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Sample records for left atrium thrombus-like

  1. UFO in the Left Atrium: How to Capture Metal Debris Floating in the Left Atrium.

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    Fassini, Gaetano; Moltrasio, Massimo; Conti, Sergio; Biagioli, Viviana; Tondo, Claudio

    2016-06-01

    Electrophysiology procedures involving left atrium navigation are becoming more frequent, mostly due to the increase of atrial fibrillation ablation. Mapping catheters of different shapes and size as well as dedicated sheaths are mandatory tools for the accomplishment of procedural end point. Therefore, technical issues are expected, usually unrelated to significant risk. However, any accidental intra-atrial device loss of integrity implies a risk of cerebrovascular embolization. The lack of clear evidence on how to manage these events and the need for a quick solution complicate the scenario. We report an empirical solution in the case of debris floating in the left atrium. Copyright © 2016 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  2. Left Atrium Papillary Fibroelastomas: A Cause of Cerebral Emboli

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    A. G. Ciss

    2012-01-01

    Full Text Available Papillary fibroelastomas are cardiac benign tumours. Among the benign cardiac tumor, papillary fibroelastomas are reported second after myxomas. Most often diagnosed incidentally, papillary fibroelastomas may embolize to cerebral circulation. Valvular locations are predominant; location in left atrium is rare. In this paper, we present a case of papillary fibroelastoma located in left atrium with symptoms of cerebral embolization. Transoesophageal echocardiography diagnosed a mobile mass. The patient was treated with surgical resection without further embolic complication.

  3. Giant left atrium encountered during right-sided thoracentesis

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    Rashmi Advani

    Full Text Available Giant left atrium is an uncommon pathology to encounter during bedside chest ultrasound, but is an important structure to be aware of when considering thoracentesis. This cardiac structure could easily be mistaken for loculated pleural fluid. This case also supports growing evidence that expert users can safely perform thoracentesis without completely reversing therapeutic anticoagulation. Keywords: Giant left atrium, Thoracentesis, Rheumatic heart disease, Ultrasound

  4. Anatomic relationship between left coronary artery and left atrium in patients undergoing atrial fibrillation ablation.

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    Anselmino, Matteo; Torri, Federica; Ferraris, Federico; Calò, Leonardo; Castagno, Davide; Gili, Sebastiano; Rovera, Chiara; Giustetto, Carla; Gaita, Fiorenzo

    2017-07-01

    Atrial fibrillation transcatheter ablation (TCA) is, within available atrial fibrillation rhythm control strategies, one of the most effective. To potentially improve ablation outcome in case of recurrent atrial fibrillation after a first procedure or in presence of structural myocardial disease, isolation of the pulmonary veins may be associated with extensive lesions within the left atrium. To avoid rare, but potentially life-threatening, complications, thorough knowledge and assessment of left atrium anatomy and its relation to structures in close proximity are, therefore, mandatory. Aim of the present study is to describe, by cardiac computed tomography, the anatomic relationship between aortic root, left coronary artery and left atrium in patients undergoing atrial fibrillation TCA. The cardiac computed tomography scan of 21 patients affected by atrial fibrillation was elaborated to segment left atrium, aortic root and left coronary artery from the surrounding structures and the following distances measured: left atrium and aortic root; left atrium roof and aortic root; left main coronary artery and left atrium; circumflex artery and left atrium appendage; and circumflex artery and mitral valve annulus. Above all, the median distance between left atrium and aortic root (1.9, 1.5-2.1 mm), and between circumflex artery and left atrium appendage ostium (3.0, 2.1-3.4 mm) were minimal (≤3 mm). None of measured distances significantly varied between patients presenting paroxysmal versus persistent atrial fibrillation. The anatomic relationship between left atrium and coronary arteries is extremely relevant when performing atrial fibrillation TCA by extensive lesions. Therefore, at least in the latter case, preablation imaging should be recommended to avoid rare, but potentially life-threatening, complications with the aim of an as well tolerated as possible procedure.

  5. Right superior vena cava draining into the left atrium

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    Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); Batisse, Alain [Institut de Puericulture et de Perinatalogie, Paris (France); Vouhe, Pascal [University Rene Descartes-Paris 5, Department of Paediatric Cardiac Surgery, Hopital Necker-Enfants Malades, Paris (France); Ou, Phalla [University Rene Descartes-Paris 5, Department of Paediatric Cardiology, Hopital Necker-Enfants Malades, Paris (France); University Rene Descartes-Paris 5, Department of Pediatric Radiology, Hopital Necker-Enfants Malades, Paris (France)

    2008-08-15

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  6. Right superior vena cava draining into the left atrium

    International Nuclear Information System (INIS)

    Calcagni, Giulio; Sidi, Daniel; Bonnet, Damien; Batisse, Alain; Vouhe, Pascal; Ou, Phalla

    2008-01-01

    The right superior vena cava draining into the left atrium is a rare malformation causing cyanosis and clubbing in patients in whom no other signs of congenital heart defect are present. Diagnosis may be difficult as cyanosis may be mild and the anomaly is not always easily detectable by echocardiography. For this reason we report a 13-month-old male in whom we confirmed the clinical and echocardiographic suspicion of anomalous drainage of the right superior vena cava using multidetector CT. This allowed successful surgical reconnection of the right superior vena cava to the right atrium. (orig.)

  7. VARIATION IN THE OPENINGS (OSTIA OF LEFT PULMONARY VEINS INTO THE LEFT ATRIUM: A CASE REPORT

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    Sesi

    2015-03-01

    Full Text Available During early embryonic development, absorption of pulmonary venous network by the left primitive atrial chamber results in opening of four pulmonary veins which drain independently into its chamber. The extent of absorption and hence, the number of pulmon ary veins which open into the left atrium, may vary. Here we report a variation in the opening of the Left upper (superior pulmonary vein into the Left atrium. A total of six openings observed

  8. LEFT ATRIUM THROMBOSIS IN PATIENTS WITH RHEUMATIC MITRAL VALVULAR DISEASE

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    N. D. Kaverin

    2012-01-01

    Full Text Available Systemic thromboembolism — fairly common complication of mitral valvular disease, often leading to disability or fatal consequences for the patient. The source of emboli in most cases, are blood clots localized in the left atrium. The survey reflected basic views on the pathogenesis, diagnosis, treatment and prevention of intraatrial thrombosis according to new scientific advances. Articles (reviews, meta-analyzes and original researchs from Pub Med database, as well as domestic literature were used.

  9. An elusive persistent left superior vena cava draining into left atrium

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    A. Soward; F.J. ten Cate (Folkert); P.M. Fioretti (Paolo); P.W.J.C. Serruys (Patrick); J.R.T.C. Roelandt (Jos)

    1986-01-01

    textabstractA case report of a persistent left superior vena cava draining into left atrium with a fibromuscular left ventricular outflow tract obstruction and a small atrial septal defect. The anomalous vessel escaped detection during two right and left heart catheterizations from the right arm and

  10. Anesthetic implications of total anomalous systemic venous connection to left atrium with left isomerism

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    Parimala Prasanna Simha

    2012-01-01

    Full Text Available Total anomalous systemic venous connection (TASVC to the left atrium (LA is a rare congenital anomaly. An 11-year-old girl presented with complaints of palpitations and cyanosis. TASVC with left isomerism and noncompaction of LV was diagnosed after contrast echocardiogram and computed tomography angiogram. The knowledge of anatomy and pathophysiology is essential for the successful management of these cases. Anesthetic concerns in this case were polycythemia, paradoxical embolism and rhythm abnormalities. The patient was successfully operated by rerouting the systemic venous connection to the right atrium.

  11. Preoperative left ventricular ejection fraction and left atrium reverse remodeling after mitral regurgitation surgery.

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    Machado, Lucia R; Meneghelo, Zilda M; Le Bihan, David C S; Barretto, Rodrigo B M; Carvalho, Antonio C; Moises, Valdir A

    2014-11-06

    Left atrium enlargement has been associated with cardiac events in patients with mitral regurgitation (MR). Left atrium reverse remodeling (LARR) occur after surgical correction of MR, but the preoperative predictors of this phenomenon are not well known. It is therefore important to identify preoperative predictors for postoperative LARR. We enrolled 62 patients with chronic severe MR (prolapse or flail leaflet) who underwent successful mitral valve surgery (repair or replacement); all with pre- and postoperative echocardiography. LARR was defined as a reduction in left atrium volume index (LAVI) of ≥ 25%. Stepwise multiple regression analysis was used to identify independent predictors of LARR. LARR occurred in 46 patients (74.2%), with the mean LAVI decreasing from 85.5 mL/m2 to 49.7 mL/m2 (p <0.001). These patients had a smaller preoperative left ventricular systolic volume (p =0.022) and a higher left ventricular ejection fraction (LVEF) (p =0.034). LVEF was identified as the only preoperative variable significantly associated with LARR (odds ratio, 1.086; 95% confidence interval, 1.002-1.178). A LVEF cutoff value of 63.5% identified patients with LARR of ≥ 25% with a sensitivity of 71.7% and a specificity of 56.3%. LARR occurs frequently after mitral valve surgery and is associated with preoperative LVEF higher than 63.5%.

  12. Gadofosveset trisodium-enhanced magnetic resonance angiography of the left atrium-A feasibility study

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    Wagner, Moritz, E-mail: moritz.wagner@charite.d [Department of Radiology, Charite - University Hospital, Berlin (Germany); Rief, Matthias; Asbach, Patrick [Department of Radiology, Charite - University Hospital, Berlin (Germany); Vogtmann, Thomas [Department of Cardioloy and Angiology, Charite - University Hospital, Berlin (Germany); Huppertz, Alexander [Imaging Science Institute Charite Berlin, Berlin (Germany); Beling, Mark [Department of Cardioloy and Angiology, Charite - University Hospital, Berlin (Germany); Butler, Craig [Mazankowski Alberta Heart Institute, University of Alberta, Edmonton (Canada); Laule, Michael [Department of Cardioloy and Angiology, Charite - University Hospital, Berlin (Germany); Warmuth, Carsten; Taupitz, Matthias; Hamm, Bernd; Lembcke, Alexander [Department of Radiology, Charite - University Hospital, Berlin (Germany)

    2010-08-15

    Aim: Imaging of the left atrium is regularly performed prior to pulmonary vein isolation. The aim of the study was to evaluate the feasibility of contrast-enhanced high-resolution magnetic resonance angiography (MRA) of the left atrium using the blood-pool contrast agent gadofosveset trisodium in comparison to noncontrast MRA. Materials and methods: Twenty consecutive patients were examined by free-breathing electrocardiogram-gated whole-heart MRA (reconstructed spatial resolution, 0.7 mm x 0.6 mm x 0.8 mm) with a noncontrast T2-prepared steady state free precession sequence (T2-prep SSFP) and a gadofosveset trisodium-enhanced inversion-recovery SSFP sequence (CE IR-SSFP). Contrast-to-noise ratio (CNR) of blood in the left atrium was determined. Depiction of the left atrium was rated by two radiologists in consensus. A cardiologist segmented the MR data sets and rated depiction of the left atrium. Results: Five of 20 patients had irregular breathing patterns with navigator efficiency less than 35% and were excluded from evaluation. CNR was significantly higher for CE IR-SSFP compared with T2-prep SSFP (18.4 {+-} 5.3 vs. 11.7 {+-} 3.5, p < 0.01). Depiction of the left atrium by T2-prep SSFP was rated as good in four patients, moderate in ten patients, and poor in one patient, whereas depiction of the left atrium by CE IR-SSFP was rated as excellent in nine patients, good in four patients, and moderate in two patients. CE IR-SSFP allowed for semiautomated segmentation of the left atrium in 15 patients, whereas T2-prep SSFP allowed for segmentation only in ten patients. Conclusion: Gadofosveset trisodium-enhanced MRA of the left atrium is feasible with significantly improved image quality compared to noncontrast MRA.

  13. The effect of percutaneous transcatheter occlusion of left atrial appendage on left atrium and adjacent anatomic structure in canine

    International Nuclear Information System (INIS)

    Yang Zhihong; Wu Hong; Qin Yongwen; Hu Jianqiang; Ding Zhongru; Liu Zongjun; Liu Biao; Zheng Xing

    2009-01-01

    Objective: To observe the effect of percutaneous transcatheter occlusion of left atrial appendage (LAA) with a new self-manufactured LAA occluder on left atrium and adjacent anatomic structure in canine. Methods: A new self-manufactured LAA occluder was implanted into the LAA through a transseptal catheter in 20 dogs. Before and after the procedure, the experimental dogs were anaesthetized and examined by transthoracic echocardiography (TTE) to measure the diameter and the volume of the left atrium, the left superior pulmonary vein flow velocity and the left atrioventricular valve flow velocity separately. The contrast radiography of the LAA and the left coronary arteriography were performed. Results: The new LAA occluder was implanted successfully in 14 dogs. No obvious changes in the diameter and the volume of the left atrium, in left superior pulmonary vein flow velocity and in left atrioventricular valve flow velocity were found. On arteriography, left circumflex artery was normally displayed after the procedure. No migration of the occluder was seen on TTE and angiography after procedure. Conclusion: Percutaneous transcatheter occlusion of left atrial appendage with a new self-manufactured LAA occluder has no obvious effect on left atrium and adjacent anatomic structure in experimental canine, which indicates that the new-type device is a safe and feasible occluder for LAA. (authors)

  14. Scimitar vein draining to the left atrium and a historical review of the scimitar syndrome

    International Nuclear Information System (INIS)

    Holt, Peter D.; Berdon, Walter E.; Marans, Zvi; Griffiths, Sylvia; Hsu, Daphne

    2004-01-01

    Scimitar vein draining to the left atrium is the rarest of the pulmonary venolobar anomalies with less than a dozen reported cases. A case is reported of a patient whose plain film radiographic findings showed a typical scimitar vein but whose echocardiography showed normal pulmonary venous drainage. Cardiac catheterization confirmed drainage of the scimitar vein to the left atrium and systemic arterial supply which was embolized. The case described is used to review the history of ''scimitar syndrome'' with reflections on the significant contributions of Halasz and colleagues, who in 1956 helped define the anatomy, and Neill and colleagues, who in 1960 described the familial occurrence and clinical spectrum of the condition. (orig.)

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

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

    2013-12-10

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

  16. Atlas-based mosaicing of 3D transesophageal echocardiography images of the left atrium

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    Mulder, H.W. (Harriët); Pluim, J.P.W.; Ren, B. (Ben); Haak, A. (Alexander); Viergever, M.A. (Max); Bosch, J.G. (Johan); Stralen, van M. (Marijn)

    2015-01-01

    3D transesophageal echocardiography (TEE) is routinely used for planning and guidance of cardiac interventions. However, the limited field-of-view dictates the compounding of multiple images for visualization of large structures, e.g. the left atrium (LA). Previously, we developed a TEE image

  17. A large tumour of the left atrium – A 10-year follow-up

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    Agnieszka M. Łebek-Szatańska

    2016-11-01

    Full Text Available Benign myxomas are the most common primary tumors in the left atrium of the heart, and they usually require urgent operative management. However, with the constant aging of the population and treatment of patients with severe concomitant diseases, an interesting question is the efficacy of the conservative approach. We present a case of a 75-year-old woman who was previously diagnosed with a left atrial myxoma, underwent an operation to resect it and then developed a recurrent tumor at the site of resection, which was found by control echocardiography 1.5 years later. She has been observed for over 10 years, as she repeatedly refused reoperation. In the setting of this example of a relatively favorable clinical course of left atrium myxoma, we discuss the current knowledge about the natural history of these tumors and the role of echocardiography in predicting their growth and complications.

  18. Bronchial compression by an enlarged left atrium in infants; a cause of hypovascularity of the left lung

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    Corr, L.; Hallidie-Smith, K.A.; McCarthy, P.A.; Lavender, J.P.

    1988-09-01

    In three infants seen recently at our institution we noted signs of compression of the left main bronchus associated with enlarged left atria. None of our cases demonstrated the more usual signs of hyperinflation which are a hyperlucent lung field, depressed hemidiaphragm and mediastinal shift away from the affected side. In addition, hypoperfusion of the left lung was noted in each case. We believe that bronchial compression due to an enlarged left atrium, with consequent hypoxic vasoconstriction is a clinically significant entity, which is not well described and may be unappreciated in infants in whom the typical signs of hyperinflation are absent.

  19. Ruptured Sinus of Valsalva Aneurysm into the Left Atrium with Multiple Fistulous Communications: A Rare Cause of Heart Failure

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    Yashwant Agrawal

    2015-01-01

    Full Text Available Ruptured noncoronary sinus of valsalva aneurysm with fistulous connections to multiple cardiac chambers has not been reported previously. We report a 66-year-old man who presented with worsening cough and exertional dyspnea. Transesophageal echocardiogram confirmed a large aneurysm involving the noncoronary cusp of the aortic sinus with aneurysmal extension to the left atrium. There were also two fistulous communications with the left atrium and one small fistulous connection with the right atrium. Open-heart surgery with aortic root replacement and reimplantation of coronary arteries along with primary closure and repair of aorta to the left atrial fistula was performed.

  20. Negative inotropism of terpenes on guinea pig left atrium: structure-activity relationships.

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    Vasconcelos, Carla M L; Oliveira, Ingrid S N; Santos, José N A; Souza, Américo A; Menezes-Filho, José E R; Silva Neto, Júlio A; Lima, Tamires C; de Sousa, Damião P

    2018-06-01

    The aim of this work was to evaluate the pharmacological effect of seven structurally related terpenes on the contractility of cardiac muscle. The effect of terpenes was studied on isolated electrically driven guinea pig left atrium. From concentration-response curves for inotropic effect were determined the EC 50 and relative potency of such terpenes. Our results revealed that all terpenes, except phytol, showed ability to reduce the contractile response of guinea pig left atrium. Further, relative potency was directly related to the number of isoprene units and to the lipophilicity of the compounds. For example, sesquiterpenes farnesol and nerolidol showed higher relative potency when compared with the monoterpenes citronellol, geraniol and nerol. We can conclude that most of the evaluated terpenes showed a promising negative inotropism on the atrial muscle. Future studies are necessary to investigate their action mechanism.

  1. Left atrium and pulmonary artery compression due to aortic aneurysm causing heart failure symptoms.

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    Jorge, Antonio José Lagoeiro; Martins, Wolney de Andrade; Moutinho, Victor M; Rezende, Juliano M; Alves, Patricia Y; Villacorta, Humberto; Silveira, Pedro F; Couto, Antonio A

    2018-05-09

    Patients with thoracic aortic aneurysm (TAA) are mostly asymptomatic and TAA is rarely related to heart failure (HF). We report the case of an 80-year-old female patient, with type A TAA without dissection, with right pulmonary artery and left atrium compression, who presented with HF, preserved ejection fraction and acute pulmonary edema. Copyright © 2018 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Rupture of the right upper pulmonary vein and left atrium caused by blunt chest trauma.

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    Osaka, Motoo; Nagai, Ryo; Koishizawa, Tadashi

    2017-11-01

    A 49-year-old man was transferred to our hospital by ambulance due to blunt chest trauma sustained in a car accident. Echocardiography and enhanced computed tomography showed hemopericardium without other vital organ damage. Emergent surgery was performed under strong suspicion of traumatic cardiac rupture. Careful inspection showed a rupture of the right upper pulmonary vein at the junction of the left atrium, a laceration of the inferior vena cava, and a left-side pericardium rupture, and they were repaired with running 4-0 polypropylene suture. Postoperative hemodynamics were stable. The patient was discharged ambulatory on postoperative day 15.

  3. Multislice CT imaging of ruptured left sinus of Valsalva aneurysm with fistulous track between left sinus and right atrium.

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    Pampapati, Praveenkumar; Rao, Hejmadi Tati Gururaj; Radhesh, Srinivasan; Anand, Hejjaji Krishnamurthy; Praveen, Lokkur Srinivasamurthy

    2011-01-01

    Sinus of valsalva aneurysm is a rare condition arising from any of the three aortic sinuses. Among them, an aneurysm arising from the left coronary sinus is the rarest. Most of these cases were earlier diagnosed using echocardiography and conventional angiography. But with the availability of advanced imaging modalities like 64 slice cardiac CT and MR modalities, this condition can be accurately assessed noninvasively. We report a case of ruptured aneurysm originating from the left coronary sinus with a long windsock type of fistulous track between the aneurysm and right atrium evaluated by 64 slice cardiac CT imaging. This was later confirmed perioperatively.

  4. The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy

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    Wachtell, K.; Devereux, R.B.; Lyle, P.A.

    2008-01-01

    was superior to atenolol-based treatment for reducing new-onset AF and complications, especially stroke, associated with new-onset or pre-existing AF. Potential mechanisms of AF prevention by angiotensin receptor blockade supported by LIFE results include greater reduction in left atrial size and LV......The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study provided extensive data on predisposing factors, consequences, and prevention of atrial fibrillation (AF) in patients with hypertension and left ventricular (LV) hypertrophy. Randomized losartan-based treatment...... hypertrophy. Differential effects of antihypertensive treatment on the left atrium and left ventricle may help prevent AF and reduce risk of stroke associated with hypertensive heart disease Udgivelsesdato: 2008/12...

  5. Validation of geometric measurements of the left atrium and pulmonary veins for analysis of reverse structural remodeling following ablation therapy

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    Rettmann, M. E.; Holmes, D. R., III; Gunawan, M. S.; Ge, X.; Karwoski, R. A.; Breen, J. F.; Packer, D. L.; Robb, R. A.

    2012-03-01

    Geometric analysis of the left atrium and pulmonary veins is important for studying reverse structural remodeling following cardiac ablation therapy. It has been shown that the left atrium decreases in volume and the pulmonary vein ostia decrease in diameter following ablation therapy. Most analysis techniques, however, require laborious manual tracing of image cross-sections. Pulmonary vein diameters are typically measured at the junction between the left atrium and pulmonary veins, called the pulmonary vein ostia, with manually drawn lines on volume renderings or on image cross-sections. In this work, we describe a technique for making semi-automatic measurements of the left atrium and pulmonary vein ostial diameters from high resolution CT scans and multi-phase datasets. The left atrium and pulmonary veins are segmented from a CT volume using a 3D volume approach and cut planes are interactively positioned to separate the pulmonary veins from the body of the left atrium. The cut plane is also used to compute the pulmonary vein ostial diameter. Validation experiments are presented which demonstrate the ability to repeatedly measure left atrial volume and pulmonary vein diameters from high resolution CT scans, as well as the feasibility of this approach for analyzing dynamic, multi-phase datasets. In the high resolution CT scans the left atrial volume measurements show high repeatability with approximately 4% intra-rater repeatability and 8% inter-rater repeatability. Intra- and inter-rater repeatability for pulmonary vein diameter measurements range from approximately 2 to 4 mm. For the multi-phase CT datasets, differences in left atrial volumes between a standard slice-by-slice approach and the proposed 3D volume approach are small, with percent differences on the order of 3% to 6%.

  6. Convolutional neural networks for the detection of diseased hearts using CT images and left atrium patches

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    Dormer, James D.; Halicek, Martin; Ma, Ling; Reilly, Carolyn M.; Schreibmann, Eduard; Fei, Baowei

    2018-02-01

    Cardiovascular disease is a leading cause of death in the United States. The identification of cardiac diseases on conventional three-dimensional (3D) CT can have many clinical applications. An automated method that can distinguish between healthy and diseased hearts could improve diagnostic speed and accuracy when the only modality available is conventional 3D CT. In this work, we proposed and implemented convolutional neural networks (CNNs) to identify diseased hears on CT images. Six patients with healthy hearts and six with previous cardiovascular disease events received chest CT. After the left atrium for each heart was segmented, 2D and 3D patches were created. A subset of the patches were then used to train separate convolutional neural networks using leave-one-out cross-validation of patient pairs. The results of the two neural networks were compared, with 3D patches producing the higher testing accuracy. The full list of 3D patches from the left atrium was then classified using the optimal 3D CNN model, and the receiver operating curves (ROCs) were produced. The final average area under the curve (AUC) from the ROC curves was 0.840 +/- 0.065 and the average accuracy was 78.9% +/- 5.9%. This demonstrates that the CNN-based method is capable of distinguishing healthy hearts from those with previous cardiovascular disease.

  7. Right-sided superior vena cava draining into the left atrium: a rare anomaly of systemic venous return

    International Nuclear Information System (INIS)

    Aminololama-Shakeri, Shadi; Wootton-Gorges, Sandra L.; Reyes, Melissa; Moore, Elizabeth H.; Pretzlaff, Robert K.

    2007-01-01

    The most commonly encountered systemic thoracic venous anomaly is a persistent left superior vena cava that drains into the right atrium via the coronary sinus. A much rarer systemic venous anomaly is that of isolated anomalous drainage of a normally positioned right superior vena cava (RSVC) into the left atrium (LA). This has been reported in approximately 20 patients with the diagnosis usually being made by cardiac catheterization. We report the case of a toddler with asymptomatic hypoxemia resulting from anomalous drainage of a normal RSVC into his LA. This was diagnosed non-invasively by contrast-enhanced chest CT. (orig.)

  8. Primary intimal sarcoma of the left atrium presenting with constitutional symptoms

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    Ferreira, António; Felgueiras, Paula; Silva, Augusta; Ribeiro, Carlos; Guerra, Diana; de Melo, Daniel Pereira; Manuel Lopes, José

    2017-01-01

    Abstract Intimal (spindle-cell) sarcomas are exceptionally rare and are highly aggressive cardiac tumors. The authors describe a case of a 43-year-old female, presenting with a 3-month history of constitutional symptoms with fever, night sweats, anorexia and weight loss, associated with productive cough and pleural effusion that was admitted with clinical suspicion of pulmonary tuberculosis. The patient developed sudden acute heart failure symptoms during hospitalization, leading to mechanical ventilation. Computed tomography scan with contrast showed a cardiac tumor filling the left atrium causing compression of pulmonary veins. Surgical resection was performed and histologic examination revealed an intimal sarcoma. Although commenced on adjuvant chemotherapy, local tumor recurrence occurred with pericardium invasion. The patient died within 4 months of initial diagnosis. This report aims to describe an unusual presentation of this rare disease entity, and to discuss its highly aggressive clinical course. PMID:28694971

  9. Cardiac dynamic magnetic resonance of a giant lung carcinoma invading the left atrium : do not let the imaging fool you

    NARCIS (Netherlands)

    Pozzoli, Alberto; Klinkenberg, Theo J.; De Maat, Gijs E.; Mariani, Massimo A.

    This study aimed to report on a non-small-cell lung cancer (NSCLC) originating from the right lung lower lobe and circulatory extension into the left atrium. Atrial involvement is an uncommon feature of advanced NSCLC, occurring in up to 10% of patients with bronchogenic carcinoma. In this case, the

  10. Determinants of Reverse Remodeling of the Left Atrium Following Transaortic Myectomy.

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    Nguyen, Anita; Schaff, Hartzell V; Nishimura, Rick A; Dearani, Joseph A; Geske, Jeffrey B; Lahr, Brian D; Ommen, Steve R

    2018-04-18

    In patients with hypertrophic cardiomyopathy (HCM), enlargement of the left atrium (LA) is associated with increased morbidity and mortality due to risk of atrial fibrillation (AF), stroke, and heart failure. In this study, we investigated whether LA reverse remodeling occurs following septal myectomy. Between March 2007 and July 2015, 656 patients underwent myectomy at our institution and had pre- and postoperative transthoracic echocardiographic (TTE) recording of LA volume index (LAVI). We reviewed clinical and echocardiographic data of these patients, and assessed for changes over time by comparing pre- and postoperative measurements. The median age was 56 (46, 65) years, and 370 (56%) were male. New York Heart Association Class III/IV dyspnea was present in 581 (89%). Preoperative TTE showed LAVI of 48 (38, 60) mL/m 2 . In patients with history of AF, preoperative LAVI was 57 (45, 68) mL/m 2 , and in those without AF, LAVI measured 45 (37, 57) mL/m 2 (p < 0.001). All patients underwent transaortic septal myectomy. Early postoperative TTE (4 [3, 5] days) demonstrated LAVI of 43 (36, 52) mL/m 2 (p < 0.001), and late postoperative TTE (2.0 [1.1, 4.1] years) showed LAVI of 38 (29, 47) mL/m 2 (p < 0.001). Preoperative LAVI was associated with late development of AF (p = 0.002). Left atrial volume decreases significantly following surgical relief of left ventricular outflow tract obstruction. Early changes likely reflect lower LA pressure due to gradient relief and abolishment of mitral regurgitation, and late reduction suggests continued reverse remodeling. Copyright © 2018. Published by Elsevier Inc.

  11. Brain Abscess Associated with Isolated Left Superior Vena Cava Draining into the Left Atrium in the Absence of Coronary Sinus and Atrial Septal Defect

    International Nuclear Information System (INIS)

    Erol, Ilknur; Cetin, I. Ilker; Alehan, Fuesun; Varan, Birguel; Ozkan, Sueleyman; Agildere, A. Muhtesem; Tokel, Kursad

    2006-01-01

    A previously healthy 12-year-old girl presented with severe headache for 2 weeks. On physical examination, there was finger clubbing without apparent cyanosis. Neurological examination revealed only papiledema without focal neurologic signs. Cerebral magnetic resonance imaging showed the characteristic features of brain abscess in the left frontal lobe. Cardiologic workup to exclude a right-to-left shunt showed an abnormality of the systemic venous drainage: presence of isolated left superior vena cava draining into the left atrium in the absence of coronary sinus and atrial septal defect. This anomaly is rare, because only a few other cases have been reported

  12. Prevalence and predictors of low voltage zones in the left atrium in patients with atrial fibrillation.

    Science.gov (United States)

    Huo, Yan; Gaspar, Thomas; Pohl, Matthias; Sitzy, Judith; Richter, Utz; Neudeck, Sebastian; Mayer, Julia; Kronborg, Mads Brix; Piorkowski, Christopher

    2017-06-10

    To describe the extent and distribution of low voltage zones (LVZ) in a large cohort of patients undergoing ablation for paroxysmal and persistent atrial fibrillation (AF), and to explore baseline predictors of LVZ in these patients. Consecutive patients who underwent a bipolar voltage map guided AF ablation, were enrolled. Voltage maps were conducted for each patient using 3-dimensional electroanatomical mapping system and LVZ were defined as areas of bipolar voltage voltage zones was present in 58 out of 292 patients with paroxysmal and 134 out of 247 persistent AF (P < 0.001). The area of LVZ was larger in patients with persistent as compare to paroxysmal AF, 5 cm2 (IQR 3-18.6) vs. 12.1 cm2 (IQR 3.6-28.5), P = 0.026, respectively. In the multivariate analysis age (OR 1.07, 95%CI 1.05-1.10, P < 0.001), female gender (OR 2.18, 95%CI 1.38-3.43, P = 0.001), sinoatrial node dysfunction (OR 3.90, 95%CI 1.24-12.21, P = 0.020), larger surface area of left atrium pr. cm2 (OR 1.01, 95%CI 1.00-1.02, P = 0.016), and persistent AF (OR 5.03, 95%CI 3.20-7.90, P<0.001) were associated with presence of LVZ. In a large cohort of patients undergoing ablation for AF, the prevalence of LVZ was higher and LVZ areas larger in patients with persistent as compared with paroxysmal AF. The most frequent localization of LVZ was anterior wall, septum and posterior wall. Presence of LVZ was associated with higher age, female gender, larger LA surface area, and sinoatrial node dysfunction. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  13. A region-specific quantitative profile of autonomic innervation of the canine left atrium and pulmonary veins.

    Science.gov (United States)

    Gao, Chong-han; Wang, Fei; Jiang, Rong; Zhang, Jin; Mou, Huamin; Yin, Yue-hui

    2011-07-05

    The aim of the present study was to determine and quantify the cardiac autonomic innervation of the canine atria and pulmonary vein. Tissue specimens were taken from the canine pulmonary veins (PVs), posterior left atrium (PLA), left atrial roof (LAR), anterior left atrium (ALA), interatrial septum (IAS), and left atrial appendage (LAA) respectively for immunohistochemical analysis and nerve density determination. Both sympathetic and parasympathetic nerve densities decreased in the order: PLA>PV>IAS>LAR>ALA>LAA. For sympathetic nerve, multiple comparisons between any two regions showed a significant difference (PIAS vs. LAR, and LAR vs. ALA; for parasympathetic nerve, all the differences between any pair of regions were statistically significant (PIAS vs. LAR, LAR vs. ALA, and ALA vs. LAA. For both nerve types, there was a decreasing gradient of nerve densities from the external to internal layer (P<0.001, for each comparisons). Nerve density at the ostia for either nerve type was significantly higher than at the distal segments of PVs (P<0.001). In summary, the LA and PVs are innervated by sympathetic and parasympathetic nerves in a regionally heterogeneous way, which may be important for the pathophysiological investigation and ablation therapy of atrial fibrillation (AF). Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Effect of the Size of the Left Atrium on Sustained Sinus Rhythm in Patients Undergoing Mitral Valve Surgery and Concomitant Bipolar Radiofrequency Ablation for Atrial Fibrillation.

    Science.gov (United States)

    Avdagić, Harun; Sijerčić Avdagić, Selma; Pirić Avdagić, Melika; Antonič, Miha

    2017-12-01

    Atrial fibrillation is associated with systemic embolization and complications due to anticoagulant therapy. Radiofrequency ablation has been established as an effective and safe method for the treatment of atrial fibrillation. The aim of this study was to evaluate the effect of the size of the left atrium on the outcome of surgical radiofrequency ablation. Forty patients scheduled for elective mitral valve surgery and radiofrequency ablation were enrolled in the study. Group 1 consisted of patients with a left atrium diameter ≤5 cm and group 2 of patients with left atrium diameter >5 cm. The primary endpoint of the study was stable sinus rhythm 6 months postoperatively. At 6 months postoperatively, sinus rhythm was present in significantly more group 1 patients as compared with group 2 patients, i.e. 15 (75%) vs. 8 (40%), p=0.025. Multivariate analysis proved the size of the left atrium to be an independent predictor of the radiofrequency ablation outcome. Accordingly, the size of the left atrium was demonstrated to be an important predictor of the outcome of radiofrequency ablation for atrial fibrillation. A lower cut-off value of surgical reduction of the atria than previously reported should be considered in order to improve the radiofrequency ablation outcome.

  15. Crude extract and purified components isolated from the stems of Tinospora crispa exhibit positive inotropic effects on the isolated left atrium of rats

    DEFF Research Database (Denmark)

    Praman, Siwaporn; Mulvany, Michael J.; Williams, David E.

    2013-01-01

    of 5 bioactive compounds: higenamine, salsolinol, tyramine, adenosine and uridine. Higenamine, salsolinol (at low concentration) and tyramine acted via the adrenergic receptors to increase the force of the atrial contraction, whereas a high concentration of salsolinol acted indirectly by stimulating...... an increase in the force of contraction of the electrical field stimulated left atrium. This effect was inhibited by propranolol, atenolol, ICI-118,551, phentolamine and atropine. The positive inotropic effect on the reserpenized isolated left atrium of the Tinospora crispa extract was significantly inhibited...... by propranolol, atenolol and ICI-118,551. Phentolamine, on the other hand, caused potentiation and the effect was inhibited when propranolol was also added. Higenamine caused an increase in the force of contraction of the electrical field stimulated left atrium and this effect was significantly inhibited by ICI...

  16. Quantitative description of the 3D regional mechanics of the left atrium using cardiac magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kuklik, P; Molaee, P; Ganesan, A N; Brooks, A G; Worthley, S G; Sanders, P; Podziemski, P

    2014-01-01

    The left atrium (LA) plays an important role in the maintenance of hemodynamic and electrical stability of the heart. One of the conditions altering the atrial mechanical function is atrial fibrillation (AF), leading to an increased thromboembolic risk due to impaired mechanical function. Preserving the regions of the LA that contribute the greatest to atrial mechanical function during curative strategies for AF is important. The purpose of this study is to introduce a novel method of regional assessment of mechanical function of the LA. We used cardiac MRI to reconstruct the 3D geometry of the LA in nine control and nine patients with paroxysmal atrial fibrillation (PAF). Regional mechanical function of the LA in pre-defined segments of the atrium was calculated using regional ejection fraction and wall velocity. We found significantly greater mechanical function in anterior, septal and lateral segments as opposed to roof and posterior segments, as well as a significant decrease of mechanical function in the PAF group. We suggest that in order to minimize the impact of the AF treatment on global atrial mechanical function, damage related to therapeutic intervention, such as catheter ablation, in those areas should be minimized. (paper)

  17. Esophageal achalasia compressing left atrium diagnosed by echocardiography using a liquid containing carbon dioxide in a 21-year-old woman with Turner syndrome.

    Science.gov (United States)

    Park, Man Je; Song, Bong Gun; Lee, Hyoun Soo; Kim, Ki Hoon; Ok, Hea Sung; Kim, Byeong Ki; Park, Yong Hwan; Kang, Gu Hyun; Chun, Woo Jung; Oh, Ju Hyeon

    2012-01-01

    Extrinsic compression of the left atrium by the esophagus, the stomach, or both is an uncommon but important cause of hemodynamic compromise. Achalasia is a motility disorder characterized by impaired relaxation of the lower esophageal sphincter and dilatation of the distal two thirds of the esophagus. Echocardiographic imaging after oral ingestion of liquid containing carbon dioxide allowed for differentiation between a compressive vascular structure and the esophagus. We report a rare case of esophageal achalasia compressing the left atrium diagnosed by echocardiography using a liquid containing carbon dioxide in a 21-year-old woman with Turner syndrome. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. The application and value of 64 multislice spiral CT of left atrium and pulmonary vein in radio-frequency ablation of atrial fibrillation

    International Nuclear Information System (INIS)

    Guo Xi; Lv Biao; Zhang Zhaoqi; Zhao Yike; Jiang Hong; Ma Changsheng; Yu Ronghui; Wang Xue; Cao Hainian

    2008-01-01

    Objective: Analyzing the left atrium and pulmonary vein morphologically by 64 multislice spiral CT (MSCT) scan to guide the catheter ablation of Atrial fibrillation. Methods: Two hundred and thirty-two patients (146 cases in atrial fibrillation group and 86 cases in control group) received 64 MSCT examination of the left atrium and pulmonary vein. The incidence of anatomical variation of pulmonary vein was compared between atrial fibrillation group and control group. For each group, the anatomical morphology of every pulmonary vein and the auricle of left atrium was analyzed, the diameter of the orifice of each pulmonary vein and the size of left atrium were measured. Results: Sixty-four MSCT of left atrium and pulmonary vein could demonstrate detailed connecting type between left atrium and pulmonary veins and the possible anatomical variation. Anatomical variation of pulmonary vein in this study accounted for 16.8% (39/232) of total sample. For both groups, orifices of pulmonary veins appeared oval and their superoinferior diameters were larger than their anteroposterior diameters. There was significant difference in the inner diameter of left atrium between atrial fibrillation group and control group [atrial fibrillation group: (39.47 ± 8.98) mm, control group: (36.94±5.49) mm, P=0.02], while there was no difference in the diameters of orifices of pulmonary veins between two groups [superoinferior diameters of pulmonary veins in atrial fibrillation group: left-up (18.15±1.35) mm, left-down (16.96±1.18) mm, right-up (17.50±1.12) mm, fight-down (17.65±0.94) mm, superoinferior diameters of pulmonary veins in control group: left-up (18.07±0.94) mm, left-down (17.50±0.57) mm, right-up (18.03±1.02) mm, fight-down (17.94±0.76) mm, the corresponding P>0.05, respectively, anteroposterior diameters of pulmonary veins in atrial fibrillation group: left-up (12.26±1.89) mm, left-down (11.96±0.61) mm, right-up (12.32± 1.08) mm, fight-down (12.39±0.95) mm

  19. A comparison of the histopathologic pattern of the left atrium in canine dilated cardiomyopathy and chronic mitral valve disease.

    Science.gov (United States)

    Janus, Izabela; Noszczyk-Nowak, Agnieszka; Nowak, Marcin; Ciaputa, Rafał; Kandefer-Gola, Małgorzata; Pasławska, Urszula

    2016-01-05

    Dilated cardiomyopathy (DCM) and chronic mitral valve disease (CMVD) in dogs are associated with heart chamber enlargement, also of the left atrium. DCM is often accompanied by rhythm disturbances (mainly atrial fibrillation or ventricular arrhythmias). In CMVD, arrhythmias are observed less frequently. It is still unclear whether left atrial enlargement in these diseases results from volume overload or if it is also connected with other factors (e.g. rhythm disturbances). This study was conducted on the left atrial myocardial specimens from 31 dogs, including those from 16 dogs with clinically diagnosed DCM and 15 dogs with CMVD. After fixation and staining (using haematoxylin-eosin and Masson-Goldner trichrome stain), the specimens underwent evaluation. Parenchymal changes (fibrosis, fatty infiltration, and vessel narrowing), degenerative changes (loss of striation, changes in cardiomyocyte structure, and abnormal cell nuclei) and the presence of inflammatory infiltrates were assessed. More interstitial fibrosis (median 4 vs. 2.5 grid fields; p < 0.05) and less perivascular fibrosis (median score 1 vs. 2; p < 0.05) was observed in the DCM group compared to the CMVD group. Moreover, less distinct vessel narrowing was observed in the DCM group than in the CMVD group (median lumen area ratio 0.3 vs. 0.26 respectively; p < 0.05). Dogs with DCM showed more strongly defined degenerative changes than the CMVD dogs (median nuclei enlargement score 3 vs. 1, median loss of striation score 3 vs. 2 and median structural alterations score 3 vs. 2, respectively; p < 0.05). The obtained results indicate a different nature of changes occurring in the left atrial myocardium of dogs with DCM compared to dogs with mitral valve disease, including differences in vessel narrowing, cardiomyocyte degeneration and in the distribution of connective tissue.

  20. Automatic intra-operative generation of geometric left atrium/pulmonary vein models from rotational X-ray angiography.

    Science.gov (United States)

    Meyer, Carsten; Manzke, Robert; Peters, Jochen; Ecabert, Olivier; Kneser, Reinhard; Reddy, Vivek Y; Chan, Raymond C; Weese, Jürgen

    2008-01-01

    Pre-procedural imaging with cardiac CT or MR has become popular for guiding complex electrophysiology procedures such as those used for atrial fibrillation ablation therapy. Electroanatomical mapping and ablation within the left atrium and pulmonary veins (LAPV) is facilitated using such data, however the pre-procedural anatomy can be quite different from that at the time of intervention. Recently, a method for intra-procedural LAPV imaging has been developed based on contrast-enhanced 3-D rotational X-ray angiography (3-D RA). These intraprocedural data now create a compelling need for rapid and automated extraction of the LAPV geometry for catheter guidance. We present a new approach to automatic intra-procedural generation of LAPV surfaces from 3-D RA volumes. Using model-based segmentation, our technique is robust to imaging noise and artifacts typical of 3-D RA imaging, strongly minimizes the user interaction time required for segmentation, and eliminates inter-subject variability. Our findings in 33 patients indicate that intra-procedural LAPV surface models accurately represent the anatomy at the time of intervention and are comparable to pre-procedural models derived from CTA or MRA.

  1. Characteristics of complex fractionated atrial electrogram in the electroanatomically remodeled left atrium of patients with atrial fibrillation

    International Nuclear Information System (INIS)

    Park, Jae-Hyung; Kim, Jong-Youn; Park, Sang-Weon

    2010-01-01

    Complex fractionated atrial electrogram (CFAE) guided ablation is effective in some patients with persistent atrial fibrillation (PeAF), but the pattern of CFAE may be different in the remodeled left atrium (LA). In 100 AF patients (83 males, 55.0±10.6 years old) with AF (51 paroxysmal AF (PAF), 49 PeAF) who underwent catheter ablation, CFAE cycle length (CL) and distribution (NavX 3D map) were compared according to the LA volume (3D-CT) and endocardial voltage (during high right atrial pacing 500-ms (Vol PACE ) and AF (Vol AF ; NavX). The mean CFAE-CL was longer (P=0.003) and the % area CFAE was smaller (P=0.006) in patients with LA ≥125 ml than those with PACE AF PACE <1.7 mV than those with ≥1.7 mV (P=0.006). The incidence of septal CFAE was consistently high, regardless of the degree of LA remodeling. In the AF patients with an electroanatomically remodeled LA, the % area of CFAE was smaller and mean CFAE-CL was longer than in those with a less remodeled LA. However, the majority of CFAE are consistently positioned on the septum in the remodeled LA. (author)

  2. A Combined Random Forests and Active Contour Model Approach for Fully Automatic Segmentation of the Left Atrium in Volumetric MRI

    Directory of Open Access Journals (Sweden)

    Chao Ma

    2017-01-01

    Full Text Available Segmentation of the left atrium (LA from cardiac magnetic resonance imaging (MRI datasets is of great importance for image guided atrial fibrillation ablation, LA fibrosis quantification, and cardiac biophysical modelling. However, automated LA segmentation from cardiac MRI is challenging due to limited image resolution, considerable variability in anatomical structures across subjects, and dynamic motion of the heart. In this work, we propose a combined random forests (RFs and active contour model (ACM approach for fully automatic segmentation of the LA from cardiac volumetric MRI. Specifically, we employ the RFs within an autocontext scheme to effectively integrate contextual and appearance information from multisource images together for LA shape inferring. The inferred shape is then incorporated into a volume-scalable ACM for further improving the segmentation accuracy. We validated the proposed method on the cardiac volumetric MRI datasets from the STACOM 2013 and HVSMR 2016 databases and showed that it outperforms other latest automated LA segmentation methods. Validation metrics, average Dice coefficient (DC and average surface-to-surface distance (S2S, were computed as 0.9227±0.0598 and 1.14±1.205 mm, versus those of 0.6222–0.878 and 1.34–8.72 mm, obtained by other methods, respectively.

  3. The effects of microsphere injections into the left atrium on the myocardial blood supply measured by thermal conductance probes

    International Nuclear Information System (INIS)

    Hahn, N.; Eichelkraut, W.; Kropp, J.; Bonn Univ.

    1990-01-01

    210 measurements made during experiments on 66 dogs under propionyl-promazine/pentobarbital narcosis were newly analysed to verify a possible influence of microspheres (9 μm diameter) injected into the left atrium on microcirculation. Using 20 additional dogs in identically performed experiments, the myocardial perfusion was measured using thermal conductance probes, following injections of isotonic NaCl solution, Ringer's solution, 5% glucose, the subject's blood, and isotonic NaCl solution mixed with the surface-active substance Tween 80 R . These supension media were injected both with and without unlabelled microspheres (8.6 μm diameter). The results led to the following conclusions. An obligatory decrease in the blood supply as the result of a mechanical blocking of capillaries by microspheres can be ruled out. The particles, the suspension media, and a suspension temperature not sufficiently adjusted to the body temperature induce reactive negative or positive changes in the microcirculation of the myocardium. Solutions containing particles cause, in the majority of cases, a decrease. The suspension medium with the smallest effect proved to be isotonic NaCl solution. From the results one can conclude that artefacts may arise from the application of the heat conductance probe method when the temperatures are not perfectly matched. However, the injected solution itself can often lead to various reactions in microcirculation which may last up to 5 min. It is advisable to allow at least 6 min to elapse after reactive changes have faded before administering the next injection. (orig./MG)

  4. Computer-based automated left atrium segmentation and volumetry from ECG-gated coronary CT angiography data. Comparison with manual slice segmentation and ultrasound planimetric methods

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, R.W.; Kraus, B.; Kerl, J.M.; Lehnert, T.; Vogl, T.J. [Universitaetsklinikum Frankfurt (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Bernhardt, D.; Vega-Higuera, F. [Siemens AG, Healthcare Sector, Forchheim (Germany). Computed Tomography; Ackermann, H. [Universitaetsklinikum Frankfurt (Germany). Inst. fuer Biostatistik und Mathematische Modellierung

    2010-12-15

    Purpose: Enlargement of the left atrium is a risk factor for cardiovascular or cerebrovascular events. We evaluated the performance of prototype software for fully automated segmentation and volumetry of the left atrium. Materials and Methods: In 34 retrospectively ECG-gated coronary CT angiography scans, the end-systolic (LAVsys) and end-diastolic (LAVdia) volume of the left atrium was calculated fully automatically by prototype software. Manual slice segmentation by two independent experienced radiologists served as the reference standard. Furthermore, two independent observers calculated the LAV utilizing two ultrasound planimetric methods ('area length' and 'prolate ellipse') on CTA images. Measurement periods were compared for all methods. Results: The left atrial volumes calculated with the prototype software were in excellent agreement with the results from manual slice segmentation (r = 0.97 - 0.99; p < 0.001; Bland-Altman) with excellent interobserver agreement between both radiologists (r = 0.99; p < 0.001). Ultrasound planimetric methods clearly showed a higher variation (r = 0.72 - 0.86) with moderate interobserver agreement (r = 0.51 - 0.79). The measurement period was significantly lower with the software (267 {+-} 28 sec; p < 0.001) than with ultrasound methods (431 {+-} 68 sec) or manual slice segmentation (567 {+-} 91 sec). Conclusion: The prototype software showed excellent agreement with manual slice segmentation with the least time consumption. This will facilitate the routine assessment of the LA volume from coronary CTA data and therefore risk stratification. (orig.)

  5. Left ventricular ejection fraction and left atrium diameter related to new-onset atrial fibrillation following acute myocardial infarction: a systematic review and meta-analysis.

    Science.gov (United States)

    Zeng, Rui-Xiang; Chen, Mao-Sheng; Lian, Bao-Tao; Liao, Peng-Da; Zhang, Min-Zhou

    2017-10-06

    New-onset atrial fibrillation (NOAF) occurs frequently in patients with acute myocardial infarction (AMI), and is associated with increased subsequent cardiovascular mortality. However, only a few studies directly evaluated the relationship of left ventricular ejection fraction (LVEF) or left atrium diameter (LAD) and NOAF following AMI. MEDLINE ® , EMBASE ® and the Cochrane Library were carried out to find studies until January 2017. Pooled mean difference (MD) and 95% confidence interval (CI) were calculated to evaluate the value of LVEF and LAD in the prediction of NOAF after AMI. We performed sensitivity analyses to explore the potential sources of heterogeneity. Statistical analyses were carried out using the Revman 5.3. We included 10 qualifying studies comprising a total of 708 patients with NOAF and 6785 controls. Overall, decreased LVEF and increased LAD levels had a significant positive association with NOAF in patients with AMI. The MD in the LVEF levels between the patients with and those without NOAF was -4.91 units (95% Cl: -5.70 to -4.12), test for overall effect z-score = 12.18 ( p < 0.00001, I 2 = 35%). Moreover, in a subgroup analysis, the MD for LAD and NOAF was 2.55 units (95% Cl: 1.91 to 3.19), test for overall effect z-score = 7.80 ( p < 0.00001, I 2 = 57%). Our meta-analysis demonstrated that both decreased LVEF and increased LAD levels were associated with greater risk of NOAF following AMI.

  6. Impact of ECG gating in contrast-enhanced MR angiography for the assessment of the pulmonary veins and the left atrium anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Katoh, M.; Buecker, A.; Muehlenbruch, G.; Guenther, R.W.; Spuentrup, E. [Klinik fuer Radiologische Diagnostik, Universitaetsklinikum RWTH Aachen (Germany); Schauerte, P. [Medizinische Klinik 1, Universitaetsklinikum RWTH Aachen (Germany)

    2006-02-15

    Purpose: Implementation of ECG gating in contrast-enhanced MR angiography (ceMRA) for improved visualization of the pulmonary veins, the left atrium, and the thoracic vessels. Materials and Methods: CeMRA was performed on twelve patients with a history of recurrent atrial fibrillation for the purpose of an intra-individual comparison with and without ECG gating on a 1.5 Tesla MR system (Gyroscan Intera, Philips Medical Systems, Best, NL). Objective image quality parameters such as the signal-to-noise ratio (SNR) of the blood and the contrast-to-noise ratio (CNR) between the blood and myocardium or lung parenchyma were analyzed. The contour sharpness of the pulmonary veins, left atrium, ascending aorta, and pulmonary trunk was also measured. In addition, the artifact level was subjectively assessed by two observers blinded with respect to the sequence parameters. Statistically significant differences (p<0.05) between the procedures were analyzed using the Wilcoxon test and Pearson Chi-square test. Results: The use of ECG gating in ceMRA significantly reduced artifacts caused by cardiac motion and vessel pulsation. This in turn lead to a significant increase in the contour sharpness of the left atrium and the thoracic vessels. In addition, higher SNR and CNR were found using ECG-gated ceMRA compared to standard ceMRA. Conclusion: The use of ECG gating in ceMRA results in artifact-free and sharper delineation of the structures of the heart and thoracic vessels. (orig.)

  7. Impact of ECG gating in contrast-enhanced MR angiography for the assessment of the pulmonary veins and the left atrium anatomy

    International Nuclear Information System (INIS)

    Katoh, M.; Buecker, A.; Muehlenbruch, G.; Guenther, R.W.; Spuentrup, E.; Schauerte, P.

    2006-01-01

    Purpose: Implementation of ECG gating in contrast-enhanced MR angiography (ceMRA) for improved visualization of the pulmonary veins, the left atrium, and the thoracic vessels. Materials and Methods: CeMRA was performed on twelve patients with a history of recurrent atrial fibrillation for the purpose of an intra-individual comparison with and without ECG gating on a 1.5 Tesla MR system (Gyroscan Intera, Philips Medical Systems, Best, NL). Objective image quality parameters such as the signal-to-noise ratio (SNR) of the blood and the contrast-to-noise ratio (CNR) between the blood and myocardium or lung parenchyma were analyzed. The contour sharpness of the pulmonary veins, left atrium, ascending aorta, and pulmonary trunk was also measured. In addition, the artifact level was subjectively assessed by two observers blinded with respect to the sequence parameters. Statistically significant differences (p<0.05) between the procedures were analyzed using the Wilcoxon test and Pearson Chi-square test. Results: The use of ECG gating in ceMRA significantly reduced artifacts caused by cardiac motion and vessel pulsation. This in turn lead to a significant increase in the contour sharpness of the left atrium and the thoracic vessels. In addition, higher SNR and CNR were found using ECG-gated ceMRA compared to standard ceMRA. Conclusion: The use of ECG gating in ceMRA results in artifact-free and sharper delineation of the structures of the heart and thoracic vessels. (orig.)

  8. Fully automatic segmentation of left atrium and pulmonary veins in late gadolinium-enhanced MRI: Towards objective atrial scar assessment.

    Science.gov (United States)

    Tao, Qian; Ipek, Esra Gucuk; Shahzad, Rahil; Berendsen, Floris F; Nazarian, Saman; van der Geest, Rob J

    2016-08-01

    To realize objective atrial scar assessment, this study aimed to develop a fully automatic method to segment the left atrium (LA) and pulmonary veins (PV) from late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI). The extent and distribution of atrial scar, visualized by LGE-MRI, provides important information for clinical treatment of atrial fibrillation (AF) patients. Forty-six AF patients (age 62 ± 8, 14 female) who underwent cardiac MRI prior to RF ablation were included. A contrast-enhanced MR angiography (MRA) sequence was acquired for anatomy assessment followed by an LGE sequence for LA scar assessment. A fully automatic segmentation method was proposed consisting of two stages: 1) global segmentation by multiatlas registration; and 2) local refinement by 3D level-set. These automatic segmentation results were compared with manual segmentation. The LA and PVs were automatically segmented in all subjects. Compared with manual segmentation, the method yielded a surface-to-surface distance of 1.49 ± 0.65 mm in the LA region when using both MRA and LGE, and 1.80 ± 0.93 mm when using LGE alone (P automatic and manual segmentation was comparable to the interobserver difference (P = 0.8 in LA region and P = 0.7 in PV region). We developed a fully automatic method for LA and PV segmentation from LGE-MRI, with comparable performance to a human observer. Inclusion of an MRA sequence further improves the segmentation accuracy. The method leads to automatic generation of a patient-specific model, and potentially enables objective atrial scar assessment for AF patients. J. Magn. Reson. Imaging 2016;44:346-354. © 2016 Wiley Periodicals, Inc.

  9. 3D patient-specific models for left atrium characterization to support ablation in atrial fibrillation patients.

    Science.gov (United States)

    Valinoti, Maddalena; Fabbri, Claudio; Turco, Dario; Mantovan, Roberto; Pasini, Antonio; Corsi, Cristiana

    2018-01-01

    Radiofrequency ablation (RFA) is an important and promising therapy for atrial fibrillation (AF) patients. Optimization of patient selection and the availability of an accurate anatomical guide could improve RFA success rate. In this study we propose a unified, fully automated approach to build a 3D patient-specific left atrium (LA) model including pulmonary veins (PVs) in order to provide an accurate anatomical guide during RFA and without PVs in order to characterize LA volumetry and support patient selection for AF ablation. Magnetic resonance data from twenty-six patients referred for AF RFA were processed applying an edge-based level set approach guided by a phase-based edge detector to obtain the 3D LA model with PVs. An automated technique based on the shape diameter function was designed and applied to remove PVs and compute LA volume. 3D LA models were qualitatively compared with 3D LA surfaces acquired during the ablation procedure. An expert radiologist manually traced the LA on MR images twice. LA surfaces from the automatic approach and manual tracing were compared by mean surface-to-surface distance. In addition, LA volumes were compared with volumes from manual segmentation by linear and Bland-Altman analyses. Qualitative comparison of 3D LA models showed several inaccuracies, in particular PVs reconstruction was not accurate and left atrial appendage was missing in the model obtained during RFA procedure. LA surfaces were very similar (mean surface-to-surface distance: 2.3±0.7mm). LA volumes were in excellent agreement (y=1.03x-1.4, r=0.99, bias=-1.37ml (-1.43%) SD=2.16ml (2.3%), mean percentage difference=1.3%±2.1%). Results showed the proposed 3D patient-specific LA model with PVs is able to better describe LA anatomy compared to models derived from the navigation system, thus potentially improving electrograms and voltage information location and reducing fluoroscopic time during RFA. Quantitative assessment of LA volume derived from our 3D LA

  10. Successful treatment of an acute infective endocarditis secondary to fish bone penetrating into left atrium caused by Granulicatella adiacens and Candida albicans: A case report.

    Science.gov (United States)

    Tong, Ya Ling; Qu, Ting Ting; Xu, Jia; Chen, Nai Yun; Yang, Mei Fang

    2017-12-01

    Infective endocarditis caused by a foreign body of the upper digestive tract is rare. We report a rare case of Granulicatella adiacens and Candida albicans coinfection acute endocarditis combined with systematic embolization caused by a fish bone from the esophagus penetrating into the left atrium. A 42-year-old woman was admitted to our hospital because of fever, abdominal pain, headache, and right limb weakness. Clinical examination indicated endocarditis and systemic embolisms secondary to a fish bone from the esophagus penetrating into the left atrium. The emergency surgery confirmed the diagnosis. Cultures of blood and vegetation show G adiacens and C albicans. Antimicrobial therapy lasted 6 weeks after surgery. The patient was discharged with excellent condition7 weeks after hospitalization and was well when followed 6 months later. The successful treatment of this patient combines quick diagnosis, timely surgery, and effective antimicrobial regimen. This rare possibility should be kept up in mind in acute infective endocarditis cases. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  11. Extended resections of non-small cell lung cancers invading the aorta, pulmonary artery, left atrium, or esophagus: can they be justified?

    Science.gov (United States)

    Reardon, Emily S; Schrump, David S

    2014-11-01

    T4 tumors that invade the heart, great vessels, or esophagus comprise a heterogenous group of locally invasive lung cancers. Prognosis depends on nodal status; this relationship has been consistently demonstrated in many of the small series of extended resection. Current National Comprehensive Cancer Network guidelines do not recommend surgery for T4 extension with N2-3 disease (stage IIIB). However, biopsy-proven T4 N0-1 (stage IIIA) may be operable. Localized tumors with invasion of the aorta, pulmonary artery, left atrium, or esophagus represent a small subset of T4 disease. Acquiring sufficient randomized data to provide statistical proof of a survival advantage for patients undergoing extended resections for these neoplasms will likely never be possible.Therefore, we are left to critically analyze current documented experience to make clinical decisions on a case-by-case basis.It is clear that the operative morbidity and mortality of extended resections for locally advanced T4 tumors have significantly improved over time,yet the risks are still high. The indications for such procedures and the anticipated outcomes should be clearly weighed in terms of potential perioperative complications and expertise of the surgical team. Patients with T4 N0-1 have the best prognosis and with complete resection may have the potential for cure. The use of induction therapy and surgery for advanced T4 tumors may improve survival. Current data suggest that for tumors that invade the aorta, pulmonary artery,left atrium, or esophagus, resection should be considered in relation to multidisciplinary care.For properly selected patients receiving treatment at high volume, experienced centers, extended resections may be warranted. Published by Elsevier Inc.

  12. Left atrium volume index is influenced by aortic stiffness and central pulse pressure in type 2 diabetes mellitus patients: a hemodynamic and echocardiographic study.

    Science.gov (United States)

    Zapolski, Tomasz; Wysokiński, Andrzej

    2013-03-04

    Left atrial volume index (LAVI) has recently emerged as a useful biomarker for risk stratification and risk monitoring in many clinical settings. Many hemodynamic factors such as preload and afterload have an effect on evaluating left atrium function. This study was performed to investigate the relationship between LAVI and aortic stiffness index (ASI) and selected markers characterizing hemodynamic state in patients with type 2 diabetes mellitus (DM2). The study population consisted of 100 patients (56 men, 44 women), 67.2 (±10.9) years old DM2, scheduled for routine coronary angiography. Standard transthoracic echocardiography was used to measure parameters needed for calculation of LAVI and ASI. During invasive procedures, central pulse pressure (CPP) in the ascendens aorta and left ventricle end-diastolic pressure (LVEDP) were recorded. Selected laboratory parameters were obtained, including lipidogram, serum uric acid, hs-CRP, fibrinogen, cTnT, myoglobin, BNP, HbA1C, creatinine, and GFR. Both LAVI and ASI were greater and CPP and LVEDP were markedly elevated in DM2 patients compared to controls. The independent predictors of LAVI were ASI (ß=0.331; p=0.011), CPP (ß=0.312; p=0.020), LVEDP (ß=0.381; p=0.006), HbA1C (ß=0.379; p=0.008), and BNP (ß=0,423; pDM2 patients.

  13. Paroxysmal postprandial atrial fibrilation suppressed by laparoscopic repair of a giant paraesophageal hernia compressing the left atrium.

    Science.gov (United States)

    Cristian, Daniel A; Constantin, Alin S; Barbu, Mariana; Spătaru, Dan; Burcoș, Traean; Grama, Florin A

    2015-03-01

    We present the case of a patient with a giant paraesophageal hernia associated with paroxysmal postprandial atrial fibrillation that was suppressed after surgery. The imaging investigations showed the intrathoracic displacement of a large part of the stomach, which pushed the left atrial wall causing atrial fibrillation. The laparoscopic surgical repair acted as sole treatment for this condition.

  14. Diagnosing Paroxysmal Atrial Fibrillation in Patients With Ischemic Strokes and Transient Ischemic Attacks Using Echocardiographic Measurements of Left Atrium Function

    DEFF Research Database (Denmark)

    Skaarup, Kristoffer Grundtvig; Christensen, Hanne Krarup; Høst, Nis

    2016-01-01

    Twenty-five to 35 percentage of stroke cases are cryptogenic, and it has been demonstrated that paroxysmal atrial fibrillation (AF) is the causal agent in up to 25% of these incidents. The purpose of this study was to investigate if left atrial (LA) parameters have value for diagnosing paroxysmal...... with paroxysmal AF. However, the atrial measurements evaluating LA function (min LA volume and LA emptying fraction) were significantly different (LA emptying fraction: 45% ± 10% vs 50% ± 10%, p = 0.004; minimal LA volume: 30.2 ml ± 17.3 ml vs 24 ml ± 10 ml, p = 0.035 in patients with paroxysmal AF, even after...

  15. Mechanical dyssynchrony of the left atrium during sinus rhythm is associated with history of stroke in patients with atrial fibrillation.

