO in HCM. © 2017 Wiley Periodicals, Inc.

  10. Q wave T wave vector discordance in hypertrophic cardiomyopathy: septal hypertrophy and strain pattern.

    Science.gov (United States)

    Goldberger, A L

    1979-08-01

    Hypertrophic cardiomyopathy is a common cause of prominent non-infarctional Q waves. A retrospective analysis of previously published cases confirmed a characteristic Q wave T wave vector discordance in hypertrophic cardiomyopathy. In 41 of 44 cases with predominant Q waves (as part of QS or Qr complexes where Q wave amplitude exceeded R wave height), the T wave was positive, and in all cases with QS type complexes the T wave was positive. This characteristic electrocardiographic sign probably represents a pattern of septal hypertrophy and strain (Q waves with positive T waves and ST segment elevation) which is the inverse of the classical pattern of left ventricular hypertrophy and strain (tall R waves with inverted T waves and ST segment depression).

  11. Apical hypertrophic cardiomyopathy with hemodynamically unstable ventricular arrhythmia – Atypical presentation

    Directory of Open Access Journals (Sweden)

    Hemant Chaturvedi

    2016-09-01

    Full Text Available We present a patient with asymptomatic apical hypertrophic cardiomyopathy (AHCM who recently developed cardiac arrhythmias, and shortly discuss the diagnostic modalities, differential diagnosis, and treatment strategy for this condition. AHCM is a rare form of hypertrophic cardiomyopathy, which usually involves the apex of the left ventricle. AHCM can occur with varied presentations such as chest pain, palpitations, dyspnea, syncope, atrial fibrillation, myocardial infarction, embolic events, ventricular fibrillation, and congestive heart failure. The most peculiar electrocardiogram findings are giant T-waves inversion in the precordial leads with left ventricular (LV hypertrophy. A transthoracic echocardiogram is the initial diagnostic modality in the evaluation of AHCM and shows hypertrophy of the LV apex. Other diagnostic modalities, including left ventriculography, multislice spiral computed tomography, and cardiac magnetic resonance imagings, are also valuable tools. Medications used to manage include verapamil, beta-blockers, and antiarrhythmic agents. An implantable cardioverter defibrillator (ICD is recommended for high-risk patients.

  12. Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies

    Science.gov (United States)

    Gauglitz, Gerd G; Korting, Hans C; Pavicic, Tatiana; Ruzicka, Thomas; Jeschke, Marc G

    2011-01-01

    Excessive scars form as a result of aberrations of physiologic wound healing and may arise following any insult to the deep dermis. By causing pain, pruritus and contractures, excessive scarring significantly affects the patient’s quality of life, both physically and psychologically. Multiple studies on hypertrophic scar and keloid formation have been conducted for decades and have led to a plethora of therapeutic strategies to prevent or attenuate excessive scar formation. However, most therapeutic approaches remain clinically unsatisfactory, most likely owing to poor understanding of the complex mechanisms underlying the processes of scarring and wound contraction. In this review we summarize the current understanding of the pathophysiology underlying keloid and hypertrophic scar formation and discuss established treatments and novel therapeutic strategies. PMID:20927486

  13. Transcriptional Profiling of Rapamycin-Treated Fibroblasts From Hypertrophic and Keloid Scars

    Science.gov (United States)

    Wong, Victor W.; You, Fanglei; Januszyk, Michael; Gurtner, Geoffrey C.; Kuang, Anna A.

    2016-01-01

    Excess scar formation after cutaneous injury can result in hypertrophic scar (HTS) or keloid formation. Modern strategies to treat pathologic scarring represent nontargeted approaches that produce suboptimal results. Mammalian target of rapamycin (mTOR), a central mediator of inflammation, has been proposed as a novel target to block fibroproliferation. To examine its mechanism of action, we performed genomewide microarray on human fibroblasts (from normal skin, HTS, and keloid scars) treated with the mTOR inhibitor, rapamycin. Hypertrophic scar and keloid fibroblasts demonstrated overexpression of collagen I and III that was effectively abrogated with rapamycin. Blockade of mTOR specifically impaired fibroblast expression of the collagen biosynthesis genes PLOD, PCOLCE, and P4HA, targets significantly overexpressed in HTS and keloid scars. These data suggest that pathologic scarring can be abrogated via modulation of mTOR pathways in procollagen and collagen processing. PMID:24835866

  14. Multimodality treatment of hypertrophic scars using long-wave X-radiation

    Energy Technology Data Exchange (ETDEWEB)

    Protsenko, T.V. (Donetskij Meditsinskij Inst. (Ukrainian SSR))

    1984-02-01

    The paper is concerned with a therapeutic method for hypertrophic scars including Bucky rays, pyrogenal, vitamins A, E, B/sub 12/, sodium salicylate and dimexide ointment. Multimodality treatment of hypertrophic scars is effective, well tolerated and can be widely used in out-patient clinics. It makes it possible to reduce the period of therapy by 2-3 mos., and the summary dose by 20 000-3000 rad (18.6-27.9 Gy) as compared to common therapy with Bucky rays only. Changes in the connective structure of scars in the process of multimodality therapy are nonspecific and account for some mechanisms of scar regression and reaffirm the efficacy of this therapeutic method.

  15. Hypertrophic lichen planus as a presenting feature of human immunodeficiency virus infection

    Directory of Open Access Journals (Sweden)

    Kumari Rashmi

    2009-01-01

    Full Text Available Lichen planus (LP is a chronic papulosquamous dermatosis in which both skin and mucous membranes may be involved. To date, there have been only five reports of human immunodeficiency virus (HIV-positive patients with hypertrophic LP. In the present report, we describe a 37-year-old female who presented with widely distributed, hyperpigmented, pruritic scaly lesions involving the face, trunk, and upper and lower extremities for one month. She also had swelling of both lower legs with low grade fever for past one week. She was diagnosed to be a HIV-positive patient who had severe, widespread hypertrophic LP lesions along with acute eruptive lesions of LP. These LP lesions were a presenting feature of HIV infection in our case.

  16. Hypertrophic Cardiomyopathy Mimicking Acute Anterior Myocardial Infarction Associated with Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Y. Daralammouri

    2012-01-01

    Full Text Available Hypertrophic cardiomyopathy is the most common genetic disease of the heart. We report a rare case of hypertrophic obstructive cardiomyopathy mimicking an acute anterior myocardial infarction associated with sudden cardiac death. The patient presented with acute ST elevation myocardial infarction and significant elevation of cardiac enzymes. Cardiac catheterization showed some atherosclerotic coronary artery disease, without significant stenosis. Echocardiography showed left ventricular hypertrophy with a left ventricular outflow tract obstruction; the pressure gradient at rest was 20 mmHg and became severe with the Valsalva maneuver (100 mmHg. There was no family history of sudden cardiac death. Six days later, the patient suffered a syncope on his way to magnetic resonance imaging. He was successfully resuscitated by ventricular fibrillation.

  17. Hypertrophic Cardiomyopathy (HCM): How Flow Analysis May Drive Medical Management and Surgical Approach

    Science.gov (United States)

    Abraham, Theodore P.

    2011-11-01

    Hypertrophic Cardiomyopathy (HCM) is the most common inherited heart disease and occurs in 1 in 500 persons worldwide regardless of race, age and gender. It is the most common cause of sudden death in the young and also causes heart failure and cardiac arrhythmias. The primary anatomic abnormality is thickening of certain walls, or sometimes global thickening of the left or right ventricle. The patterns of thickening along with increased ventricular stiffness lead to suboptimal ventricular filling and inefficient ejection of blood from the ventricle. Treatment for HCM can be medical or surgical. The choice of therapy is driven by the presence and severity of outflow obstruction. Flow analysis could provide sophisticated information about outflow and inflow ventricular dynamics. These flow dynamics features may enable better medical choices and provide information that would allow superior surgical planning. Associate Professor of Medicine & Director, Hypertrophic Cardiomyopathy Clinic

  18. Squamous Cell Carcinoma of the Penis with Pulmonary Metastasis and Paraneoplastic Hypertrophic Osteopathy in a Dog.

    Science.gov (United States)

    Jenkins, Victoria; Henrique de Mello Souza, Carlos; de Lorimier, Louis-Phillippe; de Toledo-Piza, Evandro

    Squamous cell carcinoma of the penis was diagnosed by incisional biopsy of a penile mass in a 12 yr old intact male beagle dog presenting with hemorrhagic discharge from the prepuce. Penile amputation, orchiectomy with scrotal ablation, and scrotal urethrostomy were performed. Hypertrophic osteopathy secondary to pulmonary metastatic disease occurred 10 mo after the surgery. Palliative treatment with piroxicam was administered and led to complete resolution of the clinical signs of the pain. Sixteen months following surgery, the dog presented with significant dyspnea and anorexia and was euthanized due to poor prognosis. This case report describes a rare penile tumor, squamous cell carcinoma. Consequent paraneoplastic hypertrophic osteopathy and its palliative treatment are also reviewed.

  19. Hypertrophic non-union of a pathological forearm fracture secondary to multiple myeloma: a case report

    Directory of Open Access Journals (Sweden)

    Okoro Tosan

    2010-04-01

    Full Text Available Abstract Skeletal lesions in multiple myeloma are predominantly lytic and when non-union of pathological fractures occur it is typically atrophic. We report a lady of 61 years of age with myeloma who presented with a pathological fracture through an ulnar myeloma deposit. The fracture was immobilised initially then irradiated. Nine months later she re-presented with marked forearm pain particularly on rotation. Radiographs demonstrated a hypertrophic non-union of a pathological fracture with a typical elephant's hoof appearance. The fracture was immobilised using an ulnar nail. Whilst non-unions in metastatic malignancy are typically atrophic, just occasionally hypertrophic non-unions can occur. Management principles remain the same with stabilisation of the entire bone and early mobilisation being appropriate.

  20. Efficacy and safety of the angiotensin II receptor blocker losartan for hypertrophic cardiomyopathy

    DEFF Research Database (Denmark)

    Axelsson, Anna; Iversen, Kasper; Vejlstrup, Niels

    2015-01-01

    . Treatment was well tolerated by patients with left ventricular outflow obstruction at baseline. INTERPRETATION: Our findings challenge the generally held view that angiotensin II receptor blockers reduce cardiac hypertrophy. Treatment with losartan was safe, suggesting that it can be used for other......BACKGROUND: No medical treatment has been reliably shown to halt or reverse disease progression in hypertrophic cardiomyopathy, but the results of several pilot studies have suggested beneficial effects of angiotensin II receptor blockers on left ventricular hypertrophy and fibrosis, which...... are predictive of an adverse outcome. We aimed to assess the effect of the angiotensin II receptor blocker losartan on left ventricular hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy. METHODS: In this single-centre, randomised, double-blind, placebo-controlled trial, adult patients (aged...

  1. Cheating the CHA2DS2-VASc Score: Thromboembolism in Apical Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Robin A. P. Weir

    2014-01-01

    Full Text Available Atrial fibrillation increases the risk of systemic thromboembolism in general and stroke in particular. Not all patients who develop atrial fibrillation are at significantly heightened risk of thromboembolic complications, however, with the development of risk scoring systems aiding clinicians in determining whether formal anticoagulation is mandated. The most commonly used contemporary scoring systems—CHADS2 and CHA2DS2-VASc—provide a reliable means of assessing stroke risk, but certain cardiac conditions are associated with an increased incidence of thromboembolism without impacting on these risk scores. Hypertrophic cardiomyopathy, with its apical variant, is such a condition. We present a case of a patient with apical hypertrophic cardiomyopathy and atrial fibrillation who suffered dire thromboembolic consequences despite a reassuringly low CHA2DS2-VASc score and suggest that this scoring system is modified to incorporate the thromboembolic risk inherent to certain cardiomyopathies irrespective of impairment of left ventricular systolic dysfunction or clinical heart failure.

  2. Effect of Institutional Experience on Outcomes of Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

    DEFF Research Database (Denmark)

    Veselka, Josef; Faber, Lothar; Jensen, Morten Kvistholm

    2018-01-01

    BACKGROUND: The current American College of Cardiology Foundation/American Heart Association guidelines on hypertrophic cardiomyopathy state that institutional experience is a key determinant of successful outcomes and lower complication rates of alcohol septal ablation (ASA). The aim of this study...... was to evaluate the safety and efficacy of ASA according to institutional experience with the procedure. METHODS: We retrospectively evaluated 1310 patients with symptomatic obstructive hypertrophic cardiomyopathy who underwent ASA and were divided into 2 groups. The first-50 group consisted of the first......), and a probability of repeated septal reduction therapy (P = 0.03). CONCLUSIONS: An institutional experience of > 50 ASA procedures was associated with a lower occurrence of ASA complications, better cardiovascular survival, better hemodynamic and clinical effect, and less need for repeated septal reduction therapy....

  3. Progressive Hypertrophic Genital Herpes in an HIV-Infected Woman despite Immune Recovery on Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Mark H. Yudin

    2008-01-01

    Full Text Available Most HIV-infected individuals are coinfected by Herpes simplex virus type 2 (HSV-2. HSV-2 reactivates more frequently in HIV-coinfected individuals with advanced immunosuppression, and may have very unusual clinical presentations, including hypertrophic genital lesions. We report the case of a progressive, hypertrophic HSV-2 lesion in an HIV-coinfected woman, despite near-complete immune restoration on antiretroviral therapy for up to three years. In this case, there was prompt response to topical imiquimod. The immunopathogenesis and clinical presentation of HSV-2 disease in HIV-coinfected individuals are reviewed, with a focus on potential mechanisms for persistent disease despite apparent immune reconstitution. HIV-infected individuals and their care providers should be aware that HSV-2 may cause atypical disease even in the context of near-comlpete immune reconstitution on HAART.

  4. Video capsule endoscopy and CT enterography in diagnosing adult hypertrophic pyloric stenosis.

    Science.gov (United States)

    Gurvits, Grigoriy E; Tan, Amy; Volkov, Dmitri

    2013-10-07

    Primary adult hypertrophic pyloric stenosis is a rare but important cause of gastric outlet obstruction that may be misdiagnosed as idiopathic gastroparesis. Clinically, patients present with early satiety, abdominal fullness, nausea, epigastric discomfort and eructation. Permanent gastric retention of a video capsule endoscope is diagnostic in differentiating between the two diseases, in the absence of an organic gastric outlet obstruction. This case presents the longest video capsule retention in the medical literature to date. It is also the first case report of adult hypertrophic pyloric stenosis diagnosed with video capsule endoscopy or a computed tomography scan. Finally, an unusual "plugging" of the gastric outlet with free floating capsule has an augmented effect on disease physiology and on patient's symptoms.

  5. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-01-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  6. Hypertrophic Effects of Concentric vs. Eccentric Muscle Actions: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Schoenfeld, Brad J; Ogborn, Dan I; Vigotsky, Andrew D; Franchi, Martino V; Krieger, James W

    2017-09-01

    Schoenfeld, BJ, Ogborn, DI, Vigotsky, AD, Franchi, MV, and Krieger, JW. Hypertrophic effects of concentric vs. eccentric muscle actions: A systematic review and meta-analysis. J Strength Cond Res 31(9): 2599-2608, 2017-Controversy exists as to whether different dynamic muscle actions produce divergent hypertrophic responses. The purpose of this paper was to conduct a systematic review and meta-analysis of randomized controlled trials comparing the hypertrophic effects of concentric vs. eccentric training in healthy adults after regimented resistance training (RT). Studies were deemed eligible for inclusion if they met the following criteria: (a) were an experimental trial published in an English-language refereed journal; (b) directly compared concentric and eccentric actions without the use of external implements (i.e., blood pressure cuffs) and all other RT variables equivalent; (c) measured morphologic changes using biopsy, imaging (magnetic resonance imaging, computerized tomography, or ultrasound), bioelectrical impedance, and/or densitometry; (d) had a minimum duration of 6 weeks; and (e) used human participants without musculoskeletal injury or any health condition that could directly, or through the medications associated with the management of said condition, be expected to impact the hypertrophic response to resistance exercise. A systematic literature search determined that 15 studies met inclusion criteria. Results showed that eccentric muscle actions resulted in a greater effect size (ES) compared with concentric actions, but results did not reach statistical significance (ES difference = 0.25 ± 0.13; 95% confidence interval: -0.03 to 0.52; p = 0.076). The mean percent change in muscle growth across studies favored eccentric compared with concentric actions (10.0% vs. 6.8, respectively). The findings indicate the importance of including eccentric and concentric actions in a hypertrophy-oriented RT program, as both have shown to be effective in

  7. A Systematic Review on the Effect of Mechanical Stretch on Hypertrophic Scars after Burn Injuries

    Directory of Open Access Journals (Sweden)

    Yu-ting Zhang

    2017-06-01

    Conclusion: From extensive literature search, there was no strong evidence indicating the positive effect of mechanical stretch using stretching exercise, massage, or splinting on hypertrophic scars. A firm conclusion cannot be drawn for the discrepancy of outcome measures and varied effectiveness. Most of the included studies lacked objective evaluation or control group for comparison. Further high quality studies with larger sample size and using standardized measurements are needed.

  8. Nd:YAG Laser Treatment of Keloids and Hypertrophic Scar/span>s

    Science.gov (United States)

    Akaishi, Satoshi; Koike, Sachiko; Dohi, Teruyuki; Kobe, Kyoko; Hyakusoku, Hiko; Ogawa, Rei

    2012-01-01

    Pathological cutaneous scars such as keloids and hypertrophic scar/span>s (HSs) are characterized by a diffuse redness that is caused by the overgrowth of capillary vessels due to chronic inflammation. Our group has been using long-pulsed, 1064-nm Nd:YAG laser in noncontact mode with low fluence and a submillisecond pulse duration to treat keloids and hypertrophic scar/span>s since 2006 with satisfactory results. The present study examined the efficacy of this approach in 22 Japanese patients with keloids (n = 16) or hypertrophic scar/span>s (n = 6) who were treated every 3 to 4 weeks. Treatment settings were as follows: 5 mm spot size diameter; 14 J/cm2 energy density; 300 μs exposure time per pulse; and 10 Hz repetition rate. The responses of the pathological scar/span>s to the treatment were assessed by measuring their erythema, hypertrophy, hardness, itching, and pain or tenderness. Moreover, skin samples from 3 volunteer patients were subjected to histological evaluation and 5 patients underwent thermography during therapy. The average total scar assessment score dropped from 9.86 to 6.34. Hematoxylin and eosin staining and Elastica Masson-Goldner staining showed that laser treatment structurally changed the tissue collagen. This influence reached a depth of 0.5 to 1 mm. Electron microscopy revealed plasma protein leakage, proteoglycan particles, and a change in the collagen fiber fascicles. Further analyses revealed that noncontact mode Nd:YAG laser treatment is highly effective for keloids and hypertrophic scar/span>s regardless of patient age, the origin and multiplicity of scarring, the location of the scar(s), or the tension on the scar. PMID:22259645

  9. Multiple Gene Variants in Hypertrophic Cardiomyopathy in the Era of Next-Generation Sequencing.

    Science.gov (United States)

    Burns, Charlotte; Bagnall, Richard D; Lam, Lien; Semsarian, Christopher; Ingles, Jodie

    2017-08-01

    Multiple likely pathogenic/pathogenic (LP/P; ≥2) variants in patients with hypertrophic cardiomyopathy were described 10 years ago with a prevalence of 5%. We sought to re-examine the significance of multiple rare variants in patients with hypertrophic cardiomyopathy in the setting of comprehensive and targeted panels. Of 758 hypertrophic cardiomyopathy probands, we included 382 with ≥45 cardiomyopathy genes screened. There were 224 (59%) with ≥1 rare variant (allele frequency ≤0.02%). Variants were analyzed using varying sized gene panels to represent comprehensive or targeted testing. Based on a 45-gene panel, 127 (33%) had a LP/P variant, 139 (36%) had variants of uncertain significance, and 66 (17%) had multiple rare variants. A targeted 8-gene panel yielded 125 (32%) LP/P variants, 52 (14%) variants of uncertain significance, and 14 (4%) had multiple rare variants. No proband had 2 LP/P variants. Including affected family members (total n=412), cluster-adjusted analyses identified a phenotype effect, with younger age (odds ratio, 0.95; 95% confidence interval, 0.92-0.98; P =0.004) and family history of sudden cardiac death (odds ratio, 3.5; 95% confidence interval, 1.3-9.9; P =0.02) significantly more likely in multiple versus single variant patients when considering an 8-gene panel but not larger panels. Those with multiple variants had worse event-free survival from all-cause death, cardiac transplantation, and cardiac arrest (log-rank P =0.008). No proband had multiple LP/P variants in contrast to previous reports. However, multiple rare variants regardless of classification were seen in 4% and contributed to earlier disease onset and cardiac events. Our findings support a cumulative variant hypothesis in hypertrophic cardiomyopathy. © 2017 American Heart Association, Inc.

  10. [Utility of cardiovascular magnetic resonance in hypertrophic cardiomyopathy: when is it superior to echocardiography?].

    Science.gov (United States)

    Kammoun, I; Marrakchi, S; Zidi, A; Ibn ElHaj, Z; Naccache, S; Ben Amara, W; Jebri, F; Bennour, E; Kachboura, S

    2015-02-01

    The diagnosis of hypertrophic cardiomyopathy is usually established by echocardiography. Recently, there has been greatly increased use of cardiac magnetic resonance (CMR) because of its precise determination of myocardial anatomy and the depiction of myocardial fibrosis. In this review, we describe the role of echocardiography and magnetic resonance in the assessment of this complex disease. In conclusion, there is a complementarity between cardiovascular magnetic resonance imaging and echocardiography for the diagnosis and the management of HCM. Copyright © 2014. Published by Elsevier SAS.