    Science.gov (United States)

    Ciuffo, Luisa; Inoue, Yuko Y; Tao, Susumu; Gucuk Ipek, Esra; Balouch, Muhammad; Lima, Joao A C; Nazarian, Saman; Spragg, David D; Marine, Joseph E; Berger, Ronald D; Calkins, Hugh; Ashikaga, Hiroshi

    2018-04-01

    We sought to evaluate the relationship between left atrial (LA) mechanical dyssynchrony and history of stroke or transient ischaemic attack (TIA) in patients with atrial fibrillation (AF). We hypothesized that mechanical dyssynchrony of the LA is associated with history of stroke/TIA independent of LA function and Cardiac failure, Hypertension, Age, Diabetes, Stroke/transient ischaemic attack (TIA), VAscular disease, and Sex category (CHA2DS2-VASc) score in patients with AF. We conducted a cross-sectional study of 246 patients with a history of AF (59 ± 10 years, 29% female, 26% non-paroxysmal AF) referred for catheter ablation to treat drug-refractory AF who underwent preablation cardiac magnetic resonance (CMR) in sinus rhythm. Using tissue-tracking CMR, we measured the LA longitudinal strain and strain rate in each of 12 equal-length segments in two- and four-chamber views. We defined indices of LA mechanical dyssynchrony, including the standard deviation of the time to the peak longitudinal strain (SD-TPS). Patients with a prior history of stroke or TIA (n = 23) had significantly higher SD-TPS than those without (n = 223) (39.9 vs. 23.4 ms, P stroke/TIA after adjusting for the CHA2DS2-VASc score, LA minimum index volume, and the peak LA longitudinal strain (P stroke/TIA more accurately than CHA2DS2-VASc score alone (c-statistics: 0.82 vs. 0.75, P stroke/TIA in patients with AF.

  16. Influence of heart rhythm, breathing and arm position during computed tomography scanning on the registration accuracy of electro anatomical map (EAM) images, left atrium three-dimensional computed tomography angiography images, and fluoroscopy time during ablation to treat atrial fibrillation

    International Nuclear Information System (INIS)

    Chono, Taiki; Shimoshige, Shinya; Yoshikawa, Kenta; Mizonobe, Kazuhusa; Ogura, Keishi

    2013-01-01

    In CARTOMERGE for treatment of atrial fibrillation (AF) by ablation, by integrating electro anatomical map (EAM) and left atrium three-dimensional computed tomography angiography (3D-CTA) images, identification of the ablation points is simplified and the procedure can be made carried out more rapidly. However, the influence that heart rhythm, breathing and arm position during CT scanning have on registration accuracy and fluoroscopy time is not clear. To clarify the influence on registration accuracy and fluoroscopy time of heart rhythm, breathing and arm position during CT scanning. The patients were CT-scanned during both sinus rhythm (SR) and AF in each study subject. We evaluated the registration accuracy of images reconstructed between the cardiac cycle and assessed the registration accuracy and fluoroscopy time of images obtained during inspiratory breath-hold, expiratory breath-hold and up and down position of the arm. Although the registration accuracy of the EAM image and left atrium 3D-CTA image showed a significant difference during SR, no significant difference was seen during AF. Expiratory breath-hold and down position of the arm resulted in the highest registration accuracy and the shortest fluoroscopy time. However, arm position had no significant effect on registration accuracy. Heart rhythm and breathing during CT scanning have a significant effect on the registration accuracy of EAM images, left atrium 3D-CTA images, and fluoroscopy time. (author)

  17. MDCT Evaluation of Left Atrium and Pulmonary Vein in the Patients with Atrial Fibrillation: Comparison with the Non-Atrial Fibrillation Group

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won Jung; Choi, Eun Jeong; Ham, Soo Yeon; Oh, Yu Whan; Kim, Young Hoon [Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Yong, Hwan Seok [Korea University Guro Hospital, Seoul (Korea, Republic of); Yang, Kyung Sook [Korea University, Seoul (Korea, Republic of)

    2011-02-15

    The anatomy of the left atrium (LA) and the pulmonary veins (PVs) is important in planning and performing successful electrophysiologic ablation (EPA) for atrial fibrillation (Afib) patients. The authors estimated the findings of LA and PVs of Afib patients by MDCT, and compared these with the findings of LA and PVs of the non- Afib group using coronary CT angiography (CCTA). From September, 2009 to February, 2010, 91 Afib patients underwent PVCT (male: female = 72:19, mean age = 55.0-years-old) before EPA. At same time, 90 patients underwent CCTA (male: female = 73:17, mean age = 59.1- years-old). Two radiologists reviewed and analyzed all axial and 3D images of LA and PVs retrospectively with consensus. The average LA volumes of the Afib group(100.49 mm3) was larger than that of the non-Afib group (78.38 mm3) (p<0.05). The average lengths of the LA right wall in the Afib group (40.25 mm) was longer than that of the non-Afib group (37.3 mm) (p<0.05). The average distances between the PV ostium and first segmental bifurcation of the Lt superior PV (LSPV) and the RSPV were shorter in the Afib group (LSPV, 19.38 mm: RSPV, 11.49 mm) than in the non-Afib group (LSPV, 23.23 mm: RSPV, 14.25 mm) (p<0.05). There were higher incidences of anomalous branches such as ostial, accessory branches, or common ostia in the Afib group versus the non-Afib group (p<0.05). In Afib group, variable parameters of LA and PVs were obtained and estimated by MDCT, and there was statistically significant difference in the parameters of LA and PVs between Afib and non-Afib groups

  18. MDCT Evaluation of Left Atrium and Pulmonary Vein in the Patients with Atrial Fibrillation: Comparison with the Non-Atrial Fibrillation Group

    International Nuclear Information System (INIS)

    Kim, Won Jung; Choi, Eun Jeong; Ham, Soo Yeon; Oh, Yu Whan; Kim, Young Hoon; Yong, Hwan Seok; Yang, Kyung Sook

    2011-01-01

    The anatomy of the left atrium (LA) and the pulmonary veins (PVs) is important in planning and performing successful electrophysiologic ablation (EPA) for atrial fibrillation (Afib) patients. The authors estimated the findings of LA and PVs of Afib patients by MDCT, and compared these with the findings of LA and PVs of the non- Afib group using coronary CT angiography (CCTA). From September, 2009 to February, 2010, 91 Afib patients underwent PVCT (male: female = 72:19, mean age = 55.0-years-old) before EPA. At same time, 90 patients underwent CCTA (male: female = 73:17, mean age = 59.1- years-old). Two radiologists reviewed and analyzed all axial and 3D images of LA and PVs retrospectively with consensus. The average LA volumes of the Afib group(100.49 mm3) was larger than that of the non-Afib group (78.38 mm3) (p<0.05). The average lengths of the LA right wall in the Afib group (40.25 mm) was longer than that of the non-Afib group (37.3 mm) (p<0.05). The average distances between the PV ostium and first segmental bifurcation of the Lt superior PV (LSPV) and the RSPV were shorter in the Afib group (LSPV, 19.38 mm: RSPV, 11.49 mm) than in the non-Afib group (LSPV, 23.23 mm: RSPV, 14.25 mm) (p<0.05). There were higher incidences of anomalous branches such as ostial, accessory branches, or common ostia in the Afib group versus the non-Afib group (p<0.05). In Afib group, variable parameters of LA and PVs were obtained and estimated by MDCT, and there was statistically significant difference in the parameters of LA and PVs between Afib and non-Afib groups

  19. Mitral Annulus Myxoma Extending into Left Atrium and Left Ventricle with Severe Mitral Regurgitation as a Pre-Operative Finding, a Rarity

    Directory of Open Access Journals (Sweden)

    Hamza Abdur Rahim Khan

    2017-06-01

    Full Text Available Cardiac tumors constitute 0.2% of all tumors. Primary cardiac tumors occur infrequently with an incidence of 0.0017-0.19% as shown by autopsies performed in non-selected populations. Among these tumors, cardiac myxomas are most commonly encountered, with left atrial myxomas being more prevalent than right atrial ones. The classic triad of symptoms, of which at least one is present in a patient with atrial myxoma, are obstructive traits including dyspnea and syncope, constitutional symptoms such as fever and anorexia, and thromboembolic events. Surgical resection confers almost definitive treatment with recurrence rates being as low as 3%. A 50-year-old woman referred to the Emergency Unit with a sudden episode of chest heaviness and shortness of breath. There was no significant physical examination finding and all routine lab investigations were normal. She underwent an angiography that revealed tight left anterior descending artery stenosis. An angioplasty was also performed, but she had an episode of presyncope immediately. Then, echocardiogram was performed that showed a large left atrial myxoma causing severe mitral regurgitation. Thus, urgent open heart surgery was planned. The myxoma was identified and excised, the mitral annulus resolved, and normal flow was restored. The patient was then discharged home and followed up for 2 months with no complaints. In the current study, we reported a rare case where mitral regurgitation was caused by a left atrial myxoma. Our report highlighted the diverse clinical spectrum of myxoma and emphasized the need for early echocardiographic diagnosis to aid in identification of myxoma followed by early surgical intervention.

  20. The impact of the CartoSound® image directly acquired from the left atrium for integration in atrial fibrillation ablation.

    Science.gov (United States)

    Kaseno, Kenichi; Hisazaki, Kaori; Nakamura, Kohki; Ikeda, Etsuko; Hasegawa, Kanae; Aoyama, Daisetsu; Shiomi, Yuichiro; Ikeda, Hiroyuki; Morishita, Tetsuji; Ishida, Kentaro; Amaya, Naoki; Uzui, Hiroyasu; Tada, Hiroshi

    2018-04-14

    Intracardiac echocardiographic (ICE) imaging might be useful for integrating three-dimensional computed tomographic (CT) images for left atrial (LA) catheter navigation during atrial fibrillation (AF) ablation. However, the optimal CT image integration method using ICE has not been established. This study included 52 AF patients who underwent successful circumferential pulmonary vein isolation (CPVI). In all patients, CT image integration was performed after the CPVI with the following two methods: (1) using ICE images of the LA derived from the right atrium and right ventricular outflow tract (RA-merge) and (2) using ICE images of the LA directly derived from the LA added to the image for the RA-merge (LA-merge). The accuracy of these two methods was assessed by the distances between the integrated CT image and ICE image (ICE-to-CT distance), and between the CT image and actual ablated sites for the CPVI (CT-to-ABL distance). The mean ICE-to-CT distance was comparable between the two methods (RA-merge = 1.6 ± 0.5 mm, LA-merge = 1.7 ± 0.4 mm; p = 0.33). However, the mean CT-to-ABL distance was shorter for the LA-merge (2.1 ± 0.6 mm) than RA-merge (2.5 ± 0.8 mm; p imaging, and whereas the greatest CT-to-ABL distance was observed at the roof portion of the left superior PV (3.7 ± 2.8 mm) after the RA-merge, it improved to 2.6 ± 1.9 mm after the LA-merge (p images of the LA directly acquired from the LA might lead to a greater accuracy of the CT image integration for the CVPI.

  1. Circumferential lesion formation around the pulmonary veins in the left atrium with focused ultrasound using a 2D-array endoesophageal device: a numerical study

    Energy Technology Data Exchange (ETDEWEB)

    Pichardo, Samuel; Hynynen, Kullervo [Imaging Research-Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room C713, Toronto, ON M4N 3M5 (Canada)

    2007-08-21

    Atrial fibrillation (AF) is the most frequently sustained cardiac arrhythmia affecting humans. The electrical isolation by ablation of the pulmonary veins (PVs) in the left atrium (LA) of the heart has been proven as an effective cure of AF. The ablation consists mainly in the formation of a localized circumferential thermal coagulation of the cardiac tissue surrounding the PVs. In the present numerical study, the feasibility of producing the required circumferential lesion with an endoesophageal ultrasound probe is investigated. The probe operates at 1 MHz and consists of a 2D array with enough elements (114 x 20) to steer the acoustic field electronically in a volume comparable to the LA. Realistic anatomical conditions of the thorax were considered from the segmentation of histological images of the thorax. The cardiac muscle and the blood-filled cavities in the heart were identified and considered in the sound propagation and thermal models. The influence of different conditions of the thermal sinking in the LA chamber was also studied. The circumferential ablation of the PVs was achieved by the sum of individual lesions induced with the proposed device. Different scenarios of lesion formation were considered where ultrasound exposures (1, 2, 5 and 10 s) were combined with maximal peak temperatures (60, 70 and 80 {sup 0}C). The results of this numerical study allowed identifying the limits and best conditions for controlled lesion formation in the LA using the proposed device. A controlled situation for the lesion formation surrounding the PVs was obtained when the targets were located within a distance from the device in the range of 26 {+-} 7 mm. When combined with a maximal temperature of 70 {sup 0}C and an exposure time between 5 and 10 s, this distance ensured preservation of the esophageal structures, controlled lesion formation and delivery of an acoustic intensity at the transducer surface that is compatible with existing materials. With a peak

  2. Three-dimensional rotational angiography of the left atrium and the oesophagus: the short-term mobility of the oesophagus and the stability of the fused three-dimensional model of the left atrium and the oesophagus during catheter ablation for atrial fibrillation.

    Science.gov (United States)

    Starek, Zdenek; Lehar, Frantisek; Jez, Jiri; Scurek, Martin; Wolf, Jiri; Kulik, Tomas; Zbankova, Alena; Novak, Miroslav

    2017-08-01

    The objective of this study was to evaluate the mobility of the oesophagus and the stability of the three-dimensional (3D) model of the oesophagus using 3D rotational angiography (3DRA) of the left atrium (LA) and the oesophagus, fused with live fluoroscopy during catheter ablation for atrial fibrillation. From March 2015 to September 2015, 3DRA of the LA and the oesophagus was performed in 33 patients before catheter ablation for atrial fibrillation. Control contrast oesophagography was performed every 30 min. The positions of the oesophagograms and the 3D model of the LA and the oesophagus were repeatedly measured and compared with the spine. The average shift of the oesophagus ranged from 2.7 ± 2.2 to 5.0 ± 3.5 mm. The average real-time oesophageal shift ranged from 2.7 ± 2.2 to 3.8 ± 3.4 mm. No significant shift was detected until the 90th minute of the procedure. The average shift of the 3D model of the LA and the oesophagus ranged from 1.4 ± 1.8 to 3.3 ± 3.0 mm (right-left direction) and from 0.9 ± 1.2 to 2.2 ± 1.3 mm (craniocaudal direction). During the 2 h procedure, there were no significant shifts of the model. During catheter ablation for atrial fibrillation, there is no significant change in the position of the oesophagus until the 90th minute of the procedure and no significant shift in the 3D model of the LA and the oesophagus. The 3D model of the oesophagus reliably depicts the position of the oesophagus during the entire procedure. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  3. The role of Multidetector CT in the evaluation of the left atrium and pulmonary veins anatomy before and after radio-frequency catheter ablation for atrial fibrillation. Preliminary results and work in progress.Technical note

    International Nuclear Information System (INIS)

    Centoze, Maurizio; Della Sala, Sabino Walter; Dalla Palma, Francesco; Del Greco, Maurizio; Marini, Massimiliano; Nollo, Giandomenico; Ravelli, Flavia

    2005-01-01

    Radio-frequency catheter ablation (RFCA) of the distal pulmonary veins is increasingly being used to treat recurrent or refractory atrial fibrillation that doesn't respond to pharmacologic therapy or cardioversion. Successful RFCA of atrial al fibrillation depends on the pre-procedural understanding of the complex anatomy of the distal pulmonary veins and the left atrium. Aim of this parer is to describe the technical main features that characterise the multidetector helical computed tomography in the evaluation of this anatomic region before and after RFCA procedure. The 3D post-processing techniques useful for pre-RFCA planning are straightforward [it

  4. A cooled intraesophageal balloon to prevent thermal injury during endocardial surgical radiofrequency ablation of the left atrium: a finite element study

    Energy Technology Data Exchange (ETDEWEB)

    Berjano, Enrique J [Center for Research and Innovation on Bioengineering, Valencia Polytechnic University, Camino de Vera s/n, 46022 Valencia (Spain); Hornero, Fernando [Cardiac Surgery Department, Valencia University General Hospital, Avd Tres Cruces s/n, 46014, Valencia (Spain)

    2005-10-21

    Recent clinical studies on intraoperative monopolar radiofrequency ablation of atrial fibrillation have reported some cases of injury to the esophagus. The aim of this study was to perform computer simulations using three-dimensional finite element models in order to investigate the feasibility of a cooled intraesophageal balloon appropriately placed to prevent injury. The models included atrial tissue and a fragment of esophagus and lung linked by connective tissue. The lesion depth in the esophagus was assessed using a 50 deg. C isotherm and expressed as a percentage of thickness of the esophageal wall. The results are as follows: (1) chilling the esophagus by means of a cooled balloon placed in the lumen minimizes the lesion in the esophageal wall compared to the cases in which no balloon is used (a collapsed esophagus) and with a non-cooled balloon; (2) the temperature of the cooling fluid has a more significant effect on the minimization of the lesion than the rate of cooling (the thermal transfer coefficient for forced convection); and (3) pre-cooling periods previous to RF ablation do not represent a significant improvement. Finally, the results also suggest that the use of a cooled balloon could affect the transmurality of the atrial lesion, especially in the cases where the atrium is of considerable thickness. (note)

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

    Directory of Open Access Journals (Sweden)

    Donboklang Lynser

    2015-11-01

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

  6. [Effects of 2-(p-dimethylaminostyryl) pyridine methycholide (DSPM-Ci) on ECG, left atrium contractivity and on papillary muscle action potentials].

    Science.gov (United States)

    Jiang, X Y; Zhou, C M; Li, D M; Zhang, K J

    1996-01-01

    The effects of DSPM-Cl on ECG in rats, on the dose-effect curve in guinea pig left atria and on the fast action potential (AP), high-K+ depolarized slow action potential (SAP) in guinea pigs papillary muscle were examined electrophysiologically. DSPM-Cl (2 mg.kg-1) showed significant nagative frequency, negative conductivity effect, and prolonged the PP and PR interval. DSPM-CI (30-50 mumol.L-1) was shown to inhibit left atria contractility and shift the concentration-response curve of Iso and CaCl2 to the right with PD2' values of 4.60 and 4.13, respectively. In addition, DSPM-Cl was found to prolong the duration of action potential 90 (APD90) and effective refractory period (ERP), and decrease the maximal upstroke velocity (Vmax) in K(+)-depolarized guinea pigs papillary muscles. The results suggest that, like verpamil, DSPM-Cl might be a calcium antagonist.

  7. Preferential streaming of the ductus venosus toward the right atrium is associated with a worse outcome despite a higher rate of invasive procedures in human fetuses with left diaphragmatic hernia.

    Science.gov (United States)

    Stressig, R; Fimmers, R; Schaible, T; Degenhardt, J; Axt-Fliedner, R; Gembruch, U; Kohl, T

    2013-12-01

    Preferential streaming of the ductus venosus (DV) toward the right atrium has been observed in fetuses with left diaphragmatic hernia (LDH). The purpose of this retrospective study was to compare survival rates to discharge between a group with preferential streaming of the DV toward the right heart and a group in which this abnormal flow pattern was not present. We retrospectively searched our patient records for fetuses with LDH in whom liver position, DV streaming and postnatal outcome information was available. 55 cases were found and divided into two groups: Group I fetuses exhibited abnormal DV streaming toward the right side of the heart; group II fetuses did not. Various prognostic and outcome parameters were compared. 62 % of group I fetuses and 88 % of group II fetuses survived to discharge (p = 0.032). Fetoscopic tracheal balloon occlusion (FETO) was performed in 66 % of group I fetuses and 23 % of group II fetuses (p = 0.003). Postnatal ECMO therapy was performed in 55 % of group I fetuses and 23 % of group II infants (p = 0.025). Moderate to severe chronic lung disease in survivors was observed in 56 % of the survivors of group I and 9 % of the survivors of group II (p = 0.002). Preferential streaming of the DV toward the right heart in human fetuses with left-sided diaphragmatic hernia was associated with a poorer postnatal outcome despite a higher rate of invasive pre- and postnatal procedures compared to fetuses without this flow abnormality. Specifically, abnormal DV streaming was found to be an independent predictor for FETO. © Georg Thieme Verlag KG Stuttgart · New York.

  8. Resección de un carcinoma renal izquierdo con extensión trombótica hacia la aurícula derecha Resection of a left renal carcinoma with thrombotic extension to right atrium

    Directory of Open Access Journals (Sweden)

    Alejandro Villar Inclán

    2010-09-01

    Full Text Available Se presenta el caso de un hombre de 59 años con diagnóstico de hipernefroma izquierdo y trombosis de la vena cava inferior con extensión hacia la aurícula derecha. Un equipo multidisciplinario realizó una nefrectomía radical izquierda, exposición de la vena cava inferior con técnica de piggyback, atriotomía derecha y cavotomía inferior para extracción del trombo, previo pinzamiento de la vena renal derecha y el hilio hepático. El tiempo quirúrgico total fue de 7 h 30 min. El procedimiento se realizó con anestesia general y un período mínimo de derivación cardiopulmonar. Se utilizó monitorización transoperatoria estandarizada de los parámetros vitales y además ecocardiografía transesofágica para la detección de la remoción completa del trombo y su extracción, así como posibles émbolos desprendidos. La evolución transoperatoria y posoperatoria fue satisfactoria. Se realiza una revisión de la literatura médica internacional sobre el tema y se ofrecen conclusiones.This is the male case aged 59 diagnosed with left hypernephroma and thrombosis of the inferior vena cava with extension to right atrium. A multidisciplinary staff performed a left radical nephrectomy, exposition of inferior vena cava using the piggyback technique, right atriotomy and inferior cavotomy for extension of thrombus and previous clamping of right renal vein and hepatic hilus. The total surgical time was of 7 hours and 30 minutes. The procedure was performed under general anesthesia and a minimal period of cardiopulmonary shunt. Standardized transoperative monitoring of vital parameters was used and also transesophageal echocardiography to detect the total removal of thrombus and its extraction, as well as the potential detached emboli. The transoperative and postoperative course was satisfactory. A review of the international medical literature on this subject was made offering conclusions.

  9. Acesso transeptal vertical ampliado em reoperações valvares mitrais com átrio esquerdo pequeno Extended vertical transseptal approach in mitral valve reoperation with a small left atrium

    Directory of Open Access Journals (Sweden)

    Walter Vosgrau Fagundes

    2004-03-01

    Full Text Available OBJETIVO: Avaliar a abordagem transeptal vertical ampliada em reoperações da valva mitral com átrio esquerdo pequeno. MÉTODO: De janeiro de 2001 a dezembro de 2002, 15 pacientes portadores de doença valvar mitral com indicação de reintervenção cirúrgica, átrio esquerdo pequeno (menor ou igual a 4,0 cm e fibrilação atrial crônica, foram submetidos à abordagem transeptal vertical ampliada da valva mitral. Nove pacientes (pt eram do sexo feminino. A idade variou de 22 a 48 anos. As indicações cirúrgicas foram: disfunção de prótese mitral (seis pt; insuficiência mitral (cinco pt e dupla lesão mitral (quatro pt. Três pacientes apresentavam insuficiência aórtica associada e um pt, insuficiência tricúspide. Nove (60% pacientes encontravam-se em ICC CF III da NYHA e seis (40%, em CF IV. RESULTADOS: A exposição do aparelho valvar mitral foi excelente. O tempo de circulação extracorpórea variou de 65 a 150 min (média = 95min. Foram implantadas próteses em todos os pacientes (15 mitrais, três aórticas e um tricúspide. A mortalidade hospitalar foi de 6,7%, com um óbito devido a baixo débito cardíaco e falência de múltiplos órgãos. Um (6,7% paciente apresentou broncopneumonia na fase hospitalar. Dez pacientes permaneceram com fibrilação atrial, três pt reverteram para ritmo sinusal e um evoluiu com ritmo juncional. A permanência hospitalar média foi de 8,2 dias. Doze (85,7% pacientes encontram-se em CF I e dois (14,3% em CF II. A curva atuarial de sobrevida é de 92,5 % em 22 meses de seguimento. CONCLUSÃO: A técnica cirúrgica empregada proporciona excelente visibilização do aparelho valvar mitral, com baixo índice de complicações.OBJECTIVE: To evaluate the efficacy of the extended vertical transseptal approach in mitral valve reoperation with a small left atrium. METHOD: From January 2001 to December 2002, 15 patients with previous mitral operations, small left atrium and atrial fibrillation

  10. Anomalía del retorno venoso sistémico Drenaje anómalo de la vena cava superior derecha a la aurícula izquierda: Revisión de la literatura y reporte de caso Anomalous systemic venous return. Anomalous drainage of the right superior vena cava into the left atrium: Review of literature and case report

    Directory of Open Access Journals (Sweden)

    Ríos Giovanny

    2012-06-01

    Full Text Available La anomalía total del retorno venoso sistémico tiene gran variedad de presentaciones; sin embargo, la patología de más baja frecuencia es el drenaje de vena cava superior derecha a la aurícula izquierda, hecho de peso para que en el mundo se reporten pocos casos. En la Fundación Clínica Abood Shaio se trató el caso de una paciente de seis años de edad con drenaje venoso total de cava superior derecha a la aurícula izquierda, mediante la técnica de movilización de cava superior y anastomosis cavo-atrial, y se obtuvieron buenos resultados. El caso es mención corresponde al número 21 en la literatura mundial.Total anomalous systemic venous return has a variety of presentations, being the drainage of right superior vena cava into the left atrium a low frequency condition. There are few reported cases in the world. In Shaio Clinic Foundation we have handled a case of total venous drainage of the right superior vena cava into the left atrium in a 6-year old girl, using the superior vena cava mobilization technique and cavo-atrial anastomosis, with good results. This case is reported as case number 21 in the world.

  11. Spectroscopic photoacoustic imaging of radiofrequency ablation in the left atrium

    NARCIS (Netherlands)

    S. Iskander-Rizk (Sophinese); P. Kruizinga (Pieter); A.F.W. van der Steen (Ton); G. van Soest (Gijs)

    2018-01-01

    textabstractCatheter-based radiofrequency ablation for atrial fibrillation has long-term success in 60-70% of cases. A better assessment of lesion quality, depth, and continuity could improve the procedure’s outcome. We investigate here photoacoustic contrast between ablated and healthy atrial-wall

  12. New Engineering Principles in Atrium Smoke Management

    DEFF Research Database (Denmark)

    Valkvist, Morten Birk Sabroe

    A typical atrium smoke management setup was divided into characteristic flow regions; axisymmetric plume, ceiling jet/approach flow, rotation region and spill plume. A grid convergence study was conducted on each of the flow regions in order to determine the non-dimensional grid resolution required...

  13. Investigating atrium in hot and humid climate and providing ...

    African Journals Online (AJOL)

    Atrium has thermal comfort space since the old time by two methods of greenhouse effect and chimney effect. Now these questions are raised: What impact does atrium have in terms of performance in reducing energy consumption in buildings and how is the performance of atrium in the hot and humid climate, and how it ...

  14. Increased FDG uptake in the wall of the right atrium in people who participated in a cancer screening program with whole-body PET

    International Nuclear Information System (INIS)

    Fujii, Hirofumi; Ide, Michiru; Yasuda, Seiei; Takahashi, Wakoh; Shohtsu, Akira; Kubo, Atsushi

    1999-01-01

    The purpose of this study was to evaluate the characteristics of patients who showed increased FDG uptake in the wall of the right atrium. We have encountered 10 patients with increased activity in the wall of the right atrium among a total of 2,367 examinees who participated in our cancer screening program with whole-body PET. The mean age of these examinees was 62.9 yr, higher than that of the total population. All suffered from cardiac disorders, especially atrial fibrillation. FDG accumulated almost exclusively in the wall of the right atrium, whereas only slight activity was seen in the wall of the left atrium. Although the average size of the right atria was significantly enlarged, left atria were more severely dilated than right ones. Therefore overload does not seem to account for the FDG accumulation in the wall of the right atrium. In conclusion, the increased activity in the wall of the right atrium was a rare finding that was made in older people who suffered from cardiac disease. Although the mechanism of induction of the high metabolic state of glucose in the wall of the right atrium remains unclear, this unusual activity would be another false positive finding in cancer screening with whole-body FDG PET. (author)

  15. The role of Multidetector CT in the evaluation of the left atrium and pulmonary veins anatomy before and after radio-frequency catheter ablation for atrial fibrillation. Preliminary results and work in progress.Technical note; Il ruolo della TC Multidetettore nella valutazione anatomica dell'atrio sinistro e delle vene polmonari prima e dopo ablazione percutanea con radiofrequenza della fibrillazione atriale. Risultati preliminari e work in progress

    Energy Technology Data Exchange (ETDEWEB)

    Centoze, Maurizio; Della Sala, Sabino Walter; Dalla Palma, Francesco [Azienda Provinciale per i servizi sanitari, Trento (Italy). Dipartimento di radiodiagnostica; Del Greco, Maurizio; Marini, Massimiliano [Ospedale S. Chiara, Trento (Italy). U.O. di cardiologia; Nollo, Giandomenico; Ravelli, Flavia [Trento Univ., Trento (Italy). Dipartimento di fisica

    2005-07-15

    Radio-frequency catheter ablation (RFCA) of the distal pulmonary veins is increasingly being used to treat recurrent or refractory atrial fibrillation that doesn't respond to pharmacologic therapy or cardioversion. Successful RFCA of atrial al fibrillation depends on the pre-procedural understanding of the complex anatomy of the distal pulmonary veins and the left atrium. Aim of this parer is to describe the technical main features that characterise the multidetector helical computed tomography in the evaluation of this anatomic region before and after RFCA procedure. The 3D post-processing techniques useful for pre-RFCA planning are straightforward. [Italian] La ablazione percutanea con radiofrequenza (RFCA) del tratto distale delle vene polmonari nella fibrillazione atriale, che non risponde al trattamento farmacologico e alla cardioversione elettrica, e una procedura in grande sviluppo. Il successo del trattamento dipende dalla comprensione della complessa anatomia delle vene polmonari e dell'atrio sinistro. Lo scopo di questo articolo e illustrare gli aspetti tecnici fondamentali che caratterizzano lo studio di questa regione anatomica con TC spirale multidetettore prima e dopo RFCA. Particolare risalto e stato rivolto alle tecniche di post-processing 3D estremamente utili nella pianificazione della procedura di ablazione.

  16. Beoordeling RWA-installatie Atrium Vertigo: Rookverspreiding door het gebouw

    NARCIS (Netherlands)

    Neuhaus, E.

    2004-01-01

    Het atrium van het Vertigo-gebouw is bouwkundig bedoeld als één groot brandcompartiment. De schuifdeuren en ramen naar aanliggende vertrekken staan echter vaak open. Hierdoor kan de rook zich in het geval van een brand in het atrium gemakkelijk door het gebouw verspreiden door een overdruk in het

  17. Resectable hepatoblastoma with tumor thrombus extending into the right atrium after chemotherapy: A case report

    Directory of Open Access Journals (Sweden)

    Kosuke Endo

    2016-04-01

    Full Text Available Hepatoblastoma with intraatrial tumor thrombus is relatively rare. We report a case of hepatoblastoma with tumor thrombus extending into the right atrium, which responded well to chemotherapy and was resected using extracorporeal circulation. A 4-year-old girl was referred to our hospital because of abdominal distention and tenderness. A computed tomography (CT scan showed a large tumor occupying the left 3 segments of the liver with tumor thrombus extending into the right atrium. There was also a small intrahepatic metastasis in the right lobe of the liver. She was diagnosed with hepatoblastoma on the basis of the results of open biopsy. Neoadjuvant chemotherapy with an intense CDDP-based regimen was performed. The tumor responded well to chemotherapy, and intrahepatic metastasis became undetectable on CT scan, although the tumor thrombus remained in the right atrium. After 7 courses of chemotherapy, we performed resection using extracorporeal circulation. The postoperative course was uneventful, and adjuvant chemotherapy was started 10 days after the operation. Her serum alpha-fetoprotein (AFP level decreased to the normal range, and she was free of disease for 1 year after the operation. Tumor resection using extracorporeal circulation can be performed safely and is justified in patients with intraatrial tumor thrombus.

  18. Case Report: Giant Right Atrium in Rheumatic Mitral Disease

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    Deniz Demir

    2014-06-01

    Full Text Available Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. Dilatation of the atriums which occurs slowly in time, becomes evident with ritim disturbances and embolic events. We report a case of an unusual giant right atrium in context of rheumatic mitral stenosis, mitral regurgitation, pulmonar hypertansion and severe tricuspid regurgitation in a 40-year-old man who underwent succesfull operations as mitral valve replacement, Maze-IV radiofrequency ablation, right atrium atrioplasty and De Vega anuloplasty. [J Contemp Med 2014; 4(2.000: 98-102

  19. Dataset on the energy performance of atrium type hotel buildings.

    Science.gov (United States)

    Vujosevic, Milica; Krstic-Furundzic, Aleksandra

    2018-04-01

    The data presented in this article are related to the research article entitled "The Influence of Atrium on Energy Performance of Hotel Building" (Vujosevic and Krstic-Furundzic, 2017) [1], which describes the annual energy performance of atrium type hotel building in Belgrade climate conditions, with the objective to present the impact of the atrium on the hotel building's energy demands for space heating and cooling. This dataset is made publicly available to show energy performance of selected hotel design alternatives, in order to enable extended analyzes of these data for other researchers.

  20. Inflammatory Myofibroblastic Tumor of the Right Atrium

    Directory of Open Access Journals (Sweden)

    Neerod K. Jha

    2010-01-01

    Full Text Available Cardiac inflammatory myofibroblastic tumor (IMT is a rare entity and is associated with distinct clinical, pathological and molecular features. The clinical behavior, natural history, biological potential, management and prognosis of such tumors are unclear. We present herewith an adolescent girl who presented with similar entity involving the junction of the right atrium and the inferior vena cava (IVC in association with thrombocytosis and IVC thrombosis leading to obstruction of blood flow. Diagnostic tools included imaging and immuno-histopathology studies. Surgical management included resection of the tumor and thrombo-embolectomy of the IVC under cardiopulmonary bypass. This case is unique due to association of complete obstruction of IVC caused by the strategic location of the tumor, thrombosis of vena cava and association of thrombocytosis. These features have not been reported yet in relation to the cardiac IMT. This report will help in better understanding and management of similar cases in terms of planning cannulation of femoral veins or application of total hypothermic circulatory arrest during cardiopulmonary bypass and prompt us to look for recurrence or metastasis during follow up using echocardiography and laboratory investigations. The possibility of IMT should be kept in the differential diagnosis of cardiac tumors especially in children and adolescents.

  1. Left Atrial Decompression by Percutaneous Left Atrial Venting Cannula Insertion during Venoarterial Extracorporeal Membrane Oxygenation Support

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    Ha Eun Kim

    2016-06-01

    Full Text Available Patients with venoarterial extracorporeal membrane oxygenation (ECMO frequently suffer from pulmonary edema due to left ventricular dysfunction that accompanies left heart dilatation, which is caused by left atrial hypertension. The problem can be resolved by left atrium (LA decompression. We performed a successful percutaneous LA decompression with an atrial septostomy and placement of an LA venting cannula in a 38-month-old child treated with venoarterial ECMO for acute myocarditis.

  2. Daylighting in linear atrium buildings at high latitudes

    Energy Technology Data Exchange (ETDEWEB)

    Matusiak, Barbara

    1998-12-31

    This thesis proposes new criteria for visual comfort based on knowledge of visual perception and a method for estimating the modelling ability of light by using inter-reflection calculations. Simplified calculations are presented for the daylight factor in linear building structures, using the projected solid angle principle, for uniform sky and for CIE overcast sky conditions. The calculations are compared with experimental results. Simple diagrams are created based on calculations of the mean daylight factor in rooms adjacent to a narrow street. These diagrams and presented formulas and tables can be used as a simple design tool. Daylighting strategies for linear atrium buildings at high latitudes are developed and examined. These strategies are divided into three groups: (1) the atrium space and facades as light conductor/reflector, (2) the glass roof as a light conductor, and (3) light reflectors on the neighbouring roof. The atrium space and facade strategies are subdivided into passive and active. The strategies connected to the glazed roof includes different configurations of glazing: horizontal, single pitched, double pitched, and the use of laser cut panels and prismatic panels in the glazed roof. The shapes of reflectors on the neighbouring roof are a flat reflector, a parabolic reflector and a parabolic concentrator. Strategies from all three groups are examined on a physical model of scale 1:20 in the artificial sky of mirror box type. Simulations with artificial sun have also been done. The results from model studies are compared with computer simulations. All the active daylighting systems designed for use in the atrium space or on the atrium facades have a huge potential for use in atrium buildings. From the strategies connected with the glazed roof the negatively sloped glass is found to be the best alternative for glazed roofs at high latitudes. Among the roof reflectors, the flat one performs best. 82 refs., 122 figs., 27 tabs.

  3. Massively dilated right atrium masquerading as a mediastinal tumor

    Directory of Open Access Journals (Sweden)

    Thomas Schroeter

    2011-04-01

    Full Text Available Severe tricuspid valve insufficiency causes right atrial dilatation, venous congestion, and reduced atrial contractility, and may eventually lead to right heart failure. We report a case of a patient with severe tricuspid valve insufficiency, right heart failure, and a massively dilated right atrium. The enormously dilated atrium compressed the right lung, resulting in a radiographic appearance of a mediastinal tumor. Tricuspid valve repair and reduction of the right atrium was performed. Follow up examination revealed improvement of liver function, reduced peripheral edema and improved New York Heart Association (NYHA class. The reduction of the atrial size and repair of the tricuspid valve resulted in a restoration of the conduit and reservoir function of the right atrium. Given the chronicity of the disease process and the long-standing atrial fibrillation, there is no impact of this operation on right atrial contraction. In combination with the reconstruction of the tricuspid valve, the reduction atrioplasty will reduce the risk of thrombembolic events and preserve the right ventricular function.

  4. Atrial fibrillation: effects beyond the atrium?

    Science.gov (United States)

    Wijesurendra, Rohan S; Casadei, Barbara

    2015-03-01

    Atrial fibrillation (AF) is the most common sustained clinical arrhythmia and is associated with significant morbidity, mostly secondary to heart failure and stroke, and an estimated two-fold increase in premature death. Efforts to increase our understanding of AF and its complications have focused on unravelling the mechanisms of electrical and structural remodelling of the atrial myocardium. Yet, it is increasingly recognized that AF is more than an atrial disease, being associated with systemic inflammation, endothelial dysfunction, and adverse effects on the structure and function of the left ventricular myocardium that may be prognostically important. Here, we review the molecular and in vivo evidence that underpins current knowledge regarding the effects of human or experimental AF on the ventricular myocardium. Potential mechanisms are explored including diffuse ventricular fibrosis, focal myocardial scarring, and impaired myocardial perfusion and perfusion reserve. The complex relationship between AF, systemic inflammation, as well as endothelial/microvascular dysfunction and the effects of AF on ventricular calcium handling and oxidative stress are also addressed. Finally, consideration is given to the clinical implications of these observations and concepts, with particular reference to rate vs. rhythm control. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Cardiology.

  5. Total anomalous systemic venous drainage in left heterotaxy syndrome.

    Science.gov (United States)

    Khandenahally, Ravindranath S; Deora, Surender; Math, Ravi S

    2013-04-01

    Total anomalous systemic venous drainage is an extremely rare congenital heart defect. In this study we describe an 11-year-old girl who presented with a history of fatigue and central cyanosis that she had had since early childhood with unremarkable precordial examination results. Investigations revealed left heterotaxy with all systemic venous drainage to the left-sided atrium with non-compaction of the left ventricle.

  6. Simulation of left atrial function using a multi-scale model of the cardiovascular system.

    Directory of Open Access Journals (Sweden)

    Antoine Pironet

    Full Text Available During a full cardiac cycle, the left atrium successively behaves as a reservoir, a conduit and a pump. This complex behavior makes it unrealistic to apply the time-varying elastance theory to characterize the left atrium, first, because this theory has known limitations, and second, because it is still uncertain whether the load independence hypothesis holds. In this study, we aim to bypass this uncertainty by relying on another kind of mathematical model of the cardiac chambers. In the present work, we describe both the left atrium and the left ventricle with a multi-scale model. The multi-scale property of this model comes from the fact that pressure inside a cardiac chamber is derived from a model of the sarcomere behavior. Macroscopic model parameters are identified from reference dog hemodynamic data. The multi-scale model of the cardiovascular system including the left atrium is then simulated to show that the physiological roles of the left atrium are correctly reproduced. This include a biphasic pressure wave and an eight-shaped pressure-volume loop. We also test the validity of our model in non basal conditions by reproducing a preload reduction experiment by inferior vena cava occlusion with the model. We compute the variation of eight indices before and after this experiment and obtain the same variation as experimentally observed for seven out of the eight indices. In summary, the multi-scale mathematical model presented in this work is able to correctly account for the three roles of the left atrium and also exhibits a realistic left atrial pressure-volume loop. Furthermore, the model has been previously presented and validated for the left ventricle. This makes it a proper alternative to the time-varying elastance theory if the focus is set on precisely representing the left atrial and left ventricular behaviors.

  7. EXAMINATION OF ELECTROPHYSIOLOGICAL PARAMETERS OF THE ATRIUMS IN PATIENTS WITH LONG-TERM PERSISTENT FORM OF ATRIAL FIBRILLATION AND VALVULAR HEART DISEASE

    Directory of Open Access Journals (Sweden)

    A. A. Kulikov

    2017-01-01

    Full Text Available The study objective is to examine electrophysiological parameters of atrial myocardium, characteristics of atrioventricular conduction, and potential factors affecting recurrent atrial fibrillation (AF in patients with persistent and long-term persistent forms of AF prior to the Labirynth IIIB surgery with single-step correction of valvular heart disease.Materials and methods. The study included 100 adults (48 men, 52 women with persistent and long-term persistent forms of AF and different valvular heart diseases. Mean patient age was 59 years. Mean AF duration was 4 years. All patients were prescribed antiarrhythmic therapy but it proved ineffective. In 15 % of patients, restoration of the sinus rhythm was attempted through electrical cardioversion but long-term control of the sinus rhythm wasn’t achieved. All patients were diagnosed with organic pathology of the mitral valve. Also, in 80 % of patients, relative insufficiency of the tricuspid valve was detected. Chronic heart failure functional class per NYHA was III. Size of the left atrium was 5 cm, mean left ventricular ejection fraction was 61 %. All patients underwent electrical cardioversion. After successful restoration of the sinus rhythm, endocardial electrophysiology study (EES of the heart was performed. Then, correction of valvular pathologies and the Labyrinth IIIB surgery were performed. Results. Examination of refractoriness of different parts of the atriums has shown that effective refractory period (ERP of the atrioventricular node was minimal compared to other parts of the atriums. Maximal ERP duration was observed in the upper part of the right atrium. Therefore, in patients with long history of AF, heterogeneity of atrial myocardium ERP duration is observed. In 17 % of patients, atrial vulnerability was detected. The area of atrial vulnerability was always associated with ERP. Its duration in patients with atrial vulnerability was significantly higher.Conclusion. Long

  8. Common Atrium with Unusual Electrocardiogram in Ellis-van Creveld Syndrome: A Case Report

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2015-01-01

    This report describes a case of common atrium with unusual electrocardiographic findings in a patient with EVC syndrome. This 17-year-old male of Indian origin born of a consanguineous marriage had short stature, genu valgum, polydactyly, gingival hypertrophy, multiple frenula, common atrium, and right axis deviation of QRS with clockwise depolarization in electrocardiogram.

  9. Detection of sequential activation of left atrium and coronary sinus musculature in the general population

    Directory of Open Access Journals (Sweden)

    Masaki Ota, MD

    2016-12-01

    Conclusions: Far-field LA potentials are often recorded in the CS during sequential LA and CSM activation in the general population. The timing of LA potentials in CS recordings reflected the direction of conduction across the CSM.

  10. Prevalence and predictors of low voltage zones in the left atrium in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Huo, Yan; Gaspar, Thomas; Pohl, Matthias

    2017-01-01

    of LVZ. Conclusion: In a large cohort of patients undergoing ablation for AF, the prevalence of LVZ was higher and LVZ areas larger in patients with persistent as compared with paroxysmal AF. The most frequent localization of LVZ was anterior wall, septum and posterior wall. Presence of LVZ...

  11. The Relationship between Left Atrial Mechanical Function and Functional Capacity in Mitral Stenosis

    Directory of Open Access Journals (Sweden)

    Mücahit Yetim

    2013-11-01

    Full Text Available Aim: In this study, left atrial functions of patients with rheumatic mitral stenosis and sinus rhythm, which was determined by transthorasic echocardiography, was compared with those of healhty subjects and the association of left atrial functions with functional capacity was investigated in subgroup analyses.   Material and methods: 32 patients with isolated rheumatic mitral stenosis (median age was 39.1±11  (group 1 and 20 patients in the control group ( median age was 37±8,2 (group 2 were enrolled to study. The average mitral valve area of patients was 1.1±0,3 cm2. When patients were divided according to New York Heart Association (NYHA classification ; 16 patients were NYHA 2 (Grup A and 16 patients were NYHA 3 (Grup B. There were not any asymptomatic patients and no patients were NYHA 4. Left atrium diameters, left atrium volume, left atrium fractional area change and left atrium ejection fractions  of patients in these groups were calculated.   Results: The demographic characteristics of patients is shown in table 1. Left atrium ejection fraction (LAEF and left atrium fractional area change (LAFAC that were determined echocardiographycally were significantly lower in patients with mitral stenosis (32 ± 5, 44 ± 3; p<0.001- 25 ± 11, 32 ± 6; p< 0.02.  When patients were divided according to New York Heart Association (NYHA classification ; 16 patients were NYHA 2 (Grup A and 16 patients were NYHA 3 (Grup B. There were not any asymptomatic patients and no patients were NYHA 4. The clinical and echocardiographic data of patients are shown in table 2. Despite of similar mitral valve area and average mitral gradient ,systolic pulmonary artery pressure was found to be higher in symptomatic group. But there was no difference between left atrial functions of the two groups.   Discussion: In this study we have shown that left atrial functions determined echocardiographically  can decline in patients with mitral stenosis but the

  12. Incisional left atrial isolation for ablation of atrial fibrillation in mitral valve surgery.

    Science.gov (United States)

    Graffigna, Angelo; Branzoli, Stefano; Sinelli, Stefano; Vigano, Mario

    2009-01-01

    The renewed interest in surgical techniques for atrial fibrillation (AF) limited to the left atrium has risen the importance of the original technique of left atrial isolation by means of surgical incision. Transmurality of lesions and cost containment are strong elements to be appreciated in this technique.

  13. Inotropic effects of extracts of Psidium guajava L. (guava) leaves on the guinea pig atrium.

    Science.gov (United States)

    Conde Garcia, E A; Nascimento, V T; Santiago Santos, A B

    2003-05-01

    Many pharmacological effects have been ascribed to extracts of Psidium guajava L. (guava) leaves. However, in spite of its widespread use in Brazilian folk medicine and a reasonable number of scientific reports about it, we could not find any study dealing with its action on the mammalian myocardium. In the present study, by measuring isometric force, we observed that the crude extract of P. guajava (water-alcohol extract obtained by macerating dry leaves) depresses the guinea pig atrial contractility in a concentration-dependent fashion (N = 8 hearts, 15 trials). The compound with cardiac activity was concentrated by extraction in a Soxhlet apparatus using 17 M glacial acetic acid after removing the less polar fractions (hexane, chloroform, acetone, ethanol and methanol), suggesting that this compound is a highly polar substance. In the isolated guinea pig left atrium the acetic acid fraction (10-800 mg/l) of P. guajava 1) reversibly decreased myocardial force in a concentration-dependent fashion (EC50 = 0.07g/l, N = 5 hearts, 9 trials, Pleaves depress myocardial inotropism.

  14. Echocardiographic study of left atrial myxoma

    Directory of Open Access Journals (Sweden)

    Dalal J

    1979-01-01

    Full Text Available Four cases of left atrial myxoma were diagnosed pre-operatively by echocardiography. All cases showed characteristic echocardio-graphic features of variegated shadows behind the mitral valve in diastole and within the left atrium in systole. In two cases the my-xomas were surgically removed and confirmed on histology. In one case the post-operative echocardiogram showed complete dis-appearance of the abnormal shadows. Echocardiography is the most reliable method today for the diagnosis of a myxoma.

  15. Study on simulation methods of atrium building cooling load in hot and humid regions

    Energy Technology Data Exchange (ETDEWEB)

    Pan, Yiqun; Li, Yuming; Huang, Zhizhong [Institute of Building Performance and Technology, Sino-German College of Applied Sciences, Tongji University, 1239 Siping Road, Shanghai 200092 (China); Wu, Gang [Weldtech Technology (Shanghai) Co. Ltd. (China)

    2010-10-15

    In recent years, highly glazed atria are popular because of their architectural aesthetics and advantage of introducing daylight into inside. However, cooling load estimation of such atrium buildings is difficult due to complex thermal phenomena that occur in the atrium space. The study aims to find out a simplified method of estimating cooling loads through simulations for various types of atria in hot and humid regions. Atrium buildings are divided into different types. For every type of atrium buildings, both CFD and energy models are developed. A standard method versus the simplified one is proposed to simulate cooling load of atria in EnergyPlus based on different room air temperature patterns as a result from CFD simulation. It incorporates CFD results as input into non-dimensional height room air models in EnergyPlus, and the simulation results are defined as a baseline model in order to compare with the results from the simplified method for every category of atrium buildings. In order to further validate the simplified method an actual atrium office building is tested on site in a typical summer day and measured results are compared with simulation results using the simplified methods. Finally, appropriate methods of simulating different types of atrium buildings are proposed. (author)

  16. Operational experience for the latest generation of ATRIUM trademark 10 fuel assemblies

    International Nuclear Information System (INIS)

    Schoss, Volker; Hoffmann, Petra Britt; Schaefer, Jens

    2011-01-01

    AREVA NP's ATRIUM trademark 10 product family was first introduced to the BWR market in 1992. Lead test campaigns confirmed the outstanding product performance and justified introduction of reload quantities. Further development of particular product features was demonstrated and implemented in the fuel design to meet highest expectations for reliability and fuel economics. The latest generation called ATRIUM trademark 10XP and subsequently ATRIUM trademark 10XM was introduced in 2002 and 2005, respectively. The first lead test assemblies completed their operation successfully after seven cycles. (orig.)

  17. Extreme premature with persistent left superior vena cava.

    Science.gov (United States)

    Aboitiz-Rivera, Carlos Manuel; Blachman-Braun, Ruben; Parra-Pérez, Mariana Yazmin

    2017-10-01

    Persistent left superior vena cava (PLSVC) is a congenital anomaly, that results when there is an absence of the normal regression of the left common precardinal vein during embryogenesis. Usually, this anomaly remains asymptomatic, however, when the PLSVC drains into the left atrium this could lead to a right-to-left shunt. Additionally, this can result in inadvertent delivery of air or thrombus into the systemic circulation with potential neurologic, cardiac and renal complications. In this article, we present a case of an extreme premature Mexican newborn in which the diagnosis was made after placement of a percutaneous central venues catheter.

  18. Creating marketing strategies for wedding business unit of Amari Atrium Hotel

    OpenAIRE

    Suvagondha, Apiwat; Soparat, Pattamaporn

    2008-01-01

    Abstract Date: May 29, 2008 Course: Master Thesis (EFO 705) Authors: Apiwat Suvagondha 790819 Pattamaporn Soparat 840216 Tutor: Tobias Eltebrandt Title: Creating marketing strategies for wedding business unit of Amari Atrium Hotel Problem: What should be marketing strategies for wedding business unit of Amari Atrium Hotel? Purpose: The aim of our thesis is to analyze the wedding market in Bangkok together with consumer purchasing behavior of Thai’s couple regarding to wedding ceremony in orde...

  19. Atorvastatin can ameliorate left atrial stunning induced by radiofrequency ablation for atrial fibrillation.

    Science.gov (United States)

    Xie, Ruiqin; Yang, Yingtao; Cui, Wei; Yin, Hongning; Zheng, Hongmei; Zhang, Jidong; You, Ling

    2017-09-01

    The objective of this study was to study the functional changes of the left atrium after radiofrequency ablation treatment for atrial fibrillation and the therapeutic effect of atorvastatin. Fifty-eight patients undergoing radiofrequency ablation for atrial fibrillation were randomly divided into non-atorvastatin group and atorvastatin group. Patients in the atorvastatin group were treated with atorvastatin 20 mg p.o. per night in addition to the conventional treatment of atrial fibrillation; patients in the non-atorvastatin group received conventional treatment of atrial fibrillation only. Echocardiography was performed before radiofrequency ablation operation and 1 week, 2 weeks, 3 weeks, and 4 weeks after operation. Two-dimensional ultrasound speckle tracking imaging system was used to measure the structural indexes of the left atrium. Results indicated that there was no significant change for indexes representing the structural status of the left atrium within a month after radiofrequency ablation (P > 0.05); however, there were significant changes for indexes representing the functional status of the left atrium. There were also significant changes in indexes reflecting left atrial strain status: the S and SRs of atorvastatin group were higher than those of non-atorvastatin group (P atorvastatin could improve left atrial function and shorten the duration of atrial stunning after radiofrequency ablation of atrial fibrillation.

  20. Malignant inferior vena cava obstruction involving right atrium. Palliative treatment with self expandable metallic stent

    International Nuclear Information System (INIS)

    Shao Guoliang; Wang Jianhua; Zhou Kangrong; Yan Zhiping

    2001-01-01

    Objective: To investigate the safety and efficacy of placement of self-expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods: There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56.3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. 'Z' type stainless steel stents (7.5-10.0 cm in length and 2.5 cm in diameter) were selected for these patients. Part (1.0-3.0 cm in length) of stent was placed in right atrium and the rest was in ICV. Results: All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow-up period (67-188 days). Conclusion: Placement of self-expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods

  1. The Prognostic Value of Left Atrial Peak Reservoir Strain in Acute Myocardial Infarction Is Dependent on Left Ventricular Longitudinal Function and Left Atrial Size

    DEFF Research Database (Denmark)

    Ersbøll, Mads; Andersen, Mads J; Valeur, Nana

    2013-01-01

    of PALS and left ventricular longitudinal strain (global longitudinal strain) in large-scale populations in regard to prognosis. METHODS AND RESULTS: We prospectively included 843 patients (mean age 62.1+/-11.8; 74% male) with acute myocardial infarction and measured global longitudinal strain, left......BACKGROUND: Peak atrial longitudinal strain (PALS) during the reservoir phase has been proposed as a measure of left atrium function in a range of cardiac conditions, with the potential for added pathophysiological insight and prognostic value. However, no studies have assessed the interrelation...

  2. Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome

    DEFF Research Database (Denmark)

    Lønborg, Jacob Thomsen; Engstrøm, Thomas; Møller, Jacob Eifer

    2013-01-01

    The left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is b...... function in patients following ST elevation myocardial infarction (STEMI)....

  3. Left ventricular outflow tract to left atrial communication secondary to rupture of mitral-aortic intervalvular fibrosa in infective endocarditis: diagnosis by transesophageal echocardiography and color flow imaging.

    Science.gov (United States)

    Bansal, R C; Graham, B M; Jutzy, K R; Shakudo, M; Shah, P M

    1990-02-01

    Infection of the mitral-aortic intervalvular fibrosa occurs most commonly in association with infective endocarditis of the aortic valve. Infection of the aortic valve results in a regurgitant jet that presumably strikes this subaortic interannular zone of fibrous tissue and produces a secondary site of infection. Infection of this interannular zone then leads to the formation of subaortic abscess or pseudoaneurysm of the left ventricular outflow tract. This infected zone of mitral-aortic intervalvular fibrosa or subaortic aneurysm can subsequently rupture into the left atrium with systolic ejection of blood from the left ventricular outflow tract to the left atrium. This report describes the echocardiographic findings in three patients with pathologically proved left ventricular outflow tract to left atrial communication. Precise preoperative diagnosis is important, and this lesion should be differentiated from ruptured aneurysm of the sinus of Valsalva and perforation of the anterior mitral leaflet. Transthoracic echocardiography using color flow imaging and conventional Doppler techniques may show an eccentric mitral regurgitation type of signal in the left atrium originating from the region of the left ventricular outflow tract. However, transesophageal echocardiography provides an accurate preoperative diagnosis and should be used intraoperatively during repair of such lesions.

  4. Inotropic effects of extracts of Psidium guajava L. (guava leaves on the guinea pig atrium

    Directory of Open Access Journals (Sweden)

    Conde Garcia E.A.

    2003-01-01

    Full Text Available Many pharmacological effects have been ascribed to extracts of Psidium guajava L. (guava leaves. However, in spite of its widespread use in Brazilian folk medicine and a reasonable number of scientific reports about it, we could not find any study dealing with its action on the mammalian myocardium. In the present study, by measuring isometric force, we observed that the crude extract of P. guajava (water-alcohol extract obtained by macerating dry leaves depresses the guinea pig atrial contractility in a concentration-dependent fashion (N = 8 hearts, 15 trials. The compound with cardiac activity was concentrated by extraction in a Soxhlet apparatus using 17 M glacial acetic acid after removing the less polar fractions (hexane, chloroform, acetone, ethanol and methanol, suggesting that this compound is a highly polar substance. In the isolated guinea pig left atrium the acetic acid fraction (10-800 mg/l of P. guajava 1 reversibly decreased myocardial force in a concentration-dependent fashion (EC50 = 0.07g/l, N = 5 hearts, 9 trials, P<0.05, 2 increased the atrial relaxation time measured at 20% of the force amplitude up to 35% (91 ± 15 to 123 ± 30 ms, N = 3 hearts, 6 trials, P<0.05, 3 abolished the positive staircase effect (Bowditch phenomenon in a concentration-dependent fashion suggesting a decrease of the cellular inward calcium current (N = 4 hearts, 8 trials, P<0.05, and 4 its inotropic effect was abolished by cholinergic receptor blockade with 1.5 mM atropine sulfate, indicating a cholinergic involvement in the mechanism of action of the extract (N = 7 hearts, 15 trials, P<0.05. The acetic acid extract was 20 times more potent than crude extract (EC50 = 1.4 g/l. The results showed that extracts from P. guajava leaves depress myocardial inotropism.

  5. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun [Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

    2017-08-15

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location.

  6. Anomlus pulmonary venous return aaccompanied by normal superior pulmonary veins in the left upper lobe: A case report

    International Nuclear Information System (INIS)

    Kim, Dong Eon; Kang, Min Jin; Lee, Ji Hae; Bae, Kyung Eun; Kim, Jae Hyung; Kang, Tae Kyung; Kim, Soung Hee; Kim, Ji Young; Jeong, Myeong Ja; Kim, Soo Hyun

    2017-01-01

    Partial anomalous pulmonary venous return is a rare congenital pulmonary venous anomaly, in which some of the pulmonary veins drain into the systemic circulation rather than the left atrium. Many variants of partial anomalous pulmonary venous return have been reported. We present a rare type of partial anomalous pulmonary venous return in which the anomalous left upper lobe pulmonary vein drained into the left innominate vein via the vertical vein, accompanying the left upper lobe pulmonary vein in the normal location

  7. Effects of Potassium Channel Blockers on the Negative Inotropic Responses Induced by Cromakalim and Pinacidil in Guinea Pig Atrium

    Science.gov (United States)

    1992-01-01

    RD-A2•4 875 EFFECTS OF POTASSIUM CHANNEL BLOCKERS ON THE NEGATIVE 1/1 INOTROPIC RESPONSES INDUCED BY CRONAKALIM RND PINACIDIL IN GUINEA PIG ATRIUM(U...INOTROPICTRSPONSES INDUCED BY CROMAKAUM AND PINACIDILIN GUINEA PIG ATRIUM a AUTHOR WAI-MAN LAU 7 FORMING ORG NAMES/ADDRESSES DEFENCE SCIENCE AND a...and Technology Organisaio Aot Val. Negative Inotropic Responses Victoria. Australia Induced by Cromakalim and Pinacidil in Guinea Pig Atrium Key

  8. Left atrial leiomyosarcoma as cause of heart failure

    International Nuclear Information System (INIS)

    Valdes Martin, Alexander

    2012-01-01

    The case of a 26 year-old patient with diagnosis of heart failure and presence of a mobile echogenic mass without calcification attached to the posterolateral area of the left atrium was reported. She underwent surgery and tissue examination evidenced a high-grade heart leiomyosarcoma. Postoperative course was satisfactory and her clinical state was rigorously monitored by oncology and heart specialists in the institution

  9. Cine MR imaging in mitral valve prolapse; Study on mitral regurgitation and left atrial volume

    Energy Technology Data Exchange (ETDEWEB)

    Kumai, Toshihiko [Chiba Univ. (Japan). School of Medicine

    1993-02-01

    This study was undertaken to assess the ability of cine MR imaging to evaluate the direction, timing, and severity of mitral regurgitation in patients with mitral valve prolapse (MVP). The population of this study was 33 patients with MVP diagnosed by two-dimensional echocardiography and 10 patients with rheumatic mitral valve disease (MSR) for comparison. 7 patients with MVP and 5 with MSR had atrial fibrillation and/or history of congestive heart failure as complications. Mitral regurgitation was graded for severity by color Doppler flow imaging in all patients. Direction and size of systolic flow void in the left atrium were analyzed by contiguous multilevel cine MR images and the maximum volumes of flow void and left atrium were measured. Although flow void was found at the center of the left atrium in most of MSR, it was often directed along the postero-caudal atrial wall in anterior leaflet prolapse and along the anterocranial atrial wall in posterior leaflet prolapse. In MVP, the maximum volume of flow void was often seen in late systole. The maximum volume of flow void and that of left atrium were significantly larger in patients with atrial fibrillation and/or history of congestive heart failure. The length and volume of flow void were increased with clinical severity and degree of regurgitation determined by color Doppler flow imaging. Thus cine MR imaging provides a useful means for detection and semiquantitative evaluation of mitral regurgitation in subjects with MVP. (author).

  10. “Anomalous right pulmonary artery left atrial fistula”: Growth in vain

    Directory of Open Access Journals (Sweden)

    Vishal Kumar Jain

    2015-12-01

    Full Text Available We report a case of direct communication between the right pulmonary artery and the left atrium; a rare cause of central cyanosis in 10 year old boy, emphasizing the role of multislice computed tomography scanner in delineating the complex vascular abnormality over more invasive conventional angiography.

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

    International Nuclear Information System (INIS)

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

    1988-01-01

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

  12. The Linguistic and Cultural Interpretation of Dissonant Heritage: the ATRIUM Cultural Route

    Directory of Open Access Journals (Sweden)

    Sandra Nauert

    2017-06-01

    Full Text Available The European Cultural Route ATRIUM (Architecture of Totalitarian Regimes in Europe's Urban Memory deals with dissonant heritage, referring to a contrast of meaning and value systems between the past and the present. The route will be examined within the framework of a set of communication strategies for cultural routes. This short paper will look at some linguistic aspects related to the ATRIUM route and its ‘dissonant heritage’. By analysing some examples of existing promotional approaches related to this particular heritage, it will outline some considerations for a communicative strategy appropriate to the overall narrative structure of the ATRIUM cultural route, with special regard to a bottom-up constructivist approach.

  13. Daylighting and Cooling of Atrium Buildings in Warm Climates: Impact of the Top-Fenestration and Wall Mass Area.

    Science.gov (United States)

    Atif, Morad Rachid

    1992-01-01

    Sun-lighting and daylighting contribute greatly to the aesthetic value of an atrium. However, today's atria are often found either over-lit with extensive cooling loads, or under-lit requiring increased artificial lighting loads. The increase of the top-glazing area increases the cooling loads and decreases the lighting loads. The increase of the mass in the atrium walls decreases the maximum atrium temperature and the cooling loads. Furthermore, the mass distribution and its reflectance affect the lighting levels at the atrium floor. The purpose of this study is to investigate the simultaneous impact of the top-fenestration and the mass and reflectance of atrium walls on the cooling and daylighting performance of atria in warm climates. It attempts to determine the optimum top-fenestration for efficient daylighting and low cooling loads. The daylighting performance was evaluated through illumination measurements in physical models in a sky simulator. The cooling performance was evaluated using the software TRNSYS 13.1. Two types of top-fenestration were tested: horizontal and vertical south-facing, each with three alternate areas. The variations of the atrium walls included materials (standard frame and heavyweight concrete) and percentage and reflectance of the solid area. Two and four-story atria were considered, each with square and linear configuration. The performance was evaluated for three warm climates. The optimum top-fenestration for efficient daylighting was determined. The daylighting prediction algorithm was extended to include the effective reflectance of the atrium walls. The increase of mass in the atrium walls significantly decreased the atrium temperature range, the maximum atrium temperature, and the cooling loads. This impact decreased from horizontal to vertical south-facing top-glazing. The vertical south-facing top-glazing and, to a lesser degree, the reduction of the glazed atrium cover by 50% had more cooling benefits than increasing the

  14. Transkateterlukning af venstre atriums aurikel til forebyggelse af apoplexia cerebri

    DEFF Research Database (Denmark)

    Loupis, Anastasia M; De Backer, Ole; Ihlemann, Nikolaj

    2014-01-01

    In patients with atrial fibrillation (AF) and increased risk of stroke, oral anticoagulation (OAC) is the standard treatment for stroke prevention - however, this therapy also carries a high risk of bleeding. Percutaneous closure of the left atrial appendage (LAA) has been suggested to be an alte...