  11. Lack of reliable clinical predictors to identify obstructive sleep apnea in patients with hypertrophic cardiomyopathy

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    Flávia B. Nerbass

    2013-07-01

    Full Text Available OBJECTIVE: Obstructive sleep apnea is common among patients with hypertrophic cardiomyopathy and may contribute to poor cardiovascular outcomes. However, obstructive sleep apnea is largely unrecognized in this population. We sought to identify the clinical predictors of obstructive sleep apnea among patients with hypertrophic cardiomyopathy. METHODS: Consecutive patients with hypertrophic cardiomyopathy were recruited from a tertiary University Hospital and were evaluated using validated sleep questionnaires (Berlin and Epworth and overnight portable monitoring. Ninety patients (males, 51%; age, 46±15 years; body mass index, 26.6±4.9 kg/m2 were included, and obstructive sleep apnea (respiratory disturbance index ≥15 events/h was present in 37 patients (41%. RESULTS: Compared with the patients without obstructive sleep apnea, patients with obstructive sleep apnea were older and had higher body mass index, larger waist circumference, larger neck circumference, and higher prevalence of atrial fibrillation. Excessive daytime sleepiness (Epworth scale was low and similar in the patients with and without obstructive sleep apnea, respectively. The only predictors of obstructive sleep apnea (using a logistic regression analysis were age ≥45 years (odds ratio [OR], 4.46; 95% confidence interval [CI 95%], 1.47-13.54; p = 0.008 and the presence of atrial fibrillation [OR, 5.37; CI 95%, 1.43-20.12; p = 0.013]. CONCLUSION: Consistent clinical predictors of obstructive sleep apnea are lacking for patients with hypertrophic cardiomyopathy, which suggests that objective sleep evaluations should be considered in this population, particularly among elderly patients with atrial fibrillation.

  12. Pattern and degree of left ventricular remodeling following a tailored surgical approach for hypertrophic obstructive cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ismail El-Hamamsy

    2012-07-01

    Full Text Available Background The role of a tailored surgical approach for hypertrophic cardiomyopathy (HCM on regional ventricular remodelling remains unknown. The aims of this study were to evaluate the pattern, extent and functional impact of regional ventricular remodelling after a tailored surgical approach. Conclusion Following a tailored surgical relief of outflow obstruction for HCM, there is a marked regional reverse LV remodelling. These changes could have a significant impact on overall ventricular dynamics and function.

  13. Papillary thyroid carcinoma treated with radiofrequency ablation in a patient with hypertrophic cardiomyopathy: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jian Yi; Liu, Xiao Sun; Zhang, Qing; Hong, Yan Yun; Song, Bin; Teng, Xiao Dong; Yu, Ji Ren [The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou (China)

    2016-07-15

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

  14. Asymmetric left ventricular hypertrophy associated with morbid obesity mimicking familial hypertrophic cardiomyopathy.

    Science.gov (United States)

    Wong, Raymond Ching-Chiew; Tan, Kong Bing

    2014-12-01

    Asymmetric septal hypertrophy with systolic anterior motion of the mitral valve is frequently a phenotypic, but not pathognomonic, expression of genetic hypertrophic cardiomyopathy (HCM) with or without obstruction. It can, however, be associated nonspecifically with other forms of increased left ventricular (LV) afterload. We herein report the case of a young man with obesity cardiomyopathy and heart failure who presented with asymmetric septal hypertrophy and marked LV hypertrophy, and endomyocardial biopsy ruled out genetic HCM.

  15. Lack of reliable clinical predictors to identify obstructive sleep apnea in patients with hypertrophic cardiomyopathy

    Science.gov (United States)

    Nerbass, Flávia B.; Pedrosa, Rodrigo P.; Genta, Pedro R.; Antunes, Murillo O.; Arteaga-Fernández, Edmundo; Drager, Luciano F.; Lorenzi-Filho, Geraldo

    2013-01-01

    OBJECTIVE: Obstructive sleep apnea is common among patients with hypertrophic cardiomyopathy and may contribute to poor cardiovascular outcomes. However, obstructive sleep apnea is largely unrecognized in this population. We sought to identify the clinical predictors of obstructive sleep apnea among patients with hypertrophic cardiomyopathy. METHODS: Consecutive patients with hypertrophic cardiomyopathy were recruited from a tertiary University Hospital and were evaluated using validated sleep questionnaires (Berlin and Epworth) and overnight portable monitoring. Ninety patients (males, 51%; age, 46±15 years; body mass index, 26.6±4.9 kg/m2) were included, and obstructive sleep apnea (respiratory disturbance index ≥15 events/h) was present in 37 patients (41%). RESULTS: Compared with the patients without obstructive sleep apnea, patients with obstructive sleep apnea were older and had higher body mass index, larger waist circumference, larger neck circumference, and higher prevalence of atrial fibrillation. Excessive daytime sleepiness (Epworth scale) was low and similar in the patients with and without obstructive sleep apnea, respectively. The only predictors of obstructive sleep apnea (using a logistic regression analysis) were age ≥45 years (odds ratio [OR], 4.46; 95% confidence interval [CI 95%], 1.47–13.54; p = 0.008) and the presence of atrial fibrillation [OR, 5.37; CI 95%, 1.43–20.12; p = 0.013]. CONCLUSION: Consistent clinical predictors of obstructive sleep apnea are lacking for patients with hypertrophic cardiomyopathy, which suggests that objective sleep evaluations should be considered in this population, particularly among elderly patients with atrial fibrillation. PMID:23917665

  16. Papillary Thyroid Carcinoma Treated with Radiofrequency Ablation in a Patient with Hypertrophic Cardiomyopathy: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Jianyi; Liu, Xiaosun; Zhang, Qing; Hong, Yanyun; Song, Bin [Department of Gastrointestinal and Thyroid Surgery, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China); Teng, Xiaodong [Department of Pathology, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China); Yu, Jiren [Department of Gastrointestinal and Thyroid Surgery, The First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003 (China)

    2016-11-01

    Standard therapy has not been established for thyroid cancer when a thyroidectomy is contraindicated due to systemic disease. Herein, we reported a patient who had hypertrophic cardiomyopathy and papillary thyroid carcinoma treated by radiofrequency ablation because of inability to tolerate a thyroidectomy. Radiofrequency ablation can be used to treat thyroid cancer when surgery is not feasible, although the long-term outcome needs further observation.

  17. Undifferentiated pulmonary adenocarcinoma of clear cells associated to hypertrophic osteopathy in a dog

    OpenAIRE

    Rossetto, Victor José Vieira [UNESP; Rahal, Sheila Canevese [UNESP; Pardini, Luciana Moura Campos [UNESP; Fabris, Viciany Erique [UNESP; Mamprim, Maria Jaqueline [UNESP; Ribeiro, Sergio Marrone [UNESP

    2015-01-01

    Background: Most of the primary pulmonary tumors in dogs are malignant and from epithelial origin, being bronchioalveolar tumors more prevalent. Adenocarcinoma of clear cells, however, is a very rare pulmonary tumor and its origin is still unknown. It is related to several clinical abnormalities, including hypertrophic osteopathy, an unusual paraneoplastic syndrome characterized by a periosteal reaction along the shaft of long bones. Because of the unusual presentation of the pulmonary adenoc...

  18. Intrauterine Treatment of a Fetus with Familial Hypertrophic Cardiomyopathy Secondary to MYH7 Mutation.

    Science.gov (United States)

    Hill, Meghan G; Sekhon, Mehtab K; Reed, Kathryn L; Anderson, Caroline F; Borjon, Nydia D; Tardiff, Jil C; Barber, Brent J

    2015-12-01

    There is no clear consensus on optimal management of fetuses affected by familial hypertrophic cardiomyopathy (HCM). Intrauterine treatment of the condition has not been attempted in any standardized fashion. We report the case of a fetus treated by maternal propranolol during the third trimester after septal hypertrophy and diastolic dysfunction was diagnosed on fetal echocardiogram. The pregnancy went successfully to term, and fetal septal hypertrophy was noted to improve prior to delivery.

  19. A Case Report of Percutaneous Transluminal Septal Myocardial Ablation in Patients with Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    M.H. Namazi

    2004-10-01

    Full Text Available A number of patients with severe obstruction due to hypertrophic cardiomyopathy have derived benefit at least over the short-term from inventional infarction of a portion of the interventricular septum by the infusion of alcohol into a selectively catheterized septal artery , with reduction of the outflow gradient and improvement in symptoms .This paper contains successful TASH on a symptomatic patient with high LVOT gradient and methods and complications.

  20. Burden of Recurrent and Ancestral Mutations in Families With Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Ross, Samantha Barratt; Bagnall, Richard D; Ingles, Jodie; Van Tintelen, J Peter; Semsarian, Christopher

    2017-06-01

    Hypertrophic cardiomyopathy is a genetically heterogeneous myocardial disease with >1000 causal variants identified. Nonunique variants account for disease in many families. We sought to characterize nonunique variants in Australian families and determine whether they arise from common ancestral mutations or recurrent mutation events. Genetic test results of 467 index patients from apparently unrelated families with hypertrophic cardiomyopathy were evaluated. Causal variants were found in 185 of 467 (40%) families. Nonunique variants accounted for 122 of 185 (66%) families. The most common single genetic cause of hypertrophic cardiomyopathy is the recurrent MYBPC3 (myosin-binding protein-C) variant c.1504C>T, p.Arg502Trp, which was found in 13 of 185 (7%) families with a causal variant identified. Thirteen variants in MYBPC3 and MYH7 (myosin heavy chain 7) were each identified >3 times and accounted for 78 of 185 (42%) hypertrophic cardiomyopathy families with a causal variant. Haplotype analysis of these 13 variants was performed on 126 individuals from 70 Australian families, and 11 variants arose through recurrent mutation events. Two variants, MYBPC3 c.1928-2A>G and MYH7 c.2681A>G, p.Glu894Gly, were found on 1 haplotype in 6 families each, supportive of a single mutation event inherited from a common ancestor. The majority of families with a causal variant identified have a nonunique variant. Discovery of the genetic origins of human disease forms a fundamental basis for improved understanding of disease pathogenesis and phenotype development. © 2017 American Heart Association, Inc.

  1. Improved survival with amiodarone in patients with hypertrophic cardiomyopathy and ventricular tachycardia.

    OpenAIRE

    McKenna, W. J.; Oakley, C M; Krikler, D. M.; Goodwin, J. F.

    1985-01-01

    The effect of amiodarone on survival was assessed in patients with hypertrophic cardiomyopathy and ventricular tachycardia in a drug trial with historical controls. During 1976 and 1977, 24 hour (seven) or 48 hour (79) electrocardiographic monitoring was performed in 86 consecutive patients; 24 had ventricular tachycardia and received conventional antiarrhythmic agents. Nineteen clinical, echocardiographic, and haemodynamic features were assessed. Seven patients died suddenly during follow up...

  2. Bilateral brachial plexus blocks in a patient of hypertrophic obstructive cardiomyopathy with hypertensive crisis

    OpenAIRE

    Bhat Pai, Rohini V; Hegde, Harihar V.; MCB, Santhosh; S Roopa; Shrinivas S Deshpande; P Raghavendra Rao

    2013-01-01

    Hypertrophic obstructive cardiomyopathy (HOCM) is a challenge to anesthesiologists due to the complex pathophysiology involved and various perioperative complications associated with it. We present a 50-year-old man, a known case of HOCM, who successfully underwent emergency haemostasis, and debridement of the traumatically amputated right upper limb and the contused lacerated wound on the left forearm under bilateral brachial plexus blocks. His co-morbidities included hypertension (in hypert...

  3. The PI3K pathway regulates endochondral bone growth through control of hypertrophic chondrocyte differentiation

    Directory of Open Access Journals (Sweden)

    Beier Frank

    2008-04-01

    Full Text Available Abstract Background The majority of our bones develop through the process of endochondral ossification that involves chondrocyte proliferation and hypertrophic differentiation in the cartilage growth plate. A large number of growth factors and hormones have been implicated in the regulation of growth plate biology, however, less is known about the intracellular signaling pathways involved. PI3K/Akt has been identified as a major regulator of cellular proliferation, differentiation and death in multiple cell types. Results and Discussion Employing an organ culture system of embryonic mouse tibiae and LY294002, a pharmacological inhibitor of PI3K, we show that inhibition of the pathway results in significant growth reduction, demonstrating that PI3K is required for normal endochondral bone growth in vitro. PI3K inhibition reduces the length of the proliferating and particularly of the hypertrophic zone. Studies with organ cultures and primary chondrocytes in micromass culture show delayed hypertrophic differentiation of chondrocytes and increased apoptosis in the presence of LY294002. Surprisingly, PI3K inhibition had no strong effect on IGF1-induced bone growth, but partially blocked the anabolic effects of C-type natriuretic peptide. Conclusion Our data demonstrate an essential role of PI3K signaling in chondrocyte differentiation and as a consequence of this, in the endochondral bone growth process.

  4. Topical Silicone Sheet Application in the Treatment of Hypertrophic Scar/span>s and Keloids

    Science.gov (United States)

    Westra, Iris; Pham, Hth

    2016-01-01

    Objective: Since the early 1980s, topical silicone sheets have been used in the treatment of hypertrophic scar/span>s and keloids.This study aimed to determine the optimal duration and application of these sheets. Design: multi-centered therapeutic study. Setting and participants: A total of 224 patients were included in this study; 205 patients with hypertrophic scar/span>s and 19 patients with keloids. Patients received treatment with a topical silicone sheet. Treated scars varied in age, ranging from two weeks to 62 years and treatment time ranged from one month to 16 months. Assessment of the scars was performed by the use of standardized study forms and digital photography. Measurements: Skin therapists objectively assessed the scars on its color, thickness, and elasticity. Patients themselves subjectively assessed their perception of their scar and their experience with the usage of the topical silicone sheet. Results: After applying the topical silicone sheet, all scars, regardless of type of scar and maturity, improved significantly in color, thickness, and elasticity. Conclusion: In this study, treatment with the topical silicone sheet showed significant improvement on both hypertrophic scar/span>s and keloids. Best results were reached when the silicone sheet was applied at least four hours per day. PMID:27847546

  5. Diagnostic Value of Histological and Microbiological Screening in Etiopathogenesis of Recurrent and Hypertrophic Tonsillitis

    Directory of Open Access Journals (Sweden)

    Uldis Viesturs

    2006-12-01

    Full Text Available Interest in the mechanisms and causes of recurrent tonsillitis is considerable. CD4+CD25+ T-lymphocytes have an important role in the maintenance of immunological tolerance. The aim of our research was to compare the diagnostic value of palatine tonsils histological and microbiological screening in patients with hypertrophic and recurrent tonsillitis. 14 patients with hypertrophic and 10 patients with chronic tonsillitis undergoing tonsillectomy were enrolled in the study. Rapid diagnosis of adenovirus, parainfluenza, influenza A and B, and respiratory syncytial virus infection was made before tonsillectomy by viral antigen detection using the immunofluorescence procedure from tonsils. Herpes simplex and cytomegaloviruses DNA were detected by the polymerase chain reaction. Samples for bacteriological studies were collected using a cotton swab. Immunohistochemical methods were used to evaluate S-100 and TGF-beta1 expression. The obtained results showed that patients with recurrent tonsillitis had less S-100 and TGF-beta1 positive cells in parafollicular regions compared to patients with hypertrophic tonsillitis. In both groups, tonsils were colonized predominantly by gram-positive microorganisms and adenovirus (36% of cases. However, in patients with recurrent tonsillitis, associations of gram-positive, gram-negative bacteria and viruses (40% of cases were observed. To conclude, recurrent tonsillitis is characterized by the breakdown of the immunological tolerance to oral microflora.

  6. Conditional deletion of Tgfbr2 in hypertrophic chondrocytes delays terminal chondrocyte differentiation.

    Science.gov (United States)

    Sueyoshi, Tatsuya; Yamamoto, Koji; Akiyama, Haruhiko

    2012-07-01

    Transforming growth factor β (Tgfb) signaling plays an important role in endochondral ossification. Previous studies of mice in which the Tgfb type II receptor gene (Tgfbr2) was deleted in the limb bud mesenchymal cells or differentiated chondrocytes showed defects in the development of the long bones or the axial skeleton, respectively. Here, we generated mouse embryos in which the Tgfbr2 gene was ablated in hypertrophic chondrocytes. These mice exhibited delays in both the hypertrophic conversion of proliferating chondrocytes and the subsequent terminal chondrocyte differentiation. The expression domains of Col10a1, Matrix metalloproteinase 13, and Osteopontin were small, and the expression of Vascular endothelial growth factor and Platelet endothelial cell adhesion molecule was downregulated. The calcification of the bone collar in the mutant mice was markedly delayed and the periosteum was thin, possibly because of the downregulation of Indian hedgehog expression. We conclude that Tgfb signaling in hypertrophic chondrocytes positively regulates terminal chondrocyte differentiation, angiogenesis in calcified cartilage, and osteogenesis in the bone collar, at least partly through Indian hedgehog signaling in vivo. Copyright © 2012 International Society of Matrix Biology. Published by Elsevier B.V. All rights reserved.

  7. Evaluation of hypertrophic obstructive cardiomyopathy by exercise stress echocardiography. New methodology.

    Science.gov (United States)

    Cotrim, Carlos; Loureiro, Maria José; Simões, Otília; Miranda, Rita; Cordeiro, Pedro; Ialá, Mário; Matias, Carla; João, Isabel; Carrageta, Manuel

    2005-11-01

    Exercise echocardiography with image acquisition during treadmill exercise is the most common form of stress testing used in our department. The usual evaluation of patients with hypertrophic obstructive cardiomyopathy consists of serial echocardiographic studies at rest. The purpose of this study was to evaluate intraventricular gradients during exercise echocardiography in patients with a diagnosis of hypertrophic obstructive cardiomyopathy. We studied 13 patients, 8 male, mean age 56 +/- 9 years Intraventricular gradients were measured using continuous wave Doppler; two evaluations were performed at rest: one in left lateral decubitus and the other in orthostatic position after one minute in this position. The patients then underwent a treadmill exercise test using the modified Bruce protocol, during which intraventricular gradients were measured at peak exercise. Finally, a further measurement was taken in the first 90 seconds of the recovery period in left lateral decubitus. The intraventricular gradient in left lateral decubitus was 54 +/- 29 mmHg; in orthostatic position 69 +/- 30 mmHg (p happens during effort or therefore during these patients' daily activities. This type of evaluation can help us to better understand the pathophysiology of patients with a diagnosis of hypertrophic obstructive cardiomyopathy and to optimize treatment.

  8. Aberrant α-Adrenergic Hypertrophic Response in Cardiomyocytes from Human Induced Pluripotent Cells

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    Gabor Földes

    2014-11-01

    Full Text Available Cardiomyocytes from human embryonic stem cells (hESC-CMs and induced pluripotent stem cells (hiPSC-CMs represent new models for drug discovery. Although hypertrophy is a high-priority target, we found that hiPSC-CMs were systematically unresponsive to hypertrophic signals such as the α-adrenoceptor (αAR agonist phenylephrine (PE compared to hESC-CMs. We investigated signaling at multiple levels to understand the underlying mechanism of this differential responsiveness. The expression of the normal α1AR gene, ADRA1A, was reversibly silenced during differentiation, accompanied by ADRA1B upregulation in either cell type. ADRA1B signaling was intact in hESC-CMs, but not in hiPSC-CMs. We observed an increased tonic activity of inhibitory kinase pathways in hiPSC-CMs, and inhibition of antihypertrophic kinases revealed hypertrophic increases. There is tonic suppression of cell growth in hiPSC-CMs, but not hESC-CMs, limiting their use in investigation of hypertrophic signaling. These data raise questions regarding the hiPSC-CM as a valid model for certain aspects of cardiac disease.

  9. Treatment of hypertrophic scars and keloids using intense pulsed light (IPL).

    Science.gov (United States)

    Erol, O Onur; Gurlek, Ali; Agaoglu, Galip; Topcuoglu, Ela; Oz, Hayat

    2008-11-01

    Keloids and hypertrophic scars are extremely disturbing to patients, both physically and psychologically. This study prospectively assessed the safety and efficacy of intense pulsed light (IPL) on scars originating from burns, trauma, surgery, and acne. Hypertrophic scars in 109 patients, originating from surgical incisions (n = 55), traumatic cuts (traffic accidents) (n = 24), acne scars (n = 6), keloids (n = 5), and burns (n = 19), were treated using an IPL Quantum device. Treatment was administered at 2-4-week intervals, and patients received an average of 8 treatments (range = 6-24). Using digital photographs, Changes in scar appearance were assessed by two physicians who were blinded to the study patients and treatments. The photographs were graded on a scale of 0 to 4 (none, minimal, moderate, good, excellent) for improvement in overall clinical appearance and reduction in height, erythema, and hardness. An overall clinical improvement in the appearance of scars and reductions in height, erythema, and hardness were seen in the majority of the patients (92.5%). Improvement was excellent in 31.2% of the patients, good in 25.7%, moderate in 34%, and minimal in 9.1%. Over half the patients had good or excellent improvement. In the preventive IPL treatment group, 65% had good to excellent improvement in clinical appearance. Patient satisfaction was very high. This study suggests that IPL is effective not only in improving the appearance of hypertrophic scars and keloids regardless of their origin, but also in reducing the height, redness, and hardness of scars.

  10. The follow-up of progressive hypertrophic cardiomyopathy using magnetic resonance rotating frame relaxation times.

    Science.gov (United States)

    Khan, Muhammad Arsalan; Laakso, Hanne; Laidinen, Svetlana; Kettunen, Sanna; Heikura, Tommi; Ylä-Herttuala, Seppo; Liimatainen, Timo

    2017-12-15

    Magnetic resonance rotating frame relaxation times are an alternative non-contrast agent choice for the diagnosis of chronic myocardial infarct. Fibrosis typically occurs in progressive hypertrophic cardiomyopathy. Fibrosis has been imaged in myocardial infarcted tissue using rotating frame relaxation times, which provides the possibility to follow up progressive cardiomyopathy without contrast agents. Mild and severe left ventricular hypertrophy were induced in mice by transverse aortic constriction, and the longitudinal rotating frame relaxation times (T1ρ ) and relaxation along the fictitious field (TRAFF2 , TRAFF3 ) were measured at 5, 10, 24, 62 and 89 days after transverse aortic constriction in vivo. Myocardial fibrosis was verified using Masson's trichrome staining. Increases in the relative relaxation time differences of T1ρ , together with TRAFF2 and TRAFF3 , between fibrotic and remote tissues over time were observed. Furthermore, TRAFF2 and TRAFF3 showed higher relaxation times overall in fibrotic tissue than T1ρ . Relaxation time differences were highly correlated with an excess of histologically verified fibrosis. We found that TRAFF2 and TRAFF3 are more sensitive than T1ρ to hypertrophic cardiomyopathy-related tissue changes and can serve as non-invasive diagnostic magnetic resonance imaging markers to follow up the mouse model of progressive hypertrophic cardiomyopathy. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Groundwater penetrating radar and high resolution seismic for locating shallow faults in unconsolidated sediments

    Energy Technology Data Exchange (ETDEWEB)

    Wyatt, D.E. [Westinghouse Savannah River Co., Aiken, SC (United States)]|[South Carolina Univ., Columbia, SC (United States). Earth Sciences and Resources Inst.; Waddell, M.G. [South Carolina Univ., Columbia, SC (United States). Earth Sciences and Resources Inst.; Sexton, B.G. [Microseeps Ltd., Pittsburgh, PA (United States)

    1993-12-31

    Faults in shallow, unconsolidated sediments, particularly in coastal plain settings, are very difficult to discern during subsurface exploration yet have critical impact to groundwater flow, contaminant transport and geotechnical evaluations. This paper presents a case study using cross-over geophysical technologies in an area where shallow faulting is probable and known contamination exists. A comparison is made between Wenner and dipole-dipole resistivity data, ground penetrating radar, and high resolution seismic data. Data from these methods were verified with a cone penetrometer investigation for subsurface lithology and compared to existing monitoring well data. Interpretations from these techniques are compared with actual and theoretical shallow faulting found in the literature. The results of this study suggests that (1) the CPT study, combined with the monitoring well data may suggest that discontinuities in correlatable zones may indicate that faulting is present (2) the addition of the Wenner and dipole-dipole data may further suggest that offset zones exist in the shallow subsurface but not allow specific fault planes or fault stranding to be mapped (3) the high resolution seismic data will image faults to within a few feet of the surface but does not have the resolution to identify the faulting on the scale of our models, however it will suggest locations for upward continuation of faulted zones (4) offset 100 MHz and 200 MHz CMP GPR will image zones and features that may be fault planes and strands similar to our models (5) 300 MHz GPR will image higher resolution features that may suggest the presence of deeper faults and strands, and (6) the combination of all of the tools in this study, particularly the GPR and seismic may allow for the mapping of small scale, shallow faulting in unconsolidated sediments.

  12. Occurrence of steroid hormones and antibiotics in shallow groundwater impacted by livestock waste control facilities

    Science.gov (United States)

    Bartelt-Hunt, Shannon; Snow, Daniel D.; Damon-Powell, Teyona; Miesbach, David

    2011-04-01

    Wastewater impoundments at concentrated animal feeding operations (CAFOs) represent a potential source of veterinary pharmaceuticals and steroid hormone contamination to shallow groundwater. This study investigates the occurrence of seventeen veterinary pharmaceuticals and thirteen steroid hormones and hormone metabolites in lagoons and adjacent groundwater at operating swine and beef cattle facilities. These sites were chosen because subsurface geology and previous monitoring of nitrate, ammonia and chloride levels in shallow ground water strongly indicated direct infiltration, and as such represent worst cases for ground water contamination by waste water. Pharmaceutical compounds detected in samples obtained from cattle facilities include sulfamerazine; sulfamethazine; erythromycin; monensin; tiamulin; and sulfathiazole. Lincomycin; ractopamine; sulfamethazine; sulfathiazole; erythromycin; tiamulin and sulfadimethoxine were detected in wastewater samples obtained from swine facilities. Steroid hormones were detected less frequently than veterinary pharmaceuticals in this study. Estrone, testosterone, 4-androstenedione, and androsterone were detected in wastewater impoundments at concentrations ranging from 30 to 3600 ng/L, while only estrone and testosterone were detected in groundwater samples at concentrations up to 390 ng/L. The co-occurrence of veterinary pharmaceutical and steroid hormone contamination in groundwater at these locations and the correlation between pharmaceutical occurrence in lagoon wastewater and hydraulically downgradient groundwater indicates that groundwater underlying some livestock wastewater impoundments is susceptible to contamination by veterinary pharmaceuticals and steroid hormones originating in wastewater lagoons.

  13. Concomitant ablation for atrial fibrillation during septal myectomy in patients with hypertrophic obstructive cardiomyopathy.

    Science.gov (United States)

    Bogachev-Prokophiev, Alexander V; Afanasyev, Alexander V; Zheleznev, Sergei I; Pivkin, Alexei N; Fomenko, Michael S; Sharifulin, Ravil M; Karaskov, Alexander M

    2017-09-01

    The appearance of atrial fibrillation is associated with significant clinical deterioration in patients with obstructive hypertrophic cardiomyopathy; therefore, maintenance of sinus rhythm is desirable. Guidelines and most articles have reported the results of catheter ablation and pharmacologic atrial fibrillation treatment; nevertheless, data regarding concomitant procedures during septal myectomy are limited. The aim of this study was to assess the outcomes of concomitant atrial fibrillation treatment in patients with obstructive hypertrophic cardiomyopathy. Between 2010 and 2013 in our clinic, 187 patients with obstructive hypertrophic cardiomyopathy underwent extended myectomy. In 45 cases, concomitant Cox-Maze IV procedure was performed; however, obstructive hypertrophic cardiomyopathy was the primary indication for surgery. Atrial fibrillation was paroxysmal in 26 patients (58%) and nonparoxysmal in 19 patients (42%). The mean age of patients was 52.8 ± 14.2 years (range, 22-74 years). Mean peak gradient was 90.7 ± 24.2 mm Hg, and interventricular septum thickness was 26.1 ± 4.3 mm. Mean atrial fibrillation duration was 17.3 ± 8.5 months. There were no early deaths. No procedure-related complications occurred with regard to ablation procedure. Complete atrioventricular block was achieved in 2 patients (4.0%). Mean crossclamping time was 61 ± 36 minutes. Peak left ventricular outflow tract gradient was 12.6 ± 5.5 mm Hg based on transesophageal echocardiography. The Maze IV procedure was used for ablation in all patients (radiofrequency ablation with bipolar clamp + cryolesion for mitral and tricuspid lines). Because of the atrial wall thickness (5-6 mm), applications were performed 8 to 10 times on each line. There were no cases of pacemaker implantation due to sinus node dysfunction. All patients were discharged in stable sinus rhythm. Mean follow-up was 23.7 ± 1.3 months. The rate of atrial fibrillation freedom was 100% (45

  14. Nd:YAG Laser Treatment for Keloids and Hypertrophic Scar/span>s: An Analysis of 102 Cases

    Science.gov (United States)

    Koike, Sachiko; Akaishi, Satoshi; Nagashima, Yuki; Dohi, Teruyuki; Hyakusoku, Hiko

    2014-01-01

    Background: The present retrospective cohort study was performed to determine the efficacy of contact-mode 1064 nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser laser for keloids and hypertrophic scar/span>s. The indication and limitations of this modality are discussed. Methods: The cohort consisted of 102 consecutive Japanese patients (23 males and 79 females) with keloids and hypertrophic scar/span>s for more than 1 year. They were treated every 3–4 weeks for 1 year with a long-pulsed 1064 nm Nd:YAG laser (Cutera, Brisbane, Calif.) in contact mode. Thirty-eight patients had hypertrophic scar/span>s and 64 had keloids. The scars were evaluated before the treatment commenced and 1 month after the last session by using the Japan Scar Workshop Scar Scale 2011. Recurrence was assessed at 6 months after the termination of treatment. Results: The average total Japan Scar Workshop score of the keloid and hypertrophic scar region groups dropped significantly after 1 year of treatment compared with before treatment (all P hypertrophic scar/span>s or keloids deteriorated. However, 3 of the 34 anterior chest keloids (8.8%) did not respond. The following recurrence rates were observed 6 months after stopping laser treatment: 1 of the abdomen hypertrophic scar/span>s (4%), 18 of the anterior chest keloids (52.9%), 5 of the upper arm keloids (35.7%), and 4 of the scapula keloids (25%). Conclusions: Hypertrophic scar/span>s responded significantly better to 1064 nm Nd:YAG laser treatment than keloids. However, keloid recurrence occurred when there was remaining redness and induration, even if only a small part of the scar was affected. PMID:25587506

  15. Three-Dimensional Shallow Water Acoustics

    Science.gov (United States)

    2016-03-30

    13-1-0026 entitled "Three- Dimensional Shallow Water Acoustics ," Principal Investigator Dr. Ying-Tsong Lin. Sincerely, ;l1,J-Ju1𔃻 ~{hjM1...30/03/2016 01/01/2013-12/31/2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBERS Three-Dimensional Shallow Water Acoustics 5b, GRANT NUMBER N0001 4-13-1...effects. The long-term goals of this project are targeted on understanding the 3-D acoustic effects, and their temporal and spatial variability, caused

  16. Computational modeling of shallow geothermal systems

    CERN Document Server

    Al-Khoury, Rafid

    2011-01-01

    A Step-by-step Guide to Developing Innovative Computational Tools for Shallow Geothermal Systems Geothermal heat is a viable source of energy and its environmental impact in terms of CO2 emissions is significantly lower than conventional fossil fuels. Shallow geothermal systems are increasingly utilized for heating and cooling of buildings and greenhouses. However, their utilization is inconsistent with the enormous amount of energy available underneath the surface of the earth. Projects of this nature are not getting the public support they deserve because of the uncertainties associated with

  17. Shallow water sound propagation with surface waves.

    Science.gov (United States)

    Tindle, Chris T; Deane, Grant B

    2005-05-01

    The theory of wavefront modeling in underwater acoustics is extended to allow rapid range dependence of the boundaries such as occurs in shallow water with surface waves. The theory allows for multiple reflections at surface and bottom as well as focusing and defocusing due to reflection from surface waves. The phase and amplitude of the field are calculated directly and used to model pulse propagation in the time domain. Pulse waveforms are obtained directly for all wavefront arrivals including both insonified and shadow regions near caustics. Calculated waveforms agree well with a reference solution and data obtained in a near-shore shallow water experiment with surface waves over a sloping bottom.

  18. Understanding the hydrologic impacts of wastewater treatment plant discharge to shallow groundwater: Before and after plant shutdown

    Science.gov (United States)

    Hubbard, Laura E.; Keefe, Steffanie H.; Kolpin, Dana W.; Barber, Larry B.; Duris, Joseph W.; Hutchinson, Kasey J.; Bradley, Paul M.

    2016-01-01

    Effluent-impacted surface water has the potential to transport not only water, but wastewater-derived contaminants to shallow groundwater systems. To better understand the effects of effluent discharge on in-stream and near-stream hydrologic conditions in wastewater-impacted systems, water-level changes were monitored in hyporheic-zone and shallow-groundwater piezometers in a reach of Fourmile Creek adjacent to and downstream of the Ankeny (Iowa, USA) wastewater treatment plant (WWTP). Water-level changes were monitored from approximately 1.5 months before to 0.5 months after WWTP closure. Diurnal patterns in WWTP discharge were closely mirrored in stream and shallow-groundwater levels immediately upstream and up to 3 km downstream of the outfall, indicating that such discharge was the primary control on water levels before shutdown. The hydrologic response to WWTP shutdown was immediately observed throughout the study reach, verifying the far-reaching hydraulic connectivity and associated contaminant transport risk. The movement of WWTP effluent into alluvial aquifers has implications for potential WWTP-derived contamination of shallow groundwater far removed from the WWTP outfall.

  19. Hydrochemical evaluation and identification of geochemical processes in the shallow and deep wells in the Ramganga Sub-Basin, India.

    Science.gov (United States)

    Rajmohan, Natarajan; Patel, Neelam; Singh, Gaurav; Amarasinghe, Upali A

    2017-09-01

    Groundwater samples were collected from 44 wells in the Ramganga Sub-Basin (RSB), India, and analysed for major ions, nutrients and trace metals. The primary goal of this study is to evaluate the hydrochemistry and to identify the geochemical processes that govern the water chemistry in the shallow and deep tube wells in the study area using geochemical methods. The knowledge of changes in hydrochemistry of the aquifers is important for both groundwater recharge and use in the region. This study found that there are substantial differences of water chemistry between shallow and deep wells. In the shallow wells, the average concentrations of total dissolved solid (TDS), Na, K, Ca, Mg, HCO3, Cl, SO4, NO3, PO4, F, Cu, Mn, Fe and Cr are twofold higher than the deep wells. The concentrations of dissolved silica in the groundwater do not vary with the depth, which implies that the variation in the water chemistry is not due to mineral dissolution alone. Major ion ratios and saturation indices suggest that the water chemistry is predominantly controlled by dissolution of carbonate minerals, silicate weathering and ion exchange reactions. Thermodynamic evaluation (ion activity ratios and stability filed diagrams) indicates that the kaolinite and gibbsite controlled the water chemistry in the both shallow and deep wells. In addition, the groundwater chemistry in the shallow wells is affected by the vertical infiltration of contaminated water from surface contamination sources and nitrification process. In the deep wells, absence of NO3 and low concentrations of Cl, SO4, PO4 and F imply the role of regional flow and denitrification in the groundwater. Results concluded that proper management plan is necessary to protect the shallow aquifer in the RSB since shallow aquifer pumping is less expensive than the deeper one.

  20. Characterization of the Geology of Subsurface Shallow ...

    African Journals Online (AJOL)

    In the present study, the 2D electrical resistivity imaging of subsurface shallow conglomerate has been generated using through Computerized Resistivity Meter (CRM -500) and the Wenner electrode configuration has been used for 2D electrical resistivity imaging studies. The measured apparent resistivity values have ...

  1. Approximate factorization in shallow water applications

    NARCIS (Netherlands)

    P.J. van der Houwen; B.P. Sommeijer (Ben)

    1998-01-01

    textabstractWe consider the numerical integration of problems modelling phenomena in shallow water in 3 spatial dimensions. If the governing partial differential equations for such problems are spatially discretized, then the righthand side of the resulting system of ordinary differential equations

  2. Floating offshore wind turbines for shallow waters

    NARCIS (Netherlands)

    Bulder, B.H.; Henderson, A.; Huijsmans, R.H.M.; Peeringa, J.M.; Pierik, J.T.G.; Snijders, E.J.B.; Hees, M.Th. van; Wijnants, G.H.; Wolf, M.J.

    2003-01-01

    Bottom mounted Offshore wind turbines seem to have a promising future but they are restricted to shallow waters of Northern Europe. Many projects are planned or are in the phase of construction on the North Sea and the Baltic Sea. All projects that are planned have a water depth up to approximately

  3. Viral ecology of a shallow eutrophic lake

    NARCIS (Netherlands)

    Tijdens, M.

    2007-01-01

    This thesis aims to give an insight into the ecology of the viral community in a shallow eutrophic lake. To achieve this, the population dynamics, diversity and control of the viral community in Lake Loosdrecht were studied, as well as the impact of the viral community on plankton mortality and

  4. Grain transport mechanics in shallow overland flow

    Science.gov (United States)

    A physical model based on continuum multiphase flow is described to represent saltating transport of grains in shallow overland flow. The two phase continuum flow of water and sediment considers coupled St.Venant type equations. The interactive cumulative effect of grains is incorporated by a disper...

  5. Grain transport mechanics in shallow flow

    Science.gov (United States)

    A physical model based on continuum multiphase flow is described to represent saltating transport of grains in shallow overland flows. The two-phase continuum flow of water and sediment considers coupled St.Venant type equations. The interactive cumulative effect of grains is incorporated by a dispe...

  6. A Novel Triple Medicine Combination Injection for the Resolution of Keloids and Hypertrophic Scar/span>s

    Science.gov (United States)

    Gold, Michael H.

    2014-01-01

    Keloids and hypertrophic scar/span>s remain one of the more difficult treatment concerns for clinicians. A variety of therapies have been used in the past with moderate success. On occasion, combination therapy has been used to treat these lesion, in an attempt to lessen the symptoms of pain and pruritus that often accompanies keloids and hypertrophic scar/span>s, as well as treating the actual lesions themselves. A novel triple combination injection process is introduced here in an attempt to further reduce the signs and symptoms of these lesions. The combination includes 5-fluoruracil, triamcinolone acetonide, and hyaluronidase. All three work in concert to treat keloids and hypertrophic scar/span>s, and this is the first work at looking at these medicines given together, at the same time, in a series of recalcitrant keloids and hypertrophic scar/span>s. The positive results warrant further investigation and hope for those with keloids and hypertrophic scar/span>s. PMID:25489380

  7. Effect of HMME-PDT with different parameters in rabbit ear model: a possible way for hypertrophic scarring

    Science.gov (United States)

    Cai, Hong; Gu, Ying; Zeng, Jing; Li, Shao-ran; Sun, Qiang; Wang, Ying; Shi, Dong-wen; Zhang, Lu-yong

    2007-11-01

    Background and Objective: Hypertrophic scar is a pathological scar that grows aberrantly by excessive deposition of collagens in the dermis. It is known that photodynamic therapy (PDT) contributes to a variety of diseases, however, the use of inhibiting scar formation has not been fully explored. The purpose of this study is to investigate the effect of HMME-PDT (Photodynamic therapy induced by Hematoporphyrin Monomethyl Ether) with different parameters on hypertrophic scar in rabbit ear. Materials and Methods: After the placement of 7-mm diameter dermal wounds on each ear, the acute model of dermal hypertrophic scar in the New Zealand white rabbits was established. Scar wounds were randomly separated into 2 groups: the experimental group received HMME-PDT with different parameters, and the control group received no special treatment. Specimens were harvested from scar wounds on postoperative day 28. Scar and hypertrophic index (HI) were observed by haematoxylin-eosin staining. Results: Compared with the control group, scar formation was inhibited by HMME-PDT in the experimental group with parameters as follows: photosensitizer dose 10mg/kg, power density 20mw/cm2, fluence 5J/cm2, meanwhile, HI was decreased significantly. Conclusion: HMME-PDT may play a role in inhibiting hypertrophic scarring in rabbit ear. The biological effect is determined by the dose of photosensitizer, interval between the injection of photosensitizer and irradiation, power density and energy fluence.

  8. Ablative fractional laser treatment for hypertrophic scars: comparison between Er:YAG and CO2 fractional lasers.

    Science.gov (United States)

    Choi, Jae Eun; Oh, Ga Na; Kim, Jong Yeob; Seo, Soo Hong; Ahn, Hyo Hyun; Kye, Young Chul

    2014-08-01

    Nonablative fractional photothermolysis has been reported to show early promise in the treatment of hypertrophic scars, but there are few reports on ablative fractional photothermolysis for the treatment of hypertrophic scars. To evaluate and compare the efficacy and safety of Er:YAG fractional laser (EYFL) and CO2 fractional laser (CO2FL) for treatment of hypertrophic scars. Thirteen patients with hypertrophic scars were treated with 2,940 nm EYFL, and ten were treated with 10,600 nm CO2FL. An independent physician evaluator assessed the treatment outcomes using Vancouver scar scale (VSS) and 5-point grading scale (grade 0, no improvement; grade 1, 1-25%; grade 2, 26-50%; grade 3, 51-75%; grade 4, 76-100% improvement). Patients are queried about their subjective satisfaction with the treatment outcomes. After the final treatment, average percentage changes of VSS were 28.2% for EYFL and 49.8% for CO2FL. Improvement was evident in terms of pliability, while insignificant in terms of vascularity and pigmentation. Based on physician's global assessment, mean grade of 1.8 for EYFL and 2.7 for CO2FL was achieved. Patient's subjective satisfaction scores paralleled the physician's objective evaluation. CO2FL is a potentially effective and safe modality for the treatment of hypertrophic scars, particularly in terms of pliability.