  15. Smoke Movement in an Atrium with a Fire with Low Rate of Heat Release

    DEFF Research Database (Denmark)

    Nielsen, Peter V.; Brohus, Henrik; Petersen, A. J.

    2008-01-01

    Results from small-scale experiments on smoke movement in an atrium are given, both with and without a vertical temperature gradient, and expressions for the smoke movement are developed on the basis of these experiments. Comparisons with a general analytical expression used for calculating...... the height to the location of the smoke layer are given. Furthermore, the paper discusses the air movement in a typical atrium exposed to different internal and external heat loads to elaborate on the use of the "flow element" expressions developed for smoke movement from a fire with a low rate of heat...

  16. Optimisation of Heating Energy Demand and Thermal Comfort of a Courtyard-Atrium Dwelling

    NARCIS (Netherlands)

    Taleghani, M.; Tenpierik, M.; Dobbelsteen, A.

    2013-01-01

    In the light of energy reduction, transitional spaces are recognised as ways to receive natural light and fresh air. This paper analyses the effects of courtyard and atrium as two types of transitional spaces on heating demand and thermal comfort of a Dutch low-rise dwelling, at current and future

  17. Thrombus Development on a Transseptal Sheath in the Right Atrium Before Electrical Pulmonary Vein Isolation

    Directory of Open Access Journals (Sweden)

    Nieves Romero-Rodriguez

    2008-02-01

    Full Text Available We describe the case of a patient who developed a thrombus on the transseptal sheath in the right atrium before transseptal puncture for circumferential pulmonary vein isolation for paroxysmal atrial fibrillation treatment. The use of intracardiac echocardiography allowed to its identification and probably prevented the patient from suffering a serious thromboembolic complication.

  18. Anatomical barriers in the right atrium to the coronary sinus cannulation

    Directory of Open Access Journals (Sweden)

    Wiesława Klimek-Piotrowska

    2016-01-01

    Full Text Available Background. The coronary venous system is an increasingly frequent target of minimally invasive cardiac procedures. The purpose of this paper is to assess the anatomical barriers in the right atrium to coronary sinus cannulation.Methods. We examined the anatomy of the right atrium, coronary sinus ostium, inferior and superior vena cava ostia in 110 randomly selected autopsied human hearts of both sexes (27% females; mean age 49.2 ± 17.5 years.Results. The Eustachian valve was present in 79 cases (71.8% with mean height =4.9 ± 2.6 mm. The valve was perforated in 11 cases (13.9%. It is typically too small to hinder the coronary sinus catheterization, but in some cases (about 2% a significantly protruding valve may be an obstacle. Chiari’s network (4.6% is not a barrier to catheter entry into the right atrium but may significantly impede further catheter manipulations inside the heart venous system. A typical Thebesian valve leaves enough space for the passage of the standard catheter to the coronary sinus.Discussion. Detailed anatomy of various anatomical structures within the right atrium that could play a potential role in coronary sinus cannulation is discussed.

  19. Anomalous muscle bundle in the right atrium; Implication to trans atrial device closure

    Directory of Open Access Journals (Sweden)

    Saji Philip

    2017-09-01

    Full Text Available Intracavitary muscle bands or aberrant bands have been well described in all four chambers of the heart but rarely seen thick muscular band crossing right atrium. We report a case of devisable secundum atrial septal defect with an intra-atrial anomalous muscular band, crossing right atrial wall to the rim of the secundum atrial septal defect warranting surgical closure.

  20. Rupture of sinus of Valsalva aneurysm into both right atrium and ...

    African Journals Online (AJOL)

    A young man had a congenital sinus of Valsalva aneurysm originating from the right coronary sinus, complicated by fistulas draining into both right atrium and right ventricle, as well as a congenitally abnormal aortic valve with mild aortic insufficiency. His dramatic clinical presentation, with the sudden appearance of severe ...

  1. Kids in the atrium: comparing architectural intentions and children's experiences in a pediatric hospital lobby.

    Science.gov (United States)

    Adams, Annmarie; Theodore, David; Goldenberg, Ellie; McLaren, Coralee; McKeever, Patricia

    2010-03-01

    The study reported here adopts an interdisciplinary focus to elicit children's views about hospital environments. Based at the Hospital for Sick Children (SickKids), Toronto, the research explores the ways in which designers and patients understand and use the eight-storey lobby, The Atrium, a monumental addition constructed in 1993. It is a public place that never closes; hundreds of children pass through the namesake atrium every day. Combining methodological approaches from architectural history and health sociology, the intentions and uses of central features of the hospital atrium are examined. Data were collected from observations, focused interviews, and textual and visual documents. We locate the contemporary atrium in a historical context of building typologies rarely connected to hospital design, such as shopping malls, hotels and airports. We link the design of these multi-storey, glass-roofed spaces to other urban experiences especially consumption as normalizing forces in the everyday lives of Canadian children. Seeking to uncover children's self-identified, self-articulated place within contemporary pediatric hospitals, we assess how the atrium--by providing important, but difficult-to-measure functions such as comfort, socialization, interface, wayfinding, contact with nature and diurnal rhythms, and respite from adjacent medicalized spaces--contributes to the well-being of young patients. We used theoretical underpinnings from architecture and humanistic geography, and participatory methods advocated by child researchers and theorists. Our findings begin to address the significant gap in understanding about the relationship between the perceptions of children and the settings where their healthcare occurs. The study also underlines children's potential to serve as agents of architectural knowledge, reporting on and recording their observations of hospital architecture with remarkable sophistication. 2009 Elsevier Ltd. All rights reserved.

  2. Plain chest PA evaluation of left atrial thrombosis in mitral valvular disease

    Energy Technology Data Exchange (ETDEWEB)

    Choo, Yeon Myung; Park, Jae Hyung; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1984-09-15

    Conventional posteroanterior chest radiographs of 73 patients with mitral valve disease who had had surgery were analyzed, and particular attention was directed to the absence of the convexity of the left lower mid cardiac border (left atrial segment) and to the relation with duration of illness, atrial fibrillation, pulmonary capillary wedge pressure (PCWP) as well as surgical findings. The results obtained are as follows: 1. The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in eleven (64.7%) of 17 patients who had left atrial thrombosis and in six (10.7%) of 56 patients who did not have thrombosis (false positive diagnosis). Six (35.5%) of the 17 patients who had left atrial thrombosis did not this findings on radiographs (false positive diagnosis). Six (35.3%) of the 17 patients who had left atrial thrombosis did not show this finding on radiographs (false positive diagnosis). Therefore, the accuracy in the diagnosis of thrombosis of left atrium wa 64.7% (eleven of seventeen) for patients who had thrombosis of left atrium. 2. The atrial fibrillation was observed in sixteen (94.1%)of 17 patients who had left atrial thrombosis. So, correlation between the presence of left atrial thrombosis and atrial fibrillation wa evident. But there was no correlation between the duration of illness of the PCWP of patients and the presence of left atrial thrombosis.

  3. Plain chest PA evaluation of left atrial thrombosis in mitral valvular disease

    International Nuclear Information System (INIS)

    Choo, Yeon Myung; Park, Jae Hyung; Han, Man Chung

    1984-01-01

    Conventional posteroanterior chest radiographs of 73 patients with mitral valve disease who had had surgery were analyzed, and particular attention was directed to the absence of the convexity of the left lower mid cardiac border (left atrial segment) and to the relation with duration of illness, atrial fibrillation, pulmonary capillary wedge pressure (PCWP) as well as surgical findings. The results obtained are as follows: 1. The flatness or concavity of this segment, despite other evidence of left atrial enlargement, was observed in eleven (64.7%) of 17 patients who had left atrial thrombosis and in six (10.7%) of 56 patients who did not have thrombosis (false positive diagnosis). Six (35.5%) of the 17 patients who had left atrial thrombosis did not this findings on radiographs (false positive diagnosis). Six (35.3%) of the 17 patients who had left atrial thrombosis did not show this finding on radiographs (false positive diagnosis). Therefore, the accuracy in the diagnosis of thrombosis of left atrium wa 64.7% (eleven of seventeen) for patients who had thrombosis of left atrium. 2. The atrial fibrillation was observed in sixteen (94.1%)of 17 patients who had left atrial thrombosis. So, correlation between the presence of left atrial thrombosis and atrial fibrillation wa evident. But there was no correlation between the duration of illness of the PCWP of patients and the presence of left atrial thrombosis.

  4. Aqueous leaf extract of Averrhoa carambola L. (Oxalidaceae reduces both the inotropic effect of BAY K 8644 on the guinea pig atrium and the calcium current on GH3cells

    Directory of Open Access Journals (Sweden)

    Carla M. L. Vasconcelos

    Full Text Available It was previously showed that aqueous leaf extract (AqEx of Averrhoa carambola depresses the guinea pig atrial inotropism. Therefore, experiments were carried out on guinea pig left atrium and on pituitary GH3 cells in order to evaluate the effect of AqEx on the cellular calcium influx. The atrium was mounted in an organ chamber (5 mL, Tyrode, 27 ± 0.1 ºC, 95 % O2, 5 % CO2, stretched to 10 mN, and paced at 2 Hz (0.5 ms, 400 V and GH3 cells were submitted to a whole cell voltage clamp configuration. In the atrium, the AqEx (1500 µg/mL shifted to the right the concentration-effect curve of the positive inotropic effect produced by (± BAY K 8644, an L-type calcium channel agonist. The AqEx increased EC50 (concentration required to promote 50% of the maximum effect of the inotropic effect of BAY K 8644 from 7.8 ± 0.38 to 115.1 ± 0.44 nM (N = 3; p < 0.05. In GH3 cells assayed with 500 µg/mL of AqEx, the L-type calcium inward current declined 30 % (from 282 to 190 pA. Nevertheless, the extract did not change the voltage correspondent to the peak current. These data suggest that, at least in part, the negative inotropic effect of AqEx on the guinea pig atrium is due to a reduction of the L-type calcium current.

  5. Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography: Prediction of adverse outcome and 30-day mortality.

    Science.gov (United States)

    Oz, Ibrahim Ilker; Altınsoy, Bülent; Serifoglu, Ismail; Sayın, Rasit; Buyukuysal, Mustafa Cagatay; Erboy, Fatma; Akduman, Ece Isin

    2015-12-01

    The aim of this study was to examine the association between right atrium (RA) and right ventricle (RV) diameters on computed tomography (CT) pulmonary angiography in response to acute pulmonary embolism (APE), in addition to 30-day mortality and adverse outcomes in patients with APE. This retrospective study was accepted by the institutional ethics committee. From January 2013 to March 2014, 79 hospitalized adult patients with symptomatic APE were included. Inclusion criteria were a CT pulmonary angiography positive for pulmonary embolism, availability of patient records, and a follow-up of at least 30 days. A review of patient records and images was performed. The maximum diameters of the heart chambers were measured on a reconstructed four-chamber heart view, and the vascular obstruction index was calculated on CT pulmonary angiography. There were statistically significant relationships in both the RA/RV diameter ratio and the RV/left ventricle (LV) diameter ratio between patients with and without adverse outcomes (prights reserved.

  6. THE COMPARISON BETWEEN COMPUTER SIMULATION AND PHYSICAL MODEL IN CALCULATING ILLUMINANCE LEVEL OF ATRIUM BUILDING

    Directory of Open Access Journals (Sweden)

    Sushardjanti Felasari

    2003-01-01

    Full Text Available This research examines the accuracy of computer programmes to simulate the illuminance level in atrium buildings compare to the measurement of those in physical models. The case was taken in atrium building with 4 types of roof i.e. pitched roof, barrel vault roof, monitor pitched roof (both monitor pitched roof and monitor barrel vault roof, and north light roof (both with north orientation and south orientation. The results show that both methods have agreement and disagreement. They show the same pattern of daylight distribution. In the other side, in terms of daylight factors, computer simulation tends to underestimate calculation compared to physical model measurement, while for average and minimum illumination, it tends to overestimate the calculation.

  7. Design of an atrium for a passive-solar retrofit of an office buildings

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, J.L.; Hunn, B.D.

    1980-01-01

    The Los Alamos Scientific Laboratory (LASL) has proposed to retrofit one of its administrative office buildings with a solar atrium. A 334 m/sup 2/ courtyard will be enclosed with a roof-mounted system of clerestory windows to maximize winter solar gain. This sunspace will thermally buffer the adjoining offices and also will preheat air supplied to the building's conventional heating, ventilating, and air-conditioning (HVAC) system. The use of the DOE-2 building energy analysis computer program in the design of the solar atrium is described. The results of a series of simulations are reported detailing the tradeoffs inherent in the selection of an optimal glazing area, the maintenance of acceptable comfort levels within the sunspace, and intergration of passive-solar devices with the conventional HVAC system. Potential energy savings are also discussed.

  8. Mapping of the left-sided phrenic nerve course in patients undergoing left atrial catheter ablations.

    Science.gov (United States)

    Huemer, Martin; Wutzler, Alexander; Parwani, Abdul S; Attanasio, Philipp; Haverkamp, Wilhelm; Boldt, Leif-Hendrik

    2014-09-01

    Catheter ablation of atrial fibrillation has been associated with left-sided phrenic nerve palsy. Knowledge of the individual left phrenic nerve course therefore is essential to prevent nerve injury. The aim of this study was to test the feasibility of an intraprocedural pace mapping and reconstruction of the left phrenic nerve course and to characterize which anatomical areas are affected. In patients undergoing left atrial catheter ablation, a three-dimensional map of the left atrial anatomical structures was created. The left-sided phrenic nerve course was determined by high-output pace mapping and reconstructed in the map. In this study, 40 patients with atrial fibrillation or atrial tachycardias were included. Left phrenic nerve capture was observed in 23 (57.5%) patients. Phrenic nerve was captured in 22 (55%) patients inside the left atrial appendage, in 22 (55%) in distal parts, in 21 (53%) in medial parts, and in two (5%) in ostial parts of the appendage. In three (7.5%) patients, capture was found in the distal coronary sinus and in one (2.5%) patient in the left atrium near the left atrial appendage ostium. Ablation target was changed due to direct spatial relationship to the phrenic nerve in three (7.5%) patients. No phrenic nerve palsy was observed. Left-sided phrenic nerve capture was found inside and around the left atrial appendage in the majority of patients and additionally in the distal coronary sinus. Phrenic nerve mapping and reconstruction can easily be performed and should be considered prior catheter ablations in potential affected areas. ©2014 Wiley Periodicals, Inc.

  9. Atypical leiomyoma arising in a hepatic vein with extension into the inferior vena cava and right atrium

    International Nuclear Information System (INIS)

    Dunlap, H.J.; Udjus, K.

    1990-01-01

    We report an atypical leiomyoma arising in a hepatic vein and extending into the inferior vena cava and right atrium in a fourteen year old boy. US, CT and MRI facilitated diagnosis and removal of this tumor. (orig.)

  10. Unusual Giant Right Atrium in Rheumatic Mitral Stenosis and Tricuspid Insufficiency

    Directory of Open Access Journals (Sweden)

    Jean Baptiste Anzouan-Kacou

    2011-01-01

    Full Text Available Dilation and hypertrophy of the atria occur in patients with valvular heart disease especially in mitral regurgitation, mitral stenosis or tricuspid abnormalities. In sub-saharan Africa, rheumatic fever is still the leading cause of valvular heart disease. We report a case of an unusual giant right atrium in context of rheumatic stenosis and severe tricuspid regurgitation in a 58-year-old woman.

  11. A case report: mixed thrombus formation in a previously sutured right atrium.

    Science.gov (United States)

    Yunfei, Ling; Dongxu, Li; Shuhua, Luo; Yabo, Wang; San, Deep; Changping, Gan; Ke, Lin; Qi, An

    2014-08-01

    We describe the case of a 19-year-old Chinese woman who nine months prior underwent repair of an atrial septal defect and came to our hospital with a right atrial mass attached to the anterior wall of the right atrium on transthoracic echocardiography. Pathologic examination revealed the mass was a mixed-type thrombosis with some unusual organization, which previously was not described in literature.

  12. Il patrimonio scomodo del Novecento europeo nel progetto Atrium a Forlì

    Directory of Open Access Journals (Sweden)

    Elena Pirazzoli

    2013-09-01

    Full Text Available Il Novecento ha lasciato tracce difficili nelle città d'Europa. I regimi che si sono succeduti hanno trasformato urbanisticamente e architettonicamente l'intero territorio e oggi è complesso relazionarsi con questi segni. Il progetto europeo Atrium - Architecture of Totalitarian Regimes in Urban Managements si propone di valorizzare, con attenta cura e senza intenti mistificatori, proprio il “patrimonio scomodo” di 11 paesi dell'Europa del sud.

  13. Renal Angiomyolipoma with Fatty Thrombus Extending to the Right Atrium: An Exceptional Presentation

    Directory of Open Access Journals (Sweden)

    Yassine Nouira

    2013-01-01

    Full Text Available This paper reports the case of 34-year-old woman who presented with bilateral renal angiomyolipomas (AMLs. On the right side, there was a large AML with a fatty thrombus extending to the right atrium. The treatment consisted of right nephrectomy and complete thrombectomy with extracorporeal circulation and right atriotomy. Postoperatively, the patient was septic and died on postoperative day 7 because of septic shock.

  14. Researching for sustained translation from site cluster permeability into building courtyard and interior atrium

    Science.gov (United States)

    Teddy Badai Samodra, FX; Defiana, Ima; Setyawan, Wahyu

    2018-03-01

    Many previous types of research have discussed the permeability of site cluster. Because of interaction and interconnected attribute, it will be better that there is its translation into lower context such as building and interior scale. In this paper, the sustainability design performance of both similar designs of courtyard and atrium are investigated continuing the recommendation of site space permeability. By researching related literature review and study through Ecotect Analysis and Ansys Fluent simulations, the pattern transformation and optimum courtyard and atrium design could comply the requirement. The results highlighted that the air movement from the site could be translated at the minimum of 50% higher to the building and indoor environment. Thus, it has potency for energy efficiency when grid, loop, and cul-de-sac site clusters, with 25% of ground coverage, have connectivity with building courtyard compared to the atrium. Energy saving is higher when using low thermal transmittance of transparent material and its lower area percentages for the courtyard walls. In general, it was more energy efficient option as part of a low rise building, while the courtyard building performed better with increasing irregular building height more than 90% of the difference.

  15. Implantation of a cardiac resynchronization therapy-defibrillator device in a patient with persistent left superior vena cava.

    Science.gov (United States)

    Atar, İlyas; Karaçağlar, Emir; Özçalık, Emre; Özin, Bülent; Müderrisoğlu, Haldun

    2015-06-01

    Presence of a persistent left superior vena cava (PLSVC) is generally clinically asymptomatic and discovered incidentally during central venous catheterization. However, PLSVC may cause technical difficulties during cardiac device implantation. An 82-year-old man with heart failure symptoms and an ejection fraction (EF) of 20% was scheduled for resynchronization therapy-defibrillator device (CRT-D) implantation. A PLSVC draining via a dilated coronary sinus into an enlarged right atrium was diagnosed. First, an active-fixation right ventricular lead was inserted into the right atrium through the PLSVC. The stylet was preshaped to facilitate its passage to the right ventricular apex. An atrial lead was positioned on the right atrium free wall, and an over-the-wire coronary sinus lead deployed to a stable position. CRT-D implantation procedure was successfully completed.

  16. Association Between Left Atrial Compression And Atrial Fibrillation: A Case Presentation And A Short Review Of Literature.

    Science.gov (United States)

    Ahmed, Niloy; Carlos, Morales-Mangual; Moshe, Gunsburg; Yitzhak, Rosen

    2016-01-01

    This case report describes a patient who developed palpitations and chest pain and was found to be in atrial fibrillation, which was likely due to the presence of an extra-cardiac mass. This was compressing the left atrium. The mass was related to small cell carcinoma, which decreased significantly in size after chemotherapy. Resolution of the atrial fibrillation correlated temporally with reduction in the size of the mass and alleviation of the left atrial compression.

  17. LEFT ATRIAL FIBROSIS IN PATIENTS WITH ATRIAL FIBRILLATION ACCORDING TO MAGNETIC RESONANCE IMAGING WITH LATE GADOLINIUM ENHANCEMENT

    Directory of Open Access Journals (Sweden)

    O. V. Stukalova

    2015-01-01

    Full Text Available Rationale: Atrial fibrillation (AF is the most common type of arrhythmia. Left atrial abnormalities in AF require further investigation.Aim: To evaluate characteristics of myocardial structure of the left atrium by magnetic resonance imaging (MRI with delayed contrast enhancement in patients with AF associated with essential hypertension (EH, in those without any cardiovascular disorders, and in patients with AF after cryoablation of the pulmonary artery orifice.Materials and methods: The study enrolled 53 patients with AF (mean age 56 years. Twenty eight of them had AF without any associated cardiovascular disorders (lone AF, or LAF group, 25 patients had AF related to EH (AF + EH group. Three patients had undergone anti-arrhythmic intervention. Cardiac MRI was performed in all patients with high resolution late gadolinium enhancement (LGE at 15–20 min after i.v. gadoversetamide (0.15 mmol/kg. For LGE MRI, we used a novel high resolution inversion recovery (inversion times 290–340 ms magnetic resonance pulse sequence with isotropic voxel (size 1.25 . 1.25 .2.5 mm and fat saturation. Left atrium walls were segmented semi-automatically on the LGE images. Left atrium fibrosis quantification was performed with the original software LGE Heart Analyzer, developed in Russian Cardiology Research and Production Complex (Moscow.Results: Left atrium fibrosis (mean, 9 [1.7; 18] % was found both in patients with AF + EH and with lone AF. There was a trend towards more significant left atrial fibrosis in the group of AF + EH, compared to that in the lone AF group (10.972 [6.98; 19.366] % vs 4.37 [0.893; 18.575] %, respectively, p = 0.1. The extent of left atrium fibrosis correlated with left atrium dilatation (r = 0.37, p < 0.001 and with the decreased ejection fraction (r = -0.4, р < 0.001. The patients who had undergone an antiarrhythmic intervention, demonstrated formation of intensive LGE zones in the ablation areas.Conclusion: Quantification of

  18. Spectral Doppler interrogation of the patent foramen ovale-a window to left heart hemodynamics.

    Science.gov (United States)

    Fadel, Bahaa M; Husain, Aysha; Bakarman, Hatem; Dahdouh, Ziad; Salvo, Giovanni Di; Mohty, Dania

    2015-02-01

    Spectral Doppler interrogation of flow across a patent foramen ovale (PFO) allows recording of the instantaneous pressure gradient between left and right atrium (RA). The assessment of RA pressure using the size and collapsibility of the inferior vena cava would thus allow estimation of left atrial (LA) pressure. In this article, we illustrate the value of spectral Doppler interrogation of flow across the PFO by transthoracic echocardiography as a novel and simple tool for the assessment of LA pressure and left cardiac hemodynamics in addition to the conventional noninvasive parameters. © 2014, Wiley Periodicals, Inc.

  19. Isolated left-sided partial anomalous pulmonary venous connection in a child.

    Science.gov (United States)

    Onan, İsmihan Selen; Sen, Onur; Gökalp, Selman; Onan, Burak

    2017-09-01

    Isolated left-sided partial anomalous pulmonary venous connection with intact interatrial septum is a rare diagnosis in childhood. In these cases, a vertical vein drains the left upper pulmonary lobe into the brachiocephalic vein and finally to the right atrium. Surgical treatment is performed to prevent right ventricular failure and pulmonary artery disease in advanced age. In this report, the rare entity of isolated left-sided anomalous pulmonary venous connection in a 14-year-old girl and successful minimally invasive surgery without cardiopulmonary bypass are described.

  20. Unusual case of left atrial myxoma with gastroesophageal junction adenocarcinoma.

    Science.gov (United States)

    Singh, Narinder Pal; Nagpal, Swapan Deep Singh; Goel, Arun Kumar; Dhingra, Bhupendra Kr

    2018-02-01

    Cardiac myxomas are rare tumors. Esophageal adenocarcinomas are common tumors of the gastrointestinal tract. Simultaneous occurrence of these tumors has not been reported. A 52-year-old gentleman presented to our hospital with dysphagia and was diagnosed with esophageal adenocarcinoma. Routine echocardiography discovered a cardiac tumor in the left atrium. The cardiac tumor was surgically removed and biopsy confirmed a myxoma. We removed the cardiac tumor as the first step and then initiated neoadjuvant chemotherapy. It is ideal to constitute a multidisciplinary team to decide on the course of treatment in such cases.

  1. Assessment of left atrial volume and function in patients with permanent atrial fibrillation

    DEFF Research Database (Denmark)

    Agner, Bue F Ross; Kühl, Jørgen Tobias; Linde, Jesper James

    2014-01-01

    Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with substantial morbidity and mortality. AF is associated with enlargement of the left atrium (LA), and the LA volume has important prognostic implications for the disease. The objective of the study was to determine how...... measurements of LA volume and function obtained by transthoracic echocardiography (TTE), cardiac magnetic resonance (CMR), and 320-slice multi-detector computed tomography (MDCT) correlate in patients with permanent AF....

  2. Left atrial leiomyosarcoma as cause of heart failure; Leiomiosarcoma atrial izquierdo como causa de insuficiencia cardiaca

    Energy Technology Data Exchange (ETDEWEB)

    Valdes Martin, Alexander [Instituto de Cardiologia y Cirugia Cardiovascular, La Habana (Cuba)

    2012-07-01

    The case of a 26 year-old patient with diagnosis of heart failure and presence of a mobile echogenic mass without calcification attached to the posterolateral area of the left atrium was reported. She underwent surgery and tissue examination evidenced a high-grade heart leiomyosarcoma. Postoperative course was satisfactory and her clinical state was rigorously monitored by oncology and heart specialists in the institution.

  3. Pacing Lead-Induced Granuloma in the Atrium: A Foreign Body Reaction to Polyurethane

    Directory of Open Access Journals (Sweden)

    Shinagawa Yoko

    2013-01-01

    Full Text Available We described a case of an 82-year-old male who presented with a granuloma entrapping the polyurethane-coated pacing lead at the site of contact on the atrium. He had been paced for 8 years without symptoms or signs suggestive of an allergic reaction to the pacemaker system and died from thrombosis of the superior mesenteric artery and heart failure. A histological examination of the nodule showed an incidental granuloma with multinucleated giant cells. No granuloma was found in the heart or the lung.

  4. Percutaneous retrieval of a vena cava filter from the right atrium: case report

    International Nuclear Information System (INIS)

    Rasuli, P.; Mehran, R.; French, G.; Turek, M.; Lalonde, K.A.; Cardinal, P.

    2000-01-01

    Migration of vena cava filters can occur spontaneously, but it can also occur as a result of entanglement of the filter with a guidewire, particularly during 'blind' (unguided) insertion of a central venous line. When a filter migrates to the heart, traditional practice has been either to leave the filter in place or to remove it surgically by means of open heart surgery and cardiopulmonary bypass. We found only 6 reports of successful percutaneous retrieval or repositioning of a vena cava filter (Table 1). We describe a new interventional technique for retrieving a filter from the right atrium and a novel endosurgical method for removing a filter from the innominate vein. (author)

  5. Extension of adrenocortical carcinoma into the right atrium – echocardiographic diagnosis: A case report

    Directory of Open Access Journals (Sweden)

    Rozenman Yoseph

    2003-05-01

    Full Text Available Abstract Background Adrenocortical carcinoma is a rare, highly malignant tumor. Cardiac involvement of the tumor is very rare. Echocardiography facilitates the evaluation of the cardiac involvement of the tumor. Case Presentation We describe a patient with an adrenal tumor. Transthoracic echo showed its extension into the right atrium. Accordingly, a combined abdominal and cardiac operation was performed, monitored by transesophageal echocardiography. Conclusion This case highlights the importance of echocardiography in revealing the cardiac involvement by this tumor and in planning the operative procedure.

  6. Early changes in left atrial volume after acute myocardial infarction

    DEFF Research Database (Denmark)

    Bakkestrom, R.; Andersen, Mads J; Ersboll, M.

    2016-01-01

    . The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45%, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h......Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise...... of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22...

  7. Comparison of biatrial and left atrial radiofrequency ablation in patients with heart valves diseases

    Directory of Open Access Journals (Sweden)

    А. В. Богачев-прокофьев

    2015-10-01

    Full Text Available We analysed results of left atrial and biatrial anatomic scheme of radiofrequency (RF ablation of the atria in patients with valvular heart. From 2007 to 2011, RF ablation procedure performed 283 patients with atrial fibrillation and heart valve disease. Patients were divided into two groups - group I performed a complete circuit biatrial procedure (procedure maze IV - 131 patients, in group II only ablation of the left atrium -152 patients. Most of the patients had long-term persistent AF. The main problem of early postoperative period is dysfunction of pacemaker complex, which observed in 64.9% and 50.7% patients for group I and II, respectively (p = 0.031. Permanent dysfunction of pacemaker complex required implantation of permanent pacemaker (9.2% and 4.6% of cases for group I and II, respectively, p = 0,023. Predictors of dysfunction of the pacemaker complex were biatrial execution method and duration of AF. Freedom from AF and AT during 36 months after surgery was 80.4% for patients in group I and 78.5% for patients in group II, with no statistically significant difference (log-rank test, p = 0.621. Atrial transport function has not revealed that the active fraction of the right atrium was 29.8% higher than in group II in the early postoperative phase and by 17.9% in the long term, with no difference between groups for the left atrium has been received.

  8. Left atrial isolation associated with mitral valve operations.

    Science.gov (United States)

    Graffigna, A; Pagani, F; Minzioni, G; Salerno, J; Viganò, M

    1992-12-01

    Surgical isolation of the left atrium was performed for the treatment of chronic atrial fibrillation secondary to valvular disease in 100 patients who underwent mitral valve operations. From May 1989 to September 1991, 62 patients underwent mitral valve operations (group I); 19, mitral valve operations and DeVega tricuspid annuloplasty (group II); 15, mitral and aortic operations (group III); and 4, mitral and aortic operations and DeVega tricuspid annuloplasty (group IV). Left atrial isolation was performed, prolonging the usual left paraseptal atriotomy toward the left fibrous trigone anteriorly and the posteromedial commissure posteriorly. The incision was conducted a few millimeters apart from the mitral valve annulus, and cryolesions were placed at the edges to ensure complete electrophysiological isolation of the left atrium. Operative mortality accounted for 3 patients (3%). In 79 patients (81.4%) sinus rhythm recovered and persisted until discharge from the hospital. No differences were found between the groups (group I, 80.7%; group II, 68.5%; group III, 86.7%; group IV, 75%; p = not significant). Three late deaths (3.1%) were registered. Long-term results show persistence of sinus rhythm in 71% of group I, 61.2% of group II, 85.8% of group III, and 100% of group IV. The unique risk factor for late recurrence of atrial fibrillation was found to be preoperative atrial fibrillation longer than 6 months. Due to the satisfactory success rate in recovering sinus rhythm, we suggest performing left atrial isolation in patients with chronic atrial fibrillation undergoing valvular operations.

  9. Giant tumor thrombus in the right atrium clearly detected by /sup 111/In-oxine labeled platelet scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, T; Ishikawa, N; Satoh, A; Masuda, Y; Hiramatsu, Y; Akisada, M; Sakakibara, Y

    1985-07-01

    A 54-year-old man was admitted to hospital with a 3-month history of progressive dyspnea with coughing. A giant right atrial mass, originating from a hepatocellular carcinoma, was visualized by computed tomography, and digital subtraction angiography. The volume if the right atrial mass was increasing rapidly. It was therefore essential to determine whether this giant mass was a tumor thrombus or a multiplication of the hepatocellular carcinoma. /sup 111/In-oxine labeled platelet scintigraphy revealed active accumulation in the right atrium caused by the presence of active platelet deposition, and slight accumulation in the lung fields probably due to embolic showers originating from the tumor thrombus in the right atrium. This is the first case report showing that /sup 111/In-oxine labeled platelet scintigraphy can aid in confirming the nature of a giant tumor thrombus in the right atrium and can clarify the pathogenesis of the respiratory symptoms.

  10. Computer Simulation Investigation on the Effect of Channelled and Unchannelled Screens on Smoke Contamination in Atriums Upper Balconies

    Directory of Open Access Journals (Sweden)

    Nasif Mohammad Shakir

    2014-07-01

    Full Text Available This paper performed the effect of installing channel screen on smoke contamination in the presence of 0.5 m deep down stand in a fire compartment. The results are then compared with smoke contamination occurrence when the channel screens were removed. The results showed that there will be 96% increase in upper balconies smoke contamination in an atrium when no channel screens at fire compartment opening are used. This work provides new correlation obtained from numerical study which can predict the smoke contamination height in upper balconies of the atrium in the presence of 0.5 m down stand and no channel screens. The proposed correlation will be useful design tool for building designer to design safe shopping malls (atrium.

  11. EFFECTS OF AEROBIC TRAINING ON THE CARDIOMYOCYTES OF THE RIGHT ATRIUM OF MICE

    Directory of Open Access Journals (Sweden)

    Vanessa Gonçalves Coutinho de Oliveira

    Full Text Available ABSTRACT Introduction: Polypeptide hormones (natriuretic peptides, NPs are secreted by the cardiac atria and play an important role in the regulation of blood pressure. Objective: To evaluate the effects of aerobic training on the secretory apparatus of NPs in cardiomyocytes of the right atrium. Methods: Nine-month-old mice were divided in two groups (n=10: control group (CG and trained group (TG. The training protocol was performed on a motor treadmill for 8 weeks. Systolic blood pressure was measured at the beginning of the experiment (9 months of age and at moment of the sacrifice (11 months of age. Electron micrographs were used to quantify the following variables: the quantitative density and area of NP granules, the relative volumes of the mitochondria, endoplasmic reticulum, and Golgi complex and the relative volume of euchromatin in the nucleus and the number of pores per 10 µm of the nuclear membrane. The results were compared by Student's t test (p< 0.05. Results: The cardiomyocytes obtained from TG mice showed increased density and sectional area of secretory granules of NP, higher relative volume of endoplasmic reticulum, mitochondria, and Golgi complex compared with the CG mice. Furthermore, the quantitative density of nuclear pores and the relative volume of euchromatin in the nucleus were significantly higher compared with the CG mice. Conclusion: Aerobic training caused hypertrophy of the secretory apparatus in the cardiomyocytes of right atrium, which could explain the intense synthesis of natriuretic peptides in trained mice with respect to the untrained mice.

  12. Case of right atrial myxoma with right to left shunt

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, Kenji; Suzuki, Tomoyuki; Ohzeki, Tetsuro (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1982-12-01

    A case of 49-year-old woman with right atrial myxoma resulting to right to left shunt, diagnosed by cardiac pool isotope image, was reported. She was admitted to our clinic because of progressive shortness of breath. At admission lip cyanosis was noted. Laboratory data included polycythemia, low O/sub 2/ saturation (89%) and high erythrocyte sedimentation rate (65 mm/1 h). Chest x-p showed slight right atrial enlargement, but no pulmonary congestion. The electrocardiogram showed sinus regular rhythm with biphasic p wave in leads II, III, aVf. Although 1st heart sound at the apex was splited, no heart murmur was heard. In usual echocardiographic approach, no abnormal echogram was obtained in the right ventricular region. Lung perfusion scintiscan with Tc-99 m-MAA showed visualization of thyroid gland and kidney, which suggested intracardiac right-to-left shunt. Cardiac pool image with Tc-99m-HSA revealed large photo-deficient area in the right atrium and early visualization of aortic arch. Computor tomography showed large round low density region 8 x 7 cm in size. Based on their findings, this patient was diagnosed as right atrial tumor. At operation a large tumor (diameter 8 x 7 x 7 cm, weight 160g) filled the lower part of the right atrium and was adherent to the anterolateral wall in the right atrium. As a cause of R-L shunt, streched foramen ovale (5 x 10 mm) was found. Tumor histology was typical of atrial myxoma. Post-operative gated cardiac isotope image showed no evidence of residual atrial tumor. Cardiac blood pool isotope imaging was a method for the noninvasive detection and assessment of right atrial myxoma.

  13. Numerical investigation on the effect of balcony open and solid upstand on smoke contamination in atrium balconies

    Science.gov (United States)

    Mutafi, M. A.; Nasif, M. S.; Pao, W.; Ismail, F. B.

    2017-10-01

    Atrium is a modern architectural design of buildings that has an open space at the middle and contains several floors. In atrium structure the smoke due to fire can easily flow through the open spaces and causes smoke contamination. CFD simulation using fire dynamic simulator (FDS) software is conducted in this work, to investigate the effect of balcony open upstand on smoke contamination in atrium’s balconies and compare it with balconies with solid upstand. It was found that in case of open upstand, the smoke contamination occurrence decreased inside the balcony comparing with balconies with solid upstand.

  14. [Localization of substance P- and FMRFamide-like immunoreactivity in the atrium of the snail Achatina fulica].

    Science.gov (United States)

    Shabel'nikov, S V; Bystrova, O A; Martynova, M G

    2008-01-01

    By immunohistochemical and immunocytochemical methods localization of Substanse P (SP) and FMRFamide in the atrium of the snail Achatina fulica was investigated. Nerve fibers innervating the snail atrium contact tightly with the granular cells (GC) situated between muscle and endocardial cells, forming neuroendocrine units. Both neuromediators were found in the cells of the neuroendocrine units. By immunohistochemistry SP- and FMRFamide-immunoreactive material was revealed in the granules of the atrial GC. Elecrtonmicroscopical immunocytochemistry has confirmed the presence of SP- and FMRFamide-immunoreactive material in the granules of the GC and shown their presence in the neurosecretory granules of the nerve endings contacting both the atrial GC and cardiomyocytes.

  15. Visitors׳ perceptions on the important factors of atrium design in shopping centers: A study of Gandaria City Mall and Ciputra World in Indonesia

    Directory of Open Access Journals (Sweden)

    Astrid Kusumowidagdo

    2016-03-01

    The research was conducted with the sequential exploratory method, which involved a qualitative study, followed by a quantitative study. The objects of this research were two shopping centers located in the two largest cities in Indonesia, namely, Gandaria City Mall in Jakarta and Ciputra World in Surabaya. A total of 43 informants were a part of the qualitative data collection, and 350 respondents served as survey participants. The survey research shows that the design factors considered by visitors at the Gandaria City Mall are atrium legibility, atrium decoration, event decoration, social image and interaction, and event ambience, whereas the visitors at Ciputra World considered atrium legibility, social image and interaction, atrium ambience, and atrium decoration.

  16. Persistent left superior vena cava with absent right superior vena cava: image findings

    International Nuclear Information System (INIS)

    Araujo Junior, Cyrillo Rodrigues de; Carvalho, Tarcisio Nunes; Fraguas Filho, Sergio Roberto; Costa, Marlos Augusto Bitencourt; Jacob, Beatriz Mahmud; Machado, Marcio Martins; Teixeira, Kim-Ir-Sen Santos; Ximenes, Carlos Alberto

    2003-01-01

    Persistent left superior vena cava absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the coronary sinus. We report the case of a patient with a persistent left superior vena cava and absence of right superior vena cava identified by chance during a chest radiograph and computed tomography examination for investigation of chronic pulmonary obstructive disease. The patient had no congenital heart disease and the blood from the right side was drained by the persistent left superior vena cava into the right atrium through the coronary sinus. (author)

  17. Investigation on Smoke Movement and Smoke Control for Atrium in Green and Sustainable Buildings

    DEFF Research Database (Denmark)

    Fang, Lui; Nielsen, Peter V.; Brohus, Henrik

    The concepts of green buildings and sustainable buildings are promoted actively in the developed countries. Targets are on protecting the environment, using less energy through natural ventilation provisions and daylight utilization, developing better waste management and taking resource...... design in the green or sustainable buildings with an atrium. Since the physics of air entrainment is not yet clearly understood, most of the fire plume expressions reported in the literature was derived empirically. Experiments and CFD simulation were used to study the different types of thermal plumes...... conservation into account. Architectural and building design, electrical and mechanical systems, and building management have to be upgraded. However, there are problems in dealing with fire safety, especially in complying with the existing prescriptive fire codes. A hot argument is that smoke control system...

  18. Percutaneous retrieval of a vena cava filter from the right atrium: case report

    Energy Technology Data Exchange (ETDEWEB)

    Rasuli, P. [The Ottawa Hospital and University of Ottawa, Dept. of Radiology, Ottawa, Ontario (Canada); Mehran, R. [The Ottawa Hospital and University of Ottawa, Dept. of Thoracic Surgery, Ottawa, Ontario (Canada); French, G. [The Ottawa Hospital and University of Ottawa, Dept. of Radiology, Ottawa, Ontario (Canada); Turek, M. [The Ottawa Hospital and University of Ottawa, Dept. of Internal Medicine, Ottawa, Ontario (Canada); Lalonde, K.A. [The Ottawa Hospital and University of Ottawa, Dept. of Thoracic Surgery, Ottawa, Ontario (Canada); Cardinal, P. [The Ottawa Hospital and University of Ottawa, Dept. of Internal Medicine, Ottawa, Ontario (Canada)

    2000-07-01

    Migration of vena cava filters can occur spontaneously, but it can also occur as a result of entanglement of the filter with a guidewire, particularly during 'blind' (unguided) insertion of a central venous line. When a filter migrates to the heart, traditional practice has been either to leave the filter in place or to remove it surgically by means of open heart surgery and cardiopulmonary bypass. We found only 6 reports of successful percutaneous retrieval or repositioning of a vena cava filter (Table 1). We describe a new interventional technique for retrieving a filter from the right atrium and a novel endosurgical method for removing a filter from the innominate vein. (author)

  19. Plant Atrium System for Food Production in NASA's Deep Space Habitat Tests

    Science.gov (United States)

    Massa, Gioia D.; Simpson, Morgan; Wheeler, Raymond M.; Newsham, Gerald; Stutte, Gary W.

    2013-01-01

    In preparation for future human exploration missions to space, NASA evaluates habitat concepts to assess integration issues, power requirements, crew operations, technology, and system performance. The concept of a Food Production System utilizes fresh foods, such as vegetables and small fruits, harvested on a continuous basis, to improve the crew's diet and quality of life. The system would need to fit conveniently into the habitat and not interfere with other components or operations. To test this concept, a plant growing "atrium" was designed to surround the lift between the lower and upper modules of the Deep Space Habitat and deployed at NASA Desert Research and Technology Studies (DRATS) test site in 2011 and at NASA Johnson Space Center in 2012. With this approach, no-utilized volume provided an area for vegetable growth. For the 2011 test, mizuna, lettuce, basil, radish and sweetpotato plants were grown in trays using commercially available red I blue LED light fixtures. Seedlings were transplanted into the atrium and cared for by the. crew. Plants were then harvested two weeks later following completion of the test. In 2012, mizuna, lettuce, and radish plants were grown similarly but under flat panel banks of white LEDs. In 2012, the crew went through plant harvesting, including sanitizing tlie leafy greens and radishes, which were then consumed. Each test demonstrated successful production of vegetables within a functional hab module. The round red I blue LEDs for the 2011 test lighting cast a purple light in the hab, and were less uniformly distributed over the plant trays. The white LED panels provided broad spectrum light with more uniform distribution. Post-test questionnaires showed that the crew enjoyed tending and consuming the plants and that the white LED light in 2012 provided welcome extra light for the main HAB AREA.

  20. Left atrial spindle cell sarcoma – Case report

    Directory of Open Access Journals (Sweden)

    Nihar Mehta

    2012-07-01

    Full Text Available Primary spindle cell sarcoma of the left atrium is an extremely rare tumour. Surgical excision is the mainstay of treatment since it responds poorly to chemotherapy or radiotherapy. In spite of all the treatment, the prognosis remains poor due to inadvertent delay in diagnosis, few therapeutic options and propensity to metastasize. We present a 47-year-old male who underwent a surgical excision of a left atrial mass in February 2010. It was proved to be a high-grade spindle cell sarcoma on histopathology. He presented again in October 2010 with recurrence of the tumour for which he was re-operated. However, the tumour recurred again within one month, to which the patient succumbed.

  1. Left atrial thrombus following bilobectomy: a case report

    Directory of Open Access Journals (Sweden)

    Kaya Ugur

    2010-02-01

    Full Text Available Abstract Introduction Left atrial free floating ball thrombus is a relatively rare event, especially without mitral valve disease. Case presentation A 61-year-old Turkish man was admitted to our hospital with a thrombus mass in his left atrium. Five months earlier, he had undergone right bilobectomy and superior bronchoplasty due to squamous cell carcinoma in the lung. The patient had no evidence of cardiac disease except atrial fibrillation and there were no defined embolizations. The thrombus mass was surgically removed. The patient was discharged from hospital on the sixth postoperative day. Conclusion Surgery with cardiopulmonary bypass is a safe method for treatment. The patient should be medicated with warfarin, especially in the presence of atrial fibrillation.

  2. Isolated persistent left-sided superior vena cava, giant coronary sinus, atrial tachycardia and heart failure in a child

    Directory of Open Access Journals (Sweden)

    Nagaraja Moorthy

    2013-09-01

    Full Text Available Persistence of a left-sided superior vena cava (PLSVC with absent right superior vena cava (isolated PLSVC is a very rare venous malformation and commonly associated with congenital heart disease or alterations of the cardiac situs. We describe an unusual case of a young boy presenting with persistent atrial tachycardia and congestive heart failure. He was detected to have unexplained grossly dilated right atrium, right ventricle with systolic dysfunction and a giant coronary sinus (CS. The dilated CS closely mimicked a pseudo cor-triatriatum on echocardiography. Contrast echocardiography from both arms revealed opacification of the CS before the right atrium. Bilateral upper limb venography confirmed the presence of absent right SVC and isolated persistent left SVC draining into the giant coronary sinus.

  3. Analysis and prediction of daylighting and energy performance in atrium spaces using daylight-linked lighting controls

    International Nuclear Information System (INIS)

    Chow, Stanley K.H.; Li, Danny H.W.; Lee, Eric W.M.; Lam, Joseph C.

    2013-01-01

    Highlights: ► Daylight-linked lighting control and energy performance for atrium is studied. ► Field measurement of automatic dimming control shows 93% energy saving. ► Field measurement of manual on–off control shows 95% energy saving. ► Atrium illuminance is correlated with daylight factor for energy saving prediction. - Abstract: In subtropical Hong Kong, a certain amount of electricity is used to create visually comfortable interior spaces through electric lighting, which is the second major electricity-consuming item in commercial buildings, accounting for 20–30% of total electricity use. The burning of fossil fuels for electricity generation has many adverse effects on the environment. Daylighting is an important and useful strategy for enhancing visual comfort and reducing the need for the electricity consumed by light fittings. The rational use of daylight through tools such as photoelectric lighting controls can effectively reduce buildings’ electricity consumption and the related pollutants and greenhouse gas emissions. Daylighting design techniques are often best demonstrated via field measurements that provide reliable operational and energy performance data for establishing design guidelines. An atrium provides an environmentally controlled indoor public space that introduces daylight into the hearts of large buildings. In circulation areas such as corridors, people expect the way ahead to be sufficiently lit and daylight-linked lighting controls can deliver excellent energy savings. This paper presents the daylighting and energy performance of an atrium space using daylight-linked lighting controls. The cost, energy and environmental issues related to various daylight illuminances are estimated and design implications are discussed

  4. Optimizing computed tomography pulmonary angiography using right atrium bolus monitoring combined with spontaneous respiration

    Energy Technology Data Exchange (ETDEWEB)

    Min, Wang; Jian, Li; Rui, Zhai [Jining No. 1 People' s Hospital, Department of Computed Tomography, Jining City, ShanDong Province (China); Wen, Li [Jining No. 1 People' s Hospital, Department of Gastroenterology, Jining, ShanDong (China); Dai, Lun-Hou [Shandong Chest Hospital, Department of Radiology, Jinan, ShanDong (China)

    2015-09-15

    CT pulmonary angiography (CTPA) aims to provide pulmonary arterial opacification in the absence of significant pulmonary venous filling. This requires accurate timing of the imaging acquisition to ensure synchronization with the peak pulmonary artery contrast concentration. This study was designed to test the utility of right atrium (RA) monitoring in ensuring optimal timing of CTPA acquisition. Sixty patients referred for CTPA were divided into two groups. Group A (n = 30): CTPA was performed using bolus triggering from the pulmonary trunk, suspended respiration and 70 ml of contrast agent (CA). Group B (n = 30): CTPA image acquisition was triggered using RA monitoring with spontaneous respiration and 40 ml of CA. Image quality was compared. Subjective image quality, average CT values of pulmonary arteries and density difference between artery and vein pairs were significantly higher whereas CT values of pulmonary veins were significantly lower in group B (all P < 0.05). There was no significant difference between the groups in the proportion of subjects where sixth grade pulmonary arteries were opacified (P > 0.05). RA monitoring combined with spontaneous respiration to trigger image acquisition in CTPA produces optimal contrast enhancement in pulmonary arterial structures with minimal venous filling even with reduced doses of CA. (orig.)

  5. Simultaneous Epicardial and Noncontact Endocardial Mapping of the Canine Right Atrium: Simulation and Experiment

    Science.gov (United States)

    Sabouri, Sepideh; Matene, Elhacene; Vinet, Alain; Richer, Louis-Philippe; Cardinal, René; Armour, J. Andrew; Pagé, Pierre; Kus, Teresa; Jacquemet, Vincent

    2014-01-01

    Epicardial high-density electrical mapping is a well-established experimental instrument to monitor in vivo the activity of the atria in response to modulations of the autonomic nervous system in sinus rhythm. In regions that are not accessible by epicardial mapping, noncontact endocardial mapping performed through a balloon catheter may provide a more comprehensive description of atrial activity. We developed a computer model of the canine right atrium to compare epicardial and noncontact endocardial mapping. The model was derived from an experiment in which electroanatomical reconstruction, epicardial mapping (103 electrodes), noncontact endocardial mapping (2048 virtual electrodes computed from a 64-channel balloon catheter), and direct-contact endocardial catheter recordings were simultaneously performed in a dog. The recording system was simulated in the computer model. For simulations and experiments (after atrio-ventricular node suppression), activation maps were computed during sinus rhythm. Repolarization was assessed by measuring the area under the atrial T wave (ATa), a marker of repolarization gradients. Results showed an epicardial-endocardial correlation coefficients of 0.80 and 0.63 (two dog experiments) and 0.96 (simulation) between activation times, and a correlation coefficients of 0.57 and 0.46 (two dog experiments) and 0.92 (simulation) between ATa values. Despite distance (balloon-atrial wall) and dimension reduction (64 electrodes), some information about atrial repolarization remained present in noncontact signals. PMID:24598778

  6. Simultaneous epicardial and noncontact endocardial mapping of the canine right atrium: simulation and experiment.

    Science.gov (United States)

    Sabouri, Sepideh; Matene, Elhacene; Vinet, Alain; Richer, Louis-Philippe; Cardinal, René; Armour, J Andrew; Pagé, Pierre; Kus, Teresa; Jacquemet, Vincent

    2014-01-01

    Epicardial high-density electrical mapping is a well-established experimental instrument to monitor in vivo the activity of the atria in response to modulations of the autonomic nervous system in sinus rhythm. In regions that are not accessible by epicardial mapping, noncontact endocardial mapping performed through a balloon catheter may provide a more comprehensive description of atrial activity. We developed a computer model of the canine right atrium to compare epicardial and noncontact endocardial mapping. The model was derived from an experiment in which electroanatomical reconstruction, epicardial mapping (103 electrodes), noncontact endocardial mapping (2048 virtual electrodes computed from a 64-channel balloon catheter), and direct-contact endocardial catheter recordings were simultaneously performed in a dog. The recording system was simulated in the computer model. For simulations and experiments (after atrio-ventricular node suppression), activation maps were computed during sinus rhythm. Repolarization was assessed by measuring the area under the atrial T wave (ATa), a marker of repolarization gradients. Results showed an epicardial-endocardial correlation coefficients of 0.80 and 0.63 (two dog experiments) and 0.96 (simulation) between activation times, and a correlation coefficients of 0.57 and 0.46 (two dog experiments) and 0.92 (simulation) between ATa values. Despite distance (balloon-atrial wall) and dimension reduction (64 electrodes), some information about atrial repolarization remained present in noncontact signals.

  7. Simultaneous epicardial and noncontact endocardial mapping of the canine right atrium: simulation and experiment.

    Directory of Open Access Journals (Sweden)

    Sepideh Sabouri

    Full Text Available Epicardial high-density electrical mapping is a well-established experimental instrument to monitor in vivo the activity of the atria in response to modulations of the autonomic nervous system in sinus rhythm. In regions that are not accessible by epicardial mapping, noncontact endocardial mapping performed through a balloon catheter may provide a more comprehensive description of atrial activity. We developed a computer model of the canine right atrium to compare epicardial and noncontact endocardial mapping. The model was derived from an experiment in which electroanatomical reconstruction, epicardial mapping (103 electrodes, noncontact endocardial mapping (2048 virtual electrodes computed from a 64-channel balloon catheter, and direct-contact endocardial catheter recordings were simultaneously performed in a dog. The recording system was simulated in the computer model. For simulations and experiments (after atrio-ventricular node suppression, activation maps were computed during sinus rhythm. Repolarization was assessed by measuring the area under the atrial T wave (ATa, a marker of repolarization gradients. Results showed an epicardial-endocardial correlation coefficients of 0.80 and 0.63 (two dog experiments and 0.96 (simulation between activation times, and a correlation coefficients of 0.57 and 0.46 (two dog experiments and 0.92 (simulation between ATa values. Despite distance (balloon-atrial wall and dimension reduction (64 electrodes, some information about atrial repolarization remained present in noncontact signals.

  8. Etiologic significance of enlargement of the left atrial appendage in adults

    International Nuclear Information System (INIS)

    Green, C.E.; Kelley, M.J.; Higgins, C.B.

    1982-01-01

    Fifty-one patients were divided into two groups: 20 patients with proven rheumatic mitral valve disease (RMVD) and 31 patients with left atrial enlargement (LAE) of a nonrheumatic etiology. The latter group included patients with ischemic papillary muscle dysfunction, mitral valve prolapse, and congestive cardiomyopathy. Radiographic studies showed that enlargement of the left atrial appendage (LAAE) was present in 18 of 20 rheumatics but in only one of 31 nonrheumatics. There was no direct relationship between enlargement of the LAA and radiographic or echocardiographic left atrial size, degree of pulmonary venous hypertension (PVH), or presence of atrial fibrillation. It is postulated that rheumatic influammation of the LAA allows it to dilate out of proportion to the body of the left atrium. In the adult patient with radiographic findings of PVH, LAAE is a valuable and specific radiographic sign of rheumatic mitral valve disease

  9. Use of the Amplatzer ASD Occluder for Closing a Persistent Left Vertical Vein

    International Nuclear Information System (INIS)

    Zanchetta, Mario; Zennaro, Marco; Zecchel, Roberto; Mancuso, Daniela; Pedon, Luigi

    2009-01-01

    We report the case of a very large anomalous connection of the veins draining the upper lobe of the left lung to both the left-sided vertical vein and the left atrium, associated with mild rheumatic mitral valve stenosis, in which the atrial septum was intact and the remaining venous system, including the coronary sinus, was otherwise normal (a variant of Lutembacher's syndrome). In order to abolish the left-to-right shunting, a transcatheter approach to close this venous structure was successfully attempted using an Amplatzer ASD Occluder device. The technical aspects and the alternative options of performing a procedure with a device for a purpose outside the scope of its approved label are discussed.

  10. Quantitative description of the regional mechanics of the left atria by electroanatomical mapping

    International Nuclear Information System (INIS)

    Kuklik, Pawel; Molaee, Payman; Brooks, Anthony G; John, Bobby; Worthley, Stephen G; Sanders, Prashanthan

    2010-01-01

    The left atrium is a complex chamber, which plays an integral role in the maintenance of physiologic hemodynamic and electrical stability of the heart and is involved in many disease states, most commonly atrial fibrillation. Preserving regions of the left atrium that contribute the greatest to atrial mechanical function during curative strategies for atrial fibrillation are important. We present here a new application of the CARTO electroanatomical mapping system in the assessment of the left atria mechanical function. Electroanatomical data were collected in course of the electrophysiological procedure in 11 control patients and 12 patients with paroxysmal atrial fibrillation. The three-dimensional geometry of the left atria was reconstructed in 10 ms intervals and segmented into distinct regions. For each segment, a regional ejection fraction was calculated. We found that anterior, septal and lateral segments have significantly greater regional ejection fraction than atria roof, inferior and posterior segments. Therefore, we hypothesize that in order to minimize the impact on atrial mechanical function, an important determinant of thromboembolic risk, damage should be minimized to these atrial regions

  11. Visitors׳ perceptions on the important factors of atrium design in shopping centers: A study of Gandaria City Mall and Ciputra World in Indonesia

    OpenAIRE

    Astrid Kusumowidagdo; Agus Sachari; Pribadi Widodo

    2016-01-01

    Atriums as quasi-internal public spaces in shopping centers play an essential role as an identity provider and offer spatial orientation in shopping center architecture. This study aims to examine the significant factors of atrium design, which can provide a sense of place for shopping center visitors. The research was conducted with the sequential exploratory method, which involved a qualitative study, followed by a quantitative study. The objects of this research were two shopping centers l...

  12. Factors of Formation of Various Types of Left Ventricular Diastolic Filling in Adolescents with Myocardium Pathology

    Directory of Open Access Journals (Sweden)

    L.F. Bogmat

    2016-08-01

    Full Text Available Objective: to study the main components of the formation of impaired left ventricular diastolic filling in adolescents with myocardial pathology. Materials and methods. The study involved 110 adolescents with myocardial pathology aged 13–18 years, of which 40 — with heart rhythm disorder, 40 — with dysplastic cardiomyopathy, 30 — with primary hypertension. Morphological and functional parameters of the heart were studied using ultrasound according to standard procedure. Left ventricular diastolic function has been studied in the pulsed wave Doppler mode with transmitral flow mapping from the apical access of four-chambered heart. For an adequate assessment of left ventricular diastolic function and detection of its earliest disorders, adolescents underwent tests with isometric exercise. Based on these results, adolescents were divided in terms of the E/A ratio. In order to identify common latent factors that explain the correlation between indicators, we have used the factor analysis, namely, the principal component analysis. All statistical procedures were performed using application packages Statgraphics Centurion. Results. On the initial stages of formation of diastolic dysfunction of the left ventricular myocardium in adolescents, a significant role is played by a number of factors, which can be conditionally defined as the geometric, functional and neurohumoral factors consistently included in the pathological process. Thus, during the formation of left ventricular diastolic dysfunction type 1, the number one is neurohumoral factor, namely, the activation of the sympathoadrenal system, then peripheral vascular tone is being involved in the pathological process, and, consequently, a geometric factor — changing the sizes of the left atrium. In the formation of left ventricular diastolic dysfunction type 2, the process consistently involves the renin-angiotensin system, namely, renin, a functional factor is presented by the indices

  13. The left atrio-vertebral ratio. A new simple means for assessing left atrial enlargement on computed tomography

    International Nuclear Information System (INIS)

    Montillet, Marie; Tasu, Jean-Pierre; Baque-Juston, Marie; Bertrand, Sandra; Berthier, Frederic; Zarqane, Naima; Brunner, Philippe

    2018-01-01

    The purpose of this study is to describe a new method to quickly estimate left atrial enlargement (LAE) on Computed Tomography. Left atrial (LA) volume was assessed with a 3D-threshold Hounsfield unit detection technique, including left atrial appendage and excluding pulmonary venous confluence, in 201 patients with ECG-gated 128-slice dual-source CT and indexed to body surface area. LA and vertebral axial diameter and area were measured at the bottom level of the right inferior pulmonary vein ostium. Ratio of LA diameter and surface on vertebra (LAVD and LAVA) were compared to LA volume. In accordance with the literature, a cutoff value of 78 ml/m 2 was chosen for maximal normal LA volume. 18% of LA was enlarged. The best cutoff values for LAE assessment were 2.5 for LAVD (AUC: 0.65; 95% CI: 0.58-0.73; sensitivity: 57%; specificity: 71%), and 3 for LAVA (AUC: 0.78; 95% CI: 0.72-0.84; sensitivity: 67%; specificity: 79%), with higher accuracy for LAVA (P=0.015). Inter-observer and intra-observer variability were either good or excellent for LAVD and LAVA (respective intraclass coefficients: 0.792 and 0.910; 0.912 and 0.937). A left atrium area superior to three times the vertebral area indicates LAE with high specificity. (orig.)

  14. The left atrio-vertebral ratio. A new simple means for assessing left atrial enlargement on computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Montillet, Marie; Tasu, Jean-Pierre [Centre Hospitalier Universitaire de Poitiers, Poitiers (France); Baque-Juston, Marie; Bertrand, Sandra; Berthier, Frederic; Zarqane, Naima; Brunner, Philippe [Hopital Princesse Grace, Monaco (Monaco)

    2018-03-15

    The purpose of this study is to describe a new method to quickly estimate left atrial enlargement (LAE) on Computed Tomography. Left atrial (LA) volume was assessed with a 3D-threshold Hounsfield unit detection technique, including left atrial appendage and excluding pulmonary venous confluence, in 201 patients with ECG-gated 128-slice dual-source CT and indexed to body surface area. LA and vertebral axial diameter and area were measured at the bottom level of the right inferior pulmonary vein ostium. Ratio of LA diameter and surface on vertebra (LAVD and LAVA) were compared to LA volume. In accordance with the literature, a cutoff value of 78 ml/m{sup 2} was chosen for maximal normal LA volume. 18% of LA was enlarged. The best cutoff values for LAE assessment were 2.5 for LAVD (AUC: 0.65; 95% CI: 0.58-0.73; sensitivity: 57%; specificity: 71%), and 3 for LAVA (AUC: 0.78; 95% CI: 0.72-0.84; sensitivity: 67%; specificity: 79%), with higher accuracy for LAVA (P=0.015). Inter-observer and intra-observer variability were either good or excellent for LAVD and LAVA (respective intraclass coefficients: 0.792 and 0.910; 0.912 and 0.937). A left atrium area superior to three times the vertebral area indicates LAE with high specificity. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Solmaz Fakhari

    2016-01-01

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

  16. Isolated persistent left superior vena cava: A case report and its clinical implications

    Directory of Open Access Journals (Sweden)

    Samarjit Bisoyi

    2017-01-01

    Full Text Available The venous anomaly of a persistent left superior vena cava (PLSVC affects 0.3%-0.5% of the general population. PLSVC with absent right superior vena cava, also termed as "isolated PLSVC," is an extremely rare venous anomaly. Almost half of the patients with isolated PLSVC have cardiac anomalies in the form of atrial septal defect, endocardial cushion defects, or tetralogy of Fallot. Isolated PLSVC is usually innocuous. Its discovery, however, has important clinical implications. It can pose clinical difficulties with central venous access, cardiothoracic surgeries, and pacemaker implantation. When it drains to the left atrium, it may create a right to left shunt. In this case report, we present the incidental finding of isolated PLSVC in a patient who underwent aortic valve replacement. Awareness about this condition and its variations is important to avoid complications.

  17. Types of Diastolic Dysfunction of the Left Ventricle in Adolescents with Myocardial Pathology

    Directory of Open Access Journals (Sweden)

    L.F. Bogmat

    2014-05-01

    Full Text Available In adolescents with myocardial pathology during isometric tests we detected three types of diastolic dysfunction of the left ventricle (LV of the heart, depending on E/A ratio. The most pronounced signs of diastolic filling disorders were detected in the third group of patients, as evidenced: by a tendency to increase isovolumic relaxation time, a significant increase of slowing down time of the first phase of left ventricular filling, reduced LV filling rate both in the first phase of the passive filling and the second phase of active LV filling, increasing E/A ratio of more than 2, significant dilation of the left atrium, as well as positive increase in diastolic reserve that confirms deeper diastolic dysfunction in these adolescents compared with other subgroups.

  18. Primary Leiomyosarcoma in the Inferior Vena Cava Extended to the Right Atrium: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shuichi Fujita

    2016-10-01

    Full Text Available A 38-year-old woman had developed an abdominal distention, lower extremity edema, and dyspnea. Imaging examination revealed a large mass in the right atrium which was connected to lesions within the inferior vena cava. Although complete resection of the mass was not possible, partial surgical tumor resection was performed to avoid pulmonary embolization and circulatory collapse. Leiomyosarcoma was diagnosed histologically, and chemotherapy (doxorubicin followed by radiotherapy was started. By reviewing papers published in the past 10 years that included 322 patients, we also discuss the clinical presentations and prognosis of leiomyosarcoma in the inferior vena cava.

  19. [Left atrial electric isolation in the treatment of atrial fibrillation secondary to rheumatic valvular disease].

    Science.gov (United States)

    Graffigna, A; Pagani, F; Minzioni, G; Salerno, J; Viganò, M

    1992-08-01

    Surgical isolation of the left atrium was performed for the treatment of chronic atrial fibrillation secondary to valvular disease in 100 patients who underwent valve surgery. From May 1989 to September 1991, 62 patients underwent mitral valve surgery (Group I), 19 underwent mitral valve surgery and DeVega tricuspid annuloplasty (Group II), 15 underwent mitral and aortic surgery (Group III), and 4 patients underwent mitral and aortic surgery and DeVega tricuspid annuloplasty (Group IV). Left atrial isolation was performed prolonging the usual left paraseptal atriotomy towards the left fibrous trigone anteriorly, and the postero-medial commissure posteriorly. The incision was conducted a few millimeters apart from the mitral valve annulus, and cryolesion were placed at the edges to ensure complete electrophysiological isolation of the left atrium. Operative mortality accounted for 3 cases (3%). In 79 patients (81.4%) sinus rhythm recovered and persisted until discharge from the hospital. No differences were found between the groups (Group I: 80.7%; Group II: 68.5%; Group III 86.7%, Group IV 75% - p = N.S.). Three cases of late mortality (3.1%) were registered. long-term results showed persistence of SR in 71% of Group I, 61.2% of Group II, 85.8% of Group III, and 100% of Group IV. The unique risk factor for late recurrency of atrial fibrillation was found to be a duration of preoperative AF longer than 6 months. Due to the high success rate in recovering the sinus rhythm, we suggest left atrial isolation in patients with chronic atrial fibrillation undergoing valvular surgery.

  20. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    International Nuclear Information System (INIS)

    Murdoch, Dale; McAulay, Laura; Walters, Darren L.

    2014-01-01

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy

  1. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  2. Crude extract and purified components isolated from the stems of Tinospora crispa exhibit positive inotropic effects on the isolated left atrium of rats

    DEFF Research Database (Denmark)

    Praman, Siwaporn; Mulvany, Michael J.; Williams, David E.

    2013-01-01

    -butanol soluble material was concentrated and dried under reduced pressure and lyophilized to obtain a crude powder (Tinospora crispa extract). The active components of Tinospora crispa extract were separated by column chromatography and preparative HPLC. The effects and mechanisms of the n-butanol extract...

  3. Multimodality Cardiac Imaging for the Assessment of Left Atrial Function and the Association With Atrial Arrhythmias

    DEFF Research Database (Denmark)

    Olsen, Flemming Javier; Bertelsen, Litten; de Knegt, Martina Chantal

    2016-01-01

    Several cardiac imaging modalities are able to visualize the left atrium (LA) and, therefore, allow for quantification of both structural and functional properties of this cardiac chamber. In echocardiography, only the maximal LA volume is included in the assessment of diastolic function at the c......Several cardiac imaging modalities are able to visualize the left atrium (LA) and, therefore, allow for quantification of both structural and functional properties of this cardiac chamber. In echocardiography, only the maximal LA volume is included in the assessment of diastolic function...... atrial fibrillation, which will be a point of focus in this review. Pivotal cardiac magnetic resonance imaging studies have revealed high correlation between LA fibrosis and risk of atrial fibrillation recurrence after catheter ablation, and subsequent multimodality imaging studies have uncovered...... an inverse relationship between LA reservoir function and degree of LA fibrosis. This has sparked an increased interest into the application of advanced imaging modalities, including both speckle tracking echocardiography and tissue tracking by cardiac magnetic resonance imaging. Even though increasing...

  4. Left atrial function in heart failure with impaired and preserved ejection fraction.

    Science.gov (United States)

    Fang, Fang; Lee, Alex Pui-Wai; Yu, Cheuk-Man

    2014-09-01

    Left atrial structural and functional changes in heart failure are relatively ignored parts of cardiac assessment. This review illustrates the pathophysiological and functional changes in left atrium in heart failure as well as their prognostic value. Heart failure can be divided into those with systolic dysfunction and heart failure with preserved ejection fraction (HFPEF). Left atrial enlargement and dysfunction commonly occur in systolic heart failure, in particular, in idiopathic dilated cardiomyopathy. Atrial enlargement and dysfunction also carry important prognostic value in systolic heart failure, independently of known parameters such as left ventricular ejection fraction. In HFPEF, there is evidence of left atrial enlargement, impaired atrial compliance, and reduction of atrial pump function. This occurs not only at rest but also during exercise, indicating significant impairment of atrial contractile reserve. Furthermore, atrial dyssynchrony is common in HFPEF. These factors further contribute to the development of new onset or progression of atrial arrhythmias, in particular, atrial fibrillation. Left atrial function is an integral part of cardiac function and its structural and functional changes in heart failure are common. As changes of left atrial structure and function have different clinical implications in systolic heart failure and HFPEF, routine assessment is warranted.

  5. Radionuclide detection and differential diagnosis of left-to-right cardiac shunts by analysis of time-activity curves

    International Nuclear Information System (INIS)

    Kim, Ok-Hwa

    1986-01-01

    The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity histograms of the right atrium, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunts level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was hight than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/QS ratios were equal in both lungs. (J.P.N.)

  6. The clot thickens: an incompletely ligated left  atrial appendage

    Directory of Open Access Journals (Sweden)

    Merrill Thomas

    2018-05-01

    Full Text Available Our patient presented with known mechanical mitral valve endocarditis documented by 2D transesophageal echocardiogram (TOE from a recent hospitalization at an outside facility. On admission to our center, there was no prior knowledge of an incompletely ligated left atrial appendage (LAA according to patient- or family-reported history, review of outside records or the outside facility’s 2D TOE report. A 3D TOE performed at our center to assess her pathology, since a month had passed from her prior hospitalization, revealed a LAA ligation with evidence of communication to the left atrium and with clot present in the appendage. This case report highlights the common finding of incomplete closure of the LAA following surgical ligation, thus making it inadequate for stroke prevention in patients with atrial fibrillation, and that 3D TOE plays a valuable role in assessing the durability of LAA ligation.

  7. The Hispanic Monarchy in the Era of the Holy Spirit: the Atrium of Valadés

    Directory of Open Access Journals (Sweden)

    Guillermo Serés

    2017-11-01

    Full Text Available The autghor of this article analyse the influence of the work of the Millenarian Joaquin Da Fiore, Ramon Llull and Arias Montano on the composition of Christian Rhetoric by Diego Valadés. From the first of these writers, the author takes the notion of the era of the Holy Spirit; from the second, the concept of the Earthly City, for conquering the Indians; from the third, an idea for an engraving of significance in Valadés’ book, namely, the convent atrium. Additionally, he also take into account the idea of restitutio and reductio ad unum, with which both the mission of his Franciscan order and that of the Spanish monarchy are justified.

  8. [The vulnerability of the human atrium. I. Correlations between vulnerability, sinus node recovery time and intraatrial conduction time (author's transl)].

    Science.gov (United States)

    Pop, T; Fleischmann, D; Effert, S

    1976-09-01

    Using the extrastimulus method in 100 patients, premature impulses were applied during the relative refractory period of the right atrium. Depending on the atrial response to these impulses we divided our patients in the following 3 groups: Group A: no repetitive firing (61 patients); group B: 1 to 5 additional atrial extrasystoles with a total duration of maximum 1.5 s (27 patients); group C: runs of atrial flutter or fibrilation for at least 8 s (12 patients). The statistical analysis of the following parameters: age, PA interval, absolute and corrected sinus node recovery time did not show any significant difference between the 3 groups. These results suggest that the investigated parameters are of no great importance in the genesis of the atrial vulnerability.

  9. Successful ablation of a right atrium-axillary ventricular accessory pathway associated with Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Yuan, Yuan; Long, Deyong; Dong, Jianzeng; Tao, Ling; Ma, Changsheng

    2017-12-01

    We report a case of a patient with right axillary ventricular. Similar congenital anomaly of the right atrium was reported as "right appendage diverticulum or right atrial diverticulum." However, this independent chamber has its own annulus, synchronizes with the right ventricular, and generates large ventricular potential. Under the guidance of the CARTO mapping system (Biosense Webster, Diamond Bar, CA, USA), a right atrioventricular accessory pathway associated with type B Wolff-Parkinson-White syndrome was ablated successfully. This pathway was close to the annulus of the axillary ventricular. The patient remained free of arrhythmia at 1-year follow-up. © 2017 Wiley Periodicals, Inc.

  10. Numerical investigations of buoyancy-driven natural ventilation in a simple three-storey atrium building and thermal comfort evaluation

    International Nuclear Information System (INIS)

    Hussain, Shafqat; Oosthuizen, Patrick H.

    2013-01-01

    The numerical investigations of buoyancy-driven natural ventilation and thermal comfort evaluation in a simple three-storey atrium building as a part of the passive ventilation strategy was undertaken using a validated Computational Fluid Dynamic (CFD) model. The Reynolds Averaged Navier–Stokes (RANS) modeling approach with the SST-k–ω turbulence model and the discrete transfer radiation model (DTRM) was used for the numerical investigations. The steady-state governing equations were solved using a commercial solver FLUENT©. Various flow situations of the buoyancy-driven natural ventilation in the building during day and night time were examined. The numerical results obtained for the airflow rates, airflow patterns and temperature distributions inside the building are presented in this paper. Using the numerical results, the well-known thermal comfort indices PMV (predicted mean vote) and PPD (predicted percentage of dissatisfied) were calculated for the evaluation of the thermal comfort conditions in the occupied regions of the building. It was noticed that thermal conditions prevailing in the occupied areas of the building as a result of using the buoyancy-driven ventilation were mostly in comfort zone. From the study of the night time ventilation, it was found that hot water (80 °C) circulation (heated by solar collectors during daytime) along the chimney walls during night time and heat sources present in the building can be useful in inducing night ventilation airflows in the building as a part of the passive ventilation strategy. -- Highlights: • A simple three-storey atrium building. • Numerical modeling of buoyancy-driven ventilation flow in the building. • Effect of solar intensity and geographical location on ventilation. • CFD predictions were used to calculate thermal comfort indices. • Evaluation of thermal comfort conditions for the occupants

  11. Left heart ventricular angiography

    Science.gov (United States)

    ... blood vessels. These x-ray pictures create a "movie" of the left ventricle as it contracts rhythmically. ... 22578925 www.ncbi.nlm.nih.gov/pubmed/22578925 . Review Date 9/26/2016 Updated by: Michael A. ...

  12. Left heart catheterization

    Science.gov (United States)

    Catheterization - left heart ... to help guide the catheters up into your heart and arteries. Dye (sometimes called "contrast") will be ... in the blood vessels that lead to your heart. The catheter is then moved through the aortic ...

  13. The importance of integrated left atrial evaluation: From hypertension to heart failure with preserved ejection fraction.

    Science.gov (United States)

    Beltrami, Matteo; Palazzuoli, Alberto; Padeletti, Luigi; Cerbai, Elisabetta; Coiro, Stefano; Emdin, Michele; Marcucci, Rossella; Morrone, Doralisa; Cameli, Matteo; Savino, Ketty; Pedrinelli, Roberto; Ambrosio, Giuseppe

    2018-02-01

    Functional analysis and measurement of left atrium are an integral part of cardiac evaluation, and they represent a key element during non-invasive analysis of diastolic function in patients with hypertension (HT) and/or heart failure with preserved ejection fraction (HFpEF). However, diastolic dysfunction remains quite elusive regarding classification, and atrial size and function are two key factors for left ventricular (LV) filling evaluation. Chronic left atrial (LA) remodelling is the final step of chronic intra-cavitary pressure overload, and it accompanies increased neurohormonal, proarrhythmic and prothrombotic activities. In this systematic review, we aim to purpose a multi-modality approach for LA geometry and function analysis, which integrates diastolic flow with LA characteristics and remodelling through application of both traditional and new diagnostic tools. The most important studies published in the literature on LA size, function and diastolic dysfunction in patients with HFpEF, HT and/or atrial fibrillation (AF) are considered and discussed. In HFpEF and HT, pulsed and tissue Doppler assessments are useful tools to estimate LV filling pressure, atrio-ventricular coupling and LV relaxation but they need to be enriched with LA evaluation in terms of morphology and function. An integrated evaluation should be also applied to patients with a high arrhythmic risk, in whom eccentric LA remodelling and higher LA stiffness are associated with a greater AF risk. Evaluation of LA size, volume, function and structure are mandatory in the management of patients with HT, HFpEF and AF. A multi-modality approach could provide additional information, identifying subjects with more severe LA remodelling. Left atrium assessment deserves an accurate study inside the cardiac imaging approach and optimised measurement with established cut-offs need to be better recognised through multicenter studies. © 2017 John Wiley & Sons Ltd.

  14. Unsuccessful lung scan due to major right-to-left shunt through a sinus venosus septal defect

    International Nuclear Information System (INIS)

    Brendel, A.J.; Larnaudie, B.; Lambert, B.; Leccia, F.; Barat, J.L.; Ducassou, D.; Fontan, F.

    1985-01-01

    In a patient with a prior history of cerebral abscess and cerebral ischemia, an unsuccessful perfusion lung scan led to a radionuclide angiocardiogram using an arm vein injection. This showed a total right-to-left (R-L) shunt from the superior vena cava (SVC) to the left atrium. Repeat radionuclide study, through a leg vein, demonstrated a moderate R-L shunt and an interpretable lung scan could be obtained. Catheterization and contrast cineangiogram did not provide the exact diagnosis, the preoperative conclusion being anomalous drainage of the SVC into the left atrium, with atrial septal defect (ASD) and partial anomalous pulmonary venous connection to the SVC. The operative diagnosis was high atrial (sinus venosus) septal defect. This example of major but clinically unsuspected R-L shunt emphasizes the value of performing a perfusion lung scan, preferably in conjunction with radionuclide angiocardiography in patients with a prior history of unexplained cerebral abscess or systemic ischemia. Implications of the site of an ASD on quantitation of L-R shunts by radionuclide methods are also discussed

  15. Numerical investigations of buoyancy-driven natural ventilation in a simple atrium building and its effect on the thermal comfort conditions

    International Nuclear Information System (INIS)

    Hussain, Shafqat; Oosthuizen, Patrick H.

    2012-01-01

    In the present study use of solar-assisted buoyancy-driven natural ventilation in a simple atrium building is explored numerically with particular emphasis on the thermal comfort conditions in the building. Initially various geometric configurations of the atrium space were considered in order to investigate airflows and temperature distributions in the building using a validated computational fluid dynamics (CFD) model. The Reynolds Averaged Navier–Stokes (RANS) modelling approach with the SST-k–ω turbulence model and the Discrete Transfer Radiation Model (DTRM) was used for the investigations. The steady-state governing equations were solved using a commercial CFD solver FLUENT © . From the numerical results obtained, it was noted that an atrium space integrated with a solar chimney would be a relatively better option to be used in an atrium building. In the geometry selected, the performance of the building in response to various changes in design parameters was investigated. The produced airflows and temperature distributions were then used to evaluate indoor thermal comfort conditions in terms of the thermal comfort indices, i.e. the well-known predicted mean vote (PMV) index, its modifications especially for natural ventilation, predicted percent dissatisfied (PPD) index and Percent dissatisfied (PD) factor due to draft. It was found that the thermal conditions in the occupied areas of the building developed as a result of the use of solar-assisted buoyancy-driven ventilation for the particular values of the design parameters selected are mostly in the comfortable zone. Finally, it is demonstrated that the proposed methodology leads to reliable thermal comfort predictions, while the effect of various design variables on the performance of the building is easily recognized. - Highlights: ► Numerical investigations were carried for the use of buoyancy-driven displacement ventilation in a simple atrium building. ► Effect of various atrium

  16. ABO blood groups: A risk factor for left atrial and left atrial appendage thrombogenic milieu in patients with non-valvular atrial fibrillation.

    Science.gov (United States)

    Fu, Yuan; Li, Kuibao; Yang, Xinchun

    2017-08-01

    Previous studies have identified ABO blood groups as predictors of thromboembolic diseases. In patients with atrial fibrillation (AF), however, potential association between ABO blood groups and the risk of left atrial (LA) and/or left atrial appendage (LAA) thrombogenic milieu (TM) has not been established. This is a retrospective case-control study that included 125 consecutive patients with non-valvular atrial fibrillation (NVAF) plus TM, as evidenced by transesophageal echocardiography (TEE) during a period from1 January 2010 to 31 December 2016. The controls were selected randomly from 1072 NVAF without TM at a 1:2 ratio. Potential association between ABO blood groups and TM was analyzed using multivariate logistic regression analysis. The risk of TM was higher in patients with blood group A (33.6% vs. 20.2% in non-A blood groups, P=0.005). After adjusting for age, sex, oral anticoagulant use, AF type and duration, and relevant functional measures (e.g., NT-pro BNP level, left atrium diameter, and left ventricular ejection fraction), blood group A remained associated with an increased risk of TM (OR=2.99, 95% CI 1.4-6.388, P=0.005). Blood group A is an independent risk factor for TM in NVAF patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Giant congenital aneurysm of the appendix of the left auricle; an entity potentially lethal

    International Nuclear Information System (INIS)

    Perafan, Sergio; Ascione, Giovanny; Parra, Luis E; Jimenez, Luz S

    2004-01-01

    The case of a 22 years old female patient who at 16 years of age suffered a closed thoracic trauma during a car accident is reported. She underwent surgery under extra corporeal circulation with femoro-femoral cannulation with the diagnosis of rupture of the left atrium. a large aneurysm of the left auricle without evidence of heart trauma, pericardial leakage or hemo pericardium, was found. The surgeon decided not to perform surgery on the aneurysm and to withdraw the extra corporeal circulation, proceeding to suture the patient, who was released with the recommendation of performing additional studies in order to consider the handling of the aneurysm. Six years later she is sent to our institution with the diagnosis of cerebral embolism with left hemiparesis, and a giant partially thrombosed left auricle aneurysm. With a diagnosis of an embolizing partially thrombosed aneurysm of the left auricle she underwent surgery under extracorporeal circulation in order to resect it. The case with the intraoperative findings and the surgical technique are described. Different manifestations and expressions of this potentially lethal rare entity are detailed, concluding that it is imperative to resect surgically the aneurysm once it has been diagnosed

  18. A case of anemia with left atrial myxoma suspected as late effect of an atomic bomb

    International Nuclear Information System (INIS)

    Sugahara, Hiroko; Aosaki, Noboru; Kurita, Akira

    1980-01-01

    A 43 years old housewife with a history of exposure to an atomic bomb at 8 years old, recently developed anemia and palpitation. The laboratory data showed accelerated ESR, anemia (Hb 10.0 g/dl), and hyper γ-globulinemia. Despite the suspicion of late effect of atomic radiation, further examinations confirmed the diagnosis of left atrial myxoma. The echocardiographic studies revealed the decrease of diastolic descent rate, and multiple echos reflected from the tumor within the mitral orifice during diastole. Cardiac catheterization demonstrated remarkably high value of PCWP (V-wave 38 mmHg) and space filling defect moving from left atrium to left ventricle by cineangiography. Phonecardiographic studies were similar to mitral stenosis. After left atrial myxoma was removed, her symptoms and laboratory data including all noninvasive findings were improved. Therefore we suspected that her symptoms was related with left atrial myxoma rather than the late effect of atomic bomb exposure. We have discussed its significance and usefulness of noninvasive diagnostic approaches as well as whole body computed tomography in heart tumor. (author)

  19. Size of Left Cardiac Chambers Correlates with Cerebral Microembolic Load in Open Heart Operations

    Directory of Open Access Journals (Sweden)

    Elena Z. Golukhova

    2010-01-01

    Full Text Available Background. Microemboli are a widely recognized etiological factor of cerebral complications in cardiac surgery patients. The present study was aimed to determine if size of left cardiac chambers relates to cerebral microembolic load in open heart operations. Methods. Thirty patients participated in the study. Echocardiography was performed in 2-3 days before surgery. A transcranial Doppler system was used for registering intraoperative microemboli. Results. Preoperative left atrium and left ventricular end-systolic and end-diastolic sizes significantly correlated with intraoperative microembolic load (s=0.48, 0.57 and 0.53, s≺.01, resp.. The associations between left ventricular diameters and number of cerebral microemboli remained significant when cardiopulmonary bypass time was included as a covariate into the analysis. Conclusions. The present results demonstrate that increased size of left heart chambers is an influential risk factor for elevated cerebral microembolic load during open heart operations. Mini-invasive surgery and carbon dioxide insufflation into wound cavity may be considered as neuroprotective approaches in patients with high risk of cerebral microembolism.

  20. No Community Left Behind

    Science.gov (United States)

    Schlechty, Phillip C.

    2008-01-01

    The debate over the reauthorization of No Child Left Behind (NCLB) generally overlooks--or looks past--what may be the most fundamental flaw in that legislation. As the law is now written, decisions regarding what the young should know and be able to do are removed from the hands of parents and local community leaders and turned over to officials…

  1. The Children Left Behind

    Science.gov (United States)

    Gillard, Sarah A.; Gillard, Sharlett

    2012-01-01

    This article explores some of the deficits in our educational system in regard to non-hearing students. It has become agonizingly clear that non-hearing students are being left out of the gallant sweep to enrich our children's educations. The big five areas of literacy, at best, present unique challenges for non-hearing students and, in some…

  2. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  3. Hypoplastic left heart syndrome

    Directory of Open Access Journals (Sweden)

    Thiagarajan Ravi

    2007-05-01

    Full Text Available Abstract Hypoplastic left heart syndrome(HLHS refers to the abnormal development of the left-sided cardiac structures, resulting in obstruction to blood flow from the left ventricular outflow tract. In addition, the syndrome includes underdevelopment of the left ventricle, aorta, and aortic arch, as well as mitral atresia or stenosis. HLHS has been reported to occur in approximately 0.016 to 0.036% of all live births. Newborn infants with the condition generally are born at full term and initially appear healthy. As the arterial duct closes, the systemic perfusion becomes decreased, resulting in hypoxemia, acidosis, and shock. Usually, no heart murmur, or a non-specific heart murmur, may be detected. The second heart sound is loud and single because of aortic atresia. Often the liver is enlarged secondary to congestive heart failure. The embryologic cause of the disease, as in the case of most congenital cardiac defects, is not fully known. The most useful diagnostic modality is the echocardiogram. The syndrome can be diagnosed by fetal echocardiography between 18 and 22 weeks of gestation. Differential diagnosis includes other left-sided obstructive lesions where the systemic circulation is dependent on ductal flow (critical aortic stenosis, coarctation of the aorta, interrupted aortic arch. Children with the syndrome require surgery as neonates, as they have duct-dependent systemic circulation. Currently, there are two major modalities, primary cardiac transplantation or a series of staged functionally univentricular palliations. The treatment chosen is dependent on the preference of the institution, its experience, and also preference. Although survival following initial surgical intervention has improved significantly over the last 20 years, significant mortality and morbidity are present for both surgical strategies. As a result pediatric cardiologists continue to be challenged by discussions with families regarding initial decision

  4. Left atrial accessory appendages, diverticula, and left-sided septal pouch in multi-slice computed tomography. Association with atrial fibrillation and cerebrovascular accidents.

    Science.gov (United States)

    Hołda, Mateusz K; Koziej, Mateusz; Wszołek, Karolina; Pawlik, Wiesław; Krawczyk-Ożóg, Agata; Sorysz, Danuta; Łoboda, Piotr; Kuźma, Katarzyna; Kuniewicz, Marcin; Lelakowski, Jacek; Dudek, Dariusz; Klimek-Piotrowska, Wiesława

    2017-10-01

    The aim of this study is to provide a morphometric description of the left-sided septal pouch (LSSP), left atrial accessory appendages, and diverticula using cardiac multi-slice computed tomography (MSCT) and to compare results between patient subgroups. Two hundred and ninety four patients (42.9% females) with a mean of 69.4±13.1years of age were investigated using MSCT. The presence of the LSSP, left atrial accessory appendages, and diverticula was evaluated. Multiple logistic regression analysis was performed to check whether the presence of additional left atrial structures is associated with increased risk of atrial fibrillation and cerebrovascular accidents. At least one additional left atrial structure was present in 51.7% of patients. A single LSSP, left atrial diverticulum, and accessory appendage were present in 35.7%, 16.0%, and 4.1% of patients, respectively. After adjusting for other risk factors via multiple logistic regression, patients with LSSP are more likely to have atrial fibrillation (OR=2.00, 95% CI=1.14-3.48, p=0.01). The presence of a LSSP was found to be associated with an increased risk of transient ischemic attack using multiple logistic regression analysis after adjustment for other risk factors (OR=3.88, 95% CI=1.10-13.69, p=0.03). In conclusion LSSPs, accessory appendages, and diverticula are highly prevalent anatomic structures within the left atrium, which could be easily identified by MSCT. The presence of LSSP is associated with increased risk for atrial fibrillation and transient ischemic attack. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Right atrium positioning for exposure of right pulmonary veins during off-pump atrial fibrillation ablation.

    Science.gov (United States)

    Suwalski, Grzegorz; Emery, Robert; Mróz, Jakub; Kaczejko, Kamil; Gryszko, Leszek; Cwetsch, Andrzej; Skrobowski, Andrzej

    2017-06-01

    Concomitant surgical ablation of atrial fibrillation (AF) is recommended for patients undergoing off-pump coronary revascularization in the presence of this arrhythmia. Achievement of optimal visualization of pulmonary veins while maintaining stable haemodynamic conditions is crucial for proper completion of the ablation procedure. This study evaluates the safety and feasibility of right atrial positioning using a suction-based cardiac positioner as opposed to compressive manoeuvres for exposure during off-pump surgical ablation for AF. Thirty-four consecutive patients underwent pulmonary vein isolation, ganglionated plexi ablation and left atrial appendage occlusion during off-pump coronary artery bypass grafting. Right atrial suction positioning was used to visualize right pulmonary veins. Safety and feasibility end points were analysed intraoperatively and in the early postoperative course. In all patients, right atrial positioning created optimal conditions to complete transverse and oblique sinus blunt dissection, correct placement of a bipolar ablation probe, detection and ablation of ganglionated plexi and conduction block assessment. In all patients, this entire right-sided ablation procedure was completed with a single exposure manoeuvre. Feasibility end points were achieved in all study patients. This report documents the safety and feasibility of right atrial exposure using a suction-based cardiac positioner to complete ablation for AF concomitant with off-pump coronary revascularization. This technique may be widely adopted to create stable haemodynamic conditions and optimal visualization of the right pulmonary veins. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  6. Left ventricular approach for recording His bundle potential in man.

    Science.gov (United States)

    Lee, Y S; Lien, W P

    1975-06-01

    The electrical potentials of the His bundle (HB) were recorded from the left ventricular endocardial surface in 28 patients ranging from 16 to 63 years of age. In 14 of the patients the left bundle branch (LB) potentials were also obtained. Placement of a bipolar electrode catheter tip toward the interventricular septum, right at and also 1 to 2 cm below the aortic valve, resulted in stable recordings of both potentials in successive cardiac cycles even at performing atrial or HB pacing from the right heart. The following intervals were measured in milliseconds (msec): P-A, A-H, H, H-V, LB, and LB-V. The average values in 12 patients (average age 26 plus or minus 7 years and average heart rate 90 plus or minus 16 beats per minute) with normal A-V conduction were as follows: P-A 28 plus or minus 7, A-H 76 plus or minus 16, H 19 plus or minus 3 and H-V 45 plus or minus 6 msec. The average values for LB and LB-V in 10 of these 12 patients were 15 plus or minus 3 and 25 plus or minus 3 msec respectively. Validation of the His bundle electrogram (HBE) from the left ventricular endocardial surface was based on simultaneous recordings of the intracardiac electrograms from both left and right sides of the heart in 18 patients. The individual average values for the intervals obtained from both sides of the heart in these patients were statistically not different, except that the H potential was slightly longer in duration fr m the left heart (P equals 0.05). Among these, 16 showed simultaneous onset of the H potentials, and the LB-V and RB-V conduction times from comparable points were almost the same. Indications for the left sided electro-physiologic studies include the following situations: (a) inability to record H from the right of the heart; (b) giant right atrium; and (c) possibly during atrial fibrillation.

  7. Three-Dimensional Printing as an Interdisciplinary Communication Tool: Preparing for Removal of a Giant Renal Tumor and Atrium Neoplastic Mass.

    Science.gov (United States)

    Golab, Adam; Slojewski, Marcin; Brykczynski, Miroslaw; Lukowiak, Magdalena; Boehlke, Marek; Matias, Daniel; Smektala, Tomasz

    2016-08-22

    Three-dimensional (3D) printing involves preparing 3D objects from a digital model. These models can be used to plan and practice surgery. We used 3D printing to plan for a rare complicated surgery involving the removal of a renal tumor and neoplastic mass, which reached the heart atrium. A printed kidney model was an essential element of communication for physicians with different specializations.

  8. Adrenocortical carcinoma with extension to the inferior vena cava and right atrium: 20-month-old girl with TP53 mutation

    Directory of Open Access Journals (Sweden)

    Terry L. Levin, MD

    2015-01-01

    Full Text Available A 20-month-old female presented with respiratory distress and a right adrenal mass extending into the inferior vena cava and right atrium. The mass was initially thought to be neuroblastoma. Pathology later revealed adrenocortical carcinoma. Inferior vena cava extension is far more common in adrenocortical carcinoma than neuroblastoma, and its presence should prompt clinical and laboratory evaluation for an adrenocortical tumor. The genetic findings in TP53 associated with this disease are discussed.

  9. Diadenosine pentaphosphate affects electrical activity in guinea pig atrium via activation of potassium acetylcholine-dependent inward rectifier.

    Science.gov (United States)

    Abramochkin, Denis V; Karimova, Viktoria M; Filatova, Tatiana S; Kamkin, Andre

    2017-07-01

    Diadenosine pentaphosphate (Ap5A) belongs to the family of diadenosine polyphosphates, endogenously produced compounds that affect vascular tone and cardiac performance when released from platelets. The previous findings indicate that Ap5A shortens action potentials (APs) in rat myocardium via activation of purine P2 receptors. The present study demonstrates alternative mechanism of Ap5A electrophysiological effects found in guinea pig myocardium. Ap5A (10 -4  M) shortens APs in guinea pig working atrial myocardium and slows down pacemaker activity in the sinoatrial node. P1 receptors antagonist DPCPX (10 -7  M) or selective GIRK channels blocker tertiapin (10 -6  M) completely abolished all Ap5A effects, while P2 blocker PPADS (10 -4  M) was ineffective. Patch-clamp experiments revealed potassium inward rectifier current activated by Ap5A in guinea pig atrial myocytes. The current was abolished by DPCPX or tertiapin and therefore was considered as potassium acetylcholine-dependent inward rectifier (I KACh ). Thus, unlike rat, in guinea pig atrium Ap5A produces activation of P1 receptors and subsequent opening of KACh channels leading to negative effects on cardiac electrical activity.

  10. [Left versus bi-atrial radiofrequency ablation in the treatment of atrial fibrillation].

    Science.gov (United States)

    Wang, Jian-Gang; Meng, Xu; Li, Hui

    2008-11-25

    To evaluate the effectiveness of radiofrequency modified maze operation for the treatment of atrial fibrillation (AF) and compare the results of the left versus bi-atrial procedures. 305 patients of organic heart disease combined with AF, 117 males and 188 females, aged (53 +/- 10), that underwent cardiac valve operation (n = 293) and/or coronary artery bypass graft surgery (n = 14), received concomitant atrial fibrillation, bi-atrial (n = 160) or left atrial (n = 145) with a mean duration of (36 +/- 43) months. Follow-up was conducted for (28 +/- 5) (3 - 42) months. Thirteen patients (4.3%) died postoperatively: 7 died of multisystem and organ failure, 3 of low cardiac output, 1 of rupture of left ventricle, 1 of arrhythmia, and 1 of sudden death. During the follow-up, 1 patient died of heart failure, 1 of encephalorrhagia and 1 of unknown reason in the bi-atrial group. At the end of the procedure 223 patients (73.1%) had sinus rhythm, with a sinus rhythm rate of 66.9% (107/160) in the bi-atrial group, significant lower than that in the left atrial group (80.0%, 116/145, P bi-atrial group was 80.0%, not significantly different from that of the left atrial group (81.9%, P > 0.05). The Kaplan-Meier survival analysis showed there was no significant difference in the AF rhythm rate between these 2 groups (P = 0.33). Logistic regression analysis showed that the left atrial diameter of >/= 80 mm was an independent predictor of AF recurrence. Both the left and bi-atrial procedures are successful in terms of restoring sinus rhythm. Left atrial ablation in severe cases and where the incision of right atrium is not needed is a reasonable choice.

  11. Left Ventricular Assist Devices

    Directory of Open Access Journals (Sweden)

    Khuansiri Narajeenron

    2017-04-01

    Full Text Available Audience: The audience for this classic team-based learning (cTBL session is emergency medicine residents, faculty, and students; although this topic is applicable to internal medicine and family medicine residents. Introduction: A left ventricular assist device (LVAD is a mechanical circulatory support device that can be placed in critically-ill patients who have poor left ventricular function. After LVAD implantation, patients have improved quality of life.1 The number of LVAD patients worldwide continues to rise. Left-ventricular assist device patients may present to the emergency department (ED with severe, life-threatening conditions. It is essential that emergency physicians have a good understanding of LVADs and their complications. Objectives: Upon completion of this cTBL module, the learner will be able to: 1 Properly assess LVAD patients’ circulatory status; 2 appropriately resuscitate LVAD patients; 3 identify common LVAD complications; 4 evaluate and appropriately manage patients with LVAD malfunctions. Method: The method for this didactic session is cTBL.

  12. Infective Endocarditis of the Left Main to Right Atrial Coronary Cameral Fistula

    Science.gov (United States)

    Mishra, Ramesh Chandra; Barik, Ramachandra; Patnaik, Amar Narayana

    2016-01-01

    A 7-year-old female child presented with pyrexia of unknown origin. She had received an empirical regimen of antibiotic for possible endocarditis. Evaluation included multiple imaging supports and blood culture. She had left main coronary artery to right atrium coronary cameral fistula, restricted patent ductus arteriosus, vegetation at the right atrial exit of fistula and negative blood culture. Ongoing fever more than 2 weeks, oscillating vegetation in the echo and histopathological evidence of healing vegetation suggested definite diagnosis of infective endocarditis. She was treated successfully by surgical closure of fistula from the right atrial approach. Device closure in this case would have resulted in a large residual cul-de-sac with or without tiny residual high-velocity jets, either being a threat for future enlargement, rupture of the residual aneurysmal sac, thromboembolism, prolonged anticoagulation, and infective endocarditis. PMID:28465978

  13. Fully automated left ventricular contour detection for gated radionuclide angiography, (1)

    International Nuclear Information System (INIS)

    Hosoba, Minoru; Wani, Hidenobu; Hiroe, Michiaki; Kusakabe, Kiyoko.

    1984-01-01

    A fully automated practical method has been developed to detect the left ventricular (LV) contour from gated pool images. Ejection fraction and volume curve can be computed accurately without operater variance. The characteristics of the method are summarized as follows: 1. Optimal design of the filter that works on Fourier domain, can be achieved to improve the signal to noise ratio. 2. New algorithm which use the cosine and sine transform images has been developed for the separating ventricle from atrium and defining center of LV. 3. Contrast enhancement by optimized square filter. 4. Radial profiles are generated from the center of LV and smoothed by fourth order Fourier series approximation. The crossing point with local threshold value searched from the center of the LV is defined as edge. 5. LV contour is obtained by conecting all the edge points defined on radial profiles by fitting them to Fourier function. (author)

  14. An Unusual Left Ventricular Outflow Pseudoaneurysm: Usefulness of Echocardiography and Multidetector Computed Tomography for Surgical Repair

    International Nuclear Information System (INIS)

    Da Col, Uberto; Ramoni, Enrico; Di Bella, Isidoro; Ragni, Temistocle

    2009-01-01

    Left ventricular outflow tract (LVOT) pseudoaneurysm is a rare but potentially lethal complication, mainly after aortic root endocarditis or surgery. Usually it originates from a dehiscence in the mitral-aortic intervalvular fibrosa and it arises posteriorly to the aortic root. Due to these anatomical features, its imaging assessment is challenging and surgical repair requires complex procedures. An unusual case of LVOT pseudoaneurysm is described. It was detected by transthoracic ecocardiography 7 months after aortic root replacement for acute endocarditis. Multidetector computed tomography (MDCT) confirmed the presence of a pouch located between the aortic root and the right atrium. Computed tomography also detected the origin of the pseudoaneurysm from the muscular interventricular septum of the LVOT, rather below the aortic valve plane. It was repaired with an extracardiac surgical approach, sparing the aortic root bioprosthesis previously implanted. The high-resolution three-dimensional details provided by the preoperative MDCT allowed us to plan a simple and effective surgical strategy.

  15. Prevention of Cerebral Embolism Progression by Emergency Surgery of the Left Atrial Myxoma

    Directory of Open Access Journals (Sweden)

    Syuichi Tetsuka

    2015-01-01

    Full Text Available A 21-year-old woman developed left hemiparesis during work and was hospitalized. Her National Institutes of Health Stroke Scale score was 4. Hyperintense areas in the left basal ganglia, corona radiata, and cortex of the temporal lobe were found by brain diffusion-weighted magnetic resonance imaging, indicating acute cerebral infarction. Echocardiography showed a giant mass of diameter 7 × 4 cm in the left atrium. Therefore, she was diagnosed with cerebral embolism due to a left atrial myxoma. Currently, thrombolytic therapy may continue to be effective because the embolic source may be composed of tumor tissue itself. In case of atrial myxoma, we considered that the use of tPA as emergency treatment in all patients with infarction by atrial myxoma may be questioned. Thus, cardiac tumor extraction was performed the next day after hospitalization without thrombolytic therapy. The excised myxoma measured 7 × 6 × 4 cm. The patient recovered and her neurological symptoms also improved. Furthermore, her National Institutes of Health Stroke Scale score improved to 0. Thirteen days after admission, the patient was discharged from our hospital. Cardiac myxoma is often associated with a high risk of embolic episodes, which emphasizes the need for prompt surgical excision as soon as the diagnosis is confirmed.

  16. Long-term survival of quiescent left atrial myxoma in an elderly patient.

    Science.gov (United States)

    Kay, Jay F L; Chow, Wing Hing

    2002-01-01

    Left atrial myxoma, if left untreated, is inexorably progressive and usually fatal. The classical management of this disease is prompt surgical removal. However, there may be exceptions to this traditional dogma. The authors report an 85-year-old man who presented with features of chronic obstructive airway disease and congestive heart failure 15 years previously. Auscultation of the heart showed a pansystolic murmur. Two-dimensional echocardiography revealed a nonobstructive, calcified, and well circumscribed mass in the left atrium, with a pedicle attached to the interatrial septum. Because the patient refused high-risk cardiac surgery related to his comorbidity, he was managed medically with a bronchodilator, diuretics, and digoxin. There have been no features of embolism or intracardiac obstruction, and serial echocardiography demonstrates no disease progression over this long period of time. This case illustrates that calcified left atrial myxoma may exhibit a quiescent phase. Tumor calcification, slow growth potential, and the absence of intracardiac obstruction may correlate with a better outcome in the elderly patient. (c)2002 CVRR, Inc.

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

    Science.gov (United States)

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

    2017-10-01

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

  18. Assessment of blood stasis in left-atrial appendage with electron-beam CT: filling delay in atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Tadashi [Dept. of Radiology, National Cardiovascular Center, Suita, Osaka (Japan); Hamada, Seiki [Dept. of Radiology, National Cardiovascular Center, Suita, Osaka (Japan); Takamiya, Makoto [Dept. of Radiology, National Cardiovascular Center, Suita, Osaka (Japan); Kuribayashi, Sachio [Dept. of Radiology, National Cardiovascular Center, Suita, Osaka (Japan); Naito, Hiroaki [Biomedical Research Center, Osaka Univ. School of Medicine, Suita (Japan)

    1994-10-01

    The left-atrial appendage (LAA) is the most frequent site of thrombus formation. The most probable reason is its anatomical structure and blood stasis. We hypothesized that peak time delay should occur in the LAA with stagnant blood flow. We measured peak time delay in LAA against left atrium with the flow-mode study of electron-beam CT for 49 patients (including 23 patients with atrial fibrillation [AF]). Volume-mode scannings were also performed to detect intracardiac thrombi. Patients with atrial fibrillation showed a larger value than those with sinus rhythm. Some AF patients with no filling of contrast media into the LAA and/or thrombus showed a larger value than the others. The value obtained by the flow-mode study might have the potential by the flow-mode study might have the potential to assess blood stasis and to predict the jeopardized state in the LAA. (orig.)

  19. Assessment of blood stasis in left-atrial appendage with electron-beam CT: filling delay in atrial fibrillation

    International Nuclear Information System (INIS)

    Nakanishi, Tadashi; Hamada, Seiki; Takamiya, Makoto; Kuribayashi, Sachio; Naito, Hiroaki

    1994-01-01

    The left-atrial appendage (LAA) is the most frequent site of thrombus formation. The most probable reason is its anatomical structure and blood stasis. We hypothesized that peak time delay should occur in the LAA with stagnant blood flow. We measured peak time delay in LAA against left atrium with the flow-mode study of electron-beam CT for 49 patients (including 23 patients with atrial fibrillation [AF]). Volume-mode scannings were also performed to detect intracardiac thrombi. Patients with atrial fibrillation showed a larger value than those with sinus rhythm. Some AF patients with no filling of contrast media into the LAA and/or thrombus showed a larger value than the others. The value obtained by the flow-mode study might have the potential by the flow-mode study might have the potential to assess blood stasis and to predict the jeopardized state in the LAA. (orig.)

  20. Left Atrial Enlargement in Young High-Level Endurance Athletes – Another Sign of Athlete’s Heart?

    Directory of Open Access Journals (Sweden)

    Król Wojciech

    2016-12-01

    Full Text Available Enlargement of the left atrium is perceived as a part of athlete’s heart syndrome, despite the lack of evidence. So far, left atrial size has not been assessed in the context of exercise capacity. The hypothesis of the present study was that LA enlargement in athletes was physiological and fitness-related condition. In addition, we tried to assess the feasibility and normal values of left atrial strain parameters and their relationship with other signs of athlete’s heart. The study group consisted of 114 international-level rowers (17.5 ± 1.5 years old; 46.5% women. All participants underwent a cardio-pulmonary exercise test and resting transthoracic echocardiography. Beside standard echocardiographic measurements, two dimensional speckle tracking echocardiography was used to assess average peak atrial longitudinal strain, peak atrial contraction strain and early left atrial diastolic longitudinal strain. Mild, moderate and severe left atrial enlargement was present in 27.2°%, 11.4% and 4.4% athletes, respectively. There were no significant differences between subgroups with different range of left atrial enlargement in any of echocardiographic parameters of the left ventricle diastolic function, filling pressure or hypertrophy. A significant correlation was found between the left atrial volume index and maximal aerobic capacity (R > 0.3; p < 0.001. Left atrial strain parameters were independent of atrial size, left ventricle hypertrophy and left ventricle filling pressure. Decreased peak atrial longitudinal strain was observed in 4 individuals (3.5%. We concluded that LA enlargement was common in healthy, young athletes participating in endurance sport disciplines with a high level of static exertion and was strictly correlated with exercise capacity, therefore, could be perceived as another sign of athlete’s heart.

  1. [Left atrial function and left atrial appendage flow velocity in hypertrophic cardiomyopathy: comparison of patients with and without paroxysmal atrial fibrillation].

    Science.gov (United States)

    Akasaka, K; Kawashima, E; Shiokoshi, T; Ishii, Y; Hasebe, N; Kikuchi, K

    1998-07-01

    The involvement of left atrial (LA) appendage flow velocity in reduced left atrial function was investigated in 24 patients with hypertrophic cardiomyopathy, who retained sinus rhythm at the examination. Patients were divided into 11 with a history of paroxysmal atrial fibrillation [PAf(+)] and 13 without such history [PAf(-)]. Transthoracic echocardiography was performed to evaluate LA fractional shortening (LA%FS) and mean velocity of circumferential LA fiber shortening (LAmVcf), as contractile functions of the left atrium at the phase of active atrial contraction. Transesophageal echocardiographic Doppler examination was performed in all patients to measure the LA appendage velocity. In all patients, significant positive correlations were observed between the LA appendage velocity and LA%FS (r = 0.50, p fibrillation were significantly lower than in those without (0.84 +/- 0.15 vs 1.28 +/- 0.37 circ/sec, 44 +/- 12 vs 65 +/- 20 cm/sec, both p fibrillation. These results indicate that there is a close relationship between LA appendage velocity and LA contractile function in patients with hypertrophic cardiomyopathy with paroxysmal atrial fibrilation, and these patients have potential risk of cerebral infarction.

  2. Left regular bands of groups of left quotients

    International Nuclear Information System (INIS)

    El-Qallali, A.

    1988-10-01

    A semigroup S which has a left regular band of groups as a semigroup of left quotients is shown to be the semigroup which is a left regular band of right reversible cancellative semigroups. An alternative characterization is provided by using spinned products. These results are applied to the case where S is a superabundant whose set of idempotents forms a left normal band. (author). 13 refs

  3. Why Dora Left

    DEFF Research Database (Denmark)

    Gammelgård, Judy

    2017-01-01

    The question of why Dora left her treatment before it was brought to a satisfactory end and the equally important question of why Freud chose to publish this problematic and fragmentary story have both been dealt with at great length by Freud’s successors. Dora has been read by analysts, literary...... problem toward femininity, both Dora’s and his own. In Dora, it is argued, Freud took a new stance toward the object of his investigation, speaking from the position of the master. Freud presents himself as the one who knows, in great contrast to the position he takes when unraveling the dream. Here he...

  4. Neutrosophic Left Almost Semigroup

    Directory of Open Access Journals (Sweden)

    Mumtaz Ali

    2014-06-01

    Full Text Available In this paper we extend the theory of neutrosophy to study left almost semigroup shortly LAsemigroup. We generalize the concepts of LA-semigroup to form that for neutrosophic LA-semigroup. We also extend the ideal theory of LA-semigroup to neutrosophy and discuss different kinds of neutrosophic ideals. We also find some new type of neutrosophic ideal which is related to the strong or pure part of neutrosophy. We have given many examples to illustrate the theory of neutrosophic LA-semigroup and display many properties of neutrosophic LA-semigroup in this paper.

  5. Migration of a Central Venous Catheter in a Hemodialysis Patient Resulted in Left Atrial Perforation and Thrombus Formation Requiring Open Heart Surgery.

    Science.gov (United States)

    Wong, Kevin; Marks, Barry A; Qureshi, Anwer; Stemm, Joseph J

    2016-07-01

    Central venous catheterization is widely used in patients on hemodialysis. A rare complication associated with the clinical use of central venous catheters is perforation of the heart or major vessels. We report a case of inadvertent perforation of the left atrium and thrombosis after the placement of a hemodialysis catheter in the right internal jugular vein. In such cases, surgical removal of the central venous catheter from perforation sites in the heart and vessel walls poses anesthetic challenges because of the high risk of pneumothorax, hemorrhage, arrhythmias, thrombosis, and death.

  6. Kinetic properties of /sup 3/H-16. cap alpha. -gitoxin in the isolated guinea-pig atrium

    Energy Technology Data Exchange (ETDEWEB)

    Haustein, K O; Glusa, E [Medizinische Akademie, Erfurt (German Democratic Republic)

    1978-04-01

    The accumulation and the loss of (/sup 3/H)-16..cap alpha..-gitoxin were estimated in correlation with its positive inotropic effect using the isolated spontaneously beating guinea-pig atrium. The properties of 16..cap alpha..-gitoxin were compared with those of (/sup 3/H)-ouabain and (/sup 3/H)-digitoxin. The experiments were performed with positive inotropic equieffective glycoside concentrations. During a 2-hr incubation period, 16..cap alpha..-gitoxin was accumulated to a low extent (2.05 nmoles per g w.w., tissue/medium (T/M) ratio =0.66). Similar results were obtained with ouabain (47.5 pmoles per g w.w.; T/M ratio = 0.51), while digitoxin was accumulated to a high extent (266 pmoles per g w.w.; T/M ratio = 2.98). Wash-out experiments demonstrated that the inotropic effect disappears more rapidly than the loss of tissue radioactivity occurred, the effects of 16..cap alpha..-gitoxin were diminished more easily after wash-out than those of ouabain and digitoxin. In the presence of 1.0 instead of 0.1 vol-% dimethylformamide, both the accumulation of radioactivity (5.0 nmoles per g w.w.; T/M ratio = 1.58) and the positive inotropic effect are enhanced. From the experiments it was concluded: (1) 16..cap alpha..-gitoxin has similar kinetic properties as ouabain. (2) The concentration of dimethylformamide used influences the kinetic behaviour on the tissue level. (3) No correlation exists neither between the extent of the positive inotropic effect and theamount of accumulated glycoside, nor between the loss of tissue radioactivity and the disappearance of positive inotropic effect.

  7. Non-compact left ventricle/hypertrabeculated left ventricle

    International Nuclear Information System (INIS)

    Restrepo, Gustavo; Castano, Rafael; Marmol, Alejandro

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Christina S. Chen-Milhone

    2018-01-01

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

  9. Abnormal positioning of multiple abdominal organs with anomalous direct drainage of hepatic vein into the right atrium in a post operative omphalocele patient: A case report

    International Nuclear Information System (INIS)

    Hyun, Su Jeong; Cho, Bum Sang; Kim, Sung Jin; Lee, Seung Young; Kang, Min Ho; Yi, Kyung Sik

    2012-01-01

    An omphalocele is a rare congenital anomaly in which the infant's intestines protrude through the navel. Additional anomalies that are associated with omphalocele remain present in as many as 50% of cases, and these anomalies vary greatly from patient to patient. However, the persistent anomalies or abnormal position of the abdominal organs in post operative omphalocele patients have not reported previously. Herein, we report the case of an omphalocele patient with abnormal positioning of the liver, spleen and both kidneys, as well as abnormal drainage of the hepatic vein into the right atrium, which was found during a routine, postoperative follow-up computed tomography scan

  10. [Left-handedness and health].

    Science.gov (United States)

    Milenković, Sanja; Belojević, Goran; Kocijancić, Radojka

    2010-01-01

    Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.

  11. Increased pulse pressure is associated with left atrial enlargement in resistant hypertensive patients.

    Science.gov (United States)

    Armario, Pedro; Oliveras, Anna; Hernández-Del-Rey, Raquel; Suárez, Carmen; Martell, Nieves; Ruilope, Luis M; De La Sierra, Alejandro

    2013-02-01

    Resistant hypertension (RH) is frequently associated with a high prevalence of target organ damage, which impairs the prognosis of these patients. Considering cardiac alterations in RH, most attention has been devoted to left ventricular hypertrophy (LVH), but data concerning left atrial enlargement (LAE) is less known. This cross-sectional study assessed the factors associated with LAE, with special focus on blood pressure (BP) estimates obtained by ambulatory blood pressure monitoring (ABPM), in 250 patients with RH, aged 64 ± 11 years. LAE and LVH were observed in 10.0% (95% CI 6.3-13.7) and 57.1% (95% CI 50.8-63.5) of patients, respectively. Compared with patients with normal atrium size, those exhibiting LAE were older, more frequently women, had elevated pulse pressure (PP) measured both at the office and by ABPM, and showed higher prevalence of LVH (83% vs 54%; p = 0.016). In a logistic regression analysis, adjusting for age, gender, body mass index, left ventricular mass index and BP pressure estimates, night-time PP was independently associated with LAE (OR for 5 mmHg = 1.28, 95% CI 1.24-1.32; p = 0.001). In conclusion, besides classical determinants of LAE, such as age and LVH, an elevated night-time PP was independently associated with LAE in patients with RH.

  12. Experimental Assessment of the Hydraulics of a Miniature Axial-Flow Left Ventricular Assist Device

    Science.gov (United States)

    Smith, P. Alex; Cohn, William; Metcalfe, Ralph

    2017-11-01

    A minimally invasive partial-support left ventricular assist device (LVAD) has been proposed with a flow path from the left atrium to the arterial system to reduce left ventricular stroke work. In LVAD design, peak and average efficiency must be balanced over the operating range to reduce blood trauma. Axial flow pumps have many geometric parameters. Until recently, testing all these parameters was impractical, but modern 3D printing technology enables multi-parameter studies. Following theoretical design, experimental hydraulic evaluation in steady state conditions examines pressure, flow, pressure-flow gradient, efficiency, torque, and axial force as output parameters. Preliminary results suggest that impeller blades and stator vanes with higher inlet angles than recommended by mean line theory (MLT) produce flatter gradients and broader efficiency curves, increasing compatibility with heart physiology. These blades also produce less axial force, which reduces bearing load. However, they require slightly higher torque, which is more demanding of the motor. MLT is a low order, empirical model developed on large pumps. It does not account for the significant viscous losses in small pumps like LVADs. This emphasizes the importance of experimental testing for hydraulic design. Roderick D MacDonald Research Fund.

  13. Evaluation of aspirin therapy on intracardiac thrombi using indium-111-oxine platelet scintigraphy, two-dimentional echocardiography and left ventriculography

    International Nuclear Information System (INIS)

    Shibuya, Masanori; Irino, Tadayoshi; Yoshioka, Toshiharu; Sugimoto, Tsuyoshi; Tsuji, Kazuo; Naka, Masashi; Arai, Hidekazu.

    1984-01-01

    Left ventriculography (LVG), two-dimensional echocardiography (2-DE) and indium-111-oxine platelet scintigraphy were performed in five patients with intracardiac thrombi. Thrombi were visible in 7 sites (5 in the ventricle and 2 in the atrium) by platelet scintigraphy, in 4 sites (3 in the ventricle and 1 in the atrium) by 2-DE, and in 4 sites (4 in the ventricle) by LVG. When aspirin was administered to the patients, platelet scintigraphy had become negative for thrombi in 5 sites and false-negative for them in 2 sites. However, thrombi were detected in 6 sites after the withdrawal of aspirin. On the other hand, thrombi were detected in 4 sites by 2-DE, irrespective of the administration of aspirin. Indium-111-oxine platelet scintigraphy has proved to not only have higher sensitivity for detecting thrombi but also to be capable of observing the coagulation status of platelets on the thrombi. It is therefore considered very helpful in assessing anticoagulation therapy. (Namekawa, K)

  14. A novel method of placing right ventricular leads in patients with persistent left superior vena cava using a conventional j stylet.

    Science.gov (United States)

    Mora, Guillermo

    2014-03-01

    Locating pacemaker electrodes can become complicated by congenital abnormalities such as persistent left superior vena cava (LSVC). To evaluate a technique for the implanting of ventricular electrode in patients with persistent LSVC. The study was carried out from June 2001 to June 2010 involving all patients who were admitted to the Hospital Universitario Mayor, Instituto de Corazon de Bogota and Hospital Universitario Clinica San Rafael (Bogota-Colombia) for implanting pacemakers or cardiac defibrillators. LSVC was diagnosed by fluoroscopic observation (anterior-posterior view) of the course of the stylet. Four steps were followed: 1) Move the electrode with a straight stylet to the right atrium. 2) Change the straight stylet by a conventional J stylet and push the electrode to the lateral or anterolateral wall of the right atrium. 3) Remove the guide 3-5 cm and 4) Push the electrode which crosses the tricuspid valve into the right ventricle and finally deploy the active fixation mechanism. A total of 1198 patients were admitted for pacemaker or cardiac defibrillator implant during the 9-year study period, 1114 received a left subclavian venous approach. There were 573 males and 541 females. Persistent LSVC was found in five patients (0.45%) Fluoroscopy time for implanting the ventricular electrode ranged from 60 to 250 seconds, 40 to 92 minutes being taken to complete the whole procedure. We present a simple and rapid technique for electrode placement in patients with LSVC using usual J guide and active fixation electrodes with high success.

  15. An Asymptomatic Case of Wolff-Parkinson-White Syndrome with Right-sided Free-wall Accessory Pathway and Left Ventricular Dysfunction

    Directory of Open Access Journals (Sweden)

    Takanao Mine, MD

    2011-01-01

    Full Text Available A 16-year-old girl with a known history of asymptomatic Wolff-Parkinson-White syndrome exhibited signs of left ventricular (LV septal akinesia and LV dysfunction during routine follow-up. A 12-lead surface ECG showed pre-excitation, a predominantly negative delta wave in V1 and left axis deviation, which was consistent with the presence of a right free-wall accessory pathway. Radiofrequency ablation of the anterolateral right atrium around the local shortest atrium-to-ventricle interval created the accessory pathway block. An echocardiogram taken one month after the procedure revealed that LV septal wall motion had normalized and that LV ejection fraction had improved from 50% before the ablation to 64% after the ablation. Most previous reports of asymptomatic patients of WPW with LV septal dyskinesia and dysfunction have described right septal or posteroseptal accessory pathways. This patient reported here represents a rare case with right free-wall accessory pathway and LV dysfunction without tachycardia.

  16. Left-handedness and health

    Directory of Open Access Journals (Sweden)

    Milenković Sanja

    2010-01-01

    Full Text Available Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome, developmental disorders (autism, dislexia and sttutering and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about 'anomalous' cerebral domination, as a consequence of hormonal disbalance. .

  17. Radionuclide Angiocardiographic Evaluation of Left-to-Right Cardiac Shunts: Analysis of Time-Active Curves

    International Nuclear Information System (INIS)

    Kim, Ok Hwa; Bahk, Yong Whee; Kim, Chi Kyung

    1987-01-01

    The noninvasive nature of the radionuclide angiocardiography provided a useful approach for the evaluation of left-to-right cardiac shunts (LRCS). While the qualitative information can be obtained by inspection of serial radionuclide angiocardiograms, the quantitative information of radionuclide angiocardiography can be obtained by the analysis of time-activity curves using advanced computer system. The count ratios method and pulmonary-to-systemic flow ratio (QP/QS) by gamma variate fit method were used to evaluate the accuracy of detection and localization of LRCS. One hundred and ten time-activity curves were analyzed. There were 46 LRCS (atrial septal defects 11, ventricular septal defects 22, patent ductus arteriosus 13) and 64 normal subjects. By computer analysis of time-activity curves of the right atriurn, ventricle and the lungs separately, the count ratios modified by adding the mean cardiac transit time were calculated in each anatomic site. In normal subjects the mean count ratios in the right atrium, ventricle and lungs were 0.24 on average. In atrial septal defects, the count ratios were high in the right atrium, ventricle and lungs, whereas in ventricular septal defects the count ratios were higher only in the right ventricle and lungs. Patent ductus arteriosus showed normal count ratios in the heart but high count ratios were obtained in the lungs. Thus, this count ratios method could be separated normal from those with intracardiac or extracardiac shunts, and moreover, with this method the localization of the shunt level was possible in LRCS. Another method that could differentiate the intracardiac shunts from extracardiac shunts was measuring QP/QS in the left and right lungs. In patent ductus arteriosus, the left lung QP/QS was higher than those of the right lung, whereas in atrial septal defects and ventricular septal defects QP/ QS ratios were equal in both lungs. From this study, it was found that by measuring QP/QS separately in the lungs

  18. Left atrial dysfunction in type 2 diabetes mellitus: insights from cardiac MRI

    Energy Technology Data Exchange (ETDEWEB)

    Graca, Bruno; Donato, Paulo; Caseiro-Alves, Filipe [University of Coimbra, Faculty of Medicine, Coimbra (Portugal); Coimbra' s Hospital Centre and University, Medical Imaging Department, Coimbra (Portugal); Joao Ferreira, Maria [University of Coimbra, Faculty of Medicine, Coimbra (Portugal); Coimbra' s Hospital Centre and University, Cardiology Department, Coimbra (Portugal); Gomes, Leonor [University of Coimbra, Faculty of Medicine, Coimbra (Portugal); Coimbra' s Hospital Centre and University, Endocrinology Department, Coimbra (Portugal); Castelo-Branco, Miguel [University of Coimbra, Faculty of Medicine, Coimbra (Portugal)

    2014-11-15

    The left atrium (LA) modulates left ventricular filling through reservoir, conduit and booster pump functions. Only limited data exist on LA involvement in type 2 diabetes mellitus (DM2). This study sought to assess LA function in asymptomatic DM2 with cardiac MRI. We hypothesized that cardiac MRI can detect LA dysfunction in asymptomatic DM2. Forty-five patients with asymptomatic DM2 and 24 normoglycaemic controls were studied. MRI cine imaging was performed to measure LA maximal and minimal volumes. A flow-sensitive phase-contrast gradient-echo sequence was used for flow measurements perpendicular to the orifice of the mitral valve, to quantify active LA stroke volume. LA total, passive and active emptying volumes and fractions were calculated. LA reservoir function, namely LA total ejection fraction, was significantly greater in controls compared to patients with DM2 (62.2 ± 5.2 vs 57.0 ± 7.6 %, P = 0.004). LA passive ejection fraction was also greater in the controls (26.2 ± 9.5 vs 16.1 ± 11.0 %, P < 0.001). Regarding parameters of LA booster pump function, LA active ejection fraction was not significantly different between groups. DM2 was demonstrated to be an independent determinant of LA function. Cardiac MRI enables the detection of LA dysfunction in asymptomatic DM2, characterized by a reduction in LA reservoir and conduit functions. (orig.)

  19. Left bundle-branch block

    DEFF Research Database (Denmark)

    Risum, Niels; Strauss, David; Sogaard, Peter

    2013-01-01

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

  20. Producing The New Regressive Left

    DEFF Research Database (Denmark)

    Crone, Christine

    members, this thesis investigates a growing political trend and ideological discourse in the Arab world that I have called The New Regressive Left. On the premise that a media outlet can function as a forum for ideology production, the thesis argues that an analysis of this material can help to trace...... the contexture of The New Regressive Left. If the first part of the thesis lays out the theoretical approach and draws the contextual framework, through an exploration of the surrounding Arab media-and ideoscapes, the second part is an analytical investigation of the discourse that permeates the programmes aired...... becomes clear from the analytical chapters is the emergence of the new cross-ideological alliance of The New Regressive Left. This emerging coalition between Shia Muslims, religious minorities, parts of the Arab Left, secular cultural producers, and the remnants of the political,strategic resistance...

  1. Left main percutaneous coronary intervention.

    Science.gov (United States)

    Teirstein, Paul S; Price, Matthew J

    2012-10-23

    The introduction of drug-eluting stents and advances in catheter techniques have led to increasing acceptance of percutaneous coronary intervention (PCI) as a viable alternative to coronary artery bypass graft (CABG) for unprotected left main disease. Current guidelines state that it is reasonable to consider unprotected left main PCI in patients with low to intermediate anatomic complexity who are at increased surgical risk. Data from randomized trials involving patients who are candidates for either treatment strategy provide novel insight into the relative safety and efficacy of PCI for this lesion subset. Herein, we review the current data comparing PCI with CABG for left main disease, summarize recent guideline recommendations, and provide an update on technical considerations that may optimize clinical outcomes in left main PCI. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  2. Left ventricular apical ballooning syndrome

    International Nuclear Information System (INIS)

    Rahman, N.; Tai, J.; Soofi, A.