  9. Evidence for lysosomal exocytosis and release of aggrecan-degrading hydrolases from hypertrophic chondrocytes, in vitro and in vivo

    Directory of Open Access Journals (Sweden)

    Edward R. Bastow

    2012-02-01

    The abundant proteoglycan, aggrecan, is resorbed from growth plate cartilage during endochondral bone ossification, yet mice with genetically-ablated aggrecan-degrading activity have no defects in bone formation. To account for this apparent anomaly, we propose that lysosomal hydrolases degrade extracellular, hyaluronan-bound aggrecan aggregates in growth plate cartilage, and that lysosomal hydrolases are released from hypertrophic chondrocytes into growth plate cartilage via Ca2+-dependent lysosomal exocytosis. In this study we confirm that hypertrophic chondrocytes release hydrolases via lysosomal exocytosis in vitro and we show in vivo evidence for lysosomal exocytosis in hypertrophic chondrocytes during skeletal development. We show that lysosome-associated membrane protein 1 (LAMP1 is detected at the cell surface following in vitro treatment of epiphyseal chondrocytes with the calcium ionophore, ionomycin. Furthermore, we show that in addition to the lysosomal exocytosis markers, cathepsin D and β-hexosaminidase, ionomycin induces release of aggrecan- and hyaluronan-degrading activity from cultured epiphyseal chondrocytes. We identify VAMP-8 and VAMP7 as v-SNARE proteins with potential roles in lysosomal exocytosis in hypertrophic chondrocytes, based on their colocalisation with LAMP1 at the cell surface in secondary ossification centers in mouse tibiae. We propose that resorbing growth plate cartilage involves release of destructive hydrolases from hypertrophic chondrocytes, via lysosomal exocytosis.

  10. The origin of high hydrocarbon groundwater in shallow Triassic aquifer in Northwest Guizhou, China.

    Science.gov (United States)

    Liu, Shan; Qi, Shihua; Luo, Zhaohui; Liu, Fangzhi; Ding, Yang; Huang, Huanfang; Chen, Zhihua; Cheng, Shenggao

    2018-02-01

    Original high hydrocarbon groundwater represents a kind of groundwater in which hydrocarbon concentration exceeds 0.05 mg/L. The original high hydrocarbon will significantly reduce the environment capacity of hydrocarbon and lead environmental problems. For the past 5 years, we have carried out for a long-term monitoring of groundwater in shallow Triassic aquifer in Northwest Guizhou, China. We found the concentration of petroleum hydrocarbon was always above 0.05 mg/L. The low-level anthropogenic contamination cannot produce high hydrocarbon groundwater in the area. By using hydrocarbon potential, geochemistry and biomarker characteristic in rocks and shallow groundwater, we carried out a comprehensive study in Dalongjing (DLJ) groundwater system to determine the hydrocarbon source. We found a simplex hydrogeology setting, high-level water-rock-hydrocarbon interaction and obviously original hydrocarbon groundwater in DLJ system. The concentration of petroleum hydrocarbon in shallow aquifer was found to increase with the strong water-rock interaction. Higher hydrocarbon potential was found in the upper of Guanling formation (T 2 g 3 ) and upper of Yongningzhen formation (T 1 yn 4 ). Heavily saturated carbon was observed from shallow groundwater, which presented similar distribution to those from rocks, especially from the deeper groundwater. These results indicated that the high concentrations of original hydrocarbon in groundwater could be due to the hydrocarbon release from corrosion and extraction out of strata over time.

  11. Is Recovery of Large-Bodied Zooplankton after Nutrient Loading Reduction Hampered by Climate Warming? A Long-Term Study of Shallow Hypertrophic Lake Sobygaard, Denmark

    DEFF Research Database (Denmark)

    Florencia Gutierrez, Maria; Devercelli, Melina; Brucet Balmana, Sandra

    2016-01-01

    from initial dominance of Daphnia spp. towards Bosmina spp. as well as a decline in the body size of copepods and an increase in the abundance of nauplii. These changes coincided with the increase in small sized fish as a result of rising water temperature. Despite a reduction in body size, the total...... biomass of cladocerans increased coinciding with a diminished fish catch per unit effort (CPUE), and likely then an overall reduction in the predation on zooplankton. A cascading effect to phytoplankton was evidenced by enhanced zooplankton: phytoplankton and cladoceran: phytoplankton ratios...... on phytoplankton through an expected diminished fish CPUE related to nutrient loading reduction....

  12. Is Recovery of Large-Bodied Zooplankton after Nutrient Loading Reduction Hampered by Climate Warming? A Long-Term Study of Shallow Hypertrophic Lake Søbygaard, Denmark

    Directory of Open Access Journals (Sweden)

    María Florencia Gutierrez

    2016-08-01

    Full Text Available Nutrient fluctuations and climate warming can synergistically affect trophic dynamics in lakes, resulting in enhanced symptoms of eutrophication, thereby potentially counteracting restoration measures. We performed a long-term study (23 years of zooplankton in Danish Lake Søbygaard, which is in recovery after nutrient loading reduction, but now faces the effects of climate warming. We hypothesized that the recovery of large-bodied zooplankton after nutrient loading reduction would be hampered by climate warming through indirect effects on fish size structure. We found a shift in macrozooplankton from initial dominance of Daphnia spp. towards Bosmina spp. as well as a decline in the body size of copepods and an increase in the abundance of nauplii. These changes coincided with the increase in small sized fish as a result of rising water temperature. Despite a reduction in body size, the total biomass of cladocerans increased coinciding with a diminished fish catch per unit effort (CPUE, and likely then an overall reduction in the predation on zooplankton. A cascading effect to phytoplankton was evidenced by enhanced zooplankton:phytoplankton and cladoceran:phytoplankton ratios and a decrease in Chl-a:TP and Chl-a:TN ratios. Our results indicate that climate warming, through changes in the size structure of fish community, has major effects on zooplankton size structure. In Lake Søbygaard, the decline in zooplankton size did not prevent, but modulated, the positive cascading effect on phytoplankton through an expected diminished fish CPUE related to nutrient loading reduction.

  13. Graft Infection Masquerading as Rheumatologic Disease: a Rare Case of Aortobifemoral Graft Infection Presenting as Hypertrophic Osteoarthropathy.

    Science.gov (United States)

    Chapman, Stephanie A; Delgadillo, Daniel; MacGuidwin, Elizabeth; Greenberg, Joshua I; Jameson, Andrew P

    2017-05-01

    Prosthetic vascular graft procedures are a common treatment modality for peripheral vascular disease. A relatively common complication is graft infection, occurring at a rate of 0.5-5%. When they occur, graft infections are associated with significant morbidity and mortality. Vascular graft infections also represent a diagnostic and therapeutic challenge for the physician METHODS: Here, we report a case where the rare finding of secondary hypertrophic osteoarthropathy was an important indication of underlying aortic graft infection that was initially misdiagnosed. A review of the literature revealed 34 cases of vascular graft infection associated with hypertrophic osteoarthropathy. The mean interval from surgery to time of infection was approximately 5 years. Mortality was 35%. When combined with hypertrophic osteoarthropathy, vascular graft infection was complicated by an aortoenteric fistula in 53% of the cases. The complexity of this case highlights the challenges physicians face in order to diagnose and treat this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Outcomes of Alcohol Septal Ablation in Younger Patients With Obstructive Hypertrophic Cardiomyopathy

    DEFF Research Database (Denmark)

    Liebregts, Max; Faber, Lothar; Jensen, Morten K.

    2017-01-01

    Objectives The aim of this study was to describe the safety and outcomes of alcohol septal ablation (ASA) in younger patients with obstructive hypertrophic cardiomyopathy. Background The American College of Cardiology Foundation/American Heart Association guidelines reserve ASA for older patients...... and patients with serious comorbidities. Data on long-term age-specific outcomes after ASA are scarce. Methods A total of 1,197 patients (mean age 58 ± 14 years) underwent ASA for obstructive hypertrophic cardiomyopathy. Patients were divided into young (≤50 years), middle-age (51 to 64 years), and older (≥65...... patients with obstructive hypertrophic cardiomyopathy was safe and effective for relief of symptoms at long-term follow-up. The authors propose that the indication for ASA can be broadened to younger patients....

  15. Logistics of building a laser practice for the treatment of hypertrophic burn scars.

    Science.gov (United States)

    Hultman, Charles Scott; Edkins, Renee E; Cairns, Bruce A; Meyer, Anthony A

    2013-05-01

    Although lasers can improve burn scars, such treatment has not been adopted universally, due to operational challenges starting a practice and the perception that such a program is not financially viable. We report the logistics of building a laser practice for the treatment of hypertrophic burn scars. We analyzed the clinical, operational, and financial components of our laser practice, focusing on treatment of hypertrophic burn scars, using pulsed dye laser, fractional CO2 laser, and intense pulsed light. Cases were performed in an operating room, with anesthesia, after preauthorization. We examined professional charges and collections, case time, variable and indirect expenses, and breakeven volumes. Our practice grew as follows: 2008, 1 case; 2009, 44 cases; 2010, 169 cases; and 2011, 415 cases. Overall collection rate was 32.1%. Expenses incurred by the provider, per 8-hour session, included laser rental/lease ($2375), personnel salaries ($1900), and physician overhead ($808), for a total cost of $5083. Mean charge was $1642 per case; mean collection was $527 per case. Median case time (procedure plus turnover) was 40 minutes. In this model, breakeven volume is 9.7 cases per day; breakeven time is 49.7 minutes. Provider profit margin for 10 cases per day, or 83% capacity utilization, is $187 per day (income - expenses = $5270 - $5083). Despite high costs associated with starting and operating a laser practice for the treatment of hypertrophic burn scars, a sustainable enterprise can be achieved when the provider has accrued enough volume to batch cases over an entire day. Critical to achieving breakeven is preauthorization, controlling overhead, and efficient throughput.

  16. Mechanism of Progressive Heart Failure and Significance of Pulmonary Hypertension in Obstructive Hypertrophic Cardiomyopathy.

    Science.gov (United States)

    Covella, Michele; Rowin, Ethan J; Hill, Nicholas S; Preston, Ioana R; Milan, Alberto; Opotowsky, Alexander R; Maron, Barry J; Maron, Martin S; Maron, Bradley A

    2017-04-01

    There are limited data on the prevalence, pathophysiology, and management implications of pulmonary hypertension in patients with obstructive hypertrophic cardiomyopathy and advanced heart failure. To assess the clinical significance of measured cardiopulmonary hemodynamics in hypertrophic cardiomyopathy patients with heart failure, we retrospectively assessed right heart catheterization data in 162 consecutive patients with outflow tract gradients (median [interquartile range], 90 mm Hg [70-110 mm Hg]), 59±11 years old, and 49% men, predominately New York Heart Association class III/IV status. Pulmonary hypertension (mean pulmonary artery pressure, ≥25 mm Hg) was present in 82 patients (51%), including 29 (18%) regarded as moderate-severe (mean pulmonary artery pressure, ≥35 mm Hg) and 28 (34%) also had increased pulmonary vascular resistance >3.0 WU. The pulmonary artery wedge pressure was ≤15 mm Hg in 54%, indicating that left atrial hypertension was absent in a majority of patients. Notably, 9 patients (11%) met hemodynamic criteria for precapillary pulmonary hypertension (mean pulmonary artery pressure, ≥25 mm Hg; pulmonary vascular resistance, >3.0 WU; pulmonary artery wedge pressure, ≤15 mm Hg). Over a median follow-up of 327 days (90-743 days) after surgical myectomy (or alcohol septal ablation), 92% and 95% of patients with or without preoperative pulmonary hypertension, respectively, were asymptomatic or mildly symptomatic. One postoperative death occurred in a 59-year-old woman with acute respiratory failure and mean pulmonary artery pressure of 65 mm Hg. Pulmonary hypertension was common in obstructive hypertrophic cardiomyopathy patients with advanced heart failure. Although possibly a contributor to preoperative heart failure, pulmonary hypertension did not significantly influence clinical and surgical outcome. Notably, a novel patient subgroup was identified with resting invasive hemodynamics consistent with pulmonary

  17. Suppressed inflammatory gene expression during human hypertrophic scar compared to normotrophic scar formation.

    Science.gov (United States)

    van den Broek, Lenie J; van der Veer, Willem M; de Jong, Etty H; Gibbs, Susan; Niessen, Frank B

    2015-08-01

    Hypertrophic scar formation is a result of adverse cutaneous wound healing. The pathogenesis of hypertrophic scar formation is still poorly understood. A problem next to the lack of suitable animal models is that often normal skin is compared to hypertrophic scar (HTscar) and not to normotrophic scar (NTscar) tissue. Another drawback is that often only one time period after wounding is studied, while scar formation is a dynamic process over a period of several months. In this study, we compared the expression of genes involved in inflammation, angiogenesis and extracellular matrix (ECM) formation and also macrophage infiltration in biopsies obtained before and up to 52 weeks after standard surgery in five patients who developed HTscar and six patients who developed NTscar. It was found that HTscar formation coincided with a prolonged decreased expression of inflammatory genes (TNFα, IL-1α, IL-1RN, CCL2, CCL3, CXCL2, CXCR2, C3 and IL-10) and an extended increased expression of ECM-related genes (PLAU, Col3A1, TGFβ3). This coincided with a delayed but prolonged infiltration of macrophages (type 2) in HTscar tissue compared to NTscar tissue. These findings were supported by immunohistochemical localization of proteins coding for select genes named above. Our study emphasizes that human cutaneous wound healing is a dynamic process that is needed to be studied over a period of time rather than a single point of time. Taken together, our results suggest innate immune stimulatory therapies may be a better option for improving scar quality than the currently used anti-inflammatory scar therapies. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Evaluating hypertrophic thyroidectomy scar outcomes after treatment with triamcinolone injections and copper bromide laser therapy.

    Science.gov (United States)

    On, Hye Rang; Lee, Sang Hee; Lee, Yong Sang; Chang, Hang-Seok; Park, CheongSoo; Roh, Mi Ryung

    2015-08-01

    Postoperative hypertrophic scar following thyroidectomy can be a major concern due to its disfiguring appearance. Recently, copper bromide laser (CBL) and intralesional triamcinolone injection (TA ILI) have been used to treat hypertrophic thyroidectomy scars. Data regarding the number of treatment sessions needed to reach a certain endpoint and the prognostic factors that affect treatment duration are unknown. The aim of this study was to evaluate the number of treatment sessions required to reduce VSS score by 50%, which was regarded as the treatment endpoint, and to investigate the factors that influence treatment duration when using CBL and TA ILI. A total of 67 patients were enrolled in this study. Baseline characteristics of the patients including age, sex, body mass index (BMI), distance of the scar from the sternal notch, time of development of the hypertrophic scar, sternocleidomastoid (SCM) muscle prominence, and date of operation were collected on the first visit. They were treated with CBL and TA. The concentration of triamcinolone used was 2.5 mg/ml or 5 mg/ml according to the pliability score of each scar. The mean number of treatment sessions required to achieve the endpoint was 3.85 ± 1.25. Among the variables assessed, location of the scar near the sternal notch (P = 0.020) and patient BMI (P = 0.001) were associated with the increasing number of treatment sessions. In our study cohort, four treatments were required to reduce the VSS of thyroidectomy scars by 50% when using a combination treatment of CBL and low concentration TA ILI. Also, scar location and patient BMI are factors that affect treatment outcome. © 2015 Wiley Periodicals, Inc.

  19. Desmodium gangeticum root extract attenuates isoproterenol-induced cardiac hypertrophic growth in rats.

    Directory of Open Access Journals (Sweden)

    Divya Hitler

    2014-10-01

    Full Text Available Context: Desmodium gangeticum (L DC (Fabaceae; DG, a medicinal plant that grows in tropical habitats, is widely used to treat various ailments including digestive and inflammatory disorders. Aims: To investigate the possible cardioprotective activity of a DG root extract against isoproterenol (ISO-induced left ventricular cardiac hypertrophy (LVH in adult Wistar rats. Methods: Daily intraperitoneal administration of ISO (10 mg/kg body weight, single injection for 7 days induced LVH in rats. The LVH rats were post-treated orally with DG (100 mg/kg body weight for a period of 30 days. Thereafter, changes in heart weight (HW and body weight (BW, HW/BW ratio, percent of hypertrophy, collagen accumulation, activities of matrix metalloproteinase (MMP -2 and -9, superoxide dismutase (SOD and catalase (CAT enzymes, and the level of an oxidative stress marker, lipid peroxide (LPO, were determined. Results: HW/BW ratio, an indicator of hypertrophic growth, was significantly reduced in DG root post-treated LVH rats as compared with that for the non-treated LVH rats. The altered levels of ventricular LPO, collagen, MMPs-2 and -9, and antioxidant enzymes in the ISO-treated animals reverted back to near normal upon DG treatment. Further, the anti-hypertrophic activity of DG was comparable to that of the standard drug losartan (10 mg/kg. Conclusions: The results of the present study suggest that the aqueous root extract of DG exhibited anti-hypertrophic activity in-vivo by inhibiting ISO-induced ROS generation and MMP activities.

  20. SFRP2 and slug contribute to cellular resistance to apoptosis in hypertrophic scars.

    Directory of Open Access Journals (Sweden)

    Liang Chen

    Full Text Available Hypertrophic scars (HS are skin disorders which occur after wounding and thermal injury. Our previous studies have suggested that secreted frizzled-related protein 2 (SFRP2 is involved in HS formation and that the suppression of SFRP2 promotes apoptosis of hypertrophic scar fibroblasts (HSFBs. However, the mechanisms have not been clarified. Previous studies revealed that Slug expression inhibits cell apoptosis, in vitro and in vivo, and SFRP2 regulates the expression of Slug in cervical cancer cells. In the present study, we quantified differential expression levels of expression of SFRP2 and Slug in HS and normal skin tissues by immunohistochemistry, both of which have important anti-apoptosis roles. Furthermore, a short hairpin RNA approach was adopted to investigate the potential function of SFRP2 and Slug in HSFB apoptosis. Cell apoptosis was detected using fluorescence-activated cell sorting and Caspase-3 activity was assayed by spectrophotometry. This study demonstrates that SFRP2 expression, as well as Slug, is dramatically up-regulated in HS relative to normal skin tissues, and the Slug expression is positively correlated with SFRP2. Slug expression was down-regulated in SFRP2-deficient cells, and the down-regulation of Slug expression increased sensitivity to apoptosis which was induced through a caspase-3-dependent pathway. The infected cells with reduced levels of Slug were tested for the expression of apoptosis-related genes (Bcl-2, Bax and PUMA which were previously identified as Slug targets. Bcl-2 expression was down-regulated in Slug-deficient cells. In conclusion, SFRP2 appears to interact with Slug to affect the apoptosis of hypertrophic scar fibroblasts.

  1. Guidance Index for Shallow Landslide Hazard Analysis

    Directory of Open Access Journals (Sweden)

    Cheila Avalon Cullen

    2016-10-01

    Full Text Available Rainfall-induced shallow landslides are one of the most frequent hazards on slanted terrains. Intense storms with high-intensity and long-duration rainfall have high potential to trigger rapidly moving soil masses due to changes in pore water pressure and seepage forces. Nevertheless, regardless of the intensity and/or duration of the rainfall, shallow landslides are influenced by antecedent soil moisture conditions. As of this day, no system exists that dynamically interrelates these two factors on large scales. This work introduces a Shallow Landslide Index (SLI as the first implementation of antecedent soil moisture conditions for the hazard analysis of shallow rainfall-induced landslides. The proposed mathematical algorithm is built using a logistic regression method that systematically learns from a comprehensive landslide inventory. Initially, root-soil moisture and rainfall measurements modeled from AMSR-E and TRMM respectively, are used as proxies to develop the index. The input dataset is randomly divided into training and verification sets using the Hold-Out method. Validation results indicate that the best-fit model predicts the highest number of cases correctly at 93.2% accuracy. Consecutively, as AMSR-E and TRMM stopped working in October 2011 and April 2015 respectively, root-soil moisture and rainfall measurements modeled by SMAP and GPM are used to develop models that calculate the SLI for 10, 7, and 3 days. The resulting models indicate a strong relationship (78.7%, 79.6%, and 76.8% respectively between the predictors and the predicted value. The results also highlight important remaining challenges such as adequate information for algorithm functionality and satellite based data reliability. Nevertheless, the experimental system can potentially be used as a dynamic indicator of the total amount of antecedent moisture and rainfall (for a given duration of time needed to trigger a shallow landslide in a susceptible area. It is

  2. High sensitivity of late gadolinium enhancement for predicting microscopic myocardial scarring in biopsied specimens in hypertrophic cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Tetsuo Konno

    Full Text Available BACKGROUND: Myocardial scarring can be assessed by cardiac magnetic resonance imaging with late gadolinium enhancement and by endomyocardial biopsy. However, accuracy of late gadolinium enhancement for predicting microscopic myocardial scarring in biopsied specimens remains unknown in hypertrophic cardiomyopathy. We investigated whether late gadolinium enhancement in the whole heart reflects microscopic myocardial scarring in the small biopsied specimens in hypertrophic cardiomyopathy. METHODS AND RESULTS: Twenty-one consecutive patients with hypertrophic cardiomyopathy who were examined both by cardiac magnetic resonance imaging and by endomyocardial biopsy were retrospectively studied. The right interventricular septum was the target site for endomyocardial biopsy in all patients. Late gadolinium enhancement in the ventricular septum had an excellent sensitivity (100% with a low specificity (40% for predicting microscopic myocardial scarring in biopsied specimens. The sensitivity of late gadolinium enhancement in the whole heart remained 100% with a specificity of 27% for predicting microscopic myocardial scarring in biopsied specimens. Quantitative assessments of fibrosis revealed that the extent of late gadolinium enhancement in the whole heart was the only independent variable related to the microscopic collagen fraction in biopsied specimens (β  =  0.59, 95% confident interval: 0.15 - 1.0, p  =  0.012. CONCLUSIONS: Although there was a compromise in the specificity, the sensitivity of late gadolinium enhancement was excellent for prediction of microscopic myocardial scarring in hypertrophic cardiomyopathy. Moreover, the severity of late gadolinium enhancement was independently associated with the quantitative collagen fraction in biopsied specimens in hypertrophic cardiomyopathy. These findings indicate that late gadolinium enhancement can reflect both the presence and the extent of microscopic myocardial scarring in the small

  3. A case of mid-apical obstructive hypertrophic cardiomyopathy treated with a transapical myectomy approach: a case report.