    2007-01-01

    The transient left ventricular apical ballooning syndrome, also known as Takotsubo cardiomyopathy, is characterized by transient left ventricular dysfunction in the absence of obstructive epicardial coronary disease. Although the syndrome has been reported in Japan since 1990, it is rare in other regions. Rapid recognition of the syndrome can modify the diagnostic and therapeutic attitude i.e. avoiding thrombolysis and performing catheterization in the acute phase. (author)

  3. Apraxia in left-handers.

    Science.gov (United States)

    Goldenberg, Georg

    2013-08-01

    In typical right-handed patients both apraxia and aphasia are caused by damage to the left hemisphere, which also controls the dominant right hand. In left-handed subjects the lateralities of language and of control of the dominant hand can dissociate. This permits disentangling the association of apraxia with aphasia from that with handedness. Pantomime of tool use, actual tool use and imitation of meaningless hand and finger postures were examined in 50 consecutive left-handed subjects with unilateral hemisphere lesions. There were three aphasic patients with pervasive apraxia caused by left-sided lesions. As the dominant hand is controlled by the right hemisphere, they constitute dissociations of apraxia from handedness. Conversely there were also three patients with pervasive apraxia caused by right brain lesions without aphasia. They constitute dissociations of apraxia from aphasia. Across the whole group of patients dissociations from handedness and from aphasia were observed for all manifestations of apraxia, but their frequency depended on the type of apraxia. Defective pantomime and defective tool use occurred rarely without aphasia, whereas defective imitation of hand, but not finger, postures was more frequent after right than left brain damage. The higher incidence of defective imitation of hand postures in right brain damage was mainly due to patients who had also hemi-neglect. This interaction alerts to the possibility that the association of right hemisphere damage with apraxia has to do with spatial aptitudes of the right hemisphere rather than with its control of the dominant left hand. Comparison with data from right-handed patients showed no differences between the severity of apraxia for imitation of hand or finger postures, but impairment on pantomime of tool use was milder in apraxic left-handers than in apraxic right-handers. This alleviation of the severity of apraxia corresponded with a similar alleviation of the severity of aphasia as

  4. Right colon cancer: Left behind.

    Science.gov (United States)

    Gervaz, P; Usel, M; Rapiti, E; Chappuis, P; Neyroud-Kaspar, I; Bouchardy, C

    2016-09-01

    Prognosis of colon cancer (CC) has steadily improved during the past three decades. This trend, however, may vary according to proximal (right) or distal (left) tumor location. We studied if improvement in survival was greater for left than for right CC. We included all CC recorded at the Geneva population-based registry between 1980 and 2006. We compared patients, tumor and treatment characteristics between left and right CC by logistic regression and compared CC specific survival by Cox models taking into account putative confounders. We also compared changes in survival between CC location in early and late years of observation. Among the 3396 CC patients, 1334 (39%) had right-sided and 2062 (61%) left-sided tumors. In the early 1980s, 5-year specific survival was identical for right and left CCs (49% vs. 48%). During the study period, a dramatic improvement in survival was observed for patients with left-sided cancers (Hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.29-0.62, p colon cancer patients, those with right-sided lesions have by far the worse prognosis. Change of strategic management in this subgroup is warranted. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Rotational Angiography Based Three-Dimensional Left Atrial Reconstruction: A New Approach for Transseptal Puncture.

    Science.gov (United States)

    Koektuerk, Buelent; Yorgun, Hikmet; Koektuerk, Oezlem; Turan, Cem H; Gorr, Eduard; Horlitz, Marc; Turan, Ramazan G

    2016-02-01

    Rotational angiography is a well-known method for the three-dimensional (3-D) reconstruction of left atrium and pulmonary veins during left-sided atrial arrhythmia ablation procedures. In our study, we aimed to review our experience in transseptal puncture (TSP) using 3-D rotational angiography. We included a total of 271 patients who underwent atrial fibrillation ablation using cryoballoon. Rotational angiography was performed to get the three-dimensional left atrial and pulmonary vein reconstructions using cardiac C-arm computed tomography. The image reconstruction was made using the DynaCT Cardiac software (Siemens, Erlangen, Germany). The mean age of the study population was 61 ± 10 years. The indications for left atrial arrhythmia ablation were paroxysmal AF in 140 patients (52%) and persistent AF patients in 131 (48%) patients. The success rate of TSP using only rotational guidance was (264/271 patients, 97.4%). In the remaining seven patients, transesophageal guidance was used after the initial attempt due to thick interatrial septum in five patients and difficult TSP due to abnormal anatomy and mild pericardial effusion in the remaining two patients. Mean fluoroscopy dosage of the rotational angiography was 4896.4 ± 825.3 μGym(2). The mean time beginning from femoral vein puncture to TSP was 12.3 ± 5.5 min. TSP guided by rotational angiography is a safe and effective method. Our results indicate that integration of rotational angiographic images into the real-time fluoroscopy can guide the TSP during the procedure. © 2015 John Wiley & Sons Ltd.

  6. Aphasia following left thalamic hemorrhage

    International Nuclear Information System (INIS)

    Makishita, Hideo; Miyasaka, Motomaro; Tanizaki, Yoshio; Yanagisawa, Nobuo; Sugishita, Morihiro.

    1984-01-01

    We reported 7 patients with left thalamic hemorrhage in the chronic stage (from 1.5 months to 4.5 months), and described language disorders examined by Western Aphasia Battery (WAB) and measured cerebral blood flow by single photon emission CT. Examination of language by WAB revealed 4 aphasics out of 7 cases, and 3 patients had no language deficit. The patient with Wernicke's aphasia showed low density area only in the left posterior thalamus in X-ray CT, and revealed severe low blood flow area extending to left temporal lobe in emission CT. In the case with transcortical sensory aphasia, although X-ray CT showed no obvious low density area, emission CT revealed moderate low flow area in watershed area that involved the territory between posterior cerebral and middle cerebral arteries in the left temporooccipital region in addition to low blood flow at the left thalamus. In one of the two patients classified as anomic aphasia, whose score of repetition (8.4) was higher than that of comprehension (7.4), emission CT showed slight low flow area at the temporo-occipital region similarly as the case with transcortical sensory aphasia. In another case with anomic aphasia, scored 9 on both fluensy and comprehension subtests and 10 on repetition, there was wide low density area all over the left thalamus and midline shift to the right in X-ray CT, and emission CT showed severe low blood flow in the same region spreading widely toward the cerebral surface. On the other hand, in all of the 3 patients without aphasia, emission CT showed low flow region restricted to the left thalamus. (J.P.N.)

  7. Systolic left ventricular function according to left ventricular concentricity and dilatation in hypertensive patients

    DEFF Research Database (Denmark)

    Bang, Casper; Gerdts, Eva; Aurigemma, Gerard P

    2013-01-01

    Left ventricular hypertrophy [LVH, high left ventricular mass (LVM)] is traditionally classified as concentric or eccentric based on left ventricular relative wall thickness. We evaluated left ventricular systolic function in a new four-group LVH classification based on left ventricular dilatation...... [high left ventricular end-diastolic volume (EDV) index and concentricity (LVM/EDV)] in hypertensive patients....

  8. ''Natural'' left-right symmetry

    International Nuclear Information System (INIS)

    Mohapatra, R.N.; Pati, J.C.

    1975-01-01

    It is remarked that left-right symmetry of the starting gauge interactions is retained as a ''natural'' symmetry if it is broken in no way except possibly by mass terms in the Lagrangian. The implications of this result for the unification of coupling constants and for parity nonconservation at low and high energies are stressed

  9. Clinical study on left atrial thrombi. Comparative study between echocardiography and CT scan

    Energy Technology Data Exchange (ETDEWEB)

    Shimada, E; Asano, H; Kurasawa, T; Mitsumoto, K; Yamane, Y [Tokyo Kosei-Nenkin Hospital (Japan)

    1981-09-01

    We studied left atrial thrombi (LAT) by both echocardiography and computed tomography (CT) and compared the features of the 2 methods. A total of 15 patients with mitral stenosis complicated by atrial fibrillation were selected as the subjects. LAT were noted on the M-mode echocardiograms in 2 patients including a questionably positive one, on the two-dimensional echocardiograms in 5, and on the CT scans in 6 of 15. The history of thromboembolism was rather frequent and was found in 7 of 15 patients. However, LAT was found in only 3 of these on the CT scans. A shaggy or fuzzy pattern on the M-mode echocardiogram cannot be regarded as representing thrombi, while a laminar pattern undoubtedly represented thrombi. Two-dimensional echocardiography has considerably contributed to the improved detection rate of LAT. For the characteristic properties of ultrasound beams, however, it was impossible to investigate the entire left atrium. The detection of the thrombi in the appendage was especially difficult. However, computed tomography, permitting transverse cross-sectional tomography, was capable of sectioning the heart even in the presence of air and bones. The measurement of CT values was suggestive of the properties of the substance or substances involved, and also allowed the presumption as to whether the thrombus has been fibrosed. Furthermore, it was possible to estimate more accurately as well as 3-dimensionally the location, shape and dimensions of the thrombi by the reconstruction of the heart according to the CT values. It was concluded that echocardiography and computed tomography are the mutual aid to further improvement in the detection rate of left atrial thrombi.

  10. Left atrial appendage obliteration in atrial fibrillation patients undergoing bioprosthetic mitral valve replacement.

    Science.gov (United States)

    Min, X P; Zhu, T Y; Han, J; Li, Y; Meng, X

    2016-02-01

    Left atrial appendage (LAA) obliteration is a proven stroke-preventive measure for patients with nonvalvular atrial fibrillation (AF). However, the efficacy of LAA obliteration for patients with AF after bioprosthetic mitral valve replacement (MVR) remains unclear. This study aimed to estimate the efficacy of LAA obliteration in preventing embolism and to investigate the predictors of thromboembolism after bioprosthetic MVR. We retrospectively studied 173 AF subjects with bioprosthetic MVR; among them, 81 subjects underwent LAA obliteration using an endocardial running suture method. The main outcome measure was the occurrence of thrombosis events (TEs). The mean follow-up time was 40 ± 17 months. AF rhythm was observed in 136 patients postoperatively. The incidence rate of TEs was 13.97 % for postoperative AF subjects; a dilated left atrium (LA; > 49.5 mm) was identified as an independent risk factor of TEs (OR = 10.619, 95 % CI = 2.754-40.94, p = 0.001). For postoperative AF patients with or without LAA, the incidence rate of TEs was 15.8 % (9/57) and 12.7 % (10/79; p = 0.603), respectively. The incidence rate of TEs was 2.7 % (1/36) and 4.2 % (2/48) for the subgroup patients with a left atrial diameter of  49.5 mm (p = 0.346). Surgical LAA obliteration in patients with valvular AF undergoing bioprosthetic MVR did not reduce TEs, even when the CHA2DS2-VASc score (a score for estimating the risk of stroke in AF) was ≥ 2 points.

  11. Left ventricular filling under elevated left atrial pressure

    Science.gov (United States)

    Gaddam, Manikantam; Samaee, Milad; Santhanakrishnan, Arvind

    2017-11-01

    Left atrial pressure (LAP) is elevated in diastolic dysfunction, where left ventricular (LV) filling is impaired due to increase in ventricular stiffness. The impact of increasing LAP and LV stiffness on intraventricular filling hemodynamics remains unclear. We conducted particle image velocimetry and hemodynamics measurements in a left heart simulator (LHS) under increasing LAP and LV stiffness at a heart rate of 70 bpm. The LHS consisted of a flexible-walled LV physical model fitted within a fluid-filled chamber. LV wall motion was generated by a piston pump that imparted pressure fluctuations in the chamber. Resistance and compliance elements in the flow loop were adjusted to obtain bulk physiological hemodynamics in the least stiff LV model. Two LV models of increasing stiffness were subsequently tested under unchanged loop settings. LAP was varied between 5-20 mm Hg for each LV model, by adjusting fluid level in a reservoir upstream of the LV. For constant LV stiffness, increasing LAP lowered cardiac output (CO), while ejection fraction (EF) and E/A ratio were increased. For constant LAP, increasing LV stiffness lowered CO and EF, and increased E/A ratio. The implications of these altered hemodynamics on intraventricular filling vortex characteristics will be presented.

  12. Increased cardiac alpha-myosin heavy chain in left atria and decreased myocardial insulin-like growth factor (Igf-I) expression accompany low heart rate in hibernating grizzly bears.

    Science.gov (United States)

    Barrows, N D; Nelson, O L; Robbins, C T; Rourke, B C

    2011-01-01

    Grizzly bears (Ursus arctos horribilis) tolerate extended periods of extremely low heart rate during hibernation without developing congestive heart failure or cardiac chamber dilation. Left ventricular atrophy and decreased left ventricular compliance have been reported in this species during hibernation. We evaluated the myocardial response to significantly reduced heart rate during hibernation by measuring relative myosin heavy-chain (MyHC) isoform expression and expression of a set of genes important to muscle plasticity and mass regulation in the left atria and left ventricles of active and hibernating bears. We supplemented these data with measurements of systolic and diastolic function via echocardiography in unanesthetized grizzly bears. Atrial strain imaging revealed decreased atrial contractility, decreased expansion/reservoir function (increased atrial stiffness), and decreased passive-filling function (increased ventricular stiffness) in hibernating bears. Relative MyHC-α protein expression increased significantly in the atrium during hibernation. The left ventricle expressed 100% MyHC-β protein in both groups. Insulin-like growth factor (IGF-I) mRNA expression was reduced by ∼50% in both chambers during hibernation, consistent with the ventricular atrophy observed in these bears. Interestingly, mRNA expression of the atrophy-related ubiquitin ligases Muscle Atrophy F-box (MAFBx) and Muscle Ring Finger 1 did not increase, nor did expression of myostatin or hypoxia-inducible factor 1α (HIF-1α). We report atrium-specific decreases of 40% and 50%, respectively, in MAFBx and creatine kinase mRNA expression during hibernation. Decreased creatine kinase expression is consistent with lowered energy requirements and could relate to reduced atrial emptying function during hibernation. Taken together with our hemodynamic assessment, these data suggest a potential downregulation of atrial chamber function during hibernation to prevent fatigue and dilation

  13. The effect of acute mechanical left ventricular unloading on ovine tricuspid annular size and geometry.

    Science.gov (United States)

    Malinowski, Marcin; Wilton, Penny; Khaghani, Asghar; Brown, Michael; Langholz, David; Hooker, Victoria; Eberhart, Lenora; Hooker, Robert L; Timek, Tomasz A

    2016-09-01

    Left ventricular assist device (LVAD) implantation may alter right ventricular shape and function and lead to tricuspid regurgitation. This in turn has been reported to be a determinant of right ventricular (RV) failure after LVAD implantation, but the effect of mechanical left ventricular (LV) unloading on the tricuspid annulus is unknown. The aim of the study was to provide insight into the effect of LVAD support on tricuspid annular geometry and dynamics that may help to optimize LV unloading with the least deleterious effect on the right-sided geometry. In seven open-chest anaesthetized sheep, nine sonomicrometry crystals were implanted on the right ventricle. Additional nine crystals were implanted around the tricuspid annulus, with one crystal at each commissure defining three separate annular regions: anterior, posterior and septal. Left ventricular unloading was achieved by connecting a cannula in the left atrium and the aorta to a continuous-flow pump. The pump was used for 15 min at a full flow of 3.8 ± 0.3 l/min. Epicardial echocardiography was used to assess the degree of tricuspid insufficiency. Haemodynamic, echocardiographic and sonomicrometry data were collected before and during full unloading. Tricuspid annular area, and the regional and total perimeter were calculated from crystal coordinates, while 3D annular geometry was expressed as the orthogonal distance of each annular crystal to the least squares plane of all annular crystals. There was no significant tricuspid regurgitation observed either before or during LV unloading. Right ventricular free wall to septum diameter increased significantly at end-diastole during unloading from 23.6 ± 5.8 to 26.3 ± 6.5 mm (P = 0.009), but the right ventricular volume, tricuspid annular area and total perimeter did not change from baseline. However, the septal part of the annulus significantly decreased its maximal length (38.6 ± 8.1 to 37.9 ± 8.2 mm, P = 0.03). Annular contraction was not altered. The

  14. Negative inotropic and chronotropic effects on the guinea pig atrium of extracts obtained from Averrhoa carambola L. leaves

    Directory of Open Access Journals (Sweden)

    Vasconcelos C.M.L.

    2005-01-01

    Full Text Available It has been reported that star fruit can lead to a fatal outcome in uremic patients. The intoxication syndrome consists of hiccups, mental confusion, dizziness, and vomiting. On the other hand, folk medicine uses teas and infusions of carambola leaves to treat headache, vomiting, cough, insomnia, and diabetes. This motivated us to determine if Averrhoa carambola can act on the contractility and automaticity of the guinea pig heart. We measured the atrial isometric force in stimulated left atria and determined the chronotropic changes in spontaneously beating right atria. The carambola leaf extracts (1.5 mg/ml abolished the contractile force in a concentration-dependent manner. Among the crude, methanolic, ethanolic, aqueous, and acetic extracts, the aqueous one was the most potent (EC50 = 520 ± 94 µg/ml; flavonoids and tannins are the main constituents; Na+ and K+ contents in 1.0 mg/ml of aqueous extract were 0.12 ± 0.016 and 1.19 ± 0.15 mM, respectively. The aqueous extract abolished the positive Bowditch staircase phenomenon and reduced the inotropic response to CaCl2 (0.17-8.22 mM, events that are dependent on the cellular Ca2+ inward current. The adrenergic, muscarinic or opioid membrane receptors do not seem to participate in the mechanism of action of the cardioactive substance(s. In spontaneously beating atria, the aqueous extract promoted a negative chronotropic effect that was antagonized by 0.1 µM isoproterenol bitartrate. With this agonist, the EC50 of the aqueous extract increased from 133 ± 58 to 650 ± 100 µg/ml. These data regarding the effect of A. carambola on guinea pig atrial contractility and automaticity indicate an L-type Ca2+ channel blockade.

  15. Negative inotropic and chronotropic effects on the guinea pig atrium of extracts obtained from Averrhoa carambola L. leaves.

    Science.gov (United States)

    Vasconcelos, C M L; Araújo, M S; Silva, B A; Conde-Garcia, E A

    2005-07-01

    It has been reported that star fruit can lead to a fatal outcome in uremic patients. The intoxication syndrome consists of hiccups, mental confusion, dizziness, and vomiting. On the other hand, folk medicine uses teas and infusions of carambola leaves to treat headache, vomiting, cough, insomnia, and diabetes. This motivated us to determine if Averrhoa carambola can act on the contractility and automaticity of the guinea pig heart. We measured the atrial isometric force in stimulated left atria and determined the chronotropic changes in spontaneously beating right atria. The carambola leaf extracts (1.5 mg/ml) abolished the contractile force in a concentration-dependent manner. Among the crude, methanolic, ethanolic, aqueous, and acetic extracts, the aqueous one was the most potent (EC50 = 520 +/- 94 microg/ml; flavonoids and tannins are the main constituents; Na+ and K+ contents in 1.0 mg/ml of aqueous extract were 0.12 +/- 0.016 and 1.19 +/- 0.15 mM, respectively). The aqueous extract abolished the positive Bowditch staircase phenomenon and reduced the inotropic response to CaCl2 (0.17-8.22 mM), events that are dependent on the cellular Ca2+ inward current. The adrenergic, muscarinic or opioid membrane receptors do not seem to participate in the mechanism of action of the cardioactive substance(s). In spontaneously beating atria, the aqueous extract promoted a negative chronotropic effect that was antagonized by 0.1 microM isoproterenol bitartrate. With this agonist, the EC50 of the aqueous extract increased from 133 +/- 58 to 650 +/- 100 microg/ml. These data regarding the effect of A. carambola on guinea pig atrial contractility and automaticity indicate an L-type Ca2+ channel blockade.

  16. Left Activism, Succour and Selfhood

    DEFF Research Database (Denmark)

    Hughes, Celia Penelope

    2014-01-01

    At the height of mass activity on the Left, the ascendancy of the women's liberation movement (WLM), and the beginnings of real social and personal change for men and women, the 1970s are increasingly seen as the decade when sixties permissiveness began to be truly felt in Britain. This article...... draws upon a personal archive of correspondence from this turbulent decade, between two revolutionary women, Di Parkin and Annie Howells. It argues that the women's letters form an important contribution to new understandings about the construction of the post-war gendered self. The letters represent...... an interchange of motherhood, domesticity, far-left politics, and close female friendship. The article will show how the women's epistolary friendship offers intimate insight into female self-fashioning at a breakthrough social and political moment in 1970s Britain. As they reflected on some of the key political...

  17. Time left in the mouse.

    Science.gov (United States)

    Cordes, Sara; King, Adam Philip; Gallistel, C R

    2007-02-22

    Evidence suggests that the online combination of non-verbal magnitudes (durations, numerosities) is central to learning in both human and non-human animals [Gallistel, C.R., 1990. The Organization of Learning. MIT Press, Cambridge, MA]. The molecular basis of these computations, however, is an open question at this point. The current study provides the first direct test of temporal subtraction in a species in which the genetic code is available. In two experiments, mice were run in an adaptation of Gibbon and Church's [Gibbon, J., Church, R.M., 1981. Time left: linear versus logarithmic subjective time. J. Exp. Anal. Behav. 7, 87-107] time left paradigm in order to characterize typical responding in this task. Both experiments suggest that mice engaged in online subtraction of temporal values, although the generalization of a learned response rule to novel stimulus values resulted in slightly less systematic responding. Potential explanations for this pattern of results are discussed.

  18. Medline Plus

    Full Text Available ... The four chambers of the heart are the right atrium, the right ventricle, the left atrium, and the left ventricle. ... which bring blood from the body to the right atrium, the pulmonary artery, which transports blood from ...

  19. TROMBO GIGANTE DE AURÍCULA DERECHA COMO CAUSA DE ANGINA Y SÍNCOPE / Giant thrombus in right atrium as a cause of angina and syncope

    Directory of Open Access Journals (Sweden)

    José L. Aparicio Suárez

    2012-07-01

    Full Text Available ResumenLas tumoraciones intracardíacas son poco frecuentes, y pueden ser de tipo neoplásicas y no neoplásicas. De estas últimas, los trombos, constituyen las masas más frecuentes. Se presenta un paciente joven, operado en el Cardiocentro "Ernesto Che Guevara" de Villa Clara, Cuba, con antecedentes de trastornos hematológicos desde la infancia, que comienza con episodios de disnea progresiva, angina y síncope; con diagnóstico preoperatorio de tumoración gigante en aurícula derecha que resultó ser un trombo intracardíaco, y se demostró la presencia de un agujero oval permeable. / AbstractIntracardiac tumors are rare, and may be of neoplastic and non-neoplastic types. In the latter, the thrombi are the most frequent masses. This is the case of a young patient operated at the Cardiocentro "Ernesto Che Guevara" of Villa Clara, Cuba, with a history of blood disorders since childhood, starting with episodes of progressive dyspnea, angina and syncope, with pre-operative diagnosis of giant tumor in right atrium which turned out to be an intracardiac thrombus, and the presence of a patent foramen ovale was shown.

  20. A novel device for the occlusion of left atrial appendage: an experimental study in canine models

    International Nuclear Information System (INIS)

    Yang Zhihong; Qin Yongwen; Wu Hong; Hu Jianqiang; Wang Shengqiang; Ding Zhongru; Liu Zongjun

    2011-01-01

    Objective: To evaluate the feasibility, safety and biocompatibility of a novel device designed by the authors for the occlusion of left atrial appendage (LAA) in canine models. Methods: The occlusion of LAA was performed in 20 experimental dogs by using a novel LAA occluder, which was delivered to the LAA through a transseptal catheter. During the period of 2 weeks to 6 months after the procedure, the dogs were kept under observation for the device healing, migration, perforation and the formation of thrombus. Both scanning electron microscope (SEM) and transmission electron microscope (TEM) were used to examine the endothelial growth on the surface of the occluder and the structure of the endothelial cells. Results: Of the total 20 dogs, the novel device was successfully implanted in 14. The LAA was occluded completely in 13 dogs. No mobile thrombi caused by the implantation procedure were observed. Endothelialization of the atrium-facing surface was observed at one month after the procedure, and the surface was completely covered with endothelial cells at 3 months after the treatment, which was confirmed by gross, histological and SEM examinations. TEM examination showed that the structure of endothelial cells, the mitochondrion and sarcomere of atrial cardiocyte were all normal. Gross and light microscopic examination of the kidney, lung spleen and liver showed that there was no evidence of embolism or infarction. Conclusion: The novel device is safe and feasible for the occlusion of the LAA in experimental dogs. Further study is needed to observe its long-term safety. (authors)

  1. Left atrial ejection force predicts the outcome after catheter ablation for paroxysmal atrial fibrillation.

    Science.gov (United States)

    Kishima, Hideyuki; Mine, Takanao; Takahashi, Satoshi; Ashida, Kenki; Ishihara, Masaharu; Masuyama, Tohru

    2018-02-01

    Left atrium (LA) systolic dysfunction is observed in the early stages of atrial fibrillation (AF) prior to LA anatomical change. We investigated whether LA systolic dysfunction predicts recurrent AF after catheter ablation (CA) in patients with paroxysmal AF. We studied 106 patients who underwent CA for paroxysmal AF. LA systolic function was assessed with the LA emptying volume = Maximum LA volume (LAV max ) - Minimum LA volume (LAV min ), LA emptying fraction = [(LAV max - LAV min )/LAV max ] × 100, and LA ejection force calculated with Manning's method [LA ejection force = (0.5 × ρ × mitral valve area × A 2 )], where ρ is the blood density and A is the late-diastolic mitral inflow velocity. Recurrent AF was detected in 35/106 (33%) during 14.6 ± 9.1 months. Univariate analysis revealed reduced LA ejection force, decreased LA emptying fraction, larger LA diameter, and elevated brain natriuretic peptide as significant variables. On multivariate analysis, reduced LA ejection force and larger LA diameter were independently associated with recurrent AF. Moreover, patients with reduced LA ejection force and larger LA diameter had a higher risk of recurrent AF than preserved LA ejection force (log-rank P = 0.0004). Reduced LA ejection force and larger LA diameter were associated with poor outcome after CA for paroxysmal AF, and could be a new index to predict recurrent AF. © 2017 Wiley Periodicals, Inc.

  2. [Quantitative Measurements on the Blood Flow Fields of Left Atrial Appendage using Vector Flow Mapping in Patients with Nonvalvular Atrial Fibrillation].

    Science.gov (United States)

    Cai, Yu-Yan; Wei, Xin; Zhang, Xiao-Ling; Liu, Gu-Yue; Li, Xi; Tang, Hong

    2018-01-01

    To quantify the hemodynamic characteristics of patients with nonvalvular atrial fibrillation. Twenty patients with paroxysmal atrial fibrillation and 15 patients with persistent atrial fibrillation enrolled in this study,while 12 patients with sinus rhythms served as controls. The hemodynamic characteristics of the patients in left atrial appendage were measured by transesophageal echocardiography (TEE) and vector flow mapping (VFM) using indicators such as vectors,vortex and energy loss (EL). ① Significant differences appeared between the patients with atrial fibrillation and the controls in heart rate,size of left atrium,size of left atrial appendage (LAA),and velocities of LAA filling and emptying. ② Regular vectors in LAA in early systole and late diastole were found in the patients with paroxysmal atrial fibrillation and the controls; whereas,irregular vectors with direction alternating were visualized in the whole cardiac cycle in the patients with persistent atrial fibrillation. ③ Small vortexes were observed at the opening of the left atrial appendage in late diastole in the patients with paroxysmal atrial fibrillation and the controls. ④ Peak EL values occurred in early systole and late diastole in the patients with paroxysmal atrial fibrillation and the controls. But the patients with persistent atrial fibrillation had increased EL values over the whole cardiac cycle. VFM can visualize and quantify the hemodynamics of LAA in patients with different heart rhythms. It may provide a new method for assessing atrial fibrillation. CopyrightCopyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

  3. Rebuilding the US Health Left

    Directory of Open Access Journals (Sweden)

    Victor W. Sidel, MD

    2010-02-01

    Full Text Available With this issue Social Medicine begins a series of invited papers on the topic: “Rebuilding the US Health Left.” In this editorial we will outline our vision for this series. We undertake this project aware that our good friend and mentor, Dr. Walter Lear, one of the leading health activists of the 20th century, lies critically ill. Walter was the creator and custodian of the US Health Left Archives, a collection that is now with the University of Pennsylvania library. The collection reminds us of the important role left health care workers played in US history throughout the 20th century. They advocated for a national health program (Committee on the Costs of Medical Care, Physicians Forum, Medical Care Section/APHA, HealthPAC, Physicians for a National Health Program, National Physicians Alliance, provided international solidarity (American Soviet Medical Society, international brigades during the Spanish Civil War, Central American Solidarity Movement, Committee to Help Chilean Health Workers, Doctors for Global Health, traced the connections between disease and social class (Sigerist Circle, Spirit of 1848, APHA, fought for workers’ health (Councils for Occupational Safety and Health; Occupational Health and Safety Section, APHA participated in anti-war movements (Medical Committee for Human Rights, Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War, created new models of health care delivery (Health Cooperatives, Prepaid Health Maintenance Organizations, Community Health Centers, National Health Service Corps, Free Clinics, were central to the struggle for women’s rights (Planned Parenthood, Physicians for Reproductive Choice and Health, supported the civil rights movement both in medicine and in the broader society (National Medical Association, Medical Committee for Human Rights, played key roles in the movement for gay rights (ACT-UP, Gay & Lesbian Medical Association, Lesbian, Gay

  4. A Case of Atrial Tachycardia Circulating around a Left Atrial Roof Scar with Diabetes Mellitus and Renal Failure on Hemodialysis

    Directory of Open Access Journals (Sweden)

    Naoko Hijioka

    2016-01-01

    Full Text Available Introduction. Little is known about the effects of volume change by hemodialysis (HD and mechanical stress caused by an anatomical structure being in contact with the left atrium on the progression of atrial remodeling. We experienced a case of atrial tachycardia (AT in a patient who had left atrial (LA scarring at the LA roof and a low-voltage area with slow conduction around the LA scar as components of AT circuit. Here, we present the conceivable hypothesis of the LA scar and the low-voltage area formation. Our concept can be useful in developing a strategy for ablation in a patient with chronic renal failure (CRF on HD. Case Report. A 65-year-old man with CRF on HD was referred for AT ablation. Three-dimensional electroanatomical mapping revealed that the AT conducted around an LA scar in a counterclockwise fashion. There was a slow conduction area at the superior side of the LA scar, where the AT was terminated during the ablation. Computed tomography indicated a close relationship between the LA and the anatomical structures (ascending aorta and pulmonary artery. Conclusion. Volume change by HD and close contact of anatomical structures to the LA can promote atrial remodeling, resulting in AT occurrence.

  5. Preliminary design of the internal geometry in a minimally invasive left ventricular assist device under pulsatile-flow conditions.

    Science.gov (United States)

    Smith, P Alex; Wang, Yaxin; Metcalfe, Ralph W; Sampaio, Luiz C; Timms, Daniel L; Cohn, William E; Frazier, O H

    2018-03-01

    A minimally invasive, partial-assist, intra-atrial blood pump has been proposed, which would unload the left ventricle with a flow path from the left atrium to the arterial system. Flow modulation is a common strategy for ensuring washout in the pump, but it can increase power consumption because it is typically achieved through motor-speed variation. However, if a pump's performance curve had the proper gradient, flow modulation could be realized passively. To achieve this goal, we propose a pump performance operating curve as an alternative to the more standard operating point. Mean-line theory was employed to generate an initial set of geometries that were then tested on a hydraulic test rig at ~20,000 r/min. Experimental results show that the intra-atrial blood pump performed below the operating region; however, it was determined that smaller hub diameter and longer chord length bring the performance of the intra-atrial blood pump device closer to the operating curve. We found that it is possible to shape the pump performance curve for specifically targeted gradients over the operating region through geometric variations inside the pump.

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

  7. Right and left ventricular ejection fraction at rest and during exercise assessed with radionuclide angiocardiography

    International Nuclear Information System (INIS)

    Dahlstroem, J.A.

    1982-01-01

    Right (RVEF) and left ventricular ejection fraction (LVEF) assessed with radionuclide angiocardiography were compared to simultaneously obtained catheterization results at rest and during exercise in patients with pulmonary hypertension and ischemic heart disease. Blood pool imaging was performed with red blood cells (RBC) labelled with 99 Tcsup(m) in vivo as this method gave more stable 99 Tcsup(m) levels in blood compared to 99 Tcsup(m)-labelled human serum albumin and because it was more convenient than labelling RBC in vitro. RVEF measured with first pass (FP) technique and equilibrium (EQ) technique correlated well at rest, r = 0.86, and during exercise, r = 0.91. The FP technique had the best reproducibility and reference values at rest were 49+-5 per cent increasing with exercise. When 99 Tcsup(m) and 133 Xe were compared to assess RVEF with FP technique, the correlation was good, r = 0.88. LVEF assessed with EQ technique and a fixed end-diastolic region of interest was very reproducible at rest and during exercise; reference values at rest were 56+-8 per cent increasing with exercise. In 10 patients with pulmonary hypertension significant negative correlations were found between RVEF assessed with FP technique and pressures in pulmonary artery and right atrium. Abnormal RVEF was found in all patients with right ventricular disfunction. In 22 patients with recent myocardial infarction measurements of LVEF detected left ventricular disfunction better than did measurement of pulmonary artery diastolic pressure. During effort angina in another 10 patients all had abnormal LVEF and abnormal hemodynamics. By combining ejection fraction and stroke volume, ventricular volumes were calculated at rest and during exercise. (author)

  8. Right atrium and superior vena cava pressure measurements in a novel animal model to study one and a half ventricle repair as compared to Fontan type procedure

    Directory of Open Access Journals (Sweden)

    Anil Bhattarai

    2017-01-01

    Full Text Available Background & Objectives: To evaluate the advantages of the one and a half ventricle repair on maintaining a low pressure in the inferior vena cava district. Also evaluate the competition of flows at the superior vena cava – right pulmonary artery anastomosis site, in order to understand the hemodynamic interaction of a pulsatile flow in combination to a laminar one. Materials & Methods: Adult rabbits (n=30 in terminal anaesthesia with a follow up of 8 h were used, randomly distributed in three experimental groups: Group 1: animals with an anastomosis between superior vena cava and right pulmonary artery, as a model of one and one half ventricle repair; Group 2: animals with the cavopulmonary anastomosis followed by clamping of the right pulmonary artery proximal to the anastomosis; and Group 3: sham animals. Pressures of superior vena cava and pulmonary arteries were afterwards measured, in a resting condition as well as after induced pharmacological stress test.Results: In Group 1, superior vena cava pressure was significantly higher, while venous pressure in the inferior vena cava – right atrium district was constant or lower in comparison with the other groups. After stress test, the pressure in the superior vena cava and the heart rate both increased further, but the right ventricular, right atrial and pulmonary artery pressures remained similar to the values in a resting condition. This proved that the inferior vena cava return was well-preserved, and no venous hypertension was present in the inferior vena cava district even after stress test (good exercise tolerance.Conclusion: One and one half ventricle repair can be considered a good surgical strategy for maintaining a low pressure in the inferior vena cava district with potential for right ventricle growth, restoring the more physiological circulation in borderline or failing right ventricle conditions. The experiment presented a positive finding in favour of one and one half

  9. Flavoured Dark Matter moving left

    Science.gov (United States)

    Blanke, Monika; Das, Satrajit; Kast, Simon

    2018-02-01

    We investigate the phenomenology of a simplified model of flavoured Dark Matter (DM), with a dark fermionic flavour triplet coupling to the left-handed SU(2) L quark doublets via a scalar mediator. The DM-quark coupling matrix is assumed to constitute the only new source of flavour and CP violation, following the hypothesis of Dark Minimal Flavour Violation. We analyse the constraints from LHC searches, from meson mixing data in the K, D, and B d,s meson systems, from thermal DM freeze-out, and from direct detection experiments. Our combined analysis shows that while the experimental constraints are similar to the DMFV models with DM coupling to right-handed quarks, the multitude of couplings between DM and the SM quark sector resulting from the SU(2) L structure implies a richer phenomenology and significantly alters the resulting impact on the viable parameter space.

  10. Left septal atrial tachycardia after open-heart surgery: relevance to surgical approach, anatomical and electrophysiological characteristics associated with catheter ablation, and procedural outcomes.

    Science.gov (United States)

    Adachi, Toru; Yoshida, Kentaro; Takeyasu, Noriyuki; Masuda, Keita; Sekiguchi, Yukio; Sato, Akira; Tada, Hiroshi; Nogami, Akihiko; Aonuma, Kazutaka

    2015-02-01

    Septal atrial tachycardia (AT) can occur in patients without structural heart disease and in patients with previous catheter ablation of atrial fibrillation. We aimed to assess septal AT that occurs after open-heart surgery. This study comprised 20 consecutive patients undergoing catheter ablation of macroreentrant AT after open-heart surgery. Relevance to surgical approach, mechanisms, anatomic and electrophysiological characteristics, and outcomes were assessed. Septal AT was identified in 7 patients who had all undergone mitral valve surgery. All septal ATs were localized in the left atrial septum, whereas 10 of 13 nonseptal ATs originated from the right atrium. Patients with left septal AT had a thicker fossa ovalis (median, 4.0; 25th-75th percentile, 3.6-4.2 versus 2.3; 1.6-2.6 mm; P=0.006) and broader area of low voltage (open-heart surgery was characterized by a thicker septum, more scar burden in the septum, and repeated prolongations of the tachycardia cycle length during ablation. Such an arrhythmogenic substrate may interfere with transmural lesion formation by ablation and may account for higher likelihood of recurrence of left septal AT. © 2014 American Heart Association, Inc.

  11. The effect of heart failure and left ventricular assist device treatment on right ventricular mechanics: a computational study.

    Science.gov (United States)

    Park, Jun I K; Heikhmakhtiar, Aulia Khamas; Kim, Chang Hyun; Kim, Yoo Seok; Choi, Seong Wook; Song, Kwang Soup; Lim, Ki Moo

    2018-05-22

    Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model. In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value. Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment. LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.

  12. Prognostic value of left atrial function in systemic light-chain amyloidosis: a cardiac magnetic resonance study.

    Science.gov (United States)

    Mohty, Dania; Boulogne, Cyrille; Magne, Julien; Varroud-Vial, Nicolas; Martin, Sylvain; Ettaif, Hind; Fadel, Bahaa M; Bridoux, Frank; Aboyans, Victor; Damy, Thibaud; Jaccard, Arnaud

    2016-09-01

    Cardiac involvement in systemic light-chain amyloidosis (AL) imparts an adverse impact on outcome. The left atrium (LA), by virtue of its anatomical location and muscular wall, is commonly affected by the amyloid process. Although LA infiltration by amyloid fibrils leads to a reduction in its pump function, the infiltration of the left ventricular (LV) myocardium results in diastolic dysfunction with subsequent increase in filling pressures and LA enlargement. Even though left atrial volume (LAV) is an independent prognostic marker in many cardiomyopathies, its value in amyloid heart disease remains to be determined. In addition, few data are available as to the prognostic value of LA function in systemic AL. Using cardiac magnetic resonance (CMR), the current study aims to assess the prognostic significance of the maximal LAV and total LA emptying fraction (LAEF) in patients with AL. Fifty-four consecutive patients (age 66 ± 10 years, 59% males) with confirmed systemic AL and mean LV ejection fraction of 60 ± 12% underwent CMR. As compared with patients with no or minimal cardiac involvement (Mayo Clinic [MC] stage I), those at moderate and high risk (MC stages II and III) had significantly larger indexed maximal LAV (36 ± 15 vs. 46 ± 13 vs. 52 ± 19 mL/m(2), P = 0.03) and indexed minimal LAV (20 ± 6 vs. 34 ± 11 vs. 44 ± 17 mL/m(2), P 16% (37 ± 11 vs. 94 ± 4%, P = 0.001). In multivariate analysis, lower LAEF remained independently associated with a higher risk of 2-year mortality (HR = 1.08 per 1% decrease, 95% CI: 1.02-1.15, P = 0.003). In patients with systemic AL, LAEF as assessed by CMR is associated with NYHA functional class, MC stage, myocardial LGE and 2-year mortality. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  13. Computational Fluid Dynamic Analysis of the Left Atrial Appendage to Predict Thrombosis Risk

    Directory of Open Access Journals (Sweden)

    Giorgia Maria Bosi

    2018-04-01

    Full Text Available During Atrial Fibrillation (AF more than 90% of the left atrial thrombi responsible for thromboembolic events originate in the left atrial appendage (LAA, a complex small sac protruding from the left atrium (LA. Current available treatments to prevent thromboembolic events are oral anticoagulation, surgical LAA exclusion, or percutaneous LAA occlusion. However, the mechanism behind thrombus formation in the LAA is poorly understood. The aim of this work is to analyse the hemodynamic behaviour in four typical LAA morphologies - “Chicken wing”, “Cactus”, “Windsock” and “Cauliflower” - to identify potential relationships between the different shapes and the risk of thrombotic events. Computerised tomography (CT images from four patients with no LA pathology were segmented to derive the 3D anatomical shape of LAA and LA. Computational Fluid Dynamic (CFD analyses based on the patient-specific anatomies were carried out imposing both healthy and AF flow conditions. Velocity and shear strain rate (SSR were analysed for all cases. Residence time in the different LAA regions was estimated with a virtual contrast agent washing out. CFD results indicate that both velocity and SSR decrease along the LAA, from the ostium to the tip, at each instant in the cardiac cycle, thus making the LAA tip more prone to fluid stagnation, and therefore to thrombus formation. Velocity and SSR also decrease from normal to AF conditions. After four cardiac cycles, the lowest washout of contrast agent was observed for the Cauliflower morphology (3.27% of residual contrast in AF, and the highest for the Windsock (0.56% of residual contrast in AF. This suggests that the former is expected to be associated with a higher risk of thrombosis, in agreement with clinical reports in the literature. The presented computational models highlight the major role played by the LAA morphology on the hemodynamics, both in normal and AF conditions, revealing the potential

  14. Left Paraduodenal Hernia: An Autopsy Case

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Hougen, Hans Petter

    2011-01-01

    We present a case of a left paraduodenal hernia diagnosed at autopsy. A left paraduodenal hernia is an internal hernia of congenital origin due to the abnormal rotation of the midgut during embryonic development. Internal hernias are a rare cause of intestinal obstruction, with the paraduodenal...

  15. Basal cell carcinoma on the left cheek

    International Nuclear Information System (INIS)

    Jancar, B.

    2007-01-01

    A 91-year-old female patient was treated with irradiation for histologically confirmed basal cell carcinoma on the left cheek. The tumour, measuring 3 x 3 cm, with the depth of 2 cm, was extending up to the lower lid of the left eye. (author)

  16. Pure Left Neglect for Arabic Numerals

    Science.gov (United States)

    Priftis, Konstantinos; Albanese, Silvia; Meneghello, Francesca; Pitteri, Marco

    2013-01-01

    Arabic numerals are diffused and language-free representations of number magnitude. To be effectively processed, the digits composing Arabic numerals must be spatially arranged along a left-to-right axis. We studied one patient (AK) to show that left neglect, after right hemisphere damage, can selectively impair the computation of the spatial…

  17. Congenital Absence of Left Circumflex Coronary Artery

    Directory of Open Access Journals (Sweden)

    Zahra Ansari

    2009-09-01

    Full Text Available Congenital absence of left circumflex artery is a rare congenitalanomaly of the coronary arteries. The prevalence of theanomaly in different studies ranges from 0.6% to 1.3%. Ofthese, 80% are benign and asymptomatic and 20% are clinicallyimportant. We report a 56-year-old man presented withacute resting chest pain who was diagnosed as having acuteanterolateral infarction accompanied by electrocardiographicchanges and elevated cardiac enzymes. Coronary angiographyin different views was conducted, however, no left circumflexartery was found. The territory supplied by the artery had beenperfused by the super dominant right coronary artery. Therewas no left circumflex coronary artery with anomalous origin.Sever stenosis of left anterior ascending artery superimposedto the absent left circumflex artery was presented as acute anterolateralinfarction. Although absence of the artery is mostlyconsidered as a benign condition, atherosclerotic lesions maybe more important in such cases because of diminished compensatingmechanisms.

  18. Repair of aorto-left ventricular tunnel arising from the left sinus of valsalva.

    Science.gov (United States)

    Nezafati, Mohammad Hassan; Maleki, Mahmood Hosseinzadeh; Javan, Hadi; Zirak, Nahid

    2010-05-01

    Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to the aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we are presenting a case of ALVT, of which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid the left coronary artery injury at the time of surgical repair.

  19. A stochastic approach for automatic registration and fusion of left atrial electroanatomic maps with 3D CT anatomical images

    International Nuclear Information System (INIS)

    Cristoforetti, Alessandro; Mase, Michela; Faes, Luca; Centonze, Maurizio; Greco, Maurizio Del; Antolini, Renzo; Nollo, Giandomenico; Ravelli, Flavia

    2007-01-01

    The integration of electroanatomic maps with highly resolved computed tomography cardiac images plays an important role in the successful planning of the ablation procedure of arrhythmias. In this paper, we present and validate a fully-automated strategy for the registration and fusion of sparse, atrial endocardial electroanatomic maps (CARTO maps) with detailed left atrial (LA) anatomical reconstructions segmented from a pre-procedural MDCT scan. Registration is accomplished by a parameterized geometric transformation of the CARTO points and by a stochastic search of the best parameter set which minimizes the misalignment between transformed CARTO points and the LA surface. The subsequent fusion of electrophysiological information on the registered CT atrium is obtained through radial basis function interpolation. The algorithm is validated by simulation and by real data from 14 patients referred to CT imaging prior to the ablation procedure. Results are presented, which show the validity of the algorithmic scheme as well as the accuracy and reproducibility of the integration process. The obtained results encourage the application of the integration method in post-intervention ablation assessment and basic AF research and suggest the development for real-time applications in catheter guiding during ablation intervention

  20. TMS over the Left Angular Gyrus Impairs the Ability to Discriminate Left from Right

    Science.gov (United States)

    Hirnstein, Marco; Bayer, Ulrike; Ellison, Amanda; Hausmann, Markus

    2011-01-01

    The underlying cognitive and neural mechanisms of the ability to discriminate left from right are hardly explored. Clinical studies from patients with impairments of left-right discrimination (LRD) and neuroimaging data suggest that the left angular gyrus is particularly involved in LRD. Moreover, it is argued that the often reported sex…

  1. Social aspects of left-handedness

    Directory of Open Access Journals (Sweden)

    Belojević Goran

    2010-01-01

    Full Text Available Throughout human history left-handedness has been considered as sinful. It has been associated with the devil, weakness, female gender, unhealthiness, evil, something that has to be turned to a “good” - right side by force. Left-handedness is being more and more acceptable at rational level, but in everyday life it is still considered to be unusual if someone writes with the left hand. Lessening of the number of lefthanders is associated with ageing. There are about 13% lefthanders among people in twenties and less than 1% lefthanders among those in eighties. This finding may be explaned with more pronounced socio-cultural pressure on left-handed people in the past, compared to nowadays. On the other hand, this may also support the hypothesis about a reduced life span of lefthanded people. With cross-exercising of left-handedness, certain typical characteristics and behavioral patterns appear in these people. This was a sort of provoked behavior and an attack on the integrity of an emotional attitude toward oneself. Stuttering may also appear as a consequence of unsuccessful cross-exercising of left-handedness. The hypothesis about left-handedness as an advantage is supported with the reports about relatively more lefthanders in some specific groups such as: mathematicians, sculptors, architects, painters, musicians, actors, tennis players, as well as famous army commanders and rulers.

  2. The Effects Of Short Tıme Rıght Ventrıcular Pacıng On Left Atrıal Mechanıcal Functıons

    Directory of Open Access Journals (Sweden)

    Oyku Gulmez

    2009-05-01

    Full Text Available Objectives: Left atrium (LA plays an important role in left ventricular filling. It is well known that right ventricular apical pacing has unfavorable effects on ventricular systolic and diastolic performance. The aim of this study is to evaluate the LA mechanical functions with 2D echocardiography in patients with a permanent pacemaker after short time ventricular pacing.Design: Echocardiographic examination was performed in 38 patients (mean age 63.0±10.9, 18 female with dual chamber pacemakers or defibrillators (90% ventricular pacing at 70 beats per minute in DDD mode with an optimal AV interval. Left atrial volumes (LAV including at the time of mitral valve opening (Vmax, at closure (Vmin, and at the onset of atrial systole (Volp were measured. The passive emptying, conduit, active emptying and total emptying volume, stroke volumes were also calculated. Results: No significant differences were noted at baseline and after pacing for absolute Vmax, Volp, passive emptying, conduit, active emptying, total emptying volumes as well as the volumes indexed to body surface area (p >0.05. Conclusion: Short - time RV pacing seems to have no acute effects on left atrial mechanical functions.

  3. Left atrial systolic force in hypertensive patients with left ventricular hypertrophy: the LIFE study

    DEFF Research Database (Denmark)

    Chinali, M.; Simone, G. de; Wachtell, K.

    2008-01-01

    In hypertensive patients without prevalent cardiovascular disease, enhanced left atrial systolic force is associated with left ventricular hypertrophy and increased preload. It also predicts cardiovascular events in a population with high prevalence of obesity. Relations between left atrial...... systolic force and left ventricular geometry and function have not been investigated in high-risk hypertrophic hypertensive patients. Participants in the Losartan Intervention For Endpoint reduction in hypertension echocardiography substudy without prevalent cardiovascular disease or atrial fibrillation (n...... = 567) underwent standard Doppler echocardiography. Left atrial systolic force was obtained from the mitral orifice area and Doppler mitral peak A velocity. Patients were divided into groups with normal or increased left atrial systolic force (>14.33 kdyn). Left atrial systolic force was high in 297...

  4. Evaluation of platelet aggregability during left ventricular bypass using a MedTech MagLev VAD in a series of chronic calf experiments.

    Science.gov (United States)

    Kimura, Taro; Yokoyama, Yoshimasa; Sakota, Daisuke; Nagaoka, Eiki; Kitao, Takashi; Takakuda, Kazuo; Takatani, Setsuo

    2013-03-01

    The impact of continuous flow left ventricular assist device (LVAD) pumping on platelet aggregation was investigated in animal experiments utilizing six calves. A single-use MagLev centrifugal blood pump, MedTech MagLev, was used to bypass the calves' hearts from the left atrium to the descending aorta at a flow rate of 50 ml/kg/min. The LVAD's impact on blood coagulation activities was evaluated based on the platelet aggregability, which was measured with a turbidimetric assay method during the preoperative, operative, and postoperative periods. Heparin and warfarin were used for anticoagulation, while aspirin was used for the antiplatelet therapy. A decrease in platelet aggregation immediately after the pump started was observed in the cases of successful long-term pump operation, while the absence of such a decrease might have caused coagulation-related complications to terminate the experiments. Thus, the platelet aggregability was found to be significantly affected by the pump, and its initial trend may be related to the long-term outcome of the mechanical circulatory support.

  5. Introduction to left-right symmetric models

    International Nuclear Information System (INIS)

    Grimus, W.

    1993-01-01

    We motivate left-right symmetric models by the possibility of spontaneous parity breaking. Then we describe the multiplets and the Lagrangian of such models. Finally we discuss lower bounds on the right-handed scale. (author)

  6. Left ventricular hypertrophy: virtuous intentions, malign consequences.

    Science.gov (United States)

    Pokharel, Saraswati; Sharma, Umesh C; Pinto, Yigal M

    2003-06-01

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca(2+) homeostasis, there are structural changes in myofilaments, disorganization of the cytoskeletal framework and increased collagen synthesis. LVH is associated with progressive left ventricular remodeling that culminates to heart failure. The modern treatment of left ventricular hypertrophy is now largely based on the hypothesis that neuroendocrine activation is important in the progression of the disease and inhibition of neurohormones is likely to have long-term benefit with regard to morbidity and mortality. Drugs specifically designed to unload the left ventricle, such as diuretics and vasodilators, appears to be less effective in reducing LV mass and improving prognosis. Thus, the evolution of treatment for LVH itself has provided much enlightenment for our understanding of the fundamental biology of the disorder.

  7. Quantum levitation by left-handed metamaterials

    Energy Technology Data Exchange (ETDEWEB)

    Leonhardt, Ulf; Philbin, Thomas G [School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews KY16 9SS (United Kingdom)

    2007-08-15

    Left-handed metamaterials make perfect lenses that image classical electromagnetic fields with significantly higher resolution than the diffraction limit. Here, we consider the quantum physics of such devices. We show that the Casimir force of two conducting plates may turn from attraction to repulsion if a perfect lens is sandwiched between them. For optical left-handed metamaterials, this repulsive force of the quantum vacuum may levitate ultra-thin mirrors.

  8. Quantum levitation by left-handed metamaterials

    International Nuclear Information System (INIS)

    Leonhardt, Ulf; Philbin, Thomas G

    2007-01-01

    Left-handed metamaterials make perfect lenses that image classical electromagnetic fields with significantly higher resolution than the diffraction limit. Here, we consider the quantum physics of such devices. We show that the Casimir force of two conducting plates may turn from attraction to repulsion if a perfect lens is sandwiched between them. For optical left-handed metamaterials, this repulsive force of the quantum vacuum may levitate ultra-thin mirrors

  9. Assessment of left ventricular global function

    International Nuclear Information System (INIS)

    Breuel, H.-P.; Baehre, M.

    1985-01-01

    Radionuclide ventriculography (RNV), i.e. noninvasive evaluation of left venticular performance following the application of radionuclides has had a major impact on many aspects of cardiology and has proven its clinical value and reliability in the last few years. This article deals mainly with the changes in global left ventricular function. The clinical applications of RNV for coronary artery diseases and valvular heart diseases are described. (Auth.)

  10. Occult left atrial ball-like thrombus in a patient referred for surgical removal of suspected cerebellum tumor

    International Nuclear Information System (INIS)

    Możeńska, Olga; Kalińska, Irena; Brodowski, Karol; Walecki, Jerzy; Kosior, Dariusz A.

    2014-01-01

    Atrial fibrillation and related cardio-embolic cerebrovascular accidents are two well-defined major healthcare problems worldwide. It has been approximated that 2.2 million people in America and 4.5 million in European Union have paroxysmal or persistent atrial fibrillation. And atrial fibrillation itself is an independent long-term risk factor of stroke. We present a case of patient referred to our center for surgical removal of suspected cerebellum tumor, a case that had a rather unexpected ending. A 58-year-old male patient with a history of atrial fibrillation, congestive heart failure (NYHA II/III), stable coronary artery disease, diabetes type 2 and hyperlipidemia presented with vertigo, headaches, mainly during physical activity and increased tiredness. Performed computer tomography revealed two lesions in the cerebellum and in the left lateral chamber. The diagnosis of a proliferative disease of the cerebellum was established and patient was referred to the Neurosurgical Department. Fortunately, before the operation the echocardiography was performed, which revealed two lesions in left atrium. The decision of the Heart Team was to refer the patient for an open-heart surgery, in which two thrombi were removed. Neurosurgeons decided to withdraw from further surgery and proceed with head MRI and conservative treatment, deciding that the lesion in the cerebellum was most likely an ischemic area. Looking at the brain lesion should always be done from the whole patient’s perspective. And using mutlimodality imaging may lead to appropriate diagnosis, correct course of therapeutic action and unexpected ending of a rather non-extraordinary case

  11. Comparative effects of amlodipine and benazepril on left atrial pressure in dogs with experimentally-induced mitral valve regurgitation.

    Science.gov (United States)

    Suzuki, Shuji; Fukushima, Ryuji; Ishikawa, Taisuke; Yamamoto, Yuta; Hamabe, Lina; Kim, Soomin; Yoshiyuki, Rieko; Machida, Noboru; Tanaka, Ryou

    2012-09-18

    One of the purposes of treatment for dogs with mitral regurgitation (MR) is lowering left atrial pressure (LAP). There has been few study of the amlodipine in dogs with MR and amlodipine's effect on LAP has not been fully evaluated in a quantitative manner because of difficulties in directly measuring LAP. The objective of our study was to compare the short-term effects of amlodipine (0.2 mg/kg PO q12h) vs benazepril (0.5 mg/kg PO q12h), on LAP and echocardiographic parameters in five beagle dogs with experimentally-induced MR. LAP of eight dogs that has own control were measured using radiotelemetry system at baseline and again on days 1, 2, 3, 4, 5, 6, 7 of the drug administration. Mean LAP decreased significantly after amlodipine (11.20 ± 4.19 mmHg vs 14.61 ± 3.81 mmHg at baseline, p benazepril treatment (13.19 ± 3.47 mmHg, p > .05). LAP was lower after 7 days of amlodipine treatment than after 7 days of benazepril treatment. Significant reduction was seen for the first time 4 days after the administration amlodipine. The rate of the maximal area of the regurgitant jet signals to the left atrium area (ARJ/LAA) of the amlodipine treatment was significantly lower (p benazepril treatment. Although this study did not focus on adverse effects, amlodipine may be an effective drug for helping the patients with acute onset of severe MR, such as rupture of chordae tendinae or end stage patients were the LAP is likely to be elevated. Additional studies in clinical patients with degenerative mitral valve disease and acute chordal rupture are warranted because the blood-pressure lowering effects of amlodipine can decrease renal perfusion and this can further activate the RAAS.

  12. Aetiological factors in left-handedness

    Directory of Open Access Journals (Sweden)

    Milenković Sanja M.

    2005-01-01

    Full Text Available Lateralisation associates the extremities and senses of one side of the body, which are connected by afferent and efferent pathways, with the primary motor and sensory areas of the hemisphere on the opposite side. Dominant laterality denotes the appearance of a dominant extremity or sense in the performance of complex psychomotor activities. Laterality is manifested both as right-handedness or left-handedness, which are functionally equivalent and symmetrical in the performance of activities. Right-handedness is significantly more common than left-handedness. Genetic theory is most widely accepted in explaining the onset of lateralisation. According to this theory, the models of brain organisation asymmetry (anatomical, functional, and biochemical are strongly, genetically determined. However, the inability to clearly demonstrate the association between genetic factors and left-handedness has led researchers to investigate the effects of the environment on left-handedness. Of particular interest are the intrauterine environment and the factors influencing foetal development, of which hormones and ultrasound exposure are the most significant. It has been estimated that an extra five cases of nonright-handed lateralisation can be expected in every 100 males who were exposed to ultrasound in utero compared to those who were not. Socio-cultural pressure on left-handed individuals was much more severe in the past, which is confirmed by scientific findings that left-handedness is present in 13% of individuals in their twenties, while in less than 1% of individuals in their eighties.

  13. Identification of Pulmonary Hypertension Caused by Left-Sided Heart Disease (World Health Organization Group 2) Based on Cardiac Chamber Volumes Derived From Chest CT Imaging.

    Science.gov (United States)

    Aviram, Galit; Rozenbaum, Zach; Ziv-Baran, Tomer; Berliner, Shlomo; Topilsky, Yan; Fleischmann, Dominik; Sung, Yon K; Zamanian, Roham T; Guo, Haiwei Henry

    2017-10-01

    Evaluations of patients with pulmonary hypertension (PH) commonly include chest CT imaging. We hypothesized that cardiac chamber volumes calculated from the same CT scans can yield additional information to distinguish PH related to left-sided heart disease (World Health Organization group 2) from other PH subtypes. Patients who had PH confirmed by right heart catheterization and contrast-enhanced chest CT studies were enrolled in this retrospective multicenter study. Cardiac chamber volumes were calculated using automated segmentation software and compared between group 2 and non-group 2 patients with PH. This study included 114 patients with PH, 27 (24%) of whom were classified as group 2 based on their pulmonary capillary wedge pressure. Patients with group 2 PH exhibited significantly larger median left atrial (LA) volumes (118 mL vs 63 mL; P volumes (90 mL vs 76 mL; P = .02), and smaller median right ventricular (RV) volumes (173 mL vs 210 mL; P = .005) than did non-group 2 patients. On multivariate analysis adjusted for age, sex, and mean pulmonary arterial pressure, group 2 PH was significantly associated with larger median LA and LV volumes (P volume ratios of RA/LA, RV/LV, and RV/LA (P = .001, P = .004, and P volumes demonstrated a high discriminatory ability for group 2 PH (area under the curve, 0.92; 95% CI, 0.870-0.968). Volumetric analysis of the cardiac chambers from nongated chest CT scans, particularly with findings of an enlarged left atrium, exhibited high discriminatory ability for identifying patients with PH due to left-sided heart disease. Copyright © 2017. Published by Elsevier Inc.

  14. Left atrial appendage function in prediction of paroxysmal atrial fibrilation in patients with untreated hypertension.

    Science.gov (United States)

    Tenekecioglu, Erhan; Agca, Fahriye Vatansever; Karaagac, Kemal; Ozluk, Ozlem Arican; Peker, Tezcan; Kuzeytemiz, Mustafa; Senturk, Muhammed; Yılmaz, Mustafa

    2014-01-01

    Abstract The onset of AF results in a significant increase in mortality rates and morbidity in hypertensive patients and this rhythm disorder exposes patients to a significantly increased risk of cerebral or peripheral embolisms. Tissue Doppler imaging was found to be useful in early detection of myocardial dysfunction in several diseases. It was shown that tissue Doppler analysis of the walls of the left atrial appendage (LAA) can give accurate information about the function of the LAA in hypertensive patients. In this study, we aimed to investigate and identify the specific predictive parameters for the onset of AF in patients with hypertension with tissue Doppler imaging of LAA. We studied age and sex matched 57 untreated hypertensive patients with paroxysmal atrial fibrillation (PAF) and 27 untreated hypertensive subjects without PAF. With transthoracic echocardiography, diastolic mitral A-velocity and LA maximal volume index which reflects reservoir function of left atrium was measured, with transesophageal echocardiography, LAA emptying velocity (LAA-PW D2) and tissue Doppler contracting velocity of LAA (LAA-TDI-D2) were measured. LA maximal volume index of the groups (22.28 ± 3.59 mL/m(2) in Group 1 versus 20.37 ± 3.97 mL/m(2) in Group 2, p = 0.07) and diastolic mitral A-velocity [0.93 (0.59-1.84) m/s in patients with PAF versus 0.90 (0.62-1.76) m/s in patients without PAF, p = 0.26] was not significantly different between study groups, during TEE, LAA-PW D2 (0.31 ± 0.04 m/s in Group 1 versus 0.33 ± 0.03 m/s in Group 2, p = 0.034) and LAA-TDI-D2 (0.18 ± 0.04 m/s in Group 1 versus 0.21 ± 0.05 m/s in Group 2, p = 0.014) were significantly decreased in Group 1. In this study, we found that in hypertensive PAF patients despite normal global LA functions, LAA contracting function was deteriorated. Tissue Doppler analysis of LAA is clinically usefull approach to detect the risk of developing PAF in

  15. New strict left bundle branch block criteria reflect left ventricular activation differences

    DEFF Research Database (Denmark)

    Emerek, Kasper Janus Grønn; Risum, Niels; Hjortshøj, Søren Pihlkjær

    2015-01-01

    AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left ven....... CONCLUSION: Interventricular electrical delay predicts left ventricular remodeling after CRT and new, strict ECG criteria of LBBB are superior in predicting remodeling.......AIMS: Pacing lead electrical delays and strict left bundle branch block (LBBB) criteria were assessed against cardiac resynchronization therapy (CRT) outcome. METHODS: Forty-nine patients with LBBB and QRS duration >130 milliseconds underwent CRT-implantation. Sensed right ventricular to left...... ventricular electrical delay (RV-LV-IED) was measured. Response to CRT was defined as ≥15% decrease in left ventricular end-systolic volume. RESULTS: Eighteen of 20 (90%) patients with non-ischemic dilated cardiomyopathy (DCM) and 18 of 29 (62%) with ischemic heart disease (IHD) responded to CRT, p

  16. Usefulness of left ventricular speckle tracking echocardiography and novel measures of left atrial structure and function in diagnosing paroxysmal atrial fibrillation in ischemic stroke and transient ischemic attack patients.