    Science.gov (United States)

    Scudeler, Thiago Luis; Rezende, Paulo Cury; Oikawa, Fernando Teiichi Costa; da Costa, Leandro Menezes Alves; Hueb, Alexandre Ciappina; Hueb, Whady

    2014-11-11

    Hypertrophic cardiomyopathy is a genetic cardiac disease characterized by marked variability in morphological expression and natural history. The hypertrophic myocardium is often confined to the septum or lateral wall of the left ventricle, but it can also be encountered in the middle or apical segments of the myocardium. Treatment is based on medical therapy. Others therapies, such as embolization of the septal artery or ventriculomyectomy, are indicated in special situations. Surgery is the standard treatment, and it is classically done via a transaortic approach; however, in cases in which the hypertrophic myocardium is confined to mid-apical segments, a transapical approach is an option. Only a few cases of mid-apical obstructive hypertrophic cardiomyopathy treated with a myectomy using a transapical approach have been reported in the English-language literature. In this report, we present a case of a patient with mid-apical obstructive hypertrophic cardiomyopathy treated using this new approach. A 63-year-old Caucasian woman presented with a history of chest pain and shortness of breath causing significant limitations on her daily life activities. She had a history of coronary artery disease. Her physical examination was unremarkable. Transthoracic echocardiography revealed normal systolic function and significant concentric left ventricular hypertrophy that was greater in the mid-apical region. Nuclear magnetic resonance imaging confirmed significant hypertrophy of the median segments of the left ventricle. The patient had persistent symptoms despite receiving optimized medical treatment, and a surgical approach was indicated. As a myectomy using transaortic technique was thought to be difficult to perform in her case, a transapical approach was used. No complications occurred, and her symptoms resolved. A transapical myectomy should be taken into consideration for patients with mid-apical obstructive hypertrophic cardiomyopathy that is refractory to medical

  4. Percutaneous septal ablation for left mid-ventricular obstructive hypertrophic cardiomyopathy: a case report

    Directory of Open Access Journals (Sweden)

    Alioglu Emin

    2006-04-01

    Full Text Available Abstract Background Mid-ventricular obstructive hypertrophic cardiomyopathy (MVOHC is a rare type of cardiomyopathy. The diagnosis is based on the hourglass appearance on the left ventriculogram and the presence of pressure gradient between apical and basal chamber of the ventriculum on the hemodynamic assessment. Case presentation The present case represents successful percutaneous treatment with septal ablation to patient with MVOHC associated with systolic anterior motion of the mitral valve and obstruction at both the mid-ventricular and outflow levels. Conclusion Alcohol septal ablation has been proposed as less invasive alternatives to surgery in patients with MVOHC.

  5. Non-Operative Treatment of Hypertrophic Scar/span>s and Keloids After Burns in Children

    Science.gov (United States)

    Argirova, M.; Hadjiski, O.; Victorova, A.

    2006-01-01

    Summary Scars are a consequence of the natural way of wound healing and replacement of the damaged part of the skin. Hypertrophic scar/span>s and keloids are formed as a result of the process of abnormal wound healing, causing aesthetic and functional deformities, discomfort, and disturbance of children's normal growth. The prophylaxis and treatment of these scars, i.e. burns sequelae, are a significant moment in the treatment of children with burns. The objectives of the present study are methods for the prophylaxis and non-operative treatment of hypertrophic scar/span>s and keloids in children with burns. Altogether, 547 children with 485 burns sequelae - fresh scars in the period of healing and old hypertrophic scar/span>s (377) and keloids (108) - were treated in our Clinic of Children's Burns for a period of five years. The age of the patients varied between 0 and 18 years. Non-operative treatment was applied in 276 children. The patients were divided into two groups according to the treatment applied. Compression, intralesional application of triamcinolone acetonide, and silicone sheets were employed in the first group (84.06%), while only silicone sheets were applied to children in the second group (15.94%). Unaffected areas and areas adjacent to the scar were used as control areas. The sequelae monitored in both groups were assessed using the Vancouver Scar Scale. The children were monitored in an out-patient department. The results obtained are regardless of age, anatomical location, and scar aetiology. In old scars, and especially in keloids, the treatment proved to have variable results, according to the assessment parameters. We were satisfied with the improvement of the parameters during the course of treatment and with the good final results, which we consider a therapeutic success. Analysis of the results shows that the parameters improved slowly during the course of treatment, the process being most active during the first few weeks. The use of

  6. Increased transient receptor potential vanilloid type 1 (TRPV1) channel expression in hypertrophic heart

    DEFF Research Database (Denmark)

    Thilo, Florian; Liu, Ying; Schulz, Nico

    2010-01-01

    The aim of this study was to compare the expression of transient receptor potential vanilloid type 1 (TRPV1) channels in hypertrophic hearts from transgenic mice showing overexpression of the catalytic subunit alpha of protein phosphatase 2A alpha (PP2Ac alpha) with wild-type mice and with TRPV1......-/- mice. Transcripts of TRPV1, matrix metalloproteinase 9 (MMP9), discoidin domain receptor family, member 2 (DDR-2), atrial natriuretic peptide (ANP), GATA 4, and regulatory microRNA (miR-21) were analyzed using quantitative real-time PCR. Ventricle-to-body-weight-ratio was significantly higher in PP2Ac...

  7. Periostal hypertrophic osteopathy of bones (long bones) in colitis ulcerosa in adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Bargon, G.; Arlart, I.

    1982-03-01

    The article reports on a 14-year old girl with periostal new formation of bones at the long bones of the lower arms, the femora and the lower legs the individual phalanges and metacarpalia after colitis ulcerosa which had lasted for several years and had progressed stagewise. After a clinically recorded new attack the periostal new formations of bone progressed. Some time after the last attack of colitis the periostal changes in the bones partially receded. The article discusses the hypothetic explanations aiming at interpreting the pathogenesis of hypertrophic osteoarthropathies and periostoses, as given in the literature.

  8. Takotsubo cardiomyopathy in a patient with previously undiagnosed hypertrophic cardiomyopathy with obstruction.

    Science.gov (United States)

    Brabham, William W; Lewis, Geoffrey F; Bonnema, David D; Nielsen, Christopher D; O'Brien, Terrence X

    2011-01-01

    Takotsubo cardiomyopathy (TCM) is usually characterized by left ventricular anteroapical dysfunction in the absence of significant coronary disease commonly precipitated by an emotional or stressful trigger. Hypertrophic cardiomyopathy (HCM) is usually diagnosed on the basis of symptoms, family history, echocardiography, or by the presence of a characteristic murmur. We report a unique case of TCM occurring in a patient with previously undiagnosed HCM with left ventricular outflow tract (LVOT) obstruction who presented with an acute coronary syndrome and ultimately underwent successful alcohol septal ablation. The potential pathophysiologic correlations are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Two different cardiomyopathies in a single patient : hypertrophic cardiomyopathy and left ventricular noncompaction.

    Science.gov (United States)

    Sunbul, M; Ozben, B; Mutlu, B

    2013-05-01

    Hypertrophic cardiomyopathy is a complex and relatively common genetic disorder characterized by left ventricular (LV) hypertrophy, usually associated with a nondilated and hyperdynamic chamber with heterogeneous phenotypic expression and clinical course. On the other hand, LV noncompaction is an uncommon cardiomyopathy characterized by the persistence of fetal myocardium with a pattern of prominent trabecular meshwork and deep intertrabecular recesses, systolic dysfunction, and LV dilatation. We report a 29-year-old man with these two different inherent conditions. Our case raises the possibility of a genetic mutation common to these two clinical entities or different gene mutations existing in the same individual.

  10. Hypertrophic Cardiomyopathy After a Single Dose of Dexamethasone in a Preterm Infant

    Directory of Open Access Journals (Sweden)

    Yusuf Kale

    2015-08-01

    Full Text Available Dexamethasone is widely used in preterm infants with severe pulmonary disease. Hypertrophic cardiomyopathy (HCM is a transient side effect observed after multiple doses of dexamethasone. We report a preterm infant with myocardial hypertrophy after a single dose of dexamethasone (0.5 mg/kg used to treat laryngeal edema secondary to prolonged intubation. A benign course was observed without left ventricular outflow tract obstruction and with recovery within 4 weeks. Myocardial effects of dexamethasone may be independent of dose and duration of treatment. The risk/benefit ratio must be carefully considered before using even a single dose of dexamethasone in preterm infants.

  11. Hypertrophic Pachymeningitis as an Early Manifestation of Relapsing Polychondritis: Case Report and Review of the Literature.

    Science.gov (United States)

    Ushiyama, Satoru; Kinoshita, Tomomi; Shimojima, Yasuhiro; Ohashi, Nobuhiko; Kishida, Dai; Miyazaki, Daigo; Nakamura, Katsuya; Sekijima, Yoshiki; Ikeda, Shu-Ichi

    2016-01-01

    Neurological involvement in relapsing polychondritis (RP) is relatively rare. We describe the case of an 80-year-old man who presented with hypertrophic pachymeningitis (HP) together with arthritis as the first manifestation of RP. Auricular chondritis, which subsequently determined the diagnosis of RP, occurred a few weeks after the detection of HP. The neurological symptoms, as well as arthritis, were promptly improved by treatment with corticosteroids. It is generally difficult to diagnose RP in the absence of typical cartilaginous involvement; however, the present case suggests that HP may occur as an early clinical manifestation of RP.

  12. Vagal enhancement linking abnormal blood pressure response and subendocardial ischemia in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kawasaki, Tatsuya; Sugihara, Hiroki

    2014-01-01

    An abnormal blood pressure response to exercise has been reported to be associated with left ventricular subendocardial ischemia in patients with hypertrophic cardiomyopathy (HCM), but the underlying mechanism remains unclear. We report a case of HCM with an abnormal blood pressure response and subendocardial ischemia, in which the analysis of heart rate variability revealed exercise-induced vagal enhancement. The present case highlights the possible mechanism linking abnormal blood pressure response and left ventricular subendocardial ischemia in patients with HCM. ©2013 Wiley Periodicals, Inc.

  13. Increased left ventricular torsion in hypertrophic cardiomyopathy mutation carriers with normal wall thickness

    Science.gov (United States)

    2011-01-01

    Background Increased left ventricular (LV) torsion has been observed in patients with manifest familial hypertrophic cardiomyopathy (HCM), and is thought to be caused by subendocardial dysfunction. We hypothesize that increased LV torsion is already present in healthy mutation carriers with normal wall thickness. Methods Seventeen carriers with an LV wall thickness subendocardial myocardial dysfunction. As similar abnormalities are observed in patients with manifest HCM, the changes in healthy carriers may be target for clinical intervention to delay or prevent the onset of hypertrophy. PMID:21219655

  14. Hypertrophic Cardiomyopathy due to Mitochondrial Disease: Prenatal Diagnosis, Management, and Outcome

    Directory of Open Access Journals (Sweden)

    Lutgardo García-Díaz

    2013-01-01

    Full Text Available A case of prenatally diagnosed fetal hypertrophic cardiomyopathy is reported. The mother was referred to our department at 37 weeks' gestation because of suspected congenital heart disease. Prenatal echocardiography showed biventricular hypertrophy and pericardial effusion, without additional abnormalities. Postnatal echocardiography confirmed prenatal diagnosis. Neonatal EKG showed biventricular hypertrophy and Wolff-Parkinson-White syndrome. Skeletal muscle biopsy was consistent with mitochondrial oxidative phosphorylation defect involving a combined defect of respiratory complexes I and IV. Echocardiographic followup during the first year of life showed progressive regression of hypertrophy and evolution to left ventricular myocardial noncompaction.

  15. Hypertrophic obstructive cardiomyopathy in rheumatoid arthtritis - coincidence or association? A case report.

    Science.gov (United States)

    Moyssakis, I; Lionakis, N; Votteas, V

    2009-01-01

    A 60-year-old woman with a history of rheumatoid arthritis was admitted to the hospital for investigation of dyspnea on exertion (New York Heart Association class II), polyarthralgias and mild fever. An echocardiogram revealed asymmetric hypertrophy of the interventricular septum with signs of subaortic obstruction.The coexistence of rheumatoid arthritis and hypertrophic cardiomyopathy could be connected with the human lymphocyte antigen DR4, which is common in both conditions. Further studies are necessary to assess whether a true association of the above diseases exists.

  16. Hypertrophic obstructive cardiomyopathy in rheumatoid arthtritis – coincidence or association? A case report

    Science.gov (United States)

    Moyssakis, I; Lionakis, N; Votteas, V

    2009-01-01

    A 60-year-old woman with a history of rheumatoid arthritis was admitted to the hospital for investigation of dyspnea on exertion (New York Heart Association class II), polyarthralgias and mild fever. An echocardiogram revealed asymmetric hypertrophy of the interventricular septum with signs of subaortic obstruction. The coexistence of rheumatoid arthritis and hypertrophic cardiomyopathy could be connected with the human lymphocyte antigen DR4, which is common in both conditions. Further studies are necessary to assess whether a true association of the above diseases exists. PMID:19492031

  17. Infantile hypertrophic pyloric stenosis and subsequent ulcer dyspepsia. A follow-up study of medically and surgically treated patients

    DEFF Research Database (Denmark)

    Rasmussen, L; Hansen, L P; Qvist, N

    1988-01-01

    Infantile hypertrophic pyloric stenosis was treated in 324 cases in 1950-1966. At follow-up 19-35 years later, 296 of the patients could be traced, and 284 replied to a questionnaire concerning ulcer dyspepsia. Among the 80 patients who had been medically treated for pyloric stenosis, the prevale......Infantile hypertrophic pyloric stenosis was treated in 324 cases in 1950-1966. At follow-up 19-35 years later, 296 of the patients could be traced, and 284 replied to a questionnaire concerning ulcer dyspepsia. Among the 80 patients who had been medically treated for pyloric stenosis...

  18. Rare earth elements in Holocene reefal microbialites: a new shallow seawater proxy

    Science.gov (United States)

    Webb, Gregory E.; Kamber, Balz S.

    2000-05-01

    The concentration of rare earth elements and yttrium (REE + Y) was determined in Holocene Mg-calcite microbialites from shallow reef framework cavities at Heron Reef, Great Barrier Reef. Shale-normalized REE + Y patterns of 52 microbialite samples show: (1) uniform heavy REE enrichment (Nd SN/Yb SN = 0.236, SD = 0.026); (2) consistent negative Ce and positive La anomalies; (3) marine Y/Ho ratios (56.17, SD = 2.66); and (4) slightly positive Gd anomalies. All of these features are consistent with the geochemistry of well-oxygenated, shallow ambient seawater. REE partition coefficients were calculated relative to shallow Coral Sea seawater. They are uniform (relative SD = 10.2%) across the entire mass range and almost two orders of magnitude higher than those between coral and seawater. Hence, terrigenous detritus-free, modern microbialites are a more reliable proxy for seawater REE chemistry than are skeletal carbonates. Ancient limestones have been considered largely problematic as sources for REE proxies owing to perceived problems with diagenesis, partly on the basis of relatively high REE concentrations in some limestones compared to modern skeletal carbonates. However, high REE concentrations in modern microbialites suggest that ancient limestones with relatively high REE concentrations, if not contaminated by terrigenous detritus, may reflect original seawater chemistry. Terrigenous contamination, if present, is readily detectable on the basis of co-occurring trace element concentrations (Sc, Hf, Th) and Y/Ho ratio. Hence, ancient, particularly reefal, limestones may provide reliable seawater REE proxies. The occurrence of microbialites in clean limestones as old as 3.5 Ga suggests the possibility of reconstructing shallow marine REE chemistry over most of Earth history with important implications for paleogeography and paleoredox studies.

  19. Resistivity mapping and geochemical data for groundwater contamination at Sarimukti municipal landfill, West Bandung

    Science.gov (United States)

    Ardi, Nanang Dwi; Iryanti, Mimin

    2015-09-01

    Opened dumping landfill system at the Municipal landfill Sarimukti, West Bandung has a possibility in related to the existence of leachates contamination, especially for shallow groundwater. Earth resistivity measured with 3 profiles resistivity survey on Wenner array and measurement of electrics conductivity of geochemistry samples its converted become water formation resistivity were conducted to delineate the spreading of leachates contamination by using empirical relationship. Leachates have been identified by resistivity range 0,61 - 6,3 Ωm with 6 m depth. However, result of geochemistry samples test and 2D resistivity profiles at surrounding civilian residences still have unclear in terms of leachates contamination to groundwater. High resistive rocks on imaging show that leachates are not possible to penetrate the shallow groundwater. But, this result is still early prediction to confirm a contamination to groundwater due to the age of landfill. Then, it needs improvement data continuously to monitor landfill contamination periodically.

  20. Organic contamination of the Birmingham aquifer, U.K.

    Science.gov (United States)

    Rivett, Michael O.; Lerner, David N.; Lloyd, John W.; Clark, Lewis

    1990-02-01

    A survey of the organic-water quality of the Birmingham Triassic Sandstone aquifer was conducted using 59 supply boreholes. Additional shallow-groundwater quality data were obtained from 15 monitoring wells. Chlorinated solvents are widespread, in particular trichloroethylene which is detected in 78% of supply boreholes. Trichloroethylene is frequently observed at high levels with 40% of supply boreholes contaminated above 30 μg/l to a maximum of 5500 μg/l. Occasional high values are also found for 1,1,1-trichloroethane and perchloroethylene. The distribution of solvents is shown to be controlled by land use and hydrogeological factors. Contamination by organic chemicals other than chlorinated solvents is low in the supply boreholes. When high contamination does occur it is usually in the form of a petrogenic hump of unresolved contaminants in the chromatogram. The source of such contamination is probably (degraded) lubricating oils. Greater contamination by general organic chemicals is seen in the shallow groundwater samples, a reverse trend to the chlorinated solvents results.

  1. Cooperative Error Handling and Shallow Processing

    OpenAIRE

    Bowden, Tanya

    1995-01-01

    This paper is concerned with the detection and correction of sub-sentential English text errors. Previous spelling programs, unless restricted to a very small set of words, have operated as post-processors. And to date, grammar checkers and other programs which deal with ill-formed input usually step directly from spelling considerations to a full-scale parse, assuming a complete sentence. Work described below is aimed at evaluating the effectiveness of shallow (sub-sentential) processing and...

  2. Bottom Backscattering Strengths Measured in Shallow and Deep Water

    Science.gov (United States)

    2017-01-18

    Naval Research Laboratory Washington, DC 20375-5320 NRL/MR/7160--17-9701 Bottom Backscattering Strengths Measured in Shallow and Deep Water January...LIMITATION OF ABSTRACT Bottom Backscattering Strengths Measured in Shallow and Deep Water Roger C. Gauss,1 Edward L. Kunz,1 Joseph M. Fialkowski...2 3 B2001 (SHALLOW WATER − NEW JERSEY SHELF) .............................. 4

  3. A memory-based shallow parser for spoken Dutch

    NARCIS (Netherlands)

    Canisius, S.V.M.; van den Bosch, A.; Decadt, B.; Hoste, V.; De Pauw, G.

    2004-01-01

    We describe the development of a Dutch memory-based shallow parser. The availability of large treebanks for Dutch, such as the one provided by the Spoken Dutch Corpus, allows memory-based learners to be trained on examples of shallow parsing taken from the treebank, and act as a shallow parser after

  4. Channel Shallowing as Mitigation of Coastal Flooding

    Directory of Open Access Journals (Sweden)

    Philip M. Orton

    2015-07-01

    Full Text Available Here, we demonstrate that reductions in the depth of inlets or estuary channels can be used to reduce or prevent coastal flooding. A validated hydrodynamic model of Jamaica Bay, New York City (NYC, is used to test nature-based adaptation measures in ameliorating flooding for NYC's two largest historical coastal flood events. In addition to control runs with modern bathymetry, three altered landscape scenarios are tested: (1 increasing the area of wetlands to their 1879 footprint and bathymetry, but leaving deep shipping channels unaltered; (2 shallowing all areas deeper than 2 m in the bay to be 2 m below Mean Low Water; (3 shallowing only the narrowest part of the inlet to the bay. These three scenarios are deliberately extreme and designed to evaluate the leverage each approach exerts on water levels. They result in peak water level reductions of 0.3%, 15%, and 6.8% for Hurricane Sandy, and 2.4%, 46% and 30% for the Category-3 hurricane of 1821, respectively (bay-wide averages. These results suggest that shallowing can provide greater flood protection than wetland restoration, and it is particularly effective at reducing "fast-pulse" storm surges that rise and fall quickly over several hours, like that of the 1821 storm. Nonetheless, the goal of flood mitigation must be weighed against economic, navigation, and ecological needs, and practical concerns such as the availability of sediment.

  5. Measuring Body Wave Amplitudes of Shallow Earthquakes

    Science.gov (United States)

    Sigloch, K.; Nolet, G.