    Science.gov (United States)

    Skaarup, Kristoffer Grundtvig; Christensen, Hanne; Høst, Nis; Mahmoud, Masti Mahdy; Ovesen, Christian; Olsen, Flemming Javier; Jensen, Jan Skov; Biering-Sørensen, Tor

    2017-12-01

    Asymptomatic paroxysmal atrial fibrillation (PAF) is often assumed to be the cause of cryptogenic ischemic strokes (IS) and transient ischemic attacks (TIA). We examined the usefulness of measures obtained by 2D speckle tracking echocardiography and novel left atrial measurements, in the diagnosis of PAF in patients with IS and TIA. We retrospectively included 205 patients who after acute IS or TIA underwent an echocardiogram in sinus rhythm. Patients were designated as PAF-patients if they had one or more reported incidents of AF before or after their echocardiographic examination. None of the conventional echocardiographic parameters were significantly associated with PAF. Of the speckle tracking measurements, only early diastolic strain rate (0.7±0.2 s -1 vs. 0.8±0.3 s -1 , p = 0.048) and global longitudinal displacement (GLD) (3.15 ± 1.40 mm vs. 3.87 ± 1.56 mm, p = 0.007) proved significantly different. Of the left atrial parameters both minimal and maximal left atrium volume divided by left ventricular length (min LAV/LVL and max LAV/LVL, respectively) were significantly impaired (min LAV/LVL: 3.7 ± 2.1 cm 2 vs. 2.8 ± 1.11 cm 2 , p = 0.012; max LAV/LVL: 6.6 ± 3.1 cm 2 vs. 5.6 ± 1.7 cm 2 , p = 0.012). GLD, min max LAV/LVL proved significant after adjustment for age, gender, CHA 2 DS 2 -VASc and NIHSS. By combining information regarding age, GLD, min and max LAV/LVL the diagnostic accuracy of PAF improved, resulting in a significantly increased area under the curve (p = 0.037). In patients with IS and TIA GLD, min and max LAV/LVL were independently associated with the presence of PAF.

  17. What is Beyond Right/Left?

    DEFF Research Database (Denmark)

    Dyrberg, Torben Bech

    2009-01-01

    The article looks at New Labour's move beyond right/left in the mid/late 1990s, which is an occasion to spell out the nature of right/left and what it means for democracy. In contrast to both defenders and critics of this move I argue in the first part that right/left is not an empty label bound up...... with the cleavage-lines of industrial society, but that it is an orientational metaphor which is articulated with others-in/out, up/down and front/back-and that we are in the process of moving beyond the industrial society right/left prototype. The second part looks at where New Labour is heading when moving beyond...... right/left. I argue that the new hegemonic orientation is that of front/back, which designs political renewal as a response to the social changes cutting across the outdated lines of contestation of partisan politics. The democratic problem of this move lies in squeezing politics between technocratic...

  18. Left Right Patterning, Evolution and Cardiac Development

    Science.gov (United States)

    Dykes, Iain M.

    2018-01-01

    Many aspects of heart development are determined by the left right axis and as a result several congenital diseases have their origins in aberrant left-right patterning. Establishment of this axis occurs early in embryogenesis before formation of the linear heart tube yet impacts upon much later morphogenetic events. In this review I discuss the differing mechanisms by which left-right polarity is achieved in the mouse and chick embryos and comment on the evolution of this system. I then discus three major classes of cardiovascular defect associated with aberrant left-right patterning seen in mouse mutants and human disease. I describe phenotypes associated with the determination of atrial identity and venous connections, looping morphogenesis of the heart tube and finally the asymmetric remodelling of the embryonic branchial arch arterial system to form the leftward looped arch of aorta and associated great arteries. Where appropriate, I consider left right patterning defects from an evolutionary perspective, demonstrating how developmental processes have been modified in species over time and illustrating how comparative embryology can aide in our understanding of congenital heart disease. PMID:29755990

  19. Grammatical distinctions in the left frontal cortex.

    Science.gov (United States)

    Shapiro, K A; Pascual-Leone, A; Mottaghy, F M; Gangitano, M; Caramazza, A

    2001-08-15

    Selective deficits in producing verbs relative to nouns in speech are well documented in neuropsychology and have been associated with left hemisphere frontal cortical lesions resulting from stroke and other neurological disorders. The basis for these impairments is unresolved: Do they arise because of differences in the way grammatical categories of words are organized in the brain, or because of differences in the neural representation of actions and objects? We used repetitive transcranial magnetic stimulation (rTMS) to suppress the excitability of a portion of left prefrontal cortex and to assess its role in producing nouns and verbs. In one experiment subjects generated real words; in a second, they produced pseudowords as nouns or verbs. In both experiments, response latencies increased for verbs but were unaffected for nouns following rTMS. These results demonstrate that grammatical categories have a neuroanatomical basis and that the left prefrontal cortex is selectively engaged in processing verbs as grammatical objects.

  20. Left-Wing Extremism: The Current Threat

    Energy Technology Data Exchange (ETDEWEB)

    Karl A. Seger

    2001-04-30

    Left-wing extremism is ''alive and well'' both in the US and internationally. Although the current domestic terrorist threat within the U. S. is focused on right-wing extremists, left-wing extremists are also active and have several objectives. Leftist extremists also pose an espionage threat to U.S. interests. While the threat to the U.S. government from leftist extremists has decreased in the past decade, it has not disappeared. There are individuals and organizations within the U.S. who maintain the same ideology that resulted in the growth of left-wing terrorism in this country in the 1970s and 1980s. Some of the leaders from that era are still communicating from Cuba with their followers in the U.S., and new leaders and groups are emerging.

  1. Assessment of the effect of left atrial cryoablation enhanced by ganglionated plexi ablation in the treatment of atrial fibrillation in patients undergoing open heart surgery.

    Science.gov (United States)

    Bárta, Jiří; Brát, Radim

    2017-08-17

    The aim of our study was to investigate, whether enhancement of left atrial cryoablation by ablation of the autonomic nervous system of left atrium leads to influencing the outcomes of surgical treatment of atrial fibrillation in patients with structural heart disease undergoing open-heart surgery. The observed patient file consisted of 100 patients, who have undergone a combined open-heart surgery at our department between July 2012 and December 2014. The patients were indicated for the surgical procedure due to structural heart disease, and suffered from paroxysmal, persistent, or long-standing persistent atrial fibrillation. In all cases, left atrial cryoablation was performed in the extent of isolation of pulmonary veins, box lesion, connecting lesion with mitral annulus, amputation of the left atrial appendage and connecting lesion of the appendage base with left pulmonary veins. Furthermore, 35 of the patients underwent mapping and radiofrequency ablation of ganglionated plexi, together with discision and ablation of the ligament of Marshall (Group GP). A control group was consisted of 65 patients without ganglionated plexi intervention (Group LA). The main primary outcome was establishment and duration of sinus rhythm in the course of one-year follow-up. Evaluation of the number of patients with a normal sinus rhythm in per cent has shown comparable values in both groups (Group GP - 93.75%, Group LA - 86.67%, p = 0.485); comparable results were also observed in patients with normal sinus rhythm without anti-arrhythmic treatment in the 12th month (Group GP - 50%, Group LA - 47%, p = 0.306). We have not observed any relation between the recurrence of atrial fibrillation and the presence of a mitral valve surgery, or between the presence of a mitral and tricuspid valves surgery and between the left atrial diameter > 50 mm. Enhancement of left atrial cryoablation by gangionated plexi ablation did not influence the outcomes of surgical ablation due to

  2. Clustered survival data with left-truncation

    DEFF Research Database (Denmark)

    Eriksson, Frank; Martinussen, Torben; Scheike, Thomas H.

    2015-01-01

    Left-truncation occurs frequently in survival studies, and it is well known how to deal with this for univariate survival times. However, there are few results on how to estimate dependence parameters and regression effects in semiparametric models for clustered survival data with delayed entry....... Surprisingly, existing methods only deal with special cases. In this paper, we clarify different kinds of left-truncation and suggest estimators for semiparametric survival models under specific truncation schemes. The large-sample properties of the estimators are established. Small-sample properties...

  3. Left ventricular function in right ventricular overload

    International Nuclear Information System (INIS)

    Iwanaga, Shiro; Handa, Shunnosuke; Abe, Sumihisa; Onishi, Shohei; Nakamura, Yoshiro; Kunieda, Etsuo; Ogawa, Koichi; Kubo, Atsushi

    1989-01-01

    This study clarified regional and global functions of the distorted left ventricle due to right ventricular overload by gated radionuclide ventriculography (RNV). Cardiac catheterization and RNV were performed in 13 cases of atrial septal defect (ASD), 13 of pure mitral stenosis (MS), 10 of primary pulmonary hypertension (PPH), and 10 of normal subjects (NL). Right ventricular systolic pressure (RVSP) was 32.9±13.9, 45.0±12.2, 88.3±17.1, and 21.2±4.5 mmHg, respectively. The end-systolic LAO view of the left ventricle was halved into septal and free-wall sides. The end-diastolic halves were determined in the same plane. Ejection fractions of the global left ventricle (LVEF), global right ventricle (RVEF), the septal half of the left ventricle (SEPEF), and the free-wall half of the left ventricle (FWEF) were obtained. LVEF was 56.8±9.8% in NL, 52.8±10.5% in ASD, and 49.5±12.9% in PPH. In MS, LVEF (47.0±13.0%) was smaller than those in the other groups. RVEF was 37.0±5.2% in NL, 43.7±15.5% in ASD, and 32.8±11.5% in MS. In PPH, RVEF (25.0±10.6%) was smaller than those in the other groups. SEPEF was smaller in ASD (42.5±13.2%), MS (40.4±13.1%), PPH (40.5±12.5%) than in NL (53.5±8.5%). Systolic function of the septal half of the left ventricle was disturbed by right ventricular overload. RVEF (r=-0.35, p<0.05) and SEPEF (r=-0.51, p<0.01) had negative correlations with RVSP. As RVSP rose, systolic function of the septal half of the left ventricle was more severely disturbed. FWEF was the same among the four groups; NL (57.0±12.6%), ASD (48.6±15.2%), MS (50.5±12.0%), and PPH (51.1±12.3%). There was a good correlation between SEPEF and LVEF in NL (r=0.81), although in PPH this correlation was poor (r=0.64). These data showed that the distorted left ventricular due to right ventricular overload maintains its global function with preserved function of the free-wall side. (J.P.N.)

  4. Left ventricular performance during psychological stress

    International Nuclear Information System (INIS)

    Young, D.Z.; Massachusetts General Hospital, Boston; Dimsdale, J.E.; Moore, R.H.; Barlai-Kovach, M.; Newell, J.B.; McKusick, K.A.; Boucher, C.A.; Fifer, M.A.; Strauss, H.W.

    1989-01-01

    Left ventricular ejection fraction, systolic blood pressure and plasma norepinephrine were measured in six normotensive and six mildly hypertensive subjects during rest and psychological stress. Compared with rest, 8 of the 12 subjects developed significant changes in ejection fraction (increase in 6, decrease in 2); 10 of 12 subjects developed significant elevations of plasma norepinephrine; and all developed significant increases in systolic blood pressure. When the stress effects were examined for the total group, as opposed to within subjects, there were significant increases in plasma norepinephrine and systolic blood pressure but, interestingly, mean ejection fraction and stroke volume remained unchanged, implying stress led to increased left ventricular contractility. (orig.)

  5. Aortic atresia with normal sized left ventricle

    Directory of Open Access Journals (Sweden)

    Priya Jagia

    2016-01-01

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

  6. Left brain, right brain: facts and fantasies.

    Science.gov (United States)

    Corballis, Michael C

    2014-01-01

    Handedness and brain asymmetry are widely regarded as unique to humans, and associated with complementary functions such as a left-brain specialization for language and logic and a right-brain specialization for creativity and intuition. In fact, asymmetries are widespread among animals, and support the gradual evolution of asymmetrical functions such as language and tool use. Handedness and brain asymmetry are inborn and under partial genetic control, although the gene or genes responsible are not well established. Cognitive and emotional difficulties are sometimes associated with departures from the "norm" of right-handedness and left-brain language dominance, more often with the absence of these asymmetries than their reversal.

  7. Left ventricular assist device implantation via left thoracotomy: alternative to repeat sternotomy.

    Science.gov (United States)

    Pierson, Richard N; Howser, Renee; Donaldson, Terri; Merrill, Walter H; Dignan, Rebecca J; Drinkwater, Davis C; Christian, Karla G; Butler, Javed; Chomsky, Don; Wilson, John R; Clark, Rick; Davis, Stacy F

    2002-03-01

    Repeat sternotomy for left ventricular assist device insertion may result in injury to the right heart or patent coronary grafts, complicating intraoperative and postoperative management. In 4 critically ill patients, left thoracotomy was used as an alternative to repeat sternotomy. Anastomosis of the outflow conduit to the descending thoracic aorta provided satisfactory hemodynamic support.

  8. Left-forbidding cooperating distributed grammar systems

    Czech Academy of Sciences Publication Activity Database

    Goldefus, F.; Masopust, Tomáš; Meduna, A.

    2010-01-01

    Roč. 411, 40-42 (2010), s. 3661-3667 ISSN 0304-3975 Institutional research plan: CEZ:AV0Z10190503 Keywords : cooperating distributed grammar system * cooperating derivation mode * left-forbidding grammar * generative power * descriptional complexity Subject RIV: BA - General Mathematics Impact factor: 0.838, year: 2010 http://www.sciencedirect.com/science/article/pii/S0304397510003440

  9. Magnetization of left-handed metamaterials

    International Nuclear Information System (INIS)

    Kourakis, I; Shukla, P K

    2006-01-01

    We propose a possible mechanism for the generation of magnetic fields in negative refraction index composite metamaterials. Considering the propagation of a high-frequency modulated amplitude electric field in a left-handed material (LHM), we show that the ponderomotive interaction between the field and low-frequency potential distributions leads to spontaneous generation of magnetic fields, whose form and properties are discussed

  10. Beware the left-sided gallbladder

    African Journals Online (AJOL)

    An abdominal ultrasound scan showed multiple stones in the gallbladder with no evidence of acute cholecystitis and a common bile duct (CBD) diameter of 4 mm. Owing to the atypical nature of her pain, a computed tomography (CT) scan was requested which showed a left-sided gallbladder containing gallstones (Fig. 1).

  11. Laughter-induced left bundle branch block.

    Science.gov (United States)

    Chow, Grant V; Desai, Dipan; Spragg, David D; Zakaria, Sammy

    2012-10-01

    We present the case of a patient with ischemic heart disease and intermittent left bundle branch block, reproducibly induced by laughter. Following treatment of ischemia with successful deployment of a drug-eluting stent, no further episodes of inducible LBBB were seen. Transient ischemia, exacerbated by elevated intrathoracic pressure during laughter, may have contributed to onset of this phenomenon. © 2012 Wiley Periodicals, Inc.

  12. Left-right subtraction of brain CT

    International Nuclear Information System (INIS)

    Ishiguchi, Tsuneo; Sakuma, Sadayuki

    1986-01-01

    A new image-processing method to obtain a left-right subtraction image of CT was designed for the automated detection of abnormalities in brain CT. An original CT image was divided in two by a centerline. Then the right half of the image was subtracted from the left half by calculating the absorption value of the pixels on the symmetrical positions against the centerline. The mean and the standard deviation of the absorption value of the pixels in the subtraction image were used as parameters for analysis, and the detectability of abnormal CT findings was evaluated in 100 cases - 50 cases each with normal and abnormal CT. The presence of abnormalities could be diagnosed with a sensitivity of 86 %, a specificity of 90 %, and an overall accuracy of 88 % when the borderline of these parameters between normal and abnormal CT was set at the mean + 2SD in the normal group. As a further analysis, the CT image was subdivided into several areas from a functional or anatomical viewpoint, such as cerebral vascular territories, and the left-right subtraction image of each area was obtained. The possibilities of diagnosing the location of an abnormality and of detecting smaller lesions with this method were shown. Left-right subtraction was considered to be a useful method for the detection of asymmetric abnormalities in the automated diagnosis of brain CT. (author)

  13. Left ventricular hypertrophy : virtuous intentions, malign consequences

    NARCIS (Netherlands)

    Pokharel, S; Sharma, UC; Pinto, YM

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca2+ homeostasis, there

  14. Left ventricular hypertrophy: virtuous intentions, malign consequences

    NARCIS (Netherlands)

    Pokharel, Saraswati; Sharma, Umesh C.; Pinto, Yigal M.

    2003-01-01

    Left ventricular hypertrophy (LVH) is currently the focus of intense cardiovascular research, with the resultant rapid evolution of novel concepts relating to its exceedingly complex pathophysiology. In addition to the alterations in signal transduction and disturbances in Ca(2+) homeostasis, there

  15. Left-sided portal hypertension revisited

    Directory of Open Access Journals (Sweden)

    Antonio Manenti

    2016-12-01

    Conclusions: In every case of left-sided portal hypertension, upper digestive endoscopy and close follow-up are recommended. Besides, computed tomography can demonstrate particular conditions directly favoring gastroesophageal varices, and aid in selection of the appropriate therapeutic decisions. [Arch Clin Exp Surg 2016; 5(4.000: 211-215

  16. Left ventricular function in chronic aortic regurgitation

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Manno, B.; Amenta, A.; Kane, S.A.

    1983-01-01

    Left ventricular performance was determined in 42 patients with moderate or severe aortic regurgitation during upright exercise by measuring left ventricular ejection fraction and volume with radionuclide ventriculography. Classification of the patients according to exercise tolerance showed that patients with normal exercise tolerance (greater than or equal to 7.0 minutes) had a significantly higher ejection fraction at rest (probability [p] . 0.02) and during exercise (p . 0.0002), higher cardiac index at exercise (p . 0.0008) and lower exercise end-systolic volume (p . 0.01) than did patients with limited exercise tolerance. Similar significant differences were noted in younger patients compared with older patients in ejection fraction at rest and exercise (both p . 0.001) and cardiac index at rest (p . 0.03) and exercise (p . 0.0005). The end-diastolic volume decreased during exercise in 60% of the patients. The patients with a decrease in volume were significantly younger and had better exercise tolerance and a larger end-diastolic volume at rest than did patients who showed an increase in volume. The mean corrected left ventricular end-diastolic radius/wall thickness ratio was significantly greater in patients with abnormal than in those with normal exercise reserve (mean +/- standard deviation 476 +/- 146 versus 377 +/- 92 mm Hg, p less than 0.05). Thus, in patients with chronic aortic regurgitation: 1) left ventricular systolic function during exercise was related to age, exercise tolerance and corrected left ventricular end-diastolic radius/wall thickness ratio, and 2) the end-diastolic volume decreased during exercise, especially in younger patients and patients with normal exercise tolerance or a large volume at rest

  17. Left bronchial artery arising from a replaced left hepatic artery in a patient with massive hemoptysis

    Energy Technology Data Exchange (ETDEWEB)

    Khil, Eun Kyung; Lee, Jae Myung [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

    2015-09-15

    A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

  18. Evaluation of left ventricular function by cardiac CT

    International Nuclear Information System (INIS)

    Naito, Hiroaki; Kozuka, Takahiro

    1982-01-01

    Left ventricular function was evaluated by CT, which was compared with the data of left ventriculography for various cardiac diseases. The end diastolic volume of the left ventricle can be readily computed from CT, with a satisfactory correlation with that of left ventriculography (r = 0.95). The left ventricular ejection fraction, calculated from the areal ratio of the left ventricular lumen in end-diastolic imaging to that in end-sytolic imaging, also roughly reflects left ventricular contractile function, but shows correlation with left ventriculography by only r = 0.79. Although the cardiac output is not sensitive for functional evaluation, it can be directly calculated by means of dynamic scanning and shows a satisfactory correlation with the ear piece pigment dilution (r = 0.85). Evaluation of left ventricular function by CT shows a high precision in comparison with left ventriculography, but still lacks temporal resolving power. (Chiba, N.)

  19. Left and right atrial feature tracking in acute myocarditis: A feasibility study

    International Nuclear Information System (INIS)

    Dick, Anastasia; Schmidt, Björn; Michels, Guido; Bunck, Alexander C.; Maintz, David; Baeßler, Bettina

    2017-01-01

    Purpose: The present study aims at evaluating the feasibility and reproducibility of cardiac magnetic resonance (CMR) feature tracking (FT) derived strain and strain rate (SR) parameters of the left and right atrium (LA, RA) in patients with acute myocarditis as well as their potential to detect diastolic dysfunction. In addition, the diagnostic value of LA and RA strain parameters in the setting of acute myocarditis is investigated. Methods: CMR cine data of 30 patients with CMR-positive acute myocarditis were retrospectively analyzed. 25 age- and gender-matched healthy individuals served as a control. Analysis of longitudinal strain and SR of both atria was performed in two long-axis views using a dedicated FT-software. LA and RA deformation was analyzed including reservoir function (total strain [ε s ], peak positive SR [SR s ]), conduit function (passive strain [ε e ], peak early negative SR [SR e ]) and booster pump function (active strain [ε a ], peak late negative SR [SR a ]). Intra- and inter-observer reproducibility was assessed for all strain and SR parameters using Bland-Altman analyses, intra-class correlation coefficients (ICCs) and coefficients of variation (CV). Results: FT analyses of both atria were feasible in all patients and controls. Reproducibility was good for reservoir and conduit function parameters and moderate for booster pump function parameters. Myocarditis patients demonstrated an impaired LA reservoir and conduit function when compared to healthy controls (LA ε s : 32 ± 17 vs. 46 ± 13, p = 0.019; LA SR s : 1.5 ± 0.5 vs. 1.8 ± 0.5, p = 0.117; LA SR e : −1.3 ± 0.5 vs. −1.9 ± 0.5, p < 0.001), while LA booster pump function was preserved. In logistic regression and ROC-analyses, LA SR e proved to be the best independent predictor of acute myocarditis (AUC 0.80), and using LA SR e with a cut-off of −1.6 s −1 resulted in a diagnostic sensitivity of 83% and a specificity of 80%. Changes in RA phasic function parameters

  20. Dyscalculia, Dysgraphia, and Left-Right Confusion from a Left Posterior Peri-Insular Infarct

    Directory of Open Access Journals (Sweden)

    S. Bhattacharyya

    2014-01-01

    Full Text Available The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

  1. Dyscalculia, dysgraphia, and left-right confusion from a left posterior peri-insular infarct.

    Science.gov (United States)

    Bhattacharyya, S; Cai, X; Klein, J P

    2014-01-01

    The Gerstmann syndrome of dyscalculia, dysgraphia, left-right confusion, and finger agnosia is generally attributed to lesions near the angular gyrus of the dominant hemisphere. A 68-year-old right-handed woman presented with sudden difficulty completing a Sudoku grid and was found to have dyscalculia, dysgraphia, and left-right confusion. Magnetic resonance imaging (MRI) showed a focus of abnormal reduced diffusivity in the left posterior insula and temporoparietal operculum consistent with acute infarct. Gerstmann syndrome from an insular or peri-insular lesion has not been described in the literature previously. Pathological and functional imaging studies show connections between left posterior insular region and inferior parietal lobe. We postulate that the insula and operculum lesion disrupted key functional networks resulting in a pseudoparietal presentation.

  2. Minimal Left-Right Symmetric Dark Matter.

    Science.gov (United States)

    Heeck, Julian; Patra, Sudhanwa

    2015-09-18

    We show that left-right symmetric models can easily accommodate stable TeV-scale dark matter particles without the need for an ad hoc stabilizing symmetry. The stability of a newly introduced multiplet either arises accidentally as in the minimal dark matter framework or comes courtesy of the remaining unbroken Z_{2} subgroup of B-L. Only one new parameter is introduced: the mass of the new multiplet. As minimal examples, we study left-right fermion triplets and quintuplets and show that they can form viable two-component dark matter. This approach is, in particular, valid for SU(2)×SU(2)×U(1) models that explain the recent diboson excess at ATLAS in terms of a new charged gauge boson of mass 2 TeV.

  3. [Left postpneumonectomy syndrome: early endoscopic treatment].

    Science.gov (United States)

    Rombolá, Carlos A; León Atance, Pablo; Honguero Martínez, Antonio Francisco; Rueda Martínez, Juan Luis; Núñez Ares, Ana; Vizcaya Sánchez, Manuel

    2009-12-01

    Postpneumonectomy syndrome is characterized by postoperative bronchial obstruction caused by mediastinal shift. The syndrome is well documented in the medical literature as a late complication of right pneumonectomy; however, it rarely occurs following resection of the left lung, and only 10 cases have been published. The pathophysiology, clinical manifestations, prognosis, and treatment are similar for both sides of the lung. We present the case of an adult patient who underwent left pneumonectomy and developed postpneumonectomy syndrome 15 months later. Stenosis of the intermediate bronchus occurred between the vertebral body and the right pulmonary artery. Endoscopic treatment with a self-expanding metal stent was successful, and complete remission was observed over the 6 months of follow-up.

  4. A constrained supersymmetric left-right model

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, Martin [AHEP Group, Instituto de Física Corpuscular - C.S.I.C./Universitat de València, Edificio de Institutos de Paterna, Apartado 22085, E-46071 València (Spain); Krauss, Manuel E. [Bethe Center for Theoretical Physics & Physikalisches Institut der Universität Bonn, Nussallee 12, 53115 Bonn (Germany); Institut für Theoretische Physik und Astronomie, Universität Würzburg,Emil-Hilb-Weg 22, 97074 Wuerzburg (Germany); Opferkuch, Toby [Bethe Center for Theoretical Physics & Physikalisches Institut der Universität Bonn, Nussallee 12, 53115 Bonn (Germany); Porod, Werner [Institut für Theoretische Physik und Astronomie, Universität Würzburg,Emil-Hilb-Weg 22, 97074 Wuerzburg (Germany); Staub, Florian [Theory Division, CERN,1211 Geneva 23 (Switzerland)

    2016-03-02

    We present a supersymmetric left-right model which predicts gauge coupling unification close to the string scale and extra vector bosons at the TeV scale. The subtleties in constructing a model which is in agreement with the measured quark masses and mixing for such a low left-right breaking scale are discussed. It is shown that in the constrained version of this model radiative breaking of the gauge symmetries is possible and a SM-like Higgs is obtained. Additional CP-even scalars of a similar mass or even much lighter are possible. The expected mass hierarchies for the supersymmetric states differ clearly from those of the constrained MSSM. In particular, the lightest down-type squark, which is a mixture of the sbottom and extra vector-like states, is always lighter than the stop. We also comment on the model’s capability to explain current anomalies observed at the LHC.

  5. Left brain, right brain: facts and fantasies.

    Directory of Open Access Journals (Sweden)

    Michael C Corballis

    2014-01-01

    Full Text Available Handedness and brain asymmetry are widely regarded as unique to humans, and associated with complementary functions such as a left-brain specialization for language and logic and a right-brain specialization for creativity and intuition. In fact, asymmetries are widespread among animals, and support the gradual evolution of asymmetrical functions such as language and tool use. Handedness and brain asymmetry are inborn and under partial genetic control, although the gene or genes responsible are not well established. Cognitive and emotional difficulties are sometimes associated with departures from the "norm" of right-handedness and left-brain language dominance, more often with the absence of these asymmetries than their reversal.

  6. A disappearing left-sided neck mass.

    Science.gov (United States)

    Lutwak, Nancy; Dill, Curt

    2012-07-04

    The patient was a 48-year-old man who presented to the emergency department with complaints of a left-sided painful neck mass, which changed in size relative to ingestion of meals. He denied voice change, fever, chills, weight loss, dysphagia and hoarseness. Physical examination was unremarkable. CT scan demonstrated a 3.9 mm calculus of the submandibular gland duct. Therapeutic sialendocopy was successfully performed.

  7. The New Arab Left and 1967

    DEFF Research Database (Denmark)

    Haugbølle, Sune

    2017-01-01

    In Arab political culture, the Naksa of 1967 had a number of watershed effects. Scholars have paid a lot of attention to the decline of secular Arab nationalism and the concurrent rise of Islamism. Much less research has been done on the way 1967 spurred radical left organizations, also known as ...... moment that followed. This moment has had a lasting impact on Arab political culture and is being re-interpreted in interesting ways today by Arab revolutionaries post-2011....

  8. Aortic atresia with normal sized left ventricle

    OpenAIRE

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

    2016-01-01

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

  9. Total agenesis of the left pericardium

    Directory of Open Access Journals (Sweden)

    J. Glauco Lobo Fº

    1999-09-01

    Full Text Available This is the report of a 46-year-old patient with the preoperative diagnosis of an atrial septal defect (ASD of the ostium secudum type. After sternectomy, partial agenesis of the left pericardium was diagnosed. It is our opinion that, if the radiographic picture is suggestive of this entity, a clinical search for cardiopulmonary anomalies should be performed, because the majority of these associated anomalies can and should be surgically corrected.

  10. Clustering Of Left Ventricular Wall Motion Patterns

    Science.gov (United States)

    Bjelogrlic, Z.; Jakopin, J.; Gyergyek, L.

    1982-11-01

    A method for detection of wall regions with similar motion was presented. A model based on local direction information was used to measure the left ventricular wall motion from cineangiographic sequence. Three time functions were used to define segmental motion patterns: distance of a ventricular contour segment from the mean contour, the velocity of a segment and its acceleration. Motion patterns were clustered by the UPGMA algorithm and by an algorithm based on K-nearest neighboor classification rule.

  11. Implantation of a HeartMate II left ventricular assist device via left thoracotomy.

    Science.gov (United States)

    Cho, Yang Hyun; Deo, Salil V; Schirger, John A; Pereira, Naveen L; Stulak, John M; Park, Soon J

    2012-11-01

    Left thoracotomy was used as an approach for the implantation of pulsatile ventricular assist devices. Avoiding the standard approach of median sternotomy is attractive in patients undergoing complicated redo cardiac surgery, especially with prior mediastinal radiation. We report a case of the use of left thoracotomy for the implantation of the HeartMate II axial-flow pump. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Left hemisphere regions are critical for language in the face of early left focal brain injury

    OpenAIRE

    Raja Beharelle, Anjali; Dick, Anthony Steven; Josse, Goulven; Solodkin, Ana; Huttenlocher, Peter R.; Levine, Susan C.; Small, Steven L.

    2010-01-01

    A predominant theory regarding early stroke and its effect on language development, is that early left hemisphere lesions trigger compensatory processes that allow the right hemisphere to assume dominant language functions, and this is thought to underlie the near normal language development observed after early stroke. To test this theory, we used functional magnetic resonance imaging to examine brain activity during category fluency in participants who had sustained pre- or perinatal left h...

  13. Pulmonary hypertension due to left heart disease.

    Science.gov (United States)

    Berthelot, Emmanuelle; Bailly, Minh Tam; Hatimi, Safwane El; Robard, Ingrid; Rezgui, Hatem; Bouchachi, Amir; Montani, David; Sitbon, Olivier; Chemla, Denis; Assayag, Patrick

    Pulmonary hypertension due to left heart disease, also known as group 2 pulmonary hypertension according to the European Society of Cardiology/European Respiratory Society classification, is the most common cause of pulmonary hypertension. In patients with left heart disease, the development of pulmonary hypertension favours right heart dysfunction, which has a major impact on disease severity and outcome. Over the past few years, this condition has been considered more frequently. However, epidemiological studies of group 2 pulmonary hypertension are less exhaustive than studies of other causes of pulmonary hypertension. In group 2 patients, pulmonary hypertension may be caused by an isolated increase in left-sided filling pressures or by a combination of this condition with increased pulmonary vascular resistance, with an abnormally high pressure gradient between arteries and pulmonary veins. A better understanding of the conditions underlying pulmonary hypertension is of key importance to establish a comprehensive diagnosis, leading to an adapted treatment to reduce heart failure morbidity and mortality. In this review, epidemiology, mechanisms and diagnostic approaches are reviewed; then, treatment options and future approaches are considered. Copyright © 2017. Published by Elsevier Masson SAS.

  14. Left-Deviating Prism Adaptation in Left Neglect Patient: Reflexions on a Negative Result

    Directory of Open Access Journals (Sweden)

    Jacques Luauté

    2012-01-01

    Full Text Available Adaptation to right-deviating prisms is a promising intervention for the rehabilitation of patients with left spatial neglect. In order to test the lateral specificity of prism adaptation on left neglect, the present study evaluated the effect of left-deviating prism on straight-ahead pointing movements and on several classical neuropsychological tests in a group of five right brain-damaged patients with left spatial neglect. A group of healthy subjects was also included for comparison purposes. After a single session of exposing simple manual pointing to left-deviating prisms, contrary to healthy controls, none of the patients showed a reliable change of the straight-ahead pointing movement in the dark. No significant modification of attentional paper-and-pencil tasks was either observed immediately or 2 hours after prism adaptation. These results suggest that the therapeutic effect of prism adaptation on left spatial neglect relies on a specific lateralized mechanism. Evidence for a directional effect for prism adaptation both in terms of the side of the visuomanual adaptation and therefore possibly in terms of the side of brain affected by the stimulation is discussed.

  15. Tomato (Lycopersicon esculentum Supplementation Induces Changes in Cardiac miRNA Expression, Reduces Oxidative Stress and Left Ventricular Mass, and Improves Diastolic Function

    Directory of Open Access Journals (Sweden)

    Bruna L. B. Pereira

    2015-11-01

    Full Text Available The aim of this study was to evaluate the effects of tomato supplementation on the normal rat heart and the role of oxidative stress in this scenario. Male Wistar rats were assigned to two groups: a control group (C; n = 16, in which animals received a control diet + 0.5 mL of corn oil/kg body weight/day, and a tomato group (T; n = 16, in which animals received a control diet supplemented with tomato +0.5 mL of corn oil/kg body weight/day. After three months, morphological, functional, and biochemical analyses were performed. Animals supplemented with tomato had a smaller left atrium diameter and myocyte cross-sectional area (CSA compared to the control group (C group: 474 (415–539; T group: 273 (258–297 µm2; p = 0.004. Diastolic function was improved in rats supplemented with tomato. In addition, lipid hydroperoxide was lower (C group: 267 ± 46.7; T group: 219 ± 23.0 nmol/g; p = 0.039 in the myocardium of rats supplemented with tomato. Tomato intake was also associated with up-regulation of miR-107 and miR-486 and down-regulation of miR-350 and miR-872. In conclusion, tomato supplementation induces changes in miRNA expression and reduces oxidative stress. In addition, these alterations may be responsible for CSA reduction and diastolic function improvement.

  16. Tomato (Lycopersicon esculentum) Supplementation Induces Changes in Cardiac miRNA Expression, Reduces Oxidative Stress and Left Ventricular Mass, and Improves Diastolic Function.

    Science.gov (United States)

    Pereira, Bruna L B; Arruda, Fernanda C O; Reis, Patrícia P; Felix, Tainara F; Santos, Priscila P; Rafacho, Bruna P; Gonçalves, Andrea F; Claro, Renan T; Azevedo, Paula S; Polegato, Bertha F; Okoshi, Katashi; Fernandes, Ana A H; Paiva, Sergio A R; Zornoff, Leonardo A M; Minicucci, Marcos F

    2015-11-19

    The aim of this study was to evaluate the effects of tomato supplementation on the normal rat heart and the role of oxidative stress in this scenario. Male Wistar rats were assigned to two groups: a control group (C; n = 16), in which animals received a control diet + 0.5 mL of corn oil/kg body weight/day, and a tomato group (T; n = 16), in which animals received a control diet supplemented with tomato +0.5 mL of corn oil/kg body weight/day. After three months, morphological, functional, and biochemical analyses were performed. Animals supplemented with tomato had a smaller left atrium diameter and myocyte cross-sectional area (CSA) compared to the control group (C group: 474 (415-539); T group: 273 (258-297) µm²; p = 0.004). Diastolic function was improved in rats supplemented with tomato. In addition, lipid hydroperoxide was lower (C group: 267 ± 46.7; T group: 219 ± 23.0 nmol/g; p = 0.039) in the myocardium of rats supplemented with tomato. Tomato intake was also associated with up-regulation of miR-107 and miR-486 and down-regulation of miR-350 and miR-872. In conclusion, tomato supplementation induces changes in miRNA expression and reduces oxidative stress. In addition, these alterations may be responsible for CSA reduction and diastolic function improvement.

  17. Clinical psychomotor skills among left and right handed medical students: are the left-handed medical students left out?

    Science.gov (United States)

    Alnassar, Sami; Alrashoudi, Aljoharah Nasser; Alaqeel, Mody; Alotaibi, Hala; Alkahel, Alanoud; Hajjar, Waseem; Al-Shaikh, Ghadeer; Alsaif, Abdulaziz; Haque, Shafiul; Meo, Sultan Ayoub

    2016-03-22

    There is a growing perception that the left handed (LH) medical students are facing difficulties while performing the clinical tasks that involve psychomotor skill, although the evidence is very limited and diverse. The present study aimed to evaluate the clinical psychomotor skills among Right-handed (RH) and left-handed (LH) medical students. For this study, 54 (27 left handed and 27 right handed) first year medical students were selected. They were trained for different clinical psychomotor skills including suturing, laparoscopy, intravenous cannulation and urinary catheterization under the supervision of certified instructors. All students were evaluated for psychomotor skills by different instructors. The comparative performance of the students was measured by using a global rating scale, each selected criteria was allotted 5-points score with the total score of 25. There were no significant differences in the performance of psychomotor skills among LH and RH medical students. The global rating score obtained by medical students in suturing techniques was: LH 15.89 ± 2.88, RH 16.15 ± 2.75 (p = 0.737), cannulation techniques LH 20.44 ± 2.81, RH 20.70 ± 2.56 (p = 0.725), urinary catheterization LH 4.33 ± 0.96 RH 4.11 ± 1.05 (p = 0.421). For laparoscopic skills total peg transfer time was shorter among LH medical students compared to RH medical students (LH 129.85 ± 80.87 s vs RH 135.52 ± 104.81 s) (p = 0.825). However, both RH and LH students completed their procedure within the stipulated time. Among LH and RH medical students no significant difference was observed in performing the common surgical psychomotor skills. Surgical skills for LH or RH might not be a result of innate dexterity but rather the academic environment in which they are trained and assessed. Early laterality-related mentoring in medical schools as well as during the clinical residency might reduce the inconveniences faced by the left

  18. The New Left in the European Democracies: The Case of the German Radical Left

    Directory of Open Access Journals (Sweden)

    Marco Damiani

    2015-03-01

    Full Text Available The new form of the social and political conflict cannot be explained by the traditional categories of right and left, but it articulates to them on two plans, that of the establishment, intended like plan of the structured political conflict from the traditional actors, and that of the anti-establishment, in which new representations of politics emerge. The New Left is characterized by type of intermittent participation and new perspectives on mobilization inside the parties and the social movements. This type of parties differs moreover from the traditional ones left of the socialist and social democratic left in not arranging of organizations collaterals placed under the direction of the leadership of the same party. The mobilization that spontaneously assumes not conventional forms of active participation of the citizens, or is primed by the action of an associative network of which the same parties take part, than however does not monopo-lize the collective action. In this regard, the attention will be dedicated to the study of Die Linke: an anti-establishment party of the non-socialist German left-wing, heir to the communist tradition. The choice was affected to the German model because: 1 Germany is a country with a strong social democratic tradition, but 25 years after the fall of the Berlin Wall the German political system identifies a new antagonist political party; 2 Die Linke represents an interesting case in the political landscape of the European radical left because is a one-party that gives up at the federation of parties to try to unify the political parties of German radical left-wing.

  19. Coronary artery disease, left ventricular hypertrophy and diastolic dysfunction are associated with stroke in patients affected by persistent non-valvular atrial fibrillation: a case-control study

    Directory of Open Access Journals (Sweden)

    Andrea Passantino

    2009-04-01

    Full Text Available Persistent non-valvular atrial fibrillation (NVAF is associated with an increased risk of cardiovascular events such as stroke, and its rate is expected to rise because of the ageing population. The absolute rate of stroke depends on age and comorbidity. Risk stratification for stroke in patients with NVAF derives from populations enrolled in randomized clinical trials. However, participants in clinical trials are often not representative of the general population. Many stroke risk stratification scores have been used, but they do not include transthoracic echocardiogram (TTE, pulsate wave Doppler (PWD and tissue Doppler imaging (TDI, simple and non-invasive diagnostic tools. The role of TTE, PWD and TDI findings has not been previously determined. Our study goal was to determine the association between TTE and PWD findings and stroke prevalence in a population of NVAF prone outpatients. Patients were divided into two groups: P for stroke prone and F for stroke free. There were no statistically significant differences between the two groups concerning cardiovascular risk factors, age (p=0.2, sex (p=0.2, smoking (p=0.3, diabetes (p=0.1 and hypercholesterolemia (p=0.2; hypertension was statistically significant (p less than 0.001. There were statistically significant differences concerning coronary artery disease, previous acute myocardial infarction (AMI (p less than 0.05 and non- AMI coronaropathy (p less than 0.04, a higher rate being in the P group. Concerning echo-Doppler findings, a higher statistically significant rate of left ventricular hypertrophy (LVH (p less than  0.05 and left ventricular diastolic dysfunction (p less than 0.001 was found in the P group and dilated left atrium (p Left ventricular heart failure and pulmonary hypertension†

    Science.gov (United States)

    Rosenkranz, Stephan; Gibbs, J. Simon R.; Wachter, Rolf; De Marco, Teresa; Vonk-Noordegraaf, Anton; Vachiéry, Jean-Luc

    2016-01-01

    Abstract In patients with left ventricular heart failure (HF), the development of pulmonary hypertension (PH) and right ventricular (RV) dysfunction are frequent and have important impact on disease progression, morbidity, and mortality, and therefore warrant clinical attention. Pulmonary hypertension related to left heart disease (LHD) by far represents the most common form of PH, accounting for 65–80% of cases. The proper distinction between pulmonary arterial hypertension and PH-LHD may be challenging, yet it has direct therapeutic consequences. Despite recent advances in the pathophysiological understanding and clinical assessment, and adjustments in the haemodynamic definitions and classification of PH-LHD, the haemodynamic interrelations in combined post- and pre-capillary PH are complex, definitions and prognostic significance of haemodynamic variables characterizing the degree of pre-capillary PH in LHD remain suboptimal, and there are currently no evidence-based recommendations for the management of PH-LHD. Here, we highlight the prevalence and significance of PH and RV dysfunction in patients with both HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF), and provide insights into the complex pathophysiology of cardiopulmonary interaction in LHD, which may lead to the evolution from a ‘left ventricular phenotype’ to a ‘right ventricular phenotype’ across the natural history of HF. Furthermore, we propose to better define the individual phenotype of PH by integrating the clinical context, non-invasive assessment, and invasive haemodynamic variables in a structured diagnostic work-up. Finally, we challenge current definitions and diagnostic short falls, and discuss gaps in evidence, therapeutic options and the necessity for future developments in this context. PMID:26508169

  1. Photonic-resonant left-handed medium

    International Nuclear Information System (INIS)

    Shen Jianqi

    2006-01-01

    A new scheme to realize simultaneously negative permittivity and permeability in a coherent atomic vapor medium (photonic-resonant material) via a coherent driving mechanism is suggested. It is verified that the atomic system coherently driven by a strong optical field will give rise to a negative refractive index in certain probe frequency ranges. One of the most remarkable features of the present scheme is such that a slab fabricated by the left-handed vapor medium is an ideal candidate for designing perfect lenses since the photonic-resonant atomic vapor cannot only exhibit an isotropic negative refractive index, but also provide a good impedance match at the air-medium interfaces

  2. Mycobacterium chimaera left ventricular assist device infections.

    Science.gov (United States)

    Balsam, Leora B; Louie, Eddie; Hill, Fred; Levine, Jamie; Phillips, Michael S

    2017-06-01

    A global outbreak of invasive Mycobacterium chimaera infections after cardiac surgery has recently been linked to bioaerosols from contaminated heater-cooler units. The majority of cases have occurred after valvular surgery or aortic graft surgery and nearly half have resulted in death. To date, infections in patients with left ventricular assist devices (LVADs) have not been characterized in the literature. We report two cases of device-associated M. chimaera infection in patients with continuous-flow LVADs and describe challenges related to diagnosis and management in this population. © 2017 Wiley Periodicals, Inc.

  3. Medline Plus

    Full Text Available ... valve into the pulmonary artery. The blood then travels to the lungs, where it receives oxygen. Next, ... of the lungs via the pulmonary veins, and travels to the left atrium. From the left atrium, ...

  4. Atrial natriuretic peptide (ANP)-granules: ultrastructure ...

    African Journals Online (AJOL)

    AJB SERVER

    2006-12-29

    Dec 29, 2006 ... morphometry and function. Eliane Florencio ... granules is greatest in the right atrium followed by the left atrium and left auricle and right auricle, in this order. ... family: Atrial natriuretic peptide (ANP), Urodilatin, Brain natriuretic ...

  5. Heart Failure with Transient Left Bundle Branch Block in the Setting of Left Coronary Fistula

    Directory of Open Access Journals (Sweden)

    Stephen P. Juraschek

    2011-01-01

    Full Text Available Coronary arterial fistulas are rare communications between vessels or chambers of the heart. Although cardiac symptoms associated with fistulas are well described, fistulas are seldom considered in the differential diagnosis of acute myocardial ischemia. We describe the case of a 64-year-old man who presented with left shoulder pain, signs of heart failure, and a new left bundle branch block (LBBB. Cardiac catheterization revealed a small left anterior descending (LAD-to-pulmonary artery (PA fistula. Diuresis led to subjective improvement of the patient's symptoms and within several days the LBBB resolved. We hypothesize that the coronary fistula in this patient contributed to transient ischemia of the LAD territory through a coronary steal mechanism. We elected to observe rather than repair the fistula, as his symptoms and ECG changes resolved with treatment of his heart failure.

  6. Coronary artery to left ventricle fistula

    Directory of Open Access Journals (Sweden)

    Kumar Vivek

    2005-11-01

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

  7. Nonlinear left-handed transmission line metamaterials

    International Nuclear Information System (INIS)

    Kozyrev, A B; Weide, D W van der

    2008-01-01

    Metamaterials, exhibiting simultaneously negative permittivity ε and permeability μ, more commonly referred to as left-handed metamaterials (LHMs) and also known as negative-index materials, have received substantial attention in the scientific and engineering communities [1]. Most studies of LHMs (and electromagnetic metamaterials in general) have been in the linear regime of wave propagation and have already inspired new types of microwave circuits and devices. The results of these studies have already been the subject of numerous reviews and books. This review covers a less explored but rapidly developing area of investigation involving media that combine nonlinearity (dependence of the permittivity and permeability on the magnitude of the propagating field) with the anomalous dispersion exhibited by LHM. The nonlinear phenomena in such media will be considered on the example of a model system: the nonlinear left-handed transmission line. These nonlinear phenomena include parametric generation and amplification, harmonic and subharmonic generation as well as modulational instabilities and envelope solitons. (topical review)

  8. Rare occurrence of the left maxillary horizontal third molar impaction ...

    African Journals Online (AJOL)

    Rare occurrence of the left maxillary horizontal third molar impaction, the right maxillary third molar vertical impaction and the left mandibular third molar vertical impaction with inferior alveolar nerve proximity in a 30 year old female: a case report.

  9. challenges left-handed students face in kenyan girls' secondary

    African Journals Online (AJOL)

    IICBA01

    Previous research on left-handedness has mainly taken place in developed countries. This ... participants were five left-handed science students and their respective subject teachers from a ... Qualitative data was collected through classroom.

  10. Behavioral evidence for left-hemisphere specialization of motor planning

    NARCIS (Netherlands)

    Janssen, L.; Meulenbroek, R.G.; Steenbergen, B.

    2011-01-01

    Recent studies suggest that the left hemisphere is dominant for the planning of motor actions. This left-hemisphere specialization hypothesis was proposed in various lines of research, including patient studies, motor imagery studies, and studies involving neurophysiological techniques. However,

  11. Incidental retroaortic left innominate vein in adult patient

    Directory of Open Access Journals (Sweden)

    Alexandre Semionov, MD, PhD

    2017-09-01

    Full Text Available Retro-aortic left innominate vein is a rare vascular abnormality, usually associated with congenital heart disease. Here we report a case of isolated retro-aortic left innominate vein in an adult female.

  12. Evaluation of Left Ventricle Function by Regional Fractional Area Change (RFAC) in a Mouse Model of Myocardial Infarction Secondary to Valsartan Treatment

    Science.gov (United States)

    Castiglioni, Laura; Colazzo, Francesca; Fontana, Lucia; Colombo, Gualtiero I.; Piacentini, Luca; Bono, Elisa; Milano, Giuseppina; Paleari, Serena; Palermo, Annamaria; Guerrini, Uliano; Tremoli, Elena; Sironi, Luigi

    2015-01-01

    Aim Left ventricle (LV) regional fractional area change (RFAC) measured by cardiac magnetic resonance (CMR) allows the non-invasive localization and quantification of the degree of myocardial infarction (MI), and could be applied to assess the effectiveness of pharmacological or regenerative therapies. Here we investigate the ability of RFAC to identify regional dysfunction and discriminate the effect of pharmacological treatment with valsartan, a selective antagonist of angiotensin II type 1 receptor, in a model of MI. Methods and Results C57BL/6N mice, undergoing coronary artery ligation, were divided into two groups: untreated (MI) or treated with valsartan (MI+Val). Sham-operated mice were used as a control. Cardiac dimensions and function were assessed at baseline, 24 hours, 1 and 4 weeks post surgery by CMR and echocardiography. At sacrifice histology and whole-genome gene expression profiling were performed. RFAC was able to detect significant differences between treatment groups whereas the global ejection fraction was not. RFAC showed greater loss of regional contraction in remote non-infarcted myocardium in MI group than in MI+Val group. Consistently, in the same region MI+Val mice showed reduced myocyte hypertrophy, fibroblast proliferation, and fibrosis and modulation of target genes; in addition, left atrium volumes, appendage length and duct contraction were preserved. Conclusion In this study, RFAC effectively estimated the degree of systolic dysfunction and discriminated the regions preserved by pharmacological treatment. RFAC index is a promising tool to monitor changes in LV contraction and to assess the effectiveness of therapeutic regimens in clinical settings. PMID:26291973

  13. Quantitative modeling of the accuracy in registering preoperative patient-specific anatomic models into left atrial cardiac ablation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Rettmann, Maryam E., E-mail: rettmann.maryam@mayo.edu; Holmes, David R.; Camp, Jon J.; Cameron, Bruce M.; Robb, Richard A. [Biomedical Imaging Resource, Mayo Clinic College of Medicine, Rochester, Minnesota 55905 (United States); Kwartowitz, David M. [Department of Bioengineering, Clemson University, Clemson, South Carolina 29634 (United States); Gunawan, Mia [Department of Biochemistry and Molecular and Cellular Biology, Georgetown University, Washington D.C. 20057 (United States); Johnson, Susan B.; Packer, Douglas L. [Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota 55905 (United States); Dalegrave, Charles [Clinical Cardiac Electrophysiology, Cardiology Division Hospital Sao Paulo, Federal University of Sao Paulo, 04024-002 Brazil (Brazil); Kolasa, Mark W. [David Grant Medical Center, Fairfield, California 94535 (United States)

    2014-02-15

    Purpose: In cardiac ablation therapy, accurate anatomic guidance is necessary to create effective tissue lesions for elimination of left atrial fibrillation. While fluoroscopy, ultrasound, and electroanatomic maps are important guidance tools, they lack information regarding detailed patient anatomy which can be obtained from high resolution imaging techniques. For this reason, there has been significant effort in incorporating detailed, patient-specific models generated from preoperative imaging datasets into the procedure. Both clinical and animal studies have investigated registration and targeting accuracy when using preoperative models; however, the effect of various error sources on registration accuracy has not been quantitatively evaluated. Methods: Data from phantom, canine, and patient studies are used to model and evaluate registration accuracy. In the phantom studies, data are collected using a magnetically tracked catheter on a static phantom model. Monte Carlo simulation studies were run to evaluate both baseline errors as well as the effect of different sources of error that would be present in a dynamicin vivo setting. Error is simulated by varying the variance parameters on the landmark fiducial, physical target, and surface point locations in the phantom simulation studies. In vivo validation studies were undertaken in six canines in which metal clips were placed in the left atrium to serve as ground truth points. A small clinical evaluation was completed in three patients. Landmark-based and combined landmark and surface-based registration algorithms were evaluated in all studies. In the phantom and canine studies, both target registration error and point-to-surface error are used to assess accuracy. In the patient studies, no ground truth is available and registration accuracy is quantified using point-to-surface error only. Results: The phantom simulation studies demonstrated that combined landmark and surface-based registration improved

  14. Assessment of early diastolic intraventricular pressure gradient in the left ventricle among patients with repaired tetralogy of Fallot.

    Science.gov (United States)

    Kobayashi, Maki; Takahashi, Ken; Yamada, Mariko; Yazaki, Kana; Matsui, Kotoko; Tanaka, Noboru; Shigemitsu, Sachie; Akimoto, Katsumi; Kishiro, Masahiko; Nakanishi, Keisuke; Kawasaki, Shiori; Nii, Masaki; Itatani, Keiichi; Shimizu, Toshiaki

    2017-11-01

    Assessment of left ventricular (LV) dysfunction is vital in patients with repaired tetralogy of Fallot (rTOF). The early diastolic intraventricular pressure gradient (IVPG) in the LV plays an important role in diastolic function. IVPG is calculated as the intraventricular pressure difference divided by the LV length, which allows to account for differences in LV size and therefore calculate IVPG in children. We aimed to investigate the mechanisms of LV diastolic dysfunction by measuring mid-to-apical IVPG as an indicator of the active suction force sucking blood from the left atrium into the LV. We included 38 rTOF patients and 101 healthy controls. The study population was stratified based on age group into children (4-9 years), adolescents (10-15 years), and adults (16-40 years). IVPGs were calculated based on mitral inflow measurements obtained using color M-mode Doppler echocardiography. Although total IVPGs did not differ between rTOF patients and controls, mid-to-apical IVPGs in adolescents and adults were smaller among rTOF patients than among controls (0.15 ± 0.05 vs. 0.21 ± 0.06 mmHg/cm, p < 0.05; 0.09 ± 0.07 vs. 0.17 ± 0.05 mmHg/cm, p < 0.001; respectively). Additionally, only mid-to-apical IVPG correlated linearly with peak circumferential strain (ρ = 0.217, p = 0.011), longitudinal strain (ρ = -0.231, p = 0.006), torsion (ρ = -0.200, p = 0.018), and untwisting rate in early diastole (ρ = -0.233, p = 0.006). In rTOF, the mechanisms underlying diastolic dysfunction involve reduced active suction force, which correlates with reduced LV deformation in all directions.

  15. Comparative effects of amlodipine and benazepril on Left Atrial Pressure in Dogs with experimentally-induced Mitral Valve Regurgitation

    Directory of Open Access Journals (Sweden)

    Suzuki Shuji

    2012-09-01

    Full Text Available Abstract Background One of the purposes of treatment for dogs with mitral regurgitation (MR is lowering left atrial pressure (LAP. There has been few study of the amlodipine in dogs with MR and amlodipine’s effect on LAP has not been fully evaluated in a quantitative manner because of difficulties in directly measuring LAP. The objective of our study was to compare the short-term effects of amlodipine (0.2 mg/kg PO q12h vs benazepril (0.5 mg/kg PO q12h, on LAP and echocardiographic parameters in five beagle dogs with experimentally-induced MR. LAP of eight dogs that has own control were measured using radiotelemetry system at baseline and again on days 1, 2, 3, 4, 5, 6, 7 of the drug administration. Results Mean LAP decreased significantly after amlodipine (11.20 ± 4.19 mmHg vs 14.61 ± 3.81 mmHg at baseline, p  .05. LAP was lower after 7 days of amlodipine treatment than after 7 days of benazepril treatment. Significant reduction was seen for the first time 4 days after the administration amlodipine. The rate of the maximal area of the regurgitant jet signals to the left atrium area (ARJ/LAA of the amlodipine treatment was significantly lower (p  Conclusions LAP was significantly decreased after amlodipine treatment in dogs with surgically-induced MR but not after benazepril treatment. Although this study did not focus on adverse effects, amlodipine may be an effective drug for helping the patients with acute onset of severe MR, such as rupture of chordae tendinae or end stage patients were the LAP is likely to be elevated. Additional studies in clinical patients with degenerative mitral valve disease and acute chordal rupture are warranted because the blood-pressure lowering effects of amlodipine can decrease renal perfusion and this can further activate the RAAS.

  16. A Right Brain/Left Brain Model of Acting.

    Science.gov (United States)

    Bowlen, Clark

    Using current right brain/left brain research, this paper develops a model that explains acting's underlying quality--the actor is both himself and the character. Part 1 presents (1) the background of the right brain/left brain theory, (2) studies showing that propositional communication is a left hemisphere function while affective communication…

  17. Left Ventricular Geometry In Nigerians With Type II Diabetes Mellitus ...

    African Journals Online (AJOL)

    Background: Left ventricular hypertrophy is independently associated with increased incidence of cardiovascular disease, cardiovascular and all cause mortality. In a relatively healthy hypertensive adult population, type II diabetes is associated with higher left ventricular mass, concentric left ventricular geometry and lower ...

  18. Accessory left gastric artery: angiographic anatomy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kang Soo; Lim, Hyung Guhn; Kim, Hong Soo; Jeon, Doo Sung [Presbyterian Medical Center, Chunju (Korea, Republic of); Chung, Jin Wook; Park, Jae Hyung [College of Medicine and the Institute of Radiation Medicine, Seoul National University, Seoul (Korea, Republic of); Song, Soon Young [Myongji Hospital, College of Medicine, Kwandong University, Seoul (Korea, Republic of)

    2000-09-01

    To evaluate the angiographic anatomy of the accessory left gastric artery (accLGA). We evaluated the angiographic findings of the accLGA in 50 patients (Angiostar; Siemens, Erlangen, Germany). Performing celiac and selective angiography in 50 and 34 patients, respectively. By means of celiac angiography, (1) site of origin, (2) anatomical course, (3) diameter, (4) degree of tortuosity, and (5) distal tapering were evaluated, while selective angiography was used to determine (1) arterial branching, (2) area of blood supply, and (3) patterns of gastric wall stain. Celiac angiography showed that the accLGA arose from the left hepatic artery (LHA) in 45 cases (90%) and from the proper hepatic artery in five (10%). If the accLGA arose from the LHA, its origin entirely depended on the branching pattern of the latter. It always arose from the lateral branch of the LHA furthest to the left and uppermost, and proximal to its umbilical point. The most common anatomical course of the accLGA, seen in 27 cases (54%), was between the S2 and S3 segmental branch. The diameter and degree of tortuosity of the accLGA were similar to those of adjacent intrahepatic branches in 21 (42%) and 33 cases (66%), respectively. The degree of tapering was less than that of adjacent intrahepatic vessel in 28 (56%). Selective angiography demonstrated esophageal branching of the acc LGA in 27 cases (79%), inferior phrenic arterial branching in three (9%), a mediastinal branch in one (3%), and hypervascularity of the lung in one (3%). In 15 cases (44%), bifurcation of the accLGA was recognized. The vascular territory of the accLGA was the gastric fundus together with the distal esophagus in 21 cases (62%), mainly the gastric fundus in six (18%), and mainly the distal esophagus in four (12%). The pattern of gastric mucosal stain was curvilinear wall in 31 cases (91%) and nodular in three (9%). A knowledge of the angiographic anatomy of the accLGA facilitates accurate recognition of this artery on

  19. Related anomalies of origin of left vertebral and left inferior thyroid arteries

    International Nuclear Information System (INIS)

    Sartor, K.; Freckmann, N.; Boeker, D.K.; Allgemeines Krankenhaus Altona, Hamburg

    1981-01-01

    The known rare occurrence of related anomalies of origin of vertebral and inferior thyroid arteries appears not to be documented in the angiographic literature. Three cases with manifestation on the left side are presented. Embryology is discussed briefly. Knowledge of such anomalies is of importance to surgeons as well as angiographers. (orig.) [de

  20. Visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy

    Directory of Open Access Journals (Sweden)

    Yasushi Mizukami

    2017-10-01

    Full Text Available Abstract Background Pulmonary visceral subpleural hematoma is rare. We report visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy. This very rare case was difficult to distinguish from thoracic abscess. Case presentation A 68-year-old man with hypertension had undergone video-assisted thoracoscopic left upper division segmentectomy for suspected lung carcinoma. Deep vein thrombosis of the lower leg was identified and edoxaban, a so-called novel oral anticoagulant, was started on postoperative day 7. The chest drainage tube was removed on postoperative day 12 because of persistent air leakage, but fever appeared the same day. Computed tomography revealed a cavity with mixed air and fluid, so antibiotics were started on suspicion of abscess. Computed tomography-guided drainage was attempted, but proved unsuccessful. Fever continued and surgical investigation was therefore performed. Visceral subpleural hematoma was identified under the diaphragmatic surface of the left basal lung. We excised the pleura, then performed drainage and applied running sutures. The parenchyma and visceral pleura were covered with polyglycolic acid sheet and fibrin glue. Edoxaban was restarted on postoperative day 12 of video-assisted thoracoscopic surgery and no recurrence of hematoma has been revealed. Conclusions Visceral subpleural hematoma after thoracic surgery is extremely rare. Furthermore, correct diagnosis was difficult and surgery offered a good diagnostic and therapeutic procedure.

  1. Count-based left ventricular volume determination utilizing a left posterior oblique view for attenuation correction

    International Nuclear Information System (INIS)

    Rabinovitch, M.A.; Kalff, V.; Koral, K.

    1984-01-01

    This study aimed to determine the inherent error of the left ventricular volume measurement from the gated equilibrium blood pool scintigram utilizing the count-based technique. The study population consisted of 26 patients who had undergone biplane contrast ventriculography. The patients were imaged with a parallel-hole collimator in the left anterior oblique position showing the septum to best advantage. A reference blood sample was counted and radionuclide volumes calculated without correction for attenuation. Attenuation corrected volumes were derived with the factor 1/e/sup -/+d/, where d = distance from skin marker to center of the left ventricle in the orthogonal left posterior oblique view and μ = linear attenuation coefficient. A series of μ values from 0.08 to 0.15 cm -1 was evaluated. The tightest 95% confidence limits achieved for an end-diastolic 150-ml ventricle were +/- 44ml, and for an end-systolic 75-ml ventricle +/- 32 ml. In view of the magnitude of inherent error, the count-based volume measurement may be more suitable for group analyses and in cases in which an individual patient serves as his own control

  2. Left Hemisphere Regions Are Critical for Language in the Face of Early Left Focal Brain Injury

    Science.gov (United States)

    Beharelle, Anjali Raja; Dick, Anthony Steven; Josse, Goulven; Solodkin, Ana; Huttenlocher, Peter R.; Levine, Susan C.; Small, Steven L.

    2010-01-01

    A predominant theory regarding early stroke and its effect on language development, is that early left hemisphere lesions trigger compensatory processes that allow the right hemisphere to assume dominant language functions, and this is thought to underlie the near normal language development observed after early stroke. To test this theory, we…

  3. Effects of sedation on echocardiographic variables of left atrial and left ventricular function in healthy cats.

    Science.gov (United States)

    Ward, Jessica L; Schober, Karsten E; Fuentes, Virginia Luis; Bonagura, John D

    2012-10-01

    Although sedation is frequently used to facilitate patient compliance in feline echocardiography, the effects of sedative drugs on echocardiographic variables have been poorly documented. This study investigated the effects of two sedation protocols on echocardiographic indices in healthy cats, with special emphasis on the assessment of left atrial size and function, as well as left ventricular diastolic performance. Seven cats underwent echocardiography (transthoracic two-dimensional, spectral Doppler, color flow Doppler and tissue Doppler imaging) before and after sedation with both acepromazine (0.1 mg/kg IM) and butorphanol (0.25 mg/kg IM), or acepromazine (0.1 mg/kg IM), butorphanol (0.25 mg/kg IM) and ketamine (1.5 mg/kg IV). Heart rate increased significantly following acepromazine/butorphanol/ketamine (mean±SD of increase, 40±26 beats/min) and non-invasive systolic blood pressure decreased significantly following acepromazine/butorphanol (mean±SD of decrease, 12±19 mmHg). The majority of echocardiographic variables were not significantly different after sedation compared with baseline values. Both sedation protocols resulted in mildly decreased left ventricular end-diastolic dimension and mildly increased left ventricular end-diastolic wall thickness. This study therefore failed to demonstrate clinically meaningful effects of these sedation protocols on echocardiographic measurements, suggesting that sedation with acepromazine, butorphanol and/or ketamine can be used to facilitate echocardiography in healthy cats.