    2004-05-01

    We present and evaluate a method to measure body wave amplitudes of shallow earthquakes. Compared to deep events the measurement is complicated by crustal echoes and more complex source time functions, but the effort of processing this data is very worthwhile since shallow events are far more abundant than deep ones. We use a linear model that inverts for source time function, moment tensor and amplitudes in an iterative least squares procedure. The waveform fitting is tested on digital broadband seismograms from the temporary PASSCAL line array LA RISTRA and on global GSN data. We find that robust and reproducible amplitude measurements can be obtained. Signal-to-noise ratios are adequate for fitting waveforms of shallow earthquakes with magnitude of 5.9 and higher. Waveform fits to seismograms from the same event routinely achieve a coherence of 90%-98%. Observed amplitude anomalies are on the order of ± 20%, with outliers being as large as ± 60%. The accuracy is estimated from a limited set of doublet eartquakes and was ± 3% in the best case, for time series lowpassed at 16 second period. Along the 1000-km-long RISTRA array we find several smooth amplitude trends on the scale of hundreds of kilometers. At least one of these trends changes sign depending on the event azimuth, which may indicate that the effect is caused by refraction in the mantle.

  6. Eels:Contaminant cocktails pinpointing environmental contamination

    OpenAIRE

    Belpaire, Claude; Goemans, Geert

    2008-01-01

    There is growing concern that insufficient somatic and health conditions of silver European eels (Anguilla anguilla) emigrating from European waters to oceanic spawning areas might be a key causative factor in the decline of the stock. One factor that could contribute to deterioration in the status of eels is high contaminant accumulation in their body. Contaminants may affect lipid metabolism and result in lower energy stores. A high body burden of contaminants and low energy stores might be...

  7. California Groundwater Ambient Monitoring and Assessment (GAMA) Program Priority Basin Project--shallow aquifer assessment

    Science.gov (United States)

    ,

    2013-01-01

    The California State Water Resources Control Board’s (SWRCB) GAMA Program is a comprehensive assessment of statewide groundwater quality in California. From 2004 to 2012, the GAMA Program’s Priority Basin Project focused on assessing groundwater resources used for public drinking-water supplies. More than 2,000 public-supply wells were sampled by U.S. Geological Survey (USGS) for this effort. Starting in 2012, the GAMA Priority Basin Project began an assessment of water resources in shallow aquifers in California. These shallow aquifers provide water for domestic and small community-supply wells, which are often drilled to shallower depths in the groundwater system than public-supply wells. Shallow aquifers are of interest because shallow groundwater may respond more quickly and be more susceptible to contamination from human activities at the land surface, than the deeper aquifers. The SWRCB’s GAMA Program was developed in response to the Groundwater Quality Monitoring Act of 2001 (Water Code sections 10780-10782.3): a public mandate to assess and monitor the quality of groundwater resources used for drinking-water supplies, and to increase the availability of information about groundwater quality to the public. The U.S. Geological Survey is the technical lead of the Priority Basin Project. Stewardship of California’s groundwater resources is a responsibility shared between well owners, communities, and the State. Participants and collaborators in the GAMA Program include Regional Water Quality Control Boards, Department of Water Resources, Department of Public Health, local and regional groundwater management entities, county and local water agencies, community groups, and private citizens. Well-owner participation in the GAMA Program is entirely voluntary.

  8. Microbial and geochemical quality of shallow well water in high-density areas in Mzuzu City in Malawi

    Science.gov (United States)

    Msilimba, Golden; Wanda, Elijah M. M.

    In Malawi, shallow wells constitute the most important water sources for domestic purposes. However, increasing human population coupled with poor sanitation and infrastructure is undermining the quality of shallow well water. An assessment of microbial and geochemical quality of shallow well water in high-density areas of Zolozolo, Ching’ambo and Chiputula in Mzuzu City, Northern Malawi, has been carried out. The study aimed at characterising domestic water sources, identifying possible sources of water contamination and determining levels of microbial and chemical contamination. Arc-view GIS was used to map the water sources. A questionnaire survey was carried out to elicit information on characteristics of drinking water sources. Water samples were collected from quasi-randomly selected shallow wells and analysed for microbial and chemical parameters using standard methods. HCA, performed using R-programme, was used to group sampled sites according to their bio-physicochemical characteristics. Compliance of the water with MBS/WHO water quality guidelines was determined. The WQI was computed to turn multifaceted data obtained from laboratory analyses into simple information that is comprehensible and useable by the public to assess overall quality of water at a specific water points. The GW-chart was used to show hydrogeochemical water types from each sampled site. Microbial analysis revealed that water from 96.3% of shallow wells recorded faecal coliforms ranging from 129 to 920 cfu per 100 ml which were significantly higher than the Malawi Standards and WHO thresholds. In general, shallow well water is of low mineralisation (EC range 80-500 μS cm-1), with hydrogeochemical facies dominated by Ca-HCO3, which evolves to Ca-Cl water type. The shallow well water registered a WQI range of 50.16-66.04%, with a medium WQ rating. This suggested that the water obtained from the shallow wells is unsuitable for direct human consumption. It was observed that 100% of the

  9. β-catenin activity in late hypertrophic chondrocytes locally orchestrates osteoblastogenesis and osteoclastogenesis

    Science.gov (United States)

    Houben, Astrid; Weissenböck, Martina; Graf, Julian; Teufel, Stefan; von der Mark, Klaus

    2016-01-01

    Trabecular bone formation is the last step in endochondral ossification. This remodeling process of cartilage into bone involves blood vessel invasion and removal of hypertrophic chondrocytes (HTCs) by chondroclasts and osteoclasts. Periosteal- and chondrocyte-derived osteoprogenitors utilize the leftover mineralized HTC matrix as a scaffold for primary spongiosa formation. Here, we show genetically that β-catenin (encoded by Ctnnb1), a key component of the canonical Wnt pathway, orchestrates this remodeling process at multiple levels. Conditional inactivation or stabilization of β-catenin in HTCs by a Col10a1-Cre line locally modulated osteoclastogenesis by altering the Rankl:Opg ratio in HTCs. Lack of β-catenin resulted in a severe decrease of trabecular bone in the embryonic long bones. Gain of β-catenin activity interfered with removal of late HTCs and bone marrow formation, leading to a continuous mineralized hypertrophic core in the embryo and resulting in an osteopetrotic-like phenotype in adult mice. Furthermore, β-catenin activity in late HTCs is required for chondrocyte-derived osteoblastogenesis at the chondro-osseous junction. The latter contributes to the severe trabecular bone phenotype in mutants lacking β-catenin activity in HTCs. PMID:27621061

  10. Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care

    Directory of Open Access Journals (Sweden)

    Lothar Faber

    2014-01-01

    Full Text Available Hypertrophic cardiomyopathy (HCM is one of the more common hereditary cardiac conditions. According to presence or absence of outflow obstruction at rest or with provocation, a more common (about 60–70% obstructive type of the disease (HOCM has to be distinguished from the less common (30–40% nonobstructive phenotype (HNCM. Symptoms include exercise limitation due to dyspnea, angina pectoris, palpitations, or dizziness; occasionally syncope or sudden cardiac death occurs. Correct diagnosis and risk stratification with respect to prophylactic ICD implantation are essential in HCM patient management. Drug therapy in symptomatic patients can be characterized as treatment of heart failure with preserved ejection fraction (HFpEF in HNCM, while symptoms and the obstructive gradient in HOCM can be addressed with beta-blockers, disopyramide, or verapamil. After a short overview on etiology, natural history, and diagnostics in hypertrophic cardiomyopathy, this paper reviews the current treatment options for HOCM with a special focus on percutaneous septal ablation. Literature data and the own series of about 600 cases are discussed, suggesting a largely comparable outcome with respect to procedural mortality, clinical efficacy, and long-term outcome.

  11. Higher copeptin levels are associated with worse outcome in patients with hypertrophic cardiomyopathy.

    Science.gov (United States)

    Sahin, Irfan; Gungor, Baris; Ozkaynak, Berk; Uzun, Fatih; Küçük, Suat Hayri; Avci, Ilhan Iker; Ozal, Ender; Ayça, Burak; Cetın, Sukru; Okuyan, Ertugrul; Dinckal, Mustafa Hakan

    2017-01-01

    Correlation of increased copeptin levels with various cardiovascular diseases has been described. The clinical use of copeptin levels in patients with hypertrophic cardiomyopathy (HCM) has not been investigated before. In this study, we aimed to investigate the prognostic value of copeptin levels in patients with hypertrophic cardiomyopathy (HCM). HCM was defined as presence of left ventricular wall thickness ≥15 mm in a subject without any concomitant disease that may cause left ventricular hypertrophy. Levels of copeptin and plasma N-terminal probrain natriuretic peptide (NT-proBNP) were evaluated prospectively in 24 obstructive HCM patients, 36 nonobstructive HCM patients, and 36 age- and sex-matched control subjects. Blood samples were collected in the morning between 7 and 9 am after overnight fasting. Patients were followed for 24 months. Hospitalization with diagnosis of heart failure/arrhythmia, implantable cardioverter-defibrillator implantation, and cardiac mortality were accepted as adverse cardiac events. Copeptin and NT-proBNP levels were higher in the HCM group compared with controls (14.1 vs 8.4 pmol/L, P Copeptin and NT-proBNP levels were higher in the obstructive HCM subgroup compared with the nonobstructive HCM subgroup (18.3 vs 13.1 pmol/L, P copeptin and NT-proBNP levels remained as independent predictors of heart failure (P Copeptin and NT-proBNP levels were significantly higher in patients with obstructive HCM, and higher levels were associated with worse outcome. © 2016 Wiley Periodicals, Inc.

  12. Potential mechanisms for a role of metabolic stress in hypertrophic adaptations to resistance training.

    Science.gov (United States)

    Schoenfeld, Brad J

    2013-03-01

    It is well established that regimented resistance training can promote increases in muscle hypertrophy. The prevailing body of research indicates that mechanical stress is the primary impetus for this adaptive response and studies show that mechanical stress alone can initiate anabolic signalling. Given the dominant role of mechanical stress in muscle growth, the question arises as to whether other factors may enhance the post-exercise hypertrophic response. Several researchers have proposed that exercise-induced metabolic stress may in fact confer such an anabolic effect and some have even suggested that metabolite accumulation may be more important than high force development in optimizing muscle growth. Metabolic stress pursuant to traditional resistance training manifests as a result of exercise that relies on anaerobic glycolysis for adenosine triphosphate production. This, in turn, causes the subsequent accumulation of metabolites, particularly lactate and H(+). Acute muscle hypoxia associated with such training methods may further heighten metabolic buildup. Therefore, the purpose of this paper will be to review the emerging body of research suggesting a role for exercise-induced metabolic stress in maximizing muscle development and present insights as to the potential mechanisms by which these hypertrophic adaptations may occur. These mechanisms include increased fibre recruitment, elevated systemic hormonal production, alterations in local myokines, heightened production of reactive oxygen species and cell swelling. Recommendations are provided for potential areas of future research on the subject.

  13. Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy: A Word of Endorsement.

    Science.gov (United States)

    Liebregts, Max; Vriesendorp, Pieter A; Ten Berg, Jurrien M

    2017-07-25

    Twenty years after the introduction of alcohol septal ablation (ASA) for the treatment of obstructive hypertrophic cardiomyopathy, the arrhythmogenicity of the ablation scar appears to be overemphasized. When systematically reviewing all studies comparing ASA with myectomy with long-term follow-up, (aborted) sudden cardiac death and mortality rates were found to be similarly low. The focus should instead shift toward lowering the rate of reinterventions and pacemaker implantations following ASA because, in this area, ASA still seems inferior to myectomy. Part of the reason for this difference is that ASA is limited by the route of the septal perforators, whereas myectomy is not. Improvement may be achieved by: 1) confining ASA to hypertrophic cardiomyopathy centers of excellence with high operator volumes; 2) improving patient selection using multidisciplinary heart teams; 3) use of (3-dimensional) myocardial contrast echocardiography for selecting the correct septal (sub)branch; and 4) use of appropriate amounts of alcohol for ASA. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  14. Evidence of hypertrophic osteoarthropathy in human skeletal remains from pre-Hispanic Mesoamerica.

    Science.gov (United States)

    Martínez-Lavín, M; Mansilla, J; Pineda, C; Pijoán, C; Ochoa, P

    1994-02-01

    Hypertrophic osteoarthropathy is one of the earliest recognized disease entities in the history of medicine. It has a peculiar periosteal proliferation distinctive from other bone diseases. In its advanced stage, it leaves an indelible mark on the skeleton. It has been recently shown that digital clubbing is accompanied by a bone remodeling process of the underlying phalanges. Thus, theoretically, this entity can be recognized in ancient human skeletal remains. We studied part of the collection of skeletal remains from pre-Hispanic Mesoamerica preserved at the National Museum of Anthropology of Mexico City. We examined 1000 specimens and found 2 skeletons with widespread, bilateral, symmetric periosteal proliferation of the tubular bones in addition to the bone remodeling changes of the distal phalanges. One of the specimens was from the Formative period (2000 B.C. to 100 A.D.). We conclude that hypertrophic osteoarthropathy can be recognized in ancient human skeletal remains and that this disease was present in Mesoamerica near the time of the original description of clubbing by Hippocrates about 2500 years ago.

  15. Virtual Cardiac Surgery Using CFD: Application to Septal Myectomy in Obstructive Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Vedula, Vijay; Mittal, Rajat; Abraham, Theodore

    2011-11-01

    Obstructive hypertrophic cardiomyopathy (HOCM) is characterized by ventricular wall thickening, diastolic dysfunction, and dynamic outflow tract obstruction, all of which strongly influence the vortex dynamics and pressure distribution in the left ventricle (LV). Severe cases of HCM are usually managed through septal myectomy where the surgeon resects the hypertrophic mass. Surgeons currently try to remove as much tissue as possible in order to optimize the post surgical result. However, excessive debulking increases the chance of ventricular septal defects, bundle branch block or complete heart block, and aneurysmal septal thinning. On the other hand, insufficient tissue removal also leads to unsatisfactory outcomes in terms of reduction of outflow tract pressure gradient. Knowing how much muscle to remove and where to remove it from could reduce the likelihood of complications and suboptimal outcomes. In the present study, we employ an immersed boundary solver to model the effect of septal myectomy for ventricles with HOCM and demonstrate the potential of such an approach for surgical planning. Computational resources were provided by the National Institute of Computational Science under Tergrid grant number TG-CTS100002.

  16. Ultrasound-guided paravertebral block for pyloromyotomy in 3 neonates with congenital hypertrophic pyloric stenosis

    Directory of Open Access Journals (Sweden)

    Javier Mata-Gómez

    2015-08-01

    Full Text Available BACKGROUND AND OBJECTIVES: Hypertrophic pyloric stenosis is a relatively common affection of gastrointestinal tract in childhood that results in symptoms, such as projectile vomiting and metabolic disorders that imply a high risk of aspiration during anesthetic induction. In this way, the carrying out of a technique with general anesthesia and intravenous rapid sequence induction, preoxygenation and cricoid pressure are recommended. After the correction of systemic metabolic alkalosis and pH normalization, cerebrospinal fluid can keep a state of metabolic alkalosis. This circumstance, in addition to the residual effect of neuromuscular blocking agents, inhalant anesthetics and opioids could increase the risk of postoperative apnea after a general anesthesia.CASE REPORT: We present the successful management in 3 neonates in those a pyloromyotomy was carried out because they had presented congenital hypertrophic pyloric stenosis. This procedure was done under general anesthesia with orotracheal intubation and rapid sequence induction. Then, ultrasound-guided paravertebral block was performed as analgesic method without the need for administrating opioids within intraoperative period and keeping an appropriate analgesic level.CONCLUSIONS: Local anesthesia has demonstrated to be safe and effective in pediatric practice. We consider the ultrasound-guided paravertebral block with one dose as a possible alternative for other local techniques described, avoiding the use of opioids and neuromuscular blocking agents during general anesthesia, and reducing the risk of central apnea within postoperative period.

  17. Invasive assessment of coronary microvascular dysfunction in hypertrophic cardiomyopathy: the index of microvascular resistance

    Energy Technology Data Exchange (ETDEWEB)

    Gutiérrez-Barrios, Alejandro, E-mail: aleklos@hotmail.com [Cardiology Department, Jerez Hospital, Jerez (Spain); Camacho-Jurado, Francisco [Cardiology Department, Punta Europa Hospital, Algeciras (Spain); Díaz-Retamino, Enrique; Gamaza-Chulián, Sergio; Agarrado-Luna, Antonio; Oneto-Otero, Jesús; Del Rio-Lechuga, Ana; Benezet-Mazuecos, Javier [Cardiology Department, Jerez Hospital, Jerez (Spain)

    2015-10-15

    Summary: We present a review of microvascular dysfunction in hypertrophic cardiomyopathy (HCM) and an interesting case of a symptomatic familial HCM patient with inducible ischemia by single photon emission computed tomography. Coronary angiography revealed normal epicardial arteries. Pressure wire measurements of fractional flow reserve (FFR), coronary flow reserve (CFR) and index of microvascular resistance (IMR) demonstrated a significant microcirculatory dysfunction. This is the first such case that documents this abnormality invasively using the IMR. The measurement of IMR, a novel marker of microcirculatory dysfunction, provides novel insights into the pathophysiology of this condition. - Highlights: • Microvascular dysfunction is a common feature in hypertrophic cardiomyopathy (HCM) and represents a strong predictor of unfavorable outcome and cardiovascular mortality. • The index of microvascular resistance (IMR) is a new method for invasively assessing the state of the coronary microcirculation using a single pressure-temperature sensor-tipped coronary wire. • However assessment of IMR in HCM has not been previously reported. We report a case in which microvascular dysfunction is assessed by IMR. This index may be useful in future researches of HCM.

  18. Relationship between electrocardiographic features and distribution of hypertrophy in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Tetsuya; Nakamura, Kazufumi; Yamanari, Hiroshi; Ohe, Tohru [Okayama Univ. (Japan). School of Medicine; Yoshinouchi, Takeo

    1998-07-01

    To evaluate the relationship between the distribution of hypertrophy and the electrocardiographic findings in patients with hypertrophic cardiomyopathy (HCM), 54 HCM patients were studied using magnetic resonance imaging. The patients were divided into 4 groups according to hypertrophic patterns: hypertrophy only at the apex (group I, n=12); hypertrophy in both the apex and base (group II, n=20); hypertrophy only at the base with asymmetric septal hypertrophy (ASH) (group IIIa, n=17); and hypertrophy only at the base without ASH (group IIIb, n=5). Abnormal Q waves in leads II, III and aV{sub F} were found in 1/12, 3/20, 10/17 and 0/5, respectively, and in leads I and aV{sub L} they were found in 1/12, 8/20, 4/17 and 1/5, respectively. The largest negative T waves (mm) were found in group I (group I vs group II vs group IIIa vs group IIIb: 15.2{+-}5.3, 8.2{+-}6.1, 1.6{+-}2.0, 0.8{+-}1.3, respectively). The largest positive T waves (mm) were identified in group IIIb (3.8{+-}3.0, 6.8{+-}3.2, 5.8{+-}3.6, 9.3{+-}2.1, respectively). The presence of abnormal Q waves reflected regional hypertrophy in HCM patients but the configuration of T waves represented the difference in the localization of hypertrophy between the basal and apical segments. (author)

  19. Hypertrophic Cardiomyopathy from A to Z: Genetics, Pathophysiology, Imaging, and Management.

    Science.gov (United States)

    Baxi, Ameya Jagdish; Restrepo, Carlos S; Vargas, Daniel; Marmol-Velez, Alejandro; Ocazionez, Daniel; Murillo, Horacio

    2016-01-01

    Hypertrophic cardiomyopathy (HCM) is a heterogeneous group of diseases related to sarcomere gene mutations exhibiting heterogeneous phenotypes with an autosomal dominant mendelian pattern of inheritance. The disorder is characterized by diverse phenotypic expressions and variable natural progression, which may range from dyspnea and/or syncope to sudden cardiac death. It is found across all racial groups and is associated with left ventricular hypertrophy in the absence of another systemic or cardiac disease. The management of HCM is based on a thorough understanding of the underlying morphology, pathophysiology, and clinical course. Imaging findings of HCM mirror the variable expressivity and penetrance heterogeneity, with the added advantage of diagnosis even in cases where a specific mutation may not yet be found. The diagnostic information obtained from imaging varies depending on the specific stage of HCM-phenotype manifestation, including the prehypertrophic, hypertrophic, and later stages of adverse remodeling into the burned-out phase of overt heart failure. However, subtle or obvious, these imaging findings become critical components in diagnosis, management, and follow-up of HCM patients. Although diagnosis of HCM traditionally relies on clinical assessment and transthoracic echocardiography, recent studies have demonstrated increased utility of multidetector computed tomography (CT) and particularly cardiac magnetic resonance (MR) imaging in diagnosis, phenotype differentiation, therapeutic planning, and prognostication. In this article, we provide an overview of the genetics, pathophysiology, and clinical manifestations of HCM, with the spectrum of imaging findings at MR imaging and CT and their contribution in diagnosis, risk stratification, and therapy. (©)RSNA, 2016.

  20. Myocardial Fibrosis in Hypertrophic Cardiomyopathy Demonstrated by Integrated Cardiac F-18 FDG PET/MR

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eunjung; Lee, Sanghee; Cho, Ihnho [Yeungnam Univ., Daegu (Korea, Republic of)

    2013-09-15

    Hypertrophic cardiomyopathy (HCM) is a common condition defined as a diffuse or segmental left ventricular (LV) hypertrophy with a nondilated and hyperdynamic chamber as well as cardiac arrhythmias. Cardiac MR (CMR) imaging is a key modality for evaluation of HCM. In addition to the assessment of LV wall thickness, LV function and aortic flow, CMR is capable of estimation of late gadolinium enhancement (LGE) in affected myocardium which has been shown to have a direct correlation with incidence and severity of arrhythmias in HCM. In patients with HCM, LGE on CMR is presumed to represent intramyocardial fibrosis. Meanwhile, F-18 FDG myocardial PET has been sporadically studied in HCM, mostly for evaluation of the metabolic status of a hypertrophic myocardial segment, especially after interventions or to demonstrate partial myocardial fibrosis. We presented here the case of a 25-year-old male patient referred for simultaneous F-18 FDG cardiac PET/MR for the evaluation of septal hypertrophy. The PET/MR revealed myocardial fibrosis in the septum associated with FDG-defect and LGE.

  1. Overexpression of mitofilin in the mouse heart promotes cardiac hypertrophy in response to hypertrophic stimuli.

    Science.gov (United States)

    Zhang, Yuan; Xu, Jing; Luo, Yu-Xuan; An, Xi-Zhou; Zhang, Ran; Liu, Guang; Li, Hongliang; Chen, Hou-Zao; Liu, De-Pei

    2014-10-20

    Mitofilin was originally described as a heart muscle protein because of its abundance in the heart tissue; however, its function in the heart is still to be elucidated. Thus, this study aims at investigating the role of mitofilin in the heart in response to hypertrophic stimuli. In this study, a significant increase in mitofilin expression was observed in the hearts of patients with hypertrophic cardiomyopathy. Transgenic (TG) mice with cardiomyocyte-specific overexpression of mitofilin were generated, and cardiac hypertrophy was introduced by transverse aortic constriction (TAC) or chronic infusion of isoproterenol (ISO). In TG mice overexpressing mitofilin, the level of cardiac hypertrophy was significantly greater than that in wild-type (WT) mice after TAC and ISO stimulation. A detailed analysis showed that compared with WT mice, the level of reactive oxygen species was increased after TAC and ISO induction and mitochondrial oxidative phosphorylation (OXPHOS) activity in the TG hearts was lower. These alterations may contribute to the aggravated cardiac hypertrophy observed in response to TAC and ISO stimulation. Over-expression of mitofilin promotes cardiac hypertrophy under pathological conditions both in vivo and in vitro. Mitofilin, a mitochondria protein, is shown to be related to cardiac hypertrophy for the first time, which enhances our understanding of the role of mitochondria in cardiac hypertrophy.

  2. Paquidermoperiostosis (osteoartropatía hipertrófica primaria Pachydermoperiostosis (primary hypertrophic osteoarthropathy

    Directory of Open Access Journals (Sweden)

    Javier A. Cavallasca

    2006-04-01

    Full Text Available La paquidermoperiostosis u osteoartropatía hipertrófica primaria es una rara enfermedad caracterizada por compromiso cutáneo y osteoarticular. Comunicamos dos casos que presentaban hipocratismo digital, uñas en vidrio de reloj, agrandamiento óseo, tumefacción articular y diferentes grados de afectación cutánea, sin otros hallazgos clínicos relevantes. Ambos desconocían antecedentes familiares similares. El estudio radiográfico de las zonas comprometidas mostró periostosis. Con resultados de laboratorio y radiografía de tórax normales, y ausencia de evidencia clínica de otra enfermedad subyacente, se realizó diagnóstico de osteoartropatía hipertrófica primaria.Pachydermoperiostosis or primary hypertrophic osteoarthropathy is a rare disease characterized by cutaneous and osteo-arthicular involvement. We describe two patients with finger clubbing, watch crystal nails, bones thickenings, arthritis and different grades of skin affection, without other clinical manifestations. Both did not know of having relatives with the same alterations. Radiological studies of the affected areas showed periostosis. Because of normal laboratory results and chest radiography plus the absence of other underlying causes, diagnosis of primary hypertrophic osteoarthropathy was made.

  3. Exercise Tl-201 myocardial scintigraphy and coronary blood flow velocity in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Umamoto, Ikuo; Harada, Yoshiaki (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1992-03-01

    In 22 patients with hypertrophic cardiomyopathy not associated with coronary stenosis, findings of exercise Tl-201 myocardial scintigraphy were reviewed in relation to coronary blood flow velocity. Blood flow velocity of the left antero-inferior segment was recorded by using a Doppler catheter. From time velocity integration in systolic and diastolic phases, both % systolic fraction (%SF) and %diastolic 1st third fraction (%d1F) were obtained. A decreased perfusion was visually assessed on exercise Tl-201 myocardial images. In addition, transient dilation of the left ventricular cavity was quantitatively assessed by expressing it as a transient dilation index (TDI) for subendocardial ischemia. Coronary blood flow velocity was characterized by a decrease in both %SF and %d1F and negative systolic flow. Both %SF and %d1F were inversely correlated with TDI. Coronary negative systolic flow was frequently associated with a decreased perfusion. These results suggest factors such as left ventricular relaxation impairment, other than coronary small vessel lesions, may also be involved in the occurrence of myocardial ischemia in hypertrophic cardiomyopathy. (N.K.).

  4. Continuous rhythm monitoring for ventricular arrhythmias after alcohol septal ablation for hypertrophic cardiomyopathy.

    Science.gov (United States)

    Balt, Jippe C; Wijffels, Maurits C E F; Boersma, Lucas V A; Wever, Eric F D; ten Berg, Jurriën M

    2014-12-01

    The purpose of the present study was to determine the incidence of ventricular arrhythmias before and after alcohol septal ablation (ASA). In patients with hypertrophic obstructive cardiomyopathy (HOCM), gradient reduction by ASA is an alternative for surgical myectomy. However, concerns exist about whether the induction of a myocardial scar during ASA may create substrate for ventricular arrhythmias. The study group consisted of 44 patients in whom ASA was performed for symptomatic, drug-refractory hypertrophic cardiomyopathy. Continuous rhythm monitoring was obtained by implantable loop recorder (n=30) or pacemaker (n=14). Occurrence of ventricular and supraventricular arrhythmias before and after ASA was noted, retrospectively. The ASA procedure was considered successful (resting gradient 30 days after ASA. No cardiac deaths occurred during follow-up. In a low-risk cohort of patients who underwent ASA, in which continuous rhythm monitoring was performed, sustained VT or VF within 30 days occurred in 3 patients (7%) while no VT/VF was observed before ASA. During long-term follow-up, no sustained VT or VF was observed >30 days after ASA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Magnetic resonance imaging of hypertrophic cardiomyopathy. Evaluation of diastolic function; MRT-Bildgebung bei hypertropher Kardiomyopathie (HCM). Evaluation der diastolischen Funktion

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, F.; Reiser, M.F.; Theisen, D. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Deutsches Zentrum fuer Herzkreislaufforschung (DZHK), Muenchen (Germany); Schwab, F. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Josef Lissner Laboratory for Biomedical Imaging, Institut fuer Klinische Radiologie, Muenchen (Germany); Beckmann, B.M.; Schuessler, F.; Kaeaeb, S. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Medizinische Klinik und Poliklinik I, Muenchen (Germany); Zinsser, D.; Goelz, T. [Klinikum der Ludwig-Maximilians-Universitaet Muenchen, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2013-01-15

    Hypertrophic cardiomyopathy (HCM) has a prevalence of approximately 0.2% and is clinically asymptomatic in many patients or presents with unspecific symptoms. This explains the importance of imaging for the diagnosis of HCM as well as for the assessment of the clinical course. The definitive finding in HCM is myocardial hypertrophy with thickening of the ventricular wall {>=} 15 mm. While echocardiography is an excellent screening tool magnetic resonance imaging (MRI) allows a comprehensive analysis of the heart in HCM. This includes a detailed analysis of the distribution and extent of myocardial hypertrophy, a thorough evaluation of systolic and diastolic cardiac function, the assessment of the presence and extent of dynamic outflow tract obstruction as well as the description of the systolic anterior motion (SAM) phenomenon of the mitral valve with secondary mitral insufficiency. When contrast material is administered, additional information about myocardial perfusion as well as the presence and extent of myocardial fibrosis can be obtained. This study compared systolic functional parameters as well as end systolic and end diastolic wall thickness of patients with and without diastolic dysfunction. (orig.) [German] Die hypertrophe Kardiomyopathie (HCM) hat eine Praevalenz von ca. 0,2% und verlaeuft in vielen Faellen zeitlebens klinisch asymptomatisch. Falls es zur Ausbildung von Symptomen kommt, sind diese oft unspezifisch. Dies erklaert den Stellenwert der Bildgebung bei der Erstdiagnose und Verlaufsbeurteilung der HCM. Leitbefund ist eine myokardiale Hypertrophie mit Wanddicken von {>=} 15 mm. Waehrend die Echokardiographie ein hervorragendes Screeningverfahren ist, erlaubt die MRT eine umfassende Feindiagnostik bei der HCM, zu der gezaehlt werden: eine genaue Darstellung des Verteilungsmusters und des Schweregrads der Hypertrophie, eine detaillierte Analyse der linksventrikulaeren systolischen und diastolischen Funktion, eine Beurteilung und Quantifizierung

  6. Clinical efficacy of utilizing Ultrapulse CO2 combined with fractional CO2 laser for the treatment of hypertrophic scars in Asians-A prospective clinical evaluation.

    Science.gov (United States)

    Lei, Ying; Li, Shi Feng; Yu, Yi Ling; Tan, Jun; Gold, Michael H

    2017-06-01

    Hypertrophic scarring is seen regularly. Tissue penetration of laser energy into hypertrophic scars using computer defaults from some lasers may be insufficient and penetration not enough. We have developed a treatment with an interrupted laser "drilling" by the Ultrapulse CO2 (Manual Fractional Technology, MFT) and, a second pass, with fractional CO2 . The MFT with fractional CO2 lasers to treat hypertrophic scars is evaluated. A total of 158 patients with hypertrophic scars had three sessions of MFT with fractional CO2 laser at 3-month intervals. Evaluations made before and 6 months after the 3rd treatment: (1) the Vancouver Scar Scale (VSS), (2) the University of North Carolina (UNC) Scar Scale, and (3) a survey of patient satisfaction. All data were analyzed using a t-test before and after treatment. The VSS score decreased from 9.35 to 3.12 (PCO2 laser had profound effects on the hypertrophic scars treated. It works by increasing the penetration depth of the CO2 laser in the scar tissue, exerting more precise effects on the hypertrophic scars. MFT combined with fractional CO2 laser has the potential to be a major advance in the treatment of hypertrophic scars. © 2017 Wiley Periodicals, Inc.

  7. Hypertrophic chondrocytes in the rabbit growth plate can proliferate and differentiate into osteogenic cells when capillary invasion is interposed by a membrane filter.

    Directory of Open Access Journals (Sweden)

    Tetsuya Enishi

    Full Text Available The fate of hypertrophic chondrocytes during endochondral ossification remains controversial. It has long been thought that the calcified cartilage is invaded by blood vessels and that new bone is deposited on the surface of the eroded cartilage by newly arrived cells. The present study was designed to determine whether hypertrophic chondrocytes were destined to die or could survive to participate in new bone formation. In a rabbit experiment, a membrane filter with a pore size of 1 µm was inserted in the middle of the hypertrophic zone of the distal growth plate of ulna. In 33 of 37 animals, vascular invasion was successfully interposed by the membrane filter. During 8 days, the cartilage growth plate was enlarged, making the thickness 3-fold greater than that of the nonoperated control side. Histological examination demonstrated that the hypertrophic zone was exclusively elongated. At the terminal end of the growth plate, hypertrophic chondrocytes extruded from their territorial matrix into the open cavity on the surface of the membrane filter. The progenies of hypertrophic chondrocytes (PHCs were PCNA positive and caspase-3 negative. In situ hybridization studies demonstrated that PHCs did not express cartilage matrix proteins anymore but expressed bone matrix proteins. Immunohistochemical studies also demonstrated that the new matrix produced by PHCs contained type I collagen, osteonectin, and osteocalcin. Based on these results, we concluded that hypertrophic chondrocytes switched into bone-forming cells after vascular invasion was interposed in the normal growth plate.

  8. Prevalence of exercise-induced left ventricular outflow tract obstruction in symptomatic patients with non-obstructive hypertrophic cardiomyopathy.

    LENUS (Irish Health Repository)

    Shah, J S

    2008-10-01

    Resting left ventricular outflow tract obstruction (LVOTO) occurs in 25% of patients with hypertrophic cardiomyopathy (HCM) and is an important cause of symptoms and disease progression. The prevalence and clinical significance of exercise induced LVOTO in patients with symptomatic non-obstructive HCM is uncertain.

  9. Intralesional triamcinolone acetonide injection in hypertrophic skin surrounding the percutaneous titanium implant of a bone-anchored hearing aid.

    NARCIS (Netherlands)

    Rijswijk, JB Van; Mylanus, E.A.M.

    2008-01-01

    OBJECTIVE: We present a patient with persistent hypertrophic skin surrounding the percutaneous implant of a bone-anchored hearing aid system, successfully treated with intralesional applied corticosteroids. METHOD: Case report and review of the world literature concerning bone-anchored hearing aid

  10. Mortality Risk of Untreated Myosin-Binding Protein C-Related Hypertrophic Cardiomyopathy Insight Into the Natural History

    NARCIS (Netherlands)

    Nannenberg, Eline A.; Michels, Michelle; Christiaans, Imke; Majoor-Krakauer, Danielle; Hoedemaekers, Yvonne M.; van Tintelen, J. Peter; Lombardi, M. Paola; ten Cate, Folkert J.; Schinkel, Arend F. L.; Tijssen, Jan G. P.; van Langen, Irene M.; Wilde, Arthur A. M.; Sijbrands, Eric J. G.

    2011-01-01

    Objectives The goal of this study was to assess the mortality of hypertrophic cardiomyopathy (HCM), partly in times when the disease was not elucidated and patients were untreated. Background HCM is feared for the risk of sudden cardiac death (SCD). Insight in the natural history of the disorder is

  11. Differences in collagen architecture between keloid, hypertrophic scar, normotrophic scar, and normal skin: An objective histopathological analysis

    NARCIS (Netherlands)

    Verhaegen, P.D.; Zuijlen, van P.P.; Pennings, N.M.; Marle, van J.; Niessen, F.B.; Horst, C.; Middelkoop, E.

    2009-01-01

    Normotrophic, hypertrophic, and keloidal scars are different types of scar formation, which all need a different approach in treatment. Therefore, it is important to differentiate between these types of scar, not only clinically but also histopathologically. Differences were explored for collagen

  12. Effects of dredging and lanthanum-modified clay on water quality variables in an enclosure study in a hypertrophic pond

    NARCIS (Netherlands)

    Lürling, Miquel; Waajen, Guido; Engels, Bart; Oosterhout, van Frank

    2017-01-01

    An enclosure experiment was conducted between July and September 2009 to compare the effectiveness of a phosphate fixative, the lanthanum-modified bentonite clay Phoslock® (LMB), dredging, and their combination in controlling eutrophication in a hypertrophic urban pond in Heesch, The Netherlands.

  13. Validation of the HCM Risk-SCD model in patients with hypertrophic cardiomyopathy following alcohol septal ablation

    DEFF Research Database (Denmark)

    Liebregts, Max; Faber, Lothar; Jensen, Morten K

    2018-01-01

    Aims: The HCM Risk-SCD model for prediction of sudden cardiac death (SCD) in hypertrophic cardiomyopathy recommended by the 2014 European Society of Cardiology (ESC) guidelines has not been validated after septal reduction therapy. The aim of this study was to validate the HCM Risk-SCD model...

  14. One third of Danish hypertrophic cardiomyopathy patients with MYH7 mutations have mutations [corrected] in MYH7 rod region

    DEFF Research Database (Denmark)

    Hougs, Lotte; Havndrup, Ole; Bundgaard, Henning

    2005-01-01

    Familial hypertrophic cardiomyopathy (FHC) is, in most cases, a disease of the sarcomere, caused by a mutation in one of 10 known sarcomere disease genes. More than 266 mutations have been identified since 1989. The FHC disease gene first characterized MYH7, encodes the cardiac beta-myosin heavy...

  15. Life-long tailoring of management for patients with hypertrophic cardiomyopathy: Awareness and decision-making in changing scenarios

    NARCIS (Netherlands)

    M. Michels (Michelle); I. Olivotto (Iacopo); F.W. Asselbergs (Folkert); J. van der Velden (Jolanda)

    2017-01-01

    textabstractHypertrophic cardiomyopathy (HCM) is the most common genetic heart disease, characterised by complex pathophysiology and extensive genetic and clinical heterogeneity. In most patients, HCM is caused by mutations in cardiac sarcomere protein genes and inherited as an autosomal dominant

  16. Life-long tailoring of management for patients with hypertrophic cardiomyopathy : Awareness and decision-making in changing scenarios

    NARCIS (Netherlands)

    Michels, M.; Olivotto, I; Asselbergs, F. W.|info:eu-repo/dai/nl/270752137; van der Velden, J.

    2017-01-01

    Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease, characterised by complex pathophysiology and extensive genetic and clinical heterogeneity. In most patients, HCM is caused by mutations in cardiac sarcomere protein genes and inherited as an autosomal dominant trait. The

  17. Mutation in mitochondrial ribosomal protein MRPS22 leads to Cornelia de Lange-like phenotype, brain abnormalities and hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Smits, P.; Saada, A.; Wortmann, S.B.; Heister, A.; Brink, M.; Pfundt, R.P.; Miller, C.; Haas, D.; Hantschmann, R.; Rodenburg, R.J.T.; Smeitink, J.A.M.; Heuvel, L.P.W.J. van den

    2011-01-01

    The oxidative phosphorylation (OXPHOS) system is under control of both the mitochondrial and the nuclear genomes; 13 subunits are synthesized by the mitochondrial translation machinery. We report a patient with Cornelia de Lange-like dysmorphic features, brain abnormalities and hypertrophic

  18. Targeted sequence capture and GS-FLX Titanium sequencing of 23 hypertrophic and dilated cardiomyopathy genes: implementation into diagnostics

    NARCIS (Netherlands)

    Mook, Olaf R. F.; Haagmans, Martin A.; Soucy, Jean-François; van de Meerakker, Judith B. A.; Baas, Frank; Jakobs, Marja E.; Hofman, Nynke; Christiaans, Imke; Lekanne Deprez, Ronald H.; Mannens, Marcel M. A. M.

    2013-01-01

    Genetic evaluation of cardiomyopathies poses a challenge. Multiple genes are involved but no clear genotype-phenotype correlations have been found so far. In the past, genetic evaluation for hypertrophic (HCM) and dilated (DCM) cardiomyopathies was performed by sequential screening of a very limited

  19. Unilateral Symptomatic Hypertrophic Olivary Degeneration Secondary to Midline Brainstem Cavernous Angioma: A Case Report and Review of the Literature.

    Science.gov (United States)

    Rosenblum, Jared; Nazari, Matt; Al-Khalili, Yasir; Potigailo, Valeria; Veznedaroglu, Erol

    2017-10-20

    Hypertrophic olivary degeneration (HOD) is a rare phenomenon in the dento-rubro-olivary pathway due to lesion or disruption of the fibers of the Guillain-Mollaret Triangle. Hemorrhage of pontine and midbrain cavernous angiomas rarely can lead to hypertrophic olivary degeneration (HOD) portending neurological deterioration and possible concomitant life-threatening complications; for this reason, it may define a poignant consideration in planning intervention. 57-year-old female with known midbrain-pontine cavernous angioma. For several years, the lesion was stable, as demonstrated by imaging follow-up until 10 months prior to presentation with falls, dysarthria and headache. Imaging demonstrated some decrease in size as well as blood product around the cavernous angioma suggesting interim period hemorrhage and interval development of unilateral hypertrophic olivary degeneration. Herein, the literature regarding imaging recommendations for stable cavernous angioma in the midbrain-pontine junction is reviewed. The implication of hypertrophic olivary degeneration for patient outcome is discussed and a comment is made on how the development of HOD may impact management of the cavernous angioma. Copyright © 2017. Published by Elsevier Inc.

  20. Single-dose electron beam irradiation in treatment and prevention of keloids and hypertrophic scars

    Energy Technology Data Exchange (ETDEWEB)

    Lo, T.C.M.; Salzman, F.A. (Lahey Clinic Medical Center, Burlington (USA). Department of Radiation Oncology); Seckel, B.R. (Lahey Clinic Medical Center, Burlington (USA). Department of Plastic and Reconstructive Surgery); Wright, K.A. (Massachusetts Institute of Technology, Cambridge (USA). High Voltage Research Laboratory)

    1990-11-01

    Low megavolt electron beam irradiation was used on 354 sites in 199 patients at Lahey Clinic either for palliation of symptomatic hypertrophic scars or as post operative irradiation in an attempt to prevent formation or recurrence of hypertrophic scars. Electron energies used ranged from 1.5 to 3.5 MeV. The median age of the 59 male patients was 22 years and of the 140 female patients 35 years. All patients had at least one follow-up visit, and the median follow-up was 35 months. Of the 294 sites treated for the first time, 272 were irradiated with a single fraction with a skin dose ranging from 2 to 20 Gy. Of the 85 sites in 63 patients without excision of symptomatic hypertrophic scars, single-dose electron beam irradiation was of clinically significant value in only 41 sites. No patients have been treated without surgical excision since 1973. Because of a history of formation of hypertrophic scars elsewhere in the body, 13 patients with 19 incisions were treated prophylactically after operation for other diseases. All sites were irradiated with single doses ranging from 8 to 20 Gy, and hypertrophic scars did not subsequently develop in any patient. Altogether, 119 patients with 174 sites were irradiated after surgical excision of hypertrophic scars to prevent recurrence; 168 sites received singe-fraction irradiation, and 161 received a dose of 8 Gy greater, up to 15 Gy. No statistically significant differences were observed in complete success rates, ranging from 82 to 90 per cent with doses of 9 Gy or greater. An interval of up to 72h between excision and single-fraction irradiation satisfactorily prevented recurrence, and clinically significant chronic telangiectasia was recorded in only one patient. Postoperative low megavolt electron beam irradiation with a single dose of 9 Gy or greater is highly effective in the prevention of formation recurrence of hypertrophic scars or keloids.