  4. LEFT RENAL TUMOR: A RARE CADAVERIC FINDINGS

    Directory of Open Access Journals (Sweden)

    Siva Prasad

    2015-08-01

    Full Text Available A benign tumour is a non - cancerous growth that does not spread (metastasize to other parts of the body and is not usually life - threatening. Many researchers believe that most of the following types of kidney tumours are benign. However, others feel that some of these tumours have the potential to develop into renal cell carcinoma. There are no diagnostic tests that can confirm if a benign tumour has the potential to become cancerous. Benign tumours are sometimes found along with renal cell carcinoma when a removed kidney is examined by a pathologist. For these reasons, benign kidney tumours are treated like malignant tumours. In this case we have observed a male cadaver with a large tumour in the left kidney during our routine dissections of undergraduates .

  5. Rectal volvulus following laparoscopic left hemicolectomy

    Science.gov (United States)

    Sutton, Paul Anthony; Lee, Han Sian; Din, Islah; Vimalachandran, Dale

    2013-01-01

    A 60-year-old lady with a history of Dukes B2 (T3N0M0) colorectal cancer presented some 2 years following a laparoscopic left hemicolectomy with a 4-day history of absolute constipation. A plain radiograph demonstrated large bowel obstruction, and subsequent CT of the abdomen showed the level of the obstruction to be at the rectum. Initially the aetiology was believed to be recurrence at the site of the anastomosis; however, subsequent review of the imaging and indeed endoscopic examination of the rectum showed it to be volvulus. This was initially treated with endoscopic decompression and later by the insertion of a flatus tube to good effect. The patient was discharged 3 days later with no recurrence of her symptoms at 2 months. PMID:23608861

  6. Polycythemia vera presenting with left hemichoreiform movements

    International Nuclear Information System (INIS)

    Mori, Tamiharu; Shimomura, Chikako; Ishibashi, Hiroshi; Tsujihata, Mitsuhiro; Nagataki, Shigenobu.

    1985-01-01

    A 65-year-old man developed abruptly choreiform movements involving the left face, arm and leg one day prior to admission. Physical examination revealed red face and palms, hyperemic conjunctivae and atrial fibrillations. Blood pressure was 168/90. Spleen was not palpable. Hemichoreiform movements of the left face and limbs were observed. There was no other neurological abnormalities. Laboratory studies showed RBC 880x10 4 , Hb 22.4g/dl, Hct 63%, WBC 8,100, platelets 22.9x10 4 , ESR 0mm/hr, RBC oxygen saturation 97%, serum iron 67 μg/dl, LDH 593 units, uric acid 14mg/dl, and erythropoietine (HI method) 19mIU/ml (normal 28-88). Bone marrow showed myeloid nucleated cell count 38.6x10 4 . ECG showed atrial fibrillations. Chest X-ray and scintigrams of liver and spleen were normal. CSF was normal. Brain CT scan on admission disclosed a low density area in right caudate nucleus. The choreiform movements were rapidly mitigated by venesection and by oral administration of haloperidol(3mg daily). There weeks after discontinuing haloperidol, the hemichorea returned. The routine hematology showed RBC 870x10 4 , Hb 19.8g/dl, Hct 62%, WBC 10,200, and plateret 37.4x10 4 . Another venesection reduced the chorea. Pipobroman was administered to control the polycythemia vera. He has been free of choreic movements thereafter. Choreiform movement is rarely observed in polycythemia vera. The pathogenesis is still unknown. The venous congestion, however, may play a role in this case because the choreic movements disappeared by venesection. (author)

  7. What's Left of the Left-Right Dimension? Why the Economic Policy Positions of Europeans Do Not Fit the Left-Right Dimension.

    Science.gov (United States)

    Otjes, Simon

    2018-01-01

    In political science the economic left-right dimension plays a central role. A growing body of evidence shows that the economic policy preferences of a large segment of citizens do not scale sufficiently. Using Mokken scale analysis, this study determines the causes of this phenomenon. Differences in the extent to which the economic policy preferences of citizens fit the left-right dimension can be explained in terms of the interaction between individual level and political system-level variables: citizens who spend more attention to politicians with views that conform to the left-right dimension, have views that conform to the left-right dimension. There is also a role for the legacy of communist dictatorship: citizens who were socialised in democratic countries have views that fit the left-right dimension better than those socialised during communism.

  8. Phase image characterization of ventricular contraction in left anterior hemiblock

    International Nuclear Information System (INIS)

    Ono, Akifumi; Mizuno, Haruyoshi; Tahara, Yorio; Ishikawa, Kyozo

    1991-01-01

    We investigated whether or not left anterior hemiblock is present in patients with left axis deviation using first-harmonic Fourier analysis of gated blood-pool images. Gated blood-pool images were taken in 50 patients without contraction abnormality. They included 14 normal subjects, 8 patients with right bundle branch block (RBBB), 20 with left axis deviation (LAD) and 8 with both RBBB and LAD (RBBB+LAD). ECG gated blood-pool scans were acquired in the anterior and 'best septal' left anterior oblique projections. First, the phase images were displayed cinematically as a continuous-loop movie. Next, for quantitative analysis of the phase image, the whole left ventricular and left ventricular high lateral regions of interest were drawn. The 'regional phase shift' (RPS) was then defined as {RPS=A-a} where 'A' is the mean value of the whole left ventricular phase angles and 'a' is that of phase angles in the high lateral region. The left ventricular phase changes and the RPSs in the RBBB and LAD groups were similar to those in the normal group. In the RBBB+LAD group, the latest phase changes occurred in the high anterolateral region. The RPSs of this group were significantly lower than those in the other 3 groups (p<0.01). These data suggest that left anterior hemiblock might coexist with RBBB in patients with RBBB+LAD, whereas left anterior hemiblock might not exist in the majority of patients with LAD alone. (author)

  9. [Surgical angioplasty of the left main coronary artery].

    Science.gov (United States)

    Vranes, Mile; Velinović, Milos; Kocica, Mladen; Mikić, Aleksandar; Velimirović, Dusan; Djukić, Petar

    2010-01-01

    The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery. Revascularization will establish retrograde perfusion for 50-70% of the myocardium of the left ventricle. Direct surgical angioplasty of the left main coronary artery enables normal physiological perfusion of the whole myocardium and better myocardial function. The aim of our study is to point out a new surgical approach of treating left main coronary artery stenosis. Between October 2002 and October 2003, direct surgical angioplasty of the main left coronary artery was performed on three patients with isolated stenosis of the left main coronary artery using the anterior approach and the pericardium as a patch. The procedure was performed under total endotracheal anaesthesia and standard cardiopulmonary circulation, moderate hypothermia, anterograde St. Tomas cardioplegia and local cooling. Patients were followed clinically, echocardiographically and by load-tests. All three patients were without complications. In postoperative follow-up (54-68 months) neither angina pectoris nor electrocardiographically registered ischaemic changes were found. Load-tests performed every six months on all three patients were negative. Surgical angioplasty of isolated stenosis of the left main coronary artery is a preferred method for treating this type of coronary disease. Contraindications for this type of treatment are stenosis of the left main coronary artery with bifurcation and advanced calcification of the left main coronary artery.

  10. Left hand polydactyly: a case report.

    Science.gov (United States)

    Mumoli, Nicola; Gandini, Daniele; Wamala, Edris Kalanzi; Cei, Marco

    2008-11-24

    Polydactyly is a congenital anomaly with a wide range of manifestations that occurs in many forms, ranging from varying degrees of mere splitting to completely duplicated thumb. When duplication occurs alone, it is usually unilateral and sporadic. In this case report we describe an otherwise healthy 19-year-old woman of Tibetan heritage with isolated left hand preaxial polydactyly. She experienced working related difficulties in her daily yak's milking. She subsequently underwent surgical correction, and the over number thumb was removed with associated meticulous skeletal and soft tissue reconstruction. Polydactyly is the most common congenital digital anomaly of the hand and foot. It can occur in isolation or as part of a syndrome. Surgery is necessary to create a single, functioning thumb and is indicated to improve cosmesis. Skin, nail, bone, ligament, and musculoskeletal elements must be combined to reconstruct an optimal digit. In this case (Tibetan society is almost exclusively a sheep-breeding one) surgery was necessary to leave a single, functioning thumb for her work as yak milkmaid.

  11. Assessment of left atrial volume and function

    DEFF Research Database (Denmark)

    Kühl, J Tobias; Lønborg, Jacob; Fuchs, Andreas

    2012-01-01

    dynamic LA volume changes. Conversely, cardiac magnetic resonance imaging (CMR) and multi-slice computed tomography (MSCT) appears more appropriate for such measures. We sought to determine the relationship between LA size assessed with TTE and LA size and function assessed with CMR and MSCT. Fifty......-four patients were examined 3 months post myocardial infarction with echocardiography, CMR and MSCT. Left atrial volumes and LA reservoir function were assessed by TTE. LA time-volume curves were determined and LA reservoir function (cyclic change and fractional change), passive emptying function (reservoir...... between CMR and MSCT, with a small to moderate bias in LA(max) (4.9 ± 10.4 ml), CC (3.1 ± 9.1 ml) and reservoir volume (3.4 ± 9.1 ml). TTE underestimates LA(max) with up to 32% compared with CMR and MSCT (P ...

  12. Left-right symmetric superstring supergravitation

    International Nuclear Information System (INIS)

    Burova, M.V.; Ter-Martirosyan, K.E.

    1988-01-01

    A left-right (L-R) symmetric model of four-dimensional supergravitation with a SO(10) gauge group obtained as the low-energy limit is superstring theory is considered. The spectrum of the gauge fields and their interactions are in agreement with the Weinberg-Salam theory. In addition, the model includes heavy W R ± and Z μ ' bosons. Beside the N g =3 generations of the 16-plets the SO(10) model includes the fragments of such generations which play the role of Higgs particles and also scalar chiral filds, the number of which exceeds by one the number of generations. As a result the neutrinos of each generation obtain a stable small Majorana mass. It is shown that the scalar field potential leads to spontaneous violation of the SU(2) R group and L-R symmetry and at low energies the standard Weinberg-Salam theory appears. However, reasonable values of X bosons masses M x and sun 2 Θ W (Θ W is the Weinberg angle) can be obtained in the model only in the case of high mass scale M R ∼10 10 -10 12 GeV of the right group SU(2) R violation

  13. Endocarditis in left ventricular assist device

    Science.gov (United States)

    Thyagarajan, Braghadheeswar; Kumar, Monisha Priyadarshini; Sikachi, Rutuja R; Agrawal, Abhinav

    2016-01-01

    Summary Heart failure is one of the leading causes of death in developed nations. End stage heart failure often requires cardiac transplantation for survival. The left ventricular assist device (LVAD) has been one of the biggest evolvements in heart failure management often serving as bridge to transplant or destination therapy in advanced heart failure. Like any other medical device, LVAD is associated with complications with infections being reported in many patients. Endocarditis developing secondary to the placement of LVAD is not a frequent, serious and difficult to treat condition with high morbidity and mortality. Currently, there are few retrospective studies and case reports reporting the same. In our review, we found the most common cause of endocarditis in LVAD was due to bacteria. Both bacterial and fungal endocarditis were associated with high morbidity and mortality. In this review we will be discussing the risk factors, organisms involved, diagnostic tests, management strategies, complications, and outcomes in patients who developed endocarditis secondary to LVAD placement. PMID:27672540

  14. Left ventricular noncompaction: Clinical-echocardiographic study

    Directory of Open Access Journals (Sweden)

    Nikolić Aleksandra

    2012-01-01

    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  15. Veia cava superior esquerda anômala com ausência de veia cava superior direita: achados de imagem Persistent left superior vena cava with absent right superior vena cava: image findings

    Directory of Open Access Journals (Sweden)

    Cyrillo Rodrigues de Araújo Júnior

    2003-10-01

    Full Text Available A persistência da veia cava superior esquerda com ausência da veia cava superior direita é uma anomalia rara, com menos de 150 casos descritos na literatura. A não-obliteração e regressão da veia cardinal anterior esquerda durante o desenvolvimento embriológico promove uma variação sistêmica de retorno venoso ao coração, com persistência da veia cava superior esquerda. Sua incidência varia de 0,3% em pacientes sem alterações cardíacas congênitas concomitantes a 4,3% naqueles com cardiopatias. Na maioria das vezes coexiste a veia cava superior direita, porém se houver regressão e degeneração da veia cardinal anterior direita, implicará a sua ausência e a drenagem venosa para o coração será feita pela veia cava superior esquerda ao átrio direito, através do seio coronariano. Mostramos um caso de um paciente submetido a radiografia de tórax e tomografia computadorizada para avaliação de doença pulmonar obstrutiva crônica, tendo como achado a persistência da veia cava superior esquerda com ausência da direita, sem qualquer cardiopatia associada e com a drenagem cardíaca sendo feita, através do seio coronariano, para o átrio direito.Persistent left superior vena cava with absent right superior vena cava is a rare anomaly, with less than 150 cases reported in the literature. Congenitally persistent left superior vena cava is the most common variant of systemic venous return to the heart, resulting embryologically from failure of the left anterior cardinal vein to become obliterated. Its incidence varies from 0.3% in patients with otherwise normal heart to 4.3% in patients with congenital heart disease. In the majority of the patients, a right superior vena cava is present as well, but rarely the right anterior cardinal vein degenerates resulting in the absence of the normal right superior vena cava. The blood from the right side is carried by the persistent left superior vena cava to the right atrium through the

  16. Isolated Left Pulmonary Artery Agenesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Tansel Ansal Balcı

    2012-08-01

    Full Text Available Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation- perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches. (MIRT 2012;21:80-83

  17. Evaluation of left cardiac function by exercise in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Konishi, Tokuji; Horayama, Norihisa; Hamada, Masayuki; Nakano, Takeshi; Takezawa, Hideo

    1981-01-01

    Left ventricular systolic and diastolic features at rest and exercise in hypertrophic cardiomyopathy were evaluated by Fourier analysis of blood pool scintigraphy (intracorporeal labelling with sup(99m)Tc-RBC). In the normal group (17 subjects), the left ventricular ejection fraction showed a linear increase, but no abnormality of regional ventricular wall motion, by multistage exercises. The hypertrophic cardiomyopathy group showed higher left ventricular ejection fractions at rest than those of the normal group, and in the HCM group (non-obstructive, from morphological features; 7 cases) the left ventricular ejection fraction did not increase any more when it reached a certain plateau in accordance with increased stress. In the HOCM (obstructive; 5 cases), the left ventricular ejection fraction showed a decreasing tendency as the stress was increased and also showed contractile abnormalities from the left ventricular center to the apex. Fourier analysis was effective for the evaluation of these changes. (Chiba, N.)

  18. Effect of left ventricular diastolic dysfunction on left atrial appendage function and thrombotic potential in nonvalvular atrial fibrillation.

    Science.gov (United States)

    Demirçelik, Muhammed Bora; Çetin, Mustafa; Çiçekcioğlu, Hülya; Uçar, Özgül; Duran, Mustafa

    2014-05-01

    We aimed to investigate effects of left ventricular diastolic dysfunction on left atrial appendage functions, spontaneous echo contrast and thrombus formation in patients with nonvalvular atrial fibrillation. In 58 patients with chronic nonvalvular atrial fibrilation and preserved left ventricular systolic function, left atrial appendage functions, left atrial spontaneous echo contrast grading and left ventricular diastolic functions were evaluated using transthoracic and transoesophageal echocardiogram. Patients divided in two groups: Group D (n=30): Patients with diastolic dysfunction, Group N (n=28): Patients without diastolic dysfunction. Categorical variables in two groups were evaluated with Pearson's chi-square or Fisher's exact test. The significance of the lineer correlation between the degree of spontaneous echo contrast (SEC) and clinical measurements was evaluated with Spearman's correlation analysis. Peak pulmonary vein D velocity of the Group D was significantly higher than the Group N (p=0.006). However, left atrial appendage emptying velocity, left atrial appendage lateral wall velocity, peak pulmonary vein S, pulmonary vein S/D ratio were found to be significantly lower in Group D (p=0.028, patrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities respectively (r=-0.438, r=-0.328, r=-0.233, r=-0.447). Left atrial appendage emptying, filling, pulmonary vein S/D levels and lateral wall velocities were significantly lower in SEC 2-3-4 than SEC 1 (p=0.003, p=0.029, patrial fibrillation and preserved left ventricular ejection fraction, left atrial appendage functions are decreased in patients with left ventricular diastolic dysfunction. Left ventricular diastolic dysfunction may constitute a potential risk for formation of thrombus and stroke.

  19. Left Sided Amyand's Hernia, A Rare Occurance: A Case Report.

    Science.gov (United States)

    Ravishankaran, Praveen; Mohan, G; Srinivasan, A; Ravindran, G; Ramalingam, A

    2013-06-01

    This is a case report about a 35 year old man admitted with complains of obstructed left sided inguinal hernia. On exploration of the left inguinal canal to our surprise a normal appendix was found in addition to a gangrenous omentum. Resection of the gangrenous omentum was done. Appendectomy was done. This case is reported for its rare occurance as only three such cases of left sided amyand's hernia has been reported so far in literature[4-6].

  20. On left (θ,ϕ-derivations in BCI-algebras

    Directory of Open Access Journals (Sweden)

    G. Muhiuddin

    2014-07-01

    Full Text Available The notion of (regular left (θ,ϕ-derivations of a BCI-algebra is introduced, some useful examples are discussed, and related properties are investigated. Conditions for a left (θ,ϕ-derivation to be regular are provided. The concepts of a d(θ,ϕ-invariant left (θ,ϕ-derivation and θ-ideal are introduced, and their relations are discussed. Furthermore, some more interesting results are established.

  1. Accessory hepatic lobe simulating a left hemidiaphragmatic tumor

    International Nuclear Information System (INIS)

    Kuroiwa, Toshiro; Hirata, Hitoshi; Iwashita, Akinori; Yasumori, Kotaro; Mogami, Hiroshi; Teraoka, Hiroaki

    1984-01-01

    A 72-year-old woman with a 20-year history of neuralgia was confirmed at surgery to have a tumor in the left hemidiaphragmatic region which was connected with the left lobe of the liver. Reassessment of radiological diagnosis after surgery revealed that hepatobiliary scintigraphy and computed tomography using left anterior oblique scanning are useful in differentiating the accessory hepatic lobe of the liver from a tumor and in confirming the diagnosis, respectively. (Namekawa, K.)

  2. Fallopian Tube Herniation through Left Sided Abdominal Drain Site.

    Science.gov (United States)

    Hussain, Khalid; Masood, Jovaria

    2016-06-01

    Intra-abdominal drains have been used since long to prevent intra-abdominal collection, and detect any anastomotic leaks. We report a case of left sided fallopian tube herniation from a left lower abdominal drain site in a 27-year female who underwent caesarian section for breach presentation. Several complications related to drain usage has been described but left sided fallopian tube prolapse through drain site has not been reported in literature.

  3. Detection of left ventricular thrombi by computerised tomography

    International Nuclear Information System (INIS)

    Nair, C.K.; Sketch, M.H.; Mahoney, P.D.; Lynch, J.D.; Mooss, A.N.; Kenney, N.P.

    1981-01-01

    Sixteen patients suspected of having left ventricular mural thrombi were studied. All had suffered transmural myocardial infarction. Fifteen patients had a ventricular aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four out of eight patients. Computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography, was found to have thrombi on computerised tomography. In another, two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. (author)

  4. Current status of ultrafast CT to evaluate the left ventricle

    International Nuclear Information System (INIS)

    MacMillan, R.M.; Rees, M.R.; Maranhao, V.

    1987-01-01

    Contrast-enhanced ultrafast CT with the cine mode can enable reliable assessment of left ventricular mass and function. Two oblique planar views, the long axis and short axis, are required. Right and left ventricular end-diastolic volumes, end-systolic volumes, stroke volume and ejection fraction, left ventricular segmental wall motion, and left ventricular mass can be measured. This exhibit emphasizes the methods and pitfalls in acquiring this information. Results from the authors' studies thus far to validate these measurements against reference standards are reviewed

  5. Left atrial strain: a new parameter for assessment of left ventricular filling pressure.

    Science.gov (United States)

    Cameli, Matteo; Mandoli, Giulia Elena; Loiacono, Ferdinando; Dini, Frank Lloyd; Henein, Michael; Mondillo, Sergio

    2016-01-01

    In order to obtain accurate diagnosis, treatment and prognostication in many cardiac conditions, there is a need for assessment of left ventricular (LV) filling pressure. While systole depends on ejection function of LV, diastole and its disturbances influence filling function and pressures. The commonest condition that represents the latter is heart failure with preserved ejection fraction in which LV ejection is maintained, but diastole is disturbed and hence filling pressures are raised. Significant diastolic dysfunction results in raised LV end-diastolic pressure, mean left atrial (LA) pressure and pulmonary capillary wedge pressure, all referred to as LV filling pressures. Left and right heart catheterization has traditionally been used as the gold standard investigation for assessing these pressures. More recently, Doppler echocardiography has taken over such application because of its noninvasive nature and for being patient friendly. A number of indices are used to achieve accurate assessment of filling pressures including: LV pulsed-wave filling velocities (E/A ratio, E wave deceleration time), pulmonary venous flow (S wave and D wave), tissue Doppler imaging (E' wave and E/E' ratio) and LA volume index. LA longitudinal strain derived from speckle tracking echocardiography (STE) is also sensitive in estimating intracavitary pressures. It is angle-independent, thus overcomes Doppler limitations and provides highly reproducible measures of LA deformation. This review examines the application of various Doppler echocardiographic techniques in assessing LV filling pressures, in particular the emerging role of STE in assessing LA pressures in various conditions, e.g., HF, arterial hypertension and atrial fibrillation.

  6. Left and right atrial feature tracking in acute myocarditis: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Dick, Anastasia, E-mail: anastasia-dick@web.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne (Germany); Schmidt, Björn, E-mail: bjoernschmidt1989@gmx.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne (Germany); Michels, Guido, E-mail: guido.michels@uk-koeln.de [Department III of Internal Medicine, Heart Centre, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne (Germany); Bunck, Alexander C., E-mail: alexander.bunck@uk-koeln.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne (Germany); Maintz, David, E-mail: david.maintz@uk-koeln.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne (Germany); Baeßler, Bettina, E-mail: bettina.baessler@uk-koeln.de [Department of Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne (Germany)

    2017-04-15

    Purpose: The present study aims at evaluating the feasibility and reproducibility of cardiac magnetic resonance (CMR) feature tracking (FT) derived strain and strain rate (SR) parameters of the left and right atrium (LA, RA) in patients with acute myocarditis as well as their potential to detect diastolic dysfunction. In addition, the diagnostic value of LA and RA strain parameters in the setting of acute myocarditis is investigated. Methods: CMR cine data of 30 patients with CMR-positive acute myocarditis were retrospectively analyzed. 25 age- and gender-matched healthy individuals served as a control. Analysis of longitudinal strain and SR of both atria was performed in two long-axis views using a dedicated FT-software. LA and RA deformation was analyzed including reservoir function (total strain [ε{sub s}], peak positive SR [SR{sub s}]), conduit function (passive strain [ε{sub e}], peak early negative SR [SR{sub e}]) and booster pump function (active strain [ε{sub a}], peak late negative SR [SR{sub a}]). Intra- and inter-observer reproducibility was assessed for all strain and SR parameters using Bland-Altman analyses, intra-class correlation coefficients (ICCs) and coefficients of variation (CV). Results: FT analyses of both atria were feasible in all patients and controls. Reproducibility was good for reservoir and conduit function parameters and moderate for booster pump function parameters. Myocarditis patients demonstrated an impaired LA reservoir and conduit function when compared to healthy controls (LA ε{sub s}: 32 ± 17 vs. 46 ± 13, p = 0.019; LA SR{sub s}: 1.5 ± 0.5 vs. 1.8 ± 0.5, p = 0.117; LA SR{sub e}: −1.3 ± 0.5 vs. −1.9 ± 0.5, p < 0.001), while LA booster pump function was preserved. In logistic regression and ROC-analyses, LA SR{sub e} proved to be the best independent predictor of acute myocarditis (AUC 0.80), and using LA SR{sub e} with a cut-off of −1.6 s{sup −1} resulted in a diagnostic sensitivity of 83% and a specificity of

  7. Left-handedness and language lateralization in children.

    Science.gov (United States)

    Szaflarski, Jerzy P; Rajagopal, Akila; Altaye, Mekibib; Byars, Anna W; Jacola, Lisa; Schmithorst, Vincent J; Schapiro, Mark B; Plante, Elena; Holland, Scott K

    2012-01-18

    This fMRI study investigated the development of language lateralization in left- and righthanded children between 5 and 18 years of age. Twenty-seven left-handed children (17 boys, 10 girls) and 54 age- and gender-matched right-handed children were included. We used functional MRI at 3T and a verb generation task to measure hemispheric language dominance based on either frontal or temporo-parietal regions of interest (ROIs) defined for the entire group and applied on an individual basis. Based on the frontal ROI, in the left-handed group, 23 participants (85%) demonstrated left-hemispheric language lateralization, 3 (11%) demonstrated symmetric activation, and 1 (4%) demonstrated right-hemispheric lateralization. In contrast, 50 (93%) of the right-handed children showed left-hemispheric lateralization and 3 (6%) demonstrated a symmetric activation pattern, while one (2%) demonstrated a right-hemispheric lateralization. The corresponding values for the temporo-parietal ROI for the left-handed children were 18 (67%) left-dominant, 6 (22%) symmetric, 3 (11%) right-dominant and for the right-handed children 49 (91%), 4 (7%), 1 (2%), respectively. Left-hemispheric language lateralization increased with age in both groups but somewhat different lateralization trajectories were observed in girls when compared to boys. The incidence of atypical language lateralization in left-handed children in this study was similar to that reported in adults. We also found similar rates of increase in left-hemispheric language lateralization with age between groups (i.e., independent of handedness) indicating the presence of similar mechanisms for language lateralization in left- and right-handed children. Copyright © 2011 Elsevier B.V. All rights reserved.

  8. Left ventricular function in hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    Takahashi, Hiromi; Yamaguchi, Ryutaro; Ifuku, Masayasu

    1985-01-01

    The present study was to investigate of left ventricular (LV) function during exercise in 26 patients with hypertrophic cardiomyopathy(HCM) usingTc-99m equilibrium angiocardiography, and to elucidate the mechanism of impaired functional reserve during exercise. In patients with HCM, LV ejection fraction decreased from 65 ± 8 (mean ± SD) % at rest to 59 ± 18 % at peak exercise, in contrast to an increase among controls (from 56 ± 9 % to 64 ± 9 %). As compared with resting values, cardiac output increased to 168 ± 24 % at peak exercise in HCM, but the increase was significantly less than that in controls (215 ± 47 %). Stroke volume decreased gradually to 83 ± 16 % during exercise in HCM, while it increased to 114 ± 10 % at an exercise level of half intensity, and it decreased slightly to 106 ± 16 % at peak exercise. LV end-systolic volume decreased among controls to 78 ± 27 % at peak exercise, but remained unchanged in HCM (118 ± 58 %). An increase in peak ejection rate at peak exercise was less in HCM than in controls (143 ± 26 % vs 170 ± 42 %). No significant differences were observed between the two groups concerning changes in indices of LV diastolic function including LV end-diastolic volume, peak filling rate or 1/3 filling rate during exercise. In the analysis of LV function curves, pulmonary arterial diastolic pressure increased to a greater extent in HCM than in controls (19 ± 6 mmHg vs 11 ± 6 mmHg); whereas, an increase in the stroke work index was less in HCM (80 ± 26 g.m/m 2 /beat vs 121 ± 21 g.m/m 2 /beat) at peak exercise. Thus, the LV function curve shifted downward and to the right in patients with HCM. The above findings indicate that LV functional reserve during exercise is impaired, especially as to systolic function in patients with HCM, while deterioration of diastolic function may be partly compromised by elevated filling pressure. (J.P.N.)

  9. Linear regression models for quantitative assessment of left ...

    African Journals Online (AJOL)

    Changes in left ventricular structures and function have been reported in cardiomyopathies. No prediction models have been established in this environment. This study established regression models for prediction of left ventricular structures in normal subjects. A sample of normal subjects was drawn from a large urban ...

  10. Impact of obstructive sleep apnea and snoring on left ventricular ...

    African Journals Online (AJOL)

    Background: Systemic hypertension (HTN) and obstructive sleep apnea (OSA) are individually associated with left ventricular structural and functional adaptations. However, little is known about the impact of OSA on the left ventricle in Africans with HTN. Aim: The aim of this study is to determine the association between ...

  11. Gender specific pattern of left ventricular cardiac adaptation to ...

    African Journals Online (AJOL)

    Background: Cardiac adaptation to hypertension and obesity may be related to many factors such as race, gender and haemodynamic status. Some gender specific associations with left ventricular structure and function have been described among Caucasians. Objectives: To describe the sex specific pattern of left ...

  12. Orthodontic intervention of an impacted upper left central incisor due ...

    African Journals Online (AJOL)

    A fixed orthodontic appliance was used to facilitate traction and correction of malalignement of the impacted upper left central incisor.Treatment outcome: Successful removal of the odontoma, full exposure of the crown of upper left central incisor and good alignment on the arch were achieved. Crowding on the upper and ...

  13. Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy.

    Science.gov (United States)

    Lanjewar, Swapnil S; Chhabra, Lovely; Chaubey, Vinod K; Joshi, Saurabh; Kulkarni, Ganesh; Kothagundla, Chandrasekhar; Kaul, Sudesh; Spodick, David H

    2013-01-01

    The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration. We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1) were computed and compared between the two subgroups. There was no statistically significant difference in qualitative lung function (FEV1) between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy. The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.

  14. Left ventricular systolic function in sickle cell anaemia: an ...

    African Journals Online (AJOL)

    42) and 24.17 ± 4.39 ... Aortic root diameter (Ao), left atrial dimension (LAD), left ventricu- ... Key: *Statistically significant, a= Chi-square, SCA= sickle cell anaemia, SD= standard deviation. ..... of fluctuations in response to changes in sympathetic.

  15. Hemangioma of the left coronary artery: Diagnosis and treatment

    International Nuclear Information System (INIS)

    Just, A.; Wiesmann, W.; Peters, P.E.; Haesfeld, M.; Sciuk, J.

    1992-01-01

    The authors describe the case of a histologically proven hemangioma in the left coronary artery of the left ventricle of a 24-year-old woman. The results of the different medical imaging methods applied are described and the treatment of cardiac angiomas is discussed. (orig.) [de

  16. Radionuclide evaluation of left ventricular function with nonimaging probes.

    Science.gov (United States)

    Wexler, J P; Blaufox, M D

    1979-10-01

    Portable nonimaging probes have been developed that can evaluate left ventricular function using radionuclide techniques. Two modes of data acquisition are possible with these probe systems, first-pass and gated. Precordial radiocardiograms obtained after a bolus injection can be used to determine cardiac output, pulmonary transit time, pulmonary blood volume, left ventricle ejection fraction, and left-to-right shunts. Gated techniques can be used to determine left ventricular ejection fraction and sytolic time intervals. Probe-determined indices of left ventricular function agree excellently with comparable measurements determined by conventional camera-computer methods as well as by invasive techniques. These have begun to be used in a preliminary manner in a variety of clinical problems associated with left ventricular dysfunction. This review discusses the types of probe systems available, the methods used in positioning them, and details the specifics of their data acquisition and processing capacity. The major criticisms of probe methods are that they are nonimaging and that they measure global rather than regional left ventricular function. In spite of these criticisms, probe systems, because of their portability, high sensitivity, and relatively low cost are useful supplements to conventional camera-computer systems for the measurement of parameters of left ventricular performance using radionuclide techniques.

  17. Left subclavian artery revascularization as part of thoracic stent grafting

    NARCIS (Netherlands)

    Saouti, N.; Hindori, V.; Morshuis, W.J.; Heijmen, R.H.

    2015-01-01

    OBJECTIVES: Intentional covering of the left subclavian artery (LSA) as part of thoracic endovascular aortic repair (TEVAR) can cause (posterior) strokes or left arm malperfusion. LSA revascularization can be done as prophylaxis against, or as treatment of, these complications. We report our

  18. Reversible left ventricular dysfunction - important clinical problem of contemporary cardiology

    International Nuclear Information System (INIS)

    Witkowski, A.

    1994-01-01

    An important clinical issue there is determination whether left ventricular damages are reversible or not single photon emission computed tomography and positron computed tomography techniques are shown to provide valuable data in this problem. Article describes basic syndromes connected with left ventricular dysfunction, namely: hibernating myocardium, stunned myocardium and ischemic myocardium preconditioning. (author). 18 refs

  19. Evaluation of left ventricular function using digital subtraction angiography

    International Nuclear Information System (INIS)

    Kozuka, Takahiro; Ohta, Mitsushige

    1985-01-01

    To evaluate function of the left ventricle and myocardial perfusion images, digital subtraction angiography (DSA) was performed in 45 patients with ischemic heart disease. Validity of the technique was compared with data obtained from cine left ventriculogram in all patients and 201 T1 myocardial images in 20 patients. End-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) calculated from DSA were correlated closely with those from cine left ventriculogram (r = 0.92, r = 0.94 and r = 0.86, respectively). Regional contractility at the antero-lateral wall of the left ventricle, assessed by DSA, was also correlated well with cine left ventriculogram (r = 0.75). Evaluation of the inferior wall motion showed less correlation in both procedures (r = 0.68). Phase and amplitude analysis with the same technique with radionuclide cardiac angiography was successfully applied in left ventriculogram obtained by DSA. The procedure seems to be helpful for objective evaluation of the left ventricular wall motion. Myocardial perfusion image, obtained with modified Radtke's technique, showed good coincidence with 201 T1 images. Thus, DSA is applicable for evaluation of function of the left ventricle and myocardial perfusion in patients with ischemic heart disease. (author)

  20. The organisational and ideological development of Green Left

    NARCIS (Netherlands)

    Lucardie, Anthonie; Voerman, Gerrit; Botella, Joan; Ramiro, Luis

    2003-01-01

    In 1991 the Communist Party of the Netherlands (CPN) dissolved itself into the new organisation GreenLeft, founded in 1990. Thus, GreenLeft may be considered the major ‘post-communist party’ in the Netherlands. Yet it is not the only one. A minority of former CPN-members established in 1992 the New

  1. Urban School Principals and the "No Child Left Behind" Act

    Science.gov (United States)

    Gardiner, Mary E.; Canfield-Davis, Kathy; Anderson, Keith LeMar

    2009-01-01

    This exploratory study investigated how six practicing school principals responded to the requirements of the No Child Left Behind law (United States Congress Public Law 107-110, 2002, January, No Child Left Behind Act, http://www.ed.gov/policy/elsec/leg/esea02/107-110.pdf ) in light of the multicultural leadership demands presented by an urban…

  2. On Functional Inequalities Originating from Module Jordan Left Derivations

    OpenAIRE

    Kang Sheon-Young; Chang Ick-Soon; Kim Hark-Mahn

    2008-01-01

    Abstract We first examine the generalized Hyers-Ulam stability of functional inequality associated with module Jordan left derivation (resp., module Jordan derivation). Secondly, we study the functional inequality with linear Jordan left derivation (resp., linear Jordan derivation) mapping into the Jacobson radical.

  3. On Functional Inequalities Originating from Module Jordan Left Derivations

    Directory of Open Access Journals (Sweden)

    Kang Sheon-Young

    2008-01-01

    Full Text Available Abstract We first examine the generalized Hyers-Ulam stability of functional inequality associated with module Jordan left derivation (resp., module Jordan derivation. Secondly, we study the functional inequality with linear Jordan left derivation (resp., linear Jordan derivation mapping into the Jacobson radical.

  4. Transient left atrial dysfunction is a feature of Takotsubo syndrome

    DEFF Research Database (Denmark)

    Stiermaier, Thomas; Graf, Tobias; Möller, Christian

    2017-01-01

    BACKGROUND: Takotsubo syndrome (TTS) is characterized by a transient left and/or right ventricular dysfunction as a consequence of a distinctive pattern of regional wall motion abnormalities. However, a systematic evaluation of the left atrial (LA) function in patients with TTS is lacking. The ai...

  5. Right-Brained Kids in Left-Brained Schools

    Science.gov (United States)

    Hunter, Madeline

    1976-01-01

    Students who learn well through left hemisphere brain input (oral and written) have minimal practice in using the right hemisphere, while those who are more proficient in right hemisphere (visual) input processing are handicapped by having to use primarily their left brains. (MB)

  6. Evaluation of left ventricular volumes measured by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Møgelvang, J; Thomsen, C; Mehlsen, J

    1986-01-01

    Left ventricular end-diastolic and end-systolic volumes were determined in 17 patients with different levels of left ventricular function by magnetic resonance imaging (MRI). A 1.5 Tesla Magnet was used obtaining ECG triggered single and multiple slices. Calculated cardiac outputs were compared...

  7. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    International Nuclear Information System (INIS)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja

    2010-01-01

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman

  8. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  9. Congenital bicuspid stenosis with left ventricular hypoplasia in a kitten.

    Science.gov (United States)

    van Nie, C J; van Messel, M A; Straatman, T J

    1980-01-15

    Congenital bicuspid stenosis with left ventricular hypoplasia was diagnosed in a kitten. Clinical weakness, dyspnoea and marked cardiomegaly (X rays) were related to postmortem findings. The cardiomegaly had resulted from an enlargement of the left auricular appendage. It is supposed the cardiomegaly developed after the closing of the foramen ovale.

  10. Effect of Left Ventricular Outflow Tract Obstruction on Left Atrial Mechanics in Hypertrophic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Lynne K. Williams

    2015-01-01

    Full Text Available Left atrial (LA volumes are known to be increased in hypertrophic cardiomyopathy (HCM and are a predictor of adverse outcome. In addition, LA function is impaired and is presumed to be due to left ventricular (LV diastolic dysfunction as a result of hypertrophy and myocardial fibrosis. In the current study, we assess the incremental effect of outflow tract obstruction (and concomitant mitral regurgitation on LA function as assessed by LA strain. Patients with HCM (50 obstructive, 50 nonobstructive were compared to 50 normal controls. A subset of obstructive patients who had undergone septal myectomy was also studied. Utilising feature-tracking software applied to cardiovascular magnetic resonance images, LA volumes and functional parameters were calculated. LA volumes were significantly elevated and LA ejection fraction and strain were significantly reduced in patients with HCM compared with controls and were significantly more affected in patients with obstruction. LA volumes and function were significantly improved after septal myectomy. LVOT obstruction and mitral regurgitation appear to further impair LA mechanics. Septal myectomy results in a significant reduction in LA volumes, paralleled by an improvement in function.

  11. Changes in Serum NT-Pro BNP and Left Atrial BNP Levels after Percutaneous Transvenous Mitral Commissurotomy in Sinus Rhythm Versus Atrial Firilation

    Directory of Open Access Journals (Sweden)

    Leili Pourafkari

    2014-10-01

    Full Text Available Introduction: Natriuretic peptides are secreted from the heart in response to increased wall stress. Their levels are expected to be increased in patients with mitral stenosis (MS due tohigh left atrium (LA pressure and pulmonary artery pressure (PAP. Percutaneous transvenousmitral commissurotomy (PTMC if successful is pursued by a rapid decrease in LA pressure andsubsequent decrease in pulmonary artery pressure. The concurrent changes in natriuretic peptidelevels could be affected with heart rhythm.Methods: Forty five patients with severe rheumatic MS undergoing PTMC were enrolled. Weevaluated the serum NT-Pro BNP levels before and 24 hours after PTMC. BNP levels were alsomeasured from the blood samples obtained from LA before and 20 minutes after the procedure.Changes in biomarkers were assessed based on heart rhythm and success of the procedure.Results: While serum NT-Pro BNP levels showed significant decrease 24 hours after theprocedure (P= 0.04, BNP levels taken 20 minutes after PTMC from LA were similar to theirbaseline concentrations (P= 0.26. NT-Pro BNP levels decreased 51.7±182.86 pg/ml for SR and123.4±520 pg/ml for AF (P= 0.68.Conclusion: Immediate changes in BNP levels did not predict the success of procedure probablydue to the additional balloon inflation attempts in LA in several patients and half-life of BNP. BNPlevels obtained later may be of more value considering the half-life of this marker. Heart rhythmwas not found to influence the changes in biomarker levels. BNP and NT-pro BNP changes werenot found to predict success of the procedure.

  12. Topography of the accessory left gastric artery (ALGA) analyzed by CT angiography from the left hepatic artery

    International Nuclear Information System (INIS)

    Shioyama, Yasukazu; Takasaka, Isao; Onaya, Hiroaki

    2003-01-01

    To avoid gastric complications when we perform transcatheter treatment via left hepatic artery, we analyzed the topography of ALGA (accessory left gastric artery) by left hepatic arteriography and CT angiography from left hepatic artery. Six hundred seventy eight cases of CT angiography were performed between 1995 and 2000. Among them, selective left hepatic arteriography was done in 85 cases. We analyzed the frequency and the course of ALGA on the hepatic angiogram and CT angiogram. ALGA were identified in eighteen (21.2 %) of the 85 cases. We classified them into eleven cases of the proximal type and six cases of the distal type. When ALGA bifurcated from the left hepatic artery very close to the bifurcation of A2 (dorsolateral branch) and A3 (ventrolateral branch), we classified them as the distal type on hepatic angiogram. On the other hand, when ALGA bifurcated from the left hepatic artery apart from the bifurcation of A2 and A3 they were classified as the proximal type. In one rare case ALGA originated from the dorsolateral branch of the left hepatic artery. ALGA were classified as the distal and proximal types. Distal type of ALGA often overlapped dorsolateral branch of the left hepatic artery, and it was sometimes difficult to notice the existence of them. We should check the existence of ALGA on the arterial phase of dynamic CT before we plan to make a transcatheter treatment from the left hepatic artery. Then we can avoid gastric complications caused by a transcatheter treatment from the left hepatic artery. (author)

  13. Left ventricular lipoma with pseudoaneurysm-like appearance.

    Science.gov (United States)

    Kawarai, Shun-ichi; Yaginuma, Gen-ya; Abe, Kazuo; Hamasaki, Azumi; Ishikawa, Kazunori; Tanaka, Daizo

    2010-06-01

    We describe an extremely rare cardiac lipoma, with electrocardiographic changes in ST segments and T waves, suggesting ischemic heart disease. The abnormal electrocardiogram was identified during a routine physical examination of an asymptomatic 57-year-old man. Coronary angiography showed no stenotic or occlusive lesions in the coronary arteries except that the left anterior descending artery followed a winding course in the apical region. Left ventriculography revealed a pseudoaneurysm-like mass around the apical portion. Computed tomography and magnetic resonance imaging revealed a cardiac lipoma that communicated with the left ventricle and resembled a pseudoaneurysm. After complete resection of the lipoma and left ventricle patch plasty, the postoperative course was uneventful. Histologically, the tumor was an intramyocardiac lipoma with no evidence of malignancy. To our knowledge, we are the first to describe an intramyocardiac lipoma resembling a left ventricle pseudoaneurysm.

  14. Annular subvalvular left ventricular aneurysm in Bahia, Brazil.

    Science.gov (United States)

    Guimarães, A C; Filho, A S; Esteves, J P; Abreu, W N; Vinhaes, L A; de Almeida Souza, J A; Machado, A

    1976-10-01

    Two cases of left ventricular aneurysm, a 16-year-old black boy and a 23-year-old white girl, from Bahia, Brazil, are presented. In both patients there was enlargement of the cardiac silhouette and a prominent bulge of the left inferior border. On the right oblique view a ring of calcium at the ventricular opening of the aneurysms was visualized. A left ventriculogram showed a huge aneurysm in the first case and a bulge on the lateral wall of the left ventricle in the other. Cardiac catheterization showed a rise in left and right ventricular end-diastolic pressures and in the mean pulmonary artery pressure. In the first case the contour of the right ventricular pressure curve showed a restrictive pattern. The similarities of these aneurysms with the annular submitral type described in young black Africans are stressed.

  15. A case of luftsichel sign for left upper lobe collapse

    Directory of Open Access Journals (Sweden)

    Erden Erol Ünlüer

    2015-01-01

    Full Text Available The differential diagnosis of dyspnea in Emergency Department (ED patients is broad and atelectasis is one of the differentials among these. We present a 29-year-old women presented to our ED for evaluation of shortness of breath. On her chest examination, air entry and breath sounds were diminished on the left side but normal on the right. A posteroanterior chest radiograph showed radioluscent area in the upper zone of the left lung, around the aortic arch and also hyperdens area neighbouring this, like covered by a veil. Luftsichel sign together with this hiperdensity were consistent with the diagnose of left lung upper lobe collapse. The Luftsichel sign represents the hyperexpanded superior segment of the left lower lobe interposed between the atelectatic left upper lobe and aortic arch. Patient was discharged to home with chest physiotherapy and breathing exercises together with analgesic prescreption.

  16. Left neglect dyslexia: Perseveration and reading error types.

    Science.gov (United States)

    Ronchi, Roberta; Algeri, Lorella; Chiapella, Laura; Gallucci, Marcello; Spada, Maria Simonetta; Vallar, Giuseppe

    2016-08-01

    Right-brain-damaged patients may show a reading disorder termed neglect dyslexia. Patients with left neglect dyslexia omit letters on the left-hand-side (the beginning, when reading left-to-right) part of the letter string, substitute them with other letters, and add letters to the left of the string. The aim of this study was to investigate the pattern of association, if any, between error types in patients with left neglect dyslexia and recurrent perseveration (a productive visuo-motor deficit characterized by addition of marks) in target cancellation. Specifically, we aimed at assessing whether different productive symptoms (relative to the reading and the visuo-motor domains) could be associated in patients with left spatial neglect. Fifty-four right-brain-damaged patients took part in the study: 50 out of the 54 patients showed left spatial neglect, with 27 of them also exhibiting left neglect dyslexia. Neglect dyslexic patients who showed perseveration produced mainly substitution neglect errors in reading. Conversely, omissions were the prevailing reading error pattern in neglect dyslexic patients without perseveration. Addition reading errors were much infrequent. Different functional pathological mechanisms may underlie omission and substitution reading errors committed by right-brain-damaged patients with left neglect dyslexia. One such mechanism, involving the defective stopping of inappropriate responses, may contribute to both recurrent perseveration in target cancellation, and substitution errors in reading. Productive pathological phenomena, together with deficits of spatial attention to events taking place on the left-hand-side of space, shape the manifestations of neglect dyslexia, and, more generally, of spatial neglect. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Left ventricular mass in borderline hypertension assessed by echo cardiography

    International Nuclear Information System (INIS)

    Mezzasalma, L.; Ghione, S.; Palonebo, C.

    1989-01-01

    The relationship between clinical measurement of blood pressure (BP) and left ventricular hypertrophy in arterial hypertension appears to be weak in most studies. On the contrary, stronger correlations with target organ damage in general, and left ventricular hypertrophy in particular, have been reported for blood pressure measurements obtained by ambulatory monitoring; this finding may indicate a possible role for blood pressure response to naturally occurring stresses in determining left ventricular hypertrophy. Aim of this study was to investigate, in 18 patients with borderline arterial hypertension, the relationships between echocardiographically assessed left ventricular mass and, respectively, casual BP and BP responses to some standardized stress tests. Only three patients had a diastolic wall thickness of the interventricular septum and of the posterior wall ≥1.2 cm and none had a pathologically increased left ventricular mass index. The following statistically significant correlations were found: casual diastolic BP vs. left ventricular mass index (r=0.53, p<0.02), systolic BP response to bicycle exercise test vs. left ventricular mass index (r=0.55, p<0.05). Multiple regression analysis showed that almost fifty percent of the variability of left ventricular mass index could be predicted by these two BP measurements. These findings suggest that besides the chronically increased afterload, also the transient hypertensive responses to naturally occuring physical stresses may have a role in determining the extent of cardiac structural changes in borderline hypertensive patients. In addition, they indicate a direct relation between left ventricular mass and blood pressure levels also in borderline hypertension, as previously shown for established hypertension, despite the fact that left ventricular hypertrophy represents only an occasional finding in early stages of hypertension

  18. Increased prevalences of left-handedness and left-eye sighting dominance in individuals with Williams-Beuren syndrome

    NARCIS (Netherlands)

    J.W. van Strien (Jan)

    2005-01-01

    textabstractHandedness and eye sighting dominance were assessed in a sample of 50 individuals (25 male, 25 female; aged 5 – 38 years) with Williams-Beuren syndrome (WBS). The prevalences of left-handedness and left-eyedness were compared to the normative prevalences in the general population. We

  19. Medline Plus

    Full Text Available ... heart. The four chambers of the heart are the right atrium, the right ventricle, the left atrium, and the left ventricle. ... cava, which bring blood from the body to the right atrium, the pulmonary artery, which transports blood from ...

  20. Isolated left-sided pulmonary artery agenesis with left lung hypoplasia: A report of two cases

    Directory of Open Access Journals (Sweden)

    V Govindaraj

    2017-01-01

    Full Text Available Unilateral absence of pulmonary artery or pulmonary artery agenesis (UAPA is a rare congenital malformation that can present as an isolated lesion or in association with other cardiac anomalies. Though congenital, presentation in adults are also reported. Most common presentation in adults is of exercise intolerance. The developing lung on the affected side is hypoplastic. Diagnosis of UAPA is established by imaging methods like CT and MRI . There is no specific treatment for this condition. Treatment depends on patients symptomatology, presence of pulmonary hypertension and collateral circulation. Presence of pulmonary hypertension carries a bad prognosis. We present two adult patients with isolated left sided unilateral pulmonary artery agenesis with ipsilateral lung hypoplasia. The diagnosis was confirmed by CT chest and perfusion scan.

  1. Left-right asymmetry in neutrino-produced hadron jets

    International Nuclear Information System (INIS)

    Ballagh, H.C.; Bingham, H.H.; Lawry, T.J.; Lys, J.; Lynch, G.R.; Sokoloff, M.D.; Stevenson, M.L.; Huson, F.R.; Schmidt, E.; Smart, W.; Treadwell, E.; Cence, R.J.; Harris, F.A.; Jones, M.D.; Koide, A.; Peters, M.W.; Peterson, V.Z.; Lubatti, H.J.; Moriyasu, K.; Wolin, E.

    1989-01-01

    In an experiment (E546) to study interactions of left-angle E right-angle=100 GeV and left-angle Q 2 right-angle=17 GeV 2 neutrinos in the Fermilab 15-foot bubble chamber, we have looked for a left-right asymmetry in the azimuthal angle φ of individual hadrons about the direction of the lepton momentum transfer (q vector). Significant asymmetry is found for forward positive hadrons; for x F >0.10, we find left-angle cosφ right-angle=-0.029±0.008, where x F is the Feynman x variable. Negative hadrons with x F >0.10 show no asymmetry, left-angle cosφ right-angle=0.004±0.011. A model which includes parton intrinsic transverse momentum k t reproduces the asymmetry of combined positive and negative hadrons with x F >0.10, left-angle cosφ right-angle=-0.018±0.0065, if left-angle k t 2 right-angle=0.065±0.024 GeV 2 /c 2 . But the model predicts almost equal asymmetries for positive and negative hadrons. The model also agrees poorly with the observed dependence on the kinematic variables x and Q 2 if the k t distribution is assumed to be independent of kinematic variables

  2. Anosognosia for hemiparesis after left-sided stroke.

    Science.gov (United States)

    Baier, Bernhard; Vucurevic, Goran; Müller-Forell, Wibke; Glassl, Oliver; Geber, Christian; Dieterich, Marianne; Karnath, Hans-Otto

    2014-12-01

    In patients with left-sided lesions, anosognosia for hemiparesis (AHP) seems to be a rare phenomenon. It has been discussed whether this rareness might be due to an inevitable bias due to language dysfunction and whether the left hemisphere's role for our self-awareness of motor actions thus is underestimated. By applying functional magnetic resonance imaging (fMRI) we examined whether patients with AHP following a left hemisphere stroke show a regular, left-sided or a reversed, right-sided lateralization of language functions. Only the former observation would argue for an original role of the left hemisphere in self-awareness about limb function. In a consecutive series of 44 acute left-sided stroke patients, only one patient (=2%) was identified showing AHP. In this case, we could verify by using fMRI that lateralization of AHP and spatial neglect on the one hand and of language functions on the other hand were reversed. The present single case observation thus argues against an original role of the left hemisphere in self-awareness about limb function. We discuss the data in the context of previous observations in the literature. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Neglect severity after left and right brain damage.

    Science.gov (United States)

    Suchan, Julia; Rorden, Chris; Karnath, Hans-Otto

    2012-05-01

    While unilateral spatial neglect after left brain damage is undoubtedly less common than spatial neglect after a right hemisphere lesion, it is also assumed to be less severe. Here we directly test this latter hypothesis using a continuous measure of neglect severity: the so-called Center of Cancellation (CoC). Rorden and Karnath (2010) recently validated this index for right brain damaged neglect patients. A first aim of the present study was to evaluate this new measure for spatial neglect after left brain damage. In a group of 48 left-sided stroke patients with and without neglect, a score greater than -0.086 on the Bells Test and greater than -0.024 on the Letter Cancellation Task turned out to indicate neglect behavior for acute left brain damaged patients. A second aim was to directly compare the severity of spatial neglect after left versus right brain injury by using the new CoC measure. While neglect is less frequent following left than right hemisphere injury, we found that when this symptom occurs it is of similar severity in acute left brain injury as in patients after acute right brain injury. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Left main coronary artery disease: pathophysiology, diagnosis, and treatment.

    Science.gov (United States)

    Collet, Carlos; Capodanno, Davide; Onuma, Yoshinobu; Banning, Adrian; Stone, Gregg W; Taggart, David P; Sabik, Joseph; Serruys, Patrick W

    2018-06-01

    The advent of coronary angiography in the 1960s allowed for the risk stratification of patients with stable angina. Patients with unprotected left main coronary artery disease have an increased risk of death related to the large amount of myocardium supplied by this vessel. Although coronary angiography remains the preferred imaging modality for the evaluation of left main coronary artery stenosis, this technique has important limitations. Angiograms of the left main coronary artery segment can be difficult to interpret, and almost one-third of patients can be misclassified when fractional flow reserve is used as the reference. In patients with clinically significant unprotected left main coronary artery disease, surgical revascularization was shown to improve survival compared with medical therapy and has been regarded as the treatment of choice for unprotected left main coronary artery disease. Two large-scale clinical trials published in 2016 support the usefulness of catheter-based revascularization in selected patients with unprotected left main coronary artery disease. In this Review, we describe the pathophysiology of unprotected left main coronary artery disease, discuss diagnostic approaches in light of new noninvasive and invasive imaging techniques, and detail risk stratification models to aid the Heart Team in the decision-making process for determining the best revascularization strategy for these patients.

  5. Left ventricular systolic and diastolic function in hyperthyroidism

    International Nuclear Information System (INIS)

    Friedman, M.J.; Okada, R.D.; Ewy, G.A.; Hellman, D.J.

    1982-01-01

    In order to assess the effect of hyperthyroidism on systolic and diastolic function of the left ventricle, M-mode echocardiograms and systolic time intervals were obtained in 13 patients while they were clinically hyperthyroid and again when they were euthyroid following radioactive iodine therapy. Echocardiographic tracings of the septum and left ventricular posterior wall were digitized and analyzed to provide the maximum velocity of shortening and maximum velocity of lengthening. These velocities were normalized for left ventricular diastolic dimension. The left ventricular minor axis fractional shortening and the normalized maximum velocity of shortening were both increased during the hyperthyroid state. The normalized maximum velocity of lengthening, a measure of diastolic left ventricular function, was also increased during the hyperthyroid state when compared to the euthyroid state. The preejection period index and the preejection period/left ventricular ejection time ratio were lower when the patients were hyperthyroid than when they were euthyroid. These data confirm the increased inotropic state and demonstrated increased diastolic relaxation velocities of the hyperthyroid left ventricle

  6. Fatal stroke after completion pneumonectomy for torsion of left upper lobe following left lower lobectomy

    Directory of Open Access Journals (Sweden)

    Apostolakis Efstratios

    2006-09-01

    Full Text Available Abstract Background The lobar torsion after lung surgery is a rare complication with an incidence of 0.09 to 0.4 %. It may occur after twisting of the bronchovascular pedicle of the remaining lobe after lobectomy, usually on the right side. The 180-degree rotation of the pedicle produces an acute obstruction of the lobar bronchus (atelectasis and of the lobar vessels as well. Without prompt treatment it progresses to lobar ischemia, pulmonary infarction and finally fatal gangrene. Case Presentation A 62 years old female patient was admitted for surgical treatment of lung cancer. She underwent elective left lower lobectomy for squamous cell carcinoma (pT2 N0. The operation was unremarkable, and the patient was extubated in the operating room. After eight hours the patient established decrease of pO2 and chest x-ray showed atelectasis of the lower lobe. To establish diagnosis, bronchoscopy was performed, demonstrating obstructed left lobar bronchus. The patient was re-intubated, and admitted to the operating room where reopening of the thoracotomy was performed. Lobar torsion was diagnosed, with the diaphragmatic surface of the upper lobe facing in an anterosuperior orientation. A completion pneumonectomy was performed. At the end of the procedure the patient developed a right pupil dilatation, presumably due to a cerebral embolism. A subsequent brain angio-CT scan established the diagnosis. She died at the intensive care unit 26 days later. Conclusion The thoracic surgeon should suspect this rare early postoperative complication after any thoracic operation in every patient with atelectasis of the neighboring lobe. High index of suspicion and prompt diagnosis may prevent catastrophic consequences, such as, infarction or gangrene of the pulmonary lobe. During thoracic operations, especially whenever the lung or lobe hilum is full mobilized, fixation of the remaining lobe may prevent this life threatening complication.

  7. Diagnostic electrocardiographic dyad criteria of emphysema in left ventricular hypertrophy

    Directory of Open Access Journals (Sweden)

    Lanjewar SS

    2013-11-01

    Full Text Available Swapnil S Lanjewar,1 Lovely Chhabra,1 Vinod K Chaubey,1 Saurabh Joshi,1 Ganesh Kulkarni,1 Chandrasekhar Kothagundla,1 Sudesh Kaul,1 David H Spodick21Department of Internal Medicine, 2Department of Cardiovascular Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, MA, USABackground: The electrocardiographic diagnostic dyad of emphysema, namely a combination of the frontal vertical P-vector and a narrow QRS duration, can serve as a quasidiagnostic marker for emphysema, with specificity close to 100%. We postulated that the presence of left ventricular hypertrophy in emphysema may affect the sensitivity of this electrocardiographic criterion given that left ventricular hypertrophy generates prominent left ventricular forces and may increase the QRS duration.Methods: We reviewed the electrocardiograms and echocardiograms for 73 patients with emphysema. The patients were divided into two groups based on the presence or absence of echocardiographic evidence of left ventricular hypertrophy. The P-vector, QRS duration, and forced expiratory volume in one second (FEV1 were computed and compared between the two subgroups.Results: There was no statistically significant difference in qualitative lung function (FEV1 between the subgroups. There was no statistically significant difference in mean P-vector between the subgroups. The mean QRS duration was significantly longer in patients with left ventricular hypertrophy as compared with those without left ventricular hypertrophy.Conclusion: The presence of left ventricular hypertrophy may not affect the sensitivity of the P-vector verticalization when used as a lone criterion for diagnosing emphysema. However, the presence of left ventricular hypertrophy may significantly reduce the sensitivity of the electrocardiographic diagnostic dyad in emphysema, as it causes a widening of the QRS duration.Keywords: emphysema, electrocardiogram, left ventricular hypertrophy, chronic

  8. Left-sided gall bladder: Report of two cases

    Directory of Open Access Journals (Sweden)

    Chrungoo R

    2007-01-01

    Full Text Available Left-sided gall bladder without situs inversus viscerum is a rare albeit recognized clinical entity. We report our experience of two cases of left-sided gall bladder in two women aged 36 and 48 who underwent laparoscopic cholecystectomy for chronic calculous cholecystitis. Left-sided gall bladder may provide an unusual surprise to the surgeons during laparoscopy as routine pre-operative studies may not always detect the anomaly. Awareness of the unpredictable confluence of the cystic duct into the common bile duct (CBD and selective use of intraoperative cholangiography aid in the safe laparoscopic management of this unusual entity.

  9. Primary left ventricular hydatid cyst in a child: case report

    International Nuclear Information System (INIS)

    Turkvatan, A.; Yelgec, N.S.; Calikoglu, U.; Olcer, T.

    2000-01-01

    The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

  10. Primary left ventricular hydatid cyst in a child: case report

    Energy Technology Data Exchange (ETDEWEB)

    Turkvatan, A. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey); Yelgec, N.S. [Turkiye Yuksek Ihtisas Hospital, Dept. of Cardiology, Ankara (Turkey); Calikoglu, U.; Olcer, T. [Turkiye Yuksek Ihtisas Hospital, Dept. of Radiology, Ankara (Turkey)

    2000-12-01

    The most common cause of echinococcosis in humans is Echinococcus granulosus. Although hydatid cyst is most frequently localized in liver (more than 65% of cases) and lung (25%) by means of portal and systemic circulation, it may involve other tissues and organs. Cardiac hydatid cysts account for only 0.5%-2% of all hydatid cysts, even in endemic areas. Of all cardiac hydatid cysts, the left ventricle accounts for 60%, right ventricle 10%, pericardium 7%, pulmonary artery 6%, left atrial appendage 6%, and interventricular septum 4%. We report the case of a myocardial hydatid cyst of the left ventricle in a 9-year-old boy. (author)

  11. Comunicação interatrial do tipo seio coronário, comunicação interventricular e ausência de veia cava superior esquerda Coronary sinus atrial septal defect and ventricular septal defect with no left superior vena cava

    Directory of Open Access Journals (Sweden)

    Fábio Alves Almeida

    1998-10-01

    Full Text Available Relatamos um caso raro de um paciente de 21 meses, portador de comunicação interatrial do tipo seio coronário, associada a comunicação interventricular perimembranosa, e ausência de veia cava superior esquerda. O diagnóstico foi realizado através da ecocardiografia e confirmado pela angiografia. O paciente foi operado sem intercorrências, ambos os defeitos foram fechados com patch de pericárdio bovino e o fluxo das veias coronárias ficou direcionado para o átrio esquerdo. Um ecocardiograma mostrou ausência de shunt residual através dos defeitos.We report a rare case of a 21 month old child with a coronary sinus atrial septal defect associated with perimembranous ventricular septal defect and no left superior vena cava. The diagnosis was made by transthoracic echocardiogram and confirmed by angiography. The patient was operated on uneventfully, both defects were closed with bovine pericardial patches and the flow from the coronary veins was directed towards the left atrium. An echocardiogram revealed complete closure of both defects.

  12. Echocardiographic left ventricular masses in distance runners and weight lifters

    Science.gov (United States)

    Longhurst, J. C.; Gonyea, W. J.; Mitchell, J. H.; Kelly, A. R.

    1980-01-01

    The relationships of different forms of exercise training to left ventricular mass and body mass are investigated by echocardiographic studies of weight lifters, long-distance runners, and comparatively sized untrained control subjects. Left ventricular mass determinations by the Penn convention reveal increased absolute left ventricular masses in long-distance runners and competitive weight lifters with respect to controls matched for age, body weight, and body surface area, and a significant correlation between ventricular mass and lean body mass. When normalized to lean body mass, the ventricular masses of distance runners are found to be significantly higher than those of the other groups, suggesting that dynamic training elevates left ventricular mass compared to static training and no training, while static training increases ventricular mass only to the extent that lean body mass is increased.

  13. ["Habitual" left branch block alternating with 2 "disguised" bracnch block].

    Science.gov (United States)

    Lévy, S; Jullien, G; Mathieu, P; Mostefa, S; Gérard, R

    1976-10-01

    Two cases of alternating left bundle branch block and "masquerading block" (with left bundle branch morphology in the stnadard leads and right bundle branch block morphology in the precordial leads) were studied by serial tracings and his bundle electrocardiography. In case 1 "the masquerading" block was associated with a first degree AV block related to a prolongation of HV interval. This case is to our knowledge the first cas of alternating bundle branch block in which his bundle activity was recorded in man. In case 2, the patient had atrial fibrilation and His bundle recordings were performed while differents degrees of left bundle branch block were present: The mechanism of the alternation and the concept of "masquerading" block are discussed. It is suggested that this type of block represents a right bundle branch block associated with severe lesions of the "left system".