  1. Keloid and Hypertrophic Scar/span>s Are the Result of Chronic Inflammation in the Reticular Dermis

    Science.gov (United States)

    Ogawa, Rei

    2017-01-01

    Keloids and hypertrophic scar/span>s are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection. Notably, superficial injuries that do not reach the reticular dermis never cause keloidal and hypertrophic scarring. This suggests that these pathological scar/span>s are due to injury to this skin layer and the subsequent aberrant wound healing therein. The latter is characterized by continuous and histologically localized inflammation. As a result, the reticular layer of keloids and hypertrophic scar/span>s contains inflammatory cells, increased numbers of fibroblasts, newly formed blood vessels, and collagen deposits. Moreover, proinflammatory factors, such as interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor-α are upregulated in keloid tissues, which suggests that, in patients with keloids, proinflammatory genes in the skin are sensitive to trauma. This may promote chronic inflammation, which in turn may cause the invasive growth of keloids. In addition, the upregulation of proinflammatory factors in pathological scar/span>s suggests that, rather than being skin tumors, keloids and hypertrophic scar/span>s are inflammatory disorders of skin, specifically inflammatory disorders of the reticular dermis. Various external and internal post-wounding stimuli may promote reticular inflammation. The nature of these stimuli most likely shapes the characteristics, quantity, and course of keloids and hypertrophic scar/span>s. Specifically, it is likely that the intensity, frequency, and duration of these stimuli determine how quickly the scars appear, the direction and speed of growth, and the intensity of symptoms. These proinflammatory stimuli include a variety of local, systemic, and genetic factors. These observations together suggest that the clinical differences between keloids and hypertrophic scar/span>s merely reflect differences in

  2. Shallow Aquifer Methane Gas Source Assessment

    Science.gov (United States)

    Coffin, R. B.; Murgulet, D.; Rose, P. S.; Hay, R.

    2014-12-01

    Shale gas can contribute significantly to the world's energy demand. Hydraulic fracturing (fracking) on horizontal drill lines developed over the last 15 years makes formerly inaccessible hydrocarbons economically available. From 2000 to 2035 shale gas is predicted to rise from 1% to 46% of the total natural gas for the US. A vast energy resource is available in the United States. While there is a strong financial advantage to the application of fracking there is emerging concern about environmental impacts to groundwater and air quality from improper shale fracking operations. Elevated methane (CH4) concentrations have been observed in drinking water throughout the United States where there is active horizontal drilling. Horizontal drilling and hydraulic-fracturing can increase CH4 transport to aquifers, soil and the vadose zone. Seepage can also result from casing failure in older wells. However, there is strong evidence that elevated CH4 concentrations can be associated with topographic and hydrogeologic features, rather than shale-gas extraction processes. Carbon isotope geochemistry can be applied to study CH4source(s) in shallow vadose zone and groundwater systems. A preliminary TAMU-CC isotope data set from samples taken at different locations in southern Texas shows a wide range of CH4 signatures suggesting multiple sources of methane and carbon dioxide. These data are interpreted to distinguish regions with methane contributions from deep-sourced horizontal drilling versus shallow system microbial production. Development of a thorough environmental assessment using light isotope analysis can provide understanding of shallow anthropogenic versus natural CH4sources and assist in identifying regions that require remedial actions.

  3. Spatiotemporal dynamics of a shallow fluidized bed.

    Energy Technology Data Exchange (ETDEWEB)

    Aranson, I. S.; Tsimring, L. S.; Clark, D. K.

    2000-12-05

    An experimental and theoretical study of the dynamics of an air-fluidized thin granular layer is presented. Near the threshold of instability, the system exhibits critical behavior with remarkably long transient dynamics. Above the threshold of fluidization the system undergoes a Hopf bifurcation as the layer starts to oscillate at a certain frequency due to a feedback between the layer dilation and the airflow rate. Based on our experimental data, we formulate a the simple dynamical model which describes the transition in a shallow fluidized bed.

  4. Center for Contaminated Sediments

    Data.gov (United States)

    Federal Laboratory Consortium — The U.S. Army Corps of Engineers Center for Contaminated Sediments serves as a clearinghouse for technology and expertise concerned with contaminated sediments. The...

  5. Contaminated Sites in Iowa

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — Sites contaminated by hazardous materials or wastes. These sites are those administered by the Contaminated Sites Section of Iowa DNR. Many are sites which are...

  6. The influence of hydrology on lacustrine sediment contaminant records

    Science.gov (United States)

    Rosen, Michael R.

    2015-01-01

    The way water flows to a lake, through streams, as runoff, or as groundwater, can control the distribution and mass of sediment and contaminants deposited. Whether a lake is large or small, deep or shallow, open or closed, the movement of water to a lake and the circulation patterns of water within a lake control how and where sediment and contaminants are deposited. Particle-associated contaminants may stay close to the input source of contamination or be transported by currents to bathymetric lows. A complex morphology of the lake bottom or shoreline can also affect how contaminants will be distributed. Dissolved contaminants may be widely dispersed in smaller lakes, but may be diluted in large lakes away from the source. Although dissolved contaminants may not be deposited in lake sediments, the impact of dissolved contaminants (such as nitrogen) may be reflected by the ecosystem. For instance, increased phosphorus and nitrogen may increase organic content or algal biomass, and contribute to eutrophication of the lake over time. Changes in oxidation-reduction potential at the sediment-water interface may either release some contaminants to the water column or conversely deposit other contaminants to the sediment depending on the compound’s chemical characteristics. Changes in land use generally affect the hydrology of the watershed surrounding a lake, providing more runoff if soil binding vegetation is removed or if more impervious cover (roads and buildings) is increased. Groundwater inputs may change if pumping of the aquifer connected to the lake occurs. Even if groundwater is only a small portion of the volume of water entering a lake, if contaminant concentrations in the aquifer are high compared to surface water inputs, the mass of contaminants from groundwater may be as, or more, important than surface water contributions.

  7. A Meta-analysis on the correlation between the polymorphism of angiotensin converting enzyme gene and hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ling CHEN

    2014-01-01

    Full Text Available Objective To systematically investigate the correlation between the polymorphism of angiotensin converting enzyme (ACE gene I/D and hypertrophic cardiomyopathy. Methods The databases, such as PubMed, Embase, OVID, Web of Science, Cochrane library, CNKI, WanFang Data and VIP, were searched to collect the studies on the correlation between ACE I/D polymorphism and hypertrophic cardiomyopathy susceptibility. Studies that met the inclusion criteria were Meta-analyzed using Stata 11.0 software. Results Fifteen articles were collected including 1114 cases and 1648 controls. The Meta-analysis indicated that there was significant correlation between the 4 models of ACE I/D polymorphism and hypertrophic cardiomyopathy susceptibility [D vs I: OR=1.49, 95%CI (1.20, 1.84; DD vs (ID+II: OR=1.56, 95%CI (1.17, 2.08; (DD+ID vs II: OR=1.76, 95%CI (1.30, 2.38; DD vs II: OR=2.20, 95%CI (1.44, 3.37]. In subgroup analysis, the significant difference existed in Asian population, but no significance was found in European population (P<0.05. Conclusions There is a positive correlation between hypertrophic cardiomyopathy and ACE I/D polymorphism in population, and D allele and DD genotype are likely to be the risk factors of hypertrophic cardiomyopathy. But such correlation does not exist in European population. DOI: 10.11855/j.issn.0577-7402.2013.12.07

  8. GASP. CONTAMINATION STUDY

    Science.gov (United States)

    LAUNCHING SITES, MEASUREMENT, MATHEMATICAL MODELS, TEST METHODS, TRACER STUDIES, RADIOACTIVE CONTAMINATION , INSTRUMENTATION, STATISTICAL ANALYSIS, RADIATION HAZARDS, UNDERWATER EXPLOSIONS, RADIOCHEMISTRY.

  9. T1 Mapping in Discrimination of Hypertrophic Phenotypes: Hypertensive Heart Disease and Hypertrophic Cardiomyopathy: Findings From the International T1 Multicenter Cardiovascular Magnetic Resonance Study.

    Science.gov (United States)

    Hinojar, Rocio; Varma, Niharika; Child, Nick; Goodman, Benjamin; Jabbour, Andrew; Yu, Chung-Yao; Gebker, Rolf; Doltra, Adelina; Kelle, Sebastian; Khan, Sitara; Rogers, Toby; Arroyo Ucar, Eduardo; Cummins, Ciara; Carr-White, Gerald; Nagel, Eike; Puntmann, Valentina O

    2015-12-01

    The differential diagnosis of left ventricular (LV) hypertrophy remains challenging in clinical practice, in particular, between hypertrophic cardiomyopathy (HCM) and increased LV wall thickness because of systemic hypertension. Diffuse myocardial disease is a characteristic feature in HCM, and an early manifestation of sarcomere-gene mutations in subexpressed family members (G+P- subjects). This study aimed to investigate whether detecting diffuse myocardial disease by T1 mapping can discriminate between HCM versus hypertensive heart disease as well as to detect genetically driven interstitial changes in the G+P- subjects. Patients with diagnoses of HCM or hypertension (HCM, n=95; hypertension, n=69) and G+P- subjects (n=23) underwent a clinical cardiovascular magnetic resonance protocol (3 tesla) for cardiac volumes, function, and scar imaging. T1 mapping was performed before and >20 minutes after administration of 0.2 mmol/kg of gadobutrol. Native T1 and extracellular volume fraction were significantly higher in HCM compared with patients with hypertension (P15 mm (P2 SD above the mean of the normal range. Native T1 was an independent discriminator between HCM and hypertension, over and above extracellular volume fraction, LV wall thickness and indexed LV mass. Native T1 was also useful in separating G+P- subjects from controls. Native T1 may be applied to discriminate between HCM and hypertensive heart disease and detect early changes in G+P- subjects. © 2015 American Heart Association, Inc.

  10. Hypertrophic cardiomyopathy

    Science.gov (United States)

    ... arteries that feed the thickened part of the heart (alcohol septal ablation). People who have this procedure often show much improvement. You may need surgery to repair the heart's mitral valve if it is leaking.

  11. Transport and potential attenuation of nitrogen in shallow groundwaters in the lower Rangitikei catchment, New Zealand

    Science.gov (United States)

    Collins, S.; Singh, R.; Rivas, A.; Palmer, A.; Horne, D.; Manderson, A.; Roygard, J.; Matthews, A.

    2017-11-01

    Intensive agricultural activities are generally associated with nitrogen leaching from agricultural soils, and this nitrogen has the potential to percolate and contaminate groundwater and surface waters. We assessed surface water and groundwater interactions, and nitrogen leaching and its potential attenuation in shallow groundwater in the lower Rangitikei River catchment (832 km2), New Zealand. We combined regional- and local-scale field surveys and experiments, nutrient budget modelling, and hydraulic and geochemical methods, to gain an insight into leaching, transformation and transport of nitrogen via groundwaters to the river in the study area. Concurrent river flow gaugings (in January 2015) and a piezometric map, developed from measured depths to groundwater in 110 bores (in October 2014), suggest groundwater discharges to the Rangitikei River in the upper parts of the study area, while there is groundwater recharge near the coast. The groundwater redox characterisation, based on sampling and analysis of 15 mostly shallow bores ( 5 m bgl), despite being installed under intensive land uses, such as dairying and cropping. Our in-field push-pull tests showed NO3-N reduction at four shallow groundwater piezometers, with the rates of reduction varying from 0.04 mg N L- 1 h-1 to 1.57 mg N L- 1 h-1. This highlights the importance of a sound understanding of not only the sources, but also transport and transformation, or fate, of nutrients leached from farms, to mitigate the likely impacts of land use on water quality and ecosystem health in agricultural catchments.

  12. Cardiac MRI in a Patient with Coincident Left Ventricular Non-Compaction and Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Zahra Alizadeh-Sani

    2011-12-01

    Full Text Available Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy that affects both children and adults. Since the clinical manifestations are not sufficient to establish diagnosis, echocardiography is the diagnostic tool that makes it possible to document ventricular non-compaction and establish prognostic factors. We report a 47-year-old woman with a history of dilated cardiomyopathy with unknown etiology. Echocardiography showed mild left ventricular enlargement with severe systolic dysfunction (EF = 20-25%. According to cardiac magnetic resonance imaging findings non-compaction left ventricle with hypertrophic cardiomyopathy was considered, and right ventricular septal biopsy was recommended. Right ventricular endomyocardial biopsy showed moderate hypertrophy of cardiac myocytes with foci of myocytolysis and moderate interstitial fibrosis. No evidence of infiltrative deposition was seen.

  13. Comparison of different laser systems in the treatment of hypertrophic and atrophic scars and keloids

    Science.gov (United States)

    Scharschmidt, D.; Algermissen, Bernd; Willms-Jones, J.-C.; Philipp, Carsten M.; Berlien, Hans-Peter

    1997-12-01

    Different laser systems and techniques are used for the treatment of hypertrophic scar/span>s, keloids and acne scars. Significant criteria in selecting a suitable laser system are the scar's vascularization, age and diameter. Flashlamp- pumped dye-lasers, CO2-lasers with scanner, Argon and Nd:YAG-lasers are used. Telangiectatic scars respond well to argon lasers, erythematous scars and keloids to dye-laser treatment. Using interstitial Nd:YAG-laser vaporization, scars with a cross-section over 1 cm can generally be reduced. For the treatment of atrophic and acne scars good cosmetic results are achieved with a CO2-laser/scanner system, which allows a precise ablation of the upper dermis with low risk of side-effects.

  14. Assessment of atrial diastolic function in patients with hypertrophic cardiomyopathy by cine magnetic resonance imaging.

    Science.gov (United States)

    Grassedonio, Emanuele; Todiere, Giancarlo; La Grutta, Ludovico; Toia, Patrizia; Gentile, Giovanni D; Galia, Massimo; Midiri, Federico; Pepe, Alessia; Midiri, Massimo; Aquaro, Giovanni Donato

    2015-08-01

    This study was conducted to assess the role of atrial function by cardiac magnetic resonance (CMR) for the evaluation of diastolic physiology in patients with hypertrophic cardiomyopathy (HCM) compared to healthy controls. We enrolled 23 consecutive patients affected by HCM and 43 healthy subjects as age-matched control cases (CC). CMR was performed through acquisition of cine steady-state free precession sequences using a 1.5-T scanner. Image postprocessing was carried out using Tracking Tool software. Atrial volumes were significantly higher in patients with HCM compared to CC: maximum atrial volume (p = 0.007) and minimum atrial volume (p = 0.01). A statistically significant difference was also observed in atrial ejection fraction in patients with HCM (p study demonstrated that in HCM patients with early diastolic dysfunction the parameters of left atrial function assessed by CMR are impaired before the ventricular diastolic indexes such as the early peak filling rate and the active peak filling rate.

  15. Cardiac MRI in a Patient with Coincident Left Ventricular Non-Compaction and Hypertrophic Cardiomyopathy

    Science.gov (United States)

    Alizadeh-Sani, Zahra; Madadi, Shabnam; Sadeghpour, Anita; Khajali, Zahra; Golnari, Pedram; Kiavar, Majid

    2011-01-01

    Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy that affects both children and adults. Since the clinical manifestations are not sufficient to establish diagnosis, echocardiography is the diagnostic tool that makes it possible to document ventricular non-compaction and establish prognostic factors. We report a 47-year-old woman with a history of dilated cardiomyopathy with unknown etiology. Echocardiography showed mild left ventricular enlargement with severe systolic dysfunction (EF = 20–25%). According to cardiac magnetic resonance imaging findings non-compaction left ventricle with hypertrophic cardiomyopathy was considered, and right ventricular septal biopsy was recommended. Right ventricular endomyocardial biopsy showed moderate hypertrophy of cardiac myocytes with foci of myocytolysis and moderate interstitial fibrosis. No evidence of infiltrative deposition was seen. PMID:23074372

  16. Clubbed Fingers and Hypertrophic Osteoarthropathy in a Patient with Squamous Cell Carcinoma of the Lung

    Directory of Open Access Journals (Sweden)

    Wen-Chi Yang

    2003-04-01

    Full Text Available Hypertrophic osteoarthropathy (HOA is characterized by clubbed fingers and periosteal new bone formation. Etiologically, it can be divided into primary and secondary HOA, but its pathogenesis is uncertain. We report a 42-year-old male patient who suffered from painful clubbing fingers and toes. Serial examinations revealed periosteal new bone formation in the four limb long bones and a solid mass lesion in the right upper lung field. Pathologic examination of the resected mass lesion showed squamous cell carcinoma. After surgery and chemotherapy, the severity of clubbed fingers decreased and joint pain improved. Follow-up bone scan also suggested regression of the uptake of radioactivity in the four limb bones. We concluded that the HOA in this case was probably caused by lung cancer.

  17. Hypertrophic pachymeningitis in a patient with Takayasu arteritis: One more association?

    Directory of Open Access Journals (Sweden)

    Pandurang R Wattamwar

    2012-01-01

    Full Text Available Hypertrophic pachymeningitis (HP is a rare chronic inflammatory disease of the dura mater, described in association with various infections, systemic vasculitides such as Wegener′s granulomatosis and giant cell arteritis. However, HP in association with Takayasu arteritis (TA has not been described. We report a young woman who presented with headache, seizures, and right third and fourth cranial neuropathy. Magnetic resonance imaging of the brain showed HP in bifrontal and right temporal region extending to cavernous sinus. She was also found to have systemic hypertension, stenosis of left subclavian, and left renal artery with narrowing of abdominal aorta, satisfying the diagnostic criteria for TA. A detailed evaluation for secondary causes of HP failed to reveal an alternative etiology. This report describes an unusual association of HP in a patient with TA, also emphasizing that seizures and cranial neuropathy may further expand the spectrum of neurological manifestations in patients with TA.

  18. Effects of alcohol septal ablation on coronary microvascular function and myocardial energetics in hypertrophic obstructive cardiomyopathy.

    Science.gov (United States)

    Timmer, Stefan A J; Knaapen, Paul; Germans, Tjeerd; Dijkmans, Pieter A; Lubberink, Mark; Ten Berg, Jurrien M; Ten Cate, Folkert J; Rüssel, Iris K; Götte, Marco J W; Lammertsma, Adriaan A; van Rossum, Albert C

    2011-07-01

    This study investigated the effects of alcohol septal ablation (ASA) on microcirculatory function and myocardial energetics in patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction. In 15 HCM patients who underwent ASA, echocardiography was performed before and 6 mo after the procedure to assess the LVOT gradient (LVOTG). Additionally, [(15)O]water PET was performed to obtain resting myocardial blood flow (MBF) and coronary vasodilator reserve (CVR). Changes in LV mass (LVM) and volumes were assessed by cardiovascular magnetic resonance imaging. Myocardial oxygen consumption (MVo(2)) was evaluated by [(11)C]acetate PET in a subset of seven patients to calculate myocardial external efficiency (MEE). After ASA, peak LVOTG decreased from 41 ± 32 to 23 ± 19 mmHg (P = 0.04), as well as LVM (215 ± 74 to 169 ± 63 g; P energetics.

  19. Bilateral Hypertrophic Olivary Degeneration and Holmes Tremor without Palatal Tremor: An Unusual Association

    Science.gov (United States)

    Cosentino, Carlos; Velez, Miriam; Nuñez, Yesenia; Palomino, Henry; Quispe, Darko; Flores, Martha; Torres, Luis

    2016-01-01

    Background Lesions in the Guillain–Mollaret triangle or dentate-rubro-olivary pathway may lead to hypertrophic olivary degeneration (HOD), a secondary trans-synaptic degeneration of the inferior olivary nucleus. HOD is usually associated with palatal tremor and rarely with Holmes tremor. Bilateral HOD is a very unusual condition and very few cases are reported. Case Report We report here two cases of bilateral HOD after two different vascular lesions located at the decussation of superior cerebellar peduncles, thus impairing both central tegmental tracts and interrupting bilaterally the dentate-rubral-olivary pathway. Interestingly, both developed bilateral Holmes tremor but not palatal tremor. Discussion Lesions in some of the components in the Guillain–Mollaret triangle may develop Holmes tremor with HOD and without palatal tremor. Magnetic resonance imaging is an invaluable tool in these cases. Better understanding of the pathways in this loop is needed. PMID:27536461

  20. Mitochondrial haplogroups modify the risk of developing hypertrophic cardiomyopathy in a Danish population

    DEFF Research Database (Denmark)

    Hagen, Christian M; Aidt, Frederik H; Hedley, Paula L

    2013-01-01

    Hypertrophic cardiomyopathy (HCM) is a genetic disorder caused by mutations in genes coding for proteins involved in sarcomere function. The disease is associated with mitochondrial dysfunction. Evolutionarily developed variation in mitochondrial DNA (mtDNA), defining mtDNA haplogroups...... and haplogroup clusters, is associated with functional differences in mitochondrial function and susceptibility to various diseases, including ischemic cardiomyopathy. We hypothesized that mtDNA haplogroups, in particular H, J and K, might modify disease susceptibility to HCM. Mitochondrial DNA, isolated from...... factors in the development of HCM. Thus, constitutive differences in mitochondrial function may influence the occurrence and clinical presentation of HCM. This could explain some of the phenotypic variability in HCM. The fact that haplogroup H and J are also modifying factors in ischemic cardiomyopathy...