  14. Delusional misidentifications and duplications: right brain lesions, left brain delusions.

    Science.gov (United States)

    Devinsky, Orrin

    2009-01-06

    When the delusional misidentification syndromes reduplicative paramnesia and Capgras syndromes result from neurologic disease, lesions are usually bifrontal and/or right hemispheric. The related disorders of confabulation and anosognosis share overlapping mechanisms and anatomic pathology. A dual mechanism is postulated for the delusional misidentification syndromes: negative effects from right hemisphere and frontal lobe dysfunction as well as positive effects from release (i.e., overactivity) of preserved left hemisphere areas. Negative effects of right hemisphere injury impair self-monitoring, ego boundaries, and attaching emotional valence and familiarity to stimuli. The unchecked left hemisphere unleashes a creative narrator from the monitoring of self, memory, and reality by the frontal and right hemisphere areas, leading to excessive and false explanations. Further, the left hemisphere's cognitive style of categorization, often into dual categories, leads it to invent a duplicate or impostor to resolve conflicting information. Delusions result from right hemisphere lesions. But it is the left hemisphere that is deluded.

  15. Unusual metastasis of left colon cancer: considerations on two cases.

    Science.gov (United States)

    Gubitosi, Adelmo; Moccia, Giancarlo; Malinconico, Francesca Antonella; Gilio, Francesco; Iside, Giovanni; Califano, Umberto G A; Foroni, Fabrizio; Ruggiero, Roberto; Docimo, Giovanni; Parmeggiani, Domenico; Agresti, Massimo

    2009-04-01

    Usually, left colon cancer metastasis concerns liver, abdominal lymph nodes and lungs. Other localizations are quite rare occurrences. In spite of this, some uncommon metastasis sites are reported in literature, such as: peritoneum, ovaries, uterus, kidney testis, bones, thyroid, oral cavity and central nervous system. We report two cases of unusual localizations of left colon cancer metastasis localization, one into the retroperitoneal space and the other at the left axillary lynphnodes and between liver and pancreas. In the first reported case the diffusion pathway may have been the lymphatic mesocolic vessels, partially left in place from the previous surgery. In the second case the alleged metastatic lane may have been through the periumbilical lymph nodes to the parasternal lymph nodes and then to the internal mammary ones, finally reaching the axillary limph nodes.

  16. Sonographic determination of spleen to left kidney ratio among Igbo ...

    African Journals Online (AJOL)

    The weight and height of the subjects were obtained with the participants wearing light ... Results: Measurement of spleen and left kidney lengths were reliable within and between .... obtained in the coronal plane passing through the renal.

  17. Right and left ventricular performance by nuclear stethoscope

    International Nuclear Information System (INIS)

    Nishimura, T.; Uehara, T.; Hayashida, K.; Kozuka, T.

    1983-01-01

    Right and left ventricular performance by Nuclear Stethoscope using Kr-81m and Tc-99m-RBC were performed. And physiological and pharmacological interventions were also investigated for the evaluation of coronary artery diseases (CAD)

  18. Ostial left main coronary stenosis in a frequent flyer.

    LENUS (Irish Health Repository)

    O'Sullivan, John F

    2009-05-15

    A 52 year old gentleman presented with chest pain, after a long distance flight from India; he had made long haul flights every 2 weeks over the last 5 years as part of his job. His ECG revealed T wave inversion in leads V1-3. Cardiac biomarkers including troponin were negative; we proceeded to exercise stress testing (EST). This revealed 2 mm ST depression at 2 min of the standard Bruce protocol, associated with chest pain. He was taken immediately to the coronary catheterization laboratory; engagement of the left main caused pressure damping with 6 French, then 5 French diagnostic Judkins left 4 catheters. An ostial left main stenosis was seen; the right and left coronary trees otherwise had no significant stenoses. He had normal LV function. He underwent inpatient CABG 7 days later.

  19. Left-Right Asymmetric Morphogenesis in the Xenopus Digestive System

    Science.gov (United States)

    Muller, Jennifer K.; Prather, D.R.; Nascone-Yoder, N. M.

    2003-01-01

    The morphogenetic mechanisms by which developing organs become left-right asymmetric entities are unknown. To investigate this issue, we compared the roles of the left and right sides of the Xenopus embryo during the development of anatomic asymmetries in the digestive system. Although both sides contribute equivalently to each of the individual digestive organs, during the initial looping of the primitive gut tube, the left side assumes concave topologies where the right side becomes convex. Of interest, the concave surfaces of the gut tube correlate with expression of the LR gene, Pitx2, and ectopic Pitx2 mRNA induces ectopic concavities in a localized manner. A morphometric comparison of the prospective concave and convex surfaces of the gut tube reveals striking disparities in their rate of elongation but no significant differences in cell proliferation. These results provide insight into the nature of symmetry-breaking morphogenetic events during left-right asymmetric organ development. ?? 2003 Wiley-Liss, Inc.

  20. Schwannoma of the left brachial plexus mimicking a ...

    African Journals Online (AJOL)

    Schwannoma of the left brachial plexus mimicking a cervicomediastinal ... Her voice was hoarse but there was no eye signs suggestive of thyrotoxicosis. ... A presumptive diagnosis of thyroid carcinoma with retrosternal extension was made.

  1. Left coronary arterial blood flow: Noninvasive detection by Doppler US

    International Nuclear Information System (INIS)

    Gramiak, R.; Holen, J.; Moss, A.J.; Gutierrez, O.H.; Picone, A.L.; Roe, S.A.

    1986-01-01

    Continuous wave (CW) and pulsed Doppler ultrasound studies with spectral analysis were used to detect the left coronary arterial blood flow in patients who were undergoing routine echocardiography. The pulmonary artery is a stable ultrasonic landmark from which detection of the blood flow can be effected. The left coronary artery can be distinguished by its blood flow toward the cardiac apex and by specific, functional flow features. Flow patterns vary among the left main, circumflex, and anterior descending arteries; patterns also vary with respiration cycles. In the present study, coronary arterial blood flow was detected in 58 of 70 patients (83%). Findings were validated by selectively injecting an agitated saline contrast medium into the left coronary artery and, in another study, by comparing human Doppler phasic flow waveforms with electromagnetic flowmeter recordings obtained in dogs

  2. The Colombian Left: A Paradoxical Past; A Promising Future?

    Directory of Open Access Journals (Sweden)

    Charles Bergquist

    2017-07-01

    Full Text Available The essay explores the paradoxical history of the left in Colombia: how and why one of the weakest lefts in Latin America brought about the strongest and most lasting Marxist insurrection in the hemisphere in the decades following the Cuban Revolution. The article argues that the terms of this paradox are related, that the historic weakness of the left partly explains the force and longevity of revolutionary guerrillas, and that said paradox helps clarify not only the failure of several attempts to achieve a negotiated settlement of the armed conflict, but also the negative vote in the October 2016 plebiscite. Finally, it envisions a more promising future for the country’s left, provided that a lasting peace is consolidated.

  3. Times of Crisis : Success or Decline of the Left

    Directory of Open Access Journals (Sweden)

    Valeria Tarditi

    2015-03-01

    Full Text Available The crisis that especially since the 2008 has shown the deep weakness of the capitalistic economic model induces to reflect on the role of the radical left parties and on their capacity to propose alternative policies, interpreting the citizens’ demands. Starting from these premises this article analyses three parties of the radical left party family- United Left, Left Freedom and Ecology and Syriza- that act respectively in Spain, Italy and Greece, three of the European democracies most affected by the social consequences of the crisis. The article proposes a diachronic comparison of the three parties’ policy pro-posals, organizational model and strategies in order to explain their greater or lesser ability to attract con-sensus in the last years.

  4. Phonological decisions require both the left and right supramarginal gyri

    DEFF Research Database (Denmark)

    Hartwigsen, Gesa; Baumgaertner, Annette; Price, Cathy J

    2010-01-01

    Recent functional imaging studies demonstrated that both the left and right supramarginal gyri (SMG) are activated when healthy right-handed subjects make phonological word decisions. However, lesion studies typically report difficulties with phonological processing after left rather than right...... the right or left SMG. Taken together, these findings provide converging evidence that the right SMG contributes to accurate and efficient phonological decisions in the healthy brain, with no evidence that the left and right SMG can compensate for one another during TMS. Our findings motivate detailed...... hemisphere damage. Here, we used a unique dual-site transcranial magnetic stimulation (TMS) approach to test whether the SMG in the right hemisphere contributes to modality-independent (i.e., auditory and visual) phonological decisions. To test task-specificity, we compared the effect of real or sham TMS...

  5. Contemporary Assessment of Left Ventricular Diastolic Function in Older Adults

    DEFF Research Database (Denmark)

    Shah, Amil M.; Claggett, Brian; Kitzman, Dalane

    2017-01-01

    Background: Although age-Associated changes in left ventricular diastolic function are well recognized, limited data exist characterizing measures of diastolic function in older adults, including both reference ranges reflecting the older adult population and prognostically relevant values...

  6. Left-sided native valve Staphylococcus aureus endocarditis

    NARCIS (Netherlands)

    Slabbekoorn, M.; Horlings, H. M.; van der Meer, J. T. M.; Windhausen, A.; Van der Sloot, J. A. P.; Lagrand, W. K.

    2010-01-01

    Despite improved diagnostic tools and expanded treatment options, left-sided native valve endocarditis caused by Staphylococcus aureus infection remains a serious and destructive disease. The high morbidity and mortality, however, can be reduced by early recognition, correct diagnosis, and

  7. Left ventricular structure and function in black normotensive type 2 ...

    African Journals Online (AJOL)

    Keywords: Black normotensive patients, left ventricular function, type 2 DM. Résumé ... sickle cell disease and structural heart disease were excluded ... Pulmonary venous flow (PVF) velocity ... had abnormal ECG pattern compared with 30%.

  8. Fetal Diagnosis of Abnormal Origin of the Left Pulmonary Artery.

    Science.gov (United States)

    Tretter, Justin T; Tretter, Eric M; Rafii, Daniela Y; Anderson, Robert H; Bhatla, Puneet

    2016-08-01

    Isolated anomalies of the branch pulmonary arteries are rare, more often occurring in the setting of complex congenital heart disease. These isolated anomalies are often not identified in the prenatal period. We describe two cases of isolated anomalies of the left pulmonary artery which were identified on fetal echocardiography and confirmed postnatally, an anomalous left pulmonary artery arising from the base of the left-sided brachiocephalic artery in the setting of a right-sided aortic arch, and a left pulmonary artery sling. These two cases support our current understanding of normal and abnormal development of the extrapericardial arterial vessels and highlight the importance of meticulous attention when sweeping from the three-vessel tracheal view. © 2016, Wiley Periodicals, Inc.

  9. Quantitation of global and regional left ventricular function by MRI

    NARCIS (Netherlands)

    van der Geest, RJ; Reiber, JHC; Reiber, JHC; VanDerWall, EE

    1998-01-01

    Magnetic resonance imaging (MRI) provides several imaging strategies for assessing left ventricular function. As a three-dimensional imaging technique, all measurements can be performed without relying on geometrical assumptions. Global and regional function parameters can be derived from

  10. Left-handed materials in metallic magnetic granular composites

    International Nuclear Information System (INIS)

    Chui, S.T.; Lin, Z.F.; Hu, L.-B.

    2003-01-01

    There is recently interests in the 'left-handed' materials. In these materials the direction of the wave vector of electromagnetic radiation is opposite to the direction of the energy flow. We present simple arguments that suggests that magnetic composites can also be left-handed materials. However, the physics involved seems to be different from the original argument. In our argument, the imaginary part of the dielectric constant is much larger than the real part, opposite to the original argument

  11. Political Left and Right: Our Hands-On Logic

    OpenAIRE

    Frits Bienfait; Walter E. A. van Beek

    2014-01-01

    The origins and immediate vitality of the left/right divide which emerged in French revolutionary politics from 1789 can only be understood against the background of a much older classification dynamic based on the primacy of the right hand, first described by Robert Hertz in 1909. This dynamic infused political thinking first in Versailles and since 1815 in democracies throughout the world. In the process, the classical left/right polarity acquired a new dimension: the complementary notions ...

  12. Jordan and left derivations on locally C*-algebras

    International Nuclear Information System (INIS)

    Shahzad, Naseer

    2002-07-01

    We show that left derivations as well as Jordan derivations on locally G*-algebras are always continuous. We also obtain some noncommutative extensions of the classical Singer-Wermer theorem for locally C*-algebras: (1) Every left derivation D on a locally (7*-algebra A is identically zero. (2) Every Jordan derivation D on a locally C*-algebra A which satisfies [D(x), x]D(x]=0 for all x in A, is identically zero. (author)

  13. Tensor product of left n-invertible operators

    Czech Academy of Sciences Publication Activity Database

    Duggal, B.P.; Müller, Vladimír

    2013-01-01

    Roč. 215, č. 2 (2013), s. 113-125 ISSN 0039-3223 R&D Projects: GA ČR GA201/09/0473 Institutional support: RVO:67985840 Keywords : Banach space * essentially left n- invertible operator * left n-invertible operator Subject RIV: BA - General Mathematics Impact factor: 0.630, year: 2013 http://journals.impan.pl/cgi-bin/doi?sm215-2-2

  14. Developmental dyslexia: dysfunction of a left hemisphere reading network

    Directory of Open Access Journals (Sweden)

    Fabio eRichlan

    2012-05-01

    Full Text Available This mini-review summarizes and integrates findings from recent meta-analyses and original neuroimaging studies on functional brain abnormalities in dyslexic readers. Surprisingly, there is little empirical support for the standard neuroanatomical model of developmental dyslexia, which localizes the primary phonological decoding deficit in left temporo-parietal regions. Rather, recent evidence points to a dysfunction of a left hemisphere reading network, which includes occipito-temporal, inferior frontal, and inferior parietal regions.

  15. Right Site, Wrong Route - Cannulating the Left Internal Jugular Vein.

    Science.gov (United States)

    Paik, Peter; Arukala, Sanjay K; Sule, Anupam A

    2018-01-09

    Central venous catheters are placed in approximately five million patients annually in the US. The preferred site of insertion is one with fewer risks and easier access. Although the right internal jugular vein is preferred, on occasion, the left internal jugular may have to be accessed. A patient was admitted for septic shock, cerebrovascular accident, and non-ST-segment elevation myocardial infarction. A central venous line was needed for antibiotic and vasopressor administration. Due to trauma from a fall to the right side and previously failed catheterization attempts at the left subclavian and femoral veins, the left internal jugular vein was accessed. On chest radiography for confirmation, the left internal jugular central venous catheter was seen projecting down the left paraspinal region. It did not take the expected course across the midline toward the right and into the superior vena cava (SVC). A review of a computed tomography (CT) scan of the chest with contrast done on a prior admission revealed a duplicated SVC on the left side that had not been reported in the original CT scan interpretation. A left-sided SVC is present in approximately 0.3% to 0.5% of the population, with 90% of these draining into the coronary sinus. During placements of central venous lines and pacemakers, irritation of the coronary sinus may result in hypotension, arrhythmia, myocardial ischemia, or cardiac arrest. A widened mediastinum can be an indication of a duplicated SVC. When attempting a left internal jugular vein central venous catheter placement, it is important to be aware of venous anomalies in order to prevent complications.

  16. Variation of left heart function and thyroid hormone in cirrhosis

    International Nuclear Information System (INIS)

    Liu Junchi; Du Sujun; Mao Shaorong; Lu Jun; Tang Xiaoling

    1996-01-01

    The observation of 52 cases of cirrhosis left heart function indices traced with 113 In m in quiet and motion, and the combining determination of thyroid hormone serum levels with RIA are described. The cirrhosis to the function of liver damage increased, the indices of left heart function has great change. Moreover, the serum levels of T 3 , FT 3 in thyroid hormone are decreased obviously and the serum level of rT 3 is also increased significantly

  17. Weak interaction models with spontaneously broken left-right symmetry

    International Nuclear Information System (INIS)

    Mohapatra, R.H.

    1978-01-01

    The present status of weak interaction models with spontaneously broken left-right symmetry is reviewed. The theoretical basis for asymptotic parity conservation, manifest left-right symmetry in charged current weak interactions, natural parity conservation in neutral currents and CP-violation in the context of SU(2)/sub L/ circled x SU (2)/sub R/ circled x U(1) models are outlined in detail. Various directions for further research in the theoretical and experimental side are indicated

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

    International Nuclear Information System (INIS)

    Liu Li; Zhao Shujun; Yao Zhiming; Wang Daoyu

    1999-01-01

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

  19. Foucault's Flirt? Neoliberalism, the Left and the Welfare State

    DEFF Research Database (Denmark)

    Hansen, Magnus Paulsen

    2015-01-01

    An essay on the review of works interpreting the lectures of Michel Foucault on neoliberalism is presented. It offers a history of neoliberalism as a way to reinvent the left and examines the way Foucault betrayed the left while resisting to be connected with a normative political programme...... or principle for a neoliberal stance. The author relates the risks in neoliberal thought for losing what is specific in definitive statements and the loss of neoliberal thought coherence within a reality....

  20. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Directory of Open Access Journals (Sweden)

    Simone Nascimento dos Santos

    2014-12-01

    Full Text Available Background: Left ventricular (LV diastolic dysfunction is associated with new-onset atrial fibrillation (AF, and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. Objective: To evaluate the impact of AF ablation on estimated LV filling pressure. Methods: A total of 141 patients underwent radiofrequency (RF ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind, and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e' were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. Results: One hundred seventeen patients (82.9% were free of AF during the follow-up (average, 18 ± 5 months. LAVind reduced in the successful group (30.2 mL/m2 ± 10.6 mL/m2 to 22.6 mL/m2 ± 1.1 mL/m2, p < 0.001 compared to the non-successful group (37.7 mL/m2 ± 14.3 mL/m2 to 37.5 mL/m2 ± 14.5 mL/m2, p = ns. Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001 but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns. The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001. Conclusion: Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.

  1. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Simone Nascimento dos, E-mail: simonens@cardiol.br [Instituto Brasília de Arritmia- Universidade de Brasília, DF (Brazil); Faculdade de Medicina (UnB), Brasília, DF (Brazil); Henz, Benhur Davi; Zanatta, André Rodrigues; Barreto, José Roberto; Loureiro, Kelly Bianca; Novakoski, Clarissa; Santos, Marcus Vinícius Nascimento dos; Giuseppin, Fabio F.; Oliveira, Edna Maria; Leite, Luiz Roberto [Instituto Brasília de Arritmia- Universidade de Brasília, DF (Brazil)

    2014-12-15

    Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. To evaluate the impact of AF ablation on estimated LV filling pressure. A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m{sup 2} ± 10.6 mL/m{sup 2} to 22.6 mL/m{sup 2} ± 1.1 mL/m{sup 2}, p < 0.001) compared to the non-successful group (37.7 mL/m{sup 2} ± 14.3 mL/m{sup 2} to 37.5 mL/m{sup 2} ± 14.5 mL/m{sup 2}, p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure.

  2. Impact of Atrial Fibrillation Ablation on Left Ventricular Filling Pressure and Left Atrial Remodeling

    International Nuclear Information System (INIS)

    Santos, Simone Nascimento dos; Henz, Benhur Davi; Zanatta, André Rodrigues; Barreto, José Roberto; Loureiro, Kelly Bianca; Novakoski, Clarissa; Santos, Marcus Vinícius Nascimento dos; Giuseppin, Fabio F.; Oliveira, Edna Maria; Leite, Luiz Roberto

    2014-01-01

    Left ventricular (LV) diastolic dysfunction is associated with new-onset atrial fibrillation (AF), and the estimation of elevated LV filling pressures by E/e' ratio is related to worse outcomes in patients with AF. However, it is unknown if restoring sinus rhythm reverses this process. To evaluate the impact of AF ablation on estimated LV filling pressure. A total of 141 patients underwent radiofrequency (RF) ablation to treat drug-refractory AF. Transthoracic echocardiography was performed 30 days before and 12 months after ablation. LV functional parameters, left atrial volume index (LAVind), and transmitral pulsed and mitral annulus tissue Doppler (e' and E/e') were assessed. Paroxysmal AF was present in 18 patients, persistent AF was present in 102 patients, and long-standing persistent AF in 21 patients. Follow-up included electrocardiographic examination and 24-h Holter monitoring at 3, 6, and 12 months after ablation. One hundred seventeen patients (82.9%) were free of AF during the follow-up (average, 18 ± 5 months). LAVind reduced in the successful group (30.2 mL/m 2 ± 10.6 mL/m 2 to 22.6 mL/m 2 ± 1.1 mL/m 2 , p < 0.001) compared to the non-successful group (37.7 mL/m 2 ± 14.3 mL/m 2 to 37.5 mL/m 2 ± 14.5 mL/m 2 , p = ns). Improvement of LV filling pressure assessed by a reduction in the E/e' ratio was observed only after successful ablation (11.5 ± 4.5 vs. 7.1 ± 3.7, p < 0.001) but not in patients with recurrent AF (12.7 ± 4.4 vs. 12 ± 3.3, p = ns). The success rate was lower in the long-standing persistent AF patient group (57% vs. 87%, p = 0.001). Successful AF ablation is associated with LA reverse remodeling and an improvement in LV filling pressure

  3. Skin Sodium Concentration Correlates with Left Ventricular Hypertrophy in CKD.

    Science.gov (United States)

    Schneider, Markus P; Raff, Ulrike; Kopp, Christoph; Scheppach, Johannes B; Toncar, Sebastian; Wanner, Christoph; Schlieper, Georg; Saritas, Turgay; Floege, Jürgen; Schmid, Matthias; Birukov, Anna; Dahlmann, Anke; Linz, Peter; Janka, Rolf; Uder, Michael; Schmieder, Roland E; Titze, Jens M; Eckardt, Kai-Uwe

    2017-06-01

    The pathogenesis of left ventricular hypertrophy in patients with CKD is incompletely understood. Sodium intake, which is usually assessed by measuring urinary sodium excretion, has been inconsistently linked with left ventricular hypertrophy. However, tissues such as skin and muscle may store sodium. Using 23 sodium-magnetic resonance imaging, a technique recently developed for the assessment of tissue sodium content in humans, we determined skin sodium content at the level of the calf in 99 patients with mild to moderate CKD (42 women; median [range] age, 65 [23-78] years). We also assessed total body overhydration (bioimpedance spectroscopy), 24-hour BP, and left ventricular mass (cardiac magnetic resonance imaging). Skin sodium content, but not total body overhydration, correlated with systolic BP ( r =0.33, P =0.002). Moreover, skin sodium content correlated more strongly than total body overhydration did with left ventricular mass ( r =0.56, P skin sodium content is a strong explanatory variable for left ventricular mass, unaffected by BP and total body overhydration. In conclusion, we found skin sodium content to be closely linked to left ventricular mass in patients with CKD. Interventions that reduce skin sodium content might improve cardiovascular outcomes in these patients. Copyright © 2017 by the American Society of Nephrology.

  4. Enhancing No Child Left Behind-School mental health connections.

    Science.gov (United States)

    Daly, Brian P; Burke, Robert; Hare, Isadora; Mills, Carrie; Owens, Celeste; Moore, Elizabeth; Weist, Mark D

    2006-11-01

    The No Child Left Behind Act of 2001 was signed into law by President George W. Bush in January 2002 and is regarded as the most significant federal education policy initiative in a generation. The primary focus of the No Child Left Behind Act is on promoting educational success for all children; however, the legislation also contains opportunities to advance school-based mental health. Unfortunately, the complexities of the provisions of the No Child Left Behind Act have made it difficult for educators, stakeholders, and mental health professionals to understand the legal and practical interface between No Child Left Behind and the school mental health movement. Therefore, the goals of this article are to (1) raise awareness about the challenges educators and school mental health professionals face as a result of the implementation of No Child Left Behind and (2) provide ideas and recommendations to advance the interface between No Child Left Behind and school mental health, which will support key provisions of the act and the growth of the field.

  5. Temporal order processing of syllables in the left parietal lobe.

    Science.gov (United States)

    Moser, Dana; Baker, Julie M; Sanchez, Carmen E; Rorden, Chris; Fridriksson, Julius

    2009-10-07

    Speech processing requires the temporal parsing of syllable order. Individuals suffering from posterior left hemisphere brain injury often exhibit temporal processing deficits as well as language deficits. Although the right posterior inferior parietal lobe has been implicated in temporal order judgments (TOJs) of visual information, there is limited evidence to support the role of the left inferior parietal lobe (IPL) in processing syllable order. The purpose of this study was to examine whether the left inferior parietal lobe is recruited during temporal order judgments of speech stimuli. Functional magnetic resonance imaging data were collected on 14 normal participants while they completed the following forced-choice tasks: (1) syllable order of multisyllabic pseudowords, (2) syllable identification of single syllables, and (3) gender identification of both multisyllabic and monosyllabic speech stimuli. Results revealed increased neural recruitment in the left inferior parietal lobe when participants made judgments about syllable order compared with both syllable identification and gender identification. These findings suggest that the left inferior parietal lobe plays an important role in processing syllable order and support the hypothesized role of this region as an interface between auditory speech and the articulatory code. Furthermore, a breakdown in this interface may explain some components of the speech deficits observed after posterior damage to the left hemisphere.

  6. Preterm Delivery in the Setting of Left Calyceal Rupture

    Directory of Open Access Journals (Sweden)

    Brent Hanson

    2015-01-01

    Full Text Available Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient’s worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient’s flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided.

  7. The new left and democracy in Latin America

    Directory of Open Access Journals (Sweden)

    Francisco Panizza

    2009-05-01

    Full Text Available Without embarking on a theoretical debate over the meaning of the term, it is obvious that the left is on the rise in Latin America. However, we should not ignore the fact that the coming to power of left-wing and centre-left parties and movements presents a certain amount of paradoxes and questions. One of the most important of the many paradoxes is the fact that, in spite of the leftwards electoral shift in the region, there is no evidence that the electorate of Latin America has moved to the left in a significant manner. As for the questions, these concern the connection between left-wing governments and democracy, and especially the future challenges that these governments must face to preserve and develop democracy. In an attempt to unravel the paradox and answer these questions, this article examines the roots, contexts and political challenges of left-wing governments in Latin America. To this end, the author analyses a number of issues, such as the tensions between different logics of political representation and their implications for democracy, in addition to discussing the conditions under which the tensions between the different logics of political representation can contribute (or not to the developing of democracy in the region.

  8. Phonological decisions require both the left and right supramarginal gyri.

    Science.gov (United States)

    Hartwigsen, Gesa; Baumgaertner, Annette; Price, Cathy J; Koehnke, Maria; Ulmer, Stephan; Siebner, Hartwig R

    2010-09-21

    Recent functional imaging studies demonstrated that both the left and right supramarginal gyri (SMG) are activated when healthy right-handed subjects make phonological word decisions. However, lesion studies typically report difficulties with phonological processing after left rather than right hemisphere damage. Here, we used a unique dual-site transcranial magnetic stimulation (TMS) approach to test whether the SMG in the right hemisphere contributes to modality-independent (i.e., auditory and visual) phonological decisions. To test task-specificity, we compared the effect of real or sham TMS during phonological, semantic, and perceptual decisions. To test laterality and anatomical specificity, we compared the effect of TMS over the left, right, or bilateral SMG and angular gyri. The accuracy and reaction times of phonological decisions were selectively disrupted relative to semantic and perceptual decisions when real TMS was applied over the left, right, or bilateral SMG. These effects were not observed for TMS over the angular gyri. A follow-up experiment indicated that the threshold-intensity for inducing a disruptive effect on phonological decisions was identical for unilateral TMS over the right or left SMG. Taken together, these findings provide converging evidence that the right SMG contributes to accurate and efficient phonological decisions in the healthy brain, with no evidence that the left and right SMG can compensate for one another during TMS. Our findings motivate detailed studies of phonological processing in patients with acute or long-term damage of the right SMG.

  9. Radical Left in Albania and Kosovo: Differences and Similarities

    Directory of Open Access Journals (Sweden)

    Këlliçi Klejd

    2017-06-01

    Full Text Available The main research question for this paper is: Are there radical left wing movements in Albania and Kosovo and what are their main traits? Through answering this question, we will explore the development (or lack thereof of radical left wing movements. With radical left we intend movements that reject the underlying socio-economic structure of contemporary capitalism and its values and practices without opposing democracy. Through a thorough desk research and several interviews with experts and activists both in Albania and Kosovo, we look at the two case Political Opportunity Structures to study the emergence, the strategies, success or failures of the radical left. In Albania the radical left has been in decline since 1992, with only a recent revival from 2009 on. In Kosovo, the Lëvizja Vetëvendojse! (Self-Determination Movement, a civil movement transformed in a party, has succeeded in imposing its left agenda. Both cases employ a new rhetoric unrelated to the past communist regimes thus changing the perspective of political debate in both countries.

  10. Left versus right deceased donor renal allograft outcome.

    LENUS (Irish Health Repository)

    Phelan, Paul J

    2009-12-01

    It has been suggested that the left kidney is easier to transplant than the right kidney because of the longer length of the left renal vein, facilitating the formation of the venous anastomosis. There are conflicting reports of differing renal allograft outcomes based on the side of donor kidney transplanted (left or right).We sought to determine the effect of side of donor kidney on early and late allograft outcome in our renal transplant population. We performed a retrospective analysis of transplanted left-right deceased donor kidney pairs in Ireland between January 1, 1998 and December 31, 2008. We used a time to death-censored graft failure approach for long-term allograft survival and also examined serum creatinine at different time points post-transplantation. All outcomes were included from day of transplant onwards. A total of 646 transplants were performed from 323 donors. The incidence of delayed graft function was 16.1% in both groups and there was no significant difference in acute rejection episodes or serum creatinine from 1 month to 8 years post-transplantation.There were 47 death-censored allograft failures in the left-sided group compared to 57 in the right-sided group (P = 0.24). These observations show no difference in renal transplant outcome between the recipients of left- and right-sided deceased donor kidneys.

  11. MYOCARDIAL DEFORMATION AND COMPLETE LEFT BUNDLE BRANCH BLOCK

    Directory of Open Access Journals (Sweden)

    E. N. Pavlyukova

    2015-12-01

    Full Text Available Tissue Doppler imaging is evolving as a useful echocardiographic tool for quantitative assessment of left ventricular systolic and diastolic function. Over the last 10 years, myocardial deformation imaging has become possible initially with tissue Doppler , and more recently with myocardial speckle-tracking using 2D echocardiography. Unlike simple tissue velocity measurements, deformation measurements are specific for the region of interest. Strain rate or strain measurements have been used as sensitive indicators for subclinical diseases, and it is the most widely used tool to assess mechanical dyssynchrony. Left bundle branch block is a frequent, etiologically heterogeneous, clinically hostile and diagnostically challenging entity. About 2% of patients underwent cardiac stress testing show stable or intermittent left bundle branch block. Presence of left bundle branch block is associated with a lower and slower diastolic coronary flow velocity especially during hyperemia. Stress echocardiography is the best option for the diagnosis of ischemic heart disease, albeit specificity and sensitivity reduce in patients with left bundle branch block in the territory of left anterior descending artery in presence of initial septum dyskinesia.

  12. Comparative efficacy of amiodarone with ivabradin combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation recurrence in pa- tients with left ventricular diastolic dysfunction

    Directory of Open Access Journals (Sweden)

    K. G. Adamyan

    2015-01-01

    Full Text Available Aim. To study the efficacy of use of amiodarone with ivabradine combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation (AF recurrence in patients (pts with left ventricular diastolic dysfunction (LVDD after conversion to sinus rhythm. Material and methods. 65 patients (40 males, 25 females aged 53±8 years with persistent AF and LVDD were included into the study and randomized into 3 groups to receive ivabradine and amiodarone (22 pts, bisoprolol and amiodarone (22 pts or amiodarone alone (21 pts. Left atrium (LA volume indices, LA longitudinal strain rate (LASR in systole, LV mass index, mean heart rate (HR, 24-hour HR variability and the incidence of AF by 96 h ECG monitoring were measured after the titration period, and after 3 and 6 months of follow-up. Results. After 6 months of follow-up group 1 revealed significantly lower maximum LA volume index (21.3±2.4 vs 25.2±3.0 and 28.7±3.6 ml/m2 in the 2nd and control groups, respectively, P-wave LA volume index (15.3±3.5 versus 18.1±3.8 and 20.4±4.0 ml/m2 in the 2nd and control groups, respectively, and LA systolic volume index (7.3±1.2 versus 9.4±1.6 and 9.6±1.7 ml/m2 in 2nd and control groups, respectively. The incidence of side effects in group 1 was significantly less than that in group 2 and was not different compared with control group. Conclusion. Ivabradine and amiodarone combination provides better prevention of AF recurrence and less side-effects in pts with LVDD and persistent AF after sinus rhythm restoration as compared with bisoprolol and amiodarone combination, it also reduces LA maximum, conduit and systolic volumes, and increases LASR.

  13. Relationship of left ventricular systolic function to persistence or development of electrocardiographic left ventricular hypertrophy in hypertensive patients

    DEFF Research Database (Denmark)

    Okin, Peter M; Wachtell, Kristian; Gerdts, Eva

    2014-01-01

    left ventricular systolic function in patients with new or persistent ECG LVH. METHODS: Baseline and year-3 ECG LVH and left ventricular midwall shortening (MWS) were examined in 725 hypertensive patients in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic...... 1.03-3.50, P = 0.040) at year 3. CONCLUSION: Persistence or development of new ECG LVH during antihypertensive therapy is associated with an increased risk of left ventricular systolic dysfunction after 3 years' follow-up. These findings provide insight into a possible mechanism by which changes......BACKGROUND: Persistence or development of ECG left ventricular hypertrophy (LVH) by Cornell product criteria is associated with an increased risk of developing heart failure compared with regression or continued absence of LVH. We postulated that this association might be in part mediated via worse...

  14. Is there any relationship between right and left hand dominance and right and left nasal airflow dominance?

    Science.gov (United States)

    Price, A; Eccles, R

    2017-10-01

    Left- or right-handedness is a common human trait, and it has been previously reported that human nasal airflow dominance correlates with hand dominance. Any relationship between hand dominance and nasal airflow dominance would be unusual. This study aimed to measure nasal airflow and look for any relationship to handedness. The modified Glatzel mirror was used to record the dominant nasal passage at 15-minute intervals over a 6-hour period in 29 healthy participants consisting of 15 left-handers and 14 right-handers. In left-handers, the percentage of time that the left nasal passage was dominant ranged from 0 to 100 per cent. In right-handers, the percentage of time that the right nasal passage was dominant ranged from 4.2 to 95.8 per cent. No correlation between nasal airflow dominance and hand dominance was identified. The results do not support the hypothesis that nasal airflow and handedness are related.

  15. Longitudinal strain predicts left ventricular mass regression after aortic valve replacement for severe aortic stenosis and preserved left ventricular function.

    Science.gov (United States)

    Gelsomino, Sandro; Lucà, Fabiana; Parise, Orlando; Lorusso, Roberto; Rao, Carmelo Massimiliano; Vizzardi, Enrico; Gensini, Gian Franco; Maessen, Jos G

    2013-11-01

    We explored the influence of global longitudinal strain (GLS) measured with two-dimensional speckle-tracking echocardiography on left ventricular mass regression (LVMR) in patients with pure aortic stenosis (AS) and normal left ventricular function undergoing aortic valve replacement (AVR). The study population included 83 patients with severe AS (aortic valve area regression (all P regression in patients with pure AS undergoing AVR. Our findings must be confirmed by further larger studies.

  16. Ultrasound-guided catheterization of the left subclavian vein without recognition of persistent left superior vena cava

    OpenAIRE

    Park, Sun Young; Yoo, Jae Hwa; Kim, Mun Gyu; Kim, Sang Ho; Park, Byoung-Won; Oh, Hong Chul; Kim, Hojoon

    2017-01-01

    Abstract Rationale: A persistent left superior vena cava (PLSVC) is rare, but the most common thoracic venous anomaly. We report a case of PLSVC unrecognized during left subclavian vein catheterization using real-time ultrasound-guided supraclavicular approach. Patient concerns: A 79-year-old man with history of hypertension presented with traumatic subdural hemorrhage, subarachnoid hemorrhage, and epidural hemorrhage. Before the operation, a central venous catheter (CVC) was placed into the ...

  17. Left Ulnar Artery Pseudoaneurysm and Left Hand Swelling Simulated by Elephantiasis in a Patient with Neurofibromatosis Type 1

    Directory of Open Access Journals (Sweden)

    Ta-Pin Lee

    2017-06-01

    Full Text Available Elephantiasis is a condition featured by gross enlargement of body parts to massive proportions. Neurofibromatosis type 1 (NF1 is a multisystem genetic disorder. Vascular anomaly is one among the complications of NF1. We report a case of NF1 who had a left hand vascular pseudoaneurysm with left hand swelling mimicking elephantiasis. The characteristics of sonography make it an excellent imaging modality to investigate this sort of superficial vascular lesion.

  18. Modulation of left primary motor cortex excitability after bimanual training and intermittent theta burst stimulation to left dorsal premotor cortex.

    Science.gov (United States)

    Neva, Jason L; Vesia, Michael; Singh, Amaya M; Staines, W Richard

    2014-03-15

    Bimanual visuomotor movement training (BMT) enhances the excitability of human preparatory premotor and primary motor (M1) cortices compared to unimanual movement. This occurs when BMT involves mirror symmetrical movements of both upper-limbs (in-phase) but not with non-symmetrical movements (anti-phase). The neural mechanisms mediating the effect of BMT is unclear, but may involve interhemispheric connections between homologous M1 representations as well as the dorsal premotor cortices (PMd). The purpose of this study is to assess how intermittent theta burst stimulation (iTBS) of the left PMd affects left M1 excitability, and the possible combined effects of iTBS to left PMd applied before a single session of BMT. Left M1 excitability was quantified using transcranial magnetic stimulation (TMS) in terms of both the amplitudes and spatial extent of motor evoked potentials (MEPs) for the extensor carpi radialis (ECR) before and multiple time points following (1) BMT, (2) iTBS to left PMd or (3) iTBS to left PMd and BMT. Although there was not a greater increase in either specific measure of M1 excitability due to the combination of the interventions, iTBS applied before BMT showed that both the spatial extent and global MEP amplitude for the ECR became larger in parallel, whereas the spatial extent was enhanced with BMT alone and global MEP amplitude was enhanced with iTBS to left PMd alone. These results suggest that the modulation of rapid functional M1 excitability associated with BMT and iTBS of the left PMd could operate under related early markers of neuro-plastic mechanisms, which may be expressed in concurrent and distinct patterns of M1 excitability. Critically, this work may guide rehabilitation training and stimulation techniques that modulate cortical excitability after brain injury. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. CT findings of a displaced left upper division bronchus in adults: Its importance for performing safe left pulmonary surgery

    Energy Technology Data Exchange (ETDEWEB)

    Oshiro, Yasuji, E-mail: oshiro4211@yahoo.co.jp [Department of Radiology, National Hospital Organization Okinawa Hospital, 20-14 Ganeko 3-chome, Ginowan city, Okinawa 901-2214 (Japan); Murayama, Sadayuki [Department of Radiology, University of the Ryukus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa 903-0215 (Japan); Ohta, Morio [Department of Surgery, Nakagami Hospital, 6-25-5 Chibana, Okinawa-city, Okinawa 904-2195 (Japan); Teruya, Takao [Second Department of Surgery, University of the Ryukus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa 903-0215 (Japan)

    2013-08-15

    Purpose: The aim of this study was to describe the CT findings of a displaced left upper division bronchus (DLUDB) in adults. Materials and methods: Ten patients with DLUDB were identified. The following CT features were assessed: origin of the DLUDB; distance between the origin of the DLUDB and the origin of the left upper lobe (LUL) bronchus; height of the origin of the DLUDB against the left pulmonary artery (LPA); difference of the main bronchial length; ventilated segment; course of the left pulmonary artery against the DLUDB; and presence of an accessory fissure or other anomalies. Results: DLUDB arose from the posterolateral or lateral aspect of the left main bronchus immediately proximal to the origin of the LUL bronchus. It tended to course along the posterior wall of the LPA and to ventilate the apicoposterior segment with or without the anterior segment. The LPA passed between the displaced bronchus and the lingular bronchus. The origin of the DLUDB was located lower than the inferior wall of the proximal LPA in 6 patients. The accessory fissure between the associated segment and remaining part of the LUL and right tracheal bronchus coexisted in 7 and 3 patients respectively. Conclusion: DLUDB has characteristic findings on CT. Radiologists should be aware of this entity and inform the surgeon as it can prevent serious complications in a patient who may undergo lobectomy of the left lung.

  20. CT findings of a displaced left upper division bronchus in adults: Its importance for performing safe left pulmonary surgery

    International Nuclear Information System (INIS)

    Oshiro, Yasuji; Murayama, Sadayuki; Ohta, Morio; Teruya, Takao

    2013-01-01

    Purpose: The aim of this study was to describe the CT findings of a displaced left upper division bronchus (DLUDB) in adults. Materials and methods: Ten patients with DLUDB were identified. The following CT features were assessed: origin of the DLUDB; distance between the origin of the DLUDB and the origin of the left upper lobe (LUL) bronchus; height of the origin of the DLUDB against the left pulmonary artery (LPA); difference of the main bronchial length; ventilated segment; course of the left pulmonary artery against the DLUDB; and presence of an accessory fissure or other anomalies. Results: DLUDB arose from the posterolateral or lateral aspect of the left main bronchus immediately proximal to the origin of the LUL bronchus. It tended to course along the posterior wall of the LPA and to ventilate the apicoposterior segment with or without the anterior segment. The LPA passed between the displaced bronchus and the lingular bronchus. The origin of the DLUDB was located lower than the inferior wall of the proximal LPA in 6 patients. The accessory fissure between the associated segment and remaining part of the LUL and right tracheal bronchus coexisted in 7 and 3 patients respectively. Conclusion: DLUDB has characteristic findings on CT. Radiologists should be aware of this entity and inform the surgeon as it can prevent serious complications in a patient who may undergo lobectomy of the left lung

  1. Evaluation of left ventricular function by digital subtraction angiography

    International Nuclear Information System (INIS)

    Kuribayashi, Sachio; Ootaki, Makoto; Matsuyama, Seiya; Kanemoto, Nariaki; Furuya, Hideo

    1985-01-01

    Effects of contrast medium doses on left ventriculographic images using intravenous digital subtraction angiography (IVDSA-LVG) were assessed. The validity of IVDSA-LVG in evaluating ejection fraction (FF) and left ventricular regional wall motion was determined by comparison with conventional left ventriculography using direct injection (direct LVG). The advantages of left ventriculography using intraarterial subtraction angiography (IADSA-LVG) performed by injecting small doses of contrast media directly into the left ventricle were stressed. 1. To assess the effects of doses of contrast media on IVDSA-LVG, 10, 20, and 30 ml Urografin-76 were injected into the superior vena cava in 16 patients, and the resulting images were compared in each patient. With only 10 ml contrast medium, left ventricular opacification was fairly good, and regional wall motion was evaluated in many cases, but 30 ml were needed to calculate ventricular volume and EF. 2. To determine the validity of IVDSA-LVG in evaluating EF and regional wall motion, we compared IVDSA-LVG using 30 ml of contrast medium with direct LVG in 18 patients. There was a good correlation between the two methods in determining EF (r = 0.877), and 90 % of the interpretations of regional wall motion were in agreement by the two methods. IVDSA-LVG was useful and accurate in evaluating EF and regional wall motion of the left ventricle. 3. IADSA-LVG was performed for five patients, and good quality images were obtained in many cases, even with relatively small doses (10 ml) of contrast media. These results suggested that this method may be used in cases with impaired LV function, to avoid hemodynamic derangement induced by conventional direct LVG using large doses of contrast medium. (author)

  2. Improving left spatial neglect through music scale playing.

    Science.gov (United States)

    Bernardi, Nicolò Francesco; Cioffi, Maria Cristina; Ronchi, Roberta; Maravita, Angelo; Bricolo, Emanuela; Zigiotto, Luca; Perucca, Laura; Vallar, Giuseppe

    2017-03-01

    The study assessed whether the auditory reference provided by a music scale could improve spatial exploration of a standard musical instrument keyboard in right-brain-damaged patients with left spatial neglect. As performing music scales involves the production of predictable successive pitches, the expectation of the subsequent note may facilitate patients to explore a larger extension of space in the left affected side, during the production of music scales from right to left. Eleven right-brain-damaged stroke patients with left spatial neglect, 12 patients without neglect, and 12 age-matched healthy participants played descending scales on a music keyboard. In a counterbalanced design, the participants' exploratory performance was assessed while producing scales in three feedback conditions: With congruent sound, no-sound, or random sound feedback provided by the keyboard. The number of keys played and the timing of key press were recorded. Spatial exploration by patients with left neglect was superior with congruent sound feedback, compared to both Silence and Random sound conditions. Both the congruent and incongruent sound conditions were associated with a greater deceleration in all groups. The frame provided by the music scale improves exploration of the left side of space, contralateral to the right hemisphere, damaged in patients with left neglect. Performing a scale with congruent sounds may trigger at some extent preserved auditory and spatial multisensory representations of successive sounds, thus influencing the time course of space scanning, and ultimately resulting in a more extensive spatial exploration. These findings offer new perspectives also for the rehabilitation of the disorder. © 2015 The British Psychological Society.

  3. Balloon-occluded retrograde transvenous obliteration of gastric varix draining via the left inferior phrenic vein into the left hepatic vein

    International Nuclear Information System (INIS)

    Ibukuro, Kenji; Mori, Koichi; Tsukiyama, Toshitaka; Inoue, Yoshihiro; Iwamoto, Yukako; Tagawa, Kazumi

    1999-01-01

    We encountered a patient with gastric varix draining not via the usual left suprarenal vein but via the left inferior phrenic vein joining the left hepatic vein. Transfemoral balloon-occluded retrograde transvenous obliteration (BRTO) of the varix was performed under balloon occlusion of the left inferior phrenic vein via the left hepatic vein and retrograde injection of the sclerosing agent (5% of ethanolamine oleate) into the gastric varix. Disappearance of the gastric varix was confirmed on endoscopic examination 2 months later.

  4. Evaluation of left ventricular function using digital subtraction ventriculography

    International Nuclear Information System (INIS)

    Yiannikas, J.; Detrano, R.

    1986-01-01

    Digital subtraction ventriculography following injections of contrast via peripheral veins provides excellent images to assess left ventricular function. The images are essentially identical to those following DCV, but allow more uniform mixing of contrast in the left ventricular chamber. Furthermore, few, if any, cardiac arrhythmias occur, hence obviating difficulties that arise from DCV. The spatial resolution of the method is such that regional wall motion assessment of ventricular function is more accurate than that of other noninvasive imaging methods. The use of video-densitometry allows accurate assessment of left ventricular function even when the left ventricular cavity is nonsymmetrically deformed and aneurysmal. In the setting of the cardiac catheterization laboratory, digital ventriculography may provide a safer means of assessing left ventricular function when critical coronary or myocardial disease is present and allows multiple assessments of ventricular function during the same study. Although excellent correlations with standard ventriculography have been noted by all workers, significant discrepancies still exist in individual patients, particularly in the calculations of end diastolic volumes. In the authors experience and in those of most workers, the largest discrepancies existed in patients in whom suboptimal studies are included for analysis. The most frequent reason for the occasional suboptimal study as with all digital subtraction work is the misregistration that results from motion

  5. CT assessment of tracheobronchial anomaly in left pulmonary artery sling

    Energy Technology Data Exchange (ETDEWEB)

    Zhong, Yu-Min M.; Zhu, Ming; Sun, Ai-Min M.; Wang, Qian [Shanghai Jiao Tong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China); Jaffe, Richard B. [Primary Children' s Medical Center, Department of Medical Imaging, Salt Lake City, UT (United States); Gao, Wei [Shanghai Jiao Tong University School of Medicine, Department of Cardiology, Shanghai Children' s Medical Center, Shanghai (China)

    2010-11-15

    The left pulmonary artery sling (LPAS) is a rare vascular anomaly where the left pulmonary artery arises from the right pulmonary artery, passes over the right bronchus, and goes posteriorly between the trachea and esophagus. The LPAS is frequently associated with cardiac and non-cardiac defects including tracheobronchial abnormalities. To evaluate the utility of multislice CT (MSCT) and helical CT (HCT) in diagnosing and defining the tracheobronchial anomaly and anatomic relationships between the trachea and aberrant left pulmonary artery. MSCT or HCT was performed in 27 children to determine the tracheobronchial anatomy and identify tracheobronchial stenosis. Eighteen children underwent surgery. According to the Wells [6] classification of LPAS, which includes two main types and two subtypes, there were eight cases of type 1A, five cases of type 1B, six cases of type 2A and eight cases of type 2B in this group. Twenty-four of the 27 children had substantial tracheobronchial stenosis. Four died before surgery; the 18 had reanastomosis of the left pulmonary artery. Five children also had tracheoplasty; three died after surgery. CT, especially MSCT, is an ideal modality for simultaneously identifying aberrant left pulmonary artery and any associated tracheobronchial anomaly. The Wells classification is useful for operative planning. (orig.)

  6. Etiological aspect of left-handedness in adolescents

    Directory of Open Access Journals (Sweden)

    Dragović Milan

    2013-01-01

    Full Text Available Introduction. Lateralization of brain functions such as language and manual dominance (hand preferences and fine motor control are most likely under genetic control. However, this does not preclude the effect of various environmental factors on functional brain lateralization. A strong association of non-right-handedness (left- and mixed-handedness with various neurodevelopmental conditions (e.g. schizophrenia, autism, Rett syndrome implies that in some cases, non-right-handedness may be acquired rather than inherited (i.e., pathologically determined. Objective. The aim of the study was: (a re-investigation of several known risk factors for left-handedness (age of mother and/or father, twin pregnancies, and birth order, and (b examination of hitherto uninvestigated factors (type of birth, Apgar score, maternal smoking during pregnancy. Methods. Putative, causative environmental agents for this shift in manual distributions are explored in a sample of 1031 high school students (404 males and 627 females from Belgrade. Both pre-existing (age of parents, twin pregnancy, and birth order and new (Apgar score, maternal smoking, type of birth putative agents are examined. Results. We found that maternal smoking and low Apgar score (2-6 can significantly increase risk for left-handedness (p=0.046 and p=0.042, respectively. The remaining factors showed no significant association with left-handedness in adolescents. Conclusion. Our study clearly demonstrates that left-handedness may be related to maternal smoking during pregnancy and a low Apgar score on birth.

  7. Etiological aspect of left-handedness in adolescents.

    Science.gov (United States)

    Dragović, Milan; Milenković, Sanja; Kocijancić, Dusica; Zlatko, Sram

    2013-01-01

    Lateralization of brain functions such as language and manual dominance (hand preferences and fine motor control) are most likely under genetic control. However, this does not preclude the effect of various environmental factors on functional brain lateralization. A strong association of non-right-handedness (left- and mixed-handedness) with various neurodevelopmental conditions (e.g. schizophrenia, autism, Rett syndrome) implies that in some cases, non-right-handedness may be acquired rather than inherited (i.e., pathologically determined). The aim of the study was: (a) re-investigation of several known risk factors for left-handedness (age of mother and/or father, twin pregnancies, and birth order), and (b) examination of hitherto uninvestigated factors (type of birth, Apgar score, maternal smoking during pregnancy). Putative, causative environmental agents for this shift in manual distributions are explored in a sample of 1031 high school students (404 males and 627 females) from Belgrade. Both pre-existing (age of parents, twin pregnancy, and birth order) and new (Apgar score, maternal smoking, type of birth) putative agents are examined. We found that maternal smoking and low Apgar score (2-6) can significantly increase risk for left-handedness (p=0.046 and p=0.042, respectively).The remaining factors showed no significant association with left-handedness in adolescents. Our study clearly demonstrates that left-handedness may be related to maternal smoking during pregnancy and a low Apgar score on birth.

  8. Prevalence of left-sided melanomas in an Irish population.

    LENUS (Irish Health Repository)

    de Blacam, C

    2012-02-01

    BACKGROUND: A predominance of melanomas on the left side of the body has recently been described. No associations between tumour laterality and gender, age or anatomical site have been identified. AIM: The aim of this study was to investigate the prevalence of left-sided melanomas in an Irish population and to examine potential associations with various patient and tumour characteristics. METHODS: A retrospective chart review of patients with cutaneous melanoma who were treated over a 10-year period was carried out. Lateral distribution of melanoma on either side of the body was compared using chi(2) analysis and evaluated by gender, age group, anatomic location, histologic subtype and Breslow depth. RESULTS: More melanomas occurred on the left side (57%, P = 0.015), and this finding was particularly significant in females. For both genders combined, there were no statistically significant differences in laterality by age group, anatomic location, type of melanoma and Breslow depth. There were significantly more superficial spreading melanomas on the left side in both men and women. CONCLUSIONS: This study demonstrates a predominance of left-sided melanomas in Irish patients. While a number of demographic and molecular associations have been proposed, further research is required to fully explain this phenomenon.

  9. Prevalence of left-sided melanomas in an Irish population.

    LENUS (Irish Health Repository)

    de Blacam, C

    2011-04-17

    BACKGROUND: A predominance of melanomas on the left side of the body has recently been described. No associations between tumour laterality and gender, age or anatomical site have been identified. AIM: The aim of this study was to investigate the prevalence of left-sided melanomas in an Irish population and to examine potential associations with various patient and tumour characteristics. METHODS: A retrospective chart review of patients with cutaneous melanoma who were treated over a 10-year period was carried out. Lateral distribution of melanoma on either side of the body was compared using χ(2) analysis and evaluated by gender, age group, anatomic location, histologic subtype and Breslow depth. RESULTS: More melanomas occurred on the left side (57%, P = 0.015), and this finding was particularly significant in females. For both genders combined, there were no statistically significant differences in laterality by age group, anatomic location, type of melanoma and Breslow depth. There were significantly more superficial spreading melanomas on the left side in both men and women. CONCLUSIONS: This study demonstrates a predominance of left-sided melanomas in Irish patients. While a number of demographic and molecular associations have been proposed, further research is required to fully explain this phenomenon.

  10. Enhanced activation of the left hemisphere promotes normative decision making.

    Science.gov (United States)

    Corser, Ryan; Jasper, John D

    2014-01-01

    Previous studies have reported that enhanced activation of the left cerebral hemisphere reduces risky-choice, attribute, and goal-framing effects relative to enhanced activation of the right cerebral hemisphere. The present study sought to extend these findings and show that enhanced activation of the left hemisphere also reduces violations of other normative principles, besides the invariance principle. Participants completed ratio bias (Experiment 1, N = 296) and base rate neglect problems (Experiment 2, N = 145) under normal (control) viewing or with the right or left hemisphere primarily activated by imposing a unidirectional gaze. In Experiment 1 we found that enhanced left hemispheric activation reduced the ratio bias relative to normal viewing and a group experiencing enhanced right hemispheric activation. In Experiment 2 enhanced left hemispheric activation resulted in using base rates more than normal viewing, but not significantly more than enhanced right hemispheric activation. Results suggest that hemispheric asymmetries can affect higher-order cognitive processes, such as decision-making biases. Possible theoretical accounts are discussed as well as implications for dual-process theories.

  11. Correlation of vocals and lyrics with left temporal musicogenic epilepsy.

    Science.gov (United States)

    Tseng, Wei-En J; Lim, Siew-Na; Chen, Lu-An; Jou, Shuo-Bin; Hsieh, Hsiang-Yao; Cheng, Mei-Yun; Chang, Chun-Wei; Li, Han-Tao; Chiang, Hsing-I; Wu, Tony

    2018-03-15

    Whether the cognitive processing of music and speech relies on shared or distinct neuronal mechanisms remains unclear. Music and language processing in the brain are right and left temporal functions, respectively. We studied patients with musicogenic epilepsy (ME) that was specifically triggered by popular songs to analyze brain hyperexcitability triggered by specific stimuli. The study included two men and one woman (all right-handed, aged 35-55 years). The patients had sound-triggered left temporal ME in response to popular songs with vocals, but not to instrumental, classical, or nonvocal piano solo versions of the same song. Sentimental lyrics, high-pitched singing, specificity/familiarity, and singing in the native language were the most significant triggering factors. We found that recognition of the human voice and analysis of lyrics are important causal factors in left temporal ME and provide observational evidence that sounds with speech structure are predominantly processed in the left temporal lobe. A literature review indicated that language-associated stimuli triggered ME in the left temporal epileptogenic zone at a nearly twofold higher rate compared with the right temporal region. Further research on ME may enhance understanding of the cognitive neuroscience of music. © 2018 New York Academy of Sciences.

  12. Caffeine improves left hemisphere processing of positive words.

    Science.gov (United States)

    Kuchinke, Lars; Lux, Vanessa

    2012-01-01

    A positivity advantage is known in emotional word recognition in that positive words are consistently processed faster and with fewer errors compared to emotionally neutral words. A similar advantage is not evident for negative words. Results of divided visual field studies, where stimuli are presented in either the left or right visual field and are initially processed by the contra-lateral brain hemisphere, point to a specificity of the language-dominant left hemisphere. The present study examined this effect by showing that the intake of caffeine further enhanced the recognition performance of positive, but not negative or neutral stimuli compared to a placebo control group. Because this effect was only present in the right visual field/left hemisphere condition, and based on the close link between caffeine intake and dopaminergic transmission, this result points to a dopaminergic explanation of the positivity advantage in emotional word recognition.

  13. Novel nonsurgical left ventricular assist device and system.

    Science.gov (United States)

    Misiri, Juna; DeSimone, Christopher V; Park, Soon J; Kushwaha, Sudhir S; Friedman, Paul A; Bruce, Charles J; Asirvatham, Samuel J

    2013-01-01

    Treatment options for advanced stages of congestive heart failure remain limited. Left ventricular assist devices (LVADs) have emerged as a means to support failing circulation. However, these devices are not without significant risk such as major open chest surgery. We utilized a novel approach for device placement at the aorto-left atria continuity as a site to create a conduit capable of accommodating a percutaneous LVAD system. We designed and developed an expandable nitinol based device for placement at this site to create a shunt between the LA and aorta. Our experiments support this anatomic location as an accessible and feasible site for accommodation of an entirely percutaneous LVAD. The novelty of this approach would bypass the left ventricle, and thereby minimize complications and morbidities associated with current LVAD placement. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Anomalous Origin of Left Coronary Artery from Pulmonary Artery (ALCAPA)

    International Nuclear Information System (INIS)

    Younus, Z.; Ahmed, I.; Iftikhar, R.

    2013-01-01

    Anomalous origin of the left coronary artery from the pulmonary artery also recognized as Bland White Garland syndrome is a very rare congenital condition. A two-months old baby boy presented with dyspnoea for two weeks and a pansystolic murmur on auscultation. The base line investigations showed cardiomegaly and bilateral basal haze on X-ray chest. ECG showed ST elevation in leads l and AVl and echocardiography showed situs solitus, levocardia, hypokinetic intraventricular septum, ejection fraction of 30%, mitral regurgitation of grade-I and an anomalous origin of the left coronary artery from pulmonary artery was diagnosed. Patient was in left heart failure. It was rectified surgically by creating a transpulmonary tunnel (Takeuchi repair). Postoperative course was uneventful and he was finally discharged in stable condition. (author)

  15. Evolving Concepts of Pulmonary Hypertension Secondary to Left Heart Disease.

    Science.gov (United States)

    Ramu, Bhavadharini; Thenappan, Thenappan

    2016-04-01

    Pulmonary hypertension associated with left heart disease is the most common form of pulmonary hypertension. Although its pathophysiology remains incompletely understood, it is now well recognized that the presence of pulmonary hypertension is associated with a worse prognosis. Right ventricular failure has independent and additive prognostic value over pulmonary hypertension for adverse outcomes in left heart disease. Recently, several new terminologies have been introduced to better define and characterize the nature and severity of pulmonary hypertension. Several new treatment options including the use of pulmonary arterial hypertension specific therapies are being considered, but there is lack of evidence. Here, we review the recent advances in this field and summarize the diagnostic and therapeutic modalities of use in the management of pulmonary hypertension associated with left heart disease.

  16. Left-Handed W bosons at the LHC

    International Nuclear Information System (INIS)

    Dixon, Lance

    2011-01-01

    The production of W bosons in association with jets is an important background to new physics at the LHC. Events in which the W carries large transverse momentum and decays leptonically lead to large missing energy and are of particular importance. We show that the left-handed nature of the W coupling, combined with valence quark domination at a pp machine, leads to a large left-handed polarization for both W + and W - bosons at large transverse momenta. The polarization fractions are very stable with respect to QCD corrections. The leptonic decay of the W +- bosons translates the common left-handed polarization into a strong asymmetry in transverse momentum distributions between positrons and electrons, and between neutrinos and anti-neutrinos (missing transverse energy). Such asymmetries may provide an effective experimental handle on separating W +jets from top quark production, which exhibits very little asymmetry due to C invariance, and from various types of new physics.

  17. Left-right correlation in coupled F-center defects.

    Science.gov (United States)

    Janesko, Benjamin G

    2016-08-07

    This work explores how left-right correlation, a textbook problem in electronic structure theory, manifests in a textbook example of electrons trapped in crystal defects. I show that adjacent F-center defects in lithium fluoride display symptoms of "strong" left-right correlation, symptoms similar to those seen in stretched H2. Simulations of UV/visible absorption spectra qualitatively fail to reproduce experiment unless left-right correlation is taken into account. This is of interest to both the electronic structure theory and crystal-defect communities. Theorists have a new well-behaved system to test their methods. Crystal-defect groups are cautioned that the approximations that successfully model single F-centers may fail for adjacent F-centers.

  18. Left-right correlation in coupled F-center defects

    International Nuclear Information System (INIS)

    Janesko, Benjamin G.

    2016-01-01

    This work explores how left-right correlation, a textbook problem in electronic structure theory, manifests in a textbook example of electrons trapped in crystal defects. I show that adjacent F-center defects in lithium fluoride display symptoms of “strong” left-right correlation, symptoms similar to those seen in stretched H 2 . Simulations of UV/visible absorption spectra qualitatively fail to reproduce experiment unless left-right correlation is taken into account. This is of interest to both the electronic structure theory and crystal-defect communities. Theorists have a new well-behaved system to test their methods. Crystal-defect groups are cautioned that the approximations that successfully model single F-centers may fail for adjacent F-centers.

  19. Left-right entanglement entropy of Dp-branes

    Energy Technology Data Exchange (ETDEWEB)

    Zayas, Leopoldo A. Pando [The Abdus Salam International Centre for Theoretical Physics,Strada Costiera 11, 34014 Trieste (Italy); Michigan Center for Theoretical Physics, Randall Laboratory of Physics,The University of Michigan,450 Church Street, Ann Arbor, MI 48109-1120 (United States); Quiroz, Norma [Departamento de Ciencias Exactas, Tecnología y Metodología,Centro Universitario del Sur, Universidad de Guadalajara,Enrique Arreola Silva 883, C.P. 49000, Cd. Guzmán, Jalisco (Mexico)

    2016-11-04

    We compute the left-right entanglement entropy for Dp-branes in string theory. We employ the CFT approach to string theory Dp-branes, in particular, its presentation as coherent states of the closed string sector. The entanglement entropy is computed as the von Neumann entropy for a density matrix resulting from integration over the left-moving degrees of freedom. We discuss various crucial ambiguities related to sums over spin structures and argue that different choices capture different physics; however, we advance a themodynamic argument that seems to favor a particular choice of replica. We also consider Dp branes on compact dimensions and verify that the effects of T-duality act covariantly on the Dp brane entanglement entropy. We find that generically the left-right entanglement entropy provides a suitable generalization of boundary entropy and of the D-brane tension.

  20. Caffeine improves left hemisphere processing of positive words.

    Directory of Open Access Journals (Sweden)

    Lars Kuchinke

    Full Text Available A positivity advantage is known in emotional word recognition in that positive words are consistently processed faster and with fewer errors compared to emotionally neutral words. A similar advantage is not evident for negative words. Results of divided visual field studies, where stimuli are presented in either the left or right visual field and are initially processed by the contra-lateral brain hemisphere, point to a specificity of the language-dominant left hemisphere. The present study examined this effect by showing that the intake of caffeine further enhanced the recognition performance of positive, but not negative or neutral stimuli compared to a placebo control group. Because this effect was only present in the right visual field/left hemisphere condition, and based on the close link between caffeine intake and dopaminergic transmission, this result points to a dopaminergic explanation of the positivity advantage in emotional word recognition.